bluuebunny/crossref_metadata_2025 huggingface dataset:
Finite-time robust tracking control of an autonomous underwater vehicle in the presence of uncertainties and external current disturbances
Authors: Wu Hsiu-Ming , Karkoub Mansour
Published: October 2021

The aim of this study is to achieve the trajectory-tracking control of an autonomous underwater vehicle (AUV) in the presence of random system uncertainties and external current disturbances. A comprehensive model of an AUV is developed based on its kinematic and dynamic models. By means of appropriate transformations, a new system dynamic equation with arguments of positions and orientations is obtained for the controller design. Here, a proposed finite-time robust tracking control (FTRTC) based on a nonlinear sliding surface constructed using the tracking error which leads not only to trajectory-tracking of the AUV system with a finite-time convergence, but also a high level of robust performance. The stability of the overall system is assured via the Lyapunov stability criteria. Computer simulations conducted using the developed controller demonstrates the feasibility and effectiveness of the proposed FTRTC. Moreover, the simulation results showed that the proposed control scheme resulted in a high level of robustness of the closed-loop control system.
Association of serum neurofilament light chain levels and neuropsychiatric manifestations in systemic lupus erythematosus
Authors: Engel Sinah , Boedecker Simone , Marczynski Paul , Bittner Stefan , Steffen Falk , Weinmann Arndt , Schwarting Andreas , Zipp Frauke , Weinmann-Menke Julia , Luessi Felix
Published: October 2021

Background:

The aim was to evaluate the diagnostic potential of serum neurofilament light chain (sNfL) measurements in patients with neuropsychiatric systemic lupus erythematosus (NPSLE).

Methods:

sNfL levels were determined by single molecule array assay in a retrospective cross-sectional cohort of 144 patients with systemic lupus erythematosus (SLE). After log-transformation of sNfL levels, mean sNfL levels were compared between NPSLE patients and SLE patients without neuropsychiatric disease using Student’s t test. Furthermore, the association of different neuropsychiatric manifestations with sNfL levels was assessed using a one-way analysis of variance (ANOVA) with post hoc analysis. Associations of sNfL with clinical and laboratory parameters were assessed by correlation and multiple linear regression analysis.

Results:

NPSLE patients ( n = 69) had significantly higher sNfL levels than SLE patients without neuropsychiatric disease manifestations ( n = 75; mean difference: 0.13, 95% CI: 0.04–0.22, p = 0.006). With regard to the category of NPSLE manifestation, mean sNfL levels were only increased in NPSLE patients with focal central nervous system (CNS) involvement ( n = 45; mean difference: 0.16, 95% CI: 0.02–0.30, p = 0.019), whereas mean sNfL levels of NPSLE patients with diffuse CNS and peripheral nervous system involvement did not differ from those of SLE patients without neuropsychiatric manifestations. Age and serum creatinine concentrations were identified as relevant contributors to sNfL levels.

Conclusion:

sNfL is a promising, easily accessible biomarker for neuropsychiatric involvement in SLE patients and might therefore complement the diagnostic workup of SLE patients with suspected involvement of the nervous system.
Insertional Achilles Tendinopathy: Occupational Outcomes in the Military
Authors: Lausé Greg E. , Egbert Rachel A. , Ryan Paul M.
Published: October 2021

A retrospective review of consecutive patients diagnosed with insertional Achilles tendinopathy (IAT) was performed. Outcomes included Visual Analog Scale (VAS) pain scores, return to run rates, and return to military duty rates. Our data analysis included 113 patients; 58 (55%) patients required surgery. Mean duration of follow-up was 42 months (range, 12-143). Mean age at the time of surgery was 37.2 years (range, 21-54). VAS scores significantly improved from 5.4 at the preoperative visit to 2.9 at 24 months. There was no significant improvement in VAS scores after the 3-month postoperative visit. Mean return to run time was 9 months (range, 4.5-16). At 1 year, 80% (46/58) of patients returned to military duty. Complications requiring return to the operating room were observed in 6 patients (9%). The high rate of return to duty and significant improvement in pain scores demonstrate that the surgical management of IAT is a viable treatment option for patients who could not otherwise remain on active duty. With that said, the complication rate of 27% is high. Patients and providers should consider the risks, benefits, and duration of therapy during their shared decision-making process.

Level of Evidence: Level IV
Contesting religious boundaries at school: A case from Norway
Authors: Johannessen Elise Margrethe Vike
Published: October 2021

This article examines the experiences of Norwegian high school girls with Muslim backgrounds in learning about Islam in religious education (RE). The empirical material consists of observations from a high school class in Norway and interviews with girls in the class. The findings support previous reports that Islam as a topic may be challenging for students with Muslim backgrounds. They also suggest that the RE classroom is a space where religious boundaries can go from blurred to bright as a result of students’ reactions to educational content and its foci on Islam. As many teachers find the topic of Islam potentially controversial and thus challenging to teach, this article offers insights that may help teachers to understand and deal with students’ reactions in the classroom context.
Exploring reasons for attrition among vulnerable and under-served sub-groups across an online integrated healthy lifestyles service during COVID-19
Authors: Sanders George J , Cooke Carlton , Gately Paul
Published: October 2021

Objectives:

Reported health behaviour change intervention attrition rates vary considerably, from 10% to more than 80%, depending on the type and setting of the treatment programme. A better understanding of the determinants of programme adherence is required. Between March and August 2020, a convenience sample of 44 individual telephone interviews, as well as 42 online Qualtrics surveys took place. The objective was to explore perceived barriers, facilitators, and opportunities for participation, sustained participation as well as initial non-participation to better understand reasons for attrition in online delivery during the COVID-19 lockdown among vulnerable and under-served groups within an Integrated Healthy Lifestyle Service (IHLS).

Methods:

A convenience sample of 44 individual telephone interviews, as well as 42 online Qualtrics surveys resulted in a total of 86 (33 male) individuals comprising intervention clients. Clients included children and young people (n = 16), manual workers (n = 7), Black, Asian or Minority Ethnic (n = 19), physical disability (n = 8), learning disability (n = 6), and those from areas of high deprivation (n = 19), as well as Integrated Healthy Lifestyle Service practitioners (n = 11).

Results:

The study revealed that more resources and support are needed for Black, Asian or Minority Ethnic; manual worker; learning disability; and high-deprivation sub-groups in order to reduce attrition rates. Specifically, a lack of technological equipment and competence of using such equipment was identified as key barriers to initial and sustained attendance among these vulnerable and under-served sub-groups during the COVID-19 lockdown.

Conclusion:

The pattern of differences in attrition during the COVID-19 lockdown suggests that further research is required to explore how best to ensure online health behaviour change offers are scalable and accessible to all.
Necropsy findings in a cat with diabetes mellitus and heart failure
Authors: Dobromylskyj Melanie J , Little Christopher JL
Published: October 2021

Case summary

A 7-year-old male neutered domestic shorthair cat, previously diagnosed and treated for diabetes mellitus (DM), subsequently presented in heart failure (HF). Echocardiography revealed biatrial and biventricular dilation with poor myocardial function, and a left atrial-to-aortic ratio of 1.95:1. There was caudal vena cava dilation, hepatomegaly and ascites. The HF was treated with furosemide for 5 weeks, but thereafter the cat presented recumbent and moribund, and was euthanased. Post-mortem findings included dilation of all four cardiac chambers with an increased heart weight. Microscopic examination of the heart revealed mild, predominantly interstitial or perivascular fibrosis throughout most of the myocardium, with small-to-medium-sized foci of replacement fibrosis within the left ventricular free wall and interventricular septum. There was evidence of myocyte degeneration, but myofibre disarray was mild and there was minimal evidence of inflammation.

Relevance and novel information

Cardiac disease is common in cats and while HF is less common, it is a frequent cause of clinical signs and death. DM is a relatively common feline endocrinopathy. This case report describes DM and HF presenting as comorbidities, including detailed ante- and post-mortem findings. The case, and the epidemiology of these conditions, raise the question of whether a form of diabetic cardiomyopathy exists in cats, as it appears to do in humans.
Effects of therapy with a free-standing robotic exoskeleton on motor function and other health indicators in people with severe mobility impairment due to chronic stroke: A quasi-controlled study
Authors: Postol Nicola , Grissell Jessica , McHugh Caitlyn , Bivard Andrew , Spratt Neil J , Marquez Jodie
Published: October 2021

Introduction

Robotic exoskeletons facilitate therapy in upright postures. This study aimed to evaluate potential health-related effects of this therapy for people with severe mobility impairment due to chronic stroke.

Methods

This quasi-controlled trial with 12 weeks of twice weekly therapy in a free-standing exoskeleton, and 12 weeks follow up, included people dependent for mobility, with stroke at least 3 months prior. The primary outcome was lower limb motor function. A battery of secondary outcomes was evaluated.

Results

Nine participants were enrolled. There was no change in motor function. There was a significant between phase difference in level of independence with activities of daily living (median post-intervention change = 5, IQR = 0, 10, p = 0.01), and grip strength (affected limb) (median post-intervention change = 1, IQR = 0, 2, p = 0.03). A significant difference was found for quadriceps strength (affected limb) (median change in wait phase = 4, IQR = 2, 7.5, p = 0.01). Participants consistently reported positive perceptions of the therapy.

Conclusions

Therapy with a free-standing exoskeleton is acceptable to participants and can facilitate improvements in level of independence and grip strength. Restrictions regarding eligibility to use the device, may reduce the clinical application of this therapy for people with stroke.
Implementation of a Plant-Based, Nutrition Program in a Large Integrated Health Care System: Results of a Pilot Program
Authors: Rahman Vanita J. , Horberg Michael A. , Hu Haihong , Vupputuri Suma
Published: October 2021

Introduction:

Despite the proven efficacy of plant-based diets in the management of cardiometabolic diseases, most healthcare providers do not incorporate them into treatment plans.

Objective:

Conduct a post-hoc evaluation of a novel plant-based nutrition program in a large integrated health care system, including the impact on health care outcomes.

Methods:

A large integrated health care system launched an innovative 12-week plant-based nutrition program that included weekly nutrition education, peer mentoring, and support. Plasma cholesterol levels, hemoglobin A1C, blood pressure, body weight, and healthcare utilization parameters were measured before and after the program. The current study is a pre- and post-descriptive analysis of the health metrics of individuals who participated in the program and a matched comparison group.

Results:

A total of 408 patients, across a wide range of weight categories, demographics, and co-morbidities, participated in a plant-based nutrition program, and program completers experienced mean reductions in total and LDL plasma cholesterol levels of 11.0 and 8.1 mg/dL, respectively, as well as reductions in medication usage, office visits, and body weight.

Conclusion:

Implementation of a novel plant-based, nutrition program in a large integrated health care system was associated with improvements in health outcomes.
Qualitative Evaluation of a Novel Educational Tool to Communicate Individualized Hip Fracture Prognostic Information to Patients and Surrogates: My Hip Fracture (My-HF)
Authors: Vincent Corita , Wegier Pete , Chien Vincent , Kurahashi Allison Miyoshi , Ginsburg Shiphra , Molla Ghanbari Hedieh , Wolfstadt Jesse Isaac , Cram Peter
Published: October 2021

Introduction

Mortality and morbidity are high for older adults after hip fracture (HF), but patients and surrogate decision makers (SDMs) are typically unaware of the poor prognosis. We developed a novel educational tool, My Hip Fracture (My-HF), to provide patients and SDMs of patients hospitalized with acute HF individualized estimates of their post-HF prognosis. We conducted initial usability testing of My-HF in a sample of patients with HF and SDMs.

Materials and Methods

My-HF provides information about: 1) anatomy and risk factors for HF; 2) Hip fracture treatment received; 3) individualized predicted risk of adverse events and 4) anticipated discharge trajectory. We conducted a qualitative usability study using a convenience sample of hospitalized, post-operative patients with acute HF or SDMs of patients who lacked decision-making capacity. We used semi-structured interviews to obtain feedback. Thematic analysis was used to identify themes and concepts.

Results

We conducted interviews with 8 patients and 9 SDMs (mean age of interviewees 70.1 years, 41% female). My-HF was generally well received. Thematic analysis identified legibility and visual appeal, comprehension, numeracy, utility and reflection as prominent themes. Most respondents found My-HF to be useful in improving their understanding of HF and as a potential mechanism for sharing information with other care team members (including family and professionals). Suggestions for improvement of legibility, presentation of the individualized prognosis information and content were identified.

Discussion

Patients and SDMs are generally accepting of My-HF and found it useful for communicating individualized prognostic information. Feedback identified areas for improvement for future iterations of the tool.

Conclusion

My-HF presents a means of addressing the gap in understanding of prognosis post-HF as a part of patient-centered care. Further evaluation will be needed to assess the impact of My-HF on patient and SDM reported outcomes as we transition from a paper to smart-phone enabled web application.
Strategies Used and Challenges Faced by Thai EFL Teachers When Eliciting Talk During Classroom Interactions in High School Contexts
Authors: Farrelly Martin James , Sinwongsuwat Kemtong
Published: October 2021

Utilizing Conversation Analysis, this study examined classroom interactions to identify strategies secondary school teachers used to elicit EFL learners’ talk in four micro-pedagogical contexts. How strategies were used, and the challenges teachers faced were also explored. Four Thai teachers of English participated in the study, and approximately 7 hours of video and audio recordings were transcribed and analyzed alongside semi-structured teacher interviews. Overall, the most prevalent strategy used to elicit talk by the four teachers was display questioning, followed by some form of scaffolding strategy, and referential questioning. From classroom observations, the teachers’ consistent use of a variety of strategies apparently promoted learners’ active participation. Challenges included learners’ failure to respond, preference for passivity, lack of active verbal participation, selective answering, and shouted competing responses. It is suggested that L2 learning can be enhanced if teachers are aware of areas which may impede or promote L2 interactional opportunities in the classroom.
The Will-to-Live Scale: Validity and Reliability Among Portuguese Adolescents
Authors: Neto Joana , da Costa Marta Pinto , Neto Félix , Carmel Sara
Published: October 2021

This work presents psychometric analyses of the Will-to-Live Scale (WTLS) among Portuguese adolescents. Two studies were carried out to establish the psychometric characteristics of the WTLS. Findings of both studies pointed out that the WTLS has satisfactory reliability and validity. Principal component analysis and confirmatory factor analysis of the WTLS evidenced a unidimensional structure. Different types of reliability estimates of the WTLS were also good. Findings also supported the convergent validity of the WTLS through significant positive correlations, between will-to-live and life satisfaction, satisfaction with family life, positive affect, self-esteem, and emotional intelligence, and negative associations with negative affect, depression, anxiety, and stress. Findings of this research indicate that the WTLS is a valid and reliable tool among Portuguese adolescents.
Cultural Diplomacy as a Network and Networking in International Relations: The Case of Cultural Diplomacy in Russia
Authors: Ociepka Beata , Arendarska Justyna
Published: October 2021

This article discusses the European Union (EU) member states’ cultural institutes as nodes of cultural diplomacy networks and a network approach in the analysis of cultural diplomacy at the time of Russia’s war in eastern Ukraine and its annexation of Crimea in 2014. This study’s hypothesis is that the international crisis over the war in Ukraine pushed the EU member states to establish new ties linking their cultural establishments. The authors analyzed the EU countries’ cultural diplomacy documents and considered the concepts of network structure, network synergy, and issue networks to investigate whether EU governments—and especially their cultural agencies—understand cultural diplomacy as a network. The results of the study show that while the nodes of cultural diplomacy in Russia and the selected EU countries continued their communication during the international crisis, the expected interactions among CIs in Austria, Germany, the United Kingdom, the Netherlands, and Poland were hardly established.
Humor Styles Moderate the Relationship Between Rumination and Mental Health in Community Residents
Authors: Chuang Shu Ping , Wu Jo Yung Wei , Wang Chien Shu
Published: October 2021

The present study investigated how humor styles moderate the associations between rumination and mental health (depressive symptoms, satisfaction with life, and positive mental health) in community residents. Participants ( N = 382) were assessed with the Ruminative Response Scale (RRS), Humor Styles Questionnaire (HSQ), Center for Epidemiological Studies Depression Scale (CES-D), Satisfaction With Life Scale (SWLS), and Positive Mental Health Scale (PMH-scale). Hayes’ PROCESS macro revealed that rumination had a direct effect on depressive symptoms and was moderated by affiliative humor, self-enhancing humor, and aggressive humor, respectively. The relationship between rumination and satisfaction with life was moderated by self-enhancing humor, aggressive humor, and self-defeating humor, respectively. Affiliative humor, self-enhancing humor, and aggressive humor were moderators in the relation between rumination and positive mental health. This study revealed that different humor styles have varying impacts between rumination and mental health. It is crucial for healthcare professionals to promote the importance of using adaptive humor styles to improve mental health.
Exploring Behavioral Intention to Use a Mobile Health Education Website: An Extension of the UTAUT 2 Model
Authors: Yu Chen-Wei , Chao Cheng-Min , Chang Che-Fu , Chen Rueg-Juen , Chen Po-Chung , Liu Yi-Xuan
Published: October 2021

This study developed and empirically tested a model to predict the factors affecting patients’ behavioral intentions to use a mobile health education website. It explored the behavioral intention to use a mobile health education website from the perspective of consumers by extending the Unified Theory of Acceptance and Use of Technology 2 model with the addition of mobile self-efficacy (M-SE), use motivation, and mobile literacy as moderators. For this purpose, variance-based structural equation modeling was used to analyze data collected from a sample of 1,649 patients at a hospital in Taoyuan, Taiwan. Partial least squares regression was used for model and hypothesis testing. The results revealed that (1) performance expectancy, effort expectancy, social influence, facilitating conditions, and habit were key predictors of the behavioral intentions of patients to use a mobile health education website; (2) M-SE had positive associations with effort expectancy; (3) use motivation was a significant determinant of both performance expectancy and effort expectancy; and (4) mobile literacy had a significantly negative moderating effect on the relationship between performance expectancy and behavioral intention. Our findings serve as a reference for the promotion of mobile health education in hospitals.
Do Epidural Steroid Injections Affect Outcomes and Costs in Cervical Degenerative Disease? A Retrospective MarketScan Database Analysis
Authors: Wadhwa Harsh , Varshneya Kunal , Stienen Martin N. , Veeravagu Anand
Published: October 2021

Study Design

Retrospective cohort study.

Objective

To investigate the effect of preoperative epidural steroid injection (ESI) on quality outcomes and costs in patients undergoing surgery for cervical degenerative disease.

Methods

We queried the MarketScan database, a national administrative claims dataset, to identify patients who underwent cervical degenerative surgery from 2007 to 2016. Patients under 18 and patients with history of tumor or trauma were excluded. Patients were stratified by ESI use at 3, 6, 12, 18, and 24 or more months preoperative. Propensity score matched controls for these groups were obtained. Baseline demographics, postoperative complications, reoperations, readmissions, and costs were compared via univariate and multivariate analysis.

Results

97 117 patients underwent cervical degenerative surgery, of which 29 963 (30.7%) had ESI use at any time preoperatively. Overall, 90-day complication rate was not significantly different between groups. The ESI cohorts had shorter length of stay, but higher 90-day readmission and reoperation rates. ESI use was associated with higher total payments through the 2-year follow-up period. Among patients who received preoperative ESI, male sex, history of cancer, obesity, PVD, rheumatoid arthritis, nonsmokers, cervical myelopathy, BMP use, anterior approach, 90-day complication, 90-day reoperation, and 90-day readmission were independently associated with increased 90-day total cost.

Conclusion

ESI can offer pain relief in some patients refractory to other conservative management techniques, but those who eventually undergo surgery have greater healthcare resource utilization. Certain characteristics can predispose patients who receive preoperative ESI to incur higher healthcare costs.
The Listener Effect in Multitalker Speech Segregation and Talker Identification
Authors: Lutfi Robert A. , Rodriguez Briana , Lee Jungmee
Published: October 2021

Over six decades ago, Cherry (1953) drew attention to what he called the “cocktail-party problem”; the challenge of segregating the speech of one talker from others speaking at the same time. The problem has been actively researched ever since but for all this time one observation has eluded explanation. It is the wide variation in performance of individual listeners. That variation was replicated here for four major experimental factors known to impact performance: differences in task (talker segregation vs. identification), differences in the voice features of talkers (pitch vs. location), differences in the voice similarity and uncertainty of talkers (informational masking), and the presence or absence of linguistic cues. The effect of these factors on the segregation of naturally spoken sentences and synthesized vowels was largely eliminated in psychometric functions relating the performance of individual listeners to that of an ideal observer, d′ideal. The effect of listeners remained as differences in the slopes of the functions (fixed effect) with little within-listener variability in the estimates of slope (random effect). The results make a case for considering the listener a factor in multitalker segregation and identification equal in status to any major experimental variable.
Teaching Culturally Diverse Choral Music With Intention and Care: A Review of Literature
Authors: Bennett Catherine
Published: October 2021

In this literature review, I examined choral education research that extends beyond Eurocentric norms and in which researchers focused on the transmission of culturally diverse music and/or culturally diverse transmission practices that may connect to culturally diverse choral singers. I focused on practical implications for teaching culturally diverse music with intention and care. Research findings and implications illuminate possibilities for authentic, respectful, and culturally responsive teaching preparation, such as ways to decide on the song(s) one will teach, locate informants and resources, and learn about particular music. Additionally, one can draw meaningful insights for transmission and implementation, such as considerations for teaching context, foreign languages, vocal tone, expression, and movement.Ultimately, I summarized reported practices around building community, collaborative learning, and “horizontal leadership,” which may be apt for building firsthand appreciation and awareness of (culturally diverse) choir peers.
Identification of GROWTH-REGULATING FACTOR transcription factors in lettuce (Lactuca sativa) genome and functional analysis of LsaGRF5 in leaf size regulation
Authors: Zhang Bin , Tong Yanan , Luo Kangsheng , Zhai Zhaodong , Liu Xue , Shi Zhenying , Zhang Dechun , Li Dayong
Published: October 2021

Background

GROWTH-REGULATING FACTORs (GRFs), a type of plant-specific transcription factors, play important roles in regulating plant growth and development. Although GRF gene family has been identified in various plant species, a genome-wide analysis of this family in lettuce (Lactuca sativa L.) has not been reported yet.

Results

Here we identified 15 GRF genes in lettuce and performed comprehensive analysis of them, including chromosomal locations, gene structures, and conserved motifs. Through phylogenic analysis, we divided LsaGRFs into six groups. Transactivation assays and subcellular localization of LsaGRF5 showed that this protein is likely to act as a transcriptional factor in the cell nucleus. Furthermore, transgenic lettuce lines overexpressing LsaGRF5 exhibited larger leaves, while smaller leaves were observed in LsaMIR396a overexpression lines, in which LsaGRF5 was down-regulated.

Conclusions

These results in lettuce provide insight into the molecular mechanism of GRF gene family in regulating leaf growth and development and foundational information for genetic improvement of the lettuce variations specialized in leaf character.
Is social participation associated with good self-rated health among visually impaired older adults?: the JAGES cross-sectional study
Authors: Takesue Atsuhide , Hiratsuka Yoshimune , Inoue Akira , Kondo Katsunori , Murakami Akira , Aida Jun
Published: October 2021

Background

While it has been recognized that visual impairment is associated with poor self-rated health (SRH), in addition to various negative health outcomes of visual impairment, the number of older adults with visual impairment is increasing due to population aging. As increasing evidence has been found for the effectiveness of social participation on good SRH, we examined whether there was an association between social participation and SRH and investigated whether the effect differed by visual status.

Methods

Questionnaire data on self-reported visual status, social participation, socioeconomic status, and SRH were obtained in 2016. A total of 24,313 community-dwelling individuals aged 65 and over participated. We examined the association of social participation and SRH status among older adults with visual impairment. Stratified analysis and analysis with an interaction term between social participation and visual status were also conducted. Social participation was assessed by the number of participating groups (no participation, one, two, and three or more).

Results

Overall visual impairment prevalence was 9.3% (95% CI: 8.9–9.7). Among those with and without visual impairment, prevalence of poor SRH was 38.4 and 13.1%, respectively. However, the association between social participation with SRH was similar, especially for those who participated in one or two groups. For people with (PR = 0.54) and without visual impairment (PR = 0.50), those who participated in two groups showed lower prevalence ratios for poor SRH compared to people without social participation.

Conclusion

Social participation showed a beneficial association with SRH among older adults with visual impairment. Future interventions could focus on the potentially positive role of social participation on SRH among older adults with visual impairment.
Tenosynovitis caused by Mycobacterium marseillense, initially identified as Mycobacterium avium complex using AccuProbe and COBAS TaqMan
Authors: Nomura Yusuke , Okamoto Koh , Ohama Yuki , Higurashi Yoshimi , Harada Sohei , Moriya Kyoji
Published: October 2021

Background

Mycobacterium marseillense is a new species of the Mycobacterium avium complex. There has been only a few human infections caused by M. marseillense worldwide.

Case presentation

We report a case of tenosynovitis caused by M. marseillense in an immunocompetent adult in Japan. The isolate was initially identified as M. intracellulare using commercial real time polymerase chain reaction assays and later identified as M. marseillense with sequencing of the the rpoB and hsp65 regions, and matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS).

Conclusions

This is the first case reporting on M. marseillense generating a positive result with commercial real time PCR assays targeting MAC. Human infections associated by M. marseillense might be underreported due to similarities with Mycobacterium intracellulare. To accurately identify M. marseillese, MALDI-TOF MS might provide a rapid and reliable method.
Building a biopsychosocial model of cancer-related fatigue: the BIOCARE FActory cohort study protocol
Authors: Chartogne M. , Leclercq A. , Beaune B. , Boyas S. , Forestier C. , Martin T. , Thomas-Ollivier V. , Landry S. , Bourgeois H. , Cojocarasu O. , Pialoux V. , Zanna O. , Messonnier L. A. , Rahmani A. , Morel B.
Published: October 2021

Background

Cancer-related fatigue (CRF) is the most common side effect of cancer and cancer treatment. CRF prevalence is up to 50% in breast cancer patients and can continue several years after cancer remission. This persistent subjective sense of exhaustion is multifactorial. Numerous parameters have been evidenced to be related to CRF across biological, physical, psychological, social and/or behavioral dimensions. Although CRF has been studied for many years, the majority of previous studies focused on only one dimension, i.e., physical function. Moreover, few studies investigated CRF longitudinally with repeated measures. These are the two main obstacles that limit the understanding of CRF mechanisms. The purpose of this study is to create a biopsychosocial model of CRF with simultaneous and longitudinal anthropometric, clinical, biological, physical, psychological and sociological parameters.

Methods

BIOCARE FActory is a multicentric prospective study that will consist of an 18-month follow-up of 200 women diagnosed with breast cancer. Four visits will be scheduled at diagnosis, after treatments, and 12 and 18 months after diagnosis. The same procedure will be followed for each visit. Each session will be composed of anthropometric data collection, a semi-structured interview, cognitive tests, postural control tests, neuromuscular fatigability tests and a cardiorespiratory fitness test. Clinical and biological data will be collected during medical follow-ups. Participants will also complete questionnaires to assess psychological aspects and quality of life and wear an actigraphy device. Using a structural equation modeling analysis (SEM), collected data will build a biopsychosocial model of CRF, including the physiological, biological, psychological, behavioral and social dimensions of CRF.

Discussion

This study aims to highlight the dynamics of CRF and its correlates from diagnosis to post treatment. SEM analysis could examine some relations between potential mechanisms and CRF. Thus, the biopsychosocial model will contribute to a better understanding of CRF and its underlying mechanisms from diagnosis to the aftermaths of cancer and its treatments.

Trial registration

This study is registered at ClinicalTrials.gov (NCT04391543), May 2020.
A national survey of pharmacists and interns in Aotearoa New Zealand: provision and views of extended services in community pharmacies
Authors: McDonald Janet , Morris Caroline , Pledger Megan , Dunn Phoebe , Fa’asalele Tanuvasa Ausaga , Smiler Kirsten , Cumming Jacqueline
Published: October 2021

Background

Changes in pharmacy models of care, services and funding have been occurring internationally, moving away from the traditional dispensing role to more extended patient-facing roles utilising pharmacists’ clinical skills. This study aimed to identify the extended services offered by community pharmacy in Aotearoa New Zealand and the barriers and facilitators to extended services provision. The study is unique in that it includes intern (pre-registration) pharmacists.

Methods

An online survey, conducted in 2018, of all pharmacists and intern (pre-registration) pharmacists working in a community pharmacy. Data were analysed using descriptive statistics and regression analyses.

Results

The results are based on replies from 553 community pharmacists and 59 intern pharmacists (response rate: 19 and 26% respectively). Both pharmacists (83%) and interns (85%) want to work at the top of their scope of practice. Wide variation exists in the specific services individual pharmacists offer. Most pharmacists were accredited to supply the emergency contraceptive pill (95%), sildenafil for erectile dysfunction (86%) and trimethoprim for uncomplicated urinary tract infection (85%). Fewer were able to immunise (34%) or to supply selected oral contraceptives (44%). Just under a quarter could provide a Medicines Use Review (MUR) or Community Pharmacy Anticoagulation Management Service (CPAMS). Of the pharmacists not already accredited, 85% intended to gain accreditation to supply selected oral contraceptives, 40% to become vaccinators, 37% to offer CPAMS and 30% MUR. Interns expressed strong interest in becoming accredited for all extended services.

Poisson regression analyses showed key factors supporting the likelihood of providing extended services were owner and management support and appropriate space and equipment. Being excited about the opportunities in community pharmacy, having employer funding and time for training and sufficient support staff were also statistically significant.

Conclusions

Pharmacists need time and a supportive management structure to enable them to deliver extended services. Health policy with a greater strategic emphasis on funding services and pharmacist training, and developing technician support roles, will help to minimise or eliminate some of the barriers to role expansion both in Aotearoa New Zealand and internationally.
Association of left ventricular longitudinal myocardial function with subclinical right ventricular dysfunction in type 2 diabetes mellitus
Authors: Todo Saki , Tanaka Hidekazu , Yamauchi Yuki , Yokota Shun , Mochizuki Yasuhide , Shiraki Hiroaki , Yamashita Kentaro , Shono Ayu , Suzuki Makiko , Sumimoto Keiko , Tanaka Yusuke , Hirota Yushi , Ogawa Wataru , Hirata Ken-ichi
Published: October 2021

Background

Left ventricular (LV) involvement in diabetic cardiomyopathy has been reported; however, only limited data exist on right ventricular (RV) involvement. Therefore, our purpose was to investigate RV systolic dysfunction and its association with LV longitudinal myocardial dysfunction in patients with type 2 diabetes mellitus (T2DM) and preserved LV ejection fraction (LVEF).

Methods

We studied 177 T2DM patients with preserved LVEF and 79 age-, sex-, and LVEF-matched healthy volunteers. LV longitudinal myocardial function was assessed as global longitudinal strain (GLS), and RV systolic function was assessed as RV free-wall strain, and predefined cutoff values for subclinical dysfunction were set at GLS < 18% and RV free-wall strain < 20%, respectively.

Results

RV free-wall strain in T2DM patients was significantly lower than that in normal controls (19.3% ± 4.8% vs. 24.4% ± 5.1%; P < 0.0001). RV free-wall strain in T2DM patients and LV longitudinal dysfunction was similar compared to that in T2DM patients without (19.0 ± 4.5% vs. 19.6 ± 5.0%, P = 0.40). Furthermore, multivariate logistic regression analyses showed that GLS was independently associated with RV systolic dysfunction as well as mitral inflow E and mitral e′ annular velocities ratio (odds ratio, 1.16; 95% confidence interval: 1.03–1.31; P < 0.05). Sequential logistic models evaluating the association of RV systolic dysfunction in T2DM patients showed an improvement in clinical variables (χ2 = 6.2) with the addition of conventional echocardiographic parameters (χ2 = 13.4, P < 0.001) and a further improvement with the addition of GLS (χ2 = 20.8, P < 0.001).

Conclusion

RV subclinical systolic dysfunction was observed in T2DM patients with preserved LVEF and was associated with LV longitudinal myocardial dysfunction. Our findings may provide additional findings for the management of T2DM patients.
Insecticide-treated eave ribbons for malaria vector control in low-income communities
Authors: Kaindoa Emmanuel W. , Mmbando Arnold S. , Shirima Ruth , Hape Emmanuel E. , Okumu Fredros O.
Published: October 2021

Supplementary tools are required to address the limitations of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), which are currently the core vector control methods against malaria in Africa. The eave ribbons technology exploits the natural house-entry behaviours of major malaria vectors to deliver mosquitocidal or repellent actives around eave spaces through which the Anopheles mosquitoes usually enter human dwellings. They confer protection by preventing biting indoors and in the peri-domestic outdoor spaces, and also killing a significant proportion of the mosquitoes. Current versions of eave ribbons are made of low-cost hessian fabric infused with candidate insecticides and can be easily fitted onto multiple house types without any additional modifications. This article reviews the evidence for efficacy of the technology, and discusses its potential as affordable and versatile supplementary approach for targeted and efficient control of mosquito-borne diseases, particularly malaria. Given their simplicity and demonstrated potential in previous studies, future research should investigate ways to optimize scalability and effectiveness of the ribbons. It is also important to assess whether the ribbons may constitute a less-cumbersome, but more affordable substitute for other interventions, such as IRS, by judiciously using lower quantities of selected insecticides targeted around eave spaces to deliver equivalent or greater suppression of malaria transmission.
The effect of malaria on haemoglobin concentrations: a nationally representative household fixed-effects study of 17,599 children under 5 years of age in Burkina Faso
Authors: Starck Tim , Bulstra Caroline A. , Tinto Halidou , Rouamba Toussaint , Sie Ali , Jaenisch Thomas , Bärnighausen Till
Published: October 2021

Background

Although the association between malaria and anaemia is widely studied in patient cohorts, the population-representative causal effects of malaria on anaemia remain unknown. This study estimated the malaria-induced decrease in haemoglobin levels among young children in malaria-endemic Burkina Faso.

Methods

The study was based on pooled individual-level nationally representative health survey data (2010–2011, 2014, 2017–2018) from 17 599 children under 5 years of age. This data was used to estimate the effects of malaria on haemoglobin concentration, controlling for household fixed-effects, age, and sex in a series of regression analyses. The fixed-effects controlled for observed and unobserved confounding on the household level and allowed to determine the impact of malaria infection status on haemoglobin levels and anaemia prevalence. Furthermore, the diagnostic results from microscopy and rapid diagnostic tests were leveraged to provide a quasi-longitudinal perspective of acute and prolonged effects after malaria infection.

Results

The prevalence of both malaria (survey prevalence ranging from 17.4% to 65.2%) and anaemia (survey prevalence ranging from 74% to 88.2%) was very high in the included surveys. Malaria was estimated to significantly reduce haemoglobin levels, with an overall effect of − 7.5 g/dL (95% CI − 8.5, − 6.5). Acute malaria resulted in a − 7.7 g/dL (95% CI − 8.8, − 6.6) decrease in haemoglobin levels. Recent malaria without current parasitaemia decreased haemoglobin concentration by − 7.1 g/dL (95% CI − 8.3, − 5.9). The in-sample predicted prevalence of severe anaemia was 9.4% among malaria positives, but only 2.2% among children without malaria.

Conclusion

Malaria infection has a strong detrimental effect on haemoglobin levels among young children in Burkina Faso. This effect seems to carry over even after acute infection, indicating prolonged haemoglobin reductions even after successful parasite-elimination. The quasi-experimental fixed-effect approach adds a population level perspective to existing clinical evidence.
Comparative genome analysis of colistin-resistant OXA-48-producing Klebsiella pneumoniae clinical strains isolated from two Iranian hospitals
Authors: Bolourchi Negin , Shahcheraghi Fereshteh , Giske Christian G. , Nematzadeh Shoeib , Noori Goodarzi Narjes , Solgi Hamid , Badmasti Farzad
Published: October 2021

Background

Carbapenemase-producing Klebsiella pneumoniae (CP-KP) is becoming extensively disseminated in Iranian medical centers. Colistin is among the few agents that retains its activity against CP-KP. However, the administration of colistin for treatment of carbapenem-resistant infections has increased resistance against this antibiotic. Therefore, the identification of genetic background of co-carbapenem, colistin-resistance K.pneumoniae (Co-CCRKp) is urgent for implementation of serious infection control strategies.

Methods

Fourteen Co-CCRKp strains obtained from routine microbiological examinations were subjected to molecular analysis of antimicrobial resistance (AMR) using whole genome sequencing (WGS).

Results

Nine of 14 K.pneumoniae strains belonged to sequence type (ST)-11 and 50% of the isolates had K-locus type 15. All strains carried blaOXA-48 except for P26. blaNDM-1 was detected in only two plasmids associated with P6 and P26 strains belonging to incompatibility (Inc) groups; IncFIB, IncHI1B and IncFII. No blaKPC, blaVIM and blaIMP were identified. Multi-drug resistant (MDR) conjugative plasmids were identified in strains P6, P31, P35, P38 and P40. MICcolistin of K. pneumoniae strains ranged from 4 to 32 µg/ml. Modification of PmrA, PmrB, PhoQ, RamA and CrrB regulators as well as MgrB was identified as the mechanism of colistin resistance in our isolates. Single amino acid polymorphysims (SAPs) in PhoQ (D150G) and PmrB (R256G) were identified in all strains except for P35 and P38. CrrB was absent in P37 and modified in P7 (A200E). Insertion of ISKpn72 (P32), establishment of stop codon (Q30*) (P35 and P38), nucleotides deletion (P37), and amino acid substitution at position 28 were identified in MgrB (P33 and P42). None of the isolates were positive for plasmid-mediated colistin resistance (mcr) genes. P35 and P38 strains carried iutA, iucD, iucC, iucB and iucA genes and are considered as MDR-hypervirulent strains. P6, P7 and P43 had ICEKp4 variant and ICEKp3 was identified in 78% of the strains with specific carriage in ST11.

Conclusion

In our study, different genetic modifications in chromosomal coding regions of some regulator genes resulted in phenotypic resistance to colistin. However, the extra-chromosomal colistin resistance through mcr genes was not detected. Continuous genomic investigations need to be conducted to accurately depict the status of colistin resistance in clinical settings.
Psychometric properties of the itch numeric rating scale, skin pain numeric rating scale, and atopic dermatitis sleep scale in adult patients with moderate-to-severe atopic dermatitis
Authors: Silverberg Jonathan I. , DeLozier Amy , Sun Luna , Thyssen Jacob P. , Kim Brian , Yosipovitch Gil , Nunes Fabio P. , Gugiu P. Cristian , Doll Helen A. , Eichenfield Lawrence F.
Published: October 2021

Background

The Itch Numeric Rating Scale (NRS), Skin Pain NRS, and Atopic Dermatitis Sleep Scale (ADSS) are self-administered patient-reported outcome (PRO) instruments developed to assess symptoms in patients with atopic dermatitis (AD). The objective of this study was to evaluate the psychometric properties (reliability, validity, and responsiveness) and interpretability thresholds of these PROs using data from three pivotal Phase 3 studies in adults.

Methods

BREEZE-AD1, BREEZE-AD2, and BREEZE-AD5 evaluated the safety and efficacy of baricitinib in adults with moderate-to-severe AD. Clinician-reported outcomes and other PROs commonly assessed in patients with AD were used to estimate meaningful changes and evaluate test–retest reliability, convergent and divergent validity, known-groups validity, responsiveness, and meaningful change thresholds (MCTs) of the Itch NRS, Skin Pain NRS, and ADSS.

Results

The test–retest reliability of the Itch NRS, Skin Pain NRS, and ADSS was evidenced by generally large intraclass correlation coefficients (> 0.7) in stable groups of patients between baseline and Week 1 and Weeks 4 and 8. Moderate-to-large correlations (r > 0.4) at baseline and Week 16 were generally observed between each measure and other PROs measuring the same concept, supporting convergent validity. Small-to-moderate correlations with clinician-reported outcomes demonstrated divergent validity. Each instrument was able to distinguish between known groups of disease severity as assessed using other indicators of AD severity. The responsiveness of the Itch NRS, Skin Pain NRS, and ADSS scales was demonstrated through significant differences in their change scores from baseline to Week 16 between categories of change in another PRO also from baseline to Week 16. Thresholds for interpreting meaningful change were estimated as − 4.0 for the 0–10 Itch and Skin Pain NRS items; − 1.25 for the 0–4 ADSS Items 1 and 3 and; − 1.50 for the 0–29 ADSS Item 2, these equivalent to moderate degrees of change.

Conclusions

Results of this study demonstrate that the psychometric properties of the Itch NRS, Skin Pain NRS, and ADSS are good to excellent. These findings support the use of these instruments in daily assessment of AD symptoms in adults with moderate-to-severe AD.

Trial registration ClinicalTrials.gov numbers: NCT03334396, NCT03334422, and NCT03435081.