bluuebunny/crossref_metadata_2025 huggingface dataset:
A clinical and biomechanical comparison of INFIX plus single versus double sacroiliac screw fixation for unstable pelvic ring injury
Authors: Chen Hongfen , Ding Chao , Liu Yongqiang , Kong Zhen , Chang Siling , Huang Feng , Li Heng , Guo Qingxiang , Yang Yuehua , Zhong Hua , Yang Shaozheng
Published: May 2022

Background

The aim of this study is to compare the clinical and biomechanical outcome of INFIX plus single with two sacroiliac screw fixation for unstable pelvic fractures of Type C.

Methods

Sixteen cadavers were randomly subjected to INFIX plus single or double sacroiliac screw fixations and then mounted onto the ElectroForce loading machine under different vertical loads. To investigate the clinical outcomes of the two techniques, nineteen patients were retrospectively analyzed. The main outcome measures were postoperative radiographic reduction grading (using the Tornetta and Matta grading system), functional outcome (using the Majeed scoring system), and incidence of complications.

Results

In the biomechanical study, INFIX plus double sacroiliac screw fixation showed better biomechanical stability than fixation with a single sacroiliac screw (p < 0.05). In our clinical case series, all 19 patients had bony union 6 months after the operation. INFIX plus double sacroiliac screw fixation also demonstrated a better functional outcome and a higher radiographic satisfactory rate than INFIX plus single sacroiliac screw fixation (79.25 ± 5.47; 91.33 ± 4.97; p < 0.05), (77.78% vs. 60%; p = 0.05). One patient in INFIX plus single-screw fixation group had screw loosening at 6-month follow-up postoperatively. One case in each group suffered heterotopic ossification and the lateral femoral cutaneous nerve paralysis, and one patient suffered from infection.

Conclusion

INFIX plus double sacroiliac screw fixation demonstrated more stability in cadaveric biomechanical analysis and better clinical outcomes than INFIX plus single sacroiliac screw fixation.
Factors of family impact in a Swedish–German cohort of children born with esophageal atresia
Authors: Dellenmark-Blom Michaela , Abrahamsson Kate , Dingemann Jens , Witt Stefanie , Dingemann Carmen , Jönsson Linus , Gatzinsky Vladimir , Bullinger Monika , Ure Benno M. , Chaplin John E. , Quitmann Julia H.
Published: May 2022

Background

After repair of esophageal atresia (EA), childhood survivors commonly present with digestive and respiratory morbidity, and around 55% have associated anomalies. Although it is known that these problems can reduce health-related quality of life in children with EA, less is understood about the impact on the family. We aimed to identify factors related to family impact in children with EA.

Methods

One parent each of a child with EA (2–18 years) in 180 families from Sweden and Germany answered the PedsQL™ Family Impact Module as the dependent variable. The independent variables were the child’s parent-reported health-related quality of life as measured by PedsQL™ 4.0, current symptoms, school situation, and parent/family characteristics together with child clinical data from the medical records.

Results

Stepwise multivariable regression analysis showed a multifactorial model of the total family impact scores (R2 = 0.60), with independent factors being the child’s overall generic health-related quality of life, school-absence ≥ 1/month, severe tracheomalacia, a family receiving carer’s allowance, and a parent with no university/college education, p < 0.05. Logistic regression analysis showed that an increased number of symptoms in the child the preceding 4 weeks lowered the family impact scores; however, the child’s feeding (R2 = 0.35) and digestive symptoms (R2 = 0.25) explained more in the variation of scores than the child’s respiratory symptoms (R2 = 0.09), p < 0.0001.

Conclusions

Family functioning may be a contributing factor to the maintenance of child health. The study findings suggest multifactorial explanations to family impact in children with EA, which are essential when optimizing the support to these families in clinical and psychosocial practice. Future research should explore experiences of family impact from all family members’ perspectives and multicenter studies are warranted to understand better the effectiveness of psychosocial-educational interventions to families of children with EA.
The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State
Authors: Li Mingfei , Lo Victor S. Y. , Liu Piaomu , Smith Eric
Published: May 2022

Background

Timothy's law to reduce mental health care disparities was enacted in January 2007 in New York state (NY). According to Timothy's law, "if a patient is suffering from a Biologically Based Mental Illness, or is a Child with Serious Emotional Disturbances, the Inpatient mental health benefit will be the same as for any other illness". An assessment of its impact on inpatient mental health care is lacking. We provide a rigorous study of this policy intervention’s effect over the first year of its implementation.

Methods

We used a quasi-experimental design to combine the difference-in-difference method and propensity score weighting. Data are from inpatient records in NY and California (CA) (as a control) between January 2006 to December 2006 (the pre-enactment year in NY) and January to December 2007 (the enactment year) for non-Medicare/Medicaid patients hospitalized in both years with specific illnesses covered by Timothy's Law. Change in length of stay from 2006 to 2007 was measured for each patient, and the differences observed in NY and California were compared to each other (Difference-in-Difference), with differences in the characteristics of patients in NY and California addressed through Propensity Score Weighting (PSW).

Results

Before Timothy's Law was enacted (2006), length of stay (LOS) in NY was 16.3 days on average, and length of stay per hospitalization (LOSPH) was 11.72 days on average for the 1237 patients under study in 2006. In 2007, LOS increased by 4.91 days in NY (95% CI (2.89, 7.01)) compared with similar patients in California, and LOSPH by 3.25 days (95% CI (1.96, 4.57)). Among patients with serious mental illness diagnoses, LOS in NY increased by 7.07 days (95% CI (4.15, 10.17)), and LOSPH by 4.04 days (95% CI (1.93, 6.03)) compared to California.

Conclusions

Our study strongly suggests that, within the time frame of just a single year, Timothy's Law significantly increased inpatient mental healthcare utilization in NY. Our study raises the possibility that similar laws in other locations could have similar effects.
Risk of SARS-CoV-2 Breakthrough Infection in Vaccinated Cancer Patients: A Retrospective Cohort Study
Authors: Rooney Anthony , Bivona Cory , Liu Ben , Streeter David , Gong Han , Khan Qamar
Published: May 2022

Although messenger RNA (mRNA) vaccines have established efficacy for prevention of severe SARS-CoV2 infection in the general population, their effectiveness in patients with malignancy, especially those on anti-neoplastic therapies, remains an area of open research. In order to better understand the risk of developing breakthrough SARS-CoV-2 infection and the outcomes associated with breakthrough infection for cancer patients, individual patient data from a curated outcomes database at the University of Kansas were retrospectively reviewed to determine the rate of breakthrough infection during an 8-month period encompassing the height of the delta variant surge. Although the rate of breakthrough infection in cancer patients after two doses of an mRNA vaccine remained low at 1.1%, hospitalization and death rates were 27 and 5%, respectively. Patients with hematologic malignancies, especially multiple myeloma, and those on anti-neoplastic therapy at the time of vaccination were found to be at higher risk for developing breakthrough infection.
Heterosis of growth trait regulated by DNA methylation and miRNA in allotriploid fish
Authors: Ren Li , Zhang Hong , Luo Mengxue , Gao Xin , Cui Jialin , Zhang Xueyin , Liu Shaojun
Published: May 2022

Background

Heterosis of growth traits in allotriploid fish has benefited the production of aquaculture for many years, yet its genetic and molecular basis has remained obscure. Now, an allotriploid complex, including two triploids and their diploid inbred parents, has provided an excellent model for investigating the potential regulatory mechanisms of heterosis.

Results

Here, we performed a series of analyses on DNA methylation modification and miRNA expression in combination with gene expression in the allotriploid complex. We first established a model of cis- and trans-regulation related to DNA methylation and miRNA in allotriploids. Then, comparative analyses showed that DNA methylation contributed to the emergence of a dosage compensation effect, which reduced gene expression levels in the triploid to the diploid state. We detected 31 genes regulated by DNA methylation in the subgenomes of the allotriploids. Finally, the patterns of coevolution between small RNAs and their homoeologous targets were classified and used to predict the regulation of miRNA expression in the allotriploids.

Conclusions

Our results uncovered the regulatory network between DNA methylation and miRNAs in allotriploids, which not only helps us understand the regulatory mechanisms of heterosis of growth traits but also benefits the study and application of epigenetics in aquaculture.
A novel in-plane technique ultrasound-guided pericardiocentesis via subcostal approach
Authors: Osman Adi , Ahmad Azma Haryaty , Shamsudin Nurul Shaliza , Baherin Muhammad Faiz , Fong Chan Pei
Published: May 2022

Background

Cardiac tamponade occurs when fluid or blood, fills the pericardial space, and causes hemodynamic compromise due to compression of the heart. It is a potentially life-threatening condition, that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used, and it is associated with complications. Medical technology development has enabled us to perform the procedure safely, with the assistance of ultrasound devices. This article will highlight the novel use of an in-plane subcostal technique, as a safe option for pericardiocentesis in cardiac tamponade.

Case presentation

A 50-year-old man presented to the emergency department (ED) with shortness of breath and shock. He was intubated for respiratory distress. His bedside echocardiography showed cardiac tamponade. Ultrasound-guided pericardiocentesis was carried out using an in-plane technique, at the subcostal region, with a high-frequency linear ultrasound transducer. This particular method provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient’s hemodynamic status improved post-procedure. He was successfully discharged on day 13.

Conclusions

The in-plane subcostal pericardiocentesis is a safe, and simple approach that can be performed in the ED for patients with cardiac tamponade. We recommend this new in-plane method, with high-frequency linear transducer at the subcostal area as an alternative when cardiac window for other approaches cannot be visualized.
Phosphoglucomutase 1 contributes to optimal cyst development in Toxoplasma gondii
Authors: Quach Emily V. , Cao Binh , Babacarkhial Edres , Ho Daniel , Sharma Janak , Guiton Pascale S.
Published: May 2022

Objective

Toxoplasma gondii is a ubiquitous parasite of medical and veterinary importance; however, there exists no cure for chronic toxoplasmosis. Metabolic enzymes required for the production and maintenance of tissue cysts represent promising targets for novel therapies. Here, we use reverse genetics to investigate the role of Toxoplasma phosphoglucomutase 1, PGM1, in Toxoplasma growth and cystogenesis.

Results

We found that disruption of pgm1 did not significantly affect Toxoplasma intracellular growth and the lytic cycle. pgm1-defective parasites could differentiate into bradyzoites and produced cysts containing amylopectin in vitro. However, cysts produced in the absence of pgm1 were significantly smaller than wildtype. Together, our findings suggest that PGM1 is dispensable for in vitro growth but contributes to optimal Toxoplasma cyst development in vitro, thereby necessitating further investigation into the function of this enzyme in Toxoplasma persistence in its host.
Introduction of salvage prostatectomy in Denmark: the initial experience
Authors: Mortensen Mike Allan , Poulsen Charlotte Aaberg , Ahlgren Göran , Madsen Kirsten , Poulsen Mads Hvid
Published: May 2022

Objective

To introduce salvage prostatectomy in Denmark. Prior to this, no national curative treatment for recurrent prostate cancer following radiation therapy existed in Denmark. This pilot study represent our initial experiences and the feasibility of performing salvage robot-assisted radical prostatectomy for true local, high-risk recurrence after initial therapy with external beam radiation for high-risk prostate cancer.

Results

Five patients underwent sRARP between April 2020 and July 2021. All patients were discharged within 48 h and no major complications were observed within 3 months. All patients had unmeasurable PSA (< 0.1 ng/ml) at follow-up 6 months after surgery. One patient with longer follow-up than 6 months experienced biochemical recurrence. At 3-months follow-up all patients reported considerable incontinence, at 6-month follow-up, pad usage decreased to 1 or 2 pads daily. Based on our initial results, the idea to introduce sRARP as a nationwide option remains and further patients will be included to establish the true role of sRARP in patients with recurrence after primary radiotherapy for PCa.
Study of microRNA expression in Salmonella Typhimurium-infected porcine ileum reveals miR-194a-5p as an important regulator of the TLR4-mediated inflammatory response
Authors: Herrera-Uribe Juber , Zaldívar-López Sara , Aguilar Carmen , Entrenas-García Carmen , Bautista Rocío , Claros M. Gonzalo , Garrido Juan J.
Published: May 2022

Infection with Salmonella Typhimurium (S. Typhimurium) is a common cause of food-borne zoonosis leading to acute gastroenteritis in humans and pigs, causing economic losses to producers and farmers, and generating a food security risk. In a previous study, we demonstrated that S. Typhimurium infection produces a severe transcriptional activation of inflammatory processes in ileum. However, little is known regarding how microRNAs regulate this response during infection. Here, small RNA sequencing was used to identify 28 miRNAs differentially expressed (DE) in ileum of S. Typhimurium-infected pigs, which potentially regulate 14 target genes involved in immune system processes such as regulation of cytokine production, monocyte chemotaxis, or cellular response to interferon gamma. Using in vitro functional and gain/loss of function (mimics/CRISPR-Cas system) approaches, we show that porcine miR-194a-5p (homologous to human miR-194-5p) regulates TLR4 gene expression, an important molecule involved in pathogen virulence, recognition and activation of innate immunity in Salmonella infection.
Usefulness of lung ultrasound for early detection of hospital-acquired pneumonia in cardiac critically ill patients on venoarterial extracorporeal membrane oxygenation
Authors: Pasqueron Jean , Dureau Pauline , Arcile Gauthier , Duceau Baptiste , Hariri Geoffroy , Lepère Victoria , Lebreton Guillaume , Rouby Jean-Jacques , Bouglé Adrien
Published: May 2022

Background

Hospital-acquired pneumonia (HAP) is the most common and severe complication in patients treated with venoarterial extracorporeal membrane oxygenation (VA ECMO) and its diagnosis remains challenging. Nothing is known about the usefulness of lung ultrasound (LUS) in early detection of HAP in patients treated with VA ECMO. Also, LUS and chest radiography were performed when HAP was suspected in cardiac critically ill adult VA ECMO presenting with acute respiratory failure. The sonographic features of HAP in VA ECMO patients were determined and we assessed the performance of the lung ultrasound simplified clinical pulmonary score (LUS-sCPIS), the sCPIS and bioclinical parameters or chest radiography alone for early diagnosis of HAP.

Results

We included 70 patients, of which 44 (63%) were independently diagnosed with HAP. LUS examination revealed that color Doppler intrapulmonary flow (P = 0.0000043) and dynamic air bronchogram (P = 0.00024) were the most frequent HAP-related signs. The LUS-sCPIS (area under the curve = 0.77) yielded significantly better results than the sCPIS (area under the curve = 0.65; P = 0.004), while leukocyte count, temperature and chest radiography were not discriminating for HAP diagnosis.

Discussion

Diagnosis of HAP is a daily challenge for the clinician managing patients on venoarterial ECMO. Lung ultrasound can be a valuable tool as the initial imaging modality for the diagnosis of pneumonia. Color Doppler intrapulmonary flow and dynamic air bronchogram appear to be particularly insightful for the diagnosis of HAP.
Presence of comorbidities alters management and worsens outcome of patients with acute respiratory distress syndrome: insights from the LUNG SAFE study
Authors: Rezoagli Emanuele , McNicholas Bairbre A. , Madotto Fabiana , Pham Tài , Bellani Giacomo , Laffey John G. ,   the LUNG SAFE Investigators, the ESICM Trials Group
Published: May 2022

Background

The impact of underlying comorbidities on the clinical presentation, management and outcomes in patients with ARDS is poorly understood and deserves further investigation.

Objectives

We examined these issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study.

Methods

In this secondary analysis of the patient cohort enrolled in the LUNG SAFE study, our primary objective was to determine the frequency, and impact of comorbidities on the management and ICU survival of patients with ARDS. Secondary outcomes relating to comorbidities included their impact on ventilatory management, the development of organ failures, and on end-of-life care.

Results

Of 2813 patients in the study population, 1692 (60%) had 1 or more comorbidities, of whom 631 (22.4%) had chronic respiratory impairment, 290 (10.3%) had congestive heart failure, 286 (10.2%) had chronic renal failure, 112 (4%) had chronic liver failure, 584 (20.8%) had immune incompetence, and 613 (21.8%) had diabetes. Multiple comorbidities were frequently present, with 423 (25%) having 2 and 182 (11%) having at least 3 or more comorbidities. The use of invasive ventilation (1379 versus 998, 82 versus 89%), neuromuscular blockade (301 versus 249, 18 versus 22%), prone positioning (97 versus 104, 6 versus 9%) and ECMO (32 versus 46, 2 versus 4%) were each significantly reduced in patients with comorbidities as compared to patients with no comorbidity (1692 versus 1121, 60 versus 40%). ICU mortality increased from 27% (n = 303) in patients with no comorbidity to 39% (n = 661) in patients with any comorbidity. Congestive heart failure, chronic liver failure and immune incompetence were each independently associated with increased ICU mortality. Chronic liver failure and immune incompetence were independently associated with more decisions to limitation of life supporting measures.

Conclusions

Most patients with ARDS have significant comorbidities, they receive less aggressive care, and have worse outcomes. Enhancing the care of these patients must be a priority for future clinical studies.

Trial registration LUNG-SAFE is registered with ClinicalTrials.gov, number NCT02010073.
Rampant Smoothing (RTS) Algorithm: an optimized consensus mechanism for private Blockchain enabled technologies
Authors: Tariq Usman
Published: May 2022

Blockchain is a distributed database method of storing electronic information in digital form that makes it challenging to transform, hack, or rogue the system. Each time a new operation transpires on the Blockchain, an irreversible information of that transaction is buffered in all connected ledgers. Each distributed ledger is programmable, immutable and timestamped. This paper follows an immutable policy to ensure chronological trust-administration, security and privacy to resolve anomalies within linearly stored blocks. To prove the validity of submitted data, a consensus mechanism is required, which was attained by implementing a novel ‘Rampant Smoothing Algorithm’ that was encoded using Solidity (i.e., aimed at developing smart contracts). Experimental policies were aligned with Good Clinical Data Management Practices that portrayed effective ‘smart contract modeling’ to demonstrate resistance against majority consensus attacks by harnessing the core feature of ‘privacy decentralization’. During implementation of Blockchain network, an interconnected system of six hundred nodes (i.e., data points) were gradually configured.
Kin recognition benefits clonal offspring performance of historically grazed Leymus chinensis: insights for grassland management
Authors: Zhang Zhen , Li Xiliang , Duan Junjie , Sun Juan
Published: May 2022

Background

Individual plants can identify their neighbors and adjust their biomass investment to avoid competing with their relatives or jointly cope with external stresses. Maternal effects can improve their offspring adaptability under external stresses. However, how grazing-induced maternal effects influence plant kin interactions remain unknown.

Methods

Clonal offspring of Leymus chinensis grown under multi-year grazing and non-grazing conditions were used for this study. A greenhouse experiment was conducted to evaluate the performance of focal plants in the presence of kin and stranger neighbors, with the aim of analyzing the interaction between maternal effect and kin relatedness.

Results

Kin relatedness of neighboring plants affected the biomass production and allocation of focal plants, demonstrating the presence of kin recognition in L. chinensis. Moreover, grazing-induced maternal effects significantly enhanced kin recognition in the species. Consequently, the presence of stranger neighbors significantly improved the growth potential of grazed offspring. Specifically, the total biomass of clonal offspring increased by 73.1% compared to the kin group, potentially buffering grazing-induced plant productivity declines.

Conclusions

This study shows that historical grazing enhances kin recognition in L. chinensis. Thus, introducing multi-genotypic plants can increase the productivity of grasslands. The findings of this study enhance our understanding of intraspecific plant–plant interactions in clonal species and provide new insights into sustainable grassland management.
Negative mood induction effects on problem-solving task in women with eating disorders: a multi-method examination
Authors: French Elan N. , Eneva Kalina , Arlt Jean M. , Yiu Angelina , Chen Eunice Y.
Published: May 2022

Background

The effects of negative affect on problem-solving and its psychophysiological correlates are poorly understood in eating disorder populations.

Methods

This study examined respiratory sinus arrhythmia (RSA) and skin conductance responses of women with Binge Eating Disorder (BED: n = 56), Anorexia Nervosa (AN: n = 12), Bulimia Nervosa (BN: n = 32), and 24 healthy controls (HCs) at baseline, and then during: a negative mood induction task, an adapted Means Ends Problem-Solving (MEPS) task, and recovery. The MEPS task included four interpersonal scenarios: (1) binge-eating as a solution to stress, (2) job loss, (3) rejection by friends, and (4) by a significant other.

Results

We found that individuals with eating disorders reported less positive mood than HCs and individuals with BN and BED reported more negative mood and greater urges to binge than HCs. After a negative mood induction, women with BED provided significantly less effective problem-solving strategies compared to HCs and women with BN for the binge-eating MEPS scenario. Relative to baseline and the negative mood induction, all participants exhibited significantly higher skin conductance measures throughout the MEPS scenarios and recovery. BED showed significantly lower respiratory sinus arrhythmia (RSA) levels than individuals with BN and HCs throughout the protocol.

Conclusions

The multimethod findings suggest individuals with BED are likely to have disorder-specific problem-solving difficulties after a negative mood induction.
Factors associated with the improvement of the empathy levels among clinical-year medical students in Southern Thailand: a university-based cross-sectional study
Authors: Sathaporn Katti , Pitanupong Jarurin
Published: May 2022

Background

Empathy is one of the core medical professionalisms that distress, burnout, and lack of personal well-being is also recognized as an important influencer on lower empathy levels. Therefore, this study aimed to explore the mental health, burnout, and factors associated with the empathy levels among Thai, clinical-year medical students.

Methods

This cross-sectional study surveyed all fourth-to sixth-year medical students at the Faculty of Medicine, Prince of Songkla University, in Thailand; at the end of the 2020 academic year. The questionnaires utilized were: (1) The personal and demographic information questionnaire, (2) The Toronto Empathy Questionnaire, (3) Thai Mental Health Indicator-15, and (4) The Maslach Burnout Inventory; Thai version. All data were analyzed using descriptive statistics, and factors associated with empathy levels were analyzed via the chi-square test and logistic regressions.

Results

There were 466 participants, with a response rate of 91.5%. The majority were female (56.2%), and reported a below-average level of empathy (57.1%); with a median score (IQR) of 44 (40–48). The gender proportion of a below-average empathy level among male and female participants was 66.3% and 50.4%, respectively. Of the participants, 29.6% had poor mental health, 63.5% and 39.7% reported a high level of emotional exhaustion and depersonalization scores; even though most of them (96.6%) perceived having a high level of personal accomplishment. Multivariate analysis indicated that females, higher mental health, and a low level of depersonalization were statistically significant protective factors, which improved the empathy levels.

Conclusions

More than half of the clinical-year medical students reported below-average empathy levels. Female gender, better mental health, and a low level of depersonalization were related to the improvement of the empathy levels. Therefore, medical educators should emphasize the importance of focusing supporting students, of all genders and in regards to all stages of medical education, to increase their levels of empathy, to promote individual well-being, and to effectively prevent the phenomenon of student ‘burnout’.
Evaluation of two complementary modeling approaches for fiber-reinforced soft actuators
Authors: Habibian Soheil , Wheatley Benjamin B. , Bae Suehye , Shin Joon , Buffinton Keith W.
Published: May 2022

Although robots are increasingly found in a wide range of applications, their use in proximity to humans is still fraught with challenges, primarily due to safety concerns. Roboticists have been seeking to address this situation in recent years through the use of soft robots. Unfortunately, identifying appropriate models for the complete analysis and investigation of soft robots for design and control purposes can be problematic. This paper seeks to address this challenge by proposing two complementary modeling techniques for a particular type of soft robotic actuator known as a Fiber-Reinforced Elastomeric Enclosure (FREE). We propose that researchers can leverage multiple models to fill gaps in the understanding of the behavior of soft robots. We present and evaluate both a dynamic, lumped-parameter model and a finite element model to extend understanding of the practicability of FREEs in soft robotic applications. The results of experimental simulations using a lumped-parameter model show that at low pressures FREE winding angle and radius change no more than$$2\%$$2%. This observation provided confidence that a linearized, dynamic, lumped-mass model could be successfully used for FREE controller development. Results with the lumped-parameter model demonstrate that it predicts the actual rotational motion of a FREE with at most$$4\%$$4%error when a closed-loop controller is embedded in the system. Additionally, finite element analysis was used to study FREE design parameters as well as the workspace achieved with a module comprised of multiple FREEs. Our finite element results indicate that variations in the material properties of the elastic enclosure of a FREE are more significant than variations in fiber properties (primarily because the fibers are essentially inextensible in comparison to the elastic enclosure). Our finite element analysis confirms the results obtained by previous researchers for the impact of variations in winding angle on FREE rotation, and we extend these results to include an analysis of the effect of winding angle on FREE force and moment generation. Finally, finite element results show that a$$30^{\circ }$$30∘difference in winding angle dramatically alters the shape of the workspace generated by four FREEs assembled into a module. Concludingly, comments are made about the relative advantages and limitations of lumped-parameter and finite element models of FREEs and FREE modules in providing useful insights into their behavior.
A mixed-methods approach to understanding the perspectives, experiences, and attitudes of a culturally tailored cognitive behavioral therapy/motivational interviewing intervention for African American patients with type 2 diabetes: a randomized parallel design pilot study
Authors: Cornely Ronald M. , Subramanya Vinita , Owen Ashley , McGee Robin E. , Kulshreshtha Ambar
Published: May 2022

Background

African American (AA) adults are 60% more likely to be diagnosed with diabetes mellitus (DM) and experience more complications than non-Hispanic White adults. Cognitive behavioral therapy (CBT) has shown to be an effective modality for helping patients improve health behaviors and regulate emotional states. Motivational interviewing (MI) addresses participant engagement and motivation. Therefore, MI was combined with CBT as an approach to the process of learning using CBT skills to promote healthy lifestyle choices. We aimed to assess the effects of a culturally tailored CBT/MI intervention on glycemic control in AA participants and understand their perspectives, attitudes, and experiences while participating in this intervention.

Methods

Using a randomized, parallel design pilot study (web-based group vs in-person group), 20 participants aged ≥ 18 years, identifying as AA and having a glycosylated hemoglobin (HbA1c) > 8%, were recruited. A CBT/MI intervention was administered in six sessions over 3 months. Participants completed baseline and follow-up assessments on measures for diabetes control (HbA1c), self-efficacy, generalized anxiety, depression, perceived stress, health-related quality of life, and cognitive ability. Post-CBT/MI intervention focus groups were conducted to determine patient perspectives regarding the intervention.

Results

Fourteen participants completed the study, their mean HbA1c improved from 10.0 to 8.9% (t(26) = 0.5, p-value = 0.06). The Diabetes Distress Scale demonstrated decreased distress overall (t(26) = 2.6; p-value = 0.02). The Generalized Anxiety Disorder Scale demonstrated decreased generalized anxiety for all participants (t(26) = 2.2; p = 0.04). Themes identified in focus groups included (1) intervention group social support through information sharing, (2) mental health and personal identities in diabetes understanding and management, and (3) receptivity to CBT/MI intervention positively impacts self-efficacy through improved health literacy.

Conclusion

This group-based, culturally tailored CBT/MI intervention for type 2 DM care was positively received by AA participants and helped improve diabetes control, as demonstrated by the change in HbA1c. There were additional benefits of social support through group interactions and a stronger sense of self-efficacy due to health education. A comprehensive treatment plan using a CBT/MI intervention may be useful in promoting healthy diabetes self-management.

Trial registration

ClinicalTrials.gov, NCT03562767. Registered on 19 June 2018
Enhancing the contribution of urban living labs to sustainability transformations: towards a meta-lab approach
Authors: Scholl Christian , de Kraker Joop , Dijk Marc
Published: May 2022

The contribution of the first generation of urban living labs (ULLs) to system-wide sustainability transformations is thus far less than expected. A possible explanation for this can be found in the focus of most ULLs on local, highly contextualized knowledge, and a missing link to system-wide transformations through diffusion and upscaling beyond the geographic boundaries of the lab. Meta-learning, i.e., learning across multiple, distributed experiments, through networked ULLs seems to offer a way forward. However, the literature on city networks shows that meta-learning cannot be effectively facilitated in horizontal networks without a learning infrastructure. To address this shortcoming and inspire a second generation of ULLs, this Perspective paper outlines a meta-lab approach actively facilitating the contribution of local living labs to wider sustainability transformations. We see a meta-lab as a transurban multi-actor network to connect and, where possible, align the learning processes across thematically related ULLs in different urban contexts through a central learning agenda. The meta-lab approach respects and supports local learning agendas and their focus on local solutions for local problems, while acknowledging and utilizing the potential of local experiments to contribute to a central learning agenda. Our paper argues that a meta-lab approach can act as a catalyst of learning in two important ways: (1) by accelerating local experimentation and learning processes by feeding them with lessons from other locations; and (2) by facilitating a more focused – local and transurban – learning process through a shared learning agenda. The meta-lab approach thus stimulates urban sustainability transformations by supporting faster, more focused and wider learning about effective innovations. We conclude this paper by outlining how common pitfalls in transurban learning can be avoided by a careful design of the meta-lab, or by meeting certain conditions when implementing this design.
Takayasu arteritis with congestive heart failure in 26-year-old male: a case report
Authors: Suryono Suryono , Wulandari Pipiet , Ariyanti Dwi , Maulana Aditha Satria , Sembodo R. Handi , Junior Narendra Wahyu , Saputra Antonius Dwi
Published: May 2022

Background

Takayasu arteritis (TA) is included in large vessel vasculitis with unknown aetiopathogenesis. TA is one of the rare diseases with a predilection for young women. The diagnosis of TA is difficult due to variation in clinical presentations and non-specific initial symptoms. This case demonstrates rare TA in a young male with congestive heart failure as the predominant manifestation.

Case presentation

We report a 26-year-old male presented with severe dyspnea, palpitation, orthopnea, paroxysmal nocturnal dyspnea, and claudication in the left arm. Four limbs blood pressure discrepancy was present. Chest X-ray showed cardiomegaly with calcification aortic arch and pulmonary edema. Echocardiography revealed that left ventricular ejection fraction decreased with severe aortic and mitral valve regurgitation. Computed tomography angiography showed stenosis of the left common carotid artery and total occlusion of the left subclavian artery with collateral artery. There was vascular thickness and calcification from the peri-aortic valve, ascending aorta, aortic arch, and thoracic descending aorta until abdominal aorta with high-grade stenosis on the inferior side of the renal artery branching accompanied by a post-stenotic dilatation.

Conclusions

This patient’s heart failure was precipitated by secondary hypertension and aortic regurgitation caused by vasculitis of TA. In general, there is no difference in the management of congestive heart failure in patients with TA. Optimized pharmacology therapy with combination steroid and methotrexate successfully inducing remission of TA after 3-months follow-up.
Probabilistic analysis of climate change impact on chloride-induced deterioration of reinforced concrete considering Nordic climate
Authors: Nasr Amro , Honfi Dániel , Larsson Ivanov Oskar
Published: May 2022

The impact of climate change on the deterioration of reinforced concrete elements have been frequently highlighted as worthy of investigation. This article addresses this important issue by presenting a time-variant reliability analysis to assess the effect of climate change on four limit states; the probabilities of corrosion initiation, crack initiation, severe cracking, and failure of a simply supported beam built in 2020 and exposed to chloride-induced corrosion. The historical and future climate conditions (as projected by three different emission scenarios) for different climate zones in Sweden are considered, including subarctic conditions where the impact of climate change may lead to large increases in temperature. The probabilities of all limit states are found to be: 1) higher for scenarios with higher GHG emissions and 2) higher for southern than for northern climate zones. However, the end-of-century impact of climate change on the probabilities of reaching the different limit states is found to be higher for northern than for southern climate zones. At 2100, the impact of climate change on the probability of failure can reach up to an increase of 123% for the northernmost zone. It is also noted that the end-of-century impact on the probability of failure is significantly higher (ranging from 3.5–4.9 times higher) than on the other limit states in all climate scenarios.
Diastolic Pressure and ACR Are Modifiable Risk Factors of Arterial Stiffness in T2DM Without Cardiovascular Disease
Authors: Leto Gateano , Tartaglione Lida , Rotondi Silverio , Pasquali Marzia , Maddaloni Ernesto , Mignogna Carmen , D’Onofrio Luca , Zampetti Simona , Carlone Angela , Muci Maria Luisa , Mastroluca Daniela , Fassino Valeria , Buzzetti Raffaella , Mazzaferro Sandro
Published: May 2022

Aim

To evaluate early, before the onset of cardiovascular events and of chronic renal insufficiency, the association between chronic kidney disease (CKD)-mineral bone disorder (MBD) biomarkers and vascular stiffness [Cardio Ankle Vascular Index (CAVI)] in the course of type 2 diabetes (T2DM).

Method

We evaluated 174 T2DM patients [median age 56 years; male/female (M/F) 100/74] with diabetes duration < 10 years and without decreased estimated glomerular filtration rate (eGFR; ≥60 mL/min/1.73 m2) or macrovascular complications. Thirty-four age-matched healthy subjects [M/F 13/21; age 53.5 (50.0-57.7) years; eGFR 107.5 (97.0-119.7) mL/ min1.73 m2] served as local reference control for CAVI (pathological: ≥8) and the novel CKD-MBD biomarkers.

Results

Albumin-to-creatinine ratio (ACR) averaged 8.5 mg/g (5.6-17.2) with 12.6% of the patients showing pathologic values, indicative of incipient diabetic nephropathy. Serum parathyroid hormone, fibroblast growth factor 23, and sclerostin were higher while 1,25-dihydroxyvitamin D and Klotho were lower than a control group. CAVI was normal (<8) in only 54% and correlated positively with age (P < 0.001), hemoglobin 1A1c (P = 0.036), and systolic (P = 0.021) and diastolic blood pressure (DBP) (P = 0.001) and negatively correlated with 25-hydroxyvitamin D (P = 0.046). In multivariate analysis, age, DBP, ACR, and serum Klotho were independent positive predictors of CAVI.

Conclusion

In the absence of overt cardiovascular disease and of chronic renal insufficiency, CAVI is frequently pathologic in T2DM. DBP and ACR are modifiable risk factors of vascular stiffness in T2DM, thus warranting optimal assessment.
NRF2 Serves a Critical Role in Regulation of Immune Checkpoint Proteins (ICPs) During Trophoblast Differentiation
Authors: Hong Kyunghee , Muralimanoharan Sribalasubashini , Kwak Youn-Tae , Mendelson Carole R
Published: May 2022

Using cultured human trophoblast stem cells (hTSCs), mid-gestation human trophoblasts in primary culture, and gene-targeted mice, we tested the hypothesis that the multinucleated syncytiotrophoblast (SynT) serves a critical role in pregnancy maintenance through production of key immune modulators/checkpoint proteins (ICPs) under control of the O2-regulated transcription factor, NRF2/NFE2L2. These ICPs potentially act at the maternal-fetal interface to protect the hemiallogeneic fetus from rejection by the maternal immune system. Using cultured hTSCs, we observed that several ICPs involved in the induction and maintenance of immune tolerance were markedly upregulated during differentiation of cytotrophoblasts (CytTs) to SynT. These included HMOX1, kynurenine receptor, aryl hydrocarbon receptor, PD-L1, and GDF15. Intriguingly, NRF2, C/EBPβ, and PPARγ were markedly induced when CytTs fused to form SynT in a 20% O2 environment. Notably, when hTSCs were cultured in a hypoxic (2% O2) environment, SynT fusion and the differentiation-associated induction of NRF2, C/EBPβ, aromatase (CYP19A1; SynT differentiation marker), and ICPs were blocked. NRF2 knockdown also prevented induction of aromatase, C/EBPβ and the previously mentioned ICPs. Chromatin immunoprecipitation-quantitative PCR revealed that temporal induction of the ICPs in hTSCs and mid-gestation human trophoblasts cultured in 20% O2 was associated with increased binding of endogenous NRF2 to putative response elements within their promoters. Moreover, placentas of 12.5 days postcoitum mice with a global Nrf2 knockout manifested decreased mRNA expression of C/ebpβ, Pparγ, Hmox1, aryl hydrocarbon receptor, and Nqo1, another direct downstream target of Nrf2, compared with wild-type mice. Collectively, these compelling findings suggest that O2-regulated NRF2 serves as a key regulator of ICP expression during SynT differentiation.
The β-Hydroxybutyrate-GPR109A Receptor Regulates Fasting-induced Plasticity in the Mouse Adrenal Medulla
Authors: Gupta Rajesh , Wang Manqi , Ma Yunbing , Offermanns Stefan , Whim Matthew D
Published: May 2022

During fasting, increased sympathoadrenal activity leads to epinephrine release and multiple forms of plasticity within the adrenal medulla including an increase in the strength of the preganglionic → chromaffin cell synapse and elevated levels of agouti-related peptide (AgRP), a peptidergic cotransmitter in chromaffin cells. Although these changes contribute to the sympathetic response, how fasting evokes this plasticity is not known. Here we report these effects involve activation of GPR109A (HCAR2). The endogenous agonist of this G protein–coupled receptor is β-hydroxybutyrate, a ketone body whose levels rise during fasting. In wild-type animals, 24-hour fasting increased AgRP-ir in adrenal chromaffin cells but this effect was absent in GPR109A knockout mice. GPR109A agonists increased AgRP-ir in isolated chromaffin cells through a GPR109A- and pertussis toxin–sensitive pathway. Incubation of adrenal slices in nicotinic acid, a GPR109A agonist, mimicked the fasting-induced increase in the strength of the preganglionic → chromaffin cell synapse. Finally, reverse transcription polymerase chain reaction experiments confirmed the mouse adrenal medulla contains GPR109A messenger RNA. These results are consistent with the activation of a GPR109A signaling pathway located within the adrenal gland. Because fasting evokes epinephrine release, which stimulates lipolysis and the production of β-hydroxybutyrate, our results indicate that chromaffin cells are components of an autonomic-adipose-hepatic feedback circuit. Coupling a change in adrenal physiology to a metabolite whose levels rise during fasting is presumably an efficient way to coordinate the homeostatic response to food deprivation.
Focus of Professional Development on Teachers’ Felt Needs: A Paradigm Shift in Policy
Authors: Sogunro Olusegun Agboola
Published: May 2022

A professional development that is often mandated is exclusionary, less motivating, and provides teachers with little or no improvement in their professional practice as well as student achievement. This necessitates a fundamental change in policy from prescribing professional development to addressing teachers’ self-identified felt needs. Hitherto, teachers are generally disenfranchised from specifying their felt needs for development, thus they feel uninterested, or enthusiastic to attend professional development programs that are prescribed for them by school leaders. When they do or are compelled to attend, they tend to be less attentive and are often indulged in reading newspapers, grading students’ test papers, texting, playing video games, or simply doing something unrelated to the professional development. This practice stifles teachers’ professional growth and student learning, hence it must not be allowed to continue unabated. Through a qualitative case study research design, using survey, interviews, and focus groups, this research brought to the fore, the debilitating effects of the current practice. Analysis of data yielded four major themes: choice, motivation, effectiveness, and satisfaction. The study proposed a paradigm shift in policy from mandating to granting teachers the autonomy to identify their own real or felt needs for professional development. Implications for practice, leadership, policy, and further research were also discussed.
Bird diversity in three Ficus species in the Kuningan Lowland Forest, West Java, Indonesia
Authors: HENDRAYANA YAYAN , SUDIANA EMING , ADHYA ILHAM , ISMAIL AGUS YADI
Published: May 2022

Abstract. Hendrayana Y, Sudiana E, Adhya I, Ismail AY. 2022. Bird diversity in three Ficus species in the Kuningan Lowland Forest, West Java, Indonesia. Biodiversitas 23: 2255-2261. Frugivorous birds are an important group in tropical forests, as they promote a wide diversity of plant species and animal communities via tree seed dispersal. The presence of these avifauna depends on food, such as fruits provided by Ficus spp. This study examined the diversity of birds in three species of fruiting Ficus trees located in a secondary, natural lowland forest in Mount Tilu, Kuningan, West Java, Indonesia. Bird numbers in Ficus benjamina L., Ficus sinuata Thunb., and Ficus kurzii King were determined using the concentration count method. The data were analyzed using the Shannon–Wiener diversity index (H?), evenness index (E), and dominance index (Simpson’s D). The results showed diversity index values of H´ = 2.255, E = 0.353, and D = 0.8342 for F. benjamina; H? = 2.305, E = 0.5014, and D = 0.8376 for F. sinuata; and H? = 2.305, E = 0.5014, and D = 0.8694 for F. kurzii. The bird species with the highest number of individuals was Pycnonotus simplex Lesson, 1839 (378 individuals, 20.8%), followed by Megalaima australis (Horsfield, 1821) (320, 17.7%), Pericrocotus flammeus (J.R.Forster, 1781) (203, 11.2%), Dicaeum trigonostigma (Scopoli, 1786) (116, 6.4%) and Pycnonotus melanicterus (Gmelin, 1789) (109, 6,01%). By (Horsfield, 1821) knowing the important role of ficus trees as a source of food for various species of birds, this information becomes important and can be used by forest managers to support biodiversity conservation, especially bird conservation.