bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic modeling of public and private decision‐making for hurricane risk management including insurance, acquisition, and mitigation policy
Authors: Guo Cen , Nozick Linda , Kruse Jamie , Millea Meghan , Davidson Rachel , Trainor Joseph
Published: June 2022

We develop a computational framework for the stochastic and dynamic modeling of regional natural catastrophe losses with an insurance industry to support government decision‐making for hurricane risk management. The analysis captures the temporal changes in the building inventory due to the acquisition (buyouts) of high‐risk properties and the vulnerability of the building stock due to retrofit mitigation decisions. The system is comprised of a set of interacting models to (1) simulate hazard events; (2) estimate regional hurricane‐induced losses from each hazard event based on an evolving building inventory; (3) capture acquisition offer acceptance, retrofit implementation, and insurance purchase behaviors of homeowners; and (4) represent an insurance market sensitive to demand with strategically interrelated primary insurers. This framework is linked to a simulation‐optimization model to optimize decision‐making by a government entity whose objective is to minimize region‐wide hurricane losses. We examine the effect of different policies on homeowner mitigation, insurance take‐up rate, insurer profit, and solvency in a case study using data for eastern North Carolina. Our findings indicate that an approach that coordinates insurance, retrofits, and acquisition of high‐risk properties effectively reduces total (uninsured and insured) losses.
Stopping Time Detection of Wood Panel Compression: A Functional Time-Series Approach
Authors: Shang Han Lin , Cao Jiguo , Sang Peijun
Published: June 2022

We consider determining the optimal stopping time for the glue curing of wood panels in an automatic process environment. Using the near-infrared spectroscopy technology to monitor the manufacturing process ensures substantial savings in energy and time. We collect a time-series of curves from a near-infrared spectrum probe consisting of 72 spectra and aim to detect an optimal stopping time. We propose an estimation procedure to determine the optimal stopping time of wood panel compression and the estimation uncertainty associated with the estimated stopping time. Our method first divides the entire data set into a training sample and a testing sample, then iteratively computes integrated squared forecast errors based on the testing sample. We then apply a structural break detection method with one breakpoint to determine an estimated optimal stopping time from a univariate time-series of the integrated squared forecast errors. We also investigate the finite sample performance of the proposed method via a series of simulation studies.
Brain network topology and personality traits: A source level magnetoencephalographic study
Authors: Troisi Lopez Emahnuel , Colonnello Valentina , Liparoti Marianna , Castaldi Mauro , Alivernini Fabio , Russo Paolo Maria , Sorrentino Giuseppe , Lucidi Fabio , Mandolesi Laura , Sorrentino Pierpaolo
Published: June 2022

Personality neuroscience is focusing on the correlation between individual differences and the efficiency of large‐scale networks from the perspective of the brain as an interconnected network. A suitable technique to explore this relationship is the magnetoencephalography (MEG), but not many MEG studies are aimed at investigating topological properties correlated to personality traits. By using MEG, the present study aims to evaluate how individual differences described in Cloninger's psychobiological model are correlated with specific cerebral structures. Fifty healthy individuals (20 males, 30 females, mean age: 27.4 ± 4.8 years) underwent Temperament and Character Inventory examination and MEG recording during a resting state condition. High harm avoidance scores were associated with a reduced centrality of the left caudate nucleus and this negative correlation was maintained in females when we analyzed gender differences. Our data suggest that the caudate nucleus plays a key role in adaptive behavior and could be a critical node in insular salience network. The clear difference between males and females allows us to suggest that topological organization correlated to personality is highly dependent on gender. Our findings provide new insights to evaluate the mutual influences of topological and functional connectivity in neural communication efficiency and disruption as biomarkers of psychopathological traits.
HLA graph, a free and ready‐to‐use bioinformatics tool to explore anti‐HLA eplets reactivity pattern
Authors: Usureau Cédric , Jacob Valentine , Dubois Valérie , Masson Dominique , Jollet Isabelle , Desoutter Judith , Taupin Jean‐Luc , Guillaume Nicolas
Published: June 2022

Introduction

HLA antigens are highly polymorphic, and their immunogenicity is dependent on the configurations of polymorphic amino acids. Monitoring anti‐HLA immunization is essential in organ transplantation, as antibodies directed against HLA molecules are a major cause of rejection. Anti‐HLA antibodies are not specific for HLA antigens, but recognize B‐cell epitopes present on HLA molecules.

Methods

To better understand antibody reactivity patterns, we calculated the Spearman correlation of the mean fluorescence intensity (MFI) of anti‐HLA antibodies identified by a single‐antigen assay performed using a Luminex® immunobeads assay on a large number of samples. Then, we built a computer tool analyzing antibody reactivity patterns with an accessibility by a web browser linked to the International Epitope Registry. We also extended our model to Onelambda® and Lifecodes® single‐antigen class I and class II assays.

Results and Discussion

The resulting MFI correlations reflect HLA antibody cross‐reactivity and eplets similarity. We built HLA Graph, a computer tool that analyzes the eplets involved in antibody reactivity profiles. HLA Graph is usable with Onelambda® and Lifecodes® single‐antigen class I and class II assays. The interpretation of reactivity against alleles not tested by the antibody assays and against the alpha and beta chains of HLA‐DQ and HLA‐DP loci were also developed.

Conclusion

HLA Graph is a free and ready‐to‐use bioinformatics tool that can be used by all laboratories performing anti‐HLA antibody identification by immunobead assay.
INEC-Sponsored Media Messages and Voters’ Turnout during the 2019 General Elections in Nigeria: A Study of Perception of Warri Voters
Authors: Umukoro Ese Steven , Ogwezi Joyce Ogho
Published: June 2022

The media are partners in a democracy because they ensure political participation in the democratic process. Audience perception of the media is vital as it affects credibility and believability of the media and their messages. Credibility and believability of the media are predicated to an extent upon the source of media messages. These issues prompted this study which examined the INEC-Sponsored media messages during the 2019 general elections in Nigeria with specific reference to Warri voters. The study which adopted survey research methodology sampled 384 respondents and used questionnaire to collect data. Data collected were analysed by simple percentages and measures of central tendencies, while hypotheses were tested by Regression Analysis. The study found among others that voters in Warri metropolis perceived that the INEC-Sponsored media messages during the 2019 general elections were credible and thus created the expected level of awareness and sensitization about the general elections. This consequently and significantly influenced voters’ turnout in Warri metropolis during the 2019 general elections. The study thereafter recommended among others that INEC should continue to sponsor unbiased media messages to voters as this will strengthen elections and democracy in Nigeria.
Experimental Study of Various Low-Friction Coatings for High-Temperature Gas Foil Bearings Under Cold-Start Conditions
Authors: Bagiński Paweł , Żywica Grzegorz
Published: June 2022

This article presents the experimental research carried out on five different materials with which the top foils have been coated. A foil bearing with these foils was tested under different load conditions. The key operating parameters were determined, such as the moment of friction during the run-up and run-down tests as well as the temperature of the top foil. The AS20 coating, like the TiAlN coating, was intact (with the exception of several places where it was worn and where the Inconel sheet was visible) and was suitable for further use. The WC/C coating was damaged in many places, which shows that this type of coating cannot be used in combination with a journal coated with chromium oxide. The foil coated with MoS2/C had many areas where the coating was worn and also many areas where it was erased completely, so this type of coating was not durable. The use of a combination of TiAlN and MoS2/C coatings resulted in minor wear of the outer coating (made of MoS2/C) and the appearance of the inner coating, which is more resistant to abrasion. The tested materials will be used in the future to build a foil bearing resistant to operation at elevated temperatures in a gas microturbine.
Robust Design Optimization of Component Parameters for DMDEB Powertrain System Based on Taguchi Method
Authors: Shangguan Jinyong , Yue Ming , Fang Chao , Qi Huanyu
Published: June 2022

The selection of component parameters plays an important role in the energy optimization of dual-motor drive electric buses (DMDEBs). To design a set of parameters that can be robust to different road slopes, passenger masses, and bus routes, a Taguchi-based robust design optimization method is proposed in this paper for DMDEBs. First, the dynamic programming (DP) is designed as a part of the Taguchi method to explore the optimal solution (electricity consumption) corresponding to each set of component parameters. Then, by taking the optimal electricity consumption obtained by DP as the response, the Taguchi method is utilized to find the robust component parameters that are insensitive to the noise factors. To evaluate the robustness and reliability of the designed component parameters, a six sigma analysis based on Monte Carlo sampling is employed considering three kinds of stochastic disturbances. Finally, simulation results demonstrate that the proposed robust design optimization method is effective and the designed component parameters have better robustness than the initial component parameters.
Computational Fluid Dynamics Analysis of the Influence of Gas Content on the Rotordynamic Force Coefficients for a Circumferentially Grooved Annular Seal for Multiple Phase Pumps
Authors: Wu Tingcheng , Andrés Luis San , Lu Xueliang
Published: June 2022

Pumping efficiency and rotordynamic stability are paramount to subsea multiphase pump operation since, during the life of a well, the process fluid transitions from a pure liquid to a mixture of gas in the liquid to just gas. Circumferentially grooved seals commonly serve as balance pistons in pumps while also restricting secondary flow. Prior experimental results obtained with a grooved seal operating with a mixture of air and mineral oil show the seal rotordynamic force coefficients vary significantly with the gas volume fraction (GVF). This paper, complementing an exhaustive experimental program, presents a computational fluid dynamics (CFD) analysis to predict the leakage and dynamic force coefficients of a circumferentially grooved seal supplied with air in an oil mixture with a GVF varying from 0 to 0.7. The test seal has 14 grooves, an overall axial length of 43.6 mm, and radial clearance of 0.211 mm. The 127 mm diameter rotor spins at constant angular speed (Ω = 3500 rpm). The mixture enters the seal at a supply pressure (Pin) of 2.9 bar(a), and the seal exit pressure (Pout) is 1 bar(a). The CFD two-phase flow simulations utilize the Euler–Euler multiphase model to predict the mass flowrate and the pressure field as a function of the operating conditions. Using a multi-frequency shaft orbit motion method, the CFD simulations deliver the variations of reaction force on the rotor with respect to the excitation frequency. For a pure liquid condition (GVF = 0), both the CFD and experimental results produce constant stiffness, damping, and added mass coefficients. The experimental and CFD results demonstrate the seal rotordynamic force coefficients are quite sensitive to the GVF. When introducing a small amount of air into the oil (GVF = 0.1), the direct damping coefficient increases by approximately 10%. For operation with a mixture with inlet GVF > 0.1, the cross-coupled stiffness coefficients develop strong frequency-dependent characteristics. In contrast, the direct damping coefficient has a negligible variation with excitation frequency. The CFD predictions, as well as the experimental results, evidence that air injection in a liquid stream can significantly change the seal rotordynamic characteristics, and thus can affect the rotordynamic stability of a pump. An accurate CFD analysis provides engineers to design reliable grooved seals operating under two-phase flow conditions.
Gridless sparse covariance-based beamforming via alternating projections including co-prime arrays
Authors: Park Yongsung , Gerstoft Peter
Published: June 2022

This paper presents gridless sparse processing for direction-of-arrival (DOA) estimation. The method solves a gridless version of sparse covariance-based estimation using alternating projections. Gridless sparse DOA estimation is represented by the reconstruction of Toeplitz-structured low-rank matrices, which our method recovers by alternatively projecting a solution matrix. Compared to the existing gridless sparse methods, our method improves speed and accuracy and considers non-uniformly configured linear arrays. High-resolution and reliable DOA estimation are achieved even with single-snapshot data, coherent sources, and non-uniform arrays. Simulation results demonstrate performance improvements compared to the existing DOA estimators, including gridless sparse methods. The method is illustrated using experimental data from a real ocean experiment.
Genetic and pharmacologic proteasome augmentation ameliorates Alzheimer’s-like pathology in mouse and fly APP overexpression models
Authors: Chocron E. Sandra , Munkácsy Erin , Kim Harper S. , Karpowicz Przemyslaw , Jiang Nisi , Van Skike Candice E. , DeRosa Nicholas , Banh Andy Q. , Palavicini Juan P. , Wityk Paweł , Kalinowski Leszek , Galvan Veronica , Osmulski Pawel A. , Jankowska Elzbieta , Gaczynska Maria , Pickering Andrew M.
Published: June 2022

The proteasome has key roles in neuronal proteostasis, including the removal of misfolded and oxidized proteins, presynaptic protein turnover, and synaptic efficacy and plasticity. Proteasome dysfunction is a prominent feature of Alzheimer’s disease (AD). We show that prevention of proteasome dysfunction by genetic manipulation delays mortality, cell death, and cognitive deficits in fly and cell culture AD models. We developed a transgenic mouse with neuronal-specific proteasome overexpression that, when crossed with an AD mouse model, showed reduced mortality and cognitive deficits. To establish translational relevance, we developed a set of TAT-based proteasome-activating peptidomimetics that stably penetrated the blood-brain barrier and enhanced 20
S
/26
S
proteasome activity. These agonists protected against cell death, cognitive decline, and mortality in cell culture, fly, and mouse AD models. The protective effects of proteasome overexpression appear to be driven, at least in part, by the proteasome’s increased turnover of the amyloid precursor protein along with the prevention of overall proteostatic dysfunction.
IFN-γ–dependent tumor-antigen cross-presentation by lymphatic endothelial cells promotes their killing by T cells and inhibits metastasis
Authors: Garnier Laure , Pick Robert , Montorfani Julien , Sun Mengzhu , Brighouse Dale , Liaudet Nicolas , Kammertoens Thomas , Blankenstein Thomas , Page Nicolas , Bernier-Latamani Jeremiah , Tran Ngoc Lan , Petrova Tatiana V. , Merkler Doron , Scheiermann Christoph , Hugues Stéphanie
Published: June 2022

Tumor-associated lymphatic vessels promote metastasis and regulate antitumor immune responses. Here, we assessed the impact of cytotoxic T cells on the local lymphatic vasculature and concomitant tumor dissemination during an antitumor response. Interferon-γ (IFN-γ) released by effector T cells enhanced the expression of immunosuppressive markers by tumor-associated lymphatic endothelial cells (LECs). However, at higher effector T cell densities within the tumor, T cell–based immunotherapies induced LEC apoptosis and decreased tumor lymphatic vessel density. As a consequence, lymphatic flow was impaired, and lymph node metastasis was reduced. Mechanistically, T cell–mediated tumor cell death induced the release of tumor antigens and cross-presentation by tumor LECs, resulting in antigen-specific LEC killing by T cells. When LECs lacked the IFN-γ receptor expression, LEC killing was abrogated, indicating that IFN-γ is indispensable for reducing tumor-associated lymphatic vessel density and drainage. This study provides insight into how cytotoxic T cells modulate tumor lymphatic vessels and may help to improve immunotherapeutic protocols.
Ca
v
1.3 calcium channels are full-range linear amplifiers of firing frequencies in lateral DA SN neurons
Authors: Shin Josef , Kovacheva Lora , Thomas Dominique , Stojanovic Strahinja , Knowlton Christopher J. , Mankel Johanna , Boehm Johannes , Farassat Navid , Paladini Carlos , Striessnig Jörg , Canavier Carmen C. , Geisslinger Gerd , Roeper Jochen
Published: June 2022

The low-threshold L-type calcium channel Ca
v
1.3 accelerates the pacemaker rate in the heart, but its functional role for the extended dynamic range of neuronal firing is still unresolved. Here, we show that Ca
v
1.3 calcium channels act as unexpectedly simple, full-range linear amplifiers of firing rates for lateral dopamine substantia nigra (DA SN) neurons in mice. This means that they boost in vitro or in vivo firing frequencies between 2 and 50 hertz by about 30%. Furthermore, we demonstrate that clinically relevant, low nanomolar concentrations of the L-type channel inhibitor isradipine selectively reduce the in vivo firing activity of these nigrostriatal DA SN neurons at therapeutic plasma concentrations. Thus, our study identifies the pacemaker function of neuronal Ca
v
1.3 channels and provides direct evidence that repurposing dihydropyridines such as isradipine is feasible to selectively modulate the in vivo activity of highly vulnerable DA SN subpopulations in Parkinson’s disease.
Digital selective transformation and patterning of highly conductive hydrogel bioelectronics by laser-induced phase separation
Authors: Won Daeyeon , Kim Jin , Choi Joonhwa , Kim HyeongJun , Han Seonggeun , Ha Inho , Bang Junhyuk , Kim Kyun Kyu , Lee Youngseok , Kim Taek-Soo , Park Jae-Hak , Kim C-Yoon , Ko Seung Hwan
Published: June 2022

The patterning of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) hydrogels with excellent electrical property and spatial resolution is a challenge for bioelectronic applications. However, most PEDOT:PSS hydrogels are fabricated by conventional manufacturing processes such as photolithography, inkjet printing, and screen printing with complex fabrication steps or low spatial resolution. Moreover, the additives used for fabricating PEDOT:PSS hydrogels are mostly cytotoxic, thus requiring days of detoxification. Here, we developed a previously unexplored ultrafast and biocompatible digital patterning process for PEDOT:PSS hydrogel via phase separation induced by a laser. We enhanced the electrical properties and aqueous stability of PEDOT:PSS by selective laser scanning, which allowed the transformation of PEDOT:PSS into water-stable hydrogels. PEDOT:PSS hydrogels showed high electrical conductivity of 670 S/cm with 6-μm resolution in water. Furthermore, electrochemical properties were maintained even after 6 months in a physiological environment. We further demonstrated stable neural signal recording and stimulation with hydrogel electrodes fabricated by laser.
Neuro-inspired electronic skin for robots
Authors: Liu Fengyuan , Deswal Sweety , Christou Adamos , Sandamirskaya Yulia , Kaboli Mohsen , Dahiya Ravinder
Published: June 2022

Touch is a complex sensing modality owing to large number of receptors (mechano, thermal, pain) nonuniformly embedded in the soft skin all over the body. These receptors can gather and encode the large tactile data, allowing us to feel and perceive the real world. This efficient somatosensation far outperforms the touch-sensing capability of most of the state-of-the-art robots today and suggests the need for neural-like hardware for electronic skin (e-skin). This could be attained through either innovative schemes for developing distributed electronics or repurposing the neuromorphic circuits developed for other sensory modalities such as vision and audio. This Review highlights the hardware implementations of various computational building blocks for e-skin and the ways they can be integrated to potentially realize human skin–like or peripheral nervous system–like functionalities. The neural-like sensing and data processing are discussed along with various algorithms and hardware architectures. The integration of ultrathin neuromorphic chips for local computation and the printed electronics on soft substrate used for the development of e-skin over large areas are expected to advance robotic interaction as well as open new avenues for research in medical instrumentation, wearables, electronics, and neuroprosthetics.
Targeted Transcriptomic Screen of Pneumococcal Genes Expressed during Murine and Human Infection
Authors: Basset Alan , Wall Emma , Mitsi Elena , Deshusses Chloe , Daly Raecliffe , Pojar Sherin , Reiné Jesús , Guerra-Assuncao Jose Afonso , Denis Brigitte , Jochems Simon P. , Heyderman Robert , Brown Jeremy , Lu Ying-Jie , Ferreira Daniela M. , Malley Richard
Published: June 2022

The advent of pneumococcal conjugate vaccines led to the near disappearance of most of the included serotypes in high-income settings but also the rise of nonvaccine-type colonization and disease. Alternative strategies, using genetically conserved proteins as antigens, have been evaluated preclinically and clinically for years, so far unsuccessfully.
LMP1 Induces p53 Protein Expression via the H19/miR-675-5p Axis
Authors: Li Jun , Zhang Yan , Sun Lingling , Liu Song , Zhao Menghe , Luo Bing
Published: June 2022

Epstein-Barr virus (EBV) is the first virus to be known to have direct association with human cancer and to be considered as an important DNA tumor virus. The EBV life cycle consists of both latent and lytic modes of infection in B lymphocytes and epithelial cells.
Genomic and Temporal Trends in Canine ExPEC Reflect Those of Human ExPEC
Authors: Elankumaran Paarthiphan , Cummins Max L. , Browning Glenn F. , Marenda Marc S. , Reid Cameron J. , Djordjevic Steven P.
Published: June 2022

Pathogenic
E. coli
that causes extraintestinal infections (ExPEC) in humans and canines represents a significant burden in hospital and veterinary settings. Despite the obvious interrelationship between dogs and humans favoring both zoonotic and anthropozoonotic infections, whole-genome sequencing projects examining large numbers of canine-origin ExPEC are lacking.
Synthesis and Structures of Copper and Thallium(I) Coordination Compounds [Cu2[B10H10]]n and Tl2[B10H10] with the closo-Decaborate Anion
Authors: Avdeeva V. V. , Kubasov A. S. , Korolenko S. E. , Goeva L. V. , Malinina E. A. , Kuznetsov N. T.
Published: June 2022

Solvent-free copper(I) and thallium(I) compounds of the general formula [M2[B10H10]] have been synthesized. The compounds have been identified by IR spectroscopy and X-ray diffraction. According to X-ray diffraction data, the structures of both compounds are three-dimensional frameworks. In copper(I) complex [Cu2[B10H10]]n, the formation of three-center M–H–B bonds is observed. In thallium(I) compound Tl2[B10H10], the bond between cations and anions is ionic, which is confirmed by IR spectroscopy data. The Hirschfeld surface analysis of the boron cluster anion was performed for both compounds to identify and analyze intramolecular interactions.
Maternal mental health and substance use disorders in sudden unexpected death in infancy using routinely collected health data in New Zealand, 2000–2016
Authors: Mitchell Edwin A , Zhang Doney , Thompson John M D , Liu Chris , Leversha Alison , Milne Barry J
Published: June 2022

Background

Mortality from sudden unexpected death in infancy (SUDI) has declined dramatically since the ‘Back to Sleep’ campaign. Deaths now are more prevalent in those with socioeconomic disadvantage. The investigation of SUDI frequently identifies parents that have mental health or drug, alcohol and addiction problems.

Aims

To estimate the prevalence of maternal mental health and substance use disorders and assess the magnitude of their risk for SUDI.

Methods

We conducted a population-based cohort study using data from the Integrated Data Infrastructure (IDI), a large research database containing linked data from a range of government agencies. The study population was all live births and their mothers in New Zealand from 2000 to 2016. The exposures of interest were maternal mental health problems and maternal substance use disorders in the year prior to the birth. The outcome was deaths from SUDI.

Results

The total population was 1086 504 live births and of these 1078 811 (99.3%) were able to be linked to other data sets within the IDI. The prevalence of maternal mental health problems in the total population was 5.2% and substance use disorder was 0.7%. There were 42 deaths from SUDI (0.75/1000) that were exposed to maternal mental illness and 864 deaths (0.84/1000) that were not exposed (adjusted relative risk (aRR)=1.23, 95% CI 0.90 to 1.68). There were 21 deaths from SUDI (2.67/1000) that were exposed to maternal substance use disorders and 885 (0.83/1000) that were not exposed (aRR=1.82, 95% CI 1.17 to 2.83).

Conclusions

Maternal substance use disorders, but not maternal mental health problems, in the year prior to the child’s birth was associated with an increased risk of SUDI. However, the numbers that are affected are small and the effect size moderate. This group of women should receive additional SUDI prevention services and Safe Sleep advice.
Political environment and mortality rates in the United States, 2001-19: population based cross sectional analysis
Authors: Warraich Haider J , Kumar Pankaj , Nasir Khurram , Joynt Maddox Karen E , Wadhera Rishi K
Published: June 2022

Objective

To assess recent trends in age adjusted mortality rates (AAMRs) in the United States based on county level presidential voting patterns.

Design

Cross sectional study.

Setting

USA, 2001-19.

Participants

99.8% of the US population.

Main outcome measures

AAMR per 100 000 population and average annual percentage change (APC).

Methods

The Centers for Disease Control and Prevention WONDER database was linked to county level data on US presidential elections. County political environment was classified as either Democratic or Republican for the four years that followed a November presidential election. Additional sensitivity analyses analyzed AAMR trends for counties that voted only for one party throughout the study, and county level gubernatorial election results and state level AAMR trends. Joinpoint analysis was used to assess for an inflection point in APC trends.

Results

The study period covered five presidential elections from 2000 to 2019. From 2001 to 2019, the AAMR per 100 000 population decreased by 22% in Democratic counties, from 850.3 to 664.0 (average APC −1.4%, 95% confidence interval −1.5% to −1.2%), but by only 11% in Republican counties, from 867.0 to 771.1 (average APC −0.7%, −0.9% to −0.5%). The gap in AAMR between Democratic and Republican counties therefore widened from 16.7 (95% confidence interval 16.6 to 16.8) to 107.1 (106.5 to 107.7). Statistically significant inflection points in APC occurred for Democratic counties between periods 2001-09 (APC −2.1%, −2.3% to −1.9%) and 2009-19 (APC −0.8%, −1.0% to −0.6%). For Republican counties between 2001 and 2008 the APC was −1.4% (−1.8% to −1.0%), slowing to near zero between 2008 and 2019 (APC −0.2%, −0.4% to 0.0%). Male and female residents of Democratic counties experienced both lower AAMR and twice the relative decrease in AAMR than did those in Republican counties. Black Americans experienced largely similar improvement in AAMR in both Democratic and Republican counties. However, the AAMR gap between white residents in Democratic versus Republican counties increased fourfold, from 24.7 (95% confidence interval 24.6 to 24.8) to 101.3 (101.0 to 101.6). Rural Republican counties experienced the highest AAMR and the least improvement. All trends were similar when comparing counties that did not switch political environment throughout the period and when gubernatorial election results were used. The greatest contributors to the widening AAMR gap between Republican and Democratic counties were heart disease (difference in AAMRs 27.6), cancer (17.3), and chronic lower respiratory tract diseases (8.3), followed by unintentional injuries (3.3) and suicide (3.0).

Conclusion

The mortality gap in Republican voting counties compared with Democratic voting counties has grown over time, especially for white populations, and that gap began to widen after 2008.
Low back pain and associated factors among obstetrics care providers in public hospitals of Amhara Regional State, Ethiopia: a cross-sectional study
Authors: Zewudie Bitew Tefera , Temere Bogale Chekole , Eniyew Muche Argaw , Mesfin Yibeltal , Tenaw Shegaw Geze
Published: June 2022

Objectives

Although the study of low back pain (LBP) among healthcare workers in Ethiopia is becoming common, it mainly focused on nurses leaving obstetrics care providers aside. The objective of this study was to assess the prevalence and associated factors of LBP among obstetrics care providers in public hospitals in Amhara Regional State, Ethiopia.

Design

An institution-based cross-sectional study.

Settings

The study settings were nine public hospitals in Amhara Region.

Participants

Randomly selected 416 obstetrics care providers working in public hospitals in Amhara Region, Ethiopia.

Outcomes

The outcomes of this study were the prevalence of LBP in the last 12 months among obstetrics care providers and its associated factors.

Results

Overall, the prevalence of LBP was 65.6% (95% CI 61.5% to 70.2%) among obstetrics care providers in the last 12 months.

Female gender (AOR 2.33, 95% CI 1.344 to 4.038), not having regular physical exercise habits (AOR 8.26, 95% CI 4.36 to 15.66), job stress (AOR 2.21, 95% CI 1.24 to 3.92), standing longer while doing procedures (AOR 2.04, 95% CI 1.14 to 3.66) and working more than 40 hours a week (AOR 2.20, 95% CI 1.09 to 4.45) were significantly associated with LBP.

Conclusion

About two-thirds of obstetrics care providers working in public hospitals in the Amhara region reported LBP. The prevalence of LBP was higher among those who did not have regular physical exercise habits, had job stress, stood longer than 1 hour while doing procedures, worked more than 40 hours a week and female obstetrics care providers. Providing resting periods, decreasing the working hours of obstetrics care providers in a week, and counselling on the importance of doing regular physical exercise help to reduce the prevalence of LBP.
Endometrial factors in the implantation failure spectrum: protocol of a MUltidisciplinary observational cohort study in women with Repeated Implantation failure and recurrent Miscarriage (MURIM Study)
Authors: Stevens Brentjens Linda , Habets Denise , Den Hartog Janneke , Al-Nasiry Salwan , Wieten Lotte , Morré Servaas , Van Montfoort Aafke , Romano Andrea , van Golde Ron
Published: June 2022

Introduction

Women with repeated implantation failure (RIF) and unexplained recurrent miscarriage (RM) are proposed to be at opposite ends of the implantation spectrum, with RM representing an overly receptive endometrium (implantation of genetically aberrant or poor-quality embryos) versus RIF representing an overly selective endometrium (no implantation even with good quality embryos). In both cases, often no explanation for reproductive failure can be found and although promising add-on treatments have been introduced, therapeutic options are frequently limited to supportive care. Both RM and RIF are multifactorial and research indicates that the interplay between steroidogenesis, uterine natural killer (uNK) cells and the microbiome determine the capacity of the endometrium to be a biosensor for invading embryos. Our objective is to elucidate whether there is a difference in endometrial receptivity parameters (ie, steroid metabolism, uNK cells and the microbiome) between women aged 18–38 years with reproductive failure (RIF and RM), and fertile controls.

Methods and analysis

Single-centre, observational cohort study. Endometrial biopsies, vaginal swabs and peripheral blood will be collected during the window of implantation and menstrual blood in the subsequent menstruation. The study parameters are the steroid profile (steroid levels and mRNA levels, protein expression and activity of steroid enzymes) in endometrial tissue and peripheral blood, as well as the activating or inhibitory phenotype of uNK cells based on receptor expression in menstrual blood and endometrial tissue and determination of the vaginal and endometrial microbiome using the inter spacer bacterial profiling technique.

Ethics and dissemination

The protocol is approved by the local medical ethical review committee at the Maastricht University Medical Centre. Findings from this study will be shared with the academic and medical community and the patient organisations to optimise and individualise medical care of patients with implantation failure and miscarriages.

Trial registration number

NTR7571, registered 28 February 2019.
Systematic review of educational interventions to improve the menstrual health of young adolescent girls
Authors: Evans Rebecca Lane , Harris Bronwyn , Onuegbu Chinwe , Griffiths Frances
Published: June 2022

Objectives

To systematically review interventions that include an element of menstrual education delivered to young adolescent girls.

Design

This was a systematic review and meta-analysis. Selected articles were quality assessed using the Mixed Methods Appraisal Tool quality appraisal checklist. A meta-analysis was conducted on a subset of articles, and the effect size of the intervention was calculated using Cohen’s d. A logic model was constructed to frame the effect of menstrual education interventions on menstrual health.

Setting

Papers reporting on interventions in high-income and low-income and middle-income countries were sought.

Information sources

Seven electronic databases were searched for English-language entries that were published between January 2014 and May 2020.

Participants

The interventions were aimed at younger adolescent girls aged 10–14 years old.

Interventions

The interventions were designed to improve the menstrual health of the recipients, by addressing one or more elements of menstrual knowledge, attitude or practices (KAP).

Eligibility criteria

Interventions that had not been evaluated were excluded.

Primary and secondary outcomes

The most common type of output was a difference in knowledge or skill score ascertained from a pre and post test. Some studies measured additional outcomes, such as attitude or confidence.

Results

Twenty-four eligible studies were identified. The number of participants varied from 1 to 2564. All studies reported improvements in menstrual KAP. The meta-analysis indicates that larger effect sizes were attained by those that encouraged discussion than those that distributed pamphlets.

Conclusions

Education interventions are effective in increasing the menstrual knowledge of young adolescent girls and skills training improves competency to manage menstruation more hygienically and comfortably. Interactive interventions are more motivating than didactic or written. Sharing concerns gives girls confidence and helps them to gain agency on the path to menstrual health.

Trial registration number

For this review, a protocol was not prepared or registered.
The impact of the COVID-19 pandemic on the research activity and working experience of clinical academics, with a focus on gender and ethnicity: a qualitative study in the UK
Authors: Finn Gabrielle M , Crampton Paul , Buchanan John AG , Balogun Abisola Olatokunbo , Tiffin Paul Alexander , Morgan Jessica Elizabeth , Taylor Ellie , Soto Carmen , Kehoe Amelia
Published: June 2022

Objective

To investigate the impact of the COVID-19 pandemic on the research activity and working experience of clinical academics, with a focus on gender and ethnicity.

Design

Qualitative study based on interviews and audio/written diary data.

Setting

UK study within clinical academia.

Participants

Purposive sample of 82 clinical academics working in medicine and dentistry across all career stages ranging from academic clinical fellows and doctoral candidates to professors.

Methods

Qualitative semistructured interviews (n=68) and audio diary data (n=30; including 16 participants who were also interviewed) collected over an 8-month period (January–September 2020), thematically analysed.

Results

20 of 30 (66.6%) audio diary contributors and 40 of 68 (58.8%) interview participants were female. Of the participants who disclosed ethnicity, 5 of 29 (17.2%) audio diary contributors and 19/66 (28.8%) interview participants identified as Black, Asian or another minority (BAME). Four major themes were identified in relation to the initial impact of COVID-19 on clinical academics: opportunities, barriers, personal characteristics and social identity, and fears and uncertainty. COVID-19 presented opportunities for new avenues of research. Barriers included access to resources to conduct research and the increasing teaching demands. One of the most prominent subthemes within ‘personal characteristics’ was that of the perceived negative impact of the pandemic on the work of female clinical academics. This was attributed to inequalities experienced in relation to childcare provision and research capacity. Participants described differential experiences based upon their gender and ethnicity, noting intersectional identities.

Conclusions

While there have been some positives afforded to clinical academics, particularly for new avenues of research, COVID-19 has negatively impacted workload, future career intentions and mental health. BAME academics were particularly fearful due to the differential impact on health. Our study elucidates the direct and systemic discrimination that creates barriers to women’s career trajectories in clinical academia. A flexible, strategic response that supports clinical academics in resuming their training and research is required. Interventions are needed to mitigate the potential lasting impact on capacity from the pandemic, and the potential for the loss of women from this valuable workforce.
Economic evaluation of pan-genotypic generic direct-acting antiviral regimens for treatment of chronic hepatitis C in Iran: a cost-effectiveness study
Authors: Tasavon Gholamhoseini Mohammad , Sharafi Heidar , HL Borba Helena , Alavian Seyed Moayed , Sabermahani Asma , Hajarizadeh Behzad
Published: June 2022

Introduction

Low-cost generic direct-acting antiviral (DAA) regimens for treatment of hepatitis C virus (HCV) are available in several low-income/middle-income countries, important for treatment scale-up. This study evaluated the cost-effectiveness of genotype-dependent and pan-genotypic DAA regimens in Iran as an example of a resource-limited setting.

Methods

A Markov model was developed to simulate HCV natural history. A decision tree was developed for HCV treatment, assuming four scenarios, including scenario 1: genotyping, sofosbuvir/ledipasvir (SOF/LDV) for genotype 1, and sofosbuvir/daclatasvir (SOF/DCV) for genotype 3; scenario 2: genotyping, SOF/LDV for genotype 1, and sofosbuvir/velpatasvir (SOF/VEL) for genotype 3; scenario 3: no genotyping and SOF/DCV for all; and scenario 4: no genotyping and SOF/VEL for all. A 1-year cycle length was used to calculate the cumulative cost and effectiveness over a lifetime time horizon. We calculated quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER) using a health system perspective. Costs were converted to US dollars using purchasing power parity exchange rate ($PPP). All costs and outcomes were discounted at an annual rate of 3%.

Results

Among people with no cirrhosis, scenario 3 had the minimum cost, compared with which scenario 4 was cost-effective with an ICER of 4583 $PPP per QALY (willingness-to-pay threshold: 9,311 $PPP per QALY). Among both people with compensated or decompensated cirrhosis, scenario 4 was cost saving. In sensitivity analysis, scenario 4 would be also cost-saving among people with no cirrhosis provided a 39% reduction in the cost of 12 weeks SOF/VEL.

Conclusion

Initiating all patients on pan-genotypic generic DAA regimens with no pretreatment genotyping was cost-effective compared with scenarios requiring pretreatment HCV genotype tests. Among generic pan-genotypic DAA regimens, SOF/VEL was cost-effective, for people with no cirrhosis and cost-saving for those with cirrhosis.
Effect of traditional Chinese exercise on abnormal lipid metabolism in patients with atherosclerosis: a protocol for meta-analysis of randomised controlled trials
Authors: Wang Chen , Zhang Peizhen , Yang Yuting
Published: June 2022

Introduction

Atherosclerosis (AS) is an abnormal response within the vessel wall to endothelial dysfunction and inflammatory cellular processes. Taijiquan exercise as a moderate-intensity aerobic exercise can control or reverse AS by gradually reducing the deposition of cholesterol on the walls of blood vessels. Similarly, performing Baduanjin exercise, Liuzijue Qigong, Wuqinxi exercise and Yijinjing exercise has been found to have a positive effect on lipid metabolism in patients with AS. However, these studies focused only on middle-aged and older populations over 50 years of age and had short intervention periods, poor quality control and patient compliance, and no stratification by age and gender to observe the effects of traditional Chinese exercise (TCE) on patients with AS. Therefore, this meta-analysis will explore the specific effects of different TCE interventions on lipid metabolism in patients with AS through subgroup analysis of factors such as age, gender, intervention cycle and training method and lay the foundation of evidence-based medicine for the promotion of TCE in both clinical practice and the community.

Methods and analysis

A systematic approach will be completed to search the literature published up to 30 September 2021 in the following databases: Web of Science, PubMed, Embase, Cochrane Library, EBSCO and CNKI. Other databases will also be searched manually. Lipid metabolism is the primary outcome indicator. Data synthesis, sensitivity analysis, regression analysis, subgroup analysis and risk bias evaluation will be performed using RevMan V.5.3 software. In addition, funnel plots generated by Begg’s and Egger’s tests will be used to assess reporting bias.

Ethics and dissemination

Ethical approval and consent are not necessary as no primary data will be collected. The results of the study will be disseminated through carefully reviewed publications.

PROSPERO registration number

CRD42022304283.
Body mass index, proteinuria and total lymphocyte counts in predicting treatment responses among ART naïve individuals with HIV initiated on antiretroviral treatment in Dar es Salaam, Tanzania, 2019: a cohort study
Authors: Munseri Patricia , Jassely Lazaro , Tumaini Basil , Hertzmark Ellen
Published: June 2022

Objectives

To explore the potential use of body mass index (BMI), proteinuria and total lymphocyte count changes in predicting immunological and virological response in individuals with HIV initiated on antiretroviral treatment (ART).

Design

Prospective cohort study.

Setting

Three urban HIV care and treatment centres in Dar es Salaam.

Participants

Individuals with HIV initiating ART.

Outcome measures

HIV viral load ≥1000 copies/mL (viral non-suppression) at 6 months after ART initiation.

Results

Of 215 (out of 220 enrolled) participants who returned for evaluation at 6 months, 147 (66.8%) were women. At 6 months of follow-up, 89.4% (76/85) of participants with sustained weight gain were virally suppressed compared with 31.8% (7/22) with sustained loss, p<0.001. In participants who were lymphopaenic at baseline, an increase to normal total lymphocyte counts at 6 months was associated with an increase in CD4 count compared with participants who remained lymphopaenic, 96.2% (50/52) versus 54.8% (17/31), p<0.001. At baseline, 50.0% (110/220) had proteinuria. In participants without proteinuria from baseline to 6 months, 89.8% (79/88) were virally suppressed compared with participants with proteinuria at baseline and/or 3 months, 85.6% (77/90), those with persistent proteinuria, 30.8% (8/26), and proteinuria at 6 months only, 45.5% (5/11), p<0.001. In modified Poisson regression, the independent predictors other than CD4 cell counts for viral non-suppression at 6 months among individuals with HIV initiating on ART were BMI loss >5% from baseline to 6 months (adjusted RR 2.73, 95% CI (1.36 to 5.47)), lymphopaenia at 6 months (adjusted RR=4.54, 95% CI (2.19 to 9.39)) and proteinuria at 6 months (adjusted RR=2.63, 95% CI (1.25 to 5.54)).

Conclusions

Change in BMI, total lymphocyte count and presence of proteinuria can monitor and predict ART response and may be particularly helpful in settings when CD4 counts and viral load monitoring are unavailable.
Primary motivations for and experiences with paediatric minimally invasive tissue sampling (MITS) participation in Malawi: a qualitative study
Authors: Lawrence Sarah , Namusanya Dave , Mohamed Sumaya B , Hamuza Andrew , Huwa Cornelius , Chasweka Dennis , Kelley Maureen , Molyneux Sassy , Voskuijl Wieger , Denno Donna , Desmond Nicola
Published: June 2022

Objective

To understand family member consent decision-making influences and experiences in Malawi in order to inform future minimally invasive tissue sampling (MITS) studies.

Design

Qualitative study.

Setting

Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, which serves as the central referral hospital for southern Malawi and where MITS participants were recruited from.

Participants

Families of paediatric MITS participants.

Methods

We conducted in-depth interviews with 16 families 6 weeks after the death of paediatric MITS participants. Data were analysed using a combination of thematic content and theoretical framework approaches to explain the findings.

Results

Improved cause of death (CoD) ascertainment was the principal motivator for participation to protect remaining or future children. Community burial norms, religious doctrine and relationships with healthcare workers (HCWs) were not reported influencers among family members who consented to the procedure. Primary consenters varied, with single mothers more likely to consent independently or with only female family members present. Clear understanding of MITS procedures appeared limited 6 weeks postprocedure, but research was described as voluntary and preconsent information satisfactory for decision-making. Most families intended to share about MITS only with those involved in the consent process, for fear of rumours or judgement by extended family members and the wider community.

Conclusion

Among those who consented to MITS, decision-making was informed by individual and household experiences and beliefs, but not by religious affiliation or experiences with HCWs. While understanding of the MITS procedure was limited at the time of interview, families found informed consent information sufficient for decision-making. Future MITS studies should continue to explore information presentation best practices to facilitate informed consent during the immediate grieving period.