bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences of remote consultation in UK primary care for patients with mental health conditions: A systematic review
Authors: Antonio Serena , Joseph David , Parsons Joanne , Atherton Helen
Published: March 2024

Objectives

There has been a rapid shift from face-to-face to remote consultation across healthcare settings. 90% of patients with mental health conditions are cared for entirely in primary care. Remote consultation can present challenges and benefits for patients with mental health conditions. The aim of this systematic review was to collate and examine the evidence relating to remote consultation in UK primary care on the experiences of patients with mental health conditions.

Methods

Six major databases were searched for empirical studies published in the English language between 1 January 2010 and 21 October 2022. Studies were included where remote consultation occurred between a patient and primary care clinician. Outcomes of interest include mode of remote consultation, patient experiences and characteristics. Final included studies were assessed for quality, and results analysed with narrative synthesis.

Results

Six studies met the inclusion criteria, covering a range of mental health conditions and remote consultation modalities (telephone, video, online, email, text-based). Patients were overall satisfied with remote consultation, with particular benefit for certain mental health conditions or anxious patients. However, several studies found that face-to-face was the preferred method, with highlighted negatives to remote consultation, such as inflexibility of online formats. Acceptability of remote consultation is context specific and influenced by the purpose of the consultation and individual patient. Remote consultation may reduce anxiety in some patients, but is potentially less acceptable than face-to-face for relational appointments.

Conclusions

Acceptability of remote consultation is context dependent. There is a lack of evidence surrounding patient characteristics and access to remote consultation.
The role of mentoring and coaching of healthcare professionals for digital technology adoption and implementation: A scoping review
Authors: Scandiffio Jillian , Zhang Melody , Karsan Inaara , Charow Rebecca , Anderson Melanie , Salhia Mohammad , Wiljer David
Published: March 2024

Objective

Mentoring and coaching practices have supported the career and skill development of healthcare professionals (HCPs); however, their role in digital technology adoption and implementation for HCPs is unknown. The objective of this scoping review was to summarize information on healthcare education programs that have integrated mentoring or coaching as a key component.

Methods

The search strategy and keyword searches were developed by the project team and a research librarian. A two-stage screening process consisting of a title/abstract scan and a full-text review was conducted by two independent reviewers to determine study eligibility. Articles were included if they: (1) discussed the mentoring and/or coaching of HCPs on digital technology, including artificial intelligence, (2) described a population of HCPs at any stage of their career, and (3) were published in English.

Results

A total of 9473 unique citations were screened, identifying 19 eligible articles. 11 articles described mentoring and/or coaching programs for digital technology adoption, while eigth described mentoring and/or coaching for digital technology implementation. Program participants represented a diverse range of industries (i.e., clinical, academic, education, business, and information technology). Digital technologies taught within programs included electronic health records (EHRs), ultrasound imaging, digital health informatics, and computer skills.

Conclusions

This review provided a summary of the role of mentoring and/or coaching practices within digital technology education for HCPs. Future training initiatives for HCPs should consider appropriate resources, program design, mentor-learner relationship, security concerns and setting clear expectations for program participants. Future research could explore mentor/coach characteristics that would facilitate successful skill transfer.
Handmade Bicuspid Valved Polytetrafluoroethylene Conduit for Right Ventricular Outflow Tract Reconstruction
Authors: Malankar Dhananjay P. , Dhake Shyam , Mhatre Amit , Soni Bharat , Kandavel Dinesh , Bamne Sujit , Garekar Swati
Published: March 2024

Background: Excellent outcomes of right ventricle to pulmonary artery conduits with polytetrafluoroethylene (PTFE) valves have been reported. The purpose of this study was to analyze the short-term results of our handmade PTFE bicuspid valved conduit (VC) for right ventricular outflow tract reconstruction. Methods: Between September 2019 and May 2023, bicuspid PTFE-VC was implanted in 17 patients at a median age of 2.5 years (range, 3 months to 13.6 years). The PTFE-VC was fashioned from a commercially available PTFE tube graft (14 mm in three patients, 16 mm in three patients, 18 mm in one patient, 20 mm in three patients, and 22 mm in seven patients) and 0.1 mm thick PTFE membrane for the leaflet material. Valve function was assessed by echocardiogram after the implantation. The conduit reoperation and the conduit dysfunction were analyzed. There were no early deaths, but there was one late death. Results: There were no postoperative in-hospital deaths. Follow-up echocardiograms were available for 14 of 17 patients. The median follow-up was 21 months (range, 7-49 months). Conduit stenosis was none or trivial in 11 patients while it was mild in two and moderate in one patient and severe in 0 patients. Conduit insufficiency was mild or trivial in all 14 patients. By the end of the study period, freedom from reoperation/reintervention was 100%. There were no episodes of aneurysmal dilatation of the conduit or endocarditis. Conclusions: Handmade bicuspid PTFE VC shows good short-term outcome, with no significant valve dysfunction and no reintervention. A longer follow-up is necessary to evaluate the long-term advantages of using the handmade bicuspid PTFE VC.
Predictors of Uptake of Rotavirus Vaccination Amongst Disadvantaged Communities in Pakistan
Authors: Huda Maryam , Ali Tazeen , Hasnani Fauzia Basaria , Sayani Saleem , Zaidi Shehla
Published: March 2024

Introduction. Pakistan has the highest childhood mortality associated with diarrheal diseases. The objective of this study is to identify underlying factors contributing to lack of knowledge among mothers regarding vaccine’s efficacy in the prevention of diarrhea. Methodology. Secondary data was analyzed from a cross-sectional household survey in Northern Pakistan of eligible households having under-2-year children. Univariate and multivariate logistic regression analyses were carried out. Results. Only 30% of the mothers had knowledge regarding diarrhea prevention by vaccine. The main factors found significantly correlated with this knowledge were mother’s education, distance of households from EPI centers, immunization status of children, counseling regarding clean drinking water and hygiene, provision of ORS, and antenatal care services by LHWs. Conclusion. Women’s literacy, access to care and LHW services are important for improving awareness and acceptance of vaccines for vaccine preventable diseases including diarrhea. Policy makers need to focus on improved monitoring and reprioritization of undermined services by LHWs.
What's out there? A scoping review of autism-related policies and research interests at U.K. higher education institutions
Authors: Cray Jess , Hull Laura , Sedgewick Felicity
Published: March 2024

Background

There is a growing number of autistic students in U.K. higher education institutions (HEIs), who may require autism-specific support to optimise their academic achievement, long-term prospects, and well-being. This study undertook the first known review of publicly available autism-related policies at U.K. HEIs.

Methods

Public websites of 132 HEIs were searched for eleven key terms, and the results of these searches were assessed using a policy appraisal approach. Qualitative framework analysis then explored the content of the policies identified.

Results

Three hundred thirty-six policies were identified from 92 HEIs, with 40 HEIs having no policies meeting search terms. The most common policy results were ‘autism support’ and ‘disability adjustments’. The qualitative analysis showed a wide range of policies which covered most areas of higher education life but with significant inconsistency in content and quality.

Conclusions

While many U.K. HEIs appear to be aware of autistic students and the need to support them, most institutions have minimal publicly available policies regarding support for autistic students. The policies to support students which do exist are patchy at best, and non-existent in some cases, requiring more work at individual institutions and across the HEI sector.
A multiplex RPA-CRISPR/Cas12a-based POCT technique and its application in human papillomavirus (HPV) typing assay
Authors: Liu Yan , Chao Zhujun , Ding Wei , Fang Tanfeng , Gu Xinxian , Xue Man , Wang Wei , Han Rong , Sun Wanping
Published: March 2024

Persistent infection with high-risk human papillomavirus (HR-HPV) is the primary and initiating factor for cervical cancer. With over 200 identified HPV types, including 14 high-risk types that integrate into the host cervical epithelial cell DNA, early determination of HPV infection type is crucial for effective risk stratification and management. Presently, on-site immediate testing during the HPV screening stage, known as Point of Care Testing (POCT), remains immature, severely limiting the scope and scenarios of HPV screening. This study, guided by the genomic sequence patterns of HPV, established a multiplex recombinase polymerase amplification (RPA) technology based on the concept of “universal primers.” This approach achieved the multiple amplification of RPA, coupled with the CRISPR/Cas12a system serving as a medium for signal amplification and conversion. The study successfully constructed a POCT combined detection system, denoted as H-MRC12a (HPV—Multiple RPA—CRISPR/Cas12a), and applied it to high-risk HPV typing detection. The system accomplished the typing detection of six high-risk HPV types (16, 18, 31, 33, 35, and 45) can be completed within 40 min, and the entire process, from sample loading to result interpretation, can be accomplished within 45 min, with a detection depth reaching 1 copy/μL for each high-risk type. Validation of the H-MRC12a detection system’s reproducibility and specificity was further conducted through QPCR on 34 clinical samples. Additionally, this study explored and optimized the multiplex RPA amplification system and CRISPR system at the molecular mechanism level. Furthermore, the primer design strategy developed in this study offers the potential to enhance the throughput of H-MRC12a detection while ensuring sensitivity, providing a novel research avenue for high-throughput detection in Point-of-Care molecular pathogen studies.
Causal relationship between immune cells and telomere length: mendelian randomization analysis
Authors: Li Yujian , Lai Shenglin , Kan Xuan
Published: March 2024

Background

The causal relationship between immune cells and telomere length remains controversial.

Methods

Data on the immune cells were obtained from a previous study with 3,757 participants. Data on telomere length were obtained from the OpenGWAS database. Genome-Wide Association Study (GWAS) data were obtained and screened for eligible instrumental variables (IVs) using the TwoSampleMR package and the Phenoscanner database. To investigate the genetic causality between immune cells and telomere length, Mendelian randomization (MR) analysis and Bayesian weighted Mendelian randomization (BWMR) analysis were used.

Results

MR analysis showed that there is indeed a genetic causal relationship between immune cells and telomere length. A total of 16 immune cells were successfully validated. A positive correlation was found between telomere length and immune cells such as CD28 + CD45RA + CD8br %CD8br (OR = 1.002, 95%CI: 1.000-1.003). A negative correlation was found between telomere length and immune cells such as Transitional AC (OR = 0.991, 95%CI: 0.984–0.997) (P < 0.05). Reverse MR analysis similarly confirmed that telomere length can affect four types of immune cells, including CD25 on IgD + CD24- (OR = 1.291, 95%CI: 1.060–1.571), at the genetic level.

Conclusion

There is indeed a mutual genetic causality between immune cells and telomere length, which will provide theoretical basis and support for more subsequent clinical studies.
Characterization of the major autolysin (AtlC) of Staphylococcus carnosus
Authors: Merz Maximilian , Schiffer Carolin J. , Klingl Andreas , Ehrmann Matthias A.
Published: March 2024

Background

Autolysis by cellular peptidoglycan hydrolases (PGH) is a well-known phenomenon in bacteria. During food fermentation, autolysis of starter cultures can exert an accelerating effect, as described in many studies on cheese ripening. In contrast, very little is known about autolysis of starter cultures used in other fermentations. Staphylococcus (S.) carnosus is often used in raw sausage fermentations, contributing to nitrate reduction and flavor formation. In this study, we analyzed the influence of PGHs of the strains S. carnosus TMW 2.146 and S. carnosus TMW 2.2525 on their autolytic behavior. The staphylococcal major autolysin (Atl), a bifunctional enzyme with an N-acetylmuramoyl-L-alanine amidase and a glucosaminidase as an active site, is assumed to be the enzyme by which autolysis is mainly mediated.

Results

AtlC mutant strains showed impaired growth and almost no autolysis compared to their respective wild-type strains. Light microscopy and scanning electron microscopy showed that the mutants could no longer appropriately separate from each other during cell division, resulting in the formation of cell clusters. The surface of the mutants appeared rough with an irregular morphology compared to the smooth cell surfaces of the wild-types. Moreover, zymograms showed that eight lytic bands of S. carnosus, with a molecular mass between 140 and 35 kDa, are processed intermediates of AtlC. It was noticed that additional bands were found that had not been described in detail before and that the banding pattern changes over time. Some bands disappear entirely, while others become stronger or are newly formed. This suggests that AtlC is degraded into smaller fragments over time. A second knockout was generated for the gene encoding a N-acetylmuramoyl-L-alanine amidase domain-containing protein. Still, no phenotypic differences could be detected in this mutant compared to the wild-type, implying that the autolytic activity of S. carnosus is mediated by AtlC.

Conclusions

In this study, two knockout mutants of S. carnosus were generated. The atlC mutant showed a significantly altered phenotype compared to the wild-type, revealing AtlC as a key factor in staphylococcal autolysis. Furthermore, we show that Atl is degraded into smaller fragments, which are still cell wall lytic active.
Minimal alveolar concentration of sevoflurane in combination with remimazolam in adults during laryngeal mask insertion: an up-down sequential allocation study
Authors: Huang Yan , Liao HongYu , Li LinJi , Xu Juan , Jiang PingPing , Guo YanXia , Liu KunPeng
Published: March 2024

Background

Remimazolam is a novel ultrashort-acting intravenous benzodiazepine sedative-hypnotic. The combination of remimazolam and sevoflurane does not increase respiratory sensitivity, produce bronchospasm, or cause other adverse conditions. We aimed to observe the effects of different remimazolam doses on the minimum alveolar concentration (MAC) of sevoflurane at end-expiration during laryngeal mask insertion and evaluate the effect of sex on the efficacy of the combination of remimazolam on the suppression of laryngeal mask insertion in adult patients.

Methods

We included 240 patients undergoing laparoscopic surgery under general anesthesia with elective placement of a laryngeal mask (120 males and 120 females). The patients were randomly divided into four groups according to sex: a control group (randomization for female patients, RF0; randomization for male patients, RM0) and three remimazolam groups (RF1, RM1 / RM2, RF2 / RM3, RF3), with 30 patients in each group. Induction was established by vital capacity rapid inhalation induction (VCRII), using 8% sevoflurane and 100% oxygen (6 L/min) in all patients. The (RF1, RM1), (RM2, RF2), and (RM3, RF3) groups were continuously injected with remimazolam at doses of 1, 1.5, and 2.0 mg/kg/h, respectively, while the (RM0, RF0) group was injected with an equal volume of normal saline. The end-expiratory concentration of sevoflurane was adjusted to a preset value after the patient’s eyelash reflex disappeared. After the end-expiratory concentration of sevoflurane was kept stable for at least 15 min, the laryngeal mask was placed, and the patient’s physical response to the mask placement was observed immediately and within 30 s of placement. The MAC of sevoflurane was measured using the up-and-down sequential method of Dixon.

Results

The calculated MAC of end-expiratory sevoflurane during laryngeal mask insertion in adult females was (2.94 ± 0.18)%, (2.69 ± 0.16)%, (2.32 ± 0.16)% and (1.83 ± 0.15)% in groups RF0, RF1, RF2 and RF3; (2.98 ± 0.18)%, (2.80 ± 0.19)%, (2.54 ± 0.15)% and (2.15 ± 0.15)% in male groups RM0, RM1, RM2 and RM3, respectively. The MAC values were significantly lower in the (RF1-RF3, RM1-RM3) group when compared to the (RF0, RM0) group. There was no significant difference between (RF0, RF1) and (RM0, RM1), but the MAC value of the RF2-RF3 group was significantly lower than that of the RM2-RM3 group.

Conclusions

Remimazolam can effectively reduce end-expiratory sevoflurane MAC values during laryngeal mask placement in adults. When remimazolam was measured above 1.5 mg/kg/h, the effect of inhibiting laryngeal mask implantation in female patients was stronger than that in male patients. Remimazolam at a dose of 1–2 mg/kg/h combined with sevoflurane induction can be safely and effectively used in these patients.
Health-related quality of life and self-reported health status in adolescents with chronic health conditions before transfer of care to adult health care: an international cohort study
Authors: Kallio Mira , Tornivuori Anna , Miettinen Päivi J. , Kolho Kaija-Leena , Relas Heikki , Culnane Evelyn , Loftus Hayley , Sawyer Susan M. , Kosola Silja
Published: March 2024

Background

Heath-related quality of life (HRQoL) is lower in adolescents with chronic health conditions compared to healthy peers. While there is evidence of some differences according to the underlying condition and gender, differences by measure and country are poorly understood. In this study we focus on the differences in HRQoL in adolescents with various chronic medical conditions in the year before transfer of care to adult health services. We also study the associations of two different HRQoL measurements to each other and to self-reported health.

Methods

We recruited 538 adolescents from New Children`s Hospital, Helsinki, Finland, and the Royal Children`s Hospital, Melbourne, Australia in 2017–2020. We used two validated HRQoL measurement instruments, Pediatric Quality of Life Inventory (PedsQL) and 16D, and a visual analog scale (VAS) for self-reported health status.

Results

In total, 512 adolescents (50.4% female, mean age 17.8 [SD 1.2] years), completed the survey measures. Higher HRQoL was reported in males than females in both countries (PedsQL 79.4 vs. 74.1; 16D 0.888 vs. 0.846), and in adolescents from Finland than Australia (80.6 vs. 72.2 and 0.905 vs. 0.825, p < 0.001 for all). Adolescents with diabetes, rheumatological, nephrological conditions and/or organ transplants had higher HRQoL than adolescents with neurological conditions or other disease syndromes (p < 0.001). PedsQL and 16D scores showed a strong correlation to each other (Spearman correlation coefficient r = 0.81). Using the 7-point VAS (1-7), 52% (248 of 479) considered their health status to be good (6-7) and 10% (48 of 479) rated it poor (1-2). Better self-reported health was associated with higher HRQoL.

Conclusions

The HRQoL of transition aged adolescents varies between genders, diagnostic groups, and countries of residence. The association between self-reported health and HRQoL suggests that brief assessment using the VAS could identify adolescents who may benefit from in-depth HRQoL evaluation.

Trial registration

Trial registration name The Bridge and registration number NCT04631965 (https://clinicaltrials.gov/ct2/show/NCT04631965).
Effect of early preventive supplementation with calcium and phosphorus on metabolic bone disease in premature infants
Authors: Xu Xuejing , Ma Hongfang , Cheng Shuqi , Xue Jiang
Published: March 2024

Objective

The objective was to study the effect of early preventive calcium and phosphorus supplementation on metabolic bone disease in preterm infants.

Methods

A retrospective analysis of 234 preterm infants with a gestational age < 32 weeks or birth weight < 1500 g who were hospitalized in the Neonatology Department of the Second Hospital of Shandong University from 01.2018 to 12.2020 was conducted. One hundred thirty-two premature infants hospitalized from 01.2018 to 06.2019 did not receive prophylactic calcium and phosphorus supplementation in the early postnatal period. These infants received calcium or phosphorus supplementation at the time of hypocalcaemia or hypophosphatemia diagnosis. One hundred two premature infants hospitalized from 07.2019 to 12.2020 received early preventive calcium and phosphorus supplementation after birth. The levels of serum calcium and phosphorus, alkaline phosphatase, 25-hydroxyvitamin D, calcitonin, and parathyroid hormone at different time points and growth indicators at six months of age were compared between the two groups of infants. The number of cases of metabolic bone disease and fracture between the two groups was compared.

Results

1) A total of 12 infants (5.13%) among the 234 preterm infants were diagnosed with metabolic bone disease, including 2 (1.96%) in the prophylactic supplementation group and 10 (7.58%) in the nonprophylactic supplementation group. Fractures occurred in 3 premature infants (25.0%) with metabolic bone disease, all of whom were in the group that did not receive prophylactic supplementation. 2) There was no significant difference in serum calcium and calcitonin levels between the two groups. The levels of serum phosphorus and 25 hydroxyvitamin D in the prophylactic supplementation group were higher than those in the nonprophylactic supplementation group (P < 0.05). In comparison, alkaline phosphatase and parathyroid hormone levels were lower in the prophylactic supplementation group than in the nonprophylactic supplementation group (P < 0.05). Preterm infants in the prophylactic supplementation group had higher weight, length, head circumference, and bone density values than those in the nonprophylactic supplementation group (P < 0.05).

Conclusion

Preventive supplementation with calcium and phosphorus after birth can effectively improve calcium and phosphorus metabolism, and reduce the incidence of metabolic bone disease and fractures in premature infants. This can be further publicized and used clinically.
Association between parental feeding styles, body mass index, and consumption of fruits, vegetables and processed foods with mothers´ perceptions of feeding difficulties in children
Authors: Fontanezi Nathalia Moretti , Maximino Priscila , Machado Rachel Helena Vieira , Ferrari Gerson , Fisberg Mauro
Published: March 2024

Background

Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers’ perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods.

Method

Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m2).

Results

The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20–9.85), a high body mass index (OR: 1.35; 95% CI: 1.09–1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85–9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant.

Conclusion

This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs.
Graduate medical education well-being directors in the United States: who are they, and what does the role entail?
Authors: Thomas Larissa R. , Ripp Jonathan A. , Duncan Jennifer G.
Published: March 2024

Background

Institutional Graduate Medical Education (GME) Well-being Director (WBD) roles have recently emerged in the United States to support resident and fellow well-being. However, with a standard position description lacking, the current scope and responsibilities of such roles is unknown. This study describes the scope of work, salary support, and opportunities for role definition for those holding institutional leadership positions for GME well-being.

Methods

In November 2021, 43 members of a national network of GME WBDs in the United States were invited to complete a cross-sectional survey that included questions about job responsibilities, percent effort, and dedicated budget, and a free text response question about unique leadership challenges for GME WBDs. The survey was analyzed using descriptive statistics for quantitative data and thematic analysis for qualitative data.

Results

26 members (60%) responded. Most were physicians, and the majority identified as female and White. Median percent effort salary support was 40%. A small minority reported overseeing an allocated budget. Most respondents worked to improve access to mental health services, oversaw institution-wide well-being programs, designed or delivered well-being content, provided consultations to individual programs, met with trainees, and partnered with diversity, equity, and inclusion (DEI) efforts. GME WBDs described unique challenges that had implications for perceived effectiveness related to resources, culture, institutional structure, and regulatory requirements in GME.

Discussion

There was high concordance for several key responsibilities, which may represent a set of core priorities for this role. Other reported responsibilities may reflect institution-specific needs or opportunities for role definition. A wide scope of responsibilities, coupled with limited defined budgetary support described by many GME Well-being Directors, could limit effective role execution. Future efforts to better define the role, optimize organizational reporting structures and provide funding commensurate with the scope of work may allow the GME Well-being Director to more effectively develop and execute strategic interventions.
Phenotypic, molecular detection, and Antibiotic Resistance Profile (MDR and XDR) of Aeromonas hydrophila isolated from Farmed Tilapia zillii and Mugil cephalus
Authors: Ayoub Hala F. , khafagy Ahmed R. , Esawy Aboelkair M. , El-moaty Noura Abo , Alwutayd Khairiah Mubarak , Mansour Abdallah Tageldein , Ibrahim Reham A. , Abdel-moneam Dalia A. , El-Tarabili Reham M.
Published: March 2024

In the present study, Aeromonas hydrophila was isolated from Tilapia zillii and Mugil cephalus samples collected during different seasons from various Suez Canal areas in Egypt. The prevalence of A. hydrophila, virulence genes, and antibiotic resistance profile of the isolates to the commonly used antibiotics in aquaculture were investigated to identify multiple drug resistance (MDR) and extensive drug-resistant (XDR) strains. In addition, a pathogenicity test was conducted using A. hydrophila, which was isolated and selected based on the prevalence of virulence and resistance genes, and morbidity of natural infected fish. The results revealed that A. hydrophila was isolated from 38 of the 120 collected fish samples (31.6%) and confirmed phenotypically and biochemically. Several virulence genes were detected in retrieved A. hydrophila isolates, including aerolysin aerA (57.9%), ser (28.9%), alt (26.3%), ast (13.1%), act (7.9%), hlyA (7.9%), and nuc (18.4%). Detection of antibiotic-resistant genes revealed that all isolates were positive for blapse1 (100%), blaSHV (42.1%), tetA (60.5%), and sul1 (42.1%). 63.1% of recovered isolates were considered MDR, while 28.9% of recovered isolates were considered XDR. Some isolates harbor both virulence and MDR genes; the highest percentage carried 11, followed by isolates harboring 9 virulence and resistance genes. It could be concluded that the high prevalence of A. hydrophila in aquaculture species and their diverse antibiotic resistance and virulence genes suggest the high risk of Aeromonas infection and could have important implications for aquaculture and public health.
Efficacy and immune-inflammatory mechanism of acupuncture-related therapy in animal models of knee osteoarthritis: a preclinical systematic review and network meta-analysis
Authors: Huang Yingjie , Huang Hai , Chen Qiqi , Luo Yantong , Feng Jieni , Deng Yuexia , Li Guangyao , Li Min , Sun Jian
Published: March 2024

Background

Many KOA patients have not reached indications for surgery, thus we need to find effective non-surgical treatments. Acupuncture is thought to have the potential to modulate inflammation and cytokines in KOA through the immune system. However, the mechanisms have not been elucidated, and there is no network Meta-analysis of acupuncture on KOA animals. So we evaluate the effect and mechanism of acupuncture-related therapy in KOA animals.

Methods

A comprehensive search was conducted in multiple databases including PubMed, Web of Science, Embase, CBM, CNKI, WanFang, and VIP Database to identify relevant animal studies focusing on acupuncture therapy for KOA. The included studies were assessed for risk of bias using SYRCLE's Risk of Bias tool. Subsequently, pair-wise meta-analysis and network meta-analysis were performed using Stata 15.0 software, evaluating outcomes such as Lequesne index scale, Mankin score, IL-1β, TNF-α, MMP3, and MMP13.

Results

56 RCTs with 2394 animals were included. Meta-analysis showed that among the 6 outcomes, there were significant differences between acupuncture and model group; the overall results of network meta-analysis showed that the normal group or sham operation group performed the best, followed by the acupotomy, acupuncture, and medicine group, and the model group had the worst effect, and there were significant differences between 6 interventions.

Conclusions

Acupuncture-related therapy can be a possible treatment for KOA. The mechanism involves many immune-inflammatory pathways, which may be mediated by DAMPs/TLR/NF-κB/MAPK,PI3K/Akt/NF-κB pathway, or IFN-γ/JAK-STAT pathway. It needs to be further confirmed by more high-quality animal experiments or meta-analysis.

Systematic review registration

PROSPERO identifier: CRD42023377228.
Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum β-lactamase-producing Enterobacterales by a contaminated duodenoscope
Authors: Cimen Cansu , Bathoorn Erik , Loeve Arjo J. , Fliss Monika , Berends Matthijs S. , Nagengast Wouter B. , Hamprecht Axel , Voss Andreas , Lokate Mariëtte
Published: March 2024

Contamination of duodenoscopes is a significant concern due to the transmission of multidrug-resistant organisms (MDROs) among patients who undergo endoscopic retrograde cholangiopancreatography (ERCP), resulting in outbreaks worldwide. In July 2020, it was determined that three different patients, all had undergone ERCP with the same duodenoscope, were infected. Two patients were infected with blaCTX-M-15 encoding Citrobacter freundii, one experiencing a bloodstream infection and the other a urinary tract infection, while another patient had a bloodstream infection caused by blaSHV-12 encoding Klebsiella pneumoniae. Molecular characterization of isolates was available as every ESBL-producing isolate undergoes Next-Generation Sequencing (NGS) for comprehensive genomic analysis in our center. After withdrawing the suspected duodenoscope, we initiated comprehensive epidemiological research, encompassing case investigations, along with a thorough duodenoscope investigation. Screening of patients who had undergone ERCP with the implicated duodenoscope, as well as a selection of hospitalized patients who had ERCP with a different duodenoscope during the outbreak period, led to the discovery of three additional cases of colonization in addition to the three infections initially detected. No microorganisms were detected in eight routine culture samples retrieved from the suspected duodenoscope. Only after destructive dismantling of the duodenoscope, the forceps elevator was found to be positive for blaSHV-12 encoding K. pneumoniae which was identical to the isolates detected in three patients. This study highlights the importance of using NGS to monitor the transmission of MDROs and demonstrates that standard cultures may fail to detect contaminated medical equipment such as duodenoscopes.
A soft wearable exoglove for rehabilitation assistance: a novel application of knitted shape-memory alloy as a flexible actuator
Authors: Lee Soo-Min , Park Juyeon
Published: March 2024

We developed the knitted shape-memory alloy (SMA) as a flexible actuator and applied it to a soft wearable exoglove for rehabilitation assistance. Based on user needs and anthropometric data, we custom-designed the exoglove for three hemiplegic patients using the knitted-SMA actuator and evaluated its bending performance, gripping force and wearability under the four simulation conditions (S1–S4). To address the specific needs, both SMA plain- and double-knit modules were applied to the exoglove based on the patients’ finger joint range of motion (ROMs). The joint ROMs of all fingers increased by 13.71% and the skin temperature increased by 2.21 °C after actuating the glove (p = 0.006). The gripping force increased as much as 55.01%, when compared to the baseline. All patients were able to don and doff the developed glove independently, and positively evaluated their subjective satisfaction and thermal perception. The findings suggested the potential of the knitted SMA for the future development of soft wearable robots.
Genetic variant reanalysis reveals a case of Sandhoff disease with onset of infantile epileptic spasm syndrome
Authors: Zhang Qi , Zou Liping , Lu Qian , Wang Qiuhong , Dun Shuo , Wang Jing
Published: March 2024

Background

Sandhoff disease (SD) i s an autosomal recessive lysosomal disease with clinical manifestations such as epilepsy, psychomotor retardation and developmental delay. However, infantile SD with onset of infantile epilepsy spasm syndrome (IESS) is extremely rare.

Case presentation

The case presented here was a 22-month-old boy, who presented with IESS and psychomotor retardation/regression at 6 months of age. The patient showed progressive aggravation of seizures and excessive startle responses. The whole exome sequencing data, which initially revealed negative results, were reanalyzed and indicated a homozygous mutation at the c.1613 + 4del splice site of the HEXB gene. The activities of β-hexosaminidase A and total hexosaminidase were significantly decreased. The fundus examination showed cherry red spots at the macula.

Conclusions

IESS can be an epileptic phenotype of infantile SD. Clinical phenotypes should be adequately collected in genetic testing. In the case of negative sequencing results, gene variant reanalysis can be performed when the patients show clinically suspicious indications.
Influence of commercial drivers’ risky behavior on accident involvement: moderating effect of positive driving behavior
Authors: Taiwo Olusegun Austine , Mahmud Norashikin , Hassan Sitti Asmah , Mohsin Rahmat Bin
Published: March 2024

The influence of risky driving behavior on road traffic accidents (RTAs) is a relationship that requires draconian measures to curtail the rising surge of road traffic accidents among commercial drivers. Any attempt to ignore this will result in continuous loss of lives and properties, thus weakening the global economy, especially in developing countries. The risky driving behaviors of commercial drivers (truck and taxi drivers) in Nigeria require a panacea due to their contribution to RTAs. The study examines the moderating effect of positive driving behavior on commercial truck and taxi drivers’ risky driving behavior and accident involvement relationship. A total of 1823 commercial vehicle drivers (943 taxi drivers and 880 truck drivers) completed the driver behavior questionnaire (DBQ), while the structural equation modeling (SEM) method was used for the analysis. The results indicated a significant moderating effect of positive driving behavior on the risky driving behavior and accident involvement relationship for both commercial truck and taxi drivers in Nigeria. Specifically, the truck drivers had a positive moderating effect, resulting in a decrease in RTAs with an increase in positive driving behavior. In contrast, the taxi drivers had a negative moderating effect. The results suggest that increasing positive driving behavior among truck drivers will enhance their safety, while taxi drivers will need more assessment to identify other risky behaviors that could expose them to more RTAs despite the positive driving behavior. This study will aid decision makers, transport trainers, and driver employers in knowing the importance of enforcing and promoting positive driving behaviors among drivers and include it in driving policy and driver training curricula towards RTA reduction.
Impacts of physical activity, sedentary behaviour, and sleep on depression symptoms in Canadian older adults 65 years of age and above: a compositional data analysis of the Canadian Longitudinal Study on Aging
Authors: Hakimi Shawn , Martin Luc J. , Rosenberg Mark W.
Published: March 2024

Background

Daily time spent in moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LIPA), sedentary behaviour (SB) and sleep (collectively known as ‘movement behaviours’) are compositional, co-dependent variables. However, most studies examining effects of these behaviours on depression outcomes in older adults do not account for this. Study objectives were to use compositional data analysis methods to (1) examine the relationship between movement behaviour composition (daily time spent in MVPA, LIPA, SB, sleep) and depression symptoms, (2) estimate the extent to which changing time spent in any given movement behaviour within the movement behaviour composition was associated with changes in depression symptoms.

Methods

5643 older Canadian adults ≥ 65 years of age from the Canadian Longitudinal Study on Aging were studied using a quasi-longitudinal study design. Exposure was baseline daily movement behaviours; time spent in MVPA, LIPA and SB were derived from self-reported Physical Activity Scale for the Elderly responses. Night-time sleep was self-reported separately. Outcome was depression symptoms at follow-up obtained using the ten item Center for Epidemiologic Studies Depression Scale. Compositional data analysis was used to investigate associations between movement behaviours and depression symptoms.

Results

Movement behaviour composition was significantly associated with depression symptoms. Time spent in MVPA [exp(B) = 0.97 (95% CI: 0.94, 0.99)] and sleep [exp(B) = 0.91 (95% CI: 0.85, 0.97)] relative to the remaining movement behaviours were associated with lower depression symptoms scores. Relative time spent in SB was associated with higher depression symptoms scores [exp(B) = 1.09 (95% CI: 1.04, 1.15)]. Time displacement estimates revealed that the greatest change in depression symptoms scores occurred when time spent in MVPA was decreased and replaced with LIPA, SB, sleep or combination of these behaviours (+ 0.22 to 0.26 points increase on depression symptoms scores for 30 min/day displacements).

Conclusions

Daily movement behaviour composition was associated with depression symptoms in older Canadians. Replacing time in MVPA with equivalent time from any other behaviour was associated with increased depression symptoms. Preserving time spent in MVPA may play a key role in mitigating and improving mental health in this demographic.
Achieving equitable leadership in Global Health partnerships: barriers experienced and strategies to improve grant funding for early- and mid-career researchers
Authors: Chikwari Chido Dziva , Tadesse Amare Worku , Shanaube Kwame , Shepherd Anna , McQuaid Christopher Finn , Togun Toyin O.
Published: March 2024

Calls to decolonize global health have highlighted the continued existence of colonial structures in research into diseases of public health importance particularly in low- and middle-income countries (LMICs). A key step towards restructuring the system and shaping it to local needs is equitable leadership in global health partnerships. This requires ensuring that researchers in LMICs are given the opportunity to successfully secure grant funding to lead and drive their own research based on locally defined priorities. In February 2022, the London School of Hygiene and Tropical Medicine hosted a workshop aimed at bringing together funders and early- and mid-career researchers (EMCRs) to identify funder initiatives that have worked to improve equitable leadership, to better understand barriers faced by researchers, and collectively brainstorm approaches to overcome these barriers. The workshop transcript was analyzed using a deductive thematic approach based on the workshop topic to identify key emerging themes. Barriers identified were the lack of individual and institutional level support and flawed funding structures for EMCRs in LMIC settings. Strategies on how equitable leadership can be further facilitated include institutional reforms for funders to facilitate equity, diversity, and inclusion in their partners through consultative engagement and in addition, reshaping how research priorities are defined; diversified funding streams for research organizations, building partnerships and dedicated funding for capacity building of EMCRs. Intentional advances to overcome funding barriers in global health speak directly to its decolonization. Urgently required and complex changes in practice must be intentional and do require uncomfortable shifts which will take time.
Influence of strong directional sources in ambient seismic imaging using traffic-induced noise
Authors: Wang Jiao , Sun Chengyu , Lin Tengfei , Yan Yuefeng , Wang Guanchao , Huang Hongyu , Li Yao
Published: March 2024

Continuously moving seismic sources, such as vehicles and train cars, play a crucial role as passive sources for nondestructive exploration in urban areas. Seismic interferometry is commonly used in field data acquisition and processing using linear arrays. However, the simultaneous recording of high-energy noise, excited by buildings and factories, cannot be overlooked. We simulate moving-source seismic records with strong noises using orthogonal arrays. When strong noise originates from specific angles, the energy-phase velocity curves of arrays in different directions significantly diverge. We determine that an L-shaped array, formed by orthogonal arrays, can effectively mitigate this effect, yielding more consistent results. Nonetheless, spatial constraints often preclude the deployment of L-shaped arrays. To mitigate this issue, we develop a new parallel observation system. Field tests conducted on a main road validate that the new array is comparable with the L-shaped array in terms of dispersion extraction. Similar to synthetic data, the phase velocity extracted from the linear array field data is found to be unreliable. Drilling data align well with the inversion results of the parallel observation system. Given the challenges of urban traffic-induced signal acquisition, deploying multiazimuth arrays to minimize noise impact is essential. Considering the spatial limitations, the convenient parallel observation system emerges as a good choice.
Using Tumor Marker Gene Variants to Improve the Diagnostic Accuracy of DUPAN-2 and Carbohydrate Antigen 19-9 for Pancreatic Cancer
Authors: Ando Yohei , Dbouk Mohamad , Yoshida Takeichi , Saba Helena , Abou Diwan Elizabeth , Yoshida Kanako , Dbouk Ali , Blackford Amanda L. , Lin Ming-Tseh , Lennon Anne Marie , Burkhart Richard A. , He Jin , Sokoll Lori , Eshleman James R. , Canto Marcia Irene , Goggins Michael
Published: March 2024

PURPOSE

Circulating carbohydrate antigen 19-9 (CA19-9) levels reflect FUT3 and FUT2 fucosyltransferase activity. Measuring the related glycan, DUPAN-2, can be useful in individuals unable to synthesize CA19-9. We hypothesized that similar to CA19-9, FUT functional groups determined by variants in FUT3 and FUT2 influence DUPAN-2 levels, and having tumor marker reference ranges for each functional group would improve diagnostic performance.

MATERIALS AND METHODS

Using a training/validation study design, FUT2/ FUT3 genotypes were determined in 938 individuals from Johns Hopkins Hospital: 607 Cancer of the Pancreas Screening (CAPS) study subjects with unremarkable pancreata and 331 with pancreatic ductal adenocarcinoma (PDAC). Serum DUPAN-2 and CA19-9 levels were measured by immunoassay.

RESULTS

In controls, three functional FUT groups were identified with significant differences in DUPAN-2 levels: FUT3-intact, FUT3-null/FUT2-intact, and FUT3-null/FUT2-null. DUPAN-2 training set diagnostic cutoffs for each FUT group yielded higher diagnostic sensitivity in the validation set for patients with stage I/II PDAC than uniform cutoffs (60.4% [95% CI, 50.2 to 70.0] v 39.8% [30.0 to 49.8]), at approximately 99% (96.7 to 99.6) specificity. Combining FUT/CA19-9 and FUT/DUPAN-2 tests yielded 78.4% (72.3 to 83.7) sensitivity for stage I/II PDAC, at 97.7% (95.3 to 99.1) specificity in the combined sets, with higher AUC (stage I/II: 0.960 v 0.935 for CA19-9 + DUPAN-2 without the FUT test; P < .001); for stage I PDAC, sensitivity was 62.0% (49.1 to 73.2; AUC, 0.919 v 0.883; P = .03). CA19-9 levels in FUT3-null/FUT2-null PDAC subjects were higher than in FUT3-null/FUT2-intact subjects (median/IQR; 24.9/57.4 v <1/2.3 U/mL; P = .0044). In a simulated CAPS cohort, AUC precision recall (AUCPR) scores were 0.51 for CA19-9 alone, 0.64 for FUT/CA19-9, 0.73 for CA19-9/DUPAN-2, and 0.84 for FUT/CA19-9/DUPAN-2.

CONCLUSION

Using a tumor marker gene test to individualize CA19-9 and DUPAN-2 reference ranges achieves high diagnostic performance for stage I/II pancreatic cancer.