bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a single warm compress prior to ophthalmic surgery on ocular surface and intraoperative visibility: a randomised controlled study
Authors: Ishikawa Sho , Yamaguchi Saori , Hashimoto Miho , Shinoda Kei
Published: July 2023

Purpose

We investigated the effects of a warm compress immediately before surgery on the ocular surface and intraoperative visibility during surgery.

Methods

A randomised controlled quasi-experiment at Saitama Medical University Hospital. From November 2020 to September 2021, 200 patients scheduled for endophthalmic surgery were randomly assigned to a group that received a hot compress with a spontaneously heating eye mask (HM group) or a group that received only an eye mask (control group). The eye masks were applied for 20 min from 2 hours before surgery, and before and after mask application in the non-invasive tear break-up time (NIBUT), tear meniscus height (TMH) and obstruction score of the meibomian gland (meiboscore) were evaluated. The time from wetting to dry blurring of the corneal surface (corneal blurring time, CBT) was also compared before and after the warm compress.

Results

We enrolled 100 patients in the HM group (mean age 69.0±13.3 years) and 99 patients in the control group (mean age 69.5±16.2 years). In the control group, there were no significant changes in the NIBUT, meiboscore or TMH before and after eye mask use, whereas in the HM group, the NIBUT increased from 6.7±5.1 to 9.5±5.6 s (p<0.001), the meiboscore improved from 0.71±0.93 to 0.63±0.96 (p=0.03) and the TMH significantly improved from 0.22±0.08 to 0.24±0.08 mm (p<0.001). The CBT was longer the HM group than control group (33.5±13.4 s, 25.7±14.9 s, respectively, p=0.01).

Conclusions

The condition of the ocular surface and intraoperative visibility improved after a single warm compress.

Trial registration number

UMIN R000047286.
STING mediates microglial pyroptosis via interaction with NLRP3 in cerebral ischaemic stroke
Authors: Li Wenyu , Shen Nan , Kong Lingqi , Huang Hongmei , Wang Xinyue , Zhang Yan , Wang Guoping , Xu Pengfei , Hu Wei
Published: July 2023

Background

Ischaemia-evoked neuroinflammation is a critical pathogenic event following ischaemic stroke. Gasdermin D (GSDMD)-associated pyroptosis represents a type of inflammation-associated programmed cell death, which can exacerbate neuroinflammatory responses and brain damage. Stimulator of interferon genes (STING) was recently described as a vital innate immune adaptor protein associated with neuroinflammation. Nevertheless, the regulatory effects of STING on microglial pyroptosis post-stroke have not been well elaborated.

Methods

STING-knockout and wild-type (WT) mice were subjected to middle cerebral artery occlusion (MCAO). STING small interfering RNA (siRNA) was transfected into BV2 cells before oxygen-glucose deprivation/reoxygenation (OGD/R). STING-overexpressing adeno-associated virus (AAV) and NOD-like receptor family pyrin domain containing 3 (NLRP3) siRNA were administered by stereotaxic injection. 2,3,5-Triphenyl tetrazolium chloride (TTC) staining, TdT-mediated dUTP nick end labeling (TUNEL) staining, Fluoro-Jade C (FJC) staining, neurobehavioural tests, immunohistochemistry, cytokine antibody array assay, transmission electron microscopy, immunoblot, Enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qRT-PCR) were carried out. Co-immunoprecipitation assays were used to investigate the interplay between STING and NLRP3.

Results

STING expression was increased after MCAO and mainly detected on microglia. STING deletion alleviated brain infarction, neuronal damage and neurobehavioural impairment in mice subjected to MCAO. STING knockout suppressed microglial activation and the secretion of inflammatory chemokines, accompanied by mitigation of microglial pyroptosis. Specific upregulation of microglial STING by AAV-F4/80-STING aggravated brain injury and microglial pyroptosis. Mechanistically, co-immunoprecipitation showed that STING bound to NLRP3 in microglia. Supplementation of NLRP3 siRNA reversed AAV-F4/80-STING-induced deterioration of microglial pyroptosis.

Conclusions

The current findings indicate that STING modulates NLRP3-mediated microglial pyroptosis following MCAO. STING may serve as a therapeutic target in neuroinflammation induced by cerebral ischaemic/reperfusion (I/R) injury.
Impact of green manure and weeds on selected soil health indicators in an organic grain cropping system in Nova Scotia
Authors: McNeil Morgan O. , Lynch Derek H. , Alam Mohammed Z. , Mills Aaron , Marshall Carolyn B.
Published: July 2023

The green manure residual effect on soil health 2 years later in crop rotation is understudied. Little is known about weed biomass impact on soil microbial communities or their interactions. A Colchester County, NS, Canada, organic grain research trial during 2016–2017 comprised 2 or 3-year rotations with or without green manure crop prior to wheat, and then soybeans. Fall soil sampling was conducted both years. The soybean phase of the crop rotation was managed as weedy or non-weedy. Weedy soil showed significantly increased soil respiratory activity and fungal microbial biomass. Green manure treatments did not significantly influence soil health indicators.
Neuroendocrinology of the vase tunicate, Ciona intestinalis: consideration of the practical applications for the control of this invasive species
Authors: Lovejoy Sabine R.
Published: July 2023

The vase tunicate, Ciona intestinalis (Linnaeus, 1767), is a social but non-colonial ascidian that is implicated in biofouling of aquatic structures and destruction of the shellfish industry through competition for planktonic nutrients and substrate settling habitats. The sequencing of the C. intestinalis genome has provided insight into the phylogenetic origins of this species, indicating that this lineage and its allies represent a sister taxon to the chordates. Although the practical use of this genomic information at controlling this invasive species is equivocal, a number of new studies on the neurological and neuroendocrine aspects of C. intestinalis have suggested new molecular targets that may be exploited for practical applications on the control of C. intestinalis to protect and enhance the shellfish industry from this invasive species. As a result, we have developed a novel behavioural assay for C. intestinalis, which can be employed to investigate novel agents that inhibit growth and development in this species.
A Robust and Imperceptible Dark Frame Selection Using Advanced Squeezed Convoluted Ebola Neural Network-Based Video Watermarking Scheme with All Phase Discrete Cosine Biorthogonal Transform
Authors: Showkat Haweez , Nissa Rohun , Baba Asifa
Published: July 2023

Watermarking has been developed as a beneficial approach to resolve security problems such as copyright defense, legitimate ownership, and authenticity of digital data. Grayscale or binary images and color images are the most important types of embedded watermarks in the existing video watermarking schemes, while dark frame watermarking is barely used. A new robust blind video watermarking system with an Advanced Squeezed Convoluted Ebola Neural Network (ASCENN) approach is suggested to secure copyright, reduce noise, and authenticate the authenticity of dark frames. The proposed method selects the dark frames from the extracted input video. Then the selected dark frames are embedded and extracted using Finite Ridgelet Transform (FRT), All Phase Discrete Cosine Biorthogonal Transform (APDCBT), and Singular Value Decomposition (SVD) techniques. The robustness of the introduced approach is established by evaluating it through various image watermarking techniques and evaluating its performance against geometric, nongeometric, and combinational attacks. While comparing with the other existing video watermarking approaches, the proposed method has obtained a maximum correlation coefficient of 1, and the signal-to-noise ratio of 75[Formula: see text]dB, at minimum error rate of 0.0215, respectively.
Overflow Oscillation Elimination in Fixed-Point 2D Digital Filters Based on the Roesser Model
Authors: Singh Shimpi , Kar Haranath
Published: July 2023

This paper investigates the overflow oscillation elimination problem in the fixed-point two-dimensional (2D) digital filter (DF) based on Roesser model subjected to two’s complement overflow (TCO) nonlinearities. By utilizing the system information and behavior of TCO nonlinearities more effectively, a new global asymptotic stability (GAS) criterion for 2D DFs is presented. A comparison of the obtained criterion with existing criteria is made with the help of examples.
Finite Element-Based Free Vibration and Deflection Analysis of Bio-Composites Hybrid Laminated Skew Plates Using Experimental Elastic Properties
Authors: Sahu Dhaneshwar Prasad , Prusty Jagesh Kumar , Mohanty Sukesh Chandra
Published: July 2023

In this study, the frequency and deflection response analysis of basalt, soy, flax and hybrid pineapple and flax hybrid laminated skew plates are done. The conventional hand-layup method is used to fabricate the different bio-composites-based laminated structures. The uniaxial tension test is conducted in the INSTRON 5967 UTM to determine the elastic properties of the bio-composite laminated structure as per ISO 527-5 standards. The hybrid laminate skew plate is modeled using the first-order shear deformation theory (FSDT) and their elastic properties are obtained from the uniaxial tensile test from which the frequency and deflection of the skew laminated plates are calculated. The eight-noded shell elements (S8R5) with each node having five degrees-of-freedom are deputed in the commercial finite element method (FEM) package ABAQUS to beget the numerical solutions. The damping effect is neglected in the analysis. The accuracy of the proposed model is verified with available literature and found to be in good agreement. Later, the effect of different parameters such as boundary conditions, aspect ratio and skew angles on the natural frequency and deflection of the bio-composites hybrid laminated skew plates are investigated. The obtained results inferred the natural frequencies are decreasing with an increasing aspect ratio of skew plates. The skew angles help to increase the natural frequencies of skew plates. The central deflections are lower for high-skew angled laminated plates.
The Spatial Distribution of Urban Consumer Service Firms: Evidence from Yelp Reviews
Authors: Humphreys Brad R. , Matti Josh
Published: July 2023

A growing literature employs distance-based measures of localization to assess the spatial distribution of firms with a focus on manufacturing across a country. We analyse the spatial concentration of a variety of consumer services firms in the Phoenix, AZ area using geo-referenced Yelp data from over 29,000 establishments. Results from a K-density approach indicate substantial localization and service differentiation among localised firms. Firm concentration varies across service cost and quality; higher quality/cost establishments tend to cluster. Our results further understanding of the modern urban landscape as cities are increasingly centres of consumption.
Fabrication and Mechanical Properties of Chitosan/FHA Scaffolds
Authors: Salehi Majid , Molzemi Sahar
Published: July 2023

Fluor-hydroxyapatite (FHA) is a biomaterial with dental and orthopedic potential that is highly regarded as a result of bioactivity and high biocompatibility. Chitosan is used as a growth promoting agent in the tissues of the tooth and bone. Composite scaffold from these biomaterials is used as a pattern of natural bone and tooth grafts in tissue engineering. In this study FHA was synthesized through coprecipitation method. Then chitosan/FHA composites with different amounts of FHA (15 and 30 wt%) were prepared via freeze drying way. Structural and physical characteristics of the scaffolds were determined by powder X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) spectra, and morphological properties of the scaffolds were investigated using SEM evaluation. The compressive strength, water-uptake capacity, and biodegradation behavior of scaffolds were performed, as well. The results indicated that chitosan/30%FHA scaffold showed more compressive strength, lower biodegradation in phosphate buffer solution after 4 weeks. Therefore, it might be a suitable scaffold for tooth engineering.
Teachers’ Experiences of Keeping Special Education Students Informed of the COVID-19 Pandemic: A Qualitative Study
Authors: He Min , Li Shuangping
Published: July 2023

In times of such public health crisis as the COVID-19, staying well-informed can not only help people get prepared and make wise decisions, but also relieve anxiety. Students with disabilities, however, face great difficulty in keeping up-to-date on the pandemic. Using a qualitative research method, this study explored the experiences and perceived difficulties of special education teachers in trying to keep their students informed amid the COVID-19 pandemic. Semistructured focus group interviews were conducted with a total of 24 teachers from seven special education schools in China. The results showed that teachers adopted various measures to improve students’ information access, such as holding weekly class meetings, making use of posters and LED displays, working with families and collaborating with local health institutions. Despite these efforts, teachers reported facing multiple challenges and much remains to be desired. This research highlights the need for a holistic approach to providing information for students with disabilities, one that is tailored to their special needs and that involves other players in addition to teachers.
Isolated Word Sign Language Recognition Based on Improved SKResNet‐TCN Network
Authors: Xu Xuebin , Meng Kan , Chen Chen , Lu Longbin
Published: July 2023

This paper proposes an improved selective kernel network‐temporal convolutional (SKResNet‐TCN) network‐based video recognition model for isolated word sign language with too large parameters, large computation, and difficult to extract effective features. SKResNet uses grouped convolution to save computational cost while dynamically selecting feature information of different perceptual fields to improve the feature extraction ability of the model for video frame images, and TCN introduces causal and inflation convolution to take full advantage of computer parallel computing and reduce memory overhead during computation. The introduction of causal convolution and dilation convolution allows the network to take full advantage of computer parallel computing and reduce memory overhead during computation, and it can capture the feature information between consecutive frames. In this paper, we design a hybrid SKResNet‐TCN network model based on these two networks, and propose a solution of hybrid inflated convolution for the problem of losing information between data features in inflated convolution, using adaptive maximum pooling to preserve significant features of sign language instead of adaptive average pooling, and using Mish activation function to improve the generalization ability and accuracy of the model. The accuracy is 100% on the Argentine LSA64 dataset, and the experimental results show that the model in this paper has the advantages of fewer model parameters, smaller operations, and higher accuracy in sign language recognition compared with traditional 3D convolutional networks and long–short term memory, which effectively saves computational cost and time cost.
A comprehensive survey of automatic dysarthric speech recognition
Authors: Yadav Shailaja , Manik Yadav Dinkar , Ravindra Desai Kamalakar
Published: July 2023

The need for automated speech recognition has expanded as a result of significant industrial expansion for a variety of automation and human-machine interface applications. The speech impairment brought on by communication disorders, neurogenic speech disorders, or psychological speech disorders limits the performance of different artificial intelligence-based systems. The dysarthric condition is a neurogenic speech disease that restricts the capacity of the human voice to articulate. This article presents a comprehensive survey of the recent advances in the automatic dysarthric speech recognition (DSR) using machine learning (ML) and deep learning (DL) paradigms. It focuses on the methodology, database, evaluation metrics, and major findings from the study of previous approaches. From the literature survey it provides the gaps between exiting work and previous work on DSR and provides the future direction for improvement of DSR. The performance of the various machine and DL schemes is evaluated for the DSR on UASpeech dataset based on accuracy, precision, recall, and F1-score. It is observed that the DL based DSR schems outperforms the ML based DSR schemes.
Rove beetle collection (Coleoptera: Staphylinidae: Aleocharinae) in the State Museum of Natural History (Lviv, Ukraine)
Authors: GLOTOV SERHII V. , HUSHTAN KATERYNA V. , RIZUN VOLODYMYR B.
Published: July 2023

The collection of rove beetles of the subfamily Aleocharinae, stored in the State Museum of Natural History of the National Academy of Sciences of Ukraine (Lviv), has been catalogued. The catalog contains information about 2313 specimens of the collection, which belong to 278 species in 91 genera and 17 tribes. The overwhelming majority of the representatives of the subfamily Aleocharinae represented in the collection were collected on the territory of Ukraine, as well as in the modern territories of Europe, Africa, and Asia. The obtained data will later on provide an opportunity to expand the understanding of the distribution of species—specifically for faunal research, as well as for biogeographic study.
A new species of the genus Paraphyllina (Scyphozoa: Coronatae): Paraphyllina kubanci sp. nov. from the Sea of Marmara, Turkey
Authors: ARTÜZ M. LEVENT
Published: July 2023

On August 9, 2008, during the MAREM (Marmara Environmental Monitoring) project survey, a single specimen of an unknown Scyphozoa was caught with a deep-water vertical plankton haul, below the thermo-halocline interface, at maximum 1042 m hauling depth, in the Sea of Marmara (40°44'00″N, 08°00'03″E), Turkey. In the following years, 22 specimens, which ranged in diameter from 18 to 26 mm and had the same characteristics, were caught in the same water mass of the Sea of Marmara during MAREM monitoring surveys. The specimens seem to correspond most closely with the medusae described by Maas (1903), Neppi (1915), and Russell (1956). All these specimens were similar in their essential characteristics, but differed in some details. Likewise, Paraphyllina kubanci sp. nov. differs from other species of the genus in terms of some characteristics, especially in the S-shaped gonads and in the distribution of coloration. It is identified as a new species of the genus Paraphyllina and described here.
Psychiatry and gender equity: Creating change for our profession
Authors: Galbally Megan , Kotze Beth , Barber Ryan , Mackersey Sue
Published: July 2023

Objectives

The principles of gender equity are important to achieve the Royal Australian and New Zealand College of Psychiatrists (the College) strategic goals. (1) To present the data on gender equity, (2) To describe how the action plan was developed, (3) To discuss how this work aligns with a commitment to inclusion and diversity.

Methods

Firstly, the formation of a working group with representation from across the College. Secondly, undertaking a data snapshot and discussion paper on gender equity to support consultation. Thirdly, reviewing similar action plans, a literature review, and undertaking broad consultation across the College. Finally, collating data using a thematic analysis to support the development of an action plan.

Results

Data obtained on gender equity identified clear gaps in leadership roles, academic activities and awards. Our review and consultation identified themes focused on gaps in gender equity including a role for organisational leadership approach. Together this has then informed an action plan for gender equity for the College.

Conclusions

There are no simple solutions that will solve gender inequity; this requires systemic solutions to achieve meaningful change. However, the development of the action plan is a significant step towards addressing the current gender inequities.
Coexistence of multiple sclerosis and spinocerebellar ataxia type-8
Authors: Neyal Nur , Keegan B Mark , Kantarci Orhun H , Zeydan Burcu
Published: July 2023

Cerebellar dysfunction is likely to cause severe and treatment-resistant disability in multiple sclerosis (MS). Certain spinocerebellar ataxia (SCA)-related alleles can increase MS susceptibility, and channel polymorphisms can impact disability measures. Following an index patient with the coexistence of MS and SCA Type-8 (SCA8) in the MS clinic, an institutional engine search for MS and hereditary ataxia coexistence was conducted but did not reveal any other cases. This extremely rare coexistence of MS and SCA8 in our index patient may be incidental; however, a yet-to-be-identified contribution of coexistent hereditary ataxia(s) to the susceptibility of a prominent progressive ataxia MS phenotype cannot be ruled out.
Perceptions of a machine learning-based lower-limb exercise training system among older adults with knee pain
Authors: Chen Tianrong , Or Calvin Kalun
Published: July 2023

Objective

To facilitate the older adults with knee pain to perform exercises and improve knee health, we proposed the design of a machine learning-based system for lower-limb exercise training that features three main components: video demonstration of exercises, real-time movement feedback, and tracking of exercise progress. At this early stage of design, we aimed to examine the perceptions of a paper-based prototype among older adults with knee pain and investigate the factors that may influence their perceptions of the system.

Methods

A cross-sectional survey of the participants’ ( N = 94) perceptions of the system was conducted using a questionnaire, which assessed their perceived effects of the system, perceived ease of use of the system, attitude toward the system, and intention to use the system. Ordinal logistic regression was conducted to examine whether the participants’ perceptions of the system were influenced by their demographic and clinical characteristics, physical activity level, and exercise experience.

Results

The participants’ responses to the perception statements exhibited consensus agreement (≥ 75%). Age, gender, duration of knee pain, knee pain intensity, experience with exercise therapy, and experience with technology-supported exercise programs were significantly associated with the participants’ perceptions of the system.

Conclusions

Our results demonstrate that the system appears promising for use by older adults to manage their knee pain. Therefore, it is needed to develop a computer-based system and further investigate its usability, acceptance, and clinical effectiveness.
Impact of Population, Trade Openness, and Foreign Investment on India’s Environment: An Empirical Evaluation of a STIRPAT Model
Authors: Manocha Rinku
Published: July 2023

India is excelling in almost all parameters of economic development. However, India is experiencing economic development with a pinch of salt; massive climate and environmental changes are seen. As per Global Climate Risk Index 2021, India was ranked as the 7th worst climate hit country in the world. The present study is an attempt to empirically evaluate the impact of India’s economic growth, population, foreign investment, and trade openness on carbon emissions. The study adopts the STochastic Impacts by Regression on Population, Affluence and Technology (STIRPAT) framework augmented with the Environment Kuznet’s Curve (EKC) model with a time series data over the period 1971–2020. Results for unit root testing indicated the presence of mix stationarity for the variables, therefore, the autoregressive distributed lag approach was apt for capturing the long- and short-run dynamics. The results validated EKC for affluence and population. The outcome for FDI inflows and trade openness suggested the presence of pollution haven hypothesis for India. Policy initiatives toward green and sustainable production processes are suggested.
Antecedents and Consequences of Business Model Simulation: An Empirical Study with Leadership Support as Moderator
Authors: Chatterjee Sheshadri , Chaudhuri Ranjan , Vrontis Demetris , Galati Antonino
Published: July 2023

Business model simulation is a computer-based model for understanding business processes and firm dynamics. Simulating a business model in a laboratory helps one to understand the operational and strategic aspects of firms quickly, reliably and cost-effectively, enabling them to develop new financial and operational strategies. Not many studies have focused on antecedents of the business model simulation and their consequences. Therefore, the aim of this study is to determine the antecedents and consequences of business model simulation and to further analyse the moderating effects of leadership support. A theoretical model is proposed that takes inputs from the literature and resource-based view and dynamic capability theories. The partial least squares–structural equation modelling technique tested the model by analysing the quantified responses of 327 respondents. This study finds that business model simulation is significantly impacted by firms’ competitive intensity, innovative activities and technology strategy. The study also demonstrates that leadership support moderates the relationship between business model simulation and actual business practices. The study contributes that business model simulation, which is affected by salient predictors, can impact firm performance when mediated through actual business process and practices and with the moderating effects of leadership support.
Community-Based Approach to Promote Rational Use of Antibiotics in Indonesia: The Development and Assessment of an Education Program for Cadres
Authors: Christanti JV , Setiadi AP , Setiawan E , Presley B , Halim SV , Wardhani SA , Sunderland B , Wibowo YI
Published: July 2023

Background

Cadres play an important part in providing community-based education. This study developed and assessed an education program for cadres in Malang, Indonesia, as ‘change agents’ to promote rational antibiotic use.

Methods

In-depth-interviews with stakeholders ( N = 55) and a subsequent group discussion with key personnel ( N = 5) were conducted to develop a relevant education tool for cadres. This was followed with a pilot study with cadres ( N = 40) to assess the effectiveness and acceptability of the new tool.

Results

Consensus was reached on the education tool media: an audio-recording (containing full information) with a pocketbook (containing key information) as a supplement. A pilot study on the new tool reported its effectiveness in improving knowledge ( p < 0.001) and demonstrated a high acceptability (all respondents stated ‘Strongly Agree’ or ‘Agree’ on all statements).

Conclusion

This study has created a model for an education tool which can potentially be implemented for cadres to educate their communities about antibiotics in the Indonesian context.
Preferred mode of delivery association with the body image and genital image in pregnant women - a cross-sectional study
Authors: Khosravi Hamideh , Mehrbakhsh Zahra , Moghasemi Sedigheh , Samiei Ghazale
Published: July 2023

Background

Pregnant women experience several changes in their appearance, body shape and body image. In some studies, there has been a relationship between these changes and the type of delivery. This study aimed to investigate the relationship of the prenatal body image and genital image with the mode of delivery preferred by pregnant women in Gorgan in 2020.

Methods

In this cross-sectional study, 334 pregnant women were selected by stratified sampling. The Prenatal Body Image Questionnaire (PBIQ), Female Genital Self-Image Scale (FGSIS), pregnant women’s preferences for mode of delivery questionnaire (PPMDQ) and DASS-21 were completed on line. The data was analyzed using Spearman test and linear regression.

Results

The average score of PBIQ, FGSIS, and PPMDQ was 68.24 (standard deviation = 17.71), 19.25 (standard deviation = 3.3), and 63.12 (standard deviation = 3.3) respectively. Vaginal delivery as a preferred mode of delivery was inversely correlated with dissatisfaction with body image (r=-0.32, P < 0.001), and directly correlated with satisfaction with the genital image (r = 0.19, P < 0.001). There was a significant inverse correlation between prenatal body image dissatisfaction and genital image satisfaction (r=-0.32, P < 0.001). While FGSIS score could not predict PPMDQ, PBIQ score could.

Conclusions

Satisfaction with the prenatal body image or genital image is associated with the choice of vaginal delivery. These results can be the basis for prenatal care and childbirth counselling.
Being pregnant and becoming a parent during the COVID-19 pandemic: a longitudinal qualitative study with women in the Born in Bradford COVID-19 research study
Authors: Jackson Cath , Brawner June , Ball Matthew , Crossley Kirsty , Dickerson Josie , Dharni Nimarta , Rodriguez Diego Garcia , Turner Ella , Sheard Laura , Smith Helen
Published: July 2023

Background

Uncertainty around the risk of COVID-19 to pregnant women and their babies prompted precautionary restrictions on their health and care during the pandemic. Maternity services had to adapt to changing Government guidance. Coupled with the imposition of national lockdowns in England and restrictions on daily activities, women’s experiences of pregnancy, childbirth and the postpartum period, and their access to services, changed rapidly. This study was designed to understand women’s experiences of pregnancy, labour and childbirth and caring for a baby during this time.

Methods

This was an inductive longitudinal qualitative study, using in-depth interviews by telephone with women in Bradford, UK, at three timepoints during their maternity journey (18 women at timepoint one, 13 at timepoint two and 14 at timepoint three). Key topics explored were physical and mental wellbeing, experience of healthcare services, relationships with partners and general impact of the pandemic. Data were analysed using the Framework approach. A longitudinal synthesis identified over-arching themes.

Results

Three longitudinal themes captured what was important to women: (1) women feared being alone at critical points in their maternity journey, (2) the pandemic created new norms for maternity services and women’s care, and (3) finding ways to navigate the COVID-19 pandemic in pregnancy and with a baby.

Conclusions

Modifications to maternity services impacted significantly on women’s experiences. The findings have informed national and local decisions about how best to direct resources to reduce the impact of COVID-19 restrictions and the longer-term psychological impact on women during pregnancy and postnatally.
Association and comparison of periodontal and oral hygiene status with serum HbA1c levels: a cross-sectional study
Authors: Rahim Abid , Hassan Sabreen , Ullah Naeem , Noor Nawal , Ahmed  , Rafique Rimsha , Khattak Farhad Ali , Afaq Saima
Published: July 2023

Background

Diabetes Mellitus and periodontitis are chronic diseases with known reciprocal association. Studies have shown that uncontrolled diabetes increases the risk of development and progression of periodontal disease. This study aimed to explore the association and severity of periodontal clinical parameters and oral hygiene with HbA1c levels in non-diabetics and T2DM patients.

Materials and methods

In this cross-sectional study, the periodontal status of 144 participants, categorized into non-diabetics, controlled T2DM, and uncontrolled T2DM and were assessed via the Community Periodontal Index (CPI), Loss of Attachment Index (LOA index), and the number of missing teeth, while oral hygiene was measured by utilizing the Oral Hygiene Index Simplified (OHI-S). SPSS was used for data analysis. Chi-square test was used to find out the association of different independent variables with HbA1c groups, while ANOVA and post-hoc tests were run for inter-group and intra-group comparison respectively.

Results

Out of 144 participants, the missing dentition was prevalent in uncontrolled T2DM with mean 2.64 ± 1.97 (95% CI 2.07–3.21; p = 0.01) followed by controlled T2DM 1.70 ± 1.79 (95% CI 1.18–2.23; p = 0.01) and non-diabetics 1.35 ± 1.63 (95% CI 0.88–1.82; p = 0.01) respectively. Furthermore, non-diabetics had a higher proportion of CPI score 0 (Healthy) [30 (20.8%); p = 0.001] as compared to uncontrolled T2DM [6 (4.2%); p = 0.001], while CPI score 3 was more prevalent in uncontrolled T2DM in comparison to non-diabetics. Loss of attachment (codes-2,3 and 4) was also frequently observed in uncontrolled T2DM compared to non-diabetics (p = 0.001). Similarly, based on Oral Hygiene Index- Simplified (OHI-S), the result showed that poor oral hygiene was most commonly observed in uncontrolled T2DM 29 (20.1%) followed by controlled T2DM patients 22 (15.3%) and non-diabetic [14 (9.7%); p = 0.03].

Conclusion

This study showed that periodontal status and oral hygiene status were deteriorated in uncontrolled T2DM patients compared to non-diabetic participants and controlled T2DM.
Oral mycotic infection caused by a rare Verticillium species – a case report
Authors: Habib Saqib , Naved Nighat , Awan Muhammad Sohail
Published: July 2023

Background

Deep-seated fungal infections of the oral cavity present a diagnostic challenge as the clinical presentation is usually aggressive leading to misdiagnosis of malignancy. Nevertheless, the species of fungi responsible for such diseases in immunocompromised individuals are varied thus, further complicating the diagnosis.

Case presentation

Presented below is a case regarding the diagnosis and management of deep mycotic infection of the oral cavity caused by a fungus that very rarely causes disease in humans, the Verticillium species.

Conclusions

The case highlights the fact that rare pathogens should also be considered in the differential diagnosis, especially in patients with debilitating conditions like uncontrolled diabetes. Likewise, histopathological evaluation and microbiological investigations are of paramount importance and remain the gold standard to reach a definitive diagnosis.
Development and evaluation of a customized checklist to assess the quality control of disease registry systems of Tehran, the capital of Iran in 2021
Authors: Barzin Maryam , Sabbaghi Hamideh , Kamfar Sharareh , Seifi Atena , Hajipour Mahmoud , Siri Fatemeh Hadavand , Mir-Moeini Elham , Gharajeh Anis , Ferdosifard Nasrin , Panahi Mohammadhossein , Nazari Seyed Saeed Hashemi , Atatalab Fatemeh Fallah , Etemad Koorosh
Published: July 2023

Background

Clinical registries facilitate medical research by providing ‘real data’. In the past decade, an increasing number of disease registry systems (DRS) have been initiated in Iran. Here, we assessed the quality control (QC) of the data recorded in the DRS established by Shahid Beheshti University of Medical Sciences in Tehran, the capital city of Iran, in 2021.

Methods

The present study was conducted in two consecutive qualitative and quantitative phases and employed a mixed-method design. A checklist containing 23 questions was developed based on a consensus reached following several panel group discussions, whose face content and construct validities were confirmed. Cronbach’s alpha was calculated to verify the tool’s internal consistency. Overall, the QC of 49 DRS was assessed in six dimensions, including completeness, timeliness, accessibility, validity, comparability, and interpretability. The seventy percent of the mean score was considered a cut-point for desirable domains.

Results

The total content validity index (CVI) was obtained as 0.79, which is a reasonable level. Cronbach’s alpha coefficients obtained showed acceptable internal consistency for all of the six QC domains. The data recorded in the registries included different aspects of diagnosis/treatment (81.6%) and treatment quality requirements outcomes (12.2%). According to the acceptable quality cut-point, out of 49 evaluated registries, 48(98%), 46(94%), 41(84%), and 38(77.5%), fulfilled desirable quality scores in terms of interpretability, accessibility, completeness, and comparability, however, 36(73.5%) and 32(65.3%) of registries obtained the quality requirement for timeliness and validity, respectively.

Conclusion

The checklist developed here, containing customized questions to assess six QC domains of DRSs, provided a valid and reliable tool that could be considered as a proof-of-concept for future investigations. The clinical data available in the studied DRSs fulfilled desirable levels in terms of interpretability, accessibility, comparability, and completeness; however, timeliness and validity of these registries needed to be improved.
Mathematical pharmacodynamic modeling for antimicrobial assessment of ceftazidime/colistin versus gentamicin/meropenem combinations against carbapenem-resistant Pseudomonas aeruginosa biofilm
Authors: Badawy Mona Shaban E. M. , Elkhatib Walid F. , Shebl Rania I.
Published: July 2023

Background

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) represents an escalating healthcare hazard with high mortality worldwide, especially in presence of biofilm. The current study aimed to evaluate the anti-biofilm potentials of ceftazidime, colistin, gentamicin, and meropenem alone and in combinations against biofilm-forming CRPA.

Methods

Biofilm killing and checkerboard assay were performed to detect the effectiveness of combined antibiotics against biofilms and planktonic cells, respectively. The bacterial bioburden retrieved from the established biofilms following treatment with combined antibiotics was utilized to construct a three-dimensional response surface plot. A sigmoidal maximum effect model was applied to determine the pharmacodynamic parameters (maximal effect, median effective concentration, and Hill factor) of each antibiotic to create a mathematical three-dimensional response surface plot.

Results

Data revealed statistically significant (p < 0.05) superior anti-biofilm potential in the case of colistin followed by a lower effect in the case of gentamicin and meropenem, while ceftazidime exhibited the least anti-biofilm activity. The fractional inhibitory concentration index (FICI ≤ 0.5) indicated synergism following treatment with the combined antibiotics. An elevated anti-biofilm activity was recorded in the case of gentamicin/meropenem compared to ceftazidime/colistin. Synergistic anti-biofilm potentials were also detected via the simulated pharmacodynamic modeling, with higher anti-biofilm activity in the case of the in vitro observation compared to the simulated anti-biofilm profile.

Conclusions

The present study highlighted the synergistic potentials of the tested antibiotic combinations against P. aeruginosa biofilms and the importance of the mathematical pharmacodynamic modeling in investigating the efficacy of antibiotics in combination as an effective strategy for successful antibiotic therapy to tackle the extensively growing resistance to the currently available antibiotics.
Spontaneously hypertensive rats can become hydrocephalic despite undisturbed secretion and drainage of cerebrospinal fluid
Authors: Lolansen Sara Diana , Barbuskaite Dagne , Ye Fenghui , Xiang Jianming , Keep Richard F. , MacAulay Nanna
Published: July 2023

Background

Hydrocephalus constitutes a complex neurological condition of heterogeneous origin characterized by excessive cerebrospinal fluid (CSF) accumulation within the brain ventricles. The condition may dangerously elevate the intracranial pressure (ICP) and cause severe neurological impairments. Pharmacotherapies are currently unavailable and treatment options remain limited to surgical CSF diversion, which follows from our incomplete understanding of the hydrocephalus pathogenesis. Here, we aimed to elucidate the molecular mechanisms underlying development of hydrocephalus in spontaneously hypertensive rats (SHRs), which develop non-obstructive hydrocephalus without the need for surgical induction.

Methods

Magnetic resonance imaging was employed to delineate brain and CSF volumes in SHRs and control Wistar-Kyoto (WKY) rats. Brain water content was determined from wet and dry brain weights. CSF dynamics related to hydrocephalus formation in SHRs were explored in vivo by quantifying CSF production rates, ICP, and CSF outflow resistance. Associated choroid plexus alterations were elucidated with immunofluorescence, western blotting, and through use of an ex vivo radio-isotope flux assay.

Results

SHRs displayed brain water accumulation and enlarged lateral ventricles, in part compensated for by a smaller brain volume. The SHR choroid plexus demonstrated increased phosphorylation of the Na+/K+/2Cl− cotransporter NKCC1, a key contributor to choroid plexus CSF secretion. However, neither CSF production rate, ICP, nor CSF outflow resistance appeared elevated in SHRs when compared to WKY rats.

Conclusion

Hydrocephalus development in SHRs does not associate with elevated ICP and does not require increased CSF secretion or inefficient CSF drainage. SHR hydrocephalus thus represents a type of hydrocephalus that is not life threatening and that occurs by unknown disturbances to the CSF dynamics.
The place of new antibiotics for Gram-negative bacterial infections in intensive care: report of a consensus conference
Authors: Dequin Pierre-François , Aubron Cécile , Faure Henri , Garot Denis , Guillot Max , Hamzaoui Olfa , Lemiale Virginie , Maizel Julien , Mootien Joy Y. , Osman David , Simon Marie , Thille Arnaud W. , Vinsonneau Christophe , Kuteifan Khaldoun
Published: July 2023

Introduction

New beta-lactams, associated or not with beta-lactamase inhibitors (NBs/BIs), can respond to the spread of carbapenemase-producing enterobacteriales and nonfermenting carbapenem-resistant bacteria. The risk of emergence of resistance to these NBs/BIs makes guidelines necessary. The SRLF organized a consensus conference in December 2022.

Methods

An ad hoc committee without any conflict of interest (CoI) with the subject identified the molecules (ceftolozane–tazobactam, ceftazidime–avibactam, imipenem–cilastatin–relebactam, meropenem–vaborbactam and cefiderocol); defined 6 generic questions; drew up a list of subquestions according to the population, intervention, comparison and outcomes (PICO) model; and reviewed the literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Seven experts in the field proposed their own answers to the questions in a public session and answered questions from the jury (a panel of 10 critical-care physicians without any CoI) and the public. The jury then met alone for 48 h to write its recommendations. Due to the frequent lack of powerful studies that have used clinically important criteria of judgment, the recommendations were formulated as expert opinions as often as necessary.

Results

The jury provided 17 statements answering 6 questions: (1) Is there a place in the ICU for the probabilistic use of new NBs/IBs active against Gram-negative bacteria? (2) In the context of documented infections with sensitivity to several of these molecules, are there pharmacokinetic, pharmacodynamic, ecological or medico-economic elements for prioritization? (3) What are the possible combinations with these molecules and in what context? (4) Should we integrate these new molecules into a carbapenem-sparing strategy? (5) What pharmacokinetic and pharmacodynamic data are available to optimize their mode of administration in critically ill patients? (6) What are the dosage adaptations in cases of renal insufficiency, hepatocellular insufficiency or obesity?

Conclusion

These recommendations should optimize the use of NBs/BIs in ICU patients.
Data collection in pandemic times: the case of the Belgian COVID-19 health surveys
Authors: Braekman Elise , Charafeddine Rana , Berete Finaba , Bruggeman Helena , Drieskens Sabine , Gisle Lydia , Hermans Lize , Van der Heyden Johan , Demarest Stefaan
Published: July 2023

Background

Survey data were needed to assess the mental and social health, health related behaviors and compliance with preventive measures of the population during the COVID-19 pandemic. Yet, the pandemic challenged classical survey methods. Time and budgetary constraints at the beginning of the pandemic led to ad hoc recruitment of participants and easily manageable data collection modes. This paper describes the methodological choices and results in terms of participation for the COVID-19 health surveys conducted in Belgium.

Methods

The COVID-19 health surveys refer to a series of ten non-probability web surveys organized between April 2020 and March 2022. The applied recruitment strategies were diverse including, amongst others, a launch through the website and the social media of the organizing research institute. In addition, the survey links were shared in articles published in the national press and participants were requested to share the surveys in their network. Furthermore, participants were asked consent to be re-contacted for next survey editions using e-mail invitations.

Results

These mixed approaches allowed to reach a substantial number of participants per edition ranging from 49339 in survey 1 to 13882 in survey 10. In addition, a longitudinal component was created; a large share of the same individuals were followed up over time; 12599 participants completed at least 5 surveys. There were, however, sex, age, educational level and regional differences in participation. Post-stratification weighting on socio-demographic factors was applied to at least partly take this into account.

Conclusion

The COVID-19 health surveys allowed rapid data collection after the onset of the pandemic. Data from these non-probability web surveys had their limitations in terms of representativeness due to self-selection but were an important information source as there were few alternatives. Moreover, by following-up the same individuals over time it was possible to study the effect of the different crisis phases on, amongst others, the mental health. It is important to draw lessons from these experiences: initiatives in order to create a survey infrastructure better equipped for future crises are needed.
Graphene quantum dot nanocomposites: electroanalytical and optical sensor technology perspective
Authors: Ja’farawy Muhammad Shalahuddin Al , Thirumalai Dinakaran , Lee Jaewon , Jung Ho Sang , Chang Seung-Cheol , Yoon Jang-Hee , Kim Dong-Ho
Published: July 2023

Electroanalytical and optical techniques are widely used in the development of nanomaterials-based sensor platforms. These techniques have a quick response, high sensitivity, and selectivity. Electroanalytical and optical techniques are widely used in the development of nanomaterial-based sensor platforms. These sensors must be able to detect biomarkers, pathogens, toxins, and pharmaceuticals in biological matrices associated with cardiovascular disease, cancer, and neurodegenerative diseases. Considering these pathophysiologies, numerous investigations have been undertaken to develop sensors for early diagnosis and treatment, utilizing nanomaterials such as quantum dots. Graphene quantum dots (GQDs), which are ideally nanometer-sized graphene fragments, have recently received increased attention due to their excellent physicochemical properties such as fast electron mobility, photostability, water solubility, biocompatibility, high specific surface area, and nontoxicity. Apart from the properties mentioned above, GQDs provideπ–πinteractions, electrostatic, and covalent interactions with an analyte, and ease of synthesis as well as the ability to combine with other nanomaterials, which have enabled their use in various sensing platforms. This review summarizes recent advances in GQDs-based nanocomposites for sensor applications, with a focus on electroanalytical and optical techniques, as well as current challenges and future prospects.