bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses' knowledge and attitude towards COVID-19 in the context of the acute health care settings in Jordan
Authors: Alhwamdih Sajidah , Abunab Hamzeh Y. , Algunmeeyn Abdullah Ahmad , Alfayoumi Imad , Hawamdeh Sana
Published: May 2021

Purpose

Nurses are at the front line in facing the COVID-19 outbreak and are at increased risk of becoming infected and might be the source of transmission in health-care facilities and the community. The purpose of this study is to assess the knowledge and attitude toward COVID1-19 among nurses in acute care settings in Jordan. This is expected to help with the global initiative to combat the COVID-19 epidemic.

Design/methodology/approach

A cross-sectional design was used to survey nurses' knowledge and attitude of COVID-19 among Jordanian nurses working in acute care settings.

Findings

The grand mean of knowledge items response was 8.94, implying that respondents possessed a high level of knowledge. The overall attitude score was positive for the participants, with a mean score of 5.93. Moreover, the results showed a significant relationship between knowledge and attitude scores.

Originality/value

The findings suggest that nurses in Jordan showed a high level of knowledge and a positive attitude toward COVID-19 during the outbreak's rapid rise period. This study showed specific aspects of knowledge and attitudes that should be focused on in future awareness and educational programs to promote all preventive and safety measures of COVID-19.
Design and simulation of robot hand for writing and correction assistant applications
Authors: Sri Naga Venkat Parvatini , Srinath A. , Santosh Kumar Gurram Narendra , Vijay P. , Venkatesh Rentala
Published: May 2021

Purpose

The design of robot hand for writing and correction assistant applications work will be partially replaced as to develop the remote-assisted robot hand control needed to manipulate all this kind of work. As it is stress and strain full job for all teachers, which needs to bring a sustainable solution, hence robot hand which resembles the human hand which is teleoperated with the remote control is designed.

Design/methodology/approach

This work presents the design and simulation of a robot hand for correction assistant applications. To replace the work partially especially for the teachers who are undergoing the paper correction work like putting tick mark, cross mark, allocation of marks, etc.

Findings

In this paper the design of the same and its simulation of writing the horizontal line, vertical line and writing number two is presented, in further research, a prototype model and its analysis will be done.

Originality/value

The design is been done using the modelling software Creo 5.4 where the design will be used to print the prototype model which is physical using 3D printing technology and controlling and testing will be done on the same prototype model using simple Arduino.
On the optimization of maintenance storage cost in industry a fuzzy logic application
Authors: Khalil Jean , Labib Ashraf W.
Published: May 2021

Purpose

The purpose of this paper is to construct a fuzzy logic model that acts as a decision support system to minimize inventory-related costs in the field of industrial maintenance. Achieving a balance between the unavailability and over-storage of spare parts is a problem with potentially significant consequences. That significance increases proportionally with the ever-increasing challenge of reducing overall cost. Either scenario can result in substantial financial losses because of the interruption of production or the costs of tied-up capital, also called the “solidification of capital.” Moreover, there is that additional problem of the expiry of parts on the shelf.

Design/methodology/approach

The proposed approach relies on inputs from experts with consideration for incompleteness and inaccuracy. Two levels of decision are considered simultaneously. The first is whether a part should be stored or ordered when needed. The second involves comparing suppliers with their batch-size offers based on user-determined criteria. A mathematical model is developed in parallel for validation.

Findings

The results indicate that the fuzzy logic approach is accurate and satisfactory for this application and that it is advantageous because of its limited sensitivity to the inaccuracy and/or incompleteness of data. In addition, the approach is practical because it requires minimal user effort.

Originality/value

To the best of the authors’ knowledge, the exploitation of fuzzy-logic altogether with limited sensitivity experts' inputs were never combined for the solution of this particular problem; however, this approach's positive impact is expected to be highly significant in solving a chronic problem in industry.
Beyond the formal/informal employment dualism: evaluating individual- and country-level variations in the commonality of quasi-formal employment
Authors: Williams Colin , Krasniqi Besnik
Published: May 2021

Purpose

To transcend the view of employment as either formal or informal, this paper evaluates the prevalence of quasi-formal employment where formal employers pay formal employees an unreported (“envelope”) wage in addition to their formal reported salary. To explain the individual-level variations in quasi-formal employment, the “marginalisation” thesis is evaluated that this practice is more prevalent among vulnerable groups and to explain the country-level variations, and a neo-institutionalist theory is evaluated that it is more prevalent where formal institutional failures lead to an asymmetry between the formal laws and regulations and the unwritten socially shared rules of informal institutions.

Design/methodology/approach

To evaluate the individual- and country-level variations in the prevalence of quasi-formal employment, a multi-level logistic regression is provided of data from special 2019 Eurobarometer survey 92.1 involving 11,793 interviews with employees across 28 European countries (the 27 member states of the European Union and the United Kingdom).

Findings

Of the 3.5% of employees (1 in 28) who receive under-reported salaries, the marginalisation thesis is supported that it is largely vulnerable population groups. So too is the neo-institutionalist explanation that quasi-formal employment is more common in countries where the non-alignment of formal and informal institutions is greater, with the formal institutional failings producing this identified as lower levels of economic development, less modernised state bureaucracies and lower levels of taxation and social protection.

Practical implications

The policy implication is that tackling quasi-formal employment requires not only enforcement authorities to improve the risk of detection of this illegal wage practice but also governments to change wider macro-level structural conditions. These are outlined.

Originality/value

Contemporary new evidence is provided of the prevalence of quasi-formal employment along with how this illegal wage practice can be explained and tackled.
A novel location-inventory-routing problem in a two-stage red meat supply chain with logistic decisions: evidence from an emerging economy
Authors: Rahbari Misagh , Razavi Hajiagha Seyed Hossein , Amoozad Mahdiraji Hannan , Riahi Dorcheh Farshid , Garza-Reyes Jose Arturo
Published: May 2021

Purpose

This study focuses on a specific method of meat production that involves carcass purchase and meat production by packing facilities with a novel two-stage model that simultaneously considers location-routing and inventory-production operating decisions. The considered problem aims to reduce variable and fixed transportation and production costs, inventory holding cost and the cost of opening cold storage facilities.

Design/methodology/approach

The proposed model encompasses a two-stage model consisting of a single-echelon and a three-echelon many-to-many network with deterministic demand. The proposed model is a mixed-integer linear programming (MILP) model which was tested with the general algebraic modelling system (GAMS) software for a real-world case study in Iran. A sensitivity analysis was performed to examine the effect of retailers' holding capacity and supply capacity at carcass suppliers.

Findings

In this research, the number of products transferred at each level, the number of products held, the quantity of red meat produced, the required cold storage facilities and the required vehicles were optimally specified. The outcomes indicated a two percent (2%) decrease in cost per kg of red meat. Eventually, the outcomes of the first and second sensitivity analysis indicated that reduced retailers' holding capacity and supply capacity at carcass suppliers leads to higher total costs.

Originality/value

This research proposes a novel multi-period location-inventory-routing problem for the red meat supply chain in an emerging economy with a heterogeneous vehicle fleet and logistics decisions. The proposed model is presented in two stages and four-echelon including carcass suppliers, packing facilities, cold storage facilities and retailers.
Adapting to transnational education: students’ experiences at an American university in the UAE
Authors: Mikecz Munday Zsuzsanna
Published: May 2021

Purpose

Despite the increasing number of transnational universities around the world, little attention has been paid to students who attend foreign universities in their own countries and their adjustment to the new learning environment. This study aims to examine some of the adaptations freshmen students have to undergo while studying at an American university in the United Arab Emirates (UAE).

Design/methodology/approach

This study is conducted at an American university in the UAE and involved 152 freshmen students, investigating their challenges to adapting to the university academically and socially. The target respondents were first-year students, typically 18–19 years old men and women of various majors and nationalities who completed high school in the country. Questionnaires were emailed to students; a total of 184 surveys were completed (with prior permission), but only 152 of those fitted the criteria and were used in the study.

Findings

Findings indicate that although these students study at home, by attending a foreign university many of them rely heavily on the support of peers, especially co-nationals. They require similar academic and emotional support from teachers as many first-year students at university do.

Research limitations/implications

The findings have limitations as data were collected at a single point in time through surveys. Being a single researcher, the study did not opt for breadth to answer the research questions but aimed to find out freshmen students’ challenges in adapting to the university. Despite the limitations of the study, several issues were raised that can be investigated in future studies.

Originality/value

The study provided insights into the challenges first-year students face at a transnational university in the UAE. It identifies the support that could be provided by the university to facilitate students’ successful adjustment process to the educational and socio-cultural environment of the university. Although this was small-scale research and cannot be generalized to a larger population, the findings could be transferable to other, similar settings in transnational universities in the region. Findings might be compared and contrasted to other, related cases, as the structural aspects could be noticed in similar cases or situations.
The use of technology in informal English language learning: evidence from Yemeni undergraduate students
Authors: Bin-Hady Wagdi Rashad Ali , Al-Tamimi Nasser Omer Mubarak
Published: May 2021

Purpose

This study aims to explore the use of technology-based strategies by Yemeni undergraduate students to develop their English as a foreign language skills in informal learning settings.

Design/methodology/approach

A mixed methods research design was used to collect quantitative and qualitative data from 110 undergraduate students enrolled at the English Departments in two universities in Yemen. In the first phase of the study, 10 students were interviewed to obtain information about their use of technology to develop their English language skills and subsystems in informal settings. Following the analysis of the interview data, a questionnaire was built to collect quantitative data, and the second phase of the study was carried out with 100 undergraduate students.

Findings

The findings revealed that students developed four technology-based strategies that they used in informal settings. These strategies included using social media, being inspired by someone, accessing social networks and websites. Students reported that these strategies helped them develop their listening, speaking and reading skills, while they also reported that their vocabulary was enhanced over grammar and pronunciation.

Research limitations/implications

The study findings can be of benefit not only for helping to raise students’ awareness of informal learning strategies to develop their English skills outside the classroom but also for teachers to rethink the importance of integrating technology tools and digital resources in their teaching practice. The results could also guide curriculum designers to augment textbook materials by integrating technology-based informal learning strategies.

Originality/value

This is the first study on this topic conducted in the context of higher education in Yemen and offers unique insights into informal learning practices of Yemeni students. In addition, the findings of the study open new dimensions for rethinking the classification of language learning strategies to include those that are technology-based and mainly useful for independent informal learning.
Improving Emirati students’ social responsibility competence through global citizenship education
Authors: Wren Shytance T.
Published: May 2021

Purpose

The purpose of this study is twofold: to determine if implementing a global citizenship education curriculum can aid the development of Emirati students’ social responsibility competence and to experiment with different instructional strategies that aim to yield improvement in the social responsibility of students.

Design/methodology/approach

The intervention research study used a mixed-methods quasi-experimental approach to examine Emirati students’ social responsibility gains and overall perceptions of a global citizenship education curriculum. Conceptual frameworks for instructional design of service-learning were used as theoretical underpinnings. The data were collected from student reflections, field notes, questionnaires and interviews.

Findings

Both the quantitative and qualitative data indicated that the global citizenship curriculum advanced students' understanding of social responsibility and civic concepts, specifically civic awareness, social justice and diversity.

Research limitations/implications

For future studies, researchers are encouraged to expand the current study's five-week timeframe by exploring the implications of a global citizenship education curriculum over a full term or even a whole academic year.

Practical implications

The results of the present study indicate that educators should experiment with curriculum redesign to further facilitate the development of social responsibility in undergraduate students. The results also suggest that educators incorporate specific instructional strategies such as integrated reflections and intergroup dialogue on social issues.

Originality/value

Social responsibility and global citizenship education have broadly been based on Western paradigms. Few studies have explored the impact of global citizenship education on the development of students' social responsibility in the Gulf region. This study fills the gap in knowledge by lending evidence of the role of global citizenship education in undergraduate university programs in the Gulf.
Impact assessment of contemporary international and national accounting standards adoption: evidence from Greek hotels
Authors: Koufodontis Nikolaos Iason , Zounta Stella , Papagiouvanni Maria
Published: May 2021

Purpose

This paper aims to offer new insights on how the adoption of contemporary international accounting standards can affect the financial performance of a hotel. It provides significant input for strategic decision making in property management, especially in countries where hotels properties are given a choice between different accounting standards.

Design/methodology/approach

Data was collected from 3-, 4- and 5- star hotels in Greece, through primary research with questionnaires, filled by hotel financial managers. Greece was selected because hotels can choose between national and international accounting standards; therefore, the research could focus on actual factors beyond mandatory adoption.

Findings

Microeconomic factors such as category or legal form of the hotel in combination with other factors can affect the perceived benefits of the selected accounting standards. Macroeconomic factors such as the overall tourism development of the destination also affect the perceived impact.

Research limitations/implications

The research was targeted at hotel executives with knowledge and participation in decision making regarding accounting standards. This requirement limited the sample since all hotels do not have a financial manager position.

Practical implications

The new knowledge can be utilized in property management as an element of hospitality strategic planning for improved assessment of anticipated effects resulting from the adoption of specific accounting standards.

Originality/value

The research fills a gap in existing knowledge by introducing elements not previously examined; additionally, it expands previous knowledge from other sectors to hospitality and tourism, while verifying or rejecting past findings.
From loyalty to resignation: Patient–doctor figurations in type 1 diabetes
Authors: Ardissone Alberto
Published: May 2021

This paper contributes to the debate on the patient–doctor relationship by focussing on a specific chronic disease: type 1 diabetes. This field is characterised by an increasing use of technology, specifically therapeutic devices and a significant requirement of patient self‐management. This paper presents the main findings of research conducted in Italy in 2018. It is argued that this relationship is more properly described as an interdependent figuration of actors characterised by a dynamic process of power balances, which recalls Elias' (What is sociology? Columbia University Press, 1978) figurational‐processual and relational sociology. In this theoretical context, patients may manage their (dis)satisfaction with their diabetologists by choosing different behaviours that stem from Hirschman's archetype (Exit, voice, and loyalty. Responses to decline firms, organizations, and states. Harvard University Press, 1970): voice, exit, loyalty and, we would add, resignation. These categories are fluid, and all of them can be experienced by patients over time, depending on the quality of the figurations built among these transactors.
Urinary C‐peptide/creatinine ratio: A useful biomarker of insulin resistance and refined classification of type 2 diabetes mellitus
Authors: Wang Yanai , Zou Xiantong , Cai Xiaoling , Liu Wei , Chen Ling , Zhang Rui , Zhou Lingli , Gong Siqian , Gao Ying , Li Simin , Luo Yingying , Han Xueyao , Ji Linong
Published: May 2021

Background

The urinary C‐peptide/creatinine ratio (UCPCR) is low in patients with type 1 diabetes mellitus, but it has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We aimed to measure the UCPCRs in patients with T2DM and explore the relationships among UCPCR, insulin resistance (IR), and chronic vascular complications of diabetes.

Methods

A cross‐sectional study was performed of 1299 Chinese hospitalized patients with T2DM. Binary logistic regression was used to evaluate the relationships between the chronic vascular complications of diabetes and UCPCR. K‐means analysis was used to allocate participants to subgroups with five to six variables (age at diagnosis, body mass index [BMI], glycosylated hemoglobin, homoeostasis model assessment 2‐estimated beta‐cell function (HOMA2‐B), and HOMA2‐insulin resistance (HOMA2‐IR), with or without UCPCR).

Results

UCPCR positively correlated with HOMA2‐IR (r = 0.448, P < .001). After adjustment for sex, age, duration of diabetes, and other cardiovascular risk factors, UCPCR was positively associated with diabetic kidney disease (DKD) (odds ratio [OR] = 1.198, 95% CI 1.019‐1.408, P = .029) and coronary heart disease (CHD) (OR = 1.312, 95% CI 1.079‐1.594, P = .006). When UCPCR was added, cluster analysis using the six variables identified five subgroups of T2DM, characterized by differing age at diagnosis, BMI, beta‐cell function, IR, and prevalence of vascular complications.

Conclusions

UCPCR is positively associated with IR, DKD, and CHD and represents a promising biomarker that could refine the classification of T2DM.
Activity levels of inpatients admitted to two rehabilitation units in regional hospitals: An observational study
Authors: Garner Jon , Smith Moira
Published: May 2021

Objective

The objective of this study is to measure the activity levels of patients admitted to adult general inpatient rehabilitation units in regional areas. These included physical, social, cognitive and self‐care activities. A secondary aim was to explore differences in activity levels across different diagnostic groups.

Design

An observational study using behavioural mapping. Patient activity was mapped every 15 minutes, over a 12‐hour period (07:00‐19:00), on two, non‐consecutive days.

Setting

2 inpatient rehabilitation units, inner regional NSW.

Participants

All patients were admitted for rehabilitation in an adult general rehabilitation unit. Patients presented with diverse diagnoses (eg neurological, musculoskeletal, orthopaedic, pulmonary and cardiovascular diseases). The sample had a mean age of 74.4 years with a range of 33‐96 years.

Main outcome measures

The percentage of the day spent in physical, cognitive or social activities was recorded. In addition, the patients’ location and interacting personnel were recorded.

Results

Fifty‐six participants across 8 diagnosis groups were observed. A total of 2285 observations were made. Patients were observed being active physically for 10% of their day, socially active for 23%, and cognitively for 6%. Patients engaged in other activities such as watching TV or eating 21% of their time, and completing self‐care activities 7% of their time. Patients were inactive for 27% of their day. There was no statistically significant difference between the diagnostic groups and activity categories.

Conclusion

Patients spent a large proportion of their time inactive and alone in rehabilitation. In order to maximise outcome, rehabilitation units can look at new opportunities to maximise activity and promote engagement.
Drivers of general practice–type presentations to the emergency department in a remote outback community
Authors: Fatima Yaqoot , Hays Richard , Knight Sabina , Neilson Anne , Fleming Rhonda , Panaretto Kathryn , Jatrana Santosh , Skinner Isabelle
Published: May 2021

Objective

To estimate the number of general practice‐appropriate attendances in a remote emergency department and explore the reasons for patients’ choice of service.

Design

A four‐step case study approach was adopted, focusing on hospital emergency department (ED) attendances that were potentially manageable in general practice.

Setting

A large, remote community with substantial populations of Indigenous peoples and fly‐in, fly‐out mining industry workers. The ED is experiencing rapid growth in demand for services for lower urgency.

Participants

Patients attending the emergency department with lower urgency problems.

Interventions

ED attendance data for 2016 were reviewed to identify lower urgency presentations. Patient records for 400 randomly selected presentations were subject to deeper analysis. A prospective survey was conducted over 6 months of 369 ED patients with lower urgency presentations.

Main outcome measures

The proportion of patients attending the ED with GP‐appropriate problems and influences on their decisions to attend the ED.

Results

About 48% of all attendances met the agreed definition of GP‐appropriate problems. About half of presentations were during the normal work hours and about half of patients stated that GP services were unavailable. Younger age, lack of information about local GP services, and perceptions of convenience contributed significantly to seeking ED care.

Conclusion

Increasing the availability of GP services alone is unlikely to be sufficient to change service utilisation. Strategies should include raising community awareness of how and when to utilise the appropriate service, understanding different models of care, and the need to register with a general practice.
Association of lifestyle factors with a high prevalence of overweight and obesity in Greek children aged 10–16 years
Authors: Kostopoulou Eirini , Tsekoura Efstathia , Fouzas Sotirios , Gkentzi Despoina , Jelastopulu Eleni , Varvarigou Anastasia
Published: May 2021

Aim

To investigate the prevalence of overweight, obesity and central obesity in students of primary and secondary education, and the association with lifestyle parameters.

Methods

A total of 3504 students, aged 10–16 years old, from Western Greece participated in this cross‐sectional epidemiological study (participation rate: 90%). Demographic, socioeconomic, dietary, physical activity and screen time data were obtained using a questionnaire. Anthropometric measurements were also obtained. Overweight and obesity were estimated using the Centers for Disease Control and Prevention (CDC) and International Obesity Task Force (IOTF) criteria and central obesity using the WHtR ≥0.5 and IDF criteria.

Results

The prevalence of overweight and obesity was 19.2% and 12.1% with CDC criteria, respectively, and 20.9% and 7.2%, with IOTF criteria respectively. Central obesity was 31.1 and 32.8% using the Waist‐to‐Height ratio (WHtR) ≥0.5 and International Diabetes Federation (IDF) criteria respectively. Male gender, small number of meals, breakfast skipping, frequent consumption of school food and sweets and the presence of a computer in children's rooms, were identified as the strongest lifestyle factors affecting weight.

Conclusion

Overweight, obesity and central obesity rates remain high among children and adolescents in Greece. The identification of risk factors associated with the manifestation of obesity and central obesity, may contribute to the implementation of targeted prevention and treatment interventions.
Malignant peripheral nerve sheath tumors arising from schwannomas: case series and literature review
Authors: Berner Emily Ann , Hung Yin P. , Nielsen Gunnlaugur Petur , Lozano‐Calderón Santiago A.
Published: May 2021

A malignant peripheral nerve sheath tumor (MPNST) arising from a schwannoma is extremely rare, with limited literature on its clinicopathologic features. Here, we present a case series and literature review on patients with MPNSTs arising from schwannomas. We performed a retrospective review of patients from our institution’s records to identify those with MPNSTs arising from schwannomas. We conducted a search for additional cases from the literature utilizing PubMed. 20 patients (including 2 at our institution and 18 from 16 prior publications) were identified. The patients aged 22–93 (mean 52) years, and 63% were females. Histologically, while most MPNSTs arising from schwannomas were of epithelioid‐type, 7 tumors (including 2 at our institution) were of conventional spindle‐cell type. All 20 patients underwent surgical excision, while a subset received additional radiotherapy and/or chemotherapy. In 17 patients with available follow‐up, the overall survival was 2–72 (median 12) months. MPNSTs rarely arise from schwannomas and should be considered in patients with a clinical diagnosis of schwannoma, however, with atypical radiologic or clinical features. MPNSTs arising from schwannomas can show epithelioid or spindle‐cell histology and harbor an aggressive course, even with surgical excision and adjuvant treatment.
Status: nosocomial transmission and prevention of SARS‐CoV‐2 in a Danish context
Authors: Calum Henrik Pierre , Sode Louise Palasin , Pedersen Michael
Published: May 2021

The unexpected pandemic with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has challenged the healthcare sector as regards preventing and controlling the virus from spreading between patients and hospital personnel. The massive spread of the pandemic has led state authorities to introduce restrictions on society and public behavior unprecedented in modern times. First, we describe the Danish effort regarding standard precautions, personal protective equipment, and disinfection in the healthcare setting with Denmark as an example. As regards, the number of coronavirus disease 2019 (COVID‐19)‐related hospital submissions, deaths, and infected healthcare workers in Denmark is not the hardest hit country compared with others. This cannot be explained by the hardness of the restrictions alone. Several aspects concerning the person‐to‐person spread of SARS‐CoV‐2 are not fully understood and require more experimental studies. The dogma is that virus transmission happens through either respiratory droplets or contact routes. However, it is likely not the whole truth, as we describe scenarios where droplets and/or direct contact cannot alone explain how all patients were infected. Aspects of the physiology of airborne transmission are considered, as several parameters are in play beyond particle size and respiratory rate. These are ozone concentration, ambient temperature, and humidity. In a hospital environment, these factors are not necessarily all controllable, making infection prevention and control a challenge.
The development of inhibitors of leucine‐rich repeat kinase 2 (LRRK2) as a therapeutic strategy for Parkinson's disease: the current state of play
Authors: Azeggagh Sonia , Berwick Daniel C.
Published: May 2021

Current therapeutic approaches for Parkinson's disease (PD) are based around treatments that alleviate symptoms but do not slow or prevent disease progression. As such, alternative strategies are needed. A promising approach is the use of molecules that reduce the function of leucine‐rich repeat kinase (LRRK2). Gain‐of‐function mutations in LRRK2 account for a notable proportion of familial Parkinson's disease cases, and significantly, elevated LRRK2 kinase activity is reported in idiopathic Parkinson's disease. Here, we describe progress in finding therapeutically effective LRRK2 inhibitors, summarising studies that range from in vitro experiments to clinical trials. LRRK2 is a complex protein with two enzymatic activities and a myriad of functions. This creates opportunities for a rich variety of strategies and also increases the risk of unintended consequences. We comment on the strength and limitations of the different approaches and conclude that with two molecules under clinical trial and a diversity of alternative options in the pipeline, there is cause for optimism.

LINKED ARTICLES

This article is part of a themed issue on Building Bridges in Neuropharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.8/issuetoc
Dynamics in oral health‐related factors of Indigenous Australian children: A network analysis of a randomized controlled trial
Authors: Soares Gustavo Hermes , Ribeiro Santiago Pedro Henrique , Biazevic Maria Gabriela Haye , Michel‐Crosato Edgard , Jamieson Lisa
Published: May 2021

Objectives

Network analysis is an innovative, analytic approach that enables visual representation of variables as nodes and their corresponding statistical associations as edges. It also provides a new way of framing oral health‐related questions as complex systems of variables. We aimed to generate networks of oral health variables using epidemiological data of Indigenous children, and to compare network structures of oral health variables among participants who received immediate or delayed delivery of an oral health intervention.

Methods

Epidemiological data from 448 mother‐child dyads enrolled in a randomized controlled trial of dental caries prevention in South Australia, Australia, were obtained. Networks were estimated with nodes representing study variables and edges representing partial correlation coefficients between variables. Data included dental caries, impact on quality of life, self‐rated general health, self‐rated oral health, dental service utilization, knowledge of oral health, fatalism and self‐efficacy in three time points. Communities of nodes, centrality, clustering coefficient and network stability were estimated.

Results

The oral health intervention interacted with the network through self‐rated general health and knowledge of oral health. Networks depicting groups shortly after receiving the intervention presented higher clustering coefficients and a similar arrangement of nodes. Networks tended to return to a preintervention state.

Conclusion

The intervention resulted in increased connectivity and changes in the structure of communities of variables in both intervention groups. Our findings contribute to elucidating dynamics between variables depicting oral health networks over time.
Poor response at restaging MRI and high incomplete resection rates of locally advanced mucinous rectal cancer after chemoradiation therapy
Authors: Koëter Tijmen , Stijns Rutger C. H. , van Koeverden Sebastiaan , Hugen Niek , van der Heijden Joost Albertus Gerardus , Nederend Joost , van Zwam Peter H. , Nagtegaal Iris D. , Verheij Marcel , Rutten Harm J. T. , de Wilt Johannes H. W.
Published: May 2021

Aim

Mucinous carcinoma is a histological subtype of rectal cancer and has been associated with a poor response to neoadjuvant chemoradiotherapy (CRT). The primary aim of this study was to analyse the response on MRI of mucinous locally advanced rectal cancer (LARC) after CRT compared to regular adenocarcinoma.

Method

Patients with LARC (defined as cT4 and/or cN2), who underwent CRT followed by restaging MRI and surgery in two tertiary referral hospitals were retrospectively included in the study. Pre‐ and post‐treatment MRI was reviewed by an experienced abdominal radiologist.

Results

A total of 102 patients, of whom 29 were diagnosed with mucinous carcinoma, were included for analysis. At restaging MRI, adenocarcinoma patients demonstrated significantly less clinical involvement of the mesorectal fascia (37% vs. 62%, P = 0.003) while this was not demonstrated in mucinous carcinoma patients (86% vs. 97%, P = 0.16). Significant downstaging after CRT in adenocarcinoma patients (P = 0.01) was seen while, in mucinous carcinoma patients, no downstaging after CRT (P = 0.89) was seen. Pathology revealed significantly higher rates of an involved circumferential resection margin in mucinous carcinoma versus adenocarcinoma patients (27.6% vs. 1.4%; P < 0.001). After multivariate regression analysis, mucinous carcinoma remained an independent prognostic factor for local recurrence (hazard ratio 3.6; 95% CI 1.1–12.4), although no differences in overall or disease‐free survival were observed.

Conclusion

Mucinous rectal carcinoma is associated with a poor clinical response at restaging MRI after CRT, leading to relatively higher rates of involved circumferential resection margins at pathology. In this cohort, mucinous carcinoma seems to be a prognostic factor for increased risk of local recurrence, without an effect on overall survival.
Novel principal component analysis‐based feature selection mechanism for classroom sound classification
Authors: Tsalera Eleni , Papadakis Andreas , Samarakou Maria
Published: May 2021

Machine learning algorithms for sound classification can be supported by multiple temporal, spectral, and perceptual features extracted from the sound signal. The number of features affects the classification accuracy but also the computational resources requested, so the number of features has to be carefully selected. In this work, we propose a methodology for feature selection based on the principal component analysis. The case study has been the classification of classroom sounds during face‐to‐face module delivery and six sound types have been defined. The proposed method is applied upon a set of 143 sound features to produce feature ranking. The ranking results are compared with those provided by the Relief‐F. Then the selected features are used by five classification algorithms, Linear Discriminant Analysis (LDA), Quadratic Support Vector Machine (QSVM), k Nearest Neighbors, Boosted Trees, and Random Forest. The algorithms are executed with increasing number of features, from 1 to 143, considering both feature rankings, creating 1430 models. The performance of the classification algorithms increases rapidly with the number of features with LDA, QSVM, and Boosted Trees outperforming other methods and surpassing the accuracy ratio of 90% with 25 features.
Role of CXCR4 in the progression and therapy of acute leukaemia
Authors: Su Long , Hu Zheng , Yang Yong‐Guang
Published: May 2021

CXCR4 is expressed on leukaemia cells and haematopoietic stem cells (HSCs), and its ligand stromal‐derived factor 1 (SDF‐1) is produced abundantly by stromal cells in the bone marrow (BM). The SDF‐1/CXCR4 axis plays important roles in homing to and retention in the protective BM microenvironment of malignant leukaemia cells and normal HSCs. CXCR4 expression is regulated by multiple mechanisms and the level of CXCR4 expression on leukaemia cells has prognostic indications in patients with acute leukaemia. CXCR4 antagonists can mobilize leukaemia cells from BM to circulation, which render them effectively eradicated by chemotherapeutic agents, small molecular inhibitors or hypomethylating agents. Therefore, such combinational therapies have been tested in clinical trials. However, new evidence emerged that drug‐resistant leukaemia cells were not affected by CXCR4 antagonists, and the migration of certain leukaemia cells to the leukaemia niche was independent of SDF‐1/CXCR4 axis. In this review, we summarize the role of CXCR4 in progression and treatment of acute leukaemia, with a focus on the potential of CXCR4 as a therapeutic target for acute leukaemia. We also discuss the potential value of using CXCR4 antagonists as chemosensitizer for conditioning regimens and immunosensitizer for graft‐vs‐leukaemia effects of allogeneic haematopoietic stem cell transplantation.
A risk score for pericarditis recurrence
Authors: Lazarou Emilia , Lazaros George , Antonopoulos Alexios S. , Imazio Massimo , Vasileiou Panagiotis , Karavidas Apostolos , Toutouzas Konstantinos , Vassilopoulos Dimitrios , Tsioufis Costas , Tousoulis Dimitris , Vlachopoulos Charalambos
Published: May 2021

Background

Currently, we remain uncertain about which patients are at increased risk for recurrent pericarditis. We developed a risk score for pericarditis recurrence in patients with acute pericarditis.

Materials and methods

We prospectively recruited 262 patients with a first episode of acute pericarditis. Baseline patients’ demographics, clinical, imaging and laboratory data were collected. Patients were followed up for a median of 51 months (interquartile range 21‐71) for recurrence. Variables with <10% missingness were entered into multivariable logistic regression models with stepwise elimination to explore independent predictors of recurrence. The final model performance was assessed by the c‐index whereas model's calibration and optimism‐corrected c‐index were evaluated after 10‐fold cross‐validation.

Results

We identified six independent predictors for pericarditis recurrence, that is age, effusion size, platelet count (negative predictors) and reduced inferior vena cava collapse, in‐hospital use of corticosteroids and heart rate (positive predictors). The final model had good performance for recurrence, c‐index 0.783 (95% CI 0.725‐0.842), while the optimism‐corrected c‐index after cross‐validation was 0.752. Based on these variables, we developed a risk score point system for recurrence (0‐22 points) with equally good performance (c‐index 0.740, 95% CI 0.677‐0.803). Patients with a low score (0‐7 points) had 21.3% risk for recurrence, while those with high score (≥12 points) had a 69.8% risk for recurrence. The score was predictive of recurrence among most patient subgroups.

Conclusions

A simple risk score point system based on 6 variables can be used to predict the individualized risk for pericarditis recurrence among patients with a first episode of acute pericarditis.
Seasonality, niche management and vertical migration in landscapes of relief
Authors: John Christian , Post Eric
Published: May 2021

Landscapes of vertical relief, such as mountains and continental slopes, intensify ecological and climatological variation within narrow spatial windows. Seasonal vertical migrants exploit this variation during their residence in, and movements between, vertically stratified seasonal ranges. Animals in terrestrial, marine and even human‐ecological systems undergo similar patterns of seasonal vertical movements. The diversity of arenas in which vertical migration evolved lends insight to the factors promoting seasonal use of landscapes of relief. Because animals must contend with both endogenous circannual rhythms and exogenous environmental seasonality, vertical migrants may be sensitive to inconsistent change across stratified seasonal ranges under climate change. To better understand how ongoing and future climatic and environmental changes are likely to impact vertical migrants, we examine vertical migration in the context of niche tracking and niche switching. Whereas niche trackers minimize variation in realized environmental conditions throughout their seasonal movements, niche switchers undergo seasonal transitions in realized niche space. These strategies mediate the relationship between migrants and their changing environment, and can be used to forecast impacts of future change and effectively conserve systems of vertical migration. Niche tracking may be hindered by inconsistent or unpredictable environmental change along a single niche axis across strata, while niche switching may be sensitive to incongruous spatiotemporal change across factors. We suggest that climate change will affect seasonal patterns in vertical environments discontinuously across time, space and strata, and that vertical migrants are likely to face additional anthropogenic threats that interact with environmental seasonality. Conservation of vertical migrants should prioritize the availability of, and facilitate movement between, stratified seasonal ranges.
Long‐term athletic performance in sport horses after desmotomy of the accessory ligament of the deep digital flexor tendon
Authors: Wismann Emilie S. , Jacobsen Stine , Thøfner Martin , Ladefoged Søren , Ekstrøm Claus , Lindegaard Casper
Published: May 2021

Background

Outcome after desmotomy of the accessory ligament of the deep digital flexor tendon (AL‐DDFT) to treat flexural deformity of the distal interphalangeal joint has been reported to be excellent. However, no studies have compared long‐term athletic performance of sport horses exposed to desmotomy of the AL‐DDFT to that of matched controls.

Objectives

The objective of this study is to compare long‐term athletic performance in sports horses subjected to desmotomy of the AL‐DDFT with the performance of matched controls.

Study design

This is an observational multicentre retrospective matched cohort study.

Methods

Records from horses undergoing desmotomy of the AL‐DDFT between 2004 and 2015 were reviewed. Various databases were used to identify age‐matched siblings as unexposed controls and data on the horses' athletic careers.

Results

Seventy‐four exposed and 194 matched unexposed horses were included. Although not significantly different, the proportion of exposed horses entering competition (28%, 95% CI 16%‐38%) had a substantial risk difference compared with the proportion of unexposed horses entering competition (38%, 95% CI 26%‐44%) (P = .2). Career longevity was significantly better for unexposed (15.6 competitions [95% CI 10.7‐22.5] over a median of 570 days [IQR 210‐1340]) than for exposed horses (9.7 competitions [95% CI 6.4‐14.6] over a median of 219 days [IQR 2‐1159] for horses operated in one limb and 6.1 competitions [95% CI 3.6‐9.9] over a median of 446 days [IQR 23‐603 days] for horses operated in two limbs, P < .001). Age at surgery and whether the condition was unilateral or bilateral did not affect chance of competing.

Main limitations

Small sample size, varying quality of medical records, stage of contraction not noted in many records and missing information on reasons for not entering into competition.

Conclusions

Desmotomy of the AL‐DDFT is associated with decreased long‐term athletic performance in sport horses compared with matched unexposed horses.
Influence of drought on interactions between Rhopalosiphum padi and ground dwelling predators – A mesocosm study
Authors: Njue Martin , Muturi Phyllis , Nyaga Justine , Jonsson Mattias
Published: May 2021

Climate change will lead to extreme droughts, but it is difficult to predict how this will affect crop pests. In particular, it is unclear how interactions between natural enemies and pests will be influenced. In the field, bird cherry‐oat aphids (Rhopalosiphum padi (L.)) have been observed to reside close to, or below the ground surface during dry conditions. We hypothesized that this will increase the niche overlap between R. padi and ground‐dwelling predators such as carabid beetles and wolf spiders and that aphid numbers will therefore decline during dry conditions. A fully factorial mesocosm experiment was conducted testing the combined effects of drought and predator presence on aphid position and abundance on barley (Hordeum vulgare) plants. In support of our hypothesis, we found that (a) aphids moved below ground during dry conditions, (b) predators reduced aphid numbers, but only during dry conditions, and (c) predators reduced the proportion of aphids below ground in dry conditions. This increased predation effect during dry conditions was, however, compensated for by a corresponding increase in aphid performance on the plants and so the net effect of drought on aphid numbers ended up being neutral. Thus, pests can be affected by drought in complex ways via a combination top‐down and bottom‐up mechanisms. Predicting how pest populations will be affected by droughts in the future is thus a formidable research challenge.
A novel 2A‐peptide‐containing plasmid to generate stable Perkinsusmarinus cells expressing organelle‐targeted genes
Authors: Sakamoto Hirokazu , Kita Kiyoshi , Matsuzaki Motomichi
Published: May 2021

Genetic manipulation techniques for marine protists are not well‐established, despite immense efforts. However, Perkinsus marinus is an exception and can be developed as a genetically tractable model organism for related protists. Here, we designed a new plasmid for P. marinus that allows two proteins from a single mRNA to be differently localized using a self‐cleaving 2A peptide. This enabled us to establish a stable transfectant expressing a mitochondrially targeted fluorescent protein. The system can be applied to any protein in theory and would make a powerful tool for investigating unique organelles in P. marinus and related dinoflagellates.