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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Matt W. Hayward; Matt W. Hayward; Matt W. Hayward; Ninon F. V. Meyer; +31 Authors
    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ DOAJ-Articlesarrow_drop_down
    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    DOAJ-Articles
    Article . 2022
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    Article . 2022
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ DOAJ-Articlesarrow_drop_down
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      DOAJ-Articles
      Article . 2022
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      DOAJ
      Article . 2022
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Katy AM Gaythorpe; Kaja Abbas; John Huber; Andromachi Karachaliou; +22 Authors

    Summary Background Childhood immunisation services have been disrupted by the COVID-19 pandemic. WHO recommends considering outbreak risk using epidemiological criteria when deciding whether to conduct preventive vaccination campaigns during the pandemic. Methods We used 2-3 models per infection to estimate the health impact of 50% reduced routine vaccination coverage in 2020 and delay of campaign vaccination from 2020 to 2021 for measles vaccination in Bangladesh, Chad, Ethiopia, Kenya, Nigeria, and South Sudan, for meningococcal A vaccination in Burkina Faso, Chad, Niger, and Nigeria, and for yellow fever vaccination in the Democratic Republic of Congo, Ghana, and Nigeria. Our counterfactual comparative scenario was sustaining immunisation services at coverage projections made prior to COVID-19 (i.e. without any disruption). Findings Reduced routine vaccination coverage in 2020 without catch-up vaccination may lead to an increase in measles and yellow fever disease burden in the modelled countries. Delaying planned campaigns in Ethiopia and Nigeria by a year may significantly increased the risk of measles outbreaks (both countries did complete their SIAS planned for 2020). For yellow fever vaccination, delay in campaigns leads to a potential disease burden rise of >1 death per 100,000 people until the campaigns are implemented. For meningococcal A vaccination, short term disruptions in 2020 are unlikely to have a significant impact due to the persistence of direct and indirect benefits from past introductory campaigns of the 1 to 29-year-old population, bolstered by inclusion of the vaccine into the routine immunisation schedule accompanied by further catch-up campaigns. Interpretation The impact of COVID-19-related disruption to vaccination programs varies between infections and countries. Planning and implementation of campaigns should consider country and infection-specific epidemiological factors and local immunity gaps worsened by the COVID-19 pandemic when prioritising vaccines and strategies for catch-up vaccination. Funding Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance Research in context Evidence before the study We searched PubMed for (COVID-19 OR coronavirus OR SARS-CoV-2) AND (child health intervention OR vaccin* or immuni*) AND (disruption OR suspension OR reduction) AND (indirect effect OR health impact) on January 14, 2021, with no language restrictions. We found 178 articles of which 13 articles were relevant. Six articles reported some empirical data on immunization disruption in Bangladesh, Japan, Kenya, Nigeria, Pakistan, Saudi Arabia, South Africa, Spain and Italy, and a survey study focussed on immunization disruption in low and middle-income countries. One article proposed using the WHO health systems framework to assess the effects of COVID-19 on immunisation programmes in South Africa, another study on leveraging systems thinking and implementation science to improve immunization system performance in Africa, and two studies were review articles. One modelling study focused on the indirect effects, including reduction in routine immunisation services, of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries. Another modelling study focused on a benefit-risk analysis of routine childhood immunisation during the COVID-19 pandemic in Africa. We also found one other study in the grey literature that analysed the impact on SARS-CoV-2 infections as a result of fixed-post and door-to-door vaccination campaigns targeted at children under five years of age in an Ethiopia-like setting. Added value of this study We estimated the increase in cases and deaths caused by the disruption to immunisation services leading to outbreaks for measles, meningococcal A and yellow fever in 10 countries. The reduction in routine immunisation coverage among under-immunised cohorts of children has enhanced the risk of outbreaks which cannot be averted without catch-up vaccination. This can lead to an increase of 9.89% (0.91 additional deaths per 100,000 individuals, or 48,000 in total) across the three diseases from 2020 to 2030 in the countries considered. Results vary by infection and country, but generally most excess deaths are due to measles. Postponing campaign immunisation may not have a detrimental short-term health impact if campaign immunisation is implemented ahead of future outbreaks caused by these immunity gaps. Implications of the available evidence The COVID-19 pandemic has caused significant disruptions to routine services and vaccination campaigns and resulted in immunity gaps with potential to cause outbreaks in the affected populations. The short-term and long-term health impact differ between measles, meningococcal A and yellow fever vaccination and by countries based on the local epidemiological situation. Thereby, catch-up vaccination should be planned by considering the heterogeneity in population susceptibility across different countries to measles, meningococcal A and yellow fever outbreaks and implemented in time to prevent these outbreaks. The study findings can inform risk-benefit trade-off discussions around the timing of campaigns.

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    Europe PubMed Central
    Article . 2021
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    Article . 2021
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    DOAJ-Articles
    Article . 2021
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    eLife
    Article . 2021
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    Apollo
    Other literature type . 2021
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    Apollo
    Article . 2021
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    Apollo
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
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      Article . 2021
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      https://www.medrxiv.org/conten...
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      Article . 2021
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      eLife
      Article . 2021
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      Apollo
      Other literature type . 2021
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      Apollo
      Article . 2021
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      Apollo
      Other literature type . 2021
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      Article . 2021
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      Article . 2021
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Marie E, Ward; Abel, Wakai; Ronald, McDowell; Fiona, Boland; +10 Authors

    Background Early warning score systems have been widely recommended for use to detect clinical deterioration in patients. The Irish National Emergency Medicine Programme has developed and piloted an emergency department specific early warning score system. The objective of this study was to develop a consensus among frontline healthcare staff, quality and safety staff and health systems researchers regarding evaluation measures for an early warning score system in the Emergency Department. Methods Participatory action research including a modified Delphi consensus building technique with frontline hospital staff, quality and safety staff, health systems researchers, local and national emergency medicine stakeholders was the method employed in this study. In Stage One, a workshop was held with the participatory action research team including frontline hospital staff, quality and safety staff and health systems researchers to gather suggestions regarding the evaluation measures. In Stage Two, an electronic modified-Delphi study was undertaken with a panel consisting of the workshop participants, key local and national emergency medicine stakeholders. Descriptive statistics were used to summarise the characteristics of the panellists who completed the questionnaires in each round. The mean Likert rating, standard deviation and 95% bias-corrected bootstrapped confidence interval for each variable was calculated. Bonferroni corrections were applied to take account of multiple testing. Data were analysed using Stata 14.0 SE. Results Using the Institute for Healthcare Improvement framework, 12 process, outcome and balancing metrics for measuring the effectiveness of an ED-specific early warning score system were developed. Conclusion There are currently no published measures for evaluating the effectiveness of an ED early warning score system. It was possible in this study to develop a suite of evaluation measures using a modified Delphi consensus approach. Using the collective expertise of frontline hospital staff, quality and safety staff and health systems researchers to develop and categorise the initial set of potential measures was an innovative and unique element of this study. Electronic supplementary material The online version of this article (10.1186/s12873-018-0220-3) contains supplementary material, which is available to authorized users.

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    Europe PubMed Central
    Article . 2019
    Data sources: PubMed Central
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    BMC Emergency Medicine
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    Article . 2019
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    BMC Emergency Medicine
    Article . 2019
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    Article . 2019
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      Europe PubMed Central
      Article . 2019
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      BMC Emergency Medicine
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      Article . 2019
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      BMC Emergency Medicine
      Article . 2019
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    Authors: Andrew C. Mason;

    Insects are often small relative to the wavelengths of sounds they need to localize, which presents a fundamental biophysical problem. Understanding novel solutions to this limitation can provide insights for biomimetic technologies. Such an approach has been successful using the fly Ormia ochracea (Diptera: Tachinidae) as a model. O. ochracea is a parasitoid species whose larvae develop as internal parasites within crickets (Gryllidae). In nature, female flies find singing male crickets by phonotaxis, despite severe constraints on directional hearing due to their small size. A physical coupling between the two tympanal membranes allows the flies to obtain information about sound source direction with high accuracy because it generates interaural time-differences (ITD) and interaural level differences (ILD) in tympanal vibrations that are exaggerated relative to the small arrival-time difference at the two ears, that is the only cue available in the sound stimulus. In this study, I demonstrate that pure time-differences in the neural responses to sound stimuli are sufficient for auditory directionality in O. ochracea.

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    Article . 2021
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    Frontiers in Ecology and Evolution
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    Frontiers in Ecology and Evolution
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      Frontiers in Ecology and Evolution
      Article
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
      Frontiers in Ecology and Evolution
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    Authors: Spyros Papapetropoulos; Spyros Papapetropoulos; Angela Pontius; Elizabeth Finger; +16 Authors

    A comprehensive review of published literature was conducted to elucidate the genetics, neuropathology, imaging findings, prevalence, clinical course, diagnosis/clinical evaluation, potential biomarkers, and current and proposed treatments for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), a rare, debilitating, and life-threatening neurodegenerative disorder for which disease-modifying therapies are not currently available. Details on potential efficacy endpoints for future interventional clinical trials in patients with ALSP and data related to the burden of the disease on patients and caregivers were also reviewed. The information in this position paper lays a foundation to establish an effective clinical rationale and address the clinical gaps for creation of a robust strategy to develop therapeutic agents for ALSP, as well as design future clinical trials, that have clinically meaningful and convergent endpoints.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Frontiers in Neurolo...arrow_drop_down
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    Frontiers in Neurology
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    Frontiers in Neurology
    Article . 2022
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    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Frontiers in Neurology
    Article . 2022
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    Scholarship@Western
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      Frontiers in Neurology
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      Frontiers in Neurology
      Article . 2022
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      Frontiers in Neurology
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    Authors: Susan Hunter; Alison Divine; Humberto Omana; Edward Madou; +1 Authors

    Abstract Background Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change. Methods Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results Three focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs = 0.84), but not EQ (rs = 0.39). Conclusions The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ CORE (RIOXX-UK Aggre...arrow_drop_down
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    Article . 2020
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    Europe PubMed Central
    Article . 2020
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    Scholarship@Western
    Article . 2020
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    https://doi.org/10.21203/rs.2....
    Preprint . 2020
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    https://doi.org/10.21203/rs.2....
    Preprint . 2020
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    https://doi.org/10.21203/rs.2....
    Preprint . 2020
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    BMC Geriatrics
    Article . 2020
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    BMC Geriatrics
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    BMC Geriatrics
    Article . 2020
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    https://doi.org/10.21203/rs.2....
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      https://doi.org/10.21203/rs.2....
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      https://doi.org/10.21203/rs.2....
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      https://doi.org/10.21203/rs.2....
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      https://doi.org/10.21203/rs.2....
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    Authors: Kurtenbach, Stefan; Kurtenbach, Sarah; Zoidl, Georg;

    Gap junction communication (GJC) mediated by connexins is critical for heart function. To gain insight into the causal relationship of molecular mechanisms of disease pathology, it is important to understand which mechanisms contribute to impairment of gap junctional communication. Here, we present an update on the known modulators of connexins, including various interaction partners, kinases, and signaling cascades. This gap junction network (GJN) can serve as a blueprint for data mining approaches exploring the growing number of publicly available data sets from experimental and clinical studies.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
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    Europe PubMed Central
    Article . 2014
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    Article . 2014
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    Frontiers in Physiology
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    Article . 2014
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      Frontiers in Physiology
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    Authors: Aras Kayvanrad; Stephen R. Arnott; Nathan W. Churchill; Stefanie Hassel; +16 Authors

    Quality assurance (QA) is crucial in longitudinal and/or multi-site studies, which involve the collection of data from a group of subjects over time and/or at different locations. It is important to regularly monitor the performance of the scanners over time and at different locations to detect and control for intrinsic differences (e.g., due to manufacturers) and changes in scanner performance (e.g., due to gradual component aging, software and/or hardware upgrades, etc.). As part of the Ontario Neurodegenerative Disease Research Initiative (ONDRI) and the Canadian Biomarker Integration Network in Depression (CAN-BIND), QA phantom scans were conducted approximately monthly for three to four years at 13 sites across Canada with 3T research MRI scanners. QA parameters were calculated for each scan using the functional Biomarker Imaging Research Network's (fBIRN) QA phantom and pipeline to capture between- and within-scanner variability. We also describe a QA protocol to measure the full-width-at-half-maximum (FWHM) of slice-wise point spread functions (PSF), used in conjunction with the fBIRN QA parameters. Variations in image resolution measured by the FWHM are a primary source of variance over time for many sites, as well as between sites and between manufacturers. We also identify an unexpected range of instabilities affecting individual slices in a number of scanners, which may amount to a substantial contribution of unexplained signal variance to their data. Finally, we identify a preliminary preprocessing approach to reduce this variance and/or alleviate the slice anomalies, and in a small human data set show that this change in preprocessing can have a significant impact on seed-based connectivity measurements for some individual subjects. We expect that other fMRI centres will find this approach to identifying and controlling scanner instabilities useful in similar studies.

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    Scholarship@Western
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    NeuroImage
    Article . 2020
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    Authors: Palma, David A.; Olson, Robert; Harrow, Stephen; Correa, Rohann J.M.; +21 Authors

    Background Stereotactic ablative radiotherapy (SABR) has emerged as a new treatment option for patients with oligometastatic disease. SABR delivers precise, high-dose, hypofractionated radiotherapy, and achieves excellent rates of local control for primary tumors or metastases. A recent randomized phase II trial evaluated SABR in a group of patients with a small burden of oligometastatic disease (mostly with 1–3 metastatic lesions), and found that SABR was associated with benefits in progression-free survival and overall survival. The goal of this phase III trial is to assess the impact of SABR in patients with 4–10 metastatic cancer lesions. Methods One hundred and fifty-nine patients will be randomized in a 1:2 ratio between the control arm (consisting of standard of care palliative-intent treatments), and the SABR arm (consisting of standard of care treatment + SABR to all sites of known disease). Randomization will be stratified by two factors: histology (Group 1: prostate, breast, or renal; Group 2: all others), and type of pre-specified systemic therapy (Group 1: immunotherapy/targeted; Group 2: cytotoxic; Group 3: observation). SABR is to be completed within 2 weeks, allowing for rapid initiation of systemic therapy. Recommended SABR doses are 20 Gy in 1 fraction, 30 Gy in 3 fractions, or 35 Gy in 5 fractions, chosen to minimize risks of toxicity. The primary endpoint is overall survival, and secondary endpoints include progression-free survival, time to development of new metastatic lesions, quality of life, and toxicity. Translational endpoints include assessment of circulating tumor cells, cell-free DNA, and tumor tissue as prognostic and predictive markers, including assessment of immunological predictors of response and long-term survival. Discussion This study will provide an assessment of the impact of SABR on clinical outcomes and quality of life, to determine if long-term survival can be achieved for selected patients with 4–10 oligometastatic lesions. Trial registration Clinicaltrials.gov identifier: NCT03721341. Date of registration: October 26, 2018. Electronic supplementary material The online version of this article (10.1186/s12885-019-5977-6) contains supplementary material, which is available to authorized users.

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    Europe PubMed Central
    Article . 2019
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    BMC Cancer
    Article . 2019
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    Article . 2019
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    Authors: Carrie Anne Marshall; Leonie Boland; Lee Ann Westover; Roxanne Isard; +1 Authors

    Background: Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. Objectives: To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. Results: Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; IQR = 33.4). The majority of studies evaluated interventions for the development of life skills (n = 9; 81.8%), and all were conducted in the USA. Several of the included studies were exploratory evaluation and feasibility studies, and all were quasi-experimental in design. Only three studies (27.2%) incorporated a control group. Intervention strategies included (1) integrated group and individual life skills interventions (n = 6); (2) group-based life skills interventions (n = 3); and (3) psychosocial and consultative interventions (n = 2). Conclusions: Research evaluating occupational therapy interventions aimed at supporting homeless individuals as they transition to housing is in an early stage of development. Significance: Implications for research and practice are discussed.

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    Authors: Matt W. Hayward; Matt W. Hayward; Matt W. Hayward; Ninon F. V. Meyer; +31 Authors
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    Authors: Katy AM Gaythorpe; Kaja Abbas; John Huber; Andromachi Karachaliou; +22 Authors

    Summary Background Childhood immunisation services have been disrupted by the COVID-19 pandemic. WHO recommends considering outbreak risk using epidemiological criteria when deciding whether to conduct preventive vaccination campaigns during the pandemic. Methods We used 2-3 models per infection to estimate the health impact of 50% reduced routine vaccination coverage in 2020 and delay of campaign vaccination from 2020 to 2021 for measles vaccination in Bangladesh, Chad, Ethiopia, Kenya, Nigeria, and South Sudan, for meningococcal A vaccination in Burkina Faso, Chad, Niger, and Nigeria, and for yellow fever vaccination in the Democratic Republic of Congo, Ghana, and Nigeria. Our counterfactual comparative scenario was sustaining immunisation services at coverage projections made prior to COVID-19 (i.e. without any disruption). Findings Reduced routine vaccination coverage in 2020 without catch-up vaccination may lead to an increase in measles and yellow fever disease burden in the modelled countries. Delaying planned campaigns in Ethiopia and Nigeria by a year may significantly increased the risk of measles outbreaks (both countries did complete their SIAS planned for 2020). For yellow fever vaccination, delay in campaigns leads to a potential disease burden rise of >1 death per 100,000 people until the campaigns are implemented. For meningococcal A vaccination, short term disruptions in 2020 are unlikely to have a significant impact due to the persistence of direct and indirect benefits from past introductory campaigns of the 1 to 29-year-old population, bolstered by inclusion of the vaccine into the routine immunisation schedule accompanied by further catch-up campaigns. Interpretation The impact of COVID-19-related disruption to vaccination programs varies between infections and countries. Planning and implementation of campaigns should consider country and infection-specific epidemiological factors and local immunity gaps worsened by the COVID-19 pandemic when prioritising vaccines and strategies for catch-up vaccination. Funding Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance Research in context Evidence before the study We searched PubMed for (COVID-19 OR coronavirus OR SARS-CoV-2) AND (child health intervention OR vaccin* or immuni*) AND (disruption OR suspension OR reduction) AND (indirect effect OR health impact) on January 14, 2021, with no language restrictions. We found 178 articles of which 13 articles were relevant. Six articles reported some empirical data on immunization disruption in Bangladesh, Japan, Kenya, Nigeria, Pakistan, Saudi Arabia, South Africa, Spain and Italy, and a survey study focussed on immunization disruption in low and middle-income countries. One article proposed using the WHO health systems framework to assess the effects of COVID-19 on immunisation programmes in South Africa, another study on leveraging systems thinking and implementation science to improve immunization system performance in Africa, and two studies were review articles. One modelling study focused on the indirect effects, including reduction in routine immunisation services, of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries. Another modelling study focused on a benefit-risk analysis of routine childhood immunisation during the COVID-19 pandemic in Africa. We also found one other study in the grey literature that analysed the impact on SARS-CoV-2 infections as a result of fixed-post and door-to-door vaccination campaigns targeted at children under five years of age in an Ethiopia-like setting. Added value of this study We estimated the increase in cases and deaths caused by the disruption to immunisation services leading to outbreaks for measles, meningococcal A and yellow fever in 10 countries. The reduction in routine immunisation coverage among under-immunised cohorts of children has enhanced the risk of outbreaks which cannot be averted without catch-up vaccination. This can lead to an increase of 9.89% (0.91 additional deaths per 100,000 individuals, or 48,000 in total) across the three diseases from 2020 to 2030 in the countries considered. Results vary by infection and country, but generally most excess deaths are due to measles. Postponing campaign immunisation may not have a detrimental short-term health impact if campaign immunisation is implemented ahead of future outbreaks caused by these immunity gaps. Implications of the available evidence The COVID-19 pandemic has caused significant disruptions to routine services and vaccination campaigns and resulted in immunity gaps with potential to cause outbreaks in the affected populations. The short-term and long-term health impact differ between measles, meningococcal A and yellow fever vaccination and by countries based on the local epidemiological situation. Thereby, catch-up vaccination should be planned by considering the heterogeneity in population susceptibility across different countries to measles, meningococcal A and yellow fever outbreaks and implemented in time to prevent these outbreaks. The study findings can inform risk-benefit trade-off discussions around the timing of campaigns.

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    Authors: Marie E, Ward; Abel, Wakai; Ronald, McDowell; Fiona, Boland; +10 Authors

    Background Early warning score systems have been widely recommended for use to detect clinical deterioration in patients. The Irish National Emergency Medicine Programme has developed and piloted an emergency department specific early warning score system. The objective of this study was to develop a consensus among frontline healthcare staff, quality and safety staff and health systems researchers regarding evaluation measures for an early warning score system in the Emergency Department. Methods Participatory action research including a modified Delphi consensus building technique with frontline hospital staff, quality and safety staff, health systems researchers, local and national emergency medicine stakeholders was the method employed in this study. In Stage One, a workshop was held with the participatory action research team including frontline hospital staff, quality and safety staff and health systems researchers to gather suggestions regarding the evaluation measures. In Stage Two, an electronic modified-Delphi study was undertaken with a panel consisting of the workshop participants, key local and national emergency medicine stakeholders. Descriptive statistics were used to summarise the characteristics of the panellists who completed the questionnaires in each round. The mean Likert rating, standard deviation and 95% bias-corrected bootstrapped confidence interval for each variable was calculated. Bonferroni corrections were applied to take account of multiple testing. Data were analysed using Stata 14.0 SE. Results Using the Institute for Healthcare Improvement framework, 12 process, outcome and balancing metrics for measuring the effectiveness of an ED-specific early warning score system were developed. Conclusion There are currently no published measures for evaluating the effectiveness of an ED early warning score system. It was possible in this study to develop a suite of evaluation measures using a modified Delphi consensus approach. Using the collective expertise of frontline hospital staff, quality and safety staff and health systems researchers to develop and categorise the initial set of potential measures was an innovative and unique element of this study. Electronic supplementary material The online version of this article (10.1186/s12873-018-0220-3) contains supplementary material, which is available to authorized users.

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    Europe PubMed Central
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    BMC Emergency Medicine
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    Authors: Andrew C. Mason;

    Insects are often small relative to the wavelengths of sounds they need to localize, which presents a fundamental biophysical problem. Understanding novel solutions to this limitation can provide insights for biomimetic technologies. Such an approach has been successful using the fly Ormia ochracea (Diptera: Tachinidae) as a model. O. ochracea is a parasitoid species whose larvae develop as internal parasites within crickets (Gryllidae). In nature, female flies find singing male crickets by phonotaxis, despite severe constraints on directional hearing due to their small size. A physical coupling between the two tympanal membranes allows the flies to obtain information about sound source direction with high accuracy because it generates interaural time-differences (ITD) and interaural level differences (ILD) in tympanal vibrations that are exaggerated relative to the small arrival-time difference at the two ears, that is the only cue available in the sound stimulus. In this study, I demonstrate that pure time-differences in the neural responses to sound stimuli are sufficient for auditory directionality in O. ochracea.

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    Frontiers in Ecology and Evolution
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    Authors: Spyros Papapetropoulos; Spyros Papapetropoulos; Angela Pontius; Elizabeth Finger; +16 Authors

    A comprehensive review of published literature was conducted to elucidate the genetics, neuropathology, imaging findings, prevalence, clinical course, diagnosis/clinical evaluation, potential biomarkers, and current and proposed treatments for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), a rare, debilitating, and life-threatening neurodegenerative disorder for which disease-modifying therapies are not currently available. Details on potential efficacy endpoints for future interventional clinical trials in patients with ALSP and data related to the burden of the disease on patients and caregivers were also reviewed. The information in this position paper lays a foundation to establish an effective clinical rationale and address the clinical gaps for creation of a robust strategy to develop therapeutic agents for ALSP, as well as design future clinical trials, that have clinically meaningful and convergent endpoints.

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    Frontiers in Neurology
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    Frontiers in Neurology
    Article . 2022
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    Frontiers in Neurology
    Article . 2022
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      Frontiers in Neurology
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      Frontiers in Neurology
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      Frontiers in Neurology
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    Authors: Susan Hunter; Alison Divine; Humberto Omana; Edward Madou; +1 Authors

    Abstract Background Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change. Methods Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results Three focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs = 0.84), but not EQ (rs = 0.39). Conclusions The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

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    Europe PubMed Central
    Article . 2020
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    Scholarship@Western
    Article . 2020
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    https://doi.org/10.21203/rs.2....
    Preprint . 2020
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    https://doi.org/10.21203/rs.2....
    Preprint . 2020
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    https://doi.org/10.21203/rs.2....
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    BMC Geriatrics
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    https://doi.org/10.21203/rs.2....
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      BMC Geriatrics
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      https://doi.org/10.21203/rs.2....
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    Authors: Kurtenbach, Stefan; Kurtenbach, Sarah; Zoidl, Georg;

    Gap junction communication (GJC) mediated by connexins is critical for heart function. To gain insight into the causal relationship of molecular mechanisms of disease pathology, it is important to understand which mechanisms contribute to impairment of gap junctional communication. Here, we present an update on the known modulators of connexins, including various interaction partners, kinases, and signaling cascades. This gap junction network (GJN) can serve as a blueprint for data mining approaches exploring the growing number of publicly available data sets from experimental and clinical studies.

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    Europe PubMed Central
    Article . 2014
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    Article . 2014
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    Frontiers in Physiology
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      Frontiers in Physiology
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    Authors: Aras Kayvanrad; Stephen R. Arnott; Nathan W. Churchill; Stefanie Hassel; +16 Authors

    Quality assurance (QA) is crucial in longitudinal and/or multi-site studies, which involve the collection of data from a group of subjects over time and/or at different locations. It is important to regularly monitor the performance of the scanners over time and at different locations to detect and control for intrinsic differences (e.g., due to manufacturers) and changes in scanner performance (e.g., due to gradual component aging, software and/or hardware upgrades, etc.). As part of the Ontario Neurodegenerative Disease Research Initiative (ONDRI) and the Canadian Biomarker Integration Network in Depression (CAN-BIND), QA phantom scans were conducted approximately monthly for three to four years at 13 sites across Canada with 3T research MRI scanners. QA parameters were calculated for each scan using the functional Biomarker Imaging Research Network's (fBIRN) QA phantom and pipeline to capture between- and within-scanner variability. We also describe a QA protocol to measure the full-width-at-half-maximum (FWHM) of slice-wise point spread functions (PSF), used in conjunction with the fBIRN QA parameters. Variations in image resolution measured by the FWHM are a primary source of variance over time for many sites, as well as between sites and between manufacturers. We also identify an unexpected range of instabilities affecting individual slices in a number of scanners, which may amount to a substantial contribution of unexplained signal variance to their data. Finally, we identify a preliminary preprocessing approach to reduce this variance and/or alleviate the slice anomalies, and in a small human data set show that this change in preprocessing can have a significant impact on seed-based connectivity measurements for some individual subjects. We expect that other fMRI centres will find this approach to identifying and controlling scanner instabilities useful in similar studies.

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    Scholarship@Western
    Article . 2021
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    Article . 2021
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    NeuroImage
    Article . 2020
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    Article . 2021
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      NeuroImage
      Article . 2021
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      Article . 2020
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    Authors: Palma, David A.; Olson, Robert; Harrow, Stephen; Correa, Rohann J.M.; +21 Authors

    Background Stereotactic ablative radiotherapy (SABR) has emerged as a new treatment option for patients with oligometastatic disease. SABR delivers precise, high-dose, hypofractionated radiotherapy, and achieves excellent rates of local control for primary tumors or metastases. A recent randomized phase II trial evaluated SABR in a group of patients with a small burden of oligometastatic disease (mostly with 1–3 metastatic lesions), and found that SABR was associated with benefits in progression-free survival and overall survival. The goal of this phase III trial is to assess the impact of SABR in patients with 4–10 metastatic cancer lesions. Methods One hundred and fifty-nine patients will be randomized in a 1:2 ratio between the control arm (consisting of standard of care palliative-intent treatments), and the SABR arm (consisting of standard of care treatment + SABR to all sites of known disease). Randomization will be stratified by two factors: histology (Group 1: prostate, breast, or renal; Group 2: all others), and type of pre-specified systemic therapy (Group 1: immunotherapy/targeted; Group 2: cytotoxic; Group 3: observation). SABR is to be completed within 2 weeks, allowing for rapid initiation of systemic therapy. Recommended SABR doses are 20 Gy in 1 fraction, 30 Gy in 3 fractions, or 35 Gy in 5 fractions, chosen to minimize risks of toxicity. The primary endpoint is overall survival, and secondary endpoints include progression-free survival, time to development of new metastatic lesions, quality of life, and toxicity. Translational endpoints include assessment of circulating tumor cells, cell-free DNA, and tumor tissue as prognostic and predictive markers, including assessment of immunological predictors of response and long-term survival. Discussion This study will provide an assessment of the impact of SABR on clinical outcomes and quality of life, to determine if long-term survival can be achieved for selected patients with 4–10 oligometastatic lesions. Trial registration Clinicaltrials.gov identifier: NCT03721341. Date of registration: October 26, 2018. Electronic supplementary material The online version of this article (10.1186/s12885-019-5977-6) contains supplementary material, which is available to authorized users.

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    Europe PubMed Central
    Article . 2019
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    BMC Cancer
    Article . 2019
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    Article . 2019
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    Authors: Carrie Anne Marshall; Leonie Boland; Lee Ann Westover; Roxanne Isard; +1 Authors

    Background: Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. Objectives: To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. Results: Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; IQR = 33.4). The majority of studies evaluated interventions for the development of life skills (n = 9; 81.8%), and all were conducted in the USA. Several of the included studies were exploratory evaluation and feasibility studies, and all were quasi-experimental in design. Only three studies (27.2%) incorporated a control group. Intervention strategies included (1) integrated group and individual life skills interventions (n = 6); (2) group-based life skills interventions (n = 3); and (3) psychosocial and consultative interventions (n = 2). Conclusions: Research evaluating occupational therapy interventions aimed at supporting homeless individuals as they transition to housing is in an early stage of development. Significance: Implications for research and practice are discussed.

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