bluuebunny/crossref_metadata_2025 huggingface dataset:
Narrating Europe: (Re‐)constructed and Contested Visions of the European Project in Citizens' Discourse
Authors: Beaudonnet Laurie , Belot Céline , Caune Hélène , Houde Anne‐Marie , Pennetreau Damien
Published: June 2022

Changes in public opinion and civil society over the last decade have shown that citizens, particularly in old EU Member States, have developed more complex attitudes towards European integration. While the European project was previously generally described as a teleological depoliticized project, aiming at building peace and comforting growth, different competing visions of the European project are nowadays acknowledged and surface among the public on occasions, like referendums or treaty negotiations. While EU official narratives are documented by studies on the European institutions or the visions of leaders and parties, their empirical analysis at the citizens' level is still fragmented. Using focus group data in four countries (France, Portugal, Italy and Belgium) and three social groups (21 group interviews), we provide a comparative qualitative answer to how citizens envision European integration. Our results show that, first, official narratives do not fail to reach citizens, but they are also loosened, contested, and do not systematically produce a sense of common belonging. Second, they highlight the importance of socio‐economic contexts, as well as national and personal experience in the re‐appropriation of these narratives.
E‐synthesis for carcinogenicity assessments: A case study of processed meat
Authors: De Pretis Francesco , Jukola Saana , Landes Jürgen
Published: June 2022

Rationale, Aims and Objectives

Recent controversies about dietary advice concerning meat demonstrate that aggregating the available evidence to assess a putative causal link between food and cancer is a challenging enterprise.

Methods

We show how a tool developed for assessing putative causal links between drugs and adverse drug reactions, E‐Synthesis, can be applied for food carcinogenicity assessments. The application is demonstrated on the putative causal relationship between processed meat consumption and cancer.

Results

The output of the assessment is a Bayesian probability that processed meat consumption causes cancer. This Bayesian probability is calculated from a Bayesian network model, which incorporates a representation of Bradford Hill's Guidelines as probabilistic indicators of causality. We show how to determine probabilities of indicators of causality for food carcinogenicity assessments based on assessments of the International Agency for Research on Cancer.

Conclusions

We find that E‐Synthesis is a tool well‐suited for food carcinogenicity assessments, as it enables a graphical representation of lines and weights of evidence, offers the possibility to make a great number of judgements explicit and transparent, outputs a probability of causality suitable for decision making and is flexible to aggregate different kinds of evidence.
Establishment of an astrocyte‐like cell line from the brain of tilapia (Oreochromis niloticus) for virus pathogenesis and a vitro model of the blood–brain barrier
Authors: Li Yuan , Huang Yu , Cai Jia , Jiang Dongneng , Jian Ji‐chang , Lu Yi‐shan , Wang Bei
Published: June 2022

A new cell line was established from the brain of a cultured fish, tilapia (Oreochromis niloticus), designated as TA‐02 (Tilapia Astrocyte clone 02 cell line). The TA‐02 cells are grown for 300 days in an L‐15 medium supplemented with 10% fetal bovine serum (FBS). This cell line showed excellent proliferative capacity and expressed various neuroglial cell markers, including SOX2, SOX10, Hes1, Notch1, Occludin, E‐cadherin, and GFAP. In addition, TA‐02 cells were susceptible to Tilapia Lake Virus (TiLV) as demonstrated by the presence of a severe cytopathic effect (CPE), virus particle in a transmission electron microscope (TEM), and PCR positive signal. Bacterial cytotoxicity studies showed that Streptococcus agalactiae was toxic to TA‐02 cells. When co‐culture with trans‐well, TA‐02 exhibited prominent barrier properties, manifested by tight intercellular junctions and increased trans‐endothelial electrical resistance (TEER). In addition, the barrier is effective against Escherichia coli (non‐meningitis pathogenic bacteria). In contrast, S. agalactiae (meningitis pathogenic bacteria) can pass through the membrane comprising the cells in the trans‐well insert. The newly established TA‐02 cell line provided a valuable tool for virus pathogenesis and a vitro model of the fish blood–brain barrier.
Capital depreciation allowances, redistributive taxation, and economic growth
Authors: Rehme Günther
Published: June 2022

Are capital depreciation allowances when coupled with capital income taxes good instruments for redistribution in the long run? In a simple two‐agent‐economy I find that accelerated depreciation is good for growth, but bad for redistribution. The opposite holds for capital income taxes. However, in a feedback Stackelberg equilibrium, where the government is the leader and the private sector the follower, the depreciation allowance is maximal in the long run, time‐consistent optimum. This removes the accumulation distortion of capital income taxes. Furthermore, the latter, and so redistribution, is found to be generically nonzero in the time‐consistent optimum, and depends on the social weight of transfers receivers, the pretax factor income distribution, the intertemporal elasticity of substitution and the time preference rate. Thus, accelerated depreciation allowances are an important indirect tool for redistribution. The tax scheme allows for a separation of “efficiency” and “equity” concerns for redistributive policies.
A Newly Designed “SkyWalker” Robot Applied in Total Knee Arthroplasty: A Retrospective Cohort Study for Femoral Rotational Alignment Restoration
Authors: He Rui , Sun Mao‐lin , Xiong Ran , Yang Peng‐fei , Lei Kai , Liu Li‐ming , Yang Liu , Guo Lin
Published: June 2022

Objective

This study explored whether robotic arm‐assisted total knee arthroplasty (RATKA) has the advantage of restoring femoral rotational alignment compared to conventional total knee arthroplasty (COTKA).

Methods

Sixty patients (45 women and 15 men) attending our department from May 2019 to December 2020 were selected and divided into two groups, with 30 patients in each group, according to whether they underwent COTKA or RATKA. Femoral rotational alignment results, such as, posterior condylar angle (PCA), patella transverse axis‐femoral transepicondylar axis angle (PFA), radiological findings, such as, hip‐knee‐ankle angle (HKA), lateral distal femoral angle (LDFA), and medial proximal tibial angle (MPTA), and operative data (operation time, intraoperative blood loss, tourniquet time, and length of stay (LOS), and clinical outcomes, such as maximum knee flexion angle (MKFA), Knee Society Score (KSS), and Western Ontario Mac Master University Index Score (WOMAC) were compared within and between the two groups.

Results

PCA and PFA in the RATKA group were (0.6 ± 0.3)° and (0.9 ± 0.3)°, respectively, which were smaller than (1.5 ± 2.0)° and (3.1 ± 1.1)° in the COTKA group (P < 0.05), and were closer to 0°; the differences in HKA, LDFA, and MPTA were not statistically significant. With the exception of the LDFA, the HKA, MPTA, PCA, and PFA improved in both groups after surgery (P < 0.05). The blood loss and the LOS of RATKA group were 192.3 ± 23.1 mL and 8.2 ± 1.4 days, which were less than 203.7 ± 29.8 mL and 9.3 ± 1.1 days of the COTKA group, but the operation time showed no statistically significant difference, and the tourniquet time was longer (P < 0.05). The MKFA in the RATKA group was (123.0 ± 3.7)°, which was greater than (116.3 ± 4.6)° in the COTKA group (P < 0.05). In terms of scores, the postoperative results were better than the preoperative results in both groups (P < 0.05). However, there was no statistically significant difference between the groups.

Conclusion

The accuracy of femoral rotational alignment reconstructed achieved by RATKA is significantly better than that of COTKA and is more conducive to the recovery of knee flexion function after surgery; although RATKA reduces intraoperative blood loss and postoperative LOS, the short‐term clinical efficacy comparison has not yet demonstrated the advantages of robotic technology, and a more optimized design is needed to improve the efficiency of RATKA surgery.
Sensitization symptoms are associated with psychological and cognitive variables in COVID‐19 survivors exhibiting post‐COVID pain
Authors: Fernández‐de‐las‐Peñas César , Parás‐Bravo Paula , Ferrer‐Pargada Diego , Cancela‐Cilleruelo Ignacio , Rodríguez‐Jiménez Jorge , Nijs Jo , Arendt‐Nielsen Lars , Herrero‐Montes Manuel
Published: June 2022

Objective

To investigate the association between demographic, clinical, psychological, cognitive, and health‐related variables and the Central Sensitization Inventory (CSI) in previously hospitalized COVID‐19 survivors exhibiting “de novo” post‐COVID pain.

Methods

Seventy‐seven (n = 77) COVID‐19 survivors with “de novo” post‐COVID pain completed demographic (age, height, and weight), clinical (duration and intensity of the pain), psychological (depressive/anxiety levels and sleep quality), cognitive (catastrophizing and kinesiophobia levels), and health‐related quality of life variables as well as the CSI. A multivariable correlation analysis was conducted to determine the association between variables, and a stepwise multiple linear regression model was performed to identify CSI predictors.

Results

Patients were assessed a mean of 6.0 (SD 0.8) months after hospital discharge. Twenty‐six (33.7%) individuals showed indications of sensitization‐associated symptoms (CSI score ≥40 points). The CSI score was positively associated with pain intensity (r: 0.371), anxiety (r: 0.784), depressive (r: 0.709), catastrophizing (r: 0.620), and kinesiophobia (r: 0.359) levels (all, p < 0.001). The stepwise regression analysis revealed that 60.2% of CSI was explained by anxiety levels and pain intensity.

Conclusion

This study found that psychological and cognitive variables were associated with the CSI score in previously hospitalized COVID‐19 survivors with “de novo” post‐COVID pain. Anxiety levels and the intensity of pain symptoms were independently associated with CSI score suggesting a significant overlap with psychological construct. The “de novo” post‐COVID pain association with CSI may indicate changes in the pain processing important for managing the pain.
Sm‐Nd isochron age and Sr‐Nd isotopes of the calcite from the Nibao gold deposit in the Youjiang Basin, SW China
Authors: Ji Xingzhong , Bagas Leon , Han Zhonghua , Liu Wengang
Published: June 2022

The Youjiang Basin in SW China is the second‐largest Carlin‐like goldfield in the world after Nevada, USA. However, the age and the hydrothermal origin of the gold mineralization are still in controversy, which leads to ambiguities in understanding the geodynamic setting and genetic mechanism of the gold deposition. Nibao is a large, stratabound, and fault‐controlled Carlin‐type gold deposit in the north of the Youjiang Basin. Three ore stages have been recognized in the evolution of the mineralizing hydrothermal fluid, with the stages being characterized by assemblages of the early quartz–porous pyrite, the main quartz–calcite‐apatite–sericite–pyrite–arsenopyrite‐gold, and the late quartz–calcite–fluorite–realgar–orpiment–stibnite. Calcite veins from the main and late ore stage at Nibao are enriched in middle rare earth elements, which is a distinctive characteristic of hydrothermal calcite veins associated with low‐temperature hydrothermal Au‐Sb deposits in the Youjiang Basin, and yield a Sm‐Nd isochron age of 138 ± 1 Ma. The vast majority of the ore stage calcite samples have narrow 87Sr/86Sr ratios and εNd(t) values ranging from 0.708119 to 0.708423 and − 1.1–−3.3, respectively, indicating that the gold‐bearing hydrothermal fluid could be derived from the mixing of mantle and crustal materials. Therefore, we proposed that the gold mineralization during the Early Cretaceous in the Youjiang Basin was triggered by the large‐scale lithosphere extension following the retreat of the subducted Paleo‐Pacific oceanic crust, and the hydrothermal fluid could be originated from the mantle and underwent the contamination of Yangtze upper continental crust.
Digital mapping of soil texture classes for efficient land management in the Piedmont plain of Iran
Authors: Keshavarzi Ali , del Árbol Miguel Ángel Sánchez , Kaya Fuat , Gyasi‐Agyei Yeboah , Rodrigo‐Comino Jesús
Published: June 2022

Accurate prediction of digital soil maps allows for the evaluation of larger areas with respect to the design of efficient land management plans at the regional scale. Nowadays, there is an increasing demand for high spatial resolution‐gridded soil data for crop planning and management because it saves time and costs. One of the most essential soil physical properties affecting water holding capacity, nutrient availability and crop growth is soil texture. It exhibits a high spatial variability, but accurate maps for larger scales are lacking. The aim of this research was to produce gridded maps of soil texture fractions (clay, silt and sand) using regression‐based approaches and to establish soil texture classes using classification‐based techniques for the semi‐arid Piedmont plain of Iran. To this end, a digital elevation model and derived topographic indices, vegetation and soil‐based indices generated from 4‐year timeseries of remote sensing products of Landsat 8 OLI were used as covariates. The decision tree (linear) and its improved version of random forest (nonlinear) algorithms were used for both the regression and classification analysis. For both algorithms, the topography‐based indices and remotely sensed products were the most important predictors for the soil particle fractions. For the estimation of the different textural classes with multiple algorithms, we recorded a moderate overall accuracy rate of 54% and a Kappa coefficient of 17% for the validation datasets. It was observed that the nonlinear classification method of the random forest was more effective, and this was also the case for the regression modelling. In general, the random forest algorithm produced a more useful gridded map to help to design regional management plans based on soil properties.
Evaporation Characteristics of Lubricant/Gasoline Blending Oil Film Under Different Thermal Radiations
Authors: Meng Shun , Wang Shu , Qian Yejian , Tao Changfa , Li Zhaoyuan , Hua Yang
Published: June 2022

The evaporation and pro-ignition characteristics of the lubricating oil blending in the cylinder can bring a super knock for the high-efficiency gasoline engine. The evaporation characteristics of the lubricant/gasoline blending oil film were investigated experimentally under different thermal radiative heat flux, film thickness, and carrier material in a radiation device. The blending ratios of lubricant/gasoline oil film changed from 0% to 15%. Three stages of the blending oil film evaporation process were observed according to the different evaporation rates, namely, transient heating, equilibrium evaporation, and evaporation gel. During the transient heating stage, with the increase of gasoline blending ratio, oil film thickness, and radiative heat flux, the evaporation rate increases, while the evaporation rate decreases in the equilibrium evaporation stage. The evaporation rates in transient heating stage and equilibrium evaporation stages are reasonably predicted by using the proposed relationship model.
Flow Around Curved Tandem Cylinders
Authors: Aasland Tale E. , Pettersen Bjørnar , Andersson Helge I. , Jiang Fengjian
Published: June 2022

The flow around curved tandem cylinders of equal diameter has been investigated for the first time, by means of direct numerical simulations. A convex configuration was used. The nominal gap ratio was L/D = 3.0 and a Reynolds number of 500 was chosen. Due to the change in effective gap ratio along the cylinder axis, there is a variation of tandem flow regimes, from alternating overshoot/reattachment, via stable reattachment, to co-shedding, in this case called gap shedding. The combination of reattachment and gap shedding gives near-zero drag and vertical forces for the downstream cylinder, whereas the corresponding forces on the upstream cylinder are comparable to single curved cylinders. Meanwhile, the opposite is true for the lift forces. A low-frequency variation of horizontal and vertical forces is seen, and this is attributed to a slow variation of the position where gap shedding commences. Finally, the concept of a critical angle is proposed to describe the transition to gap shedding, for a given combination of nominal gap ratio and Reynolds number.
Ultrasonic backscatter coefficient estimation in nonlinear regime using an in situ calibration target
Authors: Coila Andres , Oelze Michael L.
Published: June 2022

Tissue characterization based on the backscatter coefficient (BSC) can be degraded by acoustic nonlinearity. Often, this degradation is due to the method used for obtaining a reference spectrum, i.e., using a planar reference in water compared to a reference phantom approach resulted in more degradation. We hypothesize that an in situ calibration approach can improve BSC estimates in the nonlinear regime compared to using the reference phantom approach. The in situ calibration target provides a reference within the medium being interrogated and, therefore, nonlinear effects would already be contained in the in situ reference signal. Simulations and experiments in phantoms and in vivo were performed. A 2 mm diameter titanium bead was embedded in the interrogated media. An L9-4/38 probe (BK Ultrasound, Peabody, MA) and an analysis bandwidth from 4.5 to 7.4 MHz were used in experiments. Radiofrequency data from the sample, bead, and reference phantoms were acquired at a quasi-linear baseline power level and at further increments of output power. Better agreement between the BSC obtained at low power compared to high power was observed for the in situ calibration compared to the reference phantom approach.
Individual variability and the effect of personality on non-native speech shadowing
Authors: Hutchinson Amy E.
Published: June 2022

The present study examines whether personality traits are predictive of success in non-native speech shadowing. Seventy-four monolingual native speakers of English shadowed French words containing high rounded vowels /y/ and /u/ produced by a native French model talker and provided information about their personality through a Big Five Inventory questionnaire. Acoustic analyses support the idea that some personality traits predicted the degree of similarity between the talkers and the model. In this case, shadowed productions by talkers who had higher scores in extraversion and neuroticism were significantly more similar to the model than those who had lower scores.
Linolenic Acid-Metronidazole: a Compound Relieving Drug Resistance and Inhibiting Helicobacter pylori
Authors: Dai Yuan-Yuan , Qin Chun , Huang Gan-Rong , Qin Yan-Chun , Huang Yong-Yi , Huang Yan-Qiang , Zhao Li-juan
Published: June 2022

Metronidazole (Met) is the first choice for treating
Helicobacter pylori
(
Hp
). However,
Hp
is easy to resistant, making Met unable to be widely used.
Variants in Bedaquiline-Candidate-Resistance Genes: Prevalence in Bedaquiline-Naive Patients, Effect on MIC, and Association with Mycobacterium tuberculosis Lineage
Authors: Rivière Emmanuel , Verboven Lennert , Dippenaar Anzaan , Goossens Sander , De Vos Elise , Streicher Elizabeth , Cuypers Bart , Laukens Kris , Ben-Rached Fathia , Rodwell Timothy C. , Pain Arnab , Warren Robin M. , Heupink Tim H. , Van Rie Annelies
Published: June 2022

Studies have shown that variants in bedaquiline-resistance genes can occur in isolates from bedaquiline-naive patients. We assessed the prevalence of variants in all bedaquiline-candidate-resistance genes in bedaquiline-naive patients, investigated the association between these variants and lineage, and the effect on phenotype.
Accuracy of Tongue Swab Testing Using Xpert MTB-RIF Ultra for Tuberculosis Diagnosis
Authors: Andama A. , Whitman G. R. , Crowder R. , Reza T. F. , Jaganath D. , Mulondo J. , Nalugwa T. K. , Semitala F. C. , Worodria W. , Cook C. , Wood R. C. , Weigel K. M. , Olson A. M. , Lohmiller Shaw J. , Kato-Maeda M. , Denkinger C. M. , Nahid P. , Cangelosi G. A. , Cattamanchi A.
Published: June 2022

Tongue dorsum swabs have shown promise as alternatives to sputum for detecting
Mycobacterium tuberculosis
(MTB) in patients with pulmonary tuberculosis (TB). Some of the most encouraging results have come from studies that used manual quantitative PCR (qPCR) to analyze swabs.
Using Species a Rotavirus Reverse Genetics to Engineer Chimeric Viruses Expressing SARS-CoV-2 Spike Epitopes
Authors: Diebold Ola , Gonzalez Victoria , Venditti Luca , Sharp Colin , Blake Rosemary A. , Tan Wenfang S. , Stevens Joanne , Caddy Sarah , Digard Paul , Borodavka Alexander , Gaunt Eleanor
Published: June 2022

We explored the use of rotaviruses (RVs) to express heterologous peptides, using SARS-CoV-2 as an example. Small SARS-CoV-2 peptide insertions (<34 amino acids) into the hypervariable region of the viral protein 4 (VP4) of RV SA11 strain resulted in reduced viral titer and replication, demonstrating a limited tolerance for peptide insertions at this site.
Herpes Simplex Virus 1 Expressing GFP-Tagged Virion Host Shutoff (vhs) Protein Uncouples the Activities of RNA Degradation and Differential Nuclear Retention of the Virus Transcriptome
Authors: Wise Emma L. , Samolej Jerzy , Elliott Gillian
Published: June 2022

Like many viruses, herpes simplex virus 1 (HSV1) expresses an endoribonuclease, the virion host shutoff (vhs) protein, which regulates the RNA environment of the infected cell and facilitates the classical cascade of virus protein translation. It does this by causing the degradation of some mRNA molecules and the nuclear retention of others.
PRRSV Infection Induces Gasdermin D-Driven Pyroptosis of Porcine Alveolar Macrophages through NLRP3 Inflammasome Activation
Authors: He Sheng , Li Lu , Chen Haifan , Hu Xiaoli , Wang Wendi , Zhang Hui , Wei Ruiping , Zhang Xiaoxiao , Chen Yaosheng , Liu Xiaohong
Published: June 2022

Porcine reproductive and respiratory syndrome virus (PRRSV) is one of the pathogens responsible for major economic losses in the global swine industry. Characterizing the detailed process by which PRRSV induces cell death pathways will help us better understand viral pathogenesis and provide implications for therapeutic intervention against PRRSV.
Draft Genome Sequences of Five Putatively Novel
Saccharibacteria
Species Assembled from the Human Oral Metagenome
Authors: Saito Daniel , Lemos Leandro Nascimento , Ferreira Ana Tana Rosas Nascimento , Saito Cristiane Pereira Borges , de Oliveira Rodrigo Ferreira , Cannavan Fabiana de Souza , Tsai Siu Mui
Published: June 2022

We report the draft metagenome-assembled genomes (MAGs) of five putatively novel
Saccharibacteria
strains retrieved from the oral microbiome. MAGs were obtained from nonstimulated saliva samples from hosts with various clinical statuses and correspond to distinct species taxonomically placed within the
Saccharimonadaceae
family, as determined by genome-wide analysis against previously described TM7 genomes.
Convergent and Divergent Age Patterning of Gut Microbiota Diversity in Humans and Nonhuman Primates
Authors: Sang Jianan , Zhuang Daohua , Zhang Tao , Wu Qunfu , Yu Jiangkun , Zhang Zhigang
Published: June 2022

This study provides the first comprehensive investigation of age patterning of gut microbiota of four human populations and three nonhuman primates and found that
Prevotellamassilia
,
Prevotella
,
Gemmiger
,
Coprococcus
,
Faecalibacterium
, and
Roseburia
may be common antiaging microbial markers in both humans and nonhuman primates due to their potential metabolic capabilities for host health benefits. Our results also provide key support for using macaques as animal models in studies of the gut microbiome’s role during human aging.
Biogeographical Patterns of Bacterial Communities and Their Antibiotic Resistomes in the Inland Waters of Southeast China
Authors: Fang Peiju , Xiao Peng , Tan Fengjiao , Mo Yuanyuan , Chen Huihuang , Klümper Uli , Berendonk Thomas U. , Yang Jun
Published: June 2022

Antibiotic resistance has been a serious global threat to environmental and human health. The “One Health” concept further emphasizes the importance of monitoring the large-scale dissemination of ARGs.
Plasma Virome Reveals Blooms and Transmission of Anellovirus in Intravenous Drug Users with HIV-1, HCV, and/or HBV Infections
Authors: Li Yanpeng , Cao Le , Ye Mei , Xu Rong , Chen Xin , Ma Yingying , Tian Ren-Rong , Liu Feng-Liang , Zhang Peng , Kuang Yi-Qun , Zheng Yong-Tang , Zhang Chiyu
Published: June 2022

Virome is associated with immune status and determines or influences disease progression through both pathogenic and resident viruses. Increased viral burden in IDUs especially those with major viral infections indicated the suboptimal immune status and high infection risks of these population.
Hypokalaemia with Guillain-Barré syndrome: a diagnostic and therapeutic challenge
Authors: Hati Arkapravo , Chakraborty Uddalak , Chandra Atanu , Biswas Purbasha
Published: June 2022

Acute-onset quadriparesis is not only debilitating and a grave concern for the patient but also perturbs the clinician as it demands early diagnosis and prompt management to prevent catastrophic outcome due to respiratory failure. Guillain-Barré syndrome (GBS) and hypokalaemia are notorious causes of acute-onset lower motor neuron (LMN) quadriparesis and warrant a rapid evaluation to necessitate early management. However, coexistence of these two entities is extremely rare and may pose a diagnostic and therapeutic challenge and mandates exclusion of either condition to avoid a poor outcome. We hereby report a case of a young woman who presented with an acute-onset LMN quadriparesis, initially found to have significant hypokalaemia with poor response to supplementation and was further evaluated to have an axonal variant of GBS.
Spinal haemangioma with cauda equina syndrome in pregnancy
Authors: Raj Arathy , Abraham Anuja , Raja Navaneethan Preethi , Mathew Vivek
Published: June 2022

The true incidence of haemangiomas, which are the most common benign tumours in the spine, is not known as they are most often asymptomatic and are detected at autopsy. It can become symptomatic due to the haemodynamic and hormonal changes in pregnancy which cause sudden expansion of the lesion. In this paper, we present a case of a woman in her 30s, primigravida at 31 weeks’ gestation with acute urinary retention and neurological features suggestive of cauda equina syndrome. Imaging confirmed the diagnosis of vertebral haemangioma involving T12 vertebra encroaching the posterior dural space and abutting the cord. She underwent surgical excision of the haemangioma with complete recovery of neurological symptoms on postoperative follow-up.
What India can learn from globally successful malaria elimination programmes
Authors: Sharma Sachin , Verma Reena , Yadav Bhawna , Kumar Amit , Rahi Manju , Sharma Amit
Published: June 2022

India is targeting malaria elimination by 2030. Understanding and adopting the strategies employed by countries that have successfully eliminated malaria can serve as a crucial thrust in this direction for a geographically diverse country like India. This analysis is based on extensive literature search on malaria elimination policies, strategies and programmes adopted by nine countries (China, El Salvador, Algeria, Argentina, Uzbekistan, Paraguay, Sri Lanka, Maldives and Armenia) which have attained malaria-free status over the past decade. The key points which India can learn from their journey are mandatory time-bound response in the form of case reporting and management, rapid vector control response, continuous epidemiological and entomological surveillance, elevated community participation, more training and capacity building, private sector involvement, use of quality diagnostics, cross-border collaborations, inclusion of prevention of re-establishment programmes into the elimination plans, higher investment in research, and uninterrupted funds for successful implementation of malaria elimination programmes. These learnings would help India and other South Asian countries steer their programmes by devising tailor-made strategies for their own regions.
Exploring complementary and competitive relations between non-communicable disease services and other health extension programme services in Ethiopia: a multilevel analysis
Authors: Tesema Azeb Gebresilassie , Peiris David , Joshi Rohina , Abimbola Seye , Fentaye Fasil Walelign , Teklu Alula M , Kinfu Yohannes
Published: June 2022

Background

Ethiopia has recently revitalised its health extension programme (HEP) to address the rising burden of non-communicable diseases (NCDs). We examined the effects of existing essential HEP services on the uptake of NCD preventive services.

Methods

We applied a mixed-effect non-linear model with a logit link function to identify factors associated with a community resident’s probability of receiving NCD prevention services through the HEP. The data were drawn from the Ethiopian HEP assessment Survey conducted in all regions. The analysis included 9680 community residents, 261 health extension workers (HEWs), 153 health posts, 119 health centres, 55 districts and 9 regions, which we combined hierarchically into a single database.

Results

In the 12 months before the survey, 22% of the sample population reported receiving NCD preventive service at least once. The probability of receiving NCD prevention service increased by up to 25% (OR=1.25, CI 1.01 to 1.53) if health centres routinely gathered NCD data from health posts and by up to 48% (OR=.48, CI 1.24 to 1.78) if they provided general (ie, non-NCD specific) training to HEWs. NCD preventive service uptake also increased if the HEW held level IV qualification (OR=1.32, CI 1.06 to 1.65) and lived in the community (OR=1.24, CI 1.03 to 1.49). Conversely, if facilities delayed general performance reviews of HEWs by a month, uptake of NCD prevention services decreased by 6% (OR=0.94, CI 0.91 to 0.97). We observed that better HIV/AIDS programme performance was associated with a lower uptake of NCD preventive services (OR=0.15, CI 0.03 to 0.85).

Conclusion

Despite efforts to improve NCD services through the HEP, the coverage remains limited. A strong HEP is good for the uptake of NCD preventive services. However, integration requires a careful balance, so that the success already recorded for some existing programmes is not lost.
The global health workforce stock and distribution in 2020 and 2030: a threat to equity and ‘universal’ health coverage?
Authors: Boniol Mathieu , Kunjumen Teena , Nair Tapas Sadasivan , Siyam Amani , Campbell James , Diallo Khassoum
Published: June 2022

Objective

The 2016 Global Strategy on Human Resources for Health: Workforce 2030 projected a global shortage of 18 million health workers by 2030. This article provides an assessment of the health workforce stock in 2020 and presents a revised estimate of the projected shortage by 2030.

Methods

Latest data reported through WHO’s National Health Workforce Accounts (NHWA) were extracted to assess health workforce stock for 2020. Using a stock and flow model, projections were computed for the year 2030. The global health workforce shortage estimation was revised.

Results

In 2020, the global workforce stock was 29.1 million nurses, 12.7 million medical doctors, 3.7 million pharmacists, 2.5 million dentists, 2.2 million midwives and 14.9 million additional occupations, tallying to 65.1 million health workers. It was not equitably distributed with a 6.5-fold difference in density between high-income and low-income countries. The projected health workforce size by 2030 is 84 million health workers. This represents an average growth of 29% from 2020 to 2030 which is faster than the population growth rate (9.7%). This reassessment presents a revised global health workforce shortage of 15 million health workers in 2020 decreasing to 10 million health workers by 2030 (a 33% decrease globally). WHO African and Eastern Mediterranean regions’ shortages are projected to decrease by only 7% and 15%, respectively.

Conclusions

The latest NHWA data show progress in the increasing size of the health workforce globally as more jobs are and will continue to be created in the health economy. It however masks considerable inequities, particularly in WHO African and Eastern Mediterranean regions, and alarmingly among the 47 countries on the WHO Support and Safeguards List. Progress should be acknowledged with caution considering the immeasurable impact of COVID-19 pandemic on health workers globally.
Association between sleep duration and hypertension in southwest China: a population-based cross-sectional study
Authors: Chang Xiaoyu , Chen Xiaofang , Ji John S , Luo Guojin , Chen* Xiaofang , Sun Qiang , Zhang Ningmei , Guo Yu , Pei Pei , Li Liming , Chen Zhengming , Wu Xianping
Published: June 2022

Objective

Hypertension is a major risk factor and cause of many non-communicable diseases in China. While there have been studies on various diet and lifestyle risk factors, we do not know whether sleep duration has an association to blood pressure in southwest China. This predictor is useful in low-resource rural settings. We examined the association between sleep duration and hypertension in southwest China.

Design

Population-based cross-sectional study.

Setting

This study was part of the baseline survey of a large ongoing prospective cohort study, the China Kadoorie Biobank. Participants were enrolled in 15 townships of Pengzhou city in Sichuan province during 2004–2008.

Participants

55 687 participants aged 30–79 years were included. Sleep duration was assessed by a self-reported questionnaire.

Main outcome measures

Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, or prior physician-diagnosed hypertension in hospitals at the township (community) level or above.

Results

The prevalence of hypertension was 25.17%. The percentages of subjects with sleep durations of <6, 6, 7, 8 and ≥9 hours were 17.20%, 16.14%, 20.04%, 31.95% and 14.67%, respectively. In multivariable-adjusted analyses, the increased ORs of having hypertension were across those who reported ≥9 hours of sleep (men: 1.16, 95% CI 1.04 to 1.30; women: 1.19, 95% CI 1.08 to 1.32; general population: 1.17, 95% CI 1.08 to 1.26). The odds of hypertension was relatively flat until around 6.81 hours of sleep duration and then started to increase rapidly afterwards in subjects and a J-shaped pattern was observed. There was a U-shaped relationship between sleep duration and hypertension in females.

Conclusion

Long sleep duration was significantly associated with hypertension and a J-shaped pattern was observed among rural adults in southwest China, independent of potential confounders. However, this association was not obvious between short sleep duration and hypertension.
β-hydroxy-β-methylbutyrate-enriched nutritional supplements for obese adults during weight loss: study protocol of a randomised, double-blind, placebo-controlled clinical trial
Authors: Jing Xiaofan , Liang Yuxiang , Wang Renjie , Fu Hongbo , Jiang Jiaojiao , Yang Ming
Published: June 2022

Introduction

Obesity is a public health challenge worldwide. To maintain a healthy weight, dieting and lifestyle changes are the first-line interventions; however, these interventions are of poor compliance and may cause body composition changes, mainly skeletal muscle wasting (sarcopenia). Dietary supplements for improving body composition while inducing weight loss are therefore needed. β-hydroxy-β-methylbutyrate (HMB) has been proven to be effective for improving muscle mass and muscle strength in athletes, older adults and patients with cancer. We aim to evaluate the effectiveness and safety of HMB-enriched nutritional supplements for improving muscle mass and muscle function in obese adults during calorie restriction.

Method and analysis

A total of 72 Chinese adults with obesity will be randomised to receive HMB-enriched nutritional supplements (65 g/day) or a placebo for 12 weeks. Participants in both groups will also receive calorie restrictions based on the individualised nutrition guidance of dietitians. Participants and investigators will be blinded to the allocations. The primary outcome will be the mean change in whole-body skeletal muscle mass (measured by bioelectrical impedance analysis). The secondary outcomes will include the mean change of appendicular skeletal muscle mass, body fat mass, basal metabolic rate, phase angle, muscle function and serum biomarkers. The enrolment will commence in December 2021 and will proceed until March 2022.

Ethics and dissemination

This protocol has been approved by the Biomedical Ethics Committee of West China Hospital (2021-771). All potential subjects will be required to sign a written informed consent. The results of this study will be reported in peer-reviewed academic journals and conferences.

Trial registration number

NCT04953936.
Influence of Genetics, Immunity and the Microbiome on the Prognosis of Inflammatory Bowel Disease (IBD Prognosis Study): the protocol for a Copenhagen IBD Inception Cohort Study
Authors: Attauabi Mohamed , Madsen Gorm Roager , Bendtsen Flemming , Wewer Anne Vibeke , Wilkens Rune , Ilvemark Johan , Vladimirova Nora , Jensen Annette Bøjer , Jensen Frank Krieger , Hansen Sanja Bay , Siebner Hartwig Roman , Nielsen Yousef Jesper Wirenfeldt , Møller Jakob M , Thomsen Henrik S , Thomsen Simon Francis , Ingels Helene Andrea Sinclair , Theede Klaus , Boysen Trine , Bjerrum Jacob T , Jakobsen Christian , Dorn-Rasmussen Maria , Jansson Sabine , Yao Yiqiu , Burian Ewa Anna , Møller Frederik Trier , Fana Viktoria , Wiell Charlotte , Terslev Lene , Østergaard Mikkel , Bertl Kristina , Stavropoulos Andreas , Seidelin Jakob B , Burisch Johan
Published: June 2022

Introduction

Inflammatory bowel diseases (IBD), encompassing Crohn’s disease and ulcerative colitis, are chronic, inflammatory diseases of the gastrointestinal tract. We have initiated a Danish population-based inception cohort study aiming to investigate the underlying mechanisms for the heterogeneous course of IBD, including need for, and response to, treatment.

Methods and analysis

IBD Prognosis Study is a prospective, population-based inception cohort study of unselected, newly diagnosed adult, adolescent and paediatric patients with IBD within the uptake area of Hvidovre University Hospital and Herlev University Hospital, Denmark, which covers approximately 1 050 000 inhabitants (~20% of the Danish population). The diagnosis of IBD will be according to the Porto diagnostic criteria in paediatric and adolescent patients or the Copenhagen diagnostic criteria in adult patients. All patients will be followed prospectively with regular clinical examinations including ileocolonoscopies, MRI of the small intestine, validated patient-reported measures and objective examinations with intestinal ultrasound. In addition, intestinal biopsies from ileocolonoscopies, stool, rectal swabs, saliva samples, swabs of the oral cavity and blood samples will be collected systematically for the analysis of biomarkers, microbiome and genetic profiles. Environmental factors and quality of life will be assessed using questionnaires and, when available, automatic registration of purchase data. The occurrence and course of extraintestinal manifestations will be evaluated by rheumatologists, dermatologists and dentists, and assessed by MR cholangiopancreatography, MR of the spine and sacroiliac joints, ultrasonography of peripheral joints and entheses, clinical oral examination, as well as panoramic radiograph of the jaws. Fibroscans and dual-energy X-ray absorptiometry scans will be performed to monitor occurrence and course of chronic liver diseases, osteopenia and osteoporosis.

Ethics and dissemination

This study has been approved by Ethics Committee of the Capital Region of Denmark (approval number: H-20065831). Study results will be disseminated through publication in international scientific journals and presentation at (inter)national conferences.
Prevalence of breast fibroadenoma in healthy physical examination population in Guangdong province of China: a cross-sectional study
Authors: Zhu Lijun , Zeng Xiaoqi , Jiang Shanshan , Ruan Simin , Ma Huanrong , Li Yingjia , Ye Changsheng , Dong Jianyu
Published: June 2022

Objective

To provide an accurate assessment of the prevalence of breast fibroadenoma in a large population and to confirm the diagnostic accuracy of ultrasound for fibroadenoma.

Design

This was a cross-sectional survey.

Setting

This research was conducted at Nanfang Hospital, Guangzhou, Guangdong, China.

Participants

A total of 11 898 women aged 18–40 years who underwent breast screening between 1 January 2019 and 31 December 2019 were included in the fibroadenoma prevalence study. From 1 June 2019 to 31 December 2019, 342 breast lesions with pathology reports and preoperative ultrasound images were collected for diagnostic fibroadenoma testing (vs histological diagnostic testing).

Primary outcome measures

Pearson’s χ2 test was performed to compare the prevalence of different lesions between age groups, and descriptive statistics were used to report the clinical characteristics of fibroadenoma. For ultrasound diagnosis, fibroadenoma was defined as a well-circumscribed lesion with round or oval shape, consisting of a homogeneously hypoechoic or isoechoic solid mass, located parallel to the chest wall with a smooth margin and no posterior shadowing. Diagnostic test results for breast fibroadenoma were stratified by diagnostic type (histological vs ultrasound).

Results

Of the women aged 18–40 years, 27.6% (3285/11 898) had an ultrasound diagnosis offibroadenoma. Of these, the prevalence of fibroadenoma was stable across age groups (p=0.14) and did not differ between the left and right sides of the breast. Almost two-thirds of women presented with a single fibroadenoma, and most fibroadenomas did not exceed 1 cm in size. The sensitivity and specificity for fibroadenoma were 97.0% (95% CI for sensitivity: 93.7% to 98.8%) and 91.4% (95% CI for specificity: 85.4% to 95.5%) for ultrasonography, respectively.

Conclusions

The prevalence of fibroadenoma in South China is as high as 27.6%, and ultrasound could be used as a tool to diagnose fibroadenoma.
Acute kidney injury in patients with COVID-19 in the intensive care unit: evaluation of risk factors and mortality in a national cohort
Authors: Aukland Eirik Aasen , Klepstad Pål , Aukland Stein Magnus , Ghavidel Fatemeh Zamanzad , Buanes Eirik Alnes
Published: June 2022

Objectives

Acute kidney injury (AKI) is a frequent complication among critical ill patients with COVID-19, but the actual incidence is unknown as AKI-incidence varies from 25% to 89% in intensive care unit (ICU) populations. We aimed to describe the prevalence and risk factors of AKI in patients with COVID-19 admitted to ICU in Norway.

Design

Nation-wide observational study with data sampled from the Norwegian Intensive Care and Pandemic Registry (NIPaR) for the period between 10 March until 31 December 2020.

Setting

ICU patients with COVID-19 in Norway. NIPaR collects data on intensive care stays covering more than 90% of Norwegian ICU and 98% of ICU stays.

Participants

Adult patients with COVID-19 admitted to Norwegian ICU were included in the study. Patients with chronic kidney disease (CKD) were excluded in order to avoid bias from CKD on the incidence of AKI.

Primary and secondary outcome measures

Primary outcome was AKI at ICU admission as defined by renal Simplified Acute Physiology Score in NIPaR. Secondary outcome measures included survival at 30 and 90 days after admission to hospital.

Results

A total number of 361 patients with COVID-19 were included in the analysis. AKI was present in 32.0% of the patients at ICU admission. The risk for AKI at ICU admission was related to acute circulatory failure at admission to hospital. Survival for the study population at 30 and 90 days was 82.5% and 77.6%, respectively. Cancer was a predictor of 30-day mortality. Age, acute circulatory failure at hospital admission and AKI at ICU admission were predictors of both 30-day and 90-day mortality.

Conclusions

A high number of patients with COVID-19 had AKI at ICU admission. The study indicates that AKI at ICU admission was related to acute circulatory failure at hospital admission. Age, acute circulatory failure at hospital admission and AKI at ICU admission were associated with mortality.
What factors are associated with utilisation of health services for the poor elderly? Evidence from a nationally representative longitudinal survey in China
Authors: Zeng Yanbing , Xu Weiqian , Tao Xiaomeng
Published: June 2022

Objectives

To investigate the status and factors of healthcare service utilisation among the poor elderly in China.

Methods

We selected the poor elderly from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. The main outcome measures include utilisation indicators for the probability and costs of outpatient/inpatient services. Based on modified Andersen behaviour model, a two-part model is designed to analyse the factors of the health service utilisation of the poor elderly.

Results

The visit rate of outpatient services increased from 15.05% in 2011 to 21.26% in 2015, and the hospitalisation rate increased from 7.26% to 14.32%. The median cost of outpatient and inpatient services in 2015 for the poor elderly were 350 RMB and 10 000 RMB, respectively, and the out-of-pocket ratios were 85.2% and 53.3%, respectively. 78.44% of the people who actually needed healthcare did not use health services, and the main reason was financial difficulties (42.32%). The poor elderly who are higher educated, have children, live in central regions and have social security and a poor health status and who do not smoke or drink are more likely to use health services. The need factor plays a crucial role in determining health service utilisation.

Conclusions

The poor elderly tends to have a worse health status and a heavier medical burden but had a lower utilisation of health services. Predisposing, enabling, need and health behaviour variables should be considered to improve the health service utilisation and the health of the poor elderly.