bluuebunny/crossref_metadata_2025 huggingface dataset:
A general inverse control model of a magneto-rheological damper based on neural network
Authors: Yan Yaya , Dong Longlei , Han Yi , Li Weishuo
Published: January 2021

Because of the nonlinear hysteresis characteristics of the magneto-rheological damper, the damper’s inverse model has disadvantages of low fitting accuracy and poor practicality. Therefore, in this study, an optimized genetic algorithm has been proposed to optimize the back propagation neural network’s initial weights and threshold. Compared with other damper controllers, the proposed inverse model improves the control current’s prediction accuracy and tracks the desired damping force in real time. Moreover, the proposed inverse model and designed fuzzy controller are applied to the 1/4 vehicle suspension system simulation. The obtained results show that the optimized neural network model can be applied to a practical control. The root mean square value of body acceleration of semi-active suspension is lower than that of passive suspension under different road excitation. This method provides a foundation for the accurate modeling and semi-active control of the magneto-rheological damper.
Adaptive fault-tolerant boundary vibration control for a flexible aircraft wing against actuator and sensor faults
Authors: Gao Shiqi , Liu Jinkun
Published: January 2021

The vibration control problem was investigated in this study in the presence of unknown loss of actuator effectiveness fault and loss of sensor effectiveness fault in a flexible aircraft wing system. A series of partial differential equations was used as the mathematical model of the wing with unknown boundary disturbances. An adaptive fault-tolerant boundary controller was designed accordingly. All signals of the closed-loop control system are globally uniformly bounded and the controlled state asymptotically converges. Numerical simulations were conducted to validate the proposed control scheme.
Dynamic effects of turbulent crosswinds on a suspended monorail vehicle–curved bridge coupled system
Authors: Bao Yulong , Xiang Huoyue , Li Yongle , Hou Guangyang
Published: January 2021

The present article proposes a novel framework for analyzing the dynamic responses of suspended monorail vehicles running over curved bridges under crosswinds. In this model, the curved bridge model is established with the finite element method and vehicles are simulated as a multibody system. Subsequently, a wind model is proposed with the wind tunnel test, spectral representation method, and yaw wind-decomposition method, taking into account the effects of the angle between the wind and vehicle changes when vehicles pass through the curved bridge. Finally, a suspended monorail curved bridge is analyzed to demonstrate the effect of the wind model on the vibration of the system. The results show that wind direction has a great effect on the lateral dynamic response of curved bridges, the lateral force of guiding tire, and the vertical force of running tire. The influence of crosswind on the dynamic response of the vehicle decreases with the increase of running time of vehicle on curved bridges.
Knowledge co-production in academic-practitioner research collaboration: An expanded perspective on power
Authors: McCabe Angela , Osegowitsch Tom , Parker Rachel , Cox Stephen
Published: January 2021

Knowledge co-production within academic-practitioner research collaborations is a promising means to address the pressing issue of research impact. Yet current theorising is hampered by a limited appreciation of power in the relationship between research partners. In this study, we explore various types of power and their effects on knowledge co-production in government-funded research collaborations. Drawing on interviews with academics and practitioners working on Australian Research Council Linkage Scheme projects, we initially document the prominence of structural and normative types of power, alongside resource power. We further show that both structural and normative power fail to conform to key principles of knowledge co-production. As a result, many of the projects studied fell short of the knowledge co-production ideal. Our investigation leads us to identify a boundary condition: knowledge co-production theory in its current form is bounded by resource power conditions. Our expanded perspective provides for an elaboration of knowledge co-production theory. We also explore the implications of our findings for business schools in search of impact.
PAVING the Path to Wellness for Breast Cancer Survivors: Lifestyle Medicine Education and Group Interventions
Authors: Comander Amy , Frates Beth , Tollefson Michelle
Published: January 2021

There are over 3.5 million breast cancer survivors living in the United States. Key elements of breast cancer survivorship care include monitoring for disease recurrence, addressing medical and psychosocial consequences of treatment, and educating about lifestyle interventions which decrease risk of recurrence, improve quality of life, and improve outcome. We have developed the PAVING the Path to Wellness Program for Breast Cancer Survivors in order to provide education on evidence-based topics from lifestyle medicine, with the goal to help women adopt healthy habits and improve well-being after cancer treatment. The 12-week program includes all 6 pillars of lifestyle medicine, as well as positive psychology, gratitude, and goal setting work. The PAVING the Path to Wellness Program for Breast Cancer Survivors empowers breast cancer survivors with knowledge regarding evidence-based lifestyle recommendations and helps them achieve an improved sense of well-being following treatment. On completion of the program, participants specifically reported an improvement in attitude and well-being. Next steps involve developing a strategy to offer this program to a larger group of cancer survivors.
Kindness as a Stress Reduction–Health Promotion Intervention: A Review of the Psychobiology of Caring
Authors: Fryburg David A.
Published: January 2021

Chronic stress is a ubiquitous problem shouldered by many people worldwide. Although the stressors are myriad (eg, loneliness, finances, health, discrimination), the corporal response to them either causes or exacerbates mental and physical illness, including depression, anxiety, and cardiovascular disease. Identifying efficient ways to help people buffer their response and promote resilience and wellness is critical to improving overall health. Positive interpersonal connection is a proven way to promote resilience and happiness. It is associated with decreased mortality and markers of better health. Kindness and caring are prosocial behaviors that build positive interpersonal connections and can uplift both the giver and receiver. Simply seeing kindness and caring activates the neuropsychology of kindness, elevating the viewer and promoting generosity, interpersonal connection, and inclusion. That augmenting positive emotions, enhancing interpersonal connection, and inducing prosocial behavior change are possible through seeing kindness opens the opportunity to bolster resilience in higher stress settings like health care. In a recent study, watching kindness media in a health care setting rapidly increased self-reported feelings of happiness, calm, gratitude, and being inspired. Viewers were significantly more generous. Providing staff and patients with a nonjudgmental lift to enhance caring interactions through kindnesses media can be an important, low-cost adjunct to improving the healthcare environment.
Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study
Authors: Iweama Cylia Nkechi , Agbaje Olaoluwa Samson , Umoke Prince Christian Ifeanachor , Igbokwe Chima Charles , Ozoemena Eyuche Lawretta , Omaka-Amari Nnenna Lois , Idache Benjamin Mudi
Published: January 2021

Introduction:

Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria.

Methods:

A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05)

Results:

Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence.

Conclusion:

Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.
The Importance of Belonging: A Study About Positioning Processes in Youths’ Online Communication
Authors: Eek-Karlsson Liselotte
Published: January 2021

The aim of this study is to contribute with knowledge of young peoples’ communication in social media. A total of 32 boys and girls aged 14 to 15 years old, from two schools in Sweden, participated in this study. A hermeneutic interpretation process formed the basis of the analysis process. The data were thematized based on patterns found throughout the material. Theoretical perspectives concerning normalization processes related to the use of language were connected to the data to deepen the understanding of themes and patterns. The result shows that there is an ongoing negotiation with reciprocal processes in which both boys and girls have lots of reference points to consider, when they interact online. There are social norms and rules related to the online arena itself, as well as normative expectations connected to gender orders. The gender category is intertwined with sexuality and group hierarchies, which give the youth different power positions to act online.
“Tennis Leg”: A State-of-the-Science Review
Authors: Domeracki Sandra J.
Published: January 2021

Background:

Tennis leg (TL), a musculotendon injury to the gastrocnemius, has been associated with the eponymous sport since 1883. This article examines the historical context of TL as a sports compared with an occupational injury. This was juxtaposed with the history of tennis elbow, a tendon injury to the upper extremity also associated with sport.

Methods:

Bibliometric databases (PubMed, Web of Science [WOS], Hathi Trust) were keyword-searched; relevant citations were investigated in depth.

Results:

The search yielded 71 citations for TL (PubMed). The majority ( n = 43) were key word linked to sport terms; only one was linked to work-related search terms. Furthermore, none of the top four cited publications (Web of Science) alluded to work-related risk factors in TL in full textual analysis. Hathi Trust yielded the earliest work-related case, reported in a non-biomedical source. Tennis elbow was more frequently reported ( n = 189 citations in PubMed) and more frequently linked ( n = 193; 9.7%) to occupational search terms.

Conclusion/Application to Practice:

The history of TL, juxtaposed with tennis elbow, demonstrates how nosology can influence but does not wholly explain disease attribution, potentially to the detriment of taking into account occupational causality. The lack of recognition of occupational factors revealed in this literature search was notable because TL occurred most commonly in males of working age. By providing perspective on how historical context and nosology can affect the conceptualization of disease, this review may help inform prevention, treatment, and regulatory policy.
Registered Nurses’ Experiences Taking Breaks on Night Shift: A Qualitative Analysis
Authors: Landis Tullamora T. , Wilson Marian , Bigand Teresa , Cason Moriah
Published: January 2021

Background:

Fatigue mitigation strategies among night shift workers can include deliberate use of restful work breaks, taking naps, and consuming caffeine. However, nurses have frequently reported missing break opportunities, and the rationale for missed breaks remains unclear. The purpose of this study was to describe and interpret the lived experience of hospital night shift nurses taking breaks and the meaning of this phenomenon as it relates to the workplace.

Methods:

Registered nurses ( n = 16) from a U.S. community hospital were interviewed about how they took rest breaks during their shift. Data were analyzed with methods consistent to interpretive phenomenology.

Findings:

Identified themes about the breaks included (a) breaks are a time to eat, (b) breaks are inconsistently supported by unit-level structures and processes, and (c) breaks are a luxury, not a right.

Conclusions/Applications to Practice:

Nurses in this study reported an absence of consistent and restorative breaks. Organizations should analyze gaps within systems and processes to optimize a consistent, restorative nature of the break experience among nurses working night shift.
Hospital Nursing Staff Perceptions of Resources Provided by Their Organizations During the COVID-19 Pandemic
Authors: Cho Hyeonmi , Sagherian Knar , Steege Linsey M.
Published: January 2021

Background:

The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted the health and psychological well-being of hospital nursing staff. While additional support is needed to better cope with increased job stressors, little is known about what types of hospital resources have been provided and how nursing staff perceive them. This study addressed this gap by describing nursing staff perceptions of resources provided by hospitals during the COVID-19 pandemic in the United States.

Methods:

Registered nurses and nursing assistants who were working in hospitals during the pandemic were recruited to an online survey via social media posts and emails between May and June 2020. A total of 360 free-text responses to an open-ended survey question were analyzed using content analysis.

Results:

Over half of participants reported being provided with hospital resources. “Basic needs” resources that included food on-site, groceries, and childcare support were the most frequently reported compared with four other types of resources (personal health and safe practice, financial support, managerial support, communication). Four themes emerged related to staff perceptions of support: community support, unequal benefits, decreasing resources, and insufficient personal protective equipment.

Conclusion:

Our findings can assist organizational leaders in the planning and allocation of different types of resources that are meaningful to nursing staff and thus ensure sustainability, optimal performance, and worker well-being during crises.
Exploring Challenges of Online Education in COVID Times
Authors: Pandit Deepak , Agrawal Swati
Published: January 2021

This work is an attempt to explore aspects of online teaching and its related impact from the perspective of stakeholders in education. The paper outlines faculty experience and effectiveness in the online teaching environment, perspective requisition of students, and the support and resource building called for from academic leaders. We use observations, viewpoints, practical steps taken or needed by higher education institutions and universities in India. The primary and secondary data are content analysed and are further informed by literature. We state that academic leadership, collaborative peer learning, know-how of digital technology and online learning tools, training of faculty, dean review, readiness of students and discourse are important to create an ecosystem for effective online teaching. The article highlights the need of long-term perspective from academic leaders and the significance of blended teaching for faculty, in response to readiness in uncertain times. This paper reflects on the need for educational institutes to respond to the pandemic by building resources and factors and taking actions that result in an effective learning environment. They need to ensure training of all stakeholders and availability of technology and related resources, along with building a community for peer learning.
A Study on the Effectiveness of Problem-based Learning in Legal Education in India
Authors: Shalini S.
Published: January 2021

Legal education in India aims at enabling learners to think critically and apply what they have learned. Problem-based learning (PBL) can be used as an effective tool to achieve this objective. This study was carried out to understand the effectiveness of this tool in legal education. A comparative analysis of the traditional method with PBL has shown that the latter leads to benefits in the form of better retention of knowledge and recall, improved problem-solving skill, better decision-making ability and development of lifelong-learning ability. This article discusses the methodology adopted and the results generated through application of the method in the taxation law course taught to undergraduate students of law.
P*R*O*P: a web application to perform phylogenetic analysis considering the effect of gaps
Authors: Nishimaki Takuma , Sato Keiko
Published: January 2021

Background

Phylogenetic analysis strongly depends on evolutionary models. Most evolutionary models for estimating genetic differences and phylogenetic relationships do not treat gap sites in the alignment of sequences. Appropriately incorporating evolutionary information of sites containing insertions and deletions into genetic difference measures will be improve the accuracy of phylogenetic estimates.

Results

We introduced a new measure for estimating genetic differences, and presented P*R*O*P, a web application for performing phylogenetic analysis based on genetic difference considering the effect of gaps. As an example of phylogenetic analysis using P*R*O*P, we used complete p53 amino acid sequences of 31 organisms and illustrated that the genetic differences with and without information on sites containing gaps result in trees with different topologies.

Conclusions

P*R*O*P is available at https://www.rs.tus.ac.jp/bioinformatics/prop and the user can perform phylogenetic analysis by uploading sequence data on the website. The most distinctive feature of P*R*O*P is its genetic difference that is estimated without eliminating gap sites for alignment sequences, which helps users detect meaningful difference in an evolutionary process. The source code is available in GitHub: https://github.com/TUS-Satolab/PROP.
Impacts of fludioxonil resistance on global gene expression in the necrotrophic fungal plant pathogen Sclerotinia sclerotiorum
Authors: Taiwo Akeem O. , Harper Lincoln A. , Derbyshire Mark C.
Published: January 2021

Background

The fungicide fludioxonil over-stimulates the fungal response to osmotic stress, leading to over-accumulation of glycerol and hyphal swelling and bursting. Fludioxonil-resistant fungal strains that are null-mutants for osmotic stress response genes are easily generated through continual sub-culturing on sub-lethal fungicide doses. Using this approach combined with RNA sequencing, we aimed to characterise the effects of mutations in osmotic stress response genes on the transcriptional profile of the important agricultural pathogenSclerotinia sclerotiorumunder standard laboratory conditions. Our objective was to understand the impact of disruption of the osmotic stress response on the global transcriptional regulatory network in an important agricultural pathogen.

Results

We generated two fludioxonil-resistantS. sclerotiorumstrains, which exhibited growth defects and hypersensitivity to osmotic stressors. Both had missense mutations in the homologue of theNeurospora crassaosmosensing two component histidine kinase geneOS1, and one had a disruptive in-frame deletion in a non-associated gene. RNA sequencing showed that both strains together differentially expressed 269 genes relative to the parent during growth in liquid broth. Of these, 185 (69%) were differentially expressed in both strains in the same direction, indicating similar effects of the different point mutations inOS1on the transcriptome. Among these genes were numerous transmembrane transporters and secondary metabolite biosynthetic genes.

Conclusions

Our study is an initial investigation into the kinds of processes regulated through the osmotic stress pathway inS. sclerotiorum. It highlights a possible link between secondary metabolism and osmotic stress signalling, which could be followed up in future studies.
Genomic predictions for fillet yield and firmness in rainbow trout using reduced-density SNP panels
Authors: Al-Tobasei Rafet , Ali Ali , Garcia Andre L. S. , Lourenco Daniela , Leeds Tim , Salem Mohamed
Published: January 2021

Background

One of the most important goals for the rainbow trout aquaculture industry is to improve fillet yield and fillet quality. Previously, we showed that a 50 K transcribed-SNP chip can be used to detect quantitative trait loci (QTL) associated with fillet yield and fillet firmness. In this study, data from 1568 fish genotyped for the 50 K transcribed-SNP chip and ~ 774 fish phenotyped for fillet yield and fillet firmness were used in a single-step genomic BLUP (ssGBLUP) model to compute the genomic estimated breeding values (GEBV). In addition, pedigree-based best linear unbiased prediction (PBLUP) was used to calculate traditional, family-based estimated breeding values (EBV).

Results

The genomic predictions outperformed the traditional EBV by 35% for fillet yield and 42% for fillet firmness. The predictive ability for fillet yield and fillet firmness was 0.19–0.20 with PBLUP, and 0.27 with ssGBLUP. Additionally, reducing SNP panel densities indicated that using 500–800 SNPs in genomic predictions still provides predictive abilities higher than PBLUP.

Conclusion

These results suggest that genomic evaluation is a feasible strategy to identify and select fish with superior genetic merit within rainbow trout families, even with low-density SNP panels.
Degradome sequencing-based identification of phasiRNAs biogenesis pathways in Oryza sativa
Authors: Yu Lan , Guo Rongkai , Jiang Yeqin , Ye Xinghuo , Yang Zhihong , Meng Yijun , Shao Chaogang
Published: January 2021

Background

The microRNAs(miRNA)-derived secondary phased small interfering RNAs (phasiRNAs) participate in post-transcriptional gene silencing and play important roles in various bio-processes in plants. In rice, two miRNAs, miR2118 and miR2275, were mainly responsible for triggering of 21-nt and 24-nt phasiRNAs biogenesis, respectively. However, relative fewer phasiRNA biogenesis pathways have been discovered in rice compared to other plant species, which limits the comprehensive understanding of phasiRNA biogenesis and the miRNA-derived regulatory network.

Results

In this study, we performed a systematical searching for phasiRNA biogenesis pathways in rice. As a result, five novel 21-nt phasiRNA biogenesis pathways and five novel 24-nt phasiRNA biogenesis pathways were identified. Further investigation of their regulatory function revealed that eleven novel phasiRNAs in 21-nt length recognized forty-one target genes. Most of these genes were involved in the growth and development of rice. In addition, five novel 24-nt phasiRNAs targeted to the promoter of an OsCKI1 gene and thereafter resulted in higher level of methylation in panicle, which implied their regulatory function in transcription of OsCKI1,which acted as a regulator of rice development.

Conclusions

These results substantially extended the information of phasiRNA biogenesis pathways and their regulatory function in rice.
Relationships among types of activity engagement and insomnia symptoms among older adults
Authors: Kim Da Eun , Roberts Tonya J. , Moon Chooza
Published: January 2021

Background

An increasing awareness exists that lack of activity engagement is associated with insomnia symptoms. However, the majority of studies have focused on the association between a single type of activity engagement and insomnia symptoms.

Methods

This is a cross-sectional study using secondary data from the Health and Retirement Study examining the relationships among different types of activity engagement and insomnia symptoms among older adults. The sample for this study included 3321 older adults who responded to survey modules on activity engagement and insomnia symptoms in 2016. Activity engagement was measured using items for three types of activities (i.e., social, cognitive, and physical) validated in this study. Insomnia symptoms were measured using four items (i.e., difficulty of falling asleep, waking up during the night, waking up too early, and feeling rested). Independent t-tests were conducted to identify the differences in insomnia symptoms according to activity engagement level. Regressions were conducted to examine the associations among three types of activity engagement and insomnia symptoms after adjusting for covariates such as demographics, chronic disease, activities of daily living difficulty, cognitive function, sleep disorder, loneliness, and caregiving.

Results

The respondents in the high-level social, cognitive, and physical activity engagement groups were found to show fewer insomnia symptoms. Furthermore, higher social (β = − 0.04, p = 0.040) and cognitive (β = − 0.06, p = 0.007) activity engagements were associated with fewer insomnia symptoms even after adjusting for other types of activity engagement and all covariates.

Conclusions

This study suggests that older adults with higher social and cognitive activity engagements may be likely to have fewer insomnia symptoms. Based on these results, future research is needed to develop multi-component intervention programs that can encourage older adults to engage in these activities.
Non-local means based Rician noise filtering for diffusion tensor and kurtosis imaging in human brain and spinal cord
Authors: Zhang Zhongping , Vernekar Dhanashree , Qian Wenshu , Kim Mina
Published: January 2021

Background

To investigate the effect of using a Rician nonlocal means (NLM) filter on quantification of diffusion tensor (DT)- and diffusion kurtosis (DK)-derived metrics in various anatomical regions of the human brain and the spinal cord, when combined with a constrained linear least squares (CLLS) approach.

Methods

Prospective brain data from 9 healthy subjects and retrospective spinal cord data from 5 healthy subjects from a 3 T MRI scanner were included in the study. Prior to tensor estimation, registered diffusion weighted images were denoised by an optimized blockwise NLM filter with CLLS. Mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD) and fractional anisotropy (FA), were determined in anatomical structures of the brain and the spinal cord. DTI and DKI metrics, signal-to-noise ratio (SNR) and Chi-square values were quantified in distinct anatomical regions for all subjects, with and without Rician denoising.

Results

The averaged SNR significantly increased with Rician denoising by a factor of 2 while the averaged Chi-square values significantly decreased up to 61% in the brain and up to 43% in the spinal cord after Rician NLM filtering. In the brain, the mean MK varied from 0.70 (putamen) to 1.27 (internal capsule) while AK and RK varied from 0.58 (corpus callosum) to 0.92 (cingulum) and from 0.70 (putamen) to 1.98 (corpus callosum), respectively. In the spinal cord, FA varied from 0.78 in lateral column to 0.81 in dorsal column while MD varied from 0.91 × 10−3 mm2/s (lateral) to 0.93 × 10−3 mm2/s (dorsal). RD varied from 0.34 × 10−3 mm2/s (dorsal) to 0.38 × 10−3 mm2/s (lateral) and AD varied from 1.96 × 10−3 mm2/s (lateral) to 2.11 × 10−3 mm2/s (dorsal).

Conclusions

Our results show a Rician denoising NLM filter incorporated with CLLS significantly increases SNR and reduces estimation errors of DT- and KT-derived metrics, providing the reliable metrics estimation with adequate SNR levels.
Facial palsy after embolization with Squid® 12
Authors: Moreno-Paredes Santiago , Rodríguez-Alcalá Laura , Martín-Lagos Martínez Juan , Müller Locatelli Nicolás , Vázquez López Cristina , Vargas Fernández José Luis , Cabrera Peña Álvaro
Published: January 2021

Endovascular procedures with liquid embolic agents such as ethylene-vinyl alcohol (EVOH) copolymers are indicated before surgical treatment of cervical paraganglioma. Consequently, these agents are now available as low viscosity formulations, one of which is Squid 12, which are demonstrating superior vascular penetration. Cases of facial paralysis secondary to embolization of cervical vascular lesions with classic embolic agents have been reported in the English literature, however, this complication has not been described with new generation options such as Squid 12.

We describe the case of a 43-year-old patient with a left neck carotid paraganglioma. Embolization was performed under general anaesthesia before surgical excision. In the immediate postoperative period, the patient developed total left facial palsy. Since the imaging tests (Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)) and neurological examination showed no involvement of additional cranial nerves (CN), we hypothesise that the main cause of this complication is ischemia of the vasa nervorum of CN VII secondary to embolization. Almost six months later, the patient continues to present total facial paralysis (Grade VI House-Brackmann facial paralysis scale), and palsy of the left CN X and XII as a complication secondary to surgical resection of the paraganglioma.

This case is relevant since it is the first clinical case of permanent facial paralysis secondary to embolization with Squid 12.
Occlusive retinal vasculopathy with macular branch retinal artery occlusion as a leading sign of atypical hemolytic uremic syndrome – a case report
Authors: González David Pérez , Iglicki Matias , Svetitsky Shuli , Bar-On Yaeli , Habot-Wilner Zohar , Zur Dinah
Published: January 2021

Background

Hemolytic Uremic Syndrome (HUS) is a rare disorder characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure, considered within the group of thrombocytic microangiopathies. Ocular complications in HUS are very rare. Here, we report an adult patient who suffered from acute onset of paracentral scotoma, caused by branch retinal artery occlusion (BRAO), as a leading symptom of atypical HUS.

Case presentation

A 39-year-old healthy male was lately diagnosed with essential hypertension and mild renal impairment. He complained about acute onset of central scotoma in his left eye. Fundus examination revealed marked narrowing of retinal vessels, cotton wool spots and few retinal hemorrhages in both eyes. The patient was diagnosed with bilateral ischemic retinal vasculopathy and acute macular BRAO in his left eye. Workup revealed thrombocytopenia, worsening renal failure. Renal biopsy showed signs of chronic thrombotic microangiopathy. The patient was diagnosed with atypical HUS (aHUS) and started on plasmapheresis, together with eculizumab. As his condition continued to worsen, he was put on renal replacement therapy. Due to a persistent monoclone of IgG1, the patient underwent bone marrow biopsy which revealed Monoclonal Gammopathy of renal significance, triggering a HUS and treatment was initiated accordingly. Two months after initial presentation, the patient developed neovascularization of the optic disc (NVD) in his left eye, and was treated with 3 monthly intravitreal bevacizumab injections with complete regression of the NVD. The patient suffered from myocardial infarction in the later course and was lost for follow-up. He returned 11 months after the last bevacizumab injection because of sudden loss of vision in his left eye caused by a dense vitreous hemorrhage. Biomicroscopy revealed a new NVD in his right eye. The patient underwent panretinal photocoagulation in both eyes with regression of neovascularization. Vision improved and remained 20/20 in both eyes.

Conclusion

We present a case report showing retinal ischemia can be linked with aHUS. As clinal diagnosis might be challenging, physicians should be aware of the rare ocular manifestations of this devastating multi-organ disease. In case of retinal ischemia, panretinal photocoagulation should be initiated soon to avoid blinding complications.
Is preexisting mental illness associated with lower patient satisfaction for older trauma patients? A cross-sectional descriptive study
Authors: McGraw Constance , Pekarek Jennifer , Redmond Diane , Vogel Rebecca , Tanner Allen , Bar-Or David
Published: January 2021

Background

The purpose of this study was to examine if satisfaction with care differs among older trauma patients with and without preexisting mental illness (PMI+/PMI-).

Methods

Data from two level I trauma centers were examined from 11/2016 through 12/2017. Trauma patients ≥55 years were included and satisfaction of those who had a diagnosis of mental illness prior to the trauma admission (PMI+) to those without a diagnosis (PMI-) (n = 299; 62 PMI+ and 237 PMI-) were compared. Enrolled patients completed the Family Satisfaction with Advanced Care Cancer Scale Patient Survey (FAMCARE-P13) prior to discharge. Associations between mental illness status and patient baseline characteristics, overall mean satisfaction, and mean satisfaction by question were compared. Generalized linear models adjusted for differences in patient satisfaction by mental illness status. Analyses were stratified by hospital to account for the interaction between hospital and mental illness status.

Results

Compared to PMI- patients, PMI+ patients were more likely to be younger, female, have multiple comorbidities, and to report lower overall satisfaction with care. Among PMI+ patients, the most common diagnoses were depression and anxiety. After adjustment, PMI+ was associated with lower patient satisfaction at hospital 1; after examining individual questions lower satisfaction was associated with information provided on procedures and questions surrounding “Physical care.” Conversely, PMI+ did not affect satisfaction at hospital 2 after adjustment.

Conclusions

At hospital 1, room for improvement was identified in providing information about prognosis and procedures, symptom management, and continuity of care. Reexamining practices for older PMI+ trauma patients is warranted.
Housing first, connection second: the impact of professional helping relationships on the trajectories of housing stability for people facing severe and multiple disadvantage
Authors: Sandu Rebeca D. , Anyan Frederick , Stergiopoulos Vicky
Published: January 2021

Background

Despite the accumulating evidence on the role of professional helping relationships for highly disadvantaged populations, methodological shortcomings have made it difficult to establish a robust relationships-outcomes link. This study sought to establish the impact of professional helping relationships on the trajectories over 24 months of housing stability for 2141 people facing severe and multiple disadvantage using data from the Housing First controlled trial in Canada.

Method

The study used a mixed method design. Latent growth curve and growth mixture models assessed the impact of working alliance across the sample as a whole and within subgroups with different patterns of housing stability. Thematic analysis explored the factors that may affect the quality of working alliances within different subgroups.

Results

Three distinct trajectories of housing stability emerged (i.e., Class 1: “sharp rise, sustained, and decline housing”; Class 2: “hardly any time housed”; Class 3: “high rise, sustained, and decline housing”) with professional helping relationships having different effects in each. The analysis revealed structural and individual circumstances that may explain differences among the classes.

Conclusions

The findings underscore the role of professional helping relationships, as distinct from services, in major interventions for highly disadvantaged populations, and draws new attention to the temporal patterns of responses to both the quality of relationship and targeted interventions.
Perspectives of infant active play: a qualitative comparison of working versus stay-at-home parents
Authors: Snyder Kailey , Rech John P. , Masuda Kim , Dinkel Danae
Published: January 2021

Background

Parents play a key role in infant’s development through their interactions and the type of environment they provide to promote active play. The amount of time parents are able to spend with their infant is dependent on their working status, yet few studies have explored parent perception of their infant’s active play by working status. The purpose of this study was to explore parent perception of active play and compare responses between working and stay-at-home parents.

Methods

Twenty-nine parents participated in this qualitative study by completing a one-time, in-person semi-structured interview based on the Theory of Planned Behavior. Themes were developed and compared based on parental working status using a directed content analysis approach.

Results

All parents believed active play could have a positive effect on their child’s development through physical, social and emotional, cognitive, and/or language and communication development. However, stay-at-home parents reported a broader impact of active play across these domains; whereas working parents most often referenced active play as impacting infant’s physical development. Social and emotional interactions were the highest reported form of active play among all parents. Additionally, all parents described similar barriers to increasing the time for active play. The most commonly reported barrier for all parents was time or schedule followed by care needs of the infant, environmental concerns, and need for restrictive devices (e.g., car seats). More stay-at-home parents than working parents reported the care needs of the infant as being a barrier. Recommendations for active play were not widely known amongst all parents, with a higher percentage of working parents reporting they would desire advice from a healthcare provider.

Conclusions

Working status of parents appears to have implications on perceptions of active play which in turn may influence infants’ development. Future studies should objectively assess the impact of parents’ working status on infant development and explore how gender of the parent may serve as a confounding variable.
Quantifying and characterizing hourly human exposure to malaria vectors bites to address residual malaria transmission during dry and rainy seasons in rural Southwest Burkina Faso
Authors: Soma D. D. , Zogo B. , Taconet P. , Somé A. , Coulibaly S. , Baba-Moussa L. , Ouédraogo G. A. , Koffi A. , Pennetier C. , Dabiré K. R. , Moiroux N.
Published: January 2021

Background

To sustain the efficacy of malaria vector control, the World Health Organization (WHO) recommends the combination of effective tools. Before designing and implementing additional strategies in any setting, it is critical to monitor or predict when and where transmission occurs. However, to date, very few studies have quantified the behavioural interactions between humans and Anopheles vectors in Africa. Here, we characterized residual transmission in a rural area of Burkina Faso where long lasting insecticidal nets (LLIN) are widely used.

Methods

We analysed data on both human and malaria vectors behaviours from 27 villages to measure hourly human exposure to vector bites in dry and rainy seasons using a mathematical model. We estimated the protective efficacy of LLINs and characterised where (indoors vs. outdoors) and when both LLIN users and non-users were exposed to vector bites.

Results

The percentage of the population who declared sleeping under a LLIN the previous night was very high regardless of the season, with an average LLIN use ranging from 92.43 to 99.89%. The use of LLIN provided > 80% protection against exposure to vector bites. The proportion of exposure for LLIN users was 29–57% after 05:00 and 0.05–12% before 20:00. More than 80% of exposure occurred indoors for LLIN users and the estimate reached 90% for children under 5 years old in the dry cold season.

Conclusions

LLINs are predicted to provide considerable protection against exposure to malaria vector bites in the rural area of Diébougou. Nevertheless, LLIN users are still exposed to vector bites which occurred mostly indoors in late morning. Therefore, complementary strategies targeting indoor biting vectors in combination with LLIN are expected to be the most efficient to control residual malaria transmission in this area.
Self-estimated BMI, but not self-perceived body size, accurately identifies unhealthy weight in US adults
Authors: Smith Maia Phillips
Published: January 2021

Background

Self-perceptions of health and disease can be a major driver of health behaviors. Improving accuracy of self-ascertainment of obesity may prompt uptake of weight-control behaviors in those with obesity.

Methods

We assess performance of self-perceived body size (‘too small’, ‘about right’ or ‘too large’), self-estimated BMI in kg/m2, and sociodemographics in detecting measured BMI category (under-, normal-, overweight and obese; BMI cutpoints 18.5, 25 and 30) in first bivariate and then multivariable models.

Results

Of 37,281 adults in the US from NHANES, 2, 34, 33 and 32% were under-, normal-, overweight and obese. Respectively 56, 73, 60 and 91% self-perceived as ‘too small’, ‘about right’, ‘too large’ and ‘too large.’ Of those who self-perceived as ‘too small’, 22% were underweight and 10% were overweight or obese. 99.7% of obese participants self-estimated a BMI in the overweight/obese range, including many who did not self-perceive as ‘too large’.

Among obese participants, self-perception as either ‘about right’ or ‘too small’ was more likely for those who were younger (OR for perception as ‘too large’ 1.01 per year, 95% confidence interval 1.00–1.01) male (OR 0.33, (0.28–0.39)) nonwhite (ORs 0.36–0.79 for different ethnicities), low-income (ORs 0.61 and 1.8 for the lowest and highest of six categories, vs. the third) or measured recently (OR 0.98 (0.96–1.0) per year since 1999). Misperception was less common, but still existed, for participants with moderate or severe obesity (ORs 2.9 (2.3–3.5) and 7.9 (5.4–12), vs. ‘mild.’) (all p < 0.01.)

Conclusions

A tenth of adults in the US with obesity, especially those from overweight peer groups, self-perceive as normal or underweight and thus may not be motivated to control their weight. However, virtually all self-estimate an overweight or obese BMI. If measured BMI is not available, self-estimates are sufficiently accurate that interventions may rely on it to identify obesity.
Perspectives on voluntary assisted partner notification among providers, people with HIV and the general population in Indonesia: a formative qualitative study
Authors: Wirawan Gede Benny Setia , Januraga Pande Putu , Mahendra I. Gusti Agung Agus , Harjana Ngakan Putu Anom , Mahatmi Tiara , Luhukay Lanny , Rewari Bharat Bhushan , Johnson Cheryl , Katz David A.
Published: January 2021

Background

Voluntary assisted partner notification (aPN) services are effective in increasing access to and uptake of HIV testing among partners of people with HIV. Following recommendations by the World Health Organization in 2016, Indonesia evaluated various approaches to aPN. We present the lessons learned from formative operational research undertaken to understand provider and patient perspectives on aPN from three demonstration sites in cities with a high HIV burden.

Methods

We conducted a formative qualitative study in three cities: Jakarta, Semarang, and Denpasar between September and October 2019. We conducted six focus group discussions (FGDs) (n = 44 participants) among health-care providers, people living with HIV and the general population. We explored participant preferences and concerns about how aPN should be delivered, including the methods of and messaging for contacting partners. All FGDs were conducted in the Indonesian language. Qualitative data were analysed using thematic analysis.

Results

aPN was acceptable across different participant populations, although with caveats. Some differences were observed between the general population, providers and people living with HIV. People living with HIV were mainly concerned with confidentiality of the procedure and preferred the use of telecommunication and messages that avoid explicit mention of HIV exposure. Providers preferred similar approaches but for different reasons, being concerned mainly with self-efficacy and security. There was consensus regarding dual referral models. The use of phone calls and short messages were preferred as these are perceived to minimize negative reactions and stigma, protect client confidentiality and are suitable in the current legal situation. The general population was mainly concerned with effectiveness and prefer direct provider-led approaches, such as preferring in-person meeting with explicit notification of potential HIV exposure.

Conclusions

We found consensus among stakeholders on acceptance of aPN, especially dual referral methods. Development and implementation of aPN protocols should also consider clients’ individual situations and concerns regarding safeguarding of confidentiality, and offer a range of options to accommodate all stakeholders involved.