bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized control study: The effectiveness of multimedia education on self‐care and quality of life in patients with enterostomy
Authors: Ko Hsing‐Fang , Wu Mei‐Feng , Lu Jian‐Zhang
Published: July 2023

Colorectal cancer is typically treated through surgery, and self‐care skills play a crucial role in disease adaptation and quality of life improvement. Therefore, this study aimed to investigate the effectiveness of a multimedia patient education intervention on enhancing the self‐care and quality of life among patients with a postoperative stoma as well as on establishing an easy‐to‐use ostomy self‐care skills assessment. The sample comprised 108 patients with new ostomies who were randomly assigned to two groups. Data were collected from June 2018 to March 2019. The conventional education service program group received individual education in the hospital environment, consisting of four 3‐h sessions delivered over 4 consecutive days. The multimedia group viewed a multimedia educational program using a laptop. Data were collected at baseline and 3 months after the intervention using a demographic questionnaire, an ostomy self‐care ability scale and the Stoma Quality of Life Scale. Before the intervention, there were no significant differences in self‐care ability and quality of life scores between the two groups (p = 0.764 and p = 0.466, respectively). However, 3 months after the intervention, the group that received the multimedia software intervention showed significantly higher self‐care ability and quality of life scores compared to the group that received conventional education services (p < 0.001). When a set threshold is reached, self‐care ability and a good quality of life can be met. The threshold value of the ostomy self‐care skill scale was determined to be 20 points, resulting in a sensitivity of 77.8% and a specificity of 75.5%. The results indicate that the multimedia education program enhanced home self‐care ability and quality of life among patients with enterostomy.
Sleep–wake monitoring of people with intellectual disability: Examining the agreement of EMFIT QS and actigraphy
Authors: Buimer Hendrik P. , Siebelink Nienke M. , Gaasterland Annemarije , van Dam Kirstin , Smits Annelies , Frederiks Kyra , van der Poel Agnes
Published: July 2023

Background

Gaining insight into sleep–wake patterns of persons with intellectual disabilities is commonly done using wrist actigraphy. For some people, contactless alternatives are needed. This study compares a contactless bed sensor with wrist actigraphy to monitor sleep–wake patterns of people with moderate to profound intellectual disabilities.

Method

Data were collected with EMFIT QS (activity and presence) and MotionWatch 8/Actiwatch 2 (activity, ambient light, and event marker/sleep diary) for 14 nights in 13 adults with moderate‐profound intellectual disabilities residing in intramural care.

Results

In a care‐as‐usual setting, EMFIT QS and actigraphy assessment show little agreement on sleep–wake variables.

Conclusion

Currently, EMFIT QS should not be considered an alternative to wrist actigraphy for sleep–wake monitoring. Further research is needed into assessing sleep–wake variables using (contactless) technological devices and how the data should be interpreted within the care context to achieve reliable and valid information on sleep–wake patterns of people with intellectual disabilities.
Seasonal variation in patterns of anuran diversity along a subtropical elevational gradient
Authors: Carvalho‐Rocha Vítor , Peres Carlos A. , Neckel‐Oliveira Selvino
Published: July 2023

Aim

Although many studies have described spatial patterns along elevational gradients, only a handful have investigated their temporal dynamics, which remain poorly understood. Here we investigate patterns of frog spatiotemporal diversity (Anuran: Amphibia) along a subtropical elevational gradient, and assess the importance of temperature in explaining observed patterns.

Location

An extensive Brazilian Atlantic Forest elevational gradient ranging from 200 m to 1800 m above sea level.

Taxon

Anuran amphibians.

Methods

We sampled anurans once each month between September 2017 and August 2018 at 38 ponds along the gradient. We then applied generalized additive models to evaluate the spatiotemporal patterns of anuran diversity (measured as Hill's numbers of order q = 0, 1 and 2) and abundance, and understand the extent to which this variation is explained by ambient temperature.

Results

We found seasonal changes in the shape and magnitude of anuran diversity along the elevational gradient. While anuran diversity showed mid‐elevation peaks between spring and summer, a low‐to‐mid elevation plateau was observed during autumn and winter. Abundance peaked at mid‐elevations between spring and summer, remained high in the lowlands, and decreased in the highlands between autumn and winter. Overall, anuran diversity and abundance increased from spring to summer but then sharply declined towards winter, showing a nonlinear positive relationship with mean temperature. Temperature accounted for most of the observed spatial and spatiotemporal variation, rather than temporal trends in anuran diversity and abundance.

Main Conclusions

Our results suggest that in addition to temperature, other factors such as intrinsic species characteristics may regulate anuran activity patterns throughout the year along the elevational gradient. This study highlights how local anuran diversity is dynamic across the elevational gradient, emphasizing the relevance of considering seasonality to better understand diversity patterns in montane environments, which can be critical to inform conservation strategies.
Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B‐coinfected adults in care in the United States
Authors: Ferrante Nicole D. , Kallan Michael J. , Sukkestad Sophia , Kodani Maja , Kitahata Mari M. , Cachay Edward R. , Bhattacharya Debika , Heath Sonya , Napravnik Sonia , Moore Richard D. , Yendewa George , Mayer Kenneth H. , Reddy K. Rajender , Hayden Tonya , Kamili Saleem , Martin Jeffrey N. , Kim H. Nina , Lo Re Vincent
Published: July 2023

Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross‐sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log‐binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody‐positivity associated with determinants of interest (age, injection drug use [IDU], high‐risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%–5.6%) were HDV IgG antibody‐positive, and 10/596 (1.7%; 95% CI, 0.6%–2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09–5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody‐positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.
An improved Nicotiana benthamiana bioproduction chassis provides novel insights into nicotine biosynthesis
Authors: Vollheyde Katharina , Dudley Quentin M. , Yang Ting , Oz Mehmet T. , Mancinotti Davide , Fedi Mariano Olivera , Heavens Darren , Linsmith Gareth , Chhetry Monika , Smedley Mark A. , Harwood Wendy A. , Swarbreck David , Geu‐Flores Fernando , Patron Nicola J.
Published: July 2023

The model plant Nicotiana benthamiana is an increasingly attractive organism for the production of high‐value, biologically active molecules. However, N. benthamiana accumulates high levels of pyridine alkaloids, in particular nicotine, which complicates the downstream purification processes.

Here, we report a new assembly of the N. benthamiana genome as well as the generation of low‐nicotine lines by CRISPR/Cas9‐based inactivation of berberine bridge enzyme‐like proteins (BBLs). Triple as well as quintuple mutants accumulated three to four times less nicotine than the respective control lines.

The availability of lines without functional BBLs allowed us to probe their catalytic role in nicotine biosynthesis, which has remained obscure. Notably, chiral analysis revealed that the enantiomeric purity of nicotine was fully lost in the quintuple mutants. In addition, precursor feeding experiments showed that these mutants cannot facilitate the specific loss of C6 hydrogen that characterizes natural nicotine biosynthesis.

Our work delivers an improved N. benthamiana chassis for bioproduction and uncovers the crucial role of BBLs in the stereoselectivity of nicotine biosynthesis.
Perioperative maintenance of hybrid closed loop insulin pump systems in youth with type 1 diabetes mellitus: A case series
Authors: Kim Yoohee Claire , Wolf Risa M. , Busin Kelly M. , Vanderhoek Samuel M.
Published: July 2023

Current guidelines support the use of continuous glucose monitoring devices and insulin pumps in minor surgical procedures for pediatric patients with type 1 diabetes mellitus. However, there are few reported cases of using hybrid closed loop technology in the perioperative period. This retrospective case series presents seven pediatric patients with type 1 diabetes who underwent eight surgical procedures with maintenance of hybrid closed loop systems. This paper also provides considerations for future use of hybrid closed loop systems perioperatively.
Comparative metabolomic analysis between tomato and halophyte plants under intercropping conditions
Authors: Jurado‐Mañogil Carmen , Barba‐Espín Gregorio , Hernández José A. , Diaz‐Vivancos Pedro
Published: July 2023

Halophyte‐based intercropping appears nowadays as a valuable approach in soil remediation and agriculture. In this work, intercropping between the halophyte Arthrocaulon macrostachyum and tomato (Solanum lycopersicum var. Sargento) was studied in both plant species using comparative mass spectrometry‐based metabolomics coupled to metabolic pathway predictions. A significant number of changes in metabolites was observed in the halophyte. In terms of alteration of specific metabolic pathways, intercropping conditions stimulated sugar and starch metabolisms in tomato, whereas in the halophyte, intercropping mainly altered amino acid‐related pathways. In addition, arginine and proline metabolism were commonly affected in both tomato and halophyte plants. Moreover, metabolomic changes were associated with physiological alterations in tomato. In this sense, mild oxidative stress was induced in intercropped tomato plants, which, in turn, could trigger signaling events leading to plant adjustment to intercropping conditions. This study represents the first approach toward understanding intercropping interactions at the metabolome level and its effect on plant physiology, opening up prospects for further characterization of this crop cultivation strategy.
Asymptotic behavior of the porous elastic system with dual phase lag model: Classical versus second spectrum perspectives
Authors: Zougheib Hamza , Arwadi Toufic El , Soufyane Abdelaziz
Published: July 2023

This paper aims to analyze the energy decay of the thermoelastic porous system. The dual‐phase lag theory is used to model heat transfer. We consider two perspectives: the classical approach and the second spectrum approach. For the classical approach, the well‐posedness is obtained via the semigroup theory and the system is exponentially stable under equal wave speed conditions. On the opposite, we show a polynomial decay. On the other hand, the well‐posedness of the truncated system is obtained via the Faedo Galerkin method, and the system is exponentially stable without any assumptions on the physical parameters.
Interim performance information and risk taking in a tournament—Field evidence from professional basketball
Authors: Jane Wen‐Jhan
Published: July 2023

This paper examines whether the shooting decisions under the leading (/lagging) condition moderate (/stimulate) risk taking. Using the task of field goal attempts in basketball competitions involving National Basketball Association regular season and playoff games, I find strong evidence of a significantly causal effect of interim performance information (IPI) on the probability of a risky shooting. Our results support the leading, lagging, and nothing‐to‐lose effects on individual risk taking under different conditions of time and score proximation in high‐stakes dynamic competitions when performing skill‐based tasks. Furthermore, the IPI effects are found to differ between Covid and non‐Covid periods.
Unilateral keratitis secondary to Leishmania spp. infection in a horse: Clinical signs and successful topical therapy
Authors: Matas Riera Màrian , Cardenas Nadal Marta , Martínez‐Sogues Laura , Ferrer Lluís
Published: July 2023

Dermatological clinical signs have been seldom reported in the literature secondary to equine leishmaniasis. This case depicts the clinical signs, treatment, and outcome of a young horse with a pink, elevated lesion on the ventromedial quadrant of the cornea. A corneal cytology was performed and revealed the presence of leishmania amastigotes reaching the diagnosis of keratitis secondary to leishmania. Surgical resection was recommended but the owner declined the procedure, and the lesion was treated with a topical antimonial for 6 weeks. The lesion reduced remarkably during the first weeks of treatment. The patient had not shown recurrence of the lesion for 2 years since the treatment was started. Leishmania spp. can be responsible for ocular surface abnormalities such as keratitis. Corneal cytology is an inexpensive diagnostic method that should be considered when ocular surface abnormalities are identified in horses in endemic areas.
Ageing reduces persistent inward current contribution to motor neurone firing: Potential mechanisms and the role of exercise
Authors: Orssatto Lucas B. R. , Blazevich Anthony J. , Trajano Gabriel S.
Published: July 2023

Nervous system deterioration is a primary driver of age‐related motor impairment. The motor neurones, which act as the interface between the central nervous system and the muscles, play a crucial role in amplifying excitatory synaptic input to produce the desired motor neuronal firing output. For this, they utilise their ability to generate persistent (long‐lasting) depolarising currents that increase cell excitability, and both amplify and prolong the output activity of motor neurones for a given synaptic input. Modulation of these persistent inward currents (PICs) contributes to the motor neurones’ capacities to attain the required firing frequencies and rapidly modulate them to competently complete most tasks. Thus, PICs are crucial for adequate movement generation. Impairments in intrinsic motor neurone properties can impact motor unit firing capacity, with convincing evidence indicating that the PIC contribution to motor neurone firing is reduced in older adults. Indeed, this could be an important mechanism underpinning the age‐related reductions in strength and physical function. Furthermore, resistance training has emerged as a promising intervention to counteract age‐associated PIC impairments, with changes in PICs being correlated with improvements in muscular strength and physical function after training. In this review, we present the current knowledge of the PIC magnitude decline during ageing and discuss whether reduced serotonergic and noradrenergic input onto the motor neurones, voltage‐gated calcium channel dysfunction or inhibitory input impairments are candidates that: (i) explain age‐related reductions in the PIC contribution to motor neurone firing and (ii) underpin the enhanced PIC contribution to motor neurone firing following resistance training in older adults.

image
Technical and Economic Performance of Four Solar Cooling and Power Co-Generated Systems Integrated With Facades in Chinese Climate Zones
Authors: Lai Fei , Wu Dan , Zhou Jinzhi , Yuan Yanping
Published: July 2023

There has been an increasing interest in solar-driven combined energy supply systems for low-temperate applications, particularly those based on the Organic Rankine Cycle (ORC), Kalina Cycle (KC), or Trilateral Cycle (TLC). However, systems based on these thermodynamic cycles usually employ large area collectors that stand alone or are placed on the roof, without considering integration with the building facade. This research presents a solution to large-scale photothermal utilization integrated with facades for co-generated systems. The current study is the first to conduct performance and economic assessment for four novel solar cooling and power (SCP) co-generated systems driven by evacuated tube solar collectors (ETCs) or semi-transparent photovoltaic (STPV) integrated into the building facades. The suggested systems were simulated using TRNSYS to forecast their performance metrics when used in four Chinese cities with various climate zones. As indicators, a solar fraction (SF) and unit energy cost (UEC) were used to evaluate the technical and financial aspects of each system. The STPV-vapor compression cycle (VCC) system had the highest SF (100%, except Haikou), as well as the lowest UEC (0.211$/kWh on average) among the four cities, according to the results. Among the three solar–thermal co-generation systems, ETC–ORC–VCC had the best performance (SF,37.9%; UEC,0.597$/kWh on average).
Development of a Low-Cost Soft Robot Fish With Biomimetic Swimming Performance
Authors: Zou Ting , Jian Xinyu , Al-Tamimi Mahmoud , Wu Xing , Wu Jing
Published: July 2023

This paper investigates the methodology and techniques for a soft biomimetic robot fish that has a straightforward design, relatively simple fabrication, and low cost. In addition to the investigations of fabrication techniques, we also explore the numerical analysis of the biological fish swimming performance, with its inspiration for robot fish design, which is less studied in the literature. In this research, therefore, various swimming locomotion patterns within the body and/or caudal fin family are analyzed for kinematics and hydrodynamics using analytical methods and computational fluid dynamics (CFD) to inspire the robot fish design for improved swimming performance. By straightforward design and fabrication, the swimming performance of the numerical robot fish is verified by means of simulation using 3D CFD, and the prototype performance is validated using in-water experimental tests. This study showcases a new easy-to-design and easy-to-fabricate robust biomimetic robot fish with comparable swimming performance, which has good potential for purposes like education, research, and entertainment.
A Cyclic Differentiable Manifold Representation of Redundant Manipulator Kinematics
Authors: Haug Edward J.
Published: July 2023

An inverse kinematic mapping for redundant serial manipulators is presented at the configuration level, for which periodic manipulator operational trajectories map into periodic input trajectories, i.e., for which serial manipulators are cyclic. The inverse kinematic mapping defines a differentiable manifold on which output and self-motion coordinates comprise operational coordinates that represent manipulator redundant degrees-of-freedom. The inverse kinematic mapping and differentiable manifold are defined in analytical form and a computational method for their evaluation is presented. Numerical examples are presented to illustrate the validity of the formulation on subsets of manipulator regular configuration space, or on the entire space.
Numerical Fatigue Life Evaluation With Experimental Results for Type III Accumulators
Authors: Kim Sang-Won , Yoshikawa Nobuhiro
Published: July 2023

Type III accumulator is widely used in hydrogen stations. A high-cost pressure cycle test is mandatory to ensure the safety of the accumulator in present regulations. To reduce the high cost, the aim is to develop a methodology of numerical fatigue life prediction, where an axisymmetric finite element model for the Type III accumulator is created precisely and actual loading process including autofrettage pressure is simulated. The alternating stress intensity is evaluated based on the instructions in KD-3 of 2015 ASME Boiler & Pressure Vessel Code, Section VIII, Division 3. By comparing stress amplitude distributions with the leak positions after the pressure cycle test, and plotting the results in the design fatigue curve, it could be shown that fatigue life prediction of Type III accumulator can be done by precise finite element analysis of the liner including dome part, where the principal axes of stress change in pressure cycle.
Experimental Study of Thermal Hydraulic Performance Improvement in Solar Air Heater Channel With V-Shaped Porous Baffles
Authors: Baissi M.T. , Hassani S. , Karoua Housseyn , Aoues K. , Moummi N.
Published: July 2023

Experiments have been conducted to determine how several geometrical parameters of V-shaped porous baffles influence flow characteristics and heat transfer in a rectangular channel. Experiments were conducted on geometric parameters, namely, a relative baffle height (e/H) of 0.4–1, a relative baffle pitch (P/e) of 3–6, open area ratio values of 21–34%, and a single attack angle (α) of 60 deg. Using Reynolds numbers ranging from 2500 to 12,000, V-shaped porous baffles have been examined. Based on a relative baffle pitch of 5, a relative baffle height of 1, and an open area ratio of 21%, the maximum increases in the Nusselt number (Nu) and friction factor (f) were 2.84 and 7 times, respectively. A maximum value of 1.69 is found at e/H = 0.40, P/e = 6, and b = 34% for the thermo-hydraulic performance parameter. Correlations for (Nu) and (f) are developed as functions of P/e, e/H, and Re.
Effects of Ribbed Surfaces on Profile Losses of Low-Pressure Turbine Blades
Authors: Dellacasagrande M. , Lengani D. , Simoni D. , Ubaldi M. , Bertini F.
Published: July 2023

In this work, streamwise oriented riblets were installed on a flat plate exposed to an adverse pressure gradient typical of low-pressure turbine (LPT) blade and, successively, on the suction side of an LPT cascade operating under unsteady flow. Different riblet dimensions and positions have been tested to quantify their effects on the boundary layer transition and on losses. The flat plate experiments allowed the detailed description of the riblet effects on the coherent structures affecting transition, thus providing a rationale for the identification of the optimal riblet geometry once scaled in wall-units. For riblet heights equal to about 20 wall-units, a maximum loss reduction of 8% was observed. Otherwise, for larger riblet dimensions, earlier transition occurs due to enhanced boundary layer instability and losses increase. Interestingly, the streamwise extension of the ribbed surfaces with respect to the transition region was found to play a minor role compared with the riblet dimension. The riblet configurations providing the highest reduction of viscous losses were then tested in the LPT blade cascade for different Reynolds numbers and with impinging upstream wakes. An overall profile loss reduction comparable to that observed in the flat plate case has been confirmed also in the unsteady operation of the turbine cascade. Low sensitivity of the profile losses to the riblet streamwise extension was also observed in the cascade application. This confirms that positive effects in terms of loss reduction can be obtained even when the exact transition position is not known a priori.
Film Cooling on Turbine Vane Endwalls With Different Inlet Cooling Configurations: Experimental and Computational Results
Authors: Yang Xing , Zhao Qiang , Wu Hang , Feng Zhenping
Published: July 2023

A comparative study of turbine endwall film cooling resulting from three different cooling configurations in front of the passage inlet was conducted. The three inlet cooling configurations considered in this study were a conventional continuous slot, double rows of discrete film holes, and an interrupted slot with a backward-facing step. Pressure sensitive paint (PSP) was sprayed over the endwall surfaces to map adiabatic cooling effectiveness contours and five-hole probe and thermocouple measurements were implemented to assess aero-thermal fields at the passage exit. The evolution of cooling effectiveness was compared across a full range span of coolant flow rates of 0.3−1.8% in a real engine. Additionally, complex flow structures inside the passage due to interactions of coolant with mainstream flows were visualized using computational fluid dynamics (CFD) simulations to support the observed coolant coverage patterns. A side-by-side comparison of CFD simulations against experiments was made as well to evaluate the reliability of conventional turbulence modeling methods in such a complex flow. The continuous slot was found to produce the highest cooling effectiveness values while the double-row holes offered the most uniform coolant coverage, leading to spreading out of the coolant jets downstream of the passage throat and even beyond the trailing edge of the passage for coolant injection rates higher than 1.0%. Supported by the CFD-predicted flow structures and measured aerodynamic losses, the injection from the double-row holes weakened the passage secondary flows and thus caused the lowest aerodynamic loss. On the contrary, the interrupted slot enhanced the secondary flows due to the backward step, resulting in the highest flow loss.
Training and Competition Loads in Women’s Rugby Sevens Athletes: Are There Implications for Cardiovascular Health?
Authors: Napoli Luca , Semple Stuart , McKune Andrew J.
Published: July 2023

National- and international-level rugby sevens athletes are exposed to high training and competition loads over the course of a competitive season. Research on load monitoring and body-system responses is widespread; however, the primary focus has been on optimizing performance rather than investigating or improving cardiovascular health. There is a degree of cardiovascular remodeling, as well as local and systemic inflammation, in response to excessive exercise. These responses are moderated by many factors including previous exercise exposure, current exercise intensity and duration, age, race, and gender, as well as sport-specific physiology. For these reasons, high-performing female rugby sevens athletes may have a unique cardiovascular risk profile different from males and other rugby codes. This review aimed to characterize the training and competition loads, as well as the anthropometric and physiological profiles, of female rugby sevens athletes; discuss the potential impacts these may have on the cardiovascular system; and provide recommendations on future research regarding the relationship between rugby sevens training and competition loads and cardiovascular health. Movement demands, competition formatting, and training routines could all contribute to adverse cardiovascular adaptations. Anthropometric data and physiological characteristics may also increase the risk of cardiovascular disease. Future research needs to adopt measures of cardiovascular health to obtain a greater understanding of cardiovascular profiles and risk factors in female rugby sevens athletes.
Exercise Recommendations for e-Athletes: Guidelines to Prevent Injuries and Health Issues
Authors: Baena-Riera Arnau , Carrani Lucia Maria , Piedra Aitor , Peña Javier
Published: July 2023

In the last two decades, video games have gone from being pastimes to being a coveted profession with competitions broadcasted worldwide and high earnings for the winners. However, the esports environment is still little known, presenting a lack of knowledge on how to get physically ready to minimize the effect of prolonged sitting or avoid career-ending injuries. This article provides coaches and serious gamers with a program based on evidence and simple to implement. The main aims will be to prevent esports’ common injuries such as cervical and lumbar pain, wrist and shoulder overuse, and peripheral neuropathies. Our proposal contains protocols for warming-up, preventing injuries, and taking active breaks.
Genome sequences of 11
Alkalihalobacillus clausii, Bacillus safensis,
and
Escherichia coli
bacteriophages isolated from bovine rumen and vagina
Authors: Magossi Gabriela , Holman Devin B. , Schmidt Kaycie N. , Hoselton Scott A. , Amat Samat
Published: July 2023

Here, we present the coding-complete genomes of 11 lytic bacteriophages isolated from bovine ruminal fluid and vaginal swabs that can infect the bacterial hosts
Alkalihalobacillus clausii, Bacillus safensis,
and
Escherichia coli
.
A mixed-model approach for estimating drivers of microbiota community composition and differential taxonomic abundance
Authors: Sweeny Amy R. , Lemon Hannah , Ibrahim Anan , Watt Kathryn A. , Wilson Kenneth , Childs Dylan Z. , Nussey Daniel H. , Free Andrew , McNally Luke
Published: July 2023

Next-generation sequencing (NGS) and metabarcoding approaches are increasingly applied to wild animal populations, but there is a disconnect between the widely applied generalized linear mixed model (GLMM) approaches commonly used to study phenotypic variation and the statistical toolkit from community ecology typically applied to metabarcoding data. Here, we describe the suitability of a novel GLMM-based approach for analyzing the taxon-specific sequence read counts derived from standard metabarcoding data. This approach allows decomposition of the contribution of different drivers to variation in community composition (e.g., age, season, individual) via interaction terms in the model random-effects structure. We provide guidance to implementing this approach and show how these models can identify how responsible specific taxonomic groups are for the effects attributed to different drivers. We applied this approach to two cross-sectional data sets from the Soay sheep population of St. Kilda. GLMMs showed agreement with dissimilarity-based approaches highlighting the substantial contribution of age and minimal contribution of season to microbiota community compositions, and simultaneously estimated the contribution of other technical and biological factors. We further used model predictions to show that age effects were principally due to increases in taxa of the phylum Bacteroidetes and declines in taxa of the phylum Firmicutes. This approach offers a powerful means for understanding the influence of drivers of community structure derived from metabarcoding data. We discuss how our approach could be readily adapted to allow researchers to estimate contributions of additional factors such as host or microbe phylogeny to answer emerging questions surrounding the ecological and evolutionary roles of within-host communities.

IMPORTANCE

NGS and fecal metabarcoding methods have provided powerful opportunities to study the wild gut microbiome. A wealth of data is, therefore, amassing across wild systems, generating the need for analytical approaches that can appropriately investigate simultaneous factors at the host and environmental scale that determine the composition of these communities. Here, we describe a generalized linear mixed-effects model (GLMM) approach to analyze read count data from metabarcoding of the gut microbiota, allowing us to quantify the contributions of multiple host and environmental factors to within-host community structure. Our approach provides outputs that are familiar to a majority of field ecologists and can be run using any standard mixed-effects modeling packages. We illustrate this approach using two metabarcoding data sets from the Soay sheep population of St. Kilda investigating age and season effects as worked examples.
Supplemental Material: Exceptional age constraint on a fossiliferous sedimentary succession preceding the Cretaceous Thermal Maximum
Authors: Tucker Ryan T. , al. et
Published: July 2023

All analytical results of all samples included within this study (LA-IC-PMS, CA-ID-TIMS, XRD, and XRF) along with CL zircon images with ablation spots indicated.  
Empirical overview of a delayed diagnosis of bilateral congenital choanal atresia in an adolescent male: management with ‘coblation-assisted surgery’
Authors: Bhardwaj Abhishek , Sood Rachit , P S Suji , Malhotra Manu
Published: July 2023

Bilateral choanal atresia (CA) is a congenital anomaly consisting of an imperforated choana that leads to newborn fatalities but, if unilateral, may go unnoticed for many years. Bilateral CA occurring without significant symptoms and remaining undiagnosed for many years is rare. This case report identifies an adolescent male with bilateral CA who remained undiagnosed till adolescence. The patient presented with isolated complaints of chronic nasal obstruction and discharge and was diagnosed with bilateral CA by endoscopic and radiological evaluation. The patient underwent a coblation-assisted endoscopic CA repair, with a crossover mucoperiosteal flap technique, without stenting and with a successful outcome.
Cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS): diagnostic contribution of vestibular function tests
Authors: Melo Sousa Patrícia , Ferro Margarida , Jacinto João
Published: July 2023

Cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) is a recently recognised but underdiagnosed cause of late-onset hereditary ataxia. Symptoms may vary, and differential diagnoses can span several specialties. We report the case of a man in his 60 s who presented with a 10 year history of imbalance and progressive gait disturbance associated with a chronic spasmodic cough that preceded these symptoms by almost 30 years. He had previously undergone extensive testing for acquired and genetic causes of ataxia without a conclusive diagnosis. Brain MRI revealed cerebellar atrophy, and nerve conduction tests suggested a sensory ganglionopathy. Vestibular function testing was crucial for diagnosis, identifying a severe bilateral vestibulopathy. This led to the consideration of CANVAS, which was finally confirmed by genetic testing. This case raises awareness of this novel genetic disease, highlighting the importance of objective vestibular function tests in establishing an early diagnosis.
Using days alive and out of hospital to measure surgical outcomes in New Zealand: a cross-sectional study
Authors: Boyle Luke , Lumley Thomas , Cumin David , Campbell Doug , Merry Alan Forbes
Published: July 2023

Objectives

To measure differences at various deciles in days alive and out of hospital to 90 days (DAOH90) and explore its utility for identifying outliers of performance among district health boards (DHBs).

Methods

Days in hospital and mortality within 90 days of surgery were extracted by linking data from the New Zealand National Minimum Data Set and the births and deaths registry between 1 January 2011 and 31 December 2021 for all adults in New Zealand undergoing acute laparotomy (AL—a relatively high-risk group), elective total hip replacement (THR—a medium risk group) or lower segment caesarean section (LSCS—a low-risk group). DAOH90was calculated without censoring to zero in cases of mortality. For each DHB, direct risk standardisation was used to adjust for potential confounders and presented in deciles according to baseline patient risk. The Mann-Whitney U test assessed overall DAOH90differences between DHBs, and comparisons are presented between selected deciles of DAOH90for each operation.

Results

We obtained national data for 35 175, 52 032 and 117 695 patients undergoing AL, THR and LSCS procedures, respectively. We have demonstrated that calculating DAOH without censoring zero allows for differences between procedures and DHBs to be identified. Risk-adjusted national mean DAOH90Scores were 64.0 days, 79.0 days and 82.0 days at the 0.1 decile and 75.0 days, 82.0 days and 84.0 days at the 0.2 decile for AL, THR and LSCS, respectively, matching to their expected risk profiles. Differences between procedures and DHBs were most marked at lower deciles of the DAOH90distribution, and outlier DHBs were detectable. Corresponding 90-day mortality rates were 5.45%, 0.78% and 0.01%.

Conclusion

In New Zealand after direct risk adjustment, differences in DAOH90between three types of surgical procedure reflected their respective risk levels and associated mortality rates. Outlier DHBs were identified for each procedure. Thus, our approach to analysing DAOH90appears to have considerable face validity and potential utility for contributing to the measurement of perioperative outcomes in an audit or quality improvement setting.
Deep learning-based diagnosis of histopathological patterns for invasive non-mucinous lung adenocarcinoma using semantic segmentation
Authors: Zhao Yanli , He Sen , Zhao Dan , Ju Mengwei , Zhen Caiwei , Dong Yujie , Zhang Chen , Wang Lang , Wang Shuhao , Che Nanying
Published: July 2023

Objectives

The application of artificial intelligence (AI) to the field of pathology has facilitated the development of digital pathology, hence, making AI-assisted diagnosis possible. Due to the variety of lung cancers and the subjectivity of manual evaluation, invasive non-mucinous lung adenocarcinoma (ADC) is difficult to diagnose. We aim to offer a deep learning solution that automatically classifies invasive non-mucinous lung ADC histological subtypes.

Design

For this investigation, 523 whole-slide images (WSIs) were obtained. We divided 376 of the WSIs at random for model training. According to WHO diagnostic criteria, six histological components of invasive non-mucinous lung ADC, comprising lepidic, papillary, acinar, solid, micropapillary and cribriform arrangements, were annotated at the pixel level and employed as the predicting target. We constructed the deep learning model using DeepLab v3, and used 27 WSIs for model validation and the remaining 120 WSIs for testing. The predictions were analysed by senior pathologists.

Results

The model could accurately predict the predominant subtype and the majority of minor subtypes and has achieved good performance. Except for acinar, the area under the curve of the model was larger than 0.8 for all the subtypes. Meanwhile, the model was able to generate pathological reports. The NDCG scores were greater than 75%. Through the analysis of feature maps and incidents of model misdiagnosis, we discovered that the deep learning model was consistent with the thought process of pathologists and revealed better performance in recognising minor lesions.

Conclusions

The findings of the deep learning model for predicting the major and minor subtypes of invasive non-mucinous lung ADC are favourable. Its appearance and sensitivity to tiny lesions can be of great assistance to pathologists.
What do healthcare staff think about the quality and safety of care provided to children and young people with an intellectual disability? A qualitative study using the framework method of analysis
Authors: Ong Natalie , Lucien Abbie , Long Janet C , Weise Janelle , Walton Merrilyn , Burgess Annette
Published: July 2023

Objective

To elicit patient safety issues pertaining to children and young people with intellectual disability in hospital from healthcare staff perspectives. This follows a previous paper of parent interviews of patient safety experiences of their child in hospital.

Design

Qualitative study.

Setting

We conducted semi-structured interviews and focus groups of staff of tertiary children’s hospitals based on the domains of the Patient Safety Education Framework and using the framework methodology for data analysis.

Participants

There were 29 female and 7 male staff aged between 27 and 70 years from a range of departments and specialties including ancillary staff.

Intervention

Questions based on the patient safety framework were developed from consultation with parents, researchers and clinicians exploring staff views and experiences of safety and quality care of these children in hospital. During April 2021 to May 2022, 22 interviews and 3 focus groups were conducted of staff who have had experience caring for children and young people with intellectual disability in the last 12 months in the hospital.

Results

Key themes elicited includeDefinition of Safety, Need to consider additional vulnerabilities of children and young people with intellectual disability in hospital, Communication is key to safe care, Parent and family perspectives on safe care, Management challenges compromising safety and Service system gaps in preventing, identifying and managing risk.

Conclusions

Staff need to consider additional vulnerabilities, mitigate negative attitudes and biases towards better engagement and relationships with parents, children and young people of this population. Improvement of current systems that prevent the identification, prevention and management of risk and safety issues for this population need to be undertaken. Future developments include combining data from parent interviews, academic and grey literature in developing safety competencies in this population for training and education of staff across the health system.
Reasons and prevention strategies of unintended pregnancy in Addis Ababa, Ethiopia: a phenomenological qualitative study
Authors: Yalew Ayalnesh Zemene , Olayemi Oladapo O , Yalew Alemayehu Worku
Published: July 2023

Objectives

To explore the reasons for unintended pregnancy and effective prevention measures from the perspectives of women and healthcare providers in Addis Ababa, Ethiopia.

Design

Phenomenological qualitative study.

Setting and participants

This study was conducted at three public health facilities found in Addis Ababa, Ethiopia. Women with unintended pregnancies and healthcare providers currently working in maternal health services were purposively recruited for in-depth interviews. Twenty in-depth interviews were conducted until data saturation was achieved. Data were analysed using thematic analysis.

Results

Seven themes emerged from the transcribed interview data. These include: Personal characteristics (negligence; lower pregnancy expectation), family influence (fear of family), sociocultural and economic influence (stigma and discrimination), healthcare provider influence (disrespectful and abusive approach; disregard for women’s contraceptive choice), preconception thoughts and behaviours (unprotected early sexual practice; myths and misunderstanding), lack of access to quality family planning services (lack of trained contraceptive counsellor, inappropriate contraceptive use), and preventive strategies for unintended pregnancy (comprehensive sexual education; sexual and reproductive health and rights service integration)

Conclusions

This study identified multilevel reasons for unintended pregnancy from the perspective of the participants. Participants shared their views on preventive measures for unintended pregnancy, including comprehensive sexual education, service integration and male-inclusive contraceptive counselling. This study highlights the need to improve sexual and reproductive health services by shedding light on the viewpoints and experiences of women and healthcare providers.
HEalth And Dementia outcomes following Traumatic Brain Injury (HEAD-TBI): protocol for a retrospective cohort study
Authors: Russell Emma Rosalyn , Lyall Donald M , Stewart William
Published: July 2023

Background

It is estimated that by 2050 the global incidence of dementia will have exceeded 152 million. At present, there are no effective therapies for dementia, with a focus in research now turning to strategies for disease prevention. Traumatic brain injury (TBI) is recognised as a major risk factor for dementia; estimated to be responsible for at least 3% of cases in the community. However, adverse health outcomes after TBI are not restricted to dementia. A wide range of conditions are documented among TBI survivors, many of which also increase dementia risk. ‘HEalth And Dementia outcomes following Traumatic Brain Injury’ is a study aiming to explore the hypothesis that increased dementia risk following TBI reflects both the direct effect of the injury on the brain and the indirect effects of wider, adverse health outcomes associated with TBI which, in turn, increase dementia risk.

Methods and analysis

Comprehensive electronic medical and death certification records will be analysed for individuals with a documented history of TBI, compared with those of a matched general population control cohort with no documented TBI exposure. Cox proportional hazard regression models will be run to compare outcomes. Furthermore, existing diagnostic imaging and radiological reports for the cohort will be analysed to identify evidence of specific white matter abnormalities in TBI exposed individuals and their controls, and establish their potential diagnostic utility.

Ethics and dissemination

Approvals for the study have been obtained from the University of Glasgow College of Medical, Veterinary, and Life Sciences Research Ethics Committee (project number 200220038) and from National Health Service Scotland’s Public Benefits and Privacy Panel (application 2122-0224). As results emerge, these will be presented at appropriate multidisciplinary research conferences and made available through open access platforms where possible.
Comparing postoperative analgesia of bilateral serratus anterior plane block and thoracic paravertebral block for children following the Nuss procedure: protocol for a randomised, double-blind, non-inferiority clinical trial
Authors: He Yi , Xu Mingzhe , Jiang Xiaojuan , Li Zhi , Du Bin
Published: July 2023

Introduction

The Nuss procedure, despite being a minimally invasive surgery, is regarded as one of the most painful surgical procedures in children, and postoperative pain control remains a major clinical issue in this population. Thoracic paravertebral nerve block (TPVB) is reported as excellent pain relief for the Nuss procedure despite its challenging performance and associated adverse effects. Serratus anterior plane block (SAPB) is a simplified and effective method for managing thoracic pain as an alternative to TPVB. However, whether SAPB can provide analgesia comparable with that provided by the TPVB approach in children undergoing the Nuss procedure is unknown.

Methods and analysis

This will be a prospective, randomised, double-blind, single-centre, non-inferiority trial that will enrol children aged 7–16 years subjected to the Nuss operation for pectus excavatum. In total, 74 paediatric patients will be randomly assigned to either the SAPB or TPVB group after general anaesthesia to receive ultrasound-guided regional nerve blocks (0.25% ropivacaine 2.5 mg/kg). The primary outcome will be the assessment of postoperative pain intensity at predetermined time points. The secondary outcomes will include assessing intraoperative opioid intake, consumption of analgesics within 24 hours postoperatively, time of first use of rescue analgesics, extubation time, perioperative adverse events and plasma ropivacaine concentrations across the block groups. Demographic and clinical characteristics (eg, pectus severity and the number of bars used) of the patients will be recorded. All data will be collected by investigators who are blinded to the treatment.

Ethics and dissemination

Ethical approval was obtained from the Ethics Committee on Biomedical Research of the West China Hospital of Sichuan University (2021-1275). During the period of the study, all procedures will be conducted following the principles of the Declaration of Helsinki. The results of the trial will be published in a peer-reviewed scientific journal.

Trial registration number

ChiCTR2200056596.