bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-sectional analysis of whole-brain microstructural changes in adult patients with bipolar and unipolar depression by diffusion kurtosis imaging
Authors: Maralakunte Muniraju , Gupta Vivek , Grover Sandeep , Ahuja Chirag Kamal , Sahoo Swapnajeet , Kishore Kamal , Vyas Sameer , Garg Gaurav , Singh Paramjeet , Govind Varan
Published: July 2022

Rationale and Objectives

More than half of the bipolar depression (BD) subjects are misdiagnosed as unipolar depression (UD) due to lack of objective diagnostic criteria. We aimed to identify microstructural neuronal changes differentiating BD from UD groups using diffusion kurtosis imaging (DKI). The objective of the study is to identify an objective neuro-imaging marker to differentiate BD from UD.

Materials and Methods

A prospective, cross-sectional study included total of 62 subjects with diagnosis of bipolar depression ( n = 21), unipolar depression ( n = 21), and healthy controls ( n = 20). All subjects underwent diffusion-weighted imaging (b = 0,1000,2000) of the whole brain on 3-Tesla MR scanner. DKI data was analyzed using 189 region whole-brain atlas. Eight diffusion and kurtosis metrics including mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), and kurtosis fractional anisotropy (FKA) were measured against these 189 regions. Principle component analysis (PCA) was utilized to identify the most significant regions of the brain. ANOVA with post hoc tests was used for analyzing these regions.

Results

BD group showed increased MD, RD, decreased AK at the left amygdala and decreased MK and RK at the right hemi-cerebellum. UD group showed increased MK and RK at the right external capsule; and increased AK, MK, and RK at the right amygdala.

Conclusion

The right and left amygdala, right external capsule, and right hemi-cerebellum showed microstructural abnormalities capable of differentiating BD and UD groups. Diffusion imaging especially DKI can aid in management of depression patients.
Understanding Motives, Usage Patterns and Effects of Instagram Use in Youths: A Qualitative Study
Authors: Romero Saletti Silvana M. , Van den Broucke Stephan , Van Beggelaer Wendy
Published: July 2022

This article provides an in-depth analysis of the motives and patterns of Instagram use among a sample of Belgian and Peruvian youths. 19 participants aged 18–28 underwent in-depth interviews to assess what Instagram means to them, why and how they use it, and what consequences of their use they perceive. The most recurrent motivations for using Instagram were self-expression, curiosity, documenting, entertainment, and connection. Five distinctive usage patterns were identified: urge and craving, passive use, anxious posting, social approval, and social comparison. The perceived consequences include an increased connection to others, the rise of “ Instagram-worthy” content pursuit, issues with time management, a compulsive urge to enter, and constant comparison. Since Instagram relies mainly on visuals, poses questions about authenticity, identity, and self-presentation, and elicits strong emotional reactions from its users, it fosters social comparison, which may be harmful to youth’s views on themselves, their self-esteem, and their self-worth.
A Multiple Stakeholder Perspective on the Impact of COVID-19 on Dementia Care
Authors: White Carole L. , Masoud Sara S. , Glassner Ashlie A. , Rhodes Shanae , Mendoza Mayra , Meyer Kylie
Published: July 2022

The aim of this study was to describe the impact of the COVID-19 pandemic on dementia care from a multiple stakeholder perspective. We used a multi-method design, with a cross-sectional survey followed by focus groups/interviews. Surveys were completed by people living with dementia (n  =  27), family caregivers (n  =  161), and health and social care professionals (n  =  77). A sub-sample (n  =  55) participated in an interview or one of 9 focus groups. Surveys were analyzed with descriptive statistics and focus group/interview data were analyzed using a thematic approach. Participants reported an impact of COVID-19 on dementia care, including less access to care and resources for care. Telehealth and tele-support/education were reported to be effective alternatives to support care. Themes from the qualitative data about dementia care were: (1) planning and providing care, (2) making choices around risk and safety, (3) experiences of loss, and (4) technology and dementia care. The results of this study present opportunities to improve the quality of care through addressing inequities and identifying improved and innovative approaches to address social isolation and virtual care for this vulnerable population.
Bengali Dalits Speak: A Critical Study of Jatin Bala’s A Verse as a Sharpened Weapon
Authors: Anowar Tarik
Published: July 2022

Dalit literature in India emerged as a movement of Ambedkarite ideology to challenge caste discrimination. Poetry as a popular genre has been adopted by Dalit writers to disseminate revolutionary ideas to bring about a change in society. They significantly unmask how the upper caste Hindus hold the supreme power to ostracize the Namashudras (Dalits) in the name of religion and caste. A Bengali Dalit poet Jatin Bala with a liberal vision and mission, used his words to protest, revolt and negotiate with the domineering ideology. His poetry A Verse as a Sharpened Weapon not only breaks the myth that West Bengal is a casteless society but also carries a note of dissent against the upper caste hegemony. He has successfully constructed the poetic device with aesthetic values to showcase the domination and oppression that Dalits face in Bengal. As a revolutionary poet, Bala breaks the chain of age-old caste oppression and reverberates the message of liberty, equality and fraternity through his verse. The present article examines Jatin Bala’s poetry to explore the theme of exploitation and protest. It also shows how Bala’s poetry becomes the voice of resistance, liberation and emancipation of his community from bondage.
Dalit Women and the Question of Representation: Issues of Caste and Gender
Authors: Gohel Bhavesh R.
Published: July 2022

Gupta (2016) in The gender of caste: Representing Dalits in print points out that media and print are responsible for creating the stereotypical images of Dalit women. They are always represented by their caste identities and not as individuals. Female bodies are represented as closely knit to their caste identities; the characteristic of the caste becomes the representation of the bodies of Dalit women. On the one hand, Dalit women are represented by the upper caste as wicked, cunning, house breakers, immoral, ugly and polluted, and on the other hand, they are represented as weak and passive victims who need care and help to come out of their misery. But it is not the case when the Dalit women represent themselves. So, the question here arises: How are caste and gender related? What is the role of caste in the manipulation of the identity of Dalit women? How is caste identity related to the question of gender and the creation of stereotypes in the context of Dalit women? What are the structures which are working in the formation of stereotypes which are directly or indirectly related to such representations? This paper explores the complex relationship between representation, caste and gender concerning the representation of Dalit women through the analysis of Joseph Macwan’s The Stepchild.
Honorific personal pronouns in the Tangut language
Authors: Hongyin Nie
Published: July 2022

There is an integral system of personal pronouns in the Tangut language. It is already known that there are pairs of general and honorific pronouns in the first- and second-person singular. Besides narrating the meaning of the honorifics in detail, it is pointed out in the present paper that a parallel distinction exists in the first-person plural as well, and if more than two pronouns of the same person appear successively in one phrase, only the preceding one may be expressed by an honorific form. There is no honorific form for the pronoun of the second-person plural.
An explanation on forms of the character yōng[雝] and how lìbiàn[隸變] causing yōng [雝] to yōng[雍]
Authors: Li Jinyan , Li Fa
Published: July 2022

As known that there are several different variants related to the character yōng[雝] in Oracle Bone Inscriptions. One of them was written as one rectangle above the other, referring to two words yōng 雝 and lǚ 呂, which reflects the phenomenon of ‘一形多用’ (graphs having multiple uses) in early days of Chinese characters. In addition, two distinct forms of the writings yōng 雝 and yōng 雍 often appeared in Chinese ancient books. Most scholars are confused by the appearance of yōng 雝 and yōng 雍 and think that the two characters can be used interchangeably. By combing the clues of them, however, we found that the character yōng 雝 was mainly used in the Pre-Han dynasty. The mixed-use of characters was caused by the change from yōng 雝 to yōng 雍 in Han dynasty. In this context, we intend to correct some errors in the use of the two characters in ancient books.
Knowledge, attitudes and practices of clinical pharmacists to medication error reporting in ministry of health and population hospitals in Egypt
Authors: Youssef Elshoura Shymaa Mahmoud , Mosallam Rasha Ali
Published: July 2022

Objective

This study aimed to assess the knowledge, attitudes and practices toward medication errors (MEs) reporting among pharmacists working in Ministry of Health and Population (MOHP) hospitals in Alexandria.

Methods

A cross-sectional study was conducted among all pharmacists who are responsible for reporting medication errors in the Egyptian online reporting system (NO HARMe).

Results

The majority of pharmacists received training on MEs reporting using the Egyptian online reporting system. Around half of the pharmacists knew the correct definition for medication errors. All respondents were aware of the presence of a MEs reporting system in Egypt. Clinical pharmacists’ attitudes towards MEs reporting was favorable with an overall mean score of 4.20 ± 0.73 in a score ranging from 1 (most unfavorable attitudes score) to 5 (most favorable score). Only 60.7% of the surveyed pharmacists used the system to report MEs. Antibiotics were the most frequent drug category reported and the prescribing stage was the stage in which pharmacists perceived the greatest volume of reports were made (89.3% and 71.4%, respectively). Lack of time was the most frequently identified barrier to reporting, followed by lack of feedback to the report submitted (73.2%, 54.5%, respectively). Inconsistent with the results of other studies, fear from legal consequences and being recognized as an incompetent provider was reported by only 12.5% and 11.6% of pharmacists, respectively.

Conclusion

The majority of pharmacists have good knowledge and favorable attitudes towards medication error reporting, however around two fifths do not report medication errors.
Comparative efficacy and tolerability of novel agents vs chemotherapy in relapsed and refractory T-cell lymphomas: a meta-analysis
Authors: Shafagati Nazila , Koh Min J. , Boussi Leora , Park Hyun J. , Stuver Robert , Bain Paul , Foss Francine M. , Shen Changyu , Jain Salvia
Published: July 2022

Optimal treatment strategies for (relapsed and refractory [R/R]) peripheral T-cell lymphoma (PTCL) have not been well defined, and with the approval of several novel single agents (SA), the comparative efficacy of combination chemotherapy (CC) to single-agent strategies remains unclear. We conducted a meta-analysis to evaluate overall response rates (ORR) and toxicities of SA to CC. MEDLINE, Embase, Web of Science Core Collection, and Cochrane were systematically searched for phase I, phase II, and phase III trials investigating a defined SA or an anthracycline-, ifosfamide-, gemcitabine-, and platinum-based regimens. One hundred and fifty-one articles were included, encompassing single and combinations of 60 phase I trials involving 1075 patients, 95 phase II trials involving 3246, and 23 phase III trials involving 1888 patients. There was a high degree of heterogeneity in the trials. Using a random-effects model, the estimated ORR for SA in phase I trials were 40% (95% confidence interval [CI], 34.7%, 46.9%) relative to 41% for CC (95% CI, 27.4%, 56.1%; P = .97) and in phase II trials 34.4% (95% CI, 30.4%, 38.7%) for SA vs 55.3% (95% CI, 31%, 77.2%; P = .1) for CC. There were significant subgroup differences in ORR between histological subtypes of PTCL and drug classes. Our results highlight SA as an attractive outpatient option for R/R PTCL, and their incorporation in the development of upfront treatment paradigms merits urgent consideration. Our results underscore enrollment in clinical trials of SA as a critical strategy for R/R PTCL.
Individual dynamic prediction of clinical endpoint from large dimensional longitudinal biomarker history: a landmark approach
Authors: Devaux Anthony , Genuer Robin , Peres Karine , Proust-Lima Cécile
Published: July 2022

Background

The individual data collected throughout patient follow-up constitute crucial information for assessing the risk of a clinical event, and eventually for adapting a therapeutic strategy. Joint models and landmark models have been proposed to compute individual dynamic predictions from repeated measures to one or two markers. However, they hardly extend to the case where the patient history includes much more repeated markers. Our objective was thus to propose a solution for the dynamic prediction of a health event that may exploit repeated measures of a possibly large number of markers.

Methods

We combined a landmark approach extended to endogenous markers history with machine learning methods adapted to survival data. Each marker trajectory is modeled using the information collected up to the landmark time, and summary variables that best capture the individual trajectories are derived. These summaries and additional covariates are then included in different prediction methods adapted to survival data, namely regularized regressions and random survival forests, to predict the event from the landmark time. We also show how predictive tools can be combined into a superlearner. The performances are evaluated by cross-validation using estimators of Brier Score and the area under the Receiver Operating Characteristic curve adapted to censored data.

Results

We demonstrate in a simulation study the benefits of machine learning survival methods over standard survival models, especially in the case of numerous and/or nonlinear relationships between the predictors and the event. We then applied the methodology in two prediction contexts: a clinical context with the prediction of death in primary biliary cholangitis, and a public health context with age-specific prediction of death in the general elderly population.

Conclusions

Our methodology, implemented in R, enables the prediction of an event using the entire longitudinal patient history, even when the number of repeated markers is large. Although introduced with mixed models for the repeated markers and methods for a single right censored time-to-event, the technique can be used with any other appropriate modeling technique for the markers and can be easily extended to competing risks setting.
Telemonitoring for COVID-19 positive pregnant women; feasibility and user experience of SAFE@home Corona: prospective pilot study
Authors: Moes Shinta L. , Depmann Martine , Lely Titia A. , Bekker Mireille N.
Published: July 2022

Background

COVID-19 has catalysed digital innovations enabling remote healthcare. Pregnant women are at increased risk for severe course of COVID-19 infection. Also, the pandemic has a negative emotional impact on pregnant women as they worry about their own health and the health of their unborn child. We developed a telemonitoring platform called SAFE@home-corona consisting of a pulse oximeter and an app with symptom checklist. The aim of this study was to examine the feasibility, defined by compliance to the platform and by monitoring the course of COVID-19, patient satisfaction and user experience of a telemonitoring platform in COVID-19 positive pregnant women in the Netherlands.

Methods

We conducted a prospective pilot study among Dutch-speaking COVID-19 symptomatic pregnant women. Women were asked to monitor their oxygen-saturation with a pulse oximeter and COVID-related complaints with an in-app questionnaire daily. Oxygen-saturation and complaints were monitored by the Medical Management Centre with triage protocol. COVID-19, pregnancy, and user experience data were collected. To assess feasibility, compliance of daily self-monitoring and compliance of all intended measurements were calculated. Severity of COVID-19 was assessed via the platform and medical record. Patient satisfaction and user experience were measured through a self-developed questionnaire.

Results

Twenty-eight women were eligible of which 27 (93.1%) completed the study. Compliance of daily measurement and all intended measurements was high with 98.9 and 93.9%, respectively. Six women were hospitalized, of whom one to the intensive care unit. Overall, women indicated high satisfaction scores, varying from 8 to 10/10. Women were more concerned for the health of their unborn child or family then for themselves (66.7%). They stated that the platform offered reassurance. Patients would highly recommend the platform to pregnant peers during COVID infection.

Conclusions

This pilot study demonstrated feasibility of the SAFE@home-corona platform for self-monitoring COVID-19 course in pregnant women. Patients were satisfied, it offered reassurance, women would recommend use to peers. Upscaling the platform is needed to draw conclusions from the early signalling abilities and to keep evaluating patient satisfaction. The platform has great potential for self-monitoring of COVID-19 and possibly other pulmonary infections in pregnant women.
The effectiveness of different education methods conducted at different times for decreasing the time required for a parturient to position herself for epidural placement
Authors: Yang Chen , Cheng Yan , Hu Jianying , Lu Yaojun , Yu Xinhua , Huang Shaoqiang
Published: July 2022

Background

Decreasing the anaesthesia preparation time for primiparas experiencing painful uterine contractions is clinically relevant. This prospective intervention study investigated the effect of various educational methods conducted at different times on body positioning for primiparas undergoing labour analgesia.

Methods

Ninety primiparas who were about to receive labour analgesia were randomly divided into a verbal instruction group, a photo instructions group, and an educational video group for immediate education, and 60 primiparas who were willing to receive labour analgesia but were not in labour were randomly divided into a photo instruction group and an educational video group for advance education. The times required for body positioning were compared.

Results

In the immediate education cohort, the body positioning time in the verbal group (50.48 ± 28.97 s) was significantly longer than those in the photo group (30.47 ± 6.94 s) and the video group (23.14 ± 9.74 s) (P = 0.00). In the advance education cohort, the time in the photo group (17.47 ± 6.48 s) was longer than that in the video group (13.71 ± 7.01 s) (P = 0.042). Whether photos or videos are used, advance education can significantly decrease body positioning time.

Conclusions

Video or photo education for primiparas who are about to receive labour analgesia can decrease the body positioning time and is more effective when provided in advance.
Parental psychosocial factors, unmet dental needs and preventive dental care in children and adolescents with special health care needs: A stress process model
Authors: Gazzaz Arwa Z. , Carpiano Richard M. , Laronde Denise M. , Aleksejuniene Jolanta
Published: July 2022

Background

Children and adolescents with special health care needs (SHCN) have higher unmet dental needs, but the potential mechanisms by which parental factors can influence dental care use have not been determined. Parenting a child with SHCN can present special demands that affect parents’ well-being and, in turn, their caregiving. Hence, the study's overall aim was to apply the stress process model to examine the role of parental psychosocial factors in the association between child SHCN and dental care. Specifically, the study tested hypotheses regarding how (a) children’s SHCN status is associated with child dental care (unmet dental needs and lack of preventive dental visits), both directly and indirectly via parental psychosocial factors (parenting stress, instrumental, and emotional social support) and (b) parental social support buffers the association between parenting stress and child dental care.

Methods

A secondary data analysis of the 2011–2012 US National Survey of Children’s Health was performed for 6- to 11-year-old children (n = 27,874) and 12- to 17-year-old adolescents (n = 31,328). Our age-stratified models estimated associations between child SHCN status and parental psychosocial factors with two child dental care outcomes: parent-reported unmet child dental needs and lack of preventive dental care.

Results

Parents of children with (vs without) SHCN reported higher unmet child dental needs, higher parenting stress, and lower social support (instrumental and emotional). Instrumental, but not emotional, parental support was associated with lower odds of their child unmet dental needs in both age groups. The association between parenting stress and child dental care outcomes was modified by parental social support.

Conclusion

Differences existed in child unmet dental needs based on SHCN status, even after adjusting for parental psychosocial factors. SHCN status was indirectly associated with unmet dental needs via parental instrumental support among adolescents, and parental instrumental support buffered the negative association between parenting stress and both child dental care outcomes. Hence, parental social support was an important determinant of child dental care and partially explained the dental care disparities in adolescents with SHCN.
Qin Huang formula enhances the effect of Adriamycin in B-cell lymphoma via increasing tumor infiltrating lymphocytes by targeting toll-like receptor signaling pathway
Authors: Li Weili , Lv Lingling , Ruan Ming , Xu Jiayue , Zhu Wenhua , Li Qiong , Jiang Xufeng , Zheng Lan , Zhu Weirong
Published: July 2022

Background

As an original traditional Chinese medicinal formula, Qin Huang formula (QHF) is used as adjuvant therapy for treating lymphoma in our hospital and has proven efficacy when combined with chemotherapy. However, the underlying mechanisms of QHF have not been elucidated.

Methods

A network pharmacological-based analysis method was used to screen the active components and predict the potential mechanisms of QHF in treating B cell lymphoma. Then, a murine model was built to verify the antitumor effect of QHF combined with Adriamycin (ADM) in vivo. Finally, IHC, ELISA,18F-FDG PET-CT scan, and western blot were processed to reveal the intriguing mechanism of QHF in treating B cell lymphoma.

Results

The systemic pharmacological study revealed that QHF took effect following a multiple-target and multiple-pathway pattern in the human body. In vivo study showed that combination therapy with QHF and ADM potently inhibited the growth of B cell lymphoma in a syngeneic murine model, and significantly increased the proportion of tumor infiltrating CD4+ and CD8+ T cells in the tumor microenvironment (TME). Furthermore, the level of CXCL10 and IL-6 was significantly increased in the combination group. Finally, the western blot exhibited that the level of TLR2 and p38 MAPK increased in the combination therapy group.

Conclusion

QHF in combination of ADM enhances the antitumor effect of ADM via modulating tumor immune microenvironment and can be a combination therapeutic strategy for B cell lymphoma patients.
Quantitative comparison between carotid plaque hardness and histopathological findings: an observational study
Authors: Fukushima Daisuke , Kondo Kosuke , Harada Naoyuki , Terazono Sayaka , Uchino Kei , Shibuya Kazutoshi , Sugo Nobuo
Published: July 2022

Background

Plaque hardness in carotid artery stenosis correlates with cerebral infarction. This study aimed to quantitatively compare plaque hardness with histopathological findings and identify the pathological factors involved in plaque hardness.

Methods

This study included 84 patients (89 lesions) undergoing carotid endarterectomy (CEA) at our institution. Plaque hardness was quantitatively measured immediately after excision using a hardness meter. Collagen and calcification were evaluated as the pathological factors. Collagen was stained with Elastica van Gieson stain, converted to a gray-scale image, and displayed in a 256-step histogram. The median gray-scale median (GSM) was used as the collagen content. The degree of calcification was defined by the hematoxylin–eosin stain as follows: "0:" no calcification, "1:" scattered microcalcification, or "2:" calcification greater than 1 mm or more than 2% of the total calcification. Carotid echocardiographic findings, specifically echoluminance or the brightness of the narrowest lesion of the plaque, classified as hypo-, iso-, or hyper-echoic by comparison with the intima-media complex surrounding the plaque, and clinical data were reviewed.

Results

Plaque hardness was significantly negatively correlated with GSM [Spearman's correlation coefficient: -0.7137 (p < 0.0001)]: the harder the plaque, the higher the collagen content. There were significant differences between plaque hardness and degree of calcification between "0" and "2" (p = 0.0206). For plaque hardness and echoluminance (hypo-iso-hyper), significant differences were found between hypo-iso (p = 0.0220), hypo-hyper (p = 0.0006), and iso-hyper (p = 0.0015): the harder the plaque, the higher the luminance. In single regression analysis, GSM, sex, and diabetes mellitus were significant variables, and in multiple regression analysis, only GSM was extracted as a significant variable.

Conclusions

Plaque hardness was associated with a higher amount of collagen, which is the main component of the fibrous cap. Greater plaque hardness was associated with increased plaque stability. The degree of calcification may also be associated with plaque hardness.
Integrated PERSEVERE and endothelial biomarker risk model predicts death and persistent MODS in pediatric septic shock: a secondary analysis of a prospective observational study
Authors: Atreya Mihir R. , Cvijanovich Natalie Z. , Fitzgerald Julie C. , Weiss Scott L. , Bigham Michael T. , Jain Parag N. , Schwarz Adam J. , Lutfi Riad , Nowak Jeffrey , Allen Geoffrey L. , Thomas Neal J. , Grunwell Jocelyn R. , Baines Torrey , Quasney Michael , Haileselassie Bereketeab , Lindsell Christopher J. , Alder Matthew N. , Wong Hector R.
Published: July 2022

Background

Multiple organ dysfunction syndrome (MODS) is a critical driver of sepsis morbidity and mortality in children. Early identification of those at risk of death and persistent organ dysfunctions is necessary to enrich patients for future trials of sepsis therapeutics. Here, we sought to integrate endothelial and PERSEVERE biomarkers to estimate the composite risk of death or organ dysfunctions on day 7 of septic shock.

Methods

We measured endothelial dysfunction markers from day 1 serum among those with existing PERSEVERE data. TreeNet® classification model was derived incorporating 22 clinical and biological variables to estimate risk. Based on relative variable importance, a simplified 6-biomarker model was developed thereafter.

Results

Among 502 patients, 49 patients died before day 7 and 124 patients had persistence of MODS on day 7 of septic shock. Area under the receiver operator characteristic curve (AUROC) for the newly derived PERSEVEREnce model to predict death or day 7 MODS was 0.93 (0.91–0.95) with a summary AUROC of 0.80 (0.76–0.84) upon tenfold cross-validation. The simplified model, based on IL-8, HSP70, ICAM-1, Angpt2/Tie2, Angpt2/Angpt1, and Thrombomodulin, performed similarly. Interaction between variables—ICAM-1 with IL-8 and Thrombomodulin with Angpt2/Angpt1—contributed to the models’ predictive capabilities. Model performance varied when estimating risk of individual organ dysfunctions with AUROCS ranging from 0.91 to 0.97 and 0.68 to 0.89 in training and test sets, respectively.

Conclusions

The newly derived PERSEVEREnce biomarker model reliably estimates risk of death or persistent organ dysfunctions on day 7 of septic shock. If validated, this tool can be used for prognostic enrichment in future pediatric trials of sepsis therapeutics.

Graphical abstract
Metagenomic prediction of antimicrobial resistance in critically ill patients with lower respiratory tract infections
Authors: Serpa Paula Hayakawa , Deng Xianding , Abdelghany Mazin , Crawford Emily , Malcolm Katherine , Caldera Saharai , Fung Monica , McGeever Aaron , Kalantar Katrina L. , Lyden Amy , Ghale Rajani , Deiss Thomas , Neff Norma , Miller Steven A. , Doernberg Sarah B. , Chiu Charles Y. , DeRisi Joseph L. , Calfee Carolyn S. , Langelier Charles R.
Published: July 2022

Background

Antimicrobial resistance (AMR) is rising at an alarming rate and complicating the management of infectious diseases including lower respiratory tract infections (LRTI). Metagenomic next-generation sequencing (mNGS) is a recently established method for culture-independent LRTI diagnosis, but its utility for predicting AMR has remained unclear. We aimed to assess the performance of mNGS for AMR prediction in bacterial LRTI and demonstrate proof of concept for epidemiological AMR surveillance and rapid AMR gene detection using Cas9 enrichment and nanopore sequencing.

Methods

We studied 88 patients with acute respiratory failure between 07/2013 and 9/2018, enrolled through a previous observational study of LRTI. Inclusion criteria were age ≥ 18, need for mechanical ventilation, and respiratory specimen collection within 72 h of intubation. Exclusion criteria were decline of study participation, unclear LRTI status, or no matched RNA and DNA mNGS data from a respiratory specimen. Patients with LRTI were identified by clinical adjudication. mNGS was performed on lower respiratory tract specimens. The primary outcome was mNGS performance for predicting phenotypic antimicrobial susceptibility and was assessed in patients with LRTI from culture-confirmed bacterial pathogens with clinical antimicrobial susceptibility testing (n = 27 patients, n = 32 pathogens). Secondary outcomes included the association between hospital exposure and AMR gene burden in the respiratory microbiome (n = 88 patients), and AMR gene detection using Cas9 targeted enrichment and nanopore sequencing (n = 10 patients).

Results

Compared to clinical antimicrobial susceptibility testing, the performance of respiratory mNGS for predicting AMR varied by pathogen, antimicrobial, and nucleic acid type sequenced. For gram-positive bacteria, a combination of RNA + DNA mNGS achieved a sensitivity of 70% (95% confidence interval (CI) 47–87%) and specificity of 95% (CI 85–99%). For gram-negative bacteria, sensitivity was 100% (CI 87–100%) and specificity 64% (CI 48–78%). Patients with hospital-onset LRTI had a greater AMR gene burden in their respiratory microbiome versus those with community-onset LRTI (p = 0.00030), or those without LRTI (p = 0.0024). We found that Cas9 targeted sequencing could enrich for low abundance AMR genes by > 2500-fold and enabled their rapid detection using a nanopore platform.

Conclusions

mNGS has utility for the detection and surveillance of resistant bacterial LRTI pathogens.
An assessment of current concussion identification and diagnosis methods in sports settings: a systematic review
Authors: Daly Ed , Pearce Alan J. , Finnegan Emma , Cooney Ciara , McDonagh Maria , Scully Grainne , McCann Michael , Doherty Rónán , White Adam , Phelan Simon , Howarth Nathan , Ryan Lisa
Published: July 2022

Background

Concussion in sport is an ongoing global concern. The head injury assessment (HIA) by the field of play is acknowledged as the first step in recognising and identifying concussion. While previous systematic literature reviews have evaluated the sensitivity of side-line screening tools and assessment protocols, no systematic review has evaluated the research designs and assessments used in a field setting. This systematic review investigated existing screening and diagnostic tools used in research as part of the HIA protocol to identify concussion that are currently used in professional, semi-professional and amateur (club) sports settings.

Methods

A systematic searching of relevant databases was undertaken for peer-reviewed literature between 2015 and 2020.

Results

Twenty-six studies met the inclusion criteria. Studies were of moderate to good quality, reporting a variety of designs. The majority of studies were undertaken in professional/elite environments with medical doctors and allied health practitioners (e.g., physical therapists) involved in 88% of concussion assessments. While gender was reported in 24 of the 26 studies, the majority of participants were male (77%). There was also a variety of concussion assessments (n = 20) with the sports concussion assessment tool (SCAT) used in less than half of the included studies.

Conclusion

The majority of studies investigating concussion HIAs are focused on professional/elite sport. With concussion an issue at all levels of sport, future research should be directed at non-elite sport. Further, for research purposes, the SCAT assessment should also be used more widely to allow for consistency across studies.
Higher order Kantorovich-type Szász–Mirakjan operators
Authors: Sabancigil Pembe , Kara Mustafa , Mahmudov Nazim I.
Published: July 2022

In this paper, we define new higher order Kantorovich-type Szász–Mirakjan operators, we give some approximation properties of these operators in terms of various moduli of continuity. We prove a local approximation theorem, a Korovkin-type theorem, and a Voronovskaja-type theorem. We also prove weighted approximation theorems for these new operators.
Investigating the Hybrid Effect of Micro-steel Fibres and Polypropylene Fibre-Reinforced Magnesium Phosphate Cement Mortar
Authors: Feng Hu , Shao Qi , Yao Xupei , Li Lulu , Yuan Chengfang
Published: July 2022

To overcome the drawbacks caused by the intrinsic brittleness of cementitious materials, various types of fibres were incorporated as reinforcements. Extensive research on Ordinary Portland cement indicated that compared with the use of a single type of fibres, the mixed-use of multiple fibres can significantly improve both strength and toughness of the cementitious composites, which is referred to as the hybrid effect. However, such hybrid effect in multiple fibre-reinforced magnesium phosphate cement-based composite (HFRMC) still lack quantitative understanding. Therefore, this study conducted a series of experiments, including slump flow tests, compression tests, four-point bending tests and microstructure analysis, to investigate the hybrid effect of micro-steel fibres (MSF) and polypropylene (PP) fibres in HFRMC. Two types of mixed designs of HFRMC were conducted: 1. total fibres fraction (including both PP fibres and MSF) was fixed to be 1.6%; 2. PP fibres fraction was fixed to be 1.6% with different addition of MSF. Our results indicated that the slump flow of magnesium phosphate cement mortar varied around 7.6–8.8% with the hybrid use of MSF and PP fibres, while the flexural strength and toughness increased around 13.7–23.1% and 1.6–45.9%, respectively.
Effect of protease supplementation on apparent ileal crude protein and amino acid digestibility of over-processed soybean meals in broilers
Authors: Salazar-Villanea Sergio , Astúa-Ureña Maikol , Masís-Montoya Allison , Herrera-Muñoz Juan I. , Salas-Durán Catalina
Published: July 2022

Background

Nutritional value of proteins in feed ingredients can be negatively affected by hydrothermal processing, which causes large variation in the bioavailability of amino acids (AA) and negatively affects animal productive performance. Supplementation of exogenous proteases could increase the rate of digestion of damaged proteins, thereby increasing overall AA digestibility and bioavailability. The aim was to determine the effect of exogenous protease supplementation on the apparent ileal digestibility (AID) of crude protein (CP) and AA of soybean meals (SBM) with different degrees of hydrothermal processing in broilers.

Methods

The experiment involved a 3 × 2 factorial arrangement, with SBM processing time (commercial SBM or autoclaved for 30 or 60 min at 120 °C) and protease supplementation (not supplemented and supplemented) as factors. Protease was included at three times the recommended dose (0.06%) and the experimental diets were fed from 15 to 21 d.

Results

The interaction between the effects of SBM processing and protease supplementation was significant for the AID of CP (P = 0.01), Trp (P = 0.01), Gly (P = 0.03) and Pro (P = 0.03), and also for the average daily gain (P = 0.01) and feed conversion ratio (P = 0.04). Increasing the processing time of SBM decreased (P < 0.0001) the AID of all amino acids, whilst the effect of protease supplementation was only significant for the AID of Phe (P = 0.02) and Tyr (P = 0.01).

Conclusions

Exogenous protease supplementation at three times the commercial dose does not seem to offset the negative effects of hydrothermal processing of SBM on the apparent ileal digestibility of CP and amino acids or performance of broilers. Whilst positive numerical improvements of digestibility and performance (ADG and FCR) were noticed with protease supplementation at relatively mild processing levels, negative results were obtained with the harsh-processed meals.
Long-term work disability due to type I and II bipolar disorder: findings of a six-year prospective study
Authors: Arvilommi Petri , Pallaskorpi Sanna , Linnaranta Outi , Suominen Kirsi , Leppämäki Sami , Valtonen Hanna , Isometsä Erkki
Published: July 2022

Background

Bipolar disorder (BD) is one of the leading causes of disability worldwide. However, the prevalence and predictors of long-term work disability among patients with type I and II BD have scarcely been studied. We investigated the clinical predictors of long-term work disability among patients with BD.

Methods

The Jorvi Bipolar Study (JoBS) is a naturalistic prospective cohort study (n = 191) of adult psychiatric in- and out-patients with DSM-IV type I and II BD in three Finnish cities. Within JoBS we examined the prevalence and predictors of disability pension being granted during a six-year follow-up of the 152 patients in the labor force at baseline and collected information on granted pensions from national registers. We determined the predictors of disability pension using logistic regression models.

Results

Over the 6 years, 44% of the patients belonging to the labor force at baseline were granted a disability pension. Older age; type I BD; comorbidity with generalized anxiety disorder, post-traumatic stress disorder or avoidant personality disorder; and duration of time with depressive or mixed symptoms predicted disability pensions. Including disability pensions granted before baseline increased their total prevalence to 55.5%. The observed predictors were similar.

Conclusion

This regionally representative long-term prospective study found that about half of patients with type I or II bipolar disorder suffer from persistent work disability that leads to disability pension. In addition to the severity of the clinical course and type I bipolar disorder, the longitudinal accumulation of time depressed, psychiatric comorbidity, and older age predicted pensioning.
Gender and sociocultural factors in animal source foods (ASFs) access and consumption in lower-income households in urban informal settings of Nairobi, Kenya
Authors: Bukachi Salome A. , Ngutu Mariah , Muthiru Ann W. , Lépine Aurélia , Kadiyala Suneetha , Domínguez-Salas Paula
Published: July 2022

Background

Gender shapes household decision-making and access for nutritious diets, including animal source foods (ASFs) that impact on child health and nutrition status. However, research shows that the poorest households in the urban informal settlements of Nairobi have low ASFs consumption. This study was conducted to explore further from a qualitative perspective the gender, sociocultural factors affecting household ASF consumption this study.

Methods

To explore further on the topic of study, an exploratory qualitative study was carried out to establish the factors that influence access, allocation and consumption of animal source foods (ASFs) by households in urban informal settings of Nairobi. Nineteen focus group discussions with men and women were conducted to enable in-depth exploration of ASFs consumption.

Results

Gender influences decision-making of household ASFs dietary intake. Gendered power dynamics prevail with men as breadwinners and household heads often determining the food access and consumption of ASFs. Women are increasingly accessing short-term waged-based incomes in urban informal settings and now play a role in food and nutrition security for their households. This enforces the idea that women’s decision-making autonomy is an important aspect of women empowerment, as it relates to women’s dietary diversity and subsequently, better household nutritional status. As evidenced in this study, if a woman has bargaining power based on accessing incomes to support their household food needs, she will not jeopardize food security. The mobile digital money platform was key in enabling access to resources to access food. Use of trust to access food on credit and purchasing smaller packaged quantities of food were also enablers to access of food/ASFs.
Assessing the meaningful change threshold of Quality of Life in Depression Scale using data from two phase 3 studies of esketamine nasal spray
Authors: Rozjabek Heather , Li Nan , Hartmann Holger , Fu Dong Jing , Canuso Carla , Jamieson Carol
Published: July 2022

Background

Major depressive disorder (MDD) directly impacts patients’ lives including symptoms, functioning and health-related quality-of-life (HRQoL). Patient-reported outcomes can capture these impacts, however interpretation of clinical meaningfulness of these measurements are often not readily available. Meaningful change thresholds (MCTs) can be derived for clinical outcome assessments to quantify the change in symptoms that is meaningful to the patient following pharmacologic treatment or other interventions. The objective of this analysis was to determine the within-patient MCT of the self-reported Quality-of-Life in Depression Scale (QLDS) among patients with MDD and active suicidal ideation with intent (MDSI) using an anchor-based approach.

Methods

Data from 2 randomized phase-3 trials of esketamine nasal spray (ASPIRE I and ASPIRE II) were analyzed. The Montgomery–Åsberg Depression Rating Scale (MADRS) was the primary anchor with three different severity criteria. Other anchor variables utilized were Clinical Global Impression of Severity of Suicidality-revised version, Clinical Global Impression of Imminent Suicide Risk, and EuroQol Visual Analog Scale [EQ-VAS]. Spearman correlation coefficients between the change in QLDS and anchor variables were calculated. The mean change in QLDS score at Day 25 from baseline was calculated based on the categorical change in the anchor. Coefficient yield from linear regression of the mean changes in EQ-VAS and QLDS, and distribution-based approach with ½ SD of change in QLDS were considered.

Results

In ASPIRE I, mean (SD) improvement in QLDS score among patients with one category improvement in MADRS from baseline to Day 25 was − 8.22 (8.87), − 8.30 (9.01), and − 8.20 (8.92) using severity criteria #1, #2, and #3, respectively. Patients who achieved a 7-point improvement (MCT) in EQ-VAS yielded a mean − 9.69-point improvement in QLDS at Day 25. The ½ SD of change in QLDS was 5.63. Similar results were obtained for ASPIRE II. The MCTs identified using multiple anchors across both trials ranged from − 11.4 to − 6.7 and had an overall mean of − 7.90 (ASPIRE I) and − 7.92 (ASPIRE II). Thus, an 8-point change was recommended as the MCT for QLDS.

Conclusion

The recommended MCT will help quantify within-person changes in HRQoL using patient-reported QLDS and determine meaningful treatment benefit in an MDD patient population with acute suicidal ideation or behavior.

Trial registration: Name of the registry: ClinicalTrials.gov. Trial registration number: ASPIRE I (NCT03039192), ASPIRE II (NCT03097133). Date of registration: February 01, 2017; March 31, 2017. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT03039192; https://clinicaltrials.gov/ct2/show/NCT03097133.
Dental arch form and arch dimensions among a group of Egyptian children and adolescents
Authors: Sharaf Rasha F. , Radwan Ehab , Salem Ghada A. , Abou El-yazeed Mohamed
Published: July 2022

Background

Growth and development of the dental arch is considered a continuous and complex biological process. During transition from primary to mixed then to permanent dentition, dental arch form, length and width vary, due to tooth movement and vertical growth of alveolar process. These naturally occurring changes, which happen in untreated individuals, have been used as a comparative standard to assist in diagnosis and treatment planning of children with malocclusion. Therefore, the aim of the current study was to analyze dental arch dimensions in Egyptian children and adolescents with normal occlusion in primary, mixed, and permanent dentitions as well as detection of the most common forms of the dental arches among a group of Egyptian children and adolescents.

Results

Results showed that lower and upper arch lengths showed increase during transition from mixed to permanent dentition. A small increase in lower anterior arch length was recorded during transition from primary (4.63) to mixed dentition (4.70), while reduction of upper anterior arch length was observed during transition from primary (8.35) to mixed dentitions. An increase in anterior arch length was observed in both arches during transition from mixed to permanent dentitions (from 4.70 to 5.42 in the mandible and from7.92 to 9.90 in the maxilla). Arch perimeter, intercanine width, intermolar width increased in the upper and lower arches during transition between dentition till reaching the permanent dentition. It was also found that the ovoid arch form (58%) and square arch form (29%) were the most prevalent among Egyptian children and adolescents followed by the tapered arch form (13%).

Conclusions

Dental arch measurements of Egyptian children and adolescents can be used as a guide for treatment planning of Egyptian children and can be used in further studies to provide standard values for the arch dimensions of the Egyptian children. Regarding the arch form, the ovoid arch form was the most common among the Egyptian population followed by the square while the tapered arch form was the least common one.