bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence, clinical features, and outcomes of COVID-19 in persons with cystic fibrosis: a systematic review protocol
Authors: Antony Sherly , Vargese Saritha Susan , Idikula Mercy John , Cherian Carol Sara , Mathew Elsheba , Green Heidi , Fernandez Ritin
Published: August 2022

Objective:

The objective of this review is to determine the incidence and prevalence, clinical features, and outcomes of COVID-19 in persons with cystic fibrosis.

Introduction:

Cystic fibrosis, predominantly a chronic respiratory illness, has long been known to be fatal with concomitant bacterial or viral infections. However, the effects of COVID-19 on this protracted disease need to be understood, especially since the major manifestations affect the respiratory system. Hence, the burden, clinical features, and outcomes of COVID-19 on individuals with cystic fibrosis need to be understood.

Inclusion criteria:

This review will consider studies on persons in all age groups with preexisting cystic fibrosis who are diagnosed with COVID-19 using either a polymerase chain reaction, serology, or point-of-care test for SARS-CoV-2.

Methods:

JBI methodology for systematic reviews of prevalence and incidence will be used for this review. A methodical search for eligible studies in English (as well as available translations) in MEDLINE, Embase, Scopus, and CINAHL, and unpublished literature in Google Scholar, Dissertation Abstracts International, ProQuest Dissertations and Theses, and MedNar will be conducted from the year 2020 onwards. Studies meeting the inclusion criteria will be selected for appraisal and their methodological quality will be assessed by two independent reviewers based on study titles and abstracts, followed by full-text review focusing on sampling and statistical analysis. Data extraction will be accomplished using a standardized tool. If adequate synthesized data are obtained, a meta-analysis will be conducted; otherwise, the findings will be presented in a narrative format, including tables and figures to aid in data presentation where appropriate.

Systematic review registration number:

PROSPERO CRD42021237792
Body Image Software Programs
Authors: Pinhatti Marcelle Matiazo , Guerin Karina Silva do Amaral , De Castro Thiago Gomes
Published: August 2022

The assessment of body image has evolved in recent decades through the development of various software programs. However, it is not yet known whether this technological advance has resulted in refined evidence or whether this assessment development has been extensively applied in the field. This study reviewed the body image software programs developed and applied from 2000 to 2020. Searches were systematically conducted in four scientific databases. A total of 35 articles were selected, and 13 body image software programs were identified. The main features comprising the variability of the software were the pattern of body stimuli presentation (avatars x real body x body drawings) and the procedures of body image manipulation (whole body adjustment x adjustment of separate body parts). Heterogeneity was prevalent among the studies reviewed and prevented a favorable conclusion regarding the use of software compared to other body image assessment strategies.
Development of a Novel Welding Technique With Reduced Heat-Input by Employing Double-Pulsed Gas Metal Arc Welding for Aerospace Grade 18% Ni Maraging Steel
Authors: Jose Bibin , Manikandan M. , Arivazhagan N. , Muktinutalapati Nageswara Rao , Madhusudhan Reddy G.
Published: August 2022

Eighteen percent Ni maraging steels are high performance Fe–Ni martensite-based alloys with ultra-high strength and good toughness. They find applications in strategic sectors, joining of thick sections often coming into picture. Welding of thick section involves a longer processing time, more passes, and a higher heat-input. Double-pulsed gas metal arc welding (DP-GMAW) is an emerging welding technique, well suited for joining thick sections. DP-GMAW is capable of controlling the solidification parameters, weld pool geometry, and cooling rate at a reduced heat-input. The major concern regarding the welding of maraging steel is the formation of the reverted austenite (RA) phase in the fusion zone (FZ). The formation of RA deteriorates the mechanical performance of welded joints. The presence of RA can be supressed by the usage of suitable welding techniques and proper post-weld heat treatments (PWHTs). DP-GMAW process was employed to carry out the welding; studies on the joints produced are reported in this research paper. The studies also included the effect of various PWHTs on the metallurgical and mechanical properties of the maraging steel weldments. The research used three distinct PWHTs: direct aging (DA), solutionizing + aging (SA), and homogenizing + solutionizing + aging (HSA). The FZ microstructures under DA and SA conditions show that there is RA at the cell boundaries. However, there was no evidence of RA in FZ following HSA. The energy dispersive spectra (EDS) analysis of the as-welded FZ showed segregation along the grain boundaries (GBs). This led to the premature formation of RA upon subsequent aging. The SA treatments proved inadequate to totally eliminate RA in the microstructure. On the other hand, the HSA treatments were effective in evening out concentration differences and preventing formation of RA. This study demonstrates that DP-GMAW combined with HSA treatment has the best mechanical properties.
A Novel Design of a Multi-Fingered Bionic Hand With Variable Stiffness for Robotic Grasp
Authors: Zang Xizhe , Wang Chao , Zhang Pu , Liu Gangfeng , Zhang Xuehe , Zhao Jie
Published: August 2022

The robotic hand plays an extremely significant role in completing various robotic tasks, especially for a robot to complete different grasping tasks. In this paper, we propose a novel multi-fingered bionic hand with variable stiffness for robotic grasp. First, based on the analysis of the human hand, we design the modular finger with variable stiffness mechanism and the flexible thumb with dual-link independent mechanism. Second, the multi-fingered bionic hand composed of three modular fingers and one flexible thumb is presented, which possesses 14 degrees-of-freedom (DoFs). Then, the parameters of the designed hand are analyzed to obtain the stiffness characteristics and working space. Furthermore, the grasping control method based on position control and force control is proposed for robotic grasp. Finally, a series of experiments are designed to verify the effectiveness of the designed hand and the proposed method. The experimental results show that (1) the designed variable stiffness mechanism can be used to adjust the stiffness of hand fingers, (2) the proposed method can effectively control the grasping force under different stiffness conditions, and (3) the designed hand can successfully grasp different types of objects by various grasping strategies.
Evaluation on Redundancy-Induced Rigidity Enhancement of a Parallel Manipulator
Authors: Fang Han-liang , Tang Teng-fei , He Zhen , Zhang Jun
Published: August 2022

Redundantly actuated parallel manipulator (RAPM) has been proved to have comparative advantages of higher rigidity and higher payload over other parallel manipulators. This paper is to quantitatively reveal the effect of redundancy on rigidity enhancement of a previously invented 2UPR&1RPS&1RPU RAPM. For this purpose, three critical issues are clarified, i.e., establishing a sufficient accurate stiffness model, constructing a reasonable index frame for evaluating rigidity performance, and quantifying the effect of redundancy on the rigidity enhancement. First, drawing on the screw theory, a hierarchical method is presented to establish a semi-analytic stiffness model at the joint level for the proposed RAPM. Subsequently, based on the stiffness matrix, a set of local and global stiffness indices are constructed to evaluate the rigidity of parallel manipulators. Finally, the stiffness indices of the 2UPR&1RPS&1RPU RAPM and its non-redundantly actuated forms are predicted and compared to reveal the effort of redundancy. The present work is expected to provide a useful frame for quantitatively assessing redundancy-induced rigidity enhancement in redundantly actuated parallel manipulators.
Experimental Investigation of the Humidification Parameters in a Vertically Aligned Triple Pad Multistage Evaporative Cooler
Authors: Salins Sampath Suranjan , Kumar Shiva , Kota Reddy S.V. , Ajith Krishna
Published: August 2022

The present work involves designing and fabricating the three-stage humidifier test rig where three Celdek 7090 packings are arranged vertically at equidistance, forming a multistage humidifier. Water flowrate and airflow rates are regulated to obtain required humidification under both single-pad and three-pad configurations. Output variables like the coefficient of performance, evaporation rate, cooling effect, cooling efficiency, and pressure drop are determined. Results indicated that three-stage packing gave high performance compared to the single stage. Changes in temperature, change in humidity, saturation efficiency, and coefficient of performance values are 6.5 °C, 44%, 80%, and 2.1, respectively, are the maximum values noticed for the multistage humidifier. The study indicated that with the increase in the rate of water flow, there is a rise in performance parameters till a water flowrate of 0.6 l per minute, and after this value, performance deteriorates. Even though multistage performs better than a single stage, as the number of stages increases, the stage-wise performance declines.
The Nadir Crater offshore West Africa: A candidate Cretaceous-Paleogene impact structure
Authors: Nicholson Uisdean , Bray Veronica J. , Gulick Sean P. S. , Aduomahor Benedict
Published: August 2022

Evidence of marine target impacts, binary impact craters, or impact clusters are rare on Earth. Seismic reflection data from the Guinea Plateau, West Africa, reveal a ≥8.5-km-wide structure buried below ~300 to 400 m of Paleogene sediment with characteristics consistent with a complex impact crater. These include an elevated rim above a terraced crater floor, a pronounced central uplift, and extensive subsurface deformation. Numerical simulations of crater formation indicate a marine target (~800-m water depth) impact of a ≥400-m asteroid, resulting in a train of large tsunami waves and the potential release of substantial quantities of greenhouse gases from shallow buried black shale deposits. Our stratigraphic framework suggests that the crater formed at or near the Cretaceous-Paleogene boundary (~66 million years ago), approximately the same age as the Chicxulub impact crater. We hypothesize that this formed as part of a closely timed impact cluster or by breakup of a common parent asteroid.
The evolving role of tissue-resident memory T cells in infections and cancer
Authors: Yenyuwadee Sasitorn , Sanchez-Trincado Lopez Jose Luis , Shah Rushil , Rosato Pamela C. , Boussiotis Vassiliki A.
Published: August 2022

Resident memory T cells (T
RM
) form a distinct type of T memory cells that stably resides in tissues. T
RM
form an integral part of the immune sensing network and have the ability to control local immune homeostasis and participate in immune responses mediated by pathogens, cancer, and possibly autoantigens during autoimmunity. T
RM
express residence gene signatures, functional properties of both memory and effector cells, and remarkable plasticity. T
RM
have a well-established role in pathogen immunity, whereas their role in antitumor immune responses and immunotherapy is currently evolving. As T
RM
form the most abundant T memory cell population in nonlymphoid tissues, they are attractive targets for therapeutic exploitation. Here, we provide a concise review of the development and physiological role of CD8
+
T
RM
, their involvement in diseases, and their potential therapeutic exploitation.
De novo variants in genes regulating stress granule assembly associate with neurodevelopmental disorders
Authors: Jia Xiangbin , Zhang Shujie , Tan Senwei , Du Bing , He Mei , Qin Haisong , Chen Jia , Duan Xinyu , Luo Jingsi , Chen Fei , Ouyang Luping , Wang Jian , Chen Guodong , Yu Bin , Zhang Ge , Zhang Zimin , Lyu Yongqing , Huang Yi , Jiao Jian , Chen Jin Yun (Helen) , Swoboda Kathryn J. , Agolini Emanuele , Novelli Antonio , Leoni Chiara , Zampino Giuseppe , Cappuccio Gerarda , Brunetti-Pierri Nicola , Gerard Benedicte , Ginglinger Emmanuelle , Richer Julie , McMillan Hugh , White-Brown Alexandre , Hoekzema Kendra , Bernier Raphael A. , Kurtz-Nelson Evangeline C. , Earl Rachel K. , Meddens Claartje , Alders Marielle , Fuchs Meredith , Caumes Roseline , Brunelle Perrine , Smol Thomas , Kuehl Ryan , Day-Salvatore Debra-Lynn , Monaghan Kristin G. , Morrow Michelle M. , Eichler Evan E. , Hu Zhengmao , Yuan Ling , Tan Jieqiong , Xia Kun , Shen Yiping , Guo Hui
Published: August 2022

Stress granules (SGs) are cytoplasmic assemblies in response to a variety of stressors. We report a new neurodevelopmental disorder (NDD) with common features of language problems, intellectual disability, and behavioral issues caused by de novo likely gene-disruptive variants in
UBAP2L
, which encodes an essential regulator of SG assembly.
Ubap2l
haploinsufficiency in mouse led to social and cognitive impairments accompanied by disrupted neurogenesis and reduced SG formation during early brain development. On the basis of data from 40,853 individuals with NDDs, we report a nominally significant excess of de novo variants within 29 genes that are not implicated in NDDs, including 3 essential genes (
G3BP1
,
G3BP2
, and
UBAP2L
) in the core SG interaction network. We validated that NDD-related de novo variants in newly implicated and known NDD genes, such as
CAPRIN1
, disrupt the interaction of the core SG network and interfere with SG formation. Together, our findings suggest the common SG pathology in NDDs.
An epidermal electronic system for physiological information acquisition, processing, and storage with an integrated flash memory array
Authors: Xiang Li , Wang Yuru , Xia Fan , Liu Fang , He Daliang , Long Guanhua , Zeng Xiangwen , Liang Xuelei , Jin Chuanhong , Wang Yuwei , Pan Anlian , Peng Lian-Mao , Hu Youfan
Published: August 2022

Epidermal electronic systems that simultaneously provide physiological information acquisition, processing, and storage are in high demand for health care/clinical applications. However, these system-level demonstrations using flexible devices are still challenging because of obstacles in device performance, functional module construction, or integration scale. Here, on the basis of carbon nanotubes, we present an epidermal system that incorporates flexible sensors, sensor interface circuits, and an integrated flash memory array to collect physiological information from the human body surface; amplify weak biosignals by high-performance differential amplifiers (voltage gain of 27 decibels, common-mode rejection ratio of >43 decibels, and gain bandwidth product of >22 kilohertz); and store the processed information in the memory array with performance on par with industrial standards (retention time of 10
8
seconds, program/erase voltages of ±2 volts, and endurance of 10
6
cycles). The results shed light on the great application potential of epidermal electronic systems in personalized diagnostic and physiological monitoring.
Cognition contra camouflage: How the brain mediates predator-driven crypsis evolution
Authors: Liao Wen Bo , Jiang Ying , Li Da Yong , Jin Long , Zhong Mao Jun , Qi Yin , Lüpold Stefan , Kotrschal Alexander
Published: August 2022

While crypsis is a prominent antipredator adaptation, the role of the brain in predator-driven evolution remains controversial. Resolving this controversy requires contextualizing the brain with established antipredator traits and predation pressure. We hypothesize that the reduced predation risk through crypsis relaxes predation-driven selection on the brain and provide comparative evidence across 102 Chinese frog species for our hypothesis. Specifically, our phylogenetic path analysis reveals an indirect relationship between predation risk and crypsis that is mediated by brain size. This result suggests that at a low predation risk, frogs can afford to be conspicuous and use their large brain for cognitive predator evasion. This strategy may become less efficient or energetically costlier under higher predation pressure, favoring smaller brains and instead increasing crypsis.
The developmental impacts of natural selection on human pelvic morphology
Authors: Young Mariel , Richard Daniel , Grabowski Mark , Auerbach Benjamin M. , de Bakker Bernadette S. , Hagoort Jaco , Muthuirulan Pushpanathan , Kharkar Vismaya , Kurki Helen K. , Betti Lia , Birkenstock Lyena , Lewton Kristi L. , Capellini Terence D.
Published: August 2022

Evolutionary responses to selection for bipedalism and childbirth have shaped the human pelvis, a structure that differs substantially from that in apes. Morphology related to these factors is present by birth, yet the developmental-genetic mechanisms governing pelvic shape remain largely unknown. Here, we pinpoint and characterize a key gestational window when human-specific pelvic morphology becomes recognizable, as the ilium and the entire pelvis acquire traits essential for human walking and birth. We next use functional genomics to molecularly characterize chondrocytes from different pelvic subelements during this window to reveal their developmental-genetic architectures. We then find notable evidence of ancient selection and genetic constraint on regulatory sequences involved in ilium expansion and growth, findings complemented by our phenotypic analyses showing that variation in iliac traits is reduced in humans compared to African apes. Our datasets provide important resources for musculoskeletal biology and begin to elucidate developmental mechanisms that shape human-specific morphology.
Stratifying the autistic phenotype using electrophysiological indices of social perception
Authors: Mason Luke , Moessnang Carolin , Chatham Christopher , Ham Lindsay , Tillmann Julian , Dumas Guillaume , Ellis Claire , Leblond Claire S. , Cliquet Freddy , Bourgeron Thomas , Beckmann Christian , Charman Tony , Oakley Beth , Banaschewski Tobias , Meyer-Lindenberg Andreas , Baron-Cohen Simon , Bölte Sven , Buitelaar Jan K. , Durston Sarah , Loth Eva , Oranje Bob , Persico Antonio , Dell’Acqua Flavio , Ecker Christine , Johnson Mark H. , Murphy Declan , Jones Emily J. H.
Published: August 2022

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication, but also great heterogeneity. To offer individualized medicine approaches, we need to better target interventions by stratifying autistic people into subgroups with different biological profiles and/or prognoses. We sought to validate neural responses to faces as a potential stratification factor in ASD by measuring neural (electroencephalography) responses to faces (critical in social interaction) in
N
= 436 children and adults with and without ASD. The speed of early-stage face processing (N170 latency) was on average slower in ASD than in age-matched controls. In addition, N170 latency was associated with responses to faces in the fusiform gyrus, measured with functional magnetic resonance imaging, and polygenic scores for ASD. Within the ASD group, N170 latency predicted change in adaptive socialization skills over an 18-month follow-up period; data-driven clustering identified a subgroup with slower brain responses and poor social prognosis. Use of a distributional data-driven cutoff was associated with predicted improvements of power in simulated clinical trials targeting social functioning. Together, the data provide converging evidence for the utility of the N170 as a stratification factor to identify biologically and prognostically defined subgroups in ASD.
Transcriptome of Epibiont Saccharibacteria
Nanosynbacter lyticus
Strain TM7x During the Establishment of Symbiosis
Authors: Hendrickson Erik L. , Bor Batbileg , Kerns Kristopher A. , Lamont Eleanor I. , Chang Yunjie , Liu Jun , Cen Lujia , Schulte Fabian , Hardt Markus , Shi Wenyuan , He Xuesong , McLean Jeffrey S.
Published: August 2022

Nanosynbacter lyticus
type strain TM7x is the first cultivated member of the Saccharibacteria and the candidate phyla radiation (CPR). It was discovered to be ultrasmall in cell size with a highly reduced genome that establishes an obligate epibiotic relationship with its host bacterium.
Characterization of Macrophage-Tropic HIV-1 Infection of Central Nervous System Cells and the Influence of Inflammation
Authors: Woodburn Blaide M. , Kanchi Krishna , Zhou Shuntai , Colaianni Nicholas , Joseph Sarah B. , Swanstrom Ronald
Published: August 2022

The major feature of HIV-1 pathogenesis is the induction of an immunodeficient state in the face of an enhanced state of inflammation. However, for many of those infected, there can be an impact on the central nervous system (CNS) resulting in a wide range of neurocognitive defects.
Histone Acetyltransferase CfGcn5-Mediated Autophagy Governs the Pathogenicity of
Colletotrichum fructicola
Authors: Zhang Shengpei , Guo Yuan , Li Sizheng , Li He
Published: August 2022

Colletotrichum
spp. is ranked in the top 10 plant fungal pathogens and serves as a model for the study of hemibiotrophic pathogens, but its molecular mechanisms of pathogenesis remain largely unknown. Among species of
Colletotrichum
,
C. fructicola
causes anthracnose disease on more than 50 plants, such as pears, apples, and the important, edible-oil plant
Camellia oleifera
.
Supplemental Material: Across-strike asymmetry of the Andes orogen linked to the age and geometry of the Nazca plate
Authors: Val Pedro , Willenbring Jane
Published: August 2022

Datasets, regression data, and descriptions of minor corrections to the datasets, and a detailed description of the statistical methods. 
Superradiant Phase Transition in Microstructures with a Complex Network Architecture
Authors: Bazhenov A. Yu. , Nikitina M. M. , Alodjants A. P.
Published: August 2022

A new concept of topological organization of microstructures that maintain the ultrastrong coupling of two-level systems to a photon field and have the topology of a network (graph) with a power-law node degree distribution has been proposed. A phase transition to the superradiant state, which leads to the formation of two dispersion branches of polaritons and is accompanied by the appearance of a nonzero macroscopic polarization of two-level systems, has been studied within the mean field theory. It has been found that the specific behavior of such a system depends on the statistical characteristics of the network structure, more precisely, on the normalized second moment $$\zeta \equiv \langle {{k}^{2}}\rangle {\text{/}}\langle k\rangle $$ of the distribution of node degrees. It has been shown that the Rabi frequency can be significantly increased in the anomalous regime of the network structure, where ζ increases significantly. The multimode (waveguide) structure of the interaction between matter and field in this regime can establish a ultrastrong coupling, which is primarily responsible for the high-temperature phase transition.
On the Possibility of the Effective Isotope-Selective Infrared Dissociation of 235UF6 Molecules Vibrationally Excited by Bichromatic Laser Radiation
Authors: Makarov G. N.
Published: August 2022

Using the spectroscopic data on the235UF6and238UF6molecules and on the lasing frequencies of CF4and para-H2lasers and recent results, a method has been proposed to increase the efficiency of the isotope-selective infrared laser dissociation of235UF6molecules under nonequilibrium thermodynamic shock conditions. The method involves two processes: (i) the resonant multiphoton excitation of235UF6molecules to the 3ν3or 2ν3vibrational states by the bichromatic infrared radiation of two CF4or para-H2lasers and (ii) the irradiation of235UF6molecules with SF6molecules serving as sensitizers resonantly absorbing the radiation of these lasers. The essence of the method has been described. Schemes and parameters for isotope-selective dissociation of235UF6molecules using this method has been presented.
‘Infolded’ LASIK flap: an unusual variant of early postoperative flap dislocation
Authors: Peraka Raghav Preetam , Murthy Somasheila I , Akkulugari Vidhyadhar , Rathi Varsha M
Published: August 2022

Flap displacement is a rare but vision-threatening complication of laser-assisted in situ keratomileusis (LASIK). A young male patient underwent uneventful microkeratome-assisted LASIK. One-week postoperatively, flap displacement was noted in his right eye with its lower edge folded inwards, macrostria at the superior edge and the epithelium covering the bare stroma and into the interface. Anterior segment optical coherence tomography (AS-OCT) delineated the morphology of the displaced flap and the extent of epithelial ingrowth. The flap was repositioned by unrolling the fold and all the exposed surfaces were debrided to remove the epithelial ingrowth. Two months later, his corrected distance visual acuity improved to 20/30, and a smooth surface could be achieved. Infolded LASIK flap is a rare complication, which requires timely surgical intervention to achieve successful anatomical and functional outcomes. AS-OCT can be pivotal in determining the extent of infolding as well to delineate the extent of epithelial ingrowth within the interface.
Missed opportunities in the treatment of Turner syndrome: a case discussion and review of the guidelines
Authors: Howarth Sophie , Quinton Richard
Published: August 2022

A woman in her 50s with Turner syndrome was referred to the endocrine clinic, having been unaware of her diagnosis until she received a shielding letter from the UK government during the COVID-19 pandemic. Despite a neonatal diagnosis of Turner syndrome on her general practitioner record and despite having undergone laparoscopic examination for absent puberty and primary amenorrhoea aged 18 years, she had not received any prior hormone treatment or cardiovascular screening.

Though Turner syndrome is rare, recent data from the UK Biobank suggest that it may be underdiagnosed. Clinicians should be aware of the clinical features and associated complications of Turner syndrome to avoid delayed diagnosis and missed opportunities for treatment.

In this report, we discuss the clinical features of this rare syndrome and current guidelines for screening and treatment. We stress the importance of peer-to-peer support and information sharing through patient-led groups, such as the Turner Syndrome Support Society.
The 12-Item Hypoglycemia Impact Profile (HIP12): psychometric validation of a brief measure of the impact of hypoglycemia on quality of life among adults with type 1 or type 2 diabetes
Authors: Broadley Melanie , Chatwin Hannah , Søholm Uffe , Amiel Stephanie A , Carlton Jill , De Galan Bastiaan E , Hendrieckx Christel , McCrimmon Rory J , Skovlund Søren E , Pouwer Frans , Speight Jane
Published: August 2022

Introduction

The aim of this study was to determine the psychometric properties of the 12-Item Hypoglycemia Impact Profile (HIP12), a brief measure of the impact of hypoglycemia on quality of life (QoL) among adults with type 1 (T1D) or type 2 diabetes (T2D).

Research design and methods

Adults with T1D (n=1071) or T2D (n=194) participating in the multicountry, online study, ‘Your SAY: Hypoglycemia’, completed the HIP12. Psychometric analyses were undertaken to determine acceptability, structural validity, internal consistency, convergent/divergent validity, and known-groups validity.

Results

Most (98%) participants completed all items on the HIP12. The expected one-factor solution was supported for T1D, T2D, native English speaker, and non-native English speaker groups. Internal consistency was high across all groups (ω=0.91–0.93). Convergent and divergent validity were satisfactory. Known-groups validity was demonstrated for both diabetes types, by frequency of severe hypoglycemia (0 vs ≥1 episode in the past 12 months) and self-treated episodes (<2 vs 2–4 vs ≥5 per week). The measure also discriminated by awareness of hypoglycemia in those with T1D.

Conclusions

The HIP12 is an acceptable, internally consistent, and valid tool for assessing the impact of hypoglycemia on QoL among adults with T1D. The findings in the relatively small sample with T2D are encouraging and warrant replication in a larger sample.
Determinants of physical activity among 6856 individuals with diabetes: a nationwide cross-sectional study
Authors: Mortensen Sofie Rath , Kristensen Peter Lund , Grøntved Anders , Ried-Larsen Mathias , Lau Cathrine , Skou Søren T
Published: August 2022

Introduction

The aims of this cross-sectional study were to (1) describe habitual physical activity and adherence to WHO recommendations, and (2) investigate the association of comorbidity, obesity, stress, and health-related quality of life (HRQoL) with moderate to vigorous physical activity (MVPA) among individuals with diabetes.

Research design and methods

This study included 6856 participants with diabetes from the Danish National Health Survey from 2017. The primary outcome measure was weekly MVPA. Exposures included self-reported number of conditions, body mass index (BMI), perceived stress, and HRQoL. Mean difference in MVPA across exposures was estimated by multiple linear regression analyses.

Results

Forty per cent of individuals with diabetes were not adherent to WHO recommendations for physical activity. Individuals with diabetes had higher BMI, more comorbidities, higher perceived stress, and lower HRQoL. Individuals with three or more comorbidities were significantly associated with lower weekly MVPA (−0.48 hours/week, 95% CI −0.88 to −0.07) compared with individuals with no comorbidity. Furthermore, overweight or obese (class I–III) individuals engaged in significantly less weekly MVPA (obese class III vs normal weight: −1.98 hours/week, 95% CI −2.49 to −1.47). Higher perceived stress was significantly associated with lower weekly MVPA (−1.76 hours/week, 95% CI −2.18 to −1.34) versus low perceived stress. Finally, having low physical and mental HRQoL was associated with lower weekly MVPA (−0.93 hours/week, 95% CI −1.19 to −0.66 and −0.39 hours/week, 95% CI −0.71 to −0.08 respectively vs moderate or high HRQoL).

Conclusions

We found that 40% of individuals with diabetes do not engage regularly in adequate physical activity. Comorbidities, higher BMI, higher perceived stress, and lower HRQoL were associated with less engagement in physical activity. This study suggests that subgroups of individuals with diabetes are at higher risk of physical inactivity.
Reducing daily salt intake in China by 1 g could prevent almost 9 million cardiovascular events by 2030: a modelling study
Authors: Tan Monique , He Feng , Morris Joan K , MacGregor Graham
Published: August 2022

Introduction

In China, salt intake is among the highest in the world (~11 g/day) and cardiovascular disease (CVD) accounts for 40% of deaths. We estimated the potential impact of reducing salt intake on CVD events in China, via systolic blood pressure (SBP).

Methods

To develop our model, we extracted the effect of salt reduction on SBP from a meta-regression of randomised trials and a population study, and that of SBP on CVD risk from pooled cohort studies.

Results

Reducing population salt intake in China by 1 g/day could lower the risk for ischaemic heart disease by about 4% (95% uncertainty interval 1.8%–7.7%) and the risk for stroke by about 6% (2.4%–9.3%). Should this reduced salt level be sustained until 2030,~9 million (M) (7M–10.8M) CVD events could be prevented, of which ~4M (3.1M–4.9M) would have been fatal. Greater and gradual salt intake reductions, to achieve WHO’s target of 30% reduction by 2025 or the Chinese government’s target of ≤5 g/day by 2030, could prevent ~1.5 or 2 times more CVD events and deaths, respectively. Should the prolonged effect of salt reduction over several years be accounted for, all estimates of CVD events and deaths prevented would be 25% greater on average.

Conclusion

Bringing down the high salt intake levels in China could result in large reductions in CVD. An easily achievable reduction of 1 g/day could prevent ~9M CVD events by 2030. Urgent action must be taken to reduce salt intake in China.
Effect of voluntary Health Star Rating labels on healthier food purchasing in New Zealand: longitudinal evidence using representative household purchase data
Authors: Bablani Laxman , Ni Mhurchu Cliona , Neal Bruce , Skeels Christopher L , Staub Kevin E , Blakely Tony
Published: August 2022

Front-of-pack labelling (FoPL) aims to promote healthier diets by altering consumer food purchasing behaviour. We quantify the impact of the voluntary Health Star Rating (HSR) FoPL adopted by New Zealand (NZ) in 2014, on (i) the quantity of foods purchased by HSR scores and food groups and (ii) the quantities of different nutrients purchased.

We used Nielsen HomeScan household purchasing panel data over 2013–2019, linked to Nutritrack packaged food composition data. Fixed effects analyses were used to estimate the association of HSR with product and nutrient purchasing. We controlled for NZ-wide purchasing trends and potential confounding at the household and product level.

In 2019, HSR-labelled products accounted for 24% (2890) of 12 040 products in the dataset and 32% of purchasing volume. Of HSR-labelled products, 1339 (46%) displayed a rating of 4.0–5.0 stars and 556 (19%) displayed a rating of 0.5–2.0 stars.

We found little or no association between HSR labelling and the quantities of different foods purchased. Introduction of HSR was, however, associated with lower sodium (−9%, 95% CI −13% to −5%), lower protein (−3%, 95% CI −5% to 0%) and higher fibre (5%, 95% CI 2% to 7%) purchases when purchased products carrying an HSR were compared with the same products prior to introduction of the programme.

Robust evidence of HSR labelling changing consumer purchasing behaviour was not observed. The positive effect on nutrient purchasing of HSR-labelled foods likely arises from reformulation of products to achieve a better HSR label.
Study protocol: Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR)
Authors: James Fiona , Goh Michelle S Y , Mouhtouris Effie , Vogrin Sara , Chua Kyra Y L , Holmes Natasha E , Awad Andrew , Copaescu Ana-Maria , De Luca Joseph F , Zubrinich Celia , Gin Douglas , Cleland Heather , Douglas Abby , Kern Johannes S , Katelaris Constance H , Thien Francis , Barnes Sara , Yun James , Tong Winnie , Smith William B , Carr Andrew , Anderson Tara , Legg Amy , Bourke Jack , Mackay Laura K , Aung Ar Kar , Phillips Elizabeth J , Trubiano Jason
Published: August 2022

Introduction

Severe cutaneous adverse reactions (SCAR) are a group of T cell-mediated hypersensitivities associated with significant morbidity, mortality and hospital costs. Clinical phenotypes include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalised exanthematous pustulosis (AGEP). In this Australasian, multicentre, prospective registry, we plan to examine the clinical presentation, drug causality, genomic predictors, potential diagnostic approaches, treatments and long-term outcomes of SCAR in Australia and New Zealand.

Methods and analysis

Adult and adolescent patients with SCAR including SJS, TEN, DRESS, AGEP and another T cell-mediated hypersensitivity, generalised bullous fixed drug eruption, will be prospectively recruited. A waiver of consent has been granted for some sites to retrospectively include cases which result in early mortality. DNA will be collected for all prospective cases. Blood, blister fluid and skin biopsy sampling is optional and subject to patient consent and site capacity. To develop culprit drug identification and prevention, genomic testing will be performed to confirm human leukocyte antigen (HLA) type and ex vivo testing will be performed via interferon-γ release enzyme linked immunospot assay using collected peripheral blood mononuclear cells. The long-term outcomes of SCAR will be investigated with a 12-month quality of life survey and examination of prescribing and mortality data.

Ethics and dissemination

This study was reviewed and approved by the Austin Health Human Research Ethics Committee (HREC/50791/Austin-19). Results will be published in peer-reviewed journals and presented at relevant conferences.

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN12619000241134).
Watch me grow integrated (WMG-I): protocol for a cluster randomised controlled trial of a web-based surveillance approach for developmental screening in primary care settings
Authors: Eapen Valsamma , Liaw Siaw-Teng , Lingam Raghu , Woolfenden Susan , Jalaludin Bin , Page Andrew , Kohlhoff Jane , Scott James G , Lawson K D , Lam-Cassettari Christa , Heussler Helen , Descallar Joseph , Karlov Lisa , Ong Natalie , Colditz Paul B , Littlewood Robyn , Murphy Elisabeth , Deering April , Short Kate , Garg Pankaj , Blight Victoria , Rodgers Kim , Chalmers Lucille , Webb Kerri-Lyn , Atkins Heidi , Newcomb Dana , Beswick Rachael , Thomas Clare , Marron Catherine , Chambers Aaron , Scheinpflug Sue , Statham Matt , Samaranayake Dimuthu , Chay Paul , Tam Chun Wah Michael , Khan Feroza , Mendoza Diaz Antonio , Cibralic Sara , Winata Teresa , Pritchard Margo
Published: August 2022

Introduction

The increasing prevalence of developmental disorders in early childhood poses a significant global health burden. Early detection of developmental problems is vital to ensure timely access to early intervention, and universal developmental surveillance is recommended best practice for identifying issues. Despite this, there is currently considerable variation in developmental surveillance and screening between Australian states and territories and low rates of developmental screening uptake by parents. This study aims to evaluate an innovative web-based developmental surveillance programme and a sustainable approach to referral and care pathways, linking primary care general practice (GP) services that fall under federal policy responsibility and state government-funded child health services.

Methods and analysis

The proposed study describes a longitudinal cluster randomised controlled trial (c-RCT) comparing a ‘Watch Me Grow Integrated’ (WMG-I) approach for developmental screening, to Surveillance as Usual (SaU) in GPs. Forty practices will be recruited across New South Wales and Queensland, and randomly allocated into either the (1) WMG-I or (2) SaU group. A cohort of 2000 children will be recruited during their 18-month vaccination visit or opportunistic visit to GP. At the end of the c-RCT, a qualitative study using focus groups/interviews will evaluate parent and practitioner views of the WMG-I programme and inform national and state policy recommendations.

Ethics and dissemination

The South Western Sydney Local Health District (2020/ETH01625), UNSW Sydney (2020/ETH01625) and University of Queensland (2021/HE000667) Human Research Ethics Committees independently reviewed and approved this study. Findings will be reported to the funding bodies, study institutes and partners; families and peer-reviewed conferences/publications.

Trial registration number

ANZCTR12621000680864.
Endothelial failure and rejection in recipients of corneas from the same donor
Authors: Downward Lewis , Ahmed Mahmoud , Hopkinson Cathy , Romano Vito , Curnow Elinor , Kaye Stephen B
Published: August 2022

Objective

To determine whether patients who receive corneas from the same donor have similar risks of endothelial failure and rejection.

Methods and Analysis

Patients with Fuchs endothelial dystrophy (FED) and pseudophakic bullous keratopathy (PBK) who received their first corneal transplant between 1999 and 2016 were analysed. Patients receiving corneas from donors who donated both corneas for the same indication were defined as ‘paired’. Gray’s test was used to compare the cumulative incidence of endothelial failure and rejection within 5 years post-transplant for ‘paired’ and ‘unpaired’ groups. Cox regression models were fitted to determine whether there was an association between recorded donor characteristics (endothelial cell density (ECD), age and sex and endothelial graft failure and rejection.

Results

10 838 patients were analysed of whom 1536 (14%) were paired. The unpaired group comprised 1837 (69%) recipients of single corneal donors and 7465 (69%) donors who donated both corneas for another indication. ECD was lower for unpaired single cornea donors (p<0.01). There was no significant difference in endothelial graft failure or rejection between paired and unpaired groups for FED (p=0.37, p=0.99) or PBK (p=0.88, p=0.28) nor for donor ECD, age, sex and paired donation after adjusting for transplant factors (across all models p>0.16 for ECD, p>0.32 for donor age, p>0.14 for sex match and p>0.17 for the donor effect).

Conclusion

The absence of a significant difference in graft outcome for corneal transplants for FED and PBK between paired and unpaired donors may reflect a homogeneous donor pool in the UK.
Prevalence of Fabry disease-causing variants in the UK Biobank
Authors: Gilchrist Mark , Casanova Francesco , Tyrrell Jess S , Cannon Stuart , Wood Andrew R , Fife Nicole , Young Katherine , Oram Richard A , Weedon Michael N
Published: August 2022

Background

Fabry disease is an X-linked lysosomal storage disorder resulting from deficiency of the alpha-galactosidase A enzyme leading to accumulation of globotriaosylceramide in multiple organ sites with prominent cardiovascular and renal involvement. Global prevalence estimates of Fabry disease based on clinical ascertainment range from 1 in 40 000 to 1 in 170 000. We aimed to determine the prevalence of Fabry disease-causing variants in UK Biobank.

Methods

We soughtGLAgene variants in exome sequencing data from 200 643 individuals from UK Biobank. We used ACMG/AMP guidelines (American College of Medical Genetics/Association for Molecular Pathology) to classify pathogenicity and compared baseline biomarker data, hospital ICD-10 (International Classification of Diseases version-10) codes, general practitioner records and self-reported health data with those without pathogenic variants.

Results

We identified 81GLAcoding variants. We identified eight likely pathogenic variants on the basis of being rare (<1/10 000 individuals) and either previously reported to cause Fabry disease, or being protein-truncating variants. Thirty-six individuals carried one of these variants. In the UK Biobank, the prevalence of likely pathogenic Fabry disease-causing variants is 1/5732 for late-onset disease-causing variants and 1/200 643 for variants causing classic Fabry disease.

Conclusion

Fabry disease-causingGLAvariants are more prevalent in an unselected population sample than the reported prevalence of Fabry disease. These are overwhelmingly variants associated with later onset. It is possible the prevalence of later-onset Fabry disease exceeds current estimates.
Examining the incidence of acute stress in pediatric trauma patients
Authors: Schauss Eraina , Hawes Kiersten , Roberts Sydnie , Clayton Joseph Mitchell , Li Chi , Littlejohn Alexandria , Bartelli Debra , Williams Regan
Published: August 2022

Objective

Pediatric patients can be significantly impacted emotionally by exposure to acute trauma which may negatively impact long-term functioning and lead to an increase in overall distress. This study reports on the incidence of acute stress disorder among pediatric trauma patients in a hospital setting in the southeastern region of the USA.

Methods

Pediatric patient mental health assessments were conducted using the Childhood Stress Disorders Checklist- Short Form (CSDC-SF) as part of a new integrated behavioral health standard of care within the Trauma Services Division of a level 1 pediatric hospital. Mental health consultations occurred at bedside on inpatient hospital admission into trauma services, or at the outpatient hospital clinic after discharge for injuries treated in the emergency department.

Results

Associations among type of trauma, child age, and sex were explored in a sample of 617 children (58.9% male) aged 2–18 years (Mage=10.27). The sample was primarily ethnic minorities (56.1% black/African-American, 5% Hispanic/Latinx). Fifteen per cent or more of trauma reports were for burns (26%), motor vehicle accident (22.7%), and recreational sports or leisure activity-related injury (17.5%). Sixty-four per cent of children scored ≥1 on the CSDC-SF, indicating symptoms consistent with acute stress disorder. Higher scores were associated with female sex, age, and injury type.

Level of evidence

Level IV study provides evidence of the link between traumatic injury and mental health symptoms in a pediatric population. Findings highlight the critical need for mental health screening and provision of integrated mental health counseling services at time of acute pediatric trauma.
A review of the fatigue limit for steel bridges under Ontario highway traffic loading
Authors: Chehrazi Ali , Chien Michelle Y.X. , Walbridge Scott
Published: August 2022

In many design codes for roadway bridges, it is required that a design truck be passed over influence lines for stress at various locations on the bridge to obtain nominal stress ranges for design. For the fatigue design of Canadian bridges in the infinite or very long life domain, the nominal stress range is compared with a fatigue limit, after modification by an appropriate correction factor to account for the difference between the nominal stress range and some measure of the extreme stress range in the expected real traffic histogram, which governs infinite life design. The extent to which the influence of simultaneous truck crossings was considered in the establishment of the correction factors is believed to be limited. With this in mind, a simulation-based study, conducted to investigate the effects of simultaneous vehicle crossings on the fatigue limits for steel bridges under Ontario highway traffic loading, is presented in this paper.
Competition Effects on Audit Quality and Pricing in a Non-Big 4 Market
Authors: Azizkhani Masoud , Sami Heibatollah , Amirkhani Kourosh , Monroe Gary S.
Published: August 2022

Synopsis

The research problem

Adding to the literature on audit market competition, this study examined how increasing competition affects audit pricing and audit quality in an emerging market where regulatory policies have resulted in increased competition (less market concentration) in the audit market, and Big 4 auditors are banned.

The test hypotheses

H1: Audit market concentration (competition) is positively (negatively) associated with audit fees.

H2: Audit market competition is associated with audit quality.

Target population

Various stakeholders including regulators, auditors, firm managers, and users of financial reports.

Adopted methodology

Multivariate analysis using ordinary least squares and logit regressions.

Analyses

Using the Herfindahl index to measure competition in the audit market at the national level, we used a sample of listed firms from the emerging Iranian audit market, which is characterized by increase in audit market competition as a result of a regulatory change and a lack of market concentration because the audit market does not include Big 4 audit firms or any dominant local audit firms to examine the impact of competition on audit pricing and audit quality.

Findings

We found that higher (lower) levels of audit market competition measured using the Herfindahl index are associated with lower (higher) audit fees and higher (lower) levels of abnormal accruals. These results suggest that increased competition in audit markets in developing economies generates audit fee pressure, which negatively affects audit quality.