Showing papers by "Queen's University Belfast published in 2022"

Vaccine Hesitancy and Anti-Vaccination Attitudes during the Start of COVID-19 Vaccination Program: A Content Analysis on Twitter Data

Abstract: Twitter is a useful source for detecting anti-vaccine content due to the increasing prevalence of these arguments on social media. We aimed to identify the prominent themes about vaccine hesitancy and refusal on social media posts in Turkish during the COVID-19 pandemic. In this qualitative study, we collected public tweets (n = 551,245) that contained a vaccine-related keyword and had been published between 9 December 2020 and 8 January 2021 through the Twitter API. A random sample of tweets (n = 1041) was selected and analyzed by four researchers with the content analysis method. We found that 90.5% of the tweets were about vaccines, 22.6% (n = 213) of the tweets mentioned at least one COVID-19 vaccine by name, and the most frequently mentioned COVID-19 vaccine was CoronaVac (51.2%). We found that 22.0% (n = 207) of the tweets included at least one anti-vaccination theme. Poor scientific processes (21.7%), conspiracy theories (16.4%), and suspicions towards manufacturers (15.5%) were the most frequently mentioned themes. The most co-occurring themes were "poor scientific process" with "suspicion towards manufacturers" (n = 9), and "suspicion towards health authorities" (n = 5). This study may be helpful for health managers, assisting them to identify the major concerns of the population and organize preventive measures through the significant role of social media in early spread of information about vaccine hesitancy and anti-vaccination attitudes.

Learning Through Listening: A Scoping Review of Podcast Use in Medical Education

Abstract: To improve understanding of podcast use in medical education by examining current research on descriptive attributes and educational outcomes, highlighting implications of the current evidence base for educational practices, and identifying research gaps to guide future investigation.The authors conducted a scoping review, searching PubMed and Embase databases in June-July 2020 for English-language studies of audio-only medical education podcast use in undergraduate, graduate, and continuing medical education. The authors excluded studies without original data or with nonphysician data that could not be separated from physician data. From included studies, the authors extracted data regarding descriptive outcomes (e.g., podcast use, content areas, structure) and educational outcomes (classified using Kirkpatrick's 4 levels of evaluation).Of 491 unique articles, 62 met inclusion criteria. Descriptive outcomes were reported in 44 studies. Analysis of these studies revealed podcast use has increased over time, podcasts are a top resource for resident education, and podcasts are being incorporated into formal medical curricula. Educational outcomes were reported in 38 studies. The 29 studies that assessed learner reaction and attitudes to podcasts (Kirkpatrick level 1) showed learners value podcasts for their portability, efficiency, and combined educational and entertainment value. The 10 studies that assessed knowledge retention (Kirkpatrick level 2) showed podcasts to be noninferior to traditional teaching methods. The 11 studies that assessed behavior change (Kirkpatrick level 3) showed improved documentation skills in medical students and self-reported practice change in residents and practicing physicians after listening to podcasts. None of the studies reported system change or patient outcomes (Kirkpatrick level 4).Future research should focus on the optimal structure of podcasts for learning, higher-level outcomes of podcasts, and the implementation of podcasts into formal curricula. Podcasts may prove to be essential tools for disseminating and implementing the most current, evidence-based practices.

Implementation of the new EU IVD regulation - urgent initiatives are needed to avert impending crisis.

Abstract: Laboratory medicine in the European Union is at the dawn of a regulatory revolution as it reaches the end of the transition from IVDD 98/79/EC (https://eur-lex.eur-opa.eu/legal-content/EN/TXT/?uri=CELEX%3A31998L0079&qid=1628781352814) to IVDR 2017/746 https://eur-lex.europa.eu/eli/reg/2017/746. Without amendments and contingency plans, implementation of the IVDR in May 2022 will lead the healthcare sector into uncharted waters due to unpreparedness of the EU regulatory infrastructure. Prospective risk analyses were not made by the European Commission, and if nothing happens it can be anticipated that the consequences will impact all stakeholders of the medical test pipeline, may seriously harm patients and may prevent caregivers from making appropriate clinical decisions due to non-availability of medical tests. Finally, it also may discourage manufacturers and academia from developing specialty tests, thereby hampering innovation in medical diagnostic care. We hereby inform laboratory professionals about the imminent diagnostic collapse using testimonies from representative stakeholders of the diagnostic supply chain and from academia developing innovative in-house tests in domains of unmet clinical needs. Steps taken by the EFLM Task Force on European Regulatory Affairs, under the umbrella of the Biomedical Alliance in Europe, will be highlighted, as well as the search for solutions through dialogue with the European Commission. Although we recognize that the IVDR promotes positive goals such as increased clinical evidence, surveillance, and transparency, we need to ensure that the capabilities of the diagnostic sector are not damaged by infrastructural unpreparedness, while at the same time being forced to submit to a growing bureaucratic and unsupportive structure that will not support its "droit d'exister".

Evolving fetal phenotypes and clinical impact of progressive prenatal exome sequencing pathways: cohort study

Abstract: To determine (1) the diagnostic yield and turnaround time (TAT) of two consecutive prenatal exome sequencing (ES) pathways, (2) the evolution of the fetal phenotype and (3) the clinical impact of detecting causative pathogenic variants and incidental findings.This was a retrospective cohort analysis of prospectively collected fetal cases that underwent trio ES in the presence of a structural anomaly and normal chromosomal microarray testing in the West Midlands Regional Genetics Laboratory, Birmingham, UK. The study included two phases: (1) between July 2018 and October 2020, the clinical pathway from the Prenatal Assessment of Genomes and Exomes (PAGE) study was adopted and involved prenatal trio ES based on a panel of 1542 development disorder genes and case selection by a multidisciplinary team; (2) between October 2020 and July 2021, prenatal trio ES investigation was based on the National Health Service (NHS) England R21 pathway, with definitive inclusion criteria and a panel of 1205 prenatally relevant genes. Deep phenotyping was performed throughout pregnancy and postnatally.A total of 54 cases were included. The diagnostic yield before vs after R21 pathway implementation was 28.0% (7/25) and 55.2% (16/29), respectively (P = 0.04). The respective values for mean TAT were 54.0 days (range, 14-213 days) and 14.2 days (range, 3-29 days). In cases in which a causative pathogenic variant was identified and in which the pregnancy reached the third trimester, additional anomalies were detected between the second and third trimesters in 73.3% (11/15) of cases, predominantly secondary to progressive hydropic features (3/11 (27.3%)), arthrogryposis (3/11 (27.3%)) or brain anomaly (2/11 (18.2%)). In three cases, a variant of uncertain significance was reclassified to likely pathogenic based on postnatal information. Detection of a causative pathogenic variant had a significant clinical impact in 78.3% (18/23) of cases, most frequently affecting decision-making regarding the course of the pregnancy and neonatal management (7/18 (38.9%)).Prenatal ES using the NHS England R21 pathway showed great promise when applied to this cohort, allowing a genetic diagnosis to be made in over half of preselected cases with a fetal structural anomaly on ultrasound. Monitoring and real-time updating of fetal phenotype and reclassification of variants based on postnatal findings is vital to increase the clinical impact that is already evident from this emerging genomic technology. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Features of B Cell Responses Relevant to Allergic Disease

Abstract: This Brief Review delves into B cell responses in the context of allergy. The primary contribution of B cells to allergy is the production of IgE, the Ab isotype that triggers immediate hypersensitivity reactions through the release of mediators from mast cells and basophils. B cells may also have protective roles in allergy, such as through the production of IgG or as regulatory B cells. In this review, I focus on the basic principles of B cell differentiation and discuss features relevant to allergic immune responses. In particular, I discuss: (1) class-switch recombination; (2) plasma cell differentiation; (3) germinal centers and affinity maturation; and (4) memory B cells and recall responses, with an emphasis on IgE, IgG1, and IgG4. I also consider how B cells may contribute to allergic responses independent of Ab production-for example, by serving as APCs.

Endomembranes promote chromosome missegregation by ensheathing misaligned chromosomes

Abstract: Errors in mitosis that cause chromosome missegregation lead to aneuploidy and micronucleus formation, which are associated with cancer. Accurate segregation requires the alignment of all chromosomes by the mitotic spindle at the metaphase plate, and any misalignment must be corrected before anaphase is triggered. The spindle is situated in a membrane-free "exclusion zone"; beyond this zone, endomembranes (mainly endoplasmic reticulum) are densely packed. We investigated what happens to misaligned chromosomes localized beyond the exclusion zone. Here we show that such chromosomes become ensheathed in multiple layers of endomembranes. Chromosome ensheathing delays mitosis and increases the frequency of chromosome missegregation and micronucleus formation. We use an induced organelle relocalization strategy in live cells to show that clearance of endomembranes allows for the rescue of chromosomes that were destined for missegregation. Our findings indicate that endomembranes promote the missegregation of misaligned chromosomes that are outside the exclusion zone and therefore constitute a risk factor for aneuploidy.

Boosting engine performance with Bose–Einstein condensation

Abstract: At low-temperatures a gas of bosons will undergo a phase transition into a quantum state of matter known as a Bose-Einstein condensate (BEC), in which a large fraction of the particles will occupy the ground state simultaneously. Here we explore the performance of an endoreversible Otto cycle operating with a harmonically confined Bose gas as the working medium. We analyze the engine operation in three regimes, with the working medium in the BEC phase, in the gas phase, and driven across the BEC transition during each cycle. We find that the unique properties of the BEC phase allow for enhanced engine performance, including increased power output and higher efficiency at maximum power.

Projections of hydrofluorocarbon (HFC) emissions and the resulting global warming based on recent trends in observed abundances and current policies

Abstract: Abstract. The emissions of hydrofluorocarbons (HFCs) have increased significantly in the past 2 decades, primarily as a result of the phaseout of ozone-depleting substances under the Montreal Protocol and the use of HFCs as their replacements. In 2015, large increases were projected in HFC use and emissions in this century in the absence of regulations, contributing up to 0.5 ∘C to global surface warming by 2100. In 2019, the Kigali Amendment to the Montreal Protocol came into force with the goal of limiting the use of HFCs globally, and currently, regulations to limit the use of HFCs are in effect in several countries. Here, we analyze trends in HFC emissions inferred from observations of atmospheric abundances and compare them with previous projections. Total CO2 eq. inferred HFC emissions continue to increase through 2019 (to about 0.8 GtCO2eq.yr-1) but are about 20 % lower than previously projected for 2017–2019, mainly because of the lower global emissions of HFC-143a. This indicates that HFCs are used much less in industrial and commercial refrigeration (ICR) applications than previously projected. This is supported by data reported by the developed countries and the lower reported consumption of HFC-143a in China. Because this time period preceded the beginning of the Kigali provisions, this reduction cannot be linked directly to the provisions of the Kigali Amendment. However, it could indicate that companies transitioned away from the HFC-143a with its high global warming potential (GWP) for ICR applications in anticipation of national or global mandates. There are two new HFC scenarios developed based (1) on current trends in HFC use and Kigali-independent (K-I) control policies currently existing in several countries and (2) current HFC trends and compliance with the Kigali Amendment (KA-2022). These current policies reduce projected emissions in 2050 from the previously calculated 4.0–5.3 GtCO2eq.yr-1 to 1.9–3.6 GtCO2eq.yr-1. The added provisions of the Kigali Amendment are projected to reduce the emissions further to 0.9–1.0 GtCO2eq.yr-1 in 2050. Without any controls, projections suggest a HFC contribution of 0.28–0.44 ∘C to global surface warming by 2100, compared to a temperature contribution of 0.14–0.31 ∘C that is projected considering the national K-I policies current in place. Warming from HFCs is additionally limited by the Kigali Amendment controls to a contribution of about 0.04 ∘C by 2100.

Long-lasting drug delivery systems based on microneedles

Abstract: The development of microneedle (MN)-assisted drug delivery technologies has been highly active for nearly two decades. The microneedle array patch (MAP)-based self-application technology bypasses many of the challenges associated with injectable routes by delivering the therapeutic materials directly into the intradermal space and allowing the release of the active ingredient in a sustained or controlled manner. Different types of biodegradable solid/dissolving MAP and nanoparticle-loaded/coated polymeric MAP or hollow MN have been envisioned for long-acting sustained delivery of therapeutic payloads, aiming for reducing the side effects and administration frequency to improve patient compliance. In this chapter, we covered the different types of MAPs that are loaded with different nano/biotherapeutics for long-acting delivery for a wide range of potential clinical applications. We have outlined the future development scenario for this long-acting MAP delivery system to achieve promising clinical benefits. Finally, it discusses the challenges to realize the full potential of long-acting sustained-release MNs in the clinic.

The Impact of Hyperopia on Academic Performance Among Children: A Systematic Review

Abstract: To assess the impact of uncorrected hyperopia and hyperopic spectacle correction on children's academic performance.Systematic review and meta-analysis.We searched 9 electronic databases from inception to July 26, 2021, for studies assessing associations between hyperopia and academic performance. There were no restrictions on language, publication date, or geographic location. A quality checklist was applied. Random-effects models estimated pooled effect size as a standardized mean difference (SMD) in 4 outcome domains: cognitive skills, educational performance, reading skills, and reading speed. (PROSPERO registration: CRD-42021268972).Twenty-five studies (21 observational and 4 interventional) out of 3415 met the inclusion criteria. No full-scale randomized trials were identified. Meta-analyses of the 5 studies revealed a small but significant adverse effect on educational performance in uncorrected hyperopic compared to emmetropic children {SMD -0.18 [95% confidence interval (CI), -0.27 to -0.09]; P < 0.001, 4 studies} and a moderate negative effect on reading skills in uncorrected hyperopic compared to emmetropic children [SMD -0.46 (95% CI, -0.90 to -0.03); P = 0.036, 3 studies]. Reading skills were significantly worse in hyperopic than myopic children [SMD -0.29 (95% CI, -0.43 to -0.15); P < 0.001, 1 study]. Qualitative analysis on 10 (52.6%) of 19 studies excluded from meta-analysis found a significant (P < 0.05) association between uncorrected hyperopia and impaired academic performance. Two interventional studies found hyperopic spectacle correction significantly improved reading speed (P < 0.05).Evidence indicates that uncorrected hyperopia is associated with poor academic performance. Given the limitations of current methodologies, further research is needed to evaluate the impact on academic performance of providing hyperopic correction.