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Journals use social media to increase the awareness of their publications. Infographics show research findings in a concise and visually appealing manner, well suited for dissemination on social media platforms. We hypothesized that infographic abstracts promoted on social media would increase the dissemination and online readership of the parent research articles.
Twenty-four articles were chosen from the six issues of CJEM published between July 2016 and June 2017 and randomized to infographic or control groups. All articles were disseminated through the journal’s social media accounts (Twitter and Facebook). Control articles were promoted using a screen capture image of each article’s abstract on the journal’s social media accounts. Infographic articles were promoted similarly using a visual infographic. Infographics were also published and promoted on the CanadiEM.org’s website and social media channels. Abstract views, full-text views, and the change in Altmetric score were compared between groups using unpaired two-tailed t-tests.
There were no significant differences in the groups at baseline. Abstract views (mean, 95% CI) were higher in the infographics (379, 287-471) than the control group (176, 136-215, p<0.001). Mean change in Altmetric scores was higher in the infographics (26, 18-34) than in the control group (3, 2-4, p<0.0001). There was no difference in full-text views between the infographics (50, 0-101) and control groups (25, 18-32).
The promotion of CJEM articles using infographics on social media and the CanadiEM.org website increased Altmetric scores and abstract views. Infographics may have a role in increasing awareness of medical literature.
Background: Opportunistic infection should be considered when seeing neurological complications in the setting of immunosuppression. Accumulating evidence that enteroviral meningoencephalitis can occur after rituximab administration exists but differentiating it from non-infectious conditions can be challenging. Methods: Case report Results: We describe a 4 year-old-boy with a history of pulmonary capillaritis, treated with immunosuppressive therapy -including steroids, rituximab, and azathioprine. He developed mutism and ataxia after 18 months on rituximab. MRI Brain/Spine revealed extensive T2/FLAIR hyperintensities in the deep subcortical white matter, temporal lobes, globus pallidi, thalami, brainstem, and cerebellum; and swelling of the dorsal cervical cord, showing primarily grey matter involvement. IgG levels had a decreasing trend over the course of Rituximab. CSF, and subsequent brain biopsy, were both positive for enterovirus RNA by RT-PCR. He was thought to have enterovirus encephalitis secondary to rituximab therapy, and was treated with IVIG and fluoxetine. Conclusions: One should consider chronic opportunistic CNS infections in children treated with immunosuppressive therapy, and to consider chronic enterovirus infection when B-cell suppression has occurred. As rituximab is being increasingly used in the pediatric population, and is generally thought to be safe, attention should be paid to any child with chronic neurological signs, particularly younger children who may be at higher risk for chronic enterovirus infection.
In 2015 and 2016, the Canadian Journal of Emergency Medicine (CJEM) Social Media (SoMe) Team collaborated with established medical websites to promote CJEM articles using podcasts and infographics while tracking dissemination and readership.
CJEM publications in the “Original Research” and “State of the Art” sections were selected by the SoMe Team for podcast and infographic promotion based on their perceived interest to emergency physicians. A control group was composed retrospectively of articles from the 2015 and 2016 issues with the highest Altmetric score that received standard Facebook and Twitter promotions. Studies on SoMe topics were excluded. Dissemination was quantified by January 1, 2017 Altmetric scores. Readership was measured by abstract and full-text views over a 3-month period. The number needed to view (NNV) was calculated by dividing abstract views by full-text views.
Twenty-nine of 88 articles that met inclusion were included in the podcast (6), infographic (11), and control (12) groups. Descriptive statistics (mean, 95% confidence interval) were calculated for podcast (Altmetric: 61, 42-80; Abstract: 1795, 1135-2455; Full-text: 431, 0-1031), infographic (Altmetric: 31.5, 19-43; Abstract: 590, 361-819; Full-text: 65, 33-98), and control (Altmetric: 12, 8-15; Abstract: 257, 159-354; Full-Text: 73, 38-109) articles. The NNV was 4.2 for podcast, 9.0 for infographic, and 3.5 for control articles.
Limitations included selection bias, the influence of SoMe promotion on the Altmetric scores, and a lack of generalizability to other journals.
Collaboration with established SoMe websites using podcasts and infographics was associated with increased Altmetric scores and abstract views but not full-text article views.
Given the concerns regarding the adverse health outcomes associated with weight gain and metabolic syndrome in relation to use of second-generation antipsychotics (SGAs), we aimed in this study to explore whether the increase in the use of SGAs would have any impacts on the trend of excess mortality in people with schizophrenia and bipolar disorder (BPD).
Two nationwide samples of individuals with schizophrenia and BPD were identified in Taiwan's National Health Insurance Research Database in 2003 and in 2008, respectively. Age- and gender-standardized mortality ratios (SMRs) were calculated for each of the 3-year observation periods. The SMRs were compared between the calendar year cohorts, by disease group, and by causes of death.
The mortality gap for people with schizophrenia decreased slightly, revealing an SMR of 3.40 (95% CI 3.30–3.50) for the 2003 cohort and 3.14 (3.06–3.23) for the 2008 cohort. The mortality gap for BPD individuals remained relatively stable with only those aged 15–44 years having an SMR rising significantly from 7.04 (6.38–7.76) to 9.10 (8.44–9.79). Additionally, in this group of BPD patients aged 15–44 years, the natural-cause-SMR increased from 5.65 (4.93–6.44) to 7.16 (6.46–7.91).
Compared with the general population, the gap in the excess mortality for people with schizophrenia reduced slightly. However, the over 200% difference between the cohorts in the excess mortality for BPD individuals aged 15–44 years could be a warning sign. Future research to further examine the related factors underlying those changes is warranted.
Objectives: The aim of this study was to describe cognitive, academic, and psychosocial outcomes after an incident demyelinating event (acquired demyelinating syndromes, ADS) in childhood and to investigate the contribution of brain lesions and confirmed MS diagnosis on outcome. Methods: Thirty-six patients with ADS (mean age=12.2 years, SD=2.7, range: 7–16 years) underwent brain MRI scans at presentation and at 6-months follow-up. T2-weighted lesions on MRI were assessed using a binary classification. At 6-months follow-up, patients underwent neuropsychological evaluation and were compared with 42 healthy controls. Results: Cognitive, academic, and behavioral outcomes did not differ between the patients with ADS and controls. Three of 36 patients (8.3%) were identified with cognitive impairment, as determined by performance falling ≤1.5 SD below normative values on more than four independent tests in the battery. Poor performance on a visuomotor integration task was most common, observed among 6/32 patients, but this did not differ significantly from controls. Twelve of 36 patients received a diagnosis of MS within 3 years post-ADS. Patients with MS did not differ from children with monophasic ADS in terms of cognitive performance at the 6-months follow-up. Fatigue symptoms were reported in 50% of patients, irrespective of MS diagnosis. Presence of brain lesions at onset and 6 months post-incident demyelinating event did not associate with cognitive outcome. Conclusions: Children with ADS experience a favorable short-term neurocognitive outcome, even those confirmed to have MS. Longitudinal evaluations of children with monophasic ADS and MS are required to determine the possibility of late-emerging sequelae and their time course. (JINS, 2016, 22, 1050–1060)
Background: Sarcoidosis is a multiorgan autoimmune disease characterized by the presence of non-caseating granulomas. The diagnosis can be difficult, particularly with central nervous system (CNS) involvement, and pathology outside of the CNS has to be carefully evaluated. Early and correct diagnosis is crucial for appropriate management particularly in children where sarcoidosis and neurosarcoidosis are rare. Methods: We describe a 16 year old previously healthy boy who presented with progressive pyramidal neurological signs and symptoms localizable primarily to the brain stem. Results: Initial imaging revealed striking brainstem, as well as cerebral, cerebellar and spinal cord perivascular enhancement. Lung involvement was subclinical with a miliary pattern on chest imaging and needle biopsy revealed an interstitial lymphocytic infiltration. Extensive serum and CSF rheumatological, autoimmune and infectious investigations were noncontributory. Serum ACE levels were at first within normal limits. Steroid treatment stabilized symptoms and perhaps coincidentally, separate rituximab treatments were followed within days by vertigo (with a new pontine lesion) or a respiratory decompensation. A wedge lung biopsy revealed granulomatosis. Current treatment consists of mycophenolate, methotrexate with a prednisone wean. Conclusions: This case report reinforces the varied manifestations and mimics of sarcoidosis (including CLIPPERS) and highlights the need for a high index of suspicion despite apparently negative investigations.
The South China Sea is one of the youngest marginal seas and understanding its development is important for reconstructing the tectonic evolution of Southeast Asia. The South China Sea is thought to have been actively spreading between 32 Ma and 15.5 Ma. The East Taiwan Ophiolite (ETO) is one of the few preserved remnants of the South China Sea on land and provides an opportunity to investigate the age and the tectonic setting of the accreted easternmost portion. The age of the ETO was obtained by LA-ICP-MS in situ zircon U–Pb methods and yielded a mean 206Pb–238U age of 14.1±0.4 Ma, suggesting that magmatic activity in the South China Sea continued ~1.5 million years beyond current estimates. Cr-spinel data (Cr no. = 42–54) and depleted εNd(t) values (i.e. +9.1 to +11.4) from the serpentinized peridotites and gabbros and the light rare earth element depleted patterns (La/Yb ≤ 1) of the ETO mafic rocks are consistent with a ridge setting (i.e. N-MORB composition). Therefore, the ETO likely represents the terminal portion of the South China Sea spreading ridge that was sheared off during the northward translation of the Luzon arc.
Background: Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Methods: Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. Results: The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. Conclusions: There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.
Microlenses are used in many applications including optical coupling, light shaping, spatial light illumination modulation, and imaging (biomedical or monitoring). The basic function of a lens is to either diverge or converge the incident light beams. Solid lenses are the most widely used and have a fixed and nontunable focal length. In a solid lens module, voice coil motors (VCMs) are used to provide a back-and-forth track movement along the optical axis to achieve the required focal length change. However, the bulkiness and high power consumption of the lens module make it unsuitable for designing portable and energy saving products. The focal length of liquid lenses can be tuned by changing either the refractive index or the liquid lens geometry. As liquid lenses do not need any mechanical tracking devices such as VCMs for focal length tuning, the lenses provide the optimal solution for developing miniaturized lens modules with low power consumption in the mW range.
In the past two decades, liquid lenses have been widely investigated benefitting from the development of microfluidics (Berge & Peseux 2000, Chang et al. 2012, Chen et al. 2004). In microfluidics, the control or guidance of liquid/analyst droplets is very significant; especially for lab-on-a-chip (LOC) or micro-total analysis systems (μTAS). LOCs are devices that integrate one or several laboratory functions on a small chip of only few square millimeters to a few square centimeters in size, where the manipulation and the guidance of the tiny amounts of liquids or droplets becomes more and more significant. Certain liquid control mechanisms, such as external pressure pumping, electrowetting, and dielectrophoresis, have been developed and widely used for liquid manipulation (Agarwal et al. 2004, Berge & Peseux 2000, Cheng & Yeh 2007). The technique developed for the manipulation of liquids in microfluidics can be used to change the surface profile and the refractive indices of liquid lenses.
A liquid lens refracts the incident light beams based on the presence of the gradient index in liquids or the change in surface profiles formed from the solid (membrane)–liquid, liquid–liquid, and gas–liquid interfaces. The working liquids in the lens chamber must be transparent in the visible range and should be stable for a wide temperature range. To achieve these goals, liquid crystals, water, mixed alcohols, or silicone oil have been used and investigated.
In long-term care facilities (LTCFs), the elderly are apt to be infected because those with latent tuberculosis infections (LTBIs) are at an increased risk for reactivation and post-primary TB disease. We report an outbreak of TB in staff and residents in a LTCF. An outbreak investigation was conducted after two TB cases were reported from the LTCF. A tuberculin skin test (TST), bacteriological examination and chest radiograph were administered to all facility staff and residents. An outbreak is defined as at least two epidemiologically linked cases that have identical Mycobacterium tuberculosis genotype isolates. This outbreak infected eight residents and one staff member, who were confirmed to have TB in a LTCF between September 2011 and October 2012. Based on the Becker method, the latent and infectious periods were estimated at 223·6 and 55·9 days. Two initial TST-negative resident contacts were diagnosed as TB cases through comprehensive TB screening. Observing elderly people who have a negative TST after TB screening appears to be necessary, given the long latent period for controlling a TB outbreak in a LTCF. It is important to consider providing LTBI treatment for elderly contacts.
The increasing prevalence of obesity in children and adolescents has become one of the most important public health issues around the world. Lack of physical activity is a risk factor for obesity, while being obese could reduce the likelihood of participating in physical activity. Failing to account for the endogeneity between obesity and physical activity would result in biased estimation. This study investigates the relationship between overweight and physical activity by taking endogeneity into consideration. It develops an endogenous bivariate probit model estimated by the maximum likelihood method. The data included 4008 boys and 4197 girls in the 5th–9th grades in Taiwan in 2007–2008. The relationship between overweight and physical activity is significantly negative in the endogenous model, but insignificant in the comparative exogenous model. This endogenous relationship presents a vicious circle in which lower levels of physical activity lead to overweight, while those who are already overweight engage in less physical activity. The results not only reveal the importance of endogenous treatment, but also demonstrate the robust negative relationship between these two factors. An emphasis should be put on overweight and obese children and adolescents in order to break the vicious circle. Promotion of physical activity by appropriate counselling programmes and peer support could be effective in reducing the prevalence of obesity in children and adolescents.
This paper presents the optimal design of an electromagnetic vibration-based generator using the simulated annealing method (SA). To optimally extract the vibrational energy of a system vibrating at a specific frequency, the selected mass and spring stiffness of a resonant vibration is required. The relationship between induced energy and the generator's structure, its permanent magnet height and diameter, number of turns, and wire diameter in a single air coil are discussed. Also, a prototype of the vibrationbased electrical generator is built and tested via a shaker excited at resonance frequency and input amplitude of 0.06mm. Consequently, results reveal that the design parameters (permanent magnet height and diameter, number of turns, and wire diameter) play essential roles in maximizing electrical power.
The present study investigated dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS). A total of forty-five women (aged 25–40 years) with PCOS and 161 control women (aged 25–43 years) with non-PCOS-related infertility were recruited. Anthropometry, glucose tolerance and sex hormones were determined and dietary intake was assessed. Women with PCOS had lower serum sex hormone-binding globulin and increased BMI, waist:hip ratio, luteinising hormone, ratio of luteinising hormone:follicle-stimulating hormone, testosterone and free androgen index (FAI). Postprandial glucose, fasting insulin and insulin resistance were elevated in women with PCOS. Women with PCOS had reduced energy and carbohydrate intake but higher fat intake. Serum sex hormone-binding globulin level was negatively associated with BMI in both groups and negatively correlated with macronutrient intake in the PCOS group with hyperandrogenism. However, FAI was positively correlated with BMI, waist circumference and glucose metabolic parameters in both groups. Therefore, women with PCOS consume lower energy and carbohydrate compared with those with non-PCOS-related infertility and macronutrient intake is only negatively associated with serum sex hormone-binding globulin level in the PCOS group with hyperandrogenism.
Generic and interaction aspects of oxygen precipitation, related defect formation and denudation in Cz-Si wafers are presented. Bulk defect profiles and homogenization control are shown to be achievable by proper design of post-growth annealing.
Gettering-related phenomena are discussed including stacking fault-rich bulk defect structures and peculiarities in different epitaxy systems.
This paper proposes a complete basis set for analyzing elastic wave scattering in half-space. The half-space is an isotropic, linear, and homogeneous medium except for a finite inhomogeneity. The wave bases are obtained by combining buried source functions and their reflected counter-waves generated from the infinite-plane boundary. The source functions are the vector wave functions of infinite-space. Based on the source functions expressed in the Fourier expansion form, the reflected counter-waves are easily obtained by solving the infinite-plane boundary conditions. Few representations adopt Wely's integration, but the Fourier expansion is developed from it and applied to decouple the angular-differential terms of the vector wave functions. In addition to the scattering of the finite inhomogeneity, the transition matrix method is extended to express the surface boundary conditions. For the numerical application in this paper, the P- and the SV- waves are assumed as the incoming fields. As an example, this paper computes stress concentrations around a cavity. The steepest-descent path method yielding the optimum integral paths is used to ensure the numerical convergence of the wave bases in the Fourier expansion. The resultant patterns from these approaches are compared with those obtained from numerical simulations.
Bandgap engineered ZnSxO1-x films were grown on Fluorinated Ethylene Propylene (FEP) substrates and analyzed using transmission spectroscopy. FEP is considered as a potential substrate for application in flexible electronics and semiconductor films.
Shigella flexneri 4a caused sustained outbreaks in a large long-stay psychiatric centre, Taiwan, 2001–2006. Trimethoprim-sulphamethoxazole (SXT) prophylaxis was administered in 2004. We recovered 108 S. flexneri 4a isolates from 83 symptomatic (including one caregiver) and 12 asymptomatic subjects (11 contacts, one caregiver). The isolates were classified into eight antibiogram types and 15 genotypes (six clusters) by using antimicrobial susceptibility testing and pulsed-field gel electrophoresis of NotI-digested DNA, respectively. These characteristics altered significantly after SXT prophylaxis (P < 0·05), with concomitant emergence of SXT-resistant isolates in two antibiogram types. P01 (n = 71), the predominant epidemic genotype, caused infection in two caregivers and five patients under their care; two P01 isolates were recovered from the same patient 6 months apart. These results indicate the importance of sustained person-to-person transmission of S. flexneri 4a by long-term convalescent, asymptomatic or caregiver carriers, and support the emergence of SXT-resistant strains following selective pressure by SXT prophylaxis.