bluuebunny/crossref_metadata_2025 huggingface dataset:
An improved traffic lights recognition algorithm for autonomous driving in complex scenarios
Authors: Li Ziyue , Zeng Qinghua , Liu Yuchao , Liu Jianye , Li Lin
Published: May 2021

Image recognition is susceptible to interference from the external environment. It is challenging to accurately and reliably recognize traffic lights in all-time and all-weather conditions. This article proposed an improved vision-based traffic lights recognition algorithm for autonomous driving, integrating deep learning and multi-sensor data fusion assist (MSDA). We introduce a method to obtain the best size of the region of interest (ROI) dynamically, including four aspects. First, based on multi-sensor data (RTK BDS/GPS, IMU, camera, and LiDAR) acquired in a normal environment, we generated a prior map that contained sufficient traffic lights information. And then, by analyzing the relationship between the error of the sensors and the optimal size of ROI, the adaptively dynamic adjustment (ADA) model was built. Furthermore, according to the multi-sensor data fusion positioning and ADA model, the optimal ROI can be obtained to predict the location of traffic lights. Finally, YOLOv4 is employed to extract and identify the image features. We evaluated our algorithm using a public data set and actual city road test at night. The experimental results demonstrate that the proposed algorithm has a relatively high accuracy rate in complex scenarios and can promote the engineering application of autonomous driving technology.
Online citizenship learning of Chinese young adults
Authors: Fu Jun
Published: May 2021

This paper explores the citizenship learning of Chinese young adults through examining their participation on Weibo (the biggest micro-blogging service in China). Interview data collected from 31 young mainland Chinese adults contained their reflections on their everyday online participation on Weibo. Using the theory of communities of practice, this paper describes the citizenship learning that occurred in the context of their online participation in two intersecting dimensions. One dimension is their learning of digital citizenship in the Weibo community, manifested in their understanding and grasp of language, values, attitudes and shared commitment in this virtual space. The other is their learning of Chinese citizenship which is embodied in their understanding of Chinese society arising from their reflections of their internet-mediated social participation. This paper brings new insights into the concept of citizenship exhibited in the everyday online participation of Chinese young people, and the mutually constitutive relationship between their learning of citizenship and the forging of new citizenship. The implications of this informal learning for the content and pedagogy of formal citizenship education is discussed.
Task-order representations in dual tasks: Separate or integrated with component task sets?
Authors: Huestegge Lynn , Hoffmann Mareike A , Strobach Tilo
Published: May 2021

In situations requiring the execution of two tasks at around the same time, we need to decide which of the tasks should be executed first. Previous research has revealed several factors that affect the outcome of such response order control processes, including bottom-up factors (e.g., the temporal order of the stimuli associated with the two tasks) and top-down factors (e.g., instructions). In addition, it has been shown that tasks associated with certain response modalities are preferably executed first (e.g., temporal prioritisation of tasks involving oculomotor responses). In this study, we focused on a situation in which task order has to be unpredictably switched from trial to trial and asked whether task-order representations are coded separately or integrated with the component task sets (i.e., in a task-specific manner). Across three experiments, we combined two tasks known to differ in prioritisation, namely an oculomotor and a manual (or pedal) task. The results indicated robust task-order switch costs (i.e., longer RTs when task order was switched vs. repeated). Importantly, the data demonstrate that it is possible to show an asymmetry of task-order switch costs: While these costs were of similar size for both task orders in one particular experimental setting with specific spatial task characteristics, two experiments consistently indicated that it was easier for participants to switch to their prioritised task order (i.e., to execute the dominant oculomotor task first). This suggests that in a situation requiring frequent task-order switches (indicated by unpredictable changes in stimulus order), task order is represented in an integrated, task-specific manner, bound to characteristics (here, associated effector systems) of the component tasks.
Advertising and Media Capture in Turkey: How Does the State Emerge as the Largest Advertiser with the Rise of Competitive Authoritarianism?
Authors: Yanatma Servet
Published: May 2021

This article examines the distribution of advertising in newspapers in Turkey and the impact of the government on the allocation, in particular, of official announcements and of advertising by partially state-owned enterprises and private companies loyal to the ruling party, as well as pressure on other commercial advertisers, during the rule of the Justice and Development Party between 2002 and 2020. It demonstrates that the government has, in the last decade, largely used the advertising sector as a “carrot and stick” tactic to control newspapers through the distribution of official announcements and advertising by state-owned enterprises. It further finds that the state has emerged in recent years as the largest advertiser financing the “captured media,” control of media ownership has proved to be not enough to ensure docile news media. Turkey has shifted to competitive authoritarianism in recent years, and this article demonstrates the selective allocation of advertising, which is a strong component of suppressing the independent media. The article uncovers the impact of government on advertising, using two data sets to show: (i) the total spend on official announcements received by each newspaper and (ii) how much advertising space in square centimeters state-owned enterprises have placed in each newspaper. Interviews with editors-in-chief of newspapers also expose the direct role of government in the distribution of advertising.
Socially Distant? Social Network Confidants, Loneliness, and Health during the COVID-19 Pandemic
Authors: Bierman Alex , Upenieks Laura , Schieman Scott
Published: May 2021

In the wake of the COVID-19 pandemic, many nations around the world instituted strict social distancing measures. Although necessary to deter the spread of the virus, these measures may also have had adverse health repercussions by increasing social isolation. Using a national longitudinal study from Canada, in which respondents were surveyed in March 2020 at the beginning of stay-at-home orders and again two months later in May, we show that, at baseline, loneliness was inversely associated with perceptions of self-rated health, and there was a beneficial indirect association between respondents’ number of social network confidants and perceived health through lower levels of loneliness. Between March and May, social network confidants decreased and loneliness increased; these changes were independent of each other and contributed to declines in self-rated health. Greater loneliness at baseline was also associated with declines in self-rated health. Our observations suggest that social distancing during the COVID-19 pandemic impaired social connectedness, thereby resulting in declines in perceptions of health. We conclude by discussing several policy-related implications of our findings.
Synchronized Automatic Gain Control in Bilateral Cochlear Implant Recipients Yields Significant Benefit in Static and Dynamic Listening Conditions
Authors: Dwyer Robert T. , Chen Chen , Hehrmann Phillipp , Dwyer Nichole C. , Gifford René H.
Published: May 2021

Individuals with bilateral cochlear implants (BiCIs) rely mostly on interaural level difference (ILD) cues to localize stationary sounds in the horizontal plane. Independent automatic gain control (AGC) in each device can distort this cue, resulting in poorer localization of stationary sound sources. However, little is known about how BiCI listeners perceive sound in motion. In this study, 12 BiCI listeners’ spatial hearing abilities were assessed for both static and dynamic listening conditions when the sound processors were synchronized by applying the same compression gain to both devices as a means to better preserve the original ILD cues. Stimuli consisted of band-pass filtered (100–8000 Hz) Gaussian noise presented at various locations or panned over an array of loudspeakers. In the static listening condition, the distance between two sequentially presented stimuli was adaptively varied to arrive at the minimum audible angle, the smallest spatial separation at which the listener can correctly determine whether the second sound was to the left or right of the first. In the dynamic listening condition, participants identified if a single stimulus moved to the left or to the right. Velocity was held constant and the distance the stimulus traveled was adjusted using an adaptive procedure to determine the minimum audible movement angle. Median minimum audible angle decreased from 17.1° to 15.3° with the AGC synchronized. Median minimum audible movement angle decreased from 100° to 25.5°. These findings were statistically significant and support the hypothesis that synchronizing the AGC better preserves ILD cues and results in improved spatial hearing abilities. However, restoration of the ILD cue alone was not enough to bridge the large performance gap between BiCI listeners and normal-hearing listeners on these static and dynamic spatial hearing measures.
Attitude Towards Documentation and Its Associated Factors Among Nurses Working in Public Hospitals of Hawassa City Administration, Southern Ethiopia
Authors: Ayele Sisay , Gobena Tesfaye , Birhanu Simon , Yadeta Tesfaye Assebe
Published: May 2021

Background

Nursing documentation is the record of nursing care that has been planned and delivered to individual clients by qualified nurses or under the direction of qualified nurses. Various studies have shown that documentation is still a critical issue in both high- and low-income countries, especially in Sub-Saharan Africa like Ethiopia. However, there is a paucity of data in Ethiopia, the attitude of nurses towards nursing care documentation, particularly in the study setting. Therefore, this study aimed to assess the nurse's attitude towards documentation and associated factors in Hawassa City administration public hospitals, Southern Ethiopia.

Methods

Institutional based cross-sectional study was conducted among 422 nurses from March 01 to 30, 2020. A simple random sampling technique was applied to select the study participants. Data were collected using a self-administered questionnaire. Statistical package of social science (SPSS) version 20.0 software was used for analysis. The association between the attitude of nurses towards documentation and predictors was determined using multivariable logistic regression analysis. The level of statistical significance was determined at a p-value of less than 0.05.

Result

Among 413 nurses who participated in the study, 58.8% [95% CI of 54.5% to 63.7%] of them had a favorable attitude towards documentation. Work setting [AOR = 1.94 (95% CI: 1.23–3.05)] and Knowledge [AOR = 3.28 (95% CI: 2.08–5.16)], were significantly associated factors with nurses’ attitude towards documentation. Conclusion and Recommendations: More than half of the study participants had a favorable attitude towards documentation. Working unit and knowledge were factors associated with nurse's attitude toward nursing care documentation. Therefore, increasing nurse's knowledge about documentation and managing working units effectively are recommended to increase the nurses’ attitude toward documentation.
A Better Learning Community: Mixed-Methods Reveal Medical Student Preferences with Implications for Learning Community Design and Implementation
Authors: Vuk Jasna , McKee Steven , Tariq Sara , Mendiratta Priya
Published: May 2021

Background:

Medical school learning communities benefit students. The College of Medicine (COM) at the University of Arkansas for Medical Sciences (UAMS) provides medical students with academic, professional, and personal support through a learning community (LC) made of 7 academic houses.

Objectives:

To evaluate the effectiveness of the academic house model at UAMS utilizing a mixed-methods survey. The aims were to: (1) assess student experience and satisfaction with academic houses, (2) describe the realms of advising and guidance, and (3) identify areas for improvement.

Method:

An online survey was assigned to 723 COM students (all students enrolled, first through fourth years) at UAMS in March 2019. The survey was comprised of 25 items (10 multiple-choice, 8 on the Likert scale, and 7 open-ended questions). Data was depicted using frequency and percentages and/or thematic review of free-form responses.

Results:

The survey response rate was 31% (227 students). The majority of students responding (132, 58.1%) attended 2 or more face-to-face meetings with the faculty advisor within the preceding year. However, 27 (11.9%) students did not have any meetings. Approximately two-thirds of the respondents were satisfied or very satisfied with the guidance and direction provided by their advisors [very satisfied (n = 83; 36.6%); satisfied (n = 77; 33.9%)]. Themes that emerged from student generated areas for improvement include time constraints, advisor/advisee interest mismatch, and perceived inadequacy of advising content/connections.

Conclusions:

This study confirms the effectiveness of the LC model for advising and mentoring in the COM at UAMS. Uniquely, this study identifies not only learners’ satisfaction with their LC but also highlights areas for improvement which are widely generalizable and important to consider for institutions with or planning to start an LC.
Organizing Value-based Product Innovation: How Medical Equipment Manufacturers Embrace Complexity in Hybrid Operating Rooms
Authors: Mendes Miguel , Rademakers Martijn F.
Published: May 2021

This article shares research findings from the healthcare equipment manufacturing industry on how product management teams can enhance their value-based innovation processes. Value-based healthcare (VBHC) has transformed healthcare systems worldwide by shifting their focus towards patient-centred value creation. The VBHC concept has also inspired medical equipment manufacturers that seek to enable healthcare providers to realize their VBHC ambitions. In this article, we focus on the development of hybrid solutions for operating rooms in the context of VBHC. Hybrid operating rooms (HORs) add real-time medical imaging to surgical and interventional treatment of patients. This combination is quite challenging to realize, not just in terms of technology but also organizationally. Adjusting technology to the requirements of multiple clinical stakeholders drives complexity to unprecedented heights. How can product strategists manage this multi-stakeholder complexity? Through in-depth case research, we found that adopting a clear VBHC vision is key for product management teams designing HOR innovations. A VBHC vision allows multiple teams to align and effectively collaborate with the goal of enhancing patient care. In addition, we found that integrating inside-out and outside-in perspectives on product innovation helps medical equipment manufacturers produce VBHC-compatible innovations and foster collaboration between clinicians working in multipurpose rooms such as HORs.
Magneto convective flow of casson nanofluid due to Stefan blowing in the presence of bio-active mixers
Authors: Puneeth Venkatesh , Manjunatha Sarpabhushana , Gireesha Bijjanal Jayanna , Gorla Rama Subba Reddy
Published: May 2021

The induced magnetic field for three-dimensional bio-convective flow of Casson nanofluid containing gyrotactic microorganisms along a vertical stretching sheet is investigated. The movement of these microorganisms cause bioconvection and they act as bio-active mixers that help in stabilising the nanoparticles in the suspension. The two forces, Thermophoresis and Brownian motion are incorporated in the Mathematical model along with Stefan blowing. The resulting model is transformed to ordinary differential equations using similarity transformations and are solved using [Formula: see text] method. The Velocity, Induced Magnetic field, Temperature, Concentration of Nanoparticles, and Motile density profiles are interpreted graphically. It is observed that the Casson parameter decreases the flow velocity and enhances the temperature, concentration, and motile density profiles and also it is noticed that the blowing enhances the nanofluid profiles whereas, suction diminishes the nanofluid profiles. On the other hand, it is perceived that the rate of heat conduction is enhanced with Thermophoresis and Brownian motion.
Environmental governance: Broadening ontological spaces for a more livable world
Authors: DePuy Walker , Weger Jacob , Foster Katie , Bonanno Anya M , Kumar Suneel , Lear Kristen , Basilio Raul , German Laura
Published: May 2021

This paper contributes to global debates on environmental governance by drawing on recent ontological scholarship to ask: What would it mean to ontologically engage the concept of environmental governance? By examining the ontological underpinnings of three environmental governance domains (land, water, biodiversity), we find that dominant contemporary environmental governance concepts and policy instruments are grounded in a modernist ontology which actively shapes the world, making certain aspects and relationships visible while invisibilizing others. We then survey ethnographic and other literature to highlight how such categories and their relations have been conceived otherwise and the implications of breaking out of a modernist ontology for environmental governance. Lastly, we argue that answering our opening question requires confronting the coloniality woven into the environmental governance project and consider how to instead embrace ontological pluralism in practice. In particular, we examine what taking seriously the right to self-determination enshrined in the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) could mean for acknowledging Indigenous ontologies as systems of governance in their own right; what challenges and opportunities exist for recognizing and translating ontologies across socio-legal regimes; and how embracing the dynamism and hybridity of ontologies might complicate or advance struggles for material and cognitive justice.
Comprehensive machine-learning-based analysis of microRNA–target interactions reveals variable transferability of interaction rules across species
Authors: Ben Or Gilad , Veksler-Lublinsky Isana
Published: May 2021

Background

MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression post-transcriptionally via base-pairing with complementary sequences on messenger RNAs (mRNAs). Due to the technical challenges involved in the application of high-throughput experimental methods, datasets of direct bona fide miRNA targets exist only for a few model organisms. Machine learning (ML)-based target prediction models were successfully trained and tested on some of these datasets. There is a need to further apply the trained models to organisms in which experimental training data are unavailable. However, it is largely unknown how the features of miRNA–target interactions evolve and whether some features have remained fixed during evolution, raising questions regarding the general, cross-species applicability of currently available ML methods.

Results

We examined the evolution of miRNA–target interaction rules and used data science and ML approaches to investigate whether these rules are transferable between species. We analyzed eight datasets of direct miRNA–target interactions in four species (human, mouse, worm, cattle). Using ML classifiers, we achieved high accuracy for intra-dataset classification and found that the most influential features of all datasets overlap significantly. To explore the relationships between datasets, we measured the divergence of their miRNA seed sequences and evaluated the performance of cross-dataset classification. We found that both measures coincide with the evolutionary distance between the compared species.

Conclusions

The transferability of miRNA–targeting rules between species depends on several factors, the most associated factors being the composition of seed families and evolutionary distance. Furthermore, our feature-importance results suggest that some miRNA–target features have evolved while others remained fixed during the evolution of the species. Our findings lay the foundation for the future development of target prediction tools that could be applied to “non-model” organisms for which minimal experimental data are available.

Availability and implementation

The code is freely available at https://github.com/gbenor/TPVOD.
CDSeqR: fast complete deconvolution for gene expression data from bulk tissues
Authors: Kang Kai , Huang Caizhi , Li Yuanyuan , Umbach David M. , Li Leping
Published: May 2021

Background

Biological tissues consist of heterogenous populations of cells. Because gene expression patterns from bulk tissue samples reflect the contributions from all cells in the tissue, understanding the contribution of individual cell types to the overall gene expression in the tissue is fundamentally important. We recently developed a computational method, CDSeq, that can simultaneously estimate both sample-specific cell-type proportions and cell-type-specific gene expression profiles using only bulk RNA-Seq counts from multiple samples. Here we present an R implementation of CDSeq (CDSeqR) with significant performance improvement over the original implementation in MATLAB and an added new function to aid cell type annotation. The R package would be of interest for the broader R community.

Result

We developed a novel strategy to substantially improve computational efficiency in both speed and memory usage. In addition, we designed and implemented a new function for annotating the CDSeq estimated cell types using single-cell RNA sequencing (scRNA-seq) data. This function allows users to readily interpret and visualize the CDSeq estimated cell types. In addition, this new function further allows the users to annotate CDSeq-estimated cell types using marker genes. We carried out additional validations of the CDSeqR software using synthetic, real cell mixtures, and real bulk RNA-seq data from the Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) project.

Conclusions

The existing bulk RNA-seq repositories, such as TCGA and GTEx, provide enormous resources for better understanding changes in transcriptomics and human diseases. They are also potentially useful for studying cell–cell interactions in the tissue microenvironment. Bulk level analyses neglect tissue heterogeneity, however, and hinder investigation of a cell-type-specific expression. The CDSeqR package may aid in silico dissection of bulk expression data, enabling researchers to recover cell-type-specific information.
Life history, systematics and flight ability of the Early Permian stem-mayflies in the genus Misthodotes Sellards, 1909 (Insecta, Ephemerida, Permoplectoptera)
Authors: Sroka Pavel , Godunko Roman J. , Sinitshenkova Nina D. , Prokop Jakub
Published: May 2021

Background

The stem-group of Ephemeroptera is phylogenetically important for understanding key steps in evolutionary history of early pterygote insects. However, these taxa have been mostly studied from the taxonomy point of view focused on the pattern of wing venation and often using only classical optical microscopy devices. In-depth studies on detailed morphology of the different body structures are scarcely performed, although the results are critical for elucidation of life history traits and their evolutionary pattern among the basal pterygotes.

Results

New information is presented on the morphology of two species ofMisthodotes, which are stem-mayflies from the Early Permian. Based on new results obtained from a re-examination of the type specimens and supplementary material, we infer the life history traits of both the adult and larval stages of these Palaeozoic insects and reconsider previous interpretations. For the first time, we report the structure of the thoracic pleura and the articulation at the base of the wing in a stem-group of Ephemeroptera and compare them with those of extant mayflies. We also provide additional support for the systematic placement of investigated taxa and an amended diagnosis of the genusMisthodotes.

Conclusions

AdultMisthodotes sharoviandMisthodotes zalesskyi had chewing mouthparts, which enabled them to scavenge or feed on plants. The wing apparatus was adapted for slow powered flapping flight and gliding, using long caudal filaments for steering. The wing base does not have rows of articulary sclerites as previously hypothesized for some Palaeozoic taxa but inflexible axilla similar to that found in modern mayflies. The structure of the thoracic pleura is also similar to that in the crown group of Ephemeroptera, while differences in the course of sutures may be explained by an evolutionary trend towards more powerful dorsoventral flying musculature and forewing-based flight (anteromotorism) in modern taxa. There is no evidence for swarming behaviour and mating in the air as occurs in modern mayflies as they had none of the associated morphological adaptations. Putative larvae ofMisthodotescan not be unambiguously associated with the adults. They also exhibit some morphological specializations of Protereismatidae like 9 pairs of abdominal tracheal gills supporting their benthic lifestyle with legs adapted to burrowing.
Consumption of OLL1073R-1 yogurt improves psychological quality of life in women healthcare workers: secondary analysis of a randomized controlled trial
Authors: Kinoshita Tetsu , Maruyama Koutatsu , Suyama Keiko , Nishijima Mariko , Akamatsu Kimiko , Jogamoto Akiko , Katakami Kikumi , Saito Isao
Published: May 2021

Background

We conducted a randomized controlled trial to investigate the effects of consumption of yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 in women healthcare workers. In a previous study we used these data to investigate hypothesized preventive effects against flu, however any effects on improving mental quality of life were not analyzed at that time. In the present study, we focus on that aspect.

Methods

The participants (961 women; mainly nurses, aged 20–71 years) were randomly allocated to either the yogurt group (n = 479) or the control group (n = 482). Participants in the yogurt group drank 112 mL of OLL1073R-1 yogurt for 16 weeks, while those in the control group did not consume any yogurt. All participants were prohibited from consuming other yogurt or fermented dairy products during the study period. The participants answered the Pittsburgh Sleep Quality Index (PSQI), Short Form-8 Health Survey (SF-8), and Gastrointestinal Symptom Rating Scale (GSRS) questionnaires at baseline and after 16 weeks.

Results

The PSQI score showed significant improvement after the intake of yogurt (p < 0.01). SF-8 results showed significant intervention effects in the General Health and Vitality scores (p = 0.02 and p = 0.01, respectively). In other subscales of SF-8, we did not observe significant effects of the yogurt. In the GSRS, daily intake of yogurt exerted a preventive effect on constipation (p = 0.03).

Conclusions

Consumption of yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 enhances subjective psychological quality of life by improving quality of sleep and gastrointestinal condition among women healthcare workers.
Risk of ischaemic stroke associated with antiepileptic drugs: a population-based case-control study in Catalonia
Authors: Giner-Soriano Maria , Marsal Josep Ramon , Gomez-Lumbreras Ainhoa , Morros Rosa
Published: May 2021

Background

Cerebrovascular disorders have occurred more frequently in some Central Nervous System (CNS) disorders, such as epilepsy. Some CNS drugs have been associated with increased stroke risk. Our aim was to estimate the risk of ischaemic stroke in patients exposed to antiepileptic drugs (AED).

Methods

Population-based matched case-control study using SIDIAP database, based in electronic health records from primary healthcare from Catalonia, Spain. Cases were those patients with a registered diagnosis of first stroke during 2009–2014. Up to 10 controls were selected for each case and matched by sex, age, and geographic area and without a prior diagnosis of stroke. We considered global drug exposure to AED, past and current exposure and exposure in monotherapy to each AED.

Results

2,865 cases and 19,406 controls were exposed to AED during the study period. Global exposure to levetiracetam [(ORadj3.3, CI95 % 2.8-4.0)], phenytoin [ORadj1.5, CI95 % 1.2–41.9)], and valproic acid [(ORadj 1.3, CI95 % 1.1–1.6)], showed significantly association to ischaemic stroke that was also maintained with current exposure of levetiracetam [ORadj4.1, CI95 % 3.3–5.2)] and valproic acid [ORadj1.4, CI95 % 1.1–1.9)]. Current levetiracetam monotherapy showed a very high risk of ischaemic stroke [(ORadj 5.1, CI95 % 3.7–6.9)].

Conclusions

Drugs used for other conditions than epilepsy (pregabalin, gabapentin) were the most used AED and both did not show a risk. Levetiracetam shows a risk for stroke even when assessed in current monotherapy. The lack of data regarding the link with diagnosis and severity in our study makes it necessary to conduct further studies to confirm or dismiss our results, focussing on levetiracetam.
Global sagittal alignment of the spine, pelvis, lower limb after vertebral compression fracture and its effect on quality of life
Authors: Chau Leo Tsz Ching , Hu Zongshan , Ko Koko Shaau Yiu , Man Gene Chi Wai , Yeung Kwong Hang , Law Ying Yeung , Lau Lawrence Chun Man , Wong Ronald Man Yeung , Chu Winnie Chiu Wing , Cheng Jack Chun Yiu , Law Sheung Wai
Published: May 2021

Background

Vertebral compression fractures (VCFs) are the most common among all osteoporotic fractures. The body may compensate to the kyphosis from vertebral compression fractures with lordosis of the adjacent spinal segments, rotation of the pelvis, knee flexion and ankle dorsiflexion. However, the detailed degree of body compensation, especially the lower limb, remains uncertain. Herein, the aim of this study is to investigate the values of global sagittal alignments (GSA) parameters, including the spine, pelvis and lower limbs, in patients with and without VCFs, as well as to evaluate the effect of VCFs on various quality of life (QoL) parameters.

Methods

A cross-sectional study was conducted from May 2015 to June 2018. A total of 142 patients with VCFs aged over 60 years old and 108 age-matched asymptomatic controls were recruited. Whole body sagittal alignment including thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), sagittal vertical axis (SVA), T1-pelvic angle (TPA), knee-flex angle (KA) and ankle-flex angle (AA) were measured. In addition, lower back pain and quality of life were assessed using self-reported questionnaires.

Results

Compared to asymptomatic controls, patients with VCF showed significantly greater TK (33.4o ± 16.4o vs 28.4o ± 11.4o; p < 0.01), PT (25.4o ± 10.5o vs 16.6o ± 8.9o; p < 0.001), PI (54.6o ± 11.8o vs 45.8o ± 12.0o; p < 0.001), SVA (49.1 mm ± 39.6 mm vs 31.5 mm ± 29.3 mm; p < 0.01), and TPA (28.6o ± 10.8o vs 14.8o ± 8.6o; p < 0.001). Whereas for lower limb alignment, patients with VCF showed significantly higher KA (10.1o ± 7.8o vs 6.0o ± 6.4o; p < 0.001) and AA (7.0o ± 3.9o vs 4.8o ± 3.6o; p < 0.001) than controls. The number of VCF significantly correlated with lower limb alignments (KA and AA) and global sagittal balance (TPA). VCF patients showed poorer quality of life assessment scores in terms of SF-12 (30.0 ± 8.3 vs 72.4 ± 16.9; p < 0.001), ODI (37.8 ± 24.0 vs 18.7 ± 16.6; p < 0.001) and VAS (3.8 ± 2.8 vs 1.9 ± 2.2; p < 0.001).

Conclusion

This is the first study to illustrate the abnormal lower limb alignment exhibited in patients with VCF. Patients with VCF showed an overall worse global sagittal alignment and decreased quality of life. Poorer global sagittal alignment of VCF patients also imply worse quality of life and more severe VCF.
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus
Authors: Li Dandan , Cai Zixin , Pan Zhenhong , Yang Yan , Zhang Jingjing
Published: May 2021

Background

The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus (GDM) have not been well established. We conduct a meta-analysis to evaluate the effects of vitamin and mineral supplementation on glycemic control, inflammation and oxidative stress for women with GDM.

Methods

A systematic search of randomized controlled trials (RCTs) was conducted from PubMed, Embase, Web of Science and Cochrane Library up to July, 2020. Various results were pooled by using Review manager 5.3 and Stata 12.0. Mean difference (MD) with 95% confidence interval (CI) was estimated. Heterogeneity between studies was assessed by I-squared (I2) tests.

Results

Six hundred ninety-eight patients from 12 trials were included in our meta-analysis. Magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination) were found to significantly improve glycemic control in women with GDM compared to those receiving placebos: fasting plasma glucose (FPG) (MD = - 9.02; 95% CI: - 12.09, - 5.96;P < 0.00001), serum insulin (MD = - 4.33; 95% CI: - 5.35, - 3.32;P < 0.00001), homeostasis model assessment-insulin resistance (HOMA-IR) (MD = - 1.34; 95% CI: - 1.60, - 1.07;P < 0.00001), and homeostasis model of assessment for β cell function (HOMA-B) (MD = - 15.58; 95% CI: - 23.70, - 7.46;P = 0.0002). Vitamin and mineral supplementation was found to attenuated inflammation and oxidative stress through decreasing high-sensitivity C-reactive protein (hs-CRP) (MD = - 1.29; 95% CI: - 1.82, - 0.76;P < 0.00001), malondialdehyde (MDA) (MD = - 0.71; 95% CI: - 0.97, - 0.45;P < 0.00001), and increasing total antioxidant capacity (TAC) (MD = 45.55; 95% CI: 22.02, 69.08;P = 0.0001).

Conclusions

This meta-analysis shows that vitamin and mineral supplementation significantly improved glycemic control, attenuated inflammation and oxidative stress in women with GDM.
Facility and resident characteristics associated with variation in nursing home transfers: evidence from the OPTIMISTIC demonstration project
Authors: Blackburn Justin , Balio Casey P. , Carnahan Jennifer L. , Fowler Nicole R. , Hickman Susan E. , Sachs Greg A. , Tu Wanzhu , Unroe Kathleen T.
Published: May 2021

Background

Centers for Medicare and Medicaid Services (CMS) funded demonstration project to evaluate financial incentives for nursing facilities providing care for 6 clinical conditions to reduce potentially avoidable hospitalizations (PAHs). The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) site tested payment incentives alone and in combination with the successful nurse-led OPTIMISTIC clinical model. Our objective was to identify facility and resident characteristics associated with transfers, including financial incentives with or without the clinical model.

Methods

This was a longitudinal analysis from April 2017 to June 2018 of transfers among nursing home residents in 40 nursing facilities, 17 had the full clinical + payment model (1726 residents) and 23 had payment only model (2142 residents). Using CMS claims data, the Minimum Data Set, and Nursing Home Compare, multilevel logit models estimated the likelihood of all-cause transfers and PAHs (based on CMS claims data and ICD-codes) associated with facility and resident characteristics.

Results

The clinical + payment model was associated with 4.1 percentage points (pps) lower risk of all-cause transfers (95% confidence interval [CI] − 6.2 to − 2.1). Characteristics associated with lower PAH risk included residents aged 95+ years (− 2.4 pps; 95% CI − 3.8 to − 1.1), Medicare-Medicaid dual-eligibility (− 2.5 pps; 95% CI − 3.3 to − 1.7), advanced and moderate cognitive impairment (− 3.3 pps; 95% CI − 4.4 to − 2.1; − 1.2 pps; 95% CI − 2.2 to − 0.2). Changes in Health, End-stage disease and Symptoms and Signs (CHESS) score above most stable (CHESS score 4) increased the risk of PAH by 7.3 pps (95% CI 1.5 to 13.1).

Conclusions

Multiple resident and facility characteristics are associated with transfers. Facilities with the clinical + payment model demonstrated lower risk of all-cause transfers compared to those with payment only, but not for PAHs.
Barriers and facilitators to the implementation of a structured visual assessment after stroke in municipal health care services
Authors: Mathisen Torgeir S. , Eilertsen Grethe , Ormstad Heidi , Falkenberg Helle K.
Published: May 2021

Background

Stroke is a leading cause of disability worldwide. Visual impairments (VIs) affect 60% of stroke survivors, and have negative consequences for rehabilitation and post-stroke life. VIs after stroke are often overlooked and undertreated due to lack of structured routines for visual care after stroke. This study aims to identify and assess barriers and facilitators to the implementation of structured visual assessment after stroke in municipal health care services. The study is part of a larger knowledge translation project.

Methods

Eleven leaders and municipal interdisciplinary health care professionals participated in qualitative interviews. During two workshops, results from the interviews were discussed with 26 participants from municipal health care services and user representatives. Data from interviews and workshops were collected before the intervention was implemented and analyzed using content analysis.

Results

The analysis identified individual and contextual barriers and facilitators. The individual barriers were related to the participants' experiences of having low competence of visual functions and vision assessment skills. They considered themselves as generalists, not stroke experts, and some were reluctant of change because of previous experiences of unsuccessful implementation projects. Individual facilitators were strong beliefs that including vision in stroke care would improve health care services. If experienced as useful and evidence based, the new vision routine would implement easier. Contextual barriers were experiences of unclear responsibility for vision care, lack of structured interdisciplinary collaboration and lack of formal stroke routines. Time constraints and practical difficulties with including the vision tool in current medical records were also expressed barriers. Contextual facilitators were leader support and acknowledgement, in addition to having a flexible work schedule.

Conclusions

This study shows that improving competence about VIs after stroke and skills in assessing visual functions are particularly important to consider when planning implementation of new vision routines in municipal health care services. Increased knowledge about the consequences of living with VIs after stroke, and the motivation to provide best possible care, were individual facilitators for changing clinical practice. Involving knowledge users, solutions for integrating new knowledge in existing routines, along with easily accessible supervision in own practise, are essential facilitators for promoting a successful implementation.
Single-cell transcriptomics reveals the effect of PD-L1/TGF-β blockade on the tumor microenvironment
Authors: Lim Yoong Wearn , Coles Garry L. , Sandhu Savreet K. , Johnson David S. , Adler Adam S. , Stone Erica L.
Published: May 2021

Background

The anti-tumor activity of anti-PD-1/PD-L1 therapies correlates with T cell infiltration in tumors. Thus, a major goal in oncology is to find strategies that enhance T cell infiltration and efficacy of anti-PD-1/PD-L1 therapy. TGF-β has been shown to contribute to T cell exclusion, and anti-TGF-β improves anti-PD-L1 efficacy in vivo. However, TGF-β inhibition has frequently been shown to induce toxicity in the clinic, and the clinical efficacy of combination PD-L1 and TGF-β blockade has not yet been proven. To identify strategies to overcome resistance to PD-L1 blockade, the transcriptional programs associated with PD-L1 and/or TGF-β blockade in the tumor microenvironment should be further elucidated.

Results

We used single-cell RNA sequencing in a mouse model to characterize the transcriptomic effects of PD-L1 and/or TGF-β blockade on nearly 30,000 single cells in the tumor and surrounding microenvironment. Combination treatment led to upregulation of immune response genes, including multiple chemokine genes such as CCL5, in macrophages, and downregulation of extracellular matrix genes in fibroblasts. Analysis of publicly available tumor transcriptome profiles showed that the chemokine CCL5 was strongly associated with immune cell infiltration in various human cancers. Further investigation with in vivo models showed that intratumorally administered CCL5 enhanced cytotoxic lymphocytes and the anti-tumor activity of anti-PD-L1.

Conclusions

Taken together, our data could be leveraged translationally to complement or find alternatives to anti-PD-L1 plus anti-TGF-β combination therapy, for example through companion biomarkers, and/or to identify novel targets that could be modulated to overcome resistance.
Malaria incidence and mortality in Zimbabwe during the COVID-19 pandemic: analysis of routine surveillance data
Authors: Gavi Samuel , Tapera Oscar , Mberikunashe Joseph , Kanyangarara Mufaro
Published: May 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has posed a unique challenge to health care systems globally. To curb COVID-19 transmission, mitigation measures such as travel restrictions, border closures, curfews, lockdowns, and social distancing have been implemented. However, these measures may directly and indirectly affect the delivery and utilization of essential health services, including malaria services. The suspension of indoor residual spraying (IRS) and insecticide-treated net (ITN) distribution, shortages of malaria commodities, and reduced demand for health services have hindered the continued delivery of malaria services. The overall goal of this analysis was to describe the trends in malaria incidence and mortality in Zimbabwe prior to and during the pandemic to understand the consequences of COVID-19-related changes in the delivery and utilization of malaria services.

Methods

Monthly data on the number of malaria cases and deaths by district for the period January 2017 to June 2020 were obtained from the national health management information system (HMIS). District-level population data were obtained from the 2012 Census. Malaria incidence per 1000 population and malaria deaths per 100,000 population were calculated for 2017, 2018, 2019, and 2020 and mapped to describe the spatial and temporal variation of malaria at the district level.

Results

Compared to the same period in 2017, 2018 and 2019, there was an excess of over 30,000 malaria cases from January to June 2020. The number of malaria deaths recorded in January to June 2020 exceeded the annual totals for 2018 and 2019. District level maps indicated that areas outside high malaria burden provinces experienced higher than expected malaria incidence and mortality, suggesting potential outbreaks.

Conclusions

The observed surge in malaria cases and deaths in January to June 2020 coincided with the onset of COVID-19 in Zimbabwe. While further research is needed to explore possible explanations for the observed trends, prioritizing the continuity of essential malaria services amid the COVID-19 pandemic remains crucial.
Long noncoding RNA TUG1 regulates the progression of colorectal cancer through miR-542-3p/TRIB2 axis and Wnt/β-catenin pathway
Authors: Liu Quanlin , Zhang Wei , Luo Linshan , Han Keshun , Liu Ruitao , Wei Shue , Guo Xiaoran
Published: May 2021

Background

Colorectal cancer (CRC) is one of the third normal malignancy worldwide. Taurine-upregulated gene 1 (TUG1), a member of long noncoding RNAs (lncRNAs), has been reported to be involved in various cancers. However, the mechanism underlying TUG1 in the progression of CRC remains unclear.

Methods

The expression of TUG1, microRNA-542-3p (miR-542-3p), and tribbles homolog 2 (TRIB2) in CRC tissues and cells (LoVo and HCT116) were detected by quantitative real-time PCR (qRT-PCR). Methyl thiazolyl tetrazolium (MTT), transwell and flow cytometry assays were employed to evaluate the effects of TUG1 in CRC cells. The interaction between miR-542-3p and TUG1 or TRIB2 were verified by dual-luciferase reporter assay. A xenograft tumor model in nude mice was established to investigate the biological role of TUG1 in CRC in vivo.

Results

TUG1 was increased in CRC tissues and cells (LoVo and HCT116) in contrast with adjacent normal tissues and normal intestinal mucous cells (CCC-HIE-2). Downregulation of TUG1 or TRIB2 suppressed the proliferation, migration, invasion, and induced apoptosis in CRC cells. And knockdown of TUG1 repressed tumor growth in vivo. Besides, overexpression of TRIB2 reversed the effects of TUG1 depletion on the progression of CRC. Meanwhile, TUG1 interacted with miR-542-3p and TRIB2 was a target of miR-542-3p. Furthermore, miR-542-3p knockdown or TRIB2 overexpression partly reversed the suppression effect of TUG1 depletion on the Wnt/β-catenin pathway.

Conclusions

TUG1 served as a tumor promoter, impeded the progression of CRC by miR-542-3p/TRIB2 axis to inactivate of Wnt/β-catenin pathway, which providing a novel target for CRC treatment.
Loss of park7 activity has differential effects on expression of iron responsive element (IRE) gene sets in the brain transcriptome in a zebrafish model of Parkinson’s disease
Authors: Chin Hui Yung , Lardelli Michael , Collins-Praino Lyndsey , Barthelson Karissa
Published: May 2021

Mutation of the gene PARK7 (DJ1) causes monogenic autosomal recessive Parkinson’s disease (PD) in humans. Subsequent alterations of PARK7 protein function lead to mitochondrial dysfunction, a major element in PD pathology. Homozygous mutants for the PARK7-orthologous genes in zebrafish, park7, show changes to gene expression in the oxidative phosphorylation pathway, supporting that disruption of energy production is a key feature of neurodegeneration in PD. Iron is critical for normal mitochondrial function, and we have previously used bioinformatic analysis of IRE-bearing transcripts in brain transcriptomes to find evidence supporting the existence of iron dyshomeostasis in Alzheimer’s disease. Here, we analysed IRE-bearing transcripts in the transcriptome data from homozygous park7−/− mutant zebrafish brains. We found that the set of genes with “high quality” IREs in their 5′ untranslated regions (UTRs, the HQ5′IRE gene set) was significantly altered in these 4-month-old park7−/− brains. However, sets of genes with IREs in their 3′ UTRs appeared unaffected. The effects on HQ5′IRE genes are possibly driven by iron dyshomeostasis and/or oxidative stress, but illuminate the existence of currently unknown mechanisms with differential overall effects on 5′ and 3′ IREs.