bluuebunny/crossref_metadata_2025_split huggingface dataset:
Melanin‐concentrating hormone‐producing neurons in the hypothalamus regulate brown adipose tissue and thus contribute to energy expenditure
Authors: Izawa Shuntaro , Yoneshiro Takeshi , Kondoh Kunio , Nakagiri Shohei , Okamatsu‐Ogura Yuko , Terao Akira , Minokoshi Yasuhiko , Yamanaka Akihiro , Kimura Kazuhiro 
Published: April 2021

Key points
Melanin‐concentrating hormone (MCH) neuron‐ablated mice exhibit increased energy expenditure and reduced fat weight.
Increased brown adipose tissue (BAT) activity and locomotor activity‐independent energy expenditure contributed to body weight reduction in MCH neuron‐ablated mice.
MCH neurons send inhibitory input to the medullary raphe nucleus to modulate BAT activity.
AbstractHypothalamic melanin‐concentrating hormone (MCH) peptide robustly affects energy homeostasis. However, it is unclear whether and how MCH‐producing neurons, which contain and release a variety of neuropeptides/transmitters, regulate energy expenditure in the central nervous system and peripheral tissues. We thus examined the regulation of energy expenditure by MCH neurons, focusing on interscapular brown adipose tissue (BAT) activity. MCH neuron‐ablated mice exhibited reduced body weight, increased oxygen consumption, and increased BAT activity, which improved locomotor activity‐independent energy expenditure. Trans‐neuronal retrograde tracing with the recombinant pseudorabies virus revealed that MCH neurons innervate BAT via the sympathetic premotor region in the medullary raphe nucleus (MRN). MRN neurons were activated by MCH neuron ablation. Therefore, endogenous MCH neuron activity negatively modulates energy expenditure via BAT inhibition. MRN neurons might receive inhibitory input from MCH neurons to suppress BAT activity.
Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey
Authors: Hassan Md Zakiul , Monjur Mohammad Riashad , Biswas Md Abdullah Al Jubayer , Chowdhury Fahmida , Kafi Mohammad Abdullah Heel , Braithwaite Jeffrey , Jaffe Adam , Homaira Nusrat 
Published: April 2021

IntroductionDespite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown.MethodsWe analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI.ResultsWe analysed data for 2 144 children aged <5 years with symptoms of ARI from 17 300 households. In our sample, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6; 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5; 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics.ConclusionIn this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse.
Magnitude of internalised stigma and associated factors among people with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study
Authors: Shumet Shegaye , W/Michele Bethlehem , Angaw Dessie , Ergete Temesgen , Alemnew Nigus 
Published: April 2021

ObjectivesTo assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.DesignInstitution-based cross-sectional study design.SettingAmanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.ParticipantsWe recruited about 418 participants using systematic sampling technique for an interview during the study period.MeasurementData were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance.ResultsThe magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma.ConclusionsOne in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential.
Randomised controlled trial of a just-in-time adaptive intervention (JITAI) smoking cessation smartphone app: the Quit Sense feasibility trial protocol
Authors: Naughton Felix , Brown Chloë , High Juliet , Notley Caitlin , Mascolo Cecilia , Coleman Tim , Barton Garry , Shepstone Lee , Sutton Stephen , Prevost A Toby , Crane David , Greaves Felix , Hope Aimie 
Published: April 2021

IntroductionA lapse (any smoking) early in a smoking cessation attempt is strongly associated with reduced success. A substantial proportion of lapses are due to urges to smoke triggered by situational cues. Currently, no available interventions proactively respond to such cues in real time. Quit Sense is a theory-guided just-in-time adaptive intervention smartphone app that uses a learning tool and smartphone sensing to provide in-the-moment tailored support to help smokers manage cue-induced urges to smoke. The primary aim of this randomised controlled trial (RCT) is to assess the feasibility of delivering a definitive online efficacy trial of Quit Sense.Methods and analysesA two-arm parallel-group RCT allocating smokers willing to make a quit attempt, recruited via online adverts, to usual care (referral to the NHS SmokeFree website) or usual care plus Quit Sense. Randomisation will be stratified by smoking rate (<16 vs ≥16 cigarettes/day) and socioeconomic status (low vs high). Recruitment, enrolment, baseline data collection, allocation and intervention delivery will be automated through the study website. Outcomes will be collected at 6 weeks and 6 months follow-up via the study website or telephone, and during app usage. The study aims to recruit 200 smokers to estimate key feasibility outcomes, the preliminary impact of Quit Sense and potential cost-effectiveness, in addition to gaining insights on user views of the app through qualitative interviews.Ethics and disseminationEthics approval has been granted by the Wales NHS Research Ethics Committee 7 (19/WA/0361). The findings will be disseminated to the public, the funders, relevant practice and policy representatives and other researchers.Trial registration numberISRCTN12326962.
WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact
Authors: Keynejad Roxanne , Spagnolo Jessica , Thornicroft Graham 
Published: April 2021

QuestionThere is a large worldwide gap between the service need and provision for mental, neurological and substance use disorders. WHO’s Mental Health Gap Action Programme (mhGAP) intervention guide (IG), provides evidence-based guidance and tools for assessment and integrated management of priority disorders. Our 2017 systematic review identified 33 peer-reviewed studies describing mhGAP-IG implementation in low-income and middle-income countries.Study selection and analysisWe searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, ScieELO, Cochrane, PubMed databases, 3ie, Google Scholar and citations of our review, on 24 November 2020. We sought evidence, experience and evaluations of the mhGAP-IG, app or mhGAP Humanitarian IG, from any country, in any language. We extracted data from included papers, but heterogeneity prevented meta-analysis.FindingsOf 2621 results, 162 new papers reported applications of the mhGAP-IG. They described mhGAP training courses (59 references), clinical applications (n=49), research uses (n=27), contextual adaptations (n=13), economic studies (n=7) and other educational applications (n=7). Most were conducted in the African region (40%) and South-East Asia (25%). Studies demonstrated improved knowledge, attitudes and confidence post-training and improved symptoms and engagement with care, post-implementation. Research studies compared mhGAP-IG-enhanced usual care with task-shared psychological interventions and adaptation studies optimised mhGAP-IG implementation for different contexts. Economic studies calculated human resource requirements of scaling up mhGAP-IG implementation and other educational studies explored its potential for repurposing.ConclusionsThe diverse, expanding global mhGAP-IG literature demonstrates substantial impact on training, patient care, research and practice. Priorities for future research should be less-studied regions, severe mental illness and contextual adaptation of brief psychological interventions.
Effectiveness of intravenous r-tPA versus UK for acute ischaemic stroke: a nationwide prospective Chinese registry study
Authors: Wang Xinhong , Li Xiaoqiu , Xu Yuming , Li Runhui , Yang Qingcheng , Zhao Yong , Wang Fengyun , Sheng Baoying , Wang Runqing , Chen Shaoyuan , Wang Lihua , Shen Liying , Hou Xiaowen , Cui Yu , Wang Duolao , Peng Bin , Anderson Craig S , Chen Huisheng 
Published: April 2021

BackgroundIntravenous recombinant tissue plasminogen activator (r-tPA) and urokinase (UK) are both recommended for the treatment of acute ischaemic stroke (AIS) in China, but with few comparative outcome data being available. We aimed to compare the outcomes of these two thrombolytic agents for the treatment of patients within 4.5 hours of onset of AIS in routine clinical practice in China.MethodsA pre-planned, prospective, nationwide, multicentre, real-world registry of consecutive patients with AIS (age ≥18 years) who received r-tPA or UK within 4.5 hours of symptom onset according to local decision-making and guideline recommendations during 2017–2019. The primary effectiveness outcome was the proportion of patients with an excellent functional outcome (defined by modified Rankin scale scores 0 to 1) at 90 days. The key safety endpoint was symptomatic intracranial haemorrhage according to standard definitions. Multivariable logistic regression was used for comparative analysis, with adjustment according to propensity scores to ensure balance in baseline characteristics.ResultsOverall, 4130 patients with AIS were registered but 320 had incomplete or missing data, leaving 3810 with available data for analysis of whom 2666 received r-tPA (median dose 0.88 (IQR 0.78–0.90) mg/kg) and 1144 received UK (1.71 (1.43–2.00)×104international unit per kilogram). There were several significant intergroup differences in patient characteristics: r-tPA patients were more educated, had less history of stroke, lower systolic blood pressure, greater neurological impairment and shorter treatment times from symptom onset than UK patients. However, in adjusted analysis, the frequency of excellent outcome (OR 1.18, 95% CI 1.00 to 1.40, p=0.052) and symptomatic intracranial haemorrhage (OR 0.70, 95% CI 0.33 to 1.47, p=0.344) were similar between groups.ConclusionsUK may be as effective and carry a similar safety profile as r-tPA in treating mild to moderate AIS within guidelines in China.Registrationhttp://www.clinicaltrials.gov. unique identifier:NCT02854592.
Nano-oxides immobilize cadmium, lead, and zinc in mine spoils and contaminated soils facilitating plant growth
Authors: Indraratne Srimathie P. , Pierzynski Gary M. , Baker Lucas R. , Vara Prasad P.V. 
Published: April 2021

Nanoparticles with high reactivity can be applied as amendments to remediate soil metal contaminations by immobilizing toxic elements. Nano-oxides of Fe have been studied but Al and Ti nano-oxides have not been tested for their remediation capacity of toxic metals. The potential of synthesized iron (Fe-O), aluminum (Al-O), and titanium (Ti-O) nano-oxides for stabilizing Cd, Pb, and Zn in mine spoil (Chat) and contaminated soil was compared using adsorption studies and a greenhouse experiment. Chat and soil were amended with nano-oxides at two rates (25 and 50 g·kg−1) and a pot experiment was conducted with sorghum (Sorghum bicolor L. Moench). Leachates were collected twice per week from plant emergence to harvest at maturity and metals were compared against an unamended control. Chat was contaminated with Cd, Pb, and Zn at 84, 1583, and 6154 mg·kg−1, and soil at 15, 1260, and 3082 mg·kg−1, respectively. Adsorption conformed to the Langmuir linear isotherm and adsorption maxima of metals were in the order of Al-O > Ti-O ≥ Fe-O. Nano-oxides reduced Cd concentration by 28% (Fe-O) to 87% (Ti-O) and Zn concentration by 14% (Fe-O) to 85% (Al-O) in plant tissues compared with unamended Chat. Nano-oxides significantly reduced Cd, Pb, and Zn in leachates and available Cd and Zn in Chat/soil relative to the respective unamended controls. Nano-oxides can be used to remediate heavy metal contaminated Chat and soil and facilitate plant growth under proper nutrient supplements. Nano-oxides of Al-O and Ti-O remediated metals more effectively than Fe-O.
Anticipation-induced social tipping: can the environment be stabilised by social dynamics?
Authors: Müller Paul Manuel , Heitzig Jobst , Kurths Jürgen , Lüdge Kathy , Wiedermann Marc 
Published: April 2021

AbstractIn the past decades, human activities caused global Earth system changes, e.g., climate change or biodiversity loss. Simultaneously, these associated impacts have increased environmental awareness within societies across the globe, thereby leading to dynamical feedbacks between the social and natural Earth system. Contemporary modelling attempts of Earth system dynamics rarely incorporate such co-evolutions and interactions are mostly studied unidirectionally through direct or remembered past impacts. Acknowledging that societies have the additional capability for foresight, this work proposes a conceptual feedback model of socio-ecological co-evolution with the specific construct of anticipation acting as a mediator between the social and natural system. Our model reproduces results from previous sociological threshold models with bistability if one assumes a static environment. Once the environment changes in response to societal behaviour, the system instead converges towards a globally stable, but not necessarily desired, attractor. Ultimately, we show that anticipation of future ecological states then leads to metastability of the system where desired states can persist for a long time. We thereby demonstrate that foresight and anticipation form an important mechanism which, once its time horizon becomes large enough, fosters social tipping towards behaviour that can stabilise the environment and prevents potential socio-ecological collapse.
Physical invariant measures and tipping probabilities for chaotic attractors of asymptotically autonomous systems
Authors: Ashwin Peter , Newman Julian 
Published: April 2021

AbstractPhysical measures are invariant measures that characterise “typical” behaviour of trajectories started in the basin of chaotic attractors for autonomous dynamical systems. In this paper, we make some steps towards extending this notion to more general nonautonomous (time-dependent) dynamical systems. There are barriers to doing this in general in a physically meaningful way, but for systems that have autonomous limits, one can define a physical measure in relation to the physical measure in the past limit. We use this to understand cases where rate-dependent tipping between chaotic attractors can be quantified in terms of “tipping probabilities”. We demonstrate this for two examples of perturbed systems with multiple attractors undergoing a parameter shift. The first is a double-scroll system of Chua et al., and the second is a Stommel model forced by Lorenz chaos.
Two new light attracted rove beetle species of Astenus Dejean, 1833 (Coleoptera: Staphylinidae: Paederinae) from Kerala, India
Authors: Sreevidhya P. , Akhil S.V. , Sebastian C.D. 
Published: April 2021

Two new light attracted species of rove beetles of the genus Astenus Dejean, 1833 (Astenus keralensis sp. nov. and Astenus rougemonti sp. nov.) from Malabar coastal plains of northern Kerala in southern India are described, illustrated, and compared to closely related species. First report of Astenus kraatzi Bernhauer, 1902 from Indian mainland and a checklist and key to all 41 species of Astenus recorded from the Indian mainland are provided.
Deep Learning Algorithm for Automated Cardiac Murmur Detection via a Digital Stethoscope Platform
Authors: Chorba John S. , Shapiro Avi M. , Le Le , Maidens John , Prince John , Pham Steve , Kanzawa Mia M. , Barbosa Daniel N. , Currie Caroline , Brooks Catherine , White Brent E. , Huskin Anna , Paek Jason , Geocaris Jack , Elnathan Dinatu , Ronquillo Ria , Kim Roy , Alam Zenith H. , Mahadevan Vaikom S. , Fuller Sophie G. , Stalker Grant W. , Bravo Sara A. , Jean Dina , Lee John J. , Gjergjindreaj Medeona , Mihos Christos G. , Forman Steven T. , Venkatraman Subramaniam , McCarthy Patrick M. , Thomas James D. 
Published: April 2021

Background
Clinicians vary markedly in their ability to detect murmurs during cardiac auscultation and identify the underlying pathological features. Deep learning approaches have shown promise in medicine by transforming collected data into clinically significant information. The objective of this research is to assess the performance of a deep learning algorithm to detect murmurs and clinically significant valvular heart disease using recordings from a commercial digital stethoscope platform.

Methods and Results
Using >34 hours of previously acquired and annotated heart sound recordings, we trained a deep neural network to detect murmurs. To test the algorithm, we enrolled 962 patients in a clinical study and collected recordings at the 4 primary auscultation locations. Ground truth was established using patient echocardiograms and annotations by 3 expert cardiologists. Algorithm performance for detecting murmurs has sensitivity and specificity of 76.3% and 91.4%, respectively. By omitting softer murmurs, those with grade 1 intensity, sensitivity increased to 90.0%. Application of the algorithm at the appropriate anatomic auscultation location detected moderate‐to‐severe or greater aortic stenosis, with sensitivity of 93.2% and specificity of 86.0%, and moderate‐to‐severe or greater mitral regurgitation, with sensitivity of 66.2% and specificity of 94.6%.

Conclusions
The deep learning algorithm’s ability to detect murmurs and clinically significant aortic stenosis and mitral regurgitation is comparable to expert cardiologists based on the annotated subset of our database. The findings suggest that such algorithms would have utility as front‐line clinical support tools to aid clinicians in screening for cardiac murmurs caused by valvular heart disease.

Registration

URL:
https://clinicaltrials.gov
; Unique Identifier: NCT03458806.
Using ‘heat tagging’ to understand the remote influence of atmospheric diabatic heating through long-range transport
Authors: Fajber Robert , Kushner Paul J. 
Published: April 2021

AbstractIn the circulating atmosphere, diabatic heating influences the potential temperature content of air masses far from where the heating occurs. Budgets that balance local diabatic sources with local heat divergence and storage do not retain information about this remote influence, which requires air-mass tracking. In this study, a process based, passive-tracer diagnostic, called heat tagging, is introduced. Heat tagging locally decomposes the potential temperature into contributions from the distinctive diabatic processes that generate them, wherever they occur. The distribution, variability and transport of atmospheric heat tags are studied in the relatively simple setting of an idealized aquaplanet model. Heat tags from latent heating are generated in the deep tropics and the midlatitude storm track and then transported throughout the troposphere. By contrast dry sensible heat tags are enhanced near the surface, and radiative tags are mainly confined to the stratosphere. As a result, local heat transport, variability of potential temperature and global poleward heat transport are dominated by heat tags related to latent heating, with heat tags from sensible and radiative heating only making contributions in the polar near surface and the stratosphere respectively. Heat tagging thus quantifies how water vapor and latent heating link the structural characteristics of the atmosphere and illustrates the importance of the hydrological cycle in poleward energy transport.
Chronic Otitis in Cats: Clinical management of primary, predisposing and perpetuating factors
Authors: Brame Bailey , Cain Christine 
Published: April 2021

Practical relevance: Chronic otitis can be one of the most frustrating diseases to manage for a small animal practitioner. While it occurs less commonly in the cat than the dog, it is no less challenging. The purpose of this review is to discuss the common and uncommon causes of chronic otitis in the cat within the clinical framework used for diagnosis and treatment. The focus is on diseases that affect the ear canal, rather than those restricted to the pinnae. Clinical challenges: Otitis is multifactorial, which complicates management. A common clinical mistake is to focus solely on treating the infection present. Only by addressing all factors will a clinician successfully control chronic otitis. For the purposes of this review, the authors have adopted the established model of separating primary, predisposing and perpetuating causes of otitis. Primary factors are those that directly cause otitis (inflammation); predisposing factors are those that put the patient at risk for development of otitis; and perpetuating factors are those that result in ongoing clinical signs of otitis or that prevent clinical resolution. Audience: This review is aimed at veterinarians who treat cats and particularly those with an interest in feline dermatology and otology. Equipment: While many practitioners rely on a hand-held otoscope, a video-otoscope can be very helpful for the diagnosis and treatment of chronic otitis. Evidence base: This review presents up-to-date information regarding the diagnosis and treatment of chronic otitis in cats, with emphasis on the most recent peer-reviewed literature.