Quantitative Summary Research Articles

PO-02-235 MOVING BEYOND QRS DURATION: QRS VOLTAGE-TIME-INTEGRAL (AREA) IS A SUPERIOR PREDICTOR OF CLINICAL RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY

Cardiac resynchronization therapy (CRT) can alleviate left ventricular (LV) electrical dyssynchrony mediated systolic heart failure (HF). 15% reduction in LV end systolic volume (LVESV) with CRT is a validated surrogate of improved clinical outcomes. Prolonged baseline QRS duration (QRSd) is the only conventional quantitative ECG criteria to assess left ventricular electrical dyssynchrony. In addition to QRS duration, we evaluated the baseline QRS voltage-time-integral (VTI) and its reduction after CRT as predictors of LV reverse remodeling. We included 595 patients (68.1±11.5 yr., 32.6% women, 43.9% ischemic cardiomyopathy) who underwent CRT-defibrillator implant for clinical indications 2012-2019 and analyzed their ECGs before and after CRT. Orthogonal X, Y, Z leads were reconstructed from 12-lead ECG using Kors’s matrix. VTIQRS-X, Y ,Z and VTIQRS-3D were obtained from integration over the duration of QRS in X, Y, Z, and root-mean-squared (3D) ECGs respectively. We reviewed echocardiogram reports to obtain LV measures before and 3-12 months after CRT, including ejection fraction (LVEF), internal dimensions in diastole (LVIDd) and systole (LVIDs), end-diastolic (LVEDV) and LVESV. We used linear regression models to evaluate ECG variables as predictors of change in LV measures. We further used unadjusted and multivariable-adjusted logistic regression models to predict ≥15% reduction in LVESV from ECG variables. Baseline LVEF was 25.8±8.3%, LVIDd 5.7±0.9 cm, LVIDs 4.8±0.9 cm, LVEDV 164±67 and LVESV 109±56 mL. QRSd reduced from 153±26 to 137±22 ms with CRT. VTIQRS-3D and VTIQRS-Z of 104±49 and 75±44 respectively improved to 67±34 and 33±24 μVs. Baseline and change in VTIQRS-Z and VTIQRS-3D were more significantly associated with change in echo variables as compared to baseline and change in QRSd (Table 1). ≥15% reduction in LVESV was independently predicted by baseline VTIQRS-Z ≥71 μVs (OR 2.0, 95% CI 1.3-3.0, p=0.0009) and Δ VTIQRS-Z ≥42 μVs (OR 2.1, 1.4-3.1, p=0.004). In patients undergoing CRT, baseline QRS VTI from Z (anteroposterior) axis ECG ≥71 μVs independently predicted 2 times higher odds of salutary reverse LV remodeling post CRT. Further, a reduction in VTIQRS-Z ≥42 μVs also predicted more than 2 times odds of revrse remodeling. VTIQRS-Z is a superior automatically calculable quantitative summary ECG marker for CRT patient selection and prognostication as compared to QRS duration.

Effectiveness of Self-management eHealth Intervention for Psychological Adjustment for Health-Related Quality of Life in Cancer Survivors: A Systematic Review

eHealth interventions support psychological adjustment to life-threatening crises such as cancer survival and improving health-related quality of life. This review synthesizes existing knowledge on the effectiveness of self-management eHealth interventions and summarizes the best evidence on psychological adjustment for health-related quality of life among cancer survivors. Five electronic databases were searched for articles reporting self-management eHealth interventions for the psychological adjustment of cancer survivors from February 2011 to March 2022. Articles were included if they were published in English or Thai journals; peer-reviewed; evaluated self-management through technology to support psychological adjustment for quality of life; and concerned adult cancer survivors. Data were extracted from all included articles using online data imported into the Joanna Briggs Institute SUMARI program to increase the consistency of data extraction, with a quantitative summary and analysis by two reviewers.Eight articles met the inclusion criteria, integrating self-management eHealth interventions and demonstrating a statistically significant improvement of psychological adjustment for the participants’ health-related quality of life. This review identified that self-management eHealth interventions might assist with the development of mechanisms/strategies which may effectively support cancer survivors’ psychological adjustment for their health-related quality of life. However, supportive cancer care via eHealth interventions may subordinate additional behavioral change techniques and information resources to assist and develop an individual’s coping mechanisms. The information gained may help healthcare providers with the development and enhancement of practice-related clinical guidelines that assist with implementing self-management eHealth interventions for cancer survivors.

Understanding the value of autonomous vehicles – an empirical meta-synthesis

ABSTRACT Value of Time (VOT) is a key element in transport infrastructure planning decisions. It is widely believed that travellers using autonomous vehicles (AVs) will have a lower VOT than conventional vehicles (CVs) because of improved road safety, increased road capacity, engagement in productive activity during travel and increased mobility. A number of researchers have measured VOT effects of AVs though no consolidation of this evidence has been undertaken to date. This is the first study to provide a quantitative summary and synthesis of the estimated VOT of AV travel including a synthesis of factors affecting AV VOT. Meta-analyses of 24 studies show that mean VOTs for conventional cars, private AVs and shared AVs are respectively 17.3, 12.1 and 19.4 AU$/hr. However, wide variations in these estimates are evident and 12 factors have been identified with statistically significant effects on these variations including geographical context, study experimental characteristics, trip characteristics and socio-economic factors. We found that AV VOT estimates are lower when animated videos are used to demonstrate AV capabilities. Private AVs have the lowest VOT estimates as do commute trips and morning peak periods. Young adults (18–30 years) and people with current driving experience consistently report lower AV VOT while those with higher educational status and higher-incomes report having higher AV VOT. Implications of findings for policy and future research are presented.

Proton Beam Therapy for Early Breast Cancer: A Systematic Review and Meta-analysis of Clinical Outcomes

Adjuvant proton beam therapy (PBT) is increasingly available to patients with breast cancer. It achieves better planned dose distributions than standard photon radiation therapy and therefore may reduce the risks. However, clinical evidence is lacking. A systematic review of clinical outcomes from studies of adjuvant PBT for early breast cancer published in 2000 to 2022 was undertaken. Early breast cancer was defined as when all detected invasive cancer cells are in the breast or nearby lymph nodes and can be removed surgically. Adverse outcomes were summarized quantitatively, and the prevalence of the most common ones were estimated using meta-analysis. Thirty-two studies (1452 patients) reported clinical outcomes after adjuvant PBT for early breast cancer. Median follow-up ranged from 2 to 59 months. There were no published randomized trials comparing PBT with photon radiation therapy. Scattering PBT was delivered in 7 studies (258 patients) starting 2003 to 2015 and scanning PBT in 22 studies (1041 patients) starting 2000 to 2019. Two studies (123 patients) starting 2011 used both PBT types. For 1 study (30 patients), PBT type was unspecified. Adverse events were less severe after scanning than after scattering PBT. They also varied by clinical target. For partial breast PBT, 498 adverse events were reported (8 studies, 358 patients). None were categorized as severe after scanning PBT. For whole breast or chest wall ± regional lymph nodes PBT, 1344 adverse events were reported (19 studies, 933 patients). After scanning PBT, 4% (44/1026) of events were severe. The most prevalent severe outcome after scanning PBT was dermatitis, which occurred in 5.7% (95% confidence interval, 4.2-7.6) of patients. Other severe adverse outcomes included infection, pain, and pneumonitis (each ≤1%). Of the 141 reconstruction events reported (13 studies, 459 patients), the most prevalent after scanning PBT was prosthetic implant removal (34/181, 19%). This is a quantitative summary of all published clinical outcomes after adjuvant PBT for early breast cancer. Ongoing randomized trials will provide information on its longer-term safety compared with standard photon radiation therapy.

Characterizing zebra crossing zones using LiDAR data

AbstractLight detection and ranging (LiDAR) scanning in urban environments leads to accurate and dense three‐dimensional point clouds where the different elements in the scene can be precisely characterized. In this paper, two LiDAR‐based algorithms that complement each other are proposed. The first one is a novel profiling method robust to noise and obstacles. It accurately characterizes the curvature, the slope, the height of the sidewalks, obstacles, and defects such as potholes. It was effective for 48 of 49 detected zebra crossings, even in the presence of pedestrians or vehicles in the crossing zone. The second one is a detailed quantitative summary of the state of the zebra crossing. It contains information about the location, the geometry, and the road marking. Coarse grain statistics are more prone to obstacle‐related errors and are only fully reliable for 18 zebra crossings free from significant obstacles. However, all the anomalous statistics can be analyzed by looking at the associated profiles. The results can help in the maintenance of urban roads. More specifically, they can be used to improve the quality and safety of pedestrian routes.

Overview of the application of ecological concrete in sponge city construction

As a prominent component of the construction field of sponge cities, ecological concrete is an essential tool to reach the goals of green, low-carbon living and sustainable development. A quantitative summary of the preliminary research on ecological concrete infrastructure in sponge city architecture is needed. Therefore, CiteSpace and VOSviewer were applied to perform a comparative analysis of the number of papers, countries, institutions, core authors, literature co-citations, research hotspots, and future trends in ecological concrete in the sponge city construction industry. The results show that the number of papers on ecological concrete is increasing, the research collaboration between domestic and foreign authors is relatively single, and there is insufficient interdisciplinary integration between institutions and the phenomenon of “relatively independent research.” The number of papers published in the field of ecological concrete construction has been on the rise, reaching more than 100 in each of the last 10 years, with China and the United States contributing more to the scientific output of the field. To meet the needs of global environmental protection and resource conservation, the theme of “promoting comprehensive resource conservation and recycling” will continue in the future, making concrete a feature of green, low-carbon, sustainable development and other areas of environmental protection in the construction field.

Flash Flood Risk Assessment Due to a Possible Dam Break in Urban Arid Environment, the New Um Al-Khair Dam Case Study, Jeddah, Saudi Arabia

Recent years have seen an increase in floods with severe damage due to the intensity and frequency of rains. One of the periodic hydrological problems affecting Jeddah city, the second-biggest city in Saudi Arabia, is unexpected flash flooding. In dam breaks, water that has been retained is released uncontrollably. This study is related to a flood simulation methodology after a possible break of the New Um Al-Khair Dam, a dam built in 2012 outside residential areas, to replace the Old Um Al-Khair Dam built inside a residential area, which broke in January 2011. In fact, we simulated the impact on flood wave propagation in the study area through the use of GIS techniques coupled with hydrological/hydraulic modeling tools and the development of a flood inundation model. Planning a good emergency response in the future is possible by analyzing a supposed disaster. Based on the likelihood that there will be a flood and the corresponding inundation depth, a flood risk matrix is created as a quantitative tool to estimate flood damage, which is crucial to decision-makers. Negligible, low, moderate, high, and very high-risk categories are assigned according to that flood risk matrix. The results indicated a low to very high risk for 5 years, 50 years and 100 years return periods and a negligible to very high risk for a 200 years return period. To estimate the extent of damage, a quantitative summary of the results has been outlined graphically in order to visualize the scope of the inundation areas.

Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review.

Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.

Summary of methodology used in enterotoxigenic Escherichia coli (ETEC) challenge experiments in weanling pigs and quantitative assessment of observed variability.

Postweaning diarrhea in pigs is often caused by the F4 or F18 strains of enterotoxigenic Escherichia coli (ETEC). To evaluate interventions for ETEC, experimental infection via a challenge model is critical. Others have reviewed ETEC challenge studies, but there is a lack of explanation for the variability in responses observed. Our objective was to quantitatively summarize the responses and variability among ETEC challenge studies and develop a tool for sample size calculation. The most widely evaluated response criteria across ETEC challenge studies consist of growth performance, fecal consistency, immunoglobulins, pro-inflammatory cytokines, and small intestinal morphology. However, there is variation in the responses seen following ETEC infection as well as the variability within each response criteria. Contributing factors include the type of ETEC studied, dose and timing of inoculation, and the number of replications. Generally, a reduction in average daily gain and average daily feed intake are seen following ETEC challenge as well as a rapid increase in diarrhea. The magnitude of response in growth performance varies, and methodologies used to characterize fecal consistency are not standardized. Likewise, fecal bacterial shedding is a common indicator of ETEC infection, but the responses seen across the literature are not consistent due to differences in bacterial enumeration procedures. Emphasis should also be placed on the piglet's immune response to ETEC, which is commonly assessed by quantifying levels of immunoglobulins and pro-inflammatory cytokines. Again, there is variability in these responses across published work due to differences in the timing of sample collection, dose of ETEC pigs are challenged with, and laboratory practices. Small intestinal morphology is drastically altered following infection with ETEC and appears to be a less variable response criterion to evaluate. For each of these outcome variables, we have provided quantitative estimates of the responses seen across the literature as well as the variability within them. While there is a large degree of variability across ETEC challenge experiments, we have provided a quantitative summary of these studies and a Microsoft Excel-based tool was created to calculate sample sizes for future studies that can aid researchers in designing future work.

Comment on: Bariatric surgery and secondary hyperparathyroidism: a meta-analysis.

I thank Cai et al. [ [1] Cai Z. Zhang Q. Jiang Y. Zhang J. Liu W. Bariatric surgery and secondary hyperparathyroidism: a meta-analysis. Surg Obes Relat Dis. 2023; 19: 1-10 Google Scholar ] for their excellent meta-analysis addressing the important topic of secondary hyperparathyroidism and metabolic and bariatric surgery (MBS). This meta-analysis represents the first quantitative summary of the effect of MBS on secondary hyperparathyroidism (SHPT) risk and includes a large sample size of patients. This meta-analysis included a total of 5585 patients from 9 studies with a mean follow-up time of 3.5 years (range, .25–5). In addition to comparing the impact of MBS on SHPT, this meta-analysis compared the impact of follow-up time and surgical procedure on SHPT. For example, the first 2 years after MBS was not associated with an increased risk of SHPT (odds ratio [OR] = 1.34; 95% confidence interval [CI], .81–2.20; I2 = 95%) in either gastric bypass (GB) or SG procedures (for GB: OR = 1.42; 95% CI, .66–3.07; for SG: OR = .39; 95% CI, .09–1.62). However, at the 2-year follow-up mark and long-term follow-up intervals, a marked increase in SHPT was detected for GB (OR = 6.06; 95% CI, 3.39–10.85) (Figs. 3 and 4 in Cai et al. [ [1] Cai Z. Zhang Q. Jiang Y. Zhang J. Liu W. Bariatric surgery and secondary hyperparathyroidism: a meta-analysis. Surg Obes Relat Dis. 2023; 19: 1-10 Google Scholar ]). Additionally, this meta-analysis showed that biliopancreatic diversion with duodenal switch had higher rates of SHPT than GB which had higher rates of SHPT than SG. Bariatric surgery and secondary hyperparathyroidism: a meta-analysisSurgery for Obesity and Related DiseasesVol. 19Issue 1PreviewObesity increases the risk of obesity-related medical problems. Weight loss after metabolic and bariatric surgery (MBS) has been well studied. However, the effects of MBS on parathyroid function remain unclear. Full-Text PDF Comment on: Bariatric surgery and secondary hyperparathyroidism: a meta-analysisSurgery for Obesity and Related DiseasesVol. 19Issue 1PreviewI was recently asked by a younger bariatric surgeon why a general surgeon with no formal bariatric fellowship training was allowed to perform laparoscopic sleeve gastrostomies in her town. I explained that there are many bariatric surgeons in our great subspeciality who either were grandfathered into their career path before minimally invasive fellowships were in existence or perfected their bariatric skill sets by other means outside of a formal fellowship training paradigm. These options are perfectly acceptable within the confines and standards set forth in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program [1]. Full-Text PDF

Systematic Review of Literature for Smartphones Technology Acceptance Using Unified Theory of Acceptance and Use of Technology Model (UTAUT)

Systematic Review and Meta-analysis are techniques which attempt to associate the findings from similar studies and deliver quantitative summaries of the research literature [1]. The Systematic review of research literature identifies the common research methods, research design, sample size, parameters used, survey instruments, etc. used by the group of researchers. This study intends to fulfill this purpose in order to identify common research mythologies, dependent variables, sample sizes, moderators and mediators used in the field of analysing technology adoption based studies that utilizes the UTAUT2 model. This research collected over 59 published articles and conducted descriptive analytics. The results have revealed performance expectancy/perceived usefulness, trust and habit as the best predictors of consumer behavioural intentions towards the adoption of mobile application. Behavioural intention was the best predictor of use behaviour among the 57 articles selected. 274 was the mean sample size of research with 25 mean questionnaire items. SPSS and AMOS were the most common softwares used in all 57 studies, and 32 of those studies used UTAUT1 model while 14 researches incorporated the UTAUT2 model. There were also two promising predictors such as perceived risk on behavioural intention and habit on use behaviour.

A quantitative summary of compliance with the 2030 Agenda in the European Union. Short title: 2030 agenda compliance in the EU

Successive to the Millennium Development Goals initiated in 2000, the 2030 Agenda for Sustainable Development approved in 2015 by the United Nations affects many of the political decisions currently being made. Through this Agenda, countries commit to taking actions aimed at 17 goals, 169 targets and 232 indicators created by the UN to measure them in terms of performance. Parallel to the creation of global objectives by the UN, Eurostat established 100 indicators (many equal or similar to those of the UN) focused on the countries of the European Union to monitor their development with respect to the 2030 Agenda.
 This work proposes to undertake an exhaustive analysis of the strengths and weaknesses of the European Union countries with respect to these set objectives, also analyzing the convergence or divergence among EU member states. To this end, we build partial synthetic indices for each goal, taking existing information on the indicators collected by Eurostat in order to combine these into a composite index that provides a global vision of the (relative) situation of each country in the EU region.

THE EXTENT OF WOMEN’S ACCESS TO CUSTOMARY LAND TITLES IN MBOZI DISTRICT, IN SONGWE REGION, TANZANIA

Access to land is a crucial factor affecting women’s socio-economic status, security, and overall well-being as has increasingly been acknowledged on a global scale in recent years. However, the access and ownership of land by women in sub-Saharan Africa are continually debated, especially in terms of exclusion. The study assessed the extent of women access to customary land titles (CLTs) in Mbozi District, Songwe Region, Tanzania. A crosssectional research design was used in the study alongside non-probability sampling to purposively select 8 villages. Snowball sampling was used to select 290 women beneficiaries 0f CLTs in each village for the study. Primary data collection involved a survey questionnaire, in depth interviews, and focus group discussions. Content analysis was used to assess verbal and written information to get an interpretation of their meaning. The Statistical Package for Social Science (V. 20) was used in the analysis of the quantitative data and summary of the responses into frequencies and percentages. In general, the access of women to CLTs seemed to be on an upward trend in the study areas as acknowledged by 85.6% of the study participants. However, the control of land resources was still dominated by men in most cases. Decision-making by the women of their lands was also on an upward trajectory. Nevertheless, patriarchal domination and customary laws still affected women’s access to CLTs. The present findings are relevant for land governance in Tanzania and other parts of SSA because they evoke the voices of the marginalized gender on land ownership matters.

Nitrous oxide emissions from vermicompost preparation and application phases: Emission factors based on a meta-analysis

Vermicomposting is a biotechnology similar to composting but is more effective at degrading organic waste. Earthworms engulf the waste and digest it through the gut to form manure fertilizer. However, the nitrogen loss caused by nitrous oxide (N2O) can reduce the fertilization value of vermicompost and contribute to global warming. In the last decade, an increasing number of studies have focused on the effect of vermicomposting on N2O emissions. However, the results are contradictory, and a quantitative summary of these studies is still missing. In this study, a meta-analysis was conducted to evaluate the effects of the two phases (vermicompost preparation and vermicompost application) of vermicomposting on N2O emissions and their relationship with substrate and soil properties (e.g., substrate type, C/N ratio, soil pH, and moisture). Our results showed that the vermicompost preparation insignificantly increased N2O emissions compared with traditional composting (without earthworms), and the amounts of N2O generated during the phase of preparation were 3–143 times higher than those of the application phase. Interestingly, it is the vermicompost application phase, rather than preparation, that showed a positive effect size on N2O emissions (87 %), and the effects were highly dependent on the soil and substrate C/N ratio. A vermicomposting duration of ≥90 days promoted N2O emissions, and the vermicomposting effect size of the cumulative N2O emission was positively correlated with the temperature, soil C/N ratio and soil organic carbon (SOC) content but negatively correlated with the water-filled pore space (WFPS). Our findings indicated that, in the two phases of vermicomposting, organic matter was decomposed with the simultaneous consumption of oxygen, which accelerated N mineralization in the environment and in the guts of earthworms. As a result, nitrification and microsite denitrification were promoted, which enhanced the production of N2O. Our meta-analysis highlighted the necessity of connecting the effect of vermicomposting with soil and substrate C/N ratio to mitigate soil N2O emissions.

Helminth-HIV co-infection and malnutrition impact on immunity in Africa: dearth of empirical evidence

Helminthiasis is frequently co-endemic with HIV/AIDS in developing countries and the co-infection induces many consequences of health that can be aggravated by the nutritional status. The relationship between malnutrition and infection is complex, especially in immune deficiency. Given this intricate relationship between malnutrition, HIV epidemic and helminth infection in sub-Saharan Africa, there is a need to understand the dynamics, impact to general health and the burden in the region. This paper provide in a nutshell a systematic review and a quantitative summary of the work focusing on this relationship. A search was conducted to identify studies on malnutrition and HIV-helminth co-infection impact on immunity in Africa, using the search terms “malnutrition” and “HIV” and “HIV-helminth co-infection” and “Africa” or “malnutrition” and “HIV” or “HIV-helminth” limited to Africa. The search was also limited to human studies from the databases available on PubMed, and Google scholar. The database was searched with language, region and year restrictions (only articles in English and French and all publications from 1999 to 2013). The results showed that no study has been conducted on the intersections between malnutrition and HIV/helminth co-infection. So no article met criteria for potential inclusion and these focused on nutrition and HIV-helminth co-infection impact on immunity in Africa. There is no study conducted in Africa that investigated the immune aspect and the relationship between nutrition and HIV-helminth co-infection. The results of this review suggest insufficient data to determine whether malnutrition and HIV-helminth co-infection impact on immunity. There is strong recommendation to conduct such kind of studies in Africa where malnutrition and HIV-helminth co-infection are common.

Helminth-HIV co-infection and malnutrition impact on immunity in Africa: dearth of empirical evidence

Helminthiasis is frequently co-endemic with HIV/AIDS in developing countries and the co-infection induces many consequences of health that can be aggravated by the nutritional status. The relationship between malnutrition and infection is complex, especially in immune deficiency. Given this intricate relationship between malnutrition, HIV epidemic and helminth infection in sub-Saharan Africa, there is a need to understand the dynamics, impact to general health and the burden in the region. This paper provide in a nutshell a systematic review and a quantitative summary of the work focusing on this relationship. A search was conducted to identify studies on malnutrition and HIV-helminth co-infection impact on immunity in Africa, using the search terms “malnutrition” and “HIV” and “HIV-helminth co-infection” and “Africa” or “malnutrition” and “HIV” or “HIV-helminth” limited to Africa. The search was also limited to human studies from the databases available on PubMed, and Google scholar. The database was searched with language, region and year restrictions (only articles in English and French and all publications from 1999 to 2013). The results showed that no study has been conducted on the intersections between malnutrition and HIV/helminth co-infection. So no article met criteria for potential inclusion and these focused on nutrition and HIV-helminth co-infection impact on immunity in Africa. There is no study conducted in Africa that investigated the immune aspect and the relationship between nutrition and HIV-helminth co-infection. The results of this review suggest insufficient data to determine whether malnutrition and HIV-helminth co-infection impact on immunity. There is strong recommendation to conduct such kind of studies in Africa where malnutrition and HIV-helminth co-infection are common.

Parasitism shapes selection by drastically reducing host fitness and increasing host fitness variation.

Determining the effects of parasites on host reproduction is key to understanding how parasites affect the underpinnings of selection on hosts. Although infection is expected to be costly, reducing mean fitness, infection could also increase variation in fitness costs among hosts, both of which determine the potential for selection on hosts. To test these ideas, we used a phylogenetically informed meta-analysis of 118 studies to examine how changes in the mean and variance in the outcome of reproduction differed between parasitized and non-parasitized hosts. We found that parasites had severe negative effects on mean fitness, with parasitized hosts suffering reductions in fecundity, viability and mating success. Parasite infection also increased variance in reproduction, particularly fecundity and offspring viability. Surprisingly, parasites had similar effects on viability when either the male or female was parasitized. These results not only provide the first synthetic, comparative, and quantitative summary of the strong deleterious effects of parasites on host reproductive fitness, but also reveal a consistent role for parasites in shaping the opportunity for selection.

Change, Persistence and Convergence in NATO Member Defense Spending

This study presents an analysis and quantitative summary of 18 NATO member country defense spending over the period 1953-2020. Using recently developed econometric techniques, we explore the time series properties of change, persistence and convergence in two indicators of NATO defense spending data typically used in the literature: real (2019) US dollars and Percent of GDP. Our two indicator variables display a mix of positive, negative and zero trends over the sample period. The only NATO countries with more than 2% defense spending after the 2006 and 2014 Summits are: Greece, Turkey, UK, USA and Poland. Using the fractional difference-based persistence tests of Martins and Rodrigues, we find only UK, Hungary and Poland dollar Defense Spending reject the null of a constant fractional difference (unit root) for the entire sample period; while seven NATO members reject the null of a constant fractional difference (unit root) for Percent of GDP. The mixed set of positive, negative and zero trends render the popular relative convergence test of Phillips and Sul inappropriate for our data. Using the more appropriate weak sigma-convergence test of Kong, Phillips and Sul, we find mixed evidence for convergence of our indicator variables. Our quantitative results present a mixed picture of statistical consistency and coherence for NATO defense spending. Our tests of persistence suggest major changes in the defense policies and spending of NATO members will have a lasting effect in most cases. The emergence and growth of serious threats and potential threats from Russia (and now potentially China as well) will require the NATO allies to address these issues.

Transit Stops and Stations: Transit Managers’ Perspectives on Evaluating Performance

Passengers, transit managers, adjacent businesses and residents, and local governments all can have strong, and sometimes conflicting, ideas about what makes a good transit stop or station. This paper examines stops and stations from the transit agency’s perspective; transit managers must consider both the logistical and political factors inherent to transit operations as well as the perspectives of customers they seek to attract and retain. An online survey of U.S. transit systems was administered to estimate magnitudes of managers’ perceived importance of an array of stop/station attributes and objectives to provide a quantitative and objective summary of the collective wisdom of U.S. transit managers. This complements the mostly qualitative and case-study research on this topic. Using a sophisticated nonparametric ranking method, an estimate of the transit agency’s perspective on stops and stations was produced. Respondents clearly believe that safety and security are most important to a good stop/station, followed by ease of transferring and cost-effectiveness. Comfort and aesthetic factors rank much further below these.

Effects of Anticholinergics on Death Rattle: A Systematic Review and Network Meta-Analysis.

Background: Anticholinergics have been used to treat death rattle (DR) in dying patients with palliative care. However, the effect of anticholinergics is still controversial. No quantitative summary of their effects is reported. Objective: This study aimed to systematically review and quantitatively synthesize the effect of anticholinergics on DR treatment and prophylaxis. Design: A systematic search was performed in the electronic databases (PubMed, Embase®, and Cumulative Index to Nursing and Allied Health Literature [CINAHL]) from inception to October 2021. Studies conducted to determine the effect of anticholinergics compared with other anticholinergics or placebo on noise reduction score in dying patients were included. A network meta-analysis was performed for DR treatment. The effect of anticholinergics at four hours was assessed. A pairwise meta-analysis was performed for DR prophylaxis. Results: A total of nine studies were included with 1103 patients. Six studies were randomized controlled trials, and three studies were cohort studies. Seven studies were conducted for DR treatment, while two studies were conducted for DR prophylaxis. For DR treatment, no statistically significant difference was observed between each anticholinergic (hyoscine hydrobromide, hyoscine butyl bromide, atropine, and glycopyrrolate) and placebo and among any anticholinergics. However, the surface under cumulative ranking curve indicated that hyoscine butyl bromide had the highest surface under the cumulative ranking curve (SUCRA) with 71.3%. For DR prophylaxis, the relative risk of DR occurrence for hyoscine butyl bromide was 0.23 (0.04, 1.18; I2 = 84.5%) compared with no treatment. Conclusion: This study showed no strong evidence of the regular use of anticholinergics for DR treatment. In addition, hyoscine butyl bromide appears to have a high potential for DR prophylaxis.