bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of a client satisfaction questionnaire in a NHS psychotherapy department
Authors: Ogston Elizabeth , Herbert Kim , McGuiness Lorraine
Published: June 2021

Aims

This study aimed to assess the level of satisfaction patients feel towards their experience of attending for psychotherapy, in order to inform local management on the service being offered by the department.

Background

This survey was conducted as part of routine service provision analysis by the psychotherapy department. It aimed to assess the level of satisfaction patients feel towards their experience of attending for psychotherapy, in order to inform local management on the service being offered by the department. Ethics committee confirmed this fulfilled “Service evaluation” criterion and the project was registered with the local NHS quality improvement register.

Method

Patients who completed an episode of therapy were invited to complete a survey form. This consisted of a Client Satisfaction Questionnaire (CSQ-8) as well as four additional questions pertaining to patient satisfaction. The patient's therapist would inform administration staff of the patient's final appointment; administration staff would then issue the patient with a questionnaire which they were invited to complete and return in their own time. The questionnaires were completed anonymously and no reward was offered for completing the questionnaire. The therapies included group analysis, psychodynamic individual and Cognitive Analytic Therapy.

Result

22 patients who had completed psychotherapy in 2018–2019 returned a completed questionnaire. The average and range responses were examined.

The average response was “4: Excellent” for the overall rating of the service received, and for 5 other questions on the CSQ-8 the average score was the highest possible. The average response was slightly lower on the question about whether the service met their needs “3: Mostly”, and on the question: Has the service you received helped you to deal more effectively with your problems? (3 yes, somewhat). The additional questions highlighted how important the setting and administration role played in the experience of therapy. The questionnaire also included a free text box giving the patient the opportunity to offer any other comments. Many of these included messages of gratitude and remarks on the impact therapy has had on their general wellbeing.

Conclusion

In general it is encouraging to see that feedback provided through this survey was extremely positive. This was reflected both in the Likert scale questions and the free text box. Patients are described themselves as very satisfied with their experience within therapy and reflected a positive experience of the holding environment provided by the department as a whole.

(NO Funding received)
Metabolic side effects of clozapine in patients at south ceredigion community mental health team
Authors: Reddy Harish
Published: June 2021

Aims

The aim of the audit was to identify patients at risk of developing Metabolic Syndrome who are on Clozapine in the community. Anyone who has three of following attributes has Metabolic Syndrome. A large waist size (greater than 40 inches in men or 35 inches in women) ,high blood pressure (130/85 mm Hg or higher) ,high triglycerides — a form of fat in the blood (150 mg/dL or higher) ,high blood sugar (a fasting level of 100 mg/dL or higher).Patients receiving should be regularly monitored under clinical review particularly in relation to side effects of the drug and maintain minimum standards of review both physically and clinical investigations once a year .

Background

To measure the screening of central obesity, Blood Pressure, serum glucose levels and lipid profile in last one year.

Method

Data were collected from Blood results and electronic entries of patients who are on Clozapine in South Ceredigion Community Mental Team. There were 31 patients of which 20 were male and 11 were female patients. The age range was 31–66 years and average was 46 years.

Result

52% of the patients had obesity,34 % with Hypertension,50 %Dyslipidaemia and 43 % had Increased glucose tolerance. 80 % were only on clozapine,3% were on combined Amisulpride, 10% on combined on Ariprazole, 3 % on combined Quetiapine.

Conclusion

Treatment of causes like making changing lifestyle changes, weigh reduction using health diet and to include regular physical activity. Reduce Abdominal Obesity and in possible provide nutritional intervention.
A service evaluation of the healthy lifestyle groups in a female medium secure unit- what do our patients know about nutrition?
Authors: Shipperbottom Lauren , Scally Ruth
Published: June 2021

Aims

To assess whether patients have a good knowledge of basic nutrition compared to a group of staff. We hypothesise that the patient's knowledge will show deficits compared to the staff despite the group interventions.

Background

The Royal College of Psychiatrist's core standards for inpatient physical health outlines that patients should be engaged in healthy lifestyle groups. The women's secure service at Ardenleigh has developed healthy lifestyles groups to promote a better understanding of nutrition.

Method

An adapted University College London general knowledge nutrition questionnaire was used to investigate nutritional knowledge.

All 22 inpatients and a random selection of staff were offered the chance to complete the questionnaire. As the groups run on a regular basis, it was presumed all patients had attended at least one group session. The staff are the comparator group.

18 staff responses and 12 inpatient responses were obtained (54.5% response rate for inpatients).

Result

No participant in either group scored 100%. Both groups had a good awareness of what foods they should be eating more and less of. 83.3% of patients were aware that they should be eating breakfast everyday as opposed to 100% of staff.

Poor areas of knowledge included knowledge of the number of oily fish servings per week. Staff and patients also performed poorly when estimating their recommended daily salt intake. 1/3 of patients were unable to provide an example of a serving of fruit and vegetables.

The knowledge of the structure of the Eat-Well plate was poor in both groups. Only 16% of patients and 22% of staff were aware that starchy foods should make up 1/3 of the Eat-well plate. Knowledge of protein sources was poor. 25% of patients and 16.6% of staff thought that fruit and butter were good sources of protein

Furthermore, only 50% of patients were able to choose the healthiest evening meal choice from a list of 3 options compared to 100% of staff.

Conclusion

In conclusion staff had better knowledge of nutrition than patients but knowledge was poor in areas amongst both groups. We conclude that groups should have more focus around practical applications of nutritional knowledge to everyday life.
Appropriateness of referrals to Whiston hospital Mental Health Liaison Services
Authors: Strouther Nick , Jain Divya
Published: June 2021

Aims

1. The aim of this study was to assess the appropriateness of referrals to Whiston Mental Health Liaison Services (WMHLS) according to Royal College of Psychiatrists and local trust guidelines.

2. To assess whether the referrals were being reviewed in timely manner as per the trust's guidelines.

Method

Data collection was completed using a proforma to ensure uniform data collection. The proforma included information on patient demographics, previous mental health service involvement, other details like reasons and time of referral and their outcomes. Data sample comprised of 46 patients who had been referred to the WMHLS in the month of August 2019 were randomly selected.

Result

44 of the 46 referrals analyzed were found to be appropriate. 40 patients were deemed to have appropriate documentation. The ratio of males to females was 20:26. 21 referrals were from the observation ward, 14 from A&E, and 11 from medical wards. 40 patients were previously known to mental health services. The reasons for referral ranged from suicidal ideation/attempt (48%), Drug related (12%), Assessment (7%) and more. There were various outcomes recorded. One of them was that 18 (28%) referrals were assessed for Depression and for other mental health problems.

78.6% of patients referred from A&E, and 95.2% of patients in the observation ward, were not seen in the 1 hour window set out by the Trust's guidelines. 91.1% of patients referred from the wards were seen within the 24 hour target.

Conclusion

The vast majority of referrals were found to be appropriate (44/46). It was found that the referral form used across the Trust, contained different levels of details and information on the patient depending on the source of referral. Using a standard process to complete referral forms to be used across the whole trust may ensure that all patients receive a standardized and appropriate referral based on the guidelines. Making the form electronic may reduce problems deciphering handwriting, and could allow WMHLS have a better understanding of the patient, and allow them to identify a patient that may be more appropriate for another service, e.g. drugs and alcohol team. This may and make the overall referral process quicker and reduce waiting times in A&E, as well as faster referrals to the appropriate services.
Audit of delays in the diversion of mentally disordered defendants under the Mental Health Act 1983/2007 at a liaison and diversion service in North West London
Authors: Sukhwal Seema , Gordon-Ellis Claire , Tajblova Luneta
Published: June 2021

Aims

To ascertain the length of time defendants wait for a Mental Health Act assessment (MHAA) and where necessary, how long they are waiting for a hospital bed.

Background

The Liaison and Diversion Service in North West London (the Service) is provided by Central North West London Foundation NHS Trust (CNWL), Barnet Enfield Haringey (BEH) and Together to Willesden Magistrates Court in North West London.

One of the core activities of the Service is diverting individuals from the criminal justice system to hospital under the Mental Health Act (MHA).

The Code of Practice allows for a period of 14 days between the medical recommendation and conveyance to hospital. Defendants needing admission under MHA are remanded to custody if a bed is not available. This prevents them from receiving the assessment and care they need. We consider that all defendants found to be liable to detention under the MHA should be admitted to a hospital bed on the same day.

Method

Data were collected between October 2018 and February 2019. All patients referred for a MHAA were included. The time a MHAA was requested, took place as well as how long the defendant waited for a bed was noted.

Result

A total of 42 MHAA were requested. 25 individuals were detained under Section 2 of the MHA 1983.

The time between referral for a MHAA and the MHAA taking place was obtained in 25 of the 42 referrals. The range of times between a referral being made and the assessment taking placed varied between 1.5 hours and 22 hours. Two defendants were remanded overnight in prison as the MHAA could not take place on the same day as the referral.

In the 25 cases where an application for detention under Section 2 of the MHA was made, beds were not available on the same day in 7 cases. In 4 cases defendants required remand in prison custody due to beds not being available.

Conclusion

There were some limitations to this audit as data were not available for all 42 individuals referred for a MHAA.

Individuals referred for MHAA by the Service had both medical recommendations completed within 5 days and those who required admission to hospital were admitted within 14 days of the recommendations being completed.

Whilst these standards are being met, individuals referred for MHAA and those requiring admission to hospital are still facing remand to custody.
Medical prescription and nursing administration of medication in learning disabilities in-patient settings
Authors: Williams Ellen , Choudry Ansar , Hussain Kabeer , Ravi Praveen , Zahid Sadia
Published: June 2021

Aims

The aim of this re-audit was to review whether inpatientprescription cards are completed correctly by doctors and administered by nurses, and to compare the results with the previous audit.

Background

We carried out a re-audit of Medical Prescription and Nursing Administration of Medication in Learning Disabilities In-patient Settings. Black Country Partnership NHS Foundation Trust is committed to managing medicines safely, efficiently and effectively as a key part of delivering high quality patient centred care. In BCPFT medications are recorded by doctors on paper prescription cards and administered by registered nurses.

Method

This audit compared results against the standards for prescribing medication in BCPFT Medicines Policy.Prescription charts were retrospectively reviewed against 22 standards for all LD inpatients as outlined in the LD trust policy across all 3 of the Learning Disabilities in-patient units during May 2019 as long as they were still inpatients during this month. 27 prescription cards were reviewed in total.

Result

100% of prescription cards had patients full names , address , ward name, were fully legible , written in black ink, route of administration, approved abbreviation for route, date of prescription, signature of prescriber , prescription labelled as 1of 1 /2, frequency of prn meds and indication . Whereas only 96% had generic drug names, clearly documented doses and time of administration along with acceptable abbreviation and appropriate code for omission. 85% drugs had a stop date once drug was stopped and 85% had allergies recorded in red and had a line drawn through once drug was omitted.

Conclusion

The re- audit was highlighted to inpatient managers, nursing staff, The Medicines Management Committee (MMC) anddoctors in the Learning Disability division. Prescribers werereminded of the importance of documenting a stop date for the prescriptions and signing off once drug is crossed out. It was discussed in MMC to consider removing the standard for recording allergies in red ink as the box is already red in colour. The PRN section for medication does not have an area to sign when the drug is cancelled and this in particular is the case when PRN medication is re-written. It was discussed to limit this standard to regular medication and to be taken in consideration if the current drug chart requires redesigning in the future. We also recommended a re- audit in 2 years’ time.
Revisiting vitamin D status and supplementation for inpatients with intellectual and developmental disability in the north of England, UK
Authors: Ciausu Vlad , Ostrowski Marcin , Dudley Bethany , Ince Chris , McKinnon Iain
Published: June 2021

Aims

Vitamin D deficiency is common among people with Intellectual and Developmental Disability (IDD) and is linked to worse health outcomes.

Our aims were to re-evaluate vitamin D testing and supplementation among inpatients with IDD, examine any correlates with physical health conditions including COVID-19 and make recommendations for the current regime of supplementation and testing within inpatient IDD services.

Method

The study population comprised inpatients who were in any of the Northgate Hospital IDD inpatient services in Northumberland, UK. The wards sampled were the Medium Secure Unit, Low Secure Unit, Hospital Based Rehabilitation Wards and Specialist Autism Inpatient Service. Records of all inpatients between January 2019 and July 2020 were examined for 25-hydroxyvitamin D [25(OH)D] level, ward area, supplementation status, test seasonality, medication, and health status.

We performed a correlation to see whether there was an association between vitamin D level and length of time on treatment. In addition, comparison of the replete and inadequate group for age, ethnicity, seasonality, ward location and psychotropic medication was undertaken.

Data on physical health risk factors, obesity and COVID-19 infection were also collected. The physical comorbidities were described in order to evaluate whether any emerging patterns relating to COVID-19 infection were emerging.

Result

There were 67 inpatients in Northgate IDD services on 1 January 2019, with 11 further patients admitted up to the end of the sampling period on 31 July 2020. Nineteen patients were discharged during that period, so the sample comprised 78 patients.

Ages were comparable across three of the ward areas, except for an older group of patients in the hospital-based rehabilitation setting. Mean 25(OH)D level for supplemented (800IU/day) patients was 75nmol/l (SD 20) compared to 40nmol/l (SD 19) in the non-supplemented group (p < 0.001).

Thirty-eight percent of those who were inpatients during the first wave of the COVID-19 pandemic developed symptoms, but the small sample size could not establish vitamin D levels as a predictor of outcome.

Conclusion

Our findings show that clinicians continue to offer vitamin D supplementation for inpatients, at a dose of 800IU (20μg) per day.

The mean vitamin D levels we observed were higher for those on supplements compared to our 2013 baseline data, whereas patients not on supplementation now had levels akin to those found previously. Vitamin D (800IU/day) supplementation is effective but adequacy of the nationally recommended dose of 400IU/day is unclear. Links to COVID-19 merit further research.
Gene expression variation in Arabidopsis embryos at single-nucleus resolution
Authors: Kao Ping , Schon Michael A. , Mosiolek Magdalena , Enugutti Balaji , Nodine Michael D.
Published: June 2021

Soon after fertilization of egg and sperm, plant genomes become transcriptionally activated and drive a series of coordinated cell divisions to form the basic body plan during embryogenesis. Early embryonic cells rapidly diversify from each other, and investigation of the corresponding gene expression dynamics can help elucidate underlying cellular differentiation programs. However, current plant embryonic transcriptome datasets either lack cell-specific information or have RNA contamination from surrounding non-embryonic tissues. We have coupled fluorescence-activated nuclei sorting together with single-nucleus mRNA-sequencing to construct a gene expression atlas of Arabidopsis thaliana early embryos at single-cell resolution. In addition to characterizing cell-specific transcriptomes, we found evidence that distinct epigenetic and transcriptional regulatory mechanisms operate across emerging embryonic cell types. These datasets and analyses, as well as the approach we devised, are expected to facilitate the discovery of molecular mechanisms underlying pattern formation in plant embryos.

This article has an associated ‘The people behind the papers’ interview.
Minding the gap: learning and visual scanning behaviour in nocturnal bull ants
Authors: Islam Muzahid , Deeti Sudhakar , Kamhi J. Frances , Cheng Ken
Published: June 2021

Insects possess small brains but exhibit sophisticated behaviour, specifically their ability to learn to navigate within complex environments. To understand how they learn to navigate in a cluttered environment, we focused on learning and visual scanning behaviour in the Australian nocturnal bull ant, Myrmecia midas, which are exceptional visual navigators. We tested how individual ants learn to detour via a gap and how they cope with substantial spatial changes over trips. Homing M. midas ants encountered a barrier on their foraging route and had to find a 50 cm gap between symmetrical large black screens, at 1 m distance towards the nest direction from the centre of the releasing platform in both familiar (on-route) and semi-familiar (off-route) environments. Foragers were tested for up to 3 learning trips with the changed conditions in both environments. The results showed that on the familiar route, individual foragers learned the gap quickly compared with when they were tested in the semi-familiar environment. When the route was less familiar, and the panorama was changed, foragers were less successful at finding the gap and performed more scans on their way home. Scene familiarity thus played a significant role in visual scanning behaviour. In both on-route and off-route environments, panoramic changes significantly affected learning, initial orientation and scanning behaviour. Nevertheless, over a few trips, success at gap finding increased, visual scans were reduced, the paths became straighter, and individuals took less time to reach the goal.
Metal-Iodine and Metal-Bromine Batteries: A Review
Authors: Li Pei , Li Chuan , Guo Xun , Li Xinliang , Zhi Chunyi
Published: June 2021

Rechargeable metal-iodine and metal-bromine batteries have been pursued as potentially effective, low-cost, and mass-producible alternatives to current transition-metal-based batteries due to highly reversible redox and abundant resource. However, several challenges, such as low operability caused by thermodynamic instability of cathode and unsatisfactory cycling stability from shuttle effect, must be overcome before a real breakthrough and their widespread application. This review summarizes the state-of-the-art progress of their energy storage mechanisms and discusses the emerging metal-iodine/bromine batteries including Zn-I2 and Zn-Br2 batteries, Li-I2 and Li-BrCl batteries and other metal-I2 batteries. We show the key issues that current metal-iodine/bromine batteries are facing and, furthermore, some promising solutions proposed during the past few years are highlighted to outline key perspectives for future research in this thriving field.
Improving reference standards for validation of AI-based radiography
Authors: Duggan Gavin E , Reicher Joshua J , Liu Yun , Tse Daniel , Shetty Shravya
Published: June 2021

Objective:

Demonstrate the importance of combining multiple readers' opinions, in a context-aware manner, when establishing the reference standard for validation of artificial intelligence (AI) applications for, e.g. chest radiographs. By comparing individual readers, majority vote of a panel, and panel-based discussion, we identify methods which maximize interobserver agreement and label reproducibility.

Methods:

1100 frontal chest radiographs were evaluated for 6 findings: airspace opacity, cardiomegaly, pulmonary edema, fracture, nodules, and pneumothorax. Each image was reviewed by six radiologists, first individually and then via asynchronous adjudication (web-based discussion) in two panels of three readers to resolve disagreements within each panel. We quantified the reproducibility of each method by measuring interreader agreement.

Results:

Panel-based majority vote improved agreement relative to individual readers for all findings. Most disagreements were resolved with two rounds of adjudication, which further improved reproducibility for some findings, particularly reducing misses. Improvements varied across finding categories, with adjudication improving agreement for cardiomegaly, fractures, and pneumothorax.

Conclusion:

The likelihood of interreader agreement, even within panels of US board-certified radiologists, must be considered before reads can be used as a reference standard for validation of proposed AI tools. Agreement and, by extension, reproducibility can be improved by applying majority vote, maximum sensitivity, or asynchronous adjudication for different findings, which supports the development of higher quality clinical research.

Advances in knowledge:

A panel of three experts is a common technique for establishing reference standards when ground truth is not available for use in AI validation. The manner in which differing opinions are resolved is shown to be important, and has not been previously explored.
Associação entre uso de internet e autoconsciência ruminativa em universitários
Authors: Loss, Drª Andrea Loss , Martins,Drª Valeschka Martins , Lima,Drª Mariane Lima
Published: June 2021

Atualmente, temos uma pesquisa ou objetivo de verificar uma correlação entre o nível de uso da Internet e os estilos de autoconsciência e autoconsciência reflexiva. Participação de um estudo quantitativo de 450 universitários, entre 18 e 25 anos (50% do sexo feminino), que responderão ao Teste de Dependência da Internet e ao Questionário de Ruminação e Reflexão. Os resultados mostram uma associação positiva significativa entre o nível de uso da Internet e a autoconsciência da luz, onde uma mulher aparece mais altamente que o homem. Está implícito discutir a associação do estilo de negligência psicológica e a possibilidade de uso inexistente da Internet,
Extending P4 in-band telemetry to user equipment for latency- and localization-aware autonomous networking with AI forecasting
Authors: Scano Davide , Paolucci Francesco , Kondepu Koteswararao , Sgambelluri Andrea , Valcarenghi Luca , Cugini Filippo
Published: June 2021

In beyond-5G networks, detailed end-to-end monitoring of specific application traffic will be required along with the access-backhaul-cloud continuum to enable low latency service due to local edge steering. Current monitoring solutions are confined to specific network segments. In-band network telemetry (INT) technologies for software defined network (SDN) programmable data planes based on the P4 language are effective in the backhaul network segment, although limited to inter-switch latency; therefore, link latencies including wireless and optical segments are excluded from INT monitoring. Moreover, information such as user equipment (UE) geolocation would allow detailed mobility monitoring and improved cloud-edge steering policies. However, the synchronization between latency and location information, typically provided by different platforms, is hard to achieve with current monitoring systems. In this paper, P4-based INT is proposed to be thoroughly extended involving UE. The INT mechanism is designed to provide synchronized and accurate end-to-end latency and geolocation information, enabling decentralized steering policies, i.e., involving UE and selected switches, without SDN controller intervention. The proposal also includes an artificial-intelligence-assisted forecast system able to predict latency and geolocation in advance and trigger faster edge steering.
Multifunctional plasmonic metasurface demultiplexer and wavelength-polarization controllable beam splitter
Authors: Benetou Maria I. , Tsakmakidis Kosmas L.
Published: June 2021

We report the experimental realization of a multifunctional microscale plasmonic metasurface capable of sampling a light beam and performing five functionalities, while allowing high direct transmission and maintenance of the properties of the input light beam. The plasmonic metasurface integrates light-to-surface-plasmon coupling, two-channel wavelength demultiplexing with a channel spacing smaller than 44 nm, wavelength and polarization controllable beam splitting of a monochromatic, single polarization signal, and four-level polarization and wavelength-polarization demultiplexing in an all-in-one structure. Such a device can play a key role for on-chip adaptable integrated circuits for parallel signal processing, communications, and nondestructive sensing.
Beam quality and efficiency of ns-pulsed high-power mid-IR ZGP OPOs compared in linear and non-planar ring resonators
Authors: Medina Manuel Alessandro , Piotrowski Marcin , Schellhorn Martin , Wagner Frank R. , Berrou Antoine , Hildenbrand-Dhollande Anne
Published: June 2021

We compare the performance of ns-pulsed mid-infrared optical parametric oscillators (OPOs) based on ZGP crystals in a simple linear cavity and two non-planar image-rotating resonators. Our 2 μm pump source is a 68 W 10 kHz diffraction limited Ho:LLF MOPA system. In a linear cavity, it allows us to generate up to 38 W of the total average power with M2<2.2 from the ZGP OPO in the 3-5 μm range. Beam quality and stability are significantly improved in both types of non-planar ring resonators (M2<1.8 in RISTRA and M2<1.4 in FIRE), while the total average power is above 21 W. Factors influencing the beam quality such as average power and pump repetition rate are studied in detail.
Raman wavelength conversion in a multipass cell
Authors: Daher Nour , Délen Xavier , Guichard Florent , Hanna Marc , Georges Patrick
Published: June 2021

Positively chirped femtosecond pulses at 1030 nm are wavelength-converted using spontaneous and stimulated Raman scattering in a potassium gadolinium tungstate crystal inserted inside a multipass cell. Recirculation in the cell and the Raman material allows both a high conversion efficiency and good spatial beam quality for the generated Stokes beams. The converted pulses can be compressed to sub-picosecond duration. Multipass cells could be an appealing alternative to other Raman shifter implementations in terms of thermal effects, control of the Raman cascade, and overall output beam quality.
Multi-phase titanium oxide LIPSS formation under fs laser irradiation on titanium thin films in ambient air
Authors: Segovia Paulina , Wong Abraham , Santillan Ricardo , Camacho-Lopez Marco , Camacho-Lopez Santiago
Published: June 2021

The formation of laser-induced periodic surface structures (LIPSS) on Ti thin films, their phase and stoichiometric evolution, as a function of well below ablation threshold laser fluence, and the number of pulses, is investigated. The experiments were carried out in ambient air by using a femtosecond laser at a wavelength of 1030 nm with a pulse duration of 270 fs, operating at a repetition rate of 18.6 kHz. On the one hand, the formation of LSFL composed by an either single phase (C-Ti2O3 or r-TiO2-x) or a two-phase mixture of titanium oxide (C-Ti2O3 +r-TiO2-x) is reported. The titanium oxide phases were obtained by micro-Raman spectroscopy. The orientation of the LSFL, either parallel or perpendicular with respect to the polarization of the incident beam, correlate well with the electronic nature of the titanium oxide phases. On the other hand, the results also show the formation of HSFL, this under low cumulative fluence, with periods of 398 and 460 nm with a two-phase mixture of titanium oxide in the form ofa-Ti2O3+ C-Ti2O3and C-Ti2O3+ r-TiO2-x, respectively. To the best of our knowledge this is the first time that single phase C-Ti2O3 or r-TiO2-x LIPSS are reported.
The landscape of antibody binding in SARS-CoV-2 infection
Authors: Heffron Anna S. , McIlwain Sean J. , Amjadi Maya F. , Baker David A. , Khullar Saniya , Armbrust Tammy , Halfmann Peter J. , Kawaoka Yoshihiro , Sethi Ajay K. , Palmenberg Ann C. , Shelef Miriam A. , O’Connor David H. , Ong Irene M.
Published: June 2021

The search for potential antibody-based diagnostics, vaccines, and therapeutics for pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has focused almost exclusively on the spike (S) and nucleocapsid (N) proteins. Coronavirus membrane (M), ORF3a, and ORF8 proteins are humoral immunogens in other coronaviruses (CoVs) but remain largely uninvestigated for SARS-CoV-2. Here, we use ultradense peptide microarray mapping to show that SARS-CoV-2 infection induces robust antibody responses to epitopes throughout the SARS-CoV-2 proteome, particularly in M, in which 1 epitope achieved excellent diagnostic accuracy. We map 79 B cell epitopes throughout the SARS-CoV-2 proteome and demonstrate that antibodies that develop in response to SARS-CoV-2 infection bind homologous peptide sequences in the 6 other known human CoVs. We also confirm reactivity against 4 of our top-ranking epitopes by enzyme-linked immunosorbent assay (ELISA). Illness severity correlated with increased reactivity to 9 SARS-CoV-2 epitopes in S, M, N, and ORF3a in our population. Our results demonstrate previously unknown, highly reactive B cell epitopes throughout the full proteome of SARS-CoV-2 and other CoV proteins.
The role of the Basic Public Health Service program in the control of hypertension in China: Results from a cross-sectional health service interview survey
Authors: Qin Jiangmei , Zhang Yanchun , Fridman Masha , Sweeny Kim , Zhang Lifang , Lin Chunmei , Mao Lu
Published: June 2021

Objectives

Non-communicable diseases (NCDs) have become the main cause of mortality in China. In 2009, the Chinese government introduced the Basic Public Health Service (BPHS) program to relieve the rising burden of NCDs through public health measures and delivery of essential medical care. The primary aim of this study was to evaluate the impact of the BPHS program on hypertension control.

Methods

The China National Health Development Research Center (CNHDRC) undertook a Cross-sectional Health Service Interview Survey (CHSIS) of 62,097 people from primary healthcare reform pilot areas across 17 provinces from eastern, central, and western parts of China in 2014. The current study is based on responses to the CHSIS survey from 7,867 participants, who had been diagnosed with hypertension. Multi-variable mixed logit regression analysis was used to estimate the association between BPHS management and uncontrolled hypertension. In a follow-up analysis, generalized structural equation modelling (GSEM) was used to test for mediation of the BPHS program effect through patient compliance with medication.

Findings

The estimated proportion of patients with uncontrolled hypertension was 30% lower (23.2% vs 31.5%) in those participants who were adequately managed under the BPHS program. Other predictors of hypertension control included compliance with medication, self-reported wellbeing, income, educational attainment and exercise; smoking was associated with reduced hypertension control. The significant inverse association between uncontrolled hypertension and age indicates poor outcomes for younger patients. Additional testing suggested that nearly 40% of the effect of BPHS management (95% CI: 28.2 to 51.7) could be mediated by improved compliance with medication; there was also an indication that the effect of management was 30% stronger in districts/counties with established digital information management systems (IMS).

Conclusion

Hypertension control improved markedly following active management through the BPHS program. Some of that improvement could be explained by greater compliance with medication among program participants. This study also identified the need to tailor the BPHS program to the needs of younger patients to achieve higher levels of control in this population. Future investigations should explore ways in which existing healthcare management influences the success of the BPHS program.
Distributed optimal power flow
Authors: Oh HyungSeon
Published: June 2021

Objective

The objectives of this paper are to 1) construct a new network model compatible with distributed computation, 2) construct the full optimal power flow (OPF) in a distributed fashion so that an effective, non-inferior solution can be found, and 3) develop a scalable algorithm that guarantees the convergence to a local minimum.

Existing challenges

Due to the nonconvexity of the problem, the search for a solution to OPF problems is not scalable, which makes the OPF highly limited for the system operation of large-scale real-world power grids—“the curse of dimensionality”. The recent attempts at distributed computation aim for a scalable and efficient algorithm by reducing the computational cost per iteration in exchange of increased communication costs.

Motivation

A new network model allows for efficient computation without increasing communication costs. With the network model, recent advancements in distributed computation make it possible to develop an efficient and scalable algorithm suitable for large-scale OPF optimizations.

Methods

We propose a new network model in which all nodes are directly connected to the center node to keep the communication costs manageable. Based on the network model, we suggest a nodal distributed algorithm and direct communication to all nodes through the center node. We demonstrate that the suggested algorithm converges to a local minimum rather than a point, satisfying the first optimality condition.

Results

The proposed algorithm identifies solutions to OPF problems in various IEEE model systems. The solutions are identical to those using a centrally optimized and heuristic approach. The computation time at each node does not depend on the system size, and Niter does not increase significantly with the system size.

Conclusion

Our proposed network model is a star network for maintaining the shortest node-to-node distances to allow a linear information exchange. The proposed algorithm guarantees the convergence to a local minimum rather than a maximum or a saddle point, and it maintains computational efficiency for a large-scale OPF, scalable algorithm.
An in vitro study of dual drug combinations of anti-viral agents, antibiotics, and/or hydroxychloroquine against the SARS-CoV-2 virus isolated from hospitalized patients in Surabaya, Indonesia
Authors: Purwati  , Miatmoko Andang , Nasronudin  , Hendrianto Eryk , Karsari Deya , Dinaryanti Aristika , Ertanti Nora , Ihsan Igo Syaiful , Purnama Disca Sandyakala , Asmarawati Tri Pudy , Marfiani Erika , Yulistiani  , Rosyid Alfian Nur , Wulaningrum Prastuti Asta , Setiawan Herley Windo , Siswanto Imam , Tri Puspaningsih Ni Nyoman
Published: June 2021

A potent therapy for the infectious coronavirus disease COVID-19 is urgently required with, at the time of writing, research in this area still ongoing. This study aims to evaluate the in vitro anti-viral activities of combinations of certain commercially available drugs that have recently formed part of COVID-19 therapy. Dual combinatory drugs, namely; Lopinavir-Ritonavir (LOPIRITO)-Clarithromycin (CLA), LOPIRITO-Azithromycin (AZI), LOPIRITO-Doxycycline (DOXY), Hydroxychloroquine (HCQ)-AZI, HCQ-DOXY, Favipiravir (FAVI)-AZI, HCQ-FAVI, and HCQ-LOPIRITO, were prepared. These drugs were mixed at specific ratios and evaluated for their safe use based on the cytotoxicity concentration (CC50) values of human umbilical cord mesenchymal stem cells. The anti-viral efficacy of these combinations in relation to Vero cells infected with SARS-CoV-2 virus isolated from a patient in Universitas Airlangga hospital, Surabaya, Indonesia and evaluated for IC50 24, 48, and 72 hours after viral inoculation was subsequently determined. Observation of the viral load in qRT-PCR was undertaken, the results of which indicated the absence of high levels of cytotoxicity in any samples and that dual combinatory drugs produced lower cytotoxicity than single drugs. In addition, these combinations demonstrated considerable effectiveness in reducing the copy number of the virus at 48 and 72 hours, while even at 24 hours, post-drug incubation resulted in low IC50 values. Most combination drugs reduced pro-inflammatory markers, i.e. IL-6 and TNF-α, while increasing the anti-inflammatory response of IL-10. According to these results, the descending order of effective dual combinatory drugs is one of LOPIRITO-AZI>LOPIRITO-DOXY>HCQ-AZI>HCQ-FAVI>LOPIRITO-CLA>HCQ-DOX. It can be suggested that dual combinatory drugs, e.g. LOPIRITO-AZI, can potentially be used in the treatment of COVID-19 infectious diseases.
Predictors of severity and mortality among patients hospitalized with COVID-19 in Rhode Island
Authors: Pandita Aakriti , Gillani Fizza S. , Shi Yiyun , Hardesty Anna , McCarthy Meghan , Aridi Jad , Farmakiotis Dimitrios , Chiang Silvia S. , Beckwith Curt G.
Published: June 2021

Background

In order for healthcare systems to prepare for future waves of COVID-19, an in-depth understanding of clinical predictors is essential for efficient triage of hospitalized patients.

Methods

We performed a retrospective cohort study of 259 patients admitted to our hospitals in Rhode Island to examine differences in baseline characteristics (demographics and comorbidities) as well as presenting symptoms, signs, labs, and imaging findings that predicted disease progression and in-hospital mortality.

Results

Patients with severe COVID-19 were more likely to be older (p = 0.02), Black (47.2% vs. 32.0%, p = 0.04), admitted from a nursing facility (33.0% vs. 17.9%, p = 0.006), have diabetes (53.9% vs. 30.4%, p<0.001), or have COPD (15.4% vs. 6.6%, p = 0.02). In multivariate regression, Black race (adjusted odds ratio [aOR] 2.0, 95% confidence interval [CI]: 1.1–3.9) and diabetes (aOR 2.2, 95%CI: 1.3–3.9) were independent predictors of severe disease, while older age (aOR 1.04, 95% CI: 1.01–1.07), admission from a nursing facility (aOR 2.7, 95% CI 1.1–6.7), and hematological co-morbidities predicted mortality (aOR 3.4, 95% CI 1.1–10.0). In the first 24 hours, respiratory symptoms (aOR 7.0, 95% CI: 1.4–34.1), hypoxia (aOR 19.9, 95% CI: 2.6–152.5), and hypotension (aOR 2.7, 95% CI) predicted progression to severe disease, while tachypnea (aOR 8.7, 95% CI: 1.1–71.7) and hypotension (aOR 9.0, 95% CI: 3.1–26.1) were associated with increased in-hospital mortality.

Conclusions

Certain patient characteristics and clinical features can help clinicians with early identification and triage of high-risk patients during subsequent waves of COVID-19.
Association between biological sex and insecticide-treated net use among household members in ethnic minority and internally displaced populations in eastern Myanmar
Authors: Cheng Breagh , Htoo Saw Nay , Mhote Naw Pue Pue , Davison Colleen M.
Published: June 2021

Malaria prevalence in Myanmar is highest among remote and ethnic minority populations living near forest fringes along the country’s international borders. Insecticide-treated nets (ITNs) are a key intervention used to prevent malaria transmission, but insufficient ITN availability and low use can hinder effectiveness. This study assessed age and sex disparities in ITN possession, access, and use among household members of ethnic minority and internally displaced populations in eastern Myanmar. Cross-sectional data from the 2013 Eastern Burma Retrospective Mortality Survey were used to describe prevalence of ITN possession, access, and use. The association between a household member’s biological sex and their ITN use was assessed using multilevel log binomial regression. Age and household ITN supply were tested as potential effect modifiers. Of 37927 household members, 89.8% (95% CI: 89.5, 90.1) of people lived in households with at least one ITN. Approximately half belonged to households with sufficient ITN supply and used an ITN. Pregnant women and children under five had the highest proportion of ITN use regardless of sufficient household ITN status. Female adults aged 15 to 49 years old (Risk ratio or RR: 1.4, 95% CI: 1.29, 1.52) were more likely to use ITNs. This relationship did not differ by sufficient household ITN status. The findings suggest that among ethnic minority populations in areas where ITN use is indicated, many households do not have adequate ITN supply, and many individuals are not using ITNs. Children under five and pregnant women appear to be prioritized for ITN use and overall, women are slightly more likely to use ITNs than men. This study’s findings can support efforts ensuring that all household members belonging to ethnic minority and displaced populations in Eastern Myanmar benefit from sufficient ITN access and use for malaria prevention.
Method-specific beliefs and subsequent contraceptive method choice: Results from a longitudinal study in urban and rural Kenya
Authors: Odwe George , Wado Yohannes Dibaba , Obare Francis , Machiyama Kazuyo , Cleland John
Published: June 2021

Introduction

Evidence from sub-Saharan Africa, including Kenya, shows that negative beliefs about contraceptive methods are associated with non-use. However, little is known about the relationship between contraceptive beliefs and subsequent method choice.

Methodology

We used data from a two-year longitudinal survey of married women aged 15–39 years at enrollment from one urban site (Nairobi) and one rural site (Homa Bay) in Kenya. Analysis entails descriptive statistics and estimation of a conditional logit analysis to examine associations between method-specific beliefs and choice of injectables, implants or pills among women who were not using any method or were pregnant at baseline (round 1) but adopted these methods at 12-month follow-up (Nairobi, n = 221; Homa Bay n = 197).

Results

Beliefs about pills, injectables and implants among non-users were generally negative. With the partial exception of the pill in Nairobi, the majority thought that each method was likely to cause serious health problems, unpleasant side effects, menstrual disruption, and would be unsafe for long-term use. In both sites, satisfied past use of a method and the perception that a method is easy to use had a major influence on method choice. Concerns about menstrual disruption and safety for long-term use were unimportant in both sites. There were some marked differences between the two sites. Beliefs about long-term fertility impairment and perceived husband approval had strong influences on choice of injectables, implants or pills in the urban site but not in the rural site.

Conclusion

The relative importance of beliefs, some erroneous, in predisposing women to choose one method over another appears to be conditioned by the social context. There is need for family planning counseling programmes to pay attention to erroneous beliefs and misconceptions about contraceptives.
Emotion induction in young and old persons on watching movie segments: Facial expressions reflect subjective ratings
Authors: Zempelin Svenja , Sejunaite Karolina , Lanza Claudia , Riepe Matthias W.
Published: June 2021

Film clips are established to induce or intensify mood states in young persons. Fewer studies address induction of mood states in old persons. Analysis of facial expression provides an opportunity to substantiate subjective mood states with a psychophysiological variable. We investigated healthy young (YA; n = 29; age 24.4 ± 2.3) and old (OA; n = 28; age 69.2 ± 7.4) participants. Subjects were exposed to film segments validated in young adults to induce four basic emotions (anger, disgust, happiness, sadness). We analyzed subjective mood states with a 7-step Likert scale and facial expressions with an automated system for analysis of facial expressions (FaceReader™ 7.0, Noldus Information Technology b.v.) for both the four target emotions as well as concomitant emotions. Mood expressivity was analysed with the Berkeley Expressivity Questionnaire (BEQ) and the Short Suggestibility Scale (SSS). Subjective mood intensified in all target emotions in the whole group and both YA and OA subgroups. Facial expressions of mood intensified in the whole group for all target emotions except sadness. Induction of happiness was associated with a decrease of sadness in both subjective and objective assessment. Induction of sadness was observed with subjective assessment and accompanied by a decrease of happiness in both subjective and objective assessment. Regression analysis demonstrated pre-exposure facial expressions and personality factors (BEQ, SSS) to be associated with the intensity of facial expression on mood induction. We conclude that mood induction is successful regardless of age. Analysis of facial expressions complement self-assessment of mood and may serve as a means of objectification of mood change. The concordance between self-assessment of mood change and facial expression is modulated by personality factors.