bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact assessment of the medical practice assisting (MPA) program in general practice in the hunter New England and central coast regions of Australia
Authors: Ramanathan Shanthi Ann , Ling Rod , Tattersall Alison , Ingold Nicola , De Silva Mary Sheffi , Close Shara , Searles Andrew
Published: December 2022

Background

A regional Australian Primary Health Network (PHN) has been subsidising administrative staff from local general practices to undertake the Medical Practice Assisting (MPA) course as part of its MPA Program. The MPA Program aimed to upskill administrative staff to undertake clinical tasks and fill in for busy or absent Practice Nurses (PNs), freeing up PNs to increase revenue-generating activity, avoiding casual replacement staff wages, and increasing patient throughput. An impact assessment was undertaken to evaluate the impact and estimate the economic costs of the MPA program to the PHN, general practices, and students to inform future uptake of the intervention.

Methods

The Framework to Assess the Impact of Translational Health Research (FAIT) was utilised. Originally designed to assess the impact of health research, this was its first application to a health services project. FAIT combines three validated methods of impact assessment—Payback, economic analysis and narratives underpinned by a program logic model. Quantified metrics describe the impacts of the program within various “domains of benefit”, the economic model costs the intervention and monetises potential consequences, and the narrative tells the story of the MPA Program and the difference it has made. Data were collected via online surveys from general practitioners (GPs), PNs, practice managers; MPA graduates and PHN staff were interviewed by phone and on Zoom.

Results

FAIT was effective in evidencing the impacts and economic viability of the MPA Program. GPs and PNs reported greater work satisfaction, PNs reported less stress and reduced workloads and MPA graduates reported higher job satisfaction and greater confidence performing a range of clinical skills. MPA Program economic costs for general practices during candidature, and 12 month post-graduation was estimated at $69,756. With effective re-integration planning, this investment was recoverable within 12 months through increased revenue for practices. Graduates paid appropriately for their new skills also recouped their investment within 24 months.

Conclusion

Utilisation of MPA graduates varied substantially between practices and COVID-19 impacted on their utilisation. More strategic reintegration of the MPA graduate back into the practice to most effectively utilise their new skillset could optimise potential benefits realised by participating practices.
The importance and effectiveness of nutritional counselling in patients with autoimmune thyroid diseases in Poland
Authors: Czubek Ewa , Alcer Klaudia , Varjacic Mirjana , Romaniuk Piotr
Published: December 2022

Background

Autoimmune thyroid diseases are the most common diseases in humans. Their pathogenesis is complex, pushing patients to search different ways of alleviating their effects, one of which is diet change. The aim of this study was to assess the role of medical personnel in shaping eating habits in patients with autoimmune thyroid disease based on experiences declared by patients.

Methods

We examined 208 individuals, of which 205 were qualified for final investigation. We selected study participants using accidental sampling, based on their appearance in health care facilities, including the ones providing endocrinological advices. The relationships between the qualitative features were tested using the Chi-square test of independence, assuming the significance level of p < 0.05. In the case of the expected cardinality  < 10, the Chi-square test with correction for Yates continuity was used, while for the cardinality  < 5—the Fisher exact test.

Results

People with thyroid disease are statistically more likely to use dietitian advice than people without thyroid disease. The highest percentage of respondents decided to modify their nutrition due to their own initiative. In addition, patients with autoimmune thyroid disease are statistically more likely to consider changing their diet to improve their well-being. The connection between the source of advice and modification of eating behaviour was also noted.

Conclusion

Thanks to the joint effort of medical staff, patients can receive reliable knowledge about their disease, treatment and nutrition adapted to their needs.

Trial registration approved by the Bioethics Committee of Medical University of Silesia in Katowice (opinion no.: PCN/0022/KB1/80/2)
Ketogenic diet as a glycine lowering therapy in nonketotic hyperglycinemia and impact on brain glycine levels
Authors: Shelkowitz Emily , Saneto Russell P. , Al-Hertani Walla , Lubout Charlotte M. A. , Stence Nicholas V. , Brown Mark S. , Long Patrick , Walleigh Diana , Nelson Julie A. , Perez Francisco E. , Shaw Dennis W. W. , Michl Emma J. , Van Hove Johan L. K.
Published: December 2022

Background

Nonketotic hyperglycinemia (NKH) is a severe neurometabolic disorder characterized by increased glycine levels. Current glycine reduction therapy uses high doses of sodium benzoate. The ketogenic diet (KD) may represent an alternative method of glycine reduction.

Aim

We aimed to assess clinical and biochemical effects of two glycine reduction strategies: high dose benzoate versus KD with low dose benzoate.

Methods

Six infants with NKH were first treated with high dose benzoate therapy to achieve target plasma glycine levels, and then switched to KD with low dose benzoate. They were evaluated as clinically indicated by physical examination, electroencephalogram, plasma and cerebral spinal fluid amino acid levels. Brain glycine levels were monitored by magnetic resonance spectroscopy (MRS).

Results

Average plasma glycine levels were significantly lower with KD compared to benzoate monotherapy by on average 28%. Two infants underwent comparative assessments of brain glycine levels via serial MRS. A 30% reduction of brain glycine levels was observed in the basal ganglia and a 50% reduction in the white matter, which remained elevated above normal, and was equivalent between the KD and high dose benzoate therapies. CSF analysis obtained while participants remained on the KD showed a decrease in glycine, serine and threonine levels, reflecting their gluconeogenetic usage. Clinically, half the patients had seizure reduction on KD, otherwise the clinical impact was variable.

Conclusion

KD is an effective glycine reduction method in NKH, and may provide a more consistent reduction in plasma glycine levels than high-dose benzoate therapy. Both high-dose benzoate therapy and KD equally reduced but did not normalize brain glycine levels even in the setting of low-normal plasma glycine.
Riluzole partially restores RNA polymerase III complex assembly in cells expressing the leukodystrophy-causative variant POLR3B R103H
Authors: Pinard Maxime , Dastpeyman Samaneh , Poitras Christian , Bernard Geneviève , Gauthier Marie-Soleil , Coulombe Benoit
Published: December 2022

The mechanism of assembly of RNA polymerase III (Pol III), the 17-subunit enzyme that synthesizes tRNAs, 5 S rRNA, and other small-nuclear (sn) RNAs in eukaryotes, is not clearly understood. The recent discovery of the HSP90 co-chaperone PAQosome (Particle for Arrangement of Quaternary structure) revealed a function for this machinery in the biogenesis of nuclear RNA polymerases. However, the connection between Pol III subunits and the PAQosome during the assembly process remains unexplored. Here, we report the development of a mass spectrometry-based assay that allows the characterization of Pol III assembly. This assay was used to dissect the stages of Pol III assembly, to start defining the function of the PAQosome in this process, to dissect the assembly defects driven by the leukodystrophy-causative R103H substitution in POLR3B, and to discover that riluzole, an FDA-approved drug for alleviation of ALS symptoms, partly corrects these assembly defects. Together, these results shed new light on the mechanism and regulation of human nuclear Pol III biogenesis.
Lithium carbonate in amyotrophic lateral sclerosis patients homozygous for the C-allele at SNP rs12608932 in UNC13A: protocol for a confirmatory, randomized, group-sequential, event-driven, double-blind, placebo-controlled trial
Authors: Willemse Sean W. , Roes Kit C. B. , Van Damme Philip , Hardiman Orla , Ingre Caroline , Povedano Monica , Wray Naomi R. , Gijzen Marleen , de Pagter Mirjam S. , Demaegd Koen C. , Janse Annemarie F. C. , Vink Roel G. , Sleutjes Boudewijn T. H. M. , Chiò Adriano , Corcia Philippe , Reviers Evy , Al-Chalabi Ammar , Kiernan Matthew C. , van den Berg Leonard H. , van Es Michael A. , van Eijk Ruben P. A.
Published: December 2022

Background

Given the large genetic heterogeneity in amyotrophic lateral sclerosis (ALS), it seems likely that genetic subgroups may benefit differently from treatment. An exploratory meta-analysis identified that patients homozygous for the C-allele at SNP rs12608932, a single nucleotide polymorphism in the gene UNC13A, had a statistically significant survival benefit when treated with lithium carbonate. We aim to confirm the efficacy of lithium carbonate on the time to death or respiratory insufficiency in patients with ALS homozygous for the C-allele at SNP rs12608932 in UNC13A.

Methods

A randomized, group-sequential, event-driven, double-blind, placebo-controlled trial will be conducted in 15 sites across Europe and Australia. Patients will be genotyped for UNC13A; those homozygous for the C-allele at SNP rs12608932 will be eligible. Patients must have a diagnosis of ALS according to the revised El Escorial criteria, and a TRICALS risk-profile score between −6.0 and −2.0. An expected number of 1200 patients will be screened in order to enroll a target sample size of 171 patients. Patients will be randomly allocated in a 2:1 ratio to lithium carbonate or matching placebo, and treated for a maximum duration of 24 months. The primary endpoint is the time to death or respiratory insufficiency, whichever occurs first. Key secondary endpoints include functional decline, respiratory function, quality of life, tolerability, and safety. An interim analysis for futility and efficacy will be conducted after the occurrence of 41 events.

Discussion

Lithium carbonate has been proven to be safe and well-tolerated in patients with ALS. Given the favorable safety profile, the potential benefits are considered to outweigh the burden and risks associated with study participation. This study may provide conclusive evidence about the life-prolonging potential of lithium carbonate in a genetic ALS subgroup.

Trial registration

EudraCT number 2020-000579-19. Registered on 29 March 2021.
ANDA-Evaluating Facilitated Feedback Enhancement - a Cluster randomised Trial (ANDA-EFFECT): protocol for a cluster randomised trial of audit feedback augmented with education and support, compared to feedback alone, on acceptability, utility and health outcomes in diabetes centres in Australia
Authors: Quigley Matthew , Earnest Arul , Andrikopoulos Sofianos , Wischer Natalie , Green Sally , Zoungas Sophia
Published: December 2022

Background

People living with diabetes must manage a range of factors for optimal control of glycaemia and to minimise the risk of diabetes-related complications. Diabetes practitioners are expected to follow guidelines for the key process of care and clinical outcomes, to help people living with diabetes achieve clinical targets. In Australia, the performance of diabetes centres against guidelines is evaluated by the Australian National Diabetes Audit, an annual clinical audit and feedback activity. Previous work has identified areas for improvement in the feedback provided to participating diabetes centres and suggested additional educational and support resources to assist in using audit feedback for the development of quality improvement activities. This cluster randomised trial will test the acceptability, utility and impact on selected clinical outcomes of the developed study intervention (audit feedback and a tailored educational and peer support cointervention).

Methods

Two-armed cluster randomised trial with Australian Diabetes Centres that participated in the Australian National Diabetes Audit in 2021 as the clusters, stratified by location and type of centre. We aim to recruit 35 diabetes centres in each arm. Both the intervention and control arms will receive an augmented feedback report, accompanied by a partially pre-populated slide deck. In addition, the intervention arm will receive a tailored theory-based intervention designed to address identified, modifiable barriers to utilising and implementing the recommendations from diabetes audit feedback. The co-primary outcomes are (1) HbA1c at the patient level, measured at 6 months after delivery of the intervention, and (2) the acceptability and utility of the augmented feedback and cointerventions at the practitioner level, measured at 3 months after delivery of the intervention.

Discussion

This trial aims to test the effects of systematic development and implementation of theory and evidence-informed changes to the audit feedback delivered to diabetes centres participating in an established national clinical diabetes audit. Potential benefits of improved audit feedback include more optimal engagement with the feedback by end clinical users which, ultimately, may lead to improvements in care for people living with diabetes.

Trial registration

Australian and New Zealand Clinical Trials Registry ACTRN12621000765820. Prospectively registered on June 21, 2021
Anaesthetic efficacy and influence on cardiovascular parameters change of intraosseous computerised anaesthesia versus inferior alveolar nerve block anaesthesia in acute irreversible pulpitis of mandibular molars: study protocol for a prospective randomised controlled trial
Authors: Laham Amany , Clouet Roselyne , del Valle Gilles Amador , Gaudin Alexis , Prud’homme Tony
Published: December 2022

Background

Irreversible pulpitis is a highly painful inflammatory condition of the dental pulp. The recommended care is the removal of the coronal pulp (pulpotomy) for emergency treatment in multi-rooted teeth. However, achieving adequate analgesia in the case of mandibular molars presents many difficulties according to the dental literature. Intraosseous computerised anaesthesia (ICA), in particular, the QuickSleeper™ system, has already been demonstrated to be clinically efficient, but ICA is known to increase the heart rate reversibly in a manner that depends on the speed of injection. Therefore, accelerated heart rate was examined as a potential adverse effect of this injection. This trial aims to compare the cardiovascular effects and the anaesthetic efficacy of ICA versus inferior alveolar nerve block anaesthesia (IANB) in acute irreversible pulpitis of mandibular molars.

Methods

This study is a non-inferiority prospective, randomised, controlled, single-blind, two-group trial conducted at the Nantes University Hospital. The study design included two parallel arms at a ratio of 1:1 that will allocate seventy-two patients into two groups: the first group will receive QuickSleeper™ intraosseous anaesthesia; the second will receive an inferior alveolar nerve block before emergency treatment (pulpotomy). This study will include patients requiring emergency dental care under local anaesthesia with confirmed irreversible pulpitis in mandibular molars. The primary outcome is the time taken for the fluctuations in the cardiovascular parameters to return to baseline values during endodontic treatment in two different anaesthetic techniques. The secondary outcomes include efficacy of the technique, patient’s pain perception before and after care, any post-operative effects, and factors associated with the delay of recovery of cardiovascular parameters between the 2 anaesthetic techniques.

Discussion

This trial will evaluate the factors associated with heart rate increase during local anaesthesia administration. The use of blood pressure and cardiovascular measurements can be considered an asset and additional safety in managing local anaesthesia. Detecting early signs of potential adverse events (AEs), particularly patients with certain medical conditions (cardiac rhythm disorders), would suggest caution in administering anaesthesia.

Trial registration

ClinicalTrials.govID: NCT03802305 registered January 14, 2019. (version no. 1.2; 5 November 2021)
A mass rearing cost calculator for the control of Culex quinquefasciatus in Hawaiʻi using the incompatible insect technique
Authors: Vorsino Adam E. , Xi Zhiyong
Published: December 2022

Background

Hawaiʻi’s native forest avifauna is experiencing drastic declines due to climate change-induced increases in temperature encroaching on their upper-elevation montane rainforest refugia. Higher temperatures support greater avian malaria infection rates due to greater densities of its primary vector, the southern house mosquito Culex quinquefasciatus, and enhance development of the avian malaria parasite Plasmodium relictum. Here we propose the use of the incompatible insect technique (IIT) or the combined IIT/sterile insect technique (SIT) for the landscape-scale (i.e., area-wide) control of Cx. quinquefasciatus, and have developed a calculator to estimate the costs of IIT and IIT/SIT applications at various sites in Hawaiʻi.

Methods

The overall cost of the infrastructure, personnel, and space necessary to produce incompatible adult males for release is calculated in a unit of ~ 1 million culicid larvae/week. We assessed the rearing costs and need for effective control at various elevations in Hawaiʻi using a 10:1 overflooding ratio at each elevation. The calculator uses a rate describing the number of culicids needed to control wild-type mosquitoes at each site/elevation, in relation to the number of larval rearing units. This rate is a constant from which other costs are quantified. With minor modifications, the calculator described here can be applied to other areas, mosquito species, and similar techniques. To test the robustness of our calculator, the Kauaʻi-specific culicid IIT/SIT infrastructure costs were also compared to costs from Singapore, Mexico, and China using the yearly cost of control per hectare, and purchasing power parity between sites for the cost of 1000 IIT/SIT males.

Results

As a proof of concept, we have used the calculator to estimate rearing infrastructure costs for an application of IIT in the Alakaʻi Wilderness Reserve on the island of Kauaʻi. Our analysis estimated an initial investment of at least ~ $1.16M with subsequent yearly costs of approximately $376K. Projections of rearing costs for control at lower elevations are ~ 100 times greater than in upper elevation forest bird refugia. These results are relatively comparable to those real-world cost estimates developed for IIT/SIT culicid male production in other countries when inflation and purchasing power parity are considered. We also present supplemental examples of infrastructure costs needed to control Cx. quinquefasciatus in the home range of ʻiʻiwi Drepanis coccinea, and the yellow fever vector Aedes aegypti.

Conclusions

Our cost calculator can be used to effectively estimate the mass rearing cost of an IIT/SIT program. Therefore, the linear relationship of rearing infrastructure to costs used in this calculator is useful for developing a conservative cost estimate for IIT/SIT culicid mass rearing infrastructure. These mass rearing cost estimates vary based on the density of the targeted organism at the application site.

Graphic Abstract
Protocols for Plasmodium gametocyte production in vitro: an integrative review and analysis
Authors: Omorou Roukayatou , Bin Sa’id Ibrahim , Delves Michael , Severini Carlo , Kouakou Yobouet Ines , Bienvenu Anne-Lise , Picot Stephane
Published: December 2022

Background

The production of Plasmodium gametocytes in vitro is a real challenge. Many protocols have been described, but few have resulted in the production of viable and infectious gametocytes in sufficient quantities to conduct research on—but not limited to—transmission-blocking drug and vaccine development. The aim of this review was to identify and discuss gametocyte production protocols that have been developed over the last two decades.

Methods

We analyzed the original gametocyte production protocols published from 2000 onwards based on a literature search and a thorough review. A systematic review was performed of relevant articles identified in the PubMed, Web of Sciences and ScienceDirect databases.

Results

A total 23 studies on the production of Plasmodium gametocytes were identified, 19 involving in vitro Plasmodium falciparum, one involving Plasmodium knowlesi and three involving ex vivo Plasmodium vivax. Of the in vitro studies, 90% used environmental stressors to trigger gametocytogenesis. Mature gametocytemia of up to 4% was reported.

Conclusions

Several biological parameters contribute to an optimal production in vitro of viable and infectious mature gametocytes. The knowledge gained from this systematic review on the molecular mechanisms involved in gametocytogenesis enables reproducible gametocyte protocols with transgenic parasite lines to be set up. This review highlights the need for additional gametocyte production protocols for Plasmodium species other than P. falciparum.

Graphical abstract
Clinical application of the Panbio™ COVID-19 Ag rapid test device and SSf-COVID19 kit for the detection of SARS-CoV-2 infection
Authors: Oh Sang-Min , Lee Jee-Soo , Jo Hyeon Jae , Kim Donghwan , Park Dohyeon , Hwang Young Hoon , Choi Yunsang , Lee Chan Mi , Lee Seungjae , Chang Euijin , Lee Eunyoung , Kim Taek Soo , Seong Moon-Woo , Choe Pyoeng Gyun , Kim Nam Joong
Published: December 2022

Objective

We evaluated the sensitivity and specificity of the Panbio™ COVID-19 Ag rapid test device using nasal swabs and those of the SSf-COVID19 kit, one of RT-PCR tests, using saliva specimens. These tests were compared with RT-PCR tests using nasopharyngeal swabs for the diagnosis of SARS-CoV-2 infection. The three diagnostic tests were simultaneously conducted for patients aged ≥ 18 years, who were about to be hospitalized or had been admitted for COVID-19 confirmed by RT-PCR in two research hospitals from August 20 to October 29, 2021. Nasal swabs were tested using the Panbio™ COVID-19 Ag rapid test device. More than 1 mL of saliva was self-collected and tested using the SSf-COVID19 kit.

Results

In total, 157 patients were investigated; 124 patients who were about to be hospitalized and 33 patients already admitted for COVID-19. The overall sensitivity and specificity of the Panbio™ COVID-19 Ag rapid test device with nasal swabs were 64.7% (95% confidence interval [CI] 47.9–78.5%) and 100.0% (95% CI 97.0–100.0%), respectively. The median time to confirm a positive result was 180 s (interquartile range 60–255 s). The overall sensitivity and specificity of the SSf-COVID19 kit with saliva specimens were 94.1% (95% CI 80.9–98.4%) and 100.0% (95% CI 97.0–100.0%), respectively.
Proteomic profiling of circulating plasma exosomes reveals novel biomarkers of Alzheimer’s disease
Authors: Cai Huimin , Pang Yana , Wang Qi , Qin Wei , Wei Cuibai , Li Ying , Li Tingting , Li Fangyu , Wang Qigeng , Li Yan , Wei Yiping , Jia Longfei
Published: December 2022

Background

Neuronal- and astrocyte-derived exosomes have been identified as an optimal source for screening biomarkers for Alzheimer’s disease (AD). However, few studies focus on the bulk exosome population isolated from plasma of AD. This study investigated whether proteins in bulk exosomes can aid in the diagnosis of AD.

Methods

The plasma exosomes were collected by ultracentrifuge. Protein samples were extracted from exosomes. Cerebrospinal fluid levels of amyloid β (Aβ)42 and phosphorylated tau (P-tau)181 were measured for diagnostic purposes. A pilot study (controls, 20; AD, 20) followed by a second dataset (controls, 56; AD, 58) was used to establish a diagnostic model of AD. Mass spectrometry-based proteomics was performed to profile the plasma exosomal proteome. Parallel reaction monitoring was used to further confirm the differentially expressed proteins.

Results

In total, 328 proteins in plasma exosomes were quantified. Among them, 31 proteins were altered in AD patients, and 12 were validated. The receiver operating characteristic curve analysis revealed a combination of six proteins (upregulated: Ig-like domain-containing protein (A0A0G2JRQ6), complement C1q subcomponent subunit C (C1QC), complement component C9 (CO9), platelet glycoprotein Ib beta chain (GP1BB), Ras suppressor protein 1 (RSU1); downregulated: disintegrin and metalloproteinase domain 10 (ADA10)) has the capacity to differentiate AD patients from healthy controls with high accuracy. Linear correlation analysis showed that the combination was significantly correlated with cognitive performance.

Conclusions

The combination of plasma exosomal proteins A0A0G2JRQ6, C1QC, CO9, GP1BB, RSU1, and ADA10 acts as a novel candidate biomarker to differentiate AD patients from healthy individuals.
Cecal perforations due to descending colon obstruction (closed loop): a case report and review of the literature
Authors: Naiem Mohamed Eltayeb Abdelrahman , Suliman Suliman Hussein
Published: December 2022

Background

Cases of large bowel closed-loop phenomenon with cecal perforation are extremely rare, especially when extracolonic epiploic appendage and peritoneal bands are the cause. However, sporadic cases exist in the literature with various presentations, but very few occur in patients in the abdomen without a previous scar.

Case presentation

An 89-year-old Sudanese farmer was admitted to the emergency department with 9-day history of generalized colicky abdominal pain, abdominal distension, anorexia, persistent vomiting, and constipation. Given his clinical presentation and assessment, he was diagnosed with peritonitis due to a perforated viscus in a virgin abdomen. Operative exploration revealed an extraluminal left-sided omento–epiploic band that resulted in closed-loop colonic obstruction with secondary multiple cecal perforations. Standard right hemicolectomy with adhesiolysis was done. Postoperative wound infection and hypoalbuminemia were treated, and the patient was discharged on postoperative day 9 on a regular oral diet.

Conclusions

Although this condition is rare, it can be extremely dangerous, requiring prompt investigation and surgical intervention. It usually occurs secondary to raised intraluminal pressure with subsequent ischemia of the cecal wall. Through this case report, we aim to reflect on this rare experience, shedding light on the benign, extracolonic pathologies that can be life threatening or even fatal.
Attention mechanism combined with residual recurrent neural network for sound event detection and localization
Authors: Lan Chaofeng , Zhang Lei , Zhang Yuanyuan , Fu Lirong , Sun Chao , Han Yulan , Zhang Meng
Published: December 2022

In the task of sound event detection and localization (SEDL) in a complex environment, the acoustic signals of different events usually have nonlinear superposition, so the detection and localization effect is not good. Given this, this paper is based on the Residual-spatially and channel Squeeze-Excitation (Res-scSE) model. Combined with Multiple-scale Convolutional Recurrent Neural Network (M-CRNN), the Res-scSE-CRNN model is proposed. Firstly, to solve the problem of insufficient extraction of time-frequency feature in single-size convolution kernel, multi-scale feature fusion is carried out by using the feature hierarchy of the convolutional neural network to improve the accuracy of detection. Secondly, aiming at the problem of overlapping audio event localization accuracy is not high, with Res-scSE to replace common convolution module and add residual structure to strengthen the feature extraction, and combining with an attention mechanism to enhance neural network channels and spatial relationships, to improve the network to extract the characteristics of directivity, achieve the goal of the overlapped audio localization. In this paper, experiments are carried out in the open dataset DCASE2019, and evaluation indicators are used to analyze the effectiveness of the proposed model and baseline model in the detection and localization of audio events. The results show that compared with the M-CRNN model, the detection error rate of Res-scSE-CRNN model is reduced 4%, the F1-Score is increased 3.4%, the localization error is reduced by 22.8°, and the frame recall rate is increased 3%.
A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol
Authors: Filiatreault Sarah , Grimshaw Jeremy M. , Kreindler Sara A. , Chochinov Alecs , Linton Janice , Doupe Malcolm B.
Published: December 2022

Background

Up to 35% of older adults present to the emergency department (ED) with delirium or develop the condition during their ED stay. Delirium associated with an ED visit is independently linked to poorer outcomes such as loss of independence, increased length of hospital stay, and mortality. Improving the quality of delirium care for older ED patients is hindered by a lack of knowledge and standards to guide best practice. High-quality clinical practice guidelines (CPGs) have the power to translate the complexity of scientific evidence into recommendations to improve and standardize practice. This study will identify and synthesize recommendations from high-quality delirium CPGs relevant to the care of older ED patients.

Methods

We will conduct a multi-phase umbrella review to retrieve relevant CPGs. Quality of the CPGs and their recommendations will be critically appraised using the Appraisal of Guidelines, Research, and Evaluation (AGREE)-II; and Appraisal of Guidelines Research and Evaluation – Recommendations Excellence (AGREE-REX) instruments, respectively. We will also synthesize and conduct a narrative analysis of high-quality CPG recommendations.

Discussion

This review will be the first known evidence synthesis of delirium CPGs including a critical appraisal and synthesis of recommendations. Recommendations will be categorized according to target population and setting as a means to define the bredth of knowledge in this area. Future research will use consensus building methods to identify which are most relevant to older ED patients.

Trial registration

This study has been registered in the Open Science Framework registries: https://doi.org/10.17605/OSF.IO/TG7S6.
Effectiveness of postoperative oral administration of cephalexin and metronidazole on surgical site infection among obese women undergoing cesarean section: a randomized, double-blind, placebo-controlled, parallel-group study—phase III
Authors: Tara Fatemeh , Danesteh Sina , Rezaee Maral , Geraylow Kiarash Roustai , Moodi Ghalibaf AmirAli , Moeindarbari Somayeh
Published: December 2022

Background

Cesarean section (CS) is the most frequently performed surgery in the United States. Compared to vaginal delivery, CS has a higher risk of maternal and neonatal mortality, morbidities, and complications, among which surgical site infection (SSI) is the most common. We aimed at evaluating the effectiveness of postoperative oral administration of cephalexin and metronidazole on SSI among obese women undergoing CS.

Methods

We conducted a randomized, double-blind clinical trial comparing the prophylactic effect of oral cephalexin and metronidazole vs cephalexin and placebo on SSI following CS among obese women. who had received preoperative prophylactic cephalosporin antibiotics. The study was conducted at the Ommolbanin Hospital, affiliated with Mashhad University of Medical Sciences from April 2019 to February 2020.

Result

The participants were randomized into the intervention group (n = 210) and the control group (n = 210). At week-1 follow-up, the outcomes were significantly lower in the intervention group as compared to the control group in terms of fever (9% vs 19%,p = 0.003), abnormal discharge from the incision (serous: 8.6% vs 10.5%, purulent: 2.9% vs 16.7%,p < 0.001), incision separation (1% vs 7.1%,p = 0.001), and cellulitis (4.8% vs 13.3%,p = 0.002). At week-2 follow-up, there were no patients in the intervention group with fever, abnormal discharge from the incision, incision separation, or cellulitis and there was a statistically significant difference for fever, abnormal discharge from the incision, and incision separation between the two groups (p < 0.001,p = 0.001,p = 0.014, respectively).

Conclusion

Post-operative administration of cephalexin and metronidazole for 48-h post-cesarean delivery among obese women, in addition to the standard pre-operative prophylaxis, reduced the overall rate of surgical site infection and wound infection symptoms in a 2-week follow-up.

Trial registrationThe study protocol was approved by the Iranian Registry of Clinical Trials (IRCTID: IRCT20200608047685N2) on 2021-03-15.
Identification of DNA methylation signatures for hepatocellular carcinoma detection and microvascular invasion prediction
Authors: Hao Yijie , Yang Qingxia , He Qiye , Hu Huanjing , Weng Zongpeng , Su Zhixi , Chen Shuling , Peng Sui , Kuang Ming , Chen Zhihang , Xu Lixia
Published: December 2022

Background and aim

Preoperative evaluation of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC) is important for surgical strategy determination. We aimed to develop and establish a preoperative predictive model for MVI status based on DNA methylation markers.

Methods

A total of 35 HCC tissues and the matched peritumoral normal liver tissues as well as 35 corresponding HCC patients’ plasma samples and 24 healthy plasma samples were used for genome-wide methylation sequencing and subsequent methylation haplotype block (MHB) analysis. Predictive models were constructed based on selected MHB markers and 3-cross validation was used.

Results

We grouped 35 HCC patients into 2 categories, including the MVI− group with 17 tissue and plasma samples, and MVI + group with 18 tissue and plasma samples. We identified a tissue DNA methylation signature with an AUC of 98.0% and a circulating free DNA (cfDNA) methylation signature with an AUC of 96.0% for HCC detection. Furthermore, we established a tissue DNA methylation signature for MVI status prediction, and achieved an AUC of 85.9%. Based on the MVI status predicted by the DNA methylation signature, the recurrence-free survival (RFS) and overall survival (OS) were significantly better in the predicted MVI− group than that in the predicted MVI + group.

Conclusions

In this study, we identified a cfDNA methylation signature for HCC detection and a tissue DNA methylation signature for MVI status prediction with high accuracy.
Revisiting the electricity consumption-led growth hypothesis: is the rule defied in France?
Authors: Rafindadi Abdulkadir Abdulrashid , Aliyu Isah Buhari , Usman Ojonugwa
Published: December 2022

Recent economics literature emphasises the inextricable link between economic prosperity and efficient energy supply and consumption, arguing vehemently that much of today’s prosperity is predicated on secure and reliable energy use and that modern industry would grind to a halt without the necessary energy infrastructure. France is an example of an advanced country with enormous energy infrastructure. The country’s economic growth has been rather sluggish in recent years, despite its robust and efficient energy production and consumption. The current study analyses empirically whether France’s current sustainable electricity use defies the theoretical and empirical literature. To achieve this objective, the standard tools of growth empirics were used over the period 1961–2015. The Zivot–Andrews trended and de-trended structural break tests, as well as Autoregressive Distributed lag (ARDL) bounds testing were employed to analyse the data. The findings of this study demonstrated that France's economic growth is stimulated by electricity usage, financial development, capital, import, and export. The study sheds light on the feedback impact between economic growth and power usage as well as capital and economic growth. With these findings, we argue that it is not electricity that has ceased to serve a functional purpose in France, rather there is a need for entrepreneurial innovative capacity to create factors that require an infinite horizon for the continued use of electricity, which seems to be impeding the country's economic growth potential, among other things.
Carbohydrate malabsorption in anorexia nervosa: a systematic review
Authors: Buck Patrizia , Joli Jian , Zipfel Stephan , Stengel Andreas
Published: December 2022

Objectives

Anorexia nervosa (AN) is an eating disorder accompanied by a low body mass index and (self-) restricted food intake. Nutritional limitations can cause complaints of the digestive system, because of a disturbed absorption of food components. The absorption of carbohydrates may be seriously affected and reduced to a minimum. On this basis, a possible connection between AN, and the prevalence of gastrointestinal symptoms due to malabsorption was examined.

Methods

For the systematic literature research with the aim of a better understanding of the topic the databases PubMed, Web of Science, Cochrane Library, Livivo and Google Scholar were used.

Results

After the manual selection process of 2215 retrieved studies, 89 full texts were read and according to the predetermined eligibility criteria, finally 2 studies on the monosaccharide fructose and disaccharide lactose were included in this review.

Conclusion

Malabsorption is often observed in patients with AN. It may contribute to the gastrointestinal complaints reported by patients and hamper body weight regain. Among others, mucosal atrophy and duodenal transporter dysfunction are discussed as main reasons. In the future more studies on carbohydrate malabsorption related to low body weight as observed in AN are warranted and may be conducted rather in an outpatient setting.
Bleaching cotton in textile conservation: a closer look using atomic force microscopy
Authors: Salem Rana T. A. , Thompson Karen , Uttamlal Mahesh
Published: December 2022

Aqueous bleaching may be used in textile conservation to improve the appearance of historic and culturally significant textiles. It is generally accepted amongst conservators that bleaching imparts damage. The aim of this research is to characterise the condition of cotton fibre's surface pre- and post-bleaching using atomic force microscopy (AFM). Unprocessed cotton calico (‘raw’ cotton), scoured cotton, and a historic cotton dress shirt (circa. 1920) were bleached using three separate methods: NaBH4 for 15 min; H2O2/NaBO3 for 1 h; and H2O2/NaBO3 buffered to pH 8.4 for 1 h. AFM was used in tapping-mode to obtain height, amplitude, and phase images. AFM imaging was able to distinguish between the cuticle, primary walls, and secondary walls of the cotton fibres. The data shows that bleaching has the effect of softening and removing individual layers of the cotton structure. Unprocessed cotton calico and scoured cotton fared better against the impact of bleaching. This was in stark contrast to the historic shirt where the already damaged surface of cotton fibres underwent further degradation using both oxidative and reductive bleaching. In general, reductive bleaching was more aggressive on the fibre surface compared to oxidative bleaching. The use of AFM provides further evidence of the physical effects of bleaching on historic textiles, and cotton textiles more broadly, and it has the potential to influence the conservator’s decision-making.
Adaptive learning: toward an intentional model for learning process guidance based on learner’s motivation
Authors: Bayounes Walid , Saâdi Ines Bayoudh , Kinshuk
Published: December 2022

The goal of ITS is to support learning content, activities, and resources, adapted to the specific needs of the individual learner and influenced by learner’s motivation. One of the major challenges to the mainstream adoption of adaptive learning is the complexity and time involved in guiding the learning process. To tackle these problems, this research proposes an intentional model that adopts Map formalism to support personalized learning guidance by considering learner’s motivation. For that, the intentional model adopts the ARCS model of motivation. The proposed model couples the learner’s intention with the learning strategies and provides a multitude of paths between learner intentions. Based on the learner’s motivation and the corresponding learning mode or the individual learning style, the ITS can adaptively support the learner to achieve his/her intention through the selected strategy. The first results show that this study’s provide implications for both theoretical research and the practical development of ITSs that will help education professionals make full use of ITSs. In the initial tests, the process model has met what was expected, however, more studies with experiments must be carried out.
A decellularized and sterilized human meniscus allograft for off-the-shelf meniscus replacement
Authors: Spierings Janne , Velthuijs Wietske , Mansoor Amal , Bertrand Manon E. , Uquillas Jorge Alfredo , Ito Keita , Janssen Rob P. A. , Foolen Jasper
Published: December 2022

Purpose

Meniscus tears are one of the most frequent orthopedic knee injuries, which are currently often treated performing meniscectomy. Clinical concerns comprise progressive degeneration of the meniscus tissue, a change in knee biomechanics, and an early onset of osteoarthritis. To overcome these problems, meniscal transplant surgery can be performed. However, adequate meniscal replacements remain to be a great challenge. In this research, we propose the use of a decellularized and sterilized human meniscus allograft as meniscal replacement.

Methods

Human menisci were subjected to a decellularization protocol combined with sterilization using supercritical carbon dioxide (scCO2). The decellularization efficiency of human meniscus tissue was evaluated via DNA quantification and Hematoxylin & Eosin (H&E) and DAPI staining. The mechanical properties of native, decellularized, and decellularized + sterilized meniscus tissue were evaluated, and its composition was determined via collagen and glycosaminoglycan (GAG) quantification, and a collagen and GAG stain. Additionally, cytocompatibility was determined in vitro.

Results

Human menisci were decellularized to DNA levels of ~ 20 ng/mg of tissue dry weight. The mechanical properties and composition of human meniscus were not significantly affected by decellularization and sterilization. Histologically, the decellularized and sterilized meniscus tissue had maintained its collagen and glycosaminoglycan structure and distribution. Besides, the processed tissues were not cytotoxic to seeded human dermal fibroblasts in vitro.

Conclusions

Human meniscus tissue was successfully decellularized, while maintaining biomechanical, structural, and compositional properties, without signs of in vitro cytotoxicity. The ease at which human meniscus tissue can be efficiently decellularized, while maintaining its native properties, paves the way towards clinical use.
What factors encourage the acceptance of cosmetic surgery? Differences in sociopsychological influences contingent upon cosmetic surgery experience
Authors: Kim Sunwoo
Published: December 2022

While numerous sociopsychological factors affect one’s acceptance of cosmetic surgery, little is known about the sociopsychological influences that lead to cosmetic surgery acceptance based on one’s prior experience with cosmetic surgery. The present study identified the differences between two groups: women with cosmetic surgery experience and women without prior cosmetic surgery experience. A research model was developed with five hypotheses to identify the four sociopsychological influences on cosmetic surgery acceptance: upward appearance comparison, awareness of an emphasis on beauty ideals, internalization of beauty ideals, and body surveillance. Data were collected from 651 South Korean women in their 20 s to 40 s and were analyzed using second-order confirmatory factor analysis and multi-group structural equation modeling. In the cosmetic surgery group, upward appearance comparison, awareness of an emphasis on beauty ideals, and body surveillance had a positive effect on cosmetic surgery acceptance. Internalization of beauty ideals and body surveillance also had a positive effect on cosmetic surgery acceptance in the no cosmetic surgery group. Additionally, the effects of upward appearance comparison, awareness of an emphasis on beauty ideals, and internalization of beauty ideals on cosmetic surgery acceptance varied significantly between the two groups. The findings add insights on the design of therapeutic programs to prevent cosmetic surgery addiction and education programs to increase body appreciation.
Retrospective assessment of porcine circovirus 3 (PCV-3) in formalin-fixed, paraffin-embedded tissues from pigs affected by different clinical-pathological conditions
Authors: Cobos Àlex , Sibila Marina , Alomar Jaume , Pérez Mónica , Huerta Eva , Segalés Joaquim
Published: December 2022

Background

Porcine circovirus 3 (PCV-3) is a recently discovered pathogen of swine that has been associated with several conditions. However, many questions remain unanswered regarding its infection, especially in terms of pathogenesis and disease impact. The aim of the present study was to retrospectively investigate the presence of PCV-3 genome by real time quantitative PCR (qPCR) and in situ hybridization (ISH) on selected formalin-fixed paraffin-embedded tissues of pigs affected by different clinical conditions and histological lesions.

Materials and methods

Conditions investigated included porcine dermatitis and nephropathy syndrome (PDNS), periweaning failure-to-thrive syndrome (PFTS), congenital tremors type AII, reproductive disorders, and pigs affected by systemic periarteritis/arteritis, myocarditis, or encephalitis. Studied cases (n = 587) were investigated from a diagnostic database (n = 4162) that comprised samples collected within the period 1998–2021. From each condition/lesion, 10 to 12 cases were subsequently selected and tested by qPCR and ISH (72 cases total).

Results

A total of 587 cases fulfilled inclusion criteria of the different studied conditions and were distributed among the seven groups. For the further selected cases, PCV-3 genome was found by qPCR in 12/12 periarteritis, 5/10 reproductive disease, 5/10 PFTS, 3/10 myocarditis, 1/10 encephalitis and 1/10 congenital tremor cases. PCV-3 was not found in any of the PDNS cases assessed. In periarteritis cases, tissues more commonly affected were mesenteric arteries and kidney. Reproductive disease cases associated to PCV-3 genome consistently displayed myocarditis. The lesions and labelling distribution of PFTS cases with presence of PCV-3 genome were comparable to those of the periarteritis group. qPCR and ISH yielded similar results within each studied case and were statistically comparable.

Conclusion

Our results suggest that periarteritis is the hallmark lesion of PCV-3-SD, and that mesenteric lymph node and kidney appeared to be the most reliable organs to confirm the presence of PCV-3 genome in cases with periarteritis.