bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the school food environment for the prevention of childhood obesity: What works and what doesn't
Authors: Pineda Elisa , Bascunan Josefina , Sassi Franco
Published: January 2021

The food environment has a significant influence on dietary choices, and interventions designed to modify the food environment could contribute to the prevention of childhood obesity. Many interventions have been implemented at the school level, but effectiveness in addressing childhood obesity remains unclear.

We undertook a systematic review, a meta‐analysis, and meta‐regression analyses to assess the effectiveness of interventions on the food environment within and around schools to improve dietary intake and prevent childhood obesity. Estimates were pooled in a random‐effects meta‐analysis with stratification by anthropometric or dietary intake outcome. Risk of bias was formally assessed. One hundred papers were included. Interventions had a significant and meaningful effect on adiposity (body mass index [BMI] z score, standard mean difference: −0.12, 95% confidence interval: 0.15, 0.10) and fruit consumption (portions per day, standard mean difference: +0.19, 95% confidence interval: 0.16, 0.22) but not on vegetable intake. Risk of bias assessment indicated that n = 43 (81%) of non‐randomized controlled studies presented a high risk of bias in the study design by not accounting for a control. Attrition bias (n = 34, 79%) and low protection of potential contamination (n = 41, 95%) presented the highest risk of bias for randomized controlled trials.

Changes in the school food environment could improve children's dietary behavior and BMI, but policy actions are needed to improve surrounding school food environments to sustain healthy dietary intake and BMI.
Rewiring of peatland plant–microbe networks outpaces species turnover
Authors: Robroek Bjorn J. M. , Martí Magalí , Svensson Bo H. , Dumont Marc G. , Veraart Annelies J. , Jassey Vincent E. J.
Published: January 2021

Enviro–climatic changes are thought to be causing alterations in ecosystem processes through shifts in plant and microbial communities; however, how links between plant and microbial communities change with enviro–climatic change is likely to be less straightforward but may be fundamental for many ecological processes. To address this, we assessed the composition of the plant community and the prokaryotic community – using amplicon‐based sequencing – of three European peatlands that were distinct in enviro–climatic conditions. Bipartite networks were used to construct site‐specific plant–prokaryote co‐occurrence networks. Our data show that between sites, plant and prokaryotic communities differ and that turnover in interactions between the communities was complex. Essentially, turnover in plant–microbial interactions is much faster than turnover in the respective communities. Our findings suggest that network rewiring does largely result from novel or different interactions between species common to all realised networks. Hence, turnover in network composition is largely driven by the establishment of new interactions between a core community of plants and microorganisms that are shared among all sites. Taken together our results indicate that plant–microbe associations are context dependent, and that changes in enviro–climatic conditions will likely lead to network rewiring. Integrating turnover in plant–microbe interactions into studies that assess the impact of enviro–climatic change on peatland ecosystems is essential to understand ecosystem dynamics and must be combined with studies on the impact of these changes on ecosystem processes.
AtPFA‐DSP3, an atypical dual‐specificity protein tyrosine phosphatase, affects salt stress response by modulating MPK3 and MPK6 activity
Authors: Xin Jing , Li Chuanling , Ning Kexin , Qin Yuan , Shang Jian‐Xiu , Sun Yu
Published: January 2021

Protein phosphorylation, especially serine/threonine and tyrosine phosphorylation, plays significant roles in signalling during plant growth and development as well as plant responses to biotic or abiotic stresses. Dual‐specificity protein tyrosine phosphatases dephosphorylate components of these signalling pathways. Here, we report that an atypical dual‐specificity protein tyrosine phosphatase, AtPFA‐DSP3 (DSP3), negatively affects the response of plants to high‐salt conditions. A DSP3 loss‐of‐function mutant showed reduced sensitivity to salt treatment. DSP3 was primarily localized in nuclei and was degraded during salt treatment. Compared to wild type, the level of ROS was lower in the dsp3 mutant and higher in plants ectopically expressing DSP3, indicating that higher DSP3 level was associated with increased ROS production. DSP3 interacted with and dephosphorylated MPK3 and MPK6. Genetic analyses of a dsp3mpk3 double mutant revealed that DSP3's effect on salt stress depends on MPK3. Moreover, the phosphatase activity of DSP3 was required for its role in salt signalling. These results indicate that DSP3 is a negative regulator of salt responses in Arabidopsis by directly modulating the accumulation of phosphorylated MPK3 and MPK6.
Atypical aplasia cutis in association with Xia Gibbs syndrome
Authors: Ellis Carter , Pai Gurpur Shashidhar , Wine Lee Lara
Published: January 2021

Xia Gibbs syndrome is a genetic disorder first defined in 2014 characterized by hypotonia, intellectual disability, global developmental delay, and dysmorphic facial features. While many additional features may be present, there are few reports of dermatologic findings. We report a case of atypical aplasia cutis in a female infant who was found to have Xia Gibbs syndrome. This case highlights consideration of cutaneous manifestations of Xia Gibbs syndrome which may aid in diagnosis.
Exposure of Human Skin Models to KrCl Excimer Lamps: The Impact of Optical Filtering†
Authors: Buonanno Manuela , Welch David , Brenner David J.
Published: January 2021

Far‐UVC radiation is a promising technology that is potentially both effective at killing airborne microbes such as coronaviruses and influenza, and being minimally hazardous to the skin and eyes. Our previous studies on health risks from far‐UVC have employed a krypton‐chloride (KrCl) excimer lamp, emitting principally at 222 nm, supplemented with an optical filter to remove longer wavelength emissions inherent to these lamps. This study explores KrCl lamp health hazards by comparing filtered and unfiltered KrCl lamps using effective spectral irradiance calculations and experimental skin exposures. Analysis of effective irradiances showed a notable increase in allowable exposure when using a filter. Induction of DNA dimers (CPD and 6‐4PP) was measured in human skin models exposed to a range of radiant exposures up to 500 mJ cm−2. Compared to sham‐exposed tissues, the unfiltered KrCl lamps induced a statistically significant increase in the yield of both DNA lesions at all the radiant exposures studied. Conversely, filtered KrCl lamps do not induce increased levels of dimers at the current daily TLV exposure limit for 222 nm (23 mJ cm−2). This work supports the use of filters for far‐UVC KrCl excimer lamps when used to limit disease transmission in occupied locations.
Should leisure‐time sedentary behavior be replaced with sleep or physical activity for prevention of diabetes?
Authors: Aadahl Mette , Andreasen Anne H. , Petersen Christina B. , Gupta Nidhi , Holtermann Andreas , Lau Cathrine J.
Published: January 2021

The aim was to examine the effects of replacing self‐reported leisure‐time sedentary behavior with sleep, light‐to‐moderate physical activity, or vigorous physical activity on incident diabetes among Danish adults using isotemporal substitution modeling. Participants ≥25 years from the Danish Capital Region Health Survey 2007 (N = 69 800, response rate 52.3%), 2010 (N = 95 150, response rate 52.3%), and 2013 (N = 95 150, response rate 43.5%) were included. Information on daily sleep duration, leisure‐time sedentary behavior, and movement behaviors was collected by questionnaire. Information on incident diabetes was obtained from National registers. Analyses included Cox proportional hazards regression models and isotemporal substitution analyses, with time (in years) from baseline to incident diabetes or censoring December 31, 2017. Potential confounders, sex, age, BMI, ethnicity, education, smoking, inflammatory joint disease, perceived stress, physical and mental component scale and work status, were included. Out of N = 87 339 in the final study sample, n = 3007 had incident diabetes during a mean follow‐up time of 7.4 years. Adults with incident diabetes included more men, higher mean age, and higher BMI, compared to respondents without incident diabetes. Theoretically substituting 30 minutes of leisure‐time sedentary behavior with light‐to‐moderate PA (HR: 0.96; 95% CI: 0.94; 0.98) or with vigorous PA (HR: 0.82; 95% CI: 0.72; 0.94) decreased the risk of incident diabetes. We found no change in incident diabetes risk of substituting sedentary time with sleep (HR: 1.00; 95% CI: 0.97; 1.02). Substituting 30 minutes per day of leisure‐time sedentary behavior with light‐to‐moderate or vigorous PA may significantly reduce the risk of incident diabetes among adults.
Non‐uniform displacement within ruptured Achilles tendon during isometric contraction
Authors: M. Khair Ra’ad , Stenroth Lauri , Péter Annamária , Cronin Neil J. , Reito Aleksi , Paloneva Juha , Finni Taija
Published: January 2021

The purpose of this study was investigate tendon displacement patterns in non‐surgically treated patients 14 months after acute Achilles tendon rupture (ATR) and to classify patients into groups based on their Achilles tendon (AT) displacement patterns. Twenty patients were tested. Sagittal images of AT were acquired using B‐mode ultrasonography during ramp contractions at a torque level corresponding to 30% of the maximal isometric plantarflexion torque of the uninjured limb. A speckle tracking algorithm was used to track proximal‐distal movement of the tendon tissue at 6 antero‐posterior locations. Two‐way repeated measures ANOVA for peak tendon displacement was performed. K‐means clustering was used to classify patients according to AT displacement patterns. The difference in peak relative displacement across locations was larger in the uninjured (1.29 ± 0.87 mm) than the injured limb (0.69 ± 0.68 mm), with a mean difference (95% CI) of 0.60 mm (0.14‐1.05 mm, P < .001) between limbs. For the uninjured limb, cluster analysis formed 3 groups, while 2 groups were formed for the injured limb. The three distinct patterns of AT displacement during isometric plantarflexion in the uninjured limb may arise from subject‐specific anatomical variations of AT sub‐tendons, while the two patterns in the injured limb may reflect differential recovery after ATR with non‐surgical treatment. Subject‐specific tendon characteristics are a vital determinant of stress distribution across the tendon. Changes in stress distribution may lead to variation in the location and magnitude of peak displacement within the free AT. Quantifying internal tendon displacement patterns after ATR provides new insights into AT recovery.
Analyzing the association between emotions and socioeconomic characteristics of census tracts via user‐generated content
Authors: Yu Xinkai , Fei Teng , Li Xiang
Published: January 2021

Environmental and socioeconomic characteristics of places continuously influence human emotions. To understand the quality of human life, human emotions must be effectively evaluated and their connections with socioeconomic characteristics must be determined. Social computing tools can extract emotional information from massive user‐generated content (UGC); thus, we proposed an approach that correlates residents' emotions with the socioeconomic characteristics of place based on census tracts from New York State. First, demographic and economic characteristic data from census tracts were obtained and clustered; then, an emotion recognition technique extracted human emotions quantitatively from the UGC. Applying the Apriori algorithm and logistic regression analysis showed that the socioeconomic characteristics that may significantly influence residents’ emotions include family situation, race, and economic status. Local policymakers can use the proposed approach to compare the quality of human life in different regions over a large scale via UGC and identify socioeconomic characteristics to formulate policies to improve residents’ well‐being and welfare.
RATS: A Robotic Arm Training System Designed for Rats
Authors: Zhang Haohan , Luna Tatiana , Yang Lillian , Martin John , Agrawal Sunil
Published: January 2021

This paper presents a novel robotic system to characterize and retrain reaching in rats. This robot is intended to be a research platform for the rehabilitation of forelimb movements in rats. In this paper, we focus on the design of this robotic system. We present the design requirements, mathematical models, and details of the physical device. A parallel mechanism with a special alignment of the component chains is used to accommodate observed reaching motions of a rat’s forelimb. Additionally, we demonstrate the use of this robot to record forelimb trajectories. Three healthy rats were used to record repeated reaching motions while the robot applied nearly zero force. We believe that this robotic system can be used in future training studies with rats who have impaired arm motions due to a neurological insult.
StressGAN: A Generative Deep Learning Model for Two-Dimensional Stress Distribution Prediction
Authors: Jiang Haoliang , Nie Zhenguo , Yeo Roselyn , Farimani Amir Barati , Kara Levent Burak
Published: January 2021

Using deep learning to analyze mechanical stress distributions is gaining interest with the demand for fast stress analysis. Deep learning approaches have achieved excellent outcomes when utilized to speed up stress computation and learn the physical nature without prior knowledge of underlying equations. However, most studies restrict the variation of geometry or boundary conditions, making it difficult to generalize the methods to unseen configurations. We propose a conditional generative adversarial network (cGAN) model called StressGAN for predicting 2D von Mises stress distributions in solid structures. The StressGAN model learns to generate stress distributions conditioned by geometries, loads, and boundary conditions through a two-player minimax game between two neural networks with no prior knowledge. By evaluating the generative network on two stress distribution datasets under multiple metrics, we demonstrate that our model can predict more accurate stress distributions than a baseline convolutional neural-network model, given various and complex cases of geometries, loads, and boundary conditions.
Modeling of Natural Gas Composition Effect on Low NOx Burners Operation in Heavy Duty Gas Turbine
Authors: Romano Serena , Meloni Roberto , Riccio Giovanni , Nassini Pier Carlo , Andreini Antonio
Published: January 2021

This paper addresses the impact of natural gas composition on both the operability and emissions of lean premixed gas turbine combustion system. This is an issue of growing interest due to the challenge for gas turbine manufacturers in developing fuel-flexible combustors capable of operating with variable fuel gases while producing very low emissions at the same time. Natural gas contains primarily methane (CH4) but also notable quantities of higher order hydrocarbons such as ethane (C2H6) can also be present. A deep understanding of natural gas combustion is important to obtain the highest combustion efficiency with minimal environmental impact. For this purpose, Large Eddy Simulations of an annular combustor sector equipped with a partially premixed burner are carried out for two different natural gas compositions with and without including the effect of flame strain rate and heat loss resulting in a more adequate description of flame shape, thermal field, and extinction phenomena. Promising results, in terms of NOx, compared against available experimental data, are obtained including these effects on the flame brush modeling, enhancing the fuel-dependency under nonadiabatic condition.
Durable Abrasive Tip Design for Single Crystal Turbine Blades
Authors: Nagy Douglas , Tollett Robert
Published: January 2021

In order to create and maintain peak efficiency in turbine stages, it is useful to minimize hot air leakage over blade tips. For unshrouded blades, this means creating minimal clearance over the airfoil tip with rub-tolerate zero-gap materials systems. In this study, a refractory abrasive tip material (ABT) was developed and applied to a plain turbine blade tip to work in conjunction with an abradable coating on the tip-shoe. Process development efforts resulted in abrasive material that could be as much as 2 mm thick. Further, the abrasive media included imbedded grits that would remain in back-up until such time as they were exposed and were pressed into service. Application methods of both furnace brazing and induction brazing were explored as were pre- and post-consolidation net shaping. Evaluation testing included compatibility for the application process onto single-crystal blades. Performance testing included rub-rig testing and long-term oxidation testing. Service testing included commercial engine operation for 14,000 h followed by metallurgical reevaluation. Service performance was mechanically successful, although some material transfer from the tip-shoe was observed which decreased the abrasive nature of the tip. Metallurgically, some intergranular oxidation was observed, but the grits themselves were well retained and were sufficiently refractory to avoid microstructural or oxidation degradation. A production implementation of the coating by an induction heating process is shown.
Two-Stage Robust Tracking Controller for Linear Systems With Known Uncertainty Using Filtered Basis Functions
Authors: Ramani Keval S. , Okwudire Chinedum E.
Published: January 2021

There is growing interest in the use of the filtered basis functions (FBF) approach to track linear systems, especially nonminimum phase (NMP) plants, because of the distinct advantages it presents as compared to other popular methods in the literature. The FBF approach expresses the control input to the plant as a linear combination of basis functions. The basis functions are forward filtered through the plant dynamics and the coefficients of the linear combination are selected such that the tracking error is minimized. This paper proposes a two-stage robust filtered basis functions approach for tracking control of linear systems in the presence of known uncertainty. In the first stage, the nominal model for filtering the basis functions is selected such that a Frobenius norm metric which considers the known uncertainty is minimized. In the second stage, an optimal set of basis functions is selected such that the effect of uncertainty is minimized for the nominal model selected in the first stage. Experiments on a 3D printer, demonstrate up to 7 times improvement in tracking performance using the proposed method as compared to the standard FBF approach.
Optimal Tuning of Single-Axis Satellite Attitude Control Parameters Using Genetic Algorithm
Authors: Khalili Nasser , Ghorbanpour Amin
Published: January 2021

This paper studies the optimization of control parameters for single-axis attitude control of a rigid satellite using thrusters. It is desired to tune the control parameters to minimize the number of thruster firings. The motion task is defined as an attitude pointing maneuver from arbitrary initial condition to the rest. To this end, a control loop with pulse-width pulse-frequency modulator is suggested. The control actuators are pairs of identical non-ideal thrusters which each one produces torque in one direction around the control axis. A novel approach is proposed to model the dynamics of thruster with a design parameter which shapes the response of the actuator. Nine parameters of the control loop, e.g. feedback gains, modulator parameters, and thruster dynamics, are selected as decision variables. Genetic algorithm is used to find the optimal values of the variables such that the firing is minimized. It is shown that firing minimization requires a sluggish thruster. Moreover, to study the effect of deviation from optimal value on number of thruster firings and fuel consumption, a sensitivity analysis is performed. Based on sensitivity analysis, an optimal range is suggested for each parameter where both number of firing and fuel consumption are minimized.
Traffic Prediction for Merging Coordination Control in Mixed Traffic Scenarios
Authors: Shao Yunli , Rios-Torres Jackeline
Published: January 2021

Connected and autonomous vehicles (CAVs) have the potential to bring in safety, mobility, and energy benefits to transportation. The control decisions of CAVs are usually determined for a look-ahead horizon based on previewed traffic information. This requires an effective prediction of future traffic conditions and its integration with the CAV control framework. However, the short-term traffic prediction using information from connectivity is a challenging research topic, especially for mixed traffic scenarios. This work focuses on the development of a traffic prediction framework for a merging coordination controller. The previously developed merging controller coordinates the merging sequence and travel speed of CAVs to maximize the energy efficiency and overall mobility. In mixed traffic scenarios, the controller receives information regarding the position of all the vehicles traveling inside a control zone and controls the desired speed of all CAVs. The controller has no control on the human-driven vehicles. The merging controller does not have direct information or an explicit prediction on the behaviors of human-driven vehicles. Aiming to improve the performance of the merging controller in various mixed traffic conditions, a traffic prediction algorithm is developed and evaluated in this work. The performance of this traffic prediction algorithm is investigated for various penetration rates of connectivity for a single-lane secondary road merging to a single-lane primary road. The results show that compared to a constant speed assumption of human-driven vehicles, the proposed traffic prediction algorithm is able to reduce the prediction error of the arrival time of human-driven vehicles at the merging zone by more than 50%.
Prioritized Foraging Strategies for an Ant Colony-Inspired Swarm System
Authors: Iyer Hari R. , Kumar Manish , Ramakrishnan Subramanian
Published: January 2021

We investigate ant-colony-inspired foraging strategies for enhancing the efficiency of a swarm of artificial agents engaged in a search-and-retrieval application. First, we extend a mathematical model of ant foraging to account for the evolution of the information collected during search-and-retrieval over time. We then use the extended model to numerically investigate the efficiency of search-and-retrieval under the two distinct cases of non-depleting information and depleting information at the sources. In the former case, we obtain optimal ranges of parameter values of the ant foraging model that enhance efficiency. In the latter case, we find that appropriately designed deposition functions in the model can induce self-organization in the swarm and therefore prioritize the collection of quickly depleting information. The ability to prioritize is highly desirable in a swarm for search-and-retrieval applications and, to our knowledge, induced emergent behavior resulting in prioritization capabilities has not been reported in swarms inspired by ant foraging. The results are expected to be broadly significant for swarm robotics as well as in applications such as the Travelling Salesman Problem (TSP) with time-varying profit.
A Control-Oriented Dynamical Model of Deposited Droplet Volume in Electrohydrodynamic Jet Printing
Authors: Spiegel Isaac A. , van de Laar Tom , Oomen Tom , Barton Kira
Published: January 2021

Electrohydrodynamic jet printing (e-jet printing) is a nascent additive manufacturing process most notable for extremely high resolution printing and having a vast portfolio of printable materials. These capabilities make e-jet printing promising for applications such as custom electronics and biotechnology fabrication. However, reliably fulfilling e-jet printing’s potential for high resolution requires delicate control of the volume deposited by each jet. Such control is made difficult by a lack of models that both capture the dynamics of volume deposition and are compatible with the control schemes relevant to e-jet printing. This work delivers such a model. Specifically, this work introduces a definition of “droplet volume” as a dynamically evolving variable rather than a static variable, and uses this definition along with analysis of high speed microscope videos to develop a hybrid dynamical system model of droplet volume evolution. This model is validated with experimental data, which involves the contribution of a novel technique for extracting consistent droplet volume measurements from videos.
Vibrational Control of a 2-Link Mechanism
Authors: Ahmed Zakia , Tahmasian Sevak , Woolsey Craig A.
Published: January 2021

This paper describes vibrational control and stability of a planar, horizontal 2-link mechanism using translational control of the base pivot. The system is a 3-DOF two-link mechanism that is subject to torsional damping, torsional stiffness, and is moving on a horizontal plane. The goal is to drive the averaged dynamics of the system to a desired configuration using a high-frequency, high-amplitude force applied at the base pivot. The desired configuration is achieved by applying an amplitude and angle of the input determined using the averaged dynamics of the system. We find the range of stable configurations that can be achieved by the system by changing the amplitude of the oscillations for a fixed input angle and oscillation frequency. The effects of varying the physical parameters on the achievable stable configurations are studied. Stability analysis of the system is performed using two methods: the averaged dynamics and averaged potential.
An Integrative Behavioral-Based Physics-Inspired Approach to Traffic Congestion Control
Authors: Rastgoftar Hossein , Jeannin Jean-Baptiste , Atkins Ella
Published: January 2021

This paper offers an integrative behavioral-based physics-inspired approach to model and control traffic congestion in an efficient manner While existing physics-based approaches commonly assign density and traffic flow states with the Fundamental Diagram, this paper specifies the flow-density relation using past traffic behavior (intent) recorded over a time sliding window with constant horizon length. With this approach, traffic coordination trends can be consistently learned and incorporated into traffic planning. This is integrated with mass conservation law (continuity) to model traffic coordination as a probabilistic process and obtain traffic feasibility conditions using linear temporal logic. By spatial discretization of a network of inter-connected roads (NOIR), the NOIR is represented by a graph with inlet boundary nodes, outlet boundary nodes, and interior nodes. The paper offers a boundary control approach to manage congestion through the inlet boundary nodes. More specifically, model predictive control (MPC) is applied to control traffic congestion through the boundary of the traffic network. Therefore, the optimal boundary in flow is assigned as the solution of a constrained quadratic programming problem with equality and inequality constrained. The simulation results shows that the proposed MPC boundary controller can successfully control the traffic through the inlet boundary nodes where traffic reaches the steady state condition.
3D modeling of electron-beam lithographic process from scanning electron microscope images
Authors: Li Dehua , Lee Soo-Young , Choi Jin , Kim Seom-Beom , Jeon Chan-Uk
Published: January 2021

Computational lithography is typically based on a model representing the lithographic process where a typical model consists of three components, i.e., line spread function, conversion formula (exposure-to-developing rate conversion), and noise process (exposure fluctuation). In our previous study, a practical approach to modeling the e-beam lithographic process by deriving the three components directly from SEM images was proposed. However, a 2D model of a substrate system was employed; i.e., the exposure variation along the resist-depth dimension was not considered. In this study, the possibility of improving the accuracy of modeling using a 3D model is investigated. The 3D model is iteratively determined by modeling the critical dimension estimated based on the model to those measured in SEM images. This paper describes the 3D modeling approach and new optimization procedures and discusses in detail the results from an extensive simulation for an accuracy analysis of the 3D modeling approach.
Model-based convolutional neural network approach to underwater source-range estimation
Authors: Chen R. , Schmidt H.
Published: January 2021

This paper is part of a special issue on machine learning in acoustics. A model-based convolutional neural network (CNN) approach is presented to test the viability of this method as an alternative to conventional matched-field processing (MFP) for underwater source-range estimation. The networks are trained with simulated data generated under a particular model of the environment. When tested with data simulated in environments that deviate slightly from the training environment, this approach shows improved prediction accuracy and lower mean-absolute-error (MAE) compared to MFP. The performance of this model-based approach also transfers to real data, as demonstrated separately with field data collected in the Beaufort Sea and off the coast of Southern California. For the former, the CNN predictions are consistent with expected source range while for the latter, the CNN estimates have lower MAE compared to MFP. Examination of the trained CNNs' intermediate outputs suggests that the approach is more constrained than MFP from outputting very inaccurate predictions when there is a slight environmental mismatch. This improvement appears to be at the expense of decreased certainty in the correct source range prediction when the environment is precisely modeled.
Media Portrayals of Athlete-Perpetrated Intimate Partner Violence: An Examination of the Social Ecological Model, Race, and Communication Perceptions
Authors: Scarduzio Jennifer A. , Walker Christina S. , Lewis Nicky , Limperos Anthony M.
Published: January 2021

This study examined how participants responded to incidents of athlete-perpetrated intimate partner violence in two separate contexts: one featuring an athlete from a league that is at peak popularity among sports audiences (National Football League; NFL) and one featuring an athlete from an up-and-coming league that currently has a lower standing in professional sports (Ultimate Fighting Championship League; UFC). The authors used the social ecological model to qualitatively analyze participant perceptions about athlete-perpetrated intimate partner violence composite news packages. For the purpose of this study specifically, they centered on 1,124 responses to one of the open-ended qualitative questions asked in a larger quantitative experiment. The authors found that the participants most frequently attributed the perpetrator’s behavior to either individual or relationship-level reasons and that there were differences in the level attributed for participants of different races and ethnicities. They also determined that the participants were more likely to ascribe the violence to the suspect’s job (i.e., athlete) if they were a UFC fighter than an NFL player. Theoretical extensions of the social ecological model and practical implications for journalists, the media, and fans are offered.
Evaluation of Shoulder and Knee Isokinetic Strength Profile Among Elite Adolescent Badminton Players
Authors: Zulfikri Noh , Selvanayagam Victor S. , Yusof Ashril
Published: January 2021

Context:Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensiﬁed. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist–antagonist ratio, and bilateral deﬁcit among adolescents where age- and sex-associated growth and development should be considered.Objective:To evaluate strength proﬁle of the upper and lower limbs among adolescent elite Malaysian badminton players.Design:Cross-sectional study.Setting:Laboratory.Participants:Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13–14 y old and 15–17 y old, respectively).Main Outcome Measure(s):Strength (absolute and normalized) of the external/internal rotators of the shoulder and ﬂexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deﬁcits were measured.Results:Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups.Conclusions:For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.
Convergent Evolution of a Promiscuous 3-Hydroxypropionyl-CoA Dehydratase/Crotonyl-CoA Hydratase in
Crenarchaeota
and
Thaumarchaeota
Authors: Liu Li , Brown Philip C. , Könneke Martin , Huber Harald , König Simone , Berg Ivan A.
Published: January 2021

Inorganic carbon fixation is the most important biosynthetic process on Earth and the oldest type of metabolism. The autotrophic HP/HB cycle functions in
Crenarchaea
of the order
Sulfolobales
and in ammonia-oxidizing
Archaea
of the phylum
Thaumarchaeota
that are highly abundant in marine, terrestrial, and geothermal environments.
Interplay of Antibody and Cytokine Production Reveals CXCL13 as a Potential Novel Biomarker of Lethal SARS-CoV-2 Infection
Authors: Horspool Alexander M. , Kieffer Theodore , Russ Brynnan P. , DeJong Megan A. , Wolf M. Allison , Karakiozis Jacqueline M. , Hickey Brice J. , Fagone Paolo , Tacker Danyel H. , Bevere Justin R. , Martinez Ivan , Barbier Mariette , Perrotta Peter L. , Damron F. Heath
Published: January 2021

The SARS-CoV-2 pandemic is continuing to impact the global population, and knowledge of the immune response to COVID-19 is still developing. This study assesses the interplay of different parts of the immune system during COVID-19 disease.
Ductal and lobular carcinoma in situ arising within an enlarging biopsy proven fibroadenoma
Authors: Feliciano Yara Z , Freire Rochelle , Net Jose , Yepes Monica
Published: January 2021

The diagnosis via core needle biopsy of concurrent ductal carcinoma in situ and lobular carcinoma in situ within an enlarging previously biopsied benign fibroadenoma in women in their 40s is rare. Several case reports have described the occurrence of malignant changes within fibroadenomas, usually as an incidental finding following excision, and few reports have documented the transition of a fibroadenoma to malignancy. The current case report emphasises the importance of re-biopsying enlarging fibroadenomas, even with otherwise maintained benign appearing features on imaging, in women in their 40s, in order to exclude the possibility of malignancy.
Ibrutinib-associated necrotic nasal lesion and pulmonary infiltrates
Authors: Saling Christopher , Feller Fionna , Vikram Holenarasipur R
Published: January 2021

Herein, we report a case of a 68-year-old woman receiving ibrutinib for chronic lymphocytic leukaemia, who presented with septic shock and a progressive necrotic lesion on her nose. Surgical pathology of the nasal lesion revealed evidence of tissue necrosis, and both tissue and blood culture grewPseudomonas aeruginosa. A diagnosis of ecthyma gangrenosum was made. Additional investigations also led to the discovery of invasive pulmonary aspergillosis. To our knowledge, this is the first case of ecthyma gangrenosum secondary toPseudomonassepsis and concurrent invasive pulmonary aspergillosis associated with ibrutinib use.
Gorham-Stout disease of the mandible, manubrium and cervical spine presenting as bilateral chylothorax
Authors: Thompson Ashley Ann , Patrawala Sara
Published: January 2021

Gorham-Stout disease (GSD) is an extremely rare musculoskeletal disease of unknown aetiology characterised by non-neoplastic proliferation of vascular and lymphatic channels causing massive osteolysis, typically affecting younger individuals. Chylothorax is a known complication of GSD which is postulated to occur from thoracic spine involvement leading to pleural or thoracic duct invasion. In our case, bilateral chylothorax developed in a 60-year-old woman without any thoracic spine involvement of her disease, challenging the proposed mechanism. Despite bilateral pleural drainage and escalating doses of sirolimus, she ultimately developed respiratory failure and shock and succumbed to her illness. Overall survival of GSD is unknown, but when complicated by chylothorax, prognosis is typically poor. GSD represents a diagnostic and management challenge due to the paucity of knowledge surrounding its aetiology and management. These patients require multidisciplinary coordinated care. It is also important to note its high mortality when associated with chylothorax in particular.
Small bowel intussusception andEnterobius vermicularisinfestation in a 20-year-old woman
Authors: Pryma Collin , Youssef David , Evans David , Yang Hui-Min
Published: January 2021

A 20-year-old woman presented with abdominal pain and MRI findings of intussusception of the distal small bowel with no identifiable lead point and no visualisation of the appendix. A diagnostic laparoscopy succeeded in manually reducing the intussusception but was unable to find any candidate lead point. Intraoperatively, hyperperistalsis was observed throughout the small bowel which seemed prone to transient intussusception. Incidental appendectomy revealed an uninflamed appendix withEnterobius vermicularis(pinworm) infestation, the most common parasite present in appendectomy specimens worldwide. Although intussusception in young adults is an uncommon occurrence, the unique nature of this case is amplified by the concurrent finding ofE. vermicularisinfection of the appendix in an adolescent in western Canada, a phenomenon normally observed in paediatric populations with higher incidence in tropical areas. Although the mechanism of intussusception in this patient remains unclear, it is hypothesised thatE. vermiculariscolonisation acted as an irritant stimulating intestinal hypercontractility with resulting intussusception. Successful medical eradication of the pinworm in this individual may prevent future recurrence.
Gaze-evoked deformations of the optic nerve head in thyroid eye disease
Authors: Fisher Liam K , Wang Xiaofei , Tun Tin A , Chung Hsi-Wei , Milea Dan , Girard Michael J A
Published: January 2021

Purpose

To assess gaze evoked deformations of the optic nerve head (ONH) in thyroid eye disease (TED), using computational modelling and optical coherence tomography (OCT).

Methods

Multiple finite element models were constructed: one model of a healthy eye, and two models mimicking effects of TED; one with proptosis and another with extraocular tissue stiffening. Two additional hypothetical models had extraocular tissue softening or no extraocular tissue at all. Horizontal eye movements were simulated in these models. OCT images of the ONH of 10 healthy volunteers and 1 patient with TED were taken in primary gaze. Additional images were recorded in the same subjects performing eye movements in adduction and abduction. The resulting ONH deformation in the models and human subjects was measured by recording the ‘tilt angle’ (relative antero-posterior deformation of the Bruch’s membrane opening).

Results

In our computational models the eyes with proptosis and stiffer extraocular tissue had greater gaze-evoked deformations than the healthy eye model, while the models with softer or no extraocular tissue had lesser deformations, in both adduction and abduction. In healthy subjects, the mean tilt angle was 1.46°±0.25 in adduction and −0.42°±0.12 in abduction. The tilt angle measured in the subject with TED was 5.37° in adduction and −2.21° in abduction.

Conclusion

Computational modelling and experimental observation suggest that TED can cause increased gaze-evoked deformations of the ONH.
International experiences in the development and implementation of guideline-based quality indicators: a qualitative study
Authors: Nothacker Monika , Bolster Marie , Steudtner Mirco , Arnold Katrin , Deckert Stefanie , Becker Monika , Kopp Ina , Schmitt Jochen
Published: January 2021

Objectives

Evidence-based clinical guidelines play an important role in healthcare and can be a valuable source for quality indicators (QIs). However, the link between guidelines and QI is often neglected and methodological standards for the development of guideline-based QI are still lacking. The aim of this qualitative study was to get insights into experiences of international authors with developing and implementing guideline-based QI.

Setting

We conducted semistructured interviews via phone or skype (September 2017–February 2018) with guideline authors developing guideline-based QI.

Participants

15 interview participants from eight organisations in six European and North American countries.

Methods

Organisations were selected using purposive sampling with a maximum variation of healthcare settings. From each organisation a clinician and a methodologist were asked to participate. An interview guide was developed based on the QI development steps according to the ‘Reporting standards for guideline-based performance measures’ by the Guidelines International Network. Interviews were analysed using qualitative content analysis with deductive and inductive categories.

Results

Interviewees deemed a programmatic approach, involvement of representative stakeholders with clinical and methodological knowledge and the connection to existing quality improvement strategies important factors for developing QI parallel to or after guideline development. Methodological training of the developing team and a shared understanding of the QI purpose were further seen conducive. Patient participation and direct patient relevance were inconsistently considered important, whereas a strong evidence base was seen essential. To assess measurement characteristics interviewees favoured piloting, but often missed implementation. Lack of measurability is still experienced a serious limitation, especially for qualitative aspects and individualised care.

Conclusion

Our results suggest that developing guideline-based QI can succeed either parallel to or following the guideline process with careful planning and instruction. Strategic partnerships seem key for implementation. Patient participation and relevance, measurement of qualitative aspects and piloting are areas for further development.

Trial registration number

German Clinical Trials Registry (DRKS00013006).
Impact of dementia education and training on health and social care staff knowledge, attitudes and confidence: a cross-sectional study
Authors: Parveen Sahdia , Smith Sarah Jane , Sass Cara , Oyebode Jan R , Capstick Andrea , Dennison Alison , Surr Claire A
Published: January 2021

Objectives

The aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training.

Design

Cross-sectional survey study. Data collection occurred in 2017.

Settings

Health and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes.

Participants

All health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%).

Outcomes

Knowledge, attitude and confidence of health and social care staff.

Results

Hierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01).

Conclusion

The results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence.
Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia
Authors: Zhang Meng , Tang Jun , He Yang , Li Wenxing , Chen Zhong , Xiong Tao , Qu Yi , Li Youping , Mu Dezhi
Published: January 2021

Objective

Hyperbilirubinemia is one of the most common clinical symptoms in newborns. To improve patient outcomes, evidence-based and implementable guidelines are required. However, clinical guidelines may vary in quality, criteria and recommendations among regions and countries. In this study, we aimed to systematically assess the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation (AGREE)-II instrument and summarise the specific recommendations for neonatal hyperbilirubinemia in order to provide suggestions for future guideline development.

Design

Systematic review.

Interventions

We searched the PubMed, Embase, Medline and guideline databases for relevant articles on 10 April 2020. The studies were screened by two independent reviewers according to our inclusion criteria. Two reviewers independently extracted the descriptive data. Four appraisers assessed the guidelines using the AGREE-II instrument.

Results

Our systematic review appraised 12 clinical practice guidelines for the diagnosis and management of neonatal hyperbilirubinemia. The 12 guidelines achieved an average score of 36%–89%. The guidelines received the highest scores for clarity of presentation and lowest scores for rigour of development. Most recommendations for diagnosis were relatively consistent, but recommendations regarding risk factors, the initiating threshold of treatment and pharmacotherapy varied.

Conclusions

Our study revealed that current guidelines vary in the quality of the developing process and are inconsistent with regards to recommendations. Future guidelines should afford more attention to the quality of methodologies in guideline development, and more qualified evidence is needed to standardise the initiating threshold of treatment for neonatal hyperbilirubinemia.