bluuebunny/crossref_metadata_2025 huggingface dataset:
Hip and distal femur fracture outcomes over three successive UK lockdown periods during the COVID-19 pandemic: what have we learnt?
Authors: Sadiq Salman , Lipski Caroline , Hanif Umar-Khetaab , Arshad Faizan , Chaudary Muhammad , Chaudhry Fouad
Published: December 2021

Aims

This study assessed the impact of COVID-19 on hip and distal femur fracture patient outcomes across three successive UK lockdown periods over one year.

Methods

A single-centre retrospective cohort study was performed at an acute NHS Trust. Hip and distal femur fracture patients admitted within the first month from each of the three starting dates of each national lockdown were included and compared to a control group in March 2019. Data were collected as per the best practice tariff outcomes including additional outcomes as required. Data collection included COVID-19 status, time to theatre, 30-day mortality, presence of acute kidney injury (AKI) and pneumonia, and do not attempt cardiopulmonary resuscitation (DNACPR) status. Data were analyzed using an independent-samples t-test or chi-squared test with Fisher’s exact test where applicable. A p-value of < 0.05 was considered statistically significant.

Results

A total of 95 patients during the pandemic were included and 20 were COVID-positive. Patients experienced a statistically significant increase in time to theatre in Lockdown 1 compared to 2019 (p = 0.039) with a decrease with successive lockdown periods by Lockdown 3. The 30-day mortality increased from 8.8% in 2019 to 10.0% to 14.8% in all lockdown periods. COVID-positive patient mortality was 30.0% (p = 0.063, odds ratio (OR) = 4.43 vs 2019). The rates of AKI and pneumonia experienced were higher for patients during the pandemic. The highest rates were experienced in COVID-positive patients, with 45.0% of patients with AKI versus 27.0% in 2019 (p = 0.38, OR = 1.80), and 50.0% of patients diagnosed with pneumonia versus 16.2% in 2019 (p = 0.0012, OR = 5.17). The percentage of patients with a DNACPR increased from 30.0% in 2019 to 60.7% by Lockdown 3 (p = 0.034, OR = 3.61).

Conclusion

COVID-positive hip and distal femur fracture patients are at a higher risk of mortality due to AKI and pneumonia. Patient outcomes have improved with successive lockdowns to pre-pandemic levels. Cite this article: Bone Jt Open 2021;2(12):1017–1026.
Who are the fairest? ethnic segmentation in London's media production
Authors: Ashika Thanki  , Steve Jefferys
Published: December 2021

London is a global media city where over 30 per cent of the workforce is from black and ethnic minorities. Yet only seven per cent of those in media production come from these minorities, and they are concentrated in lower level and non-mainstream jobs. The authors argue that the anachronistic survival of institutional racism is not simply about the survival of a discriminatory ‘monoculture’. While racism is enabled by the major casualisation of the industry, it is also functional, helping to defend a stable process of elite formation and defence in a key area of capitalist ideological production. This racism is about power and the authors' research into why ethnic minority professionals quit London's media production sector also explains how this power imbalance deters resistance.
Divided they stand: Hollywood unions in the information age
Authors: Catherine McKercher  , Vincent Mosco
Published: December 2021

In an effort to increase labour power, trade unions representing communications and creative workers in North America have pursued a form of convergence, merging with each other and restructuring themselves along similar lines to their employers. This paper examines the issues surrounding labour convergence by taking up the failed merger between the Screen Actors Guild and the American Federation of Television and Radio Artists. It finds that, although the leaders of both unions supported the merger, the particular characteristics of the unions, including their culture, sense of craft identity and the lived experience of members, derailed the effort.
Conceptualising globalisation: fossil energy, global finance and the labour market
Authors: Elmar Altvater
Published: December 2021

Modern globalisation can best be described as a process of expansion and acceleration whereby production, labour and the conditions of life in all regions of the world influence each other. These effects result from the massive use of fossil energy. The imminent shortage of fossil energy (‘Peak Oil’) and the disastrous climate effect of the emissions of CO2. are now major sources of public discontent with globalisation. Global finance, however, exerts a considerable pressure on production to increase growth rates and to reduce labour costs. As a result, labour is also subjected to the dynamics of the global economy with consequences for working conditions, wages, job security, skills and benefits. This is one of the reasons why the ‘informal economy’ is growing. An exit exists: from a fossil energy regime to the use of renewable energy and from informal and often precarious forms of labour to solidaristic and cooperative ways to organise production.
Global forces and national Institutions: call centre work in Colombia
Authors: Anita Weiss
Published: December 2021

The aim of this article is to contribute to the discussion about the relationship between global forces and national institutions, from a Latin American perspective. In addition to presenting some data about the diffusion of information and communications technologies in Latin America, we try to establish the relationship between some characteristics of Colombian society and the particular nature of the working conditions and employment relationships in call centres in this country, drawing on some exploratory case studies of call centres carried out in 2004, that formed part of a larger ongoing research project. It concludes that several features that are specific to the Colombian context appear to play a major role in shaping working conditions in Colombian call centres, including the particular characteristics of the labour market, the low regulatory power of the State, low compliance with labour laws, the persistence of the armed conflict that weakens all social and labour movements and the existence of a ‘culture of distrust’. This suggests that the national institutional environment exerts an important role in shaping local working conditions, even when powerful global forces are at play.
Behind the screens: telemediated work in the Canadian public sector
Authors: Norene Pupo
Published: December 2021

Among the recent measures undertaken in Canada to adapt the public sector to the ‘new economy’ in order to maintain or enhance economic competitiveness on an international level has been the adoption of new technologies and e-government, affecting both labour processes and service delivery. All three levels of government — municipal, provincial, and federal — have adopted ‘virtual service techniques’. This paper examines telemediated processes and new work arrangements in the public sector and raises questions regarding the impact on workers and their trade unions, working conditions, service delivery, and social citizenship.
Ultrasensitive terahertz sensing in all-dielectric asymmetric metasurfaces based on quasi-BIC
Authors: Li Zhongfu , Xiang Yuanjiang , Xu Shixiang , Dai Xiaoyu
Published: December 2021

The bound state in the continuum (BIC), which supports exceptional resonance in the optical range, has attracted significant attention for its bright applications in sensors and other optical devices. However, it is difficult to cover the analyte’s transmission/reflection spectrum since BIC possesses an infinite

Q

factor. In this work, we proposed a thoughtful all-dielectric columns structure with broken symmetry that supports quasi-BIC to achieve ultrasensitive sensing in the terahertz range. Our metasurfaces consist of a series of periodic unit cells, including two silicon columns with asymmetric cylindrical holes and a

S
i
O

2

substrate. Quasi-BIC resonances can be observed by the transmission/reflection spectrum. The quasi-BIC resonances with a narrow frequency width are sensitive to the surrounding media and the sensitivity can achieve 170.58 GHz/RIU. We believe our ultrasensitive sensor with high performance and sensitivity provides an exciting platform for biosensing.
Photocurrent in plasmonic nanofibers
Authors: Singh Mahi R. , Parihar Shashankdhwaj , Yastrebov Sergey , Ivanov-Omskii Vladimir
Published: December 2021

We developed a theory of photoresponse and photocurrent in photonic nanofibers. Photonic nanofiber is a compound system doped with an ensemble of quantum dots and metallic nanoparticles, where they interact with each other via the dipole–dipole interaction. The bound states of the confined probe photons in the nanofiber hybrid are calculated using the transfer matrix method based on Maxwell’s equations. It is found that the density of states of photons in the nanofiber depends on the dipole–dipole interaction coupling. The nonradiative decay rate due to dipole–dipole interaction rates is calculated using the quantum mechanical perturbation theory. An analytical expression of the photoresponse coefficient and the photocurrent is calculated using the density matrix method. We predicted that the quenching in photocurrent is due to the dipole–dipole interaction. Furthermore, we have shown that the photoluminescence quenching increases as the strength of the dipole–dipole coupling increases. We also compared our theory with the experimental results of the photocurrent in a nanofiber doped with Al metallic nanoparticle nanodisks and Ge/Si quantum dots. A good agreement between theory and experiment is found. Our analytical expressions can be used by experimentalists to perform new types of experiments and for inventing new types of nanosensors and nanoswitches.
Ultrafast dynamic nonlinear phenomena and mechanisms of photonic crystals over photonic gap and band regions
Authors: Shi Xueyang , Zhang Yu , Jiang Xunya
Published: December 2021

We systematically investigate ultrafast dynamic nonlinear mechanisms of photonic crystals (PhCs) with femtosecond (fs) pumping via the transmission change of a signal pulse. The pumping causes a nonlinear decrease (or increase) in the dielectric constant of the PhC material. A new phenomenon of the asymmetric change in the transmission spectra was observed in the gap region and the band-gap edge modes. For the band region, a sloped change in the transmission spectra was observed, and for the transition region, a hybrid of the two was observed. In addition, a universal dynamic picture of the fs nonlinear responses of the PhC was constructed.
Backward optical parametric oscillator threshold and linewidth studies
Authors: Godard Antoine , Guionie Marie , Dherbecourt Jean-Baptiste , Melkonian Jean-Michel , Raybaut Myriam
Published: December 2021

We carry out a theoretical investigation of the backward interaction optical parametric oscillator (OPO), in which one of the generated waves is counterpropagating with respect to the pump. We derive simple, self-consistent analytical formulas for the continuous-wave and pulsed regimes. While consistent with previous works on the continuous-wave regime, our study enables us to extend the analysis to the pulsed regime. In particular, we derive simple expressions of the oscillation build-up time, pulsed threshold, and efficiency, for the first time, to our knowledge. We also investigate the peculiar spectral features of the backward OPO when pumped with a narrow-linewidth pulsed radiation, in particular, the absence of tolerance to phase mismatch and the natural ability to emit two waves with a Fourier-transform-limited spectrum. A comparison with the conventional forward OPO is also carried out to emphasize the unique properties of the backward OPO.
Non-destructive and high-sensitivity plasma diagnostics based on third-harmonic generation of ultrashort-pulsed laser
Authors: Pang Shanbiao , Deng Lunhua , Huang Xiaodong , Liu Ke , Zhang Meng , Xu Huailiang
Published: December 2021

We report a principle-of-proof approach for non-destructive and high-sensitivity plasma diagnosis based on third-harmonic generation (THG) of an ultrashort-pulsed laser. We show that the on- and off-axial spectral intensities of the generated TH depend strongly on the electron density of a discharged plasma, even when the laser is non-contact to the plasma, and that the two TH components exhibit distinctly different detection sensitivities, in which the sensitivity measured by the on-axial TH component is about one order of magnitude higher than that by the off-axial one. This difference is ascribed to their different generation mechanisms, where the on- and off-axial components require quasi-phase- and phase-matching conditions, respectively. The quasi-phase-matching condition for on-axial THG is improved in the plasma, benefiting from the change in nonlinear properties related to the electron density. Our results open up a viable route for high spatiotemporal resolution diagnosis of various types of plasmas.
Multifunctional highly dispersive mirror for fiber oscillator
Authors: Zhang Yuhui , Wang Yanzhi , Wei Xiaoming , Wang Wenlong , Ling Lin , Chen Ruiyi , Wang Zhihao , Chen Chang , Shao Yuchuan , He Hongbo , Shao Jianda
Published: December 2021

Dispersive mirrors are generally used as reflective elements in ultrafast laser systems. In this study, a multifunctional highly dispersive mirror (MFDM) was prepared on the fiber tip, providing high transmittance in the pump wavelength, partial reflection and dispersion compensation in the working band. To achieve this, a starting structure that combines a quarter-wavelength structure, multi-cavities, and an anti-reflection structure was proposed. A large amount of dispersion was introduced while maintaining a certain reflectivity in the range of 1,050–1,060 nm and high transmittance at 976 nm. Employing the input and output coupling mirror as a dispersive mirror for the first time, the MFDM was successfully applied to an all-fiber oscillator to generate ultrafast seed pulses. This unprecedented MFDM is expected to replace dispersion compensation fibers, opening an avenue for the development of compact fiber lasers.
GAWBS noise correlation between cores in multi-core fibers
Authors: Sato Kozo , Yoshida Masato , Kasai Keisuke , Hirooka Toshihiko , Nakazawa Masataka
Published: December 2021

We describe experimental and analytical results regarding the guided acoustic-wave Brillouin scattering (GAWBS) noise correlation between cores in a multi-core fiber. First, we evaluated the GAWBS phase noise correlation between cores in an uncoupled four-core fiber (4CF) spaced at equal intervals of 90 degrees. We clarified that there are strong correlations in the TR2,m and TR4,m modes because the profile of the TR
n
,m mode has a torsional dependence given by cos(nθ) and sin(nθ). In contrast, the TR3,m modes showed a strong correlation in an uncoupled 19-core fiber (19CF) with a hexagonal close-packed structure since a strong interaction occurs where the cores are arranged at 60 degrees from each other. We also clarified that the correlation strength of the TR3,m mode depends on the distance of the core from the fiber center because the amplitude of the TR3,m mode changes in a radial direction.
Theoretical concentration limit and maximum annual optical efficiency of static/low-concentration CPV for horizontal integration to vehicle bodies
Authors: Sato Daisuke , Masuda Taizo , Tomizawa Ryota , Yamada Noboru
Published: December 2021

This study proposes an extended theoretical formula to characterize the relationship between the geometrical concentration ratio Cg and arbitrary incidence-angle range to objectively understand the theoretical limit performance of vehicle-integrated concentrator photovoltaics (VICPVs), i.e., static and low-concentration CPVs installed on a horizontal surface. Theoretical analysis revealed that the maximum annual optical efficiency (maximum annual solar energy yield) can be achieved by selectively collecting the sunlight incident only from a specific incidence-angle range of θ1–θ2 (θ1 ≠ 0°), regardless of the geographical location, which is associated with the angular distribution of the annual solar energy on the concentrator aperture. Moreover, the results of the solar concentrator design based on the obtained formula clarified that the annual optical efficiencies of the optical systems with aspheric lens or dielectric-filled crossed compound-parabolic-concentrator lens were 64–89% of the theoretical limit depending on the location for Cg = 3.5×. Nevertheless, the concentrator design can be further improved for practical applications.
Machine learning for sensing with a multimode exposed core fiber specklegram sensor
Authors: Smith Darcy L. , Nguyen Linh V. , Ottaway David J. , Cabral Thiago D. , Fujiwara Eric , Cordeiro Cristiano M. B. , Warren-Smith Stephen C.
Published: December 2021

Fiber specklegram sensors (FSSs) traditionally use statistical methods to analyze specklegrams obtained from fibers for sensing purposes, but can suffer from limitations such as vulnerability to noise and lack of dynamic range. In this paper we demonstrate that deep learning improves the analysis of specklegrams for sensing, which we show here for both air temperature and water immersion length measurements. Two deep neural networks (DNNs); a convolutional neural network and a multi-layer perceptron network, are used and compared to a traditional correlation technique on data obtained from a multimode fiber exposed-core fiber. The ability for the DNNs to be trained against a random noise source such as specklegram translations is also demonstrated.
Tm3+ heavily doped NIR-III bioprobe with 1 µm Stokes shift towards deep-tissue applications
Authors: Zhang Shaojian , Li Ji , Zhou Ziwen , Zhu Yin , Ning Danyang , Ren Jing , Liu Lu , Zhang Jianzhong
Published: December 2021

Recently developed rare earth ions doped NIR-NIR bioprobes, with excitation and emission both falling in the NIR region, have attracted wide attention due to their deep-tissue penetration, high signal-to-noise ratio, and high imaging resolution. The current NIR-NIR bioprobes focused mainly on the 1.5 µm emission of Er3+. Here, we developed a novel bioprobe utilizing the 1.8 µm emission of Tm3+ upon 0.8 µm excitation. After an inert shell effectively suppressing the surface quenching effect, the strong cross relaxation 3H4 + 3H6 → 3F4 + 3F4 between heavily doped Tm3+ greatly improves the luminescence intensity at 1.8 µm. As a result, the formed Tm3+ based NIR-III bioprobe exhibits better penetration ability of the state-of-the-art Er3+ based NIR-III bioprobe, and holding an even larger Stokes shift beneficial for the multiplexed bioimaging and labeling applications.
Deep learning assisted design of high reflectivity metamirrors
Authors: Shelling Neto L. , Dickmann J. , Kroker S.
Published: December 2021

The advent of optical metasurfaces, i.e. carefully designed two-dimensional nanostructures, allows unique control of electromagnetic waves. To unlock the full potential of optical metasurfaces to match even complex optical functionalities, machine learning provides elegant solutions. However, these methods struggle to meet the tight requirements when it comes to metasurface devices for the optical performance, as it is the case, for instance, in applications for high-precision optical metrology. Here, we utilize a tandem neural network framework to render a focusing metamirror with high mean and maximum reflectivity of Rmean = 99.993 % and Rmax = 99.9998 %, respectively, and a minimal phase mismatch of Δϕ = 0.016 % that is comparable to state-of-art dielectric mirrors.
Broad-spectrum diffractive network via ensemble learning
Authors: Shi Jiashuo , Chen Yingshi , Zhang Xinyu
Published: December 2021

We propose a broad-spectrum diffractive deep neural network (BS-D2NN) framework, which incorporates multiwavelength channels of input lightfields and performs a parallel phase-only modulation using a layered passive mask architecture. A complementary multichannel base learner cluster is formed in a homogeneous ensemble framework based on the diffractive dispersion during lightwave modulation. In addition, both the optical sum operation and the hybrid (optical–electronic) maxout operation are performed for motivating the BS-D2NN to learn and construct a mapping between input lightfields and truth labels under heterochromatic ambient lighting. The BS-D2NN can be trained using deep learning algorithms to perform a kind of wavelength-insensitive high-accuracy object classification.
Monostable dissipative Kerr solitons
Authors: Tsao Eugene , Xie Yijun , Nie Mingming , Huang Shu-Wei
Published: December 2021

Kerr microcombs hold the promise of bringing frequency combs onto the chip and into a variety of applications requiring low size, weight, power, and cost. However, reliable Kerr microcomb generation is hindered by the thermal effect and multistability of dissipative Kerr solitons (DKSs). Past approaches toward Kerr microcomb reliability include either deterministic single-soliton generation or self-starting soliton behavior but not both. Here we describe a regime of DKSs that is both deterministic and self-starting, in which only a single soliton can stably exist. We term this new DKS regime “monostable DKSs” (MS-DKSs) as all other optical behaviors, such as continuous-wave-only and multiple solitons, are fundamentally forbidden by the design. We establish a graphical model to describe MS-DKSs and discuss the design principles of MS-DKSs. We numerically demonstrate the MS-DKS behavior in an example periodically poled lithium niobate microring resonator.
Multiple-polarization-sensitive photodetector based on a perovskite metasurface
Authors: Li Cheng-Yao , Chen Chaowei , Liu Yu , Su Jing , Qi Dong-Xiang , He Jie , Fan Ren-Hao , Cai Qing , Li Qingxuan , Peng Ruwen , Huang Xian-Rong , Wang Mu
Published: December 2021

Most polarization-sensitive photodetectors detect either linearly polarized (LP) or circularly polarized (CP) light. Here, we experimentally demonstrate a multiple-polarization photodetector based on a hybrid organic–inorganic perovskite (HOIP) metasurface, which is sensitive to both LP and CP light simultaneously. The perovskite metasurface is composed of a HOIP antenna array on a single-crystal HOIP film. Owing to the antenna anisotropy, the absorption of linearly polarized light at the metasurface depends on the polarization angle; also, due to the mirror asymmetry of the antenna elements, the metasurface is also sensitive to different circular polarizations. Polarization-dependent photocurrent responses to both LP and CP light are detected. Our results highlight the potential of perovskite metasurfaces for integrated photoelectric applications.
Cascaded effect in a high-peak-power terahertz-wave parametric generator
Authors: Li Weifan , Qi Feng , Liu Pengxiang , Wang Yelong , Liu Zhaoyang
Published: December 2021

We demonstrate megawatt-level terahertz (THz)-wave generation via a
Stokes-seed-injected THz-wave parametric generator and study the
cascaded effect. The optical-to-THz conversion efficiency was
1.72 × 10−3, and the peak power was conservatively
estimated to be 1.09 MW using the pulse width of the pump. More than
80% of the THz-wave energy came from primary parametric generation,
with the rest coming from high-order parametric amplification. Clear
cascaded Stokes spots of second to fourth order were observed, and the
factors affecting the high-order parametric process are discussed. The
cascaded parametric effect is beneficial for achieving a higher
optical-to-THz conversion efficiency, thereby improving the
performance of high-peak-power THz-wave parametric sources.
Waveguide-type Maxwellian near-eye display using a pin-mirror holographic optical element array
Authors: Choi Myeong-Ho , Shin Kwang-Soo , Jang Junyoung , Han Woongseob , Park Jae-Hyeung
Published: December 2021

We propose a novel, to the best of our knowledge, waveguide-type optical see-through Maxwellian near-eye display for augmented reality. A pin-mirror holographic optical element (HOE) array enables the Maxwellian view and eye-box replication. Virtual images with deep depth of field are presented by each pin-mirror HOE, alleviating the discrepancy between vergence and accommodation distance. The compact form factor is achieved by the thin waveguide and HOE couplers.
When and why direct transmission models can be used for environmentally persistent pathogens
Authors: Benson Lee , Davidson Ross S. , Green Darren M. , Hoyle Andrew , Hutchings Mike R. , Marion Glenn
Published: December 2021

Variants of the susceptible-infected-removed (SIR) model of Kermack & McKendrick (1927) enjoy wide application in epidemiology, offering simple yet powerful inferential and predictive tools in the study of diverse infectious diseases across human, animal and plant populations. Direct transmission models (DTM) are a subset of these that treat the processes of disease transmission as comprising a series of discrete instantaneous events. Infections transmitted indirectly by persistent environmental pathogens, however, are examples where a DTM description might fail and are perhaps better described by models that comprise explicit environmental transmission routes, so-called environmental transmission models (ETM). In this paper we discuss the stochastic susceptible-exposed-infected-removed (SEIR) DTM and susceptible-exposed-infected-removed-pathogen (SEIR-P) ETM and we show that the former is the timescale separation limit of the latter, with ETM host-disease dynamics increasingly resembling those of a DTM when the pathogen’s characteristic timescale is shortened, relative to that of the host population. Using graphical posterior predictive checks (GPPC), we investigate the validity of the SEIR model when fitted to simulated SEIR-P host infection and removal times. Such analyses demonstrate how, in many cases, the SEIR model is robust to departure from direct transmission. Finally, we present a case study of white spot disease (WSD) in penaeid shrimp with rates of environmental transmission and pathogen decay (SEIR-P model parameters) estimated using published results of experiments. Using SEIR and SEIR-P simulations of a hypothetical WSD outbreak management scenario, we demonstrate how relative shortening of the pathogen timescale comes about in practice. With atttempts to remove diseased shrimp from the population every 24h, we see SEIR and SEIR-P model outputs closely conincide. However, when removals are 6-hourly, the two models’ mean outputs diverge, with distinct predictions of outbreak size and duration.
Hospital delivery and neonatal mortality in 37 countries in sub-Saharan Africa and South Asia: An ecological study
Authors: Gage Anna D. , Fink Günther , Ataguba John E. , Kruk Margaret E.
Published: December 2021

Background

Widespread increases in facility delivery have not substantially reduced neonatal mortality in sub-Saharan Africa and South Asia over the past 2 decades. This may be due to poor quality care available in widely used primary care clinics. In this study, we examine the association between hospital delivery and neonatal mortality.

Methods and findings

We used an ecological study design to assess cross-sectional associations between the share of hospital delivery and neonatal mortality across country regions. Data were from the Demographic and Health Surveys from 2009 to 2018, covering 682,239 births across all regions. We assess the association between the share of facility births in a region that occurred in hospitals (versus lower-level clinics) and early (0 to 7 days) neonatal mortality per 1,000 births, controlling for potential confounders including the share of facility births, small at birth, maternal age, maternal education, urbanicity, antenatal care visits, income, region, and survey year. We examined changes in this association in different contexts of country income, global region, and urbanicity using interaction models.

Across the 1,143 regions from 37 countries in sub-Saharan Africa and South Asia, 42%, 29%, and 28% of births took place in a hospital, clinic, and at home, respectively. A 10-percentage point higher share of facility deliveries occurring in hospitals was associated with 1.2 per 1,000 fewer deaths (p-value < 0.01; 95% CI: 0.82 to 1.60), relative to mean mortality of 22. Associations were strongest in South Asian countries, middle-income countries, and urban regions. The study’s limitations include the inability to control for all confounding factors given the ecological and cross-sectional design and potential misclassification of facility levels in our data.

Conclusions

Regions with more hospital deliveries than clinic deliveries have reduced neonatal mortality. Increasing delivery in hospitals while improving quality across the health system may help to reduce high neonatal mortality.
What is the impact of acquired immunity on the transmission of schistosomiasis and the efficacy of current and planned mass drug administration programmes?
Authors: Kura Klodeta , Hardwick Robert J. , Truscott James E. , Anderson Roy M.
Published: December 2021

Schistosomiasis causes severe morbidity in many countries with endemic infection with the schistosome digenean parasites in Africa and Asia. To control and eliminate the disease resulting from infection, regular mass drug administration (MDA) is used, with a focus on school-aged children (SAC; 5–14 years of age). In some high transmission settings, the World Health Organization (WHO) also recommends the inclusion of at-risk adults in MDA treatment programmes. The question of whether ecology (age-dependant exposure) or immunity (resistance to reinfection), or some combination of both, determines the form of observed convex age-intensity profile is still unresolved, but there is a growing body of evidence that the human hosts acquire some partial level of immunity after a long period of repeated exposure to infection. In the majority of past research modelling schistosome transmission and the impact of MDA programmes, the effect of acquired immunity has not been taken into account. Past work has been based on the assumption that age-related contact rates generate convex horizontal age-intensity profiles. In this paper, we use an individual based stochastic model of transmission and MDA impact to explore the effect of acquired immunity in defined MDA programmes. Compared with scenarios with no immunity, we find that acquired immunity makes the MDA programme less effective with a slower decrease in the prevalence of infection. Therefore, the time to achieve morbidity control and elimination as a public health problem is longer than predicted by models with just age-related exposure and no build-up of immunity. The level of impact depends on the baseline prevalence prior to treatment (the magnitude of the basic reproductive number R0) and the treatment frequency, among other factors. We find that immunity has a larger impact within moderate to high transmission settings such that it is very unlikely to achieve morbidity and transmission control employing current MDA programmes.
ASK ME!—Routine measurement of patient experience with patient safety in ambulatory care: A mixed-mode survey
Authors: Stahl Katja , Groene Oliver
Published: December 2021

Objective

Routine measurement of patient safety from the patients’ perspective receives increasing attention as an important component of safety measurement systems. The aim of this study was to examine patients’ experience with patient safety in ambulatory care and the results’ implications for routine patient safety measurement in ambulatory care.

Design

Cross-sectional mixed-mode survey.

Setting

General practitioner and specialist practices.

Participants

Patients aged >18 years seeking care in ambulatory care practices between February and June 2020.

Methods

A 22-item-questionnaire was completed in the practice or at home either on paper or online. Multivariate logistic regression was used to analyse the influence of survey mode and patient characteristics on patient experience with patient safety.

Results

The overall response rate was 71.1%. Most patients completed the questionnaire on site (76.6%) and on paper (96.1%). Between 30.1% to 68.5% of the respondents report the most positive option for patient experience with the main domains of patient safety. A total of 2.9% of patients reported having experienced a patient-safety event (PSE) during the last 12 months. Patients who filled in the questionnaire off site were more likely to report negative experiences for the scales communication & information (OR 1.2, 95% CI 1.0–1.5), rapport & participation (OR 1.4, 95% CI 1.1–1.7) and access (OR 1.3, 95% CI 0.9–1.4) than those who completed it on site. Those who chose a paper questionnaire were more likely to report negative experiences for all five scales compared to web responders.

Conclusion

Routine measurement of patient experience with factors contributing to the occurrence of PSEs can achieve high response rates by offering flexible participation options. Results gained from mixed-mode surveys need to take mode-effects into account when interpreting and using the results. Further research is needed in how to adequately assess number and type of experienced events in routine measurements.
Genomic characterization of non-schistosomiasis-related squamous cell carcinoma of the urinary bladder: A retrospective exploratory study
Authors: Al-ezzi Esmail M. , Veitch Zachary W. , Salah Samer H. , Van der Kwast Theodorus H. , Stockley Tracy L. , Selvarajah Shamini , Zhang Tong , Sridhar Srikala S. , Sacher Adrian G. , Fallah-rad Nazanin , Kulkarni Girish S. , Zlotta Alexandre R. , Finelli Antonio , Hansen Aaron R.
Published: December 2021

Background

Non-schistosomiasis related-squamous cell carcinoma of urinary bladder (NSR-SCCUB) is a rare tumor subtype distinct from urothelial carcinoma (UC). Studies assessing molecular biomarkers in bladder cancer have generally focused on UC, and genomic data of NSR-SCCUB is limited. We aim to provide additional insight into the molecular underpinnings of this rare entity.

Methods

NSR-SCCUB patients were identified retrospectively at Princess Margaret Cancer Centre between 2002 and 2017. Demographics, disease characteristics, therapeutic approaches, and outcomes were collected. Tissue samples were interrogated using the Oncomine Comprehensive Assay v3 (ThermoFisher). Kaplan-Meier method was used to estimate the disease-free survival and overall survival (OS).

Results

Overall, 11 patients with NSR-SCCUB were identified between 2002 and 2017 with adequate tissue samples. Median age was 71 years (45–86), predominantly male (63.6%). At time of diagnosis, 9 patients (81.8%) had muscle-invasive disease, 1 (9.1%) had non-muscle invasive, and 1 (9.1%) had advanced disease. Nine (81.8%) patients had radical cystectomy and pelvic lymph nodes dissection. Eight (72.7%) patients had pT3 or pT4 with N0, and 5 (45.5%) were grade 3. Median OS was 12.5 months (95% CI 7.7–17.2 months). Single nucleotide variants or insertion/deletions were identified in TP53, TERT, PIK3CA, PTEN, CREBBP, FBXW7, and FGFR3. Amplifications were found in CCND1, and EGFR.

Conclusions

NSR-SCCUB has potentially actionable genomic alterations with anticancer agents and many of these aberrations are also seen in UC. The recruitment of NSR-SCCUB patients harboring such mutations should be considered in biomarker driven urinary bladder cancer studies.
Public consultation in the evaluation of animal research protocols
Authors: Brunt Michael W. , Weary Daniel M.
Published: December 2021

One response to calls for increased openness in animal research is to make protocols publicly accessible, but it is unclear what type of input the public would provide if given this opportunity. In this study we invited public responses to five different research projects, using non-technical summaries intended for lay audiences. Our aim was to assess the potential for this type of public consultation in protocol review, and a secondary aim was to better understand what types of animal research people are willing to accept and why. US participants (n = 1521) were asked (via an online survey) “Do you support the use of these (insert species) for this research”, and responded using a seven-point scale (1 = “No”, 4 = “Neutral”, and 7 = “Yes”). Participants were asked to explain the reasons for their choice; open-ended text responses were subjected to thematic analysis. Most participants (89.7%) provided clear comments, showing the potential of an online forum to elicit feedback. Four themes were prevalent in participant reasoning regarding their support for the proposed research: 1) impact on animals, 2) impact on humans, 3) scientific merit, and 4) availability of alternatives. Participant support for the proposed research varied but on average was close to neutral (mean ± SD: 4.5 ± 2.19) suggesting some ambivalence to this animal use. The protocol describing Parkinson’s research (on monkeys) was least supported (3.9 ± 2.17) and the transplant research (on pigs) was most supported (4.9 ± 2.02). These results indicate that public participants are sensitive to specifics of a protocol. We conclude that an online forum can provide meaningful public input on proposed animal research, offering research institutions the opportunity for improved transparency and the chance to reduce the risk that they engage in studies that are out of step with community values.
Do exhausted primary school students cheat more? A randomized field experiment
Authors: Keller Tamás , Kiss Hubert János
Published: December 2021

Motivated by the two-decade-long scientific debate over the existence of the ego-depletion effect, our paper contributes to exploring the scope conditions of ego-depletion theory. Specifically, in a randomized experiment, we depleted students’ self-control with a cognitively demanding task that required students’ effort. We measured the effect of depleted self-control on a subsequent task that required self-control to not engage in fraudulent cheating behavior—measured with an incentivized dice-roll task—and tested ego-depletion in a large-scale preregistered field experiment that was similar to real-life situations. We hypothesized that treated students would cheat more. The data confirms the hypothesis and provides causal evidence of the ego-depletion effect. Our results provide new insights into the scope conditions of ego-depletion theory, contribute methodological information for future research, and offer practical guidance for educational policy.
Measurement properties of the Brazilian versions of Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in individuals with shoulder pain
Authors: Kamonseki Danilo Harudy , Haik Melina Nevoeiro , Ribeiro Larissa Pechincha , Almeida Rafaela Firmino de , Almeida Lucas Araújo de , Fonseca Carlos Luques , Camargo Paula Rezende
Published: December 2021

Purpose

To verify the measurement properties of the Brazilian versions of Fear-avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK) in individuals with shoulder pain.

Methods

Individuals with shoulder pain (>18 years) were included in this study. Structural validity was verified by exploratory factor analysis, which was used to identify dimensionality of the FABQ and TSK. Test-retest reliability was assessed with intraclass correlation coefficient(3,1)and internal consistency with Cronbach’s alpha. Floor or ceiling effects were also investigated. Responsiveness was verified by effect sizes and area under the receiver operating characteristic curve (AUC).

Results

Exploratory factor analysis identified two and one factor in the FABQ and TSK, respectively. FABQ and TSK presented moderate to good reliability and adequate internal consistency (Cronbach’s alpha > 0.70). The floor effect was present in one factor of the FABQ. The FABQ and TSK showed small to moderate effect sizes and did not show adequate AUC.

Conclusion

FABQ and TSK are multidimensional and unidimensional instruments, respectively. Those instruments presented moderate to good reliability and the responsiveness was considered to be suboptimal in individuals with shoulder pain.
Identification and verification of seed development related miRNAs in kernel almond by small RNA sequencing and qPCR
Authors: Jafari Marjan , Shiran Behrouz , Rabiei Gholamreza , Ravash Roudabeh , Sayed Tabatabaei Badraldin Ebrahim , Martínez-Gómez Pedro
Published: December 2021

Many studies have investigated the role of miRNAs on the yield of various plants, but so far, no report is available on the identification and role of miRNAs in fruit and seed development of almonds. In this study, preliminary analysis by high-throughput sequencing of short RNAs of kernels from the crosses between almond cultivars ‘Sefid’ × ‘Mamaee’ (with small and large kernels, respectively) and ‘Sefid’ × ‘P.orientalis’ (with small kernels) showed that the expressions of several miRNAs such asPdu-miR395a-3p,Pdu-miR8123-5p,Pdu-miR482f,Pdu-miR6285, andPdu-miR396awere significantly different. These miRNAs targeted genes encoding different proteins such asNYFB-3,SPX1,PGSIP3 (GUX2),GH3.9, andBEN1. The result of RT-qPCR revealed that the expression of these genes showed significant differences between the crosses and developmental stages of the seeds, suggesting that these genes might be involved in controlling kernel size because the presence of these miRNAs had a negative effect on their target genes. Pollen source can influence kernel size by affecting hormonal signaling and metabolic pathways through related miRNAs, a phenomenon known as xenia.
The effect of gender and parenting daughters on judgments of morally controversial companies
Authors: Niszczota Paweł , Białek Michał
Published: December 2021

Earlier findings suggest that men with daughters make judgments and decisions somewhat in line with those made by women. In this paper, we attempt to extend those findings, by testing how gender and parenting daughters affect judgments of the appropriateness of investing in and working for morally controversial companies (“sin stocks”). To do so, in Study 1 (N = 634) we investigate whether women judge the prospect of investing in sin stocks more harshly than men do, and test the hypothesis that men with daughters judge such investments less favorably than other men. In Study 2 (N = 782), we investigate the willingness to work in morally controversial companies at a significant wage premium. Results show that—for men—parenting daughters yields harsher evaluations of sin stocks, but no evidence that it lowers the propensity to work in such companies. This contrasts to the effect of gender: women reliably judge both investment and employment in morally controversial companies more harshly than men do. We suggest that an aversion towards morally controversial companies might be a partial determinant of the gender gap in wages.
Unsupervised feature learning for electrocardiogram data using the convolutional variational autoencoder
Authors: Jang Jong-Hwan , Kim Tae Young , Lim Hong-Seok , Yoon Dukyong
Published: December 2021

Most existing electrocardiogram (ECG) feature extraction methods rely on rule-based approaches. It is difficult to manually define all ECG features. We propose an unsupervised feature learning method using a convolutional variational autoencoder (CVAE) that can extract ECG features with unlabeled data. We used 596,000 ECG samples from 1,278 patients archived in biosignal databases from intensive care units to train the CVAE. Three external datasets were used for feature validation using two approaches. First, we explored the features without an additional training process. Clustering, latent space exploration, and anomaly detection were conducted. We confirmed that CVAE features reflected the various types of ECG rhythms. Second, we applied CVAE features to new tasks as input data and CVAE weights to weight initialization for different models for transfer learning for the classification of 12 types of arrhythmias. The f1-score for arrhythmia classification with extreme gradient boosting was 0.86 using CVAE features only. The f1-score of the model in which weights were initialized with the CVAE encoder was 5% better than that obtained with random initialization. Unsupervised feature learning with CVAE can extract the characteristics of various types of ECGs and can be an alternative to the feature extraction method for ECGs.
Performance of a new symptom checker in patient triage: Canadian cohort study
Authors: Chan Forson , Lai Simon , Pieterman Marcus , Richardson Lisa , Singh Amanda , Peters Jocelynn , Toy Alex , Piccininni Caroline , Rouault Taiysa , Wong Kristie , Quong James K. , Wakabayashi Adrienne T. , Pawelec-Brzychczy Anna
Published: December 2021

Background

Computerized algorithms known as symptom checkers aim to help patients decide what to do should they have a new medical concern. However, despite widespread implementation, most studies on symptom checkers have involved simulated patients. Only limited evidence currently exists about symptom checker safety or accuracy when used by real patients. We developed a new prototype symptom checker and assessed its safety and accuracy in a prospective cohort of patients presenting to primary care and emergency departments with new medical concerns.

Method

A prospective cohort study was done to assess the prototype’s performance. The cohort consisted of adult patients (≥16 years old) who presented to hospital emergency departments and family physician clinics. Primary outcomes were safety and accuracy of triage recommendations to seek hospital care, seek primary care, or manage symptoms at home.

Results

Data from 281 hospital patients and 300 clinic patients were collected and analyzed. Sensitivity to emergencies was 100% (10/10 encounters). Sensitivity to urgencies was 90% (73/81) and 97% (34/35) for hospital and primary care patients, respectively. The prototype was significantly more accurate than patients at triage (73% versus 58%, p<0.01). Compliance with triage recommendations in this cohort using this iteration of the symptom checker would have reduced hospital visits by 55% but cause potential harm in 2–3% from delay in care.

Interpretation

The prototype symptom checker was superior to patients in deciding the most appropriate treatment setting for medical issues. This symptom checker could reduce a significant number of unnecessary hospital visits, with accuracy and safety outcomes comparable to existing data on telephone triage.