bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of bubble removal performances of five membrane oxygenators with and without a pre-filter
Authors: Ishida Mitsuru , Takahashi Sho , Okamura Homare
Published: February 2022

When employing minimal invasive extracorporeal circulation (MiECC), the removal of bubbles in the circuit is important to prevent air embolism. We investigated the bubble removal performance of the FHP oxygenator with a pre-filter and compared it with that of four oxygenators, including the Fusion oxygenator, Quadrox oxygenator, Inspire oxygenator, and FX oxygenator. A closed test circuit filled with an aqueous glycerin solution was used. Air injection (10 mL) was performed prior to the oxygenator, and the number and volume of the bubbles were measured at the inlet and outlet of each oxygenator. At the inlet of the five oxygenators, there were no significant differences in the total number of bubbles detected. At the outlet, bubbles were classified into two groups according to the bubble size: ≥100 μm and <100 μm. Tests were performed at pump flow rates of 4 and 5 L/min. For bubbles ≥100 μm, which are considered clinically detrimental, the FHP was the lowest number and volume of bubbles at both pump flow rates compared to the other oxygenators. Regarding the bubbles <100 μm, the number of bubbles was higher in the FHP than those in others; however, the volume of bubbles was significantly lower at 4 L/min and tended to be lower at 5 L/min. The use of the FHP with the pre-filter removed more bubbles ≥100 μm in the circuit than that by the other oxygenators.
A pilot economic evaluation of a feasibility trial for SUpporting wellbeing through PEeR-Befriending (SUPERB) for post-stroke aphasia
Authors: Flood Chris , Behn Nicholas , Marshall Jane , Simpson Alan , Northcott Sarah , Thomas Shirley , Goldsmith Kimberley , McVicker Sally , Jofre-Bonet Mireia , Hilari Katerina
Published: February 2022

Objectives

To explore the feasibility of a full economic evaluation of usual care plus peer-befriending versus usual care control, and potential cost-effectiveness of peer-befriending for people with aphasia. To report initial costs, ease of instruments’ completion and overall data completeness.

Design

Pilot economic evaluation within a feasibility randomised controlled trial

Setting

Community, England

Participants

People with post-stroke aphasia and low levels of psychological distress

Intervention

All participants received usual care; intervention participants received six peer-befriending visits between randomisation and four months

Main measures

Costs were collected on the stroke-adapted Client Service Receipt Inventory (CSRI) for health, social care and personal out-of-pocket expenditure arising from care for participants and carers at 4- and 10-months post-randomisation. Health gains and costs were reported using the General Health Questionnaire-12 and the EQ-5D-5L. Mean (CI) differences for costs and health gains were reported and uncertainty represented using non-parametric bootstrapping and cost-effectiveness acceptability curves.

Results

56 participants were randomised. Mean age was 70.1 (SD 13.4). Most ( n = 37, 66%) had mild and many ( n = 14; 25%) severe aphasia. There was ≥94% completion of CSRI questions. Peer-befriending was higher in intervention arm ( p < 0.01) but there were no significant differences in total costs between trial arms. Peer-befriending visits costed on average £57.24 (including training and supervision costs). The probability of peer-befriending being cost-effective ranged 39% to 66%.

Conclusions

Economic data can be collected from participants with post-stroke aphasia, indicating a full economic evaluation within a definitive trial is feasible. A larger study is needed to demonstrate further cost-effectiveness of peer-befriending.
Measuring Entrepreneurship Intention in Secondary Education: Validation of the Entrepreneurial Intention Questionnaire
Authors: Martínez-Gregorio Sara , Oliver Amparo
Published: February 2022

This article is the first attempt to validate the Entrepreneurial Intention Questionnaire (EIQ) in secondary education students. It is based on the Theory of Planned Behavior (TPB) and includes its constructs: attitude towards entrepreneurship, subjective norm, entrepreneurial self-efficacy, and entrepreneurial intention. The promotion of entrepreneurship in early education requires valid and reliable measures to assess the desired outcomes and evaluate the effectiveness of the interventions. The EIQ presents good psychometric qualities in a Spanish sample of high school students ( N = 226): (a) The four-factor structure fits the data with factor loadings ranging between .378 and .862; (b) Each dimension presents satisfactory reliability results (above .7); and (c) The dimensions reproduce expected relationships with entrepreneurial attitudes. Additionally, competing models of the TPB have been tested to provide evidence to support a modified version of the original TPB model. Consequently, the EIQ is adequate for secondary education in Spain, being especially useful for longitudinal studies.
Less Fragmented but Highly Centralized: A Bibliometric Analysis of Research in Computational Social Science
Authors: Wang Xiaohui , Song Yunya , Su Youzhen
Published: February 2022

Since its inception, computational social science (CSS) has been characterized as an interdisciplinary field. Nevertheless, unlike a mature interdisciplinary field that duly integrates knowledge beyond disciplinary boundaries, CSS has arguably been fragmented into multiple lines of inquiry. Although such fragmentation has been a constant concern, limited empirical evidence exists to substantiate any degree of integration in research on CSS. To systematically map the landscape of research on CSS, we examined the dynamic topology of the bibliometric network of CSS during the past 20 years. By comparing the structure of the coupling network and the co-subject network with three prototypical network models that we simulated—the centralized model, the fragmented model, and the cohesive model—our analysis revealed that the citation networks of research on CSS are highly centralized but less fragmented than often assumed. Beyond that, a driving factor shaping the coupling network’s cohesive structure is the citation to high-impact articles. Those and other findings contribute to current understandings of the process of integration in the evolution of disciplines.
Entropy generation analysis of radiative heat transfer in Williamson fluid flowing in a microchannel with nonlinear mixed convection and Joule heating
Authors: Mahanthesh B. , Srinivas Reddy C. , Srikantha N. , Lorenzini G.
Published: February 2022

In this article, the spectral quasi-linearization (SQLM) method is implemented to solve the complicated differential equations governing the nonlinear mixed convective heat transfer of a Williamson fluid through a vertical microchannel. Unlike the conventional Boussinesq approximation, the quadratic Boussinesq approximation is taken into account in the formulation. The effects of Rosseland thermal radiation, Joule heating, and viscous dissipation are described in the thermal analysis subjected to the boundary conditions of convective thermal heating. The analysis of entropy production is also performed. The importance of various parameters governing velocity, Bejan number, temperature, and entropy generation was explored using graphic illustrations. It was found that the nonlinear density change with a temperature significantly affects the heat transport in the microchannel and thus increases the magnitude of the Bejan number and the production of entropy. Entropy production occurs maximum due to the boundary conditions of convection heating at the walls of the microchannel. Furthermore, due to a stronger viscous heating mechanism, the magnitude of the Bejan number is reduced, while the production of entropy increases significantly. As a limiting case of the problem, a comparison was made with results previously published in the literature and excellent agreement was established. The calculations provide a solid reference point for future CFD models and are relevant to the dynamics of polymers in microfluidic devices and the polymer industries.
Optimization of metro wheel reprofiling based on cluster analysis
Authors: Lin Zonghui , Lu Zhenggang , Yong Xinjian , Wei Juyao , Wang Xiaochao
Published: February 2022

According to the characteristics of the metro vehicles running on the same track leading to a similar wheel wear, a clustering method based on k-means is proposed. The weighted wheel flange height of Sh and qR, and wheel flange thickness of Sd are used as clustering parameters. This paper classifies the treads of the wheels to be repaired and obtains a typical worn wheel profile to reprofile the wheels. Under the premise of ensuring the operation safety of vehicles, the wheel profile optimization model is established for a typical worn wheel profile based on the minimum repair volume. The optimized profile is used as the reprofiling template for all wheels in the same classification. Finally, based on the reprofiling standard for the wheel diameter difference between the left and right wheels, the optimization reprofiling of the wheel profile is achieved. The research results show that the proposed optimization strategy base on cluster analysis can significantly reduce the material removal.
A multi-parameter stable-distribution-based protection levels calculation method for ground-based augmentation systems integrity assessment
Authors: Liu Haiying , Shi Xiaozhu , Sun Hao , Meng Xiaolin
Published: February 2022

The Protection Levels (PL) of Ground-Based Augmentation Systems (GBAS) are bounds of the positioning errors associated with given integrity levels. However, the practical Gaussian Overbounding Method (GOM) cannot describe the non-Gaussian nature of the error model such as “thick tail,” which makes PL tend to be overestimated. To overcome this problem, an error overbounding model based on stable distribution is proposed in this paper. Four stable distribution parameters are involved to accurately describe the GBAS ranging error. The weighted summation feature of the stable distribution is combined with the maximum likelihood estimation when calculating PL. Thus, it is possible to achieve a higher accuracy of PL under similar calculation complexity. In addition, this paper puts forward the Concept of Tightness (CoT) to describe the overbounding effect intuitively and quantitatively. In order to verify the effect of this method, multiple receivers are set to simulate the GBAS system, theyn the Stable Overbounding Method (SOM) is used to calculate the PL in two directions (Vertical and Lateral) under the hypotheses of H0 and H1. The CoT convincingly proves that the SOM has a better overbounding effect and improves the continuity of GBAS. It is evident that the multi-parameter SOM makes the overbounding of the protection level tighter and reduces the probability that the protection level is close to the Alarm Limit (AL), thus improving the accuracy of PL computing and the availability of GBAS systems.
Significance of the Microcredit Delivery Models for Livelihood Upgradation: A Comparison Between SHGs–Bank Linkage Model and Micro Finance Institutions Model with Case Studies from Rural West Bengal, India
Authors: Sarkar Suparna , Chattopadhyay Subhra
Published: February 2022

Microfinance is seen as a useful way to alleviate the financial problem of the rural poor. In India, SHG bank linkage (SBL) programme and the Microfinance institution (MFI) are two main sources of microcredit. This article aims to compare the importance of the credit delivery processes under these two types of microfinancing approaches in ordering the livelihood of the recipients. For this purpose, a set of indicators are chosen from different domains of livelihood. Information is collected through a primary survey in some selective villages of West Bengal, India and is analysed using different statistical techniques. It is found that the MFI recipients experience better impact than SBL recipients though the SBL’s recipients have greater improvement in cases of savings habit, mobility, and access to the health. Besides, the number of loans received and the mode of utilisation of the credit are observed as the most significant factors influencing the livelihood outcome in both cases.
Programmable self-folding of trilayer and bilayer-hinge structures by time-dependent swelling of tough hydrogels
Authors: Shojaeifard Mohammad , Niroumandi Soha , Baghani Mostafa
Published: February 2022

Inspired by nature, active materials are used to developed complex 3D configurations considering their specific characteristics. One of the shape-shifting methods in smart structures is utilizing programmable materials in self-folding structures. Hydrogels due to their biocompatibility, controllable functionalities, large reversible deformations, and their sensitivity to environmental stimuli are vital candidates to be used in self-folding structures. To avoid the mechanical weakness of conventional hydrogels, in this paper polyampholyte tough hydrogel is inspected considering a transient electro-chemo-mechanical constitutive model combining a visco-hyperelastic model with Nernst-Planck and Poisson’s equations. After calibrating the material parameters and verifying the accuracy of the model and its implementation, we present two approaches in order to generate self-folding hydrogel-based structures: polymer structure with bilayer hinges and trilayer structure composed of a hydrogel film sandwiched between two elastomer layers. Next, diverse factors are examined in the self-folding of smart structures which conforms with experimental test data, including hydrogel swelling, structure thickness and stiffness, bilayer configuration and composition, the width of the bilayer as well as opening width in trilayer and layers thickness. Finally, several transient self-folding of 2D flat patterns which turn into 3D complex configurations are scrutinized such as the closure of box, pyramids, and flower-shaper gripper.
Child Maltreatment During School and Childcare Closure Due to the COVID-19 Pandemic
Authors: Vermeulen Samantha , Alink Lenneke R. A. , van Berkel Sheila R.
Published: February 2022

The aim of the present study was to examine child maltreatment prevalence rates during the first COVID-19 related national closure of schools and childcare settings (the lockdown) in the Netherlands. Based on reports of childcare professionals and primary and secondary school teachers ( N = 444) the prevalence of child maltreatment during the 3 months of this first lockdown was estimated at almost 40,000 children, or 14 per 1,000 children. The prevalence of emotional neglect was found to be three times higher during the lockdown compared to a period without lockdown. This significant difference was reflected in overall emotional neglect as well as for two main subtypes of emotional neglect: educational neglect and witnessing domestic violence. No significant differences were found for other types of child maltreatment. Most of the reported cases of maltreatment were already problematic before the lockdown and became worse during the lockdown. The results of this study indicate that the closure of schools and childcare settings may have enormous negative consequences for vulnerable children.
Attitude Toward the Color Blue: An Ideal Marker Variable
Authors: Miller Brian K. , Simmering Marcia J.
Published: February 2022

Researchers often turn to post hoc statistical techniques to identify common method variance (CMV) in same source data and one viable option is to use a marker variable. The choice of marker variable is important, yet these variables are difficult to find, primarily because they must be theoretically unrelated to study variables but measured in the same way (e.g., perceptual; on a Likert scale). This manuscript uses scale development best practices to create a marker variable—attitude toward the color blue—that can be applied in a wide variety of social science research. Scale reliability and validity are addressed, discriminant validity with other measures that detect CMV is tested, and the Confirmatory Factor Analysis Marker Technique is applied with this scale. An experiment designed to analyze the effect of the placement of the scale in surveys is reported. Recommendations to researchers for use of this new scale to detect CMV are provided.
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic
Authors: Kalwani Neil M , Osmanlliu Esli , Parameswaran Vijaya , Qureshi Lubna , Dash Rajesh , Heidenreich Paul A , Scheinker David , Rodriguez Fatima
Published: February 2022

Early in the COVID-19 pandemic, cardiology clinics rapidly implemented telemedicine to maintain access to care. Little is known about subsequent trends in telemedicine use and visit volumes across cardiology subspecialties. We conducted a retrospective cohort study including all patients with ambulatory visits at a multispecialty cardiovascular center in Northern California from March 2019 to February 2020 (pre-COVID) and March 2020 to February 2021 (COVID). Telemedicine use increased from 3.5% of visits (1200/33,976) during the pre-COVID period to 63.0% (21,251/33,706) during the COVID period. Visit volumes were below pre-COVID levels from March to May 2020 but exceeded pre-COVID levels after June 2020, including when local COVID-19 cases peaked. Telemedicine use was above 75% of visits in all cardiology subspecialties in April 2020 and stabilized at rates ranging from over 95% in electrophysiology to under 25% in heart transplant and vascular medicine. From June 2020 to February 2021, subspecialties delivering a greater percentage of visits through telemedicine experienced larger increases in new patient visits (r = 0.81, p = 0.029). Telemedicine can be used to deliver a significant proportion of outpatient cardiovascular care though utilization varies across subspecialties. Higher rates of telemedicine adoption may increase access to care in cardiology clinics.
Calibration of a stress-strain response for geopolymer concrete under axial compressive load
Authors: Dao Dong Van , Tran Hung Viet , Ly Hai-Bang , Le Tien-Thinh
Published: February 2022

The use of geopolymer concrete (GPC) in common load-bearing structures is still limited, mainly due to the lack of specific design procedures and limited understanding of the stress–strain behavior under uniaxial loading. The present work investigates the mechanical responses of GPC under axial compressive load by conducting a large number of experiments. For this purpose, 198 samples with three GPC mixes were designed, including concrete grades of 30, 40, and 50 MPa. The samples were prepared following the ASTM standards to determine the stress–strain relationship under compression. The results showed that fly ash-based GPC had average elastic modulus values of 30.424, 31.497, and 33.650 GPa, respectively, for G30, G40, and G50, lower than estimated using formulae for Ordinary Portland Cement (OPC) concrete, such as ACI standard 318-11, AASHTO-2007, and others. Furthermore, a novel model of GPC stress–strain response was proposed, mainly based on the empirical formulation suggested by Sargin using a modified factor D. Besides, the deformation of GPC was observed larger than that of OPC with similar strength, for instance, the strain at peak stress [Formula: see text]. The GPC was also found to have better plasticity behavior than OPC while conducting the axial stress–strain response, with the obtained values of [Formula: see text]. The findings of this work might lead to additional in-depth research into GPC's mechanical characteristics, particularly its structural behavior.
Experiences of baby removal prevention: A collective case study of mothers and community-based workers
Authors: Keddell Emily , Cleaver Kerri , Fitzmaurice Luke
Published: February 2022

The removal of a baby at birth is a significant intervention in family life. Avoiding removal requires attention to all levels of the family social ecology. Utilising a collective case study approach, and a critical realist epistemology, this project explores the experiences of three women who have avoided removal, and their community-based workers. Key themes are the necessity of intensive, ecological and relational service provision; and the mediation role of the community-based worker between women and the statutory child protection service. Services that were ‘by Māori for Māori’ were reported as most likely to maintain these fragile relationships. Effective services were holistic and intensive, drew on parent’s own motivation of care for children, and focussed on stress reduction and creating ‘friend-like’ relationships. The mediation role of community workers reflected their instrumental position, and included mediating risk perceptions between the statutory agency and women. In the instance of disability, mediation included direct, collective advocacy to challenge risk perceptions utilising children’s rights concepts and a social model of disability. The implications for policy and practice are: to improve equitable access to intensive services based on an ecological theory of change and with an emphasis on relational practice; improve provision of by Māori, for Māori services; and require services to take a rights-based approach to both mothers with disabilities and their children. It also highlights the important role of community-based workers to advocate, support change and improve coordination between families and the statutory child protection system.
The lived experience of wounded helpers: A phenomenological study of social workers working with suicidal cases in mental health settings in Hong Kong
Authors: Hung King Lun , Ku Hok Bun , Leung Sameul S M
Published: February 2022

This study explores the grief of social workers who experience the death of clients in community mental health settings. “The ten participants represented three occupational categories: social work administrators, senior social workers team leaders and clinical leaders), and novice and frontline social workers.” A phenomenological research approach was adopted, and semi-structured interviews were conducted to explore the types of grief experienced by the participants. Researchers found that the grief of these “wounded helpers” took various forms: guilt, shock, panic, anger, shame, loss, sadness, helplessness, regret, fear, and anxiousness. In addition, some suffered from debilitating flashbacks. Their experiences produced psychological pain that took a long time to fade. Studies have shown that the grief and suffering of those in the helping professions are strongly connected to their perceived professional identity and their understanding of what constitutes professionalism. Based on our findings, we finally discuss the lessons that can be learned from this group of social workers who experienced recovery from traumatic situations in their career.
Examining Technology-Facilitated Intimate Partner Violence: A Systematic Review of Journal Articles
Authors: Kim Chunrye , Ferraresso Riccardo
Published: February 2022

As intimate partner violence in a cyber world is increasing, scholars have started to pay attention to this phenomenon. This study aims to provide a systematic review of empirical studies in the technology-facilitated intimate partner violence (TFIPV) field. We analyzed 31 studies that examined direct TFIPV perpetration and/or victimization experiences identified from four of the largest databases (i.e., Web of Science, PsyInfo, PubMed, and SCOPUS). We found that most studies recruited adolescents or young adults (i.e., college students) and used a very diverse range of terminologies that describe similar phenomena but are not based on validated instruments. We discuss the implications of our findings and suggestions that can enhance the field’s rigor and guide future research.
Renewed rationale for sex- and gender-disaggregated research: A COVID-19 commentary review
Authors: Thompson Kelly , Vassallo Amy , Finfer Simon , Woodward Mark
Published: February 2022

The COVID-19 pandemic provides a contemporaneous illustration of the need to consider sex and gender in research. Using surveillance, treatment and vaccine research examples, in this commentary review, we highlight opportunities for innovation in sex- and gender-sensitive and transformative health and medical research.
A survey on the English FA heading guidelines for youth soccer: Evidence of compliance, but with limited knowledge of safety
Authors: Roberts James W , Towlson Christopher P , J Malone James
Published: February 2022

Soccer heading may be problematic for neurocognitive function. The English Football Association (FA) recently introduced guidelines in order to limit the number of headers within training for youth soccer. However, it remains to be seen what the influence of these guidelines has been on the leaders of soccer teams that are primarily responsible for implementing the guidelines. Thus, we aimed to explore grassroot youth coaches’ knowledge of, views on, and adherence to the heading guidelines. An online survey was distributed to team representatives across Local County FAs. The survey comprised of three sections: (1) background information, (2) heading practices including details on heading activities and views on heading safety, and (3) heading guidelines including levels of awareness, knowledge, and compliance. 240 coaches responded by stating they rarely (21%) or never (73%) practiced heading, although they mostly perceived heading as being somewhat safe (36%). While respondents indicated being only somewhat aware of the guidelines (43%), they scored very high on their perceived (92%) and actual (based on retrospective accounts of heading) (87%) compliance with the guidelines. There was a mixed perceived change within practice following the introduction of the guidelines (disagree = 26% vs. agree = 22%), and they were perceived as safe (86%) and appropriate (81%). Factors that were identified as being potential barriers were only marginally agreed upon (<30%) and tended to be related to in-game rules. While there is scope to successfully implement heading guidelines, there is some discrepancy between the requirements for heading safety and coaches’ knowledge.
Variations in Attack Patterns between Female and Male outside hitters in top-level Volleyball
Authors: Drikos Sotirios , Sotiropoulos Konstantinos , Gkreka Sofia , Tsakiri Marina , Barzouka Karolina
Published: February 2022

In volleyball outside hitters have wide participation in the offensive game. This study aims to analyze the variables that predict attack effectiveness in top-level volleyball depending on gender. Inferential statistics, multinomial logistic regression and multiple correspondence analysis were applied to analyze 1931 attacks (1154 for women and 777 for men) from the six top-ranked teams in the Men and Women World Championships 2018. The analysis revealed that the two genders vary in some aspects of the game at the top level. In order to increase the odds for a winning attack, male volleyball teams must pass the ball to the setter accurately, setting in 2nd fast tempo to zones 4 and 6, enriching offensive options across all the net to avoid attack against an organized block. On the other hand, female teams must set in 2nd fast tempo to the offensive zone (positions 4 & 2), to avoid off-speed attacks, to spike primarily parallel and to take advantage of no block situations. A similarity between genders is that attack against a single block is more difficult and causes lower effectiveness than spike versus open double block.
Repair of flexor digitorum profundus avulsions including the palmar plate: a retrospective comparative study of 56 cases
Authors: Fathy Sadek Ahmed , Azmy Mohamed M. , Nady Saleh Elsaid Ahmed , Zein Asem M. N. , Yehya Hasan Mohamed
Published: February 2022

We retrospectively reviewed 56 fingers with a type 1 flexor digitorum profundus avulsion (jersey finger) injury. Nineteen fingers were treated with a four-strand pull-out suture technique that did not include the distal palmar plate, and 37 were treated with a six-strand pull-out suture technique that included the distal palmar plate. An early active mobilization regimen was used. At follow-up (mean 13 and 14 months, respectively), total active interphalangeal joint motion was significantly better in the six-strand/palmar plate group, as were the results assessed with the Strickland–Glogovac grading system and patient satisfaction according to the Stark criteria. No repair ruptures occurred in this group versus two ruptures in the four-strand/no-palmar-plate group. We consider that the better results can be attributed to a stronger repair, which facilitated early active mobilization.

Level of evidence: III
Multicenter Study of the Impact of COVID-19 Shelter-In-Place on Tertiary Hospital-based Care for Pediatric Neurologic Disease
Authors: Hutchinson Melissa L. , Nash Kendall B. , Abend Nicholas S. , Moharir Mahendranath , Wells Elizabeth , Messer Ricka D. , Palaganas Jamie , Helbig Ingo , Wietstock Sharon O. , Suslovic William , Gonzalez Alexander K. , Kaufman Michael C. , Press Craig A. , Piantino Juan ,   The Pediatric Neurohospitalist Work Group
Published: February 2022

Objective

To describe changes in hospital-based care for children with neurologic diagnoses during the initial 6 weeks following regional Coronavirus 2019 Shelter-in-Place orders.

Methods

This retrospective cross-sectional study of 7 US and Canadian pediatric tertiary care institutions included emergency and inpatient encounters with a neurologic primary discharge diagnosis code in the initial 6 weeks of Shelter-in-Place (COVID-SiP), compared to the same period during the prior 3 years (Pre-COVID). Patient demographics, encounter length, and neuroimaging and electroencephalography use were extracted from the medical record.

Results

27,900 encounters over 4 years were included. Compared to Pre-COVID, there was a 54% reduction in encounters during Shelter-in-Place. COVID-SiP patients were younger (median 5 years vs 7 years). The incidence of encounters for migraine fell by 72%, and encounters for acute diagnoses of status epilepticus, infantile spasms, and traumatic brain injury dropped by 53%, 55%, and 56%, respectively. There was an increase in hospital length of stay, relative utilization of intensive care, and diagnostic testing (long-term electroencephalography, brain MRI, and head CT (all P<.01)).

Conclusion

During the initial 6 weeks of SiP, there was a significant decrease in neurologic hospital-based encounters. Those admitted required a high level of care. Hospital-based neurologic services are needed to care for acutely ill patients. Precise factors causing these shifts are unknown and raise concern for changes in care seeking of patients with serious neurologic conditions. Impacts of potentially delayed diagnosis or treatment require further investigation.
Regulating algorithms at work: Lessons for a ‘European approach to artificial intelligence’
Authors: Adams-Prassl Jeremias
Published: February 2022

This article scrutinises the potential of the existing regulatory apparatus in Union law to tackle the social, technical, and legal challenges inherent in deploying automated systems in high-risk settings such as the workplace, with a view to setting out key lessons for the proposed EU Artificial Intelligence Act. Surveying data protection and discrimination rules as well as the social acquis, it highlights key areas for further development, from coherence between different regulatory regimes to the role of social partnership in shaping key standards and monitoring their implementation.
The distribution of non-sense and the cultivation of the less-than-sensible
Authors: Dodds Klaus
Published: February 2022

Ben Gerlofs’ article on the transgressive qualities of humour reminds us that it humour is a deadly serious business. Getting it wrong can be costly, even fatal. Comedians and humourists have along with journalists and academics been targeted by regimes and individuals who don’t care for interventions that expose either the nonsensical nature of regimes and/or assault cultural and religious norms. In this short intervention, some comments are offered about the popular geopolitics of humour and laughter alongside a discussion about future directions.
Development of Guidelines for Spouses Engaged in Home-Based Care of Persons With Motor Neuron Disease From Indian Context
Authors: Warrier Manjusha G , Thomas Priya Treesa , Sadasivan Arun , Nashi Saraswati , Vengalil Seena , Nalini A.
Published: February 2022

Background: The caregivers of persons with motor neuron disease (MND) have several needs that are usually not voiced on any platform. Aim: To explore the lived experience of spouses of persons with MND, identify their needs and develop guidelines for better home-based care. Method: An exploratory study with 3-point in-depth interviews among 13 participants was conducted. Participants were the spouses of persons with MND under treatment at a national quaternary referral center. The interpretative phenomenological analysis identified participants’ needs. These needs, with literature review synthesis, guided the drafting of guidelines, which was validated by experts. Results: The needs were emotional, social, care systems, and skills. The guidelines developed contained 2 sections (1) Information for the spouses: understanding MND, communication, symptom management, marital relationship, palliative care, and everyday life made easier. (2) Well-being of the spouse caregivers: well-being of the spouse caregivers, self-care, mental health, supporting carers in palliative care, where to find help. Conclusion: The guidelines can be developed as a manual for the caregivers and for training healthcare professionals working with neurodegenerative conditions.
In silico design of recombinant multi-epitope vaccine against influenza A virus
Authors: Maleki Avisa , Russo Giulia , Parasiliti Palumbo Giuseppe Alessandro , Pappalardo Francesco
Published: February 2022

Background

Influenza A virus is one of the leading causes of annual mortality. The emerging of novel escape variants of the influenza A virus is still a considerable challenge in the annual process of vaccine production. The evolution of vaccines ranks among the most critical successes in medicine and has eradicated numerous infectious diseases. Recently, multi-epitope vaccines, which are based on the selection of epitopes, have been increasingly investigated.

Results

This study utilized an immunoinformatic approach to design a recombinant multi-epitope vaccine based on a highly conserved epitope of hemagglutinin, neuraminidase, and membrane matrix proteins with fewer changes or mutate over time. The potential B cells, cytotoxic T lymphocytes (CTL), and CD4 T cell epitopes were identified. The recombinant multi-epitope vaccine was designed using specific linkers and a proper adjuvant. Moreover, some bioinformatics online servers and datasets were used to evaluate the immunogenicity and chemical properties of selected epitopes. In addition, Universal Immune System Simulator (UISS) in silico trial computational framework was run after influenza exposure and recombinant multi-epitope vaccine administration, showing a good immune response in terms of immunoglobulins of class G (IgG), T Helper 1 cells (TH1), epithelial cells (EP) and interferon gamma (IFN-g) levels. Furthermore, after a reverse translation (i.e., convertion of amino acid sequence to nucleotide one) and codon optimization phase, the optimized sequence was placed between the two EcoRV/MscI restriction sites in the PET32a+ vector.

Conclusions

The proposed “Recombinant multi-epitope vaccine” was predicted with unique and acceptable immunological properties. This recombinant multi-epitope vaccine can be successfully expressed in the prokaryotic system and accepted for immunogenicity studies against the influenza virus at the in silico level. The multi-epitope vaccine was then tested with the Universal Immune System Simulator (UISS) in silico trial platform. It revealed slight immune protection against the influenza virus, shedding the light that a multistep bioinformatics approach including molecular and cellular level is mandatory to avoid inappropriate vaccine efficacy predictions.
Molecular evolution of hatching enzymes and their paralogous genes in vertebrates
Authors: Nagasawa Tatsuki , Kawaguchi Mari , Nishi Kohki , Yasumasu Shigeki
Published: February 2022

Background

Hatching is identified as one of the most important events in the reproduction of oviparous vertebrates. The genes for hatching enzymes, which are vital in the hatching process, are conserved among vertebrates. However, especially in teleost, it is difficult to trace their molecular evolution in detail due to the presence of other C6astacins, which are the subfamily to which the genes for hatching enzymes belong and are highly diverged. In particular, the hatching enzyme genes are diversified with frequent genome translocations due to retrocopy.

Results

In this study, we took advantage of the rapid expansion of whole-genome data in recent years to examine the molecular evolutionary process of these genes in vertebrates. The phylogenetic analysis and the genomic synteny analysis revealed C6astacin genes other than the hatching enzyme genes, which was previously considered to be retained only in teleosts, was also retained in the genomes of basal ray-finned fishes, coelacanths, and cartilaginous fishes. These results suggest that the common ancestor of these genes can be traced back to at least the common ancestor of the Gnathostomata. Moreover, we also found that many of the C6astacin genes underwent multiple gene duplications during vertebrate evolution, and the results of gene expression analysis in frogs implied that genes derived from hatching enzyme genes underwent neo-functionalization.

Conclusions

In this study, we describe in detail the molecular evolution of the C6astacin gene in vertebrates, which has not been summarized previously. The results revealed the presence of the previously unknown C6astacin gene in the basal-lineage of jawed vertebrates and large-scale gene duplication of hatching enzyme genes in amphibians. The comprehensive investigation reported in this study will be an important basis for studying the molecular evolution of the vertebrate C6astacin genes, hatching enzyme, and its paralogous genes and for identifying these genes without the need for gene expression and functional analysis.
Effect of chronic kidney disease on all-cause mortality in tuberculosis disease: an Australian cohort study
Authors: Carr Beau Z. , Briganti Esther M. , Musemburi Joseph , Jenkin Grant A. , Denholm Justin T.
Published: February 2022

Background

While there has been a recent epidemiological and clinical focus on the interaction between diabetes and tuberculosis, the interaction between chronic kidney disease and tuberculosis has been less studied. In particular, little is known of the effect of eGFR levels well above that seen in end stage kidney disease on mortality.

Methods

We conducted a retrospective cohort study of 653 adults from a large Australian hospital network, using data from a state-wide registry of reported tuberculosis cases between 2010 and 2018, with ascertainment of diabetes status and renal function data from hospital medical records and laboratory data. Cox proportional hazards regression models were used to calculate hazard ratios for all-cause mortality associated with categories of chronic kidney disease in adults with tuberculosis disease.

Results

Total number of deaths was 25 (3.8%). Compared to tuberculosis cases with eGFR ≥ 60 ml/min, all-cause mortality was higher for those with chronic kidney disease from an eGFR level of 45 ml/min. The association was independent of sex, age and diabetes status with adjusted hazard ratio of 4.6 (95% CI: 1.5, 14.4) for eGFR 30–44 ml/min and 8.3 (95% CI: 2.9, 23.7) for eGFR < 30 ml/min.

Conclusions

Our results suggest a notably increased risk of all-cause mortality even in those with more moderate degrees of renal impairment, in a low tuberculosis prevalence setting. The impact of these findings on a population basis are at least as significant as that found with diabetes and warrant further investigation in populations with higher tuberculosis prevalence.
Acceptability and safety of thermal ablation to prevent cervical cancer in sub-Saharan Africa
Authors: Metaxas Tania , Kenfack Bruno , Sormani Jessica , Tincho Eveline , Lemoupa Makajio Sophie , Wisniak Ania , Vassilakos Pierre , Petignat Patrick
Published: February 2022

Background

The World Health Organization recommends thermal ablation as an alternative to cryotherapy to treat women with precancerous lesions in low-resource settings. However, limited data are available on women’s experience and adverse events (AEs) of the procedure in the context of Sub-Saharan Africa. The objective of this study was to evaluate the acceptability and safety of thermal ablation in women screened positive for precancerous cervical lesions.

Methods

Asymptomatic women aged 30–49 years old living in the Dschang Health District were invited to participate in a cervical cancer screening campaign termed “3 T-Approach” (for Test-Triage and Treat). Recruited women were asked to perform HPV self-sampling followed by triage with visual assessment and treatment with thermal ablation if required. After treatment and 4–6 weeks later, interviews were conducted to assess women’s experience on anxiety, discomfort, and pain during thermal ablation. AEs were recorded on pre-defined electronic forms 4–6 weeks after treatment to assess the procedure’s safety.

Results

Between September 2018 and December 2020, 399 HPV-positive women (18.7% of women screened) were recruited, 236 (59.1%) had a positive visual assessment, 234 were treated by thermal ablation and 198 (84.6%) received therapy in the same visit. Treatment was not considered as painful (score ≤ 4/10) by 209 (90.9%) patients while 5 (2.5%) reported high pain (score 8–10/10). During post-treatment interviews 4–6 weeks later, most reported AEs were graded mild or moderate (grade I-II). The most frequent symptoms reported as mild AEs (grade 1–2) were vaginal watery discharge (75.5%), vaginal bloody-stained discharge (21.5%) and malodourous discharge (14.5%). None of the participants experienced serious AEs (grade 3–4) or AEs requiring admission to hospital or emergency consultation. The vast majority of women (99.6%) would agree to repeat the procedure if necessary and (99.6%) would recommend it to friends or family.

Conclusion

Thermal ablation is widely accepted by women and appears as a safe procedure. It may contribute to improving the link between screening and treatment in a single visit and to optimizing cervical cancer control in low-resource settings.

Trial registration

The study was registered on clinicaltrials.gov (NCT03757299) in November 2018 (28/11/2018).
Depressive and anxiety symptoms among Japanese cancer survivors: Japan cancer survivorship research project
Authors: Endo Motoki , Matsui Kentaro , Akaho Rie , Mitsui Kiyomi , Yan Yan , Imai Yuya , Ueda Yuito , Muto Go , Deshpande Gautam A. , Terao Yasuhisa , Takeda Satoru , Saito Mitsue , Hayashi Kazuhiko , Nishimura Katsuji , Tanigawa Takeshi
Published: February 2022

Background

This study aimed to clarify predictors of depressive symptoms and anxiety symptoms after cancer diagnosis among Japanese cancer survivors (CSs).

Methods

As part of a Japanese cancer survivorship research project commissioned by the Ministry of Health, Labour and Welfare (MHLW) of Japan, we conducted a web-based nationwide survey of CSs in 2018. We analyzed the risk factors for depressive and anxiety symptoms, as measured by the Hospital Anxiety and Depression Scale Japanese version (HADS).

Results

Of 1,234 Japanese CSs, mean score of HADS-depression and HADS-anxiety were 4.08 and 4.78, respectively. At the time of the study, the number of CSs with symptoms of depression and anxiety were 111 (9.0%) and 269 (21.8%), respectively. After multivariable analysis, CSs ≥ 60 years old (reference: ≤ 39 years old, odds ratios (OR): 0.39, 95%CI: 0.17–0.90) and those ≥ 10 years from cancer diagnosis (reference: 0–4 years, OR: 0.55, 95%CI: 0.32–0.96) had lower odds for depressive symptoms. And CSs ≥ 60 years old (reference: ≤ 39 years old, OR: 0.27, 95%CI: 0.15–0.49) and those ≥ 10 years from cancer diagnosis (reference: 0–4 years, OR: 0.62, 95%CI: 0.42–0.90) also had lower odds for anxiety symptoms. CSs who received chemotherapy (OR: 1.56, 95%CI: 1.10–2.20) had higher odds for anxiety symptoms.

Conclusions

Based on manifestation of symptoms, CSs who were younger, closer to the time of cancer diagnosis, had advanced-staged cancer, or received chemotherapy may be at higher risk for depressive or anxiety symptoms. Those CSs who have higher risk for depression and anxiety symptoms, should be followed-up more carefully for better cancer survivorship, by medical professionals, companies, and society.
The association between COVID-19-related fear and reported self-harm in a national survey of people with a lifetime history of self-harm
Authors: Keyworth Chris , Quinlivan Leah , Leather Jess Z. , O’Connor Rory C. , Armitage Christopher J.
Published: February 2022

Background

Relatively little is known about the characteristics of people living in the community who have previously self-harmed and may benefit from interventions during and after COVID-19. We therefore aimed to: (a) examine the relationship between reported self-harm and COVID-19-related fear, and (b) describe the characteristics of a community sample of people who reported a lifetime history of self-harm.

Methods

A cross-sectional national online survey of UK adults who reported a lifetime history of self-harm (n = 1029) was conducted. Data were collected May – June 2020. Main outcomes were self-reported COVID-19-related fear (based on the Fear of COVID-19 scale [FCV-19S]), lifetime history of COVID-19, and lifetime history of self-harm. Data were analysed using descriptive statistics and binary logistic regression. Chi-square was used to compare characteristics of our sample with available national data.

Results

Overall, 75.1, 40.2 and 74.3% of the total sample reported lifetime suicidal ideation, suicidal attempts and non-suicidal self-harm respectively. When adjusting for age, sex, ethnicity, social grade, and exposure to death and suicide, binary logistic regression showed higher levels of perceived symptomatic (or physiological) reactions to COVID-19 were associated with suicidal ideation (OR = 1.22, 95%CI 1.07, 1.39) and suicidal attempts (OR = 3.91, 95%CI 1.18, 12.96) in the past week.

Conclusions

Results suggest an urgent need to consider the impact of COVID-19 on people with a lifetime history of self-harm when designing interventions to help support people in reducing suicidal ideation and suicidal attempts. Experiencing symptomatic reactions of fear in particular is associated with self-harm. Helping to support people to develop coping plans in response to threat-related fear is likely to help people at risk of repeat self-harm during public health emergencies.