bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of three colloidal gold immunoassays and GeneXpert Carba-R for the detection of
Klebsiella pneumoniae bla
KPC-2
variants
Authors: Zhang Jinghao , Xu Jieli , Shen Siquan , Ding Li , Yang Weiwei , Tang Chengkang , Shi Qingyu , Zhao Hu , Guo Yan , Han Renru , Hu Fupin
Published: May 2024

The increasing use of ceftazidime-avibactam has led to the emergence of a wide range of ceftazidime-avibactam-resistant
bla
KPC-2
variants. Particularly, the conventional carbapenemase phenotypic assay exhibited a high false-negative rate for KPC-2 variants. In this study, three colloidal gold immunoassays, including the Gold Mountainriver CGI test, Dynamiker CGI test and NG-Test CARBA5, and GeneXpert Carba-R, were used to detect the presence of KPC-2 carbapenemase and its various variants in 42
Klebsiella pneumoniae
strains. These strains covered
bla
KPC-2
(13/42) and 16 other
bla
KPC-2
variants including
bla
KPC-12
(1/42),
bla
KPC-23
(1/42),
bla
KPC-25
(1/42),
bla
KPC-33
(6/42),
bla
KPC-35
(1/42),
bla
KPC-44
(1/42),
bla
KPC-71
(1/42),
bla
KPC-76
(8/42),
bla
KPC-78
(1/42),
bla
KPC-79
(1/42),
bla
KPC-100
(1/42),
bla
KPC-127
(1/42),
bla
KPC-128
(1/42),
bla
KPC-144
(1/42),
bla
KPC-157
(2/42), and
bla
KPC-180
(1/42). For KPC-2 strains, all four assays showed 100% negative percentage agreement (NPA) and 100% positive percentage agreement (PPA) with sequencing results. For all 16 KPC-2 variants, GeneXpert Carba-R showed 100% NPA and 100% PPA, and the three colloidal gold immunoassays showed 100% NPA, while the PPAs of the Gold Mountainriver CGI test, Dynamiker CGI test, and NG-Test CARBA5 were 87.5%, 87.5%, and 68.8%, respectively. We also found a correlation between the mutation site in the amino acid of the variants and false-negative results by colloidal gold immunoassays. In conclusion, the GeneXpert Carba-R has been proven to be a reliable method in detecting KPC-2 and its variants, and the colloidal gold immunoassay tests offer a practical and cost-effective approach for their detection. For the sample with a negative result by a colloidal gold immunoassay test but not matching the drug-resistant phenotype, it is recommended to retest using another type of kit or the GeneXpert Carba-R assay, which can significantly improve the accuracy of detection.
Complete genome sequence of
Pseudomonas aeruginosa
L3, a bacterium with Mn(II) oxidative property isolated from heavy metal-contaminated soils
Authors: Xue Lan , Guo Yueshuai , Tang Fengzhen , Chen Sha , Liao Fengfeng , Li Ding
Published: May 2024

Pseudomonas aeruginosa
L3, isolated from heavy metal-contaminated soils, possesses the ability of Mn(II) oxidation. To further enhance the understanding of genes involved in Mn(II) oxidation, the complete genome of this strain was sequenced and annotated, which has a total size of 6.39 Mb with a G + C content of 66.39%.
Complete genome sequences of
Clostridioides difficile
surveillance isolates representing the top 10 ribotypes from the Emerging Infections Program, United States, 2016
Authors: Adamczyk Michelle , Vlachos Nicholas , Breaker Erin , Orazi Giulia , Paulick Ashley L. , Rowe Lori A. , McAllister Gillian , Machado María-José , Korhonen Lauren , Guh Alice Y. , Rasheed J. Kamile , Karlsson Maria , McKay Susannah L. , Lutgring Joseph D. , Gargis Amy S. ,   the Emerging Infections Program Clostridioides difficile Pathogen Group
Published: May 2024

Ten
Clostridioides difficile
isolates representing the top 10 ribotypes collected in 2016 through the Emerging Infections Program underwent long-read sequencing to obtain high-quality reference genome assemblies. These isolates are publicly available through the CDC & FDA Antibiotic Resistance Isolate Bank.
The phage shock protein (PSP) envelope stress response: discovery of novel partners and evolutionary history
Authors: Ravi Janani , Anantharaman Vivek , Chen Samuel Zorn , Brenner Evan Pierce , Datta Pratik , Aravind L. , Gennaro Maria Laura
Published: May 2024

Bacterial phage shock protein (PSP) systems stabilize the bacterial cell membrane and protect against envelope stress. These systems have been associated with virulence, but despite their critical roles, PSP components are not well characterized outside proteobacteria. Using comparative genomics and protein sequence-structure-function analyses, we systematically identified and analyzed PSP homologs, phyletic patterns, domain architectures, and gene neighborhoods. This approach underscored the evolutionary significance of the system, revealing that its core protein PspA (Snf7 in ESCRT outside bacteria) was present in the last universal common ancestor and that this ancestral functionality has since diversified into multiple novel, distinct PSP systems across life. Several novel partners of the PSP system were identified: (i) the Toastrack domain, likely facilitating assembly of sub-membrane stress-sensing and signaling complexes, (ii) the newly defined HTH-associated α-helical signaling domain-PadR-like transcriptional regulator pair system, and (iii) multiple independent associations with ATPase, CesT/Tir-like chaperone, and Band-7 domains in proteins thought to mediate sub-membrane dynamics. Our work also uncovered links between the PSP components and other domains, such as novel variants of SHOCT-like domains, suggesting roles in assembling membrane-associated complexes of proteins with disparate biochemical functions. Results are available at our interactive web app,https://jravilab.org/psp.

IMPORTANCE

Phage shock proteins (PSP) are virulence-associated, cell membrane stress-protective systems. They have mostly been characterized in Proteobacteria and Firmicutes. We now show that a minimal PSP system was present in the last universal common ancestor that evolved and diversified into newly identified functional contexts. Recognizing the conservation and evolution of PSP systems across bacterial phyla contributes to our understanding of stress response mechanisms in prokaryotes. Moreover, the newly discovered PSP modularity will likely prompt new studies of lineage-specific cell envelope structures, lifestyles, and adaptation mechanisms. Finally, our results validate the use of domain architecture and genetic context for discovery in comparative genomics.
The usefulness of nanopore sequencing in whole-genome sequencing-based genotyping of
Listeria monocytogenes
and
Salmonella enterica
serovar Enteritidis
Authors: Hong Yu-Ping , Chen Bo-Han , Wang You-Wun , Teng Ru-Hsiou , Wei Hsiao-Lun , Chiou Chien-Shun
Published: May 2024

Bacterial genotyping through whole-genome sequencing plays a crucial role in disease surveillance and outbreak investigations in public health laboratories. This study assessed the effectiveness of Oxford Nanopore Technologies (ONT) sequencing in the genotyping of
Listeria monocytogenes
and
Salmonella enterica
serovar Enteritidis. Our results indicated that ONT sequences, generated with the R10.4.1 flow cell and basecalled using the Dorado 0.5.0 Super Accurate 4.3 model, exhibited comparable accuracy to Illumina sequences, effectively discriminating among bacterial strains from outbreaks. These findings suggest that ONT sequencing has the potential to be a promising tool for rapid whole-genome sequencing of bacterial pathogens in public health laboratories for epidemiological investigations.

IMPORTANCE

This study unveils that Oxford Nanopore Technologies sequencing, by itself, holds the potential to serve as a whole-genome sequencing-based genotyping tool in public health laboratories, enabling routine subtyping of bacterial isolates for disease surveillance and outbreak investigations
How Mentors and the State Made a Blind Scientist
Authors: Vermeij Geerat J.
Published: May 2024

As a blind paleobiologist and evolutionary biologist, I have been fortunate to have had highly supportive parents, teachers, and colleagues, whose qualities and insights I discuss. Curiosity, hard work, a willingness to take risks, and a keen ability to observe and to ask questions are critical attributes.
Managing menstruation for medically complex paediatric patients
Authors: Gray Susan H
Published: May 2024

Physicians who care for children and adolescents need evidence-based information about how to manage menses for medically complicated patients. The use of many hormonal medications for menstrual management is considered ‘off-label’ because many of these medications have indications only for contraception. A growing body of evidence supports the use of particular medications or strategies for a wide variety of medical conditions, but this information has been slow to reach all paediatric patients, perhaps in part because of the off-label nature of prescribing. Specialists skilled in hormone management are in short supply and often not immediately available for consultation, and they may also be inexperienced prescribing for medically complex paediatric patients. Misconceptions about the necessity of menstruation or concerns regarding use of contraceptives in young patients may also limit the use of medically indicated off-label hormonal regimens. This review will outline current patient-centred strategies to inform physicians’ choices about when and how to intervene medically to improve quality of life for medically complex girls with problematic periods—whether by making periods more predictable, preventing ovulation, reducing pain or eliminating menses altogether.
Concurrent transverse myelitis and acute inflammatory demyelinating polyneuropathy
Authors: Shrimpton Matthew , Shaw Cameron
Published: May 2024

A woman in her 40s presented with thoracic banding dysaesthesia and lower motor neuron weakness. Spinal imaging revealed a short segment of transverse myelitis and neurophysiology was suggestive of concurrent acute inflammatory demyelinating polyneuropathy. The patient improved with consecutive intravenous immunoglobulin and methylprednisolone treatment. Acute inflammatory demyelinating polyneuropathy is a progressive immune-mediated peripheral neuropathy which responds to intravenous immunoglobulin or plasmapheresis, whereas transverse myelitis is a central inflammatory syndrome usually treated with corticosteroid. We highlight differentiating features of the clinical presentation and the utility of investigations such as neurophysiology and MRI along with a review of treatment and the role for corticosteroid therapy.
Treating benign paroxysmal positional vertigo in acute traumatic brain injury: a prospective, randomised clinical trial assessing safety, feasibility, and efficacy
Authors: Smith Rebecca M , Burgess Caroline , Beattie Jenna , Newdick Abby , Tahtis Vassilios , Sahu Bithi , Golding John F , Marsden Jonathan , Seemungal Barry M
Published: May 2024

Background

Benign paroxysmal positional vertigo (BPPV) affects approximately half of acute, moderate-severe traumatic brain injury (TBI) patients. To date, there have been no rigorous studies of BPPV assessment or treatment in this cohort. We aimed to determine the safety, practicability, and efficacy of therapist-led BPPV management in acute TBI and the feasibility of a larger effectiveness trial.

Methods

This was a multi-centre, three-arm, parallel-groups, randomised, feasibility trial. Recruitment was via convenience sampling. The main inclusion criteria were age over 18 years and a confirmed, non-penetrating, acute TBI. BPPV-positive patients were randomly allocated to one of three interventions (repositioning manoeuvres, Brandt–Daroff exercises or advice) using minimisation criteria. Outcome assessors were blinded to the intervention.

Results

Of 2014 patients screened for inclusion, 180 were assessed for BPPV. Of those assessed, 34% (62/180) had BPPV, and 58 patients received an intervention. Therapist-led interventions were delivered safely and accurately according to intervention monitoring criteria. Resolution of BPPV was observed in 35/58 (60%) patients. The resolution rate was highest following repositioning manoeuvres (78%), followed by the advice (53%) and Brandt–Daroff interventions (42%). 10 patients experienced recurrence. This was observed more frequently in those with skull fractures and bilateral or mixed BPPV.

Conclusions

Overall, the results provide strong evidence for the feasibility of a future trial. Therapist-led management of BPPV in acute TBI was safe and practicable. Repositioning manoeuvres seemingly yielded a superior treatment effect. However, given the high recurrence rate of post-traumatic BPPV, the optimal time to treat according to patients’ specific recurrence risk requires further investigation.

Trial registration

ISRCTN91943864,https://doi.org/10.1186/ISRCTN91943864.
Spontaneous spinal cord infarction: a systematic review
Authors: Gharios Maria , Stenimahitis Vasilios , El-Hajj Victor Gabriel , Mahdi Omar Ali , Fletcher-Sandersjöö Alexander , Jabbour Pascal , Andersson Magnus , Hultling Claes , Elmi-Terander Adrian , Edström Erik
Published: May 2024

Background and objectives

Spontaneous spinal cord infarction (SCInf) is a rare condition resulting in acute neurological impairment. Consensus on diagnostic criteria is lacking, which may present a challenge for the physician. This review aims to analyse the current literature on spontaneous SCInf, focusing on epidemiology, the diagnostic process, treatment strategies and neurological outcomes.

Methods

The study was performed in accordance with a previously published protocol. PubMed, Web of Science and Embase were searched using the keywords ‘spontaneous’, ‘spinal cord’, ‘infarction’ and ‘ischaemic’. The eligibility of studies was evaluated in two steps by multiple reviewers. Data from eligible studies were extracted and systematically analysed.

Results

440 patients from 33 studies were included in this systematic review. Analysis of vascular risk factors showed that hypertension was present in 40%, followed by smoking in 30%, dyslipidaemia in 29% and diabetes in 16%. The severity of symptoms at admission according to the American Spinal Injury Association (ASIA) Impairment Scale was score A 19%, score B14%, score C36% and score D32%. The mean follow-up period was 34.8 (±12.2) months. ASIA score at follow-up showed score A 11%, score B 3%, score C 16%, score D 67% and score E 2%. The overall mortality during the follow-up period was 5%. When used, MRI with diffusion-weighted imaging (DWI) supported the diagnosis in 81% of cases. At follow-up, 71% of the patients were able to walk with or without walking aids.

Conclusion

The findings suggest a significant role for vascular risk factors in the pathophysiology of spontaneous SCInf. In the diagnostic workup, the use of DWI along with an MRI may help in confirming the diagnosis. The findings at follow-up suggest that neurological recovery is to be expected, with the majority of patients regaining ambulation. This systematic review highlights gaps in the literature and underscores the necessity for further research to establish diagnostic criteria and treatment guidelines.
Identifying characteristics that enable resilient immunisation programmes: a scoping review
Authors: Baxter Luke , Slater Rebeccah , Hermany Lindsay , Bhatti Alexandra , Eiden Amanda L , Mitrovich Rachel , Connolly Mark P , Vanderslott Samantha , Nyaku Mawuli , Bhatt Aomesh
Published: May 2024

Objectives

The COVID-19 pandemic highlighted the fragility of immunisation programmes and resulted in a significant reduction in vaccination rates, with increasing vaccine-preventable disease outbreaks consequently reported. These vulnerabilities underscore the importance of resilient immunisation programmes to ensure optimal performance during crises. To date, a framework for assessing immunisation programme resilience does not exist. We conducted a scoping review of immunisation programmes during times of crisis to identify factors that characterise resilient immunisation programmes, which may inform an Immunisation Programme Resilience Tool.

Design

Scoping review design followed the Arksey and O’Malley framework, and manuscript reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines.

Data sources

CINAHL, CENTRAL, Embase, Google Scholar, MEDLINE, PsycINFO and Web of Science and databases were searched between 1 January 2011 and 2 September 2023. Citation searching of identified studies was also performed.

Eligibility criteria

We included primary empirical peer-reviewed studies that discussed the resilience of immunisation programme to crises, shocks or disruptions.

Data extraction and synthesis

Two independent reviewers screened records and performed data extraction. We extracted data on study location and design, crisis description, and resilience characteristics discussed, and identified evidence gaps in the literature. Findings were synthesised using tabulation and an evidence gap map.

Results

Thirty-seven studies met the eligibility criteria. These studies captured research conducted across six continents, with most concentrated in Africa, Asia and Europe. One study had a randomised controlled trial design, while 36 studies had observational designs (15 analytical and 21 descriptive). We identified five characteristics of resilient immunisation programmes drawing on the Health System Resilience Index (Integration, Awareness, Resource Availability and Access, Adaptiveness and Self-regulation) and several evidence gaps in the literature.

Conclusions

To our knowledge, no immunisation programme resilience tool exists. We identified factors from the Health System Resilience Index coupled with factors identified through primary empirical evidence, which may inform development of an immunisation programme resilience tool.
Current US prevalence of myocardial injury patterns and clinical outcomes among hospitalised patients with familial hypercholesterolaemia: insight from the National Inpatient Sample—a retrospective cohort study
Authors: Kumi Dennis , Narh Joshua Tetteh , Odoi Samuel Michael , Oduro Anna , Gajjar Rohan , Gwira-Tamattey Edwin , Karki Sadichhya , Abbasi Ayesha , Fugar Setri , Alyousef Tareq
Published: May 2024

Background

Familial hypercholesterolaemia (FH) increases propensity for premature atherosclerotic disease. Knowledge of inpatient outcomes among patients with FH admitted with acute myocardial injury (AMI) is limited.

Objectives

Our study aimed to identify myocardial injury types, including type 1 myocardial infarction (MI), type 2 MI and takotsubo cardiomyopathy, assess lesion severity and study adverse short-term inpatient outcomes among patients with FH admitted with AMI.

Setting

Our study retrospectively queried the US National Inpatient Sample from 2018 to 2020.

Population

Adults admitted with AMI and dichotomised based on the presence of FH.

Study outcomes

We evaluated myocardial injury types and complexity of coronary revascularisation. Primary outcome of all-cause mortality and other clinical secondary outcomes were studied.

Results

There were 3 711 765 admissions with AMI including 2360 (0.06%) with FH. FH was associated with higher odds of ST-elevation MI (STEMI) (adjusted OR (aOR): 1.62, p<0.001) and non-ST-elevation MI (NSTEMI) (aOR: 1.29, p<0.001) but lower type 2 MI (aOR: 0.39, p<0.001) and takotsubo cardiomyopathy (aOR: 0.36, p=0.004). FH was associated with higher multistent percutaneous coronary interventions (aOR: 2.36, p<0.001), multivessel coronary artery bypass (aOR: 2.65, p<0.001), higher odds of intracardiac thrombus (aOR: 3.28, p=0.038) and mechanical circulatory support (aOR: 1.79, p<0.001). There was 50% reduction in odds of all-cause mortality (aOR: 0.50, p=0.006) and lower odds of mechanical ventilation (aOR: 0.37, p<0.001). There was no difference in rate of ventricular tachycardia, cardioversion, new implantable cardioverter defibrillator implantation, cardiogenic shock and cardiac arrest.

Conclusion

Among patients hospitalised with AMI, FH was associated with higher STEMI and NSTEMI, lower type 2 MI and takotsubo cardiomyopathy, higher number of multiple stents and coronary bypasses, and mechanical circulatory support device but was associated with lower all-cause mortality and rate of mechanical ventilation.
Protocol for a multicentre prospective exploratory mixed-methods study investigating the modifiable psychosocial variables influencing access to and outcomes after kidney transplantation in children and young people in the UK
Authors: Kim Ji Soo , Wray Jo , Ridout Deborah , Plumb Lucy , Nitsch Dorothea , Robb Matthew , Marks Stephen D
Published: May 2024

Introduction

Kidney transplantation is the preferred therapy for children with stage 5 chronic kidney disease (CKD-5). However, there is a wide variation in access to kidney transplantation across the UK for children. This study aims to explore the psychosocial factors that influence access to and outcomes after kidney transplantation in children in the UK using a mixed-methods prospective longitudinal design.

Methods

Qualitative data will be collected through semistructured interviews with children affected by CKD-5, their carers and paediatric renal multidisciplinary team. Recruitment for interviews will continue till data saturation. These interviews will inform the choice of existing validated questionnaires, which will be distributed to a larger national cohort of children with pretransplant CKD-5 (n=180) and their carers. Follow-up questionnaires will be sent at protocolised time points regardless of whether they receive a kidney transplant or not. Coexisting health data from hospital, UK renal registry and National Health Service Blood and Transplant registry records will be mapped to each questionnaire time point. An integrative analysis of the mixed qualitative and quantitative data will define psychosocial aspects of care for potential intervention to improve transplant access.

Analysis

Qualitative data will be analysed using thematic analysis. Quantitative data will be analysed using appropriate statistical methods to understand how these factors influence access to transplantation, as well as the distribution of psychosocial factors pretransplantation and post-transplantation.

Ethics and dissemination

This study protocol has been reviewed by the National Institute for Health Research Academy and approved by the Wales Research Ethics Committee 4 (IRAS number 270493/ref: 20/WA/0285) and the Scotland A Research Ethics Committee (ref: 21/SS/0038). Results from this study will be disseminated across media platforms accessed by affected families, presented at conferences and published in peer-reviewed journals.
Does the effect of adolescent health behaviours on adult cardiometabolic health differ by socioeconomic background? Protocol for a population-based cohort study
Authors: Jackisch Josephine , Noor Nazihah , Raitakari Olli T , Lehtimäki Terho , Kähönen Mika , Cullati Stéphane , Delpierre Cyrille , Kivimäki Mika , Carmeli Cristian
Published: May 2024

Introduction

Adolescence is a sensitive period for cardiometabolic health. Yet, it remains unknown if adolescent health behaviours, such as alcohol use, smoking, diet and physical activity, have differential effects across socioeconomic strata. Adopting a life-course perspective and a causal inference framework, we aim to assess whether the effects of adolescent health behaviours on adult cardiometabolic health differ by levels of neighbourhood deprivation, parental education and occupational class. Gaining a better understanding of these social disparities in susceptibility to health behaviours can inform policy initiatives that aim to improve population health and reduce socioeconomic inequalities in cardiometabolic health.

Methods and analysis

We will conduct a secondary analysis of the Young Finns Study, which is a longitudinal population-based cohort study. We will use measures of health behaviours—smoking, alcohol use, fruit and vegetable consumption, and physical activity—as exposure and parental education, occupational class and neighbourhood deprivation as effect modifiers during adolescence (ages 12–18 years). Eight biomarkers of cardiometabolic health (outcomes)—waist circumference, body mass index, blood pressure, low-density lipoprotein cholesterol, apolipoprotein B, plasma glucose and insulin resistance—will be measured when participants were aged 33–40. A descriptive analysis will investigate the clustering of health behaviours. Informed by this, we will conduct a causal analysis to estimate effects of single or clustered adolescent health behaviours on cardiometabolic health conditional on socioeconomic background. This analysis will be based on a causal model implemented via a directed acyclic graph and inverse probability-weighted marginal structural models to estimate effect modification.

Ethics and dissemination

The Young Finns study was conducted according to the guidelines of the Declaration of Helsinki, and the protocol was approved by ethics committees of University of Helsinki, Kuopio, Oulu, Tampere and Turku. We will disseminate findings at international conferences and a manuscript in an open-access peer-reviewed journal.
Design of the multicentre randomised controlled BENTO trial to demonstrate patient-relevant benefit of bronchoscopic lung volume reduction using thermal vapour ablation in the German healthcare system for patients with upper lobe emphysema: a study protocol
Authors: Kontogianni Konstantina , Darwiche Kaid , Huebner Ralf Harto , Hassinger Fathema , Riemer Thomas , Herth Felix JF , Brock Judith
Published: May 2024

Introduction

Application of vapour ablation as a novel approach to lung volume reduction has positive effects in patients with severe emphysema. The BENTO study is a randomised, controlled, open, multicentre trial, to assess the effects of bronchoscopic thermal vapour ablation (BTVA) in the German healthcare system.

Methods and analysis

Patients with bilateral heterogeneous emphysema of the upper lobes in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3/4 will be enrolled in this trial and will receive either standard medical management alone (according to GOLD guidelines) or BTVA treatment with the InterVapor system together with standard medical management. Patients will be randomised in a 2:1 ratio (treatment group:control group). A total of 224 patients will be enrolled at 15 study sites. The primary endpoint is the change in patient-reported disease-specific quality of life, as measured by the St George’s Respiratory Questionnaire for chronic obstructive pulmonary disease patients between randomisation and the 9-month follow-up visit. Secondary endpoints include adverse events, mortality, vital status, changes in lung function parameters, exercise capacity and other efficacy measures at 3, 9 and 12 months.

The BENTO trial was commissioned by the German Federal Joint Committee, to demonstrate that this approach is an efficient and safe treatment option in the German healthcare system.

Ethics and dissemination

The protocol has been approved by the lead ethics committee in Germany (Ethics Committee of the Medical Faculty of Heidelberg) and until present also by the following ethics committees: Ethics Committee of the Medical Faculty of Duisburg-Essen, Ethics Committee of the Medical Faculty of Martin-Luther-University Halle-Wittenberg, Ethics Committee of the State Medical Association of Hessen, Ethics Commission of the State Office for Health and Social Affairs of the State of Berlin, Ethics Committee of the Medical Faculty of Greifswald. The results will be published in a peer-reviewed journal.

Trial registration number

NCT05717192.
Cross-sectional study of prevalence and correlates of fear of falling in the older people in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)
Authors: Marmamula Srinivas , Kumbham Thirupathi Reddy , Modepalli Satya Brahmanandam , Barrenkala Navya Rekha , Keeffe Jill Elizabeth , Friedman David S
Published: May 2024

Objective

To report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India.

Design

Cross-sectional study.

Setting

Homes for the aged centres in Hyderabad, India.

Participants

The study included individuals aged ≥60 years from homes for the aged centres. The participants underwent a comprehensive eye examination in make-shift clinics setup in homes. Trained investigators collected the personal and demographic information of the participants and administered the Patient Health Questionnaire-9 and Hearing Handicap Inventory for Elderly questionnaire in the vernacular language. FOF was assessed using the Short Falls Efficacy Scale. The presence of hearing and visual impairment in the same individual was considered dual sensory impairment (DSI). A multiple logistic regression analysis was done to assess the factors associated with FOF.

Primary outcome measure

FOF.

Results

In total, 867 participants were included from 41 homes for the aged centres in the analyses. The mean (±SD) age of the participants was 74.2 (±8.3) years (range 60–96 years). The prevalence of FOF was 56.1% (95% CI 52.7% to 59.4%; n=486). The multivariate analysis showed that those with DSI had eleven times higher odds of reporting FOF than those with no impairment (OR 11.14; 95% CI 3.15 to 41.4.) Similarly, those with moderate depression had seven times higher odds (OR 6.85; 95% CI 3.70 to 12.70), and those with severe depression had eight times higher odds (OR 8.13; 95% CI 3.50 to 18.90) of reporting FOF. A history of falls in the last year was also associated with increased odds for FOF (OR 1.52; 95% CI 1.03 to 2.26).

Conclusion

FOF is common among older individuals in residential care in India. Depression, falling in the previous year and DSI were strongly associated with FOF. A cross-disciplinary approach may be required to address FOF among the older people in residential care in India.
Exploring the factors influencing nutritional literacy based on the socioecological model among patients with age-related macular degeneration: a qualitative study from China
Authors: Luo Peilin , Zhang Feng , Li Xin , Wan Junli , Bian Wei
Published: May 2024

Objectives

Although nutritional support is beneficial to the visual rehabilitation of patients with age-related macular degeneration (AMD), a large gap continues to exist between the relevant guidelines and the actual practices of AMD patients; this gap can be attributed to a lack of nutritional literacy. Therefore, this study explored the factors affecting nutritional literacy among AMD patients.

Design

A qualitative study was carried out based on individual in-person interviews with 15 AMD patients; a semistructured interview guide was used for data collection. The socioecological model (SEM) was employed for data analysis.

Setting

The Southwest Hospital in Chongqing Province, China.

Participants

A purposive sample of 15 AMD patients was recruited between May and June 2023.

Results

The social ecosystem of patients with AMD has not been positive. At the intrapersonal level, the factors affecting the nutritional literacy of such patients are lack of knowledge, nutrition self-efficacy, economic burdens, dietary preferences and health status. At the interpersonal level, the factors that can influence patients’ nutritional literacy are social support and social roles. At the institutional level, the relevant factors are doctor–patient trust and interdisciplinary-team consistency. Finally, at the policy level, a powerful factor is the large gap between policy and implementation.

Discussion

Nutritional literacy focuses on the changes in an individual’s knowledge and behaviour concerning nutrition. To inform the development of nutritional-literacy interventions for people with AMD, medical staff should consider multiple perspectives that can remove the barriers to the SEM at all levels.
Eight years into the horizon of aspirational maternal and newborn health
pledges: a nationwide cross-sectional exploration of the Burundian EmONC
network capacity and budget deficits
Authors: Habonimana Desire , Leckcivilize Attakrit , Nicodemo Catia , Nzorironkankuze Jean Baptiste , Ndacayisaba Ananie , Bishinga Aristide , Ndayisenga Jeanine , Niane Eugenie Siga Diane , Bazikamwe Sylvestre , Ndabashinze† Pontien , English Mike
Published: May 2024

Objective

The Burundian emergency obstetric and neonatal care (EmONC)
programme, which was initiated in 2017 and supported by a specific
policy, does not appear to reverse maternal and newborn mortality
trends. Our study examined the capacity challenges facing participating
EmONC facilities and developed alternative investment proposals to
improve their readiness paying particular attention to EmONC
professionals, physical infrastructure, and capital equipment.

Design

Cross-sectional study.

Setting

Burundian EmONC facilities (n=112).

Participants

We examined EmONC policy documents, consulted 12 maternal and
newborn health experts and 23 stakeholders and policymakers, surveyed
all EmONC facilities (n=112), and collected cost data from the Ministry
of Health and local suppliers in Burundi. We developed three
context-specific EmONC resource benchmark standards by facility type;
the Burundian policy norms and the expert minimum and maximum suggested
thresholds; and used these alternatives to estimate EmONC resource gaps.
We forecasted three corresponding budget estimates needed to address
prevailing deficits taking a government perspective for a 5-year EmONC
investment strategy. Additionally, we explored relationships between
EmONC professionals and selected measures of service delivery using
bivariate analyses and graphically.

Results

The lowest EmONC resource benchmark revealed that 95% of basic EmONC
and all comprehensive EmONC facilities lack corresponding sets of human
resources and 90% of all facilities need additional physical
infrastructure and capital equipment. Assessed against the highest
benchmark which proposes the most progressive set of standards for the
prevailing workloads, Burundi would require 162 more medical doctors,
1005 midwives and nurses, 132 delivery rooms, 191 delivery tables, 678
and 156 maternity and newborn care beds, and 395 incubators amounting to
US$32.9 million additional budget for 5 years.

Conclusion

We demonstrated that Burundian EmONC facilities face enormous
capacity challenges equivalent to US$32.9 million funding gap for 5
years; averagely approximating to 5.96% total health budget increase
annually.
Efficacy and safety of hyperbaric oxygen therapy for long COVID: a protocol for systematic review and meta-analysis
Authors: Li Yuxin , Lin Jingnan , Gao Jiazhu , Tang Lijuan , Liu Yuntao , Zhang Zhongde
Published: May 2024

Introduction

There is still a lack of therapeutic options for long COVID. Several studies have shown the benefit of hyperbaric oxygen therapy (HBOT) on long COVID. However, the efficacy and safety of HBOT for long COVID remain unclear. Therefore, we will conduct this systematic review to assess the feasibility of HBOT as a primary or complemental therapy for long COVID.

Methods and analysis

Databases such as Web of Science, PubMed, Embase, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, International Clinical Trials Registry Platform, Wanfang Database, China National Knowledge Infrastructure, SINOMED, VIP Database and the Chinese Clinical Trial Registry will be searched systematically from the establishment to 9 December 2023. All articles will be reviewed by two independent reviewers. Cochrane risk of bias tool will be used to assess the risk of bias in the study. We will evaluate heterogeneity using a visual inspection of the funnel plot. If an available number of studies are identified, we will perform a meta-analysis.

Ethics and dissemination

No ethical approval is required since this study is based on published articles. The findings will be published in a peer-reviewed journal or disseminated through conference presentations.

PROSPERO registration number

CRD42023482523.
Paroxysmal sympathetic hyperactivity during neurorehabilitation for severe acquired brain injury: current Scandinavian practice and Delphi consensus recommendations
Authors: Godbolt Alison K , Zampakas Alexandros , Nygren Deboussard Catharina
Published: May 2024

Objectives

To document current practice and develop consensus recommendations for the assessment and treatment of paroxysmal sympathetic hyperactivity (PSH) during rehabilitation after severe acquired brain injury.

Design

Delphi consensus process with three rounds, based on the Guidance on Conducting and REporting DElphi Studies (CREDES) guidelines, led by three convenors (the authors) with an expert panel. Round 1 was exploratory, with consensus defined before round 2 as agreement of at least 75% of the panel.

Setting

A working group within the Nordic Network for Neurorehabilitation.

Panel participants

Twenty specialist physicians, from Sweden (9 participants), Norway (7) and Denmark (4), all working clinically with patients with severe acquired brain injury and with current involvement in clinical decisions regarding PSH.

Results

Consensus was reached for 21 statements on terminology, assessment and principles for pharmacological and non-pharmacological treatment, including some guidance on specific drugs. From these, an algorithm to support clinical decisions at all stages of inpatient rehabilitation was created.

Conclusions

Considerable consensus exists in the Nordic countries regarding principles for PSH assessment and treatment. An interdisciplinary approach is needed. Improved documentation and collation of data on treatment given during routine clinical practice are needed as a basis for improving care until sufficiently robust research exists to guide treatment choices.
Smoking, nicotine and pregnancy 2 (SNAP2) trial: protocol for a randomised controlled trial of an intervention to improve adherence to nicotine replacement therapy during pregnancy
Authors: Clark Miranda M , Cooper Sue , Naughton Felix , Ussher Michael , Emery Joanne , McDaid Lisa , Thomson Ross , Phillips Lucy , Bauld Linda , Aveyard Paul , Torgerson David , Berlin Ivan , Lewis Sarah , Parrott Steve , Hewitt Catherine , Welch Charlie , Parkinson Gill , Dickinson Anne , Sutton Stephen , Brimicombe James , Bowker Katharine , McEwen Andrew , Vedhara Kavita , Coleman Tim
Published: May 2024

Introduction

Smoking during pregnancy is harmful to unborn babies, infants and women. Nicotine replacement therapy (NRT) is offered as the usual stop-smoking support in the UK. However, this is often used in insufficient doses, intermittently or for too short a time to be effective. This randomised controlled trial (RCT) explores whether a bespoke intervention, delivered in pregnancy, improves adherence to NRT and is effective and cost-effective for promoting smoking cessation.

Methods and analysis

A two-arm parallel-group RCT was conducted for pregnant women aged ≥16 years and who smoke ≥1 daily cigarette (pre-pregnancy smoked ≥5) and who agree to use NRT in an attempt to quit. Recruitment is from antenatal care settings and via social media adverts. Participants are randomised using blocked randomisation with varying block sizes, stratified by gestational age (<14 or ≥14 weeks) to receive: (1) usual care (UC) for stop smoking support or (2) UC plus an intervention to increase adherence to NRT, called ‘Baby, Me and NRT’ (BMN), comprising adherence counselling, automated tailored text messages, a leaflet and website. The primary outcome is biochemically validated smoking abstinence at or around childbirth, measured from 36 weeks gestation. Secondary outcomes include NRT adherence, other smoking measures and birth outcomes. Questionnaires collect follow-up data augmented by medical record information. We anticipate quit rates of 10% and 16% in the control and intervention groups, respectively (risk ratio=1.6). By recruiting 1320 participants, the trial should have 90% power (alpha=5%) to detect this intervention effect. An economic analysis will use the Economics of Smoking in Pregnancy model to determine cost-effectiveness.

Ethics and dissemination

Ethics approval was granted by Bloomsbury National Health Service’s Research Ethics Committee (21/LO/0123). Written informed consent will be obtained from all participants. Findings will be disseminated to the public, funders, relevant practice/policy representatives, researchers and participants.

Trial registration number

ISRCTN16830506.

Protocol version

5.0, 10 Oct 2023.
Outcomes and safety of endovascular treatment from 6 to 24 hours in patients with a pre-stroke moderate disability (mRS 3): a multicenter retrospective study
Authors: Maestrini Ilaria , Rocchi Lorenzo , Diana Francesco , Requena Ruiz Manuel , Elosua-Bayes Iker , Ribo Marc , Abdalkader Mohamad , Klein Piers , Gabrieli Joseph D , Alexandre Andrea M , Pedicelli Alessandro , Lacidogna Giordano , Ciullo Ilaria , Marnat Gaultier , Cester Giacomo , Broccolini Aldobrando , Nguyen Thanh N , Tomasello Alejandro , Garaci Francesco , Diomedi Marina , Da Ros Valerio
Published: May 2024

Background

Approximately 30% of patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion have pre-stroke modified Rankin Scale (mRS) scores ≥2. We aimed to investigate the safety and outcomes of endovascular treatment (EVT) in patients with AIS with moderate pre-stroke disability (mRS score 3) in an extended time frame (ie, 6–24 hours from the last time known well).

Methods

Data were collected from five centers in Europe and the USA from January 2018 to January 2023 and included 180 patients who underwent EVT in an extended time frame. Patients were divided into two groups of 90 each (Group 1: pre-mRS 0–2; Group 2: pre-mRS 3; 71% women, mean age 80.3±11.9 years). Primary outcomes were: (1) 3-month good clinical outcome (Group 1: mRS 0–2, Group 2: mRS 0–3) and ΔmRS; (2) any hemorrhagic transformation (HT); and (3) symptomatic HT. Secondary outcomes were successful and complete recanalization after EVT and 3-month mortality.

Results

No between-group differences were found in the 3-month good clinical outcome (26.6% vs 25.5%, P=0.974), any HT (26.6% vs 22%, P=0.733), and symptomatic HT (8.9 vs 4.4%, P=0.232). Unexpectedly, ΔmRS was significantly smaller in Group 2 compared with Group 1 (1.64±1.61 vs 2.97±1.69, P<0.001). No between-group differences were found in secondary outcomes.

Conclusion

Patients with pre-stroke mRS 3 are likely to have similar outcomes after EVT in the extended time frame to those with pre-stroke mRS 0–2, with no difference in safety.
A practical synthesis and X-ray crystal structure of (E)-4-(1-naphthylvinyl)pyridine and related compounds
Authors: Moffat James G.D. , Pham-Tran Victoria N.P. , Marczenko Katherine M.
Published: May 2024

The synthesis, structure, and photoreactivity of (E)-4-(1-naphthylvinyl)pyridine ((E)-4-1-nvp; 1) and its coordination compounds have been investigated. Synthesis of (1) via Wittig olefination resulted in a challenging isomer separation and purification process. By synthesizing (1) via a Horner–Wadsworth–Emmons reaction, high stereoselectivity and purity were achieved. The crystal structure of (1) revealed significant intramolecular rotation facilitated by CH···π interactions, ultimately preventing olefin stacking in both the solid-state structure of (1) and a cocrystal with a structural isomer. Novel Ag(I) and Zn(II) coordination complexes that utilize (1) as a ligand were also synthesized and fully characterized, facilitating the examination of the relationship between molecular planarity and secondary bonding contributions via Hirshfeld surface analyses. These findings deepen our understanding of intermolecular interactions involving (E)-4-1-nvp and offer insights for designing novel photoresponsive materials capable of solid-state [2 + 2] cycloaddition.
The Yellowknife greenstone belt and underlying Central Slave Cover Group, Slave craton, Canada: constraints and questions arising from a U–Pb dating study
Authors: Ketchum John W.F. , Bleeker Wouter , Falck Hendrik , Jackson Valerie A.
Published: May 2024

Legacy U–Pb isotopic data are reported for the Mesoarchean Central Slave Cover Group and Neoarchean Yellowknife greenstone belt, Slave craton, Northwest Territories, Canada. In two locations north of the City of Yellowknife, exposures of cover group rocks occur beneath mafic volcanic and subvolcanic units traditionally assigned to the basal Chan Formation of the Kam Group. Both cover group occurrences contain felsic volcanic tuff units that yield eruption ages of 2853 + 2/−1.5 Ma and 2826 ± 1.5 Ma. The younger tuff is underlain by felsic volcaniclastic schist with a dominant, basement-aged detrital zircon population that was deposited after 2840 ± 6 Ma. Near the south end of the exposed greenstone belt, a felsic tuff within the Octopus Formation provides an age of 2699 ± 3 Ma, confirming that this formation is not part of the Central Slave Cover Group. A pillowed basalt flow within the Chan Formation is cut by a composite gabbro dyke dated as 2738 +3.5/−3 Ma. However, a more general ca. 2730–2740 Ma age interpretation for this dyke may be appropriate due to the potential for complex lead loss behaviour in the dated baddeleyite fractions. Younger U–Pb zircon and monazite ages reported herein (2710–2706 Ma) contribute to our understanding of felsic magmatic and gold-mineralizing events that influenced later development of the Yellowknife greenstone belt. Although the depositional history of the autochthonous Central Slave Cover Group is becoming better known, questions remain regarding the age and tectonomagmatic affinity of adjacent mafic volcanic rocks traditionally assigned to the Kam Group and correlative assemblages. Are some of these rocks actually part of the Central Slave Cover Group?
Fermion-soliton scattering in a modified $$\mathbb{C}\mathbb{P}^{1}$$ model
Authors: Loginov A. Yu.
Published: May 2024

The scattering of fermions in the background field of a topological soliton of the modified $$(2 + 1)$$

(
2
+
1
)

-dimensional $$\mathbb{C}\mathbb{P}^{1}$$

C

P

1

model is studied here both analytically and numerically. Unlike the original $$\mathbb{C}\mathbb{P}^{1}$$

C

P

1

model, the Lagrangian of the modified model contains a potential term. Due to this, a dilatation zero mode of the topological soliton disappears, which results in stability of the fermion-soliton system. The symmetry properties of the fermion-soliton system are established, and the asymptotic forms of fermionic radial wave functions are studied. Questions related to the bound states of the fermion-soliton system are then discussed. General formulae describing the scattering of fermions are presented. The amplitudes of the fermion-soliton scattering are obtained in an analytical form within the framework of the Born approximation, and their symmetry properties and asymptotic forms are studied. The energy levels of the fermionic bound states and the partial phase shifts of fermionic scattering are obtained by numerical methods, and the ultrarelativistic limits of the partial phase shifts are found.
In search of the biggest bangs since the big bang
Authors: Ellis John , Fairbairn Malcolm , Urrutia Juan , Vaskonen Ville
Published: May 2024

Many galaxies contain SuperMassive Black Holes (SMBHs), whose formation and history raise many puzzles. Pulsar timing arrays have recently discovered a low-frequency cosmological “hum” of gravitational waves that may be emitted by SMBH binary systems, and the JWST and other telescopes have discovered an unexpectedly large population of high-redshift SMBHs. We argue that these two discoveries may be linked, and that they may enhance the prospects for measuring gravitational waves emitted during the mergers of massive black holes, thereby opening the way towards resolving many puzzles about SMBHs as well as providing new opportunities to probe general relativity.