bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multigenerational transmission of obesity: A systematic review and meta‐analysis
Authors: Kanmiki Edmund W. , Fatima Yaqoot , Mamun Abdullah A. 
Published: December 2021

SummaryThere is a strong link between parental and offspring obesity status. However, the state of epidemiological evidence on multigenerational transmission of overweight/obesity, such as from grandparents to grandchildren, is relatively unknown. This systematic review collates and appraises existing evidence on multigenerational transmission of overweight/obesity and uses meta‐analytic estimates for quantitative synthesis. Six electronic databases were searched for publications reporting the relationship between grandparents and their grandchildren overweight/obesity status. A total of 25 studies from 17 countries with a combined population of 238,771 study participants met the inclusion criteria. About 60% (15) of the reviewed studies reported a positive association between grandparent–grandchild (GP‐GC) overweight/obesity, out of which 11 were statistically significant. Seven studies reported odds ratios of GP‐GC overweight/obesity associations and were included in the meta‐analysis. The pooled estimates showed a significant GP‐GC association in overweight/obesity status (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.01–2.57). Thus, the current research evidence shows that grandchildren's overweight/obesity status is associated with their grandparents' overweight/obesity status, indicating a multigenerational transmission of obesity. However, more studies, especially from developing countries, are required to assess the robustness of these findings. Future studies should also focus on the mechanisms through which this transmission occurs.
Propofol context‐sensitive decrement times in children
Authors: Morse James D. , Cortinez Luis Ignacio , Meneely Stephen , Anderson Brian J. 
Published: December 2021

AbstractPlasma drug concentration is the variable linking dose to effect. The decrement time required for plasma concentration of anesthetic agents to decrease by 50% (context‐sensitive half‐time) correlates with the time taken to regain consciousness. However, the decrement time to consciousness may not be 50%. An effect compartment concentration is associated more closely with return of consciousness than plasma concentration. An alternative decrement time, the time required for propofol to decrease to a predetermined effect compartment concentration associated with movement (eg, 2 µg.ml−1), was used to simulate time for the concentration to decrease from steady state at a typical targeted effect compartment concentration 3.5 µg.ml−1 in children. These times were short and reflected a decrement time to consciousness (CSTAWAKE) increase that was small with longer infusion time. CSTAWAKE ranged from 7.5 min in 1‐year‐old infant given propofol for 15 min to 13.5 min in a 15‐year‐old adolescent given a 2‐hour infusion. Changes in decrement time with age reflect maturation of drug clearance. Neonates had prolonged increment times, 10 min after 15 min infusion and 18 min after 120 min infusion using a target concentration of 3.5 µg.ml−1. Decrement times to a targeted arousal concentration are context‐sensitive. Use of a higher target concentration of 6 µg.ml−1 doubled decrement times. Decrement times are associated with variability: delayed recovery beyond these simulated times is likely more attributable to the use of adjuvant drugs or the child's clinical status. An understanding of propofol decrement times can be used to guide recovery after anesthesia.
Finding a breather for Oryza sativa: Understanding hormone signalling pathways involved in rice plants to submergence stress
Authors: Mittal Lavanya , Tayyeba Sumaira , Sinha Alok K. 
Published: December 2021

AbstractDuring the course of evolution, different ecotypes of rice (Oryza sativa L.) have evolved distinct strategies to cope with submergence stress. Such contrasting responses are mediated by plant hormones that are principle regulators of growth, development and responses to various biotic and abiotic stresses. These hormones act cooperatively and show extensive crosstalk which is mediated by key regulatory genes that serve as nodes of molecular communication. The presence or absence of such genes leads to significant changes in hormone signalling pathways and hence, governs the type of response that the plant will exhibit. As flooding is one of the leading causes of crop loss across all the major rice‐producing countries, it is crucial to deeply understand the molecular nexus governing the response to submergence to produce flood resilient varieties. This review focuses on the hormonal signalling pathways that mediate two contrasting responses of the rice plant to submergence stress namely, rapid internode elongation to escape flood waters and quiescence response that enables the plant to survive under complete submergence. The significance of several key genes such as Sub1A‐1, SLR1, SD1 and SK1/SK2, in defining the ultimate response to submergence has also been discussed.
Peen forming and stress peen forming of rectangular 2024–T3 aluminium sheets: Curvatures, natural curvatures and residual stresses
Authors: Faucheux Pierre A. , Miao Hong Yan , Lévesque Martin , Gosselin Frédérick P. 
Published: December 2021

AbstractAluminium skins on the lower wings of most commercial aircraft are shaped using shot peen forming. This process, which involves bombarding the skins with hard shot, uses nonuniform plastic flow to induce curvatures—in the same way that differential expansion makes metal bilayers bend when heated. Here, we investigate experimentally how constraining conditions affect the final shape of peen formed parts. We report peen forming experiments for 4.9‐mm‐thick rectangular 2024–T3 aluminium sheets of different aspect ratios uniformly shot peened on one face with a low intensity saturation treatment. Some specimens were free to deform during peening while others were elastically prestressed in a four‐point bending jig. For each aspect ratio and prestress condition, residual stresses were measured near the peened surface with the hole drilling method. Additional residual stress profiles were also obtained with the slitting method. The residual stress measurements show that the progressive deformation of unconstrained specimens had the same effect as an externally applied prestress. For the peening conditions investigated, this progressive deformation caused unconstrained strips to exhibit curvatures 33% larger than identical strips held flat during peening. Furthermore, we found that the relative importance of material anisotropy and geometric effects did determine the bending direction of unconstrained specimens.
Canine endotheliitis: Clinical characteristics, advanced imaging features, and treatment
Authors: Mayes Melaney A. , Casanova Maria Isabel , Park Sangwan , Steele Kirsten , Linton Lana , Kim Soohyun , Good Kathryn L. , Moore Bret A. , Newbold Georgina M. , Leonard Brian C. , Li Jennifer Y. , Thomasy Sara M. 
Published: December 2021

AbstractObjectiveTo describe the clinical findings, multimodal corneal imaging features and treatment in canine patients diagnosed with endotheliitis.Animals studiedFour canine patients met inclusion criteria for bilateral corneal disease with endothelial inflammation and secondary corneal edema that responded to topical anti‐inflammatory treatment.MethodsThe patients selected underwent a complete ophthalmic examination with emphasis on the cornea including ultrasound pachymetry (USP), Fourier‐domain optical coherence tomography (FD‐OCT), in vivo confocal microscopy (IVCM), and digital slit lamp photography.ResultsAll patients in this study demonstrated thickened corneas due to edema with USP and FD‐OCT. With IVCM, mild to severe polymegathism and pleomorphism of corneal endothelial cells, reduced endothelial cell density, hyperreflective keratic precipitates (KPs), and extracellular debris as well as hyporeflective pseudoguttata were observed. With FD‐OCT, hyperreflective KPs were commonly observed on the inferior cornea. Clinical examination and advanced imaging results were consistent with a diagnosis of endotheliitis. All patients initially responded to topical anti‐inflammatory treatment and required continued therapy; two patients also received topical netarsudil, a rho‐associated coiled‐coil kinase inhibitor.ConclusionEndotheliitis should be considered for canine patients with bilateral edema that is most severe in the inferior cornea. Careful inspection of Descemet's membrane–endothelial complex should be performed for KPs or inflammatory debris. Chronic administration of topical anti‐inflammatories may be necessary to prevent flare‐ups of endotheliitis.
Suspensory ligament size does not change after plantar fasciotomy and neurectomy of the deep branch of the lateral plantar nerve by ultrasonographic assessment
Authors: Scharf Alexandra , de Solis Cristobal Navas , Sampson Sarah N. , Glass Kati , Watts Ashlee E. 
Published: December 2021

AbstractObjectiveTo determine the short‐term effect of plantar fasciotomy and neurectomy (PFN) of the deep branch of the lateral plantar nerve on the proximal suspensory ligament (PSL) cross‐sectional area (CSA) in horses with hindlimb proximal suspensory desmopathy (PSD).Study designAnalytical, observational, cohort study.Sample populationTwenty‐one horses.MethodsRecords of horses with chronic PSD treated by PFN were included if a preoperative ultrasonographic examination was available and at least one postoperative ultrasonographic examination. One masked observer measured the ultrasonographic cross‐sectional area (CSA) of the PSL. Intraobserver reliability was determined by repeatedly measuring a subset of ultrasonographic images (n = 127). Two masked observers measured the cross‐sectional area of the proximal suspensory ligament (PSL‐CSA) on preoperative proton density (PD)‐weighted transverse high field magnetic resonance images (n = 19 horses) . Agreements for PSL‐CSA between preoperative ultrasonographic and MRI measures and between the two magnetic resonance imaging (MRI) observers were assessed. Follow up considered the horses’ ability to return to exercise and their owners’ satisfaction.ResultsThe reliability of the ultrasonographic measurement of the PSL‐CSA was excellent. Agreement between ultrasonographic assessment and MRI assessment of PSL‐CSA was good. No difference was detected between preoperative (median, interquartile range; oblique‐incidence, 2.07, 1.72‐2.55; on‐incidence, 2.23, 1.98‐2.65) and postoperative (oblique‐incidence, 2.08, 1.80‐2.74; on‐incidence, 2.28, 2.01‐2.74) PSL‐CSAs. At a median of 12 months (4‐33 months), 16/20 (80%) owners reported the horse was “better” and 15/20 (75%) functioned at or above preoperative levels.ConclusionUltrasonographic measurement of the PSL‐CSA was reproducible and in good agreement with MRI measurement. The PSL‐CSA was not influenced by PFN.Clinical significanceThe PSL‐CSA cannot be used to guide return to function.
Dose–response relationships between polycyclic aromatic hydrocarbon exposure and blood cell counts among coke oven workers: a sex-stratified analysis
Authors: Liu Chengjuan , Wu Min , Fu Mengmeng , Wang Huimin , Nie Jisheng 
Published: December 2021

ObjectivesTo explore sex differences and dose–response relationships between nine urinary polycyclic aromatic hydrocarbon (PAH) metabolites and neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and complete blood counts among coke oven workers.Design and settingA cross-sectional study with stratified sex was conducted in Shanxi, China.ParticipantsA total of 458 male workers and 226 female workers were selected.Primary and secondary outcome measuresGeneral linear models, p values for trend tests and natural cubic spline models were used to explore the dose–response relationships between nine urinary PAH metabolites and NLR, PLR and complete blood counts.ResultCompared with male workers, female workers had lower exposure level of PAH (0.95 ng/mL vs 1.38 ng/mL). Only among female workers did we observe that a 1-unit increase in lg(1-OHPyr) was related to a 0.149 (95% CI: 0.055 to 0.242; p for trend=0.041) and 0.103 (95% CI: 0.025 to 0.181; p for trend=0.007) increase in lg(NLR) and lg(PLR), and a 0.116 (95% CI: −0.179 to –0.054; p for trend=0.007) decrease in lg(lymphocyte counts (LYMs)). A 1-unit increase in lg(2-OHNap) was related to a 0.045 (95% CI: 0.003 to 0.086; p for trend=0.037) increase in lg(PLR) and a 0.029 (95% CI: −0.056 to –0.002; p for trend=0.030) and 0.016 (95% CI: −0.029 to –0.003; p for trend=0.010) decrease in lg(white blood cell counts (WBCs)) and lg(haemoglobin (HGB)).ConclusionFemale workers’ NLR, PLR, WBCs, HGB and LYMs may be more susceptible than those of male workers when affected by PAH.
Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
Authors: Magadzire Bvudzai Priscilla , Joao Gabriel , Bechtel Ruth , Matsinhe Graça , Nic Lochlainn Laura , Ogbuanu Ikechukwu Udo 
Published: December 2021

ObjectiveMissed opportunities for vaccination (MOV) are a significant contributor to low vaccination coverage. To better understand the magnitude and underlying causes of MOV among children aged 0–23 months in Mozambique, we conducted an assessment and developed a roadmap for strengthening the country’s childhood immunisation programme.SettingThree provinces in North, South and Central Mozambique.MethodsThe assessment applied a mixed-method approach. From a sample of 41 health facilities, we conducted exit interviews with caregivers of children aged 0–23 months (n=546), surveys with health workers (n=223), focus group discussions with caregivers (n=6) and health workers (n=5), and in-depth interviews with health facility managers (n=9). We analysed the data to assess the magnitude of MOV and to identify causes of MOV and ways of preventing them.ResultsVaccination records were available for 538 children. Sixty per cent (n=324) were eligible for vaccination on arriving for their health facility visit. Of these, 76% (n=245) were not fully vaccinated, constituting MOV. Our analysis shows that these MOV were most frequently attributable to practices of caregivers and health workers and also to health systems reasons. Inadequate information about vaccination among both caregivers and health workers, poor or poorly understood health facility practices, inadequate integration of curative and preventative services, inadequate tracking systems to identify children due for vaccination and, less often, limited supply of vaccines, syringes and other related supplies at service points resulted in MOV.ConclusionsThe results of the assessment informed the development of roadmaps for reducing MOV that may be applicable to other settings. The global immunisation community should continue to invest in efforts to reduce MOV and thereby make health service visits more effective and efficient for vaccination.
Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study
Authors: Jessup Rebecca Leigh , Bramston C , Beauchamp A , Gust A , Cvetanovska N , Cao Y , Haywood C , Conilione P , Tacey Mark , Copnell Beverley , Mehdi H , Alnasralah Dialla , Kirk M , Zucchi Emilliano , Campbell D , Trezona A , Haregu T , Oldenburg Brian , Stockman K , Semciw Adam Ivan 
Published: December 2021

ObjectivesThe COVID-19 pandemic has changed the way people are accessing healthcare. The aim of this study was to examine the impact of COVID-19 on emergency department (ED) attendance for frequent attenders and to explore potential reasons for changes in attendance.DesignThis convergent parallel mixed methods study comprised two parts.SettingAn interrupted time-series analysis evaluated changes in ED presentation rates; interviews investigated reasons for changes for frequent ED users in a culturally and linguistically diverse setting.ParticipantsA total of 4868 patients were included in the time series. A subgroup of 200 patients were interviewed, mean age 66 years (range 23–99).ResultsInterrupted time-series analysis from 4868 eligible participants showed an instantaneous decrease in weekly ED presentations by 36% (p<0.001), with reduction between 45% and 67% across emergency triage categories. 32% did not know they could leave home to seek care with differences seen in English versus non-English speakers (p<0.001). 35% reported postponing medical care. There was a high fear about the health system becoming overloaded (mean 4.2 (±2) on 6-point scale). Four key themes emerged influencing health-seeking behaviour: fear and/or avoidance of hospital care; use of telehealth for remote assessment; no fear or avoidance of hospital care; not leaving the house for any reason.ConclusionsThis study demonstrated reduced ED use by a vulnerable population of previously frequent attenders. COVID-19 has resulted in some fear and avoidance of hospitals, but has also offered new opportunity for alternative care through telehealth.
Malnutrition assessment methods in adult patients with tuberculosis: a systematic review
Authors: ter Beek Lies , Bolhuis Mathieu S , Jager-Wittenaar Harriët , Brijan René X D , Sturkenboom Marieke G G , Kerstjens Huib A M , de Lange Wiel C M , Tiberi Simon , van der Werf Tjip S , Alffenaar Jan-Willem C , Akkerman Onno W 
Published: December 2021

ObjectivesMalnutrition is associated with a twofold higher risk of dying in patients with tuberculosis (TB) and considered an important potentially reversible risk factor for failure of TB treatment. The construct of malnutrition has three domains: intake or uptake of nutrition; body composition and physical and cognitive function. The objectives of this systematic review are to identify malnutrition assessment methods, and to quantify how malnutrition assessment methods capture the international consensus definition for malnutrition, in patients with TB.DesignDifferent assessment methods were identified. We determined the extent of capturing of the three domains of malnutrition, that is, intake or uptake of nutrition, body composition and physical and cognitive function.ResultsSeventeen malnutrition assessment methods were identified in 69 included studies. In 53/69 (77%) of studies, body mass index was used as the only malnutrition assessment method. Three out of 69 studies (4%) used a method that captured all three domains of malnutrition.ConclusionsOur study focused on published articles. Implementation of new criteria takes time, which may take longer than the period covered by this review. Most patients with TB are assessed for only one aspect of the conceptual definition of malnutrition. The use of international consensus criteria is recommended to establish uniform diagnostics and treatment of malnutrition.PROSPERO registration numberCRD42019122832.
Association of the patterns of use of medications with mortality of COVID-19 infection: a hospital-based observational study
Authors: Wallace Arthur W , Cirillo Piera M , Ryan James C , Krigbaum Nickilou Y , Badathala Anusha , Cohn Barbara A 
Published: December 2021

ObjectivesSARS-CoV-2 enters cells using the ACE2 receptor. Medications that affect ACE2 expression or function such as angiotensin receptor blockers (ARBs) and ACE inhibitors (ACE-I) and metformin have the potential to counter the dysregulation of ACE2 by the virus and protect against viral injury. Here, we describe COVID-19 survival associated with ACE-I, ARB and metformin use.DesignThis is a hospital-based observational study of patients with COVID-19 infection using logistic regression with correction for pre-existing conditions and propensity score weighted Cox proportional hazards models to estimate associations between medication use and mortality.SettingMedical record data from the US Veterans Affairs (VA) were used to identify patients with a reverse transcription PCR diagnosis of COVID-19 infection, to classify patterns of ACE inhibitors (ACE-I), ARB, beta blockers, metformin, famotidine and remdesivir use, and, to capture mortality.Participants9532 hospitalised patients with COVID-19 infection followed for 60 days were analysed.Outcome measureDeath from any cause within 60 days of COVID-19 diagnosis was examined.ResultsDiscontinuation of ACE-I was associated with increased risk of death (OR: 1.4; 95% CI 1.2–1.7). Initiating (OR: 0.3; 95% CI 0.2–0.5) or continuous (OR: 0.6; 95% CI 0.5–0.7) ACE-I was associated with reduced risk of death. ARB and metformin associations were similar in direction and magnitude and also statistically significant. Results were unchanged when accounting for pre-existing morbidity and propensity score adjustment.ConclusionsRecent randomised clinical trials support the safety of continuing ACE-I and ARB treatment in patients with COVID-19 where indicated. Our study extends these findings to suggest a possible COVID-19 survival benefit for continuing or initiating ACE-I, ARB and metformin medications. Randomised trials are appropriate to confirm or refute the therapeutic potential for ACE-I, ARBs and metformin.
Cost-effectiveness of paediatric surgery: an economic evaluation of World Paediatric Project surgical interventions in St. Vincent and the Grenadines (2002–2019)
Authors: Dolan Carrie B , Agyemang Samuel A , Clare Brian , Coleman Charles , Richter Bill , Robertson Emily , Nonvignon Justice 
Published: December 2021

ObjectivesThe purpose of this study is to examine the cost-effectiveness of six types of surgical interventions as part of a sustained paediatric surgical programme in St.Vincent and the Grenadines from 2002 to 2019.DesignIn this economic model, six paediatric surgical interventions (ophthalmic, orthopaedic, plastic, general, urology, neurosurgery) were compared with no surgery in a deterministic cost-effectiveness model. We assessed health benefits as averted disability-adjusted life-years (DALYs). Costs were included from the programme perspective and measured using standard micro-costing methods. Incremental cost-effectiveness ratios (ICERs) were calculated for each type of surgical intervention. Interventions with ICERs of <50% of gross domestic product (GDP) per capita were considered cost-effective. Costs are reported in 2019 US$. Univariate sensitivity analyses were conducted to assess the effect of uncertainty.ResultsThe average cost per procedure was US$16 685 (range: US$9791.78–US$72 845.76). The cumulative discounted 18-year health impact was 5815 DALYs averted with a cost per DALY averted of US$2622. Most paediatric surgical interventions were cost-effective, yielding cost per DALY estimates less than 50% of GDP per capita of St. Vincent and the Grenadines. When undiscounted, only orthopaedic surgeries had cost per DALY more than 50% GDP per capita. When considering discounting, orthopaedic and urology surgeries exceeded the adopted threshold for cost-effectiveness.ConclusionsWe found that short-term, recurrent surgical interventions could yield substantial economic benefits in this limited resource setting. This research indicates that investment in paediatric surgical interventions is cost-effective for the majority of specialties. These findings are of clinical significance given the large burden of disease attributable to surgically treatable diseases. This work demonstrates that scaling up dedicated surgical programmes for children is a cost-effective and essential component to improve paediatric health.