bluuebunny/crossref_metadata_2025 huggingface dataset:
Lubrication characteristics analysis of slipper pair of digital valve distribution axial piston pump
Authors: Zhao Kaiping , He Tao , Wang Chuanli , Chen Qiangman , Li Zhipeng
Published: March 2022

The digital valve distribution axial piston pump is a swashplate rotary piston pump, the force on slippers is different from that of traditional axial piston pump. At the same time, the control strategy of the distribution valve will affect the pressure in the piston cavity, and then affect the oil film lubrication. According to these characteristics, the modeling method of oil film thickness field was proposed, and the force model of slipper pair and the numerical solution model of oil film lubrication of digital valve distribution axial piston pump were further established. The influence of swashplate rotation speed, swashplate inclination angle, and distribution valve control strategy on the characteristics of oil film lubrication were solved. The results show that the established thickness field model of oil film conforms to the stress characteristics of the slipper of the valve distribution pump. Increasing the swashplate rotation speed and the swashplate inclination angle is beneficial to optimize the oil film lubrication performance. The discharge valve should be opened in advance or closed in delay, which is beneficial to prevent eccentric wear and adhesion wear of slippers. The research results can provide theoretical basis for the optimal design of valve distribution axial piston pump.
Ethical issues in multilingual research situations: a focus on interview-based research
Authors: Schembri Natalie , Jahić Jašić Alma
Published: March 2022

Interview-based research in multilingual situations can present researchers with specific ethical challenges relating to language-based power play, data handling and presentation. Studies indicate favouring the L1 (first language) as an interviewing language may produce better quality data, but external pressures can favour English as the dominant research language. This article examines researcher perceptions and experiences of the ethical consequences of language choice and the practical issues involved. Interviews were conducted with five European researchers working on an interview-based project with experiences of diverse interviewing scenarios. The four moral principles of respect for autonomy, justice, beneficence and non-maleficence were used as a framework for analysis. The analysis revealed a nuanced picture of ethical issues in both L1- and English-oriented scenarios. This included potential misrepresentation and deculturalisation of the data in the former, and language-based power asymmetries in the latter. The findings highlight the importance of documenting ethics-related methodological details of language use, and advocates publication practices favouring the inclusion and foregrounding of L1 data.
Velocity encoded mitral valve inflow cine: A novel and more reproducible method to determine cardiac rest periods during coronary magnetic resonance angiography
Authors: Markus Richard , Tandon Animesh , Fares Munes , Dillenbeck Jeanne , Greil Gerald F. , Batsis Maria , Greer Joshua , Potersnak Amanda , Zhang Song , Hussain Tarique , Avula Sravani
Published: March 2022

A high temporal resolution, 4-chamber (4CH) cine is the standard method for determining cardiac rest periods during whole heart coronary magnetic resonance angiography (CMRA). We evaluated the image quality and reproducibility between the 4CH cine method and a novel approach using a velocity encoded mitral valve inflow cine (MVI). The goal of this study was to compare the quality of CMRAs utilizing MVI versus 4CH methods. Sharpness and vessel length for the LCA and RCA using each method were determined using Soap Bubble and two blinded observers independently assessed coronary image quality. Offline analysis on a separate, retrospective cohort (n = 25) was used to compare MVI and 4CH reproducibility. In the prospectively evaluated cohort there was no difference in overall vessel sharpness (4CH vs MVI mean ± SD) (31.0 ± 5.5% vs 30.5 ± 5.7%, p = .63), LCA vessel sharpness (30.0 ± 5.4% vs 31.1 ± 8.2%, p = .44), LCA length (4.7 ± 1.4 cm vs 4.6 ± 1.6 cm, p = .66), RCA vessel sharpness (32.1 ± 6.9% vs 31.1 ± 7.7%, p = .55), RCA length (5.51 ± 2.6 cm vs 5.95 ± 2.4 cm, p = .38), or image quality rating (2.66 vs 2.62, p = .80) between methods. In the retrospective cohort, the MVI method had 5.4% lower inter-observer variability (95% CI 3.7,7.2%, p < .0001) and 3.9% lower intra-observer variability (95% CI 2.4,5.4%, p < .0001) than the 4CH method.

MVI is a technically feasible and more reproducible method to determine cardiac rest periods compared to 4CH while preserving vessel sharpness, vessel length & image quality.
Two lives at stake: Obstetric anaphylactic shock resulting in acute respiratory distress syndrome – A case report
Authors: Munasinghe BM , Perera RN , Kumara SKWR
Published: March 2022

Maternal anaphylaxis is rare albeit life-threatening critical incident dreaded by many due to negative effects on not only the mother but the foetus as well. Antibiotics and anaesthetic agents still contribute to majority of the episodes. Consequences of anaphylaxis such as placental insufficiency and subsequent foetal neurocognitive deficits are devastating outcomes. Acute respiratory distress syndrome following anaphylaxis is even rarer among the normal population. The management of maternal anaphylaxis does not differ from routine recommendations even though close monitoring and preparedness for early delivery should be embedded in the protocols. This is a rare case report of a primi mother who developed anaphylactic shock following intravenous penicillin in the background of negative allergic history, resultant foetal distress requiring emergency lower segment caesarian section and delayed onset acute respiratory distress syndrome which was later attributed to anaphylaxis. Pertinent identification and management which included a multidisciplinary team culminated in favourable outcomes.
Computational grounded theory revisited: From computer-led to computer-assisted text analysis
Authors: Carlsen Hjalmar Bang , Ralund Snorre
Published: March 2022

The size and variation in both meaning-making and populations that characterize much contemporary text data demand research processes that support both discovery, interpretation and measurement. We assess one dominant strategy within the social sciences that takes a computer-led approach to text analysis. The approach is coined computational grounded theory. This strategy, we argue, relies on a set of unwarranted assumptions, namely, that unsupervised models return natural clusters of meaning, that the researcher can understand text with limited immersion and that indirect validation is sufficient for ensuring unbiased and precise measurement. In response to this criticism, we develop a framework that is computer assisted. We argue that our reformulation of computational grounded theory better aligns with the principles within grounded theory, anthropological theory generation and ethnography.
Magnetic resonance image-based brain tumour segmentation methods: A systematic review
Authors: Bhalodiya Jayendra M , Lim Choi Keung Sarah N , Arvanitis Theodoros N
Published: March 2022

Background

Image segmentation is an essential step in the analysis and subsequent characterisation of brain tumours through magnetic resonance imaging. In the literature, segmentation methods are empowered by open-access magnetic resonance imaging datasets, such as the brain tumour segmentation dataset. Moreover, with the increased use of artificial intelligence methods in medical imaging, access to larger data repositories has become vital in method development.

Purpose

To determine what automated brain tumour segmentation techniques can medical imaging specialists and clinicians use to identify tumour components, compared to manual segmentation.

Methods

We conducted a systematic review of 572 brain tumour segmentation studies during 2015–2020. We reviewed segmentation techniques using T1-weighted, T2-weighted, gadolinium-enhanced T1-weighted, fluid-attenuated inversion recovery, diffusion-weighted and perfusion-weighted magnetic resonance imaging sequences. Moreover, we assessed physics or mathematics-based methods, deep learning methods, and software-based or semi-automatic methods, as applied to magnetic resonance imaging techniques. Particularly, we synthesised each method as per the utilised magnetic resonance imaging sequences, study population, technical approach (such as deep learning) and performance score measures (such as Dice score).

Statistical tests

We compared median Dice score in segmenting the whole tumour, tumour core and enhanced tumour.

Results

We found that T1-weighted, gadolinium-enhanced T1-weighted, T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging are used the most in various segmentation algorithms. However, there is limited use of perfusion-weighted and diffusion-weighted magnetic resonance imaging. Moreover, we found that the U-Net deep learning technology is cited the most, and has high accuracy (Dice score 0.9) for magnetic resonance imaging-based brain tumour segmentation.

Conclusion

U-Net is a promising deep learning technology for magnetic resonance imaging-based brain tumour segmentation. The community should be encouraged to contribute open-access datasets so training, testing and validation of deep learning algorithms can be improved, particularly for diffusion- and perfusion-weighted magnetic resonance imaging, where there are limited datasets available.
It Could Be Us: Black Faculty as “Threats” on the Path to Tenure
Authors: Carter TaLisa J. , Craig Miltonette O.
Published: March 2022

Racial disparities in tenure and promotion outcomes are well known in the existing research literature. Scholarship establishes that Black and Brown faculty experience unique challenges when navigating the tenure and promotion process, such as lack of diverse mentorship, biased student/peer evaluations, and disproportionately high service demands. However, the public has entered this discourse due to recent media attention involving the tenure cases of Nikole Hannah-Jones and Cornel West, and this has prompted minoritized faculty nationwide to reflect on the implications of these incidents on their own careers. This study relies on theoretical and conceptual literature to discuss the professional realities Black faculty face on the job. We make the theoretical claim that the racial threat hypothesis can facilitate understanding of how Black faculty pursuing tenure is a political threat to white hegemony in the academy resulting in an increase of social control. We conclude with concrete recommendations on how Black scholars can wield the label of “threat” to successfully navigate the academy.
Average Time Spent in Referral Process and its Determinants Among Clients of Maternal and Child Health Service in 2 Districts of Jimma Zone, Ethiopia
Authors: Kitila Sena Belina , Tesema Abebe Abera , Bekele Gadisa , Olika Ayantu Kebede , Biratu Terfa Yonas , Ololo Sinkie Shimelis , Olika Alemi Kebede
Published: March 2022

Background: The time spent between referring and receiving health facilities is an important determinant of the outcome of the referred patients/clients especially among women in low-income countries due to poor access to early and appropriate referrals. Thus, the aim of this study is to assess the average time spent between referring and service utilization at receiving health facility. Methods: A cross-sectional study was employed by using time and motion approach. Structured questionnaire and observation checklist were used for collecting data. SPSS 21 version was used for data analysis and binary and multivariable logistic regression analysis was carried out to identify a variable that has a significant association on the basis of OR, 95% confidence interval, and a P value of less than .05. Result: A total of 266 women participated in the study with the mean age of the study population is 24.65 (±5.03) years. The majority, (223 (83.8%)) of the participants came for maternal health services and more than half, (143 (53.8%)) of the respondents were self-referrals. Among the referred cases, the main reason for the referral was for further evaluation and management. Women spent a maximum of 540 min on the way to arrive at receiving health facility. Residence and distance were the predictor variables for average time spent. Conclusion: In general, women wait a maximum of one and half hours to contact health care providers for assessment and more than two-fifth of the women wait more than 3 h to get the service at receiving health facility.
Improving Diagnostic Efficiency with Frequency Double-Trees and Frequency Nets in Bayesian Reasoning
Authors: Kunzelmann Alexandra K. , Binder Karin , Fischer Martin R. , Reincke Martin , Braun Leah T. , Schmidmaier Ralf
Published: March 2022

Background. Medical students often have problems with Bayesian reasoning situations. Representing statistical information as natural frequencies (instead of probabilities) and visualizing them (e.g., with double-trees or net diagrams) leads to higher accuracy in solving these tasks. However, double-trees and net diagrams (which already contain the correct solution of the task, so that the solution could be read of the diagrams) have not yet been studied in medical education. This study examined the influence of information format (probabilities v. frequencies) and visualization (double-tree v. net diagram) on the accuracy and speed of Bayesian judgments. Methods. A total of 142 medical students at different university medical schools (Munich, Kiel, Goettingen, Erlangen, Nuremberg, Berlin, Regensburg) in Germany predicted posterior probabilities in 4 different medical Bayesian reasoning tasks, resulting in a 3-factorial 2 × 2 × 4 design. The diagnostic efficiency for the different versions was represented as the median time divided by the percentage of correct inferences. Results. Frequency visualizations led to a significantly higher accuracy and faster judgments than did probability visualizations. Participants solved 80% of the tasks correctly in the frequency double-tree and the frequency net diagram. Visualizations with probabilities also led to relatively high performance rates: 73% in the probability double-tree and 70% in the probability net diagram. The median time for a correct inference was fastest with the frequency double tree (2:08 min) followed by the frequency net diagram and the probability double-tree (both 2:26 min) and probability net diagram (2:33 min). The type of visualization did not result in a significant difference. Discussion. Frequency double-trees and frequency net diagrams help answer Bayesian tasks more accurately and also more quickly than the respective probability visualizations. Surprisingly, the effect of information format (probabilities v. frequencies) on performance was higher in previous studies: medical students seem also quite capable of identifying the correct solution to the Bayesian task, among other probabilities in the probability visualizations.

Highlights

Frequency double-trees and frequency nets help answer Bayesian tasks not only more accurately but also more quickly than the respective probability visualizations. In double-trees and net diagrams, the effect of the information format (probabilities v. natural frequencies) on performance is remarkably lower in this high-performing sample than that shown in previous studies.
Word imageability is associated with expressive vocabulary in children with autism spectrum disorder
Authors: Lin Kimberly R , Wisman Weil Lisa , Thurm Audrey , Lord Catherine , Luyster Rhiannon J
Published: March 2022

Background & aims

Throughout typical development, children prioritize different perceptual, social, and linguistic cues to learn words. The earliest acquired words are often those that are perceptually salient and highly imageable. Imageability, the ease in which a word evokes a mental image, is a strong predictor for word age of acquisition in typically developing (TD) children, independent of other lexicosemantic features such as word frequency. However, little is known about the effects of imageability in children with autism spectrum disorder (ASD), who tend to have differences in linguistic processing and delayed language acquisition compared to their TD peers. This study explores the extent to which imageability and word frequency are associated with early noun and verb acquisition in children with ASD.

Methods

Secondary analyses were conducted on previously collected data of 156 children (78 TD, 78 ASD) matched on sex and parent-reported language level. Total expressive vocabulary, as measured by the MacArthur Bates Communicative Development Inventory (MB-CDI), included 123 words (78 nouns, 45 verbs) that overlapped with previously published imageability ratings and word input frequencies. A two-step hierarchical linear regression was used to examine the relationship between word input frequency, imageability, and total expressive vocabulary. An F-test was then used to assess the unique contribution of imageability on total expressive vocabulary when controlling for word input frequency.

Results

In both the TD and ASD groups, imageability uniquely explained a portion of the variance in total expressive vocabulary size, independent of word input frequency. Notably, imageability was significantly associated with noun vocabulary and verb vocabulary size alone, with imageability explaining a greater portion of the variance in total nouns produced than in total verbs produced.

Conclusions

Imageability was identified as a significant lexicosemantic feature for describing expressive vocabulary size in children with ASD. Consistent with literature on TD children, children with ASD who have small vocabularies primarily produce words that are highly imageable. Children who are more proficient word learners with larger vocabularies produce words that are less imageable, indicating a potential shift away from reliance on perceptual-based language processing. This was consistent across both noun and verb vocabularies.

Implications

Our findings contribute to a growing body of literature describing early word learning in children with ASD and provide a basis for exploring the use of multisensory language learning strategies.
Late Mandible Fracture After Surgical Extraction of Mandibular Third Molar: A Retrospective Data From a Tertiary Institute
Authors: Jolly Satnam Singh , Rattan Vidya , Rai Sachin
Published: March 2022

Introduction

A late mandibular fracture after third molar extractions is a very rare complication. The main etiological factors of it are considered to be age greater than 40, male patients, tooth position, and trauma to the mandible. The main features commonly described by the patients are occurrence after few days of extraction with history of crackling due to fracture of mandible and pain on chewing.

Material and Method

We retrospectively review the treatment chart of mandibular trauma patients and observe cases of fracture mandible angle after third molar surgery. Five patients who reported late mandibular fracture after a third molar extraction were treated either by maxillomandibular fixation (MMF) or by open reduction and internal fixation (ORIF) studied.

Results

Out of the 5 patients, 3 were treated with ORIF and 2 were treated with MMF. After maximum follow-ups, all healed well without any complications.

Conclusion

It is observed that all the causative factors should be assessed before any third molar surgery, and that this rare complication should be explained to the patients and written consent should be taken before undergoing any difficult surgical extractions.
Impact of Dispense Tracking Software on Inpatient Pharmacy Operations
Authors: Gunter Zachariah , Lawson Nikolaus , Bondarenka Carolyn
Published: March 2022

Background: When medications dispensed from a hospital inpatient pharmacy aren’t able to be found at their intended destination (ie, a missing dose), this can result in delayed medication administration and rework to redispense the medication. Technology advancements in the medication use process have led to development of dose-tracking software that has the capability to track medication doses throughout the medication use cycle and document a medication’s location to its destination. Objective: The primary objective of this study was to evaluate the impact of dose-tracking software on the number of inpatient pharmacy redispenses and nursing requests for missing medications. Secondary objectives included pharmacy staff satisfaction with dose-tracking software, its impact on workflow and patient safety, and compliance with dose-track scanning. Methods: The study design was a prospective, pre-post implementation to compare the requests for missing doses and associated dispenses of injectable medications during the set evaluation period. Dose-track scanning compliance data was collected and evaluated. A survey was also administered to staff to evaluate employee perception and satisfaction with usability and value of the software. Results: During the preimplementation period, 40 021 injectable doses were dispensed, and 9841 (24.6%) were documented as redispensed doses. After dose-tracking implementation, 42 975 total injectable doses were dispensed with 9839 (22.9%) being redispensed. The count of medication messages was 10 661 in the preperiod and 11 475 in the postperiod. The data were normalized using case mix index (CMI) and patient days to account for variation in severity of illness. Conclusion: Implementation of dose-tracking software showed a decrease in the percentage of redispensed injectable medications.
Measurement of apparent sintering activation energy for densification of clays
Authors: Comin André Biava , Zaccaron Alexandre , de Souza Nandi Vitor , Inocente Jordana Mariot , Muller Thuani Gesser , Dal Bó Alexandre Gonçalves , Bernardin Adriano Michael , Peterson Michael
Published: March 2022

Clays are raw materials with properties that are necessary for the manufacture of ceramic tiles. The characteristics of clay ceramic raw materials may vary within the same mineral deposit. Clay blending promotes better use of clay reserves, thereby increasing the applicability and life cycle of raw materials. Therefore, it is important to understand the mechanisms controlling the firing of ceramic tiles. In this study, three different clays from a clay deposit were assessed and ten formulations were prepared using the mixture design method. The formulations were analysed using differential thermal and thermogravimetric analyses and dilatometric analysis. Subsequently, the most refractory and fluxing formulations were subjected to thermal tests under various heating rates, similar to the process used for the calculation of apparent sintering activation energy for the densification of clays and for pyroplasticity tests. It is suggested that a mineral deposit can be assessed based on activation energy and thermal kinetics, expanding the alternatives available to the miner through the planning of mixtures with various clays and thus reducing the energy costs of the industrial process.
Profiles of genetic parameters of body weight and feed efficiency in two divergent broiler lines for meat ultimate pH
Authors: Berger Quentin , Guettier Elodie , Bernard Jérémy , Ganier Patrice , Chahnamian Marine , Le Bihan-Duval Elisabeth , Mignon-Grasteau Sandrine
Published: March 2022

Background

Selection for feed efficiency is one of the best ways to decrease poultry production costs and environmental impacts. While literature on its genetic determinism is abundant, it is limited to one or a few periodic values over the animals’ lifespans. With the development of new phenotyping tools, kinetics of growth and feed intake are now available, providing access to daily data on feed efficiency. In this study, over the course of 6 weeks, we described the kinetics of body weight (BW), average daily weight gain (ADG), feed intake (FI), and daily cumulative feed conversion ratio (DCFCR) using electronic feed stations. We then estimated the genetic parameters of daily data in two fast growing lines of chicken divergently selected for breast meat ultimate pH (heritability and genetic correlations with breast meat yield and pH).

Results

Birds from the line selected to have a more acidic meat (pHu-), were more efficient than those selected to have a less acidic meat (pHu+), with a 4.3% higher BW from d7 to d29 and 5.0% better feed efficiency from d12 to slaughter. The line effect for ADG and DCFCR appeared to be significant as early as d5, which is consistent with the early age at which metabolic differences between the two lines appear. Genetic parameters estimated within each line revealed different genetic determinisms of growth and feed efficiency, with a higher impact of maternal effects on BW during the growing phase (d10 to d20) in the pHu+ line and much higher heritability values of DCFCR during the finishing phase (d26-d42) in the pHu- line.

Conclusion

Genetic profiles of daily performance highlighted the difference between both lines. Their behavior during dietary transitions reinforced the already known impact of these periods in the animals’ lives. Based on the profiles of genetic parameters within each line, it seems feasible to identify early criteria for selecting feed efficiency, but they must be defined for each line, as the genetic determinism of these traits is line-dependent.
Evolution of the recombination regulator PRDM9 in minke whales
Authors: Damm Elena , Ullrich Kristian K. , Amos William B. , Odenthal-Hesse Linda
Published: March 2022

Background

PRDM9 is a key regulator of meiotic recombination in most metazoans, responsible for reshuffling parental genomes. During meiosis, the PRDM9 protein recognizes and binds specific target motifs via its array of C2H2zinc-fingers encoded by a rapidly evolving minisatellite. The gene coding for PRDM9 is the only speciation gene identified in vertebrates to date and shows high variation, particularly in the DNA-recognizing positions of the zinc-finger array, within and between species. Across all vertebrate genomes studied for PRDM9 evolution, only one genome lacks variability between repeat types – that of the North Pacific minke whale. This study aims to understand the evolution and diversity ofPrdm9in minke whales, which display the most unusual genome reference allele ofPrdm9so far discovered in mammals.

Results

Minke whales possess all the features characteristic of PRDM9-directed recombination, including complete KRAB, SSXRD and SET domains and a rapidly evolving array of C2H2-type-Zincfingers (ZnF) with evidence of rapid evolution, particularly at DNA-recognizing positions that evolve under positive diversifying selection. Seventeen novel PRDM9 variants were identified within the Antarctic minke whale species, plus a single distinct PRDM9 variant in Common minke whales – shared across North Atlantic and North Pacific minke whale subspecies boundaries.

Conclusion

The PRDM9 ZnF array evolves rapidly, in minke whales, with at least one DNA-recognizing position under positive selection. Extensive PRDM9 diversity is observed, particularly in the Antarctic in minke whales. Common minke whales shared a specificPrdm9allele across subspecies boundaries, suggesting incomplete speciation by the mechanisms associated with PRDM9 hybrid sterility.
Genome-wide analysis of trehalose-6-phosphate phosphatases (TPP) gene family in wheat indicates their roles in plant development and stress response
Authors: Du Linying , Li Shumin , Ding Li , Cheng Xinxiu , Kang Zhensheng , Mao Hude
Published: March 2022

Background

Trehalose-6-phosphate phosphatases genes (TPPs) are involved in the development and stress response of plants by regulating the biosynthesis of trehalose, though little is currently known about TPPs in common wheat (Triticum aestivum L.).

Results

In this study, we performed a genome-wide identification of the TPP gene family in common wheat, and identified a total of 31 TaTPP genes. These were subdivided into six subfamilies based on the phylogenetic relationships and the conservation of protein in six monocot and eudicot plants. The majority of TPP genes were represented by 2–3 wheat homoalleles (named TaTPPX_ZA, TaTPPX_ZB, or TaTPPX_ZD), where Z is the location on the wheat chromosome of the gene number (X). We also analyzed the chromosomal location, exon-intron structure, orthologous genes, and protein motifs of the TaTPPs. The RNA-seq data was used to perform an expression analysis, which found 26 TaTPP genes to be differentially expressed based on spatial and temporal characteristics, indicating they have varied functions in the growth and development of wheat. Additionally, we assessed how the promoter regulatory elements were organized and used qRT-PCR in the leaves to observe how they were expressed following ABA, salt, low tempreture, and drought stress treatments. All of these genes exhibited differential expression against one or more stress treatments. Furthermore, ectopic expression of TaTPP11 in Arabidopsis exhibited a phenotype that delayed plant development but did not affect seed morphology.

Conclusions

TaTPPs could serve important roles in the development and stress response in wheat. These results provide a basis for subsequent research into the function of TaTPPs.
Long-term outcomes after surgery to prevent aspiration for patients with amyotrophic lateral sclerosis
Authors: Soga Temma , Suzuki Naoki , Kato Kengo , Kawamoto-Hirano Ai , Kawauchi Yuko , Izumi Rumiko , Toyoshima Masaya , Mitsuzawa Shio , Shijo Tomomi , Ikeda Kensuke , Warita Hitoshi , Katori Yukio , Aoki Masashi , Kato Masaaki
Published: March 2022

Background

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons selectively. In particular, weakness in respiratory and swallowing muscles occasionally causes aspiration pneumonia and choking, which can be lethal. Surgery to prevent aspiration, which separates the trachea and esophagus, can reduce the associated risks. Central-part laryngectomy (CPL) is a relatively minimally invasive surgery to prevent aspiration. No studies have been conducted on the long-term outcomes of surgery to prevent aspiration in patients with ALS. This case series aimed to determine the long-term outcomes of surgery to prevent aspiration and the use of a continuous low-pressure aspirator in patients with ALS by evaluating the frequency of intratracheal sputum suctions performed per day, intra- and postoperative complications, oral intake data, and satisfaction of patients and their primary caregiver to predict improvement in patients’ quality of life (QOL).

Methods

We report a case series of six patients with ALS who underwent CPL along with tracheostomy to prevent aspiration between January 2015 and November 2018. We evaluated their pre- and postoperative status and administered questionnaires at the time of last admission to the patients and their primary caregivers.

Results

The mean follow-up period after CPL was 33.5 months. Aerophagia was a common postoperative complication. The use of a continuous low-pressure aspirator resulted in reduced frequency of intratracheal sputum suctions. All cases avoided aspiration pneumonia. Oral intake was continued for 2–4 years after the tracheostomy and CPL. The satisfaction levels of the patient and primary caregiver were high.

Conclusion

Our case series suggests that the use of a continuous low-pressure aspirator in patients undergoing CPL improves oral intake and reduces the frequency of intratracheal sputum suctions, which improves the QOL of patients with ALS and their families and caregivers. CPL and continuous low-pressure aspiration should be considered as a management option for ALS with significant bulbar and respiratory muscle weakness/dysfunction.
Clinical and prognostic aspects of patients with the Neuromyelitis Optica Spectrum Disorder (NMOSD) from a cohort in Northeast Brazil
Authors: Fukuda Thiago Gonçalves , Silva Ivã Taiuan Fialho , dos Santos Tayla Samanta Silva , Filho Marcos Baruch Portela , de Abreu Fernanda Ferreira , Oliveira-Filho Jamary
Published: March 2022

Introduction

Neuromyelitis optica spectrum disorders (NMOSD) is a rare inflammatory and demyelinating disease of the central nervous system (CNS) more frequent in women and Afro-descendants. No previous epidemiological or prognostic study has been conducted in the region of the state of Bahia, Brazilian Northeast.

Objective

To evaluate clinical and prognostic aspects in patients with NMOSD from a cohort in northeastern Brazil.

Material and methods

A single-center retrospective study was conducted with consecutive patients diagnosed with NMOSD. Clinical and epidemiological characteristics were described. The degree of disability was expressed by the Expanded Disability Status Scale (EDSS). Worsening disability were analyzed through negative binomial regression adjusted for disease duration.

Results

Ninety-one patients were included, 72 (79.1%) female and 67 (73.6%) afro descendants. Mean age at onset was 36 (± 14) years and 73.3% were anti-aquaporin-4 antibody positive. Isolated transverse myelitis (32.9%) and isolated optic neuritis (22.4%) were the most frequent initial clinical syndromes. After multivariate analysis, optic neuritis (RR = 0.45; 95% CI = 0.23 – 0.88; p = 0.020) and dyslipidemia (RR = 0.40; 95% CI = 0.20 – 0.83; p = 0.014) were associated with slower disease progression. Area postrema involvement (RR = 6.70; 95% CI = 3.31 – 13.54; p < 0.001) and age at onset (RR = 1.03; 95% CI = 1.01 – 1.05; p = 0.003) were associated with faster disease progression.

Conclusions

In the first clinical and prognostic study in northeastern Brazil, we identified area postrema involvement, age at onset, optic neuritis at fist syndrome and dyslipidemia as the main prognostic factors associated with disease progression.
The impact of AMIGO2 on prognosis and hepatic metastasis in gastric cancer patients
Authors: Goto Keisuke , Morimoto Masaki , Osaki Mitsuhiko , Tanio Akimitsu , Izutsu Runa , Fujiwara Yoshiyuki , Okada Futoshi
Published: March 2022

Background

Gastric cancer (GC) is one of the most common malignancies, and the liver is the most common site of hematogenous metastasis of GC. AMIGO2 is a type I transmembrane protein that has been implicated in tumour cell adhesion in adenocarcinomas; however, its importance in GC remains undetermined.

Methods

We analyzed AMIGO2 expression by immunohistochemistry using the specific monoclonal antibody for human AMIGO2 in 128 patients who underwent GC surgery to evaluate its relationship between various metastatic and clinical outcomes in GC.

Results

Immunohistochemistry revealed that AMIGO2 expression was an independent prognostic factor for overall survival, disease-specific survival, and liver metastasis in GC patients.

Conclusions

This study showed that AMIGO2 is induced in GC tissues and can mediate hepatic metastasis. Determining AMIGO2 expression in GC will help predict patient prognosis and the incidence of liver metastasis.
Clinical features of excyclotorsion in the non-paretic eye of patients with congenital unilateral superior oblique palsy
Authors: Cha Eun-Hyang , Ha Suk-gyu , Suh Shu Youngwoo , Kim Seung-Hyun
Published: March 2022

Background

To investigate preoperative clinical features and postoperative results according to the correspondence between excyclotorsion and the paretic eye in patients with congenital unilateral superior oblique palsy (USOP).

Methods

A retrospective review of medical charts was performed. The patients were divided into the accordance (ocular excyclotorsion in the paretic eye) and disaccordance (ocular excyclotorsion in the non-paretic eye) groups. The degree of excyclotorsion (scale, 0–4) was measured. Age, sex, hypertropia at the primary position, fixation preference, inferior oblique overaction, and degree of excyclotorsion were measured.

Results

Ninety-eight patients were included in this study. There were 70 (71.4%) and 28 patients (28.6%) in the accordance and disaccordance groups. Sixteen patients (22.9%) in the accordance group and 12 patients (42.9%) in the disaccordance group were aged under 2 years (p = 0.04). A fixation preference of the paretic eye was observed in 2 (2.9%) and 8 (28.6%) patients in the accordance and disaccordance groups (p < 0.01). The postoperative degree of excyclotorsion in the accordance group (0.14 ± 0.39) was lower than that in the disaccordance group (0.28 ± 0.71) (p = 0.01). The residual postoperative excyclotorsion (> 1) were observed in the disaccordance group (14 patients, 50%) and accordance group (16 patients, 22.9%) (p = 0.01).

Conclusion

Preoperative disaccordance between excyclotorsion and the paretic eye was observed in patients who were under 2 years of age and preferred fixation of the paretic eye. The postoperative degree of excyclotorsion was lower in the accordance group.
Association between intergenerational solidarity involving elders and mental health of Indigenous people living off reserve
Authors: Viscogliosi Chantal , Asselin Hugo , Trottier Lise , D’Amours Monia , Levasseur Mélanie
Published: March 2022

Background

Indigenous elders play an important role in transmitting knowledge, values and practices, hence fostering identity-building through intergenerational solidarity. We aimed to verify the association between intergenerational solidarity involving Indigenous elders and mental health of Indigenous people living off reserve.

Methods

We carried secondary analyses of data for a subsample from the cross-sectional 2012 Aboriginal Peoples Survey (total sample:n = 28,410 Indigenous persons aged ≥6 years old living off reserve; subsample:n = 13,020 aged 18–44 years old). Controlling for age as well as material and social deprivation, we used logistic regressions to verify the association between intergenerational solidarity (proxied as time spent with an elder and potential of turning to an elder or grandparent for support in times of need) and mental health (perceived mental health, mood disorders, anxiety, suicidal thoughts and attempts).

Results

About 39 and 9% of the respondents respectively reported having spent time with an elder and would have turned to an elder or grandparent for support in times of need. Women who would not turn to an elder or grandparent for support in times of need were more likely to report fair or poor perceived mental health (OR = 1.69,p = 0.03). Men not spending time with an elder were more likely to experience mood disorders (OR = 1.66,p = 0.004). Women who would not turn to an elder or grandparent for support in times of need were more likely to experience anxiety disorders (OR = 1.57,p = 0.04). Women not spending time with an elder or who would not turn to an elder or grandparent for support in times of need were respectively more likely to have suicidal thoughts (OR = 1.62,p = 0.04) or to have attempted suicide (OR = 3.38,p = 0.04).

Conclusion

Intergenerational solidarity is associated with better mental health outcomes of Indigenous people living off reserve. These results could guide policies and practices that aim to enhance mental health and wellness in Indigenous populations.
Making Europe health literate: including older adults in sparsely populated Arctic areas
Authors: Gustafsdottir Sonja S. , Sigurdardottir Arun K. , Mårtensson Lena , Arnadottir Solveig A.
Published: March 2022

Background

Older people have been identified as having lower health literacy (HL) than the general population average. Living in sparsely populated Arctic regions involves unique health challenges that may influence HL. The research aim was to explore the level of HL, its problematic dimensions, and its association with the selection of contextual factors among older adults living in sparsely populated areas in Northern Iceland.

Method

This was a cross-sectional study based on a stratified random sample from the national register of one urban town and two rural areas. The study included 175 participants (57.9% participation rate) who were community-dwelling (40% rural) and aged 65–92 years (M74.2 ±SD6.3), 43% of whom were women. Data were collected in 2017-2018 via face-to-face interviews, which included the standardised European Health Literacy Survey Questionnaire-short version (HLS-EU-Q16) with a score range from 0 to 16 (low-high HL).

Results

The level of HL ranged from 6–16 (M13.25,SD± 2.41) with 65% having sufficient HL (score 13–16), 31.3% problematic HL (score 9–12) and 3.7% inadequate HL (score 0–8). Most problematic dimension of HL was within the domains of disease prevention and health promotion related to information in the media. Univariate linear regression revealed that better HL was associated with more education (p=0.001), more resiliency (p=0.001), driving a car (p=0.006), good access to health care- (p=0.005) and medical service (p=0.027), younger age (p=0.005), adequate income (p=0.044) and less depression(p=0.006). Multivariable analysis showed that more education (p=0.014) and driving a car (p=0.017) were independent predictors of better HL.

Conclusion

Difficulties in HL concern information in the media. HL was strongly associated with education and driving a car however, not with urban-rural residency. Mobility and access should be considered for improving HL of older people.
The effects of living and learning conditions on the health-related quality of life of children and adolescents during the COVID-19 lockdown in the French Grand Est region
Authors: Bourion-Bédès Stéphanie , Rousseau Hélène , Batt Martine , Tarquinio Pascale , Lebreuilly Romain , Sorsana Christine , Legrand Karine , Tarquinio Cyril , Baumann Cédric
Published: March 2022

Introduction

COVID-19 lockdown measures resulted in children and adolescents staying and learning at home. This study investigated health-related quality of life (HRQoL) and its associated factors among youth during the first lockdown.

Methods

A cross-sectional study was conducted among 8- to 18-year-olds from the French Grand Est region. Sociodemographic data and information on living and learning conditions were collected using an online survey. HRQoL was assessed using the KIDSCREEN-27. Multiple regression analysis was performed to explore factors related to low HRQoL in each dimension.

Results

In total, 471 children from 341 households were included. Difficulties isolating at home were associated with low HRQoL in the psychological well-being (OR = 2.2, 95% CI: 1.2–4.0) and parent relations and autonomy (OR = 2.1, 95% CI: 1.2–3.8) dimensions. Conflicts with dwelling occupants were related to increased ORs in the psychological well-being (OR = 2.9, 95% CI: 1.9–4.6), parent relations and autonomy (OR = 2.2, 95% CI: 1.4–3.4) and school environment (OR = 2.4, 95% CI: 1.5–3.7) dimensions. Living in an apartment (OR = 1.8, 95% CI: 1.1–3.1), never leaving home (OR = 2.6, 95% CI: 1.2–5.9), having indoor noise at home (OR = 2.3, 95% CI: 1.2–4.6), and having a parent with high anxiety (OR = 1.8, 95% CI: 1.1–3.1) were associated with low HRQoL in the social support and peers dimension. Children working less than 1 h/day on schoolwork had an increased OR of 3.5 (95% CI: 1.4–9.0) in the school environment dimension.

Conclusion

Living and learning conditions were associated with low HRQoL among children and adolescents during the COVID-19 lockdown. Prevention and intervention programs are needed to support youth by facilitating their interactions and improving their coping and to prepare for future waves.
Ethical challenges and moral distress among field epidemiologists
Authors: Cooke Emma , Lopez George , Hilmers Angela , Addiss David G.
Published: March 2022

Background

As ‘disease detectives’ and directors of public health programs, field epidemiologists play essential roles in protecting public health. Although ethical issues receive considerable attention in medical and research settings, less is known about ethical challenges faced by field epidemiologists in public health programs. Similarly, little is known about moral distress among field epidemiologists, i.e., situations in which they are constrained from acting on what they know to be morally right. Moral distress is strongly associated with empathy fatigue, burnout, reduced job retention, and disengagement. To better understand ethics training needs for field epidemiologists, in February 2019, members of TEPHIConnect, an online and mobile networking platform for Field Epidemiology Training Program (FETP) alumni, were invited to participate in an anonymous survey about ethical challenges and moral distress.

Results

Among 126 respondents from 54 countries, leading causes of ethical dilemmas included inadequate informed consent (61%), inequitable allocation of resources (49%), and conflicts of interest (43%). These occur primarily in settings of disease outbreaks (60%); research (55%); and public health programs at the state, province, or national level (45%) or community level (43%). Work-related moral distress was reported by 91% of respondents, including 26% who experience it “frequently” or “almost always.” Field epidemiologists working in low- and low-middle income countries were more likely to report moral distress “frequently” or “almost always” than those in higher-income countries (33.0% vs 9.1%,P = 0.006). The most common perceived contributors to moral distress included excessive stress and work demands (30%) and inadequate support from leaders (25%).

Conclusions

Field epidemiologists face significant work-related ethical challenges, which are endemic to public health and political systems. A substantial proportion of field epidemiologists also experience some degree of moral distress, often in association with these challenges. These findings indicate an unmet need among field epidemiologists for support in navigating ethical challenges, as well as for resources to address the human and professional consequences of moral distress.