bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-dose aspirin and incidence of lung carcinoma in patients with chronic obstructive pulmonary disease in Hong Kong: A cohort study
Authors: Yu Si-Yeung , Ip Mary Sau-Man , Li Xue , Cheung Ka-Shing , Ren Qing-Wen , Wu Mei-Zhen , Li Hang-Long , Wong Pui-Fai , Tse Hung-Fat , Yiu Kai-Hang
Published: January 2022

Background

Evidence suggests that chronic obstructive pulmonary disease (COPD) is associated with a higher risk of lung carcinoma. Using a territory-wide clinical electronic medical records system, we investigated the association between low-dose aspirin use (≤160 mg) among patients with COPD and incidence of lung carcinoma and the corresponding risk of bleeding.

Methods and findings

This is a retrospective cohort study conducted utilizing Clinical Data Analysis Reporting System (CDARS), a territory-wide database developed by the Hong Kong Hospital Authority. Inverse probability of treatment weighting (IPTW) was used to balance baseline covariates between aspirin nonusers (35,049 patients) with new aspirin users (7,679 patients) among all eligible COPD patients from 2005 to 2018 attending any public hospitals. The median age of the cohort was 75.7 years (SD = 11.5), and 80.3% were male. Competing risk regression with Cox proportional hazards model were performed to estimate the subdistribution hazard ratio (SHR) of lung carcinoma with low-dose aspirin and the associated bleeding events. Of all eligible patients, 1,779 (4.2%, 1,526 and 253 among nonusers and users) were diagnosed with lung carcinoma over a median follow-up period of 2.6 years (interquartile range [IQR]: 1.4 to 4.8). Aspirin use was associated with a 25% lower risk of lung carcinoma (SHR = 0.75, 95% confidence interval [CI] 0.65 to 0.87, p = <0.001) and 26% decrease in lung carcinoma–related mortality (SHR = 0.74, 95% CI 0.64 to 0.86, p = <0.001). Subgroup analysis revealed that aspirin was beneficial for patients aged above or below 75 years, but was also beneficial among populations who were male, nondiabetic, and nonhypertensive. Aspirin use was not associated with an increased risk of upper gastrointestinal bleeding (UGIB) (SHR = 1.19, 95% CI 0.94 to 1.53, p = 0.16), but was associated with an increased risk of hemoptysis (SHR = 1.96, 95% CI 1.73 to 2.23, p < 0.001). The main limitations of the study were (i) that one group of patients may be more likely to seek additional medical attention, although this was partially mitigated by the use of propensity score analysis; and (ii) the observational nature of the study renders it unable to establish causality between aspirin use and lung carcinoma incidence.

Conclusions

In this study, we observed that low-dose aspirin use was associated with a lower risk of lung carcinoma and lung carcinoma–related mortality among COPD patients. While aspirin was not associated with an increased risk of UGIB, the risk of hemoptysis was elevated.
Development of a questionnaire to determine the case detection delay of leprosy: A mixed-methods cultural validation study
Authors: de Bruijne Naomi D. , Urgesa Kedir , Aseffa Abraham , Bobosha Kidist , Schoenmakers Anne , van Wijk Robin , Hambridge Thomas , Waltz Mitzi M. , Kasang Christa , Mieras Liesbeth
Published: January 2022

Background

Delay in case detection is a risk factor for developing leprosy-related impairments, leading to disability and stigma. The objective of this study was to develop a questionnaire to determine the leprosy case detection delay, defined as the period between the first signs of the disease and the moment of diagnosis, calculated in total number of months. The instrument was developed as part of the PEP4LEP project, a large-scale intervention study which determines the most effective way to implement integrated skin screening and leprosy post-exposure prophylaxis with a single-dose of rifampicin (SDR-PEP) administration in Ethiopia, Mozambique and Tanzania.

Methodology/Principal findings

A literature review was conducted and leprosy experts were consulted. The first draft of the questionnaire was developed in Ethiopia by exploring conceptual understanding, item relevance and operational suitability. Then, the first draft of the tool was piloted in Ethiopia, Mozambique and Tanzania. The outcome is a questionnaire comprising nine questions to determine the case detection delay and two annexes for ease of administration: a local calendar to translate the patient’s indication of time to number of months and a set of pictures of the signs of leprosy. In addition, a body map was included to locate the signs. A ‘Question-by-Question Guide’ was added to the package, to provide support in the administration of the questionnaire. The materials will be made available in English, Oromiffa (Afaan Oromo), Portuguese and Swahili via https://www.infolep.org.

Conclusions/Significance

It was concluded that the developed case detection delay questionnaire can be administered quickly and easily by health workers, while not inconveniencing the patient. The instrument has promising potential for use in future leprosy research. It is recommended that the tool is further validated, also in other regions or countries, to ensure cultural validity and to examine psychometric properties like test-retest reliability and interrater reliability.
Machine learning and deep learning techniques to support clinical diagnosis of arboviral diseases: A systematic review
Authors: da Silva Neto Sebastião Rogério , Tabosa Oliveira Thomás , Teixeira Igor Vitor , Aguiar de Oliveira Samuel Benjamin , Souza Sampaio Vanderson , Lynn Theo , Endo Patricia Takako
Published: January 2022

Background

Neglected tropical diseases (NTDs) primarily affect the poorest populations, often living in remote, rural areas, urban slums or conflict zones. Arboviruses are a significant NTD category spread by mosquitoes. Dengue, Chikungunya, and Zika are three arboviruses that affect a large proportion of the population in Latin and South America. The clinical diagnosis of these arboviral diseases is a difficult task due to the concurrent circulation of several arboviruses which present similar symptoms, inaccurate serologic tests resulting from cross-reaction and co-infection with other arboviruses.

Objective

The goal of this paper is to present evidence on the state of the art of studies investigating the automatic classification of arboviral diseases to support clinical diagnosis based on Machine Learning (ML) and Deep Learning (DL) models.

Method

We carried out a Systematic Literature Review (SLR) in which Google Scholar was searched to identify key papers on the topic. From an initial 963 records (956 from string-based search and seven from a single backward snowballing procedure), only 15 relevant papers were identified.

Results

Results show that current research is focused on the binary classification of Dengue, primarily using tree-based ML algorithms. Only one paper was identified using DL. Five papers presented solutions for multi-class problems, covering Dengue (and its variants) and Chikungunya. No papers were identified that investigated models to differentiate between Dengue, Chikungunya, and Zika.

Conclusions

The use of an efficient clinical decision support system for arboviral diseases can improve the quality of the entire clinical process, thus increasing the accuracy of the diagnosis and the associated treatment. It should help physicians in their decision-making process and, consequently, improve the use of resources and the patient’s quality of life.
Does the digital finance revolution validate the Environmental Kuznets Curve? Empirical findings from China
Authors: Zhong Kaiyang
Published: January 2022

In recent years, digital finance has become a crucial part of the financial system and reshaped the mode of green finance in China. Digital finance has brought certain impact on economic growth, industrial structure, and resident income, which may affect pollution. The nexus of digital finance and environment in China is thus worth exploring. By revising the traditional Environmental Kuznets Curve model with income inequality variable, this paper decomposes the environmental effects of economic activities into income growth effect, industrial structure effect and income inequality effect, and use panel data of China’s provinces to conduct an empirical analysis. The results reveal the following: (1) the Environmental Kuznets Curve is still valid in sample, and digital finance can reduce air and water pollution (as measured through SO2 and COD emission) directly; (2) in the influence mechanism, digital finance can alleviate income inequality and promote green industrial structure, thus reducing pollution indirectly, but the scale effect of income growth outweighs the technological effect, which increases pollution indirectly; and (3) digital finance has a threshold effect on improving the environment, then an acceleration effect appears after a certain threshold value. From the regional perspective, digital finance development in eastern regions is generally ahead of central and western regions, and the effects of environmental improvement in the eastern regions are greater. According to the study, this paper suggest that digital finance can be an effective way to promote social sustainability by alleviating income inequality and environmental sustainability by reducing pollution.
Calmodulin binds the N-terminus of the functional amyloid Orb2A inhibiting fibril formation
Authors: Soria Maria A. , Cervantes Silvia A. , Siemer Ansgar B.
Published: January 2022

The cytoplasmic polyadenylation element-binding protein Orb2 is a key regulator of long-term memory (LTM) in Drosophila. The N-terminus of the Orb2 isoform A is required for LTM and forms cross-β fibrils on its own. However, this N-terminus is not part of the core found in ex vivo fibrils. We previously showed that besides forming cross-β fibrils, the N-terminus of Orb2A binds anionic lipid membranes as an amphipathic helix. Here, we show that the Orb2A N-terminus can similarly interact with calcium activated calmodulin (CaM) and that this interaction prevents fibril formation. Because CaM is a known regulator of LTM, this interaction could potentially explain the regulatory role of Orb2A in LTM.
The “Walking Estimated Limitation Stated by History” (WELSH) visual tool is applicable and accurate to determine walking capacity, even in people with low literacy level
Authors: Sempore Wendsèndaté Yves , Ouedraogo Nafi , Gandema Salifou , Henni Samir , Ilboudo Alassane , Yameogo Téné Marceline , Abraham Pierre
Published: January 2022

Determination of the self-reported walking capacity by interview or standardized questionnaire is important. However, the existing questionnaires require the patient to be able to read and write in a specific language. We recently proposed the WELSH (Walking Estimated Limitation Stated by History) tool to be administrable to illiterate people. The main objective was to assess the applicability of WELSH tool in the community and in a large group. We performed a prospective study in the city of Bobo-Dioulasso in Burkina Faso during June 2020. We recruited 630 interviewers among medical students. They were trained to administer the WELSH, and to conduct a 6-minute walk test. We performed a Pearson’s “r” correlation between the WELSH and maximal walking distance (MWD). Of the 1723 participants available for the analysis, 757 (43.9%: 41.6–46.3) never went to school or attended only elementary school. The percentage of questionnaires with participant filling-in errors corrected by the investigator decreased with the decrease in educational level (p<0.001). The average WELSH score was 53 ± 22 and the average MWD was 383 ±142 meters. The Spearman correlation coefficient between the WELSH score and the MWD was r = 0.567 (p<0.001). Correlations ranged from 0.291 to 0.576 in males and females, (all p values < 0.05) and in different levels of education, with the highest coefficients found in illiterate people. The WELSH is feasible on the community by a wide variety of interviewers. It correlates with the MWD estimated by the 6-minutes’ walk test even for people with little or no schooling.
“Facilitating HIV status adjustment: Qualitative insights from the Tambua Mapema proof-of-concept study in Kenya”
Authors: van der Elst Elise M. , Abuna Mitchelle , Agutu Clara , Ogada Fred , Galole Aisha , Shikuku Joyce , Oduor Tony , Graham Susan M. , Sanders Eduard J. , Operario Don
Published: January 2022

Systematic efforts are needed to prepare persons newly diagnosed with acute or chronic HIV infection to cope. We examined how patients dealt with this news, looking at how readiness to accept an HIV diagnosis impacted treatment outcomes, prevention of transmission, and HIV status disclosure. We examined vulnerability and agency over time and considered implications for policy and practice. A qualitative sub-study was embedded in the Tambua Mapema (“Discover Early”) Plus (TMP) study (NCT03508908), conducted in coastal Kenya between 2017 and 2020, which was a stepped wedge trial to evaluate an opt-out HIV-1 nucleic acid testing intervention diagnosing acute and chronic HIV infections. Diagnosed participants were offered antiretroviral therapy (ART), viral load monitoring, HIV partner notification services, and provision of pre-exposure prophylaxis (PrEP) to their uninfected partners. Data were analyzed using thematic approaches. Participants included 24 individuals who completed interviews at four time points (2 weeks and 3, 6, and 9 months after diagnosis), including 18 patients (11 women and 7 men) and 6 partners (1 woman, 5 men, of whom 4 men started PrEP). Acceptance of HIV status was often a long, individualized, and complex process, whereby participants’ coping strategies affected day-to-day issues and health over time. Relationship status strongly impacted coping. In some instances, couples supported each other, but in others, couples separated. Four main themes impacted participants’ sense of agency: acceptance of diagnosis and commitment to ART; positive feedback after attaining viral load suppression; recognition of partner supportive role and focus on sustained healthcare support whereby religious meaning was often key to successful transition. To support patients with acute or newly diagnosed chronic HIV, healthcare and social systems must be more responsive to the needs of the individual, while also improving quality of care, strengthening continuity of care across facilities, and promoting community support.
Non-strategic detection of identity-threatening information: Epistemic validation and identity defense may share a common cognitive basis
Authors: Abendroth Johanna , Nauroth Peter , Richter Tobias , Gollwitzer Mario
Published: January 2022

Readers use prior knowledge to evaluate the validity of statements and detect false information without effort and strategic control. The present study expands this research by exploring whether people also non-strategically detect information that threatens their social identity. Participants (N= 77) completed a task in which they had to respond to a “True” or “False” probe after reading true, false, identity-threatening, or non-threatening sentences. Replicating previous studies, participants reacted more slowly to a positive probe (“True”) after reading false (vs. true) sentences. Notably, participants also reacted more slowly to a positive probe after reading identity-threatening (vs. non-threatening) sentences. These results provide first evidence that identity-threatening information, just as false information, is detected at a very early stage of information processing and lends support to the notion of a routine, non-strategic identity-defense mechanism.
Support Models for Addiction Related Treatment (SMART) for pregnant women: Study protocol of a cluster randomized trial of two treatment models for opioid use disorder in prenatal clinics
Authors: Forray Ariadna , Mele Amanda , Byatt Nancy , Londono Tobon Amalia , Gilstad-Hayden Kathryn , Hunkle Karen , Hong Suyeon , Lipkind Heather , Fiellin David A. , Callaghan Katherine , Yonkers Kimberly A.
Published: January 2022

Introduction

The prevalence of opioid use disorder (OUD) in pregnancy increased nearly five-fold over the past decade. Despite this, obstetric providers are less likely to treat pregnant women with medication for OUD than non-obstetric providers (75% vs 91%). A major reason is many obstetricians feel unprepared to prescribe medication for opioid use disorder (MOUD). Education and support may increase prescribing and overall comfort in delivering care for pregnant women with OUD, but optimal models of education and support are yet to be determined.

Methods and analysis

We describe the rationale and conduct of a matched-pair cluster randomized clinical trial to compare the effectiveness of two models of support for reproductive health clinicians to provide care for pregnant and postpartum women with OUD. The primary outcomes of this trial are patient treatment engagement and retention in OUD treatment. This study compares two support models: 1) a collaborative care approach, based upon the Massachusetts Office-Based-Opioid Treatment Model, that provides practice-level training and support to providers and patients through the use of care managers, versus 2) a telesupport approach based on the Project Extension for Community Healthcare Outcomes, a remote education model that provides mentorship, guided practice, and participation in a learning community, via video conferencing.

Discussion

This clustered randomized clinical trial aims to test the effectiveness of two approaches to support practitioners who care for pregnant women with an OUD. The results of this trial will help determine the best model to improve the capacity of obstetrical providers to deliver treatment for OUD in prenatal clinics.

Trial registration

Clinicaltrials.gov trial registration number: NCT0424039.
Use of telehealth in the provision of after-hours palliative care services in rural and remote Australia: A scoping review protocol
Authors: Namasivayam Pathmavathy , Bui Dung T. , Low Christine , Barnett Tony , Bridgman Heather , Marsh Pauline , Lee Simone
Published: January 2022

Introduction

After-hours services are essential in ensuring patients with life limiting illness and their caregivers are supported to enable continuity of care. Telehealth is a valuable approach to meeting after-hours support needs of people living with life-limiting illness, their families, and caregivers in rural and remote communities. It is important to explore the provision of after-hours palliative care services using telehealth to understand the reach of these services in rural and remote Australia. A preliminary search of databases failed to reveal any scoping or systematic reviews of telehealth in after-hours palliative care services in rural or remote Australia.

Aim

To review and map the available evidence about the use of telehealth in providing after-hours palliative care services in Australian rural and remote communities.

Methods

The proposed scoping review will be conducted using the Arksey and O’Malley methodological framework and in accordance with the Joanna Briggs Institute methodology for scoping reviews. The reporting of the scoping review will be guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will consider research and evaluation of after-hours services using telehealth for palliative care stakeholders in rural and remote Australia. Peer reviewed studies and grey literature published in English from 2000 to May 2021 will be included. Scopus, Web of Science, CINAHL Complete, Embase via Ovid, PsycINFO via Ovid, Emcare via Ovid, Medline via Ovid, and grey literature will be searched for relevant articles. Titles and abstracts will be screened by two independent reviewers for assessment against the inclusion criteria. Data will be extracted and analysed by two reviewers using an adapted data extraction tool and thematic analysis techniques. Diagrams, tables, and summary narratives will be used to map, summarise and thematically group the characteristics of palliative care telehealth services in rural and remote Australia, including stakeholders’ perceptions and benefits and challenges of the services.
The association of social capital with depression and quality of life in school-aged children
Authors: Mori Hiroyuki , Takahashi Michio , Adachi Masaki , Shinkawa Hiroki , Hirota Tomoya , Nishimura Tomoko , Nakamura Kazuhiko
Published: January 2022

Social capital is an important factor that affects mental health. The purpose of this study was to examine the relationship between social capital and depression and between social capital and quality of life (QoL) in children in elementary and junior high school and to examine how this relationship differs in relevant patterns at both the individual- and school-level. The study was conducted in all elementary and junior high schools in a single municipality; the subjects consisted of 3,722 elementary school and 3,987 junior high school students (aged from 9 to 15). A multilevel linear mixed effect model analysis revealed that all three subscales of social capital were associated with depression and QoL at the individual-level: The school social capital at the individual-level showed the strongest association with depression and QoL. We also found that some of social capital at the school-level was associated with depression and QoL. An interactive effect was observed between educational stage (elementary and junior high) and some of social capital subscales. Specifically, the inverse association between school social capital and depression was stronger among the junior high students, while the positive association between school and neighborhood social capital and QoL was stronger among the elementary students. These interactions suggest that social capital impacts depression and QoL differently in elementary and junior high students. These findings suggest that the degree of association of social capital domains differs in mental health among the educational stage.
Impact of the COVID-19 pandemic on neonatal admissions in a tertiary children’s hospital in southwest China: An interrupted time-series study
Authors: Liu Weiqin , Yang Qifen , Xu Zhen-e , Hu Ya , Wang Yongming , Liu Zhenqiu , Zhao Qianqian , Wang Zhuangcheng , Wei Hong , Hua Ziyu
Published: January 2022

Background

The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures in a tertiary Children’s Hospital in southwest China, which might be used to predict long-term effects related to health-seeking behavior of parents/caregivers.

Methods

This study included newborns enrolled over a span of 86 weeks between January 4, 2019, and August 27, 2020. We designated two time periods for analysis purposes: a stable pre-COVID period(55 weeks between January 4, 2019, and January 23, 2020) and a COVID-impacted period (31 weeks between January 24, 2020, and August 27, 2020). An interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectra before and after the period of nonpharmaceutical interventions (NPIs). Furthermore, this study was conducted to evaluate whether the health-seeking behavior of parents/caregivers was influenced by pandemic factors.

Results

Overall, 16,640 infants were admitted to the neonatology department during the pre-COVID period (n = 12,082) and the COVID-impacted period (n = 4,558). The per week neonatal admissions consistently decreased following the first days of NPIs (January 24, 2020). The average weekly admission rates of 220/week pre-COVID period and 147/week COVID-impacted period. There was an evident decrease in the volume of admissions for all disease spectra after the intervention, whereas the decrease of patients complaining about pathological jaundice-related conditions was statistically significant (p<0.05). In the COVID-impacted period, the percentage of patients who suffered from respiratory system diseases, neonatal encephalopathy, and infectious diseases decreased, while the percentage of pathological jaundice-related conditions and gastrointestinal system diseases increased. The neonatal mortality rates (NMRs) increased by 8.7% during the COVID-impacted period compared with the pre-COVID period.

Conclusions

In summary, there was a significant decline in neonatal admissions in a tertiary care hospital during the COVID-19 Pandemic and the associated NPIs. Additionally, this situation had a remarkable impact on disease spectra and health-seeking behavior of parents/caregivers. We, therefore, advise continuing follow-ups and monitoring the main health indicators in vulnerable populations affected by this Pandemic over time.
Th17 cell-mediated immune response in a subpopulation of dogs with idiopathic epilepsy
Authors: Knebel Anna , Kämpe Annika , Carlson Regina , Rohn Karl , Tipold Andrea
Published: January 2022

Background

Canine idiopathic epilepsy (IE) is a common neurological disease with severe impact on the owner´s and the dog’s quality of life. A subpopulation of dogs with IE does not respond to antiseizure drugs (non-responder). Th17 cells (T helper cells) and their proinflammatory Interleukin-17 (IL-17) are part of the immune system and previous studies showed their involvement in the pathogenesis of several autoimmune diseases. Non-responder might have an abnormal immune response against structures of the central nervous system. To discover a new aetiology of canine IE and thereby optimising the therapy of intractable IE, this prospective study aimed to investigate Th17 cells and IL-17 in dogs with IE. The underlying hypothesis was that in some dogs with IE a Th17 cell-mediated immune response could be detectable.

Methods

57 dogs with IE and 10 healthy dogs (control group, C) were enrolled in the study. EDTA blood was taken to measure Th17 cells by flow cytometry. IL-17 was measured in 35 cerebrospinal fluid (CSF) and 33 serum samples using an enzyme-linked immunosorbent assay (ELISA). It was investigated whether there was a significant increase of stimulated Th17 cells in blood samples or of IL-17 in serum and CSF samples of dogs with IE in comparison to C. Correlations between the amount of Th17 cells/μL or IL-17 and different clinical parameters e.g. seizure frequency, seizure type, seizure severity or treatment response were evaluated. Additionally, Th17 cells/μL were randomly controlled of 17 dogs with IE and were examined for changes over time and in relation to treatment response.

Results

Ten dogs with IE had strongly elevated stimulated Th17 cells/μL within the blood (>100 Th17 cells/μL). A slight positive correlation between stimulated Th17 cells/μL and seizure severity (p = 0.046; rSpear = 0.27) was proven in these dogs. In addition, 4/10 dogs with elevated Th17 levels experienced cluster seizures and status epilepticus in comparison to 9% of the dogs with non-elevated Th17 levels (<100 Th17 cells/μL). Dogs with IE had significantly higher IL-17 values in CSF and serum samples compared to C (p<0.001; p<0.002; respectively).

Conclusion

In single dogs with IE, strongly increased amounts of Th17 cells were detectable and dogs with elevated Th17 cells seemed to have a greater risk for experiencing a combination of cluster seizures and status epilepticus. Therefore, an underlying Th17-cell mediated immune response was suspected and hence anti-inflammatory drugs could be indicated in these single cases with intractable epilepsy.
Risk predictive tools of perioperative drug hypersensitivity reaction: A case-control study
Authors: Pradhan Ujal , Oofuvong Maliwan , Karnjanawanichkul Orarat , Pakpirom Jatuporn
Published: January 2022

Objective

We aimed to determine the risk factors of perioperative drug hypersensitivity reaction (DHR) and develop a predictive score for use in clinical practice.

Methods

A case-control study was conducted in patients who underwent anesthesia at a tertiary hospital in Thailand, between 2015–2018. DHR cases were graded clinically from 1 to 4 according to the World Federation of Societies of Anesthesiologists by two anesthesiologists. Controls were randomly matched with cases (ratio 2:1) by age group and month and type of surgery. Patient and anesthesia-related factors and agents given intraoperatively were recorded. A risk score was derived from the coefficients of the significant predictors of the final multivariate logistic regression model. Risk scores, adjusted odds ratios (OR) for perioperative DHR and 95% confidence intervals (CI) were determined.

Results

Overall, 325 cases and 650 controls were recruited. The severity of DHR was grade 1 (72.9%), grade 2 (24%), and grade 3 (3.1%). Our risk predictive tools for perioperative DHR provided a sensitivity of 62% and specificity of 65%. Predictive scores of subgroups of moderate to severe DHR showed high specificity (80%) but low sensitivity (47%). Common predictors of overall DHR and moderate to severe DHR were history of drug allergy to 2 or more drug categories (score 2.5–3.5), being allergic to analgesics (score 2.5–4.0), and intraoperative morphine use (score of 1). The sole predictor of high-risk perioperative DHR (score ≥3.5) was airway management with an endotracheal tube intubation (OR 5.6, 95% CI 2.2–14.4) whereas history of allergic rhinitis (OR 11.7, 95% CI 1.3–105.1) was a predictor of high-risk moderate to severe DHR (score ≥2.5).

Conclusions

Our predictive tool for perioperative DHR provided a modest predictive ability. History of drug allergies, rhinitis, morphine use and endotracheal intubation were significant risk factors of DHR after adjusting for age and type of surgery.
Evolutionary paths to macrolide resistance in a Neisseria commensal converge on ribosomal genes through short sequence duplications
Authors: Raisman Jordan C. , Fiore Michael A. , Tomin Lucille , Adjei Joseph K. O. , Aswad Virginia X. , Chu Jonathan , Domondon Christina J. , Donahue Ben A. , Masciotti Claudia A. , McGrath Connor G. , Melita Jo , Podbielski Paul A. , Schreiner Madelyn R. , Trumpore Lauren J. , Wengert Peter C. , Wrightstone Emalee A. , Hudson André O. , Wadsworth Crista B.
Published: January 2022

Neisseria commensals are an indisputable source of resistance for their pathogenic relatives. However, the evolutionary paths commensal species take to reduced susceptibility in this genus have been relatively underexplored. Here, we leverage in vitro selection as a powerful screen to identify the genetic adaptations that produce azithromycin resistance (≥ 2 μg/mL) in the Neisseria commensal, N. elongata. Across multiple lineages (n = 7/16), we find mutations that reduce susceptibility to azithromycin converge on the locus encoding the 50S ribosomal L34 protein (rpmH) and the intergenic region proximal to the 30S ribosomal S3 protein (rpsC) through short tandem duplication events. Interestingly, one of the laboratory evolved mutations in rpmH is identical (7LKRTYQ12), and two nearly identical, to those recently reported to contribute to high-level azithromycin resistance in N. gonorrhoeae. Transformations into the ancestral N. elongata lineage confirmed the causality of both rpmH and rpsC mutations. Though most lineages inheriting duplications suffered in vitro fitness costs, one variant showed no growth defect, suggesting the possibility that it may be sustained in natural populations. Ultimately, studies like this will be critical for predicting commensal alleles that could rapidly disseminate into pathogen populations via allelic exchange across recombinogenic microbial genera.
Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia
Authors: Kanguya Tukiya , Koyuncu Aybüke , Sharma Anjali , Kusanathan Thankian , Mubanga Martha , Chi Benjamin H. , Vinikoor Michael J. , Mubiana-Mbewe Mwangelwa
Published: January 2022

Background

Though antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery.

Methods

We conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted 28 in-depth interviews among women and 2 focus group discussions among male partners. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework.

Results

Men thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and, expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one’s children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women’s intrinsic motivation.

Conclusion

The results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men’s role in couples’ joint decision-making and women’s maternal love as motivators for adherence.
A framework for mutational signature analysis based on DNA shape parameters
Authors: Karolak Aleksandra , Levatić Jurica , Supek Fran
Published: January 2022

The mutation risk of a DNA locus depends on its oligonucleotide context. In turn, mutability of oligonucleotides varies across individuals, due to exposure to mutagenic agents or due to variable efficiency and/or accuracy of DNA repair. Such variability is captured by mutational signatures, a mathematical construct obtained by a deconvolution of mutation frequency spectra across individuals. There is a need to enhance methods for inferring mutational signatures to make better use of sparse mutation data (e.g., resulting from exome sequencing of cancers), to facilitate insight into underlying biological mechanisms, and to provide more accurate mutation rate baselines for inferring positive and negative selection. We propose a conceptualization of mutational signatures that represents oligonucleotides via descriptors of DNA conformation: base pair, base pair step, and minor groove width parameters. We demonstrate how such DNA structural parameters can accurately predict mutation occurrence due to DNA repair failures or due to exposure to diverse mutagens such as radiation, chemical exposure, and the APOBEC cytosine deaminase enzymes. Furthermore, the mutation frequency of DNA oligomers classed by structural features can accurately capture systematic variability in mutagenesis of >1,000 tumors originating from diverse human tissues. A nonnegative matrix factorization was applied to mutation spectra stratified by DNA structural features, thereby extracting novel mutational signatures. Moreover, many of the known trinucleotide signatures were associated with an additional spectrum in the DNA structural descriptor space, which may aid interpretation and provide mechanistic insight. Overall, we suggest that the power of DNA sequence motif-based mutational signature analysis can be enhanced by drawing on DNA shape features.
The effects of antithrombotic therapy in ab interno trabeculotomy with a spatula-shaped microhook
Authors: Kanda Satoru , Fujishiro Takashi , Omoto Takashi , Fujino Ryosuke , Ishii Kiyoshi , Aihara Makoto
Published: January 2022

To evaluate the effects of the discontinuation of antithrombotic drugs on intraocular pressure (IOP) reduction and complications from ab interno trabeculotomy for patients with glaucoma. We performed a retrospective chart review on the data of patients treated with antithrombotic agents who have undergone ab interno trabeculotomy through Tanito microhook combined with cataract surgery at the Asahi General Hospital and the Tokyo University Hospital, with 6 months of follow-up. The patients were classified into two groups depending on whether they discontinued (AT-) or continued (AT+) antithrombotic therapy during the perioperative phase. The demographics, pre- and postoperative IOP, medication score, best-corrected visual acuity (BCVA), and postoperative complications were analyzed preoperatively and postoperatively at 1 week and 1–6 months. The series included 44 eyes from 44 Japanese patients. The AT- and AT+ groups included 21 eyes from 21 patients and 23 eyes from 23 patients, respectively. The decrease in IOP from the baseline at 1 week postoperative was significantly different between the two groups (p = 0.009), but there were no significant differences observed in the other visits. Hyphema and IOP spikes exceeding 30 mmHg occurred in 10% and 10% of AT- participants, and in 43% and 26% of AT+ participants, respectively. Hyphema and spikes with hyphema occurred more frequently in the AT+ than in the AT- group (p = 0.02 and p = 0.05). The number of patients who had spikes was not significantly different (p = 0.27). In trabeculotomy using the Tanito microhook®, discontinuing antithrombotic therapy had better IOP-lowering effects and less postoperative complications.
Novel Cluster AZ Arthrobacter phages Powerpuff, Lego, and YesChef exhibit close functional relationships with Microbacterium phages
Authors: Kapinos Andrew , Aghamalian Pauline , Capehart Erika , Alag Anya , Angel Heather , Briseno Eddie , Corado Perez Byron , Farag Emily , Foster Hilory , Hakim Abbas , Hernandez-Casas Daisy , Huang Calvin , Lam Derek , Mendez Maya , Min Ashley , Nguyen Nikki , Omholt Alexa L. , Ortiz Emily , Saldivar Lizbeth Shelly , Shannon Jack Arthur , Smith Rachel , Sridhar Mihika V. , Ta An , Theophilus Malavika C. , Ngo Ryan , Torres Canela , Reddi Krisanavane , Freise Amanda C. , Moberg Parker Jordan
Published: January 2022

Bacteriophages exhibit a vast spectrum of relatedness and there is increasing evidence of close genomic relationships independent of host genus. The variability in phage similarity at the nucleotide, amino acid, and gene content levels confounds attempts at quantifying phage relatedness, especially as more novel phages are isolated. This study describes three highly similar novel Arthrobacter globiformis phages–Powerpuff, Lego, and YesChef–which were assigned to Cluster AZ using a nucleotide-based clustering parameter. Phages in Cluster AZ, Microbacterium Cluster EH, and the former Microbacterium singleton Zeta1847 exhibited low nucleotide similarity. However, their gene content similarity was in excess of the recently adopted Microbacterium clustering parameter, which ultimately resulted in the reassignment of Zeta1847 to Cluster EH. This finding further highlights the importance of using multiple metrics to capture phage relatedness. Additionally, Clusters AZ and EH phages encode a shared integrase indicative of a lysogenic life cycle. In the first experimental verification of a Cluster AZ phage’s life cycle, we show that phage Powerpuff is a true temperate phage. It forms stable lysogens that exhibit immunity to superinfection by related phages, despite lacking identifiable repressors typically required for lysogenic maintenance and superinfection immunity. The ability of phage Powerpuff to undergo and maintain lysogeny suggests that other closely related phages may be temperate as well. Our findings provide additional evidence of significant shared phage genomic content spanning multiple actinobacterial host genera and demonstrate the continued need for verification and characterization of life cycles in newly isolated phages.
Extensión de efectos de sentencias españolas versus extensión de jurisprudencia colombiana
Authors: Domínguez Barragán María Luisa
Published: January 2022

En este trabajo se realiza la comparación entre dos figuras procesales muy parecidas y que poseen una raíz común. Igualmente, se exponen sus fundamentos, acercando ambas herramientas, lo que permite observar el desarrollo y mejoras que se han hecho a la institución originaria española y la importancia del derecho comparado para el progreso del ordenamiento jurídico.
Alcance de la infracción de denominaciones de origen por «evocación» o por cualquier otra práctica que induzca a error acerca de la procedencia geográfica
Authors: Arroyo Aparicio Alicia
Published: January 2022

Cuando un producto tiene un origen geográfico específico y una reputación —esto es, una cualidad determinada u otras características atribuibles fundamentalmente a su origen— puede protegerse mediante una indicación geográfica. El sistema de Denominaciones de Origen e Indicaciones Geográficas Protegidas permite identificar, por tanto, los productos y situarlos en un área geográfica determinada al tiempo que asegura unos elevados estándares de calidad, siendo esta última garantía la que requiere de controles. La normativa europea resulta fundamental en tanto que se busca un régimen uniforme y exhaustivo, de ahí que la interpretación de qué queda amparado por el sistema de protección constituya un hito decisivo. Decisivo porque, en un sector absolutamente competitivo, la defensa de los derechos de los titulares de los derechos exclusivos se sustancia ante los tribunales nacionales que en ocasiones acuden al tjue para presentar cuestiones prejudiciales que faciliten la interpretación de las normas. De hecho, en el último año, desde finales del año 2020 hasta ahora, han tenido lugar dos pronunciamientos del tjue destacables, conocidos con el nombre de los productos ?o «servicios»? implicados: el Asunto del queso «Morbier» y el Asunto «Champanillo», este último planteado por la AP de Barcelona, sobre el uso de esa denominación. Ambos pronunciamientos destacan entre otros anteriores que ya fueron delineando la infracción por «evocación», siendo importante tener una panorámica de la evolución y sus matices.
Responsabilidad contractual en tiempos de pandemia en Colombia
Authors: Buitrago Jiménez Andrea Lizeth
Published: January 2022

En época de pandemia el Estado requiere actuar con eficacia y prontitud en el desafío de atender la «emergencia económica, social y ecológica», así como en brindar soluciones urgentes a las relaciones jurídico-negociales vigentes que se vieron afectadas en su ejecución y cumplimiento por la toma de medidas transitorias de aislamiento preventivo obligatorio, distanciamiento social, horarios restringidos, exigencias de protocolos de bioseguridad, restricciones en el desplazamiento de una ciudad a otra, mayor valor de los materiales, bienes o servicios y toda una serie de normas expedidas por el Gobierno Nacional motivadas en el brote de la enfermedad covid-19 en el país. En la esfera de la responsabilidad contractual, las medidas proferidas en el estado de excepción pudieron afectar el cumplimiento de las obligaciones contractuales, encontrando de gran importancia el análisis de las posibles teorías que se pueden aplicar a los contratos estatales; sin embargo, las soluciones deben estar analizadas sobre la base de las circunstancias individuales de cada negocio jurídico, conllevando propuestas diferentes que en principio deberían ser tomadas de mutuo acuerdo por las partes en aras de satisfacer el interés general bajo la línea de los dogmas de la contratación pública estatal.
O constitucionalismo sob a perspectiva dos direitos fundamentais: a natureza normativa da Constituição brasileira
Authors: Nunes Carvalho Sobral De Souza Patrícia Verônica , De Moura Borges Antônio
Published: January 2022

Os direitos fundamentais e o constitucionalismo têm um laço estreito de afinidade. Assim, o surgimento deste é essencial para a materialização daquele. Assim, a delimitação e o estudo do tema objetiva delinear e fomentar o exame dos direitos fundamentais, como produto de função social do direito constitucional contemporâneo. O presente artigo tem como objetivo examinar o tema sobre o constitucionalismo na perspectiva dos direitos fundamentais. Para tanto, analise-se o panorama histórico justificador desses direitos, cirando uma relação entre os institutos. Utilizou-se de pesquisa bibliográfica, de caráter exploratório e descritivo, com base em teses, artigos e doutrinas pertinentes ao tema. O que se buscou foi ressaltar a necessidade em inter-relacionar estes institutos, para promover a discussão acerca do tema e, ainda, esclarecer a natureza dos mesmos, sua evolução e a percepção filosófica.
Empirikus vizsgálati mód három névszói esetrag jelentéseinek
elkülönítésére
Authors: Pomázi Bence
Published: January 2022

A tanulmány egy empirikus módszert kínál három magyar névszói
esetrag jelentéseinek elkülönítésére. A három vizsgált esetrag a -nak/-nek,
a -hoz/-hez/-höz és a -nál/-nél, mindegyik gazdag poliszém
jelentésstruktúrával rendelkezik. A vizsgálat célja az volt, hogy meg
lehessen állapítani az egyes jelentéseket, mégpedig anyanyelvi beszélők
intuíciói alapján. Ehhez egy előzetes korpusz alapú vizsgálat után
csoportosítási feladatot végeztettem 25 anyanyelvi beszélővel, akiknek a
feladata az volt, hogy a kiválasztott esetragok 20–20 előfordulásából
tetszőleges csoportokat állítsanak fel a ragok jelentése alapján. Az
adatokon Past szoftverrel hierarchikus klaszteranalízist végeztem, az
eredmények dendrogramon ábrázolhatók. A dendrogramról leolvasható csoportok
az egyes ragok jelentéseinek elrendeződéséről árulnak el sokat a poliszém
jelentéshálózatban.
Azottszokatlan szerepei
Authors: Kocsány Piroska
Published: January 2022

Azotthatározószó redundáns használata (= ahol a mondatban szerepel a nominális helymegjelölés is, vö.Évaottállt akapubanversusÉva a kapuban állt) összevethető a hasonló irányhatározós szerkezetekkel (Évabelépett aszobába). Az irányhatározós szerkezetben az ige terminatív igekötővel (be-) áll. Ennek analógiájára vezeti be É. Kiss Katalin a lokatív igekötő fogalmát (ott/kint/bent stb.), amelynek használata beleilleszkedik az igeidőrendszer fokozatos átalakulásába az ómagyar kortól napjainkig: a nézőponti aspektust hordozó formákat felváltja a szituatív aspektust támogató igekötőrendszer. A dolgozat ezt a tételt próbálja továbbgondolni, különös tekintettel azokra a példákra, amelyekben egy inchoatív jelentésű időhatározó kijelöl egy időbeni vonatkozási pontot, ahonnan egy folyamatra/állapotra rátekintünk. Ez az együttállás kiváltja az ott mint igekötő in statu nascendi létét, és magyarázni tudja azokat az eseteket, amelyekben az ott a nominális helymegjelölés mellett kötelező, valamint azokat is, amelyekben a redundáns ott használatát stratégiai-pragmatikai tények indokolják. Az ott lokális jelentése az érvelésben összekapcsolódik a temporális jelentéssel, a temporális jelentés pedig elvezet a temporális perzisztencia kifejeződéséhez. Ennek sajátos megjelenésével találkozunk az ott mint diskurzuspartikula használata során.

A pilot kutatás elsődleges célja az, hogy a szociálpszichológiai és a pragmatikai megközelítéseket ötvözve létrehozzon egy olyan tesztet, amely alkalmas az énmegjelenítés/benyomáskeltés vizsgálatára. A dolgozatban a magyar anyanyelvű egyetemi hallgatók számára létrehozott, az énmegjelenítési stratégiákat vizsgáló nyílt végű diskurzuskiegészítéses teszt adatgyűjtési módszert ismertetem, illetve annak metodológiai problémáit járom körül. A pilot teszt eredményei alapján megállapítható, hogy egy szituációban nem megjósolhatóak a stratégiák, hanem a különböző társas interakciók esetében vannak kevésbé vagy inkább preferált metódusok, melyeket meghatároznak a benyomáskeltés mögött meghúzódó lehetséges motivációk, az arculatfenyegetettség mértéke, a szociológiai és szociokulturális változók.