bluuebunny/crossref_metadata_2025 huggingface dataset:
25‐hydroxyvitamin D sufficiency is associated with lower de novo anti‐HLA donor specific antibody and better kidney transplant outcomes
Authors: Bakis Hugo , Bouthemy Charlène , Corcuff Jean‐Benoît , Lauro Cindy , Guidicelli Gwendaline , Cargou Marine , Guibet Claire , Taton Benjamin , Merville Pierre , Couzi Lionel , Moreau Karine , Visentin Jonathan
Published: August 2023

T‐cell mediated rejection (TCMR), de novo anti‐HLA donor‐specific antibodies (dnDSAs) and ensuing antibody‐mediated rejection (ABMR) reduce kidney transplantation (KT) survival. The immunomodulatory effects of 25‐hydroxyvitamin D [25(OH)D] could be beneficial for KT outcomes. We aimed to evaluating the association between 25(OH)D levels, the development of dnDSAs, clinical TCMR and ABMR, and graft survival. This single center retrospective study included 253 KT recipients (KTRs) transplanted without preformed DSA between 2010 and 2013. We measured 25(OH)D in successive serum samples: at KT (M0) and M12 for the entire cohort, and additionally at M24 and/or M36 when sera were available. We assessed graft outcomes up to 5 years post‐KT. The proportion of KTRs having sufficient 25(OH)D at KT (M0) was high (81.4%) and then dropped at M12 (71.1%). KTRs with sufficient 25(OH)D at M0 experienced less clinical TCMR (HR, 0.41; 95% CI, 0.19–0.88 in multivariate analysis). A sufficient 25(OH)D at M12 was independently associated with a longer dnDSA‐free survival (HR, 0.34; 95% CI, 0.17–0.69). There was no association between 25(OH)D and clinical AMBR. Studying the KTRs with 25(OH)D measurements at M12, M24 and M36 (n = 203), we showed that 25(OH)D sufficiency over the 3 first‐years post‐KT was associated with a longer graft survival in multivariate analyses (HR, 0.39; 95% CI, 0.22–0.70). To our knowledge, this study is the first showing an association between 25(OH)D sufficiency post‐KT and dnDSA occurrence in KTRs. Moreover, we reinforce previously published data showing an association between 25(OH)D, TCMR and graft survival in KT.
Characterization of the novel HLA‐DRB1*11:01:01:12N allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Cambridge Charlotte A. , Lasseaux Eulalie , Visentin Jonathan
Published: August 2023

HLA‐DRB1*11:01:01:12N differs from HLA‐DRB1*11:01:01:03 by one nucleotide substitution in intron 3 at position c.652+1G>C, hg19.
Reframing morning report: Cognitive simulation in a safe space
Authors: Villacres Sindy , Hinds Autumn , Fagan Heather , Kahana Madelyn
Published: August 2023

Background

Various purposes for morning report (MR), in addition to education, have been cited in the literature. Learners can find traditional MR challenging secondary to a perceived lack of psychological safety, the sense that they are being evaluated. Despite the recognition of unsafe learning environments, there is a paucity of literature on how to promote psychological safety in the MR setting.

Approach

Our aim was to create an MR format utilizing scientifically proven teaching strategies to enhance its educational value. The creation of a safe learning environment was at the forefront of this initiative. Using Kern's six steps of curriculum development, we describe one institution's experience in reframing the morning report experience.

Results

We conducted a pilot trial of the new MR with 35 paediatric residents beginning in July 2020 and followed the resident experience over 2 years. The primary outcome was attitudinal data as measured via a Likert scale. We found that by the second‐year post‐curricular implementation, greater than 50% of residents were less hesitant to participate in conference, increased their practice of retrieval and perceived feeling more prepared for examinations as the curriculum progressed.

Implications

We believe the use of proven teaching strategies based in the cognitive psychology of learning can enhance the quality of education. Furthermore, we believe that central to the success of learning is the perception that the classroom is a safe space to be wrong. This model can serve as a steppingstone for institutions that look to improve their MR series.
From Hegemonic to Where? The Public Spatialities of Shifting Positionings for Those Who Are Opposed to/Concerned About Socio‐Legal Changes in Sexual and Genders
Authors: Browne Kath , Nash Catherine J.
Published: August 2023

In 21st‐century Ireland, Canada and the Great Britain, significant changes to sexual and gender legislation, abortion access and associated social and cultural life include the legalisation of same‐sex marriage, employment rights, access to abortion and self‐identification/gender recognition. This paper draws on interviews from the Beyond Opposition research to explore the experiences of those who are concerned about and/or actively oppose these socio‐legal changes. We consider participants understandings of themselves as losing power within social relations and the ways in which their positionings can be seen as excluded or marginalised in public spaces. Examining their experiences of public space offers insights into experiences of new power relations, including state sanctions, that contest binaries of marginalisation/privilege. These positions between marginalisation/privilege, illustrate the effectiveness and limitations of framing these views as ‘unacceptable’ in public arenas. Operating between marginal/privileged requires a reworking of these 20th Century paradigms for 21st Century social divisions.
Nontuberculous mycobacterial infections in patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation
Authors: El Zein Said , Mendoza Maria A. , Wilson John W.
Published: August 2023

Background

The incidence of mycobacterial infections in patients with hematologic malignancies and hematopoietic stem cell transplant (HSCT) recipients is increasing, contributing to significant mortality and morbidity. This review explores the epidemiology, risk factors, clinical presentation, diagnosis, and treatment of nontuberculous mycobacteria (NTM) in this population.

Methods

A literature search was performed using PubMed with keywords and MeSH terms pertaining to the topics of nontuberculous mycobacteria, hematologic malignancies, hematopoietic stem cell transplant, cellular therapies, chimeric antigen therapies, epidemiology, diagnosis, and treatment. Additionally, we examined the reference lists of the included articles to identify other pertinent studies.

Results

Diagnosing mycobacterial disease among patients with hematologic disease and treatment‐associated immunosuppressive conditions is challenging due to the lack of distinctive clinical, radiographic, and laboratory markers, as well as the atypical manifestations compared to immunocompetent patients. Treatment involves using a combination of antibiotics for extended durations, coupled with strategies to achieve source control and reduce immunosuppression when feasible. This is complicated by the absence of clear data correlating in‐vitro drug susceptibility and clinical outcome for many antimicrobials use to treat NTM, adverse drug‐drug interactions, and the frequent challenges related to poor medication tolerability and toxicities.

Conclusion

The rising incidence and corresponding clinical challenges of mycobacterial infections in this unique patient population necessitate a heightened awareness and familiarity of NTM disease by clinicians to achieve timely diagnosis and favorable treatment outcomes.

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What's ‘left’ for a ‘geopolitical Europe’?
Authors: Bialasiewicz Luiza
Published: August 2023

How can political geographers bring their critical tools to questioning the EU's ‘geopolitical turn’? This commentary challenges the narrative of an EU‐wide ‘Zeitenwende’, pointing out some of the limitations of a ‘geopolitical Europe’ as it is being envisioned currently, while also noting the divided geographies of Europeans’ support for continued military assistance to Ukraine. In closing, the piece points to some of the perils of the rhetoric of ‘no alternative’ in EU geopolitics, noting how it risks leaving the discursive space open to illiberal political forces.
Platelet transfusion in critical care: A new method to analyze transfusion practice based on decision time intervals
Authors: Dzik Walter Sunny , Healy Brian , Brunker Patricia , Ruby Kristen , Collins Julia , Paik Hyun‐il , Berra Lorenzo , Shelton Kenneth , North Crystal M. , Makar Robert
Published: August 2023

Background

While prior studies of platelet transfusion in critical care have focused on transfusions given, proper analysis of clinical transfusion practice also requires consideration of the decision not to transfuse.

Study Design and Methods

We introduce a new method to assess transfusion practice based on decision time intervals (DTIs). Each patient's intensive care (ICU) stay was segmented into a series of DTIs defined by a time interval following results of a complete blood count (CBC). We studied the presence of 17 clinical factors during each DTI whether transfusion was given or not. We used a generalized linear mixed model to assess the most influential clinical triggers for platelet transfusion.

Results

Among 6125 ICU patients treated between October 2016 and October 2021, we analyzed 39,745 DTIs among patients (n = 2921) who had at least one DTI with thrombocytopenia (≤150,000/μL). We found no association between platelet count and two markers of bleeding: drop in hemoglobin and chest tube drainage. We found that the majority of DTIs were associated with no platelet transfusion regardless of the platelet count; that no specific platelet value triggered transfusion; but rather that multiple clinical factors in conjunction with the platelet count influenced the decision to transfuse.

Discussion

DTI analysis represents a new method to assess transfusion practice that considers both transfusions given and not given, and that analyzes clinical circumstances present when decisions regarding transfusion are made. The method is easily adapted to blood components other than platelet transfusions and is easily extended to other ICU and other hospital settings.
A new look to the tourism and economic growth nexus: A clustering and panel causality analysis
Authors: Albaladejo Isabel P. , Brida Juan Gabriel , González‐Martínez María Isabel , Segarra Verónica
Published: August 2023

This paper explores the dynamic relationship between tourism and economic growth using panel data for 144 countries over the period 1995–2019. The study was carried out in two steps. First, the set of countries was classified by considering simultaneously two criteria, tourism and the economic development of the countries over time. Two classifications of homogeneous countries with four clusters each are obtained using a non‐parametric methodology and two tourism indicators. Second, the Granger causality was tested for each of the identified groups and the entire sample. The results determined that there were significant differences between clusters and that causality from tourism to economic growth could only be verified for the group of countries with low income and low tourism. This relationship was confirmed by estimating impulse response functions, which showed a positive response of economic growth to innovations in tourism. The tourism sector could, therefore, be a way out of poverty and generate development and prosperity in low‐income countries that are in the early stages of tourism development.
On vacuum free boundary problems in ideal compressible magnetohydrodynamics
Authors: Secchi Paolo , Trakhinin Yuri , Wang Tao
Published: August 2023

We survey some recent results on vacuum free boundary problems in three‐dimensional ideal compressible magnetohydrodynamics, restate the main theorems in our works (Secchi and Trakhinin, Nonlinearity 27(1) (2014) 105–169; Trakhinin and Wang, Arch. Ration. Mech. Anal. 239(2) (2021) 1131–1176; Trakhinin and Wang, Math. Ann. 383(1–2) (2022) 761–808; Trakhinin and Wang, SIAM J. Math. Anal. 54(6) (2022) 5888–5921), and provide an alternative proof for the linear well‐posedness of the full plasma–vacuum interface problem under the noncollinearity condition.
Monodromy of subrepresentations and irreducibility of low degree automorphic Galois representations
Authors: Hui Chun Yin
Published: August 2023

Let be a smooth, separated, geometrically connected scheme defined over a number field and a system of semisimple ‐adic representations of the étale fundamental group of such that for each closed point of , the specialization is a compatible system of Galois representations under mild local conditions. For almost all , we prove that any type A irreducible subrepresentation of is residually irreducible. When is totally real or CM, , and is the compatible system of Galois representations of attached to a regular algebraic, polarized, cuspidal automorphic representation of , for almost all , we prove that is (i) irreducible and (ii) residually irreducible if in addition .
Localizations for quiver Hecke algebras II
Authors: Kashiwara Masaki , Kim Myungho , Oh Se‐jin , Park Euiyong
Published: August 2023

We prove that the localization of the monoidal category is rigid, and the category admits a localization via a real commuting family of central objects. For a quiver Hecke algebra and an element in the Weyl group, the subcategory of the category of finite‐dimensional graded ‐modules categorifies the quantum unipotent coordinate ring . In the previous paper, we constructed a monoidal category such that it contains and the objects corresponding to the frozen variables are invertible. In this paper, we show that there is a monoidal equivalence between the category and . Together with the already known left‐rigidity of , it follows that the monoidal category is rigid. If in the Bruhat order, there is a subcategory of that categorifies the doubly‐invariant algebra . We prove that the family of simple ‐module forms a real commuting family of graded central objects in the category so that there is a localization of in which are invertible. Since the localization of the algebra by the family of the isomorphism classes of is isomorphic to the coordinate ring of the open Richardson variety associated with and , the localization categorifies the coordinate ring .
A cross‐sectional study of ageing at the mouse neuromuscular junction and effects of an experimental therapeutic approach for dynapenia
Authors: Li Y. , Patel M. , Baroudi J. , Wu M. , Gatti S. , Liang M. , Wipf P. , Badawi Y. , Meriney Stephen D.
Published: August 2023

Despite prior efforts to understand and target dynapenia (age‐induced loss of muscle strength), this condition remains a major challenge that reduces the quality of life in the aged population. We have focused on the neuromuscular junction (NMJ) where changes in structure and function have rarely been systematically studied as a dynamic and progressive process. Our cross‐sectional study found neurotransmission at the male mouse NMJ to be biphasic, displaying an early increase followed by a later decrease, and this phenotype was associated with structural changes to the NMJ. A cross‐sectional characterization showed that age‐induced alterations fell into four age groups: young adult (3–6 months), adult (7–18 months), early aged (19–24 months), and later aged (25–30 months). We then utilized a small molecule therapeutic candidate, GV‐58, applied acutely during the later aged stage to combat age‐induced reductions in transmitter release by increasing calcium influx during an action potential, which resulted in a significant increase in transmitter release. This comprehensive study of neuromuscular ageing at the NMJ will enable future research to target critical time points for therapeutic intervention.

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Key points

Age‐induced frailty and falls are the leading causes of injury‐related death and are caused by an age‐induced loss of muscle strength due to a combination of neurological and muscular changes.

A cross‐sectional approach was used to study age‐induced changes to the neuromuscular junction in a mouse model, and physiological changes that were biphasic over the ageing time course were found.

Changes in physiology at the neuromuscular junction were correlated with alterations in neuromuscular junction morphology.

An acutely applied positive allosteric gating modifier of presynaptic voltage‐gated calcium channels was tested as a candidate therapeutic strategy that could increase transmitter release at aged neuromuscular junctions.

These results provide a detailed time course of age‐induced changes at the neuromuscular junction in a mouse model and test a candidate therapeutic strategy for weakness.
Feasibility of Using Topographic Data by TOPODATA Image in Urban Drainage Projects
Authors: Sousa Lilian Paixao Aleixo de , Fernandes Lindemberg Lima , Bittencourt Germana Menescal
Published: August 2023

In general, the urbanization process in cities increases the impermeabilization of the soil, increasing surface runoff, leading the population to suffer from risks of flooding. In this context, the design of the drainage system is fundamental, which depends on the terrain characteristics. The total station is one of the most used equipment in topographic survey in field service. With the technological advance, it is possible to obtain this information remotely, as through satellite image with the aid of geoprocessing software. Thus, the objective of this research was to carry out a feasibility study on the use of topographic data obtained by TOPODATA Project images generated by Instituto Nacional de Pesquisas Espaciais - INPE in an urban drainage project. The seat of the municipality of Ipixuna do Pará was adopted as study area, where altimetry information was obtained by total station and by TOPODATA images. The interpolation kriging method was used to generate the contour lines and the Digital Terrain Model (DTM). To evaluate the performance of the TOPODATA data, the Pearson correlation coefficient test (R) and the Root Mean Square Error (RMSE) were used. For the microdrainage project, an area of approximately 14 hectares was delimited within the municipality's seat. From the statistical analysis, satisfactory results were obtained with R of 0.81, a “very high” correlation; and the RMSE of 1.27 m in the project area. Therefore, it was verified that it is feasible to use the TOPODATA image in the altimetry survey for areas considered small, with good correlation, considering the agility in obtaining the data, allowing access to information in places of difficult access, in addition to the economic aspect.
An overview of ultrasound-derived radiomics and deep learning in liver
Authors: Zhang Di , Zhang Xian-Ya , Duan Ya-Yang , Dietrich Christoph F , Cui Xin-Wu , Zhang Chao-Xue
Published: August 2023

Over the past few years, developments in artificial intelligence (AI), especially in radiomics and deep learning, have enabled the extraction of pathophysiology-related information from varied medical imaging and are progressively transforming medical practice. AI applications are extending into domains previously thought to be accessible only to human experts. Recent research has demonstrated that ultrasound-derived radiomics and deep learning represent an enticing opportunity to benefit preoperative evaluation and prognostic monitoring of diffuse and focal liver disease. This review summarizes the application of radiomics and deep learning in ultrasound liver imaging, including identifying focal liver lesions and staging of liver fibrosis, as well as the evaluation of pathobiological properties of malignant tumors and the assessment of recurrence and prognosis. Besides, we identify important hurdles that must be overcome while also discussing the challenges and opportunities of radiomics and deep learning in clinical applications.
Classification of solutions for guided waves in fluid-loaded viscoelastic composites with large numbers of layers
Authors: Huber Armin M. A.
Published: August 2023

Guided ultrasonic waves are used for the inspection of multilayered composite aerospace structures. Calculating the corresponding dispersion diagrams is challenging for thick-walled composites with more than 100 layers, such as in modern rocket booster pressure vessels. The Dispersion Calculator (DC) is an open source software for calculating such dispersion diagrams and mode shapes of guided waves. Attenuation caused by viscoelasticity and fluid-loading makes the dispersion curve tracing much more difficult than in the nonattenuated case because the modal solutions are sought in the complex wavenumber plane. The tracing problem is mastered by a reliable algorithm. Whereas leaky Lamb and Scholte waves in coupled and decoupled cases are modeled using the stiffness matrix method, shear horizontal (SH) waves are traced using the transfer matrix method without facing the numerical instability. Through implementation of mode family specific dispersion equations in both matrix techniques for nonattenuated and attenuated cases, symmetric, antisymmetric, and nonsymmetric leaky Lamb, Scholte, and SH waves can be traced separately with better efficiency and robustness. The capabilities of DC are demonstrated by calculating dispersion diagrams and mode shapes for a viscoelastic composite with 400 layers immersed in water. Results are compared against DISPERSE (Imperial College London, London, UK) for selected cases.
Readability of Postconcussion Home Care Instructions
Authors: Schellhase Kristen C. , McIntosh Andrew A. , Jennings-Collier Isis I.A. , Dininny Madison D. , Zraick Richard I. , Mangum L. Colby
Published: August 2023

Patient education materials should be written at or below a fifth grade reading level. Postconcussion home care instructions outline what signs/symptoms warrant a visit to the emergency department and actions that should be taken/not taken by the caregiver. The purpose of this study was to determine the readability of postconcussion home care instructions provided by national organizations seen as setting the standard of care. Readability analyses were performed using the Readability Studio 2019 Standard Edition, by Oleander Software (Oleander Solutions). All postconcussion home care instructions were written above the recommended reading grade level. Poor comprehension of written material may lead to poor health outcomes; therefore, those organizations should consider amending handouts to meet the recommended reading level. Athletic trainers should examine the readability of home care instructions they provide, use both written and verbal instructions, and ensure caregiver understanding by using the skills in the Health Literacy Universal Precautions Toolkit.
Convergent activation of two-pore channels mediated by the NAADP-binding proteins JPT2 and LSM12
Authors: Gunaratne Gihan S. , Brailoiu Eugen , Kumar Sushil , Yuan Yu , Slama James T. , Walseth Timothy F. , Patel Sandip , Marchant Jonathan S.
Published: August 2023

The second messenger nicotinic acid adenine dinucleotide phosphate (NAADP) evokes calcium ion (Ca
2+
) release from endosomes and lysosomes by activating two-pore channels (TPCs) on these organelles. Rather than directly binding to TPCs, NAADP associates with proteins that indirectly confer NAADP sensitivity to the TPC complex. We investigated whether and how the NAADP-binding proteins Jupiter microtubule–associated homolog 2 (JPT2) and like-Sm protein 12 (LSM12) contributed to NAADP-TPC-Ca
2+
signaling in human cells. Biochemical and functional analyses revealed that recombinant JPT2 and LSM12 both bound to NAADP with high affinity and that endogenous JPT2 and LSM12 independently associated with TPC1 and TPC2. On the basis of knockout and rescue analyses, both NAADP-binding proteins were required to support NAADP-evoked Ca
2+
signaling and contributed to endolysosomal trafficking of pseudotyped coronavirus particles. These data reveal that the NAADP-binding proteins JPT2 and LSM12 convergently regulate NAADP-evoked Ca
2+
release and function through TPCs.
Supplemental Material: Tracking multiple stages of serpentinization processes of the Yarlung Zangbo Suture Zone peridotites in southern Tibet: Implications for the tectonic evolution of the Neotethyan oceanic lithosphere
Authors: Zhao Qi , YAN Yi , et al.
Published: August 2023

Tables S1-S3.
Metastatic methicillin-resistantStaphylococcus aureusinfection with infective endocarditis, pulmonary septic emboli, axillary abscess with a subacute presentation in a patient with chronic end-stage kidney disease on maintenance haemodialysis
Authors: Saha Debapriya , Dighe Tushar A , Sajgure Atul D , Bale Charan
Published: August 2023

A male adult patient on maintenance haemodialysis due to end-stage diabetic nephropathy presented with low-grade intermittent fever, cough and generalised weakness for 3 weeks. Initial blood investigations revealed an elevated neutrophil count with raised inflammatory markers. Chest CT revealed loculated hydropneumothorax with multiple cavitary nodules. Repeated blood cultures from the cuffed tunnelled catheter site and the right arm and sputum cultures were negative for pyogenic bacteria and yeast aetiology. The patient complained about left axillary pain on the fourth day of admission. Ultrasound-guided percutaneous aspiration from an axillary focal collection and subsequent culture revealed a methicillin-resistantStaphylococcus aureus(MRSA) infection. Echocardiography detected multiple vegetations on the tricuspid valve. The patient responded clinically to vancomycin and removal of the permanent catheter. This was a case of a tunnelled catheter-related metastatic MRSA infection with infective endocarditis, pulmonary septic embolism with a subacute presentation, and repeated blood culture negativity.
Comparison of high-intensity interval training versus moderate-intensity continuous training in pulmonary rehabilitation for interstitial lung disease: a randomised controlled pilot feasibility trial
Authors: Nikoletou Dimitra , Chis Ster Irina , Lech Carmen Y , MacNaughton Iain S , Chua Felix , Aul Raminder , Jones Paul W
Published: August 2023

Objectives

This study aimed to investigate the feasibility and efficacy of high-intensity interval training (HIIT) compared with moderate-intensity continuous training (MICT) in pulmonary rehabilitation (PR) for people with interstitial lung disease (ILD).

Design

Single-centre, randomised controlled feasibility, pilot trial.

Setting

Patients were recruited from the chest clinic of a tertiary ILD centre and attended circuit-based PR in the hospital’s gym, followed by a personalised 6-month community programme.

Participants

58 patients, stratified per ILD type, were randomised into two groups: 33 to HIIT (18 males:15 females) (mean age (SD): 70.2 (11.4) years) and 25 to the MICT exercise mode (14 males:11 females) (mean age (SD): 69.8 (10.8) years).

Interventions

8-week, twice weekly, circuit-based PR programme of exercise and education, followed by a personalised 6-month community exercise programme.

Outcome measures

Feasibility outcomes included staff-to-patient ratio and dropout rates per group. Primary outcome was the 6 min walk distance (6MWD). Secondary outcomes included the sniff nasal pressure, mouth inspiratory and expiratory pressures, handgrip and quadriceps strength and health status. Random-effects models were used to evaluate average variation in outcomes through time across the two groups.

Results

The 6MWD peaked earlier with HIIT compared with MICT (at 4 months vs 5 months) but values were lower at peak (mean (95% CI): 26.3 m (3.5 to 49.1) vs 51.6 m (29.2 to 73.9)) and declined faster at 6 months post-PR. Secondary outcomes showed similar faster but smaller improvements with HIIT over MICT and more consistent maintenance 6 months post-PR with MICT than HIIT.

Conclusions

HIIT is feasible in circuit-based ILD PR programmes and provides quick improvements but requires closer supervision of training and resources than MICT and benefits may be less well sustained. This would make it a less attractive option for clinical PR programmes. A definitive, multicentre randomised controlled trial is required to address the role of HIIT in ILD.

Trial registration number

ISRCTN55846300.
Psychosocial impact of COVID-19 pandemic on front-line healthcare workers in Sierra Leone: an explorative qualitative study
Authors: Tengbe Sia Morenike , Kamara Ibrahim Franklyn , Ali Desta B , Koroma Fanny F , Sevalie Stephen , Dean Laura , Theobald Sally
Published: August 2023

Introduction

The COVID-19 pandemic has wide-reaching health and non-health consequences, especially on mental health and psychosocial well-being. Healthcare workers involved in COVID-19 patient care are particularly vulnerable to psychosocial distress due to increased pressure on healthcare systems. We explored the psychosocial experiences of front-line healthcare workers during the COVID-19 pandemic in Sierra Leone.

Methods

This qualitative study used purposive sampling to recruit 13 healthcare workers from different cadres across 5 designated COVID-19 treatment centres in Freetown, Sierra Leone. In-depth interviews were conducted remotely in July and August 2020, transcribed verbatim and analysed using the framework approach.

Results

This study identified three overarching themes: vulnerability, resilience and support structures. Participants expressed vulnerability relating to the challenging work environment and lack of medications as key stressors resulting in anxiety, stress, anger, isolation and stigmatisation. Signs of resilience with experiences drawn from the 2014 Ebola outbreak, teamwork and a sense of duty were also seen. Peer support was the main support structure with no professional psychosocial support services available to healthcare workers.

Conclusions

This is the first study to provide evidence of the psychosocial impacts of COVID-19 among front-line healthcare workers in Sierra Leone. Despite signs of resilience and coping mechanisms displayed, they also experienced adverse psychosocial outcomes. There is a need to focus on enhancing strategies such as psychosocial support for healthcare workers and those that overall strengthen the health system to protect healthcare workers, promote resilience and guide recommendations for interventions during future outbreaks.
Drug exposure during pregnancy in primary care: an algorithm and observational study from SIDIAP database, Catalunya, Spain
Authors: Lestón Vázquez Marta , Vilaplana-Carnerero Carles , Gomez-Lumbreras Ainhoa , Prat-Vallverdu Oriol , Marsal Josep Ramon , Vedia Urgell Cristina , Giner-Soriano Maria , Morros Rosa
Published: August 2023

Objectives

To develop an algorithm to identify pregnancy episodes in women at childbearing age using SIDIAP (Information System for the Improvement of Research in Primary Care) data (Catalunya, Spain).

To describe drugs dispensed during gestation.

Design

Construction of an algorithm to identify all pregnancy episodes occurred from January 2011 to June 2020 in women aged 12–50. The variables used to create the algorithm include first day of last menstrual period, reasons for pregnancy termination and diagnoses registered in the primary healthcare records. Population-based cohort study including the pregnancy episodes identified by the algorithm.

Setting

Catalonia, Spain.

Participants

All women aged 12–50 with at least one pregnancy episode occurred during January 2011–June 2020.

Interventions

No interventions performed.

Primary and secondary outcome measures

Identification of pregnancy episodes through an algorithm and description of drug exposure.

Results

We identified 327 865 pregnancy episodes in 250 910 people with a mean age of 31.3 years. During the study period, 83.4% of the episodes were exposed to at least one drug. The most frequent groups dispensed were iron preparations (48% of pregnancy episodes), iodine therapy (40.2%), analgesics and antipyretics (28%), penicillins (19.8%), vitamin B12plus folic acid (19.7%) and non-steroidal anti-inflammatory drugs (NSAIDs, 15.1%). The supplements were more frequently dispensed at least twice, and the drugs for acute conditions were mainly dispensed only once during the pregnancy episode.

Conclusions

We developed an algorithm to automatically identify the pregnancy periods in SIDIAP.

We described prescription drugs used during pregnancy. The most used ones were supplements, analgesics, NSAID or antibiotics.

SIDIAP might be an efficient database to study drug safety during pregnancy and the consequences of drug use in the offspring.

Trial registration number

EUPAS37675.
Childhood mortality and associated factors in Migori County, Kenya: evidence from a cross-sectional survey
Authors: Starnes Joseph R , Rogers Ash , Wamae Jane , Okoth Vincent , Mudhune Sandra A , Omondi Alyn , Were Vincent , Baraza Awino Doreen , Lefebvre Christina Hope , Yap Samantha , Otieno Odhong Tom , Vill Beffy , Were Lawrence , Wamai Richard
Published: August 2023

Objectives

The under-five mortality (U5M) rate in Kenya (41 per 1000 live births) remains significantly above international goals (25 per 1000 live births). This is further exacerbated by regional inequalities in mortality. We aimed to describe U5M in Migori County, Kenya, and identify associated factors that can serve as programming targets.

Design

Cross-sectional observational survey.

Setting

Areas served by the Lwala Community Alliance and control areas in Migori County, Kenya.

Participants

This study included 15 199 children born to respondents during the 18 years preceding the survey.

Primary and secondary outcome measures

The primary outcome was mortality in the first 5 years of life. The survey was powered to detect a 10% change in various health metrics over time with 80% power.

Results

A total of 15 199 children were included in the primary analyses, and 230 (1.5%) were deceased before the fifth birthday. The U5M rate from 2016 to 2021 was 32.2 per 1000 live births. Factors associated with U5M included year of birth (HR 0.926, p<0.001), female sex (HR 0.702, p=0.01), parental marriage (HR 0.642, p=0.036), multiple gestation pregnancy (HR 2.776, p<0.001), birth spacing less than 18 months (HR 1.894, p=0.005), indoor smoke exposure (HR 1.916, p=0.027) and previous familial contribution to the National Hospital Insurance Fund (HR 0.553, p=0.009). The most common cause of death was malaria.

Conclusions

We describe factors associated with childhood mortality in a Kenyan community using survival analyses of complete birth histories. Mortality rates will serve as the baseline for future programme evaluation as a part of a 10-year study design. This provides both the hyperlocal information needed to improve programming and generalisable conclusions for other organisations working in similar environments.
Protocol for developing a set of performance measures to monitor and evaluate delirium care quality for older adults in the emergency department using a modified e-Delphi process
Authors: Filiatreault Sarah , Kreindler Sara , Grimshaw Jeremy , Chochinov Alecs , Doupe Malcolm
Published: August 2023

Introduction

Older adults are at high risk of developing delirium in the emergency department (ED). Delirium associated with an ED visit is independently linked to poorer outcomes such as increased length of hospital stay and mortality. Performance measures (PMs) are needed to identify variations in the quality of delirium care to help focus improvement efforts where they are most needed. A preliminary list of 11 quality statements and 24 PMs was developed based on a synthesis of high-quality clinical practice guidelines. The purpose of this study is to gain consensus on a subset of PMs that can be used to evaluate delirium care quality for older ED patients.

Methods and analysis

This protocol for a modified e-Delphi study is informed by the Guidance on Conducting and REporting DElphi Studies. Clinical experts from across Canada and internationally will be recruited through peer referral, professional organisations and social media calls for expressions of interest. A minimum of 17 participants will be recruited. The primary survey for each round will consist of closed-ended questions with the opportunity to provide comments to justify decisions and clarify understanding. Using 9-point Likert scales, participants will rate each quality statement according to the concepts of importance and actionability, then its associated PMs according to the concept of necessity. Results will be fed back to participants in subsequent rounds. A priori stopping criteria have been defined in terms of consensus and stability. A minimum of three rounds will be undertaken to allow participants to have feedback, revise previous responses, then stabilise responses.

Ethics and dissemination

Ethical approval was provided at the University of Manitoba Health Research Ethics Board (ID HS25728 (H2022:340)). Informed consent will be obtained electronically using the Research Electronic Data Capture secure online platform. Knowledge translation and dissemination will be done through traditional (eg, conference presentations, peer-reviewed publications) and non-traditional (eg, ED Grand Rounds) strategies.
Endovascular thrombectomy first-pass reperfusion and ancillary device placement
Authors: Navia Pedro , Espinosa de Rueda Mariano , Rodriguez-Benitez Amado , Ballenilla Marco Federico , Pumar José Manuel , Gallego-Leon Jose Ignacio , Diaz-Valiño Jose Luis , Mendez Jose Carlos , Hernández Fernández Francisco , Rodriguez-Paz Carlos Manuel , Hernandez David , Maynar Franscisco Javier , Vega-Villar Juan , García-Benassi Juan Manuel , Martínez-Galdámez Mario , Larrea Jose-Angel , Fernandez-Prieto Andres
Published: August 2023

Background

Recent randomized trials have demonstrated the efficacy of mechanical thrombectomy in treating acute ischemic stroke, however, further research is required to optimize this technique. We aimed to evaluate the impact of guide catheter position and clot crossing on revascularization rates using A Direct Aspiration First Pass Technique (ADAPT).

Methods

Data were collected between January 2018 and August 2019 as part of the Spanish ADAPT Registry on ACE catheters (SARA), a multicenter observational study assessing real-world thrombectomy outcomes. Demographic, clinical, and angiographic data were collected. Subgroup analyses assessed the relationship between guide catheter/microguidewire position and modified Trombolysis in Cerebral Infarction (mTICI) scores. First pass effect (FPE) was defined as mTICI 3 after single pass of the device.

Results

From a total of 589 patients, 80.8% underwent frontline aspiration thrombectomy. The median score on the National Institutes of Health Stroke Scale (NIHSS) was 16.0. After adjusting for confounders, the likelihood of achieving FPE (adjusted Odds Ratio (aOR), 0.587; 95% confidence interval (CI), 0.38 to 0.92; p=0.0194) were higher among patients with more distal petrocavernous placement of guide catheter. The likelihood of achieving FPE (aOR, 0.592; 95% CI, 0.39 to 0.90; p=0.0138) and final angiogram complete reperfusion (aOR, 0.465; 95% CI, 0.30 to 0.73; p=0.0008) were higher among patients without microguidewire crossing the clot. No difference was noted for time from arterial puncture to reperfusion in any study group. At the 90-day follow-up, the mortality rate was 9.2% and 65.8% of patients across the entire study cohort were functionally independent (modified Rankin Scale (mRS) 0–2).

Conclusions

Petrocavernous guide catheter placement improved first-pass revascularization. Crossing the occlusion with a microguidewire lowered the likelihood of achieving FPE and complete reperfusion after final angiogram.
Low-impact line construction retains and speeds recovery of trees on seismic lines in forested peatlands
Authors: Filicetti Angelo T. , Tigner Jesse , Nielsen Scott E. , Wolfenden Katherine , Taylor Murdoch , Bentham Paula
Published: August 2023

Seismic lines are linear features created by the oil and gas industry for energy exploration. Though individually narrow, collectively seismic lines are a pervasive management challenge, resulting in changes to biogeochemical cycles, plant and animal abundance and behaviour, predator–prey relationships, and forest successional trajectories. These impacts arise from historical construction methods that used bulldozers to remove vegetation and substrate leaving lines as persistent openings in a state of arrested succession. In the mid-1990s, “low-impact seismic” (LIS) line construction began, using mulchers to remove vegetation aboveground to minimize impacts and hasten reforestation. Here, we evaluated the effectiveness of LIS in retention, recruitment, and growth of seedlings in forested peatlands in northeast British Columbia. Retained and recruited trees on LIS lines were found at 69% and 64% of sites, had mean densities of 3400 and 6000 stems/ha, and mean heights of 42 and 11 cm, respectively. These LIS lines appeared to recover along expected trajectories toward tree cover, thereby mitigating challenges typical of older seismic exploration. Our results suggest it is feasible to further fast-forward line recovery by ensuring mulcher drums are kept as high as possible to increase the number and height of trees through the mulching process.
Carbon and biomass models for five Sierra Nevada mixed conifer species
Authors: Jones Dryw A. , O'Hara Kevin L.
Published: August 2023

Data from tree cores and disks were used to develop biomass and carbon mass taper models for five major Sierra Nevada conifer species. These taper models were used to predict masses of tree boles, tree bole portions, branch, and foliage using carbon fraction data for oven-dried and living tissues. Taper models developed using core data were well modeled to disk data with R2 values ranging from 0.98 to 0.99 by inclusion of a calibration parameter. The fit of the final models suggests our approach can be used to include large diameter trees that cannot be cut down in biomass data collection efforts that otherwise would only sample smaller diameter trees. Our results show that biomass-weighted living carbon estimates at the whole tree level ranged from 2.8% to 9% higher than estimation methods using the standard carbon fraction of 0.5 depending on the tree species. Our approach addresses the need to account for variation in carbon fraction and wood density throughout trees, as well as demonstrating a data collection and modeling approach to include large old growth trees that cannot be destructively sampled.
Wood age, rootstocks and cultivars drive the formation of productivity and fruit size in sweet cherry
Authors: Bondarenko P. , Yudytska I. , Alekseeva O.
Published: August 2023

To maintain the high yields and fruit quality necessary for profitability of sweet cherry production, it is important to consider precision crop load and canopy management techniques during limb renewal. The effects of branch section age, rootstock, and cultivar on spur and flower density and fruit quality have been discussed in previous studies, but most of them focus on a limited range of fruiting wood ages and scion-rootstock combinations. This study aims to analyse the processes of sweet cherry productivity and fruit size formation on a wide range of wood age to determine the limit after which branch preservation is not sustainable, and to evaluate the influence of rootstocks and cultivars on these parameters. The results indicate that wood age is one of the main drivers of productivity formation in cherry. The highest flower density was observed on 3-year-old branch sections – 324 flowers per linear m, due to high spur density, number of reproductive buds per spur and flowers per bud. Productivity on 2-year-old wood was also good (256 flowers per linear m), while a sharp decline in flower density was noted on 4- and 5-year-old wood. The largest fruits were formed on young branch sections, with a significant decline in fruit weight and diameter on 4- and 5-year-old sections. Rootstock vigour had a bigger effect on floral organ induction on 1-year-old shoots, than on spurs. Based on the results, it is advisable to regularly renew lateral branches older than 3 years to maintain high yield efficiency and fruit quality.
Semi-inclusive decays of B meson into a dark anti-baryon and baryons
Authors: Shi Yu-Ji , Xing Ye , Xing Zhi-Peng
Published: August 2023

Using the recently developed B-Mesogenesis scenario, we studied the semi-inclusive decays of B meson into a dark anti-baryon $$\psi $$
ψ
plus any possible states X containing u/c and d/s quarks with unit baryon number. The two types of effective Lagrangians proposed by the scenario are both considered in the study. The semi-inclusive decay branching fractions of $$B\rightarrow X \psi $$

B
→
X
ψ

are calculated by the method of heavy quark expansion, where the non-perturbative contributions from the matrix elements of dimension-5 operators are included. We obtained the branching fractions as functions of the dark anti-baryon mass. Using the experimental upper limits of the branching fractions, we presented the constraints of the coupling constants in the B-Mesogenesis scenario.
Electron probe petrochronology of monazite- and garnet-bearing metamorphic rocks in the Saxothuringian allochthonous domains (Erzgebirge, Granulite and Münchberg massifs)
Authors: Schulz Bernhard , Krause Joachim
Published: August 2023

In the Saxothuringian Zone, a unique assemblage of high- to ultra-high-pressure and ultra-high-temperature metamorphic units is associated with medium- to low-pressure and temperature rocks. The units were studied in a campaign with garnet and monazite petrochronology of gneisses, micaschists and phyllites, and monazite dating in granites. P–T path segments of garnet crystallization were reconstructed by geothermobarometry and interpreted in terms of the monazite stability field, EPMA Th–U–Pb monazite ages and garnet Y + HREE zonations. One can recognize (1) Cambrian plutonism (512–503 Ma) with contact metamorphism in the Münchberg Massif. Subordinate monazite populations may indicate a (2) widespread but weak Silurian (444–418 Ma) thermal event. A (3) Devonian (389–360 Ma) high-pressure metamorphism prevails in the Münchberg and Frankenberg massifs. In the ultra-high-pressure and high-pressure units of the Erzgebirge the predominant (4) Carboniferous (336–327 Ma) monazites crystallized at the decompression paths. In the Saxonian Granulite Massif, prograde–retrograde P–T paths of cordierite-garnet gneisses can be related to monazite ages from 339 to 317 Ma. A (5) local hydrothermal overprint at 313–302 Ma coincides partly with post-tectonic (345–307 Ma) granite intrusions. Such diverse monazite age pattern and P–T time paths characterize the tectono-metamorphic evolution of each crustal segment involved in the Variscan Orogeny.
Evolution of a Model System: New Insights from the Study of Anolis Lizards
Authors: Muñoz Martha M. , Frishkoff Luke O. , Pruett Jenna , Mahler D. Luke
Published: August 2023

Following decades of intensive study, Anolis lizards have emerged as a biological model system. We review how new research on anoles has advanced our understanding of ecology and evolution, challenging long-standing paradigms and opening new areas of inquiry. Recent anole research reveals how changes in behavior can restructure ecological communities and can both stimulate and stymie evolution, sometimes simultaneously. Likewise, investigation of anoles as spatial or phylogenetic evolutionary experiments has documented evolutionary repeatability across spatiotemporal scales, while also illuminating its limits. Current research places anoles as a promising model for Anthropocene biology, with recent work illustrating how species respond as humans reconfigure natural habitats, alter the climate, and create novel environments and communities through urbanization and species introduction. Combined with ongoing methodological developments in genomics, phylogenetics, and ecology, the growing foundational knowledge of Anolis positions them as a powerful model system in ecology and evolution for years to come.