bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing a Model of Patient Portal Use in Adult Patients
Authors: Son Hyojin , Nahm Eun‐Shim , Zhu Shijun , Galik Elizabeth , Seidl Kristin L. , Van de Castle Barbara , Russomanno Vince
Published: February 2021

Purpose

The aim of this study was to test a modified version of the Technology Acceptance Model, which describes users’ technology adoption, to examine the relations between patient portal use and potential influencing factors in adult patients who have used patient portals. The modified model posits that patient portal use can be explained by attitude and self‐efficacy for using patient portals, perceived usefulness and ease of use, data privacy and security concerns, eHealth literacy, education level, and age.

Design

A cross‐sectional anonymous online survey was conducted for adult patients who had used their patient portals in the past 12 months.

Methods

Participants were recruited from 20 settings selected in a large integrated health care system. Data from 743 patients were subject to structural equation modeling for model testing.

Findings

Sixty‐eight percent were White and female, with a mean age of 53.1 years (SD = 15.34). Forty‐seven percent used patient portals about monthly or more frequently. Scores for perceived usefulness and ease of use of patient portals were relatively high (as measured using the modified Perceived Health Web Site Usability Questionnaire; each item mean, 6.0–6.2; range, 1–7). The final model adequately fit the data (comparative fit index = .983, standardized root mean square residual = .064, root mean square error of approximation = .059). Patient portal self‐efficacy and data privacy and security concerns had a direct impact on patient portal use. Perceived usefulness and ease of use, eHealth literacy, education level, and age indirectly influenced patient portal use.

Conclusions

This study contributes to expanding a theoretical understanding of adult patients' patient portal use in a real health care environment. Future studies need to include more diverse populations in various settings.

Clinical Relevance

Knowledge gained from this study can be used by technology experts to make patient portals more user friendly and by administrators to implement patient portals more effectively.
Research note: Age, retirement, and intertemporal resource decision ability
Authors: Carpenter Craig Wesley , Loveridge Scott , Mickus Maureen
Published: February 2021

Population studies show the importance of active aging for maintaining cognitive health, but much of the research has focused on episodic memory and verbal skills. Aging and ability to make rational intertemporal financial decisions is less understood, despite its critical role in consumer finance. This study describes the relationship between age, retirement, and intertemporal decision ability. A survey of adults examines the interplay of aging and retirement related to completing simple calculations with time trade‐offs in benefits. A negative association between intertemporal skills and age is indicated, with a sharp downward inflection around age 66. Regression analysis results in a significant, negative retirement‐age interaction term. This research has implications for policy and consumer decision‐making. The negative relationship of age and retirement status may suggest limits to career extension, or alternatively, that extending some types of careers could provide cognitive benefits. Further research is needed to understand the direction of causality.
Social media use and subjective well‐being among middle‐aged consumers in Korea: Mediation model of social capital moderated by disability
Authors: Hwang Hyesun , Nam Su‐Jung
Published: February 2021

This study investigated the moderating effect of disability on the relationship between middle‐aged consumers' well‐being and their social media use, through the mediating effect of social capital. The study used data from the South Korean National Information Society Agency's “2018 Information Divide Index Dataset.” The results showed consumers with disabilities to be less active on social media, implying that they are likely to experience restrictions on social media use, regardless of degree of disability. Degree of disability had significant moderating effects on the relationship between social media use and subjective well‐being, mediated by bonding social capital. Although bonding social capital mediated the relationship between social media use and well‐being for all consumers, the effect was stronger for consumers with severe disabilities.
Acrodermatitis chronica atrophicans: clinical and microbiological characteristics of a cohort of 693 Slovenian patients
Authors: Ogrinc K. , Maraspin V. , Lusa L. , Cerar Kišek T. , Ružić‐Sabljić E. , Strle F.
Published: February 2021

Background

Information on large groups of patients with acrodermatitis chronica atrophicans (ACA) is limited.

Methods

We assessed clinical and microbiological characteristics of patients with ACA diagnosed at a single medical centre and compared findings in periods 1991–2004 vs. 2005–2018. The cohort is representative of Slovenian ACA patients.

Results

We assessed 693 patients: 461 females and 232 males, with median age of 64 years. Median duration of ACA before diagnosis was 12 months. In all but 2 patients, the skin lesions were located on extremities, more often on the lower (70.0%) than the upper (45.2%), bilaterally in 42.4%. Reddish‐blue discoloration, swelling, thinning and wrinkling of skin were present in 95.2%, 28.1%, 46.4% and 20.5% of patients, respectively. Overall, 64.4% of patients reported constitutional symptoms, 23.1% had local symptoms, and 20.8% had symptoms/signs of peripheral neuropathy. Nodules, arthritis, joint deformity, muscle atrophy and paresis were rare (<3%). Borreliae were isolated from 200/664 (30.1%) skin samples; 92.8% wereBorrelia afzelii.B. gariniiandB. burgdorferis.s. were more often isolated from the skin of male patients (OR = 4.17) and from those with arthropathy (OR = 11.74). Patients included in the more recent period were older, complained less often of constitutional symptoms but more often of local symptoms, and more often had local swelling but less often skin atrophy and bilateral involvement, probably as a consequence of earlier diagnosis.

Conclusions

ACA, typically caused byB. afzelii, usually affects older women. Clinical presentation depends on the duration of illness and probably on theBorreliaspecies causing the disease.
Testing the associations between dispositions toward ridicule and being laughed at and romantic jealousy in couples: An APIM analysis
Authors: Brauer Kay , Sendatzki Rebekka , Proyer René T.
Published: February 2021

Objective

How people deal with ridicule and being laughed at plays a role in romantic life. We extend the research on the fear of being laughed at (gelotophobia), joy in being laughed at (gelotophilia), and joy in laughing at others (katagelasticism) by testing their associations with romantic jealousy and its consequences for relationship satisfaction (RS).

Method

Our study is based on Actor–Partner Interdependence Model (APIM) analyses of self and partner ratings of the laughter‐related dispositions using data from 228 opposite‐sex couples. APIM mediation analyses estimated indirect effects of jealousy on the associations between the dispositions and RS.

Results

As expected, gelotophobia‐related positively to jealousy in actors, whereas gelotophilia and katagelasticism showed differential relationships. The analysis of partner effects showed that the actual expressions in the dispositions are unrelated to jealousy but perceived expressions account robustly for experiences of jealousy beyond self‐ratings. Finally, jealousy had indirect effects on the associations between the dispositions and RS.

Conclusion

These findings contribute to our understanding of the role of dealing with ridicule and laughter in romantic life. We embed the findings into the literature, discuss practical implications, and derive future directions to expand the knowledge on gelotophobia, gelotophilia, and katagelasticism in romantic life.
Scaling the baseline: Technicalities and environmental regulation in Owens Valley, California
Authors: Bertenthal Alyse
Published: February 2021

If we want to understand the logic of environmental regulation—as well as its uneven effects—we should look to how regulators and regulated alike generate and deploy baselines. In this article, I chart the scalar frames used to mark the “natural” conditions that are perceived as normal, desirable, and worthy of legal protection and intervention. I explore these frames and resulting legal standards through the case of Owens Lake, California, which has long been a subject of state efforts to regulate resources and remediate pollution. This case study provides an opportunity to understand how presumed technicalities of environmental governance, such as baselines, are constructed and deployed.
Runway roadkill: a global review of mammal strikes with aircraft
Authors: Ball Samantha , Caravaggi Anthony , Butler Fidelma
Published: February 2021

The number of reported collisions (i.e. strikes) between aircraft and wildlife is increasing globally, with consequences for personnel and passenger safety as well as for industry economics. These are important considerations for airport operators that are obliged to mitigate wildlife hazards at airfields. Incidents involving mammals account for approximately 3–10% of all recorded strikes. However, relatively little research has been conducted on mammal strikes with aircraft outside of the USA.

We collate mammal strike data from six major national aviation authorities and a global aircraft database and review the available scientific and grey literature. We aim to identify which mammal families are involved in strike events and how widespread the issue is on a global scale. We also aim to demonstrate the importance of consistently recording strike instances in national databases.

We identified 40 families that were involved in strike events in 47 countries. Reported mammal strike events have been increasing by up to 68% annually. Chiroptera (4 families) accounted for the greatest proportion of strikes in Australia; leporids and canids in Canada, Germany and the UK; and Chiroptera (5 families) and cervids in the USA. More mammals were struck during the landing phase of an aircraft's rotation than any other phase. Circa‐diel strike risk was greatest at dusk and circa‐annum strike risk was greatest during late summer, with some international variation. The total estimated cost of damage resulting from reported mammal strikes exceeded US$103 million in the USA alone, over 30 years.

Mammal strikes represent a substantial risk in airfield environments. Monitoring of existing wild mammal populations is required to understand temporal trends in presence, abundance, and activity patterns and to inform management decisions. Increased and accurate reporting of strike events globally is needed to inform Wildlife Hazard Management Plans and support effective strike mitigation.
Gamma carbonic anhydrases are subunits of the mitochondrial complex I of diatoms
Authors: Cainzos Maximiliano , Marchetti Fernanda , Popovich Cecilia , Leonardi Patricia , Pagnussat Gabriela , Zabaleta Eduardo
Published: February 2021

Diatoms are unicellular organisms containing red algal‐derived plastids that probably originated as result of serial endosymbioses between an ancestral heterotrophic organism and a red alga or cryptophyta algae from which has only the chloroplast left. Diatom mitochondria are thus believed to derive from the exosymbiont. Unlike animals and fungi, diatoms seem to contain ancestral respiratory chains. In support of this, genes encoding gamma type carbonic anhydrases (CAs) whose products were shown to be intrinsic complex I subunits in plants, Euglena and Acanthamoeba were found in diatoms, a representative of Stramenopiles. In this work, we experimentally show that mitochondrial complex I in diatoms is a large complex containing gamma type CA subunits, supporting an ancestral origin. By using a bioinformatic approach, a complex I integrated CA domain with heterotrimeric subunit composition is proposed.
Association between self‐reported appetite and clinical outcomes of peritoneal dialysis patients: Findings from a low middle‐income country
Authors: Boonyakrai Chanchana , Kanjanabuch Talerngsak , Puapatanakul Pongpratch , Halue Guttiga , Johnson David W. , Lorvinitnun Pichet , Tangjittrong Kittisak , Kittiskulnam Piyawan , Pongpirul Krit , Bieber Brian , Tungsanga Kriang ,   Thailand PDOPPS Steering Committee
Published: February 2021

Aim

Patient‐reported outcome measures (PROM) has gained international recognition as important predictors of clinical outcomes in peritoneal dialysis (PD). We sought to understand the associations between patient‐reported appetite and clinical outcomes.

Methods

In the Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS), 690 of 848 randomly selected PD patients from 22 facilities reported their appetite by using the short form (three items) of the Appetite and Diet Assessment Tool (ADAT), between 2016 and 2018. In this questionnaire, the patients rated their appetite as well as a change in appetite over time. Cox proportional hazards model regression was used to estimating associations between self‐reported appetite and clinical outcomes, including mortality, haemodialysis (HD) transfer and peritonitis.

Results

Half of the PD patients reported a good appetite, whereas 34% and 16% reported fair and poor appetites, respectively. Poor appetite was more prevalent among female, diabetic, congestive heart failure, older age and patients who had worse nutritional indicators, including lower time‐averaged serum albumin and serum creatinine concentrations, as well as a higher proportions of hypokalaemia and severe hypoalbuminemia (serum albumin <3 g/dl). After adjusting for age, sex, comorbidities, and PD vintage, poor appetite was associated with increased risks of peritonitis (adjusted hazard ratio [HR] 1.73, 95% confidence interval [CI] 1.14–2.62), HD transfer (adjusted HR 2.25, 95% CI 1.24–4.10) and all‐cause mortality (adjusted HR 1.60, 95% CI 1.08–2.39) compared to patients with good appetite.

Conclusion

Patient‐reported poor appetite was independently associated with higher risks of peritonitis, HD transfer and all‐cause mortality. This warrants further investigation to identify effective interventions.
Ethical Dilemma: An Unprecedented Strike by Health care Workers in Early February 2020 in Hong Kong
Authors: Cheng Fung Kei
Published: February 2021

Urging the government to exercise a complete border closure to inhibit the spread of the novel coronavirus from Mainland China, about 8,000 health care workers participated in a 5‐day strike in early February 2020 in Hong Kong. Despite gaining 61% support from the public, dissenters criticised that the participants violated professional ethics and abandoned their accountabilities, which led to moral distress. However, the participants were guided by the four fundamental medical principles (autonomy, beneficence, non‐maleficence, and justice) for public interest and health equity. Their concerns for occupational safety should not be ignored to maintain an effective health care system. In short, the strike adopted a bottom‐up initiative and adhered to a public‐centered perspective and community‐driven ethical behaviors, through which the participants deliberated over professionalism, humanism and the imminence of public health, and the balance between them. Strikers showed care and concern for the safety of the community, sustainability of the health care system, and well‐being of all people in Hong Kong.
“The One Bright Spot”: Presidential Personal Diplomacy and the Good Neighbor Policy
Authors: Chavez Tizoc
Published: February 2021

In the 1930s and 1940s, personal diplomacy by U.S. presidents was still in its infancy, but it was central to the Good Neighbor policy in Latin America. To overcome years of mistrust, U.S. presidents, both at home and abroad, tried to personally convince their Latin American counterparts of their sincerity for more equitable relations. This article examines how Calvin Coolidge, Herbert Hoover, and especially Franklin Roosevelt used leader‐to‐leader diplomacy to change perceptions of the United States in Latin America and usher in a new era in hemispheric relations. The diplomacy of the Good Neighbor policy also had implications for the presidency, as it foreshadowed what would become standard practice for modern presidents.
Brain responses of dysphoric and control participants during a self‐esteem implicit association test
Authors: Lou Yixue , Lei Yi , Astikainen Piia , Peng Weiwei , Otieno Suzanne , Leppänen Paavo H. T.
Published: February 2021

Previous studies have reported lowered implicit self‐esteem at the behavioral level among depressed individuals. However, brain responses related to the lowered implicit self‐esteem have not been investigated in people with depression. Here, event‐related potentials were measured in 28 dysphoric participants (individuals with elevated amounts of depressive symptoms) and 30 control participants during performance of an implicit association task (IAT) suggested to reflect implicit self‐esteem. Despite equivalent behavioral performance, differences in brain responses were observed between the dysphoric and the control groups in late positive component (LPC) within 400–1,000 ms poststimulus latency. For the dysphoric group, self‐negativity mapping stimuli (me with negative word pairing and not‐me with positive word pairing) induced significantly larger LPC amplitude as compared to self‐positivity mapping stimuli (me with positive pairing and not‐me with negative pairing), whereas the control group showed the opposite pattern. These results suggest a more efficient categorization toward implicit self‐is‐negative association, possibly reflecting lower implicit self‐esteem among the dysphoric participants, in comparison to the controls. These results demonstrate the need for further investigation into the functional significance of LPC modulation during IAT and determination of whether LPC can be used as a neural marker of depressive‐related implicit self‐esteem.
Is existing legislation supporting socially acceptable aquaculture in the European Union? A transversal analysis of France, Italy and Spain
Authors: Cavallo Marianna , Pérez Agúndez José A. , Raux Pascal , Frangoudes Katia
Published: February 2021

According to the European Commission, aquaculture is among those maritime sectors contributing to the blue economy due to its potential for generating jobs, business opportunities and, most importantly, for ensuring food security in Europe. In 2014, EU member states set new strategies to support sustainable aquaculture and ambitious targets of productions to be met by 2020 in the three segments, marine fish, freshwater fish and shellfish. A recent assessment made by the European Commission concludes that some countries might not be able to attain the established goals and this paper presents an in‐depth analysis of such strategies to identify the social constraints hampering aquaculture growth in France, Italy and Spain as well as the measures established to overcome them. Most of the identified issues are related to the social acceptability of local communities, local stakeholders and consumers, suggesting that this still represents an unsolved issue hampering aquaculture development in Europe. In fact, our results show that (a) the sector suffers from a bad image related to its environmental impacts; (b) a lack of integrated spatial planning is leading to increasing conflicts with other activities; and (c) there is predominance of top‐down consultation mechanisms. It is concluded that there is not a single solution to enhance social acceptability of aquaculture since this depends on a number of social, economic and environmental factors that may differ from site to site, and countries need to adopt a more integrated approach where concerns of local communities and stakeholders are understood and taken into account.
The effectiveness of biosecurity interventions in reducing the transmission of bacteria from livestock to humans at the farm level: A systematic literature review
Authors: Youssef Dina Mohamed , Wieland Barbara , Knight Gwenan M. , Lines Jo , Naylor Nichola R.
Published: February 2021

Zoonotic bacterial infections are a health hazard for people who are in regular contact with livestock at the farm level. Improved biosecurity can limit zoonotic pathogen transmission within farms. The aim of this review was to summarize the effectiveness of farm‐level biosecurity interventions in reducing bacterial transmission from animals to people who lived, worked in or visited farms. A systematic literature review was conducted using Embase, Ovid Medline and Agris databases, which were searched on 7th of July 2019, limited to English language papers but with no time exclusion criteria. A narrative synthesis was undertaken utilizing the Centre for Reviews and Dissemination approach, reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Risk of bias within and across the included studies was performed using established checklists. Out of 869 studies retrieved through database searches, 11 studies were selected. In addition, three studies were found through study reference lists. Fourteen studies were therefore included in this review. Biosecurity interventions were grouped into five categories: hand washing, sanitization and hygienic measures (six studies); personal protective equipment (five studies); vaccination (two studies); other interventions (e.g. air ventilation flap) (four studies); and routine farm activities (two studies). Across studies that investigated odds of human colonization or infection (three studies), odds were seen to both be increased and decreased through use of tested biosecurity measures. Large confidence intervals that often crossed the threshold of an odds ratio equal to 1 were found. Most of the studies' overall risk of bias was ‘medium risk’ (11 studies), with selection bias domains generally being scored ‘medium risk.’ Biosecurity interventions are potentially beneficial in reducing bacterial transmission from animals to humans. However, more high‐quality evidence is needed to increase certainty in which interventions, in which contexts, are most effective from the human health perspective.
Tracing oral Na+ and K+ in sweat during exercise and recovery in horses
Authors: Lindinger Michael I. , Waller Amanda P.
Published: February 2021

New Findings

What is the central question of this study?

What are the mechanisms by which equine sweat glands transport sodium, potassium and water into sweat?

What is the main finding and its importance?

The flux of sodium into sweat does not have an active transport component, the flux of potassium into sweat is partially dependent on an active transport mechanism, and there is no evidence for paracellular transport.

In two series of experiments, this study used radioactive sodium (Na+) and potassium (K+) to trace the net flux, and calculate the unidirectional fluxes, of these ions from extracellular fluid into sweat of horses during exercise and recovery. The effect of an oral electrolyte supplement (PNW) on the sweating responses and ion fluxes was also examined. Compared to 8 litres of water (controls), provision of 8 litres of PNW resulted in significantly increased sweating duration (P < 0.001). Two hours before exercise, 99Tc‐labelled diethylene‐triamine‐pentaacetate (DTPA) was administered i.v. to determine if there was paracellular flux of this molecule in sweat glands during the period of sweating. One hour before beginning moderate‐intensity exercise, horses were nasogastrically administered either 24Na (1–3 litres) or 42K (8 litres) with water (control) or an electrolyte supplement. Both radiotracers appeared in sweat within 10 min of exercise onset, and the sweat specific activity of both ions increased during exercise (P < 0.001), approaching plasma specific activities. There was no appearance of 99Tc‐DTPA in sweat. The activities of 24Na and 42K, together with the concentrations Na+, K+ and Cl–, argued against significant paracellular flux of these ions into the lumen of sweat glands. The flux analysis for 24Na indicated a small intracellular pool within sweat gland cells, and no evidence for an active transport component. The flux analysis for 42K indicated a relatively large intracellular equilibration pool within sweat gland cells, with evidence for an active transport component. The results are discussed with respect to the current understanding of sweat gland epithelial cell ion transport mechanisms at both the basal and the apical membranes. It appears likely that the majority of ions appearing in sweat pass through sweat gland epithelial cells by transcellular mechanisms that include ion transporting pathways as well as apical vesicular exocytosis.
Improved Strength and Recovery After Velocity-Based Training: A Randomized Controlled Trial
Authors: Held Steffen , Hecksteden Anne , Meyer Tim , Donath Lars
Published: February 2021

Purpose:The present intervention study examined the effects of intensity-matched velocity-based strength training with a 10% velocity loss (VL10) versus traditional 1-repetition maximum (1RM) based resistance training to failure (TRF) on 1RM and maximal oxygen uptake () in a concurrent training setting.Methods:Using the minimization method, 21 highly trained rowers (4 females and 17 males; 19.6 [2.1] y, 1.83 [0.07] m, 74.6 [8.8] kg,) were either assigned to VL10 or TRF. In addition to rowing endurance training (about 75 min·d−1), both groups performed strength training (5 exercises, 80% 1RM, 4 sets, 2–3 min interset recovery, 2 times/week) over 8 weeks. Squat, deadlift, bench row, and bench press 1RM androwing-ergometer ramp tests were completed. Overall recovery and overall stress were monitored every evening using the Short Recovery and Stress Scale.Results:Large and significant group × time interactions (P < .03,, standard mean differences [SMD] > 0.65) in favor of VL10 (averaged +18.0% [11.3%]) were observed for squat, bench row, and bench press 1RM compared with TRF (averaged +8.0% [2.9%]).revealed no interaction effects (P = .55,, standard mean difference < .23) but large time effects (P < .05,). Significant group × time interactions (P = .001,, SMD > |0.525|) in favor of VL10 were also observed for overall recovery and overall stress 24 and 48 hours after strength training.Conclusions:VL10 serves as a promising means to improve strength capacity at lower repetitions and stress levels in highly trained athletes. Future research should investigate the interference effects of VL10 in strength endurance sports and its effects when increasing weekly VL10 sessions within one macrocycle.
Effects of Exercise Sequence and Velocity Loss Threshold During Resistance Training on Following Endurance and Strength Performance During Concurrent Training
Authors: Nájera-Ferrer Pablo , Pérez-Caballero Carlos , González-Badillo Juan José , Pareja-Blanco Fernando
Published: February 2021

Purpose: This study aimed to analyze the response to 4 concurrent training interventions differing in the training sequence and in the velocity loss (VL) threshold during strength training (20% vs 40%) on following endurance and strength performance. Methods: A randomized crossover research design was used. Sixteen trained men performed 4 training interventions consisting of endurance training (ET) followed by resistance training (RT), with 20% and 40% VL, respectively (ET + RT20 and ET + RT40), and RT with 20% and 40% VL, respectively, followed by ET (RT20 + ET and RT40 + ET). The ET consisted of running for 10 minutes at 90% of maximal aerobic velocity. The RT consisted of 3 squat sets with 60% of 1-repetition maximum. A 5-minute rest was given between exercises. The oxygen uptake throughout the ET and repetition velocity during RT were recorded. The blood lactate concentration, vertical jump, and squat velocity were measured at preexercise and after the endurance and strength exercises. Results: The RT40 + ET protocol showed an impaired running time along with higher ventilatory equivalents compared with those protocols that performed the ET without previous fatigue. No significant differences were observed in the repetitions per set performed for a given VL threshold, regardless of the exercise sequence. The protocols consisting of 40%VL induced greater reductions in jump height and squat velocity, along with elevated blood lactate concentration. Conclusions: A high VL magnitude (40%VL) induced higher metabolic and mechanical stress, as well as greater residual fatigue, on the following ET performance.
Effects of Blood Flow Restriction on Muscle Activation During Dynamic Balance Exercises in Individuals With Chronic Ankle Instability
Authors: Burkhardt Michael , Burkholder Erin , Goetschius John
Published: February 2021

Context: Dynamic balance exercises are commonly utilized during ankle sprain and chronic ankle instability (CAI) rehabilitation. Blood flow restriction (BFR) has been used to enhance muscle activity during exercise and improve outcomes of traditional rehabilitation exercises in clinical populations. Objective: Examine the effects of BFR on lower-extremity muscle activation during dynamic balance exercises in individuals with CAI. Design: Crossover study design. Setting: Laboratory. Patients or Other Participants: Twenty-five (N = 25) young adults with a history of CAI. Interventions: Participants performed dynamic balance reaching exercises during 2 randomized order conditions, BFR, and control. For each condition, participants performed 2 trials of balance exercises. Each trial included 4 sets (30 × 15 × 15 × 15) of reaches in anterior, posteromedial, and posterolateral directions. For the BFR condition, the authors placed a cuff around the proximal thigh at 80% of arterial occlusion pressure. For the control condition, no cuff was worn. Main Outcome Measure(s): The authors recorded normalized electromyography muscle activation of the vastus lateralis, soleus, tibialis anterior, and fibularis longus during balance exercise trials and recorded participants’ ratings of perceived postural instability and exertion after each trial of balance exercises. Results: The authors observed greater vastus lateralis (P < .001, d = 0.86 [0.28 to 1.44]) and soleus (P = .03, d = 0.32 [−0.24 to 0.87]) muscle activation during balance exercises with BFR than control. The authors observed no differences in tibialis anterior (P = .33, d = 0.09 [−0.46 to 0.65]) or fibularis longus (P = .13, d = 0.06 [−0.50 to 0.61]) muscle activation between the conditions. The authors observed greater ratings of perceived postural instability (P = .004) and exertion (P < .001) during balance exercises with BFR than control. Conclusions: Individuals with CAI demonstrated large increases in vastus lateralis and small increases in soleus muscle activation during dynamic balance exercises with BFR. The BFR had no effect on fibularis longus and tibialis anterior muscle activation. Individuals with CAI perceived greater postural instability and exertion during dynamic balance exercises with BFR.
E-cadherin is regulated by GATA-2 and marks the early commitment of mouse hematopoietic progenitors to the basophil and mast cell fates
Authors: Wanet Anaïs , Bassal Mahmoud A. , Patel Sweta B. , Marchi Francisco , Mariani Samanta A. , Ahmed Nouraiz , Zhang Haoran , Borchiellini Marta , Chen Sisi , Zhang Junyan , Di Ruscio Annalisa , Miyake Kensuke , Tsai Mindy , Paranjape Anuya , Park Shin-Young , Karasuyama Hajime , Schroeder Timm , Dzierzak Elaine , Galli Stephen J. , Tenen Daniel G. , Welner Robert S.
Published: February 2021

E-cadherin expression on mouse hematopoietic progenitors marks their commitment to the basophil and mast cell fates at an early stage.
Quantifying Variation in Bacterial Reproductive Fitness: a High-Throughput Method
Authors: Frey Pascal M. , Baer Julian , Bergada-Pijuan Judith , Lawless Conor , Bühler Philipp K. , Kouyos Roger D. , Lemon Katherine P. , Zinkernagel Annelies S. , Brugger Silvio D.
Published: February 2021

Reproductive fitness of bacteria is a major factor in the evolution and persistence of antimicrobial resistance and may play an important role as a pathogen factor in severe infections. With a computational approach to quantify fitness in bacteria growing competitively on agar plates, our high-throughput method has been designed to obtain additional phenotypic data for antimicrobial resistance analysis at a low cost.
Atypical presentation of peripheral posterior lenticonus and role of multi-modal ocular imaging in its diagnosis and management
Authors: Agarwal Rinky , Jain Vatika , Kaur Manpreet , Titiyal Jeewan S
Published: February 2021

A 6-year-old systemically healthy child presented with visual acuity of 1/60, N18 oculusdextrus (OD), and 6/18, N6 oculus sinister (OS). Slit-lamp biomicroscopy revealed suspicious bilateral inferotemporal pigmented ciliary body (CB) tumour, protruding posterior capsule and temporal posterior subcapsular cataract oculus uterque. Anterior segment optical coherence tomography, ultrasonography, ultrasonic biomicroscopy and Scheimpflug imaging revealed protruding posterior capsule and cortex abutting but not arising from CB suggestive of peripheral pigmented posterior lenticonus with hypermetropia (axial length 20.27 mm OD and 19.97 mm OS). Aberrometry revealed high internal aberrations and low Dysfunctional Lens Index (DLI). Lens aspiration with intraocular lens implantation in the bag OD and contact lens correction OS were undertaken. The child had a postoperative visual gain of 3/60, N18 with improved aberrometric profile OD, and was advised amblyopia therapy. Rarely posterior lenticonus can mimic a CB mass. Multi-modal ocular imaging can aid in its diagnosis and management. DLI may serve as a useful indicator of surgery in such cases.
Successful electroconvulsive therapy for depression in a man with cerebral amyloid angiopathy
Authors: Schurgers Geert , Arts Baer M G , Postma Alida A , de Kort Anna
Published: February 2021

Cerebral amyloid angiopathy (CAA) is a condition characterised by accumulation of amyloid beta protein (Aβ) in the wall of cerebral blood vessels which increases the risk of intracranial haemorrhage and contributes to cognitive impairment. We describe the case of a man around the age of 70 with ‘probable’ CAA according to the modified Boston criteria and severe depression whose depression was treated successfully with electroconvulsive therapy (ECT). To the best of our knowledge, there are no earlier published reports of ECT in a patient with CAA. We briefly discuss possible safety measures for these patients, the impact of ECT on cognition in CAA and a possible influence of ECT on Aβ clearance.
Management of cataract in a case of retinitis pigmentosa with bilateral pseudoexfoliation syndrome
Authors: Parija Sucheta , Chakraborty Koyel
Published: February 2021

Retinitis pigmentosa (RP) patients are at higher risk for macular oedema, anterior capsular phimosis and spontaneous dislocation of the implanted lens after cataract surgery. A 70-year-old hypertensive woman presented with diminution of vision in her left eye since 2 years. She had history of cataract surgery in the right eye 1 year ago. Her visual acuity was 20/200 in right eye and hand movements in left eye. Slit-lamp examination showed anterior capsular phimosis with intraocular lens in the right eye and pseudoexfoliation in both the eyes. Fundus examination revealed features of RP in both the eyes. Optical coherence tomography showed bilateral foveal atrophy. The patient underwent phacoemulsification cataract surgery with intraocular lens implantation in left eye and Nd:YAG laser capsulotomy in right eye. Postoperative best corrected distance visual acuity was 20/125 in right eye and 20/80 in left eye. This case highlights a rare coincidence of pseudoexfoliation syndrome in a patient with RP and the precautions undertaken during cataract surgery for an optimal visual outcome.
Low fraction of fetal haemoglobin is associated with retinopathy of prematurity in the very preterm infant
Authors: Hellström William , Martinsson Tobias , Morsing Eva , Gränse Lotta , Ley David , Hellström Ann
Published: February 2021

Background

Blood loss and adult blood transfusions are common during the neonatal period in preterm infants. The objective of the study was to clarify if degree of loss of fetal haemoglobin (HbF) was associated with later retinopathy of prematurity (ROP).

Methods

Retrospective observational cohort study. In total, 452 infants born <30 gestational weeks at a tertiary level neonatal intensive care unit in Sweden in 2009–2015 were included, 385 of whom had final ROP outcome. Mean fractions of HbF (%) during the first postnatal week were calculated from 11 861 arterial blood gas analyses. The relationship between fractions of HbF (%) and ROP was evaluated.

Results

The mean (SD) gestational age (GA) at birth was 26.4 (1.8) weeks. In total, 104 (27 %) infants developed ROP. Higher fraction of HbF (%) was associated with a lower prevalence of ROP, OR by a 10% increase 0.83 (95% CI: 0.71 to 0.97; p=0.019), following adjustment for GA at birth, small for GA and sex. Infants with HbF (%) in the lowest quartile had OR of 22.0 (95% CI: 8.1 to 59.2; p<0.001) for ROP development compared with those in the highest quartile. The predictive ability (area under the curve) of HbF (%) in the full model during the first week was 0.849 for ROP.

Conclusions

Early low fraction of HbF is independently associated with abnormal retinal neurovascular development in the very preterm infant. The potential benefit of minimising blood loss on development of ROP will be investigated in a multicenter randomised trial (NCT04239690).
Injury rates decreased in men’s professional football: an 18-year prospective cohort study of almost 12 000 injuries sustained during 1.8 million hours of play
Authors: Ekstrand Jan , Spreco Armin , Bengtsson Håkan , Bahr Roald
Published: February 2021

Background

The UEFA Elite Club Injury Study is the largest and longest running injury surveillance programme in football.

Objective

To analyse the 18-season time trends in injury rates among male professional football players.

Methods

3302 players comprising 49 teams (19 countries) were followed from 2000–2001 through 2018–2019. Team medical staff recorded individual player exposure and time-loss injuries.

Results

A total of 11 820 time-loss injuries were recorded during 1 784 281 hours of exposure. Injury incidence fell gradually during the 18-year study period, 3% per season for both training injuries (95% CI 1% to 4% decrease, p=0.002) and match injuries (95% CI 2% to 3% decrease, p<0.001). Ligament injury incidence decreased 5% per season during training (95% CI 3% to 7% decrease, p<0.001) and 4% per season during match play (95% CI 3% to 6% decrease, p<0.001), while the rate of muscle injuries remained constant. The incidence of reinjuries decreased by 5% per season during both training (95% CI 2% to 8% decrease, p=0.001) and matches (95% CI 3% to 7% decrease, p<0.001). Squad availability increased by 0.7% per season for training sessions (95% CI 0.5% to 0.8% increase, p<0.001) and 0.2% per season for matches (95% CI 0.1% to 0.3% increase, p=0.001).

Conclusions

Over 18 years: (1) injury incidence decreased in training and matches, (2) reinjury rates decreased, and (3) player availability for training and match play increased.
Towards attainment of Indigenous health through empowerment: resetting health systems, services and provider approaches
Authors: Barnabe Cheryl
Published: February 2021

Colonial policies and practices have introduced significant health challenges for Indigenous populations in commonwealth countries. Health systems and models of care were shaped for dominant society, and were not contextualised for Indigenous communities nor with provision of Indigenous cultural approaches to maintain health and wellness. Shifts to support Indigenous health outcomes have been challenged by debate on identifying which system and service components are to be included, implementation approaches, the lack of contextualised evaluation of implemented models to justify financial investments, but most importantly lack of effort in ensuring equity and participation by affected communities to uphold Indigenous rights to health. Prioritising the involvement, collaboration and empowerment of Indigenous communities and leadership are critical to successful transformation of healthcare in Indigenous communities. Locally determined priorities and solutions can be enacted to meet community and individual needs, and advance health attainment. In this paper, existing successful and sustainable models that demonstrate the empowerment of Indigenous peoples and communities in advocating for, designing, delivering and leading health and wellness supports are shared.
Mental health treatment experiences of commonwealth veterans from diverse ethnic backgrounds who have served in the UK military
Authors: Pearson E.J , Baumann J , Murphy D
Published: February 2021

Introduction

Research has shown that the likelihood of ex-military personnel developing mental health problems following service is around one in five. Little is known about the barriers to accessing mental health in veterans from diverse ethnic backgrounds. This study aims to explore mental health treatment experiences of veterans from commonwealth countries and therefore diverse ethnic backgrounds.

Methods

Semi-structured interviews were conducted over the telephone with veterans from commonwealth countries. Veterans were recruited from a mental health charity and were at various stages of treatment.

Results

We interviewed six veterans who were from a diverse range of commonwealth countries including St Lucia, Gambia, Ghana, Fiji and South Africa. All had served in the UK army in combat roles. Our findings consisted of key themes: (1) feeling that they are treated differently, (2) they felt as though they were unheard when reaching out for help, (3) systemic pressures such as financial difficulties, missed opportunities and lack of insight about mental health and (4) the importance of involving the wider community in care.

Conclusion

Our findings highlight some distinct barriers to mental health treatment that commonwealth veterans experience. The themes reported by the participants appear to suggest they had experience signs of institutional racism. Suggesting the importance of highlighting these issues, and to help overcome these potential barriers to accessing services. Given that commonwealth veterans involvement in the UK military is significant and increasing, the findings in this study should be used to support this population by implementing service provision and policy.
Medical services provided on the ‘Harmonious Mission—2017’ Peace Ark from China
Authors: Tang Bihan , Han Y , Liu X , Zhang H , Li M , Hu C , Zhang L
Published: February 2021

Introduction

The Chinese Naval ship Peace Ark provided humanitarian medical services to people in eight low-income countries in Africa and Asia during the 2017 “Harmonious Mission’. The expedition lasted 155 days. Our study aimed to analyse the details of the medical services provided including outpatient care, medical patrol, operations, examinations and medications.

Method

The patient demographic data and medical information were extracted from electronic medical records. The diagnoses and procedures aboard were coded by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The sociodemographic data of the medical staff aboard were collected via questionnaire. Descriptive statistics and statistical software (SAS, V.9.4) were used to analyse the data.

Results

In total, 115 Chinese military medical personnel participated in the mission, completing a total of 50 758 outpatient visits, 10 232 medical patrols and 252 operations. The five most frequently used outpatient departments were ophthalmology, general surgery, general internal medicine, orthopaedics and traditional Chinese medicine. The five most common operations were lipoma excision, cataract extraction, skin tissue removal (such as warts and cysts), pterygium transposition and herniorrhaphy.

Conclusions

Our study revealed the medical services in demand during the ‘Harmonious Mission—2017’. It is essential to report their experiences so that future ventures can provide medical services more effectively.
Healing features of experimental injuries of soft tissues that contain foreign bodies in the form of fragments of military personnel uniforms
Authors: Pavlov Sergey , Litvinova O , Mikhaylusov R , Negoduyko V , Kumetchko M , Semko N
Published: February 2021

Introduction

The healing of combat wounds can be complicated by the presence of foreign bodies. The present research aimed to study the regeneration of soft tissue injuries complicated by foreign bodies in the form of fragments of military uniforms.

Methods

60 rats were divided into four groups: intact (Int), control (Con) and two experimental (EG1, EG2). In Con, wounds were sutured without implantation of foreign bodies. A uniform consisting of 100% cotton was used as foreign bodies for EG1 and a uniform consisting of 65% cotton and 35% polyester for EG2. Histological studies were performed according to generally accepted methods. The growth factors wеre determined by ELISA.

Results

In EG1, the inflammatory reaction proceeded protractedly, which complicated the development of granulation tissue. In EG2, considering the moderate inflammatory reactions, healing of the wounds became possible. The increase of the growth factors content in Con was maximal at the 15th day: basic fibroblast growth factor (bFGF)—2.2 times and vascular endothelial growth factor (VEGF)—1.6 times (p<0.001). In experimental groups, the bFGF content was maximal at the 60th day and exceeded the normal values by 1.7 times in EG1 and by 2.6 times in EG2 (p<0.001); the level of VEGF was slightly higher than that in healthy animals.

Conclusions

The study showed wound healing in all groups. The repair of injuries in rats of EG1 and EG2 was complicated by the textile implant and took longer. The dynamics of the content of growth factors reflected the impairment of wound healing processes. These violations were more pronounced in the EG1 group.
Defence Medical Rehabilitation Centre (DMRC) COVID-19 Recovery Service
Authors: O'Sullivan Oliver , Barker-Davies R , Chamley R , Sellon E , Jenkins D , Burley R , Holden L , Nicol A M , Phillip R , Bennett A N , Nicol E , Holdsworth D A
Published: February 2021

Coronavirus disease 2019 (COVID-19) causes significant mortality and morbidity, with an unknown impact in the medium to long term. Evidence from previous coronavirus epidemics indicates that there is likely to be a substantial burden of disease, potentially even in those with a mild acute illness. The clinical and occupational effects of COVID-19 are likely to impact on the operational effectiveness of the Armed Forces. Collaboration between Defence Primary Healthcare, Defence Secondary Healthcare, Defence Rehabilitation and Defence Occupational Medicine resulted in the Defence Medical Rehabilitation Centre COVID-19 Recovery Service (DCRS). This integrated clinical and occupational pathway uses cardiopulmonary assessment as a cornerstone to identify, diagnose and manage post-COVID-19 pathology.