bluuebunny/crossref_metadata_2025_split huggingface dataset:
Azithromycin and high-dose vitamin D for treatment and prevention of asthma-like episodes in hospitalised preschool children: study protocol for a combined double-blind randomised controlled trial
Authors: Kyvsgaard Julie Nyholm , Ralfkiaer Ulrik , Følsgaard Nilofar , Jensen Trine Mølbæk , Hesselberg Laura Marie , Schoos Ann-Marie M , Bønnelykke Klaus , Bisgaard Hans , Stokholm Jakob , Chawes Bo 
Published: April 2022

IntroductionPrevious randomised controlled trials (RCTs) suggest antibiotics for treating episodes of asthma-like symptoms in preschool children. Further, high-dose vitamin D supplementation has been shown to reduce the rate of asthma exacerbations among adults with asthma, while RCTs in preschool children are lacking. The aims of this combined RCT are to evaluate treatment effect of azithromycin on episode duration and the preventive effect of high-dose vitamin D supplementation on subsequent episodes of asthma-like symptoms among hospitalised preschoolers.Methods and analysisEligible participants, 1–5 years old children with a history of recurrent asthma-like symptoms hospitalised due to an acute episode, will be randomly allocated 1:1 to azithromycin (10 mg/kg/day) or placebo for 3 days (n=250). Further, independent of the azithromycin intervention participants will be randomly allocated 1:1 to high-dose vitamin D (2000 IU/day+ standard dose 400 IU/day) or standard dose (400 IU/day) for 1 year (n=320). Participants are monitored with electronic diaries for asthma-like symptoms, asthma medication, adverse events and sick-leave. The primary outcome for the azithromycin intervention is duration of asthma-like symptoms after treatment. Secondary outcomes include duration of hospitalisation and antiasthmatic treatment. The primary outcome for the vitamin D intervention is the number of exacerbations during the treatment period. Secondary outcomes include time to first exacerbation, symptom burden, asthma medication and safety.Ethics and disseminationThe RCTs are approved by the Danish local ethical committee and conducted in accordance with the guiding principles of the Declaration of Helsinki. The Danish Medicines Agency has approved the azithromycin RCT, which is monitored by the local Unit for Good Clinical Practice. The vitamin D RCT has been reviewed and is not considered a medical intervention. Results will be published in peer-reviewed journals and presented at international conferences.Trial registration numbersNCT05028153,NCT05043116.
Effectiveness of therapeutic ultrasound for the treatment of carpal tunnel syndrome (the USTINCTS trial): study protocol for a three-arm, prospective, multicentre, randomised controlled trial
Authors: Chen Shuai , Qian Yun , Sun Ziyang , Liu Weixuan , Sun Guixin , Liu Junjian , Wang Jian , Wang Wei , Zheng Yuanyi , Fan Cunyi 
Published: April 2022

IntroductionThere has no consensus on optimal management of carpal tunnel syndrome (CTS), the most common compression neuropathy. Conservative therapy is generally accepted as first-line intervention. Therapeutic ultrasound has been widely reported to be treatment beneficial in nerve regeneration and conduction, and further accelerate compression recovery. The purpose of this study is to investigate the effectiveness of therapeutic ultrasound for CTS treatment.Methods and analysisThis study protocol entails a three-arm, prospective, multicentre, randomised controlled trial. 162 eligible adult participants diagnosed with mild to moderate CTS by using criteria developed from a consensus survey by the UK Primary Care Rheumatology Society will be assigned to either (1) therapeutic ultrasound, (2) night splint or (3) therapeutic ultrasound +night splint (combined) group. Primary outcome will be difference in Symptom Severity Scale of Boston Carpal Tunnel Questionnaire (BCTQ-SSS) at 6-week between night splint and therapeutic ultrasound +night splint groups. Secondary outcomes include Functional Status Scale of BCTQ, sleep questionnaire for interrupted sleep, EuroQol-5D for general health, Hospital Anxiety and Depression Scale for mental status, Work Limitations Questionnaire-25 for functional limitations at work, Global Rating of Change for treatment success and recurrence rate, physical examination, electrophysiological and ultrasound parameters. Intention-to-treat analyses will be used.Ethics and disseminationEthics committees of all clinical centres have approved this study. The leading centre is Shanghai Sixth People’s Hospital, whose approval number is 2021-152. New versions with appropriate amendments will be submitted to the committee for further approval. Final results will be published in peer-reviewed journals and presented at local, national and international conferences.Trial registration numberChiCTR2100050701.
Association between serum vitamin D levels and Helicobacter pylori cytotoxic-associated gene A seropositivity: a cross-sectional study in US adults from NHANES III
Authors: Kuang Wei-ming , Ren Yu-jie , Chen Xu , Luo Qi , Chen Weijing , Pan Huai-geng , Li Ru-liu , Hu Ling 
Published: April 2022

ObjectiveTo assess the association of serum vitamin D (VD) levels and Helicobacter pylori (H. pylori) cytotoxic-associated gene A (CagA) seropositivity, and further explore potential effect modifiers in this association.DesignCross-sectional study.SettingData from phase I of the National Health and Nutrition Examination Survey (NHANES III, 1988–1991) led by the Center for Disease Control and Prevention.ParticipantsA total of 3512 US adults (≥20 years) with both serum VD levels and H. pylori CagA antibody data from NHANES III were included in the analysis.MethodsVD deficiency was defined as serum 25(OH)D concentrations<20 ng/mL. Logistic regression models were used to assess the association of serum VD levels and H. pylori CagA seropositivity (VD–Hp CagA+), and stratification analyses were used to explore potential effect modifiers.ResultsThere was no significant association of VD–Hp CagA+ in the general population. But serum 25(OH)D concentrations were associated with H. pylori CagA+ in non-Hispanic whites (adjusted OR=1.02, 95% CI: 1.00 to 1.03), other races/ethnicities (adjusted OR=1.08, 95% CI: 1.01 to 1.06), populations born in other countries (adjusted OR=1.09, 95% CI: 1.04 to 1.15) or occasional drinkers (adjusted OR=0.93, 95% CI: 0.88 to 0.99). VD deficiency was associated with H. pylori CagA+ in non-Hispanic whites (adjusted OR=0.69, 95% CI: 0.53 to 0.92), populations born in other countries (adjusted OR=0.47, 95% CI: 0.25 to 0.89), non-drinkers (adjusted OR=0.80, 95% CI: 0.65 to 0.99), occasional drinkers (adjusted OR=2.53, 95% CI: 1.06 to 6.05), population with first quartile level of serum ferritin (adjusted OR=0.70, 95% CI: 0.51 to 0.96) or fourth quartile level of serum folate (adjusted OR=0.63, 95% CI: 0.46 to 0.87).ConclusionsRacial/ethnic differences and different serum ferritin or serum folate levels may be effect modifiers for the association of VD–Hp CagA+.
Factors influencing hesitancy towards adult and child COVID-19 vaccines in rural and urban West Africa: a cross-sectional study
Authors: Faye Sylvain Landry B. , Krumkamp Ralf , Doumbia Seydou , Tounkara Moctar , Strauss Ricardo , Ouedraogo Henri Gautier , Sagna Tani , Barry Alpha Mahmoud , Mbawah Abdul Karim , Doumbia Cheick Oumar , Diouf Souleymane , Cisse Kadari , Harding Mohamed , Donven Paule , May Jürgen , Puradiredja Dewi Ismajani , Fusco Daniela 
Published: April 2022

ObjectivesThis study aims: (1) to identify and describe similarities and differences in both adult and child COVID-19 vaccine hesitancy, and (2) to examine sociodemographic, perception-related and behavioural factors influencing vaccine hesitancy across five West African countries.DesignCross-sectional survey carried out between 5 May and 5 June 2021.Participants and setting4198 individuals from urban and rural settings in Burkina Faso, Guinea, Mali, Senegal and Sierra Leone participated in the survey.Study registrationThe general protocol is registered on clinicaltrial.gov.ResultsFindings show that in West Africa at the time only 53% of all study participants reported to be aware of COVID-19 vaccines, and television (60%, n=1345), radio (56%; n=1258), social media (34%; n=764) and family/friends/neighbours (28%; n=634) being the most important sources of information about COVID-19 vaccines. Adult COVID-19 vaccine acceptance ranges from 60% in Guinea and 50% in Sierra Leone to 11% in Senegal. This is largely congruent with acceptance levels of COVID-19 vaccinations for children. Multivariable regression analysis shows that perceived effectiveness and safety of COVID-19 vaccines increased the willingness to get vaccinated. However, sociodemographic factors, such as sex, rural/urban residence, educational attainment and household composition (living with children and/or elderly), and the other perception parameters were not associated with the willingness to get vaccinated in the multivariable regression model.ConclusionsPrimary sources of information about COVID-19 vaccines include television, radio and social media. Communication strategies addressed at the adult population using mass and social media, which emphasise COVID-19 vaccine effectiveness and safety, could encourage greater acceptance also of COVID-19 child vaccinations in sub-Saharan countries.Trial registration numberNCT04912284.
Changes in caesarean section rates in China during the period of transition from the one-child to two-child policy era: cross-sectional National Household Health Services Surveys
Authors: Long Qian , Zhang Yaoguang , Zhang Jing , Tang Xiaojun , Kingdon Carol 
Published: April 2022

ObjectivesSince 2009, China has introduced policies, principally targeting health professionals, to reduce caesarean section (CS) overuse. In 2016, China endorsed a universal two-child policy. Advanced maternal age and previous CS may indicate changes in obstetric risks, which raise concerns on the need for and safety of CS. This study investigated changes in CS rates in 2008–2018, and factors associated with CS use during the period of transition from the one-child to two-child policy era.DesignWe used births data from the cross-sectional National Household Health Services Surveys in 2013 and 2018.SettingPopulation-based national survey.ParticipantsWomen who had the last live birth within 5 years before the survey.Primary outcome measureCS rate.ResultsOverall CS use increased from 40.9% in 2008 to 47.2% in 2014 with significant increase in rural areas and the western region, and slightly decreased to 45.2% in 2018 with the greatest decrease among nulliparous women. Maternal request for CS by urban nulliparous women decreased from 36.8% in 2008–2009 to 22.2% in 2016–2018, but this change was not statistically significant in rural areas. Maternal age over 35 years old (OR 2.40, 95% CI 1.72 to 3.35) and births that occurred at a private hospital (OR 1.52, 95% CI 1.25 to 1.86) were associated with CS use among nulliparous women in 2016–2018. The CS rate among multiparous women increased over time. Individual socioeconomic factors associated with CS use among multiparous women.ConclusionsThe CS rate rise in China in 2008–2018 is attributable to increased use in rural areas and the less developed western region. The population policy shift, alongside facility policies for unnecessary CS reduction, are likely factors in CS reduction in urban areas. The challenge remains to reduce unnecessary CS, at the same time as providing safe, universal access to CS for women in need.
Immune correlates of clinical parameters in patients with HPV-associated malignancies treated with bintrafusp alfa
Authors: Tsai Yo-Ting , Strauss Julius , Toney Nicole J , Jochems Caroline , Venzon David J , Gulley James L , Schlom Jeffrey , Donahue Renee N 
Published: April 2022

PurposeBintrafusp alfa is a bifunctional agent consisting of an anti-human PD-L1 antibody linked to two TGFβRII. It is designed to act both as a checkpoint inhibitor and to ‘trap’ TGFβ in the tumor microenvironment. Phase I and II clinical studies demonstrated clinical activity in patients with a range of human papillomavirus (HPV)-associated cancers. The purpose of the studies reported here was the interrogation of various aspects of the peripheral immunome in patients with HPV-associated cancers, both prior to and early in the treatment regimen of bintrafusp alfa to better understand the mode of action of the agent and to help define which patients are more likely to benefit from bintrafusp alfa treatment.Patients and methodsThe peripheral immunome of patients (n=65) with HPV+malignancies was analyzed both prior to treatment with bintrafusp alfa and day 14 post-treatment for levels and changes in (1) 158 different immune cell subsets, (2) multiple plasma soluble factors including analytes reflecting immune stimulatory and inhibitory status, (3) complete blood counts, and in a subset of patients (4) TCR diversity and (5) HPV-specific T-cell responses.ResultsInterrogation of the peripheral immunome prior to bintrafusp alfa treatment revealed several factors that associated with clinical response, including (1) higher levels of sCD27:sCD40L ratios, (2) lower levels of TGFβ1 and 12 additional factors associated with tumor mesenchymalization, and (3) higher CD8+T cell:MDSC ratios. Analysis at 2 weeks post bintrafusp alfa revealed that eventual clinical responders had fewer increases in IL-8 levels and the neutrophil to lymphocyte ratio, and higher levels of HPV-16 specific CD8+T cells. This study also provided information concerning differences in the peripheral immunome for patients who were naïve versus refractory to prior checkpoint inhibition therapy. While preliminary, two multivariate models developed predicted clinical benefit with 76%–91% accuracy.ConclusionsThese studies add insight into the mechanism of action of bintrafusp alfa and provide evidence that the interrogation of both cellular and soluble components of the peripheral immunome of patients with HPV-associated malignancies, either prior to or early in the therapeutic regimen, can provide information as to which patients are more likely to benefit with bintrafusp alfa therapy.
A dark leptophilic scalar with the updated muon $$g-2$$ anomaly
Authors: Jia Lian-Bao 
Published: April 2022

AbstractThe muon $$g-2$$

g
-
2

anomaly was strengthened by recent experimental results at Fermilab, which may be signatures of new physics. A scenario of leptophilic scalar $$\phi _L$$

ϕ
L

accounting for the muon $$g-2$$

g
-
2

anomaly is investigated in this paper. Although a light $$\phi _L$$

ϕ
L

mainly decaying into standard model (SM) particles has been excluded by experiments, a dark leptophilic scalar $$\phi _L$$

ϕ
L

predominantly decaying into invisible fermionic dark matter (DM) $$\chi {\bar{\chi }}$$

χ

χ

¯

is still allowed. Considering the decay mode $$\phi _L \rightarrow \chi {\bar{\chi }}$$

ϕ
L

→
χ

χ

¯

opened (here $$m_{\phi _L} = 3 m_\chi $$

m

ϕ
L

=
3

m
χ

), the coupling preferred by the muon $$g-2$$

g
-
2

and the $$\phi _L-\chi $$

ϕ
L

-
χ

coupling are derived. The light/heavy $$\phi _L$$

ϕ
L

(roughly 1 GeV as a benchmark value) can be tested by future experiments via DM/SM decay modes, and the contribution of $$\phi _L$$

ϕ
L

to the anomalous magnetic moment of the tau lepton could be investigated at lepton colliders. The search for $$\chi $$
χ
via $$\chi $$
χ
-electron scattering in direct detection of DM is not sensitive due to a tiny $$\phi _L$$

ϕ
L

-electron coupling, especially for $$m_\chi > rsim m_\mu $$

m
χ

≳

m
μ

.
Prognostic Relationship Between Coronary Artery Calcium Score, Perfusion Defects, and Myocardial Blood Flow Reserve in Patients With Suspected Coronary Artery Disease
Authors: Patel Krishna K. , Peri-Okonny Poghni A. , Qarajeh Raed , Patel Femina S. , Sperry Brett W. , McGhie A. Iain , Thompson Randall C. , Kennedy Kevin F. , Chan Paul S. , Spertus John A. , Bateman Timothy M. 
Published: April 2022

Background:
Coronary artery calcium score (CACS) is an anatomic measure of calcified atherosclerosis. Myocardial perfusion defects and reduced myocardial blood flow reserve (MBFR) are physiological measures of ischemia and coronary circulatory health. We aimed to assess the relative prognostic importance of MBFR, perfusion defects, and CACS in patients with suspected coronary artery disease.

Methods:

A total of 5983 consecutive patients without known history of coronary artery disease or cardiomyopathy, who underwent a CACS and
82
Rb positron emission tomography myocardial perfusion imaging between 2010 and 2016, were followed for all-cause death (n=785) over median of 3 years. Prognostic value was assessed using multivariable Cox regression models, and incremental risk discrimination for imaging variables was evaluated by comparing model c-indices after adjusting for clinical risk factors (RF).

Results:

Mean age was 67.1 years, 60% were female, and 83% were symptomatic. CACS was 0 in 22%, abnormal perfusion in 19%, and MBFR <2 in 53.3%. When added to RF, the model with MBFR had the best fit (c=0.78,
P
<0.0001). Addition of CACS to model with RF and perfusion (c=0.77) offered modest improvement in discrimination over the model with RF and perfusion (c=0.76,
P
=0.02). Adding CACS to a model with RF, perfusion, and MBFR did not provide incremental prognostic value (c=0.785 for both,
P
=0.16). CACS and MBFR both had independent prognostic value in patients with normal and abnormal myocardial perfusion imaging. Even among patients with CACS of 0, MBFR <2 was present in 37.8%, being associated with higher risk of death (hazard ratio per 0.1↓, 1.10 [1.04–1.15];
P
<0.001), but perfusion defects were not.

Conclusions:
Use of anatomic testing such as CACS of 0 to avoid myocardial perfusion imaging in symptomatic patients could lead to missing microvascular dysfunction in 4 out of 10 patients, a finding associated with a high mortality risk. Higher CACS was independently associated with the risk of death but did not provide incremental prognostic value over positron emission tomography with MBFR.
Investigating Language Relationships in Multilingual Sentence Encoders Through the Lens of Linguistic Typology
Authors: Choenni Rochelle , Shutova Ekaterina 
Published: April 2022

Abstract
Multilingual sentence encoders have seen much success in cross-lingual model transfer for downstream NLP tasks. The success of this transfer is, however, dependent on the model’s ability to encode the patterns of cross-lingual similarity and variation. Yet, we know relatively little about the properties of individual languages or the general patterns of linguistic variation that the models encode. In this article, we investigate these questions by leveraging knowledge from the field of linguistic typology, which studies and documents structural and semantic variation across languages. We propose methods for separating language-specific subspaces within state-of-the-art multilingual sentence encoders (LASER, M-BERT, XLM, and XLM-R) with respect to a range of typological properties pertaining to lexical, morphological, and syntactic structure. Moreover, we investigate how typological information about languages is distributed across all layers of the models. Our results show interesting differences in encoding linguistic variation associated with different pretraining strategies. In addition, we propose a simple method to study how shared typological properties of languages are encoded in two state-of-the-art multilingual models—M-BERT and XLM-R. The results provide insight into their information-sharing mechanisms and suggest that these linguistic properties are encoded jointly across typologically similar languages in these models.
Hierarchy into Heterarchy
Authors: Parciack Ronie 
Published: April 2022

Abstract
This article addresses the heterarchical dynamism generated by the reorganization of sacred geographies in India and the Arabian Peninsula through contemporary iconographies and religious practices. The cities at the top of the orthodox Islamic/Arab sacred, authoritative hierarchy have lost their status in the current Indian context both concretely and symbolically, and have become equated, embedded, or subordinated to the Indian space. This dynamism is unfolding primarily in Indian vernacular spaces: in the material culture and audiovisual media produced and sold in Islamic bazaars in proximity to Sufi shrines; and in public religious practices that are reshuffling the sacred spaces of both India and the Hijaz, manifesting a polyphonic, at times rhizomatic fabric corresponding to social theorist Kyriakos Kontopoulos’s definition of a heterarchy.
R2P and Counter-terrorism: Where Sovereignties Collide
Authors: Zimmerman Shannon 
Published: April 2022

Abstract
States play the lead role in implementing the norms of the international system. They interpret norms through the lens of their sovereignty, refining and revising them until they are suitable to local interests and context. The complex nature of sovereignty and its diverse manifestations across states means that norms will be interpreted and implemented in different ways. This article argues that R2P and counter-terrorism are complex norm regimes which are susceptible to modification as they are interpreted through diverse conceptions of state sovereignty. Using the cases of China’s response to the Uyghurs and Sri Lanka’s response to the Liberation Tigers of Tamil Eelam, this article shows that the malleable prescriptive norms of R2P and counter-terrorism can be reinterpreted by states in ways contingent on their sovereignty that deeply impact, and may even violate, the original intent of the norm.
Increased Lengths of Stay, ICU, and Ventilator Days in Trauma Patients with Asymptomatic COVID-19 Infection
Authors: Klutts Garrett N , Squires Austin , Bowman Stephen M , Bhavaraju Avi , Kalkwarf Kyle J 
Published: April 2022

Background The SARS-Cov-2 coronavirus has varying clinical effects—from asymptomatic patients to life-threatening illness and death. At the only Level 1 Trauma Center in a rural state, outcomes appeared worse in trauma patients who tested positive for COVID despite these patients presumably being asymptomatic or only mildly affected before their traumatic event. This study compares all trauma admissions that were COVID-positive to those who were not. Methods The institutional database was queried for all level 1 and 2 trauma activations from March 2020-July 2021. The analysis consisted of a multivariate regression between COVID-negative and the COVID-positive group controlling for age, injury severity score (ISS), and Glasgow Coma Score (GCS). Outcomes compared were hospital length-of-stay (LOS), ICU LOS, ventilator days, days to discharge to a facility, and in-hospital mortality. Results Hospital LOS was 2.7 days longer in the COVID-positive group ( P < .0005). ICU LOS was 2.9 days longer for patients admitted to the ICU in the COVID positive-group ( P = .017). Ventilator days were 4.7 days longer for patients requiring mechanical ventilation in the COVID-positive group ( P = .002). Discharge to a post-acute facility required 6.1 more days in the COVID-positive group ( P = .005). Conclusion Trauma patients presenting positive for COVID-19 are presumed to be asymptomatic before their traumatic event. Despite this, the physiologic toll of trauma combined with the COVID infection causes significantly worse clinical outcomes, including increasing hospital days in this patient population, which continues to tax the already burdened healthcare system.