bluuebunny/crossref_metadata_2025 huggingface dataset:
Random Errors in the Stable Boundary Layer: Implications for Modern Observational Techniques
Authors: Greene Brian R. , Salesky Scott T.
Published: October 2022

For decades, stable boundary layer (SBL) turbulence has proven challenging to measure, parameterize, simulate, and interpret. Uncrewed aircraft systems (UAS) are becoming a reliable method to sample the atmospheric boundary layer, offering new perspectives for understanding the SBL. Moreover, continual computational advances have enabled the use of large-eddy simulations (LES) to simulate the atmosphere at ever-smaller scales. LES is therefore a powerful tool in establishing a baseline framework to understand the extent to which vertical profiles from UAS can represent larger-scale SBL flows. To quantify the representativeness of observations from UAS profiles and eddy-covariance observations within the SBL, we performed a random error analysis using a suite of six large-eddy simulations for a wide range of stabilities. We combine these random error estimates with emulated observations of a UAS and eddy-covariance systems to better inform future observational studies. For each experiment, we estimate relative random errors using the so-called relaxed filtering method for first- and second-order moments as functions of height and averaging time. We show that the random errors can be on the same order of magnitude as other instrument-based errors due to bias or dynamic response. Unlike instrument errors, however, random errors decrease with averaging time. For these reasons, we recommend coupling UAS observations with other ground-based instruments as well as dynamically adjusting the UAS vertical ascent rate to account for how errors change with height and stability.

Significance Statement

Weather-sensing uncrewed aircraft systems are rapidly being realized as effective tools to collect valuable observations within the atmospheric boundary layer. To fully capitalize on this novel observational technique, it is necessary to develop an understanding of how well their observations can represent the surrounding atmosphere across various spatial and temporal scales. In this study we quantify the representativeness of atmospheric observations in the stable boundary layer by evaluating the random errors for parameters such as temperature, wind speed, and fluxes as estimated from a suite of large-eddy simulations. Our results can better inform future studies utilizing uncrewed aircraft systems by highlighting how random errors in their observations relate to vertical ascent rate, atmospheric stability, and measurement height.
Winter–Summer Transition in the Southern South China Sea Western Boundary Current
Authors: Xie Yi , Wang Qiang , Zeng Lili , Chen Ju , He Yunkai
Published: October 2022

The winter–summer transition in the southern South China Sea (SCS) western boundary current (WBC) is studied. Two categories have been identified. In case 1, the southern SCS WBC transition in the lower layer (below the thermocline) lags that in the upper layer (above the thermocline). In case 2, there is no transition lag at full depth. In both categories, the geostrophic balance dominates the transition. In case 1, the upper layer geostrophic balance is dominated by the sea surface height pressure gradient (SSHPG) and Coriolis forcing during southern SCS WBC transition. Therefore, there is no transition lag with depth in the upper layer. Below the thermocline layer, the competition between the SSHPG and the density pressure gradient (DPG) determines the transition. During the transition, the amplitudes of the SSHPG and DPG are basically equivalent. The SSHPG needs time to develop sufficiently larger than the DPG. Therefore, the transition in the deeper layer significantly lags that in the shallower layer. The reversal of the SSHPG is mainly attributed to the change in the basin-scale wind stress curl over the southern SCS. The change in the DPG is mainly associated with the cooling of the water along the western continental slope, which is induced by upwelling. In case 2, there is no cooling along the western continental slope, and then the amplitude of the DPG is always far smaller than that of the SSHPG. Responding to the change in the SSHPG, the southern SCS WBC transition behaves consistently at full depth.

Significance Statement

We have a comprehensive understanding of the South China Sea (SCS) circulation patterns in winter and summer. However, their seasonal transitions remain unclear, and a better understanding of them is potentially helpful for improving ocean circulation modeling and prediction. This paper focuses on the winter–summer transition in the SCS western boundary current (WBC). Above the thermocline (∼100 m), the transition behaves consistently in the vertical direction and is controlled by the conversion of the sea surface height–induced pressure gradient. Below the thermocline, the transition in the deeper layer of the WBC significantly lags that in the shallower layer of the WBC, which is associated with the competition between the SSH-induced pressure gradient and the density-induced pressure gradient at the sea surface.
Attitudes toward people with mental disorders in Bulgaria
Authors: Dimitrova Veronika Simeonova , Zahariev Boyan , Martinova Maria
Published: October 2022

Public attitudes toward people with mental disorders determine their life chances and potential integration in society. In this article, we present results from a large representative study that aims to understand whether and how Bulgarian society stigmatizes people with mental disorder, and how demographic characteristics relate to certain types of attitudes. The CAMI III instrument was the basis for the specific research design. The article presents two types of analysis of the data. Firstly, Factor analysis revealed three factors which partially coincide with original categories of the CAMI III Scale – Factor 1 ‘Authoritarianism and Social Restrictiveness’, Factor 2 ‘Benevolence and Community Mental Health Ideology’, and Factor 3 ‘Liberalism’. Secondly, a one-way ANOVA test was carried out, taking the assigned factor scores as dependent variable, on one hand, and demographic and social-economic characteristics as independent variables, on the other. Results reveal that people between 18–24 and over 75 years old are the most authoritarian and socially restrictive, while those between 24–75 years old are the most benevolent. Our analysis show an influence of religion and ethnicity on authoritarianism and social restrictiveness, but on benevolence as well. Education, occupation, and profession is related to the scores of the factors. The results correspond to findings from studies form other contexts but reveal underrepresented aspects such as 1. socio-economic characteristics – ethnicity and religion; 2. the socializing role of the institutions in the formation of the image of the mentally ill among different age groups.
Migrant-led diversification and differential inclusion in arrival cities across Asia and the Pacific
Authors: Ye Junjia , Yeoh Brenda SA
Published: October 2022

The closely related processes of migration and diversification call for greater scrutiny of how contemporary arrival cities incorporate increasingly diverse groups of newcomers through practices and processes of differential inclusion. This special issue highlights arrival cities in the Asia-Pacific region, attending to how they are being transformed by the wide-ranging temporal and spatial dimensions of migrant-driven diversification. Rather than begin with how coexistence in the context of diversification ought to be, the collection of papers included here builds inter-references through contexts that are, ultimately, non-universal. In so doing, this special issue responds to recent calls by social scientists to extend our frames of reference beyond the dominant centres of knowledge production in Europe and North America in understanding the links between migration and urban diversity. The papers included here focus on arrival cities and urban places in Hong Kong, the Philippines, Singapore, Malaysia, Japan, Australia and New Zealand as an exercise in open-ended imagination, advancing the conversation on urban diversification in the age of global migration. We organise these forms of urban change and migration-driven differentiation along four key themes of temporalities, spatialities, intermediaries and norms that emerged from the collection of papers. Using these four conceptual themes, modes of differential inclusion function as tools of discipline and governance at one level, and are mobilised to subvert and negotiate power relations at another. As refracted through these four axes of analysis, differential inclusion draws our attention to the multiscalar and multi-actor politics of diversification.
The Effect of Teachers’ Unions on Teacher Stress: Evidence from District-Teacher Matched Data
Authors: Han Eunice S. , García Emma
Published: October 2022

This study examines the effect of teachers’ unions on the stress that teachers experience in their schools. Relying on a nationally representative district-teacher matched dataset in pre-pandemic periods, we employ principal factor analysis to assess to teacher stress and use both contractual status and union membership to measure union strength. Based on multilevel linear model, we find that teachers’ unions are negatively associated with teacher stress. We then exploit natural experiments that occurred in several U.S. states to identify the effect of legal and institutional changes weakening the strength of teachers’ unions on teacher stress. Using the difference-in-difference estimation, we find that the new legislation in these states significantly increases teacher stress, and that the magnitudes of this negative impacts are greater for male, experienced, more qualified, and STEM-subject teachers.
Electrical Conductivity Modeling and Fabrication of Carbon Nanotubes/Silicone Rubber Composites for High Voltage Insulators in Regions With a Polluted Atmosphere
Authors: Mohammadnabi Saman , Rahmani Khosrow , Mataei Moghaddam Mohammad
Published: October 2022

The condensation mechanism of the insulators’ surface, increase the surface electrical conductivity. The electrical conductivity of the insulator creates a high level of leakage current and causes the failure. Difference between the dew point and the surface temperature of the insulator which occur due to radiative cooling mechanism, is the major reason of the moisture condensation on the polluted insulator surface. To compensate for the temperature difference, carbon nanotubes (CNTs) are being added to the silicone rubber housing material. The main idea of this research is based on generating joule heating by reducing the surface resistance of high voltage insulators. For this purpose, a developed model based on Halpin–Tsai formulation for tensile modulus of nanocomposites is joined with the conventional power-law model for the effective electrical conductivity of silicone rubber matrix carbon nanotube composite (SMCNT). SMCNT samples are prepared with the addition of various CNT volume fractions to high temperature vulcanizing (HTV) silicone rubber by melt-blending method. The developed model reveals that the high fraction of thinner and longer CNT, thicker interphase, higher concentration of percolated CNT, lower waviness of CNT, and higher conductivity of CNT can make a higher effective conductivity for SMCNT.
Numerical investigation of heat transfer enhancement in microchannel heat sink with fan cavities using secondary channels and ribs
Authors: Bala Subrahmanyam K , Das Pritam
Published: October 2022

A computational three-dimensional modeling of microchannel heat sink (MCHS) with fan cavity and four different rib configurations along with secondary channels (SCs) has been performed in detail to identify the influence of geometrical parameters on characteristics of heat transfer and provide insight into optimum configuration. The adverse effect of high processing speed and heat flux demands lower operational temperature at the expense of high pumping power in order to increase the lifespan of electronic equipment. Single phase, laminar flow of fluid is considered in the Reynolds number range from 136 to 588. The novel design of the SC benefits heat transfer enhancement by the increase in flow area, originates secondary flows subsequently transforms into symmetric counter-rotating vortices on the basis of rib, however, the influence of the rib blocking effect also depletes, resulting in minimal pressure drop. The comparison between various rib structures confirms that the FC-FTR-SC configuration acquired superior heat transfer performance with a TP of 2.07, at Re = 261. The FC-FTR-SC configuration has a great deal of evidence that pumping power decreases by 10.1% and TP increases by 11.7% as β increases from 0.5 to 1.25. The influence of four geometric parameters: relative width of rib ( α), relative width of the SC ( β), relative length of cavity ( γ), and relative angle of the SC ( ϕ) on heat transfer enhancement and pressure drop have been performed using parametric optimization, response surface methodology.
Factors associated with poor outcomes in SLE patients with COVID-19: Data from ReumaCoV-Brazil register
Authors: Carvalho Joana S , dos Reis Neto Edgard T , Kakehasi Adriana M , Ribeiro Sandra LE , Studart Samia AS , Martins Francielle P , Cavalheiro do Espírito Santo Rafaela , Ranzolin Aline , Fernandino Diana C , Dinis Valquiria G , Sato Emília I , Resende Gustavo G , Marinho Adriana , Mariz Henrique A , Sacilotto Nathália C , Ribeiro Francinne M , Shinjo Samuel K , Dias Laiza H , Yazbek Michel A , Omura Felipe , Rached Thiago HS , Gomides Ana Paula M , Marques Claudia DL , Pillegi Gecilmara CS , Mota Lícia MH , Pinheiro Marcelo M , Monticielo Odirlei A , Xavier Ricardo M , Ferreira Gilda A ,   on behalf of ReumaCoV Brasil Registry
Published: October 2022

Objectives

To evaluate factors associated with COVID-19 severity outcomes in patients with systemic lupus erythematosus (SLE).

Methods

This was a cross-sectional analysis of baseline data of a prospective, multi-stage cohort study—“The ReumaCoV Brazil”—designed to monitor patients with immune-mediated rheumatologic disease (IMRD) during the SARS-CoV-2 pandemic. SLE adult patients with COVID-19 were compared with those without COVID-19. SLE activity was evaluated by the patient global assessment (PGA) and SLE Disease Activity Index 2000 (SLEDAI-2K).

Results

604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the control group. SLE COVID-19 patients reported a lower frequency of social isolation and worked more frequently as health professionals. There was no difference in the mean SLEDAI-2K score between groups in the post–COVID-19 period (5.8 [8.6] vs. 4.5 [8.0]; p = 0.190). However, infected patients reported increased SLE activity according to the Patient Global Assessment (PGA) during this period (2.9 [2.9] vs. 2.3 [2.6]; p = 0.031. Arterial hypertension (OR 2.48 [CI 95% 1.04–5.91], p = 0.041), cyclophosphamide (OR 14.32 [CI 95% 2.12–96.77], p = 0.006), dyspnea (OR: 7.10 [CI 95% 3.10–16.23], p < 0.001) and discontinuation of SLE treatment medication during infection (5.38 [CI 95% 1.97–15.48], p = 0.002), were independently associated with a higher chance of hospitalization related to COVID-19. Patients who received telemedicine support presented a 67% lower chance of hospitalization (OR 0.33 [CI 95% 0.12–0.88], p = 0.02).

Conclusion

Hypertension and cyclophosphamide were associated with a severe outcome, and telemedicine can be a useful tool for SLE patients with COVID-19.
The impact of course format on student perceptions of the classroom learning environment and teamwork
Authors: Minosky Shayna A , Wiechers Michael , Landaverde-Umana Leonardo
Published: October 2022

Traditionally, education has been largely delivered in an in-person format; however, an increasing number of courses are being delivered entirely online or with a blend of online and in-person components. These formats differ along various dimensions, such as the quantity and quality of interpersonal interactions and connections, which will likely lead to different student experiences. Using a sample of 200 undergraduate student responses from an online survey, we compared five different course formats (in-person, synchronous online, asynchronous online, blended with alternating weeks and blended exam only) on students’ perceptions of various elements of their learning environment, including teaching presence, cognitive presence, social presence, sense of community and teamwork. A between groups ANOVA demonstrated significant differences for seven of the eight variables examined. In each case, the in-person format was rated the most positively and the blended exam only format tended to receive the poorest ratings. Overall, our results suggest that live interaction among students, and between students and instructors, whether it is from an in-person format or a blended alternating format, appears to be linked to more positive perceptions of the social learning environment.
Disparities in Loss to Follow-Up Among Adults With Congenital Heart Disease in North Carolina
Authors: Serfas J.D. , Spates Toi , D’Ottavio Alfred , Spears Tracy , Ciociola Elizabeth , Chiswell Karen , Davidson-Ray Linda , Ryan Grace , Forestieri Nina , Krasuski Richard A. , Kemper Alex R. , Hoffman Timothy M. , Walsh Michael J. , Sang Charlie J. , Welke Karl F. , Li Jennifer S.
Published: October 2022

Background

The AHA/ACC Adult Congenital Heart Disease guidelines recommend that most adults with congenital heart disease (CHD) follow-up with CHD cardiologists every 1 to 2 years because longer gaps in care are associated with adverse outcomes. This study aimed to determine the proportion of patients in North Carolina who did not have recommended follow-up and to explore predictors of loss to follow-up.

Methods

Patients ages ≥18 years with a healthcare encounter from 2008 to 2013 in a statewide North Carolina database with an ICD-9 code for CHD were assessed. The proportion with cardiology follow-up within 24 months following index encounter was assessed with Kaplan-Meier estimates. Cox regression was utilized to identify demographic factors associated with differences in follow-up.

Results

2822 patients were identified. Median age was 35 years; 55% were female. 70% were white, 22% black, and 3% Hispanic; 36% had severe CHD. The proportion with 2-year cardiology follow-up was 61%. Those with severe CHD were more likely to have timely follow-up than those with less severe CHD (72% vs 55%, P < .01). Black patients had a lower likelihood of follow-up than white patients (56% vs 64%, P = .01). Multivariable Cox regression identified younger age, non-severe CHD, and non-white race as risk factors for a lower likelihood of follow-up by 2 years.

Conclusion

39% of adults with CHD in North Carolina are not meeting AHA/ACC recommendations for follow-up. Younger and minority patients and those with non-severe CHD were particularly vulnerable to inadequate follow-up; targeted efforts to retain these patients in care may be helpful.
Surface layer protein A from hypervirulent Clostridioides difficile ribotypes induce significant changes in the gene expression of tight junctions and inflammatory response in human intestinal epithelial cells
Authors: Noori Maryam , Azimirad Masoumeh , Eslami Gita , Looha Mehdi Azizmohammad , Yadegar Abbas , Ghalavand Zohreh , Zali Mohammad Reza
Published: October 2022

Background

Surface layer protein A (SlpA), the primary outermost structure of Clostridioides difficile, plays an essential role in C. difficile pathogenesis, although its interaction with host intestinal cells are yet to be understood. The aim of this study was to investigate the effects of SlpA extracted from C. difficile on tight junction (TJ) proteins expression and induction of pro-inflammatory cytokines in human colon carcinoma cell line HT-29. SlpA was extracted from three toxigenic C. difficile clinical strains including RT126, RT001, RT084 as well as C. difficile ATCC 700057 as non-toxigenic strain. Cell viability was performed by MTT assay, and the mRNA expression of TJ proteins and inflammation-associated genes was determined using quantitative RT-PCR. Additionally, the secretion of IL-8, IL-1β and TNF-α cytokines was measured by ELISA.

Results

C. difficile SlpA from selected RTs variably downregulated the expression level of TJs-assassinated genes and increased the expression level of TLR-4 and pro-inflammatory cytokines in HT-29 treated cells. SlpA from RT126 significantly (padj<0.05) decreased the gene expression level of claudins family and JAM-A and increased the secretion of IL-8, TNF-α and IL1-β as compared to untreated cells. Moreover, only SlpA from RT001 could significantly induce the expression of IL-6 (padj<0.05).

Conclusion

The results of the present study highlighted the importance of SlpA in the pathogenesis of CDI and C. difficile-induced inflammatory response in the gut. Further studies are required to unravel the significance of the observed results in promoting the intestinal inflammation and immune response induced by C. difficile SlpA from different RTs.
Caregiver’s perspectives on the Central Nervous System infection illness trajectory among older persons with dementia in Northern Uganda—a qualitative community-based study
Authors: Benyumiza Deo , Kumakech Edward , Gutu Jastine , Banihani Jude , Mandap Joshua , Talib Zohray M. , Wakida Edith K. , Maling Samuel , Obua Celestino
Published: October 2022

Background

Few studies have explored the Central Nervous System (CNS) infection illness trajectory among older persons with dementia in sub-Saharan African (SSA) settings. This study explored the Caregiver’s perspectives on the Central Nervous System infection illness trajectory among the older persons with dementia in Northern Uganda.

Methods

This was a qualitative study conducted in Lira District northern Uganda in March 2022 amongst purposively selected 20 caregivers of the older persons aged 50 + years with a positive history of CNS infection and later life dementia. Data were collected using an in-depth interview guide. Audio recordings and field notes of the interviews were undertaken. The interviews generated data on the CNS infection illness trajectory from onset to the current demented state of the older persons. The audio-recorded interviews were transcribed verbatim before manual reflective thematic analysis.

Results

Older persons with a positive history of CNS infection illness and later life dementia in rural northern Uganda presented with symptoms of early life CNS infection illness ranging from neck pain, back pain, chronic headache, and fatigue. There were also manifestations of comorbidities particularly road traffic accidents involving traumatic injury to the head, neck, and spine, high blood pressure, chronic headache, and or their medications in the older person’s trajectory to later life dementia. A plurality of healthcare which included both formal and informal healthcare medicines was sought and utilized for the treatment and care of the CNS infection illness and dementia by the older persons amidst improper diagnosis and mismanagement.

Conclusions and recommendations

Older persons with early-life CNS infections illness and later-life dementia were reported to present with symptoms including neck pain, back pain, chronic headache, high blood pressure, and fatigue. The reported symptoms of CNS infection illness may be intertwined with co-morbidities particularly traumatic injury involving the head, neck, and spine, high blood pressure, and chronic headache. Healthcare professionals should integrate routine screening of older persons for the history of CNS infections, chronic headache, high blood pressure, trauma to the head, neck, and spine, and dementia and early treatment.
Characteristics and outcomes of COVID-19 patients during B.1.1.529 (Omicron) dominance compared to B.1.617.2 (Delta) in 89 German hospitals
Authors: Leiner Johannes , Pellissier Vincent , Hohenstein Sven , König Sebastian , Schuler Ekkehard , Möller Robert , Nachtigall Irit , Bonsignore Marzia , Hindricks Gerhard , Kuhlen Ralf , Bollmann Andreas
Published: October 2022

Background

The SARS-CoV-2 variant B.1.1.529 (Omicron) was first described in November 2021 and became the dominant variant worldwide. Existing data suggests a reduced disease severity with Omicron infections in comparison to B.1.617.2 (Delta). Differences in characteristics and in-hospital outcomes of COVID-19 patients in Germany during the Omicron period compared to Delta are not thoroughly studied. ICD-10-code-based severe acute respiratory infections (SARI) surveillance represents an integral part of infectious disease control in Germany.

Methods

Administrative data from 89 German Helios hospitals was retrospectively analysed. Laboratory-confirmed SARS-CoV-2 infections were identified by ICD-10-code U07.1 and SARI cases by ICD-10-codes J09-J22. COVID-19 cases were stratified by concomitant SARI. A nine-week observational period between December 6, 2021 and February 6, 2022 was defined and divided into three phases with respect to the dominating virus variant (Delta, Delta to Omicron transition, Omicron). Regression analyses adjusted for age, gender and Elixhauser comorbidities were applied to assess in-hospital patient outcomes.

Results

A total cohort of 4,494 inpatients was analysed. Patients in the Omicron dominance period were younger (mean age 47.8 vs. 61.6; p < 0.01), more likely to be female (54.7% vs. 47.5%; p < 0.01) and characterized by a lower comorbidity burden (mean Elixhauser comorbidity index 5.4 vs. 8.2; p < 0.01). Comparing Delta and Omicron periods, patients were at significantly lower risk for intensive care treatment (adjusted odds ratio 0.72 [0.57–0.91]; p = 0.005), mechanical ventilation (adjusted odds ratio 0.42 [0.31–0.57]; p < 0.001), and in-hospital mortality (adjusted odds ratio 0.42 [0.32–0.56]; p < 0.001). This also applied mostly to the separate COVID-SARI group. During the Delta to Omicron transition, case numbers of COVID-19 without SARI exceeded COVID-SARI for the first time in the pandemic’s course.

Conclusion

Patient characteristics and outcomes differ during the Omicron dominance period as compared to Delta suggesting a reduced disease severity with Omicron infections. SARI surveillance might play a crucial role in assessing disease severity of future SARS-CoV-2 variants.
Playing a musical instrument and the risk of dementia among older adults: a systematic review and meta-analysis of prospective cohort studies
Authors: Arafa Ahmed , Teramoto Masayuki , Maeda Saori , Sakai Yukie , Nosaka Saya , Gao Qi , Kawachi Haruna , Kashima Rena , Matsumoto Chisa , Kokubo Yoshihiro
Published: October 2022

Background

Engaging in leisure activities was suggested to protect older adults from dementia. However, the association between playing a musical instrument and the risk of dementia is not well-established. This study aimed to investigate this association in older adults using a systematic review and meta-analysis of prospective cohort studies.

Methods

Pooled hazard ratio (HR) and 95% confidence interval (CI) of having dementia for older adults playing a musical instrument were calculated using the random-effects model. We performed the I2 statistic to detect heterogeneity across studies and the test for funnel plot asymmetry to assess publication bias. The risk of bias assessment was conducted using the modified Newcastle–Ottawa Scale.

Results

A total of three prospective cohort studies were found eligible: two from the U.S. and one from Japan. Playing a musical instrument, in the meta-analysis, was significantly associated with a decreased risk of dementia (HR = 0.64; 95% CI: 0.41, 0.98) among older adults. No signs of significant heterogeneity across studies (I2 = 23.3% and p-heterogeneity = 0.27) or publication bias (z= -1.3 and p-publication bias = 0.18) were identified.

Conclusion

Playing a musical instrument was associated with a decreased risk of dementia among older adults. Older adults should be encouraged to engage in leisure activities, especially playing musical instruments.
Cultural adaptation of the guidelines for offering mental health first aid to a person after a potentially traumatic event: a delphi expert consensus study in Brazil
Authors: Mendes Kathlen Nataly , Peres Carlos Henrique Mesquita , Cerqueira Amanda Vidotto , Assumpção Thais Alves , Loch Alexandre Andrade , Reavley Nicola J
Published: October 2022

Background:

Traumatic events increase the risk of mental disorders. In a country with relatively under-developed mental health support systems, services to assist people who have experienced potentially traumatic events may be unavailable. In such situations, people in the community become key sources of support. However, they do not always have the knowledge and skills to offer effective help. This study reports on the cultural adaptation for Brazil of the English-language mental health first aid guidelines for helping someone who has experienced a potentially traumatic event.

Methods:

A Delphi expert consensus study with two expert panels, one comprising health professionals with experience in the treatment of trauma (n = 33) and the other comprising people with lived experience, (n = 29) was conducted. A questionnaire containing 131 statements from the English language guidelines was translated into Brazilian Portuguese. Participants were asked to rate the importance of actions to be taken to help a person who has experienced a potentially traumatic event and to suggest new items where appropriate.

Results:

Data were collected over two survey rounds. A total of 149 items were included in the final guidelines (110 items from the English-language guidelines and 39 new items created from expert panel comments, in the second round). Immediate action items were endorsed by both panels, while items related to encouraging victims were rejected by the professional panel. The suggested statements mostly related to providing psychological support and attending to the person’s subjective experience rather than providing material or structural support.

Conclusion:

While there were many similarities with the English-language guidelines for high-income countries, the guidelines also incorporate actions of importance for Brazil, including the emphasis on the first aider’s management of the person’s subjective experiences. These guidelines may inform Mental Health First Aid training for Brazil and may also be used as standalone resources.
Future public health emergencies and disasters: sustainability and insights into support programs for healthcare providers
Authors: Dhuper Misha , Ruttan Lesley , MacGillvray Lindsey , McKay Martha , Li Adrienne , Stewart Donna , Abbey Susan , Berkhout Suze , Sheehan Kathleen , Schulz-Quach Christian
Published: October 2022

Background

The mental health of healthcare workers (HCWs) has been at the forefront throughout the COVID-19 pandemic. While workplace-based support programs have been developed in hospitals globally, few systematically collected data. While critical to their success, information on these programs and the experience of mental healthcare providers (MHP) who support colleagues is limited. The objective of this study was to explore the experiences of MHP caring for HCW colleagues within a novel workplace-based mental health support program during the COVID-19 pandemic, to provide insights on facilitators, areas for improvement and barriers to program sustainability.

Methods

This qualitative study used semi-structured interviews conducted by videoconference between September 2020 to October 2021. UHN CARES (University Health Network Coping and Resilience for Employees and Staff) Program was developed during the first wave of the COVID-19 pandemic in March 2020. It supports over 21,000 staff members within the UHN, Canada’s largest academic health research institution, in Toronto, Canada. Purposive sampling was used to select 10 of the 22 MHP in the UHN CARES Program (n = 10). Using a critical realism framework, key components required to sustain a successful workplace-based mental health support program for HCWs and balance the needs of MHP were determined.

Results

Six psychiatrists and four psychologists (n = 10) with varying roles at UHN participated in 17 interviews, including seven repeat interviews exploring changes over time within the pandemic and program. Components which facilitated the success of the program included flexibility in scheduling, confidential health record storage, comprehensive administrative support, availability of resources and adaptive quality improvement approach. Recommendations for improvement included opportunities for peer supervision, triaging of cases, and managing HCW expectations. MHP found caring for HCWs to be meaningful and they utilized existing clinical skills during sessions. Challenges included working in a virtual setting, navigating boundaries when caring for colleagues, and managing the range of service users and their needs.

Conclusions

These findings suggest how support programs can be structured for HCWs, how to provide support, and how to sustain this support, allowing health systems to balance the needs of HCWs and MHPs in preparation for future public health emergencies.
Electroconvulsive therapy combined with lithium developed reversible pure anomic aphasia: a case report
Authors: Yang Qian , Cheng Xiaofei , Su Zhewei , Sun Linyuan , Li Mingli
Published: October 2022

Background

Electroconvulsive therapy (ECT) combined with mood stabilizers is an effective method of treatment for manic episodes; however, there are controversial views on its side effects.

Case presentation

A 53-year-old man was diagnosed with bipolar disorder during a manic episode, and had previous conditions such as hypertension, and diabetes. He developed reversible delirium and anomic aphasia during combined treatment with lithium and ECT (Li-ECT). No other neurological symptoms or signs happened during the one-month follow-up period.

Conclusions

The anomic aphasia appeared after ECT was reversible. Li-ECT should be administered with caution to middle- and older-aged patients with comorbidities, and serum Li levels should be closely monitored during the treatment period.
Knowledge of COVID-19 and the impact on indigents’ access to healthcare in Burkina Faso
Authors: Bonnet E. , Beaugé Y. , Ba M. F. , Sidibé S. , De Allegri M. , Ridde V.
Published: October 2022

Background

COVID-19 constitutes a global health emergency of unprecedented proportions. Preventive measures, however, have run up against certain difficulties in low and middle-income countries. This is the case in socially and geographically marginalized communities, which are excluded from information about preventive measures. This study contains a dual objective, i) to assess knowledge of COVID-19 and the preventive measures associated with it concerning indigents in the villages of Diebougou’s district in Burkina Faso. The aim is to understand if determinants of this understanding exist, and ii) to describe how their pathways to healthcare changed from 2019 to 2020 during the COVID-19 pandemic.

Methods

The study was conducted in the Diebougou healthcare district, in the south-west region of Burkina Faso. We relied on a cross-sectional design and used data from the fourth round of a panel survey conducted among a sample of ultra-poor people that had been monitored since 2015. Data were collected in August 2020 and included a total of 259 ultra-poor people. A multivariate logistic regression to determine the factors associated with the respondents' knowledge of COVID-19 was used.

Results

Half of indigents in the district said they had heard about COVID-19. Only 29% knew what the symptoms of the disease were. The majority claimed that they protected themselves from the virus by using preventive measures. This level of knowledge of the disease can be observed with no differences between the villages. Half of the indigents who expressed themselves agreed with government measures except for the closure of markets. An increase of over 11% can be seen in indigents without the opportunity for getting healthcare compared with before the pandemic.

Conclusions

This research indicates that COVID-19 is partially known and that prevention measures are not universally understood. The study contributes to reducing the fragmentation of knowledge, in particular on vulnerable and marginalized populations. Results should be useful for future interventions for the control of epidemics that aim to leave no one behind.
Inpatient care provider perspectives on the development and implementation of an addiction medicine consultation service in a small urban setting
Authors: Beckett Madelaine , Hering Ramm , Urbanoski Karen
Published: October 2022

Background

To evaluate provider perspectives on the development and implementation of an inpatient Addiction Medicine Consult Service, including their awareness of the service, its perceived role in the continuum of care, and changes over time in their perceptions of care quality for inpatients with substance use disorders.

Methods

Repeated cross-sectional survey of hospital-based physicians, nurses and social workers performed at service launch (April–June, 2017) and 4 years later (March–June, 2021).

Results

Providers had generally positive perceptions of the service and its impact on care quality, but encountered significant barriers at both time points in meeting patient needs (related to high patient complexity and difficulty connecting patients with community services post-discharge). Relative to physicians and social workers, nurses were less likely to be familiar with the service or see it as beneficial.

Conclusions

Findings indicate that the service fills a gap that existed previously in the local system of care; however, numerous opportunities exist to further strengthen the system beyond the hospital setting to promote longer-term health among people who use substances. For nurses in particular, outreach, education, and other resources (e.g., dedicated nursing role support, nurse liaison) are warranted to ensure that nurses feel supported and confident caring for this patient population.
DrugTax: package for drug taxonomy identification and explainable feature extraction
Authors: Preto A. J. , Correia Paulo C. , Moreira Irina S.
Published: October 2022

DrugTax is an easy-to-use Python package for small molecule detailed characterization. It extends a previously explored chemical taxonomy making it ready-to-use in any Artificial Intelligence approach. DrugTax leverages small molecule representations as input in one of their most accessible and simple forms (SMILES) and allows the simultaneously extraction of taxonomy information and key features for big data algorithm deployment. In addition, it delivers a set of tools for bulk analysis and visualization that can also be used for chemical space representation and molecule similarity assessment. DrugTax is a valuable tool for chemoinformatic processing and can be easily integrated in drug discovery pipelines. DrugTax can be effortlessly installed via PyPI (https://pypi.org/project/DrugTax/) or GitHub (https://github.com/MoreiraLAB/DrugTax).

Graphical Abstract
We are not ready yet: limitations of state-of-the-art disease named entity recognizers
Authors: Kühnel Lisa , Fluck Juliane
Published: October 2022

Background

Intense research has been done in the area of biomedical natural language processing. Since the breakthrough of transfer learning-based methods, BERT models are used in a variety of biomedical and clinical applications. For the available data sets, these models show excellent results - partly exceeding the inter-annotator agreements. However, biomedical named entity recognition applied on COVID-19 preprints shows a performance drop compared to the results on test data. The question arises how well trained models are able to predict on completely new data, i.e. to generalize.

Results

Based on the example of disease named entity recognition, we investigate the robustness of different machine learning-based methods - thereof transfer learning - and show that current state-of-the-art methods work well for a given training and the corresponding test set but experience a significant lack of generalization when applying to new data.

Conclusions

We argue that there is a need for larger annotated data sets for training and testing. Therefore, we foresee the curation of further data sets and, moreover, the investigation of continual learning processes for machine learning-based models.
User-centric non-full interference cellular networks: BS cooperation and bandwidth partitioning
Authors: Mardani Mohammadreza , Mary Philippe , Baudais Jean-Yves
Published: October 2022

This paper presents a user-centric frequency reuse scheme depending on the user classification in the cell in a homogeneous Poisson point process network. Each cell is partitioned into multiple regions delimited by the signal-to-interference ratio of the user considered. A given resource block (RB) is assigned to one user in a cell and cannot be shared by another user in this cell. The typical user only uses a fraction of the RB, and the remaining part is left unused to avoid interference with the other cells. The base stations (BS) interfering set is hence determined by the coverage probability of the typical user, and this set can be approximated by a thinned version of the original PPP. Using this, coverage probability and spectral efficiency (SE) for each user types are derived, and a BS cooperation technique is proposed to improve the SE of the cell edge user. Finally, the average network spectral efficiency and fairness among users are analyzed under the developed theoretical framework. Our results show that the user-centric frequency reuse improves the coverage probability and the SE compared to the conventional frequency reuse scheme.
Genetic abnormality of cytochrome-P2C9*3 allele predisposes to epilepsy and phenytoin-induced adverse drug reactions: genotyping findings of cytochrome-alleles in the North Indian population
Authors: Garg Vivek Kumar , Supriya  , Shree Ritu , Prakash Ajay , Takkar Aastha , Khullar Madhu , Saikia Biman , Medhi Bikash , Modi Manish
Published: October 2022

Background

This research aims to study the association of genetic polymorphism in genes coding for CYP2C9 and CYP2C19 in phenytoin-induced dose-related toxicity and to assess if the presence of allele CYP2C9*3 plays a role in phenytoin-induced idiosyncratic adverse effects. Current observational case control study included 142 patients with phenytoin-induced adverse drug reactions (ADRs) and 100 controls. All these patients underwent genotyping to determine the type of CYP2C9 allele [CYP2C9*1, CYP2C9*2 or CYP2C9*3) and CYP2C19 allele (CYP2C19*1, CYP2C19*2 or CYP2C19*3] by real-time polymerase chain reaction (RT-PCR) using Applied Biosystems (ABI) 7500 Real-Time PCR System (USA).

Results

Presence of homozygous status for allele CYP2C9*3 was associated with significantly higher risk of phenytoin-induced dose-dependent ADRs, dose-independent ADRs, gum hyperplasia, and skin rash. Presence of heterozygous status for allele CYP2C9*3 was associated with significantly higher risk of phyenytoin-induced dose-dependent ADRs and dose-independent ADRs. Presence of either heterozygous or homozygous status for CYP2C9*2 and CYP2C19*2 did not have any bearing on dose-related side effects. None of the patients showed CYP2C19*3 allele.

Conclusion

Variant alleles of CYP2C9*3 are significantly overexpressed among patients with phenytoin-induced ADRs, thereby suggesting the role for CYP2C9 genotype testing to predict risk of phenytoin-related ADRs.
Primaquine-loaded transdermal patch for treating malaria: design, development, and characterization
Authors: Sharma Pankaj , Tailang Mukul
Published: October 2022

Background

The goal of the current study was to create, improve, and test a transdermal patch loaded with primaquine for the treatment of malaria. Several ingredients were used to create the transdermal patch. For the choosing of polymers, placebo patches were created. The optimization of polymer ratios for patch development and testing their impact on tensile strength, in vitro drug release, in vitro drug permeation, and ex vivo drug permeation employed response surface methods. The F5 formulation was chosen as the optimal formulation based on these answers to the data. The stability of the F5 formulation was examined. According to the findings of trials on acute skin irritation, no place where transdermal patches were given showed any signs of clinical abnormalities or a change in body weight. No erythema or edema of the skin was seen in the rabbit’s skin.

Results

It was observed that tensile strength of the transdermal films formulated with Eudragit RL100 and hydroxypropyl methylcellulose (Pmix) was found between 0.32 ± 0.017 and 0.59 ± 0.013 kg/cm2, which were 0.32 ± 0.017 (F1), 0.36 ± 0.012 (F2), 0.35 ± 0.015 (F3) for Pmix ratio 1:1, 0.42 ± 0.011 (F4), 0.49 ± 0.010 (F5), 0.55 ± 0.016 (F6) for Pmix ratio 1:2 and 0.56 ± 0.014 (F7), 0.57 ± 0.010 (F8), 0.59 ± 0.013 (F9) for Pmix ratio 1:3. Data fitting to the Peppas, Hixon–Crowell, Higuchi, and Zero-order models was used to examine the optimized transdermal patch (F5) release kinetic mechanism. Data comparison was done using the correlation coefficient (R2). Zero-order had an observed correlation coefficient (R2) of 0.9988, which was greater than that for other models. Therefore, it was clear that the medication was released from the formulation after the Zero-order release.

Conclusion

The ideal thickness, percent elongation, and tensile strength of the primaquine therapeutic transdermal patches were prepared for transdermal delivery. The therapeutic transdermal patch was prepared by using Eudragit RL100: HPMC K15M (1:2) into the patch because this combination was responsible for the significant delivery of the drug into the bloodstream. The therapeutic transdermal patch has a notable penetration rate. Dimethyl sulfoxide was used as a permeation enhancer, which helped to obtain a high penetration rate. The statistical analysis was used to support the improved formulation. The therapeutic transdermal patch is a potential vehicle for the administration of primaquine, according to stability studies.
Too Much Data: Prices and Inefficiencies in Data Markets
Authors: Acemoglu Daron , Makhdoumi Ali , Malekian Azarakhsh , Ozdaglar Asu
Published: October 2022

When a user shares her data with online platforms, she reveals information about others. In such a setting, externalities depress the price of data because once a user's information is leaked by others, she has less reason to protect her data and privacy. These depressed prices lead to excessive data sharing. We characterize conditions under which shutting down data markets improves welfare. Platform competition does not redress the problem of excessively low data prices and too much data sharing and may further reduce welfare. We propose a scheme based on mediated data sharing that improves efficiency. (JEL D62, D83, H23, L51, L86, L88)
Deposit Requirements in Auctions
Authors: Che Xiaogang , Li Tong , Lu Jingfeng , Zheng Xiaoyong
Published: October 2022

We examine optimal auction design when buyers may receive future outside offers. The winning bidder may choose to default upon observing her outside offer. Under the optimal mechanism, the bidder with the highest value wins if and only if her value is above a cutoff, and the winner never defaults. The optimal auction takes the form of a second-price auction with a reserve price and a deposit by the winning bidder. Under regularity conditions, both the optimal reserve price and the deposit increase when the distribution of outside offers worsens. (JEL D44, D82)