bluuebunny/crossref_metadata_2025 huggingface dataset:
Ranked determinants of telemedicine diabetic retinopathy screening performance in the United States primary care safety-net setting: an exploratory CART analysis
Authors: Ware S. Lee , Studts Christina R. , Lei Feitong , Bush Heather , Higgins Eric B. , Studts Jamie L. , Bastos de Carvalho Ana
Published: April 2022

Background

Diabetic retinopathy (DR) is a leading cause of blindness worldwide, despite easy detection and effective treatment. Annual screening rates in the USA remain low, especially for the disadvantaged, which telemedicine-based DR screening (TDRS) during routine primary care has been shown to improve. Screening rates from such programs have varied, however, pointing to inconsistent implementation and unaddressed barriers. This work seeks to identify and prioritize modifiable barriers for targeted intervention.

Methods

In this final phase of an exploratory mixed-methods study, we developed, validated, and administered a 62-item survey to multilevel stakeholders involved with TDRS in primary care safety-net clinics. Survey items were aligned with previously identified determinants of clinic-level screening and mapped to the Consolidated Framework for Implementation Research (CFIR). Classification and Regression Tree (CART) analyses were used to identify and rank independent variables predictive of individual-level TDRS screening performance.

Results

Overall, 133 of the 341 invited professionals responded (39%), representing 20 safety-net clinics across 6 clinical systems. Respondents were predominately non-Hispanic White (77%), female (94%), and between 31 and 65 years of age (79%). Satisfaction with TDRS was high despite low self-reported screening rates. The most important screening determinants were: provider reinforcement of TDRS importance; explicit instructions by providers to staff; effective reminders; standing orders; high relative priority among routine diabetic measures; established TDRS workflows; performance feedback; effective TDRS champions; and leadership support.

Conclusions

In this survey of stakeholders involved with TDRS in safety-net clinics, screening was low despite high satisfaction with the intervention. The best predictors of screening performance mapped to the CFIR constructs Leadership Engagement, Compatibility, Goals & Feedback, Relative Priority, Champions, and Available Resources. These findings facilitate the prioritization of implementation strategies targeting determinants of TDRS performance, potentially increasing its public health impact.
Rapidly improving acute respiratory distress syndrome in COVID-19: a multi-centre observational study
Authors: Gavrielatou Evdokia , Vaporidi Katerina , Tsolaki Vasiliki , Tserlikakis Nikos , Zakynthinos George E. , Papoutsi Eleni , Maragkuti Aikaterini , Mantelou Athina G. , Karayiannis Dimitrios , Mastora Zafeiria , Georgopoulos Dimitris , Zakynthinos Epaminondas , Routsi Christina , Zakynthinos Spyros G. , Schenck Edward J. , Kotanidou Anastasia , Siempos Ilias I.
Published: April 2022

Background

Before the pandemic of coronavirus disease (COVID-19), rapidly improving acute respiratory distress syndrome (ARDS), mostly defined by early extubation, had been recognized as an increasingly prevalent subphenotype (making up 15–24% of all ARDS cases), associated with good prognosis (10% mortality in ARDSNet trials). We attempted to determine the prevalence and prognosis of rapidly improving ARDS and of persistent severe ARDS related to COVID-19.

Methods

We included consecutive patients with COVID-19 receiving invasive mechanical ventilation in three intensive care units (ICU) during the second pandemic wave in Greece. We defined rapidly improving ARDS as extubation or a partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO2:FiO2) greater than 300 on the first day following intubation. We defined persistent severe ARDS as PaO2:FiO2 of equal to or less than 100 on the second day following intubation.

Results

A total of 280 intubated patients met criteria of ARDS with a median PaO2:FiO2 of 125.0 (interquartile range 93.0–161.0) on day of intubation, and overall ICU-mortality of 52.5% (ranging from 24.3 to 66.9% across the three participating sites). Prevalence of rapidly improving ARDS was 3.9% (11 of 280 patients); no extubation occurred on the first day following intubation. ICU-mortality of patients with rapidly improving ARDS was 54.5%. This low prevalence and high mortality rate of rapidly improving ARDS were consistent across participating sites. Prevalence of persistent severe ARDS was 12.1% and corresponding mortality was 82.4%.

Conclusions

Rapidly improving ARDS was not prevalent and was not associated with good prognosis among patients with COVID-19. This is starkly different from what has been previously reported for patients with ARDS not related to COVID-19. Our results on both rapidly improving ARDS and persistent severe ARDS may contribute to our understanding of trajectory of ARDS and its association with prognosis in patients with COVID-19.
Factors that influence scope of practice of the chiropractic profession in Australia: a scoping review
Authors: Wiggins Desmond , Downie Aron , Engel Roger , Brown Benjamin T.
Published: April 2022

Introduction

The World Health Organization describes chiropractic as a health profession that treats the musculoskeletal system and the effects of that system on the function of the nervous system and general health. Notwithstanding such descriptions, scope of practice remains a contentious issue in Australia chiropractic with various authors defining it differently. To date, the peak governing body, the Chiropractic Board of Australia, has focused on title protection rather than defining a scope of practice for the profession. A well-defined scope of practice is important, as it helps to identify what is acceptable in the profession and the role chiropractic has in the broader healthcare system.

Objective

The objective of this scoping review was to explore the literature on the factors that influence scope of practice of chiropractic in Australia.

Methods

This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the chiropractic profession in Australia.

Results

A total of 1270 articles were identified from the literature search. Six studies fulfilled the inclusion criteria and were included in the final analysis. Four factors that influence scope of practice were identified: education, professional identity, patient safety, and organisational structure.

Conclusion

The results of this study will inform future discussions around establishing a framework for a more comprehensive scope of practice for the chiropractic profession in Australia. Such a framework has the potential to benefit patient safety, professional identity, public perception, education, and regulation of the profession.
Closed-loop oxygen control improves oxygen therapy in acute hypoxemic respiratory failure patients under high flow nasal oxygen: a randomized cross-over study (the HILOOP study)
Authors: Roca Oriol , Caritg Oriol , Santafé Manel , Ramos Francisco J. , Pacheco Andrés , García-de-Acilu Marina , Ferrer Ricard , Schultz Marcus J. , Ricard Jean-Damien
Published: April 2022

Background

We aimed to assess the efficacy of a closed-loop oxygen control in critically ill patients with moderate to severe acute hypoxemic respiratory failure (AHRF) treated with high flow nasal oxygen (HFNO).

Methods

In this single-centre, single-blinded, randomized crossover study, adult patients with moderate to severe AHRF who were treated with HFNO (flow rate ≥ 40 L/min with FiO2 ≥ 0.30) were randomly assigned to start with a 4-h period of closed-loop oxygen control or 4-h period of manual oxygen titration, after which each patient was switched to the alternate therapy. The primary outcome was the percentage of time spent in the individualized optimal SpO2 range.

Results

Forty-five patients were included. Patients spent more time in the optimal SpO2 range with closed-loop oxygen control compared with manual titrations of oxygen (96.5 [93.5 to 98.9] % vs. 89 [77.4 to 95.9] %; p < 0.0001) (difference estimate, 10.4 (95% confidence interval 5.2 to 17.2). Patients spent less time in the suboptimal range during closed-loop oxygen control, both above and below the cut-offs of the optimal SpO2 range, and less time above the suboptimal range. Fewer number of manual adjustments per hour were needed with closed-loop oxygen control. The number of events of SpO2 < 88% and < 85% were not significantly different between groups.

Conclusions

Closed-loop oxygen control improves oxygen administration in patients with moderate-to-severe AHRF treated with HFNO, increasing the percentage of time in the optimal oxygenation range and decreasing the workload of healthcare personnel. These results are especially relevant in a context of limited oxygen supply and high medical demand, such as the COVID-19 pandemic.

Trial registration The HILOOP study was registered at www.clinicaltrials.gov under the identifier NCT04965844.
The impacts of COVID-19 on cattle traders and their response in agro-pastoral and pastoral regions in Uganda: A case of Karamoja and Teso cattle traders
Authors: Ilukor John , Joyce Akello , Okiror Simon Peter
Published: April 2022

The study assessed the economic impact of COVID-19 on cattle traders in the Karamoja and Teso pastoral and agro-pastoral areas in Uganda and their response after the COVID-19 lockdown in 2020. The results reveal that cattle traders were negatively affected by COVID-19 in many ways including reduction in cattle sales, erosion in operating capital, and failure to sell animals while others have diversified or moved to other businesses. Twenty-five per cent of the cattle traders did not sell any animal during the lockdown. A majority of these were from Karamoja (43%) compared to those in Teso sub-region. The decline in cattle sales was significantly higher in Karamoja than in Teso sub-region. However, their recovery was significantly higher in Karamoja than in Teso sub-region because traders in Teso greatly diversified to other economic activities compared to traders in Karamoja sub-region. The traders who lost capital were mainly in Teso sub-region (63%). As expected, there was a sharp decline in the number of cattle buyers from markets outside the study area, mainly from Juba, Kampala, Busia, and Kenya. Coping strategies by cattle traders included crop cultivation (80%), burning charcoal (15%), selling food items (8%), and boda-boda riding (12%), while others did not engage in any economic activity (25%). To mitigate against the pandemic, traders were observing some of the standard operating procedures (SOPs) such as wearing face masks (76.1%), handwashing (19.3%), sanitising (2.3%), and social distancing (2.3%). Traders from Karamoja performed poorly in both diversification and mitigation measures. Based on our findings, recommendations to mitigate the impact of COVID-19 on cattle traders include offering loans to cattle traders through their Village Savings and Loan Association (VSLA), reducing transaction costs, offering mobile phones especially for Karamoja traders, and promoting the adoption of enforcing SOPs to reduce the need for lockdowns and cattle market closures which are detrimental to pastoral livelihood.
Effects of wearing knee-guards on skin pressure and skin blood flow during dynamic motions
Authors: Baek Yoon Jeong , Ju Heeyoung , Lee Joo-Young , Oh Kyung Wha
Published: April 2022

The purpose of the present study was to explore the effects of wearing knee guards on skin blood flow and skin pressure during dynamic soccer motions. Twenty-one male subjects participated in the following two experimental conditions: wearing knee guards (KG) and no knee guards (Control). Subjects performed several consecutive soccer motions along with a standing position between each motion. Skin blood flow and skin pressure on the thigh, knee, and calf were monitored. The results showed that skin pressure had the greatest value in a sitting position for both the KG condition and Control, but the smallest during instep kicking and switching directions (P < 0.001). The rear calf had the greatest skin pressure for the KG condition (P < 0.001), while the side knee showed the greatest for the Control (P < 0.001). Normalized skin blood flow based on values from their standing position was the greatest during the jump motion among the various soccer motions. Interestingly, skin blood flow decreased by wearing the knee guards on the front thigh and calf (r = − 0.859; r = − 0.835; P < 0.001), while the blood flow increased on the side knee (r = 0.295, P < 0.001). Subjects felt greater skin pressure sensation during the jump motion and switching directions than other soccer positions/motions (P < 0.001). These results indicate that the knee guards result in relatively lighter pressure for dynamic motions (e.g., kick, switching directions, or jump) than for static positions (e.g., sitting or standing), and the skin blood flows for the thigh, knee, and calf are redistributed by wearing the knee guards, especially during jumping.
Coping styles to vitiate the risk of psychological morbidities among pre/para-clinical and clinical undergraduate medical students: a comparative cross-sectional study in India
Authors: Garg Sunny , Chauhan Alka , Sharma Devesh , Sharma Anchal , Singh Sanjeet
Published: April 2022

Background

Psychological morbidities are high among undergraduate medical students. They experience the transition between pre/para-clinical and clinical training as a stressful period and cope differently. Research from India in this regard are lacking. The aim of this study is to assess and compare the prevalence of psychological morbidities, associated factors and coping styles between pre/para-clinical and clinical undergraduate medical students. This institution-based cross-sectional observational design study was conducted among pre/para-clinical and clinical group of undergraduate medical students (a total of 382) by using a questionnaire in the period between April and June 2021. Stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like GHQ-28 and Lin-Chen’s coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities, and coping styles between two groups, were compared using chi-square test, independentt-test and binary logistic regression analysis.

Results

Out of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high level, a slightly higher preponderance in clinical (61.5%) than pre/para-clinical students (60.6%) and with nonsignificant difference of psychological morbidities. Compared to pre/para-clinical group, clinical group was found to have more substance consumption behavior (p< 0.001), dissatisfaction with academic performance (p< 0.001), sought psychiatric consultation (p< 0.004) and currently on psychiatric treatment (p< 0.04). Overall, coping was found to be average and good among the participants. Active problem coping behavior was more significantly used by pre/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in clinical group.

Conclusions

This study established a significant correlation between psychological morbidities and passive coping styles in clinical group. These students need interventions to encourage the use of more active coping styles during the training to provide advances in future career. A strong correlation with dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.
Improved Survival With Enzalutamide in Patients With Metastatic Hormone-Sensitive Prostate Cancer
Authors: Armstrong Andrew J. , Azad Arun A. , Iguchi Taro , Szmulewitz Russell Z. , Petrylak Daniel P. , Holzbeierlein Jeffrey , Villers Arnauld , Alcaraz Antonio , Alekseev Boris , Shore Neal D. , Gomez-Veiga Francisco , Rosbrook Brad , Zohren Fabian , Yamada Shunsuke , Haas Gabriel P. , Stenzl Arnulf
Published: April 2022

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

In primary analysis, enzalutamide plus androgen deprivation therapy (ADT) improved radiographic progression-free survival (rPFS) in patients with metastatic hormone-sensitive prostate cancer (mHSPC); however, overall survival data were immature. In the phase III, double-blind, global ARCHES trial (ClinicalTrials.gov identifier: NCT02677896 ), 1,150 patients with mHSPC were randomly assigned 1:1 to enzalutamide (160 mg once daily) plus ADT or placebo plus ADT, stratified by disease volume and prior docetaxel use. Here, we report the final prespecified analysis of overall survival (key secondary end point) and an update on rPFS, other secondary end points, and safety. After unblinding, 180 (31.3%) progression-free patients randomly assigned to placebo plus ADT crossed over to open-label enzalutamide plus ADT. As of May 28, 2021 (median follow-up, 44.6 months), 154 of 574 patients randomly assigned to enzalutamide plus ADT and 202 of 576 patients randomly assigned to placebo plus ADT had died. Enzalutamide plus ADT reduced risk of death by 34% versus placebo plus ADT (median not reached in either group; hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P < .001). Enzalutamide plus ADT continued to improve rPFS and other secondary end points. Adverse events were generally consistent with previous reports of long-term enzalutamide use. In conclusion, enzalutamide plus ADT significantly prolongs survival versus placebo plus ADT in patients with mHSPC.
Metabolomic Profiling of Peripheral Plasma by GC-MS and Correlation With Size of Uterine Leiomyomas
Authors: Barison Gustavo Anderman Silva , D’Amora Paulo , Izidoro Mário Augusto , Corinti Mariana , Martins Luísa Marcella , Bonduki Claudio Emílio , Castro Rodrigo de Aquino , Girão Manoel João Batista Castello , Gomes Mariano Tamura Vieira
Published: April 2022

Background

Uterine leiomyomas are benign monoclonal tumors originating from the myometrium. Little information exists concerning metabolomics and the presence of leiomyomas.

Objective

The present study evaluated circulating metabolites in the plasma and their correlation with the presence and size of leiomyomas.

Study Design

Cross-sectional observational study, including women divided into 3 groups: 37 with leiomyomas and uterus >500 cm3, 17 with leiomyomas and uterus ≤150 cm3, and 21 leiomyoma-free. Patients underwent peripheral blood collection using untargeted metabolic assessment by gas chromatography coupled to mass spectrometer.

Results

There was no statistical difference between patients’ anthropometric and demographic features and laboratory tests. Statistical differences in uterus volume (P < 0.0001) were found. Forty-six metabolites were identified (35% amino acids and derivatives, 22% fatty acids, and 18% carbohydrates). Statistically significant metabolic distinction (P < 0.05, false discovery rate< 0.05) was observed for 14 metabolites. Most amino acids (L-isoleucine, L-valine, and pyroglutamic acid) were significantly reduced in plasma levels of patients with large leiomyomas. The only exception was L-glutamine, with a significant increase. Fatty acids (arachidonic acid, alfa-tocopherol, palmitic acid, and stearic acid) were similarly reduced in large leiomyomas patients, except for alpha-linolenic acid, which increased. For carbohydrates (myo-inositol, D-threitol, and D-ribose), there was a decrease in the plasma of patients with leiomyomas.

Conclusion

There are different plasma metabolites levels of amino acids, fatty acids, and carbohydrates among patients with leiomyomas, most of them reduced, but some significantly increased in large leiomyomas, compared to leiomyoma-free patients.
Transient C5 Sensory and Motor Blockade After a Unilateral T4 Paravertebral Block: A Case Report
Authors: Mortazavi Siavash , Trinder Matthew , Li Ran , Hennessy Brien , Yeo Allen
Published: April 2022

A thoracic paravertebral block (TPVB) can provide anesthesia for breast cancer surgeries. This case report describes a 58-year-old woman with a prolonged ipsilateral dense C5 dermatomal sensory and motor blockade after receiving a TPVB at T4 with 40 mL of 0.2% ropivacaine for a left total mastectomy, suggesting a high cephalad spread of anesthesia up to C5 paravertebral spaces. The lower extremities and the diaphragm were not involved. It is possible that the large volume of local anesthetic, even at low concentration, combined with her previous neural pathology and surgical laminectomy resulted in unexpected postoperative neurological changes.
The GBA1 D409V mutation exacerbates synuclein pathology to differing extents in two alpha-synuclein models
Authors: Polinski Nicole K. , Martinez Terina N. , Ramboz Sylvie , Sasner Michael , Herberth Mark , Switzer Robert , Ahmad Syed O. , Pelligrino Lee J. , Clark Sean W. , Marcus Jacob N. , Smith Sean M. , Dave Kuldip D. , Frasier Mark A.
Published: April 2022

Heterozygous mutations in the GBA1 gene – encoding lysosomal glucocerebrosidase (GCase) – are the most common genetic risk factors for Parkinson's disease (PD). Experimental evidence suggests a correlation between decreased GCase activity and accumulation of alpha-synuclein (aSyn). To enable a better understanding of the relationship between aSyn and GCase activity, we developed and characterized two mouse models that investigate aSyn pathology in the context of reduced GCase activity. The first model used constitutive overexpression of wild-type human aSyn in the context of the homozygous GCase activity-reducing D409V mutant form of GBA1. Although increased aSyn pathology and grip strength reductions were observed in this model, the nigrostriatal system remained largely intact. The second model involved injection of aSyn preformed fibrils (PFFs) into the striatum of the homozygous GBA1 D409V knock-in mouse model. The GBA1 D409V mutation did not exacerbate the pathology induced by aSyn PFF injection. This study sheds light on the relationship between aSyn and GCase in mouse models, highlighting the impact of model design on the ability to model a relationship between these proteins in PD-related pathology.
UV-Vis Higher-Order Derivative Spectra Disclose the Involvement of Two Processes in the Solid-State 4+4 Photocycloaddition of an Amorphous Bisanthracene
Authors: Ichimura Kunihiro , Sonoda Taishi , Ubukata Takashi
Published: April 2022

UV-induced solid-state oligomerization of an amorphous bisanthracene in films was determined by UV-Vis even-order derivative spectra to reveal the involvement of fast and slow photocycloaddition processes due to the difference in the level of π,π-interactions and the marked enhancement of the photoreaction above glass transition temperature.
Cosmological implications of scalar tensor theories
Authors: Καζαντζίδης Λαυρέντιος
Published: April 2022

Στην παρούσα Διδακτορική Διατριβή μελετάμε τις κοσμολογικές συνέπειες τροποποιημένων θεωριών βαρύτητας. Ορμώμενοι από τις θεωρητικές και παρατηρησιακές προκλήσεις του καθιερωμένου κοσμολογικού προτύπου ΛCDM, χρησιμοποιούμε πρόσφατες γεωμετρικές και δυναμικές παρατηρήσεις για την ταυτοποίηση χαρακτηριστικών προβλέψεων συγκεκριμένων θεωριών τροποποιημένης βαρύτητας και τον υπολογισμό των αντίστοιχων βέλτιστων τιμών των παραμέτρων τους. Αρχικά, εισάγουμε τον αναγνώστη στον μαθηματικό φορμαλισμό της Κοσμολογίας και έπειτα επικεντρωνόμενοι στη μία από τις δύο παρατηρησιακές ασυμβατότητες που αντιμετωπίζει το ΛCDM, εισάγουμε μία φαινομενολογική παραμετροποίηση για την δυναμικά εξελισσόμενη σταθερά του Νεύτωνα. Κατασκευάζοντας μία εκτεταμένη συλλογή δεδομένων που περιγράφουν Παραμορφώσεις στον Χώρο της Ερυθράς Μετατόπισης, υπολογίζουμε τις βέλτιστες τιμές των παραμέτρων της παραμετροποίησης της δυναμικά εξελισσόμενης σταθεράς του Νεύτωνα και μελετάμε συγκεκριμένες τροποποιημένες θεωρίες βαρύτητας (όπως f(R) και βαθμοτανυστικές θεωρίες βαρύτητας), για να δούμε, εάν μπορούν να υποστηρίξουν την συγκεκριμένη παρατηρήσιμη συμπεριφορά της. Έπειτα, εξετάζουμε και άλλου τύπου παρατηρησιακά δεδομένα (όπως για παράδειγμα δεδομένα Κοσμικής Ακτινοβολίας Υποβάθρου και τα δεδομένα Pantheon, δηλαδή τα πιο πρόσφατα δημοσιευμένα δεδομένα Υπερκαινοφανών Αστέρων Τύπου Ia) για την εύρεση των βέλτιστων τιμών των παραμέτρων της φαινομενολογικής παραμετροποίησης δυναμικά εξελισσόμενης σταθεράς του Νεύτωνα. Στο πλαίσιο της παρούσας Διδακτορικής Διατριβής ερευνήθηκε επιπλέον η ευαισθησία ερευνητικών αποστολών στην ανίχνευση ενός μεγάλου εύρους κοσμολογικών παραμέτρων και αποδείχθηκε οτι η ευαισθησία τους δεν αυξάνει γραμμικά με την τιμή της ερυθράς μετατόπισης, αλλά παρουσιάζει μια μεταβολή ανάλογα με την περιοχή της ερυθράς μετατόπισης που πραγματοποιείται η μέτρηση/ανίχνευση. Ακόμα, μελετήθηκαν μοντέλα σκοτεινής ενέργειας που παρουσιάζουν μια απότομη μεταβολή της απόλυτης λαμπρότητας Μ σε συγκεκριμένη τιμή της ερυθράς μετατόπισης, τα οποία έχουν τη δυνατότητα να λύσουν τις δύο βασικές παρατηρησιακές ασυμβατότητες που αντιμετωπίζει το μοντέλο ΛCDM. Ειδικότερα, υπολογίσαμε την ποιότητα προσαρμογής αυτών των μοντέλων σε διάφορα προσφατα κοσμολογικά δεδομένα (μεταξύ αυτών και τα πλήρη δεδομένα Κοσμικής Ακτινοβολίας Υποβάθρου) και την συγκρίναμε με την ποιότητα προσαρμογής που παρέχει τόσο το μοντέλο ΛCDM, όσο και άλλα εναλλακτικά μοντέλα σκοτεινής ενέργειας που έχουν προταθεί στη βιβλιογραφία ως λύσεις των παρατηρούμενων ασυμβατοτήτων στο πλαίσιο του μοντέλου ΛCDM. Τέλος, μελετήθηκαν οι επιπτώσεις παραμετροποιήσεων που προκύπτουν από τροποποιημένες θεωρίες βαρύτητας στις κλίμακες χιλιοστού, με την αξιοποίηση δεδομένων του πειράματος Washington.
A Randomized controlled trial of the Effect of intraVenous iron on Anaemia in Malawian Pregnant women (REVAMP): Statistical analysis plan
Authors: Harding Rebecca , Ataide Ricardo , Mwangi Martin N , Simpson Julie A , Mzembe Glory , Moya Ernest , Truwah Zinenani , Nkhwazi Brains Changaya , Mwabinga Mphatso , Nkhono William , Phiri Kamija S , Pasricha Sant-Rayn , Braat Sabine
Published: April 2022

Background: Anaemia affects more than half of Africa’s pregnancies. Standard care, with oral iron tablets, often fails to achieve results, with compliance and gastrointestinal side-effects being a significant issue. In recent years, intravenous iron formulations have become safe, effective, and quick to administer, allowing the complete iron requirements of pregnancy to be provided in one 15-minute infusion. The Randomized controlled trial of the Effect of intraVenous iron on Anaemia in Malawian Pregnant women (REVAMP) will evaluate whether a modern intravenous iron formulation, ferric carboxymaltose (FCM), given once during the second trimester is effective and safe in improving maternal and neonatal outcomes for treatment of moderate to severe anaemia in sub-Saharan Africa.  

The objective was to publish the detailed statistical analysis plan for the REVAMP trial prior to unblinding the allocated treatments and performing the analysis.  

Methods: REVAMP is a multicentre, two-arm, open-label, parallel-group randomized control trial (RCT) in 862 pregnant women in their second trimester. The trial statistician developed the statistical analysis plan in consultation with the trial management team based on the protocol, data collection forms, and study outcomes available in the blinded study database.  

Results: The detailed statistical analysis plan will support the statistical analyses and reporting of the REVAMP trial after unblinding the treatment allocations.  

Conclusions: A statistical analysis plan allows for transparency as well as reproducibility of reporting and statistical analyses.
Assessment of the effectiveness of physiotherapy in the treatment of shoulder pain syndrome
Authors: Mirus Alicja , Zdziarski Krzysztof
Published: April 2022

Abstract

Painful shoulder syndrome is a common condition of the musculoskeletal system in adults.  This disorder affects your ability to work, overall body function, sleep, and quality of life.  The treatment of shoulder syndrome is multifaceted and covers a broad spectrum of physiotherapy options. These include progressive strengthening exercises, laser therapy, electrotherapy and magnetotherapy. There are a number of treatments available that are reimbursed by the National Health Fund (NFZ). Aim of the research: The aim of the research was to assess the impact of rehabilitation on the treatment of shoulder pain syndrome.

Material and methods: The method used in the study was a diagnostic survey. The research was supplemented with an author's questionnaire to compare demographic data and assess the quality of life.  The ranges of mobility were assessed before and after 10 series of treatments and the level of pain using the VAS scale.  The study involved 80 patients presenting with the diagnosis of painful shoulder syndrome, 60% of whom were women and 40% men. The most numerous age group was between 50-60 years old (31 people) and 30-40 years old (24 people). 

Results: The treatment process was successful in patients.  Out of the studied population, 95% of patients experienced an improvement in their health compared to the baseline.  A significant reduction in pain was observed with the use of physiotherapeutic procedures.  The patients most favorably assessed massage, kinesiotherapy and cryotherapy. Conclusions: Conservative treatment reimbursed under the National Health Fund is an effective method of improving mobility and reducing to a large extent discomfort in the shoulder joint.
Persuasion Contest: Disclosing Own and Rival Information
Authors: Iyer Ganesh , Singh Shubhranshu
Published: April 2022

This paper investigates a contest in information revelation between firms that seek to persuade consumers by disclosing own and rival’s information.
Coordinate Descent Without Coordinates: Tangent Subspace Descent on Riemannian Manifolds
Authors: Gutman David H. , Ho-Nguyen Nam
Published: April 2022

We extend coordinate descent to manifold domains and provide convergence analyses for geodesically convex and nonconvex smooth objective functions. Our key insight is to draw an analogy between coordinate blocks in Euclidean space and tangent subspaces of a manifold. Hence, our method is called tangent subspace descent (TSD). The core principle behind ensuring convergence of TSD is the appropriate choice of subspace at each iteration. To this end, we propose two novel conditions, the (C, r)-norm and C-randomized norm conditions on deterministic and randomized modes of subspace selection, respectively, that promise convergence for smooth functions and that are satisfied in practical contexts. We propose two subspace selection rules, one deterministic and another randomized, of particular practical interest on the Stiefel manifold. Our proof-of-concept numerical experiments on the sparse principal component analysis problem demonstrate TSD’s efficacy.

Funding: This work was supported by the National Science Foundation [Grant 1740707] and the Defense Advanced Research Projects Agency Lagrange Program [Grant N660011824020].
Presentación del FORO UNIA de Seguridad y Salud en el Trabajo “Teletrabajo, realidad y regulación: de la protección a la salud de las personas trabajadoras”. La Rábida, Huelva (España), noviembre 2021
Authors: Galán Agustín , Pérez Ventura , G. Benavides Fernando , Cobos Sanchiz David , Gómez Salgado Juan
Published: April 2022

La protección de la salud de las personas trabajadoras es una exigencia básica en el desarrollo de las relaciones sociales, políticas y comerciales presentes y futuras entre la Unión Europea y los países de Latinoamérica y el Caribe, entre otras regiones del mundo. La armonización del marco normativo y su aplicación real es un objetivo compartido por todas las partes. Dicho objetivo está alineado con los Objetivos de Desarrollo Sostenible de la Agenda 2030, en concreto el número 8, relacionado con el trabajo decente y productivo.

Con estos planteamientos como premisa principal, el Vicerrectorado de Calidad, Igualdad y Responsabilidad Social y la Sede Santa María de la Rábida de la Universidad Internacional de Andalucía (UNIA), han promovido un Foro Iberoamericano que ha servido para poner sobre la mesa temas de actualidad en materia de salud laboral y prevención de riesgos laborales, debatidos en profundidad con expertos en la materia y agentes sociales y económicos de toda Iberoamérica. De esta forma, se han extraído conclusiones operativas que pueden ser de utilidad para los decisores de políticas públicas de nuestros países.…
Pros y contras del teletrabajo en la salud física y mental de la población general trabajadora: una revisión narrativa exploratoria
Authors: Tomasina Fernando , Pisani Adriana
Published: April 2022

El teletrabajo es una realidad compleja que se encuentra en pleno desarrollo desde hace varias décadas. La situación de pandemia por la COVID-19 aceleró dicho proceso. Son variadas las formas de presentación, siendo la del trabajo a domicilio quizás de las más frecuentes. El objetivo del presente estudio fue realizar una revisión narrativa exploratoria y reflexiva sobre el teletrabajo en los aspectos positivos (pros) y negativos (contras) en relación con la salud física y mental de la persona teletrabajadora.

Así, de la literatura consultada se identifican factores de riesgo para la salud de los teletrabajadores, mayoritariamente corresponden a daños derivados de la exposición a riesgos psicosociales y ergonómicos. Destacan como daños a la salud mental las alteraciones del sueño, la ansiedad y la angustia y la depresión. Con respecto a los daños a la salud física se identifican trastornos músculo-esqueléticos, alteraciones derivadas de la disminución de la actividad física por el sedentarismo y el estrés, en particular enfermedades no transmisibles, y alteraciones de la visión.

Desde la prevención se deberán fomentar acciones dirigidas a políticas vinculadas con la organización del teletrabajo. En particular se deberá prestar atención a los tiempos de trabajo y de descanso, asegurando el denominado derecho a la desconexión. El diseño ergonómico del puesto de trabajo y la realización de pausas activas son elementos que contribuyen también al bienestar del trabajador. La participación activa de los actores sociales, trabajadores, empleadores y Estado, resulta estratégica para que el teletrabajo contribuya al trabajo decente y no a su precarización.
La regulación del teletrabajo estructural en Iberoamérica
Authors: Carrizosa-Prieto Esther
Published: April 2022

La pandemia originada por la COVID-19 ha provocado, como necesidad súbita e imprevisible, la implantación del teletrabajo en los sistemas productivos de la generalidad de los países. Muchos Estados han tenido que recurrir a normas antiguas y desfasadas que no asumían las pocas garantías de los instrumentos internacionales y supranacionales existentes. Sin embargo, otros países han aprovechado la situación de emergencia sanitaria para reformar y actualizar sus normas de teletrabajo. 

La presente contribución tiene por objeto analizar las nuevas normas surgidas con ocasión de la pandemia y efectuar una valoración general de sus contenidos para comprobar si se adaptan a las exigencias y recomendaciones que, en una sociedad digital, deben caracterizar al teletrabajo. Para ello hacemos un recorrido por el ordenamiento internacional con la finalidad de identificar los instrumentos, reglas y principios que nos puedan ayudar a perfilar las instituciones básicas que deben sostener la regulación del teletrabajo para, seguidamente, hacer una valoración de las legislaciones que en los últimos meses se han implantado en algunos de los países que integran el espacio iberoamericano (Argentina, Bolivia, Chile, Colombia, Costa Rica, España, El Salvador, México, Perú, Portugal) para hacer frente a esta realidad. 

El análisis efectuado evidencia que, aún con escasos referentes internacionales, los distintos ordenamientos han sabido articular regulaciones garantistas que observan las pocas directrices existentes: voluntariedad, reversibilidad y un conjunto importante de derechos para las personas teletrabajadoras. No obstante, existen cuestiones pendientes que deben ser abordadas con una mayor profundidad: las relacionadas con el derecho a la salud laboral y con los derechos digitales, así como el desarrollo de la institución mediante la negociación colectiva, mecanismo que podría equilibrar los distintos intereses y garantizar una mayor aceptación de estas regulaciones.
Evaluation of a virtual quality improvement training programme
Authors: Gupta Poonam , Hassan Mawahib , Thomas Mincy , Anilkumar Smitha , Chacko Gracy , Shiju Shiny , Savarimuthu Indirani , Siddiqui Raana , Arafa Salah
Published: April 2022

Background/Aims

The COVID-19 pandemic challenged not only global healthcare systems, but also educational systems, with many large, in-person training programmes being suspended. Instead, virtual learning platforms have been used, with promising results. This study explored the effectiveness of a virtual quality improvement training programme in a healthcare setting.

Methods

A 6-week interprofessional virtual quality improvement training programme was developed and delivered to a total of 137 participants across three cohorts. Pre- and post-programme surveys were administered to assess knowledge gained from training. Focus groups were also conducted for more in-depth feedback about the sessions. Information was then collected regarding any quality improvement projects participants had undertaken after completing the training.

Results

Mean scores were higher in the post-programme than the pre-programme survey across all knowledge domains (P<0.001, Cohens d=6.63). Over 80% of participants reported that the training improved their understanding of and confidence in undertaking a quality improvement project, and that they would recommend the training to their colleagues. Participants went on to either lead or contribute to a variety of quality improvement projects across a wide range of specialisms.

Conclusions

The virtual quality improvement training programme is an effective method of teaching, leading to participants being able to demonstrate competency in quality improvement. This approach to training delivery represents an efficient alternative to in-person training for building capability in frontline healthcare staff.
Refractive index sensor based on a ring with a disk-shaped cavity for temperature detection applications
Authors: Zhang Xiaoyu , Yan Shubin , Chen Zhanbo , Ren Yifeng , Zhang Yi , Liu Pengwei , Shen Lifang , Li Tingsong
Published: April 2022

In this study, we proposed a novel refractive index sensor structure, comprising a metal–insulator–metal (MIM) waveguide and a circular ring containing a disk-shaped cavity (CRDC). The finite element method was used to theoretically analyze the sensor characteristics. The simulation results showed that the disk-shaped cavity is the key to the asymmetric Fano resonance, and the radius of the CRDC has a significant influence on the performance of the sensor. A maximum sensitivity and figure of merit (FOM) of 2240 nm/RIU and 62.5, respectively, were realized. Additionally, the refractive index sensor exhibits the potential of aiding in temperature detection owing to its simple structure and high sensitivity of 1.186 nm/ºC.
Terahertz-wave decoding of femtosecond extreme-ultraviolet light pulses
Authors: Ilyakov I. , Agarwal N. , Deinert J.-C. , Liu J. , Yaroslavtsev A. , Foglia L. , Kurdi G. , Mincigrucci R. , Principi E. , Jakob G. , Kläui M. , Seifert T. S. , Kampfrath T. , Kovalev S. , Carley R. E. , Scherz A. O. , Gensch M.
Published: April 2022

In recent years, femtosecond extreme-ultraviolet (XUV) and x-ray pulses from free-electron lasers have developed into important probes to monitor processes and dynamics in matter on femtosecond-time and angstrom-length scales. With the rapid progress of versatile ultrafast x-ray spectroscopy techniques and more sophisticated data analysis tools, accurate single-pulse information on the arrival time, duration, and shape of the probing x-ray and XUV pulses becomes essential. Here, we demonstrate that XUV pulses can be converted into terahertz electromagnetic pulses using a spintronic terahertz emitter. We observe that the duration, arrival time, and energy of each individual XUV pulse is encoded in the waveform of the associated terahertz pulses, and thus can be readily deduced from single-shot terahertz time-domain detection.
Network pharmacology and in vitro testing of Theobroma cacao extract’s antioxidative activity and its effects on cancer cell survival
Authors: Patil Priyanka P. , Patil Vishal S. , Khanal Pukar , Darasaguppe Harish R. , Charla Rajitha , Bhatkande Arati , Patil Basanagouda M. , Roy Subarna
Published: April 2022

Theobroma cacao L. is a commercially important food/beverage and is used as traditional medicine worldwide against a variety of ailments. In the present study, computational biology approaches were implemented to elucidate the possible role of cocoa in cancer therapy. Bioactives of cocoa were retrieved from the PubChem database and queried for targets involved in cancer pathogenesis using BindingDB (similarity index ≥0.7). Later, the protein-protein interactions network was investigated using STRING and compound-protein via Cytoscape. In addition, intermolecular interactions were investigated via molecular docking. Also, the stability of the representative complex Hirsutrin-epidermal growth factor receptor (EGFR) complex was explored using molecular dynamics simulations. Crude extract metabolite profile was carried out by LC-MS. Further, anti-oxidant and cytotoxicity studies were performed in Chinese hamster ovary (normal) and Ehrlich ascites carcinoma (cancer) cell lines. Herein, the gene set enrichment and network analysis revealed 34 bioactives in cocoa targeting 50 proteins regulating 21 pathways involved in cancer and oxidative stress in humans. EGFR scored the highest edge count amongst 50 targets modulating 21 key pathways. Hence, it was selected as a promising anticancer target in this study. Structural refinement of EGFR was performed via all-atom molecular dynamics simulations in explicit solvent. A complex EGFR-Hirsutrin showed the least binding energy (-7.2 kcal/mol) and conserved non-bonded contacts with binding pocket residues. A stable complex formation of EGFR-Hirsutrin was observed during 100 ns MD simulation. In vitro studies corroborated antioxidant activity for cocoa extract and showed a significantly higher cytotoxic effect on cancer cells compared to normal cells. Our study virtually predicts anti-cancer activity for cocoa affected by hirsutrin inhibiting EGFR. Further wet-lab studies are needed to establish cocoa extract against cancer and oxidative stress.
Isolation and optimization of extracellular PHB depolymerase producer Aeromonas caviae Kuk1-(34) for sustainable solid waste management of biodegradable polymers
Authors: Amir Mohammad , Bano Naushin , Baker Abu , Zia Qamar , Banawas Saeed , Zaheer Mohd. Rehan , Shariq Mohammad , Nawaz Md Sarfaraz , Khan Mohd. Farhan , Azad Z. R. Azaz Ahmad , Gupta Anamika , Iqbal Danish , Roohi
Published: April 2022

Bioplastics, synthesized by several microbes, accumulates inside cells under stress conditions as a storage material. Several microbial enzymes play a crucial role in their degradation. This research was carried to test the biodegradability of poly-β-hydroxybutyrate (PHB) utilizing PHB depolymerase, produced by bacteria isolated from sewage waste soil samples. Potent PHB degrader was screened based on the highest zone of hydrolysis followed by PHB depolymerase activity. Soil burial method was employed to check their degradation ability at different incubation periods of 15, 30, and 45 days at 37±2°C, pH 7.0 at 60% moisture with 1% microbial inoculum of Aeromonas caviae Kuk1-(34) (MN414252). Without optimized conditions, 85.76% of the total weight of the PHB film was degraded after 45 days. This degradation was confirmed with Fourier-transform infrared spectroscopy (FTIR) and Scanning electron microscope (SEM) analysis. The presence of bacterial colonies on the surface of the degraded film, along with crest, holes, surface erosion, and roughness, were visible. Media optimization was carried out in statistical mode using Plackett Burman (PB) and Central Composite Design (CCD) of Response Surface Methodology (RSM) by considering ten different factors. Analysis of Variance (ANOVA), Pareto chart, response surface plots, and F-value of 3.82 implies that the above statistical model was significant. The best production of PHB depolymerase enzyme (14.98 U/mL) was observed when strain Kuk1-(34) was grown in a media containing 0.1% PHB, K2HPO4 (1.6 gm/L) at 27 ℃ for seven days. Exploiting these statistically optimized conditions, the culture was found to be a suitable candidate for the management of solid waste, where 94.4% of the total weight of the PHB film was degraded after 45 days of incubation.
Profiling dynamic decision-makers
Authors: Grabiszewski Konrad , Horenstein Alex
Published: April 2022

From CEOs confronting competition to children playing board games, our professional and personal lives are full of dynamic decisions. Naturally, while playing the role of a decision-maker, people differ. To comprehend and analyze how they differ, first it is necessary to construct a profiling method that classifies dynamic decision-makers. Developing such a method is the main objective of our article. We equate dynamic decision-making with backward inducting. We rely on response times to construct the profiles. Our method has both descriptive power and predictive power: a subject’s profile resembles her reasoning process and forecasts the likelihood of her correctly backward inducting. To test the proposed profiling method, we use data generated by 22 different finite dynamic scenarios from the mobile appBlues and Reds. Our sample consists of 35,826 observations from 6,463 subjects located in 141 countries. We construct the profiles of our subjects, and, in a variety of exercises supported by an array of robustness checks, we successfully establish the predictive power of our profiling method.