bluuebunny/crossref_metadata_2025 huggingface dataset:
ROS‐derived lipid peroxidation is prevented in barley leaves during senescence
Authors: Shimakawa Ginga , Krieger‐Liszkay Anja , Roach Thomas
Published: August 2022

Senescence in plants enables resource recycling from senescent leaves to sink organs. Under stress, increased production of reactive oxygen species (ROS) and associated signalling activates senescence. However, senescence is not always associated with stress since it has a prominent role in plant development, in which the role of ROS signalling is less clear. To address this, we investigated lipid metabolism and patterns of lipid peroxidation related to signalling during sequential senescence in first‐emerging barley leaves grown under natural light conditions. Leaf fatty acid compositions were dominated by linolenic acid (75% of total), the major polyunsaturated fatty acid (PUFA) in galactolipids of thylakoid membranes, known to be highly sensitive to peroxidation. Lipid catabolism during senescence, including increased lipoxygenase activity, led to decreased levels of PUFA and increased levels of short‐chain saturated fatty acids. When normalised to leaf area, only concentrations of hexanal, a product from the 13‐lipoxygenase pathway, increased early upon senescence, whereas reactive electrophile species (RES) from ROS‐associated lipid peroxidation, such as 4‐hydroxynonenal, 4‐hydroxyhexenal and acrolein, as well as β‐cyclocitral derived from oxidation of β‐carotene, decreased. However, relative to total chlorophyll, amounts of most RES increased at late‐senescence stages, alongside increased levels of α‐tocopherol, zeaxanthin and non‐photochemical quenching, an energy dissipative pathway that prevents ROS production. Overall, our results indicate that lipid peroxidation derived from enzymatic oxidation occurs early during senescence in first barley leaves, while ROS‐derived lipid peroxidation associates weaker with senescence.
Ammonia induced toxico‐physiological responses in fish and management interventions
Authors: Parvathy Ashokkumar Jayasree , Das Bini C. , Jifiriya Marathippallam Jamal , Varghese Tincy , Pillai Devika , Rejish Kumar Vattiringal Jayadradhan
Published: August 2022

Intensification of aquaculture practices resulted in increased ammonia production in the culture systems. Lack of proper management of the culture system will result in elevated ammonia, which adversely affects the culture species. Moreover, with the ongoing global warming, fish metabolism and ammonia excretion are expected to increase. This, coupled with the hypoxic condition, exacerbates the severity of ammonia toxicity. Ammonia toxicity can alter the growth and the biochemical, physiological and immunological responses of fish. Several factors such as pH, temperature, salinity, dissolved oxygen, species and life stages of fish, physical activity, feeding and stress influence the toxicity of ammonia in fish. A proper understanding of these factors is a prerequisite for successful aquaculture. The physiological changes caused by the elevated ammonia hinder homeostasis that eventually increases their susceptibility to diseases. This review discusses ammonia toxicity in fish, factors affecting the toxicity and various physiological, haematological, histological and immunological responses induced by the elevated ammonia. Furthermore, the review summarizes various management and dietary interventions to mitigate ammonia and ammonia induced stress in aquaculture.
Identification of the novel HLA‐DRB4*01:162N allele using next‐generation sequencing
Authors: Kim Seo Wan , Hong Jun Young , Jung Sunmi , Lee Jina , Park Younhee
Published: August 2022

The HLA‐DRB4*01:162N allele differs from HLA‐DRB4*01:03:01:01 allele by a single nucleotide in codon 131.
The nose is not enough: Multi‐site sampling is best forMRSPdetection in dogs and households
Authors: Frosini Sian‐Marie , Bond Ross , King Ruth H. , Loeffler Anette
Published: August 2022

Background

Following recovery from meticillin‐resistantStaphylococcus pseudintermedius(MRSP) infection of any type, dogs may continue to carry MRSP asymptomatically on skin and mucosae, contributing to the spread of this multidrug‐resistant, veterinary hospital‐associated pathogen with zoonotic potential to others and into the environment.

Objectives

This study determined which canine anatomic and household environmental sites are most sensitive for sampling to identify carriage and contamination.

Methods and Materials

Fifty‐one dogs and 22 households, MRSP‐positive on at least one tested site, were sampled on 132 and 40 occasions over time, respectively. Dogs were swabbed at six sites (mouth, nose, conjunctiva, skin, prepuce/vulva, perianal area); household environments were sampled using contact plates (mannitol salt agar [MSA] and MSA + 6 mg/L oxacillin [MS+]) on five sites. MRSP was isolated after enrichment, grown on MSA/MS+ and was confirmed by PCR. Generalized estimating equations were used for calculation of sensitivity (95% confidence interval) for each site/combination.

Results

Each anatomical and environmental site yielded MRSP at least once. MRSP was isolated from only a single site in 27.3% of dogs, with the buccal mucosa showing the highest sensitivity (63.8%). Multi‐site sampling of a minimum of four canine anatomical or four environmental sites, respectively, was needed to achieve >95% sensitivity.

Conclusions and clinical relevance

The canine buccal mucosa should be included in MRSP sampling protocols, ideally in addition to at least three other anatomical sites. Likewise, environment sampling should be of multiple household sites in cases where it is used as a part of clinical case management.
Machine Learning the Concrete Compressive Strength From Mixture Proportions
Authors: Xu Xiaojie , Zhang Yun
Published: August 2022

Concrete mixture design usually requires labor-intensive and time-consuming work, which involves a significant amount of “trial batching” approaches. Recently, statistical and machine learning methods have demonstrated that a robust model might help reduce the experimental work greatly. Here, we develop the Gaussian process regression model to shed light on the relationship among the contents of cement, blast furnace slag, fly ash, water, superplasticizer, coarse aggregates, fine aggregates, and concrete compressive strength (CCS) at 28 days. A total of 399 concrete mixtures with CCS ranging from 8.54 MPa to 62.94 MPa are examined. The modeling approach is highly stable and accurate, achieving the correlation coefficient, mean absolute error, and root mean square error of 99.85%, 0.3769 (1.09% of the average experimental CCS), and 0.6755 (1.96% of the average experimental CCS), respectively. The model contributes to fast and low-cost CCS estimations.
Design of a Stiffened Space Membrane Structure Using Explicit Topology Optimization
Authors: Wang Yue , Zhang Hua , Du Zongliang , Zhang Weisheng , Guo Xu
Published: August 2022

In this work, a hybrid topology optimization scheme based on the moving morphable component (MMC) method is presented for the design of stiffened membrane structure. The stiffened membrane structure is composed of a base membrane, reinforcing stiffeners, and functional cells. For an accurate and effective simulation of the structure, a hybrid structure model with multiple element types is constructed. In this study, MMC components used as the basic elements for the topology description will include several different types: bar elements for the stiffeners and continuum elements for the base membrane and functional cells. The base membrane is modeled using bi-modulus material. With this approach, the distribution of element types in different parts can be changed as the components are moved around during the optimization process. Some numerical examples are presented to validate the effectiveness of the proposed scheme.
Interplay of Clusters of Acoustic and Intrinsic Thermoacoustic Modes in Can-Annular Combustors
Authors: Fournier Guillaume J. J. , Schaefer Felicitas , Haeringer Matthias , Silva Camilo F. , Polifke Wolfgang
Published: August 2022

Thermoacoustic systems can exhibit self-excited instabilities of two nature, namely cavity modes or intrinsic thermoacoustic (ITA) modes. In heavy-duty land-based gas turbines with can-annular combustors, the cross-talk between cans causes the cavity modes of various azimuthal order to create clusters, i.e., ensembles of modes with close frequencies. Similarly, in systems exhibiting rotational symmetry, ITA modes also have the peculiar behavior of forming clusters. In the present study, we investigate how such clusters interplay when they are located in the same frequency range. We first consider a simple Rijke tube configuration and derive a general analytical low-order network model using only dimensionless numbers. We investigate the trajectories of the eigenmodes when changing the downstream length and the flame position. In particular, we show that ITA and acoustic modes can switch nature and their trajectories are strongly influenced by the presence of exceptional points. We then study a generic can-annular combustor. We show that such configuration can be approximated by an equivalent Rijke tube. We demonstrate that, in the absence of mean flow, the eigenvalues of the system necessarily lie on specific trajectories imposed by the upstream conditions.
Analysis of the Propulsion Phase of Water Rockets Using Smartphone Sensors and Video Analysis
Authors: Marranghello Guilherme Frederico , Lucchese Márcia Maria , Rocha Fábio Saraiva da
Published: August 2022

Water rockets can be used in a variety of ways, from schools to planetariums, with very young kids or adults. We propose here simple forms to work with water rockets, going one step further than a simple launch. A smartphone can be used to film the launch and analyze its motion with video analysis or it can even be attached to the rocket, using its acceleration sensor. We present both experimental techniques, theory, and a discussion about the propelling phase of the rocket’s motion. The results show amazing features that are frequently neglected when discussing parabolic motion.
Charging a Capacitor with Another Capacitor by Using Arduino
Authors: Moya Antonio Angel
Published: August 2022

Resistor–capacitor (RC) circuit labs help students, but most courses don’t include them because of complications and cost. This work presents an easy and inexpensive Arduino-based lab on the charge and energy transfer between two capacitors with different values of the initial electric charge when they are connected through a resistor. Capacitors are electromagnetic devices widely described in calculus-based introductory physics courses. The concept of capacitance, the determination of the capacitance in planar and cylindrical geometries, the description of the series and parallel combinations of capacitors, or the evaluation of the electric energy stored in them are classic topics studied under electrostatic equilibrium conditions. Charge and discharge of a capacitor through a resistor is also studied in order to experimentally determine the capacitance of the capacitor or measure the electric charge stored in it. Energy balances in the charging and discharging processes of a capacitor are also widely discussed in textbooks. To get a better understanding of the basic concepts, other complex exercises are included in these courses. Among them, one can find the determination of the final charge and energy stored in each of the two capacitors, with different initial charge states, which are combined in parallel. In addition, the study of the charge through a resistor of a discharged capacitor by using a charged capacitor is also a classical exercise when one studies in depth the RC circuit. However, lab exercises covering these last topics are lacking in introductory physics courses. This is mainly due to the need to use complex experimental setups to simultaneously handle various power sources and various multimeters.
Rolling Motion: Augmented Reality Animations and Multiplatform Simulation
Authors: Vidak Andrej , Šapić Iva Movre , Hadžimehmedović Mirza
Published: August 2022

In the past decade, we have witnessed the emergence of a large number of different computer-based animations and simulations that have the goal to foster better learning of different physics topics. Past studies have shown many benefits of animations and simulations, but for their efficient usage it is very important that teachers are well educated in the teaching material and usage of selected visualizations. Furthermore, studies have proven that augmented reality technology has a potential to reduce cognitive load and improve the quality of physics lectures. Many of these visualizations are generally designed for targeted physics phenomena, and sometimes it is not easy to address specific students’ misconceptions. In this paper, we will present augmented reality animations and a simulation that can generally be useful for teaching about counterintuitive aspects of rolling motion, and specifically address students’ misconceptions about rolling friction and velocity in contact with the ground.
Augmented Reality Experiment with a Van de Graaff Generator
Authors: Wildan Ardan , Yau Chin Doong , Wijesinghe Chamaka , Xiao Kevin , Ng Tuck Wah
Published: August 2022

The Van de Graaff (VDG) generator is ubiquitous in the physics laboratory, but the high-voltage discharges that emanate from it can cause user discomfort or damage to nearby electronics during experimentation. In this work, an augmented reality (AR) tool is developed to help students conduct the experiment safely. More specifically, it allows them to observe and investigate the discharge characteristics as a function of distance between the charged metallic sphere of the VDG generator and the spherical wand. The tool is shown to work well, and the feedback from students on its use was positive.
Using Different Smartphone Sensors to Find the Speed of a Toy Car
Authors: Kapucu Serkan
Published: August 2022

There are many examples of using smartphones in physics experiments. Students and teachers can easily perform many physics experiments with the help of smartphone sensors, even experiments for which high-cost materials are needed. There are different types of such experiments in which various kinds of sensors are used. Many physical quantities can be reliably measured with smartphone sensors after some calibration. One of the physical quantities that can be determined with these sensors is object speed. For example, the angular velocities of rotating objects have been measured with a smartphone light as well as proximity, acceleration, and magnetic field sensors. The speeds of light-emitting objects traveling on a straight path and inclined plane have also been determined with a smartphone light sensor. Ball velocities have also been determined with a smartphone oscilloscope app. In this study, we determine the speed of a toy car over a certain distance using smartphone magnetic field, light, and proximity sensors simultaneously with just one experiment.
Tracking Inequity: An Actionable Approach to Addressing Inequities in Physics Classrooms
Authors: Christensen Julie , Shah Niral , Ortiz Nickolaus Alexander , Stroupe David , Reinholz Daniel L.
Published: August 2022

Recent studies reveal people from marginalized groups (e.g., people of color and women) continue to earn physics degrees at alarmingly low rates. This phenomenon is not surprising given reports of the continued perception of physics as a masculine space and the discrimination faced by people of color and women within the field. To realize the vision of an equitable physics education, fully open to and supportive of marginalized groups, teachers need ways of seeing equity as something that is concrete and actionable on an everyday basis. In our work, teachers have found value in intentionally reflecting on their instruction and their students explicitly in terms of race, gender, and other social markers. We find they are then better positioned to build equitable physics classrooms. Without a focus on specific social markers, common obstacles such as color-evasiveness emerge, which obstruct the pursuit of equity in classrooms.
Color Vision Deficiency and Teaching Electromagnetism
Authors: Tompkins Nathan , Gunther Karen L.
Published: August 2022

What colors do you use in class when teaching electromagnetism? For many physics educators we simply use what we learned or what is used in the textbook. Browsing through a large collection of introductory physics textbooks reveals that the vast majority use red for the electric field, blue for the magnetic field, and some shade of green for the electric potential. These color choices, although common, may be confusing to students with color vision deficiency. Color vision deficiency (CVD), often incorrectly referred to as color blindness, affects roughly 6% of physics majors (calculated from Refs. 2–4). For people with red/green CVD, the fall colors (red, orange, yellow, green) collapse into shades of yellow. In addition to yellows, those with red/green CVD can perceive blues (and blacks and whites), hence they are not color “blind.” Using an alternative color palette when teaching electromagnetism is a quick and easy way to facilitate the learning of students with CVD.
Fractals on a Benchtop: Observing Fractal Dimension in a Resistor Network
Authors: Creffield Charles
Published: August 2022

Our first experience of dimension typically comes in the intuitive Euclidean sense: a line is one dimensional, a plane is two dimensional, and a volume is three dimensional. However, following the work of Mandelbrot, systems with a fractional dimension, “fractals,” now play an important role in science. The novelty of encountering fractional dimension, and the intrinsic beauty of many fractals, has a strong appeal to students and provides a powerful teaching tool. I describe here a low-cost and convenient experimental method for observing fractal dimension, by measuring the power-law scaling of the resistance of a fractal network of resistors. The experiments are quick to perform, and the students enjoy both the construction of the network and the collaboration required to create the largest networks. Learning outcomes include analysis of resistor networks beyond the elementary series and parallel combinations, scaling laws, and an introduction to fractional dimension.
Open-Source Virtual Labs with Failure-Mode-Inspired Physics and Optics Experiments
Authors: Lee Sukmock , Guthery Charlotte , Kim Daewook , Calkins Addison
Published: August 2022

An essential goal for physics and optical science instructors is to encourage students to find excitement and beauty in physical and optical phenomena while helping them learn the theoretical concepts and conducting experiments that can test the validity of the concepts. Such motivation largely relies on realistic hands-on lab opportunities where students can interact with physics-based phenomena as well as their corresponding laws and principles. Virtual simulation and modeling tools provide a great alternative to deliver interactive experiences when participating in physical lab environments is limited or unavailable (i.e., during distance learning due to the COVID-19 pandemic). The use of computer-based simulations can improve students’ ability to make predictions and explain the phenomena practiced in the experiments. The educational value of virtual labs has been extensively investigated and reported, showing that students who use simulated equipment outperformed their peers.
Learning about the early history of astronomy through Phystory
Authors: Behrman Joanna
Published: August 2022

To help bring history to life in the classroom, the Center for History of Physics at the American Institute of Physics (AIP) has published Phystory: a timeline-building game that can inspire students to learn about major events and people in the history of physics and astronomy and put them in perspective with the dates of major world events. Students will learn not just whether Hypatia or the Roman Colosseum came first, but also who John Buridan, Su Song, and Ibn al-Shatir were, along with many more scientific thinkers.
Emergent properties of species-habitat networks in an insular forest landscape
Authors: Palmeirim Ana Filipa , Emer Carine , Benchimol Maíra , Storck-Tonon Danielle , Bueno Anderson S. , Peres Carlos A.
Published: August 2022

Deforestation and fragmentation are pervasive drivers of biodiversity loss, but how they scale up to entire landscapes remains poorly understood. Here, we apply species-habitat networks based on species co-occurrences to test the effects of insular fragmentation on multiple taxa—medium-large mammals, small nonvolant mammals, lizards, understory birds, frogs, dung beetles, orchid bees, and trees—across 22 forest islands and three continuous forest sites within a river-damming quasi-experimental landscape in Central Amazonia. Widespread, nonrandom local species extinctions were translated into highly nested networks of low connectance and modularity. Networks’ robustness considering the sequential removal of large-to-small sites was generally low; between 5% (dung beetles) and 50% (orchid bees) of species persisted when retaining only <10 ha of islands. In turn, larger sites and body size were the main attributes structuring the networks. Our results raise the prospects that insular forest fragmentation results in simplified species-habitat networks, with distinct taxa persistence to habitat loss.
Transcriptional regulation of the thymus master regulatorFoxn1
Authors: Kadouri Noam , Givony Tal , Nevo Shir , Hey Joschka , Ben Dor Shifra , Damari Golda , Dassa Bareket , Dobes Jan , Weichenhan Dieter , Bähr Marion , Paulsen Michelle , Haffner-Krausz Rebecca , Mall Marcus A. , Plass Christoph , Goldfarb Yael , Abramson Jakub
Published: August 2022

FOXN1 is a transcription factor critical for the development of both thymic epithelial cell (TEC) and hair follicle cell (HFC) compartments. However, mechanisms controlling its expression remain poorly understood. To address this question, we performed thorough analyses of the evolutionary conservation and chromatin status of theFoxn1locus in different tissues and states and identified several putative cis-regulatory regions unique to TECs versus HFCs. Furthermore, experiments using genetically modified mice with specific deletions in theFoxn1locus and additional bioinformatic analyses helped us identify key regions and transcription factors involved in either positive or negative regulation ofFoxn1in both TECs and HFCs. Specifically, we identified SIX1 and FOXN1 itself as key factors inducingFoxn1expression in embryonic and neonatal TECs. Together, our data provide important mechanistic insights into the transcriptional regulation of theFoxn1gene in TEC versus HFC and highlight the role of FOXN1 in its autoregulation.
A case of Ampferer-type subduction beneath the New Caledonia arc: Evidence for inefficient subduction of hydrated lithologies into the upper mantle
Authors: Nicholson Kirsten N. , Ali Abu El-Rus Mohamed
Published: August 2022

New Caledonia is one of the world’s best-exposed subduction/obduction complexes and is central to understanding the geodynamic evolution of the southwest Pacific region. We present new geochemical and Ar/Ar age dates from the in situ eruptive sequences of the La Conception basaltic-andesite lavas (ca. 29.12 Ma) and correlate the generation of these lavas with the generation of the Saint Louis and Koum/Borindi Massifs (ca. 24 Ma) to provide information on the magmatic processes operating within the mantle wedge over time and to indicate the direction of the subducted slab during the Oligocene. The La Conception basaltic-andesite lavas were emplaced in an arc-to-trench direction to the southwest of New Caledonia due to the partial melting of metasomatized, amphibole-bearing garnet peridotites at the base of mantle wedge (∼112−118 km). However, both the Saint Louis and Koum/Borindi granodiorite massifs were derived from melting within the lower crust of an island arc overlying a mantle wedge. Such temporal and spatial variations of magmatism in New Caledonia are consistent with a northeast subduction zone during the Oligocene. The absence of voluminous arc magmatism related to the Oligocene subduction is a consequence of the low Tp temperatures of the mantle wedge, the old age and the high sinking velocity of the downgoing slab, and the absence of stress within the overriding plate. The Oligocene subduction beneath New Caledonia, therefore, is an ideal example of Ampferer-type subduction, which is an amagmatic closure area due to the inefficient subduction of hydrated lithologies into the convective upper mantle. Once the Paleocene to Miocene contraction in the southwest Pacific region ceased, the subduction west of New Caledonia shut down, the system relaxed, and no more melting occurred during the Oligocene.
Supplemental Material: High-magnitude stresses induced by mineral-hydration reactions
Authors: Plümper Oliver , al. et
Published: August 2022

High-magnitude, reaction-induced stresses. 
Supplemental Material: Dominant precessional forcing of the East Asian summer monsoon since 260 ka
Authors: Guo Benhong , Nie Junsheng , al. et
Published: August 2022

Supplemental discussion and Figures S1–S3. 
Reactivation of adult-onset Still’s disease after use of the COVID-19 ChAdOx1-S vaccine
Authors: Ibáñez Vodnizza Sebastián E , Morales Murillo Luis , de la Rivera Vergara Matías , Saldías Martínez Roberto
Published: August 2022

A woman in her 60s with a history of adult-onset Still’s disease (AOSD) in remission for 14 years received the ChAdOx1-S vaccine as a booster to her initial vaccination schedule (two doses of CoronaVac vaccine 6 months apart). Two weeks later, she consulted for symptoms suggestive of AOSD reactivation. This was confirmed during hospitalisation, where renal and cardiac involvement were also observed. Despite using high-dose corticosteroids, troponin T and N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) were persistently elevated. Tocilizumab was used, with which the patient achieved complete remission of her symptoms and normalised her laboratory tests.
Total colonic volvulus with a 720° twist of freely mobile colon
Authors: Parker Dominic Robert , Kaczmarczyk Janina , Rana Abdullah , Sia Tiong Cheng
Published: August 2022

Segmental colonic volvulus involving the sigmoid or ileocaecal region is an important cause of large bowel obstruction and a well-established surgical emergency. Volvulus of the entire colon however is hazardously rare, in which case the diagnosis is likely to be made intraoperatively. The surgeon is then faced with the conundrum of the best surgical management, especially in the case of early intervention with viable bowel. To our knowledge this has never been reported.
Benign phaeochromocytoma presenting with recurrent spells and negative biochemical screening
Authors: Abukhaled Jamal , Balinski Alexander Michael
Published: August 2022

A woman in her 40s presented with spells of hypertension, warmth, flushing and bradycardia for more than 1 year. Despite normal plasma metanephrines of 0.48 nmol/L (reference range: <0.50 nmol/L) and normal 24-hour urine metanephrines of 199 µg/day (reference range: 52–341 µg/day), an abdominal CT scan was obtained which revealed a 1.7 × 1.4 cm right adrenal gland nodule. During her next spell, 24-hour urine metanephrines were elevated at 585 µg/day with total metanephrines of 1026 µg/day (reference range: 140–785 µg/day). Subsequent MRI demonstrated a 1.5 × 1.5 cm right adrenal gland lesion concerning for phaeochromocytoma. Right adrenal gland excision was performed and pathology confirmed a benign phaeochromocytoma. Follow-up genetic testing was negative. This case highlights the challenges of identifying phaeochromocytomas in the clinical setting. Early imaging may assist in the timely diagnosis and treatment of these tumours in patients presenting with recurrent spells and negative biochemical screening.
An exploration of practices affecting research integrity in global health partnerships
Authors: Troughton Lindsay , Obasi Angela
Published: August 2022

Background

Research integrity is central to good research practice yet it is under-researched in global health.

Aim

To identify and explore factors which promote or constrain adherence to research integrity principles in global health research partnerships, specifically at a UK higher education institution (HEI) and its low-to-middle-income country (LMIC) partners.

Methods

Qualitative study using key informant interviews among researchers at a HEI and a number of its LMIC partners exploring their understanding of the principles of research integrity and experience of its implementation in relation to research.

Results

Thirteen interviews, five from HEI and eight from partner organisations, were conducted. Analysis found that understanding of research integrity focused on issues relating to rigour and did not include ‘care and respect’. Barriers to research integrity included, supra institutional factors such as funding flows, inequitable power relations, the competitive culture of the global health ecosystem and institutional psychosocial safety. Most respondents had direct or indirect knowledge of incidences of research misconduct.

Conclusion

Improved recognition of the importance of care and respect is key to improving the integrity of research conduct within global health partnerships.
Severity of maternal SARS-CoV-2 infection and perinatal outcomes of women admitted to hospital during the omicron variant dominant period using UK Obstetric Surveillance System data: prospective, national cohort study
Authors: Engjom Hilde M , Ramakrishnan Rema , Vousden Nicola , Bunch Kathryn , Morris Eddie , Simpson Nigel A B , Gale Chris , O'Brien Patrick , Quigley Maria , Brocklehurst Peter , Kurinczuk Jennifer J , Knight Marian
Published: August 2022

Objectives

To describe the severity of maternal infection when the omicron SARS-CoV-2 variant (B.1.1.529) was dominant (15 December 2021 to 14 March 2022) and describe outcomes by symptoms and vaccination status.

Design

Prospective, national cohort study using the UK Obstetric Surveillance System.

Setting

94 hospitals in the UK with a consultant led maternity unit.

Participants

Pregnant women admitted to hospital for any cause with a positive SARS-CoV-2 test.

Main outcome measures

Symptomatic or asymptomatic infection, vaccination status by doses before admission, and severity of maternal infection (moderate or severe infection according to modified World Health Organization's criteria).

Results

Of 3699 women who were admitted to hospital, 986 (26.7%, 95% confidence interval 25.3% to 28.1%) had symptoms; of these, 144 (14.6%, 12.5% to 17.0%) had a moderate to severe infection, 99 (10.4%, 8.6% to 12.5%) of 953 received respiratory support, and 30 (3.0%, 2.1% to 4.3%) were admitted to an intensive care unit. Covid-19 specific drug treatment was given to 13 (43.3%) of the 30 women in intensive care. Four women with symptoms died (0.4%, 0.1% to 1.1%). Vaccination status was known for 845 (85.6%) women with symptoms; 489 (58.9%) were unvaccinated and only 55 (6.5%) had three doses. Moderate to severe infection was reported for 93 (19.0%) of 489 unvaccinated women with symptoms, decreasing to three (5.5%) of 55 after three doses. Among the 30 women with symptoms who were admitted to intensive care, 23 (76.7%) were unvaccinated and none had received three doses.

Conclusion

Most women with severe covid-19 disease were unvaccinated and vaccine coverage among pregnant women admitted to hospital with SARS-CoV-2 was low. Ongoing action to prioritise and advocate for vaccine uptake in pregnancy is essential. A better understanding of the persistent low use of drug treatments is an urgent priority.

Trial registration

ISRCTN 40092247.
Career aspirations of specialty among medical students in sub-Saharan Africa: a systematic review and meta-analysis of data from two decades, 2000–2021
Authors: Bajunirwe Francis , Semakula Daniel , Izudi Jonathan
Published: August 2022

Objectives

To determine the distribution of career aspirations for the discipline of specialty among undergraduate medical students in sub-Saharan Africa (SSA).

Design

We searched PubMed/MEDLINE, EMBASE Google Scholar and Google for studies published between 1 January 2000 and 31 June 2021. Two reviewers extracted data from eligible studies, with disagreements resolved through consensus with a third reviewer. The random effects model was used to pool proportions, presented with the corresponding 95% CI. Heterogeneity was assessed using Cochrane’s (Q) test but quantified with I2values. Sources of heterogeneity were checked using meta-regression analysis while publication bias was assessed using funnel plot and Egger’s test.

Setting

SSA.

Participants

Undergraduate medical students.

Outcomes

Primary outcome was pooled proportion of career aspirations for the discipline of medical specialty and the secondary outcome was reasons for the specialty selection.

Results

We identified 789 citations but meta-analysed 32 studies, with an overall sample size of 8231 participants. The most popular career aspiration for the discipline of specialty was surgery (29.5%; 95% CI 25.0% to 34.2%), followed by internal medicine (17.3%, 95% CI 11.7% to 23.7%), and then obstetrics and gynaecology (15.0%, 95% CI 12.3% to 17.9%), and paediatrics (11.3%; 95% CI 9.6% to 13.2%). The less popular medical disciplines of specialty included public health, orthopaedics, ophthalmology, family medicine, pathology, anaesthesiology, dermatology, otolaryngology, psychiatry and emergency medicine. The reasons for the selection of a medical discipline for specialty related to mentor and peer influences, prospect for economic gains, personal factors, long-term career interests and goals and discipline-specific factors.

Conclusion

Surgery is the most preferred career aspiration for medical students in SSA, followed by internal medicine. The choices do not necessarily match the disease burden on the continent and medical schools should consider strengthening career counselling and mentoring in their curriculum.

PROSPERO registration number

CRD42021260501.
mHealth guideline training for non-communicable diseases in primary care facilities in Nigeria: a mixed methods pilot study
Authors: Otu Akaninyene Asuquo , Effa Emmanuel E , Onwusaka Obiageli , Omoyele Chiamaka , Arakelyan Stella , Okuzu Okey , Walley John
Published: August 2022

Objective

To pilot the use of a scalable innovative mobile health (mHealth) non-communicable diseases (NCDs) training application for nurses at the primary care level.

Design

Mixed methods pilot of mHealth training on NCD care for nurses at primary healthcare (PHC) facilities. We provide a descriptive analysis of mHealth training test scores, with trend analysis of blood pressure (BP) control using paired t-test for quantitative data and thematic analysis for qualitative data.

Setting

PHC facilities in rural and urban communities in Cross River State, south eastern Nigeria. NCDs were not part of routine training previously. As in most low-and-middle-income settings, funding for scale-up using conventional classroom in-service training for NCDs is not available in Nigeria, and onsite supervision poses challenges.

Participants

Twenty-four health workers in 19 PHC facilities.

Intervention

A self-paced mHealth training module on an NCD desk guide was adapted to be applicable within the Nigerian context in collaboration with the Federal Ministry of Health. The training which focused on hypertension, diabetes and sickle cell disease was delivered via Android tablet devices, supplemented by quarterly onsite supervision and group support via WhatsApp. The training was evaluated with pre/post-course tests, structured observations and focus group discussions. This was an implementation pilot assessing the feasibility and potential effectiveness of mHealth training on NCD in primary care delivery.

Results

Nurses who received mHealth training recorded a statistically significant difference (p<0.001) in average pretest and post-test training scores of 65.2 (±12.2) and 86.5 (±7.9), respectively. Recordings on treatment cards indicated appropriate diagnosis and follow-up of patients with hypertension with significant improvements in systolic BP (t=5.09, p<0.001) and diastolic BP (t=5.07, p<0.001). The mHealth nurse training and WhatsApp support groups were perceived as valuable experiences and obviated the need for face-to-face training. Increased workload, non-availability of medications, facility-level conflicts and poor task shifting were identified challenges.

Conclusions

This initiative provides evidence of the feasibility of implementing an NCD care package supported by mHealth training for health workers in PHCs and the strong possibility of successful scale-up nationally.
Public preferences towards data management and governance in Swiss biobanks: results from a nationwide survey
Authors: Brall Caroline , Berlin Claudia , Zwahlen Marcel , Vayena Effy , Egger Matthias , Ormond Kelly E
Published: August 2022

Objectives

This article aims to measure the willingness of the Swiss public to participate in personalised health research, and their preferences regarding data management and governance.

Setting

Results are presented from a nationwide survey of members of the Swiss public.

Participants

15 106 randomly selected Swiss residents received the survey in September 2019. The response rate was 34.1% (n=5156). Respondent age ranged from 18 to 79 years, with fairly uniform spread across sex and age categories between 25 and 64 years.

Primary and secondary outcome measures

Willingness to participate in personalised health research and opinions regarding data management and governance.

Results

Most respondents preferred to be contacted and reconsented for each new project using their data (39%, 95% CI: 37.4% to 40.7%), or stated that their preference depends on the project type (29.4%, 95% CI: 27.9% to 31%). Additionally, a majority (52%, 95% CI: 50.3% to 53.8%) preferred their data or samples be stored anonymously or in coded form (43.4%, 95% CI: 41.7% to 45.1%). Of those who preferred that their data be anonymised, most also indicated a wish to be recontacted for each new project (36.8%, 95% CI: 34.5% to 39.2%); however, these preferences are in conflict. Most respondents desired to personally own their data. Finally, most Swiss respondents trust their doctors, along with researchers at universities, to protect their data.

Conclusion

Insight into public preference can enable Swiss biobanks and research institutions to create management and governance strategies that match the expectations and preferences of potential participants. Models allowing participants to choose how to interact with the process, while more complex, may increase individual willingness to provide data to biobanks.
Regional variation in healthcare usage for Medicare beneficiaries: a cross-sectional study based on the health and retirement study
Authors: Luo Dian
Published: August 2022

Objectives

To investigate whether regional variation changes with different beneficiary health insurance coverage types.

Design

A cross-sectional study of the Health and Retirement Study (HRS) in 2018 was used.

Setting

Medicare beneficiaries only covered by Medicare (group 1) are compared with those covered by Medicare and other health insurance (group 2). Outcomes included healthcare usage measures: (1) whether beneficiaries have a hospital stay and (2) the number for those with at least one stay; (3) whether beneficiaries have a doctor’s visit and (4) the number for those with at least one visit. We compared healthcare usage in both groups across the five regions: (1) New England and Mid-Atlantic; (2) East North Central and West North Central; (3) South Atlantic; (4) East South Central and West South Central; (5) Mountain and Pacific. We used logistic regression for binary outcomes and negative binomial regression for count outcomes in each group.

Participants

We identified 8749 Medicare beneficiaries, of which 4098 in group 1 and 4651 in group 2.

Results

Residents in all non-reference regions had a significantly lower probability of seeking a doctor’s visit in group 1 (OR with 95% CI 0.606 (0.374 to 0.982), 0.619 (0.392 to 0.977), 0.472 (0.299 to 0.746) and 0.618 (0.386 to 0.990) in the order of above regions, respectively), which is not significant in group 2. Residents in most non-reference regions (except South Atlantic) had a significantly fewer number of seeking a hospital stay in group 2 (incident rate ratio (IRR) with 95% CI 0.797 (0.691 to 0.919), 0.740 (0.643 to 0.865), 0.726 (0.613 to 0.859) in the order of above regions, respectively), which is not significant in group 1.

Conclusion

Regional variation in the likelihood of having a doctor’s visit was reduced in Medicare beneficiaries covered by supplemental health insurance. Regional variation in hospital stays was accentuated among Medicare beneficiaries covered by supplemental health insurance.
Effects of respiratory physiotherapy interventions on pulmonary mechanics of newborns: a protocol for a systematic review
Authors: Nunes Adriele de Morais , Fernandes Ana Tereza do Nascimento Sales Figu , de Castro Silva Adynna Tévina , Pereira Costa Mayara Fabiana , Monteiro Karolinne Souza , Pereira Silvana Alves
Published: August 2022

Introduction

Although respiratory physiotherapy techniques may reduce respiratory load in newborns, manual contact with the ribcage may interfere with pulmonary mechanics. Therefore, this systematic review aims to evaluate the effects of conventional and non-conventional respiratory physiotherapies on pulmonary mechanics of newborns.

Methods and analysis

We will search PubMed, LILACS, SciELO, ScienceDirect, Cochrane Central and Web of Science databases. Searches will be conducted from September 2022. We will include randomised clinical trials reporting thoracoabdominal synchrony, lung volumes and capacities, respiratory discomfort and pain in newborns aged between 1 hour and 28 days and admitted to neonatal intensive care units. We will exclude studies not fully available or incomplete and studies conducted with newborns presenting structural alterations. Two independent researchers will perform the study selection, data extraction and quality assessment. After consensus, one reviewer will proceed with the process. We will include studies published in English or Portuguese, without publication date restriction. An overview of the included studies and extracted information will be reported and the quality of studies will be assessed. A meta-analysis will be conducted if data regarding between-group comparisons are available.

Ethics and dissemination

Ethics approval is not required for this systematic review. Results will be presented in journals and national and international conferences, and findings will be shared on social media using accessible language.

PROSPERO registration number

CRD42021266729.
Association between haemoglobin concentration and intradialytic hypotension in patients undergoing maintenance haemodialysis: a retrospective cohort study
Authors: Hara Takashi , Kasahara Yuto , Nakagawa Takahiko
Published: August 2022

Objectives

Haemoglobin concentration is a potentially modifiable factor that may help lower the risk of intradialytic hypotension (IDH), but its association with IDH is not well understood. This study aimed to clarify the relationship between haemoglobin concentration and IDH.

Design

Retrospective cohort study.

Setting

We evaluated patients undergoing maintenance haemodialysis in December 2017 at Rakuwakai Otowa Kinen Hospital.

Participants

A total of 543 patients were included. We defined exposure according to the following five categories depending on haemoglobin concentrations by 1.0 increments: <9.0, ≥9.0 to <10.0, 10.0 to <11.0, ≥11.0 to <12.0 and ≥12.0 g/dL.

Primary outcome measure

The primary outcome of interest was the development of IDH, defined as any nadir <100 mm Hg if the pre-dialysis systolic blood pressure (SBP) was ≥160 mm Hg or any nadir <90 mm Hg if the pre-dialysis SBP was <160 mm Hg (IDHnadir).

Results

Overall, IDHnadiroccurred in 14.3% (465/3250) of the sessions. With a haemoglobin concentration of ≥10.0 to <11.0 g/dL set as reference, the adjusted ORs for IDHnadirwere 0.82 (95% CI, 0.32 to 2.15), 1.16 (95% CI, 0.56 to 2.39), 1.26 (95% CI, 0.68 to 2.36) and 3.01 (95% CI, 1.50 to 6.07) for haemoglobin concentrations of <9.0, ≥9.0 to <10.0, ≥11.0 to <12.0 and ≥12.0 g/dL, respectively. In the cubic spline analysis, a high haemoglobin concentration was associated with the development of IDHnadir.

Conclusion

High haemoglobin concentration is associated with IDH, and thus, the upper limit of haemoglobin concentration should be closely monitored in patients with IDH.
A cohort study of adolescents with depression in China: tracking
multidimensional outcomes and early biomarkers for intervention
Authors: Zhang Xiaofei , Zhou Yanling , Sun Jiaqi , Yang Ruilan , Chen Jianshan , Cheng Xiaofang , Li Zezhi , Chen Xinlei , Yang Chanjuan , Zhu Xinhong , Cao Liping
Published: August 2022

Background

Depression in adolescents is recognised as a global public health
concern, but little is known about the trajectory of its clinical
symptoms and pathogenesis. Understanding the nature of adolescents with
depression and identifying early biomarkers can facilitate personalised
intervention and reduce disease burden.

Aims

To track multidimensional outcomes of adolescents with depression
and develop objective biomarkers for diagnosis, as well as response to
treatment, prognosis and guidance for early identification and
intervention.

Methods

This is a multidimensional cohort study on the Symptomatic
trajectory and Biomarkers of Early Adolescent Depression (sBEAD). We
planned to recruit more than 1000 adolescents with depression and 300
healthy controls within 5 years. Multidimensional clinical presentations
and objective indicators are collected at baseline, weeks 4, 8, 12 and
24, and years 1, 2, 3, 4 and 5.

Conclusions

To the best of our knowledge, this is the first longitudinal cohort
study that examines multidimensional clinical manifestations and
multilevel objective markers in Chinese adolescents with depression.
This study aims at providing early individualised interventions for
young, depressed patients to reduce the burden of disease.

Trial registration number

Chinese Clinical Trial Registry ID ChiCTR2100049066.