bluuebunny/crossref_metadata_2025 huggingface dataset:
Flexible carbon nanofiber yarn electrodes for self-standing fiber supercapacitors
Authors: Altin Yasin , Celik Bedeloglu Ayse
Published: April 2022

In this study, polyacrylonitrile (PAN) nanofiber yarns were obtained by twisting the nanofiber mat strips produced in the electrospinning device. On the drum collector, the nanofibers are produced in such a way that the diameter change can be controlled. Through stabilization and carbonization processes, PAN nanofiber yarns were converted to carbon nanofiber (CNF) yarns. The stabilization process stabilized the yarn structure, which was previously unstable, due to thermal treatments. The obtained CNF yarn had a diameter of approximately 360 μm and an average nanofiber diameter of 123 ± 20 nm. On a three-electrode system, the electrochemical performance of CNF yarn in 1 m H2SO4 electrolyte was determined using cyclic voltammetry and galvanostatic charge/discharge test methods. The specific capacitance of the CNF yarn electrode was determined to be 145 F/g at a current density of 0.2 A/g. Up to 500 charge/discharge cycles, the specific capacitance increased by approximately 20% and remained constant thereafter. Due to their superior properties such as high surface area, lightweight, and flexibility, CNF yarn electrodes can be used in a wide variety of electronic applications, including energy harvesting, energy storage (supercapacitors, batteries, etc.), and sensors.
Bilingualism as a Contributor to Cognitive Reserve: What it Can do and What it Cannot do
Authors: Berkes Matthias , Bialystok Ellen
Published: April 2022

In the absence of effective pharmacological interventions for the prevention of dementia, attention has turned to lifestyle factors that contribute to cognitive reserve. Although cognitive reserve cannot prevent the occurrence of disease, the trajectory is different for high reserve and low reserve patients, giving more time for independent living to high reserve individuals. We argue that lifelong bilingual experience meets the criteria for an experience that confers cognitive reserve, although neural reserve, a related concept, is more difficult to validate. Bilingual patients show symptoms at a later stage of disease and decline more rapidly than comparable monolingual patients. These patterns are considered in terms of evidence from behavioural, imaging and epidemiological studies. Finally, the role of bilingualism in protecting against symptoms of some forms of dementia are discussed in the context of other protective factors and the limits of this reserve approach in dealing with the consequences of dementia.
The Establishment of the Swinney Conservatory of Music at Central Methodist University
Authors: Samson David W.
Published: April 2022

The Swinney Conservatory of Music at Central Methodist University in Fayette, Missouri has a long history with unique beginnings. After the Civil War, Central College (Central Methodist’s original name) grew alongside a “Female Seminary,” Howard-Payne Female College. Through the late 19th and early 20th centuries, the two schools developed their own distinct musical cultures with Howard-Payne faculty developing a music curriculum, and Central students forming their own musical ensembles. When the schools merged in 1923 these two cultures united to create a conservatory of music at a time when many other American conservatories were being established. Just before the merger, Kansas City banker Edward Fletcher Swinney, who had strong family ties to the Fayette area and a history of philanthropy towards causes in Missouri education, donated $35,000 to Howard-Payne College for the construction of the conservatory building that would eventually bear his name. This article focuses on the early history of both Central College and Howard-Payne Female College, the role that music played at both schools (as a curricular and non-curricular activity) and the events leading to the formation of Central College’s music curriculum and construction of the Swinney Conservatory.
Evaluation of Remodeling of Visceral Arteries and Impact on Renal Function Post-endovascular Repair of Type B Aortic Dissection Vis-A-Vis Baseline Visceral Artery Morphology
Authors: Deshpande Amit Ajit , Pandey Niraj Nirmal , Shaw Manish , Kumar Sanjeev , Jagia Priya , Choudhary Shiv
Published: April 2022

Purpose

To evaluate the remodeling of visceral arteries post-endovascular repair (TEVAR) of type B aortic dissection and to investigate interval change in renal volume and estimated glomerular filtration rate (eGFR) vis-a-vis baseline visceral artery morphology.

Materials and Methods

All patients of type B aortic dissection who underwent TEVAR with a baseline and follow-up CT during the study period were included. Baseline morphology of visceral arteries (celiac, superior, and inferior mesenteric artery and bilateral renal artery) were classified into 7 patterns depending upon the origin of the artery (from true/false lumen) and the extension of dissection flap, while occluded vessels were categorized as pattern 8.

Results

One hundred and thirty-two branches were analyzed in 25 patients (23 males; mean age: 50.1 years) with a mean follow-up of 386 days. 51 visceral branches were arising from the true lumen without any stenosis. Of the remaining 81 branches, 48 showed favorable remodeling ( P = .0001). The highest incidence of favorable remodeling was observed in arteries arising from the true lumen (pattern 2,3: 44/48; 91.6%) whereas only one thrombosed and artery arising from the false lumen each (pattern 5 and 8) showed favorable remodeling. Kidneys perfused by false lumen or occluded renal artery suffered statistically significant volume loss compared to kidneys perfused by true or both lumens (−16.5% vs .2%; P = .01); however, the change in eGFR failed to reach statistical significance.

Conclusion

Visceral arteries arising from the true lumen are more likely to undergo favorable remodeling. The kidneys supplied by false lumen or by occluded renal artery suffer significantly more volume loss after TEVAR.
An individualised psychosocial intervention program for persons with MND/ALS and their families in low resource settings
Authors: Thomas Priya Treesa , Warrier Manjusha G , Arun S , Bhuvaneshwari B , Vengalil Seena , Nashi Saraswati , Preethish-Kumar Veeramani , Polavarapu Kiran , Rajaram Prakashi , Nalini Atchayaram
Published: April 2022

Motor Neuron Disease (MND) leads to significant psychosocial distress for the person with the illness and caregivers. Psychosocial factors influence the management and quality of life to a significant degree.

Objective

To develop individualised psychosocial intervention program for people with MND and their families in India.

Methods

People with MND and healthcare staff were constructively involved in co-designing the intervention program in four phases adapted from the MRC framework: 1. A detailed need assessment phase where 30 participants shared their perceptions of psychosocial needs 2. Developing the intervention module (synthesis of narrative review, identified needs); 3. Feasibility testing of the intervention program among seven participants; 4. Feedback from participants on the feasibility (acceptance, practicality adaptation). The study adopted an exploratory research design.

Results

Intervention program of nine sessions, addressing psychosocial challenges through the different stages of progression of the illness and ways to handle the challenges, specific to the low resource settings, was developed and was found to be feasible. People with MND and families who participated in the feasibility study shared the perceived benefit through feedback interviews.

Conclusion

MND has changing needs and challenges. Intervention programme was found to be feasible to be implemented among larger group to establish efficacy.
Cembranoids From the Leaves of Nicotiana tabacum and Their Neuroprotective Activities
Authors: Yang Peng-fei , Chen Mei-yu , Yu Jian-chun , Yang Jing , Wang Qiong-bo , Mao Duo-bin
Published: April 2022

A new cembrane-type diterpenoid (1) and 9 known cembranoids (2-10) were isolated from the leaves of Nicotiana tabacum. The structure of the new metabolite was confirmed by extensive analyses of their spectroscopic data, including high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), 1D- and 2D nuclear magnetic resonance (NMR) spectroscopy, and infrared spectroscopy (IR). All of the isolated compounds were tested for their protective effects against oxygen-glucose deprivation (OGD)-induced neurotoxicity in SH-SY5Y cells. The new compound 1 exhibited a moderate protective effect against OGD-induced neurotoxicity at 10 μM.
Regulating the oxides of nitrogen – popping the myths
Authors: Ferreira Plinio M , Nutt David
Published: April 2022

In 2015 and 2016, during the debates that culminated in The Psychoactive Substances Act 2016, both houses of the UK parliament debated the pharmacology of nitric oxide and amyl nitrites, otherwise known as “poppers”. The original draft Psychoactive Substances Bill had recommended that poppers should be made illegal. However, after strong opposition inside the Conservative party, the ruling party at the time, the government found a way to not ban them by claiming they were not psychoactive. Nitrous oxide, another recreational gas, was also a possible target of the Psychoactive Substances Bill but this was never explicitly mentioned in the debates. Once the Psychoactive Substances Act came into force the Crown Prosecution Service stated that nitrous oxide was psychoactive and so illegal to sell for psychoactive purposes. Many sellers of nitrous oxide canisters were arrested and some sent to prison. A series of Crown court prosecutions for nitrous oxide possession followed in which the Crown claim that nitrous oxide was psychoactive was challenged. In some of these the defendant was acquitted so making its current legal status uncertain . Here we delve into the pharmacology of nitric oxide and nitrous oxide and how the effects of these two gasses are related. A clear understanding of the pharmacology of these gasses is essential for the scientific underpinning of legislation which will directly impact on the life of recreational users and people involved in the selling of these substances.
Individual benefits and collective challenges: Experts’ views on data-driven approaches in medical research and healthcare in the German context
Authors: Buhr Lorina , Schicktanz Silke
Published: April 2022

Healthcare provision, like many other sectors of society, is undergoing major changes due to the increased use of data-driven methods and technologies. This increased reliance on big data in medicine can lead to shifts in the norms that guide healthcare providers and patients. Continuous critical normative reflection is called for to track such potential changes. This article presents the results of an interview-based study with 20 German and Swiss experts from the fields of medicine, life science research, informatics and humanities of digitalisation. The aim of the study was to explore expert opinions regarding current challenges and opportunities related to data-driven medicine and medical research and to provide a methodological framework for empirically grounded, continuous normative reflection. To this end, we developed a heuristic tool to map and structure empirical findings for normative analysis. Using this tool, our interview material points to a polarisation between individualistic and collectivistic orientated argumentations among experts. The study shows that a multilevel analysis is required to deal with complex normative implications of data-driven approaches in medical research and healthcare.
COVID-19 Infection in Patients with Humoral Immunodeficiency: A Case Series and Literature Review
Authors: Jalil Maaz , Pietras Julianne , Ahmed Syed N. , Daniels Phuong , Hostoffer Robert
Published: April 2022

Background

The coronavirus 2019 disease (COVID-19) has infected many individuals worldwide and continues to pose a significant threat to those with weakened immune systems. The data evaluating the clinical outcomes of patients with humoral immunodeficiencies that contract COVID-19 is limited and conflicting.

Objective

To describe the clinical outcomes of COVID-19 infections in patients with primary humoral immunodeficiency and compare results to current literature.

Methods

We conducted a retrospective cohort review on 15 patients with a humoral immunodeficiency defined as Common Variable Immunodeficiency, Specific Antibody Deficiency, or unspecified hypogammaglobulinemia, who contracted COVID-19. Severity scores were determined to evaluate the clinical outcomes of these patients.

Results

Of our 15-patient cohort, 33% of individuals with a humoral immunodeficiency infected with COVID-19 had moderate to severe disease, requiring hospitalization or resulting in death. COVID-19 mortality rate was found to be 7%. All 5 of our patients with severe COVID-19 infection had at least 1 comorbidity or risk factor.

Conclusion

Within our cohort of humoral immunodeficient patients infected with COVID-19, we found a higher rate of moderate to severe COVID-19 infection and worse clinical outcomes, particularly in patients with comorbidities or risk factors.
Driving, Fast and Slow: An Experimental Investigation of Speed Choice and Information
Authors: Goldbach Carina , Kayar Deniz , Pitz Thomas , Sickmann Jörn
Published: April 2022

This study aimed to investigate the role of information and individual determinants on speed choice in a controlled laboratory setting in order to improve the general understanding of individual speeding behavior. A novel and interactive speed choice experiment was designed where participants repeatedly had to choose between fast or slow driving. Results showed that additional information had an effect on speeding choice if it contains quantitative instead of qualitative information. However, the provided quantitative information led to increased speeding behavior and a higher number of accidents—potentially because it reduces uncertainty about accident risk. This—at the first sight unexpected—finding may be partially explained by different effects of uncertainty and risk. Results further indicate that an increase in the underlying crash risk actually reduces accidents by decreasing the attractiveness of speeding. Across all treatments it was found that individual characteristics help explain differences in speeding behavior significantly.
Citations and the Nature of Cited Sources: A Cross-Disciplinary and Cross-Linguistic Study
Authors: Wang Guihua , Hu Guangwei
Published: April 2022

Extant scholarship on citation has examined a limited number of citational features, adopted disciplinary and ethnolinguistic perspectives disjunctively, and paid little systematic attention to the nature of cited sources. Drawing on appraisal theory, the present study investigated the nature of cited sources, namely personalization (i.e., whether humans are foregrounded as a cited source) and identification (i.e., whether and how the cited sources are identified), to understand their dialogic functionality in knowledge making. We analyzed citations in a corpus of 84 research articles sampled from two disciplines and two languages. Greater citation-based dialogic contraction was found in the medical articles than in the applied linguistic articles, whereas the cross-linguistic contrasts revealed a mixed picture. The differences are explained in terms of divergent epistemologies, cultural beliefs, discursive practices, institutional settings, and co-patterning of different citation features.
Beyond Reporting Verbs: Exploring Chinese EFL Learners’ Deployment of Projection in Summary Writing
Authors: Chen Shukun , Xuan Winfred Wenhui , Yu Wei
Published: April 2022

Adopting the framework of projection from Systemic Functional Linguistics, the present study explored the deployment of projection in summary writing by three levels of college EFL learners from a university in mainland China. Data were collected from one summary writing by three classes of different levels’ learners in an English program from a university in the southern part of mainland China. Quantitative analysis showed that projections increased dramatically from Year 1 to Year 2 and dropped slightly from Year 2 to Year 3. Qualitative analysis revealed that the use of projecting verbs showed huge differences among the three levels of learners. Year 1 students used only a very limited range of projecting verbs. Year 2 learners used a more comprehensive range of such verbs but tended to use them repetitively and inappropriately. In contrast, year 3 students used a much more comprehensive range of projecting verbs in their summary writing and construed projection at different levels. It is recommended that more attention should be paid to the teaching of projection at phrase and text levels in EAP.
Messaging and Action around Race and Inclusion at a Predominantly White Institution: Perceived Dissonance of Black, Indigenous, and People of Color Students
Authors: Velez Gabriel , Jessup-Anger Jody
Published: April 2022

As college has increasingly become part of emerging adulthood for United States youth, Predominantly White and Historically White Institutions (PWI/HWIs) have faced pressures to diversify and address problematic racial/ethnic campus climates. Within the rich and evolving literature, there is room for better understanding how Black, Indigenous, and People of Color (BIPOC) emerging adults experience institutional messaging. This report draws on environmental press and meaning making to explore this experience for 21 BIPOC students at an urban, Midwestern PWI/HWI. In focus groups, students highlighted the role of the university’s messaging around race/ethnicity and inclusion as problematic: negative descriptions about the urban context surrounding the university held implicit messages about BIPOC students on campus, while positive messaging about inclusion and diversity efforts was dissonant with the lack of perceived action. The findings speak to the importance of emerging adults’ perception and interpretation of messaging and institutional action to promote diversity.
Two Cases of Pelvic Diffuse Large B-Cell Lymphoma
Authors: Sharma Rupam , Heidari Arash , Cobos Everardo , Petersen Greti , Ramzan Amin A. , Polineni Rahul D.
Published: April 2022

Primary diffuse large B-cell lymphoma presenting as an extranodal site in the pelvis is rare and can mimic a gynecological malignancy. Although management for diffuse large B-cell lymphoma is standardized and curative, prognosis depends on timely diagnosis and therapy. Diagnosis can be challenging as patients lack classical symptoms of fever, night sweats, weight loss, and lymphadenopathy associated with lymphoma. A multidisciplinary approach is recommended to diagnose and treat judiciously. In this article, we present cases of 2 females who presented with pelvic masses with initial suspicion of a gynecological malignancy but were ultimately diagnosed as diffuse large B-cell lymphoma of the pelvis and managed accordingly.
Evaluating the Chase Utley Rule: The Association Between a Rule Change and Collision-Related Injuries in Major League Baseball
Authors: Tanenbaum Joseph E. , Knapik Derrick M. , Karns Michael R. , Salata Michael J. , Gillespie Robert J. , Voos James E.
Published: April 2022

Background:

Major League Baseball (MLB) adopted a rule change in 2016 to reduce the number of collisions that occur when a player slides into a base. The effect of rule 6.01(j) has not been quantified, and it remains unknown if this rule change has led to improved player safety.

Hypothesis:

Rule 6.01(j) would be associated with a reduction in the number of collision-related injuries at second base.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Using data from the MLB Health and Injury Tracking System, we quantified the number of collision-related injuries for defensive (ie, fielding) players in the infield at the major and minor league levels between the 2010 and 2019 seasons. We compared the median number of collision-related injuries for defensive players in the infield from before (2010-2015) to after (2016-2019) the implementation of rule 6.01(j) and also calculated the difference in location of the median from the seasons before versus after the rule change. An additional 3 analyses were performed to support or contradict a conclusion that any observed reduction in injuries at the start of the 2016 season was likely caused by the adoption of rule 6.01(j).

Results:

The median number of collision-related injuries for defensive players at second base decreased from 58.5 to 37.5 injuries per season after the rule change, which was a 36% decrease (difference in location, 19.5 [95% CI, 5.0 to 31.0]; P = .019). In contrast, the median number of collision-related injuries at first base decreased by only 14.1%, from 49.5 before to 42.5 after the rule change (difference in location, –9.0 [95% CI, –4.0 to 18.0]; P = .16), and the median number of collision-related injuries per season at third base was unchanged at 15 per season.

Conclusion:

This rule change was associated with a decrease in the number of collision-related injuries, with the largest effect observed at second base, as expected.
Acute Lower Respiratory Infection Profile in Children at Tertiary Hospital Bandung: Is There a Difference Before and During COVID-19 Pandemic?
Authors: Majeda Allisa , Nataprawira Heda Melinda , Idjradinata Ponpon
Published: April 2022

This study aims to analyze differences of the prevalence and characteristics of acute lower respiratory infection (ALRI) in children at tertiary hospital before and during COVID-19 pandemic. This was an observational analytic study with cross-sectional design involving pediatric patients based on the time of the study which was in 1 year-prepandemic (A) and 1 year-pandemic period (B). For period A inpatient data were retrieved from medical records and period B used pediatric ALRI registry. The ALRI characteristics were analyzed with significance if P < .05. Prevalence in periods A and B were 5.8% (534/9252) and 4.9% (409/8283), respectively. The characteristics of ALRI for clinical, comorbidities, laboratory findings (NLR, TLC), and chest radiograph showed significant differences ( P < .05). ALRI as manifestation of confirmed COVID-19 were identified in 16 (4.9%) cases. Prevalence of ALRI in children during COVID-19 pandemic is lower compared to before. There are differences in the characteristics of ALRI in pediatrics.
Revision Shoulder Hemiarthroplasty and Total Shoulder Arthroplasty A Systematic Review and Meta-Analysis
Authors: Davies Andrew , Selmi Hussain , Sabharwal Sanjeeve , Vella-Baldacchino Martinique , Liddle Alex D. , Reilly Peter
Published: April 2022

The number of shoulder replacements performed each year continues to increase, and the need for revision replacements has grown accordingly. The outcome of a revision replacement may influence which primary implant is selected and the timing of primary surgery, particularly in younger patients. The aim of this study was to establish the expected improvement in shoulder function and implant survival following revision of a hemiarthroplasty and revision of an anatomical total shoulder arthroplasty (TSA). A systematic review and meta-analysis were performed of all studies reporting shoulder scores or implant survival following revision hemiarthroplasty or revision TSA. MEDLINE, EMBASE, CENTRAL, The Cochrane Database of Systematic Reviews and National Joint Registry reports were searched. 15 studies were included, reporting on 593 revision anatomical shoulder replacements. There was large variation in the magnitude of improvement in shoulder scores following revision surgery. Over 80% of revision replacements last 5 years and over 70% last 10 years. There was no significant difference in shoulder scores or implant survival according to the type of primary implant. The belief that revision of a shoulder hemiarthroplasty may lead to improved outcomes compared to revision of a TSA is not supported by the current literature.
Role of stem cell transplant in CD30+ PTCL following frontline brentuximab vedotin plus CHP or CHOP in ECHELON-2
Authors: Savage Kerry J. , Horwitz Steven M. , Advani Ranjana , Christensen Jacob Haaber , Domingo-Domenech Eva , Rossi Giuseppe , Morschhauser Franck , Alpdogan Onder , Suh Cheolwon , Tobinai Kensei , Shustov Andrei , Trneny Marek , Yuen Sam , Zinzani Pier Luigi , Trümper Lorenz , Ilidge Tim , O’Connor Owen A. , Pro Barbara , Miao Harry , Bunn Veronica , Fenton Keenan , Fanale Michelle , Puhlmann Markus , Iyer Swaminathan
Published: April 2022

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive non-Hodgkin lymphomas, the majority of which have high relapse rates following standard therapy. Despite use of consolidative stem cell transplant (SCT) following frontline therapy, there remains no consensus on its utility. The double-blind randomized phase 3 ECHELON-2 study (#NCT01777152; clinicaltrials.gov) demonstrated improved progression-free survival (PFS) and overall survival with frontline brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP). Herein, we conducted an exploratory subgroups analysis of the impact of consolidative SCT on PFS in patients with previously untreated CD30+ PTCL (ALK− anaplastic large cell lymphoma [ALCL] and non-ALCL) who were in complete response (CR) after frontline treatment with A+CHP or cyclophosphamide, doxorubicin, vincristine, and prednisone. Median PFS follow-up was 47.57 months. The PFS hazard ratio was 0.36, equating to a 64% reduction in the risk of a PFS event in patients who underwent SCT. The median PFS in patients who underwent SCT was not reached, vs 55.66 months in patients who did not undergo SCT. PFS results favored the use of SCT in both ALK− ALCL and non-ALCL subgroups. These data support the consideration of consolidative SCT in patients with CD30+PTCL who achieve CR following treatment with A+CHP.
Progression of severity in coronavirus disease 2019 patients before treatment and a self-assessment scale to predict disease severity
Authors: Yao Ye , Tian Jie , Meng Xia , Kan Haidong , Zhou Lian , Wang Weibing
Published: April 2022

Objectives

This study aims to further investigate the association of COVID-19 disease severity with numerous patient characteristics, and to develop a convenient severity prediction scale for use in self-assessment at home or in preliminary screening in community healthcare settings.

Setting and participants

Data from 45,450 patients infected with COVID-19 from January 1 to February 27, 2020 were extracted from the municipal Notifiable Disease Report System in Wuhan, China.

Primary and secondary outcome measures

We categorized COVID-19 disease severity, based on The Chinese Diagnosis and Treatment Protocol for COVID-19, as “nonsevere” (which grouped asymptomatic, mild, and ordinary disease) versus “severe” (grouping severe and critical illness).

Results

Twelve scale items—age, gender, illness duration, dyspnea, shortness of breath (clinical evidence of altered breathing), hypertension, pulmonary disease, diabetes, cardio/cerebrovascular disease, number of comorbidities, neutrophil percentage, and lymphocyte percentage—were identified and showed good predictive ability (area under the curve = 0·72). After excluding the community healthcare laboratory parameters, the remaining model (the final self-assessment scale) showed similar area under the curve (= 0·71).

Conclusions

Our COVID-19 severity self-assessment scale can be used by patients in the community to predict their risk of developing severe illness and the need for further medical assistance. The tool is also practical for use in preliminary screening in community healthcare settings.

Our study constructed a COVID-19 severity self-assessment scale that can be used by patients in the community to predict their risk of developing severe illness and the need for further medical assistance.
Screening for infectious maternal morbidity - knowledge, attitudes and perceptions among healthcare providers and managers in Malawi: a qualitative study
Authors: Slezak Emilia , Unger Holger , Gadama Luis , McCauley Mary
Published: April 2022

Background

Maternal morbidity and mortality related to infection is an international public health concern, but detection and assessment is often difficult as part of routine maternity care in many low- and middle-income countries due to lack of easily accessible diagnostics. Front-line healthcare providers are key for the early identification and management of the unwell woman who may have infection. We sought to investigate the knowledge, attitudes, and perceptions of the use of screening tools to detect infectious maternal morbidity during and after pregnancy as part of routine antenatal and postnatal care. Enabling factors, barriers, and potential management options for the use of early warning scores were explored.

Methods

Key informant interviews (n = 10) and two focus group discussions (n = 14) were conducted with healthcare providers and managers (total = 24) working in one large tertiary public hospital in Blantyre, Malawi. Transcribed interviews were coded by topic and then grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.

Results

Most healthcare providers are aware of the importance of the early detection of infection and would seek to better identify women with infection if resources were available to do so. In current practice, an early warning score was used in the high dependency unit only. Routine screening was not in place in the antenatal or postnatal departments. Barriers to implementing routine screening included lack of trained staff and time, lack of thermometers, and difficulties with the interpretation of the early warning scores. A locally adapted early warning screening tool was considered an enabler to implementing routine screening for infectious morbidity. Local ownership and clinical leadership were considered essential for successful and sustainable implementation for clinical change.

Conclusions

Although healthcare providers considered infection during and after pregnancy and childbirth a danger sign and significant morbidity, standardised screening for infectious maternal morbidity was not part of routine antenatal or postnatal care. The establishment of such a service requires the availability of free and easy to access rapid diagnostic testing, training in interpretation of results, as well as affordable targeted treatment. The implementation of early warning scores and processes developed in high-income countries need careful consideration and validation when applied to women accessing care in low resource settings.
Association between early sonographic findings and acetabular index at the age of 6 months: a prospective observational study
Authors: Chang Wen-Chieh , Hsu Kuei-Hsiang , Su Yu-Ping
Published: April 2022

Background

This study investigated the association between early Graf classification and femoral head coverage (FHC) with the acetabular index (AI) at the age of 6 months.

Methods

A prospective observational study was conducted between 2017–2018. Patients requiring Pavlik harness treatment and patients with syndromic dislocation or neurogenic dislocation were excluded. In total, 169 newborns with the first ultrasound performed at the mean age of 12.3 (0–15) days, the second ultrasound performed at the mean age of 3.2 (2.5–4.1) months, and the AI measured at the age of 6.6 (4.3–7.1) months were enrolled. The correlation between the AI and first and second alpha angles and FHC measurements, and the correlation of dysplasia in early ultrasound with dysplasia in the AI were analyzed.

Results

At the first ultrasound, only the FHC (P = .02) demonstrated a significant negative correlation with the AI. At the second ultrasound, both the alpha angle (P < .01) and FHC (P < .01) demonstrated a significant negative correlation with the AI. With the AI as a reference, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found to be 77%, 7%, 5%, and 81%, respectively, for the first Graf; 91%, 37%, 9%, and 98%, respectively, for the first FHC measurement; 82%, 90%, 35%, and 99%, respectively, for the second Graf; and 95%, 97%, 68% and 99%, respectively, for the second FHC measurement.

Conclusions

FHC and alpha angle exhibited significant negative correlations with the AI at six months, both ultrasound parameters may have the potential to predict AI in DDH screening. Compared to the ultrasound measurements taken at 2 weeks, Graf and FHC at 3 months demonstrated superior sensitivity, specificity, PPV, and NPV to detect abnormal AI. The best timing to perform ultrasound examination may need further research.
Infection control of COVID-19 in pediatric tertiary care hospitals: challenges and implications for future pandemics
Authors: Remppis Jonathan , Hilberath Johannes , Ganzenmüller Tina , Slavetinsky Christoph , Vasconcelos Malte Kohns , Gnädig Marion , Liese Jan , Göpel Siri , Lang Peter , Heinzel Oliver , Renk Hanna
Published: April 2022

Background

More than 2 years into the COVID-19 pandemic, SARS-CoV-2 still impacts children’s health and the management of pediatric hospitals. However, it is unclear which hygiene and infection control measures are effective and useful for pediatric hospitals. Here, we report infection control measures implemented at a tertiary care children’s hospital. We evaluated frequency of SARS-CoV-2 detection in admitted patients, in-hospital transmission and infection related findings. Furthermore, we aimed to capture perspectives of health-care workers and caregivers on effectiveness and burden of infection control measures. Knowledge gained can inform management of the ongoing and future pandemics.

Methods

We designed a retrospective observational study and survey at a pediatric tertiary care referral center. Local infection control measures and respective guidelines regarding COVID-19 were reviewed. Three thousand seven hundred sixteen children under 18 years were tested for SARS-CoV-2 at the University Children’s Hospital Tuebingen and data on SARS-CoV-2 transmission were retrieved from internal records. Two surveys were conducted among 219 staff members and 229 caregivers.

Results

Local infection control measures comprised the formation of a task force, triage, protective hygiene measures and an adaptable SARS-CoV-2 test strategy. Between January 2020 and March 2021, SARS-CoV-2 infection was detected in 37 children presenting to our hospital, 21 of these were admitted. One hospital-acquired infection occurred. About 90% of health-care staff perceived the majority of measures as effective and appropriate. However, visitor restrictions and cancellation of scheduled treatments were perceived least effective by hospital staff and as a particular burden for patients and their caregivers. Visits at the pediatric emergency department significantly decreased during the pandemic. We drafted a pandemic action plan by ranking infection control measures according to local transmission stages.

Conclusions

SARS-CoV-2 infection control measures implemented in our tertiary care children’s hospital were evaluated by health-care workers as mostly effective and appropriate. In particular, good communication, transparency of decision-making as well as universal masking and infection screening were assessed as successful measures of infection control management. Visitor restrictions and cancellation of routine appointments, in contrast, were perceived as a particular burden on patient care and should be avoided. An established pandemic action plan may guide children’s hospitals in the future.
Cross-sectional association of light sensor-measured time outdoors with physical activity and gross motor competency among U.S. preschool-aged children: the 2012 NHANES National Youth Fitness Survey
Authors: Kwon Soyang , Tandon Pooja S. , O’Neill Meghan E. , Becker Adam B.
Published: April 2022

Background

Time spent outdoors (outdoor time) has been suggested to be beneficial for physical activity (PA) and healthy development among preschool-aged children. The aim of this study was to quantify PA level and gross motor competency associated with light sensor-measured daily outdoor time in a representative sample of U.S. children aged 3 to 5 years.

Methods

The study sample included 301 participants (149 girls) aged 3 to 5 years from the 2012 U.S. National Health and Examination Survey National Youth Fitness Survey. ActiGraph GT3X+ accelerometers with a built-in ambient light sensor were used to measure PA (expressed in monitor-independent movement summary [MIMS]) and outdoor time. The Test of Gross Motor Development-Second Edition (TGMD-2) was used to assess gross motor skills. Multivariable linear regression models were fit to predict daily and gross motor scores by daily outdoor time.

Results

Average daily outdoor time was 95 min (median of 84 min; interquartile range of 52 to 123 min). Means of daily outdoor time and daily MIMS were not significantly different between boys and girls. Among girls, every additional 10 min of daily outdoor time was associated with an additional 540 daily total MIMS (95% CI = 372, 708). Among boys, every additional 10 min of daily outdoor time was associated with an additional 296 daily total MIMS (95% CI = 131, 460). Every additional 10 min of daily outdoor time was associated with a 0.1-point (95% CI = 0.001, 0.130) higher object control standard score. Daily outdoor time was not associated with a locomotor standard score.

Conclusions

In a representative sample of U.S. preschool-aged children, daily outdoor time was positively associated with daily PA. The contribution of outdoor time to PA was greater among girls than boys, suggesting that providing outdoor opportunities is critical for promoting PA, particularly among girls.
Radiographic measurement of the posterior tibial slope in normal Chinese adults: a retrospective cohort study
Authors: Chen Yong , Ding Jianping , Dai Siyu , Yang Jiao , Wang Mengke , Tian Tian , Deng Xiaolong , Li Boyi , Cheng Guohua , Liu Jie
Published: April 2022

Background

Measurement of the posterior tibial slope (PTS) angle has important applications in total knee replacement surgery, high tibial osteotomy, and anterior cruciate ligament reconstruction. This study aimed to determine the mean PTS of knee joints in healthy Chinese adults, and provide data to guide knee surgery in China.

Methods

A retrospective analysis of 1257 (n = 1233, 50.4% male) plain X-ray films of participants aged 25–59 years was performed. The picture archiving and communication system was used for PTS measurement. The PTS was defined as the angle between the vertical line of the tangent of the anterior tibial cortex of the proximal tibia, and the tangent line of the tibial cortex. Two imaging physicians conducted the PTS measurements independently, and both the inter- and intraclass correlation coefficients (ICCs) were calculated.

Results

The mean PTS value was 7.68 ± 3.84° (range: 0–21°). The left PTS was significantly smaller in males than in females (7.22 ± 3.89 vs 8.05 ± 3.60; P = 0.005). Additionally, the PTS in participants aged 25–29 years was significantly larger than that in the other age groups (Left side: 8.64 ± 3.73 vs 6.92 ± 3.42, 7.42 ± 3.75, 7.53 ± 3.98; P <  0.001 and Right side: 8.68 ± 3.84 vs 7.48 ± 4.21, 7.13 ± 3.64, 7.66 ± 3.80; P = 0.004). There were no significant differences in PTS between the left and right sides. Two-way analysis of variance suggested that the differences in PTS between age groups were not affected by sex. The interobserver ICC was 0.91 (95% confidence interval [CI]: 0.85–0.94), and the intraobserver ICC was 0.90 (95% CI: 0.82–0.94).

Conclusions

This study demonstrated that there were significant differences in PTS based on sex and age, highlighting the need to provide individualized treatment for knee surgery. It provided valuable information regarding the normal PTS values in Chinese adults and presented regionalised data to guide knee surgery.
Types of therapeutic errors in the management of osteoporosis made by physicians and medical students
Authors: Tausendfreund Olivia , Braun Leah T. , Schmidmaier Ralf
Published: April 2022

Background

Clinical reasoning is of high importance in clinical practice and thus in medical education research. Regarding the clinical reasoning process, the focus has primarily been on diagnostic reasoning and diagnostic errors, but little research has been done on the subsequent management reasoning process, although the therapeutic decision-making process is at least equally important. The aim of this study was to investigate the frequency of therapeutic decision errors and the cognitive factors leading to these errors in the context of osteoporosis, as it is known to be frequently associated with inadequate treatment decisions in clinical practice worldwide.

Methods

In 2019, 19 medical students and—for comparison—23 physicians worked on ten patient cases with the medical encounter of osteoporosis. A total of 254 cases were processed. The therapeutic decision errors were quantitatively measured, and the participants’ cognitive contributions to therapeutic errors and their clinical consequences were qualitatively analysed.

Results

In 26% of the cases, all treatment decisions were correct. In the remaining 74% cases, multiple errors occurred; on average, 3 errors occurred per case. These 644 errors were further classified regarding the cognitive contributions to the error. The most common cognitive contributions that led to errors were faulty context generation and interpretation (57% of students, 57% of physicians) and faulty knowledge (38% of students, 35% of physicians). Errors made due to faulty metacognition (5% of students, 8% of physicians) were less common. Consequences of these errors were false therapy (37% of cases), undertreatment (30% of cases) or overtreatment (2.5% of cases).

Conclusion

The study is the first to show that errors in therapy decisions can be distinguished and classified, similar to the already known classification for errors in diagnostic reasoning. Not only the correct diagnosis, but particularly the correct therapy, is critical for the outcome of a patient.
Psychological first aid for workers in care and nursing homes: systematic review
Authors: Schoultz Mariyana , McGrogan Claire , Beattie Michelle , Macaden Leah , Carolan Clare , Polson Rob , Dickens Geoffrey
Published: April 2022

Background

The Covid-19 pandemic has produced unprecedented challenges across all aspects of health and social care sectors globally. Nurses and healthcare workers in care homes have been particularly impacted due to rapid and dramatic changes to their job roles, workloads, and working environments, and residents’ multimorbidity. Developed by the World Health Organisation, Psychological First Aid (PFA) is a brief training course delivering social, emotional, supportive, and pragmatic support that can reduce the initial distress after disaster and foster future adaptive functioning.

Objectives

This review aimed to synthesise findings from studies exploring the usefulness of PFA for the well-being of nursing and residential care home staff.

Methods

A systematic search was conducted across 15 databases (Social Care Online, Kings Fund Library, Prospero, Dynamed, BMJ Best Practice, SIGN, NICE, Ovid, Proquest, Campbell Library, Clinical Trials, Web of Knowledge, Scopus, Ebsco CINAHL, and Cochrane Library), identifying peer-reviewed articles published in English language from database inception to 20th June 2021.

Results

Of the 1,159 articles screened, 1,146 were excluded at title and abstract; the remaining 13 articles were screened at full text, all of which were then excluded.

Conclusion

This review highlights that empirical evidence of the impact of PFA on the well-being of nursing and residential care home staff is absent. PFA has likely been recommended to healthcare staff during the Covid-19 pandemic. The lack of evidence found here reinforces the urgent need to conduct studies which evaluates the outcomes of PFA particularly in the care home staff population.
Electronic transfusion consent and blood delivering pattern improve the management of blood bank in China
Authors: Jiang Luxi , Zhang Guobing , Hao Ke , Xiang Weiling , Zhang Qin , Xie Yiwei , Wang Zhen , Chen Bingyu , Du Yaoqiang
Published: April 2022

Background

The aim of this study was to improve the blood transfusion treatment consent accuracy, simplify the verification process, prolong the temperature control time before the blood transfusion, and save the blood transportation labor cost.

Methods

We designed the blood transfusion consent electronic signing process, which can generate personalized the text content and can automatically check the filling accuracy. The signal can be transmitted to the blood transfusion management system (TMS) to relieving the blood distribution. For blood delivering pattern, we established the blood transport center, recruited full-time nurses and used temperature-controlled blood transfer boxes to deliver blood in batches on a regular basis.

Results

A quarterly data analysis of blood transfusion quality showed a 100% blood transfusion consent accuracy after an electronic signing process was implemented. The average confirmation time savings between the electronic content and paper content was 26 min for the Department of Emergency (estimated difference 95% CI = 26 (20 to 36), p < 0.05). The blood delivering pattern reduced the time for each unit by leaving the average temperature control by 7.24 min (estimated difference 95% CI = 7.24 (6.92 to 7.56), p < 0.05). Furthermore, $3.67 was saved for the blood transportation labor cost for each unit as well.

Conclusion

Blood transfusion consent electronic signing process not only ensures the accuracy, but also saves the verification time. Moreover, the blood delivering pattern prolongs the blood temperature control time and saves blood transportation labor costs. Thus, these two improvements could enhance transfusion management.
Ontology-aware deep learning enables ultrafast and interpretable source tracking among sub-million microbial community samples from hundreds of niches
Authors: Zha Yuguo , Chong Hui , Qiu Hao , Kang Kai , Dun Yuzheng , Chen Zhixue , Cui Xuefeng , Ning Kang
Published: April 2022

The taxonomic structure of microbial community sample is highly habitat-specific, making source tracking possible, allowing identification of the niches where samples originate. However, current methods face challenges when source tracking is scaled up. Here, we introduce a deep learning method based on the Ontology-aware Neural Network approach, ONN4MST, for large-scale source tracking. ONN4MST outperformed other methods with near-optimal accuracy when source tracking among 125,823 samples from 114 niches. ONN4MST also has a broad spectrum of applications. Overall, this study represents the first model-based method for source tracking among sub-million microbial community samples from hundreds of niches, with superior speed, accuracy, and interpretability. ONN4MST is available at https://github.com/HUST-NingKang-Lab/ONN4MST.