bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidrug-resistant bacteria with ESBL genes: a growing threat among people living with HIV/AIDS in Nepal
Authors: Maharjan Riju , Bastola Anup , Adhikari Nabaraj , Rijal Komal Raj , Banjara Megha Raj , Ghimire Prakash , Shrestha Upendra Thapa
Published: June 2022

Background

Bacterial opportunistic infections are common in people living with HIV/AIDS (PLHA). Besides HIV-TB co-infection, lower respiratory tract infections (LRTIs) due to multidrug-resistant (MDR) bacteria cause significant morbidity and mortality among PLHA. This study identified bacterial co-infection of the lower respiratory tract and detected plasmid-mediated blaTEM and blaCTX-M genes among Extended-Spectrum β-Lactamase (ESBL) producing isolates from sputum samples in PLHA.

Methods

A total of 263 PLHA with LRTIs were enrolled in this study, out of which, 50 were smokers, 70 had previous pulmonary tuberculosis, and 21 had CD4 count < 200 cells/µl. Sputum samples collected from PLHA were processed with standard microbiological methods to identify the possible bacterial pathogens. The identified bacterial isolates were assessed for antibiotic susceptibility pattern using modified Kirby Bauer disk diffusion method following Clinical Laboratory Standard Institute (CLSI) guidelines. In addition, plasmid DNA was extracted from MDR and ESBL producers for screening of ESBL genes; blaCTX-M and blaTEM by conventional PCR method using specific primers.

Results

Of 263 sputum samples, 67 (25.48%) showed bacterial growth. Among different bacterial pathogens, Klebsiella pneumoniae, (17; 25.37%) was the most predominant, followed by Haemophillus influenzae, (14; 20.90%) and Escherichia coli, (12; 17.91%). A higher infection rate (4/8; 50%) was observed among people aged 61–70 years, whereas no infection was observed below 20 years. About 30.0% (15/50) of smokers, 32.86% (23/70) cases with previous pulmonary tuberculosis, and 52.38% (11/21) with CD4 count < 200 cells/µl had bacterial LRTIs. Among 53 bacterial isolates excluding H. influenzae, 28 isolates were MDR and 23 were ESBL producers. All ESBL producers were sensitive to colistin and polymyxin B. Among ESBL producers, 47.83% (11/23) possessed blaCTX-M, 8.6% (2/23) were positive for blaTEM gene, and 43.48% (10/23) possessed both ESBL genes.

Conclusion

The increasing rate of MDR bacterial infections, mainly ESBL producers of LRTIs causes difficulty in disease management, leading to high morbidity and mortality of PLHA. Hence, it is crucial to know the antibiogram pattern of the isolates to recommend effective antimicrobial therapy to treat LRTIs in PLHA.
Real-world disease-modifying therapy pathways from administrative claims data in patients with multiple sclerosis
Authors: Fox Robert J. , Mehta Rina , Pham Timothy , Park Julie , Wilson Kathleen , Bonafede Machaon
Published: June 2022

Background

Over a dozen disease-modifying therapies (DMTs) have been approved for treatment of multiple sclerosis (MS). Treatment guidelines focus on when to initiate, change, and discontinue treatment but provide little guidance on how to select or sequence DMTs. This study assessed sequencing patterns of DMTs in patients with newly diagnosed MS.

Methods

Adults newly diagnosed with MS in the United States were identified from January 2007 to October 2017 using IBM MarketScan database. Patients had ≥12 months of continuous enrollment prior to diagnosis and ≥ 2 years of follow-up. Treatment pathways consisting of up to 3 DMT courses were reported, and each treatment course ended with discontinuation, switch, or end of follow-up.

Results

In total, 14,627 MS patients were treated with DMTs and had ≥2 years of follow-up. More than 400 DMT treatment pathways were observed. Glatiramer acetate was the most common DMT; 40% of patients initiated this treatment. Among these, 51.3% had 2 DMT courses during follow-up and 26.5% had 3 DMT courses. Approximately 70% of patients switched or discontinued their initial DMT, and rates of switch and discontinuation differed by initial DMT. Injectable DMTs were used most commonly over the study period (87.5% as first course to 66.6% as third course). Oral DMTs were more common as second or third treatment courses (29.9% and 31.8%, respectively).

Conclusions

A wide variety in treatment patterns were observed among patients newly diagnosed with MS. Further examination of DMT prescribing practices is needed to understand the reasons behind treatment discontinuation and treatment cycling.
Influence of parental weight change on the incidence of overweight and obesity in offspring
Authors: Fan Hui , Zhang Xingyu
Published: June 2022

Background

There is limited information on the association of parental weight change with overweight and obesity in offspring. This study aimed to investigate the association between parental weight change and incident overweight and obesity in offspring.

Methods

This longitudinal cohort study included 2,963 parent–offspring trios who participated in at least two waves of the China Health and Nutrition Survey. The children without overweight and obesity defined by the International Obesity Task Force were included at the initial survey. Parental overweight and obesity were defined as body mass index ≥ 25 kg/m2.

Results

The incidence of overweight and obesity in offspring was 5.8% during a mean follow-up of 5.4 years. Paternal and maternal overweight and obesity at baseline were associated with this condition in offspring at follow-up (both Ps < 0.05). Compared with the persistent normal group, the persistent overweight and obesity group and incident overweight and obesity group (normal weight to overweight and obesity), but not the reversion group (overweight and obesity to normal weight), were more likely to report overweight and obesity in offspring at follow-up, regardless of father’s or mother’s condition. Additionally, compared with offspring whose both parents remained normal weight, those whose both parents changed from overweight and obesity to normal weight or whose one parent changed from overweight and obesity to normal weight while the other remained normal weight had no higher risks of overweight and obesity.

Conclusion

This study highlights the importance of parental weight management in the prevention of overweight/obesity in offspring.
Risk factors of sleep paralysis in a population of Polish students
Authors: Wróbel-Knybel Paulina , Flis Michał , Rog Joanna , Jalal Baland , Karakuła-Juchnowicz Hanna
Published: June 2022

Background

Sleep paralysis (SP) is a transitional dissociative state associated with the REM sleep phase that affects approximately 28.3% of the student population during their lifetime. The reasons for the high prevalence of SP in the student population are not entirely clear. Research indicates possible influencing factors such as the intensification of anxiety symptoms, a tendency to worry, the presence of PTSD symptoms, and behavioral factors such as the consumption of psychoactive substances (caffeine, alcohol, nicotine), sleep deprivations and poor sleep hygiene. The study aimed to assess the prevalence of SP and determine the risk factors for the occurrence of SP in the population of Polish students.

Methods

The study used a battery online consisting of a set of questionnaires 1) a personal questionnaire, 2) the SP-EPQ, 3) the PCL −5, 4) the STAI-T, 5) the PSWQ. The questionnaire was sent via Facebook to 4500 randomly selected students from different universities in Poland. The questionnaire was completed by 2598 students. To unify the participant sample, people over 35 were excluded from the study (45 students). Ultimately, data from 2553 students were analyzed.

Results

A total of 33.14% of individuals experienced at least one episode of SP in their lives. The highest odds ratio for SP was associated with: the presence of three or more health problems (OR: 2.3; p = 0.002), the presence of any mental disorder (OR: 1.77; p = 0.002), including mood disorders (OR: 2.07; p = 0.002), suffering from at least one somatic disease (OR: 1.34; p = 0.002), a high level of anxiety as a constant personality trait (OR: 1.20; p = 0.035) and smoking (OR: 1.48; p = 0.0002), alcohol consumption (OR: 1.52; p < 0.0001), physical activity (OR: 1.31; p = 0.001).

Conclusions

The results of our research indicate that a large proportion of students experienced isolated sleep paralysis. Mental and somatic health problems and lifestyle factors were found to predispose individuals to this disorder. Due to the numerous risk factors for SP, it is necessary to conduct additional research to confirm the impact of these factors and to investigate the mechanisms of their influence on SP.
Understanding determinants of COVID-19 vaccine hesitancy; an emphasis on the role of religious affiliation and individual’s reliance on traditional remedy
Authors: Hassen Hanna Defar , Welde Mengistu , Menebo Mesay Moges
Published: June 2022

Background

The damage COVID-19 has caused interms of mortalities, economic breakdown and social disruption is immense. The COVID-19 vaccine has been one of the efficient prevention strategies so far in preventing the pandemic. However, the publics’ hesitancy towards vaccines has enormously affected this task. With emerging research findings indicating that a substantial proportion of adults are hesitant about a vaccine for COVID-19, important work that identifies and describes vaccine hesitant individuals is required to begin to understand and address this problem.

Objective

This study assessed public attitude towards COVID-19 Vaccine and identified important factors that lead to its hesitancy.

Methods

A web and paper-based cross-sectional survey study was conducted from July 31 to August 12, 2021. The study participants are staffs and students at Jimma University. A total of 358 participants were selected using stratified simple random sampling and requested to fill a survey questionnaire. Binomial logistic regression analysis was done to identify factors associated with COVID-19 vaccine hesitancy.

Results

Half of the participants were found to be hesitant to COVID-19 vaccine. The odds of becoming vaccine hesitant among middle income was two times more than those with lower income (AOR 2.17, 95% CI 1.05–4.5). Furthermore, respondent’s extent of exposure was associated with vaccine hesitancy with the odds of becoming vaccine hesitant among those whose source of COVID-19 information is from four media sources (Social Media, Mass Media, Health care worker and Friends/family/Neighbor) being 74% lower (AOR .26, 95% CI .09–.69) than those with one media source. Concern towards vaccine side effect, vaccine effectiveness and having the belief to treat COVID-19 with traditional remedies were found to increase the odds of becoming vaccine hesitant by 31%, 42% and 37% respectively. Moreover, the association between side-effect concern and vaccine hesitancy was moderated by participant’s religious affiliation.
The diurnal pattern and social context of screen behaviours in adolescents: a cross-sectional analysis of the Millennium Cohort Study
Authors: Kontostoli Elli , Jones Andy P. , Atkin Andrew J.
Published: June 2022

Background

Screen behaviours are highly prevalent in young people and excessive screen use may pose a risk to physical and mental health. Understanding the timing and social settings in which young people accumulate screen time may help to inform the design of interventions to limit screen use. This study aimed to describe diurnal patterns in adolescents’ screen-based behaviours and examine the association of social context with these behaviours on weekdays and weekend days.

Methods

Time use diary data are from the sixth wave (2015/2016) of the Millennium Cohort Study, conducted when participants were aged 14 years. Outcome variables were electronic games/Apps, TV-viewing, phone calls and emails/texts, visiting social networking sites and internet browsing. Social context was categorised as alone only, parents only, friends only, siblings only, parents and siblings only. Multilevel multivariable logistic regression was used to examine the association between social contexts and screen activities.

Results

Time spent in TV-viewing was greatest in the evening with a peak of 20 min in every hour between 20:00 and 22:00 in both sexes on weekdays/weekend days. Time spent using electronic games/Apps for boys and social network sites for girls was greatest in the afternoon/evening on weekdays and early afternoon/late evening on weekend days. Screen activities were mainly undertaken alone, except for TV-viewing. Compared to being alone, being with family members was associated with (Odds Ratio (95% Confidence Interval)) more time in TV-viewing in both boys and girls throughout the week (Weekdays: Boys, 2.84 (2.59, 3.11); Girls, 2.25 (2.09, 2.43); Weekend days: Boys, 4.40 (4.16, 4.67); Girls, 5.02 (4.77, 5.27)). Being with friends was associated with more time using electronic games on weekend days in both sexes (Boys, 3.31 (3.12, 3.51); Girls, 3.13 (2.67, 3.67)).

Conclusions

Reductions in screen behaviours may be targeted throughout the day but should be sensitive to differing context. Family members, friends, and adolescent themselves may be important target groups in behaviour change interventions. Future research to address the complex interplay between social context, content and quality of screen behaviours will aid the design of behaviour change interventions.
The influence of two photobiomodulation protocols on orthodontically induced inflammatory root resorption (a randomized controlled clinical trial)
Authors: Eid Farah Y. , El-Kenany Walid A. , Mowafy Mohamed I. , El-Kalza Ahmed R.
Published: June 2022

Background

Controversial results have been reported regarding the impact of photobiomodulation (PBM) on orthodontically induced inflammatory root resorption (OIIRR). The aim of this study was to evaluate the influence of two PBM protocols, one of them requiring a high application frequency (on days 0, 3, 7, 14, then every 2 weeks), while the second requires less frequent applications (every 3 weeks), on OIIRR accompanying orthodontic treatment.

Methods

Twenty female patients were recruited for this randomized controlled trial, requiring the therapeutic extraction of maxillary first premolars, and they were randomly divided into 2 equal groups. In Group A, one side of the maxillary arch randomly received PBM on days 0, 3, 7, 14, and every 2 weeks thereafter, while in Group B, one side was randomly chosen to receive PBM every 3 weeks. The laser applied was a Diode laser with a wavelength of 980 nm, in a continuous mode. Canine retraction in both groups was carried out using closed-coil springs, delivering 150 g of force, and the force level was checked every 3 weeks, over a 12-week study period. Pre-retraction and post-retraction cone-beam computed tomography (CBCT) was done for the evaluation of OIIRR.

Results

No significant differences in the amount of OIIRR have been reported between the laser and control sides in both groups A and B. Also, no significant differences have been reported between the laser sides in both groups.

Conclusions

Photobiomodulation does not affect OIIRR, whether by increasing or decreasing its occurrence, with both laser application protocols. Therefore, it can be stated that PBM does not result in root resorption less than the commonly observed range elicited with conventional orthodontic treatment, and that it has no effect on OIIRR.

Trial registration Two Low-level Laser Irradiation Protocols on the Rate of Canine Retraction (NCT04926389), 15/06/2021—retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04926389.
Student physiotherapists perceptions of online curriculum delivery during the COVID-19 pandemic
Authors: Chesterton Paul , Richardson Mark , Tears Craig
Published: June 2022

Background

As a result of the COVID-19 pandemic a rapid transformation from face-to-face curriculum delivery to an online teaching and learning environment, was adopted in a number of higher education institutions globally. Allied Health Profession courses such as physiotherapy, traditionally utilising an in person teaching model to prepare students for practice, needed to swiftly adopt new methods of delivery, involving both synchronous and asynchronous approaches. Understanding physiotherapy student perceptions of this transition is important to allow faculty to develop their delivery of online teaching and provide an evidence base for future course curricula.

Methods

Cross-sectional survey of UK higher education students studying either an undergraduate or post-graduate pre-registration degree in physiotherapy was conducted between October 2020 and February 2021. The survey investigated the student’s perception of the transition to either an online or hybrid model of learning during the COVID-19 pandemic. A mixed method approach was adopted allowing respondents to share their experiences and facilitate the exploration of questions which required in-depth thought.

Results

Two hundred thirty-six respondents completed the questionnaire. Online learning was perceived to be a flexible (49%, n=116,CI 95% 43 to 55) and convenient (49, 116, 43 to 55) method of learning. Despite this, 79% of the students surveyed felt that the online learning experience had a negative impact on their understanding of the subject and were disadvantaged compared to traditional face-to-face teaching provision (mean 4.14 ± SD 1.06). Online physiotherapy delivery produced low student satisfaction, leaving respondents feeling disadvantaged. Decreased levels of engagement and the lack of ability to practice ‘hands-on’ skills were detrimental aspects of the online approach, with 55% (n=106) reporting they did not perceive the academic staff had the necessary skills to deliver effective online content.

Conclusions

The majority of UK physiotherapy students surveyed were dissatisfied and lacked engagement with an online learning approach within the curricula, compared with the traditional face-to-face delivery. Although several positives of both a synchronous and asynchronous delivery were highlighted, faculty must consider how they best deliver online learning content, making use of pedagogical strategies that will create as many learning and engagement opportunities as possible.
Effect of the BOPPPS model combined with case-based learning versus lecture-based learning on ophthalmology education for five-year paediatric undergraduates in Southwest China
Authors: Chen Lin , Tang Xiao-Jiao , Chen Xin-Ke , Ke Ning , Liu Qin
Published: June 2022

Background

To investigate the effect of the bridge-in, objective, preassessment, participatory learning, post assessment, and summary (BOPPPS) model combined with case-based learning (CBL) on ophthalmology teaching for five-year paediatric undergraduates.

Methods

The effects of the BOPPPS model combined with CBL (BOPPPS-CBL) and traditional lecture-based learning (LBL) on ophthalmology teaching were compared among students in a five-year programme. The questionnaire surveys of the students were collected and statistically analysed after the class. The final examination scores, including on elementary knowledge and case analysis, in the two groups were analysed.

Results

There were no statistically significant differences between the teachers and students in the baseline data. More students agreed that the BOPPPS-CBL model helped develop their problem-solving skills, analytical skills and motivation for learning better than the LBL model. There was no significant difference in learning pressure between the two groups. The final examination scores of the BOPPPS-CBL group were significantly higher than those of the LBL group. The overall course satisfaction of the BOPPPS-CBL group was obviously higher than that of the LBL group.

Conclusions

The BOPPPS-CBL model is an effective ophthalmology teaching method for five-year paediatric undergraduates.
Knowledge, attitude and use of evidence based practice (EBP) among registered nurse-midwives practicing in central hospitals in Malawi: a cross-sectional survey
Authors: Kaseka Paul Uchizi , Mbakaya Balwani Chingatichifwe
Published: June 2022

Background

Even though evidence based practice (EBP) is being considered as a critical element in improving the quality of health services and achieving excellence in patient care, there is currently little knowledge of how EBP relates to nursing and midwifery in Malawi. This paper is a report of a study describing EBP knowledge, attitudes, and use of registered nurse-midwives practicing in central hospitals across Malawi.

Methods

The descriptive, cross-sectional research design was conducted with a randomly selected sample of 183 nurse-midwives (response rate of 87.9%). The study used a paper version questionnaire to collect the data. The data were analysed using both descriptive and inferential statistics in the Statistical Product and Service Solutions version 23. Descriptive statistics were calculated to summarise overall knowledge levels, attitudes, and use of nurse-midwives as percentages based on their scores on the assessment scale (1 to 7 Likert scale) in the EBP questionnaire. Non-parametric Mann-Whitney and Kruskal-Wallis tests were carried out to compare evidence-based practice scores based on demographics. Pearson’s correlation (r) and stepwise regression analysis were further performed to analyse the relationship between the knowledge, attitude and use of nurse-midwives on the overall EBP of nurse-midwives.

Results

The average scores (mean±SD) of evidence-based practice amongst nurse-midwives were 78.7 ± 19.6 for attitude, 70.6 ± 15.1 for knowledge levels, 57.8 ± 23 for use, and 68.9 ± 14.2 for the overall EBP. Higher educational qualification was associated with higher scores in knowledge levels (P= 0.02). Research experience was associated with higher scores in nursing use (P= 0.005), and higher overall evidence-based practice were associated with both research experience (P= 0.035) and educational qualification (P= 0.004). Nurse-midwives attitude was affected by clinical experience (P= 0.006) and the hospital where nurse-midwives worked (P= 0.016). There was no significant difference in the EBP scores of nurse-midwives based on gender and/or their administrative roles in their respective central hospitals.

Conclusion

It is important to develop the knowledge or skills of nurse midwives in order to enhance evidence-based practice amongst nurse-midwives in Malawian hospitals. The results can be used by nurse managers, nurse educators, policy makers at the Ministry of Health and Nurses and Midwives Council of Malawi to enhance implementation of EBP.
Adverse effects of COVID-19 vaccines and measures to prevent them
Authors: Yamamoto Kenji
Published: June 2022

Recently, The Lancet published a study on the effectiveness of COVID-19 vaccines and the waning of immunity with time. The study showed that immune function among vaccinated individuals 8 months after the administration of two doses of COVID-19 vaccine was lower than that among the unvaccinated individuals. According to European Medicines Agency recommendations, frequent COVID-19 booster shots could adversely affect the immune response and may not be feasible. The decrease in immunity can be caused by several factors such as N1-methylpseudouridine, the spike protein, lipid nanoparticles, antibody-dependent enhancement, and the original antigenic stimulus. These clinical alterations may explain the association reported between COVID-19 vaccination and shingles. As a safety measure, further booster vaccinations should be discontinued. In addition, the date of vaccination should be recorded in the medical record of patients. Several practical measures to prevent a decrease in immunity have been reported. These include limiting the use of non-steroidal anti-inflammatory drugs, including acetaminophen to maintain deep body temperature, appropriate use of antibiotics, smoking cessation, stress control, and limiting the use of lipid emulsions, including propofol, which may cause perioperative immunosuppression. In conclusion, COVID-19 vaccination is a major risk factor for infections in critically ill patients.
Long-range enhancement of N501Y-endowed mouse infectivity of SARS-CoV-2 by the non-RBD mutations of Ins215KLRS and H655Y
Authors: Zhu Yichao , Zhou Wenzhao , Niu Zubiao , Sun Jiayi , Zhang Zhengrong , Li Qinqin , Zheng You , Wang Chenxi , Gao Lihua , Sun Qiang
Published: June 2022

Background

Rodents, such as mice, are vulnerable targets, and potential intermediate hosts, of SARS-CoV-2 variants of concern, including Alpha, Beta, Gamma, and Omicron. N501Y in the receptor-binding domain (RBD) of Spike protein is the key mutation dictating the mouse infectivity, on which the neighboring mutations within RBD have profound impacts. However, the impacts of mutations outside RBD on N501Y-mediated mouse infectivity remain to be explored.

Results

Herein, we report that two non-RBD mutations derived from mouse-adapted strain, Ins215KLRS in the N-terminal domain (NTD) and H655Y in the subdomain linking S1 to S2, enhance mouse infectivity in the presence of N501Y mutation, either alone or together. This is associated with increased interaction of Spike with mouse ACE2 and mutations-induced local conformation changes in Spike protein. Mechanistically, the H655Y mutation disrupts interaction with N657, resulting in a less tight loop that wraps the furin-cleavage finger; and the insertion of 215KLRS in NTD increases its intramolecular interaction with a peptide chain that interfaced with the RBD-proximal region of the neighboring protomer, leading to a more flexible RBD that facilitates receptor binding. Moreover, the Omicron Spike that contains Ins214EPE and H655Y mutations confer mouse infectivity > 50 times over the N501Y mutant, which could be effectively suppressed by mutating them back to wild type.

Conclusions

Collectively, our study sheds light on the cooperation between distant Spike mutations in promoting virus infectivity, which may undermine the high infectiousness of Omicron variants towards mice.
Intron losses and gains in the nematodes
Authors: Ma Ming-Yue , Xia Ji , Shu Kun-Xian , Niu Deng-Ke
Published: June 2022

Background

The evolution of spliceosomal introns has been widely studied among various eukaryotic groups. Researchers nearly reached the consensuses on the pattern and the mechanisms of intron losses and gains across eukaryotes. However, according to previous studies that analyzed a few genes or genomes, Nematoda seems to be an eccentric group.

Results

Taking advantage of the recent accumulation of sequenced genomes, we extensively analyzed the intron losses and gains using 104 nematode genomes across all the five Clades of the phylum. Nematodes have a wide range of intron density, from less than one to more than nine per kbp coding sequence. The rates of intron losses and gains exhibit significant heterogeneity both across different nematode lineages and across different evolutionary stages of the same lineage. The frequency of intron losses far exceeds that of intron gains. Five pieces of evidence supporting the model of cDNA-mediated intron loss have been observed in tenCaenorhabditisspecies, the dominance of the precise intron losses, frequent loss of adjacent introns, high-level expression of the intron-lost genes, preferential losses of short introns, and the preferential losses of introns close to 3′-ends of genes. Like studies in most eukaryotic groups, we cannot find the source sequences for the limited number of intron gains detected in theCaenorhabditisgenomes.

Conclusions

These results indicate that nematodes are a typical eukaryotic group rather than an outlier in intron evolution.
Analysis of a debonding model of two elastic 2D-bars
Authors: Shillor Meir , Kuttler Kenneth L.
Published: June 2022

This work establishes the existence of a weak solution to a new model for the process of debonding of two elastic 2D-bars caused by humidity and vibrations. A version of the model was first presented in the PCM-CMM-2019 conference in Krakow, Poland, and was published in (Shillor in J. Theor. Appl. Mech. 58(2): 295–305 2020). The existence of a weak solution is proved by regularizing the problem and then setting it in an abstract form that allows the use of tools for pseudo-differential operators and a fixed point theorem. Questions of further analysis of the solutions, effective numerical methods and simulations, as well as possible controls, are unresolved, yet.
Facilitating and supporting the engagement of patients, families and caregivers in research: the “Ottawa model” for patient engagement in research
Authors: Vanderhout Shelley , Nicholls Stuart , Monfaredi Zarah , Hampel Claudia , Ashdown Lynn , Bilodeau Maxime , Rich Susan , Shea Beverley , Fergusson Dean
Published: June 2022

Background

Patient engagement is increasingly being recognized as a critical component of health research; however, institutional models for building infrastructure and capacity for patient engagement in research are limited. There is an opportunity to create reproducible and scalable models of patient engagement in research and share best and promising practices.

Main body

In this article, we describe the development and features of the framework for the Ottawa Patient Engagement in Research Model at The Ottawa Hospital (TOH) and the Ottawa Hospital Research Institute (OHRI). Key components of the model include: a Patient and Family Engagement Program at TOH, which recruits, educates, and supports patients, families and caregivers to engage in clinical care, governance, and research; the Ottawa Methods Centre within the OHRI, which leads methodological research and provides support to investigators for patient engagement and patient-oriented research at TOH; and the Office of Patient Engagement in Research Activities, also within the OHRI, which facilitates collaborations between patients, researchers, clinicians and other stakeholders. Early success of this model can be attributed to aligned institutional priorities between TOH, OHRI and patients, the establishment of a patient engagement policy, ongoing education and support provided to patient partners and researchers, and innovative recruitment, tracking and evaluation procedures. Ongoing challenges and next steps include promoting diversity among patient partners, implementing an equitable compensation policy, engaging patients across a variety of roles and research areas, and developing resources to expand and sustain this program.

Conclusion

This model represents a unique effort of patients, clinicians, researchers, and policymakers across disciplines and institutions to produce a harmonized strategy and infrastructure for meaningful collaboration with patients and families in health research, and capacity building in patient-oriented research.
Mineralocorticoid receptor antagonists for chronic central serous chorioretinopathy: systematic review and meta-analyses
Authors: Felipe Camila Q. , Biancardi Ana Luiza , Civile Vinicius T. , Carvas Junior Nelson , Serracarbassa Pedro D. , Koike Marcia K.
Published: June 2022

Background

Mineralocorticoid receptor antagonists (MRAs) are widely used for chronic central serous chorioretinopathy (cCSCR), but their effectiveness remains unclear. This research was conducted to evaluate the efficacy of this drugs for cCSCR.

Methods

This is a review of randomized clinical trials (RCT) comparing MRAs to placebo in adults with cCSCR, using the effects of MRAs on best-corrected visual acuity (BCVA) and adverse events as primary outcomes and the effects of MRAs on anatomical parameters as secondary outcomes: central subfield thickness (CST), subretinal fluid height (SFH) and central choroidal thickness (CCT). Our all-language online search included Medline (via PubMed), Central, Embase, Lilacs, Ibecs, and RCT registers platforms, as late as May 2021. We used the Cochrane risk-of-bias tool (version 2) to assess the methodological quality of each study and synthesized the results in meta-analyses using a random-effects model.

Results

The search identified 302 records, five of which were eligible, totaling 225 cCSCR patients (aged 45–62 years; M/F ratio 3.1:1) treated for 1 to 12 months with spironolactone (50 mg/day) or eplerenone (50 mg/day) vs. placebo. Moderate-certainty evidence suggests MRAs result in little to no improvement in BCVA compared to placebo (SMD 0.22; 95% CI − 0.04 to 0.48; studies = 5; comparisons = 6; participants = 218; I2 = 0%). Very low-certainty evidence suggests that, when compared to placebo, MRAs have a very uncertain impact on adverse effects (no meta-analysis was performed), and CST (MD 18.1; 95% CI − 113.04 to 76.84; participants = 145; studies = 2; I2 = 68%). MRAs also result in little to no difference in SFH (SMD − 0.35; 95% CI − 0.95 to 0.26; studies = 5; comparisons = 6; participants = 221; I2 = 76%; moderate certainty) and CCT (MD − 21.23; 95% CI − 64.69 to 22.24; participants = 206; studies = 4; comparisons = 5; I2 = 85%; low certainty).

Conclusion

MRAs have little to no effect on BCVA. Evidence for adverse events and CST is very uncertain. MRAs also have little to no effect on SFH and CCT. These findings should be considered when prescribing MRAs for cCSCR.

This research was previous registration in the PROSPERO platform (CRD42020182601).
Swiss pension funds: funding ratio, discount rate, and asset allocation
Authors: Schäublin Jorma J.
Published: June 2022

The funding ratio is a financial indicator to measure the viability of pension funds. The paper analyzes how Swiss occupational pension funds’ technical discount rate and asset allocation are related to the funding ratio. The paper shows that funds with weaker funding ratios apply higher rates to discount future pension liabilities what points toward euphemistic discounting. Further, weaker funded pension funds invest less in equities—with the exception of pension funds below the regulatory minimum threshold. The latter invest more in equities than funds above the threshold, which points to gambling for resurrection. The findings question the funding ratio as a transparent measure for pensions’ sustainability and unfold the regulatory environment’s disincentives.
Application of computer-aided image reconstruction and image guide in parasagittal meningioma resection
Authors: Zhang Rui , Alpdogan Serdar , Kong Shiqi , Muhammad Sajjad
Published: June 2022

Background

In recent years, smaller-sized (diameter < 2.5 cm) meningiomas are diagnosed due to increased cranial imaging. Symptomatic meningiomas need to be removed surgically. Therefore, it is extremely important to locate the lesion exactly to tailor the craniotomy especially if the neuro-navigation system is not available. Many hospitals located in the underdeveloped countries cannot afford the high costs of neuro-navigation equipment. Hence, it is relevant to discover low-cost associated and effective methods for lesion localization for surgery.

Methods

The use of localization markers in advance can help to acquire preoperative CT images of the patients to create and calculate a three-dimensional (3D) virtual graph using a computer. With the 3D graph, spatial distance of the tumor from the markers is calculated and the tumor location projected on the scalp by the Triangle Pythagorean theorem. This enables precise localization of intracranial microlesions preoperatively.

Results

The location of the tumor was consistent with that of the pre-operative virtual image, and the craniotomy was exact. The patient was discharged 3 days later without any neurological deficits.

Conclusions

This method is simple and reliable, inexpensive, and accurate in the location of small-sized lesions, which can partially compensate for the lack of neuro-navigation and is suitable for widespread application in hospitals in developing countries.
Implicit finite-difference time-domain schemes for TDEM modeling in three dimensions
Authors: Cabrer Roberto , Gallardo Luis A. , Flores Carlos
Published: June 2022

Geophysical exploration methods that use controlled electromagnetic sources in time domain are becoming ubiquitous because of their ease of deployment and data coverage capabilities. Although these prospecting methodologies have evolved significantly, most computational numerical modeling techniques have been developed in the frequency domain. Given this evolution, it is pertinent to ask whether some known advantages of implicit finite-difference (FD) modeling techniques, which are common among other disciplines, apply to the time-domain electromagnetic (TDEM) problem in geophysics. To explore the potential advantages of 3D time-domain modeling for TDEM, we have analyzed the differences between two implicit FD formulations: a single-order backward Euler scheme and a second-order Crank-Nicolson scheme. To validate our algorithms, we tested them with existing analytical solutions for simple geometries and performed detectability tests for various electromagnetic sources. The results find an acceptable match of both numerical schemes to the analytical solutions and higher accuracy of the second-order discrete operator without a significant difference in computing time.
Multiple seismic attributes fusion approach with support vector regression and forward simulation for sand body prediction and sedimentary facies interpretation — A case of the X gas field in Xihu Sag
Authors: Liu Yuming , Xie Pengfei , Duan Dongping , Yao Yuanrong , Liu Peipei , Li Wenjun , Chen Bo , Wang Wei , Hou Jiagen
Published: June 2022

Marine exploration and production play a vital role in petroleum industries. It is difficult to acquire sufficient well data in marine settings, so seismic data become the most important interpretation data in research. In general, the seismic data in marine exploration have low quality because of the deep depth from the surface. To partly address this, the support vector regression (SVR) algorithm is proposed to fuse multiple seismic attributes for sand thickness prediction. First, we use forward modeling to establish virtual wells for improving the training data set. Second, we select the optimal attributes by correlation analysis. Third, we apply the SVR algorithm to learn the relationship between seismic attributes and sand thickness. Fourth, we use the SVR model to predict the sand thickness between wells by calculating a fused attribute. The results indicate that the fusion attribute with SVR has a higher correlation coefficient with sand thickness than the original attributes by statistical method. The approach can be widely used for improving the seismic interpretation quality of the research area with few wells.
Exploring factors affecting the performance of deep learning in seismic fault attribute computation
Authors: Zhang Bo , Pu Yitao , Xu Zhaohui , Liu Naihao , Li Shizhen , Li Fangyu
Published: June 2022

Recently, the computation of seismic fault attribute that may be significant in seismic interpretation is that seismic fault detection is treated as an image segmentation problem using different deep-learning (DL) architectures. To do this, researchers have concentrated on applying cutting-edge DL architectures in computing seismic fault attributes. To explore the factors that may affect the accuracy of seismic fault attribute, we compare the computed fault probability using DL architectures under different scenarios. The designed scenarios aim to highlight the leading factors that may affect the accuracy and resolution of seismic image segmentation. The discussed factors include the dimension and size of training data, training data preparation, ensemble learning, and batch size in DL. The proposed comparisons are applied to one marine seismic survey from New Zealand and one land seismic survey from China. The results demonstrate that properly preparing training data is far more important than choosing a cutting-edge DL architecture in computing seismic fault attribute. We also propose a practical workflow that can include real seismic data and corresponding interpreted fault sticks in training data for a specific seismic survey.
Sharp change of the channel bar pattern within the river delta: Insights from modern Ganjiang River delta in Jiangxi province, China
Authors: Xu Zhenhua , Yang Shuo , Zhang Tianyou , Wu Shenghe , Zhang Ke , Chen Mei , Yang Zheng , Gao Zijie , Zhang Changmin
Published: June 2022

Channel bars (midchannel bars or point bars) in river deltas present challenges to water transportation; meanwhile, they provide a source of building materials, habitats, and farmlands, and they could become targets in hydrocarbon reservoirs. Researchers focus on the channel bar pattern in rivers, while ignoring the channel bar pattern in distributary channels. We have analyzed a sharp change of the channel bar pattern from the river to the delta. The integration of remote map analysis, fieldwork, and a flume experiment has resulted in a quantified sharp change in the channel bar pattern in the Ganjiang River delta and revealed a hydrodynamic mechanism. The result finds that distributary channels develop much finer-grained, smaller-scale, less channel bars with the lower width-length ratio, compared to the upstream river. Distributary channels develop more point bars and fewer midchannel bars than the upstream braided river, and they develop fewer point bars than the upstream meandering river. Sharply weakening bank erosions in distributary channels lead to the formation of the sharp change in the channel bar pattern from the upstream river, due to backwater effect-induced sharp gentling of landform gradient. The backwater effect impedes bank erosions in the distributary channels, but it promotes bank erosions in upstream rivers, which, in turn, enhances the sharp change of the channel bar pattern. We provide insights into channel bars’ growth in modern river deltas and provide new facies models for the river-delta system.
Six-Month Periodic Fasting in Patients With Type 2 Diabetes and Diabetic Nephropathy: A Proof-of-Concept Study
Authors: Sulaj Alba , Kopf Stefan , von Rauchhaupt Ekaterina , Kliemank Elisabeth , Brune Maik , Kender Zoltan , Bartl Hannelore , Cortizo Fabiola Garcia , Klepac Katarina , Han Zhe , Kumar Varun , Longo Valter , Teleman Aurelio , Okun Jürgen G , Morgenstern Jakob , Fleming Thomas , Szendroedi Julia , Herzig Stephan , Nawroth Peter P
Published: June 2022

Context

Novel fasting interventions have gained scientific and public attention. Periodic fasting has emerged as a dietary modification promoting beneficial effects on metabolic syndrome.

Objective

Assess whether periodic fasting reduces albuminuria and activates nephropathy-driven pathways.

Design/Participants

Proof-of-concept study where individuals with type 2 diabetes (n = 40) and increased albumin-to-creatinine ratio (ACR) were randomly assigned to receive a monthly fasting-mimicking diet (FMD) or a Mediterranean diet for 6 months with 3-month follow-up.

Main Outcomes Measures

Change in ACR was assessed by analysis of covariance adjusted for age, sex, weight loss, and baseline value. Prespecified subgroup analysis for patients with micro- vs macroalbuminuria at baseline was performed. Change in homeostatic model assessment for insulin resistance (HOMA-IR), circulating markers of dicarbonyl detoxification (methylglyoxal-derived hydroimidazolone 1, glyoxalase-1, and hydroxyacetone), DNA-damage/repair (phosphorylated histone H2AX), lipid oxidation (acylcarnitines), and senescence (soluble urokinase plasminogen activator receptor) were assessed as exploratory endpoints.

Results

FMD was well tolerated with 71% to 95% of the participants reporting no adverse effects. After 6 months, change in ACR was comparable between study groups [110.3 (99.2, 121.5) mg/g; P = 0.45]. FMD led to a reduction of ACR in patients with microalbuminuria levels at baseline [−30.3 (−35.7, −24.9) mg/g; P ≤ 0.05] but not in those with macroalbuminuria [434.0 (404.7, 463.4) mg/g; P = 0.23]. FMD reduced HOMA-IR [−3.8 (−5.6, −2.0); P ≤ 0.05] and soluble urokinase plasminogen activator receptor [−156.6 (−172.9, −140.4) pg/mL; P ≤ 0.05], while no change was observed in markers of dicarbonyl detoxification or DNA-damage/repair. Change in acylcarnitines was related to patient responsiveness to ACR improvement. At follow-up only HOMA-IR reduction [−1.9 (−3.7, −0.1), P ≤ 0.05]) was sustained.

Conclusions

Improvement of microalbuminuria and of markers of insulin resistance, lipid oxidation, and senescence suggest the potential beneficial effects of periodic fasting in type 2 diabetes.
Breaking Consensus, Transforming Metabolisms
Authors: De Rosa Salvatore Paolo
Published: June 2022

This article discusses the politics of direct action against fossil fuels put forward by climate justice movements, focusing in particular on the tactic of the blockade. Drawing on the conceptual toolkit of urban political ecology, the argument moves from a critique of the consensual regime of climate change governance to highlight conflict and dissent as central forces for the transformation of the socioecological metabolisms structuring the capitalist urbanization of nature—of which fossil fuels constitute the lifeblood. This approach shifts the debate around climate change politics from an issue of technological transition to one of metabolic transformation. On this basis, the article proposes a characterization of direct action against fossil fuels as expressions of metabolic activism: instances of grassroots ecopolitical engagement that aim to break consensus by disrupting capitalist-driven metabolic relations while also experimenting with alternative values, knowledges, spaces, and sociomaterial relations. To ground these reflections, the article offers an account of the Swedish climate justice coalition Fossilgasfällan and its successful three-year campaign, culminating in a blockade to halt the expansion of the gas terminal of Gothenburg port.
Stimuli-Responsive and Switchable Platinum(II) Complexes and Their Applications in Memory Storage
Authors: Yam Vivian Wing-Wah , Cheng Yat-Hin
Published: June 2022

Platinum(II) complexes can be fascinating candidates for the design of effective stimuli-responsive materials. Being one of the most extensively explored classes of transition metal complexes, their square-planar molecular geometry, rich charge-transfer transitions and strong propensity to form supramolecular assemblies with the aid of directional Pt(II)⋯Pt(II) interactions have endowed the Pt(II) complexes with distinct features to display responsive behavior in the presence of stimuli, such as light, external electric field and organic solvent vapor. Together with other unique advantages, including low-energy charge-transfer excited states, red emission and high photostability, many functional and switchable materials based on platinum(II) complexes have been developed. In this account, we introduce a summary of our advances in the development of various classes of responsive and switchable platinum(II) complexes with selected examples.
Imaging of hydatid cyst of kidney, ureter and urinary bladder
Authors: Gupta Shivani , Das Chandan Jyoti
Published: June 2022

Renal hydatid is an uncommon finding, reported in less than 5% patients with hydatid infection. Hydatid involvement of ureter and urinary bladder is an even rarer entity. Renal hydatid is typically unilateral, solitary and arises from cortex. It is essential to be aware of the imaging features of the hydatid cyst for proper diagnosis. Knowledge of the imaging features of various stages is essential since treatment decision is based on cyst stage. Hydatid cyst can mimic several entities both benign and malignant. We present a pictorial review to illustrate the radiological imaging features of hydatid disease involving kidney, ureter and bladder region and its complications.