bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac Safety of Clonidine and Quetiapine in Post-Cardiac Surgery Intensive Care Unit Patients
Authors: Alshaya Abdulrahman I. , Gilmore James F. , Nashett Rebecca M. , Kovacevic Mary P. , Dube Kevin M. , Assiri Ibrahim M. , Malloy Rhynn J.
Published: September 2021

Background: Clonidine and quetiapine are frequently used medications in the cardiac surgery intensive care unit (ICU). Objective: The purpose of this study is to assess the impact of clonidine compared to quetiapine on cardiac safety outcomes in adult cardiac surgery ICU patients. Methods: This was a single-center, retrospective observational analysis at a tertiary care, academic medical center. Results: One hundred and sixty-one cardiac surgery patients who were administered clonidine or quetiapine during their ICU stay were included between June 2015 and May 2017. The major endpoint of this study was a cardiac safety composite of bradycardia, hypotension, and QTc prolongation. Minor endpoints included ICU and hospital length of stay, and in-hospital mortality. There were 115 patients included in the clonidine arm and 46 patients in the quetiapine arm. There was no difference between groups with regard to the major endpoint (30.43% vs 33.15%; P < .8). There was a shorter ICU and hospital length of stay in the clonidine arm compared to quetiapine P < .0001. All other endpoints were not statistically significant. Conclusion: Patients who received clonidine tended to have undergone less complex procedures, be younger, and have a lower APACHE II score than patients who received quetiapine. The incidence of composite cardiac safety outcomes was not different in clonidine compared to quetiapine in cardiac surgery ICU patients.
Influence of barite particulate filler on the mechanical behaviour of carbon fiber reinforced LY556 epoxy matrix composites
Authors: Benin SR , Selvakumar G , Sumathi M , Bright Renjin J
Published: September 2021

This work is intended to explore the influence of barite particulate filler on the mechanical behaviour of carbon fiber (Cf) reinforced polymer matrix (CFRP) composites. The carbon fiber utilized for the study was T300 grade and the polymer matrix utilized was LY556 epoxy resin (Epr). The CFRP composites prepared with 55 weight (wt.) % T300 carbon fiber and 45 wt.% LY556 epoxy resin without barite particulate filler was utilized for control experimentation. The CFRP composites with barite filler were prepared by varying the proportion of barite particles from 2.5 wt.% to 15 wt.% in steps of 2.5 wt.%. The composites were prepared using the hand lay-up process and the barite particles were mixed with the epoxy resin by means of ultrasonic agitation. The prepared composites were subjected to tension, compression, hardness, flexural and impact testing. The CFRP composites with 10 wt.% barite particles yielded the best tensile strength, hardness and impact strength. The tensile strength, hardness and impact strength attained an increase of 13.18%, 5.6% and 18.68% respectively, compared to the CFRP composite without barite filler. The compressive strength of the CFRP composite with 15 wt.% barite filler was observed to be more than twice the compressive strength of the CFRP composite without barite filler. However, the flexure strength reduced steadily with the addition of barite particulates. The fractured surface morphologies of the prepared composites were characterised using the Scanning Electron Microscope (SEM). The chemical composition and morphology of barite powder was analysed using Energy Dispersive X-Ray Spectroscopy (EDX) and SEM, respectively.
COVID-19 in systemic lupus erythematosus: A pooled analysis and systematic review of case reports and series
Authors: Sakthiswary Rajalingham , Chuah Hui Yuan , Chiang Ker Shing , Liew Yee Shan , Muhammad Aizat Noor Azman
Published: September 2021

Objective

In the recent months, there have been several case reports and case series on COVID-19 in patients with systemic lupus erythematosus(SLE). We conducted a pooled analysis and systematic review to summarise the findings of these articles. Besides, we aimed to determine the predictors of severe COVID-19 infection in SLE by comparing the mild to moderate cases with the severe to critical ones.

Method

All case reports and case series pertaining to COVID-19 in SLE were retrieved from Pubmed, Wiley Online Library, Springer Link, Science Direct and Web of Science databases using ‘lupus’, ‘systemic lupus erythematosus’, ‘coronavirus’, ‘SARS-CoV-2’, ‘SLE’ and “Covid-19” as keywords. The following data were extracted from the selected articles: country, age of the patient and the characteristics of SLE such as disease duration, organ or system involved, baseline medications and the severity of the COVID-19 infection. Data extracted from the articles were utilised to perform the pooled analysis.

Results

A total of 24 articles with 48 patients met the eligibility criteria. The median age at diagnosis of COVID-19 infection was 41 years (IQR: 11–66 years). The median SLE disease duration prior to the diagnosis of COVID-19 was 9 years (IQR: 0–30 years). A total of 22 (45.83%) patients had severe to critical COVID-19. This pooled data did not demonstrate any difference in the baseline medications between the 2 groups. Patients with lupus nephritis were significantly more prone to develop severe to critical disease ( p = 0 .036) with an odds ratio of 5.40 (95% confidence interval of 1.120–26.045).

Conclusion

We found that lupus nephritis was the only predictor of severe to critical COVID-19 in SLE.
Book review: Annie Devenish, Debating Women’s Citizenship in India 1930–1960
Authors: Chakraborty Rachana
Published: September 2021

Annie Devenish, Debating Women’s Citizenship in India 1930–1960. New Delhi, India: Bloomsbury, 2019, xxix + 269 pages, ₹1,299 (hardback). ISBN 978-93-88271-94-3.
Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis
Authors: Fell Matthew , Dack Kyle , Chummun Shaheel , Sandy Jonathan , Wren Yvonne , Lewis Sarah
Published: September 2021

A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology.

Medline, Embase, Web of Science and the Cochrane Library from inception to November, 2020.

Observational studies of cigarette smoking habits in pregnant women. Outcomes included cleft lip and/or palate, cleft lip  ±  palate and cleft palate only.

Publication bias analyses were performed and the Newcastle Ottawa scales were used to assess study quality. Fixed or random effect models were used in the meta-analysis, dependent on risk of statistical heterogeneity.

Forty-five studies were eligible for inclusion of which 11 were cohort and 34 were case–control studies. Sixteen studies were of sufficient standard for inclusion in the meta-analysis. The summary odds ratio for the association between smoking and cleft lip and/or palate was 1.42 (95%CI 1.27-1.59) with a population attributable fraction of 4% (95%CI 3%-5%). There was limited evidence to show a dose–response effect of smoking.

This review reports a moderate association between maternal smoking and orofacial cleft but the overall quality of the conventional observational studies included was poor. There is a need for high quality and novel research strategies to further define the role of smoking in the etiology of cleft lip and palate.
Conducting Online Crime and Safety Surveys with British Farmers
Authors: Smith Kreseda
Published: September 2021

Rural crime continues to be an under-represented area of academia. As a result, much of the methodological guidance tends to stem from health or rural development research, providing general guidance, but lacking the specific considerations of conducting crime and safety research in a rural environment. However, the impact of COVID-19 has led to a wider consideration of online surveys, particularly in rural communities. This paper provides guidance on conducting online crime and safety surveys with the farming community based on the extensive experience of the author in the field of rural criminology. Methodological considerations will be addressed that distinguish rural online crime and safety surveying from its urban counterpart, and the advantages and disadvantages of this methodology will be discussed. The aim being to guide the rural criminological researcher in the use of online surveys to obtain key data from the farming community to support and extend their research.
None of My Business? An Experiment Analyzing Willingness to Formally Report Incidents of Intimate Partner Violence Against Women
Authors: Leon Carmen M. , Aizpurua Eva , Rollero Chiara
Published: September 2021

Although data show that intimate partner violence against women (IPVAW) is a concealed phenomenon that is severely underreported, studies examining willingness to report episodes of IPVAW are limited. To contribute to this field of research, a factorial survey experiment was implemented in which each respondent ( N = 1,007) received a unique vignette describing a hypothetical case of IPVAW. Slightly over one in four respondents (28.1%) indicated that they would report the aggression. It was also found that willingness to report was influenced by both the characteristics of the vignettes and certain personal ones of the respondents. Practical implications are proposed that may contribute to preventing IPVAW.
Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: A case of acute pancreatitis
Authors: Unsal Oktay , Sütcüoğlu Osman , Yazıcı Ozan
Published: September 2021

Introduction

Acute pancreatitis associated with Pazopanib has been reported in the literature. Bitter Melon (Momordica Charantia) is traditionally used as a folk medicine in many regions. In this report, we describe a 65-year-old patient with a diagnosis of renal cell carcinoma, admitted to the hospital with symptoms of acute pancreatitis at the 8th year of pazopanib treatment.

Case Report

The patient diagnosed with renal cell carcinoma was admitted to the hospital with the complaint of abdominal pain, nausea, and vomiting in the 8th year of Pazopanib treatment. It was noticed from the patient's history that he had received Bitter Melon extract for 4 days prior to the beginning of his complaints (100–150 ml/day). Levels of serum amylase and lipase were measured as 9163 U/L and 14,206 U/L, respectively.

Management & Outcome

Pazopanib drug was held. The patient was treated for acute pancreatitis. Pazopanib treatment was started again after the clinical condition of the patient had improved and levels of serum amylase and lipase had returned to normal levels. Levels of serum amylase and lipase did not increase again after re-administration of pazopanib treatment.

Discussion

It is thought that Bitter Melon extract and pazopanib interaction might have led to acute pancreatitis. To the best of our knowledge, this case is the first to highlight the interaction of Bitter Melon extract with pazopanib. The Drug Interaction Probability Scale indicates that there is a probable association between bitter melon and acute pancreatitis.
Impact of brief educational intervention on knowledge of cancer among community pharmacists
Authors: Mensah Kofi Boamah , Boamah Mensah Adwoa Bemah , Wiafe Ebenezer , Padayachee Neelaveni , Aduse Poku Abena Yeboah , Dwobeng Amo Bismark , Hoyte Williams Margaret , Bangalee Varsha , Oosthuizen Frasia
Published: September 2021

Introduction

Community pharmacists may play a vital role in early detection and prevention of cancer. Findings from our pre-assessment studies showed that the Ghanaian community have inadequate knowledge of cancer. We assessed the impact of a brief educational intervention on knowledge level of cancer among Ghanaian community pharmacists.

Method

The study was a descriptive interventional study. Knowledge of cancer, signs and symptoms, risk factors and cancer screening tests were assessed before in a pre-assessment study and after a brief online education in our current study. A total of 435 community pharmacists were recruited in both studies.

Results

The mean ± SD total knowledge score of cancer increased from 9.03 ± 2.65 to 12.97 ± 1.43 out of a maximum score of 15 points. The mean ± SD total knowledge score of signs and symptoms of cancer increased from 4.15 ± 2.14 to 6.86 ± 0.76 out of a maximum score of 7 points. For the total knowledge score of causes and risk factors of cancer, the mean ± SD score increased from 8.13 ± 3.31 to 11.59 ± 0.87 out of a maximum score of 12 points. Lastly, the mean ± SD total knowledge score of cancer screening tests increased from 9.04 ± 5.01 to 16.39 ± 0.86 out of a maximum score of 18 points.

Conclusion

There were overall statistically significant improvements of participants knowledge in all aspects of cancer in this study compared to the pre-assessment study. Our study presents evidence of the effectiveness of a brief educational intervention tailor-made for Ghanaian community pharmacists.
Prevalence of frailty and associated factors among community-dwelling older adults after total hip arthroplasty
Authors: Ninomiya Kazunari , Takahira Naonobu , Ikeda Takashi , Suzuki Koji , Sato Ryoji , Kazuo Hirakawa
Published: September 2021

Objective:

To evaluate the prevalence of frailty and associated factors among community-dwelling older adults who have undergone total hip arthroplasty (THA).

Materials and methods:

This study, which employed a cross-sectional, observational design, was conducted between April and November 2020. The participants were older adults (⩾65 years) who had undergone primary THA at the study hospital. Based on Fried’s modified phenotype, frailty was stratified into 3 degrees according to the presence of 3 or more of the following components: weight loss, weakness, exhaustion, low activity level, and slow walking speed. Multinomial logistic regression was used to analyse the associations of frailty with its potential risk factors.

Results:

The data of 518 participants were analysed. The overall prevalence of frailty and prefrailty was 11.4% and 51.0%, respectively. The multinomial logistic regression analysis showed that calf circumference (odds ratio [OR] 0.716, 95% confidence interval [CI], 0.611–0.839; p < 0.001), fall history (OR 2.435, 95% CI, 1.114–5.322; p = 0.026), hip abductor muscle strength (OR 0.962, 95% CI, 0.938–0.987; p = 0.003), knee extensor muscle strength (OR 0.980, 95% CI, 0.964–0.996; p = 0.013), and Timed Up and Go test (TUG) performance (OR 1.802, 95% CI, 1.458–2.228; p < 0.001) were associated with frailty.

Conclusions:

Frailty was highly prevalent in community-dwelling older adults after THA. Further, its potential associations with calf circumference, hip abductor and knee extensor muscle strength, TUG performance, and fall history highlight the significance of these factors for interventions.
Upper limb anatomy and preoperative mapping
Authors: Vallespin Joaquim , Meola Mario , Ibeas Jose
Published: September 2021

Vascular access is absolutely essential for haemodialysis due to its relationship with quality of dialysis and associated morbidity. Therefore, it must be monitored and continuously surveilled from the moment it is created to prevent failure in maturation and thrombosis. Multidisciplinary collaboration is necessary when the main aim is to achieve the adequate vascular access flow with the fewest possible complications. The starting point, and probably the main one, is vascular access planning. This planning requires both a deep understanding of the anatomy of the upper limb and enough skill to examine it by Doppler ultrasound. The aim of this article is to review the anatomical and haemodynamical concepts of the arterial and venous vascular tree and explain how to perform ultrasound mapping, optimising the technical resources provided by this tool. Likewise, adequate access creation criteria that minimise the risk of failure and associated complications will be discussed.
The effectiveness of interventions to increase patient involvement in decision-making in orthodontics: A systematic review
Authors: Shelswell Jonathan , Patel Veena Abigale , Barber Sophy
Published: September 2021

Objectives:

To examine the effectiveness of interventions that aim to increase patient involvement in treatment decisions in orthodontic, orthognathic and cleft treatment, based on patient-reported outcomes and patient knowledge.

Design:

Systematic review.

Data sources:

OVID databases (MEDLINE, EMBASE and EBM reviews), CENTRAL, WHO’s International Clinical Trials Registry Platform and reference lists of included studies.

Data selection:

Studies were selected by two reviewers independently and in duplicate based on pre-defined eligibility criteria: Population: People considering or undergoing orthodontic, orthognathic or cleft treatment. Intervention: Any intervention that aims to increase patient involvement in decision-making. Outcomes: Patient-reported outcomes and patient knowledge. Studies: All experimental studies published in English from January 2000 to October 2019 were eligible.

Data extraction:

Standardised data extraction of study information and assessment of risk of bias using the Cochrane Risk of Bias Tool for RCTs and ROBINS-I for non-randomised studies of interventions.

Data synthesis:

13 randomised controlled trials were included. Due to heterogeneity in the studies, a narrative synthesis was undertaken. The majority (n=11) of studies involved orthodontic patients, with one study of cleft patients and one study of orthognathic and orthodontic patients. Six included studies reported significant differences between intervention and control groups with improved patient knowledge or better patient-reported outcomes.

Conclusions:

A variety of different interventions and outcome measures were used making data synthesis challenging. There is some evidence that interventions to increase patient involvement in decision-making can improve patient-reported outcomes and patient knowledge.
The art of touch: lending a hand to the sighted majority
Authors: Kleege Georgina
Published: September 2021

This article describes three collaborative projects designed to explore tactile and haptic encounters with visual art. As a blind person, the author takes advantage of touch tours offered in many of the world’s museums. As rewarding as these can be, she often leaves feeling that there is something missing. She is aware that people who witness a touch tour for blind people, both companions who might be with them and strangers who might observe it, are curious, even envious. It seems only right that she, and other blind people who enjoy this privilege, have a responsibility to share the experience as a way to expand cultural knowledge about art. The projects described here enable her to begin to establish a taxonomy and vocabulary of tactile and haptic aesthetics, and model tactile descriptions of art that can benefit anyone. She does this both to reciprocate for the privilege cultural institutions bestowed on her, as well as to show that touch is not merely a poor substitute for sight, but rather a different mode of inquiry and appreciation. She hopes this work will support challenges to the ocularcentrism of the museum sector by showing how art can engage the full human sensorium.

These projects all took place in the years leading up to the Covid-19 global pandemic and were a small part of initiatives at arts institutions to promote equity and inclusion by drawing on the knowledge and expertise of members of marginalized communities. As these institutions reopen post-pandemic and restructure their staff and programming, it remains to be known if they will continue the progress toward greater inclusion or return to previous models designed to serve only normative audiences. In her conclusion, the author speculates on the kind of systematic changes that will need to happen to continue to diversify museum audiences and increase multisensory access to art.
Blue like the Mediterranean: the work of the monochrome in the Atlas Group Archive
Authors: Korola Katerina
Published: September 2021

In the prologue to Walid Raad’s Hostage: The Bachar Tapes (2001), the speaker asks that his words appear against a grey background. Or, he continues after a pause, ‘use a blue background . . . blue just like the Mediterranean’. Beginning with this colourful riddle, this article investigates the work of the monochrome in the Atlas Group Archive. With this attention to the monochrome as a format, the author’s goal is to move away from the categories of documentary and fiction that dominate discussions of Raad and parafictional work more generally, towards the formal infrastructure through which such works command belief and emotion. This attention to the aesthetic form of the archive not only brings into focus the constituent role of design in the construction of knowledge, but it also reveals the transformation of the monochrome in its encounters with the archive, technical media, and the chromatics of affective capitalism.
Roles of Lipid Profiles in Human Non-Small Cell Lung Cancer
Authors: Jianyong Zhang , Yanruo Huang , Xiaoju Tang , Yiping Wei , Fengming Luo
Published: September 2021

Aims: This review aims to identify lipid biomarkers of non-small cell lung cancer (NSCLC) in human tissue samples and discuss the roles of lipids in tissue molecular identification, the discovery of potential biomarkers, and surgical margin assessment. Methods: A review of the literature focused on lipid-related research using mass spectrometry (MS) techniques in human NSCLC tissues from January 1, 2015, to November 20, 2020, was conducted. The quality of included studies was assessed using the QUADAS-2 tool. Results: Twelve studies met the inclusion criteria and were included in the review. The risk of bias was unclear in the majority of the studies. The contents of lipids including fatty acids, phosphatidyl choline, phosphatidyl ethanolamine, phosphatidyl inositol, cardiolipin, phosphatidyl serine, phosphatidyl glycerol, ceramide, lysophosphatidylethanolamine, lysophosphatidylcholine, and lysophosphatidylglycerol differed significantly between cancer and healthy tissues. The sensitivity or specificity of the discrimination model was reported in 8 studies, and the sensitivity and specificity varied among the reported methods. The lipid profiles differed between adenocarcinoma and squamous cell carcinoma NSCLC subtypes. Conclusion: In preclinical studies, MS analysis and multiple discrimination models can be combined to distinguish NSCLC tissues from healthy tissues based on lipid profiles, which provides a new opportunity to evaluate the surgical margin and cancer subtype intraoperatively. Future studies should provide guidance for selecting patients and discrimination models to develop an improved method for clinical application.
Assessment of Telemedicine and Phone Consultation Effects on Rate of Hand Transfers to Trauma Centers and Specialty Services Referrals
Authors: Bracey John , Morell Sean , Tait Mark , Frazier G. Tom , Wyrick Theresa O.
Published: September 2021

Background

Telemedicine consultation can increase patients’ access to subspecialty care and decrease the number of unnecessary hospital transfers. In 2014, the Arkansas Hand Trauma Telemedicine Program (AHTTP) was established to extend specialized hand care throughout Arkansas. The purpose of this study is to assess whether transfers are affected when consultation with a hand specialist is performed by phone compared with using a live audiovisual consultation.

Methods

We reviewed data from the first year of the AHTTP. Data collection included type of consultation (telephone only or live audiovisual), need for transfer, and type of transfer (general orthopedic or hand specialist).

Results

In 2014, the first year of AHTTP there were 331 hand injuries identified; of those, 298 used the AHTTP with 195 (65%) using telemedicine and 103 (35%) using phone consultation only. The use of video when compared with phone consultation did not significantly affect the decision to transfer ( P = .42) or alter the rate of transfer for general orthopedic or hand specialist care ( P = .25).

Conclusions

The assessment of both phone and telemedicine modalities showed that there was no significant difference in transfer rates for either consultation, highlighting that communication with a hand surgeon was the key to accurate assessment of the need for transfer.
Distracted Driving and Driving Patterns in Older Drivers With Glaucoma
Authors: Jain Purva , Unkart Jonathan T. , Daga Fabio B. , Hill Linda
Published: September 2021

Limited research exists examining self-perceived vision and driving ability among individuals with glaucoma, and this study assessed the relationship between glaucoma, visual field, and visual acuity with driving capability.

137 individuals with glaucoma and 75 healthy controls were asked to evaluate self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Visual acuity and visual field measurements were also obtained. Multivariable linear regressions were run to test each visual measure with driving outcomes.

The average age was 72.2 years, 57.3% were male, and 72.5% were White. There were significant associations for a one-point increase in visual field and quality of corrected vision (RR = 1.06; 95% CI = 1.03–1.10), day vision (RR = 1.05; 95% CI = 1.03–1.08), night vision (RR = 1.08; 95% CI = 1.05–1.13), visual acuity score and higher quality of corrected of vision (RR = .41; 95% CI = .22-.77), day vision (RR = .39; 95% CI=.22–.71), and night vision (RR = .41; 95% CI = .18–.94); visual acuity score and ability to drive safely compared to other drivers your age (RR = .53; 95% CI = .29–.96).

Individuals with poorer visual acuity and visual fields rate their vision and ability to drive lower than those with better vision, and this information will allow clinicians to understand where to target interventions to enhance safe driving practices.
Serum epithelial membrane protein 1 serves as a feasible biomarker in extrahepatic cholangiocarcinoma
Authors: Li Xiang , Yan Lang , Xue Hao
Published: September 2021

Background

Extrahepatic cholangiocarcinoma is a malignancy that originates from bile duct epithelium with an unfavorable prognosis. Epithelial membrane protein 1 was first discovered in 1995, functioning as an oncogene or anti-tumor gene in various cancers. However, the clinical role of epithelial membrane protein 1 extrahepatic cholangiocarcinoma remained unclear.

Methods

Differentially expressed genes were identified using Gene Ontology and the Kyoto Encyclopedia and Genomes pathway analysis. Out of 183 extrahepatic cholangiocarcinoma patients and 61 healthy controls, the expression level of epithelial membrane protein 1 was detected and compared using reverse transcription-quantitative polymerase chain reaction analysis and western blot assay. Meanwhile, the diagnosis and prognosis of EMP1 in ECCA were measured by receiver operating characteristic and Kaplan–Meier analysis. Finally, the relationship between epithelial membrane protein 1 expression and clinicopathological indexes were compared to further verify the clinical role of epithelial membrane protein 1 in extrahepatic cholangiocarcinoma.

Results

After analyzing data from GSE76297, GSE89749, and GSE26566GO, we found 1554 down-regulated and 1065 up-regulated genes. Through Gene Ontology and Kyoto Encyclopedia and Genomes analysis, extracellular matrix organization, extracellular structure organization, cholesterol metabolism, interleukin-17 signaling pathway, and vitamin digestion and absorption were significantly enriched and involved in targeted differentially expresses genes. Epithelial membrane protein 1 messenger ribonucleic acid was notably decreased in serum samples from extrahepatic cholangiocarcinoma patients, compared with that in healthy controls. Receiver operating characteristic analysis revealed that the area under the curve of epithelial membrane protein 1 messenger ribonucleic acid for the diagnosis of extrahepatic cholangiocarcinoma was 0.9281 (95% CI = 0.8967–0.9595). Moreover, the correlation analysis presented that epithelial membrane protein 1 expression was negatively correlated with lymph node metastasis, tumour node metastasis stage, cancer antigen 19-9 level, and carcinoembryonic antigen level.

Conclusion

Aberrant expression of epithelial membrane protein 1 contributed to distinguishing extrahepatic cholangiocarcinoma patients and healthy controls, and a low expression level of epithelial membrane protein 1 indicated an unfavorable prognosis. Hence, epithelial membrane protein 1 was a feasible and credible biomarker for extrahepatic cholangiocarcinoma diagnosis and prognosis, with high accuracy, sensitivity, and specificity.
Autonomous speed adaptation by a muscle-driven hind leg robot modeled on a cat without intervention from brain
Authors: Fukuoka Yasuhiro , Habu Yasushi , Inoue Kouta , Ogura Satoshi , Mori Yoshikazu
Published: September 2021

This study aims to design a nervous system model to drive the realistic muscle-driven legs for the locomotion of a quadruped robot. We evaluate our proposed nervous system model with a hind leg simulated model and robot. We apply a two-level central pattern generator for each leg, which generates locomotion rhythms and reproduces cat-like leg trajectories by driving different sets of the muscles at any timing during one cycle of moving the leg. The central pattern generator receives sensory feedback from leg loading. A cat simulated model and a robot with two hind legs, each with three joints driven by six muscle models, are controlled by our nervous system model. Even though their hind legs are forced backward at a wide range of speeds, they can adapt to the speed variation by autonomously adjusting its stride and cyclic duration without changing any parameters or receiving any descending inputs. In addition to the autonomous speed adaptation, the cat hind leg robot switched from a trot-like gait to a gallop-like gait while speeding up. These features can be observed in existing animal locomotion tests. These results demonstrate that our nervous system is useful as a valid and practical legged locomotion controller.
The relationship between the perception of chronic disease care and health-related quality of life in adults with chronic kidney disease
Authors: Akca Nesrin , Saygili Meltem , Ture Aysun Kandemir
Published: September 2021

Objectives

In this study, it was aimed to determine the chronic disease care assessments and health-related quality of life (HRQoL) levels in adults with chronic kidney disease (CKD) undergoing hemodialysis and to reveal the relationship between chronic disease care assessment and HRQoL.

Methods

A single-center cross-sectional design has been used. Data were collected from 105 adults with CKD, who undergoing hemodialysis. Patient Evaluation Chronic Illness Care (PACIC) scale and Kidney Disease Quality of Life Short Form-36 (KDQOL-36) were used to obtain data.

Results

The mean scale scores of PACIC were low (2.66 ± 0.891). Although participants achieved high HRQoL scores on the symptoms subdimension of the KDQoL-36 scale, they got low scores on the subdimensions of mental health, physical health, and burden of disease. Participants' HRQoL is affected significantly by gender, age, educational level, working status, income, and presence of comorbidity (especially diabetes), diagnosis time of CKD, and hemodialysis time at the hospital ( p < 0.05). A positive and statistically significant relationship was found between PACIC and subdimensions of KDQoL-36 ( p < 0.05).

Discussion

The results can be a guide for improving the quality of chronic disease care in healthcare institutions. To improve this, patients' evaluations on this issue should be taken into account.
Using the patient activation measure to examine the self-management support needs of a population of UK workers with long-term health conditions
Authors: Hemming Sally , Munir Fehmidah
Published: September 2021

Objectives

To examine differences in patient activation and self-management support needs in a population of UK workers with long-term health conditions.

Methods

Demographic, health and activation information were taken from the data of participants with long-term conditions, collected via an online cross-sectional survey of workers. The 13-item British patient activation measure measured workers knowledge, skills and confidence towards self-managing.

Results

Three hundred and seven workers with mental health, musculoskeletal and other conditions completed the patient activation measure. Mental health conditions were most prevalent (36.8%). Workers were higher activated, however workers with mental health conditions were significantly less activated ( p = 0.006). Differences in activation by condition severity and age were revealed.

Discussion

This study provides insight to the activation of UK workers with long-term conditions. Whilst workers with mental health conditions need more training and education to self-manage, workers are variably activated indicating broader support needs. There is a gap for workplace self-management support. The patient activation measure is used in healthcare to improve people’s self-management and should be considered to be included in the workplace, and could form part of interventions to support workers self-management. More rigorous studies, including the patient activation measure, are needed to identify the best approaches to identifying workers self-management support needs.
Reclassifications of ischemic stroke patterns due to variants of the Circle of Willis
Authors: Rangus Ida , Milles Lennart S , Galinovic Ivana , Villringer Kersten , Audebert Heinrich J , Fiebach Jochen B , Nolte Christian H , Hebun Erdur
Published: September 2021

Background

Variants of the Circle of Willis (vCoW) may impede correct identification of ischemic lesion patterns and stroke etiology. We assessed reclassifications of ischemic lesion patterns due to vCoW.

Methods

We analyzed vCoW in patients with acute ischemic stroke from the 1000+ study using time-of-flight magnetic resonance angiography (TOF MRA) of intracranial arteries. We assessed A1 segment agenesis or hypoplasia in the anterior circulation and fetal posterior cerebral artery in the posterior circulation. Stroke patterns were classified as one or more-than-one territory stroke pattern. We examined associations between vCoW and stroke patterns and the frequency of reclassifications of stroke patterns due to vCoW.

Results

Of 1000 patients, 991 had evaluable magnetic resonance angiography. At least one vCoW was present in 37.1%. VCoW were more common in the posterior than in the anterior circulation (33.3% vs. 6.7%). Of 238 patients initially thought to have a more-than-one territory stroke pattern, 20 (8.4%) had to be reclassified to a one territory stroke pattern after considering vCoW. All these patients had fetal posterior cerebral artery and six (30%) additionally had carotid artery disease. Of 753 patients initially presumed to have a one-territory stroke pattern, four (0.5%) were reclassified as having more-than-one territory pattern.

Conclusions

VCoW are present in about one in three stroke patients and more common in the posterior circulation. Reclassifications of stroke lesion patterns due to vCoW occurred predominantly in the posterior circulation with fetal posterior cerebral artery mimicking multiple territory stroke pattern. Considering vCoW in these cases may uncover symptomatic carotid disease.
SWIFT DIRECT: Solitaire™ With the Intention For Thrombectomy Plus Intravenous t-PA Versus DIRECT Solitaire™ Stent-retriever Thrombectomy in Acute Anterior Circulation Stroke: Methodology of a randomized, controlled, multicentre study
Authors: Fischer Urs , Kaesmacher Johannes , S Plattner Patricia , Bütikofer Lukas , Mordasini Pasquale , Deppeler Sandro , Cognard Christoph , Pereira Vitor M , Siddiqui Adnan H , Froehler Michael T , Furlan Anthony J , Chapot René , Strbian Daniel , Wiesmann Martin , Bressan Jenny , Lerch Stefanie , Liebeskind David S , Saver Jeffery L , Gralla Jan ,   on behalf of the SWIFT DIRECT study investigators
Published: September 2021

Rationale

Whether treatment with intravenous alteplase prior to mechanical thrombectomy (MT) in acute ischemic stroke patients with large vessel occlusion is beneficial remains unclear.

Aim

To determine whether patients experiencing acute ischemic stroke due to occlusion of the intracranial internal carotid artery or the M1 segment of the middle cerebral artery who are referred to an endovascular stroke center and who are candidates for intravenous alteplase will have non-inferior functional outcome at 90 days when treated with MT alone (direct MT) with stent retrievers compared to patients treated with combined intravenous thrombolysis (IVT) with alteplase plus MT (IVT + MT) with stent retrievers.

Sample size

To randomize 404 patients 1:1 to direct MT or combined IVT+MT.

Methods and design

A multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) trial utilizing an adaptive statistical design.

Outcomes

The primary efficacy endpoint is functional independence (modified Rankin Scale 0–2) at 90 days. Secondary clinical efficacy outcomes include change in National Institutes of Health Stroke Scale score from baseline to day 1 and health-related quality of life at 90 days. Secondary technical efficacy outcomes include successful reperfusion prior to start of MT and time from randomization to successful reperfusion. Safety outcomes include all serious adverse events, symptomatic intracranial hemorrhage, and mortality up to 90 days.

Discussion

SWIFT DIRECT will inform physicians whether direct MT in acute ischemic stroke patients with large vessel occlusion is equally or more efficacious than combined treatment with intravenous alteplase and MT.

Trial registration

ClinicalTrials.gov Identifier: NCT03192332
Weakly supervised multitask learning models to identify symptom onset time of unclear-onset intracerebral hemorrhage
Authors: Jianbo Chang , Hanqi Pei , Yihao Chen , Cheng Jiang , Hong Shang , Yuxiang Wang , Xiaoning Wang , Zeju Ye , Xingong Wang , Fengxuan Tian , Jianjun Chai , Jijun Xu , Zhaojian Li , Wenbin Ma , Junji Wei , Yao Jianhua , Ming Feng , Renzhi Wang
Published: September 2021

Background

Approximately one-third of spontaneous intracerebral hemorrhage patients did not know the onset time and were excluded from studies about time-dependent treatments for hyperacute spontaneous intracerebral hemorrhage.

Aims

To help clinicians explore the benefit of time-dependent treatments for unclear-onset patients, we presented artificial intelligence models to identify onset time using non-contrast computed tomography (NCCT) based on weakly supervised multitask learning (WS-MTL) structure.

Methods

The patients with reliable symptom onset time (strong label) or repeat CT (weak label) were included and split into training set and test set (internal and external). The WS-MTL structure utilized strong and weak labels simultaneously to improve performance. The models included three binary classification models for classifying whether NCCT acquired within 6, 8 or 12 h for different treatments measured by area under curve, and a regression model for determining the exact onset time measured by mean absolute error. The generalizability of models was also explored in comprehensive analysis.

Results

A total of 4004 patients with 10,780 NCCT scans were included. The performance of WS-MTL classification model showed high accuracy, and that of regression model was satisfactory in ≤6 h subgroup. In comprehensive analysis, the WS-MTL showed better performance for larger hematomas and thinner scans. And the performance improved effectively as training amounts increasing and could be improved steadily through retraining.

Conclusions

The WS-MTL models showed good performance and generalizability. Considering the large number of unclear-onset spontaneous intracerebral hemorrhage patients, it may be worth to integrate the WS-MTL model into clinical practice to identify the onset time.
Being Moved: Motion and Emotion in Classical Antiquity and Today
Authors: Konstan David
Published: September 2021

Efforts to identify in the expression “being moved” a new emotion have found a hospitable environment in the recent turn to the body in emotion and cognitive studies, exemplified herein affect theory, with a particular focus on the effects of music. Although classical Greek and Latin had comparable expressions, however, they did not single out a specific emotion. Given that music played an important role in ancient educational theories, and was imagined as having arousing powerful reactions, this might seem a curious absence. The reason, at least in part, maybe the strong cognitive conception of emotions characteristic of classical theories. But this should not discourage the search for emotions that are not included in the ancient canons.
Perceptions of participation in school and association with health and wellbeing: comparison among Nigerian and Irish pupils
Authors: John-Akinola Yetunde O. , Balogun Mary O. , Desmennu Adeyimika T. , Awobiyi Damilola O. , Gabhainn Saoirse Nic
Published: September 2021

School participation among pupils is considered a key value of the health promoting school approach. However, few studies have documented the relationship between the school participation of pupils and health and wellbeing outcomes in different geographical contexts, especially looking at developing and developed country contexts. This study investigated the perceptions of Nigerian and Irish pupils on participation in school and reported health and wellbeing. Data was collected using self-completed questionnaires among 333 and 231 primary school pupils in 4th, 5th and 6th classes across 17 schools in Nigeria and Ireland. Logistic regression analysis was used to analyse the data from both countries. There was no statistically significant difference in the mean scores for participation in school activities (NIG mean = 22.8, SD 3.5; IRE mean = 22.3, SD 3.4) and school events (NIG mean = 18.8, SD 3.7; IRE mean = 17.1, SD 3.6). However, participation in school decisions and rules (NIG mean = 17.3, SD 4.7; IRE mean = 15.8, SD 3.6) and health and wellbeing (NIG mean = 16.9, SD 1.7; IRE mean = 15.3, SD 2.4) scores were significantly higher among Nigerian pupils, while positive perception of school participation (NIG mean = 24.2, SD 4.1; IRE mean = 26.2, SD 3.4) was significantly higher among Irish pupils. The findings suggest that Irish and Nigerian pupils have positive perceptions of their schools irrespective of their location and levels of development. However, further research using qualitative approaches might be needed to better clarify dimensions of pupils’ perceptions of school life and school participation among Nigerian pupils in order to substantiate these claims.
Natural Indoles From the Bacterium Pseudovibrio denitrificans P81 Isolated From a Marine Sponge, Aaptos Species
Authors: Fang Shu-Yen , Chen Sheng-Yuan , Chen You-Ying , Kuo Tsu-Jen , Wen Zhi-Hong , Chen Yu-Hsin , Hwang Tsong-Long , Sung Ping-Jyun
Published: September 2021

A new natural indole, vibrindole B (1), together with known analogs, vibrindole A (2), trisindoline (3), norharmane (4), and 3-(hydroxyacetyl)indole (5), produced by the bacterium Pseudovibrio denitrificans P81, were isolated from a sponge, Aaptos species. The structures of indoles 1 to 5 were established by spectroscopic methods. The proposed biosynthetic pathway of 1 to 5 is also discussed, starting from tryptophan. Moreover, indoles 1 to 3 were found to exhibit cytotoxicity toward T24 tumor cells with IC50 values of 1.71 ± 0.11, 4.53 ± 0.14, and 2.26 ± 0.26 µM, respectively.
Achievement of long-term local control after radiation and anti-PD-1 immunotherapy in locally advanced non-small cell lung cancer
Authors: Jing Zhao , Zhou Rongjin , Zhang Ni
Published: September 2021

Although concurrent chemoradiotherapy (CRT) is recommended as standard of care in patients with locally advanced, unresectable, stage III non-small cell lung cancer (NSCLC), many patients who refuse or are not eligible for chemotherapy received radiotherapy (RT) alone with 5-year overall survival (OS) rate of about 5–6%. Immune-checkpoint inhibitors have demonstrated objective antitumor responses in patients with advanced NSCLC, but it is unclear how these agents can be used in the curative therapy with concurrent radiation. We report three cases of stage III unresectable NSCLC patients who refused chemotherapy received radiation and pembrolizumab immunotherapy. All patients had no local-regional recurrence with acceptable tolerance.
COVID-Care – a safe and successful digital self-assessment tool for outpatients with proven and suspected coronavirus-2019
Authors: Drewett George P , Holmes Natasha E , Trubiano Jason A , Vogrin Sara , Feldman Jeff , Rose Morgan
Published: September 2021

Introduction

The coronavirus-2019 (COVID-19) pandemic and restrictions placed on movement to prevent its transmission have led to a surge in demand for remote medical care. We investigated whether COVID-Care, a patient-reported, telehealth, symptom monitoring system, was successful at delivering safe monitoring and care for these patients leading to decreased hospital presentations.

Methods

We performed a single centre, prospective, interventional cohort study with symptomatic outpatients who presented for COVID-19 screening at Austin Health, Australia. Participants were invited to take part in the COVID-Care programme, entering common COVID-19 symptoms on a purpose-built, online survey monitored by infectious diseases physicians, and matched with clinical data including date of symptom onset, hospital admission, and screening clinic presentations.

Results

42,158 COVID-19 swabs were performed in 31,626 patients from March to October 2020, with 414 positive cases. 20,768 people used the COVID-Care survey at least once. COVID-Care users were significantly younger than non-users. Of the 414 positive cases, 254 (61.3%) used COVID-Care, with 160 (38.6%) non-users. Excluding presentations on the same day or prior to the COVID-19 swab, of the positive cases there were 56 hospital presentations. 4.3% (11) of COVID-Care users and 28.1% (45) non-users were admitted to hospital or the emergency department ( p < 0.001), with 3.9% (10) versus 22.5% (36) requiring inpatient admission ( p < 0.001). There were no deaths in COVID-Care users versus 2 deaths in non-users.

Conclusion

COVID-Care, a digitally integrated, outpatient, symptom tracking and telemedical service for patients with COVID-19, was safe and successful at reducing hospital and emergency department admissions, suggesting a strong role for telemedicine for future healthcare delivery in this logistically challenging setting.