bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of an Intensive Mindful Practice Workshop on Patient-Centered Compassionate Care, Clinician Well-Being, Work Engagement, and Teamwork
Authors: Epstein Ronald M. , Marshall Frederick , Sanders Mechelle , Krasner Michael S.
Published: August 2021

Introduction:

Mindfulness-based interventions for health professionals have been linked to improvements in burnout, well-being, empathy, communication, patient-centered care, and patient safety, but the optimal formats and intensity of training have been difficult to determine because of the paucity of studies and the heterogeneity of programs. A 4-days residential “Mindful Practice” workshop for physicians and medical educators featuring contemplative practices, personal narratives, and appreciative dialogs about challenging experiences may hold promise in improving participants' well-being while also improving compassionate care, job satisfaction, work engagement, and teamwork.

Methods:

We collected baseline and 2-month follow-up data during four workshops conducted in 2018 to 2019 at conference centers in the United States and Europe. Primary outcomes were burnout, work-related distress, job satisfaction, work engagement, patient-centered compassionate care, and teamwork.

Results:

Eighty-five of 120 participants (71%) completed both surveys (mean age was 49.3 and 68.2% female). There were improvements (P < .01) in two of three burnout components (emotional exhaustion and depersonalization), work-related distress, job satisfaction, patient-centered compassionate care, work engagement and meaning, teamwork, well-being, positive emotion, mindfulness, somatic symptoms, and spirituality. Effect sizes (standardized mean difference of change) ranged from 0.25 to 0.61. With Bonferroni adjustments (P < .0031), teamwork, general well-being, and mindfulness became nonsignificant.

Discussion:

An intensive, multiday, mindfulness-based workshop for physicians had clinically significant positive effects on clinician well-being, quality of interpersonal care and work satisfaction, and meaning and engagement, all important indicators of improved health and sustainability of the health care workforce. Future iterations of the program should increase the focus on teamwork.
Complexities of Continuing Professional Development in Context: Physician Engagement in Clinical Coaching
Authors: Kahlke Renate , Pratt Daniel D. , Bluman Bob , Overhill Kirstie , Eva Kevin W.
Published: August 2021

Introduction:

Effective continuing professional development (CPD) is critical for safe and effective health care. Recent shifts have called for a move away from didactic CPD, which often fails to affect practice, toward workplace learning such as clinical coaching. Unfortunately, coaching programs are complex, and adoption does not guarantee effectiveness. To resolve this problem, thus ensuring resources are well spent, there is a critical need to understand what physicians try to achieve and how they engage. Therefore, we examined the types of change physicians pursue through clinical coaching and the impact of context on their desired changes.

Methods:

In the context of two clinical coaching programs for rural physicians, we applied a generic qualitative approach. Coachees (N = 15) participated in semistructured interviews. Analysis involved iterative cycles of initial, focused, and theoretical coding.

Results:

Coachees articulated desired practice changes along a spectrum, ranging from honing their current practice to making larger changes that involved new skills outside their current practice; changes also ranged from those focused on individual physicians to those focused on the practice system. Desired changes were affected by factors in the learning/practice environment, including those related to the individual coachee, coach, and learning/practice context.

Discussion:

These results suggest that the current focus on acquiring new knowledge through CPD may miss important learning that involves subtle shifts in practice as well as learning that focusses on systems change. Moreover, an appreciation of the contextual nature of CPD can ensure that contextual affordances are leveraged and barriers are acknowledged.
Cancer mortality in Italian populations: differences between Italy and the USA
Authors: Santucci Claudia , Medina Heidy N. , Carioli Greta , Negri Eva , La Vecchia Carlo , Pinheiro Paulo S.
Published: August 2021

Background

The comparison of cancer mortality rates and risk factors among foreign-born populations in a host country with those in the country of origin provides insights into differences in access to care, timely diagnosis, and disease management between the two countries.

Methods

Using 2008–2018 cancer mortality data for the Italian population and for Italy-born Americans, we calculated age-standardized mortality rates (ASMRs) and standardized mortality ratios (SMRs).

Results

ASMRs were lower in Italy-born Americans (201.5 per 100 000) compared to Italians (255.1 per 100 000). For all neoplasms combined, SMRs for Italy-born American men and women were 0.75 [95% confidence interval (CI), 0.73–0.77] and 0.78 (95% CI, 0.76–0.80), respectively. Among men, the SMRs were significantly below 1 for oral cavity, stomach, colorectal, liver, lung, prostate, bladder and kidney cancer. Among women, the SMRs were 0.69 for oral, 0.40 for stomach, 0.61 for colorectal, 0.72 for liver, 0.73 for breast and 0.53 for kidney cancers. Mortality was not reduced for lung (1.02, 95% CI, 0.94–1.10) cancer in women.

Conclusion

Generational differences in smoking prevalence patterns between the US and Italy may explain the advantages for Italy-born Americans for lung and other tobacco-related cancers compared to their Italian men counterparts. Lower prevalence of Helicobacter pylori, alcohol consumption, hepatitis B and C virus in the USA may justify the lower mortality for stomach and liver cancer, among Italy-born Americans. Earlier and more widespread adoption of cancer screening and effective treatments in the USA is likely to be influential in breast, colorectal and prostate cancer mortality.
Renal adverse drug reactions
Authors: Hughes Christine
Published: August 2021

Purpose of review

Chronic kidney disease (CKD) is common in people living with HIV (PLWH) and is related to a multitude of factors. The aim of this review is to provide an overview of the most recent evidence of renal adverse effects of antiretroviral drugs, predictors of CKD risk and areas for future research.

Recent findings

Advancing age, cardiometabolic risk factors and adverse effects of antiretroviral drugs contribute to the higher prevalence of CKD in PLWH. Genetic factors and baseline clinical CKD risk are strongly correlated to risk of incident CKD, although it is unclear to what extent gene polymorphisms explain renal adverse effects related to tenofovir disoproxil fumarate (TDF). Switching from TDF to tenofovir alafenamide (TAF) in people with baseline renal dysfunction improves renal parameters; however, the long-term safety and benefit of TAF in individuals at low risk of CKD is an area of ongoing research.

Several factors contribute to estimated glomerular function decline and CKD in PLWH. Clinical risk scores for CKD may be useful to inform selection of ART in an ageing population. In people with baseline renal dysfunction, potentially nephrotoxic antiretroviral drugs should be avoided.
Prediction and prevention of stillbirth: dream or reality
Authors: Ishak Melania , Khalil Asma
Published: August 2021

Purpose of review

Stillbirth has a high global prevalence and has not improved despite other advances in maternal and perinatal outcomes in the last 20 years. The global applicability of research is challenged by the fact that most evidence originates from high-income countries, whereas the burden is greatest in low- and middle-income countries. Robust universally applicable evidence is therefore desired to address this problem.

Recent findings

Good quality evidence has identified key risk factors for stillbirth. However, an effective universally applicable model is yet to be developed. Published prediction models lack internal or external validation, suffer from the risk of bias or cannot be applied to different populations. Term induction of labour suggests good clinical outcomes with no increase in obstetric interventions but must be considered within the context of the healthcare system's feasibility, cost-effectiveness and the experiences of women.

The most realistic focus to reduce stillbirth is placental insufficiency. Globally, the greatest benefit will come from treating those with the highest risk of disease, such as those in low and middle-income countries. Further high-quality trials need to be conducted in these settings as a priority.
Building new cardiac vasculature and myocardium: where are we at?
Authors: Sedlakova Veronika , Ahumada Manuel , Suuronen Erik J. , Alarcon Emilio I.
Published: August 2021

Purpose of review

This review describes the latest advances in cell therapy, biomaterials and 3D bioprinting for the treatment of cardiovascular disease.

Recent findings

Cell therapies offer the greatest benefit for patients suffering from chronic ischemic and nonischemic cardiomyopathy. Rather than replacing lost cardiomyocytes, the effects of most cell therapies are mediated by paracrine signalling, mainly through the induction of angiogenesis and immunomodulation. Cell preconditioning, or genetic modifications are being studied to improve the outcomes. Biomaterials offer stand-alone benefits such as bioactive cues for cell survival, proliferation and differentiation, induction of vascularization or prevention of further cardiomyocyte death. They also provide mechanical support or electroconductivity, and can be used to deliver cells, growth factors or drugs to the injured site. Apart from classical biomaterial manufacturing techniques, 3D bioprinting offers greater spatial control over biomaterial deposition and higher resolution of the details, including hollow vessel-like structures.

Cell therapy induces mainly angiogenesis and immunomodulation. The ability to induce direct cardiomyocyte regeneration to replace the lost cardiomyocytes is, however, still missing until embryonic or induced pluripotent stem cell use becomes available. Cell therapy would benefit from combinatorial use with biomaterials, as these can prolong cell retention and survival, offer additional mechanical support and provide inherent bioactive cues. Biomaterials can also be used to deliver growth factors, drugs, and other molecules. 3D bioprinting is a high-resolution technique that has great potential in cardiac therapy.
Institutional factors associated with hospital partnerships for population health: A pooled cross-sectional analysis
Authors: Ellis Hilts Katy , Gibson P. Joseph , Blackburn Justin , Yeager Valerie A. , Halverson Paul K. , Menachemi Nir
Published: August 2021

Background

Hospitals are increasingly engaging in partnerships to address population health in response to national policies, such as value-based payment models. However, little is known about how institutional factors influence hospital partnerships for population health.

Purpose

Guided by institutional theory, we examine the association between institutional pressures (coercive, normative, and mimetic isomorphism) and hospital partnerships for population health.

Methodology

A pooled cross-sectional analysis used an unbalanced panel of 10,777 hospital-year observations representing respondents to a supplemental question of the American Hospital Association’s annual survey (2015–2017). The analysis included descriptive and bivariate statistics, and regression models that adjusted for repeated observations to examine the relationship between key independent variables and partnerships over time.

Findings

In regression analyses, we found the most support for measures of coercive (e.g., regulatory factors) isomorphism, with nonprofit status, participation in accountable care organizations, and acceptance of bundled payments, all being consistently and significantly associated with partnerships across all organization types. Modest increases were observed from 2015 to 2017 for hospital partnerships with public health organizations (+2.8% points, p < .001), governmental organizations (+2.0% points, p = .009), schools (+4.1% points, p < .001), and businesses (+2.2% points, p = .007).

Practice Implications

Our results suggest that institutional factors, particularly those related to regulatory policies and programs, may influence hospital partnerships to support population health. Findings from this study can assist hospital leaders in assessing the factors that can support or impede the creation of partnerships to support their population health efforts.
Leisure but Not Occupational Physical Activity and Sedentary Behavior Associated With Better Health
Authors: Gallagher Jacob , Carr Lucas J.
Published: August 2021

Objective:

This study explores relations between occupational and leisure-time physical activity (OPA, LTPA) and sedentary behavior (OSB, LTSB) and several health outcomes.

Methods:

A total 114 full-time workers had their body composition, waist circumference, height, weight, resting heart rate, and resting blood pressure measured. ActivPal monitor measured physical activity behaviors. Stress, mood, and pain were measured with ecological momentary assessment. General linear models were used to examine the relationship between high and low OPA, LTPA, OSB, and LTSB with each health outcome while controlling for covariates.

Results:

The high LTPA group had lower body mass index (BMI) (P = 0.04) and better mood (P = 0.007) than the low LTPA group. The high LTSB group had higher systolic blood pressure (P = 0.001), higher diastolic blood pressure (P = 0.01), higher BMI (P = 0.027), higher body fat percentage (P = 0.003), higher waist circumference (P = 0.01), and worse mood (P = 0.032) than the low LTSB group. No differences were found between OPA and OSB groups.

Conclusions:

These findings suggest there may be differential relations between PA and SB accumulated during leisure versus occupational time.
The « race » correction in estimating glomerular filtration rate: an European point of view
Authors: Delanaye Pierre , Mariat Christophe , Cavalier Etienne , Glassock Richard J. , Gemenne François , Pottel Hans
Published: August 2021

Purpose of review

There is currently a heated debate ongoing whether or not to use the race coefficient for black people in the Modification of Diet in Renal Diseases and Chronic Kidney Disease Epidemiology-equation. The use of the race coefficient is thought by several American authors as a source of discrimination.

Recent findings

It has recently been shown that the race coefficient is inaccurate in European and African black people. Therefore, it seems that the race correction is more a correction for black Americans, rather than for black in general. This ‘correction’ at the glomerular filtration rate (GFR)-level has been criticized, as it is misleading, and should be abandoned, as it has not been shown that GFR is different between black and white people. However, as differences in creatinine generation between black and white people might exist, a correction or adjustment, different for black and white people, at the creatinine level might be required, very similar to the different scaling of creatinine for males and females.

The current debate on the race coefficient is particularly difficult because of the absence of good scientific data in black subjects and there lies the real discrimination in our opinion. We therefore call for future dedicated studies, both in Europe and USA.
Advances in the treatment of gastric cancer: 2020–2021
Authors: Ilson David H.
Published: August 2021

Purpose of review

To review studies from 2020 to 2021 in esophagogastric cancer.

Recent findings

After up front D2 gastrectomy for lymph node-positive gastric cancer, 6 months of adjuvant chemotherapy with S-1 and oxaliplatin achieved superior disease-free survival (DFS) compared with 1 year of S-1. The addition of adjuvant radiotherapy, however, added no benefit. After chemoradiotherapy and surgery in esophageal and gastroesophageal junction cancer, in patients with residual disease found at surgery, 1 year of adjuvant nivolumab substantially improved DFS compared with observation alone, leading to regulatory approval for adjuvant nivolumab. In metastatic esophagogastric cancer, the addition of either pembrolizumab or nivolumab to first-line chemotherapy improved response, disease free, and overall survival with the greatest survival benefit dependent on programmed death receptor ligand, programmed death receptor ligand -1 status, leading to regulatory approval for these agents. A preliminary report of a phase 3 trial adding pembrolizumab to first-line chemotherapy with trastuzumab in HER2-positive gastric cancer reported a significant improvement in response, leading to regulatory approval for pembrolizumab. The fibroblast growth factor receptor appears to be a promising new target in gastroesophageal cancer based on phase 2 data for bemarituzumab.

Optimal adjuvant chemotherapy after D2 resection of node-positive gastric cancer is 6 months of a fluorinated pyrimidine and oxaliplatin, with no benefit for adjuvant radiotherapy. Adjuvant nivolumab after resection of esophageal cancer after chemoradiotherapy improves DFS and is a new care standard. Pembrolizumab added to first-line chemotherapy in both HER2-positive and negative esophagogastric cancer improves outcome and is a new standard of care. Nivolumab added to first-line chemotherapy in HER2-negative gastric cancer improves treatment outcome and is a new care standard.
Emerging artificial intelligence applications in otological imaging
Authors: Chawdhary Gaurav , Shoman Nael
Published: August 2021

Purpose of review

To highlight the recent literature on artificial intelligence (AI) pertaining to otological imaging and to discuss future directions, obstacles and opportunities.

Recent findings

The main themes in the recent literature centre around automated otoscopic image diagnosis and automated image segmentation for application in virtual reality surgical simulation and planning. Other applications that have been studied include identification of tinnitus MRI biomarkers, facial palsy analysis, intraoperative augmented reality systems, vertigo diagnosis and endolymphatic hydrops ratio calculation in Meniere's disease. Studies are presently at a preclinical, proof-of-concept stage.

The recent literature on AI in otological imaging is promising and demonstrates the future potential of this technology in automating certain imaging tasks in a healthcare environment of ever-increasing demand and workload. Some studies have shown equivalence or superiority of the algorithm over physicians, albeit in narrowly defined realms. Future challenges in developing this technology include the compilation of large high quality annotated datasets, fostering strong collaborations between the health and technology sectors, testing the technology within real-world clinical pathways and bolstering trust among patients and physicians in this new method of delivering healthcare.
Screening Strategy for Detecting Double-Hit Lymphoma in a Resource-Limited Setting
Authors: Thirunavukkarasu Balamurugan , Bal Amanjit , Prakash Gaurav , Malhotra Pankaj , Singh Harmandeep , Das Ashim
Published: August 2021

Aim:

High-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements [double-hit lymphomas (DHL)] are aggressive lymphomas. Current literature recommends fluorescent in-situ hybridization analysis (FISH) in all cases of diffuse large B-cell lymphoma (DLBCL) to identify cases of DHL. However, this approach is not feasible in a resource-limited setting. We analyzed cases of de novo high-grade B-cell non-Hodgkin lymphoma using histomorphology, immunohistochemistry and FISH to identify which cases need to undergo FISH testing in a resource-limited setting.

Materials and Methods:

Cases of de novo high-grade B-cell non-Hodgkin lymphoma that included DLBCL, not otherwise specified and B-cell lymphoma unclassifiable (BCLU) with features intermediate between DLBCL and Burkitt lymphoma diagnosed over a period of 5 years were analyzed by Hans algorithm, MYC, BCL2, and Ki67. MYC, BCL2, and BCL6 break apart FISH was tested in selected cases.

Results:

One hundred and nine cases were obtained, of which 102 had DLBCL morphology and 7 had BCLU/blastoid morphology. BCL2 expression was noted in 48 cases (44%), MYC in 33 cases (30.3%) and MYC/BCL2 co-expression in 24 cases (22%). FISH testing could be done in 42 consecutive cases, of which 5 cases had MYC and BCL2 co-rearrangement (11.9%) (double-hit) and 2 cases showed rearrangement for only MYC (4.7%) (single-hit). Single-hit lymphoma/DHL showed significant independent positive correlation with BCLU/blastoid morphology, CD10 expression, germinal center B-cell phenotype, and MYC/BCL2 co-expression. The sensitivity and specificity of each parameters include BCLU/blastoid morphology (42% vs. 94%), CD10 positive (50% vs. 88%), germinal center B-cell phenotype (57% vs. 82%), MYC/BCL2 co-expression (85% vs. 80%). Selected candidates for FISH (any one of the above parameters) using this strategy showed a sensitivity and specificity of 100% and 68%, respectively (P=0.001).

Conclusion:

We propose a highly sensitive screening strategy for detection of MYC/BCL2 rearrangement in high-grade B-cell lymphoma in a resource-limited setting (pending validation in a larger cohort).
Long Noncoding RNA Metastasis-Associated Lung Adenocarcinoma Transcript 1 Promotes the Osteoblast Differentiation of Human Bone Marrow-Derived Mesenchymal Stem Cells by Targeting the microRNA-96/Osterix Axis
Authors: Zang Lu-Yang , Yang Xiao-Lin , Li Wei-Juan , Liu Ge-Ling
Published: August 2021

Objectives:

To investigate whether and how the long noncoding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) sponges microRNA-96 (miR-96) to achieve the osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBMSCs).

Methods:

Protein levels were detected by Western blot. Mineralized bone matrix formation was studied by alizarin red staining. Metastasis-associated lung adenocarcinoma transcript 1, miR-96, and osteogenesis-related Messenger RNA expression was assessed by Quantitative Real-time Polymerase Chain Reaction (qRT-PCR). The interactions between miR-96 and osterix (Osx), MALAT1, and miR-96 were determined by luciferase reporter assay.

Results:

The expression of MALAT1 was upregulated whereas that of miR-96 was downregulated in osteogenic hBMSCs. In addition, the expression of MALAT1 significantly decreased whereas that of miR-96 increased in the hBMSCs of osteoporosis (OP) patients. qRT-PCR and alizarin red staining assays showed that MALAT1 silencing or miR-96 overexpression inhibits hBMSC osteogenic differentiation and vice versa. overexpression of miR-96 reversed the promotive effect of MALAT1 on the osteogenic differentiation of hBMSCs. Dual luciferase report assay verified that miR-96 is a regulatory target of MALAT1 and that Osx is a gene target of miR-96.

Conclusions:

Taken together, the results demonstrate that MALAT1 promotes the osteogenic differentiation of hBMSCs by regulating the miR-96/Osx axis. Our study provides novel mechanistic insights into the critical role of lncRNA MALAT1 as a microRNA sponge in OP patients and sheds new light on lncRNA-directed diagnostics and therapeutics in OP.
Periorbital and Perioral Defect Reconstruction Using the Split Pre-Expanded Medial Arm Flap Aided by Using Indocyanine Green Angiography
Authors: Li Shanshan , Zhu Shan , Zang Mengqing , Chen Bo , Han Tinglu , Xie Tingjun , Yue Shuai , Wang Danying , Liu Yuanbo
Published: August 2021

The pre-expanded medial arm flap provides suitable skin for the resurfacing of a periorbital or perioral defect. However, the flap must be intraoperatively split to imitate the appearance of the oral or ophthalmic fissure, which can compromise flap perfusion. This study aimed to evaluate the safety and effectiveness of splitting pre-expanded medial arm flaps with the aid of indocyanine green angiography. All 8 patients underwent periorbital or perioral soft tissue reconstruction using a split pre-expanded medial arm flap. Flap splitting was aided by indocyanine green angiography. It was used during 2 stages of the procedure, tissue expander placement and flap transfer. The pedicle was divided 3 weeks later, and the flaps were used to resurface the defect. The distal portion of the flap was split into a fishmouth pattern in 5 patients and a window pattern in 3 patients. The donor sites were closed directly or by using a latissimus dorsi myocutaneous flap. There were no perioperative complications or flap necrosis. A pre-expanded split medial arm flap could be an option for the reconstruction of periorbital and perioral defects. With the assistance of indocyanine green angiography, vessel distribution and distal flap perfusion can be reliably evaluated, facilitating the safe splitting of the flap for the reconstruction of defects.
Association of Historic Housing Policy, Modern Day Neighborhood Deprivation and Outcomes After Inpatient Hospitalization
Authors: Diaz Adrian , O’Reggio Rachel , Norman Marc , Thumma Jyothi R. , Dimick Justin B. , Ibrahim Andrew M.
Published: August 2021

Objective:

To evaluate the association of historical racist housing policies and modern-day healthcare outcomes.

Summary of Background Data:

In 1933 the United States Government Home Owners Loan Corporation (HOLC) used racial composition of neighborhoods to determine creditworthiness and labeled them “Best”, “Still Desirable”, “Definitely Declining”, and “Hazardous.” Although efforts have been made to reverse these racist policies that structurally disadvantage those living in exposed neighborhoods, the lasting legacy on modern day healthcare outcomes is uncertain.

Methods:

We performed a cross-sectional retrospective review of 212,179 Medicare beneficiaries’ living in 171,930 unique neighborhoods historically labeled by the HOLC who underwent 1 of 5 of common surgical procedures – coronary artery bypass, appendectomy, colectomy, cholecystectomy, and hernia repair – between 2012 and 2018. We compared 30-day mortality, complications, and readmissions across HOLC grade and Area Deprivation Index (ADI) of each neighborhood. Outcomes were risk-adjusted using a multivariable logistical regression model accounting for patient factors (age, sex, Elixhauser comorbidities), admission type (elective, urgent, emergency), type of operation, and each neighborhoods ADI; a modern day measure of neighborhood disadvantage that includes education, employment, housing-quality, and poverty measures.

Results:

Overall, 212,179 Medicare beneficiaries (mean age, 71.2 years; 54.2% women) resided in 171,930 unique neighborhoods historically graded by the HOLC. Outcomes worsened in a stepwise fashion across HOLC neighborhoods. Overall, 30-day postoperative mortality was 5.4% in “Best” neighborhoods, 5.8% in “Still Desirable”, 6.1% in “Definitely Declining”, and 6.4% in “Hazardous” (Best vs Hazardous Odds Ration: 1.23, 95% CI: 1.13–1.24, P < 0.001). The same stepwise pattern was seen from “Best” to “Hazardous” neighborhoods for complications (30.5% vs 32.2%; OR: 1.12 [95% CI: 1.07–1.17]; P < 0.001) and Readmissions (16.3% vs 17.1%; OR: 1.06 [95% CI: 1.01–1.11]; P = 0.023). After controlling for modern day deprivation using ADI, the patterns persisted with “Hazardous” neighborhoods having higher mortality (OR: 1.17 [95% CI: 1.08–1.27]; P < 0.001) and complications (OR: 1.07 [95% CI: 1.02–1.12]; P = 0.003), but not for readmissions (OR: 1.02 [95% CI: 0.97–1.07]; P = 0.546).

Conclusions:

Patients residing in neighborhoods previously “redlined” or labeled “Hazardous” were more likely to experience worse outcomes after inpatient hospitalization compared to those living in “Best” neighborhoods, even after taking into account modern day measures of neighborhood disadvantage.
A unified lattice Boltzmann model and application to multiphase flows
Authors: Luo Kai H. , Fei Linlin , Wang Geng
Published: August 2021

In this work, we develop a unified lattice Boltzmann model (ULBM) framework that can seamlessly integrate the widely used lattice Boltzmann collision operators, including the Bhatnagar–Gross–Krook or single-relation-time, multiple-relaxation-time, central-moment or cascaded lattice Boltzmann method and multiple entropic operators (KBC). Such a framework clarifies the relations among the existing collision operators and greatly facilitates model comparison and development as well as coding. Importantly, any LB model or treatment constructed for a specific collision operator could be easily adopted by other operators. We demonstrate the flexibility and power of the ULBM framework through three multiphase flow problems: the rheology of an emulsion, splashing of a droplet on a liquid film and dynamics of pool boiling. Further exploration of ULBM for a wide variety of phenomena would be both realistic and beneficial, making the LBM more accessible to non-specialists.

This article is part of the theme issue ‘Progress in mesoscale methods for fluid dynamics simulation’.
Structure and dynamics of water confined in cylindrical nanopores with varying hydrophobicity
Authors: Tinti Antonio , Camisasca Gaia , Giacomello Alberto
Published: August 2021

We report a detailed study of the main structural and dynamical features of water confined in model Lennard–Jones nanopores with tunable hydrophobicity and finite length (

L
=
26

Å). The generic model of cylindrical confinement used is able to reproduce the wetting features of a large class of technologically and biologically relevant systems spanning from crystalline nanoporous materials, to mesoporous silica and ion channels. The aim of this work is to discuss the influence of parameters such as wall hydrophobicity, temperature, and pore size on the structural and dynamical features of confined water. Our simulation campaign confirmed the existence of a core domain in which water displays bulk-like structural features even in extreme (

R
=
7.0

 Å) confinement, while dynamical properties were shown to depend non-trivially on the size and hydrophobicity of the pores.

This article is part of the theme issue ‘Progress in mesoscale methods for fluid dynamics simulation’.
A multiple-relaxation-time collision model by Hermite expansion
Authors: Shan Xiaowen , Li Xuhui , Shi Yangyang
Published: August 2021

The Bhatnagar–Gross–Krook (BGK) single-relaxation-time collision model for the Boltzmann equation serves as the foundation of the lattice BGK (LBGK) method developed in recent years. The description of the collision as a uniform relaxation process of the distribution function towards its equilibrium is, in many scenarios, simplistic. Based on a previous series of papers, we present a collision model formulated as independent relaxations of the irreducible components of the Hermite coefficients in the reference frame moving with the fluid. These components, corresponding to the irreducible representation of the rotation group, are the minimum tensor components that can be separately relaxed without violating rotation symmetry. For the 2nd, 3rd and 4th moments, respectively, two, two and three independent relaxation rates can exist, giving rise to the shear and bulk viscosity, thermal diffusivity and some high-order relaxation process not explicitly manifested in the Navier–Stokes-Fourier equations. Using the binomial transform, the Hermite coefficients are evaluated in the absolute frame to avoid the numerical dissipation introduced by interpolation. Extensive numerical verification is also provided.

This article is part of the theme issue ‘Progress in mesoscale methods for fluid dynamics simulation’.
IgA deficiency destabilizes immunological homeostasis towards intestinal microbiota and increases the risk of systemic immune dysregulation
Authors: Conrey Peyton E. , Denu Lidiya , O’Boyle Kaitlin C. , Green Jamal , Maslanka Jeffrey , Lubin Jean-Bernard , Duranova Tereza , Haltzman Brittany L. , Gianchetti Lauren , Oldridge Derek , Vella Laura A , Allman David , Spergel Jonathan , Tanes Ceylan , Bittinger Kyle , Henrickson Sarah E. , Silverman Michael A.
Published: August 2021

Mammals produce large quantities of mucosal and systemic antibodies that maintain the intestinal barrier, shape the intestinal microbiome and promote lifelong mutualism with commensal microbes. Here, we developed an integrated host-commensal approach combining microbial flow cytometry and 16s rRNA gene sequencing to define the core microbes that induce mucosal and systemic antibodies in pediatric selective Immunoglobulin A (IgA) deficient and household control siblings with CyTOF analysis to determine the impacts of IgA deficiency on host cellular immune phenotype. In healthy controls, mucosal secretory IgA and IgM antibodies coat an overlapping subset of microbes, predominantly Firmicutes and Proteobacteria. Serum IgG antibodies target a similar consortium of fecal microbes, revealing connections between mucosal and systemic antibody networks. Unexpectedly, IgM provides limited compensation for IgA in children lacking intestinal IgA. Furthermore, we find broad systemic immune dysregulation in a subset of children and mice lacking IgA, including enhanced IgG targeting of fecal microbiota, elevated levels of inflammatory and allergic cytokines and alterations in T cell activation state. Thus, IgA tunes systemic interactions between the host and commensal microbiota. Understanding how IgA tunes baseline immune tone has implications for predicting and preventing autoimmune, inflammatory and allergic diseases broadly, as well as providing improved prognostic guidance to patients with IgA deficiency.

One Sentence Summary

IgA deficiency impairs immune homeostasis toward microbiota in children, increasing the risk of immune dysregulation.
Exploring Vaccine Hesitancy in Care Home Employees in North West England: A Qualitative Study
Authors: Dennis Amelia , Robin Charlotte , Jones Leah , Carter Holly
Published: August 2021

Objectives

Care homes have experienced a high number of COVID-19 outbreaks, and it is therefore important for care home employees to receive the COVID-19 vaccine. However, there is vaccine hesitancy at a greater rate among this group than in the wider community. We aimed to understand barriers and facilitators to getting the COVID-19 vaccine, as well as views on potential mandatory vaccination policies.

Design

Semi-structured interviews.

Setting

Care home employees in North West England. Interviews conducted in April 2021.

Participants

10 care home employees (aged 25 to 61 years old) in the North West, who had been invited to have, but had not yet received, the COVID-19 vaccine.

Results

We analysed the interviews using a framework analysis. Our analysis identified eight themes: perceived risk of COVID-19, efficacy of the vaccine, concerns about the vaccine, mistrust in authorities, facilitators to getting the vaccine, views on potential mandatory COVID-19 vaccination policies, negative experiences of care work during the COVID-19 pandemic, and communication challenges.

Conclusions

The care home employees interviewed at the time of this study reported a low perceived risk of COVID-19, alongside concerns over the efficacy of the vaccine, side effects, and speed of vaccine development, which is exacerbated by mistrust in authorities. Facilitators to getting the vaccine included wanting to protect others, perceived severity of COVID-19, and workplace norms. Making COVID-19 vaccination a condition of deployment may not result in increased willingness to get the COVID-19 vaccination, with most care home employees in this study favouring leaving their job rather than getting vaccinated. At a time when many of the workers already had negative experiences of care work during the pandemic due to perceived negative judgment from others and a perceived lack of support facing care home employees, policies that require vaccination as a condition of deployment were not positively received.
A novel Vascular Leak Index identifies sepsis patients with a higher risk for in-hospital death and fluid accumulation
Authors: Chandra Jay , Ángel Armengol Miguel , Lee Gwendolyn , Lee Alexandria , Thoral Patrick , Elbers Paul , Lee Hyung-Chul , Munger John S. , Celi Leo Anthony , Kaufman David A.
Published: August 2021

Purpose

Sepsis is a leading cause of morbidity and mortality worldwide and is characterized by vascular leak syndrome. Treatment for sepsis, specifically intravenous fluids, may worsen deterioration in the context of vascular leak.

Methods

We performed a retrospective cohort study of sepsis patients in four ICU databases in North America, Europe, and Asia. We developed an intuitive vascular leak index (VLI) and determined the relationship between VLI and in-hospital death and 36h-84h fluid balance using generalized additive models (GAM).

Results

Using GAM, we found that increased VLI is associated with an increased risk of in-hospital death. Patients with a VLI in the highest quartile (Q4), across the four datasets, had a 1.61-2.31 times increased odds of dying in the hospital compared to patients with a VLI in the lowest quartile (Q1). VLI Q2 and Q3 were also associated with increased odds of dying. The relationship between VLI, treated as a continuous variable, and in-hospital death and 36h-84h death was statistically significant in the three datasets with a large number of patients. Specifically, we observed that as VLI increased, there was increase in the risk for in-hospital death and 36h-84h fluid balance. For the few patients with a positive VLI, this relationship differed across databases.

Conclusions

Our VLI identifies groups of patients who may be at higher risk for in-hospital death and for fluid accumulation early in the ICU course. This relationship persisted in models developed to control for severity of illness and chronic comorbidity burden.
AEROSOL GENERATION DURING COUGHING - QUANTITATIVE DEFINITION FOR AEROSOL GENERATING PROCEDURES: OBSERVATIONAL STUDY
Authors: Sanmark Enni , Oksanen Lotta-Maria A.H. , Rantanen Noora , Lahelma Mari , Anttila Veli-Jukka , Lehtonen Lasse , Hyvärinen Antti-Pekka , Geneid Ahmed
Published: August 2021

Aim

The purpose of the study was to determine aerosol exposure generated by coughing in operation room environments to create a quantitative limit value for high-risk aerosol-generating medical procedures.

Background

Coughing is known to produce a significant amount of aerosols and is thus commonly used as a best reference for high-risk aerosol-generation. Accordingly, procedures during which aerosol generation exceeds the amount of aerosol generated in instances of coughing are seen as high-risk aerosol generating procedures. However, no reliable quantitative values are available for high-risk aerosol-generation.

Methods

Coughing was measured from 37 healthy volunteers in the operating room environment. Aerosol particles generated during coughing within the size range of 0.3–10 µm were measured with Optical Particle Sizer from 40cm, 70cm, and 100cm distances. The distances reflected potential exposure distances where personnel are during surgeries.

Results

A total of 306 coughs were measured. Average aerosol concentration during coughing was 1.580 ± 13.774 particles/cm3 (range 0.000 – 195.528).

Discussion

The aerosol concentration measured in this study can be used as a limit for high-risk aerosol generation in the operating room environment when assessing the aerosol generating procedures and the risk of operating room staff’s exposure for aerosol particles.
Optimized extraction method enables quantitative analysis of surface metabolite recovery for exposomics and behavioral studies
Authors: Katemauswa Mitchelle , Hossain Ekram , Liu Zongyuan , Lesani Mahbobeh , Parab Adwaita R. , Dean Danya A. , McCall Laura-Isobel
Published: August 2021

Workplace chemical exposures are a major source of occupational injury. Although over half of these are skin exposures, exposomics research often focuses on chemical levels in the air or in worker biofluids such as blood and urine. Until now, one limitation has been the lack of methods to quantitatively measure surface chemical transfer. Outside the realm of harmful chemicals, the small molecules we leave behind on surfaces can also reveal important aspects of human behavior. In this study, we developed a swab-based quantitative approach to determine small molecule concentrations across common surfaces. We demonstrate its utility using one drug, cyclobenzaprine, and two human-derived metabolites, carnitine and phenylacetylglutamine, on four common surfaces: linoleum flooring, plastified laboratory workbench, metal and Plexiglass. This approach enabled linear small molecule recovery and quantification of molecule abundance on workplace built environment surfaces. Overall, this method paves the way for future quantitative exposomics studies.
Peer teaching as bioinformatics training strategy: incentives, challenges, and benefits
Authors: Rahman Nur-Taz , Meyer Caitlin , Thakral Durga , Cai Wesley L. , Chen Ann T. , Obaid Razib , Garcia-Milian Rolando
Published: August 2021

As biomedical research becomes more data-intensive, bioinformatics is becoming essential to understanding biological processes, systems, and diseases. In this paper we describe the use of a series of peer teaching workshops as a strategy to respond to the bioinformatics training needs at a research-intensive institution. In addition to the data collected from the workshops, we also used personal experiences of researchers who participated as peer teachers to understand the incentives, challenges, and benefits of peer teaching. Developing communication skills such as confidence in teaching, explaining complex concepts, and better understanding of the topic emerged as primary benefits that the teachers obtained from this experience. Lack of time for teaching and the struggles of classroom management were identified as two major challenges. We suggest that peer teaching can be beneficial not only to train researchers in bioinformatics, but also as a professional development opportunity for graduate students and postdoctoral trainees.
Risk of Serious Infections in Patients with Psoriasis on Biologic Therapies: An Updated Systematic Review and Meta-Analysis
Authors: Manounah L. , Yiu Z.Z.N. , Mahil S.K. , Exton L.S. , Ezejimofor M.C. , Burden A.D. , Murphy R. , Owen C.M. , Parslew R. , Woolf R.T. , Smith C.H. , Mohd Mustapa M.F.
Published: August 2021

Background

The increase in the number of available biologic agents for psoriasis has led to an urgent need to evaluate their associated risk of serious infections to help inform clinical decisions.

Methodology

We systematically searched PubMed, Medline, Embase, and Cochrane databases for biologics targeting TNF (adalimumab, etanercept, infliximab, certolizumab pegol), interleukin (IL)-12/23 (ustekinumab), IL-17A (secukinumab, ixekizumab), IL-17RA (brodalumab) and IL-23p19 (guselkumab, risankizumab, and tildrakizumab) for the primary outcome serious infections, at 10– 16 weeks, 1 year and 3 years. Peto’s method (fixed effect model) was used to estimate the pooled odds ratio (OR) in meta-analyses comparing biologics with one another, methotrexate, or placebo.

Results

Forty-three publications (49 trials) consisting of 29,724 participants met our inclusion criteria. Serious infections across all studies were low (n=97) at 10–16 weeks and did not show an increased risk with biologic therapies compared with placebo. Seven head-to-head RCTs were identified, most of which showed no significant difference in the risk of serious infections at 10–16 weeks and at 1 year. Adalimumab was not associated with a significant increased risk of serious infections compared with methotrexate in children at 10–16 weeks.

Conclusions

Biologics for psoriasis were not associated with an increased risk of serious infections compared with placebo or one another at 10–16 weeks. Longer-term, real-world data with larger sample sizes are warranted.
Accuracy of mutual predictions of plant and microbe communities varies along a successional gradient in an alpine glacier forefield
Authors: He Xie , Hanusch Maximilian , Ruiz-Hernández Victoria , Junker Robert R.
Published: August 2021

Due to climate warming, recently deglaciated glacier forefields create virtually uninhabited substrates waiting for initial colonization of bacteria, fungi and plants and serve as an ideal ecosystem for studying transformations in community composition and diversity over time and the interactions between taxonomic groups.

In this study, we investigated the composition and diversity of bacteria, and fungi, plants and environmental factors (pH, temperature, plot age and soil nutrients) along a 1.5km glacier forefield. We used random forest analysis to detect how well the composition and diversity of taxonomic groups and environmental factors can be mutually predicted.

Community composition and diversity of taxonomic groups predicted each other more accurately than environmental factors predicted the taxonomic groups; within the taxonomic groups bacteria and fungi predicted each other best and the taxa’s composition was better predicted than diversity indices. Additionally, accuracy of prediction among taxonomic groups and environmental factors considerably varied along the successional gradient.

Although our results are no direct indication of interactions between the taxa investigated and the environmental conditions, the accurate predictions among bacteria, fungi, and plants do provide insights into the concerted community assembly of different taxa in response to changing environments along a successional gradient.
Cell tip growth underlies injury response of marine macroalgae
Authors: Shirae-Kurabayashi Maki , Edzuka Tomoya , Suzuki Masahiro , Goshima Gohta
Published: August 2021

Regeneration is a widely observed phenomenon by which the integrity of an organism is recovered after damage. So far, studies on the molecular and cellular mechanisms of regeneration have been limited to a handful of model multicellular organisms. Here, we systematically surveyed the regeneration ability of marine macroalgae (Rhodophyta, Phaeophyceae, Chlorophyta) after thallus severing and applied live cell microscopy on them to uncover the cellular response to the damage. We observed three types of responses – budding, rhizoid formation and/or sporulation – in 25 species among 66 examined, demonstrating the high potential of regeneration of macroalgae. In contrast, callus formation, which often accompanies plant regeneration, was never observed. We monitored the cellular and nuclear dynamics during cell repair or rhizoid formation of four phylogenetically diverged Rhodophyta and Chlorophyta species (Colaconemasp.,Dasya sessilis, Cladophora albida, Codium fragile). We observed tip growth of the cells near the damaged site as a common response, despite the difference in the number of nuclei and cells across species. Nuclear translocation follows tip growth, enabling overall uniform distribution of multinuclei (Dasya sessilis, Cladophora albida, Codium fragile) or central positioning of the mononucleus (Colaconemasp.). In contrast, the control of cell cycle events, such as nuclear division and septation, varied in these species. InDasya sessilis, the division of multinuclei was synchronised, whereas it was not the case inCladophora albida. Septation was tightly coupled with nuclear division inColaconemaandDasyabut not in others. These observations show that marine macroalgae utilise a variety of regeneration pathways, with some common features. This study also provides a novel methodology of live cell biology in macroalgae, offering a foundation for the future of this under-studied taxon.