bluuebunny/crossref_metadata_2025 huggingface dataset:
Stability Analysis and Control Strategy for the Chained Propagation of Delay or Disruption Risk in a Port-Hinterland Service Network
Authors: Kuang Haibo , Zhang Pengfei , Han Bing , Ouyang Peng
Published: February 2021

In a port-hinterland service network (PHSN), the occurrence of delays or disruption risks in the ports could impose serious impacts on carriers, nodes in hinterlands, or even the entire port-hinterland service network. To study how such risks are generated, propagated, and effectively controlled in the port-hinterland service network, this paper builds a model for the chained propagation of network risks that is consistent with the characteristics of the port-hinterland service network after analysing the risk factors and the risk-generating path by using the fuzzy analytic hierarchy process (FAHP) framework. On the premise of model stability analysis, the paper analyses the elasticity of carriers and ports to the infected proportion of nodes in the hinterlands, infection rate, and recovery rate in order to obtain the optimal control strategy and control coefficient, and the paper finally validates the model through a simulation analysis under a real case. The research shows that external factors causing delay or disruption risk are more important than internal factors, while the occurrence probability of external factors is lower than that of internal factors. There are four equilibrium points in this system. When the equilibrium conditions are met, the infected proportion of carriers and ports gradually approaches zero or narrows to a fixed ratio, and there is only one no-epidemic point. In the equilibrium conditions, when the infected proportion of inland ports is greater than a certain threshold, the infected proportion of carriers and ports decreases with an increase in the infected proportion of inland ports. Moreover, it is determined that increasing the recovery rate is the most effective and direct control measure. The results of this study provide new insights for the risk control of port-hinterland service network managers and participants.
Multiobjective Optimization of Large‐Scale EVs Charging Path Planning and Charging Pricing Strategy for Charging Station
Authors: Hou Weicheng , Luo Qingsong , Wu Xiangdong , Zhou Yimin , Si Gangquan
Published: February 2021

With the increasing number of electric vehicles (EVs), the charging demand of EVs has brought many new research hotspots, i.e., charging path planning and charging pricing strategy of the charging stations. In this paper, an integrated framework is proposed for multiobjective EV path planning with varied charging pricing strategies, considering the driving distance, total time consumption, energy consumption, charging fee such factors, while the charging pricing strategy is designed based on the objectives of maximizing the total revenues of the charging stations and balancing the profits of the charging stations. First, the energy consumption model of EVs, the M/M/S queuing model of charging stations, and the charging model of charging piles are established. A novel charging path planning algorithm is proposed based on bidirectional Martins’ algorithm, which can assist EV users to select charging stations and plan charging paths. Then, a particle swarm optimization (PSO) algorithm is applied to solve the optimal solution of charging station pricing designation. Finally, the method proposed in the paper is simulated on the street map of Shenzhen to verify the efficacy of the multiobjective charging path planning for EVs and the feasibility of the charging pricing strategy.
Factors Predicting Physical Activity and Sports Participation in Adolescence
Authors: Rullestad Amalie , Meland Eivind , Mildestvedt Thomas
Published: February 2021

Physical activity is important for children’s health and wellbeing, yet participation declines across teenage years. It is important to understand the mechanisms that could support adolescents to maintain physical activity participation. The aim of this study was firstly to examine change in sports and nonsports activities over two years during adolescence. Secondly, we explored possible predictors of physical activity and sports participation after two years. Method. A longitudinal cohort study was conducted between 2011 and 2013. Our data were collected from 1225 Norwegian adolescents who were followed over a two-year period, from 6th to 8th grade (11 to 13 years) and from 8th to 10th grade (13 to 15 years). We examined the relations between physical activity and predictors such as peer support, parent support, socioeconomic status (SES), attitude towards physical education, active transportation to school, self-rated health, body image, and change of nonsports activities. We used linear regression analyses and binary logistic regression to explore possible predictors of physical activity and sports participation after two years. Results. We found a significant reduction in sports participation during early adolescence, most pronounced, from 8th to 10th grade (from 13 to 15 years). Factors which predicted physical activity after two years were a positive attitude towards physical education, perceived support from parents, if the student travelled to school in an active way (by walk or bicycle) and also how the student rated his/her own health. The last three factors also predicted improvements of physical activity during the two years. Possible predictors of persisting or starting doing sports were increasing levels of self-rated health, increasing socioeconomic status, whereas increasing engagement in nonsports activities predicted reduced participation in sports. Conclusion. Health promotive efforts aiming at increasing active school transportation, parental support, and subjective health seem important for maintenance of physical activity and sports participation during adolescence. Attitudes may improve by adapting physical education to individual needs and interests and can function as an additional promotive factor.
Preclinical Assessment of AMG 596, a Bispecific T-cell Engager (BiTE) Immunotherapy Targeting the Tumor-specific Antigen EGFRvIII
Authors: Sternjak Alexander , Lee Fei , Thomas Oliver , Balazs Mercedesz , Wahl Joachim , Lorenczewski Grit , Ullrich Ines , Muenz Markus , Rattel Benno , Bailis Julie M. , Friedrich Matthias
Published: February 2021

AMG 596 is a bispecific T-cell engager (BiTE) immuno-oncology therapy in clinical development for treatment of glioblastoma multiforme (GBM), the most common primary brain tumor in adults with limited therapeutic options. AMG 596 is composed of two single-chain variable fragments that simultaneously bind to the tumor-specific antigen, EGFR variant III (EGFRvIII), on GBM cells and to CD3 on T cells, thereby activating T cells to proliferate and secrete cytotoxic substances that induce lysis of the bound tumor cell. T-cell–redirected lysis by AMG 596 is very potent; in vitro studies revealed EC50 values in the low picomolar range, and in vivo studies showed that AMG 596 treatment significantly increased the overall survival of mice bearing EGFRvIII-expressing orthotopic tumors. In addition, AMG 596 activity is highly specific; no AMG 596–induced T-cell activity can be observed in assays with EGFRvIII-negative GBM cells, and no signs of toxicity and activity were observed in cynomolgus monkeys, which lack expression of EGFRvIII on normal tissues. With EGFRvIII-expressing GBM cells, we showed shedding of EGFRvIII-containing membrane vesicles, followed by vesicle uptake and EGFRvIII cell surface presentation by EGFRvIII noncoding GBM cells. Cell membrane presentation of EGFRvIII following microvesicle transfer allows engagement by AMG 596, resulting in T-cell activation and T-cell–dependent lysis of GBM cells. Together, these data show a compelling preclinical efficacy and safety profile of AMG 596, supporting its development as a novel immunotherapy for treatment of GBM.
The Kosovo Specialist Chambers and Specialist Prosecutor’s Office Paradox
Authors: Mucaj Avdylkader
Published: February 2021

In August 2015 the Assembly of Kosovo, following an international request, passed constitutional amendments and the Law on Specialist Chambers and Specialist Prosecutor’s Office [‘the Law’], marking the legal foundation of the Kosovo Specialist Chambers and the Specialist Prosecutor’s Office (‘the Specialist Chambers’). However, what has sparked widespread reaction in Kosovo is the narrow jurisdiction of the Specialist Chambers. Therefore, this article argues first that the Specialist Chambers have mono-ethnic jurisdiction, being charged with investigating and prosecuting only one warring party and effectively granting an amnesty to the other. Next it will be argued that the current jurisdiction of the Specialist Chambers ought to be extended to cover all mass atrocities committed during and after the Kosovo war by all warring parties. Finally, the article briefly discusses the indictment against the President of Kosovo, Hashim Thaçi, and others vis-á-vis the rejection of the main allegation of the Marty Report, on organ trafficking.
Black Robes and the Book of Heaven
Authors: Bremer Thomas S.
Published: February 2021

Protestant and Catholic sources tell different stories about four Nez Perce emissaries from beyond the Rocky Mountains who arrived in St. Louis in the fall of 1831. Although their respective historical accounts reveal little about why native peoples would find it advantageous to send a delegation to an American frontier town asking for help, they reveal much about the contrasts between these rival groups of American Christians in the nineteenth century as well as their common objectives in Christianizing the American west. A third version of Christian missionaries arriving in the intermountain west from an indigenous oral tradition offers a different interpretation of Christianity’s consequences for the native peoples of the region.
The Primitive Church Revived
Authors: Mitchell William H.F.
Published: February 2021

Recent scholarship has highlighted the religious dimensions of political argument in William III’s England. This article adds to this trend through a political analysis of pieces on the Apostolic Age that were written, re-printed, or cited, in the reign of William III. The Age was manipulated to legitimise the Williamite settlement in two ways. First, the early Christians’ ecclesiastical structures and practices were compared favourably to the contemporary Church of England, and unfavourably with Roman Catholic regimes. This contrast bolstered the bipolar confessional divide that underpinned William III’s claim to the English throne. Second, the supposed pan-national spiritual sympathy of the early Christians was regarded as a template for contemporary European Protestants, who were worthy of the protection that formed the bedrock of William III’s foreign policy.
Amphipoda from the Late Neogene of Shanxi, China
Authors: WEI YUN-FENG , DONG AI-GUAN , HUANG DI-YING , DU YAN-WEI , HEGNA THOMAS A. , LIAN XIN-NENG , AUDO DENIS
Published: February 2021

Amphipods are extremely diverse malacostracan crustaceans that have conquered many environments from oceanic abysses to the terrestrial realm. Despite their impressive modern diversity and abundance, they are particularly rare in the fossil record. Herein, we describe the exceptionally preserved Gammaroidorum yooling sp. nov. from the Late Neogene of Xiaobai Formation near Pandao village, Shanxi, China. Due to the limitation of the preservation, namely the non-preservation of setae, we could not establish a precise generic assignment, so used the collective group Gammaroidorum Jarzembowski, Chény, Fang & Wang, 2020. Although there are still doubts on the precise placement of this new species within amphipods, these fossils are important since they represent the first known fossil occurrence of an amphipod in China. Besides, these fossils have an unusual preservation, being almost transparent in most cases, and being most easily seen by reflecting light on the fossil.
Neoarisemus groehni sp. nov., a notable moth fly (Diptera, Psychodidae, Psychodinae) from Ukrainian amber

Authors: WAGNER RÜDIGER
Published: February 2021

The genus Neoarisemus was proposed by Botoşaneanu & Vaillant (1970) for the extant North American species Psychoda nigra Banks, 1894. The diagnostic characters are eyes without eye suture, wing venation with R5 vein pectinate, wing forks complete and in basal position, epandrial appendages basally swollen, and aedeagus asymmetrical. In his treatise on Palearctic Psychodidae Vaillant (1975: p. 168) transferred to the genus Neoarisemus several species previously placed in genus Telmatoscopus Eaton, 1904, among them N. spinitibialis (Tokunaga & Komyo, 1955) [Japan] and N. lindbergi (Vaillant, 1963) [Afghanistan]. Neoarisemus ibericus Wagner, 1977 [Spain], and N. sardous Wagner & Salamanna, 1984 [Sardinia] were described later.
Temporal–Spatial Variations of Atmospheric Static Stability: A Comparison of the Influences from Temperature and Its Vertical Difference
Authors: Lu Er , Hao Jiawei , Yang Kexin
Published: February 2021

The temporal–spatial variations of the static stability of dry air and the relative importance of their influencing quantities are explored. Derivation shows that while it links to the vertical difference of temperature, static stability also relates to the temperature itself. The static stability is expressed as a nonlinear function of temperature and the vertical difference of temperature. The relative importance of the two influencing quantities is assessed with linear regression. Tests show that the linear fitting method is robust. The results of the dominance rely on the data examined, which include an interannual variation, a seasonal variation, and a spatial variation that consists of the grid points over the globe. It is revealed that in the lower troposphere, while the temporal variations of static stability are dominated by the vertical difference of temperature, the temperature itself may also have considerable influence, especially over the high latitudes of the two hemispheres. In the stratosphere, temperature tends to have more contributions. Over the Antarctic, temperature dominates the seasonal and interannual variations of the static stability. The spatial variation of the static stability of July is influenced by both temperature and its vertical difference before 1980, but after that it is dominated by temperature.
On the Role of Bottom Pressure Torques in Wind-Driven Gyres
Authors: Stewart Andrew L. , McWilliams James C. , Solodoch Aviv
Published: February 2021

Previous studies have concluded that the wind-input vorticity in ocean gyres is balanced by bottom pressure torques (BPT), when integrated over latitude bands. However, the BPT must vanish when integrated over any area enclosed by an isobath. This constraint raises ambiguities regarding the regions over which BPT should close the vorticity budget, and implies that BPT generated to balance a local wind stress curl necessitates the generation of a compensating, nonlocal BPT and thus nonlocal circulation. This study aims to clarify the role of BPT in wind-driven gyres using an idealized isopycnal model. Experiments performed with a single-signed wind stress curl in an enclosed, sloped basin reveal that BPT balances the winds only when integrated over latitude bands. Integrating over other, dynamically motivated definitions of the gyre, such as barotropic streamlines, yields a balance between wind stress curl and bottom frictional torques. This implies that bottom friction plays a nonnegligible role in structuring the gyre circulation. Nonlocal bottom pressure torques manifest in the form of along-slope pressure gradients associated with a weak basin-scale circulation, and are associated with a transition to a balance between wind stress and bottom friction around the coasts. Finally, a suite of perturbation experiments is used to investigate the dynamics of BPT. To predict the BPT, the authors extend a previous theory that describes propagation of surface pressure signals from the gyre interior toward the coast along planetary potential vorticity contours. This theory is shown to agree closely with the diagnosed contributions to the vorticity budget across the suite of model experiments.
A Move Towards Intelligent Economy: Indian Evidence
Authors: Singh Gagandeep
Published: February 2021

The current study accounts for a transitional move initiated by NITI Aayog and Securities and Exchange Board of India (SEBI) recently in the form of adoption of artificial intelligence (AI) in Indian economy. Empirical analysis of data of top 500 Indian companies reveals that adoption of this transformation is likely to enhance firm performance. The annual reports of Indian companies mention the use of AI in the business, which clearly indicates that Indian economy has initiated a move towards intelligent economy. It is observed that the banking companies are using AI and chatbots at a wider scale. Firms belonging to other sectors are gradually following the adoption of AI in the business process which results in improved financial performance. The findings of the study suggest that Indian legislators should gradually move towards mandatory adoption of AI in business economy at large in line with the global trend, which began its footprints through Digital India.
Validation of the Chinese Version of the Multidimensional Workaholism Scale
Authors: Xu Yan , Li Chaoping
Published: February 2021

The aim of this study was to translate the Multidimensional Workaholism Scale (MWS) into Chinese and then test its reliability and validity among full-time Chinese employees in two stages. In Study 1 ( N = 220), the MWS was translated and exploratory factor analysis was conducted resulting in a four-factor solution consistent with the original MWS: motivational, cognitive, emotional, and behavioral. In Study 2 ( N = 425), confirmatory factor analysis showed that a four-factor, bifactor model was the best fit for the data. Configural, metric, and scalar invariance models were tested which demonstrated that the Chinese version of the MWS did not differ across gender, age, and job position groups. Finally, workaholism and engagement were related and distinct from one another, and they correlated with emotional exhaustion, work-family conflict and life well-being uniquely. This study indicated that the Chinese version of the MWS is a valid and reliable tool for Chinese employees, and this has important practical implications for the individual health and career development of Chinese working adults.
Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease
Authors: Morris Michael F. , Pershad Yash , Kang Paul , Ridenour Lauren , Lavon Ben , Lanclus Maarten , Godon Rik , De Backer Jan , Glassberg Marilyn K.
Published: February 2021

Introduction

Evidence suggests that vascular inflammation and thrombosis may be important drivers of poor clinical outcomes in patients with COVID-19. We hypothesised that a significant decrease in the percentage of blood volume in vessels with a cross-sectional area between 1.25 and 5 mm2relative to the total pulmonary blood volume (BV5%) on chest computed tomography (CT) in COVID-19 patients is predictive of adverse clinical outcomes.

Methods

We performed a retrospective analysis of chest CT scans from 10 hospitals across two US states in 313 COVID-19-positive and 195 COVID-19-negative patients seeking acute medical care.

Results

BV5% was predictive of outcomes in COVID-19 patients in a multivariate model, with a BV5% threshold below 25% associated with OR 5.58 for mortality, OR 3.20 for intubation and OR 2.54 for the composite of mortality or intubation. A model using age and BV5% had an area under the receiver operating characteristic curve of 0.85 to predict the composite of mortality or intubation in COVID-19 patients. BV5% was not predictive of clinical outcomes in patients without COVID-19.

Conclusions

The data suggest BV5% as a novel biomarker for predicting adverse outcomes in patients with COVID-19 seeking acute medical care.
Microbial and clinical factors are related to recurrence of symptoms after childhood lower respiratory tract infection
Authors: de Koff Emma M. , Man Wing Ho , van Houten Marlies A. , Vlieger Arine M. , Chu Mei Ling J.N. , Sanders Elisabeth A.M. , Bogaert Debby
Published: February 2021

Childhood lower respiratory tract infections (LRTI) are associated with dysbiosis of the nasopharyngeal microbiota, and persistent dysbiosis following the LRTI may in turn be related to recurrent or chronic respiratory problems.

Therefore, we aimed to investigate microbial and clinical predictors of early recurrence of respiratory symptoms as well as recovery of the microbial community following hospital admission for LRTI in children.

To this end, we collected clinical data and characterised the nasopharyngeal microbiota of 154 children (4 weeks–5 years old) hospitalised for a LRTI (bronchiolitis, pneumonia, wheezing illness or mixed infection) at admission and 4–8 weeks later. Data were compared to 307 age-, sex- and time-matched healthy controls.

During follow-up, 66% of cases experienced recurrence of (mild) respiratory symptoms. In cases with recurrence of symptoms during follow-up, we found distinct nasopharyngeal microbiota at hospital admission, with higher levels ofHaemophilus influenzae/haemolyticus, Prevotella orisand other gram-negatives and lower levels ofCorynebacterium pseudodiphtheriticum/propinquumandDolosigranulum pigrumcompared with healthy controls. Furthermore, in cases with recurrence of respiratory symptoms, recovery of the microbiota was also diminished. Especially in cases with wheezing illness, we observed a high rate of recurrence of respiratory symptoms, as well as diminished microbiota recovery at follow-up.

Together, our results suggest a link between the nasopharyngeal microbiota composition during LRTI and early recurrence of respiratory symptoms, as well as diminished microbiota recovery after 4–8 weeks. Future studies should investigate whether (speed of) ecological recovery following childhood LRTI is associated with long-term respiratory problems.
Accuracy of urine flow cytometry and urine test strip in predicting relevant bacteriuria in different patient populations
Authors: Gehringer Christian , Regeniter Axel , Rentsch Katharina , Tschudin-Sutter Sarah , Bassetti Stefano , Egli Adrian
Published: February 2021

Background

Urinary tract infection (UTI) is diagnosed combining urinary symptoms with demonstration of urine culture growth above a given threshold. Our aim was to compare the diagnostic accuracy of Urine Flow Cytometry (UFC) with urine test strip in predicting bacterial growth and in identifying contaminated urine samples, and to derive an algorithm to identify relevant bacterial growth for clinical use.

Methods

Species identification and colony-forming unit (CFU/ml) quantification from bacterial cultures were matched to corresponding cellular (leucocytes/epithelial cells) and bacteria counts per μl. Results comprise samples analysed between 2013 and 2015 for which urine culture (reference standard) and UFC and urine test strip data (index tests, Sysmex UX-2000) were available.

Results

47,572 urine samples of 26,256 patients were analysed. Bacteria counts used to predict bacterial growth of ≥105 CFU/ml showed an accuracy with an area under the receiver operating characteristic curve of > 93% compared to 82% using leukocyte counts. The relevant bacteriuria rule-out cut-off of 50 bacteria/μl reached a negative predictive value of 98, 91 and 89% and the rule-in cut-off of 250 bacteria/μl identified relevant bacteriuria with an overall positive predictive value of 67, 72 and 73% for microbiologically defined bacteriuria thresholds of 105, 104 or 103 CFU/ml, respectively. Measured epithelial cell counts by UFC could not identify contaminated urine.

Conclusions

Prediction of a relevant bacterial growth by bacteria counts was most accurate and was a better predictor than leucocyte counts independently of the source of the urine and the medical specialty ordering the test (medical, surgical or others).
Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children
Authors: Zhang Ruimu , Wang Hongmei , Tian Shufeng , Deng Jikui
Published: February 2021

Background

Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children.

Methods

We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia.

Results

A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia.

Conclusions

Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.
Case series of acute appendicitis association with SARS-CoV-2 infection
Authors: Prichard Charlsea , Canning Matthew , McWilliam-Ross Kindra , Birbari John , Parker William , Wasson Lori , Hollingsworth John W.
Published: February 2021

Background

Describe the indications for surgical interventions in asymptomatic patients with SARS-CoV-2. We are unaware of previous reports of an association between SARS-CoV-2 and acute appendicitis.

Methods

We performed a single institution retrospective review of SARS-CoV-2 pre-procedure testing and indications for surgical intervention. Statistical comparisons were performed using Chi Square analysis or two-tailed Student T test.

Results

We report a high prevalence of SARS-CoV-2 in both all testing and pre-procedure testing during the enrollment period. We observe a high prevalence of acute appendicitis among patients identified to be SARS-CoV-2 positive during pre-procedure testing and without recognized symptoms of COVID19.

Conclusion

We report a previously unrecognized association between SARS-CoV-2 and acute appendicitis.
Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya
Authors: Gersh Jill K. , Barnabas Ruanne V. , Matemo Daniel , Kinuthia John , Feldman Zachary , Lacourse Sylvia M. , Mecha Jerphason , Warr Alex J. , Kamene Maureen , Horne David J.
Published: February 2021

Background

People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed.

Methods

We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis.

Results

The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23).

Conclusions

In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.
Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: a community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK
Authors: Makaronidis Janine , Firman Chloe , Magee Cormac G. , Mok Jessica , Balogun Nyaladzi , Lechner Matt , Carnemolla Alisia , Batterham Rachel L.
Published: February 2021

Background

Loss of smell and/or taste are cardinal symptoms of COVID-19. ‘Long-COVID’, persistence of symptoms, affects around one fifth of people. However, data regarding the clinical resolution of loss of smell and/or taste are lacking. In this study we assess smell and taste loss resolution at 4–6 week follow-up, aim to identify risk factors for persistent smell loss and describe smell loss as a feature of long-COVID in a community cohort in London with known SARS-CoV-2 IgG/IgM antibody status. We also compare subjective and objective smell assessments in a subset of participants.

Methods

Four hundred sixty-seven participants with acute loss of smell and/or taste who had undergone SARS-CoV-2 IgG/IgM antibody testing 4–6 weeks earlier completed a follow-up questionnaire about resolution of their symptoms. A subsample of 50 participants completed an objective olfactory test and results were compared to subjective smell evaluations.

Results

People with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative (smell recovery: 57.7% vs. 72.1%, p = 0.027. taste recovery 66.2% vs. 80.3%, p = 0.017). In SARS-CoV-2 positive participants, a higher percentage of male participants reported full resolution of smell loss (72.8% vs. 51.4%; p < 0.001) compared to female participants, who were almost 2.5-times more likely to have ongoing smell loss after 4–6 weeks (OR 2.46, 95%CI 1.47–4.13, p = 0.001). Female participants with SARS-CoV-2 antibodies and unresolved smell loss and unresolved taste loss were significantly older (> 40 years) than those who reported full resolution. Participants who experienced parosmia reported lower smell recovery rates and participants with distorted taste perception lower taste recovery rates. Parosmia had a significant association to unresolved smell loss (OR 2.47, 95%CI 1.54–4.00, p < 0.001).

Conclusion

Although smell and/or taste loss are often transient manifestations of COVID-19, 42% of participants had ongoing loss of smell, 34% loss of taste and 36% loss of smell and taste at 4–6 weeks follow-up, which constitute symptoms of ‘long-COVID’. Females (particularly > 40 years) and people with a distorted perception of their sense of smell/taste are likely to benefit from prioritised early therapeutic interventions.

Trials registration

ClinicalTrials.govNCT04377815 Date of registration: 23/04/2020.
The probability of receiving a kidney transplantation in end-stage kidney disease patients who are treated with haemodiafiltration or haemodialysis: a pooled individual participant data from four randomised controlled trials
Authors:   on behalf of the HDF Pooling project investigators, Vernooij Robin W. M. , Law Way , Peters Sanne A. E. , Canaud Bernard , Davenport Andrew , Grooteman Muriel P. C. , Kircelli Fatih , Locatelli Francesco , Maduell Francisco , Morena Marion , Nubé Menso J. , Ok Ercan , Torres Ferran , Woodward Mark , Blankestijn Peter J. , Bots Michiel L.
Published: February 2021

Background

Due to a critical shortage of available kidney grafts, most patients with Stage 5 Chronic Kidney Disease (CKD5) require bridging dialysis support. It remains unclear whether treatment by different dialysis modalities changes the selection and/or preparation of a potential transplant candidate. Therefore, we assessed whether the likelihood of receiving kidney transplant (both living or deceased kidney donors) differs between haemodialysis (HD) and online haemodiafiltration (HDF) in patients with CKD5D.

Methods

Individual participant data from four randomised controlled trials comparing online HDF with HD were used. Information on kidney transplant was obtained during follow-up. The likelihood of receiving a kidney transplant was compared between HD and HDF, and evaluated across different subgroups: age, sex, diabetes, history of cardiovascular disease, albumin, dialysis vintage, fistula, and level of convection volume standardized to body surface area. Hazard ratios (HRs), with corresponding 95% confidence intervals (95% CI), comparing the effect of online HDF versus HD on the likelihood of receiving a kidney transplant, were estimated using Cox proportional hazards models with a random effect for study.

Results

After a median follow-up of 2.5 years (Q1 to Q3: 1.9–3.0), 331 of the 1620 (20.4%) patients with CKD5D received a kidney transplant. This concerned 22% (n = 179) of patients who were treated with online HDF compared with 19% (n = 152) of patients who were treated with HD. No differences in the likelihood of undergoing a kidney transplant were found between the two dialysis modalities in both the crude analyse (HR: 1.07, 95% CI: 0.86–1.33) and adjusted analysis for age, sex, diabetes, cardiovascular history, albumin, and creatinine (HR: 1.15, 95%-CI: 0.92–1.44). There was no evidence for a differential effect across subgroups based on patient- and disease-characteristics nor in different categories of convection volumes.

Conclusions

Treatment with HD and HDF does not affect the selection and/or preparation of CKD5D patients for kidney transplant given that the likelihood of receiving a kidney transplant does not differ between the dialysis modalities. These finding persisted across a variety of subgroups differing in patient and disease characteristics and is not affected by the level of convection volume delivered during HDF treatment sessions.
Comprehensive molecular profiling of Taiwanese breast cancers revealed potential therapeutic targets: prevalence of actionable mutations among 380 targeted sequencing analyses
Authors: Huang Chi-Cheng , Tsai Yi-Fang , Liu Chun-Yu , Chao Ta-Chung , Lien Pei-Ju , Lin Yen-Shu , Feng Chin-Jung , Chiu Jen-Hwey , Hsu Chih-Yi , Tseng Ling-Ming
Published: February 2021

Background

Breast cancer is one of the leading causes of cancer-related deaths in women, and there is a demand in developing an Asian-based genetic profiling database for breast cancer in improving the treatment response. This study aimed to determine molecular alternations and identify potential therapeutic targets by analyzing the genetic profiling from a cohort of Taiwanese breast cancers using a commercialized next-generation sequencing (NGS) targeted panel.

Methods

The study population comprised a broad spectrum of breast cancer patients in Taiwan, including Group 1: planned to receive first-line surgery and followed by adjuvant therapy, or early relapse within three years, Group 2: planned to receive first-line neoadjuvant therapy and followed by surgery, and Group 3: de novo stage IV, or stage IV with recurrence beyond three years. Molecular profiles were determined using Thermo Fisher™ Oncomine™ Comprehensive Assay version 3 (TMO comprehensive assay) from Formalin-Fixed Paraffin-Embedded (FFPE) tissues. Level of actionability was evaluated with the ESMO Scale of clinical actionability of molecular targets (ESCAT).

Results

A total of 380 TMO comprehensive assays were conducted on 372 patients, and we presented targeted sequencing analyses of Tier I: alteration-drug match associated with improved outcome in clinical trials including ERBB2 amplification, BRCA1/2 germline mutation, PIK3CA mutation, and NTRK translocation, and Tier II: antitumor activity associated with the matched alteration-drug but lack of prospective outcome data including PTEN loss, ESR1 mutation, AKT1 mutation, and ERBB2 mutation, and Tier III: matched drug-alteration that led to clinical benefit in another tumor type including MDM2 amplification, and ERBB3 mutation. Among them, 249 (66%) showed at least one actionable alternation based on the ESCAT criteria. The most frequent impacted genes (all variants combined within each sample) were PIK3CA (38%), followed by ERBB2 (23%), ESR1 (10%), AKT1 (6%), and BRCA2 (5%), and the remaining rare variants (less than 5% of assayed cohort) were BRCA1 (3%), MDM2 (2.2%), and ERBB3 (1.1%).

Conclusion

Targeted sequencing of actionable genes is believed to provide clinical applicability and substantial benefits for Taiwanese breast cancer patients. A valid scale of clinical actionability should be adopted for precision medicine practice under multidisciplinary molecular tumor board.
Diabetes mellitus hospitalization and mortality rate according to a national database in Brazil: a longitudinal study
Authors: Florêncio Rêncio Bento , de Araújo Fonseca Luiza Gabriela , da Silva Vivian Fernanda Dantas , Lima Íllia Nadinne Dantas Florentino , Gualdi Lucien Peroni
Published: February 2021

Background

Diabetes mellitus (DM) is an important public health problem worldwide. In addition to the impairment in functionality, the large number of complications which lead to hospitalizations results in high treatment costs. The aim of this study was to analyze the incidence of hospitalizations, mortality rate and hospital costs, as well as to observe the temporal trend of hospitalizations and length of hospital stay due to DM between 2008 and 2019 in Brazil.

Methods

This is a longitudinal descriptive study in which all data regarding hospital admissions registered in the Brazilian system of Hospital Information of “Sistema Único de Saúde” (SIH/SUS; http://datasus.saude.gov.br) due to DM (ICD-10) were included. Comparisons among the groups were performed by an unpaired Student’s t-test, two-way ANOVA with a Tukey post hoc test (p < 0.05).

Results

An increased hospitalization of 1.83% due to DM was observed between 2008 and 2019 in Brazil. The Southeastern region had the highest incidence (34.6%) and mortality rate when compared to the other regions (p < 0.05). We also found that females were more likely to be hospitalized in comparison to males, without a statistically significant difference. Finally, a progressive increase of hospitalizations and mortality rate were observed according to age groups, as well as increased spending due to DM hospitalizations over the years.

Conclusion

Hospitalizations due to DM in Brazil showed an expressive increase over the last 12 years, and there is a need for primary healthcare interventions to help reduce this situation.
Sociocultural barriers to hepatitis B health literacy in an immigrant population: a focus group study in Korean Americans
Authors: Hyun Sarah , Ko Okhyun , Kim Soonsik , Ventura William R.
Published: February 2021

Background

Chronic hepatitis B (CHB) is a major global health issue disproportionately affecting Asian Americans and other immigrant populations in the United States. Despite the high risk of morbid complications from CHB, the majority of individuals with CHB do not access healthcare due to a complex of barriers. These barriers influence health literacy which may affect behaviors linked to hepatitis B care. We aimed to identify and evaluate various sociocultural factors and how they interact with health literacy to impact CHB care and health seeking in a Korean American population.

Methods

A total of 28 Korean American individuals with CHB were divided into 5 different focus discussion groups. This study investigated the participants’ sociocultural backgrounds as well as their awareness and utilization of the healthcare system that could influence their health literacy and behaviors in accessing care.

Results

Our analysis identified and concentrated on three themes that emerged from these discussions: low risk perception and knowledge of CHB and its complications; language, immigrant status, and stigma; and financial and institutional barriers. The participants’ overall awareness of the disease and prevention methods demonstrated poor understanding of important characteristics and potential outcomes of the disease. Additionally, differences in cultural expectations and a lack of understanding and utilization of healthcare systems affected health literacy in further limiting participants’ motivation to seek care.

Conclusions

The present study suggests that there are culture-specific barriers to health literacy governing individuals’ health behavior in accessing hepatitis B care. These findings may inform strategies for developing culturally tailored resources and programs and for facilitating the implementation of community-wide hepatitis B education and screening initiatives in immigrant communities.
Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys
Authors: Leight Jessica , Wilson Nicholas
Published: February 2021

Background

High rates of maternal mortality and intimate partner violence (IPV) are both major worldwide health challenges. Evidence from single-country samples suggests that IPV may be an important risk factor for low utilization of maternal health services, but there is little large-scale evidence on this association. This paper evaluates whether IPV is a risk factor for low utilization of maternal health services in a large cross-country sample, and also compiles evidence on the relative effects of different forms of IPV.

Methods

We analyze the association between intimate partner violence and utilization of maternal health care, using a dataset compiling all Demographic and Health Surveys that report data on intimate partner violence. Using data on 166,685 women observed in 36 countries between 2005 and 2016, we estimate logistic regression models to analyze the relationship between lifetime experience of IPV and utilization of antenatal care (ANC), facility delivery care, and postnatal care. We estimate both unadjusted models and models adjusted for geographic and sociodemographic characteristics that are generally correlated with utilization of maternal health care (including age, education, number of children, wealth status, marital status, and urbanity).

Results

Lifetime experience of any IPV is associated with decreased use of maternal health services in a broad sample of births observed in lower and middle-income countries: in particular, the utilization of four or more ANC visits, the number of ANC visits, and the utilization of facility care at birth. This association remains statistically significant even after adjusting for country of residence, subnational region of residence, and additional individual-level covariates; however, there is no statistically significant association between experience of any IPV and postnatal care. The only form of IPV significantly associated with care utilization is physical IPV.

Conclusions

Women experiencing physical intimate partner violence show lower levels of utilization of maternal health services in a large sample of developing and middle-income countries. Given that reduced utilization of maternal health services is correlated with maternal and neonatal health outcomes, this pattern suggests that IPV prevention may be an important component of interventions targeting enhanced maternal and neonatal health.
Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial
Authors: Deng Wei , Hou Xiao-min , Zhou Xu-yan , Zhou Qing-he
Published: February 2021

Background

Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery.

Methods

Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups.

Results

The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons).

Conclusion

Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.