bluuebunny/crossref_metadata_2025 huggingface dataset:
Upward migration of calanoid copepods is driven by high food quality in surface waters in an alpine lake
Authors: Cui Suzhen , Ding Ruirui , Wang Qianhong , Li Yun , Chen Feizhou
Published: September 2023

The diel vertical migration of zooplankton includes downward migration to deep water during the day and upward migration to surface water at night. Diurnal downward migration has been well explained; zooplankton migration to surface water at night remains unclear. This study aimed to explore the reason of the nocturnal upward migration of the calanoid copepod Arctodiaptomus sp. In Lake Heihai, an alpine lake (elevation 4,090 m above sea level) without predators.

Herein, we present the vertical profiles of the lake, including water temperature, chlorophyll a (Chl‐a), fatty acids, and astaxanthin synthesis precursors (ASPs) of seston in the water column. The distributions and concentrations of fatty acids and astaxanthin in Arctodiaptomus sp. were characterised through field investigations during the day and at night. Meanwhile, the effect of ultraviolet radiation (UVR) on ASPs in seston was explored through indoor experiments.

Lake Heihai had the characteristics of low temperature, low food availability, high transparency, and high UVR intensity. Arctodiaptomus sp. was distributed in water layers below 6 m during the day and throughout the water column at night. Arctodiaptomus sp. accumulated large amounts of fatty acids, especially polyunsaturated fatty acids (PUFAs), and inhibitors of fatty acid oxidation–astaxanthin in the cold alpine lake. The concentrations of lutein, a kind of ASP, and PUFAs in seston were highest in surface waters. The indoor experiment verified that UVR can enhance the synthesis of ASP.

The calanoids migrated to surface waters at night to obtain ASPs and PUFAs in seston, which were at high concentrations in surface waters. PUFAs and ASP may be of high food quality for zooplankton in alpine lakes. The findings indicated that the upward migration of Arctodiaptomus sp. at night was driven by the high quality of food sources (PUFAs and ASP) in surface waters. Arctodiaptomus sp. adapts behaviour and physiology to the environment of the alpine lake.

We explored why zooplankton migrated to surface waters at night from the perspective of their physiological characteristics and adaptability to the environment. Our findings provide a new way to investigate the diel vertical migration of zooplankton, especially in alpine lakes.
Effect of frozen hot‐boned meat and myofibrillar protein on physicochemical properties of phosphate‐free emulsion‐type meat
Authors: Kim Yea‐Ji , Kim Yun Jeong , Kim Tae‐Kyung , Shin Dong‐Min , Lee Jae‐Hoon , Choi Yoo‐Jung , Jung Samooel , Choi Yun‐Sang
Published: September 2023

Phosphate serves as a food additive to improve the emulsion properties and texture parameters of meat products, yet excessive ingestion could be harmful to the health. Thus, we aimed to evaluate the combined effects of hot‐boned meat, freezing and myofibrillar protein supplementation on the physicochemical properties of phosphate‐free emulsion‐type sausage. Freezing hot‐boned meat and adding myofibrillar protein enhanced pH, protein solubility and thermal stability, which reduced cooking losses (9.50%–15.48%) and enhanced emulsion stability, resulting in a positive effect on the rheological and texture profiles of the phosphate‐free emulsion‐type sausage. In particular, the sausage prepared with frozen hot‐boned meat and myofibrillar protein addition exhibited the highest hardness value (39.60 N), and its physical properties were almost identical to the positive control. Accordingly, hot‐boned meat, freezing and myofibrillar protein incorporation could enhance the quality of phosphate‐free meat products. This study highlights promising avenues for improving meat products to meet consumer preferences.
Effects of proteases on textural softening and changes in physical property of harpiosquillid mantis shrimp (Harpiosquilla raphidea) during the iced storage
Authors: Chanchi Prashanthkumar Mallikarjun , Temdee Wattana , Suyapoh Watcharapol , Sornying Peerapon , Palamae Suriya , Patil Umesh , Ma Lukai , Benjakul Soottawat
Published: September 2023

Rapid softening of texture is a major problem associated with quality loss and consumer rejection of harpiosquillid mantis shrimp (Harpiosquilla raphidea) (HMS). Effects of endogenous proteases in muscles and digestive tract on protein degradation and softening were investigated. Scanning electron microscopic and histological images indicated drastic destruction of muscle during iced storage. Based on autolysis, maximal activity was found at pH 8.5 and 55 °C, and serine proteases including trypsin were dominant. Cathepsin B and L + B in muscle were altered throughout storage, while trypsin remained constant in HMS meat for 1–3 days. Firmness and toughness decreased and coincided with augmented degradation of myofibrillar proteins and collagen. Trypsin from the digestive tract was contaminated into the abdomen during iced storage, therefore inducing drastic hydrolysis of muscle proteins. This phenomenon caused the undesirable pasty/mushy texture associated with the loss in firmness and toughness of meat within 3 days of storage.
Changes in bioactive compounds during solid‐state fermentation of Sphenarium purpurascens with Aspergillus oryzae
Authors: Pérez‐Rodríguez Elizabeth , Reyes‐Herrera Alicia , Ibarra‐Herrera Celeste C. , Pérez‐Carrillo Esther
Published: September 2023

Solid‐state fermentation (SSF) can improve the availability of nutrients in food products by converting complex molecules into simpler ones with the help of microorganisms. The present research focuses on using the fungi Aspergillus oryzae in SSF to ferment grasshoppers (Sphenarium purpurascens). The fermentation was carried out for 8 days, and kinetic growth, enzyme, and bioactive compound (TPC, ABTS, and DPPH) production were monitored. Second order equation modelled the growth of A. oryzae on a grasshopper substrate. During fermentation, a protein increase of 50% was obtained after day 4. TPC, ABTS, DPPH scavenging activity percentage, β‐glucan, and amylase activity increased 116%, 70%, 10%, 380%, and 629.6% at 8, 0.5, 3, 4, and 7 days, respectively, as maximum during fermentation. Results herein clearly indicate that A. oryzae could use S. purpurascens as a substrate in SSF to produce enzymes and bioactive compounds of industrial and nutritional interest.
Neuroimaging in insomnia: Review and reconsiderations
Authors: Aquino Giulia , Schiel Julian E.
Published: September 2023

Over the last decades, neuroimaging has become a substantial component of insomnia research. While theoretical underpinnings of different studies vary just like methodological choices and the experimental design, it is suggested that major features of insomnia disorder rely on the impaired function, structure, metabolism and connectivity of brain areas involved in sleep generation, emotion regulation, self‐processing/‐awareness and attentional orientation. However, neuroimaging research on insomnia often suffers from small sample sizes, heterogeneous methodology and a lack of replicability. With respect to these issues, the field needs to address the questions: (1a) how sufficiently large sample sizes can be accumulated within a reasonable economic framework; (1b) how effect sizes in insomnia‐related paradigms can be amplified; (2a) how a higher degree of standardisation and transparency in methodology can be provided; and (2b) how an adequate amount of flexibility/complexity in study design can be maintained. On condition that methodological consistency and a certain degree of adaptability are given, pooled data/large cohort analyses can be considered to be one way to answer these questions. Regarding experimental single‐centre trials, it might be helpful to focus on insomnia‐related transdiagnostic concepts. In doing so, expectable effect sizes (in between‐subjects designs) can be increased by: (a) comparing groups that are truly distinct regarding the variables examined in a concept‐specific paradigm; and (b) facilitated, intensified and precise elicitation of a target symptom.
Resting metabolic rate and lung function in fasted and fed rough‐toothed dolphins, Steno bredanensis
Authors: Fahlman Andreas , Rhieu Kaylee , Alessi Brie , Marquardt Shelly , Schisa Michelle B. , Sanchez‐Contreras Guillermo J. , Larsson Josefin
Published: September 2023

We measured resting metabolic rate (RMR), tidal volume (VT), breathing frequency (fR), respiratory flow, and end‐expired gases in rough‐toothed dolphins (Steno bredanensis) housed in managed care after an overnight fast and 1–2 hr following a meal. The measured average (± standard deviation) VT (4.0 ± 1.3 L) and fR (1.9 ± 1.0 breaths/min) were higher and lower, respectively, as compared with estimated values from both terrestrial and aquatic mammals, and the average VT was 43% of the estimated total lung capacity. The end‐expired gas levels suggested that this species keep alveolar O2 (10.6% or 80 mmHg) and CO2 (7.6% or 57 mmHg), and likely arterial gas tensions, low and high, respectively, to maximize efficiency of gas exchange. We show that following an overnight fast, the RMR (566 ± 158 ml O2/min) was 1.8 times the estimated value predicted by Kleiber for terrestrial mammals of the same size. We also show that between 1 and 2 hr after ingestion of a meal, the metabolic rate increases an average of 29% (709 ± 126 ml O2/min). Both body mass (Mb) and fR significantly altered the measured RMR and we propose that both these variables should be measured when estimating energy use in cetaceans.
Live bedside music for hospitalized older adults: A qualitative descriptive interview study
Authors: van der Wal‐Huisman Hanneke , van den Berg Nina M. , Paans Wolter , Bezold Laura , Stegemann Thomas , de Graeff Pauline , Van Leeuwen Barbara L.
Published: September 2023

Introduction

Hospitalization may have a major impact on older patients as it is often a period of psychosocial vulnerability. Music is one of the most described art forms used in healthcare. Applied in clinical settings, it can affect a patients' emotional and psychosocial well‐being. Incorporating a wider perspective of health promotion that aims to advance not only physical health, but a patients' overall well‐being, is part of a person‐centred approach to care. We developed an innovative participatory music practice in which professional musicians and music therapists visited patients at their bedside for 10–15 min in a Dutch and Austrian hospital. This qualitative study explores the added value of live bedside music practice for older hospitalized patients in Austria and the Netherlands.

Methods

Semi‐structured interviews were conducted between October 2020 and February 2022 with 23 hospitalized patients aged ≥60 years. Due to the COVID‐19 pandemic, the music sessions in Austria were facilitated by establishing a live connection between musicians and patients using a tablet. Data were transcribed verbatim and performed qualitative content analysis following the steps of thematic analysis. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was applied to report data collection, analysis and results.

Results

Four themes emerged from the data analysis. Participants described the perceived influences of live bedside music in terms of (1) emotional release, (2) positive distraction, (3) alterations in contact and (4) shared humanity. Overall, participants positively valued the live bedside music practice and expressed a desire for its continuation.

Conclusion

This study explores the experiences and the added value of live bedside music for older hospitalized patients. By facilitating distraction and emotional release and enhancing nurse–patient interactions, live bedside music can significantly improve hospital experiences for older patients. Results reveal that live bedside music provides a positive patient experience and can be part of integrative and holistic care for hospitalized older patients. Live bedside music can attend to the emotional needs of older patients which are often under addressed in clinical settings but are crucial for enhancing their well‐being.
Opening the “black box” of public administration: The need for interpretive research
Authors: Elías María Verónica
Published: September 2023

Important research questions in public administration and management cannot be studied through the scientific method. A fundamental example is how public administrators utilize their discretion and judgment in their everyday work. Inquiring into the process of administrative practice has been characterized as “opening the black box” of public administration and policy implementation—that is, how people in public administration and management situations do what they do. This paper argues that expanding the menu of worthwhile research approaches from quantitative empiricism, the current “gold standard” in public administration, to include interpretivism makes it possible to view inside the black box of administrative process. After a brief narrative describing how the field lost the balance between quantitative and interpretive approaches it once had, the discussion lays out the philosophical grounding and methodology of interpretive research and offers phenomenology as illustration of how such an expansion will benefit both administrative theory and practice.
Exchange rate expectations and exports: Firm‐level evidence from China
Authors: Bao Xiaohua , Huang Hailiang , Qiu Larry D. , Wang Xiaozhuo
Published: September 2023

The notion that the exchange rate affects exports is well understood. However, whether exporters respond to the expectations of the exchange rate is unknown. Hence, in this study, we construct a measure of exchange rate expectations based on news articles from the Factiva database. We use machine learning to identify and classify news articles about the appreciation of the renminbi (RMB, Chinese currency). Our empirical estimation shows that from 2000 to 2006, Chinese firms reduced their exports in response to a higher expectation of RMB appreciation. They switched their sales from export to domestic markets. The responses are larger in low‐productivity firms, state‐owned enterprises, processing trade, and final goods trade.
A craton‐like subcontinental lithospheric mantle beneath the Trans‐North China Orogen revealed by the ca. 1.54 Ga kimberlites
Authors: Zhu Yu‐Sheng , Yang Jin‐Hui , Li Qiu‐Li , Wang Hao , Wu Ya‐Dong , Wu Fu‐Yuan
Published: September 2023

Ancient orogens within the supercontinent like Columbia can remain stable evolution as long as the cratons. What kind of lithospheric mantle was beneath those orogens and how it evolved into a stable state are still enigmatic. The Trans‐North China orogen (TNCO) is one of the typical collisional orogens within the Columbia supercontinent and was formed at ca. 1.85 Ga. Our work reveals that a cluster of kimberlites intruded the orogenic belt at ca. 1.54 Ga. These rocks were originally generated under a thick lithosphere (>200 km). Their entrained olivine cores show a composition of overlapping olivines from refractory mantle peridotites. The results suggest a thick and refractory lithospheric mantle beneath the TNCO at ca. 1.54 Ga. Such craton‐like property may result from large volume melt extraction from the lithospheric mantle, possibly caused by the ca. 1.78 Ga large igneous event, which eventually induces the long‐term stability of the TNCO during the subsequent supercontinent cycle.
Secret Leviathan
Authors: Harrison Mark
Published: September 2023

The Soviet Union was one of the most secretive states that ever existed. Defended by a complex apparatus of rules and checks administered by the secret police, the Soviet state had seemingly unprecedented capabilities based on its near monopoly of productive capital, monolithic authority, and secretive decision making. But behind the scenes, Soviet secrecy was double-edged: it raised transaction costs, incentivized indecision, compromised the effectiveness of government officials, eroded citizens' trust in institutions and in each other, and led to a secretive society and an uninformed elite. The result is what this book calls the secrecy/capacity tradeoff: a bargain in which the Soviet state accepted the reduction of state capacity as the cost of ensuring its own survival.
This book is the first comprehensive, analytical, multi-faceted history of Soviet secrecy in the English language. Harrison combines quantitative and qualitative evidence to evaluate the impact of secrecy on Soviet state capacity from the 1917 Bolshevik Revolution to the collapse of the Soviet Union in 1991. Based on multiple years of research in once-secret Soviet-era archives, this book addresses two gaps in history and social science: one the core role of secrecy in building and stabilizing the communist states of the twentieth century; the other the corrosive effects of secrecy on the capabilities of authoritarian states.
Whig Prose Cultures
Authors: Willan Claude
Published: September 2023

The fall of the house of Stuart left many cultural and social vacuums for Williamites to fill. This chapter gathers together four representative Whiggish non-fiction prose writers in order to show the persistence of a particular kind of totalizing logic linking parts to wholes and tending to argue for the absolute necessity of Williamite rule for the avoidance cultural, military, economic, or moral apocalypse. Bracketing Joseph Addison, the third earl of Shaftesbury, John Dennis, and Walter Derham, I show the breadth and flexibility of the Whig theodicy in order to show the sophistication of their program of cultural reform and domination.
Samuel Johnson’s Struggle with Pope
Authors: Willan Claude
Published: September 2023

Noted self-canoniser Samuel Johnson is the last focal figure of the book. The chapter begins by showing the depth and particularity of Johnson’s engagement with Pope in London and Vanity of Human Wishes. It next shows Johnson’s renowned prose style as a way of recasting the epistemological structure of the Popean couplet into what I call prose couplets . I discuss a selection of Johnson’s abundant prose couplets and show how faithfully they remediate Pope’s complex, splintering ironies. The chapter closes with a discussion of Johnson’s exercises in monument-building, both for their implicit politics – such as which passages of Locke which Johnson cites – and for their gestalt effect of positioning Johnson as his culture’s adjudicator.
Gnosis and the Covert Theology of Antitheology
Authors: Wolfson Elliot R.
Published: September 2023

This chapter focuses on Susan Taubes’s engagement with Heidegger in comparison to the interpretation that may be elicited from Jacob Taubes. Susan’s major contribution is her insight regarding gnosis as Jewish heresy and the effort to retrieve Heidegger’s atheological theology through utilizing symbols and images culled from ancient Gnosticism. Most relevant to the gnostic interpretation of Heidegger was his use of the themes of thrownness and homelessness to explain Dasein’s estrangement in the world, a philosophical analogue to the understanding of Gnosticism as a denial of the integral meaning of the world and hence the need to escape therefrom. The ancient gnostics and Heidegger share the belief that there is no redemption in time but only redemption from time. Deviating from Jacob, Susan did not posit an apocalyptic-gnostic eschatology that held out the hope of a novum breaking into history.
Why and how to implement worked examples in upper division theoretical physics
Authors: Scheiger Philipp , Cartarius Holger , Nawrodt Ronny
Published: September 2023

Studying worked examples has been shown by extensive research to be an effective method for learning to solve well-structured problems in physics and mathematics. The effectiveness of learning with worked examples has been demonstrated and documented in many research projects. In this work, we propose a new four-step approach for teaching with worked examples that includes writing explanations and finding and correcting errors. This teaching method can even be implemented in courses in which homework performance constitutes part of the grading system. This four-step approach is illustrated in the context of Lagrangian mechanics, which is ideal for the application of worked examples due to its universal approach to solve problems.
An undergraduate physics experiment to measure the frequency-dependent impedance of inductors using an Anderson bridge
Authors: Murray Andrew James , Hickman Carl
Published: September 2023

One of the most accurate ways to measure the impedance of an electrical component is to place it in a bridge that is then balanced. The most familiar bridge in an undergraduate laboratory is the Wheatstone bridge, which can measure resistance to high precision. Other types are, however, required for reactive components. This paper describes the use of Anderson's bridge to measure inductance, allowing both the inductance and resistance of different inductors to be determined. The inductors are analysed with different cores: perspex, copper, and steel. Models for the inductance that include the effect of skin depth, winding proximity, eddy currents, and core effects are introduced and compared to measurements in the frequency range from 100 Hz to 100 kHz.
Sidelined
Authors: Couzin-Frankel Jennifer
Published: September 2023

Svetlana Mojsov helped discover the hormone GLP-1, paving the way for blockbuster obesity drugs. Now, she’s fighting for recognition
Possible misconduct in papers from Italian health minister
Authors: Catanzaro Michele
Published: September 2023

Orazio Schillaci denies responsibility for duplicated images in eight papers he co-authored between 2018 and 2022
Criticism builds against Ph.D. careers firm Cheeky Scientist
Authors: Offord Catherine
Published: September 2023

Researchers say they felt pushed into signing away thousands of dollars for services they ultimately didn’t want
Quantum algorithm offers faster way to hack internet encryption
Authors: Kramer Anna
Published: September 2023

Scheme to factor giant numbers could be more efficient than 30-year-old Shor’s algorithm
Recursive genome engineering decodes the evolutionary origin of an essential thymidylate kinase activity in
Pseudomonas putida
KT2440
Authors: Wirth Nicolas T. , Rohr Katja , Danchin Antoine , Nikel Pablo I.
Published: September 2023

Thymidylate kinases (TMPKs) play an essential role in DNA biosynthesis across all domains of life by catalyzing dTMP phosphorylation to dTDP. In
Pseudomonas putida
KT2440, a model Gram-negative soil bacterium,
tmk
is disrupted by a 65-kb genomic island (GI), posing questions about the origin of the essential TMPK function. To solve this long-standing evolutionary riddle, we addressed three competing hypotheses: (i) assembly of two Tmk segments into a functional protein, (ii) complementation by a deoxynucleotide monophosphate kinase encoded within the GI, or (iii) fulfillment of the essential function by the product of
PP_3363
, yet another gene annotated as “thymidylate kinase.” Systematic genome engineering, quantitative physiology and targeted proteomics, complementation assays, phylogenetic analysis, and structure homology modeling were combined to investigate the role of genes within the GI. Our findings revealed that the GI-encoded dNMPK gene
PP_1964
plays a critical role in complementing the disrupted TMPK function—exposing a non-essential character for the native
PP_3363
gene and the
tmk
pseudogene. This dNMPK was found to be structurally related to that of bacteriophage T4, as part of a distinct evolutionary domain connected to mobile genetic elements and phages. The recursive genome reduction approach in this work deepens our understanding of the genetic architecture of a model bacterium while it provides evidence that the essential TMPK function has been acquired by horizontal gene transfer. Furthermore, the insights gained in the present study have broader implications for understanding the essentiality and functionality of dNMPK homologs in other bacteria.

IMPORTANCE

Investigating fundamental aspects of metabolism is vital for advancing our understanding of the diverse biochemical capabilities and biotechnological applications of bacteria. The origin of the essential thymidylate kinase function in the model bacterium
Pseudomonas putida
KT2440, seemingly interrupted due to the presence of a large genomic island that disrupts the cognate gene, eluded a satisfactory explanation thus far. This is a first-case example of an essential metabolic function, likely acquired by horizontal gene transfer, which “landed” in a locus encoding the same activity. As such, foreign DNA encoding an essential dNMPK could immediately adjust to the recipient host—instead of long-term accommodation and adaptation. Understanding how these functions evolve is a major biological question, and the work presented here is a decisive step toward this direction. Furthermore, identifying essential and accessory genes facilitates removing those deemed irrelevant in industrial settings—yielding genome-reduced cell factories with enhanced properties and genetic stability.
Chromosome-level draft genome sequences of three isolates of the toxigenic fungus
Claviceps purpurea
showing structural rearrangements
Authors: Witte Thomas E. , Hicks Carmen , Shoukouhi Parivash , Dadej Kasia , Findlay Wendy , Liu Miao , Overy David P.
Published: September 2023

The whole genomes of three
Claviceps purpurea
strains were sequenced using Oxford Nanopore Technologies’ MinION and assembled into complete, chromosome-level assemblies. The
C. purpurea
genome consists of eight conserved chromosomes, with evidence of inter-chromosomal structural rearrangements between strains.
Complete genome sequence of
Bradyrhizobium
NP1, isolated from forest soil
Authors: Fisher Trevor , Durmazolu Francesca , DeAngelis Kristen M. , Morrow Maureen A.
Published: September 2023

We report the complete genome sequence of
Bradyrhizobium
strain NP1. This bacterium was isolated from forest soil that had been subject to chronic warming. The genome of this novel isolated bacteria is presented as a single circular contig of 7,712,921 base pairs with 64.14% GC content.
Multicentre, observational, retrospective cohort of hyperkalaemia burden at haemodialysis facility-level in China: the Visualize-HD study protocol
Authors: Zhao Xinju , Zuo Li
Published: September 2023

Objectives

Hyperkalaemia is a potentially life-threatening disorder in patients undergoing haemodialysis (HD). Excess mortality and hospitalisation have been associated with hyperkalaemia (HK) after the long (2-day) interdialytic interval (LIDI) in patients on thrice a week HD compared with the short (1-day) interdialytic interval. Moreover, not much research has been conducted in China on the descriptive epidemiology and management of HK among different HD centres. The aim of this study is to address this evidence gap by investigating the risk factors associated with HK clinical burden at the HD facility level, current HD centres management patterns, serum potassium management patterns, as well as the risk factors associated with crude mortality in China.

Design

Multicentre, observational, retrospective cohort study.

Setting

This study plans to enrol 300 HD centres across China. Haemodialysis centres having ≥100 patients on maintenance HD within 3 years before study initiation, with participation willingness, routine blood collection post-LIDI and death records will be included.

Participants

Patients aged ≥18 years and on chronic HD for ≥3 months will be considered eligible. Summary data about serum potassium, characteristics of patients, facility practice patterns will be collected at HD facility level and death records will be at the patient level.

Primary and secondary outcome measures

The primary outcome will be to examine the association between suspected risk factors and HK prevalence at HD facility level. Suspected risk factors include dialysis prescriptions and serum potassium testing frequency, characteristics of patients and related medication usage. The secondary outcome will be to determine the HK prevalence, serum potassium management pattern and risk factors associated with crude mortality. The primary and secondary outcomes will be analysed using regression models. Exploratory outcomes will further investigate the risk factors associated with serum potassium ≥6.0 and ≥6.5 mmol/L.

Conclusion

The study is expected to provide insights to improve dialysis practice patterns and understand the clinical burden of HK.

Ethics and dissemination

This study protocol was reviewed and approved by the Institutional Review Boards and Ethics Committee of Peking University People’s Hospital (Approval number: 2020PHB324-01). The results will be disseminated through national and international presentations and peer-reviewed publications.

Trial registration number

NCT05020717.
Persistent symptoms and conditions among children and adolescents hospitalised with COVID-19 illness: a qualitative study
Authors: Messiah Sarah E , Francis Jackson , Weerakoon Sitara , Mathew M Sunil , Shaikh Sumbul , Veeraswamy Apurva , Lozano Alejandra , He Weiheng , Xie Luyu , Polavarapu Dhatri , Ahmed Nabila , Kahn Jeffrey
Published: September 2023

Objectives

There is limited in-depth research exploring persistent symptoms and conditions among children and adolescents who contracted COVID-19 illness that required hospitalisation. The main objective of this study was to conduct qualitative interviews among families who had a child hospitalised with COVID-19 illness to elucidate their child’s physical, mental and social health outcomes months after initial acute infection.

Design, setting and participants

A qualitative study that composed of in-depth interviews among families with a child hospitalised with COVID-19 illness in one large urban US paediatric healthcare system. Parents (N=25) were recruited from an ongoing quantitative study to estimate the prevalence of long COVID in children hospitalised with COVID-19 illness. During in-depth interviews, parents were invited to describe their child’s post-COVID-19 symptoms and experiences. Interviews were audiotaped, transcribed and coded in NVivo.

Results

Seven themes were identified concerning the child’s prolonged COVID-19 experiences: (1) post-traumatic stress disorder, (2) social anxiety, (3) severe symptoms on reinfection, (4) worsened pre-existing conditions, (5) lack of insurance coverage for costly treatments, (6) access and utilisation of support systems and (7) overall resilience and recovery. Four parent-specific themes were identified: (1) fear of COVID-19 unknowns, (2) mixed messaging from health information sources, (3) schools being both a support system and a hindrance and (4) desire for and access to support systems.

Conclusions

A subset of children who were hospitalised with COVID-19 illness are experiencing a range of serious mental health impacts related to persistent COVID-19 symptoms. Clinical and public health support strategies should be developed to support these children and their families as they reintegrate in school, social and community activities.
Young people’s opinions of cancer care in England: the BRIGHTLIGHT cohort
Authors: Hughes Luke , Fern Lorna A , Whelan Jeremy S , Taylor Rachel M , Study Group BRIGHTLIGHT
Published: September 2023

Objectives

The BRIGHTLIGHT cohort study was the national evaluation of cancer services for teenager and young adults (TYA). This was analysis of free-text survey data to better understand their experiences of cancer care.

Design

Cohort study

Setting

National Health Service hospitals delivering cancer care in England

Participants

830 young people newly diagnosed with cancer.

Interventions

Exposure to specialist care in the first 6 months after diagnosis defined as care in a TYA Principal Treatment Centre (PTC). This was categorised as follows: all care in a TYA-PTC (ALL-TYA-PTC), no care in a TYA-PTC (NO-TYA-PTC) so care delivered in a children/adult unit only and some care in a TYA-PTC with additional care in a children’s/adult unit (SOME-TYA-PTC).

Primary outcome

Data were collected through the BRIGHTLIGHT survey included free-text questions which asked patients ‘what was the best aspects of their experiences of care’ and ‘what aspects could be improved’. These comments were analysed using content analysis. Themes were compared between categories of care, then ranked in order of frequency, ranging from the most endorsed to the least.

Results

Overall, young people were most positive about their healthcare team, while the area highlighted for improvement was diagnostic experience. Differences between the three groups suggested those who had some or all treatment in a TYA-PTC valued the place of care. Regardless of where TYA were treated their healthcare teams were favourably viewed. Age appropriate place of care was highlighted to be of value for those in PTCs.

Conclusions

These data show the value young people placed on the care they received in TYA specific wards. Young people who accessed some or all of their care in a TYA-PTC highly endorsed their place of care as one of the best elements of their care, and it is further emphasised by those who had shared care who experienced difficulty with lack of age-appropriate care when treated outside the TYA-PTC.
Developing consensus on the principles and key actions for collaborative working between general practices and community pharmacies: a modified eDelphi study
Authors: Harris Simon , Mills Elizabeth , Venables Rebecca Hayley , Bradley Fay , White Simon
Published: September 2023

Objectives

To develop consensus on the principles and key actions for collaborative working in practice between general practice, community pharmacy and patients and their carers.

Design

Three-round modified eDelphi study, starting from an established conceptual model of collaboration between general practitioners (GPs) and community pharmacists.

Setting

Community pharmacies and general practices in England, UK.

Participants

A panel of 123 experts: 43% from a community pharmacy background; 36% from a GP background; 13% patients, carers or patient representatives and 8% from academic or commissioner backgrounds. Panellist numbers reduced by approximately 30% in rounds 2 and 3.

Primary and secondary outcome measures

Consensus between expert panellists, defined as at least 75% agreement.

Results

A high level of consensus (>80%) was achieved on all components of a model of collaboration composed of Fundamental Principles of Collaboration and Key Activities for Action, supported by a series of aspirational statements and suggested practical actions. The fundamental principles and key activities are appended by contextual points. The findings indicate that collaboration in practice involves team members other than just GPs and community pharmacists and recognises that patients often want to know how each professional team is involved in their care. This study also provides insights into how collaboration between general practice and community pharmacy settings appears to have shifted during the COVID-19 pandemic, especially through opportunities for virtual collaboration and communication that can transcend the need for close geographical proximity.

Conclusion

A consensus-based model of collaboration between general practice teams, community pharmacy teams, and patients and their carers has been developed. It is practically focused, values the patient voice and incorporates general practice and community pharmacy team members. While developed in England, the model is likely to also have applicability to other countries with similar health systems that include general practices and community pharmacies.
Protocolised early de-resuscitation in septic shock (REDUCE): protocol for a randomised controlled multicentre feasibility trial
Authors: Messmer Anna , Pietsch Urs , Siegemund Martin , Buehler Philipp , Waskowski Jan , Müller Martin , Uehlinger Dominik E , Hollinger Alexa , Filipovic Miodrag , Berger David , Schefold Joerg C , Pfortmueller Carmen A
Published: September 2023

Background

Fluid overload is associated with excess mortality in septic shock. Current approaches to reduce fluid overload include restrictive administration of fluid or active removal of accumulated fluid. However, evidence on active fluid removal is scarce. The aim of this study is to assess the efficacy and feasibility of an early de-resuscitation protocol in patients with septic shock.

Methods

All patients admitted to the intensive care unit (ICU) with a septic shock are screened, and eligible patients will be randomised in a 1:1 ratio to intervention or standard of care. Intervention: Fluid management will be performed according to the REDUCE protocol, where resuscitation fluid will be restricted to patients showing signs of poor tissue perfusion. After the lactate has peaked, the patient is deemed stable and assessed for active de-resuscitation (signs of fluid overload). The primary objective of this study is the proportion of patients with a negative cumulative fluid balance at day 3 after ICU. Secondary objectives are cumulative fluid balances throughout the ICU stay, number of patients with fluid overload, feasibility and safety outcomes and patient-centred outcomes. The primary outcome will be assessed by a logistic regression model adjusting for the stratification variables (trial site and chronic renal failure) in the intention-to-treat population.

Ethics and dissemination

The study was approved by the respective ethical committees (No 2020–02197). The results of the REDUCE trial will be published in an international peer-reviewed medical journal regardless of the results.

Trial registration number

ClinicalTrials.gov,NCT04931485.
Applying clinical decision aids for the assessment and management of febrile infants presenting to emergency care in the UK and Ireland: Febrile Infant Diagnostic Assessment and Outcome (FIDO) Study protocol
Authors: Umana Etimbuk , Mills Clare , Norman-Bruce Hannah , Wilson Kathryn , Mitchell Hannah , McFetridge Lisa , Woolfall Kerry , Lynn Fiona A , McKeeman Gareth , Foster Steven , Barrett Michael , Roland Damian , Lyttle Mark D , Watson Chris , Waterfield Thomas
Published: September 2023

Introduction

Febrile infants 90 days and younger are at risk of invasive bacterial infections (bacteraemia and meningitis) and urinary tract infections. Together this is previously termed serious bacterial infection with an incidence of approximately 10–20%. The National Institute for Health and Care Excellence guidance advocates a cautious approach with most infants requiring septic screening, parenteral broad-spectrum antibiotics and hospital admission. Internationally, variations exist in the approach to febrile infants, with European and North American guidance advocating a tailored approach based on clinical features and biomarker testing. None of the available international clinical decision aids (CDAs) has been validated in the UK and Irish cohorts. The aim of the Febrile Infant Diagnostic Assessment and Outcome (FIDO) Study is to prospectively validate a range of CDAs in a UK and Irish population including CDAs that use procalcitonin testing.

Methods and analysis

The FIDO Study is a prospective multicentre mixed-methods cohort study conducted in UK and Irish hospitals. All infants aged 90 days and younger presenting with fever or history of fever (≥38°C) are eligible for inclusion. Infants will receive standard emergency clinical care without delay. Clinical data and blood samples will be collected, and consent will be obtained at the earliest appropriate opportunity using research without prior consent methodology. The performance and cost-effectiveness of CDAs will be assessed. An embedded qualitative study will explore clinician and caregiver views on different approaches to care and perceptions of risk.

Ethics and dissemination

This study was reviewed and approved by the Office for Research Ethics Committees Northern Ireland-Health and Social Care Research Ethics Committee B, Public Benefit and Privacy Panel for Health and Social Care Scotland, and Children’s Health Ireland Research and Ethics Committee Ireland. The results of this study will be presented at academic conferences and in peer-reviewed publications.

Trial registration number

NCT05259683.
Updates to the modern diagnosis of GERD: Lyon consensus 2.0
Authors: Gyawali C Prakash , Yadlapati Rena , Fass Ronnie , Katzka David , Pandolfino John , Savarino Edoardo , Sifrim Daniel , Spechler Stuart , Zerbib Frank , Fox Mark R , Bhatia Shobna , de Bortoli Nicola , Cho Yu Kyung , Cisternas Daniel , Chen Chien-Lin , Cock Charles , Hani Albis , Remes Troche Jose Maria , Xiao Yinglian , Vaezi Michael F , Roman Sabine
Published: September 2023

The Lyon Consensus provides conclusive criteria for and against the diagnosis of gastro-oesophageal reflux disease (GERD), and adjunctive metrics that consolidate or refute GERD diagnosis when primary criteria are borderline or inconclusive. An international core and working group was assembled to evaluate research since publication of the original Lyon Consensus, and to vote on statements collaboratively developed to update criteria. The Lyon Consensus 2.0 provides a modern definition of actionable GERD, where evidence from oesophageal testing supports revising, escalating or personalising GERD management for the symptomatic patient. Symptoms that have a high versus low likelihood of relationship to reflux episodes are described. Unproven versus proven GERD define diagnostic strategies and testing options. Patients with no prior GERD evidence (unproven GERD) are studied using prolonged wireless pH monitoring or catheter-based pH or pH-monitoring off antisecretory medication, while patients with conclusive GERD evidence (proven GERD) and persisting symptoms are evaluated using pH-impedance monitoring while on optimised antisecretory therapy. The major changes from the original Lyon Consensus criteria include establishment of Los Angeles grade B oesophagitis as conclusive GERD evidence, description of metrics and thresholds to be used with prolonged wireless pH monitoring, and inclusion of parameters useful in diagnosis of refractory GERD when testing is performed on antisecretory therapy in proven GERD. Criteria that have not performed well in the diagnosis of actionable GERD have been retired. Personalisation of investigation and management to each patient’s unique presentation will optimise GERD diagnosis and management.
Sex differences in adverse events following seasonal influenza vaccines: a meta-analysis of randomised controlled trials
Authors: Kiely Marilou , Tadount Fazia , Lo Ernest , Sadarangani Manish , Wei Shu Qin , Rafferty Ellen , Quach Caroline , MacDonald Shannon E
Published: September 2023

Background

Despite being a vaccine-preventable disease, influenza remains a major public health threat with vaccine safety concerns reducing vaccine acceptability. Immune responses to vaccines and adverse events may differ between males and females, but most studies do not report results by sex. Using data from clinical trials, we explored sex differences in adverse events following seasonal influenza vaccines.

Methods

We obtained data for phase III randomised controlled trials identified through a systematic review and clinical trials registries, and performed a two-stage meta-analysis. Risk ratios (RR) and 95% confidence intervals (95% CI) comparing solicited reactions in femalesversusmales were pooled using the Mantel-Haenszel method and a random-effects model. We used the ROBINS-I tool to assess risk of bias and the I2statistic for heterogeneity. Main analysis was stratified by age: 18–64 years and ≥65 years.

Results

The dataset for this analysis included 34 343 adults from 18 studies (12 with individual-level data and 6 with aggregate data). There was a higher risk of injection site reactions in females compared with males for both younger and older participants, with RRs of 1.29 (95% CI 1.21 to 1.37) and 1.43 (95% CI 1.28 to 1.60), respectively. Higher risk in females was also observed for systemic reactions, with RRs of 1.25 (95% CI 1.20 to 1.31) and 1.27 (95% CI 1.20 to 1.34) for younger and older participants, respectively. We also observed elevated risks of severe reactions in females, with a higher RR in youngerversusolder participants for systemic reactions (RRs 2.12 and 1.48, p=0.03, I2=79.7%). RRs were not found to vary between quadrivalent and trivalent vaccines.

Conclusion

This meta-analysis suggested a higher risk of solicited reactions following influenza vaccines for females compared with males, irrespective of age and vaccine type. Transparent communication of this risk could increase the trust in vaccines and limit vaccine hesitancy. Future studies should report results stratified by sex and explore the role of gender in the occurrence of adverse events.
Diagnostic genome sequencing improves diagnostic yield: a prospective single-centre study in 1000 patients with inherited eye diseases
Authors: Weisschuh Nicole , Mazzola Pascale , Zuleger Theresia , Schaeferhoff Karin , Kühlewein Laura , Kortüm Friederike , Witt Dennis , Liebmann Alexandra , Falb Ruth , Pohl Lisa , Reith Milda , Stühn Lara G , Bertrand Miriam , Müller Amelie , Casadei Nicolas , Kelemen Olga , Kelbsch Carina , Kernstock Christoph , Richter Paul , Sadler Francoise , Demidov German , Schütz Leon , Admard Jakob , Sturm Marc , Grasshoff Ute , Tonagel Felix , Heinrich Tilman , Nasser Fadi , Wissinger Bernd , Ossowski Stephan , Kohl Susanne , Riess Olaf , Stingl Katarina , Haack Tobias B
Published: September 2023

Purpose

Genome sequencing (GS) is expected to reduce the diagnostic gap in rare disease genetics. We aimed to evaluate a scalable framework for genome-based analyses ‘beyond the exome’ in regular care of patients with inherited retinal degeneration (IRD) or inherited optic neuropathy (ION).

Methods

PCR-free short-read GS was performed on 1000 consecutive probands with IRD/ION in routine diagnostics. Complementary whole-blood RNA-sequencing (RNA-seq) was done in a subset of 74 patients. An open-source bioinformatics analysis pipeline was optimised for structural variant (SV) calling and combined RNA/DNA variation interpretation.

Results

A definite genetic diagnosis was established in 57.4% of cases. For another 16.7%, variants of uncertain significance were identified in known IRD/ION genes, while the underlying genetic cause remained unresolved in 25.9%. SVs or alterations in non-coding genomic regions made up for 12.7% of the observed variants. The RNA-seq studies supported the classification of two unclear variants.

Conclusion

GS is feasible in clinical practice and reliably identifies causal variants in a substantial proportion of individuals. GS extends the diagnostic yield to rare non-coding variants and enables precise determination of SVs. The added diagnostic value of RNA-seq is limited by low expression levels of the major IRD disease genes in blood.
Posterior semicircular canal cupulolithiasis during acute pontomedullary demyelination
Authors: Matos Sara , Martins Ana Inês , Jorge André , Macário Maria do Carmo , Pereira Daniela , Strupp Michael , Lemos João
Published: September 2023

Positional vertigo poses a diagnostic challenge in people with multiple sclerosis (MS). The characteristics of positional nystagmus and its response to repositioning manoeuvres are usually sufficient to diagnose benign paroxysmal positional vertigo (BPPV). However, certain BPPV variants respond poorly to repositioning manoeuvres and their nystagmus pattern can resemble that of central positional vertigo caused by infratentorial demyelination. This diagnostic difficulty is particularly challenging if positional vertigo occurs during an MS relapse. We describe a woman with MS who developed a sixth nerve palsy and gaze-evoked nystagmus, caused by demyelination near or within areas classically involved in central positional vertigo. However, she also had positional vertigo from coincident BPPV (and not central positional vertigo). This was initially a treatment resistant-posterior semicircular canal cupulolithiasis but it later progressed to a posterior semicircular canal canalolithiasis, with symptoms promptly resolving after a repositioning manoeuvre.