bluuebunny/crossref_metadata_2025 huggingface dataset:
Antecedents of Intention to Adopt Mobile Health (mHealth) Application and Its Impact on Intention to Recommend: An Evidence from Indonesian Customers
Authors: Octavius Gilbert Sterling , Antonio Ferdi
Published: April 2021

Introduction. Mobile health (mHealth) applications gain popularity due to the increasing number of mobile phone usage and internet penetration, which might help some of Indonesia’s medical issues. However, the uptake of mHealth applications is still low in Indonesia. This study is aimed at understanding the factors that drive individuals to adopt mHealth applications and their impact on the intention to recommend. Methods. We applied a new model that combines three different theories with some other constructs: an extended unified theory of acceptance and use of technology, diffusion of innovation, and the internet customer trust model. The study used a cross-sectional study design with partial least squares causal modeling approach. Results. There are 787 respondents in our study, with the majority of them being female, young adults. Our model could explain 53.2% of the variance of intention to adopt while explaining 48.3% of the variance of intention to recommend. Initial trust in mHealth platform (

β
=
0.373

,

p
=
<
0.001

), facilitating conditions (

β
=
0.131

,

p
=
<
0.01

), and performance expectancy (

β
=
0.099

,

p
=
<
0.05

) are the top three most important drivers of intention to adopt mHealth applications. Lastly, importance-performance map analysis (IPMA) showed that the mHealth application’s initial trust is the most important construct with a high-performance score. Discussion. Mobile health developers and managers need to improve initial trust in the mHealth platform, facilitating conditions, and performance expectancy when developing the applications. With a medium

Q

2

predict

, these factors can be applied out of the research context with medium predictive power.
Path Planning of Mobile Robot Based on Improved Multiobjective Genetic Algorithm
Authors: Li Kairong , Hu Qianqian , Liu Jinpeng
Published: April 2021

Path planning is the core technology of mobile robot decision‐making and control and is also a research hotspot in the field of artificial intelligence. Aiming at the problems of slow response speed, long planning path, unsafe factors, and a large number of turns in the conventional path planning algorithm, an improved multiobjective genetic algorithm (IMGA) is proposed to solve static global path planning in this paper. The algorithm uses a heuristic median insertion method to establish the initial population, which improves the feasibility of the initial path and generates a multiobjective fitness function based on three indicators: path length, path security, and path energy consumption, to ensure the quality of the planned path. Then, the selection, crossover, and mutation operators are designed by using the layered method, the single‐point crossover method, and the eight‐neighborhood‐domain single‐point mutation method, respectively. Finally, the delete operation is added, to further ensure the efficient operation of the mobile robot. Simulation experiments in the grid environment show that the algorithm can improve the defects of the traditional genetic algorithm (GA), such as slow convergence speed and easy to fall into local optimum. Compared with GA, the optimal path length obtained by planning is shortened by 17%.
Dynamic Analysis of the Rental Prices of Long-Rental Apartments and Ordinary Rental Housing Based on the Impact of Long-Rental Apartment Enterprises’ Competitive Behaviors
Authors: Mu Lingling , Qin Xiangyu , Wang Yaoyao
Published: April 2021

This paper addresses the issue of the impact of the competitive behaviors of long-rental apartment firms on the rents of long-rental apartments and ordinary rental housing and introduces a dynamic gaming approach to the housing rental market domain to reveal changes in the long-term complexity of rents of long-rental apartments and ordinary rental housing caused by the competitive behavior of long-rental apartment firms. Through numerical simulation, it is found that the adoption of smaller rent adjustment strategies by firms is important for maintaining system stability, while the changes in reference effect behavior of landlords and service quality and differences in demand share have moderating effects on system stability. The enhanced reference effect of landlords, the improvement of service quality, and the increase of the difference in demand share between the two long-rental apartments help to mitigate the disruption of system stability by the increase of the adjustment factor of the firms. The decentralized long-lease apartment firms, which occupy a higher proportion of the market, are able to exert a major impact on the rent of general rental housing by taking advantage of the market, while the difference in the demand share between the two firms is the main reason for the change in the rent of long-rental apartments.
Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression
Authors: Phadsri Supaluck , Shioji Rieko , Tanimura Atsuko , Jaknissai Jeerawit , Apichai Sopida , Sookruay Tippawan
Published: April 2021

Background. Social withdrawal is predominantly seen among adults with depression. However, a dearth of reviews exists that explore nonpharmacological treatments, especially occupational therapy (OT) interventions and their effect in promoting social participation. The aim of this research was to review what intervention programs are conducted to support the social participation of adults with depression and their effectiveness. Method. A systematic review was performed wherein relevant articles were searched in PubMed, CINAHL, Wiley Online Library, PsycINFO, and OTseeker databases and AJOT, BJOT, SJOT, and OTMH journals. Only English articles published from January 2010 to December 2018, which tackled intervention for adults aged 20–60 years with depression, were considered. Ten out of 918 studies met the screening criteria. Result. Among the ten studies, the effective intervention programs were categorized as either occupation-based intervention (OBI) or cognitive behavioral therapy-based intervention (CBT-BI). These programs sought the following outcomes: behavioral change in social participation (n=4), reduction of depression or depressive symptoms (n=13), life satisfaction (n=4), and quality of life (QoL) (n=1). Studies showed moderate (n=3) to strong (n=7) level of certainty, whereas they also revealed high to unclear (n=3) and low (n=7) risk of bias. Conclusion. Both OBI such as animal-assisted therapy and CBT-BI such as behavioral change program and health education have a strong level of certainty and low risk of bias in promoting social participation by supporting positive behavioral change and reducing depressive symptoms. Furthermore, the sport and exercise program of OBI was popular in encouraging participation and engagement with other people. Other programs were suggested for combined interventions to support social participation, life satisfaction, and QoL.
Theoretical and Experimental Analysis of Thin-Walled Curved Rectangular Box Beam under In-Plane Bending
Authors: Yanze Long , Ke Zhang , Huaitao Shi , Songhua Li , Xiaochen Zhang
Published: April 2021

Thin-walled curved box beam structures especially rectangular members are widely used in mechanical and architectural structures and other engineering fields because of their high strength-to-weight ratios. In this paper, we present experimental and theoretical analysis methods for the static analysis of thin-walled curved rectangular-box beams under in-plane bending based on 11 feature deformation modes. As to the numerical investigations, we explored the convergence and accuracy analysis by normal finite element analysis, higher-order assumed strain plane element, deep collocation method element, and inverse finite element method, respectively. The out-of-plane and in-plane characteristic deformation vector modes derived by the theoretical formula are superimposed by transforming the axial, tangential, and the normal deformation values into scalar tensile and compression amounts. A one-dimensional deformation experimental test theory is first proposed, formulating the specific contributions of various deformation modes. In this way, the magnitude and trend of the influence of each low-order deformation mode on the distortion and warping in the actual deformation are determined, and the significance of distortion and warping in the actual curved beams subjected to the in-plane loads is verified. This study strengthens the deformation theory of rectangular box-type thin-walled curved beams under in-plane bending, thus providing a reference for analyzing the mechanical properties of curved-beam structures.
The Effect of Stromal‐Derived Factor 1α on Osteoinduction Properties of Porous β‐Tricalcium Phosphate Bioceramics
Authors: Jin Fangchun , Cai Qixun , Wang Wei , Fan Xiaohui , Lu Xiao , He Ning , Ding Jing
Published: April 2021

β‐Tricalcium phosphate (TCP) is a type of bioceramic material which is commonly used for hard tissue repair and famous of its remarkable biocompatibility and osteoconductivity with similar composition to natural bone. However, TCP lacks osteoindcutive properties. Stromal‐derived factor 1α (SDF‐1α) can promote bone regeneration with excellent osteoinduction effect. In this study, SDF‐1α was loaded into TCP to investigate the in vitro effects of SDF‐1α on the osteoinductive properties of TCP. In vitro studies showed that SDF‐1α/TCP scaffold significantly stimulated the expression of osteopontin and osteocalcin. As to the in vivo studies, the rabbit bone defect model showed that SDF‐1α stimulated more new bone formation. In conclusion, SDF‐1α/TCP bioceramic scaffolds could further promote bone regeneration compared to pure TCP bioceramics.
Numerical Simulation Research on the Stability of Urban Underground Interchange Tunnel Group
Authors: Cao Shiding , Huo Shusen , Guo Aipeng , Qin Ke , Xie Yongli , Meng Zhigang
Published: April 2021

Highway tunnel group has the characteristics of large span and small spacing, and the load distribution characteristics of surrounding rock between each tunnel section are complex. Based on geological prospecting data and numerical analysis software, the stress distribution characteristics along the characteristic section and the profile of the tunnel group were obtained. Taking Shenzhen Nanlong complex interchange tunnel group project as an example, the results show that (1) the excavation area of Qiaocheng main tunnel gradient section is large, and the grade of surrounding rock is poor, which leads to the phenomenon of large-area stress concentration on the right wall of this section. (2) The tunnels in the joint construction section of the tunnel group belong to the stress concentration area, and the influence of the right line excavation of Qiaocheng on the stability of the main tunnel of the right line of Baopeng is greater than that of the main tunnel of the left line of Baopeng. (3) The stress concentration of surrounding rock in the intersection section between the main tunnel and the ramp is caused by the too small distance between the main tunnel and the ramp of Baopeng. (4) The distance between the partitions in the K3 + 240 multiarch section of Qiaocheng is an important factor affecting the stability of the surrounding rock of the cave.
Values of Magnetic Resonance Imaging and Computed Tomography in the Diagnosis of Patients with Syndromes of Subacromial Impingement
Authors: Jiang Xingfang , Guo Zhiyan , Hu Linlin , Liu Pan , Xu Leiming , Pan Jiangfeng
Published: April 2021

Subacromial impingement syndrome (SIS) is defined as pressurization and impingement between the acromion, the bursa under the acromion, and the rotator cuff during the abduction and elevation of the shoulder joint, resulting in pain and a functional disturbance of elevation. It is the most common disorder of the shoulder, accounting for 44-65% of all complaints of shoulder pain during a physician’s office visit. The study was performed with the aim of valuing the magnetic resonance imaging (MRI) and computed tomography (CT) in diagnosing patients with SIS. A total of 68 patients with SIS were selected as study subjects and subjected to MRI and CT examinations. The diagnostic accuracy and sensitivity of MRI and CT were, respectively, 97.06 and 70.59% (

P
<
0.05

); the detection rates of SIS grade I, grade II, and grade III by MRI were 91.67%, 96.77%, and 100%, respectively, which were significantly higher than 50%, 80.65%, and 68% by CT, respectively (

P
<
0.05

). MRI and CT detection indicated that there was no significant difference in extensive rotator cuff tear, acromion stenosis, and normal acromion detected by MRI and CT (

P
>
0.05

). In conclusion, the diagnostic accuracy, sensitivity, and detection rate of acromion of MRI were higher compared with those of CT examination, and MRI is more suitable in the clinical diagnosis of SIS.
Adaptive Fuzzy Path Tracking Control for Mobile Robots with Unknown Control Direction
Authors: Du Qifei , Sha Lin , Shi Wuxi , Sun Liankun
Published: April 2021

In order to synthesize controllers for wheeled mobile robots (WMRs), some design techniques are usually based on the assumption that the center of mass is at the center of the robot itself. Nevertheless, the exact position of the center of mass is not easy to measure, thus WMRs is a typical uncertain nonlinear system with unknown control direction. Based on the fast terminal sliding mode control, an adaptive fuzzy path tracking control scheme is proposed for mobile robots with unknown control direction. In this scheme, the fuzzy system is used to approximate unknown functions, and a robust controller is constructed to compensate for the approximation error. The Nussbaum-type functions are integrated into the robust controller to estimate the unknown control direction. It is proved that all the signals in the closed-loop system are bounded, and the tracking error converges to a small neighborhood of the origin in a limited time. The effectiveness of the proposed scheme is illustrated by a simulation example.
Environmental and Genetic Factors in the Pathogenesis of COPD in the Road-Working Population
Authors: Zhou Yumin , Wang Man , Yang Weiyan , Li Jianjun , Li Jialin , Hu Yueying , Wang Wei , Che Chunli , Qi Hong
Published: April 2021

Background. Chronic obstructive pulmonary disease (COPD) is a typical heterogeneous condition caused by environmental and genetic risk factors. Objectives. We investigated extrinsic (environmental) and intrinsic (genetic) factors contributing to the development of COPD in a nonsmoker road-working population in Northeast China. Method. The target population was divided into a COPD group and an exposed control group. Another healthy nonroad working nonsmoker control group was also included for environmental factor comparison. Peripheral blood was collected and analyzed using inductively coupled plasma mass spectrometry for inorganic elements of PM2.5, and microarray, rt-PCR, and Multiplex ELISA for genetic factors. Results. Forty-three COPD road workers, thirty-nine non-COPD road workers, and 52 age and gender-matched healthy nonroad workers were enrolled. There were significantly higher levels in all 24 inorganic elements in the COPD group compared with the healthy control group except potassium and manganese, while the majority of inorganic elements were similar between the COPD group and the exposed control group except in aluminum and cobalt. There were 39 genes showing significant differences between the COPD group and the exposed control group. Collagen, type XV, alpha 1 (COL15A1), Meis homeobox 1 (MEIS1), carbonyl reductase 3 (CBR3), and amine oxidase, copper containing 3 (AOC3) were confirmed by rt-PCR to be differentially expressed. Their correlations with blood cytokines were also evaluated. Conclusions. Aluminum might contribute to the development of COPD in the road-working population. CBR3 and AOC3 seem expressed in different patterns than previously reported, evidenced by their correlation with proinflammatory and anti-inflammatory cytokines.
On Behavior Laplace Integral Operators with Generalized Bessel Matrix Polynomials and Related Functions
Authors: Hidan Muajebah , Akel Mohamed , Boulaaras Salah Mahmoud , Abdalla Mohamed
Published: April 2021

Recently, the applications and importance of integral transforms (or operators) with special functions and polynomials have received more attention in various fields like fractional analysis, survival analysis, physics, statistics, and engendering. In this article, we aim to introduce a number of Laplace and inverse Laplace integral transforms of functions involving the generalized and reverse generalized Bessel matrix polynomials. In addition, the current outcomes are yielded to more outcomes in the modern theory of integral transforms.
Tribological Properties of ZrO2 Coating on the Ball Joint of an Axial Piston Pump in High Water-Based Emulsion Medium
Authors: Kou Baofu , Li Zhenshun , Zhang Zhang , Li Ruiqing
Published: April 2021

This paper studies the tribological properties of the ZrO2-coated spherical joint pair of the axial piston pump in a high water-based emulsion medium. Firstly, atmospheric plasma spraying was used to prepare the ZrO2 coating on the surface of the spherical joint pair. Secondly, the tribological characteristics of the steel-steel pair and ceramic-ceramic pair were analyzed by the friction and wear testing machine under the conditions of a high water-based emulsion concentration, load size, and load frequency. White light interference three-dimensional surface profiler and scanning electron microscope were used to analyze the original and worn surfaces of the samples, and then the friction and wear of the different material pairs were discussed. The results show that the friction reduction and wear resistance of the ceramic ball joint are superior to those of the steel ball joint. When the load is 100 N, the frequency is 1 Hz, and the emulsion concentration is 5%, and the friction coefficient and wear loss of the ceramic-ceramic ball joint pair are the lowest. The emulsion concentration and load have great influence on the friction coefficient and wear amount, while the frequency has little influence on them. With increasing concentration of the emulsion, the friction coefficient decreases and tends to be stable, but with increasing of load, the friction coefficient and wear increase. The friction coefficient and wear loss of the ceramic-ceramic ball joint in pure water are 0.25 times higher than those of the steel ball joint under the same working conditions. Therefore, when the concentration of the high water-based emulsion is 5%, 100 N load, 1 Hz frequency, the ceramic-ceramic ball joints display the best friction and wear resistance of the two. The research results provide a theoretical basis for the design, manufacture, and application of the ceramic coating hydraulic components in a high water-based emulsion medium.
Stem Cells: A Historical Review about Biological, Religious, and Ethical Issues
Authors: Charitos Ioannis Alexandros , Ballini Andrea , Cantore Stefania , Boccellino Mariarosaria , Di Domenico Marina , Borsani Elisa , Nocini Riccardo , Di Cosola Michele , Santacroce Luigi , Bottalico Lucrezia
Published: April 2021

Stem cells can be used to replace damaged cells or regenerate organs and have broadened our knowledge of the development and progression of certain diseases. Despite significant advances in understanding stem cell biology, several problems limit their use. These problems are related not only to the growth of tumors in animal models and their rejection in transplant cases but also to ethical and social issues about the use of embryonic cells. The ethical-scientific debate on this type of cells has taken on great interest both for their application in regenerative medicine and for the potential possibilities in the field of cell and gene therapy. Different points of view often have the expression of a perception that depends on scientific goals or opportunities or on religious traditions and beliefs. Therefore, as the questions and doubts about when life begins, so do the answers for the use of these cells as therapy or otherwise. So, in addition to the origin of stem cells, there are currently some social bioethical (such as political and legislative issues) and religious dilemmas. The purpose of the study is aimed at being a narrative on the history of stem cells and the evolution of their use to date, as well as to clarify the bioethical position of the various religions today in comparison with the social ones regarding the research and use of embryonic and adult ones. Hence, their biological hypostasis regarding the concepts of “conception” and “fertilization” and their development and therapeutic use compared to those of the main theological doctrines.
Accidental Corneal Intrastromal Intraocular Lens Implantation with the Wound-Assisted Technique and Clinical Course with Anterior Segment Optical Coherence Tomography
Authors: Moriya Jo , Sakamoto Shinichi , Inoda Satoru , Takahashi Hidenori , Kawashima Hidetoshi
Published: April 2021

Accidental intraocular lens (IOL) implantation into the corneal stroma is a rare clinical entity that can occur during the wound-assisted technique. In this report, we describe a case of an 81-year-old man who underwent cataract surgery in which the IOL was implanted into the corneal stroma with the wound-assisted technique, and we present changes in anterior segment optical coherence tomography. The IOL was removed and reinserted after widening the incision. Air tamponade was created by intracameral injection. An anterior chamber tap was performed 10 h later to reduce increased intraocular pressure. Interlayer separation of the corneal stroma was confirmed 30 min postoperatively but was corrected 4 days later. The patient’s best-corrected visual acuity (BCVA) was logMAR 0.30, and he had been diagnosed with age-related macular degeneration before surgery. Although the opacity of the corneal stroma persisted, BCVA improved to logMAR 0. When using the wound-assisted technique for IOL insertion, surgeons should take care not to implant the IOL into the corneal stroma.
Intraoperative Correction of Cochlear Implant Electrode Translocation
Authors: Morrel William G. , Manzoor Nauman F. , Dawant Benoit M. , Noble Jack H. , Labadie Robert F.
Published: April 2021

Introduction: Translocation of precurved cochlear implant (CI) electrodes reduces hearing outcomes, but it is not known whether it is possible to correct scalar translocation such that all electrodes reside fully in the scala tympani (ST). Methods: Six cadaveric temporal bones were scanned with CT and segmented to delineate intracochlear anatomy. Mastoidectomy with facial recess was performed. Precurved CI electrodes (CI532; Cochlear Limited) were implanted until scalar translocation was confirmed with postoperative CT. Then, electrodes were removed and replaced. CT scan was repeated to assess for translocation correction. Scalar position of electrode contacts, angular insertion depth (AID) of the electrode array, and M– (average distance between each electrode contact and the modiolus) were measured. An in vivo case is reported in which intraoperative translocation detection led to removal and replacement of the electrode. Results: Five of 6 cadaveric translocations (83%) were corrected with 1 attempt, resulting in full ST insertions. AID averaged 285 ± 77° for translocated electrodes compared to 344 ± 28° for nontranslocated electrodes (p = 0.109). M– averaged 0.75 ± 0.18 mm for translocated electrodes and 0.45 ± 0.11 mm for nontranslocated electrodes (p = 0.016). Reduction in M– with translocation correction averaged 38%. In the in vivo case, translocation was successfully corrected in a single attempt. Conclusion: Scalar translocation of precurved CI electrodes can be corrected by removal and reinsertion. This significantly improves the perimodiolar positioning of these electrodes. There was a high rate of success (83%) in this cadaveric model as well as a successful in vivo attempt.
Advanced Biomarkers: Therapeutic and Diagnostic Targets in Urticaria
Authors: Zhang Yue , Zhang Hanyi , Du Shengyi , Yan Siyu , Zeng Jinrong
Published: April 2021

Urticaria is a type of skin disease characterized by rapid onset of hives (superficial dermis edema, erythema, pruritus, or burning sensation). According to whether the natural course exceeds 6 weeks, urticaria can be divided into acute and chronic urticaria (CU). At present, the evaluation of CU activity mainly depends on the Urticaria Activity Score (UAS), but the evaluation indicators are relatively single, and we need more reliable experimental data for evaluation. We typically summarize advanced biomarkers and several related pathogenic pathways discovered in recent years on urticaria, including the cell adhesion/chemotaxis pathway, interleukin (IL)-6/Janus tyrosine kinase/STAT pathway, IL-17/IL-23 pathway, basophil- and mast cell-related pathway, coagulation/fibrinolysis-related pathways, single-nucleotide polymorphism, and some other pathways. This review aims to find appropriate biomarkers so that we can evaluate disease activity, discover novel therapeutic targets, and predict the patients’ response more accurately to therapeutic agents.
Neuroprotective and Antioxidant Effects of Riparin I in a Model of Depression Induced by Corticosterone in Female Mice
Authors: Maia Oliveira Iris Cristina , Vasconcelos Mallmann Auriana Serra , Adelvane de Paula Rodrigues Francisco , Teodorio Vidal Laura Maria , Lopes Sales Iardja Stéfane , Rodrigues Gabriel Carvalho , Ferreira de Oliveira Natalia , de Castro Chaves Raquell , Cavalcanti Capibaribe Victor Celso , Rodrigues de Carvalho Alyne Mara , Maria de França Fonteles Marta , Chavez Gutierrez Stanley Juan , Barbosa-Filho José Maria , Florenço de Sousa Francisca Cléa
Published: April 2021

Background: Depression is a common, chronic, and often recurrent serious mood disorder. Conventional antidepressants present limitations that stimulate the search for new drugs. Antioxidant and neuroprotective substances are potential antidepressant agents. In this context, riparin I (RIP I) has presented promising results, emerging as a potential source of a new therapeutic drug. In this study, the antidepressant effect of RIP I was evaluated in an animal model of depression induced by corticosterone (CORT). The involvement of neuroprotective and antioxidant mechanisms in the generation of this effect was also assessed. Methods: Female mice were submitted to CORT for 21 days and treated with RIP I in the last 7 days. Behavioral and neurochemical analyses were performed. Results: The administration of RIP I reversed the depressive and psychotic-like behavior, as well as the cognitive impairment caused by CORT, in addition to regulating oxidative stress parameters and BDNF levels in depression-related brain areas. Conclusion: These findings suggest that RIP I can be a strong candidate for drugs in the treatment of depression.
Multimodale Bronchoskopie in der Rundherddiagnostik: Gewinnbringende Kombinationen ausloten
Authors: Kempa Axel Tobias
Published: April 2021

There are cases of peripheral lung nodules that are difficult to approach despite using ancillary diagnostic devices during multimodal bronchoscopy. The use of ultrathin bronchoscopes has shown superiority over standard thin bronchoscopes. We retrospectively evaluated whether substitution of the thin-bronchoscope by the ultrathin device during multimodal bronchoscopy improves lesion ultrasound visualization and diagnostic yield in patients with difficult-to-approach pulmonary lesions. The study comprised 44 out of 338 patients that underwent multimodal bronchoscopy at Matsusaka Municipal Hospital. The thin-bronchoscope with an external diameter of 4 mm was substituted by the ultrathin-bronchoscope with an external diameter of 3 mm when the radial endobronchial ultrasound showed that the probe position was not within the target lesion. The median diameter of the pulmonary tumors was 17.5 mm (range: 6.0–5.2.0 mm). The endobronchial ultrasound showed the probe’s position adjacent to the lesion in 12 cases and no visible lesion in 32 cases using a thin-bronchoscope. However, the endobronchial ultrasound views changed from adjacent to the lesion to within the lesion in nine cases, from no visible lesion to within the lesion in 17 cases, and from no visible lesion to adjacent to the lesion in nine cases after bronchoscope substitution. After substitution, the diagnostic yield was 80.8% in cases with the radial probe within the target lesion, 72.7% in cases with the probe adjacent to the target lesion, and 0% in cases with no visible lesion. The overall diagnostic yield was 65.9% after bronchoscope substitution. The substitution of the thin bronchoscope by the ultrathin device on a need basis improves the position of the radial endobronchial ultrasound probe and diagnostic yield of pulmonary lesions during multimodal diagnostic bronchoscopy.
Spontaneous Closure of Full-Thickness Macular Holes
Authors: Nawrocka (vel Michalewska) Zofia Anna , Nawrocka Zofia , Nawrocki Jerzy
Published: April 2021

Purpose: To describe retinal morphology and vision recovery after spontaneous closure of full-thickness macular hole (FTMH). Materials and Methods: Retrospective, observational study. From a database containing 750 FTMH, we included 23 cases. All patients had a complete ophthalmic examination. Swept-source optical coherence tomography angiography was performed. Results: Prior to spontaneous closure in 11 women and 12 men (mean age 67 years), the mean minimum FTMH diameter was 201 μm, and mean base FTMH diameter was 638 μm. Visual acuity improved from 0.29 Snellen to 0.47 Snellen (p = 0.001) after 6 months and showed no further improvement. Spontaneous closure of FTMH was associated with vitreous detachment in less than half of the cases. Irregularities in the deep vascular layer and hyporeflective areas in the choriocapillaris were noted. Discussion: Equal sex distribution of spontaneous closures (1:1) differs from the high prevalence of females seen in the literature. Complete visual recovery is uncommon in cases of spontaneous closure of FTMH. It might be explained by prolonged defects of the choriocapillaris layer. These findings, along with the evolution of the various morphologies reported in the study, could possibly suggest that delaying vitrectomy while hoping for spontaneous closure might not be justified.
Missing data handling for machine learning models
Authors: Erian Karim H. , Regalado Pedro H. , Conrad James M.
Published: April 2021

This paper discusses a novel algorithm for solving a missing data problem in the machine learning pre-processing stage. A model built to help lenders evaluate home loans based on numerous factors by learning from available user data, is adopted in this paper as an example. If one of the factors is missing for a person in the dataset, the currently used methods delete the whole entry therefore reducing the size of the dataset and affecting the machine learning model accuracy. The novel algorithm aims to avoid losing entries for missing factors by breaking the dataset into multiple subsets, building a different machine learning model for each subset, then combining the models into one machine learning model. In this manner, the model makes use of all available data and only neglects the missing values. Overall, the new algorithm improved the prediction accuracy by 5% from 93% accuracy to 98% in the home loan example.
Salud mental primaria para niños, niñas y adolescentes institucionalizados: perspectiva de equipos de salud
Authors: Fernández González Olga María , Irarrázaval Domínguez Matias , Ortega Beatriz , Carrasco Paula , Martínez Diaz Pablo , Rojas castillo Graciela , Mundt Adrian
Published: April 2021

(analítico)La salud mental de los niños, niñas y adolescentes institucionalizados en hogares es un desafío clínico y ético para Chile y América Latina. Con el objetivo de explorar experiencias y desafíos percibidos por profesionales de la atención primaria de salud que atienden esta población, se realizó una investigación cualitativa, utilizando un cuestionario con preguntas abiertas. Los datos se analizaron mediante teoría fundamentada. Los resultados mostraron que la atención era parcializada y discontinua. La información sobre el desarrollo vital, la familia, los contextos de vulneración e institucionalización era insuficiente y fragmentada. Además, existía escasa coordinación entre las instituciones que intervienen simultáneamente con los niños, niñas y adolescentes. Se discuten las implicancias para la formación de equipos de salud mental de la atención primaria de salud y la implementación efectiva del trabajo intersectorial y multinivel.
Palabras clave: Salud mental, salud pública, adolescencia vulnerada.
Estudios de juventudes: una revisión de investigaciones en Argentina, Brasil y Colombia, 2011-2019
Authors: Alvarado Sara Victoria , Vommaro Pablo , Patiño Jhoana , Borelli Silvia
Published: April 2021

(analítico)Se presenta una revisión documental sistemática de estudios de juventudes en Argentina, Brasil y Colombia entre el año 2011 y el 2019. Los resultados describen las condiciones de vida en las dimensiones social, cultural y política de las juventudes e identifican las tendencias investigativas en los estudios de juventudes en estos tres países. La discusión muestra que construcción social, política y cultural de las juventudes en la Argentina, Brasil y Colombia es entendida desde tres elementos: las condiciones de desigualdades y violencias estructurales en las que despliegan y producen sus vidas las y los jóvenes, una intensificación de las pluralidades y multiplicidades como marca generacional y la consolidación del sujeto juvenil como protagonista de la vida política y el conflicto social en contextos contemporáneos.
Palabras clave: Investigación, Argentina, Colombia, Brasil.
Nampt Potentiates Antioxidant Defense in Diabetic Cardiomyopathy
Authors: Oka Shin-ichi , Byun Jaemin , Huang Chun-yang , Imai Nobushige , Ralda Guersom , Zhai Peiyong , Xu Xiaoyong , Kashyap Sanchita , Warren Junco S. , Alan Maschek John , Tippetts Trevor S. , Tong Mingming , Venkatesh Sundararajan , Ikeda Yoshiyuki , Mizushima Wataru , Kashihara Toshihide , Sadoshima Junichi
Published: April 2021

Rationale:

Diabetic cardiomyopathy is accompanied by increased production of NADH, predominantly through oxidation of fatty acids and consequent increases in oxidative stress. The role of Nampt (nicotinamide phosphoribosyltransferase), the rate-limiting enzyme of the salvage pathway of nicotinamide adenine dinucleotide synthesis, in the development of diabetic cardiomyopathy is poorly understood.

Objective:

We investigated the role of endogenous and exogenous Nampt during the development of diabetic cardiomyopathy in response to high-fat diet (HFD) consumption and in the context of oxidative stress.

Methods and Results:

HFD consumption upregulated endogenous Nampt, and HFD-induced cardiac diastolic dysfunction, fibrosis, apoptosis, and proinflammatory signaling were alleviated in transgenic mice with cardiac-specific overexpression of Nampt. The alleviation of diastolic dysfunction observed in these mice was abolished by inhibition of NADP(H) production via NADK (NAD kinase) inhibition. Nampt overexpression decreased oxidation of GSH (glutathione) and Trx1 (thioredoxin 1) targets, dityrosine, and the accumulation of toxic lipids, including ceramides and diglycerides, in the presence of HFD consumption. Nampt overexpression upregulated not only NAD
+
(nicotinamide adenine dinucleotide) but also NADP
+
(nicotinamide adenine dinucleotide phosphate) and NADPH in the heart and in cultured cardiomyocytes, which, in turn, stimulated the glutathione and Trx1 systems and alleviated oxidative stress in the heart induced by HFD consumption. In cultured cardiomyocytes, Nampt-induced upregulation of NADPH was abolished in the presence of NADK knockdown, whereas that of NAD
+
was not. Nampt overexpression attenuated H
2
O
2
-induced oxidative inhibition of Prdx1 (peroxiredoxin 1) and mTOR (mammalian target of rapamycin) in an NADK-dependent manner in cultured cardiomyocytes. Nampt overexpression also attenuated H
2
O
2
-induced cell death, an effect that was partly abolished by inhibition of NADK, Trx1, or glutathione synthesis. In contrast, oxidative stress and the development of diabetic cardiomyopathy in response to HFD consumption were exacerbated in Nampt heterozygous knockout (Nampt
+/−
) mice.

Conclusions:

Nampt-mediated production of NAD
+
protects against oxidative stress, in part, through the NADPH-dependent reducing system, thereby alleviating the development of diabetic cardiomyopathy in response to HFD consumption.
Spending on Cardiovascular Disease and Cardiovascular Risk Factors in the United States: 1996 to 2016
Authors: Birger Maxwell , Kaldjian Alexander S. , Roth Gregory A. , Moran Andrew E. , Dieleman Joseph L. , Bellows Brandon K.
Published: April 2021

Background:

Spending on cardiovascular disease and cardiovascular risk factors (cardiovascular spending) accounts for a significant portion of overall US health care spending. Our objective was to describe US adult cardiovascular spending patterns in 2016, changes from 1996 to 2016, and factors associated with changes over time.

Methods:

We extracted information on adult cardiovascular spending from the Institute for Health Metrics and Evaluation’s disease expenditure project, which combines data on insurance claims, emergency department and ambulatory care visits, inpatient and nursing care facility stays, and drug prescriptions to estimate >85% of all US health care spending. Cardiovascular spending (2016 US dollars) was stratified by age, sex, type of care, payer, and cardiovascular cause. Time trend and decomposition analyses quantified contributions of epidemiology, service price and intensity (spending per unit of utilization, eg, spending per inpatient bed-day), and population growth and aging to the increase in cardiovascular spending from 1996 to 2016.

Results:

Adult cardiovascular spending increased from $212 billion in 1996 to $320 billion in 2016, a period when the US population increased by >52 million people, and median age increased from 33.2 to 36.9 years. Over this period, public insurance was responsible for the majority of cardiovascular spending (54%), followed by private insurance (37%) and out-of-pocket spending (9%). Health services for ischemic heart disease ($80 billion) and hypertension ($71 billion) led to the most spending in 2016. Increased spending between 1996 and 2016 was primarily driven by treatment of hypertension, hyperlipidemia, and atrial fibrillation/flutter, for which spending rose by $42 billion, $18 billion, and $16 billion, respectively. Increasing service price and intensity alone were associated with a 51%, or $88 billion, cardiovascular spending increase from 1996 to 2016, whereas changes in disease prevalence were associated with a 37%, or $36 billion, spending reduction over the same period, after taking into account population growth and population aging.

Conclusions:

US adult cardiovascular spending increased by >$100 billion from 1996 to 2016. Policies tailored to control service price and intensity and preferentially reimburse higher quality care could help counteract future spending increases caused by population aging and growth.
Lime Burning as a Religious Metaphor in Buddhist India
Authors: Hanneder Jürgen
Published: April 2021

The Buddhist author Ravigupta compares the destruction of afflictions, thought to come about through jñāna and samādhi, to a “sudhopala”, a limestone thrown into water for the production of quicklime. The article explores the realia and Sanskrit terminology behind the image and its intertextual ramifications.
Kalanchoe torrejacqii (Crassulaceae subfam. Kalanchooideae), a new species in K. subg. Bryophyllum from the Namorona River valley, Madagascar

Authors: SHTEIN RONEN , SMITH GIDEON F.
Published: April 2021

Kalanchoe torrejacqii (Crassulaceae subfam. Kalanchooideae) is described as a new phyllo-bulbiliferous species. It occurs in the Namorona River valley, near Ranomafana, southern Madagascar. Differences between K. torrejacqii and the partially sympatric K. laxiflora are discussed and the new species is contrasted with representatives of the K. rosei complex with which it shares some similarities. Kalanchoe torrejacqii is the most northern pink-flowered species among other such species that belong to the recently described K. sect. Invasores, to which K. laxiflora and representatives of the K. rosei complex also belong.
A new genus and two new species of Tarsonemidae (Acari: Heterostigmata) associated with bark beetles (Coleoptera: Curculionidae: Scolytinae) from Peru
Authors: KHAUSTOV ALEXANDER A. , PETROV ALEXANDER V. , KOLESNIKOV VASILIY B.
Published: April 2021

A new genus and species, Unguitarsonemus paradoxus n. gen., n. sp. and a new species, Pseudotarsonemoides peruviensis n. sp. (Acari: Trombidiformes: Tarsonemidae), are described based on phoretic females collected on bark beetles Phloeotribus pilula and Ph. biguttatus, respectively, from Peru. A key to species of the genus Pseudotarsonemoides is provided.
Lightning Occurrence and Casualties in U.S. National Parks
Authors: Holle Ronald L. , Brooks William A. , Cummins Kenneth L.
Published: April 2021

National park visitors travel primarily to view natural features while outdoors; however, visits often occur in warmer months when lightning is present. This study uses cloud-to-ground flashes from 1999 to 2018 and cloud-to-ground strokes from 2009 to 2018 from the National Lightning Detection Network to identify lightning at the 46 contiguous United States national parks larger than 100 km2. The largest density is 6.10 flashes per kilometer squared per year within Florida’s Everglades, and the smallest is near zero in Pinnacles National Park. The six most-visited parks are Great Smoky Mountains, Grand Canyon, Rocky Mountain, Zion, Yosemite, and Yellowstone. For each of these parks, lightning data are described by frequency and location as well as time of year and day. The four parks west of the Continental Divide have most lightning from 1 July to 15 September and from 1100 to 1900 LST. Each park has its own spatial lightning pattern that is dependent on local topography. Deaths and injuries from lightning within national parks have the same summer afternoon dominance shown by lightning data. Most casualties occur to people visiting from outside the parks’ states. The most common activities and locations are mountain climbing, hiking, and viewing canyons from overlooks. Lightning fatality risk, the product of areal visitor and CG flash densities, shows that many casualties are not in parks with high risk, while very small risk indicates parks where lightning awareness efforts can be minimized. As a result, safety advice should focus on specific locations such as canyon rims, mountains, and exposed high-altitude roads where lightning-vulnerable activities are engaged in by many visitors.
Transoral Laser-Assisted Diverticulectomy: Swallow Study Results after Complete Endoscopic Pouch Excision for Zenker’s Diverticulum
Authors: McMillan Ryan A. , Bowen Andrew J. , Wells Michael L. , Ekbom Dale C.
Published: April 2021

Objective:

Transoral endoscopic laser-assisted diverticulotomy (TELD) with diverticulectomy and diverticuloplasty (TELD + DD) for the management of Zenker’s diverticulum (ZD) has been utilized by our institution since 2016 in attempts to reduce residual pouch size. This technique involves complete endoscopic pouch excision with partial advancement of mucosal flaps. Our study compares the subjective outcomes, objective outcomes, and complication rates between TELD and TELD + DD.

Methods:

A retrospective cohort study was performed on patients who underwent TELD or TELD + DD by a single surgeon at a tertiary academic center (2013-2019). Videofluoroscopic swallow studies (VFSS) with esophagram, Eating Assessment Tool (EAT-10), Reflux Symptom Index (RSI), and Functional Outcome Swallowing Scale (FOSS) were collected at preoperative and 3 month follow-up visits. A single blinded reviewer recorded height, width, and depth of pre and postoperative pouches with volumetric analysis performed assuming an ellipsoid shape. Comorbidities, complications, postoperative course, and recurrence were recorded.

Results:

Of the 75 patients that met criteria, 27 underwent TELD + DD and 48 underwent TELD. Eighteen TELD + DD and 37 TELD had both pre and post-operative VFSS. TELD + DD and TELD had a 96 ± 7% and 87 ± 16% reduction in pouch volume, respectively ( t-test; P = .01). Complications (TELD + DD 7%, TELD 17%, fisher’s exact; P = .31) and final subjective outcomes after adjusting for initial were not significantly different between methods (EAT-10 with TELD + DD ∆ + 1.3, P = .18; RSI ∆ + 1.4, P = .29; FOSS ∆-0.02, P = .91). One short-term recurrence was reported with TELD.

Conclusion:

Use of TELD + DD is associated with a statistically significantly decreased residual pouch size with no significant difference in short-term subjective outcomes. Complication rates and short-term recurrence rates are comparable. Long-term recurrence rates will require further studies to characterize.

Level of Evidence:

Level 3.
Concordance between adolescents and parents on the Strengths and Difficulties Questionnaire: Analysis of an Australian nationally representative sample
Authors: Gray Emma J , Scott James G , Lawrence David M , Thomas Hannah J
Published: April 2021

Objective:

Differences between adolescent self-reported and parent-reported emotional and behavioural difficulties may influence psychiatric epidemiological research. This study examined concordance between adolescents and their parents about mental health symptoms using the Strengths and Difficulties Questionnaire.

Methods:

The study comprised a randomly selected, nationally representative sample of adolescents aged 11–17 years who participated in the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing ( N = 2967). Matched adolescent and parent responses across the five Strengths and Difficulties Questionnaire subscales (emotional problems, hyperactivity, peer problems, conduct problems and prosocial behaviour), as well as total difficulties and total impact scores were examined to estimate concordance. Concordance patterns were analysed by sex, after stratifying the sample by age group (younger adolescents: 11–14 years; older adolescents: 15–17 years).

Results:

Concordance was 86.7% for total difficulties, 77.5% for total impact and ranged from 82.4% to 94.3% across the five Strengths and Difficulties Questionnaire subscales. There were no differences in concordance between sexes on the total difficulties score. Older females were more likely to disagree with their parents about emotional problems compared to males of the same age. Younger males were more likely to disagree with their parents compared to same-aged females about peer problems, hyperactivity, conduct problems and prosocial skills, as well as the impact of their problems. Older males were more likely to disagree with their parents about their prosocial skills compared to older females.

Conclusion:

Overall, concordance between adolescents and parents on the Strengths and Difficulties Questionnaire was largely driven by the high proportion of respondents who reported having no problems. Discordance on a subscale increased as the prevalence of problems in a sex and age demographic subgroup increased. These findings highlight the need for a multi-informant approach to detect emotional and behavioural difficulties in adolescents, particularly when assessing the impact of symptoms, as this subscale had the lowest concordance.