Potential Influencing Factors Research Articles

Urinary neonicotinoid insecticides in children from South China: Concentrations, profiles and influencing factors

Neonicotinoid insecticides can selectively interact with the unique nicotinic acetylcholine receptor subtypes in insects and are considered to be low toxic to mammals. However, there is still insufficient knowledge on human exposure to neonicotinoid insecticides, especially for children. This study aimed to investigate urinary concentrations and profiles of neonicotinoid insecticides in South China children and to analyze potential influencing factors. Six neonicotinoid insecticides, including imidacloprid (IMI), thiamethoxam (THM), acetamiprid (ACE), clothianidin (CLO), thiacloprid (THD) and dinotefuran (DIN), exhibited high detection frequencies (>90%) in urine samples collected from 305 children, suggesting broad exposure in South China children. The median concentrations were determined to be 0.13, 0.21, 0.01, 0.19, 0.002 and 1.64 μg/L, respectively. Among the target neonicotinoids, urinary concentrations of CLO and THM exhibited a significant and positive correlation between each other (p < 0.05), suggesting similar sources of these two chemicals.

Ixazomib Based Maintenance Therapy for the Patients with Newly Diagnosed Multiple Myeloma in Real-World Practice

BackgroundThe Phase III TOURMALINE-MM4 Trial demonstrated that the oral proteasome inhibitor, Ixazomib maintenance significantly improved progression-free survival (PFS) in patients with newly diagnosed multiple myeloma (NDMM) not undergoing ASCT. However, patient recruitment for clinical trials is highly selective so the extent to which study populations represent real-world patients is unclear. Currently, data validating the use of ixazomib maintenance in clinical practice in Chinese landscape is scarce.Methodswe conducted a retrospective, observational study of NDMM patients meeting International Myeloma Working Group (IMWG) criteria, who received ixazomib-based maintenance therapy. Data was collected from 26 medical centers in southern China. Enrollment was stratified by risk stage, transplant status and maintenance regimens. The characteristics, toxicities and survival outcomes were recorded.ResultsWe included 105 NDMM patients who received ixazomib-based maintenance treatment. Mean age at diagnosis was 59.82 ± 9.80 years, with 62.9% male patients. MM International Staging System (ISS), stage 3 was the most common with 49.04% of patients; 62.86% had an Eastern Cooperative Oncology Group performance score ≥2, and 81.9% with concomitant diseases. By the end of over 70 months follow-up since initial diagnosis, median PFS was 69.45 (95%CI: 31.42-107.48) months, and median OS was not achieved yet. We explored potential influencing factors of progression at the post-maintenance evaluation with a crude model using logistic regression. Difference in PFS was not statistically significant by status at pre-maintenance response, transplantation, maintenance therapy regimens (single/two/three-agent) and dexamethasone in maintenance regimens (p >0.05). Eight patients (7.62%) had grade≥3 treatment-emergent adverse events (TEAEs); 5.7% discontinued treatment because of TEAEs. Common any-grade TEAEs included fatigue (18.1%), diarrhea (16.19%), and peripheral neuropathy (11.43%).ConclusionAlthough there are certain differences in maintenance treatment options for newly diagnosed multiple myeloma patients in real-world practice, the results of our retrospective study support that the ixazomib-based maintenance therapy was effective with acceptable toxicity and single-agent ixazomib maintenance provided enough clinical benefit compared to two or three agents.Keywords: multiple myeloma, ixazomib, maintenance therapy, real-world practice [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Drought propagation modification after the construction of the Three Gorges Dam in the Yangtze River Basin

The construction of Three Gorges Dam (TGD) has exerted substantial effects on local hydrological regime and eco-system since its operation in 2003. Due to this significant anthropogenic activity, drought propagation processes from Meteorological drought to Hydrological (M-H) and Soil moisture (M-S) drought are inevitably modified. However, current studies are still insufficient to answer whether the TGD operation mitigated or exacerbated the drought propagation process due to its complex impacts. To explore this key issue, this study proposed an integrated framework to quantify the impact of TGD construction on drought propagation process in the Yangtze River Basin (YRB). The drought characteristics propagation models and propagation time were calculated to identify the modification of drought propagation process between different TGD operation scenarios. Trend and attribution analyses were also utilized to explore potential influence factors. Results demonstrated that TGD construction did significantly aggravate the drought characteristics propagation. Specifically, the slopes of hydrological drought duration and severity in linear propagation models increased 23.98% and 29.23% in average. While for M-S propagation, the slopes of duration and severity models increased 28.72% and 21.91%, respectively. This research also found that, after TGD operation, the M-H propagation speed had been slowed down but the M-S lag time became shorter. Additionally, the variations and trend patterns of six potential influence factors at four separate periods were full analyzed to provide implications for the drought propagation modifications. And TGD operation was confirmed to become a major factor inducing the variations of annual runoff, which accounted for 56.75% for the entire YRB. The above quantitative findings are expected to reveal the potential changes of drought propagation process caused by the construction of TGD in YRB. The proposed integrated framework is also beneficial to the drought early warning system and understanding of drought development not only in YRB, but also in other basins at the global scale.

Chemoembolization Plus Microwave Ablation vs Chemoembolization Alone in Unresectable Hepatocellular Carcinoma Beyond the Milan Criteria: A Propensity Scoring Matching Study.

PurposeTransarterial chemoembolization (TACE) is recommended in patients with unresectable HCC beyond the Milan criteria (MC). However, the long-term efficacy of TACE remains unsatisfactory. Percutaneous microwave ablation (MWA) is a curative therapy for early-stage HCC that provides better local tumor control than TACE; however, MWA is limited for large or multifocal lesions. We aimed to compare treatment efficacy and downstaging rate following combined TACE-MWA and TACE alone in patients with unresectable HCC beyond the MC.Patients and MethodsPatients with unresectable HCC beyond the MC who underwent either TACE-MWA (n=91) or TACE alone (n=140) at four medical institutions were included. Potential influencing factors on overall survival (OS) and progression-free survival (PFS) were included in the Cox regression analysis. Propensity-score matching of patients treated with TACE-MWA and TACE alone was performed. Differences in OS and PFS were compared with the Log rank test. Patients who met the University of California, San Francisco criteria were eligible for assessment of the probability of downstaging within the MC. Downstaging rate was compared between the two groups.ResultsIn multivariate analysis, treatment with TACE alone was an independent predictor of poor PFS (P=0.011) and OS (P<0.001). Both PFS (P=0.043) and OS (P=0.002) were significantly higher in patients treated with TACE-MWA than those treated with TACE alone. The downstaging rate was higher in patients treated with TACE-MWA than those treated with TACE alone (P=0.039).ConclusionCompared with TACE alone, TACE-MWA may offer a survival benefit in terms of OS and PFS in HCC patients beyond the MC. Additionally, TACE-MWA may provide higher probability of downstaging within the MC than TACE alone, thereby increasing the possibility of liver transplantation.

Prevalence and associated factors of anxiety among 538,500 Chinese students during the outbreak of COVID-19: A web-based cross-sectional study

This study was conducted on elementary school students in Henan Province, China, from February 4th to 11th, 2020, during the coronavirus disease 2019 (COVID-19) epidemic. The purpose of the study was to examine the prevalence of anxiety among students and identify the related risk factors contributing to anxiety. Demographic information and psychological status were assessed by using self-reported measures. The generalized anxiety disorder tool (GAD-7) and a multiple logistic regression model were used to assess anxiety and identify potential influencing factors. Cross-sectional data indicated that the overall anxiety prevalence was 13.4%. The prevalence of anxiety symptoms was highest among rural primary school students and lowest among city students. Three groups of students in different regions were surveyed, and the prevalence of anxiety symptoms was significantly higher among students with poor knowledge of COVID-19 than among students with good knowledge of COVID-19. After adjusting for potential confounding factors, it was found that location, knowledge, and practice were related to anxiety. This study showed that the prevalence of anxiety symptoms was higher among Chinese primary school students. The influencing factors found in this study may help relevant staff improve the mental health of children during the epidemic.

Global burden and attributable risk factors of acute lymphoblastic leukemia in 204 countries and territories in 1990-2019: Estimation based on Global Burden of Disease Study 2019.

To provide a foundational guideline for policy-makers to efficiently allocate medical resources in the context of population aging and growth, the latest spatial distribution and temporal trend of acute lymphoblastic leukemia (ALL) along with attributable risk factors by sex and age were mapped. Based on the Global Burden of Disease Study 2019, estimated annual percentage change (EAPC) was calculated according to the relativity between age-standardized rate and calendar year, to quantify temporal trends in morbidity and mortality of ALL. We used applied Spearman rank correlation to estimate the relationship between the EAPC and potential influence factors. The population attributable fraction of potential risk factors for ALL-related disability-adjusted life years were estimated by the comparative risk assessment framework. As a result, we found that new ALL cases increased significantly by 1.29% worldwide, and the age-standardized incidence rate increased by 1.61% annually. The proportion of elder patients sharply increased, especially within the higher socio-demographic index (SDI) region. Smoking and high body mass index remained the predominant risk factors for ALL-related mortality. Notably, the contribution of high body mass index presented an increasing trend. In conclusion, the global burden of ALL has steadily increased, especially in Middle SDI region. Health measures and new drugs should be taken into consideration to improve the management and treatment of elders with ALL due to an increasing proportion in the higher SDI region. For Low SDI areas, attention should be paid to the environmental problems caused by industrial development.

The Role of Predictability During Negation Processing in Truth-Value Judgment Tasks

In experiments investigating the processing of true and false negative sentences, it is often reported that polarity interacts with truth-value, in the sense that true sentences lead to faster reaction times than false sentences in affirmative conditions whereas the same does not hold for negative sentences. Various reasons for this difference between affirmative and negative sentences have been discussed in the literature (e.g., lexical associations, predictability, ease of comparing sentence and world). In the present study, we excluded lexical associations as a potential influencing factor. Participants saw artificial visual worlds (e.g., a white square and a black circle) and corresponding sentences (i.e., “The square/circle is (not) white”). The results showed a clear effect of truth-value for affirmative sentences (true faster than false) but not for negative sentences. This result implies that the well-known truth-value-by-polarity interaction cannot solely be due to long-term lexical associations. Additional predictability manipulations allowed us to also rule out an explanatory account that attributes the missing truth-value effect for negative sentences to low predictability. We also discuss the viability of an informativeness account.

Application of OXITEST for Prediction of Shelf-Lives of Selected Cold-Pressed Oils

Introduction: Due to the enhanced awareness of consumers concerning healthy foods, homemade expeller-pressed oils have become popular worldwide. However, an extended storage period may lead to oxidization of the oil and exposure to hazardous byproducts by consumers.Methods: In this study, 10 pressed oil samples prepared from common oilseeds using a small-scale expeller oil press were analyzed by OXITEST with a sample amount of 5 g of oil and an oxygen pressure of 800 kPa under accelerated conditions for shelf-life projections. The oil properties were investigated, including the recovery, smoke point, acid value, iodine value, “fatty acid composition, and contents of pigments and tocopherols”.Results: The autoxidation reaction of various expeller-pressed oils under an accelerated testing system followed zero-order Arrhenius kinetics (R2 > 0.99). Shelf-lives of the pressed oils at 25°C were estimated by extrapolation to range 105~1,089 days. The obtained shelf-lives were significantly correlated with log induction period (IP) values (r > 0.81, p < 0.05) and unsaturated fatty acids (UFAs) (r < −0.69, p < 0.05), but not with the iodine value, acid value, or smoke point. Scatter diagrams between shelf-lives and UFAs suggested that these pressed oils could be grouped by two linear regression curves (r > 0.98, p < 0.05). The predictive equations using multiple linear regression are presented herein, with predictor variables of UFAs and an unspecified item involving potential influencing factors such as tocopherol contents (r > 0.88, p < 0.05).Conclusions: Our findings first revealed that the UFA portion was partially correlated with the shelf-lives of selected expeller-pressed seed oils as estimated by the OXITEST. The derived equations can be applied for shelf-life predictions of expeller-pressed oils stored under dark ambient conditions based on the fatty acid profile.

Assessing Income-Related Inequality on Health Service Utilization among Chinese Rural Migrant Workers with New Co-Operative Medical Scheme: A Multilevel Approach.

Background: Eliminating inequality in health service utilization is an explicit goal of China’s health system. Rural migrant workers with New Rural Cooperative Medical Insurance (NCMS) still face the dilemma of limited health service; however, there is a lack of analysis or measurement on the income-related inequality of health service utilization. Method: The nationally representative data of the China Labor-Force Dynamic Survey in 2016 were used for analysis. Multilevel regressions were used to obtain robust estimates and to account for various covariates associated with health service utilization of rural migrant workers with NCMS. The concentration index and its decomposition method were applied to quantify the income-related inequality of health service utilization of rural migrant workers. Result: The multilevel model analysis indicated that influencing factors of health service utilization were diversified, including gender, city service quality index, type of industry, the per capita annual income, marital status, health self-assessment, the community health index and the number of friends. The concentration indices of the total cost of inpatient and OOP cost of inpatient were 0.102 (95%CI: 0.031, 0.149), and the CI of OOP cost of inpatient was 0.094 (95%CI: 0.007, 0.119), respectively. The horizontal inequality indices of the total cost of inpatient and OOP cost of inpatient were 0.051 and 0.009, respectively. Conclusion: Our study presented a unique opportunity to examine the potential influence factors of health service utilization of rural migrant workers with NCMS, and highlighted that unequal health service utilization is evident among rural migrant workers with NCMS. This study provides important corroborative evidence to take full account of the contribution of each determinant to the inequality and health service needs among rural migrant workers with NCMS, in order to improve the basic medical insurance and social security systems—particularly for some marginal groups in China.

Assessing assistive devices for manipulation: Design universality and users' perception

Although alienation toward parents is important for children (for current mental health status or later interpersonal relationships in adulthood), it is undervalued and even lacks a standardized tool of assessment. Moreover, the large number of left-behind children in China is a cause of public concern. However, their experienced alienation toward their parents remains unclear, which may be important for early detection or intervention for behavioral problems in this population. Hence, the current study aimed to develop an alienation inventory for children and then use it to investigate the experienced alienation toward parents in Chinese left-behind children.Two studies were carried out. Study 1 was designed to develop a standard inventory of alienation toward parents (IAP). In study 2, 8361 children and adolescents (6704 of them were left-behind status) of the Chongqing area, aged between 8 and 19 years old, were recruited for investigation. All participants were surveyed with a standard sociodemographic questionnaire, children's cognitive style questionnaire, children's depression inventory, adolescent self-rating life events checklist, and newly built IAP in study 1.In study 1, we developed a two-component (communication and emotional distance) and 18-item (9 items for maternal or paternal form, respectively) IAP questionnaire. In study 2, exploratory factor analysis indicated an expected two-factor structure of IAP, which was confirmed by confirmatory factor analysis. The Cronbach's alpha coefficients showed a good reliability (0.887 and 0.821 for maternal and paternal form, respectively). Children with absent mother experienced the highest alienation toward parents. Boys as well as children aged 8–10 years old experienced higher alienation toward parents. Poor communication with parents (sparse or no connection), level of left-behind condition (parents divorced, been far away from parents), and psychosocial vulnerability (stressful life events, negative cognitive style) were risk factors of alienation toward parents.The current study develops a two-factor (communication and emotional distance) IAP, which offers a reliable tool to assess experienced alienation of affection toward parents in children aged between 8 and 19 years old. Our result is the first investigation of experienced alienation and potential influential factors in Chinese left-behind children. The findings that children with absent mother experience higher alienation toward parents, as well as three recognized risk factors for alienation of affection toward parents (poor communication with absent parents, worse left-behind condition, and psychosocial vulnerability), give valuable guidance for parents who intend to leave or who are already leaving as well as for government policymaking.

Interleukin-6 versus Common Inflammatory Biomarkers for Diagnosing Fracture-Related Infection: Utility and Potential Influencing Factors.

Currently, the utility of white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), for diagnosis of fracture-related infection (FRI), is still controversial, and potential efficiency of interleukin-6 (IL-6) as a novel cytokine in assisted diagnosis of FRI remains unclear. This study is aimed at investigating the utility and potential influencing factors of IL-6 and the common biomarkers for diagnosing FRI. Preoperative serological levels of IL-6 and the three biomarkers were compared between 407 FRI patients and 195 fracture-healed (FH) patients. Diagnostic efficiency of the indicators was evaluated using the areas under the receiver operating characteristic (ROC) curves, and their potential influencing factors were also analyzed. Outcomes showed that the median levels of all of the four biomarkers were significantly higher among the FRI patients than those among the FH patients (P < 0.01). The areas below the ROC curves of ESR, CRP, and IL-6 were 76.5%, 76.4%, and 71.8%, respectively, with WBC of only 56.9%. Compared with ESR and CRP, IL-6 displayed a lower sensitivity (ESR vs. CRP vs. IL − 6 = 72.7% vs. 65.6% vs. 57.5%) but a higher specificity (ESR vs. CRP vs. IL − 6 = 70.3% vs. 75.4% vs. 83.6%). Serological IL-6 level was influenced by pathogen culture result and pathogen number; nonetheless, bacteria type appeared to have no influence on the levels of the four biomarkers. In short, this study displayed similar value of IL-6 with that of ESR and CRP in assisted diagnosis of FRI. Whether IL-6 can be regarded as a promising diagnostic indicator requires more studies.

Installation of caisson in non-uniform clay interbedded with a sand layer

Accurately predict the resistance of caisson penetrating in stratified soil deposits is an engineering challenge for application of such foundation system. This paper performs large deformation finite element analysis to investigate the penetration behavior of caisson foundations in non-uniform clay interbedded with a sand layer. The numerical model is validated by comparing with previously testing data, in which good agreement is obtained. Parametric study is then conducted to examine potential influencing factors, including the penetration depth, the top clay layer thickness, clay properties, and the thickness of the second sand layer. It is found that the soil failure mechanism and corresponding penetration resistance of caisson foundations in clay-sand-clay are significantly different from that in pure clay or sand soil deposits, especially for the part in the middle sand layer, where the peak resistance could be overestimated by 10–40% using the current design codes without considering the influence of the weak underlying layer. In this study, based on intensive numerical modeling results, approximating expressions are proposed to describe the unique trends of the resistance profile for caisson penetration in non-uniform clay interbedded with a sand layer soil deposit, which can provide design guide for engineering application.

Kinetics of anti-SARS-CoV-2 IgG antibody levels and potential influential factors in subjects with COVID-19: A 11-month follow-up study

We aim to study kinetics of anti-SARS-CoV-2 IgG antibody levels in subjects with COVID-19 for up to 11 months and the potential influential factors. The study was a prospective longitudinal study. The analyses were based on 77 serum/plasma samples with a mean of 4 samples per participant (range 1 – 18) in 20 participants with at least one positive Polymerase Chain Reaction testing result from 19 March 2020 up to 10 February 2021. Among the subjects (median age 34.5 years, 65% male), IgG level declined with the follow-up time (per month; geometric mean ratio [GMR] 0.73; 95% CI, 0.72 – 0.74). In a small sample of subjects from the general population with COVID-19, IgG levels declined non-linearly from month 2 to 11 with individual heterogeneity in quantity and changing speed and may be associated with gender, race and the loss of smell and taste.

Microbial community coalescence: does it matter in the Three Gorges Reservoir?

The microbial community coalescence describes the mixing of microbial communities and the merging of their surrounding environments. Despite its prevalence in natural ecosystems and its potential influence on ecological processes, little research focused on the extent of coalescence between aquatic microbial communities. In this research, we analyzed the microbial communities in the Three Gorges Reservoir, a typical deep-water reservoir on the Yangtze River. The biogeography and the coalescence of microbial communities in water and sediment were illustrated and analyzed based on 16S rRNA gene amplicon sequence variants (ASVs). Differences in composition and diversity were identified between microbial communities in water and sediment, and microbial communities in sediment were more diverse than those in water. Between adjacent communities, by calculating the proportion of overlapped taxa, adopting the SourceTracker algorithm, and quantifying the connectivity of microbial cohesion, we found that the extent of intra-medium coalescence was strong (19.8%) and inter-media coalescence was faint (0.2%). 50 keystone species were selected using the cohesion metric. They displayed a stronger coalescence extent than average, and formed an accumulating pattern from upstream to downstream in the Three Gorges Reservoir, exhibiting their importance in the ecological network. Potential influencing factors of microbial community coalescence in aquatic environments were discussed, including environmental conditions, types of habitats, suspended particles in water, and microscale microbial activities. To summarize, this research depicted the coalescence of microbial communities in a deep-water reservoir and emphasized its ecological importance. We anticipate more attention and further research on the processes of microbial coalescence in the aquatic environment, which might provide new insights into turnover of microbial keystone species and changes in aquatic ecological conditions.

Clinical Outcomes of Implant-Supported Dental Prostheses: A Retrospective Analysis Considering Patient-Related Factors.

To investigate the clinical performance of implant-supported dental prostheses (ISDPs), this retrospective clinical study observed influencing factors on survival of the prostheses and necessary maintenance treatments during the observation time and complications of the dental implants. Patients who were provided either with fixed implant-supported dental prostheses (FISDPs) or telescopic-retained removable implant-supported dental prostheses (TR-RISDPs) were included in this retrospective clinical study. Potential influencing factors on the survival probability of the prostheses were observed using Kaplan-Meier analysis: patient sex, type of prosthesis, location, dentition in opposing arch, participation in follow-up visits, and whether the patient had a previous history of oral cancer. The type and number of maintenance treatments and complications of dental implants were also analyzed. A collective of 473 patients who were provided with either FISDPs (n = 320) or TR-RISDPs (n = 153) and 1,499 implants were included in the study. 6.6% of the prostheses (24 FISDPs and 7 TR-RISDPs) had to be replaced, and 6.3% of the implants (n = 45) were lost. The calculated 5-year survival probabilities were 87.4% for FISDPs and 95.5% for TR-RISDPs. FISDPs in patients who also had ISDPs in the opposing arch showed the lowest survival probabilities (P < .05). TR-RISDPs in patients who regularly attended follow-up visits showed the highest survival rates (P < .05). Maintenance treatments had to be performed at an earlier stage for patients with TR-RISDPs, and especially for TR-RISDPs located in the mandible (P < .05). FISDPs and TR-RISDPs showed good survival rates in this study. However, when planning FISDPs, the dentition in the opposing arch should be considered to prevent possible failure. TR-RISDPs indicate a higher need for aftercare measures, especially in the early years of function. Regular attendance of follow-up visits is still a decisive factor for success.

Pancreatic Safety of Once-Weekly Dulaglutide in Chinese Patients with Type 2 Diabetes Mellitus: Subgroup Analysis by Potential Influencing Factors.

IntroductionIn the randomized, open-label, parallel-arm, active-controlled phase III AWARD-CHN2 trial, once-weekly dulaglutide plus concomitant oral antihyperglycemic medications (OAMs) improved HbA1c over 26 weeks compared with once-daily insulin glargine in patients with type 2 diabetes mellitus (T2DM). This post-hoc subgroup analysis of AWARD-CHN2 investigated the pancreatic safety of dulaglutide in Chinese patients with T2DM, stratified by potential influencing factors.MethodsChanges in pancreatic enzyme (pancreatic amylase, total amylase, and lipase) levels over 26 weeks were assessed and stratified by patient age (< 60, ≥ 60 years), sex (female, male), duration of diabetes (< 10, ≥ 10 years), baseline weight (< 70, ≥ 70 kg), BMI (< 25, ≥ 25 kg/m2), HbA1c (< 8.5, ≥ 8.5%), triglycerides (< 2.3, ≥ 2.3 mmol/L), and concomitant OAMs (metformin, sulfonylurea, metformin plus sulfonylurea).ResultsA total of 203 Chinese patients with T2DM were included in this post-hoc analysis. Pancreatic enzyme levels increased within the normal range from baseline to Week 26, and no pancreatitis events were confirmed by independent adjudication. Least-squares mean increase in pancreatic amylase (U/L) from baseline to Week 26 was comparable across all subgroups with no statistically (all P-values > 0.05) or clinically significant between-group differences for age (< 60 years: 5.34; ≥ 60 years: 6.71), sex (female: 5.85; male: 5.66), duration of diabetes (< 10 years: 6.15; ≥ 10 years: 4.85), weight (< 70 kg: 6.19; ≥ 70 kg: 5.39), BMI (< 25 kg/m2: 5.92; ≥ 25 kg/m2: 5.61), HbA1c (< 8.5%: 6.82; ≥ 8.5%: 4.08), triglycerides (< 2.3 mmol/L: 4.94; ≥ 2.3 mmol/L: 8.04), and concomitant OAMs (metformin: 5.68; sulfonylurea: 5.44; metformin plus sulfonylurea: 5.87). Similar results were observed for total amylase and lipase.ConclusionIn Chinese patients with T2DM receiving dulaglutide 1.5 mg in AWARD-CHN2, elevations of pancreatic enzymes over 26 weeks were within the normal range and were neither associated with pancreatitis nor baseline factors, which suggests the clinical use of dulaglutide in Chinese patients with T2DM is not associated with pancreatic safety issues.Clinical Trial registrationNCT01648582.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-021-01139-2.

State and trait of finger tapping performance in multiple sclerosis

Finger tapping tests have been shown feasible to assess motor performance in multiple sclerosis (MS) and were observed to be strongly associated with the estimated clinical severity of the disease. Therefore, tapping tests could be an adequate tool to assess disease status in MS. In this study we examined potential influencing factors on a maximum tapping task with the whole upper-limb for 10 s in 40 MS patients using linear mixed effects modelling. Patients were tested in three sessions with two trials per body-side per session over the course of 4–27 days of inpatient rehabilitation. Tested factors were the expanded disability scale (EDSS) score, laterality of MS, age, sex, hand dominance, time of day, session, trial (first or second), time between sessions, and the reported day form. A second model used these factors to examine the self-reported day form of patients. Linear mixed effects modelling indicated the tapping test to have a good inter-trial (proportional variance < 0.01) and inter-session reliability (non-significant; when controlling for time between sessions), an influence of hand-dominance (proportional variance 0.08), to be strongly associated with the EDSS (eta2 = 0.22, interaction with laterality of MS eta2 = 0.12) and to be not associated with the reported day form. The model explained 87% (p < 0.01) of variance in tapping performance. Lastly, we were able to observe a positive effect of neurologic inpatient rehabilitation on task performance obvious from a significant effect of the time between sessions (eta2 = 0.007; longer time spans between sessions were associated with higher increments in performance). Day form was only impacted by EDSS and the time of the day (p < 0.01, R2 = 0.57, eta2TIME = 0.017, eta2EDSS = 01.19). We conclude that the tapping test is a reliable and valid assessment tool for MS.

Local management or wider context: What determines the value of farm revegetation plantings for birds?

AbstractSmall‐scale revegetation plantings on farms are common to restoration efforts in agricultural regions worldwide. Such plantings provide habitat for diverse faunal groups. A key question concerns the degree to which their value for biodiversity is influenced by the features of individual plantings, which can be controlled by local land managers, or by broader‐scale drivers in the wider landscape.We developed a conceptual model of factors of potential influence on birds in revegetation plantings at different spatial scales. To test this model, we surveyed native birds in 133 plantings in south‐eastern Australia. Regression models were used to compare the effect of ‘habitat‐’, ‘patch‐’, ‘farm‐’ and ‘landscape‐’ scale variables on species richness (of woodland and open country birds) and the occurrence of individual species in plantings. We further tested whether the influence of variables representing local actions was swamped by larger‐scale variables.Birds that occupied plantings were influenced by variables at all scales. Woodland birds were consistently richer and more likely to use older plantings (patch scale) with higher floristic richness (habitat scale), and surrounded by more wooded vegetation (at patch, farm and landscape scales). Open country species responded positively to the density of live trees (habitat scale) and the presence of large remnant tree/s (patch scale) in plantings.Variables representing local management actions generally maintained a strong influence on birds in plantingsirrespectiveof the influence of broader drivers. Few relationships between bird species and planting attributes were contingent on features of the surrounding landscape; those that were suggested woodland birds aremore responsiveto local actions when broad‐scale vegetation cover is greater.Synthesis and applications. Land managers can enhance the conservation value of plantings by (a) planting a greater diversity of trees and shrubs and (b) locating revegetation near other vegetation or around mature remnant tree/s. These actions will measurably increase the value of plantings for birds, irrespective of larger‐scale drivers. Nonetheless, the important role of increased vegetation cover across broader agricultural landscapes emphasises that the collective efforts of individuals and larger initiatives are critical for conservation.

Diurnal Cortisol Rhythm in Female Flight Attendants.

The work of flight attendants is associated with exposure to long-term stress, which may cause increased secretion of cortisol. The aim of the study is to determine the circadian rhythm of cortisol and to seek factors of potential influence on the secretion of cortisol in female flight attendants working within one time zone as well as on long-distance flights. The prospective study covers 103 women aged 23–46. The study group (I) was divided into two subgroups: group Ia, comprising female flight attendants flying within one flight zone, and group Ib, comprising female flight attendants working on long-distance flights. The control group (II) are women of reproductive age who sought medical assistance due to marital infertility in whom the male factor was found to be responsible for problems with conception in the course of the diagnostic process. The assessment included: age, BMI, menstrual cycle regularity, the length of service, the frequency of flying, diurnal profile of the secretion of cortisol, testosterone, estradiol, 17-OH progesterone, SHBG, androstenedione, and progesterone concentration. Descriptive methods and inferential statistics methods were used to compile the data. Comparing the profile of flight attendants from groups Ia and Ib shows that the curve flattened among women flying within one time zone. The secretion curve is also more flattened in women with less years worked and in flight attendants working less than 60 h per month. Due to the character of work, the female flights attendants do not have hypersecretion of cortisol. Frequency of flying and length of work affect the dysregulation of HPA axis.

Impact of large choroidal vessels on choriocapillaris flow deficit analyses in optical coherence tomography angiography.

PurposeTo investigate the impact of large choroidal vessels (LCV) on Choriocapillaris (CC) flow deficit (FD) analyses with swept-source optical coherence tomography angiography (SS-OCTA)DesignProspective, cross-sectional study.MethodsMacular 6x6mm SS-OCTA scans were obtained from intermediate age-related macular degeneration (iAMD) and healthy eyes. Images were captured and processed according to most common standards and analyzed for percentage of flow-deficits (FD%) within four 1x1mm squares at the corners of each image. Choroidal thickness (CT), iris color and refraction error were considered as potential influential factors for LCV visibility. A linear mixed model and logistic regression models were calculated for statistical evaluation.ResultsSixty-nine iAMD and 49 age-matched healthy eyes were enrolled. LCV were visible in at least one sector in 52% of iAMD and 47% of healthy eyes. Within the iAMD group FD% were significantly lower in areas containing LCV (p = 0.0029). Increasing CT resulted in an odds ratio decrease of LCV (OR: 0.94, p<0.0001). Below a CT value of ≤118μm LCV could be expected with a sensitivity of 86% and a specificity of 85%.ConclusionsLCV can significantly affect CC FD analyses of SS-OCTA images. Their visibility is negatively associated with CT. The impact of LCV should be taken into account when performing CC FD assessments, especially in patients where reduced CT is to be expected and inclusion of affected areas should be considered carefully.