bluuebunny/crossref_metadata_2025 huggingface dataset:
69 COVID-19 NURSING HOMES EXPERT PANEL REPORT IMPACT ASSESSMENT:
Authors: Daly T , Shanagher D
Published: February 2023

Background

The COVID-19 pandemic disproportionately affected older people and had a profound impact on the nursing home and residential care sector. COVID-19 also exposed weaknesses in how our health systems support the nursing home sector that must be addressed. The National Public Health Emergency Team recommended the establishment of an Expert Panel to examine the issues regarding the management of COVID-19 in nursing homes. A report was published in August 2020 that contains a range of recommendations in line with lessons learned and best practice, to be implemented over the following 12–18 months.

Methods

A review and analysis of the COVID-19 Nursing Homes Expert Panel Report and its 86 recommendations took place to understand the impact of implementing the recommendations on the nursing home sector, to understand the supports required to implement the recommendations and to outline an implementation framework to deliver the recommendations and to realise a sustainable change.

Results

The impact Assessment revealed the following:

1. Community integration is required where nursing home residents have greater access to services and where adequate supports and collaboration across the continuum of care is realise.

2. A workforce strategy is required that considers recruitment, retention, training and education.

3. A funding model that ensures funding is based on an assessment of resident need and dependency level is required.

Conclusion

While the long-term timeline and impacts of COVID-19 are still unknown, it is clear that health and social care services need to plan for future healthcare emergencies and the long-term sustainability of the nursing home sector. This pandemic and the Expert Panel’s recommendations have reinforced the urgent need to create systems where collaborative actions and integrated care is resident focussed and will ensure ‘care is better planned, coordinated, delivered and easier to access.
89 CSF BIOMARKER UTILITY IN SUPPORTING ALZHEIMER’S DISEASE DIAGNOSIS: CLINICAL PERSPECTIVES FROM AN IRISH REGIONAL SPECIALIST MEMORY SERVICE
Authors: Dolphin H , Fallon A , McHale C , Dookhy J , O'Neill D , Coughlan T , Coveney S , O'Dowd S , Kennelly S P
Published: February 2023

Background

CSF (cerebrospinal fluid) biomarkers [amyloid- beta-42 (AB-42), phosphorylated tau (p-tau)] are increasingly used in supporting clinical diagnosis of Alzheimer’s Disease (AD). Both elevated CSF p-tau and reduced AB-42 are necessary for pathological diagnosis of AD. The aim of this study is to apply recent international recommendations to patients attending a regional specialist memory service, evaluating consistency with detailed clinical, neuroimaging, and neuropsychological ad-phenotype profiling.

Methods

All patients age < 80, with mild/subjective cognitive and/or atypical neurobehavioral symptoms, non-significant vascular burden on neuroimaging, and without contraindication to lumbar puncture are offered CSF analysis. Clinical diagnosis was ascribed on the basis of specialist multi-disciplinary consensus review. We undertook a case-note and database retrospective review of those who had ad-biomarker CSF analysis, collecting demographic, clinical phenotype diagnosis, and neuropsychological performance. Data was extracted and analysed using SPSS v.25.

Results

One-hundred-sixteen patients underwent CSF biomarker testing. Forty-nine patients (42%) had positive AD-CSF biomarkers, 41/49 (84%) of whom presented with common ad phenotypes (Amnestic/Logopenic PPA/PCA). Twenty patients (17%) had negative ad-CSF (elevated AB-42, and low p-tau) studies, and half of those (10/20, 50%) had a consistent atypical non-AD clinical phenotype. Patients with negative ad-CSF were younger and tended to have non-amnestic neuropsychological profile. Therefore there was a mismatch in 18/69 (26%) people in these groups with definitive +/− ad biomarker results and ad/Non-ad clinical phenotype. A further forty seven (40%) patients had indeterminate CSF studies with one or other changes in AB-42 or p-tau, but not both as is necessary for definitive diagnosis.

Conclusion

Incorporation of CSF biomarker analysis is quickly being established as a key component of the neurocognitive/dementia diagnostic pathway. However, there are challenges and limitations arising as they are applied in clinical settings, and further research is warranted to explore variations between pathological results and clinical phenotype presentation.
95 DOCUMENTATION OF URINARY CATHETER INDICATION AND INSERTION PROCEDURE FOR MEDICAL INPATIENTS AT A UNIVERSITY TEACHING HOSPITAL
Authors: McAteer C , Sullivan R , McRory C , O’Domhnaill O , Murphy D E , Rehman M A , Muller T , Gallagher M , Miranda J , Parihar V , Mulpeter K
Published: February 2023

Background

Approximately 25% of inpatients have urinary catheters at some point during their hospital stay; over half are deemed inappropriate. This is significant as catheter-associated urinary tract infections (CAUTI) increase morbidity, mortality and length of hospitalisation. Lack of medical documentation and clinician awareness of catheters have been identified as risk factors for inappropriate catheterisation. The aim of this audit was to assess inpatient urinary catheter use among medical inpatients to determine if the indication and insertion procedure were clearly documented.

Methods

The audit was conducted over one day and included all medical inpatients aged 18 years and above. Emergency Department and High Dependency patients were excluded. Data was collected using standardised data collection sheets and involved a review of medical/nursing notes. Data was benchmarked against Health Service Executive guidelines.

Results

27 of 132 medical inpatients (20%) had a urinary catheter in situ on the day of audit. 37% (n = 10) had long-term urinary catheters in situ prior to admission and are not considered further. Of the remaining 63% (n = 17), 9 were female (53%), 8 were male (47%), and the average age was 75 years. Indication was documented in nursing notes for 76% and in medical notes for 53%. Indications included monitoring urinary output (29%), urinary retention (24%), sepsis (18%), comfort (6%) and haematuria (6%). Catheter insertion procedure was documented in nursing notes for 59% and in medical notes for 12%.

Conclusion

One fifth of medical inpatients had urinary catheters on the day of audit. 63% of these patients did not have a catheter prior to admission. Overall medical documentation of catheter indication and insertion procedure is poor. Better documentation would likely improve clinician awareness of their patient’s catheters and prompt earlier review of appropriateness. Education sessions, insertion proforma stickers and catheter review reminder systems are suggested to improve documentation.
A prospective analysis examining frailty remission and the association with future falls risk in older adults in England
Authors: Davies Katie , Maharani Asri , Chandola Tarani , O’Neill Terence W , Todd Chris , Pendleton Neil
Published: February 2023

Background

Previous research has shown older adults experience dynamic changes in frailty status. This study aimed to determine the occurrence of sustained frailty remission and how remission is associated with falls risk.

Methods

Participants who contributed data to the analysis were in the English Longitudinal Study of Ageing from Waves 1 to 8 (2002–2017). Frailty was defined across waves using the frailty index and categorised into robust, pre-frail and frail. We classified participants who improved their frailty category from Wave 1 (2002) to Wave 2 (2004) and sustained/improved category again into Wave 3 (2006) and compared them with those who were either robust or frail across Waves 1–3. Cox proportional hazard modelling was used to determine the risk of incident falls reported at Waves 4–8, with results expressed as hazard ratios and 95% confidence intervals.

Results

Of 2,564 participants, 389 (15·2%) improved frailty category and sustained this during Waves 2–3, 1,489 (58·1%) remained robust and 686 (26·8%) remained frail during Waves 1–3. During the 10-year period (Waves 4–8), a total of 549 participants reported a fall. Compared with those who remained frail during Waves 1–3, those who with sustained frailty remission had a lower risk of future falls (HR 0·41; 95% CI = 0·36–0·45).

Conclusions

Frailty remission is possible and can be sustained across 5 years. There is a lower risk of future falls in those who sustain frailty remission compared with those who remain frail.
Trends of polypharmacy among older people in Asia, Australia and the United Kingdom: a multinational population-based study
Authors: Lee Hyesung , Baek Yeon-Hee , Kim Ju Hwan , Liao Tzu-Chi , Lau Wallis C Y , Man Kenneth K C , Qin Xiwen , Wood Stephen , Ilomäki Jenni , Bell J Simon , Lai Edward Chia-Cheng , Leung Miriam T Y , Chan Adrienne Y L , Chui Celine S L , Wong Ian C K , Shin Ju-Young
Published: February 2023

Background

Polypharmacy among older people represents a global challenge due to its association with adverse drug events. The reported prevalence of polypharmacy varies widely across countries, and is particularly high in Asian countries. However, there is no multinational study using standardised measurements exploring variations in prescribing trends.

Objective

To compare polypharmacy trends in older people in Asia, Australia and the United Kingdom.

Design

Multinational, retrospective, time-trend, observational study using a common study protocol.

Setting

Outpatient and community settings.

Subjects

All individuals aged ≥ 65 years between 2013 and 2016.

Methods

We defined polypharmacy as the concomitant use of ≥5 medications for ≥45 days per year. We estimated the annual prevalence of polypharmacy and calculated average annual percentage change (AAPC) to assess the time trends.

Results

A total of 1.62 million individuals were included in this study. The highest prevalence of polypharmacy was observed in Hong Kong (46.4%), followed by Taiwan (38.8%), South Korea (32.0%), the United Kingdom (23.5%) and Australia (20.1%) in 2016. For the time trend, the Asian region showed a steady increase, particularly in Hong Kong and South Korea (AAPC: Hong Kong, 2.7%; South Korea, 1.8%; Taiwan, 1.0%). However, Australia and the United Kingdom showed a decreasing trend (Australia, −4.9%; the United Kingdom, −1.1%).

Conclusions

Polypharmacy prevalence in older people was higher in Hong Kong, Taiwan and South Korea, with an increasing trend over time, compared with Australia and the United Kingdom. Our findings underline the necessity to monitor polypharmacy among older people in Asia by conducting government-level interventions and introducing medicine-optimisation strategies.
Leaf vein density correlates with crassulacean acid metabolism, but not hydraulic capacitance, in the genus Clusia
Authors: Leverett Alistair , Ferguson Kate , Winter Klaus , Borland Anne M
Published: February 2023

Background and Aims

Many succulent species are characterized by the presence of Crassulacean acid metabolism (CAM) and/or elevated bulk hydraulic capacitance (CFT). Both CAM and elevated CFT substantially reduce the rate at which water moves through transpiring leaves. However, little is known about how these physiological adaptations are coordinated with leaf vascular architecture.

Methods

The genus Clusia contains species spanning the entire C3–CAM continuum, and also is known to have >5-fold interspecific variation in CFT. We used this highly diverse genus to explore how interspecific variation in leaf vein density is coordinated with CAM and CFT.

Key Results

We found that constitutive CAM phenotypes were associated with lower vein length per leaf area (VLA) and vein termini density (VTD), compared to C3 or facultative CAM species. However, when vein densities were standardized by leaf thickness, this value was higher in CAM than C3 species, which is probably an adaptation to overcome apoplastic hydraulic resistance in deep chlorenchyma tissue. In contrast, CFT did not correlate with any xylem anatomical trait measured, suggesting CAM has a greater impact on leaf transpiration rates than CFT.

Conclusions

Our findings strongly suggest that CAM photosynthesis is coordinated with leaf vein densities. The link between CAM and vascular anatomy will be important to consider when attempting to bioengineer CAM into C3 crops.
Investigating the diversification of holocentromeric satellite DNATybainRhynchospora(Cyperaceae)
Authors: Costa Lucas , Marques André , Buddenhagen Christopher E , Pedrosa-Harand Andrea , Souza Gustavo
Published: February 2023

Background and Aims

Satellite DNAs (satDNAs) are repetitive sequences composed by tandemly arranged, often highly homogenized units called monomers. Although satDNAs are usually fast evolving, some satDNA families can be conserved across species separated by several millions of years, probably because of their functional roles in the genomes. Tyba was the first centromere-specific satDNA described for a holocentric organism, until now being characterized for only eight species of the genus Rhynchospora Vahl. (Cyperaceae). Here, we characterized Tyba across a broad sampling of the genus, analysing and comparing its evolutionary patterns with other satDNAs.

Methods

We characterized the structure and sequence evolution of satDNAs across a robust dadated phylogeny based on Hybrid Target-Capture Sequencing (hyb-seq) of 70 species. We mined the repetitive fraction for Tyba-like satellites to compare its features with other satDNAs and to construct a Tyba-based phylogeny for the genus.

Key Results

Our results show that Tyba is present in the majority of examined species of the genus, spanning four of the five major clades and maintaining intrafamily pairwise identity of 70.9% over 31 Myr. In comparison, other satellite families presented higher intrafamily pairwise identity but are phylogenetically restricted. Furthermore, Tyba sequences could be divided into 12 variants grouped into three different clade-specific subfamilies, showing evidence of traditional models of satDNA evolution, such as the concerted evolution and library models. Besides, a Tyba-based phylogeny showed high congruence with the hyb-seq topology. Our results show structural indications of a possible relationship of Tyba with nucleosomes, given its high curvature peaks over conserved regions and overall high bendability values compared with other non-centromeric satellites.

Conclusions

Overall, Tyba shows a remarkable sequence conservation and phylogenetic significance across the genus Rhynchospora, which suggests that functional roles might lead to long-term stability and conservation for satDNAs in the genome.
Simulated infection alters the behavior of pair bonded songbirds and their healthy neighbors
Authors: Love Ashley C , Anthony Anna C , Nash Aimee , Campos-Melara Angel , Kodali Jahnavi , DuRant Sarah E
Published: February 2023

While infection and perceived infection risk can influence social and reproductive behavior in several taxa, relatively little is known about how infection specifically affects pair bond behaviors. Some pair bond maintenance behaviors may be costly to maintain during infection, and infection could promote avoidance behaviors within an established pair. Many species exhibiting pair bonds are part of larger social groups, and behavioral shifts in established pairs can result in altered extra-pair contact rates that could also shape disease transmission. Using captive zebra finches (Taeniopygia guttata), we examined how an immune challenge with lipopolysaccharide (LPS) influences activity, social behavior, and pair bond maintenance behaviors in established pairs and their healthy neighbors. We observed shifts in individual and pair maintenance behaviors in both immune-challenged pairs and healthy pairs exposed to a social cue of infection (sick conspecifics). Specifically, LPS-challenged birds decreased activity and social interaction attempts relative to control birds, consistent with LPS-induced sickness behavior. LPS-challenged birds also increased the frequency of clumping (perching together in bodily contact) between individuals within a pair. Healthy birds exposed to immune-challenged conspecifics decreased flight activity and increased self-preening, behaviors which could function to limit infection risk. Exploring how both infection and the perceived risk of infection shape behaviors within and among paired individuals will increase our understanding of the role of social behaviors in shaping disease dynamics.
Spatial learning overshadows learning novel odors and sounds in both predatory and frugivorous bats
Authors: Dixon Marjorie May , Carter Gerald G , Ryan Michael J , Page Rachel A
Published: February 2023

To forage efficiently, animals should selectively attend to and remember the cues of food that best predict future meals. One hypothesis is that animals with different foraging strategies should vary in their reliance on spatial versus feature cues. Specifically, animals that store food in dispersed caches or that feed on spatially stable food, such as fruits or flowers, should be relatively biased towards learning a meal’s location, whereas predators that hunt mobile prey should instead be relatively biased towards learning feature cues such as odor or sound. Several authors have predicted that nectar-feeding and fruit-feeding bats would rely relatively more on spatial cues, whereas closely related predatory bats would rely more on feature cues, yet no experiment has compared these two foraging strategies under the same conditions. To test this hypothesis, we compared learning in the frugivorous bat, Artibeus jamaicensis, and the predatory bat, Lophostoma silvicolum, which hunts katydids using acoustic cues. We trained bats to find food paired with a unique and novel odor, sound, and location. To assess which cues each bat had learned, we then dissociated these cues to create conflicting information. Rather than finding that the frugivore and predator clearly differ in their relative reliance on spatial versus feature cues, we found that both species used spatial cues over sounds or odors in subsequent foraging decisions. We interpret these results alongside past findings on how foraging animals use spatial cues versus feature cues, and explore why spatial cues may be fundamentally more rich, salient, or memorable.
Factoring in Family: Considerations of Parenthood in the Assessment, Enforcement, and Collection of Legal Financial Obligations (LFOs)
Authors: Martin Brittany T , Spencer Suarez Kimberly , Giuffre Andrea , Edgemon Timothy G , Horowitz Veronica
Published: February 2023

Prior research has yet to address how criminal legal system actors take parenthood into account when imposing and enforcing LFOs. Drawing on evidence from 205 semi-structured interviews conducted across four states, this study explores the relationship between monetary punishment and parenthood from the perspectives of court and community corrections professionals. Engaging Kathleen Daly’s framework of familial paternalism (1987a, 1987b, 1989a, 1989b), we find that system actors obtain and interpret information about defendant circumstances to (1) consider family complexity, (2) construct deservingness and (3) curb spill-over punishment. Ultimately, we find that system actors consider parental status in relation to LFOs and defendants’ ability to pay, though their decisions also hinge on gender and the nature of parental involvement.
Functional imaging and anatomical connections in squirrel monkeys reveal parietal–frontal circuits underlying eye movements
Authors: Stepniewska Iwona , Kahler-Quesada Sofia , Kaas Jon H , Friedman Robert M
Published: February 2023

The posterior parietal cortex (PPC) of squirrel monkeys contains subregions where long trains of intracortical microstimulation evoke complex, behaviorally meaningful movements. Recently, we showed that such stimulation of a part of the PPC in the caudal lateral sulcus (LS) elicits eye movements in these monkeys. Here, we studied the functional and anatomical connections of this oculomotor region we call parietal eye field (PEF) with frontal eye field (FEF) and other cortical regions in 2 squirrel monkeys. We demonstrated these connections with intrinsic optical imaging and injections of anatomical tracers. Optical imaging of frontal cortex during stimulation of the PEF evoked focal functional activation within FEF. Tracing studies confirmed the functional PEF-FEF connections. Moreover, tracer injections revealed PEF connections with other PPC regions on the dorsolateral and medial brain surface, cortex in the caudal LS, and visual and auditory cortical association areas. Subcortical projections of PEF were primarily with superior colliculus, and pontine nuclei as well as nuclei of the dorsal posterior thalamus and caudate. These findings suggest that PEF in squirrel monkey is homologous to lateral intraparietal (LIP) area of macaque, supporting the notion that these brain circuits are organized similarly to mediate ethologically relevant oculomotor behaviors.
Exploring the heterogeneity of brain structure in autism spectrum disorder based on individual structural covariance network
Authors: Guo Xiaonan , Zhang Xia , Chen Heng , Zhai Guangjin , Cao Yabo , Zhang Tao , Gao Le
Published: February 2023

Autism spectrum disorder (ASD) is characterized by highly structural heterogeneity. However, most previous studies analyzed between-group differences through a structural covariance network constructed based on the ASD group level, ignoring the effect of between-individual differences. We constructed the gray matter volume-based individual differential structural covariance network (IDSCN) using T1-weighted images of 207 children (ASD/healthy controls: 105/102). We analyzed structural heterogeneity of ASD and differences among ASD subtypes obtained by a K-means clustering analysis based on evidently different covariance edges relative to healthy controls. The relationship between the distortion coefficients (DCs) calculated at the whole-brain, intra- and interhemispheric levels and the clinical symptoms of ASD subtypes was then examined. Compared with the control group, ASD showed significantly altered structural covariance edges mainly involved in the frontal and subcortical regions. Given the IDSCN of ASD, we obtained 2 subtypes, and the positive DCs of the 2 ASD subtypes were significantly different. Intra- and interhemispheric positive and negative DCs can predict the severity of repetitive stereotyped behaviors in ASD subtypes 1 and 2, respectively. These findings highlight the crucial role of frontal and subcortical regions in the heterogeneity of ASD and the necessity of studying ASD from the perspective of individual differences.
Using The Virtual Brain to study the relationship between structural and functional connectivity in patients with multiple sclerosis: a multicenter study
Authors: Martí-Juan Gerard , Sastre-Garriga Jaume , Martinez-Heras Eloy , Vidal-Jordana Angela , Llufriu Sara , Groppa Sergiu , Gonzalez-Escamilla Gabriel , Rocca Maria A , Filippi Massimo , Høgestøl Einar A , Harbo Hanne F , Foster Michael A , Toosy Ahmed T , Schoonheim Menno M , Tewarie Prejaas , Pontillo Giuseppe , Petracca Maria , Rovira Àlex , Deco Gustavo , Pareto Deborah
Published: February 2023

The relationship between structural connectivity (SC) and functional connectivity (FC) captured from magnetic resonance imaging, as well as its interaction with disability and cognitive impairment, is not well understood in people with multiple sclerosis (pwMS). The Virtual Brain (TVB) is an open-source brain simulator for creating personalized brain models using SC and FC. The aim of this study was to explore SC–FC relationship in MS using TVB. Two different model regimes have been studied: stable and oscillatory, with the latter including conduction delays in the brain. The models were applied to 513 pwMS and 208 healthy controls (HC) from 7 different centers. Models were analyzed using structural damage, global diffusion properties, clinical disability, cognitive scores, and graph-derived metrics from both simulated and empirical FC. For the stable model, higher SC–FC coupling was associated with pwMS with low Single Digit Modalities Test (SDMT) score (F=3.48, P$\lt$0.05), suggesting that cognitive impairment in pwMS is associated with a higher SC–FC coupling. Differences in entropy of the simulated FC between HC, high and low SDMT groups (F=31.57, P$\lt$1e-5), show that the model captures subtle differences not detected in the empirical FC, suggesting the existence of compensatory and maladaptive mechanisms between SC and FC in MS.
Symptoms and Systemic Drug Reactions in Persons Receiving Weekly Rifapentine Plus Isoniazid (3HP) Treatment for Latent Tuberculosis Infection
Authors: Sadowski Claire , Belknap Robert , Holland David P , Moro Ruth N , Chen Michael P , Wright Alicia , Millet Joan Pau , Caylà Joan A , Scott Nigel A , Borisov Andrey , Gandhi Neel R
Published: February 2023

Background

Three months of weekly rifapentine plus isoniazid (3HP) therapy for latent tuberculosis infection (LTBI) is recommended worldwide. The development of symptoms and systemic drug reactions (SDRs) on 3HP have not been fully characterized. We aimed to determine the patterns of symptom development and identify SDRs and associated factors in patients taking 3HP.

Methods

We analyzed symptoms data in participants receiving 3HP in the Tuberculosis Trials Consortium's iAdhere study (Study 33). We examined the patterns of symptom reporting across participants from baseline and 4 monthly visits. Bivariate analyses and multivariable regression models were used to identify factors associated with SDRs. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated.

Results

Among 1002 participants receiving 3HP, 768 (77%) reported at least 1 symptom; 97% of these symptoms were grade 1 (79%) or grade 2 (18%). Most symptoms developed in the first month and resolved. A total of 111 (11%) participants had symptoms that met criteria for SDRs; however, 53 (48%) of these participants completed therapy. Factors associated with SDRs and discontinuation included female sex (RR: 2.05; 95% CI: 1.19–3.54), age ≥45 years (RR: 1.99; 95% CI: 1.19–3.31), and use of concomitant medications (RR: 2.26; 95% CI: 1.15–4.42).

Conclusions

Although most patients receiving 3HP reported symptoms, most were mild, occurred early, and resolved without stopping treatment. Among patients experiencing SDRs, nearly half were able to complete therapy. Patient and provider education should focus on differentiating severe reactions where 3HP should be stopped from minor symptoms that will resolve.

Clinical Trials Registration. NCT01582711.
Magnetic resonance assessment of left atrial scar formation following a novel very high-power short-duration workflow for atrial fibrillation ablation
Authors: Sciacca Vanessa , Fink Thomas , Körperich Hermann , Bergau Leonard , Guckel Denise , Nischik Flemming , Eckstein Jan , Braun Martin , Hamriti Mustapha El , Imnadze Guram , Piran Misagh , Sommer Philipp , Sohns Christian
Published: February 2023

Aims

Atrial fibrillation (AF) ablation protocols using energy delivery with very high power and short duration (vHPSD) have been introduced to improve lesion formation. This study reports procedural data of vHPSD ablation in AF patients and analyses characteristics of ablation-induced left atrial (LA) scar formation from cardiac magnetic resonance imaging (MRI).

Methods and results

Sixty consecutive patients undergoing index pulmonary vein isolation following our institutional Q4U-AF workflow were prospectively enrolled. Ablation was conducted using a contact force sensing catheter allowing for vHPSD ablation using a temperature-controlled ablation mode. Thirty patients underwent cardiac late gadolinium enhancement MRI of the LA 3 months after ablation to assess LA scar. Mean procedural duration was 66.5 ± 14.8 min. Mean ablation time was 4.7 ± 0.9 min with a mean number of 69.9 ± 14.2 applications. First-pass isolation was achieved in 51 patients (85%) for the right pulmonary veins (RPVs), in 37 patients (61.7%) for the left pulmonary veins (LPVs), and in 34 patients (56.7%) for both pulmonary veins (PVs). Magnetic resonance imaging at 3 months post-ablation demonstrated a mean scar width of 14.4 ± 2.6 mm around RPVs and 11.9 ± 1.9 mm at LPVs (P > 0.05). Complete PV encirclement was observed in 76.7% for RPVs, in 76.7% for LPVs, and in 66.7% for both PV pairs. During a mean follow-up of 4.7 ± 1.4 months, arrhythmia recurrence was observed in 3.3% of the patients.

Conclusion

Pulmonary vein isolation following a novel vHPSD workflow resulted in short procedure duration and high acute and mid-term efficacy. Magnetic resonance imaging demonstrated durable and transmural PV lesions with homogeneous and contiguous scar formation.
Effects of pore fluids on the hardening of shear modulus in tight dolomite: experimental observations and theoretical modelling
Authors: Li Dongqing , Wei Jianxin
Published: February 2023

SUMMERY

Understanding the influence of pore fluids on acoustic characteristics of rocks containing pores of low aspect ratio, that is, cracks is crucial for both laboratory and field observations of seismic exploration. Unlike the petrophysical aspects of conventional rock species, those of tight dolomites are relatively more complex and poorly understood. To address this problem, we investigated the ultrasonic velocity of dry and saturated tight dolomite in the effective pressure range of 2–60 MPa and analysed the variation in shear modulus upon fluid saturation. Our results showed that while undergoing the change in form from the dry state to being saturated with water, the rock may weaken or harden, and the shear modulus may correspondingly either decrease or increase. Shear modulus hardening was more apparent in dolomites, with microcracks mostly dispersed between and within particles of a high proportion of soft pores with a wide distribution range of aspect ratio. This study used the Walsh–Hudson model to satisfactorily simulate the hardening of shear modulus in fluid-saturated tight dolomites. The suppression of squirt flow that is responsible for the increased shear modulus of fluid-saturated tight dolomites tested at sufficiently high frequencies. As the change in shear modulus affects the prediction of longitudinal and shear wave velocities, using Gassmann's theory to fluid substitution in unconventional reservoirs such as tight dolomite may yield inaccurate results. Therefore, it may be necessary to consider variation in shear modulus while selecting the appropriate simulation model.
Transcriptome Analysis of Dermal Fibroblasts Derived From Visceral Leishmaniasis and Post–Kala-Azar Dermal Leishmaniasis Patients Reveal Disease-Specific Gene Expression and Pathological Regulation
Authors: Singh Sneha , Madhukar Major , Dikhit Manas Ranjan , Ravidas Vidya Nand , Pandey Krishna , Sen Abhik
Published: February 2023

Background

Post–kala-azar dermal leishmaniasis (PKDL), a dermal form of the disease, occurs in some visceral leishmaniasis (VL) patients following treatment. The PKDL disease mechanism is not yet clearly understood. Here we have studied the role of dermal fibroblasts in VL and PKDL disease mechanism.

Methods

Dermal fibroblasts were grown from skin biopsy explants collected from individual VL and PKDL patients and healthy controls. Fibroblasts from the third passage were subjected to RNA sequencing to analyze differentially expressed genes (DEGs). Significantly important genes were further validated by reverse transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA).

Results

Transcriptome analysis of PKDL versus VL identified 516 DEGs (263 were overrepresented and 253 were underrepresented in PKDL). Among the top hub genes, MMP2, IL1B, CXCL8, IFIH1, NFKB1A, IL6, ISG15, and EGFR were underexpressed and ACTB, HSP90AA1, RAB7A, and RPS27A were overexpressed in PKDL compared to VL.

Conclusions

Our data indicate that PKDL fibroblasts may present antigens through the MHC I pathway activating CD8+ T-cell mediated response, while VL fibroblasts express nuclear factor-κB (NFκB)-mediated chemokines, IL1B, IL6, and IL8, resulting in the recruitment of natural killer (NK)-cells and monocytes to the site of infection, leading to the clearance of parasite from the skin and visceralization of the disease.
Influence of factors commonly known to be associated with health inequalities on antibiotic use in high-income countries: a systematic scoping review
Authors: Harvey Eleanor J , De Brún Caroline , Casale Ella , Finistrella Viviana , Ashiru-Oredope Diane
Published: February 2023

Introduction

Inappropriate antibiotic use contributes to antimicrobial resistance. High-income countries have high rates of antibiotic use, with a prevalence of health inequalities amongst populations.

Objectives

To understand the influence of factors commonly known to be associated with health inequalities on antibiotic use in high-income countries.

Methods

Factors commonly known to be associated with health inequalities were defined as protected characteristics under UK’s Equality Act (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race/ethnicity, religion or belief, sex, sexual orientation), socioeconomic characteristics (income, insurance, employment status, deprivation, education), geography (urban versus rural, region) and vulnerable groups. The study followed PRISMA-ScR and, PRISMA-E statements.

Results

Fifty-eight of 402 identified studies met inclusion criteria. Fifty of those papers (86%) included one or more protected characteristics, 37 (64%) socioeconomic characteristics, 21 (36%) geography and 6 (10%) vulnerable groups. Adults in older age groups, especially those in residential care, had the highest antibiotic use. The influence of race or ethnicity and antibiotic use was particular to country context. Areas of high deprivation had higher antibiotic use compared with areas of no or low deprivation, and geographical variation existed within countries. When faced with health system barriers, migrants relied on alternative routes of antibiotic supply other than prescription.

Recommendations for future research

To investigate how factors and wider social determinants of health interplay and impact antibiotic use, using frameworks/approaches to reduce health inequalities such as England’s Core20PLUS approach. Antimicrobial stewardship initiatives should equip healthcare professionals to review patients at the highest risk of antibiotic use.
Frequency and factors associated with infusion-related local complications of vancomycin on peripheral venous catheters
Authors: Ammar Helmi , Rolland Simon , Jouffroy Romain , Dubert Marie , Le Beller Christine , Podglajen Isabelle , Lillo-Lelouet Agnès , Lebeaux David , Bensaid Samuel
Published: February 2023

Background

Vancomycin is a reference antibiotic against methicillin-resistant staphylococci. Its administration is associated with infusion-related local complications (IRLC). To reduce this risk, it has been proposed to increase vancomycin dilution in the IV bag and to perform continuous infusion using the volumetric pump. The aim of our study was to assess the safety of peripheral infusion of vancomycin with the volumetric pump.

Objectives

To compare the frequency of IRLC between patients receiving vancomycin and those receiving β-lactam (BL) antibiotics. Our secondary objective was to assess factors associated with the occurrence of IRLC.

Patients and methods

We conducted a prospective observational study in a French tertiary hospital. Between February 2021 and November 2021, we included all patients receiving continuous infusions of vancomycin or BL through a peripherally inserted venous catheter (PIVC). The primary endpoint was the occurrence of IRLC on Day 1 (D1).

Results

We included 168 patients (56 vancomycin, 112 BL). At D1, 14 patients (25%) presented IRLC in the vancomycin group versus 11 patients (10%) in the BL group (P = 0.01). There was significantly more IRLC in the group receiving vancomycin at an infused concentration above 5 mg/mL than those receiving BL (8/15, 53.3% versus 11/112, 10%, respectively, P < 0.01). However, no significant difference was observed between patients receiving infused vancomycin concentration ≤5 mg/mL and patients receiving BL (P = 0.4).

Conclusion

Our data support safe administration of vancomycin if infused at a concentration under 5 mg/mL, through the volumetric pump on PIVC.
Progress and bioapplication of CRISPR-based one-step, quantitative and multiplexed infectious disease diagnostics
Authors: Shen Yue , Hu Kai , Yuan Mingzhu , Duan Guangcai , Guo Yongjun , Chen Shuaiyin
Published: February 2023

In Vitro Diagnosis (IVD) technology is able to accurately detect pathogens or biomarkers at an initial stage of disease, which works as an important toolbox for disease diagnosis. Clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated (Cas) system, as an emerging IVD method, plays a crucial role in the field of infectious disease detection due to its superior sensitivity and specificity. Recently, an increasing number of scientists have been devoted to improving the performance of CRISPR-based detection and on-site point-of-care testing (POCT) from extraction-free detection, amplification-free, modified Cas/crRNA complexes, quantitative assays, one-pot detection, and multiplexed platform. In this review, we describe the potential roles of these novel approaches and platforms in one-pot methods, quantitative molecular diagnostics as well as multiplexed detection. This review will not only help guide the full use of the CRISPR-Cas tools for quantification, multiplexed detection, POCT and as next-generation diagnostic biosensing platforms but also inspire new ideas, technological advances, and engineering strategies to address real-world challenges like the ongoing COVID-19 pandemic.
Non-visual functions of opsins in Crustacea: a review
Authors: Pérez-Calderón José R , Botello Alejandro , Pérez-León Jorge A
Published: February 2023

Opsins are transmembrane proteins that have a covalent bond with a chromophore 11-cis-retinal in the intracellular region, opsins transiently bind to a G protein, which in turn is alternatively coupled to GTP or GDP. These characteristics allow opsins to function as photopigments and, after reacting with light, they launch the cascade of intracellular communication processes known as phototransduction. Commonly referred to as the starting point of the visual pathway, phototransduction as initiated by opsins, can also mediate physiological processes as varied as taxis, metabolic synchronization, and seasonal migration. This review analyzes such functions performed by opsins in crustaceans, a group with a huge diversity of species that, owing to their plasticity, have been able to invade habitats that other arthropods or terrestrial vertebrates have been unable to occupy. Our analysis emphasizes the way in which opsins take part in crustacean behavioral display under extreme habitat conditions as in the case of cave fauna), as well as in essential ontogenic events. The many functions of opsins have been scarcely investigated due to bias generated by their participation in visual processes. Attention to the non-visual activity of opsins can break new grounds towards an integrative understanding of animal physiology.
Value chain, regional institutions and firm growth in Europe
Authors: Cainelli Giulio , Ganau Roberto , Giunta Anna
Published: February 2023

We analyse whether and to what extent the quality of regional institutions has a differential effect on firms’ growth driven by heterogeneity in firm value chain positioning. We analyse turnover growth during the period 2010–2013 for a sample of manufacturing firms located in four European countries—France, Germany, Italy and Spain. We distinguish final firms serving end markets from suppliers serving other firms. Our instrumental variable estimates point to high-quality regional institutions enhancing the growth performance of only locally embedded suppliers with operations confined to the own regional market—that is, the ‘weakest’ node of the value chain.
Where to draw the line? Expanding the delineation of conservation units to highly mobile taxa
Authors: Turbek Sheela P , Funk W Chris , Ruegg Kristen C
Published: February 2023

Conservation units (CUs) are an essential tool for maximizing evolutionary potential and prioritizing areas across a species’ range for protection when implementing conservation and management measures. However, current workflows for identifying CUs on the basis of neutral and adaptive genomic variation largely ignore information contained in patterns of isolation by distance (IBD), frequently the primary signal of population structure in highly mobile taxa, such as birds, bats, and marine organisms with pelagic larval stages. While individuals located on either end of a species’ distribution may exhibit clear genetic, phenotypic, and ecological differences, IBD produces subtle changes in allele frequencies across space, making it difficult to draw clear boundaries for conservation purposes in the absence of discrete population structure. Here, we highlight potential pitfalls that arise when applying common methods for delineating CUs to continuously distributed organisms and review existing methods for detecting subtle breakpoints in patterns of IBD that can indicate barriers to gene flow in highly mobile taxa. In addition, we propose a new framework for identifying CUs in all organisms, including those characterized by continuous genomic differentiation, and suggest several possible ways to harness the information contained in patterns of IBD to guide conservation and management decisions.
Linear association between radioactive iodine dose and second primary malignancy risk in thyroid cancer
Authors: Kim Kyeong Jin , Kim Kyoung Jin , Choi Jimi , Kim Nam Hoon , Kim Sin Gon
Published: February 2023

Background

We aimed to investigate whether the risk of second primary malignancy (SPM) in patients with thyroid cancer (TC) receiving radioactive iodine (RAI) therapy rises in a cumulative, dose-dependent manner compared with those not undergoing RAI.

Methods

Using the Korean National Health Insurance Service National Health Information Database (2002-2019), we investigated hazard ratios of SPM associated with RAI in TC. SPM was defined as a second primary malignancy diagnosed at least 1 year after TC diagnosis.

Results

Of 217 777 patients with TC (177 385 women and 40 392 men; mean [SD] age, 47.2 [11.6] years), 100 448 (46.1%) received RAI therapy. The median (IQR) follow-up duration was 7.7 (5.5-10.3) years, and the median (IQR) cumulative RAI dose was 3.7 (1.9-5.6) GBq. From 2004 to 2019, SPM incidence rates were 7.30 and 6.56 per 1000 person-years in the RAI and non-RAI groups, respectively, with an unadjusted hazard ratio of 1.09 (95% confidence interval = 1.05 to 1.13); this rate remained at 1.08 (95% confidence interval = 1.04 to 1.13) after adjustment for multiple clinical confounding factors. Notably, SPM risk increased significantly, from 3.7 GBq with full adjustments, and a strong linear association between cumulative RAI dose and SPM was observed in the restricted cubic spline analysis. Regarding cancer subtypes, myeloid leukemia and salivary gland, trachea, lung and bronchus, uterus, and prostate cancers were the most significantly elevated risks in patients who underwent RAI therapy.

Conclusions

This study identified that SPM risk increased linearly in a dose-dependent manner in patients with TC undergoing RAI therapy compared with those not undergoing RAI therapy.
C
Authors: Dickman Andrew
Published: February 2023

This chapter includes drugs beginning with the letter C
G
Authors: Dickman Andrew
Published: February 2023

This chapter includes drugs beginning with the letter G
K
Authors: Dickman Andrew
Published: February 2023

This chapter includes drugs beginning with the letter K
P
Authors: Dickman Andrew
Published: February 2023

This chapter includes drugs beginning with the letter P
Q
Authors: Dickman Andrew
Published: February 2023

This chapter includes drugs beginning with the letter Q
R
Authors: Dickman Andrew
Published: February 2023

This chapter includes drugs beginning with the letter R
How to pass the Part II examination
Authors: Zerafa Mario , Hill Sue
Published: February 2023

This chapter covers the European Diploma in Anaesthesiology and Intensive Care (EDAIC) Part II examination, including how to understand the oral examination, the Structured Oral Examinations (on Basic Sciences and then Clinical Anaesthesia and Intensive Care). It describes how to prepare for Part II, how to behave during the exam, common pitfalls that may cause failure and how to avoid these, and how to practise answering oral questions. The Part II examination consists of four Structured Oral Examinations (SOE), two in the morning and two in the afternoon. The morning SOEs concentrate on the Basic Sciences and the afternoon ones concentrate on Clinical Anaesthesia and Intensive Care. Each SOE lasts 25 minutes and consists of five questions and there will be two examiners present, each of whom will score your performance independently on all the questions asked, not just those they ask.
Anatomy
Authors: Dziadzko Mikhail
Published: February 2023

This chapter provides ten practice multiple-choice questions (MCQs) about anatomy along with answers, explanations, and references for further reading to increase your in-depth understanding. Anatomy of the cardiovascular, cardiac, and nervous system are of prime importance to anaesthetists, so these topics are commonly covered in the written examination. However, the anatomy of other areas of the body may also be the focus of a question if, for example, vascular access is required, or ultrasound is useful. As far as possible, these questions appear as they would on a Part I paper. However, there are some publisher-defined style differences that should not affect your understanding of the questions presented here. The main differences include certain spelling conventions, when and where abbreviations are explained and then used in a question, and the presence of Oxford commas, which are present throughout this book but used only for clarification on an examination paper.
Physics
Authors: Varvinskiy Andrey
Published: February 2023

This chapter provides 25 multiple-choice questions about physics, equipment, and clinical measurement along with answers, explanations, and references for further reading to increase your in-depth understanding. It is important that anaesthetists have a good understanding of the physical principles that underlie our anaesthetic practice and the equipment that we use to keep the patient safe. Fluid dynamics, the principles of electrical circuitry, electrical safety, and monitoring temperature and humidity are of prime importance alongside an understanding of the anaesthetic machine and vapourizers. As far as possible, these questions appear as they would on an actual EDAIC Part I paper. However, there are some publisher-defined style differences that should not affect your understanding of the questions presented here. The main differences have been pointed out in a previous chapter but beware differences in spelling conventions and the use of abbreviations.
Special anaesthesia
Authors: Firago Vladislav , Sahin Altan
Published: February 2023

This chapter provides 30 practice multiple-choice questions (MCQs) about special anaesthesia together with answers and references to improve your knowledge and in-depth understanding. The topics included in special anaesthesia are obstetrics, paediatrics, neurosurgical, cardiopulmonary, and chronic pain management. As far as possible, the questions here are presented in exactly the way they will appear in an actual Part I examination paper. Similar MCQs to the ones in this chapter will be part of Paper B, Clinical Anaesthesia. There are some minor differences due to publication style, as pointed out in preceding chapters, but these should not impair your understanding of the questions.