bluuebunny/crossref_metadata_2025 huggingface dataset:
External validation of a surgical mortality risk prediction model for inpatient noncardiac surgery in an Australian private health insurance dataset
Authors: Reilly Jennifer Richelle , Wong Darren , Brown Wendy Ann , Gabbe Belinda Jane , Myles Paul Stewart
Published: August 2022

Background

We previously conducted a systematic review to identify surgical mortality risk prediction tools suitable for adapting in the Australian context and identified the Surgical Outcome Risk Tool (SORT) as an ideal model. The primary aim was to investigate the external validity of SORT for predicting in‐hospital mortality in a large Australian private health insurance dataset.

Methods

A cohort study using a prospectively collected Australian private health insurance dataset containing over 2 million deidentified records. External validation was conducted by applying the predictive equation for SORT to the complete case analysis dataset. Model re‐estimation (recalibration) was performed by logistic regression.

Results

The complete case analysis dataset contained 161 277 records. In‐hospital mortality was 0.2% (308/161277). The mean estimated risk given by SORT was 0.2% and the median (IQR) was 0.01% (0.003%–0.08%). Discrimination was high (c‐statistic 0.96) and calibration was accurate over the range 0%–10%, beyond which mortality was over‐predicted but confidence intervals included or closely approached the perfect prediction line. Re‐estimation of the equation did not improve over‐prediction. Model diagnostics suggested the presence of outliers or highly influential values.

Conclusion

The low perioperative mortality rate suggests the dataset was not representative of the overall Australian surgical population, primarily due to selection bias and classification bias. Our results suggest SORT may significantly under‐predict 30‐day mortality in this dataset. Given potential differences in perioperative mortality, private health insurance status and hospital setting should be considered as covariables when a locally validated national surgical mortality risk prediction model is developed.
Impact of COVID‐19, gender, race, specialty and seniority on mental health during surgical training: an international study
Authors: Kovoor Joshua G. , Layton Georgia R. , Burke Joshua R. , Churchill James A. , Jacobsen Jonathan Henry W. , Reid Jessica L. , Edwards Suzanne , Issa Eyad , Garrod Tamsin J. , Archer Julian , Tivey David R. , Babidge Wendy J. , Dennison Ashley R. , Maddern Guy J.
Published: August 2022

Background

Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross‐sectional study determining relative impacts of COVID‐19, gender, race, specialty and seniority on mental health of surgical trainees.

Method

Trainees across Australia, New Zealand and UK enrolled in surgical training accredited by the Royal Australasian College of Surgeons or Royal College of Surgeons were included. Outcomes included the short version of the Perceived Stress Scale, Oxford Happiness Questionnaire short scale, Patient Health Questionnaire‐2 and the effect on individual stress levels of training experiences affected by COVID‐19. Predictors included trainee characteristics and local COVID‐19 prevalence. Multivariable linear regression analyses were conducted to assess association between outcomes and predictors.

Results

Two hundred and five surgical trainees were included. Increased stress was associated with number of COVID‐19 patients treated (P = 0.0127), female gender (P = 0.0293), minority race (P = 0.0012), less seniority (P = 0.001), and greater COVID‐19 prevalence (P = 0.0122). Lower happiness was associated with training country (P = 0.0026), minority race (P = 0.0258) and more seniority (P < 0.0001). Greater depression was associated with more seniority (P < 0.0001). Greater COVID‐19 prevalence was associated with greater reported loss of training opportunities (P = 0.0038), poor working conditions (P = 0.0079), personal protective equipment availability (P = 0.0008), relocation to areas of little experience (P < 0.0001), difficulties with career progression (P = 0.0172), loss of supervision (P = 0.0211), difficulties with pay (P = 0.0034), and difficulties with leave (P = 0.0002).

Conclusion

This is the first study to specifically describe the relative impacts of COVID‐19 community prevalence, gender, race, surgical specialty and level of seniority on stress, happiness and depression of surgical trainees on an international scale.
Preoperative PET/CT score can predict incomplete resection after debulking surgery for advanced serous ovarian cancer better than CT score, MTV, tumor markers and hematological markers
Authors: Wang Jie , Liu Li , Pang Hua , Liu Lili , Jing Xingguo , Li Yongmei
Published: August 2022

Introduction

Complete resection after debulking surgery is strongly associated with prolonged survival for advanced serous ovarian cancer (ASOC). Though positron emission tomography/computed tomography (PET/CT) is more advantageous than computed tomorgraphy (CT) for detecting metastases, studies on the PET/CT prediction model for incomplete resection for ovarian cancer are insufficient. We analyzed and compared the predictive value of preoperative PET/CT score, CT score, metabolic parameters, tumor markers and hematological markers for incomplete resection after debulking surgery for ASOC.

Material and methods

A total of 62 ASOC patients who underwent preoperative [18F]FDG PET/CT and debulking surgery were retrospectively analyzed. PET/CT and CT scores were based on the Suidan model. The predictive value of PET/CT score, CT score, the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), human epididymis protein 4 (HE4), cancer antigen 125 (CA125), lymphocyte‐to‐monocyte ratio (LMR), platelet‐to‐lymphocyte ratio (PLR) and neutrophil‐to‐lymphocyte ratio (NLR) for incomplete resection were analyzed and compared.

Results

Preoperative PET/CT score had the highest predictive value for incomplete resection in primary debulking surgery group (sensitivity: 65.0%, specificity: 88.9%, area under the ROC curve (AUC): 0.847, p < 0.001), however, in secondary debulking surgery group, preoperative PET/CT score and CT score had the same and highest predictive value for incomplete resection (sensitivity: 80.0%, specificity: 94.7%, AUC: 0.853, p = 0.017), compared with preoperative metabolic parameters SUVmax and MTV, tumor markers HE4 and CA125, and hematological markers LMR, PLR and NLR. Preoperative PET/CT score ≥ 3 (Suidan model) and preoperative PET/CT score ≥ 2 predicted a high risk of incomplete resection after primary and secondary debulking surgeries, respectively. There was no statistical difference between primary and secondary debulking surgery groups in predictive value of PET/CT score for incomplete resection (p = 0.971). There were significant differences between PET/CT scores and CT scores in primary debulking surgery group and no significant differences in secondary debulking surgery group.

Conclusions

A high PET/CT score predicted a high risk of incomplete resection. The preoperative PET/CT score had an identical predictive value in primary and secondary debulking surgery groups. PET/CT score was more accurate in the detection of metastases than CT score was.
Model‐based analysis for the population pharmacokinetics of iberdomide and its major active metabolite in healthy subjects and patients with relapsed and refractory multiple myeloma
Authors: Cheng Yiming , Xue Yongjun , Chen Lu , Masin Mark , Maciag Paulo , Peluso Teresa , Zhou Simon , Li Yan
Published: August 2022

Aims

A parent‐metabolite population pharmacokinetic (popPK) model of iberdomide and its pharmacologically active metabolite (M12) was developed and the influence of demographic and disease‐related covariates on popPK parameters was assessed based on data from 3 clinical studies of iberdomide (dose range, 0.1–6 mg) in healthy subjects (n = 81) and patients with relapsed and refractory multiple myeloma (n 245).

Methods

Nonlinear mixed effects modelling was used to develop the popPK model based on data from 326 subjects across 3 clinical studies.

Results

The pharmacokinetics (PK) of iberdomide were adequately described with a 2‐compartment model with first‐order absorption and elimination. A first‐order conversion rate was used to link the 1‐compartment linear elimination metabolite model with the parent model. Subject type (multiple myeloma patients vs. healthy subject) was a statistically significant covariate on apparent clearance and apparent volume of distribution for the central compartment, suggesting different PK between patients with multiple myeloma and healthy subjects. Aspartate aminotransferase and sex were statistically but not clinically relevant covariates on apparent clearance. Metabolite (M12) PK tracked the PK of iberdomide. The metabolite to parent ratio was consistent across doses and combinations.

Conclusion

The parent‐metabolite population PK model adequately described the time course PK data of iberdomide and M12. Iberdomide and M12 PK exposure were not complicated by demographic factors (age [19–82 y], body weight [41–172 kg], body surface area [1.4–2.7 m2], body mass index [16.4–59.3 kg/m2]), combination (in combination with dexamethasone and daratumumab), mild hepatic, or mild and moderate renal impairments. The model can be used to guide the dosing strategy for special patient population and inform future iberdomide study design.
Risk factors of hand eczema: A population‐based study among 900 subjects
Authors: Koskelo Marjut , Sinikumpu Suvi‐Päivikki , Jokelainen Jari , Huilaja Laura
Published: August 2022

Background

Many risk factors such as atopic dermatitis (AD) have shown to associate with hand eczema (HE). However, studies concerning other atopic diseases, parental or longitudinal risk factors of HE are scarce.

Objectives

To examine the association between HE and atopic diseases, parental factors, environmental factors (keeping animals, exposure to moulds) and lifestyle factors (obesity, tobacco smoking, alcohol consumption and physical activity) at population level.

Methods

Subjects belonging to the Northern Finland Birth Cohort 1966 Study (NFBC1966) (n = 6830) answered a comprehensive health questionnaire. The data was completed with parental information.

Results

HE was reported in 900 (13.3%) individuals. All atopic diseases, parental allergy, female gender and obesity increased the risk of HE whereas physical activity decreased the risk of HE. A statistically significant association was not found between HE and tobacco smoking or alcohol consumption.

Conclusions

All atopic diseases, not only AD, seem to have influence on the presence of HE. In addition, parental and environmental factors associated with HE.
Effect of congenital or acquired renal mass reduction on arterial stiffness
Authors: Yazıcı Raziye , Altıntepe Lutfullah , Guney İbrahim , Yazıcı Mehmet
Published: August 2022

Background

The changes in kidney functions, adversely affect the cardiovascular system. The aim of this study was to investigate whether arterial stiffness (AS), an indicator of subclinical atherosclerosis, was affected in patients with congenital or acquired reduced renal mass.

Methods

In this prospective study, a total 135 patients (mean age 43.4 ± 8.5 years and 71.9% female) with congenital unilateral small/nonfunctioning kidney or unilateral agenesis or with unilateral nephrectomy were included. As control group, 44 healthy individuals with similar age and gender (mean age, 42.5 ± 7.1 year and 61.4% female) were included. Estimated glomerular filtration rate (eGFR) was calculated by Modification of Diet in Renal Disease formula. Official blood pressures (BP) and 24‐h ambulatory noninvasive BP of both groups were measured. AS was assessed with pulse wave velocity (PWV) by using Mobile‐O‐Graph new genaration arteriograph device using oscillometrical method.

Results

There was no difference in terms of BP parameters and body mass index between groups. eGFR values of control group and study group were 93 ± 19 ml/min/1.73 m² and 89 ± 28 ml/min/1.73 m², respectively (p = 0.379). Compared with control group, the study group had higher PWV values (6.72 ± 1.11 m/s vs. 6.29± 0.75 m/s, p = 0.018). In linear regression analysis, PWV was found to be correlated with age (β = 0.752, p < 0.001), and daytime ambulatory systolic BP (β = 0.345, p < 0.001).

Conclusion

Our study showed that AS was increased in patients with reduced renal mass and this increase in AS was related to age and systolic BP. No relation was determined between AS and eGFR.
Measuring habitat complexity and spatial heterogeneity in ecology
Authors: Loke Lynette H. L. , Chisholm Ryan A.
Published: August 2022

Habitat complexity has been considered a key driver of biodiversity and other ecological phenomena for nearly a century. However, there is still no consensus over the definition of complexity or how to measure it. Up‐to‐date and clear guidance on measuring complexity is urgently needed, particularly given the rise of remote sensing and advent of technologies that allow environments to be scanned at unprecedented spatial extents and resolutions. Here we review how complexity is measured in ecology. We provide a framework for metrics of habitat complexity, and for the related concept of spatial heterogeneity. We focus on the two most commonly used complexity metrics in ecology: fractal dimension and rugosity. We discuss the pros and cons of these metrics using practical examples from our own empirical data and from simulations. Fractal dimension is particularly widely used, and we provide a critical examination of it drawing on research from other scientific fields. We also discuss informational metrics of complexity and their potential benefits. We chart a path forward for research on measuring habitat complexity by presenting, as a guide, sets of essential and desirable criteria that a metric of complexity should possess. Lastly, we discuss the applied significance of our review.
The association of food insecurity with tooth decay and periodontitis among middle‐aged and older adults in the United States and Korea
Authors: Lee Jane J. , Kim Yujin , Scott JoAnna M. , Hill Courtney M. , Chi Donald L.
Published: August 2022

Introduction

Food insecurity is an important social determinant of health, but there is limited understanding of its relationship with adult oral health. This study examined the associations between food insecurity and dental diseases (caries and periodontitis) among middle‐aged and older adults in the United States and South Korea.

Methods

This study focused on middle‐aged (40–59 years) and older adults (>59 years) who participated in the 2011–2016 US National Health and Nutrition Examination Surveys (NHANES) or the 2013–2015 South Korean NHANES. The exposure was food insecurity severity (food secure/early‐stage food insecurity/middle‐stage or severe food insecurity) assessed using the 18‐item US Household Food Security Survey Module. The two outcomes were any untreated tooth decay and periodontitis measured using the Modified Community Periodontal Index of Treatment Needs. Covariate‐adjusted odds ratios (OR) with 95% confidence intervals (CI) were generated using multivariable logistic regression models.

Results

Middle or severe food insecurity was associated with significantly higher odds of having untreated tooth decay than no food insecurity, but only among middle‐aged adults in the United States (OR: 1.4, 95% CI 1.2, 1.9; P = .037) and Korea (OR = 1.8; 95% CI:1.0, 3.2; P = .036) and older adults in the United States (OR: 2.6, 95% CI 1.7, 4.0; P < .001). The associations between food insecurity and periodontitis were inconsistent across age group and country.

Conclusion

Differing cultural norms and access to dental services in the United States and South Korea may influence the relationship between food insecurity and oral health. Future research should explore how addressing food insecurity could help to promote the oral health of middle‐aged and older adults in diverse sociocultural contexts.
The chemical framework: Exploring Europeanisation in French, Austrian, and Irish eHealth policy processes
Authors: Bérut Chloé
Published: August 2022

The aim of this article is to present a new “chemical” framework, through which heterogeneous observations on public policy‐making can be systematically interpreted. This chemical framework is based on a combination of policy stages and John W. Kingdon's Multiple Streams Framework. This framework has three points of potential analytical leverage, which are identified in this article: the conceptualisation of temporal triggers that go beyond agenda‐setting, the opportunity to conduct holistic analyses of the policy processes, and a focus on the connections between policy stages and the way these connections affect the three streams. These three dimensions are explored by analysing the process of soft Europeanisation occurring in French, Austrian, and Irish digital health (eHealth) policies. The empirical sections therefore detail how EU‐induced changes may be conceptualised using the chemical framework, highlighting avenues for future research in Europeanisation and policy studies.
Efficacy and safety of switching to bictegravir, emtricitabine, and tenofovir alafenamide in virologically suppressed Asian adults living with HIV: A pooled analysis from three international phase III randomized trials
Authors: Avihingsanon Anchalee , Chetchotisakd Ploenchan , Kiertiburanakul Sasisopin , Ratanasuwan Winai , Siripassorn Krittaecho , Supparatpinyo Khuanchai , Martin Hal , Wang Hui , Wong TinHung , Wang Hsiu Yin
Published: August 2022

Objectives

Data on switching to bictegravir, emtricitabine, and tenofovir alafenamide (B/F/TAF) in virologically suppressed Asian people living with HIV are limited. We performed a pooled analysis of virologically suppressed Asian participants from three international phase III trials to evaluate the efficacy and safety of switching to B/F/TAF.

Methods

Virologically suppressed people living with HIV were randomized to switch to B/F/TAF or to stay on baseline regimens. The primary endpoint was the proportion of participants with plasma HIV‐1 RNA ≥50 copies/ml at week 48. We analysed the incidence of adverse events (AEs), laboratory abnormalities, and changes in relevant tolerability parameters through 48 weeks.

Results

Overall, 136 Asian participants were included. The proportions of participants with plasma HIV‐1 RNA ≥50 copies/ml at week 48 were low in both arms (0% for B/F/TAF vs 1.4% for those who stayed on baseline regimens). Those who switched to B/F/TAF had virological suppression rates similar to those who stayed on baseline regimens (100% vs 95.9%, p = 0.2485), with no treatment‐emergent resistance. Drug‐related AEs occurred in three participants in each arm; none were serious. No participants discontinued the study drug because of AEs, and no deaths were observed. No significant differences were observed between the arms in the median changes in estimated glomerular filtration rate, body weight, and most lipid parameters. Switching from tenofovir disoproxil fumarate‐containing regimens to B/F/TAF resulted in a significant decrease in tubular proteinuria compared with those who stayed on baseline regimens (p < 0.01).

Conclusions

Virologically suppressed Asian people living with HIV who switched to B/F/TAF maintained 100% virological suppression at week 48, with no treatment‐emergent drug resistance and safety profiles comparable to those seen in people who stayed on baseline regimens.

Clinical Trial Number

ClinicalTrials.gov (NCT02603120, NCT02652624, and NCT02603107).
Translation and validation of the Persian version of diabetic foot ulcer scaleshort form (DFS‐SF)
Authors: Tavassolmand Sedigheh Sadat , Montazeri Ali , Madadizadeh Farzan , Dehghan Hamid Reza , Ranjbar Mohammad , Ameri Hosein
Published: August 2022

Foot ulcer in diabetic patients could often result in significantly impaired quality of life. This study aimed to translate and validate the DFS‐SF in Iran. The DFS‐SF was translated into Persian, and then its validity and reliability were tested in 262 patients with DFUs. Content validity was evaluated using content validity ratio (CVR) and content validity index (CVI), and criterion validity was assessed through Spearman's correlation between dimensions of the DFS‐SF and the EQ‐5D‐5L. Construct validity was measured using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and convergent‐discriminant validity was examined by calculating the average variance extracted (AVE) and composite reliability (CR). Cronbach's alpha and intraclass correlation coefficient (ICC) were calculated to evaluate the reliability of the measure. CVR ≥0.66 and CVI = 0.81 were calculated. Spearman's correlation ranged from 0.23 to 0.78 across all dimensions. The results of EFA showed that all six dimensions of the DFS‐SF had an eigenvalue more than 1; accounting for 68.88% of the total variance. CFA confirmed the DFS‐SF as a six‐dimension structure with good fit indices of χ2/df = 2.15 < 5, RMSEA = 0.06 < 0.08, CFI = 0.91 ≥ 0.90, TLI = 0.90 ≥ 0.90, and RMR = 0.04, as well as with adequate fit indices of GFI = 0.84 ≤ 0.90, NFI = 0.86 ≤ 0.90. Estimates of ≥0.50 for AVE were not observed in two of the six dimensions and CR ≥0.70 was obtained for all dimensions. The reliability was calculated with a Cronbach's alpha of 0.89 and ICC >0.69 for all dimensions. Our findings confirmed the validity and reliability of the Persian DFS‐SF; therefore, it can be used to assess QoL in patients with DFSs in clinical and research settings in Iran.
Comparative analysis of galactomannan lateral flow assay, galactomannan enzyme immunoassay and BAL culture for diagnosis of COVID‐19‐associated pulmonary aspergillosis
Authors: Ghazanfari Mona , Yazdani Charati Jamshid , Davoodi Lotfollah , Arastehfar Amir , Moazeni Maryam , Abastabar Mahdi , Haghani Iman , Mayahi Sabah , Hoenigl Martin , Pan Weihua , Hedayati Mohammad T.
Published: August 2022

Background

Galactomannan Enzyme Immunoassay (GM‐EIA) is proved to be a cornerstone in the diagnosis of COVID‐19‐associated pulmonary aspergillosis (CAPA), its use is limited in middle and low‐income countries, where the application of simple and rapid test, including Galactomannan Lateral Flow Assay (GM‐LFA), is highly appreciated. Despite such merits, limited studies directly compared GM‐LFA with GM‐EIA. Herein we compared the diagnostic features of GM‐LFA, GM‐EIA and bronchoalveolar lavage (BAL) culture for CAPA diagnosis in Iran, a developing country.

Materials/Methods

Diagnostic performances of GM‐LFA and GM‐EIA in BAL (GM indexes ≥1) and serum (GM indexes >0.5), i.e. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and areas under the curve (AUC), were evaluated using BAL (n = 105) and serum (n = 101) samples from mechanically ventilated COVID‐19 patients in intensive care units. Patients were classified based on the presence of host factors, radiological findings and mycological evidences according to 2020 ECMM/ISHAM consensus criteria for CAPA diagnosis.

Results

The Aspergillus GM‐LFA for serum and BAL samples showed a sensitivity of 56.3% and 60.6%, specificity of 94.2% and 88.9%, PPV of 81.8% and 71.4%, NPV of 82.3% and 83.1%, when compared with BAL culture, respectively. GM‐EIA showed sensitivities of 46.9% and 54.5%, specificities of 100% and 91.7%, PPVs of 100% and 75%, NPVs of 80.2% and 81.5% for serum and BAL samples, respectively.

Conclusion

Our study found GM‐LFA as a reliable simple and rapid diagnostic tool, which could circumvent the shortcomings of culture and GM‐EIA and be pivotal in timely initiation of antifungal treatment.
Integrated parent–child music classes for preschoolers with and without autism: Parent expectations and experiences
Authors: Lense Miriam , Liu Talia , Booke Lauren , Crawley Zoe , Beck Sara
Published: August 2022

Integrated recreational programs designed to support neurodiverse children and their families are important vehicles for community participation. In this mixed‐methods study, we investigated the mechanisms by which parent–child music classes for autistic and neurotypical children can support community participation. Parents of autistic (n = 33) and typically developing (TD; n = 28) preschoolers were interviewed about their expectations for and experiences of participating in a 12‐week psychoeducational parent–child music program. Parents completed ratings of momentary affect and social connection, and researchers coded children's behavioral engagement during classes at multiple time points throughout the program. Primary motivations for enrolling in an integrated music class included children's interest in music and opportunities for child socialization. Parent‐focused reasons were less frequently endorsed as primary motivations for participation. Yet, momentary ratings indicated that music classes supported parents’ affect regulation and social connection with other parents at the level of individual classes and across the program. These in‐class experiences were echoed by interviews following program completion, which additionally highlighted the use of new parenting strategies through the musical activities. Since parental emotional experiences of activities, supportive community relationships, and parenting confidence are all linked with increased community participation, integrated music classes may support participation and satisfaction with community experiences.
Sensitized Photooxidation of Ortho‐Prenyl Phenol: Biomimetic Dihydrobenzofuran Synthesis and Total 1O2 Quenching†
Authors: Jabeen Shakeela , Ghosh Goutam , Lapoot Lloyd , Durantini Andrés M. , Greer Alexander
Published: August 2022

The sensitized photooxidation of ortho‐prenyl phenol is described with evidence that solvent aproticity favors the formation of a dihydrobenzofuran [2‐(prop‐1‐en‐2‐yl)‐2,3‐dihydrobenzofuran], a moiety commonly found in natural products. Benzene solvent increased the total quenching rate constant (kT) of singlet oxygen with prenyl phenol by ~10‐fold compared to methanol. A mechanism is proposed with preferential addition of singlet oxygen to prenyl site due to hydrogen bonding with the phenol OH group, which causes a divergence away from the singlet oxygen ‘ene’ reaction toward the dihydrobenzofuran as the major product. The reaction is a mixed photooxidized system since an epoxide arises by a type I sensitized photooxidation.
Anchoring, feelings of belonging, and the complex identities of migrant teenagers in Slovenia
Authors: Sedmak Mateja , Medarić Zorana
Published: August 2022

The article addresses the processes of becoming of migrant teenagers in Slovenia, both those with first‐hand experience of migration and those with a migrant background. It draws upon a collection of 30 autobiographical stories and the application of facet methodology to their analysis. The article contributes to both theoretical and empirical understandings of migrant teenagers’ processes of becoming through the analytical concepts of anchoring, identity, and belonging; these are treated as different facets, each of which sets a different perspective on the research issue. The experiences of migrant teenagers differ from those of adults because they experience the transition to adulthood alongside their geographical displacement at one and the same time. Our analysis of the processes of anchoring, developing a sense of belonging, the (re)construction of an ethnic/cultural identity as well as transculturation and hybridization processes reveals the complexity and multidimensionality of this research issue.
Humoral response to heterologous prime‐booster vaccination in heart transplant recipients aged 18–70 years primed with a viral vector SARS‐CoV‐2 vaccine
Authors: Tanner Richard , Starr Neasa , Perez‐Garcia Carlos Nicolas , Chan Grace , Dempsey Eimear , Heffernan Emma , Lynch Breda , Hannan Margaret M , Joyce Emer
Published: August 2022

Solid organ transplant recipients have demonstrated a blunted immune response to standard 2‐dose vaccination against SARS‐CoV‐2. This study sought to determine the humoral response to heterologous booster vaccination (viral vector vaccine dose 1 and 2 + mRNA booster). Heart transplant recipients, aged 18 to 70 years of age who initially received two doses of the viral vector ChAdOx1 nCoV‐19 vaccine followed by a BNT162b2 mRNA booster were recruited. A detectable antibody response in the absence of prior SARS‐CoV‐2 was the primary outcome measured. This was defined as an anti‐spike titre of ≥0.8 U/mL on the Elecsys anti‐SARS‐CoV‐2 S immunoassay. A total of 80 heart transplant patients (mean age 49 ± 13 years, 28% female) were included. Blood samples were drawn at a median of 30 (IQR 28‐33) days after the BNT162b2 mRNA booster. The frequency of a detectable antibody response increased from 37.5% (n = 30) after dose 2 to 56% (n = 45) post dose 3 (p < 0.001). A non‐detectable antibody response was significantly more common in recipients with a shorter time interval from transplantation (p < 0.001), lower likelihood of cardiac allograft vasculopathy (p = 0.003) and in those prescribed a triple versus dual immunosuppressant regime (p = 0.009) and a tacrolimus versus cyclosporine basedregimen (p = 0.007). Despite heterologous prime‐booster vaccination 44% of this vulnerable population ultimately continue to have no detectable antibodies.

image
Cationic lignin polymers as flocculants for municipal wastewater
Authors: Moore Courtney , Gao Weijue , Fatehi Pedram
Published: August 2022

In this research, two lignin‐[2‐(methacryloyloxy)ethyl]trimethylammonium chloride (METAC) polymers were generated and assessed for their efficiency in treating municipally produced wastewater. The removals of chemical oxygen demand (COD) and turbidity were 47.5% and 71.2%, respectively, for the singular flocculation system at the dosage of 40–70 mg/L. For the dual coagulation/flocculation system, the polymer with a higher charge density (AM2) achieved higher COD and turbidity removals than the polymer with a lower charge density (AM1). To achieve the same organic removal from the wastewater, the alum use could be reduced from 150 mg/L in the single alum use to 35 mg/L in the dual system when used along with 65 mg/L of AM2. In both systems, lignin‐METAC polymers exhibited better performance than the flocculant used at a local wastewater treatment plant. Lignin‐METAC polymers could be used as bio‐based flocculants for the replacement of petroleum‐based flocculants and inorganic coagulants.
Nonevaporable getter-MEMS for generating UHV conditions in small volumina
Authors: Diekmann Leonard Frank , Kassner Alexander , Dencker Folke , Wurz Marc Christopher
Published: August 2022

The industrial use of quantum sensors requires further miniaturization of the experimental peripherals, i.e., the high vacuum chamber, laser technology, and control electronics. A central part of the high vacuum chamber is the maintenance of vacuum conditions. For this purpose, a prototype of a compact, i.e., miniaturized, ultrahigh vacuum pump in the form of a nonevaporable getter (NEG) pump at a wafer level (MEMS), is developed within the scope of this work. With regard to the basic conditions of the functionality of the NEG, a miniaturized heating plate with temperature sensors is analytically and numerically developed, constructed, and characterized in an ultrahigh vacuum test stand. This is followed by the integration of the NEG into the existing system, which, in connection with the characterization of material-specific parameters, enables a first correlation of heat input and pumping power. Thus, performance data of the getter-MEMS under high-vacuum confinement confirm its usability for quantum sensors. In addition, optimization potentials are shown with regard to all partial aspects of the MEMS.
Weighted Baseball Training Affects Arm Speed Without Increasing Elbow and Shoulder Joint Kinetics
Authors: O’Connell Michael E. , Lindley Kyle E. , Scheffey John O. , Caravan Alex , Marsh Joseph A. , Brady Anthony C.
Published: August 2022

Long-term training effects of weighted ball throwing programs have been well documented. However, the mechanisms that facilitate these effects are poorly understood. The purpose of this study is to investigate within-session effects of throwing overload and underload baseballs to provide mechanistic evidence for weighted baseball training methods. Twenty-six collegiate- and professional-level baseball pitchers aged 20–30 years (mean age 23.5 [2.7] y) participated in a biomechanical evaluation while pitching a series of leather weighted baseballs. A 1-way repeated-measures analysis of variance was used to evaluate the intrasubject effect of ball weight on a total of 15 kinematic, kinetic, and performance parameters. Ball weight significantly affected pitch velocity, maximum elbow flexion, maximum pelvis rotation velocity, maximum shoulder internal rotation velocity, maximum elbow extension velocity, and anterior trunk tilt at ball release. None of the measured arm joint kinetics were significantly affected by ball weight. Training with 3- to 7-ounce (85- to 198-g) baseballs can be used to work on increasing pitching velocity without increasing throwing arm joint kinetics.
Functional regulatory variants implicate distinct transcriptional networks in dementia
Authors: Cooper Yonatan A. , Teyssier Noam , Dräger Nina M. , Guo Qiuyu , Davis Jessica E. , Sattler Sydney M. , Yang Zhongan , Patel Abdulsamie , Wu Sarah , Kosuri Sriram , Coppola Giovanni , Kampmann Martin , Geschwind Daniel H.
Published: August 2022

Predicting the function of noncoding variation is a major challenge in modern genetics. In this study, we used massively parallel reporter assays to screen 5706 variants identified from genome-wide association studies for both Alzheimer’s disease (AD) and progressive supranuclear palsy (PSP), identifying 320 functional regulatory variants (frVars) across 27 loci, including the complex 17q21.31 region. We identified and validated multiple risk loci using CRISPR interference or excision, including complement 4 (
C4A
) and
APOC1
in AD and
PLEKHM1
and
KANSL1
in PSP. Functional variants disrupt transcription factor binding sites converging on enhancers with cell type–specific activity in PSP and AD, implicating a neuronal SP1-driven regulatory network in PSP pathogenesis. These analyses suggest that noncoding genetic risk is driven by common genetic variants through their aggregate activity on specific transcriptional programs.
Soybean photosynthesis and crop yield are improved by accelerating recovery from photoprotection
Authors: De Souza Amanda P. , Burgess Steven J. , Doran Lynn , Hansen Jeffrey , Manukyan Lusya , Maryn Nina , Gotarkar Dhananjay , Leonelli Lauriebeth , Niyogi Krishna K. , Long Stephen P.
Published: August 2022

Crop leaves in full sunlight dissipate damaging excess absorbed light energy as heat. This protective dissipation continues after the leaf transitions to shade, reducing crop photosynthesis. A bioengineered acceleration of this adjustment increased photosynthetic efficiency and biomass in tobacco in the field. But could that also translate to increased yield in a food crop? Here we bioengineered the same change into soybean. In replicated field trials, photosynthetic efficiency in fluctuating light was higher and seed yield in five independent transformation events increased by up to 33%. Despite increased seed quantity, seed protein and oil content were unaltered. This validates increasing photosynthetic efficiency as a much needed strategy toward sustainably increasing crop yield in support of future global food security.
Evaluation of Metabolic Engineering Strategies on 2-Ketoisovalerate Production by Escherichia coli
Authors: Zhou Li , Zhu Ying , Yuan Zhongzhe , Liu Guangqing , Sun Zijin , Du Shiyu , Liu He , Li Yating , Liu Haili , Zhou Zhemin
Published: August 2022

An efficient microbial strain was constructed for 2-ketoisovalerate synthesis. The positive effect of the
leuA
deletion on 2-ketoisovalerate production was found.
Decoding the Role of Temperature in RNA Virus Infections
Authors: Bisht Karishma , te Velthuis Aartjan J. W.
Published: August 2022

RNA viruses include respiratory viruses, such as coronaviruses and influenza viruses, as well as vector-borne viruses, like dengue and West Nile virus. RNA viruses like these encounter various environments when they copy themselves and spread from cell to cell or host to host.
Ex vivo
differences, such as geographical location and humidity, affect their stability and transmission, while
in vivo
differences, such as pH and host gene expression, impact viral receptor binding, viral replication, and the host immune response against the viral infection.
Development of Microfluidic Chip-Based Loop-Mediated Isothermal Amplification (LAMP) Method for Detection of Carbapenemase Producing Bacteria
Authors: Wu Bin , Tong Xinxin , Chen Bin , Yuan Wenchang , Fu Mingpeng , Yang Xiao , Chen Huiling , Zhang Guohao , Wu Guojun , Xu Banglao
Published: August 2022

Rapid and accurate identification of CPO may reduce the genetic exchanges among bacteria and prevent further dissemination of carbapenemases to non-CPO. The current method had designed microfluidic chip-based LAMP amplification method for multiplex detection of carbapenemase genes and evaluated the detection performance of the newly method.
Crushed turtle shells: Proxies for lithification and burial-depth histories
Authors: Petermann Holger , Lyson Tyler R. , Miller Ian M. , Hagadorn James W.
Published: August 2022

We propose a new proxy that employs assemblages of fossil turtle shells to estimate the timing and depth at which fossilization and lithification occur in shallowly buried terrestrial strata. This proxy, the Turtle Compaction Index (TCI), leverages the mechanical failure properties of extant turtle shells and the material properties of sediments that encase fossil turtle shells to estimate the burial depths over which turtle shells become compacted. Because turtle shells are one of the most abundant macroscopic terrestrial fossils in late Mesozoic and younger strata, the compactional attributes of a suite of turtle shells can be paired with geochronologic and stratigraphic data to constrain burial histories of continental settings—a knowledge gap unfilled by traditional burial-depth proxies, most of which are more sensitive to deeper burial depths. Pilot TCI studies of suites of shallowly buried turtle shells from the Denver and Williston basins suggest that such assemblages are sensitive indicators of the depths (~10–500 m) at which fossils and their encasing sediment become sufficiently lithified to inhibit further shell compaction, which is when taphonomic processes correspondingly wane. This work also confirms previously hypothesized shallow Cenozoic burial histories for each of these basins. TCI from mudstone-encased turtle shells can be paired with thicknesses and ages of overlying strata to create geohistorical burial curves that indicate when such post-burial processes were active.
Extensive actinomycosis with intracranial and mediastinal involvement: a therapeutic challenge
Authors: Ansari Farzana , Budania Anil , Rao Meenakshi , Yadav Taruna
Published: August 2022

Central nervous system (CNS) involvement by actinomycosis is rare, seen in 2%–3% cases. It mostly spreads to CNS by haematogenous route from a distant primary site such as oral cavity, lung, abdomen or pelvis. Direct CNS extension can also occur. It mostly presents as brain abscess, meningoencephalitis, actinomycetoma, subdural empyema and epidural abscess. We report one case of extensive actinomycosis having intra and extraparenchymal CNS, spinal canal, retropharyngeal and mediastinal involvement. Due to such widespread extension and involvement of vital areas, complete surgical debulking was not possible. In addition to therapeutic resistance to conventional antibiotics, repetitive negative cultures posed significant difficulty in the case management.
Recovery from AA amyloidosis-cardiomyopathy complexed with unicentric Castleman disease
Authors: Imamura Kanako , Kojima Sunao , Imamura Takahisa , Tsujita Kenichi
Published: August 2022

We report a case of cardiac amyloid A (AA) amyloidosis due to unicentric Castleman disease (UCD) in a patient whose cardiac function was restored 15 years after surgical resection of the mesenteric lymph node lesion. A man in his 40s had recurrent palpitations and fainting spells. ECG revealedtorsades de pointes. Increased C-reactive protein, interleukin-6 and serum AA levels, and marked concentric thickening of the left ventricular (LV) wall with diastolic restrictive filling pattern were observed. Duodenal biopsy revealed AA amyloid deposits. He had a mesenteric tumour, comprising many plasma cells. He was diagnosed with plasma cell-type UCD associated with secondary AA amyloidosis. C-reactive protein, interleukin-6 and serum AA levels were normalised 2 months postresection. Episodes of lethal ventricular arrhythmias decreased. LV wall thickness was gradually reduced. Approximately 15 years postresection, the LV wall thickness nearly normalised and ventricular arrhythmias disappeared. Better outcomes are expected following surgical tumour resection.
Developing a communication-skills training curriculum for resident-physicians to enhance patient outcomes at an academic medical centre: an ongoing mixed-methods study protocol
Authors: Shahbaz Hamna , Noorali Ali Aahil , Inam Maha , Qadeer Namra , Merchant Asma Altaf Hussain , Khan Adnan Ali , Afzal Noreen , Abdul Rahim Komal , Munaf Ibrahim , Ahmad Rida , Tariq Muhammad , Haider Adil H
Published: August 2022

Introduction

Effective physician–patient communication is directly linked to enhanced patient safety, improved healthcare quality and health outcomes. Numerous studies have been done to implement and reinforce communication skills as core competencies to be acquired during residency training for providing culturally competent care. Pakistan has an ethnically diverse culture with people from varying diasporas. Hence there is a need to develop a curriculum that teaches cultural competency to residents. Thus, the aim of this study is (1) the identification of existing problems of communication skills among residents across various specialties, and (2) to strategise a communication skills curriculum by organising a conference of experts based on the Delphi method/estimate-talk-estimate method.

Methods and analysis

This study is divided into two phases. The first phase will employ a mixed-methods approach whereby the perceptions of attendings, residents, fellows, nurses, medical students and patients about resident–patient communication will be assessed via validated surveys, focused group discussions and in-depth interviews. Quantitative and qualitative data will be analysed using Stata and NVivo, respectively. The second phase is the development of a communication skills curriculum for residents based on results from phase one and a Delphi consensus involving medical education experts. Both phases will be conducted at a tertiary care hospital in Karachi, Pakistan.

Ethics and dissemination

This study has received ethical approval from the Ethical Review Committee at the Aga Khan University (2021-6041-17126). All participants will be mandated to provide informed consent and their confidentiality will be maintained by using de-identifiers and limiting access of the data to the research team only. The findings from this study will be presented in the form of original research papers.
Intrathecal diamorphine for perioperative analgesia during colorectal surgery: a cross-sectional survey of current UK practice
Authors: Alderman Joseph , Sharma Amit , Patel Jaimin , Gao-Smith Fang , Morgese Ciro
Published: August 2022

Objectives

To describe current UK clinical practice around the use of intrathecal diamorphine as analgesia for major elective laparoscopic colorectal surgery.

Design

Online self-administered survey.

Setting

Acute public hospitals in the UK (National Health Service – NHS) .

Participants

Consultant anaesthetists involved in colorectal surgery lists.

Main outcome measures

Rate of intrathecal opioids used by anaesthetists for elective laparoscopic colorectal procedures; minimum, most common and maximum doses of intrathecal diamorphine used, timing of administration of intrathecal injection, and relationship between the number of patients anaesthetised for laparoscopic colorectal resections per month by each anaesthetist, and the doses of intrathecal diamorphine they administer.

Results

In total, 479 responses were received. Of these, 399 (83%) use intrathecal opioid routinely: 351/399 (88%) use diamorphine, 35 (8.8%) use morphine, 8 (2%) use fentanyl, and 7 (1.3%) use other drugs. The median intrathecal diamorphine dose most commonly administered by anaesthetists was 500 µg (IQR 400–750 [(range 200–1500])). The median of the maximum dose administered by anaesthetists was 600 µg (IQR 500–1000 [(range 200–2000])). Greater intrathecal diamorphine dosing was positively associated with higher number of cases per month (rho=0.113, pp=0.033).

Conclusions

Intrathecal diamorphine is widely used by UK anaesthetists for patients undergoing major elective laparoscopic colorectal surgery. However, there is little consensus regarding optimal dosing. Therefore, high-quality randomised dose-response trials are needed to investigate the relationship between doses of intrathecal diamorphine and patient outcomes.
Which factors play a role in the decision of mothers to participate in child follow-up examinations after participation in an RCT?: a semi-quantitative study
Authors: den Harink Tamara , Hoek Annemieke , Groen Henk , Roseboom Tessa J , Deutekom Arend van
Published: August 2022

Objectives

To determine which factors contribute to the decision of mothers to participate with their child in follow-up (FU) examinations after participation in a randomised controlled trial (RCT) prior to conception.

Design

A cross-sectional survey, including Likert-scale items. Comparisons will be made between respondents who participated in all FU rounds of data collection and those who did not participate in any FU round with their child.

Participants

Women who participated in an RCT investigating the effect of a preconception lifestyle intervention (LIFEstyle study: Netherlands Trial Register: NTR1530) were invited to participate with their child in three FU data collections when the child had a mean age of 4.2 years, 4.6 years and 6.5 years, respectively. FU rounds included a health questionnaire, physical examination and cardiac assessment, successively.

Results

Sixty-seven respondents were included, of whom 7 (10%) did not participate in any FU round and 24 (36%) participated in all FU rounds. Women who participated with their child in all 3 FU data collection rounds felt more involved in the FU research (95.8%) and agreed more often that the FU was introduced well (91.7%) as compared with women that did not participate in any FU data collection round with their child (14.3% and 28.6%, respectively). Participants of FU rounds more often agreed that participation felt like a health check for their child as compared with non-participants. In addition, participants of the physical examination and cardiac assessment more often let their decision to participate depend fully on their child, as compared with non-participants (39.4% vs 17.7% and 52.5% vs 24%, respectively).

Conclusions

To increase participation rates in future FU studies of children after maternal participation in an RCT, we suggest to involve women in the design of the FU study, to emphasise possible perceived benefits of participation and to encourage women to actively involve their child in the decision of participation.