How should the role of the nurse change in response to Covid-19?

The UK nursing workforce has made a substantial contribution during the Covid-19 public health emergency and we now need to evaluate its current skills and knowledge and what it needs to cope with future potential outbreaks. This article discusses several approaches that warrant urgent consideration from the UK government, nurse leaders and policy makers to ensure long-term investment is made to support the profession and that nurses are well equipped to effectively respond to outbreaks, with a particular focus on meeting the needs of vulnerable groups and advocating on their behalf to reduce inequity in access to healthcare, health protection and cultural sensitivity

A Bayesian phylogenetic hidden Markov model for B cell receptor sequence analysis.

The human body generates a diverse set of high affinity antibodies, the soluble form of B cell receptors (BCRs), that bind to and neutralize invading pathogens. The natural development of BCRs must be understood in order to design vaccines for highly mutable pathogens such as influenza and HIV. BCR diversity is induced by naturally occurring combinatorial "V(D)J" rearrangement, mutation, and selection processes. Most current methods for BCR sequence analysis focus on separately modeling the above processes. Statistical phylogenetic methods are often used to model the mutational dynamics of BCR sequence data, but these techniques do not consider all the complexities associated with B cell diversification such as the V(D)J rearrangement process. In particular, standard phylogenetic approaches assume the DNA bases of the progenitor (or "naive") sequence arise independently and according to the same distribution, ignoring the complexities of V(D)J rearrangement. In this paper, we introduce a novel approach to Bayesian phylogenetic inference for BCR sequences that is based on a phylogenetic hidden Markov model (phylo-HMM). This technique not only integrates a naive rearrangement model with a phylogenetic model for BCR sequence evolution but also naturally accounts for uncertainty in all unobserved variables, including the phylogenetic tree, via posterior distribution sampling

Accelerated Orthodontics

Clinical orthodontics is ever dynamic branch of Dentistry. Traditionally orthodontics was always considered as aesthetic treatment of face & also needed for proper oral oral function. This treatment may take up 2–3 years of total duration. The chapter describes changing trends in this aspect wherein we speed up the treatment by various methods thus reducing the overall time duration. These modalities include alteration in bio mechanics, pharmacological, chemical & by biological means. It is also cautioned here that the clinician has to take up these changing trends based on sound clinical knowledge & evidence based applicability

A study of antenatal anxiety: comparison across trimesters

Background: The aim of present study was to investigate the antenatal anxiety across all three trimesters of pregnancy.Methods: This is a cross sectional, observational study for which data is collected from consenting subjects attending antenatal Out Patients department for routine antenatal checkup. Data included socio demographic information’s and Hospital Anxiety and Depression Scale and statistical analysis done.Results: Out of 169 Pregnant females 27.8% were during first trimester, 40.8% during second trimester and 31.4% during 3rd trimester. The mean anxiety scores for first, second and third trimester was 10.74±2.97, 11.69±3.09 and 14.20±3.10 respectively. Independent t test revealed significantly higher anxiety scores for third trimester when compared to first trimester scores (t= -6.035, p value = 0.000).Conclusions: This study finds a significantly higher antenatal anxiety during third trimester of pregnancy

A Public Health Perspective on Campus Initiatives Against Sexual Violence

With the public health model of violence prevention as a lens, this Undergraduate Research Scholarship project utilized a statistical analysis to determine whether a relationship could be established between number of sexual violence prevention initiatives on a university campus and proportion of students who have experienced nonconsensual sexual contact.Using a public health framework, this project aims to address the question, “How does quantity of university prevention initiatives correlate with rates of campus sexual violence, including harassment, assault, and rape?”. Using the results of the 2019 Association of American Universities Campus Climate Survey and publicly available information regarding individual university trainings and programs (collected using defined search terms), hypothesis testing was conducted to determine whether the existence of a linear relationship could be established between the explanatory variable of number of initiatives and the response variable of proportion of students experiencing sexual violence. Using a scatterplot, a point estimate regression line was created with formula ŷ = .129946 + 0.004992x and p-value of 0.3071, from which it was determined that there was not enough evidence to establish a correlation between these two variables at the 0.05 significance level.This research was supported by the Undergraduate Research Opportunities Program (UROP)

An agricultural price forecasting model under nonstationarity using functional coefficient autoregression

In this globalized world, management of food security in the developing countries like India where agriculture is dominated needs efficient and reliable price forecasting models more than ever. Forecasts of agricultural prices are handy to the policymakers, agribusiness industries and farmers. In the present study, Functional Coefficient Autoregression (FCAR) has been applied for modeling and forecasting the monthly wholesale price of clean coffee seeds in Hyderabad coffee consuming center using the data from Jan, 2001 to Sep, 2014. FCAR (2,2) model was found suitable based on the minimum Average Prediction Error (APE) criterion. The FCAR model thus obtained was compared with the Autoregressive Integrated Moving Average (ARIMA) model. Since the original series was found to be nonstationary from Augmented Dickey-Fuller test (ADF statistic=-2.84, p=0.22), the differenced series (ADF statistic=-4.20, p<0.01) was used and ARIMA (12,1,0) was found suitable. The FCAR model obtained was compared with the ARIMA model with respect to forecast accuracy measures viz., Root Mean Square Error (RMSE) and Mean Absolute Percentage Error (MAPE). The RMSE and MAPE for the FCAR (2,2) were found to be 17.16 and 4.41%, respectively, whereas for the ARIMA (12,1,0) models, 62.64 and 26.15%, respectively. The results indicated that the FCAR model was efficient than the ARIMA model in forecasting the future prices

Genetic Architecture of Acute Myocarditis and the Overlap With Inherited Cardiomyopathy.

Background: Acute myocarditis is an inflammatory condition that may herald the onset of dilated cardiomyopathy (DCM) or arrhythmogenic cardiomyopathy (ACM). We investigated the frequency and clinical consequences of DCM and ACM genetic variants in a population-based cohort of patients with acute myocarditis. Methods: This was a population-based cohort of 336 consecutive patients with acute myocarditis enrolled in London and Maastricht. All participants underwent targeted DNA sequencing for well-characterized cardiomyopathy-associated genes with comparison to healthy controls (n=1053) sequenced on the same platform. Case ascertainment in England was assessed against national hospital admission data. The primary outcome was all-cause mortality. Results: Variants that would be considered pathogenic if found in a patient with DCM or ACM were identified in 8% of myocarditis cases compared with <1% of healthy controls (P=0.0097). In the London cohort (n=230; median age, 33 years; 84% men), patients were representative of national myocarditis admissions (median age, 32 years; 71% men; 66% case ascertainment), and there was enrichment of rare truncating variants (tv) in ACM-associated genes (3.1% of cases versus 0.4% of controls; odds ratio, 8.2; P=0.001). This was driven predominantly by DSP-tv in patients with normal LV ejection fraction and ventricular arrhythmia. In Maastricht (n=106; median age, 54 years; 61% men), there was enrichment of rare truncating variants in DCM-associated genes, particularly TTN-tv, found in 7% (all with left ventricular ejection fraction <50%) compared with 1% in controls (odds ratio, 3.6; P=0.0116). Across both cohorts over a median of 5.0 years (interquartile range, 3.9–7.8 years), all-cause mortality was 5.4%. Two-thirds of deaths were cardiovascular, attributable to worsening heart failure (92%) or sudden cardiac death (8%). The 5-year mortality risk was 3.3% in genotype-negative patients versus 11.1% for genotype-positive patients (Padjusted=0.08). Conclusions: We identified DCM- or ACM-associated genetic variants in 8% of patients with acute myocarditis. This was dominated by the identification of DSP-tv in those with normal left ventricular ejection fraction and TTN-tv in those with reduced left ventricular ejection fraction. Despite differences between cohorts, these variants have clinical implications for treatment, risk stratification, and family screening. Genetic counseling and testing should be considered in patients with acute myocarditis to help reassure the majority while improving the management of those with an underlying genetic variant.post-print738 K