bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensible prototype learning for real‐time traffic signal control
Authors: Han Yohee , Lee Hyosun , Kim Youngchan
Published: November 2022

Congestion resolution continues to remain a challenge even though various signal control systems have been developed for traffic‐intersection control. To address this issue, reinforcement learning (RL)‐based approaches that focus on solving the associated data‐driven problems have been proposed. However, only a few methods have been developed and applied to dual‐ring traffic signal control systems. Therefore, we develop an RL‐based traffic signal control model for such a system to efficiently allocate the green interval in different oversaturation states of the conflicting phases. The proposed model employs a deep deterministic policy gradient algorithm to optimize the green value in the continuous action space. Further, we develop an extensible prototype learning framework for application to new intersections without additional transfer learning. The proposed model is validated based on morning peak hours in a simulation environment that reflects the actual intersection phase system and minimum green time constraints. The proposed model achieves an average 20% intersection delay reduction, compared with the fixed control method.
Morphological variation between the two species of the palm genus Gaussia (Arecaceae) from Mesoamerica
Authors: Santos‐Hernández Nancy Gabriela , Pérez‐Farrera Miguel Ángel , Eguiarte Luis E. , Vovides Andrew P. , Gutiérrez‐Ortega José Said
Published: November 2022

Palms (Arecaceae) represent a challenge for studies of morphological variation for several various reasons. For instance, the height of many species makes them difficult to collect, and in some cases, the size of the leaves or the presence of spines make them hard to process and preserve in herbaria. Arecaceae is one of the most diverse families of monocots (ca 2600 species), and many of its species remain poorly studied. The genus Gaussia has five recognized species. Their distributions are restricted to Central America and the Caribbean islands, and for most of them, their taxonomic descriptions are the only information available. Two species – Gaussia maya and G. gomez‐pompae – are exclusively distributed in Mesoamerica. They occur allopatrically and their populations are isolated from each other. The aim of this work was to evaluate the levels of intra‐ and inter‐population morphological variation in both species and determine the possible factors that influence such a variation. We examined the morphological variation of 13 vegetative structures of 155 adult individuals from nine populations of G. maya and G. gomez‐pompae. The differentiation among populations was significant for almost all the variables and was consistent with an isolation‐by‐distance pattern. A linear discriminant analysis, Mahalanobis distances and UPGMA cluster analysis based on Euclidean distances among populations showed that three morphological groups could be distinguished. One group contained only individuals of G. maya, the second only G. gomez‐pompae, while the third group represents a yet unknown taxon. Pairwise differentiation tests clarified the morphological distinction among the three groups. This work highlights the importance of quantifying morphological variation between populations of little‐studied palms.
Linking microenvironment modification to species interactions and demography in an alpine plant community
Authors: Ray Courtenay A. , Kapas Rozalia E. , Opedal Øystein H. , Blonder Benjamin W.
Published: November 2022

Individual plants can modify the microenvironment within their spatial neighborhood. However, the consequences of microenvironment modification for demography and species interactions remain unclear at the community scale. In a study of co‐occurring alpine plants, we 1) determined the extent of species‐specific microclimate modification by comparing temperature and soil moisture between vegetated and non‐vegetated microsites for several focal species. We 2) determined how vital rates (survival, growth, fecundity) of all species varied in response to aboveground and belowground vegetative overlap with inter‐ and intraspecific neighbors as proxies for microenvironment modification. For 1), surface temperatures were buffered (lower maximums and higher minimums) and soil moisture was higher below the canopies of most species compared to non‐vegetated areas. For 2), vegetative overlap predicted most vital rates, although the effect varied depending on whether aboveground or belowground overlap was considered. Vital rate response to microenvironment‐modification proxies (vegetative overlap) was also frequently context dependent with respect to plant size and macroclimate. Microenvironment modification and spatial overlapping of individuals are key drivers of demography and species interactions in this alpine community.
Chronic low back pain comorbidity count and its impact on exacerbating opioid and non‐opioid prescribing behavior
Authors: Moses‐Hampton Malcolm K. , Povieng Boss , Ghorayeb Joe H. , Zhang Yanyu , Wu Hong
Published: November 2022

Research Objectives

The objective of the study was to determine the characteristics of chronic low back pain (CLBP) comorbidity and its impact on opioid and non‐opioid treatments among Chicagoland patients with CLBP.

Design

A retrospective cross‐sectional study comparing differences in comorbidity and treatment patterns among Chicagoland patients with CLBP against a matched control arm without chronic low back pain (NCLBP).

Setting

Academic hospital system outpatient services.

Participants

Using the International Classification of Diseases, 10th Revision codes (ICD 10) 9589 patients were identified with CLBP with a median age of 57 years old and 62.32% female distribution. The NCLBP group comprised 9589 age‐, sex‐, race‐, and region‐matched patients.

Results

An increased prevalence across all 17 studied comorbidities was found in CLBP patients as compared to NCLBP patients. CLBP patients carried an average of 3.5 comorbidities compared with 2.4 comorbidities in NCLBP patients. Rheumatoid arthritis (RA), joint arthritis, and obesity had the strongest relationship with CLBP. Additionally, we found that the most prescribed treatment for CLBP were opioids, which ranked above NSAIDs and physical therapy. 56% of CLBP patients were prescribed opioids as compared to 36% of NCLBP patients (Odds Ratio = 2.28, 95% CI: 2.16–2.42). Tramadol was the agent with the strongest relationship to CLBP. CLBP patients were more likely to use two or more opioids concomitantly. The number of total treatments was positively associated with the number of comorbidities in both CLBP and NCLBP patients (Cochran‐Armitage trend test p < 0.0001).

Conclusions

Chronic low back pain patients showed a higher number of comorbidities than their NCLBP counterparts. Comorbidity count trended positively with higher treatment burden with opioids being the most prescribed treatment, often with poly‐opioid use, over conservative modalities such as NSAIDs and physical therapy.
Can we identify “at‐risk” children and adolescents for poor transplant outcomes in the psychosocial evaluation before solid organ transplantation? The reliability and validity study of Pediatric Transplant Rating Instrument (P‐TRI) in Turkish pediatric renal transplant patients
Authors: Taner Hande Ayraler , Sarı Burcu Akın , Baskın Esra , Karakaya Jale , Gülleroğlu Kaan Savaş , Kazancı Nafia Özlem , Haberal Mehmet
Published: November 2022

Background

This study aims to translate the Pediatric Transplant Rating Instrument (P‐TRI) to conduct a validity and reliability study on Turkish children and define a cutoff value of this scale.

Method

A total of 151 pediatric kidney transplant patients were included in the study. The files of the patients were reviewed by two clinicians, and the scale was filled for inter‐rater reliability. One of the clinicians filled the scale again after one month for intra‐rater reliability. Glomerular filtration rate (GFR) and creatinine values were used for predictive validity. A GFR below <60 ml/min/1.73 m2and creatinine up to 3.0 mg/dl was defined as risk factors.

Results

Correlation of P‐TRI with GFR (r = .252,p = .003) and creatinine (r = −.249,p = .002) was performed, and the internal consistency of the scale items as measured by Cronbach's alpha coefficient was found to be 0.825. When the test was performed again, the intra‐class correlation coefficient was found as .922 for intra‐rater reliability and as .798 for inter‐rater reliability. For both creatinine and GFR, the best cutoff point for the total score was found to be 66.5.

Conclusions

Patients who received P‐TRI above 66.5 could be at risk in the post‐transplant period. Identification of these patients before transplantation and following these young people more closely will aid in the prevention of serious consequences. The reliability and validity scores are satisfactory for use in transplantation clinics for psychosocial evaluation and compliance in Turkish pediatric renal transplantation patients.
Competition for multiproduct firms
Authors: Feng Hong , Ma Jie , Yue Yang
Published: November 2022

We use a first‐price menu auction approach to studying a fiscal competition between two countries of different sizes to attract a foreign monopolist intending to supply two vertically differentiated products in a regional economy composed of the same two countries. Market size and cannibalization exclusively determine the firm's location choice. Though import substitution provides each country with an incentive to bid for FDI, this does not affect the firm's location decisions. As a result, fiscal competition for FDI only involves transfers between the host country/countries of FDI and the firm. We also report novel welfare effects of FDI competition.
Identification of the novel HLA‐C*02:212 allele detected in a potential hematopoietic stem cell donor
Authors: Ananeva Anastasiia , Shcherbakova Anastasia , Kuznetsova Anna , Shragina Olga , Shagimardanova Elena
Published: November 2022

The novel HLA‐C*02:212 allele was characterized using next generation sequencing technology.
Robustness and resilience of supply chains during the COVID‐19 pandemic
Authors: Todo Yasuyuki , Oikawa Keita , Ambashi Masahito , Kimura Fukunari , Urata Shujiro
Published: November 2022

Using a unique firm‐level data set from Asia, this study examines what determined the robustness and resilience of supply chain links, that is, the ability of maintaining links and recovering disrupted links by substitution, respectively, when firms faced economic shocks due to the spread of the coronavirus disease (COVID‐19). We find that a supply chain link was likely to be robust if the link was between a foreign‐owned firm and a firm located in the foreign‐owned firm's home country, implying that homophily on a certain dimension generates strong ties and thus supply chain robustness. We also find that firms with geographic diversity of customers and suppliers tended to increase their transaction volume with one partner while decreasing the volume with others. This evidence shows that firms with diversified customers and suppliers are resilient, mitigating the damage from supply chain disruption through the substitution of partners. Furthermore, the robustness and resilience of supply chains are found to have led to higher performance.
The effect of various breath‐hold techniques on the cardiorespiratory response to facial immersion in humans
Authors: Burley Matthew J. , Blackwell Jamie , Bond Bert , Williams Craig , Stephens Francis B.
Published: November 2022

Repeated maximal breath‐holds have been demonstrated to induce bradycardia, increase haematocrit and haemoglobin and prolong subsequent breath‐hold duration by 20%. Freedivers use non‐maximal breath‐hold techniques (BHTs) to improve breath‐hold duration. The aim of this study was to investigate the cardiorespiratory and haematological responses to various BHTs. Ten healthy men (34.5 ± 1.9 years) attended five randomized experimental trials and performed a 40 min period of quiet rest or one of three BHTs followed by a maximal breath‐hold challenge during facial immersion in water at 30 or 10°C. Cardiovascular and respiratory parameters were measured continuously using finger plethysmography and breath‐by‐breath gas analysis, respectively, and venous blood samples were collected throughout. Facial immersion in cold water caused marked bradycardia (74.1 vs. 50.2 beats/min after 40 s) but did not increase breath‐hold duration compared with warm water control conditions. Facial immersion breath‐hold duration was 30.8–43.3% greater than the control duration when preceded by BHTs that involved repeated breath‐holds of constant duration (P = 0.021), increasing duration (P < 0.001) or increasing frequency (P < 0.001), with no difference observed between BHTs. The increased duration of apnoea across all three BHT protocols was associated with a 6.8% increase in end‐tidal O2 and a 13.1% decrease in end‐tidal CO2 immediately before facial immersion. There were no differences in blood pressure, cardiac output, heart rate, haematocrit or haemoglobin between each BHT and control conditions (P > 0.05). In conclusion, the duration of apnoea can be extended by manipulating blood gases through repeated prior breath‐holds, but changes in cardiac output and red blood cell mass do not appear essential.
Archaeological Research 2014 to 2021: an examination of its intellectual base, collaborative networks and conceptual language using science maps
Authors:   University of Liverpool, Sinclair Anthony
Published: November 2022

A series of six science maps have been created visualising the shape of archaeological research between 2014 and 2021, using metadata from more than 50,000 academic documents. These maps present the intellectual base of the discipline as co-citation networks of sources and of authors, the language of archaeological research as both terms extracted from titles and abstracts and as author keywords, and, lastly, the networks of collaboration created by co-authorship between individuals and institutions. Comparison is made between 2014-2021 and an earlier study examining archaeological research between 2004 and 2013. Archaeology is revealed as a consistently broad and developing subject drawing extensively on methods and approaches from the sciences, social sciences, arts and humanities. It is intrinsically international in practice. Archaeological research is growing at a rate faster than the average for academic research. While there has been progress towards a more diverse community of researchers among those most highly cited, there remain significant issues in the observable diversity between different research areas within the same discipline and sometimes between similar research specialties. Classifications of archaeology by external bodies fail to grasp this diversity of archaeological research. Finally, diversity in terms variants suggests that there is a pressing need for the discipline to take control of its terminology.
Intervención educativa para mejorar el diagnóstico y manejo del dolor en unidades de recién nacidos en Colombia
Authors: Devia Neira Claudia Patricia , Atencia Herrera Cindy Margarita , Lonngi Gabriel , Muñoz Velandia Oscar Mauricio
Published: November 2022

Objetivo: Evaluar el impacto en profesionales y pacientes de desarrollar e implementar una estrategia educativa en tres unidades neonatales en Bogotá (Colombia) para el reconocimiento y manejo del dolor. Metodología: Estudio de antes y después para evaluar el cambio en los conocimientos y aptitudes de los profesionales mediante encuestas consecutivas, y el cambio en el registro y manejo del dolor, evaluando la información consignada en las historias clínicas en ambos periodos. Resultados: Se encuestaron 70 profesionales de la salud antes y después de la implementación de la estrategia. Se encontró un cambio en sus aptitudes con respecto al uso de escalas de dolor (p = 0,03), el conocimiento de medidas no farmacológicas (p = 0,009) y el uso de medidas farmacológicas (p = 0,009). Adicionalmente, se analizaron las historias clínicas de 75 neonatos antes y 75 después de la implementación de la estrategia, lo que evidenció un incremento en el uso de escalas para evaluar el dolor asociado con procedimientos diagnósticos (1,3% vs. 20%; p < 0,01), y terapéuticos (0% vs. 56,7%; p < 0,01) y en la proporción de pacientes que recibieron manejo farmacológico (17,3% vs. 53,7%; p < 0,01). Conclusión: Los resultados sugieren que la implementación de una estrategia educativa mejora los conocimientos y aptitudes de los profesionales, así como el compromiso con las medidas dirigidas a diagnosticar y tratar adecuadamente el dolor en las unidades neonatales.
Broncoaspiración en el anciano: reflejo de la disfagia como síndrome geriátrico.
Authors: Guarín Navas Erika Geraldine , García Morales Olga Milena
Published: November 2022

Mujer de 86 años con enfermedad de Alzheimer, ingresa al hospital por síntomas respiratorios; estudio de imagen con lesión redondeada obstructiva a nivel del bronquio intermediario atribuido a broncoaspiración de cuerpo extraño (arveja). Se exhibe la asociación entre un síndrome geriátrico y una complicación respiratoria prevenible con rehabilitación y educación.
Perspectivas sobre dignidad y autonomía. Relatos de tres personas cercanas al final de la vida
Authors: Gempeler Rueda Fritz Eduardo , Montoya Rubiano María Alejandra
Published: November 2022

Este artículo de reflexión presenta tres relatos de individuos que se ubican en momentos biográficos diferentes, pero que comparten un mismo deseo: morir con dignidad, y así liberarse y descansar de una vida en la cual se desdibuja la autonomía y el control del propio ser. Con la intención de que el lector se aproxime de la forma más fiel a las vivencias, sentimientos y experiencias de los que relatan las historias, primero se comparten las tres historias y, acto seguido, se analizan brevemente en el apartado de consideraciones finales, donde se enuncia la importancia de comprender las perspectivas frente a dignidad, autonomía y control, resaltando cómo pueden variar dependiendo de cómo las personas se vean a sí mismas en diferentes momentos biográficos, de cómo sean vistas por los demás e, incluso, de cómo la naturaleza de la enfermedad afecta sus vidas y su identidad, en relación con la capacidad de controlar las funciones físicas en su entorno inmediato.
Do robots reflect their creators?
Authors: Murphy Robin R.
Published: November 2022

IG-11 in “The Mandalorian” poses the question of whether roboticists are the Bounty Hunters’ Guild or Kuiil.
Gene editing of human iPSCs rescues thrombophilia in hereditary antithrombin deficiency in mice
Authors: Tang Liang V. , Tao Yanyi , Feng Yuanzheng , Ma Jiewen , Lin Wenyi , Zhang Yuyang , Zhang Yi , Wu Tingting , Cai Yaohua , Lu Hui , Wei Jun , Corral Javier , Hu Yu
Published: November 2022

Hereditary antithrombin deficiency is caused by
SERPINC1
gene mutations and predisposes to recurrent venous thromboembolism that can be life-threatening. Therefore, lifelong anticoagulation is required, which has side effects and may not be effective. In this study, peripheral blood mononuclear cells from a patient with severe antithrombin deficiency were reprogrammed into induced pluripotent stem cells (iPSCs). The mutation was corrected using CRISPR-Cas9 and Cre/LoxP genome editing. iPSCs were differentiated into hepatocytes, which were injected into the spleen of antithrombin knockout mice to restore the activity of antithrombin and reduce the thrombophilic state. Human iPSC-differentiated hepatocytes colonized mice and secreted antithrombin stably, normalizing antithrombin in plasma (activity: from 46.8 ± 5.7% to 88.6 ± 7.6%,
P
 < 0.0001; antigen: from 146.9 ± 19.5 nanograms per milliliter to 390.7 ± 16.1 nanograms per milliliter,
P
 < 0.0001). In venous thrombosis model, the rate of thrombosis in mice treated with edited hepatocytes, parental hepatocytes, and wild-type mice were 60, 90, and 70%, respectively. The thrombus weight was much lighter in mice treated with edited hepatocytes compared with parental hepatocytes (7.25 ± 2.00 milligrams versus 15.32 ± 2.87 milligrams,
P
 = 0.0025) and showed no notable difference compared with that in wild-type mice (10.41 ± 2.91 milligrams). The activity and concentration of antithrombin remained high for 3 weeks after injection. The liver and kidney function markers showed no obvious abnormality during the observation period. This study provides a proof of principle for correction of mutations in patient-derived iPSCs and potential therapeutic applications for hereditary thrombophilia.
Functional Analysis of EspM, an ESX-1-Associated Transcription Factor in Mycobacterium marinum
Authors: Sanchez Kevin G. , Prest Rebecca J. , Nicholson Kathleen R. , Korotkov Konstantin V. , Champion Patricia A.
Published: November 2022

Pathogenic mycobacteria are bacteria that pose a large burden to human health globally. The ESX-1 secretion system is required for pathogenic mycobacteria to survive within and interact with the host.
Comparative Analysis of Commercially Available Typhoid Point-of-Care Tests: Results of a Prospective and Hybrid Retrospective Multicenter Diagnostic Accuracy Study in Kenya and Pakistan
Authors: Sapkota Jyotshna , Hasan Rumina , Onsare Robert , Arafah Sonia , Kariuki Sam , Shakoor Sadia , Qamar Farah , Mundalo Sheillah , Njeru Frida , Too Rael , Ndegwa Elizabeth , Andrews Jason R. , Dittrich Sabine
Published: November 2022

Blood and bone marrow cultures are considered the gold standard for the diagnosis of typhoid, but these methods require infrastructure and skilled staff that are not always available in low- and middle-income countries where typhoid is endemic. The objective of the study is to evaluate the sensitivity and specificity of nine commercially available
Salmonella Typhi
rapid diagnostic tests (RDTs) using blood culture as a reference standard in a multicenter study.
Detection of Airborne Influenza A and SARS-CoV-2 Virus Shedding following Ocular Inoculation of Ferrets
Authors: Belser Jessica A. , Sun Xiangjie , Kieran Troy J. , Brock Nicole , Pulit-Penaloza Joanna A. , Pappas Claudia , Basu Thakur Poulami , Jones Joyce , Wentworth David E. , Zhou Bin , Tumpey Terrence M. , Maines Taronna R.
Published: November 2022

Documented human infection with influenza viruses and SARS-CoV-2 has been reported among individuals wearing respiratory protection in the absence of eye protection, highlighting the capacity of these respiratory tract-tropic viruses to exploit nonrespiratory routes of exposure to initiate productive infection. However, comprehensive evaluations of how ocular exposure may modulate virus pathogenicity and transmissibility in mammals relative to respiratory exposure are limited and have not investigated multiple virus families side by side.
Redundant and Specific Roles of A-Type Lamins and Lamin B Receptor in Herpes Simplex Virus 1 Infection
Authors: Takeshima Kosuke , Maruzuru Yuhei , Koyanagi Naoto , Kato Akihisa , Kawaguchi Yasushi
Published: November 2022

This study demonstrated that lamin A/C and LBR had redundant functions associated with HSV-1 gene expression and DNA replication by regulating the dynamics of the nuclear architecture during HSV-1 infection. This is the first report to demonstrate the redundant roles of lamin A/C and LBR as well as the involvement of LBR in the regulation of these viral and cellular features in HSV-1-infected cells.
Supplemental Material: Constraining the crustal composition of the continental U.S. using seismic observables
Authors: Sui Siyuan , Shen Weisen , al. et
Published: November 2022

Supplemental text, Figures S1–S4, and Tables S1–S3.
Perivascular epithelioid cell tumour and investigation of genetic susceptibility
Authors: Sadeghi Negin , Smyth Sarah , Damato Stephen , Soleymani majd Hooman
Published: November 2022

A patient in her 60s was referred to be investigated for an incidental large uterus with a history of renal cell carcinoma and melanoma. Uterine biopsy revealed features of perivascular epithelioid cell tumours (PEComas) and she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Final histology confirmed PEComa with malignant features. Genomic studies did not reveal any deleterious germline variants; however, in view of her history, she is now under a 6-month follow-up with gynaecology-oncology. PEComas are rare tumours associated with tuberous sclerosis and melanoma, sharing genetic abnormalities. Gynaecological PEComas usually present with no or non-specific symptoms. Preoperative investigations are often misleading. Final histology and immunohistochemistry have overlapping features with smooth muscle tumours. Although rare, PEComas need to be treated aggressively to minimise the potential risk of spread. There is currently little evidence about further adjuvant treatment and no clear follow-up protocol. However, the literature suggests that the prognosis is generally good.
Spontaneous resolution of superficial temporal artery pseudoaneurysm
Authors: Raskin Jonathan , Pak Kaitlynne , Lee Matthew Kun
Published: November 2022

Superficial temporal artery (STA) pseudoaneurysms are rare vascular lesions that typically present after traumatic head injury. Currently, surgery is the recommended treatment as spontaneous resolution has not been previously reported. Our study aims to present a review of the literature on STA pseudoaneurysms and report a case of spontaneous resolution of a traumatic STA pseudoaneurysm without the need for direct intervention.
Hypercalcaemia secondary to acute rhinovirus infection
Authors: Guo Hui Jun , Karan Abhinav , Kiamos Amy , Jaikaransingh Vishal
Published: November 2022

Hypercalcaemia-induced rhinovirus has only been reported in a single study in children. Here, we report a case of hypercalcaemia in an adult who tested positive for rhinovirus. This patient underwent an extensive evaluation of hypercalcaemia, and it was found to be mediated by an increase in 1,25 hydroxy-vitamin D that could not be attributed to a cause. Their hypercalcaemia responded to standard treatment with intravascular expansion, bisphosphonates and calcitonin. Serum 1,25 OH vitamin D levels returned to normal with recovery from rhinovirus infection.
Effect of sport on health in people aged 60 years and older: a systematic review with meta-analysis
Authors: S Oliveira Juliana , Gilbert Stephen , Pinheiro Marina B , Tiedemann Anne , Macedo Liane Brito , Maia Laísa , Kwok Wing , Hassett Leanne , Sherrington Catherine
Published: November 2022

Objectives

To summarise evidence of benefits of sport for health among people aged 60+.

Design

Systematic review with meta-analysis of randomised controlled trials (RCTs).

Data sources

Medline, CINAHL, SPORTDiscus, the Physiotherapy Evidence Database from inception to April 2021.

Study selection

RCTs investigating the effect of sport on health-related outcomes in people aged 60+ compared with non-active control.

Data synthesis and analysis

Pooled effect sizes were calculated using random-effect models. Standardised mean differences (SMD), and mean difference (MD) were calculated. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the certainty of the evidence for analyses with ≥3 studies.

Results

Nine trials (628 participants) reported in 15 articles were included. Participation in sport improved cardiorespiratory fitness (n=5 trials; SMD=0.43, 95% CI 0.17 to 0.70; low certainty evidence), physical function (n=4; SMD=0.62, 95% CI 0.05 to 1.18; very low certainty evidence), and mental health (n=2; SMD=0.28, 95% CI 0.06 to 0.51) and reduced fat mass (n=6; MD=−0.99 kg, 95% CI −1.75kg to −0.23 kg; low certainty evidence) among older people. We found no significant effects of sport on overall physical activity participation, strength, balance, lean mass and bone mineral density (BMD). One study investigating quality of life reported a positive, but non-significant effect of sport.

Conclusion

Sport may have a positive impact on health outcomes in people aged 60+. There was uncertainty on the effect of sport on strength, balance, lean mass and BMD. Further research is needed to investigate the optimal type and dose of sport to maximise the long-term benefits among older people.
Preventing chronic disease in overweight and obese patients with low health literacy using eHealth and teamwork in primary healthcare (HeLP-GP): a cluster randomised controlled trial
Authors: Parker Sharon M , Barr Margo , Stocks Nigel , Denney-Wilson Elizabeth , Zwar Nicholas , Karnon Jon , Kabir Alamgir , Nutbeam Don , Roseleur Jackie , Liaw Siaw-Teng , McNamara Carmel , Frank Oliver , Tran An , Osborne Richard , Lau Annie Y S , Harris Mark
Published: November 2022

Objectives

To evaluate a multifaceted intervention on diet, physical activity and health literacy of overweight and obese patients attending primary care.

Design

A pragmatic two-arm cluster randomised controlled trial.

Setting

Urban general practices in lower socioeconomic areas in Sydney and Adelaide.

Participants

We aimed to recruit 800 patients in each arm. Baseline assessment was completed by 215 patients (120 intervention and 95 control).

Intervention

A practice nurse-led preventive health check, a mobile application and telephone coaching.

Primary and secondary outcome measures

Primary outcomes were measured at baseline, 6 and 12 months, and included patient health and eHealth literacy, weight, waist circumference and blood pressure. Secondary outcomes included changes in diet and physical activity, preventive advice and referral, blood lipids, quality of life and costs. Univariate and multivariate analyses of difference-in-differences (DiD) estimates for each outcome were conducted.

Results

At 6 months, the intervention group, compared with the control group, demonstrated a greater increase in Health Literacy Questionnaire domain 8 score (ability to find good health information; mean DiD 0.22; 95% CI 0.01 to 0.44). There were similar differences for domain 9 score (understanding health information well enough to know what to do) among patients below the median at baseline. Differences were reduced and non-statistically significant at 12 months. There was a small improvement in diet scores at 6 months (DiD 0.98 (0.50 to 1.47); p=0.026) but not at 12 months. There were no differences in eHealth literacy, physical activity scores, body mass index, weight, waist circumference or blood pressure.

Conclusions

Targeted recruitment and engagement were challenging in this population. While the intervention was associated with some improvements in health literacy and diet, substantial differences in other outcomes were not observed. More intensive interventions and using codesign strategies to engage the practices earlier may produce a different result. Codesign may also be valuable when targeting lower socioeconomic populations.

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN 12617001508369) (http://www.ANZCTR.org.au/ACTRN12617001508369.aspx).

Trial protocol

The protocol for this trial has been published (open access;https://bmjopen.bmj.com/content/8/6/e023239).
Trends in the prevalence of metabolically healthy and unhealthy obesity in the US adult population: analysis of eight NHANES cross-sectional survey cycles, 1999–2014
Authors: Wen Yue , Liu Tingting , Li Shengxu , Gong Renrong , Li Changwei
Published: November 2022

Objective

To exam the time trend of the prevalence of metabolically healthy obesity (MHO) in the US adult population.

Design

Eight cross-sectional survey cycles.

Setting

National Health and Nutrition Examination Survey (NHANES), 1999–2014.

Participants

16 459 NHANES participants aged 20 years and older.

Primary outcome measure

MHO was defined as central obesity (waist circumference ≥102 cm for men and ≥88 cm for women) without any of the following conditions: elevated levels of blood pressure (≥130/85 mm Hg), glucose (≥100 mg/dL) and triglycerides (≥150 mm/dL); reduced levels of high-density lipoprotein cholesterol (<40 mg/dL for men and <50 mg/dL for women) or any medication use for high cholesterol, hypertension or diabetes.

Results

The prevalence of central obesity significantly increased from 45.2% in 1999–2000 to 56.7% in 2013–2014 (p=0.003). Over the same period, MHO prevalence among those with central obesity only slightly and non-significantly increased from 11.0% to 15.7% (p=0.38). However, MHO prevalence among women increased significantly (p=0.04) from 7.1% to 13.7%. Female gender, a younger age, being Hispanic and non-Hispanic black and high education (some college or above) were significantly (p<0.05) associated with higher prevalence of MHO.

Conclusions

While the prevalence of central obesity in the US population has increased since 1999, the prevalence of MHO among those who are centrally obese remained fairly stable.
Prevalence of malnutrition among old people in Africa: systematic review and meta-analysis
Authors: Seid Ahmed Muhye , Fentahun Netsanet
Published: November 2022

Objective

To summarise available evidence and estimate the pooled prevalence of malnutrition among old people in Africa.

Design

Systematic review and meta-analysis.

Setting

Any healthcare or community research reporting the prevalence or incidence of malnutrition in Africa from January 2000 to October 2021.

Participants

Old people, aged above 60 years.

Outcome measures

Malnutrition, either undernutrition or overnutrition.

Results

A total of 1442 studies were retrieved based on the search strategy, where only 36 studies (n=15 266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2% to 77.3% across the continent. Overall, the pooled prevalence rates of undernutrition and overnutrition were 18% (95% CI: 15% to 22%; I2=98.1; p<0.001) and 33% (95% CI: 22% to 44%; p<0. 001), respectively.

Conclusion

The prevalence of malnutrition in old African people is high and differs by setting, assessment tool and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable and simple screening tool should be thought of.
Experiences of medical and dental students of Pakistan during COVID-19 pandemic lockdown: a qualitative study
Authors: Iftikhar Sundus , Saleem Sarosh , Aziz Iqra , Sana Momal
Published: November 2022

Objective

The COVID-19 pandemic resulted in medical institutes being shut down. Face-to-face activities were shifted to online medium. The unpredictability of the situation impacted medical faculty and students alike, creating panic and anxiety. Since these students are to take hold of the healthcare system of the country soon, it is important to learn their perspective on how COVID impacted them. Therefore, this study aimed to explore the lived experiences of Pakistani medical students in-depth by a qualitative observation of their personal and educational experiences.

Design

A phenomenological qualitative study interviewing medical students of Pakistan was conducted.

Participants/Methodology

This study was designed to interview medical and dental students from various cities in Pakistan using a semistructured, open-ended questionnaire. A total of 34 interviews were recorded and transcripts were prepared. All authors (SI, SS, IA and MS) were involved in the thematic analysis of the data, whereby transcripts were read thoroughly, and codes were developed. Similar codes were then combined to generate themes.

Results

Three major themes emerged after the analysis of results. The students’ ‘diverse experiences’ of panic and anxiety or excitement were high initially but gradually reduced as time progressed. The ‘unprecedented academic experiences’ of students included teaching/learning, communication and technical challenges that they faced during online classes. Despite facing a lot of challenges, the students still saw ‘light at the end of the tunnel’ and looked forward to going back to their college.

Conclusion

The effects of COVID on the physical, psychological, social and academic life of medical students were enormous. It is highly recommended that institutes and faculty provide support for personal and professional development of students in these unprecedented times in the form of counselling, provision of technical facilities or leniency in fee process. Peer support is also considered crucial in reducing anxiety among students.
Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study
Authors: Huang Jiaqi , Ma Yue , Lv Qiang , Liu Yaqiong , Zhang Tao , Yin Fei , Shui Tiejun
Published: November 2022

Objectives

Hand, foot, and mouth disease (HFMD) is a viral infectious disease that poses a substantial threat in the Asia-Pacific region. It is widely reported that meteorological factors are associated with HFMD. However, the relationships between air pollutants and HFMD are still controversial. In addition, the interactive effects between meteorological factors and air pollutants on HFMD remain unknown. To fill this research gap, we conducted a time-series study.

Design

A time-series study.

Setting and participants

Daily cases of HFMD as well as meteorological and air pollution data were collected in Chengdu from 2011 to 2017. A total of 184 610 HFMD cases under the age of 15 were included in our study.

Outcome measures

Distributed lag nonlinear models were used to investigate the relationships between HFMD and environmental factors, including mean temperature, relative humidity, SO2, NO2, and PM10. Then, the relative excess risk due to interaction (RERI) and the proportion attributable to interaction were calculated to quantitatively evaluate the interactions between meteorological factors and air pollutants on HFMD. Bivariate response surface models were used to visually display the interactive effects.

Results

The cumulative exposure–response curves of SO2and NO2were inverted ‘V’-shaped and ‘M’-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10on HFMD, with individualRERIs of 0.334 (95% CI 0.119 to 0.548), 0.428 (95% CI 0.214 to 0.642) and 0.501 (95% CI 0.262 to 0.741), respectively, indicating that the effects of SO2and PM10on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions.

Conclusions

There were interactive effects between meteorological factors and air pollutants on HFMD. Our findings could provide guidance for targeted and timely preventive and control measures for HFMD.
Isoformic PD-1-mediated immunosuppression underlies resistance to PD-1 blockade in hepatocellular carcinoma patients
Authors: Tan Zhiwu , Chiu Mei Sum , Yang Xinxiang , Yue Ming , Cheung Tan To , Zhou Dongyan , Wang Yuewen , Chan Anthony Wing-Hung , Yan Chi Wing , Kwan Ka Yi , Wong Yik Chun , Li Xin , Zhou Jingying , To Ka Fai , Zhu Jiye , Lo Chung Mau , Cheng Alfred Sze-Lok , Chan Stephen Lam , Liu Li , Song You-Qiang , Man Kwan , Chen Zhiwei
Published: November 2022

Objective

Immune checkpoint blockade (ICB) has improved cancer treatment, yet why most hepatocellular carcinoma (HCC) patients are resistant to PD-1 ICB remains elusive. Here, we elucidated the role of a programmed cell death protein 1 (PD-1) isoform, Δ42PD-1, in HCC progression and resistance to nivolumab ICB.

Design

We investigated 74 HCC patients in three cohorts, including 41 untreated, 28 treated with nivolumab and 5 treated with pembrolizumab. Peripheral blood mononuclear cells from blood samples and tumour infiltrating lymphocytes from tumour tissues were isolated for immunophenotyping. The functional significance of Δ42PD-1 was explored by single-cell RNA sequencing analysis and validated by functional and mechanistic studies. The immunotherapeutic efficacy of Δ42PD-1 monoclonal antibody was determined in HCC humanised mouse models.

Results

We found distinct T cell subsets, which did not express PD-1 but expressed its isoform Δ42PD-1, accounting for up to 71% of cytotoxic T lymphocytes in untreated HCC patients. Δ42PD-1+T cells were tumour-infiltrating and correlated positively with HCC severity. Moreover, they were more exhausted than PD-1+T cells by single T cell and functional analysis. HCC patients treated with anti-PD-1 ICB showed effective PD-1 blockade but increased frequencies of Δ42PD-1+T cells over time especially in patients with progressive disease. Tumour-infiltrated Δ42PD-1+T cells likely sustained HCC through toll-like receptors-4-signalling for tumourigenesis. Anti-Δ42PD-1 antibody, but not nivolumab, inhibited tumour growth in three murine HCC models.

Conclusion

Our findings not only revealed a mechanism underlying resistance to PD-1 ICB but also identified anti-Δ42PD-1 antibody for HCC immunotherapy.
Cryotherapy for oral mucositis in cancer: review of systematic reviews and meta-analysis
Authors: Amiri Khosroshahi Reza , Talebi Sepide , Travica Nikolaj , Mohammadi Hamed
Published: November 2022

Background

One of the most common side effects of cancer treatment is oral mucositis. Although studies have shown that oral cryotherapy has a favourable effect on oral mucositis, the reliability of the results is questionable.

Objective

The goal of this umbrella review was to provide insight into the effects of oral cryotherapy against oral mucositis in patients with cancer, as well as to assess the certainty of this evidence.

Method

Studies were searched for through PubMed, Scopus and Web of Science, with no restrictions until August 2021. The risk ratio (RR) and 95% CI for each meta-analysis were recalculated using a random-effects model, and the certainty of the evidence was judged using Grading of Recommendations Assessment, Development and Evaluation.

Results

Ten meta-analyses including 25 original RCTs that fit our inclusion criteria were included. The use of oral cryotherapy markedly reduced the occurrence of overall (RR 0.72, 95% CI 0.64 to 0.83, n=20 trials), moderate to severe (RR 0.60, 95% CI 0.45 to 0.80, n=16 trials) and severe oral mucositis (RR 0.48, 95% CI 0.34 to 0.67, n=16 trials), as well as average severity score of oral mucositis (standardised mean difference=−0.94, 95% CI −1.28 to −0.59, n=4 trials) in comparison to a control group; however, the certainty of evidence for all outcomes was rated very low.

Conclusion

In patients with cancer, oral cryotherapy appears to greatly lower the severity and occurrence of oral mucositis, but, with very low certainty of evidence.
Precipitation Irregularity and Solar Radiation Play a Role in Determining Short-Season Soybean Yield
Authors: Cober Elroy R. , Morrison Malcolm John
Published: November 2022

Climate change, resulting from increased atmospheric CO2, will affect temperature (T), and precipitation (ppt) amount and regularity. Changes in solar radiation (SR) have been observed in the recent past. Precipitation irregularity (Pir) is a measure of rainfall distribution during a growing season (calculated as the standard error of the slope from regression of cumulative ppt on day of the growing season). We investigated whether Pir and SR contributed to soybean yield. Fourteen short-season cultivars, released from 1930 to 1992, were grown from 1993 to 2019 at Ottawa, Canada. Stepwise multiple linear regression was used to investigate the contribution to seed yield of Pir and SR, and also previously modeled parameters genetic improvement, annual [CO2], and cumulative ppt and average Tmin during the vegetative, flowering and podding, and seed filling growth stages. While SR and Pir did not trend over the years of our study and Pir was not related to growing season ppt, both were significant factors in our model, accounting for 2.5 and 6.5% respectively of the seed yield variability. Ppt during all three stages were similar as they each accounted for 4 to 7% of seed yield variability. We observed contrasting temperature effects where higher Tmin during vegetative and seed filiing reduced yield, while during flowering and podding increased yield. Estimated yield improvement due to elevated [CO2] was 7.8 kg ha-1 ppm-1 and to genetic improvement over time was 7.1 kg ha-1 year-1. Over the extremes of our study we found that Pir could cause up to a 30% yield reduction.
Analytic solutions of Brans–Dicke cosmology: Early inflation and late time accelerated expansion
Authors: Ildes Medine , Arik Metin
Published: November 2022

In this paper, we investigate the most general exact solutions of Brans–Dicke cosmology by choosing the scale factor “a” as the new independent variable. It is shown that a set of three field equations can be reduced to a constraint equation and a first-order linear differential equation. Thus this new set of equations is solvable when one supplies one of the following pairs of functions: ([Formula: see text], [Formula: see text]), ([Formula: see text], [Formula: see text]) or ([Formula: see text], [Formula: see text]). A universe with a single component energy-matter density, the early universe with constant energy density and radiation and the present universe with constant energy density and matter are studied. It is seen that in all cases initial values of the universe cause [Formula: see text] potential and a constant term in the Hubble function which causes an exponential expansion of the universe. The relation between cosmological constant and initial values of the universe is found.
Bridge Static Influence Line Identification Based on Structural Dynamic Responses Under High-Speed Trains
Authors: Wei Yun-Tao , Yang Dong-Hui , Yi Ting-Hua , Li Hong-Nan , Zhou Peng , Xue Xing-Wei
Published: November 2022

Bridge influence lines can reflect the performance status of bridge structures and are an important tool to evaluate high-speed railway bridges. Because a high-speed train can cause large dynamic response on a bridge, it is difficult to identify the static influence line of the bridge. To extract the static bridge influence lines for bridge evaluation, this paper proposes a low-pass filter design method for static influence line identification. By maximizing the difference in bridge static and dynamic energy, the relationship between the frequency domain characteristics of the bridge dynamic response and the filter parameters is established. Based on this relationship, reasonable values of the low-pass filter parameters can be determined. After filtering the dynamic response, the quasi-static response can be effectively obtained, and the bridge static influence line can be identified through the least square regularization method. Finally, a numerical example of the vehicle–bridge interaction model is used to verify the effectiveness of the proposed method. The results show that the low-pass filter designed through the proposed principle can accurately remove the dynamic effects, and its stability and robustness are good. The research results provide a reliable method for the static influence line identification of high-speed railway bridges.
On evolution of compact stars from string fluid in Rastall gravity
Authors: Sheikh Umber , Aziz Yousra , Bhatti M. Z. , Pincak Richard
Published: November 2022

The aim of this work is to discuss the evolution of compact stars from the view point of a string fluid in Rastall theory using Krori–Barua (KB) metric as interior geometry. The exterior spacetime is considered as Schwarzschild metric while matching of interior and exterior spacetimes lead to coefficients of KB ansatz. The field equations and dynamical variables of the string fluid are explored. We found the values of Rastall parameter [Formula: see text] for which the dynamical variables satisfy the energy conditions which shows the existence of physical matter. The model is applied to specific physical features including energy conditions, anisotropy, stability, Tolman–Oppenheimer–Volkoff equation, mass function, compactness and redshift of compact stars, in particular, SAX J1808.4-3658, Vela X-12 and Hercules X-1. It is found that the presented model fulfills all the physical requirements and thus, is realistic. We conclude that the string fluid is responsible for the evolution of compact stars in the cosmos.