bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of leukoreduction and temperature on risk of bacterial growth in CPDA‐1 whole blood: A study of Escherichia coli
Authors: Braathen Hanne , Sivertsen Joar , Lunde Turid Helen Felli , Strandenes Geir , Lindemann Paul Christoffer , Assmus Jörg , Hervig Tor Audun , Apelseth Torunn Oveland
Published: July 2021

Background

Collection of non‐leukoreduced citrate‐phosphate‐dextrose‐adenine (CPDA‐1) whole blood is performed in walking blood banks. Blood collected under field conditions may have increased risk of bacterial contamination. This study was conducted to examine the effects of WBC reduction and storage temperature on growth of Escherichia coli (ATCC® 25922™) in CPDA‐1 whole blood.

Methods

CPDA‐1 whole blood of 450 ml from 10 group O donors was inoculated with E. coli. Two hours after inoculation, the test bags were leukoreduced with a platelet‐sparing filter. The control bags remained unfiltered. Each whole blood bag was then split into three smaller bags for further storage at 2–6°C, 20–24°C, or 33–37°C. Bacterial growth was quantified immediately, 2 and 3 h after inoculation, on days 1, 3, 7, and 14 for all storage temperatures, and on days 21 and 35 for storage at 2–6°C.

Results

Whole blood was inoculated with a median of 19.5 (range 12.0–32.0) colony‐forming units per ml (CFU/ml) E. coli. After leukoreduction, a median of 3.3 CFU/ml (range 0.0–33.3) E. coli remained. In the control arm, the WBCs phagocytized E. coli within 24 h at 20–24°C and 33–37°C in 9 of 10 bags. During storage at 2–6°C, a slow self‐sterilization occurred over time with and without leukoreduction.

Conclusions

Storage at 20–24°C and 33–37°C for up to 24 h before leukoreduction reduces the risk of E. coli‐contamination in CPDA‐1 whole blood. Subsequent storage at 2–6°C will further reduce the growth of E. coli.
Intraoperative blood transfusions in burn patients
Authors: Rizzo Julie A. , Ross Evan , Ostrowski Megan L. , Gomez Brian G. , Aden James K. , Cap Andrew P.
Published: July 2021

Background

Donated blood is a valuable and limited resource. Excision of burn wounds often leads to significant blood loss requiring transfusion. Accurately estimating blood loss is difficult, so examining the amount of blood products given intraoperatively is a clinically relevant way to measure utilization of this valuable resource. In this study, we examined the factors that influenced the amount of blood given intraoperatively during burn wound excisions.

Study Design and Methods

A retrospective analysis of patients admitted to a single burn center over 5 years who underwent excision of their burn wounds and received intraoperative blood products was performed. Patient and burn characteristics as well as pertinent surgical data and laboratory values on the day of surgery and postoperatively were gathered. A linear regression analysis examined factors influencing the number of units of products given and a predictive model was generated.

Results

A total of 563 operations performed on 166 patients were included. The amount of burn excised was the most influential variable on the amount of blood products given. Hemoglobin level, international normalized ratio, and platelet count on the day of surgery were associated with transfusion of different blood products. A predictive model was generated to aid in preoperative ordering of blood products.

Conclusion

The amount of burn excised and common hematology and coagulation lab values were associated with the amount of different blood products administered during burn surgery. The predictive model generated needs to be validated prospectively to aid in preoperative planning for burn excisions.
If you build it, they will learn: A review of models in veterinary surgical education
Authors: Hunt Julie A. , Simons Micha C. , Anderson Stacy L.
Published: July 2021

Surgical skills are learned through deliberate practice, and veterinary educators are increasingly turning to models for teaching and assessing surgical skills. This review article sought to compile and review the literature specific to veterinary surgical skills models, and to discuss the themes of fidelity, educational outcomes, and validity evidence. Several literature searches using broad terms such as “veterinary surgery model,” “veterinary surgical model,” and “veterinary surgical simulator” were performed using PubMed, CAB abstracts, and Google scholar. All articles describing a model created and utilized for veterinary surgical training were included. Other review articles were used as a source for additional models. Commercially available models were found using review articles, internet browser searches, and communication with veterinary clinical skills educators. There has been an explosion of growth in the variety of small animal surgical task trainers published in the last several decades. These models teach orthopedic surgery, ligation and suturing, open celiotomy and abdominal surgery, sterilization surgeries, and minimally invasive surgeries. Some models were published with accompanying rubrics for learner assessment; these rubrics have been noted where present. Research in veterinary surgical models is expanding and becoming an area of focus for academic institutions. However, there is room for growth in the collection of validity evidence and in development of models for teaching large animal surgery, training surgical residents, and providing continuing education to practitioners. This review can assist with evaluation of current surgical models and trends, and provide a platform for additional studies and development of best practices.
Condiciones asociadas a la hiperfrecuentación según número anual de consultas en una institución de salud de primer nivel de atención en Medellín, Colombia, 2018
Authors: Morales Botero John Jairo , Montoya Sierra Silvana Montoya , Gómez-Arias Rubén Darío
Published: July 2021

Objetivo. Describir y comparar el comportamiento de la hiperfrecuentación a partir de tres modelos multivariados e identificar las condiciones demográficas, socioeconómicas, clínicas y administrativas que pudieran asociarse con su prevalencia en una institución prestadora de servicios de salud. Materiales y métodos. Estudio transversal sobre el censo de atenciones registradas durante un año. Se estudiaron variables demográficas, socioeconómicas, clínicas y administrativas. Ante la ausencia de acuerdo en el concepto de hiperfrecuentación se estudiaron tres escenarios para tres, ocho y diez consultas o más durante el periodo de estudio. Se midió la prevalencia de las variables y se establecieron asociaciones bi y multivariadas con base en la Razón de Oportunidades (OR por sus siglas en inglés). Resultados. Un mayor número de consultas se asoció estadísticamente con ser mujer, mayor de 60 años, contar con pareja, asistir a consultas programadas de prevención, consultar en el primer semestre del año, tener algún diagnóstico de enfermedades del sistema osteomuscular o del tejido conectivo y haber recibido cuatro o más días de incapacidad en el año. Algunos tamaños del efecto fueron pequeños y su utilidad práctica puede ser limitada. Conclusiones. Comprender la hiperfrecuentación exige considerar condiciones individuales, del sistema de salud, del contexto sociocultural y la legislación vigente. Se recomienda realizar auditorías de calidad y estudios cualitativos que exploren la percepción de los pacientes sobre su estado de salud y utilización de los servicios.
The Unified Theory of Tubesheet Design—Part I: Theoretical Foundation
Authors: Zhu Hong-Song , Zhai Jinguo
Published: July 2021

The unified theory of tubesheet (TS) design for fixed TS heat exchangers (HEXs), floating head and U-tube HEXs is developed by removing the midplane symmetry (MPS) assumption, which assumes a geometric and loading plane of symmetry at the midway between the two TSs so that only half of the HEX or one TS need be considered. The unified theory can be successfully extended to all common types of HEXs, with arbitrary combinations of TS configurations for two TSs, and with arbitrary material properties and temperature for each component due to less assumptions. The effects of unperforated annual plate, TS flange, gravitational (e.g., dead-weight of tubes, catalyst inside tubes, shell side fluid and tube side fluid) and fluid flow pressure loss, bending stiffness of the tubes, TS in-plane stretch, pressure in TS perforations as well as temperature gradient across TS are also evaluated by the unified theory. Theoretical analysis shows that the existing theories of TS design can be derived from the unified theory as special deductions. The limitations and problems faced in the existing theories and codes are systematically reviewed and solutions to these limitations and problems are also provided by the unified theory. Numerical comparisons indicate that predictions given by the unified theory agree well with finite element analysis (FEA), while ASME results are not accurate or not correct and may lead to unsafety design.
Plasmid hypermutation using a targeted artificial DNA replisome
Authors: Yi Xiao , Khey Joleen , Kazlauskas Romas J. , Travisano Michael
Published: July 2021

A designed protein complex processively copies one strand of a plasmid with errors to speed up molecular evolution in vivo.
OAS1/RNase L executes RIG-I ligand–dependent tumor cell apoptosis
Authors: Boehmer Daniel F. R. , Formisano Simone , de Oliveira Mann Carina C. , Mueller Stephan A. , Kluge Michael , Metzger Philipp , Rohlfs Meino , Hörth Christine , Kocheise Lorenz , Lichtenthaler Stefan F. , Hopfner Karl-Peter , Endres Stefan , Rothenfusser Simon , Friedel Caroline C. , Duewell Peter , Schnurr Max , Koenig Lars M.
Published: July 2021

5′-Triphosphate RNA–induced apoptosis consists of a RIG-I–dependent priming and an OAS1/RNase L–dependent effector phase.
Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA): a study protocol using codesign and participatory action research
Authors: Svedin Frida , Brantnell Anders , Farrand Paul , Blomberg Oscar , Coumoundouros Chelsea , von Essen Louise , Åberg Anna Cristina , Woodford Joanne
Published: July 2021

Introduction

Dementia is a worldwide health concern with incident rates continuing to increase. While depression prevalence is high in people with dementia and psychological interventions such as cognitive behavioural therapy (CBT) are effective, access to psychological interventions remains limited. Reliance on traditional CBT for people with dementia and depression may present difficulties given it is a complex psychological approach, costly to deliver, and professional training time is lengthy. An alternative approach is behavioural activation (BA), a simpler psychological intervention for depression. The present study seeks to work with people with dementia, informal caregivers, community stakeholders, and healthcare professionals, to adapt a guided low-intensity BA intervention for people with dementia and depression, while maximising implementation potential within the Swedish healthcare context.

Methods and analysis

A mixed methods study using codesign, principles from participatory action research (PAR) and normalisation process theory to facilitate the cultural relevance, appropriateness and implementation potential of the intervention. The study will consist of four iterative PAR phases, using focus groups with healthcare professionals and community stakeholders, and semi-structured interviews with people with dementia and informal caregivers. A content analysis approach will be adopted to analyse the transcribed focus groups and semi-structured interviews recordings.

Ethics and dissemination

The study will be conducted in accordance with the Declaration of Helsinki and data handled according to General Data Protection Regulation. Written informed consent will be obtained from all study participants. In accordance with the Swedish Health and Medical Services Act, capacity to consent will be examined by a member of the research team. Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-05542 and Dnr: 2021-00925). Findings will be published in an open access peer-reviewed journal, presented at academic conferences, and disseminated among lay and healthcare professional audiences.
COVID-19-related attitudes, risk perceptions, preventive behaviours and economic impact in sub-Saharan African countries: implementing a longitudinal phone-based survey protocol in rural Senegalese households
Authors: Seror Valerie , Maradan Gwenaëlle , Ba El-Hadj , Cortaredona Sebastien , Berenger Cyril , L’Haridon Olivier , Sokhna Cheikh
Published: July 2021

Introduction

Rural areas are considered safe havens against the increased spread of COVID-19 and associated restrictive measures, especially in contexts where public authorities are not in a position to systematically and substantially ease COVID-19-induced economic shocks. In the current sub-Saharan Africa context, still marked by uncertainty surrounding the spread of COVID-19, we present the protocol of an ongoing longitudinal study aimed at investigating COVID-19-related attitudes, risks perceptions, preventive behaviours and economic impact in rural areas in Senegal.

Methods and analysis

A prospective randomised longitudinal study of 600 households located in three semiurban villages and nine randomly selected rural villages in the Niakhar area (located 135 km East of Dakar). Three ad hoc phone surveys are administered to 600 heads of households, their housewives in charge of managing the household and a relative living temporarily in the household, respectively. In addition to sharing identical sets of questions on several topics (risks perceptions, attitudes to curfew, attitudes to vaccines, beliefs about COVID-19 infection), the three separate survey questionnaires also include other topics (economic impact, local preventive strategies) whose related questions differ between questionnaires. As analysing evolutions is the study’s primary focus, data on all the topics covered will be collected in three waves unless the spread of COVID-19 by mid-2021 justifies extending data collection. The present article presents the study protocol and details about the implementation of the first wave of data collection which started in July 2020. The decision to wait before presenting the protocol was based on the unprecedented context the COVID-19 pandemic.

Ethics and dissemination

The survey’s protocol was approved by the Senegalese National Ethical Committee for Research in Health (131/MSAS/CNERS/Sec) and received authorisation from both the Senegalese Ministry of Health (619/MSAS/DPRS/DR) and the French Commission on Information Technology and Liberties (CNIL 2220771).
Cellulitis in children: a retrospective single centre study from Australia
Authors: Salleo Elise , MacKay Conor I , Cannon Jeffrey , King Barbara , Bowen Asha C
Published: July 2021

Aim

To characterise the epidemiology, clinical features and treatment of paediatric cellulitis.

Methods

A retrospective study of children presenting to a paediatric tertiary hospital in Western Australia, Australia in 2018. All inpatient records from 1 January to 31 December 2018 and emergency department presentations from 1 July to 31 December 2018 were screened for inclusion.

Results

302 episodes of cellulitis were included comprising 206 (68.2%) admitted children and 96 (31.8%) non-admitted children. The median age was 5 years (IQR 2–9), 40 (13.2%) were Aboriginal and 180 (59.6%) boys. The extremities were the most commonly affected body site among admitted and non-admitted patients. There was a greater proportion of facial cellulitis in admitted patients (27.2%) compared with non-admitted patients (5.2%, p<0.01). Wound swab was the most frequent microbiological investigation (133/302, 44.0%), yielding positive cultures in the majority of those tested (109/133, 82.0%). The most frequent organisms identified were Staphylococcus aureus (94/109, 86.2%) (methicillin-susceptible S. aureus (60/94, 63.8%), methicillin-resistant S. aureus) and Streptococcus pyogenes (22/109, 20.2%) with 14 identifying both S. aureus and S. pyogenes. Intravenous flucloxacillin was the preferred antibiotic (154/199, 77.4%), with median intravenous duration 2 days (IQR 2–3), oral 6 days (IQR 5–7) and total 8 days (IQR 7–10).

Conclusions

Cellulitis is a common reason for presentation to a tertiary paediatric hospital. We confirm a high prevalence of extremity cellulitis and demonstrate that children with facial cellulitis often require admission. Cellulitis disproportionately affected Aboriginal children and children below 5 years. Prevention of cellulitis involves early recognition and treatment of skin infections such as impetigo and scabies.
Prevalence of traumatic psychological stress reactions in children and parents following paediatric surgery: a systematic review and meta-analysis
Authors: Turgoose David Paul , Kerr Stephanie , De Coppi Paolo , Blackburn Simon , Wilkinson Simon , Rooney Natasha , Martin Richard , Gray Suzanne , Hudson Lee Duncan
Published: July 2021

Background

Children undergoing surgery and their parents are at risk of developing post-traumatic stress reactions. We systematically reviewed the literature to understand the prevalence of this issue, as well as potential risk factors.

Methods

We conducted a systematic review and meta-analysis, using PubMed, PsycInfo, Web of Science and Google Scholar, with searches conducted in February 2021. Papers were included if they measured post-traumatic stress in children and/or parents following paediatric surgery and were excluded if they did not use a validated measure of post-traumatic stress. Data were extracted from published reports.

Findings

Our search yielded a total of 1672 papers, of which 16 met our inclusion criteria. In meta-analysis, pooled studies of children estimated an overall prevalence of 16% meeting criteria for post-traumatic stress disorder post surgery (N=187, 95% CI 5% to 31%, I2=80%). After pooling studies of parents, overall prevalence was estimated at 23% (N=1444, 95% CI 16% to 31%, I2=91%). Prevalence rates were higher than those reported in the general population. Risk factors reported within studies included length of stay, level of social support and parental mental health.

Interpretation

There is consistent evidence of traumatic stress following surgery in childhood which warrants further investigation. Those delivering surgical care to children would benefit from a raised awareness of the potential for post-traumatic stress in their patients and their families, including offering screening and support.
Coronary artery calcium score may be a novel predictor of COVID-19 prognosis: a retrospective study
Authors: Takeshita Yuichiro , Terada Jiro , Fujita Retsu , Hirasawa Yasutaka , Kinoshita Taku , Isaka Yuri , Kinouchi Toru , Tajima Hiroshi , Tada Yuji , Kiryu Shigeru , Tsushima Kenji
Published: July 2021

Background

Although several studies have reported an association between atherosclerosis-related diseases and COVID-19, the relationship between COVID-19 severity and atherosclerosis progression remains unclear. The aim of this study is to determine the coronary artery calcium score (CACS) prognostic value in patients with COVID-19 using indices such as deterioration in oxygenation and CT images of the chest.

Methods

This was a single-centre retrospective study of 53 consecutive patients with COVID-19 in Narita who were admitted to our hospital between March 2020 and August 2020. CACS was calculated based on non-gated CT scans of the chest performed on admission day. The patients were divided into the following two groups based on CACS: group 1 (CACS ≥180, n=11) and group 2 (CACS <180, n=42). Following univariate analysis of the main variables, multivariate analysis of variables that may be associated with COVID-19 progression was performed.

Results

Multivariable logistic regression analysis of age, sex, smoking history, diabetes, hypertension, dyslipidaemia, number of days from symptom onset to hospitalisation and CACS of ≥180 was performed. It revealed that unlike CACS of <180, CACS of ≥180 is associated with exacerbation of oxygenation or CT images of the chest during hospitalisation (OR: 12.879, 95% CI: 1.399 to 380.401). Furthermore, this model of eight variables showed good calibration (Hosmer-Lemeshow p=0.119).

Conclusion

CACS may be a prognosis marker of COVID-19 severity. Although coronary artery calcification is not typically assessed in pneumonia cases, it may provide a valuable clinical indicator for predicting severe COVID-19 outcomes.
#3101 Imbalanced basal ganglia connectivity is associated with motor deficits and apathy in Huntingtons disease: first evidence from human in vivo neuroimaging
Authors: Nair Akshay , Razi Adeel , Gregory Sarah , Rutledge Robb , Rees Geraint , Tabrizi Sarah
Published: July 2021

Background

The gating of movement in humans is thought to depend on activity within the cortico-striato-thalamic loops. Within these loops, emerging from the cells of the striatum, run two opponent pathways the direct and indirect pathway. Both are complex and polysynaptic but the overall effect of activity within these pathways is to encourage and inhibit movement respectively. In Huntingtons disease (HD), the preferential early loss of striatal neurons forming the indirect pathway is thought to lead to disinhibition that gives rise to the characteristic motor features of the condition. But early HD is also specifically associated with apathy, a failure to engage in goal-directed movement. We hypothesised that in HD, motor signs and apathy may be selectively correlated with indirect and direct pathway dysfunction respectively.

Methods

Using a novel technique for estimating dynamic effective connectivity of the basal ganglia, we tested both of these hypotheses in vivo for the first time in a large cohort of patients with prodromal HD (n = 94). We used spectral dynamic casual modelling of resting state fMRI data to model effective connectivity in a model of these cortico-striatal pathways. We used an advanced approach at the group level by combining Parametric Empirical Bayes and Bayesian Model Reduction procedure to generate large number of competing models and compare them by using Bayesian model comparison.

Results

With this fully Bayesian approach, associations between clinical measures and connectivity parameters emerge de novo from the data. We found very strong evidence (posterior probability > 0.99) to support both of our hypotheses. Firstly, more severe motor signs in HD were associated with altered connectivity in the indirect pathway and by comparison, loss of goal-direct behaviour or apathy, was associated with changes in the direct pathway component of our model.

Conclusions

The empirical evidence we provide here is the first in vivo demonstration that imbalanced basal ganglia connectivity may play an important role in the pathogenesis of some of commonest and disabling features of HD and may have important implications for therapeutics.
#2950 Should the presence of neurodegenerative disease alter our management and understanding of psychiatric comorbidities?
Authors: Blake Jack , List Penny , El-Nimr George
Published: July 2021

As people are living longer, we are seeing more neurodegenerative diseases (NDs). NDs have both neurological and psychiatric manifestations. Depression and anxiety are common comorbidities in Alzheimers and Parkinsons disease. The diagnosis and intervention of depression and anxiety on the background of the aforementioned NDs is complicated by cognitive and motor disturbance. We aim to capture a general overview of the diagnostic and management challenges and compare these with the National Institute for Health and Care Excellence (NICE) guidance to identify any disparities that may exist.

A general review of this topic was sought through the MEDLINE database. Papers matching search terms were selected based on size, novelty and relevance to diagnostics or treatment of the psychiatric complications, namely depression and anxiety, in Parkinsons (PD) and Alzheimers disease (AD). Large systematic reviews helped establish strong evidence, novelty allowed for emerging ideas to be identified and all articles were relevant to either PD or AD.

The general approach to these psychiatric manifestations by non-specialists is as a one-size-fits-all approach. The efficacy of pharmacological treatments is questionable as often the side effects are much worse in this population and the action may vary on the degenerating anatomy. Many non-pharmacological treatments exist with some less traditional methods showing positive results including therapies focused on informal carers.

Drawing on the expertise of neuropsychiatrists and non-conventional therapies could yield better management of these patients and inform NICE guidance which would improve practice nationally.
#3118 Tic-severity moderators: a systematic review on the subjectivity of external and internal factors in moderating tic-severity in Tourette’s syndrome
Authors: Conti Francesca , Tyagi Himanshu
Published: July 2021

Objectives

Changes in the severity of tics in Tourettes syndrome (TS), as seen with variations in the intensity or frequency of tics, can be moderated by a variety of independent simple or complex factors suchasexternalorinternalstimulioverlaidwithpsychologicalandphysiological variables. Identifying such moderators has important clinical implications as it can aid clinicians in adjusting interventions. Here we review research literature related to tic-severity moderators and their tic-worsening, tic-improving and neutral effects in individuals with TS with the aim to create a clinical inventory of moderating variables.

Methods

A literature search using terms relating to tic severity, tic frequency, factors and moderators was conducted on Ovid Medline, Psych Info, APA Psych Articles, ProQuest,Scopus and PubMed following PRISMA guidelines. The criteria for this review included any published study, review and meta-analysis after the last review in 2008, investigating external and internal factors that had a tic-worsening, improving or neutral effect on children, adolescents or adults with TS and comorbidities.

Results

225 studies were initially identified after deduplication. A variety of tic severity moderators were identified with the most prominent being the effects of exe, sleep, distraction and comorbidities such as ADHD. However, an interesting finding was the high variability in these tic-moderating effects, as the same factor was tic-worsening in some patients and tic-improving in others, highlighting the subjectivity of these effects on tic severity. It was also noted that most of there viewed research did not report the possibility of a neutral effect.

Conclusions

As previous research has looked at these moderators in a dichotomous way, clinicians and researchers should be made more aware of the existence and variability of these tic severity moderators and of their highly subjective effects. This also has important, direct implications for the psychological assessment and treatment of tics. This review invites future research and clinicians to take this holistic approach on the effects ontic severity into consideration.
#3116 Preliminary findings of visual hallucinations in organic psychosis: a meta-analysis
Authors: Dadwal Amber Kaur , Teixeira-Dias Maria , Blackman Graham
Published: July 2021

Objectives/Aims

In some cases, psychosis arises due to a secondary, or organic cause. Identifying these cases early on is important in ensuring these patients receive appropriate management, which may reverse the underlying cause. Determining whether the psychiatric phenotype differs in patients with an organic cause would be a major advance in the field. We sought to determine whether the presence and content of visual hallucinations was associated with an organic cause of psychosis.

Methods

A meta-analysis of case-control studies was conducted. PubMed, OVID, MEDLINE, Embase, Psych INFO and Global Health databases were searched without date restrictions by two researchers using the keywords Psychos* AND Schizophreni* AND Visual hallucinat*. The inclusion criteria were a) reported frequency of visual hallucinations, b) categorisation of patients into having an organic or non-organic psychosis and c) publication in English. A random-effects model, following the DerSimonian and Laird method, was used to pool studies to generate overall odds ratios (OR) and 95% confidence intervals (CI).

Results

Fifteen studies (890 organic and 955 non-organic psychosis patients) were included. Visual hallucinations were significantly associated with organic psychosis (OR = 3.17, 95% CI = 1.92, 5.24), however there was moderate between-study heterogeneity (I2 = 70%).In the 4 studies where content was reported (158 organic and 52 non-organic psychosis patients), visual hallucinations most frequently took the form of people in both organic (n = 76; 48.1%) and non-organic psychosis (n = 31; 59.6%). However, inanimate objects were significantly associated with organic psychosis (χ2(1) = 5.44, p = 0.020).

Conclusions

Visual hallucinations are associated with organic psychosis. The presence of visual hallucinations, and in particular inanimate objects, may serve as a potential red flag for an organic psychosis. Findings have important clinical utility, as a simple and convenient bedside assessment to inform which patients would benefit from further neurological investigation.
#3104 Is dipsogenic diabetes insipidus the same condition as psychogenic polydipsia?
Authors: Leon Ewelina de , Yorston Graeme
Published: July 2021

Objectives/Aims

Traumatic brain injury is a common cause of permanent or long-term disability,1 and up to 80% of people with moderate to severe brain injury have some degree of pituitary insufficiency. Endocrine disruption has been documented in medical literature since the 1940s,2-4 where central diabetes insipidus has been described as a common transient complication which causes polydipsia (insatiable thirst). However, polydipsia can be caused by other conditions. It is classified into dipsogenic, in a syndrome of disordered thirst-regulating mechanism in patients without psychiatric disease called dipsogenic diabetes insipidus, psychogenic, as a compulsive water drinking in patients with psychiatric conditions referred to as psychogenic polydipsia or psychogenic diabetes insipidus and iatrogenic where large quantities of water are consumed for health benefits. All of which are referred to as primary polydipsia if these conditions cannot be distinguished. Dipsogenic diabetes insipidus and psychogenic polydipsia can be easily mixed up, misdiagnosed or even unrecognised, mainly because their pathophysiology is still unclear. Are these conditions different, or is there anything that can relate them to each other? With this literature review, we are aiming to find the link between subsets of polydipsia after brain trauma, to compare proposed differential diagnosis and their functionality in clinical settings.

Method

A literature review was conducted following a search of MEDLINE, CINAHL Plus, APA PsycArticles, APA PsycBooks, APA PsycInfo databases from 1858 onwards.

Results

We will present our findings from the literature review.

Conclusion

Polydipsia is a common clinical problem and requires careful evaluation and management to prevent long term neurological sequelae, and there are no evidence-based treatment guidelines.

References

National Institute of Health and Care Excellence (NICE). (2019). Head Injury. CG176. Retrieved from: https://www.nice.org.uk/guidance/cg176

Escamilla RF, Lisser H. Simmonds disease: A clinical study with revie of the literature; Differentiation from anorexia nervosa by statistical analysis of 595 cases, 101 of which were provided pathologically. The Journal of Clinical Endocrinology & Metabolism 1942;2(2):6596.

Porter RJ, Miller RA. Diabetes insipidus following closed head injury. Journal of Neurology, Neurosurgery, and Psychiatry 1946;11:528562.

Webb NE, Little B, Loupee-Wilson S, Power EM. Traumatic brain injury and neuro-endocrine disruption: medical and psychosocial rehabilitation. NeuroRehabilitation (Reading, Mass.) 2014;34(4):625636.
#3100 A service evaluation of the experiences of patients with functional neurological disorders within the NHS
Authors: OKeeffe Shauna , Chowdhury Ibrahim , Sinanaj Anila , Ewang Iberedem , Blain Camilla , Teodoro Tiago , Edwards Mark , Yogarajah Mahinda
Published: July 2021

Objectives/Aims

Previous research into Functional Neurological Disorder (FND) has shown that there are significant barriers in providing multidisciplinary, patient-centred care for these patients, including stigmatising attitudes, poor knowledge about FND, and a lack of structured care pathways. However, there has been no specific research into patient experiences of care for FND within NHS services to date, and whether these experiences meet the standards of care expected for long-term neurological conditions (LTNCs). The current study thus aimed to investigate the types of problems experienced by FND patients, and whether they differed in frequency and type to patients with another LTNC, multiple sclerosis (MS).

Methods

Both FND (n = 40) and MS patients (n = 37) were recruited from tertiary neurology clinics at an NHS hospital and completed two questionnaires on their experiences of health and social care services and on their level of disability.

Results

The results indicated significant differences in experiences of care between the two patient groups, with FND patients reporting significantly more problems (p<0.001)overall. These problems were reported in relation to their diagnosis and treatment, relationships with healthcare professionals, and difficulties in accessing services. This was despite FND patients reporting significantly higher levels of disability (p=0.001), highlighting the burden of care experienced by FND patients as a result of these difficulties in accessing and receiving care. A small sample size, specificity to a single neurology centre, and a cross-sectional design are acknowledged as limitations.

Conclusions

Together, these results suggest that current care for FND patients is not meeting the standards expected for LTNCs, and highlight the need for further research and the development of structured, multidisciplinary pathways with a patient-centred approach.
#3064 Prevalence of, and risk factors for, dementia in adult outpatient referrals to a regional referral hospital in Arusha, Northern Tanzania
Authors: Roe Caitlin , Safic Ssenku , Mwaipopo Lawtiko , Dotchin Catherine , Klaptocz Johanna , Gray Keith , Joseph Marcella , Walker Richard
Published: July 2021

Objectives

The global burden of dementia is increasing, with the greatest increase predicted to occur in sub-Saharan Africa (SSA). Despite this there are limited previous data on the prevalence of, and risk factors for, dementia in SSA. This study aimed to estimate the prevalence of dementia, and investigate its associations, in those aged 60 years and older attending the outpatient department of Mount Meru Hospital in northern Tanzania. This is the first hospital-based outpatient dementia prevalence and risk factors study to be conducted in an east African population.

Methods

This was a one-phase cross-sectional study. Adults aged 60 years and over attending medical outpatients were screened for dementia using The Identification and Intervention for Dementia in Elderly Africans cognitive screening tool. Those who scored ≤9 were clinically assessed using the DSM-IV criteria. Demographic, medical comorbidity and lifestyle information were collected during a clinical assessment.

Results

Prevalence of dementia was 5.0% (95% confidence interval: 3.7-6.3). Binary logistic regression found female sex (odds ratio (OR)=2.778), having no formal education(OR=6.088), quantity of alcohol consumption (units/week) (OR=1.080), uncorrected visual impairment (OR=4.260), body mass index <18.5kg/m2 (OR=6.588) and stroke (OR=15.790with wide 95% confidence interval (3.48-74.475)) to be significantly, independently associated with dementia.

Conclusions

The prevalence of dementia in this population is lower than previously reported community-based rates in Tanzania, and similar to those in high-income countries.This is the first time the association between uncorrected visual impairment and dementia has been reported in SSA. Other associations identified are in keeping with previous literature. Further research on the management of dementia and its risk factors, and the support and education of carers and patients in east African populations is required to advise future policy.
Simplified treatment algorithm for the management of trauma-induced hemorrhage without viscoelastic testing
Authors: Casu Sebastian
Published: July 2021

Uncontrolled bleeding after major trauma remains a significant cause of death, with up to a third of trauma patients presenting with signs of coagulopathy at hospital admission. Rapid correction of coagulopathy is therefore vital to improve mortality rates and patient outcomes in this population. Early and repeated monitoring of coagulation parameters followed by clear protocols to correct hemostasis is the recommended standard of care for bleeding trauma patients. However, although a number of treatment algorithms are available, these are frequently complex and can rely on the use of viscoelastic testing, which is not available in all treatment centers. We therefore set out to develop a concise and pragmatic algorithm to guide treatment of bleeding trauma patients without the use of point-of-care viscoelastic testing. The algorithm we present here is based on published guidelines and research, includes recommendations regarding treatment and dosing, and is simple and clear enough for even an inexperienced physician to follow. In this way, we have demonstrated that treatment protocols can be developed and adapted to the resources available, to offer clear and relevant guidance to the entire trauma team.
Simulating the effect of climate change on performance of a monolayer cover combined with an elevated water table placed on acid-generating mine tailings
Authors: Lieber Elodie , Demers Isabelle , Pabst Thomas , Bresson Émilie
Published: July 2021

Several reclamation approaches were developed in the last decades to control acid mine drainage from tailings storage facilities, including the monolayer cover combined with an elevated water table. Its performance is dependent on water table elevation and tailings saturation and is directly affected by climatic conditions; therefore, climate change needs to be taken into account to design resilient reclamation systems. The objective of this research was to evaluate three approaches to simulate climate change and compare the impact on reclamation performance up to year 2100. Numerical simulations were calibrated using experimental field data, and future weather conditions were established based on three climate change scenarios adapted for local conditions. Results showed that the projected impact of climate change varied depending on the approach used. Simpler and more conservative approaches indicated that reclamation would eventually fail following an increase of droughts during future summers. However, 80 year simulations showed that reclamation failures (evaluated as oxygen flux) could be limited to a few isolated summers and that a well-designed monolayer cover with elevated water table appeared to remain efficient in the long term. Overall, the probability to exceed the oxygen flux target of 1 mol/m2/year did not exceed 2% for the simulated conditions.
Clonal variation in coppiced and uncoppiced growth, root sprout stem formation, and biomass partitioning in Salix interior on two highly disturbed site types
Authors: Mosseler Alex , Major John E.
Published: July 2021

Salix interior Rowlee (INT) is a wide-ranging North American willow from the small taxonomic group Salix section Longifoliae, notable for its ability to form multi-stemmed vegetative stem colonies arising via root sprouts (RS) from a shallow horizontal root network. This study quantifies biomass production for both 1-year-old coppiced plants and the original 4-year-old plants established from dormant, unrooted stem cuttings, as well as for the RS stems associated with each ortet (original mother plant) using eight selected INT clones established on two distinct site types. Significantly greater coppiced and uncoppiced ortet stem dry mass was recorded on coarse-textured, shale rock overburden (SO); possibly due to significantly greater fertility, compared to adjacent gravel outwash deposits (GD), which had greater RS stem mass. The total stem dry mass (ortet + associated RS) was comparable across the two different site types for both the 1-year-old coppiced plants and the 4-year-old uncoppiced plants, showing rapid recovery of biomass growth and yield in the year following coppicing. Significant clonal differences, as well as site type × clone interactions, were found for ortet stem dry mass, especially on SO sites, indicating that clonal selection might be useful to increase biomass production on different site types. When expressed as a fraction of total stem dry mass produced on 2 m × 2 m biomass plots, the RS component represented a significant 57% of total stem dry mass per plot (ortet + associated RS) on GD sites and only 18% on SO sites. The use of colony-forming willows such as INT minimizes the need for periodic replanting, providing a cost advantage over conventional short-rotation, coppice-based woody biomass plantations using species that do not have the ability to produce new stems via root sprouting. This root-sprouting trait enables INT to rapidly colonize and spread on difficult-to-manage sites, making it suitable for use in land reclamation.
Recycled nutrients as a phosphorus source for Canadian organic agriculture: a perspective
Authors: Nicksy Jessica , Entz Martin H.
Published: July 2021

The challenges associated with the global phosphorus (P) cycle are complex and multifaceted, from geological resource limitation, to P deficiency on arable farmland, to environmental contamination via excess P fertilization. Although no single solution can address all of the challenges associated with the P cycle, the principle of circularity provides a framework toward a more sustainable and food-secure P system. Phosphorus deficiency on farmland is widespread, particularly on organically managed farms due to negative P balances in low-input cropping systems. Recycled nutrient sources divert food and human wastes back onto farmland; they have the potential to ameliorate both the global-scale issues of phosphate rock depletion and environmental contamination and the farm-scale issue of P deficiency, particularly for organic farms. For recycled nutrients to act as viable alternatives to conventional nutrient sources, their ability to supply P and improve yields must be demonstrated. This paper provides an introduction to the importance of recycled fertilizer sources in the global P cycle, and the key role they can play on organic farmland in Canada.
Magnetized Kerr–Newman–Taub-NUT spacetimes
Authors: Ghezelbash Masoud , Siahaan Haryanto M.
Published: July 2021

We find a new class of exact solutions in the Einstein–Maxwell theory by employing the Ernst magnetization process to the Kerr–Newman–Taub-NUT spacetimes. We study the solutions and find that they are regular everywhere. We also find the quasilocal conserved quantities for the spacetimes, the corresponding Smarr formula and the first law of thermodynamics.
From particle swarm optimization to consensus based optimization: Stochastic modeling and mean-field limit
Authors: Grassi Sara , Pareschi Lorenzo
Published: July 2021

In this paper, we consider a continuous description based on stochastic differential equations of the popular particle swarm optimization (PSO) process for solving global optimization problems and derive in the large particle limit the corresponding mean-field approximation based on Vlasov–Fokker–Planck-type equations. The disadvantage of memory effects induced by the need to store the local best position is overcome by the introduction of an additional differential equation describing the evolution of the local best. A regularization process for the global best permits to formally derive the respective mean-field description. Subsequently, in the small inertia limit, we compute the related macroscopic hydrodynamic equations that clarify the link with the recently introduced consensus based optimization (CBO) methods. Several numerical examples illustrate the mean field process, the small inertia limit and the potential of this general class of global optimization methods.
The g-Extra Edge-Connectivity of Balanced Hypercubes
Authors: Wei Yulong , Li Rong-hua , Yang Weihua
Published: July 2021

The [Formula: see text]-extra edge-connectivity is an important measure for the reliability of interconnection networks. Recently, Yang et al. [Appl. Math. Comput. 320 (2018) 464–473] determined the [Formula: see text]-extra edge-connectivity of balanced hypercubes [Formula: see text] and conjectured that the [Formula: see text]-extra edge-connectivity of [Formula: see text] is [Formula: see text] for [Formula: see text]. In this paper, we confirm their conjecture for [Formula: see text] and [Formula: see text], and disprove their conjecture for [Formula: see text] and [Formula: see text], where [Formula: see text].
Barriers to Digital Transformation in Higher Education: An Interpretive Structural Modeling Approach
Authors: Aditya Bayu Rima , Ferdiana Ridi , Kusumawardani Sri Suning
Published: July 2021

This paper presents a study of developing a framework using Interpretive Structural Modeling (ISM) for the barriers to digital transformation in higher education in a particular context: Indonesia. This study has identified 55 contextual relationships between the 11 key barriers and has developed five levels of the structure hierarchy. This study also proposed a four-phase strategy that will guide us to improve the strategy of the implementation of digital transformation in higher education in Indonesia. This research gives contribution by providing a better understanding of barriers and the interrelationships among barriers in the implementation of the digital transformation in the higher education domain.
CLT with explicit variance for products of random singular matrices related to Hill’s equation
Authors: Mariano Phanuel , Panzo Hugo
Published: July 2021

We prove a central limit theorem (CLT) for the product of a class of random singular matrices related to a random Hill’s equation studied by Adams–Bloch–Lagarias. The CLT features an explicit formula for the variance in terms of the distribution of the matrix entries and this allows for exact calculation in some examples. Our proof relies on a novel connection to the theory of m-dependent sequences which also leads to an interesting and precise nondegeneracy condition.