bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of long-acting injectable antipsychotics on hospitalizations and global functioning in schizophrenia: a naturalistic mirror-image study
Authors: Montemagni Cristiana , Del Favero Elisa , Cocuzza Elena , Vischia Flavio , Rocca Paola
Published: October 2022

Background:

Partial adherence to antipsychotics is the most common cause of relapses and rehospitalization in patients with schizophrenia (SZ), leading to higher health care costs and psychosocial disability. The use of long-acting injectable (LAI) antipsychotics may improve therapeutic continuity and adherence to treatment.

Objective:

To assess the effectiveness of switching from oral antipsychotics (OAs) to long-acting antipsychotics.

Methods:

This 1-year mirror-image study evaluated the effect of switching from OAs to LAIs on the reduction of psychiatric hospitalizations and the improvement of global functioning in patients with schizophrenia. Differences in outcomes between second-generation (SGA) LAIs and first-generation (FGA) LAIs were also analyzed.

Results:

In all, 166 patients were included: 32.5% treated by FGA-LAIs and 67.5% by SGA-LAIs. There was an overall reduction of 71% in the average number of hospital admissions and an overall improvement of 29.3% in the Global Assessment of Functioning (GAF) score between the previous 12 months and the 12 months following the switching to LAIs. Patients who switched to SGA-LAIs had no significant differences in hospitalization occurrences but a significant improvement in GAF scores when compared with patients who switched to FGA-LAIs.

Conclusion:

Our results suggest that using LAIs could be the most adequate treatment choice for SZ patients with a high risk of relapse and low adherence rate. Patients with poorer social functioning may be ideal candidates for SGA-LAIs treatment. Our findings may be of particular interest from a clinical and health care management perspective.
Clinical and biological consequences of respiratory syncytial virus genetic diversity
Authors: Rios Guzman Estefany , Hultquist Judd F.
Published: October 2022

Respiratory syncytial virus (RSV) is one of the most common etiological agents of global acute respiratory tract infections with a disproportionate burden among infants, individuals over the age of 65, and immunocompromised populations. The two major subtypes of RSV (A and B) co-circulate with a predominance of either group during different epidemic seasons, with frequently emerging genotypes due to RSV’s high genetic variability. Global surveillance systems have improved our understanding of seasonality, disease burden, and genomic evolution of RSV through genotyping by sequencing of attachment (G) glycoprotein. However, the integration of these systems into international infrastructures is in its infancy, resulting in a relatively low number (~2200) of publicly available RSV genomes. These limitations in surveillance hinder our ability to contextualize RSV evolution past current canonical attachment glycoprotein (G)-oriented understanding, thus resulting in gaps in understanding of how genetic diversity can play a role in clinical outcome, therapeutic efficacy, and the host immune response. Furthermore, utilizing emerging RSV genotype information from surveillance and testing the impact of viral evolution using molecular techniques allows us to establish causation between the clinical and biological consequences of arising genotypes, which subsequently aids in informed vaccine design and future vaccination strategy. In this review, we aim to discuss the findings from current molecular surveillance efforts and the gaps in knowledge surrounding the consequence of RSV genetic diversity on disease severity, therapeutic efficacy, and RSV–host interactions.
A survey of local diagnostic reference levels for the head, thorax, abdomen and pelvis computed tomography in Norway and Canada
Authors: Tonkopi Elena , Wikan Eline Jahre , Hovland Tor Olav , Høgset Sivert , Kofod Thomas Alexander , Sefenu Selasi K , Hughes-Ryan Emily , d´Entremont-O´Connell Dakota , Gunn Catherine , Holter Tanja , Johansen Safora
Published: October 2022

Background

Computed tomography (CT) contributes to 60% of the collective dose in medical imaging. Literature has demonstrated that patient dose varies across regions and countries. Establishing diagnostic reference levels (DRLs) contributes to the optimization of clinical practices and radiation protection.

Purpose

To survey the dose indices (CTDIvol and dose-length product) for frequently performed CT examinations from the chosen hospitals in Norway and Canada and to determine local DRLs (LDRLs) based on the collected data.

Material and Methods

The survey included eight scanners from two Norwegian hospitals and four scanners from four Canadian hospitals. Dosimetry data were collected for the following routine CT examinations: head, contrast-enhanced thorax, and abdomen and pelvis. Overall 480 adult average-sized patients from Norway and 360 from Canada were included in the survey. The LDRLs were determined as the 75th percentile of distributions of median values of dose indicators from different CT scanners. The differences in dose between scanners were determined using single-factor ANOVA.

Results

The LDRLs determined in Norway were higher overall than in Canada. The obtained values were compared to the national DRLs. The dose from several scanners in Norway exceeded national Norwegian DRLs, while Canadian LDRLs were below the Canadian reference levels. The differences between the means of the dose distributions from each scanner were statistically significant ( p < 0.05) for all examinations with exception of identical scanners located in the same hospital and using the same protocols.

Conclusion

Observed dose variations even in the same hospital, or from the same scanner model confirmed the need for CT protocol optimization.
What Drives? What Restrains? Hidden Dynamics of Knowledge Transfer from Buddhist Male Managers to Female Trainees
Authors: Wijerathna Mandari Pabasara , Hewapathirana Gertrude I.
Published: October 2022

Knowledge is power; if so, what hidden dynamics interplay during the employee training process between Buddhist male managers and their female subordinates who would potentially be future peers? Using a phenomenological enquiry, we explored hidden forces driving and restraining effective knowledge transfer and managers’ underlying beliefs, attitudes, prejudices, and motives. The findings revealed the societal and individual prejudices towards women as the restraining forces, while Buddhist ideologies and values as the driving forces of knowledge transfer. The results can be interpreted at individual, national, and organizational levels, thus leading to a new conceptualization of knowledge transfer practices in similar religious and ideological contexts. The underlying contradictions between Buddhist beliefs and societal prejudices thwarted knowledge transfer effectiveness. These findings guide practitioners to innovate practical training to initiate a paradigm shift to eliminate the harmful effect of societal ideologies and gender prejudices and integrate Buddhist values’ driving forces into knowledge transfer practices. We concluded that religious doctrines play a vital role in knowledge transfer practices, attitudes, values, and workplace behaviour in native Buddhist societies; however, future research would enhance the generalizability of the findings in similar religious contexts specific to South Asian countries.
Turnover Intentions of IT Repatriates in India: Exploring the Role of Organizational Commitment
Authors: Saxena Manisha , Das Sudeep Kumar
Published: October 2022

The turnover intention of repatriates in the IT sector requires immediate attention due to the rapid rise of India as a global market. To survive in an environment of cut-throat competition, organizations are required to have a proper understanding of the reasons for repatriate turnover in the IT sector and of the solutions to overcome this problem. Factors such as repatriate adjustment, job satisfaction, and organizational commitment are the key to understand the intentions for repatriate turnover. The primary objective of this study was to compare the role of organizational commitment as a mediator and as an independent variable for explaining the intent to leave. Feedback from IT repatriates in Indian organizations were generated. The items of the questionnaires were adapted from various previous studies to generate the relevant data. Data was generated from a sample of 273 respondents. Appropriate tools were employed for the purpose of refining and analysis of data. Study findings supported that organizational commitment role as a mediator is more important than as an independent variable in explaining the intentions of repatriate regarding the turnover. The study will provide useful insights to the practitioners and policymakers in understanding the process of repatriate adjustment and, hence, can assist in reducing the turnover intentions among the repatriates. Indian IT sector faces considerable high attrition. It has been observed that employees after returning from their foreign assignments find it difficult to readjust and thereafter eventually quit the organization. The turnover intention of repatriation in the IT sector requires immediate attention to arrest this kind of attrition. There is a paucity of studies focusing on turnover intention of repatriates in the Indian context. This study aims to fill that gap.
Making Students ‘Industry-Ready’: An Empirical Analysis of Management Programme Outcomes
Authors: Upadhyay Parijat , Paul Manas , Shrivastava Santosh
Published: October 2022

This study empirically validates the knowledge management conceptual framework that explains the relationship between an institution’s pedagogical approach and field-based projects (FBPs) vis-a-vis student preparedness for the job market. The 431 Indian B-school students sample is collected to validate the knowledge management conceptual framework. A structured questionnaire designed on a five-point Likert scale has been used based on purposive sampling. The goodness of fit is validated by applying a structural equation modelling (SEM) approach. The association between various variables is investigated using path analysis for hypothesis testing. The findings of this study indicate that the factors such as benchmarking against global practices (BAGP), FBPs, industry connects (IC) and organizational aspiration (OA) have significant impacts on the students’ learning outcomes and their subsequent transformation into industry-ready future jobs. These factors help infuse the necessary skills and experiential learning into students who look to prepare for future employment through knowledge-intensive organizations. This study also highlights the factors that B-schools should focus on to improve graduates’ employability and industrial performance.
Learning-Mode Choice, Student Engagement, and Achievement Growth During the COVID-19 Pandemic
Authors: Darling-Aduana Jennifer , Woodyard Henry T. , Sass Tim R. , Barry Sarah S.
Published: October 2022

The COVID-19 pandemic resulted in an unanticipated, near-universal shift from in-person to virtual instruction in the spring of 2020. During the 2020–21 school year, schools began to reopen, and families were faced with decisions regarding the instructional mode for their children. We leverage administrative, survey, and virtual-learning data to examine the determinants of family learning-mode choice and associations between virtual education, student engagement, and academic achievement. Family preference for virtual (versus face-to-face) instruction was highly associated with subsequent school-level infection rates and appeared relatively uniform within schools. We find that students assigned to a higher proportion of instructional days in virtual mode experienced higher rates of attendance but negative achievement growth compared to students who were assigned a higher proportion of instructional days in face-to-face mode. Insights from this study can be used to better understand family preferences as well as to target and refine virtual learning in a post-COVID-19 society.
Integrating a Patient Decision Aid into the Electronic Health Record: A Case Report on the Implementation of BREASTChoice at 2 Sites
Authors: Lee Clara N. , Sullivan Janessa , Foraker Randi , Myckatyn Terence M. , Olsen Margaret A. , Phommasathit Crystal , Boateng Jessica , Parrish Katelyn L. , Rizer Milisa , Huerta Tim , Politi Mary C.
Published: October 2022

Patient decision aids can support shared decision making and improve decision quality. However, decision aids are not widely used in clinical practice due to multiple barriers. Integrating patient decision aids into the electronic health record (EHR) can increase their use by making them more clinically relevant, personalized, and actionable. In this article, we describe the procedures and considerations for integrating a patient decision aid into the EHR, based on the example of BREASTChoice, a decision aid for breast reconstruction after mastectomy. BREASTChoice’s unique features include 1) personalized risk prediction using clinical data from the EHR, 2) clinician- and patient-facing components, and 3) an interactive format. Integrating a decision aid with patient- and clinician-facing components plus interactive sections presents unique deployment issues. Based on this experience, we outline 5 key implementation recommendations: 1) engage all relevant stakeholders, including patients, clinicians, and informatics experts; 2) explicitly and continually map all persons and processes; 3) actively seek out pertinent institutional policies and procedures; 4) plan for integration to take longer than development of a stand-alone decision aid or one with static components; and 5) transfer knowledge about the software programming from one institution to another but expect local and context-specific changes. Integration of patient decision aids into the EHR is feasible and scalable but requires preparation for specific challenges and a flexible mindset focused on implementation.

Highlights

Integrating an interactive decision aid with patient- and clinician-facing components into the electronic health record could advance shared decision making but presents unique implementation challenges. We successfully integrated a decision aid for breast reconstruction after mastectomy called BREASTChoice into the electronic health record. Based on this experience, we offer these implementation recommendations: 1) engage relevant stakeholders, 2) explicitly and continually map persons and processes, 3) seek out institutional policies and procedures, 4) plan for it to take longer than for a stand-alone decision aid, and 5) transfer software programming from one site to another but expect local changes.
Interpreting Breast Cancer Mortality Trends Related to Introduction of Mammography Screening: A Simulation Study
Authors: Heggland Torunn , Vatten Lars Johan , Opdahl Signe , Weedon-Fekjær Harald
Published: October 2022

Background. Several studies have evaluated the effect of mammography screening on breast cancer mortality based on overall breast cancer mortality trends, with varied conclusions. The statistical power of such trend analyses is, however, not carefully studied. Methods. We estimated how the effect of screening on overall breast cancer mortality is likely to unfold. Because a screening effect is based on earlier treatment, screening can affect only new incident cases after screening introduction. To evaluate the likelihood of detecting screening effects on overall breast cancer mortality time trends, we calculated the statistical power of joinpoint regression analysis on breast cancer mortality trends around screening introduction using simulations. Results. We found that a very gradual increase in population-level screening effect is expected due to prescreening incident cases. Assuming 25% effectiveness of a biennial screening program in reducing breast cancer mortality among women 50 to 69 y of age, the expected reduction in overall breast cancer mortality was 3% after 2 y and reached a long-term effect of 18% after 20 y. In common settings, the statistical power to detect any screening effects using joinpoint regression analysis is very low (<50%), even in an artificial setting of constant risk of baseline breast cancer mortality over time. Conclusions. Population effects of screening on breast cancer mortality emerge very gradually and are expected to be considerably lower than the effects reported in trials excluding women diagnosed before screening. Studies of overall breast cancer mortality time trends have too low statistical power to reliably detect screening effects in most populations. Implications. Researchers and policy makers evaluating mammography screening should avoid using breast cancer mortality trend analysis that does not separate pre- and postscreening incident cases.

Highlights

Population-level mammography screening effects on breast cancer mortality emerge gradually following screening introduction, resulting in very low statistical power of trend analysis. Researchers and policy makers evaluating mammography screening should avoid relying on population-wide breast cancer mortality trends. Expected mammography screening effects at population level are lower than those from screening trials, as many cases of breast cancer fall outside the screening age range.
Book review: Mukulika Banerjee, Cultivating Democracy: Politics and Citizenship in Agrarian India
Authors: Talukdar Neelakshi
Published: October 2022

Mukulika Banerjee, Cultivating Democracy: Politics and Citizenship in Agrarian India. New York, NY: Oxford University Press, 2021. 257 pp., £19.99, ISBN: 9780197601877.
Regular medication as a risk factor for intracranial aneurysms: A comparative case–control study
Authors: Jabbarli Ramazan , Darkwah Oppong Marvin , Chihi Mehdi , Dinger Thiemo Florin , Said Maryam , Rodemerk Jan , Dammann Philipp , Schmidt Börge , Deuschl Cornelius , Guberina Nika , Wrede Karsten H. , Sure Ulrich
Published: October 2022

Background:

Previous medical history strongly contributes to the genesis of intracranial aneurysms (IA). A possible impact of regular medication on the occurrence of abdominal aortic aneurysms has been reported.

Aim:

To evaluate the value of regular medication on the risk of development and rupture of IA.

Methods:

Data on medication use and related comorbidities were obtained from the institutional IA registry. A 1:1 age- and sex-matched patient sample was collected from the population-based Heinz Nixdorf Recall Study with individuals from the same area.

Results:

In the analysis comparing IA cohort ( n = 1960) with the matched normal population ( n = 1960), the use of statins (adjusted odds ratio, 1.34 [95% confidence interval 1.02–1.78]), antidiabetics (1.46 [1.08–1.99]), and calcium channel blockers (1.49 [1.11–2.00]) was independently associated with higher risk of IA, whereas uricostatics (0.23 [0.14–0.38]), aspirin (0.23 [0.13–0.43]), beta-blockers (0.51 [0.40–0.66]), and angiotensin-converting enzyme inhibitors (0.38 [0.27–0.53]) were related to lower risk of IA. In the multivariable analysis within the IA cohort ( n = 2446), SAH patients showed higher drug exposure with thiazide diuretics (2.11 [1.59–2.80]), but lower prevalence of remaining antihypertensive medication—beta-blockers (0.38 [0.30–0.48]), calcium channel blockers (0.63 [0.48–0.83]), angiotensin-converting enzyme inhibitors (0.56 [0.44–0.72]), and angiotensin-1 receptor blockers (0.33 [0.24–0.45]). Patients with ruptured IA were less likely to be treated with statins (0.62 [0.47–0.81]), thyroid hormones (0.62 [0.48–0.79]), and aspirin (0.55 [0.41–0.75]).

Conclusions:

Regular medication might impact the risks related to the development and rupture of IA. Further clinical trials are required to clarify the effect of regular medication on IA genesis.
Vernacular Tradition, Dalits and Connected Social History in the Littoral Bay of Bengal
Authors: Das Debojyoti
Published: October 2022

The Bengal delta has been a recipient of Islamic influences since medieval times through trade, commerce and cultural exchanges with Southeast and West Asia via the Bay of Bengal–Indian Ocean trade route. This aspect of Bengal’s cultural history and engagement with different religious traditions has gained attention in recent times through works done on subaltern literature, cultural history and global history. The vernacular tradition of littoral Bengal presents a strong frontrunner for this. Jatra (theatre), pala (lyrical play), scroll painting of pir, gazi, fakir and poetic discourse locally known as tarja demonstrate the diverse forms of vernacular philosophy in the littoral Bay of Bengal. In this article, I will engage with Bonbibis Johurnama, an Islamic text 1 which illustrates the struggle of the protagonist Dukhe who is protected by Bonbibi (forest goddess) from the man-eating tiger, personified as Dakhin Ray, the Hindu god. The article will explore the cosmic and mundane aspects of marginalized seafaring communities who depend on the delta’s backwaters and the mangrove forest for livelihood. Bonbibi is venerated as the ultimate protector in this amorphous landscape, interspersed by land and water. The vernacular history of the region exposes the serendipity and the mundane everyday activities of Dalit fisherman who venture into the forests and backwaters to collect honey and wax. Through vernacular text – punthi literature – I will show how the ritual practices are shared and how this shapes the religious syncreticism that creates solidarity between Dalit Hindu and Muslim foresters and fishers in the delta. These syncretic and heterodox religious practices are part of the vernacular literary tradition that illustrates how the littoral villages have lived together. The maritime trade and cultural acquaintances with the wider littoral world has been an obvious influence on the creation of liminal religiosity.
Dalit Humanism: Marginal Spatial Reality as a Site of Dalit Counterpublic in Bama’s Sangati and Tulsiram’s Murdahiya
Authors: Kumar Anurag , Malhotra Isha , Kumar Nagendra
Published: October 2022

In India, one of the major counter-discourses constituted to critique the culture of violence, silence and impunity, harboured by the Indian public sphere, is offered by Dalit literary writings. Dalit counterpublic highlights the alternate cultural spaces that subvert and disrupt the dominant structures of repression by valuing the Dalit standpoint. The present article claims that the Dalit counterpublic is subaltern as well as locational; subalternity is based on the marginal position prescribed to Dalit people in the Indian social and cultural structure while location refers to the geopolitical territorial segregation. Bama’s Sangati and Tulsiram’s Murdahiya have been analysed using theoretical perspectives of counterpublic proposed by critics such as Nancy Fraser, Kanika Batra and Michel Warner. The findings suggest that Dalit people have transformed Dalit marginal site into a source of resistance.
Factors Associated with Multi-Biologic Use in Psoriasis Patients at an Academic Medical Center and Review of Biologic Survival
Authors: Hadeler Edward , Kumar Sugandh , Yeroushalmi Samuel , Hong Julie , Wallace Elizabeth , Han George , Mosca Megan , Bartholomew Erin , Chung Mimi , Hakimi Marwa , Reddy Soumya , Scher Jose , Bhutani Tina , Gondo George , Armstrong April , Bell Stacie , Liao Wilson
Published: October 2022

Background

Despite their impressive efficacy in phase 3 trials, biologic agents for psoriasis (PsO) may lose efficacy over time. The factors associated with loss of efficacy have yet to be fully elucidated.

Objective

We aimed to identify factors associated with PsO patients using multiple biologics in comparison to patients who used 1 biologic. We also reviewed the literature comparing the survival of different biologic agents for PsO.

Methods

We examined clinical data from 222 psoriasis patients at the University of California San Francisco, of whom 51 reported use of 3 or more biologics and of whom 171 reported use of only a single biologic agent at the time of enrollment into a research database from 2006-2020. This study was IRB-approved at UCSF (#10-02830) and all subjects provided written informed consent. We performed univariate and multivariate regression analysis to identify significant demographic features, clinical features, and co-morbidities associated with multi-biologic use. We performed a literature review of studies comparing psoriasis biologic survival at 1, 2, and 5 years and factors associated with single biologic failure.

Results

In univariate analysis, duration of PsO, initial presentation of PsO on the gluteal cleft, erythrodermic psoriasis, and acne were associated with using 3 or more biologics. In multivariate analysis, duration of PsO, erythrodermic psoriasis, and acne remained significant. Our review of biologic survival revealed differences according to biologic class.

Conclusion

We identified novel factors associated with multi-biologic use in PsO. Further studies in this area are needed to achieve a precision medicine approach.
Third wave COVID-19 delta variant breakthrough infection in a Hispanic-dominant suburb of Miami, Florida: ethical dilemma and vaccination hesitancy
Authors: Kara Sam , Lazovic Gavrilo , Chohan Farah , Lawrence Jannel A. , Sukaina Mahnoor , Edaki Omoyeme , Nedd Kester
Published: October 2022

Background and Aims:

The peak of the third wave of COVID-19 infection was in the summer (August–September) of 2021, dominated by the Delta variant. Florida was the epicenter of the third wave with more than 151,449 cases in the first week of August with a positivity rate of 20%. The purpose of this study is to identify the percentage of COVID-19 infection in vaccinated patients in a minority population in south Florida and to elucidate the relationship, if any, between demographics and breakthrough infections, the rate of vaccine hesitancy, as well as the willingness to receive the monoclonal antibody REGEN-COV for the treatment of COVID-19.

Methods:

This cross-sectional study was performed at the Emergency Department, Larkin Community Hospital Palm Spring Campus, located in Hialeah, the fourth largest city in Florida. Hialeah is dominated (94.7%) by Hispanics and Latinos. This city represents a cross-sectional sample of US cities in general and Florida in specific. We enrolled 127 COVID-19 PCR-positive patients.

Results:

The infection in vaccinated patients (breakthrough) was found to be about one in three (34%). Despite the high infection rate and mounting death toll, about 73% of our unvaccinated patients answered no to the question ‘knowing the consequences of being infected with COVID-19 and the fact that you are positive, would you have chosen to be vaccinated earlier?’ However, about 27% of these patients agreed to receive the vaccine and 20.5% received the monoclonal antibody REGEN-COV.

Conclusions:

Our study revealed that vaccine hesitancy in South Florida continues to be a major challenge, especially with the emergence of mutations including Delta plus and Omicron.
The hierarchy of multiple stressors’ effects on benthic invertebrates: a case study from the rivers Erft and Niers, Germany
Authors: Markert Nele , Guhl Barbara , Feld Christian K.
Published: October 2022

Background

A variety of anthropogenic stressors influences the ecological status of rivers wordwide. Important stressors include elevated concentrations of nutrients, salt ions, heavy metals and other pollutants, habitat degradation and flow alteration. Some stressors tend to remain underrepresented in multiple-stressor studies, which in particular is apparent for micropollutants (e.g. pesticides, pharmaceuticals) and alterations of the flow regime. This case study analysed and compared the effects of 19 different stressor variables on benthic macroinvertebrates in the two German rivers Erft and Niers (Federal State of North Rhine-Westphalia, Germany). The stressors variables were assigned to four stressor groups (physico-chemical stress, mixture toxicity of 42 micropollutants, hydrological alteration and morphological degradation) and were put into a hierarchical context according to their relative impact on the macroinvertebrate community using redundancy analysis and subsequent variance partitioning.

Results

The results suggest a strong and unique effect of physico-chemical stress, yet at the same time reveal also a strong joint effect of physico-chemical and hydrological stressor variables. Morphological degradation showed subordinate effects. Notably, only a minor share of the explained variance was attributed to the mixture toxicity of micropollutants in these specific catchments.

Conclusions

The stressor hierarchy indicates that management measures for improving the ecological status still need to address water quality issues in both rivers. The strong joint effect of physico-chemical stress and hydrological alteration might imply a common source of both stressor groups in these two catchment areas: lignite mining drainage, urban area and effluents of wastewater treatment plants. The findings point at the important role of alterations in the flow regime, which often remain unconsidered in hydro-morphological surveys.
A graph-based approach for the visualisation and analysis of bacterial pangenomes
Authors: Harling-Lee Joshua D. , Gorzynski Jamie , Yebra Gonzalo , Angus Tim , Fitzgerald J. Ross , Freeman Tom C.
Published: October 2022

Background

The advent of low cost, high throughput DNA sequencing has led to the availability of thousands of complete genome sequences for a wide variety of bacterial species. Examining and interpreting genetic variation on this scale represents a significant challenge to existing methods of data analysis and visualisation.

Results

Starting with the output of standard pangenome analysis tools, we describe the generation and analysis of interactive, 3D network graphs to explore the structure of bacterial populations, the distribution of genes across a population, and the syntenic order in which those genes occur, in the new open-source network analysis platform, Graphia. Both the analysis and the visualisation are scalable to datasets of thousands of genome sequences.

Conclusions

We anticipate that the approaches presented here will be of great utility to the microbial research community, allowing faster, more intuitive, and flexible interaction with pangenome datasets, thereby enhancing interpretation of these complex data.
Revealing the characteristics of ZIKV infection through tissue-specific transcriptome sequencing analysis
Authors: Chen Zhi-lu , Yin Zuo-jing , Qiu Tian-yi , Chen Jian , Liu Jian , Zhang Xiao-yan , Xu Jian-qing
Published: October 2022

Background

Recently, Zika virus (ZIKV) re-emerged in India and was potentially associated with microcephaly. However, the molecular mechanisms underlying ZIKV pathogenesis remain to be explored.

Results

Herein, we performed a comprehensive RNA-sequencing analysis on ZIKV-infected JEG-3, U-251 MG, and HK-2 cells versus corresponding uninfected controls. Combined with a series of functional analyses, including gene annotation, pathway enrichment, and protein–protein interaction (PPI) network analysis, we defined the molecular characteristics induced by ZIKV infection in different tissues and invasion time points. Data showed that ZIKV infection and replication in each susceptible organ commonly stimulated interferon production and down-regulated metabolic-related processes. Also, tissue-specific immune responses or biological processes (BPs) were induced after ZIKV infection, including GnRH signaling pathway in JEG-3 cells, MAPK signaling pathway in U-251 MG cells, and PPAR signaling pathway in HK-2 cells. Of note, ZIKV infection induced delayed antiviral interferon responses in the placenta-derived cell lines, which potentially explains the molecular mechanism by which ZIKV replicates rapidly in the placenta and subsequential vertical transmission occurs.

Conclusions

Together, these data may provide a systemic insight into the pathogenesis of ZIKV infection in distinct human tissue-derived cell lines, which is likely to help develop prophylactic and therapeutic strategies against ZIKV infection.
Transcriptome analysis of MYB transcription factors family and PgMYB genes involved in salt stress resistance in Panax ginseng
Authors: Liu Mingming , Li Ke , Sheng Shichao , Wang Mingyu , Hua Panpan , Wang Yanfang , Chen Ping , Wang Kangyu , Zhao Mingzhu , Wang Yi , Zhang Meiping
Published: October 2022

Background

As the king of all herbs, the medicinal value of ginseng is self-evident. The perennial nature of ginseng causes its quality to be influenced by various factors, one of which is the soil environment. During plant growth and development, MYB transcription factors play an important role in responding to abiotic stresses and regulating the synthesis of secondary metabolites. However, there are relatively few reports on the MYB transcription factor family in Panax ginseng.

Results

This study identified 420 PgMYB transcripts under 117 genes ID in the Jilin ginseng transcriptome database. Phylogenetic analysis showed that PgMYB transcripts in Jilin ginseng were classified into 19 functional subclasses. The GO annotation result indicated that the functional differentiation of PgMYB transcripts was annotated to 11 functional nodes at GO Level 2 in ginseng. Expression pattern analysis of PgMYB transcripts based on the expression data (TPM) that PgMYB transcripts were revealed spatiotemporally specific in expression patterns. We performed a weighted network co-expression network analysis on the expression of PgMYB transcripts from different samples. The co-expression network containing 51 PgMYB transcripts was formed under a soft threshold of 0.85, revealing the reciprocal relationship of PgMYB in ginseng. Treatment of adventitious roots of ginseng with different concentrations of NaCl revealed four up-regulated expression of PgMYB transcripts that can candidate genes for salt resistance studies in ginseng.

Conclusions

The present findings provide data resources for the subsequent study of the functions of MYB transcription factor family members in ginseng, and provide an experimental basis for the anti-salt functions of MYB transcription factors in Panax ginseng.
Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study
Authors: Swale Matthew , Paul Vincent , Delacroix Sinny , Young Glenn , McSpadden Luke , Ryu Kyungmoo , Di Fiore David , Santos Maria , Tan Isabel , Conradie Andre , Duong MyNgan , Schwarz Nisha , Worthley Stephen , Pavia Stephen
Published: October 2022

Background

Insertable cardiac monitors (ICMs) are small subcutaneously implanted devices that detect changes in R-wave amplitudes (RWAs), effective in arrhythmia-monitoring. Although ICMs have proven to be immensely successful, electrical artefacts are frequent and can lead to misdiagnosis. Thus, there is a growing need to sustain and increase efficacy in detection rates by gaining insight into various patient-specific factors such as body postures and activities.

Methods

RWAs were measured in 15 separate postures, including supine, lying on the right-side (RS) or left-side (LS) and sitting, and two separate ICM orientations, immediately after implantation of Confirm Rx™ ICM in 99 patients.

Results

The patients (53 females and 46 males, mean ages 66.62 ± 14.7 and 66.40 ± 12.25 years, respectively) had attenuated RWAs in RS, LS and sitting by ~ 26.4%, ~ 27.8% and ~ 21.2% respectively, compared to supine. Gender-based analysis indicated RWAs in RS (0.32 mV (0.09–1.03 mV), p < 0.0001) and LS (0.37 mV (0.11–1.03 mV), p = 0.004) to be significantly attenuated compared to supine (0.52 mV (0.20–1.03 mV) for female participants. Similar attenuation was not evident for male participants. Further, parasternally oriented ICMs (n = 44), attenuated RWAs in RS (0.37 mV(0.09–1.03 mV), p = 0.05) and LS (0.34 mV (0.11–1.03 mV), p = 0.02) compared to supine (0.48 mV (0.09–1.03 mV). Similar differences were not observed in participants with ICMs in the 45°-relative-to-sternum (n = 46) orientation. When assessing the combined effect of gender and ICM orientation, female participants demonstrated plausible attenuation in RWAs for RS and LS postures compared to supine, an effect not observed in male participants.

Conclusion

This is the first known study depicting the effects on RWA due to body postures and activities immediately post-implantation with an overt impact by gender and orientation of ICM. Future work assessing the cause of gender-based differences in RWAs may be critical.

Trial registration: Clinical Trials, NCT03803969. Registered 15 January 2019 – Retrospectively registered, https://clinicaltrials.gov/NCT03803969
Infrastructure challenges to doing health research “where populations with the most disease live” in Covid times—a response to Rai et al. (2021)
Authors: MacLellan Jennifer , Turnbull Joanne , Pope Catherine
Published: October 2022

Background

The failure of randomised controlled trials to adequately reflect areas of highest health need have been repeatedly highlighted. This has implications for the validity and generalisability of findings, for equity and efficiency, but also for research capacity-building. Rai et al. (BMC Med Res Methodol 21:80, 2021) recently argued that the poor alignment between UK clinical research activity (specifically multi-centre RCTs) and local prevalence of disease was, in part, the outcome of behaviour and decision-making by Chief Investigators involved in trial research. They argued that a shift in research culture was needed. Following our recent multi-site mixed methods evaluative study about NHS 111 online we identify some of the additional structural barriers to delivering health research “where populations with the most disease live”, accounting for the Covid-19 disruption to processes and delivery.

Methods

The NHS 111 study used a mixed-method research design, including interviews with healthcare staff and stakeholders within the primary, urgent and emergency health care system, and a survey of users and potential users of the NHS 111 online service. This paper draws on data collated by the research team during site identification and selection, as we followed an action research cycle of planning, action, observation and reflection. The process results were discussed among the authors, and grouped into the two themes presented.

Results

We approached 22 primary and secondary care sites across England, successfully recruiting half of these. Time from initial approach to first participant recruitment in successful sites ranged from one to ten months. This paper describes frontline bureaucratic barriers to research delivery and recruitment in the local Clinical Research Network system and secondary care sites carrying large research portfolios, alongside the adaptive practices of research practitioners that mitigate these.

Conclusions

This paper augments the recommendations of Rai et al., describing delays encountered during the COVID-19 pandemic, and suggesting in addition to cultural change, it may be additionally important to dismantle infrastructural barriers and improve support to research teams so they can conduct health research “where populations with the most disease live”.
Moyamoya associated with Turner syndrome in a patient with type 2 spinocerebellar ataxia—Occam’s razor or Hickam’s dictum: a case report
Authors: Nóbrega Paulo Ribeiro , da Costa Francisco Bruno Santana , Rodrigues Pedro Gustavo Barros , de Maria Frota Vasconcelos Thais , Soares Danyela Martins Bezerra , Araújo Jéssica Silveira , Dias Daniel Aguiar , Sobreira-Neto Manoel Alves , de Paiva Anderson Rodrigues Brandão , Braga-Neto Pedro , Kok Fernando , Fontenele Eveline Gadelha Pereira
Published: October 2022

Background

Turner syndrome (TS) is a rare condition associated with a completely or partially missing X chromosome that affects 1 in 2500 girls. TS increases the risk of autoimmune diseases, including Graves’ disease (GD). Moyamoya disease is a rare cerebral arteriopathy of unknown etiology characterized by progressive bilateral stenosis of the internal carotid artery and its branches. Both TS and GD have been associated with Moyamoya. Type 2 spinocerebellar ataxia (SCA2) is an autosomal dominant cerebellar ataxia caused by a CAG repeat expansion in ATXN2. We present the first case of Moyamoya syndrome in a patient with a previous diagnosis of TS and GD who tested positive for SCA2 and had imaging findings compatible with an overlap of SCA2 and Moyamoya.

Case presentation

A 43-year-old woman presented with mild gait imbalance for 2 years. Her family history was positive for type 2 spinocerebellar ataxia (SCA2). She had been diagnosed with Turner Syndrome (45,X) and Graves disease three years before. Brain MRI revealed bilateral frontal and parietal cystic encephalomalacia in watershed zones, atrophy of pons, middle cerebellar peduncles and cerebellum. MR angiography showed progressive stenosis of both internal carotid arteries with lenticulostriate collaterals, suggestive of Moya-Moya disease. Molecular analysis confirmed the diagnosis of SCA2.

Conclusions

With increased availability of tools for genetic diagnosis, physicians need to be aware of the possibility of a single patient presenting two or more rare diseases. This report underscores the modern dilemmas created by increasingly accurate imaging techniques and available and extensive genetic testing.
Gestational diabetes mellitus, prenatal maternal depression, and risk for postpartum depression: an Environmental influences on Child Health Outcomes (ECHO) Study
Authors: Shuffrey Lauren C. , Lucchini Maristella , Morales Santiago , Sania Ayesha , Hockett Christine , Barrett Emily , Carroll Kecia N. , Cioffi Camille C. , Dabelea Dana , Deoni Sean , Dunlop Anne L. , Deutsch Arielle , Fifer William P. , Firestein Morgan R. , Hedderson Monique M. , Jacobson Melanie , Kelly Rachel S. , Kerver Jean M. , Mason W. Alex , Mirzakhani Hooman , O’Connor Thomas G. , Trasande Leonardo , Weiss Scott , Wright Rosalind , Zhu Yeyi , Crum Rosa M. , Lee Seonjoo , Elliott Amy J. , Monk Catherine ,   program collaborators for Environmental influences on Child Health Outcomes
Published: October 2022

Background

Prior research has demonstrated bidirectional associations between gestational diabetes mellitus (GDM) and perinatal maternal depression. However, the association between GDM, prenatal depression, and postpartum depression (PPD) has not been examined in a prospective cohort longitudinally.

Methods

Participants in the current analysis included 5,822 women from the National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) Research Program: N = 4,606 with Neither GDM nor Prenatal Maternal Depression (Reference Category); N = 416 with GDM only; N = 689 with Prenatal Maternal Depression only; and N = 111 with Comorbid GDM and Prenatal Maternal Depression. The PROMIS-D scale was used to measure prenatal and postnatal maternal depressive symptoms. Primary analyses consisted of linear regression models to estimate the independent and joint effects of GDM and prenatal maternal depression on maternal postpartum depressive symptoms.

Results

A higher proportion of women with GDM were classified as having prenatal depression (N = 111; 21%) compared to the proportion of women without GDM who were classified as having prenatal depression (N = 689; 13%), however this finding was not significant after adjustment for covariates. Women with Comorbid GDM and Prenatal Maternal Depression had significantly increased postpartum depressive symptoms measured by PROMIS-D T-scores compared to women with Neither GDM nor Prenatal Maternal Depression (mean difference 7.02, 95% CI 5.00, 9.05). Comorbid GDM and Prenatal Maternal Depression was associated with an increased likelihood of PPD (OR 7.38, 95% CI 4.05, 12.94). However, women with GDM only did not have increased postpartum PROMIS-D T-scores or increased rates of PPD.

Conclusions

Our findings underscore the importance of universal depression screening during pregnancy and in the first postpartum year. Due to the joint association of GDM and prenatal maternal depression on risk of PPD, future studies should examine potential mechanisms underlying this relation.
Barriers to effective management of primary postpartum haemorrhage following in-hospital births in northwest Ethiopia: healthcare providers’ views using a qualitative approach
Authors: Bewket Tiruneh , Ensieh Fooladi , Virginia Plummer , Gayle McLelland
Published: October 2022

Background

Data showed that postpartum haemorrhage contributed to over 40% of in-hospital deaths of Ethiopian women. However, little is known about the barriers to effective management of primary postpartum haemorrhage. This study aims to explore the views and experiences of maternity healthcare professionals about the barriers to managing primary postpartum haemorrhage following in-hospital births in northwest Ethiopia using the ‘Three Delays’ model as a conceptual framework.

Methods

A qualitative descriptive study was employed at two tertiary referral hospitals between December 2018 and May 2019. Forty-one maternal healthcare providers, including midwives, midwifery unit managers, and obstetricians, participated in this study. Individual face-to-face interviews, focus group discussions, and self-administered open-ended questionnaires were used to collect data. A framework analysis approach was used for the qualitative data analysis. Themes were identified based on the Three Delays model of ‘delay the decision to seek care’, ‘delay arrival at a health facility’, and ‘delay the provision of appropriate and quality care’.

Results

Participants reported several modifiable issues when managing primary postpartum haemorrhage, and all were linked to a delay in receiving appropriate and quality care due to limited resources. Five sub-themes were identified: ‘workforce’, ‘communication issues between healthcare providers’, ‘systemic issues’, ‘education, training, and resourcing issues’, and ‘lack of identification and referral’.

Conclusion

Maternal healthcare providers in these hospitals require training in managing a birthing emergency. In addition, the birth units need adequate supplies and continuous essential services.