bluuebunny/crossref_metadata_2025 huggingface dataset:
A mirror-image analysis of psychiatric hospitalisations among people with severe mental illness using Independent Supported Housing
Authors: Adamus Christine , Zürcher Simeon Joel , Richter Dirk
Published: July 2022

Background

Evidence on the effectiveness of Independent Supported Housing (ISH) for non-homeless people with severe mental illness primarily comes from observational cohort studies, which have high risk of bias due to confounding by time-invariant sample characteristics. The present study proposes an alternative study design known from pharmacology to overcome this bias and strengthen evidence.

Methods

We conducted a retrospective mirror-image analysis with medical records of 144 ISH service users to assess the effectiveness of ISH in reducing the number and duration of hospitalisations. Outcomes occurring in equal periods before and during ISH utilisation were compared for every ISH user. Differences between the periods were tested with incidence rate ratios (IRR).

Results

Included service users were on average 38.2 years old, female (54%) and predominately had an affective (28.5%) or a schizophrenic or psychotic (22.9%) disorder with ISH utilisation days ranging from 36–960. Fewer admissions (IRR = 0.41, 95%-CI 0.27–0.64) and fewer person-days hospitalised (IRR = 0.38, 95%-CI 0.35–0.41) were observed during ISH utilisation compared to prior to their ISH utilisation. While the reduction in psychiatric admissions may be somewhat confounded by time-variant characteristics, the substantial reduction in hospitalised bed-bays represents at least partially an intervention effect.

Conclusions

The mirror-image study design allowed for a cost-effective investigation of ISH effectiveness in reducing hospitalisation without confounding by time-invariant sample characteristics. We provide recommendations for the design’s application and suggest further research with larger samples.
Predicting the success of multimodal rehabilitation in chronic ankle instability based on patient-reported outcomes
Authors: Zhang Ran , Qi Qiushi , Song Weiqun , Chen Yaping
Published: July 2022

Background

The aim of this study was to identify potential indicators to predict the success of multimodal rehabilitation in chronic ankle instability (CAI) patients based on patient-reported outcomes.

Methods

Sixty patients with self-reported CAI participated. Their demographic information, injury history, and symptoms were recorded. Physical examinations and dynamic posture control tests were performed. The participants underwent sixteen 30-min treatment sessions of multimodal rehabilitation over 8 weeks. Fifty-one patients (85.0%) were available for follow-up after 8 weeks of the intervention. Treatment success was defined based on the participants’ perceived recovery using the global rating of change (GRC). Potential predictor variables were entered into a stepwise logistic regression model to identify variables for the prediction of treatment success.

Results

Forty of 51 participants (78.4%) were considered to have a successful outcome. Of the variables assessed, time since last sprain ≤ 8 months was a predictor of treatment success (p < 0.05). If a patient met the criteria, there was an 88.03% probability of successful multimodal rehabilitation.

Conclusion

A time since the last sprain ≤ 8 months may predict successful patient-reported outcomes after multimodal rehabilitation in CAI patients.

Level of evidence

Prospective study, Level 2.
Injury rates in female and male military personnel: a systematic review and meta-analysis
Authors: Schram Ben , Canetti Elisa , Orr Robin , Pope Rodney
Published: July 2022

Background

An effective military force is required to be agile, capable, efficient, and potent. Injuries to military personnel interrupt active-duty service and can detract from overall capability. These injuries are associated with a high individual and organizational burden, with lost work time and financial costs—all problematic for the ongoing functioning of a military force. Injury control strategies have therefore been described as force multipliers. Female personnel form an integral part of any modern defence force, but little research has examined their specific experiences of injury, to inform targeted injury control efforts. The aim of this review was to identify and synthesise findings from studies of injury rates and patterns in female military personnel, comparing them to those of male personnel.

Methods

A systematic search was conducted for studies which compared injury rates between the sexes at any stage of military service, from basic training through to deployment. Databases searched included PUBMED, CINAHL and Medline through OVID. Methodological quality of eligible articles was assessed using the Critical Appraisal Skills Program (CASP), and AXIS tools and data were extracted, synthesized, and, where possible, underwent meta-analysis.

Results

Of 2287 identified studies, a total of 25 studies were eligible and included. Methodological quality ranged from 60% up to a perfect score of 100%, with an average of 82% across all studies. Relative risks for injuries (reported as RR [95%CI]) to females when compared to males were 2.10 [1.89–2.33] during basic training, 1.70 [1.33–2.17] during officer training, and 1.23 [1.05–1.43] post initial training. After adjustment for differences between the sexes in average fitness levels (2-mile run time), there was no longer a significant difference in injury rates (adjusted RR: 0.95 [0.86–1.05]). Female personnel tended to make bigger improvements in their fitness during basic training than males and tended to report their injuries more frequently and sooner than males.

Conclusion

While this review found a higher rate of reported injuries in female military personnel when compared to male personnel, differences between the sexes in average fitness levels and injury reporting behaviours may largely explain this rate difference. The difference in rates of reported injuries was greatest during basic training, and reduced thereafter, possibly due in part to a reduced difference in fitness between the sexes or increased opportunity to self-determine workloads relative to fitness levels.
Perceived effectiveness of video interviews for orthopaedic surgery residency during COVID-19
Authors: Warren Jonathan R. , Khalil Lafi S. , Pietroski Alexander D. , Burdick Gabriel B. , McIntosh Michael J. , Guthrie Stuart T. , Muh Stephanie J.
Published: July 2022

Background

During the 2020–21 residency interview season, interviews were conducted through virtual platforms due to the COVID-19 pandemic. The purpose of this study is to assess the general perceptions of applicants, residents and attendings at a single, large, metropolitan orthopaedic residency with regards to the video interview process before and after the interview season.

Methods

Surveys were sent to all orthopaedic applicants, residents, and attendings before the interview season. Applicants who received interviews and responded to the first survey (46) and faculty who responded to the first survey (28) were sent a second survey after interviews to assess how their perceptions of video interviews changed.

Results

Initially, 50% of applicants (360/722) and 50% of faculty and residents (28/56) responded before interview season. After interviews, 55% of interviewees (25/46) and 64% of faculty and residents (18/28) responded. Before interviews, 91% of applicants stated they would prefer in-person interviews and 71% were worried that video interviews would prevent them from finding the best program fit. Before interviews, 100% of faculty and residents stated they would rather conduct in-person interviews and 86% felt that residencies would be less likely to find applicants who best fit the program. Comparing responses before and after interviews, 16% fewer applicants (p = 0.01) perceived that in-person interviews provide a better sense of a residency program and faculty and residents’ perceived ability to build rapport with interviewees improved in 11% of respondents (p = 0.01). However, in-person interviews were still heavily favored by interviewees (84%) and faculty and residents (88%) after the interview season.

Conclusions

In-person interviews for Orthopaedic Surgery Residency are perceived as superior and are preferred among the overwhelming majority of applicants, residents, and interviewers. Nevertheless, perceptions toward video interviews improved in certain domains after interview season, identifying potential areas of improvement and alternative interview options for future applicants.
Online selection of a physician by patients: the impression formation perspective
Authors: Huang Zhengwei , Duan Chen , Yang Yanni , Khanal Ribesh
Published: July 2022

Background

With the rapid development of online health communities (OHCs), an increasing number of physicians provide services in OHCs that enable patients to consult online in China. However, it is difficult for patients to figure out the professional level of doctors before consultation and diagnosis because of information asymmetry. A wealth of information about physicians is displayed in their profiles as a new way to help patients evaluate and select quickly and accurately.

Objective

This research explores how the profile information (PI) presented in OHCs influences patients' impression formation, especially the perception of professional capital (i.e., status capital and decisional capital). The impression influences their intention to consult further, which is partially mediated by the initial trust. The Toulmin’s model of argumentation is used to decide the strength of the argument presented in physicians’ homepage information and divide it into claim, data, and backing.

Methods

This study conducts an internet experiment and recruits 386 subjects through the internet to investigate the effect of impression formation on online selection behavior by a patient.

Results

The results show that the strength of argument has a significant positive association with the perception of professional capital. Perceptions of professional capital are highest when a fully composed argument (claim/data/backing) is included in a profile, with claim/data being the next highest and claim only the lowest. Recommendations from connections have the strongest impact. In turn, patients' selection decisions are influenced by their perception of professional capital, which is partially mediated by initial trust.

Conclusions

This study is significant in terms of its implications for theory and practice. On the one hand, this research contributes to the online health community literature and suggests that the perception of professional capital on physicians should be pre-presumed and built based on the information before in-person interaction online. On the other hand, this study is helpful in understanding the effect of various components included in PI on perceiving physicians’ abilities, and not all information is equally important.
Metabolic engineering of Corynebacterium glutamicum for efficient production of optically pure (2R,3R)-2,3-butanediol
Authors: Kou Mengyun , Cui Zhenzhen , Fu Jing , Dai Wei , Wang Zhiwen , Chen Tao
Published: July 2022

Background

2,3-butanediol is an important platform compound which has a wide range of applications, involving in medicine, chemical industry, food and other fields. Especially the optically pure (2R,3R)-2,3-butanediol can be employed as an antifreeze agent and as the precursor for producing chiral compounds. However, some (2R,3R)-2,3-butanediol overproducing strains are pathogenic such as Enterobacter cloacae and Klebsiella oxytoca.

Results

In this study, a (3R)-acetoin overproducing C. glutamicum strain, CGS9, was engineered to produce optically pure (2R,3R)-2,3-butanediol efficiently. Firstly, the gene bdhA from B. subtilis 168 was integrated into strain CGS9 and its expression level was further enhanced by using a strong promoter Psod and ribosome binding site (RBS) with high translation initiation rate, and the (2R,3R)-2,3-butanediol titer of the resulting strain was increased by 33.9%. Then the transhydrogenase gene udhA from E. coli was expressed to provide more NADH for 2,3-butanediol synthesis, which reduced the accumulation of the main byproduct acetoin by 57.2%. Next, a mutant atpG was integrated into strain CGK3, which increased the glucose consumption rate by 10.5% and the 2,3-butanediol productivity by 10.9% in shake-flask fermentation. Through fermentation engineering, the most promising strain CGK4 produced a titer of 144.9 g/L (2R,3R)-2,3-butanediol with a yield of 0.429 g/g glucose and a productivity of 1.10 g/L/h in fed-batch fermentation. The optical purity of the resulting (2R,3R)-2,3-butanediol surpassed 98%.

Conclusions

To the best of our knowledge, this is the highest titer of optically pure (2R,3R)-2,3-butanediol achieved by GRAS strains, and the result has demonstrated that C. glutamicum is a competitive candidate for (2R,3R)-2,3-butanediol production.
Scoping review of managed alcohol programs
Authors: Smith-Bernardin Shannon M. , Suen Leslie W. , Barr-Walker Jill , Cuervo Isabel Arrellano , Handley Margaret A.
Published: July 2022

Background

Internationally, strategies focusing on reducing alcohol-related harms in homeless populations with severe alcohol use disorder (AUD) continue to gain acceptance, especially when conventional modalities focused on alcohol abstinence have been unsuccessful. One such strategy is the managed alcohol program (MAP), an alcohol harm reduction program managing consumption by providing eligible individuals with regular doses of alcohol as a part of a structured program, and often providing resources such as housing and other social services. Evidence to the role of MAPs for individuals with AUD, including how MAPs are developed and implemented, is growing. Yet there has been limited collective review of literature findings.

Methods

We conducted a scoping review to answer, “What is being evaluated in studies of MAPs? What factors are associated with a successful MAP, from the perspective of client outcomes? What are the factors perceived as making them a good fit for clients and for communities?” We first conducted a systematic search in PubMed, Embase, PsycINFO, CINAHL, Sociological Abstracts, Social Services Abstracts, and Google Scholar. Next, we searched the gray literature (through focused Google and Ecosia searches) and references of included articles to identify additional studies. We also contacted experts to ensure relevant studies were not missed. All articles were independently screened and extracted.

Results

We included 32 studies with four categories of findings related to: (1) client outcomes resulting from MAP participation, (2) client experience within a MAP; (3) feasibility and fit considerations in MAP development within a community; and (4) recommendations for implementation and evaluation. There were 38 established MAPs found, of which 9 were featured in the literature. The majority were located in Canada; additional research works out of Australia, Poland, the USA, and the UK evaluate potential feasibility and fit of a MAP.

Conclusions

The growing literature showcases several outcomes of interest, with increasing efforts aimed at systematic measures by which to determine the effectiveness and potential risks of MAP. Based on a harm reduction approach, MAPs offer a promising, targeted intervention for individuals with severe AUD and experiencing homelessness. Research designs that allow for longitudinal follow-up and evaluation of health- and housing-sensitive outcomes are recommended.
Seminal plasma extracellular vesicles tRF-Val-AAC-010 can serve as a predictive factor of successful microdissection testicular sperm extraction in patients with non-obstructive azoospermia
Authors: Han Xiaoxiao , Hao Lin , Shi Zhenduo , Li Ying , Wang Liang , Li Zhenbei , Zhang Qiang , Hu Fangfang , Cao Yijuan , Pang Kun , Zhu Zuobin
Published: July 2022

Background

There is a lack of biomarkers for distinguishing non-obstructive azoospermia (NOA) patients with successful sperm retrieval (Sp+) from those with failed sperm retrieval (Sp-). This study aimed to determine the potential of extracellular vesicles tRNA-derived small RNA (tsRNA) as a novel non-invasive biomarker for successful sperm retrieval by microdissection testicular sperm extraction (mTESE).

Methods

The study included 18 patients with NOA with successful sperm retrieval (Sp+) and 23 patients with NOA with failed sperm retrieval (Sp-), 15 obstructive azoospermia (OA) patients, 5 idiopathic oligospermia (IO) patients, and 12 healthy people. Seminal plasma extracellular vesicles tsRNA levels were used in a two-stage case-control study (screened by tsRNA sequencing on Illumina NextSeq instrument and validated by qRT-PCR). The bioinformatic analysis was performed to determine the role of tsRNA in the pathogenesis of non-obstructive azoospermia.

Results

Two tsRNAs (tRF-Val-AAC-010: AUC = 0.96, specificity = 80%, sensitivity = 95%; tRF-Pro-AGG-003: AUC = 0.96, specificity = 87%, sensitivity = 95%) were found to have high predictive accuracy for distinguishing the origin of azoospermia. In addition, the extracellular vesicles tRF-Val-AAC-010 resulted in high predictive ability (AUC = 0.89, sensitivity = 72%, specificity = 91%, P < 0.0001) in predicting the presence of sperm in non-obstructive azoospermia undergoing mTESE. Finally, bioinformatic analysis revealed that tRF-Val-AAC-010 were involved in spermatogenesis.

Conclusions

This study identified that the extracellular vesicles tRF-Val-AAC-010 and tRF-Pro-AGG-003 are biomarkers for the diagnosis of non-obstructive azoospermia, and that tRF-Val-AAC-010 as a potential non-invasive biomarker for predicting the presence of sperm in non-obstructive azoospermia testicular tissue.
Acute kidney injury in critical COVID-19: a multicenter cohort analysis in seven large hospitals in Belgium
Authors: Schaubroeck Hannah , Vandenberghe Wim , Boer Willem , Boonen Eva , Dewulf Bram , Bourgeois Camille , Dubois Jasperina , Dumoulin Alexander , Fivez Tom , Gunst Jan , Hermans Greet , Lormans Piet , Meersseman Philippe , Mesotten Dieter , Stessel Björn , Vanhoof Marc , De Vlieger Greet , Hoste Eric
Published: July 2022

Background

Acute kidney injury (AKI) has been reported as a frequent complication of critical COVID-19. We aimed to evaluate the occurrence of AKI and use of kidney replacement therapy (KRT) in critical COVID-19, to assess patient and kidney outcomes and risk factors for AKI and differences in outcome when the diagnosis of AKI is based on urine output (UO) or on serum creatinine (sCr).

Methods

Multicenter, retrospective cohort analysis of patients with critical COVID-19 in seven large hospitals in Belgium. AKI was defined according to KDIGO within 21 days after ICU admission. Multivariable logistic regression analysis was used to explore the risk factors for developing AKI and to assess the association between AKI and ICU mortality.

Results

Of 1286 patients, 85.1% had AKI, and KRT was used in 9.8%. Older age, obesity, a higher APACHE II score and use of mechanical ventilation at day 1 of ICU stay were associated with an increased risk for AKI. After multivariable adjustment, all AKI stages were associated with ICU mortality. AKI was based on sCr in 40.1% and UO in 81.5% of patients. All AKI stages based on sCr and AKI stage 3 based on UO were associated with ICU mortality. Persistent AKI was present in 88.6% and acute kidney disease (AKD) in 87.6%. Rapid reversal of AKI yielded a better prognosis compared to persistent AKI and AKD. Kidney recovery was observed in 47.4% of surviving AKI patients.

Conclusions

Over 80% of critically ill COVID-19 patients had AKI. This was driven by the high occurrence rate of AKI defined by UO criteria. All AKI stages were associated with mortality (NCT04997915).
ZetaSuite: computational analysis of two-dimensional high-throughput data from multi-target screens and single-cell transcriptomics
Authors: Hao Yajing , Zhang Shuyang , Shao Changwei , Li Junhui , Zhao Guofeng , Zhang Dong-Er , Fu Xiang-Dong
Published: July 2022

Two-dimensional high-throughput data have become increasingly common in functional genomics studies, which raises new challenges in data analysis. Here, we introduce a new statistic called Zeta, initially developed to identify global splicing regulators from a two-dimensional RNAi screen, a high-throughput screen coupled with high-throughput functional readouts, and ZetaSuite, a software package to facilitate general application of the Zeta statistics. We compare our approach with existing methods using multiple benchmarked datasets and then demonstrate the broad utility of ZetaSuite in processing public data from large-scale cancer dependency screens and single-cell transcriptomics studies to elucidate novel biological insights.
Development of a highly efficient prime editor 2 system in plants
Authors: Li Juan , Chen Like , Liang Jing , Xu Rongfang , Jiang Yingli , Li Yizhen , Ding Jian , Li Min , Qin Ruiying , Wei Pengcheng
Published: July 2022

Low efficiency has seriously restricted the application of prime editing (PE) systems in plants. In this study, we develop an enhanced plant prime editor 2 system, enpPE2, by stacking various optimization strategies, including updating the PE architecture to PEmax and expressing engineered pegRNA with a structured motif under the control of a composite promoter. In T0 rice plants, enpPE2 exhibits editing frequencies of 64.58% to 77.08%, which are much higher than the frequencies with unmodified pPE2. Our results indicate that the enpPE2 system provides a robust and powerful tool for the precise modification of plant genomes.
Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial
Authors: Macaulay Lisa , O’Dolan Catriona , Avenell Alison , Carroll Paula , Cotton Seonaidh , Dombrowski Stephan , Elders Andrew , Goulao Beatriz , Gray Cindy , Harris Fiona M. , Hunt Kate , Kee Frank , MacLennan Graeme , McDonald Matthew David , McKinley Michelle , Skinner Rebecca , Torrens Claire , Tod Martin , Turner Katrina , van der Pol Marjon , Hoddinott Pat
Published: July 2022

Background

Obesity increases the risk of type 2 diabetes, heart disease, stroke, mobility problems and some cancers, and its prevalence is rising. Men engage less than women in existing weight loss interventions. Game of Stones builds on a successful feasibility study and aims to find out if automated text messages with or without endowment incentives are effective and cost-effective for weight loss at 12 months compared to a waiting list comparator arm in men with obesity.

Methods

A 3-arm, parallel group, assessor-blind superiority randomised controlled trial with process evaluation will recruit 585 adult men with body mass index of 30 kg/m2 or more living in and around three UK centres (Belfast, Bristol, Glasgow), purposively targeting disadvantaged areas. Intervention groups: (i) automated, theory-informed text messages daily for 12 months plus endowment incentives linked to verified weight loss targets at 3, 6 and 12 months; (ii) the same text messages and weight loss assessment protocol; (iii) comparator group: 12 month waiting list, then text messages for 3 months. The primary outcome is percentage weight change at 12 months from baseline. Secondary outcomes at 12 months are as follows: quality of life, wellbeing, mental health, weight stigma, behaviours, satisfaction and confidence. Follow-up includes weight at 24 months. A health economic evaluation will measure cost-effectiveness over the trial and over modelled lifetime: including health service resource-use and quality-adjusted life years. The cost-utility analysis will report incremental cost per quality-adjusted life years gained. Participant and service provider perspectives will be explored via telephone interviews, and exploratory mixed methods process evaluation analyses will focus on mental health, multiple long-term conditions, health inequalities and implementation strategies.

Discussion

The trial will report whether text messages (with and without cash incentives) can help men to lose weight over 1 year and maintain this for another year compared to a comparator group; the costs and benefits to the health service; and men’s experiences of the interventions. Process analyses with public involvement and service commissioner input will ensure that this open-source digital self-care intervention could be sustainable and scalable by a range of NHS or public services.

Trial registration

ISRCTN 91974895. Registered on 14/04/2021.
Concurrent molecular characterization of sand flies and Leishmania parasites by amplicon-based next-generation sequencing
Authors: Nasereddin Abedelmajeed , Ereqat Suheir , Al-Jawabreh Amer , Taradeh Mohamad , Abbasi Ibrahim , Al-Jawabreh Hanan , Sawalha Samer , Abdeen Ziad
Published: July 2022

Background

Phlebotomine sand flies are vectors of Leishmania parasites, which are the causative agents of leishmaniasis. Herein, we developed an amplicon-based next-generation sequencing (Amp-NGS) to characterize sand flies and Leishmania parasites simultaneously targeting partial fragments of 18S rDNA and ITS1 genes, respectively.

Methods

Our assay was optimized using reference sand fly (n = 8) and Leishmania spp. (n = 9) samples and validated using wild-caught sand flies from Palestine. The assay was highly specific, and all DNA references were successfully identified to the species level.

Results

Among the wild-caught sand flies (n = 187), Phlebotomus spp. represented 95% of the collected samples (177/187), including Ph. sergenti (147/187, 79%), Ph. papatasi (19/187, 10.2%), Ph. perfiliewi (3/187, 1.6%), Ph. tobbi (2/187, 1.2%) and Ph. syriacus (6/187, 3.2%). Sergentomyia spp. represented only 5% (10/187) of the collected samples and included S. dentata (n = 6), S. fallax (n = 2), S. schwetzi (n = 1) and S. ghesquiere (n = 1). The study observed strong positive correlation between sand fly identification results of the Amp-NGS and morphological identification method (r = 0.84, df = 185, P < 0.001). Some discrepancies between the two methods in the identification of closely related species (i.e. Ph. perfiliewi, Ph. tobbi and Ph. syriacus) were observed. Leishmania DNA was detected and identified as L. tropica in 14 samples (14/187, 7.5%).

Conclusions

Our assay was sensitive to detect (limit of detection was 0.0016 ng/reaction) and identify Leishmania DNA in sand flies, thus representing a new tool for studying sand flies and their associated Leishmania parasites in endemic areas.

Graphical Abstract
Intensive care unit versus high-dependency care unit admission on mortality in patients with septic shock: a retrospective cohort study using Japanese claims data
Authors: Endo Koji , Mizuno Kayoko , Seki Tomotsugu , Joo Woo Jin , Takeda Chikashi , Takeuchi Masato , Kawakami Koji
Published: July 2022

Background

Septic shock is a common and life-threatening condition that requires intensive care. Intensive care units (ICUs) in Japan are classified into ICUs and high-dependency care units (HDUs), depending on presence of full-time certified intensivists and the number of assigned nurses. Compared with other developed countries, there are fewer intensive care beds and certified intensivists in Japan; therefore, non-intensivists often treat patients with septic shock in HDUs. It is unknown where we should treat patients with septic shock because no studies have compared the clinical outcomes between ICU and HDU treatment. This study aimed to elucidate which units should admit patients with septic shock by comparing mortality data and resource use between ICU and HDU admissions.

Methods

In this retrospective cohort study, we used a nationwide Japanese administrative database to identify adult patients with septic shock who were admitted to ICUs or HDUs between January 2010 and February 2021. The patients were divided into two groups, based on admittance to ICU or HDU on the day of hospitalization. The primary outcome was 30-day all-cause mortality adjusted for covariates using Cox regression analyses; the secondary outcomes were the length of ICU or HDU stay and length of hospital stay.

Results

Of the 10,818 eligible hospitalizations for septic shock, 6584 were in the ICU group, and 4234 were in the HDU group. Cox regression analyses revealed that patients admitted to the ICUs had lower 30-day mortality (adjusted hazard ratio: 0.89; 95% confidence interval: 0.83–0.96; P = 0.005). Linear regression analyses showed no significant difference in hospital length of stay or ICU or HDU length of stay.

Conclusions

An association was observed between ICU admission and lower 30-day mortality in patients with septic shock. These findings could provide essential insights for building a more appropriate treatment system.
Gross tumor volume delineation in primary prostate cancer on 18F-PSMA-1007 PET/MRI and 68Ga-PSMA-11 PET/MRI
Authors: Zhang Yan-Nan , Lu Zhen-Guo , Wang Shuai-Dong , Lu Xin , Zhu Lei-Lei , Yang Xu , Fu Li-Ping , Zhao Jun , Wang Hai-Feng , Xiang Zuo-Lin
Published: July 2022

Background

We aimed to assess the clinical value of 18F-PSMA-1007 and 68Ga-PSMA-11 PET/MRI in the gross tumor volume (GTV) delineation of radiotherapy for prostate cancer (PCa).

Methods

Sixty-nine patients were retrospectively enrolled (57 in the 18F subgroup and 12 in the 68Ga subgroup). Three physicians delineated the GTV and tumor length by the visual method and threshold method with thresholds of 30%, 40%, 50%, and 60% SUVmax. The volume correlation and differences in GTVs were assessed. The dice similarity coefficient (DSC) was applied to estimate the spatial overlap between GTVs. For 51 patients undergoing radical prostatectomy, the tumor length (Lpath) of the maximum area was measured, and compared with the longest tumor length obtained based on the images (LMRI, LPET/MRI, LPET, LPET30%, LPET40%, LPET50%, LPET60%) to determine the best delineation method.

Results

In the 18F subgroup, (1) GTV-PET/MRI (p < 0.001) was significantly different from the reference GTV-MRI. DSC between them was > 0.7. (2) GTV-MRI (R2 = 0.462, p < 0.05) was the influencing factor of DSC. In the 68Ga subgroup, (1) GTV-PET/MRI (p < 0.05) was significantly different from the reference GTV-MRI. DSC between them was > 0.7. (2) There was a significant correlation between GTV-MRI (r = 0.580, p < 0.05) and DSC. The longest tumor length measured by PET/MRI was in good agreement with that measured by histopathological analysis in both subgroups.

Conclusion

It is feasible to visually delineate GTV on PSMA PET/MRI in PCa radiotherapy, and we emphasize the utility of PET/MRI fusion images in GTV delineation. In addition, the overlap degree was the highest between GTV-MRI and GTV-PET/MRI, and it increased with increasing volume.
Cure rate and associated factors for children 6–59 months with severe acute malnutrition under the out patient therapeutic care programme in the health centres of Kabale District in Southwestern Uganda: a cross sectional study
Authors: ssekajja Vincent , Wamani Henry , Kitutu Freddy Eric , Atukwase Abel
Published: July 2022

Background

Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality among children below five years with sub-Saharan Africa being the most affected. In Kabale district, SAM affects 2.9% children under the age of five. Uganda government introduced Outpatient therapeutic care (OTC) programme in all health centre level III and IV of Kabale. However, there was limited information about the cure rate and its associated factors among children under the programme hence the cause for the study.

Methods

A retrospective cross-sectional study was carried out on records of children 6–59 months (n = 637), presenting with SAM on OTC programme in the health centres of Kabale between 2013 and 2015. Data on cure rate (outcome) and other independent factors were collected, cleaned in excel and then exported into STATA 12 for analysis. Univariate, bivariate and logistic regression analysis was run to generate frequencies and factors associated.

Results

The cure rate was 36.3% (n = 231 cases) with a median recovery time of 21 days. The default rate was 58.6% (n = 373 cases) while the non-response and death rate were 0.6% (n = 4) and 1.1% (n = 7) respectively. Source at admission (Adjusted Odds Ratio [AOR] = 0.1, 95% CI 0.0, 0.7, p = 0.012), Weight at admission (AOR = 0.5, 95% CI 0.0, 0.9, p = 0.014) and Number of visits to the program (AOR = 14.9, 95% CI 9.3, 24.2, p = 0.040) were positively associated with cure rate of SAM children on OTC programme in Kabale.

Conclusion

Overall the cure and default rate for children on OTC programme in Kabale were significantly higher than national and international standards making the findings quite alarming. However, the weight of the child at admission, the number of visits to the programme to receive services and the source where the child was coming from were very important determinants of cure rate. To improve the cure rates of SAM children in Kabale, there is need for policy makers and programme implementers to think about a community based management of severe acute malnutrition program approach.
Motor speed does not impact the drift rate: a computational HDDM approach to differentiate cognitive and motor speed
Authors: Sandry Joshua , Ricker Timothy J.
Published: July 2022

The drift diffusion model (DDM) is a widely applied computational model of decision making that allows differentiation between latent cognitive and residual processes. One main assumption of the DDM that has undergone little empirical testing is the level of independence between cognitive and motor responses. If true, widespread incorporation of DDM estimation into applied and clinical settings could ease assessment of whether response disruption occurs due to cognitive or motor slowing. Across two experiments, we manipulated response force (motor speed) and set size to evaluate whether drift rates are independent of motor slowing or if motor slowing impacts the drift rate parameter. The hierarchical Bayesian drift diffusion model was used to quantify parameter estimates of drift rate, boundary separation, and non-decision time. Model comparison revealed changes in set size impacted the drift rate while changes in response force did not impact the drift rate, validating independence between drift rates and motor speed. Convergent validity between parameter estimates and traditional assessments of processing speed and motor function were weak or absent. Widespread application, including neurocognitive assessment where confounded changes in cognitive and motor slowing are pervasive, may provide a more process-pure measurement of information processing speed, leading to advanced disease-symptom management.
Perception of direct gaze in a video-conference setting: the effects of position and size
Authors: Horstmann Gernot , Linke Linda
Published: July 2022

A common problem in video conferences is gaze direction. In face-to-face communication, it is common that speaker and listener intermittently look at each other. In a video-conference setting, where multiple participants are on the screen, things are complicated and not necessarily optimal. If the listener feels looked at when the speaker looks into the camera, how tolerant is the listener for slight deviations? And does this depend on the position of the speaker’s tile on the screen, or the size of the tile? In a first experiment, participants from a student population judged whether they are looked at, while vertical gaze direction of the looker was varied. Furthermore, the position of the tile on the screen varied. The results showed that a slightly upward directed gaze was optimal for the direct gaze judgment, with a width of ± 4 degrees. Optimal gaze direction was somewhat higher for tiles at the bottom of the screen. A second experiment tested the effect of size on the perception of horizontal gaze directions. Size was found to increase the gaze cone. The paper concludes with some recommendations for a setup of video conference systems, optimized for perceived gaze contact.
Hypertonic saline in ICU setting: what is its position? A systematic review and empirical analysis
Authors: Dornelles Marco , Dornelles Erik P. , Dornelles Larissa P.
Published: July 2022

Background

Fluid overload has been linked to poor outcomes in the critically ill in recent years, with multiple studies showing an increase in mortality in the overall intensive care unit population. Although the administration of hypertonic saline has increased in recent years, few publications involving its use in intensive care unit have been published to date. The aim of this systematic review is to compare hypertonic and isotonic saline solutions and assess the current evidence to determine whether hypertonic saline can be used in the intensive care unit to treat critically ill or injured patients.

Main body

The PRISMA protocol was applied to conduct the search, which generated 622 possible trials. Only four papers were chosen and included in our study after duplicates and studies that did not fulfill our inclusion criteria, and outcomes were removed. The primary outcome was mortality, with the length of time spent in intensive care and in the hospital as secondary outcomes, and patients assessed in the intensive care unit ranged from 3 to 55, according to our revision. There were three to 24 trials in all, and not all of them used mortality or intensive care unit stay as an endpoint. The concentration of HS used in the intervention group ranged from 1.4 to 30%, while not all studies used isotonic saline solution as a control group.

Conclusions

Despite the limited scientific evidence, there seems to be support for the administration/use of hypertonic saline in the intensive care unit setting, in highly selected circumstance. Although hypertonic saline may have favorable therapeutic effects, no effect on mortality has been demonstrated. Patients suffering from a traumatic brain injury evidence suggests that hypertonic saline can effectively lower intracranial pressure, and there is a new trend supporting the use of hypertonic sodium solutions in these situations. Our updated review shows that studies still have a lot of variability, and that more controlled research are needed.
Laccase-functionalized magnetic framework composite enabled chlorophenols degradation, a potential remediation for fungicides residues in leather
Authors: Cao Min , Yu Jie , Zhang Xing , Lin Yamei , Huang He
Published: July 2022

Chlorophenols, used as the fungicides in leather, are strictly limited in leather products. In this work, a metal–organic framework material, zeolitic metal azolate framework-7 (MAF-7), was first used to encapsulate laccase (Lac) to prepare MAF-7/Lac bio-composites with 98.5% immobilization yield. Afterward, Lac/MNP@MOM was formed by introducing the magnetic nanoparticles (MNPs) into the Lac@MOM. MAF-7 with better hydrophilicity and stronger pH buffering ability, exhibits good compatibility with laccase, which can reserve the activity of laccase after immobilization. Moreover, the porous structure of MAF-7 is favorable for the sufficient contact between laccase and substrates. Lac/MNP@MOM exhibited excellent activity when exposed to high temperature, extreme pH, and organic solvents, which also simplified complex recovery steps. Furthermore, the degradation rate of 2,4-dichlorophenol (2,4-DCP) could reach as high as 97% within 24 h by immobilized laccase, and after nine consecutive cycles of operation, enzyme activity could remain over 80%, which gives it the potential for practical applications.

Graphical abstract
Role of PET/CT in the follow-up of postoperative and/or post-therapy cancer rectum: comparison with pelvic MRI
Authors: Faheem Mohamed H. , Nathan Evram , Youssef Ahmed Farid
Published: July 2022

Background

In locally advanced rectal cancer, many imaging modalities are used, for example 18F-2-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) and MRI. The aim of our study is to compare the diagnostic accuracy of 18 F-FDG-PET/CT & pelvic MRI; as well as to investigate the possible added value of using combined pelvic MRI and PET-CT for assessment of tumor response.

Results

Regarding the presence of local tumor, both PET CT and MRI showed perfect agreement with 97.1% overall accuracy, while in N category, PET CT showed higher specificity but lower sensitivity than MRI. MRI was superior to PET/CT in detecting extension to nearby organs; owing to the more anatomical details of MRI regarding the involvement of mesorectal fascia and EMVI. Almost total agreement of both MRI and PET/CT was noticed in evaluating post-therapy and postoperative complications.

Conclusion

For locally advanced rectal cancer (pT3–4 N0 M0 or any T N1 M0), a multimodality strategy has been shown to be the best option to evaluate local disease process, using the diagnostic criteria that were based on morphology, as well as glucose uptake, instead of the SUV alone for reassessment of post-therapy or postoperative changes.
The effectiveness of champions in implementing innovations in health care: a systematic review
Authors: Santos Wilmer J. , Graham Ian D. , Lalonde Michelle , Demery Varin Melissa , Squires Janet E.
Published: July 2022

Background

Champions have been documented in the literature as an important strategy for implementation, yet their effectiveness has not been well synthesized in the health care literature. The aim of this systematic review was to determine whether champions, tested in isolation from other implementation strategies, are effective at improving innovation use or outcomes in health care.

Methods

The JBI systematic review method guided this study. A peer-reviewed search strategy was applied to eight electronic databases to identify relevant articles. We included all published articles and unpublished theses and dissertations that used a quantitative study design to evaluate the effectiveness of champions in implementing innovations within health care settings. Two researchers independently completed study selection, data extraction, and quality appraisal. We used content analysis and vote counting to synthesize our data.

Results

After screening 7566 records titles and abstracts and 2090 full text articles, we included 35 studies in our review. Most of the studies (71.4%) operationalized the champion strategy by the presence or absence of a champion. In a subset of seven studies, five studies found associations between exposure to champions and increased use of best practices, programs, or technological innovations at an organizational level. In other subsets, the evidence pertaining to use of champions and innovation use by patients or providers, or at improving outcomes was either mixed or scarce.

Conclusions

We identified a small body of literature reporting an association between use of champions and increased instrumental use of innovations by organizations. However, more research is needed to determine causal relationship between champions and innovation use and outcomes. Even though there are no reported adverse effects in using champions, opportunity costs may be associated with their use. Until more evidence becomes available about the effectiveness of champions at increasing innovation use and outcomes, the decision to deploy champions should consider the needs and resources of the organization and include an evaluation plan. To further our understanding of champions’ effectiveness, future studies should (1) use experimental study designs in conjunction with process evaluations, (2) describe champions and their activities and (3) rigorously evaluate the effectiveness of champions’ activities.

Registration

Open Science Framework (https://osf.io/ba3d2). Registered on November 15, 2020.
Management of self-injurious behaviour, reducing restrictive interventions and predictors of positive outcome in intellectual disability and/or autism
Authors: Biswas Asit , Gumber Rohit , Furniss Frederick
Published: July 2022

Perceptions of self-injurious behaviour as refractory to treatment, and of treatment outcomes as unpredictable, in children and adults with intellectual disabilities and/or autism may lead to treatment inertia or nihilism, restrictive practices and overuse of psychotropic medication in its management. Recent research suggests, however, that from infancy to young adulthood prospects for a positive outcome are fair, and markers predictive of treatment outcome have begun to be identified. In this clinical reflection we briefly describe this work, consider how it may contribute to case stratification, and outline current thinking on further functional differentiation of cases of SIB, promoting non-restrictive practices.
The consequences of a year of the COVID-19 pandemic for the mental health of young adult twins in England and Wales
Authors: Rimfeld Kaili , Malanchini Margherita , Arathimos Ryan , Gidziela Agnieszka , Pain Oliver , McMillan Andrew , Ogden Rachel , Webster Louise , Packer Amy E. , Shakeshaft Nicholas G. , Schofield Kerry L. , Pingault Jean-Baptiste , Allegrini Andrea G. , Stringaris Argyris , von Stumm Sophie , Lewis Cathryn M. , Plomin Robert
Published: July 2022

Background

The COVID-19 pandemic has affected all our lives, not only through the infection itself but also through the measures taken to control the spread of the virus (e.g. lockdown).

Aims

Here, we investigated how the COVID-19 pandemic and unprecedented lockdown affected the mental health of young adults in England and Wales.

Method

We compared the mental health symptoms of up to 4773 twins in their mid-20s in 2018 prior to the COVID-19 pandemic (T1) and during four-wave longitudinal data collection during the pandemic in April, July and October 2020, and in March 2021 (T2–T5) using phenotypic and genetic longitudinal designs.

Results

The average changes in mental health were small to medium and mainly occurred from T1 to T2 (average Cohen d = 0.14). Despite the expectation of catastrophic effects of the pandemic on mental health, we did not observe trends in worsening mental health during the pandemic (T3–T5). Young people with pre-existing mental health problems were disproportionately affected at the beginning of the pandemic, but their increased problems largely subsided as the pandemic persisted. Twin analyses indicated that the aetiology of individual differences in mental health symptoms did not change during the lockdown (average heritability 33%); the average genetic correlation between T1 and T2–T5 was 0.95, indicating that genetic effects before the pandemic were substantially correlated with genetic effects up to a year later.

Conclusions

We conclude that on average the mental health of young adults in England and Wales has been remarkably resilient to the effects of the pandemic and associated lockdown.
Superior terahertz sensing metasurface based on ultrahigh-Q toroidal dipole governed by quasi-BIC
Authors: Zhao Jing , Zhang Lei , Li Yongdong
Published: July 2022

Sharp quasi-bound states in the continuum (quasi-BIC) in all-dielectric metasurfaces with high quality-factor (Q-factor) resonance provide an important platform for terahertz (THz) sensing technology because of its ability to enhance the strong light-matter interaction between THz waves and analytes. In this paper, we propose an ultrasensitive sensing substrate based on an all-dielectric metasurface consisting of an array of stacked high-index structures. By introducing a geometry asymmetry along the horizontal direction in the unit cell, a toroidal-dipole–dominated quasi-BIC transitioned from a distorted symmetry-protected BIC is excited with a Q-factor as high as

, which could maintain at a high level as the structure geometry varies. After characterizing the surface sensing performance, an ultrahigh surface sensitivity is achieved to be 263GHz per refractive index unit, while the resultant figure of merit reaches

, which outperforms the existing designs. The proposed metasurface is promising for superior label-free sensing performance at THz regime.