bluuebunny/crossref_metadata_2025 huggingface dataset:
April 2021 Critical Care Case of the Month: Abnormal Acid-Base Balance in a Post-Partum Woman
Authors:   Emanuel Medical Center, Turlock, CA USA, Mahmoud Mohammad
Published: April 2021

No abstract available. Article truncated after first page. History of Present Illness: A 29-year-old healthy woman, who is 8 weeks postpartum, presented to the emergency department with severe shortness of breath, fast shallow breathing, nausea, several episodes of nonbloody nonbilious emesis, abdominal pain and malaise for 1 week. The patient delivered a healthy boy at full-term by spontaneous vaginal delivery. Her pregnancy was uneventful. She denied smoking or use of alcohol. Physical Exam: On presentation to the emergency department her blood pressure was found to be 121/71, temperature 36.8°C, pulse 110 beats per minute, respiratory rate 20 breaths per minute and SpO2 saturation of 99% while breathing ambient air. Physical exam was remarkable except for dry mucous membranes, sinus tachycardia, and tachypnea with mild epigastric tenderness with light palpation. Which of the following should be done? 1. Complete blood count (CBC) 2. Metabolic panel 3. Chest x-ray 4. Arterial blood gases (ABGs) 5. All of the above …
Examining Association Between Reported High Cholesterol and Risk Factors in Adults With Intellectual and Developmental Disabilities (IDD): A Five-Year Follow-Up
Authors: Murthy Sumithra , Hsieh Kelly
Published: April 2021

Adults with intellectual and developmental disabilities (IDD) are at a greater risk of developing high cholesterol and cardiovascular disease. We examined whether physical inactivity, obesity, and diabetes were predictive of reported high cholesterol and whether there were any mediating effects of diabetes on the relationship between obesity and high cholesterol in 1,618 adults with IDD across five years. Results suggest that obesity and diabetes were significantly associated with high cholesterol after adjusting for age, sex, and residence type with a partial mediator effect of diabetes in the relationship between obesity and high cholesterol across all time points. Further research is needed to explore the causal mechanisms behind the relationships between obesity, diabetes, and high cholesterol.
STOP model development and analysis of an optical collimation system for a tactical high-energy laser weapon
Authors: Lyu Chenyang , Zhan Renjun
Published: April 2021

To effectively avoid the bottleneck of optical collimation system distortion in the use of tactical high-energy laser weapons (THELWs), this paper proposes and realizes an optical–multiphysics–finite-element coupling analysis method. Combined with dynamic physical parameters, we construct and verify a structure–thermal–optical-performance (STOP) model and accurately restore the multiphysics coupling phenomenon in the THELW lens. Finally, we conclude that the limiting output power of THELW assembled with the doublet lens is 1155.6 W. Then, we draw a series of conclusions from different physical fields and make a comprehensive analysis of the optical collimation system performance. The analysis methods and conclusions described in the paper are of great significance for the R & D of future laser weapons and other optical systems.
Micro-opto-electro-mechanical gyroscope based on the Talbot effect of a single-layer near-field diffraction grating
Authors: Xie Kunyang , Zhang Rui , Xin Chenguang , Jin Li , Wang Zhibin , Wang Zhaoba , Li Mengwei , Zhao Hongbo
Published: April 2021

We demonstrate a novel, to the best of our knowledge, micro-opto-electro-mechanical system (MOEMS) gyroscope based on the Talbot effect of a single-layer near-field diffraction grating. The Talbot effect of an optical grating is studied both theoretically and experimentally. A structure of grating–mirror combination, fabricated by the micro–nano processing method, is used for out-of-plane structure detection. The detection of a weak Coriolis force is realized by using the highly sensitive displacement characteristic of Talbot imaging of near-field diffraction with a mirror mass block and single-layer grating. The experimental results show that, the micro-displacement detection sensitivity can reach up to 0.09%/nm, and the MOEMS gyroscope can be moved in the driven direction, with a resonant frequency of  7048 Hz and a quality factor of 700, which indicates great potential of the Talbot effect in developing novel high-performance micro-gyroscopes.
2.4  kW 1045  nm narrow-spectral-width monolithic single-mode CW fiber laser by using an FBG-based MOPA configuration
Authors: Xu Yang , Sheng Quan , Wang Peng , Cui Xuelong , Zhao Yizhu , Xu Haixin , Ding Xiangdong , Fang Qiang , Shi Wei , Yao Jianquan
Published: April 2021

A 24 kW narrow-spectral-width near-diffraction-limited monolithic fiber laser system at

∼

1045.2

n
m

in a fiber Bragg grating (FBG)-based master oscillator power amplifier (MOPA) configuration is demonstrated in this paper. The near-diffraction-limited beam quality (

M

2

∼

1.2

) and a spectral width of 0.35 nm (

∼

96

G
H
z

) are achieved. The stimulated Raman scattering (SRS) is theoretically and experimentally investigated. The SRS has been suppressed by carefully optimizing the length of the Yb-doped fiber and the pumping scheme, and a signal-to-noise ratio of

∼

33

d
B

between the laser signal and the Raman Stokes component is achieved. The stimulate Brillouin scattering and the transverse mode instability are not observed. To our best knowledge, this is the highest-output power for

104

×

n
m

single-mode fiber laser with

∼

96

G
H
z

spectral width by using an FBG-based MOPA configuration.
Polarization neutral point pairs of the solar corona and the lunar disc observed during the total solar eclipse on 11 August 1999 in Hungary
Authors: Horváth Gábor , Slíz-Balogh Judit , Pomozi István , Kriska György
Published: April 2021

During the total solar eclipses on 11 August 1999 in Kecel (Hungary)
and on 29 March 2006 in Side (Turkey), two Hungarian groups performed
full-sky imaging polarimetric measurements of the eclipsed sky. They
observed the spatiotemporal change of the celestial polarization
pattern and detected three polarization neutral points as well as two
points with maximal polarization of the sky. Parallel to these
studies, the polarization pattern in front of the lunar disc, the
solar corona, and the surrounding sky have also been measured. During
the total solar eclipse on 21 August 2017 in the USA (Rexburg–Idaho,
Madras–Oregon), three American/international groups have measured the
polarization characteristics of the full sky and the solar corona. The
first group observed the spatiotemporal variation of the celestial
polarization pattern, and the second group detected three polarization
neutral points of the sky and observed two neutral points of the solar
corona. The latter were named as Minnaert and van de Hulst neutral
points. The third group observed two neutral points of the lunar disc.
We have reanalyzed the earlier polarization patterns of the lunar
disc, solar corona, and the surrounding sky measured during the
Hungarian total eclipse on 11 August 1999. In these reanalyzed
polarization patterns, all four neutral points observed during the
eclipse on 21 August 2017 in the USA occur: the Minnaert/van de Hulst
neutral point pair above/below the eclipsed Sun, where coronal
polarization is canceled by sky polarization, and the northern and
southern (unnamed) neutral points of the lunar disc, where the
directions of polarization of coronal light and foreground skylight
are perpendicular to each other with the same polarized intensity. We
name the latter two polarization neutral points after Coulson and
Vorobiev.
Freight-Logistics-as-a-Service – Innovative Geschäftsmodelle für ein datengetriebenes Transportmanagement
Authors: Heinbach Christoph , Hagen Simon , Thomas Oliver
Published: April 2021

Die Gestaltung digitaler Geschäftsmodelle basiert auf dem disruptiven Potenzial von technologischen Innovationen, das in unterschiedlichen Branchen genutzt wird. Der Logistik kommt in Anbetracht ihrer essentiellen Querschnittfunktion sowie der Entstehung umfangreicher Daten durch den Einsatz verschiedener IT-Systeme für die Abwicklung von Frachttransporten eine besondere Bedeutung zu. Derzeitige Debatten werden mit Blick auf das Cloud-Computing sowie die Merkmale neu entstehender digitaler Plattformen geführt. Insbesondere für das Transportmanagement im Güterkraftverkehr entstehen datenbasierte as-a-Service Konzepte, die das tradierte Geschäftsmodell von Logistikdienstleistern sowie das Geschäftsfeld der Anbieter von Transportmanagementsystemen (TMS) attackieren. Auffällig ist, dass einer prozessorientierten Betrachtung der cloudbasierten Anwendungssysteme bislang wenig Aufmerksamkeit entgegengebracht wurde. In diesem Beitrag soll ein vertieftes Verständnis für Fracht-Plattformen im Güterverkehr erzeugt werden. Anhand von Experteninterviews wird zunächst das Konzept Freight-Logistics-as-a-Service (FLaaS) für ein datengetriebenes Transportmanagement (DTM) entworfen. Im Anschluss werden auf Grundlage des Business Model Canvas die strategischen Betrachtungen der digitalen Plattformen um Aspekte der Geschäftsmodellentwicklung der Datendienstleister erweitert. Eine intelligente Nutzung des Datenpotentials zeigt sich insbesondere in der Verbesserung der Transparenz sowie der optimierten Auslastung der verfügbaren Transportressourcen. Durch das präsentierte Konzept FLaaS und das betrachtete cloudbasierte Geschäftsmodell werden abschließend strategische Handlungsmaßnahmen formuliert. Die Aspekte Datenkompetenz, Datenstrategie und Kollaboration sind für die Akteure von hoher Relevanz, um eine nachhaltige und wertschöpfende Gestaltung von datengetriebenen Transportketten zu erreichen.
Daten-Ökosysteme wider Willen: Herausforderungen des Pay-as-you-live-Geschäftsmodells im Kontext deutscher Krankenversicherungen
Authors: Wulf Nele , Betz Stefanie
Published: April 2021

In dem vorliegenden Beitrag wird der aktuelle Trend, Pay-as-you-live-Systeme (PAYL) in Verbindung mit Krankenversicherungen anzubieten, analysiert. PAYL-Systeme bedeutet konkret die kontinuierliche Erfassung von Gesundheitsdaten mithilfe technischer Geräte und Übermittlung dieser Daten an Versicherungen sowie die Auszahlung von Boni für erreichte Fitnessziele. Zunächst wird eine Definition von PAYL-Systemen dargelegt, dann werden die technischen Rahmenbedingungen erläutert, schließlich werden die Auswirkungen dieser sozio-technischen Systeme näher beleuchtet. Dies geschieht auf Grundlage unserer empirischen Untersuchung. Die drei identifizierten Hauptkonflikte betreffen die Genese von PAYL, seine Auswirkungen auf den Wert der Datensouveränität besonders für Versicherte und die Schwierigkeit, für den Anspruch auf Prävention und Kostenersparnis durch PAYL Evidenz zu erzeugen. Diese Konflikte werden diskutiert, um sowohl die direkten wie auch indirekten Auswirkungen der Digitalisierung und der Ökonomisierung des Sozialen durch PAYL zu beleuchten.
Stress and odorant receptor feedback during a critical period after hatching regulates olfactory sensory neuron differentiation in Drosophila
Authors: Jafari Shadi , Henriksson Johan , Yan Hua , Alenius Mattias
Published: April 2021

Here, we reveal that the regulation of Drosophila odorant receptor (OR) expression during the pupal stage is permissive and imprecise. We found that directly after hatching an OR feedback mechanism both directs and refines OR expression. We demonstrate that, as in mice, dLsd1 and Su(var)3-9 balance heterochromatin formation to direct OR expression. We show that the expressed OR induces dLsd1 and Su(var)3-9 expression, linking OR level and possibly function to OR expression. OR expression refinement shows a restricted duration, suggesting that a gene regulatory critical period brings olfactory sensory neuron differentiation to an end. Consistent with a change in differentiation, stress during the critical period represses dLsd1 and Su(var)3-9 expression and makes the early permissive OR expression permanent. This induced permissive gene regulatory state makes OR expression resilient to stress later in life. Hence, during a critical period OR feedback, similar to in mouse OR selection, defines adult OR expression in Drosophila.
Constraints on the deformation of the vibrissa within the follicle
Authors: Luo Yifu , Bresee Chris S. , Rudnicki John W. , Hartmann Mitra J. Z.
Published: April 2021

Nearly all mammals have a vibrissal system specialized for tactile sensation, composed of whiskers growing from sensor-rich follicles in the skin. When a whisker deflects against an object, it deforms within the follicle and exerts forces on the mechanoreceptors inside. In addition, during active whisking behavior, muscle contractions around the follicle and increases in blood pressure in the ring sinus will affect the whisker deformation profile. To date, however, it is not yet possible to experimentally measure how the whisker deforms in an intact follicle or its effects on different groups of mechanoreceptors. The present study develops a novel model to predict vibrissal deformation within the follicle sinus complex. The model is based on experimental results from a previous ex vivo study on whisker deformation within the follicle, and on a new histological analysis of follicle tissue. It is then used to simulate whisker deformation within the follicle during passive touch and active whisking. Results suggest that the most likely whisker deformation profile is “S-shaped,” crossing the midline of the follicle right below the ring sinus. Simulations of active whisking indicate that an increase in overall muscle stiffness, an increase in the ratio between deep and superficial intrinsic muscle stiffness, and an increase in sinus blood pressure will all enhance tactile sensitivity. Finally, we discuss how the deformation profiles might map to the responses of primary afferents of each mechanoreceptor type. The mechanical model presented in this study is an important first step in simulating mechanical interactions within whisker follicles.
Reviewing the ecological evidence base for management of emerging tropical zoonoses: Kyasanur Forest Disease in India as a case study
Authors: Burthe Sarah J. , Schäfer Stefanie M. , Asaaga Festus A. , Balakrishnan Natrajan , Chanda Mohammed Mudasssar , Darshan Narayanaswamy , Hoti Subhash L. , Kiran Shivani K. , Seshadri Tanya , Srinivas Prashanth N. , Vanak Abi T. , Purse Bethan V.
Published: April 2021

Zoonoses disproportionately affect tropical communities and are associated with human modification and use of ecosystems. Effective management is hampered by poor ecological understanding of disease transmission and often focuses on human vaccination or treatment. Better ecological understanding of multi-vector and multi-host transmission, social and environmental factors altering human exposure, might enable a broader suite of management options. Options may include “ecological interventions” that target vectors or hosts and require good knowledge of underlying transmission processes, which may be more effective, economical, and long lasting than conventional approaches. New frameworks identify the hierarchical series of barriers that a pathogen needs to overcome before human spillover occurs and demonstrate how ecological interventions may strengthen these barriers and complement human-focused disease control. We extend these frameworks for vector-borne zoonoses, focusing on Kyasanur Forest Disease Virus (KFDV), a tick-borne, neglected zoonosis affecting poor forest communities in India, involving complex communities of tick and host species. We identify the hierarchical barriers to pathogen transmission targeted by existing management. We show that existing interventions mainly focus on human barriers (via personal protection and vaccination) or at barriers relating to Kyasanur Forest Disease (KFD) vectors (tick control on cattle and at the sites of host (monkey) deaths). We review the validity of existing management guidance for KFD through literature review and interviews with disease managers. Efficacy of interventions was difficult to quantify due to poor empirical understanding of KFDV–vector–host ecology, particularly the role of cattle and monkeys in the disease transmission cycle. Cattle are hypothesised to amplify tick populations. Monkeys may act as sentinels of human infection or are hypothesised to act as amplifying hosts for KFDV, but the spatial scale of risk arising from ticks infected via monkeys versus small mammal reservoirs is unclear. We identified 19 urgent research priorities for refinement of current management strategies or development of ecological interventions targeting vectors and host barriers to prevent disease spillover in the future.
alms1 mutant zebrafish do not show hair cell phenotypes seen in other cilia mutants
Authors: Parkinson Lauren , Stawicki Tamara M.
Published: April 2021

Multiple cilia-associated genes have been shown to affect hair cells in zebrafish (Danio rerio), including the human deafness genedcdc2, the radial spoke genersph9, and multiple intraflagellar transport (IFT) and transition zone genes. Recently a zebrafishalms1mutant was generated. TheALMS1gene is the gene mutated in the ciliopathy Alström Syndrome a disease that causes hearing loss among other symptoms. The hearing loss seen in Alström Syndrome may be due in part to hair cell defects asAlms1mutant mice show stereocilia polarity defects and a loss of hair cells. Hair cell loss is also seen in postmortem analysis of Alström patients. The zebrafishalms1mutant has metabolic defects similar to those seen in Alström syndrome andAlms1mutant mice. We wished to investigate if it also had hair cell defects. We, however, failed to find any hair cell related phenotypes inalms1mutant zebrafish. They had normal lateral line hair cell numbers as both larvae and adults and normal kinocilia formation. They also showed grossly normal swimming behavior, response to vibrational stimuli, and FM1-43 loading. Mutants also showed a normal degree of sensitivity to both short-term neomycin and long-term gentamicin treatment. These results indicate that cilia-associated genes differentially affect different hair cell types.
Impact of initial vancomycin pharmacokinetic/pharmacodynamic parameters on the clinical and microbiological outcomes of methicillin-resistant Staphylococcus aureus bacteremia in children
Authors: Yoo Reenar , So Hyejin , Seo Euri , Kim Mina , Lee Jina
Published: April 2021

Optimal vancomycin exposure is important to minimize treatment failure of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. We aimed to analyze the impact of initial vancomycin pharmacokinetic/pharmacodynamic (PK/PD) parameters, including the initial vancomycin C trough and the area under the curve (AUC)/minimal inhibitory concentration (MIC) on the outcomes of pediatric MRSA bacteremia. The study population consisted of hospitalized children aged between 2 months and 18 years with MRSA bacteremia, in whom C trough was measured at least one time within the time period of January 2010 to March 2018. Demographic profiles, underlying diseases, and clinical/microbiological outcomes were abstracted retrospectively. During the study period, 73 cases of MRSA bacteremia occurred in children with a median age of 12.4 months. Severe clinical outcomes leading to intensive care unit stay and/or use of mechanical ventilation occurred in 47.5% (35/73); all-cause 30-day mortality was 9.7% (7/72). The median dosage of vancomycin was 40.0 mg/kg/day. There was a weak linear relationship between C trough and the corresponding AUC/MIC (r = 0.235). ROC curves for achieving an AUC/MIC of 300 suggested that the initial C trough at 10 μg/mL could be used as a cut-off value with a sensitivity of 90.5% and a specificity of 44%. Although persistent bacteremia at 48–72 hours after vancomycin administration was observed more frequently when the initial C trough was < 10 μg/mL and initial AUC/MIC was < 300, initial AUC/MIC < 300 was the only risk factor associated with persistent bacteremia at 48–72 hours (adjusted OR 3.05; 95% CI, 1.07–8.68). Initial C trough and AUC/MIC were not associated with 30-day mortality. Although there was a weak relationship between C trough and AUC/MIC, initial AUC/MIC < 300 could be used as a predictor of persistent MRSA bacteremia at 48–72 hours. Further prospective data on optimal vancomycin dosing are necessary to improve clinical and microbiological outcomes in pediatric MRSA bacteremia.
Early-phase scale-up of isoniazid preventive therapy for people living with HIV in two districts in Malawi (2017)
Authors: Nabity Scott A. , Gunde Laurence J. , Surie Diya , Shiraishi Ray W. , Kirking Hannah L. , Maida Alice , Auld Andrew F. , Odo Michael , Jahn Andreas , Nyirenda Rose K. , Oeltmann John E.
Published: April 2021

Background

Isoniazid preventive therapy (IPT) against tuberculosis (TB) is a life-saving intervention for people living with HIV (PLHIV). In September 2017, Malawi began programmatic scale-up of IPT to eligible PLHIV in five districts with high HIV and TB burden. We measured the frequency and timeliness of early-phase IPT implementation to inform quality-improvement processes.

Methods and findings

We applied a two-stage cluster design with systematic, probability-proportional-to-size sampling of six U.S. Centers for Disease Control and Prevention (CDC)-affiliated antiretroviral therapy (ART) centers operating in the urban areas of Lilongwe and Blantyre, Malawi (November 2017). ART clinic patient volume determined cluster size. Within each cluster, we sequentially sampled approximately 50 PLHIV newly enrolled in ART care. We described a quality-of-care cascade for intensive TB case finding (ICF) and IPT in PLHIV. PLHIV newly enrolled in ART care were eligibility-screened for hepatitis and peripheral neuropathy, as well as for TB disease using a standardized four-symptom screening tool. Among eligible PLHIV, the overall weighted IPT initiation rate was 70% (95% CI: 46%–86%). Weighted IPT initiation among persons aged <15 years (30% [95% CI: 12%–55%]) was significantly lower than among persons aged ≥15 years (72% [95% CI: 47%–89%]; Rao-Scott chi-square P = 0.03). HIV-positive children aged <5 years had a weighted initiation rate of only 13% (95% CI: 1%–79%). For pregnant women, the weighted initiation rate was 67% (95% CI: 32%–90%), similar to non-pregnant women aged ≥15 years (72% [95% CI: 49%–87%]). Lastly, 95% (95% CI: 92%–97%) of eligible PLHIV started ART within one week of HIV diagnosis, and 92% (95% CI: 73%–98%) of patients receiving IPT began on the same day as ART.

Conclusions

Early-phase IPT uptake among adults at ART centers in Malawi was high. Child uptake needed improvement. National programs could adapt this framework to evaluate their ICF-IPT care cascades.
CD40 signaling augments IL-10 expression and the tolerogenicity of IL-10-induced regulatory dendritic cells
Authors: Dawicki Wojciech , Huang Hui , Ma Yanna , Town Jennifer , Zhang Xiaobei , Rudulier Chris D. , Gordon John R.
Published: April 2021

CD40 expressed on stimulatory dendritic cells (DC) provides an important accessory signal for induction of effector T cell responses. It is also expressed at lower levels on regulatory DC (DCreg), but there is little evidence that CD40 signaling contributes to the tolerogenic activity of these cells. Indeed, CD40 silencing within DCreg has been reported to induce T cell tolerance in multiple disease models, suggesting that CD40 is superfluous to DC-induced tolerance. We critically assessed whether CD40 does have a role in tolerance induced by IL-10-differentiated DC (DC10) by using DC10 generating from the bone marrow of wild-type (w.t.) or CD40-/-donor mice, or IL-10-complemented CD40-/-DC10 to treat asthmatic mice. Wild-type DC10 ablated the OVA-asthma phenotype via induction of Foxp3+Treg responses, but CD40-/-DC10 had no discernible effects on primary facets of the phenotype (e.g., IL-5, IL-9, IL-13 levels, IgE & IgG1 antibodies; p>0.05) and were ≤40% effective in reversal of others. Foxp3+T cells from the lungs of CD40-/-DC10-treated mice expressed reduced levels of a panel of six Treg-specific activation markers relative to Treg from w.t. DC10-treated mice. Coculture with effector T cells from asthmatic mice induced a marked upregulation of cell surface CD40 on w.t. DC10. While untreated CD40-/-and w.t. DC10 secreted equally low levels of IL-10, stimulation of w.t. DC10 with anti-CD40 for 72 h increased their expression of IL-10 by ≈250%, with no parallel induction of IL-12. Complementing IL-10 expression in CD40-/-DC10 by IL-10 mRNA transfection fully restored the cells’ abilities to suppress the asthma phenotype. In summary, CD40 signaling in DC10 contributes importantly to their expression of IL-10 and to a robust induction of tolerance, including activation of induced Treg.
Controlled hypotension during neuraxial anesthesia is not associated with increased odds of in-hospital common severe medical complications in patients undergoing elective primary total hip arthroplasty – A retrospective case control study
Authors: Liu Jiabin , Zhong Haoyan , DeMeo Danya , Do Huong , Kirksey Meghan , Gonzalez Della Valle Alejandro , YaDeau Jacques
Published: April 2021

Introduction

The use of controlled hypotension during neuraxial anesthesia for joint arthroplasty is controversial. We conducted a large institutional database analysis to assess common in-hospital complications and mortality of patients undergoing primary total hip arthroplasty (THA) under controlled hypotension and neuraxial anesthesia.

Methods

We conducted a large retrospective case control study of 11,292 patients who underwent primary THA using neuraxial anesthesia between March 2016 and May 2019 in a single institution devoted to musculoskeletal care. The degree and duration of various mean arterial pressure (MAP) thresholds were analyzed for adjusted odds ratios with composite common severe complications (in-hospital myocardial infarction, stroke, and/or acute kidney injury) as the primary outcome.

Results

Sixty-eight patients developed common severe complications (0.60%). Patients with complications were older (median age 75.6 vs 64.0 years) and had a higher American Society of Anesthesiologists (ASA) classification (45.6% vs 17.6% ASA III). The duration of hypotension at various MAP thresholds (45 to 70 mm Hg) was not associated with increasing odds of common severe medical complications.

Conclusions

Controlled hypotension (ranging from 45 to 70 mmHg) for a moderate duration during neuraxial anesthesia was not associated with increased odds of common severe complications (myocardial infarction, stroke, and/or acute kidney injury) among patients receiving neuraxial anesthesia for elective THA.
Balance rehabilitation with a virtual reality protocol for patients with hereditary spastic paraplegia: Protocol for a clinical trial
Authors: Zeigelboim Bianca Simone , José Maria Renata , Santos Geslaine Janaina Bueno dos , Severiano Maria Izabel Rodrigues , Teive Hélio Afonso Ghizoni , Stechman-Neto José , Santos Rosane Sampaio , de Araújo Cristiano Miranda , Cavalcante-Leão Bianca Lopes
Published: April 2021

Background

Neurodegenerative diseases are sporadic hereditary conditions characterized by progressive dysfunction of the nervous system. Among the symptoms, vestibulopathy is one of the causes of discomfort and a decrease in quality of life. Hereditary spastic paraplegia is a heterogeneous group of hereditary degenerative diseases involving the disorder of a single gene and is characterized by the progressive retrograde degeneration of fibers in the spinal cord.

Objective

To determine the benefits of vestibular rehabilitation involving virtual reality by comparing pre intervention and post intervention assessments in individuals with hereditary spastic paraplegia.

Methods

In this randomized controlled clinical trial from the Rebec platform RBR-3jmx67 in which allocation concealment was performed and the evaluators be blinded will be included. The participants will include 40 patients diagnosed with hereditary spastic paraplegia. The interventions will include vestibular rehabilitation with virtual reality using the Wii® console, Wii-Remote and Wii Balance Board (Nintendo), and the studies will include pre- and post intervention assessments. Group I will include twenty volunteers who performed balance games. Group II will include twenty volunteers who performed balance games and muscle strength games. The games lasted from 30 minutes to an hour, and the sessions were performed twice a week for 10 weeks (total: 20 sessions).

Results

This study provides a definitive assessment of the effectiveness of a virtual reality vestibular rehabilitation program in halting the progression of hereditary spastic paraplegia, and this treatment can be personalized and affordable.

Conclusion

The study will determine whether a vestibular rehabilitation program with the Nintendo Wii® involving virtual reality can reduce the progressive effect of hereditary spastic paraplegia and serve as an alternative treatment option that is accessible and inexpensive.

Rebec platform trial: RBR-3JMX67.
Spatial variations and determinants of anemia among under-five children in Ethiopia, EDHS 2005–2016
Authors: Anteneh Zelalem Alamrew , Van Geertruyden Jean-Pierre
Published: April 2021

Background

Anemia has severe public health significance in sub-Saharan Africa. In Ethiopia, anemia has been increasing in the last two decades, reaching the highest national level in 2016, however, the geospatial distribution and determinants of anemia in children weren’t well explored at a national level.

Methods

We used the Ethiopian Demographic and Health Survey(EDHS) data from 2005–2016. The data consists of samples of households (HHs) obtained through a two-stage stratified sampling procedure. Our analysis included 19,699 children. Descriptive statistics, geospatial analysis, and Generalized Linear Mixed Model (GLMMs) were used.

Results

The overall prevalence of anemia was 51.5%; the spatial distribution of anemia significantly different across clusters in each survey. Children from 6 to 11 months had higher odds of anemia compared to 24–59 months (Adjusted Odds ratio (AOR) = 3.4, 95%Confidence level (CI): 2.99–3.76). Children with the first and second birth order were less likely to be anemic compared to fifth and above (AOR = 0.60, 95%CI: 0.38–0.95, and AOR = 0.83, 95%C: 0.73–0.93) respectively. Mothers’ age 15 to 24 years was associated with higher odds of anemia compared to 35 to 49 years (AOR = 1.37, 95%CI: 1.20–1.55). Children from HHs with the poorest and poorer wealth category showed a higher odds of anemia compared to the richest (AOR = 1.67, 95%CI: 1.45–1.93, and AOR = 1.25, 95%CI: 1.08–1.45) respectively. Moreover, children from HHs with one to two under-five children were less likely to be anemic compared to those three and more (AOR = 0.83, 95%CI: 0.76–0.91).

Conclusions

The geospatial distribution of anemia among children varies in Ethiopia; it was highest in the East, Northeast, and Western regions of the country. Several factors were associated with anemia; therefore, interventions targeting the hotspots areas and specific determinant factors should be implemented by the concerned bodies to reduce the consequences of anemia on the generation.
Protocol: Prospective observational study investigating the prevalence and clinical outcome of portopulmonary hypertension in Japanese patients with chronic liver disease
Authors: Wakabayashi Shun-ichi , Joshita Satoru , Kimura Kazuhiro , Motoki Hirohiko , Kobayashi Hiroyuki , Yamashita Yuki , Sugiura Ayumi , Yamazaki Tomoo , Kuwahara Koichiro , Umemura Takeji
Published: April 2021

Background

Portopulmonary hypertension (PoPH) is a subtype of the pulmonary arterial hypertension (PAH) associated with portal hypertension. There is a dissociation between the proportion of PoPH in PAH and that of PoPH in patients with liver cirrhosis, suggesting PoPH underdiagnosis and an incomplete understanding of this entity in the clinical setting. Specifically, real-world data in Japan is largely unknown as compared with in Europe and the United States. The present study aims to elucidate the prevalence and etiology of PoPH in Japanese patients with chronic liver disease.

Methods and design

In this prospective, single-center, observational investigation of PoPH patients with chronic liver disease, a targeted 2,500 Japanese adult patients regularly visiting Shinshu University Hospital in Matsumoto, Japan, for chronic liver disease will complete a standardized questionnaire on the presence of PoPH symptoms. If the respondent has signs of possible PoPH, ultrasound echocardiography (UCG) will be performed as a primary screening. In the case that UCG findings indicate pulmonary hypertension, the patient will be referred to a cardiologist for further evaluation, whereby a definitive diagnosis PoPH can be made. PoPH prevalence and etiology will be investigated at the time of diagnosis. Afterwards, patients with PoPH will be followed for five years for determination of survival rate.

Discussion

This study will reveal the prevalence, etiology, and 5-year survival rate of PoPH in Japanese patients with chronic liver disease.

Trial registration

This study is being performed at Shinshu University following registration as UMIN 000042287 on October 29, 2020.
Prognostic factors of chronic pulmonary aspergillosis: A retrospective cohort of 264 patients from Japan
Authors: Kimura Yuya , Sasaki Yuka , Suzuki Junko , Suzuki Jun , Igei Hiroshi , Suzukawa Maho , Matsui Hirotoshi
Published: April 2021

Background

Chronic pulmonary aspergillosis (CPA) develops in various underlying pulmonary conditions. There is scarce data evaluating interstitial lung disease (ILD)/abnormalities (ILA) as such conditions, and it has not been explored much whether non-tuberculous mycobacterial pulmonary disease (NTM-PD) is a prognostic factor for mortality in CPA patients. Few reports had investigated prognostic factors of CPA including underlying pulmonary conditions.

Objectives

To explore prognostic factors of CPA including pulmonary conditions.

Methods

We conducted a retrospective cohort study of 264 CPA patients from a center for pulmonary aspergillosis in Japan.

Results

Survival rates were 78.7%, 61.0%, and 47.4% at 1, 3, and 5 years, respectively. Of 264 patients, 53 (20.1%) and 87 (33.1%) were complicated with ILA and NTM-PD. Several independent prognostic factors were identified by multivariate Cox proportional analysis: ILA (HR 1.76, 95%CI 1.06–2.92, p = 0.029), age (1.05, 1.02–1.08, p<0.001), male sex (2.48, 1.34–4.59, p = 0.004), body mass index of <18.5 kg/m2(1,87, 1.20–2.90, p = 0.005), presence of aspergilloma (1.59, 1.04–2.45, p = 0.033), and lower serum albumin (0.56, 0.38–0.83, p = 0.004). NTM-PD was not associated with higher mortality (0.85, 0.52–1.38, p = 0.51).

Conclusions

The poor prognosis of CPA and several prognostic factors were revealed. Early diagnosis and intervention is required with reference to such factors.
Prevalence of IgG antibodies against SARS-CoV-2 among healthcare workers in a tertiary pediatric hospital in Poland
Authors: Kasztelewicz Beata , Janiszewska Katarzyna , Burzyńska Julia , Szydłowska Emilia , Migdał Marek , Dzierżanowska-Fangrat Katarzyna
Published: April 2021

Data on the prevalence of the SARS-CoV-2 antibody in healthcare workers (HCWs) is scarce, especially in pediatric settings. The purpose of this study was to evaluate SARS-CoV-2 IgG-positivity among HCWs of a tertiary pediatric hospital. In addition, follow-up of the serological response in the subgroup of seropositive HCWs was analysed, to gain some insight on the persistence of IgG antibodies to SARS-CoV-2. We performed a retrospective analysis of voluntary SARS-CoV-2 IgG testing, which was made available free of charge to HCWs of the Children’s Memorial Health Institute in Warsaw (Poland). Plasma samples were collected between July 1 and August 9, 2020, and tested using the Abbott SARS-CoV-2 IgG assay. Of 2,282 eligible participants, 1,879 (82.3%) HCWs volunteered to undergo testing. Sixteen HCWs tested positive for SARS-CoV-2 IgG, corresponding to a seroprevalence of 0.85%. Among seropositive HCWs, three HCWs had confirmed COVID-19. Nine (56.3%) of the seropositive HCWs reported neither symptoms nor unprotected contact with confirmed SARS-CoV-2 cases in the previous months. A decline in the IgG index was observed at a median time of 86.5 days (range:84‒128 days) after symptom onset or RT-PCR testing. Further studies are necessary to elucidate the duration of persistence of anti-SARS-CoV-2 antibodies, as well as the correlation between seropositivity and protective immunity against reinfection. Regardless of the persistence of antibodies and their protective properties, such low prevalence indicates that this population is vulnerable to a second wave of the COVID-19 pandemic.
Bronchial epithelial DNA methyltransferase 3b dampens pulmonary immune responses during Pseudomonas aeruginosa infection
Authors: Qin Wanhai , Brands Xanthe , van’t Veer Cornelis , F. de Vos Alex , Sirard Jean-Claude , J. T. H. Roelofs Joris , P. Scicluna Brendon , van der Poll Tom
Published: April 2021

DNA methyltransferase (Dnmt)3b mediates de novo DNA methylation and modulation of Dnmt3b in respiratory epithelial cells has been shown to affect the expression of multiple genes. Respiratory epithelial cells provide a first line of defense against pulmonary pathogens and play a crucial role in the immune response during pneumonia caused by Pseudomonas (P.) aeruginosa, a gram-negative bacterium that expresses flagellin as an important virulence factor. We here sought to determine the role of Dntm3b in respiratory epithelial cells in immune responses elicited by P. aeruginosa. DNMT3B expression was reduced in human bronchial epithelial (BEAS-2B) cells as well as in primary human and mouse bronchial epithelial cells grown in air liquid interface upon exposure to P. aeruginosa (PAK). Dnmt3b deficient human bronchial epithelial (BEAS-2B) cells produced more CXCL1, CXCL8 and CCL20 than control cells when stimulated with PAK, flagellin-deficient PAK (PAKflic) or flagellin. Dnmt3b deficiency reduced DNA methylation at exon 1 of CXCL1 and enhanced NF-ĸB p65 binding to the CXCL1 promoter. Mice with bronchial epithelial Dntm3b deficiency showed increased Cxcl1 mRNA expression in bronchial epithelium and CXCL1 protein release in the airways during pneumonia caused by PAK, which was associated with enhanced neutrophil recruitment and accelerated bacterial clearance; bronchial epithelial Dnmt3b deficiency did not modify responses during pneumonia caused by PAKflic or Klebsiella pneumoniae (an un-flagellated gram-negative bacterium). Dnmt3b deficiency in type II alveolar epithelial cells did not affect mouse pulmonary defense against PAK infection. These results suggest that bronchial epithelial Dnmt3b impairs host defense during Pseudomonas induced pneumonia, at least in part, by dampening mucosal responses to flagellin.
Dressing the weightless body: Subjective verticality and the disoriented experience of dress in microgravity
Authors: Brownie Barbara
Published: April 2021

Design practice has historically been constrained by the assumption that designed objects, including clothing, will be made and worn in Earth gravity. The notion that designed objects have an upright state has influenced common approaches to design, including the tendency towards depiction and presentation of designed objects in elevation view, which, for fashion, is frequently understood in terms of silhouette. However, those who have experienced weightlessness, either in space travel or on board reduced-gravity aircraft, describe a post-gravity experience that prompts them to revisit these assumptions and consider the extent to which future commercial space travel will liberate creative practitioners to operate at all angles and orientations. As we enter the commercial space age, fashion will be increasingly worn in a variety of gravitational conditions, and the dressed body will therefore be encountered at a variety of orientations, showcasing views of garments that are not often encountered on Earth, and that are therefore often overlooked by fashion designers. This article responds to descriptions of the post-gravity experience by identifying the need to consider alternative views of the clothed body, and consequently to define garments without reference to the silhouette in fashion design for the new commercial space age.
ÉTICA E PSICOLOGIA CONSIDERAÇÕES SOBRE A PESSOA NA PSICOTERAPIA
Authors: De Carvalho José Mauricio
Published: April 2021

Neste trabalho, vamos apresentar as interdições éticas aos

procedimentos psicoterápicos. Nossa reflexão vai se concentrar

sobre a psicoterapia individual e terá por referencial teórico as

contribuições da fenomenologia para a compreensão da existência

humana.
OS EDITORIAIS DA REVISTA EDUCAÇÃO E FILOSOFIA DA UNIVERSIDADE FEDERAL DE UBERLÂNDIA: UMA PRIMEIRA ANaLISE
Authors: Loureiro Maria Dulcinea da Silva , Favacho André Marcio Picanço
Published: April 2021

O presente artigo propõe-se a fazer uma reflexão sobre a Revista

Educação e Filosofia da Universidade Federal de Uberlândia, tendo

como objeto de análise os seus editoriais. Inicialmente,

descreveremos a trajetória da Revista em seus 17 anos de existência

e, para isso, faremos uma rápida incursão no seu ciclo de vida,

com o intuito de acompanhar as mudanças ocorridas, tanto no

seu aspecto técnico - referente Ã  organização, publicação e

editoração da revista - quanto no conteúdo dos seus editoriais.

Em seguida, deter-nos-emos na análise dos editoriais, pois

compreendemos que os mesmos assumiram, durante muito tempo,

o papel de porta vozes dos inconformismos com a política social,

educacional, e com os encaminhamentos econômicos que estavam

sendo postos em prática com a política neoliberal.
É POSSaVEL ENSINAR O CERTO E O ERRADO?
Authors: Fenerich Claudia
Published: April 2021

Este breve artigo procura encaminhar uma resposta

contemporânea à velha questão socrático-platônica sobre a

possibilidade de se ensinar a virtude. O problema é enfrentado sob

a perspectiva filosófica que confere à argumentação um papel

central com relação à moralidade. A partir dos pressupostos gerais

da teoria da argumentação, procede-se, então, estabelecendo-se

um confronto simultâneo entre essa perspectiva e as duas visões

filosóficas tradicionais, a essencialista e a relativista. Como aportes

teóricos principais, a título de exemplificação das tendências

consideradas, bem como dos embates histórico-filosóficos travados

entre elas, destacam-se aqui os pensamentos de Sócrates-Platão e

Perelman.
The Influence of Brand Credibility towards Words of Mouth of Fashion Brand
Authors: Shindy Shindy , Hariandja Evo Sampetua
Published: April 2021

This research tries to examine the factors influencing the positive word of mouth of Indonesianâ€™s consumer towards fashion brand. The factors studied include brand credibility and brand-self connection as independent variables, brand-self connection and brand-social connection as the mediating variables, and memorial brand experience as the moderating variable. This study is quantitative research with data collection method using the electronic questionnaires of Google forms. This study uses 300 respondents of Prada Italian brand in Indonesia and the data is analyzed using structural equation modelling. The results show that brand credibility, brand self-connection, and brand social connection have a positive effect on word of mouth. Both brand self-connection and brand social connection mediate the influence of brand credibility on word of mouth. This study suggests that by preserving the relationships with consumers as well as consumer relationships with other consumers, managers would be able to produce more positive word of mouth.
The Islamic Ethical Leadership and Employeesâ€™ Ethical Behavior: The Moderating Role of Ethical Sensitivity
Authors: Yulianti Emma , Setiawan Margono , Surachman Surachman , Irawanto Dodi Wirawan
Published: April 2021

Previous literatures have described the influence of ethical leadership on employeesâ€™ outcomes. However, many researchers have not yet revealed the mechanism of this effect. Previous research has found that cultural and social factors influence leader-ship styles; therefore, studying ethical leadership styles in different cultural and social environments is important in order to uncover the effectiveness of ethical leadership styles. The purpose of this study was to examine how the mechanism of Islamic ethical leadership influences the behavior of professional nurses who work at the Islamic Hos-pital. There were 212 professional nurses used as the respondents in this study. The data were collected using questionnaires and processed quantitatively using Struc-tural Equation Model (SEM) - WarpPLS 5.0. The results showed that all the hypoth-eses proposed were accepted. Islamic ethical leadership is proven to have a significant influence on ethical behavior of nurses. Besides, ethical sensitivity is proven to have a significant positive effect on ethical behavior. This study also proves that ethical sensitivity moderates the influence of Islamic ethical leadership on nurses' ethical be-havior. It can be implied that ethical sensitivity is an important factor for developing employeesâ€™ ethical behavior in the workplace.
Maintaining the Performance and Sustainability of MSMEs with E-Commerce: Research during the Covid-19 Pandemic
Authors: Budiarto Dekeng Setyo , Vivianti Ervana , Diansari Rani Eka
Published: April 2021

Even though they have a considerable contribution to economic growth, MSMEs have various business sustainability problems. This study aims to test whether e-commerce, information technology, business network affects performance. Besides, this study also examines the effect of performance on business sustainability. The data were obtained employing a questionnaire given to 193 MSMEs owners in Yogyakarta. This research was conducted during the COVID-19 pandemic so that questionnaires were distributed both online and offline. The analysis results using PLS show that e-commerce and business networks affect performance, while information technology does not affect performance. Furthermore, performance affects the sustainability of SME businesses. This research implies that there is still need for support from the government so that MSMEs can take advantage of e-commerce and expand business networks to survive during the Covid-19 pandemic
Strategi Lembaga Pendidikan Anak Usia Dini dalam Melibatkan Guru Laki-Laki
Authors: Hayati Miratul , Yubaedi Siron  , Hermawati Erma
Published: April 2021

The involvement of male teachers in Early Childhood Education (ECE) institutions is still a matter of debate. Data for the last 10 years shows a decrease in the number of male teachers in ECE institutions. Even though their involvement is as a substitute figure for their father at school. This study aims to determine the strategy carried out at ECE institutions in KB-TK Al-Fath Cirendeu in involving male teachers. This research uses a qualitative approach with a case study method. The research subjects included: the principal, 2 female teachers and 7 male teachers. Data collection was carried out employing observation, in-depth interviews and documentation. Data analysis using Miles Huberman through the stages of data reduction, data presentation, verification, and concluding. The results of the study found that the ECE institutional strategy to involve male teachers in the institution was carried out through the planning of male teacher involvement objectives, recruitment plans, provision of special facilities, preparation of organizational structures, division of job descriptions between male and female teachers and institutional supervision of male teacher performance.