bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning techniques for automated detection of autism spectrum disorder based on thermal imaging
Authors: Ganesh Kavya , Umapathy Snekhalatha , Thanaraj Krishnan Palani
Published: June 2021

Children with autism spectrum disorder have impairments in emotional processing which leads to the inability in recognizing facial expressions. Since emotion is a vital criterion for having fine socialisation, it is incredibly important for the autistic children to recognise emotions. In our study, we have chosen the facial skin temperature as a biomarker to measure emotions. To assess the facial skin temperature, the thermal imaging modality has been used in this study, since it has been recognised as a promising technique to evaluate emotional responses. The aim of this study was the following: (1) to compare the facial skin temperature of autistic and non-autistic children by using thermal imaging across various emotions; (2) to classify the thermal images obtained from the study using the customised convolutional neural network compared with the ResNet 50 network. Fifty autistic and fifty non-autistic participants were included for the study. Thermal imaging was used to obtain the temperature of specific facial regions such as the eyes, cheek, forehead and nose while we evoked emotions (Happiness, anger and sadness) in children using an audio-visual stimulus. Among the emotions considered, the emotion anger had the highest temperature difference between the autistic and non-autistic participants in the region’s eyes (1.9%), cheek (2.38%) and nose (12.6%). The accuracy obtained by classifying the thermal images of the autistic and non-autistic children using Customised Neural Network and ResNet 50 Network was 96% and 90% respectively. This computer aided diagnostic tool can be a predictable and a steadfast method in the diagnosis of the autistic individuals.
Putting US First: How Outgroup Hostilities and Defense of the Status Quo Motivate White Evangelical Affect Toward Candidates in U.S. Elections 2004 to 2016
Authors: Marsh Wayde Z.C.
Published: June 2021

How do voters construct feelings toward inparty elites? More specifically, how do they do so when they lack a shared policy agenda or shared salient social identity with candidates beyond partisan identification? In this paper, I investigate this puzzle by developing a theory of Putting America First to explain white evangelical affect toward Republican presidential candidates from 2004 to 2016. Using ANES surveys from 2004 to 2016, I test the effectiveness of this model of candidate affect. I find that shared outgroup hostility, what I call Putting Us First, motivates positive affect for presidential candidates among white evangelicals, regardless of shared policy objectives and descriptive representation. Overtime, white evangelicals’ affect is driven by outgroup hostilities rather than Culture Wars values. Overall, this informs our understanding of voter affect toward candidates and the increasingly important role of social outgroup hostility in defense of the status quo.
Toxicity and verbal aggression on social media: Polarized discourse on wearing face masks during the COVID-19 pandemic
Authors: Pascual-Ferrá Paola , Alperstein Neil , Barnett Daniel J , Rimal Rajiv N
Published: June 2021

Medical and public health professionals recommend wearing face masks to combat the spread of the coronavirus disease of 2019 (COVID-19). While the majority of people in the United States support wearing face masks as an effective tool to combat COVID-19, a smaller percentage declared the recommendation by public health agencies as a government imposition and an infringement on personal liberty. Social media play a significant role in amplifying public health issues, whereby a minority against the imposition can speak loudly, perhaps using tactics of verbal aggression taking the form of toxic language. We investigated the role that toxicity plays in the online discourse around wearing face masks. Overall, we found tweets including anti-mask hashtags were significantly more likely to use toxic language, while tweets with pro-mask hashtags were somewhat less toxic with the exception of #WearADamnMask. We conclude that the tensions between these two positions raise doubt and uncertainty around the issue, which make it difficult for health communicators to break through the clutter in order to combat the infodemic. Public health agencies and other governmental institutions should monitor toxicity trends on social media in order to better ascertain prevailing sentiment toward their recommendations and then apply these data-driven insights to refine and adapt their risk communication messaging toward mask wearing, vaccine uptake, and other interventions.
Solitary Cystic Psoas Muscle Metastasis From Rectosigmoid Adenocarcinoma
Authors: Farraj Kristen , Im Jaehyuck , Gonzalez Luis F. , Lu Andrew , Portnoy Reid , Podrumar Alida
Published: June 2021

The most common subtype of colon cancer is colorectal adenocarcinoma. Compared with other subtypes, such as signet-ring and mucinous, colorectal adenocarcinoma has been found to have lower rates of metastasis. Approximately 20% of colorectal cancer cases present with metastatic disease on initial evaluation. The most common locations for metastasis are the liver, lung, peritoneum, bone, and extra-regional lymph nodes. Metastatic disease to the skeletal muscle, however, is considerably rare. We present a clinical case of a 52-year-old female found to have a cystic iliopsoas muscle metastasis from rectosigmoid adenocarcinoma, initially classified as an infected fluid collection.
Heterozygous variants of CLPB are a cause of severe congenital neutropenia
Authors: Warren Julia T. , Cupo Ryan R. , Wattanasirakul Peeradol , Spencer David H. , Locke Adam E. , Makaryan Vahagn , Bolyard Audrey Anna , Kelley Merideth L. , Kingston Natalie L. , Shorter James , Bellanné-Chantelot Christine , Donadieu Jean , Dale David C. , Link Daniel C.
Published: June 2021

Severe congenital neutropenia is an inborn disorder of granulopoiesis. Approximately one third of cases do not have a known genetic cause. Exome sequencing of 104 persons with congenital neutropenia identified heterozygous missense variants of CLPB (caseinolytic peptidase B) in 5 severe congenital neutropenia cases, with 5 more cases identified through additional sequencing efforts or clinical sequencing. CLPB encodes an adenosine triphosphatase that is implicated in protein folding and mitochondrial function. Prior studies showed that biallelic mutations of CLPB are associated with a syndrome of 3-methylglutaconic aciduria, cataracts, neurologic disease, and variable neutropenia. However, 3-methylglutaconic aciduria was not observed and, other than neutropenia, these clinical features were uncommon in our series. Moreover, the CLPB variants are distinct, consisting of heterozygous variants that cluster near the adenosine triphosphate-binding pocket. Both genetic loss of CLPB and expression of CLPB variants result in impaired granulocytic differentiation of human hematopoietic progenitor cells and increased apoptosis. These CLPB variants associate with wild-type CLPB and inhibit its adenosine triphosphatase and disaggregase activity in a dominant-negative fashion. Finally, expression of CLPB variants is associated with impaired mitochondrial function but does not render cells more sensitive to endoplasmic reticulum stress. Together, these data show that heterozygous CLPB variants are a new and relatively common cause of congenital neutropenia and should be considered in the evaluation of patients with congenital neutropenia.
Chronic cough is associated with increased reporting of autonomic symptoms
Authors: Dockry Rachel J. , Farrelly Carmen L. , Mitchell Joanne , Corfield Douglas R. , Smith Jaclyn A.
Published: June 2021

Background

Patients with some neuronal hypersensitivity syndromes experience increased autonomic symptoms. Chronic cough is thought to be a neuronal hypersensitivity disorder and, therefore, may be associated with increased autonomic symptoms.

Methods

96 chronic cough subjects were recruited from the tertiary cough clinic based at Wythenshawe Hospital, Manchester, UK; 76 healthy controls were also recruited. Subjects were aged >18 years. Those with significant respiratory disease, significant smoking history or taking medication known to affect cough or autonomic function were excluded. Subjects completed the Composite Autonomic Symptom Score (COMPASS) 31 autonomic symptom questionnaire, the Cough Quality of Life Questionnaire (CQLQ) and a cough severity visual analogue scale (VAS).

Results

96 chronic cough subjects and 76 healthy volunteers were included in the final analysis. Mann–Whitney U-tests comparing COMPASS 31 scores in both groups showed that the total COMPASS 31 score was significantly higher in the patient group (median 18.4, interquartile range (IQR) 7.5–32.0) than the control group (median 3.6, IQR 1.1–9.5; p<0.001). The chronic cough subjects had significantly higher symptom scores than the healthy volunteer groups in all domains (p≤0.001) except vasomotor symptoms (p=0.770). There was a positive association between COMPASS 31 and CQLQ in the patient group (p<0.001, r=0.432) but not COMPASS 31 and VAS (p=0.227).

Interpretation

Chronic cough patients do indeed report more frequent and severe autonomic symptoms than healthy volunteers, indicating that this population may suffer from dysautonomia. At present, it remains unclear whether this occurs as a result of the cough or whether both the cough and dysfunction are part of some wider vagal pathology.
The validity of shortened multiple-breath washout testing using sulfur hexafluoride in the assessment of patients with COPD
Authors: Daynes Enya , Greening Neil , Owers-Bradley John , Singh Sally J. , Siddiqui Salman
Published: June 2021

Introduction

COPD affects the small airways and is associated with ventilation heterogeneity. There are little data on the multiple-breath washout (MBW) in patients with COPD, particularly the variability over 8 weeks, using a shortened sulfur hexafluoride (SF6) washout. This work evaluated the repeatability of the lung clearance index (LCI)1/40and LCI1/20among subjects with COPD and compared to spirometry and clinical markers.

Methods

The MBW was performed on patients with COPD to determine ventilation heterogeneity globally (LCI), at conductive (Scond) and acinar (Sacin) levels. The LCI was repeated in triplicate and measured at a traditional 1/40th washout and retrofitted to a shortened 1/20th end tidal SF6concentration washout. Tests were repeated after 20 min and 8  weeks to determine within and between visit repeatability and compared with spirometry.

Results

Eighty-four subjects were recruited to perform LCI and spirometry with 20 subjects performing the repeatability protocol. There were weak correlations between forced expiratory volume in 1 s ( FEV1) per cent predicted and LCI1/40thr=−0.311 (p=0.02), and LCI1/20thr=−0.40 (p<0.01). The LCI demonstrated excellent within and good between visit repeatability for both a 1/40th and 1/20th washout (intraclass correlation coefficient (ICC)≥0.80). There was a statistically significant strong correlation between LCI1/40thand a shortened LCI1/20of 0.86 (p<0.01).

Conclusions

The LCI is repeatable within and between visits. There are weak correlations with measures of spirometry. A shortened LCI1/20thstarting concentration correlates highly with a 1/40th washout, which may encourage clinical use.
Transcriptome analysis of Cinnamomum migao seed germination in medicinal plants of Southwest China
Authors: Huang Xiaolong , Tian Tian , Chen Jingzhong , Wang Deng , Tong Bingli , Liu Jiming
Published: June 2021

Background

Cinnamomum migao is an endangered evergreen woody plant species endemic to China. Its fruit is used as a traditional medicine by the Miao nationality of China and has a high commercial value. However, its seed germination rate is extremely low under natural and artificial conditions. As the foundation of plant propagation, seed germination involves a series of physiological, cellular, and molecular changes; however, the molecular events and systematic changes occurring during C. migao seed germination remain unclear.

Results

In this study, combined with the changes in physiological indexes and transcription levels, we revealed the regulation characteristics of cell structures, storage substances, and antioxidant capacity during seed germination. Electron microscopy analysis revealed that abundant smooth and full oil bodies were present in the cotyledons of the seeds. With seed germination, oil bodies and other substances gradually degraded to supply energy; this was consistent with the content of storage substances. In parallel to electron microscopy and physiological analyses, transcriptome analysis showed that 80–90 % of differentially expressed genes (DEGs) appeared after seed imbibition, reflecting important development and physiological changes. The unigenes involved in material metabolism (glycerolipid metabolism, fatty acid degradation, and starch and sucrose metabolism) and energy supply pathways (pentose phosphate pathway, glycolysis pathway, pyruvate metabolism, tricarboxylic acid cycle, and oxidative phosphorylation) were differentially expressed in the four germination stages. Among these DEGs, a small number of genes in the energy supply pathway at the initial stage of germination maintained high level of expression to maintain seed vigor and germination ability. Genes involved in lipid metabolism were firstly activated at a large scale in the LK (seed coat fissure) stage, and then genes involved in carbohydrates (CHO) metabolism were activated, which had their own species specificity.

Conclusions

Our study revealed the transcriptional levels of genes and the sequence of their corresponding metabolic pathways during seed germination. The changes in cell structure and physiological indexes also confirmed these events. Our findings provide a foundation for determining the molecular mechanisms underlying seed germination.
Comparison of bioelectrical body and visceral fat indices with anthropometric measures and optimal cutoffs in relation to hypertension by age and gender among Chinese adults
Authors: Zhang Binbin , Fan Yaqi , Wang Yuxue , Zhang Li , Li Chunjun , He Jiangshan , Guo Pei , Zhang Mianzhi , Zhang Minying
Published: June 2021

Background

Few studies have compared bioelectrical body and visceral fat indices with anthropometric measures, or evaluated their optimal cutoffs in relation to hypertension among Asians. We compared the efficiencies of bioelectrical indices (percentage of body fat, PBF; visceral fat area, VFA) with anthropometric measures (body mass index, BMI; waist-hip ratio, WHR) for hypertension and re-evaluated the optimal cutoffs of each index by age and gender.

Methods

We conducted a cross-sectional survey among 8234 adults for health examination. PBF, VFA, BMI, WHR, and data on hypertension and behaviors were collected. Receiver operating characteristic (ROC) curve and areas under curves (AUCs) were used to analyze the efficiencies of the indices for hypertension, optimal cutoffs were estimated using the Youden index.

Results

A total of 8234 individuals aged 21–91 with median age 44 (interquartile range [IQR] 33–56) years were included and 40.56% were men. The overall prevalence of hypertension was 27.47%. The studied indices were all associated with hypertension in all age-specific groups both among men and women except for WHR in 21–29 years old men and PBF in in 21–29 years old women. Among males, there were no statistical differences in powers of four indices for hypertension in all age-specific groups, except for 40–49 years, in which WHR was better than VFA. Among females, no differences were found among the indices in 30–39 and 70–79 years groups, while WHR was the best in 21–29 years group, VFA was better than PBF in 30–39 and 50–59 years groups, BMI was better than PBF and WHR in 60–69 years group. The optimal cutoffs of PBF, VFA, BMI and WHR ranged from 23.9 to 28.7%, 86.4 to 106.9cm2, 23.5 to 27.1 kg/m2, 0.92 to 0.96 across the age categories in males, and 32.8 to 36.3%, 75.9 to 130.9cm2, 21.9 to 26.4 kg/m2, 0.84 to 0.95 across the age categories in females, respectively.

Conclusions

The obesity indices’ efficiencies for hypertension varied by age and gender, and their cutoff values varied across the age categories and gender. Specific indices and cutoffs based on person’s age and gender should be used to identify individuals with hypertension.
Initial in-hospital heart rate is associated with three-month functional outcomes after acute ischemic stroke
Authors: Kuo Ya-Wen , Lee Meng , Huang Yen-Chu , Lee Jiann-Der
Published: June 2021

Background

Increased heart rate (HR) has been associated with stroke risk and outcomes.

Material and methods

We analyzed 1,420 patients from a hospital-based stroke registry with acute ischemic stroke (AIS). Mean initial in-hospital HR and the coefficient of variation of HR (HR-CV) were derived from the values recorded during the first 3 days of hospitalization. The study outcome was the 3-month functional outcome. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using multivariable logistic regression analysis.

Results

A higher mean HR level was significantly and continuously associated with a higher probability of unfavorable functional outcomes. Compared with the reference group (mean HR < 70 beats per minute), the multivariate-adjusted OR for an unfavorable outcome was 1.81 (95% CI, 1.25–2.61) for a mean HR ≥ 70 and < 80 beats per minute, 2.52 (95% CI, 1.66 − 3.52) for a mean HR ≥ 80 and < 90 beats per minute, and 3.88 (95% CI, 2.20–6.85) for mean HR ≥ 90 beats per minute. For stroke patients with a history of hypertension, the multivariate-adjusted OR for patients with a HR-CV ≥ 0.12 (versus patients with a HR-CV < 0.08 as a reference) was 1.73 (95% CI, 1.11–2.70) for an unfavorable outcome.

Conclusions

Our results indicated that a high initial in-hospital HR was significantly associated with unfavorable 3-month functional outcomes in patients with AIS. In addition, stroke patients with a HR-CV ≥ 0.12 also had unfavorable outcomes compared with those with a HR-CV < 0.08 if they had a history of hypertension.
Ensemble machine learning approach for screening of coronary heart disease based on echocardiography and risk factors
Authors: Zhang Jingyi , Zhu Huolan , Chen Yongkai , Yang Chenguang , Cheng Huimin , Li Yi , Zhong Wenxuan , Wang Fang
Published: June 2021

Background

Extensive clinical evidence suggests that a preventive screening of coronary heart disease (CHD) at an earlier stage can greatly reduce the mortality rate. We use 64 two-dimensional speckle tracking echocardiography (2D-STE) features and seven clinical features to predict whether one has CHD.

Methods

We develop a machine learning approach that integrates a number of popular classification methods together by model stacking, and generalize the traditional stacking method to a two-step stacking method to improve the diagnostic performance.

Results

By borrowing strengths from multiple classification models through the proposed method, we improve the CHD classification accuracy from around 70–87.7% on the testing set. The sensitivity of the proposed method is 0.903 and the specificity is 0.843, with an AUC of 0.904, which is significantly higher than those of the individual classification models.

Conclusion

Our work lays a foundation for the deployment of speckle tracking echocardiography-based screening tools for coronary heart disease.
Sovereignty in a Minor Key
Authors: Hansen Thomas Blom
Published: June 2021

Theories of sovereignty in the twentieth century are generally based on a teleological “out-of-Europe” narrative where the modern, centralized nation-state form gradually spread across the world to be the foundation of the international order. In this article, the author reflects on how the conceptualization of sovereignty may change if one begins a global account of modern sovereignty not from the heart of Western Europe but from the complex arrangements of “distributed sovereignty” that emerged in the Indian Ocean and other colonized territories from the eighteenth century onward. These arrangements were organized as multiple layers of dependency and provisional domination, captured well by Eric Beverley's term minor sovereignty. Thinking through sovereignty in a minor key allows us to see sovereignty less as a foundation of states and societies and more as a performative category, emerging in a dialectic between promises of order, prosperity, and law, and the realities of violent domination and occupation.
Colonial Diffractions in Illiberal Times: Forecasts on the Future
Authors: Stoler Ann Laura
Published: June 2021

This article identifies two radical shifts in how colonialism is politically positioned and temporally framed, shifts that alter what invocations of colonialism look like, what distinguishes the attention they garner, and thus what they are implicitly or explicitly called upon to do. For one, invocations of colonialism are now oriented less to “residual” damage than to deepening racial inequalities on which (il)liberal politics increasingly thrive. Two, they are rendered not only as violating histories of the present but as premonitions in a dark diagnostics, as foreboding forecasts—histories of the global future across broader zones of disrepair, disregard, and degraded care.
Dead Point of Translation
Authors: Kalinova Maria
Published: June 2021

This essay focuses on the problem of translation, which Galin Tihanov regards as the afterlife of literary theory in his book The Birth and Death of Literary Theory: Regimes of Relevance in Russia and Beyond (2019). According to Tihanov, it is exactly through translation and translatability that literary theory continues to exist today, but it does so only as a discreet background in the contemporary discourse of world literature, linked to the contemporary processes of signifying art only through its market and entertainment value. Using Mikhail Bakhtin’s concept of exotopy as a conceptual framework, the author raises the question of literature in its resistance to the market and takes up the problem of semi-translation in Jean Laplanche through the prism of psychoanalysis. In so doing, the article introduces the problem of the incommensurability of literature and literary theory as it relates to the discourse of the other in its specific dimensions.
Performing the Role of Playwright: Jia Zhongming's Sanqu Songs in the Supplement to The Register of Ghosts
Authors: Chang Wenbo
Published: June 2021

This article investigates how sanqu composition modifies the social contract of poetic composition in how a text is mediated between authorship and social identity, through a close analysis of Jia Zhongming's sanqu songs written in the supplement to The Register of Ghosts. It challenges the conventional reading of Jia's songs as reliable sources of biographical information on individual playwrights to whom those songs are dedicated and argues instead that, if read together as a whole, they represent a catalog of various personas Jia constructs for the social role of playwright. The authorial figure that plays a central role in more polite poetic genres is reduced to a faceless and easily replaceable mannequin with a name tag on it—be it Guan Hanqing, Wang Shifu, or any other name—in Jia's sanqu songs, only to foreground the fashioning of the playwright's social role from his particular perspective. The role Jia Zhongming constructs for the playwright displays the imprint of urban commercial theater as well as the influence of the state and elite values. Therefore, the true value of Jia's songs lies in how they help us better understand the condition of playwrights in Jia's time. Moreover, a proper interpretation of Jia's songs also helps us better understand the performativeness of sanqu as a genre.
Regular Resistance Training Enhances Fibrinolytic Potential but Does Not Affect Coagulation
Authors: NAGELKIRK PAUL R. , SOAVE KAYLA , ALTHERR CODY , DEL POZZI ANDREW
Published: June 2021

Elevated coagulation and/or lowered fibrinolytic activity increases the risk of a thrombotic event, which affects more than 2 million people each year. Resistance training (RT) produces various adaptations that are theorized to influence hemostasis, but research in this area is limited.

Purpose

This study aimed to identify effects of an 8-wk, whole-body RT program on coagulation and fibrinolysis.

Methods

Sixteen healthy women and men (23 ± 5 yr) completed an RT program three times per week for 8 wk. Exercises included 2–3 sets of 8–12 repetitions performed at approximately 60%–80% of a one repetition maximum. Strength, body composition, and body circumferences were assessed before and after training. Plasma samples were obtained before and after training, and analyzed for active tissue plasminogen activator (tPA activity), total tissue plasminogen activator (tPA antigen), active plasminogen activator inhibitor-1 (PAI-1 activity), total plasminogen activator inhibitor-1 (PAI-1 antigen), fibrinogen, and coagulation factors VII (FVII) and VIII (FVIII).

Results

Significant increases in lean mass, arm and thigh circumferences, maximal chest press (PRE: 57.8 ± 37.5 kg, POST: 73.3 ± 43.2 kg), and leg press (PRE: 189.5 ± 96.0 kg, POST: 256.7 ± 97.9 kg) were observed (P < 0.05 for all). PAI-1 activity (PRE: 20.3 ± 32.5 IU·mL−1, POST 9.5 ± 20.9 IU·mL−1) and PAI-1 antigen decreased (PRE: 10.2 ± 9.0 ng·dL−1, POST: 7.2 ± 5.7 ng·dL−1; both, P < 0.05). No change in tPA activity or tPA antigen occurred. Fibrinogen, FVII, and FVIII did not change after training.

Conclusions

Inhibition of fibrinolysis was decreased after training, and coagulation was unaffected. These results suggest that regular RT may beneficially influence the risk of a thrombotic event. More research is warranted to understand the mechanisms through which RT affects hemostasis.
Dance Exposure, Individual Characteristics, and Injury Risk over Five Seasons in a Professional Ballet Company
Authors: SHAW JOSEPH W. , MATTIUSSI ADAM M. , BROWN DERRICK D. , WILLIAMS SEAN , KELLY SHANE , SPRINGHAM MATTHEW , PEDLAR CHARLES R. , TALLENT JAMIE
Published: June 2021

Purpose

This study aimed to describe the relationships between dance exposure, dancer characteristics, and injury risk across five seasons in a professional ballet company.

Methods

Dance exposure time and clinician-reported time-loss and medical attention injury data were prospectively collected from 118 professional dancers of The Royal Ballet between 2015/2016 and 2019/2020. Cox proportional hazards and shared frailty models were fitted to overuse and traumatic injuries; individualized robust Z-scores for 7- and 28-d accumulated exposure, and week-to-week change in exposure, age, sex, company rank, and injury history were included as time-varying covariates.

Results

Across 381,710 h of exposure, 1332 medical attention and 427 time-loss injuries were observed. Positive relationships were observed between week-to-week change in exposure and overuse time-loss (+1 Z-score hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.06–1.53) and medical attention injury risk (+1 Z-score HR, 1.17; 95% CI, 1.06–1.28). A negative relationship was observed between 7-d accumulated exposure and overuse medical attention injury risk (+1 Z-score HR, 0.74; 95% CI, 0.66–0.84). Overuse time-loss injury risk was greater in soloists compared with the corps de ballet (HR, 1.47; 95% CI, 1.01–2.15) and in dancers with a higher previous injury rate (+1 injury per 1000 h HR, 1.06; 95% CI, 1.02–1.10). Only age was associated with traumatic time-loss (+1-yr HR, 1.05; 95% CI, 1.01–1.09) or medical attention injury risk (+1-yr HR, 1.04; 95% CI, 1.01–1.07).

Conclusions

Professional ballet companies should implement training principles such as periodization and progression, particularly in the case of senior-ranking dancers, older dancers, and dancers with high rates of previous injury. These findings provide a basis for future prospective investigations into specific causal injury pathways.
US Population-referenced Percentiles for Wrist-Worn Accelerometer-derived Activity
Authors: BELCHER BRITNI R. , WOLFF-HUGHES DANA L. , Dooley ERIN E. , STAUDENMAYER JOHN , BERRIGAN DAVID , EBERHARDT MARK S. , TROIANO RICHARD P.
Published: June 2021

Purpose

This study aimed to present age- and sex-specific percentiles for daily wrist-worn movement metrics in US youth and adults. This metric represents a summary of all recorded movement, regardless of the purpose, context, or intensity.

Methods

Wrist-worn accelerometer data from the combined 2011–2014 National Health and Nutrition Examination Survey cycles and the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey were used for this analysis. Monitor-Independent Movement Summary units (MIMS-units) from raw triaxial accelerometer data were used. We removed the partial first and last assessment days and days with ≥5% nonwear time. Participants with ≥1 valid day were included. Mean MIMS-units were calculated across all valid days. Percentile tables and smoothed curves of daily MIMS-units were calculated for each age and sex using the Generalized Additive Models for Location Shape and Scale.

Results

The analytical sample included 14,705 participants age ≥3 yr. The MIMS-unit activity among youth was similar for both sexes, whereas adult females generally had higher MIMS-unit activity than did males. Median daily MIMS-units peaked at age 6 yr for both sexes (males, 20,613; females, 20,706). Lowest activity was observed for males and females 80+ yr of age: 8799 and 9503, respectively.

Conclusions

Population referenced MIMS-unit percentiles for US youth and adults are a novel means of characterizing total activity volume. By using MIMS-units, we provide a standardized reference that can be applied across various wrist-worn accelerometer devices. Further work is needed to link these metrics to activity intensity categories and health outcomes.
CT-guided preoperative localization of ground glass nodule: comparison between the application of embolization microcoil and the locating needle designed for pulmonary nodules
Authors: Li Chuan-dong , Huang Zhen-Guo , Sun Hong-liang , Wang Li-tao , Wang Yu-li
Published: June 2021

Objectives:

To compare the efficacy and safety of pre-operative localization of ground glass nodule (GGN) using embolization microcoils and the locating needles designed for pulmonary nodules.

Methods:

From June 2019 to December 2020, 429 patients who received CT-guided localization of single GGN before video-assisted thoracoscopic surgery (VATS) were enrolled. The diameter and depth of GGNs were 0.84 ± 0.39 cm and 1.66 ± 1.37 cm. Among 429 cases, the first 221 GGNs were marked with microcoils (the microcoil group), and the remaining 208 GGNs were marked with the locating needles designed for pulmonary nodules (the locating needle group). SPSS 17.0 statistical software was used to compare the marking success rate, marking time, marking-related complications between two groups. p values < 0.05 were considered statistically significant.

Results:

The marking time in the microcoil group was longer than that in the locating needle group (11.1 ± 3.9 vs 8.2 ± 2.0 min, t = −7.87, p = 0.000). The marking success rate in the microcoil group was lower than that in the locating needle group (91.4% vs 98.6%, χ2 = 11.27, p = 0.001). In the microcoil group, marking failures included 16 cases of microcoil dislocation and 3 cases of unsatisfactory microcoil position, while all 3 cases of marking failure in the locating needle group were due to unsatisfactory anchor position. No significant differences in the incidence of total complications (23.1% vs 22.1%), pneumothorax (18.1% vs 19.2%), hemorrhage (9.5% vs 9.1%), and hemoptysis (1.8% vs 1.4%) were observed between the two groups. All the complications were minor and did not need special treatment. Except for one case in the microcoil group, which was converted to thoracotomy, the remaining 428 GGNs were successfully resected by VATS.

Conclusions:

It is safe and effective to perform pre-operative localization of GGN using either embolization microcoil or the locating needle designed for pulmonary nodules. The locating needle is superior to microcoil for marking GGN in terms of procedure time and the success rate. The complication rate of both methods is similar.

Advances in knowledge:

The locating needle designed for pulmonary nodules has recently been used to mark pulmonary nodule. Its structure can effectively avoid dislocation after localization, and the marking process is simple and quick. Compared with localization using microcoil, it takes less time and has higher success rate to mark GGNs using the locating needle. The complication rate of both methods is similar.
Γενικευμένες γεωμετρικές δομές σε τροποποιημένες θεωρίες βαρύτητας
Authors: Μηνάς Γεώργιος
Published: June 2021

Στόχος της παρούσας διατριβής, είναι η μελέτη κοσμολογικών μοντέλων, τα οποία βασίζονται σε γενικευμένες γεωμετρικές δομές του χωροχρόνου, συγκεκριμένασε γεωμετρίες Finsler και τύπου Finsler. Οι θεωρίες αυτές αποτελούν μέρος των λεγόμενων ανισοτροπικών θεωριών πεδίου. Η γεωμετρία Finsler, αποτελεί μίαφυσική γενίκευση της γεωμετρίας Riemann, στην οποία όλα τα γεωμετρικά αντικείμενα εξαρτώνται, εκτός από τη θέση, και από ένα όρισμα κατεύθυνσης ή ταχύτητας.Η γεωμετρία Finsler είναι χρήσιμη στη μελέτη της βαρύτητας, καθώς ενσωματώνει την τοπική ανισοτροπία ως εγγενή ιδιότητα του χωροχρόνου, περιγράφει συστήματαμε αυθόρμητη παραβίαση της συμμετρίας Lorentz, παρέχει πληροφορία για την κίνηση της μάζας και επιτρέπει τον απευθείας υπολογισμό του μετρικού τανυστήαπό τη Λαγκρανζιανή του συστήματος. Αρχικά, αναπτύσσονται οι βασικές έννοιες της διαφορικής γεωμετρίας πολλαπλοτήτων, μελετώνται τα κύρια στοιχεία τηςγεωμετρίας Riemann και της γεωμετρίας Finsler και περιγράφονται τα σημαντικότερα σημεία της γενικής θεωρίας της σχετικότητας, της βαρύτητας και της κοσμολογίαςσε χώρο Riemann. Στη συνέχεια, τα παραπάνω εφαρμόζονται στην κοσμολογία Finsler - Randers, όπου η ύλη κινείται στο χωρόχρονο, υπό την ταυτόχρονη επίδρασηενός βαρυτικού και ενός ηλεκτρομαγνητικού πεδίου. Τέλος, ερευνάται το φαινόμενο της Κοσμολογικής Αναπήδησης, δηλαδή της μετάβασης του σύμπαντος από συστολικήσε διαστολική φάση με συνεχή τρόπο. Ειδικότερα, έπειτα από μία λεπτομερή ανάλυση της έννοιας και των συνθηκών της κοσμολογικής αναπήδησης, εξετάζεται ηδυνατότητα υλοποίησης Αναπήδησης, σε διάφορα μοντέλα τροποποιημένης βαρύτητας, τα οποία βασίζονται σε γεωμετρίες Finsler και τύπου Finsler. Συγκεκριμένα,διερευνώνται οι συνθήκες που πρέπει να ικανοποιούνται για τη δημιουργία Αναπήδησης, στην General Very Special Relativity, στο χωρόχρονο Finsler - Randers,σε γενικευμένη βαρύτητα τύπου Finsler στην εφαπτόμενη δέσμη, καθώς και σε μία θεωρία βαθμωτού - τανυστή σε νηματική δέσμη.
Doxorubicin induces delayed heart and liver mitochondrial depolarisation
Authors: Mandziuk Slawomir , Bis Lena , Bury Katarzyna , Korga Agnieszka , Burdan Franciszek , Dudka Jaroslaw
Published: June 2021

The effect of repeated administration of doxorubicin (DOX) on heart and liver morphology, mitochondrial function and redox equilibrium was investigated in rats, contributing in explanation of delayed cardiomyopathy. Male Wistar rats were weekly intraperitoneally exposed to doxorubicin (1.5 mg/kg to achieve cumulative dose of 18 mg/kg). To assess persistence changes the heart and liver were studied 3 weeks after last drug administration. Histological examination did not reveal any significant changes in heart and liver in drug-treated animals. However, mitochondrial depolarisation was observed in both organs. These changes in the liver were accompanied by significant increasing in mitochondrial oxidised glutathione and marked decrease of reduced/oxidised glutathione ratio. No changes in cardiac and hepatic NADPH and NADH levels were found. The depolarisation of mitochondria of both studied organs after three weeks since the last injection seems to be a programmed effect of the drug. It may be assumed that this is an early physiological change leading to mitochondrial insufficiency and consequently the cardiac failure.
A rare case of vernakalant-induced 1:1 atrial flutter during chemical cardioversion of atrial fibrillation requiring emergency direct current cardioversion
Authors: Stoneman Paul , Adams Joseph , Colbert Fiona , Sheahan Richard
Published: June 2021

Vernakalant is an atrial-selective, multi-channel anti-arrhythmic that offers a safe alternative to traditional approaches to chemical cardioversion of recent-onset, non-valvular atrial fibrillation. This case report describes a very rare occurrence of unstable accelerated 1:1 atrial flutter during an attempted cardioversion of non-valvular atrial fibrillation using vernakalant hydrochloride that required emergent direct current cardioversion. This case report highlights the need for clinicians to remain vigilant and be prepared to treat rare consequences of vernakalant administration.
The state of education
Authors: Duckett Robin
Published: June 2021

Do you have something to share, reflect on or provoke thinking around? Write to the editor: angelica.celinska@markallengroup.com
Career pathways: Q&A
Authors: Hart Karen
Published: June 2021

A career in the early years is not just one of huge responsibility but also hugely rewarding. It is now a popular career choice for school leavers and those looking for a career change - with a recent increase in male practitioners joining the sector.
Working closely with parents and carers
Authors: Hewson Claire
Published: June 2021

Parent partnerships are integral to an educator's role, even more so when working with children with SEND. But what does this actually mean? Claire Hewson touches on explaining your inclusive practice to parents and identifying and overcoming barriers to communication.
REVIEWS
Authors: Bradbury Aaron , Hewson Claire
Published: June 2021

This month EYE editor invites Aaron Bradbury, early childhood academic, to review the latest book centred around a loving pedagogy in the early years, exploring ‘professional love’, self-reflection and the tactile nature of working with children.
Reinventing the play centre
Authors: Celinska Angelica
Published: June 2021

EYE'S editor, Angelica Celinska, interviews the owner of Pure Imaginations with Gemma – featured throughout this issue and the setting of our front cover this month. Gemma Bohr shares her journey with us.
Tips on teething
Authors: Rawstrone Annette
Published: June 2021

Uh-oh, teething! Your once placid baby is unsettled and their sleep pattern is disrupted. It's highly likely that your child's first teeth are starting to emerge.
Accuracy of pediatric advanced life support method for predicting the depth of endotracheal tube in Indonesian children
Authors: Ramlan Andi Ade Wijaya , Sugiharto Adhrie , Mutakim Agus
Published: June 2021

BACKGROUND The pediatric advanced life support (PALS) method can predict the depth of endotracheal tube (ETT) in pediatric patients easily, but it has limitations due to variations in the children’s characteristics, especially the racial consideration. This study compared the accuracy of ETT depth prediction based on the PALS methods in Indonesian children. METHODS Patients aged 0–12 years, who underwent elective surgery with oral intubation, were recruited consecutively based on their ages: 0–24 months and 25 months–12 years for this cross-sectional study in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to August 2014. Bland–Altman analysis was used to compare the two measurement methods: PALS method to predict the ETT depth accuracy and auscultation method to confirm the position of the ETT. Furthermore, correlation analysis was done to examine the relationship of age, weight, height, and ETT internal diameter with ETT depth. RESULTS 50 patients were recruited in each group. Bland–Altman test of ETT depth in the 0–24 months age group showed a 1.18 cm mean difference from confirmation using the auscultation method (limits of agreement −0.71 to 3.08). The 25 months–12 years age group showed a 1.11 cm mean difference with limits of agreement were −0.95 to 3.17 from confirmation using the auscultation method. Age and weight had the strongest correlation value to ETT depth in the 25 months–12 years age group (R2 = 62.3%). CONCLUSIONS The PALS method is inaccurate for predicting ETT depth in Indonesian children aged 0–12 years old compared with the auscultation method.
A qualitative assessment of the context and enabling environment for the control of Taenia solium infections in endemic settings
Authors: Ngwili Nicholas , Johnson Nancy , Wahome Raphael , Githigia Samuel , Roesel Kristina , Thomas Lian
Published: June 2021

Background

Taenia solium (T. solium), is a zoonotic helminth causing three diseases namely; taeniasis (in humans), neurocysticercosis (NCC, in humans) and porcine cysticercosis (PCC, in pigs) and is one of the major foodborne diseases by burden. The success or failure of control options against this parasite in terms of reduced prevalence or incidence of the diseases may be attributed to the contextual factors which underpin the design, implementation, and evaluation of control programmes.

Methodology/Principal findings

The study used a mixed method approach combining systematic literature review (SLR) and key informant interviews (KII). The SLR focused on studies which implemented T. solium control programmes and was used to identify the contextual factors and enabling environment relevant to successful inception, planning and implementation of the interventions. The SLR used a protocol pre-registered at the International prospective register of systematic reviews (PROSPERO) number CRD42019138107 and followed PRISMA guidelines on reporting of SLR. To further highlight the importance and interlinkage of these contextual factors, KII were conducted with researchers/implementers of the studies included in the SLR. The SLR identified 41 publications that had considerations of the contextual factors. They were grouped into efficacy (10), effectiveness (28) and scale up or implementation (3) research studies. The identified contextual factors included epidemiological, socioeconomic, cultural, geographical and environmental, service and organizational, historical and financial factors. The enabling environment was mainly defined by policy and strategies supporting T. solium control.

Conclusion/Significance

Failure to consider the contextual factors operating in target study sites was shown to later present challenges in project implementation and evaluation that negatively affected expected outcomes. This study highlights the importance of fully considering the various domains of the context and integrating these explicitly into the plan for implementation and evaluation of control programmes. Explicit reporting of these aspects in the resultant publication is also important to guide future work. The contextual factors highlighted in this study may be useful to guide future research and scale up of disease control programmes and demonstrates the importance of close multi-sectoral collaboration in a One Health approach.
REM-related obstructive sleep apnea and vertigo: A retrospective case-control study
Authors: Chen Po-Yueh , Chen Tzu-Ying , Chao Pin-Zhir , Liu Wen-Te , Bai Chyi-Huey , Tsao Sheng-Teng , Lin Yi-Chih
Published: June 2021

Background

In recent population-based case-control studies, sleep apnea was significantly associated with a higher incidence (hazard ratio, 1.71) of vertigo and the risk of tinnitus was found to increase 1.36 times in patients with sleep apnea. The possibility that obstructive sleep apnea (OSA) might affect neurotological consequences was not noticed, until studies using polysomnography (PSG) for these patients.

Objectives

The purpose of this study was to investigate the relationship between vertigo and OSA.

Methods

The collected data among patients from May 1st, 2018 to October 31th, 2018 at Shuang Ho Hospital. Eligibility criteria included an age older than 20 years, a diagnosis of obstructive sleep apnea. The diagnosis of OSA was defined as an oxygen desaturation index of at least 5, was established with the use of polysomnographic examination at hospital. Patients were excluded from the study if they had head injury, brain tumour, headache history and hearing loss. Patients who had vertigo were labeled as Vertigo group. In the other hand, patients who had no dizziness were labeled as control group. 58 patients were in the Vertigo group, and 113 were in the control group.

Results

After PSG examination, 58 patients who had vertigo, were diagnosed OSA (29 males, average age = 57.07 years old, BMI = 26.64, RDI = 24.69, ESS = 8.65), and 24 patients of them (41.3%) were REM-related OSA. Meanwhile, in the control group, 113 patients had OSA (92male, average age = 49.66 years old, BMI = 26.06, RDI = 35.19, ESS = 11.43), and 18 patients of them (15.9%) were REM-related OSA (Table 1). Therefore, patient who had vertigo, would have higher proportion of REM OSA (P<0.001).

Conclusions

The vertigo patients have a higher rate of REM-related OSA, and the acceptance rate to CPAP use is low. Further research is needed to explore novel therapeutic approaches, or combination of currently available non-CPAP therapies, in patients with REM OSA.
Pulmonary function with expiratory resistive loading in healthy volunteers
Authors: Erram Jyotika , Bari Monica , Domingo Antoinette , Cannon Daniel T.
Published: June 2021

Expiratory flow limitation is a key characteristic in obstructive pulmonary diseases. To study abnormal lung mechanics isolated from heterogeneities of obstructive disease, we measured pulmonary function in healthy adults with expiratory loading. Thirty-seven volunteers (25±5 yr) completed spirometry and body plethysmography under control and threshold expiratory loading of 7, 11 cmH2O, and a subset at 20 cmH2O (n = 11). We analyzed the shape of the flow-volume relationship with rectangular area ratio (RAR; Ma et al., Respir Med 2010). Airway resistance was increased (p<0.0001) with 7 and 11 cmH2O loading vs control (9.20±1.02 and 11.76±1.68 vs. 2.53± 0.80 cmH2O/L/s). RAR was reduced (p = 0.0319) in loading vs control (0.45±0.07 and 0.47±0.09L vs. 0.48±0.08). FEV1 was reduced (p<0.0001) in loading vs control (3.24±0.81 and 3.23±0.80 vs. 4.04±1.05 L). FVC was reduced (p<0.0001) in loading vs control (4.11±1.01 and 4.14±1.03 vs. 5.03±1.34 L). Peak expiratory flow (PEF) was reduced (p<0.0001) in loading vs control (6.03±1.67 and 6.02±1.84 vs. 8.50±2.81 L/s). FEV1/FVC (p<0.0068) was not clinically significant and FRC (p = 0.4) was not different in loading vs control. Supra-physiologic loading at 20 cmH2O did not result in further limitation. Expiratory loading reduced FEV1, FVC, PEF, but there were no clinically meaningful differences in FEV1/FVC, FRC, or RAR. Imposed expiratory loading likely leads to high airway pressures that resist dynamic airway compression. Thus, a concave expiratory flow-volume relationship was consistently absent–a key limitation for model comparison with pulmonary function in COPD. Threshold loading may be a useful strategy to increase work of breathing or induce dynamic hyperinflation.