bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancement of a dynamic vibration absorber by means of an electromagnetic shunt
Authors: Auleley Michel , Thomas Olivier , Giraud-Audine Christophe , Mahé Hervé
Published: September 2020

In this study, we address the reduction of structural vibrations by means of an electromagnetic shunt damper (EMSD) combined with a mechanical dynamic vibration absorber (DVA). Two architectures, that differs in the placement of the EMSD with respect to the DVA, are tested, showing that one of them enhances the vibration control. In parallel, three shunt architecture are tested: a resistive shunt, a resonant conservative shunt and a resonant dissipative shunt. Optimal values of the EMSD and DVA parameters are obtained; then, the performances of all architecture, according to relevant criteria, are estimated and compared to a single DVA or a single EMSD. The case of a conservative DVA, that creates an anti-resonance, is particularly targeted. It is shown that the performances rely on two free parameters only: the mass ratio for the DVA and the electromagnetic coupling factor for the EMSD, thus giving generic abacuses that can be applied to any practical cases. Finally, experiments are proposed and a good agreement with the theoretical results is obtained, thus validating them.
Study of an electromechanical nonlinear vibration absorber: Design via analytical approach
Authors: Guillot Vinciane , Savadkoohi Alireza Ture , Lamarque Claude-Henri
Published: September 2020

This article deals with the behavior and design of a homogeneous beam linked to an electrical absorber, via a piezoelectric material patched on the beam. The beam presents a cubic nonlinearity, which is consistent with geometrical nonlinearities for clamped-free beams. A cubic nonlinearity is added to the electrical circuit for similarity purposes. The coupled electromechanical equations are reduced to a two degrees of freedom system. The equation representing the mechanical response of the system is seen as the main system, whereas the equation coming from the electrical circuit would represent a nonlinear absorber. An analytical treatment at different time scales is endowed to identify electrical coefficients allowing the design of the electromechanical vibration absorber behavior. The equilibrium and singular points are identified, allowing the definition of ranges of forcing amplitudes leading to periodic and modulated regimes. The analytical results are compared with those obtained from direct numerical integration of the two degree of freedom system.
Bifactor Model Is Not the Best-Fitting Model for Self-Esteem: Investigation With a Novel Technique
Authors: Kam Chester Chun Seng
Published: September 2020

In the measurement of self-esteem, previous research assumes that all respondents are qualitatively similar. The assumption has not been adequately tested. The current study examines its validity using factor mixture modeling. Results reveal two qualitatively distinct classes: the first provides more consistent responses to positive self-esteem items than the second. The correlations between positive and negative self-esteem suggest that self-esteem is essentially unidimensional in the first class but bidimensional in the second. Furthermore, those with high self-esteem are more likely to belong to the first class; those with low self-esteem are more likely to belong to the second class. The observed dimensionality of self-esteem depends on a person’s level on the trait. Finally, we found that the two-class solution fits the data much better than a simple one-class, two-factor solution or a bifactor solution. Psychometric researchers should no longer ignore the possible existence of qualitatively distinct groups in an underlying population. We include M plus syntax together with a detailed explanation for researchers to conduct similar investigations on constructs of interest.
Lead Health Fairs: A Community-Based Approach to Addressing Lead Exposure in Chicago
Authors: Lippert Julia , Montgomery James , DeMarco Camille
Published: September 2020

Lead exposure has been linked to neurological, reproductive, and developmental effects, and approximately 3.5% of Chicago children under the age of 3 years have elevated blood lead levels. The aim of this research was to provide outreach opportunities to address the issue of lead exposure in water and soil. A series of seven community-based health fairs were held with a combined approach of screening and education accomplished through partnerships with organizations established within underserved communities that leveraged resources. Community members attending the fairs brought in samples of soil from their yards and tap water for lead testing. Lead concentrations in the soil samples had a mean value of 305.7 parts per million, and 30% of the samples were above the Environmental Protection Agency’s action level for children’s play lots. The mean lead concentration in tap water was 8.3 parts per billion, with 6% of sample testing above the Environmental Protection Agency’s action level. There was no significant correlation between the lead levels in water and soil ( p = .21), and there was no significant difference between the average lead concentrations in different areas of the city. A multifaceted approach was utilized to educate and engage and ultimately empower the communities affected by exposure to lead in urban settings.
Clickbait orientalism and vintage Iranian snapshots
Authors: Malek Amy
Published: September 2020

What happens when vintage family photos are digitized and enter the global visual economy as representations of a people, politics, time, and place? In this article, I examine the social life of an exemplary viral snapshot from pre-revolutionary Iran to demonstrate three of the many shifting uses and social meanings of these snapshots in online global circulations: as representations for diasporic nostalgizing, as tools of soft power in public diplomacy, and as sources for viral journalism that contribute to what I call clickbait orientalism. A 21st-century form of digital soft weaponry, this latter use of Iranian vintage photos trades on gendered orientalist tropes, the indexical power of family photographs, and the context of four decades of geopolitical tension to attract attention and thus revenue. Ultimately, these further remediations render such family snapshots as anonymous, symbolic, weaponized, and monetized, confirming that latent orientalist ideologies continue to circulate even as their manifest forms change over time.
Improved time-dependent seismic fragility estimates for deteriorating RC bridge substructures exposed to chloride attack
Authors: Cui Fengkun , Li Huihui , Dong Xu , Wang Baoqun , Li Jin , Xue Hongyun , Qi Meili
Published: September 2020

RC bridge substructures exposed to chloride environments inevitably suffer from corrosion of reinforcement embodied in concrete. This deterioration issue leads to the loss of reinforcement areas and a reduction in seismic capacity of reinforced concrete (RC) bridge substructures. To quantify the effect of steel corrosion on seismic fragility estimates, this paper proposes an improved time-dependent seismic fragility framework by taking into account the increase in the corrosion rate after concrete cracking and the reduction in seismic capacity of RC bridge substructures during the service life. Additionally, an analytical method based on a back propagation artificial neural network (BP-ANN) is proposed to provide probabilistic capacity estimates of deteriorating RC substructures. A three-span T-shaped girder bridge is selected as a case study bridge to provide improved time-dependent seismic fragility estimates that consider uncertainties in the material properties, geometric parameters, deterioration process and ground motions. The obtained fragility curves show that there is a nonlinear increase in the exceedance probability of deteriorating RC bridge substructures for different damage states during the service life. In addition, time-dependent seismic fragility analysis shows that the cases of considering only the effect of an increase in seismic demand or the reduction in seismic capacity as well as neither of them may lead to a significant underestimation of the seismic vulnerability of deteriorating RC bridge substructures.
Upvoting extremism: Collective identity formation and the extreme right on Reddit
Authors: Gaudette Tiana , Scrivens Ryan , Davies Garth , Frank Richard
Published: September 2020

Since the advent of the Internet, right-wing extremists and those who subscribe to extreme right views have exploited online platforms to build a collective identity among the like-minded. Research in this area has largely focused on extremists’ use of websites, forums, and mainstream social media sites, but overlooked in this research has been an exploration of the popular social news aggregation site Reddit. The current study explores the role of Reddit’s unique voting algorithm in facilitating “othering” discourse and, by extension, collective identity formation among members of a notoriously hateful subreddit community, r/The_Donald. The results of the thematic analysis indicate that those who post extreme-right content on r/The_Donald use Reddit’s voting algorithm as a tool to mobilize like-minded members by promoting extreme discourses against two prominent out-groups: Muslims and the Left. Overall, r/The_Donald’s “sense of community” facilitates identity work among its members by creating an environment wherein extreme right views are continuously validated.
Aspirational lifestyle journalism: The impact of social class on producers’ and audiences’ views in the context of socio-economic inequality
Authors: Banjac Sandra , Hanusch Folker
Published: September 2020

A growing amount of scholarship on lifestyle journalism and role conceptions has shown its relevance in the context of consumption cultures and societal changes. However, the existing literature has tended to focus on countries with relatively prosperous economies, neglecting to explore those with greater socio-economic inequality. Likewise, scholarship has offered some insight into what audiences expect of political journalists, but we know little about expectations of lifestyle journalism. Exploring role conceptions and expectations in socio-economically unequal societies gives rise to the question: How may social class shape these? To examine this, our study draws on 22 in-depth interviews with lifestyle journalists and three focus groups with audiences from different class backgrounds in South Africa. Findings suggest that lifestyle journalists’ awareness of class disparity and the country’s history of racial segregation and oppression shapes their roles in three ways. First, journalists expressed strong support for roles typically associated with political journalism, albeit interconnected with lifestyle roles. Second, journalists acted as ‘ responsible’ cultural intermediaries, mediating the worlds of luxury and inequality. Third, journalists expressed a strong role orientation toward providing aspiration, as did audience expectations, indicating a level of congruence. Applying a Bourdieusian framework, we argue that lifestyle journalism allows audiences who live under ‘conditions of scarcity’ and who have been conceptualized as having a ‘taste of necessity’, to perform a ‘ taste of aspiration’. We suggest a need to reconceptualize scholarship’s approach to studying journalistic roles by moving beyond a politics-lifestyle binary, and to more closely examine the role of aspiration in lifestyle journalism.
People living with dementia and their family carers’ adherence to home-based Tai Chi practice
Authors: Barrado-Martín Yolanda , Heward Michelle , Polman Remco , Nyman Samuel R
Published: September 2020

Objectives

The aim of this study was to understand what influenced people living with dementia and their family carers’ adherence to the home-based component of a Tai Chi exercise intervention.

Method

Dyads, of people living with dementia and their family carers, who participated in the intervention arm of the Tai Chi for people living with dementia trial, were invited to join weekly Tai Chi classes for 20 weeks and practice at home. Semi-structured dyadic home interviews were conducted on average after 16 weeks of classes. The views of 15 dyads with a range of home practice adherence were sought in semi-structured interviews. The interviews were analysed using an inductive thematic approach.

Results

Most participants found time to practise Tai Chi at home and practised for 18 hours on average. Amongst the barriers to adherence were participants’ competing commitments and a booklet not sufficiently conveying the Tai Chi movements. Hence, a video or DVD was requested by participants. Facilitators of their adherence to the home-based component of the intervention were their enjoyment of the practice and the development of a habit, which was supported by their commitment to the study and their willingness to benefit from Tai Chi.

Conclusion

Enjoyment and perceived benefits had a great impact on participants living with dementia and their carers’ adherence to home-based Tai Chi practice. However, difficulties to perceive the Tai Chi movements through images might be hindering sustained participation. Hence, alternative aids such as videos and DVDs should be explored to facilitate adherence.
Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities
Authors: Radder Danique L. M. , Lígia Silva de Lima Ana , Domingos Josefa , Keus Samyra H. J. , van Nimwegen Marlies , Bloem Bastiaan R. , de Vries Nienke M.
Published: September 2020

Background

Physiotherapy is a commonly prescribed intervention for people with Parkinson’s disease (PD). Conventional types of physiotherapy have been studied extensively, while novel modalities are being developed and evaluated.

Objective

To evaluate the effectiveness of conventional and more recent physiotherapy interventions for people with PD. The meta-analysis performed as part of the 2014 European Physiotherapy Guideline for PD was used as the starting point and updated with the latest evidence.

Methods

We performed a systematic search in PubMed, CINAHL, Embase, and Web of Science. Randomized controlled trials comparing any physiotherapy intervention with no intervention or sham treatment were included. Trials were classified into 12 categories: conventional physiotherapy, resistance training, treadmill training, strategy training, dance, martial arts, aerobic exercises, hydrotherapy, balance and gait training, dual tasking, exergaming, and Nordic walking. Outcomes included motor symptoms, balance, gait, and quality of life, and are presented as standardized mean differences. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to systematically appraise methodological quality.

Results

A total of 191 trials with 7998 participants were included. Conventional physiotherapy significantly improved motor symptoms, gait, and quality of life. Resistance training improved gait. Treadmill training improved gait. Strategy training improved balance and gait. Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait. Exergaming improved balance and quality of life. Hydrotherapy improved balance. Finally, dual task training did not significantly improve any of the outcomes studied.

Conclusions

This meta-analysis provides a comprehensive overview of the evidence for the effectiveness of different physiotherapy interventions in the management of PD, allowing clinicians and patients to make an evidence-based decision for specific treatment modalities. Further work is needed to directly compare the relative efficacy of the various treatments.
Design, Fabrication, and Testing of a Novel Surgical Handwashing Machine
Authors: Amiraslani Shahryar , Darbemamieh Goldis , Karimian Faramarz , Tabatabai Ghomsheh Farhad
Published: September 2020

Background. Surgical hand scrub is strongly recommended as an essential measure to reduce surgical site infections (SSIs). SSI results in morbidity and additional cost. Micropunctures may occur on surgical gloves during operation, thus hand scrub cannot be omitted in any condition. Generally speaking, the adequacy of hand scrub is decided by the surgeon. Only occasionally, surveillance of hygienic status of hands is performed after scrub. Therefore, the potential exists that suboptimal handwash leads to SSIs. There are standards for preoperative handwash, but all of them are operator dependent, and continuous surveillance is actually impossible. One solution is to omit the role of surgeon in handwashing. This can be achieved by designing a standard procedure, performed mechanically by a machine, considering the detailed requirements of hygienic surgical hand scrub. The goal of this study was to develop a procedure that works on the design, fabrication, and trial of a new handwashing machine, for surgical hand scrub. Methods. A machine with a reciprocal spraying mechanism was designed that covers from the fingertips up to the elbow. Various combinations of staged irrigations with antiseptic solutions and water were to be programmed and implemented. Clinical experiments were performed several times with different handwashing programs, and swabs were taken from the skin surface and creases. Results. There was no microbial growth after 72 hours with any handwashing program. Conclusion. The preliminary experiments with this new handwashing machine show promising results for its application in surgical hand scrub.
An Analysis of Retracted Articles with Authors or Co-authors from the African Region: Possible Implications for Training and Awareness Raising
Authors: Rossouw Theresa M. , Matsau Liapeng , van Zyl Christa
Published: September 2020

Retraction of research articles is increasing but the reasons and characteristics of retractions involving authors from Africa have not been studied. Using records from the Retraction Watch database, we analyzed information on articles retracted between 2014 and 2018 with at least one author or co-author affiliated with an institution in the African region to determine the most prevalent types of misconduct, subject fields, and the characteristics of researchers or research teams associated with retraction. Plagiarism was the most frequent form of misconduct, followed by duplication. International collaboration was associated with fewer retractions for plagiarism and errors in data, but increased retractions due to authorship issues. Teams with at least one senior member were associated with fewer retractions due to plagiarism but more due to duplication of articles. We conclude by making recommendations for best practice, further research, and highlighting implications for education.
Posture control for humanoid robot on uneven ground and slopes using inertial sensors
Authors: Chiang Shu-Yin , Wang Jin-Long
Published: September 2020

We designed a stable gait pattern and posture-control balance system to enable a biped humanoid robot to maintain balance and avoid falling when walking on uneven ground or slopes. In this study, we first examined the problem of gait generation and the balance of a humanoid robot and then proposed a posture-control balance system using the inertial sensors of a gyroscope and accelerometer to sense the tilt angle of the robot according to the environment. To process the data obtained by the sensors, the mean filter was applied to eliminate the noise in the data, and the complementary filter was used to properly combine the data from both the gyroscope and accelerometer. The system further modifies the gait and posture of the robot based on the results obtained through a fuzzy system to attain the angle of balance and stabilization. A robot with an open platform was used to test the implementation of the proposed algorithm, and the experimental results demonstrated that the robot could successfully maintain balance when walking uphill and downhill on uneven surfaces. Moreover, because only one parameter needs to be adjusted when applying the balance-control system, the system can be easily extended to any related humanoid robot.
Juror and community views of the guilty plea sentencing discount: Findings from a national Australian study
Authors: Warner Kate , Spiranovic Caroline , Bartels Lorana , Roberts Lynne , Gelb Karen
Published: September 2020

A plea of guilty is a long-accepted factor mitigating sentence in many countries, including Australia, although academic debate over the merits and application of the discount is ongoing. This paper presents findings from a national Australian study on public opinion on the guilty plea sentencing discount, with a particular focus on sexual offences. Survey data were drawn from 989 jurors in cases that resulted in a guilty verdict and 450 unempanelled jurors and 306 online respondents who were provided with vignettes based on real cases. A third of the respondents would have supported a discount in their case if the offender had pleaded guilty. In contrast, more than one half of the respondents surveyed, who had received a vignette with a guilty plea scenario, supported an increment in sentence if the offender had gone to trial. There was more support for a discount in cases involving non-sexual violent offences versus sexual offences and adult versus child victims. Where a discount was supported, this most commonly was a reduction in the length of custodial sentence, with online respondents allocating the least generous discounts. Willingness to accept a sentencing discount was predicted by a range of variables including gender, education, punitive attitudes, offence type and offence seriousness. We conclude by considering the implications of our findings for sentencing law and practice.
Uveitis in spondyloarthritis
Authors: Rademacher Judith , Poddubnyy Denis , Pleyer Uwe
Published: September 2020

Uveitis is the most frequent extra-articular manifestation of axial spondyloarthritis (SpA), occurring in up to one-third of the patients. In the majority of patients, uveitis is acute, anterior and unilateral and presents with photosensitivity, sudden onset of pain and blurred vision. Topical steroids are an effective treatment; however, recurrent or refractory cases may need conventional disease-modifying antirheumatic drugs or biological treatment with monoclonal tumor necrosis factor (TNF) inhibitors, thus also influencing treatment strategy of the underlying SpA.

Though the exact pathogenesis of SpA and uveitis remains unknown, both seem to result from the interaction of a specific, mostly shared genetical background (among other HLA-B27 positivity), external influences such as microbiome, bacterial infection or mechanical stress and activation of the immune system resulting in inflammation. Up to 40% of patients presenting with acute anterior uveitis (AAU) have an undiagnosed SpA. Therefore, an effective referral strategy for AAU patients is needed to shorten the diagnostic delay of SpA and enable an early effective treatment. Further, the risk for ophthalmological manifestations increases with the disease duration in SpA; and patients presenting with ocular symptoms should be referred to an ophthalmologist. Thus, a close collaboration between patient, rheumatologist and ophthalmologist is needed to optimally manage ocular inflammation in SpA.
Increased levels of HE4 (WFDC2) in systemic sclerosis: a novel biomarker reflecting interstitial lung disease severity?
Authors: Zhang Mingxia , Zhang Liyun , E Linning , Xu Ke , Wang Xu Fei , Zhang Bin , Su Jie , Meng Zemin
Published: September 2020

Background:

Human epididymis protein 4 (HE4, also known as WFDC-2) has been implicated in fibrotic disorders pathobiology. We tested the hypothesis that HE4 may be used as a candidate biomarker for systemic sclerosis (SSc)-related interstitial lung disease (SSc-ILD).

Methods:

A total of 169 consecutive SSc patients and 169 age-and sex-matched healthy controls were enrolled and blood samples were collected. Pulmonary function tests (PFTs) and paired lavage was performed on 169 patients and 37 healthy controls. All patients were classified as having SSc-no ILD or SSc-ILD, based on high-resolution computed tomography (CT) scans of the chest, and a semiquantitative grade of ILD extent was evaluated through CT scans (grade 1, 0–25%; grade 2, 26–50%; grade 3, 51–75%; grade 4, 76–100%). Serum and bronchoalveolar lavage fluid (BALF) HE4 levels were measured by enzyme-linked immunosorbent assay.

Results:

Serum HE4 levels were higher in SSc patients [median (interquartile range), 139.4 (85.9–181.8) pmol/l] compared with healthy controls [39.5 (24.3–54.2) pmol/l, p < 0.001] and were higher in patients with SSc-ILD [172.1 (94.8–263.3) pmol/l] than in those with SSc-no ILD [97.4 (85.5–156.5) pmol/l, p < 0.001]. This observation was replicated in the BALF samples. Corresponding values were 510.8 (144.6–1013.8) pmol/l for SSc cohort, 754.4 (299–1060) pmol/l for SSc-ILD, 555.1 (203.7–776.2) pmol/l for SSc-no ILD, and 238.7 (97.7–397.6) pmol/l for controls. The semiquantitative grade of ILD on CT scan was significantly proportional to the HE4 levels and the lung function parameter (i.e., FVC) had a negative correlation with the HE4 levels.

Conclusion:

This is the first study to demonstrate the potential clinical utility of blood and BALF HE4 as a biomarker for SSc-ILD. Future prospective validation studies are warranted.
Self-reported allergies in Russia and impact on skin
Authors: Seité Sophie , Taieb Charles , Lazic Strugar Tamara , Lio Peter , Bobrova Elena E
Published: September 2020

Introduction:

The rising prevalence of allergies can substantially impact the skin, which is one of the largest targets for allergic and immunologic responses. We present the results of an online survey assessing self-reported allergy prevalence in Russians, outline the populations who report allergies and characterize the skin conditions associated with allergy.

Methods:

An online survey was conducted in Russia of 2010 adults as a representative sample of the general Russian population.

Results:

A total of 34.9% of Russian adults (mean age: 41.3 ± 14.4 years old) reported having allergies. Reported allergies included skin allergies (73.3%), food allergies (53.9%) and respiratory allergies (43.4%), and 65.9% reported their allergies had been diagnosed by a doctor. In total, 75.1% of those who reported allergies also reported experiencing associated skin reactions, they were 1.5–5.5 times more likely to report a cutaneous disease and were 1.5 times to report sensitive skin compared to those who did not report allergies. In addition, those that reported allergies were also 2 times more likely to report experiencing skin reactions when using skincare products.

Conclusion:

It is estimated that over 35 million Russian adults have allergies. These results will help raise awareness about the burden of allergies and the need to develop solutions to mitigate their impact on health.
Genetic diversity and population structure of Amorphophallus albus, a plant species with extremely small populations (PSESP) endemic to dry-hot valley of Jinsha River
Authors: Tang Rong , Liu Erxi , Zhang Yazhou , Schinnerl Johann , Sun Weibang , Chen Gao
Published: September 2020

Background

Amorphophallus albus P. Y. Liu & J. F. Chen (Araceae) is a plant species with extremely small populations (PSESP) and an important economic crop endemic to dry-hot valleys along the Jinsha River. In order to gain information for sustaining the development and conservation of A. albus, we studied the genetic diversity and population structure of this species using microsatellite markers (SSR). In this study, we analysed 364 individuals belonging to 24 populations, including four wild populations and three ex-situ cultivated populations, collected in the provinces Yunnan, Sichuan and Hubei.

Results

The population genetic analyses indicated that A. albus possesses moderate genetic diversity with the percentage of polymorphic loci (PPL) from 69.23 to 100%, an expected heterozygosity (He) of 0.504 and an average Shannon’s Information Index (I) 0.912. Analysis of molecular variance (AMOVA) indicated that most of the variance (71%) resided within populations and the estimated gene flow (Nm) was 0.61. The results of UPGMA cluster tree, STRUCTURE analyses together with the Mantel test (R2 = 0.352, P < 0.01) indicated that geographically closely located populations are clustered together with some exceptions.

Conclusions

Our results showed that A. albus still possesses moderate genetic variation in most of the studied populations, and for now, most cultivated populations were naturally distributed but still some reintroduction exists. For sustaining the present genetic variation, some protections measures are necessary for the wild populations and also for the cultivated ones with high genetic diversity.
Patient safety culture in primary and home care services
Authors: Lousada Letícia Martins , da Silva Dutra Francisco Clécio , da Silva Beatriz Viana , de Oliveira Natália Lúcia Lima , Bastos Ismael Brioso , de Vasconcelos Patrícia Freire , de Carvalho Rhanna Emanuela Fontenele Lima
Published: September 2020

Background

Safety culture is still a poorly studied subject in primary care and home care, although these settings are considered gateways to access to healthcare. This study aims to evaluate safety culture in primary and home care settings.

Methods

An observational cross-sectional study was carried out with 147 professionals from nine districts covered by one home care program and six primary healthcare centres. The Safety Attitudes Questionnaire (SAQ) was used to evaluate the safety culture, in which scores ≥75 are indicative of a positive safety culture.

Results

A total of 56 (86,1%) questionnaires returned from the home care professionals and 91 (86,6%) from the primary care professionals. The Job satisfaction domain was the best evaluated, achieving a score of 88.8 in home care and 75.1 in primary care. The achievement of high scores on Safety Climate, Job Satisfaction, Teamwork Climate, and Total SAQ was related to male gender, and time of professional experience of three to 4 years. Perception of management and Working conditions had the lowest scores, and this result was related with long time of experience.

Conclusions

It is concluded that professionals working in home care gave higher scores for safety culture in their workplace than the primary care workers.
Impacts of CR1 genetic variants on cerebrospinal fluid and neuroimaging biomarkers in alzheimer’s disease
Authors: Zhu Xi-chen , Dai Wen-zhuo , Ma Tao
Published: September 2020

Background

The complement component (3b/4b) receptor 1 gene (CR1) gene has been proved to affect the susceptibility of Alzheimer’s disease (AD) in different ethnic and districts groups. However, the effect of CR1 genetic variants on amyloid β (Aβ) metabolism of AD human is still unclear. Hence, the aim of this study was to investigate genetic influences of CR1 gene on Aβ metabolism.

Methods

All data of AD patients and normal controls (NC) were obtained from alzheimer’s disease neuroimaging initiative database (ADNI) database. In order to assess the effect of each single nucleotide polymorphism (SNP) of CR1 on Aβ metabolism, the PLINK software was used to conduct the quality control procedures to enroll appropriate SNPs. Moreover, the correlation between CR1 genotypes and Aβ metabolism in all participants were estimated with multiple linear regression models.

Results

After quality control procedures, a total of 329 samples and 83 SNPs were enrolled in our study. Moreover, our results identified five SNPs (rs10494884, rs11118322, rs1323721, rs17259045 and rs41308433), which were linked to Aβ accumulation in brain. In further analyses, rs17259045 was found to decrease Aβ accumulation among AD patients. Additionally, our study revealed the genetic variants in rs12567945 could increase CSF Aβ42 in NC population.

Conclusions

Our study had revealed several novel SNPs in CR1 genes which might be involved in the progression of AD via regulating Aβ accumulation. These findings will provide a new basis for the diagnosis and treatment AD.
Unruptured aneurysmal clipping complicated by delayed and refractory vasospasm: case report
Authors: Peterson Crina M. , Podila Sahitya S. , Girotra Tarun
Published: September 2020

Background

Delayed symptomatic vasospasm is a rare complication following clipping of an unruptured intracranial saccular aneurysm. There have been ten reported cases of delayed symptomatic vasospasm and only two of these occurred after 2 weeks from initial intervention. Our case is the first to document the refractory nature of such vasospasm despite aggressive first line therapy.

Case presentation

Here, we present a 67-year-old female who had surgical clipping of a 10x7mm right middle cerebral artery (MCA) bifurcation aneurysm. Her surgery and initial postoperative course were uncomplicated, but she presented with acute left hemiparesis, dysarthria, headache and vomiting on post-op day 29 secondary to vasospasm of M2. She was initially stabilized with intra-arterial verapamil then managed with volume expansion, permissive hypertension, and nimodipine. She developed recurrent vasospasm of M2 the following day and was again treated with intra-arterial verapamil. Magnetic resonance imaging (MRI) brain showed an infarction involving the right basal ganglia, frontal lobe, and parietal lobe and her hospital course was complicated by super-refractory status epilepticus. At her follow up appointment she displayed continued left lower extremity weakness, left visual field defect, and left-sided neglect.

Conclusions

Overall, cerebral vasospasms associated with unruptured aneurysms remain rare complications and are not often monitored for after initial recovery. Reviewing the documented cases highlights the unpredictability of when these events occur with our current knowledge. Current hypotheses for the mechanisms responsible for delayed and refractory vasospasms include: blood-derived breakdown products, mechanically induced vasospastic responses, and delayed reactions from the trigemino-cerebrovascular system (TCVS). The uncertainly of these events warrants further research and supports a strong argument for monitoring patients with initial surgical clipping up to a month out from their initial procedure.
Respiratory effects of acute milk consumption among asthmatic and non-asthmatic children: a randomized controlled study
Authors: Koren Yael , Armoni Domany Keren , Gut Guy , Hadanny Amir , Benor Shira , Tavor Oren , Sivan Yakov
Published: September 2020

Background

A commonly held public belief is that cow’s milk products increase mucus production and respiratory symptoms. Dietary milk elimination is often attempted despite lack of evidence. Our objective was to investigate whether a single exposure to cow’s milk is associated with respiratory symptoms and changes in pulmonary functions in asthmatic and non-asthmatic children.

Methods

We conducted a prospective double blind, placebo-controlled trial on non-asthmatic and asthmatic children aged 6–18 years evaluated at a pediatric pulmonology unit.

The children were randomly challenged with cow’s milk or soy milk substitute. Symptoms, spirometry, fractional-exhaled nitric-oxide (FeNO), and pulse oximetry findings were obtained at baseline and at 30, 60, 90, and 120 min following challenge.

A two-way ANCOVA (with repeated measures when required) was used to compare the performances of all groups and subgroups over time. The outcome measures of each participant were compared to his/her own variables over time and in relation to his/her baseline values. In case of missing data points, missingness analysis was performed using Little’s missing completely at random (MCAR) test.

Results

Fifty non-asthmatic children (26 assigned to the cow’s milk group and 24 to the soy substitute group), and 46 asthmatic children (22 in the cow’s milk group and 24 in the soy substitute group) were enrolled. Age, gender, and body mass index Z-score were comparable between the two groups. No changes in symptoms, spirometry, FeNO, or oxygen saturation measurements were observed following challenge in any of the participants in both groups, at any time point compared to baseline.

Conclusions

A single exposure to cow’s milk is not associated with symptoms, bronchial inflammation, or bronchial constriction in both non-asthmatic and asthmatic children. Our findings do not support the strict elimination of dairy products from a child’s diet for the prevention of respiratory symptoms.

Trial registration

This study was approved by the Tel Aviv Sourasky Medical Center Institutional Review Board and the Israeli Ministry of Health review board (Helsinki Committee, NIH #NCT02745899). Registered April 2016 https://clinicaltrials.gov/ct2/show/NCT02745899?cond=milk+asthma&rank=1.
A rare case report of laryngopharyngeal polyp formation following anterior cervical discectomy and fusion (ACDF)
Authors: Li Xiucheng , He Lei , He Wei , Lv Zuo , Chen Xuerong
Published: September 2020

Background

Anterior Cervical Discectomy and Fusion (ACDF) has been regarded as the “gold standard” treatment of cervical spondylosis. Though it has good outcomes, many complications still exist, such as loss of fixation, degeneration of adjacent segments, dysphagia and pharyngeal perforation. In view of current literature, this study is the first to report a case of laryngopharyngeal polyp following ACDF.

Case presentation

A 63 year old male patient suffered from cervical spine hyperextension after trauma accompanied by numbness of the hands and decreased muscle strength in both upper limbs. Anterior cervical fusion surgery was performed in our hospital, after which the patient’s upper limb numbness disappeared and muscle strength returned to normal. In the fifth month after surgery, the patient developed a sore throat and dysphagia. Symptoms gradually worsened, and the patient was hospitalized four times, subsequently undergoing tracheotomy, internal fixation removal, and polypectomy. The patient’s pronunciation, breathing, and swallowing functions returned to normal, and the incision healed. After a one-year follow-up, the polyp did not recur.

Conclusions

Laryngopharyngeal polyp formation following ACDF has yet to be reported in literature. By excluding esophageal fistula as soon as possible, removing internal fixation and polypectomy serves as the best treatment in relieving patient symptoms.
Use of symptom-focused oncological cancer therapies in hospices: a retrospective analysis
Authors: Kaiser Ulrich , Vehling-Kaiser Ursula , Kück Fabian , Mechie Nicolae-Catalin , Hoffmann Ana , Kaiser Florian
Published: September 2020

Background

There is controversy regarding the practical implementation of symptom-focused oncological cancer therapies to hospice residents. In this study, we aim to analyse the use and indication of supportive-oncological cancer therapies in hospices.

Methods

We conducted a retrospective survey of all residents of two hospice centres in the government district of Lower Bavaria, Germany. Hospice 1 (H1) was a member of an oncological–palliative medical network, and hospice 2 (H2) was independently organized. The evaluation period was the first 40 months after the opening of the respective hospice care centre. Demographical and epidemiological data as well as indications and type of supportive-oncological cancer therapies were recorded. A descriptive analysis and statistical tests were performed.

Results

Of the 706 residents, 645 had an underlying malignant disease. The average age was 72 years and the mean residence time was 28 days. The most frequent cancer types were gastrointestinal cancers, gynaecological cancers and bronchial carcinomas. Overall 39 residents (33 in H1 and 6 in H2, p < 0.01) received symptom-focused oncological cancer therapy. The average age of these residents was 68 years, and the mean residence time was 55 days. The most common therapeutic indications were dyspnoea and pain. The most common symptom-focused oncological cancer therapies were bisphosphonates, transfusions (erythrocyte- and platelet- concentrates), radiotherapy and anti-proliferative drugs (chemotherapy, anti-hormonal- and targeted- therapies). Patients with therapy lived significantly longer than patients without therapy (p < 0.01).

Conclusions

Symptom-focused oncological cancer therapies can be implemented in hospices; however, their implementation seems to require certain structural and organizational prerequisites as well as careful patient selection. As a palliative medical approach, the focus is to ameliorate the symptoms and not prolong life. Symptom-focused oncology treatment could be a further and important part for the therapy of hospice patients in the future.
Correction to: Blood transcriptomic discrimination of bacterial and viral infections in the emergency department: a multi-cohort observational validation study
Authors: Sampson Dayle , Yager Thomas D. , Fox Brian , Shallcross Laura , McHugh Leo , Seldon Therese , Rapisarda Antony , Hendriks Roslyn A. , Brandon Richard B. , Navalkar Krupa , Simpson Nandi , Stafford Sian , Gil Eliza , Venturini Cristina , Tsaliki Evi , Roe Jennifer , Chain Benjamin , Noursadeghi Mahdad
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
New acute respiratory management in tracheal rupture caused by chest trauma
Authors: Shen Cheng , Ma Lin
Published: September 2020

We report a case who is a 33-year-old man admitted to our Emergency room for chest trauma caused by the factory’s mechanical arm. Despite the endotracheal tube, the patient’s respiratory state was poor and the oxygen saturation did not improve and the subcutaneous emphysema progressed. To improve distressed breathing, we first proposed the concept “mechanical ventilation with dual ventilator” to maintain oxygen saturation of the patient. This is, to our knowledge, the first report of using a special mechanical ventilation method in emergency surgery.
Isolated fallopian tube torsion associated with hydrosalpinx in a 12-year-old girl: a case report
Authors: Martín-Vallejo Javier , Garrigós-Llabata Enrique E. , Molina-Bellido Patricia , Clemente-Pérez Pedro A.
Published: September 2020

Background

Isolated fallopian tube torsion associated with hydrosalpinx is a rare condition in the pediatric population. We present this unusual clinical case study in a sexually inactive girl.

Case presentation

a12-year-old Caucasian girl presented symptoms of acute abdominal pain. Pelvic ultrasound revealed a normal looking uterus and ovaries and next to left ovary a imaging compatible with hydrosalpinx. She was discharged 48 hours later after clinical monitoring with oral analgesia and normal blood workup. At 3 weeks, she was readmitted for acute abdominal pain. Leukocytosis with left shift and raised C-reactive protein were observed. Her clinical condition worsened, and complication of the preexisting hydrosalpinx was suspected. Exploratory laparoscopy confirmed torsion of the fallopian tube. Left salpingectomy was performed. Histopathologic study confirmed a fallopian tube with hemorrhagic infarct.

Conclusion

Torsion of the fallopian tube must be considered in the event of acute abdominal pain. Early diagnosis and trying conservative management with a view to preserving fertility in this group of patients are essential.
Hand hygiene compliance in Dutch general practice offices
Authors: Hilt Nataliya , Lokate Mariëtte , OldeLoohuis Alfons , Hulscher Marlies E. J. L. , Friedrich Alex W. , Voss Andreas
Published: September 2020

Background

Hand hygiene (HH) is considered one of the most important measures to prevent healthcare-associated infections (HAI). Most studies focus on HH compliance within the hospital setting, whereas little is known for the outpatient setting. The aim of this study was to evaluate compliance with HH recommendations in general practitioners (GPs) office, based on World Health Organization (WHO) guideline.

Methods

An observational study was conducted at five Dutch GPs-practices in September 2017. We measured HH compliance through direct observation using WHO’s ‘five moments of hand hygiene’ observation tool. All observations were done by one trained professional.

Results

We monitored a total of 285 HH opportunities for 30 health care workers (HCWs). The overall compliance was 37%. Hand hygiene compliance was 34, 51 and 16% for general practitioners, practice assistants, and nurses, respectively. It varies between 63% after body fluid exposure and no HH performance before-, during and after home visit of a patient (defined as moment 5). The preferred method of HH was soap and water (63%) versus 37% for alcohol-based hand rub (ABHR). The median time of disinfecting hands was 8 s (range 6–11 s) for HCWs in our study.

Conclusions

HH compliance among HCWs in Dutch GPs was found to be low, especially with regard to home visits. The WHO recommended switch from hand wash to ABHR was not implemented by the majority of HCWs in 5 observed GPs offices.
Effect of milk fat-based infant formulae on stool fatty acid soaps and calcium excretion in healthy term infants: two double-blind randomised cross-over trials
Authors: Manios Yannis , Karaglani Eva , Thijs-Verhoeven Inge , Vlachopapadopoulou Elpis , Papazoglou Anastasia , Maragoudaki Eleni , Manikas Zafeiris , Kampani Tarek-Michail , Christaki Iliana , Vonk Marlotte M. , Bos Rolf , Parikh Panam
Published: September 2020

Background

Palmitic acid (PA) is predominantly esterified at the SN-2 position of triacylglycerols in human milk. PA at the SN-2 position is more efficiently absorbed and results in reduced formation of PA soaps, as well as reduced fatty acid (FA) and calcium malabsorption. Bovine milk fat (MF), a natural source of SN-2-palmitate, was used in the fat blend of infant formulae (IF) in the current study to investigate its effect on stool fatty acid soaps, calcium excretion and stool characteristics.

Methods

Two double-blind, randomised cross-over trials (CS1, CS2) were conducted in parallel with healthy term, formula-fed infants aged 9–14 weeks. After a two-week run-in period, infants in CS1 (n = 17) were randomly allocated to receive either a 50% MF-based formula (50MF) or a 100% vegetable fat (VF) formula; in CS2 (n = 18), infants received either a 20% MF-based formula (20MF) or the VF formula, in a 2 × 2-week cross-over design. At the end of each two-week intervention period, stool samples were collected for FA, FA soaps and calcium excretion analysis and stool consistency was assessed according to the Amsterdam Infant Stool Scale (AISS).

Results

MF-based groups showed no significant difference in PA in stools compared to VF group, although reduced stool PA soaps (CS1: 111.28 ± 18.33 vs. 220.25 ± 29.35 mg/g dry weight, p < 0.0001; CS2: 216.24 ± 25.16 vs. 233.94 ± 35.12 mg/g dry weight, p = 0.0023), total FA soaps and calcium excretion (CS1: 46.40 ± 5.27 vs. 49.88 ± 4.77 mg/g dry weight, p = 0.0041; CS2: 46.20 ± 4.26 vs. 50.47 ± 6.71 mg/g dry weight, p = 0.0067) were observed. Furthermore, the 50MF group showed a favourable lower mean stool consistency score compared to the VF group (1.64 ± 0.49 vs. 2.03 ± 0.19, p = 0.0008).

Conclusions

While the use of bovine MF in IF did not affect PA concentrations in stool, lower excretion of palmitate soaps, total FA soaps and calcium was seen in healthy term infants. 50MF formula also showed improved stool consistency. The use of MF in IF could be an interesting approach to improve gut comfort and stool characteristics in infants, warranting further research.

Trial registration

Netherlands Trial Registry Identifier: NTR6702. Date registered: December 01, 2017.