A physiotherapy-led early mobilisation protocol for neurosurgical patients with external ventricular drains in intensive care: A service evaluation

Background: An external ventricular drain (EVD) is used to relieve elevated intracranial pressure in neurosurgical patients, and remains in place for an average of 8 days post-surgery. The presence of an EVD poses a major barrier to early mobilisation due to safety concerns. Eligibility criteria published in EVD mobilisation protocols only consisted of parameters related to the neurological system (Moyer et al., 2017; Young et al., 2019). Parameters pertaining to cardiovascular, respiratory and musculoskeletal systems deemed safe for mobilisation were not stated. Aims: To determine the safety, feasibility and effectiveness of implementing an early mobilisation protocol, which included physiological parameters, in patients with EVDs. Methods: A retrospective service evaluation was conducted in a neurological intensive care unit. Medical records were reviewed for 2 periods from October 2017 to March 2018 (pre-protocol period) and October 2019 to March 2020 (protocol period). Eligible patients for out-of-bed mobilisation were screened and identified by physiotherapists. Results: After protocol implementation, there was a 64.8% increase in the proportion of patients with EVDs mobilised (95% CI, 35.9–82.1%, p <0.0001). Median time from EVD placement to 1st mobilisation decreased from 14 to 3.5 days (p <0.0001). Moreover, the median intensive care and hospital length of stays were significantly reduced from 8 to 3.5 days (p = 0.037) and 38 to 22.5 days (p = 0.030) respectively. No adverse events were recorded in the protocol period. Conclusion: The early mobilisation protocol for patients with EVDs enabled safe, feasible and effective mobilisation. Future prospective, controlled research studies are warranted

Impact of Pharmacist Care in a Shared Medical Appointment Model for the Management of Type 2 Diabetes in a Micronesian Population

More than 25 million people have diabetes in the United States and its complications make it a leading cause of death. Pacific Islanders, specifically Micronesians, experience even higher rates of diabetes, and pharmacist care for these individuals may improve health outcomes. Objective: To better address health disparities in this population, a health center serving Hawaii Island added clinical pharmacy services into their shared medical appointment program for diabetes management. Methods: Standard care (n= 21) consisted of weekly education sessions for patients provided by a multi-disciplinary team, after which patients had one-on-one appointments with a primary care provider if they met threshold clinical criteria. The intervention group (n=36) received the same services, plus a medication management service provided by a pharmacist during the one-on-one appointments. Results: There was no statistically significant difference between the pharmacist care and standard care groups on clinical measures including glycosylated hemoglobin, low density lipoprotein and blood pressure at the end of the eighteenmonth intervention period. Conclusion: Pacific Islanders face unique health care challenges including low socioeconomic status, language barriers and differences in cultural perceptions of health care. The value of clinical pharmacy has been well-documented in the literature but further study of the role and impact of these services is warranted for high-risk populations

The past, current and future epidemiological dynamic of SARS-CoV-2

SARS-CoV-2, the agent of the COVID-19 pandemic, emerged in late 2019 in China, and rapidly spread throughout the world to reach all continents. As the virus expanded in its novel human host, viral lineages diversified through the accumulation of around two mutations a month on average. Different viral lineages have replaced each other since the start of the pandemic, with the most successful Alpha, Delta and Omicron variants of concern (VoCs) sequentially sweeping through the world to reach high global prevalence. Neither Alpha nor Delta was characterized by strong immune escape, with their success coming mainly from their higher transmissibility. Omicron is far more prone to immune evasion and spread primarily due to its increased ability to (re-)infect hosts with prior immunity. As host immunity reaches high levels globally through vaccination and prior infection, the epidemic is expected to transition from a pandemic regime to an endemic one where seasonality and waning host immunization are anticipated to become the primary forces shaping future SARS-CoV-2 lineage dynamics. In this review, we consider a body of evidence on the origins, host tropism, epidemiology, genomic and immunogenetic evolution of SARS-CoV-2 including an assessment of other coronaviruses infecting humans. Considering what is known so far, we conclude by delineating scenarios for the future dynamic of SARS-CoV-2, ranging from the good—circulation of a fifth endemic ‘common cold’ coronavirus of potentially low virulence, the bad—a situation roughly comparable with seasonal flu, and the ugly—extensive diversification into serotypes with long-term high-level endemicity

Retrospective analysis of main and interaction effects in genetic association studies of human complex traits

<p>Abstract</p> <p>Background</p> <p>The etiology of multifactorial human diseases involves complex interactions between numerous environmental factors and alleles of many genes. Efficient statistical tools are demanded in identifying the genetic and environmental variants that affect the risk of disease development. This paper introduces a retrospective polytomous logistic regression model to measure both the main and interaction effects in genetic association studies of human discrete and continuous complex traits. In this model, combinations of genotypes at two interacting loci or of environmental exposure and genotypes at one locus are treated as nominal outcomes of which the proportions are modeled as a function of the disease trait assigning both main and interaction effects and with no assumption of normality in the trait distribution. Performance of our method in detecting interaction effect is compared with that of the case-only model.</p> <p>Results</p> <p>Results from our simulation study indicate that our retrospective model exhibits high power in capturing even relatively small effect with reasonable sample sizes. Application of our method to data from an association study on the catalase -262C/T promoter polymorphism and aging phenotypes detected significant main and interaction effects for age-group and allele T on individual's cognitive functioning and produced consistent results in estimating the interaction effect as compared with the popular case-only model.</p> <p>Conclusion</p> <p>The retrospective polytomous logistic regression model can be used as a convenient tool for assessing both main and interaction effects in genetic association studies of human multifactorial diseases involving genetic and non-genetic factors as well as categorical or continuous traits.</p

THE IMPACT OF SOCIAL MEDIA ON GEN-Y EMPLOYEES’ WORK PERFORMANCE IN A TELCO, MALAYSIA

Generation-Y (Gen-Y) is the largest generational cohort in the global workforce, surpassing 50 percent in 2020, making them the most influential group to impact work performance. Highly competitive telecommunication companies continuously look for ways to improve employees' work performance. This research focuses on how social media improves the work performance of Gen-Y employees of a telco in Malaysia through social media use, shared vision, network ties, trust, and knowledge transfer. This research discovered an insignificant relationship between social media use at the workplace and work performance. This is because social media is currently not an official workplace tool, and its usage is limited among Gen-Y employees in the telco. It was also uncovered that using social media to act as a tool to gain trust did not influence work performance, even though the telco's primary official communication tool is email and a mobile app for communication and collaboration purposes. Nevertheless, this research uncovered that shared vision, network ties, and knowledge transfer is significant for the telco's Gen-Y employees to enhance their work performance. In conclusion, the telco's management can leverage social media to improve the work performance of Gen-Y employees by developing a social media strategy to provide a suitable framework with proper guidelines, policies, and procedures.  Article visualizations

A supply chain framework for characterizing indirect vulnerability

Purpose Climate vulnerability assessments are often operationalized by the analysis of indicators defined by the spatial boundaries of the community under study. These, however, sometimes fail to capture interdependency among communities for basic resources. This paper aims to propose a framework for characterizing vulnerability caused by interdependency by adapting a supply chain lens. Design/methodology/approach The paper proposes a definition for “indirect vulnerability” that recognizes the transboundary and teleconnected nature of vulnerability arising from resource networks among cities and communities. A conceptual framework using a supply chain approach is presented for climate hazards in particular. This approach is then demonstrated through a rapid appraisal of the rice, energy and water supply chains and the waste management chains of Metro Manila. Findings The application of the supply chain lens to assessing the indirect vulnerability of Metro Manila brings to fore issues extending beyond the decision-making boundaries of local government units. Addressing these will require vertical government coordination and horizontal inter-sectoral collaboration. Thus, this supply chain-based indirect vulnerability assessment can be complementary to traditional vulnerability assessments in providing a larger systems perspective. Originality/value Innovative tools are needed to make community vulnerability assessments both holistic and tractable. Existing methods in the private sector can be adapted rather than reinventing the wheel. This supply chain framework can be a useful decision support and planning tool across governance levels to comprehensively address vulnerability

Multi-Object Tracking by Iteratively Associating Detections with Uniform Appearance for Trawl-Based Fishing Bycatch Monitoring

The aim of in-trawl catch monitoring for use in fishing operations is to detect, track and classify fish targets in real-time from video footage. Information gathered could be used to release unwanted bycatch in real-time. However, traditional multi-object tracking (MOT) methods have limitations, as they are developed for tracking vehicles or pedestrians with linear motions and diverse appearances, which are different from the scenarios such as livestock monitoring. Therefore, we propose a novel MOT method, built upon an existing observation-centric tracking algorithm, by adopting a new iterative association step to significantly boost the performance of tracking targets with a uniform appearance. The iterative association module is designed as an extendable component that can be merged into most existing tracking methods. Our method offers improved performance in tracking targets with uniform appearance and outperforms state-of-the-art techniques on our underwater fish datasets as well as the MOT17 dataset, without increasing latency nor sacrificing accuracy as measured by HOTA, MOTA, and IDF1 performance metrics

A new gnotobiotic pig model of P[6] human rotavirus infection and disease for preclinical evaluation of rotavirus vaccines

Human rotavirus (HRV) is a leading cause of gastroenteritis in children under 5 years of age. Licensed vaccines containing G1P[8] and G1-4P[8] strains are less efficacious against newly emerging P[6] strains, indicating an urgent need for better cross protective vaccines. Here, we report our development of a new gnotobiotic (Gn) pig model of P[6] HRV infection and disease as a tool for evaluating potential vaccine candidates. The Arg HRV (G4P[6]) strain was derived from a diarrheic human infant stool sample and determined to be free of other viruses by metagenomic sequencing. Neonatal Gn pigs were orally inoculated with the stool suspension containing 5.6 × 105 fluorescent focus units (FFU) of the virus. Small and large intestinal contents were collected at post inoculation day 2 or 3. The virus was passaged 6 times in neonatal Gn pigs to generate a large inoculum pool. Next, 33–34 day old Gn pigs were orally inoculated with 10−2, 103, 104, and 105 FFU of Arg HRV to determine the optimal challenge dose. All pigs developed clinical signs of infection, regardless of the inoculum dose. The optimal challenge dose was determined to be 105 FFU. This new Gn pig model is ready to be used to assess the protective efficacy of candidate monovalent and multivalent vaccines against P[6] HRV.Instituto de VirologíaFil: Nyblade, Charlotte. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Hensley, Casey. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Parreño, Gladys Viviana. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Parreño, Gladys Viviana. Instituto Nacional de Tecnología Agropecuaria (INTA). INCUINTA. Instituto de Virologia e Innovaciones Tecnologicas (IVIT); ArgentinaFil: Zhou, Peng. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Frazier, Maggie. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Frazier, Annie. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Ramesh, Ashwin. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Lei, Shaohua. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados UnidosFil: Degiuseppe, Juan Ignacio. Administración Nacional de Laboratorios e Institutos de Salud (ANLIS). Instituto Nacional de Enfermedades Infecciosas “Dr. Carlos G. Malbrán” (INEI). Laboratorio de Gastroenteritis Virales; ArgentinaFil: Tan, Ming. Cincinnati Children’s Hospital Medical Center. Division of Infectious Diseases; Estados UnidosFil: Tan, Ming. University of Cincinnati College of Medicine. Department of Pediatrics; Estados UnidosFil: Yuan, Lijuan. Virginia-Maryland College of Veterinary Medicine. Department of Biomedical Sciences and Pathobiology; Estados Unido

Towards Efficient Detection of Small Near-Earth Asteroids Using the Zwicky Transient Facility (ZTF)

We describe ZStreak, a semi-real-time pipeline specialized in detecting small, fast-moving near-Earth asteroids (NEAs) that is currently operating on the data from the newly-commissioned Zwicky Transient Facility (ZTF) survey. Based on a prototype originally developed by Waszczak et al. (2017) for the Palomar Transient Factory (PTF), the predecessor of ZTF, ZStreak features an improved machine-learning model that can cope with the $10\times$ data rate increment between PTF and ZTF. Since its first discovery on 2018 February 5 (2018 CL), ZTF/ZStreak has discovered $45$ confirmed new NEAs over a total of 232 observable nights until 2018 December 31. Most of the discoveries are small NEAs, with diameters less than $\sim100$ m. By analyzing the discovery circumstances, we find that objects having the first to last detection time interval under 2 hr are at risk of being lost. We will further improve real-time follow-up capabilities, and work on suppressing false positives using deep learning.Comment: PASP in pres

Src Family Kinases and p38 Mitogen-Activated Protein Kinases Regulate Pluripotent Cell Differentiation in Culture

Multiple pluripotent cell populations, which together comprise the pluripotent cell lineage, have been identified. The mechanisms that control the progression between these populations are still poorly understood. The formation of early primitive ectoderm-like (EPL) cells from mouse embryonic stem (mES) cells provides a model to understand how one such transition is regulated. EPL cells form from mES cells in response to l-proline uptake through the transporter Slc38a2. Using inhibitors of cell signaling we have shown that Src family kinases, p38 MAPK, ERK1/2 and GSK3β are required for the transition between mES and EPL cells. ERK1/2, c-Src and GSK3β are likely to be enforcing a receptive, primed state in mES cells, while Src family kinases and p38 MAPK are involved in the establishment of EPL cells. Inhibition of these pathways prevented the acquisition of most, but not all, features of EPL cells, suggesting that other pathways are required. L-proline activation of differentiation is mediated through metabolism and changes to intracellular metabolite levels, specifically reactive oxygen species. The implication of multiple signaling pathways in the process suggests a model in which the context of Src family kinase activation determines the outcomes of pluripotent cell differentiation