bluuebunny/crossref_metadata_2025 huggingface dataset:
Familiares vivenciando cuidados paliativos de crianças com câncer hospitalizadas: uma revisão integrativa
Authors: Anjos Cristineide Dos , Silva Rose Mary Costa Rosa Andrade , Pereira Eliane Ramos , Sampaio Carlos Eduardo Peres , Silva Marcos Andrade , Carneiro Eliane Cristina Da Silva Pinto
Published: July 2021

Objetivos: analisar a produção do conhecimento sobre a experiência da família acerca dos cuidados paliativos da criança com câncer hospitalizada na unidade de terapia intensiva e discutir o papel da enfermagem no atendimento à família da criança com câncer frente aos cuidados paliativos. Método: revisão integrativa realizada na PUBMED, LILACS, SCOPUS, SCIELO e CINAHL entre janeiro e março de 2020. Resultados: a amostra foi composta por 13 artigos, originando duas categorias: O impacto do cuidado paliativo da criança com câncer na dinâmica familiar e o cuidado multiprofissional, em especial dos enfermeiros, à família da criança com câncer. Conclusão: os estudos revelaram o panorama nacional e internacional dos cuidados paliativos à criança com câncer e a desestruturação da dinâmica familiar nos aspectos físicos, sociais, psicológicos, e financeiros, caracterizando o período como estressante e doloroso. Os enfermeiros estabelecem condutas terapêuticas objetivando promover qualidade de vida para crianças em cuidados paliativos e seus familiares.
Significados atribuídos à morte segundo a perspectiva de profissionais de saúde da área de oncologia
Authors: Cunha José Henrique Da Silva , Ferreira Lúcia Aparecida , Frizzo Heloísa Cristina Figueiredo , Galon Tanyse , Rodrigues Leiner Resende
Published: July 2021

Objetivo: compreender a construção dos significados da morte pelos profissionais de saúde frente ao cuidado à pessoa com câncer. Método: estudo qualitativo realizado em ambiente online, com a participação de 34 profissionais de saúde. Foram realizadas entrevistas semiestruturadas, interpretadas segundo análise temática. Resultados: duas categorias analíticas emergiram dos dados, indicando que os significados atribuídos à morte pelos participantes foram: como um processo inerente ao ciclo da vida humana, passagem para a outra vida, e fim do sofrimento tanto do paciente quanto dos profissionais de saúde. As dificuldades que apontaram em lidar com a morte se referem à falta de suporte psicológico, escassez de conhecimento sobre morte, cuidados paliativos e comunicação de más notícias. Conclusão: os profissionais construíram diferentes significados à morte de seus pacientes, tais como um processo natural da vida, vontade de um ser superior, passagem para uma nova existência e término do sofrimento dessas pessoas.
Ideação suicida em mulheres e violência por parceiro íntimo
Authors: Silva Júnior Fernando José Guedes da , Monteiro Claudete Ferreira de Souza , Sales Jaqueline Carvalho e Silva , Costa Ana Paula Cardoso , Teixeira Maria Isabelly Reis , Santos Clara Ananda Pimentel de Sousa
Published: July 2021

Objetivo: investigar a associação entre ideação suicida e violência por parceiro íntimo em mulheres. Método: estudo analítico e transversal, desenvolvido em Unidades Básicas de Saúde do Piauí-Brasil, com 369 mulheres adultas e com histórico de relacionamento. Os dados foram coletados de agosto de 2015 a março de 2016, por meio do Revised Conflict Tactics Scales e Self-Reporting Questionnaire, e analisados no software Statistical Package for the Social Science, versão 20.0. Resultados: verificou-se que 65,3% das mulheres sofreram violência por parceiro íntimo, 61,0% foi vítima de violência psicológica, 32,2% física, 18,7% moral e 17,1% sexual. Identificou-se associação entre ideação suicida e violência por parceiro íntimo (p=0,000), violência psicológica (p=0,001) e moral (p=0,000). Ser vítima de violência por parceiro íntimo aumenta 4,35 vezes as chances de as mulheres pensarem em cometer atos contra a própria vida. Conclusão: a ideação suicida está associada a violência por parceiro íntimo, violência psicológica e moral.
Incidência e fatores associados a complicações em feridas operatórias de mulheres mastectomizadas
Authors: Noronha Isabela Da Rosa , Noronha Isabele Da Rosa , Dantas Carolina Siqueira , Penna Lucia Helena Garcia , Jomar Rafael Tavares
Published: July 2021

Objetivo: descrever a incidência de complicações em feridas operatórias de mastectomia e identificar fatores associados. Método: estudo retrospectivo desenvolvido em uma coorte hospitalar de 545 mulheres mastectomizadas por câncer de mama no ano 2018 em um centro de assistência de alta complexidade em oncologia da cidade do Rio de Janeiro, Brasil, após aprovação por Comitê de Ética em Pesquisa. Os dados foram coletados a partir dos prontuários, permitindo cálculos da taxa de incidência e da razão da taxa de incidência para cada complicação. Resultados: a complicação que apresentou maior taxa de incidência foi o sangramento (57,14/100 mastectomias-dia), tendo como fatores associados a raça/cor da pele não branca (Razão da Taxa de Incidência: 3,11) e a diabetes mellitus (Razão da Taxa de Incidência: 0,48). Conclusão: os fatores associados ao sangramento da ferida operatória apontam para a necessidade de novas práticas no cuidado ao pós-operatório de mulheres mastectomizadas.
Rethinking resistance: How antibiotics are evolving
Authors: Greener Mark
Published: July 2021

Mark Greener looks at the efforts being undertaken to tackle antibiotic resistance
Effect of temperament on recovery in isoflurane-anaesthetised horses
Authors: Bryant Helen , Loomes Kate , Dugdale Alex
Published: July 2021

Background:

Recovery is a crucial phase of equine anaesthesia and factors influencing recovery quality are an active area of research.

Aim:

To investigate the effect of temperament on recovery score after isoflurane-anaesthesia in 30 adult horses undergoing elective surgery.

Methods:

Two veterinarians used a numerical rating scale to score each horse's response to five tests as a gauge of temperament. Owners used a numerical rating scale to score their horse's temperament according to seven behaviour-related questions. Horses underwent elective surgery under general anaesthesia using a standardised protocol. Recovery was recorded and scored by a blinded assessor using the simple descriptive scale for scoring recovery (R1) and the Edinburgh system (R2).

Findings:

There was no correlation between veterinarian or owner-assessed temperament and recovery score. Veterinary-assessed temperament score was negatively correlated with pre-induction romifidine and total romifidine dose. Both recovery scores were negatively correlated with anaesthetic duration and R1 was positively correlated with time to first movement in recovery.

Conclusions:

Temperament did not influence recovery score in our population of horses.
The orthopaedic waiting list crisis
Authors: Hampton Matthew , Riley Ella , Garneti Naren , Anderson Alexander , Wembridge Kevin
Published: July 2021

Aims

Due to widespread cancellations in elective orthopaedic procedures, the number of patients on waiting list for surgery is rising. We aim to determine and quantify if disparities exist between inpatient and day-case orthopaedic waiting list numbers; we also aim to determine if there is a ‘hidden burden’ that already exists due to reductions in elective secondary care referrals.

Methods

Retrospective data were collected between 1 April 2020 and 31 December 2020 and compared with the same nine-month period the previous year. Data collected included surgeries performed (day-case vs inpatient), number of patients currently on the orthopaedic waiting list (day-case vs inpatient), and number of new patient referrals from primary care and therapy services.

Results

There was a 52.8% reduction in our elective surgical workload in 2020. The majority of surgeries performed in 2020 were day case surgeries (739; 86.6%) with 47.2% of these performed in the independent sector on a ‘lift and shift’ service. The total number of patients on our waiting lists has risen by 30.1% in just 12 months. As we have been restricted in performing inpatient surgery, the inpatient waiting lists have risen by 73.2%, compared to a 1.6% rise in our day-case waiting list. New patient referral from primary care and therapy services have reduced from 3,357 in 2019 to 1,722 in 2020 (49.7% reduction).

Conclusion

This study further exposes the increasing number of patients on orthopaedic waiting lists. We observed disparities between inpatient and day-case waiting lists, with dramatic increases in the number of inpatients on the waiting lists. The number of new patient referrals has decreased, and we predict an influx of referrals as the pandemic eases, further adding to the pressure on inpatient waiting lists. Robust planning and allocation of adequate resources is essential to deal with this backlog. Cite this article: Bone Jt Open 2021;2(7):530–534.
Primary total hip arthroplasty outcomes in octogenarians
Authors: Zak Stephen Gerard , Lygrisse Katherine , Tang Alex , Meftah Morteza , Long William J. , Schwarzkopf Ran
Published: July 2021

Aims

As our population ages, the number of octogenarians who will require a total hip arthroplasty (THA) rises. In a value-based system where operative outcomes are linked to hospital payments, it is necessary to assess the outcomes in this population. The purpose of this study was to compare outcomes of elective, primary THA in patients ≥ 80 years old to those aged < 80.

Methods

A retrospective review of 10,251 consecutive THA cases from 2011 to 2019 was conducted. Patient-reported outcome (PRO) scores (Hip disability and Osteoarthritis Outcome Score (HOOS)), as well as demographic, readmission, and complication data, were collected.

Results

On average, the younger cohort (YC, n = 10,251) was a mean 61.60 years old (SD 10.71), while the older cohort (OC, n = 609) was 84.25 years old (SD 3.02) (p < 0.001). The OC had greater surgical risk based on their higher mean American Society of Anesthesiologists (ASA) scores (2.74 (SD 0.63) vs 2.30 (SD 0.63); p < 0.001) and Charlson Comorbidity Index (CCI) scores (6.26 (SD 1.71) vs 3.87 (SD 1.98); p < 0.001). While the OC stayed in the hospital longer than the YC (mean 3.5 vs 2.5 days; p < 0.001), there were no differences in 90-day emergency visits (p = 0.083), myocardial infarctions (p = 0.993), periprosthetic joint infections (p = 0.214), dislocations (p = 0.993), or aseptic failure (p = 0.993). The YC was more likely to be readmitted within 90 days (3.88% vs 2.18%, Β = 0.57; p = 0.048). There were no observed differences in 12-week (p = 0.518) or one-year (p = 0.511) HOOS scores.

Conclusion

Although patients ≥ 80 years old have a greater number of comorbidities than younger patients, they had equivalent perioperative complication rates and PRO scores. This study demonstrates the safety and success of elective THA in octogenarians. Cite this article: Bone Jt Open 2021;2(7):535–539.
An Overview of Agricultural Injuries in Florida from 2015-2019
Authors: Gorucu Serap , Weichelt Bryan , Diehl David , Galindo Sebastian
Published: July 2021

Highlights

We identified 48 fatal and 187 non-fatal agricultural injuries in Florida from 2015-2019.

Vehicles and environmental sources were the two leading injury sources.

Using multiple data sources helped us understand the at-risk populations.

Abstract
. The purpose of this study was to examine and describe fatal and non-fatal agricultural injuries documented in Florida. We used Occupational Safety and Health Administration (OSHA) data and AgInjuryNews.org (AIN) data from 2015 through 2019 to identify 48 fatal and 187 non-fatal injuries during the five-year study period, with 86% (40 fatal, 175 non-fatal) of these injuries being occupational. A total of 101 (43%) people were injured as a result of transportation incidents. Major injury sources were vehicles (46%) and environmental sources (heat, lightning, etc.) (14%). Using AIN data, we identified risks for youth under the age of 18 and for individuals age 65 and older. This study suggests the need for additional injury surveillance efforts to gather demographic information to identify at-risk populations. Keywords: Agriculture, Fatal, Injury, Surveillance, Transportation.
Making sense of discomfort: the performance of masculinity and (counter-)transference
Authors: Gammon Thi Luong
Published: July 2021

This article features a case study about the author’s two research encounters with an emotionally reluctant male participant who seemed to experience discomfort and who also made the author feel uncomfortable. To make sense of this mutual experience of discomfort, the article explores the intersubjective exchange between the interviewer and her participant through the application of the psychoanalytic concepts of ‘defence’ and ‘(counter-)transference’. The article argues that the mutual discomfort resulted from the participant’s desire to perform masculinity in ways that fit the Vietnamese hegemonic masculinity and from the researcher’s inability to identify this desire during the interviews. By locating the participant’s engagement with hegemonic masculinity within the sociocultural context of contemporary Vietnam, and investigating the resulting discomfort, the article demonstrates how applying a psychosocial approach to a research relationship can be fruitful. It shows that such an approach can help researchers acquire unexpected insights into the psychological and social meanings of research encounters beyond an analysis of just the text, thus adding to methodological discussions about qualitative interviews.
Design and analysis of broadband guided-mode resonant reflectors with coated triangular and trapezoidal profiles in TE polarization
Authors: Xing Guohua , Zhang Shanwen , Mi Xiaotao , Zhang Rongjun
Published: July 2021

A low-refractive-index grating layer with symmetrical triangular/trapezoidal grooves covered with a high-refractive-index Si layer is used to design a broadband guided-mode resonant reflector. Software Rsoft is used to simulate the reflection and transmission spectra as well as the internal electric field distribution at the resonant wavelength. It is discovered that the interaction between resonant modes promotes the formation of a wideband spectrum. The reflector has been proven to provide wideband (Δλ > 450 nm) and high reflectivity (R > 98.4%) spectra over a wide range of base angles from 44° to 72°, and the maximum high reflectivity (R > 99%) spectral range in transverse electric polarization is 458 nm, spanning 1422 to 1880nm. The results not only demonstrate excellent tolerance to the base angle and grating depth but also provide more possibilities for the design of broadband reflectors.
Spatially modulated broad-area lasers for narrow lateral far-field divergence
Authors: Zeghuzi Anissa , Koester Jan-Philipp , Radziunas Mindaugas , Christopher Heike , Wenzel Hans , Knigge Andrea
Published: July 2021

A novel laser design is presented that combines a longitudinal-lateral gain-loss modulation with an additional phase tailoring achieved by etching rectangular trenches. At 100 A pulsed operation, simulations predict a far-field profile with 0.3° full width at half maximum (

Θ

F
W
H
M

=

0.3

∘

) where a 0.4°-wide main lobe contains 40% of the emitted optical output power (

Θ

40
%

=

0.4

∘

). While far-field measurements of these structured lasers emitting 10 ns long pulses with 35 W peak power confirm a substantial enhancement of radiation within the central

1
∘

angular range, the measured far-field intensity outside of the obtained central peak remains high.
Spin-decoupled metasurface for broadband and pixel-saving polarization rotation and wavefront control
Authors: Ji Ruonan , Song Kun , Guo Xuyue , Xie Xin , Zhao Yang , Jin Chuan , Wang Shaowei , Jiang Chengming , Yin Jianbo , Liu Yahong , Zhai Shilong , Zhao Xiaopeng , Lu Wei
Published: July 2021

In this paper, a strategy to achieve a simultaneous wavefront shaping and polarization rotation, without compromising the number of pixels and energy efficiency as well as having broadband operation range, is proposed. This strategy is based on the application of a spin-decoupled phase metasurface composed by only one set of metal-insulator-metal (MIM) umbrella-shaped chiral unit cells. Quasi-non-dispersive and spin-decoupled phase shift can be achieved simply by changing single structural parameter of the structure. By further merging the Pancharatnam-Berry (PB) geometric phase, conversion of an incident LP light beam into right- and left-handed circularly polarized reflected beams with similar amplitudes, desired phase profiles and controlled phase retardation on a nanoscale is enabled with high efficiency. Based on the proposed strategy, a polarization-insensitive hologram generator with control optical activity, and a multiple ring vortex beam generator are realized. The results obtained in this work provide a simple and pixel-saving approach to the design of integratable and multitasking devices combining polarization manipulation and wavefront shaping functions, such as vectorial holographic generators, multifocal metalenses, and multichannel vector beam generators.
1.7-μm Tm-doped fiber laser intracavity-pumped by an erbium/ytterbium-codoped fiber laser
Authors: Zhang Lu , Zhang Junxiang , Sheng Quan , Li Yanyan , Shi Chaodu , Shi Wei , Yao Jianquan
Published: July 2021

In this paper, we demonstrate an efficient 1.7-μm Tm-doped fiber laser whose cavity was embedded in a 1560 nm erbium/ytterbium-codoped fiber laser cavity, which enabled bidirectional pumping and made full use of the circulating pump in the parent laser cavity. A rate equation model was developed to optimize the fiber length and output coupling for a desired output power. In the experiment, a maximum output power at 1720 nm of 1.13 W was obtained under 10 W of 976 nm diode pump power, which correlated well with our modeling. The slope efficiency from the multimode 976 nm diode pump to 1720 nm output was 13.5%, while the slope efficiency in terms of launched 1560 nm pump power reached 62.5%. By using a short Tm-doped fiber to minimize signal reabsorption, a high signal-to-noise ratio over 65 dB was achieved. The prospect for further power scaling was also discussed based on our developed model.
Equal-intensity beam splitter fabricated by segmented half-wave plate for passive laser speckle reduction
Authors: Tong Zhaomin , Yan Yuxiang , Ma Yifei , Wang Mei , Jia Suotang , Chen Xuyuan
Published: July 2021

An equal-intensity beam splitter (EIBS) for passive laser speckle reduction is reported. The EIBS consists of a segmented half-wave plate (SHWP) with the designed orientation of the fast axis of each segment, a polarization beam splitter, and a mirror. The SHWP is fabricated using patterned photoalignment material and liquid crystal polymer. Ten laser sub-beams are generated by the twenty-one-pixelated EIBS, where the largest intensity ratio among them is 7.6. Laser temporal and spatial coherences are destroyed because of the optical path delays among the laser sub-beams. The EIBS is used to reduce laser speckle passively, and objective speckle contrast is reduced from 0.82 to 0.33 when all 10 laser sub-beams are used.
Geometrical effect of graded index on the transport of polarized lights
Authors: Shao Jiang , Zhu Keyong , Shi Guodong , Huang Yong
Published: July 2021

We investigate the geometrical effect of graded index on the transport of polarized lights in the scope of geometrical optics, and present three effective methods based on the Runge-Kutta ray tracing technique in the Frenet-Serret frame and a fixed global Cartesian frame, respectively, for obtaining the polarization state of a polarized light that propagates in graded-index media. The three methods have their own advantages in accuracy, computational efficiency, and difficulty of implementation, respectively. Simulations on a three-dimensional graded-index model show that the results obtained by the three methods are in perfect agreement with each other.
Optical charge state manipulation of divacancy spins in silicon carbide under resonant excitation
Authors: Wang Jun-Feng , Zhou Ji-Yang , Li Qiang , Yan Fei-Fei , Yang Mu , Lin Wu-Xi , Hao Ze-Yan , Li Zhi-Peng , Liu Zheng-Hao , Liu Wei , Sun Kai , Wei Yu , Tang Jian-Shun , Xu Jin-Shi , Li Chuan-Feng , Guo Guang-Can
Published: July 2021

Spin defects in silicon carbide (SiC) have attracted much attentions in various quantum technologies. In this work, we study the optical manipulation of charge state and coherent control of multifold divacancy spins ensemble in SiC under resonant excitation. The results reveal that the resonantly excited divacancy ensemble counts have dozens of enhancements by repumping a higher-energy laser. Moreover, it has a similar optimal repump laser wavelength of around 670 nm for multiple divacancies. On the basis of this, the optically detected magnetic resonance (ODMR) experiment shows that repump lasers with different wavelengths do not affect the ODMR contrast and line width. In addition, the repump lasers also do not change the divacancy spins’ coherence times. The experiments pave the way for using the optimal repump excitation method for SiC-based quantum information processing and quantum sensing.
Perception of biological motion by jumping spiders
Authors: De Agrò Massimo , Rößler Daniela C. , Kim Kris , Shamble Paul S.
Published: July 2021

The body of most creatures is composed of interconnected joints. During motion, the spatial location of these joints changes, but they must maintain their distances to one another, effectively moving semirigidly. This pattern, termed “biological motion” in the literature, can be used as a visual cue, enabling many animals (including humans) to distinguish animate from inanimate objects. Crucially, even artificially created scrambled stimuli, with no recognizable structure but that maintains semirigid movement patterns, are perceived as animated. However, to date, biological motion perception has only been reported in vertebrates. Due to their highly developed visual system and complex visual behaviors, we investigated the capability of jumping spiders to discriminate biological from nonbiological motion using point-light display stimuli. These kinds of stimuli maintain motion information while being devoid of structure. By constraining spiders on a spherical treadmill, we simultaneously presented 2 point-light displays with specific dynamic traits and registered their preference by observing which pattern they turned toward. Spiders clearly demonstrated the ability to discriminate between biological motion and random stimuli, but curiously turned preferentially toward the latter. However, they showed no preference between biological and scrambled displays, results that match responses produced by vertebrates. Crucially, spiders turned toward the stimuli when these were only visible by the lateral eyes, evidence that this task may be eye specific. This represents the first demonstration of biological motion recognition in an invertebrate, posing crucial questions about the evolutionary history of this ability and complex visual processing in nonvertebrate systems.
Origins of 1/f-like tissue oxygenation fluctuations in the murine cortex
Authors: Zhang Qingguang , Gheres Kyle W. , Drew Patrick J.
Published: July 2021

The concentration of oxygen in the brain spontaneously fluctuates, and the distribution of power in these fluctuations has a 1/f-like spectra, where the power present at low frequencies of the power spectrum is orders of magnitude higher than at higher frequencies. Though these oscillations have been interpreted as being driven by neural activity, the origin of these 1/f-like oscillations is not well understood. Here, to gain insight of the origin of the 1/f-like oxygen fluctuations, we investigated the dynamics of tissue oxygenation and neural activity in awake behaving mice. We found that oxygen signal recorded from the cortex of mice had 1/f-like spectra. However, band-limited power in the local field potential did not show corresponding 1/f-like fluctuations. When local neural activity was suppressed, the 1/f-like fluctuations in oxygen concentration persisted. Two-photon measurements of erythrocyte spacing fluctuations and mathematical modeling show that stochastic fluctuations in erythrocyte flow could underlie 1/f-like dynamics in oxygenation. These results suggest that the discrete nature of erythrocytes and their irregular flow, rather than fluctuations in neural activity, could drive 1/f-like fluctuations in tissue oxygenation.
Accumulation of continuously time-varying sensory evidence constrains neural and behavioral responses in human collision threat detection
Authors: Markkula Gustav , Uludağ Zeynep , Wilkie Richard McGilchrist , Billington Jac
Published: July 2021

Evidence accumulation models provide a dominant account of human decision-making, and have been particularly successful at explaining behavioral and neural data in laboratory paradigms using abstract, stationary stimuli. It has been proposed, but with limited in-depth investigation so far, that similar decision-making mechanisms are involved in tasks of a more embodied nature, such as movement and locomotion, by directly accumulating externally measurable sensory quantities of which the precise, typically continuously time-varying, magnitudes are important for successful behavior. Here, we leverage collision threat detection as a task which is ecologically relevant in this sense, but which can also be rigorously observed and modelled in a laboratory setting. Conventionally, it is assumed that humans are limited in this task by a perceptual threshold on the optical expansion rate–the visual looming–of the obstacle. Using concurrent recordings of EEG and behavioral responses, we disprove this conventional assumption, and instead provide strong evidence that humans detect collision threats by accumulating the continuously time-varying visual looming signal. Generalizing existing accumulator model assumptions from stationary to time-varying sensory evidence, we show that our model accounts for previously unexplained empirical observations and full distributions of detection response. We replicate a pre-response centroparietal positivity (CPP) in scalp potentials, which has previously been found to correlate with accumulated decision evidence. In contrast with these existing findings, we show that our model is capable of predicting the onset of the CPP signature rather than its buildup, suggesting that neural evidence accumulation is implemented differently, possibly in distinct brain regions, in collision detection compared to previously studied paradigms.
Risk sensitivity and theory of mind in human coordination
Authors: Ferreira Pedro L. , Santos Francisco C. , Pequito Sérgio
Published: July 2021

What humans do when exposed to uncertainty, incomplete information, and a dynamic environment influenced by other agents remains an open scientific challenge with important implications in both science and engineering applications. In these contexts, humans handle social situations by employing elaborate cognitive mechanisms such as theory of mind and risk sensitivity. Here we resort to a novel theoretical model, showing that both mechanisms leverage coordinated behaviors among self-regarding individuals. Particularly, we resort to cumulative prospect theory and level-k recursions to show how biases towards optimism and the capacity of planning ahead significantly increase coordinated, cooperative action. These results suggest that the reason why humans are good at coordination may stem from the fact that we are cognitively biased to do so.
Estimating the effect of moving meat-free products to the meat aisle on sales of meat and meat-free products: A non-randomised controlled intervention study in a large UK supermarket chain
Authors: Piernas Carmen , Cook Brian , Stevens Richard , Stewart Cristina , Hollowell Jennifer , Scarborough Peter , Jebb Susan A.
Published: July 2021

Background

Reducing meat consumption could bring health and environmental benefits, but there is little research to date on effective interventions to achieve this. A non-randomised controlled intervention study was used to evaluate whether prominent positioning of meat-free products in the meat aisle was associated with a change in weekly mean sales of meat and meat-free products.

Methods and findings

Weekly sales data were obtained from 108 stores: 20 intervention stores that moved a selection of 26 meat-free products into a newly created meat-free bay within the meat aisle and 88 matched control stores. The primary outcome analysis used a hierarchical negative binomial model to compare changes in weekly sales (units) of meat products sold in intervention versus control stores during the main intervention period (Phase I: February 2019 to April 2019). Interrupted time series analysis was also used to evaluate the effects of the Phase I intervention. Moreover, 8 of the 20 stores enhanced the intervention from August 2019 onwards (Phase II intervention) by adding a second bay of meat-free products into the meat aisle, which was evaluated following the same analytical methods.

During the Phase I intervention, sales of meat products (units/store/week) decreased in intervention (approximately −6%) and control stores (−5%) without significant differences (incidence rate ratio [IRR] 1.01 [95% CI 0.95–1.07]. Sales of meat-free products increased significantly more in the intervention (+31%) compared to the control stores (+6%; IRR 1.43 [95% CI 1.30–1.57]), mostly due to increased sales of meat-free burgers, mince, and sausages. Consistent results were observed in interrupted time series analyses where the effect of the Phase II intervention was significant in intervention versus control stores.

Conclusions

Prominent positioning of meat-free products into the meat aisle in a supermarket was not effective in reducing sales of meat products, but successfully increased sales of meat-free alternatives in the longer term.

A preregistered protocol (https://osf.io/qmz3a/) was completed and fully available before data analysis.
The epidemic of Q fever in 2018 to 2019 in Zhuhai city of China determined by metagenomic next-generation sequencing
Authors: Huang Mingxing , Ma Jinmin , Jiao Jun , Li Chunna , Chen Luan , Zhu Zhongyi , Ruan Feng , Xing Li , Zheng Xinchun , Fu Mengjiao , Ma Binyin , Gan Chongjie , Mao Yuanchen , Zhang Chongnan , Sun Ping , Liu Xi , Lin Ziliang , Chen Lu , Lu Zhiyu , Zhou Dongsheng , Wen Bohai , Chen Weijun , Xiong Xiaolu , Xia Jinyu
Published: July 2021

Q fever is a worldwide zoonosis caused by Coxiella burnetii (Cb). From January 2018 to November 2019, plasma samples from 2,382 patients with acute fever of unknown cause at a hospital in Zhuhai city of China were tested using metagenomic next-generation sequencing (mNGS). Of those tested, 138 patients (5.8%) were diagnosed with Q fever based on the presence of Cb genomic DNA detected by mNGS. Among these, 78 cases (56.5%) presented from Nov 2018 to Mar 2019, suggesting an outbreak of Q fever. 55 cases with detailed clinical information that occurred during the outbreak period were used for further analysis. The vast majority of plasma samples from those Cb-mNGS-positive patients were positive in a Cb-specific quantitative polymerase chain reaction (n = 38) and/or indirect immunofluorescence assay (n = 26). Mobile phone tracing data was used to define the area of infection during the outbreak. This suggested the probable infection source was Cb-infected goats and cattle at the only official authorized slaughterhouse in Zhuhai city. Phylogenic analysis based on genomic sequences indicated Cb strains identified in the patients, goat and cattle were formed a single branch, most closely related to the genomic group of Cb dominated by strains isolated from goats. Our study demonstrates Q fever was epidemic in 2018–2019 in Zhuhai city, and this is the first confirmed epidemic of Q fever in a contemporary city in China.
Determination of freedom-from-rabies for small Indian mongoose populations in the United States Virgin Islands, 2019–2020
Authors: Browne A. Springer , Cranford Hannah M. , Morgan Clint N. , Ellison James A. , Berentsen Are , Wiese Nicholas , Medley Alexandra , Rossow John , Jankelunas Leanne , McKinley Alan S. , Lombard Claudia D. , Angeli Nicole F. , Kelley Thomas , Valiulus Jennifer , Bradford Bethany , Burke-France Valicia J. , Harrison Cosme J. , Guendel Irene , Taylor Marissa , Blanchard Gerard L. , Doty Jeffrey B. , Worthington David J. , Horner David , Garcia Keith R. , Roth Joseph , Ellis Brett R. , Bisgard Kristine M. , Wallace Ryan , Ellis Esther M.
Published: July 2021

Mongooses, a nonnative species, are a known reservoir of rabies virus in the Caribbean region. A cross-sectional study of mongooses at 41 field sites on the US Virgin Islands of St. Croix, St. John, and St. Thomas captured 312 mongooses (32% capture rate). We determined the absence of rabies virus by antigen testing and rabies virus exposure by antibody testing in mongoose populations on all three islands. USVI is the first Caribbean state to determine freedom-from-rabies for its mongoose populations with a scientifically-led robust cross-sectional study. Ongoing surveillance activities will determine if other domestic and wildlife populations in USVI are rabies-free.
Epidemiological, clinical and laboratory features of acute Q fever in a cohort of hospitalized patients in a regional hospital, Israel, 2012-2018
Authors: Finn Talya , Babushkin Frida , Geller Keren , Alexander Hanna , Paikin Svetlana , Lellouche Jonathan , Atiya-Nasagi Yafit , Cohen Regev
Published: July 2021

Introduction

Acute Q fever is endemic in Israel, yet the clinical and laboratory picture is poorly defined.

Methods

A retrospective study reviewing the medical records of acute Q fever patients, conducted in a single hospital in the Sharon district, Israel. Serum samples from suspected cases were preliminary tested by a qualitative enzyme immunoassay (EIA). Confirmatory testing at the reference laboratory used an indirect immunofluorescence assay (IFA). Positive cases were defined as fever with at least one other symptom and accepted laboratory criteria such as a single-phase II immunoglobulin G (IgG) antibody titer ≥1:200. Cases not fulfilling these criteria and in which acute Q fever was excluded, served as a control group.

Results

Between January 2012 and May 2018, 484 patients tested positive. After confirmatory testing, 65 (13.4%) were positive for acute Q fever (with requisite clinical picture), 171 (35.3%) were definitely not infected, the remaining 248 were excluded because of past/chronic/undetermined infection. The average age was 58 years and 66% were males. Most resided in urban areas with rare animal exposure. Pneumonia was seen in 57% of cases and a combination with headache/hepatitis was highly suggestive of acute Q fever diagnosis. Syncope/presyncope, fall and arthritis were more common in acute Q fever cases. Laboratory indexes were similar to the control group, except for erythrocyte sedimentation rate (ESR) which was more common and higher in the study group.

Conclusion

Acute Q fever in the Sharon district could be better diagnosed by using a syndromic approach in combination with improved rapid diagnostic testing.
Knowledge, attitude and preventive practice towards COVID-19 and associated factors among outpatient service visitors at Debre Markos compressive specialized hospital, north-west Ethiopia, 2020
Authors: Feleke Bekele Taye , Wale Mengistu Zelalem , Yirsaw Mesenbet Terefe
Published: July 2021

Background

COVID-19 is an emerging infectious disease which is a major public health problem worldwide. Given the serious threats imposed by COVID-19 and the absence of vaccines until August 2020, preventive measures play an essential role in reducing infection rates and controlling its spread. This shows the necessity of public adherence for preventive and control measures, which is affected by their knowledge, attitudes, and practices.

Objective

This study aimed to determine knowledge, attitude, and practice (KAP) towards COVID-19 and associated factors among outpatient service visitors, Debre Markos compressive specialized hospital, north-west,Ethiopia.

Method

Institutional-based cross-sectional study design with a systematic random sampling technique was conducted from July to August 2020. Among a total of 404 participants, 398 were recruited. Data were collected using a structured questionnaire. The data was edited, coded, and entered into Epi data version 4.6 and exported to SPSS-25 for analysis. Bivariable and multivariable logistic regression models were employed to identify factors associated with KAP. A p-value of <0.05 was considered statistically significant.

Result

The prevalence of poor knowledge, attitude and practice among the outpatient service visitors were 27.1%, 30.7% and 44%, respectively. The mean age of the participants was 33.4 ±10.9 years. Variables like; educational status, ‘‘can’t read and write” [AOR = 3.76, 95% CI (1.36–10.42), P = 0.01], read and write [AOR = 5.90, 95% CI (2.39–14.98), P = 0.01], rural residence [AOR = 3.04, 95% CI (1.43–6.46), P = 0.01] and having no television [AOR = 0.8, 95% CI (0.79–0.89), P = 0.03] were significantly associated with poor knowledge. While, educational status of “can’t read and write”, [AOR = 6.71, 95% CI (2.78–16.16), P = 0.01] and rural residence [AOR = 2.03, 95% CI (1.14–3.61), P = 0.02] were significantly associated with poor attitude. Additionally, poor knowledge, [AOR = 22.73, 95% CI (10.5–49.21), P = 0.01], rural residence [AOR = 2.08, 95% CI (1.08–4.88), P = 0.04] and having no television [AOR = 2.24, 95% CI (1.05–4.79), P = 0.01] were significantly associated with poor practice.

Conclusion

In this study, knowledge, attitude, and practice among outpatient service visitors was poor which needs targeted health education and interventions from the health professional to enhance their knowledge, attitude, and practice towards COVID-19. In parallel with this, special attention should be given for the rural community and for those with an educational status of can’t read and write.
Impact of the COVID-19 pandemic on clinical research activities: Survey of study participants and health care workers participating in a hypertension trial in Vietnam
Authors: Nguyen Hoa L. , Tran Oanh T. , Ha Duc A. , Phan Van H. , Nguyen Cuc T. , Nguyen Giang H. , Nguyen Thang T. , Chiriboga Germán , Goldberg Robert J. , Allison Jeroan J.
Published: July 2021

Background

The COVID-19 pandemic has had a profound worldwide impact. Vietnam, a lower middle-income country with limited resources, has successfully slowed this pandemic. The objectives of this report are to explore the impact of the COVID-19 pandemic on the research activities of an ongoing hypertension trial using a storytelling intervention in Vietnam.

Methods

Data were collected in a mixed-methods study among 86 patients and 10 health care workers participating in a clinical trial designed to improve hypertension control. Several questions related to the impact of COVID-19 on patient’s daily activities and adherence to the study interventions were included in the follow-up visits. A focus group discussion was conducted among health care workers to discuss the impact of COVID-19 on research related activities.

Results

Fewer patients in the intervention group reported that they faced difficulties in adhering to prescribed study interventions, wanted to receive a call from a dedicated hotline, or have a visit from a community health worker as compared with those in the comparison group. Most study patients are willing to participate in future health research studies. When asked about the potential use of mobile phones in health research studies, fewer patients in the intervention group felt comfortable using a mobile phone for the delivery of intervention and interviews compared with those in the comparison condition. Community health workers shared that they visited patient’s homes more often than previously due to the pandemic and health care workers had to perform more virus containment activities without a corresponding increase in ancillary staff.

Conclusions

Both patients and health care workers in Vietnam faced difficulties in adhering to recommended trial interventions and procedures. Multiple approaches for intervention delivery and data collection are needed to overcome these difficulties during future health crises and enhance the implementation of future research studies.

Trial registration

ClinicalTrials.gov. Registration number: https://clinicaltrials.gov/ct2/show/NCT03590691 (registration date July 17, 2018).
Effect of the HXBM408 bacteria on rat intestinal bacterial diversity and the metabolism of soybean isoflavones
Authors: Xiaobin Li , Jinglong Xie , Fang Zhao , Chenchen Wang , Kailun Yang
Published: July 2021

The purpose of this study was to investigate the effect of the HXBM408 bacteria on the diversity of rat intestinal bacteria and the metabolism of soybean isoflavones. The control group was administered sterilized water and daidzein by gavage for 7 days. Conversely, the experimental group was administered HXBM408 solution and daidzein by gavage for 7 days. The content of the daidzein metabolite equol in rat feces in the experimental group was significantly higher than that in the control group (P < 0.05) on the 7th and 14th days. However, the content of daidzein and its metabolites in feces was not significantly different (P > 0.05). On the 7th day, the relative abundance of Streptococcus in the feces of the experimental group was significantly higher than that of the control group (P < 0.05), but the difference disappeared over time (P > 0.05). In the intestinal digesta of rats, the proteobacteria of the experimental group was significantly lower than those of the control group (P < 0.05). HXBM408 can increase the degradation ability of soybean isoflavones in a short period after ingestion, increase the number of beneficial intestinal flora, and improve the structure of the flora.
In vivo mitochondrial ATP production is improved in older adult skeletal muscle after a single dose of elamipretide in a randomized trial
Authors: Roshanravan Baback , Liu Sophia Z. , Ali Amir S. , Shankland Eric G. , Goss Chessa , Amory John K. , Robertson H. Thomas , Marcinek David J. , Conley Kevin E.
Published: July 2021

Background

Loss of mitochondrial function contributes to fatigue, exercise intolerance and muscle weakness, and is a key factor in the disability that develops with age and a wide variety of chronic disorders. Here, we describe the impact of a first-in-class cardiolipin-binding compound that is targeted to mitochondria and improves oxidative phosphorylation capacity (Elamipretide, ELAM) in a randomized, double-blind, placebo-controlled clinical trial.

Methods

Non-invasive magnetic resonance and optical spectroscopy provided measures of mitochondrial capacity (ATPmax) with exercise and mitochondrial coupling (ATP supply per O2 uptake; P/O) at rest. The first dorsal interosseous (FDI) muscle was studied in 39 healthy older adult subjects (60 to 85 yrs of age; 46% female) who were enrolled based on the presence of poorly functioning mitochondria. We measured volitional fatigue resistance by force-time integral over repetitive muscle contractions.

Results

A single ELAM dose elevated mitochondrial energetic capacity in vivo relative to placebo (ΔATPmax; P = 0.055, %ΔATPmax; P = 0.045) immediately after a 2-hour infusion. No difference was found on day 7 after treatment, which is consistent with the half-life of ELAM in human blood. No significant changes were found in resting muscle mitochondrial coupling. Despite the increase in ATPmax there was no significant effect of treatment on fatigue resistance in the FDI.

Conclusions

These results highlight that ELAM rapidly and reversibly elevates mitochondrial capacity after a single dose. This response represents the first demonstration of a pharmacological intervention that can reverse mitochondrial dysfunction in vivo immediately after treatment in aging human muscle.
Anemia design effects in cluster surveys of women and young children in refugee settings
Authors: Hulland Erin N. , Leidman Eva , Wilkinson Caroline , Tondeur Mélody , Bilukha Oleg
Published: July 2021

Background

Nutrition surveys in many refugee settings routinely estimate anemia prevalence in high-risk population groups. Given the lack of information on anemia design effects (DEFF) observed in surveys in these settings, the goal of this paper is to better understand the magnitude and distribution of DEFFs and intracluster correlation coefficients (ICCs) in order to inform future survey design.

Methods

Two-stage cluster surveys conducted during 2013–2016 were included if they measured hemoglobin in refugee children aged 6–59 months and/or non-pregnant women aged 15–49 years. Prevalence of anemia, anemia DEFFs and ICCs, mean cluster size, number of clusters, and total sample size were calculated per-survey for non-pregnant women and children. Non-parametric tests were used to assess differences and correlations of ICC and DEFF between women and children and inter-regional differences.

Results

Eighty-seven unique cluster surveys from nine countries were included in this analysis. More than 90% of all surveys had ICC values for anemia below 0.10. Median ICC for children was 0.032 (IQR: 0.015–0.048), not significantly different from that observed for non-pregnant women for whom the median was 0.024 (IQR: -0.002–0.055). DEFFs were significantly higher for children [1.54 (IQR: 1.21–1.82)] versus women [1.20 (IQR: 0.99–1.46)]. Regional differences in DEFFs and ICCs were observed.

Conclusions

Both ICCs and DEFF were relatively small for both non-pregnant women and preschool children and fall in a narrow range. Differences in ICCs between women and children were non-significant, suggesting similar inter-cluster distributions of anemia; significant differences in DEFF were likely attributable to differing cluster sizes. Given regional differences in both ICCs and DEFFs, location-specific values are preferred. However, in the absence of other context-specific information, we suggest using DEFFs of 1.4–1.8 if mean cluster size is around 20, and DEFFs of 1.2–1.4 if mean cluster size is around 10.
Accuracy of online symptom checkers and the potential impact on service utilisation
Authors: Ceney Adam , Tolond Stephanie , Glowinski Andrzej , Marks Ben , Swift Simon , Palser Tom
Published: July 2021

Objectives

The aims of our study are firstly to investigate the diagnostic and triage performance of symptom checkers, secondly to assess their potential impact on healthcare utilisation and thirdly to investigate for variation in performance between systems.

Setting

Publicly available symptom checkers for patient use.

Participants

Publicly available symptom-checkers were identified. A standardised set of 50 clinical vignettes were developed and systematically run through each system by a non-clinical researcher.

Primary and secondary outcome measures

System accuracy was assessed by measuring the percentage of times the correct diagnosis was a) listed first, b) within the top five diagnoses listed and c) listed at all. The safety of the disposition advice was assessed by comparing it with national guidelines for each vignette.

Results

Twelve tools were identified and included. Mean diagnostic accuracy of the systems was poor, with the correct diagnosis being present in the top five diagnoses on 51.0% (Range 22.2 to 84.0%). Safety of disposition advice decreased with condition urgency (being 71.8% for emergency cases vs 87.3% for non-urgent cases). 51.0% of systems suggested additional resource utilisation above that recommended by national guidelines (range 18.0% to 61.2%). Both diagnostic accuracy and appropriate resource recommendation varied substantially between systems.

Conclusions

There is wide variation in performance between available symptom checkers and overall performance is significantly below what would be accepted in any other medical field, though some do achieve a good level of accuracy and safety of disposition. External validation and regulation are urgently required to ensure these public facing tools are safe.