bluuebunny/crossref_metadata_2025 huggingface dataset:
A method for mapping morphological convergence on three‐dimensional digital models: the case of the mammalian sabre‐tooth
Authors: Melchionna Marina , Profico Antonio , Castiglione Silvia , Serio Carmela , Mondanaro Alessandro , Modafferi Maria , Tamagnini Davide , Maiorano Luigi , Raia Pasquale , Witmer Lawrence M. , Wroe Stephen , Sansalone Gabriele
Published: May 2021

Morphological convergence can be assessed using a variety of statistical methods. None of the methods proposed to date enable the visualization of convergence. All are based on the assumption that the phenotypes either converge, or do not. However, between species, morphologically similar regions of a larger structure may behave differently. Previous approaches do not identify these regions within the larger structures or quantify the degree to which they may contribute to overall convergence. Here, we introduce a new method to chart patterns of convergence on three‐dimensional models using the R function conv.map. The convergence between pairs of models is mapped onto them to visualize and quantify the morphological convergence. We applied conv.map to a well‐known case study, the sabre‐tooth morphotype, which has evolved independently among distinct mammalian clades from placentals to metatherians. Although previous authors have concluded that sabre‐tooths kill using a stabbing ‘bite’ to the neck, others have presented different interpretations for specific taxa, including the iconic Smilodon and Thylacosmilus. Our objective was to identify any shared morphological features among the sabre‐tooths that may underpin similar killing behaviours. From a sample of 49 placental and metatherian carnivores, we found stronger convergence among sabre‐tooths than for any other taxa. The morphological convergence is most apparent in the rostral and posterior parts of the cranium. The extent of this convergence suggests similarity in function among these phylogenetically distant species. In our view, this function is most likely to be the killing of relatively large prey using a stabbing bite.
Challenging the regulators: Enforcement and appeals in financial regulation
Authors: Gava Roy
Published: May 2021

This article investigates the conditions under which regulatees challenge regulatory sanctions in court. Targets of enforcement have the right to make independent regulatory agencies (IRAs) accountable in court, but IRAs would prefer not to have their enforcement actions challenged. This article argues that, when deciding whether to contest regulators through appeals, regulatees consider the price of harming the regulatory relationship. Regulatory litigation is expected to be shaped by the type of enforcement measures at stake, the type of entity (i.e., firm or individual), and the kind of relation between firms and authorities (i.e., primary regulators). The empirical analysis relies on more than 3,700 cases from 18 financial regulators covering 13 European countries between 2004 and 2020. Results suggest that enforcement actions that impose costlier sanctions and target individuals are at higher risk of appeal; in contrast, firms sanctioned by their national primary regulators show less appetite for appeals.
Psychological needs matter more than social and organizational resources in explaining organizational commitment
Authors: Stan Rosana , Vîrgă Delia
Published: May 2021

This study investigates the effects of psychological needs satisfaction on teacher’s commitment, over and above the impact of social and organizational resources, by building a model based on the Job Demands‐Resources theory, Self‐Determination Theory, and Conservation of Resources Theory. Hierarchical multiple regressions with data obtained from a sample of 301 Romanian teachers (89% women) reveal that psychological needs satisfaction explains a significant amount of variance in teacher commitment, compared to the variance explained by social resources and organizational resources (affective and normative organizational commitment). These results highlight the role of needs’ satisfaction in predicting teachers’ commitment and provide valuable information for practitioners aiming to design interventions to increase teachers’ commitment.
Identification of the novel HLA‐B*40:125:03 allele in a Chinese bone marrow donor
Authors: Tao Sudan , He Yanmin , Wang Fang , He Ji , Zhu Faming
Published: May 2021

HLA‐B*40:125:03 shows a single nucleotide substitution at position 378 C > T when compared with HLA‐B*40:125:02.
The prognostic significance of metabolic tumour volume and total lesion glycolysis for dogs staged for appendicular osteosarcoma with fluorine‐18 fluorodeoxyglucose positron emission tomography/computed tomography
Authors: Griffin Lynn R. , Brody Ariel , Lee Ber‐In
Published: May 2021

Metabolic tumour volumes (MTV) and total lesion glycolysis (TLG) are metabolic parameters that are becoming more commonly reported in human medicine to quantify tumours detected on fluorine‐18 fluorodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT). In this retrospective study dogs afflicted with appendicular osteosarcoma that were staged with18F‐FDG PET/CT had MTV and TLG at a variety of set and fixed thresholds calculated by two observers. These values, along with SUVmax, were evaluated for prognostic significance in this population of dogs. There was excellent correlation between two observers for all values. Multiple volumetric parameters were significantly associated with survival. SUVmaxhad the highest sensitivity for survival and TLG at 2.5 SUV*cm3had the highest specificity for prediction of survival based on ROC calculations. The SUVmax, MTV at 2.5 SUV and TLG at 2.5 SUV*cm3were significantly different between dogs that survived more than or less than 1 year. This study is the first of its kind in veterinary medicine that retrospectively evaluated volumetric tumour values for prognostic significance and may provide a basis for standardized method of reporting18F‐FDG PET/CT results.
Axis spinous process malformations are commonly identified in a sample of English Bull Terriers without associated clinical signs
Authors: Frias João Miguel , De Decker Steven , Dirrig Helen , Fenn Joe
Published: May 2021

Congenital cervical vertebral malformations (CCVM) have been infrequently reported in veterinary medicine, with limited examples of axis spinous process malformations. The objective of this retrospective cross‐sectional study was to describe the radiological characteristics, prevalence, and clinical relevance of a characteristic axis vertebral malformation in a sample of English Bull Terriers (EBTs). Medical records and diagnostic imaging studies of the cervical vertebral column of EBTs presenting for any reason were reviewed and described. Based on evaluation of the images, EBTs were divided in two groups; axis spinous process malformation and normal cases. Referring veterinary surgeons were contacted for long‐term follow‐up information. A total of 27 cervical radiographs, 23 CT, and nine MRI studies from 53 EBTs were reviewed. An axis spinous process malformation, characterized by a linear defect of varying length along the base of the spinous process, was identified in 22 of 53 EBTs (41.5%). There was no significant difference in age, body weight, or sex (P < .05) between EBTs with and without the malformation. No traumatic causes or clinical signs were identified in EBTs with the malformation that could be directly attributed to it. To the authors’ knowledge, this is the first report of a malformation of the axis spinous process in a sample of EBTs. The malformation was not associated with clinical signs and should not be misinterpreted as a traumatic vertebral fracture or other pathology.
Multidetector CT and cone‐beam CT have substantial agreement in detecting dental and sinus abnormalities in equine cadaver heads
Authors: van Zadelhoff Claudia , Liuti Tiziana , Dixon Padraic M. , Reardon Richard J.M.
Published: May 2021

The performance of cone‐beam CT (CBCT) systems compared to conventional helical multidetector CT (MDCT) imaging of the equine head is unknown. The aim of this prospective, method‐comparison study was to compare the ability of CBCT and MDCT to detect abnormalities in equine cadaver heads. Eleven equine cadaver heads were scanned using a CBCT scanner and a 64‐slice MDCT scanner. Consensus evaluations for CBCT and MDCT scans were performed by three observers. Identified abnormalities were grouped into subcategories with a focus on dental abnormalities. Kappa agreement values between detected abnormalities for CBCT and MDCT methods were calculated. Of 468 teeth evaluated, 122 (26.1%) were found to have abnormalities (including in 58 infundibula and 7 pulps) using MDCT and 105 (22.4%) were found to have abnormalities (including in 52 infundibula and 2 pulps) using CBCT. The agreement between CBCT and MDCT was almost perfect for overall detection of dental abnormalities (k = 0.90) with k = 1 for diastema k = 0.95 for clinical crown abnormalities, and k = 0.93 for infundibular abnormalities. However, the detection of pulp changes by CBCT was only moderate k = 0.44. Increased scatter radiation, non‐calibrated Hounsfield Unit and artefacts in CBCT images made accurate identification of the pulp density difficult. In conclusion, CBCT results were similar to conventional MDCT for the majority of dental abnormalities, however, pulp abnormalities were not reliably identified using CBCT, potentially limiting its clinical use for detecting endodontic disease in its current form. Further comparison with more cases with confirmed dental disease and studies in clinical cases are warranted.
Computed tomography may be helpful in discriminating grass awn foreign body rhinitis from non‐foreign body rhinitis in dogs
Authors: Lafuma Francois , Baudin Tréhiou Clement , Bernardin Fanny , Blond Laurent
Published: May 2021

Grass awn foreign bodies are a common cause of rhinitis in dogs.  Early detection and complete removal of these foreign bodies are important for minimizing risks of long term complications. The objective of this retrospective, descriptive cross‐sectional study was to determine whether discriminating CT findings exist between dogs with grass awn foreign body rhinitis and dogs with non‐foreign body rhinitis. Computed tomography scans of 47 dogs with a confirmed diagnosis of non‐foreign body rhinitis (25 cases) or of a nasal grass awn foreign body (22 cases) were reviewed. In the latter group, grass seeds were visualized directly on CT images for one of 22 (5%) cases. Focal lysis was more strongly associated with the presence of a grass awn foreign body (P = .012, LR = 3.0) and widespread lysis (involving more than one‐third of the nasal cavity and/or bilateral) appeared associated with non‐foreign body rhinitis (P = .046, LR = 2.0). Maxillary recess filling was associated with non‐foreign body rhinitis (LR = 4.4) as was widespread lysis (LR = 2.0). Findings supported prioritizing grass awn foreign body rhinitis as a differential diagnosis for dogs with the former CT characteristics, even if a grass awn cannot be directly visualized.
Faecal bacterial contamination of rivers: Evolution, suitability, and health risk implications for recreational use
Authors: Arce‐Navarro Kenia Sarai , Castañeda‐Ruelas Gloria M. , Romero‐Quintana Jose G. , Rendon‐Maldonado Jose G. , Leon‐Sicairos Claudia R. , Jiménez‐Edeza Maribel
Published: May 2021

The suitability of rivers for recreational purposes is an important issue in public health and water management. A quantitative microbial risk assessment was conducted using a dataset of E. coli concentrations in three Sinaloa rivers from 2013 to 2018 to define the level of faecal contamination and estimate the risks of acquiring gastrointestinal infections (GI) from recreational exposure. Faecal contamination was conditioned by river flow or time (p > 0.05) and increase during summer in urban areas. The national laws classify these rivers as suitable for recreational activities. However, the dose‐response model estimated the probability of acquiring GI during recreational use (>1.0 × 10–4), which implies the occurrence of 283 and 788 GI annually in adults and children, respectively. This research exposes the risk for the development of GI in the population of the region, especially in children; and justifies the controlling microbiological quality of rivers used for recreational use.
Exposure of wild boar to Influenza A viruses in Bavaria: Analysis of seroprevalences and antibody subtype specificity before and after the panzootic of highly pathogenic avian influenza viruses A (H5N8)
Authors: Schülein Anika , Ritzmann Mathias , Christian Jürgen , Schneider Katharina , Neubauer‐Juric Antonie
Published: May 2021

Swine influenza A viruses (S‐IAV) circulate in wild boar populations worldwide. Subtypes primarily reflect those actually present within the respective pig industry. Accordingly, infections with swine H1N1, H1N2 and H3N2 have been reported for several regions of Germany. As pigs are susceptible not only to S‐IAV but also to avian and human influenza A viruses, it is necessary to consider the possibility that new reassortant viruses with pandemic potential may arise in these new hosts. Therefore, in this study the impact of recent IAV epidemics on antibody prevalences in Bavarian wild boar was assessed. Important events considered were the H1N1pdm09 pandemic, which affected humans and swine, and the highly pathogenic avian influenza (HPAI) H5N8 panzootic in 2016 and 2017, affecting wild and domestic birds. IAV seroprevalences were determined analysing 1,396 samples from before and after the H5N8 panzootic, from various regions in Bavaria, a large administrative region in the South of Germany. Taken together, seroprevalences varied markedly from 1.44% to 12.59%, relative to region and time. However, no discrete correlation was found to population density either in wild boar or in pigs. Antibodies against H1N1 were the most prevalent. In addition, antibodies were detected reacting against H1N2 and against H1pdmNx reassortant viruses, already known to circulate in domestic pigs in Bavaria and notably also against the avian influenza A virus H5N8; the latter in samples taken in 2017. These results confirm the exposure of wild boar to IAV of diverse origin and the increasing variability of S‐IAV present in the field. The necessity for continuous IAV surveillance not only of domestic swine but also of wildlife is emphasized.
Ecology of Arctic rabies: 60 years of disease surveillance in the warming climate of northern Canada
Authors: Simon Audrey , Beauchamp Guy , Bélanger Denise , Bouchard Catherine , Fehlner‐Gardiner Christine , Lecomte Nicolas , Rees Erin , Leighton Patrick A.
Published: May 2021

Rabies occurs throughout the Arctic, representing an ongoing public health concern for residents of northern communities. The Arctic fox (Vulpes lagopus) is the main reservoir of the Arctic rabies virus variant, yet little is known about the epidemiology of Arctic rabies, such as the ecological mechanisms driving where and when epizootics in fox populations occur. In this study, we provide the first portrait of the spatio‐temporal spread of rabies across northern Canada. We also explore the impact of seasonal and multiannual dynamics in Arctic fox populations and climatic factors on rabies transmission dynamics. We analysed data on rabies cases collected through passive surveillance systems in the Yukon, Northwest Territories, Nunavut, Nunavik and Labrador from 1953 to 2014. In addition, we analysed a large and unique database of trapped foxes tested for rabies in the Northwest Territories and Nunavut from 1974 to 1984 as part of active surveillance studies. Rabies cases occurred in all Arctic regions of Canada and were relatively synchronous among foxes and dogs (Canis familiaris). This study highlights the spread of Arctic rabies virus variant across northern Canada, with contrasting rabies dynamics between different yet connected areas. Population fluctuations of Arctic fox populations could drive rabies transmission dynamics in a complex way across northern Canada. Furthermore, this study suggests different impacts of climate and sea ice cover on the onset of rabies epizootics in northern Canada. These results lay the groundwork for the development of epidemiological models to better predict the spatio‐temporal dynamics of rabies occurrence in both wild and domestic carnivores, leading to better estimates of human exposure and transmission risk.
Detection of spatial and spatio‐temporal Salmonella Heidelberg and Salmonella Typhimurium human case clusters focused around licensed abattoirs in Ontario in 2015, and their potential relation to known outbreaks
Authors: Paphitis Katherine , Pearl David L. , Berke Olaf , McEwen Scott A. , Trotz‐Williams Lise
Published: May 2021

Salmonellosis is one of several zoonotic diseases for which individuals with occupational animal contact, including abattoir workers, are at an increased risk. If meat is contaminated during slaughter, this can increase the risk of enteric illness for consumers. In this study, we investigated whether reported cases of Salmonella Heidelberg and Typhimurium were clustered around abattoirs in Ontario in 2015 and whether there was any evidence (laboratory/exposure) to suggest an abattoir at the centre of a cluster might be the source of exposure. Data for each reported case of S. Heidelberg and S. Typhimurium in Ontario in 2015 were collected. Multi‐focused and non‐focused spatial and space‐time cluster detection tests were performed for each serotype, with and without cases linked to known outbreaks, using Poisson and space‐time permutation models. Focused tests included the location of abattoirs operational in all or part of 2015. Laboratory data and exposure information were used to explore the relatedness of cases within identified clusters. Focused spatial tests identified clusters of S. Heidelberg and S. Typhimurium around abattoirs. Focused space‐time permutation tests identified 2 significant space‐time clusters of S. Heidelberg; one cluster (n = 11 cases) included 8 of 9 cases associated with a known outbreak and the other cluster (n = 18 cases) was not part of a previously identified outbreak. Review of laboratory and risk factor information suggested that cases within each cluster shared a common exposure. Cases were not asked about goat or sheep meat consumption. The focused cluster test, particularly with the space‐time permutation model, could assist in identifying outbreaks associated with a particular physical location, such as an abattoir. Improvements to the current case investigation process, such as consistent collection and reporting of high‐risk occupation information and more detailed food consumption history, could assist in outbreak identification when coupled with this statistic.
Optimization of Airfoil Blend Limits With As-Manufactured Geometry Finite Element Models
Authors: Brown Jeffrey M. , Kaszynski Alex A. , Gillaugh Daniel L. , Carper Emily B. , Beck Joseph A.
Published: May 2021

Conventional airfoil blend repair limits are established using nominal, design intent geometry. This convention does not explicitly consider the inherent blade-to-blade structural response variation associated with geometric manufacturing deviations. In this work, we explore whether accounting for these variations leads to significant differences in blend depths and develop a novel approach to effectively predict blade-specific blend allowable. These blade-specific values maximize the part repairability according to their proximity to defined structural integrity constraints. The methodology is demonstrated on the as-manufactured geometry of an aerodynamic research rig compressor rotor. Geometric point cloud data of this rotor is used to construct as-built finite element models (FEMs) of each airfoil. The effect of two large blends on these airfoils demonstrates the opportunity of blade-specific blend limits. A new approach to determine each airfoil's blend repair capacity is developed that uses sequential least-squares quadratic programing and a parametric blended blade FEM that accounts for manufacturing geometry variations and variable blend geometry. A mesh morphing algorithm modifies a nominal geometry model to match the as-built airfoil surface and blend geometry. The numerical optimization maximizes blend depth values within the frequency, mode shape, and high cycle fatigue constraint boundaries. It is found that there are large variations in blend depth allowable between blades and competing structural integrity criteria are responsible for their limits. It is also found that, despite complex modal behavior caused by eigenvalue veering, the proposed optimization approach converges. The developed methodologies may be used in the future to extend blend limits, enable continued operations, and reduce sustainment costs.
Adsorption and reaction kinetics of SO2 on graphene: An ultrahigh vacuum surface science study
Authors: Stach Thomas , Johnson Melody C. , Stevens Samuel , Burghaus Uwe
Published: May 2021

The adsorption of sulfur dioxide, SO2, on graphene, epitaxially grown on Ru(0001) (short Gr/Ru), was studied at ultrahigh vacuum conditions, by thermal desorption spectroscopy, TDS, and Auger electron spectroscopy, AES. TDS detected the parent mass, i.e., a molecular adsorption/desorption pathway was present. However, deviations in the gas-phase fragmentation pattern and multimass TDS were observed. In addition, AES revealed adsorbed sulfur after TDS experiments. Thus, SO2 partially decomposed on Gr/Ru.
Work Pressures Stemming From School Authorities and Burnout Among Physical Education Teachers: The Mediating Role of Psychological Needs Thwarting
Authors: Franco Evelia , Cuevas Ricardo , Coterón Javier , Spray Christopher
Published: May 2021

Purpose: To examine the role of psychological need thwarting in mediating physical education teachers’ work pressures stemming from school authorities and burnout. Method: A total of 345 physical education teachers (M = 47.46; SD = 8.79) completed some online validated questionnaires. Results: Structural equation modeling first revealed that pressures from school authorities predicted needs thwarting which, in turn, predicted burnout. In a second model, in which burnout was deemed as a multidimensional construct, autonomy and competence thwarting was found to predict both emotional exhaustion and depersonalization. Discussion: These findings suggest that when teachers find themselves pressured by school authorities to act in certain way, they are more likely to feel more exhausted and to adopt more cynical attitudes toward their students due to the thwarting of their basic needs. Practical implications related to school and national policies are discussed. Conclusion: External pressures affect PE teachers’ emotional states and educational policies should address this issue.
An inverse-breathing encapsulation system for cell delivery
Authors: Wang Long-Hai , Ernst Alexander Ulrich , Flanders James Arthur , Liu Wanjun , Wang Xi , Datta Ashim K. , Epel Boris , Kotecha Mrignayani , Papas Klearchos K. , Ma Minglin
Published: May 2021

A cell encapsulation system generates oxygen from carbon dioxide for self-oxygenation.
A framework for highly multiplexed dextramer mapping and prediction of T cell receptor sequences to antigen specificity
Authors: Zhang Wen , Hawkins Peter G. , He Jing , Gupta Namita T. , Liu Jinrui , Choonoo Gabrielle , Jeong Se W. , Chen Calvin R. , Dhanik Ankur , Dillon Myles , Deering Raquel , Macdonald Lynn E. , Thurston Gavin , Atwal Gurinder S.
Published: May 2021

A computational framework expedites the identification and prediction of T cell antigen recognition.
Bond-selective imaging by optically sensing the mid-infrared photothermal effect
Authors: Bai Yeran , Yin Jiaze , Cheng Ji-Xin
Published: May 2021

Mid-infrared photothermal microscopy enables vibrational spectroscopic imaging at submicrometer spatial resolution.
Regulation of Wnt/PCP signaling through p97/VCP-KBTBD7–mediated Vangl ubiquitination and endoplasmic reticulum–associated degradation
Authors: Feng Di , Wang Jin , Yang Wei , Li Jingyu , Lin Xiaochen , Zha Fangzi , Wang Xiaolu , Ma Luyao , Choi Nga Ting , Mii Yusuke , Takada Shinji , Huen Michael S. Y. , Guo Yusong , Zhang Liang , Gao Bo
Published: May 2021

The abundance of core Wnt/PCP protein Vangl is regulated by the endoplasmic reticulum–associated degradation (ERAD) pathway.
FBPAII and rpoBC, the Two Novel Secreted Proteins Identified by the Proteomic Approach from a Comparative Study between Antibiotic-Sensitive and Antibiotic-Resistant Helicobacter pylori-Associated Gastritis Strains
Authors: Kittisenachai Suthathip , Rojpibulstit Panadda , Vilaichone Ratha-Korn , Gamnarai Pornpen , Phaonakrop Narumon , Suealek Nuchanart
Published: May 2021

Helicobacter pylori
infection is the leading cause of chronic gastritis, which can develop into gastric cancer. Eliminating
H. pylori
infection with antibiotics achieves the prevention of gastric cancer.
Geology of southeastern Barbados
Authors: Speed* Robert C. , Cheng† Hai
Published: May 2021

This chapter presents geological documentation of Quaternary (and perhaps older) event histories of southeastern Barbados. The Barbados Limestone is herein formally defined. A time-stratigraphic division of the Barbados Limestone in southeastern Barbados and the properties of the stratigraphic units are presented. A major finding of this study is that the marine terraces originated wholly by marine erosion, not by reef construction, and evolved in stages over a long duration.

The hydrology and thickness data of the Barbados Limestone are discussed, and hypotheses on causes of thickness variations are given. The study domain is divided into seven areas that contain a continuous flight of nine marine terraces preserved in various partial sequences. Discussions of these key seven areas in southeastern Barbados are supported by geologic maps at large scale and cross sections. Sections with VE > 1 display limestone stratigraphy and facies over relatively large lengths. Sections with VE = 1 show true structural configurations over short lengths. Detailed observations and radio isotopic dating of the limestone units permit differentiation and correlation among them.
Open transperitoneal partial nephrectomy in a horseshoe kidney
Authors: Romeo Alex , Spencer Evan , Baber Jacob , Ferretti Mark
Published: May 2021

We report the case of a 50-year-old Tibetan man who presented to an outpatient urology clinic after abdominal ultrasound for poorly defined abdominal pain demonstrated horseshoe kidney (HK) with a right moiety ~3.7 cm mass further characterised using contrast-enhanced CT scan (CECT). This dedicated imaging confirmed HK with a heterogeneously enhancing right upper pole 3.1 cm×3.7 cm×2.7 cm mass. Due to suspicion for aberrant vasculature on CECT, renovascular angiography was performed, which revealed recruitment of a right paravertebral vessel alongside two right renal moiety arteries and multiple right renal moiety veins. Based on vascular complexity and the surgical exposure required for arterial clamping, open transperitoneal right partial nephrectomy was preferred to minimally invasive techniques. Postoperative course was complicated by ileus, which resolved with standard management. Pathologic analysis revealed complete resection of a 5.0 cm Fuhrman grade II clear cell renal cell carcinoma.
Physical activity and cardiometabolic health in adolescents with type 2 diabetes: a cross-sectional study
Authors: Slaght Jana L , Wicklow Brandy Alexandra , Dart Allison B , Sellers Elizabeth A C , Gabbs Melissa , Carino Marylin , McGavock Jonathan M
Published: May 2021

Introduction

Youth living with type 2 diabetes display increased risk of cardiovascular disease (CVD). It is unclear if regular physical activity (PA) modifies this risk.

Research design and methods

We compared CVD risk factors in a cross-sectional study of 164 youth with type 2 diabetes stratified according to weekly vigorous-intensity PA. Outcomes were hemoglobin A1c (HbA1c), ambulatory blood pressure (BP; ambulatory 24-hour readings), plasma lipoproteins, and albuminuria. The main exposure, vigorous-intensity PA, was quantified with the Adolescent Physical Activity Recall Questionnaire.

Results

Youth were 15±3 years, and 78% lived rurally and 68% were female, with a mean body mass index (BMI) Z-score of 2.4±1.1 and a mean HbA1c of 9.6% ±2.6%. Youth who participated in regular vigorous-intensity PA (40%; n=67) achieved nearly twice the dose of PA than peers who did not (62 vs 34 metabolic equivalent score-hour/week, p=0.001). After adjusting for duration of diabetes, BMI Z-score, sex, and smoking, youth who engaged in vigorous-intensity PA displayed lower HbA1c (9.1% vs 9.9%, p=0.052), diastolic BP (70 mm Hg vs 73 mm Hg, p=0.002), diastolic load (20% vs 26%, p=0.023), and mean arterial pressure (87.3 mm Hg vs 90.3 mm Hg, p<0.01), compared with youth who did not. Compared with youth who did not participate in regular vigorous-intensity PA, those who did also displayed lower odds of albuminuria after adjusting for duration of diabetes, sex, smoking, rural residence, and BMI Z-score (adjusted OR: 0.40, 95% CI 0.19 to 0.84).

Conclusions

Among youth with type 2 diabetes, participation in vigorous-intensity PA is associated with lower CVD risk.
Virtual reality as a distraction therapy in obstetrics and gynaecology
Authors: Harper Alice M , Wastnedge Elizabeth , Sivanathan Aparajithan , Jordan Aileen , Harper Samuel , Lim Theodore , Denison Fiona C
Published: May 2021

Background

Virtual reality (VR) is an effective distraction therapy across a variety of healthcare settings but there is minimal research on its potential applications within obstetrics and gynaecology.

Aim

To explore the acceptability and preferences for VR as distraction therapy within obstetrics and gynaecology.

Methods

Questionnaires were developed and administered to seek both obstetric and gynaecology women’s and staff members’ opinions on VR use within clinical settings and hardware and software options. Likert scales were used to explore opinions on VR. Data were analysed by descriptive statistics.

Results

247 questionnaires were completed (90 obstetric and 157 gynaecology). On average 57% of women and 75% of staff felt positively about trialling VR within obstetric and gynaecology clinical settings. For hardware, glasses were the preferred head equipment but there were no clear preferences for image viewing. For software, ‘beach’ was the most popular environment and accompanying audio favoured. Women’s and staff members’ opinion on complete immersion was largely negative.

Conclusions

There is wide acceptability for VR within obstetrics and gynaecology. Differing opinions for specific hardware and software preferences prompts consideration of clinical settings, end-users and healthcare professionals in the design of future VR technologies and clinical trials for obstetrics and gynaecology.
Iodine status in women attending Mnazi Mmoja Hospital in Zanzibar: a matched case-control study
Authors: Bysheim Olivia , Vogt Elinor Margrethe Chelsom , Engebretsen Ingunn Marie S , Kassim Mohammed Naufal , Storaas Torgeir , Rosendahl-Riise Hanne
Published: May 2021

Background

Iodine deficiency can have adverse health effects in all age groups affecting growth, development and cognitive functions as well as the incidence of goitre. Worldwide, the most important dietary source of iodine is iodised salt. In Tanzania, iodine intake has varied due to multiple salt suppliers producing iodised salt with varying quality. Zanzibar has faced challenges with the packing, storing and monitoring of salt iodisation, and universal salt iodisation has not been achieved. Furthermore, the number of available studies on the iodine status in Zanzibar are sparse.

Objective

The main objective of this study is to describe the iodine status of euthyroid female adult patients with and without goitre in Zanzibar.

Design and methods

A single-centre matched case-control study was conducted among 48 female patients at the ear, nose and throat clinic of Mnazi Mmoja Hospital, Zanzibar. Blood samples were drawn for serum-analysis of the thyroid hormone profile to confirm that all patients were euthyroid prior to inclusion. Urinary iodine concentrations and the iodine concentration in household salt samples were analysed. A semiquantitative food frequency questionnaire (FFQ) was used to describe trends in the dietary intake of iodine-rich and goitrogenic foods. Clinical examinations were conducted, and the patients were categorised into goitre (cases) and non-goitre (controls) groups.

Results

A moderate iodine deficiency (median urinary iodine concentration between 20 and 49 µg/L) was found in patients both with and without goitre. In total, only 35 % of the salt samples were adequately iodised. The salt samples from the cases had a lower average concentration of iodine compared with the controls. The FFQ revealed that the daily consumption of marine fish and the weekly consumption of raw cassava were more frequent in the cases than the controls.

Conclusion

These findings suggest that iodine deficiency may be a problem in both patients with and without goitre in Zanzibar. The salt iodisation programme may require monitoring and implementation of satisfactory quality control practices as universal salt iodisation is yet to be achieved in Zanzibar.
Development of social contact and loneliness measures with validation in social prescribing
Authors: Benson Tim , Seers Helen , Webb Nicola , McMahon Philippa
Published: May 2021

Aims

This paper describes two patient-reported measures of social contact and loneliness, which are closely related concepts. The first measure (R-Outcomes Social Contact measure) was developed from scratch, based on customer needs and literature review. It covers emotional and social aspects using positive terms. The second measure (R-Outcomes Loneliness measure) is adapted from the GSS Loneliness Harmonised Standard. Both measures are patient-reported outcome measures, based on patients’ own perception of how they feel.

Method

This development started in 2016 in response to customers’ requests to measure social contact/loneliness for patients in social prescribing projects.

Both measures are compared with three other loneliness measures (the GSS Loneliness Harmonised Standard, De Jong Gierveld and Campaign to End Loneliness). Both measures are short (36 and 21 words, respectively). Mean improvement is reported as a positive number on a 0–100 scale (where high is good).

We tested the psychometric performance and construct validity of the R-Outcomes Social Contact measure using secondary analysis of anonymised data collected before and after social prescribing interventions in one part of Southern England.

Results

In the validation study, 728 responses, collected during 2019–2020, were analysed. 90% were over 70 years old and 62% women. Cronbach’s α=0.76, which suggests that it is appropriate to use a single summary score. Mean Social Contact scores before and after social prescribing intervention were 59.9 (before) and 66.7 (after, p<0.001).

Exploratory factor analysis shows that measures for social contact, health status, health confidence, patient experience, personal well-being, medication adherence and social determinants of health are correlated but distinct factors. Construct validation shows that the results are consistent with nine hypotheses, based on the loneliness literature.

Conclusion

The R-Outcomes Social Contact measure has good psychometric and construct validation results in a population referred to social prescribing. It is complementary to other R-Outcomes measures.
Autoimmune hepatitis and acquired partial lipodystrophy
Authors: Bakewell Christopher , Dayasiri Kavinda , Brown Rachel M , Rodrigues Astor , Williams Rachel , Anand Geetha , Gupte Girish L
Published: May 2021

The lipodystrophies are an extremely rare group of metabolic conditions which are categorised based on their pathogenesis and phenotype. While primarily known for the striking loss of subcutaneous adipose tissue which they induce, they may also be associated with significant liver injury. In most cases, this results from the secondary deposition of lipid within hepatic parenchyma and is seen predominantly in generalised lipodystrophy. More rarely, patients may develop autoimmune hepatitis. We report a rare case of a 17-month-old boy who developed features of acquired partial lipodystrophy in association with anti-LKM1-positive autoimmune hepatitis following initial presentation with a Henoch-Schönlein purpura-like illness. We describe his challenging path to diagnosis and discuss his ongoing management in an effort to further our understanding of this rare but significant association. This report highlights the need for close clinical observation and a high index of suspicion for recognising early features of lipodystrophy.
Exercise capacity in patients with repaired Tetralogy of Fallot aged 6 to 63 years
Authors: Eshuis Graziella , Hock Julia , Marchie du Sarvaas Gideon , van Duinen Hiske , Neidenbach Rhoia , van den Heuvel Freek , Hillege Hans , Berger Rolf MF , Hager Alfred
Published: May 2021

Objectives

This study aimed to provide a perspective for the interpretation of exercise capacity (peakVO2) in patients with repaired Tetralogy of Fallot (patients with rTOF) by describing the course of peakVO2from patients aged 6–63 years.

Methods

A retrospective study was performed between September 2001 and December 2016 in the German Heart Centre Munich, Germany, and in the University Medical Centre Groningen, the Netherlands. A total of 1175 cardiopulmonary exercise tests (CPETs) were collected from 586 patients with rTOF, 46% female. Maximal exertion was verified using a respiratory exchange ratio ≥1.00. PeakVO2was modelled using time-dependent multilevel models for repeated measurements (n=889 in 300 patients), and compared with subject-specific reference values calculated by the models of Bongerset aland Myliuset al.

Results

The peakVO2of patients with rTOF was reduced at all ages. At the age of 6, the peakVO2was 614 mL/min (70% of predicted (95% CI 67 to 73)). The reduced increase in peakVO2during adolescence resulted in a significant lower maximum peakVO2of 1209 mL/min at 25 years (65% predicted, p<0.001). A linear decline after 25 years was observed in patients and references, although patients showed an accelerated decline, with a -0.24% point of predicted (95% CI 0.11 to 0.38) per year without differences between sexes (p=0.263).

Conclusions

This study provides a context for peakVO2across ages in patients with rTOF under contemporary treatment strategies. It showed that the reduction in peakVO2originates from childhood and declines over time. Sex differences in patients with rTOF were similar to natural existing sex differences.
Ramadan fasting: recommendations for patients with cardiovascular disease
Authors: Akhtar Abid Mohammed , Ghouri Nazim , Chahal C. Anwar A , Patel Riyaz , Ricci Fabrizio , Sattar Naveed , Waqar Salman , Khanji Mohammed Yunus
Published: May 2021

Ramadan fasting is observed by most of the 1.8 billion Muslims around the world. It lasts for 1 month per the lunar calendar year and is the abstention from any food and drink from dawn to sunset. While recommendations on ‘safe’ fasting exist for patients with some chronic conditions, such as diabetes mellitus, guidance for patients with cardiovascular disease is lacking. We reviewed the literature to help healthcare professionals educate, discuss and manage patients with cardiovascular conditions, who are considering fasting. Studies on the safety of Ramadan fasting in patients with cardiac disease are sparse, observational, of small sample size and have short follow-up. Using expert consensus and a recognised framework, we risk stratified patients into ‘low or moderate risk’, for example, stable angina or non-severe heart failure; ‘high risk’, for example, poorly controlled arrhythmias or recent myocardial infarction; and ‘very high risk’, for example, advanced heart failure. The ‘low-moderate risk’ group may fast, provided their medications and clinical conditions allow. The ‘high’ or ‘very high risk’ groups should not fast and may consider safe alternatives such as non-consecutive fasts or fasting shorter days, for example, during winter. All patients who are fasting should be educated before Ramadan on their risk and management (including the risk of dehydration, fluid overload and terminating the fast if they become unwell) and reviewed after Ramadan to reassess their risk status and condition. Further studies to clarify the benefits and risks of fasting on the cardiovascular system in patients with different cardiovascular conditions should help refine these recommendations.
Research on Innovation Management of Science and Technology Innovation Team Members Based on Constructive Conflict Evolution Game
Authors: Wan Tao , Wang Qi , Xu Ketong , Zhao Jiaqi , Otsuki Hiroshi
Published: May 2021

How to give full play to the positive function of constructive conflicts (task conflicts and process conflicts) in the science and technology innovation team, give appropriate stimulation, mobilize the enthusiasm of employees and improve the team's innovative ability to improve team performance and organizational effectiveness are issues that deserve both team leaders’ and scholars’ attention. Through selecting multiple medical technology R&D personnel from a specific science and technology innovation team of health organization, the research studies the constructive conflicts among the members of the science and technology innovation team, constructs and analyzes the conflict evolution game model, proposes countermeasures and suggestions for improving the innovation ability of the science and technology innovation team and discusses the innovation management mechanism of the science and technology innovation team. The study shows that task conflicts, process conflicts and innovation game decisions cannot be avoided. The unstable choice of members does not promote innovation. However, on the one hand, constructive conflicts can be controlled to maintain a moderate state of control. On the other hand, it is also necessary to establish a mutually trusting communication environment and convenient communication channels in the science and technology innovation team, combined with modern information management technology, to handle the problems that were difficult to be found or accumulated for a long time under the previous management mechanism and cooperate with the science and technology innovation team to improve the technology innovation team's innovation capability.
Limits of remote working: the ethical challenges in conducting Mental Health Act assessments during COVID-19
Authors: Schölin Lisa , Connolly Moira , Morgan Graham , Dunlop Laura , Deshpande Mayura , Chopra Arun
Published: May 2021

COVID-19 has created additional challenges in mental health services, including the impact of social distancing measures on care and treatment. For situations where a detention under mental health legislation is required to keep an individual safe, psychiatrists may consider whether to conduct an assessment in person or using video technology. The Mental Health (Care and Treatment) (Scotland) Act 2003 does not stipulate that an assessment has to be conducted in person. Yet, the Code of Practice envisions that detention assessments would be conducted face to face in all circumstances. During the pandemic, the Mental Welfare Commission for Scotland, a statutory body with a duty to promote best practice of the Act, has been asked whether it may be acceptable and indeed preferable for some assessments to be conducted via video technology. Where an assessment is needed to determine if a patient needs to be detained, and where there is a need for social distancing or the need for ‘shielding’, remote assessments may in some circumstances be preferable. In this article, we outline the modification of the Mental Welfare Commission’s previous outright rejection of virtual assessments as the pandemic progressed and discuss the ethical and legal issues the possibility of remote assessments has exposed. We also discuss the limits and when a virtual assessment is not considered ethical. As the pandemic moves from a state of emergency into a ‘new normal’ in psychiatric services during second, or subsequent, waves, the use and place (if any) of remote assessments for detention needs to be considered.
Complexities in interdisciplinary community engagement projects: some reflections and lessons from an applied drama and theatre project in diabetes care
Authors: Watermeyer Jennifer , Hume Victoria Jane , Seabi Tshegofatso , Nattrass Rhona
Published: May 2021

There is a growing interest in using drama techniques and theatrical performance to disseminate health information to lay audiences as part of community engagement projects. This process can be challenging for a number of reasons, however. In this paper, we describe the process and pitfalls of an interdisciplinary project involving the development and performance of a play about diabetes mellitus. The play formed part of a long-term, three-way community engagement project between social science, applied drama and a diabetes clinic in South Africa. Building on a framework derived from a number of applied drama methods, we elicited narratives from key ‘storytellers’ that were developed and embodied by actors in a new performance calledBlood Sugars. Creating this play provided insight into working in an interdisciplinary space and highlighted the importance of establishing shared goals and joint ownership of the project right from the outset. This was without doubt a challenging project and the complexities of finding common ground across three disciplines are not to be underestimated. In this paper, we explore the collaboration and its challenges, drawing on the framework of complexity theory. In particular, we examine the layers of complexity that emerged as a result of the interdisciplinary nature of the project and the demands of balancing the authenticity of the stories with the perceived requirements of health messaging. We consider the methodological, conceptual and ethical challenges of this type of research, and discuss some recommendations for teams taking on similar complex multidisciplinary research and intervention projects.
Advances in mass spectrometry for molecular characterization of oil sands naphthenic acids and process chemicals in wetlands
Authors: Headley John V. , Peru Kerry M. , Vander Meulen Ian
Published: May 2021

Advances in mass spectrometry in the authors’ and key collaborators’ research are reviewed for analysis of oil sands naphthenic acids fraction compounds (NAFCs) and industrial process chemicals, sulfolane and alkanolamines, in wetlands. Focus is given to developments of analyses of NAFCs in constructed wetland treatment systems and natural wetlands in the Athabasca oil sands region, Alberta, Canada. The analytical developments are applied to show the utility of wetlands to sequester and oxidize oil sands naphthenic acids. The advancements in molecular characterization led to the first application of high-resolution mass spectrometry (Fourier transform ion-cyclotron resonance and Orbitrap mass spectrometry) for elucidation of toxic mono- and di-carboxylic NAFCs in oil sands environmental samples. Key findings reveal that oil sands NAFCs are not limited to saturated structures but contain a diverse range of components, many of which contain S, N, heteroatomic species and aromatic species. Other developments of mass spectrometry methods for industrial process chemicals show for the first time that the completely water-miscible chemical, sulfolane, translocate to upper portions of cattails at natural wetland sites in the Canadian environment. Likewise, wetland-plant mediated changes of complex mixtures of alkanolamines were revealed based on the coupling of ion chromatography mass spectrometry and ultrahigh resolution mass spectrometry. The advances in mass spectrometry are of particular benefit to Canada, for development of soil and water quality guidelines for oil sands NAFCs and process chemicals. In turn, the water quality guidelines serve to protect Canadian aquatic environments.