bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a community‐based child health counselling intervention on health‐seeking behaviours, complementary feeding and nutritional condition among children aged 6–23 months in rural China: A pre‐ and post‐comparison study
Authors: Yao Shiyi , Xiao Shuyue , Jin Xi , Xiong Mei , Peng Jing , Jian Lijun , Mei Yongli , Huang Yuehua , Zhou Haiqun , Xu Tao
Published: November 2021

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government‐funded nutrition programme, Ying Yang Bao (YYB; soybean powder‐based iron‐rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6–23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check‐up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check‐ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron‐rich or iron‐fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource‐limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education.
Teleology beyond explanation
Authors: Joo Sehrang , Yousif Sami R. , Knobe Joshua
Published: November 2021

People often think of objects teleologically. For instance, we might understand a hammer in terms of its purpose of driving in nails. But how should we understand teleological thinking in the first place? This paper separatesmere teleology(simply ascribing a telos) andteleological explanation(thinking something is explained by its telos) by examining cases where an object was designed for one purpose but is now widely used for a different purpose. Across four experiments, we show that teleology judgments and teleological explanation judgments are dissociable, and identify three factors that influenced teleology judgments (and one that did not).
The Development and Validation of the Short Form of the Foreign Language Enjoyment Scale
Authors: BOTES ELOUISE , DEWAELE JEAN–MARC , GREIFF SAMUEL
Published: November 2021

We used a data set with n = 1,603 learners of foreign languages (FL) to develop and validate the short form of the Foreign Language Enjoyment Scale (S‐FLES). The data was split into 2 groups, and we used the first sample to develop the short‐form measure. A 3‐factor hierarchical model of foreign language enjoyment (FLE) was uncovered, with FLE as a higher‐order factor and with teacher appreciation, personal enjoyment, and social enjoyment as 3 lower‐order factors. We selected 3 items for each of the 3 lower‐order factors of the S‐FLES. The proposed 9‐item S‐FLES was validated in the second sample, and the fit statistics for the factor structure indicated close fit. Further evidence was found to support the internal consistency, convergent validity, and discriminant validity of the S‐FLES. The S‐FLES provides a valid and reliable short‐form measure of FLE, which can easily be included in any battery of assessments examining individual differences in FL learning.
Pedicle Subtraction Osteotomy in Lateral Position: A New Strategy for Correcting Severe Thoracolumbar Kyphosis Combined with Hip Flexion Contracture in Ankylosing Spondylitis
Authors: Song Di‐yu , Zhang Zi‐fang , Wang Tian‐hao , Qi Deng‐bin , Wang Yan , Zheng Guo‐quan
Published: November 2021

Objective

To describe spinal osteotomy in lateral position, which might be a new strategy for correcting thoracolumbar kyphotic deformity combined with severe hip flexion contracture, and to present two cases in which this method was successfully performed.

Methods

Spinal osteotomies in lateral position were performed in two patients with severe thoracolumbar kyphosis combined with hip flexion contracture, which was not suitable for operation in the prone position. Case 1: a 33‐year‐old female AS patient still had severe hip flexion contracture due to poor rehabilitation after total hip replacement (THR). The range of movement of the hip was only about 15° in right and 10° in left. Pre‐operativethoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), and sagittal vertical axis (SVA) were 52.4°, 49.1°, 42.7°, and 315 mm, respectively. Pedicle subtraction osteotomy (PSO) at L3 was performed in the lateral position. The eggshell procedure was used during osteotomy. Case 2: a 45‐year‐old male AS patient presented coexisting rigid thoracolumbar kyphosis and hip flexion contracture. The range of movement of the hip was only about 20° in right and 25° in left. Pre‐operativeTK, TLK, LL and SVA were 34.9°, 66.8°, 58.8° and 290.8 mm, respectively. PSO at L2 was performed in lateral position. The eggshell procedure was also used.

Results

Sagittal malalignments of both patients were greatly improved. For case 1, the total operation time was 5.5 h. The blood loss was 1500 mL and the amount of allogeneic blood transfusion was 1580 mL during the operation. SVA was reduced to 127 mm and LL decreased from preoperative 42.7° to −28.4°. The correction angle through L3 was 34.7° and the correction angle through the osteotomy segment was 62.9°. For case 2, the duration of surgery was 6.5 h. The operative blood loss was 2000 mL and the total amount of blood transfusion was 2020 mL. SVA was reduced to 209.8 mm and LL decreased from preoperative 58.8° to 9.2°.The correction angle through L2 was 37.1° and the correction angle through the osteotomy segment was 55°. No intra‐operative or post‐operative complications were observed. Six months after PSO, case 1 had good posture for standing and sitting. The case 2 underwent bilateral THRs nine months after PSO.

Conclusion

PSO could be performed in the lateral position successfully. For AS patients who cannot be placed in the prone position due to coexisting severe thoracolumbar kyphosis and hip flexion contracture, performing spinal osteotomy in the lateral position as the first step is an alternative.
Making Populations for Deportation: Bureaucratic Knowledge Practices Inside a European Deportation Unit
Authors: Wissink Lieke M.
Published: November 2021

This article explores how people are made deportable through bureaucratic practices within European migration infrastructures. Drawing on months of ethnographic fieldwork in a deportation unit, the article focuses on the daily work of file practices. Bridging scholarship on street‐level bureaucrats and the materiality of paperwork, it traces how deportation files move along procedural trajectories, among case workers, databases, police, whiteboards, quota, subunits, embassies, and airlines. This shows how the relations gathered in file practices mobilize categories of populations, for example racialized or gendered. The research elaborates that the deportable subject is formed in a constellation of various populations, paradoxically given the legal call to individualize all deportees. Moreover, the populations themselves need to be made in file practices, too, unfolding a dual bureaucratic knowledge practice that shows the populations that are demarcated by state deportations to be intrinsically situated. [deportation, bureaucracy, file practices, population, Europe]
Farm advisors amid the transition to Agriculture 4.0: Professional identity, conceptions of the future and future‐specific competencies
Authors: Charatsari Chrysanthi , Lioutas Evagelos D. , Papadaki‐Klavdianou Afroditi , Michailidis Anastasios , Partalidou Maria
Published: November 2021

The transition to Agriculture 4.0 creates new responsibilities for farm advisors and initiates changes to the professional trajectories. In this work, following a mixed research design, we examine how Greek advisors experience the transition to and anticipate the future of Agriculture 4.0. We also aim at identifying what elements they are changing in their professional identities to respond to the challenges associated with Agriculture 4.0, which are the new responsibility‐related competency needs that this transition generates, and how conceptions of the future of farming impact upon these needs. Our findings suggest that the transition to Agriculture 4.0 urges the emergence of a new culture, in which data and technology are considered more reliable than human advice, and creates new responsibility gaps. To cope with these changes, advisors add new roles in their professional identities, emphasising the principle of beneficence and paying limited attention to the societal externalities of transition. Advisors view Agriculture 4.0 as a threat or disruption more than as evolution or promise. In parallel, they prioritise different sets of competencies needed to responsibly facilitate agricultural digitalisation, depending on how they grasp the future of Agriculture 4.0.
Spatial modeling of migration using GIS‐based multi‐criteria decision analysis: A case study of Iran
Authors: Mijani Naeim , Shahpari Sani Davoud , Dastaran Mohsen , Karimi Firozjaei Hamzeh , Argany Meysam , Mahmoudian Hossein
Published: November 2021

Spatial modeling of migration and the identification of the effective parameters are imperative for planning and managing demographic, economic, social, and environmental changes on various geographical scales. The recent climate change stressors as well as inequality in terms of education and life quality have triggered internal mass migrations in Iran, causing pressure on housing, the job market, and potential slums around large cities. This study proposes a new approach to modeling migration patterns in Iran based on multi‐criteria decision analysis. For this purpose, a total of 23 individual criteria embedded within four criteria groups (economic, socio‐cultural, welfare, and environmental) affecting national migration were used. The analytic hierarchy process was employed to determine weights for the input factors and the weighted linear combination (WLC) model was used for the integration of criteria, based on which maps of migration potential were produced. The model applied was evaluated based on the correlation coefficient between migration potential values obtained from the WLC model and the actual net migration rate. Among the input individual criteria, unemployment, higher education centers, number of physicians, and dust storms were found to influence national migration. Furthermore, our findings reveal that the potential for migration across Iranian provinces is heterogeneous, with the spatial potential for emigration being the highest and lowest in the border and central provinces, respectively. The correlation coefficient calculated between outputs from the WLC model and the net migration rate from 2011 to 2016, was .81, indicating the relatively high performance of the proposed model in producing a migration spatial potential map. Our proposed approach, along with the results achieved, can be useful to decision‐makers and planners in designing data‐driven policies against inequality‐ and climate‐induced stressors.
The blind spot: value‐based health care in obstetrics and gynaecology
Authors: Naji Osama , Souter Vivienne , Mullins Edward , Gaughran Jonathan , Diab Yasser , Fitzgerald J Edward , Bourne Tom , Morris Edward
Published: November 2021

Key content

Continuing financial constraints on the UK’s National Health Service means the need for clinicians to provide high‐quality care in a cost‐effective way has never been greater.

While the medical education system equips doctors with skills to provide safe clinical care, it should also provide an understanding of healthcare costs and cost‐effectiveness analysis.

Value‐based care is becoming a key paradigm in women’s health services, where clinicians must employ strategies for delivering value, rationalising costs and capitalising on the use of emerging technologies.

The calculation of value of an intervention for providers and service users may differ; care must be taken to ensure this concept is adapted for, and not imposed on healthcare systems.

Engaging trainees in systems transformation and embedding the concepts of ‘do no financial harm’ are essential to ensure sustainable healthcare services.

Learning Objectives

To understand the principles of value‐based health care.

To highlight the importance of adopting ‘cost‐conscious’ care within daily clinical practice.

To learn the differences between ‘cost’, ‘charge’, ‘price’ and ‘reimbursement.

To encourage developing value‐based competencies for future medical workforce through utilising out of programme placements and digital resources.

Ethical Issues

The ethical obligation of clinicians to consider cost may encompass justice and equity. However, the impact of practicing value‐based health care is yet to be evaluated.
The use of social media as a tool for patient blood management and transfusion medicine education
Authors: Brunetta Denise Menezes , Carvalho Luany , Barbosa Suzanna , Santos Franklin , Barroso Karine , Carneiro‐Silva Fabiana , Puster Rainardo , Carlos Luciana
Published: November 2021

Background and Objectives

Transfusion is one of the most performed medical procedures. Wrong indications are common and are probably related to the scarcity of transfusion teaching during medical education. The development of a new way to improve transfusion education is paramount. Social media has the potential to reach larger audiences for rapid communication of medical content. The use of social media for transfusion education in Brazil has not been published. The aim of this article is to describe a new tool to improve transfusion learning.

Materials and Methods

Evidence‐based cards were created. Initially, these cards were sent by WhatsApp. Later, Instagram and Facebook pages were created. EducaSangue, as this e‐learning project was called, is a tool for the spreading of transfusion knowledge that permits the exchange of experiences.

Results

By April 2021, Facebook and Instagram pages had 8300 and 5100 followers, respectively. Cards about single red blood cell (RBC) unit, alternatives to transfusion, transfusion reactions and pre‐transfusion tests were published. Doctors and other health professionals follow EducaSangue. RBC transfusions reduced in Ceara and single‐unit RBC increased by 28%, although not statistically significant. In Brazil, the minority of medical schools have transfusion as a discipline. The scarcity of transfusion education is related to the poorer care of the patient. Technological innovation has been used for educational changes and is an alternative to formal education.

Conclusion

Social media is an interesting tool to provide quality to medical services, since they can reach a broader public, especially where personal contact is difficult.
A New Method for Estimating Bubble Diameter at Different Gravity Levels for Nucleate Pool Boiling
Authors: Banerjee Sandipan , Lian Yongsheng , Liu Yang , Sussman Mark
Published: November 2021

Nucleate boiling has significant applications in earth gravity (in industrial cooling applications) and microgravity conditions (in space exploration, specifically in making space applications more compact). However, the effect of gravity on the growth rate and bubble size is not yet well understood. We perform numerical simulations of nucleate boiling using an adaptive moment-of-fluid (MoF) method for a single vapor bubble (water or Perfluoro-n-hexane) in saturated liquid for different gravity levels. Results concerning the growth rate of the bubble, specifically the departure diameter and departure time, have been provided. The MoF method has been first validated by comparing results with a theoretical solution of vapor bubble growth in superheated liquid without any heat-transfer from the wall. Next, bubble growth rate, bubble shape, and heat transfer results under earth gravity, reduced gravity, and microgravity conditions are reported, and they are in good agreement with experiments. Finally, a new method is proposed for estimating the bubble diameter at different gravity levels. This method is based on an analysis of empirical data at different gravity values and using power-series curve fitting to obtain a generalized bubble growth curve irrespective of the gravity value. This method is shown to provide a good estimate of the bubble diameter for a specific gravity value and time.
Nonlinear Vibration Analysis of Turbine Bladed Disks With Midspan Dampers
Authors: Ferhatoglu Erhan , Zucca Stefano , Botto Daniele , Auciello Jury , Arcangeli Lorenzo
Published: November 2021

Friction dampers are one of the most common secondary structures utilized to alleviate excessive vibration amplitudes in turbomachinery applications. In this paper, the dynamic behavior of the turbine bladed disks coupled with one of the special damper designs, the so-called Midspan Dampers (MSDs) that is commonly used in steam turbines of Baker Hughes Company, is thoroughly studied. Friction between the blade and the damper is modeled through a large number of contact nodes by using two-dimensional contact elements with a variable normal load. In the solution procedure, the coupled static/dynamic Harmonic Balance approach is utilized for the first time in the assessment of the dissipation capability of MSDs, computationally shown by predicting the forced response levels of the system at different resonances. Moreover, it is demonstrated that the nonlinear dynamic response is non-unique and it may vary considerably even if all the user-controlled inputs are kept identical. This phenomenon is a novel observation for MSDs, and it is explained by an uncertainty present in the contact forces. Contact conditions corresponding to multiple responses are also investigated to unveil the different kinematics of the damper under the same nominal conditions.
Tuning of Friction Oscillation Amplitude in Halloysite, Montmorillonite, and Wollastonite Filled Friction Composites: Load, Speed, and Temperature Sensitivity
Authors: Saha Debarghya , Satapathy Bhabani K.
Published: November 2021

The influence of clay mineral silicate types, such as halloysite, montmorillonite, and wollastonite with tubular, plate like, and acicular morphologies respectively, on frictional oscillation of composite materials has been evaluated on chase-type dynamometer and optimized following the combination of Taguchi’s L9 design of experiment and regression analysis approaches. The coefficient of friction of ∼0.35–0.45 and cumulative wear at <10% remained well within the acceptable range. The optimal tuning of friction oscillation to reduce braking-induced noise and vibration propensity has been achieved by montmorillonite clay with platelet-type morphology or by combination of MgO and wollastonite clay with acicular morphology. The extent of Fe- content in wear debris close to ∼80% on the composite surface led to an optimal level of friction oscillation amplitude (Aamp). The hierarchical ranking of the clay-based composites by technique for an order of preference by similarity to ideal solution (TOPSIS)-based operation research approach leads to the understanding of design ideology optimization for composites to ensure minimal friction oscillations.
Structural basis for the Pr-Pfr long-range signaling mechanism of a full-length bacterial phytochrome at the atomic level
Authors: Otero Lisandro H. , Foscaldi Sabrina , Antelo Giuliano T. , Rosano Germán L. , Sirigu Serena , Klinke Sebastián , Defelipe Lucas A. , Sánchez-Lamas Maximiliano , Battocchio Giovanni , Conforte Valeria , Vojnov Adrián A. , Chavas Leonard M. G. , Goldbaum Fernando A. , Mroginski Maria-Andrea , Rinaldi Jimena , Bonomi Hernán R.
Published: November 2021

A bacterial phytochrome reversibly interconverts between a parallel and antiparallel dimeric arrangement during photoconversion.
Scaling DNA data storage with nanoscale electrode wells
Authors: Nguyen Bichlien H. , Takahashi Christopher N. , Gupta Gagan , Smith Jake A. , Rouse Richard , Berndt Paul , Yekhanin Sergey , Ward David P. , Ang Siena D. , Garvan Patrick , Parker Hsing-Yeh , Carlson Rob , Carmean Douglas , Ceze Luis , Strauss Karin
Published: November 2021

A demonstration of DNA synthesis control at over 1000x higher density shows the path to large scale DNA data storage.
Self-adaptive cardiac optogenetics device based on negative stretching-resistive strain sensor
Authors: Hong Wen , Jiang Chunpeng , Qin Mu , Song Ziliang , Ji Pengfei , Wang Longchun , Tu Kejun , Lu Lijun , Guo Zhejun , Yang Bin , Wang Xiaolin , Liu Jingquan
Published: November 2021

A closed-loop and self-adaptive cardiac optogenetics is realized by a negative stretching-resistive strain sensor.
SEC23A rescues SEC23B-deficient congenital dyserythropoietic anemia type II
Authors: King Richard , Lin Zesen , Balbin-Cuesta Ginette , Myers Gregg , Friedman Ann , Zhu Guojing , McGee Beth , Saunders Thomas L. , Kurita Ryo , Nakamura Yukio , Engel James Douglas , Reddy Pavan , Khoriaty Rami
Published: November 2021

The COPII component SEC23A overlaps functionally with its paralogous protein and rescues the SEC23B-deficient CDAII defect.
Direct writing of customized structural-color graphics with colloidal photonic inks
Authors: Kim Jong Bin , Chae Changju , Han Sang Hoon , Lee Su Yeon , Kim Shin-Hyun
Published: November 2021

Structural color graphics with any design and color combination can be directly printed with high precision.
Generation of high-density nanoparticles in the carbothermal shock method
Authors: Song Ji-Yoon , Kim Chansol , Kim Minki , Cho Kyeong Min , Gereige Issam , Jung Woo-Bin , Jeong Hyeonsu , Jung Hee-Tae
Published: November 2021

Carbothermal shock can produce a high surface coverage of metal nanoparticles by introducing cellulose.
Seasonal Dynamics of Methanotrophic Bacteria in a Boreal Oil Sands End Pit Lake
Authors: Albakistani Emad A. , Nwosu Felix C. , Furgason Chantel , Haupt Evan S. , Smirnova Angela V. , Verbeke Tobin J. , Lee Eun-Suk , Kim Joong-Jae , Chan Amelia , Ruhl Ilona A. , Sheremet Andriy , Rudderham Sarah B. , Lindsay Matthew B. J. , Dunfield Peter F.
Published: November 2021

The study examined methanotrophic bacteria in an industrial end pit lake, combining molecular DNA methods (both quantitative and descriptive) with biogeochemical measurements. The lake was sampled over 5 years, in all four seasons, as often as weekly, and included sub-ice samples.
Effects of an Alphasatellite on the Life Cycle of the Nanovirus
Faba Bean Necrotic Yellows Virus
Authors: Mansourpour Mahsa , Gallet Romain , Abbasi Alireza , Blanc Stephane , Dizadji Akbar , Zeddam Jean-Louis
Published: November 2021

Alphasatellites are circular single-stranded DNA molecules frequently found in association with natural isolates of nanoviruses and some geminiviruses, the two ssDNA plant-infecting virus families. While the implications of alphasatellite presence in geminivirus infections are relatively well documented, comparable studies on alphasatellites associated with nanoviruses are not available.
The N-Terminal Region of Middle East Respiratory Syndrome Coronavirus Accessory Protein 8b Is Essential for Enhanced Virulence of an Attenuated Murine Coronavirus
Authors: Li Yuming , Jin Yingkang , Kuang Lijun , Luo Zhenhua , Li Fang , Sun Jing , Zhu Airu , Zhuang Zhen , Wang Yanqun , Wen Liyan , Liu Donglan , Chen Chunke , Gan Mian , Zhao Jingxian , Zhao Jincun
Published: November 2021

Multiple coronaviruses (CoV) cause severe respiratory infections and become global public health threats such as SARS-CoV, MERS-CoV, and SARS-CoV-2. Each coronavirus contains different numbers of accessory proteins which show high variability among different CoVs.
Whole-Genome Sequences of SARS-CoV-2 Isolates from the Dominican Republic
Authors: Paulino-Ramirez R. , Riego E. , Vallejo-Degaudenzi A. , Calderon V. V. , Tapia L. , León Patricia , Licastro Danilo , Dal Monego Simeone , Rajasekharan Sreejith , Orsini Emanuele , Marcello Alessandro
Published: November 2021

Here, we report the genome sequences of five severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains that were obtained from symptomatic individuals with travel histories during community surveillance in the Dominican Republic in 2020. These sequences provide a starting point for further genomic studies of gene flow and molecular diversity in the Caribbean nation. Phylogenetic analysis suggests that all genomes correspond to the B.1 variant.
Genomic Characterization of Imipenem- and Imipenem-Relebactam-Resistant Clinical Isolates of Pseudomonas aeruginosa
Authors: López-Pérez Mario , Haro-Moreno Jose M. , Molina-Pardines Carmen , Ventero Maria Paz , Rodríguez Juan Carlos
Published: November 2021

The growing emergence and spread of carbapenem-resistant pathogens worldwide exacerbate the clinical challenge of treating these infections. Given the importance of carbapenems for the treatment of infections caused by
Pseudomonas aeruginosa
, this study aimed to investigate the underlying genomic properties of the clinical isolates that exhibited resistance to imipenem and imipenem-relebactam.
In Vitro
Activity of Rifabutin and Rifampin against Antibiotic-Resistant Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae
Authors: Lee Bosul , Yan Jun , Ulhaq Amber , Miller Sarah , Seo Wonjae , Lu Peggy , She Rosemary , Spellberg Brad , Luna Brian
Published: November 2021

Rifabutin has been recently described as a potential adjunctive therapy for antibiotic-resistant
A. baumannii
infections due to hypersensitivity in iron-depleted media, which may more closely mimic an
in vivo
environment. Here, we report that this hyperactivity is specific for
A. baumannii
, rather than being a general effect for other pathogens.
Garlic: An Alternative Treatment for Group B Streptococcus
Authors: Torres Kátia Andrea de Menezes , Lima Sônia Maria Rolim Rosa , Torres Luce Maria Brandão , Gamberini Maria Thereza , Silva Junior Pedro Ismael da
Published: November 2021

Invasive disease due to group B streptococcal (GBS) infection results in a wide spectrum of clinical disease in neonates. Maternal colonization by GBS is the primary risk factor for disease.
A Novel Trehalose Synthase for the Production of Trehalose and Trehalulose
Authors: Agarwal Neera , Singh Sudhir P.
Published: November 2021

Trehalose is a rare sugar of high importance in biological research, with its property to stabilize cell membrane and proteins and protect the organism from drought. It is instrumental in the cryopreservation of human cells, e.g., sperm and blood stem cells.
Broad-Spectrum
In Vitro
Antiviral Activity of ODBG-P-RVn: An Orally-Available, Lipid-Modified Monophosphate Prodrug of Remdesivir Parent Nucleoside (GS-441524)
Authors: Lo Michael K. , Shrivastava-Ranjan Punya , Chatterjee Payel , Flint Mike , Beadle James R. , Valiaeva Nadejda , Murphy Joyce , Schooley Robert T. , Hostetler Karl Y. , Montgomery Joel M. , Spiropoulou Christina F.
Published: November 2021

While remdesivir remains one of the few drugs approved by the FDA to treat coronavirus disease 2019 (COVID-19), its intravenous route of administration limits its use to hospital settings. Optimizing the stability and absorption of remdesivir may lead to a more accessible and clinically potent therapeutic.
Evaluation of Metallo-β-Lactamase Susceptibility Testing in a Physiologic Medium
Authors: Asempa Tomefa E. , Bajor Hannah , Mullins Jessica H. , Hartnett Janice , Nicolau David P.
Published: November 2021

Studies assessing antibiotic susceptibility profiles in nonconventional media are lacking. MBL-mediated resistance has come under scrutiny due to the dependence on extracellular zinc concentrations, which makes the choice of testing medium influential for β-lactam MICs. This study explores human urine as a physiologically relevant matrix with which susceptibility profiles of MBL-harboring isolates can be assessed, relative to conventional broth.
Rapid Diagnostic Tests to Guide Case Management of and Improve Antibiotic Stewardship for Pediatric Acute Respiratory Illnesses in Resource-Constrained Settings: a Prospective Cohort Study in Southwestern Uganda
Authors: Ciccone Emily J. , Kabugho Lydia , Baguma Emmanuel , Muhindo Rabbison , Juliano Jonathan J. , Mulogo Edgar , Boyce Ross M.
Published: November 2021

Globally, respiratory illness is one of the most common reasons that children seek care. It is often treated inappropriately with antibiotics, which can drive the development of antibiotic resistance.
Mapping Molecular Recognition of β1,3-1,4-Glucans by a Surface Glycan-Binding Protein from the Human Gut Symbiont Bacteroides ovatus
Authors: Correia Viviana G. , Trovão Filipa , Pinheiro Benedita A. , Brás Joana L. A. , Silva Lisete M. , Nunes Cláudia , Coimbra Manuel A. , Liu Yan , Feizi Ten , Fontes Carlos M. G. A. , Mulloy Barbara , Chai Wengang , Carvalho Ana Luísa , Palma Angelina S.
Published: November 2021

With the knowledge of bacterial gene systems encoding proteins that target dietary carbohydrates as a source of nutrients and their importance for human health, major efforts are being made to understand carbohydrate recognition by various commensal bacteria. Here, we describe an integrative strategy that combines carbohydrate microarray technology with structural studies to further elucidate the molecular determinants of carbohydrate recognition by BoSGBP
MLG
-A, a key protein expressed at the surface of
Bacteroides ovatus
for utilization of mixed-linkage β1,3-1,4-glucans.
Prospective Activity of PLG0206, an Engineered Antimicrobial Peptide, on Chronic Periprosthetic Joint Infection Total Knee Arthroplasty Components
Ex Vivo
: The Knee Explant Analysis (KnEA) Study
Authors: Huang David , Parker Dana M. , Mandell Jonathan B. , Brothers Kimberly M. , Gish Charles G. , Koch John A. , Pachuda Nicholas , Dobbins Despina , Steckbeck Jonathan , Urish Kenneth L.
Published: November 2021

Chronically infected prosthetics of the knee were exposed to PLG0206, an engineered antimicrobial peptide, at a concentration of 1 mg/mL for 15 min. Consequently, a mean 4-log
10
reduction (range, 1 to 7) in the number of bacteria occurred, which may translate to improved clinical outcomes for persons with prosthetic joint infection of the knee.
Randomised crossover trial comparing algorithms and averaging times for automatic oxygen control in preterm infants
Authors: Schwarz Christoph E , Kreutzer Karen B , Langanky Lukas , Wolf Nicole S , Braun Wolfgang , O'Sullivan Marc Paul , Poets Christian F , Franz Axel R
Published: November 2021

Objective

Automatic control (SPOC) of the fraction of inspired oxygen (FiO2), based on continuous analysis of pulse oximeter saturation (SpO2), improves the proportion of time preterm infants spend within a specified SpO2-target range (Target%). We evaluated if a revised SPOC algorithm (SPOCnew, including an upper limit for FiO2) compared to both routine manual control (RMC) and the previously tested algorithm (SPOCold, unrestricted maximum FiO2) increases Target%, and evaluated the effect of the pulse oximeter’s averaging time on controlling the SpO2 signal during SPOC periods.

Design

Unblinded, randomised controlled crossover study comparing 2 SPOC algorithms and 2 SpO2 averaging times in random order: 12 hours SPOCnew and 12 hours SPOCold (averaging time 2 s or 8 s for 6 hours each) were compared with 6-hour RMC. A generated list of random numbers was used for allocation sequence.

Setting

University-affiliated tertiary neonatal intensive care unit, Germany

Patients

Twenty-four infants on non-invasive respiratory support with FiO2 >0.21 were analysed (median gestational age at birth, birth weight and age at randomisation were 25.3 weeks, 585 g and 30 days).

Main outcome measure

Target%.

Results

Mean (SD) [95% CI] Target% was 56% (9) [52, 59] for RMC versus 69% (9) [65, 72] for SPOCold_2s, 70% (7) [67, 73] for SPOCnew_2s, 71% (8) [68, 74] for SPOCold_8s and 72% (8) [69, 75] for SPOCnew_8s.

Conclusions

Irrespective of SpO2-averaging time, Target% was higher with both SPOC algorithms compared to RMC. Despite limiting the maximum FiO2, SPOCnew remained significantly better at maintaining SpO2 within target range compared to RMC.

Trial registration

NCT03785899
Hemoglobin glycation index, calculated from a single fasting glucose value, as a prediction tool for severe hypoglycemia and major adverse cardiovascular events in DEVOTE
Authors: Klein Klara R , Franek Edward , Marso Steven , Pieber Thomas R , Pratley Richard E , Gowda Amoolya , Kvist Kajsa , Buse John B
Published: November 2021

Introduction

Hemoglobin glycation index (HGI) is the difference between observed and predicted glycated hemoglobin A1c (HbA1c), derived from mean or fasting plasma glucose (FPG). In this secondary, exploratory analysis of data from DEVOTE, we examined: whether insulin initiation/titration affected the HGI; the relationship between baseline HGI tertile and cardiovascular and hypoglycemia risk; and the relative strengths of HGI and HbA1cin predicting these risks.

Research design and methods

In DEVOTE, a randomized, double-blind, cardiovascular outcomes trial, people with type 2 diabetes received once per day insulin degludec or insulin glargine 100 units/mL. The primary outcome was time to first occurrence of a major adverse cardiovascular event (MACE), comprising cardiovascular death, myocardial infarction or stroke; severe hypoglycemia was a secondary outcome. In these analyses, predicted HbA1cwas calculated using a linear regression equation based on DEVOTE data (HbA1c=0.01313 FPG (mg/dL) (single value)+6.17514), and the population data were grouped into HGI tertiles based on the calculated HGI values. The distributions of time to first event were compared using Kaplan–Meier curves; HRs and 95% CIs were determined by Cox regression models comparing risk of MACE and severe hypoglycemia between tertiles.

Results

Changes in HGI were observed at 12 months after insulin initiation and stabilized by 24 months for the whole cohort and insulin-naive patients. There were significant differences in MACE risk between baseline HGI tertiles; participants with high HGI were at highest risk (low vs high, HR: 0.73 (0.61 to 0.87)95% CI; moderate vs high, HR: 0.67 (0.56 to 0.81)95% CI; p<0.0001). No significant differences between HGI tertiles were observed in the risk of severe hypoglycemia (p=0.0911). With HbA1cincluded within the model, HGI no longer significantly predicted MACE.

Conclusions

High HGI was associated with a higher risk of MACE; this finding is of uncertain significance given the association of HGI with insulin initiation and HbA1c.

Trial registration number

NCT01959529.
Was the risk of death among the population of teachers and other school workers in England and Wales due to COVID-19 and all causes higher than other occupations during the pandemic in 2020? An ecological study using routinely collected data on deaths from the Office for National Statistics
Authors: Lewis Sarah J , Dack Kyle , Relton Caroline L , Munafo Marcus R , Davey Smith George
Published: November 2021

Objectives

To estimate occupation risk from COVID-19 among teachers and others working in schools using publicly available data on mortality in England and Wales.

Design

Analysis of national death registration data from the Office for National Statistics.

Setting

England and Wales, 8 March–28 December 2020, during the COVID-19 pandemic.

Participants

The total working age population in England and Wales plus those still working aged over 65 years.

Primary and secondary outcomes

Death with COVID-19 as a primary outcome and death from all causes as a secondary outcome.

Results

Across occupational groups, there was a strong correlation between COVID-19 mortality and both non-COVID-19 and all-cause mortality. The absolute mortality rates for deaths with COVID-19 were low among those working in schools (from 10 per 100 000 in female primary school teachers to 39 per 100 000 male secondary school teachers) relative to many other occupations (range: 9–50 per 100 000 in women; 10–143 per 100 000 in men). There was weak evidence that secondary school teachers had slightly higher risks of dying with COVID-19 compared with the average for all working-aged people, but stronger evidence of a higher risk compared with the average for all professionals; primary school teachers had a lower risk. All-cause mortality was also higher among all teachers compared with all professionals. Teaching and lunchtime assistants were not at higher risk of death from COVID-19 compared with all working-aged people.

Conclusion

There was weak evidence that COVID-19 mortality risk for secondary school teachers was above expectation, but in general school staff had COVID-19 mortality risks which were proportionate to their non-COVID-19 mortality risk.
Codeveloping a multibehavioural mobile phone app to enhance social and emotional well-being and reduce health risks among Aboriginal and Torres Strait Islander women during preconception and pregnancy: a three-phased mixed-methods study
Authors: Kennedy Michelle , Kumar Ratika , Ryan Nicole M , Bennett Jessica , La Hera Fuentes Gina , Gould Gillian Sandra
Published: November 2021

Objective

Describe the development and pretest of a prototype multibehavioural change app MAMA-EMPOWER.

Design

Mixed-methods study reporting three phases: (1) contextual enquiry included stakeholder engagement and qualitative interviews with Aboriginal women, (2) value specification included user-workshop with an Aboriginal researcher, community members and experts, (3) codesign with Aboriginal researchers and community members, followed by a pretest of the app with Aboriginal women, and feedback from qualitative interviews and the user-Mobile Application Rating Scale (U-MARS) survey tool.

Settings

Aboriginal women and communities in urban and regional New South Wales, Australia.

Participants

Phase 1: interviews, 8 Aboriginal women. Phase 2: workshop, 6 Aboriginal women. Phase 3: app trial, 16 Aboriginal women. U-MARS, 5 Aboriginal women.

Results

Phase 1 interviews revealed three themes: current app use, desired app characteristics and implementation. Phase 2 workshop provided guidance for the user experience. Phase 3 app trial assessed all content areas. The highest ratings were for information (mean score of 3.80 out of 5, SD=0.77) and aesthetics (mean score of 3.87 with SD of 0.74), while functionality, engagement and subjective quality had lower scores. Qualitative interviews revealed the acceptability of the app, however, functionality was problematic.

Conclusions

Developing a mobile phone app, particularly in an Aboriginal community setting, requires extensive consultation, negotiation and design work. Using a strong theoretical foundation of behavioural change technique’s coupled with the consultative approach has added rigour to this process. Using phone apps to implement behavioural interventions in Aboriginal community settings remains a new area for investigation. In the next iteration of the app, we aim to find better ways to personalise the content to women’s needs, then ensure full functionality before conducting a larger trial. We predict the process of development will be of interest to other health researchers and practitioners.
Is subjectively perceived treatment urgency of patients in emergency departments associated with self-reported health literacy and the willingness to use the GP as coordinator of treatment? Results from the multicentre, cross-sectional, observational study PiNo Bund
Authors: Schäfer Ingmar , Menzel Agata , Oltrogge Jan Hendrik , Slagman Anna , Möckel Martin , Lühmann Dagmar , Scherer Martin
Published: November 2021

Objectives

Aim of this study was to analyse if subjectively perceived treatment urgency of patients in emergency departments is associated with self-reported health literacy and the willingness to use the general practitioner (GP) as coordinator of treatment.

Design

A multicentre, cross-sectional, observational study.

Setting

Emergency departments in five hospitals. Each hospital was visited 14 times representing two 8-hour shifts on each day of the week. Calendar dates were randomly assigned.

Participants

All patients of legal age registered at the emergency department or hospital reception desk. Exclusion criteria included immediate or very urgent need of treatment, high level of symptom burden and severe functional impairments in terms of hearing, vision and speech. We conducted standardised personal interviews. Additionally, clinical data were extracted from patient records.

Primary and secondary outcome measures

Our target variable was subjectively perceived treatment urgency. Predictor variables included age, sex, education, health-related quality of life (EuroQol Five-Dimension Scale, value set UK), anxiety and depression (Hospital Anxiety and Depression Scale), somatic symptoms (Patient Health Questionnaire, 15 items version), self-reported health literacy (European Health Literacy Questionnaire, 16 questions version) and the commitment to the GP (Fragebogen zur Intensität der Hausarztbindung, ‘F-HaBi’). Data were analysed by multilevel, multivariable linear regression adjusted for random effects at the hospital level.

Results

Our sample comprised 276 patients with a mean age of 50.1 years and 51.8% women. A low treatment urgency (defined as 0–5 points on a Numerical Rating Scale) was reported by 111 patients (40.2%). In the final model, lower subjective treatment urgency was associated with male sex (β=0.84; 95% CI 0.11/1.57, p=0.024), higher health-related quality of life (−2.27 to –3.39/−1.15, p<0.001), lower somatic symptoms score (0.09, 0.004/0.17, p=0.040), higher anxiety score (−0.13 to –0.24/−0.01, p=0.027) and lower commitment to the GP (0.08, 0.01/0.14, p=0.029).

Conclusions

A lower level of subjectively perceived treatment urgency was predicted by a lower willingness to use the GP as coordinator of treatment. Self-reported health literacy did not predict the patients’ urgency rating.
Rhesus isoimmunisation in unsensitised RhD-negative individuals seeking abortion at less than 12 weeks’ gestation: a systematic review
Authors: Chan Michelle C , Gill Roopan Kaur , Kim Caron Rahn
Published: November 2021

Aim

The aim of this review was to systematically review the outcome of routine anti-D administration among unsensitised rhesus (RhD)-negative individuals who have an abortion. This review is registered with Prospero.

Methods

A search for all published and ongoing studies, without restrictions on language or publication status, was performed using the following databases from their inception: EBM Reviews Ovid - Cochrane Central Register of Controlled Trials, MEDLINE Ovid (Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily), Embase.com, Popline and Google Scholar. Study types included: randomised controlled trials, controlled trials, cohort and case–control studies from 1971 onwards. The population included women who undergo an abortion (induced, incomplete, spontaneous or septic abortion), medical or surgical <12 weeks, and isoimmunisation in a subsequent pregnancy. The primary outcomes were: (1) development of a positive Kleihauer–Betke test and (2) development of Rh alloimmunisation in a subsequent pregnancy.

Results

A total of 2652 studies were screened with 105 accessed for full-text review. Two studies have been included with high bias appreciated. Both studies found few women to be sensitised in forming antibodies after an abortion. The limited studies available and heterogeneity prevent the conduction of a meta-analysis.

Conclusions

Rh immunoglobulin has well-documented safety. However, it is not without risks and costs, is a possible barrier to delivering efficient services, and may have limited availability in some countries. The evidence base and quality of studies are currently limited. There is unclear benefit from the recommendation for Rh testing and immunoglobulin administration in early pregnancy. More research is needed as clinical practice guidelines are varied, based on expert opinions and moving away from testing and administration at time of abortion.

Implications

There is limited evidence surrounding medical benefit of Rh testing and immunoglobulin administration in early pregnancy. Further research is needed to define alloimmunisation and immunoglobulin benefit to update standards of care. Additionally, other factors should be considered in forming clinical policies and guidelines such as costs, feasibility and impact on access to care for patients.
2021 DORIS definition of remission in SLE: final recommendations from an international task force
Authors: van Vollenhoven Ronald F , Bertsias George , Doria Andrea , Isenberg David , Morand Eric , Petri Michelle A , Pons-Estel Bernardo A , Rahman Anisur , Ugarte-Gil Manuel Francisco , Voskuyl Alexandre , Arnaud Laurent , Bruce Ian N , Cervera Ricard , Costedoat-Chalumeau Nathalie , Gordon Caroline , Houssiau Frédéric A , Mosca Marta , Schneider Matthias , Ward Michael M , Alarcon Graciela , Aringer Martin , Askanase Anca D , Bae Sang-Cheol , Bootsma Hendrika , Boumpas Dimitrios T , Brunner Hermine , Clarke Ann Elaine , Coney Cindy , Czirják László , Dörner Thomas , Faria Raquel , Fischer Rebecca , Fritsch-Stork Ruth , Inanc Murat , Jacobsen Søren , Jayne David , Kuhn Annegret , van Leeuw Bernadette , Limper Maarten , Mariette Xavier , Navarra Sandra , Nikpour Mandana , Olesinska Marzena Helena , Pons-Estel Guillermo , Romero-Diaz Juanita , Rubio Blanca , Schoenfeld Yehuda , Bonfá Eloisa , Smolen Josef , Teng Y K Onno , Tincani Angela , Tsang-A-Sjoe Michel , Vasconcelos Carlos , Voss Anne , Werth Victoria P , Zakharhova Elena , Aranow Cynthia
Published: November 2021

Objective

To achieve consensus on a definition of remission in SLE (DORIS).

Background

Remission is the stated goal for both patient and caregiver, but consensus on a definition of remission has been lacking. Previously, an international task force consisting of patient representatives and medical specialists published a framework for such a definition, without reaching a final recommendation.

Methods

Several systematic literature reviews were performed and specific research questions examined in suitably chosen data sets. The findings were discussed, reformulated as recommendations and voted on.

Results

Based on data from the literature and several SLE-specific data sets, a set of recommendations was endorsed. Ultimately, the DORIS Task Force recommended a single definition of remission in SLE, based on clinical systemic lupus erythematosus disease activitiy index (SLEDAI)=0, Evaluator’s Global Assessment <0.5 (0–3), prednisolone 5 mg/day or less, and stable antimalarials, immunosuppressives, and biologics.

Conclusion

The 2021 DORIS definition of remission in SLE is recommended for use in clinical care, education, and research including clinical trials and observational studies.