bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexually transmitted diseases in people living with HIV after implementation of cost coverage of HIV pre‐exposure prophylaxis by statutory health insurance in Germany
Authors: Schuettfort Gundolf , Groh Ana , Kann Gerrit , Haberl Annette , Herrmann Eva , Wetzstein Nils , Vehreschild Maria Johanna Gobertina Tetuanui , Stephan Christoph
Published: July 2022

Objectives

After pre‐exposure prophylaxis (PrEP) was introduced, rates of sexually transmitted infections (STIs) increased among PrEP users. However, data on STI trends in people living with HIV since then are limited. Since September 2019, PrEP has been covered by statutory German health insurance (SHI) in vulnerable groups. This study aimed to determine whether this coverage of PrEP costs affected STI rates in people living with HIV (specifically, men who have sex with men).

Methods

All patients of the HIVCENTER Frankfurt diagnosed with at least one STI within the observation period were retrospectively enrolled in the study. STIs included infection with Treponema pallidum, Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. The observation period covered 1 year before and 1 year after the coverage of PrEP costs by German SHI. Data were collected from outpatient clinic records.

Results

In total, 143 patients were enrolled in the study. The observation period was September 2018 to August 2019 for group 1 (n = 73) and September 2019 to August 2020 for group 2 (n = 70). The most frequent STIs were syphilis and infections due to chlamydia, gonococci, and trichomonads, in descending order. Infections with T. pallidum occurred more often in group 2 than in group 1 (60.0% vs. 50.7%; p = 0.253) as did chlamydia (37.1% vs. 28.8%; p = 0.286).

Conclusions

A tendency for an increased ratio of STIs in people living with HIV was observed after the introduction of PrEP coverage by German SHI. STIs should be discussed intensively with people living with HIV, since the communities of PrEP users and people living with HIV overlap, and changes in risk behaviour might influence both groups.
Thermoablative resistance of Ta/TaHfC2‐laminated composites under plasma flame
Authors: Xiao Peng , Wang Song , Yu Yiping , Fang Bing , Li Wei , Li Hao
Published: July 2022

A strong and tough Ta/TaHfC2‐laminated composite was proposed and investigated in terms of its thermoablative behavior under plasma flame for a medium–long time (30–120 s) beyond 2517 K. In comparison to TaHfC2, the composite performed a better thermal shock resistance but an equivalent linear ablation rate (−5.40 vs. −4.08 μm/s) after ablation for 30 s. With extending the ablation time, the linear ablation rate of the composite increases. Combined with the characterization results of the ablative layer and the established volatile phase diagram at 2273 K, it was found that the composite mainly undergoes active oxidation, passive oxidation, and dissolution of oxygen during the ablation, whereas its ablative layer mainly experiences the sintering, solid solution, and loss processes of oxides. The reason the composite possesses a good ablation resistance is because the introduction of Ta‐foil‐improved toughness as well as protective effect of the ablative layer of TaHfC2.
Blue light‐excitable Eu‐doped yellow emitting borate KSr4B3O9 phosphor for white light‐emitting diodes
Authors: Lv Qingyi , Ma Xiaoxi , Dong Yujuan , Li Ying , Shao Bohuai , Wang Chuqi , Yang Shuo , Wang Chuang
Published: July 2022

In the development of novel phosphors for solid‐state light applications, the suitable excitation peak matching with blue LED chip was usually neglected. However, the excitation peak of phosphors was strongly related to the Stocks shift, crystal field splitting, and centroid shift. Here, an environmentally friendly borate phosphor KSr4B3O9: Eu2+ with the maximum excitation peak position at ∼460 nm was prepared in a quite mild synthesis condition. With a blue light excitation, KSr4B3O9: Eu2+ phosphors could emit a bright yellow light centered at ∼560 nm, which could be attributed to the drastic centroid shift and strong crystal field splitting. The strong electron cloud overlaps between Eu–O and the high electron density on the O atom turned out to be the main reason that induces the strong nephelauxetic effect. In addition, the strong crystal field splitting was benefited to the relatively short average Sr–O distance and the large Sr–O distances distribution range from ∼2.23 to 2.96 Å. Meanwhile, the Eu2+ occupation of all the Sr2+ sites in KSr4B3O9 host identified by Rietveld refinement, cryogenic emission spectra, and Eu3+ fluorescent probe gave another evidence to the wide absorption region. The final WLED device and three‐dimensional colorful artwork were fabricated and displayed to suggest a potential application in the solid‐state lighting field and some expressions of esthetic concepts.
The role of cobalt to control the synthesis of nanoscale Co/UiO‐66 composite for photocatalysis
Authors: Ahmed Moustafa , Al‐Hadeethi Yas M. , Alshahrie Ahmed , Kutbee Arwa T. , Al‐Hossainy Ahmed F. , Shaaban Essam R.
Published: July 2022

Restricted synthesis of nanoscale metal–organic frameworks (MOFs) is highly desirable for optimizing their performance and extending their applications. In the present work, Co was utilized as an additive for the mixture of zirconium‐based MOF adding of Co. We found a significant effect on reducing the crystal size of UiO‐66 by increasing the Co additive. The XCo/UiO‐66 composites, where X refers to the weight percentage, were characterized by XRD, SEM, BET, UV, TGA, and DTA. Consequently, well‐dispersed nanoscale UiO‐66 crystals of nanocrystal size can be easily synthesized by adding Co. Such a difficult process involves a couple of equivalent mechanisms, one is related to the adsorption of the coloring into the pores of the MOF, whereas the other mechanism is that the adsorption capacity and photocatalytic performance of XCo/UiO‐66 nanoparticles are higher than those of pristine UiO‐66. Furthermore, increasing the Co additive can reduce the bandgap of the material; therefore, it enhances the photocatalytic performance. The synthesized nanoscale UiO‐66 crystals exhibit a high degree of crystallinity and porosity.
Virulence, antimicrobial susceptibility and phylogenetic analysis of Cronobacter sakazakii isolates of food origins from Jordan
Authors: Jaradat Ziad W. , Al-Mousa Waseem A. , Elbetieha Ahmed M. , Ababneh Qutaiba O. , Al-Nabulsi Anas A. , Jang Hyein , Gangiredla Jayanthi , Patel Isha R. , Gopinath Gopal R. , Tall Ben D.
Published: July 2022

Aims

The aim was to characterize a collection of Cronobacter sakazakii isolates collected from various origins in Jordan.

Methods and Results

The isolates were characterized using 16S rRNA sequencing, DNA microarray, multi-locus sequence typing (MLST), O-serotyping, virulence gene identification and antibiotic susceptibility testing. The identities and phylogenetic relatedness revealed that C. sakazakii sequence type 4 (ST4) and Csak O:1 serotype were the most prevalent STs and serovars amongst these C. sakazakii strains. PCR screening of putative virulence genes showed that the siderophore-interacting protein gene (sip) and iron acquisition gene clusters (eitCBAD and iucABCD/iutA) were the most detected genes with noticeable variability in the type 6 secretion system (T6SS) and filamentous hemagglutinin/adhesion (FHA) gene loci. The antibiotic resistance profiles revealed that the majority of the isolates were susceptible to all antibiotics used despite harbouring a class C β-lactamase resistance gene.

Conclusions

The results described in this report provide additional insights about the considerable genotypic and phenotypic heterogeneity within C. sakazakii.

Significance and Impact of the Study

The information reported in this study might be of great value in understanding the origins of C. sakazakii isolates, in addition to their diversity and variability, which might be helpful in preventing future outbreaks of this pathogen.
Eat Walk Engage: Enabling acute care teams to deliver consistent fundamentals of care for older people
Authors: Cahill Margaret , Neill Sharne , Treleaven Elise , Lee‐Steere Karen , Carter Andy , McCormack Linda , Mudge Alison
Published: July 2022

Aims

Fundamentals of care are particularly important for older people in acute inpatient settings, who are at increased risk of serious hospital‐associated complications like delirium and functional decline. These complications occur due to interactions between clinical complexity and the complex processes and context of hospital care and can be reduced by consistent attention to the fundamentals of care. This paper aims to illustrate of how multi‐level nursing leadership of fundamentals of care can be supported to emerge within complex multidisciplinary delivery systems in acute care.

Design

Discussion paper informed by clinical and organizational experience of a multidisciplinary leadership team and complexity leadership theory.

Data sources

We provide a series of vignettes as practical illustrations of a successful multidisciplinary improvement program called Eat Walk Engage which supports the delivery of better care for older inpatients, significantly reducing delirium. We argue that taking a broader complexity‐based approach including collaborative multidisciplinary engagement, iterative and integrated interventions and appropriate knowledge translation frameworks can enable emergent leadership by nurses at all levels.

Implications for nursing

This promising approach to improving care for older patients requires organizational support for facilitation and reflective practice, and for meaningful data to support change. Our discussion challenges nursing leaders to support the time, agency and connections their nursing staff need in order to emerge as local leaders in fundamental care.

Conclusion

The debate around scope and responsibilities for fundamentals of care in hospital care has important practical implications for conceptualizing leadership and accountability for improvement.

Impact

Our discussion illustrates how a structured multidisciplinary approach that acknowledges and navigates complexity can empower nurses to lead and improve outcomes of older patients in acute care.
Seasoned equity offerings and payout policy
Authors: Walker Mark D. , Yost Keven
Published: July 2022

We investigate firms that issue seasoned equity following a period of payouts to equity holders. Firms that engage in this roundtrip of equity exhibit strong growth in investment in capital expenditures. Issuing seasoned equity for payout firms does not appear to be associated with future declines in operating cash flow, but rather is associated more with large absolute increases in future cash flow. These firms tend to issue equity when their equity valuations are high, suggesting that market conditions matter. Our findings are consistent with firms issuing equity to use the capital for valuable investments in fixed assets, consistent with market assessments of growth opportunities.
Vulnerable Elder Protection Team: Initial experience of an emergency department‐based interdisciplinary elder abuse program
Authors: Rosen Tony , Elman Alyssa , Clark Sunday , Gogia Kriti , Stern Michael E. , Mulcare Mary R. , Makaroun Lena K. , Gottesman Elaine , Baek Daniel , Pearman Morgan , Sullivan Michelle , Brissenden Kelly , Shaw Amy , Bloemen Elizabeth M. , LoFaso Veronica M. , Breckman Risa , Pillemer Karl , Sharma Rahul , Lachs Mark S.
Published: July 2022

Background

An emergency department (ED) visit provides a unique opportunity to identify elder abuse and initiate intervention, but emergency providers rarely do. To address this, we developed the Vulnerable Elder Protection Team (VEPT), an ED‐based interdisciplinary consultation service. We describe our initial experience in the first two years after the program launch.

Methods

We launched VEPT in a large, urban, academic ED/hospital. From 4/3/17 to 4/2/19, we tracked VEPT activations, including patient characteristics, assessment, and interventions. We compared VEPT activations to frequency of elder abuse identification in the ED before VEPT launch. We examined outcomes for patients evaluated by VEPT, including change in living situation at discharge. We assessed ED providers' experiences with VEPT via written surveys and focus groups.

Results

During the program's initial two years, VEPT was activated and provided consultation/care to 200 ED patients. Cases included physical abuse (59%), neglect (56%), financial exploitation (32%), verbal/emotional/psychological abuse (25%), and sexual abuse (2%). Sixty‐two percent of patients assessed were determined by VEPT to have high or moderate suspicion for elder abuse. Seventy‐five percent of these patients had a change in living/housing situation or were discharged with new or additional home services, with 14% discharged to an elder abuse shelter, 39% to a different living/housing situation, and 22% with new or additional home services. ED providers reported that VEPT made them more likely to consider/assess for elder abuse and recognized the value of the expertise and guidance VEPT provided. Ninety‐four percent reported believing that there is merit in establishing a VEPT Program in other EDs.

Conclusion

VEPT was frequently activated and many patients were discharged with changes in living situation and/or additional home services, which may improve safety. Future research is needed to examine longer‐term outcomes.
Invoicing Currency and Financial Hedging
Authors: LYONNET VICTOR , MARTIN JULIEN , MEJEAN ISABELLE
Published: July 2022

We examine the link between exporters' currency choices and their use of financial hedging instruments. Large firms are more likely to use hedging instruments, especially those pricing in a foreign currency. We provide suggestive evidence that access to hedging instruments increases the probability of pricing in a foreign currency. A model of invoicing currency choice augmented with hedging can rationalize these facts. In the model, large firms that would have chosen to price in their own currency in the absence of hedging instruments can decide to set prices in a foreign currency if they have access to such instruments.
A developmental perspective on personality–relationship transactions: Evidence from three nationally representative samples
Authors: Bühler Janina Larissa , Mund Marcus , Neyer Franz J. , Wrzus Cornelia
Published: July 2022

Objective

Throughout their lives, people experience different relationship events, such as beginning or dissolving a romantic relationship. Personality traits predict the occurrence of such relationship events (i.e., selection effects), and relationship events predict changes in personality traits (i.e., socialization effects), summarized as personality–relationship transactions. So far, evidence was partly inconsistent as to how personality traits and relationship events are linked with each other. In this article, we argue that unnoticed age differences might have led to these inconsistencies. To systematically test for age differences in transactions, we conceptualize relationship events in terms of gains and losses and apply a developmental perspective on transactions.

Methods

Using longitudinal data from three nationally representative samples (SOEP, HILDA, Understanding Society), we computed event‐focused latent growth models and summarized the results meta‐analytically.

Results

The findings indicated some transactions. Of these, selection effects were stronger than socialization effects, and effects of gain‐based events were stronger than effects of loss‐based events. We observed few interactions with age.

Conclusion

Selection effects and, particularly, socialization effects, tend to be rare and fairly independent of age. We discuss a series of broader and narrower factors that may have an impact on the strength of transactions across adulthood.
Ageism on Twitter during the COVID‐19 pandemic
Authors: Ng Reuben , Indran Nicole , Liu Luyao
Published: July 2022

The COVID‐19 crisis has sparked a resurgence of scholarly interest in the issue of ageism. Whether the outbreak thwarts or facilitates efforts to combat ageism hinges upon public sentiments toward the older demographic. This study aims to explore discourse surrounding older adults by analyzing 183,179 related tweets posted during the COVID‐19 pandemic from February to December 2020. Overall, sentiments toward older adults became significantly less negative over time, being the least negative in April, August, and October, though the score remained below the neutral value throughout the 11 months. Our topic modelling analysis generated four themes: “The Need to Protect Older Adults” (41%), “Vulnerability and Mortality” (36%), “Failure of Political Leadership” (12%), and “Resilience” (11%). These findings indicate nascent support for older adults, though attempts to show solidarity may well worsen benevolent ageism.
Geochemistry of lunar meteorite Northwest Africa 11962 and its potential source region/crater in the Procellarum KREEP terrane
Authors: Bechtold Andreas , Schulz Toni , Wegner Wencke , Mader Dieter , Patterer Christian , Koeberl Christian
Published: July 2022

Lunar meteorite Northwest Africa (NWA) 11962 is a regolith breccia with a diverse range of mineral and lithic clasts. For the present study, major and trace element contents and selected isotopic compositions were determined on a homogenized bulk powder of NWA 11962 by instrumental neutron activation analysis, thermal ionization mass spectrometry, and inductively coupled plasma mass spectrometry. The chemical composition of the sample points toward an origin of the meteorite from within the Procellarum KREEP terrane (PKT). Samarium‐Nd and Rb‐Sr isotopic compositions and concentrations show a similarity to those of Apollo 15 soils and KREEP basalt. Highly siderophile element (HSE) abundances and ratios, as well as the Re/Os isotopic system, are often used as tracers of different impactor types. The 187Os/188Os and 187Re/188Os isotopic ratios are within the range of ordinary chondrites, yet some of the siderophile element and highly siderophile element ratios are comparable to those of iron meteorites. Using Fe, Th, and Ti abundances of lunar surface regolith, measured by the Lunar Prospector gamma‐ray spectrometer, we attempt to constrain potential lunar source regions for NWA 11962. By matching these possible source regions with coordinates of recently (<1 Ma) formed lunar impact craters (so‐called lunar cold spots), we localized a potential source crater of NWA 11962 at the western rim of the PKT close to Sinus Medii.
Effect of intracolonic volume on gastric sensory‐motor responses in constipation‐predominant irritable bowel syndrome
Authors: Caballero Noemi , Marin Ingrid , Riu Fausto , Leal Carles , Serra Jordi
Published: July 2022

Background

Interaction between gut stimuli may induce symptom overlap in patients with functional gastrointestinal disorders. The aim is to determine the effect of increased volumes of colonic contents on gastric sensory/motor responses and satiety in patients with constipation‐predominant irritable bowel syndrome (IBS‐C) and overlapping dyspeptic symptoms, and a cohort of healthy subjects.

Methods

In 15 patients with IBS‐C and 10 healthy subjects, the effect of real versus sham colonic filling with gas (1080 ml) on gastric sensitivity (measured by stepwise distensions of the stomach), gastric compliance, abdominal perception, and nutrient drink tolerance was studied on separate days.

Results

In healthy subjects, colonic gas filling induced an increment in gastric sensitivity to distension (mean score 2.0 ± 0.2 before, and 3.0 ± 0.4 after; p = 0.038). In IBS, basal sensitivity was greater and remained unchanged after colonic gas filling (score 4.0 ± 0.1 and 3.8 ± 0.3, respectively; p < 0.001 vs. basal in health). Colonic gas infusion induced abdominal symptoms that were significantly greater in IBS‐C (score 2.6 ± 0.1) than in health (score 1.7 ± 0.4; p = 0.027), with minor changes in gastric tone, and no changes in gastric compliance in both groups. Colonic filling produced a profound reduction in nutrient drink tolerance in IBS (791 ± 87 ml sham filling, 491 ± 58 ml gas filling; p < 0.001) but only a minor reduction in health (940 ± 70 ml sham filling, 860 ± 94 ml gas filling; p = 0.223).

Conclusions & Inferences

The volume of the colonic contents modulates satiety in patients with IBS‐C, due to a general visceral pan‐hypersensitivity. These effects should be considered in the choice of treatment for constipation in these patients.
Outcome of catheter ablation for paroxysmal atrial fibrillation in patients with stable coronary artery disease
Authors: Cui Yi‐Kai , Dong Jian‐Zeng , Du Xin , Hu Rong , He Liu , Long De‐Yong , Bai Rong , Yu Rong‐Hui , Sang Cai‐Hua , Jiang Chen‐Xi , Liu Nian , Li Song‐Nan , Wang Wei , Guo Xue‐Yuan , Zhao Xin , Zuo Song , Tang Ri‐Bo , Ma Chang‐Sheng
Published: July 2022

Background

Atrial fibrillation (AF) and stable coronary artery disease (SCAD) frequently coexist. This study aimed to assess the long‐term outcome of catheter ablation in patients with paroxysmal AF and SCAD.

Methods

In total, 12,104 patients with paroxysmal AF underwent catheter ablation in the Chinese Atrial Fibrillation Registry between 2011 and 2019 were screened. A total of 441 patients with SCAD were matched with patients without SCAD in a 1:4 ratio. The primary endpoint was AF recurrence after single ablation. The composite secondary endpoints were thromboembolism, coronary events, major bleeding, all‐cause death.

Results

Over a mean follow‐up of 46.0 ± 18.9 months, the recurrence rate in patients with SCAD was significantly higher after a single ablation (49.0% vs. 41.9%,p = .03). The very late recurrence rate of AF in the SCAD group was also significantly higher than that in the control group (38.9% vs. 31.2%;p = .04). In multivariate analysis, adjusted with the female, smoking, duration of AF, previous thromboembolism, COPD, and statins, SCAD was independently associated with AF recurrence (adjusted HR, 1.19 [1.02–1.40],p = .03). The composite secondary endpoints were significantly higher in the SCAD group (12.70% vs. 8.54%,p = .02), mainly due to thromboembolism events (8.16% vs. 4.41%,p < .01).

Conclusions

SCAD significantly increased the risk of recurrence after catheter ablation of paroxysmal AF. The incidence of thromboembolic events after catheter ablation of paroxysmal AF in the patients with SCAD was significantly higher than that in those without SCAD.
Epidemiology and outcomes of pediatric transplant‐associated thrombotic microangiopathy in Hong Kong
Authors: Chan Wilson Yau Ki , Ma Alison Lap Tak , Chan Eugene Yu Hin , Kan Amanda Nim Chi , Ng Wai Fu , Lee Pamela Pui Wah , Cheuk Daniel Ka Leung , Chiang Alan Kwok Shing , Leung Wing , Chan Godfrey Chi Fung
Published: July 2022

Background

Transplant‐associated thrombotic microangiopathy (TA‐TMA) is an under‐recognized yet potentially devastating complication of hematopoietic stem cell transplantation (HSCT) which had increased awareness in recent years. This report summarizes the demographics and outcomes of pediatric TA‐TMA in Hong Kong.

Methods

All patients aged below 18 years who underwent HSCT in the Hong Kong Children's Hospital and were diagnosed to have TA‐TMA during the 2‐year period from April 1, 2019 to March 31, 2021 were included.

Results

A total of 73 transplants (51 allogeneic and 22 autologous) in 63 patients had been performed. Six patients (four males and two females) developed TA‐TMA at a median duration of 2.5 months post‐HSCT. The incidence rate was 9.52%. Of the six TA‐TMA patients, five underwent allogenic one underwent autologous HSCT, respectively. Three of them were histologically proven. All four patients with cyclosporine had stopped the drug once TA‐TMA was suspected. Median six doses of eculizumab were administered to five out of six patients. Three patients died (two due to fungal infection and one due to acute‐on‐chronic renal failure) within 3 months upon diagnosis of TA‐TMA. Among three survivors, two stabilized with mild stage 2 chronic kidney disease (CKD) while the other suffered from stage 5 end‐stage CKD requiring lifelong dialysis.

Conclusion

In conclusion, recognition and diagnosis of TA‐TMA are challenging. Early recognition and prompt administration of complement blockage with eculizumab may be beneficial in selected cases. Further prospective research studies are recommended to improve the management and outcomes of TA‐TMA.
Alternative paths of diversification for developing countries
Authors: Eum Wonsub , Lee Jeong‐Dong
Published: July 2022

This study analyzes different diversification options of countries at different economic stages, and complements the previous diversification literature from the perspective of coevolution between production and technological capability. This study points out that path dependence theories concerning diversification patterns of countries cannot give useful policy implications to developing countries, because they can only take either the “high‐risk high‐return” or “low‐risk low‐return” tracks. The analysis includes 84 countries from 1980 to 2005, and studies the close relationship between product space and knowledge space to understand the alternative drivers of product and technological diversification. The results show that countries at different income levels have different factors of diversification. Specifically, production capability of developing countries guides future technological diversification, and technological capability of developed countries leads to product diversification in related products.
Inverse‐probability‐weighted logrank test for stratified survival data with missing measurements
Authors: Ben Elouefi Rim , Saâdaoui Foued
Published: July 2022

The stratified logrank test can be used to compare survival distributions of several groups of patients, while adjusting for the effect of some discrete variable that may be predictive of the survival outcome. In practice, it can happen that this discrete variable is missing for some patients. An inverse‐probability‐weighted version of the stratified logrank statistic is introduced to tackle this issue. Its asymptotic distribution is derived under the null hypothesis of equality of the survival distributions. A simulation study is conducted to assess behavior of the proposed test statistic in finite samples. An analysis of a medical dataset illustrates the methodology.
Responses of retinal rods to single photons.
Authors: Baylor D A , Lamb T D , Yau K W
Published: July 2022

1. A suction electrode was used to record the membrane current of single rod outer segments in pieces of toad retina. During dim illumination the membrane current showed pronounced fluctuations. 2. Amplitude histograms of responses to dim flashes of fixed intensity exhibited two discrete peaks, one at 0 pA and one near 1 pA, suggesting that the response was quantized. By setting a criterion amplitude level, flash responses could be classed as 'failures' (no response) or as 'successes' (at least one quantal event). 3. The variation of fraction of successes with flash intensity was consistent with the hypothesis that each quantal electrical event resulted from a single photoisomerization. 4. The quantal event had a mean amplitude of about 1 pA (5% of the standing dark current) and a standard deviation of 0.2 pA. Dispersion in the event amplitude prevented identification of histogram peaks corresponding to two or more photoisomerizations. 5. Individual quantal responses exhibited a smooth shape very similar to that of the average quantal response. This suggests that a single photoisomerization releases many particles of transmitter and that radial diffusion of internal transmitter is not a major source of delay in the light response. 6. The 'quantum efficiency' with which an absorbed photon generated an electrical event was measured as 0.5 +/‐ 0.1 (S.E. of mean, n = 4). This is slightly lower than the quantum efficiency of photoisomerization obtained previously for rhodopsin in solution. 7. At wavelengths between 420 and 700 nm the quantal event was invariant in size, although the cell's sensitivity varied over a range of 10(5). 8. The power spectrum of the fluctuations in dim steady light was predicted by assuming that a random series of quantal events occurred independently. 9. In brighter light the fluctuations were faster, and the response to an incremental flash was reduced in size and duration. The power spectrum could be predicted by assuming random superposition of events with the shape of the incremental flash response.
Regularization of a Mathematical Model of the Wheatley Heart Valve
Authors: Rebolledo R. J. , McKee S. , Cuminato J. A. , Stewart I. W. , Wheatley D. J.
Published: July 2022

This note considers the mathematical model published in the Journal of Biomechanical Engineering by McKee et al. [McKee, S., Cuminato, J. A., Stewart, I. W., and Wheatley, D. J., 2021, “A Mathematical Representation of the Wheatley Heart Valve,” ASME J. Biomech. Eng., 143(8), p. 081006]. The model presented there suffers from the fact that there is a line discontinuity in the first derivative producing what appears to be a kink in each of the leaflets. This note is concerned with regularizing the shape of the valve while holding to Wheatley's essential idea [Wheatley, D. J., 2016, “Heart Valve,” U.S. Patent No. 9,259,313, UK Patent No. 2,982,340 (2017), European Patent No. 2,979,666 (2017)].
Mathematical Modeling of Material Removal and Surface Roughness in Ultrasonic-Assisted Magnetic Abrasive Flow Machining Process
Authors: Dixit Nitin , Sharma Varun , Kumar Pradeep
Published: July 2022

Ultrasonic-assisted magnetic abrasive flow machining (UAMAFM) process shows enhanced finishing performance compared to conventional abrasive flow machining (AFM). In this present research paper, mathematical models for M˙R and Ra have been developed for the UAMAFM process by considering both steady-state and transient phenomena. The external ultrasonic and magnetic field assistance enhanced the velocity and length of contact of active abrasives, calculated from the kinematic analysis. The resultant finishing forces have also been evaluated by considering these external aids. The steady-state material removal per finishing cycle remains constant and depends on the velocity of motion, length of contact, resulting forces, number of active abrasives, and work material hardness. The transient material removal per finishing cycle was calculated in terms of the volume of irregularities present over the work surface, i.e., initial surface roughness. The mathematical model for surface roughness was developed in terms amount of material removed (MR), and initial (Ra0) and critical surface roughness (Racr). The predicted values of material removed and surface roughness from developed mathematical models agreed with experimental results with a deviation of 7.80% and 2.44%, respectively.
Actuation Arrangement of Rigid Foldable Waterbomb Origami
Authors: Wang Sen , Liang Dongbo , Huang Hailin , Li Bing , Liu Rongqiang , Xi Fengfeng
Published: July 2022

A novel approach is proposed to arrange the actuations of rigid foldable waterbomb origami with multiple facet loops such that the number of actuations equaled the degrees-of-freedom (DOF) of the origami. In this approach, the rigid waterbomb origami was regarded as a combination of three types of six-crease origami units, which is equivalent to spherical 6R mechanisms with three DOF. Then, clear, target, and arrangement parts were created to define the facets of the origami pattern in the proposed extrapolation method. The actuation arrangement for a waterbomb origami pattern, which extended outwards circumferentially from a six-crease origami unit, was completed, and adams software was used to verify the correctness of the arrangement. Finally, an intuitive mathematical method was used to arrange the actuations for this type of waterbomb origami. The proposed approach provided DOF for the rigid foldable waterbomb origami and facilitated an actuation design such that the origami exhibits unique motion and can be normally actuated.
Design of Hybrid Fully Actuated and Self-Adaptive Mechanism for Anthropomorphic Robotic Finger
Authors: Lee Chun-Tse , Chang Jen-Yuan (James)
Published: July 2022

Prior research on robotic hands predominantly focused on high degrees-of-freedom of fully actuated fingers to replicate a natural human hand or on creative designs of underactuated fingers to make a self-adaptive motion. However, in most cases, fully actuated fingers encounter difficulty in grasping unstructured objects, while underactuated fingers experience problems in performing precise grasping motions. To deal with any possible scenarios, this study presents a novel design of an anthropomorphic robotic finger that combines both advantages—fully actuated and self-adaptive (FASA) modes—at once. Actuated by tendons, the FASA finger can grasp objects adaptively and achieve accurate angle positioning with the same mechanical design. Based on the kinetostatic analysis, the guideline for selecting a torsion spring is proposed to fulfill the functions of the FASA finger and attain the optimal design of torsional stiffness, which manifests itself in a series of tests on different configurations of torsion spring. Likewise, the kinematic analysis for the fully actuated mode is given proof that two joints can move independently by controlling two motors. Ultimately, experimental results reflected the capability of the FASA finger to perform not only independent precision angle motion but also self-adaptive grasping motion without any change in mechanical structure.
Monitoring Elite Youth Football Players’ Physiological State Using a Small-Sided Game: Associations With a Submaximal Running Test
Authors: Houtmeyers Kobe C. , Helsen Werner F. , Jaspers Arne , Nanne Sjaantje , McLaren Shaun , Vanrenterghem Jos , Brink Michel S.
Published: July 2022

Purpose: To examine the utility of a standardized small-sided game (SSG) for monitoring within-player changes in mean exercise heart rate (HRex) when compared with a submaximal interval shuttle-run test (ISRT). Methods: Thirty-six elite youth football players (17 [1] y) took part in 6 test sessions across an in-season period (every 4 wk). Sessions consisted of the ISRT (20-m shuttles, 30″:15″ work:rest ratio, 70% maximal ISRT) followed by an SSG (7v7, 80 × 56 m, 6 min). HRex was collected during both protocols, with SSG external load measured as high-speed running distance (>19.8 km·h–1) and acceleration distance (>2 m·s−2). Data were analyzed using linear mixed-effect models. Results: Controlling for SSG external load improved the model fit describing the SSG–ISRT HRex relationship (χ2 = 12.6, P = .002). When SSG high-speed running distance and SSG acceleration distance were held constant, a 1% point change in SSG HRex was associated with a 0.5% point change in ISRT HRex (90% CI: 0.4 to 0.6). Inversely, when SSG HRex was held constant, the effects of a 100-m change in SSG high-speed running distance and a 21-m change in SSG acceleration distance on ISRT HRex were −1.0% (−1.5 to −0.4) and −0.6% points (−1.1 to 0.0), respectively. Conclusions: An SSG can be used to track within-player changes in HRex for monitoring physiological state. Given the uncertainty in estimates, we advise to only give meaning to changes in SSG HRex >2% points. Additionally, we highlight the importance of considering external load when monitoring SSG HRex.
Epigenetic controls of Sonic hedgehog guarantee fidelity of epithelial adult stem cells trajectory in regeneration
Authors: Yu Fanyuan , Li Feifei , Zheng Liwei , Ye Ling
Published: July 2022

Given that adult stem cells (ASCs) fuel homeostasis and healing by providing tissue-specific descendants, the fidelity of ASC fate determination is crucial for regeneration. Here, we established that an epigenetic control of epithelial ASC fate fidelity via Ezh2/H3K27me3 was indispensable for incisor homeostasis and regeneration. Mechanistically, in homeostasis, H3K27me3 upstream occupies the Sonic hedgehog (Shh) promoter to directly restrain Shh expression, thereby precisely confining Shh expression. When injury occurred, Ezh2/H3K27me3 was substantially induced within inner enamel epithelium and preameloblast zones, and such epigenetic response guaranteed the fidelity of ASC commitment via pulling injury-increased Shh back to homeostatic levels, utterly underlying regeneration progression. Once losing H3K27me3-dependent restriction of Shh expression through the Cre-Loxp system totally disrupted lineage commitment and stemness exhaustion, and abolished hard tissue regeneration emerged in vivo. We next uncovered the molecular mechanisms by which injury-induced Ezh2 mediated the spatiotemporal dynamics of H3K27me3 to repress Shh expression, thus epigenetically deciding ASC fate.
Unprovoked piriformis myositis presenting in a pregnant patient
Authors: Kennedy Bernard , Botros Karim , Rashid Hibah , Bermingham John
Published: July 2022

A patient in her mid-30s presented to hospital at 25 weeks’ gestation with acute onset of leg pain.

Routine investigations were performed to rule out the common causes of leg and back pain in pregnancy, which were grossly normal. Piriformis pyomyositis was diagnosed on MRI and a collection was drained. Following an initial response to antibiotic therapy, the patient delivered by elective caesarean section, but the pain returned on postnatal day 2 and muscle inflammation was diagnosed again, requiring a repeat course of antibiotics.

This case highlights a rare cause of leg pain in a pregnant patient, and the additional complexities of managing cases in the obstetric population.
International Olympic Committee (IOC) consensus statement on acute respiratory illness in athletes part 1: acute respiratory infections
Authors: Schwellnus Martin , Adami Paolo Emilio , Bougault Valerie , Budgett Richard , Clemm Hege Havstad , Derman Wayne , Erdener Uğur , Fitch Ken , Hull James H , McIntosh Cameron , Meyer Tim , Pedersen Lars , Pyne David B , Reier-Nilsen Tonje , Schobersberger Wolfgang , Schumacher Yorck Olaf , Sewry Nicola , Soligard Torbjørn , Valtonen Maarit , Webborn Nick , Engebretsen Lars
Published: July 2022

Acute illnesses affecting the respiratory tract are common and form a significant component of the work of Sport and Exercise Medicine (SEM) clinicians. Acute respiratory illness (ARill) can broadly be classified as non-infective ARill and acute respiratory infections (ARinf). The aim of this consensus is to provide the SEM clinician with an overview and practical clinical approach to ARinf in athletes. The International Olympic Committee (IOC) Medical and Scientific Commission appointed an international consensus group to review ARill (non-infective ARill and ARinf) in athletes. Six subgroups of the IOC Consensus group were initially established to review the following key areas of ARill in athletes: (1) epidemiology/risk factors for ARill, (2) ARinf, (3) non-infective ARill including ARill due to environmental exposure, (4) acute asthma and related conditions, (5) effects of ARill on exercise/sports performance, medical complications/return-to-sport and (6) acute nasal/vocal cord dysfunction presenting as ARill. Several systematic and narrative reviews were conducted by IOC consensus subgroups, and these then formed the basis of sections in the consensus documents. Drafting and internal review of sections were allocated to ‘core’ members of the consensus group, and an advanced draft of the consensus document was discussed during a meeting of the main consensus core group in Lausanne, Switzerland on 11 to 12 October 2021. Final edits were completed after the meeting. This consensus document (part 1) focusses on ARinf, which accounts for the majority of ARill in athletes. The first section of this consensus proposes a set of definitions and classifications of ARinf in athletes to standardise future data collection and reporting. The remainder of the consensus paper examines a wide range of clinical considerations related to ARinf in athletes: epidemiology, risk factors, pathology/pathophysiology, clinical presentation and diagnosis, management, prevention, medical considerations, risks of infection during exercise, effects of infection on exercise/sports performance and return-to-sport guidelines.
Open spaces and a sense of belonging improve wellbeing
Authors: Saul Helen , Gursul Deniz , Cassidy Samantha , Corcoran Rhiannon
Published: July 2022

The study

McElroy E, Ashton M, Bagnall AM, et al. The individual, place, and wellbeing—a network analysis.
BMC Public Health
2021;21:1621.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/open-spaces-and-community-cohesion-improve-wellbeing/
Cultivating design thinking skills through the biodesign process in Japan
Authors: Kiriyama Hiroyuki , Kakihiana Takaaki , Maeda Yujiro , Sugimoto Munemasa , Machida Megumi , Inoue Tomotaka , Ikeno Fumiaki , Komuro Issei , Ono Minoru
Published: July 2022

Background

The biodesign process, which originated at Stanford University, has had a significant impact on medical device invention. Design thinking skills are core elements in the biodesign process, but there has been no quantitative evaluation of how design thinking is actually affected by a biodesign course. The purpose of this study was to examine the usefulness of the biodesign process by quantifying design thinking ability.

Methods

We recruited 17 participants who had studied a systematic biodesign process in Japan and 20 participants who were unfamiliar with the biodesign process. All participants took the design thinking test and we evaluated their design thinking skills using a combination of the creation score and the evaluation score.

Results

The average age of the participants was 34.4 years and 84% were male. Participants who had taken the biodesign program generated more ideas than other participants (5.3±1.9 ideas vs 3.7±2.3 ideas; p=0.01). They also had significantly higher design thinking score, especially creation score, than those who had not taken the program (design thinking score, 220.1±39.7 vs 194.6±32.1; p=0.02; creation score, 91.3±23.0 vs 70.7±20.2; p=0.03).

Conclusion

The findings suggest that the biodesign process can cultivate design thinking skills, especially the ability to visualise needs and create solutions. Exposure of more people to the biodesign process may accelerate innovation in the medical technology field.
Exploring physician approaches to conflict resolution in end-of-life decisions in the adult intensive care unit: protocol for a systematic review of qualitative research
Authors: Johal Harleen Kaur , Birchley Giles , Huxtable Richard
Published: July 2022

Introduction

Conflict is unfortunately well-documented in the adult intensive care unit (AICU). In the context of end-of-life (EOL) decision-making (ie, the withdrawal or withholding of life-sustaining treatment), conflict commonly occurs when a consensus cannot be reached between the healthcare team and the patient’s family on the ‘best interests’ of the critically ill, incapacitated patient. While existing literature has identified potential methods for conflict resolution, it is less clear how these approaches are perceived and used by stakeholders in the EOL decision-making process. We aim to explore this by systematically reviewing and synthesising the published evidence, which addresses the following research question: what does existing qualitative research reveal about physician approaches to addressing conflict arising in EOL decisions in the AICU?

Methods and analysis

Peer-reviewed qualitative studies (retrieved from MEDLINE, Project Muse, Scopus, EMBASE, Web of Science, PsycINFO, CINAHL, and LILACS) examining conflict and dispute resolution in the context of EOL decisions in the AICU setting will be included. Two reviewers will independently screen either all or a randomly selected sample of studies, with a third reviewer independently screening studies of uncertain eligibility. The ‘thematic synthesis’ approach will be employed to analyse the resulting data. The quality of included papers will be assessed using the 2018 Mixed-Methods Assessment Tool. The ‘Grading of Recommendations, Assessment, Development, and Evaluations-Confidence in the Evidence from Reviews of Qualitative research’ approach will be used to assess our confidence in the findings.

Ethics and dissemination

Ethical approval is not required for this review, as only published data will be included. We anticipate that the findings will be of interest to healthcare professionals working in AICUs and individuals working in bioethics, given the ethically contentious nature of EOL decisions. The findings will be disseminated at academic conferences and through open-access publication in a peer-reviewed journal.

PROSPERO registration number

CRD42021193769.
From registration, protocol to report: are COVID-19-related RCTs in mainland China consistent? A systematic review of clinical trial registry and literature
Authors: Chen Yu , Yan Ruiqing
Published: July 2022

Objective

To provide a comprehensive review of registered COVID-19-related randomised controlled trials (RCTs) in mainland China and evaluate the transparency of reporting through comparison of registrations, protocols and full reports.

Design

Systematic review of trial registrations and publications.

Data sources

International Clinical Trials Registry Platform, Chinese Clinical Trial Registry, ClinicalTrials.gov, the ISRCTN registry and EU Clinical Trial Register were accessed on 1 February 2022. Publications were searched in PubMed, Embase, Cochrane Library, Google Scholar, CNKI.net and Wanfangdata from 10 February 2022 to 12 February 2022.

Eligibility criteria

Eligible trials were COVID-19 related RCTs carried out in mainland China. Observational studies, non-randomised trials and single-arm trials were excluded.

Data extraction and synthesis

Two reviewers independently extracted data from registrations, publications and performed risk of bias assessment for trial reports. Information provided by registrations and publications was compared. The findings were summarised with descriptive statistics.

Results

The number of eligible studies was 415. From these studies 20 protocols and 77 RCT reports were published. Seven trials published both protocol and RCT full report. Between registrations and publications, discrepancy or omission was found in sample size (7, 35.0% for protocols and 47, 61.0% for reports, same below), trial setting (13, 65.0% and 43, 55.8%), inclusion criteria (12, 60.0% and 57, 74.0%), exclusion criteria (10, 50.0% and 54, 70.1%), masking method (9, 45.0% and 35, 45.5%) and primary outcome or time frame of primary outcome measurement (14, 70.0% and 51, 66.2%). Between protocols and full reports, 5 (71.4%) reports had discrepancy in primary outcome or time frame of primary outcome measurement.

Conclusions

Discrepancy among registrations, protocols and reports revealed compromised transparency in reporting of COVID-19-related RCTs in mainland China. The importance of trial registration should be further emphasised to enhance transparent RCT reporting.