bluuebunny/crossref_metadata_2025 huggingface dataset:
Dislocation re-emission induced staged work hardening in graphene-nanotwin reinforced Cu: A molecular dynamics simulation study
Authors: Hu YQ , Zhang S , Huang P , Wang F
Published: January 2022

Graphene and nanotwins are two effective reinforced microstructural features to achieve improved mechanical properties of metallic composites, while the two features are generally applied separately. In this study, graphene/nano-twinned Cu nanocomposites models with different arrangement of the graphene and twin boundaries were designed by using molecular dynamics (MD) simulations, and the dislocation processes and the interactions between dislocation and graphene/twin were simulated and investigated. The simulation results indicated the arrangement of graphene and nanotwin affects the work hardening behaviors in the graphene/nano-twinned Cu composites, i.e., two staged work hardening behavior corresponded to cyclic process of dislocation hindrance-absorption-reemission in the model with relatively small twin spacing and twin-graphene spacing, while the work hardening dominated by dislocation intersection and multiplication occurred in the model with large twin-spacing. The simulation provided herein demonstrated that the special arrangement of graphene and nanotwins led a way to tailoring the mechanical properties of metallic composites with various work hardening behaviors.

Graphical abstract

Highlights

1. Dislocation reactions between twins and graphene were simulated and analyzed.

2. Twin-graphene distance and the twin distance play key roles in the reaction.

3. The mechanism corresponding to work hardening changes in the limited two distances.
Confronting horror, embracing fantasy: A conversation about Lovecraft Country and radical imagination in higher education
Authors: Harper Jordan , Jenkins Henry
Published: January 2022

Higher education is at a pivotal point of reflection due to the forces of neoliberalism, anti-Blackness, and the ongoing COVID-19 pandemic. In the past, higher education has overlooked the university’s far future, opting to focus on readily conspicuous change. Along with this disregarded conversation, these crises present higher education faculty, administrators, and staff an opportunity to critically re-think the future of higher education given what we know now and what we do not. In this dialogic essay between a higher education policy doctoral student and a tenured media and communications professor, the authors peer into the hit HBO series Lovecraft Country and its underlying themes of horror, fantasy, and historical reality to extract vital lessons for higher education. The authors further participate in conversations about utilizing world and storymaking tactics to help higher education envision the university of the future—a future that is radical and boundless.
Optimization of electromagnetic shielding of three-dimensional orthogonal woven hybrid fabrics in ku band frequency region by response surface methodology
Authors: Singh Mukesh Kumar , Saraswat Gaurav , Mukhopadhyay Samrat , Baskey Himangshu B
Published: January 2022

Electromagnetic shielding (EMS) has become the necessity of the present era due to enormous expansion in electronic devices accountable to emit electromagnetic radiation. The principal target of this paper is to originate three-dimensional (3D) orthogonal fabrics with conductive hybrid weft yarn and to determine their electromagnetic shielding. DREF-III core-spun yarn using copper filament in the core and polyphenylene sulfide (PPS) fiber on the sheath and fabric constructed of such yarn has a promising electromagnetic shielding characteristic. Box–Behnken experimental design has been employed to prepare various samples to investigate the electromagnetic shielding efficiency of 3D orthogonal woven structures. The orthogonal fabric samples were tested in an electromagnetic Ku frequency band using free space measurement system (FSMS) to estimate absorbance, reflectance, transmittance, and electromagnetic shielding. The increase in copper core filament diameter and hybrid yarn linear density enhances the EMS of orthogonal fabric. Statistical analysis has been done to bring out the effect and interaction of various yarn and fabric variables on EMS. Metal filament diameter, orientation, sheath fibers percentage, and fabric constructional parameters significantly affected electromagnetic shielding efficiency. The inferences of this study can be applied in other 3D structures like angle interlock, spacer fabrics for curtains, and coverings for civilians and military applications.
On identification and estimation of Heckman models
Authors: Cook Jonathan , Lee Joon-Suk , Newberger Noah
Published: January 2022

In this article, we present commands to enable fixing the value of the correlation between the unobservables in Heckman models. These commands can solve two practical issues. First, for situations in which a valid exclusion restriction is not available, these commands enable exploring how the results could be affected by sample-selection bias. Second, stepping through values of this correlation can verify whether the global maximum of the likelihood function has been found. We provide several commands to fit these and related models with a fixed value of the correlation between the unobservables.
Low Energy Availability and Relative Energy Deficiency in Sport: What Coaches Should Know
Authors: Charlton Braeden T. , Forsyth Sara , Clarke David C.
Published: January 2022

The Female Athlete Triad (Triad) and the more encompassing Relative Energy Deficiency in Sport (RED-S) are disorders caused by low energy availability (LEA). LEA is a state of insufficient energy intake by an athlete relative to their energy expenditure. Persistent LEA results in the deleterious consequences to health and performance that comprise RED-S. With respect to both the Triad and RED-S, researchers have called for more education of those involved with sport, particularly coaches, to help reduce the incidence of these disorders. Recent studies have shown that as few as 15% of coaches are aware of the Triad, with up to 89% unable to identify even one of its symptoms. RED-S is a more recently established concept such that coach knowledge regarding it has only begun to be assessed, but the results of these initial studies indicate similar trends as for the Triad. In this review, we synthesize research findings from 1986 to 2021 that pertains to LEA and RED-S, which coaches should know so they can better guide their athletes.
Dihydrobenzofurans and Propynylthiophenes From the Roots of Eupatorium heterophyllum
Authors: Hu Yiming , Saito Yoshinori , Gong Xun , Matsuo Yosuke , Tanaka Takashi
Published: January 2022

Seven new dihydrobenzofurans and 2 new propynyl thiophenes were isolated from the roots of Eupatorium heterophyllum together with 13 known compounds. The compounds were characterized using spectroscopic methods including 2D NMR, infrared, and mass spectrometric techniques. Aerial parts of this plant have been known to contain various sesquiterpenoids and displayed high chemical diversity (several compounds isolated and/or identified) among their chemical constituents depending on the collection site. Nevertheless, we found that the chemical diversity in the roots was lower than in the aerial parts.
“I’m Doing the Best I Can”: Teaching General Music in the Time of Covid-19
Authors: Kuebel Christa , Haskett Elizabeth
Published: January 2022

The purpose of this multiple case study was to examine the experiences of four elementary general music teachers (first year, early-career, mid-career, late-career) during the time of COVID-19. We considered impacts on the participants’ instruction and professional lives from data that were collected throughout the 2020–2021 academic year. Participants reported changes to their teaching environments, schedules, and job responsibilities. They shared the technology resources they implemented and highlighted inequities that emerged for virtual versus in-person students. Participants provided insight into the impacts of the year on their personal lives as well. Our implications include considerations for music teachers, music teacher educators, and school administrators as a result of participants’ experiences.
Lymphocyte cytosolic protein 1 (L-plastin) I232F mutation impairs granulocytic proliferation and causes neutropenia
Authors: Mahat Upendra , Garg Bhavuk , Yang Chao-Yie , Mehta Hrishikesh , Hanna Rabi , Rogers Heesun J. , Flagg Aron , Ivanov Andrei I. , Corey Seth J.
Published: January 2022

Neutrophils migrate into inflamed tissue, engage in phagocytosis, and clear pathogens or apoptotic cells. These processes require well-coordinated events involving the actin cytoskeleton. We describe a child with severe neutropenia and episodes of soft tissue infections and pneumonia. Bone marrow examination showed granulocytic hypoplasia with dysplasia. Whole-exome sequencing revealed a de novo heterozygous missense mutation in LCP1, which encodes the F-actin–binding protein Lymphocyte Cytosolic Protein 1. To determine its pathophysiological significance, we stably transduced cells with doxycycline-inducible wild-type LCP1 and LCP1 I232F lentiviral constructs. We observed dysplastic granulocytic 32D cells expressing LCP1 I232F cells. These cells showed decreased proliferation without a block in differentiation. In addition, expression of LCP1 I232F resulted in a cell cycle arrest at the G2/M phase, but it did not lead to increased levels of genes involved in apoptosis or the unfolded protein response. Both 32D and HeLa cells expressing mutant LCP1 displayed impaired cell motility and invasiveness. Flow cytometry showed increased F-actin. However, mutant LCP1-expressing 32D cells exhibited normal oxidative burst upon stimulation. Confocal imaging and subcellular fractionation revealed diffuse intracellular localization of LCP1, but only the mutant form was found in the nucleus. We conclude that LCP1 is a new gene involved in granulopoiesis, and the missense variant LCP1 I232F leads to neutropenia and granulocytic dysplasia with aberrant actin dynamics. Our work supports a model of neutropenia due to aberrant actin regulation.
Characterization of histone deacetylases and their roles in response to abiotic and PAMPs stresses in Sorghum bicolor
Authors: Du Qiaoli , Fang Yuanpeng , Jiang Junmei , Chen Meiqing , Fu Xiaodong , Yang Zaifu , Luo Liting , Wu Qijiao , Yang Qian , Wang Lujie , Qu Zhiguang , Li Xiangyang , Xie Xin
Published: January 2022

Background

Histone deacetylases (HDACs) play an important role in the regulation of gene expression, which is indispensable in plant growth, development, and responses to environmental stresses. In Arabidopsis and rice, the molecular functions of HDACs have been well-described. However, systematic analysis of the HDAC gene family and gene expression in response to biotic and abiotic stresses has not been reported for sorghum.

Results

We conducted a systematic analysis of the sorghum HDAC gene family and identified 19 SbHDACs mainly distributed on eight chromosomes. Phylogenetic tree analysis of SbHDACs showed that the gene family was divided into three subfamilies: RPD3/HDA1, SIR2, and HD2. Tissue-specific expression results showed that SbHDACs displayed different expression patterns in different tissues, indicating that these genes may perform different functions in growth and development. The expression pattern of SbHDACs under different stresses (high and low temperature, drought, osmotic and salt) and pathogen-associated molecular model (PAMPs) elf18, chitin, and flg22) indicated that SbHDAC genes may participate in adversity responses and biological stress defenses. Overexpression of SbHDA1, SbHDA3, SbHDT2 and SbSRT2 in Escherichia coli promoted the growth of recombinant cells under abiotic stress. Interestingly, we also showed that the sorghum acetylation level was enhanced when plants were under cold, heat, drought, osmotic and salt stresses. The findings will help us to understand the HDAC gene family in sorghum, and illuminate the molecular mechanism of the responses to abiotic and biotic stresses.

Conclusion

We have identified and classified 19 HDAC genes in sorghum. Our data provides insights into the evolution of the HDAC gene family and further support the hypothesis that these genes are important for the plant responses to abiotic and biotic stresses.
Distribution of serotypes and antibiotic resistance of invasive Pseudomonas aeruginosa in a multi-country collection
Authors: Nasrin Shamima , Hegerle Nicolas , Sen Shaichi , Nkeze Joseph , Sen Sunil , Permala-Booth Jasnehta , Choi Myeongjin , Sinclair James , Tapia Milagritos D. , Johnson J. Kristie , Sow Samba O. , Thaden Joshua T. , Fowler Vance G. , Krogfelt Karen A. , Brauner Annelie , Protonotariou Efthymia , Christaki Eirini , Shindo Yuichiro , Kwa Andrea L. , Shakoor Sadia , Singh-Moodley Ashika , Perovic Olga , Jacobs Jan , Lunguya Octavie , Simon Raphael , Cross Alan S. , Tennant Sharon M.
Published: January 2022

Background

Pseudomonas aeruginosa is an opportunistic pathogen that causes a wide range of acute and chronic infections and is frequently associated with healthcare-associated infections. Because of its ability to rapidly acquire resistance to antibiotics, P. aeruginosa infections are difficult to treat. Alternative strategies, such as a vaccine, are needed to prevent infections. We collected a total of 413 P. aeruginosa isolates from the blood and cerebrospinal fluid of patients from 10 countries located on 4 continents during 2005–2017 and characterized these isolates to inform vaccine development efforts. We determined the diversity and distribution of O antigen and flagellin types and antibiotic susceptibility of the invasive P. aeruginosa. We used an antibody-based agglutination assay and PCR for O antigen typing and PCR for flagellin typing. We determined antibiotic susceptibility using the Kirby-Bauer disk diffusion method.

Results

Of the 413 isolates, 314 (95%) were typed by an antibody-based agglutination assay or PCR (n = 99). Among the 20 serotypes of P. aeruginosa, the most common serotypes were O1, O2, O3, O4, O5, O6, O8, O9, O10 and O11; a vaccine that targets these 10 serotypes would confer protection against more than 80% of invasive P. aeruginosa infections. The most common flagellin type among 386 isolates was FlaB (41%). Resistance to aztreonam (56%) was most common, followed by levofloxacin (42%). We also found that 22% of strains were non-susceptible to meropenem and piperacillin-tazobactam. Ninety-nine (27%) of our collected isolates were resistant to multiple antibiotics. Isolates with FlaA2 flagellin were more commonly multidrug resistant (p = 0.04).

Conclusions

Vaccines targeting common O antigens and two flagellin antigens, FlaB and FlaA2, would offer an excellent strategy to prevent P. aeruginosa invasive infections.
Transcriptional dynamics of gametogenesis in the green seaweed Ulva mutabilis identifies an RWP-RK transcription factor linked to reproduction
Authors: Liu Xiaojie , Blomme Jonas , Bogaert Kenny A. , D’hondt Sofie , Wichard Thomas , Deforce Dieter , Van Nieuwerburgh Filip , De Clerck Olivier
Published: January 2022

Background

The molecular mechanism underlying sexual reproduction in land plants is well understood in model plants and is a target for crop improvement. However, unlike land plants, the genetic basis involved in triggering reproduction and gamete formation remains elusive in most seaweeds, which are increasingly viewed as an alternative source of functional food and feedstock for energy applications.

Results

Gametogenesis of Ulva mutabilis, a model organism for green seaweeds, was studied. We analyzed transcriptome dynamics at different time points during gametogenesis following induction of reproduction by fragmentation and removal of sporulation inhibitors. Analyses demonstrated that 45% of the genes in the genome were differentially expressed during gametogenesis. We identified several transcription factors that potentially play a key role in the early gametogenesis of Ulva given the function of their homologs in higher plants and microalgae. In particular, the detailed expression pattern of an evolutionarily conserved transcription factor containing an RWP-RK domain suggested a key role during Ulva gametogenesis.

Conclusions

Transcriptomic analyses of gametogenesis in the green seaweed Ulva highlight the importance of a conserved RWP-RK transcription factor in the induction of sexual reproduction. The identification of putative master regulators of gametogenesis provides a starting point for further functional characterization.
The SAFEST review: a mixed methods systematic review of shock-absorbing flooring for fall-related injury prevention
Authors: Drahota Amy , Felix Lambert M. , Raftery James , Keenan Bethany E. , Lachance Chantelle C. , Mackey Dawn C. , Markham Chris , Laing Andrew C.
Published: January 2022

Background

Shock-absorbing flooring may minimise impact forces incurred from falls to reduce fall-related injuries; however, synthesized evidence is required to inform decision-making in hospitals and care homes.

Methods

This is a Health Technology Assessment mixed methods systematic review of flooring interventions targeting older adults and staff in care settings. Our search incorporated the findings from a previous scoping review, MEDLINE, AgeLine, and Scopus (to September 2019) and other sources. Two independent reviewers selected, assessed, and extracted data from studies. We assessed risk of bias using Cochrane and Joanna Briggs Institute tools, undertook meta-analyses, and meta-aggregation.

Results

20 of 22 included studies assessed our outcomes (3 Randomised Controlled Trials (RCTs); 7 observational; 5 qualitative; 5 economic), on novel floors (N = 12), sports floors (N = 5), carpet (N = 5), and wooden sub-floors (N = 1). Quantitative data related to 11,857 patient falls (9 studies), and 163 staff injuries (1 study). One care home-based RCT found a novel underlay produced similar injurious falls rates (high-quality evidence) and falls rates (moderate-quality evidence) to a plywood underlay with vinyl overlay and concrete sub-floors. Very low-quality evidence suggested that shock-absorbing flooring may reduce injuries in hospitals (Rate Ratio 0.55, 95% CI 0.36 to 0.84, 2 studies; 27.1% vs. 42.4%; Risk Ratio (RR) = 0.64, 95% CI 0.44 to 0.93, 2 studies) and care homes (26.4% vs. 33.0%; RR 0.80, 95% CI 0.70 to 0.91, 3 studies), without increasing falls. Economic evidence indicated that if injuries are fewer and falls not increased, then shock-absorbing flooring would be a dominant strategy. Fracture outcomes were imprecise; however, hip fractures reduced from 30 in 1000 falls on concrete to 18 in 1000 falls on wooden sub-floors (OR 0.59, 95% CI 0.45 to 0.78; one study; very low-quality evidence). Staff found moving wheeled equipment harder on shock-absorbing floors leading to workplace adaptations. Very low-quality evidence suggests staff injuries were no less frequent on rigid floors.

Conclusion

Evidence favouring shock-absorbing flooring is uncertain and of very low quality. Robust research following a core outcome set is required, with attention to wider staff workplace implications.

Trial registration

PROSPERO CRD42019118834.
To see, meet and adapt – an interview study about physiotherapists’ pedagogical approach to dementia
Authors: Nordell Karin , Hellström Karin , Fjellman-Wiklund Anncristine
Published: January 2022

Background

Physiotherapists need to use pedagogical approaches and strategies in their work. However, there is no previous definition of what a pedagogical approach in physiotherapy means neither in general nor specifically to dementia. The purpose of this study was therefore to gain greater insight into physiotherapists’ pedagogical approach to dementia by investigating physiotherapists’ views and working methods in contact with older people with dementia, relatives, and nursing staff in elderly care.

Methods

This was a qualitative study with an inductive approach. Semi-structured individual interviews were conducted with 15 physiotherapists with experience of working with older people with dementia in elderly care. The interviews were analyzed with qualitative content analysis.

Results

The term “pedagogical approach” could sometimes be experienced as “vague” or “hard to grasp”. Our research nonetheless identified one overarching theme To see, meet and adapt which is based on insights from the interviews grouped in to five categories. This theme can be seen as an expression of the physiotherapists’ pedagogical approach in contact with older people with dementia, relatives, and nursing staff. It captures the participants’ desire to always see the person in front of them, meet them where they are and adapt their own way of working accordingly. Creating a trusting relationship was described as important and made it easier for the participants to adapt their working methods. The participants’ adaptations could apply to the way they communicated with people with dementia, and how they organized tutoring/education of relatives and nursing staff to maximize learning. Learning through experience and reflection was described as a key to advancing the pedagogical approach and the participants experienced their own learning as constantly ongoing.

Conclusions

This study provides increased understanding into physiotherapists’ pedagogical approach in contact with older people with dementia, relatives, and nursing staff in elderly care and shows that learning through experience and reflection can contribute to the development of the pedagogical approach. Thus, opportunity for reflection should be accommodated in the physiotherapists’ work. The importance of more pedagogical education for physiotherapists both in bachelor and master level were also highlighted. Increasing mobility and physical activity in older people with dementia is important since physical inactivity and sedentary behavior is common. Future research may be directed at further exploring physiotherapists’ pedagogical approach in tutoring/education of nursing staff, with the aim of increasing physical activity among older people with dementia.
OncoSNIPE® Study Protocol, a study of molecular profiles associated with development of resistance in solid cancer patients
Authors: Vachenc Sébastien , Gobbo Jessica , Moujarrebe Sarah El , Desmoulins Isabelle , Gilabert Marine , Beau-Faller Michelle , Mitry Emmanuel , Girard Nicolas , Bertaut Aurélie , Dusetti Nelson , Iovanna Juan L. , Yousfi Rahima , Pierrat Fabien , Bruno Roman , Cueff Adèle , Boidot Romain , Genne Philippe
Published: January 2022

Background

Nowadays, evaluation of the efficacy and the duration of treatment, in context of monitoring patients with solid tumors, is based on the RECIST methodology. With these criteria, resistance and/or insensitivity are defined as tumor non-response which does not allow a good understanding of the diversity of the underlying mechanisms. The main objective of the OncoSNIPE® collaborative clinical research program is to identify early and late markers of resistance to treatment.

Methods

Multicentric, interventional study with the primary objective to identify early and / or late markers of resistance to treatment, in 600 adult patients with locally advanced or metastatic triple negative or Luminal B breast cancer, non-small-cell lung cancer or pancreatic ductal adenocarcinoma. Patients targeted in this study have all rapid progression of their pathology, making it possible to obtain models for evaluating markers of early and / or late responses over the 2-year period of follow-up, and thus provide the information necessary to understand resistance mechanisms. To explore the phenomena of resistance, during therapeutic response and / or progression of the pathology, we will use a multidisciplinary approach including high-throughput sequencing (Exome-seq and RNAseq), clinical data, medical images and immunological profile by ELISA. Patients will have long-term follow-up with different biological samples, at baseline (blood and biopsy) and at each tumoral evaluation or tumoral progression evaluated by medical imaging. Clinical data will be collected through a dedicated Case Report Form (CRF) and enriched by semantic extraction based on the French ConSoRe (Continuum Soins Recherche) initiative, a dedicated Semantic Clinical Data Warehouse (SCDW) to cancer.

The study is sponsored by Oncodesign (Dijon, France) and is currently ongoing.

Discussion

The great diversity of intrinsic or acquired molecular mechanisms involved in resistance to treatment constitutes a real therapeutic issue. Improving understanding of mechanisms of resistance of cancer cells to anti-tumor treatments is therefore a major challenge. The OncoSNIPE cohort will lead to a better understanding of the mechanisms of resistance and will allow to explore new mechanisms of actions and to discover new therapeutic targets or strategies making it possible to circumvent the escape in different types of cancer.

Trial registration

Clinicaltrial.gov. Registered 16 September 2020, https://clinicaltrials.gov/ct2/show/NCT04548960?term=oncosnipe&draw=2&rank=1 and ANSM ID RCB 2017-A02018-45.
Development of gut microbiota along with its metabolites of preschool children
Authors: Xiong Jingjing , Hu Hongwei , Xu Chuanzhi , Yin Jianwen , Liu Mei , Zhang Lizhi , Duan Yong , Huang Yongkun
Published: January 2022

Background

To reveal the changes of intestinal microbial abundance and composition, as well as the microbiota metabolic levels of bile acids and short chain fatty acids of healthy preschool children during their growth.

Methods

Feces of 120 healthy newborns and 150 healthy children aged 6 months to 6 years were collected. Then the composition of intestinal flora was analyzed by 16S rRNA, and the contents of bile acids and short chain fatty acids in feces were detected by LC-MS and GS methods, respectively.

Results

The composition and function of intestinal microflora were not stable in neonatal period but significantly improved at 6 months after birth, and gradually stabilized and tended to adult-like formation after 2–3 years old. The levels of short chain fatty acids and secondary bile acids were consistent with the development of gut microbiota.

Conclusion

The age of 6 months may be a critical period for the development of intestinal microflora in children.
Sex education and self-poisoning in Sri Lanka: an explorative analysis
Authors: Crowley Grace , Bandara Piumee , Senarathna Lalith , Malalagama Ayodhya , Gunasekera Sonali , Rajapakse Thilini , Knipe Duleeka
Published: January 2022

Background

Self-harm and suicide are important causes of morbidity and mortality in Sri Lanka, but our understanding of these behaviours is limited. Qualitative studies have implicated familial and societal expectations around sex and relationships. We conducted an explorative analysis using case-control data to investigate the association between sex education and self-poisoning in Sri Lanka.

Methods

Cases (N=298) were self-poisoning inpatients on a toxicology ward, Teaching Hospital Peradeniya. Controls (N=500) were sex and age frequency matched to cases and were outpatients/visitors to the same hospital. Participants were asked whether they had received sex education, and to rate the quality and usefulness of any sex education received. Logistic regression models adjusted for age, sex, and religion quantified the association between receipt, quality and usefulness of sex education and self-poisoning. We tested whether the associations differed by sex.

Results

Roughly 1-in-3 cases and 1-in-5 controls reported having not received sex education. Individuals who did not receive sex education were nearly twice as likely to have self-poisoned than those who did (OR 1.68 (95% CI 1.11-2.55)). Those who reported the sex education they received as not useful were more likely to have self-poisoned compared to those who reported it useful (OR 1.95 (95% CI 1.04-3.65)). We found no evidence of an association between self-poisoning and the self-rated quality of sex education, or that associations differed by participant sex.

Conclusion

As sex education is potentially modifiable at the population-level, further research should aim to explore this association in more depth, using qualitative methods and validated measurement tools.
The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review
Authors: Henni Silje Havrevold , Maurud Sigurd , Fuglerud Kristin Skeide , Moen Anne
Published: January 2022

Objective

Globally, the number of digital health solutions is increasing, but they are not always designed with access and utilisation for people with impairments in mind. Development efforts have often not included the voice and requirements of people with impairments, who make up 15% of the world’s population, despite the fact that this can help ensure broad access and utilisation. Little attention to and limited inclusion of people with impairments in the development of digital health solutions results in continued and reinforced inequalities in health services provision for people with impairments. This review investigates the needs and barriers of people with impairments related to use of digital health solutions and strategies to foster user participation, access and utilisation of digital health solutions.

Methods

This scoping review, based on the Joanna Briggs Institute Manual, had five phases: 1) identification of aim and research questions, 2) literature search in five databases (April/May 2020), 3) literature screening based on predetermined inclusion and exclusion criteria, 4) data extraction, and (5) reporting results.

Results

The literature search resulted in 5968 sources, of which 25 met our inclusion criteria. People with impairments appreciate digital health solutions that are designed to meet their specific impairment-related challenges. The reported needs and barriers related to technological design varied depending on the individuals’ challenges. The literature reported different types of participatory co-design strategies to foster access and utilisation of digital health solutions.

Conclusion

This scoping review support needs for increased awareness among developers to design solutions that meet people’s needs, contexts and states of health. By applying universal design as a strategy and including people with different types of impairments, starting in the idea creation phase of digital health solutions and throughout the development, developers can design solutions with better accessibility. Digital health solutions that are accessible and usable have a tremendous opportunity to foster health equity and achieve health promotion, prevention and self-care. This in turn can contribute to closing the gap between different population groups, reduce disparities and get the most from available healthcare services.
Military service experiences and reasons for service separation among lesbian, gay, and bisexual individuals in a large military cohort
Authors: Carey Felicia R. , Jacobson Isabel G. , Lehavot Keren , LeardMann Cynthia A. , Kolaja Claire A. , Stander Valerie A. , Rull Rudolph P.
Published: January 2022

Background

The well-being of lesbian, gay, and bisexual (LGB) individuals is a topic of increasing concern within the military where significant institutional barriers, targeted aggression, and differential organizational policies such as “Don’t Ask Don’t Tell” have historically contributed to experiences of exclusion and discrimination. However, limited research has examined specific military and post-separation experiences among LGB service members and veterans. The goal of this study was to examine differences in military and service separation experiences by sexual orientation among a large representative sample of United States service members and veterans.

Methods

Survey data from the 2016 Millennium Cohort Study follow-up questionnaire were used to assess sexual orientation and multiple outcomes of interest: military experiences (morale, feelings about the military, missed workdays) and service separation experiences (reasons for separation, post-separation employment). The associations between sexual orientation (LGB versus heterosexual) and each of these outcomes were evaluated in a series of adjusted logistic regression models, stratified by sex when interactions were observed.

Results

Of the 99,599 participants, 3.4% identified as LGB. In adjusted models, LGB service members had significantly higher odds than heterosexual service members of feeling: unimpressed by the quality of unit leadership, unsupported by the military, and negative about the military overall. Bisexual women were more likely than heterosexual women to feel less unit camaraderie; both gay and bisexual men felt less camaraderie than heterosexual men. LGB veterans were more likely than heterosexual peers of the same sex to separate from service due to unplanned administrative reasons. Compared to heterosexual women, lesbian and bisexual women were more likely to separate from service due to dissatisfaction with promotions/pay and disability/medical reasons, while bisexual women specifically separated due to dissatisfaction with leadership and incompatibility with the military. Gay and bisexual men also reported separating due to incompatibility with the military, but only bisexual men were more likely to report separating due to disability/medical reasons compared to heterosexual men.

Conclusions

Less positive military- and separation-specific experiences disproportionately affected LGB service members in this study. Promoting inclusion and increasing support for LGB service members may improve satisfaction with military service and retention.
Association of neighborhood greenness with severity of hand, foot, and mouth disease
Authors: Du Zhicheng , Yang Boyi , Jalaludin Bin , Knibbs Luke , Yu Shicheng , Dong Guanghui , Hao Yuantao
Published: January 2022

Background

Hand, foot, and mouth disease (HFMD) is an epidemic infectious disease in China. Relationship of neighborhood greenness with human health has been widely studied, yet its association with severe HFMD has not yet been established.

Methods

Individual HFMD cases that occurred in Guangdong province in 2010 were recruited and were categorised into mild and severe cases. Residential greenness was assessed using global land cover data. We used a case-control design (i.e., severe versus mild cases) with logistic regression models to assess the association between neighborhood greenness and HFMD severity. Effect modification was also examined.

Results

A total of 131,606 cases were included, of whom 130,840 were mild cases and 766 were severe cases. In an unadjusted model, HFMD severity increased with higher proportion of neighborhood greenness (odds ratio, OR = 1.029, 95%CI: 1.009–1.050). The greenness-HFMD severity association remained (OR = 1.031, 95%CI: 1.006–1.057) after adjusting for population density, demographic variables and climate variables. Both population density (Z = 4.148, P < 0.001) and relative humidity (Z = -4.297, P < 0.001) modified the association between neighborhood greenness and HFMD severity. In the stratified analyses, a protective effect (OR = 0.769, 95%CI: 0.687–0.860) of greenness on HFMD severity were found in the subgroup of population density being lower than and equal to 5 ln(no.)/km2. While in both the subgroups of population density being higher than 5, the greenness had hazard effects (subgroup of > 5 & ≤7: OR = 1.071, 95%CI: 1.024–1.120; subgroup of > 7: OR = 1.065, 95%CI: 1.034–1.097) on HFMD severity. As to relative humidity, statistically significant association between greenness and HFMD severity was only observed in the subgroup of being lower than and equal to 76% (OR = 1.059, 95%CI: 1.023–1.096).

Conclusions

Our study found that HFMD severity is associated with the neighborhood greenness in Guangdong, China. This study provides evidence on developing a prevention strategy of discouraging the high-risk groups from going to the crowded green spaces during the epidemic period.
c-Fos is a mechanosensor that regulates inflammatory responses and lung barrier dysfunction during ventilator-induced acute lung injury
Authors: Zhou Leilei , Xue Chunju , Chen Zongyu , Jiang Wenqing , He Shuang , Zhang Xianming
Published: January 2022

Background

As one of the basic treatments performed in the intensive care unit, mechanical ventilation can cause ventilator-induced acute lung injury (VILI). The typical features of VILI are an uncontrolled inflammatory response and impaired lung barrier function; however, its pathogenesis is not fully understood, and c-Fos protein is activated under mechanical stress. c-Fos/activating protein-1 (AP-1) plays a role by binding to AP-1 within the promoter region, which promotes inflammation and apoptosis. T-5224 is a specific inhibitor of c-Fos/AP-1, that controls the gene expression of many proinflammatory cytokines. This study investigated whether T-5224 attenuates VILI in rats by inhibiting inflammation and apoptosis.

Methods

The SD rats were divided into six groups: a control group, low tidal volume group, high tidal volume group, DMSO group, T-5224 group (low concentration), and T-5224 group (high concentration). After 3 h, the pathological damage, c-Fos protein expression, inflammatory reaction and apoptosis degree of lung tissue in each group were detected.

Results

c-Fos protein expression was increased within the lung tissue of VILI rats, and the pathological damage degree, inflammatory reaction and apoptosis in the lung tissue of VILI rats were significantly increased; T-5224 inhibited c-Fos protein expression in lung tissues, and T-5224 inhibit the inflammatory reaction and apoptosis of lung tissue by regulating the Fas/Fasl pathway.

Conclusions

c-Fos is a regulatory factor during ventilator-induced acute lung injury, and the inhibition of its expression has a protective effect. Which is associated with the antiinflammatory and antiapoptotic effects of T-5224.
Multivariate analysis of pedicle screw invasion of the proximal facet joint after lumbar surgery
Authors: Wang Peng Tao , Zhang Jia Nan , Liu Tuan Jiang , Yang Jun Song , Hao Ding Jun
Published: January 2022

Background

To analyze the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery.

Methods

From January 2019 to January 2021, 1794 patients with lumbar degenerative disease, such as lumbar disc herniation, lumbar spinal stenosis and lumbar spondylolisthesis, were treated at our hospital. In all, 1221 cases were included. General data (sex, age, BMI), bone mineral density, proximal facet joint angle, degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment in the two groups were recorded. After the operation, vertebral CT of the corresponding surgical segments was performed for three-dimensional reconstruction and evaluation of whether the vertebral arch root screw interfered with the proximal facet joint. The included cases were divided into an invasion group and a noninvasion group. Univariate analysis was used to screen the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery, and the selected risk factors were included in the logistic model for multivariate analysis.

Results

The single-factor analysis showed a significant difference in age, BMI, proximal facet joint angle, degenerative lumbar spondylolisthesis, and fixed segment (P < 0.1). Multifactor analysis of the logistic model showed a significant difference for age ≥ 50 years (P < 0.001, OR = 2.291), BMI > 28 kg/m2 (P < 0.001, OR = 2.548), degenerative lumbar spondylolisthesis (P < 0.001, OR = 2.187), gorge cleft lumbar relaxation (P < 0.001, OR = 2.410), proximal facet joint angle (35 ~ 45°:P < 0.001, OR = 3.151; > 45°:P < 0.001, OR = 3.578), and fixed segment (lower lumbar spine:P < 0.001, OR = 2.912).

Conclusion

Age (≥ 50 years old), BMI (> 28 kg/m2), proximal facet joint angle (35 ~ 45°, > 45°), degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment (lower lumbar spine) are independent risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. Compared with degenerative lumbar spondylolisthesis, facet joint intrusion is more likely in isthmic lumbar spondylolisthesis.
Bayesian updating and sequential testing: overcoming inferential limitations of screening tests
Authors: Balayla Jacques
Published: January 2022

Background

Bayes’ theorem confers inherent limitations on the accuracy of screening tests as a function of disease prevalence. Herein, we establish a mathematical model to determine whether sequential testing with a single test overcomes the aforementioned Bayesian limitations and thus improves the reliability of screening tests.

Methods

We use Bayes’ theorem to derive the positive predictive value equation, and apply the Bayesian updating method to obtain the equation for the positive predictive value (PPV) following repeated testing. We likewise derive the equation which determines the number of iterations of a positive test needed to obtain a desired positive predictive value, represented graphically by the tablecloth function.

Results

For a given PPV ($$\rho$$
ρ
) approaching k, the number of positive test iterations needed given a prevalence of disease ($$\phi$$
ϕ
) is:

$$n_i =\lim _{\rho \rightarrow k}\left\lceil \frac{ln\left[ \frac{\rho (\phi -1)}{\phi (\rho -1)}\right] }{ln\left[ \frac{a}{1-b}\right] }\right\rceil \qquad \qquad (1)$$

n
i

=

lim

ρ
→
k

l
n

ρ
(
ϕ
-
1
)

ϕ
(
ρ
-
1
)

l
n

a

1
-
b

(
1
)

where $$n_i$$

n
i

= number of testing iterations necessary to achieve $$\rho$$
ρ
, the desired positive predictive value, ln = the natural logarithm, a = sensitivity, b = specificity, $$\phi$$
ϕ
= disease prevalence/pre-test probability and k = constant.

Conclusions

Based on the aforementioned derivation, we provide reference tables for the number of test iterations needed to obtain a $$\rho (\phi )$$

ρ
(
ϕ
)

of 50, 75, 95 and 99% as a function of various levels of sensitivity, specificity and disease prevalence/pre-test probability. Clinical validation of these concepts needs to be obtained prior to its widespread application.
Mental health status of COVID-19 survivors: a cross sectional study
Authors: Jafri Munam Raza , Zaheer Anna , Fatima Sahar , Saleem Taiba , Sohail Atif
Published: January 2022

Background

Coronavirus disease-19 (COVID-19) is a communicable disease caused by a virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Pandemics are associated with the high level of mental stress. In many countries, general people reported the high level of depression, anxiety, psychological distress, post-traumatic stress disorder during recent a pandemic. This study aims to investigate the mental health status of people who survived through this alarming situation of COVID-19.

Methods

In this study, seventy individuals (either gender) between the age of 18–60 years, who contracted COVID-19 previously and then recovered as indicated by negative PCR results, were included. Data was collected by using three tools: impact of event scale (IES-R), patient health questionnaire-9(PHQ-9) and corona anxiety scale (CAS). People with other systemic/mental disorders, ongoing malignancies, upper/lower motor disorders and inability to give consent were excluded from the study.

Results

Mean age of participants was 26.29 + 11.79. All the 70 responders suffered from COVID-19. Among these 23 (32.9%) were asymptomatic and 47(67.1%) had common symptoms related to COVID-19 53 (75.7%) responders also had symptoms post-recovery. Most of the people who suffered COVID-19 had mild depression. Twenty-nine participants (41.4%) reported the highest impact of this traumatic event on their mental health. After suffering from COVID-19, 74.3% reported no anxiety as measured through corona anxiety scale (CAS).

Conclusion

High level of post-traumatic stress was seen among participants who recovered from COVID-19, especially those patients who were symptomatic. Mild depression and anxiety were also noted among them.
Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment
Authors: Crable Erika L. , Benintendi Allyn , Jones David K. , Walley Alexander Y. , Hicks Jacqueline Milton , Drainoni Mari-Lynn
Published: January 2022

Background

Despite the important upstream impact policy has on population health outcomes, few studies in implementation science in health have examined implementation processes and strategies used to translate state and federal policies into accessible services in the community. This study examines the policy implementation strategies and experiences of Medicaid programs in three US states that responded to a federal prompt to improve access to evidence-based practice (EBP) substance use disorder (SUD) treatment.

Methods

Three US state Medicaid programs implementing American Society of Addiction Medicine (ASAM) Criteria-driven SUD services under Section 1115 waiver authority were used as cases. We conducted 44 semi-structured interviews with Medicaid staff, providers and health systems partners in California, Virginia, and West Virginia. Interviews were triangulated with document review of state readiness and implementation plans. The Exploration, Preparation, Implementation, Sustainment Framework (EPIS) guided qualitative theme analysis. The Expert Recommendations for Implementing Change and Specify It criteria were used to create a taxonomy of policy implementation strategies used by policymakers to promote providers’ uptake of statewide EBP SUD care continuums.

Results

Four themes describe states’ experiences and outcomes implementing a complex EBP SUD treatment policy directive: (1) Medicaid agencies adapted their inner/outer contexts to align with EBPs and adapted EBPs to fit their local context; (2) enhanced financial reimbursement arrangements were inadequate bridging factors to achieve statewide adoption of new SUD services; (3) despite trainings, service providers and managed care organizations demonstrated poor fidelity to the ASAM Criteria; and (4) successful policy adoption at the state level did not guarantee service providers’ uptake of EBPs. States used 29 implementation strategies to implement EBP SUD care continuums. Implementation strategies were used in the Exploration (n=6), Preparation (n=10), Implementation (n=19), and Sustainment (n=6) phases, and primarily focused on developing stakeholder interrelationships, evaluative and iterative approaches, and financing.

Conclusions

This study enhances our understanding of statewide policy implementation outcomes in low-resource, public healthcare settings. Themes highlight the need for additional pre-implementation and sustainment focused implementation strategies. The taxonomy of detailed policy implementation strategies employed by policymakers across states should be tested in future policy implementation research.