bluuebunny/crossref_metadata_2025 huggingface dataset:
Design, Implementation and Evaluation of a Distance Learning Framework to Expedite Medical Education during COVID-19 pandemic: A Proof-of-Concept Study
Authors: Azar Aida J , Khamis Amar Hassan , Naidoo Nerissa , Lindsbro Marjam , Boukhaled Juliana Helena , Gonuguntla Suneetha , Davis David , Banerjee Yajnavalka
Published: April 2021

Background:

The COVID-19 pandemic has forced medical schools to suspend on-campus live-sessions and shift to distance-learning (DL). This precipitous shift presented medical educators with a challenge, ‘to create a “ simulacrum” of the learning environment that students experience in classroom, in DL’. This requires the design of an adaptable and versatile DL-framework bearing in mind the theoretical underpinnings associated with DL. Additionally, effectiveness of such a DL-framework in content-delivery followed by its evaluation at the user-level, and in cognitive development needs to be pursued such that medical educators can be convinced to effectively adopt the framework in a competency-based medical programme.

Main:

In this study, we define a DL-framework that provides a ‘ simulacrum’ of classroom experience. The framework’s blueprint was designed amalgamating principles of: Garrison’s community inquiry, Siemens’ connectivism and Harasim’s online-collaborative-learning; and improved using Anderson’s DL-model. Effectiveness of the DL-framework in course delivery was demonstrated using the exemplar of fundamentals in epidemiology and biostatistics (FEB) course during COVID-19 lockdown. Virtual live-sessions integrated in the framework employed a blended-approach informed by instructional-design strategies of Gagne and Peyton. The efficiency of the framework was evaluated using first 2 levels of Kirkpatrick’s framework. Of 60 students, 51 (85%) responded to the survey assessing perception towards DL (Kirkpatrick’s Level 1). The survey-items, validated using exploratory factor analysis, were classified into 4-categories: computer expertise; DL-flexibility; DL-usefulness; and DL-satisfaction. The overall perception for the 4 categories, highlighted respondents’ overall satisfaction with the framework. Scores for specific survey-items attested that the framework promoted collaborative-learning and student-autonomy. For, Kirkpatrick’s Level 2 that is, cognitive-development, performance in FEB’s summative-assessment of students experiencing DL was compared with students taught using traditional methods. Similar, mean-scores for both groups indicated that shift to DL didn’t have an adverse effect on students’ learning.

Conclusion:

In conclusion, we present here the design, implementation and evaluation of a DL-framework, which is an efficient pedagogical approach, pertinent for medical schools to adopt (elaborated using Bourdieu’s Theory of Practice) to address students’ learning trajectories during unprecedented times such as that during the COVID-19 pandemia.
Outcome of surgery for traumatic cataract in children in a child eye health tertiary facility, Ibadan, Nigeria
Authors: Ugalahi Mary Ogbenyi , Olusanya Bolutife Ayokunnu , Aremu Olanipekun Olalekan , Baiyeroju Aderonke Mojisola
Published: April 2021

Objective:

The objective of this study was to describe the outcome of surgery for traumatic cataract and associated factors in children aged 16 years and below operated in a tertiary facility.

Methods:

This was a retrospective review of records of children who had surgery for traumatic cataract between August 2015 and August 2019. Information on biodata, preoperative visual acuity, surgical methods, complications, and postoperative visual acuity were retrieved. Data were analyzed using IBM SPSS Statistics 20.0.

Results:

Traumatic cataract accounted for 87 (14.7%) of 593 eyes operated for childhood cataract during the period. Of these, a total of 79 records were available for review. There were 56 (70.9%) males with a mean age of 10.11 (±3.39) years. All injuries were unilateral; closed globe injuries accounted for 70 (88.8%) of the cataracts and the left eye was affected in 42 (53.2%) patients. Fifty-two (67.09%) eyes had other ocular injuries apart from cataracts. The morphology of the cataract was membranous in 44 (55.7%) eyes, and 76 (96.2%) eyes had cataract surgery with intraocular lens (IOL) implantation; 39 (51.3%) of these IOLs were implanted within the capsular bag. The preoperative best corrected visual acuity was worse than 6/18 in all 79 (100%) eyes and improved to 6/18 or better in 32 (40.5%) eyes at 3 months postoperatively.

Conclusion:

Traumatic cataract accounted for less than a quarter of all childhood cataracts in our center. Majority of the eyes had successful IOLs implantation during surgery, and the best corrected visual acuity improved in a moderate proportion of these patients.
Role of Multimodal Psychotherapeutic Approaches in Bisexual Adult Man: A Case Study
Authors: Gupta Babita , Thyloth Murali
Published: April 2021

The objective was to see the effectiveness of multimodal psychotherapeutic approaches on depression, anxiety, stress, sexual arousal, and desire in bisexual adult man. There was a positive change in the level of depression, anxiety, stress, sexual arousal, and desire after the intervention in a bisexual adult man. Single case design was used. He was seen in an independent practice setting with once in a week, 90-min duration of sessions for 8 months. Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, ICMR Psychosocial Stress Questionnaire, and Sexual Arousal and Desire Inventory were used. Orgasmic reconditioning, cognitive behavior therapy, mindfulness meditation, and sensate focus were carried out. Pretest, midtest, and posttest assessments were done. Two months follow-ups were carried out. Preassessment revealed that client had severe depression, very high stress, moderate anxiety and very high sexual arousal and desire, frequently masturbation, guilt feeling, and tingling sensation in genital area. Postintervention results revealed remarkable reduction in the level of anxiety, depression, stress, improvement in sexual knowledge and functioning, management of sexual arousal and desire, and achieving sexual satisfaction with his spouse. It can be concluded that multimodal psychotherapeutic approaches have been proven effective.
The semiotics of movement and mobility
Authors: van Leeuwen Theo
Published: April 2021

The paper presents a framework for the distinctive feature analysis of movement and mobility in texts, performances and semiotic artefacts, showing its applicability to the analysis of meaning-making in dance, music, animated and live action film and video, and product design. Emphasis is placed on the role of movement and mobility in identity design. Identity design is realized by the style in which movements are performed and can be analysed in terms of the gradable distinctive features present in any movement – direction, expansiveness, velocity, force, angularity, fluidity, directedness and regularity. The paper includes a historical dimension, focusing on the development of movement and mobility as semiotic resources, and argues for the pioneering role of modernist artists in this development.
Decolonising a landscape architecture studio: Spatial modelling of student narratives
Authors: Price Christine
Published: April 2021

This paper problematises the dominance of global north perspectives in landscape architectural education, in South Africa where there are urgent calls to decolonise education and make visible indigenous and vernacular meaning-making practices. In grappling with these concerns, this research finds resonance with a multimodal social semiotic approach that acknowledges the interest, agency and resourcefulness of students as meaning-makers in both accessing and challenging dominant educational discourses. This research involves a case study of a design project in a first-year landscape architectural studio. The project requires students to choose a narrative and to represent it as a spatial model: a scaled, 3D maquette of a spatial experience that could be installed in a public park. This practitioner reflection closely analyses the spatial model of one student, Malibongwe, focusing on his interest in meaning-making; the innovative meaning-making practices and diverse resources he draws on; and his expression of spatial signifiers of the Black experiences portrayed in his narrative. This reflection shows how Malibongwe’s narrative is not only reproduced in the spatial model, it is remade: the transformation of resources into three-dimensional spatial form results in new understandings and the production of new meanings.
Fast and optimal algorithm for case-control matching using registry data: application on the antibiotics use of colorectal cancer patients
Authors: Mamouris Pavlos , Nassiri Vahid , Molenberghs Geert , van den Akker Marjan , van der Meer Joep , Vaes Bert
Published: April 2021

Background

In case-control studies most algorithms allow the controls to be sampled several times, which is not always optimal. If many controls are available and adjustment for several covariates is necessary, matching without replacement might increase statistical efficiency. Comparing similar units when having observational data is of utter importance, since confounding and selection bias is present. The aim was twofold, firstly to create a method that accommodates the option that a control is not resampled, and second, to display several scenarios that identify changes of Odds Ratios (ORs) while increasing the balance of the matched sample.

Methods

The algorithm was derived in an iterative way starting from the pre-processing steps to derive the data until its application in a study to investigate the risk of antibiotics on colorectal cancer in the INTEGO registry (Flanders, Belgium). Different scenarios were developed to investigate the fluctuation of ORs using the combination of exact and varying variables with or without replacement of controls. To achieve balance in the population, we introduced the Comorbidity Index (CI) variable, which is the sum of chronic diseases as a means to have comparable units for drawing valid associations.

Results

This algorithm is fast and optimal. We simulated data and demonstrated that the run-time of matching even with millions of patients is minimal. Optimal, since the closest controls is always captured (using the appropriate ordering and by creating some auxiliary variables), and in the scenario that a case has only one control, we assure that this control will be matched to this case, thus maximizing the cases to be used in the analysis. In total, 72 different scenarios were displayed indicating the fluctuation of ORs, and revealing patterns, especially a drop when balancing the population.

Conclusions

We created an optimal and computationally efficient algorithm to derive a matched case-control sample with and without replacement of controls. The code and the functions are publicly available as an open source in an R package. Finally, we emphasize the importance of displaying several scenarios and assess the difference of ORs while using an index to balance population in observational data.
Using a brief web-based 5A intervention to improve weight management in primary care: results of a cluster-randomized controlled trial
Authors: Welzel Franziska D. , Bär Jonathan , Stein Janine , Löbner Margrit , Pabst Alexander , Luppa Melanie , Grochtdreis Thomas , Kersting Anette , Blüher Matthias , Luck-Sikorski Claudia , König Hans-Helmut , Riedel-Heller Steffi G.
Published: April 2021

Background

The primary health care setting is considered a major starting point in successful obesity management. However, research indicates insufficient quality of weight counseling in primary care. Aim of the present study was to implement and evaluate a 5A online tutorial aimed at improving weight management and provider-patient-interaction in primary health care. The online tutorial is a stand-alone low-threshold minimal e-health intervention for general practitioners based on the 5As guidance for obesity management by the Canadian Obesity Network.

Methods

In a cluster-randomized controlled trial, 50 primary care practices included 160 patients aged 18 to 60 years with obesity (BMI ≥ 30). The intervention practices had continuous access to the 5A online tutorial for the general practitioner. Patients of control practices were treated as usual. Primary outcome was the patients’ perspective of the doctor-patient-interaction regarding obesity management, assessed with the Patient Assessment of Chronic Illness Care before and after (6/12 months) the training. Treatment effects over time (intention-to-treat) were evaluated using mixed-effects linear regression models.

Results

More than half of the physicians (57%) wished for more training offers on obesity counseling. The 5A online tutorial was completed by 76% of the physicians in the intervention practices. Results of the mixed-effects regression analysis showed no treatment effect at 6 months and 12 months’ follow-up for the PACIC 5A sum score. Patients with obesity in the intervention group scored lower on self-stigma and readiness for weight management compared to participants in the control group at 6 months’ follow-up. However, there were no significant group differences for weight, quality of life, readiness to engage in weight management, self-stigma and depression at 12 months’ follow-up.

Conclusion

To our knowledge, the present study provides the first long-term results for a 5A-based intervention in the context of the German primary care setting. The results suggest that a stand-alone low-threshold minimal e-health intervention for general practitioners does not improve weight management in the long term. To improve weight management in primary care, more comprehensive strategies are needed. However, due to recruitment difficulties the final sample was smaller than intended. This may have contributed to the null results.

Trial registration

The study has been registered at the German Clinical Trials Register (Identifier:DRKS00009241, Registered 3 February 2016).
Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation
Authors: Seckler Eva , Regauer Verena , Krüger Melanie , Gabriel Anna , Hermsdörfer Joachim , Niemietz Carolin , Bauer Petra , Müller Martin
Published: April 2021

Background

Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial.

Methods

This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis.

Results

A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences.

Conclusion

Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT.

Trial registration

Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered).
Household mold exposure interacts with inflammation-related genetic variants on childhood asthma: a case–control study
Authors: Zhang Yu , Hua Li , Liu Quan-Hua , Chu Shu-Yuan , Gan Yue-Xin , Wu Min , Bao Yi-Xiao , Chen Qian , Zhang Jun
Published: April 2021

Background

A number of studies have examined the association between mold exposure and childhood asthma. However, the conclusions were inconsistent, which might be partly attributable to the lack of consideration of gene function, especially the key genes affecting the pathogenesis of childhood asthma. Research on the interactions between genes and mold exposure on childhood asthma is still very limited. We therefore examined whether there is an interaction between inflammation-related genes and mold exposure on childhood asthma.

Methods

A case–control study with 645 asthmatic children and 910 non-asthmatic children aged 3–12 years old was conducted. Eight single nucleotide polymorphisms (SNPs) in inflammation-related genes were genotyped using MassARRAY assay. Mold exposure was defined as self-reported visible mold on the walls. Associations between visible mold exposure, SNPs and childhood asthma were evaluated using logistic regression models. In addition, crossover analyses were used to estimate the gene-environment interactions on childhood asthma on an additive scale.

Results

After excluding children without information on visible mold exposure or SNPs, 608 asthmatic and 839 non-asthmatic children were included in the analyses. Visible mold exposure was reported in 151 asthmatic (24.8%) and 119 non-asthmatic children (14.2%) (aOR 2.19, 95% CI 1.62–2.97). The rs7216389 SNP in gasdermin B gene (GSDMB) increased the risk of childhood asthma with each C to T substitution in a dose-dependent pattern (additive model, aOR 1.32, 95% CI 1.11–1.57). Children carrying the rs7216389 T allele and exposed to visible mold dramatically increased the risk of childhood asthma (aOR 3.21; 95% CI 1.77–5.99). The attributable proportion due to the interaction (AP: 0.47, 95% CI 0.03–0.90) and the relative excess risk due to the interaction (RERI: 1.49, 95% CI 0–2.99) were statistically significant.

Conclusions

In the present study, there was a significant additive interaction between visible mold exposure and rs7216389 SNP on childhood asthma. Future studies need to consider the gene-environment interactions when exploring the risk factors of childhood asthma.
Validation and investigation of cross cultural equivalence of the Fremantle back awareness questionnaire - German version (FreBAQ-G)
Authors: Schäfer Axel , Wand Benedict M. , Lüdtke Kerstin , Ehrenbrusthoff Katja , Schöttker-Königer Thomas
Published: April 2021

Background

Disrupted self-perception of the low back might contribute to chronic non-specific low back pain. The Fremantle back awareness questionnaire is a simple questionnaire to assess back specific self-perception. The questionnaire has recently been translated to German (FreBAQ-G). The aim was to further investigate the psychometric properties of the FreBAQ-G, to evaluate its cross cultural validity in patients with chronic non-specific LBP and to explore potential relationships between body perception, pain, disability and back pain beliefs.

Methods

In this cross-sectional multicentre study, sample data were merged with data from the validation sample of the original English version to examine cross-cultural validity. Item Response Theory was used to explore psychometric properties and differential item function (DIF) to evaluate cross-cultural validity and item invariance. Correlations and multiple linear regression analyses were used to explore the relationship between altered back specific self- perception and back pain parameters.

Results

Two hundred seventy-two people with chronic low back pain completed the questionnaires. The FreBAQ-G showed good internal consistency (Cronbach’s alpha = 0.84), good overall reliability (r = 0.84) and weak to moderate scalability (Loevinger Hj between 0.34 and 0.48). The questionnaire showed unidimensional properties with factor loadings between 0.57 and 0.80 and at least moderate correlations (r > 0.35) with pain intensity, pain related disability and fear avoidance beliefs (FABQ total - and subscores). Item and test properties of the FreBAQ-G are given. Only item 7 showed uniform DIF indicating acceptable cross-cultural validity.

Conclusions

Our results indicate that the FreBAQ-G is a suitable questionnaire to measure back specific self-perception, and has comparable properties to the English-language version.
Clinical predictors for deep vein thrombosis on admission in patients with intertrochanteric fractures: a retrospective study
Authors: Fan Jixing , Zhou Fang , Xu Xiangyu , Zhang Zhishan , Tian Yun , Ji Hongquan , Guo Yan , Lv Yang , Yang Zhongwei , Hou Guojin
Published: April 2021

Background

Limited studies were available to investigate the prevalence of deep vein thrombosis (DVT) on admission in elderly patients with intertrochanteric fractures. The aim of present study was to evaluate risk factors and the prevalence of pre-admission DVT in elderly patients with intertrochanteric fractures.

Methods

This retrospective study included 788 elderly patients with intertrochanteric fracture who were eligible for this study from January 1, 2010, to December 31, 2019. Color doppler ultrasonography was performed for DVT detection at admission. All patients’ clinical data were collected. Univariate analysis and stepwise backward multivariate logistic regression were used to identify the risk factors contributing to the occurrence of DVT.

Results

The overall prevalence of pre-admission DVT in patients with intertrochanteric fractures was 20.81% (164 of 788 patients). The mean time from injury to admission was 2.1 days in the total population, 2.96 and 1.87 days in patients with and without DVT. Univariate analysis showed that significantly elevated risk of DVT were found in patients with longer time from injury to admission, high energy injury, lower Hb value, higher BMI, diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation, dementia, varicose veins, higher age-adjusted CCI, higher ASA class and A3 type intertrochanteric fractures (P < 0.05). The adjusted multivariate logistic regression analysis demonstrated that longer time from injury to admission, high energy trauma, COPD, lower Hb, diabetes and A3 type intertrochanteric fractures were independent risk factors of pre-admission DVT.

Conclusions

A high prevalence of pre-admission DVT was found in elderly Chinese patients with intertrochanteric fractures. Therefore, surgeons should be aware of the high prevalence of DVT for elderly patients with intertrochanteric fractures in order to prevent intraoperative and postoperative PE and other lethal complications.
Correction to: Presumptive primary intrathoracic mast cell tumours in two dogs
Authors: Cartagena-Albertus Juan Carlos , Moise Antoaneta , Moya-García Sergio , Cámara-Fernández Nora , Montoya-Alonso Jose Alberto
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Tropomyosin in mugwort cross-reacts to house dust mite, eliciting non-Th2 response in allergic rhinitis patients sensitized to house dust mite
Authors: Duan Su , Zhao Limin , Zhang Yuling , Zhang Nan , Zheng Ming , Wang Qiqi , Zhang Xu , Wang Xiangdong , Ying Sun , Bachert Claus , Zhang Luo , Lan Feng
Published: April 2021

Background

Mugwort and house dust mite (HDM) are two of the most common inhalant allergens in Asia, however, whether mugwort affects polysensitized HDM+ allergic rhinitis (AR) patients has not been elucidated.

Methods

Overall, 15,884 AR outpatients were assessed for clinical status. Amino acid sequences of mugwort were determined by mass spectrometry. Afterward, cross-reactivity between mugwort tropomyosin and Dermatophagoides pteronyssinus 10 (Der p10) was analysed by ELISA inhibition and basophil activation experiments. To compare immunologic responses eliciting by two different tropomyosins, peripheral blood mononuclear cells (PBMCs) of HDM-monosensitized patients were stimulated by mugwort, HDM, Der p10 and synthetic peptides representing mugwort tropomyosin respectively.

Results

Polysensitized HDM+AR patients were mainly sensitized to cat and mugwort, and the positive rate of monosensitized HDM+AR out-clinic patients was increased during the mugwort pollen season. Tropomyosin protein was able to find in mugwort. Synthetic tropomyosin peptide of mugwort activated basophils which were primed by HDM-specific IgE; ELISA inhibition experiment showed synthetic tropomyosin peptide of mugwort inhibited IgE binding to HDM tropomyosin, Der p10. Unlike HDM and Derp 10, mugwort and mugwort tropomyosin mainly induced IFN-γ and IL-17 release in PBMCs of monosensitized HDM+AR patients, but not IL-5.

Conclusions

Pan-allergen tropomyosin accounts for the cross-reactivity between mugwort and HDM, which reminds HDM+ patients to reduce mugwort exposure in mugwort pollen season in virtue of the tropomyosin induced mild inflammation.
Anti-Xa activity and hemorrhagic events under extracorporeal membrane oxygenation (ECMO): a multicenter cohort study
Authors: Descamps Richard , Moussa Mouhamed D. , Besnier Emmanuel , Fischer Marc-Olivier , Preau Sébastien , Tamion Fabienne , Daubin Cédric , Cousin Nicolas , Vincentelli André , Goutay Julien , Du Cheyron Damien
Published: April 2021

Background

Hemorrhagic events remain a major concern in patients under extracorporeal membrane oxygenation (ECMO) support. We tested the association between anticoagulation levels and hemorrhagic events under ECMO using anti-Xa activity monitoring.

Methods

We performed a retrospective multicenter cohort study in three ECMO centers. All adult patients treated with veno-venous (VV)- or veno-arterial (VA)-ECMO in 6 intensive care units between September 2017 and August 2019 were included. Anti-Xa activities were collected until a hemorrhagic event in the bleeding group and for the duration of ECMO in the non-bleeding group. All dosages were averaged to obtain means of anti-Xa activity for each patient, and patients were compared according to the occurrence or not of bleeding.

Results

Among 367 patients assessed for eligibility, 121 were included. Thirty-five (29%) presented a hemorrhagic complication. In univariate analysis, anti-Xa activities were significantly higher in the bleeding group than in the non-bleeding group, both for the mean anti-Xa activity (0.38 [0.29–0.67] vs 0.33 [0.22–0.42] IU/mL; p = 0.01) and the maximal anti-Xa activity (0.83 [0.47–1.46] vs 0.66 [0.36–0.91] IU/mL; p = 0.05). In the Cox proportional hazard model, mean anti-Xa activity was associated with bleeding (p = 0.0001). By Kaplan–Meier analysis with the cutoff value at 0.46 IU/mL obtained by ROC curve analysis, the probability of survival under ECMO without bleeding was significantly lower when mean anti-Xa was > 0.46 IU/mL (p = 0.0006).

Conclusion

In critically ill patients under ECMO, mean anti-Xa activity was an independent risk factor for hemorrhagic complications. Anticoagulation targets could be revised downward in both VV- and VA-ECMO.
Mondor’s disease of the breast: a case series
Authors: Ben Hamida K. , Ghalleb M. , Triki A. , Jebir I. , Makhlouf R. , Touinsi H.
Published: April 2021

Background

Mondor’s disease of the breast (MDB) is a rare and benign disorder of the breast. It is characterized by thrombophlebitis of the superficial veins of the chest wall. Clinically, it manifests as a cord-like induration of the breast area. MDB resolves spontaneously without sequela.

Case presentation

We report cases of three Caucasian African patients aged 29, 40 and 34, respectively. One patient was under progestative contraception. All the patients had a cord-like induration on the chest wall. Ultrasonography was performed in all patients and was normal in two cases and showed a thrombotic vein in one case. All the patients had symptomatic treatment with total resolution of symptoms within 1 to 4 weeks. No relapse was observed.

Conclusion

MDB is benign in most cases. However, it is not to be taken lightly, because it can be the manifestation of an underlying disease such as breast cancer. The diagnosis is based on clinical findings; ultrasonography can be helpful for the diagnosis. Treatment is based on analgesic and anti-inflammatory drugs.
Term gravid uterus in a congenital umbilical hernia: a case report
Authors: Saidi Friday , Rajab Bakari , Chinula Lameck , Kafumba Nomsa , Chagomerana Maganizo , Tang Jennifer H.
Published: April 2021

Background

Umbilical hernias are a frequent and well-known pathology in children or adults. Congenital umbilical hernias are commonly diagnosed in childhood, and in adulthood such a hernia is usually acquired. Umbilical hernia in pregnancy may result in serious obstetric complications including antepartum hemorrhage, intrauterine fetal demise, and preterm labor, particularly if incarcerated.

Case presentation

We present a rare case of a congenital umbilical hernia in a term pregnancy. The patient was a 34-year-old African (Malawian) woman, living with human immunodeficiency virus (HIV) and on antiretroviral treatment, gravida 4, with three previous vaginal deliveries, and with two babies weighing 4 kg at birth. We performed herniorrhaphy at caesarean section, and at 3 months of follow-up she had no evidence of a recurrent hernia.

Conclusion

Congenital umbilical hernias are commonly diagnosed in childhood but might first be seen by medical practitioners in adulthood. A patient-centered approach addressing patient complaints, associated risk factors, and possible complications is recommended. Primary repair at caesarean section is a feasible option.
Conditions for the validity of a class of optimal Hilbert type multiple integral inequalities with nonhomogeneous kernels
Authors: He Bing , Hong Yong , Li Zhen
Published: April 2021

For the Hilbert type multiple integral inequality$$ \int _{\mathbb{R}_{+}^{n}} \int _{\mathbb{R}_{+}^{m}} K\bigl( \Vert x \Vert _{m,\rho }, \Vert y \Vert _{n, \rho }\bigr) f(x)g(y) \,\mathrm{d} x \,\mathrm{d} y \leq M \Vert f \Vert _{p, \alpha } \Vert g \Vert _{q, \beta } $$∫R+n∫R+mK(∥x∥m,ρ,∥y∥n,ρ)f(x)g(y)dxdy≤M∥f∥p,α∥g∥q,βwith a nonhomogeneous kernel$K(\|x\|_{m, \rho }, \|y\|_{n, \rho })=G(\|x\|^{\lambda _{1}}_{m, \rho }/ \|y\|^{\lambda _{2}}_{n, \rho })$K(∥x∥m,ρ,∥y∥n,ρ)=G(∥x∥m,ρλ1/∥y∥n,ρλ2)($\lambda _{1}\lambda _{2}> 0$λ1λ2>0), in this paper, by using the weight function method, necessary and sufficient conditions that parametersp,q,$\lambda _{1}$λ1,$\lambda _{2}$λ2,α,β,m, andnshould satisfy to make the inequality hold for some constantMare established, and the expression formula of the best constant factor is also obtained. Finally, their applications in operator boundedness and operator norm are also considered, and the norms of several integral operators are discussed.
HIV incidence among men who have sex with men using geosocial networking smartphone application in Beijing, China: an open cohort study
Authors: Mi Guo-Dong , Zhang Bin-Bin , Yu Fei , Ren Xian-Long , Ong Jason J. , Fan Ya-Qi , Guo Feng-Hua , Li Chun-Jun , Zhang Mian-Zhi , Zhang Min-Ying
Published: April 2021

Background

Sexual transmission among men who have sex with men (MSM) is the dominant route of HIV transmission in China. Extensive use of geosocial networking (GSN) smartphone application (app) has dramatically changed the pattern of sexual behaviors and HIV risk among MSM, but data on HIV incidence and the changing risk behaviors of GSN app-using MSM are limited. We aims to assess the HIV incidence and its correlates among gay GSN app-using MSM in China.

Methods

We constructed an open cohort which was initiated and maintained using a GSN app to assess the HIV incidence among app-using MSM, recruited from June 2017 to December 2018. MSM completed an online questionnaire on their sociodemographic characteristics, sexual behaviors, recreational drug use and sexually transmitted infections status. Then each man had an HIV test, and those tested negatives were enrolled into the cohort. Participants completed follow-ups with additional HIV tests though the app during the study period, and were censored at HIV seroconversion or study end date. HIV incidence was calculated by dividing the sum of observed HIV seroconversions by the observed person-time. Univariate (Chi-square test and Fisher’s exact test) and multivariate (proportional hazards regression) analyses were used to examine correlates of HIV incidence.

Results

A total of 6957 HIV negative MSM were enrolled in the open cohort, 37 seroconversions occurred among 1937 men contributing 1065 observed person-years: HIV incidence was 3.47 per 100 person-years [95% confidence interval (CI): 2.37–4.57]. More than five sexual partners [hazard ratio (HR) = 2.65, 95% CI: 1.04–6.67], and sex with HIV positive partners (HR = 3.82, 95% CI: 1.16–12.64) in the preceding six months were positively associated with HIV seroconversion. Consistent condom use for anal sex (HR = 0.27, 95% CI: 0.07–0.96), and reporting insertive anal sex only (HR = 0.23, 95% CI: 0.08–0.62) in the preceding six months were protective factors for HIV seroconversion.

Conclusions

Tailored interventions targeting app-using MSM are urgently needed given their high risk of HIV. As a new tool for accessing MSM at higher HIV risk, GSN smartphone app could play an important role in HIV research among MSM.
Internet of things issues related to psychiatry
Authors: Monteith Scott , Glenn Tasha , Geddes John , Severus Emanuel , Whybrow Peter C. , Bauer Michael
Published: April 2021

Background

Internet of Things (IoT) devices for remote monitoring, diagnosis, and treatment are widely viewed as an important future direction for medicine, including for bipolar disorder and other mental illness. The number of smart, connected devices is expanding rapidly. IoT devices are being introduced in all aspects of everyday life, including devices in the home and wearables on the body. IoT devices are increasingly used in psychiatric research, and in the future may help to detect emotional reactions, mood states, stress, and cognitive abilities. This narrative review discusses some of the important fundamental issues related to the rapid growth of IoT devices.

Main body

Articles were searched between December 2019 and February 2020. Topics discussed include background on the growth of IoT, the security, safety and privacy issues related to IoT devices, and the new roles in the IoT economy for manufacturers, patients, and healthcare organizations.

Conclusions

The use of IoT devices will increase throughout psychiatry. The scale, complexity and passive nature of data collection with IoT devices presents unique challenges related to security, privacy and personal safety. While the IoT offers many potential benefits, there are risks associated with IoT devices, and from the connectivity between patients, healthcare providers, and device makers. Security, privacy and personal safety issues related to IoT devices are changing the roles of manufacturers, patients, physicians and healthcare IT organizations. Effective and safe use of IoT devices in psychiatry requires an understanding of these changes.
Transdiagnostic comparison of visual working memory capacity in bipolar disorder and schizophrenia
Authors: Barnes-Scheufler Catherine V. , Passow Caroline , Rösler Lara , Mayer Jutta S. , Oertel Viola , Kittel-Schneider Sarah , Matura Silke , Reif Andreas , Bittner Robert A.
Published: April 2021

Background

Impaired working memory is a core cognitive deficit in both bipolar disorder and schizophrenia. Its study might yield crucial insights into the underpinnings of both disorders on the cognitive and neurophysiological level. Visual working memory capacity is a particularly promising construct for such translational studies. However, it has not yet been investigated across the full spectrum of both disorders. The aim of our study was to compare the degree of reductions of visual working memory capacity in patients with bipolar disorder (PBD) and patients with schizophrenia (PSZ) using a paradigm well established in cognitive neuroscience.

Methods

62 PBD, 64 PSZ, and 70 healthy controls (HC) completed a canonical visual change detection task. Participants had to encode the color of four circles and indicate after a short delay whether the color of one of the circles had changed or not. We estimated working memory capacity using Pashler’s K.

Results

Working memory capacity was significantly reduced in both PBD and PSZ compared to HC. We observed a small effect size (r = .202) for the difference between HC and PBD and a medium effect size (r = .370) for the difference between HC and PSZ. Working memory capacity in PSZ was also significantly reduced compared to PBD with a small effect size (r = .201). Thus, PBD showed an intermediate level of impairment.

Conclusions

These findings provide evidence for a gradient of reduced working memory capacity in bipolar disorder and schizophrenia, with PSZ showing the strongest degree of impairment. This underscores the importance of disturbed information processing for both bipolar disorder and schizophrenia. Our results are compatible with the cognitive manifestation of a neurodevelopmental gradient affecting bipolar disorder to a lesser degree than schizophrenia. They also highlight the relevance of visual working memory capacity for the development of both behavior- and brain-based transdiagnostic biomarkers.
Correction to: High-fidelity elastic Green’s functions for subduction zone models consistent with the global standard geodetic reference system
Authors: Hori Takane , Agata Ryoichiro , Ichimura Tsuyoshi , Fujita Kohei , Yamaguchi Takuma , Iinuma Takeshi
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Single-leg hop distance normalized to body height is associated with the return to sports after anterior cruciate ligament reconstruction
Authors: Ohji Shunsuke , Aizawa Junya , Hirohata Kenji , Ohmi Takehiro , Mitomo Sho , Jinno Tetsuya , Koga Hideyuki , Yagishita Kazuyoshi
Published: April 2021

Purpose

To investigate the relationship between single-leg hop distance (SLHD), normalized body height, and return-to-sports (RTS) status after anterior cruciate ligament reconstruction (ACLR) and to identify the cut-off value for SLHD on the operated side.

Methods

Seventy-three patients after primary ACLR (median 13.5 months) participated in this cross-sectional study. Participants were divided into ‘‘Yes-RTS’’ (YRTS) or ‘‘No-RTS’’ (NRTS) groups based on a self-reported questionnaire. SLHD was measured, and the limb symmetry index (LSI) and SLHD (%body height) were calculated. A minimum p-value approach was used to calculate the SLHD cut-off points (%body height) on the operated side that were strongly associated with the RTS status. Logistic regression analysis was used to analyse the association between RTS status and SLHD cut-off point (%body height). Isokinetic strength and Tampa scale for kinesiophobia (TSK) were measured as covariates.

Results

Among 73 patients, 43 (59%) were assigned to the YRTS and 30 (41%) to the NRTS group. The 70% body height cut-off point for SLHD on the operated side was most strongly associated with RTS status. In a logistic regression analysis including other covariates, SLHD (%body height) < 70% and TSK were negatively associated with RTS status. Except for two participants, the LSI of the SLHD exceeded 90% and there was no significant association between the LSI of the SLHD and RTS status.

Conclusion

Even after improvement in the LSI of the SLHD, planning rehabilitation with the goal of achieving SLHD over 70% body height may be important for supporting RTS after ACLR.

Level of evidence

Cross-sectional study, Level IV
Observation of dose dependent intravaginal Prostaglandin E2 application in free farrowing sows during parturition – a pilot study
Authors: Grahofer Alexander , Bill Ramona , Nathues Heiko
Published: April 2021

The duration of birth is an important factor influencing the survival of piglets and the health of sows. A prolonged parturition is usually treated with oxytocin, even though several undesirable side effects are described. Therefore, the aim of this study was to evaluate the safety and efficacy of Prostaglandin E2 (PGE2) of different concentrations as an intravaginal applied gel after the birth of the fourth piglet in sows. Twelve sows were randomly allocated to one of four treatment groups: Group I (control group) application of placebo gel; Group II application of 0.5 mg; Group III application of 1.0 mg PGE2; Group IV PGE2 application of 2.0 mg PGE2. Total duration of parturition (time between first piglet and last placenta), piglet interval before and after treatment and placenta expulsion duration (time between first and last placenta) were recorded, and each piglet was scored for meconium staining and vitality. Furthermore, stillborn piglets were categorized into ante-partum and intra-partum deaths.

A significant dose-dependent effect of PGE2 after the fourth piglet in a linear regression model with group I, II and III on the total duration of parturition and the placenta expulsion duration was detected. An increase of the PGE2 dosage from 0 to 1 mg significantly reduced the total duration of parturition (group I: 553.7 ± 114.2; group II:456 ± 167.9; group III: 284.7 ± 40.5; p-value: 0.02) and placenta expulsion duration (group I: 364 ± 120; group II: 289 ± 144.1; group III: 119 ± 46.13; p-value: 0.03). Although no further significant differences between the groups using ANCOVA and a linear regression model including all groups were detected, severe meconium staining in more than 10% of piglets was observed in group II and IV. Moreover, piglets of group IV showed oedematous and haemorrhagic umbilical cords, lethargy and anoxia after treatment, and intra-partum deaths were recorded.

The best outcome for the sows and piglets was achieved using the 1 mg PGE2 dosage, whereas the other dosages showed more negative side effects, impairing the health and welfare of the animals. The results of this study can be used for further studies with larger sample sizes.
A wavelet approach of investing behaviors and their effects on risk exposures
Authors: Mestre Roman
Published: April 2021

Exposure to market risk is a core objective of the Capital Asset Pricing Model (CAPM) with a focus on systematic risk. However, traditional OLS Beta model estimations (Ordinary Least Squares) are plagued with several statistical issues. Moreover, the CAPM considers only one source of risk and supposes that investors only engage in similar behaviors. In order to analyze short and long exposures to different sources of risk, we developed a Time–Frequency Multi-Betas Model with ARMA-EGARCH errors (Auto Regressive Moving Average Exponential AutoRegressive Conditional Heteroskedasticity). Our model considers gold, oil, and Fama–French factors as supplementary sources of risk and wavelets decompositions. We used 30 French stocks listed on the CAC40 (Cotations Assistées Continues 40) within a daily period from 2005 to 2015. The conjugation of the wavelet decompositions and the parameters estimates constitutes decision-making support for managers by multiplying the interpretive possibilities. In the short-run, (“Noise Trader” and “High-Frequency Trader”) only a few equities are insensitive to Oil and Gold fluctuations, and the estimated Market Betas parameters are scant different compared to the Model without wavelets. Oppositely, in the long-run, (fundamentalists investors), Oil and Gold affect all stocks but their impact varies according to the Beta (sensitivity to the market). We also observed significant differences between parameters estimated with and without wavelets.
The impact of the COVID-19 outbreak on Chinese-listed tourism stocks
Authors: Wu Wenmin , Lee Chien-Chiang , Xing Wenwu , Ho Shan-Ju
Published: April 2021

This research explored the effects of the coronavirus disease (COVID-19) outbreak on stock price movements of China’s tourism industry by using an event study method. The results showed that the crisis negatively impacted tourism sector stocks. Further quantile regression analyses supported the non-linear relationship between the government’s responses and stock returns. The results present that the resurgence of the virus in Beijing did bring about a short-term negative impact on the tourism industry. The empirical results can be used for future researchers to conduct a comparative study of cultural differences concerning government responses to the COVID-19.
Correction to references of ‘Countries’
Authors:   Financial Innovation
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Electrical control strategy for an ocean energy conversion system
Authors: Noman Muhammad , Li Guojie , Wang Keyou , Han Bei
Published: April 2021

Globally abundant wave energy for power generation attracts ever increasing attention. Because of non-linear dynamics and potential uncertainties in ocean energy conversion systems, generation productivity needs to be increased by applying robust control algorithms. This paper focuses on control strategies for a small ocean energy conversion system based on a direct driven permanent magnet synchronous generator (PMSG). It evaluates the performance of two kinds of control strategies, i.e., traditional field-oriented control (FOC) and robust adaptive control. The proposed adaptive control successfully achieves maximum velocity and stable power production, with reduced speed tracking error and system response time. The adaptive control also guarantees global system stability and its superiority over FOC by using a non-linear back-stepping control technique offering a better optimization solution. The robustness of the ocean energy conversion system is further enhanced by investigating the Lyapunov method and the use of a DC-DC boost converter. To overcome system complexity, turbine-generator based power take-off (PTO) is considered. A Matlab/Simulink study verifies the advantages of a non-linear control strategy for an Oscillating Water Column (OWC) based power generation system.