bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring for valproate and phenytoin toxicity in hypoalbuminaemia: A retrospective cohort study
Authors: Madan Arushi , Donovan Peter J. , Risetto Tracy , Trenerry Helen , Lander Cecilie M.
Published: April 2021

Aims

Equations to calculate albumin‐adjusted total concentrations have been validated to correlate with measured free concentrations for both phenytoin and valproate, but there is a lack of data to assess correlation with clinical outcomes. We aimed to assess the association of hypoalbuminaemia and albumin‐adjusted total concentrations with concentration‐dependent toxicity for phenytoin and valproate and review the impact on management decisions following concentration monitoring in hypoalbuminaemia.

Methods

Patients undergoing concentration monitoring for phenytoin or valproate between January and December 2018 were included. Patients were identified using a centralised laboratory database with data extracted from medical records.

Results

Total phenytoin concentrations were measured for 144 patients, with hypoalbuminaemia (≤30 g L−1) recorded in 59 (41%) patients. Albumin‐adjusted phenytoin concentration >20 mg L−1 was associated with increased neurological adverse effects (77% vs. 43%, P < .001). On logistic regression, higher albumin‐adjusted phenytoin concentration was an independent risk factor for neurotoxicity (OR 1.06, 95% CI 1.01–1.12, P = .011). Total valproate concentrations were measured for 383 patients, with hypoalbuminaemia (≤30 g L−1) noted in 53 (14%) patients. For the valproate cohort, hypoalbuminaemia (42% vs. 28%, P = .039) and albumin‐adjusted valproate concentration >100 mg L−1 (49% vs. 23%, P < .001) were both associated with increased neurotoxicity. On multiple logistic‐regression, valproate daily dose (aOR = 1.01, 95% CI 1.00–1.02, P = .006) and albumin‐adjusted valproate concentration (aOR 1.01, 95% CI 1.00–1.02, P = .033) were independent risk factors for neurotoxicity after accounting for confounders.

Conclusion

While measuring free drug concentrations in hypoalbuminaemia would be ideal, the adjustment equations can help identify vulnerable patients needing further assessment of potential concentration‐dependent toxicity.
Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials
Authors: Yan Zhipeng , Yang Ming , Lai Ching‐Lung
Published: April 2021

Objective

To evaluate the efficacy of lenvatinib in the treatment of radioiodine‐refractory thyroid carcinoma.

Background

Thyroid carcinoma is one of the top ten carcinomas worldwide. Clinically, thyroid cancers are managed with resections and adjuvant therapy with radioiodine. However, radioiodine is not effective for radioiodine‐refractory (RR) thyroid carcinoma in some patients.

Lenvatinib is a multi‐kinase inhibitor for the treatment of RR thyroid carcinoma. Several clinical trials showed its efficacy in prolonging progression‐free survival (PFS) and overall survival (OS).

Design, patients and measurements

A systematic search was done on databases (PubMed, Embase, MEDLINE, Cochrane) on 8 June 2020. Search keywords were lenvatinib, thyroid carcinoma and randomized controlled trials. Clinical trials fulfilling the SELECT protocol were selected to evaluate the efficacy of lenvatinib in terms of prolongation of PFS, OS and objective response rate (ORR). The risk ratio and distribution of grade 3 or above adverse events were documented.

Results

Of the 3997 patients of mean age 62.5 years in fifteen selected studies, lenvatinib is associated with prolonged PFS (hazard ratio 0.24, 95% CI, 0.19‐0.31, p < .001) and OS (hazard ratio 0.65, 95% CI, 0.52‐0.81, p < .001). Compared with placebo, the risk ratio of ORR and incidence of grade 3 or above adverse events are 35.41 (95% CI, 19.42‐64.58, p < .001) and 8.25 (95% CI, 6.50‐10.46, p < .001), respectively. Subgroup analysis shows that lenvatinib is effective for all patients with RR thyroid carcinoma, regardless of age, histological subtypes, radiological subtypes and mutation status.

Conclusion

Lenvatinib is effective in the treatment of RR thyroid carcinoma. Close monitoring of serious adverse events is recommended.
Northernization for Breaking‐through International Isolation: Taiwan’s Trilateral Aid Cooperation in the Middle East Refugee Crisis and beyond
Authors: Wu Yi‐Chen , Chien Shiuh‐Shen
Published: April 2021

Motivation

Taiwan, a de facto independent state, previously preferred bilateral aid focused on its diplomatic partners in response to China’s efforts to isolate the country internationally. More recently, Taiwan has been active in trilateral aid co‐operation with many international agencies supporting work in camps for refugees and internally displaced persons (IDPs) and host communities in the Middle East and beyond.

Purpose

The article analyses how and under what circumstances Taiwan’s South–North–South (SNS) co‐operation functions, which differs from the conventional trilateral North–South–South (NSS) model. We argue that Taiwan’s trilateral aid is a desire for “Northernization” in the global aid hierarchy in order to break through its political isolation.

Methods and approach

The research included the collection of government documents and media reports as well as field research and off‐the‐record interviews in Jordan and Taiwan. We visited Jordan for a month each in 2018 and 2019.

Findings

Taiwan’s top three partners in trilateral aid co‐operation are the United States (US) and related organizations, the European Bank of Reconstruction and Development (EBRD), and the Holy See. Focusing on such co‐operation in the Middle East we analyse the consequences and impacts in three dimensions: following Northern norms in aid practices; diversifying aid resources to involve business and non‐governmental sectors; and scaling up Taiwan–US regional and global relations. The article casts new light on the complex development geography beyond the conventional North–South axes.

Policy implications

The case of Taiwan illustrates the need to question the conventional division between the Global North and Global South. It is also time for the former to include Taiwan as a reliable partner and to use its example to encourage other politically isolated countries and regions to play more important roles as responsible global stakeholders.
The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery
Authors: Liu Shin‐Huei , Lin Yenn‐Jiang , Lee Po‐Tseng , Vicera Jennifer Jeanne , Chang Shih‐Lin , Lo Li‐Wei , Hu Yu‐Feng , Chung Fa‐Po , Tuan Ta‐Chuan , Chao Tze‐Fan , Liao Jo‐Nan , Chang Ting‐Yung , Lin Chin‐Yu , Wu Cheng‐I , Liu Chih‐Min , Cheng Wen‐Han , Chen Shih‐Ann
Published: April 2021

Introduction

Identifying the critical isthmus (CI) in scar‐related macroreentrant atrial tachycardia (AT) is challenging, especially for patients with cardiac surgery. We aimed to investigate the electrophysiological characteristics of scar‐related macroreentrant ATs in patients with and without cardiac surgery.

Methods

A prospective study of 31 patients (mean age 59.4 ± 9.81 years old) with scar‐related macroreentrant ATs were enrolled for investigation of substrate properties. Patients were categorized into the nonsurgery (n = 18) and surgery group (n = 13). The CIs were defined by concealed entrainment, conduction velocity less than 0.3 m/s, and the presence of local fractionated electrograms.

Results

Among the 31 patients, a total of 65 reentrant circuits and 76 CIs were identified on the coherent map. The scar in the surgical group is larger than the nonsurgical group (18.81 ± 9.22 vs. 10.23 ± 5.34%, p = .016). The CIs in surgical group have longer CI length (15.27 ± 4.89 vs. 11.20 ± 2.96 mm, p = .004), slower conduction velocity (0.46 ± 0.19 vs. 0.69 ± 0.14 m/s, p < .001), and longer total activation time (45.34 ± 9.04 vs. 38.24 ± 8.41%, p = .016) than those in the nonsurgical group. After ablation, 93.54% of patients remained in sinus rhythm during a follow‐up of 182 ± 19 days.

Conclusion

The characteristics of the isthmus in macroreentrant AT are diverse, especially for surgical scar‐related AT. The identification of CIs can facilitate the successful ablation of scar‐related ATs.
Extracellular vesicle‐derived microRNA‐18b ameliorates preeclampsia by enhancing trophoblast proliferation and migration via Notch2/TIM3/mTORC1 axis
Authors: Yang Zhongmei , Shan Nan , Deng Qinyin , Wang Yujue , Hou Yan , Mei Jie , Wu Zhao
Published: April 2021

Preeclampsia (PE), a common disorder of pregnancy, is characterized by insufficient trophoblast migration and inadequate vascular remodelling, such that promotion of trophoblast proliferation might ameliorate PE. In the current study, we sought to study the underlying mechanism of extracellular vesicle (EV)‐derived microRNA‐18 (miR‐18b) in PE. Human umbilical cord mesenchymal stem cells (HUCMSCs) isolated from placental tissues were verified through osteogenic, adipogenic and chondrogenic differentiation assays. Bioinformatics analyses and dual‐luciferase reporter gene assay were adopted to confirm the targeting relationship between miR‐18b and Notch2. The functional roles of EV‐derived miR‐18b and Notch2 in trophoblasts were determined using loss‐ and gain‐of‐function experiments, and trophoblast proliferation and migration were assayed using CCK‐8 and Transwell tests. In vivo experiments were conducted to determine the effect of EV‐derived miR‐18b, Notch2 and TIM3/mTORC1 in a rat model of PE, with monitoring of blood pressure and urine proteinuria. TUNEL staining was conducted to observe the cell apoptosis of placental tissues of PE rats. We found down‐regulated miR‐18b expression, and elevated Notch2, TIM3 and mTORC1 levels in the placental tissues of PE patients compared with normal placenta. miR‐18b was delivered to trophoblasts and targeted Notch2 and negatively its expression, whereas Notch2 positively mediated the expression of TIM3/mTORC1. EV‐derived miR‐18b or Notch2 down‐regulation enhanced trophoblast proliferation and migration in vitro and decreased blood pressure and 24 hours urinary protein in PE rats by deactivating the TIM3/mTORC1 axis in vivo. In summary, EV‐derived miR‐18b promoted trophoblast proliferation and migration via down‐regulation of Notch2‐dependent TIM3/mTORC1.
Impact of baricitinib in combination with topical steroids on atopic dermatitis symptoms, quality of life and functioning in adult patients with moderate‐to‐severe atopic dermatitis from the BREEZE‐AD7 Phase 3 randomized trial
Authors: Wollenberg A. , Nakahara T. , Maari C. , Peris K. , Lio P. , Augustin M. , Silverberg J.I. , Rueda M.J. , DeLozier A.M. , Pierce E. , Yang F.E. , Sun L. , Ball S. , Tauber M. , Paul C.
Published: April 2021

Background

Baricitinib is an oral, selective, reversible Janus kinase 1/2 inhibitor approved in the European Union and Japan and under investigation in the United States for treatment of atopic dermatitis (AD).

Objectives

To evaluate the impact of baricitinib plus background topical corticosteroids (TCS) on health‐related quality of life (HRQoL), how AD symptoms impact work productivity and life functioning, and treatment benefit using patient‐reported outcome (PRO) assessments in patients with moderate‐to‐severe AD previously experiencing inadequate response to TCS.

Methods

Adult patients with AD in BREEZE‐AD7, a Phase 3, multicentre, double‐blind trial, were randomised 1 : 1 : 1 to daily oral placebo (control) or baricitinib 4‐ or 2‐mg plus TCS. PROs reported Week 1 through Week 16: Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment‐AD (WPAI‐AD); Patient‐Reported Outcomes Measurement Information System (PROMIS) Itch and Sleep measures, and Patient Benefit Index (PBI). Data were analysed using logistic regression (categorical) and mixed model repeated measures (continuous). PBI scores were analysed using analysis of variance.

Results

A total of 329 patients were randomised. Treatment with baricitinib 4‐mg (N = 111) or 2 mg (N = 109) plus TCS led to rapid, statistically significant improvements [vs. TCS plus placebo (N = 109)] in DLQI ≥4‐point improvement starting at Week 2 (4‐mg plus TCS, P ≤ 0.001; 2‐mg plus TCS P ≤ 0.05), change from baseline in WPAI‐AD presenteeism at Week 1 (4‐mg plus TCS, P ≤ 0.01; 2‐mg plus TCS P ≤ 0.05) and PROMIS itch interference at Week 2 (4‐mg plus TCS P ≤ 0.01). Improvements were sustained through Week 16 for baricitinib 4‐mg. Statistically significant improvements were observed at Week 16 for PBI global score (4‐mg plus TCS, P ≤ 0.001; 2‐mg plus TCS P ≤ 0.05).

Conclusions

Baricitinib plus TCS vs. placebo plus TCS showed significant improvements in treatment benefit at Week 16 and rapid significant improvements in HRQoL and impact of AD symptoms on work productivity and functioning through 16 weeks.
Clinical Evaluation of Crestal Bone Levels, Peri‐Implant Indices, and Mucosal Margin Position of Immediately Impressed Posterior Dental Implants: A Cross‐Sectional Study
Authors: Genetti Loren , Ercoli Carlo , Kotsailidi Elli Anna , Feng Changyong , Tsigarida Alexandra , Chochlidakis Konstantinos
Published: April 2021

Purpose

This is a cross‐sectional clinical study to evaluate crestal bone levels, mucosal margin position, probing depths, bleeding on probing, and plaque and bleeding indices of implants restored with an immediate impression workflow compared to implants restored with a delayed impression workflow.

Materials and methods

Patients who had received a posterior single implant crown in the premolar and molar regions were identified and scheduled for a single‐visit study appointment. Outcome measurements included soft tissues peri‐implant indices, peri‐implant mucosal margin position, and crestal bone levels. Several systemic‐, local‐, and prosthesis‐related factors were recorded. Bitewing radiographs were used to assess crestal bone levels. Wilcoxon rank sum test was used to compare the medians of continuous measurements and Pearson chi‐square test (or Fisher's exact test) was used to compare the distributions of categorical variables between the two groups.

Results

Twenty eight patients were included. Crestal bone levels, peri‐implant mucosal margin position and peri‐implant soft tissue parameters for the immediately impressed group were not statistically different from the delayed impressed group, except for probing depth for the immediately impressed buccal site, which was less than that of the delayed group. Mesial bone level for cement‐retained crowns was significantly more coronal than for screw‐retained ones.

Conclusions

While an isolated statistical difference was found in probing depth, the current study suggests that there is no clinically significant difference between implants impressed with immediate and delayed implant workflows when considering crestal bone levels, peri‐implant mucosal margin position, and most peri‐implant indices.
Asthma, bronchial hyperresponsiveness, allergy and lung function development until early adulthood: A systematic literature review
Authors: Koefoed Hans Jacob L. , Zwitserloot Annelies M. , Vonk Judith M. , Koppelman Gerard H.
Published: April 2021

Background

It is unclear in which periods of life lung function deficits develop, and whether these are affected by risk factors such as asthma, bronchial hyper‐responsiveness (BHR) and allergic comorbidity. The goal of this systematic review was to identify temporal associations of asthma, BHR and allergic comorbidity with large and small lung function development from birth until peak function in early adulthood.

Methods

We searched MEDLINE, EMBASE, Web of Science and CINAHL for papers published before 01.01.2020 on risk factors and lung function measurements of large and small airways. Studies were required to report lung function at any time point or interval from birth until peak lung function (age 21‐26) and include at least one candidate risk factor.

Results

Of the 45 papers identified, 44 investigated cohorts and one was a clinical trial with follow‐up. Asthma, wheezing, BHR and allergic sensitization early in life and to multiple allergens were associated with a lower lung function growth of large and small airways during early childhood compared with the control populations. Lung function development after childhood in subjects with asthma or persistent wheeze, although continuing to grow at a lower level, largely tracked parallel to non‐affected individuals until peak function was attained.

Clinical implications and future research

Deficits in lung function growth develop in early childhood, and children with asthma, BHR and early‐life IgE (poly)sensitization are at risk. This period is possibly a critical window of opportunity to identify at‐risk subjects and provide treatment aimed at preventing long‐term sequelae of lung function.
Oral immunotherapy in severe cow’s milk allergic patients treated with omalizumab: Real life survey from a Spanish registry
Authors: Ibáñez‐Sandín María Dolores , Escudero Carmelo , Candón Morillo Rocío , Lasa Eva M. , Marchán‐Martín Eva , Sánchez‐García Silvia , Terrados Soledad , González Díaz Carlos , Juste Sonsoles , Martorell Antonio , Gázquez García Vanessa , Ramírez Jiménez Antonio , Abellán Ángel , Martos Calahorro María D. , Tabar Ana I. , Bartra Joan , García Rodríguez Rosa , Gómez Galán Catalina , Martín‐Muñoz María Flora , Meseguer Arce José , Miralles Juan C. , Montoro de Francisco Ana M. , Poza Guedes Paloma , Rodríguez del Río Pablo ,   The OmaBASE task force (Pediatric Allergy Committee, Spanish Society of Allergy and Clinical Immunology)
Published: April 2021

Background

Oral immunotherapy is a frequent treatment for the management of food allergies, but adverse events (AE) are common. This study assessed the outcome of cow's milk oral immunotherapy (MOIT) in severe cow`s milk–allergic patients treated with omalizumab in a real‐life setting.

Methods

OmaBASE was a national, multicenter, open, and observational registry that collected clinical, immunologic, and treatment from patients with food allergy receiving omalizumab.

Results

Data derived from 58 patients aged 10.3 years (IQR 6.3‐13.2) and median milk‐specific IgE 100 kUA/L at the start of omalizumab treatment. Most had experienced anaphylaxis by accidental exposures (70.7%) and had asthma (81.0%). Omalizumab in monotherapy induced tolerance to ≥6000 mg of cow's milk protein (CMP) to 34.8% of patients tested by oral food challenge. Omalizumab combined with MOIT conferred desensitization to ≥6000 mg of CMP to 83.0% of patients. Omalizumab withdrawal triggered more AE (P = .013) and anaphylaxis (P = .001) than no discontinuation. Anaphylaxis was observed in 36.4% of patients who discontinued omalizumab, and more in those with sudden (50.0%) rather than progressive (12.5%) discontinuation. At database closure, 40.5% of patients who had completed follow‐up tolerated CMP without omalizumab (7.2% 1500‐4500 mg; 33.3% ≥6000 mg).

Conclusion

Milk oral immunotherapy initiated under omalizumab allows the desensitization of subjects with severe cow's milk allergy even after omalizumab discontinuation. However, discontinuation of omalizumab can lead to severe AE and should be carefully monitored.
Yoga complements cognitive behaviour therapy as an adjunct treatment for anxiety and depression: Qualitative findings from a mixed‐methods study
Authors: Capon Hannah , O’Shea Melissa , Evans Subhadra , McIver Shane
Published: April 2021

Objectives

Cognitive behaviour therapy (CBT) is recommended for treating anxiety and depression, demonstrating good efficacy and moderate rates of engagement. To further improve outcomes and access to evidence‐based treatments, researchers have sought to enhance CBT protocols with mindfulness‐based approaches, such as yoga. This study aimed to examine whether yoga is an acceptable and complementary adjunct to CBT through exploring the lived experiences of adults with anxiety and depression who engaged in an adjunct therapeutic yoga programme alongside group CBT.

Design

Single‐group qualitative design with post‐intervention and follow‐up timepoints.

Methods

Thirty‐six adults with anxiety and depression self‐selected into a therapeutic yoga programme as an adjunct to group CBT. Qualitative interviews were conducted with 27 participants immediately after the eight‐week programme and again three months later. Thematic analysis was used to identify common themes from the lived experiences.

Results

Three primary themes, with nine subthemes, were identified which reflect the experiences of the combined therapies, the complementary elements, and process of engagement over time. The adjunct yoga programme was highly acceptable to adults with anxiety and depression, enhancing engagement and perceived outcomes. Yoga was identified as providing a unique combination of elements that complemented processes of CBT, such as behavioural activation and thought disputation. Yoga practices represented mental health self‐management tools that are accessible and available as relapse prevention strategies.

Conclusions

Therapeutic yoga warrants consideration as an adjunct treatment for anxiety and depression as it offers unique and complementary elements to CBT and can enhance engagement and perceived clinical outcomes.

Practitioner points

Adults with anxiety and depression experienced a therapeutic yoga programme as a suitable and appealing adjunct that enhanced engagement with psychological treatment.

Yoga offers a unique combination of elements, including a values system, body‐based mindfulness practices, and breathing techniques, that complement CBT processes, such as behavioural activation, awareness of maladaptive patterns, and thought disputation.

A therapeutic yoga programme provides adults with anxiety and depression with an accessible and sustainable mental health self‐management tool.

Therapeutic yoga can be considered for integration to models of mental health service provision to enhance engagement and clinical outcomes for adults with anxiety and depression.
Entrepreneurship Policy Agenda in the European Union: A Text Mining Perspective
Authors: Arenal Alberto , Feijoo Claudio , Moreno Ana , Ramos Sergio , Armuña Cristina
Published: April 2021

This study analyzes the learning curve in the emergence and development of an entrepreneurship policy in the European Union (EU) during the period 1990–2016 by identifying the key topics in the policy agenda setting and their evolution over time within a corpus of 576 selected policy‐making documents. To this end, the study uses a combination of text mining techniques, cluster analysis, and qualitative assessment, which illustrate the possibilities of these tools to learn about the evolution of the policy cycle in a particular domain. The results from the analysis display three main stages, each of which have two substages. During the initial period, which lasted up until the late 1990s, labelled (i) latent EU entrepreneurship policy, there were hardly any specific entrepreneurship policy initiatives and only some general enterprise‐fostering policies at the EU level which included, tangentially, SMEs and entrepreneurs. In the (ii) emergent EU entrepreneurship policy stage, which can be traced from the late 1990s to the early 2010s, saw the initial steps of an entrepreneurship policy with a main focus on diagnosis of the entrepreneurial ecosystem and some measures of support, mainly to SMEs. The third and last period to date, which began in the 2010s is a (iii) new normal for EU entrepreneurship policy, which is a more targeted stage aimed at promoting not only the quantity but also quality of business ventures. Overall, this study provides a complete overview of the EU entrepreneurship policy evolution and concludes with a granular proposal for its continued development, while identifying main themes and foundational concepts, establishing patterns, and finding temporal and contextual relations within the EU policy cycle.
State Capacity and Innovation Policy Performance: A Comparative Study on Two Types of Innovation Projects in China
Authors: Feng Kaidong , Jiang Ziying
Published: April 2021

This study analyzes state capacity by comparing two types of innovation policies in China and estimating its impacts on policy performance. State capacity is defined as the extent to which the state can realize its objectives in policy and it is determined by government professionalism and penetration into industrial activities. Due to both the lack of channels to grasp information regarding complicated innovation processes and professional personnel capable of understanding such information, the state capacity demonstrated in these policies is low. The government relies more on indicators of innovation quantity rather than those of innovation quality as criteria for identifying innovation. This leads to poor policy performances in which grantees tend to meet only the qualitative requirements of the policies, namely increasing the number of patents, rather than engaging in genuine innovation and pursuing the essential objective of the policies. Therefore, even with market‐oriented reform, transitional economies like China still need to strengthen state building for achieving policy objectives.
Monitoring the Degradation in the Switching Behavior of a Hydraulic Valve Using Recurrence Quantification Analysis and Fractal Dimensions
Authors: Prakash Jatin , Kankar P. K. , Miglani Ankur
Published: April 2021

Valves are crucial components of a hydraulic system that enable reliable fluid management. Hydraulic valves actuated by a solenoid are prone to degradation in their switching behavior, which may induce undesirable fluctuations in the fluid pressure and flow rate, thereby impairing the system performance and limiting its predictability and reliability. Therefore, it is imperative to monitor the switching behavior of solenoid-actuated hydraulic valves. First, recurrence quantification analysis (RQA) has been applied to the experimental flow signals from a hydraulic circuit to understand the complex switching behavior of the valve. Using RQA, the monotonicity of six recurrence-based parameters has been assessed. In addition, two more nonlinear features, namely, Higuchi and Katz fractal dimensions have been extracted from the flow signals. Based on these eight features (six RQA-derived features and two nonlinear features) a feature matrix is formulated. Second, in a parallel approach, eight different statistical features are extracted from the flow signal to construct another feature matrix. Subsequently, different machine learning methods namely Ensemble learning, K-Nearest Neighbor (KNN), and support vector machine (SVM) have been trained on these two feature sets to predict the valve switching characteristics. A comparison between two feature sets shows that ensemble learning gives better prediction accuracy (99.95% versus 92.2% using statistical features) when fed with RQA features combined with fractal dimensions. Therefore, this study demonstrates that by utilizing the recurrence plots and machine learning techniques on the flow rate signals, the degradation in the switching behavior of hydraulic valves can be monitored effectively, with a high-prediction accuracy.
Noise thresholds in harmonic series maskers
Authors: Labuschagne Ilse B. , Ciocca Valter
Published: April 2021

The presence of noise is a salient cue to the perception of breathiness and aspiration in speech sounds. The detection of noise within harmonic series (maskers) composed of unresolved components was found to depend on the fundamental frequency (fo) and the overall level of the masker [Gockel, Moore, and Patterson (2002). J. Acoust. Soc. Am., 111 (6), 2759–2770]. In the present study, noise detection thresholds were measured as a function of the frequency range, the fo, and the overall level of harmonic maskers. Frequency range was specified in equivalent rectangular bandwidth (ERB) units (3–13, 13–23, 23–33, or 3–33 ERBs). The results were consistent with the idea that listeners rely on spectral cues when maskers comprise only resolved components (3–13 ERBs), and on temporal (dip listening) cues when maskers contain only unresolved components (23–33 ERBs). Noise detection thresholds were generally lower when masker level was high (70 dBA) than when it was low (50 dBA). Masker fo affected thresholds only when listeners relied on spectral cues for noise detection. With the wideband (3–33 ERBs) masker, listeners likely detected noise by focusing on the frequency band (23–33 ERBs) with the most advantageous noise-to-harmonic ratio.
A Pilot Randomized Controlled Trial of Interval Training and Sleep Hygiene for Improving Sleep in Older Adults
Authors: Mahajan Aashirwad , Mahajan Satish , Tilekar Swanand
Published: April 2021

The primary objective of this pilot randomized controlled trial was to study the feasibility (recruitment and retention rates) for interval training and sleep hygiene (SH) in adults aged above 60 years. Thirteen out of 46 screened individuals from a home for older adults in Shirdi (Maharashtra, India) were randomly assigned by permuted block randomization to either an interval training with SH group (n = 6) or an SH alone group (n = 7). The authors measured sleep with the S+ sleep monitor manufactured by ResMed (USA) Pittsburgh Sleep Quality Index and quality of life with Short Form-12 health survey version 2. Interval training consisted of 8 weeks of stationary cycling, whereas SH consisted of lecture and handouts. Recruitment was 38.2%, retention was >80% for both the interventions, and there was one loss to follow-up in SH. Interval training and SH were feasible for older adults and supported a full-scale randomized controlled trial.
Objectively Measured Sedentary Levels and Bouts by Day Type in Australian Young Children
Authors: Pereira João R. , Cliff Dylan P. , Sousa-Sá Eduarda , Zhang Zhiguang , McNeill Jade , Veldman Sanne L.C. , Santos Rute
Published: April 2021

Background: This study aimed to understand whether a higher number of sedentary bouts (SED bouts) and higher levels of sedentary time (SED time) occur according to different day types (childcare days, nonchildcare weekdays, and weekends) in Australian toddlers (1–2.99 y) and preschoolers (3–5.99 y). Methods: The SED time and bouts were assessed using ActiGraph GT3X+ accelerometers. The sample was composed of 264 toddlers and 343 preschoolers. The SED bouts and time differences were calculated using linear mixed models. Results: The toddlers’ percentage of SED time was higher on nonchildcare days compared with childcare days (mean difference [MD] = 2.3; 95% confidence interval, 0.7 to 3.9). The toddlers had a higher number of 1- to 4-minute SED bouts on nonchildcare days compared with childcare days. The preschoolers presented higher percentages of SED time during nonchildcare days (MD = 3.1; 95% confidence interval, 1.6 to 4.5) and weekends (MD = 1.9; 95% confidence interval, 0.4 to 3.4) compared with childcare days. The preschoolers presented a higher number of SED bouts (1–4, 5–9, 10–19, and 20–30 min) during nonchildcare days and weekends compared with childcare days. No SED times or bout differences were found between nonchildcare days and weekends, neither SED bouts >30 minutes on toddlers nor on preschoolers. Conclusion: The SED time and bouts seem to be lower during childcare periods, which means that interventions to reduce sedentary time should consider targeting nonchildcare days and weekends.
Latest Russian vaccine comes with a big dose of mystery
Authors: Dobrovidova Olga
Published: April 2021

Vaccine trial participants call for review after unusual private study found they have no virus-blocking antibodies.
Bilateral visual projections exist in non-teleost bony fish and predate the emergence of tetrapods
Authors: Vigouroux Robin J. , Duroure Karine , Vougny Juliette , Albadri Shahad , Kozulin Peter , Herrera Eloisa , Nguyen-Ba-Charvet Kim , Braasch Ingo , Suárez Rodrigo , Del Bene Filippo , Chédotal Alain
Published: April 2021

Dating the ipsilateral visual pathway

In primates, visual connections are bilateral: Each eye sends neural connections to both sides of the brain. Vigouroux
et al.
looked at the evolutionary underpinnings of the bilateral visual system. A close look at the connections between the retina and the brain in a variety of fish species representing a span of evolutionary divergence revealed that contralateral connections seem to be universal. The ipsilateral connections, which add to the contralateral connections to form a bilateral visual system, arrived later in evolution but before the transition to land-dwelling animals.

Science
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The story behind COVID-19 vaccines
Authors: Fauci Anthony S.
Published: April 2021

Amid the staggering amount of suffering and death during this historic pandemic of COVID-19, a remarkable success story stands out. The development of several highly efficacious vaccines against a previously unknown viral pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in less than 1 year from the identification of the virus is unprecedented in the history of vaccinology. A frequently asked question is how such an extraordinary accomplishment could have been realized in such a short time frame, when timelines for other vaccines are measured in years if not decades. In fact, concern about this truncated timeline has contributed in part to the hesitancy in accepting these vaccines. What is not fully appreciated is that the starting point of the timeline for SARS-CoV-2 vaccines was not 10 January 2020, when the Chinese published the genetic sequence of the virus. Rather, it began decades earlier, out of the spotlight.
Epidural abscess related toStreptococcus mitisin a 57-year-old immunocompetent patient
Authors: Prod'homme Marc , Grasset Didier , Chalaron Marc , Boscherini Duccio
Published: April 2021

A 57-year-old immunocompetent male patient presented himself to our emergency department with lumbar pain for 10 days, after a lumbar torsion. He was neurologically intact, but showed signs of systemic inflammatory syndrome. A lumbar MRI found a spinal epidural abscess from L3-L4 to L5-S1 levels. The patient was operated early before occurrence of neurological deficit. The abscess cultures found aStreptococcus mitisinfection. The patient made a good recovery after surgical decompression, washout with samples taken for cultures and targeted antibiotic therapy for 6 weeks.
Case of e-cigarette or vaping product use-associated lung injury (EVALI) in London, UK
Authors: Evans Ruth Elizabeth , Herbert Sophie , Owen William , Rao Deepak
Published: April 2021

We present a case of a 38-year-old man with no medical comorbidities who presented to the hospital with haemoptysis and shortness of breath on a background of vaping home-manufactured cannabis oil. He developed e-cigarette or vaping product use-associated lung injury (EVALI) visible on chest X-ray requiring oxygen, and corticosteroid treatment before making a recovery. Research reports that the contents vitamin E acetate and tetrahydrocannabinol are frequently found in substances acquired from informal sources which increase the likelihood of EVALI developing. Further research into their synergistic effect is ongoing. Although safer than smoking, vaping is not risk free and EVALI should be considered in patients presenting with respiratory disease.
Anaesthetic challenges in a patient with Wolff-Parkinson-White (WPW) syndrome for orchidectomy
Authors: Yeap Tat Boon , Teah Ming Kai , Thevarajah Shankaran , Azerai Salamah
Published: April 2021

Wolff-Parkinson-White (WPW) syndrome is an extremely rare congenital cardiac conduction disorder. It is due to an aberrant pathway between the atrium and ventricle. This manuscript entails a man with an underlying WPW who was posted for an elective orchidectomy. We discussed the important perioperative precautions to prevent the precipitation of acute cardiac events.
Growth failure and metabolic acidosis due to total body sodium depletion in an infant with an ileostomy
Authors: Zarraga Christina Marie , Borowitz Stephen Mark
Published: April 2021

Sodium is an essential nutrient and inadequate sodium intake and/or excessive sodium losses can result in suboptimal growth. Infants with ileostomies are at significant risk of developing growth failure as a result of excessive sodium loss in their ileostomy effluent. Chronic sodium depletion can also limit the kidney’s ability to excrete hydrogen and potassium ions, mimicking electrolyte abnormalities found in type 4 renal tubular acidosis. This report describes an infant with an ileostomy with severe growth failure, hyperkalaemia and metabolic acidosis—all of which promptly resolved with sodium supplementation.
Diagnostic value of culture results from aqueous tap versus vitreous tap in cases of bacterial endophthalmitis
Authors: AlBloushi Abdulrahman F , Ajamil-Rodanes Sofia , Testi Ilaria , Wagland Catherine , Grant-McKenzie Nadine , Pavesio Carlos
Published: April 2021

Objective

To investigate the concordance between aqueous and vitreous tap culture results among different types of bacterial endophthalmitis.

Methods and analysis

This retrospective cohort analysis included all cases diagnosed with endophthalmitis at Moorfields Eye Hospital between January 2008 and March 2020. Aqueous and vitreous samples obtained simultaneously at presentation. Samples were evaluated for sensitivity, specificity, negative and positive predictive values.

Results

A total of 217 patients (217 eyes) were included in the study. Postsurgical endophthalmitis was the most common type of endophthalmitis and diagnosed in 35.9% of the cases. The rate of positive culture results was 32.2% from vitreous tap and 21.7% from aqueous tap. The culture yield through vitreous sampling was 15.7% when aqueous culture results were negative, and in 5.1%, the aqueous sample was positive when the vitreous tap results were negative. Considering the vitreous tap as the gold standard, aqueous sample culture results showed a statistically significant high specificity and positive predictive values in cases of postsurgical endophthalmitis, late-onset endophthalmitis associated with glaucoma procedures, postintravitreal injection and endophthalmitis associated with bacterial keratitis. Coagulase Negative Staphylococcus was the most common organism isolated from vitreous and aqueous samples.

Conclusions

Even though the sensitivity and specificity of aqueous tap are low, our results show that in a few cases it identified important organisms, otherwise missed by vitreous sampling alone. Culture of vitreous sample remains the gold standard for isolation of pathogen in bacterial endophthalmitis, but aqueous samples should also be obtained as an adjunct for the diagnosis.
Cultivation of compound ability of postgraduates with medical professional degree: the importance of double tutor system
Authors: Xiao Yu , Wu Xiao-Hong , Huang Yu-Hong , Zhu Shao-Yi
Published: April 2021

As we all know, medical postgraduate education is very important for training high-quality clinicians, and can have a long-term impact on the promotion of the global health service system. In recent years, following the example of developed countries in Europe and America, the Chinese government has reformed the training mode of medical postgraduates and implemented the double tutor system. Although this system will bring many positive effects in theory, the difficulties encountered in implementing this system are real and need the joint efforts of schools, tutors and students to solve them. This article closely follows the background of the current era, compares the differences between Chinese and foreign graduate training modes, and emphatically discusses the significance and problems of the double tutor system in the postgraduate education reform in China.
Recent greening driven by species-specific shrub growth characteristics in Nunatsiavut, Labrador, Canada
Authors: Larking Taylor , Davis Emma , Way Robert , Hermanutz Luise , Trant Andrew
Published: April 2021

Satellite remote sensing is a popular approach for identifying vegetation change in northern environments; however, disentangling ecological processes causing variability in spectral indices remains a challenge. Here, we aim to determine how shrub characteristics differ between low and rapidly greening areas near Nain, Nunatsiavut, Canada. Using a cross-scale approach, we combined remotely sensed spectral greening trends (Normalized Difference Vegetation Index; Landsat Collection 1, 1985–2018) with shrub dynamics derived from ring-widths of green alder (Alnus alnobetula (Ehrh.) K. Koch) and dwarf birch (Betula glandulosa Michx.). Differentiation of spectral greening classes appears to be driven by the distribution of shrub species. Alder were taller, grew faster, had more recent stem initiation than dwarf birch, and were dominant in rapid greening subplots. In low greening subplots, alder were co-dominant with dwarf birch, whose dominant stems initiated more gradually, were shorter, and had lower rates of vertical growth. The radial growth of both shrub species was favoured by warm winter temperatures and precipitation, whereas rapid greening alder was also favoured by warm summer temperatures. Further shrub growth will likely be enhanced under continued climate warming if moisture does not become limiting. This research demonstrates the importance of species identity in determining rates of spectral greening in northern environments.
Effects of broiler chicks fed the low crude protein diet supplemented with Achyranthes japonica Nakai root extract on growth performance and carcass traits
Authors: Dang De Xin , Yun Kwan Sik , Kim In Ho
Published: April 2021

A total of 360 one-day-old broiler chicks were randomly assigned to four treatments with five replicate cages and 18 birds per cage for a 35 d trial to investigate the effects of supplementing Achyranthes japonica Nakai (AJN) root extract in low crude protein (CP) diet on growth performance and carcass traits. Experimental diets were divided as standard CP content diet, low CP content (LCP) diet, and LCP diet supplemented with 0.025% or 0.050% AJN root extract. Dietary CP reduction impaired growth performance and carcass traits, whereas supplementing AJN root extract improved growth performance and carcass traits.
Long-lived population demographics in a declining, vulnerable fishery — bigmouth buffalo (Ictiobus cyprinellus) of Jamestown Reservoir, North Dakota
Authors: Lackmann Alec R. , Kratz Brandon J. , Bielak-Lackmann Ewelina S. , Jacobson Reed I. , Sauer Derek J. , Andrews Allen H. , Butler Malcolm G. , Clark Mark E.
Published: April 2021

Despite decades of commercial harvest of bigmouth buffalo (Ictiobus cyprinellus) from Jamestown Reservoir, North Dakota, and the recent rapid growth of sport bowfishing that targets this species, there is a lack of biological information on this native catostomid. At present, no-limit recreational and commercial harvest of bigmouth buffalo occurs in North Dakota, with no harvest-reporting for recreational take. A long-lived life history was recently documented for this species, with a life-span exceeding 100 years. At Jamestown Reservoir, bigmouth buffalo were aged to 58 years of age, with onset of sexual maturity 10 years for females. Evidence for episodic recruitment over a 60-year period was in 1962–1979, 1993–2011, and 2017, with recruitment success more likely during non-drought periods. Annual commercial harvest data from this reservoir indicate bigmouth buffalo have declined significantly over the past 30 years, most precipitously since 2010 during the bowfishing era. The demographic patterns, episodic recruitment, and harvest changes observed in this population are relevant for informing management of bigmouth buffalo and other long-lived freshwater fishes.
Ghost dark energy in Rastall theory
Authors: Kangal E. E. , Salti M. , Aydogdu O.
Published: April 2021

Making use of the generalized form of the Ghost dark energy density, which has the functional form [Formula: see text] where [Formula: see text] represents the Hubble expanding rate, the present accelerated enlargement behavior of the cosmos is investigated from the Rastall theory perspective. After finding a relation for the Hubble cosmic expansion rate, we consider recent cosmology-independent measurements calculated for the expansion history of the cosmos to fit the model via the [Formula: see text]-analysis. Moreover, we discuss the cosmographic properties of the model with the help of some cosmological quantities. We show that our model is stable and consistent with the recent astrophysical data. Also, for our model, we investigate cosmological interpretations of thermodynamics.
STRESS SENSITIVITY ANALYSIS OF FRACTAL POROUS MEDIA BASED ON THE ELASTO-PLASTIC THICK-WALLED CYLINDER MODEL
Authors: HUANG ZHAOQIN , SU XIN , LI YANCHAO , ZHANG KAI , YAO JUN
Published: April 2021

The stress-dependent flow and transport behaviors of porous media are ubiquitous in various scientific and engineering applications. It has been shown that the change of effective stress has important effects on the permeability and porosity of porous media. In this paper, a new stress sensitivity model for porous media is developed based on the fractal theory and the elasto-plastic thick-walled cylinder model. The proposed model is able to predict the elasto-plastic deformation of the fractal porous media under loading–unloading stress cycles, which plays a crucial role on the permanent variations of the permeability and porosity. It is found that the permeability of stress-sensitivity porous media is related to the capillary fractal dimension, capillary fractal tortuosity dimension, minimum and maximum capillary diameters, Young’s modulus and Poisson’s ratio of capillary. Each parameter has a clear physical meaning. The validity of the developed fractal model is verified by comparing the model predictions with the available experimental data.
AUTOMATED CLASSIFICATION OF SOLITARY PULMONARY NODULES USING CONVOLUTIONAL NEURAL NETWORK BASED ON TRANSFER LEARNING STRATEGY
Authors: LI SHIWEI , LIU DANDAN
Published: April 2021

This study aimed to propose an effective malignant solitary pulmonary nodule classification method based on improved Faster R-CNN and transfer learning strategy. In practice, the existing solitary pulmonary nodule classification methods divide the lung cancer images into two categories only: normal and cancerous. This study proposed the deep convolution neural network to classify the computed tomography (CT) images of lung cancer into four categories: lung adenocarcinoma, lung squamous cell carcinoma, metastatic lung cancer, and normal types of lung cancer. Some high-resolution lung CT images have unnecessary characters such as a large number of high-density continuity features, small-size lung nodule targets, CT image background complexity, and so forth. In this study, the CT image sub-block preprocessing strategy was used to extract nodule features for enhancement and alleviate the aforementioned problems. The experimental results showed that the proposed system was effective in resolving issues such as high false-positive rate and long classification time cost based on the original Faster R-CNN detection method. Meanwhile, the transfer learning strategy was used to improve the classification efficiency so as to avoid the overfitting problem caused by a few labeled samples of lung cancer datasets. The classification results were integrated using the majority vote algorithm. The classification results of the lung CT imaging showed that the proposed method had an average detection accuracy of 89.7% and reduced the rate of misdiagnosis to meet the clinical needs.