Augmented renal clearance is a common finding with worse clinical outcome in critically ill patients receiving antimicrobial therapy

INTRODUCTION

We describe incidence and patient factors associated with augmented renal clearance (ARC) in adult intensive care unit (ICU) patients.

MATERIALS AND METHODS

A prospective observational study in a mixed cohort of surgical and medical ICU patients receiving antimicrobial therapy at the Ghent University Hospital, Belgium. Kidney function was assessed by the 24-hour creatinine clearance (Ccr); ARC defined as at least one Ccr of >130 mL/min per 1.73 m2. Multivariate logistic regression analysis: to assess variables associated with ARC occurrence. Therapeutic failure (TF): an impaired clinical response and need for alternate antimicrobial therapy.

RESULTS

Of the 128 patients and 599 studied treatment days, ARC was present in 51.6% of the patients. Twelve percent permanently expressed ARC. ARC patients had a median Ccr of 144 mL/min per 1.73 m2 (IQR 98-196). Median serum creatinine concentration on the first day of ARC was 0.54 mg/dL (IQR 0.48-0.69). Patients with ARC were significantly younger (P<.001). Age and male gender were independently associated with ARC whereas the APACHE II score was not. ARC patients had more TF (18 (27.3%) vs. 8 (12.9%); P=.04).

CONCLUSION

ARC was documented in approximately 52% of a mixed ICU patient population receiving antibiotic treatment with worse clinical outcome. Young age and male gender were independently associated with ARC presence.

Ethnomedicinal application of native remedies used against diabetes and related complications in Mauritius

ETHNOPHARMACOLOGICAL RELEVANCE

Notoriously, the tropical island of Mauritius has one of the highest prevalence of diabetes worldwide and the economic burden associated with it is alarming. The use of native remedies (NRs) is well anchored in the local culture and it continues to be the cornerstone of therapy for diabetic patients. However, there is currently a dearth of updated primary data on NRs used by Mauritians against diabetes and diabetes related complications (DRCs). This study was therefore designed to record, analyze and document orally transmitted ethnopharmacological knowledge from diabetic patients and traditional medicine practitioners (TMPs) in Mauritius concerning NRs commonly used against diabetes and DRCs which might open new avenues to initiate novel antidiabetic drugs discovery.

MATERIALS AND METHODS

Data was collected following interviews from diabetic patients (n=328) and TMPs (n=20). Eleven quantitative indexes, namely informant consensus factor (FIC), fidelity level (FL), use value (UV), relative frequency of citation (RFC), relative importance (RI), cultural importance index (CII), index of agreement on remedies (IAR), cultural agreement index (CAI), quality use value (QUV), quality use agreement value (QUAV) and ethnobotanicity index (EI) were calculated. Statistical analysis such as Pearson correlation and Chi-squared test were performed to determine any association.

RESULTS

A total of 111 plant species distributed over 56 families, 30 polyherbal formulations and 16 animal species were documented to be traditionally used against diabetes and DRCs. For the first time 8 endemic plants have been recorded to be used against diabetes and DRCs from Mauritius. The most encountered medicinal plant family was Asteraceae. According to the EI, 16.2% of the native plants in Mauritius were used against diabetes and DRCs. As far as we know, Vangueria madagascariensis, Apium graveolens, Petroselinum crispum and Rubus alceifolius with high RFC values are recorded against diabetes and DRCs for the first time. Sociodemographic characteristics (age, gender, income, religious belief, education and residence) were found to significantly (p<0.05) influence the use of NRs. The average FIC for all ailments for plant and animal products were 0.94 and 0.87 respectively. Bryophyllum pinnatum, a native plant to Mauritius scored a high FL value (100%) used against diabetic neuropathy, Allium sativum had the highest RI value (2.00) due to its versatility, Aloe vera had the highest RFC (0.61), the CII (0.640) and the highest CAI value (0.635), Psidium guajava had the highest QUAV (0.961) which indicates its high bioactivity and Allium cepa was reported as the most effective plant species (QUV=0.965). According to UV, the most important species was Morinda citrifolia (1.21). Panoply of animal products were reported whereby fish (39.7%) was recorded as the most utilised zootherapy and Salmo salar scored the highest FL (100%) for diabetes. Some animal species (n=14) not previously documented against diabetes and DRCs are reported in the present study.

CONCLUSION

Our present investigation revealed that the use of NRs constitutes the common legacy of Mauritians and despite the penetration of allopathic medicine; NRs continue to play a crucial role in the primary health care system of Mauritius. To this effect, it is of uttermost importance to record this knowledge before it disappears. In addition, further experimental investigations are required to elucidate the pharmacological properties of the reported medicinal flora and fauna of Mauritius.

Validity of 24-h recalls in (pre-)school aged children: comparison of proxy-reported energy intakes with measured energy expenditure

BACKGROUND & AIMS

Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (EI) in young children. This study aimed to evaluate the validity of proxy-reported EI by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique.

METHODS

The agreement between EI and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of EI over TEE by application of age- and sex-specific cut-off values.

RESULTS

There was good agreement between means of EI (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between EI and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between EI and TEE was only -86 kcal/day. Among the participants, 28 (78%) were classified as AER, five (14%) as HER and three (8%) as LER.

CONCLUSION

Two proxy-reported 24-HDRs were found to be a valid instrument to assess EI on group level but not on the individual level.

Obese but not lean adolescents spontaneously decrease energy intake after intensive exercise

BACKGROUND

Acute intensive exercise has been shown to induce a decreased subsequent daily energy intake in obese adolescents without altering the subjective appetite feelings. It is however unclear whether or not those nutritional adaptations to acute exercise are affected by the adolescents' weight status. The aim of this study was to compare the energy intake and macronutrient preferences, appetite feeling and energy expenditure response to acute exercise between lean and obese adolescents.

METHODS

Ten obese and nine normal weight 12-15year old adolescents randomly completed a session with a 30minute cycling exercise at 75% VO2max and a sedentary session. During both sessions energy expenditure was assessed using Armband, ad libitum energy intake measured by weighing at both lunch and dinner time and appetite feelings assessed using visual analog scales.

RESULTS

Daily, morning and afternoon energy expenditure were significantly higher in obese than in normal weight adolescents (p<0.001). Total energy expenditure was significantly higher during EX (1086±157kcal) compared to SED (853±154kcal) in lean (p<0.05) but not significantly different in obese (respectively 1865±222 and 1803±232kcal). Afternoon energy expenditure was significantly lower during EX compare to SED in obese (p<0.05) but not in normal weight adolescents. Lunch, dinner and total daily energy intake were significantly reduced after the exercise session in obese (p>0.05) but not in lean adolescents. No group or condition effects were observed on subjective appetite feelings.

DISCUSSION

Post exercise spontaneous energy intake and energy expenditure are reduced in obese but not in normal weight adolescents, without appetite feeling changes. Acute exercise may have a greater impact on energy balance through the induced decreased energy intake in the absence of significant change in energy expenditure in obese youth.

Catabolite regulation analysis of Escherichia coli for acetate overflow mechanism and co-consumption of multiple sugars based on systems biology approach using computer simulation

It is quite important to understand the basic principle embedded in the main metabolism for the interpretation of the fermentation data. For this, it may be useful to understand the regulation mechanism based on systems biology approach. In the present study, we considered the perturbation analysis together with computer simulation based on the models which include the effects of global regulators on the pathway activation for the main metabolism of Escherichia coli. Main focus is the acetate overflow metabolism and the co-fermentation of multiple carbon sources. The perturbation analysis was first made to understand the nature of the feed-forward loop formed by the activation of Pyk by FDP (F1,6BP), and the feed-back loop formed by the inhibition of Pfk by PEP in the glycolysis. Those together with the effect of transcription factor Cra caused by FDP level affected the glycolysis activity. The PTS (phosphotransferase system) acts as the feed-back system by repressing the glucose uptake rate for the increase in the glucose uptake rate. It was also shown that the increased PTS flux (or glucose consumption rate) causes PEP/PYR ratio to be decreased, and EIIA-P, Cya, cAMP-Crp decreased, where cAMP-Crp in turn repressed TCA cycle and more acetate is formed. This was further verified by the detailed computer simulation. In the case of multiple carbon sources such as glucose and xylose, it was shown that the sequential utilization of carbon sources was observed for wild type, while the co-consumption of multiple carbon sources with slow consumption rates were observed for the ptsG mutant by computer simulation, and this was verified by experiments. Moreover, the effect of a specific gene knockout such as Δpyk on the metabolic characteristics was also investigated based on the computer simulation.

Do hunger and exposure to food affect scores on a measure of hedonic hunger? An experimental study

Research suggests that visceral bodily states, such as hunger, can affect participants' responses on self-report measures of eating behavior. The present study evaluated the influence of hunger and exposure to palatable food on self-reported hedonic appetite, measured using the Power of Food Scale (PFS). A secondary aim was to evaluate the effects of these manipulations on self-reported external eating and disinhibition. Participants (N=67) ate a standardized meal followed by a 4-h fast. Participants were randomized to one of four groups (Fasted/Food Absence, Fasted/Food Exposure, Fed/Food Absence, or Fed/Food Exposure). In Phase I of the experiment (Hunger Manipulation), participants randomized to the "Fed" group drank a protein shake, while those in the "Fasted" group did not receive a shake. In Phase II (Palatable Food Exposure), participants in the "Food Exposure" group were visually exposed to palatable food items, while "Food Absence" participants were not. All participants completed the PFS, Dutch Eating Behavior Questionnaire External Eating subscale, and the Disinhibition subscale from the Eating Inventory during Phase II. Results showed no significant main or interactive effects of Hunger condition or Food Exposure condition on PFS, External Eating, or Disinhibition scores (all p's<.33). All effect sizes were small (partial etas squared ⩽.015). Manipulation checks confirmed that the intended hunger and exposure interventions were successful. Results suggest that relatively short fasting periods (e.g., 4h) analogous to typical breaks between meals are not associated with changes in scores on the PFS, External Eating, or Disinhibition scales. Hedonic hunger, at least as measured by the PFS, may represent a relatively stable construct that is not substantially affected by daily variations in hunger. In addition, individual differences in exposure to food in the immediate environment are unlikely to confound research using these measures.

The history of electron ionization in LC-MS, from the early days to modern technologies: A review

This review article traces the history of the use of liquid chromatography coupled with mass spectrometry (LC-MS) using electron ionization (EI) from the first attempts up to the present day. At the time of the first efforts to couple LC to MS, 70 eV EI was the most common ionization technique, typically used in gas chromatography-mass spectrometry (GC-MS) and providing highly reproducible mass spectra that could be collated in libraries. Therefore, it was obvious to transport this dominant approach to the early LC-MS coupling attempts. The use of LC coupled to EI-MS is challenging mainly due to restrictions related to high-vacuum and high-temperature conditions required for the operation of EI and the need to remove the eluent carrying the analyte before entering the ion source. The authors will take readers through a journey of about 50 years, showing how through the succession of different attempts it has been possible to successfully couple LC with EI-MS, which in principle appear to be incompatible.

Improved correlation between CT emphysema quantification and pulmonary function test by density correction of volumetric CT data based on air and aortic density

OBJECTIVES

To determine the improvement of emphysema quantification with density correction and to determine the optimal site to use for air density correction on volumetric computed tomography (CT).

METHODS

Seventy-eight CT scans of COPD patients (GOLD II-IV, smoking history 39.2±25.3 pack-years) were obtained from several single-vendor 16-MDCT scanners. After density measurement of aorta, tracheal- and external air, volumetric CT density correction was conducted (two reference values: air, -1,000 HU/blood, +50 HU). Using in-house software, emphysema index (EI) and mean lung density (MLD) were calculated. Differences in air densities, MLD and EI prior to and after density correction were evaluated (paired t-test). Correlation between those parameters and FEV1 and FEV1/FVC were compared (age- and sex adjusted partial correlation analysis).

RESULTS

Measured densities (HU) of tracheal- and external air differed significantly (-990 ± 14, -1016 ± 9, P<0.001). MLD and EI on original CT data, after density correction using tracheal- and external air also differed significantly (MLD: -874.9 ± 27.6 vs. -882.3 ± 24.9 vs. -860.5 ± 26.6; EI: 16.8 ± 13.4 vs. 21.1 ± 14.5 vs. 9.7 ± 10.5, respectively, P<0.001). The correlation coefficients between CT quantification indices and FEV1, and FEV1/FVC increased after density correction. The tracheal air correction showed better results than the external air correction.

CONCLUSION

Density correction of volumetric CT data can improve correlations of emphysema quantification and PFT.

Does Emotional Intelligence Mediate the Relation Between Mindfulness and Anxiety and Depression in Adolescents?

High anxiety and depression are often observed in the Australian adolescent population, and if left untreated, can have long-term negative consequences impacting educational attainment and a range of important life outcomes. The utilization of mindfulness techniques has been associated with decreased anxiety and depression, but the underlying mechanisms for this is only beginning to be understood. Previous research with adult samples has suggested that the development of emotional intelligence (EI) may be one mechanism by which mindfulness confers its benefits on wellbeing. This study is the first to examine the relation between mindfulness, EI, anxiety, and depression in an adolescent population. It was hypothesized that EI would mediate the relationships between mindfulness and anxiety, as well as mindfulness and depression. The sample consisted of 108 adolescents from a public secondary school, aged between 13 and 15 years (M_age = 13.68, SD_age = 0.56, 51 males and 57 females). Participants completed an online self-report questionnaire which measured dispositional mindfulness, EI, anxiety, and depression. The results indicated that one subscale of EI – Emotional Recognition and Expression (ERE) mediated the relation between mindfulness and anxiety, while two subscales of EI – ERE and Emotional Management and Control (EMC) mediated the relation between mindfulness and depression. Future research utilizing a mindfulness intervention should be conducted to examine whether the use of mindfulness increases EI and decreases anxiety and depression in adolescents.

A gas chromatography full scan high resolution Orbitrap mass spectrometry method for separation and characterization of 3-hydroxymethyl pyridine ester of fatty acids at low levels

Fatty acid methyl esters (FAMEs), which are commonly used to characterize lipids, have several limitations to conclude on many structures. 3-Pyridylcarbinol esters (3-PCE) are used to characterize fatty acid structures [1], in particular, to identify ring and double bond positions on the carbon chain. Chromatographic separation of these esters is complex due to their polarity and high boiling points. In this study, we used a column with high resolutive power based on ionic liquids to increase the separation quality in gas chromatography (GC). In addition, we used a high-resolution detector (Orbitrap) to limit non-specific signals and improve the detection limits. This detector could be used with a mass filter at 5 ppm for the rapid determination of 3-PCE from its characteristic ions (m/z = 108.0441 and 92.0495). This filter allowed the identification of derivative fatty acids with good sensibility. Thus, it was possible to characterize 3-PCE by measuring the exact fragment masses to confirm structures such as C19:2n12cycloΔ9.

Boosting the Detection Potential of Liquid Chromatography-Electron Ionization Mass Spectrometry Using a Ceramic Coated Ion Source

Detection of target and non-target substances and their characterization in complex samples is a challenging task. Here we demonstrate that coating the electron ionization (EI) ion source of an LC-MS system with a sol-gel ceramic film can drastically improve the detection of high-molecular weight and high-boiling analytes. A new ion source coated with a ceramic material was developed and tested with a mixture of polycyclic aromatic hydrocarbons (PAH) with an increasing number of rings. Comparison of the results obtained with those for an uncoated stainless steel (SS) ion source shows a dramatic improvement in the MS signals, with a nearly 40-fold increase of the signal-to-noise ratio. We also demonstrate the ability of the new system to produce excellent chromatographic profiles for hard-to-detect hormones.

Social and environmental contexts modulate sleep deprivation-induced c-Fos activation in rats

People often sleep deprive themselves voluntarily for social and lifestyle reasons. Animals also appear to stay awake longer as a result of their natural curiosity to explore novel environments and interact socially with conspecifics. Although multiple arousal systems in the brain are known to act jointly to promote and maintain wakefulness, it remains unclear whether these systems are similarly engaged during voluntary vs. forced wakefulness. Using c-Fos immunohistochemistry, we compared neuronal responses in rats deprived of sleep for 2 h by gentle sensory stimulation, exploration under social isolation, or exploration with social interaction, and rats under undisturbed control conditions. In many arousal, limbic, and autonomic nuclei examined (e.g., anterior cingulate cortex and locus coeruleus), the two sleep deprivation procedures involving exploration were similarly effective, and both were more effective than sleep deprivation with sensory stimulation, in increasing the number of c-Fos immunoreactive neurons. However, some nuclei (e.g., paraventricular hypothalamic nucleus and select amygdala nuclei) were more responsive to exploration with social interaction, while others (e.g., histaminergic tuberomammillary nucleus) responded more strongly to exploration in social isolation. In the rostral basal forebrain, cholinergic and GABAergic neurons responded preferentially to exploration with social interaction, whereas resident neurons in general responded most strongly to exploration without social interaction. These results indicate that voluntary exploration with/without social interaction is more effective than forced sleep deprivation with gentle sensory stimulation for inducing c-Fos in arousal and limbic/autonomic brain regions, and suggest that these nuclei participate in different aspects of arousal during sustained voluntary wakefulness.

Liquid Extraction Surface Analysis (LESA) Electron-Induced Dissociation and Collision-Induced Dissociation Mass Spectrometry of Small Molecule Drug Compounds

Here, we present liquid extraction surface analysis (LESA) coupled with electron-induced dissociation (EID) mass spectrometry in a Fourier-transform ion cyclotron resonance mass spectrometer for the analysis of small organic pharmaceutical compounds directly from dosed tissue. First, the direct infusion electrospray ionisation EID and collision-induced dissociation (CID) behaviour of erlotinib, moxifloxacin, clozapine and olanzapine standards were compared. EID mass spectra were also compared with experimental or reference electron impact ionisation mass spectra. The results show that (with the exception of erlotinib) EID and CID result in complementary fragment ions. Subsequently, we performed LESA EID MS/MS and LESA CID MS/MS on singly charged ions of moxifloxacin and erlotinib extracted from a thin tissue section of rat kidney from a cassette-dosed animal. Both techniques provided structural information, with the majority of peaks observed for the drug standards also observed for the tissue-extracted species. Overall, these results demonstrate the feasibility of LESA EID MS/MS of drug compounds from dosed tissue and extend the number of molecular structures for which EID behaviour has been determined. Graphical Abstract ᅟ.

Influences of musk administration on the doping test

Musk is widely used as a traditional drug in Asia for the treatment of stroke, tumour, and cardiopathy with an oral dosage of 0.03-0.1 g per day. Because of the potential anabolic effect, musk preparations have been included in the list of medical products containing prohibited substances employed for doping. The application of musk pod formulation was regarded as the reason of some adverse analytical findings in the 2011 FIFA Women's World Cup. In order to investigate the influence of musk administration on the doping test, we executed a chemical analysis and excretion study. The gas chromatography/mass spectrometry (GC-MS) analysis demonstrated the diversity of steroid concentrations in musk samples. Furthermore, the δ(13)C-values of steroids from wild deer musk showed more depleted than those of domestic deer musk by gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS) analysis. Because the steroids from some musk had δ(13)C-values in the range of naturally produced steroids in human body, the possible abuse of this kind of musk is very hard to be detected by isotope ratio mass spectrometry (IRMS) in doping control. Musk grains from wild and domestic deer were administrated for the excretion study respectively. Spot urine samples were collected from two male volunteers before and after 100 mg musk grains administration. The profiles and carbon isotope ratios of urinary steroids were determined by GC-MS and GC/C/IRMS. The ingestion of either wild or domestic deer musk did not lead to the adverse analytical finding of doping control in the single dosage of 100mg.

Influence of emotional intelligence on the clinical ability of nursing interns: a structural equation model

Background

Internship is a critical period during which nursing students develop clinical skills and establish professional attitudes. Requirements for nursing interns are evolving with the development of medicine and the transformation of teaching models. The emotional intelligence (EI) of nursing students has an influence on their clinical performance. This study aimed to investigate the impact of EI on the clinical ability of nursing interns.

Methods

A cross-sectional observational study was designed to include nursing students interning in a tertiary hospital in Shanghai, China from April 1, 2019 to April 30, 2020 (N = 310). Chinese versions of the EI scale (EIS) and holistic clinical assessment tool (HCAT) were used to measure the EI and clinical ability of interns, respectively. Pearson’s correlation coefficient was utilized to determine the correlation between EI and clinical ability. Multiple linear regression analysis was performed to further explore the influence of EI on clinical ability, and the structural equation model (SEM) was used for multivariate path analysis.

Results

The mean EI and clinical ability scores of interns were 125.17 ± 14.98 and 97.91 ± 19.55, respectively, indicating an upper-moderate level in both aspects. EI scores were correlated positively with clinical ability ones (R = 0.534, p < 0.05). Multivariate path analysis showed that “managing emotions” and “facilitating thought” of EI branches have direct effects on clinical ability. Furthermore, the type of school, family financial state and the knowledge of EI indirectly influence clinical ability through their impact on “managing emotions” and “facilitating thought”.

Conclusions

EI is essential to enhancing the clinical ability of nursing students. EI training should focus on facilitating thought and managing emotions. It is also necessary for educators to consider the context of nursing students and the characteristics of schools.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00933-y.

Gamma ray sterilization of delta inulin adjuvant particles (Advax™) makes minor, partly reversible structural changes without affecting adjuvant activity

We earlier identified a developmental series of seven isoforms/polymorphs of microparticulate inulin by comparing non-covalent bonding strengths. Their pharmaceutical utility lies in the modulation of cellular immunity, exploited as vaccine adjuvants (Advax™) especially for delta inulin (DI). As such particles cannot be sterilized by filtration we explore the effect of (60)Co gamma radiation (GR) on inulin isoforms, particularly DI. Its adjuvant activity and overt physical properties were unaffected by normal GR sterilizing doses (up to 25kGy). Heating irradiated isoform suspensions near their critical dissolution temperature revealed increased solubility deduced to reflect a single lethal event in one component of a multi-component structure. Local oxidative effects of GR on DI were not found. The observed DI loss was almost halved by re-annealing at the critical temperature: surviving inulin chains apparently reassemble into smaller amounts of the original type of structure. Colorimetric tetrazolium assay revealed increases in reducing activity after GR of raw inulin powder, which yielded DI with normal physical properties but only 25% normal recovery yet 4× normal reducing ability, implying final retention of some GR-changed inulin chains. These findings suggest minimal inulin chain cleavage and confirm that GR may be a viable strategy for terminal sterilization of microparticulate inulin adjuvants.

Laser-Induced Acoustic Desorption/Electron Ionization of Amino Acids and Small Peptides

Laser-induced acoustic desorption (LIAD) allows for desorption of neutral nonvolatile compounds independent of their volatility or thermal stability. Many different ionization methods have been coupled with LIAD. Hence, this setup provides a better control over the types of ions formed than other mass spectrometry evaporation/ionization methods commonly used to characterize biomolecules, such as ESI or MALDI. In this study, the utility of LIAD coupled with electron ionization (EI) was tested for the analysis of common amino acids with no derivatization. The results compared favorably with previously reported EI mass spectra obtained using thermal desorption/EI. Further, LIAD/EI mass spectra collected for hydrochloride salts of two amino acids were found to be similar to those measured for the neutral amino acids with the exception of the appearance of an HCl^+● ion. However, the hydrochloride salt of arginine showed a distinctly different LIAD/EI mass spectrum than the previously published literature EI mass spectrum, likely due to its highly basic side chain that makes a specific zwitterionic form particularly favorable. Finally, EI mass spectra were measured for seven small peptides, including di-, tri-, and tetrapeptides. These mass spectra show a variety of ion types. However, a_n type ions are prevalent. Also, electron-induced dissociation (EID) of protonated peptides has been reported to form primarily a_n type ions. In addition, the loss of small neutral molecules and side-chain cleavages were observed that are reminiscent of other high-energy fragmentation methods, such as EID. Finally, the isomeric dipeptides LG and IG were found to produce drastically different EI mass spectra, thus allowing differentiation of the leucine and isoleucine amino acids in these dipeptides. Graphical Abstract ᅟ.

The Midwest Exercise Trial for the Prevention of Weight Regain: MET POWeR

Weight reduction in overweight and obese individuals results in physiological and behavioral changes that make the prevention of weight regain more difficult than either initial weight loss or the prevention of weight gain. Exercise is recommended for the prevention of weight regain by both governmental agencies and professional organizations. To date, the effectiveness of exercise recommendations for the prevention of weight regain has not been evaluated in a properly designed, adequately powered trial. Therefore, we will conduct a randomized trial to evaluate the effectiveness of 3 levels of exercise on the prevention of weight regain, in initially overweight and obese sedentary men and women. Participants will complete a 3 month weight loss intervention of decreased energy intake (EI) and increased exercise (100 min/week). Participants achieving clinically significant weight loss (≥ 5% of initial weight), will then be randomly assigned to 12 months of verified exercise at 3 levels (150, 225 or 300 min/week). This study will evaluate: 1) the effectiveness of 3 levels of exercise on the prevention of weight regain over 12 months subsequent to clinically significant weight loss (≥ 5%); 2) gender differences in weight regain in response to 3 levels of exercise; and 3) potential compensatory changes in daily physical activity (PA) and EI on weight regain in response to the 3 levels of exercise. The results of this investigation will provide information to develop evidence-based recommendations for the level of exercise associated with the prevention of weight regain.

Ability emotional intelligence of nurse managers in the Midwestern United States

Objective:

The aim of this study was to describe the emotional intelligence (EI) and examine the corresponding demographic characteristics of front-line Nurse Managers in acute care settings.

Methods:

This quantitative descriptive study was conducted in eight acute care hospitals in the Midwestern United States. The Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) was used to measure the EI of 87 front-line Nurse Managers. Demographic characteristics of the participants were captured on a second tool, the Nurse Manager Demographic Characteristics questionnaire. Descriptive and inferential statistics were used for analysis.

Results:

Significant correlations were found between the perceiving and using branches of the model and total EI score and nurses certified in a specialty. No significant correlations were found between EI and graduate education, age, years in management, percentage of time in management or number of direct reports. Considerations for future research are discussed.

Conclusions:

Opportunity exists to develop EI in front-line Nurse Managers.

Employment Insurance may mitigate impact of unemployment on food security: Analysis on a propensity-score matched sample from the Canadian Income Survey

Food insecurity, the inadequate access to food due to financial constraints, affects one-sixth of Canadian households, with substantial health implications. We examine the impact of unemployment and the mitigating effect of Employment Insurance (EI) on household food insecurity in Canada. Using the Canadian Income Survey 2018-2019, we sampled 28,650 households with adult workers 18-64 years old. We used propensity score matching to pair the 4085 households with unemployed workers with 3390 households with only continuously employed workers on their propensity towards unemployment. Among unemployed households, we also matched 2195 EI recipients with 950 nonrecipients. We applied adjusted logistic regression to the two matched samples. Food insecurity affected 15.1% of the households without unemployed workers and 24.6% of their unemployed counterparts, including 22.2% of EI recipients and 27.5% of nonrecipients. Unemployment was associated with 48% (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.32-1.66; 5.67 percentage points) higher likelihood of food insecurity. This association was significant and similar across income levels, full-time and part-time workers, and household compositions. EI receipt was associated with 23% (aOR 0.77, 95% CI 0.66-0.90; 4.02 percentage points) lower likelihood of food insecurity, but this association was only significant among households with lower income, full-time workers, and children under 18. The findings suggest a broad impact of unemployment on working adults' food insecurity and a substantial mitigating effect by EI on select unemployed workers. Making EI more generous and accessible for part-time workers may help alleviate food insecurity.

Method of determining technique from weight and height to achieve targeted detector exposures in portable chest and abdominal digital radiography

This study presents a methodology to develop an X-ray technique chart for portable chest and abdomen imaging which utilizes patient data available in the modality worklist (MWL) to reliably achieve a predetermined exposure index (EI) at the detector for any patient size. The method assumes a correlation between the patients' tissue equivalent thickness and the square root of the ratio of the patient's weight to height. To assess variability in detector exposures, the EI statistics for 75 chest examinations and 99 abdominal portable X-ray images acquired with the new technique chart were compared to those from a single portable unit (chest: 3877 images; abdomen: 200 images) using a conventional technique chart with three patient sizes, and to a stationary radiography room utilizing automatic exposure control (AEC) (chest: 360 images; abdomen: 112 images). The results showed that when using the new technique chart on a group of portable units, the variability in EI was significantly reduced (p < 0.01) for both AP chest and AP abdomen images compared to the single portable using a standard technique chart with three patient sizes. The variability in EI for the images acquired with the new chart was comparable to the stationary X-ray room with an AEC system (p > 0.05). This method could be used to streamline the entire imaging chain by automatically selecting an X-ray technique based on patient demographic information contained in the MWL to provide higher quality examinations to clinicians by eliminating outliers. In addition, patient height and weight can be used to estimate the patients' tissue equivalent thickness.

The Utility of Imaging Parameters in Predicting Long-Term Clinical Improvement After Shunt Surgery in Patients with Idiopathic Normal Pressure Hydrocephalus

OBJECTIVE

It is difficult to predict which patients with idiopathic normal pressure hydrocephalus (iNPH) will improve after shunt surgery. This study investigated the association between preoperative imaging parameters in patients with iNPH and long-term outcome after shunt placement.

METHODS

Patients with iNPH who showed a response to large-volume cerebrospinal fluid drainage and subsequently underwent ventriculoperitoneal shunt surgery were reviewed. Long-term patient-reported outcomes were obtained by telephone interview. Preoperative computed tomography and/or magnetic resonance imaging were retrospectively reviewed to determine associations between imaging parameters and clinical outcome.

RESULTS

The final analysis included 37 patients. The median duration between shunt surgery and telephone interview was 30 months (range, 12-56 months). Gait improvement after shunting was present more often in patients without focally dilated sulci (95% vs. 71%, P = 0.04), but a statistically significant relationship was not established after logistic regression. Patients with cognitive improvement after shunting had a higher preoperative Evans index (mean 0.41 vs. 0.36, P < 0.01), and Evans index was a predictor of cognitive improvement (odds ratio = 1.40, scale of 0.01, P = 0.01).

CONCLUSIONS

Higher Evans index is a predictor of long-term cognitive improvement after shunt placement; however, no cutoff value demonstrates sufficient accuracy for the selection of shunt candidates. None of the evaluated imaging features was predictive of long-term gait or urinary improvement. The utility of imaging to predict a response to shunting is limited, and no imaging feature alone can be used to exclude patients from shunt surgery.

Comparative Analysis of Binary Similarity Measures for Compound Identification in MassSpectrometry-Based Metabolomics

Compound identification is a critical step in untargeted metabolomics. Its most important procedure is to calculate the similarity between experimental mass spectra and either predicted mass spectra or mass spectra in a mass spectral library. Unlike the continuous similarity measures, there is no study to assess the performance of binary similarity measures in compound identification, even though the well-known Jaccard similarity measure has been widely used without proper evaluation. The objective of this study is thus to evaluate the performance of binary similarity measures for compound identification in untargeted metabolomics. Fifteen binary similarity measures, including the well-known Jaccard, Dice, Sokal–Sneath, Cosine, and Simpson measures, were selected to assess their performance in compound identification. using both electron ionization (EI) and electrospray ionization (ESI) mass spectra. Our theoretical evaluations show that the accuracy of the compound identification was exactly the same between the Jaccard, Dice, 3W-Jaccard, Sokal–Sneath, and Kulczynski measures, between the Cosine and Hellinger measures, and between the McConnaughey and Driver–Kroeber measures, which were practically confirmed using mass spectra libraries. From the mass spectrum-based evaluation, we observed that the best performing similarity measures were the McConnaughey and Driver–Kroeber measures for EI mass spectra and the Cosine and Hellinger measures for ESI mass spectra. The most robust similarity measure was the Fager–McGowan measure, the second-best performing similarity measure in both EI and ESI mass spectra.

Multiple geophysical surveys for old landfill monitoring in Singapore

One-dimensional boring presents limitations on mapping the refuse profile in old landfills owning to waste heterogeneity. Electrical imaging (EI) and multiple-analysis of surface wave (MASW) were hereby deployed at an old dumping ground in Singapore to explore the subsurface in relation to geotechnical analysis. MASW estimated the refuse boundary with a higher precision as compared to EI, due to its endurance for moisture variation. EI and MASW transection profiles suggested spots of interest, e.g., refuse pockets and leachate mounds. 3D inversion of EI and MASW data further illustrated the transformation dynamics derived by natural attenuation, for instance the preferential infiltration pathway. Comparison of geophysical surveys at different years uncovered the subterranean landfill conditions, indicating strong impacts induced by aging, precipitation, and settlement. This study may shed light on a characterization framework of old landfills via combined geophysical models, thriving landfill knowledge with a higher creditability.