bluuebunny/crossref_metadata_2025 huggingface dataset:
Streamlining out-of-court disposals: Assessing the impact on reoffending and police practice
Authors: Rowe Michael , Amankwaa Aaron , Biddle Paul , Bengtsson Lyndsey
Published: April 2022

Police services in England and Wales have developed varied approaches to the use of conditional cautions, and this study examines the effectiveness of one set of reforms: a Revised Conditional Caution Framework. With an overall aim of diverting offenders from the Criminal Justice System and addressing offenders’ criminogenic needs, various programmes of meaningful activity were mandated for offenders. The Revised Conditional Caution Framework refers offenders to a relevant ‘pathway’, to address their offending behaviour(s). If an offender fails to complete the activity within the relevant pathway, without good reason, they revert back through the court system. The aim of the Revised Conditional Caution Framework was to apply meaningful conditions to the conditional caution (e.g. alcohol educational intervention), to focus upon addressing the root cause of the offending behaviour. In this study, the authors evaluated the effectiveness of the Revised Conditional Caution Framework in reducing reoffending. The research was conducted between January 2018 and May 2019 and adopted a mixed methodology of qualitative and quantitative research; notably, focus groups with police officers, semi-structured interviews with offenders and pathway providers and an analysis of police data on offender compliance levels. We found that the Revised Conditional Caution Framework is perceived by many professionals and offenders to provide a platform for tackling the root cause of recidivism and thereby reducing reoffending. It is argued that the premise of Revised Conditional Caution Framework is one that conceives of offending in individualistic terms that pay insufficient attention to the social and economic context in which offending is situated. The article also raises questions about the impact of the Revised Conditional Caution Framework on police professionalism and argues that it might be understood as a restriction on the exercise of discretion since it further restricts officers’ scope to respond to offenders and criminal behaviour.
The Last Broadcast: Reflections on the life and legacy of BBC Four
Authors: Weston Leanne , Samuel Michael
Published: April 2022

Following the news detailed in the BBC Annual Plan 2021/22 that BBC Four will cease to broadcast original content and will revert to an archive-only channel as a cost-cutting measure, this article endeavours to understand the legacy of the channel as it was, as it is and what it could become.
SCORE2 versus SCORE in patients with systemic lupus erythematosus
Authors: Quevedo-Abeledo Juan Carlos , González-Gay Miguel Á. , Ferraz-Amaro Iván
Published: April 2022

Introduction:

Systemic lupus erythematosus (SLE) has been associated with an increased risk of cardiovascular (CV) disease. Recently, the Systematic Coronary Risk Assessment (SCORE), a well-known CV risk algorithm, has been updated to a new predictive model (SCORE2). This new algorithm improves the identification of individuals at high risk of developing CV disease across Europe. Since carotid atherosclerosis is a predictor of future CV events and CV death, our objective was to compare the predictive capacity of SCORE2 versus SCORE for the presence of subclinical carotid atherosclerosis in patients with SLE.

Methods:

Two hundred and thirty-five individuals over 40 years of age diagnosed with SLE were consecutively recruited in this cross-sectional study. SCORE and SCORE2 were calculated. The relationship of SCORE and SCORE2 with each other, and with the presence of subclinical carotid atherosclerosis (both carotid plaque and carotid intima media thickness -cIMT-), was studied.

Results:

SCORE2 and SCORE did not correlate with each other (Spearman’s Rho = 0.125, p = 0.065). Although SCORE did not correlate with cIMT (Spearman’s Rho = -0.022, p = 0.75), the correlation of SCORE2 with cIMT was statistically significant (Spearman’s Rho = 0.367, p < 0.001). Similarly, SCORE did not show significant discrimination for the presence of carotid plaque [AUC = 0.521 (95% CI = 0.443–0.600)], while SCORE2 did [AUC = 0.720 (95% CI = 0.656–0.785)]. The difference between AUCs was found to be statistically significant ( p < 0.001), thus showing that the prediction capacity of SCORE2 was significantly higher than that of SCORE.

Conclusion:

In SLE patients, the ability of SCORE2 to predict the presence of subclinical atherosclerosis is higher than that of SCORE. According to our results, SCORE2, rather than SCORE, should be used in the CV risk stratification of patients with SLE. Prospective studies are needed to confirm these findings.
SPECTRa: An Online Tool for Simulating Prehospital Patient Care
Authors: Davidson Thomas J. , Waxenegger Harald , Mohamed Ismail , McConnell Duncan S. , Sanderson Penelope M.
Published: April 2022

Objectives:

To (1) develop a simulation software environment to conduct prehospital research during the COVID-19 pandemic on paramedics’ teamwork and use of mobile computing devices, and (2) establish its feasibility for use as a research and training tool.

Background:

Simulation-based research and training for prehospital environments has typically used live simulation, with highly realistic equipment and technology-enhanced manikins. However, such simulations are expensive, difficult to replicate, and require facilitators and participants to be at the same location. Although virtual simulation tools exist for prehospital care, it is unclear how best to use them for research and training.

Methods:

We present SPECTRa—Simulated Prehospital Emergency Care for Team Research—an online simulated prehospital environment that lets participants care concurrently for single or multiple patients remotely. Patient scenarios are designed using Laerdal’s SimDesigner. SPECTRa records data about scenario states and participants’ virtual interaction with the simulated patients. SPECTRa’s supporting environment records participants’ verbal communication and their visual and physical interactions with their interface and devices using Zoom conferencing and audiovisual recording. We discuss a pilot research implementation to assess SPECTRa’s feasibility.

Results:

SPECTRa allows researchers to systematically test small-team interaction in single- or multipatient care scenarios and assess the impact of mobile devices on participants’ assessment and care of patients. SPECTRa also supports pedagogical features that could allow prehospital educators to provide individual trainees or teams with online simulation training and evaluation.

Conclusions:

SPECTRa, an online tool for simulating prehospital patient care, shows potential for remote healthcare research and training.
Patterns and Trends of Facial Fractures at a Tertiary Care Trauma Center in India - A 13 years Retrospective Study
Authors: Shome Debraj , Surana Monika , Male Shiva Ram , Kumar Vaibhav , Vyavahare Supriya S. , Abrol Arundha , Kapoor Rinky
Published: April 2022

Study Design

Retrospective study

Objective

The purpose of this study was to retrospectively analyze the prevalence, pattern, diagnosis, and treatment of the facial fractures falling under ambit of facial plastic surgery in a multi-specialty hospital at India from the year 2006–2019.

Methods

This retrospective study analyzed 1508 patients, having orbital fractures (from 2006 to 2019) for demographic data, cause of trauma, type of fracture, and the treatment given. The data were compiled in excel and analyzed by using SPSS version 21.0.

Results

Out of these 1508 patient (1127 (74.73%)–males and 381 (25.27%)–females), the etiology of injuries was Road traffic accident (RTA) (49.20%), assault (26.52%), and sports injuries (11.47%). The most common fracture pattern was Isolated Orbit and/or Orbital Floor fracture in 451 patients (32.08%), followed by Mid-facial fractures (21.93%). Also, 105 patients (6.96%) experienced ocular/retinal trauma along with other fractures.

Conclusions

Orbit, peri-ocular, and mid-face trauma comprised a large position of this study. It requires a great deal of expertise to treat such complex trauma, which is not covered in one specialty alone. Hence, a holistic approach of craniofacial fracture management, rather than limiting these skills to water-tight craniofacial compartments becomes necessary. The study highlights the critical need of multidisciplinary approach for predictable and successful management of such complex cases.
Low-Intensity Pulsed Ultrasound Enhances the Efficacy of Bone Marrow–Derived MSCs in Osteoarthritis Cartilage Repair by Regulating Autophagy-Mediated Exosome Release
Authors: Xia Peng , Wang Qi , Song Jiulong , Wang Xiaoju , Wang Xinwei , Lin Qiang , Cheng Kai , Chen Anliang , Li Xueping
Published: April 2022

Objective

The present study explored whether low-intensity pulsed ultrasound (LIPUS) enhances the therapeutic efficacy of mesenchymal stem cells (MSCs) in osteoarthritis (OA) cartilage repair by regulating autophagy-mediated exosome release.

Design

MSCs were isolated from the rat bone marrow and treated with rapamycin, 3-methyladenine, or LIPUS. The mechanism of the LIPUS-stimulated exosome release by MSCs was analyzed by inhibiting autophagy. In addition, the MSCs were co-cultured with OA chondrocytes and stimulated by LIPUS, with or without exosome release inhibitor intervention. The exosome release was detected through transmission electron microscopy (TEM), nanoparticle tracking analysis, and biomarker expression analysis. Autophagy was analyzed through TEM, autophagy-related gene expression analysis, and immunofluorescence analysis in vitro. Furthermore, a rat knee OA model was constructed and treated with MSCs, GW4869, and LIPUS. The cartilage repair was assessed through histopathological analysis and extracellular matrix protein expression analysis.

Results

The in vitro results indicated that LIPUS promoted MSC exosome release by activating autophagy. The in vivo results demonstrated that LIPUS significantly enhanced the positive effects of MSCs on OA cartilage. These effects were significantly blocked by GW4869, an inhibitor of exosome release.

Conclusions

LIPUS can enhance the therapeutic efficacy of MSCs in OA cartilage repair, and the underlying mechanism is related to the increase in autophagy-mediated exosome release.
Antibiotics non-adherence and its associated factors among households in southern Ethiopia
Authors: Endashaw Hareru Habtamu , Sisay Daniel , Kassaw Chalachew , Kassa Reta
Published: April 2022

Objectives:

This study aimed at assessing the prevalence of antibiotics non-adherence and its associated factor among households in southern Ethiopia.

Methods:

A community-based cross-sectional study was conducted among 323 randomly selected households in Wenago town. To collect the data, structured questionnaire was used. Categorical variables were represented by frequency and percentage. For continuous variables, the mean value and standard deviation were used. Bivariate and multivariate logistic regression analyses were used to identify factors related to antibiotic non-adherence. Finally, for significant factors with p-values less than 0.05, the adjusted odds ratio with 95% confidence interval was calculated and evaluated.

Results:

The prevalence of antibiotic non-adherence in the household was 194 (60.1%) (95% confidence interval = 55.1–65.6). Remission of symptoms (63%) is one of the top reasons for antibiotic non-adherence in the home. Male sex (adjusted odds ratio = 1.77, 95% confidence interval = 1.03–3.08), lower educational status (adjusted odds ratio = 3.42, 95% confidence interval = 1.51–7.75; adjusted odds ratio = 2.37, confidence interval = 1.12–5.02), poor attitude toward antibiotics use (adjusted odds ratio = 1.89; 95% confidence interval = 1.23–3.04), poor knowledge about antibiotics use (adjusted odds ratio = 1.34; 95% confidence interval = 1.11–2.39), and no-prescription information from pharmacy (adjusted odds ratio = 2.02, 95% confidence interval = 1.09–3.72) were all associated with non-adherence. While no medication discomfort (adjusted odds ratio = 0.31, 95% confidence interval = 0.178–0.56) had a negative effect on non-adherence.

Conclusion:

In this study, antibiotic non-adherence was considerably high among the participants. Being male, lower educational status, poor attitude, poor knowledge, no-prescription information from pharmacy/druggist, and medication discomfort were related with antibiotic non-adherence. As a result, community service providers must provide relevant prescription information as well as appropriate counseling to antibiotic non-adherent patients.
Drug-related problems identified during pharmaceutical care interventions in an intensive care unit at a tertiary university hospital
Authors: Tharanon Vichapat , Putthipokin Krongtong , Sakthong Phantipa
Published: April 2022

Introduction:

Drug-related problems could potentially worsen the clinical outcomes in critically ill patients. Critically ill patients are generally considered more vulnerable to harm from drug-related problems due to frequent medication-related events and complicated clinical courses. However, drug-related problems identified by on-ward clinical pharmacists in medical intensive care units in Thailand are not well reported. This study reports clinically relevant data with the description of identified problems, common causes of drug-related problems, and pharmacists’ interventions performed in real world, so that it may serve as an educational material for pharmacists who implement a pharmaceutical care and participate in medical intensive care units.

Methods:

A retrospective descriptive study was conducted at a tertiary university hospital in Bangkok, Thailand, from January 2015 to December 2020. The drug-related problems were categorized according to Cipolle et al.’s classification. The severity of drug-related problems in this study was rated by modifying the definition of The National Coordinating Council for Medication Error Reporting and Prevention Taxonomy of Medication Error to report harm from drug-related problem-related patient outcomes.

Results:

A total of 698 drug-related problems were detected in 374 critically ill patients. The prevalence of drug-related problems occurring in critically ill patients admitted to the medical intensive care unit was 73.9%. The most frequent drug-related problems were dosage too high (27.7%), ineffective drug (17.2%), need for additional drug therapy (15.3%), unnecessary drug therapy (14.6%), dosage too low (14.3%), adverse drug reaction (9.7%), and non-adherence (1.2%). The severity of drug-related problems in the medical intensive care unit was assessed as a drug-related problem with no harm (78.2%). Pharmacists’ interventions were advised according to drug-related problem identification to provide personalized pharmacotherapy optimization in critically ill patients.

Conclusion:

The most frequent drug-related problem identified during pharmaceutical care interventions in the medical intensive care unit at tertiary university hospital is dosage too high. The severity of drug-related problems is mostly determined as drug-related problems with no harm.
Robotic-assisted radical cystectomy with intracorporeal urinary diversion: Initial South Australian experience
Authors: Shepherd Andrew RH , Bunjo Zachary , Sutherland Peter , Fuller Andrew
Published: April 2022

Aim:

The aim of this study was to describe the initial experience with robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) performed by two robotic surgeons at a single, Australian centre.

Methods:

Retrospective analysis was conducted on 30 consecutive patients who underwent RARC with ICUD with curative intent for muscle-invasive and high-risk non-muscle-invasive bladder cancer between 2017 and 2021. Variables analysed included patient baseline characteristics, operative and peri-operative outcomes, as well as short-term pathological outcomes.

Results:

A total 30 patients were included; 87% were male and the median age was 71 years. Half of patients had muscle-invasive bladder cancer and 93% had ileal conduit formation (with the remaining two patients undergoing neobladder formation). The median operating time was 247 minutes. The median estimated blood loss was 450 mL and 20% of patients received a blood transfusion. A high-grade complication (Clavien III–V) was encountered in 13% of patients post-operatively. At 90 days, 30 overall complications (Clavien I–V) occurred across 67% of the patients.

Conclusion:

This series provides further support for the safe introduction of RARC with ICUD in Australia. Further studies with extended duration of follow-up, including oncological outcomes, are required to support widespread adoption of RARC.

Level of evidence:

Level 4 (case series)
Robot-assisted surgery in horseshoe kidneys: A safety and feasibility multi-centre case series
Authors: Ng Alexander , Nathan Arjun , Campain Nicholas , Fortune-Ely Mariella , Patki Siddhant , Yuminaga Yuigi , Mumtaz Faiz , Gulamhusein Aziz , Tran Maxine , Nathan Senthil , Barod Ravi , Bex Axel , Patki Prasad
Published: April 2022

Objective:

We assessed the safety and feasibility of minimally invasive robot-assisted surgery for horseshoe kidney (HSK).

Method:

A prospectively maintained data set for consecutive patients undergoing robotic kidney surgery was reviewed for patients with HSK. Cases were performed by experienced robotic surgeons, across two high-volume centres between 2016 and 2020.

Results:

Seven patients underwent robotic surgery for HSK, comprising three partial nephrectomies for renal masses, one nephroureterectomy and three benign nephrectomies for non-functioning kidneys. The median age was 53 (interquartile range (IQR) = 47–60) years and median body mass index (BMI) was 25 (IQR = 25–26.5). Median console time was 120 (IQR = 118–215) minutes and median estimated blood loss was 150 (IQR = 125–250) mL. The median pre- and post-operative estimated glomerular filtration rate (eGFR) was 76 (IQR = 72–90) and 71 (IQR = 60–81), respectively. There were no higher-grade complications (Clavien–Dindo III–IV) and one Clavien–Dindo grade II complication (wound infection treated with IV antibiotics). Median length of stay (LOS) was 2 days and there were no 30-day readmissions. Negative margins were achieved in 75% of tumour resections.

Conclusion:

We report one the largest series of robot-assisted surgery on HSK. Robotic surgery is safe and feasible for HSK in centralised high-volume centres with acceptable perioperative outcomes. Established benefits of minimally invasive surgery, such as reduced LOS and low complication rates, were demonstrated.

Level of evidence:

4
Rituximab for Adults With Multi-Drug Resistant Focal Segmental Glomerulosclerosis: A Case Series and Review of the Literature
Authors: Zhong Ellia , Ghadiri Siavash , Pai Alexander , Marin Judith G. , Barbour Sean J.
Published: April 2022

Background:

Adults with primary focal segmental glomerulosclerosis (FSGS) are frequently resistant to multiple immunosuppressive agents, which is associated with ongoing complications of nephrotic syndrome and a high risk of progression to end-stage renal disease (ESRD). Rituximab, a monoclonal antibody against the B cell CD20 antigen, has shown some preliminary evidence in treating nephrotic syndrome.

Objectives:

Describe the usage and the efficacy of rituximab for adults with FSGS in British Columbia (BC) (Canada) and perform a literature review of multi-immunosuppressive drug resistant FSGS in adult patients treated with rituximab to estimate the overall response rate.

Design:

Case series report and a literature review.

Patients:

For the case-series, all BC patients who received rituximab for a diagnosis of primary FSGS were included. The literature review included all cases of immunosuppressive-resistant FSGS patients treated with rituximab. We excluded transplant and pediatric patients in both groups.

Methods:

We describe all cases of adults with native-kidney FSGS resistant to conventional immunosuppressive medications from our provincial health database who were treated with rituximab from 2014 to 2018. A review of the existing literature was performed via PubMed, MEDLINE, and Embase using the following keywords: rituximab, focal segmental glomerulosclerosis, and FSGS up to August 2019.

Results:

We characterize four immunosuppressive-resistant FSGS patients who were treated with rituximab as part of our provincial program, all of whom showed a response to rituximab with a sustained remission. We found 29 specific cases in the literature of adults with native-kidney FSGS treated with rituximab after being resistant to other immunosuppressive medications, of whom 15 cases showed a response to rituximab. This has increased the total response rate from 15/29 (52%) to 19/33 (58%).

Limitations:

Literature on this topic is coming predominantly from case series. Prospective trials are needed to confirm efficacy, tolerability, and duration of remission.

Conclusions:

Due to the low number of currently reported cases and variable response rates, these four cases provide critical data to generate a more accurate understanding of the role of rituximab in adults with resistant FSGS. Adding these results to the confirmed literature cases of multiple-immunosuppressive-resistant FSGS patients treated with rituximab results in a total remission rate of 19/33 cases.
Folk Theories of Online Dating: Exploring People’s Beliefs About the Online Dating Process and Online Dating Algorithms
Authors: Huang Sabrina Angela , Hancock Jeffrey , Tong Stephanie Tom
Published: April 2022

How do online daters come to understand and make sense of their online dating experiences and the algorithms that underlie online dating platforms? Across two mixed-method studies, we take a metaphoric approach to identify and explore people’s folk theories about traditional dating, online dating, and online dating algorithms. In Study 1, we take a quantitative approach and use an innovative wiki-survey procedure to identify individuals’ folk theories of online dating and their associated themes through content analyses. In Study 2, we take a qualitative approach, exploring participants’ folk theories through in-depth interviews, extended case method, and grounded theory. Our studies uncovered two folk theories unique to traditional dating ( movies, nurturing), one folk theory unique to online dating ( game), three folk theories related to online dating algorithms ( filter, personalized advertisements, bracket), and two folk theories that were found to overlap between traditional and online dating ( shopping, chance and randomness). Our findings provide novel insights into how daters make sense of traditional and online relationship development processes as well as the algorithms that underlie online dating platforms.
“They think you are weak”: Examining the Drivers of Gender-Based Violence in Three Urban Informal Settlements
Authors: Maclin Beth J. , Bustamante Nirma D. , Wild Hannah , Patel Ronak B.
Published: April 2022

The global trend of rapid urbanization raises concerning issues related to the living standards of the urban poor, many of whom live in dense informal settlements. Residents of informal urban settlements can face significant insecurity, with men and women experiencing different threats. While space and socioeconomic status have specific consequences on the hazard of violence that urban residents face, gender modifies the impact of that violence. In an attempt to understand the drivers of insecurity within a social ecological framework, this study investigated underdeveloped neighborhoods in Addis Ababa, Ethiopia; Dhaka, Bangladesh; and Port-au-Prince, Haiti. The qualitative approach employed focus group discussions using various probing techniques and key informant interviews followed by a thematic analysis of the data. The direct quotes and experiences of young and older women compared to those of young and older men highlight how the combination of factors - gender and poverty - drive differential risk for women compared to men among the urban poor in these cities.
Building Construction Clients’ Design Consultant and Contractor Selection Criteria Versus Post-Occupancy Satisfaction Levels
Authors: Egemen Mehmedali
Published: April 2022

In today’s competitive building construction markets, achieving clients’ satisfaction is of utmost importance. The choice of a design consultant and a contractor for a building project has a crucial influence on the post-occupancy satisfaction of the client. Hence, this study provides insights into private building construction clients’ perceptions of a set of criteria contributing to their selections of design consultant and contractor together with the resulting post-occupancy overall client satisfaction levels eventually reached, by presenting survey findings of 330 clients in North Cyprus construction market. Unlike previous studies, the current study combined all the interrelated and vital stages of design consultant and contractor selection with post-occupancy client satisfaction levels. A further contribution is differentiating among various types of client groups’ behaviors in each of the three specified stages. Clients in different categories had distinct approach differences in selection stages, and different post-occupancy satisfaction values indicating that firms may benefit from market segmentation. “Residential” and “<120,000£” type building clients were the least satisfied groups, while “project execution stage” and “functionality” emerged as major features creating dissatisfaction. The findings revealed the importance attached by the clients to “references about the firm” in the selection stages and low client satisfaction with the completed projects. Regression analysis findings revealed different design consultant and contractor selection factors predicting overall clients’ satisfaction while assigning high importance to the “cost-effectiveness approach of the firm” emerged as the only strong predictor of dissatisfaction. This study provides a guide for building construction clients to attain higher post-occupancy satisfaction and assists design consultants and contractors in adopting specific customer-focused strategies.
Comparison of Nurses’ and Patients’ Readiness for Hospital Discharge: A Multicenter Study
Authors: Mehraeen Parisa , Jafaraghaee Fateme , Paryad Ezzat , Kazemnejad Leyli Ehsan
Published: April 2022

Decision to discharge is often based solely on clinical criteria but readiness for discharge is multifactorial and perceived differently by patients, families, nurses, and physicians. This is an analytical cross-sectional study aimed to compare perceptions of readiness to discharge 452 patients and their assigned nurses on the day of hospital discharge. To compare perceptions of readiness to discharge patients and their assigned nurses on the day of hospital discharge via readiness for hospital discharge (RHD) self-reported questionnaire. The biggest difference between nurses and patients’ perception scores was in the knowledge subscale. The results of linear regression model showed that patients’ gender, education, occupation, ward, nurse’s age, and marital status predict the difference between nurses and patients’ perception of readiness. Hospitalization in ear, nose, and throat (ENT) department with increasing difference and the older age of nurses is associated with a decrease in the difference between the perception. Assessment of nurse’s self-readiness can help with the development of care and education planning tailored to patients’ needs before discharge.
Cognitive and behavioural bias in advance care planning
Authors: Whyte Stephen , Rego Joanna , Fai Chan Ho , Chan Raymond J. , Yates Patsy , Dulleck Uwe
Published: April 2022

Background:

We explore cognitive and behavioural biases that influence individual’s willingness to engage advance care planning (ACP). Because contexts for the initiation of ACP discussions can be so different, our objective in this study was to identify specific groups, particular preferences or uniform behaviours, that may be prone to cognitive bias in the ACP decision process.

Method:

We collected data from the Australian general public ( n = 1253), as well as general practitioners (GPs) and nurses ( n = 117) including demographics, stated preference for ACP decision-making; six cognitive bias tests commonly used in Behavioural Economics; and a framing experiment in the context of ACP.

Results:

Compared to GPs ( M = 57.6 years, SD = 17.2) and the general public (58.1 years, SD = 14.56), nurses on average recommend ACP discussions with patients occur approximately 15 years earlier ( M = 42.9 years, SD = 23.1; p < 0.0001 in both cases). There is a positive correlation between the age of the general population and the preferred age for the initial ACP discussion ( ρ = 0.368, p < 0.001). Our shared decision-making analysis shows the mean share of doctor’s ACP input is viewed to be approximately 40% by the general public, significantly higher than health professionals (GPs and nurses), who believe doctors should only contribute approximately 20% input. The general public show varying relationships (all p < 0.05) for both first ACP discussion, and shared decision-making for five of six cognitive tests. However, for health professionals, only those who exhibit confirmation bias show differences (8.4% higher; p = 0.035) of patient’s input. Our framing experiment results show that positive versus negative framing can result in as much as 4.9–7.0% shift in preference for factors most relevant to ACP uptake.

Conclusion:

Understanding how GPs, nurses and patients perceive, engage and choose to communicate ACP and how specific groups, particular preferences or uniform behaviours, may be prone to cognitive bias in the decision process is of critical importance for increasing future uptake and efficient future healthcare provision.
Breaking the Symmetry of a Metal–Insulator–Metal-Based Resonator for Sensing Applications
Authors: Chou Chao Chung-Ting , Chou Chau Yuan-Fong , Chiang Hai-Pang
Published: April 2022

This article designed a novel multi-mode plasmonic sensor based on a metal–insulator–metal waveguide side-coupled to a circular-shaped resonator containing an air path in the resonator. The electromagnet field distributions and transmittance spectra are investigated using finite element method-based simulations. Simulation results show that an air path in the resonator's core would impact the transmittance spectrum of SPPs. Besides, the air path is crucial in offering efficient coupling and generating multiple plasmon modes in the sensor system. The proposed structure has the advantage of multi-channel, and its sensitivity, figure of merit, and dipping strength can reach 2800 nm/RIU, 333.3 1/RIU, and 86.97%, respectively. The achieved plasmonic sensor can also apply for lab-on-chip in biochemical analysis for detecting the existence or nonappearance of diabetes through the human glucose concentration in urine.
Using egg production longitudinal recording to study the genetic background of resilience in purebred and crossbred laying hens
Authors: Bedere Nicolas , Berghof Tom V. L. , Peeters Katrijn , Pinard-van der Laan Marie-Hélène , Visscher Jeroen , David Ingrid , Mulder Han A.
Published: April 2022

Background

There is growing interest in using genetic selection to obtain more resilient farm animals (i.e. that are minimally affected by disturbances or rapidly recover from them). The aims of this study were to: (i) estimate the genetic parameters of resilience indicator traits based on egg production data, (ii) assess whether these traits are genetically correlated in purebreds and crossbreds, and (iii) assess the genetic correlations of these traits with egg production (EP) as total number of eggs between 25 and 83 weeks. Purebred hens (33,825 from a White Leghorn (WA) line and 34,397 from a Rhode Island (BD) line were housed in individual cages, while crossbred hens were housed in collective cages of 6 to 8 paternal half-sibs (12,852 WA and 3898 BD crossbred groups, where the name of the group refers to the line used as the sire). Deviations of a hen’s weekly egg production from the average of the corresponding batch were calculated. Resilience indicator traits investigated were the natural logarithm of the variance (LNVAR), the skewness (SKEW), and the lag-one autocorrelation (AUTO-R) of these deviations.

Results

In both purebred lines, EP was estimated to be lowly heritable (WA: 0.11 and BD: 0.12). Resilience indicators were also estimated to be lowly heritable in both lines (LNVAR: 0.10 and 0.12, SKEW: 0.04 and 0.02, AUTO-R: 0.06 and 0.08 in WA and BD, respectively). In both crossbred groups, EP, AUTO-R, and SKEW were estimated to be less heritable than in purebreds (EP: $$h^{2}$$

h
2

 ≤ 0.07; and resilience indicator traits: $$h^{2}$$

h
2

 ≤ 0.03), while LNVAR had an $$h^{2}$$

h
2

estimate that was similar to or higher in crossbreds ($$h^{2}$$

h
2

ranged from 0.13 to 0.21) than in purebreds. In both purebreds and crossbreds, resilience indicator traits were estimated to have favorable genetic correlations with EP and between each other. For all traits and in both lines, estimates of genetic correlations between purebreds and crossbreds ($$r_{pc}$$

r

pc

) differed from 1 and ranged from 0.16 to 0.63.

Conclusions

These results show that selection for resilience based on EP data can be considered in breeding programs for layers. Genetic improvement of resilience in crossbreds can be achieved by using information on purebreds, but would be greatly enhanced by the integration of information on crossbreds in breeding programs.
Integrative analysis of mutated genes and mutational processes reveals novel mutational biomarkers in colorectal cancer
Authors: Dashti Hamed , Dehzangi Iman , Bayati Masroor , Breen James , Beheshti Amin , Lovell Nigel , Rabiee Hamid R. , Alinejad-Rokny Hamid
Published: April 2022

Background

Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths worldwide. Recent studies have observed causative mutations in susceptible genes related to colorectal cancer in 10 to 15% of the patients. This highlights the importance of identifying mutations for early detection of this cancer for more effective treatments among high risk individuals. Mutation is considered as the key point in cancer research. Many studies have performed cancer subtyping based on the type of frequently mutated genes, or the proportion of mutational processes. However, to the best of our knowledge, combination of these features has never been used together for this task. This highlights the potential to introduce better and more inclusive subtype classification approaches using wider range of related features to enable biomarker discovery and thus inform drug development for CRC.

Results

In this study, we develop a new pipeline based on a novel concept called ‘gene-motif’, which merges mutated gene information with tri-nucleotide motif of mutated sites, for colorectal cancer subtype identification. We apply our pipeline to the International Cancer Genome Consortium (ICGC) CRC samples and identify, for the first time, 3131 gene-motif combinations that are significantly mutated in 536 ICGC colorectal cancer samples. Using these features, we identify seven CRC subtypes with distinguishable phenotypes and biomarkers, including unique cancer related signaling pathways, in which for most of them targeted treatment options are currently available. Interestingly, we also identify several genes that are mutated in multiple subtypes but with unique sequence contexts.

Conclusion

Our results highlight the importance of considering both the mutation type and mutated genes in identification of cancer subtypes and cancer biomarkers. The new CRC subtypes presented in this study demonstrates distinguished phenotypic properties which can be effectively used to develop new treatments. By knowing the genes and phenotypes associated with the subtypes, a personalized treatment plan can be developed that considers the specific phenotypes associated with their genomic lesion.
Exogenously applied spermidine alleviates hypoxia stress in Phyllostachys praecox seedlings via changes in endogenous hormones and gene expression
Authors: Gao Jianshuang , Zhuang Shunyao , Zhang Yuhe , Qian Zhuangzhuang
Published: April 2022

Background

Hypoxia stress is thought to be one of the major abiotic stresses that inhibits the growth and development of higher plants. Phyllostachys pracecox is sensitive to oxygen and suffers soil hypoxia during cultivation; however, the corresponding solutions to mitigate this stress are still limited in practice. In this study, Spermidine (Spd) was tested for regulating the growth of P. praecox seedlings under the hypoxia stress with flooding.

Results

A batch experiment was carried out in seedlings treated with 1 mM and 2 mM Spd under flooding for eight days. Application of 1 mM and 2 mM Spd could alleviate plant growth inhibition and reduce oxidative damage from hypoxia stress. Exogenous Spd significantly (P < 0.05) increased proline, soluble protein content, catalase (CAT), superoxide dismutase (SOD), and S-adenosylmethionine decarboxylase (SAMDC) activity, enhanced abscisic acid (ABA) and indole-3-acetic acid (IAA) content, and reduced ethylene emission, hydrogen peroxide (H2O2), superoxide radical (O2·−) production rate, ACC oxidase (ACO) and ACC synthase (ACS) to protect membranes from lipid peroxidation under flooding. Moreover, exogenous Spd up-regulated the expression of auxin-related genes auxin responsive factor1 (ARF1), auxin1 protein (AUX1), auxin2 protein (AUX2), auxin3 protein (AUX3) and auxin4 protein (AUX4), and down-regulated the expression of ethylene-related ACO and ACS genes during flooding.

Conclusion

The results indicated that exogenous Spd altered hormone concentrations and the expression of hormone-related genes, thereby protecting the bamboo growth under flooding. Our data suggest that Spd can be used to reduce hypoxia-induced cell damage and improve the adaptability of P. praecox to flooding stress.
A clinical study of genetic testing to guide the dosing of warfarin after heart valve replacement
Authors: Zhang Fan , Zhang Congcong , Gu Chengxiong , Yu Yang , Li Jingxing
Published: April 2022

Objective

To explore the role of genetic testing of VKORC1 and CYP2C9 in determining the dosage of warfarin after aortic valve replacement.

Methods

A total of 172 patients receiving warfarin after aortic valve replacement were divided into a control group (n = 86) and an experimental (n = 86) group based on acceptance of genetic testing. In the experimental group, three loci of VKORC1 and CYP2C9 were tested by polymerase chain reaction-restriction fragment length polymorphism technique, and the initial dose of warfarin was determined based on the genetic testing results and warfarin oral-dose table recommended by U.S. Food and Drug Administration (FDA). In the control group, warfarin (3 mg per night) was used as the initial dose. The international normalized ratio (INR) of each patient was continuously monitored after medication. The percentages of patients meeting the target INR in the two groups at specific time points and at 3-month follow-up after discharge from the hospital were monitored, and the incidence of various adverse events was compared between the groups.

Results

Based on the results of genetic testing, 68 patients received 3–4 mg/d (79.1%), 10 patients received 0.5–2 mg/d (11.6%), and eight patients received 5–7 mg/d (9.3%) as the initial dosages of warfarin in the experimental group. The percentages of the patients meeting the target INR on the third and sixth day of postoperative medication were 45.3% and 73.3%, respectively, in the experimental group, and 29.8% and 58.3%, respectively, in the control group. The INR critical values during hospitalization occurred in 2.3% in the experimental group and in 7.1% in the control group, while the percentage of the patients meeting the target INR after 3 months was 86.1% in the experimental group and 83.1% in the control group.

Conclusion

Genetic testing may guide the selection of the initial dose of warfarin after heart valve replacement to rapidly achieve a stable dose.
Trajectories of physical frailty and cognitive impairment in older adults in United States nursing homes
Authors: Yuan Yiyang , Lapane Kate L. , Tjia Jennifer , Baek Jonggyu , Liu Shao-Hsien , Ulbricht Christine M.
Published: April 2022

Background

U.S. nursing homes provide long-term care to over 1.2 million older adults, 60% of whom were physically frail and 68% had moderate or severe cognitive impairment. Limited research has examined the longitudinal experience of these two conditions in older nursing home residents.

Methods

This national longitudinal study included newly-admitted non-skilled nursing care older residents who had Minimum Data Set (MDS) 3.0 (2014–16) assessments at admission, 3 months, and 6 months (n = 266,001). Physical frailty was measured by FRAIL-NH and cognitive impairment by the Brief Interview for Mental Status. Separate sets of group-based trajectory models were fitted to identify the trajectories of physical frailty and trajectories of cognitive impairment, and to estimate the association between older residents’ characteristics at admission with each set of trajectories. A dual trajectory model was used to quantify the association between the physical frailty trajectories and cognitive impairment trajectories.

Results

Over the course of the first six months post-admission, five physical frailty trajectories [“Consistently Frail” (prevalence: 53.0%), “Consistently Pre-frail” (29.0%), “Worsening Frailty” (7.6%), “Improving Frailty” (5.5%), and “Consistently Robust” (4.8%)] and three cognitive impairment trajectories [“Consistently Severe Cognitive Impairment” (35.5%), “Consistently Moderate Cognitive Impairment” (31.8%), “Consistently Intact/Mild Cognitive Impairment” (32.7%)] were identified. One in five older residents simultaneously followed the trajectories of “Consistently Frail” and “Consistently Severe Cognitive Impairment”. Characteristics associated with higher odds of the “Improving Frailty”, “Worsening Frailty”, “Consistently Pre-frail” and “Consistently Frail” trajectories included greater at-admission cognitive impairment, age ≥ 85 years, admitted from acute hospitals, cardiovascular/metabolic diagnoses, neurological diagnoses, hip or other fractures, and presence of pain. Characteristics associated with higher odds of the “Consistently Moderate Cognitive Impairment” and “Consistently Severe Cognitive Impairment” included worse at-admission physical frailty, neurological diagnoses, hip fracture, and receipt of antipsychotics.

Conclusions

Findings provided information regarding the trajectories of physical frailty, the trajectories of cognitive impairment, the association between the two sets of trajectories, and their association with residents’ characteristics in older adults’ first six months post-admission to U.S. nursing homes. Understanding the trajectory that the residents would most likely follow may provide information to develop a comprehensive care approach tailored to their specific healthcare goals.
A study on the current state and equity level of social participation ability among older adults in Henan Province, China
Authors: Ren Weicun , Chen Dongming , Tarimo Clifford Silver , Tian Qingfeng , Wu Jian , Wang Yinying , Li Shangying
Published: April 2022

Background

The social participation ability among older adults (SPAOA) plays an important role in enhancing their quality of life and utilization of medical services. This study aimed to evaluate the current state and equity level of SPAOA in Henan Province, China, as well as explore the factors associated with the current state and equity level of SPAOA.

Methods

This study analyzed data from the “2019 Henan Provincial Older Adults Ability Assessment Survey”, which included 4,593 older people (over 60 years old). The relationships among the SPAOA indicators were explored using the Structural Equation Model (SEM). The Dynamic Material Element Analysis (DMA) and Logistic Regression (LR) were used to examine the current state of SPAOA and its associated factors. The equity level of SPAOA and its correlated factors were determined using the concentration index and T Theil index.

Results

SPAOA received an overall score of 91.89 ± 9.83. Daily living, perception ability and mental state were positively correlated with SPAOA (r = 0.13, 0.83, 0.11, all P < 0.05). Results of LR indicated that the most significant predictors of SPAOA were age, education level, pre-retirement occupation, and income (all P < 0.05). The concentration index of SPAOA based on age and income were -0.0058 and 0.0096, respectively. SPAOA had a total T Theil index of 0.030–0.031, and the contribution rate of the difference within the group was greater than 94%.

Conclusions

While the overall level of SPAOA has been demonstrated to be outstanding, persons with a higher educational level and income are likely to benefit the most. The observed unequal distribution of SPAOA is primarily related to disparities in age or income within the group. To better serve older adults and improve their position and equity in terms of social participation ability, policymakers could emphasize older males with little income who live in urban areas, as well as unhealthy older females who live in rural residences.
The role and diagnostic accuracy of serology for COVID-19
Authors: Kundu Debasree , Gautam Priyanka , Dayanand Divya , Gunasekaran Karthik , Manesh Abi , Sebastian Merylin , Abhilash Kundavaram P. P. , Zachariah Anand , George Tina , Sathyendra Sowmya , Hansdak Samuel G. , Abraham O. C. , Iyadurai Ramya , Thangakunam Balamugesh , Gupta Richa , Karthik Rajiv , Moorthy Mahesh , Varghese George M.
Published: April 2022

Background

The role and performance of various serological tests for the diagnosis of COVID-19 are unclear. This study aimed to evaluate the performance of seven commercially available serological assays for SARS-CoV-2 antibodies by testing COVID-19 cases and controls.

Methods

Adult patients with fever for > 5 days, admitted to a tertiary-care teaching hospital in South India, were enrolled prospectively between June and December 2020. SARS-CoV-2 RT-PCR confirmed patients were classified as cases, and patients with febrile illness with laboratory-confirmed alternative diagnosis and healthy participants were controls. All participants were tested with SCoV-2 Detect™ IgM ELISA kit and SCoV-2 Detect™ IgG ELISA kit (InBios International, Seattle, USA) (Inbios), SARS-CoV-2 Total and SARS-CoV-2 IgG (Siemens Healthcare Diagnostics Inc., Tarrytown, USA) (Siemens), Roche Elecsys® Anti-SARS-CoV-2 (Roche Diagnostics, Rotkreuz, Switzerland) (Roche), Abbott SARS-CoV-2 IgG (Abbott Diagnostics, IL, USA) (Abbott), and Liaison® SARS-CoV-2 S1/S2 IgG (DiaSorinS.p.A., Saluggia, Italy) (Liaison). The sensitivities, specificities, positive predictive values (PPV), negative predictive values (NPV), and accuracies were compared.

Results

There were 303 participants: 153 cases and 150 controls. ELISA detecting anti-S protein antibody was more sensitive (88.9% for IgG and 86.3% for IgM) than the CLIAs (82.4% for total antibodies and 76.5–85.6% for IgG). Among CLIAs, Roche IgG was most sensitive (85.6%) followed by Abbott (83%) and Liaison (83%). Abbot had the best PPV (88.8%) and was more specific (89.3%) than Liaison (82%) and Roche (82%). Siemens IgG was less sensitive (76.5%) than Siemens Total (82.4%). The specificity of all the serological assays was modest (75–90%). Antibody test positivity increased with the duration of illness reaching 90% after 10 days of illness. When cases were compared against pre-pandemic controls, the IgG gave excellent specificity (98–100%). For seroprevalence studies, InBios IgG had the best accuracy (90.8%) with 88.9% sensitivity and 97.6% specificity.

Conclusion

The serological assays are important adjuncts for the diagnosis of COVID-19 in patients with persistent symptoms, especially in the second week of illness. The value of serological diagnostic tests is limited in the first week of illness and they provide additional value in seroprevalence studies. The diagnostic accuracy of the ELISA and CLIA platforms were comparable.