bluuebunny/crossref_metadata_2025 huggingface dataset:
Allo‐anti‐M: Detection peaks around 2 years of age, but may be attenuated by red blood cell transfusion
Authors: Tamai Yoshiko , Ohto Hitoshi , Yasuda Hiroyasu , Takeshita Akihiro , Fujii Nobuharu , Ogo Hiroaki , Yazawa Yurika , Hato Takaaki , Mitani Kinuko , Suzuki Keijiro , Yokohama Akihiko , Kato Yoko , Abe Misao , Kumagawa Midori , Ueda Yasunori , Nollet Kenneth E. , Cooling Laura , Kitazawa Junichi ,   for the Pediatric RBC Alloimmunization Consortium
Published: July 2021

Background

Anti‐M is frequently observed as a naturally occurring antibody of little clinical significance. Naturally occurring anti‐M is often found in children although the specific triggers of production, persistence, and evanescence of anti‐M have yet to be elucidated.

Methods

In a retrospective, multicenter, nationwide cohort survey conducted from 2001 to 2015, alloantibody screening was performed before and after transfusion in 18,944 recipients younger than 20 years. Recipients were categorized into six cohorts based on their age at transfusion; within and among these cohorts, allo‐anti‐M was analyzed in regard to its production, persistence, and evanescence.

Results

In 44 patients, anti‐M detected before and/or after transfusion was an age‐related phenomenon, with a median age of 2 years and an interquartile range of 1–3 years; anti‐M was most frequently detected in a cohort of children 1 to <5 years (0.77%, 31 of 4035). At least five patients were presumed to have concurrent infections. Among 1575 adolescents/young adults (15 to <20 years), no anti‐M was detected. Of 29 patients with anti‐M prior to transfusion, the antibody fell to undetectable levels in 17 recipients (89.5%, of whom at least 13 received only M‐negative red cells) after anywhere from 5 days to 5.8 years; anti‐M persisted in 2, and was not tested in 10. Only 15 recipients (0.08%) produced new anti‐M after transfusion.

Conclusion

Naturally occurring anti‐M is a phenomenon of younger ages, predominantly between 1 and 3 years. After transfusion, it often falls to undetectable levels.
Comparison of STA‐NeoPTimal (Stago) and STA‐Neoplastine CI Plus (Stago) thromboplastin reagents using a STA Satellite Max analyzer to measure prothrombin times in dogs
Authors: Beurlet Stéphanie , Coisnon Camille , Nguyen Trung Thanh , Richet Marine , Carlo Audrey , Briend‐Marchal Alexandra
Published: July 2021

Background

Different thromboplastins are available to measure prothrombin time (PT). Stago coagulation analyzers and reagents are currently used in veterinary laboratories and enable PT measurements to explore the coagulation cascade (extrinsic pathway).

Objectives

The main objective was to compare PT measurements obtained with the STA‐NeoPTimal reagent with the commonly used STA‐Neoplastine CI Plus reagent. The secondary objective was to compare the PT ratio with the international normalized ratio (INR) calculated from our derived clotting times.

Methods

Analytical performance was evaluated with intra‐assay and inter‐assay precision. Seventy‐two individual canine plasma samples were collected. Each sample was tested with both thromboplastins, using an STA Satellite Max analyzer. The PT, PT ratio, and INR values obtained with the two reagents were compared using Passing‐Bablok regression for correlations and Bland‐Altman plots for method agreements.

Results

The analytical performance of STA‐NeoPTimal reagent was acceptable. Compared with the STA‐Neoplastine CI Plus reagent, the STA‐NeoPTimal reagent showed a positive proportional bias for PT values. Narrow range analyses showed good agreement for normal PT values (less than 9.5 seconds, internal reference cutoff with STA‐Neoplastine CI Plus), and clinical concordance was achieved. When PT was prolonged (more than 9.5 seconds), PT increases were more marked with the STA‐NeoPTimal reagent. Agreement was good for INR values across the whole range of PT results.

Conclusion

STA‐NeoPTimal can be reliably implemented in veterinary laboratories for canine PT measurements, as agreement between the PT results measured with the two reagents was clinically acceptable.
Microrregiones estéticas: disputas y resistencias visuales indígenas en la amazonia contemporánea
Authors: Cortés-Garzón Liliana
Published: July 2021

A partir del estudio del arte amazónico contemporáneo se encuentran en esta investigación microrregiones artísticas en las cuencas hidrográficas en las cuales es posible determinar la producción, circulación y comercialización de pinturas amazónicas impactadas por el proceso de globalización que ingresa a la macrorregión amazónica en la venta de obras en dos sentidos: como suvenires, al mercado turístico y la salida de artistas indígenas que salen de su hábitat para migrar a grandes ciudades. Las obras artísticas indígenas se encuentran en horizontes de riesgo frente al sentido intrínseco de sus trabajos en mercados del arte que descontextualizan su sentido y comercializan de acuerdo con sus intereses producciones locales en ámbitos nacionales e internacionales. En esta investigación se presentan elementos teóricos frente al trabajo de artistas amazónicos contemporáneos, algunas temáticas de sus obras y sus retos para sobrevivir en un mercado del arte marcado por la desigualdad en el conocimiento del arte indígena.
“Track’s Coed, I Never Thought of It as Separate”: Challenging, Reproducing, and Negotiating Gender Stereotypes in Track and Field
Authors: Posbergh Anna , Jette Shannon
Published: July 2021

In contrast to the sex-segregated model that dominates sport and contributes to its tradition of hegemonic masculinity, collegiate track and field typically follows a sex-integrated structure whereby men and women train, travel, and compete together. In this article, the authors examined how six collegiate male track-and-field athletes who are part of a sex-integrated team navigate gendered norms and hierarchies with a particular focus on their understandings of gender(ed) performance and abilities. Grounded in a feminist poststructuralist framework, the authors’ analysis found that although the participants were accepting of a sex-integrated training environment and challenged some gender stereotypes and instances of sexism, they simultaneously reified these same gender stereotypes by characterizing women athletes as “emotional” or “less competitive” and advocated individual solutions to institutional sexism.
Heat-Treated Virus Inactivation Rate Depends Strongly on Treatment Procedure: Illustration with SARS-CoV-2
Authors: Gamble Amandine , Fischer Robert J. , Morris Dylan H. , Yinda Claude Kwe , Munster Vincent J. , Lloyd-Smith James O.
Published: July 2021

Heat is a powerful weapon against most infectious agents. It is widely used for decontamination of medical, laboratory, and personal protective equipment, and for biological samples.
Assessment of Antiviral Coatings for High-Touch Surfaces by Using Human Coronaviruses HCoV-229E and SARS-CoV-2
Authors: Butot S. , Baert L. , Zuber S.
Published: July 2021

SARS-CoV-2, the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, is transmitted mainly person-to-person through respiratory droplets, while the contribution of fomite transmission is less important than suspected at the beginning of the pandemic. Nevertheless, antiviral-coating solutions can offer an additional measure to mitigate the risk of SARS-CoV-2 transmission from high-touch surfaces.
Phospholipid
N
-Methyltransferases Produce Various Methylated Phosphatidylethanolamine Derivatives in Thermophilic Bacteria
Authors: Kleetz Julia , Welter Leon , Mizza Ann-Sophie , Aktas Meriyem , Narberhaus Franz
Published: July 2021

In recent years, the presence of phosphatidylcholine (PC) in bacterial membranes has gained increasing attention, partly due to its critical role in the interaction with eukaryotic hosts. PC biosynthesis via a three-step methylation of phosphatidylethanolamine, catalyzed by phospholipid
N
-methyltransferases (Pmts), has been described in a range of mesophilic bacteria.
A Simple Reverse Transcriptase PCR Melting-Temperature Assay To Rapidly Screen for Widely Circulating SARS-CoV-2 Variants
Authors: Banada Padmapriya , Green Raquel , Banik Sukalyani , Chopoorian Abby , Streck Deanna , Jones Robert , Chakravorty Soumitesh , Alland David
Published: July 2021

The increased transmission of SARS-CoV-2 variants of concern (VOC), which originated in the United Kingdom (B.1.1.7/alpha), South Africa (B1.351/beta), Brazil (P.1/gamma), the United States (B.1.427/429 or epsilon), and India (B.1.617.2/delta), requires a vigorous public health response, including real-time strain surveillance on a global scale. Although genome sequencing is the gold standard for identifying these VOCs, it is time-consuming and expensive.
Long Noncoding RNA IFITM4P Regulates Host Antiviral Responses by Acting as a Competing Endogenous RNA
Authors: Xiao Meng , Chen Yuhai , Wang Song , Liu Shasha , Rai Kul Raj , Chen Biao , Li Fang , Li Yingying , Maarouf Mohamed , Chen Ji-Long
Published: July 2021

lncRNAs play important roles in various biological processes, but their involvement in host antiviral responses remains largely unknown. In this study, we revealed that the pseudogene
IFITM4P
belonging to the IFITM family can transcribe a functional long noncoding RNA termed lncRNA IFITM4P.
Characterization of a Novel ACE2-Based Therapeutic with Enhanced Rather than Reduced Activity against SARS-CoV-2 Variants
Authors: Ferrari Mathieu , Mekkaoui Leila , Ilca F. Tudor , Akbar Zulaikha , Bughda Reyisa , Lamb Katarina , Ward Katarzyna , Parekh Farhaan , Karattil Rajeev , Allen Christopher , Wu Philip , Baldan Vania , Mattiuzzo Giada , Bentley Emma M. , Takeuchi Yasuhiro , Sillibourne James , Datta Preeta , Kinna Alexander , Pule Martin , Onuoha Shimobi C.
Published: July 2021

Mutational drift of SARS-CoV-2 risks rendering both therapeutics and vaccines less effective. Receptor decoy strategies utilizing soluble human ACE2 may overcome the risk of viral mutational escape since mutations disrupting viral interaction with the ACE2 decoy will by necessity decrease virulence, thereby preventing meaningful escape.
Structural Insight into the Interaction of Sendai Virus C Protein with Alix To Stimulate Viral Budding
Authors: Oda Kosuke , Matoba Yasuyuki , Sugiyama Masanori , Sakaguchi Takemasa
Published: July 2021

Human parainfluenza virus type I (hPIV1) is a respiratory pathogen affecting young children, immunocompromised patients, and the elderly, with no available vaccines or antiviral drugs. Sendai virus (SeV), a murine counterpart of hPIV1, has been studied extensively to determine the molecular and biological properties of hPIV1.
Comparative Genomics of Three Novel Jumbo Bacteriophages Infecting Staphylococcus aureus
Authors: Korn Abby M. , Hillhouse Andrew E. , Sun Lichang , Gill Jason J.
Published: July 2021

This study describes the comparative genomics of the following three novelS. aureusjumbo phages: MarsHill, Madawaska, and Machias. These threeS. aureusmyophages represent an emerging class ofS. aureusphage.
Dental Plaque Microbial Resistomes of Periodontal Health and Disease and Their Changes after Scaling and Root Planing Therapy
Authors: Kang Yutong , Sun Bianjin , Chen Yiju , Lou Yongliang , Zheng Meiqin , Li Zhenjun
Published: July 2021

The emergence and development of resistance to antibiotics in periodontal pathogens have affected the success rate of treatment for periodontitis. The development of new antibacterial strategies is urgently needed to help control and treat periodontal disease, and dental plaque microbiome studies offer a promising new angle of attack.
Mycobiome Traits Associated with Disease Tolerance Predict Many Western North American Bat Species Will Be Susceptible to White-Nose Syndrome
Authors: Vanderwolf Karen J. , Campbell Lewis J. , Taylor Daniel R. , Goldberg Tony L. , Blehert David S. , Lorch Jeffrey M.
Published: July 2021

White-nose syndrome is one of the most devastating wildlife diseases ever documented. Some bat species are resistant to or tolerant of the disease, and we previously reported that certain traits of the skin mycobiome of bat species in eastern North America are strongly associated with resistance to WNS.
Expanding Molecular Coverage in Mass Spectrometry Imaging of Microbial Systems Using Metal-Assisted Laser Desorption/Ionization
Authors: Lukowski Jessica K. , Bhattacharjee Arunima , Yannarell Sarah M. , Schwarz Kaitlyn , Shor Leslie M. , Shank Elizabeth A. , Anderton Christopher R.
Published: July 2021

Matrix-assisted laser desorption ionization mass spectrometry imaging is becoming an important technique to investigate molecular processes within microbial colonies and microbiomes under different environmental conditions. However, this method is limited in terms of the types and classes of molecules that can be detected.
Optic perineuritis in polyarthritis nodosa
Authors: Droger Sijgje Maria , Hensen Jan-Hein , van Rooij Lucas Cornelis
Published: July 2021

A 52-year-old male patient with polyarthritis nodosa (PAN) was referred to our neurology outpatient clinic. His main symptom was paroxysmal alternating bilateral blindness. Subsequently, he developed retro-orbital pain. Neurological examination including funduscopy was normal and laboratory tests showed no relevant abnormalities. MRI orbits showed remarkable perineural thickening and contrast enhancement of the optic nerve sheaths with sparing of the central optic nerve. These findings are pathognomonic for the clinical-radiological diagnosis of optic perineuritis (OPN). The patient was treated with high-dose immunosuppressants and had a good clinical outcome. Rapid diagnosis of OPN is important because early treatment is associated with a better outcome.
Rare presentation of isolated hydatid disease of the breast
Authors: Kori Ronal , Jain Sudhir Kumar , Khan Rehan Nabi
Published: July 2021

Isolated hydatid disease of the breast is a rare condition, possessing a diagnostic dilemma for the clinicians. Hydatid disease is common in endemic areas affecting most commonly the liver and lungs. Other organs rarely involved are the kidney, bone and brain. It is caused by the parasiteEchinococcus granulosus, widely spread by cattle and sheep. Humans are the accidental host for this organism. We present a similar case of isolated hydatid cyst of the breast, which was diagnosed preoperatively and managed successfully.
Postinfantile giant cell hepatitis in the setting of autoimmune hepatitis: exclusively a histological pattern or a prognosis predictor?
Authors: Teles Carolina , Santos Rui , Silva Carlos Dias , Vaio Teresa
Published: July 2021

Autoimmune hepatitis (AIH) is a rare chronic liver disease with a non-specific clinical presentation. Its physiopathology is not fully understood and, if untreated, can progress to cirrhosis and even fulminant liver failure. Here, we describe a case of a 73-year-old patient with an 11-month history suggestive of liver disease, who was concomitantly diagnosed with AIH and the extremely rare postinfantile giant cell hepatitis (PIGCH). Despite standard immunosuppressive therapy, the patient presented a severe clinical course, culminating in acute-on-chronic liver failure and death. This case reminds physicians of the importance of an early diagnosis, close monitoring and timely treatment of AIH. It also highlights the significant role in prognosis of the specific histological pattern of PIGCH, which has been mainly associated with a serious clinical outcome and unpredictable response to immunosuppressive therapy. Triggers of both AIH and PIGCH, such as viral infections, must be excluded, given their treatment implications.
Mesh hernioplasty in emergency repair of traumatic abdominal wall hernia following bull horn injury
Authors: Bodda Arvind Kumar , Sasmal Prakash Kumar , Mishra Swastik , Shettar Ankit
Published: July 2021

Traumatic abdominal wall hernia (TAWH) is uncommon, mostly following motor vehicle accidents, fall from height and bullfighting. Bullhorn injury, common in rural areas, presents as either penetrating injuries to the abdomen or blunt injuries leading to internal organs injury. Rarely the bull horn injury may lead to TAWH. We report a 70-year-old female from a rural area who suffered bull horn injury to the abdomen leading to TAWH without penetrating the horn and was managed in the emergency by an open mesh hernioplasty. We suture closed the 10×5 cm size defect and reinforced it with a polypropylene mesh of 15×15 cm in the emergency setting. The patient recovered well without any complications or recurrence and doing well at 1 year of follow-up. Mesh hernioplasty can be considered a feasible and safe option in the emergency repair of traumatic abdominal hernia following bull horn injury.
Short message service (SMS) reminders for childhood immunisation in low-income and middle-income countries: a systematic review and meta-analysis
Authors: Eze Paul , Lawani Lucky Osaheni , Acharya Yubraj
Published: July 2021

Introduction

Childhood vaccine delivery services in the low- and middle-income countries (LMIC) are struggling to reach every child with lifesaving vaccines. Short message service (SMS) reminders have demonstrated positive impact on a number of attrition-prone healthcare delivery services. We aimed to evaluate the effectiveness of SMS reminders in improving immunisation coverage and timeliness in LMICs.

Methods

PubMed, Embase, Scopus, Cochrane CENTRAL, CINAHL, CNKI, PsycINFO and Web of Science including grey literatures and Google Scholar were systematically searched for randomised controlled trials (RCTs) and non-RCTs that evaluated the effect of SMS reminders on childhood immunisation and timeliness in LMICs. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 assessment tool for RCTs and Cochrane Risk of Bias in Non-randomised Studies of Interventions tool for non-RCTs. Meta-analysis was conducted using random-effects models to generate pooled estimates of risk ratio (RR).

Results

18 studies, 13 RCTs and 5 non-RCTs involving 32 712 infants (17 135 in intervention groups and 15 577 in control groups) from 11 LMICs met inclusion criteria. Pooled estimates showed that SMS reminders significantly improved childhood immunisation coverage (RR=1.16; 95% CI: 1.10 to 1.21; I2=90.4%). Meta-analysis of 12 included studies involving 25 257 infants showed that SMS reminders significantly improved timely receipt of childhood vaccines (RR=1.21; 95% CI: 1.12 to 1.30; I2=87.3%). Subgroup analysis showed that SMS reminders are significantly more effective in raising childhood immunisation coverage in lower middle-income and low-income countries than in upper middle-income countries (p<0.001) and sending more than two SMS reminders significantly improves timely receipt of childhood vaccines than one or two SMS reminders (p=0.040).

Conclusion

Current evidence from LMICs, although with significant heterogeneity, suggests that SMS reminders can contribute to achieving high and timely childhood immunisation coverage.

PROSPERO registration number

CRD42021225843.
Return on investment of a model of access combining triage with initial management: an economic analysis
Authors: Snowdon David A , Harding Katherine E , Taylor Nicholas F , Leggat Sandra G , Kent Bridie , Lewis Annie K , Watts Jennifer J
Published: July 2021

Objectives

Timely access to outpatient services is a major issue for public health systems. To address this issue, we aimed to establish the return on investment to the health system of the implementation of an alternative model for access and triage (Specific Timely Appointments for Triage: STAT) compared with a traditional waitlist model.

Design

Using a prospective pre–post design, an economic analysis was completed comparing the health system costs for participants who were referred for community outpatient services post-implementation of STAT with a traditional waitlist comparison group.

Setting

Eight community outpatient services of a health network in Melbourne, Australia.

Participants

Adults and children referred to community outpatient services.

Interventions

STAT combined targeted activities to reduce the existing waiting list and direct booking of patients into protected assessment appointments. STAT was compared with usual care, in which new patients were placed on a waiting list and offered appointments as space became available.

Outcomes

Health system costs included STAT implementation costs, outpatient health service use, emergency department presentations and hospital admissions 3 months before and after initial outpatient appointment. Waiting time was the primary outcome. Incremental cost-effectiveness ratios (ICERs) were estimated from the health system perspective.

Results

Data from 557 participants showed a 16.9 days or 29% (p<0.001) reduction in waiting time for first appointment with STAT compared with traditional waitlist. The ICER showed a cost of $A10 (95% CI −19 to 39) per day reduction in waiting time with STAT compared with traditional waitlist. Modelling showed the cost reduced to $A4 (95% CI −25 to 32) per day of reduction in waiting, if reduction in waiting times is sustained for 12 months.

Conclusions

There was a significant reduction in waiting time with the introduction of STAT at minimal cost to the health system.

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN12615001016527).
Treatment outcomes of patients with drug-sensitive tuberculosis under community-based versus facility-based directly observed treatment, short course strategy in Southwest Ethiopia: a prospective cohort study
Authors: Ereso Berhane Megerssa , Sagbakken Mette , Gradmann Christoph , Yimer Solomon Abebe
Published: July 2021

Objective

To compare tuberculosis (TB) treatment outcomes and associated factors among patients attending community-based versus facility-based directly observed treatment, short course (DOTS).

Design

A prospective cohort study.

Setting

The study was conducted in Southwest Ethiopia. There were seven hospitals (five primary, one general and one specialised), 120 health centres and 494 health posts.

Participants

A total of 1161 individuals consented to participate in the study (387 patients under community-based DOTS (CB-DOTS) and 774 patients under facility-based DOTS (FB-DOTS)). Individuals who could not respond to the questions, mentally or critically ill patients, and those less than 15 years old, were excluded from the study.

Primary outcome measure

TB treatment outcomes were compared among patients under CB-DOTS versus FB-DOTS. Risk ratio (RR), risk difference (RD) and confidence interval (CI) were calculated among the study groups. In addition, χ2or Fisher’s exact tests were used to compare group differences, with a p value of <0.05 considered statistically significant.

Results

Patients who opted for CB-DOTS were more likely to be cured by 12% than those who opted for FB-DOTS (RR=1.12, 95% CI=0.96 to 1.30). Patients under CB-DOTS had a lesser risk of death (RR=0.93, 95% CI=0.49 to 1.77) and a lower risk of treatment failure (RR=0.86, 95% CI=0.22 to 3.30) than those under FB-DOTS. Furthermore, patients who opted for CB-DOTS were less likely to have a positive sputum smear result at the end of the treatment period (p=0.042) compared with their counterparts.

Conclusion

The study showed that CB-DOTS is more effective than FB-DOTS in terms of improving cure rate and sputum conversion rate, as well as lowering treatment failure rate. Our findings show the need for scaling up and a further decentralisation of CB-DOTS approach to improve access to TB treatment service for the rural community.
Engaging communities in non-communicable disease research and interventions in low- and middle-income countries: a realist review protocol
Authors: Klingberg Sonja , Adhikari Bipin , Draper Catherine E , Bosire Edna N , Tiigah Priscilla , Nyirenda Deborah , Mukumbang Ferdinand C
Published: July 2021

Introduction

Engaging communities and intended beneficiaries at various stages of health research is a recommended practice. The contribution of community engagement to non-communicable disease research in low- and middle-income countries has not yet been extensively studied or synthesised. This protocol describes the steps towards generating an understanding of community engagement in the context of non-communicable disease research, prevention and health promotion using a realist review approach. A realist lens enables a rich explanatory approach to causation while capturing complexity, and an openness to multiple outcomes, including unintended consequences. The review will thus develop an understanding of community engagement without assuming that such practices result in more ethical research or effective interventions.

Methods and analysis

We propose a realist approach aiming to examine how, why, under what circumstances and for whom community engagement works or does not work. The iterative review steps include clarifying the review scope; searching for evidence; appraising studies and extracting data; synthesising evidence and drawing conclusions; and disseminating, implementing and evaluating the findings. Principles of meta-narrative review (pragmatism, pluralism, historicity, contestation, reflexivity and peer review) are employed to ensure practicable and contextualised review outputs. The proposed review will draw on theoretical and empirical literature beyond specific diseases or settings, but with a focus on informing non-communicable disease research and interventions in low- and middle-income countries. The synthesis of existing literature will be complemented by qualitative realist interviews and stakeholder consultation. Through drawing on multiple types of evidence and input from both experts and intended beneficiaries, the review will provide critical and pragmatic insights for research and community engagement in low- and middle-income countries.

Ethics and dissemination

Ethical approval has been obtained from the University of the Witwatersrand. Dissemination will include traditional academic channels, institutional communications, social media and discussions with a wide range of stakeholders.
Analysis of sex differences in the clinical presentation, management and prognosis of infective endocarditis in Spain
Authors: Varela Barca Laura , Vidal-Bonnet Laura , Fariñas MC , Muñoz Patricia , Valerio Minero Maricela , de Alarcón Arístides , Gutiérrez Carretero Encarnacion , Gutiérrez Cuadra Manuel , Moreno Camacho Asuncion , Kortajarena Urkola Xabier , Goikoetxea Agirre Josune , Ojeda Burgos Guillermo , López-Cortés Luis Eduardo , Porres Azpiroz JC , Lopez-Menendez Jose
Published: July 2021

Introduction

Sex-dependent differences of infective endocarditis (IE) have been reported. Women suffer from IE less frequently than men and tend to present more severe manifestations. Our objective was to analyse the sex-based differences of IE in the clinical presentation, treatment, and prognosis.

Material and methods

We analysed the sex differences in the clinical presentation, modality of treatment and prognosis of IE in a national-level multicentric cohort between 2008 and 2018. All data were prospectively recorded by the GAMES cohort (Spanish Collaboration on Endocarditis).

Results

A total of 3451 patients were included, of whom 1105 were women (32.0%). Women were older than men (mean age, 68.4 vs 64.5). The most frequently affected valves were the aortic valve in men (50.6%) and mitral valve in women (48.7%).Staphylococcus aureusaetiology was more frequent in women (30.1% vs 23.1%; p<0.001).

Surgery was performed in 38.3% of women and 50% of men. After propensity score (PS) matching for age and estimated surgical risk (European System for Cardiac Operative Risk Evaluation II (EuroSCORE II)), the analysis of the matched cohorts revealed that women were less likely to undergo surgery (OR 0.74; 95% CI 0.59 to 0.91; p=0.05).

The observed overall in-hospital mortality was 32.8% in women and 25.7% in men (OR for the mortality of female sex 1.41; 95% CI 1.21 to 1.65; p<0.001). This statistical difference was not modified after adjusting for all possible confounders.

Conclusions

Female sex was an independent factor related to mortality after adjusting for confounders. In addition, women were less frequently referred for surgical treatment.
Education on cardiac risk and CPR in cardiology clinic waiting rooms: a randomised clinical trial
Authors: McIntyre Daniel , Thiagalingam Aravinda , Klimis Harry , Von Huben Amy , Marschner Simone , Chow Clara K
Published: July 2021

Objective

Waiting time is inevitable during cardiovascular (CV) care. This study examines whether waiting room-based CV education could complement CV care.

Methods

A 2:1 randomised clinical trial of patients in waiting rooms of hospital cardiology clinics. Intervention participants received a series of tablet-delivered CV educational videos and were randomised 1:1 to receive another video on cardiopulmonary resuscitation (CPR) or no extra video. Control received usual care. The primary outcome was the proportion of participants reporting high motivation to improve CV risk-modifying behaviours (physical activity, diet and blood pressure monitoring) post-clinic. Secondary outcomes: clinic satisfaction, CV lifestyle risk factors (RFs) and confidence to perform CPR. Assessors were blinded to treatment allocation.

Results

Among 514 screened, 330 were randomised (n=220 intervention, n=110 control) between December 2018 and March 2020, mean age 53.8 (SD 15.2), 55.2% male. Post-clinic, more intervention participants reported high motivation to improve CV risk-modifying behaviours: 29.6% (64/216) versus 18.7% (20/107), relative risk (RR) 1.63 (95% CI 1.04 to 2.55). Intervention participants reported higher clinic satisfaction RR: 2.19 (95% CI 1.45 to 3.33). Participants that received the CPR video (n=110) reported greater confidence to perform CPR, RR 1.61 (95% CI 1.20 to 2.16). Overall, the proportion of participants reporting optimal CV RFs increased between baseline and 30-day follow-up (16.1% vs 24.8%, OR=2.44 (95% CI 1.38 to 4.49)), but there was no significant between-group difference at 30 days.

Conclusion

CV education delivery in the waiting room is a scalable concept and may be beneficial to CV care. Larger studies could explore its impact on clinical outcomes.

Trial registration number

ANZCTR12618001725257.
Physician moral injury in the context of moral, ethical and legal codes
Authors: Day Philip , Lawson Jennifer , Mantri Sneha , Jain Abhi , Rabago David , Lennon Robert
Published: July 2021

After 40 years of attributing high rates of physician career dissatisfaction, attrition, alcoholism, divorce and suicide to ‘burnout’, there is growing recognition that these outcomes may instead be caused by moral injury. This has led to a debate about the relative diagnostic merits of these two terms, a recognition that interventions designed to treat burnout may be ineffective, and much perplexity about how—if at all—this changes anything.

The current research seeks to develop the construct of moral injury outside military contexts, generate more robust validity tests and more fully describe and measure the experiences of persons exposed to moral harms. Absent from the literature is a mechanism through which to move from the collective moral injury experience of physicians to a systematic change in the structure of medical practice. To address this, after providing a brief history, definitions and contrasts between burnout, moral distress and moral injury, we review the interplay of moral and ethical codes in the context of moral injury. We conclude by suggesting that professional associations can potentially prevent moral injury by providing protections for physicians within their codes of ethics.
Work-life balance: a comparison of women in cardiology and other specialties
Authors: Vlachadis Castles Anastasia , Burgess Sonya , Robledo Kristy , Beale Anna L , Biswas Sinjini , Segan Louise , Gutman Sarah , Mukherjee Swati , Leet Angeline , Zaman Sarah
Published: July 2021

Objective

Significant gender disparities exist in some medical specialties, particularly cardiology. We assessed work, personal life and work-life balance in women in cardiology in Australia and New Zealand (NZ), compared with other specialties, to determine factors that may contribute to the lack of women in the specialty.

Methods

This study is a prospective survey-based cohort study comparing cardiology and non-cardiology specialties. An online survey was completed by female doctors in Australia and NZ, recruited via email lists and relevant social media groups. The survey included demographics, specialty, stage of training, work hours/setting, children and relationships, career satisfaction, income and perceptions of specialty.

Results

452 participants completed the survey (median age 36 years), of which 57 (13%) worked in cardiology. Of all respondents, 84% were partnered and 75% had children, with no difference between cardiology and non-cardiology specialties. Compared with non-cardiology specialties, women in cardiology worked more hours per week (median 50 hours vs 40 hours, p<0.001), were more likely to be on call more than once per week (33% vs 12%, p<0.001) and were more likely to earn an annual income >$3 00 000 (35% vs 10%, p<0.001). Women in cardiology were less likely to agree that they led a balanced life (33% vs 51%, p=0.03) or that their specialty was female friendly (19% vs 75%, p<0.001) or family friendly (20% vs 63%, p<0.001).

Conclusions

Compared with other specialties, women in cardiology reported poorer work-life balance, greater hours worked and on-call commitments and were less likely to perceive their specialty as female friendly or family friendly. Addressing work-life balance may attract and retain more women in cardiology.
BLANKETS: a toasty tool to improve social history documentation for our older patients
Authors: Warner Bronwen E , Millar Kate , Bolland Mhairi , McNicholas Jackie , Dani Melanie
Published: July 2021

A thorough social history is an important component of all medical clerkings and is particularly crucial when admitting an older patient. Standards exist to guide the social history content but are rarely referenced in practice. This quality improvement project conceived and implemented the novel BLANKETS (Bladder and bowels, Legal arrangements, Activities of daily living, Neurology (cognition), Kit (dentures, hearing or visual aids), EtOH and smoking, Trips, walking aids and exercise tolerance, Setup at home) tool for social history documentation, derived from existing standards, at a specialist medical inpatient hospital setting. Over a 15-week period with two cycles of intervention involving 125 patients in total, there was good staff engagement and overall improvement in social history documentation with 194/403 (48.1%) vs 199/545 (36.5%) criteria met overall and on average 6.3/13 vs 4.7/13 criteria documented for each patient. The social history BLANKETS tool is a memorable acronym to prompt clerking doctors to take a thorough and focused social history which is intrinsic to determining appropriate rehabilitation goals for effective discharge planning and setting appropriate ceiling of care decisions.
‘If I hadn’t seen this picture, I'd be smoking’—perceptions about innovations in health warnings for cigarette packages in Brazil: a focus group study
Authors: Perez Cristina de Abreu , Camacho Luiz Antonio Bastos , Mendes Felipe Lacerda , Oliveira da Silva Andre Luiz , Figueiredo Valeska Carvalho , Latuf Gloria Maria de Oliveira , Fernandes Ana Marcia Messeder Sebrao , Albertassi Patrícia Gonçalves Duarte , Castello Branco Patricia Aleksitch , Branco Patricia Francisco , Piras Stefania Schimaneski , Suarez Maribel Carvalho
Published: July 2021

Objective

To investigate the perceptions of young people and adults, smokers and non-smokers about the current set of innovations introduced in 2018 into the Brazilian tobacco products’ health warnings.

Methods

Twenty focus groups were conducted in five state capitals in Brazil. The participants (n=163) were segmented by smoking status, age (15–17 years, 18–55 years) and social grade (C, D–E classes) to examine cigarette packaging and explore the participants’ perceptions of health warnings.

Results

Health warnings capture attention, eliciting apprehension, fear, disgust and concern about the negative consequences of cigarette consumption. The 2018 Brazil health warnings are spontaneously recalled by participants, even without the presence of cigarette packages. However, the analysis also reveals the challenges of overcoming communication barriers and distorted interpretations, especially among smokers. The inclusion of direct and provocative stimuli, such as the use of the word ‘you’, attracts attention and creates more proximity to the recipient of the message. The results also highlight the interest and fear elicited by warnings on toxic constituents and the importance of using contrasting colours in warnings, which differentiate them from the colours of cigarette packs.

Conclusion

Introducing innovative components in health warnings can catch consumers’ attention but considering that the interviewees encountered difficulties interpreting textual warnings about toxic constituents in cigarettes, the study reinforces the importance of adopting direct language and pictures, instead of text, which can visually transmit the warning messages and the use of specific wording that generates proximity between the emitter and receiver.
Final results of CALDER: kinetic inductance light detectors to search for rare events
Authors: Cardani L. , Casali N. , Colantoni I. , Cruciani A. , Di Domizio S. , Martinez M. , Pettinacci V. , Pettinari G. , Vignati M.
Published: July 2021

The next generation of bolometric experiments searching for rave events, in particular for the neutrino-less double beta decay, needs fast, high-sensitivity and easy-to-scale cryogenic light detectors. The CALDER project (2014–2020) developed a new technology for light detection at cryogenic temperature. In this paper we describe the achievements and the final prototype of this project, consisting of a $$5\times 5~\hbox {cm}^2$$

5
×
5

cm
2

, $$650~\upmu \text {m}$$

650

μ
m

thick silicon substrate coupled to a single kinetic inductance detector made of a three-layer aluminum-titanium-aluminum. The baseline energy resolution is $$34\pm 1$$

34
±
1

(stat)$$\pm 2$$

±
2

(syst) eV RMS and the response time is $$120~\upmu $$

120

μ

s. These features, along with the natural multiplexing capability of kinetic inductance detectors, meet the requirements of future large-scale experiments.
Feeder Ship Size Optimization in Maritime Markets with Uncertainty
Authors: Hu Hongtao , Mo Jiao , Huang Lufei
Published: July 2021

This paper considers the ship size optimization problem for a liner shipping company that provides feeder service between one hub port and one feeder port. In the maritime market with uncertainty, this problem becomes more challenging. This research first analyzes the decision behaviors of the shipping company. Then, a stochastic dynamic programming method is proposed to calculate the expected total volume of containers transported within the planning horizon. Using the calculated volumes as input parameters calculate the profit of each ship sizes and then determine the suitable ship size for the feeder route. Numerical experiments are performed to validate the effectiveness of the proposed method and the efficiency of the proposed algorithm.
Research on the Measurement of Subject Credit Risk of Chinese Port Enterprises by Constrained Logistic Regression
Authors: Wu Ming , Cheng Gang , Gao Jiajing
Published: July 2021

This paper studies the subject credit risk of Chinese port enterprises. Since the impact of cash flow ability on credit risk measurement will be increased under extreme case, ordinary logistic regression methods may lack explanatory power for port enterprise default under extreme cases. Considering the characteristics of cash flow in port industry, we introduce the constrained logistic regression method to establish a default probability model which can describe the credit risk level of the industry with higher accuracy in the extreme case where an enterprise’s quick ratio is lower than a cutoff point, For empirical study, we leverage the data of more than 900 companies in port and transportation industry in 2016–2018. The constrained logistic regression splits the data into two subspaces based on quick ratios with the cutoff of 1.8. Then logistic regression is built on the two subspaces, respectively. The recall ratios show that the constrained logistic regression method performs better than the ordinary logistic regression on the study of corporate default probability in port and transportation industry.
Interacting dynamical dark energy with stable high-scale cosmological perturbations at radiation-dominated epoch
Authors: Neomenko Roman
Published: July 2021

In this paper, the cosmological perturbations of dynamical dark energy and dark matter, which interact non-gravitationally are studied. This dark energy–dark matter non-gravitational interaction is linearly dependent on the energy densities of dark components. However, in the interacting quintessence dark energy models with such type of interaction, the non-adiabatic instabilities of cosmological perturbations at radiation-dominated epoch arise. To avoid this problem, the model of dynamical dark energy was chosen as the basis. Here, the equation of state parameter of dark energy evolves in time but can be assumed constant at early epoch, so this model can be tuned in such a way that the non-adiabatic instabilities would not appear. The drawback of this cosmological model is that the energy densities of dark components can take the negative values for the certain range of interaction parameter, so the conditions for positivity of dark components densities were derived. Using obtained constraints on the model parameters, the impact of coupling parameter on modification of cosmological perturbations’ evolution is analyzed.
ON THE FAST INCREASING DIGITS IN LÜROTH EXPANSIONS
Authors: LÜ MEIYING , XIE JING
Published: July 2021

For any [Formula: see text], let [Formula: see text] be its Lüroth expansion with digits [Formula: see text]. Let [Formula: see text] be a function satisfying [Formula: see text] as [Formula: see text] and [Formula: see text] In this paper, we give the Hausdorff dimension of the set [Formula: see text] without any extra condition on [Formula: see text]. This result extends the former work of the first author (Fractals 28(4) (2020) 2050064, doi:10.1142/S0218348X20500644).
Strong 1-boundedness of unimodular orthogonal free quantum groups
Authors: Elzinga Floris
Published: July 2021

Recently, Brannan and Vergnioux showed that the orthogonal free quantum group factors [Formula: see text] have Jung’s strong [Formula: see text]-boundedness property, and hence are not isomorphic to free group factors. We prove an analogous result for the other unimodular case, where the parameter matrix is the standard symplectic matrix in [Formula: see text] dimensions [Formula: see text]. We compute free derivatives of the defining relations by introducing self-adjoint generators through a decomposition of the fundamental representation in terms of Pauli matrices, resulting in [Formula: see text]-boundedness of these generators. Moreover, we prove that under certain conditions, one can add elements to a [Formula: see text]-bounded set without losing [Formula: see text]-boundedness. In particular, this allows us to include the character of the fundamental representation, proving strong [Formula: see text]-boundedness.
Existence of exponentially growing finite energy solutions for the charged Klein–Gordon equation on the de Sitter–Kerr–Newman metric
Authors: Besset Nicolas , Häfner Dietrich
Published: July 2021

We show the existence of exponentially growing finite energy solutions for the charged Klein–Gordon equation on the De Sitter–Kerr–Newman metric for small charge and mass of the field and small angular momentum of the black hole. The mechanism behind is that the zero resonance that exists for zero charge, mass and angular momentum moves into the upper half plane.
Regularity and global structure for Hamilton–Jacobi equations with convex Hamiltonian
Authors: Li Tian-Hong , Wang Jinghua , Wen Hairui
Published: July 2021

We consider the multidimensional Hamilton–Jacobi (HJ) equation [Formula: see text] with [Formula: see text] being a constant and for bounded [Formula: see text] initial data. When [Formula: see text], this is the typical case of interest with a uniformly convex Hamiltonian. When [Formula: see text], this is the famous Eikonal equation from geometric optics, the Hamiltonian being Lipschitz continuous with homogeneity [Formula: see text]. We intend to fill the gap in between these two cases. When [Formula: see text], the Hamiltonian [Formula: see text] is not uniformly convex and is only [Formula: see text] in any neighborhood of [Formula: see text], which causes new difficulties. In particular, points on characteristics emanating from points with vanishing gradient of the initial data could be “bad” points, so the singular set is more complicated than what is observed in the case [Formula: see text]. We establish here the regularity of solutions and the global structure of the singular set from a topological standpoint: the solution inherits the regularity of the initial data in the complement of the singular set and there is a one-to-one correspondence between the connected components of the singular set and the path-connected components of the set [Formula: see text].
Dissipative structure and asymptotic profiles for symmetric hyperbolic systems with memory
Authors: Taniue Shogo , Kawashima Shuichi
Published: July 2021

We study symmetric hyperbolic systems with memory-type dissipation and investigate their dissipative structures under Craftsmanship condition. We treat two cases: memory-type diffusion and memory-type relaxation, and observe that the dissipative structures of these two cases are essentially different. Namely, we show that the dissipative structure of the system with memory-type diffusion is of the standard type, while that of the system with memory-type relaxation is of the regularity-loss type. Moreover, we investigate the asymptotic profiles of the solutions for [Formula: see text]. In the diffusion case, it is proved that the systems with memory and without memory have the same asymptotic profile for [Formula: see text], which is given by the superposition of linear diffusion waves. We have the same result also in the relaxation case under enough regularity assumption on the initial data.
Hybrid Structures on EQ-Algebras
Authors: Paad Akbar
Published: July 2021

In this paper, the notion of hybrid structures on EQ-algebras is introduced, and some related properties are provided. Moreover, the concept of hybrid (pre)filters in EQ-algebras is provided and some related results are given. In the following, the quotient EQ-algebras with respect to a hybrid filter of an EQ-algebra are studied and it is shown that this quotient structure is a separated EQ-algebra for any hybrid filter. Moreover, the concept of strong relative congruence relation is introduced and some related properties are characterized. Finally, it is proved that there is a one-to-one correspondence between the set of all relative congruence relation and the set of all hybrid filters with a few additional conditions.
Sino–Indian Conflict: Foreign Policy Options for the Smaller South Asian States
Authors: ATTANAYAKE Chulanee
Published: July 2021

The relationship between China and India is characterised by competition intertwined with issues over sovereignty, territorial integrity and prestige. Since the war in 1962, they have engaged in several small skirmishes. The increasing tension and frequency of clashes have led the smaller South Asian countries being caught in the middle. What impacts do the changing dynamics have on smaller South Asian countries? What options do these smaller countries have in navigating the relationship amid increasing border tensions? This article attempts to examine the aforementioned research questions.