Factors affecting intraperitoneal pressure (IPP) and its prognostic value in predicting leak risk and gastrointestinal symptoms in adult peritoneal dialysis patients: a systematic review and meta-analysis.

BACKGROUND: Intraperitoneal pressure measurement offers therapeutic and prognostic benefits in predicting leak risks and gastrointestinal symptoms in Peritoneal Dialysis (PD) patients. This systematic review aims to evaluate the prognostic utility of intraperitoneal pressure measurements and different estimated intraperitoneal pressure equations in predicting the risk of non-infectious complications in PD patients. METHODS: Databases including MEDLINE, EMBASE and Cochrane were searched up to July 2023. Randomised and non-randomised trials were included, focusing on End-Stage Kidney Disease (ESKD) patients undergoing PD. Primary outcomes were variables associated with intraperitoneal pressure, while secondary outcomes included PD-related non-infectious complications and gastrointestinal symptoms. Data synthesis combined meta-analysis with narrative synthesis. This review has been registered on PROSPERO (CRD42023475138). RESULTS: Out of 1828 identified studies, 12 were included for systematic review and 10 for meta-analysis. Body Mass Index (BMI) and Body Surface Area (BSA) showed a consistent positive correlation with intraperitoneal pressure (BMI: r = 0.49, 95% CI 0.35-0.61, I2 = 67.39%, p = 0.003; BSA: r = 0.2, 95% CI 0.08-0.31, I2 = 14.10%, p = 0.324). Conversely, the association between intraperitoneal pressure and age, intraperitoneal volume, and Charlson Comorbidity Index were less consistent. Subgroup analysis demonstrated an association between higher intraperitoneal pressure in patients with increased BMI and BSA. However, the relationship between intraperitoneal pressure and non-infectious mechanical complications remained inconclusive. DISCUSSION: This review underscores a significant association between intraperitoneal pressure and anthropometric measures (BMI and BSA). The majority of the studies identified included a small sample and considerable bias. However, the association between intraperitoneal pressure and clinically relevant outcomes was not clear. CONCLUSIONS: While increasing body mass index and body surface areas are associated with increasing intraperitoneal pressure, the clinical relevance of measuring intraperitoneal pressure in an adult population remains unclear, particularly given the absence of an association with clinically relevant non-infectious outcomes.

Revealing the intricate temporal dynamics and adaptive responses of prokaryotic and eukaryotic microbes in the coastal South China Sea.

This comprehensive two-year investigation in the coastal South China Sea has advanced our understanding of marine microbes at both community and genomic levels. By combining metagenomics and metatranscriptomics, we have revealed the intricate temporal dynamics and remarkable adaptability of microbial communities and phytoplankton metagenome-assembled genomes (MAGs) in response to environmental fluctuations. We observed distinct seasonal shifts in microbial community composition and function: cyanobacteria were predominant during warmer months, whereas photosynthetic protists were more abundant during colder seasons. Notably, metabolic marker KOs of photosynthesis were consistently active throughout the year, underscoring the persistent role of these processes irrespective of seasonal changes. Our analysis reveals that environmental parameters such as temperature, salinity, and nitrate concentrations profoundly influence microbial community composition, while temperature and silicate have emerged as crucial factors shaping their functional traits. Through the recovery and analysis of 37 phytoplankton MAGs, encompassing nine prokaryotic cyanobacteria and 28 eukaryotic protists from diverse phyla, we have gained insights into their genetic diversity and metabolic capabilities. Distinct profiles of photosynthesis-related pathways including carbon fixation, carotenoid biosynthesis, photosynthesis-antenna proteins, and photosynthesis among the MAGs indicated their genetic adaptations to changing environmental conditions. This study not only enhances our understanding of microbial dynamics in coastal marine ecosystems but also sheds light on the ecological roles and adaptive responses of different microbial groups to environmental changes.

Horizontal plasmid transfer promotes antibiotic resistance in selected bacteria in Chinese frog farms.

The emergence and dissemination of antibiotic resistance genes (ARGs) in the ecosystem are global public health concerns. One Health emphasizes the interconnectivity between different habitats and seeks to optimize animal, human, and environmental health. However, information on the dissemination of antibiotic resistance genes (ARGs) within complex microbiomes in natural habitats is scarce. We investigated the prevalence of antibiotic resistant bacteria (ARB) and the spread of ARGs in intensive bullfrog (Rana catesbeiana) farms in the Shantou area of China. Antibiotic susceptibilities of 361 strains, combined with microbiome analyses, revealed Escherichia coli, Edwardsiella tarda, Citrobacter and Klebsiella sp. as prevalent multidrug resistant bacteria on these farms. Whole genome sequencing of 95 ARB identified 250 large plasmids that harbored a wide range of ARGs. Plasmid sequences and sediment metagenomes revealed an abundance of tetA, sul1, and aph(3″)-Ib ARGs. Notably, antibiotic resistance (against 15 antibiotics) highly correlated with plasmid-borne rather than chromosome-borne ARGs. Based on sequence similarities, most plasmids (62%) fell into 32 distinct groups, indicating a potential for horizontal plasmid transfer (HPT) within the frog farm microbiome. HPT was confirmed in inter- and intra-species conjugation experiments. Furthermore, identical mobile ARGs, flanked by mobile genetic elements (MGEs), were found in different locations on the same plasmid, or on different plasmids residing in the same or different hosts. Our results suggest a synergy between MGEs and HPT to facilitate ARGs dissemination in frog farms. Mining public databases retrieved similar plasmids from different bacterial species found in other environmental niches globally. Our findings underscore the importance of HPT in mediating the spread of ARGs in frog farms and other microbiomes of the ecosystem.

Measuring Social Frailty: A Scoping Review of Available Scales and Tools.

BACKGROUND AND OBJECTIVES: Social frailty is an emerging concept characterized by state of vulnerability due to the lack or absence of social resources that enable health and wellbeing, particularly among older people. However, there is no consensus on how to accurately measure and assess social frailty, given the broad coverage of social dimensions affecting older individuals. This scoping review aimed to identify existing tools and scales used to measure social frailty in older people. RESEARCH DESIGN AND METHODS: A scoping review methodology was employed. Articles published between January 2014 and April 2024 were searched in six electronic databases: PubMed, PsycINFO, ProQuest, Scopus, SocIndex, and CINAHL. The scoping review followed a five-stage process by Arksey and O'Malley and adhered to the guidelines provided by PRISMA-ScR. RESULTS: Nine social frailty tools were identified across the 58 papers included in this review. The individual question item commonly used in the scales were classified into main categories based on their conceptual characteristics and intentions. The most common individual questionnaire constructs used to measure social frailty included financial status, social resources, social behaviours and activities, and sense of purpose. The reviewed tools varied in terms of their robustness and the process of scale development. DISCUSSION AND IMPLICATIONS: Our review suggested the development of a standardized, psychometrically tested, and accurate screening tool to screen social frailty status. An accurate social frailty assessment can inform the development of useful interventions, which also has implications in preventing the development of physical frailty.

Efficacy of molnupiravir and interferon for the treatment of SARS-CoV-2 in golden Syrian hamster.

The mortality and hospitalization rate by COVID-19 dropped significantly currently, but its seasonal outbreaks make antiviral treatment still vital. The mortality and hospitazation rate by COVID-19 dropped significantly currently, but its seasonal ourbreaks make antiviral treatment still vital. In our study, syrian golden hamsters were treated with molnupiravir and interferons (IFNs) after SARS-CoV-2 infection. Their weight changes, pathological changes, virus replication and inflammation levels were evaluated. In the IFNs single treatment, only IFN-α group reduced viral load (p < 0.05) and virus titer in hamster lungs. The TNF-α expression decreased significantly in both IFNs treatment at 2dpi. Histological and immunofluorescence results showed lung damage in the IFNs groups were milder at 4dpi. In the molnupiravir/IFN-α combination treatment, weight loss and virus replication in lung were significantly decreased in the mono-molnupiravir group and combination group (p < 0.05), the expression of IL-6, TNF-α, IL-1ß and MIP-1α also decreased significantly (p < 0.05), but the combination treatment was not more effective than the mono-molnupiravir treatment. Histological and immunofluorescence results showed the lung damage and inflammation in mono-molnupiravir and combination groups were milder. In summary, IFNs treatment had anti-inflammatory effect against SARS-CoV-2, only IFN-α showed a weak antiviral effect. Molnupiravir/IFN-α combination treatment was effective against SARS-CoV-2 but was not superior to mono-molnupiravir treatment. IFN-α could be considered for immunocompromised patients to stimulate and activate early immune responses.

Real-time monitoring of cellular superoxide anion release in THP-1 cells using a catalytically amplified superoxide dismutase-based microbiosensor.

Reactive oxygen species (ROS) including the superoxide anion (O2•-) are typically studied in cell cultures using fluorescent dyes, which provide only discrete single-point measurements. These methods lack the capabilities for assessing O2•- kinetics and release in a quantitative manner over long monitoring times. Herein, we present the fabrication and application of an electrochemical biosensor that enables real-time continuous monitoring of O2•- release in cell cultures for extended periods (> 8 h) using an O2•- specific microelectrode. To achieve the sensitivity and selectivity requirements for cellular sensing, we developed a biohybrid system consisting of superoxide dismutase (SOD) and Ti3C2Tx MXenes, deposited on a gold microwire electrode (AuME) as O2•- specific materials with catalytic amplification through the synergistic action of the enzyme and the biomimetic MXenes-based structure. The biosensor demonstrated a sensitivity of 18.35 nA/µM with a linear range from 147 to 930 nM in a cell culture medium. To demonstrate its robustness and practicality, we applied the biosensor to monitor O2•- levels in human leukemia monocytic THP-1 cells upon stimulation with lipopolysaccharide (LPS). Using this strategy, we successfully monitored LPS-induced O2•- in THP-1 cells, as well as the quenching effect induced by the ROS scavenger N-acetyl-L-cysteine (NAC). The biosensor is generally useful for exploring the role of oxidative stress and longitudinally monitoring O2•- release in cell cultures, enabling studies of biochemical processes and associated oxidative stress mechanisms in cellular and other biological environments.

Computational Docking as a Tool in Guiding the Drug Design of Rutaecarpine Derivatives as Potential SARS-CoV-2 Inhibitors.

COVID-19 continues to spread around the world. This is mainly because new variants of the SARS-CoV-2 virus emerge due to genomic mutations, evade the immune system and result in the effectiveness of current therapeutics being reduced. We previously established a series of detection platforms, comprising computational docking analysis, S-protein-based ELISA, pseudovirus entry, and 3CL protease activity assays, which allow us to screen a large library of phytochemicals from natural products and to determine their potential in blocking the entry of SARS-CoV-2. In this new screen, rutaecarpine (an alkaloid from Evodia rutaecarpa) was identified as exhibiting anti-SARS-CoV-2 activity. Therefore, we conducted multiple rounds of structure-activity-relationship (SAR) studies around this phytochemical and generated several rutaecarpine analogs that were subjected to in vitro evaluations. Among these derivatives, RU-75 and RU-184 displayed remarkable inhibitory activity when tested in the 3CL protease assay, S-protein-based ELISA, and pseudovirus entry assay (for both wild-type and omicron variants), and they attenuated the inflammatory response induced by SARS-CoV-2. Interestingly, RU-75 and RU-184 both appeared to be more potent than rutaecarpine itself, and this suggests that they might be considered as lead candidates for future pharmacological elaboration.

Interaction and antiviral treatment of coinfection between SARS-CoV-2 and influenza in vitro.

BACKGROUND: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has lasted for three years. Coinfection with seasonal influenza may occur resulting in more severe diseases. The interaction between these two viruses for infection and the effect of antiviral treatment remains unclear. METHODS: A SARS-CoV-2 and influenza H1N1 coinfection model on Calu-3 cell line was established, upon which the simultaneous and sequential coinfection was evaluated by comparing the viral load. The efficacy of molnupiravir and baloxavir against individual virus and coinfection were also studied. RESULTS: The replication of SARS-CoV-2 was significantly interfered when the influenza virus was infected simultaneously or in advance (p < 0.05). On the contrary, the replication of the influenza virus was not affected by the SARS-CoV-2. Molnupiravir monotherapy had significant inhibitory effect on SARS-CoV-2 when the concentration reached to 6.25 µM but did not show any significant anti-influenza activity. Baloxavir was effective against influenza within the dosage range and showed significant effect of anti-SARS-CoV-2 at 16 µM. In the treatment of coinfection, molnupiravir had significant effect for SARS-CoV-2 from 6.25 µM to 100 µM and inhibited H1N1 at 100 µM (p < 0.05). The tested dosage range of baloxavir can inhibit H1N1 significantly (p < 0.05), while at the highest concentration of baloxavir did not further inhibit SARS-CoV-2, and the replication of SARS-CoV-2 significantly increased in lower concentrations. Combination treatment can effectively inhibit influenza H1N1 and SARS-CoV-2 replication during coinfection. Compared with molnupiravir or baloxavir monotherapy, combination therapy was more effective in less dosage to inhibit the replication of both viruses. CONCLUSIONS: In coinfection, the replication of SARS-CoV-2 would be interfered by influenza H1N1. Compared with molnupiravir or baloxavir monotherapy, treatment with a combination of molnupiravir and baloxavir should be considered for early treatment in patients with SARS-CoV-2 and influenza coinfection.

Deep learning algorithms for predicting renal replacement therapy initiation in CKD patients: a retrospective cohort study.

BACKGROUND: Chronic kidney disease (CKD) requires accurate prediction of renal replacement therapy (RRT) initiation risk. This study developed deep learning algorithms (DLAs) to predict RRT risk in CKD patients by incorporating medical history and prescriptions in addition to biochemical investigations. METHODS: A multi-centre retrospective cohort study was conducted in three major hospitals in Hong Kong. CKD patients with an eGFR < 30ml/min/1.73m2 were included. DLAs of various structures were created and trained using patient data. Using a test set, the DLAs' predictive performance was compared to Kidney Failure Risk Equation (KFRE). RESULTS: DLAs outperformed KFRE in predicting RRT initiation risk (CNN + LSTM + ANN layers ROC-AUC = 0.90; CNN ROC-AUC = 0.91; 4-variable KFRE: ROC-AUC = 0.84; 8-variable KFRE: ROC-AUC = 0.84). DLAs accurately predicted uncoded renal transplants and patients requiring dialysis after 5 years, demonstrating their ability to capture non-linear relationships. CONCLUSIONS: DLAs provide accurate predictions of RRT risk in CKD patients, surpassing traditional methods like KFRE. Incorporating medical history and prescriptions improves prediction performance. While our findings suggest that DLAs hold promise for improving patient care and resource allocation in CKD management, further prospective observational studies and randomized controlled trials are necessary to fully understand their impact, particularly regarding DLA interpretability, bias minimization, and overfitting reduction. Overall, our research underscores the emerging role of DLAs as potentially valuable tools in advancing the management of CKD and predicting RRT initiation risk.

Green conversion of waste alkaline battery material to zeolitic imidazolate framework-8 and its iodine capture mechanism.

Zeolitic imidazolate framework-8 (ZIF-8) exhibits excellent performance in capturing iodine. However, the solvent-based procedures and raw materials for ZIF-8 synthesis often lead to secondary pollution. We developed a solvent-minimizing method for preparing ZIF-8 via ball milling of raw material obtained from spent alkaline batteries, and studied its iodine-capture performance and structural changes. Exposure of the ZIF-8 to iodine vapor for 60 min demonstrated that it exhibited industrially competitive iodine-capture performance (the adsorbed amount reaches to 1123 mg g-1 within 60 min). Spectroscopic studies showed that ZIF-8 underwent a structural transformation upon iodine loading. Iodine molecules were adsorbed onto the surface of ZIF-8 and also formed C-I bond with the methyl groups on the imidazole rings, reducing iodine release. This work represents a comprehensive revelation of long-range order and short-range order evolution of ZIF-8 during iodine vapor adsorption over time. Moreover, this green synthesis of ZIF-8 is of lower cost and generates fewer harmful by-products than existing methods, and the produced ZIF-8 effectively entraps toxic iodine vapor. Thus, this synthesis enables a sustainable and circular material flow for beneficial utilization of waste materials.

Barriers to healthcare-worker adherence to infection prevention and control practices in British Columbia during the coronavirus disease 2019 (COVID-19) pandemic: A cross-sectional study.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of robust infection prevention and control (IPAC) practices to maintain patient and staff safety. However, healthcare workers (HCWs) face many barriers that affect their ability to follow these practices. We identified barriers affecting HCW adherence to IPAC practices during the pandemic in British Columbia, Canada. DESIGN: Cross-sectional web-based survey. SETTING: Acute care, long-term care or assisted living, outpatient, mental health, prehospital care, and home care. PARTICIPANTS: Eligible respondents included direct-care providers and IPAC professionals working in these settings in all health authorities across British Columbia. METHODS: We conducted a web-based survey from August to September 2021 to assess respondent knowledge and attitudes toward IPAC within the context of the COVID-19 pandemic. Respondents were asked to rate the extent to which various barriers affected their ability to follow IPAC practices throughout the pandemic and to make suggestions for improvement. RESULTS: The final analysis included 2,488 responses; 36% of respondents worked in acute care. Overall, perceptions of IPAC practice among non-IPAC professionals were positive. The main self-perceived barriers to adherence included inadequate staffing to cover absences (58%), limited space in staff rooms (57%), multibed rooms (51%), and confusing messages about IPAC practices (51%). Common suggestions for improvement included receiving more support from IPAC leadership and clearer communication about required IPAC practices. CONCLUSIONS: Our findings highlight frontline HCW perspectives regarding priority areas of improvement for IPAC practices. They will inform policy and guideline development to prevent transmission of COVID-19 and future emerging infections.

Effectiveness of a COVID-19 contact tracing app in a simulation model with indirect and informal contact tracing.

During the COVID-19 pandemic, contact tracing was used to identify individuals who had been in contact with a confirmed case so that these contacted individuals could be tested and quarantined to prevent further spread of the SARS-CoV-2 virus. Many countries developed mobile apps to find these contacted individuals faster. We evaluate the epidemiological effectiveness of the Dutch app CoronaMelder, where we measure effectiveness as the reduction of the reproduction number R. To this end, we use a simulation model of SARS-CoV-2 spread and contact tracing, informed by data collected during the study period (December 2020 - March 2021) in the Netherlands. We show that the tracing app caused a clear but small reduction of the reproduction number, and the magnitude of the effect was found to be robust in sensitivity analyses. The app could have been more effective if more people had used it, and if notification of contacts could have been done directly by the user and thus reducing the time intervals between symptom onset and reporting of contacts. The model has two innovative aspects: i) it accounts for the clustered nature of social networks and ii) cases can alert their contacts informally without involvement of health authorities or the tracing app.

Statin Therapy Is Associated With a Lower Risk of Heart Failure in Patients With Atrial Fibrillation: A Population-Based Study.

BACKGROUND: Whether statin use can reduce the risk of heart failure (HF) remains controversial. The present study evaluates the association between statin use and HF in patients with atrial fibrillation. METHODS AND RESULTS: Patients with newly diagnosed atrial fibrillation from 2010 to 2018 were included. An inverse probability of treatment weighting was used to balance baseline covariates between statin users (n=23 239) and statin nonusers (n=29 251). The primary outcome was incident HF. Cox proportional hazard models with competing risk regression were used to evaluate the risk of HF between statin users and nonusers. The median age of the cohort was 74.7 years, and 47.3% were women. Over a median follow-up of 5.1 years, incident HF occurred in 3673 (15.8%) statin users and 5595 (19.1%) statin nonusers. Statin use was associated with a 19% lower risk of HF (adjusted subdistribution hazard ratio, 0.81 [95% CI, 0.78-0.85]). Restricted to the statin users, duration of statin use was measured during follow-up; compared with short-term use (3 months to <2 years), there was a stepwise reduction in the risk of incident HF among those with 2 to <4 years of statin use (subdistribution hazard ratio, 0.86 [95% CI, 0.84-0.88]), 4 to <6 years of statin use (subdistribution hazard ratio, 0.74 [95% CI, 0.72-0.76]), and ≥6 years of statin use (subdistribution hazard ratio, 0.71 [95% CI, 0.69-0.74]). Subgroup analysis showed consistent reductions in the risk of HF with statin use. CONCLUSIONS: Statin use was associated with a decreased risk of incident HF in a duration-dependent manner among patients with atrial fibrillation.

Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis.

BACKGROUND: Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries. METHOD: The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults. RESULTS: A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience. CONCLUSION: The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.

PIWI-interacting RNA expression regulates pathogenesis in a Caenorhabditis elegans model of Lewy body disease.

PIWI-interacting RNAs (piRNAs) are small noncoding RNAs that regulate gene expression, yet their molecular functions in neurobiology are unclear. While investigating neurodegeneration mechanisms using human α-syn(A53T)Tg and AßTg;α-syn(A53T)Tg pan-neuronal overexpressing strains, we unexpectedly observed dysregulation of piRNAs. RNAi screening revealed that knock down of piRNA biogenesis genes improved thrashing behavior; further, a tofu-1 gene deletion ameliorated phenotypic deficits in α-syn(A53T)Tg and AßTg;α-syn(A53T)Tg transgenic strains. piRNA expression was extensively downregulated and H3K9me3 marks were decreased after tofu-1 deletion in α-syn(A53T)Tg and AßTg;α-syn(A53T)Tg strains. Dysregulated piRNAs targeted protein degradation genes suggesting that a decrease of piRNA expression leads to an increase of degradation ability in C. elegans. Finally, we interrogated piRNA expression in brain samples from PD patients. piRNAs were observed to be widely overexpressed at late motor stage. In this work, our results provide evidence that piRNAs are mediators in pathogenesis of Lewy body diseases and suggest a molecular mechanism for neurodegeneration in these and related disorders.

Gestational glucose intolerance and pregnancy outcomes: a retrospective study in the primary care setting of Macau.

Although glucose intolerance is prevalent in Macau, it is rarely assessed during pregnancy. This study examined short-term maternal and neonatal outcomes at different maternal glucose levels in Macau. A total of 2388 pregnant women who received antenatal care at Health Centers and delivered at the Centro Hospitalar Conde de São Januário between June 2018 and December 2019 were included in this study. Gestational diabetes mellitus (GDM) was diagnosed using Carpenter and Coustan criteria, involving a 50 g glucose challenge test (GCT) followed by a 100g oral glucose tolerance test (OGTT). Participants were categorized into 4 groups: normal glucose tolerance if GCT was negative; mild gestational hyperglycemia in this study if positive GCT without GDM; GDM patients with normal fasting blood glucose (FBG) or high FBG in OGTT. Logistic regression analysis was employed to compare pregnancy outcomes among these 4 groups. Due to the limited number of cases, we combined several adverse maternal outcomes, including pregnancy-induced hypertension, assisted delivery, primary Caesarean section, moderate to severe perineal trauma, and postpartum hemorrhage, into a composite measure. The results showed higher rates of the aforementioned outcomes for mild gestational hyperglycemia and GDM with high FBG in OGTT groups [adjusted odds ratio (aOR) 1.32, 95% confidence interval (CI) 1.06-1.64; aOR 2.04, 95% CI 1.24-3.37], as well as macrosomia risk (aOR 2.02, 95% CI 1.11-3.66; aOR 5.04, 95% CI 2.03-12.52) and large-for-gestational age infants (aOR 1.48, 95% CI 1.02-2.16; aOR 4.34, 95% CI 2.31-8.15). Pregnancy outcomes were similar for normal glucose tolerance and GDM with normal FBG in OGTT. Mild gestational hyperglycemia raised the likelihood of adverse maternal outcomes and excessive infant birth weights. Even after achieving target glucose levels, GDM patients with elevated fasting glucose readings in OGTT remained at significant risk for these events. Instead, fasting normoglycemic GDM was treated effectively at Macau Health Centers.

Corrigendum: A Chinese medicine formula (Bushen Huoxue Tongluo) for the treatment of chronic subjective tinnitus: a study protocol for a pilot, assessor-blinded, randomized clinical trial.

[This corrects the article DOI: 10.3389/fphar.2022.844730.].

Barriers to infection prevention and control in long-term care/assisted living settings in British Columbia during the COVID-19 pandemic: a cross-sectional survey.

BACKGROUND: The COVID-19 pandemic disproportionately impacted long-term care and assisted living (LTC/AL) facilities in Canada, where infection prevention and control (IPAC) programs had been suboptimal. We aimed to identify barriers affecting healthcare workers' (HCW) adherence to IPAC practices during the pandemic in British Columbia in LTC/AL compared to acute care settings. METHODS: We conducted a web-based survey of direct care providers and IPAC professionals across BC from August to September 2021, focused on knowledge and attitudes toward IPAC within the context of the COVID-19 pandemic, and barriers that affected respondents' abilities to follow IPAC practices throughout the pandemic. RESULTS: The final analysis included 896 acute care respondents and 441 from LTC/AL. More LTC/AL respondents reported experiencing the following barriers: following IPAC guidance was of lower priority compared to other tasks (29.1% vs. 14.7%, FDR = 0.001) and not their responsibility (28.0% vs. 11.2%, FDR = 0.001); limited supplies for personal protective equipment (PPE) (49.0% vs. 33.6%, FDR = 0.001), hand hygiene products (42.2% vs. 28.8%, FDR = 0.001), and cleaning/disinfection products (44.1% vs. 30.3%, FDR = 0.001); deficits in IPAC leadership support (46.2% vs. 38.9%, FDR = 0.012), IPAC education and training (46.9% vs. 32.0%, FDR = 0.001), and patient care knowledge for managing COVID-19 infections (46.6% vs. 36.0%, FDR = 0.001). CONCLUSIONS: This survey found that barriers to HCWs' adherence to IPAC practices during the COVID-19 pandemic were different in LTC/AL settings compared to acute care. Improvement efforts should focus on strengthening IPAC programs in LTC/AL, particularly enhanced IPAC staffing/leadership, increased training and education, and improving access to PPE, hand hygiene, and cleaning products.

Salt-Induced High-Density Vacancy-Rich 2D MoS2 for Efficient Hydrogen Evolution.

Emerging non-noble metal 2D catalysts, such as molybdenum disulfide (MoS2 ), hold great promise in hydrogen evolution reactions. The sulfur vacancy is recognized as a key defect type that can activate the inert basal plane to improve the catalytic performance. Unfortunately, the method of introducing sulfur vacancies is limited and requires costly post-treatment processes. Here, a novel salt-assisted chemical vapor deposition (CVD) method is demonstrated for synthesizing ultrahigh-density vacancy-rich 2H-MoS2 , with a controllable sulfur vacancy density of up to 3.35 × 1014  cm-2 . This approach involves a pre-sprayed potassium chloridepromoter on the growth substrate. The generation of such defects is closely related to ion adsorption in the growth process, the unstable MoS2 -K-H2 O triggers the formation of sulfur vacancies during the subsequent transfer process, and it is more controllable and nondestructive when compared to traditional post-treatment methods. The vacancy-rich monolayer MoS2 exhibits exceptional catalytic activity based on the microcell measurements, with an overpotential of ≈158.8 mV (100 mA cm-2 ) and a Tafel slope of 54.3 mV dec-1 in 0.5 m H2 SO4 electrolyte. These results indicate a promising opportunity for modulating sulfur vacancy defects in MoS2 using salt-assisted CVD growth. This approach represents a significant leap toward achieving better control over the catalytic performances of 2D materials.

The smart-home study: A feasibility study to pilot the use of smartphone technology to identify environmental falls risk factors in the home.

Introduction: While occupational therapy home assessments are effective to identify environmental falls risk factors, patients may not receive these services due to workforce distribution and geographical distances. Technology may offer a new way for occupational therapists to conduct home assessments to identify environmental fall risks. Objectives: To (i) explore the feasability of identifying environmental risk factors using smartphone technology, (ii) develop and pilot a suite of procedures for taking smartphone images and (iii) examine the inter-rater reliability and content validity between occupational therapists when assessing smartphone images using a standardised assessment tool. Method: Following ethical approval a procedure was developed and participants recruited to submit smartphone images of their bedroom, bathroom and toilet. Two independent occupational therapists then assessed these images using a home safety checklist. Findings were analysed using inferential and descriptive statistics. Results: Of 100 volunteers screened, 20 individuals participated. A guideline for instructing patients to take home images was developed and tested. Participants averaged 9.00 minutes (SD 4.401) to complete the task, whilst occupational therapists took approximately 8 minutes to review the images. The inter-rater reliability between the two therapists was 0.740 (95% CI: 0.452-0.888). Conclusion: The study found that use of smartphones was to a large extent feasible and conclude that the use of smartphone technologies is a potential complimentary service to traditional home visits. The effective prescription of equipment in this trial was identified as a challenge. The impact on costs and potential falls incidents remains uncertain and more research is warranted in representative populations.