bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical Fitness in Preschool Children
Authors: Mrozkowiak Mirosław , Kaiser Alicja
Published: January 2022

Introduction. The level of mental and motor development as well as physical fitness and perceptual-motor performance should guarantee success in adapting to the new school environment.

The aim of the research. The aim of the research was to determine physical fitness in preschool children of both genders aged from 4 to 7 years.

Material and methods. The study included 275 children at the chronological age of 4 to 7 years including 134 girls and 141 boys. In order to assess physical fitness, the authors used the Wrocław Physical Fitness Test for preschool children completed by the endurance test

Results. Final physical fitness results showed that six-year-old boys were the fittest and less fit were girls at the age of seven. The least fit were boys and girls at the age of four.       

Conclusions

The Wrocław Physical Fitness Test and the endurance test revealed that the experimental group of children aged between four and seven years from the Western Pomerania region represented a satisfactory physical fitness level. It should be noted that this level was significantly lower than the ones obtained in tests conducted by other authors in 2006, 1996, 1972, and 1967.

The represented fitness level, especially the level of endurance, may result in adaptation disorders during the school shock period.

The phenomenon of sexual dimorphism at preschool age is demonstrated by significantly better physical fitness in boys at the age of five and six and balanced fitness at the age of seven.

Positive development of physical fitness is not supported by ongoing lifestyle pre-orientation. It is recommended to complete primary school admission criteria for the first form by physical fitness standards, including endurance.
Secukinumab, Pituitary Enlargement and Panhypopituitarism: Are They Related?
Authors: Ramalho Diogo , Araújo André , Rocha Gustavo , Duarte-Ribeiro Filipa
Published: December 2021

Pituitary adenomas are the most common cause of hypopituitarism associated with pituitary enlargement, but other aetiologies have been emerging, namely immune checkpoint inhibitor-induced hypophysitis (ipilimumab, nivolumab and pembrolizumab). Secukinumab is a recently approved human monoclonal antibody used for the treatment of psoriasis, with no know reported cases of hypophysitis. We describe a challenging case of panhypopituitarism in a patient with a pituitary incidentaloma and a temporal relationship between secukinumab initiation and the manifestation of clinical features suggestive of hypopituitarism. In such intricate work-up, the differential diagnoses should be carefully considered, taking into account the therapeutic and prognostic implications.
Effect of Psychiatric Nursing Practice Online Education Using Case-Based VR
Authors: Lee Young Shin , Kim Juhang , Lim Ji Young , Kim Geun Myun
Published: December 2021

Purpose: This study was conducted to verify the effect of a simulation-based virtual reality psychiatric nursing education programMethods: This was a quasi-experimental study that used two groups and a pretest-posttest design. There were 35 nursing students in both the experimental and control groups. Data were collected between January 18 and February 28. The educational program was configured in four stages over four weeks. An afterprogram post-test was conducted for one week.Results: The experimental group showed significantly higher values for depression nursing knowledge (t=-3.96, p<.001), learning self-efficacy (t=-3.34, p=.001), and problem solving processes (t=-3.01, p=.004) than the control group.Conclusion: The educational program was found to be effective for nursing students' depression nursing knowledge, learning self-efficacy, and problem-solving processes. It is expected to be foundational material for developing various virtual reality-based simulation education programs.
Factors Affecting Burnout among Tertiary Hospital Nurses during the COVID-19 Outbreak
Authors: Kim Geun-Hee , You Jun Ok , Lee Mira , Choi Yunju , Lee Yoon Mi , Shin Ji Hye
Published: December 2021

Purpose: The aim of this study was to determine burnout and its related factors among nurses working at a tertiary hospital, who had experienced caring for patients with confirmed and suspected coronavirus disease 2019 (COVID-19), including those with severe and critical conditions during the outbreak.Methods: Responses of 129 nurses, who worked in a tertiary hospital in Daegu, which was designated as a special control area for infectious disease in Korea, were analyzed. Data were collected from November 1, 2020 to December 14, 2020 using self-report questionnaires. Analysis was performed using t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression.Results: Burnout did not show any statistically significant differences in age, sex, marital status, total length of clinical experience, and the department at the time of caring for COVID-19 patients. Compassion fatigue, stress, depression, and anxiety were positively related with burnout, and compassion satisfaction was negatively related with burnout. In regression analysis, compassion satisfaction, compassion fatigue, and stress were confirmed as the predictive factors of burnout.Conclusion: The study results suggest that compassion satisfaction, compassion fatigue, and stress could play an important role in reducing burnout among tertiary hospital nurses during infectious disease outbreaks.
Preludes and fugues for piano in the polyphonic works of Chinese composers
Authors: Chernyavska Marianna , Zhang Mengzhe
Published: December 2021

The objective of the study is to identify the role of the small cycle “Prelude and Fugue” in the piano work of Chinese composers in the field of polyphonic genres, to consider the most striking examples of Preludes and fugues from the standpoint of the interpretation of the genre, the use of musical and expressive means, performing implementation. The research methodology is based on an integrated approach that combines theoretical methods with historical ones, reflecting the evolution of musical thinking. All the issues raised in the process of analyzing fugues are considered in combination with certain artistic tasks generated by the internal content of the work. The analysis of piano Preludes and fugues by composers Ding Shande, Chen Zhi Ming, Wang Lisan, Rao Yu Yang, Lin Hua made it possible to deduce a number of features of their construction and musical language in connection with the issues of form formation, thematic content, tonal lighting, rhythmic features, polyphonic ways of development and qualitative transformation of the material. In the Preludes and fugues of Chinese composers, essential and fundamental factors come into close interaction: deep connections coming from the polyphony of the “strict style” and the fugues of J. S. Bach, the organic implementation of the principles of national folk melos and the polyphonic warehouse of instrumental folklore, innovation rooted in the incessant search for new means of expression and enrichment of the musical language. The latter is determined by the content of the composers' music, its fullness with a variety of moods, experiences, reflections on the meaning of human life, about our complex century, saturated with the most serious events and phenomena. In the fusion of these qualities, a subjective moment plays a primary role: the uniqueness of the composer's creative individuality, which leaves a certain imprint on all the compositions — in close-up and in detail.
Evaluation of the Influence of Stirring Speed on the Release Kinetics of Fexofenadine HCl Polymeric Microspheres
Authors: Arefin Paroma , Habib Md Shehan , Mostafa Mohammad , Chakraborty Dipankar , Bhattacharjee Sreebash Chandra , Arefin Md Saidul , Karmakar Debabrata
Published: December 2021

Microspheres, a potential drug delivery approach, has opened a new era for attaining versatile release patterns needed. By optimizing the formulation variables, they can be prepared to obtain targeted release, immediate release, sustained release patterns. The release of the active drug material depends upon a number of formulation parameters such as polymers, stirring speed (rpm), methodology, surfactants, etc. Fexofenadine hydrochloride (HCl) is a second generation antihistamine. Our present research has explored the effects of using different rpm (600- 1000 rpm) in preparing fexofenadine hydrochloride (HCl) microspheres by emulsion solvent evaporation method. The formulation is aimed to provide sustained release for the required long period with a high margin of safety. We used a blended mixture of Hydroxy Propyl Methyl Cellulose (HPMC) K 100 MCR and Eudragit RL100 polymers to have sustained-release microspheres. The impact of different rpm on Yield, drug encapsulation efficiency, flow properties, and dissolution pattern were appraised. We observed the release of the drug for 10 hours in phosphate buffer (pH 6.8) and evaluated the drug release spectrophotometrically. Our study finds that the release of fexofenadine HCl from the microspheres was significantly increased with drug loading. We found the dosage forms to follow Higuchi release kinetics and Hixson-Crowell release kinetics the most, indicating successful achievement of sustained-release pattern in the dosage form. The change in drug release rate was statistically significant for variation in the stirring rate. We found that 600 rpm was the most optimized stirring rate for preparing microspheres in the emulsion solvent evaporation method.
Fexofenadine HCl Microspheres – Can it be the First Line therapy for Allergic Disorders ?
Authors: Arefin Paroma , Habib Md Shehan , Mostafa Mohammad , Chakraborty Dipankar , Bhattacharjee reebash Chandra , Arefin Md Saidul , Karmakar Debabrata
Published: December 2021

Fexofenadine HCl is a second-generation antihistamine which is commonly used for allergic disorders. But it has low bioavailability. Intranasal corticosteroids (INCs) and Immunotherapy and Allergen Specific Immunotherapy (ASIT) are now commonly being suggested for the treatment of allergic disorders. Despite the fact that current treatment alternatives have been in use for decades, patient quality of life has remained static. The treatment options are not much explored for their respective adverse effects. Therefore, they are in desperate need of research. Fexofenadine HCl is available in the form of a suspension, tablet, or capsule. In our current study, we have explored whether microspheres can be the perfect dosage form of Fexofenadine HCl to treat allergic disorders considering the pharmacokinetics of the drug, available dosage forms options and the probable side effects of the current therapies.
In-silico Studies of Thiopyridine Compounds as Anti-Bacterial agents Targeting Enoyl - Acyl Carrier Protein Reductase
Authors: Sudharsan Meenambiga Setti , Jose Sandra , Hari Sowmya , Ragunathan Venkataraghavan , Punniavan Sakthiselvan
Published: December 2021

In the Fatty Acid Synthase II system, Enoyl-(acyl-carrier-protein) reductase (ENR) encoded by FabI genes is a limiting step enzyme and there is no homologue ENR found in invertebrates which makes it selective target for drug discovery. From Molecular dynamics simulations it was concluded that the solvated protein stabilized at 2.5 ns with larger mobility in the substrate - binding loop and the conformational flexibility of the molecule was revealed. To study the inhibitory effects of novel small molecules in the thiopyridine series, a 2D QSAR model was developed and evaluated for its efficiency. The R2 > 0.96 and Q2 = 0.978 depicted the predictive ability of the models which was determined using a test set of 3 compounds. The receptor-ligand interactions were studied and highest affinity was reported for GCT ID, 343129 (-9.09 Kcal/mol), 341772 (-8.90 Kcal/mol) and 268776 (-8.85 Kcal/mol). These compounds were analysed for their drug like properties and toxicity which projected acceptable blood brain barrier permeation and human intestinal absorption and reduced lipotoxicity. Thus the results suggest further synthesis of new thipyridine series of compounds and experimental testing against drug resistant Staphylococcal infections
First Report on Karyotypic, Morphometric and Meiotic Analysis of a Predatory Bombardier Beetle Pherosophus catoirai (Coleoptera: Carabidae) from Jammu region of Outer Himalayas, India
Authors: Bhatti Arshad Ayoub , Slathia Nidhi , K Manvi
Published: December 2021

Chromosomal studies and manual karyotyping are the aged techniques for determining the identity of a species on evolutionary scale; however, these techniques are simple, reliable and inexpensive to authenticate the existence of a particular species. In the present work, the chromosome complement and meiotic processes of a predatory bombardier beetle Pherosophus catoirai were investigated. This species presented 2n=35 as diploid chromosome number and the chromosomal formula was found to be 12m+8sm+12st+X0. Sex mechanism was X0 type with metacentric X chromosome. Y chromosome was absent in this species. Karyotype revealed small chromosomes except X chromosome which is found to be largest in the spermatogonial metaphase stage. Meiotic stages were pachytene, diplotene, diakinesis and metaphase-I. Present study may find importance to analyse evolution of chromosomes in order Coleoptera particularly in family Carabidae.
A comparative study of patients presenting for planned and unplanned revision hip or knee arthroplasty
Authors: Kingsbury Sarah R. , Smith Lindsay K. , Shuweihdi Farag , West Robert , Czoski Murray Carolyn , Conaghan Philip G. , Stone Martin H.
Published: December 2021

Aims

The aim of this study was to conduct a cross-sectional, observational cohort study of patients presenting for revision of a total hip, or total or unicompartmental knee arthroplasty, to understand current routes to revision surgery and explore differences in symptoms, healthcare use, reason for revision, and the revision surgery (surgical time, components, length of stay) between patients having regular follow-up and those without.

Methods

Data were collected from participants and medical records for the 12 months prior to revision. Patients with previous revision, metal-on-metal articulations, or hip hemiarthroplasty were excluded. Participants were retrospectively classified as ‘Planned’ or ‘Unplanned’ revision. Multilevel regression and propensity score matching were used to compare the two groups.

Results

Data were analyzed from 568 patients, recruited in 38 UK secondary care sites between October 2017 and October 2018 (43.5% male; mean (SD) age 71.86 years (9.93); 305 hips, 263 knees). No significant inclusion differences were identified between the two groups. For hip revision, time to revision > ten years (odds ratio (OR) 3.804, 95% confidence interval (CI) (1.353 to 10.694), p = 0.011), periprosthetic fracture (OR 20.309, 95% CI (4.574 to 90.179), p < 0.001), and dislocation (OR 12.953, 95% CI (4.014 to 41.794), p < 0.001), were associated with unplanned revision. For knee, there were no associations with route to revision. Revision after ten years was more likely for those who were younger at primary surgery, regardless of route to revision. No significant differences in cost outcomes, length of surgery time, and access to a health professional in the year prior to revision were found between the two groups. When periprosthetic fractures, dislocations, and infections were excluded, healthcare use was significantly higher in the unplanned revision group.

Conclusion

Differences between characteristics for patients presenting for planned and unplanned revision are minimal. Although there was greater healthcare use in those having unplanned revision, it appears unlikely that routine orthopaedic review would have detected many of these issues. It may be safe to disinvest in standard follow-up provided there is rapid access to orthopaedic review. Cite this article: Bone Joint J 2022;104-B(1):59–67.
Development and internal validation of a clinical prediction model for acute adjacent vertebral fracture after vertebral augmentation
Authors: Hijikata Yasukazu , Kamitani Tsukasa , Nakahara Masayuki , Kumamoto Shinji , Sakai Tsubasa , Itaya Takahiro , Yamazaki Hajime , Ogawa Yusuke , Kusumegi Akira , Inoue Takafumi , Yoshida Takashi , Furue Naoya , Fukuhara Shun-ichi , Yamamoto Yosuke ,   AVA Score Research Group
Published: December 2021

Aims

To develop and internally validate a preoperative clinical prediction model for acute adjacent vertebral fracture (AVF) after vertebral augmentation to support preoperative decision-making, named the after vertebral augmentation (AVA) score.

Methods

In this prognostic study, a multicentre, retrospective single-level vertebral augmentation cohort of 377 patients from six Japanese hospitals was used to derive an AVF prediction model. Backward stepwise selection (p < 0.05) was used to select preoperative clinical and imaging predictors for acute AVF after vertebral augmentation for up to one month, from 14 predictors. We assigned a score to each selected variable based on the regression coefficient and developed the AVA scoring system. We evaluated sensitivity and specificity for each cut-off, area under the curve (AUC), and calibration as diagnostic performance. Internal validation was conducted using bootstrapping to correct the optimism.

Results

Of the 377 patients used for model derivation, 58 (15%) had an acute AVF postoperatively. The following preoperative measures on multivariable analysis were summarized in the five-point AVA score: intravertebral instability (≥ 5 mm), focal kyphosis (≥ 10°), duration of symptoms (≥ 30 days), intravertebral cleft, and previous history of vertebral fracture. Internal validation showed a mean optimism of 0.019 with a corrected AUC of 0.77. A cut-off of ≤ one point was chosen to classify a low risk of AVF, for which only four of 137 patients (3%) had AVF with 92.5% sensitivity and 45.6% specificity. A cut-off of ≥ four points was chosen to classify a high risk of AVF, for which 22 of 38 (58%) had AVF with 41.5% sensitivity and 94.5% specificity.

Conclusion

In this study, the AVA score was found to be a simple preoperative method for the identification of patients at low and high risk of postoperative acute AVF. This model could be applied to individual patients and could aid in the decision-making before vertebral augmentation. Cite this article: Bone Joint J 2022;104-B(1):97–102.
Reporting of glenoid bone loss measurement in clinical studies and the need for standardization
Authors: Weil Simon , Arnander Magnus , Pearse Yemi , Tennent Duncan
Published: December 2021

Aims

The amount of glenoid bone loss is an important factor in deciding between soft-tissue and bony reconstruction when managing anterior shoulder instability. Accurate and reproducible measurement of glenoid bone loss is therefore vital in evaluation of shoulder instability and recommending specific treatment. The aim of this systematic review is to identify the range methods and measurement techniques employed in clinical studies treating glenoid bone loss.

Methods

A systematic review of the PubMed, MEDLINE, and Embase databases was undertaken to cover a ten-year period from February 2011 to February 2021. We identified clinical studies that incorporated bone loss assessment in the methodology as part of the decision-making in the management of patients with anterior shoulder instability. The Preferred Reporting Items for Systematic Reviews (PRISMA) were used.

Results

A total of 5,430 articles were identified from the initial search, of which 82 studies met the final inclusion criteria. A variety of imaging methods were used: three studies did not specify which modality was used, and a further 13 used CT or MRI interchangeably. There was considerable heterogeneity among the studies that specified the technique used to quantify glenoid bone loss. A large proportion of the studies did not specify the technique used.

Conclusion

This systematic review has identified significant heterogeneity in both the imaging modality and method used to measure glenoid bone loss. The recommendation is that as a minimum for publication, authors should be required to reference the specific measurement technique used. Without this simple standardization, it is impossible to determine whether any published paper should influence clinical practice or should be dismissed. Cite this article: Bone Joint J 2022;104-B(1):12–18.
Fungal and mycobacterial cultures should not be routinely obtained for diagnostic work-up of patients with suspected periprosthetic joint infections
Authors: Tai Don Bambino Geno , Wengenack Nancy L. , Patel Robin , Berbari Elie F. , Abdel Matthew P. , Tande Aaron J.
Published: December 2021

Aims

Fungal and mycobacterial periprosthetic joint infections (PJI) are rare events. Clinicians are wary of missing these diagnoses, often leading to the routine ordering of fungal and mycobacterial cultures on periprosthetic specimens. Our goal was to examine the utility of these cultures and explore a modern bacterial culture technique using bacterial blood culture bottles (BCBs) as an alternative.

Methods

We performed a retrospective review of patients diagnosed with hip or knee PJI between 1 January 2010 and 31 December 2019, at the Mayo Clinic in Rochester, Minnesota, USA. We included patients aged 18 years or older who had fungal, mycobacterial, or both cultures performed together with bacterial cultures. Cases with positive fungal or mycobacterial cultures were reviewed using the electronic medical record to classify the microbiological findings as representing true infection or not.

Results

There were 2,067 episodes of PJI diagnosed within the study period. A total of 3,629 fungal cultures and 2,923 mycobacterial cultures were performed, with at least one of these performed in 56% of episodes (n = 1,157). Test positivity rates of fungal and mycobacterial cultures were 5% (n = 179) and 1.2% (n = 34), respectively. After a comprehensive review, there were 40 true fungal and eight true mycobacterial PJIs. BCB were 90% sensitive in diagnosing true fungal PJI and 100% sensitive in detecting rapidly growing mycobacteria (RGM). Fungal stains were performed in 27 true fungal PJI but were only positive in four episodes (14.8% sensitivity). None of the mycobacterial stains was positive.

Conclusion

Routine fungal and mycobacterial stains and cultures should not be performed as they have little clinical utility in the diagnosis of PJI and are associated with significant costs. Candida species and RGM are readily recovered using BCB. More research is needed to predict rare non- Candida fungal and slowly growing mycobacterial PJI that warrant specialized cultures. Cite this article: Bone Joint J 2022;104-B(1):53–58.
Effects of Heat Generation/Absorption on Magnetohydrodynamics Flow Over a Vertical Plate with Convective Boundary Condition
Authors: Akinbo Bayo Johnson , Olajuwon Bakai Ishola
Published: December 2021

Heat generation effect in a steady two-dimensional magnetohydrodynamics (MHD) flow over a moving vertical plate with a medium porosity has been studied. By similarity transformation variables, the coupled non-linear ordinary differential equations describing the model are obtained. The resulting equation is then solved, using Galerkin Weighted Residual Method (GWRM), where the effect of heat generation, Magnetic Parameter as well as other physical parameters encountered were examined and discussed. Some of the major findings were that increase in heat generation and convective heat parameter enhances the plate surface temperature as well as temperature field which allows the thermal effect to penetrate deeper into the quiescent fluid.
Botnet Attack Detection Using A Hybrid Supervised Fast-Flux Killer System
Authors: Al-Nawasrah Ahmad , Almomani Ammar , A. Al_Issa Huthaifa , Alissa Khalid , Alrosan Ayat , A. Alaboudi Abdulellah , B. Gupta Brij
Published: December 2021

A Fast Flux Service Network (FFSN) domain name system method is a technique used on botnet that bot herders used to support malicious botnet actions to rapidly change the domain name IP addresses and to increase the life of malicious servers. While several methods for the detection of FFSN domains are suggested, they are still suffering from relatively low accuracy with the zero-day domain in particular. Throughout the current research, a system that’s deemed new is proposed. The latter system is called (the Fast Flux Killer System) and is abbreviated as (FFKS)). It allows one to have the FF-Domains “zero-day”, via a deployment built on (ADeSNN). It is a hybrid, which consists of two stages. The online phase according to the learning outcomes from the offline phase works on detecting the zero-day domains while the offline phase helps in enhancing the classification performance of the system in the online phase. This system will be compared to a previously published work that was based on a supervised detection method using the same ADeSNN algorithm to have the FFSNs domains detected, also to show better performance in detecting malicious domains. A public data set for the impacts of the hybrid ADeSNN algorithm is employed in the experiment. When hybrid ADeSNN was used over the supervised one, the experiments showed better accuracy. The detection of zero-day fast-flux domains is highly accurate (99.54%) in a mode considered as an online one.
Prevalence of Sleep Disturbances During COVID-19 Pandemic in a Nepalese Population: A Cross-Sectional Study
Authors: Chandra Avinash , Prakash Pooja , Sharma Nabina , Chandra Ayush
Published: December 2021

Objectives: The coronavirus disease (COVID-19) pandemic and news of daily increasing cases inside Nepal and worldwide is adding to the fear that leads to anger, anxiety, frustration, and stress, emotions that directly affect sleep quality. This study aimed to assess sleep disturbances during the COVID-19 pandemic in a Nepalese population.Methods: This cross-sectional study recruited 206 Nepali residents who completed anonymous self-administered questionnaires. The Insomnia Severity Index (ISI) questionnaire was used to measure sleep disturbances before and after the COVID-19 pandemic. The gathered data were analyzed using descriptive statistics and inferential statistics using SPSS version 20 statistical software.Results: There was a significant variation in sleep disturbances among Nepalese residents before versus after the COVID-19 pandemic (p<0.001). The prevalence of clinical moderate insomnia has increased tremendously in Nepalese individuals. Before the pandemic’s onset, only 3.9% of the participants had moderate to severe levels of clinical insomnia; after its onset, this value increased to 17.5%. The mean ISI scores were 6.35±4.65 and 8.01±6.01 before and after the pandemic’s onset, respectively.Conclusions: Our study findings suggest that people are suffering tremendously with sleep disturbances and calls for further research and active measures to help increase sleep quality during the COVID-19 pandemic.
Efficacy of Oxcarbazepine for Sleep-Related Leg Cramps: A Retrospective Study
Authors: Ahn Seon-Jae , Shin Yong-Won , Jung Ki-Young
Published: December 2021

Objectives: Sleep-related leg cramps (SRLC) are common among older people. Severe clinical symptoms of SRLC usually cause great discomfort to patients. To date, many treatment drugs have been tried; however, there are currently no drugs approved for treating this condition. We aimed to assess the efficacy of a new drug, oxcarbazepine (OXC), in the treatment of SRLC.Methods: We retrospectively analyzed clinical outcomes following OXC administration. A daily dose of 150 mg OXC was prescribed to control nocturnal leg cramps. Clinical outcomes were measured using the Clinical Global Impression Scale to confirm the effectiveness of OXC.Results: A total of 88.9% (16/18) of patients clinically improved four weeks after OXC prescription, and 94% (15/16) of patients continued to improve at the last follow-up (3–6 months). None of the patients complained of side effects related to 150 mg OXC.Conclusions: OXC may be a new medical option for treatment of SRLC.
Sleep-Wake Pattern, Sleep Quality and Daytime Status in Fixed Day-Shift Hospital Workers
Authors: Choi Su Jung , Jo Hyunjin , Kim Dongyeop , Joo Eun Yeon
Published: December 2021

Objectives: Sleep issues are more prevalent in healthcare workers compared to workers in other industries. This study investigated sleep-wake pattern, sleep quality, and daytime status in hospital workers using a Galaxy Watch3 (GW3), a wrist-worn device that uses an accelerometer and heart rate sensor to distinguish sleep and wakefulness.Methods: Multiple sleep parameters including total sleep time (TST) were obtained using a GW3. The Epworth sleepiness scale (ESS), insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), and bedtime procrastination scale (BPS) were used to assess participants’ status.Results: A total of 70 daytime hospital workers (male, 45.7%; mean age, 35.66±7.79 yr) participated in the monitoring of their sleep-wake patterns for 30 consecutive days. Participants had a mean ESS of 8.14±3.62, ISI of 6.13±3.83, and PSQI of 4.86±2.14. The mean TST was 5.75±0.74 hr (range: 3.42–6.88) during workdays and 5.92±0.92 hr (range: 2.87–8.25) during free days. Chronotype (mid-sleep on freedays corrected for sleep debt accumulated over the work week) was 3.60±1.03 clock hr (range: 1.84–6.69). BPS was negatively correlated with age (rho=-0.27, p=0.022), TST of workdays (rho=-0.53, p<0.001), and TST of free days (rho=-0.43, p<0.001). A higher BPS was associated with larger social jetlag (rho=0.28, p=0.018) and later chronotype (rho=0.41, p<0.001).Conclusions: In this study, 91.5% of daytime hospital workers suffered from chronic sleep insufficiency (<7 hr during both workdays and free days) although their daytime sleepiness or subjective sleep were not poor. Individuals with a later chronotype had poorer sleep quality and worse sleep procrastination behavior.
Proposal for Preventing Motor Vehicle Accident Related to Drowsy Driving in Patients With Narcolepsy
Authors: Cho Jae Wook , Sunwoo Jun-Sang , Yim Soo Hwan , Kim Daeyoung , Koo Dae Lim , Im Hee-Jin , Kim Hyeyun , Kim Kyung Min , Yang Kwang IK ,   On behalf of the Korean Sleep Research Society
Published: December 2021

Narcolepsy is a chronic sleep disorder characterized by irresistible sleep attacks, hypersomnolence, cataplexy (sudden loss of muscle tone provoked by emotion), and sleep paralysis. Individuals with narcolepsy are at a high risk of experiencing sleepiness while driving leading to road traffic accidents. To prevent such accidents, some countries have regulations for commercial and noncommercial drivers with narcolepsy. Evaluating sleepiness is essential. Therefore, several subjective reports and objective tests were used to predict the possibility of car crashes or near-misses. Brain stimulants are effective in treating narcolepsy and can reduce daytime sleepiness in these patients. However, no guideline has been established for the driving safety of patients with narcolepsy in Korea. The Korean Sleep Research Society has prepared this proposal for preventing motor vehicle accidents caused by drowsy driving in patients with narcolepsy.
Decision prioritization and causal reasoning in decision hierarchies
Authors: Zylberberg Ariel
Published: December 2021

From cooking a meal to finding a route to a destination, many real life decisions can be decomposed into a hierarchy of sub-decisions. In a hierarchy, choosing which decision to think about requires planning over a potentially vast space of possible decision sequences. To gain insight into how people decide what to decide on, we studied a novel task that combines perceptual decision making, active sensing and hierarchical and counterfactual reasoning. Human participants had to find a target hidden at the lowest level of a decision tree. They could solicit information from the different nodes of the decision tree to gather noisy evidence about the target’s location. Feedback was given only after errors at the leaf nodes and provided ambiguous evidence about the cause of the error. Despite the complexity of task (with 107latent states) participants were able to plan efficiently in the task. A computational model of this process identified a small number of heuristics of low computational complexity that accounted for human behavior. These heuristics include making categorical decisions at the branching points of the decision tree rather than carrying forward entire probability distributions, discarding sensory evidence deemed unreliable to make a choice, and using choice confidence to infer the cause of the error after an initial plan failed. Plans based on probabilistic inference or myopic sampling norms could not capture participants’ behavior. Our results show that it is possible to identify hallmarks of heuristic planning with sensing in human behavior and that the use of tasks of intermediate complexity helps identify the rules underlying human ability to reason over decision hierarchies.
Integrating digital and field surveillance as complementary efforts to manage epidemic diseases of livestock: African swine fever as a case study
Authors: Tizzani Michele , Muñoz-Gómez Violeta , De Nardi Marco , Paolotti Daniela , Muñoz Olga , Ceschi Piera , Viltrop Arvo , Capua Ilaria
Published: December 2021

SARS-CoV-2 has clearly shown that efficient management of infectious diseases requires a top-down approach which must be complemented with a bottom-up response to be effective. Here we investigate a novel approach to surveillance for transboundary animal diseases using African Swine (ASF) fever as a model. We collected data both at a population level and at the local level on information-seeking behavior respectively through digital data and targeted questionnaire-based surveys to relevant stakeholders such as pig farmers and veterinary authorities. Our study shows how information-seeking behavior and resulting public attention during an epidemic, can be identified through novel data streams from digital platforms such as Wikipedia. Leveraging attention in a critical moment can be key to providing the correct information at the right moment, especially to an interested cohort of people. We also bring evidence on how field surveys aimed at local workers and veterinary authorities remain a crucial tool to assess more in-depth preparedness and awareness among front-line actors. We conclude that these two tools should be used in combination to maximize the outcome of surveillance and prevention activities for selected transboundary animal diseases such as ASF.
Identification of a distal RXFP1 gene enhancer with differential activity in fibrotic lung fibroblasts involving AP-1
Authors: Chen Ting-Yun , Li Xiaoyun , Goobie Gillian C. , Hung Ching-Hsia , Hung Tin-Kan , Hamilton Kyle , Bahudhanapati Harinath , Tan Jiangning , Kass Daniel J. , Zhang Yingze
Published: December 2021

Relaxin/insulin-like family peptide receptor 1 (RXFP1) mediates relaxin’s antifibrotic effects and has reduced expression in the lung and skin of patients with fibrotic interstitial lung disease (fILD) including idiopathic pulmonary fibrosis (IPF) and systemic sclerosis (SSc). This may explain the failure of relaxin-based anti-fibrotic treatments in SSc, but the regulatory mechanisms controllingRXFP1expression remain largely unknown. This study aimed to identify regulatory elements ofRXFP1that may function differentially in fibrotic fibroblasts. We identified and evaluated a distal regulatory region ofRXFP1in lung fibroblasts using a luciferase reporter system. Using serial deletions, an enhancer upregulating pGL3-promoter activity was localized to the distal region between -584 to -242bp from the distal transcription start site (TSS). This enhancer exhibited reduced activity in IPF and SSc lung fibroblasts. Bioinformatic analysis identified two clusters of activator protein 1 (AP-1) transcription factor binding sites within the enhancer. Site-directed mutagenesis of the binding sites confirmed that only one cluster reduced activity (-358 to -353 relative to distal TSS). Co-expression of FOS in lung fibroblasts further increased enhancer activity.In vitrocomplex formation with a labeled probe spanning the functional AP-1 site using nuclear proteins isolated from lung fibroblasts confirmed a specific DNA/protein complex formation. Application of antibodies against JUN and FOS resulted in the complex alteration, while antibodies to JUNB and FOSL1 did not. Analysis of AP-1 binding in 5 pairs of control and IPF lung fibroblasts detected positive binding more frequently in control fibroblasts. Expression ofJUNandFOSwas reduced and correlated positively withRXFP1expression in IPF lungs. In conclusion, we identified a distal enhancer ofRXFP1with differential activity in fibrotic lung fibroblasts involving AP-1 transcription factors. Our study provides insight intoRXFP1downregulation in fILD and may support efforts to reevaluate relaxin-based therapeutics alongside upregulation ofRXFP1transcription.
Facilitating cancer systems epidemiology research
Authors: Barajas Rolando , Hair Brionna , Lai Gabriel , Rotunno Melissa , Shams-White Marissa M. , Gillanders Elizabeth M. , Mechanic Leah E.
Published: December 2021

Systems epidemiology offers a more comprehensive and holistic approach to studies of cancer in populations by considering high dimensionality measures from multiple domains, assessing the inter-relationships among risk factors, and considering changes over time. These approaches offer a framework to account for the complexity of cancer and contribute to a broader understanding of the disease. Therefore, NCI sponsored a workshop in February 2019 to facilitate discussion about the opportunities and challenges of the application of systems epidemiology approaches for cancer research. Eight key themes emerged from the discussion: transdisciplinary collaboration and a problem-based approach; methods and modeling considerations; interpretation, validation, and evaluation of models; data needs and opportunities; sharing of data and models; enhanced training practices; dissemination of systems models; and building a systems epidemiology community. This manuscript summarizes these themes, highlights opportunities for cancer systems epidemiology research, outlines ways to foster this research area, and introduces a collection of papers, “Cancer System Epidemiology Insights and Future Opportunities” that highlight findings based on systems epidemiology approaches.
Uptake and toxicity of polystyrene micro/nanoplastics in gastric cells: Effects of particle size and surface functionalization
Authors: Banerjee Amrita , Billey Lloyd O. , Shelver Weilin L.
Published: December 2021

Toxicity of micro or nanoplastics (MP/NP) in aquatic life is well-documented, however, information about the consequences of exposure to these particles in terrestrial species is scarce. This study was used to evaluate the uptake and/or toxicity of polystyrene MP/NP in human gastric cells, comparing doses, particle sizes (50, 100, 200, 500, 1000 or 5000 nm) and surface functionalization (aminated, carboxylated or non-functionalized). In general, the uptake of 50 nm particles was significantly higher than 1000 nm particles. Among the 50 nm particles, the aminated particles were more avidly taken up by the cells and were cytotoxic at a lower concentration (≥ 7.5 μg/mL) compared to same sized carboxylated or non-functionalized particles (≥ 50 μg/mL). High toxicity of 50 nm aminated particles corresponded well with significantly high rates of apoptosis-necrosis induced by these particles in 4 h (29.2% of total cells) compared to all other particles (≤ 16.8%). The trend of apoptosis-necrosis induction by aminated particles in 4 h was 50 > 5000 > 1000 > 500 > 200 > 100 nm. The 50 nm carboxylated or non-functionalized particles also induced higher levels of apoptosis-necrosis in the cells compared to 100, 1000 and 5000 nm particles with same surface functionalization but longer exposure (24 h) to 50 nm carboxylated or non-functionalized particles significantly (p<0.0001) increased apoptosis-necrosis in the cells. The study demonstrated that the toxicity of MP/NP to gastric cells was dependent on particle size, dose surface functionalization and exposure period.
Severe maternal morbidity and its associated factors: A cross-sectional study in Morang district, Nepal
Authors: Rajbanshi Sushma , Norhayati Mohd Noor , Nik Hazlina Nik Hussain
Published: December 2021

Background

Understanding maternal morbidity and its determinants can help identify opportunities to prevent obstetric complications and improvements for maternal health. This study was conducted to determine the prevalence of severe maternal morbidity (SMM) and the associated factors.

Methods

A hospital-based cross-sectional study was conducted at Koshi Hospital, Nepal, from January to March 2020. All women who met the inclusion criteria of age ≥18 years of age, Morang residents of Nepalese nationality, had received routine antenatal care, and given birth at Koshi Hospital were recruited consecutively. The World Health Organization criteria were used to identify the women with SMM. A multiple logistic regression analysis was performed. Overall, 346 women were recruited.

Findings

The prevalence of SMM was 6.6%. Among the SMM cases, the most frequently occurring SMM conditions were hypertensive disorders (12, 56.5%), hemorrhagic disorders (6, 26.1%), and severe management indicators (8, 34.8%). Women with no or primary education (adjusted odds ratio: 0.10, 95% confidence interval: 0.01, 0.76) decreased the odds of SMM compared to secondary education.

Conclusion

The approximately 7% prevalence of SMM correlated with global studies. Maternal education was significantly associated with SMM. If referral hospitals were aware of the expected prevalence of potentially life-threatening maternal conditions, they could plan to avert future reproductive complications.
Evaluating the citywide Edinburgh 20mph speed limit intervention effects on traffic speed and volume: A pre-post observational evaluation
Authors: Nightingale Glenna F. , Williams Andrew James , Hunter Ruth F. , Woodcock James , Turner Kieran , Cleland Claire L. , Baker Graham , Kelly Michael , Cope Andy , Kee Frank , Milton Karen , Foster Charlie , Jepson Ruth , Kelly Paul
Published: December 2021

Objectives

Traffic speed is important to public health as it is a major contributory factor to collision risk and casualty severity. 20mph (32km/h) speed limit interventions are an increasingly common approach to address this transport and health challenge, but a more developed evidence base is needed to understand their effects. This study describes the changes in traffic speed and traffic volume in the City of Edinburgh, pre- and 12 months post-implementation of phased city-wide 20mph speed limits from 2016–2018.

Methods

The City of Edinburgh Council collected speed and volume data across one full week (24 hours a day) pre- and post-20mph speed limits for 66 streets. The pre- and post-speed limit intervention data were compared using measures of central tendency, dispersion, and basic t-tests. The changes were assessed at different aggregations and evaluated for statistical significance (alpha = 0.05). A mixed effects model was used to model speed reduction, in the presence of key variables such as baseline traffic speed and time of day.

Results

City-wide, a statistically significant reduction in mean speed of 1.34mph (95% CI 0.95 to 1.72) was observed at 12 months post-implementation, representing a 5.7% reduction. Reductions in speed were observed throughout the day and across the week, and larger reductions in speed were observed on roads with higher initial speeds. Mean 7-day volume of traffic was found to be lower by 86 vehicles (95% CI: -112 to 286) representing a reduction of 2.4% across the city of Edinburgh (p = 0.39) but with the direction of effect uncertain.

Conclusions

The implementation of the city-wide 20mph speed limit intervention was associated with meaningful reductions in traffic speeds but not volume. The reduction observed in road traffic speed may act as a mechanism to lessen the frequency and severity of collisions and casualties, increase road safety, and improve liveability.
Risk factors and pharmacotherapy for chemotherapy-induced peripheral neuropathy in paclitaxel-treated female cancer survivors: A retrospective study in Japan
Authors: Hiramoto Shiori , Asano Hajime , Miyamoto Tomoyoshi , Takegami Manabu , Kawabata Atsufumi
Published: December 2021

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse reaction in cancer patients treated with several cytotoxic anticancer agents including paclitaxel. Duloxetine, an antidepressant known as a serotonin-noradrenalin reuptake inhibitor, is the only agent that has moderate evidence for the use to treat painful CIPN. The present retrospective cohort study aimed to analyze risk factors for paclitaxel-induced peripheral neuropathy (PIPN), and investigate ongoing prescription drug use for PIPN in Japan. Female breast and gynecologic cancer patients who underwent paclitaxel-based chemotherapy at a single center in Japan between January 2016 and December 2019 were enrolled in this study. Patients’ information obtained from electronic medical records were statistically analyzed to test possible risk factors on PIPN diagnosis. Patients’ age, total paclitaxel dose, the history of female hormone-related diseases, hypertension and body mass index (BMI), but not additional platinum agents, were significantly associated with increased PIPN diagnosis. Drugs prescribed for PIPN included duloxetine, pregabalin, mecobalamin and Goshajinkigan, a polyherbal medicine, regardless of poor evidence for their effectiveness against CIPN, and were greatly different between breast and gynecologic cancer patients diagnosed with PIPN at the departments of Surgery and Gynecology, respectively. Thus, older age, greater total paclitaxel dose, the history of estrogen-related diseases, hypertension and BMI are considered risk factors for PIPN in paclitaxel-based chemotherapy of female cancer patients. It appears an urgent need to establish a guideline of evidence-based pharmacotherapy for PIPN.