bluuebunny/crossref_metadata_2025 huggingface dataset:
978 ADVANCED CARE PLANNING IN PATIENTS WITH PARKINSONIAN DISORDERS
Authors: Lonsdale-Eccles E , Peters A , Richfield E
Published: June 2022

Introduction

Advanced care planning (ACP) supports individuals to make decisions regarding their future care. Guidelines (NICE, 2017) recommend offering ACP discussions to people with Parkinson’s Disease (PD), but uptake lags behind other countries (Sokol, NPJ Parkinson’s Dis, 2019, 22:5–24). As part of a project to improve ACP in the community we audited ACP practice at North Bristol NHS Trust.

Method

Records for 100 patients with idiopathic PD or atypical Parkinsonian syndromes seen in Movement Disorders clinics from March to October 2021 were scrutinised. ACP was defined as including: Do not attempt cardio-pulmonary resuscitation (DNACPR), Advanced Statement of Wishes, Advanced Decision to Refuse Treatment (ADRT) and Lasting Power of Attorney (LPOA). Disease severity was assessed using Hoehn and Yahr (H&Y) score.

Results

87 records were audited, 13 were excluded due to non-Parkinsonian disorders (11) or unavailable records (2). ACP was completed for 22 (25%) cases, (18 DNACPR and 11 Advanced Statements, 1 LPA, 0 ADRT). Informal ACP, such as documentation of wishes in clinic letters, were present in 5 cases. Of the 22 instances of ACP, 20 were recorded on Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. Preferences included ventilation (10), hospital admission (6), life prolonging treatments (6), preferred place of care (4), nutrition (0). Completed ACP was associated with higher H&Y scores or atypical syndromes.

Conclusion

It is recognised that there is a need to further investigate how ACP is delivered for patients with Parkinsonian Disorders. Three US studies estimated ACP rates ranging from 14.6%–53%. (Nimmons, European Journal of Neurology 2020, 27:1971–1987). We are not aware of any comparable UK data. This is a preliminary audit for a project to improve ACP within our MD Service. We are collecting further data on the views of our community movement disorders team with a view to upskilling in ACP.
995 MULTIPLE ORGANISATIONAL FACTORS IMPROVE MULTI-DISCIPLINARY CARE DELIVERY TO PATIENTS WITH HIP FRACTURES: A QUALITATIVE STUDY
Authors: Drew S , Fox F , Gregson C L , Patel R , Judge A , Johansen A , Marques E M R , Barbosa E C , Griffin J , Bradshaw M , Whale K , Chesser T , Griffin X L , Javaid M K , Ben-Shlomo Y , Gooberman-Hill R
Published: June 2022

Introduction

Hip fractures are devastating injuries which incur high healthcare costs. Despite national standards and guidelines, there is substantial variation in hospital delivery of hip fracture care and in patient outcomes. This study aimed to understand organisational processes that facilitate successful delivery of hip fracture services.

Method

Forty qualitative interviews were conducted with healthcare professionals involved in delivering hip fracture care at four English hospitals. Interview data were supplemented with documentary analysis of 23 anonymised British Orthopaedic Association hospital-initiated peer-review reports of services. Data were analysed thematically, with themes transposed onto key components of the care pathway.

Results

We identified multiple aspects of service organisation that facilitated good care delivery. At admission, standardisation of training in nerve block administration impacted care delivery. During hospital stays, service delivery was improved by integrated, shared-care between orthopaedics and orthogeriatrics, and by strategies to improve trauma list efficiency. Adequately staffed orthogeriatric services and the ‘right’ skills and seniority mix were important to holistic care provision. Placing patients on designated hip fracture wards concentrated staff expertise. Collaborative working was achieved through multi-disciplinary team (MDT) meetings between key staff, protocols and care pathways that defined roles and responsibilities, MDT documentation, ‘joined-up’ IT systems within hospitals and with primary care, and shared working spaces such as shared offices and onwards. Trauma and hip fracture coordinators organised care processes and provided a valuable central point of contact within teams. Nominated leads, representing diverse specialties, worked together in MDT planning meetings to develop joint protocols, establish audit priorities, and agree shared goals. Routine, comprehensive monitoring and evaluation of service delivery, with findings shared throughout the MDT, was beneficial.

Conclusion

Our study has characterised potentially modifiable elements of successful hip fracture service delivery. Findings are intended to help services overcome organisational barriers towards delivery of high-quality hip fracture services.
1011 CONTINUUM OF GERIATRIC CARE FOR OLDER ADULTS WITH DUAL SENSORY LOSS DURING THE COVID-19 PANDEMIC IN CANADA: LESSONS LEARNED
Authors: Jaiswal A , Holzhey P , Budhiraja S , Paramasivam A , Santhakumaran S , Cöté S , Boie N R , Savundranayagam M , Vincent C , Kröger E , Wittich W
Published: June 2022

Introduction

Around 1.1 million older Canadians live with combined hearing and vision impairment (dual sensory loss/DSL). Evidence highlights that they are at a high risk of cognitive impairment, functional decline, social isolation, falls, depression, and mortality. Compared to their non-DSL peers, older adults with DSL experience various challenges in accessing healthcare, which were exacerbated during the COVID-19 pandemic. This study aimed to explore the continuum of geriatric care for older adults with DSL by integrating their perspectives, those of caregivers who accompany them on healthcare visits, and their healthcare providers in Canada during the pandemic.

Method

We conducted a qualitative study with 32 older Canadians with DSL and their caregivers, and an online survey with 228 healthcare providers across the country. Qualitative interviews were audio-recorded using Zoom and transcribed verbatim, while the survey data were collected using Lime Survey. Thematic analysis was used to analyse qualitative data, whereas descriptive statistics were used for quantitative survey data.

Results

The findings highlighted the gaps in the continuum of care for this population. The reported gaps were lack of training on DSL among healthcare providers, lack of time and comfort to go beyond one’s specialty, lack or limited support to overcome communication challenges while providing care to older adults with DSL, difficulty in using technologies for virtual/telehealth, presence of comorbidities such as cognitive impairment, and restrictions in caregiver accompaniment during the pandemic.

Conclusion

Our findings indicate that the continuum of care for this group is negatively affected due to the pandemic, in a disproportionate manner, and structural barriers are experienced by older adults with DSL and their caregivers for access to care. To ensure effective care, healthcare professionals need training on DSL-specific accessibility and communication. A collaborative, cross-disciplinary geriatric care approach with the active involvement of essential care partners is an utmost need.
1028 OLDER PERSON’S ASSESSMENT SERVICE (OPAS): DELIVERING COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) IN THE EMERGENCY DEPARTMENT (ED)
Authors: Burgess A , Venkatesh A , Davies E A , Howells C J B , Quinn P , Burberry D J , James L , Hopkins C , Mdhlongwa A , Davies D A , Ansar A , Clee D
Published: June 2022

Introduction

Innovative models of service delivery are required to provide Comprehensive Geriatric Assessment for older patients presenting to the Emergency Department with frailty syndromes.

Method

In 2018, the Older Person’s Assessment Service began a liaison service to the ED, taking referrals from the medical and ED teams for patients who presented with frailty syndromes (falls, cognitive impairment, care dependence, polypharmacy). The service saw 437 patients April–August 2018. 76% of the patients assessed were discharged by utilising available community services, rapid access outpatient follow up and inpatient reablement off the acute site. The service was estimated to avoid 50–80 admissions per month to medicine (saving 17–23 beds a year) and was commissioned as a permanent service. Phase 2 In 2020, a dedicated unit within ED was allocated to OPAS, enabling the acceptance of patients directly from triage and from the Ambulance Service by direct referral. This provided rapid access to specialist assessment, continued access to Elderly Care services, avoided exposure to coronavirus related admissions and the risks of nosocomial infection associated with admission. The service operates from 8 am-4 pm on weekdays.

Results

Between June 2020 and October 2021, the service saw 1,173 new patients. 988 patients (84.5%) were discharged off the acute site on the day of assessment. 68 (5.79%) patients were admitted to other facilities run by the Health Board (e.g Inpatient Reablement). The average age of an OPAS patient was 83 yrs and had a CFS > 5. Readmission rate at 14 days was 4% (47).Of the 253 patients who were admitted to an inpatient setting, 13.5% (35) contracted nosocomial covid-19.

Conclusion

The service has been supported and funded to expand into extended weekday hours as a result of this success and there are plans for future 7 day working.
1041 HAND GRIP STRENGTH AMONG POST-ACUTE COVID-19 OLDER ADULTS
Authors: Tai M H , Wan S N , Engkasan J , Ong T
Published: June 2022

Introduction

Muscle strength is one crucial determinant of functional activity among older adults. While COVID-19 infection is often described as an acute respiratory disease with potential multiorgan involvement, its severe inflammatory nature may lead to changes to structure and function of skeletal muscles. This present study aimed to evaluate grip strength among post COVID-19 elderly with exploration of factors influencing the change in grip strength.

Method

Patients with history of COVID-19 infection aged ≥65 years were recruited in the COVID-19 follow up clinic. Grip strength was assessed using Jamar dynamometer following standard protocol while baseline clinical information was collected from hospital electronic medical record. Data collected were analysed to evaluate grip strength in relation to participants’ demographics, comorbidity, length of hospital stay and steroids medication use. Total steroids equivalent doses were calculated and dichotomy of 400 mg was selected based on its median.

Results

Ninety-three participants (mean [SD] age: 73 [6], 52.7% males) were recruited at an average (SD) of 55 (37) days after hospital discharge, with 79.6% participants hospitalized with COVID-19 of clinical category 4. Majority (74.2%) of the participants recorded measurements lower than diagnostic cut-off for low grip strength recommended by Asian Working Group for Sarcopenia (AWGS) 2019. Results showed that increasing age was associated with a decrease in grip strength (r = −0.30, p = 0.003). Besides, increase in hospital stay (r = −0.22, p = 0.035) and Charlson Comorbidity Index (CCI) score (r = −0.42, p = 0.000) were associated with decreasing grip strength measurements. No significant discrepancy in grip strength was observed between subgroups of patients receiving total steroids equivalent doses of <400 mg and ≥ 400 mg (p = 0.881).

Conclusion

Low grip strength readings were recorded among post COVID-19 elderly particularly patients of older age, with longer hospital stay and higher CCI. This suggests the need for close monitoring and provision of rehabilitation intervention to older adults affected by COVID-19 infection.
1049 IMPROVING TELEPHONE COMMUNICATION WITH FAMILIES ON A BUSY MEDICAL WARD DURING THE PANDEMIC
Authors: Cohen S , Singh R , Aldawoodi R , Sukhnani M , Munavvar R , Topiwala U , Beckett H , O'Kelly K
Published: June 2022

During the pandemic it became critical to reduce visiting to only very specific situations. This resulted in an increase of complaints where a lack of communication from the ward had been recognised as a theme, in spite of the fact that many doctors spent a great deal of time providing updates over the phone to patient’s families. It was noted there were a number of inefficiencies with respect to communicating with families; some families were being contacted repeatedly whereas others were struggling to get in touch. Chronic staffing shortages were also a barrier to effective and timely communication. Qualitative data collected via an online survey demonstrated that junior doctors valued the importance of communicating with families, particularly to provide clinical updates or obtain collateral histories, but found that the extra burden created by the pandemic resulted in far less time to do this efficiently and often resulted in time management difficulties.

We introduced a strategy, by way of a magnetic communication board, that provided a flexible, at-a-glance method of ensuring all families had received regular updates from the medical team and collateral histories had been obtained for all relevant patients. We collected weekly data regarding the number of interactions between the medical team and patient relatives’ as a percentage of the total number of bed spaces. An overall improvement was noted: 67% pre-intervention to 76% post, with a maximum of 88% during one particularly successful week. We also were able to demonstrate an increase in ReSPECT form completion (from 40% to 65%).

The introduction of an organisational tool such as our communication board resulted in improved patient and relatives’ satisfaction; and an improvement in team performance and overall time management. We are now aiming to build on this and roll it out during the next wave of the pandemic.
1082 OPTIMISING CONSTIPATION IN ORTHOGERIATRIC FRACTURED NECK OF FEMUR PATIENTS THROUGH NALOXEGOL USE
Authors: Hira S , Fomani N
Published: June 2022

Introduction

Constipation is a major concern within the care of the elderly, particularly on Orthogeriatric wards where patients are given opioids, kept nil by mouth and can be immobile for days. On average patients were opening their bowels after 4.5 days and given various laxative regimes, 43% were administered a phosphate enema. The aim of this project was to reduce the number of days that patients did not open their bowels and ultimately improve their quality of care. This was implemented by reducing the use of phosphate enemas and increasing prescriptions of Naloxegol through a stepwise structure for laxative use. NICE recommends Naloxegol prescription after 4 days of patients not opening bowels (BNO) but local policy for Wythenshawe Hospital was amended in 2020 to allow for Naloxegol to be given after 3 days.

Method

Audit data was initially collected to produce a baseline to compare to; then an initial intervention, a presentation to all ward staff on the new regime and Naloxegol prescription was given on two occasions. Following this; data on bowel movements, urinary catheterisation and MSU result was taken from electronic patient records along with prescription data from drug charts. The data was analysed, in addition to reviewing any issues that had arisen as a result of the intervention. The second intervention, a laminated poster in the doctor's office reiterating the same information as previous was implemented 4 weeks later, again the same data was collected and analysed.

Results

Phosphate enema use was reduced by 83%, and Naloxegol use increased by 336%, bowels on average opened 1.5 days earlier and patients were trialled without catheter (TWOC) approximately 4 days quicker than previous.

Conclusion

(s) Implementing a structured regime with Naloxegol prescription on Day 3 BNO at its heart provides for a significant improvement in constipation within Orthogeriatrics.
Unanswered questions on the use of hydrocortisone, ascorbic acid, and thiamine therapy in sepsis and septic shock
Authors: Ragoonanan David , Tran Nicolas , Modi Veeshal , Morgan Nickelsen Paige
Published: June 2022

Purpose

To evaluate current evidence on the utility of hydrocortisone, ascorbic acid, and thiamine (HAT) therapy for the management of septic shock.

The following keyword search terms were utilized in PubMed to identify relevant articles: ascorbic acid, thiamine, hydrocortisone, shock, and critical care. Articles relevant to HAT therapy in patients with septic shock were selected. Retrospective cohorts and randomized controlled trials were included in this review; case reports/series were excluded. Data from included studies illustrating the use of HAT therapy for the management of sepsis and septic shock, including data on time to HAT therapy initiation, severity of illness at baseline, duration of vasopressor therapy, progression of organ failure, and mortality, were evaluated.

Conclusion

The utilization of HAT therapy for the management of sepsis and septic shock remains controversial. Hemodynamic benefits have been shown to be most pronounced when HAT therapy is initiated earlier. Future studies directed at earlier initiation may be necessary to confirm this theory.
Network approaches for modeling the effect of drugs and diseases
Authors: Rintala T J , Ghosh Arindam , Fortino V
Published: June 2022

The network approach is quickly becoming a fundamental building block of computational methods aiming at elucidating the mechanism of action (MoA) and therapeutic effect of drugs. By modeling the effect of drugs and diseases on different biological networks, it is possible to better explain the interplay between disease perturbations and drug targets as well as how drug compounds induce favorable biological responses and/or adverse effects. Omics technologies have been extensively used to generate the data needed to study the mechanisms of action of drugs and diseases. These data are often exploited to define condition-specific networks and to study whether drugs can reverse disease perturbations. In this review, we describe network data mining algorithms that are commonly used to study drug’s MoA and to improve our understanding of the basis of chronic diseases. These methods can support fundamental stages of the drug development process, including the identification of putative drug targets, the in silico screening of drug compounds and drug combinations for the treatment of diseases. We also discuss recent studies using biological and omics-driven networks to search for possible repurposed FDA-approved drug treatments for SARS-CoV-2 infections (COVID-19).
Regional associations of white matter hyperintensities and early cortical amyloid pathology
Authors: Lorenzini Luigi , Ansems Loes T , Lopes Alves Isadora , Ingala Silvia , Vállez García David , Tomassen Jori , Sudre Carole , Salvadó Gemma , Shekari Mahnaz , Operto Gregory , Brugulat-Serrat Anna , Sánchez-Benavides Gonzalo , ten Kate Mara , Tijms Betty , Wink Alle Meije , Mutsaerts Henk J M M , den Braber Anouk , Visser Pieter Jelle , van Berckel Bart N M , Gispert Juan Domingo , Barkhof Frederik , Collij Lyduine E ,   the EPAD consortium for the ALFA cohort, Beteta Annabella , Brugulat Anna , Cacciaglia Raffaele , Cañas Alba , Deulofeu Carme , Cumplido Irene , Dominguez Ruth , Emilio Maria , Fauria Karine , Fuentes Sherezade , Hernandez Laura , Huesa Gema , Huguet Jordi , Marne Paula , Menchón Tania , Polo Albina , Pradas Sandra , Rodriguez-Fernandez Blanca , Sala-Vila Aleix , Sánchez-Benavides Gonzalo , Soteras Anna , Vilanova Marc
Published: June 2022

White matter hyperintensities (WMHs) have a heterogeneous aetiology, associated with both vascular risk factors and amyloidosis due to Alzheimer’s disease. While spatial distribution of both amyloid and WM lesions carry important information for the underlying pathogenic mechanisms, the regional relationship between these two pathologies and their joint contribution to early cognitive deterioration remains largely unexplored.

We included 662 non-demented participants from three Amyloid Imaging to Prevent Alzheimer’s disease (AMYPAD)-affiliated cohorts: EPAD-LCS (N = 176), ALFA+ (N = 310), and EMIF-AD PreclinAD Twin60++ (N = 176). Using PET imaging, cortical amyloid burden was assessed regionally within early accumulating regions (medial orbitofrontal, precuneus, and cuneus) and globally, using the Centiloid method. Regional WMH volume was computed using Bayesian Model Selection. Global associations between WMH, amyloid, and cardiovascular risk scores (Framingham and CAIDE) were assessed using linear models. Partial least square (PLS) regression was used to identify regional associations. Models were adjusted for age, sex, and APOE-e4 status. Individual PLS scores were then related to cognitive performance in 4 domains (attention, memory, executive functioning, and language).

While no significant global association was found, the PLS model yielded two components of interest. In the first PLS component, a fronto-parietal WMH pattern was associated with medial orbitofrontal–precuneal amyloid, vascular risk, and age. Component 2 showed a posterior WMH pattern associated with precuneus-cuneus amyloid, less related to age or vascular risk. Component 1 was associated with lower performance in all cognitive domains, while component 2 only with worse memory.

In a large pre-dementia population, we observed two distinct patterns of regional associations between WMH and amyloid burden, and demonstrated their joint influence on cognitive processes. These two components could reflect the existence of vascular-dependent and -independent manifestations of WMH-amyloid regional association that might be related to distinct primary pathophysiology.
New smart home energy management systems based on inclining block-rate pricing scheme
Authors: Elazab Rasha , Saif Omar , Amin Metwally Amr M A , Daowd Mohamed
Published: June 2022

There are wide applications of block-rate pricing schemes in many countries. However, there are no significant studies that apply this common tariff for smart home energy management systems. In this paper, a three-time-frame energy management scheme has been proposed for photovoltaic (PV)-powered grid-connected smart homes based on the well-known mixed-integer linear programming optimization technique. This paper provides three original and novel smart home energy management algorithms that depend on the most common residential tariff specifically in developing countries. Three different management concepts have been studied for a typical Egyptian house. The concepts of shifting load, vehicle-to-home and reducing air conditioning have been tested according to a commonly applied slab tariff. The proposed scheme considers the home battery extending lifetime constraints. It also preserves comfortable lifestyle limits for home users according to Arab housing climatic conditions and culture. Moreover, the economic feasibility of integrated PV modules for the studied home has been verified according to the Egyptian tariff. The proposed energy management scheme of PV-powered home reduces the electrical power bill significantly in a wide range from 61% to only 19% of the default case bill according to the applied management technique.
Simultaneous Determination of Metabolites Related to Arginine Metabolism in Rat plasma by Hydrophilic Interaction Chromatography–Tandem Mass Spectrometry
Authors: Wang Ying , Li ZhiRong , Chen RongXiang
Published: June 2022

Arginine and its metabolites play important roles in pain and analgesia. This study aimed to develop a comprehensive quantification method for amino acids and metabolites related to arginine metabolism in rat plasma by hydrophilic interaction chromatography–tandem mass spectrometry (HILIC–MS/MS). Rat plasma was diluted to reduce the matrix effect and deproteinized with acetonitrile. The analytes were separated on a Syncronis HILIC column with a gradient elution. MS analysis was performed in positive ion mode with an electrospray ionization source using multiple reaction monitoring technology. All calibration curves for the 10 analytes showed good linear regression (R2 > 0.99). The limits of detection (LODs) were in the range of 0.9–13.4 μg/L. The established method was validated for intra-day and inter-day precisions (relative standard deviation [RSDs] < 6.21%) and accuracy (average recovery ranged from 87.34% to 100.35% with the RSD values less than 11.41%). This method was successfully applied to characterize dynamic alterations in the plasma of rats with neuropathic pain and thus provide service to explore the mechanism of action between metabolite changes and clinical disease.
Lung transplant and severe coronary artery disease: results from a single-centre experience
Authors: Franz Maximilian , Siemeni Thierry , Aburahma Khalil , Yablonski Pavel , Poyanmehr Reza , Avsar Murat , Bobylev Dmitry , Sommer Wiebke , Boethig Dietmar , Greer Mark , Gottlieb Jens , Tudorache Igor , Hoeper Marius M , Warnecke Gregor , Haverich Axel , Kuehn Christian , Ius Fabio , Salman Jawad
Published: June 2022

OBJECTIVES

The management of severe coronary artery disease at the time of a lung transplant remains a challenge. We analysed the short- and long-term outcomes of lung transplant recipients with severe coronary artery disease.

METHODS

Records of adult patients who received transplants at our institution between April 2010 and February 2021 were reviewed retrospectively. Severe coronary artery disease was defined as coronary stenosis ≥70% (main stem ≥50%) seen on the coronary angiographic scans performed before or at the time of listing. Patient characteristics, perioperative and long-term outcomes were compared between patients with and without severe coronary artery disease.

RESULTS

Among 896 patients who received lung transplants who had undergone coronary angiography before the transplant, 77 (8.5%) had severe coronary artery disease; the remaining 819 (91.5%) did not. Patients with severe coronary artery disease were older (p < 0.0001), more often male (p < 0.0001) and received transplants more often for pulmonary fibrosis (p = 0.0007). The median (interquartile range) follow-up was 46 (20–76) months. At the Cox multivariable analysis, severe coronary artery disease was not associated with death. Patients with pretransplant percutaneous transluminal coronary angioplasty and patients with coronary artery bypass graft surgery concomitant to a transplant had survival equivalent to that of patients without severe coronary artery disease (p = 0.513; p = 0.556).

CONCLUSIONS

Severe coronary artery disease was not associated with decreased survival after a lung transplant. Concomitant coronary artery bypass graft surgery and pretransplant percutaneous transluminal coronary angioplasty can be used for revascularization.
Coexistence of blaNDM-1, blaOXA-51, blaOXA-23, and armA in conjunction with novel mutations detected in RND efflux pump regulators in tigecycline resistant clinical isolates of Acinetobacter baumannii
Authors: Sawant Ajit Ramesh , Pagal Sudhakar , Amar Ashutosh Kumar , Panda Lipsa , devi C Sheela , Shashikala P , Kanungo Reba , Prashanth K
Published: June 2022

This study has investigated a total of 51 Acinetobacter baumannii isolates for the prevalence of resistant determinants in tigecycline susceptible and non-susceptible clinical isolates of A. baumannii. Antimicrobial susceptibility testing revealed 74% of isolates were tigecycline resistant. Mutations in RND-efflux pump regulatory genes and the expression of efflux pump genes were measured in tigecycline resistant isolates. There was a strong co-relation between the blaNDM-1 and armA wherein majority of the isolates that are positive for blaNDM-1 have also harbored armA. Compared with TSAB (tigecycline susceptible A. baumannii), TNAB (tigecycline non-susceptible A. baumannii) isolates show increased distribution of blaNDM-1 (P = 0.048), blaIMP-1 (P< 0.0001) and blaOXA-51 (P = 0.0029) carbapenemase genes. The variants of RND-efflux pump regulatory genes due to amino-acid mutations in adeS (F12S, K84E, W61R, N268H and Q299R) and adeL (G21R and Q262R) were identified in tigecycline resistant isolates as well as ISAba1 mediated disruption of adeN were observed causing overexpression of adeIJK efflux pump. Additionally, mutations in adeRS were also associated with increased expression of adeABC efflux pump. Besides, TNAB isolates showed significantly (P< 0.0001) higher ability of biofilm formation as compared to TSAB isolates. The tigecycline resistance due to mutations in contemporary A. baumannii isolates having a higher ability to form biofilm may pose therapeutic difficulties.
A chromosome-level genome assembly of Artocarpus nanchuanensis (Moraceae), an extremely endangered fruit tree
Authors: He Jiaoyu , Bao Shanfei , Deng Junhang , Li Qiufu , Ma Shiyu , Liu Yiran , Cui Yanru , Zhu Yuqi , Wei Xia , Ding Xianping , Ke Kehui , Chen Chaojie
Published: June 2022

Artocarpus nanchuanensis (Moraceae), which is naturally distributed in China, is a representative and extremely endangered tree species. In this study, we obtained a high-quality chromosome-scale genome assembly and annotation information for A. nanchuanensis using integrated approaches, including Illumina, Nanopore sequencing platform, and Hi-C. A total of 128.71 Gb of raw Nanopore reads were generated from 20-kb libraries, and 123.38 Gb of clean reads were obtained after filtration with 160.34× coverage depth and a 17.48-kb average read length. The final assembled A. nanchuanensis genome was 769.44 Mb with a 2.09 Mb contig N50, and 99.62% (766.50 Mb) of the assembled data was assigned to 28 pseudochromosomes.

In total, 39,596 genes (95.10%, 39,596/41,636) were successfully annotated, and 129 metabolic pathways were detected. Plants disease resistance/insect resistance genes, plant–pathogen interaction metabolic pathways, and abundant biosynthesis pathways of vitamins, flavonoid, and gingerol were detected. Unigene reveals the basis of species-specific functions, and gene family in contraction and expansion generally implies strong functional differences in the evolution. Compared with other related species, a total of 512 unigenes, 309 gene families in contraction, and 559 gene families in expansion were detected in A. nanchuanensis.

This A. nanchuanensis genome information provides an important resource to expand our understanding of the unique biological processes, nutritional and medicinal benefits, and evolutionary relationship of this species. The study of gene function and metabolic pathway in A. nanchuanensis may reveal the theoretical basis of a special trait in A. nanchuanensis and promote the study and utilization of its rare medicinal value.
A decade of GigaScience: What can be learned from half a million RRIDs in the scientific literature?
Authors: Bandrowski Anita
Published: June 2022

Research resource identifiers (RRIDs) are persistent unique identifiers for scientific resources used to conduct studies such as reagents and tools. Inclusion of these identifiers into the scientific literature has been demonstrated to improve the reproducibility of papers because resources, like antibodies, are easier to find, making methods easier to reproduce. RRIDs also dramatically reduce the use of problematic resources, such as contaminated cell lines. The addition of RRIDs into a manuscript means that authors have to look up information that they may have previously omitted or confront information about problems that may have been reported about their resources. The use of RRIDs is primarily driven by champion journals, such as GigaScience and others. Although still nascent, this practice lays important groundwork for citation types that can cover non-traditional scholarly output, such as software tools and key reagents; giving authors of various types of tools scholarly credit for their contributions.
On the Image of the Period Map for Polarized Hyperkähler Manifolds
Authors: Song Jieao
Published: June 2022

The moduli space for polarized hyperkähler manifolds of ${\textrm {K3}^{[m]}}$-type or ${\textrm {Kum}}_m$-type with a given polarization type is not necessarily connected, which is a phenomenon that only happens for $m$ large. The period map restricted to each connected component gives an open embedding into the period domain, and the complement of the image is a finite union of Heegner divisors. We give a simplified formula for the number of connected components, as well as a simplified criterion to enumerate the Heegner divisors in the complement. In particular, we show that the image of the period map may be different when restricted to different components of the moduli space.
Some New Results in Quantitative Diophantine Approximation
Authors: Ghosh Anish , Kumaraswamy V Vinay
Published: June 2022

In this article we establish two new results on quantitative Diophantine approximation for one-parameter families of diagonal ternary indefinite forms. In the first result, we consider quadratic forms taking values at prime points. In the second, we examine inhomogeneous forms of arbitrary degree taking values at integer points.
Resource Sharing in Households with Children: A Generalized Model and Empirical Evidence from the UK
Authors: Bargain Olivier , Donni Olivier , Hentati Imen
Published: June 2022

We suggest a generalized collective model of consumption that extends Browning, Chiappori, and Lewbel to couples with children. Economies of scale are defined using a general form of Barten scales. We identify resource sharing among household members and, originally, the contribution of each parent to the expenditure on children. We provide a tractable estimation approach based on a simple demand system for male and female clothing, that is, two exclusive goods commonly available in standard surveys. We illustrate the method on thirty years of expenditure data for the UK. We relax the independence of the sharing rule on total expenditure and actually find that women’s shares increase with living standards. This, and progress in education levels, explains most of the reduction in intra-household inequality over the period.
The complex of Fas-associated factor 1 with Hsp70 stabilizes the adherens junction integrity by suppressing RhoA activation
Authors: Song Soonhwa , Park Joon Kyu , Shin Sang Chul , Lee Jae-Jin , Hong Seung Kon , Song In-Kang , Kim Bokyung , Song Eun Joo , Lee Kong-Joo , Kim Eunice EunKyeong
Published: June 2022

Fas-associated factor 1 (FAF1) is a scaffolding protein that plays multiple functions, and dysregulation of FAF1 is associated with many types of diseases such as cancers. FAF1 contains multiple ubiquitin-related domains (UBA, UBL1, UBL2, UAS, and UBX), each domain interacting with a specific partner. In particular, the interaction of UBL1 with heat shock protein 70 (Hsp70) is associated with tumor formation, although the molecular understanding remains unknown. In this study, the structural analysis revealed that His160 of FAF1 is important for its interaction with Hsp70. The association of Hsp70 with FAF1 is required for the interaction with IQGAP1. FAF1 negatively regulates RhoA activation by FAF1–Hsp70 complex formation, which then interacts with IQGAP1. These steps play a key role in maintaining the stability of cell-to-cell junction. We conclude that FAF1 plays a critical role in the structure and function of adherens junction during tissue homeostasis and morphogenesis by suppressing RhoA activation, which induces the activation of Rho-associated protein kinase, phosphorylation of myosin light chain, formation of actin stress fiber, and disruption of adherens junction. In addition, depletion of FAF1 increased collective invasion in a 3D spheroid cell culture. These results provide insight into how the FAF1–Hsp70 complex acts as a novel regulator of the adherens junction integrity. The complex can be a potential therapeutic target to inhibit tumorigenesis and metastasis.
First Record ofBrachymeria podagrica(Hymenoptera: Chalcididae) in Bisha City, Asir Region, Saudi Arabia
Authors: Abd Al Galil Fahd Mohammed , Al-Keridis Lamya Ahmed , Al-Mekhlafi Fahd A , Al-Amri Abdulaziz Mohammed , Al-Khalifa Mohammed S
Published: June 2022

Chalcid Brachymeria podagrica (Fabricius), formerly known as Brachymeria fonscolombei (Dufour), is a parasitoid wasp that infests dipteran larvae of fly, Sarcophaga dux (Thomson), (Diptera: Sarcophagidae) recovered from the dead body of sheep in Bisha City, Asir region–Saudi Arabia. S. dux larvae were infested by B. podagrica. The first instar larvae and pupae of B. podagrica were found inside the larvae and pupae of S. dux. The adults of the parasitic wasp emerged from the pupae of the host. Adults and larvae of the parasitoid wasp were observed under a dissecting microscope. Identification was made by following the identification keys. It was confirmed that it was B. podagrica, which is herewith reported for the first time in Saudi Arabia.
Evaluation of antipsychotic medication adherence and its relation to negative and positive psychiatric symptoms
Authors: Khdour Maher , Salman Aroub
Published: June 2022

Objectives

The aim of this study was to assess antipsychotic medication adherence and its relation to Psychiatric symptoms in a sample of patients with schizophrenia in Palestine.

Methods

Patients were recruited from the governmental psychiatry clinic in Ramallah in a cross-sectional study. The self-reported Morisky–Green–Levine (MGL) scale was used to measure patients’ adherence. Psychiatric symptoms were measured using the expanded Brief Psychiatric Rating Scale (BPRS-E).

Key findings

Of the 130 participants in the study, 78 (60%) were men and mean age was 41.8 ± 9.8 years 70 (53.8%). of the sample participants were classified as low-adherent while 60 (46.2%) of patients classified as high adherent. That negative symptom scores of high adherence group are significantly lower than low adherence group (12.5 vs. 15.0, P = 0.002) and lower depression anxiety scores (18.3 vs. 22.1, P < 0.001) indicated that high adherence group had lower depression, anxiety, social isolation, anxiety and suicidal ideation symptoms than low-adherence group. The multivariate regression model demonstrated that four variables remain significant and associated with nonadherence; no formal education (OR = 2.11; CI: 0.8–3.8; P = 0.04), age (OR = 2.88; CI: 1.2–4.4; P = 0.01), having comorbidity (OR = 3.2; CI: 1.9–4.3; P = 0.01) and having higher negative symptoms scores (OR = 2.5; CI: 1.2–3.9; P = 0.03); as they are positively correlated to nonadherence.

Conclusion

Medication nonadherence was significant, and it was linked to poor psychiatric outcomes and adherence scores were unaffected by medication-related variables.
Assessment of Jordanian physicians’ knowledge about venous thromboembolism risk and management among COVID-19 patients
Authors: Zaini Mohammad , Abu Farha Rana , Abutayeh Reem , Alsaud Wesam , Hammoudeh Ayman , Al-Shudifat Abdel-Ellah , Al-Kharabsheh Thamer
Published: June 2022

Objectives

The aim of this study was to assess Jordanian physicians’ awareness about venous thromboembolism (VTE) risk among COVID-19 patients and its treatment protocol.

Methods

This was a cross-sectional-based survey that was conducted in Jordan in 2020. During the study period, a convenience sample of physicians working in various Jordanian hospitals were invited to participate in this study. Physicians’ knowledge was evaluated and physicians gained one point for each correct answer. Then, a knowledge score out of 23 was calculated for each.

Key findings

In this study, 102 physicians were recruited. Results from this study showed that most of the physicians realize that all COVID-19 patients need VTE risk assessment (n = 69, 67.6%). Regarding VTE prophylaxis, the majority of physicians (n = 91, 89.2%) agreed that low molecular weight heparin (LMWH) is the best prophylactic option for mild-moderate COVID-19 patients with high VTE risk. Regarding severe/critically ill COVID-19 patients, 75.5% of physicians (n = 77) recognized that LMWH is the correct prophylactic option in this case, while 80.4% of them (n = 82) knew that mechanical prevention is the preferred prophylactic option for severe/critically ill COVID-19 patients with high bleeding risk. Moreover, 77.5% of physicians (n = 79) knew that LMWH is the treatment of choice for COVID-19 patients diagnosed with VTE. Finally, linear regression analysis showed that consultants had an overall higher knowledge score about VTE prevention and treatment in COVID-19 patients compared with residents (P = 0.009).

Conclusion

All physicians knew about VTE risk factors for COVID-19 patients. However, consultants showed better awareness of VTE prophylaxis and treatment compared with residents. We recommend educational workshops be conducted to enhance physicians’ knowledge and awareness about VTE thromboprophylaxis and management in COVID-19 patients.
Testicular torsion in an undescended testicle: chasing a diagnosis
Authors: Reed Benedict , Banerjee Rishi , Tsampoukas Georgios , Gray Robert
Published: June 2022

Undescended testicles (UTs) and torsion of the testicle are a rare clinical combination. Symptoms may be misleading and interpreted as signs of other common conditions. Moreover, late identification of an UT may significantly delay the diagnosis and lead to adverse outcomes. Here, we present a case of a 17-year-old boy with cerebral palsy and learning disabilities who presented with painful right-sided inguinal mass. Intraoperatively, he was confirmed to have torsion of an UT and orchidectomy was performed. This article also emphasizes the importance of early diagnosis of testicular ectopia.
Small bowel obstruction caused by appendiceal and ileal endometriosis: a case report
Authors: Kobayashi Kazuki , Yamadera Masato , Takeo Hiroaki , Murayama Michinori
Published: June 2022

Endometriosis is characterized by the presence of an ectopic endometrial gland. Intestinal endometriosis with small bowel obstruction is uncommon. In this case, a 37-year-old woman with no history of endometriosis presented with a chief complaint of abdominal pain. Computed tomography revealed a distal small bowel obstruction. Surgical intervention was performed because of the emergent abdominal condition and the potential resistance to conservative management. Histopathological examination revealed appendiceal and ileal endometriotic lesions. Preoperative diagnosis was difficult because there were no specific clinical features. Intraoperatively, it is difficult to distinguish intestinal endometriosis and bowel malignancy; thus, oncological resection should be performed.
The radial recurrent artery propeller flap for elbow coverage in an extensive burn
Authors: Wallace David L , Rogers Alan D
Published: June 2022

Obtaining durable coverage of the elbow may be challenging when surrounding tissue as well as standard free flap donor sites are not available for use. Here we describe the application of the radial recurrent artery perforator propeller flap to good effect for the coverage of the elbow joint and ulnar nerve in the context of an extensive flame burn injury of over 80% of the body surface area. Despite few descriptions of its use in the literature, it is a relatively straightforward flap to elevate and inset, the donor area was effectively autografted and there were no postoperative complications.
Successful treatment of rectal cancer with pelvic abscess using transrectal drainage followed by laparoscopic radical resection: a case report
Authors: Nishina Yusuke , Ohta Hiroyuki , Terada Yoshitaka , Akabori Hiroya , Kitamura Naomi , Nagai Nozomi , Mekata Eiji
Published: June 2022

The incidence of rectal cancer with a pelvic abscess is rare; hence, treatment strategies are difficult because both malignant and infectious inflammation need to be addressed. Here, we report the case of a 53-year-old man diagnosed with rectal cancer accompanied by a pelvic abscess. We performed transrectal drainage of the abscess, and a transanal rectal drainage tube was inserted into the abscess cavity. His symptoms rapidly improved, and computed tomography showed that the pelvic abscess had disappeared. Six weeks after drainage, radical laparoscopic Hartmann’s procedure with resection of the rectal cancer and incision drainage scar was performed. After adjuvant chemotherapy, laparoscopic stoma closure was performed a year after the operation. The patient showed no evidence of cancer recurrence 1.5 years after radical surgery. Transrectal drainage followed by laparoscopic radical resection can be a less invasive and effective treatment for rectal cancer accompanied by a pelvic abscess.
A curious adult case of small bowel volvulus with congenital malrotation
Authors: Tan Hao Han , Sivasuthan Goutham , Wong Man-Shun
Published: June 2022

Intestinal volvulus is defined as a twisting of the bowel on its mesentery. It itself is a rare occurrence, with documented incidence of 1% as the cause of all small bowel obstruction, with further 0.82% of them being associated with intestinal malrotation. The classical radiographic feature described in literatures is the whirlpool sign. We herein report a rare presentation of congenital malrotation causing a small bowel obstruction in a 43-year-old man. The patient presented with acute abdominal pain and underwent an emergency laparotomy and resection of small and large bowel (total of 3 m with primary anastomosis), with an estimated 2.6 m of viable small bowel left. The patient had a prolonged recovery complicated by another relook operation, superior mesenteric vein thrombus and a high-output stoma with subsequent electrolyte derangements and acute kidney injury. He was discharged on Day 26 and had been seen in the outpatient department with good functionality.
AGN X-ray spectroscopy with neural networks
Authors: Parker M L , Lieu M , Matzeu G A
Published: June 2022

We explore the possibility of using machine learning to estimate physical parameters directly from active galactic nucleus (AGN) X-ray spectra without needing computationally expensive spectral fitting. Specifically, we consider survey quality data, rather than long pointed observations, to ensure that this approach works in the regime where it is most likely to be applied. We simulate Athena Wide Field Imager spectra of AGN with warm absorbers, and train simple neural networks to estimate the ionization and column density of the absorbers. We find that this approach can give comparable accuracy to spectral fitting, without the risk of outliers caused by the fit sticking in a false minimum, and with an improvement of around three orders of magnitude in speed. We also demonstrate that using principal component analysis to reduce the dimensionality of the data prior to inputting it into the neural net can significantly increase the accuracy of the parameter estimation for negligible computational cost, while also allowing a simpler network architecture to be used.
Oxygen and calcium nebular emission line relationships in core-collapse supernovae and Ca-rich transients
Authors: Prentice S J , Maguire K , Siebenaler L , Jerkstrand A
Published: June 2022

This work examines the relationships between the properties (flux ratios, full width at half-maximum velocities) of the [O i] λλ6300, 6364, [Ca ii] λλ7291, 7323, and the Ca ii near-infrared triplet, emission lines of a large sample of core-collapse supernovas (SNe) and Ca-rich transients (509 spectra of 86 transients, of which 10 transients are Ca-rich events). Line-flux ratios as a function of time were investigated with differences identified between the transient classes, in particular the Type II SNe were found to have distinct line-flux ratios compared to stripped-envelope (SE) SNe. No correlation was found between the [Ca ii]/[O i] flux ratios of SE-SNe and their ejecta masses and kinetic energies (as measured from light-curve modelling), suggesting that there may be a contribution from an additional power source in more luminous SE-SNe. We found that the mean characteristic width of the [Ca ii] emission line is less than the [O i] emission line for all SN types, indicating that the [Ca ii] emission typically originates from deeper in the ejecta than [O i]. This is in some tension with standard models for emission in Type II SNe. The emission line properties of Type II SNe were also compared to theoretical models and found to favour lower mass tracks (MZAMS< 15 M⊙), with no evidence found for significant mixing of 56Ni into the H envelope nor Ca mixed into the O shell. The flux ratios of some superluminous SNe were found to be similar to those of SE-SNe when scaling to account for their longer rise times was applied (although we caution the sample size is small).