bluuebunny/crossref_metadata_2025 huggingface dataset:
A methodology for class analysis: Agricultural investments and agrarian change in South Africa
Authors: Bunce Brittany
Published: August 2022

This paper presents a class‐analytic approach, which combines a “labour exploitation criterion” with class typologies developed for the South African context and the author's additions. The labour exploitation criterion distinguishes between rural classes based on the degree to which one employs others, works for others, or works for oneself. I combine the principal indicator of “labour exploitation” with the income contributions of social grants, ownership of farming assets and livestock, and the contribution of agricultural production to simple or expanded reproduction. Debates around class formation are explored in the context of a comparative analysis of two joint venture (JV) dairy farms, located in the Eastern Cape Province of South Africa, which involve residents as both landowners and workers. A class‐analytic approach illuminates the emerging agrarian class structure that a JV‐type intervention both reflects and in turn conditions, in dialectical fashion, with important implications for debates around agrarian change in South Africa.
Student and Teacher Views on Cheating in High School: Perceptions, Evaluations, and Decisions
Authors: Waltzer Talia , DeBernardi Fiona C. , Dahl Audun
Published: August 2022

Why do so many adolescents cheat despite judging that cheating is wrong? Two studies tested a new model of cheating in high school. In Study 1, 85 high schoolers in the Western U.S. reported their perceptions, evaluations, and motivations surrounding their own and hypothetical cheating. In Study 2, 83 teachers reported their views about cheating; we also analyzed course syllabi. About half of the adolescents reported unintentional cheating, and many judged their own cheating—but not hypothetical cheating—as acceptable. Decisions to cheat were responses to competing pressures, low value placed on the assignment, and other considerations. Study 2 revealed teacher‐student disagreements about cheating, and minimal content about academic integrity in syllabi. The findings supported the proposed model of adolescent cheating.
Optimal social distancing and the economics of uncertain vaccine arrival
Authors: Iverson Terrence , Karp Larry , Peri Alessandro
Published: August 2022

We analytically identify two mechanisms that explain why a later arrival time for a pandemic‐ending vaccine has an ambiguous effect on optimal social‐distancing policy. We assess the net effect of these channels using a quantitative model solved for over a thousand parameter combinations. Optimal policy and welfare comparisons are both highly sensitive to beliefs about vaccine arrival. A policy of moving quickly to herd immunity by requiring social distancing for only the most vulnerable might be loosely justified for expected vaccine arrivals over 2 years, but becomes catastrophic if the expected arrival is within a year.
The risk assessment of high‐fat diet in farmed fish and its mitigation approaches: A review
Authors: Naiel Mohammed A. E. , Negm Samar S. , Ghazanfar Shakira , Shukry Mustafa , Abdelnour Sameh A.
Published: August 2022

In the era of intensification of fish farms, the high‐fat diet (HFD) has been applied to promote growth and productivity, provide additional energy and substitute partial protein in fish feeds. Certainly, HFD within specific concentrations was found to be beneficial in boosting fish performance throughout a short‐term feeding. However, excessive dietary fat levels displayed vast undesirable impacts on growth, feed efficiency, liver function, antioxidant capacity and immune function and finally reduced the economic revenue of cultured fish. Moreover, studies have shown that fish diets containing a high level of fats resulted in increasing lipid accumulation, stimulated endoplasmic reticulum stress and suppressed autophagy in fish liver. Investigations showed that HFD could impair the intestinal barrier of fish via triggering inflammation, metabolic disorders, oxidative stress and microbiota imbalance. Several approaches have been widely used for reducing the undesirable influences of HFD in fish. Dietary manipulation could mitigate the adverse impacts triggered by HFD, and boost growth and productivity via reducing blood lipids profile, attenuating oxidative stress and hepatic lipid deposition and improving mitochondrial activity, immune function and antioxidant activity in fish. As well, dietary feed additives have been shown to decrease hepatic lipogenesis and modulate the inflammatory response in fish. Based on the literature, previous studies indicated that phytochemicals could reduce apoptosis and enhance the immunity of fish fed with HFD. Thus, the present review will explore the potential hazards of HFD on fish species. It will also provide light on the possibility of employing some safe feed additives to mitigate HFD risks in farmed fish.
Micrograph analysis of morphological alteration and cellular damage of fruit rot fungal pathogens treated with Averrhoa bilimbi fruit and Garcinia mangostana pericarp ethanolic extracts
Authors: Abd Murad N.B. , Mustafa M. , Shaari K. , Mohd Zainudin N.A.I.
Published: August 2022

The aim of this study is to assess the antifungal action of Averrhoa bilimbi fruit and Garcinia mangostana pericarp ethanolic extracts in altering the morphology and causing cellular damage of Fusarium oxysporum, Fusarium proliferatum, Colletotrichum gloeosporioides and Lasiodiplodia theobromae. The pathogens were cultured on media containing both extracts individually and carbendazim as positive control, whereas media alone as negative control. All samples were processed for microscopy observations using scanning (SEM) and transmission electron (TEM) microscopes. Observation via SEM showed significant alterations in the hyphae of F. oxysporum, F. proliferatum and C. gloeosporioides compared to the control in which the hyphae were in normal form. However, no significant alteration in hyphae had been observed in the treated plate compared to the control for L. theobromae. The development of calcium carbonate crystals was also observed abundantly in control compared to treated pathogens for F. oxysporum and F. proliferatum only. This indicated that the plant extracts can inhibit some metabolic processes in the pathogens too. Observations via TEM had been conducted for F. proliferatum and C. gloeosporioides, respectively. The results showed disintegration of cytoplasmic organelles and cell wall, intense vacuolization and lyses part of fungal cells. The plant extracts have equivalent or even greater effects compared to commercial fungicide carbendazim.
Antifungal prescription practices and consumption in a tertiary care hospital of a developing country
Authors: Kaur Harsimran , Krishnamoorthi Sivanantham , Dhaliwal Navneet , Biswal Manisha , Singh Shreya , Muthu Valliappan , Rudramurthy Shivaprakash M. , Agarwal Ritesh , Ghoshal Sushmita , Singh Surjit , Malhotra Pankaj , Jain Sanjay , Samujh Ram , Ghosh Anup , Chakrabarti Arunaloke
Published: August 2022

Background

Antifungal stewardship is a less explored component of antimicrobial stewardship programmes, especially in developing countries.

Objective

We aimed to determine antifungal prescription practices in a tertiary centre of a developing country to identify the challenges for antifungal stewardship programmes.

Methods

Four single‐day point prevalent surveys were performed in inpatient units and data were collected from medical records. Antifungal use was recorded in terms of consumption, therapeutic strategies and appropriateness.

Results

We found a 2.42%‐point prevalence of antifungal prescriptions. Antifungal use was higher in children than adults (4.1% vs. 2.03%), medical than surgical units (3.7% vs. 1.24%) and ICUs than general wards (5.8% vs. 1.9%). The highest antifungal use was observed in the haematology‐oncology units (29.3%) followed by emergency (16.2%) and gastroenterology units (11.6%). Among 215 prescriptions, amphotericin B was the most commonly prescribed (50.2%) followed by fluconazole (31.6%). The targeted antifungal therapy was practised more commonly (31.5%) than empiric (29.1%), pre‐emptive (22.6%) and prophylactic (16.8%) therapy. Amphotericin B was commonly used for pre‐emptive (p = .001) and targeted (p = .049) therapy, while fluconazole (p = .001) and voriconazole (p = .011) for prophylaxis. The prescriptions were inappropriate in 25.1% due to the wrong choice of antifungal (44.4%), indication (27.7%) and dosage (24%). The overall mean antifungal consumption was 2.71 DDD/1000 PD and 8.96 DOT/1000 PD.

Conclusions

We report here the low prevalence of antifungal use at a tertiary care centre in a developing country. Though training for antifungal use would be important for antifungal stewardship, the challenge would remain with the affordability of antifungals.
Modeling and propagating inventory‐based sampling uncertainty in the large‐scale forest demographic model “MARGOT”
Authors: Audinot Timothée , Wernsdörfer Holger , Le Moguédec Gilles , Bontemps Jean‐Daniel
Published: August 2022

Models based on national forest inventory (NFI) data intend to project forests under management and policy scenarios. This study aimed at quantifying the influence of NFI sampling uncertainty on parameters and simulations of the demographic model MARGOT. Parameter variance–covariance structure was estimated from bootstrap sampling of NFI field plots. Parameter variances and distributions were further modeled to serve as a plug‐in option to any inventory‐based initial condition. Forty‐year time series of observed forest growing stock were compared with model simulations to balance model uncertainty and bias. Variance models showed high accuracies. The Gamma distribution best fitted the distributions of transition, mortality and felling rates, while the Gaussian distribution best fitted tree recruitment fluxes. Simulation uncertainty amounted to 12% of the model bias at the country scale. Parameter covariance structure increased simulation uncertainty by 5.5% in this 12%. This uncertainty appraisal allows targeting model bias as a modeling priority.
Maternal stress during pregnancy and gestational duration: A cohort study from the Danish National Birth Cohort
Authors: Bergeron Julie , Cederkvist Luise , Fortier Isabel , Rod Naja Hulvej , Andersen Per Kragh , Andersen Anne‐Marie Nybo
Published: August 2022

Background

Preterm birth is one of the most important contributors to neonatal mortality and morbidity. Experiencing stress during pregnancy may increase the risk of adverse birth outcomes, including preterm birth. This association has been observed in previous studies, but differences in measures used limit comparability.

Objective

The objective of the study was to investigate the association between two measures of maternal stress during pregnancy, life stress and emotional distress, and gestation duration.

Methods

Women recruited in the Danish National Birth Cohort from 1996 to 2002, who provided information on their stress level during pregnancy and expecting a singleton baby, were included in the study. We assessed the associations between the level of life stress and emotional distress in quartiles, both collected at 31 weeks of pregnancy on average, and the rate of giving birth using Cox regression within intervals of the gestational period.

Results

A total of 80,991 pregnancies were included. Women reporting moderate or high levels of life stress vs no stress had a higher rate of giving birth earlier within all intervals of gestational age (e.g. high level: 27–33 weeks: hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.04, 1.84; 34–36 weeks: 1.10, 95% CI 0.97, 1.25; 37–38 weeks: 1.21, 95% CI 1.15, 1.28). These associations between life stress and preterm birth were mainly driven by pregnancy worries. For emotional distress, a high level of distress was associated with shorter length of gestation in the preterm (27–33 weeks: 1.38, 95% CI 1.02, 1.86; 34–36 weeks: 1.05, 95% CI 0.91, 1.19) and early term (1.11, 95% CI 1.04, 1.17) intervals.

Conclusions

Emotional distress and life stress were shown to be associated with gestational age at birth, with pregnancy‐related stress being the single stressor driving the association. This suggests that reverse causality may, at least in parts, explain the earlier findings of stress as a risk factor for preterm birth.
Biopsychosocial Experiences of Elite Athletes Retiring From Sport for Career-Ending Injuries: A Critically Appraised Topic
Authors: Moore Haley S. , Walton Samuel R. , Eckenrod Morgan R. , Kossman Melissa K.
Published: August 2022

Clinical Scenario: Injuries cause individuals varying amounts of time loss from participation, which may depend on injury and sport-specific factors such as level of participation. Athletes who never return to sport either choose or are forced to retire due to numerous factors. At elite levels of play, when an athlete chooses retirement, they have the opportunity to create and execute a retirement plan; however, if unexpected (eg, due to career-ending injury), athletes may struggle to transition out of sport effectively, impacting physical, mental, and social health. The biopsychosocial model looks at the relationship between biology, psychology, and socio-environmental factors. Therefore, the purpose of this study was to better understand the biopsychosocial experiences elite athletes face after a career-ending injury so that sport stakeholders can develop and implement strategies to support a healthy transition. Clinical Question: How does suffering a career-ending injury affect elite athletes’ biopsychosocial experiences during retirement from sport? Summary of Key Findings: All studies found that a career-ending injury negatively impacted athlete’s biopsychosocial health during the transition period. In addition, social support was identified as a positive coping mechanism and research highlighted the role of education in promoting successful transitions. Sport stakeholders should educate athletes regarding the importance of creating secondary plans. By creating a culture of athletic and nonathletic identity, athletes can feel empowered to navigate different phases of their life despite transition being forced upon them due to injury. Clinical Bottom Line: Career-ending injuries negatively impact the biopsychosocial experiences of elite athletes as they transition out of sport. Athletes may face many transitional challenges including a loss of identity, a lack of external support, and/or mental health decline; those more closely identifying with their role as an athlete tend to have a harder transition. Therefore, it is important for all athletes to be adequately prepared for sport retirement, especially given the uncertainty about when and how retirement may occur. Strength of Recommendation: Collectively, the body of evidence included to answer the clinical question aligns with the strength of recommendation of C.
Efficacy of Acidified Oils against
Salmonella
in Low-Moisture Environments
Authors: Ghoshal Mrinalini , Chuang Shihyu , Zhang Ying , McLandsborough Lynne
Published: August 2022

Currently, dry sanitization products used during food processing often contain flammable compounds which require processing to stop and equipment to cool before application. This leads to processing downtimes and consequently, economic losses.
A Defect in Lipoprotein Modification by Lgt Leads to Abnormal Morphology and Cell Death in Escherichia coli That Is Independent of Major Lipoprotein Lpp
Authors: Legood S. , Seng D. , Boneca I. G. , Buddelmeijer N.
Published: August 2022

Incomplete maturation and envelope mislocalization of lipoproteins, through inhibition or mutations in lipoprotein modification enzymes or transport to the outer membrane, are lethal in proteobacteria. Resistance to small-molecule inhibition or the appearance of suppressor mutations is often directly correlated with the presence of abundant outer membrane lipoprotein Lpp.
Insight into Viral Hijacking of CRL4 Ubiquitin Ligase through Structural Analysis of the pUL145-DDB1 Complex
Authors: Wick Elizaveta T. , Treadway Colton J. , Li Zhijun , Nicely Nathan I. , Ren Zhizhong , Baldwin Albert S. , Xiong Yue , Harrison Joseph S. , Brown Nicholas G.
Published: August 2022

Many different viruses modulate the protein machinery required for ubiquitination to enhance viral fitness. Specifically, several viruses hijack the cullin-RING ligase CRL4
DDB1
to degrade host resistance factors.
Rhythmic Spatial Self-Organization of Bacterial Colonies
Authors: Sartor Francesca , Kovács Ákos T.
Published: August 2022

Bacteria display a remarkable capacity to organize themselves in space and time within biofilms. Traditionally, the spatial organization of biofilms has been dissected vertically; however, biofilms can exhibit complex, temporally structured, two-dimensional radial patterns while spreading on a surface.
Whole-Genome Sequence of Beauveria bassiana JEF-350, a Strain with High Insecticidal Activity against Melon Thrips (Thrips palmi)
Authors: Kim Jong-Cheol , Park So Eun , Lee Se Jin , Kim Jae Su
Published: August 2022

The entomopathogenic fungus
Beauveria bassiana
JEF-350 was isolated from forest soil in South Korea. Here, we report the whole-genome sequence of JEF-350, along with the analyzed genetic information, which can be used to study insecticidal mechanisms and fungal diversity.
Four
Lentisphaerae
Family Metagenome-Assembled Genomes from the South Atlantic Ocean
Authors: Makinde Oluwatayo A. , Lunga Percy Mutseka , Bezuidt Oliver K. I. , Makhalanyane Thulani P.
Published: August 2022

We present four
Lentisphaerae
metagenome-assembled genomes (MAGs) from the South Atlantic Ocean. The medium-quality genomes, affiliated with the family of
Lentisphaeraceae,
ranged from 4.86 to 5.46 Mbp and harbored the genetic capacity to produce secondary metabolites. This resource provides a basis for investigating the functional attributes of this phylum.
Mixed T Helper1/T Helper2/T Cytotoxic Profile in Subjects with Chronic Chagas Disease with Hypersensitivity Reactions to Benznidazole
Authors: Castro Eiro Melisa D. , Natale María A. , Alvarez María G. , Castro Araceli , Seigelshifer Débora , Viotti Rodolfo , Fernández Marisa , Mazzuoccolo Luis , Lococo Bruno , Bertocchi Graciela L. , Cesar Gonzalo , Albareda María C. , Elias María J. , Caputo María B. , Gaddi Eduardo , Balbaryski Jeanette , Vigliano Carlos A. , Laucella Susana A.
Published: August 2022

This study identified the risk factors for the development of adverse reactions to benznidazole and identified a set molecule to monitor the appearance of these reactions. This knowledge might improve the safety of benznidazole administration.
Prediction of Th1 and Cytotoxic T Lymphocyte Epitopes of
Mycobacterium tuberculosis
and Evaluation of Their Potential in the Diagnosis of Tuberculosis in a Mouse Model and in Humans
Authors: Gong Wenping , Liang Yan , Wang Jie , Liu Yinping , Xue Yong , Mi Jie , Li Pengchuan , Wang Xiaoou , Wang Lan , Wu Xueqiong
Published: August 2022

Latent tuberculosis infection (LTBI) is a challenging problem in preventing, diagnosing, and treating tuberculosis (TB). The innate and adaptive immune responses are essential for eliminating or killing the mycobacteria.
Remote ischaemic conditioning in necrotising enterocolitis: a phase I feasibility and safety study
Authors: Zozaya Carlos , Ganji Niloofar , Li Bo , Janssen Lok Maarten , Lee Carol , Koike Yuhki , Gauda Estelle , Offringa Martin , Eaton Simon , Shah Prakeshkumar S , Pierro Agostino
Published: August 2022

Objective

Remote ischaemic conditioning (RIC) improves the outcome of experimental necrotising enterocolitis (NEC) by preserving intestinal microcirculation. The feasibility and safety of RIC in preterm infants with NEC are unknown. The study aimed to assess the feasibility and safety of RIC in preterm infants with suspected or confirmed NEC.

Design

Phase I non-randomised pilot study conducted in three steps: step A to determine the safe duration of limb ischaemia (up to 4 min); step B to assess the safety of 4 repeated cycles of ischaemia-reperfusion at the maximum tolerated duration of ischaemia determined in step A; step C to assess the safety of applying 4 cycles of ischaemia-reperfusion on two consecutive days.

Setting

Level III neonatal intensive care unit, The Hospital for Sick Children (Toronto, Canada).

Patients

Fifteen preterm infants born between 22 and 33 weeks gestational age.

Intervention

Four cycles of ischaemia (varying duration) applied to the limb via a manual sphygmomanometer, followed by reperfusion (4 min) and rest (5 min), repeated on two consecutive days.

Outcomes

The primary outcomes were (1) feasibility defined as RIC being performed as planned in the protocol, and (2) safety defined as perfusion returning to baseline within 4 min after cuff deflation.

Results

Four cycles/day of limb ischaemia (4 min) followed by reperfusion (4 min) and a 5 min gap, repeated on two consecutive days was feasible and safe in all neonates with suspected or confirmed NEC.

Conclusions

This study is pivotal for designing a future randomised controlled trial to assess the efficacy of RIC in preterm infants with NEC.

Trial registration number

NCT03860701.
Relationship between dry eye symptoms and quality of life: associations and mediation analysis
Authors: Lim Elizabeth Wen Ling , Chong Crystal Chun Yuen , Nusinovici Simon , Fenwick Eva , Lamoureux Ecosse Luc , Sabanayagam Charumathi , Cheng Ching-Yu , Tong Louis
Published: August 2022

Purpose

(1) To determine the independent association of dry eye symptoms with health-related quality of life (HRQoL) in the Singapore population and (2) to further investigate which factors mediate this association.

Methods

In this cross-sectional study, 7707 participants were included. The presence of dry eye symptoms was defined as experiencing at least one out of the six symptoms either ‘often’ or ‘all the time’. The EuroQoL-5 dimensions (EQ-5D) utility instrument (raw scores converted to UK time trade-off (TTO) values) was used to assess generic HRQoL and the overall score from the Visual Functioning Questionnaire for visual functioning. The association between dry eye symptoms and EQ-5D was investigated using multivariable linear regression, adjusting for demographic and socioeconomic information, comorbidities, systemic and ocular examinations results. Mediation analysis was used to determine whether certain factors mediated this association.

Results

After adjusting for relevant factors, those with dry eye symptoms had significantly lower HRQoL (difference in EQ-5D TTO: −0.062 (95% CI −0.073 to –0.050)), with the inability to open eyes affected the most (−0.101 (95% CI −0.161 to –0.042)), followed by a sandy sensation (−0.089 (95% CI −0.121 to –0.058)), a burning sensation (−0.070 (95% CI −0.105 to –0.036)), red eyes (−0.059 (95% CI −0.082 to –0.036)), a dry sensation (−0.058 (95% CI −0.072 to –0.044)) and crusting of eyelids (−0.040 (95% CI −0.071 to –0.008)). Visual functioning and the presence of recent falls accounted for 8.63% (4.98%–14.5%) and 2.93% (0.04%–5.68%) of the indirect relationship between dry eye and HRQoL, respectively.

Conclusion

Dry eye symptoms were independently associated with poor HRQoL. Moreover, this was partly mediated by reduced visual functioning and experiencing recent falls. Our results suggest that efforts to reduce severity of dry eye symptoms are essential to optimise patients’ overall functioning and well-being.
Is in-utero exposure to cannabis associated with the risk of attention deficit with or without hyperactivity disorder? A cohort study within the Quebec Pregnancy Cohort
Authors: Tchuente Vanina , Sheehy Odile , Zhao Jin-Ping , Gorgui Jessica , Gomez Yessica-Haydee , Berard Anick
Published: August 2022

Importance and objective

Prenatal cannabis effect on attention deficit with or without hyperactivity disorder (ADHD) remains to be determined. Our aim is to quantify the impact of in-utero exposure to cannabis on the risk of ADHD.

Design

Cohort study.

Setting

Questionnaires were mailed to women sampled from the Quebec Pregnancy Cohort (QPC). Data from questionnaires were then linked with their QPC (built with administrative health databases, hospital patient charts and birth certificate databases).

Participants

Respondents who gave birth to a singleton live born between January 1998 and December 2003 and were continuously enrolled in the Régie de l’assurance maladie du Québec (RAMQ) medication insurance plan for at least 12 months before the first day of gestation and during pregnancy.

Exposure

In-utero cannabis exposure was based on mothers’ answers to the question on cannabis use during pregnancy (yes/no) and categorised as occasionally, regularly exposed and unexposed if they chose one of these categories.

Outcomes

ADHD was defined by a diagnosis of ADHD through the RAMQ medical services or MedEcho databases or a prescription filled for ADHD medication through RAMQ pharmaceutical services between birth and the end of the follow-up period. Follow-up started at the birth and ended at the index date (first diagnosis or prescription filled for ADHD), child death (censoring), end of public coverage for medications (censoring) or the end of study period, which was December 2015 (censoring), whichever event came first.

Results

A total of 2408 children met the inclusion criteria. Of these children, 86 (3.6%) were exposed to cannabis in-utero and 241 (10.0%) had an ADHD diagnosis or medication filled. After adjustments for potential confounders, no significant association was found between in-utero cannabis exposure (occasional (1.22 (95% CI 0.63 to 2.19)) or regular (1.22 (95% CI 0.42 to 2.79))) and the risk of ADHD in children.

Conclusions

In-utero exposure to cannabis seemed to not be associated with the risk ADHD in children.
Long-term outcomes following antenatal exposure to low-dose aspirin: study protocol for the 4-year follow-up of the APRIL randomised controlled trial
Authors: Landman Anadeijda J E M C , van Limburg Stirum Emilie V J , van 't Hooft Janneke , Leemhuis Aleid G , Finken Martijn J J , van Baar Anneloes L , Roseboom Tessa J , Ravelli Anita C J , van Wely Madelon , Oosterlaan Jaap , Painter Rebecca C , Pajkrt Eva , Oudijk Martijn A , de Boer Marjon A
Published: August 2022

Introduction

The use of low-dose aspirin by pregnant women to prevent preterm pre-eclampsia is gradually increasing. The administration of aspirin during pregnancy improves perinatal outcome, which could translate into improved child outcome in the long term. However, antenatal exposure to aspirin could have adverse effects on child development that may manifest later in life. The aim of this follow-up study is to assess the long-term effects of antenatal exposure to low-dose aspirin compared with placebo on survival, (neuro)development, behaviour and general health at 4 years corrected age.

Methods and analysis

This is a follow-up study of the Dutch double-blind randomised controlled APRIL trial which assessed the effectiveness of treatment with aspirin (80 mg daily) compared with placebo for the prevention of preterm birth in women with a previous spontaneous preterm birth. Treatment was initiated before 16 weeks of gestation and continued until 36 weeks or birth. We aim to follow-up all 379 children born to women who participated in the APRIL trial and survived the neonatal period, at the corrected age of 4 years. The main outcomes are (neuro)development as assessed by the Ages and Stages Questionnaire, and behaviour as assessed by the Strength and Difficulties Questionnaire. Additional outcomes include mortality, growth and general health from birth up to 4 years, and a composite outcome including mortality, abnormal (neuro)development and problem behaviour. Analyses will be performed by intention-to-treat using a superiority design.

Ethics and dissemination

Institutional Review Board approval was obtained from the Medical Research Ethics Committee from Amsterdam Medical Center (no. W20 289#20.325). The results will be published in a peer-reviewed journal and presented at conferences.

Trial registration number

The APRIL trial (NTR5675, NL5553; EudraCT number 2015-003220-31) and the APRIL follow-up study (NL8950) are registered in the Dutch trial register. The study is funded by the Amsterdam Reproduction & Development research institute.
PreScription DigitaL ThErapEutic for Patients with Insomnia (SLEEP-I): a protocol for a pragmatic randomised controlled trial
Authors: Dreyer Rachel P , Berkowitz Alyssa , Yaggi Henry Klar , Schneeberg Lynelle , Shah Nilay D , Emanuel Lindsay , Kolla Bhanuprakash , Jeffery Molly Moore , Deeg Mark , Ervin Keondae , Thorndike Frances , Ross Joseph S
Published: August 2022

Introduction

Cognitive behavioural therapy for insomnia (CBT-I) is effective at treating chronic insomnia, yet in-person CBT-I can often be challenging to access. Prior studies have used technology to bridge barriers but have been unable to extensively assess the impact of the digital therapeutic on real-world patient experience and multidimensional outcomes. Among patients with insomnia, our aim is to determine the impact of a prescription digital therapeutic (PDT) (PEAR-003b, FDA-authorised as Somryst; herein called PDT) that provides mobile-delivered CBT-I on patient-reported outcomes (PROs) and healthcare utilisation.

Methods and analysis

We are conducting a pragmatically designed, prospective, multicentre randomised controlled trial that leverages Hugo, a unique patient-centred health data-aggregating platform for data collection and patient follow-up from Hugo Health. A total of 100 participants with insomnia from two health centres will be enrolled onto the Hugo Health platform, provided with a linked Fitbit (Inspire 2) to track activity and then randomised 1:1 to receive (or not) the PDT for mobile-delivered CBT-I (Somryst). The primary outcome is a change in the insomnia severity index score from baseline to 9-week postrandomisation. Secondary outcomes include healthcare utilisation, health utility scores and clinical outcomes; change in sleep outcomes as measured with sleep diaries and a change in individual PROs including depressive symptoms, daytime sleepiness, health status, stress and anxiety. For those allocated to the PDT, we will also assess engagement with the PDT.

Ethics and dissemination

The Institutional Review Boards at Yale University and the Mayo Clinic have approved the trial protocol. This trial will provide important data to patients, clinicians and policymakers about the impact of the PDT device delivering CBT-I on PROs, clinical outcomes and healthcare utilisation. Findings will be disseminated to participants, presented at professional meetings and published in peer-reviewed journals.

Trial registration number

NCT04909229.
Community-based interventions to prevent stroke in low-income and middle-income countries: a protocol for a systematic review and meta-analysis
Authors: Nowrin Iffat , Bhattacharyya Dipika Shankar , Saif-Ur-Rahman K M
Published: August 2022

Introduction

Stroke is the second leading cause of death and morbidity across the globe. In low-income and middle-income countries (LMICs), it has become an overwhelming burden over the past few decades. This burden is escalating at a much greater pace compared with that of high-income countries. It is considered the most frequent cause of adult disability that affects the quality of life. ‘Prevention’ is one of the key components to combating stroke. In this regard, community-based interventions can play a vital role in improving population-level health and well-being. Considering the escalating trend of stroke in LMICs, this systematic review aims to map the available community-based interventions in preventing stroke and to conduct further analysis regarding the effectiveness of the identified interventions.

Methods and analysis

We have searched Medline, Web of Science and Scopus using a comprehensive search strategy in October 2021. Two reviewers will independently perform screening, data extraction and risk of bias (ROB) assessment. The ROB assessment and applicability of results of eligible studies will be performed using the Cochrane ROB tool for assessing randomised controlled trials and the ROBANS (Risk Of Bias Assessment tool for Non-randomised Studies) to assess non-randomised studies. A random-effect model meta-analysis will be used to calculate pooled results and to obtain weighted OR and risk ratio of incidence of stroke along with corresponding 95% CI.

Ethics and dissemination

The results will be disseminated through publishing in a peer-reviewed journal and public presentations at relevant national and international conferences. Ethical approval is not required as this is a systematic review of publicly available data.

PROSPERO registration number

CRD42021283670.
Use of a penicillin allergy clinical decision rule to enable direct oral penicillin provocation: an international multicentre randomised control trial in an adult population (PALACE): study protocol
Authors: Copaescu Ana-Maria , James Fiona , Vogrin Sara , Rose Morgan , Chua Kyra , Holmes Natasha E , Turner Nicholas A , Stone Cosby , Phillips Elizabeth , Trubiano Jason
Published: August 2022

Introduction

Penicillin allergies are highly prevalent in the healthcare setting and associated with the prescription of second-line inferior antibiotics. More than 85% of all penicillin allergy labels can be removed by skin testing and 96%–99% of low-risk penicillin allergy labels can be removed by direct oral challenge. An internally and externally validated clinical assessment tool for penicillin allergy, PEN-FAST, can identify a low-risk penicillin allergy without the need for skin testing; a score of less than 3 has a negative predictive value of 96.3% (95% CI, 94.1 to 97.8) for the presence of a penicillin allergy. It is hypothesised that PEN-FAST is a safe and effective tool for assessing penicillin allergy in an outpatient clinic setting.

Methods and analysis

This is an international, multicentre randomised control trial using the PEN-FAST tool to risk-stratify penicillin allergy labels in adult outpatients. The study’s primary objective is to evaluate the non-inferiority of using PEN-FAST score-guided management with direct oral challenge compared with standard care (defined as prick and intradermal skin testing followed by oral penicillin challenge). Participants will be randomised 1:1 to the intervention arm (direct oral penicillin challenge) or standard of care arm (skin testing followed by oral penicillin challenge, if skin testing is negative). The sample size of 380 randomised patients (190 per treatment arm) is required to demonstrate non-inferiority.

Ethics and dissemination

The study will be performed according to the guidelines of the Helsinki Declaration and is approved by the Austin Health Human Research Ethics Committee (HREC/62425/Austin-2020) in Melbourne Australia, Vanderbilt University Institutional Review Board (IRB #202174) in Tennessee, USA, Duke University Institutional Review Board (IRB #Pro00108461) in North Carolina, USA and McGill University Health Centre Research Ethics Board in Canada (PALACE/2022-7605). The results of this study will be published and presented in various scientific forums.

Trial registration number

NCT04454229.
Quality improvement initiative: how the setting up of an anaesthesia consultant-led perioperative outreach service addressed anaesthesia-specific issues to improve anaesthesia consult and surgery timings for hip fracture patients
Authors: Siow Wei Shyan , Tay Leeanna , Mah Chou Liang
Published: August 2022

Background

Surgery is recommended within 48 hours of hip fractures for better perioperative outcomes. Yet, such targets still commonly remain a challenge. Our institution is no exception.

As part of a hospital-wide initiative, our anaesthesia department focused on improving perioperative processes with aims to reduce the time to first anaesthesia consult and surgery for hip fracture patients. Acknowledging multiple causes for surgical delay, we decided first to address anaesthesia-specific factors—(a) first anaesthetist contact usually happens after surgery is offered which leaves a short runway for preoptimisation, (b) this is compounded by varying degrees of anaesthetist involvement for follow-up thereafter. (c) There is a need to calibrate our perioperative care standards and (d) enforce more consistent auditing in quality assurance. This project was conducted in a 1000-bed hospital serving eastern Singapore.

Intervention

We created an integrated anaesthesia consultant-led outreach service for hip fracture patients, based on a perioperative workflow system to provide proactive anaesthetist consults within 24 hours of admission in advance of surgical decision. This was streamlined with a coordinated follow-up system for preoptimisation until surgery.

Methods

Our quality improvement project applied the iterative Plan-Do-Study-Act model from pilot to sustainability stage. We collected data at baseline followed by 6-monthly audits from electronic databases.

Primary outcomes measured were time to first anaesthesia consult and surgery. Secondary outcomes included rate of critical care reviews and admission, mortality rate, length of stay and time to nerve blocks.

Results

Post implementation, our service reviewed >600 hip fracture patients. Median time to anaesthesia consult reduced significantly from 35.3 hours (2019) to 21.5 hours (2021) (p=0.029). Median time to surgery was reduced from 61.5 hours (2019) to 50 hours (2021) (p=0.897) with a 13.6% increase in patients operated <48 hours. Critical care admissions, 6-monthly and 12-monthly mortality rates and time to nerve block were reduced with a greater percentage of patients discharged within 10 days.

Conclusion

Our project focused on improving anaesthesia perioperative processes to address surgical delays in hip fracture patients. Our consultant-led anaesthesia service ensured that proactive anaesthesia care was delivered to provide sufficient time for preoptimisation with greater standardisation to follow-up, better communication and quality assurance.
Validation of accelerometer placement to capture energy expenditure using doubly labeled water
Authors: Dougherty Ryan J. , Liu Fangyu , Etzkorn Lacey , Wanigatunga Amal A. , Walter Peter J. , Knuth Nicolas D. , Schrack Jennifer A. , Ferrucci Luigi
Published: August 2022

This study compared accelerometer-measured physical activity by body placement to daily total energy expenditure (TEE) and activity energy expenditure (AEE) measured using doubly labeled water (DLW). Forty-nine adult participants wore accelerometers placed on the nondominant wrist, dominant wrist, and chest while also undergoing DLW assessments. In adjusted models, wrist-measured physical activity ( p < 0.05), but not chest-measured physical activity ( p > 0.05), was associated with TEE and AEE and explained a significant amount of variance that was not explained by age, sex, height, or body composition ( R2 change = 0.04–0.08; all p < 0.05). Accelerometer placement location is an important consideration when using accelerometry to provide information about energy expenditure.
Enriched tandem repeats in chromosomal fusion points of Rineloricaria latirostris (Boulenger, 1900) (Siluriformes: Loricariidae)
Authors: Glugoski Larissa , Nogaroto Viviane , Deon Geize Aparecida , Azambuja Matheus , Moreira-Filho Orlando , Vicari Marcelo Ricardo
Published: August 2022

Cytogenetic data showed the enrichment of repetitive DNAs in chromosomal rearrangement points between closely related species in armored catfishes. Still, few studies integrated cytogenetic and genomic data aiming to identify their prone-to-break DNA sites. Here, we aimed to obtain the repetitive fraction in Rineloricaria latirostris to recognize the microsatellite and homopolymers flanking the regions previously described as chromosomal fusion points. The results indicated that repetitive DNAs in R. latirostris are predominantly DNA transposons, and considering the microsatellite and homopolymers, A/T-rich expansions were the most abundant. The in situ localization demonstrated the A/T-rich repetitive sequences were scattered on the chromosomes, while A/G-rich microsatellite units were accumulated in some regions. The DNA transposon hAT, the 5S rDNA, and 45S rDNA (previously identified in Robertsonian fusion points in R. latirostris) were clusterized with some microsatellites, especially (CA) n, (GA) n, and poly-A, which were also enriched in regions of chromosomal fusions. Our findings demonstrated that repetitive sequences such as rDNAs, hAT transposons, and microsatellite units flank probable evolutionary breakpoint regions in R. latirostris. However, due to the sequence unit homologies in different chromosomal sites, these repeat DNAs only may facilitate chromosome fusion events in R. latirostris rather than working as a double-strand breakpoint site.
Convolutional Neural Networks-Based Framework for Early Identification of Dementia Using MRI of Brain Asymmetry
Authors: Herzog Nitsa J , Magoulas George D
Published: August 2022

Computer-aided diagnosis of health problems and pathological conditions has become a substantial part of medical, biomedical, and computer science research. This paper focuses on the diagnosis of early and progressive dementia, building on the potential of deep learning (DL) models. The proposed computational framework exploits a magnetic resonance imaging (MRI) brain asymmetry biomarker, which has been associated with early dementia, and employs DL architectures for MRI image classification. Identification of early dementia is accomplished by an eight-layered convolutional neural network (CNN) as well as transfer learning of pretrained CNNs from ImageNet. Different instantiations of the proposed CNN architecture are tested. These are equipped with Softmax, support vector machine (SVM), linear discriminant (LD), or [Formula: see text] -nearest neighbor (KNN) classification layers, assembled as a separate classification module, which are attached to the core CNN architecture. The initial imaging data were obtained from the MRI directory of the Alzheimer’s disease neuroimaging initiative 3 (ADNI3) database. The independent testing dataset was created using image preprocessing and segmentation algorithms applied to unseen patients’ imaging data. The proposed approach demonstrates a 90.12% accuracy in distinguishing patients who are cognitively normal subjects from those who have Alzheimer’s disease (AD), and an 86.40% accuracy in detecting early mild cognitive impairment (EMCI).
Hardware Efficient Hybrid Pseudo-Random Bit Generator Using Coupled-LCG and Multistage LFSR with Clock Gating Network
Authors: Gupta Mangal Deep , Chauhan R. K. , Gulia Sandeep
Published: August 2022

A new method for the generation of pseudo-random bits, based on a coupled-linear congruential generator (CLCG) and two multistage variable seeds linear feedback shift registers (LFSRs) is presented. The proposed algorithm dynamically changes the value of the seeds of each linear congruential generator (LCG) by utilizing the multistage variable seeds LFSR. The proposed approach exhibits several advantages over the pseudo-random bit generator (PRBG) methods presented in the literature. It provides low hardware complexity and high-security strength while maintaining the minimum critical path delay. Moreover, this design generates the maximum length of pseudo-random bit sequence with uniform clock latency. Furthermore, to improve the critical path delay, one more architecture of PRBG is proposed in this work. It is based on the combination of coupled modified-LCG with two variable seeds multistage LFSRs. The modified LCG block is designed by the two-operand modulo adder and XOR gate, rather than the three-operands modulo adder and shifting operation, while it maintains the same security strength. The clock gating network (CGN) is also used in this work to minimize the dynamic power dissipation of the overall PRBG architecture. The proposed architectures are implemented using Verilog HDL and further prototyped on commercially available field-programmable gate array (FPGA) devices Virtex-5 and Virtex-7. The realization of the proposed architecture in this FPGA device accomplishes an improved speed of PRBG, which consumes low power with high randomness compared to existing techniques. The generated binary sequence from the proposed algorithms has been verified for randomness tests using NIST statistical test suites.
Free Vibration Analysis of FRP Sandwich Composite Plate and Quantification of Uncertainties in its Vibration Response
Authors: Behera Suryamani , Mohapatra Deepti Ranjan , Mondal Subhajit
Published: August 2022

Sandwich composite structures may have a significant variation in their dynamic behavior due to the uncertain preconditions of the manufacturing processes, material properties, geometry, etc. Therefore, quantifying and modeling such variability in the dynamic behavior of sandwich composite structures is a necessity. In this study, free vibration analysis is carried out for a glass-fiber reinforced plastic (GFRP) sandwich composite plate. The natural frequencies are obtained by taking into account various uncertainties involved in preparing the sandwich composite plate. The Kolmogorov–Smirnov (KS) and Anderson–Darling (AD) goodness-of-fit (GOF) tests are performed for the quantification of the uncertainty of the natural frequencies. The appropriate probabilistic distribution describing the variability of the vibrational response is recommended. The knowledge of the uncertainty of dynamic responses might help to control the quality of the manufacturing process, as well as for the reliability study of the sandwich composite structures.
Design and Optimization of Negative Poisson Ratio Thin-Walled Tube Using Sensitivity-Based Response Surface Model Methodology
Authors: Wang Weiwei , Xu Xiaomei , Lv Liya
Published: August 2022

Under low-speed collision conditions, the thin-walled structures located at the forepart of passenger car act as a significant energy absorber, which can reduce the injury degree of passengers in collision accidents. Therefore, the design of thin-walled structures is particularly important in automobile body development. High stiffness and strength contribute to structural integrity, but the resulting large collision force will be detrimental to occupant safety. To address this issue, the paper proposed a novel negative Poisson ratio thin-walled tube (NPR-TWT). In addition, the second-order sensitivity-based response surface models (SB-RSMs) were established to improve the efficiency of design optimization. Furthermore, the NPR-TWT was optimized by using the non-dominated sorting genetic algorithm (NSGA-II) to enhance its comprehensive performance. The results showed that the optimized NPR-TWT could absorb collision energy by sufficient displacement deformation and reduce the peak impact force. It can provide theoretical and practical guidance for the application of thin-walled structures in automobile body safety.