bluuebunny/crossref_metadata_2025 huggingface dataset:
Are there task-specific effects in morphological processing? Examining semantic transparency effects in semantic categorisation and lexical decision
Authors: Chee Qian Wen , Yap Melvin J
Published: January 2022

Current theories of morphological processing include form-then-meaning accounts, form-with-meaning accounts, and connectionist theories. Form-then meaning accounts argue that the morphological decomposition of complex words is based purely on orthographic structure, while form-with meaning accounts argue that decomposition is influenced by the semantic properties of the stem. Connectionist theories, however, argue that morphemes are encoded as statistical patterns of occurrences between form and meaning. The weight of evidence from the literature thus far suggests that morphological decomposition is best explained by form-then-meaning accounts. That said, conflicting empirical findings exist, and more importantly, semantic transparency effects in morphological processing have been examined almost exclusively with the lexical decision task, in which participants discriminate between words and nonwords. Consequently, the extent to which observed results reflect the specific demands of the lexical decision task remains unclear. The present study extends previous work by testing whether the processing dynamics of early morphological processing are moderated by task requirements. Using the masked morphological priming paradigm, this hypothesis was tested by examining semantic transparency effects for a common set of words across semantic categorisation and lexical decision. In both tasks, priming was stronger for transparent (e.g., painter-PAINT) than opaque (e.g., corner-CORN) prime–target pairs; these results speak against form-then-meaning accounts. These findings further inform theories of morphological processing and underscore the importance of examining the interplay between task-general and task-specific mechanisms.
The influence of coaching efficacy on trust and usage of technology in golf instruction
Authors: Rittenberg Benjamin SP , Neyedli Heather F , Young Bradley W , Dithurbide Lori
Published: January 2022

The rise of technology in sport has provided coaches with another tool to aid athlete development, but there is little research on its relationship to coaching practices. Research in non-sport domains has demonstrated a relationship between user trust in and use of technology. The user's confidence can also affect this relationship, where higher confidence is typically associated with less technology use. Minimal work has examined factors that influence technology use within the sports domain; therefore, the present study sought to determine whether coaching experience and coaching efficacy could predict golf coaches' use of technology in training. A one-time survey that gathered demographic information, and measured coaching experience, coaching technique efficacy, trust in technology and use of technology was completed by 83 registered Professional Golfers Association golf coaches and instructors. Results showed that coaching technique efficacy was predictive of coaches’ use of technology in training, where more technique efficacy resulted in increased use of technology. Mediation analyses showed that this association was mediated by their levels of trust in technology. There was no relationship between coaching experience and use of technology. Therefore, coaching technique efficacy, rather than experience, seems to be an important variable in predicting coaches' use of technology in training and instruction. Further, because higher efficacy predicted increased usage, the results illustrate the differences between the sport training environment and other non-sport domains regarding the factors that influence technology use. These findings are an important first step towards investigating how technology can be used by coaches to best improve athlete performance.
Prevention of type 2 diabetes in sub-Saharan Africa, a review
Authors: L. McCrory-Churchill Shannon , Hill Ellen
Published: January 2022

Background:

Type 2 diabetes (T2D) is a significant factor in the overall burden of non-communicable diseases (NCDs) in sub-Saharan Africa (SSA). While many health organizations call for increased attention to this disease, far fewer resources are being allocated to evidence-based prevention programs. The literature demonstrates a lack of reporting on prevention programs, interventions targeted to decrease the development of T2D, and success stories.

Methods:

This review followed the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched were PubMed, Google Scholar, Ovid, Medline, World Health Organization (WHO) Library Information System, and African Journals Online. The following terms were searched individually and in multiple combinations: prevention, intervention, type 2 diabetes, sub-Saharan Africa, education, strategy, strategic plan, risk factors. In total, 253 articles were found and 17 were removed as duplicates. Of these, 78 abstracts were reviewed, with 20 being excluded for not meeting criteria, one was excluded as it was not available in English and one was excluded for lack of availability. After the remaining 56 full-text studies were assessed, seven were included in the review.

Results:

Throughout the review, the common theme between articles was a lack of resources, lack of prevention strategies, and increasing risk factors. The review highlights the fact that while there are WHO guidelines and packages targeted at primary care level interventions for the prevention and treatment of NCDs, they remain underutilized. Included studies looked at the knowledge level of family members, social marketing and sugar consumption, and primary prevention strategies.

Conclusion:

There is an overall lack of reporting on interventions targeting the prevention of type 2 diabetes in SSA. Further research is warranted on interventions, prevention strategies, and implementation of the WHO package targeted at NCDs
Revolutionizing elementary disaster prevention education and training via augmented reality-enhanced collaborative learning
Authors: Lu Su-Ju , Lin Yu-Chiao , Tan Kim Hua , Liu Ying-Chieh
Published: January 2022

In light of a recent spike in natural and man-made disasters, there has been an increase in interest in disaster prevention education and training. The effectiveness of both publicly-funded and voluntarily organized disaster education (DE) has attracted wide attention. More studies are needed to understand the innovative pedagogical practice and the impact of technological advances on disaster learning content development, effectiveness and motivation. This study investigates the application of augmented reality (AR) in DE and training. An AR-enhanced tool named ‘disaster-proof warrior’ was developed and tested to evaluate its enhancement effect on learning under two collaborative learning modes. A series of quasi-experiments involving 85 elementary school subjects was carried out to assess the learning effectiveness and the subjective reaction in learning motivation. The results showed the AR embedded learning tool is effective in engaging and motivating collaborative team knowledge building. This study adds to the existing literature of AR applications in education and training as well as providing a useful reference for future development and improvement of national DE and training.
CNN-based severity prediction of neurodegenerative diseases using gait data
Authors: Berke Erdaş Çağatay , Sümer Emre , Kibaroğlu Seda
Published: January 2022

Neurodegenerative diseases occur because of degeneration in brain cells but can manifest as impairment of motor functions. One of the side effects of this impairment is an abnormality in walking. With the development of sensor technologies and artificial intelligence applications in recent years, the disease severity of patients can be estimated using their gait data. In this way, decision support applications for grading the severity of the disease that the patient suffers in the clinic can be developed. Thus, patients can have treatment methods more suitable for the severity of the disease. The presented research proposes a deep learning-based approach using gait data represented by a Quick Response code to develop an effective and reliable disease severity grading system for neurodegenerative diseases such as amyotrophic lateral sclerosis, Huntington’s disease, and Parkinson’s disease. The two-dimensional Quick Response data set was created by converting each one-dimensional gait data of the subjects with a novel representation approach to a Quick Response code. This data set was regressed with the convolutional neural network deep learning method, and a solution was sought for the problem of grading disease severity. Further, to demonstrate the success of the results obtained with the novel approach, native machine learning approaches such as Multilayer Perceptron, Random Forest, Extremely Randomized Trees, and K-Nearest Neighbours, and ensemble machine learning methods, such as voting and stacking, were applied on one-dimensional data. Finally, the results obtained on the prediction of disease severity by testing one-dimensional gait data with a convolutional neural network architecture that operates on one-dimensional data were included. The results showed that, in most cases, the two-dimensional convolutional neural network approach performed the best among all methods.
Difficult decisions: Coercion in asymmetric security cooperation
Authors: Munir Syed Rashid
Published: January 2022

How do minor states protect themselves against coercion from their major power allies? Asymmetric security cooperation is often reduced to tradeoffs between security and autonomy, but coercion is another factor that minor states fear while cooperating. Coercing partner states can take the form of major powers threatening or undertaking regime change, and minor states must weigh the benefits of cooperation against this risk. To this end, I suggest that minor states with anti-major power political oppositions cooperate more extensively with their major power partners than minor states with pro-major power oppositions. A pro-major power opposition provides opportunities for major powers to threaten or replace the incumbent regime; therefore, such minor states limit their cooperation out of fear of coercion. I employ original data on opposition characteristics to present evidence from security relations between the United States and 65 minor states during 1950–1991 to support the hypothesis.
Mindfulness-Based Programs: Why, When, and How to Adapt?
Authors: Loucks Eric B. , Crane Rebecca S. , Sanghvi Menka A. , Montero-Marin Jesús , Proulx Jeffrey , Brewer Judson A. , Kuyken Willem
Published: January 2022

This paper provides a framework for understanding why, when and how to adapt mindfulness-based programs (MBPs) to specific populations and contexts, based on research that developed and adapted multiple MBPs. In doing so, we hope to support teachers, researchers and innovators who are considering adapting an MBP to ensure that changes made are necessary, acceptable, effective, cost-effective, and implementable. Specific questions for reflection are provided such as (1) Why is an adaptation needed? (2) Does the theoretical premise underpinning mainstream MBPs extend to the population you are considering? (3) Do the benefits of the proposed adaptation outweigh the time and costs involved to all in research and implementation? (4) Is there already an evidenced-based approach to address this issue in the population or context? Fundamental knowledge that is important for the adaptation team to have includes the following: (1) essential ingredients of MBPs, (2) etiology of the target health outcome, (3) existing interventions that work for the health outcome, population, and context, (4) delivery systems and settings, and (5) culture, values, and communication patterns of the target population. A series of steps to follow for adaptations is provided, as are case examples. Adapting MBPs happens not only by researchers, but also by MBP teachers and developers, who endeavor to best serve the populations and contexts they work within. We hope that these recommendations for best practice provide a practical framework for skilfully understanding why, when, and how to adapt MBPs; and that this careful approach to adaptation maximizes MBP safety and efficacy.
Power in a Pandemic: Teachers’ Unions and Their Responses to School Reopening
Authors: Marianno Bradley D. , Hemphill Annie A. , Loures-Elias Ana Paula S. , Garcia Libna , Cooper Deanna , Coombes Emily
Published: January 2022

Drawing on Bachrach and Baratz’s first and second faces of interest group power, we explore the relationship between teachers’ union power and reopening decisions during the fall 2020 semester in 250 large districts around the United States. We leverage a self-collected panel data set of reopening decisions coupled with measures of teachers’ union first face power (drawn from social media postings on teachers’ unions’ Facebook pages) and second face power (operationalized as district size, whether the school district negotiates a collective bargaining agreement with the teachers’ union, the length of the collective bargaining agreement, and the amount of revenue raised by the union). We found that school districts where teachers’ unions exhibit strong second face power (but not first face power) were less likely to start the school year with in-person instruction, were less likely to ever open during fall semester with in-person instruction and spent fewer weeks in in-person learning.
Urban form planning and tsunami risk vulnerability: Analysis of 12 Chilean coastal cities
Authors: Vicuña Magdalena , León Jorge , Guzmán Simón
Published: January 2022

Urban form has a significant impact on risk. Spatial planning instruments can optimize urban form in areas exposed to hazards. This work discusses how urban planning instruments, specifically Communal Regulatory Plans (CRPs), affect vulnerability to the risk of tsunami inundation in Chilean coastal cities. We analyze urban form and address exposure, susceptibility, and response capacity parameters. Exposure is evaluated by comparing existing and planned densities and to what extent planned risk areas coincide with inundation zones. We analyze existing critical facilities and land uses permitted by the CRP in inundation zones to evaluate susceptibility. We explore response capacity through the street network connectivity and green areas outside the inundation zone and how CRPs influence the structuring of new roads and new green spaces. We found that CRPs do not hold the sufficient capacity to incorporate and manage the tsunami inundation risk adequately. The planning scenario leads to a systematic increase in vulnerability as cities develop in exposed areas. We suggest to strengthen CRPs capacities to prevent the construction and reconstruction of areas affected by tsunamis, reinforcing the urban fabric’s potential for evacuation, and to strengthen joint work between municipal urban planning and disaster risk management departments, among other recommendations.
Artificial neural network–based constitutive relation modelling for the laminated fabric used in stratospheric airship
Authors: Gao Minjun , Meng Junhui , Ma Nuo , Li Moning , Liu Li
Published: January 2022

There have been gradually increasing interests in the stratospheric airship (SSA) as a cost-effective alternative to earth orbit satellites for telecommunication and high-resolution earth observation. Lightweight and high strength envelopes are the keys to the design of SSAs as it directly determines the endurance flight performance and loading deformation characteristics of the airship. Typical SSA envelope material is a laminated fabric, which is composed of fabric layer and other functional layers. Compared with conventional composite structures, the laminated fabric has complex nonlinear mechanical characteristics. Artificial neural network (ANN) has good processing ability to nonlinear information so that it is suitable to model the constitutive relation of laminated fabrics. In this work, an ANN based on the Scaled Conjugate Gradient (SCG) algorithm is proposed firstly to model the constitutive relation of fabric Uretek3216LV. Considering significant errors of the SCG ANN results, the network model is optimized through methods of selecting the number of hidden-layer nodes and training algorithms. Results show that the improved network model based on Bayesian Regularization (BR) algorithm and eight nodes of single hidden layer can better describe the constitutive relation of the laminated fabric than other conventional training algorithms. The proposed constitutive modelling method with ANN is expected to gain a deeper understanding of the mechanical mechanism and guide structural design of envelope material in further work.
The role of virtual community of practice in alleviating social and professional isolation during emergency remote teaching
Authors: Bissessar Charmaine
Published: January 2022

Social Networking Sites have become ubiquitous in the classroom as educators continue to grapple with teaching remotely. Emergency remote teaching (ERT) continues to be the main staple in the virtual teaching menu. However, teachers are experiencing social and professional isolation. This qualitative intrinsic case study couched in the interpretivist paradigm determined that 37 Trinidadian teachers belonging to the teachers’ Facebook page – A Teacher’s Voice – were able to use the page as Virtual Community of Practices in order to motivate themselves and others. They share knowledge of online teaching and learning pedagogy, connect and collaborate with each other. They exchange insightful discussions, they share achievements, commiserate with each other and, above all, they share humour. In this manner, they are able to alleviate their social and professional feelings of isolation and form a kinship that transcends space and time reverberating a collective mindset.
Seizures Associated With Bone Density Conservation Agents
Authors: Sturgill Kuan , Reinert Justin P.
Published: January 2022

Objective

The purpose of this review is to discuss the existing literature regarding patients who have experienced seizures after administration of a bone density conservation agent (BDCA).

Data Sources

A comprehensive literature review was performed between September and October 2021 using the following keywords: osteoporosis/drug therapy, seizures/chemically induced, hypercalcemia, hypocalcemia, osteoporosis, seizure risk, osteoclast medication, seizures, bisphosphonates, risedronate, zoledronic acid, pamidronate, denosumab, Prolia, Xgeva, calcitonin, BDCAs.

Study Selection and Data Extraction

A total of 90 articles were identified, but only 6 articles met prespecified inclusion and exclusion criteria. These articles included 4 case reports, 1 case series, and 1 retrospective cohort study.

Data Synthesis

Two case reports and 1 case series described the occurrence of seizures with the use of zoledronic acid. One case report described the occurrence of seizures with the use of alendronate, 1 retrospective cohort study with the use of denosumab, and 1 case report with the use of calcitonin. The articles displayed a variety of contributing factors that could have caused seizures including those with a prior history of seizures, calcium or vitamin D deficiency prior to starting therapy, a history of gastrectomy impairing glucose homeostasis, or concurrent infection.

Conclusion

While there is not a direct link to BDCA causing seizures, the hypocalcemic effect may be severe enough in some patients to precipitate a seizure. The correction of underlying conditions and electrolyte disturbances should be addressed before initiating a BDCA. Further studies are needed to better explore the relationship between BDCA and seizures.
Beyond the Classroom: An Observational Study to Assess Student Pharmacists’ Confidence and Perception of a High-Fidelity Manikin Chemotherapy Infusion Reaction Simulation
Authors: Jessee Jeremiah K. , Miller Akera , Ebied Alex M.
Published: January 2022

Objective: To assess the impact of a high-fidelity manikin chemotherapy infusion simulation on student pharmacists’ confidence in applying clinical knowledge and perception of oncology pharmacy practice. Methods: One cohort of third professional year student pharmacists completed a high-fidelity manikin simulation during the last week of their didactic training. The 10-minute manikin experience simulated an acute paclitaxel infusion reaction, requiring students to apply their knowledge on how to provide patient care during a chemotherapy-induced infusion reaction. A pre- and post-survey was administered to determine whether there was a change in students’ confidence and perception. Results: Thirty-three student pharmacists (62%) completed the pre- and post-surveys and manikin simulation. A statistically significant improvement was seen in median confidence scores when comparing pre- and post-questions of all 10 survey items ( P < 0.001). Students’ perception of oncology pharmacy and the manikin simulation had mean of 4.4 on a 0- to 5-point Likert scale. Conclusion: The high-fidelity manikin experience improved student pharmacists’ post-survey confidence of applying clinical skills. In addition, students’ perception of oncology pharmacy improved and the use of a manikin simulation to support didactic learning was seen as an additional avenue for delivering didactic curriculum. This study explored the feasibility of introducing a manikin simulation into the oncology pharmacy curriculum and the benefit of providing hands-on application of clinical skills to support didactic concept-based learning.
Structure of shear-induced platelet aggregated clot formed in an in vitro arterial thrombosis model
Authors: Kim Dongjune A. , Ku David N.
Published: January 2022

The structure of occlusive arterial thrombi is described herein. Macroscopic thrombi were made from whole blood in a collagen-coated, large-scale stenosis model with high shear flow similar to an atherosclerotic artery. The millimeter-sized thrombi were harvested for histology and scanning electron microscopy. Histological images showed 3 distinctive structures of the thrombus. (1) The upstream region showed string-like platelet aggregates growing out from the wall that protrude into the central lumen, with red blood cells trapped between the strings. The strings were >10 times as long as they were wide and reached out to join the strings from the opposite wall. (2) Near the apex, the platelet strings coalesced into a dense mass with microchannels that effectively occluded the lumen. (3) In the expansion region, the thrombus ended abruptly with an annulus of free blood in the flow-separation zone. Scanning electron microscopy showed dense clusters of spherical platelets upstream and downstream, with amorphous platelets in the occluded throat consistent with prior activation. The total clot is estimated to contain 1.23 billion platelets with pores 10 to 100 μm in diameter. The results revealed a complex structure of arterial thrombi that grow from their tips under high shear stress to bridge the 2.5-mm lumen quickly with von Willebrand factor platelet strings. The occlusion leaves many microchannels that allow for some flow through the bulk of the thrombus. This architecture can create occlusion or hemostasis rapidly with minimal material, yet can remain porous for potential delivery of lytic agents to the core of the thrombus.
The methyl-CpG-binding domain 2 facilitates pulmonary fibrosis by orchestrating fibroblast to myofibroblast differentiation
Authors: Wang Yi , Zhang Lei , Huang Teng , Wu Guo-Rao , Zhou Qing , Wang Fa-Xi , Chen Long-Min , Sun Fei , Lv Yongman , Xiong Fei , Zhang Shu , Yu Qilin , Yang Ping , Gu Weikuan , Xu Yongjian , Zhao Jianping , Zhang Huilan , Xiong Weining , Wang Cong-Yi
Published: January 2022

Although DNA methylation has been recognised in the pathogenesis of idiopathic pulmonary fibrosis (IPF), the exact mechanisms are yet to be fully addressed. Herein, we demonstrate that lungs originated from IPF patients and mice after bleomycin (BLM)-induced pulmonary fibrosis are characterised by altered DNA methylation along with overexpression in myofibroblasts of methyl-CpG-binding domain 2 (MBD2), a reader responsible for interpreting DNA methylome-encoded information. Specifically, depletion ofMbd2in fibroblasts or myofibroblasts protected mice from BLM-induced pulmonary fibrosis coupled with a significant reduction of fibroblast differentiation. Mechanistically, transforming growth factor (TGF)-β1 induced a positive feedback regulatory loop between TGF-β receptor I (TβRI), Smad3 and Mbd2, and erythroid differentiation regulator 1 (Erdr1). TGF-β1 induced fibroblasts to undergo a global DNA hypermethylation along with Mbd2 overexpression in a TβRI/Smad3 dependent manner, and Mbd2 selectively bound to the methylated CpG DNA within theErdr1promoter to repress its expression, through which it enhanced TGF-β/Smad signalling to promote differentiation of fibroblast into myofibroblast and exacerbate pulmonary fibrosis. Therefore, enhancing Erdr1 expression strikingly reversed established pulmonary fibrosis. Collectively, our data support that strategies aimed at silencing Mbd2 or increasing Erdr1 could be viable therapeutic approaches for prevention and treatment of pulmonary fibrosis in clinical settings.
Florigen and its homologs of FT/CETS/PEBP/RKIP/YbhB family may be the enzymes of small molecule metabolism: review of the evidence
Authors: Tsoy Olga , Mushegian Arcady
Published: January 2022

Background

Flowering signals are sensed in plant leaves and transmitted to the shoot apical meristems, where the formation of flowers is initiated. Searches for a diffusible hormone-like signaling entity (“florigen”) went on for many decades, until a product of plant gene FT was identified as the key component of florigen in the 1990s, based on the analysis of mutants, genetic complementation evidence, and protein and RNA localization studies. Sequence homologs of FT protein are found throughout prokaryotes and eukaryotes; some eukaryotic family members appear to bind phospholipids or interact with the components of the signal transduction cascades. Most FT homologs are known to share a constellation of five charged residues, three of which, i.e., two histidines and an aspartic acid, are located at the rim of a well-defined cavity on the protein surface.

Results

We studied molecular features of the FT homologs in prokaryotes and analyzed their genome context, to find tentative evidence connecting the bacterial FT homologs with small molecule metabolism, often involving substrates that contain sugar or ribonucleoside moieties. We argue that the unifying feature of this protein family, i.e., a set of charged residues conserved at the sequence and structural levels, is more likely to be an enzymatic active center than a catalytically inert ligand-binding site.

Conclusions

We propose that most of FT-related proteins are enzymes operating on small diffusible molecules. Those metabolites may constitute an overlooked essential ingredient of the florigen signal.
Resident and informal caregiver involvement in medication-related decision-making and the medicines’ pathway in nursing homes: experiences and perceived opportunities of healthcare professionals
Authors: Damiaens Amber , Van Hecke Ann , De Lepeleire Jan , Foulon Veerle
Published: January 2022

Background

Person-centered care has been shown to be beneficial for nursing home residents. The know-how and attitude of healthcare professionals, however, can make its implementation difficult. Also, research on person-centered care with regard to medication decision-making and the medicines’ pathway in nursing homes is lacking. This study aimed to provide an understanding of healthcare professionals’ attitudes and perspectives on current resident and informal caregiver involvement in medication decision-making and the medicines’ pathway in nursing homes.

Methods

A qualitative, explorative study using semi-structured interviews with a sample of 25 healthcare professionals from four different nursing homes was performed. Interview transcripts were analyzed by means of an inductive thematic framework.

Results

Three overarching domains were identified: 1) features of, 2) drivers and barriers for, and 3) perceived consequences of resident and informal caregiver involvement in medication decision-making and the medicines’ pathway. Involvement was mainly initiated by residents and informal caregivers themselves, pointing towards information and participation needs among both groups. Nevertheless, actions of healthcare professionals towards resident and informal caregiver involvement were mainly reactive and fragmentary. Their actions were influenced by the perception of residents and informal caregivers’ desire and capabilities to be involved, the perception of their own professional role, but also by organizational factors such as the nursing home’s philosophy. Furthermore, organizational concerns tempered the motivation to provide residents and informal caregivers with more medication-related responsibilities.

Conclusions

Resident and informal caregiver involvement in medication decision-making and the medicines’ pathway remains limited in nursing homes. Information and participation needs of residents and informal caregivers were not fully acknowledged by healthcare professionals. As such, we can conclude that there is a need for initiatives, both on an individual and on an organizational level, to create and improve awareness on opportunities to improve resident and informal caregiver involvement in medication decision-making and the medicines’ pathway.
The poor accuracy of D-dimer for the diagnosis of prosthetic joint infection but its potential usefulness in early postoperative infections following revision arthroplasty for aseptic loosening
Authors: Fernandez-Sampedro M. , Sanlés-González I. , García-Ibarbia C. , Fañanás-Rodríquez N. , Fakkas-Fernández M. , Fariñas M. C.
Published: January 2022

Background

D-dimer was introduced in 2018 as an alternative biomarker for C-reactive protein (CRP) in the diagnostic of prosthetic joint infection (PJI) criteria of the Musculoskeletal Infection Society. We assessed the accuracy of plasma D-dimer for the diagnosis of early, delayed, and late PJI according to Infectious Diseases Society of America (IDSA) criteria, and whether persistently high levels of D-dimer in cases of aseptic loosening (AL) may be predictive of subsequent implant-related infection.

Methods

A prospective study of a consecutive series of 187 revision arthroplasties was performed at a single institution. Septic (n = 39) and aseptic revisions (n = 141) were classified based on IDSA criteria. Preoperative assessment of CRP, erythrocyte sedimentation rate (ESR) and D-dimer was performed. Receiver operating curves were used to determine maximum sensitivity and specificity of the biomarkers. The natural progress of D-dimer for AL cases was followed up either until the date of implant-related infection at any time during the first year or 1 year after revision in patients without failure. Clinical outcomes for those AL cases included infection-related failure that required a new surgery or need for antibiotic suppression.

Results

Preoperative D-dimer level was significantly higher in PJI cases than in AL cases (p = 0.000). The optimal threshold of D-dimer for the diagnosis of PJI was 1167 ng/mL. For overall diagnosis of PJI, C-reactive protein (CRP) achieved the highest sensitivity (84.6%), followed by erythrocyte sedimentation rate (ESR) and D-dimer (82% and 71.8%, respectively). Plasma D-dimer sensitivity was lower for all PJI types. When combinations of 2 tests were studied, the combined use of ESR and CRP achieved the best accuracy for all types of PJI (76.9%). 4.25% of AL cases had implant failure due to implant-related infection during the first year after the index revision arthroplasty, only the cases with early failure maintained high D-dimer levels.

Conclusions

Plasma D-dimer did not offer an improvement over the individual or combined diagnosis for any type of PJI according to IDSA criteria. Persistently raised levels of D-dimer after revision arthroplasty in AL cases might be used to effectively diagnose early postoperative infection.
The impact of the COVID-19 pandemic and associated suppression measures on the burden of tuberculosis in India
Authors: Arentz Matthew , Ma Jianing , Zheng Peng , Vos Theo , Murray Christopher J. L. , Kyu Hmwe H.
Published: January 2022

Background

Tuberculosis (TB) is a major cause of death globally. India carries the highest share of the global TB burden. The COVID-19 pandemic has severely impacted diagnosis of TB in India, yet there is limited data on how TB case reporting has changed since the pandemic began and which factors determine differences in case notification.

Methods

We utilized publicly available data on TB case reporting through the Indian Central TB Division from January 2017 through April of 2021 (prior to the first COVID-19 related lockdown). Using a Poisson model, we estimated seasonal and yearly patterns in TB case notification in India from January 2017 through February 2020 and extended this estimate as the counterfactual expected TB cases notified from March 2020 through April 2021. We characterized the differences in case notification observed and those expected in the absence of the pandemic by State and Territory. We then performed a linear regression to examine the relationship between the logit ratio of reported TB to counterfactual cases and mask use, mobility, daily hospitalizations/100,000 population, and public/total TB case reporting.

Results

We found 1,320,203 expected cases of TB (95% uncertainty interval (UI) 1,309,612 to 1,330,693) were not reported during the period from March 2020 through April 2021. This represents a 63.3% difference (95% UI 62.8 to 63.8) in reporting. We found that mobility data and average hospital admissions per month per population were correlated with differences in TB case notification, compared to the counterfactual in the absence of the pandemic (p > 0.001).

Conclusion

There was a large difference between reported TB cases in India and those expected in the absence of the pandemic. This information can help inform the Indian TB program as they consider interventions to accelerate case finding and notification once the pandemic related TB service disruptions improve. Mobility data and hospital admissions are surrogate measures that correlate with a greater difference in reported/expected TB cases and may correlate with a disruption in TB diagnostic services. However, further research is needed to clarify this association and identify other key contributors to gaps in TB case notifications in India.
Association of abnormal electrocardiograph metrics with prolonged recovery time in incident hemodialysis patients
Authors: Watt Jacqueline , Fitzpatrick Jessica , Sozio Stephen M. , Jaar Bernard G. , Estrella Michelle M. , Tereshchenko Larisa G. , Monroy-Trujillo Jose M. , Walsh Michael , Parekh Rulan S.
Published: January 2022

Background

Patients receiving intermittent hemodialysis have variable times of recovery to feeling better after dialysis. QT prolongation, a precursor to clinical and subclinical cardiovascular events, may contribute to delayed recovery time. We hypothesized that abnormal electrocardiographic parameters indicating perturbations in ventricular action are associated with longer recovery times thus impacting a patient-centered quality of life.

Methods

Among 242 incident in-center hemodialysis participants from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) study, corrected QT interval (QTc), QRST angle and heart rate variance were measured on non-dialysis days using a standard 5-min electrocardiograph recording. Left ventricular hypertrophy (LVH) was defined using the Cornell voltage product. Recovery time was ascertained during a phone interview with a standardized validated questionnaire. Associations between QTc, QRST angle, heart rate variance, and LVH and natural log-transformed recovery time were examined using linear regression adjusted for participant characteristics and electrolytes.

Results

Mean age was 55 (standard deviation 13) years, 55% were male, 72% were African American. Longer QTc interval was associated with increased recovery time (per 10 ms increase in QTc, recovery time increased by 6.2%; 95% confidence interval: 0.0–10.5). QRST angle, heart rate, heart rate variability and LVH were not significantly associated with recovery time.

Conclusion

Longer QTc intervals are associated with longer recovery time independent of serum electrolytes. This supports a relationship between a patient’s underlying arrhythmic status and time to recovery after hemodialysis. Future studies will determine if maneuvers to reduce QTc improves recovery time and quality of life of patients on hemodialysis.
Serum NFL discriminates Parkinson disease from essential tremor and reflect motor and cognition severity
Authors: Huang Yixian , Huang Caili , Zhang Qilin , Shen Tingting , Sun Jiawei
Published: January 2022

Objective

To investigate the diagnostic value of serum neurofilament light chain (NFL) for discriminating Parkinson disease (PD) from Essential tremor (ET) and healthy controls, and to evaluate its correlation with some clinical features of PD patients.

Methods

This cross-sectional study measured NFL levels with electrochemiluminescence immunoassay in serum of 146 PD patients, 82 ET patients and 60 age-matched healthy controls. We used multivariate regression analyses to examine whether NFL contributes to PD biomarkers. Disease severity were assessed by Unified Parkinson’s Disease Rating Scale part III (UPDRS III), Hoehn & Yahr (H-Y) stage and Mini-Mental State Examination (MMSE).

Results

Serum NFL levels were significantly higher in PD than in ET and healthy controls (16.6 ± 3.5, 12.2 ± 2.4 and 11.8 ± 2.4 pg/mL, respectively, p < 0.001). In patients with PD, serum NFL were markedly increased in patients with advanced H-Y stage and patients with dementia (both p < 0.001). The correlation analysis revealed that serum NFL was positively associated with UPDRS III score (r = 0.79, p < 0.001) and H-Y stage (r = 0.86, p < 0.001), and negatively correlated with MMSE scores (r = − 0.70, p < 0.001). Further multivariate regression analyses showed that serum NFL was an independent contributor to motor symptom and cognition severity in PD patients (all p < 0.01).

Conclusions

Serum NFL levels were markedly elevated may be a useful clinical biomarker for discriminating PD patients from ET and controls. Serum NFL may serve as a potential blood biomarker for motor and cognition severity of PD.
From coercion to respectful care: women’s interactions with health care providers when planning a VBAC
Authors: Keedle Hazel , Schmied Virginia , Burns Elaine , Dahlen Hannah Grace
Published: January 2022

Background

In many countries caesarean section rates are increasing and this impacts on choices made around mode of birth in subsequent pregnancies. Having a vaginal birth after caesarean (VBAC) can be a safe and empowering experience for women, yet most women have repeat caesareans. High caesarean section rates increase maternal and neonatal morbidity, health costs and burden on hospitals. Women can experience varied support from health care providers when planning a VBAC. The aim of this paper is to explore the nature and impact of the interactions between women planning a VBAC and health care providers from the women’s perspective.

Methods

A national Australian VBAC survey was undertaken in 2019. In total 559 women participated and provided 721 open-ended responses to six questions. Content analysis was used to categorise respondents’ answers to the open-ended questions.

Results

Two main categories were found capturing the positive and negative interactions women had with health care providers. The first main category, ‘Someone in my corner’, included the sub-categories ‘belief in women birthing’, ‘supported my decisions’ and ‘respectful maternity care’. The negative main category ‘Fighting for my birthing rights’ included the sub-categories ‘the odds were against me’, ‘lack of belief in women giving birth’ and ‘coercion’. Negative interactions included the use of coercive comments such as threats and demeaning language. Positive interactions included showing support for VBAC and demonstrating respectful maternity care.

Conclusions

In this study women who planned a VBAC experienced a variety of positive and negative interactions. Individualised care and continuity of care are strategies that support the provision of positive respectful maternity care.
Visual outcomes after vitrectomy for epiretinal membrane in pseudophakic eyes with a diffractive trifocal intraocular lens: a retrospective cohort study
Authors: Arrevola-Velasco Luis , Beltran Jaime , Gimeno Maria Jesus , Ortega-Usobiaga Julio , Druchkiv Vasyl , Llovet-Osuna Fernando , Baviera-Sabater Julio
Published: January 2022

Background

Diffractive intraocular lenses (IOLs) could affect visual acuity in patients with macular pathologies such as epiretinal membrane (ERM) and could influence the results of pars plana vitrectomy (PPV) for ERM removal in pseudophakic eyes with these IOLs. The aim of this study is to evaluate the effect on visual outcomes of a diffractive trifocal IOL in PPV for ERM peeling.

Methods

This is a retrospective cohort study on 20 eyes with a single model of trifocal IOL that underwent PPV for removal of ERM between January 2015 and September 2018 in our clinics. Follow up was at least 1 year. Primary outcome measure was mean change in visual acuity. Secondary outcome measures were mean change in central macular thickness (CMT), recovery of the external retinal layers, and change in spherical equivalent (SE).

Results

Mean corrected distance visual acuity (CDVA) was 0.03 ± 0.03 logMAR after phacoemulsification; this worsened to 0.23 ± 0.10 logMAR with ERM, improving to 0.10 ± 0.04 log MAR 12 months after PPV (p = 0.001). Mean uncorrected near visual acuity (UNVA) was Jaeger 2.62 ± 0.51 after lensectomy. This worsened to Jaeger 5.46 ± 1.67 with ERM and improved to the initial Jaeger 2.69 ± 0.84 after PPV (p = 0.005). CMT decreased significantly, from 380.15 ± 60.50 μm with the ERM to 313.70 ± 36.98 μm after PPV. Mean SE after lensectomy was − 0.18 ± 0.38 D, which minimally changed to – 0.18 ± 0.47 D after PPV (p = 0.99). The only complication recorded after PPV was a case of cystoid macular edema. No difficulties in visualization due to IOL design were reported during PPV.

Conclusion

PPV for ERM in eyes with this trifocal IOL seems to be safe and effective, and allows recovery of the loss of UNVA.
Antibiotics in the medical and surgical treatment of necrotizing enterocolitis. A systematic review
Authors: Gill Ester Maria , Jung Kristine , Qvist Niels , Ellebæk Mark Bremholm
Published: January 2022

Background

The aim of this review was to identify relevant randomized controlled trials (RCTs) and non-RCTs to evaluate the existing knowledge on the effect of antibiotic treatment for infants with necrotizing enterocolitis (NEC).

Objective

Identifying 1) the best antibiotic regimen to avoid disease progression as assessed by surgery or death, 2) the best antibiotic regimen for infants operated for NEC as assessed by re-operation or death.

Methods

Embase, MEDLINE and Cochrane were searched systematically for human studies using antibiotics for patients with NEC, Bell’s stage II and III.

Results

Five studies were included, with a total of 375 infants. There were 2 RCT and 3 cohort studies. Four main antibiotic regimens appeared. Three with a combination of ampicillin + gentamycin (or similar) with an addition of 1) clindamycin 2) metronidazole or 3) enteral administration of gentamycin. One studied investigated cefotaxime + vancomycin. None of the included studies had a specific regimen for infants undergoing surgery.

Conclusions

No sufficient evidence was found for any recommendation on the choice of antibiotics, the route of administration or the duration in infants treated for NEC with Bell’s stage II and III.
Service user perspectives of community mental health services for people with complex emotional needs: a co-produced qualitative interview study
Authors: Trevillion Kylee , Stuart Ruth , Ocloo Josephine , Broeckelmann Eva , Jeffreys Stephen , Jeynes Tamar , Allen Dawn , Russell Jessica , Billings Jo , Crawford Mike J. , Dale Oliver , Haigh Rex , Moran Paul , McNicholas Shirley , Nicholls Vicky , Foye Una , Simpson Alan , Lloyd-Evans Brynmor , Johnson Sonia , Oram Sian
Published: January 2022

Background

There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users’ views and co-production initiatives have had little impact on the development of interventions and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs.

Methods

A co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data.

Results

Participants reported some experiences of good practice but also of experiences of severely stigmatising interventions, a lack of effective support and service fragmentation. Relational Practice was identified as the central overarching theme and describes how community services can best support people with complex emotional needs. This approach involves care delivered in a non-stigmatising, individualised and compassionate way and care that is trauma-informed. It involves care that is planned collaboratively with service users to ensure their multiple needs are addressed in a flexible, holistic and consistent way which accounts for the long-term and fluctuating nature of their needs.

Conclusions

Relational practice approaches have potential to facilitate better community care for people with complex emotional needs. Research and service development are needed to examine how best to implement such approaches across the mental health service system. This work must be co-produced with people with relevant lived experience, their carers and the professionals who support them.