bluuebunny/crossref_metadata_2025 huggingface dataset:
Double Trouble of “Double Segmental” Fractures – A Report of Two Cases
Authors: Bansal Nitish , Singh Gitesh , Tiwari Punit , Kaur Harmeet
Published: July 2022

Introduction:A “double segmental” fracture is an injury pattern that has three fracture sites and four fracture segments in a single bone. It is extremely rare, with only three “Double segmental femoral fracture” and only four “double segmental tibia fracture” cases reported in the literature. These fractures are associated with difficulty in deciding the implant for fixation, segment reduction, maintenance of reduction, maintaining blood supply of segment during fixation, and the high risk of post-operative complications. Case Report:We present two unique cases, one of “double segmental femur fracture” and the other of “double segmental tibia fracture,” fixed with intramedullary nailing. When Schanz screw or Steinman pins were used to reduce the intermediate fragments and hold them in place, they interfered with the reaming due to the protruding part in the narrow canal. This problem could be solved using weber clamps to hold reduction as they do not obscure the canal. All the fractures united uneventfully at 9 months follow-up. Conclusion: A “single intramedullary device” to fix “all the segments” can help provide stabilization without compromising soft-tissue attachments and viability of the intermediate fracture segments in “double segmental” fractures. Keywords: Double segmental fracture, intramedullary nailing, trifocal fracture, femur, tibia, fracture.
Non-Isthmic Spondylolysis Imaging Features: A Case Report
Authors: Desouza Clevio , Jani Chiranjivi , Patil Vishal
Published: July 2022

Introduction: The leading cause of low back pain in our country like India in children and in adolescent has been found to be lumbar spondylolysis. This affects approximately 6–8% of adults in the general population which includes a large number of asymptomatic cases. The main cause in this disease is found to be that of fatigue features which are found in 10% of young adults during heavy labor work, sports, and athletic activities. Case Report: A 25-year-old, left hand dominant, cricket player was referred to Dr. DY Patil Hospital and Research Centre, Pimpri, Pune with complaint of low back pain while playing cricket with no neurological symptoms. His symptoms started 6 months back to this visit and have worsened despite conservative treatment with medications and rehabilitation. No obvious line was seen on the X-rays, but a right non-isthmic spondylolysis was noted at L5 on computed tomography scan. Based on our imaging findings and clinical examination, we made a diagnosis of non-isthmic spondylolysis. As the patient desired an early return to activity, we did not aim for bone union and provided pain relieving treatment which included temporary wearing of soft brace. As a result his pain improved. Conclusion:In our case, the fracture type is more coronally oriented compared with a fracture line in typical spondylolysis. Furthermore, lifting weights transmit a force from the upper limb to lower limbs, it is likely that high loading causes this type of fracture. From a view of biomechanics, reducing extension loading should be an effective means in the treatment of this type of fracture. Keywords:Non-isthmic, Spondylolysis, Low back pain, Fracture.
Recurrent Aneurysmal Bone Cyst of Proximal Femur with Pathological Fracture – A Case Report
Authors: Pai Satvik N , Harshavardhan Giriraj , Menon P Gopinath
Published: July 2022

Introduction: Aneurysmal bone cyst (ABC) is a rare, benign, and cystic lesion. The most common sites are the femur, tibia, humerus, and spine. It is more common in females and usually occurs during the second decade of life. Case Report:A 5-year-old female child had a trivial fall, following which she developed pain in her left hip. Radiographs revealed an expansile, lytic lesion in the metaphysis of the left proximal femur. Cortical breach was present resulting in a pathological fracture. Biopsy of the lesion showed blood filled cystic spaces confirming the diagnosis of ABC. We performed an extended curettage of the lesion, bone grafting, and angle blade plate fixation. The angle blade plate was removed 1 year after the surgery. Two years later, she complained of pain in the left hip. Radiographs showed a geographic lytic lesion surrounding the previously inserted bone graft. Magnetic resonance imaging revealed multiple blood fluid levels. We performed an extended curettage with high speed burr. We filled the cavity with bone substitute and stabilized the region using a proximal humerus internal locking system plate. The histopathological examination of intraoperative samples confirmed the diagnosis of recurrence of ABC. We found no further recurrence of the tumor after 3 years of follow-up. Conclusion:ABCs can present with pathological fractures and requires management of the cyst and stabilization of the bone. Recurrent ABCs can be managed by re-curettage of the lesion and prophylactic internal fixation. The curettage has to be extensive through a large cortical window and using a high speed burr. Keywords:Aneurysmal bone cyst, recurrence, pathological fracture, treatment.
Fibrocartilaginous Dysplasia – A Report of Five Cases with Review of Literature
Authors: Lakshmanan Archana , Parameswaran Ashok
Published: July 2022

Introduction:Fibrocartilaginous dysplasia (FCD) is a variant of fibrous dysplasia (FD) with extensive cartilaginous differentiation. This has been reported in both monostotic and polyostotic types of FD, the proximal femur being the most common site involved. Case Report:We report five cases of fibrocartilaginous dysplasia with varying degrees of cartilaginous differentiation. The age of the patients ranged from 7 to 30 years, and there was a female predominance (M:F ratio of 1:4). The proximal femur was the site of involvement in all the cases. Imaging showed well demarcated radiolucent lesions with stippled calcifications. Histologically, cartilaginous areas were noted juxtaposed to typical areas of fibrous dysplasia. Four of the patients were treated with curettage and one with a marginal resection. None of the five cases had recurrences at the past follow-up. Conclusion:FCD is a rare variant of fibrous dysplasia which needs to diagnosed and treated early, as there is a high risk of pathological fracture. Keywords:Fibrous dysplasia, fibrocartilaginous, cartilaginous tumors, enchondroma, chondrosarcoma.
Management of Short Proximal Femur Nail Peri Peri-Implant Fracture of Femur Shaft with Implant Removal and Long Distal Femur Locking Plate and Bone Grafting – A Case Report
Authors: Mahajan Neetin P , Ghoti Santosh , Patil Tushar C , Pande Kartik P , Talukder Pritam
Published: July 2022

Introduction:The rising demographic trend towards elderly population and increased incidence of osteosynthesis of proximal femur fractures are associated with increased recurrent falls and rise in incidence of peri- implant fractures. Case Report: Here, we present a difficult case of a peri- implant femur shaft fracture in a 55-year-old male, with stuck short proximal femur nail (PFN) removal followed by long distal femur plating with bone grafting showing good fracture union at 1 year with satisfactory functional outcome. Conclusion:Peri- implant femur fractures are quite rare and more commonly occur in elderly. Among all treatment modalities for intertrochanteric femur fracture fixation, the literature shows short PFN having highest comparative risk for peri peri-implant fractures. Implant removal followed by locking plates for long spiral fractures provides a stable, anatomical, and reliable fixation. Bone grafting augments bony union, especially in cases of bone defects. Keywords: Peri-implant, femur, fracture, proximal femur nail, distal femur locking plate.
Independent Living as a Counter-Narrative
Authors: Tarrant Alison
Published: July 2022

This article explores the concept of independent living as a counter-narrative. I argue that in addition to being both an aim for disabled people and a campaign objective for the global disabled people’s movement, independent living also acts as a narrative tool that opposes majoritarian social constructions of disability and creates ‘repaired’ identities for disabled people. I analyse documents produced by the disabled people’s movement in the UK to establish how independent living performs the work of resistance and re-draws social identities to enable equality and social justice for disabled people. I suggest that if independent living is to be effectively enshrined in domestic law and policy, the challenge it poses to dominant social narratives must be fully understood, and consider the role of the UN Convention on the Rights of Persons with Disabilities in effecting this.
Flat-optics generation of broadband photon pairs with tunable polarization entanglement
Authors: Sultanov Vitaliy , Santiago-Cruz Tomás , Chekhova Maria V.
Published: July 2022

The concept of “flat optics” is quickly conquering different fields of photonics, but its implementation in quantum optics is still in its infancy. In particular, polarization entanglement, strongly required in quantum photonics, is so far not realized on “flat” platforms. Meanwhile, relaxed phase matching of “flat” nonlinear optical sources enables enormous freedom in tailoring their polarization properties. Here we use this freedom to generate photon pairs with tunable polarization entanglement via spontaneous parametric downconversion (SPDC) in a 400-nm GaP film. By changing the pump polarization, we tune the polarization state of photon pairs from maximally entangled to almost disentangled, which is impossible in a single bulk SPDC source. Polarization entanglement, together with the broadband frequency spectrum, results in an ultranarrow (12 fs) Hong–Ou–Mandel effect and promises extensions to hyperentanglement.
Fabrication and characterization of a composite TiO2-polypropylene high-refractive-index solid immersion lens for super-resolution THz imaging
Authors: Chapdelaine Quentin , Nallappan Kathirvel , Cao Yang , Guerboukha Hichem , Chernomyrdin Nikita , Zaytsev Kirill , Skorobogatiy Maksim
Published: July 2022

Terahertz (THz) near-field imaging is attracting a lot of attention for its potential applications in medical diagnosis and material characterization. However, the spatial resolution of the recorded THz image was mainly limited by the diffraction limit of the commonly used lens- and mirror-based THz optical systems. Alternatively, a solid immersion lens (SIL) can be a promising approach for achieving super-resolution imaging as it reduces the spot size of the focused THz beam by a factor of 1/n, where n is the refractive index (RI) of the lens material. In this work, we present the design and fabrication of hemispherical THz SIL using powder mixes of titanium dioxide (TiO2) and polypropylene (PP) whose RIs are ≈10 and ≈1.51, respectively, at 1.0 THz. In particular, we present two different lens fabrication strategies that are simple and cost-effective solutions. The first strategy uses pressing the TiO2 powder with a PP powder at the Vicat temperature of PP while controlling the concentration of TiO2 and the resultant lens porosity. The second design consists in pressing the TiO2 powder in a hollow hemisphere that is 3D printed using PP. The fabricated lenses are then characterized physically and optically, and their RIs are compared to the theoretical estimates using the Bruggeman model of the effective media. From the experimental measurements of the proposed SIL, a resolution limit as low as 0.2λ was achieved at 0.09 THz (λ ≈ 3.3 mm), which is comparable to the best resolutions reported in the literature.
Sexual and developmental variations of ecto-parasitism in damselflies
Authors: Paul Shatabdi , Khan Md Kawsar , Herberstein Marie E.
Published: July 2022

The prevalence and intensity of parasitism can have different fitness costs between sexes, and across species and developmental stages. This variation could arise because of species specific sexual and developmental differences in body condition, immunity, and resistance. Theory predicts that the prevalence of parasitism will be greater in individuals with poor body condition and the intensity of parasitism will be greater in individuals with larger body size. These predictions have been tested and verified in vertebrates. In insects, however, contradictory evidence has been found in different taxa. Here, we tested these predictions on two species ofAgriocnemis(Agriocnemis feminaandAgriocnemis pygmaea) damselflies, which are parasitized byArrenuruswater mite ectoparasites. We measured body weight, total body length, abdomen area and thorax area of non-parasitized damselflies and found body condition varied between males and females, between immature females and mature females and betweenA.feminaandA.pygmaea. Then, we calculated the parasite prevalence, i.e., the absence or presence of parasites and intensity, i.e., the number of parasites per infected damselfly in eleven natural populations of both species. In line to our predictions, we observed greater prevalence in immature females than mature females but found no difference in parasite prevalence between males and females. Furthermore, we found that parasite intensity was higher in females than males and in immature females than mature females. Our result also showed that the frequency and intensity of parasitism varied between the two studied species, being higher inA.pygmaeathanA.femina. Our study provides evidence that parasitism impacts sexes, developmental stages and species differentially and suggests that variation may occur due to sex, developmental stage, and species-specific resistance and tolerance mechanism.
A low-cost, open-source centrifuge adaptor for separating large volume clinical blood samples
Authors: Haque Md Ehtashamul , Marriott Linda , Naeem Noman , Henry Taygan , Conde Alvaro J. , Kersaudy-Kerhoas Maïwenn
Published: July 2022

Blood plasma separation is a prerequisite in numerous biomedical assays involving low abundance plasma-borne biomarkers and thus is the fundamental step before many bioanalytical steps. High-capacity refrigerated centrifuges, which have the advantage of handling large volumes of blood samples, are widely utilized, but they are bulky, non-transportable, and prohibitively expensive for low-resource settings, with prices starting at $1,500. On the other hand, there are low-cost commercial and open-source micro-centrifuges available, but they are incapable of handling typical clinical amounts of blood samples (2-10mL). There is currently no low-cost CE marked centrifuge that can process large volumes of clinical blood samples on the market. As a solution, we customised the rotor of a commercially available low-cost micro-centrifuge (~$125) using 3D printing to enable centrifugation of large clinical blood samples in resource poor-settings. Our custom adaptor ($15) can hold two 9 mL S-Monovette tubes and achieve the same separation performance (yield, cell count, hemolysis, albumin levels) as the control benchtop refrigerated centrifuge, and even outperformed the control in platelet separation by at least four times. This low-cost open-source centrifugation system capable of processing clinical blood tubes could be valuable to low-resource settings where centrifugation is required immediately after blood withdrawal for further testing.
Horizontal connectivity in V1: Prediction of coherence in contour and motion integration
Authors: Le Bec Benoit , Troncoso Xoana G. , Desbois Christophe , Passarelli Yannick , Baudot Pierre , Monier Cyril , Pananceau Marc , Frégnac Yves
Published: July 2022

This study demonstrates the functional importance of the Surround context relayed laterally in V1 by the horizontal connectivity, in controlling the latency and the gain of the cortical response to the feedforward visual drive. We report here four main findings: 1) a centripetal apparent motion sequence results in a shortening of the spiking latency of V1 cells, when the orientation of the local inducer and the global motion axis are both co-aligned with the RF orientation preference; 2) this contextual effects grows with visual flow speed, peaking at 150–250°/s when it matches the propagation speed of horizontal connectivity (0.15–0.25 mm/ms); 3) For this speed range, the axial sensitivity of V1 cells is tilted by 90° to become co-aligned with the orientation preference axis; 4) the strength of modulation by the surround context correlates with the spatiotemporal coherence of the apparent motion flow. Our results suggest an internally-generated binding process, linking local (orientation /position) and global (motion/direction) features as early as V1. This long-range diffusion process constitutes a plausible substrate in V1 of the human psychophysical bias in speed estimation for collinear motion. Since it is demonstrated in the anesthetized cat, this novel form of contextual control of the cortical gain and phase is a built-in property in V1, whose expression does not require behavioral attention and top-down control from higher cortical areas. We propose that horizontal connectivity participates in the propagation of an internal “prediction” wave, shaped by visual experience, which links contour co-alignment and global axial motion at an apparent speed in the range of saccade-like eye movements.
Static posturography as a novel measure of the effects of aging on postural control in dogs
Authors: Mondino Alejandra , Wagner Grant , Russell Katharine , Lobaton Edgar , Griffith Emily , Gruen Margaret , Lascelles B. Duncan X. , Olby Natasha Jane
Published: July 2022

Aging is associated with impairment in postural control in humans. While dogs are a powerful model for the study of aging, the associations between age and postural control in this species have not yet been elucidated. The aims of this work were to establish a reliable protocol to measure center of pressure excursions in standing dogs and to determine age-related changes in postural sway. Data were obtained from 40 healthy adult dogs (Group A) and 28 senior dogs (Group B) during seven trials (within one session of data collection) of quiet standing on a pressure sensitive walkway system. Velocity, acceleration, root mean square, 95% ellipse area, range and frequency revolve were recorded as measures of postural sway. In Group A, reliability was assessed with intraclass correlation, and the effect of morphometric variables was evaluated using linear regression. By means of stepwise linear regression we determined that root mean square overall and acceleration in the craniocaudal direction were the best variables able to discriminate between Group A and Group B. The relationship between these two center-of-pressure (COP) measures and the dogs’ fractional lifespan was examined in both groups and the role of pain and proprioceptive deficits was evaluated in Group B. All measures except for frequency revolve showed good to excellent reliability. Weight, height and length were correlated with most of the measures. Fractional lifespan impacted postural control in Group B but not Group A. Joint pain and its interaction with proprioceptive deficits influence postural sway especially in the acceleration in the craniocaudal direction, while fractional lifespan was most important in the overall COP displacement. In conclusion, our study found that pressure sensitive walkway systems are a reliable tool to evaluate postural sway in dogs; and that postural sway is affected by morphometric parameters and increases with age and joint pain.
Metformin suppresses pro-inflammatory cytokines in vitreous of diabetes patients and human retinal vascular endothelium
Authors: Li Yue , Gappy Shawn , Liu Xiuli , Sassalos Therese , Zhou Tongrong , Hsu Andrew , Zhang Alice , Edwards Paul A. , Gao Hua , Qiao Xiaoxi
Published: July 2022

Metformin is a traditional anti-hyperglycemic medication that has recently been shown to benefit vascular complications of diabetes via an anti-inflammatory mechanism other than glycemic control. This study aims to test the hypothesis that metformin suppresses diabetic retinopathy (DR) associated intraocular inflammation. Human vitreous from control and proliferative diabetic retinopathy (PDR) patients with or without long-term metformin treatment (> 5 years) were collected for multiple inflammatory cytokines measurements with a cytokine array kit. The vast majority of the measurable cytokines in PDR vitreous has a lower level in metformin group than non-metformin group. Although the p values are not significant due to a relatively small sample size and large deviations, the 95% confidence interval (CI) for the mean difference between the two groups shows some difference in the true values should not be neglected. Using quantitative ELISA, soluble intercellular adhesion molecule -1 (ICAM-1) and monocyte chemoattractant protein -1 (MCP-1) presented with significantly lower concentrations in metformin group versus non-metformin group. Metformin group also has significantly less up-regulated cytokines and diminished positive correlations among the cytokines when compared to non-metformin group. Possible role of AMP-activated protein kinase (AMPK) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) in metformin’s anti-inflammatory effects were studied in human retinal vascular endothelial cells (hRVECs) cultured in normal glucose (NG) and high glucose (HG) conditions. Metformin inhibited HG-induced ICAM-1, IL-8, and MCP-1 via AMPK activation, whereas pharmacological AMPK inhibition had no effect on its inhibition of NF-κB p65, sICAM-1, and tumor necrosis factor-α (TNF-α). Metformin-induced suppression of the inflammatory cytokines could also be mediated through its direct inhibition of NF-κB, independent of AMPK pathway. This is a proof-of-concept study that found metformin treatment was associated with reduced inflammatory responses in vitreous of diabetes patients and retinal vascular endothelial cells, supporting the rationale for using metformin to treat DR at an early stage.
Early echocardiographic assessment of cardiac function may be prognostically informative in unresuscitated patients with sepsis: A prospective observational study
Authors: Ehrman Robert R. , Favot Mark J. , Harrison Nicholas E. , Khait Lyudmila , Ottenhoff Jakob E. , Welch Robert D. , Levy Phillip D. , Sherwin Robert L.
Published: July 2022

Purpose

The goal of this study was to explore the association cardiac function at Emergency Department (ED) presentation prior to the initiation of resuscitation, and its change at 3-hours, with adverse outcomes in patients with sepsis.

Methods

This was a prospective observational study of patients presenting to an urban ED with suspected sepsis. Patients had a point-of-care echocardiogram performed prior to initiation of resuscitation and again 3 hours later. Left-ventricular (LV) parameters recorded included e’, and E/e’, and ejection fraction (EF); right-ventricular (RV) function was evaluated using tricuspid annular plane systolic excursion (TAPSE). Logistic and generalized linear regression were used to assess the association of echocardiographic parameters and ≥ 2-point increase in SOFA score at 24 hours (primary outcome) and 24-hours SOFA score and in-hospital mortality (secondary outcomes).

Results

For ΔSOFA ≥ 2 and 24-hour SOFA score, declining LVEF was associated with better outcomes in patients with greater baseline SOFA scores, but worse outcomes in patients with lower baseline scores. A similar relationship was found for ΔTAPSE at 3 hours. Reduced LVEF at presentation was associated with increased mortality after adjusting for ED SOFA score (odds-ratio (OR) 0.76 (CI 0.60–0.96). No relationship between diastolic parameters and outcomes was found. IVF administration was similar across ΔLVEF/TAPSE sub-groups.

Conclusions

Our results suggest that early change in LV and RV systolic function are independently prognostic of sepsis illness severity at 24-hours. Further study is needed to determine if this information can be used to guide treatment and improve outcomes.
Assessing the impact of caregiving on informal caregivers of adults with a mental disorder in OECD countries: A systematic literature review of concepts and their respective questionnaires
Authors: Bremmers Leonarda G. M. , Fabbricotti Isabelle N. , Gräler Eleonora S. , Uyl-de Groot Carin A. , Hakkaart-van Roijen Leona
Published: July 2022

We conducted a systematic literature review to identify and review the concepts and questionnaires used to assess the impact of caregiving on caregivers for adults with a mental disorder. With our study, we aimed to provide an overview and categorize the conceptualization and operationalization of the impact of caregiving, with special attention for the complexity and multi-conceptualization of concepts. Embase, Medline, PsycInfo, Web of Science Core Collection, Cochrane Central Register of Trials, Cinahl Plus, Econlit and Google Scholar were systematically searched for articles from 1 January 2004 to 31 December 2019. Eligible articles were peer-reviewed studies that assessed the impact of caregiving for informal caregivers of adults with a reported mental disorder by means of a questionnaire. The complete study protocol can be found on PROSPERO (CRD42020157300). A total of 144 questionnaires were identified that assessed the impact of caregiving. Based on similarities in meaning, concepts were classified into 15 concept clusters. The most frequently assessed concept clusters were mental health, caregiving burden, other caregiving consequences, family impact, and overall health-related outcomes. The use of concept clusters differed per diagnosis group, with diagnoses, such as schizophrenia, using a wide range of caregiving impact concepts and other diagnoses, such as personality disorders, only using a limited range of concepts. This is the first study that identified and reviewed the concepts and questionnaires that are used to assess the impact of caregiving. Caregiving is researched from a broad array of perspectives, with the identification of a variety of concepts and dimensions and use of non-specific questionnaires. Despite increasing interest in this field of research, a high degree of variability remains abundant with limited consensus. This can partially be accredited to differences in the naming of concepts. Ultimately, this review can serve as a reference to researchers who wish to assess the impact of caregiving and require further insight into concepts and their respective questionnaires.
Impact of rigid gas-permeable contact lens on keratometric indices and corneal thickness of keratoconus eyes examined with anterior segment optical coherence tomography
Authors: Akiyama Kaho , Ono Takashi , Ishii Hitoha , Chen Lily Wei , Kitamoto Kohdai , Toyono Tetsuya , Yoshida Junko , Aihara Makoto , Miyai Takashi
Published: July 2022

Purpose/Aim

Detecting keratoconus (KC) progression helps determine the surgical indication for corneal cross-linking (CXL). This retrospective observational study aimed to examine changes in keratometric indices and corneal thickness in patients with KC who used rigid gas-permeable (RGP) contact lenses.

Materials and methods

This study involved 31 eyes (31 patients) diagnosed with KC. No patient had used RGP or any other type of contact lenses for at least 1 month. Corneal topographic data were obtained using three-dimensional anterior segment optical coherence tomography before and after >1 month of RGP lens use.

Results

The average and maximum keratometry values changed after using an RGP lens (-1.05 ± 1.92 D, p < 0.01 and -1.65 ± 4.20 D, p = 0.04, respectively); the spherical component of the anterior corneal surface became significantly smaller (p = 0.02). No change was observed in the central or thinnest corneal thickness values. Keratometric changes were greater in eyes with severe KC than in those with moderate KC (p = 0.014).

Conclusions

Keratometry and spherical components of the anterior corneal surface values decreased after RGP lens use; keratometric changes were greater in eyes with severe KC than in those with moderate KC. Corneal progression indices, including corneal thickness, posterior keratometry, and irregular astigmatism values, mostly remained unchanged. It is important to consider these findings when evaluating corneal topography of KC and preparing CXL.
Choice experiment selection of tourism destinations in a dual process theory framework: The role of decision style and potential to promote deliberation
Authors: Lindberg Kreg , Stemmer Kathrin
Published: July 2022

Models of consumer choice that assume rational decision processes are too simplistic, as they ignore intuitive processes and combinations of intuition and rationality. In dual process theory, System 1 processes are intuitive, fast, require low cognitive effort, and involve autonomous systems, while System 2 processes are deliberative, slower, reflect greater cognitive effort, and involve controlled attention. The dual process framework facilitates understanding of decision processes that may be diverse and complex. Based on response time as an indicator of System 2 use, we fill gaps in the tourism and choice experiment literatures by i) assessing the dimensionality of a decision style scale and its role in predicting System 2 use and ii) assessing whether researcher interventions, such as instructions, can promote System 2 use. The study is based on survey-based choice experiment responses of 483 domestic and international visitors across two Norwegian nature-based tourism destination contexts. Each visitor completed four choice experiment tasks for a total of 1,932 choice occasions. Results indicated diversity in extent of System 2 use. The decision style scale was multidimensional with both the intuitive and rational subscales predicting response time. We encourage inclusion of decision style scales–and specifically multidimensional scales–in future tourism choice and choice experiment applications. Statistically significant coefficients for instructions and unhurriedness suggest potential for researchers to increase System 2 processing in survey tasks. We encourage future use of this intervention, especially when survey tasks are intended to replicate “real world” decisions that rely heavily on System 2 use.
Exploring alternative cytokines as potential biomarkers for latent tuberculosis infection in pregnant women
Authors: Indrati Agnes Rengga , Sumarpo Anton , Atmadja Petty , Wisesa Rositha Ratna , Ghozali Mohammad , Judistiani Raden Tina Dewi , Setiabudiawan Budi
Published: July 2022

Background

Interferon gamma release assays (IGRAs) are widely used to determine latent tuberculosis infection status. However, its pregnancy-affected performance and cost-expensive nature warrants for different alternatives for pregnant women. This study aims to evaluate the diagnostic performance of several alternative cytokines, including interleukin 2 (IL-2), interleukin 10 (IL-10), and interferon gamma-induced protein 10 (IP-10) to identify latent tuberculosis status in pregnant women.

Materials and methods

123 pregnant womens were recruited for this study. The IGRA status was determined by using QuantiFERON Gold In-Tube. Meanwhile, we measured the level IL-2, IL-10, and IP-10 by using sandwich-microELISA method. We performed normality and comparison test by SPSS. In addition, receiver-operator characteristic (ROC) analyses and the optimal cutoff scores were identified using the EasyROC webtool.

Results

We showed that IL-2, IL-10, and IP-10 were able to discriminate between IGRA-negative and IGRA-positive pregnant women. Moreover, IP-10 showed the highest discriminatory and diagnostic performance when compared to IL-2 and IL-10 with area under the curve (AUC) of 0.96 and cutoff point of 649.65 pg/mL.

Conclusions

Our study showed that IP-10 can be considered as a promising alternative biomarker for IGRAs to diagnose LTBI in pregnant women.
Study protocol of guided mobile-based perinatal mindfulness intervention (GMBPMI) - a randomized controlled trial
Authors: Ng Siu-man , Leng Ling Li , Chan Ka Po , Lo Hay-ming Herman , Yeung Albert , Lu Shuang , Wang Amenda , Li Hui Yun
Published: July 2022

Background

Psychological distress is a common occurrence among women during the perinatal period. Maternal psychological distress (MPS) can also have a negative influence on neonatal outcomes such as infant health, child development or mother-child interaction. Hence, interventions to improve mental wellbeing during this period are vital. Mindfulness based intervention (MBI) has been found to be effective in reducing psychological distress. Delivery of MBI via the internet, making it accessible and inexpensive, is showing a promising positive effect in reducing psychological distress. A randomized control trial with sufficient power is required to confirm its positive effect among pregnant women. The positive effects of MBI have been found to be associated with heart rate variability (HRV) biofeedback; however, the efficacy of MBI on HRV has been rarely studied among pregnant women. Also, the potential association of HRV with MBI and psychological wellbeing needs further examination. This research aims to test the effectiveness of guided mobile-based perinatal mindfulness intervention (GMBPMI) among pregnant women experiencing psychological distress during the pre- and post-natal period, as well as examining the efficacy of GMBPMI on HRV.

Method

This study is a randomized controlled trial that follows a parallel design. Consenting pregnant women in their second trimester (between 12th and 20th week gestation) will be randomly assigned to an intervention group (GMBPMI) or a control group (psychoeducation). The intended sample size is 198, with 99 participants in each group. Three levels of outcomes will be measured at baseline, post intervention in both the intervention and control groups, and at 36-week gestation and five-week postpartum. The primary outcomes include maternal psychological stress, mindfulness and positive appraisal HRV. Secondary outcomes are psychological and physical wellbeing. Tertiary outcomes include obstetric and neonatal outcomes, and social support. Analyses will follow an intention-to-treat method and repeated measures MANOVA will be conducted to compare changes in primary and secondary outcomes. A series of mixed-effects models will be fitted to assess the mediation effects.

Discussion

This trial expects to increase understanding of GMBPMI on HRV and psychological wellbeing for pregnant women, with extended support in both pre-and post-natal periods. The study could also potentially provide evidence for delivery of cost-effective and accessible services to pregnant women.

Trial registration

ClinicalTrials.gov: NCT04876014, registered on 30 March 2021. Protocol Version 1.0., 10 May 2021.
Development and application of a next-generation sequencing protocol and bioinformatics pipeline for the comprehensive analysis of the canine immunoglobulin repertoire
Authors: Cullen Jonah N. , Martin Jolyon , Vilella Albert J. , Treeful Amy , Sargan David , Bradley Allan , Friedenberg Steven G.
Published: July 2022

Profiling the adaptive immune repertoire using next generation sequencing (NGS) has become common in human medicine, showing promise in characterizing clonal expansion of B cell clones through analysis of B cell receptors (BCRs) in patients with lymphoid malignancies. In contrast, most work evaluating BCR repertoires in dogs has employed traditional PCR-based approaches analyzing the IGH locus only. The objectives of this study were to: (1) describe a novel NGS protocol to evaluate canine BCRs; (2) develop a bioinformatics pipeline for processing canine BCR sequencing data; and (3) apply these methods to derive insights into BCR repertoires of healthy dogs and dogs undergoing treatment for B-cell lymphoma. RNA from peripheral blood mononuclear cells of healthy dogs (n = 25) and dogs newly diagnosed with intermediate-to-large B-cell lymphoma (n = 18) with intent to pursue chemotherapy was isolated, converted into cDNA and sequenced by NGS. The BCR repertoires were identified and quantified using a novel analysis pipeline. The IGK repertoires of the healthy dogs were far less diverse compared to IGL which, as with IGH, was highly diverse. Strong biases at key positions within the CDR3 sequence were identified within the healthy dog BCR repertoire. For a subset of the dogs with B-cell lymphoma, clonal expansion of specific IGH sequences pre-treatment and reduction post-treatment was observed. The degree of expansion and reduction correlated with the clinical outcome in this subset. Future studies employing these techniques may improve disease monitoring, provide earlier recognition of disease progression, and ultimately lead to more targeted therapeutics.
Assessment of drag measurement techniques in a shock tunnel
Authors: Kim Keunyeong , Jang Byungkook , Lee Sanghoon , Park Gisu
Published: July 2022

Three force measurement techniques in a shock tunnel, the free-flight, movable-support force balance, and stress-wave force balance techniques were employed, and each technique’s characteristics were assessed. For each force measurement technique, the system setup, data processing method, measurement uncertainties, and applied range of the test model size-flow establishment time were described in detail and compared. For a comparison and discussion, the drag coefficients of a circular pointed cone model with a semi-angle of 18.4° at a nominal freestream Mach number of 6 were measured. As a result, three force measurement techniques yield similar drag coefficients. However, the measurement uncertainties were increased in the order of the free-flight, the stress-wave force balance, and the movable-support force balance techniques. The main causes of the measurement uncertainties were the corner detection uncertainties for the free-flight techniques, and the propagation of the internal or external vibrations for the movable-support and stress-wave force balance techniques. To estimate the appropriate range of the test model size and flow establishment time for each technique’s application, the force measurement systems of the present work and the available literature were compared. As a result of comparative discussion, force measurement environments that can be advantageous for each technique are suggested.
Epidemiology of biopsy-proven Henoch–Schönlein purpura nephritis in children: A nationwide survey in Japan
Authors: Terano Chikako , Hamada Riku , Tatsuno Ichiro , Hamasaki Yuko , Araki Yoshinori , Gotoh Yoshimitsu , Nakanishi Koichi , Nakazato Hitoshi , Matsuyama Takeshi , Iijima Kazumoto , Yoshikawa Norishige , Kaneko Tetsuji , Ito Shuichi , Honda Masataka , Ishikura Kenji ,   on behalf of the Japanese Study Group of Renal Disease in Children
Published: July 2022

Background

Little is known about the epidemiology of Henoch–Schönlein purpura nephritis (HSPN).

Methods

We conducted a nationwide epidemiological survey of Japanese children aged 1 to 15 years with HSPN. Children who were newly diagnosed with HSPN by biopsy between January 2013 and December 2015 were eligible for the survey to clarify the incidence of HSPN. We also conducted an institutional survey on kidney biopsy criteria and treatment protocols.

Results

A total of 353 of 412 institutions (85.7%) responded to the questionnaire. Of the 353 institutions, 174 reported to perform kidney biopsies at their institutions, and 563 children were diagnosed with HSPN. Considering the collection rate, the estimated incidence of biopsy-proven HSPN was 1.32 cases/100,000 children per year. The median age at biopsy was 7.0 years, and the male-to-female ratio was 1.2:1. The kidney biopsy criteria and treatment protocols for HSPN were as follows. Patients with acute kidney injury underwent biopsy at least one month after onset. For patients without kidney dysfunction, the timing for biopsy was determined by the amount of proteinuria. Regarding the treatment of HSPN, there were certain commonalities among the treatment protocols, they eventually differed depending on the institutions involved.

Conclusions

The incidence of biopsy-proven HSPN was 1.32 cases/100,000 children per year in Japan. The male-to-female ratio and date of diagnosis of HSPN were similar to those in previous studies. The kidney biopsy criteria and treatment protocols for HSPN varied among institutions. Further studies are warranted to establish an optimal treatment policy based on the prognosis.
Thinking globally to improve care locally: A Delphi study protocol to achieve international clinical consensus on best-practice end-of-life communication with adolescents and young adults with cancer
Authors: Sansom-Daly Ursula M. , Wiener Lori , Darlington Anne-Sophie , Poort Hanneke , Rosenberg Abby R. , Weaver Meaghann S. , Schulte Fiona , Anazodo Antoinette , Phillips Celeste , Sue Louise , Herbert Anthony R. , Mack Jennifer W. , Lindsay Toni , Evans Holly , Wakefield Claire E. ,   on behalf of The Global Adolescent and Young Adult Cancer Accord End-of-Life Study Group
Published: July 2022

For the sizeable subset of adolescents and young adults whose cancer is incurable, developmentally appropriate end-of-life discussions are critical. Standards of care for adolescent and young adult end-of-life communication have been established, however, many health-professionals do not feel confident leading these conversations, leaving gaps in the implementation of best-practice end-of-life communication. We present a protocol for a Delphi study informing the development and implementation of clinician training to strengthen health-professionals’ capacity in end-of-life conversations. Our approach will inform training to address barriers to end-of-life communication with adolescents and young adults across Westernized Adolescent and Young Adult Cancer Global Accord countries. The Adolescent and Young Adult Cancer Global Accord team involves 26 investigators from Australia, New Zealand, the United States, Canada and the United Kingdom. Twenty-four consumers, including adolescents and young adults with cancer history and carers, informed study design. We describe methodology for a modified Delphi questionnaire. The questionnaire aims to determine optimal timing for end-of-life communication with adolescents and young adults, practice-related content needed in clinician training for end-of-life communication with adolescents and young adults, and desireability of evidence-based training models. Round 1 involves an expert panel of investigators identifying appropriate questionnaire items. Rounds 2 and 3 involve questionnaires of international multidisciplinary health-professionals, followed by further input by adolescents and young adults. A second stage of research will design health-professional training to support best-practice end-of-life communication. The outcomes of this iterative and participatory research will directly inform the implementation of best-practice end-of-life communication across Adolescent and Young Adult Cancer Global Accord countries. Barriers and training preferences identified will directly contribute to developing clinician-training resources. Our results will provide a framework to support further investigating end-of-life communication with adolescents and young adults across diverse countries. Our experiences also highlight effective methodology in undertaking highly collaborative global research.
MYL9 deficiency is neonatal lethal in mice due to abnormalities in the lung and the muscularis propria of the bladder and intestine
Authors: Huang Chu-Han , Schuring Joyce , Skinner Jarrod P. , Mok Lawrence , Chong Mark M. W.
Published: July 2022

Class II myosin complexes are responsible for muscle contraction as well as other non-sarcomeric contractile functions in cells. Myosin heavy chain molecules form the core of these structures, while light chain molecules regulate their stability and function. MYL9 is a light chain isoform that is thought to regulate non-sarcomeric myosin. However, whether this in only in specific cell types or in all cells remains unclear. To address this, we generated MYL9 deficient mice. These mice die soon after birth with abnormalities in multiple organs. All mice exhibited a distended bladder, shortening of the small intestine and alveolar overdistension in the lung. The Myl9 allele in these mice included a LacZ reporter knockin that allowed for mapping of Myl9 gene expression. Using this reporter, we show that MYL9 expression is restricted to the muscularis propria of the small intestine and bladder, as well as in the smooth muscle layer of the bronchi in the lung and major bladder vessels in all organs. This suggests that MYL9 is important for the function of smooth muscle cells in these organs. Smooth muscle dysfunction is therefore likely to be the cause of the abnormalities observed in the intestine, bladder and lung of MYL9 deficient mice and the resulting neonatal lethality.
COVID-19 vaccine hesitancy in Malaysia: Exploring factors and identifying highly vulnerable groups
Authors: Jafar Adi , Dambul Ramzah , Dollah Ramli , Sakke Nordin , Mapa Mohammad Tahir , Joko Eko Prayitno
Published: July 2022

Vaccine hesitancy is a global health challenge in controlling the virulence of pandemics. The prevalence of vaccine hesitancy will put highly vulnerable groups, such as the elderly or groups with pre-existing health conditions, at a higher risk, as seen with the outbreak of the pandemic Covid-19. Based on the trends of vaccine hesitancy in the state of Sabah, located in East Malaysia, this study seeks to identify several variables that contribute to vaccine hesitancy. In addition to this, this study also determines which groups are affected by vaccine hesitancy based on their demographics. This study is based on a sampling of 1,024 Sabahan population aged 18 and above through an online and face-to-face questionnaire. The raw data was analysed using the K-Means Clustering Analysis, Principal Component Analysis (PCA), Mann-Whitney U Test, Kruskal-Wallis Test, and frequency. The K-Means Clustering found that more than half of the total number of respondents (Cluster 2 = 51.9%) tend to demonstrate vaccine hesitancy. Based on the PCA analysis, six main factors were found to cause vaccine hesitancy in Sabah: confidence (var(X) = 21.6%), the influence of local authority (var(X) = 12.1%), ineffectiveness of mainstream media (var(X) = 8.4%), complacency (var(X) = 7.4%), social media (var(X) = 6.4%), and convenience issues (var(X) = 5.8%). Findings from both Mann-Whitney U and Kruskal-Wallis tests demonstrate that several factors of group demographics, such as employment status, level of education, religion, gender, and marital status, may explain the indicator of vaccine hesitancy. In particular, specific groups tend to become vaccine hesitancy such as, unemployed, self-employed, students, male, single, level of education, and Muslim. Findings from this empirical study are crucial to inform the relevant local authorities on the level of vulnerability among certain groups in facing the hazards of COVID-19. The main contribution of this study is that it seeks to analyse the factors behind vaccine hesitancy and identifies which groups more likely hesitant toward vaccines based on their demographics.