bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibody Response 3 Months after 2 Doses of BNT162b2 mRNA COVID-19 Vaccine in Residents of Long-Term Care Facilities
Authors: Causa Roberta , Almagro-Nievas Diego , Rivera-Izquierdo Mario , Benítez-Muñoz Nicolás , López-Hernández Begoña , García-García Fernando , Alvarez-Estévez Marta , Soto-Pérez Maria de la O. , Bermúdez-Tamayo Clara
Published: November 2021

Background: Older adults living in long-term care facilities (LTCFs) are at increased risk for severe outcomes from COVID-19 and were identified as a priority group in COVID-19 vaccination strategies. Emerging evidence suggests vaccine effectiveness in LTCF populations, but data about median and long-term durability of immune response after vaccination are still limited. Objectives: In this study, we assessed the humoral response to BNT162b2 mRNA COVID-19 vaccine 3 months after the second dose, in a cohort of 495 residents aged ≥65 years from 11 LTCF in Granada, Spain. Method: Between April 19 and April 30, 2021, we measured anti-SARS-CoV-2 Spike IgG to evaluate the humoral vaccination response. Antibody titers were reported in binding antibody units (BAU/mL). Bivariate and multivariate logistic regression models were performed to investigate the impact of age, sex, underlying health conditions, and prior COVID-19 infection on the antibody levels. Results: Over 96% of the participants developed an adequate humoral response. We detected higher antibody titers in previously infected individuals, compared with those previously uninfected (B: 1,150.059 BAU/mL, p < 0.001). Moreover, we found a significant inverse association between age and antibody levels (B: −7.943 BAU/mL, p < 0.05). This negative age-dependent response was more noticeable among residents over 85 years old. In contrast, baseline health conditions and cognitive status were not associated with different antibody levels. Conclusions: These findings support monitoring COVID-19 vaccination response trend in older adults, in order to optimize future disease prevention and control strategies in this vulnerable population.
White-Coat Hypertension: Pathophysiological and Clinical Aspects: Excellence Award for Hypertension Research 2020
Authors: Mancia Giuseppe , Facchetti Rita , Bombelli Michele , Cuspidi Cesare , Grassi Guido
Published: November 2021

Few issues of modern cardiovascular medicine have been as controversial as the relationship between white-coat hypertension (WCH), that is, a common condition in which office blood pressure is elevated while out-of-office blood pressure (ambulatory blood pressure or home blood pressure) is normal. While earlier studies showed no increased risk of cardiovascular events in WCH compared with the normotensive state, more recent studies have changed this conclusion by showing that an increased cardiovascular risk represents a trait of this hypertensive phenotype. The present article will review a number of issues related to WCH, that is, its definition, pathophysiological background, clinical alterations, and prognostic significance. This will be done by considering the available evidence published during the last decades, with special focus on the data collected in PAMELA (Pressioni Arteriose Monitorate e Loro Associazioni)—a research project performed with a cross-sectional and longitudinal design, which has provided a series of novel clinical information on WCH throughout the years. The final part of the article will discuss the therapeutic implications of the abovementioned evidence, as well as some controversial or still undefined issues related to WCH, whose investigation will be an important goal to pursue by future research.
CMIP6 Model-projected Hydroclimatic and Drought Changes and Their Causes in the 21st Century
Authors: Zhao Tianbao , Dai Aiguo
Published: November 2021

Drought is projected to become more severe and widespread as global warming continues in the 21st century, but hydroclimatic changes and their drivers are not well examined in the latest projections from the Phase Six of the Coupled Model Inetercomparison Project (CMIP6). Here, precipitation (P), evapotranspiration (E), soil moisture (SM), and runoff (R) from 25 CMIP6 models, together with self-calibrated Palmer Drought Severity Index with Penman-Monteith potential evapotranspiration (scPDSIpm), are analyzed to quantify hydroclimatic and drought changes in the 21st century and the underlying causes. Results confirm consistent drying in these hydroclimatic metrics across most of the Americas (including the Amazon), Europe and the Mediterranean region, southern Africa, and Australia; although the drying magnitude differs, with the drying being more severe and widespread in surface SM than in total SM. Global drought frequency based on surface SM and scPDSIpm increases by ~25%–100% (50%–200%) under the SSP2-4.5 (SSP5-8.5) scenario in the 21st century together with large increases in drought duration and areas, which result from a decrease in the mean and flattening of the probability distribution functions of SM and scPDSIpm; while the R-based drought changes are relatively small. Changes in both P and E contribute to the SM change, whereas scPDSIpm decreases result from ubiquitous PET increases and P decreases over subtropical areas. The R changes are determined primarily by P changes, while the PET change explains most of the E increase. Inter-model spreads in surface SM and R changes are large, leading to large uncertainties in the drought projections.
Sea Breeze Geoengineering to Increase Rainfall over the Arabian Red Sea Coastal Plains
Authors: Mostamandi Suleiman , Predybaylo Evgeniya , Osipov Sergey , Zolina Olga , Gulev Sergey , Parajuli Sagar , Stenchikov Georgiy
Published: November 2021

The Red Sea (RS) has a high evaporation rate, exceeding 2 m of water per year. The water vapor is transported from the shorelines by sea breezes as far as 200 km landward. Relative humidity in the vicinity of the RS exceeds 80% in summer. Nevertheless, precipitation is scarce in most of the Arabian RS coastal plain. In this work we use the Weather Research and Forecasting (WRF) regional model to assess how deliberate changes (geoengineering) in the surface albedo or conversion of bare land to wide-leaf forests over a vast coastal plain region affect precipitation over the Arabian RS coast. Our simulations show that geoengineering of land surface characteristics perturbs coastal circulation; alters temperature, moisture, and momentum exchange between the land surface and atmosphere; and changes the breeze intensity, cloud cover, and eventually the amount of precipitation. We find that extended afforestation and increased surface albedo are not effective in triggering rainfall over the RS coastal plains. Conversely, decreasing surface albedo to 0.2, assuming installation of solar panels over the coastal plains, increases surface air temperature by 1–2 K, strengthens horizontal surface temperature differences between sea and land, intensifies breezes, increases water vapor mixing ratio in the boundary layer above 3 km by about 0.5 g kg−1, enhances vertical mixing within the planetary boundary layer, and generates 1.5 Gt of extra rainwater, equivalent to the annual consumption of five million people. Thus, this form of regional land surface geoengineering, along with advanced methods of collection and underground storage of freshwater, provides a feasible solution to mitigation of the existing water crisis in the arid coastal regions.
Evaluation of Global Forecast System (GFS) Medium-Range Precipitation Forecasts in the Nile River Basin
Authors: Yue Haowen , Gebremichael Mekonnen , Nourani Vahid
Published: November 2021

Reliable weather forecasts are valuable in a number of applications, such as agriculture, hydropower, and weather-related disease outbreaks. Global weather forecasts are widely used, but detailed evaluation over specific regions is paramount for users and operational centers to enhance the usability of forecasts and improve their accuracy. This study presents evaluation of the Global Forecast System (GFS) medium-range (1–15 day) precipitation forecasts in the nine subbasins of the Nile basin using NASA’s Integrated Multisatellite Retrievals (IMERG) Final Run satellite–gauge merged rainfall observations. The GFS products are available at a temporal resolution of 3–6 h and a spatial resolution of 0.25°, and the version-15 products are available since 12 June 2019. GFS forecasts are evaluated at a temporal scale of 1–15 days, a spatial scale from 0.25° to all the way to the subbasin scale, and for a period of one year (15 June 2019–15 June 2020). The results show that performance of the 1-day lead daily basin-averaged GFS forecast performance, as measured through the modified Kling–Gupta efficiency (KGE), is poor (0 < KGE < 0.5) for most of the subbasins. The factors contributing to the low performance are 1) large overestimation bias in watersheds located in wet climate regimes in the northern hemispheres (Millennium watershed, Upper Atbara and Setit watershed, and Khashm El Gibra watershed), and 2) lower ability in capturing the temporal dynamics of watershed-averaged rainfall that have smaller watershed areas (Roseires at 14 110 km2 and Sennar at 13 895 km2). GFS has better bias for watersheds located in the dry parts of the Northern Hemisphere or wet parts of the Southern Hemisphere, and better ability in capturing the temporal dynamics of watershed-average rainfall for large watershed areas. IMERG Early has better bias than GFS forecast for the Millennium watershed but still comparable and worse bias for the Upper Atbara and Setit and Khashm El Gibra watersheds. The variation in the performance of the IMERG Early could be partly explained by the number of rain gauges used in the reference IMERG Final product, as 16 rain gauges were used for the Millennium watershed but only one rain gauge over each Upper Atbara and Setit and Khashm El Gibra watershed. A simple climatological bias correction of IMERG Early reduces in the bias in IMERG Early over most watersheds, but not all watersheds. We recommend exploring methods to increase the performance of GFS forecasts, including postprocessing techniques through the use of both near-real-time and research-version satellite rainfall products.
Diurnal Variation of the Planetary Boundary Layer Height Observed from GNSS Radio Occultation and Radiosonde Soundings over the Southern Great Plains
Authors: Nelson Kevin J. , Xie Feiqin , Ao Chi O. , Oyola-Merced Mayra I.
Published: November 2021

The planetary boundary layer (PBL) height (PBLH) is a key physical parameter of the PBL affected by numerous physical processes within the boundary layer. Specifically, the PBLH over land exhibits large spatial and temporal variation across different geographical regions. In this study, the Constellation Observing System for Meteorology, Ionosphere and Climate (COSMIC) radio occultation (RO) profiles and high-resolution radiosonde profiles from 2007 to 2013 were analyzed to estimate the diurnal cycle of the PBLH over the Southern Great Plains (SGP) in the United States. Large variations in PBLH derived from radiosonde temperature, moisture, and refractivity are observed on seasonal scales. COSMIC RO is capable of observing diurnal and seasonal variations in the terrestrial PBLH over the SGP region. Annual mean diurnal amplitude of approximately 250 m in the terrestrial PBLH was observed, with maxima occurring at around 1500 local solar time (LST) in both the collocated radiosondes and COSMIC RO profiles. Seasonal changes in the PBLH diurnal cycles ranging from approximately 100 to 400 m were also observed. Such PBL diurnal and seasonal changes can be further incorporated into PBL parameterizations to help improve weather and climate model prediction.

Significance Statement

The atmospheric planetary boundary layer (PBL) and its height (PBLH) control many atmospheric processes that affect our everyday lives. Observations of the PBL are usually limited to radiosondes at limited time intervals. GNSS radio occultation (RO) provide high-vertical-resolution atmospheric observations that are ideal for PBL study. This study demonstrates that the GNSS RO is capable of capturing the diurnal and seasonal variations of the PBLH over the southern Great Plains (SGP) well as compared to the collocated radiosonde observations.
Steady ship: Digital, online, and e-libraries (1971–2020)
Authors: Ali Nusrat , Shoaib Muhammad , Syed Kazim
Published: November 2021

This paper attempts to examine the e-libraries, digital libraries, electronic libraries, and online libraries employing bibliometric study techniques from 1971 to 2020. It focuses to consolidate the published documents on the library indexed in Web of Science. It has been observed that we found 4266 published documents employing bibliometric analysis. The study findings show that digital libraries are the top topic, proceeding paper is the top type of document, and most are published in the English language. Similarly, the year 2006 to 2010 has the highest number of published documents, top author Fox EA, Dept. Comp Sci top organisation, United States top country, and digital libraries as a top keyword has been found. Further, the name of Liu et al. has been at the top of the author’s list. Moreover, the results are presented in tables and figures to show the trend of data.
Introduction: Language and Communication Related to COVID-19
Authors: Jucks Regina , Hendriks Friederike
Published: November 2021

The occurrence of COVID-19 has a strong impact on individuals’ as well as public life. This Special Issue brings together research on language and communication addressing the challenges resulting from the Corona virus situation. Seven original papers followed by a discussion, address research on language and communication related to COVID-19 using different theoretical backgrounds, methodological approaches, as well as different foci on individual, interpersonal, and intergroup perspectives. The foci addressed in the contributions of the Special Issue stretch from discrimination and intergroup stigmatization to the laypeople's perception and evaluation of science and health communication messages.
Development and validation of the acceptance of dating violence questionnaire
Authors: Lara Laura , Gómez-Urrutia Verónica
Published: November 2021

The purpose of this study was to develop and validate a questionnaire to measure the acceptance of dating violence among young Chileans, that evaluates both victimization and perpetration perspectives. Based on the Intimate Partner Violence Attitudes Scale, items were developed to fulfill these criteria and were refined through experts’ revisions and participant focus groups. The 30-item questionnaire created (with 15 similar items to measure both perpetration and victimization) was applied to 1120 Chilean high school and university students (14–27 years old, 59.9% females). Results of factorial analysis showed the questionnaire had an adequate fit with the correlated three-factor model (control, emotional violence, and physical violence) for each version (victimization and perpetration). Reliability analyses indicated an adequate internal consistency, and correlations with dating violence provide evidence on its concurrent validity. Results also showed that boys/men accepted more dating violence than girls/women, and adolescents than emerging adults.
Elevated soluble CD163 predicts renal function deterioration in lupus nephritis: a cohort study in Eastern China
Authors: Yang Guangxia , Guo Naifeng , Yin Jun , Wu Jianhua
Published: November 2021

Objective

This study investigated the association between soluble scavenger receptor differentiation antigen 163 (sCD163) and the severity and prognosis of renal injury in lupus nephritis (LN).

Methods

Serum sCD163 levels in 121 Eastern Chinese patients with LN who underwent renal biopsy were determined by enzyme-linked immunosorbent assays. Clinical data were collected, and the glomerular filtration rate and disease activity score of lupus were calculated. Pathological classification was performed, and renal pathological scores were assessed by the activity index (AI) and chronic index (CI). Kaplan–Meier survival curves were drawn to evaluate prognosis.

Results

The pathological classification, AI and CI scores in the high sCD163 group were increased. The sCD163 levels were positively correlated with serum creatinine, blood urea nitrogen, AI scores and CI scores and negatively correlated with the estimated glomerular filtration rate. Kaplan–Meier survival analysis showed that the incidence of renal endpoint events was increased in the high sCD163 group compared with the normal sCD163 group.

Conclusion

The serum sCD163 level correlates with the severity of LN and is an important indicator of poor renal prognosis in patients with LN.
Critiquing Latour’s Explanation of Climate Change Denial: Moving Beyond the Modernity/Anthropocene Binary
Authors: Tängh Wrangel Claes , Causevic Amar
Published: November 2021

The concept of the Anthropocene has reintroduced politics of denial at the centre of critical studies of international relations. This article interrogates Bruno Latour’s explanation of climate change denial with reference to an ontological difference between Modernity and the Anthropocene, together with his advocacy for a new language beyond the Modern gaze. Our aims are twofold: to disclose how Latour’s posthuman critique risk reproducing prevalent forms of climate change denial in the global North, and to question what falls outside Latour’s dualistic frame: the heterogenous ways through which climate change and the Anthropocene is met across the globe; the ambiguous relation with nature through which modernity was formed; the modernist genealogy of Anthropocene discourse, and lastly how discourses of global governance have absorbed posthumanist critique in its attempt to naturalise postcolonial power relations. At stake, we argue, is critical theory’s paradoxical complicity in the denialism it seeks to critique.
A Global Silence: A Critical Interpretive Synthesis of Aboriginal Mothering Through Domestic and Family Violence
Authors: Andrews Shawana , Hamilton Bridget , Humphreys Cathy
Published: November 2021

Aboriginal women globally face extreme risk of violence and their exposure to domestic and family violence (DFV) and state sanctioned violence is increasing. Attention to the impact on Aboriginal mothering is lacking and is underpinned by issues of social justice. This study employs Critical Interpretive Synthesis to examine the evidence on Aboriginal mothering through DFV. Serrant-Green’s Silences Framework was used to structure the critique, understand its problematics and generate an argument to counter the evidential silence. From 6,117 search results, ten publications were reviewed, only four of which substantially addressed Aboriginal mothering in the context of family and domestic violence; a conspicuous absence from the literature about Aboriginal women, children, and mothering. Studies addressing Aboriginal women’s experience of DFV did not credit the issue of mothering. Equally, studies that did address mothering through violence were generally not inclusive of Aboriginal women. Silence, therefore, sits at the nexus of DFV, Aboriginal women, and mothering. While violence against Aboriginal women is acknowledged as a social ill, inattention to mothering in research represents a disregard for Aboriginal women’s mothering identities and roles. Aboriginal women’s voice and citizenship are critical to addressing this issue.
Perspectives of patients on medical acupuncture in a primary care setting in Lebanon: a cross-sectional study
Authors: El-Jarrah Rana T , Naji Fadila Bassem , Hamadeh Ghassan , Abdul Rahman Maya , Charafeddine Hassan
Published: November 2021

Introduction:

There is paucity of data on the knowledge of acupuncture and its use among patients in Lebanon and the Arab countries.

Objectives:

The primary objectives of this study were to determine the knowledge and attitude of patients in a primary care setting in Lebanon toward Western medical acupuncture and to determine factors that may affect their attitudes toward acupuncture use. The secondary objective was to compare the attitudes and knowledge of patients who had tried acupuncture with those who had not.

Methods:

This was a cross-sectional descriptive study about the perspectives of patients in a primary care setting in Lebanon on medical acupuncture.

Results:

A total of 212 surveys were completed (78.5% response rate). 24% of participants had not tried and were unwilling to try acupuncture (group 1), 63.5% of participants had not tried but indicated they would be willing to try acupuncture (group 2), and 12.5% of participants had previously tried acupuncture (group 3). Most participants in group 1 (55.6%) stated they would be unwilling to try acupuncture even if referred for it by a physician. Participants who had tried acupuncture (12.5%) had done so for pain conditions.

Discussion:

Group 3 scored higher on knowledge questions and had a more positive attitude toward the acupuncture procedure. Most patients who had tried it had done so to treat pain complaints.

Conclusion:

Patients in groups 2 and 3 were more knowledgeable about acupuncture, had tried more complementary and alternative medicine (CAM) modalities, and were more likely to try acupuncture as an add-on or last resort treatment, compared to group 1.
Entrepreneurship Education at the Crossroads: Challenging Taken-for-Granted Assumptions and Opening New Perspectives
Authors: Loi Michela , Fayolle Alain , van Gelderen Marco , Riot Elen , Refai Deema , Higgins David , Haloub Radi , Salusse Marcus Alexandre Yshikawa , Lamy Erwan , Verzat Caroline , Cavarretta Fabrice
Published: November 2021

This work presents a synthesis of a debate regarding taken-for-granted assumptions and challenges in entrepreneurship education, matured after a developmental workshop organized to increase the research salience of the field. From the five contributions selected, three challenges emerge. The first is recognizing that participants’ representations about entrepreneurship play a crucial role in defining goals and impact of entrepreneurship education; second, integrating new perspectives of conceiving entrepreneurship into the current models of teaching entrepreneurship; and, lastly, facilitating the integration of entrepreneurship knowledge into practice. These challenges opened up to a conception of entrepreneurship education as a dynamic concept reflecting personal values, societal changes, and cultural differences. As a result, learning places of entrepreneurship education promotes exploration and not adaptation to existing schemes, where personal models for practicing entrepreneurship have room to emerge. Defining knowledge priorities, instead of targeting knowledge exhaustiveness, becomes of greatest importance to make entrepreneurship education‘s impact more relevant.
Avascular Osteonecrosis of the Talus: Current Treatment Strategies
Authors: Zhang Hanci , Fletcher Amanda N. , Scott Daniel J. , Nunley James
Published: November 2021

Avascular osteonecrosis (AVN) of the talus (AVNT) is a painful and challenging clinical diagnosis. AVNT has multiple known risk factors and etiologies and presents at different stages in severity. Given these unique factors, the optimal treatment solution has yet to be determined. Both joint-preserving and joint-sacrificing procedures are available, including core decompression and arthrodeses. Recently, new salvage and replacement techniques have been described including vascularized pedicle bone grafts and total talus replacement using patient-specific prosthesis; however, evidence remains limited. This review examines the current trends AVNT treatment and the emerging data behind these novel techniques.
The Impact of Narrow and Tiered Networks on Costs, Access, Quality, and Patient Steering: A Systematic Review
Authors: Mazurenko Olena , Taylor Heather L. , Menachemi Nir
Published: November 2021

Health insurers use narrow and tiered networks to lower costs by contracting with, or favoring, selected providers. Little is known about the contemporary effects of narrow or tiered networks on key metrics. The purpose of this systematic review was to synthesize the evidence on how narrow and tiered networks impact cost, access, quality, and patient steering. We searched PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials databases for articles published from January 2000 to June 2020. Both narrow and tiered networks are associated with reduced overall health care costs for most cost-related measures. Evidence pertaining to access to care and quality measures were more limited to a narrow set of outcomes or were weak in internal validity, but generally concluded no systematic adverse effects on narrow or tiered networks. Narrow and tiered networks appear to reduce costs without affecting some quality measures. More research on quality outcomes is warranted.
ADHD Comorbidity Structure and Impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS)
Authors: Mak Arthur D. P. , Lee Sue , Sampson Nancy A. , Albor Yesica , Alonso Jordi , Auerbach Randy P. , Baumeister Harald , Benjet Corina , Bruffaerts Ronny , Cuijpers Pim , Ebert David D. , Gutierrez-Garcia Raúl A. , Hasking Penelope , Lapsley Coral , Lochner Christine , Kessler Ronald C.
Published: November 2021

Objective

To examine the prevalence of ADHD and the association of comorbid disorders, and multivariate disorder classes with role impairment in college students.

Method

About 15,991 freshmen (24 colleges, 9 countries, WMH-ICS) (response rate = 45.6%) completed online WMH-CIDI-SC surveys for 6-month ADHD and six 12-month DSM-IV disorders. We examined multivariate disorder classes using latent class analysis (LCA) and simulated a population attributable risk proportions (PARPs) of ADHD-related impairment.

Results

About 15.9% had ADHD, of which 58.4% had comorbidities. LCA classified ADHD respondents to pure (42.9%), internalizing (36.0%), bipolar comorbidities (11.3%), and externalizing disorder classes (9.8%). ADHD, comorbidities, and multivariate disorder classes independently predicted severe impairment. PARPs: eliminating ADHD hypothetically reduced severe impairment by 19.2%, 10.1% adjusted for comorbidities, 9.5% for multivariate disorder classes.

Conclusions

ADHD and comorbid disorders are common and impairing in college students. Personalized transdiagnostic interventions guided by multivariate disorder classes should be explored.
Friction and wear behavior of ultra-high molecular weight polyethylene/graphene nanoplatelets nanocomposite coatings at elevated temperatures
Authors: Kayode Aliyu Ismaila , Abdul Samad Mohammed , Al-Qutub Amro M
Published: November 2021

Ultra-high molecular weight polyethylene nanocomposite coatings reinforced with 1 wt.% graphene nanoplatelets were deposited on aluminum substrates. Sliding wear tests with a pin-on-disc configuration were conducted at different temperatures (25oC, 75oC, 90oC, 115oC, and 125oC) to evaluate the wear behavior of the coating at elevated temperatures. The ultra-high molecular weight polyethylene/1 wt.% graphene nanoplatelets nanocomposite coating showed an outstanding performance by passing the wear test without failing even until temperatures of 115oC as compared to the pure ultra-high molecular weight polyethylene coating which failed at a much lower temperature of 75oC, indicating an improvement in the operating temperature range of ultra-high molecular weight polyethylene by at least 44%.
‘At least I have done something’: A qualitative study of women's social egg freezing experiences
Authors: De Proost Michiel , Coene Gily , Nekkebroeck Julie , Provoost Veerle
Published: November 2021

Social egg freezing has become an expanding clinical practice and there is a growing body of empirical literature on women's attitudes and the sociocultural implications of this phenomenon. Yet, its impact remains subject to ethical controversy. This article reports on a qualitative study, drawing on 18 interviews with women who had elected to initiate at least one egg freezing cycle in Belgium. Our findings, facilitated by a ‘symbiotic empirical ethics’ approach, shed light on the concerns and perceptions that accompany women's decisions while supporting a more context-sensitive reading of the ethical debate. We identified three key themes: feeling overwhelmed with uncertainty and a threatening future, bodily discomfort and distress during the medical process, and the endless pursuit of peace of mind. One of the issues that emerges from these findings is the risk ritual function of social egg freezing, referring to routine actions of risk anticipation that mitigate uncertainty and express a sense of individual responsibility. While more research is needed, this conceptualisation provides a starting point to flesh out the wider context of this moral practice and its symbolic meaning for women.
Assessment of accelerometer-derived data in the context of seat height changes in cycling and the impact on running in triathlon
Authors: Evans Stuart A , James Daniel A , Rowlands David , Lee James B
Published: November 2021

Triathlon has been an Olympic sport since the 2000 Sydney Olympics and has developed rapidly, leading to variations in race categories. Although running after cycling necessitates a postural change from a non-weight-bearing activity to a weight bearing one, no study has quantified the magnitude of trunk acceleration during cycling in different seat positions and the consequential effect on running. Therefore, this study was conducted to evaluate the effectiveness of a triaxial accelerometer to determine acceleration magnitudes of the trunk in a 20 km outdoor cycling event in two seat positions that were immediately followed by a 5 km overground run. Interpretation of data was evaluated based on cadence changes while triathletes cycled in an aerodynamic position in two seat positions. Running data was evaluated based on sinusoidal curves and foot strike peaks. The evaluation of accelerometer derived data within a characteristic overground setting suggests that cycling in an adjusted seat position significantly reduced trunk acceleration in both longitudinal and mediolateral directions with large effects ( p < 0.0001, d > 0.9). A significant and large effect was found in both longitudinal and anteroposterior trunk acceleration in post-cycle running between seat positions ( d > 0.9, p < 0.0001). In the longitudinal direction, a significant reduction in trunk acceleration occurred when running after the seat was adjusted with participants completing the 5 km run faster (21:55 ± 3:17 min compared to 22:05 ± 2:53 min). The results suggest that when the seat position is adjusted based on individual anthropometrics, overall trunk acceleration magnitude is reduced in both cycling and running. Accessible and practical sensor technology could be beneficial for postural considerations in triathlons.
The Continuous Learning Cycle: A Multi-phase Post-occupancy Evaluation (POE) of Decentralized Nursing Unit Design
Authors: Cai Hui , Spreckelmeyer Kent
Published: November 2021

Purpose:

This study aims to demonstrate how multiphase postoccupancy evaluation (POE) research was integrated into multiple projects to develop a continuous learning cycle.

Background:

Despite the well-recognized importance of POE, few studies have reported how knowledge from POE is applied in new designs.

Method:

This study is developed as a multiphase POE that spanned 3 years and across three units. Phase I POE compared an existing unit (Unit A) in Hospital A and a new Unit B in Hospital B that has implemented innovative design features such as decentralized nurse stations. The idea was to understand the challenges of the existing facility in Hospital A and gather lessons learned from the new design in Unit B to inform the design of the Hospital A expansion (Unit C). After the new expansion was occupied, the Phase II POE was conducted using the same set of POE tools in both Unit C and Unit A. The POE applied the following methods: (1) patient room evaluations using the Center for Health Design standardized POE tools, (2) space syntax analysis of visibility, and (3) a pre- and postmove analysis of Press Ganey data.

Results:

The results demonstrated that by incorporating lessons learned from the Phase I POE, Unit C has further improvement on patient room design ratings, improved patient satisfaction, and better visibility among nurse work areas compared to Unit A and Unit B.

Conclusions:

The multiphase, multisite POE with standardized tools has demonstrated its value as an important tool for continuous design quality improvement.
Book review: Vikas Bajpai and Anoop Saraya (2018). Food Security in India: Myth and Reality
Authors: Ramanamurthy R. V.
Published: November 2021

Vikas Bajpai and Anoop Saraya (2018). Food Security in India: Myth and Reality, New Delhi: Aakar Books. ISBN 9350025132 (Hardback), 456 pp., ₹1295.
Safety and Efficacy of Autologous Dermal Fibroblast Injection to Enhance Healing After Full-Thickness Rotator Cuff Repair: First-in-Human Pilot Study
Authors: Yoon Ji Young , Park Joo Hyun , Rhee Sung-Min , Jeong Hyeon Jang , Han Jikhyon , Lee Ji-Hye , Jeon Saewha , Oh Joo Han
Published: November 2021

Background:

There is growing interest in various biological supplements to improve tendon healing in patients after arthroscopic rotator cuff repair. The ideal biological supplement to strengthen rotator cuff remains unknown.

Purpose:

To assess the safety and efficacy of autologous cultured dermal fibroblast (ADF) injection on tendon-to-bone healing in patients after arthroscopic rotator cuff repair.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included were 6 patients who underwent arthroscopic rotator cuff repair between June 2018 and March 2020; all patients had a full-thickness rotator cuff tear (>2 cm) involving the supraspinatus and infraspinatus tendons. The patients were injected with ADF between the repaired tendon and footprint during arthroscopic rotator cuff repair using the suture bridge technique. The safety of ADFs and the procedure was evaluated at 5 weeks postoperatively, and the anatomical healing of the repaired tendon was accessed at 6 months postoperatively using magnetic resonance imaging and at 12 months using ultrasonography. Outcomes including shoulder range of motion (ROM), visual analog scale (VAS) for pain, and functional scores were measured at 6 and 12 months postoperatively.

Results:

Adverse reactions to ADF injection were not observed at 6 months after surgery. VAS and functional scores at 6 and 12 months postoperatively were significantly improved compared with preoperative scores (all P < .05). However, there was no significant difference on any ROM variable between preoperative and postoperative measurements at 6 and 12 months (all P > .05). No healing failure was found at 6 and 12 months postoperatively.

Conclusion:

There was no adverse reaction to ADF injection, and all patients had successful healing after rotator cuff repair. A simple and easily accessible ADF injection may be a novel treatment option for increasing the healing capacity of torn rotator cuff tendons. Further clinical research is needed to verify the study results.
Characterizing Firearms-Related Injuries and Craniofacial Fractures: A TQIP Study
Authors: Bourdillon Alexandra T. , Dobrow Sebastian , Steren Benjamin , Salehi Parsa P. , Pei Kevin Y. , Lee Jonathan Y. , Lee Yan Ho
Published: November 2021

Background: Interest in firearm injuries (FAIs), from medical and public health perspectives continues to grow. Few studies have analyzed the relationship of FAIs, craniofacial fractures, and traumatic brain injuries (TBIs). Methods: FAIs were isolated from national data from the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) 2014 to 2016 using external cause encodings. Pertinent demographic, injury, and hospital characteristics were extracted to characterize trends and statistically significant outcomes. Results: Thirty-two thousand eight hundred ninety-three (out of 829 805 cases) FAIs were captured, with a majority of patients being male and non-Hispanic/Latino Black. Multivariate linear regression revealed that race/ethnicity, age, hospital size, hospital region, intent of injury, and ISS significantly contributed to risk of mortality, increased hospital length of stay (LOS), and intensive care unit (ICU) duration. Five thousand nine hundred ten (18.0%) FAIs had at least 1 craniofacial fracture, and among these 75.1% (4441) incurred a traumatic brain injury (TBI). Mortality rate among patients with craniofacial FAI was 43.8% (2586/5910), compared to 9.7% (2618/26 983) without. Delayed surgical repair significantly increased hospital LOS ( P < .01), but not mortality ( P = .09). Conclusion: FAIs with craniofacial injury have significantly higher mortality rates than those without craniofacial injury. FAI-associated craniofacial injuries are frequently associated with TBI which is associated with significant morbidity and mortality. Such findings pose important public health and economic implications.
Evaluation of implementation and effectiveness of digital adherence technology with differentiated care to support tuberculosis treatment adherence and improve treatment outcomes in Ethiopia: a study protocol for a cluster randomised trial
Authors: Tadesse Amare W. , Mohammed Zemedu , Foster Nicola , Quaife Matthew , McQuaid Christopher Finn , Levy Jens , van Kalmthout Kristian , van Rest Job , Jerene Degu , Abdurhman Tofik , Yazew Hiwot , Umeta Demekech G. , Assefa Demelash , Weldemichael Gedion T. , Bedru Ahmed , Letta Taye , Fielding Katherine L.
Published: November 2021

Background

Digital adherence technologies (DATs) are recommended to support patient-centred, differentiated care to improve tuberculosis (TB) treatment outcomes, but evidence that such technologies improve adherence is limited. We aim to implement and evaluate the effectiveness of smart pillboxes and medication labels linked to an adherence data platform, to create a differentiated care response to patient adherence and improve TB care among adult pulmonary TB participants. Our study is part of the Adherence Support Coalition to End TB (ASCENT) project in Ethiopia.

Methods/Design

We will conduct a pragmatic three-arm cluster-randomised trial with 78 health facilities in two regions in Ethiopia. Facilities are randomised (1:1:1) to either of the two intervention arms or standard of care. Adults aged ≥ 18 years with drug-sensitive (DS) pulmonary TB are enrolled over 12 months and followed-up for 12 months after treatment initiation. Participants in facilities randomised to either of the two intervention arms are offered a DAT linked to the web-based ASCENT adherence platform for daily adherence monitoring and differentiated response to patient adherence for those who have missed doses. Participants at standard of care facilities receive routine care. For those that had bacteriologically confirmed TB at treatment initiation and can produce sputum without induction, sputum culture will be performed approximately 6 months after the end of treatment to measure disease recurrence. The primary endpoint is a composite unfavourable outcome measured over 12 months from TB treatment initiation defined as either poor end of treatment outcome (lost to follow-up, death, or treatment failure) or treatment recurrence measured 6 months after the scheduled end of treatment. This study will also evaluate the effectiveness, feasibility, and cost-effectiveness of DAT systems for DS-TB patients.

Discussion

This trial will evaluate the impact and contextual factors of medication label and smart pillbox with a differentiated response to patient care, among adult pulmonary DS-TB participants in Ethiopia. If successful, this evaluation will generate valuable evidence via a shared evaluation framework for optimal use and scale-up.

Trial registration: Pan African Clinical Trials Registry PACTR202008776694999, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=12241, registered on August 11, 2020.
Residual malaria among migrant workers in Myanmar: why still persistent and how to eliminate it?
Authors: Nyunt Myat Htut , Aye Khin Myo , Naing Shine Thura , Mon Aye Su , Htwe Mi Mi , Win Su Mon , Thwe Wai Myat , Zaw Ni Ni , Kyaw Myat Phone , Thi Aung
Published: November 2021

Background

Residual malaria is probably an important source for the re-emergence of malaria infection in the elimination era. Assessment to identify the factors influencing residual malaria in high-risk groups is needed to develop evidence-based decisions by stakeholders and policymakers.

Methods

This study was conducted to explore the factors influencing the residual malaria infection among migrant workers in two sentinel sites (endemic vs. pre-elimination areas) in Myanmar using the mixed-model method.

Results

A total of 102 migrant respondents (65 in Bamauk and 37 in Shwegyin) were included for the quantitative assessment using pretested questionnaires during household visits. Although 87.3% of them had insecticidal bed nets (ITNs/LLINs), only 68.3% of the migrants in Bamauk and 57.9% in Shwegyin used it regularly. The use of any bed net was high (79.9% in Bamauk vs. 91.0% in Shwegyin). The mean LLINs in their families were 1.64 (95%CI: 1.48–1.81) in Bamauk and 2.89 (95%CI: 2.67–3.11) in Shwegyin. Most of them received no health information for malaria prevention within the last year and their knowledge about malaria was low. Their working nature was a challenge for control measures against malaria in migrants.

Conclusion

The strategy for distributing LLINs and health promotion activities for mobile/migrant populations should be reviewed, and an appropriate action plan should be developed for the specific migrant group. Moreover, health promotion activities for behavior change communication should be strengthened in the migrant population in Myanmar.
Tuberculosis reactivation at ileum following immune checkpoint inhibition with pembrolizumab for metastatic nasopharyngeal carcinoma: a case report
Authors: Lau Kin-Sang , Cheung Ben Man-Fei , Lam Ka-On , Chan Sum-Yin , Lam Ka-Ming , Yeung Chun-Fai , Hung Ivan Fan-Ngai , Kwong Dora Lai-Wan , Tong Chi-Chung , Leung To-Wai , Luk Mai-Yee , Lee Anne Wing-Mui , Yuen Kwok-Keung , Lee Victor Ho-Fun
Published: November 2021

Background

Tuberculosis (TB) reactivation has been increasingly identified following immune checkpoint inhibitor (ICI) therapy for cancer patients. However there has been no report on TB reactivation in the gastrointestinal tract. In the report, we describe a patient who developed TB ileitis after pembrolizumab for her metastatic nasopharyngeal carcinoma (NPC). Rechallenge with pembrolizumab after its temporary interruption together with anti-TB therapy produced continuous tumor response but without further TB reactivation.

Case presentation

A 29-year-old lady with metastatic NPC involving the cervical nodes, lungs and bones started pembrolizumab after failure to multiple lines of chemotherapy. She complained of sudden onset of abdominal pain, vomiting and bloody diarrhea with mucus 21 months after pembrolizumab. Colonoscopy revealed terminal ileitis with multiple caseating granulomas with Langerhan cells. Serum interferon gamma release assay was strongly positive. She was treated with anti-TB medication and was later rechallenged with pembrolizumab for her progressive lung metastases without further TB relapse while her lung metastases were brought under control again.

Conclusion

To date, this is the first gastrointestinal TB reactivation after ICI therapy for cancer. Guidelines to screen for TB before initiation of ICIs in endemic areas should be established.
PD-1 inhibitors versus chemotherapy as second-line treatment for advanced esophageal squamous cell carcinoma: a meta-analysis
Authors: Zhu Xinxin , Shanzhou Qiyue , Li Danyang , Pang Xuezhou , Ma Daiyuan
Published: November 2021

Background

Aim to establish the inhibitors of programmed cell death protein 1 (PD-1) as second-line therapy for advanced esophageal squamous cell carcinoma (ESCC).

Methods

Published clinical trials in the PubMed, Medline, Embase databases on PD-1 inhibitors for the treatment of ESCC were searched, along with an additional search on abstracts from the American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO) from inception to September 2021. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (TRAEs) were synthesized using STATA.

Results

A total of 1970 patients (PD-1 inhibitors: 987; chemotherapy: 983) were enrolled in five randomized controlled trials. Compared with conventional chemotherapy, second-line PD-1 inhibitors significantly improved the OS (hazard ratio [HR] = 0.73, 95% confidence interval [CI]: 0.66–0.81; P < 0.001) and ORR (relative risk [RR] = 1.89, 95% CI: 1.16–3.05; P = 0.01) of advanced ESCC patients, especially significantly prolonged the OS in the patients with positive programmed death-ligand 1 (PD-L1) status (HR = 0.64, 95% CI: 0.53–0.77; P < 0.001); but did not better PFS (HR = 0.88, 95% CI: 0.68–1.14; P = 0.330) and DCR (RR = 0.89, 95% CI: 0.59–1.37; P = 0.603). Moreover, PD-1 inhibitors were associated with statistically lower incidences of grade 3–5 TRAEs.

Conclusion

Second line PD-1 inhibitors significantly improved the OS and ORR of patients with advanced ESCC, especially the OS of those with positive PD-L1 expression, and did not result in significant improvement in PFS and DCR. Compared to chemotherapy, second-line PD-1 inhibitors had superior safety profiles for the treatment of advanced ESCC.
Blowout fracture-associated orbital cellulitis progressing to panophthalmitis: a case report
Authors: Takesue Atsuhide , Asada Yosuke , Ooya Hiroki , Yokoyama Toshiyuki
Published: November 2021

Background

Parvimonas micra is known as a causative agent of chronic periodontal disease. This Gram-positive obligate anaerobic coccus was cultured from the ocular surface of blowout fracture-related orbital cellulitis progressing to panophthalmitis.

Case presentation

The patient was a woman in her fifties who had panic disorder and subsequently was a victim of domestic violence. These factors led to delayed consultation. At the initial visit to an ophthalmologist, the ocular surface of the right eye was covered with pus. Swelling of the upper and lower eyelids prevented the eyelid from closing and exophthalmos, severe corneal ulcer, panophthalmitis, and no light perception were observed. Head computed tomography revealed an old blowout fracture and chronic sinusitis with orbital cellulitis. P. micra were isolated from culture of pus samples from the sinus and from the ocular surface.

Conclusions

There is a possibility that P. micra invaded the orbit via the fragile bony site and caused orbital cellulitis, severe corneal ulcer, and panophthalmitis that required enucleation. In cases of coexisting old blowout fracture and chronic sinusitis, the chronic sinusitis should be treated as quickly as possible.