bluuebunny/crossref_metadata_2025 huggingface dataset:
The effective connectivity of the human hippocampal memory system
Authors: Rolls Edmund T , Deco Gustavo , Huang Chu-Chung , Feng Jianfeng
Published: November 2021

Effective connectivity measurements in the human hippocampal memory system based on the resting-state blood oxygenation-level dependent signal were made in 172 participants in the Human Connectome Project to reveal the directionality and strength of the connectivity. A ventral “what” hippocampal stream involves the temporal lobe cortex, perirhinal and parahippocampal TF cortex, and entorhinal cortex. A dorsal “where” hippocampal stream connects parietal cortex with posterior and retrosplenial cingulate cortex, and with parahippocampal TH cortex, which, in turn, project to the presubiculum, which connects to the hippocampus. A third stream involves the orbitofrontal and ventromedial-prefrontal cortex with effective connectivity with the hippocampal, entorhinal, and perirhinal cortex. There is generally stronger forward connectivity to the hippocampus than backward. Thus separate “what,” “where,” and “reward” streams can converge in the hippocampus, from which back projections return to the sources. However, unlike the simple dual stream hippocampal model, there is a third stream related to reward value; there is some cross-connectivity between these systems before the hippocampus is reached; and the hippocampus has some effective connectivity with earlier stages of processing than the entorhinal cortex and presubiculum. These findings complement diffusion tractography and provide a foundation for new concepts on the operation of the human hippocampal memory system.
Impact of Isolation and Exclusion as a Public Health Strategy to Contain Measles Virus Transmission During a Measles Outbreak
Authors: Banerjee Emily , Paul Prabasaj , Griffith Jayne , Laine Ellen , Como-Sabetti Kathryn , Gastañaduy Paul A
Published: November 2021

Responding to measles outbreaks in the United States puts a considerable strain on public health resources, and limited research exists about the effectiveness of containment strategies. In this paper we quantify the impact of isolation, contact tracing, and exclusion in reducing transmission during a measles outbreak in an under-vaccinated community.
Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Associates With Unstable Housing and Occurs in the Presence of Antibodies
Authors: Bean David J , Monroe Janet , Turcinovic Jacquelyn , Moreau Yvetane , Connor John H , Sagar Manish
Published: November 2021

Background

The factors associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) reinfection remain poorly defined.

Methods

We identified patients with SARS-CoV-2 infection and at least 1 repeat reverse transcription polymerase chain reaction result a minimum of 90 days after the initial positive test and before 21 January 2021. Those with a repeat positive test were deemed to have reinfection (n = 75), and those with only negative tests were classified as convalescents (n = 1594). Demographics, coronavirus disease 2019 (COVID-19) severity, and treatment histories were obtained from the Boston Medical Center electronic medical record. Humoral responses were analyzed using SARS-CoV-2–specific enzyme-linked immunosorbent assays and pseudovirus neutralizations in a subset of reinfection (n = 16) and convalescent samples (n = 32). Univariate, multivariate, and time to event analyses were used to identify associations.

Results

Individuals with reinfection had more frequent testing at shorter intervals compared with the convalescents. Unstable housing was associated with more than 2-fold greater chance of reinfection. Preexisting comorbidities and COVID-19 severity after the initial infection were not associated with reinfection. SARS-CoV-2 immunoglobulin G levels and pseudovirus neutralization were not different within the early weeks after primary infection and at a timepoint at least 90 days later in the 2 groups. In the convalescents, but not in those with reinfection, the late as compared with early humoral responses were significantly higher.

Conclusions

Reinfection associates with unstable housing, which is likely a marker for virus exposure, and reinfection occurs in the presence of SARS-CoV-2 antibodies.
A Novel Generation Method for Diverse Privacy Image Based on Machine Learning
Authors: Niu Weina , Luo Yuheng , Ding Kangyi , Zhang Xiaosong , Wang Yanping , Li Beibei
Published: November 2021

In recent years, deep neural networks have been extensively applied in various fields, and face recognition is one of the most important applications. Artificial intelligence has reached or even surpassed human capabilities in many fields. However, while artificial intelligence application provides convenience to the human lives, it also leads to the risk of privacy leaking. At present, the privacy protection technology for human faces has received extensive attention. Research goals of face privacy protection technology mainly include providing face anonymization and data availability protection. Existing methods usually have insufficient anonymity and they are not easy to control the degree of image distortion, which makes it difficult to achieve the purpose of privacy protection. Moreover, they do not explicitly perform diversity preservation of attributes such as emotions, expressions and ethnicities, so they cannot perform data analysis tasks on non-identity attributes. This paper proposes a diverse privacy face image generation algorithm based on machine learning, called DIVFGEN. This algorithm comprehensively considers image distortion, identity mapping distance loss and emotion classification loss; transforms the privacy protection target into the problem of generating adversarial examples based on the recognition model; and uses an adaptive optimization algorithm to generate anonymity and diversity of privacy images. The experimental results show that on the Cohn-Kanade+ dataset, our algorithm can reduce the probability of facial recognition by the neural network when it accurately classifies sentiment, from 98.6% to 4.8%.
A New Approach for Resource Recommendation in the Fog-Based IoT Using a Hybrid Algorithm
Authors: Xu Zhiwang , Qin Huibin , Yang Shengying , Arefzadeh Seyedeh Maryam
Published: November 2021

Internet of things (IoT) is an architecture of connected physical objects; these objects can communicate with each other and transmit and receive data. Also, fog-based IoT is a distributed platform that provides reliable access to virtualized resources based on various technologies such as high-performance computing and service-oriented design. A fog recommender system is an intelligent engine that suggests suitable services for fog users with less answer time and more accuracy. With the rapid growth of files and information sharing, fog recommender systems’ importance is also increased. Besides, the resource management problem appears challenging in fog-based IoT because of the fog’s unpredictable and highly variable environment. However, many current methods suffer from the low accuracy of fog recommendations. Due to this problem’s Non-deterministic Polynomial-time (NP)-hard nature, a new approach is presented for resource recommendation in the fog-based IoT using a hybrid optimization algorithm. To simulate the suggested method, the CloudSim simulation environment is used. The experimental results show that the accuracy is optimized by about 1–8% compared with the Cooperative Filtering method utilizing Smoothing and Fusing and Artificial Bee Colony algorithm. The outcomes of the present paper are notable for scholars, and they supply insights into subsequent study domains in this field.
Outcomes and Long-Term Effects of COVID-19 in Patients with Inflammatory Bowel Diseases – A Danish Prospective Population-Based Cohort Study with Individual-Level Data
Authors: Attauabi Mohamed , Dahlerup Jens Frederik , Poulsen Anja , Hansen Malte Rosager , Vester-Andersen Marianne Kajbæk , Eraslan Sule , Prahm August Pilegaard , Pedersen Natalia , Larsen Lone , Jess Tine , Neumann Anders , Haderslev Kent V , Molazahi Akbar , Lødrup Anders Berg , Glerup Henning , Oppfeldt Asser Mathiassen , Jensen Michael Dam , Theede Klaus , Kiszka-Kanowitz Marianne , Seidelin Jakob Benedict , Burisch Johan
Published: November 2021

Background and Aims

The health consequences of coronavirus disease 2019 [COVID-19] among patients with ulcerative colitis [UC] and Crohn’s disease [CD] remain largely unknown. We aimed to investigate the outcomes and long-term effects of COVID-19 in patients with UC or CD.

Methods

We conducted a prospective, population-based study covering all Danish patients with CD or UC and confirmed COVID-19 between January 28, 2020 and April 1, 2021, through medical records and questionnaires.

Results

All 319 patients with UC and 197 patients with CD who developed COVID-19 in Denmark were included in this study and compared with the Danish background population with COVID-19 [N = 230 087]. A significantly higher risk of COVID-19-related hospitalization was observed among patients with UC (N = 46 [14.4%], relative risk [RR] = 2.49 [95% confidence interval, CI, 1.91–3.26]) and CD (N = 24 [12.2%], RR = 2.11 [95% CI 1.45–3.07]) as compared with the background population (N = 13 306 [5.8%]). A similar pattern was observed for admission to intensive care (UC: N = 8 [2.51%], RR = 27.88 [95% CI 13.88–56.00]; CD: N = 3 [1.52%], RR = 16.92 [95% CI 5.46–52.46]). After a median of 5.1 months (interquartile range [IQR] 4.5–7.9), 58 [42.3%] and 39 [45.9%] patients with UC and CD, respectively, reported persisting symptoms which were independently associated with discontinuation of immunosuppressive therapies during COVID-19 (odds ratio [OR] = 1.50 [95% CI 1.07–10.22], p = 0.01) and severe COVID-19 (OR = 2.76 [95% CI 1.05–3.90], p = 0.04), but not with age or presence of comorbidities.

Conclusion

In this population-based study of 516 patients with IBD and COVID-19, 13.6% needed hospitalization and 2.1% required intensive care. Furthermore, sequelae were frequent, affecting 43.7% of COVID-19-infected patients. These findings might have implications for planning the healthcare of patients in the post-COVID-19 era.
Modeling the Influence of Abiotic and Biotic Factors on Spatial and Temporal Fluctuations of Prostephanus truncatus (Coleoptera: Bostrichidae) Populations in Mozambique
Authors: Muatinte Bernardo L , Van den Berg Johnnie
Published: November 2021

The larger grain borer, Prostephanus truncatus (Horn) (Coleoptera: Bostrichidae), is a serious pest of stored maize in Mozambique and in other African countries. This study investigated the influence of abiotic and biotic factors on populations of P. truncatus at four sites over a two-year period (2013–2014) in Mozambique. Fourteen 250 × 250 m quadrants were selected at each site. Plant species diversity, temperature, precipitation, and relative humidity data were recorded. Pheromone-baited Uni-traps were used to monitor P. truncatus inside each quadrant. In addition, plant species were identified using visual observation and measurement of morphological features of leaves and fruits, and quantified, after which the percentage of host plant species of P. truncatus was determined out of all species in each quadrant. Multiple regression analysis and generalized linear models showed that host plant species dominance, maximum and minimum temperature, relative humidity, and rainfall influenced the variations in P. truncatus abundance. The development of these models of P. truncatus flight activity provides a baseline for further studies predicting dispersal and potential areas of invasion by this pest.
Moderate aortic stenosis: importance of symptoms and left ventricular ejection fraction
Authors: Stassen Jan , Ewe See Hooi , Butcher Steele C , Amanullah Mohammed R , Hirasawa Kensuke , Singh Gurpreet K , Sin Kenny Y K , Ding Zee P , Pio Stephan M , Sia Ching-Hui , Chew Nicholas W S , Kong William K F , Poh Kian Keong , Cohen David J , Généreux Philippe , Leon Martin B , Marsan Nina Ajmone , Delgado Victoria , Bax Jeroen J
Published: November 2021

Aims

The aim of this study is to investigate the independent determinants of survival in patients with moderate aortic stenosis (AS), stratified by severity of symptoms and left ventricular ejection fraction (LVEF).

Methods and results

Patients with a first diagnosis of moderate AS (aortic valve area >1.0 and ≤1.5 cm2) were identified. Patients were stratified by New York Heart Association (NYHA) functional class (NYHA I, NYHA II, or NYHA III–IV) and LVEF (LVEF ≥60%, LVEF 50–59%, or LVEF <50%) at the time of moderate AS diagnosis. The primary endpoint was all-cause mortality, while the secondary endpoint included all-cause mortality and aortic valve replacement. Of 1961 patients with moderate AS (mean age 73 ± 10 years, 51% men), 1108 (57%) patients were in NYHA class I, while 527 (27%) and 326 (17%) patients had symptoms of NYHA class II and III–IV, respectively. Regarding LVEF, 1032 (53%) had LVEF ≥60%, 544 (28%) LVEF 50–59%, and 385 (20%) LVEF <50%. During a median follow-up of 50 (23–82) months, 868 (44%) patients died. On multivariable analysis, NYHA class II [hazard ratio (HR): 1.633; 95% confidence interval (CI): 1.431–1.864; P < 0.001], NYHA class III–IV (HR: 2.084; 95% CI: 1.797–2.417; P < 0.001), LVEF 50–59% (HR: 1.194; 95% CI: 1.013–1.406; P = 0.034), and LVEF <50% (HR: 1.694; 95% CI: 1.417–2.026; P < 0.001) were independently associated with increased mortality.

Conclusion

Moderate AS is associated with poor long-term survival. Baseline symptom severity and LVEF are associated with worse outcomes in these patients. Patients with low-normal LVEF (<60%) and mild symptoms (NYHA II) already have an increased risk of adverse events.
Miniseries 2—Septal and paraseptal accessory pathways—Part III: Mid-paraseptal accessory pathways—revisiting bypass tracts crossing the pyramidal space
Authors: Farré Jerónimo , Anderson Robert H , Rubio José-Manuel , García-Talavera Camila , Sánchez-Quintana Damián , Bansal Raghav , Lokhandwala Yash , Cabrera José-Angel , Wellens Hein J J , Back Sternick Eduardo
Published: November 2021

The mid-paraseptal region corresponds to the portion of the pyramidal space whose right atrial aspect is known as the triangle of Koch. The superior area of this mid-paraseptal region is also para-Hisian, and is close to the compact atrioventricular node and the His bundle. The inferior sector of the mid-paraseptal area is unrelated to the normal atrioventricular conduction pathways. It is, therefore, a safe zone in which, if necessary, to perform catheter ablation. The middle part of the mid-paraseptal zone may, however, in some patients, house components of the compact atrioventricular node. This suggests the need for adopting a prudent attitude when considering catheter ablation in this area. The inferior extensions of the atrioventricular node, which may represent the substrate for the slow atrioventricular nodal pathway, take their course through the middle, and even the inferior, sectors of the mid-paraseptal region. In this review, we contend that the middle and inferior areas of the mid-paraseptal region correspond to what, in the past, was labelled by most groups as the ‘midseptal’ zone. We describe the electrocardiographic patterns observed during pre-excitation and orthodromic reciprocating tachycardia in patients with pathways ablated in the middle or inferior sectors of the region. We discuss the modification of the ventriculo-atrial conduction times during tachycardia after the development of bundle branch block aberrancy. We conclude that the so-called ‘intermediate septal’ pathways, as described in the era of surgical ablation, were insufficiently characterized. They should not be considered the surrogate of the ‘midseptal’ pathways defined using endocardial catheter electrode mapping.
A systematic review of the use of positive deviance approaches in primary care
Authors: O’Malley Roisin , O’Connor Paul , Madden Caoimhe , Lydon Sinéad
Published: November 2021

Background

The Positive Deviance (PD) approach focuses on identifying and learning from those who demonstrate exceptional performance despite facing similar resource constraints to others. Recently, it has been embraced to improve the quality of patient care in a variety of healthcare domains. PD may offer one means of enacting effective quality improvement in primary care.

Objective(s)

This review aimed to synthesize the extant research on applications of the PD approach in primary care.

Methods

Seven electronic databases were searched; MEDLINE, CINAHL, Embase, PsycINFO, Academic Search Complete, Psychology and Behavioral Sciences Collection, and Web of Science. Studies reporting original data on applications of the PD approach, as described by the PD framework, in primary care were included, and data extracted. Thematic analysis was used to classify positively deviant factors and to develop a conceptual framework. Methodological quality was appraised using the Quality Assessment with Diverse Studies (QuADS).

Results

In total, 27 studies were included in the review. Studies most frequently addressed Stages 1 and 2 of the PD framework, and targeted 5 core features of primary care; effectiveness, chronic disease management, preventative care, prescribing behaviour, and health promotion. In total, 268 factors characteristic of exceptional care were identified and synthesized into a framework of 37 themes across 7 system levels.

Conclusion

Several useful factors associated with exceptional care were described in the literature. The proposed framework has implications for understanding and disseminating best care practice in primary care. Further refinement of the framework is required before its widespread recommendation.
Assemblies of the genomes of parasitic wasps using meta-assembly and scaffolding with genetic linkage
Authors: Wittmeyer Kameron T , Oppenheim Sara J , Hopper Keith R
Published: November 2021

Safe, effective biological-control introductions against invasive pests depend on narrowly host-specific natural enemies with the ability to adapt to a changing environment. As part of a project on the genetic architectures of these traits, we assembled and annotated the genomes of two aphid parasitoids, Aphelinus atriplicis and Aphelinus certus. We report here several assemblies of A. atriplicis made with Illumina and PacBio data, which we combined into a meta-assembly. We scaffolded the meta-assembly with markers from a genetic map of hybrids between A. atriplicis and A. certus. We used this genetic-linkage scaffolded (GLS) assembly of A. atriplicis to scaffold a de novo assembly of A. certus. The de novo assemblies of A. atriplicis differed in contiguity, and the meta-assembly of these assemblies was more contiguous than the best de novo assembly. Scaffolding with genetic-linkage data allowed chromosomal-level assembly of the A. atriplicis genome and scaffolding a de novo assembly of A. certus with this GLS assembly, greatly increased the contiguity of the A. certus assembly to the point where it was also at the chromosomal-level. However, completeness of the A. atriplicis assembly, as measured by percent complete, single-copy BUSCO hymenopteran genes, varied little among de novo assemblies and was not increased by meta-assembly or genetic scaffolding. Furthermore, the greater contiguity of the meta-assembly and GLS assembly had little or no effect on the numbers of genes identified, the proportions with homologs or functional annotations. Increased contiguity of the A. certus assembly provided modest improvement in assembly completeness, as measured by percent complete, single-copy BUSCO hymenopteran genes. The total genic sequence increased, and while the number of genes declined, gene length increased, which together suggest greater accuracy of gene models. More contiguous assemblies provide uses other than gene annotation, for example, identifying the genes associated with quantitative trait loci and understanding of chromosomal rearrangements associated with speciation.
Genetic and genomic architecture in eight strains of the laboratory opossum Monodelphis domestica
Authors: Xiong Xiao , Samollow Paul B , Cao Wenqi , Metz Richard , Zhang Chao , Leandro Ana C , VandeBerg John L , Wang Xu
Published: November 2021

The gray short-tailed opossum (Monodelphis domestica) is an established laboratory-bred marsupial model for biomedical research. It is a critical species for comparative genomics research, providing the pivotal phylogenetic outgroup for studies of derived vs ancestral states of genomic/epigenomic characteristics for eutherian mammal lineages. To characterize the current genetic profile of this laboratory marsupial, we examined 79 individuals from eight established laboratory strains. Double digest restriction site-associated DNA sequencing and whole-genome resequencing experiments were performed to investigate the genetic architecture in these strains. A total of 66,640 high-quality single nucleotide polymorphisms (SNPs) were identified. We analyzed SNP density, average heterozygosity, nucleotide diversity, and population differentiation parameter Fst within and between the eight strains. Principal component and population structure analysis clearly resolve the strains at the level of their ancestral founder populations, and the genetic architecture of these strains correctly reflects their breeding history. We confirmed the successful establishment of the first inbred laboratory opossum strain LSD (inbreeding coefficient F > 0.99) and a nearly inbred strain FD2M1 (0.98 < F < 0.99), each derived from a different ancestral background. These strains are suitable for various experimental protocols requiring controlled genetic backgrounds and for intercrosses and backcrosses that can generate offspring with informative SNPs for studying a variety of genetic and epigenetic processes. Together with recent advances in reproductive manipulation and CRISPR/Cas9 techniques for Monodelphis domestica, the existence of distinctive inbred strains will enable genome editing on different genetic backgrounds, greatly expanding the utility of this marsupial model for biomedical research.
Do Epigenetic Clocks Provide Explanations for Sex Differences in Life Span? A Cross-Sectional Twin Study
Authors: Kankaanpää Anna , Tolvanen Asko , Saikkonen Pirkko , Heikkinen Aino , Laakkonen Eija K , Kaprio Jaakko , Ollikainen Miina , Sillanpää Elina
Published: November 2021

Background

The sex gap in life expectancy has been narrowing in Finland over the past 4–5 decades; however, on average, women still live longer than men. Epigenetic clocks are markers for biological aging which predict life span. In this study, we examined the mediating role of lifestyle factors on the association between sex and biological aging in younger and older adults.

Methods

Our sample consists of younger and older twins (21‒42 years, n = 1 477; 50‒76 years, n = 763) including 151 complete younger opposite-sex twin pairs (21‒30 years). Blood-based DNA methylation was used to compute epigenetic age acceleration by 4 epigenetic clocks as a measure of biological aging. Path modeling was used to study whether the association between sex and biological aging is mediated through lifestyle-related factors, that is, education, body mass index, smoking, alcohol use, and physical activity.

Results

In comparison to women, men were biologically older and, in general, they had unhealthier life habits. The effect of sex on biological aging was partly mediated by body mass index and, in older twins, by smoking. Sex was directly associated with biological aging and the association was stronger in older twins.

Conclusions

Previously reported sex differences in life span are also evident in biological aging. Declining smoking prevalence among men is a plausible explanation for the narrowing of the difference in life expectancy between the sexes. Data generated by the epigenetic clocks may help in estimating the effects of lifestyle and environmental factors on aging and in predicting aging in future generations.
Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum
Authors: Jenkins Morales Meghan , Robert Stephanie A
Published: November 2021

Objectives

To examine how different care arrangements across the long-term care continuum are associated with experiencing unmet care need consequences (UCNCs), such as skipping meals, going without clean clothes, or taking the wrong medication.

Methods

We include older adults receiving assistance with at least one self-care, mobility, or household activity (for health/functioning reasons) in the 2015 National Health and Aging Trends Study (N = 2,388). We examine the likelihood of experiencing a UCNC across the long-term care continuum: those receiving unpaid community care only, paid community care, and residential care. Cross-sectional logistic and longitudinal multinomial logistic regression models examine if type of care arrangement in 2015 is associated with UCNCs in 2015 and change in UCNCs by 2017.

Results

In adjusted cross-sectional models, paid community care recipients had roughly 2 times greater odds of experiencing a UCNC in 2015 compared to those living in residential care or receiving only unpaid care. In adjusted longitudinal models, the risk of experiencing persistent UCNCs (compared to having needs met in both years) was 4.81 times higher for those receiving paid community care compared to those in residential care and 2.17 times that of those receiving unpaid care only.

Discussion

Older adults receiving paid care face significant and consequential gaps in care, particularly in comparison to those in other care arrangements. More attention is needed to determine how paid care arrangements can be improved and/or expanded to meet the needs of the growing number of older adults receiving paid care in the community.
South Africa's experimental fisheries closures and recovery of the endangered African penguin
Authors: Sydeman William J , Hunt George L , Pikitch Ellen K , Parrish Julia K , Piatt John F , Boersma P Dee , Kaufman Les , Anderson Daniel W , Thompson Sarah Ann , Sherley Richard B
Published: November 2021

In a scientifically-transformative project, South Africa implemented a decade-long field experiment to understand how fisheries may be affecting its most iconic seabird, the African penguin Spheniscus demersus. This unique effort prohibits the take of anchovy and sardine within relatively small areas around four African penguin breeding colonies, two in the Benguela upwelling ecosystem and two in the adjacent Agulhas region. For the Benguela, fisheries closures within the birds’ primary foraging range increased their breeding productivity and perhaps reduced parental foraging efforts, indicating that the fisheries are competing with the birds for food. Results were less clear for foraging behaviour in the Agulhas, but no data on breeding success were collected there. The African penguin is endangered, its population continues to decline, and fisheries closures have been demonstrated to improve demographic traits that contribute to population growth. Therefore, given the critical status of the species, fisheries closures should be maintained, at least at Dassen Island where the population has great capacity to expand and support other nearby colonies. Continuing or implementing corresponding fisheries closures in the Agulhas region is also warranted, as well as creating and testing the value of pelagic closed areas during the non-breeding season when the penguins disperse widely across these ecosystems. These management actions would increase penguin food supplies and may help to meet societal goals of halting the decline of the penguin population, as well as maintaining the economic and cultural services provided by fisheries and ecotourism.
Global decentralized control for uncertain large-scale feedforward nonlinear time-delay systems via output feedback
Authors: Shao Yiming , Jia Xianglei , Ju Xinxu , Shi Xiaocheng
Published: November 2021

In this paper, the problem of global decentralized output feedback control is addressed for a class of large-scale nonlinear systems with zero dynamics and unknown time-varying delay. System disturbance nonlinearities are subject to feedforward growth restrictions with unknown growth rate. In the spirit of dynamic scaling change technique, a novel pair of time-varying-gain observer and controller is proposed. Compared with the existing results, the controller proposed is capable of handling the difficulties caused by the zero-dynamics, the uncertainties and the unknown time-varying delay. With the help of the Razumikhin theorem, it is shown that the closed-loop states asymptotically converge to zero. Finally, the effectiveness of the proposed control scheme is illustrated by a numerical example.
Estimating Tuberculosis Transmission Risks in a Primary Care Clinic in South Africa: Modeling of Environmental and Clinical Data
Authors: Zürcher Kathrin , Riou Julien , Morrow Carl , Ballif Marie , Koch Anastasia , Bertschinger Simon , Warner Digby F , Middelkoop Keren , Wood Robin , Egger Matthias , Fenner Lukas
Published: November 2021

Background

Congregate settings, such as healthcare clinics, may play an essential role in Mycobacterium tuberculosis (Mtb) transmission. Using patient and environmental data, we studied transmission at a primary care clinic in South Africa.

Methods

We collected patient movements, cough frequency, and clinical data, and measured indoor carbon dioxide (CO2) levels, relative humidity, and Mtb genomes in the air. We used negative binomial regression model to investigate associations.

Results

We analyzed 978 unique patients who contributed 14 795 data points. The median patient age was 33 (interquartile range [IQR], 26–41) years, and 757 (77.4%) were female. Overall, median CO2 levels were 564 (IQR 495–646) parts per million and were highest in the morning. Median number of coughs per day was 466 (IQR, 368–503), and overall median Mtb DNA copies/μL/day was 4.2 (IQR, 1.2–9.5). We found an increased presence of Mtb DNA in the air of 32% (95% credible interval, 7%–63%) per 100 additional young adults (aged 15–29 years) and 1% (0–2%) more Mtb DNA per 10% increase of relative humidity. Estimated cumulative transmission risks for patients attending the clinic monthly for at least 1 hour range between 9% and 29%.

Conclusions

We identified young adults and relative humidity as potentially important factors for transmission risks in healthcare clinics. Our approach should be used to detect transmission and evaluate infection control interventions.
Surfaces and Air Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 Using High-Flow Nasal Oxygenation or Assisted Mechanical Ventilation in Intensive Care Unit Rooms of Patients With Coronavirus Disease 2019
Authors: Lebreil Anne-Laure , Greux Vincent , Glenet Marie , Huguenin Antoine , N’Guyen Yohan , Berri Fatma , Bajolet Odile , Mourvillier Bruno , Andreoletti Laurent
Published: November 2021

Background

Understanding patterns of environmental contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection prevention policies.

Methods

We screened surfaces and air samples from single-bed intensive-care unit rooms of adult patients with coronavirus disease 2019 (COVID-19) for SARS-CoV-2 RNA and viable viruses.

Results

We evidenced viral RNA environmental contamination in 76% of 100 surfaces samples and in 30% of 40 air samples without any viable virus detection by cell culture assays. No significant differences of viral RNA levels on surfaces and in ambient air were observed between rooms of patients with assisted mechanical ventilation and those of patients with a high-flow nasal cannula system. Using an original experimental SARS-CoV-2 infection model of surfaces, we determined that infectious viruses may have been present on benches within 15 hours before the time of sampling in patient rooms.

Conclusions

We observed that SARS-CoV-2 environmental contamination around patients with COVID-19 hospitalized in single-bed ICU rooms was extensive and that a high-flow nasal cannula system did not generate more viral aerosolization than a mechanical ventilation system in patients with COVID-19. Despite an absence of SARS-CoV-2 viable particles in study samples, our experimental model confirmed the need to apply strict environmental disinfection procedures and classic standard and droplet precautions in ICU wards.
The future of data management for pediatric cataract
Authors: Bartlett Sarah , Hassan Amina , Ibrahim Nazaradden , Isiyaku Sunday , Muhammad Nasiru , Ngom Babacar , Nwosu Christian
Published: November 2021

Cataract is a leading cause of blindness in children worldwide. Blindness can be treated with effective surgery, but in low-resource settings this treatment can be difficult to access. In addition, positive outcomes of the surgery are heavily dependent on comprehensive postoperative care. To date in Nigeria and many other low-resource countries, robust electronic data-management systems that help facility teams to manage their patient data, especially when it comes to tracking children for follow-up visits after surgery, have either yet to be put into place or are in place but have yet to be refined to respond to the specific needs of eye care programs. Sightsavers has worked with multiple state ministries in Nigeria to set up and test a system that responds to those needs.
A multimodal approach to improve asthmatic adolescents’ self-efficacy in Taiwan
Authors: Tseng Tzu-Jung , Wu Chiung-Jung (Jo)
Published: November 2021

Background

An efficient asthma self-management for adolescents must be based on adolescents’ needs, increase self-efficacy and adherence to treatment. The effects of such program are likely be dose dependent.

Aim

To examine the impact of the dose-effect of multiple components on an asthma self-management program for adolescents aged 12-18 years in Taiwan.

Methods

A scoring system was developed to classify intervention groups into high- (19-23), medium- (11-18) and low (< 11) dose according to the number of components completed by participants. The impacts of the dose level on outcomes of asthma self-efficacy, prevention behaviors, asthma medication adherence, and asthma symptoms were examined.

Results/Conclusion

Our results suggest that a high dose of the intervention can improve adolescents’ self-efficacy, asthma prevention behavior, and medication adherence.

Trial Registration

Trial Registration No: ACTRN12613001294741.
Quality Management to Improve CSF Gram Stain Turnaround Time
Authors: Kerantzas Christopher A , Merwede Jacob P , Fadlallah Hasan , Durant Thomas J S , Peaper David R
Published: November 2021

Background

With appropriate turnaround time (TAT), cerebrospinal fluid (CSF) Gram stains can provide rapid, clinically actionable information in patients with meningitis. Monitoring CSF Gram stain TAT at our institution revealed workflow gaps that were causing result reporting delays. We then implemented a new quality management program to improve TAT.

Methods

We reviewed the TAT of all CSF specimens submitted for bacterial culture received between August 1, 2016, and July 31, 2020, and began prospectively monitoring CSF Gram stain TAT in January 2019. We then implemented the following changes in April 2019: (i) monthly reviews of TAT with staff, (ii) hand-off sheets for shift transitions, and (iii) pre- and post-shift walk throughs including centrifuge checks.

Results

A total of 6913 samples were included in the analysis. CSF samples with TAT > 60 min decreased from 27.3% to 9.89% (P < 0.0001), and median TAT decreased by 9 min (P < 0.0001) with significantly reduced variability. These changes were sustained throughout the follow-up period across all shifts and shift transitions.

Conclusions

A new monthly quality metric allowed us to track CSF Gram stain TAT, identify barriers to TAT goals, and implement workflow changes that significantly improved TAT without the need for costly interventions.
Dark clouds and silver linings: impact of COVID-19 on internet users’ privacy
Authors: Gopal Ram D , Hidaji Hooman , Patterson Raymond A , Yaraghi Niam
Published: November 2021

Objectives

To examine the impact of coronavirus disease 2019 (COVID-19) pandemic on the extent of potential violations of Internet users’ privacy.

Materials and Methods

We conducted a longitudinal study of the data sharing practices of the top 1000 websites in the United States between April 9 and August 27, 2020. We fitted a conditional latent growth curve model on the data to examine the longitudinal trajectory of the third-party data sharing over the 21 weeks period of the study and examine how website characteristics affect this trajectory. We denote websites that asked for permission before placing cookies on users’ browsers as “privacy-respecting.”

Results

As the weekly number of COVID-19 deaths increased by 1000, the average number of third parties increased by 0.26 (95% confidence interval [CI] 0.15–0.37) P < 0.001 units in the next week. This effect was more pronounced for websites with higher traffic as they increased their third parties by an additional 0.41 (95% CI 0.18–0.64); P < 0.001 units per week. However, privacy respecting websites that experienced a surge in traffic reduced their third parties by 1.01 (95% CI −2.01 to 0); P = 0.05 units per week in response to every 1000 COVID-19 deaths in the preceding week.

Discussion

While in general websites shared their users’ data with more third parties as COVID-19 progressed in the United States, websites’ expected traffic and respect for users’ privacy significantly affect such trajectory.

Conclusions

Attention should also be paid to the impact of the pandemic on elevating online privacy threats, and the variation in third-party tracking among different types of websites.
The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia
Authors: Shimodaira Hiroki , Hatakeyama Akihisa , Suzuki Hitoshi , Takada Shinichiro , Murata Yoichi , Sakai Akinori , Uchida Soshi
Published: November 2021

Femoroacetabular impingement syndrome (FAIS) has been associated with osteitis pubis; however, it is still unclear whether hip dysplasia is associated with osteitis pubis. This study aimed to investigate (i) the incidence of pubic bone marrow edema (BME) on magnetic resonance imaging in symptomatic patients with FAIS, borderline developmental dysplasia of the hip (BDDH) and developmental dysplasia of the hip (DDH) undergoing hip arthroscopic surgery with labral preservation and (ii) the demographic and radiographic factors associated with pubic BME. A total of 259 symptomatic patients undergoing hip arthroscopic surgery between July 2016 and April 2019 were retrospectively reviewed and divided into three groups: FAIS (180 patients), BDDH (29 patients) and DDH (50 patients). Diffuse changes in the pubic bone adjacent to the pubic symphysis were labeled pubic BME, and the prevalence of their occurrence was examined. Multivariate logistic regression analysis was performed to identify factors involved in pubic BME, and odds ratios (ORs) for relevant factors were calculated. There was no significant difference in the prevalence of pubic BME among the three groups (20 [11.1%] of 180 FAIS patients, 6 [20.6%] of 29 BDDH patients and 7 [14%] of 50 DDH patients, P = 0.325). Multivariate logistic regression analysis showed that acetabular coverage was not associated with pubic BME, whereas younger age and greater alpha angle were still independent associated factors [age ≤26 years (OR, 65.7) and alpha angle ≥73.5° (OR, 4.79)]. Determining the possible association of osteitis pubis with cam impingement in dysplastic hips may provide insights toward a more accurate understanding of its pathophysiology.
Recent progress in three-dimensionally-printed dosage forms from a pharmacist perspective
Authors: Anwar-Fadzil Ahmad Fahmi bin , Yuan Yunong , Wang Lingxin , Kochhar Jaspreet S , Kachouie Nezamoddin N , Kang Lifeng
Published: November 2021

Objective

Additive manufacturing (AM), commonly known as 3D printing (3DP), has opened new frontiers in pharmaceutical applications. This review is aimed to summarise the recent development of 3D-printed dosage forms, from a pharmacists’ perspective.

Methods

Keywords including additive manufacturing, 3D printing and drug delivery were used for literature search in PubMed, Excerpta Medica Database (EMBASE) and Web of Science, to identify articles published in the year 2020.

Results

For each 3DP study, the active pharmaceutical ingredients, 3D printers and materials used for the printing were tabulated and discussed. 3DP has found its applications in various dosage forms for oral delivery, transdermal delivery, rectal delivery, vaginal delivery, implant and bone scaffolding. Several topics were discussed in detail, namely patient-specific dosing, customisable drug administration, multidrug approach, varying drug release, compounding pharmacy, regulatory progress and future perspectives. AM is expected to become a common tool in compounding pharmacies to make polypills and personalised medications.

Conclusion

3DP is an enabling tool to fabricate dosage forms with intricate structure designs, tailored dosing, drug combinations and controlled release, all of which lend it to be highly conducive to personalisation, thereby revolutionising the future of pharmacy practice.
Political Barriers to Reform: Analysing Australia’s Legitimation of Its Guardianship Framework
Authors: Bennett India
Published: November 2021

The guardianship of unaccompanied asylum-seeker children is a contentious aspect of Australian asylum-seeker law and policy. The current legislative framework for guardianship is curtailed by migration legislation and policy and is ineffective for realizing the rights of these children under international law. This paper contributes to existing scholarship on guardianship by critically examining political discourse on child asylum seekers. It combines the discourse-historical approach with doctrinal analysis to uncover the historical and political context and outcomes of the legislation. Critical discourse analysis examines statements made by politicians from both major Australian political parties and the parliamentary report rejecting the most recent attempt at reform. This paper reveals that, to reject reform and justify maintaining the status quo, the government has rationalized the detention of child asylum-seekers as essential to the success of deterrence measures, and moralized these measures by framing them as necessary to protect the lives of those attempting to reach Australia by boat.
Coronary artery bypass graft in an isolated single coronary ostium with triple vessel disease
Authors: Al-Sarraf Nael , Chandrasekar Baskaran
Published: November 2021

Single coronary artery (SCA) is a rare congenital anomaly whereby only one coronary artery arises from single coronary artery ostium of the aortic trunk and supplies the whole heart. The incidence of this anomaly is 0.0024–0.066% in patients undergoing coronary angiography. It is usually an isolated anomaly and majority of patients are picked up incidentally. Lipton classification is widely used to classify this anomaly. Most cases are detected by computerized tomography and/or coronary angiography and are treated medically. Here, we present a rare case of type RII-B in which the patient underwent coronary artery bypass graft for severe triple vessel disease presenting as acute myocardial infarction.
Lack of other molecules in CO-rich debris discs: is it primordial or secondary gas?
Authors: Smirnov-Pinchukov Grigorii V , Moór Attila , Semenov Dmitry A , Ábrahám Péter , Henning Thomas , Kóspál Ágnes , Hughes A Meredith , di Folco Emmanuel
Published: November 2021

The nature of the gas in CO-rich debris discs remains poorly understood, as it could either be a remnant from the earlier Class II phase or of secondary origin, driven by the destruction of icy planetesimals. The aim of this paper was to elucidate the origin of the gas content in the debris discs via various simple molecules that are often detected in the less-evolved Class II discs. We present millimetre molecular line observations of nine circumstellar discs around A-type stars: four CO-rich debris discs (HD 21997, HD 121617, HD 131488, HD 131835) and five old Herbig Ae protoplanetary discs (HD 139614, HD 141569, HD 142666, HD 145718, HD 100453). The sources were observed with the Atacama Large Millimeter/submillimeter Array (ALMA) in Bands 5 and 6 with 1–2 arcsec resolution. The Herbig Ae discs are detected in the CO isotopologues, CN, HCN, HCO+, C2H, and CS lines. In contrast, only CO isotopologues are detected in the debris discs, showing a similar amount of CO to that found in the Herbig Ae protoplanetary discs. Using chemical and radiative transfer modelling, we show that the abundances of molecules other than CO in debris discs are expected to be very low. We consider multiple sets of initial elemental abundances with various degrees of H2 depletion. We find that the HCO+ lines should be the second brightest after the CO lines, and that their intensities strongly depend on the overall CO/H2 ratio of the gas. However, even in the ISM-like scenario, the simulated HCO+ emission remains weak as required by our non-detections.
Helicity observations of active regions during the exchange period of Solar Cycle 24 and 25
Authors: Liu Jihong , Liu Yu , Zhang Yin , Huang Jin , Zhang HongQi
Published: November 2021

Using vector magnetic field data from the Helioseismic and Magnetic Imager instrument onboard the Solar Dynamics Observatory, we study the signs of helicity (magnetic twist αav, z-component of current helicity Hc) and tilt angle of 85 sample active regions (ARs) that appeared on the central solar disc (within ±45° from disc centre) between December 2018 and November 2020. This time range spans the exchange period of Solar Cycle 24 and 25. The main findings are as follows: (1) As a whole, 62 per cent of sample ARs follow the helicity hemispherical sign rule, and our observational results do not show any hemispherical rule sign reversal at the end or beginning of a Solar Cycle. (2) Interestingly, there is no significant statistical relationship between helicity and tilt angle, as in contrast with the general idea on the conservation of magnetic helicity in the solar convection zone inferred by the relationship between the photospheric helicity and tilt angle. It is also found that the hemispherical tendency of helicity and tilt angle is more obvious for ARs at high latitudes, and the hemispherical preference is more obvious for ARs with magnetic twist and writhe of the opposite signs than for ARs with the same signs.