bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospital and Operator Variation in Cardiac Rehabilitation Referral and Participation After Percutaneous Coronary Intervention: Insights From Blue Cross Blue Shield of Michigan Cardiovascular Consortium
Authors: Sukul Devraj , Seth Milan , Thompson Michael P. , Keteyian Steven J. , Boyden Thomas F. , Syrjamaki John D. , Yaser Jessica , Likosky Donald S. , Gurm Hitinder S.
Published: November 2021

Background:

Despite its established benefit and strong endorsement in international guidelines, cardiac rehabilitation (CR) use remains low. Identifying determinants of CR referral and use may help develop targeted policies and quality improvement efforts. We evaluated the variation in CR referral and use across percutaneous coronary intervention (PCI) hospitals and operators.

Methods:

We performed a retrospective observational cohort study of all patients who underwent PCI at 48 nonfederal Michigan hospitals between January 1, 2012 and March 31, 2018 and who had their PCI clinical registry record linked to administrative claims data. The primary outcomes included in-hospital CR referral and CR participation, defined as at least one outpatient CR visit within 90 days of discharge. Bayesian hierarchical regression models were fit to evaluate the association between PCI hospital and operator with CR referral and use after adjusting for patient characteristics.

Results:

Among 54 217 patients who underwent PCI, 76.3% received an in-hospital referral for CR, and 27.1% attended CR within 90 days after discharge. There was significant hospital and operator level variation in in-hospital CR referral with median odds ratios of 3.88 (95% credible interval [CI], 3.06–5.42) and 1.64 (95% CI, 1.55–1.75), respectively, and in CR participation with median odds ratios of 1.83 (95% CI, 1.63–2.15) and 1.40 (95% CI, 1.35–1.47), respectively. In-hospital CR referral was significantly associated with an increased likelihood of CR participation (adjusted odds ratio, 1.75 [95% CI, 1.52–2.01]), and this association varied by treating PCI hospital (odds ratio range, 0.92–3.75) and operator (odds ratio range, 1.26–2.82).

Conclusions:

In-hospital CR referral and 90-day CR use after PCI varied significantly by hospital and operator. The association of in-hospital CR referral with downstream CR use also varied across hospitals and less so across operators suggesting that specific hospitals and operators may more effectively translate CR referrals into downstream use. Understanding the factors that explain this variation will be critical to developing strategies to improve CR participation overall.
Racializing a New Nation: German Coloniality and Anthropology in Maharashtra, India
Authors: Barbosa Thiago P.
Published: November 2021

This paper deals with the transnationalism of racial anthropological frameworks and its role in the understanding of human difference during India’s decolonization and nation-building. With attention to the circulation of scientific objects, I focus on the practices and articulations of Irawati Karve (1905–1970), an Indian anthropologist with a transnational scientific trajectory and nationalistic political engagements. I argue that Karve’s adaptation of an internationally validated German racial approach to study caste, ethnic and religious groups contributed to the further racialization of these categories as well as to the racialization of nationalistic projects in Maharashtra and India. I conclude with a reflection on the transnationalization of the coloniality of racialization.
Populism and ‘People’: Precarities and Polarizations as a Challenge and Task for a Public Theology
Authors: von Sinner Rudolf , Gabatz Celso
Published: November 2021

Two main elements pervade the argument. First, we argue that both ‘populism” and ‘the people’ are precarious concepts that can neither easily be defined, nor easily be claimed by any representative. We hold this to be true both in political and in theological terms, empirically referring to the civil and the religious population and their construction as ‘a people’, respectively. Second, in view of a common disregard for the people, namely as plebs, we reaffirm the importance of participatory popular subjects as a necessary part of both the political system and Christian communities. This bibliographical and conceptual essay contextualizes and explains the precariousness of realities and concepts, then analyses the concepts of populism and ‘people’. It seeks to deepen the discussion of populism by means of dialogue with Ernesto Laclau and Chantal Mouffe, and then through a theological reflection by way of a public theology.
‘The Palestinian Talmud Was Not Tampered with by the Pens of Emenders’: Clarifying a Textual Version Rule
Authors: Yahalom Shalem
Published: November 2021

This article will demonstrate that Nahmanides’s statement regarding the unamended Palestinian Talmud relates to the sources cited in that work. The advantage of the Palestinian Talmud stemmed from the neglect suffered by that work which enabled it to escape the hegemony of the Babylonian Talmud whose textual versions were imposed on all other Oral Torah works. Of course, it also stemmed from the proximity of the Palestinian Talmud in both time and place to the Mishnah and Tosefta. This advantage lent great significance to the exegesis of these sources in the Palestinian Talmud.
Two new Diptacus and one new Trimeroptes species (Acari: Diptilomiopidae) from China
Authors: TAN MENG-CHAO , LV AN-KANG , RUAN HONG-YAN , ZHAO PING
Published: November 2021

Two new Diptacus species and one new Trimeroptes species (Acari: Eriophyoidea: Diptilomiopidae) are described and illustrated from China: Diptacus suichangensis sp. nov. on Aralia chinensis L. (Araliaceae) and Diptacus pyracanthae sp. nov. on Pyracantha fortuneana (Maxim.) Li (Rosaceae), and Trimeroptes longlinensis sp. nov. on Carpinus sp. (Betulaceae). These new species were found to be vagrant on the lower surface of their associated plants leaves, albeit with no apparent damage observed.
New fossil giant lacewings from the Middle Jurassic Jiulongshan Formation of China (Neuroptera, Ithonidae)
Authors: XU YIFAN , ZHENG BINGYU , FANG HUI , SHIH CHUNGKUN , REN DONG , WANG YONGJIE
Published: November 2021

A new genus with a new species, Fuscopolystoechotes reticulatus Xu, Zheng, Shih & Wang, gen. et sp. nov., and a new species Lichenipolystoechotes fenestratus Xu, Fang, Shih & Wang, sp. nov. of Ithonidae, are described from the Middle Jurassic Jiulongshan Formation, Inner Mongolia, China. Both new species are assigned to Polystoechotes genus-group mainly based on the combination of following characters: the distinctly narrowed costal space in distal half, presence of recurrent humeral veinlet and ScA, absence of interlinked crossveins in between costal crossveins, converged ScP and RA and pectinately branched MA and MP in distal. But the new genus of Fuscopolystoechotes gen. nov. is differentiated from all other genera by a combination of characters, i.e., specialized markings on forewing; scp-ra crossveins absent; CuP with pectinate branches and crossveins in RP–A area complicated. These two new species with the remarkable markings in forewings are considered to be adapted for the particular Mesozoic environments for camouflage or mimicry.
Appendix 5
Authors: Grant Morag Josephine
Published: November 2021

This introduction poses the basic question that this book attempts to answer: How did an eighteenth-century Scots song, the words of which not even most Scots fully understand, become one of the most well-known songs in the world? This book argues that to answer this question, we need to investigate the social practices that have emerged around the song, and not just its distribution through media such as print, broadcasting and recording: these practices are, in particular, its use as a song of parting, as a song of New Year, and the tradition of singing it in a circle with joined, crossed hands. The introduction also outlines the approach taken to referencing and bibliography in this book, and acknowledges the significant support the author received in researching, writing and publishing it.
The Role of Latent Heating Anomalies in Exciting the Summertime Eurasian Circulation Trend Pattern and High Surface Temperature
Authors: Kim Dong Wan , Lee Sukyoung
Published: November 2021

Dynamical mechanisms for the summer Eurasian circulation trend pattern are investigated by analyzing reanalysis data and conducting numerical model simulations. The daily circulations that resemble the Eurasian circulation trend pattern are identified and categorized into two groups based on surface warming signal over central and eastern Europe. In the group with large warm anomaly, the upper-level circulation takes on a wave packet form over Eurasia, and there are enhanced latent heating anomalies centered over the North Sea and suppressed latent heating anomalies over the Caspian Sea. The numerical model calculations indicate that these latent heating anomalies can excite an upper-level circulation response that resembles the Eurasian circulation trend pattern. Additional analysis indicates that trends of these two latent heating centers contribute to the long-term circulation trend. In the weak warm anomaly group, the circulation pattern takes on a circumglobal teleconnection (CGT) pattern, and there is no heating signal that reinforces the circulation. These results indicate that not all CGT-like patterns excite temperature anomalies that are persistent and in phase with the trend pattern, and that quasi-stationary forcings, such as the latent heating anomalies, play an important role in driving the boreal summer circulation anomaly that accompanies the strong and persistent surface temperature signal.
Revisit of the Occurrence of the Kuroshio Large Meander South of Japan
Authors: Qiu Bo , Chen Shuiming
Published: November 2021

A unique characteristic by the Kuroshio off the southern coast of Japan is its bimodal path variations. In contrast to its straight path that follows the coastline, the Kuroshio takes a large meander (LM) path when its axis detours southward by as much as 300 km. Since 1950, eight Kuroshio LM events took place and their occurrences appeared random. By synthesizing available in situ/satellite observations and atmospheric reanalysis product, this study seeks to elucidate processes conducive for the LM occurrence. We find neither changes in the inflow Kuroshio transport from the East China Sea nor in the downstream Kuroshio Extension dynamic state are determinant factors. Instead, intense anticyclonic eddies with transport > 20 Sv (1 Sv ≡ 106 m3 s−1) emanated from the Subtropical Countercurrent (STCC) are found to play critical roles in interacting with Kuroshio path perturbations southeast of Kyushu that generate positive relative vorticities along the coast and lead the nascent path perturbation to form a LM. Occurrence of this intense cyclonic–anticyclonic eddy interaction is favored when surface wind forcing over the STCC is anticyclonic during the positive phasing of Pacific decadal oscillations (PDOs). Such wind forcing strengthens the meridional Ekman flux convergence and enhances eddy generation by the STCC, and seven of the past eight LM events are found to be preceded by 1–2 years by the persistent anticyclonic wind forcings over the STCC. Rather than a fully random phenomenon, we posit that the LM occurrence is regulated by regional wind forcing with a positive PDO imprint.
Parameter estimation of a susceptible–infected–recovered–dead computer worm model
Authors: Deng Yue , Pei Yongzhen , Li Changguo
Published: November 2021

Computer worms are serious threats to Internet security and have caused billions of dollars of economic losses during the past decades. In this study, we implemented a susceptible–infected–recovered–dead (SIRD) model of computer worms and analyzed the characteristics and mechanisms of worm transmission. We applied the ordinary differential equation model to simulate the transmission process of computer worms and estimated the unknown parameters of the SIRD model through the methods of least squares, Markov chain Monte Carlo, and ensemble Kalman filtering (ENKF). The results reveal that the proposed SIRD model is more accurate than the susceptible–exposed–infected–recovered–susceptible model with respect to parameter estimation.
Primary Inverted Papilloma of the Middle Ear
Authors: Blioskas Sarantis , Konstantinidis Iordanis , Antoniadis Ioannis , Kypriotou Anastasia , Hytiroglou Prodromos , Markou Konstantinos
Published: November 2021

Significance Statement: Primary middle ear inverted papilloma is an exceedingly rare finding posing a diagnostic challenge, as symptomatology often mimics common clinical entities like serous otitis media. Clinical and radiological findings are not specific, whilst high recurrence rates, local destruction, and potential malignant transformation constitute an overall demanding surgical challenge, requiring aggressive procedures. We report the case of a primary inverted papilloma of the middle ear, discussing diagnostic and therapeutic issues.
Tracing Long-term Value Change in (Energy) Technologies: Opportunities of Probabilistic Topic Models Using Large Data Sets
Authors: de Wildt T. E. , van de Poel I. R. , Chappin E. J. L.
Published: November 2021

We propose a new approach for tracing value change. Value change may lead to a mismatch between current value priorities in society and the values for which technologies were designed in the past, such as energy technologies based on fossil fuels, which were developed when sustainability was not considered a very important value. Better anticipating value change is essential to avoid a lack of social acceptance and moral acceptability of technologies. While value change can be studied historically and qualitatively, we propose a more quantitative approach that uses large text corpora. It uses probabilistic topic models, which allow us to trace (new) values that are (still) latent. We demonstrate the approach for five types of value change in technology. Our approach is useful for testing hypotheses about value change, such as verifying whether value change has occurred and identifying patterns of value change. The approach can be used to trace value change for various technologies and text corpora, including scientific articles, newspaper articles, and policy documents.
Investigation of the implementation of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward: A before-and-after pilot study
Authors: D’Souza Sarah , Godecke Erin , Ciccone Natalie , Hersh Deborah , Armstrong Elizabeth , Tucak Claire , Janssen Heidi
Published: November 2021

Objectives:

Develop and implement a Communication Enhanced Environment model and explore its effect on language activities for patients early after stroke.

Method and design:

Before-and-after pilot study.

Setting:

An acute/slow stream rehabilitation and a rehabilitation ward in a private hospital in Perth, Western Australia.

Participants:

Fourteen patients recruited within 21 days of stroke. Seven recruited during the before-phase (control group: patients with aphasia = 3, patients without aphasia = 4) and seven recruited in the after-phase (intervention group: patients with aphasia = 4, patients without aphasia = 3).

Intervention:

The intervention group exposed to a Communication Enhanced Environment model had access to equipment, resources, planned social activities and trained communication partners. Both groups received usual stroke care.

Data collection:

Hospital site champions monitored the availability of the intervention. Behavioural mapping completed during the first minute of each 5-minute interval over 12 hours (between 7 am and 7 pm) determined patient engagement in language activities.

Results:

Seventy-one percent of the Communication Enhanced Environment model was available to the intervention group who engaged in higher, but not significant (95% CI), levels of language activities (600 of 816 observation time points, 73%) than the control group (551 of 835 observation time points, 66%). Unforeseen reorganisation of the acute ward occurred during the study.

Conclusions:

Implementation of a Communication Enhanced Environment model was feasible in this specific setting and may potentially influence patients’ engagement in language activities. The unforeseen contextual challenges that occurred during the study period demonstrate the challenging nature of the hospital environment and will be useful in future research planning.
V. Gordon Childe and Arnold Hauser on the social origins of the artist
Authors: Berryman Jim
Published: November 2021

Vere Gordon Childe’s theory of craft specialisation was an important influence on Arnold Hauser’s book The Social History of Art, published in 1951. Childe’s Marxist interpretation of prehistory enabled Hauser to establish a material foundation for the occupation of the artist in Western art history. However, Hauser’s effort to construct a progressive basis for artistic labour was complicated by art’s ancient connections to religion and superstition. While the artist’s social position and class loyalties were ambiguous in Childe’s accounts of early civilisations, Hauser consigned artists to the lower echelons of society. This relegation did not imply that Hauser had a low regard for artistic skills. Quite the opposite, the artist’s inferior social status enabled Hauser to distance artists from the ruling class, and consequently, to separate artistic handiwork from the dominant ideology that works of art manifested.
The Impact of Physical Environment on the Cognitive Function of the Elderly: A Scoping Review of Cohort Studies
Authors: Kim Jihye , Lee Jiyeong , Park Jihye , Kim Hakseong , Yoo Ingyu
Published: November 2021

This review examined whether the physical environment can change the cognitive function of the elderly and categorized the specific environmental types. Four databases, CINAHL, Embase, PubMed, and PsycINFO, were searched for relevant literature published as of December 2020. The framework used was proposed by Arksey and O’Malley, which includes a 5-stage review process. A total of 12 studies were examined. The physical environments with similar characteristics, among all the environmental elements, were grouped together into 4 categories: residential density and road connectivity, limited living space, urban/rural, and care facilities. Residential density and road connectivity, limited living space, and care facilities were found to have a significant effect on the cognitive function of the elderly. However, there was no significant effect on the cognitive function of the elderly when comparing the urban and rural environments. Although studies on environments that affect the cognitive function of the elderly are still ongoing, the ones analyzing specific environments in detail are insufficient. With the increasing importance of the role played by the environment in the cognitive impairment of the elderly, detailed studies on specific environments among the various environmental factors surrounding the elderly, such as this study, should be conducted more actively.
COVID-19 outbreak and increased risk of amblyopia and epidemic myopia: Insights from EUROCOVCAT group
Authors: Toro Mario Damiano , Bremond-Gignac Dominique , Brézin Antoine Pierre , Cummings Arthur Bernard , Kemer Ozlem Evren , Kermani Omid , Malyugin Boris Edvard , Prieto Isabel , Teus Miguel Angel , Tognetto Daniele , Zweifel Sandrine , Rejdak Robert
Published: November 2021

The most common cause of vision impairment in children is amblyopia. It is defined as impaired visual acuity in one or both eyes that is present with no demonstrable abnormality of the visual pathway and is not immediately resolved by wearing glasses. After the World Health Organization (WHO) recognized COVID-19 as a global pandemic on March 11, 2020, widespread changes and restrictions to social and sanitary practices have presented significant issues in access to eye care during the COVID-19 pandemic. A reduction of more than 80% in pediatric eye care volume up to its total cessation has been observed in different departments. In this scenario, reduced or absent eyesight, due to delay in timely treatment of amblyopic conditions, could create major, long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities and the ability to access public services. Processes coming out of lockdown should be gradually easing restrictions giving priority to ophthalmology and eye care facilities so that amblyopia does not remain unattended and irreversible as in adults due to lack of timely treatments. If not reversible, this process could lead to a dramatic increase in disability and unsustainable social costs for many governments.
Influence of tomographic and biomechanical corneal indexes on myopic refractive surgery indications: A multicenter study
Authors: Duch Francesc , López-Marín Ignacio , Alonso-Aliste Federico , Hernández-Barahona-Campos Mariano , Manito Santiago C , Sánchez-Trancón Ángel , Cadarso Luís , Sánchez-González José-María , Fernández Joaquín
Published: November 2021

Purpose

To evaluate the influence of corneal tomographic and biomechanical indexes on the refractive technique indication.

Methods

A total of 251 eyes from 251 patients interested in refractive surgery were enrolled in this cross-sectional and multicenter study. Previous to the surgeon decision, a preoperative protocol was performed by refractive optometrists, containing four sections: refraction, biometry, corneal tomography and biomechanics. The refractive surgeons made a first decision based only on refraction, biometric and tomographic information. Biomechanical indexes were revealed, and refractive surgeons made a second indication. Additionally, for Laser-Assisted in-situ Keratomileusis cases, the percent tissue altered were calculated. Possible indications were no refractive surgery, photorefractive keratectomy, Laser-Assisted in-situ Keratomileusis or intraocular Collamer lens.

Results

After the first surgery indication, the distribution was photorefractive keratectomy (47.4%), Laser-Assisted in-situ Keratomileusis (48.2%) while intraocular Collamer lens achieved 2.8%. This proportion changed significantly after the second indication regarding corneal biomechanics and photorefractive keratectomy and Laser-Assisted in-situ Keratomileusis decreased by 24% while intraocular Collamer lens increased 19%. A total of 69 eyes changed the indication (27.5%) and 182 eyes (72.5%) remained unchanged. All indications changes were from photorefractive keratectomy or Laser-Assisted in-situ Keratomileusis to intraocular Collamer lens or no surgery. Indication changes to intraocular Collamer lens were observed in 49 eyes (71%). Tomographic, biomechanical indexes, ablation depth and percent tissue altered achieved statistically significant differences between eyes without and with indication changes (all, P < .01).

Conclusion

New corneal biomechanical indexes could change the indication decision regarding biometric and tomographic data alone. Intraocular Collamer len was the preferred indication for eyes at risk of ectasia or with subclinical keratoconus due to corneal biomechanical parameters.
Efficacy and safety of vitamin supplements with resveratrol in diabetic macular edema: Long-term results of a comparative study
Authors: Chatziralli Irini , Dimitriou Eleni , Chatzirallis Alexandros , Aissopou Evaggelia , Kazantzis Dimitrios , Theodossiadis George , Theodossiadis Panagiotis
Published: November 2021

Purpose

To investigate the adjunct efficacy and safety of vitamin supplements, including resveratrol, in patients with diabetic macular edema (DME) treated with intravitreal anti-vascular endothelial factor (anti-VEGF) agents.

Methods

Participants in this prospective study were 45 patients with DME, who were treated with either intravitreal anti-VEGF injections (n = 23, Group I) or with combination of intravitreal anti-VEGF injections and vitamin supplements, including resveratrol (n = 22, Group II). All patients underwent visual acuity measurement, slit-lamp examination and spectral domain-optical coherence tomography (SD-OCT) at baseline and monthly after the loading phase of three-monthly anti-VEGF injections, following a PRN protocol.

Results

There was a statistically significant improvement in visual acuity in both groups at month 12 compared to baseline, although the mean change in visual acuity did not differ between the two groups (p = 0.183). Accordingly, there was a statistically significant decrease in central retinal thickness in both groups at month 12 compared to baseline, while the mean difference in central retinal thickness was significantly greater in the “combination” group. The mean number of intravitreal anti-VEGF injection was less in Group II (6.45 ± 1.12 in Group II vs. 7.39 ± 1.31 in Group I, p = 0.018).

Conclusions

Vitamin supplements with resveratrol was found to be an effective adjunct to intravitreal anti-VEGF injections in patients with DME, offering better anatomic restoration with less injections at the 12-month follow-up.
Natural fibre composites – an alternative to plastics in the automotive industry: A review
Authors: Babu T. Narendiranath , Shyam Suraj , Kaul Shivam , Prabha D. Rama
Published: November 2021

Natural fibre composites are ideal material substitutes for combating the issues of pollution and non-biodegradability. Several industries, the automobile industry, in particular, have shown tremendous inclination towards the usage of natural fibre composites in their deliverables. Besides providing a wide array of useful properties, natural fibre composites have offered flexibility in terms of choosing various combinations of fibres and resins. Owing to this, this paper aims to collect data and categorize the natural fibre composites based on the types of treatments and properties they exhibit. Characterization was done by taking into consideration chemical and enzymatic treatments as well as tests such as the tensile, flexural, compressive, impact, shear and hardness. Based on the values obtained from the characterization, the paper suggests suitable and feasible natural fibre composites as biocompatible replacements to conventionally used materials in the automotive industry.
An investigation on the effect of nanoparticle reinforcement and weld surface shape on bending behavior of rotary friction-welded high-density polyethylene
Authors: Asghari Vahid , Kami Abdolvahed , Bagheri Abbasali
Published: November 2021

In this research, high-density polyethylene rods were joined together using rotary friction-welding. The effects of nanoparticle reinforcement and weld surface shape on the welded joint strength were investigated. To this aim, high-density polyethylene rods with a length of 50 mm and a diameter of 22 mm were machined, and three weld surface shapes, that is, flat, step, and conic shapes (on male and female counterparts), were created. The high-density polyethylene rods were rotary friction-welded with the addition of ZnO and SiO2 nanoparticles. The bending strength of rotary friction-welded rods was assessed by conduction of three-point bending tests. The results showed that both the weld surface shape and nanoparticles influence the bending strength of the welded joints. It was found that the step sample welds have higher bending strength (average bending depth and force of 6.27 mm and 2027.8 N, respectively). Furthermore, except for the case of flat samples, the addition of the reinforcement nanoparticles resulted in the improvement of the bending strength of the rotary friction-welded rods.
Effect of Strength Training on Jump-Landing Biomechanics in Adolescent Females
Authors: Herman Daniel C. , Pritchard Kimberly A. , Cosby Nicole L. , Selkow Noelle M.
Published: November 2021

Background:

Sex-based differences in neuromuscular characteristics relevant to anterior cruciate ligament (ACL) injury risk may arise as compensation for divergent strength development during puberty. Strength training during this period may prevent the development of these undesirable neuromuscular characteristics.

Hypothesis:

Strength-trained middle school girls will have improved jump-landing biomechanics compared with control participants.

Study Design:

Cohort study.

Level of Evidence:

Level 3.

Methods:

Maximum voluntary isometric contraction in hip extension and abduction and knee extension and flexion as well as Landing Error Scoring System (LESS) scores were collected for healthy female middle school students of grades 6 to 8. Strength-training participants (STR: N = 30; height, 1.63 ± 0.07 m; mass, 48.1 ± 7.6 kg; age, 12.5 ± 1.0 y) were matched with control participants (CON: N = 30; height, 1.60 ± 0.09 m; mass, 47.2 ± 8.9 kg; age, 12.6 ± 0.9 y). The training consisted of a 6-month strength-training program administered through a gym class curriculum that targeted the lower extremity. A repeated-measures mixed-model analysis of variance was used for comparisons between groups and across time (α = 0.05). Stepwise linear regression was used to examine the relationship between strength change and LESS score change.

Results:

Strength values (N·m/kg) increased across time and to a greater degree in STR for hip extension (baseline 3.98 ± 1.15 vs follow-up 4.77 ± 1.80), hip abduction (4.22 ± 1.09 vs 5.13 ± 2.55), and knee flexion (3.27 ± 0.62 vs 3.64 ± 1.40) compared with CON. LESS grades significantly decreased across time in STR (5.58 ± 1.21 vs 4.86 ± 1.44) and were significantly lower than CON (5.98 ± 1.42) at follow-up ( P < 0.001). The change in hip extension and knee extension strength explained 67% of the variance ( P < 0.001) in the LESS change score in the STR group.

Conclusion:

A school-based strength-training program that focused on hip and knee musculature significantly improved jump-landing biomechanics (as determined by LESS) relevant to ACL injury risk. Further investigation using different strength-training approaches in this age group is warranted.

Clinical Relevance:

Strength training during adolescence holds promise as an injury prevention program. The use of a school-based approach is novel and may represent a robust opportunity for injury prevention programs, as physical education class is often mandatory in this age group.
Socio-demographic variables related to self-esteem, psychological stress and health-related quality of life among older adults: A cross-sectional study in Kavrepalanchowk district of Nepal
Authors: Karki Kshitij , Sapkota Amrita , Jajko Shannon , Singh Devendra Raj
Published: November 2021

Objective:

The study aimed to assess how socio-demographic variables related to self-esteem, psychological stress and health-related quality of life among older adults in Nepal.

Method:

A cross-sectional community-based study was conducted in the Kavrepalanchowk district of Nepal. A two-stage cluster sampling technique was used for selecting the study areas, and 239 older adult participants were selected randomly from the clusters. The interview technique was applied to gather data using validated tools. The tools used in the study were Rosenberg self-esteem scale, Perceived Stress Scale and WHOQOL-BREF scale. Scoring was carried out for self-esteem, perceived stress and WHOQOL-BREF in accordance with the procedures. Data were analyzed using descriptive statistics and inferential statistics (Chi-square, independent t-test and one-way analysis of variance).

Results:

Among the total participants, 27.2% were 60–64 years old and more than two-thirds (69.9%) were male. The majority of participants were married (65.5%) and cannot read and write (60.7%). Half of the older adults (49.8%) were living with their partners. Self-esteem was high among the age group 70–74 years (24.80 ± 3.01), and psychological stress was high among the age group 60–64 years (17.23 ± 2.93) within the older adults. Furthermore, the mean score for the social relationship domain and physical health domain of health-related quality of life were 12.0 and 11.9, respectively. Comparing the domains of physical health, psychological health and social relationship with age and education level were statistically significant.

Conclusion:

Self-esteem was lower among older male adults aged 60–64 years and those who attended secondary level education. An increase in participants’ age increases the psychological stress and decreases the psychological domain of health-related quality of life.
New Avenues in Audio Intelligence: Towards Holistic Real-life Audio Understanding
Authors: Schuller Björn , Baird Alice , Gebhard Alexander , Amiriparian Shahin , Keren Gil , Schmitt Maximilian , Cummins Nicholas
Published: November 2021

Computer audition (i.e., intelligent audio) has made great strides in recent years; however, it is still far from achieving holistic hearing abilities, which more appropriately mimic human-like understanding. Within an audio scene, a human listener is quickly able to interpret layers of sound at a single time-point, with each layer varying in characteristics such as location, state, and trait. Currently, integrated machine listening approaches, on the other hand, will mainly recognise only single events. In this context, this contribution aims to provide key insights and approaches, which can be applied in computer audition to achieve the goal of a more holistic intelligent understanding system, as well as identifying challenges in reaching this goal. We firstly summarise the state-of-the-art in traditional signal-processing-based audio pre-processing and feature representation, as well as automated learning such as by deep neural networks. This concerns, in particular, audio interpretation, decomposition, understanding, as well as ontologisation. We then present an agent-based approach for integrating these concepts as a holistic audio understanding system. Based on this, concluding, avenues are given towards reaching the ambitious goal of ‘holistic human-parity’ machine listening abilities.
Marfan syndrome and the eye clinic: from diagnosis to management
Authors: Akram Haseeb , Aragon-Martin Jose Antonio , Chandra Aman
Published: November 2021

Marfan syndrome (MFS) is an autosomal dominantly inherited disorder affecting the cardiovascular, ocular and musculoskeletal systems. Frequently, clinical suspicion and subsequent diagnosis begins in the ophthalmology clinic. Importantly, the ophthalmologist has a responsibility to cater not only to the eye, but also to be involved in a holistic approach for these patients. In this review, we discuss how MFS may present to an eye clinic, including clinical features, ocular morbidity, genetic diagnosis and management. Although this condition is ideally managed by a multidisciplinary team, our focus will be on MFS and the eye, including other conditions which may present with similar phenotypes. The ophthalmologist’s role as the potential first contact for a patient with suspected MFS is crucial in making the proper investigations and referral, with the knowledge that not all ectopia lentis cases are MFS and vice versa. Management of ocular conditions in MFS may range from simple observation to surgical intervention; current options will be discussed.
A novel role for endoplasmic reticulum protein 46 (ERp46) in platelet function and arterial thrombosis in mice
Authors: Zhou Junsong , Wu Yi , Rauova Lubica , Koma Gavin , Wang Lu , Poncz Mortimer , Li Hong , Liu Tong , Fong Karen P. , Bennett Joel S. , Kunapuli Satya P. , Essex David W.
Published: November 2021

Although several members of protein disulfide isomerase (PDI) family support thrombosis, other PDI family members with the CXYC motif remain uninvestigated. ERp46 has 3 CGHC redox-active sites and a radically different molecular architecture than other PDIs. Expression of ERp46 on the platelet surface increased with thrombin stimulation. An anti-ERp46 antibody inhibited platelet aggregation, adenosine triphosphate (ATP) release, and αIIbβ3 activation. ERp46 protein potentiated αIIbβ3 activation, platelet aggregation, and ATP release, whereas inactive ERp46 inhibited these processes. ERp46 knockout mice had prolonged tail-bleeding times and decreased platelet accumulation in thrombosis models that was rescued by infusion of ERp46. ERp46-deficient platelets had decreased αIIbβ3 activation, platelet aggregation, ATP release, and P-selectin expression. The defects were reversed by wild-type ERp46 and partially reversed by ERp46 containing any of the 3 active sites. Platelet aggregation stimulated by an αIIbβ3-activating peptide was inhibited by the anti-ERp46 antibody and was decreased in ERp46-deficient platelets. ERp46 bound tightly to αIIbβ3 by surface plasmon resonance but poorly to platelets lacking αIIbβ3 and physically associated with αIIbβ3 upon platelet activation. ERp46 mediated clot retraction and platelet spreading. ERp46 more strongly reduced disulfide bonds in the β3 subunit than other PDIs and in contrast to PDI, generated thiols in β3 independently of fibrinogen. ERp46 cleaved the Cys473-Cys503 disulfide bond in β3, implicating a target for ERp46. Finally, ERp46-deficient platelets have decreased thiols in β3, implying that ERp46 cleaves disulfide bonds in platelets. In conclusion, ERp46 is critical for platelet function and thrombosis and facilitates αIIbβ3 activation by targeting disulfide bonds.
ReRF-Pred: predicting amyloidogenic regions of proteins based on their pseudo amino acid composition and tripeptide composition
Authors: Teng Zhixia , Zhang Zitong , Tian Zhen , Li Yanjuan , Wang Guohua
Published: November 2021

Background

Amyloids are insoluble fibrillar aggregates that are highly associated with complex human diseases, such as Alzheimer’s disease, Parkinson’s disease, and type II diabetes. Recently, many studies reported that some specific regions of amino acid sequences may be responsible for the amyloidosis of proteins. It has become very important for elucidating the mechanism of amyloids that identifying the amyloidogenic regions. Accordingly, several computational methods have been put forward to discover amyloidogenic regions. The majority of these methods predicted amyloidogenic regions based on the physicochemical properties of amino acids. In fact, position, order, and correlation of amino acids may also influence the amyloidosis of proteins, which should be also considered in detecting amyloidogenic regions.

Results

To address this problem, we proposed a novel machine-learning approach for predicting amyloidogenic regions, called ReRF-Pred. Firstly, the pseudo amino acid composition (PseAAC) was exploited to characterize physicochemical properties and correlation of amino acids. Secondly, tripeptides composition (TPC) was employed to represent the order and position of amino acids. To improve the distinguishability of TPC, all possible tripeptides were analyzed by the binomial distribution method, and only those which have significantly different distribution between positive and negative samples remained. Finally, all samples were characterized by PseAAC and TPC of their amino acid sequence, and a random forest-based amyloidogenic regions predictor was trained on these samples. It was proved by validation experiments that the feature set consisted of PseAAC and TPC is the most distinguishable one for detecting amyloidosis. Meanwhile, random forest is superior to other concerned classifiers on almost all metrics. To validate the effectiveness of our model, ReRF-Pred is compared with a series of gold-standard methods on two datasets: Pep-251 and Reg33. The results suggested our method has the best overall performance and makes significant improvements in discovering amyloidogenic regions.

Conclusions

The advantages of our method are mainly attributed to that PseAAC and TPC can describe the differences between amyloids and other proteins successfully. The ReRF-Pred server can be accessed at http://106.12.83.135:8080/ReRF-Pred/.
Regional differences in clonal Japanese knotweed revealed by chemometrics-linked attenuated total reflection Fourier-transform infrared spectroscopy
Authors: Holden Claire A. , Morais Camilo L. M. , Taylor Jane E. , Martin Francis L. , Beckett Paul , McAinsh Martin
Published: November 2021

Background

Japanese knotweed (R. japonica var japonica)is one of the world’s 100 worst invasive species, causing crop losses, damage to infrastructure, and erosion of ecosystem services. In the UK, this species is an all-female clone, which spreads by vegetative reproduction. Despite this genetic continuity, Japanese knotweed can colonise a wide variety of environmental habitats. However, little is known about the phenotypic plasticity responsible for the ability of Japanese knotweed to invade and thrive in such diverse habitats. We have used attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy, in which the spectral fingerprint generated allows subtle differences in composition to be clearly visualized, to examine regional differences in clonal Japanese knotweed.

Results

We have shown distinct differences in the spectral fingerprint region (1800–900 cm− 1) of Japanese knotweed from three different regions in the UK that were sufficient to successfully identify plants from different geographical regions with high accuracy using support vector machine (SVM) chemometrics.

Conclusions

These differences were not correlated with environmental variations between regions, raising the possibility that epigenetic modifications may contribute to the phenotypic plasticity responsible for the ability ofR. japonicato invade and thrive in such diverse habitats.
Supraclavicular block with Mepivacaine vs Ropivacaine, their impact on postoperative pain: a prospective randomised study
Authors: Sellbrant Irén , Karlsson Jon , Jakobsson Jan G. , Nellgård Bengt
Published: November 2021

Background

Supraclavicular block (SCB) with long-acting local anaesthetic is commonly used for surgical repair of distal radial fractures (DRF). Studies have shown a risk for rebound pain when the block fades. This randomised single-centre study aimed to compare pain and opioid consumption the first three days post-surgery between SCB-mepivacaine vs. SCB-ropivacaine, with general anaesthesia (GA) as control.

Methods

Patients (n = 90) with ASA physical status 1–3 were prospectively randomised to receive; SCB with mepivacine 1%, 25–30 ml (n = 30), SCB with ropivacaine 0.5%, 25–30 ml (n = 30) or GA (n = 30) with propofol/fentanyl/sevoflurane. Study objectives compared postoperative pain with Numeric Rating Scale (NRS) and sum postoperative Opioid Equivalent Consumption (OEC) during the first 3 days post-surgery between study-groups.

Results

The three groups showed significant differences in postoperative pain-profile. Mean NRS at 24 h was significantly lower for the SCB-mepivacaine group (p = 0.018). Further both median NRS and median OEC day 0 to 3 were significanly lower in the SCB-mepivacaine group as compared to the SCB-ropivacaine group during the first three days after surgery; pain NRS 1 (IQR 0.3–3.3) and 2.7 (IQR 1.3–4.2) (p = 0.017) and OEC 30 mg (IQR 10–80) and 85 mg (IQR 45–125) (p = 0.004), respectively. The GA-group was in between both in pain NRS and median sum OEC. Unplanned healthcare contacts were highest among SCB-ropivacaine patients (39.3%) vs. SCB-mepivacaine patients (0%) and GA-patients (3.4%).

Conclusions

The potential benefit of longer duration of analgesia, associated to a long-acting local anaesthetic agent, during the early postoperative course must be put in perspective of potential worse pain progression following block resolution.

Trial registration

NCT03749174 (clinicaltrials.gov, Nov 21, 2018, retrospectively registered).
Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
Authors: Herath H. M. M. T. B. , Rodrigo Chaturaka , Alahakoon A. M. B. D. , Ambawatte Sathyajith Buddhika , Senanayake Sunethra , Senanayake Bimsara , Fernando Arjuna
Published: November 2021

Background

Stroke related deaths are relatively higher in low- and middle-income countries where only a fraction of eligible patients undergo thrombolysis. There is also limited evidence on post-thrombolysis outcomes of patients from Asian countries in these income bands.

Methods

This is a single center prospective observational study of a patient cohort with acute ischaemic stroke, undergoing thrombolysis with alteplase (low and standard dose), over a 24-month period in 2019/2020. Modified Rankin scale (mRS) for dependency at 3 months (primary outcome), duration of hospital stay, incidence of symptomatic intracranial haemorrhages and all-cause mortality at 3 months (secondary outcomes) were recorded. Demographic, clinical and treatment related factors associated with these outcomes were explored.

Results

Eighty-nine patients (males – 61, 69%, mean age: 60 years ±12.18) were recruited. Time from symptom onset to reperfusion was 174 min ± 56.50. Fifty-one patients were independent according to mRS, 11 (12.4%) patients died, and 11 (12.5%) developed symptomatic intracranial haemorrhages by 3 months. Functional independence at 3 months was independently associated with National Institutes of Health Stroke Scale (NIHSS) on admission (p < 0.05). Thrombolysis with low dose alteplase did not lead to better or worse outcomes compared to standard dose.

Conclusions

On admission NIHSS is predictive of functional independence at 3 months post-thrombolysis. Low dose alteplase may be as efficacious as standard dose alteplase with associated cost savings, but this needs to be confirmed by a prospective clinical trial for the Sri Lankan population.
Development and validation of a knowledge, attitude, and practice questionnaire regarding cardiovascular diseases in an Iranian general population
Authors: Koohi Fatemeh , Amiri Parisa , Mehrabi Yadollah , Karimi Mehrdad , Khalili Davood
Published: November 2021

Background

Studies on knowledge, attitude, and practice (KAP) can be valuable for public health to help to develop targeted educational programs and assess the effectiveness of intervention programs. The purpose of this study was to develop and examine the validity and reliability of a questionnaire on knowledge, attitude, and practice (KAP) regarding cardiovascular diseases (CVDs), their risk factors, and symptoms among an Iranian general population.

Methods

This cross-sectional study was conducted on an Iranian population older than 20 years referred to some of Tehran’s healthcare centers. An initial 62-item questionnaire was developed, and the face, content, and construct validities were assessed.

Results

In all, 300 adults with a mean age (SD) of 39.79 (12.1) years participated in this study. Based on the results of the content validity, a questionnaire with 30 essential items was designed. Exploratory factor analysis suggested a four-factor subscale with 29 finalized items (CVD-KAP29), and acceptable goodness of fit indices was demonstrated by confirmatory factor analysis. The Cronbach’s alpha and McDonald’s ω coefficients were higher than 0.60 for all domains except the nutrition and smoking subscales.

Conclusions

Results provided evidence of the validity of the CVD-KAP29 for KAP studies for cardiovascular diseases in the general population.