bluuebunny/crossref_metadata_2025 huggingface dataset:
Engineering a suite of E. coli strains for enhanced expression of bacterial polysaccharides and glycoconjugate vaccines
Authors: Kay Emily J. , Mauri Marta , Willcocks Sam J. , Scott Timothy A. , Cuccui Jon , Wren Brendan W.
Published: April 2022

Background

Glycoengineering, in the biotechnology workhorse bacterium,Escherichia coli, is a rapidly evolving field, particularly for the production of glycoconjugate vaccine candidates (bioconjugation). Efficient production of glycoconjugates requires the coordinated expression within the bacterial cell of three components: a carrier protein, a glycan antigen and a coupling enzyme, in a timely fashion. Thus, the choice of a suitableE. colihost cell is of paramount importance. Microbial chassis engineering has long been used to improve yields of chemicals and biopolymers, but its application to vaccine production is sparse.

Results

In this study we have engineered a family of 11E. colistrains by the removal and/or addition of components rationally selected for enhanced expression ofStreptococcus pneumoniaecapsular polysaccharides with the scope of increasing yield of pneumococcal conjugate vaccines. Importantly, all strains express a detoxified version of endotoxin, a concerning contaminant of therapeutics produced in bacterial cells. The genomic background of each strain was altered using CRISPR in an iterative fashion to generate strains without antibiotic markers or scar sequences.

Conclusions

Amongst the 11 modified strains generated in this study,E. coliFalcon, Peregrine and Sparrowhawk all showed increased production ofS. pneumoniaeserotype 4 capsule. Eagle (a strain without enterobacterial common antigen, containing a GalNAc epimerase and PglB expressed from the chromosome) and Sparrowhawk (a strain without enterobacterial common antigen, O-antigen ligase and chain length determinant, containing a GalNAc epimerase and chain length regulators fromStreptococcus pneumoniae) respectively produced an AcrA-SP4 conjugate with 4 × and 14 × more glycan than that produced in the base strain, W3110. Beyond their application to the production of pneumococcal vaccine candidates, the bank of 11 new strains will be an invaluable resource for the glycoengineering community.
The KIDSCREEN-27 scale: translation and validation study of the Slovenian version
Authors: Budler Leona Cilar , Pajnkihar Majda , Ravens-Sieberer Ulrike , Barr Owen , Stiglic Gregor
Published: April 2022

Background

There are many methods available for measuring social support and quality of life (QoL) of adolescents, of these, the KIDSCREEN tools are most widely used. Thus, we aimed to translate and validate the KIDSCREEN-27 scale for the usage among adolescents aged between 10 and 19 years old in Slovenia.

Methods

A cross-sectional study was conducted among 2852 adolescents in primary and secondary school from November 2019 to January 2020 in Slovenia. 6-steps method of validation was used to test psychometric properties of the KIDSCREEN-27 scale. We checked descriptive statistics, performed a Mokken scale analysis, parametric item response theory, factor analysis, classical test theory and total (sub)scale scores.

Results

All five subscales of the KIDSCREEN-27 formed a unidimensional scale with good homogeneity and reliability. The confirmatory factor analysis showed poor fit in user model versus baseline model metrics (CFI = 0.847; TLI = 0.862) and good fit in root mean square error (RMSEA = 0.072; p(χ2) < 0.001). A scale reliability was calculated using Cronbach's α (0.93), beta (0.86), G6 (0.95) and omega (0.93).

Conclusions

The questionnaire showed average psychometric properties and can be used among adolescents in Slovenia to find out about their quality of life. Further research is needed to explore why fit in user model metrics is poor.
Gut microbiota modulation: a tool for the management of colorectal cancer
Authors: Wang Yan , Li Hui
Published: April 2022

Colorectal cancer (CRC) is the second cause of cancer death and the third most frequently diagnosed cancer. Besides the lifestyle, genetic and epigenetic alterations, and environmental factors, gut microbiota also plays a vital role in CRC development. The interruption of the commensal relationship between gut microbiota and the host could lead to an imbalance in the bacteria population, in which the pathogenic bacteria become the predominant population in the gut. Different therapeutic strategies have been developed to modify the gut immune system, prevent pathogen colonization, and alter the activity and composition of gut microbiota, such as prebiotics, probiotics, postbiotics, antibiotics, and fecal microbiota transplantation (FMT). Even though the employed strategies exhibit promising results, their translation into the clinic requires evaluating potential implications and risks, as well as assessment of their long-term effects. This study was set to review the gut microbiota imbalances and their relationship with CRC and their effects on CRC therapy, including chemotherapy and immunotherapy. More importantly, we reviewed the strategies that have been used to modulate gut microbiota, their impact on the treatment of CRC, and the challenges of each strategy.
The “Great Debate” at Immunotherapy Bridge 2021, December 1st–2nd, 2021
Authors: Ascierto Paolo A. , Butterfield Lisa H. , Finn Olivera J. , Futreal Andrew , Hamid Omid , LaVallee Theresa , Postow Michael A. , Puzanov Igor , Sosman Jeffrey , Fox Bernard A. , Hwu Patrick
Published: April 2022

As part of the 2021 Immunotherapy Bridge virtual congress (December 1–2, Naples, Italy), the Great Debate sessions featured experts who were assigned counter opposing views on four important questions in immunotherapy today. The first topic was whether oncolytic viruses or other specific immunomodulators were the more promising approach for intralesional therapy. The second was whether early surrogate endpoints, such as response rate or progression-free survival, correlate with long-term overall survival was considered. Thirdly, whether vaccines can transform cold into hot tumors was discussed and, finally, broad versus deep analytic profiling approaches to gain insights into immune-oncology development were compared. As with previous Bridge congresses, presenters were invited by the meeting Chairs and positions taken during the debates may not have reflected their respective personal view. In addition, the views summarised in this article are based on available evidence but may reflect personal interpretation of these data, clinical experience and subjective opinion of the speaker.
circMAP3K4 regulates insulin resistance in trophoblast cells during gestational diabetes mellitus by modulating the miR-6795-5p/PTPN1 axis
Authors: Du Runyu , Wu Na , Bai Yu , Tang Lei , Li Ling
Published: April 2022

Background

Insulin resistance (IR) during gestational diabetes mellitus (GDM) has been linked to dysregulated insulin-PI3K/Akt pathway. A defective insulin-PI3K/Akt pathway and dysregulated circular RNA (circRNA) levels have been observed in the placentas of patients with GDM; however, the mechanisms underlying this association remain unclear.

Methods

circRNAs potentially associated with GDM were selected through bioinformatics analysis and initially identified by quantitative real-time PCR (qPCR) in 9 GDM patients and 9 healthy controls, of which circMAP3K4 was further validated in additional 84 samples by qPCR. circMAP3K4 identity and localization were verified. Pearson correlation analysis was applied to evaluate the correlation between circMAP3K4 expression in the placental tissues of GDM patients and IR-related indicators. An IR model of trophoblasts was constructed using glucosamine. Interactions between miR-6795-5p and circMAP3K4 or PTPN1 were confirmed using a dual-luciferase reporter assay. The circMAP3K4/miR-6795-5p/PTPN1 axis and key markers in the insulin-PI3K/Akt pathway in placentas and trophoblasts were evaluated through qRT-PCR, immunofluorescence, and western blotting. The role of circMAP3K4 in glucose metabolism and cell growth in trophoblasts was determined using the glucose uptake and CCK8 assay, respectively.

Results

circMAP3K4 was highly expressed in the placentas of patients with GDM and the IR trophoblast model; this was associated with a dysregulated insulin-PI3K/Akt pathway. circMAP3K4 in the placentas of GDM patients was positively correlated with weight gain during pregnancy and time-glucose area under the curve of OGTT. circMAP3K4 and PTPN1 could both bind to miR-6795-5p. miR-6795-5p and PTPN1 were downregulated and upregulated, respectively, in the placentas of GDM patients and the IR trophoblast model. circMAP3K4 silencing or miR-6795-5p overexpression partially reversed the decrease in glucose uptake, inhibition in cell growth, and downregulated IRS1 and Akt phosphorylation in IR-trophoblasts; this restoration was reversed upon co-transfection with an miR-6795-5p inhibitor or PTPN1.

Conclusion

circMAP3K4 could suppress the insulin-PI3K/Akt signaling pathway via miR-6795-5p/PTPN1 axis, probably contributing to GDM-related IR.
Impact of contextual factors on patient outcomes following conservative low back pain treatment: systematic review
Authors: Sherriff Bronwyn , Clark Carol , Killingback Clare , Newell Dave
Published: April 2022

Background and objective

Chronic low back pain is pervasive, societally impactful, and current treatments only provide moderate relief. Exploring whether therapeutic elements, either unrecognised or perceived as implicit within clinical encounters, are acknowledged and deliberately targeted may improve treatment efficacy. Contextual factors (specifically, patient’s and practitioner’s beliefs/characteristics; patient-practitioner relationships; the therapeutic setting/environment; and treatment characteristics) could be important, but there is limited evidence regarding their influence. This research aims to review the impact of interventions modifying contextual factors during conservative care on patient’s pain and physical functioning.

Databases and data treatment

Four electronic databases (Medline, CINAHL, PsycINFO and AMED) were searched from 2009 until 15th February 2022, using tailored search strategies, and resulted in 3476 unique citations. After initial screening, 170 full-text records were potentially eligible and assessed against the inclusion–exclusion criteria. Thereafter, studies were assessed for methodological quality using a modified Downs and Black scale, data extracted, and synthesised using a narrative approach.

Results

Twenty-one primary studies (N = 3075 participants), were included in this review. Eight studies reported significant improvements in pain intensity, and seven in physical functioning, in favour of the contextual factor intervention(s). Notable contextual factors included: addressing maladaptive illness beliefs; verbal suggestions to influence symptom change expectations; visual or physical cues to suggest pain-relieving treatment properties; and positive communication such as empathy to enhance the therapeutic alliance.

Conclusion

This review identified influential contextual factors which may augment conservative chronic low back pain care. The heterogeneity of interventions suggests modifying more than one contextual factor may be more impactful on patients’ clinical outcomes, although these findings require judicious interpretation.
Increased estimated remnant-like particle cholesterol is associated with impaired coronary collateralization in patients with coronary chronic total occlusions
Authors: Gao Ang , Liu Jinxing , Liu Yan , Hu Chengping , Zhu Yong , Zhou Yujie , Han Hongya , Zhao Yingxin
Published: April 2022

Aims

This study intends to explore whether, or to what extent, the estimated remnant-like particle cholesterol was associated with coronary collateralization in patients with chronic total occlusion lesions.

Methods

792 patients with at least one coronary chronic total occlusion lesion were enrolled. Serum level of lipid profiles were determined and the estimated remnant-like particle cholesterol was calculated. The development of coronary collateralization was graded as low (Rentrop score 0–1) or high (Rentrop score 2–3) collateralization according to the Rentrop classification system and then the association between the estimated remnant-like particle cholesterol and collateralization was assessed.

Results

222 participants were classified into low collateralization group. The estimated remnant-like particle cholesterol level was significantly higher in low collateralization (P < 0.001) and type 2 diabetes mellitus (P = 0.009) group. To further explore the association between the estimated remnant-like particle cholesterol and the development of coronary collateralization, these patients were divided into 3 groups based on the estimated remnant-like particle cholesterol tertiles. The prevalence of low collateralization increased stepwise with the tertile groups (T1 12.5% vs. 27.1% vs. 45.3%, P < 0.001). Multivariate logistic regression analysis showed that the estimated remnant-like particle cholesterol was independently associated with the under-developed collateralization, with an OR and 95%CI of 2.34 (1.46–3.74) and 4.91 (3.01–8.02) in the T2 and T3 group, respectively. The following receiver-operating characteristic analysis indicated that the diagnostic value of estimated remnant-like particle cholesterol for the low collateralization was 0.696, with a cut-off value of 0.485, and its sensitivity was 82.88%. Besides, the addition of the estimated remnant-like particle cholesterol into the baseline model consisting of traditional risk factors could improve the incremental value of the discrimination of impaired collateralization only in overall and type 2 diabetes mellitus populations.

Conclusions

The increased estimated remnant-like particle cholesterol is independently associated with impaired collateralization in patients with coronary chronic total occlusion lesions. Therapies targeting at remnant-like particle cholesterol may be needed in advanced coronary artery disease patients with type 2 diabetes mellitus not suitable for vascular revascularization.
Congenital cardiac masses: a case report
Authors: Alsabri Mohammed , Gonzalez Alejandro , Sircy Aaron , Policherla Sai Sarada , Mascoll-Robertson Kemi
Published: April 2022

Background

Cardiac tumors in infants and children are rare. The most common cardiac tumor is rhabdomyoma, which may be associated with tuberous sclerosis. However, not all cardiac rhabdomyomas are pathognomonic for tuberous sclerosis, and not all congenital cardiac tumors are rhabdomyomas. During the prenatal period, early cardiac tumor detection provides important information about fetal wellbeing, delivery planning, and necessary postnatal care.

Case presentation

We report a 36-year-old African American pregnant women. At 32 weeks 5 days gestational age, the male fetus had a fetal echocardiogram due to fetal arrhythmia. The fetal echocardiogram showed two small echogenic, RV apex and septal masses, suspicious of rhabdomyomas. After a routine pregnancy and a normal spontaneous vaginal delivery (39 weeks 1 day), the male baby was admitted to the neonatal intensive care unit for further monitoring and postnatal evaluation.

Conclusions

Rhabdomyomas are extremely rare and unique tumors. These tumors are very dangerous, but they usually regress after birth. During the prenatal period, early cardiac tumor detection provides important information about fetal wellbeing, delivery planning, and necessary postnatal care. We present this case to share our findings with our pediatric colleagues. Although a rarely reported case, we hope this cardiac rhabdomyoma case report and literature review can increase cardiac tumor awareness.
An LBL positioning algorithm based on an EMD–ML hybrid method
Authors: Yang Huibao , Gao Xiujing , Huang Hongwu , Li Banshuai , Xiao Bo
Published: April 2022

Autonomous underwater vehicles (AUVs) are essential assets for ocean exploration requiring reliable underwater positioning technology. Aiming to improve the latter technology in a low SNR and reverberation environment, the Chan–Taylor hybrid positioning algorithm establishes a long-baseline system (LBL) based on the time difference of arrival (TDOA) by reducing the number of sensors required while preserving the positioning accuracy. However, the traditional LBL algorithm’s accuracy is reduced due to the critical time delay estimation under such environmental conditions. Hence, this paper suggests a new LBL positioning technology relying on an empirical mode decomposition (EMD) to construct a filter function combined with the maximum likelihood (ML) estimation method. MATLAB/Simulink is applied to establish the simulation environment of LBL localization system, simulating the AUV motion under 5–30 dB SNR. This paper analyzes the accuracy of TDOA by generalizing the cross-correlation method (GCC), phase transform (PHAT), ML, and EMD–ML. Based on the TDOA value obtained by the EMD–ML filtering algorithm, the positioning errors of the Chan–Taylor hybrid positioning algorithm and the Chan algorithm are compared. The results show that comparative synthetic evaluations against the traditional GCC demonstrate that the proposed method has a higher time delay estimation accuracy within a reverberation environment with SNR less than 15 dB. The Chan–Taylor hybrid positioning algorithm limits the errors of the CHAN algorithm and improves the overall positioning system accuracy.
Provision of safe patient care during the COVID-19 pandemic despite shared patient rooms in a tertiary hospital
Authors: Füszl Astrid , Bouvier-Azula Lukas , Van den Nest Miriam , Ebner Julia , Strassl Robert , Gabler Cornelia , Diab-Elschahawi Magda , Presterl Elisabeth
Published: April 2022

Background

The COVID-19 pandemic has resulted in the disruption of healthcare systems. Vienna General Hospital (VGH), a tertiary hospital located in Austria, ran at almost full capacity despite high levels of community SARS-CoV-2 transmission and limited isolation room capacity. To ensure safe patient care, a bundle of infection prevention and control (IPC) measures including universal pre-admission screening and serial SARS-CoV-2 testing during hospitalization was implemented. We evaluated whether testing as part of our IPC approach was effective in preventing hospital outbreaks during different stages of the pandemic.

Methods

In this retrospective single center study, we analyzed the SARS-CoV-2 PCR test results of cases admitted to VGH between a low (15/05/2020–01/08/2020) and a high incidence period (15/09/2020–18/05/2021). Outcomes were the diagnostic yield of (a) admission screening, (b) the yield of serial testing during hospitalization and (c) the occurrence of healthcare-associated COVID-19 (HA-COVID-19) and SARS-CoV-2 related hospital outbreaks.

Results

The admission test positivity rate was 0.2% during the low and 2.3% during the high incidence phase. Regarding test conversions, 0.04% (low incidence phase) and 0.5% (high incidence phase) of initially negative cases converted to a positive test result within 7 days after admission The HA-COVID-19 incidence rate per 100,000 patient days was 1.0 (low incidence phase) and 10.7 (high incidence phase). One COVID-19 outbreak affecting eight patients in total could be potentially ascribed to the non-compliance with our IPC protocol.

Conclusion

Testing in conjunction with other IPC measures enabled the safe provision of patient care at a hospital with predominantly shared patient rooms despite high case numbers in the community.
TCDD exposure alters fecal IgA concentrations in male and female mice
Authors: Foxx Christine L. , Nagy Madeline R. , King Aspen E. , Albin Dreycey , DeKrey Gregory K.
Published: April 2022

Background

Activation of the aryl hydrocarbon receptor (AhR) can alter diurnal rhythms including those for innate lymphoid cell numbers, cytokine and hormone levels, and feeding behaviors. Because immune responses and antibody levels are modulated by exposure to AhR agonists, we hypothesized that some of the variation previously reported for the effects of AhR activation on fecal secretory immunoglobulin A (sIgA) levels could be explained by dysregulation of the diurnal sIgA rhythm.

Methods

C57Bl/6 J mice were exposed to peanut oil or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, 10 or 40 μg/Kg) and fecal sIgA levels were determined in samples collected every 4 h over 4 days.

Results

Fecal sIgA concentrations were not significantly different between light and dark phases of the photoperiod in either male or female mice, and there were no significant circadian rhythms observed, but TCDD exposure significantly altered both fecal mesor sIgA and serum IgA concentrations, in parallel, in male (increased) and female (biphasic) mice.

Conclusions

AhR activation can contribute to the regulation of steady state IgA/sIgA concentrations.
Expanded graph embedding for joint network alignment and link prediction
Authors: Alnaimy MHD Samy , Desouki Mohammad Said
Published: April 2022

Link prediction in social networks has been an active field of study in recent years fueled by the rapid growth of many social networks. Many link prediction methods are harmed by users’ intention of avoiding being traced across networks. They may provide inaccurate information or overlook a great deal of information in multiple networks. This problem was overcome by developing methods for predicting links in a network based on known links in another network. Node alignment between the two networks significantly improves the efficiency of those methods. This research proposes a new embedding method to improve link prediction and node alignment results. The proposed embedding method is based on the Expanded Graph, which is our new novel network that has edges from both networks in addition to edges across the networks. Matrix factorization on the Finite Step Transition and Laplacian similarity matrices of the Expanded Graph has been used to obtain the embeddings for the nodes. Using the proposed embedding techniques, we jointly run network alignment and link prediction tasks iteratively to let them optimize each other’s results. We performed extensive experiments on many datasets to examine the proposed method. We achieved significant improvements in link prediction precision, which was 50% better than the peer’s method, and in recall, which was 500% better in some datasets. We also scale down the processing time of the solution to be more applicable to big social networks. We conclude that computed embedding in this type of problem is more suitable than learning the embedding since it shortens the processing time and gives better results.
Optimization of levetiracetam dosing regimen in critically ill patients with augmented renal clearance: a Monte Carlo simulation study
Authors: Bilbao-Meseguer Idoia , Barrasa Helena , Rodríguez-Gascón Alicia , Asín-Prieto Eduardo , Maynar Javier , Sánchez-Izquierdo José Ángel , Solinís María Ángeles , Isla Arantxazu
Published: April 2022

Background

Levetiracetam pharmacokinetics is extensively altered in critically ill patients with augmented renal clearance (ARC). Consequently, the dosage regimens commonly used in clinical practice may not be sufficient to achieve target plasma concentrations. The aim of this study is to propose alternative dosage regimens able to achieve target concentrations in this population. Furthermore, the feasibility of the proposed dosing regimens will be discussed from a clinical point of view.

Methods

Different dosage regimens for levetiracetam were evaluated in critically ill patients with ARC. Monte Carlo simulations were conducted with extended or continuous infusions and/or high drug doses using a previously developed population pharmacokinetic model. To assess the clinical feasibility of the proposed dosages, we carried out a literature search to evaluate the information on toxicity and efficacy of continuous administration or high doses, as well as the post-dilution stability of levetiracetam.

Results

According to the simulations, target concentrations in patients with CrCl of 160 or 200 mL/min can be achieved with the 3000 mg daily dose by prolonging the infusion time of levetiracetam. For patients with CrCl of 240 mL/min, it would be necessary to administer doses higher than the maximum recommended. Available evidence suggests that levetiracetam administration in continuous infusion or at higher doses than those approved seems to be safe. It would be desirable to re-examinate the current recommendations about drug stability and to achieve a consensus in this issue.

Conclusions

Conventional dosage regimens of levetiracetam (500–1500 mg twice daily in a short infusion) do not allow obtaining drug plasma concentrations among the defined target in critically ill patients with ARC. Therefore, new dosing guidelines with specific recommendations for patients in this subpopulation are needed. This study proposes new dosages for levetiracetam, including extended (4 or 6 h) infusions, continuous infusions or the administration of doses higher than the recommended in the summary of product characteristics (> 3000 mg). These new dosage recommendations take into account biopharmaceutical and pharmacokinetic aspects and meet feasibility criteria, which allow them to be transferred to the clinical environment with safety and efficacy. Nevertheless, further clinical studies are needed to confirm these results.
Living donor liver transplantation for idiopathic portal hypertension with focal nodular hyperplasia
Authors: Tanji Yoshiaki , Furukawa Kenei , Igarashi Yosuke , Yanagaki Mitsuru , Haruki Koichiro , Shirai Yoshihiro , Taniai Tomohiko , Gocho Takeshi , Okui Norimitsu , Ikegami Toru
Published: April 2022

The patient was a 61-year-old woman with a history of diabetes mellitus who had undergone ileocecal resection for ascending colon carcinoma 5 years earlier, followed by a postoperative adjuvant chemotherapy with XELOX (capecitabine + oxaliplatin). During follow-up, the liver gradually atrophied, and radiological imaging showed suspicious findings of 20 × 14 mm hepatocellular carcinoma (HCC) in the right lobe of the liver. The patient also underwent endoscopic variceal ligation for the esophageal varices. She was referred to our hospital for living donor liver transplantation (LDLT) due to decompensated liver cirrhosis with HCC. The patient did not have hepatitis B or C, and history of alcohol, suggesting that her liver cirrhosis was caused by a non-alcoholic steatohepatitis. The Child–Pugh score was 10 points (class C) and the Model for End-Stage Liver Disease (MELD) score was 8 points. The possibility of HCC could not be ruled out, and LDLT was performed. Postoperative pathological examination revealed idiopathic portal hypertension (IPH), and the mass lesion was diagnosed as focal nodular hyperplasia (FNH). The postoperative course was uneventful and the patient was discharged on postoperative day 14. This is the first case of liver transplantation for IPH with FNH.
Feasibility of randomizing Danish citizens aged 65–79 years to high-dose quadrivalent influenza vaccine vs. standard-dose quadrivalent influenza vaccine in a pragmatic registry-based setting: rationale and design of the DANFLU-1 Trial
Authors: Johansen Niklas Dyrby , Modin Daniel , Nealon Joshua , Samson Sandrine , Salamand Camille , Larsen Carsten Schade , Claggett Brian L. , Solomon Scott D. , Landray Martin J. , Gislason Gunnar H. , Køber Lars , Jensen Jens Ulrik Stæhr , Sivapalan Pradeesh , Vestergaard Lasse Skafte , Valentiner-Branth Palle , Krause Tyra Grove , Biering-Sørensen Tor
Published: April 2022

Background

High-dose influenza vaccines provide better protection against influenza infection than standard-dose in persons aged 65 years and above; however, in most countries, high-dose vaccines are not widely implemented. Assessing the relative effectiveness of high-dose compared to standard-dose vaccines on hospitalizations and mortality would enable more robust public health and cost-effectiveness estimates. This study aims to investigate the feasibility of conducting a pragmatic randomized clinical trial in Denmark comparing high-dose to standard-dose vaccines utilizing existing vaccination infrastructure and the Danish nationwide health registries for data collection.

Methods

The DANFLU-1 trial (NCT05048589) is a pragmatic, open-label, active-controlled randomized trial randomizing Danish citizens aged 65–79 years to either high-dose quadrivalent influenza vaccine or standard-dose quadrivalent influenza vaccine. The study utilizes the infrastructure of a private vaccination provider (Danske Lægers Vaccinations Service) for recruitment, inclusion, randomization, and vaccination. All collection of baseline and follow-up data including safety monitoring is performed centrally by the Department of Cardiology at Herlev and Gentofte Hospital, Copenhagen, Denmark using the Danish nationwide health registries. The study aims to include 40,000 participants during the 2021/2022 influenza season. The primary endpoints address feasibility and include the number of participants enrolled, randomization balance, and representativeness compared to the Danish general population. Relative vaccine effectiveness will also be assessed, however, this feasibility study is not powered for clinical outcomes and may be affected by the COVID-19 pandemic.

Discussion

The DANFLU-1 study is investigating the feasibility of conducting a large-scale pragmatic clinical trial in Denmark utilizing existing infrastructure and the Danish nationwide registries. This will provide valuable insight, especially for potential future fully powered vaccine trials, but also for trials wishing to investigate other interventions.

Trial registration

Clinicaltrials.gov: NCT05048589, registered September 17, 2021.
Mitigating the increased risk of domestic abuse among people with mental illness: challenges and opportunities of the COVID-19 pandemic
Authors: Wilson Claire A.
Published: April 2022

The rise in domestic violence and abuse has been dubbed a ‘pandemic within a pandemic’. Individuals known to mental health services are particularly vulnerable. Yet despite challenges to mitigating domestic violence and abuse in this group, the COVID-19 pandemic has provided opportunities to develop new interventions to support those affected.
Cities in Flux
Authors: Dawson Ashley , Varma Rashmi , Perks Samuel , Sinha Chinki , Varghese Mathew A , Ngwane Trevor , Macdonald Graeme , Mason-Deese Liz
Published: April 2022

From Singapore to New York, via New Delhi, Johannesburg, London, Glasgow and Buenos Aires, “Cities in Flux” registers some of the most profound impacts of the COVID-19 pandemic on cities around the world. Narrated in different styles, the individual pieces draw on theories of global cities in neoliberal times as well as on the phenomenological truths of inhabiting these disparate places bound together by a global crisis. The pieces make use of a plethora of urban signs—flashing images, sounds of silence and emergency vehicles, Whatsapp chatter, billboards, found objects, and media noise—to reflect on experiences that are both deeply personal and embodied as well as reflective of a common urban predicament. Even as the pandemic exacerbated problems of housing, transport, health, schooling, employment, environment, and food supply, it also created feelings of waste, loss, and loneliness. All the pieces draw inspiration from a range of urban projects such as the Hot City Collective in New York, the Workers’ Stories Project in Glasgow, the Black Lives Matter movement in London, the Feminist Assembly in Buenos Aires, the C-19 People's Coalition in Johannesburg, and the anti–citizenship law protests and the farmers’ movement in Indian cities. Against the multiplying crises of cities during the time of the pandemic, the different pieces in this pod come together to hope for an urban commons that is based on justice and freedom.
Data set of a representative online survey on search engines with a focus on search engine optimization (SEO): a cross-sectional study
Authors: Schultheiß Sebastian , Lewandowski Dirk
Published: April 2022

To gain a better understanding of user knowledge and perspectives of search engines, a fruitful approach are representative online surveys. In 2020, we conducted an online survey with a sample representative of the German online population aged 16 through 69 (N = 2,012). The online survey included 12 search engine-related sections. The questions cover topics such as usage behavior, self-assessed search engine literacy, trust in search engines, knowledge of ads and search engine optimization (SEO), ability to distinguish ads from organic results, assessments and opinions regarding SEO, and personalization of search results. SEO is the specific focus of the survey, as it was conducted as part of the SEO Effect project, dealing with issues such as the role of SEO from the user perspective. This data set contains complete data from the online survey. On the one hand, the data set will allow further analyses, and, on the other hand, comparisons with follow-up studies.
Embodying an artificial hand increases blood flow to the investigated limb
Authors: Di Pino Giovanni , Mioli Alessandro , Altamura Claudia , D'Alonzo Marco
Published: April 2022

Background: The autonomic nervous system is the main determinant of the blood flow directed towards a body part, and it is tightly connected to the representation of the body in the brain; would the experimental modulation of the sense of limb ownership affect its blood perfusion?

Methods: In healthy participants, we employed the rubber hand illusion paradigm to modulate limb ownership while we monitored the brachial artery blood flow and resistance index within the investigated limb.

Results: In all conditions with brush-stroking, we found an initial drop in the blood flow due to tactile stimulation. Subsequently, in the illusion condition (where both the rubber and real hand synchronous brush-stroking were present), the blood flow rose significantly faster and reached significantly higher values. Moreover, the increase in blood flow correlated with the extent of embodiment as measured by questionnaires and correlated negatively with the change of peripherical vascular resistance.

Conclusions: These findings suggest that modulating the representation of a body part impacts its blood perfusion.
Consortium management structures, processes, and approaches: The DELTAS Africa example
Authors: Tagoe Nadia , Molyneux Sassy , Pulford Justin , Kinyanjui Sam
Published: April 2022

Background: Global efforts to strengthen health research capacity in low- and middle-income countries (LMICs) have intensified in the past few decades, and these efforts are often implemented by consortia. Our review of the literature indicated that reports on health research capacity strengthening (HRCS) consortia have primarily focused on programme outputs and outcomes while management processes and their contributions to consortia goals have received little attention. This qualitative study sought to identify the consortium management processes employed by 10 DELTAS Africa consortia, factors influencing these processes, and leaders’ consortium management experiences.

Methods: We conducted 24 key informant interviews with the directors and programme managers of all the 10 DELTAS Africa consortia, and funding actors who worked closely with the consortia. The interviews were supplemented by reviews of DELTAS and consortium-specific documents. Data were analysed using the content analysis approach.

Results: The consortia studied employed similar management processes but adopted different strategies in executing these processes. Study results indicate that decision-making in consortia is not always a straightforward process as leaders were often faced with dilemmas when determining management strategies to adopt, and often tried to balance multiple factors which were not always aligned. This was demonstrated as consortia selected partners, determined goals and activities, assigned roles and responsibilities, allocated resources, established governance and partner management systems, and coordinated and monitored consortia activities. Factors that influenced the choice of processes and approaches included previous experiences, funders expectations, and the pressure to deliver research outputs. Consortia’s unique approaches to management were due to varying contexts and influences and indicate that management decisions are nuanced and cannot easily be formularized.

Conclusion: The study has highlighted the importance of flexibility in consortium management and the need to generate research capacity strengthening (RCS)-specific guidance that can assist consortia in resolving dilemmas and making appropriate management decisions.
Blasts in pleural fluid: a clue to diagnose acute myeloid leukemia
Authors: Songtanin Busara , Evans Abbie , Warraich Irfan
Published: April 2022

Acute myeloid leukemia is usually diagnosed in older patients, and its incidence increases with age. Most patients with acute myeloid leukemia present with symptoms related to anemia, bleeding, and infections. Blast infiltration into other tissues can occur. Leukemic pleural infiltration has been reported previously but is very rare. Here we discuss a 62-year-old woman diagnosed with acute myeloid leukemia with a leukemic infiltrate in a pleural effusion.
 
Keywords: AML, pleural effusion, blast cell, leukemic pleural infiltrate
Ventilator management using esophageal balloon pressure measurements
Authors: Morataya Cristina , Armin Sabiha , Nugent Kenneth
Published: April 2022

Mechanical ventilation provides essential support for patients with acute respiratory failure and provides time for these patients to recover from the primary disorder.  Ventilator strategies need to provide adequate oxygenation and avoid barotrauma.  This trauma develops when some regions of the lungs are overinflated and develops when some regions are underinflated and have cyclical opening and closing during the respiratory cycle.  The ARDS network trial demonstrated that a low tidal volume and low pressure strategy improved outcomes.  Subsequent trials have tried to determine the optimal PEEP level in patients with moderate to severe ARDS.  The use of esophageal balloons provides information about the transpulmonary pressure at the end of inspiration and the transpulmonary pressure at the end of expiration.  However, available studies to date do not demonstrate a definite improvement in outcomes in patients with ventilator adjustments based on esophageal pressures. Beitler et al. randomized 200 patients with moderate to severe ARDS into one group in which PEEP titration was based on esophageal balloon pressure measurements, and a second group in which PEEP titration was based on a high FiO2/PEEP table studied in earlier trials.  There were no differences in mortality between the two groups.  Reanalysis of this information after the trial was completed suggested that transpulmonary pressures in the range of -2 to + 2 cm H2O at the end of expiration were associated with improved outcomes compared to pressures outside that range.
Efficacy of positive psychological interventions in anxiety treatment
Authors: Vicki Jeng  , Travis Pham  , Regina Baronia  , Chanaka Kahathuduwa  , Wail Amor  , Yasin Ibrahim
Published: April 2022

Psychiatry traditionally emphasizes psychopharmacology and psychotherapy as the primary modalities of treatment. Recently, however, positive psychological interventions are increasingly recognized as a treatment modality that aims to improve a patient's general wellness. Our goal is to review published data on the efficacy of positive psychological interventions (PPI) in the treatment of anxiety. A systematic literature search was conducted on PubMed, Web of Science, and PsycINFO. The keywords used were "positive psychology" and "treatment of anxiety." The search involved all articles published until 2019. To meet inclusion criteria, articles needed to report using positive psychological interventions with patients diagnosed with anxiety or suffering from anxiety symptoms. The main outcome measure was a change in anxiety levels post-intervention. Our initial literature search of 1010 articles was narrowed down to 6 papers that met the inclusion criteria. Interventions used were body-mind-spirit therapy, online positive psychology modules, self-help books, positive activity intervention, future-directed therapy, and mindfulness-based therapies. Pre- and post-treatment anxiety was measured using scales such as State Anxiety Inventory, Depression Anxiety Stress Scale-Short form, Overall Anxiety Severity, Impairment Scale, Hospital Anxiety and Depression Scale, Liebowitz Social Anxiety Scale – Self-Report, Beck Anxiety Inventory, Social Interaction Anxiety Scale, Profile of Mood States, Brief Symptom Inventory, and Revised Children's Manifest Anxiety Scale. In all six included studies, PPI decreased anxiety symptoms with variable effect sizes. The review suggests that PPI offers therapeutic benefits to patients diagnosed with anxiety symptoms. Thus, more research is needed to examine the feasibility of incorporating PPI into the traditional mental health care.
Where is my tooth? A case multiple cough-induced rib fracture
Authors: Tasnim Saria , Anees Muhammad , Vo Thien
Published: April 2022

Rib fracture can occur from cough in presence of osteoporosis, malignancy or renal disease. In absence of these risk factors, it is very rare to happen and we found only few case reports where rib fracture due to cough happened without any risk factors. Our patient had persistent and forceful cough secondary to probable aspiration of foreign body leading to rib fracture. Such cases should always be reviewed thoroughly to evaluate and treat any potential reversible causes.
Instruments to assess the burden of care for family caregivers of adult palliative care patients
Authors: Pop Rodica Sorina , Payne Sheila , Tint Diana , Pop Cristina Paula , Mosoiu Daniela
Published: April 2022

Background:

A primary caregiver shares the illness experience of the patient and undertakes vital care work, alongside managing the patient's emotions, and is actively involved in care process without being paid. When faced with the palliative care patient's needs, caregivers are affected on multiple levels (physical, psychological and socio-economic), thereby experiencing a moderate or severe burden of care.

Aim:

To identify assessment instruments for the burden of care for family caregivers that are suitable to be used in clinical practice.

Method:

A narrative review was conducted using an electronic search in Pubmed, PsychINFO, CINAHL of articles published in English between 2009–2019, using the search terms: ‘caregiver/family, caregiver/carer and burden and palliative care/hospice/end of life’. An assessment grid was developed to appraise the clinical use of identified instruments.

Results:

Of the 568 articles identified, 40 quantitative studies were selected using 31 instruments to measure the caregiver burden of cancer, noncancer and terminally ill patients. Most instruments 23 (74.11%) evaluate the psycho-emotional and, 22 (70.96%) the social domain, 12 instruments (38.7%) focused on the physical domain, three (9.67%) on the spiritual field and six instruments (19.35%) on economic aspects. For the multidimensional instruments, the assessment grid scored highest for the Burden Scale for Family Caregiver (BSFC).

Conclusion:

The BSFC is the tool that seems to meet the most requirements, being potentially the most useful tool in clinical practice.
SecureOnt: A Security Ontology for Establishing Data Provenance in Semantic Web
Authors: Patel Archana , Debnath Narayan C. , Shukla Prashant Kumar
Published: April 2022

Security becomes a primary concern during sharing of information over the web. To overcome this problem, many security ontologies have been developed so far. The available security ontologies help to track data provenance and contain different aspects of data security like confidentiality, integrity, data availability, and access control. This paper provides a security ontology for establishing data provenance in the semantic web. The proposed ontology contains a comprehensive knowledge base of data security by consolidating all the available security ontologies and derives data provenance with annotations at the extensional level and thus lower maintenance cost. By this paper, analysts and researchers find a road map, an overview of what exists in terms of security ontologies.
The impact of mentoring in trauma and orthopaedic training: a systematic review
Authors: Enson J , Malik-Tabassum K , Faria A , Faria G , Gill K , Rogers B
Published: April 2022

Introduction

Trauma and orthopaedics is renowned for being a challenging yet rewarding career. The value of mentorship in medical and surgical training is known to be beneficial; however, the prevalence and quality of mentorship opportunities in orthopaedics are less well studied. Identifying the strengths and weaknesses of mentoring programmes in orthopaedic training and recognising barriers to effective mentorship are key to unlocking the full potential of future orthopaedic surgeons.

Methods

A comprehensive search of PubMed, Medline, EMBASE and the Cochrane Library was performed. All studies published in the English language that reported data on mentorship programmes in orthopaedic training were included.

Findings

A total of 23 studies met the inclusion criteria. These studies demonstrated that formal mentorship programmes in orthopaedics are lacking but are sought after, with a positive influence on satisfaction and future career choice/subspecialty selection identified. Several barriers to mentoring in the field were recognised including the difficulty faced by female trainees, the availability of mentors and time constraints. The opportunity to choose a mentor, a mentor with the same interests, regular meetings and the option of gender congruent mentorship were all identified as crucial requirements for effective mentorship.

Conclusion

Mentorship opportunities must be more accessible to all orthopaedic trainees alike and should aim to incorporate the attributes identified to provide the highest calibre of training to prospective orthopaedic surgeons.
Implications of equipment failure occurring during surgery
Authors: Efthymiou CA , Cale AR
Published: April 2022

Introduction

Few formal studies have been performed investigating the frequency of equipment failure during surgery. Surgeons are unable to operate without the plethora of instruments and equipment surrounding them in the operating theatre. As with any mechanical component, instruments and equipment are subject to time- and use-dependent degradation in their performance. Yet no formal requirements exist for the routine inspection or maintenance of instruments. Owing to this lack of information regarding equipment failure we undertook the first investigation of intraoperative equipment malfunction occurring during cardiac surgical procedures.

Methods

Over a 12-month period cardiac surgeons were required to report equipment malfunction during each procedure. Operating theatre equipment was divided into three categories broadly based on equipment portability and function: group 1, theatre infrastructure and components; group 2, large medical equipment; and group 3, surgical instruments.

Results

In a highly significant proportion of operations performed (92%) there was an issue with equipment. The most common issues occurred in group 3 with fine surgical instrument malfunctions; most commonly worn-out needle holders and blunt scissors. Theatre infrastructure and large medical equipment failures (groups 1 and 2) resulted in the cancellation of four cases. Some intraoperative instrument failures were potentially catastrophic.

Conclusions

The incidence of equipment failure during cardiac surgery is unacceptably high. In some instances, cases were cancelled and revenue lost owing to equipment malfunction. A balance between the safety and quality of equipment and cost effectiveness is required. These findings suggest that surgical instruments warrant an annual compulsory inspection.