bluuebunny/crossref_metadata_2025 huggingface dataset:
A third-order two-step numerical scheme for heat and mass transfer of chemically reactive radiative MHD power-law fluid
Authors: Nawaz Yasir , Abodayeh Kamaleldin , Arif Muhamamd Shoaib , Ashraf Muhammad Usman
Published: October 2021

A two-stage third-order numerical scheme is proposed for solving ordinary differential equations. The scheme is explicit and implicit type in two stages. First, the stability region of the scheme is found when it is applied to the linear equation. Further, the stability conditions of the scheme are found using a linearized homogenous set of differential equations. This set of equations is obtained by applying transformations on the governing equations of heat and mass transfer of incompressible, laminar, steady, two-dimensional, and non-Newtonian power-law fluid flows over a stretching sheet with effects of thermal radiations and chemical reaction. The proposed scheme with an iterative method is employed in two different forms called linearized and non-linearized. But it is found that the non-linearized approach performs better than the linearized one when residuals are compared through plots. Additionally, the proposed scheme is compared to the second-order central finite difference method for second-order non-linear differential equations and the Keller-Box/trapezoidal method for a linear differential equation. It is determined that the proposed scheme is more effective and computationally less expensive than the standard/classical finite difference methods. Moreover, the impact of magnetic parameter, radiation parameter, modified Prandtl and Schmidt numbers for power-law fluid, and chemical reaction rate parameter on velocity, temperature, and concentration profiles are displayed through graphs and discussed. The power-law fluid’s heat and mass transfer simulations are also carried out with varying flow behavior index, sheet velocity, and mass diffusivity. We hoped that this effort would serve as a guide for investigators tasked with resolving unresolved issues in the field of enclosures used in industry and engineering.
Influence of variability in hygrothermal properties on analytical results of simultaneous heat and moisture transfer in porous materials
Authors: Yamamoto Hiroaki , Takada Satoru
Published: October 2021

Depending on the data source used, the material hygrothermal properties that are used in the numerical analysis of simultaneous heat and moisture transfer will not be consistent. Differences in measurement methods and the individuality of specimens account for this. It is necessary to choose values from these different physical property sets to conduct a numerical calculation, which can cause the calculated results to differ. The subsequent range of variation in the calculated results should be quantitatively evaluated. In this study, the physical properties of several types of porous building materials were first gathered from four databases. The data were then categorized based on the kind of material and compared in terms of each physical property (density, porosity, specific heat, moisture capacity, thermal conductivity, and vapor permeability). The density, porosity, and specific heat varied by 10% on average, and the moisture capacity, thermal conductivity, and vapor permeability varied by 20% or more for all types of materials. In particular, the vapor permeability of plywood and moisture capacity of gypsum board differed by 50%. The influence that these physical property value variations had on hygrothermal calculation results was then quantitatively demonstrated for moisture and heat flow rate under a step change in the relative humidity or temperature of indoor air for a single layer wall. The moisture and heat flow rate into a single layer wall fluctuated by approximately 10%–40% due to differences in the vapor permeability and moisture capacity of the materials. For all types of materials, moisture was transferred more slowly than heat. Therefore, differences in moisture property values, such as vapor permeability and moisture capacity, influenced the results more significantly. Moreover, the moisture flow was accompanied by a phase change. The differences in moisture property values thus affected the heat flow.
Green Diabetes Summit 2021
Authors: Nguyen Kevin T. , Xu Nicole Y. , Zhang Jennifer Y. , Shang Trisha , DuBord Ashley Y. , Heinemann Lutz , Krisiunas Edward P. , Stumpe Tobias , Seid Donna A. , Klonoff David C.
Published: October 2021

On July 21, 2021, Diabetes Technology Society convened the virtual Green Diabetes Summit. The event consisted of 23 representatives from key stakeholder groups based in both the United States and Europe. The purposes of the summit were to (1) provide background on the complexity of addressing sustainability-related issues, including waste management, of diabetes devices from many different perspectives along the products’ life cycle stages, and (2) determine the feasibility and role of a coalition of stakeholders to find solutions, particularly in the design, use, and proper disposal of diabetes devices used in home care that no one stakeholder can resolve on their own.
Renal outcomes and prognostic factors in patients with type-2 diabetes and chronic kidney disease confirmed by renal biopsy
Authors: Jing Na , Pan Mengxing , Song Yi , Guo Feng , Zhang Haohao , Wang Jiao , Cao Zhe , Liu Shiyu , Wu Lina , Ji Hongfei , Huang Fengjuan , Ding Xiaoxu , Qi Chang , Huang Sen , Yang Xinyu , Zhang Li , Song Chunhua , Qin Guijun , Zhao Yanyan
Published: October 2021

Aim:

To evaluate the renal outcomes and prognostic factors among patients with type-2 diabetes (T2D) and biopsy-confirmed diabetic nephropathy (DN), non-diabetic renal disease (NDRD) and DN mixed with NDRD (MIX).

Design and Methods:

Patients with both T2D and chronic kidney disease (CKD) who underwent renal biopsy between January 2014 and December 2016 were recruited in this prospective observational study. Participants were divided into DN group, NDRD group, or MIX group according to the baseline pathological diagnosis. The primary endpoint was a composite renal event of end-stage renal disease (ESRD) or ⩾ 40% reduction in estimated glomerular filtration rate (eGFR).

Results:

Among the 292 participants included, 153 (52.4%) belonged to the DN group, 30 (10.3%) belonged to the NDRD group, and 109 (37.3%) belonged to the MIX group. During the median follow-up of 27 months, the adverse renal events occurred in 132 (44.2%) patients. Compared with NDRD group, the multiple adjusted hazard ratios (HRs) for renal events in patients with DN and MIX groups were 3.900 (95% confidence interval [CI]: 1.103–13.788) and 2.691 (95% CI: 0.662–10.936), respectively. Baseline lower eGFR (HR: 1.159, 95% CI: 1.060–1.266), severe proteinuria (HR: 2.047, 95% CI: 1.227–3.416), lower hemoglobin (HR: 1.170, 95% CI: 1.008–1.267), and a family history of diabetes (HR: 1.138, 95% CI: 1.008–2.285) were independent predictors for adverse renal outcomes in patients with DN.

Conclusion:

In patients with T2D and CKD, pure DN and MIX group displayed a worse renal prognosis than NDRD group. Worse renal function, severe proteinuria, lower hemoglobin, and a family history of diabetes may be associated with adverse renal outcomes in patients with DN.
Parole practises in Lithuania: Factors predicting court decisions
Authors: Jarutiene Liubove
Published: October 2021

This article examines factors that predict parole decisions in Lithuanian courts. The study state has a two-stage discretionary parole system where applicants are first evaluated through a parole board hearing, and the board’s decision is then reviewed in court. The study sample included 360 court verdicts from various court institutions. Intergroup comparisons suggest that parole boards tend to grant parole more often than courts. The results of regression analysis suggest that courts weigh heavily on the decision made by the parole board as well as the number of misconduct reports, time left to serve and previous parole or probation violations.
The Quality of Life, Patient Satisfaction and Rehabilitation in Patients With a Low Energy Fracture—Part III of an Observational Study
Authors: van der Vet Puck C. R. , Kusen Jip Q. , Rohner-Spengler Manuela , Link Bjoern-Christian , Verleisdonk Egbert-Jan M. M. , Knobe Matthias , Henzen Christoph , Schmid Lukas , Babst Reto , Beeres Frank J. P.
Published: October 2021

Introduction

Due to the aging population the incidence of Low Energy Fractures (LEF) increases. LEF have high mortality and morbidity rates and often cause elderly to lose independence. Patient-reported outcomes, such as Quality of Life (QoL) and patient satisfaction (PS) are needed to evaluate treatment, estimate cost-benefit analyses, and to improve clinical decision-making and patient-centered care.

Objective

The primary goal was to evaluate QoL and PS in patients with LEF, and to compare QoL scores to the community dwelling population. Second, we observed the amount and type of physiotherapy (PT) sessions the patients conducted.

Methods

A single-center cohort study was conducted in Switzerland. Patients between 50 and 85 years, who were treated in the hospital for LEF, were followed 1 year after initial fracture. Data on QoL were obtained through the Euroqol-5-Dimension questionnaire-3-Level (EQ-5D-3L) and the EQ VAS (visual analog scale). PS was measured by a VAS on satisfaction with treatment outcome. Data on PT sessions, mobility and use of analgesics were collected by telephone interviews and written surveys. Results were compared between the different fracture locations and subgroup analyses were performed for age categories.

Results

411 patients were included for analysis. The median scores of the EQ-5D-3L index—VAS and PS were 0.90 (0.75–1.0), 90 (71.3–95) and 100 (90–100). Significant differences in all scores were found between fracture location ( P < .05), with hip fracture patients and patients with a malleolar fracture scoring lowest in all measures. QoL index in hip fracture patients was 0.76 (0.70–1.00), QoL VAS 80 (70–90), and PS 95 (80–100). Median amount of PT sessions in all patients was 18 (9–27) and a significant difference was found between fracture locations. Patients with a fracture of the humerus received the highest amount of PT sessions 27 (18–36), hip fracture patients had a median of 18 (9–27) sessions.

Conclusion

At follow-up, QoL throughout all patients with a LEF was comparable to a normal population. Remarkably, though hip fracture patients seem to suffer from a clinically relevant loss of QoL, they received fewer PT sessions and performed fewer long-lasting home training than patients with a humerus fracture. Intensive, progressive rehabilitation with a high frequency of supervised training is recommended after hip fracture. The low frequency of PT sessions found in this study is unsatisfying. In hip fracture patients and in patients with a malleolar fracture, especially when aged over 75 years, more efforts are required to improve rehabilitation and subsequently QoL.
Has India’s Employment Guarantee Program Achieved Intended Targets?
Authors: Reddy A. Amarender , Singha Roy Namrata , Pradeep Divya
Published: October 2021

This paper explores the performance of the world’s largest employment guarantee program, the Mahatma Gandhi National Rural Employment Guarantee Scheme in India, both nationally and through a sub-national-level comparison based on key performance indicators viz. (i) financial indicators, (ii) physical performance indicators, and (iii) inclusiveness indicators. The paper is based on administrative data taken from the Ministry of Rural Development from 2006 to 2019. Despite sharp increases in fund allocation, total expenditures, and utilization rates, there was deceleration in majority of physical performance indicators after 2016, including total person-days employment and person-days of employment per household, with wide variation in sub-national level implementation capabilities. The finding also rejects the falsity of saturation of MGNREGA work in the rural areas, which is reflected in a strong positive correlation between fund allocation and employment generation. Its broader objective of social safety net for vulnerable people in rural areas shows an achievement, although with some gaps in implementation.

JEL classification: H53, J43, P25
Under Reporting of Abuse of Older Adults in the Canadian Prairie Provinces
Authors: Roger Kerstin , Walsh Christine A. , Goodridge Donna , Miller Stacey , Cewick Marina , Liepert Carla
Published: October 2021

This tri-provincial mixed methods study explores the reasons for under reporting abuse of older adults in the Prairie Provinces of Canada. Abuse of community-residing older adults, and specifically the reasons for not reporting such abuse, is poorly understood. This paper discusses the findings of the qualitative arm of the study that collected data through interviews with older adults having histories of abuse, their family members and service providers from related sectors. Content analysis was employed to identify three key themes: (1) recognizing and naming abuse; (2) barriers to disclosure; and (3) facilitators of reporting. Recommendations are made to improve awareness, education, and service provision in prevention and treatment of the abuse of community-residing older adults.
Surgery for Metastatic Spinal Disease in Octogenarians and Above: Analysis of 78 Patients
Authors: Hussain Ibrahim , Hartley Benjamin R. , McLaughlin Lily , Reiner Anne S. , Laufer Ilya , Bilsky Mark H. , Barzilai Ori
Published: October 2021

Study Design:

Retrospective Cohort Study.

Objective:

Octogenarians living with spinal metastases are a challenging population to treat. Our objective was to identify the rate, types, management, and predictors of complications and survival in octogenarians following surgery for spinal metastases.

Methods:

A retrospective review of a prospectively collected cohort of patients aged 80 years or older who underwent surgery for metastatic spinal tumor treatment between 2008 and 2019 were included. Demographic, intraoperative, complications, and postoperative follow-up data was collected. Cox proportional hazards regression and logistic regression were used to associate variables with overall survival and postoperative complications, respectively.

Results:

78 patients (mean 83.6 years) met inclusion criteria. Average operative time and blood loss were 157 minutes and 615 mL, respectively. The median length of stay was 7 days. The overall complication rate was 31% (N = 24), with 21% considered major and 7% considered life-threatening or fatal. Blood loss was significantly associated with postoperative complications (OR = 1.002; P = 0.02) and mortality (HR = 1.0007; P = 0.04). Significant associations of increased risk of death were also noted with surgeries with decompression, and cervical/cervicothoracic index level of disease. For deceased patients, median time to death was 4.5 months. For living patients, median follow-up was 14.5 months. The Kaplan-Meier based median overall survival for the cohort was 11.6 months (95% CI: 6.2-19.1).

Conclusions:

In octogenarians undergoing surgery with instrumentation for spinal metastases, the median overall survival is 11.6 months. There is an increased complication rate, but only 7% are life-threatening or fatal. Patients are at increased risk for complications and mortality particularly when performing decompression with stabilization, with increasing intraoperative blood loss, and with cervical/cervicothoracic tumors.
Evaluation of Central Sensitization Inventory in Patients Undergoing Elective Spine Surgery in a Multicenter Study
Authors: Akeda Koji , Yamada Junichi , Takegami Norihiko , Fujiwara Tatsuhiko , Murata Koichiro , Kono Toshibumi , Sudo Takao , Imanishi Takao , Asanuma Yumiko , Kurata Tatsuya , Kawakita Eiji , Sakakibara Toshihiko , Kondo Tetsushi , Takegami Kenji , Sato Masayoshi , Sudo Akihiro
Published: October 2021

Study Design

This study is a retrospective review.

Objective

Central sensitization (CS) is a neurological phenomenon that involves hypersensitivity of the central nervous system. The central sensitization inventory (CSI) was developed as a screening tool to assess CS-related symptoms. The purpose of this study was to evaluate the association of preoperative CSI scores with patient-reported outcome measures (PROMs) including neurological symptoms for patients who underwent spine surgeries in a multicenter study.

Methods

A consecutive 673 patients who underwent spine surgery at 8 different institutions were included in this study. Preoperative CSI scores were assessed for all subjects. The participants completed the following PROMs: the Oswestry Disability Index (ODI), the Japanese Orthopaedic Association (JOA) back pain evaluation questionnaire (JOABPEQ) for lumbar spinal diseases, and the JOA cervical myelopathy evaluation questionnaire (JOACMEQ) for cervical spinal diseases. The association of CSI scores with PROMs was statistically evaluated.

Results

The average CSI score for the total subjects was 23.6 ± 13.5. The subjects with CS-related symptoms (CSI ≥ 40) were 13.2% (n = 89). The CSI score showed a significant and weak-to-moderate correlation with the PROMs including neurological symptoms that included all the domains of the JOACMEQ for cervical spinal diseases, and JOABPEQ and ODI for lumbar spinal diseases. Among these, psychological factors had the most influence on the correlation with CSI score.

Conclusion

Central sensitization evaluated by the CSI is related to neurological symptoms and health-related quality of life in patients undergoing elective spine surgery.
Oral Health Status and Oral Health–Related Quality of Life of First Nations and Metis Children
Authors: Lee J. , Schroth R.J. , Sturym M. , DeMaré D. , Rosteski M. , Batson K. , Chartrand F. , Bertone M.F. , Kennedy T. , Hai-Santiago K. ,   the Scaling-up Healthy Smile Happy Child Team,   Pine Creek First Nation,   Manitoba Metis Federation
Published: October 2021

Objectives:

To assess the oral health status and oral health–related quality of life (OHRQoL) of young First Nations and Metis children.

Methods:

This cross-sectional study assessed the oral health status of Indigenous children <72 mo of age while their parents/caregivers completed a questionnaire, including the Early Childhood Oral Health Impact Scale (ECOHIS), to assess OHRQoL. Analysis included descriptive statistics, bivariate analyses, and multiple regression. A P value ≤0.05 was considered significant.

Results:

Overall, 146 children were recruited with a mean age of 40.1 ± 21.2 (SD) months, and 49% were male. Among First Nations children, 65.4% had early childhood caries (ECC) as compared with 45.2% among Metis children (P = 0.025). However, there was no statistically significant difference in the prevalence of severe ECC (S-ECC) between First Nations and Metis children (60.6% v. 42.9%, P = 0.051). The mean decayed, missing, and filled primary teeth (dmft) score was 4.9 ± 5.3 (range 0–20), and the mean decayed, missing, and filled surfaces (dmfs) score was 14.5 ± 20.4 (range 0–80). The total mean ECOHIS score was 4.4 ± 5.9 (range 0–25), while the mean Child Impact Section and Family Impact Section scores were 2.6 ± 4.0 (range 0–10) and 1.8 ± 2.8 (range 0–8), respectively. Multiple linear regression showed S-ECC was associated with total mean ECOHIS scores (P = 0.02). Higher total mean ECOHIS scores (which indicates poorer OHRQoL) were observed in children with ECC compared with caries-free children (5.8 v. 2.4, P = 0.0001).

Conclusion:

Oral health disparities such as ECC and reduced OHRQoL exist among many First Nations and Metis children in Manitoba. This is the first Canadian study exploring the OHRQoL of Indigenous children in addition to their oral health status.

Knowledge Transfer Statement:

This study is the first to report on the oral health–related quality of life and its relationship to early childhood caries (ECC) among young Canadian First Nations and Metis children. Metis children are just as likely to suffer from severe ECC than First Nations children. The findings of this study have informed community-based and community-developed oral health promotion and ECC prevention activities.
The Role of Human Fallibility in Psychological Research: A Survey of Mistakes in Data Management
Authors: Kovacs Marton , Hoekstra Rink , Aczel Balazs
Published: October 2021

Errors are an inevitable consequence of human fallibility, and researchers are no exception. Most researchers can recall major frustrations or serious time delays due to human errors while collecting, analyzing, or reporting data. The present study is an exploration of mistakes made during the data-management process in psychological research. We surveyed 488 researchers regarding the type, frequency, seriousness, and outcome of mistakes that have occurred in their research team during the last 5 years. The majority of respondents suggested that mistakes occurred with very low or low frequency. Most respondents reported that the most frequent mistakes led to insignificant or minor consequences, such as time loss or frustration. The most serious mistakes caused insignificant or minor consequences for about a third of respondents, moderate consequences for almost half of respondents, and major or extreme consequences for about one fifth of respondents. The most frequently reported types of mistakes were ambiguous naming/defining of data, version control error, and wrong data processing/analysis. Most mistakes were reportedly due to poor project preparation or management and/or personal difficulties (physical or cognitive constraints). With these initial exploratory findings, we do not aim to provide a description representative for psychological scientists but, rather, to lay the groundwork for a systematic investigation of human fallibility in research data management and the development of solutions to reduce errors and mitigate their impact.
Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography
Authors: Arias Juan D. , Arango Francisco J. , Parra Maria Margarita , Sánchez-Ávila Ronald M. , Parra-Serrano Gustavo A. , Hoyos Andrea T. , Granados Silvia J. , Viteri Eduardo J. , Gaibor-Santos Ivetteh , Perez Yanny
Published: October 2021

Background:

Timely detection of early microvascular changes in patients with prediabetes could help reduce the likelihood of progression of diabetes-related retinal complications.

Aim:

To determine early microvascular changes in patients with prediabetes using optical coherence tomography angiography (OCT-A).

Methods:

In this single-center retrospective case-control study, macular OCT-A images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed in non-diabetic controls, and prediabetic and diabetic subjects. A quantitative analysis was performed using ImageJ software of the foveal avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD), and vascular length density (VLD).

Results:

A total of 94 eyes of 53 patients were included in this study. The global mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, the mean PD was 0.283 ± 0.15, 0.186 ± 0.720, and 0.186 ± 0.07 in non-diabetic controls, and prediabetic and diabetic groups, respectively. The mean VLD was 8.728 ± 3.425 in non-diabetic controls, 6.147 ± 1.399 in prediabetic group, and 6.292 ± 1.997 in patients with diabetes. The comparison of prediabetic patients and controls shows statistical differences between PD and VLD in both plexus SCP ( p = 0.002 and p = 0.001, respectively) and DCP ( p = 0.005 and p = 0.002, respectively). The mean area of FAZ in patients with diabetes and normal individuals was 0.281 and 0.196 mm2, respectively ( p < 0.001). AI was higher in the control group (0.87 ± 0.14) and prediabetic group (0.80 ± 0.17) compared to diabetic patients (0.64 ± 0.19). There were no differences in FAZ area and AI between prediabetic and non-diabetic controls.

Conclusion:

PD and VLD demonstrated to be early microvascular changes in prediabetic patients evaluated by OCT-A. No alterations of FAZ were evidenced in this group.
Towards a Systemic Approach to Business
Authors: Ramanathan Ram
Published: October 2021

Ram’s career has spanned over 40 years, during which he has donned multiple avatars: corporate leader (CEO), business builder, government advisor, angel investor and runaway monk internship. He is presently a systemic leadership coach.

In this article, he argues that Indian leaders are schizophrenic. On the one hand, they are torn between the inherited cultural values of harmony and family obligations, and on the other hand, a product of imbibed Western B-School concepts of professional management and profit above all else.

This dichotomy leads to hypocrisy and duplicity in Indian business. This is evidenced by treating people as means to an end rather than resources, much talked about, but not practised. Unlike their more forthright Western counterparts, who make no bones about profit making, Indian business leaders pretend to be of service to society and the system; yet acting only for personal gains of wealth and power through manipulation and lack of transparency.

Ram shares his experiences on Indianness and the Indian business leaders. He explores where the hypocrisy may possibly emanate from, how this behaviour is at odds with changing generational needs and what are the likely fallouts even while pointing to emerging trends of systemic approach moving from diversity to unity, built on people engagement and collaborative teamwork in leadership. Indian companies and leaders, he argues, have what it takes to be far better and greater than they are now.
Treatment of pulmonary hypertension associated with COPD: a systematic review
Authors: Arif Ragdah , Pandey Arjun , Zhao Ying , Arsenault-Mehta Kyle , Khoujah Danya , Mehta Sanjay
Published: October 2021

Chronic obstructive pulmonary disease-associated pulmonary hypertension (COPD-PH) is an increasingly recognised condition which contributes to worsening dyspnoea and poor survival in COPD. It is uncertain whether specific treatment of COPD-PH, including use of medications approved for pulmonary arterial hypertension (PAH), improves clinical outcomes. This systematic review and meta-analysis assesses potential benefits and risks of therapeutic options for COPD-PH.

We searched Medline and Embase for relevant publications until September 2020. Articles were screened for studies on treatment of COPD-PH for at least 4 weeks in 10 or more patients. Screening, data extraction, and risk of bias assessment were performed independently in duplicate. When possible, relevant results were pooled using the random effects model.

Supplemental long-term oxygen therapy (LTOT) mildly reduced mean pulmonary artery pressure (PAP), slowed progression of PH, and reduced mortality, but other clinical or functional benefits were not assessed. Phosphodiesterase type 5 inhibitors significantly improved systolic PAP (pooled treatment effect −5.9 mmHg; 95% CI −10.3, −1.6), but had inconsistent clinical benefits. Calcium channel blockers and endothelin receptor antagonists had limited haemodynamic, clinical, or survival benefits. Statins had limited clinical benefits despite significantly lowering systolic PAP (pooled treatment effect −4.6 mmHg; 95% CI −6.3, −2.9).

This review supports guideline recommendations for LTOT in hypoxaemic COPD-PH patients as well as recommendations against treatment with PAH-targeted medications. Effective treatment of COPD-PH depends upon research into the pathobiology and future high-quality studies comprehensively assessing clinically relevant outcomes are needed.
Starch branching enzymes as putative determinants of postharvest quality in horticultural crops
Authors: Yu Jingwei , Wang Keyun , Beckles Diane M.
Published: October 2021

Starch branching enzymes (SBEs) are key determinants of the structure and amount of the starch in plant organs, and as such, they have the capacity to influence plant growth, developmental, and fitness processes, and in addition, the industrial end-use of starch. However, little is known about the role of SBEs in determining starch structure-function relations in economically important horticultural crops such as fruit and leafy greens, many of which accumulate starch transiently. Further, a full understanding of the biological function of these types of starches is lacking. Because of this gap in knowledge, this minireview aims to provide an overview of SBEs in horticultural crops, to investigate the potential role of starch in determining postharvest quality. A systematic examination of SBE sequences in 43 diverse horticultural species, identified SBE1, 2 and 3 isoforms in all species examined except apple, olive, and Brassicaceae, which lacked SBE1, but had a duplicated SBE2. Among our findings after a comprehensive and critical review of published data, was that as apple, banana, and tomato fruits ripens, the ratio of the highly digestible amylopectin component of starch increases relative to the more digestion-resistant amylose fraction, with parallel increases in SBE2 transcription, fruit sugar content, and decreases in starch. It is tempting to speculate that during the ripening of these fruit when starch degradation occurs, there are rearrangements made to the structure of starch possibly via branching enzymes to increase starch digestibility to sugars. We propose that based on the known action of SBEs, and these observations, SBEs may affect produce quality, and shelf-life directly through starch accumulation, and indirectly, by altering sugar availability. Further studies where SBE activity is fine-tuned in these crops, can enrich our understanding of the role of starch across species and may improve horticulture postharvest quality.
Integration of the metabolome and transcriptome reveals the mechanism of resistance to low nitrogen supply in wild bermudagrass (Cynodon dactylon (L.) Pers.) roots
Authors: Li Dandan , Liu Jianxiu , Zong Junqin , Guo Hailin , Li Jianjian , Wang Jingjing , Wang Haoran , Li Ling , Chen Jingbo
Published: October 2021

Background

Nitrogen (N) is an essential macronutrient that significantly affects turf quality. Commercial cultivars of bermudagrass (Cynodon dactylon (L.) Pers.) require large amounts of nitrogenous fertilizer. Wild bermudagrass germplasm from natural habitats with poor nutrition and diverse N distributions is an important source for low-N-tolerant cultivated bermudagrass breeding. However, the mechanisms underlying the differences in N utilization among wild germplasm resources of bermudagrass are not clear.

Results

To clarify the low N tolerance mechanism in wild bermudagrass germplasm, the growth, physiology, metabolome and transcriptome of two wild accessions, C291 (low-N-tolerant) and C716 (low-N-sensitive), were investigated. The results showed that root growth was less inhibited in low-N-tolerant C291 than in low-N-sensitive C716 under low N conditions; the root dry weight, soluble protein content and free amino acid content of C291 did not differ from those of the control, while those of C716 were significantly decreased. Down-regulation of N acquisition, primary N assimilation and amino acid biosynthesis was less pronounced in C291 than in C716 under low N conditions; glycolysis and the tricarboxylic acid (TCA) cycle pathway were also down-regulated, accompanied by a decrease in the biosynthesis of amino acids; strikingly, processes such as translation, biosynthesis of the structural constituent of ribosome, and the expression of individual aminoacyl-tRNA synthetase genes, most of genes associated with ribosomes related to protein synthesis were all up-regulated in C291, but down-regulated in C716.

Conclusions

Overall, low-N-tolerant wild bermudagrass tolerated low N nutrition by reducing N primary assimilation and amino acid biosynthesis, while promoting the root protein synthesis process and thereby maintaining root N status and normal growth.
Obesity measures, metabolic health and their association with 15-year all-cause and cardiovascular mortality in the SAMINOR 1 Survey: a population-based cohort study
Authors: Michalsen Vilde Lehne , Wild Sarah H. , Kvaløy Kirsti , Svartberg Johan , Melhus Marita , Broderstad Ann Ragnhild
Published: October 2021

Background

The mortality of metabolic-obesity phenotypes has been thoroughly studied, but it is not known if or how the association between mortality and body mass index (BMI), waist circumference or a body shape index (ABSI) differ in strata of cardiometabolic health status.

Methods

We linked data on 12,815 men and women aged 36–79 years from the SAMINOR 1 Survey with mortality data from the Norwegian Cause of Death Registry. We defined metabolically healthy and unhealthy as having zero and ≥ 1, respectively, of the following: MetS, pre-existing diabetes or cardiovascular disease (CVD), or prescribed drugs for high blood pressure, hyperglycaemia or dyslipidaemia. We defined general and abdominal obesity as BMI ≥ 30 kg/m2 and waist circumference ≥ 88 cm (women) or 102 cm (men), respectively, and cross-classified these categories with metabolic status to create metabolically healthy non-obese and obese (MHNO and MHO) and metabolically unhealthy non-obese and obese (MUNO and MUO) phenotypes. We used Cox regression to estimate the hazard ratio (HR) for all-cause and CVD mortality for 1) the four phenotypes and 2) BMI, waist circumference and ABSI fitted with restricted cubic splines. We adjusted for age and lifestyle, and tested for interactions with sex and metabolic status (only continuous measures).

Results

The MHO phenotype was present in 7.8% of women and 5.8% of men. During a median follow-up of 15.3/15.2 years, 596/938 women/men had died, respectively. The MUNO and MUO groups had higher mortality than the MHNO group. Sex and phenotypes interacted with respect to CVD mortality: relative to the MHNO group, the MHO group had an adjusted HR (95% confidence interval) for CVD mortality of 1.05 (0.38–2.88) in women and 2.92 (1.71–5.01) in men. We found curvilinear associations between BMI/waist circumference and all-cause mortality irrespective of metabolic status. Corresponding relationships with CVD mortality were linear and the slope differed by sex and metabolic status. ABSI was linearly and positively associated with all-cause and CVD mortality in men.

Conclusion

The relationships between BMI, waist circumference or ABSI and mortality differed by sex, metabolic status and cause of death. Poor metabolic health substantially increases mortality regardless of obesity status.
Fear of falling and associated factors among older people living in Bahir Dar City, Amhara, Ethiopia- a cross-sectional study
Authors: Birhanie Gebremeskel , Melese Haimanot , Solomon Gebrerufael , Fissha Berihu , Teferi Molla
Published: October 2021

Background

Fear of falling (FOF) is the most common public health problem, which can lead to loss of confidence, reducing physical and social activities, depression, loss of mobility, increased risk of falls, physical weakness, and strong negative impact on an older people’s quality of life. However, studies in developing country were lacking, particularly in the study area. Therefore, the aim of the current study was to fill this gap in the study area in particular and the country in general. The purpose of the current study was to assess the prevalence and associated factors with fear of falling among older people 60 years and older who were living in Bahir Dar city, Ethiopia.

Methods

A community based cross sectional study design was conducted with a total sample size of 527 participants and multistage random sampling technique was used to select the study participants. The fall efficacy scale tool was used to develop the questionnaire. Data were coded, cleaned and entered into SPSS version 23 for analysis. Multi-collinearity and model fitting were checked. In bivariate logistic regression analyses, variables with p-value< 0.25 were considered as potential candidates for multivariable logistic regression analyses. A variable with p-value< 0.05 at 95% CI was considered as statistically significant. Finally, the odds ratio and 95% confidence interval were estimated and interpreted.

Results

A total of 481 participants was included in this study. The prevalence of fear of falling among the older people was 59.9% (95% CI; 55.7–64.4). Fear of falling was significantly associated with the following variables:- advanced age (AOR = 4.01, 95% CI; 1.65–9.74), female (AOR = 4.25, 95% CI; 2.25–8.01), lower education level (AOR = 2.77, 95% CI; 1.12–6.82), anxiety [AOR = 9.03, 95% CI; 4.78–17.07), confirmed medical conditions (AOR = 2.01, 95% CI; 1.03–3.91) and walking aids used (AOR = 13.82; 95% CI; 5.21–36.63).

Conclusions

A moderate prevalence of fear of falling was observed. The major associated factors were advanced age, being female, lower educational level, anxiety, confirmed medical conditions and walking aids used. Hence, we recommend the need of rehabilitation programs that enable healthy aging and further rigor research is recommended.
Application of mNGS to describe the clinical and microbial characteristics of severe burn a tanker explosion at a tertiary medical center: a retrospective study patients following
Authors: Wu Jing , Huang Man
Published: October 2021

Background

Multiple organ dysfunction syndrome secondary to infection is the leading cause of death in burn patients. Bloodstream infection (BSI) and the prognosis of burn patients are negatively correlated. Metagenomic next-generation sequencing (mNGS) can detect many potential pathogens and may be more valuable for patients with severe burns.

Methods

We retrospectively explored the utility of mNGS in describing the clinical and microbial characteristics of severely burned patients with BSI. We compared mNGS with blood culture.

Results

Fourteen patients (127 blood samples) developed 71 episodes of BSIs with 102 unique causative pathogens. The median total body surface area was 93%. The overall 90-day mortality was 43%. In total, 17 (23.9%) episodes were polymicrobial, and 61 (86.1%) episodes originated from the wound. In total, 62/71 cases (87%) showed positive findings by mNGS, while 42/71 cases (59%) showed positive findings using blood culture. We found that mNGS outperformed culture, especially in terms of fungi (27% vs. 6%, p < 0.0001).

Conclusions

The incidence of BSI and polymicrobial in patients with large-area severe burns is high. mNGS has potential value in the diagnosis of fungal infections and coinfections in such patients. In addition, mNGS may provide unique guidance for antibiotic therapy in complicated BSI.
The efficiency of 18F-FDG-PET/CT in the assessment of tumor response to preoperative chemoradiation therapy for locally recurrent rectal cancer
Authors: Uemura Mamoru , Ikeda Masataka , Handa Rio , Danno Katsuki , Nishimura Junichi , Hata Taishi , Takemasa Ichiro , Mizushima Tsunekazu , Yamamoto Hirofumi , Sekimoto Mitsugu , Doki Yuichiro , Eguchi Hidetoshi
Published: October 2021

Background

Locally recurrent rectal cancer (LRRC) remains a major problem after curative resection of primary rectal cancer. A noninvasive, prognostic biomarker with which to accurately evaluate disease status and assess the treatment response is critically needed to optimize treatment plans. This study assesses the effectiveness of PET/CT evaluation of preoperative chemoradiation therapy (CRT) in patients with LRRC.

Methods

Since 2004, we have been performing preoperative CRT to improve local tumor control and survival. Between 2004 and 2013, 40 patients with LRRC underwent preoperative CRT (radiation: 50 Gy/25 fractions; chemotherapy: irinotecan plus UFT [tegafur and uracil]/leucovorin) and radical surgery, and underwent 18F-FDG-PET/CT before and 3 weeks after the completion of CRT. The maximum standardized uptake values (SUVmax) of the pre-CRT scan (Pre-SUV) and the post-CRT scan (Post-SUV) were measured. The predictive value of the 18F-FDG-PET and CT/MRI response assessments was evaluated.

Results

The mean Pre-SUV was significantly higher than the Post-SUV (8.2 ± 6.1, vs. 3.8 ± 4.0; P < 0.0001). Following CRT, 17/40 patients (42.5%) were classified as responders according to the Mandard tumor regression grade (TRG1–2). The mean Post-SUV was significantly lower in responders than in nonresponders (2.0 ± 1.7 vs. 5.1 ± 3.9; P = 0.0038). Pathological response was not correlated with the response as evaluated by CT (P > 0.9999) or MRI (P > 0.9999). Multivariate regression analysis identified Post-SUV as an independent predictor of local re-recurrence-free survival (P = 0.0383) and for overall survival (P = 0.0195).

Conclusions

PET/CT is useful in assessing tumor response to preoperative CRT for LRRC and predicting prognosis after surgery.
Reducing worry and rumination in young adults via a mobile phone app: study protocol of the ECoWeB (Emotional Competence for Well-Being in Young Adults) randomised controlled trial focused on repetitive negative thinking
Authors: Edge Daniel , Newbold Alexandra , Ehring Thomas , Rosenkranz Tabea , Frost Mads , Watkins Edward R.
Published: October 2021

Background

Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety.

Method/design

The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16–24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored.

Discussion

This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people.

Trial registration

ClinicalTrials.gov, NCT04950257. Registered 6 July 2021 – Retrospectively registered.
Digital messaging to support control for type 2 diabetes (StAR2D): a multicentre randomised controlled trial
Authors: Farmer A. , Bobrow K. , Leon N. , Williams N. , Phiri E. , Namadingo H. , Cooper S. , Prince J. , Crampin A. , Besada D. , Daviaud E. , Yu L-M , N’goma J. , Springer D. , Pauly B. , Tarassenko L. , Norris S. , Nyirenda M. , Levitt N.
Published: October 2021

Background

Failure to take medicines for diabetes as prescribed contributes to poor outcomes from the condition. Mobile phones are ubiquitous and short message service (SMS) texts have shown promise as a low-cost intervention. We tested the effectiveness of SMS-text messaging in improving outcomes in adults with type 2 diabetes.

Methods

StAR2D was a 12-month two-arm randomised trial of SMS-text messaging and usual care in Cape Town, South Africa and Lilongwe, Malawi. Messages used behaviour change theory and were developed with patients and staff. The intervention group received four messages each week. The primary outcome was change in HbA1c. Secondary outcomes were the proportion of patients who collected > 80% medication and changes in systolic blood pressure, lipids, cardiovascular risk, and the proportion of the participants reaching treatment goals.

Results

The trial took place between 1 October, 2016 and 1 October 2018, 1186 participants were randomised to intervention (593) and control (593) groups. 91% of participants completed follow-up. There was a reduction in HbA1c (DCCT) in both groups but not in mean change (95% CI) between groups (− 0.08% (− 0.31 to 0.16) (IFCC − 0.82 mmol/mol (− 3.44 to 1.79). There was a small but not significant increase in the proportions of participants likely to have collected 80% or more of medication (Relative risk 1.11 (0.84 to 1.47; P = 0.47). There was a significant difference between groups in change in systolic blood pressure from baseline of 3.46 mmHg (1.48 to 5.44, P = 0.001) in favour of the intervention group. The between group difference in change in 10-year risk of coronary heart disease was − 0.71% (− 1.46 to 0.04, P = 0.064). The proportion of participants meeting treatment goals in the intervention group was 36.0% and in the control group 26.8% (Relative risk 1.36 (1.13 to 1.63, P = 0.001). Participants reported many challenges to adherence despite finding messages acceptable and useful.

Conclusions

Whilst SMS text messages do not lead to improved glycaemia in these low-resource settings there appeared to be an impact on blood pressure and achievement of treatment goals but the mechanisms for this are unclear. Text messages alone, may be unsuccessful unless accompanied by health system strengthening and other forms of self-management support for type 2 diabetes.

Trial registration

Trial registration: ISRCTN, ISRCTN70768808. Registered 1 July 2015, http://www.isrctn.com/I ISRCTN70768808.
Association of total pre-existing comorbidities with stroke risk: a large-scale community-based cohort study from China
Authors: Zhang Ya , Wang Cuicui , Liu Dong , Zhou Zhengyuan , Gu Shujun , Zuo Hui
Published: October 2021

Background

Comorbidities, any other coexisting diseases in patients with a particular index disease, are known to increase the mortality of a stroke. However, the association of pre-existing comorbidities with stroke risk has not been fully studied.

Methods

This study included 16,246 adults from a prospective community-based cohort with a baseline survey conducted in 2013 in China. Participants were followed up with hospitalization records and the Cause of Death Registry. The association of eight pre-existing comorbidities (coronary heart disease, hyperlipidemia, hypertension, diabetes, previous stroke, chronic obstructive pulmonary disease, nephropathy, and cancer) with stroke risk was analyzed using the Cox proportional hazard model in 2020.

Results

At a median follow-up of 5.5 years, a total of 449 participants (206 men and 243 women) developed a stroke. Four pre-existing comorbidities (hypertension, congenital heart disease, previous stroke, and diabetes) were independently and positively associated with the risk for all types of stroke. The adjusted hazard ratios for participants with only 1 and ≥ 2 pre-existing comorbidities compared with those without pre-existing conditions were 1.96 (95% CI: 1.44, 2.67; P < 0.001) and 2.87 (95% CI; 2.09, 3.94; P < 0.001) for total stroke, respectively. Moreover, male and female participants with a combination of increased age and a higher number of pre-existing comorbidities experienced the greatest risk of stroke.

Conclusions

The number of pre-existing comorbidities was independently associated with an increased risk of stroke. There was a synergic effect between increased age and a higher number of pre-existing comorbidities on stroke occurrence. Our novel findings emphasize the importance and potential application of pre-existing comorbidities as a risk indicator in stroke prevention.