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Differences in sensory nerve block between levobupivacaine and bupivacaine at low concentrations in humans and animals
Physiochemical properties of levobupivacaine and bupivacaine are identical, but pharmacokinetic and pharmacodynamics properties differ due to stereoselective interactions at the molecular sites of action. An evaluation of nerve block characteristics is essential for optimal clinical application. This study compared the sensory blocking characteristics of levobupivacaine to bupivacaine in humans and model animals. Levobupivacaine and bupivacaine were compared for sensory block efficacy using a randomized, double-blinded, crossover study design. Eighteen healthy volunteers were randomized to receive levobupivacaine or bupivacaine by subcutaneous injection into the forearm, followed by the other drug 1 week later with injection order counterbalanced across subjects. Tactile detection and mechanical pain thresholds were determined using von Frey hairs and thermal pain threshold using a thermal stimulator. Effects of levobupivacaine and bupivacaine, on the spiking activity of spinal dorsal horn (SDH) neurons evoked by innocuous or noxious stimuli were also compared in anesthetized Sprague–Dawley rats by in vivo extracellular recordings. There were no significant differences in mechanical and thermal pain thresholds following levobupivacaine or bupivacaine injection at 0.025%, 0.0625%, and 0.125%. There was also no significant difference in tactile detection threshold following levobupivacaine or bupivacaine injection at 0.125%. However, tactile detection threshold was significantly higher after administration of bupivacaine at 0.025% and 0.0625% compared to equivalent doses of levobupivacaine. Subcutaneous injection of bupivacaine at 0.05% also induced significantly greater inhibition of SDH neuron spiking activity evoked by innocuous stimuli compared to an equivalent dose of levobupivacaine, while there was no significant difference in suppression of spiking activity evoked by noxious stimuli. Low-dose bupivacaine induces greater suppression tactile sensation than low-dose levobupivacaine. Thus, low-dose levobupivacaine demonstrates relatively greater blocking selectivity for noxious over innocuous stimuli compared to low-dose bupivacaine. Levobupivacaine may be advantageous for applications where pain must be suppressed but non-nociceptive sensations maintained.
Disaster victim identification: the co-utilisation of applied biosystems RapidHIT ID system and DJI Matrice 300 drone for onsite DNA analysis
Genome wide association study reveals novel associations with face morphology
Genome-wide association studies (GWAS) on the Middle Eastern population, including the United Arab Emirates (UAE), have been relatively limited. The present study aims to investigate genotype-face morphology associations in the UAE population through Genome Wide Association Studies (GWAS). Phenotypic data (44 face measurements) from 172 Emiratis was obtained through three-dimensional (3D) scanning technology and an automatic face landmarking technique. GWAS analysis revealed associations of 19 genetic loci with six face features, 14 of which are novel. The GWAS analysis revealed 11 significant relationships between 44 face parameters and 242 SNPs, exceeding the GWAS significance threshold. These phenotypes were previously associated with body height, craniofacial defects, and facial characters. The most significant associations of these genetic variations were related to six main facial features which were facial convexity, left orbital protrusion, mandibular contour, nasolabial angle D, inferior facial angle B, and inferior facial angle A. To the best of our knowledge, this is the first GWAS study to investigate the association of SNP variations with face morphology in the Middle Eastern population.
Biopsychosocial based machine learning models predict patient improvement after total knee arthroplasty
Validity evidence for assessing social-emotional psychological strengths in Colombian adolescents using the SEHS-S
Background Covitality is a multidimensional hierarchical construct of core psychological strengths that synergistically promote resilience and well-being and that has been shown to be effective in preventing mental health problems in individuals of different age groups. The Covitality Model consists of 12 first-order latent factors, 4 second-order factors, and one general higher-order Covitality factor. Purpose In this study, we aim at obtaining validity evidence for the assessment of Covitality in Colombian adolescents by means of the Social Emotional Health Survey-Secondary (SEHS-S). Method A sample of 1461 adolescents responded the SEHS-S and four other instruments that measure well-being and distress. The internal structure of the SEHS-S was examined through confirmatory factor analyses as well as its relations with other variables. Results The hierarchical factor structure of the SEHS-S was supported (with goodness-of-fit statistics: χ2 = 1727.6, df = 578, p < .001; RMSEA = .037; SRMSR = .044; AGFI = .962; CFI = .940; and NNFI = .935) and configural and metric invariance across gender and age was confirmed; however, the assumption of scalar invariance across males and females and across age groups was violated for some items. Furthermore, we found moderate to high correlations (r = .56 –.68) of Covitality with related constructs. Conclusion As a conclusion, the SEHS-S can be considered a valid tool to assess psychological strengths, well-being, and resilience (i.e., Covitality) in Colombian adolescents, though further research is needed to explore the differences in item functioning across gender and age.
Drug coated balloon angioplasty for de novo coronary lesions in large vessels: a systematic review and meta-analysis
Identifying priorities and developing collaborative action plans to improve accessible housing practice, policy, and research in Canada
This article describes the development of priorities and actions to improve the state of research, policy, and practice related to accessible housing in Canada for persons with disability or with accessible housing needs. A modified Delphi approach with an expert cross-sectoral panel was used to gain convergence on a set of priorities for advancing the accessible housing field in Canada. This included circulating an anonymous pre-meeting survey (N = 49) followed by an in-person planning meeting (N = 45). The expert panel at the in-person meeting identified three clusters of priorities from an initial list of 21 priorities, which included: 1) engaging with all levels of government to support accessible housing efforts; 2) developing educational resources to raise awareness about accessible housing, and creating services to facilitate locating and acquiring accessible housing; and 3) fostering meaningful engagement across key interest groups and sectors to find solutions to enact positive change in this space. The findings provide an initial roadmap for bringing greater cohesion to the accessible housing field, which will enable cross-sectoral partnerships and collective action towards informing the next generation of accessible housing standards, regulations and practices for people with accessible housing needs.
Decoupling chemical and mechanical signaling in colorectal cancer cell migration
Patient-Reported Outcomes among people living with Chronic Pruritus (PROs-CP): Protocol for a single-center, multistage, mixed-methods prospective cohort study in Thailand
Background Although there have been well-validated patient-reported outcome (PRO) measurements in dermatology practice, there is limited evidence of the adopted comprehensive aspects of PRO measures in long-term follow-up among people living with chronic pruritus. As such, we aim to create a cohort study of the Patient-Reported Outcomes among people living with Chronic Pruritus (PROs-CP) in Thailand. Methods and design This study is a single-center, prospective, open cohort, observational longitudinal study using a multistage, mixed-methods parallel designs to integrate both quantitative and qualitative data regarding PROs among people living with chronic pruritus (itch lasting six or more weeks). The multistage of the PROs-CP study will comprise three sub-studies: (i) study I, PROs measure development, translation, and psychometric validation; (ii) study II, perspectives of people living with chronic pruritus to gain more information regarding disease burden and unmet treatment care responses; and (iii) study III, a longitudinal study to assess the impact of chronic pruritus on long-term health outcomes. Based on a comprehensive review of a panel of stakeholders with chronic skin disease, a set of PRO measurement tools will comprise an established validated Thai version. Meanwhile, meaningful non-Thai versions or unestablished PRO instruments will be translated and developed through this study as appropriate. Quantitative data will be collected based on PRO measures regarding pruritus symptoms and severity, disease activity control and treatment satisfaction, general- and dermatology-specific health-related quality of life, mental health and psychosocial issues, and psychosomatic symptoms. Qualitative data will be obtained from the patient’s perspectives through individual interviews. Ethics and dissemination The study protocol was approved by the Ethics Committee of the Faculty of Medicine, Chiang Mai University (MED-2566-0299), Thailand. Our findings will be disseminated through scientific conferences and publications in peer-reviewed journals. Conclusion Regarding the mixed-methods approach, this open cohort, prospective longitudinal study will provide an evidence-based better understanding of patient perspectives on chronic pruritus burden and inform the utility of a comprehensive set of PROs to measure their long-term health outcomes. Trial registration Thai Clinical Trials Registry (TCTR, thaiclinicaltrials.org) registration TCTR20240327001 (registered on March 27, 2024).
Machine learning prediction of breast cancer local recurrence localization, and distant metastasis after local recurrences
Abstract Local recurrences (LR) can occur within residual breast tissue, chest wall, skin, or newly formed scar tissue. Artificial intelligence (AI) technologies can extract a wide range of tumor features from large datasets helping in oncological decision-making. Recently, machine learning (ML) models have been developed to predict breast cancer recurrence or distant metastasis (DM). However, there is still a lack of models that consider the localization of LR as a tumor feature. To address this gap, here, we analysed data from 154 patients including pathological, clinical, and follow-up data (with an average follow-up of 133.16 months) on both primary tumors (PT) and recurrences. By using ML methods we predicted the localization of LR and the occurrence of DM after LR. The performance (ROC AUC) of the best ML models was 0.75, and 0.69 for predicting LR in breast parenchyma, and surgical scar tissue, respectively, and 0.74 for predicting DM after LR. We identified recurrence localization, and the time elapsed between the detection of primary breast carcinoma and the recurrence, and adjuvant chemotherapy as the most important features associated with further DM. We conclude that combining traditional prognostic factors with ML may provide important tools in the risk assessment of patients with breast LR.
Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: A participatory action approach
The purpose of our study was to develop a toolkit to facilitate the implementation of functional electrical stimulation (FES) cycling for persons with a newly acquired spinal cord injury (SCI) in the acute care inpatient hospital setting. The researchers and community members used participatory action as a research approach to co-create the toolkit. We held two focus groups to develop drafts, with a third meeting to provide feedback, and a fourth meeting to evaluate the toolkit and determine dissemination strategies. Toolkit development followed the Planning, Action, Reflection, Evaluation cycle. We used an iterative design informed by focus group and toolkit consultant (SC) feedback. In focus group discussions, we included FES cycling champions (JK, DW) who led acute care implementation. Focus group members, recruited through purposive sampling, had to 1) have an understanding about FES cycling in acute care for SCI and 2) represent one of these groups: individual living with SCI, social support, hospital manager, clinician, therapist, researcher, and/or acute care FES cycling champion. Twelve individuals took part in four focus groups to develop a toolkit designed to facilitate implementation of FES cycling in SCI acute care in Edmonton, Alberta. Group members included an individual with lived experience, three acute-care occupational or physical therapists, three acute-care hospital managers, and five researchers. Two physical therapists also identified as clinical FES cycling champions. Following an inductive content analysis, we identified four main themes: 1) Health care provider toolkit content and categories, 2) Health care provider toolkit end product, 3) Collaborations between groups and institutions and 4) Infrastructure. Interested parties who utilize FES cycling in acute care for SCI rehabilitation agree that toolkits should target the appropriate group, be acute care setting-specific, and provide information for a smooth transition in care.
The long-term associations of childhood parental loss with attachment, creativity, and epigenetic regulation
Correction: Health and wellness in the Australian coal mining industry: An analysis of pre-post findings from the RESHAPE workplace health promotion program
Understanding in same- versus cross-race close relationships predicts the well-being of people of color over time
Fair food futures UK: Protocol for a mixed methods study exploring what approaches adopted by community food organisations are more likely to prevent the need for emergency food in two multicultural communities in Northern and Southern England
Introduction Food insecurity reduces people’s chances to live healthy and active lives and places a significant burden on healthcare systems. Levels have significantly increased in the UK since 2010, due to the impact of austerity and, more recently, the COVID-19 pandemic and the cost of living crisis. This increase is projected to continue. Households with children are amongst those at highest risk for food insecurity. A variety of community food organisations (CFOs), such as community gardens, community kitchens, food banks and social markets, have been essential in responding to rising food insecurity, including providing emergency food and other types of support such as welfare advice. However, beyond food banks, little is known about differing approaches to food aid in the UK, including how these organisations provide additional services to address the underlying issue that has led someone to seek emergency food support. Aim To understand what approaches used by community food organisations are most likely to help prevent the need for emergency food in two multicultural communities in the North (Bradford) and South (Tower Hamlets, London) of England, with high levels of ill-health and food insecurity. Research design, setting and participants This is a mixed methods study informed by complex systems theory. Methods include participatory systems mapping and qualitative longitudinal research. We will map the availability and type of help with food, and produce a typology of CFO approaches, using a survey, multiple local and national participatory system mapping workshops and interviews with local and national stakeholders (WP1). Then, we will conduct a longitudinal qualitative research using a ‘researcher in residence’ approach in up to 10 CFOs purposively sampled to reflect the diversity of prevention strategies adopted by CFOs. Research will include: a) a 12 month ethnographic study; b) three waves of ‘go along’ interviews with up to 35 families; and c) a visual study where the same families are invited to share photos and videos about their food thoughts via Indeemo research app. Outputs and dissemination Outputs will include: a) a toolkit on CFOs to support local and national policy and implementation decisions, b) a travelling exhibition with visual representations of people’s lived experiences c) publications in academic journals, d) blog posts, e) public talks, and f) policy briefs. Findings will help decision makers to invest in the most accessible, beneficial and culturally appropriate resources for communities.
Two-stream spatio-temporal GCN-transformer networks for skeleton-based action recognition
The impact of Duration of Untreated Psychosis on functioning and quality of life over one year of Coordinated Specialty Care (CSC)
Background This study examined the relationship between the Duration of Untreated Psychosis (DUP) and functional outcomes at baseline, 6 months, and 12 months after admission to Coordinated Specialty Care (CSC). Methods A total of 246 participants from two U.S. public-sector CSC programs were categorized into Low and High DUP groups using two criteria: (i) a median split of the DUP distribution and (ii) the World Health Organization (WHO) aspirational standard of 3 months. Changes in global functioning (GAF), social functioning (GF: Social), and occupational functioning (GF: Role), symptom severity (PANSS), and quality of life (QoL) were assessed using a Linear Mixed Model Repeated Measures (MMRM) analysis across the three time points. A Generalized Linear Model (GLM) with a logit link function was applied to analyze binary outcomes, specifically the status of being Neither in the Labor Force, Education, or Training (NLFET). Both models adjusted for time and site as covariates and used an unstructured variance-covariance matrix to account for within-subject correlations in repeated measures. The difference-in-differences method was employed to estimate the impact of DUP on outcomes over time, with results reported as least square means for continuous outcomes, odds ratios for binary outcomes, and 95% confidence intervals (CI) for both Low and High DUP groups. Results No significant differences were observed between the Low and High DUP groups at baseline. By 6 months, participants in the Low DUP group (DUP < 3 months) exhibited significantly greater improvements (reduction) in NLFET status (3-month OR = 3.25, p = 0.03; median split OR = 2.25, p = 0.03) and global functioning, GF: Role, and GF: Social. By 12 months, the Low DUP group continued to show significantly greater NLFET status improvement (3-month OR = 3.59, p = 0.03; median split OR = 3.40, p = 0.0032). Improvements in global functioning were sustained at 12 months, while social and occupational functioning gains were not. No significant differences were observed between groups for quality of life or symptom severity over time. Conclusion Shorter DUP is linked to more rapid functional recovery within the first year after CSC admission.
Research on the properties of polymer stabilized coal gangue materials in rubber powder slag base
Prevalence and associated factors of diabetic ketoacidosis among patients with diabetes mellitus at the University of Gondar Comprehensive and Specialized Referral Hospital Northwest, Ethiopia
Background Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetic ketoacidosis is one of the life-threatening complications in diabetic individuals with, high morbidity and mortality globally. However, the data related to the prevalence and associated factors of diabetic ketoacidosis are limited in the study setting. Objective To assess the prevalence of diabetic ketoacidosis and its associated factors among diabetic mellitus patients at the University of Gondar Comprehensive Specialized Hospital. Methods A hospital-based cross-sectional study was conducted from March 1 to September 30, 2021. A total of 405 diabetic patients aged 20 and above were selected using a systematic random sampling technique. A total of 810 blood and urine samples (each 405) were collected using sterile serum separator tubes and urine collection cups, respectively. Sociodemographic and clinical data was collected using a structured questionnaire. Chemical analysis of urine was done using urine reagent strips to determine urine ketone bodies and PH. BECKMAN COULTER DxC700 AU clinical chemistry analyzer instrument was used to determine electrolytes and metabolites. The data was entered using Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analyses were used to determine the factors associated with the diabetic ketoacidosis. The results were considered statistically significant if the adjusted odds ratio was reported with a 95% confidence interval and a P-value below 0.05. Results The overall prevalence of diabetic ketoacidosis among diabetic patients was 35/405 (8.6%, 95% CI: 6.0–11.0%). Of these cases, 25 (71.4%) had type 1 diabetes mellitus, while 10 (28.6%) had type 2 diabetes mellitus. Statistically significant factors associated with diabetic ketoacidosis included being a young adult aged 20–29 years (AOR = 2.262; 95% CI = 1.090–4.758; P = 0.013), unemployment (AOR = 2.578; 95% CI = 1.457–6.113; P = 0.017), the presence of infection (AOR = 2.819; 95% CI = 1.138–8.428; P = 0.024), and being T1DM (AOR = 3.106; 95% CI = 1.150–7.273; P = 0.003). Conclusions and recommendations The prevalence of diabetic ketoacidosis among follow-up diabetes patients in this study was high, particularly among those aged 20–29 years, unemployed, or with infections. Increased vigilance, regular monitoring, timely infection management, and comprehensive diabetes education are essential for early detection and prevention of DKA. Social and financial support for unemployed diabetic patients can further enhance access to care and reduce DKA risk.