bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensing-triggered stiffness-tunable smart adhesives
Authors: Wang Duorui , Hu Hong , Li Shuai , Tian Hongmiao , Fan Wei , Li Xiangming , Chen Xiaoliang , Taylor Ambrose C. , Shao Jinyou
Published: March 2023

Artificial dry adhesives have exhibited great potential in the field of robotics. However, there is still a wide gap between bioinspired adhesives and living tissues, especially regarding the surface adaptability and switching ability of attachment/detachment. Here, we propose a sensing-triggered stiffness-tunable smart adhesive material, combining the functions of muscle tissues and sensing nerves rather than traditional biomimetic adhesive strategy that only focuses on structural geometry. Authorized by real-time perception of the interface contact state, conformal contact, shape locking, and active releasing are achieved by adjusting the stiffness based on the magnetorheological effect. Because of the fast switching of the magnetic field, a millisecond-level attachment/detachment response is successfully achieved, breaking the bottleneck of adhesive materials for high-speed manipulation. The innovative design can be applied to any toe’s surface structure, opening up a previously unknown avenue for the development of adhesive materials.
Interaction network of extracellular vesicles building universal analysis via eye tears: iNEBULA
Authors: Hu Liang , Liu Xiaoling , Zheng Qiaolan , Chen Wuhe , Xu Hao , Li Hengrui , Luo Jiaxin , Yang Rui , Mao Xulong , Wang Siyao , Chen Tucan , Lee Luke P. , Liu Fei
Published: March 2023

Discovering the secrets of diseases from tear extracellular vesicles (EVs) is well-recognized and appreciated. However, a precise understanding of the interaction network between EV populations and their biogenesis from our body requires more in-depth and systematic analysis. Here, we report the biological profiles of different-size tear EV subsets from healthy individuals and the origins of EV proteins. We have identified about 1800 proteins and revealed the preferential differences in the biogenesis among distinct subsets. We observe that eye-related proteins that maintain retinal homeostasis and regulate inflammation are preferentially enriched in medium-size EVs (100 to 200 nm) fractions. Using universal analysis in combination with the Human Protein Atlas consensus dataset, we found the genesis of tear EV proteins with 37 tissues and 79 cell types. The proteins related to retinal neuronal cells, glial cells, and blood and immune cells are selectively enriched among EV subsets. Our studies in heterogeneous tear EVs provide building blocks for future transformative precision molecular diagnostics and therapeutics.
Laser-assisted failure recovery for dielectric elastomer actuators in aerial robots
Authors: Kim Suhan , Hsiao Yi-Hsuan , Lee Younghoon , Zhu Weikun , Ren Zhijian , Niroui Farnaz , Chen Yufeng
Published: March 2023

Insects maintain remarkable agility after incurring severe injuries or wounds. Although robots driven by rigid actuators have demonstrated agile locomotion and manipulation, most of them lack animal-like robustness against unexpected damage. Dielectric elastomer actuators (DEAs) are a class of muscle-like soft transducers that have enabled nimble aerial, terrestrial, and aquatic robotic locomotion comparable to that of rigid actuators. However, unlike muscles, DEAs suffer local dielectric breakdowns that often cause global device failure. These local defects severely limit DEA performance, lifetime, and size scalability. We developed DEAs that can endure more than 100 punctures while maintaining high bandwidth (>400 hertz) and power density (>700 watt per kilogram)—sufficient for supporting energetically expensive locomotion such as flight. We fabricated electroluminescent DEAs for visualizing electrode connectivity under actuator damage. When the DEA suffered severe dielectric breakdowns that caused device failure, we demonstrated a laser-assisted repair method for isolating the critical defects and recovering performance. These results culminate in an aerial robot that can endure critical actuator and wing damage while maintaining similar accuracy in hovering flight. Our work highlights that soft robotic systems can embody animal-like agility and resilience—a critical biomimetic capability for future robots to interact with challenging environments.
Prior SARS-CoV-2 infection enhances and reshapes spike protein–specific memory induced by vaccination
Authors: Barateau Véronique , Peyrot Loïc , Saade Carla , Pozzetto Bruno , Brengel-Pesce Karen , Elsensohn Mad-Hélénie , Allatif Omran , Guibert Nicolas , Compagnon Christelle , Mariano Natacha , Chaix Julie , Djebali Sophia , Fassier Jean-Baptiste , Lina Bruno , Lefsihane Katia , Espi Maxime , Thaunat Olivier , Marvel Jacqueline , Rosa-Calatrava Manuel , Pizzorno Andres , Maucort-Boulch Delphine , Henaff Laetitia , Saadatian-Elahi Mitra , Vanhems Philippe , Paul Stéphane , Walzer Thierry , Trouillet-Assant Sophie , Defrance Thierry
Published: March 2023

The diversity of vaccination modalities and infection history are both variables that have an impact on the immune memory of individuals vaccinated against SARS-CoV-2. To gain more accurate knowledge of how these parameters imprint on immune memory, we conducted a long-term follow-up of SARS-CoV-2 spike protein–specific immune memory in unvaccinated and vaccinated COVID-19 convalescent individuals as well as in infection-naïve vaccinated individuals. Here, we report that individuals from the convalescent vaccinated (hybrid immunity) group have the highest concentrations of spike protein–specific antibodies at 6 months after vaccination. As compared with infection-naïve vaccinated individuals, they also display increased frequencies of an atypical mucosa-targeted memory B cell subset. These individuals also exhibited enhanced T
H
1 polarization of their SARS-CoV-2 spike protein–specific follicular T helper cell pool. Together, our data suggest that prior SARS-CoV-2 infection increases the titers of SARS-CoV-2 spike protein–specific antibody responses elicited by subsequent vaccination and induces modifications in the composition of the spike protein–specific memory B cell pool that are compatible with enhanced functional protection at mucosal sites.
Comparison of Toxicities among Different Bumped Kinase Inhibitor Analogs for Treatment of Cryptosporidiosis
Authors: Hulverson Matthew A. , Choi Ryan , Schaefer Deborah A. , Betzer Dana P. , McCloskey Molly C. , Whitman Grant R. , Huang Wenlin , Lee Sangun , Pranata Andy , McLeod Malcolm D. , Marsh Kennan C. , Kempf Dale J. , LeRoy Bruce E. , Zafiratos Mark T. , Bielinski Aimee L. , Hackman Robert C. , Ojo Kayode K. , Arnold Samuel L. M. , Barrett Lynn K. , Tzipori Saul , Riggs Michael W. , Fan Erkang , Van Voorhis Wesley C.
Published: March 2023

Recent advances on the development of bumped kinase inhibitors for treatment of cryptosporidiosis have focused on the 5-aminopyrazole-4-carboxamide scaffold, due to analogs that have less hERG inhibition, superior efficacy, and strong
in vitro
safety profiles. Three compounds, BKI-1770, -1841, and -1708, showed strong efficacy in
C. parvum
infected mice.
In Vitro
and
In Vivo
Efficacy of NITD-916 against Mycobacterium fortuitum
Authors: Roquet-Banères Françoise , Alcaraz Matthéo , Hamela Claire , Abendroth Jan , Edwards Thomas E. , Kremer Laurent
Published: March 2023

Mycobacterium fortuitum
represents one of the most clinically relevant rapid-growing mycobacterial species. Treatments are complex due to antibiotic resistance and to severe side effects of effective drugs, prolonged time of treatment, and co-infection with other pathogens.
Pili Subunit PilA Contributes to the Cytoadhesion of
Glaesserella Parasuis
to Host Cells and Provides Immunoprotection
Authors: An Jiahui , Cai Jinshuang , Zhang Baoge , Li Yufeng
Published: March 2023

G. parasuis
is one of the most prevalent bacterial infections in swine production and can lead to huge economic losses around the world. A full understanding of colonization and immunity with
G. parasuis
infections will be essential in disease control.
Transport and Utilization of Glycogen Breakdown Products by
Gardnerella
spp. from the Human Vaginal Microbiome
Authors: Bhandari Pashupati , Hill Janet E.
Published: March 2023

Increased abundance of
Gardnerella
spp. is a diagnostic characteristic of bacterial vaginosis, an imbalance in the human vaginal microbiome associated with troubling symptoms and negative reproductive health outcomes, including increased transmission of sexually transmitted infections and preterm birth. Competition for nutrients is likely an important factor in causing dramatic shifts in the vaginal microbial community.
Gardnerella
produces enzymes to digest glycogen, an important nutrient source for vaginal bacteria, but little is known about the mechanisms in
Gardnerella
for uptake of the products of this digestion, or whether
Gardnerella
use some or all of the products.
Catastrophic craton destruction via wholesale lithosphere delamination
Authors: Chen Hao , Tang Ming , Song Shuguang
Published: March 2023

The nuclei of continents, manifested as cratons, are the most long-lived parts of Earth’s lithosphere. However, ancient cratons in some areas can be substantially destroyed through mechanisms that are not fully understood. We used experimentally calibrated geobarometers to calculate the equilibrium pressures of mafic magmas in the North China craton, which directly constrain the evolving depth of the lithosphere-asthenosphere boundary beneath the craton through time. We show that the lithospheric thickness of the eastern part of the craton decreased from ~200 km to ~35 km in the Early Cretaceous. This intense destruction took place within a short time interval of ~10 m.y., at least locally. Following this destruction, the lithosphere gradually rethickened and stabilized as the upwelling asthenosphere cooled and formed a juvenile lithosphere. We suggest that this catastrophic lithosphere thinning resulted from wholesale lithosphere delamination. As a consequence of this catastrophic loss of thick mantle roots, the eastern part of the North China craton may have undergone rapid crustal rebound and surface uplift, as recorded by the regional unconformities formed between 130 and 120 Ma in the destructed area.
Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management
Authors: Fleming Ben , Edison Paul , Kenny Laura
Published: March 2023

Cognitive impairment is a debilitating side effect experienced by patients with cancer treated with systemically administered anticancer therapies. With around 19.3 million new cases of cancer worldwide in 2020 and the five year survival rate growing from 50% in 1970 to 67% in 2013, an urgent need exists to understand enduring side effects with severe implications for quality of life. Whereas cognitive impairment associated with chemotherapy is recognized in patients with breast cancer, researchers have started to identify cognitive impairment associated with other treatments such as immune, endocrine, and targeted therapies only recently. The underlying mechanisms are diverse and therapy specific, so further evaluation is needed to develop effective therapeutic interventions. Drug and non-drug management strategies are emerging that target mechanistic pathways or the cognitive deficits themselves, but they need to be rigorously evaluated. Clinically, consistent use of objective diagnostic tools is necessary for accurate diagnosis and clinical characterization of cognitive impairment in patients treated with anticancer therapies. This should be supplemented with clinical guidelines that could be implemented in daily practice. This review summarizes the recent advances in the mechanisms, clinical characterization, and novel management strategies of cognitive impairment associated with treatment of non-central nervous system cancers.
Mpox (monkeypox) information on TikTok: analysis of quality and audience engagement
Authors: Shi Ao , El Haddad Joe , Cai Peng , Song Shijie , Wang Yuan Jia , Liu Qi , Li Pengyang
Published: March 2023

Background

Online information on mpox (monkeypox) is not well studied. We have analysed the video content, information quality, and audience engagement of mpox-related videos on TikTok.

Methods

Using a hashtag-based searching strategy, we identified 2462 mpox-related videos on TikTok from 1 January to 11 August 2022; 85 were included after exclusion criteria screening. Videos were evaluated for content on features and treatment of mpox. Video and information quality was assessed using the DISCERN instrument and theJournal of the American Medical Association(JAMA) criteria. We recorded video source, evaluation scores, and viewer engagement metrics. The Kruskal-Wallis test was used for statistical analysis and multiple linear regression for factor-association studies.

Results

Of the 85 videos, two assessed all content topics and highlighted 33% of all content items in clinical guidelines. The overall average score for the videos was 39.56 of 80 on the DISCERN instrument and 1.93 of 4 on the JAMA criteria. No video met all JAMA criteria. Subgroup analysis based on author identity suggested the variance in video scores by source (p<0.05 for all). Overall scores were higher for videos produced by doctors and science communicators than for those made by institutional users, nurses, and the general public. Multiple linear regression analysis showed that having people in the video (69.20, p=0.0001) and including information on treatment choices (1.15, p=0.045) were significant, independent determinants of audience engagement.

Conclusion

Public-directed TikTok videos on mpox frequently provide incomplete, inaccurate information, highlighting the potential risks of using TikTok as a health information source.
Women, their Offspring and iMproving lifestyle for Better cardiovascular health of both (WOMB project): a protocol of the follow-up of a multicentre randomised controlled trial
Authors: van de Beek Cornelieke , Hoek Annemieke , Painter Rebecca C , Gemke Reinoud J B J , van Poppel Mireille N M , Geelen Anouk , Groen Henk , Willem Mol Ben , Roseboom Tessa J
Published: March 2023

Introduction

Women, their Offspring and iMproving lifestyle for Better cardiovascular health of both (WOMB) project is the follow-up of the LIFEstyle study, a randomised controlled trial in obese infertile women, and investigates the effects of a preconception lifestyle intervention on later health of women (WOMB women) and their children (WOMB kids).

Methods and analysis

Obese infertile women, aged between 18 and 39 years, were recruited in 23 Dutch fertility clinics between June 2009 and June 2012. The 284 women allocated to the intervention group received a 6-month structured lifestyle programme. The 280 women in the control group received infertility care as usual. 4 to 7 years after inclusion in the trial, all women (n=564) and children conceived during the trial (24 months after randomisation) (n=305 singletons and age 3–5 years) will be approached to participate in this follow-up study (starting in 2015). The main focus of outcome will be cardiovascular health, but the dataset comprises a wide range of physical and mental health measures, diet and physical activity measures, child growth and development measures, biological samples and genetic and epigenetic information. The follow-up assessment consists of three stages that take place between 2016 and 2018, and includes (online) questionnaires, accelerometry and physical and behavioural measurements in a mobile research vehicle. A subsample of 100 women and 100 children are planned for cardiac ultrasound measurements.

Ethics and dissemination

The protocol of this follow-up study is approved by the local medical ethics committee (University Medical Centre Groningen). Study findings of the WOMB project will be widely disseminated to the scientific community, healthcare professionals, policy makers, future parents and general public.

Trial registration number

The original LIFEstyle study is registered at The Netherlands Trial Registry (number 1530).
Effectiveness of an internet-based perioperative care programme to enhance postoperative recovery in gynaecological patients: cluster controlled trial with randomised stepped-wedge implementation
Authors: Bouwsma Esther V A , Huirne Judith A F , van de Ven Peter M , Vonk Noordegraaf Antonie , Schaafsma Frederieke G , Schraffordt Koops Steven E , van Kesteren Paul J M , Brölmann Hans A M , Anema Johannes R
Published: March 2023

Objective

To evaluate the implementation and effectiveness of an internet-based perioperative care programme for patients following gynaecological surgery for benign disease.

Design

Stepped-wedge cluster randomised controlled trial.

Setting

Secondary care, nine hospitals in the Netherlands, 2011–2014.

Participants

433 employed women aged 18–65 years scheduled for hysterectomy and/or laparoscopic adnexal surgery.

Interventions

An internet-based care programme was sequentially rolled out using a multifaceted implementation strategy. Depending on the implementation phase of their hospital, patients were allocated to usual care (n=206) or the care programme (n=227). The care programme included an e-health intervention equipping patients with tailored personalised convalescence advice.

Main outcome measures

The primary outcome was duration until full sustainable return to work (RTW). The degree of implementation of the care programme was evaluated at the level of the patient, healthcare provider and organisation by indicators measuring internet-based actions by patients and providers.

Results

Median time until RTW was 49 days (IQR 27–76) in the intervention group and 62 days (42–85) in the control group. A piecewise Cox model was fitted to take into account non-proportionality of hazards. In the first 85 days after surgery, patients receiving the intervention returned to work faster than patients in the control group (HR 2.66, 95% CI 1.88 to 3.77), but this effect was reversed in the small group of patients that did not reach RTW within this period (0.28, 0.17 to 0.46). Indicators showed that the implementation of the care programme was most successful at the level of the patient (82.8%) and professional (81.7%).

Conclusions

Implementation of an internet-based care programme has a large potential to lead to accelerated recovery and improved RTW rates following different types of gynaecological surgeries.

Trial registration number

NTR2933; Results.
Impact of Obesity on Postoperative Outcomes following cardiac Surgery (The OPOS study): rationale and design of an investigator-initiated prospective study
Authors: Aguiar Christie , MacLeod Jeffrey , Yip Alexandra , Melville Sarah , Légaré Jean-Francois , Pulinilkunnil Thomas , Kienesberger Petra , Brunt Keith , Hassan Ansar
Published: March 2023

Introduction

Increasing levels of obesity worldwide have led to a rise in the prevalence of obesity-related complications including cardiovascular risk factors such as diabetes, hypertension and dyslipidaemia. Healthcare providers believe that overweight and obese cardiac surgery patients are more likely to experience adverse postoperative outcomes. The body mass index (BMI) is the primary measure of obesity in clinical practice, without accounting for a patient’s level of cardiopulmonary fitness or muscle mass. The objective of this study is to determine whether fitness capacity of obese cardiac surgical patients and biomarkers, alone or in combination, will help identify patients at risk for adverse outcomes when undergoing cardiac surgery.

Methods and analysis

Patients between the ages of 18 and 75 years undergoing elective cardiac surgery are consented to participate in this prospective observational study. Patients will be invited to participate in measures of obesity, functional capacity and exercise capacity assessments, quality of life questionnaires, and blood and tissue sampling for biomarker analysis. The endpoints evaluated are measures other than BMI that could be predictive of short-term and long-term postoperative outcomes. Clinical outcomes of interest are prolonged ventilation, hospital length of stay, renal failure and all-cause mortality. Biomarkers of interest will largely focus on metabolism (lipids, amino acids) and inflammation (adipokines, cytokines and chemokines).

Ethics and dissemination

This study has been approved by the institutional review board at the Horizon Health Network. On completion of the study, the results shall be disseminated through conference presentations and publications in peer-reviewed journals. Additionally, the report shall also be diffused more broadly to the general public and the cardiovascular community.

Trial registration number

NCT03248921.
‘Secretly, it’s a competition’: a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives
Authors: Van den Brand Floor A , Dohmen Lisa M E , Van Schayck Onno C P , Nagelhout Gera E
Published: March 2023

Objectives

Smoking cessation programmes in combination with financial incentives have shown to increase quit rates in smokers, but it is not clear which elements of this intervention help smokers to succeed in their quit attempt. The aim of this study was to explore the view of successful and unsuccessful quitters about which factors had affected their ability to quit smoking.

Design

Semistructured qualitative interviews were conducted and analysed using the Framework method.

Setting

Interviews were conducted in 2017 with employees from nine different Dutch companies.

Participants

24 successful and unsuccessful quitters from the intervention group of a cluster randomised controlled trial (RCT) who participated in a workplace smoking cessation group training programme in which smoking abstinence was rewarded with financial incentives.

Results

Themes that emerged were the workplace setting, quitting with colleagues, motivation, family support, strategies and the financial incentives. The interviewees reported that the smoking cessation programme was appreciated in general, was convenient, lowered the threshold to sign up, stimulated peer support and competition and provided strategies to resist smoking. Personal motivation and a mind set to never smoke again were regarded as important factors for quit success. The financial incentives were not considered as a main motivator to quit smoking, which contradicts the results from the RCT. The financial incentives were considered as more attractive to smokers with a low income.

Conclusions

According to participants, contributors to quitting smoking were the workplace cessation programme, personal motivation and peer support, but not the incentives. More research is needed on the contradiction between the perceived effects of financial incentives on quit success and the actual difference in quit rates.

Trial registration number

NTR5657.
Premorbid risk factors influencing labour market attachment after mild traumatic brain injury: a national register study with long-term follow-up
Authors: Graff Heidi Jeannet , Siersma Volkert , Møller Anne , Kragstrup Jakob , Andersen Lars L , Egerod Ingrid , Malá Rytter Hana
Published: March 2023

Objectives

Some patients with mild traumatic brain injury (mTBI) experience persistent postconcussive symptoms, influencing the ability to work. This study assessed associations between mTBI and labour market attachment (up to 5 years postinjury) in patients with different premorbid characteristics.

Design and setting

Danish national cohort study with 5-year register follow-up.

Participants

We included hospital admitted patients between 18 and 60 years diagnosed with mTBI (International Classification of Diseases, version 10 diagnosis S06.0) (n=19 732). For each patient, one control was selected matched on age, gender and municipality (n=18 640).

Primary outcome measure

Primary outcome was ‘not attending ordinary work’, and premorbid risk factors were cohabitation status, education, ethnicity, gender, age and comorbidities.

Results

The odds of not attending ordinary work increased from 6 months to 5 years. The highest increased odds (approximately twice as high for patients) of not attending ordinary work at 5 years were found in the highest educational group (OR 2.15, 95% CI 1.78 to 2.59), for patients of non-Danish origin (OR 1.98, 95% CI 1.52 to 2.57), for patients between 30 and 39 years (OR 1.93, 95% CI 1.68 to 1.23) and for patients with somatic comorbidities (OR 1.81, 95% CI 1.38 to 2.37). Contrary to expectations, we did not find higher odds in patients with psychiatric diagnoses (OR 1.12, 95% CI 0.76 to 1.60).

Conclusions

Important premorbid characteristics for lower labour market participation after mTBI were higher education, non-Danish origin, age 30–39 years and having somatic comorbidities. Demographic and health-related variables should be considered when assessing patients with mTBI at risk of long-term sickness absence.

Trial registration number

NCT03214432; Results.
Prevalence of risk factors of non-communicable diseases in Kerala, India: results of a cross-sectional study
Authors: Sarma P S , Sadanandan Rajeev , Thulaseedharan Jissa Vinoda , Soman Biju , Srinivasan Kannan , Varma R P , Nair Manju R , Pradeepkumar A S , Jeemon Panniyammakal , Thankappan K R , Kutty Raman V
Published: March 2023

Objective

To estimate the prevalence of non-communicable disease (NCD) risk factors in Kerala.

Design

A community-based, cross-sectional survey.

Participants

In 2016–2017 a multistage, cluster sample of 12 012 (aged 18–69 years) participants from all 14 districts of Kerala were studied.

Main outcome measures

NCD risk factors as stipulated in the WHO’s approach to NCD risk factors surveillance were studied. Parameters that were studied included physical activity score, anthropometry, blood pressure (BP), and fasting blood glucose (FBG) and morning urine sample to estimate dietary intake of salt.

Results

The mean age was 42.5 years (SD=14.8). Abdominal obesity was higher in women (72.6%; 95% CI 70.7 to 74.5) compared with men (39.1%; 95% CI 36.6 to 41.7), and also higher among urban (67.4%; 95% CI 65.0 to 69.7) compared with rural (58.6%; 95% CI 56.6 to 60.5) residents. Current use of tobacco and alcohol in men was 20.3% (95% CI 18.6 to 22.1) and 28.9% (95% CI 26.5 to 31.4), respectively. The estimated daily salt intake was 6.7 g/day. The overall prevalence of raised BP was 30.4% (95% CI 29.1 to 31.7) and raised FBG was 19.2% (95% CI 18.1 to 20.3). Raised BP was higher in men (34.6%; 95% CI 32.6 to 36.7) compared with women (28%; 95% CI 26.4 to 29.4), but was not different between urban (33.1%; 95% CI 31.3 to 34.9) and rural (29.8%; 95% CI 28.3 to 31.3) residents. Only 12.4% of individuals with hypertension and 15.3% of individuals with diabetes were found to have these conditions under control. Only 13.8% of urban and 18.4% of rural residents did not have any of the seven NCD risk factors studied.

Conclusion

Majority of the participants had more than one NCD risk factor. There was no rural–urban difference in terms of raised BP or raised FBG prevalence in Kerala. The higher rates of NCD risk factors and lower rates of hypertension and diabetes control call for concerted primary and secondary prevention strategies to address the future burden of NCDs.
Socioeconomic and behavioural determinants of overweight/obesity among adults in Botswana: a cross-sectional study
Authors: Keetile Mpho , Navaneetham Kannan , Letamo Gobopamang , Bainame Kenabetsho , Rakgoasi Serai Daniel , Gabaitiri Lesego , Masupe Tiny , Molebatsi Robert
Published: March 2023

Objective

To undertake a comprehensive assessment of socioeconomic and behavioural determinants of overweight/obesity among adult population in Botswana.

Design

The study adopted a cross-sectional design by selecting adult respondents in 3 cities and towns, 15 urban villages and 15 rural areas across Botswana using a multistage probability sampling technique.

Setting

The study was conducted in selected rural and urban areas of Botswana.

Participants

The study sample consisted of 1178 adult males and females aged 15 years and above.

Primary outcome measures

Objectively measured overweight/obesity.

Results

Prevalence of overweight/obesity in the study population was estimated at 41%. The adjusted OR (AOR) of overweight/obesity were highest among women (AOR=2.74, 95% CI 1.92 to 3.90), in ages 55–64 years (AOR=5.53, 95% CI 2.62 to 11.6), among individuals with secondary (AOR=1.70, 95% CI 1.11 to 2.61) and tertiary education (AOR=1.99, 95% CI 1.16 to 3.38), smokers (AOR=2.16, 95% CI 1.22 to 3.83) and people with poor physically activity (AOR=1.46, 95% CI 1.03 to 3.24). These were statistically significant at 5% level.

Conclusion

Women, older adults, people with high education level, smokers and people who reported poor physical activity were found to have higher odds of being overweight/obesity. These findings suggest the need for broad based strategies encouraging physical activity among different socioeconomic groups.
Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
Authors: Elimian Kelly Osezele , Ochu Chinwe Lucia , Ebhodaghe Blessing , Myles Puja , Crawford Emily E , Igumbor Ehimario , Ukponu Winifred , Olayinka Adobola , Aruna Olusola , Dan-Nwafor Chioma , Olawepo Olatayo Ayodeji , Ogunbode Oladipo , Atteh Rhoda , Nwachukwu William , Venkatesan Sudhir , Obagha Chijioke , Ngishe Samuel , Suleiman Kabir , Usman Muhammad , Yusuff Hakeem Abiola , Nwadiuto Ifeoma , Mohammed Abbas Aliyu , Usman Rabi , Mba Nwando , Aderinola Olaolu , Ilori Elsie , Oladejo John , Abubakar Ibrahim , Ihekweazu Chikwe
Published: March 2023

Objective

Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria.

Design

Retrospective cohort study.

Setting

COVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control.

Participants

Individuals who were investigated for SARS-CoV-2 using real-time PCR testing during the study period 27 February–8 June 2020.

Methods

COVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs.

Results

A total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trend<0.0001), male sex (aOR 1.11, 95% CI 1.04 to 1.18) and the following presenting symptoms: cough (aOR 1.23, 95% CI 1.13 to 1.32), fever (aOR 1.45, 95% CI 1.45 to 1.71), loss of smell (aOR 7.78, 95% CI 5.19 to 11.66) and loss of taste (aOR 2.50, 95% CI 1.60 to 3.90). An increased risk of mortality following COVID-19 was observed in those aged ≥51 years, patients in farming occupation (aOR 7.56, 95% CI 1.70 to 33.53) and those presenting with cough (aOR 2.06, 95% CI 1.41 to 3.01), breathing difficulties (aOR 5.68, 95% CI 3.77 to 8.58) and vomiting (aOR 2.54, 95% CI 1.33 to 4.84).

Conclusion

The significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals.
Qualitative study exploring heterogeneity in caregiving experiences post-stroke in Singapore
Authors: Tyagi Shilpa , Luo Nan , Tan Chuen Seng , Tan Kelvin Bryan , Tan Boon Yeow , Menon Edward , Venketasubramanian N , Loh Wei Chin , Fan Shu Hui , Yang Kenneth Lam Thuan , Swee Ling Chan Audrey , Farwin Aysha , Lukman Zunairah Binti , Koh Gerald Choon-Huat
Published: March 2023

Objective

Stroke, a common illness in older adults, accounts for up to 4% of direct medical costs in developed nations. Informal caregiving contributing a significant proportion of economic burden post-stroke warrants a deeper understanding of the caregiving context to sustain caregiving arrangement. While literature exists describing differences in motivation and preferences of caregivers, limited literature explores differences in caregiving experiences of different types of caregivers (ie, spouse, adult-child, sibling or others). Addressing this gap, our study aimed to explore the caregiving experience of stroke survivors and their family caregivers across different caregiver identities in an Asian setting.

Design

Qualitative descriptive study.

Setting

Community setting.

Participants

We conducted semi-structured interviews with 26 stroke survivors and 35 caregivers purposively sampled from an outpatient rehabilitation setting, an outpatient clinic and a support organisation. Data were analysed using thematic analysis.

Outcome measures

Themes including caregiving experience of stroke survivors and their family caregivers across different caregiver identities.

Results

Following five themes were reported: caregiver reserve, coping strategies, caregiver burden, competing commitments and role of foreign domestic worker (FDW) in family caregiving. Spouse caregivers were less willing to ask for help, commonly adopted faith-based, and spacing or recharging types of coping, reported emotional strain and shared limited accounts of FDWs. Adult-child caregivers were more willing to ask for help, engaged in alternative care arrangements involving FDWs, commonly adopted action-focussed coping and reported multidimensional caregiver burden.

Conclusion

Our findings illustrated the heterogeneity in factors affecting caregiving experience across spouse and adult-child caregivers. Practical implications include conducting a needs assessment for caregiver-stroke survivor dyads and providing tailored support, training and information to help caregivers cope better.
‘A war of a different kind’: local municipalities’ experiences in managing the COVID-19 pandemic in Israel–a qualitative study
Authors: Nehushtan Hilla , Barel Hila , Donchin Milka , Bar-Zeev Yael
Published: March 2023

Objectives

In Israel, in 2020, 57/257 local municipalities were part of the Healthy Cities Network (HCN). HCN municipalities have a strong political commitment to health promotion and reducing health inequalities. This research aimed to (1) explore local municipalities’ management of the pandemic and (2) assess whether belonging to the HCN impacted this management.

Design, setting and participants

Fourteen municipalities were chosen—seven HCN municipalities, matched to seven non-HCN municipalities. In each municipality, semistructured telephone interviews were conducted with three to four officials. Interviews were recorded, transcribed and analysed using inductive thematic coding, both in general and specifically to compare HCN and non-HCN municipalities.

Results

Forty-two interviews were conducted, with five main themes: (1) relationship with the government; with the transference of information to the local municipalities found to be challenging and a strong need for more independence at the local level; (2) contact with residents which was divided into several actions, such as mapping the city population, supporting vulnerable populations and managing volunteers; (3) relationships within the municipality which included a sense of collaboration and community but also a feeling of wear out; (4) difference between the first lockdown compared with following lockdowns; within these themes, no significant differences were found between HCN municipalities and non-HCN municipalities and (5) the role of the Healthy City (HC) coordinator which was critical in several municipalities. They served as brokers, had a pre-existing intersectoral network and held a broader vision of health.

Conclusions

Local municipalities in Israel played an important role in the pandemic response. Municipalities requested a central information source and more independence at the local level. Challenges and responses were similar across municipalities and residents, regardless of their HCN status. However, in some municipalities, the role of the HC coordinator was crucial for the pandemic response due to pre-existing interprofessional and intersectoral networks.
High continuous positive airway pressures versus non-invasive positive pressure ventilation in preterm neonates: protocol for a multicentre pilot randomised controlled trial
Authors: Mukerji Amit , Rempel Emily , Thabane Lehana , Johnson Heather , Schmolzer Georg , Law Brenda Hiu Yan , Jani Pranav , Tracy Mark , Rottkamp Catherine , Keszler Martin , Kirpalani Haresh , Shah Prakesh S
Published: March 2023

Introduction

Low pressure nasal continuous positive airway pressure (nCPAP) has long been the mainstay of non-invasive respiratory support for preterm neonates, at a constant distending pressure of 5–8 cmH2O. When traditional nCPAP pressures are insufficient, other modes including nasal intermittent positive pressure ventilation (NIPPV) are used. In recent years, high nCPAP pressures (≥9 cmH2O) have also emerged as an alternative. However, the comparative benefits and risks of these modalities remain unknown.

Methods and analysis

In this multicentre pilot randomised controlled trial, infants <29 weeks’ gestational age (GA) who either: (A) fail treatment with traditional nCPAP or (B) being extubated from invasive mechanical ventilation with mean airway pressure ≥10 cmH2O, will be randomised to receive either high nCPAP (positive end-expiratory pressure 9–15 cmH2O) or NIPPV (target mean Paw 9–15 cmH2O). Primary outcome is feasibility of the conduct of a larger, definitive trial as assessed by rates of recruitment and protocol violations. The main secondary outcome is failure of assigned treatment within 7 days postrandomisation. Multiple other clinical outcomes including bronchopulmonary dysplasia will be ascertained. All randomised participants will be analysed using intention to treat. Baseline and demographic variables as well as outcomes will be summarised and compared using univariate analyses, and a p<0.05 will be considered significant.

Ethics and dissemination

The trial has been approved by the respective research ethics boards at each institution (McMaster Children’s Hospital: Hamilton integrated REB approval #2113; Royal Alexandra Hospital: Health Research Ethics Board approval ID Pro00090244; Westmead Hospital: Human Research Ethics Committee approval ID 2022/ETH01343). Written, informed consent will be obtained from all parents/guardians prior to study enrolment. The findings of this pilot study will be disseminated via presentations at national and international conferences and via publication in a peer-reviewed journal. Social media platforms including Twitter will also be used to generate awareness.

Trial registration number

NCT03512158.
Clarifying the clinical landscape of pediatric spinal arteriovenous shunts: an institutional experience and individual patient-data meta-analysis
Authors: Reynolds Conner D , Caton M Travis , Baker Amanda , Smith Eric R , Amans Matthew R , Cooke Daniel L , Dowd Christopher F , Higashida Randall T , Gupta Nalin , Abla Adib A , Auguste Kurtis , Fox Christine H , Fullerton Heather , Hetts Steven W
Published: March 2023

Background

Pediatric spinal arteriovenous shunts (SAVS) are rare lesions with heterogeneous pathogenesis and clinical manifestations.

Objective

To evaluate the clinical characteristics, angioarchitecture, and technical/clinical outcomes in SAVS through a large single-center cohort analysis and meta-analysis of individual patient data.

Methods

A retrospective institutional database identified children (aged 0–21 years) who underwent digital subtraction spinal angiography (DSA) for SAVS between January 1996 and July 2021. Clinical data were recorded to evaluate angioarchitecture, generate modified Aminoff-Logue gait disturbance scores (AL) and McCormick grades (MC), and assess outcomes. We then performed a systematic literature review following PRISMA-IPD (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for individual patient data) guidelines, extracting similar data on individual patients for meta-analysis.

Results

The cohort consisted of 28 children (M:F=11:17) with 32 SAVS lesions, with a mean age of 12.8±1.1 years at diagnosis. At presentation, SAVS were most highly concentrated in the cervical region (40.6%). Children had a median AL=2 and MC=2, with thoracolumbar AVS carrying the greatest disability. Among treated cases, complete obliteration was achieved in 48% of cases and median AL scores and MC grades both improved by one point. Systematic literature review identified 161 children (M:F=96:65) with 166 SAVS lesions with a mean age of 8.7±0.4 years. Among studies describing symptom chronicity, 37/51 (72.5%) of children presented acutely. At presentation, children had a median AL=4 and MC=3, with thoracolumbar AVS carrying the highest MC grades. After intervention, median AL and MC both improved by one point.

Conclusions

This study provides epidemiologic information on the location, onset, and presentation of the full spectrum of pediatric SAVS, highlighting the role of targeted treatment of high-risk features.
Effects of exergaming on the microcirculation of adolescents with overweight or obesity—a clinical trial efficacy
Authors: Ramos Thacira Dantas Almeida , Medeiros Carla Campos Muniz , Figueiroa José Natal , de Carvalho Danielle Franklin , Gusmão Tatianne Moura Estrela , Alves João Guilherme Bezerra
Published: March 2023

To assess the effect of exergaming on the microcirculation function of adolescents with overweight or obesity, this non-randomized clinical trial efficacy was conducted with 61 adolescents aged between 10 and 16 years. The intervention group ( n = 31) performed exergaming three times per week for 8 weeks. Both groups received guidelines for a healthy diet and staying physically active. Microcirculation was assessed using a laser Doppler flowmetry (LDF) at baseline and after intervention. Primary outcomes derived from LDF assessment included resting flow, maximum flow, maximum/resting flow ratio, area under hyperemia, and post-occlusive reactive hyperemia (PORH). Secondary outcomes were body mass index and systemic blood pressure. Unpaired Student's t test compared intergroup analyses, and paired Student's t test compared intragroup analyses. The significance was set at 5%. Statistical analysis intergroup and intragroup was done by fitting a two-way mixed effects model. Microcirculation was similar between groups. Maximum flow (109.0 ± 38.3 versus 124.6 ± 43.0, P = 0.022), area under hyperemia (1614 ± 472 versus. 1755 ± 461, P = 0.023), and PORH (2.18 ± 0.49 versus 2.01 ± 0.52, P = 0.031) were statistically different after intervention. Body mass index decreased in intervention (24.5 ± 3.8–24.1 ± 4.0 kg/m2, P = 0.002) and control (25.2 ± 3.2–25.1 ± 3.3 kg/m2, P = 0.031) groups. Systolic blood pressure decreased significantly in the intervention group (110 ± 10–106 ± 9 mm Hg; P = 0.041) but not diastolic blood pressure (66.0 ± 7–68.8 ± 8 mm Hg; P = 0.089). Exergaming for 8 weeks led to improvements in the microcirculation function in adolescents with overweighed or obesity. Clinical trials: NTC03532659.
Aspects of the map from exact RG to holographic RG in AdS and dS
Authors: Dharanipragada Pavan , Dutta Semanti , Sathiapalan B.
Published: March 2023

In earlier work, the evolution operator for the exact RG equation was mapped to a field theory in Euclidean AdS. This gives a simple way of understanding AdS/CFT. We explore aspects of this map by studying a simple example of a Schrödinger equation for a free particle with time-dependent mass. This is an analytic continuation of an ERG like equation. We show for instance that it can be mapped to a harmonic oscillator. We show that the same techniques can lead to an understanding of dS/CFT too.
MULTIFRACTAL ANALYSIS OF SOLAR RADIATION IN THE NORTHEASTERN REGION OF BRAZIL
Authors: DOS SANTOS FÁBIO SANDRO , DO NASCIMENTO KEROLLY KEDMA FELIX , JALE JADER SILVA , XAVIER JÚNIOR SÍLVIO FERNANDO ALVES , FERREIRA TIAGO A. E.
Published: March 2023

In this work, we used hourly data of high frequency of solar radiation from the entire Northeast region of Brazil. We used the Multifractal Detrended Fluctuation Analysis (MFDFA) method to analyze the characteristics of the solar radiation series in 137 meteorological stations from 2010 to 2022. For all analyzed series, the parameter [Formula: see text] characterizes persistent series. The values of [Formula: see text] reveal asymmetry to the right, indicating that large fluctuations contributed to the multifractality process. The states of Maranhão and Bahia presented the highest values of spectrum width [Formula: see text], indicating greater complexity. We found that long-range correlations are the leading cause of multifractality observed in the dynamics of the series of solar radiation anomalies.
Insulin-induced vasoconstriction is prevalent in muscle microvasculature of otherwise healthy persons with type 1 diabetes
Authors: Jahn Linda A. , Hartline Lee M. , Kleiner Amanda J. , Horton William B. , Hasan Farhad , Wai Kit Tan Alvin , Liu Zhenqi , Barrett Eugene J.
Published: March 2023

Using contrast ultrasound and measures of vascular stiffness, we compared vascular and metabolic responses to insulin in patients with type 1 diabetes with age-matched controls. The patients with type 1 diabetes demonstrated both vascular and metabolic insulin resistance with more than half of the patients with diabetes having a paradoxical vasoconstrictive vascular response to insulin.
Research on Asphalt Pavement Disease Detection Based on Improved YOLOv5s
Authors: Wu Lingxiao , Duan Zhugeng , Liang Chenghao
Published: March 2023

Pavement disease detection and classification is one of the key problems in computer vision and intelligent analysis. This is an automated target detection technology with great development potential, which can improve the detection efficiency of road management departments. The research based on the convolutional neural network is aimed at realizing asphalt pavement disease detection based on low resolution, occlusive interference, and complex environment. Considering the powerful function of the convolutional neural network and its successful application in object detection, we apply it to asphalt pavement disease detection, and the detection results are used for subsequent analysis and decision‐making. At present, most of the research on pavement disease detection focuses on crack detection, and the detection of multiclass diseases is less, and its detection accuracy and speed need to be improved, which does not meet the actual engineering application. Therefore, a rapid asphalt pavement disease detection method based on improved YOLOv5s was proposed. The complex scene data enhancement technique was developed, which is used to enhance and extend the original data to improve the robustness of the model. The improved lightweight attention module SCBAM was integrated into the backbone network, which can enhance the feature extraction ability and improve the detection performance of the model for small targets. The spatial pyramid pooling was improved into SPPF to fuse the input features, which can solve the multiscale problem of the target and improve the reasoning efficiency of the model to a certain extent. The experimental results showed that, after the model is improved, the average accuracy of pavement disease reaches 94.0%. Compared with YOLOv5s, the precision of the improved YOLOv5‐pavement is increased by 3.1%, the recall rate is increased by 4.4%, the F1 score is increased by 3.7%, and the mAP is increased by 3.8%. For transverse cracks, longitudinal cracks, mesh cracks, potholes, and repaired pavement, the detection accuracy of pavement disease detection method based on YOLOv5‐pavement is improved by 3.4%, 3.1%, 4.0%, 7.5%, and 4.8%, respectively, compared with that based on YOLOv5s. The proposed method provides support for the detection work of pavement diseases.