bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiotherapy for Bone Pain
Authors: Needham P R , Mithal N P , Hoskin P J
Published: August 2022

Painful bone metastases are a common problem for cancer patients. Although current evidence supports the use of a single fraction of radiotherapy as the treatment of choice, many radiotherapists, for a variety of reasons, continue to use fractionated regimens. Over one six month period 105 patients received external beam irradiation for painful bone metastases at the Royal London Hospital (RLH). Thirty-one per cent of the patients were aged 70 or over. The treatment of 97 of these patients was assessed. They had a total of 280 sites treated over the course of their disease. Fifty-nine per cent of sites treated received a fractionated course of radiotherapy. Site significantly influenced fractionation. Overall response rates of 82% were achieved. Fractionation did not appear to influence this. Ten patients received large field irradiation. Fifteen patients had five or more sites irradiated, of whom only one received hemibody irradiation.
The Psychosocial Assessment of Patients Discharged from Accident and Emergency Departments after Deliberate Self-Poisoning
Authors: Ebbage J , Farr C , Skinner D V , White P D
Published: August 2022

One-third of accident and emergency (A & E) patients who deliberately take an overdose are not admitted to hospital, and this proportion is increasing. We conducted an audit of 300 case records of such patients from two different district health authorities in London. We found that only 4% of patients were assessed in the manner recommended by the Department of Health and 10% had no psychosocial assessment whatsoever. We recommend specific training, an assessment form, regular audit, and communication with the general practitioner.
A Comparison of the Attitudes Shown by General Practitioners, Hospital Doctors and Medical Students towards Alternative Medicine
Authors: Perkin Michael R , Pearcy Richard M , Fraser Jocelyn S
Published: August 2022

The aim of this study was to compare and contrast the views of general practitioners (GPs), hospital doctors and medical students to alternative medicine. A questionnaire was sent to a random sample of 100 GPs and 100 hospital doctors in the South West Thames Regional Health Authority (SWTRHA). A convenience sample of 237 pre-clinical medical students at St George's Hospital Medical School was also given a questionnaire. Eighty-seven GPs and 81 hospital doctors replied. Five therapies were investigated: acupuncture; chiropractice; homoeopathy; naturopathy; and osteopathy. All respondents were asked about their attitude towards and knowledge of these therapies. Doctors were asked how often they referred patients for such treatment and whether they practised it themselves. GPs and hospital doctors had similar levels of knowledge of the therapies. Medical students were the least informed but the most enthusiastic respondents. Seventy per cent of hospital doctors and 93% of GPs had, on at least one occasion, suggested a referral for alternative treatment. GPs were making these referrals more frequently and earlier. Twelve per cent of hospital doctors and 20% of GPs were practising alternative medicine. The majority of the respondents felt that alternative medicine should be available on the National Health Service (NHS) and that medical students should receive some tuition about alternative therapies. A considerable proportion of those doctors referring patients to alternative practitioners were ignorant of their official qualifications.
Effects of Lymphoma on the Peripheral Nervous System
Authors: Hughes R A C , Britton T , Richards M
Published: August 2022

Peripheral nervous system abnormalities occur in 5% of patients with lymphoma and have a wide differential diagnosis. Herpes zoster is the commonest cause. Vinca alkaloids are the only drugs used in lymphoma which commonly cause neuropathy. Compression or infiltration of nerve roots by lymphoma is a rare presenting feature but becomes more common with advanced disease. Radiation plexopathy does not usually develop until at least 6 months after irradiation and can be difficult to distinguish from neoplastic infiltration. Either multifocal infiltration of nerves or lymphoma-associated vasculitis may present as a peripheral neuropathy. The incidence of Guillain-Barré (GBS) syndrome, and possibly chronic idiopathic demyelinating polyradiculoneuropathy, appears to be increased in association with lymphoma, especially Hodgkin's disease. Subacute sensory neuronopathy and subacute lower motor neuronopathy have both been reported as paraneoplastic syndromes associated with Hodgkin's disease. Treatment of the underlying lymphoma is only rarely followed by recovery of the associated neuropathy.
Beyond ‘Clinical’?: Four-Dimensional Medical Education
Authors: Iliffe Steve , Zwi Anthony
Published: August 2022

Medical education is in crisis. Undergraduates experience an excessive burden of information, develop attitudes to learning that are based on passive acquisition of knowledge than on curiosity and exploration, and suffer from progressive disenchantment with medicine. There is also a serious problem of providing adequate clinical experience for medical students at existing teaching sites, largely because of reduction in bed numbers, increased patient throughput and clinical specialization. This problem was identified over a decade ago in London but has not been solved by the merger of medical schools. A recent survey in one London teaching hospital showed underemployment of students and limited patient contact. A review of clinical clerkships in an Australian medical school revealed that one-third of teachers were perceived as unconcerned, discouraging, derogatory or hostile, and only one-half were rated as effective educators. One consequence has been the development of a wide-ranging debate on changing medical education. Traditionalists have diminishing room for manoeuvre in defence of existing educational practices, as cautious bodies like the General Medical Council (GMC) opt for fundamental reform.
Aortobronchial Fistula following Aortic Valve Surgery
Authors: Ninan Mathew , Hunter Steven , Parker D John
Published: August 2022

We report the case of a 54-year-old man with an aortobronchial fistula following aortic valve replacement for prosthetic endocarditis. He presented with massive haemoptysis and the diagnosis was made following computerized tomography of the chest. Effective treatment was achieved by adhering to the basic principles of fistula management. The patient remains well at 1 year follow-up.
How Negative are We to the Idea of Suicide Prevention?
Authors: Morgan H G , Evans M O
Published: August 2022

Assessment of attitudes amongst health care professionals to suicide prevention reveals a considerable degree of doubt with regards to its feasibility and appropriateness. The various professional groups may vary considerably in the degree of negative attitudes which they exhibit. Such findings suggest that there is an urgent need to ensure that health care professionals are fully informed about the key facts concerning suicide and preventive strategies. Key elements of clinical practice and service organization with regards to suicide prevention are discussed.
Addressing Animal Welfare Issues in Fetal Blood Collection for Fetal Bovine Serum Production
Authors: McCann Terence J. , Treasure Carol
Published: August 2022

There is ethical debate over whether fetal calves suffer when their dam is slaughtered and fetal blood extracted by cardiac puncture for fetal bovine serum (FBS) production. Yet, the serum industry does not follow best practice, as recommended by the European Food Safety Authority (EFSA), to avoid fetal distress. We discuss the key elements of this debate, and recommend how the serum industry can alter its practices to improve animal welfare.
Eight years of CRASH: A bi-national initiative helping critical care doctors return to work
Authors: Allen Kara J , Wright Janette C , Lee Emelyn M , Vickerman Brooke J , Barnett Sheila G
Published: August 2022

Returning to work in critical care after a break in clinical practice can be a daunting process. This article describes development and evolution of the Critical Care, Resuscitation, Airway Skills: Helping you return to work (CRASH) course, including the supporting literature. CRASH is the first bi-national course assisting return to work (RTW) for critical care practitioners. It evolved as a collaborative effort across Australia and New Zealand, involving anaesthetists, emergency physicians and intensivists. The course is based around tailored sessions practising skills and clinical decision-making using simulation and case discussions, incorporating practical tips on returning to work. Participants receive resources to assist RTW including questionnaires and checklists developed by the faculty, which have been used to aid RTW in more than 30 hospitals in Australia and New Zealand. Attendance is open to all critical care practitioners who are registered with the relevant medical board and returning to work, who have taken leave from work for any reason. Since 2014, 197 participants have attended CRASH in-person or virtually, one of the largest RTW groups described in the literature. The aim of this article is to outline the literature around inactivity and RTW, and describe the development and adaptation of the CRASH course.
Efficacy of lasmiditan for the acute treatment of perimenstrual migraine
Authors: MacGregor E Anne , Komori Mika , Krege John Henry , Baygani Simin , Vincent Maurice , Pavlovic Jelena , Igarashi Hisaka
Published: August 2022

Background

Perimenstrual migraine attacks in women with menstrual migraine is difficult to treat. This post-hoc analysis evaluated the efficacy of lasmiditan, a high affinity and selective 5-HT1F receptor agonist, for perimenstrual attacks.

Methods

Patients from two randomized, double-blind, placebo-controlled clinical trials (MONONOFU and CENTURION) were instructed to treat an attack with a single dose of study medication within four hours of pain onset. After dosing, the proportion of patients who achieved freedom from migraine-related head pain, most bothersome symptom, and disability was reported at baseline up to 48 hours after dose and pooled data were evaluated.

Results

A total of 303 patients (MONONOFU N = 78; CENTURION N = 225) treated perimenstrual migraine attacks with lasmiditan 50 mg (N = 24), 100 mg (N = 90), 200 mg (N = 110), and placebo (N = 79). More patients achieved migraine-related head pain freedom with lasmiditan 200 mg versus placebo at all time points assessed. At 2 hours, 33.6% of patients in the 200-mg group (p < 0.001), and 16.7% of patients in the 100-mg (p = 0.11) and 50-mg (p = 0.19) groups were pain free, compared with 7.6% in the placebo group.

Conclusions

Lasmiditan treatment of perimenstrual migraine attacks was associated with freedom from migraine-related head pain at two hours, early onset of efficacy, and sustained efficacy. Clinical Trial registration: NCT03962738 and NCT03670810
Multisystem Inflammatory Syndrome in Adults (MIS-A) After COVID-19 Infection and Recent Vaccination with Recombinant Adenoviral Vector Encoding the Spike Protein Antigen of SARS-CoV-2 (ChAdOx1 nCoV-19, Vaxzevria)
Authors: Ehikhametalor Kelvin , Deans-Minott Jacqueline , Duncan Jacqueline P
Published: August 2022

The clinical spectrum of Coronavirus 2019 (COVID-19) includes acute COVID-19, long covid and multisystem inflammatory syndrome in children and adults (MISC/A). The rapid roll-out of COVID-19 vaccination has the potential to affect the clinical presentation of COVID-19 and case reports document rare occurrences of MIS-A after COVID-19 infection and recent vaccination with m-RNA vaccines. We describe 2 cases of MIS-A after COVID-19 infection and recent vaccination with ChAdOx1 nCoV-19.
Metabolic syndrome in people with HIV from Guatemala: analysis of components and risk factors
Authors: Ortíz Dean W , Marroquin Hugo E , Larson Lindsey , Franco Katherine B , Spec Andrej , Melendez Johanna R , Pinzón Rodolfo , Samayoa Ana J , Mejia-Chew Carlos , O´Halloran Jane A
Published: August 2022

Background

People with HIV (PWH) in Latin America are at a greater risk of developing comorbidities due to the increasing burden of obesity and metabolic syndrome in the region. We explored the associations between social, cardiovascular and HIV-related risk factors with metabolic syndrome in PWH from Guatemala.

Methods

Cross-sectional study analyzing demographic, clinical and laboratory data from PWH. Metabolic syndrome diagnosis and components are defined by the harmonized Joint Scientific Statement criteria. Data were collected from July 2019 to March 2020 and analyzed using correlations and logistic regression.

Results

Median age was 39 years [IQR 31-48], 56.8% of participants were male and 31.5% ( n = 266, 95% CI 0.28–0.34) had metabolic syndrome. Age (adjusted odds ratio (aOR): 1.03, 95% CI 1.02–1.05, p <0.001), urban dweller (aOR: 1.48, 95% CI 1.00–2.18, p = 0.049), low physical activity (aOR: 1.45, 95% CI 1.01–2.08, p = 0.046), hyperuricemia (aOR: 3.31, 95% CI 1.93–5.67, p <0.001), current CD4+ T cell count < 200 cells/mm3 (aOR: 1.96, 95% CI 1.19–3.23, p = 0.009), 6 months of efavirenz (aOR: 1.89, 95% CI 1.29–2.77, p = 0.001), and obesity (aOR: 37.0, 95% CI 7.70–178.2, p < 0.001) were independently associated with metabolic syndrome.

Conclusions

Prevalence of metabolic syndrome in this study was high and driven mainly by social and cardiovascular risk factors such as age, urban dwelling, obesity, hyperuricemia and low physical activity. Efavirenz use and CD4 count were the only HIV-related factors associated with metabolic syndrome.
Introduction: Madness and psychiatry in East Asian countries in the modern period
Authors: Suzuki Akihito , Wang Wen-Ji
Published: August 2022

In the past decades, there has been an increasing scholarly interest in understanding the development of psychiatry and mental health in non-Western worlds in the modern period. Several collective efforts have been made on the East Asian part, and this special issue has selected the examples of the countries of China, Japan, Korea, Hong Kong and Taiwan. Articles have utilized social and political constructions of psychiatric discourse, as well as the use of case files to research patients’ experiences in mental hospitals. Through these historiographies, connections and meanings of East Asian psychiatry are discussed in both global and local contexts.
A Case Study: Explaining the Price Collapse of Tongan Squash Export to Japan
Authors: Segawa Noriyuki
Published: August 2022

This article focuses on the squash industry of Tonga, which was successfully developed in the 1990s and declined in the 2000s. It analyses how squash export prices are affected by the quantity of squash export and the number of squash exporters. An examination of the squash industry demonstrates that the collapse of the export prices and the decline of the industry is caused due to the lack of structural frameworks for managing the industry effectively and/or the functional failure of the framework. It is perceived that the decline of the industry was due to the withdrawal of the squash export quota from the government, but the main factor appears to be the failure of the government to control the quality of the squash exported to Japan. Thus, a weak institutional capacity prevented the sustainable development of the industry. This article concludes that the development of institutional and human capacity to establish structural frameworks for managing industries and operating the frameworks effectively will contribute to the sustainable development of an export-oriented agriculture-based industry in the PICs.
‘Maybe I Shouldn’t Talk’: The Role of Power in the Telling of Mental Health Recovery Stories
Authors: Llewellyn-Beardsley Joy , Rennick-Egglestone Stefan , Pollock Kristian , Ali Yasmin , Watson Emma , Franklin Donna , Yeo Caroline , Ng Fiona , McGranahan Rose , Slade Mike , Edgley Alison
Published: August 2022

Mental health ‘recovery narratives’ are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing ‘acceptable’ stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience.
Accuracy of 4 Free Online Dosing Calculators in Predicting the Vancomycin Area Under the Concentration-Time Curve Calculated Using a 2-Point Pharmacokinetic Approach
Authors: Belz Sarah N. , Seabury Robert W. , Steele Jeffrey M. , Darko William , Miller Christopher D. , Probst Luke A. , Kufel Wesley D.
Published: August 2022

Background:

Free online adaptive vancomycin dosing calculators are available to estimate area under the concentration-time curve (AUC), but the accuracy of predicting vancomycin AUC using these calculators compared with using a 2-point pharmacokinetic approach has not been described.

Objective:

To evaluate the accuracy of calculator-predicted AUC (cpAUC) using 4 free online calculators compared with reference AUC (rAUC), and to assess pharmacists’ impressions of the ease of use.

Methods:

Vancomycin AUC was estimated using (1) the reference method via the Sawchuk-Zaske method and linear-logarithmic trapezoidal rule using 2 steady-state postdistributional vancomycin serum concentrations and (2) 4 free online vancomycin dosing calculators including ClinCalc, VancoPK, TDMx, and DMC. Accuracy was calculated by dividing cpAUC by rAUC. Ease of cpAUC estimation was determined by using a 10-point Likert scale.

Results:

All 4 calculators had a median cpAUC accuracy ranging from 89% to 110%. Concordance between cpAUC and rAUC determinations of AUC <400 and > 600 mg·h/L occurred 63.3% to 71.4% and 74.5% to 78.6% of the time, respectively. Pharmacist investigators agreed that ClinCalc and VancoPK calculators were easiest to use.

Conclusion and Relevance:

cpAUC accuracy varied among the 4 calculators, but all consistently identified patients with an rAUC <400 mg·h/L and an rAUC > 600 mg·h/L at comparable frequencies. All 4 calculators demonstrated some imprecision based on their wide 95% CIs and potential inaccuracies in predicting an rAUC <400 mg·h/L or an rAUC > 600 mg·h/L. Clin Calc and VancoPK were most user friendly based on our pharmacists’ impressions.
From demon to deity: Forging a new iconography for Mahishasur
Authors: Sen Moumita
Published: August 2022

This article focuses on the forging of a new iconography for Mahishasur, a ‘demon’ in Hindu mythology who was reclaimed by indigenous communities both as a ‘god’ and as a champion of their political autonomy. The public political ritual of venerating Mahishasur was deemed blasphemous by the Hindu nationalist party in power. Among clay-modellers of Bengal, the dominant ‘demon’ image of Mahishasur embodies the highly-valued skill of Naturalistic sculpture; but the movement needed a new benevolent image. Through interviews with image-makers and organisers of this political ritual in several villages of West Bengal, I will show how local aesthetic ideals of masculinity, virtue, and political ideology are expressed in the new aesthetic form(s) and iconographies of this emerging hero of Indian politics.
Using end buckles to improve debonding resistance in FRP-bonded precracked RC beams
Authors: Zhou Chao-Yang , Chen Heng-Yi , Wang Yi , He Xue-Jun
Published: August 2022

The strengthening effect of reinforced concrete (RC) members externally bonded (EB) with fiber reinforced polymer (FRP) laminates is significantly affected by interfacial debonding failure. To improve the connection between FRP sheets and concrete, a novel type of anchor device for FRP sheets called buckle was proposed in this study. This device can effectively lock the end of the sheet using a patented method of wrapping. In addition to conventional external bonding, bolts were installed on the buckles to form hybrid anchored (HA) FRP sheet. To verify the effectiveness of this new method, a precracked RC beam was prepared in comparison with two undamaged beams strengthened with EB or HA FRP sheets. As observed, end buckles can limit the development of cracks regardless of initial cracking. Despite the occurrence of intermediate debonding due to initial cracks, both the ultimate capacity and failure ductility were significantly improved. Owing to the end buckles, the debonding resistance was excellent, and the initial cracking of the beam hardly affected the strengthening effect. In addition, existing formulas were used to calculate the lower limit of the ultimate load of the specimen strengthened with HA FRP, which was still higher than that of the specimen strengthened by EB FRP. Therefore, the results confirmed that the debonding resistance was greatly enhanced due to the locking of the FRP sheet via end buckles, and the proposed method is useful to guarantee the strengthening effect.
How Effective Altruism Can Help Psychologists Maximize Their Impact
Authors: Gainsburg Izzy , Pauer Shiva , Abboub Nawal , Aloyo Eamon T. , Mourrat Jean-Christophe , Cristia Alejandrina
Published: August 2022

Although many psychologists are interested in making the world a better place through their work, they are often unable to have the impact that they would like. Here, we suggest that both individuals and psychology as a field can better improve human welfare by incorporating ideas from effective altruism, a growing movement whose members aim to do the most good by using science and reason to inform their efforts. In this article, we first briefly introduce effective altruism and review important principles that can be applied to how psychologists approach their work, such as the importance, tractability, and neglectedness framework. We then review how effective altruism can inform individual psychologists’ choices. Finally, we close with a discussion of ideas for how psychology, as a field, can increase its positive impact. By applying insights from effective altruism to psychological science, we aim to integrate a new theoretical framework into psychological science, stimulate new areas of research, start a discussion on how psychology can maximize its impact, and inspire the psychology community to do the most good.
‘Why is it Different with a Hare?’ Game-Law Melodrama on Stage and Screen in Colin Hazlewood's Waiting for the Verdict
Authors: Ridgwell Stephen
Published: August 2022

Much of Colin Hazlewood's prolific mid-Victorian output consisted of adaptations. A classic example of Hazlewood's adaptational practice and an excellent case study in the restlessly intermedial nature of nineteenth- and early-twentieth-century popular culture was his 1859 game-law melodrama Waiting for the Verdict. One of Hazlewood's most successful plays, it was later adapted for the screen by the Edwardian filmmakers Mitchell and Kenyon. Tracing his work across different media forms, this article further confirms Hazlewood as a highly skilled adaptor, while offering some viewable evidence of the creative links between theatre and early cinema. The article also suggests that what I term game-law melodrama represented a significant sub-genre variant to the broader one of domestic drama. Game-law melodramas such as Waiting for the Verdict offered picturesque entertainment for largely urban audiences, but they also provided pertinent social comment on a major concern of the day.
The effect of information technology intervention on using appropriate VTE prophylaxis in non-surgical patients: A systematic review and meta-analysis
Authors: Karajizadeh Mehrdad , Hassanipour Soheil , Sharifian Roxana , Tajbakhsh Fatemeh , Saeidnia Hamid Reza
Published: August 2022

Introduction

Clinical decision support systems (CDSSs) play an important role in summarizing the best clinical practices, thereby promoting high standards of care in specific medical fields. These systems can serve as tools for gaining knowledge and mediating between clinical guidelines and physicians thereby providing the right information to the right person at the right time.

Objective

This review aims to evaluate the effect of CDSSs on adherence to guidelines for venous thromboembolism (VTE) prophylaxis and VTE events compared to routine care without CDSSs in non-surgical patients.

Methods

In order to conduct a systematic literature review, the published studies were identified through screening EMBASE, the international clinical trials registry, OVID, Cochrane database, PubMed, ISI Web of Science, and Scopus databases, from 1982 to March 2021. The included studies were reviewed by two independent reviewers; the proportion of patients that correctly received VTE prophylaxis has been next extracted for further analysis. Additionally, patients were divided into two groups: CDSS-recommended VTE prophylaxis and routine care without using a CDSS.

Results

Twelve articles (three randomized controlled trials, seven prospective cohort trials, and two retrospective cohort trials) were in fine analyzed. The use of CDSSs is found to be associated with a significant increase in the rate of using the appropriate prophylaxis for VTE ( p < 0.05) and a significant decrease in the incidence of VTE ( p < 0.05).

Conclusion

Implementation of CDSSs can help improving the appropriate use of VTE prophylaxis in non-surgical patients. Further, evidence-based and interventional studies on the development of CDSSs can provide more in-depth knowledge on both this tool design and efficiency.
What drives the use of wearable healthcare devices? A cross-country comparison between the US and Korea
Authors: Rha Jong-Youn , Nam Youngwon , Ahn Sun Young , Kim Jihye , Chang Youchung , Jang Jisu , Kurita Keiko , Park Jin-Young , Eom Kunsun , Moon Hyunseok , Jung Myoung Hoon , Kim Yoon Jae , Hwang Jeong-Eun , Choo HyucK
Published: August 2022

Objective

Given the rapid growth of the wearable healthcare device market, we examined the associations among health-related and technology-related characteristics of using wearable healthcare devices and demonstrated how the associations differ between the US and Korean users.

Methods

Online self-administered surveys were conducted with 4098 participants (3035 in the US and 1063 in Korea) who were recruited through two online survey service providers based on quota sampling. The primary outcome was the use of wearable healthcare devices. Seven health-related, two technology-related, and five socio-demographic factors were included as explanatory variables. Binary logistic regression analyses and a Chow test were conducted.

Results

The health-related characteristics that were significantly associated with using wearable healthcare devices included disease-related worries (β = 0.11**), health information seeking (β = 0.26***), physical activity (β = 0.62***), and health-related expenditures ($50–$199, β = 0.38***; $200 or more, β = 0.56***). Hedonic (β = 0.33***), social (β = 0.31***), and cognitive innovativeness (β = 0.14*) also exhibited positive relationships. Younger, higher earner, and individuals with a child were more likely to use wearable healthcare devices. However, for Korean users, several associations disappeared including health information seeking, hedonic and social innovativeness, age, and household income.

Conclusions

Key drivers of using wearable healthcare devices include greater concern about a specific illness, active engagement in health-promoting behaviors, and hedonic and social motivation to adopt new technologies. However, more country-specific considerations are needed in future studies to identify the main benefits for target markets.
Association between speech rate measures and cognitive function in people with relapsing and progressive multiple sclerosis
Authors: O’Keeffe Clodagh , Yap Siew Mei , Davenport Laura , Cogley Clodagh , Craddock Fiona , Kennedy Alex , Tubridy Niall , Looze Céline De , Suleyman Narin , O’Keeffe Fiadhnait , Reilly Richard B. , McGuigan Christopher
Published: August 2022

Background

Cognitive impairments are well-documented in multiple sclerosis (MS), while speech impairments are often overlooked despite their significant effect on quality of life. For effective clinical management of multisystem conditions such as MS, consideration should be given to the interaction between deficits in multiple domains, such as speech and cognition. To evaluate speech rate measures of spontaneous and read speech, in people with MS and to examine the link between speech and cognition.

Methods

Forty-five people with MS and 25 controls underwent an extensive cognitive battery, including executive functioning, information processing and memory tasks, and completed two speech tasks: a reading task and a picture description task, from which speech rate measures were derived.

Results

The progressive MS cohort had reduced articulation ( p < 0.04) and speech rate ( p < 0.02) compared to controls and those with relapsing MS. Regression models also revealed information processing speed accounted for 18% to 30% of the variance of spontaneous speech rate measures, and 27% of read speech. Executive functioning accounted for a further 10% of the variance of speech rate in those with MS.

Conclusions

The present study suggests that speech production is contingent on cognitive ability, with information processing speed and executive functioning linked with speech timing patterns.
Unvaccinated Non-Elderly Adult Population Hospitalized for COVID-19: Risk for Severe Disease and Poor Outcomes
Authors: Jo Diana , Sophonsri Anthony , Ny Pamela , Lou Mimi , Nieberg Paul , Shriner Kimberly , Wong-Beringer Annie
Published: August 2022

Introduction:

Vaccination offers significant protection against hospitalization and death due to severe COVID-19. However, a significant portion of the nonelderly U.S. adult population remains unvaccinated.

Methods:

This retrospective analysis of adult patients aged under 65 years hospitalized with PCR-confirmed SARS-CoV-2 between March and November 2021 assessed the age-biased risk for severe disease and outcome in non-elderly unvaccinated adults hospitalized for COVID-19. Main measures included predisposing risk factors, disease severity and progression, and outcomes in non-elderly adults compared between (1) vaccinated and unvaccinated individuals and (2) unvaccinated individuals grouped by 10-year age increment.

Results:

Two hundred nineteen non-elderly adults were included; of whom, 82.6% were unvaccinated. Overall, unvaccinated patients were more likely to be obese (60% vs 29%, P < .001) while vaccinated patients were more likely to have cardiovascular disease (50% vs 29%, P = .03). Unvaccinated individuals had prolonged ICU stay (11 vs 2 days, P = .002) and overall length of stay (6 vs 5 days, P < .0001), and higher proportion requiring oxygen at discharge (54% vs 29%, P < .0001). An age-stratified analysis of the unvaccinated cohort found that the time to discharge increased with age ( P = .003). Compared to unvaccinated patients aged <46 years, unvaccinated patients aged ≥46 years demonstrated 1.47- and 3.49-times higher likelihood of oxygen dependency upon discharge ( P = .002) and requiring higher level of care or worse at discharge ( P = .004), respectively.

Conclusion:

Results from our non-elderly cohort affirm the benefit of vaccination despite a subset requiring hospitalization for breakthrough infection. In unvaccinated non-elderly adults, risk for worse outcomes and severe disease increased substantially from middle age onward and provides strong support for vaccination efforts in this population.
Signature Pedagogies versus Trauma Informed Approaches: Thematic Analysis of Graduate Students’ Reflections
Authors: L. Friedman Zahava
Published: August 2022

The COVID-19 pandemic is evidenced as a traumatic event, impacting college students preparing for healthcare careers. Trauma-informed pedagogical evidence-based recommendations include clear instruction, faculty availability, and open acknowledgment of challenges . This study explored trauma-informed mechanisms embedded in a fully online health sciences course at a public New Jersey university, given during COVID-19 pandemic in spring, 2021, to ascertain student perceptions of mechanisms and sense of belonging within the online classroom environment. Thirty-four ( n = 34) Master’s and Doctoral graduate students were enrolled in this course, which met for 3 hours weekly, for a 15 week semester. Qualitative data were collected from students, including 42 reflective posts per student (for a total of 1,428 reflections) and anecdotal observations at semester’s end. Via qualitative reflexive thematic analysis, the following four themes emerged: (1) Recognizing the Moment, (2) Creating Empathic Connections, (3) Appreciating Availability/Flexibility, and (4) Clarity of Instruction. These themes are discussed, and implications for an actionable model for signature pedagogies embedded in trauma-informed care in graduate health science education are reviewed.
Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: a pooled analysis of placebo-controlled trials
Authors: Lampl Christian , Kraus Viktoria , Lehner Katrina , Loop Brett , Chehrenama Mahan , Maczynska Zofia , Ritter Shannon , Klatt Jan , Snellman Josefin
Published: August 2022

Background

Erenumab, a fully human monoclonal antibody that targets the calcitonin gene-related peptide receptor, has demonstrated efficacy and safety in the prevention of episodic and chronic migraine. There exists an unmet need to establish the safety of erenumab in older individuals, in view of existing multiple comorbidities, polypharmacy, and age-related physiological changes. This pooled analysis of five large migraine-prevention studies examined the safety of erenumab stratified across age groups, particularly in older populations.

Methods

Pooled and age-stratified analysis of safety data from the 12-week double-blind treatment phase (DBTP) of five randomized, placebo-controlled Phase 2 and 3 studies of erenumab in participants with episodic or chronic migraine across the age groups < 40 years, 40–49 years, 50–59 years, and ≥ 60 years was completed. The safety of erenumab across age groups was determined by assessing safety endpoints including treatment-emergent adverse events (AEs), serious AEs, and events leading to study drug discontinuation.

Results

Overall, 3345 participants across five studies were randomized to receive either placebo (n = 1359), erenumab 70 mg (n = 1132) or erenumab 140 mg (n = 854); 3176 (94.9%) completed the DBTP, and 169 (5.1%) discontinued, mainly due to participant decision (110; 3.3%). Overall, 1349 (40.6%), 1122 (33.8%), and 850 (25.6%) participants received at least one dose of placebo, erenumab 70 mg, and erenumab 140 mg, respectively.

Incidence of treatment-emergent AEs was similar across all age groups for both doses of erenumab (70 mg or 140 mg) and placebo (< 40 years, 44.0% vs 44.4%; 40–49 years, 42.5% vs 49.2%; 50–59 years, 46.5% vs 41.6%; ≥ 60 years, 43.8% vs 59.4%). Incidence of treatment-emergent serious AEs overall, and stratified by age groups for both doses and placebo was low (< 40 years, 0.9% vs 1.2%; 40–49 years, 1.7% vs 1.9%; and 50–59 years, 1.6% vs 1.1%), with no serious AEs reported in participants aged ≥ 60 years. No deaths were reported.

Conclusions

Erenumab (70 mg or 140 mg) exhibited a similar safety profile compared with placebo across age groups in individuals with episodic or chronic migraine, with no increased emergence of events due to age. Erenumab was well tolerated in older participants with multiple comorbidities, polypharmacy, and age-related physiological changes.

Trial registration number

ClinicalTrials.gov Identifiers: NCT02066415, NCT02456740, NCT02483585, NCT03096834, NCT03333109.
A machine learning model for classifying G-protein-coupled receptors as agonists or antagonists
Authors: Oh Jooseong , Ceong Hyi-thaek , Na Dokyun , Park Chungoo
Published: August 2022

Background

G-protein coupled receptors (GPCRs) sense and transmit extracellular signals into the intracellular machinery by regulating G proteins. GPCR malfunctions are associated with a variety of signaling-related diseases, including cancer and diabetes; at least a third of the marketed drugs target GPCRs. Thus, characterization of their signaling and regulatory mechanisms is crucial for the development of effective drugs.

Results

In this study, we developed a machine learning model to identify GPCR agonists and antagonists. We designed two-step prediction models: the first model identified the ligands binding to GPCRs and the second model classified the ligands as agonists or antagonists. Using 990 selected subset features from 5270 molecular descriptors calculated from 4590 ligands deposited in two drug databases, our model classified non-ligands, agonists, and antagonists of GPCRs, and achieved an area under the ROC curve (AUC) of 0.795, sensitivity of 0.716, specificity of 0.744, and accuracy of 0.733. In addition, we verified that 70% (44 out of 63) of FDA-approved GPCR-targeting drugs were correctly classified into their respective groups.

Conclusions

Studies of ligand–GPCR interaction recognition are important for the characterization of drug action mechanisms. Our GPCR–ligand interaction prediction model can be employed in the pharmaceutical sciences for the efficient virtual screening of putative GPCR-binding agonists and antagonists.
2022 BMC Ecology and Evolution image competition: the winning images
Authors: Harman Jennifer , Hipsley Christy A. , Jacobus Luke M. , Liberles David A. , Settele Josef , Traulsen Arne
Published: August 2022

In 2022, researchers from around the world entered the BMC Ecology and Evolution photography competition. The contest produced a spectacular collection of photographs that capture the wonder of the natural world and the growing need to protect it as the human impact on the planet intensifies. This editorial celebrates the winning images selected by the Editor of BMC Ecology and Evolution and senior members of the journal’s editorial board.
Predictors of falls and hospital admissions in people with cognitive impairment in day-care: role of multimorbidity, polypharmacy, and potentially inappropriate medication
Authors: Scheel Jennifer , Luttenberger Katharina , Graessel Elmar , Kratzer André , Donath Carolin
Published: August 2022

Background

Multimorbidity, polypharmacy, and potentially inappropriate medication (PIM) pose challenges for the care of people with cognitive impairment. The aim of the present study is to explore whether multimorbidity, polypharmacy, and PIM predict falls and hospital admissions in a sample of people with cognitive impairment in day-care centers in Germany.

Methods

We used data from the German day-care study (multicenter longitudinal study, n = 433). Multimorbidity was defined as ≥ 2 chronic diseases. Polypharmacy was defined as prescriptions to ≥ 5 drugs. Potentially inappropriate medication was defined as scoring on the PRISCUS list. Binary logistic regression analyses were computed to determine whether multimorbidity, polypharmacy, and potentially inappropriate medication at t0 predicted falls and hospital admissions as outcomes at t1 (six months later).

Results

The rate of multimorbidity and polypharmacy was 87.8% and 60.3%, respectively. 15.9% of the people with cognitive impairment received PIM / PRISCUS-listed drugs, 43.6% ACB-listed drugs, and 52.7% CNS depressant drugs. Falls and hospital admissions during follow-up were prevalent in 19.4% and 24.7% of the people with cognitive impairment. Both were significantly predicted by the total number of drugs (falls: OR = 1.152, p = 0.001, overall model: p < 0.001; hospital admissions: OR = 1.103, p = 0.020, overall model: p = 0.001), even if regression analyses were controlled for the number of comorbidities.

Conclusions

Polypharmacy and potentially inappropriate medication are highly prevalent in people with cognitive impairment in German day-care centers. The number of drugs and appropriateness of medication seem to be crucial for the risk of falls and hospital admissions. Polypharmacy and PIM should be critically reviewed by healthcare providers and avoided as much as and whenever possible.

Trial registration

ISRCTN16412551, 30 July 2014, registered partly retrospectively.
Clinical testing on SARS-CoV-2 swab samples using reverse-transcription loop-mediated isothermal amplification (RT-LAMP)
Authors: Lai Meng Yee , Bukhari Fatma Diyana Mohd , Zulkefli Nur Zulaikha , Ismail Ilyiana , Mustapa Nur Izati , Soh Tuan Suhaila Tuan , Hassan Afifah Haji , Peariasamy Kalaiarasu M. , Lee Yee Leng , Suppiah Jeyanthi , Thayan Ravindran , Isa Mohd Khairi Mat , Wahid Nur Zafirah Abdul , Lau Yee Ling
Published: August 2022

Background

High cost of commercial RNA extraction kits limits the testing efficiency of SARS-CoV-2. Here, we developed a simple nucleic acid extraction method for the detection of SARS-CoV-2 directly from nasopharyngeal swab samples.

Methods

A pH sensitive dye was used as the end point detection method. The obvious colour changes between positive and negative reactions eliminates the need of other equipment.

Results

Clinical testing using 260 samples showed 92.7% sensitivity (95% CI 87.3–96.3%) and 93.6% specificity (95% CI 87.3–97.4%) of RT-LAMP.

Conclusions

The simple RNA extraction method minimizes the need for any extensive laboratory set-up. We suggest combining this simple nucleic acid extraction method and RT-LAMP technology as the point-of care diagnostic tool.
3D variable flip angle T1 mapping for differentiating benign and malignant liver lesions at 3T: comparison with diffusion weighted imaging
Authors: Wang Fei , Yang Qing , Zhang Yupei , Liu Jun , Liu Mengxiao , Zhu Juan
Published: August 2022

Background

Different methods have been used to improve the imaging diagnosis of focal liver lesions (FLL). Among them, magnetic resonance imaging (MRI) has received more attention since it provides significant amount of information without radiation exposure. However, atypical imaging characteristics of FLL on MRI may complicate the differential diagnosis between benign and malignant FLL. This study aimed to compare the diagnostic value of T1 mapping and diffusion-weighted imaging (DWI) for differentiating of benign and malignant FLLs.

Methods

This retrospective study enrolled 294 FLLs, including 150 benign and 144 malignant lesions. Whole liver T1 mapping sequences were obtained before and 2 min after the administration of Gd-DTPA to acquire native T1 and enhanced T1 and ΔT1%. Additionally, DWI sequence was conducted to generate apparent diffusion coefficient (ADC) maps. These quantitative parameters were compared using one-way analysis of variance, and the diagnostic accuracy of T1 mapping and ADC for FLLs was calculated by area under the curve (AUC).

Results

Significant differences were observed regarding the native T1, enhanced T1, ΔT1%, and ADC between benign and malignant FLLs. Furthermore, the sensitivity and specificity of the parameters are as follows: native T1 0.797/0.702 (cut off value 1635.5 ms); enhanced T1, 0.911/0.976 (cutoff value 339.2 ms); ΔT1%, 0.901/0.905 (cutoff value 70.8%); and ADC, 0.975/0.952 (cutoff value 1.21 × 10−3 mm2/s). The ideal cutoff values for native T1 and ADC in identifying cyst and haemangioma were 2422.9 ms (AUC 0.990, P < 0.01) and 2.077 × 10–3 mm2/s (AUC 0.949, P < 0.01), respectively, with a sensitivity and specificity of 0.963/1 and 0.852/0.892, respectively. ADC was significantly positively correlated with T1 and ΔT1%, and significantly negatively correlated with enhanced T1.

Conclusion

The 3D Variable flip angle T1 mapping technique with Gd-DTPA has a high clinical potential for identifying benign and malignant FLLs. The enhanced T1 and ΔT1% values have similar diagnostic accuracy compared with DWI in evaluating FLLs. Native T1 shows better performance than DWI in distinguishing benign liver lesions, specifically, cysts, and haemangioma.
Serum glycated albumin as a predictive biomarker for renal involvement of antineutrophil cytoplasmic antibody-associated vasculitis in non-diabetic patients
Authors: Park Pil Gyu , Pyo Jung Yoon , Ahn Sung Soo , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won
Published: August 2022

Background

Glycated albumin (GA) is known to reflect the current inflammatory burden in non-diabetes mellitus (DM) patients. In this study, we investigated whether GA at diagnosis could reflect the cross-sectional activity and predict poor outcomes during follow-up in non-DM patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Methods

The medical records of 118 immunosuppressive drug-naïve AAV patients were retrospectively reviewed, and 76 patients who had both GA and glycated haemoglobin (HbA1c) results but not DM were included in this study. Demographic, clinical, and laboratory data at diagnosis were assessed.

Results

The median age of AAV patients was 61 years, and 31 patients were male. GA was positively correlated with five-factor score (r = 0.282), Birmingham vasculitis activity score (BVAS) assigned to renal manifestation (r = 0.315), and blood urea nitrogen (r = 0.382), whereas negatively correlated with haemoglobin (r = -0.345). AAV patients with end-stage renal disease (ESRD) exhibited significantly higher GA than those without ESRD (15.8% vs. 13.6%). When the cut-off of GA at diagnosis for ESRD was set at GA ≥ 14.25%, AAV patients with GA ≥ 14.25% had a significantly higher risk for ESRD development than those without (relative risk 12.040). In addition, AAV patients with GA ≥ 14.25% exhibited significantly lower cumulative ESRD-free survival rates than those without (P = 0.020).

Conclusion

In conclusion, GA at diagnosis can reflect the cross-sectional BVAS assigned to renal manifestation of AAV and predict ESRD development during follow-up better than HbA1c or GA/HbA1c in AAV patients.