Wellcome Open Research最新文献

Hysterectomy, removal of the uterus, is a commonly performed surgery for gynaecological morbidities. Emerging evidence indicates that hysterectomy performed before age 45 (early hysterectomy), is associated with considerable risks to women's health. While most evidence on hysterectomy is from high-income settings, national surveys from India report high prevalence of early hysterectomy in specific regions, as well as higher prevalence amongst women in rural areas and with less education. The median age at hysterectomy in India is close to ten years before the onset of natural menopause. India has recently introduced national guidelines to address early hysterectomy, but large evidence gaps on the causes and consequences remain - which in turn limits the potential effectiveness of interventions at the clinical, health system and community level.

Methods: SAHELI is a Team Science study that will examine: (i) individual, social and health system determinants of early hysterectomy; (ii) women's treatment pathways to hysterectomy and for gynaecological morbidity in general; and (iii) the consequences of undergoing hysterectomy on women's physical, mental, economic and social well-being across the life course. This mixed-methods study includes population surveys amongst women in ages 25-49 in three high-prevalence states; qualitative health systems research to trace treatment journeys with women, health care providers and other stakeholders; evidence syntheses; and knowledge translation activities to ensure findings inform co-produced strategies and interventions. The study is grounded in a feminist epidemiology approach, aiming to examine individual and structural causes of vulnerability and prioritising the views of women, particularly in knowledge translation.

Conclusions: SAHELI, implemented by an all-women, multi-disciplinary team, is the first study in India to examine the causes and consequences of hysterectomy in a life course approach. We aim to influence interventions, policy and future research on women's health, particularly access to quality gynaecological care and comprehensive health services through the life course.

Background: The paucity of state-supported rehabilitation for chronically ill patients with long-term tracheostomies has ramifications of prolonged hospital-stay, increased burden on acute-care resources, and nosocomial infections. Few interventions describe home rehabilitation of adult tracheostomized patients. Almost none involve stakeholders. This paper describes the All-India Institute of Medical Sciences (AIIMS) ICU rehabilitation (AIR) healthcare intervention developed to facilitate home rehabilitation of chronically ill tracheostomized patients.

Methods: The AIR intervention development was based on the experience-based codesign theory (EBCD). A core research-committee studied prevalent knowledge and gaps in the area. Patients-carer and health-care stakeholders' experiences of barriers and facilitators to home care resulted in an intervention with interlinked components: family-carer training, equipment bank, m-health application, and follow-up, guided by the Medical Research Council (MRC) framework. Healthcare stakeholders (doctors, nurses, medical equipment vendors) and patient-carer dyads were engaged to gather experiences at various stages to form smaller codesign teams for each component. Multiple codesign meetings iteratively allowed refinement of the intervention over one year. The Template for Intervention Description and Replication (TIDieR) checklist was used to report the AIR intervention.

Results: The first component comprised a minimum of three bedside hands-on training sessions for carers relating to tracheostomy suction, catheter care, monitoring oxygenation, enteral feeding, skincare, and physiotherapy, buttressed by pictorial-books and videos embedded in a mobile-application. The second was an equipment-bank involving a rental-retrieval model. The third component was a novel m-health tool for two-way communication with the core group and community of other patient-carers in the project for follow-up and troubleshooting. Home visits on days 7 and 21 post-discharge assessed patient hygiene, nutrition, physiotherapy, and established contact with the nearest primary healthcare facility for the future.

Conclusions: Findings support the EBCD-based development using active feedback from stakeholders. Assessment of feasibility, process and effectiveness evaluation will follow.

Background: Collecting and storing large number of sputum samples with a view to culturing these in the future requires an efficient initial handling method. We devised a modified sputum digestion and decontamination method that maximised storage capacity and Mycobacterium tuberculosis (M.tb) recovery from culture while minimising laboratory workload and risk of contamination.

Methods: We collected smear microscopy positive sputum samples from patients with pulmonary tuberculosis (TB). The sputum samples were split and processed using both the standard N-Acetyl-L-cysteine and sodium hydroxide (NALC-NaOH) method and our modified method before freezing and later culturing in BD BACTEC 960 Mycobacterium Growth Indicator Tubes (MGIT) system. We assessed the Time to Positivity (TPP) and Growth Unit (GU) data.

Results: We selected 22 sputum samples to compare two digestion and decontamination methods. The samples that underwent the modified method had longer TTP (p < 0.05) but similar GU in comparison to standard method. Overall, 1/22 samples failed to grow in MGIT after being processed by the modified method. We then applied the modified method to 348 sputum samples with Rifampicin resistance detected by GeneXpert MTB/RIF assay, which were frozen for between 1-25 months. The overall MGIT positive, negative, and contamination rate was 90.5%, 7.8%, and 1.7%, respectively. There was no significant difference in MGIT result when samples were grouped by duration of storage or positive smear grade.

Conclusions: Our modified method yielded acceptable M.tb recovery rate and low contamination risk while allowing us to collect and store thousands of sputum samples over a long period of time for future tests.

We present a genome assembly from an individual male Aporia crataegi (the black-veined white; Arthropoda; Insecta; Lepidoptera; Pieridae). The genome sequence is 230 megabases in span. The complete assembly is scaffolded into 26 chromosomal pseudomolecules, with the Z sex chromosome assembled. Gene annotation of this assembly on Ensembl has identified 10,860 protein coding genes.

We present a genome assembly from an individual male Achlya flavicornis (the Yellow Horned; Arthropoda; Insecta; Lepidoptera; Drepanidae). The genome sequence is 444.6 megabases in span. Most of the assembly is scaffolded into 30 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 15.34 kilobases in length. Gene annotation of this assembly on Ensembl identified 17,588 protein coding genes.

We present a genome assembly from a female specimen of Actenicerus siaelandicus (Marsh Click Beetle; Arthropoda; Insecta; Coleoptera; Elateridae). The genome sequence has a total length of 854.91 megabases. Most of the assembly (95.23%) is scaffolded into 10 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 17.17 kilobases in length.

We present a genome assembly from a specimen of Blennius ocellaris (the butterfly blenny; Chordata; Actinopteri; Blenniiformes; Blenniidae). The genome sequence spans 728.70 megabases. Most of the assembly is scaffolded into 24 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 16.5 kilobases in length.

Health research is needed to develop new treatments, diagnostic methods and prevention strategies for many diseases, but resources are limited particularly in low-and middle-income countries (LMICs). Our proposed project involves in-depth engagement with community advisory boards and existing community groups in healthcare research priority setting in Thailand. We will use Wellcome's "Responsive Dialogues" engagement approach, focusing on "under-served" groups, as their voices are seldom heard in healthcare research priority setting. We estimate that we will engage with 6-8 community groups involving 48-80 participants. Our objectives are firstly, to contribute to the health research agenda setting in Thailand for government, non-governmental actors, academia, and others who conduct health research in the next 5 to 10 years. Secondly, we aim to identify ethical and practical issues related to healthcare research priority setting, specifically in relation to involving under-served communities.

We present a genome assembly from a specimen of Alucita hexadactyla (Twenty-plume Moth; Arthropoda; Insecta; Lepidoptera; Alucitidae). The genome sequence has a total length of 878.53 megabases. Most of the assembly (99.74%) is scaffolded into 30 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 15.32 kilobases in length.

We present a genome assembly from an individual female specimen of Eudasyphora cyanicolor (Arthropoda; Insecta; Diptera; Muscidae). The genome sequence has a total length of 1,450.40 megabases. Most of the assembly (99.68%) is scaffolded into 5 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 19.34 kilobases in length.