bluuebunny/crossref_metadata_2025 huggingface dataset:
Weight gain and lifestyle factors in women with and without polycystic ovary syndrome
Authors: Awoke Mamaru Ayenew , Earnest Arul , Joham Anju E , Hodge Allison M , Teede Helena J , Brown Wendy J , Moran Lisa J
Published: October 2021

STUDY QUESTION

Do extrinsic factors including lifestyle, psychosocial factors and healthcare professional engagement independently contribute to weight gain in women with and without polycystic ovary syndrome (PCOS)?

SUMMARY ANSWER

Women with PCOS had a higher rate of weight gain than women without PCOS which was most marked in those with unhealthy lifestyles.

WHAT IS KNOWN ALREADY

Women with PCOS have a higher prevalence of overweight/obesity and greater weight gain than women without PCOS. The association of lifestyle factors with weight change in PCOS is not known.

STUDY DESIGN, SIZE, DURATION

The study was a population-based observational study with data collected from seven surveys over 19 years (N = 14 127; Survey 1) involving women with and without PCOS.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We used data from the 1973–1978 birth cohort of the Australian Longitudinal Study on Women’s Health.

MAIN RESULTS AND THE ROLE OF CHANCE

Women with PCOS gained more weight annually (0.26 kg/year; 95% CI 0.12, 0.39; P < 0.0001) and over 19 years (4.62 kg; 95% CI 3.04, 6.21; P < 0.0001) than women without PCOS (adjusted analyses). For all women, there were positive associations between weight gain and energy intake, sitting time and stress; inverse associations with fibre intake and physical activity (PA); and no associations with diet quality, glycaemic index, healthcare utilization, depression or anxiety. There were interactions between lifestyle factors (energy intake P = 0.006, glycaemic index P = 0.025, sitting time P = 0.041 and PA P = 0.021), PCOS status and time such that weight gain varied between women with and without PCOS according to these factors.

LIMITATIONS, REASONS FOR CAUTION

The limitations of this study include the use of self-reported measures such as diet, PA, sitting time, psychological factors and health care utilization.

WIDER IMPLICATIONS OF THE FINDINGS

While women with PCOS are more prone to weight gain, lifestyle factors have a more profound impact on weight gain in women with PCOS than without PCOS. These study findings have implications for understanding the mechanisms of weight gain in women with PCOS. They also highlight the importance of early lifestyle intervention as soon as PCOS is diagnosed to address modifiable extrinsic factors and prevent excess weight gain and worsening of the clinical features of PCOS.

STUDY FUNDING/COMPETING INTEREST(S)

M.A.A. is funded by the Monash International Tuition Scholarship and Monash Graduate Scholarship and L.J.M. is funded by a National Heart Foundation Future Leader Fellowship. The authors declared no conflict of interest.

TRIAL REGISTRATION NUMBER

N/A.
Azithromycin in patients with COVID-19: a systematic review and meta-analysis
Authors: Ayerbe Luis , Risco-Risco Carlos , Forgnone Ivo , Pérez-Piñar Maria , Ayis Salma
Published: October 2021

Background

Azithromycin has been widely used in the management of COVID-19. However, the evidence on its actual effects remains disperse and difficult to apply in clinical settings. This systematic review and meta-analysis summarizes the available evidence to date on the beneficial and adverse effects of azithromycin in patients with COVID-19.

Methods

The PRISMA 2020 statement criteria were followed. Randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of patients treated with and without azithromycin, indexed until 5 July 2021, were searched in PubMed, Embase, The Web of Science, Scopus, The Cochrane Central Register of Controlled Trials and MedRXivs. We used random-effects models to estimate pooled effect size from aggregate data.

Results

The initial search produced 4950 results. Finally, 16 studies, 5 RCTs and 11 with an observational design, with a total of 22 984 patients, were included. The meta-analysis showed no difference in mortality for those treated with or without azithromycin, in observational studies [OR: 0.90 (0.66–1.24)], RCTs [OR: 0.97 (0.87–1.08)] and also when both types of studies were pooled together [with an overall OR: 0.95 (0.79–1.13)]. Different individual studies also reported no significant difference for those treated with or without azithromycin in need for hospital admission or time to admission from ambulatory settings, clinical severity, need for intensive care, or adverse effects.

Conclusions

The results presented in this systematic review do not support the use of azithromycin in the management of COVID-19. Future research on treatment for patients with COVID-19 may need to focus on other drugs.
Opportunities to enhance antibiotic stewardship: colistin use and outcomes in a low-resource setting
Authors: Moolla Muhammad S , Whitelaw Andrew , Decloedt Eric H , Koegelenberg Coenraad F N , Parker Arifa
Published: October 2021

Background

Colistin use is increasing with the rise in MDR Gram-negative infections globally. Effective antibiotic stewardship is essential to preserve this antibiotic of last resort.

Objectives

This study investigated stewardship and safety errors related to colistin use to identify opportunities for improvement.

Patients and methods

A prospective descriptive study involving all patients 13 years and older treated with colistin at a tertiary hospital in Cape Town, South Africa, between August 2018 and June 2019. We collected clinical, laboratory and outcome data and assessed provided treatment for stewardship and safety errors.

Results

We included 44 patients. Treatment errors were identified for 34 (77%) patients (median = 1), most commonly inadequate monitoring of renal function (N = 16, 32%). We also identified no rational indication for colistin (N = 9, 20%), loading dose error (N = 12, 27%); maintenance dose error (N = 10, 23%); no prior culture (N = 11, 25%); and failure to de-escalate (2 of 9) or adjust dose to changes in renal function (6 of 15). All cause in-hospital mortality was 47%. Amongst survivors, median ICU stay was 6 days and hospital stay more than 30 days. Eight (18%) patients developed renal injury or failure during treatment. Three (7%) patients in this study were found to have colistin-resistant organisms including two prior to colistin exposure.

Conclusions

This study has identified opportunities to enhance colistin stewardship and improve efficacy and safety of prescription. The appearance of colistin-resistant organisms reinforces the urgent need to ensure effective and appropriate use of colistin.
Chemotyping of ∆8-THC-Containing e-Liquids Analyzed during the 2019–2020 New York State EVALI Investigation
Authors: Duffy Bryan C , Li Lingyun , Lu Shijun , Dittmar Mark A , Delaney-Baldwin Em , Durocher Lorie A , Spink David C
Published: October 2021

The investigation of the 2019–2020 E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) outbreak in New York State provided a unique opportunity to examine the formulations and chemical components found in clandestine cannabis-containing e-liquids. In this EVALI investigation, it was determined that an unusually high proportion (16%) of the cannabis e-liquids analyzed contained significant levels of ∆8-tetrahydrocannabinol (∆8-THC). Although not thought to be the causative agent in the outbreak, the manufacturing origin of vaping e-liquids containing large concentrations of ∆8-THC was of great interest, since high ∆8-THC concentrations are not observed in the extracts of common cannabis strains. A principal component analysis of multiple cannabinoid concentrations revealed clusters of similar or identical ∆8-THC-containing products. This technique may be useful in identifying common manufacturing sources in this and future investigations. Several possible manufacturing methods to enrich ∆8-THC appear in literature and are discussed based on their likelihood as sources of this cannabinoid in these samples from the EVALI investigation. The presence of high levels of ∆8-THC in numerous illicit vaping products may implicate cannabidiol, which is readily available at low cost, as its synthetic precursor.
Initial Results of the American Burn Association Observational Multicenter Evaluation on the Effectiveness of the Burn Navigator
Authors: Rizzo Julie A , Liu Nehemiah T , Coates Elsa C , Serio-Melvin Maria L , Foster Kevin N , Shabbir Misbah , Pham Tam N , Salinas Jose
Published: October 2021

The objective of this multicenter observational study was to evaluate resuscitation volumes and outcomes of patients who underwent fluid resuscitation utilizing the Burn Navigator (BN), a resuscitation clinical decision support tool. Two analyses were performed: examination of the first 24 hours of resuscitation and the first 24 hours postburn regardless of when the resuscitation began, to account for patients who presented in a delayed fashion. Patients were classified as having followed the BN (FBN) if all hourly fluid rates were within ±20 ml of BN recommendations for that hour at least 83% of the time; otherwise, they were classified as not having followed BN (NFBN). Analysis of resuscitation volumes for FBN patients in the first 24 hours resulted in average volumes for primary crystalloid and total fluids administered of 4.07 ± 1.76 ml/kg/TBSA (151.48 ± 77.46 ml/kg) and 4.68 ± 2.06 ml/kg/TBSA (175.01 ± 92.22 ml/kg), respectively. Patients who presented in a delayed fashion revealed average volumes for primary and total fluids of 5.28 ± 2.54 ml/kg/TBSA (201.11 ± 106.53 ml/kg) and 6.35 ± 2.95 ml/kg/TBSA (244.08 ± 133.5 ml/kg), respectively. There was a significant decrease in the incidence of burn shock in the FBN group (P < .05). This study shows that the BN provides comparable resuscitation volumes of primary crystalloid fluid to the Parkland formula, recommends total fluid infusion less than the Ivy index, and was associated with a decreased incidence of burn shock. Early initiation of the BN device resulted in lower overall fluid volumes.
FBBVA Lecture 2020Exposure, Experience, and Expertise: Why Personal Histories Matter in Economics
Authors: Malmendier Ulrike
Published: October 2021

Personal experiences of economic outcomes, from global financial crises to individual-level job losses, can shape individual beliefs, risk attitudes, and choices for years to come. A growing literature on experience effects shows that individuals act as if past outcomes that they experienced were overly likely to occur again, even if they are fully informed about the actual likelihood. This reaction to past experiences is long-lasting though it decays over time as individuals accumulate new experiences. Modern brain science helps understand these processes. Evidence on neural plasticity reveals that personal experiences and learning alter the strength of neural connections and fine-tune the brain structure to those past experiences (“use-dependent brain”). I show that experience effects help understand belief formation and decision-making in a wide range of economic applications, including inflation, home purchases, mortgage choices, and consumption expenditures. I argue that experience-based learning is broadly applicable to economic decision-making and discuss topics for future research in education, health, race, and gender economics.
Presidential Address 2020 Suboptimal Climate Policy
Authors: Hassler John , Krusell Per , Olovsson Conny
Published: October 2021

There is a scientific consensus that human activities, in the form of emissions of carbon dioxide into the atmosphere, cause global warming. These emissions mostly occur in the marketplace, that is, they are undertaken by private individuals and firms. Governments seeking to curb emissions thus need to design policies that influence market behavior in the direction of their goals. Economists refer to Pigou taxation as “the” solution here, since the case of global warming can be seen as a pure (negative) externality. We agree. However, given the reluctance of policymakers to agree with us, there is an urgent need to consider, and compare, suboptimal policies. In this paper, we look at one such instance: setting a global tax on carbon at the wrong level. How costly are different errors? Since there is much uncertainty about how much climate change there will be, and how damaging it is when it occurs, ex-post errors will most likely be made. We compare different kinds of errors qualitatively and quantitatively and find that policy errors based on over-pessimistic views on climate change are much less costly than those made based on over-optimism. This finding is an inherent feature of standard integrated assessment models, even though these models do not feature tipping points or strong linearities.
Microbial adaptive evolution
Authors: Shi Aiqin , Fan Feiyu , Broach James R
Published: October 2021

Bacterial species can adapt to significant changes in their environment by mutation followed by selection, a phenomenon known as “adaptive evolution.” With the development of bioinformatics and genetic engineering, research on adaptive evolution has progressed rapidly, as have applications of the process. In this review, we summarize various mechanisms of bacterial adaptive evolution, the technologies used for studying it, and successful applications of the method in research and industry. We particularly highlight the contributions of Dr. L. O. Ingram. Microbial adaptive evolution has significant impact on our society not only from its industrial applications, but also in the evolution, emergence, and control of various pathogens.
Identification of a Cryptic t(8;20;21)(q22;p13;q22) Resulting in RUNX1T1/RUNX1 Fusion in a Patient with Newly Diagnosed Acute Myeloid Leukemia
Authors: Macke Erica L , Meyer Reid G , Hoppman Nicole L , Ketterling Rhett P , Greipp Patricia T , Xu Xinjie , Baughn Linda B , Shafer Danielle A , He Rui R , Peterson Jess F
Published: October 2021

The detection of recurrent genetic abnormalities in acute myeloid leukemia (AML), including RUNX1T1/RUNX1 gene fusion, is critical for optimal medical management. Herein, we report a 45 year old woman with newly diagnosed AML and conventional chromosome studies that revealed an apparently balanced t(8;20)(q22;p13) in all 20 metaphases analyzed. A RUNX1T1/RUNX1 dual-color dual-fusion fluorescence in situ hybridization (FISH) probe set was subsequently performed and revealed a RUNX1T1/RUNX1 gene fusion. Metaphase FISH studies performed on abnormal metaphases revealed a cryptic, complex translocation resulting in RUNX1T1/RUNX1 fusion, t(8;20;21)(q22;p13;q22). This case study shows the importance of performing FISH studies or other high-resolution genetic testing concurrently with conventional chromosome studies for the detection of cryptic recurrent gene fusions in AML, particularly a focused genetic evaluation such as RUNX1T1/RUNX1 gene fusion, when specific abnormalities involving 8q22 are identified.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the Drafting Committee (CHR) United States Suggestions for Redrafts, 11 June 1947.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Philippines corrigendum to amendments, 27 May 1949.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Chile amendment, 1 June 1949.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Yugoslavia amendment, 1 June 1949.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Chile, Egypt, France, Philippines and United States proposal, 2 June 1949.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Meeting Summary, 11 April 1950.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Meeting Summary, 14 April 1950.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR United Kingdom amendment, 17 April 1950.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Meeting Summary, 18 April 1950.
Commission on Human Rights
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR India amendment, 24 April 1950.
United NationsCommission on Human RightsReport of the Sixth
Session(27 March – 19 May 1950)Economic and Social CouncilOfficial
RecordsFifth Year: Eleventh SessionSupplement No. 5Lake Success, New
York
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the CHR Report, 25 May 1950.
Fourteenth sessionThird CommitteeAgenda item 34
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the Third Committee (GA) Israel amendment, 6 November 1959.
Agenda Item 34
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the Third Committee (GA) Meeting Summary, 20 November 1959.
Fourteenth sessionThird CommitteeAgenda item 34
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the Third Committee (GA) Italy-Japan amendment, 20 November 1959.
Fourteenth sessionThird CommitteeAgenda item 34
Authors: Clooney Amal , Webb Philippa , Nelson Matthew
Published: October 2021

This section presents the Third Committee (GA) Mexico-Saudi Arabia amendment, 26 November 1959.
Soft Clauses in Letters of Credit
Authors: Davies Martin
Published: October 2021

Soft clauses in letters of credit make the issuing bank’s obligation conditional upon some event or certification that is in the control either of the applicant, or some agent, entity, or organisation in the applicant’s country. Such clauses make an apparently irrevocable letter of credit into what is, in essence, a conditional undertaking dependent on the applicant’s approval. Soft clauses are not always a vehicle for fraud—there may be genuine reasons for their inclusion—but they certainly make it easy for an applicant to ensure that the issuing bank does not pay the beneficiary. This chapter will consider the problems caused by the use of soft clauses, some possible solutions, and it will suggest alternatives, some of which look to the past (bills of exchange/time drafts), some to the present (open account and standby letters of credit), and some to the future (the advent of blockchain technology).
Perspectives on the Role of the Nominated Bank in a Letter of Credit
Authors: Sing Toh Kian , Zhida Chen
Published: October 2021

This chapter considers the role of the nominated bank in a letter of credit against the backdrop of the Singapore Court of Appeal decision of Grains and Industrial Products Trading Pte Ltd v Bank of India which addresses the situation where a nominated bank declines to act on its nomination. This situation is not covered by the UCP 600 and questions arise as to what, if any, obligations the nominated bank owes towards the issuing bank or the beneficiary. The chapter also examines the extent to which principles of agency law can operate effectively in the relationship between the issuing bank and the nominated bank.
The Fraud Rule in the Law of Letters of Credit Revisited
Authors: Gao Xiang
Published: October 2021

The fraud rule in the law of letters of credit is still developing and has proven to be very controversial. The current international rules and national laws and decisions by most of the courts in many jurisdictions have taken the position that the fraud rule should be applied in a strict fashion or in cases of ‘material’ fraud. This chapter argues that a bifurcated approach should be adopted. That is, for fraud in the documents, a clear and simple fraud should be able to trigger the application of the rule; for fraud in the transaction, a high standard of fraud should be adopted.
Injunctions to Restrain Payment on Independent Guarantees
Authors: Neo Dora
Published: October 2021

This chapter explores the grant of injunctions to restrain calls on independent guarantees based on the unconscionability exception to the autonomy principle. Using Singapore law as the primary basis for discussion, it explains the rationale and operation of the unconscionability exception and its relationship with the traditional fraud exception. This approach is compared with the UK approach, and brief reference is also made to the position in Australia and the USA. The chapter argues that the unconscionability exception is a justifiable policy response to address the potentially oppressive nature of performance bonds. If used sparingly and confined within narrow limits, this approach will promote integrity in the call on performance bonds without affecting the commercial usefulness of these instruments. The chapter also examines the situation where the underlying contract is affected by frustration or force majeure—a question which has become of greater prominence after the COVID-19 pandemic—and discusses whether the grant of an injunction to restrain payment on a performance bond in these circumstances can be supported based on the fraud or unconscionability exception or some other principle.
The effect of late giant collisions on the atmospheres of protoplanets and the formation of cold sub-Saturns
Authors: Ali-Dib Mohamad , Cumming Andrew , Lin Douglas N C
Published: October 2021

We investigate the origins of cold sub-Saturns (CSSs), an exoplanetary population inferred from microlensing surveys. If confirmed, these planets would rebut a theorized gap in planets’ mass distribution between those of Neptune and Jupiter caused by the rapid runaway accretion of supercritical cores. In an attempt to resolve this theoretical-observational disparity, we examine the outcomes of giant collisions between sub-critical protoplanets. Due to the secular interaction among protoplanets, these events may occur in rapidly depleting discs. We show that impactors ∼5 per cent the mass of near-runaway envelopes around massive cores can efficiently remove these envelopes entirely via a thermally driven super-Eddington wind emanating from the core itself, in contrast with the stellar Parker winds usually considered. After a brief cooling phase, the merged cores resume accretion. But, the evolution time-scale of transitional discs is too brief for the cores to acquire sufficiently massive envelopes to undergo runaway accretion despite their large combined masses. Consequently, these events lead to the emergence of CSS without their transformation into gas giants. We show that these results are robust for a wide range of disc densities, grain opacities, and silicate abundance in the envelope. Our fiducial case reproduces CSS with heavy (≳30 M⊕) cores and less massive (a few M⊕) sub-critical envelopes. We also investigate the other limiting cases, where continuous mergers of comparable-mass cores yield CSS with wider ranges of core-to-envelope mass ratios and envelope opacities. Our results indicate that it is possible for CSS and Uranus and Neptune to emerge within the framework of well-studied processes, and they may be more common than previously postulated.
scEnhancer: a single-cell enhancer resource with annotation across hundreds of tissue/cell types in three species
Authors: Gao Tianshun , Zheng Zilong , Pan Yihang , Zhu Chengming , Wei Fuxin , Yuan Jinqiu , Sun Rui , Fang Shuo , Wang Nan , Zhou Yang , Qian Jiang
Published: October 2021

Previous studies on enhancers and their target genes were largely based on bulk samples that represent ‘average’ regulatory activities from a large population of millions of cells, masking the heterogeneity and important effects from the sub-populations. In recent years, single-cell sequencing technology has enabled the profiling of open chromatin accessibility at the single-cell level (scATAC-seq), which can be used to annotate the enhancers and promoters in specific cell types. A comprehensive resource is highly desirable for exploring how the enhancers regulate the target genes at the single-cell level. Hence, we designed a single-cell database scEnhancer (http://enhanceratlas.net/scenhancer/), covering 14 527 776 enhancers and 63 658 600 enhancer-gene interactions from 1 196 906 single cells across 775 tissue/cell types in three species. An unsupervised learning method was employed to sort and combine tens or hundreds of single cells in each tissue/cell type to obtain the consensus enhancers. In addition, we utilized a cis-regulatory network algorithm to identify the enhancer-gene connections. Finally, we provided a user-friendly platform with seven useful modules to search, visualize, and browse the enhancers/genes. This database will facilitate the research community towards a functional analysis of enhancers at the single-cell level.
The Sequence Read Archive: a decade more of explosive growth
Authors: Katz Kenneth , Shutov Oleg , Lapoint Richard , Kimelman Michael , Brister J Rodney , O’Sullivan Christopher
Published: October 2021

The Sequence Read Archive (SRA, https://www.ncbi.nlm.nih.gov/sra/) stores raw sequencing data and alignment information to enhance reproducibility and facilitate new discoveries through data analysis. Here we note changes in storage designed to increase access and highlight analyses that augment metadata with taxonomic insight to help users select data. In addition, we present three unanticipated applications of taxonomic analysis.
Evaluation of health outcomes in patients aged 70 years and above with glioblastoma multiforme in NHS Tayside between 2017-2020
Authors: Finnan Caitlin , Lord Hannah
Published: October 2021

Aims

The aim of this study is to evaluate health-related outcomes in patients aged 70 years and above diagnosed with glioblastoma multiforme (GBM) in NHS Tayside between 2017-2020. Objectives include identification of factors which influence the oncological treatment modalities pursued; disease progression/recurrence and outcomes within each treatment modality category.

Method

Medical databases were reviewed retrospectively to identify patients aged 70 years and above diagnosed with GBM in NHS Tayside, between 2017-2020. Analysed data identified patients' past medical history, symptoms and investigations preceding diagnosis; date of first brain imaging which demonstrated abnormality in-keeping with a likely diagnosis of GBM; factors influencing treatment modalities undertaken, molecular and genetic analysis of tumour samples; disease recurrence/progression, and date of death if applicable.

Results

54 patients diagnosed with GBM. 13 patients were aged over 70 years. 8 males, 5 females. Commonest co-morbid conditions were hypertension and gout. 2/13 received best supportive care only, based on poor performance status and extensive disease burden. 9/13 underwent neurosurgery; 7 debulked; 2 biopsy only. 7 isocitrate dehydrogenase (IDH1) wild-type; 2 IDH classification not known. 3 MGMT methylated; 4 unmethylated; 2 MGMT classification not known.3/13 received temozolomide (TMZ) alone. 2 later received palliative radiotherapy (30Gy in 6 #) to control symptoms. 4/13 received 40Gy in 15 # with concurrent TMZ 4/13 received 60Gy in 30 # with concurrent TMZ. 5 received adjuvant TMZ following initial chemo-radiation: 3 after 40Gy and 2 after 60Gy. As of March 2021, 6/13 were alive, including all 4 who had received hypofractionated radiotherapy. 4 of these continue to demonstrate stable disease on most recent imaging.

Conclusion

Baseline fitness levels of patients were generally high, with few having significant co-morbidity pre-diagnosis. Prognosis and morbidity was significantly poorer in patients who did not undergo any form of radiotherapy. Patients who received hypofractionated radiotherapy demonstrated most favourable health-related outcomes, demonstrating longest survival and least evidence of disease recurrence/progression.Although the sample size for this study is small, it highlights the potential benefits of radiotherapy on survival, particularly hypofractionated courses such as 40Gy in 15 fractions in a real-world population, even during a global pandemic. It would be useful to prospectively follow-up elderly patients with GBM to assess outcomes and quality of life.
Evaluation of an occupational medicine patient consultation note assessment tool
Authors: Spilchuk V , House R , Nisenbaum R , Holness D L
Published: October 2021

Background

Medical education focuses on assessment, diagnosis and management of various clinical entities. The communication of this information, particularly in the written form, is rarely emphasized. Though there have been assessment tools developed to support medical learner improvement in this regard, none are oriented to occupational medicine (OM) practice.

Aims

This study was aimed to develop and evaluate an assessment tool for consultation letters, by modifying a previously validated assessment tool to suit practice in OM.

Methods

Using an iterative process, OM specialists added to the Consultation Letter Rating Scale (CLRS) of the Royal College of Physicians and Surgeons of Canada (henceforth abbreviated as RC) additional questions relevant to communication in the OM context. The tool was then used by two OM specialists to rate 40 anonymized OM clinical consultation letters. Inter-rater agreement was measured by percent agreement, kappa statistic and intraclass correlation.

Results

There was generally good percent agreement (>80% for the majority of the RC and OM questions). Intraclass correlation for the five OM questions total scores was slightly higher than the intraclass correlations for the five RC questions (0.59 versus 0.46, respectively), suggesting that our modifications performed at least as well as the original tool.

Conclusions

This new tool designed specifically for evaluation of patient consultation notes in OM provides a good option for medical educators in a variety of practice areas in providing non-summative, low-stakes assessment and/or feedback to nurture increased competency in written communication skills for postgraduate trainees in OM.
Impact of Choice of Prophylaxis on the Microbiology of Cardiac Implantable Electronic Device Infections: Insights From the Prevention of Arrhythmia Device Infection Trial (PADIT)
Authors: Longtin Yves , Gervais Philippe , Birnie David H , Wang Jia , Alings Marco , Philippon François , Parkash Ratika , Manlucu Jaimie , Angaran Paul , Rinne Claus , Coutu Benoit , Low R Aaron , Essebag Vidal , Morillo Carlos , Redfearn Damian , Toal Satish , Becker Giuliano , Degrâce Michel , Thibault Bernard , Crystal Eugene , Tung Stanley , LeMaitre John , Sultan Omar , Bennett Matthew , Bashir Jamil , Ayala-Paredes Felix , Rioux Leon , Hemels Martin E W , Bouwels Leon H R , Exner Derek V , Dorian Paul , Connolly Stuart J , Krahn Andrew D
Published: October 2021

Background

The Prevention of Arrhythmia Device Infection Trial (PADIT) investigated whether intensification of perioperative prophylaxis could prevent cardiac implantable electronic device (CIED) infections. Compared with a single dose of cefazolin, the perioperative administration of cefazolin, vancomycin, bacitracin, and cephalexin did not significantly decrease the risk of infection. Our objective was to compare the microbiology of infections between study arms in PADIT.

Methods

This was a post hoc analysis. Differences between study arms in the microbiology of infections were assessed at the level of individual patients and at the level of microorganisms using the Fisher exact test.

Results

Overall, 209 microorganisms were reported from 177 patients. The most common microorganisms were coagulase-negative staphylococci (CoNS; 82/209 [39.2%]) and S. aureus (75/209 [35.9%]). There was a significantly lower proportion of CoNS in the incremental arm compared with the standard arm (30.1% vs 46.6%; P = .04). However, there was no significant difference between study arms in the frequency of recovery of other microorganisms. In terms of antimicrobial susceptibility, 26.5% of microorganisms were resistant to cefazolin. CoNS were more likely to be cefazolin-resistant in the incremental arm (52.2% vs 26.8%, respectively; P = .05). However, there was no difference between study arms in terms of infections in which the main pathogen was sensitive to cefazolin (77.8% vs 64.3%; P = .10) or vancomycin (90.8% vs 90.2%; P = .90).

Conclusions

Intensification of the prophylaxis led to significant changes in the microbiology of infections, despite the absence of a decrease in the overall risk of infections. These findings provide important insight on the physiopathology of CIED infections.

Trial registration

NCT01002911.
Socioeconomic Disparities in Severe Acute Respiratory Syndrome Coronavirus 2 Serological Testing and Positivity in New York City
Authors: Lieberman-Cribbin Wil , Galanti Marta , Shaman Jeffrey
Published: October 2021

Background

We characterized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody test prevalence and positive test prevalence across New York City (NYC) in order to investigate disparities in testing outcomes by race and socioeconomic status (SES).

Methods

Serologic data were downloaded from the NYC Coronavirus data repository (August 2020–December 2020). Area-level characteristics for NYC neighborhoods were downloaded from United States census data and a socioeconomic vulnerability index was created. Spatial generalized linear mixed models were performed to examine the association between SES and antibody testing and positivity.

Results

The proportion of Hispanic population (posterior median, 0.001 [95% credible interval, 0.0003–0.002]), healthcare workers (0.003 [0.0001–0.006]), essential workers (0.003 [0.001–0.005]), age ≥65 years (0.003 [0.00002–0.006]), and high SES (SES quartile 3 vs 1: 0.034 [0.003–0.062]) were positively associated with antibody tests per 100000 residents. The White proportion (–0.002 [–0.003 to –0.001]), SES index (quartile 3 vs 1, –0.068 [–0.115 to –0.017]; quartile 4 vs 1, –0.077 [–0.134 to –0.018]) and age ≥65 years (–0.005 [–0.009 to –0.002]) were inversely associated with positive test prevalence (%), whereas the Hispanic (0.004 [0.002–0.006]) and essential worker (0.008 [0.003–0.012]) proportions had positive coefficients.

Conclusions

Disparities in serologic testing and seropositivity exist on SES and race/ethnicity across NYC, indicative of excess coronavirus disease burden in vulnerable and marginalized populations.
Numerical universal solutions in a-gauge in open string field theory
Authors: Kishimoto Isao
Published: October 2021

In bosonic open string field theory, we construct numerical universal solutions in a-gauge corresponding to “double brane” and “ghost brane” solutions in Siegel gauge in addition to the tachyon vacuum solution, and evaluate their gauge invariants, which are energy- and gauge-invariant observables. The a-gauge condition, which contains a real parameter a, was introduced by Asano and Kato. In earlier works it has been applied to find the tachyon vacuum solution with the level truncation method up to level 14. The “double brane” and “ghost brane” solutions were constructed by Kudrna and Schnabl in Siegel gauge, which corresponds to (a = 0)-gauge, up to level 28. Starting from these solutions, by varying a little by little, we have constructed numerical solutions in a-gauge for various values of a including a = ∞ up to level 20. Contrary to naive expectation, the gauge invariants of “double brane” and “ghost brane” solutions in a-gauge seem to be non-constant for a. In particular, although the normalized energy E of the “double brane” solution in a-gauge is approximately two for a ∼ 0, we find that E becomes almost one for 0.5 < a < 1. The gauge-invariant observable behaves similarly. This might imply that the “double brane” solution varies to a single brane solution in such a-gauges.
Exploring the Relationship Between Schizophrenia and Cardiovascular Disease: A Genetic Correlation and Multivariable Mendelian Randomization Study
Authors: Veeneman Rada R , Vermeulen Jentien M , Abdellaoui Abdel , Sanderson Eleanor , Wootton Robyn E , Tadros Rafik , Bezzina Connie R , Denys Damiaan , Munafò Marcus R , Verweij Karin J H , Treur Jorien L
Published: October 2021

Individuals with schizophrenia have a reduced life-expectancy compared to the general population, largely due to an increased risk of cardiovascular disease (CVD). Clinical and epidemiological studies have been unable to unravel the nature of this relationship. We obtained summary-data of genome-wide-association studies of schizophrenia (N = 130 644), heart failure (N = 977 323), coronary artery disease (N = 332 477), systolic and diastolic blood pressure (N = 757 601), heart rate variability (N = 46 952), QT interval (N = 103 331), early repolarization and dilated cardiomyopathy ECG patterns (N = 63 700). We computed genetic correlations and conducted bi-directional Mendelian randomization (MR) to assess causality. With multivariable MR, we investigated whether causal effects were mediated by smoking, body mass index, physical activity, lipid levels, or type 2 diabetes. Genetic correlations between schizophrenia and CVD were close to zero (−0.02–0.04). There was evidence that liability to schizophrenia causally increases heart failure risk. This effect remained consistent with multivariable MR. There was also evidence that liability to schizophrenia increases early repolarization pattern, largely mediated by BMI and lipids. Finally, there was evidence that liability to schizophrenia increases heart rate variability, a direction of effect contrasting clinical studies. There was weak evidence that higher systolic blood pressure increases schizophrenia risk. Our finding that liability to schizophrenia increases heart failure is consistent with the notion that schizophrenia involves a systemic dysregulation of the body with detrimental effects on the heart. To decrease cardiovascular mortality among individuals with schizophrenia, priority should lie with optimal treatment in early stages of psychosis.
Emotions and Ambient Racism in America’s Whitest Big City
Authors: Woody Ashley
Published: October 2021

This article explores the ways communities of color experience racism in Portland, Oregon—the whitest big city in the Unites States. Drawing from 40 in-depth interviews with an ethnically diverse sample of Portlanders of color, the study’s findings demonstrate how emotions are constitutive of racialized lived experiences. Participants’ emotions were deeply intertwined with Portland’s demographics and historical legacies of white supremacy in the city, highlighting the importance of place in structuring racialized emotions. Participants also describe emotional and impression management strategies they used to navigate predominantly white spaces. As a conceptual link between racial structures and racialized emotions, I introduce the concept of ambient racism, which describes how legacies of racism are “baked into” the social environment that racialized people navigate and emotionally contend with daily. Ambient racism bridges structural and emotional dimensions of racism by illustrating how racial structures are felt by racially subordinated groups.
The ‘Curious Effects’ of Acting: Homosexuality, Theatre and Female Impersonation at the University of Cambridge, 1900–39
Authors: Janes Dominic
Published: October 2021

The University of Cambridge educated a significant proportion of Britain’s elite in the early twentieth century. The homosocial environment of the colleges was similar in many ways to that of the single-sex public boarding schools which many of the undergraduates had attended. Student theatre was a popular activity, and because such shows were acted by single-sex ensembles, there was a strong tradition of female impersonation on stage. The interwar diaries of Cecil Beaton, who identified privately as a homosexual man, provide an unusually detailed source of information about a period when sexual controversy began to surround theatrical cross-dressing. In the 1930s, when moves were made to open previously men-only university drama clubs to women, the issue of male homosexuality and its alleged connections with student theatre came to be widely discussed. This reflected significant changes in the ways in which queerness was accommodated within the predominantly male environment of the University.
Blood Neurofilament Light Chain as a Potential Biomarker for Central and Peripheral Nervous Toxicity in Rats
Authors: Sano Tomoya , Masuda Yasushi , Yasuno Hironobu , Shinozawa Tadahiro , Watanabe Takeshi , Kakehi Masaaki
Published: October 2021

Neurotoxicity is a principal concern in nonclinical drug development. However, standardized and universally accepted fluid biomarkers for evaluating neurotoxicity are lacking. Increasing clinical evidence supports the potential use of neurofilament light (NfL) chain as a biomarker of several neurodegenerative diseases; therefore, we investigated changes in the cerebrospinal fluid (CSF) and serum levels of NfL in Sprague Dawley rats treated with central nervous system (CNS) toxicants (trimethyltin [TMT, 10 mg/kg po, single dose], kainic acid [KA, 12 mg/kg sc, single dose], MK-801 [1 mg/kg sc, single dose]), and a peripheral nervous system (PNS) toxicant (pyridoxine, 1200 mg/kg/day for 3 days). Animals were euthanized 1 (day 2), 3 (day 4), or 7 days after administration (day 8). Increased serum NfL was observed in TMT- and KA-treated animals, which indicated neuronal cell death in the brain on days 2, 4, and/or 8. MK-801-treated animals exhibited no changes in the serum and CSF levels of NfL and no histopathological changes in the brain at any time point. Pyridoxine-induced chromatolysis of the dorsal root ganglion on day 2 and degeneration of peripheral nerve fiber on day 4; additionally, serum NfL was increased. A strong correlation was observed between the serum and CSF levels of NfL and brain lesions caused by TMT and KA, indicating that NfL could be a useful biomarker for detecting CNS toxicity. Additionally, PNS changes were correlated with serum NfL levels. Therefore, serum NfL could serve as a useful peripheral biomarker for detecting both CNS and PNS toxicity in rats.
The Private Administrative Law of Technical Standardization
Authors: Vallejo Rodrigo
Published: October 2021

The nature and place of technical standards has remained an enigma for EU law and legal thought, despite their ubiquitous part and growing importance in market-building processes within and beyond Europe. The significance and intractability of this enigma has been heightened by the landmark Fra.bo (2012) and James Elliot (2016) judgments of the ECJ. These judgments have prompted contradictory positions regarding the publicity and justiciability of technical standards among European legal scholarship and even between the European Commission and the European Parliament. The enigma and these contradictory positions have recently reached the ECJ again through the Stichting Rookpreventie case currently under review by its Grand Chamber. Drawing upon a reconstructive analysis of these and other relevant legal sources concerning technical standardization in Europe, this paper surmounts these seeming contradictions by advancing a new account of these legal developments. Contrary to the mainstream positions nowadays in tension, the article argues that these judgments have reaffirmed the New Approach and the distinctive place of technical standardization organizations in the European legal order while avoiding dysfunctional modes of judicialization. It has done so by acknowledging the techno-political character of technical standards and aptly delineating institutional competences between the government and the judiciary throughout technical standardization processes. To guide future legal thinking and reasoning on these processes, the paper recasts these legal developments through the idea of a ‘private administrative law’ as signifying the way that EU Law has transformed the nature and place of technical standardization in the internal market and as an eventual means for the global reach of EU law.
Cell-to-Cell Communication During Plant-Pathogen Interaction
Authors: Tabassum Naheed , Blilou Ikram
Published: October 2021

Being sessile, plants are continuously challenged by changes in their surrounding environment and must survive and defend themselves against a multitude of pathogens. Plants have evolved a mode for pathogen recognition that activates signaling cascades such as reactive oxygen species, mitogen-activated protein kinase, and Ca2+ pathways, in coordination with hormone signaling, to execute the defense response at the local and systemic levels. Phytopathogens have evolved to manipulate cellular and hormonal signaling and exploit hosts’ cell-to-cell connections in many ways at multiple levels. Overall, triumph over pathogens depends on how efficiently the pathogens are recognized and how rapidly the plant response is initiated through efficient intercellular communication via apoplastic and symplastic routes. Here, we review how intercellular communication in plants is mediated, manipulated, and maneuvered during plant-pathogen interaction.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2022.
Vertical Stratification of Microbial Communities in Woody Plants
Authors: Bahram Mohammad , Küngas Kati , Pent Mari , Põlme Sergei , Gohar Daniyal , Põldmaa Kadri
Published: October 2021

Bacterial and fungal endophytes form diverse communities and contribute to the performance and health of their host plants. Recent evidence suggests that both host-related factors and environmental conditions determine the community structure of plant endophytes. However, we know little about their distribution patterns and underlying community assembly mechanisms across plant compartments. Here, we analyzed the structure of bacterial and fungal communities associated with tree compartments as well as their underlying soils across 12 tree individuals in boreal forests. We found that the structure of bacterial and fungal communities depends more strongly on the vertical location of tree compartments rather than the locality, species, and individuals of host trees. Microbial communities showed much stronger host specificity in aboveground than belowground compartments. Compared with fungal communities, the composition and diversity of bacterial communities were markedly more distinct between below- and aboveground components but not between hosts, reflecting the greater importance of environmental conditions rather than dispersal limitation and host identity in their community assembly. Our data suggest that spatial distance from soil as a major microbiome source contributes to the formation of microbiomes in plants, and that bacterial and fungal communities may follow contrasting assembly processes in associating with a single individual tree.