bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in diabetes incidence and associated risk factors among people with HIV in the current treatment era
Authors: Spieler Gabriel , Westfall Andrew O. , Long Dustin M. , Cherrington Andrea , Burkholder Greer A. , Funderburg Nicholas , Raper James L. , Overton Edgar T. , Willig Amanda L.
Published: August 2022

Objective:

To examine type 2 diabetes mellitus incidence and associated risk factors among people with HIV (PWH).

Design:

A retrospective clinical cohort study of PWH at a Southeastern US academic HIV clinic between 2008 and 2018.

Methods:

PWH who attended at least two clinic visits were evaluated with demographic and clinical data extracted from the electronic medical record (EMR). Diabetes was defined as: hemoglobin A1C ≥6.5% and/or 2 glucose results >200 mg/dl (at least 30 days apart), diagnosis of diabetes in the EMR, or exposure to diabetes medication. Time to diabetes incidence was computed from the entire clinic population for each year. Multivariable Cox proportional hazard regression models with time-dependent covariates were created to evaluate the independent association between covariates and time to incident diabetes.

Results:

Among 4113 PWH, we identified 252 incident cases of diabetes. Incidence increased from 1.04 incidents per 1000 person years (PY) in 2008, to 1.55 incidents per 1000 PY in 2018. Body mass index (hazard ratio [HR] 10.5 (6.2, 17.7)), liver disease (HR 1.9 (1.2, 3.1)), steroid exposure (HR 1.5 (1.1, 1.9)), and use of integrase inhibitors (HR 1.5 (1.1, 2.0)) were associated with incident diabetes. Additional associated factors included lower CD4+ cell counts, duration of HIV infection, exposure to nonstatin lipid-lowering therapy, and dyslipidemia.

Conclusions:

Rapidly increasing incident diabetes rates among PWH were associated with both traditional and HIV-related associated risk factors, particularly body weight, steroid exposure, and use of Integrase Inhibitors. Notably, several of the risk factors identified are modifiable and can be targeted for intervention.
Cryptococcal Antigen Screening and Missed Opportunities for Earlier Diagnosis Among People With HIV and Poor Virologic Control in the Bronx, NY
Authors: Yoon Hyunah , Hemmige Vagish S. , Lee Audrey , Conway-Pearson Liam S. , Pirofski Liise-anne , Felsen Uriel R.
Published: August 2022

Background:

There is no established cryptococcal antigen (CrAg) screening guideline for people with HIV who are antiretroviral therapy experienced but have poor virologic control. We assessed factors associated with CrAg screening and describe missed opportunities for earlier testing.

Setting:

Ambulatory clinics affiliated with Montefiore Medical Center, Bronx, NY.

Methods:

This was a retrospective chart review of CrAg screening among asymptomatic people with HIV with absolute CD4 counts

200 cells/mm3 and HIV viral loads (VLs) > 200 copies/mL receiving HIV care from 2015 to 2020. We used Cox proportional hazards regression to identify predictors of screening, including longitudinal CD4 count and HIV VL as time-varying covariables. Among cases of diagnosed cryptococcosis, we assessed for opportunities for earlier diagnosis.

Results:

Screening CrAg was performed in 2.9% of 2201 individuals meeting the inclusion criteria. Compared with those not screened, those who were screened had a shorter duration of HIV infection (0.09 vs. 5.1 years; P = 0.001) and lower absolute CD4 counts (12 vs. 24 cells/mm3; P < 0.0001). In a multivariable model stratified by median HIV duration, CD4 < 100 [hazard ratio (HR), 7.07; 95% confidence interval (CI): 2.43 to 20.6], VL > 10,000 (HR, 15.0; 95% CI: 4.16 to 54.0), and a shorter duration of HIV infection (HR, 0.60; 95% CI: 0.42 to 0.86) were associated with screening for those with HIV < 5 years. Among those diagnosed with cryptococcosis (n = 14), 6 individuals had an ambulatory visit in the preceding 6 months but did not undergo screening.

Conclusion:

CrAg screening was infrequently performed in this at-risk population. Those with a longer duration of HIV infection were less likely to undergo CrAg screening, highlighting potential missed opportunities for earlier diagnosis.
Antiretroviral Therapy Adherence During and Postbreastfeeding Cessation Measured by Tenofovir Levels in Hair
Authors: Nematadzira Teacler G. , Murnane Pamela M. , Odiase Osamuedeme J. , Bacchetti Peter , Okochi Hideaki , Tallerico Regina , Chanaiwa Vongai M. , Vhembo Tichaona , Mutambanengwe-Jacob Mercy T. , Louie Alexander , Chipato Tsungai , Gandhi Monica , Stranix-Chibanda Lynda ,   for the IMPAACT PROMISE Study Team
Published: August 2022

Background:

We examined change in antiretroviral treatment (ART) adherence after breastfeeding (BF) cessation using hair tenofovir (TFV) concentrations as an objective metric of medication consumption.

Methods:

A subset of postpartum women in Zimbabwe randomized in IMPAACT PROMISE to take ART while BF and post-BF cessation had hair TFV measured longitudinally. Using linear mixed-effect models, we estimated differences in hair TFV levels after BF cessation, accounting for trends in levels over time regardless of BF status and change in slope after breastfeeding cessation. We also estimated the relative risk of viremia (>50 copies/mL) per doubling of hair TFV concentration.

Results:

Among 55 women (median age 26, interquartile range 24–29 years), hair TFV levels (n = 305) were available for a median of 9 visits per woman between 3 and 29 months postpartum. Hair TFV levels ranged from undetected to 0.25 ng/mg (median 0.04 ng/mg). Controlling for trends since delivery [decline of 2.2% per month, 95% confidence interval (CI): −5.3 to 1.0], TFV levels averaged 24.4% higher (95% CI: −5.1 to 63.1) post-BF cessation than during BF, with no change in slope (0.0% per month, 95% CI: −3.8 to 3.9). Postpartum, 42% of women were ever viremic. Higher TFV levels were strongly protective; relative risk of viremia per doubling of TFV was 0.52 (95% CI: 0.43 to 0.63; P < 0.0001).

Conclusions:

Leveraging an objective metric of ART use, we observed modestly declining adherence across the postpartum period, but no additional decline associated with breastfeeding cessation. High viremia frequency and varying postpartum TFV levels observed highlight the importance of enhanced adherence support with viral load monitoring among postpartum women.
Arthroscopic Disk Repositioning After Failed Open Disk Repositioning
Authors: Zhang Wenhao , Luo Yi , Abdelrehem Ahmed , Liu Xiaohan , Chen Minjie , Yang Chi , Yu Chuangqi , Wang Fang
Published: August 2022

Purpose:

Open disk repositioning has been long achieving excellent functional and stability outcomes. However, still remains some relapses for whom a second open surgery is often challenging. This study aimed to evaluate the effectiveness of arthroscopic disk reposition as an alternative surgery for unsuccessful cases of anterior disk displacement (ADD) after an initial open disk repositioning.

Materials and Methods:

This retrospective study included all patients who underwent secondary arthroscopy for disk repositioning of the relapsed ADD after an initial open surgery between January 2012 to June 2017. The redo arthroscopic disk repositioning and suturing procedure was the primary predictor input variable in this study. Outcome evaluation was based on both clinical (visual analog scale and maximal interincisal opening) and magnetic resonance imaging data.

Results:

Twenty-seven joints fulfilling the inclusion criteria were included. A significant improvement was detected at 24-month postoperatively compared with the baseline visual analog scale. The maximal interincisal opening showed a statistical improvement from 25.07 mm preoperatively to 38.44 mm at 24-month postoperatively. Twenty-six joints maintained a stable disk position with only 1 joint relapsed to ADD without reduction.

Conclusion:

Arthroscopic disk reposition and suturing technique is a reliable and effective repeat surgery after failed initial open disk repositioning for management of ADD.
Evaluation of Complications and Outcomes in Craniosynostosis by Age of Operation: Analysis of the National Surgical Quality Improvement Program-Pediatric
Authors: Puthumana Joseph S. , Lopez Christopher D. , Lake Isabel V. , Yang Robin
Published: August 2022

Considerable controversy exists around the optimal age on which to operate for craniosynostosis. This study aims to use data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric to assess the impact of operative age on hospital stay and outcomes. After excluding patients who underwent endoscopic cranial vault remodeling, a total of 3292 patients met inclusion criteria in the National Surgical Quality Improvement Program-Pediatric between 2012 and 2019. Median age at surgery was 300 days (interquartile range: 204–494). Patients between 0 and 6 months underwent the highest proportion of complex cranial vault remodeling, Current Procedural Terminology 61,558 (n=44, 7.7%) and Current Procedural Terminology 61,559 (n=317, 55.1%). White blood cell counts peaked in the 12 to 18 months group, and were lowest in the 24± months group. Hematocrit was lowest in the 0 to 6 months group and rose steadily to the 24± months group; the inverse pattern was found in platelet concentration, which was highest in the youngest patients and lowest in the oldest. Prothrombin time, international normalized ratio, and partial thromboplastin time were relatively consistent across all age groups. Younger patients had significantly shorter operating room times, which increased with patient age (P<0.001). Younger patients also had significantly shorter length of stay (P=0.009), though length of stay peaked between 12 and 18 months. There was a significantly lower rate of surgical site infection in younger patients, which occurred in 0.7% of patients 0 to 12 months and 1.0 to 3.0% in patients over 12 to 24± months. There was no significant difference in the average number of transfusions required in any age group (P=0.961).
Orthognathic Surgery in Goldenhar Syndrome With a Rare Course of the IAN
Authors: Moreno Stephen D. , Niloy Injamamul L. , Kim Peter M. , English M. Caleb
Published: August 2022

Although there are multiple variations of accessory foramina described in the literature, to our knowledge there is only 1 report of an isolated mandibular foramen and inferior alveolar neurovascular bundle that courses through the lateral ramus, particularly in those with branchial arch syndromes. Goldenhar syndrome, of the oculo-auriculo-vertebral spectrum, is a rare congenital condition, which most characteristically presents with hemifacial microsomia. Depending on the severity of hemifacial microsomia, there are predictable treatment modalities to correct the consequent facial asymmetry. We report on a patient with Goldenhar syndrome who was found to have a unique course of the inferior alveolar nerve during orthognathic surgery work-up and treatment.
Earlobe Reconstruction Using Two Opposed Periauricular Dermal Pedicled Flap
Authors: Ryu Hyeong Rae , Lee Da Woon , Kim Jun Hyuk
Published: August 2022

There are several flap techniques of earlobe reconstruction. The ideal method should be a 1-stage procedure that is simple, has fewer complications, and has excellent esthetic outcomes with a proper earlobe texture and volume. We report a case of a 45-year-old man presented with skin and soft tissue defect of right ear lobule. He underwent composite graft using 2×1 cm sized stump. Two weeks later, total necrosis of graft site was observed. After that, he underwent 2 opposed periauricular dermal pedicled flap. Each flap caudally based periauricular flaps were elevated and consisted of redundant fat tissue. These flaps were sutured like sandwich and the donor sites were closured by primary repair. There was no complication as flap congestion or hematoma. After 6 months, the patient was satisfied esthetically and there was no need of additional surgical procedure. We introduce new technique of earlobe reconstruction named 2 opposed periauricular flap. This method affords reconstruction of large sized and full-thickness earlobe defect in a simple, easy manner. It provides proper texture and volume as normal earlobe. Also, it is 1-stage method not requiring skin graft or debulking procedure. Therefore, if plastic surgeon reconstructs a large defect of earlobe, our technique can be thought of as one good option.
A Modified Technique for Harvesting Scapular Tip Flap and to Allow 2 Teams to Work at the Same Time
Authors: Cariati Paolo , Arroyo Rodriguez Susana , Ferrari Silvano
Published: August 2022

Aim:

The main aim of the present report is to describe a modified technique of tip scapular flap harvesting to allow 2 surgical teams to work at the same time and to shorten surgical times.

Materials and Methods:

The medical records of 25 patients that had undergone maxillary or mandibular reconstruction by using a free scapular tip flap were retrospectively reviewed to identify the possible advantages and disadvantages of this type of flap.

Results:

Thirteen patients analyzed in this series underwent maxillary reconstruction with tip scapular flap, while the other 12 patients underwent mandibular reconstruction. No failures, partial failures, or infections were evidenced in this series. Scapular tip flap allowed for acceptable esthetic and functional outcomes. In all cases, the patient was placed supine. No major complications were observed at the donor site during follow-up.

Conclusion:

Scapular tip flap might be extremely useful for head and neck reconstruction. Pedicle length, versatility, and reliability represent the major advantages of this reconstructive recourse. Moreover, the resistance of the scapular vascular system to atherosclerosis could be helpful in patients showing contraindications to free fibula flaps.
Enhancing the clinical supervision experience of staff members working within primary and community care: a best practice implementation project
Authors: Smith Cathryn , Bennett Clare , Morgan Kate , Carrier Judith , Klugarová Jitka , Klugar Miloslav
Published: August 2022

Objectives:

The project aimed to assess compliance with evidence-based criteria regarding the use of clinical supervision amongst district nurses and to improve knowledge and engagement in clinical supervision activities within the workplace.

Introduction:

It is important to provide clinical support to all healthcare workers that provide opportunities to develop and be listened to in a supervised environment. Clinical supervision is seen as a key element to provide this support. It provides a professional working relationship between two or more members of staff where the reflection of practice and personal emotion can be discussed, which is outlined in many policies and guidelines.

Methods:

A baseline audit was carried out using the JBI Practical Application of Clinical Evidence System program involving 16 participants in one district nursing team in South Wales. The first step involved the development of the project and generating the evidence. Following this, a baseline audit was conducted, and educational training on clinical supervision was undertaken followed by clinical supervision sessions. A postimplementation re-audit was conducted following implementation.

Results:

A total of 16 participants enrolled on the project. Receiving basic training and participating in clinical supervision was much higher than the baseline audit with both increasing to 100% compliance. Furthermore, 94% of participants were aware of clinical supervision activities and 88% knew of existing records on clinical supervision. The project results show a large increase in compliance with all of the criteria.

Conclusion:

Overall the implementation project achieved an improvement in evidence-based practice regarding clinical supervision in primary care.
Medical device-related pressure injury prevention related to fixation of nutritional and derivative probes: a best practice implementation project
Authors: Saibertová Simona , Klugarová Jitka , Klugar Miloslav , Pokorná Andrea
Published: August 2022

Objectives:

The main objective was to improve the provision of clinical care in pressure injury prevention related to the use of medical devices focused on nasogastric probes.

Introduction:

The insertion of nasogastric probes could lead to the formation of medical device-related pressure injuries (MDRPI). The risk increases with the length of the probe insertion and is higher in patients in intensive care. MDRPI prevention is mostly based on appropriate skin and mucosa membrane and tissue monitoring and positioning of the medical devices.

Methods:

The project has been conducted based on JBI Implementation approach for promoting change in healthcare practice. A baseline audit on MDRPI prevention was undertaken and involved 21 nurses and 12 patients using a questionnaire for nurses and a record sheet for patient's monitoring. The intervention included education, clinical practice training, consultation, and other strategies. A follow-up audit was undertaken, including all original participants. Results data on changes in compliance were measured using descriptive statistics embedded in JBI-PACES in the form of percentage changes from baseline.

Results:

There were significantly improved outcomes across all best practice criteria. The level of knowledge of nurses increased. Skin barrier creams and mass-supplied fixation are now used to prevent skin injuries on the nose. The new monitoring and documentation is more accurate and in line with evidence-based practice.

Conclusion:

Overall, the project achieved an improvement in evidence-based practice in the prevention of MDRPI in patients with nasogastric probes based on nurses’ increased level of knowledge and usage of appropriate preventative measures.
Acid fast bacillus smear, mycobacterial culture and Xpert MTB/RIF assay for the diagnosis of tuberculous peritonitis in patients with and without end stage renal failure
Authors: Misra Richa , Kar Mitra , Mohindra Samir , Gupta Amit
Published: August 2022

Introduction. Diagnosis of tuberculous peritonitis (TBP) requires a high index of suspicion.

Hypothesis /gap statement. Information about the diagnostic features of TBP among patients with end-stage renal failure (ESRF) from India is limited.

Aim. To assess the utility of the Gene Xpert MTB/RIF assay in the diagnosis of TBP in patients with end-stage renal failure (ESRF), compared with those without ESRF.

Methodology. This prospective observational single centre cohort study was performed at a tertiary care centre in Northern India. Ascitic fluid and/or whole continuous ambulatory peritoneal dialysis (CAPD) bag with effluent from 300 clinically suspected cases of TBP were included in the study. Diagnosis was based on detection of Mycobacteria on smear, Xpert MTB/RIF assay and/or culture. Cell counting was done in a Neubauer chamber. Cell predominance was seen by Giemsa stain. Line probe assay (LPA) for drug susceptibility testing was performed on all positive cultures.

Results. TBP was diagnosed in 168 cases. Diabetes mellitus was a significant risk factor for developing TBP in patients with ESRF (P value<0.01). Lymphocytic predominance was seen in 21 patients without ESRF (P value 0.033) while majority of the patients in both groups had neutrophils in their ascitic and peritoneal fluids (138/168; P value 0.033). We recovered 15 cases of laboratory diagnosed TBP (11 without ESRF and four with ESRF). Microscopy was positive in two cases while ten isolates were recovered on culture. The Xpert MTB/RIF assay was positive in seven ascitic fluid samples out of which three were rifampicin resistant. All these were patients without renal failure (P value 0.010). Eight culture positive samples tested by the line probe assay did not detect any resistance to either rifampicin or isoniazid.

Conclusion. The GeneXpert MTB/RIF assay has a limited value in the diagnosis of TBP in patients with ESRF.
Risk of Sexually Transmitted Infections Among U.S. Military Service Members in the Setting of HIV Pre-Exposure Prophylaxis Use
Authors: Blaylock Jason M. , Ewers Evan C. , Bianchi Elizabeth J. , King David B. , Casimier Rosemary O. , Erazo Hector , Grieco Stephen , Lay Jenny , Peel Sheila A. , Modjarrad Kayvon , Beckett Charmagne G. , Okulicz Jason F. , Scott Paul T. , Hakre Shilpa
Published: August 2022

Background

The evidence for an increased incidence of sexually transmitted infections (STIs) among patients utilizing HIV pre-exposure prophylaxis (PrEP) has been inconsistent. We assessed the risk of incident STI while on PrEP compared to periods off PrEP among military service members starting PrEP.

Methods

Incidence rates of chlamydia, gonorrhea, syphilis, hepatitis C virus, and HIV were determined among military service members without HIV prescribed daily oral tenofovir disoproxil fumarate and emtricitabine for HIV PrEP from February 1, 2014 through June 10, 2016. Hazard ratios for incident STIs were calculated using an Anderson-Gill recurrent event proportional hazard regression model.

Results

Among 755 male service members, 477 (63%) were diagnosed with incident STIs (overall incidence 21.4 per 100 person-years). In multivariate analysis, male service members had a significantly lower risk of any STIs (adjusted hazard ratio (aHR) 0.24, 95% CI 0.12-0.47) compared to periods off PrEP after adjustment for socio-demographic characteristics and reasons for initiating PrEP. However, when stratifying for site and type of infection, the risk of extragenital gonorrhea infection (pharyngeal: aHR 2.08, 95% CI 0.85-5.11; rectal: aHR 1.36, 95% CI 0.54-3.46) and extragenital chlamydial infection (pharyngeal: aHR 3.33, 95% CL 0.54-20.36; rectal: aHR 1.73, 95% CI 0.93-3.24) was greater on PrEP compared to off PrEP although these values did not reach statistical significance.

Conclusions

The data suggest entry into PrEP care reduced the overall risk of STIs. Service members engaged in PrEP services also receive more STI prevention counseling, which might contribute to decreases in STI risk while on PrEP.
Migratory hoverflies orientate north during spring migration
Authors: Hawkes Will L. S. , Weston Scarlett T. , Cook Holly , Doyle Toby , Massy Richard , Guri Eva Jimenez , Wotton Jimenez Rex E. , Wotton Karl R.
Published: August 2022

Migratory hoverflies are long-range migrants that, in the northern hemisphere, move seasonally to higher latitudes in the spring and lower latitudes in the autumn. The preferred migratory direction of hoverflies in the autumn has been the subject of radar and flight simulator studies while spring migration has proved to be more difficult to characterise due to a lack of ground observations. Consequently, the preferred migratory direction during spring has only been inferred from entomological radar studies and patterns of local abundance and currently lacks ground confirmation. Here, during a springtime arrival of migratory insects onto the Isles of Scilly and mainland Cornwall, UK, we provide ground proof that spring hoverfly migrants have an innate northward preference. Captured migratory hoverflies displayed northward vanishing bearings when released under sunny conditions under both favourable wind and zero-wind conditions. In addition, and unlike autumn migrants, spring individuals were also able to orientate when the sun was obscured. Analysis of winds suggests an origin for insects arriving on the Isles of Scilly in from western France. These findings of spring migration routes and preferred migration directions are likely to extend to the diverse set of insects found within the western European migratory assemblage.
Efficient computation of adjoint sensitivities at steady-state in ODE models of biochemical reaction networks
Authors: Lakrisenko Polina , Stapor Paul , Grein Stephan , Paszkowski Łukasz , Pathirana Dilan , Fröhlich Fabian , Lines Glenn Terje , Weindl Daniel , Hasenauer Jan
Published: August 2022

Dynamical models in the form of systems of ordinary differential equations have become a standard tool in systems biology. Many parameters of such models are usually unknown and have to be inferred from experimental data. Gradient-based optimization has proven to be effective for parameter estimation. However, computing gradients becomes increasingly costly for larger models, which are required for capturing the complex interactions of multiple biochemical pathways. Adjoint sensitivity analysis has been pivotal for working with such large models, but methods tailored for steady-state data are currently not available. We propose a new adjoint method for computing gradients, which is applicable if the experimental data include steady-state measurements. The method is based on a reformulation of the backward integration problem to a system of linear algebraic equations. The evaluation of the proposed method using real-world problems shows a speedup of total simulation time by a factor of up to 4.4. Our results demonstrate that the proposed approach can achieve a substantial improvement in computation time, in particular for large-scale models, where computational efficiency is critical.

Author summary

Large-scale dynamical models are nowadays widely used for the analysis of complex processes and the integration of large-scale data sets. However, computational cost is often a bottleneck. Here, we propose a new gradient computation method that facilitates the parameterization of large-scale models based on steady-state measurements. The method can be combined with existing gradient computation methods for time-course measurements. Accordingly, it is an essential contribution to the environment of computationally efficient approaches for the study of large-scale screening and omics data, but not tailored to biological applications, and, therefore, also useful beyond the field of computational biology.
Cancer Serum Atlas supported precise pan-targeted proteomics enable multi-cancer detection
Authors: Hu Anqi , Zhang Lei , Wang Zhenxin , Yuan Chunyan , Lin Ling , Zhang Jiayi , Gao Xia , Chen Xuguang , Guo Wei , Yang Pengyuan , Shen Huali
Published: August 2022

The wide dynamic range of serum proteome restrained discovery of the clinically interested proteins in large cohort studies. Herein, we presented a high-sensitivity, high-throughput and precise pan-targeted serum proteomic strategy for high-efficient cancer serum proteomic research and biomarker discovery. We constructed a resource of over 2000 cancer-secreted proteins and the standard MS assays and spectra of at least one synthetic unique peptide per protein were acquired and documented (Cancer Serum Atlas,www.cancerserumatlas.com). Then, the standard peptides anchored parallel reaction monitoring (SPA-PRM) method was developed with support of Cancer Serum Atlas, achieving precise quantification of cancer-secreted proteins with high throughput and sensitivity. We directly quantified 325 cancer-related serum proteins in 288 serum of four cancer types (liver, stomach, lung, breast) and controls with the pan-targeted strategy, and discovered considerable potential biomarkers benefit for early detection of cancer. Finally, a proteomics based multi-cancer detection model was built, demonstrating high sensitivity (87.2%), specificity (100%), with 73.8% localization accuracy for an independent test set. In conclusion, the Cancer Serum Atlas provides a wide range of potential biomarkers that serve as targets and standard assays for systematic and high-efficient serological studies of cancer, and the Cancer Serum Atlas supported pan-targeted proteomic strategy enables high-efficient biomarker discovery and multi-cancer detection, thus can be a powerful tool for liquid biopsy.
RapiD_AI: A framework for Rapidly Deployable AI for novel disease & pandemic preparedness
Authors: Youssef Alexey , Zhu Tingting , Thakur Anshul , Watkinson Peter , Horby Peter , Eyre David W , Clifton David A
Published: August 2022

COVID-19 is unlikely to be the last pandemic that we face. According to an analysis of a global dataset of historical pandemics from 1600 to the present, the risk of a COVID-like pandemic has been estimated as 2.63% annually or a 38% lifetime probability. This rate may double over the coming decades. While we may be unable to prevent future pandemics, we can reduce their impact by investing in preparedness. In this study, we proposeRapiD_AI: a framework to guide the use of pretrained neural network models as a pandemic preparedness tool to enable healthcare system resilience and effective use of ML during future pandemics. The RapiD_AI framework allows us to build high-performing ML models using data collected in the first weeks of the pandemic and provides an approach to adapt the models to the local populations and healthcare needs. The motivation is to enable healthcare systems to overcome data limitations that prevent the development of effective ML in the context of novel diseases. We digitally recreated the first 20 weeks of the COVID-19 pandemic and experimentally demonstrated the RapiD_AI framework using domain adaptation and inductive transfer. We (i) pretrain two neural network models (Deep Neural Network and TabNet) on a large Electronic Health Records dataset representative of a general in-patient population in Oxford, UK, (ii) fine-tune using data from the first weeks of the pandemic, and (iii) simulate local deployment by testing the performance of the models on a held-out test dataset of COVID-19 patients. Our approach has demonstrated an average relative/absolute gain of 4.92/4.21% AUC compared to an XGBoost benchmark model trained on COVID-19 data only. Moreover, we show our ability to identify the most useful historical pretraining samples through clustering and to expand the task of deployed models through inductive transfer to meet the emerging needs of a healthcare system without access to large historical pretraining datasets.
Examining neurophysiological markers of apathy and processing speed in late premanifest and early-stage manifest Huntington’s disease
Authors: Davis Marie-Claire , Hill Aron T. , Fitzgerald Paul B. , Bailey Neil W. , Stout Julie C. , Hoy Kate E.
Published: August 2022

Objective

To find sensitive biological markers of non-motor symptoms in Huntington’s disease (HD), which are essential for the development and assessment of novel treatments.

Methods

We used resting state EEG to examine differences in oscillatory activity (analysing the isolated periodic as well as the complete EEG signal) and functional connectivity in 22 late premanifest and early stage people with HD and 20 neurotypical controls. We then assessed the correlations between these neurophysiological markers and clinical measures of apathy and cognitive functioning.

Results

Significantly lower theta and greater delta resting state power was seen in the HD group, as well as significantly greater delta connectivity. There was a significant positive correlation between theta power and processing speed, however there were no associations between the neurophysiological and apathy measures.

Conclusions

We speculate that these changes in oscillatory power and connectivity reflect ongoing, frontally concentrated degenerative and compensatory processes associated with HD.

Significance

Our findings support the potential utility of quantitative EEG as a proximate marker for non-motor symptoms in HD.

Highlights

We examined EEG oscillatory power and functional connectivity as a marker of non-motor symptoms in HD.

The HD group had lower theta power, higher delta power and connectivity, and theta power was correlated with processing speed.

Our findings support the use of quantitative EEG metrics as potential non-motor symptom markers for clinical research in HD.
Metagenomic insight into taxonomic composition, environmental filtering, and functional redundancy for shaping worldwide modern microbial mats
Authors: Viladomat M. , García-Ulloa M. , Zapata-Peñasco I. , Eguiarte L. E , Souza V.
Published: August 2022

Although microbial mats are considered relictual communities that are nowadays mostly constrained in their distribution by predation and phosphorus availability, they are still found in a wide range of environmental conditions. Their ancestral history, geographical isolation, stratified community composition and interspecies dynamics make them an interesting model to study community ecological processes and concepts. In this study, we analyzed different metagenomic datasets from worldwide modern microbial mats to compare community structure and functions. We found significant differentiation in both alpha and beta diversity of taxonomic and functional categories without significant correlation with temperature and pH. Differences depended more on the presence of very highly abundant cyanobacteria and some generalist microorganisms. Our results suggest that there is more than just Grinnellian niche dynamics in the determination of microbial mat community assembly, opening the hypothesis of interactions as the driver behind these ancient communities. We also discuss the influence of niche dynamics and environmental filtering in the community assembly of microbial mats.
A rapid review of barriers and facilitators to cancer screening uptake (breast, cervical and bowel) in underserved populations
Authors: Okolie Chukwudi , Hookway Amy , Wale Alesha , Everitt Jordan , Shaw Hannah , Lewis Ruth , Cooper Alison , Edwards Adrian
Published: August 2022

In the United Kingdom (UK), the National Health Service (NHS) provides population-based screening programmes for breast, bowel, and cervical cancer. These programmes were temporarily paused in March 2020, due to the COVID-19 pandemic, resulting in large numbers of the eligible population having their invitations delayed. This disruption may have had a disproportionate impact on underserved populations for whom there was a lower uptake prior to the pandemic. Some people may also be less willing to attend screening after the pandemic. Interventions and campaigns designed to encourage people to take part in cancer screening may need to be adapted after the pandemic, in particular those targeting underserved populations.

This rapid review aimed to identify the barriers and facilitators to breast, bowel, and cervical screening uptake in underserved populations (e.g. clinically vulnerable, shielding, multi-morbidities, ethnic minorities, social deprivation, gender, age) during and since the onset of the pandemic, using evidence from the UK and other countries with similar cancer screening programmes (such as Australia and Netherlands), and to compare with the pre-pandemic literature. The pre-pandemic literature was identified using a supplementary scoping search for published systematic reviews.

Three primary studies (two published and one ongoing trial) conducted during the pandemic were identified. Five systematic reviews of pre-pandemic evidence were also included. Two qualitative studies conducted during the pandemic were appraised as high quality but both included sample populations with limited representation.

No primary studies specifically exploring the impact of the pandemic on barriers and facilitators to screening uptake among underserved groups were identified. The findings did not show marked differences in the barriers and facilitators for screening uptake before and during the COVID-19 pandemic in underserved populations. However, it is unclear whether this is because these genuinely remain unchanged or reflects the lack of available evidence. The findings may only be transferable to the population groups studied.
Prevalence and correlates of alcohol and tobacco consumption among research scholars: evidence from a cross-sectional survey of three Indian universities
Authors: Usman Mohd , Anand Enu , Akhtar Saddaf Naaz , Umenthala Srikanth Reddy , Anwar Tarique , Unisa Sayeed
Published: August 2022

Purpose

Alcohol and tobacco consumption are significant public health concerns and considered some of the riskiest behaviors among students. Despite strong indications of heavy consumption of these substances, certain sections of the student population remain unexplored regarding their consumption patterns and associated factors, including research scholars pursuing Doctor of Philosophy degrees. This study aims to explore the patterns and correlations of consumption of alcohol and tobacco among doctoral students in three Indian universities.

Design/methodology/approach

A cross-sectional study was conducted on a total of 530 scholars from three central universities, Aligarh Muslim University, Banaras Hindu University and Jawahar Lal Nehru University, and focused on two substances (alcohol and tobacco) frequently used by students in India. Bi-variate analysis and penalized logistic regressions were applied to analyse the prevalence and associated factors of alcohol, smoking and smokeless tobacco among doctoral students.

Findings

Tobacco consumption was observed to be the dominant form of substance use among doctoral students. Findings revealed that 34% of scholars smoked and 25% consumed smokeless tobacco daily and around 14% consumed alcohol at least once a week. Major significant correlates of substance consumption among scholars were found to be gender, religion, parental mortality, dissatisfaction with academic performance and stress about future career/employment. Significant variation in substance use patterns was observed among universities.

Originality/value

This study provides first-hand evidence on substance use patterns and the correlates among doctoral students in three Indian universities. Findings indicate the implementation of specific intervention programs for mental health and counselling for this section of students to prevent substance use addiction would be beneficial.
Applying Kansei engineering to the design of headwear pieces with traditional shape features
Authors: Tsai Hung-Cheng , Hsu Yuan-Chin
Published: August 2022

Purpose

It is desirable that shape appeal in craft design takes people's cultural and emotional influencers into consideration. Five Royal Lords worship, prevalent in the southwest coastal part of Taiwan and a source of religious and spiritual support to the local residents, offers such a shape appeal. This study takes the design of Taiwan's cultural handicrafts as the main point of discussion and uses Kansei engineering with semantic technique to promote the linkage between shape and the mental image of the Five Royal Lords' headwear. There are only two types of traditional headwear for the Five Royal Lords: the Imperial Crown and Lord Crown, despite the different personal characteristics of the five deities. This study aims to design a crown for each that matches their individuality.

Design/methodology/approach

In the first stage of the research process, the Kawakita Jiro method was used to arrive at appropriate descriptions representative of the deities' individuality. Fuzzy set theory was then applied to convert the relationship between the representative descriptions and headwear shape features into a quantitative one, after which the headwear could be redesigned and validated.

Findings

The study results show that: (1) analysis of the relationship between shape features and representative deity descriptions offered guidance to the redesign. (2) A method combining fuzzy theory and description terms could generate quantitative data that helped to provide design suggestions and result validation, supporting both scientific rationality and designers' sensibility. (3) The validation revealed that the redesigned headwear was better than the original headwear.

Originality/value

The study successfully established a design and development process featuring collaboration by folklore experts, designers, craftspeople and worshippers, and helping to promote new cultural product development. The success of the research process can serve as a reference to the development of other different products with shape features.
How do human resource practices help employees alleviate stress in enforced remote work during lockdown?
Authors: Li Gang , Zheng Qiqi , Xia Mengyao
Published: August 2022

Purpose

Due to the fact that most employees have been forced to work remotely during the lockdown resulting from the COVID-19 pandemic, there is great concern about how to alleviate increased stress among employees through human resource (HR) practices. Drawing upon the job demands-control (JDC) model and the job demands-resources (JDR) model, this study empirically investigated the direct effect of HR practices on employee stress in enforced remote work and the mediating role of sources of stress (SoS) and sense of control (SoC).

Design/methodology/approach

Data were collected through an online survey platform called Wenjuanxing from March 15 to 22, 2020 in Hubei, China and from April 22 to 29, 2022 in Shanghai, China. Respondents scanned the QR code on WeChat to enter the platform. A total of 511 valid questionnaires were received with a response rate of 75.4%. After controlling demographic variables, the authors used the mediation modeling and PROCESS tool to test the proposed hypotheses.

Findings

HR practices negatively affect stress in enforced remote work among employees. Both SoS and SoC partially mediate the relationship between HR practices and stress. HR practices can alleviate stress via decreasing SoS and enhancing SoC, respectively. Moreover, employee care and training are found to be two key factors of HR practices to help employees alleviate stress in enforced remote work.

Originality/value

Lockdown as an extreme external condition has brought great challenges in employee work arrangement as well as HR practices. Although the relationship between HR practices and job stress was studied previously, there is a lack of research on the effects of HR practices on stress in enforced remote work due to lockdown. It advances knowledge on HR practices' stress-reducing effect in the context of remote work and provides suggestions for HR practitioners on ways of alleviating employee stress in remote work.
How does domestic market fragmentation affect enterprise innovation performance? Empirical evidence from China
Authors: Qi Xiao-Feng , Zhou Lihong
Published: August 2022

Purpose

This paper aims to explore the impact of domestic market fragmentation on the innovation performance of enterprises and its mechanism from the perspective of market segmentation, a government behavior with Chinese characteristics.

Design/methodology/approach

In order to verify the theoretical hypothesis proposed in the previous article, that is, whether domestic market fragmentation can effectively improve the innovation performance of enterprises, this paper bases on the data of listed companies from 2010 to 2016, empirically testing the theoretical hypothesis by constructing a measurement model.

Findings

Domestic market fragmentation has a significant inhibitory effect on enterprise innovation performance. Domestic market fragmentation has heterogeneous effects on innovation performance of enterprises and regions. It is undeniable that domestic market fragmentation does have a certain support effect on state-owned enterprises but the support effect is achieved by distorting regional resource allocation and creating an unfair market environment.

Originality/value

Firstly, this paper explores the impact mechanism of domestic market fragmentation on corporate innovation performance from the perspective of market segmentation, a government behavior with Chinese characteristics, so as to expand and enrich the relevant research on enterprise innovation. Secondly, from the perspective of corporate innovation performance, this paper provides new evidence for the “curse effect” of domestic market fragmentation. Thirdly, this paper tries to shake the domestic market fragmentation support theory from the perspective of distortion effect brought by the “hand of support” of domestic market fragmentation.
Leader–member exchange congruence and feedback seeking behavior: a role theory perspective
Authors: Khan Tamania , Iqbal Muhammad Zahid
Published: August 2022

Purpose

While studying the association between leader–member exchange (LMX) quality and employee work outcomes, the existing scholarship has generally focused on employee perspectives of LMX quality. Being more inclusive, this study utilizes role theory to incorporate the dyadic (in)congruence in LMX quality and their effects on ratee feedback seeking behavior.

Design/methodology/approach

Data elicited from N = 156 matched rater–ratee dyads comprising engineers working with telecommunication organizations of Pakistan. Purposive sampling was done to ensure that rater–ratee dyads were in continuous contact by their customized employee portals.

Findings

Results of polynomial regression analysis revealed that leader–member congruence in their perceptions of LMX quality enhanced member's feedback seeking behavior. Asymmetrical incongruence, i.e. the member perceived higher LMX quality than the leader, is found to predict member's feedback seeking behavior, even higher than both levels of congruence (high- and low-quality LMX).

Research limitations/implications

The scope of this study was members' reactions to performance appraisal. However, other performance appraisal outcomes are plausible such as, leader performance. This study explored the objective incongruence, yet subjective congruence can be more conclusive about the results of the present study.

Practical implications

LMX incongruence is more detrimental to members in high interaction situations. When the member perceives lower quality LMX than the leader, expectations regarding resource exchanges and behaviors are more likely to be unfulfilled for the member. Feedback seeking behavior being a member related outcome is likely to be affected more negatively in such conditions of incongruence. Second, it is likely that when there is a high degree of incongruence among the dyads, LMX congruence may become more critical to the members which in turn may give them a sense of belongingness within the dyad. Third, the relationship between leader–member dyads is affected by the social interactions facilitating the members' opinion sharing.

Originality/value

The study suggests that to fully grasp the implications of LMX theory, we need to consider the viewpoints of both the dyadic members at the same time.
Planned or unplanned purchases? The effects of perceived values on omnichannel continuance intention
Authors: Chang Yaping , Geng Lixiao
Published: August 2022

Purpose

This study explores customers' omnichannel continuance intention from the perceived value perspective and examines the differences between planned and unplanned purchases.

Design/methodology/approach

A survey method was used to collect data from 311 omnichannel customers. The research model was tested by employing structural equation modelling.

Findings

The results indicate that perceived values, namely, utilitarian, hedonic and social value, positively affect customers' omnichannel continuance intention through attitude. Hedonic value is the main demand of omnichannel customers. Purchase plan plays a moderating role in the relationships between perceived values and attitude. Specifically, the effect of utilitarian value on attitude is greater for unplanned purchases than for planned purchases, whilst the effects of hedonic and social value have no difference between planned and unplanned purchases.

Practical implications

The findings provide guidelines for omnichannel retailers' channel integration and customer value proposition. Retailers should provide more hedonic and social value in customers' entire shopping process through channel integration and consider customers' purchase plan when providing utilitarian value.

Originality/value

This study contributes to the literature on omnichannel customer behaviour by identifying new influential factors that impact customers' omnichannel choice. It also extends the application of the theory of consumption values to omnichannel shopping and identifies the role of purchase plan in value offerings.