bluuebunny/crossref_metadata_2025 huggingface dataset:
Using multi-source data to understand the factors affecting mini-park visitation in Yancheng
Authors: Zhou Conghui , Fu Leshan , Xue Yanwen , Wang Zhijie , Zhang Yu
Published: July 2021

Mini-parks are becoming a popular form of outdoor recreational space in densely populated areas, largely because their small size makes site selection easier than for ordinary parks. However, existing studies on mini-parks are limited because most of them rely on data collected through traditional surveys, which are severely restricted by space and time. In this study, we utilised Tencent user density data – a type of space–time synchronous data with high spatial resolution – to trace mini-park visitation in the main city of Yancheng, China, and we integrated data about land use, points of interest, transportation, demographics and housing prices to measure the parks’ surrounding features. We investigated how factors relating to the parks’ spatial and internal attributes, surrounding physical features and surrounding socio-economic features affected the number of park visits during the week versus during the weekend by establishing a series of multiple linear regression models. The results showed that higher resident population, more surrounding public toilets and larger open site promoted mini-park visits while distance to the city centre, surrounding large parks and main roads discouraged mini-park visits. This study also found that the effects of weekend visitation factors were more complex than those of weekday visitation factors. These findings can help urban green space planners and decision makers to efficiently allocate mini-parks to areas where they will be most effective.
First Tarsometatarsal Joint Loading After Sequential Correction of Hallux Valgus Using a Proximal Opening Wedge Metatarsal Osteotomy and Distal Soft Tissue Procedure
Authors: Kraus Jonathan , Ziegele Michael J. , Wang Mei , Law Brian
Published: July 2021

Background:

The proximal opening wedge osteotomy (POWO) of the first metatarsal (TMT-1) is commonly performed in the operative treatment of hallux valgus. Limited work has been dedicated to study POWO’s effect on the TMT-1 joint, however. The purpose of this study is to evaluate the changes in TMT-1 joint contact stress following POWO of the first metatarsal.

Methods:

Five fresh-frozen cadaveric below-knee specimens (mean age: 73 years) with hallux valgus deformities (mean hallux valgus angle [HVA]: 37.4 ± 8.5 degrees) were studied. The specimens were loaded to 400 N on an MTS servohydraulic load frame. Joint contact characteristics at TMT-1 joint were measured with a Tekscan pressure sensor (Model 6900, 1100 psi; Tekscan Inc, Boston, MA) with various opening wedge sizes of 3, 5, and 7 mm both without and with a distal soft tissue release (DSTR). The contact force, area, and peak contact stress were compared among groups using analysis of variance and post hoc multiple comparisons over the untreated (Dunnett test, P < .05).

Results:

The mean contact force was 47.7 ± 33.5 N for untreated specimens. This increased sequentially with opening wedge size and reached statistical significance for 7-mm opening wedge (129.7 ± 62.3 N, P = .01) and 7-mm wedge + DSTR (134.8 ± 60.5 N, P = .008). The mean peak contact stress was 2.8 ± 1.3 MPa for the untreated specimens and increased incrementally with wedge size to 5.7 ± 3.0 MPa for 7-mm wedge only ( P = .03) and 5.6 ± 2.5 MPa for 7-mm wedge + DSTR ( P = .05). The contact area increased with corrections, but none reached significance.

Conclusion:

With increasing opening wedge size, loading of the TMT-1 joint increases. Joint stresses higher than 4.7 MPa have been shown to be chondrotoxic, potentially predisposing patients to arthritic joint changes following POWO.

Level of Evidence:

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From sustainable development to social-ecological justice: Addressing taboos and naturalizations in order to shift perspective
Authors: Grossmann Katrin , Connolly James JT , Dereniowska Małgorzata , Mattioli Giulio , Nitschke Luca , Thomas Nicola , Varo Anaïs
Published: July 2021

While sustainability was introduced as a game-changing idea, it has often been criticized for its vagueness and its over-accommodating bent toward powerful, vested interests, economic growth, and profit seeking—or, on the contrary, for not being able to enter mainstream politics. As a result, in the current political climate, sustainability policies seem to be everywhere, but so does the social and ecological critique of these policies.

In this article, we articulate the seeds of an emerging cross-sectoral shift away from sustainability and toward social-ecological justice. Coming from a multidisciplinary background, we explore commonalities in the shortcomings of sustainability agendas and identify discursive barriers to change across three critical fields: transport, energy, and urban greening. Within each of these fields, we observe an upswing of scholarly work addressing the pitfalls and trade-offs of sustainability, but we also show how taboos and naturalizations embedded in these fields hinder adequately questioning the economy’s role in sustainability thinking and action.

To develop our argument that there is an emerging cross-sectoral push away from sustainability agendas and toward social-ecological justice goals, we briefly examine the current state of the wider sustainability discourse together with its critique from a social and ecological justice angle. We then review relevant academic work across the applied fields of transport, energy, and urban greening, focusing on the normative and analytical aspects dealt with, and how they address and conceptualize tensions between the different dimensions of sustainability. In the concluding section, we highlight how a focus on sectoral and local tensions between ecological, economic, and social policy goals uncovers the ways in which injustices or environmental degradation are continually reproduced, despite the sustainability framework. We conclude with suggestions for thinking and acting under the umbrella of social-ecological justice.
Shake table tests of seven-story reinforced concrete structures with torsional irregularities: Test program and datasets
Authors: Suzuki Tomomi , Puranam Aishwarya Y , Elwood Kenneth J , Lee Hung-Jen , Hsiao Fu-Pei , Hwang Shyh-Jiann
Published: July 2021

The shake table tests presented in this article aims to explore seismic displacement demands for existing reinforced concrete buildings resulting from inelastic torsion associated with different sources of irregularities. Two half-scale seven-story reinforced concrete structures were subjected to unidirectional earthquake excitations on the shake table at the National Center for Research on Earthquake Engineering (NCREE) Tainan laboratory. The specimens reflected structural weaknesses of buildings which collapsed during the Meinong earthquake in Taiwan. This data paper presents an overview of the project as well as the organization of obtained test datasets. The data are available for public use under the Designsafe-CI project “Shake table tests of seven-story reinforced concrete structures with torsional irregularities.”
Ground-motion model for subduction earthquakes in northern South America
Authors: Arteta Carlos A , Pajaro Cesar A , Mercado Vicente , Montejo Julián , Arcila Mónica , Abrahamson Norman A
Published: July 2021

Subduction ground motions in northern South America are about a factor of 2 smaller than the ground motions for similar events in other regions. Nevertheless, historical and recent large-interface and intermediate-depth slab earthquakes of moment magnitudes Mw = 7.8 (Ecuador, 2016) and 7.2 (Colombia, 2012) evidenced the vast potential damage that vulnerable populations close to earthquake epicenters could experience. This article proposes a new empirical ground-motion prediction model for subduction events in northern South America, a regionalization of the global AG2020 ground-motion prediction equations. An updated ground-motion database curated by the Colombian Geological Survey is employed. It comprises recordings from earthquakes associated with the subduction of the Nazca plate gathered by the National Strong Motion Network in Colombia and by the Institute of Geophysics at Escuela Politécnica Nacional in Ecuador. The regional terms of our model are estimated with 539 records from 60 subduction events in Colombia and Ecuador with epicenters in the range of −0.6° to 7.6°N and 75.5° to 79.6°W, with Mw≥4.5, hypocentral depth range of 4 ≤  Zhypo ≤ 210 km, for distances up to 350 km. The model includes forearc and backarc terms to account for larger attenuation at backarc sites for slab events and site categorization based on natural period. The proposed model corrects the median AG2020 global model to better account for the larger attenuation of local ground motions and includes a partially non-ergodic variance model.
Placental Thrombus After Maternal COVID-19 Infection: A Case Study
Authors: Wernlein Shelley M.
Published: July 2021

A 34-year-old patient developed an area of thrombus within her placenta. This resulted in severe fetal growth restriction which physicians felt was due to contracting and recovering from the coronavirus disease (COVID-19), during her pregnancy. Serial sonograms demonstrated a slowing of fetal growth and an area of thrombosis within the placenta. This was confirmed by pathologic examination of the placenta after delivery. Since COVID-19 and pregnancy are both known hypercoagulable states, it is vital for the ultrasonographer to recognize thrombosis in the placenta. It is also important to understand the possible pregnancy outcomes, based on the location and appearance of a nonvascular placental lesion.
The Mediating Role of Project Citizenship Behavior in the Relationship Between Organizational Justice Dimensions and Project Success
Authors: Shafi Muhammad Qaiser , Iqbal Rimsha , Shahzad Khurram , Unterhitzenberger Christine
Published: July 2021

The impact of behavioral aspects on project success remains an area that requires more attention. Drawing on the social exchange theory (SET), our study tested the mediating role of project citizenship behavior (PCB) in the relationships of all four organizational justice dimensions (i.e., procedural, distributive, informational, and interpersonal justice) with project success. A time-lagged survey of project team members ( n = 233) was conducted and analyzed through structural equation modeling (SEM). The results indicate that all four organizational justice dimensions are positively associated with project success, whereas informational justice appears to be the most influential dimension, and that PCB mediates all of these relationships. Project managers/sponsors should enact organizational justice and enhance project citizenship to achieve project success.
RPS15 mutations rewire RNA translation in chronic lymphocytic leukemia
Authors: Ntoufa Stavroula , Gerousi Marina , Laidou Stamatia , Psomopoulos Fotis , Tsiolas Georgios , Moysiadis Theodoros , Papakonstantinou Nikos , Mansouri Larry , Anagnostopoulos Achilles , Stavrogianni Niki , Pospisilova Sarka , Plevova Karla , Makris Antonios M. , Rosenquist Richard , Stamatopoulos Kostas
Published: July 2021

Recent studies of chronic lymphocytic leukemia (CLL) have reported recurrent mutations in the RPS15 gene, which encodes the ribosomal protein S15 (RPS15), a component of the 40S ribosomal subunit. Despite some evidence about the role of mutant RPS15 (mostly obtained from the analysis of cell lines), the precise impact of RPS15 mutations on the translational program in primary CLL cells remains largely unexplored. Here, using RNA sequencing and ribosome profiling, a technique that involves measuring translational efficiency, we sought to obtain global insight into changes in translation induced by RPS15 mutations in CLL cells. To this end, we evaluated primary CLL cells from patients with wild-type or mutant RPS15 as well as MEC1 CLL cells transfected with mutant or wild-type RPS15. Our data indicate that RPS15 mutations rewire the translation program of primary CLL cells by reducing their translational efficiency, an effect not seen in MEC1 cells. In detail, RPS15 mutant primary CLL cells displayed altered translation efficiency of other ribosomal proteins and regulatory elements that affect key cell processes, such as the translational machinery and immune signaling, as well as genes known to be implicated in CLL, hence highlighting a relevant role for RPS15 in the natural history of CLL.
Practical Options for Adopting Recurrent Neural Network and Its Variants on Remaining Useful Life Prediction
Authors: Wang Youdao , Zhao Yifan , Addepalli Sri
Published: July 2021

The remaining useful life (RUL) of a system is generally predicted by utilising the data collected from the sensors that continuously monitor different indicators. Recently, different deep learning (DL) techniques have been used for RUL prediction and achieved great success. Because the data is often time-sequential, recurrent neural network (RNN) has attracted significant interests due to its efficiency in dealing with such data. This paper systematically reviews RNN and its variants for RUL prediction, with a specific focus on understanding how different components (e.g., types of optimisers and activation functions) or parameters (e.g., sequence length, neuron quantities) affect their performance. After that, a case study using the well-studied NASA’s C-MAPSS dataset is presented to quantitatively evaluate the influence of various state-of-the-art RNN structures on the RUL prediction performance. The result suggests that the variant methods usually perform better than the original RNN, and among which, Bi-directional Long Short-Term Memory generally has the best performance in terms of stability, precision and accuracy. Certain model structures may fail to produce valid RUL prediction result due to the gradient vanishing or gradient exploring problem if the parameters are not chosen appropriately. It is concluded that parameter tuning is a crucial step to achieve optimal prediction performance .
Genome-wide characterization of MATE gene family and expression profiles in response to abiotic stresses in rice (Oryza sativa)
Authors: Du Zhixuan , Su Qitao , Wu Zheng , Huang Zhou , Bao Jianzhong , Li Jianbin , Tu Hang , Zeng Chuihai , Fu Junru , He Haohua
Published: July 2021

Multidrug and toxic compound extrusion (MATE) proteins are involved in many physiological functions of plant growth and development. Although an increasing number of MATE proteins have been identified, the understanding of MATE proteins is still very limited in rice. In this study, 46 MATE proteins were identified from the rice (Oryza sativa) genome by homology searches and domain prediction. The rice MATE family was divided into four subfamilies based on the phylogenetic tree. Tandem repeats and fragment replication contribute to the expansion of the rice MATE gene family. Gene structure and cis-regulatory elements reveal the potential functions of MATE genes. Analysis of gene expression showed that most of MATE genes were constitutively expressed and the expression patterns of genes in different tissues were analyzed using RNA-seq. Furthermore, qRT-PCR-based analysis showed differential expression patterns in response to salt and drought stress. The analysis results of this study provide comprehensive information on the MATE gene family in rice and will aid in understanding the functional divergence of MATE genes.
Reproductive development and genetic structure of the mycoheterotrophic orchid Pogoniopsis schenckii Cogn.
Authors: Alves Mariana Ferreira , Pinheiro Fabio , Nunes Carlos Eduardo Pereira , Prosdocimi Francisco , Sarzi Deise Schroder , Furtado Carolina , Mayer Juliana Lischka Sampaio
Published: July 2021

Background

Pogoniopsis schenckiiCogn. is a mycoheterotrophic orchid that can be used as a model to understand the influence of mycoheterotrophy at different stages of the reproductive cycle. We aimed to verify the presence of endophytic and epiphytic fungi at each stage of the reproductive process and investigated how the breeding system may relate to genetic structure and diversity of populations. In this study we performed anatomical and ultrastructural analyses of the reproductive organs, field tests to confirm the breeding system, and molecular analysis to assess genetic diversity and structure of populations.

Results

During the development of the pollen grain, embryo sac and embryogenesis, no fungal infestation was observed. The presence of endophytic fungal hyphae was observed just within floral stems and indehiscent fruit. Beyond assuring the presence of fungus that promote seed germination, specific fungi hyphae in the fruit may affect other process, such as fruit ripening. As other mycoheterotrophic orchids,P. schenckiiis autogamous, which may explain the low genetic diversity and high genetic structure in populations.

Conclusions

We discuss an interesting interaction: fungal hyphae in the indehiscent fruit. These fungal hyphae seem to play different roles inside fruit tissues, such as acting in the fruit maturation process and increasing the proximity between fungi and plant seeds even before dispersion occurs. As other mycoheterotrophic orchids,P. schenckiiis autogamous, which may explain the low genetic diversity and high genetic structure in populations. Altogether, our findings provide important novel information about the mechanisms shaping ecology and evolution of fragmented populations of mycoheterotrophic plant.
Characterization of TGFβ-associated molecular features and drug responses in gastrointestinal adenocarcinoma
Authors: Zhang Qiaofeng , Liu Furong , Qin Lu , Liao Zhibin , Song Jia , Liang Huifang , Chen Xiaoping , Zhang Zhanguo , Zhang Bixiang
Published: July 2021

Background

Gastrointestinal adenocarcinoma (GIAD) has caused a serious disease burden globally. Targeted therapy for the transforming growth factor beta (TGF-β) signaling pathway is becoming a reality. However, the molecular characterization of TGF-β associated signatures in GIAD requires further exploration.

Methods

Multi-omics data were collected from TCGA and GEO database. A pivotal unsupervised clustering for TGF-β level was performed by distinguish status of TGF-β associated genes. We analyzed differential mRNAs, miRNAs, proteins gene mutations and copy number variations in both clusters for comparison. Enrichment of pathways and gene sets were identified in each type of GIAD. Then we performed differential mRNA related drug response by collecting data from GDSC. At last, a summarized deep neural network for TGF-β status and GIADs was constracted.

Results

The TGF-βhigh group had a worse prognosis in overall GIAD patients, and had a worse prognosis trend in gastric cancer and colon cancer specifically. Signatures (including mRNA and proteins) of the TGF-βhigh group is highly correlated with EMT. According to miRNA analysis, miR-215-3p, miR-378a-5p, and miR-194-3p may block the effect of TGF-β. Further genomic analysis showed that TGF-βlow group had more genomic changes in gastric cancer, such as TP53 mutation, EGFR amplification, and SMAD4 deletion. And drug response dataset revealed tumor-sensitive or tumor-resistant drugs corresponding to TGF-β associated mRNAs. Finally, the DNN model showed an excellent predictive effect in predicting TGF-β status in different GIAD datasets.

Conclusions

We provide molecular signatures associated with different levels of TGF-β to deepen the understanding of the role of TGF-β in GIAD and provide potential drug possibilities for therapeutic targets in different levels of TGF-β in GIAD.
Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study
Authors: Boyer Annabel , Begin Yannick , Dupont Julie , Rousseau-Gagnon Mathieu , Fernandez Nicolas , Demian Maryam , Simonyan David , Agharazii Mohsen , Mac-Way Fabrice
Published: July 2021

Background

Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD).

Methods

This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups.

Results

Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001).

Conclusion

In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.
Neighborhood disadvantage and the sales of unhealthy products: alcohol, tobacco and unhealthy snack food
Authors: Wallace Lauren A. , Paul Rajib , Gholizadeh Shafie , Zadrozny Wlodek , Webster Caitlan , Mayfield Melanie , Racine Elizabeth F.
Published: July 2021

Background

Individuals may use unhealthy coping mechanisms such as alcohol, tobacco, and unhealthy snack consumption. The purpose of this study was to assess how neighborhood disadvantage is associated with sales of alcohol, tobacco, and unhealthy snacks at stores of a discount variety store chain.

Methods

Alcohol, tobacco, and unhealthy snack sales were measured monthly for 20 months, 2017–2018, in 16 discount variety stores in the United States. Mixed effects linear regressions adjusted for population size, with store-specific random effects, to examine the relationship of weekly unit sales with three outcome variables and neighborhood disadvantage, measured using the Area Deprivation Index (ADI).

Results

The discount variety stores were located in neighborhoods where the median ADI percentile was 87 [interquartile range 83,89], compared to the median ADI percentile of 50 for all US communities, indicating that the stores were located in substantially disadvantaged neighborhoods. For every 1% increase in ADI, weekly unit sales of unhealthy snack food increased by 43 [95% confidence interval, CI 28–57], and weekly unit sales of tobacco products increased by 11.5 [95% CI 5–18] per store. No significant relationship between neighborhood disadvantage and the weekly unit sales of alcohol products was identified.

Conclusions

The positive relationship between neighborhood disadvantage and the sale of tobacco and snack foods may help explain the pathway between neighborhood disadvantage and poor health outcomes. It would be useful for future research to examine how neighborhood disadvantage influences resident health-related behaviors.
The impact of smoking on outcomes following anterior cervical fusion-nonfusion hybrid surgery: a retrospective single-center cohort study
Authors: Wang Han , Meng Yang , Liu Hao , Wang Xiaofei , Hong Ying
Published: July 2021

Background

There is mixed evidence for the impact of cigarette smoking on outcomes following anterior cervical surgery. It has been reported to have a negative impact on healing after multilevel anterior cervical discectomy and fusion, however, segmental mobility has been suggested to be superior in smokers who underwent one- or two-level cervical disc replacement. Hybrid surgery, including anterior cervical discectomy and fusion and cervical disc replacement, has emerged as an alternative procedure for multilevel cervical degenerative disc disease. This study aimed to examine the impact of smoking on intermediate-term outcomes following hybrid surgery.

Methods

Radiographical and clinical outcomes of 153 patients who had undergone continuous two- or three-level hybrid surgery were followed-up to a minimum of 2-years post-operatively. The early fusion effect, 1-year fusion rate, the incidence of bone loss and heterotopic ossification, as well as the clinical outcomes were compared across three smoking status groups: (1) current smokers; (2) former smokers; (3) nonsmokers.

Results

Clinical outcomes were comparable among the three groups. However, the current smoking group had a poorer early fusion effect and 1-year fusion rate (P < 0.001 and P < 0.035 respectively). Both gender and smoking status were considered as key factors for 1-year fusion rate. Upon multivariable analysis, male gender (OR = 6.664, 95% CI: 1.248–35.581, P = 0.026) and current smoking status (OR = 0.009, 95% CI: 0.020–0.411, P = 0.002) were significantly associated with 1-year fusion rate. A subgroup analysis demonstrated statistically significant differences in both early fusion process (P < 0.001) and the 1-year fusion rate (P = 0.006) across the three smoking status groups in female patients. Finally, non-smoking status appeared to be protective against bone loss (OR = 0.427, 95% CI: 0.192–0.947, P = 0.036), with these patients likely to have at least one grade lower bone loss than current smokers.

Conclusions

Smoking is associated with poor outcomes following hybrid surgery for multilevel cervical disc disease. Current smokers had the poorest fusion rate and most bone loss, but no statistically significant differences were seen in clinical outcomes across the three groups.
Process evaluation of a programme to empower community nurse leadership
Authors: Vogel Ruth G. M. , Bours Gerrie J. J. W. , Rooijackers Teuni H. , Metzelthin Silke F. , Erkens Petra M. G. , van Rossum Erik , Zwakhalen Sandra M. G.
Published: July 2021

Background

The Nurses in the Lead (NitL) programme consists of a systematic approach and training to 1) empower community nurses in implementing evidence, targeted at encouraging functional activities of older adults, and 2) train community nurses in enabling team members to change their practice. This article aims to describe the process evaluation of NitL.

Methods

A mixed-methods formative process evaluation with a predominantly qualitative approach was conducted. Qualitative data were collected by interviews with community nurses (n = 7), focus groups with team members (n = 31), and reviewing seven implementation plans and 28 patient records. Quantitative data were collected among community nurses and team members (N = 90) using a questionnaire to assess barriers in encouraging functional activities and attendance lists. Data analysis was carried out through descriptive statistics and content analysis.

Results

NitL was largely executed according to plan. Points of attention were the use and value of the background theory within the training, completion of implementation plans, and reporting in patient records by community nurses. Inhibiting factors for showing leadership and encouraging functional activities were a lack of time and a high complexity of care; facilitating factors were structure and clear communication within teams. Nurses considered the systematic approach useful and the training educational for their role. Most team members considered NitL practical and were satisfied with the coaching provided by community nurses. To optimise NitL, community nurses recommended providing the training first and extending the training. The team members recommended continuing clinical lessons, which were an implementation strategy from the community nurses.

Conclusions

NitL was largely executed as planned, and appears worthy of further application in community care practice. However, adaptations are recommended to make NitL more promising in practice in empowering community nurse leadership in implementing evidence.
Does rehabilitation setting influence risk of institutionalization? A register-based study of hip fracture patients in Oslo, Norway
Authors: Fosse Rina Moe , Ambugo Eliva Atieno , Moger Tron Anders , Hagen Terje P. , Tjerbo Trond
Published: July 2021

Background

Reducing the economic impact of hip fractures (HF) is a global issue. Some efforts aimed at curtailing costs associated with HF include rehabilitating patients within primary care. Little, however, is known about how different rehabilitation settings within primary care influence patients’ subsequent risk of institutionalization for long-term care (LTC). This study examines the association between rehabilitation setting (outside an institution versus short-term rehabilitation stay in an institution, both during 30 days post-discharge for HF) and risk of institutionalization in a nursing home (at 6–12 months from the index admission).

Methods

Data were for 612 HF incidents across 611 patients aged 50 years and older, who were hospitalized between 2008 and 2013 in Oslo, Norway, and who lived at home prior to the incidence. We used logistic regression to examine the effect of rehabilitation setting on risk of institutionalization, and adjusted for patients’ age, gender, health characteristics, functional level, use of healthcare services, and socioeconomic characteristics. The models also included fixed-effects for Oslo’s boroughs to control for supply-side and unobserved effects.

Results

The sample of HF patients had a mean age of 82.4 years, and 78.9 % were women. Within 30 days after hospital discharge, 49.0 % of patients received rehabilitation outside an institution, while the remaining 51.0 % received a short-term rehabilitation stay in an institution. Receiving rehabilitation outside an institution was associated with a 58 % lower odds (OR = 0.42, 95 % CI = 0.23–0.76) of living in a nursing home at 6–12 months after the index admission. The patients who were admitted to a nursing home for LTC were older, more dependent on help with their memory, and had a substantially greater increase in the use of municipal healthcare services after the HF.

Conclusions

The setting in which HF patients receive rehabilitation is associated with their likelihood of institutionalization. In the current study, patients who received rehabilitation outside of an institution were less likely to be admitted to a nursing home for LTC, compared to those who received a short-term rehabilitation stay in an institution. These results suggest that providing rehabilitation at home may be favorable in terms of reducing risk of institutionalization for HF patients.
Early whole blood transcriptional responses to radiation-attenuated Plasmodium falciparum sporozoite vaccination in malaria naïve and malaria pre-exposed adult volunteers
Authors: Duffy Fergal J. , Du Ying , Carnes Jason , Epstein Judith E. , Hoffman Stephen L. , Abdulla Salim , Jongo Said , Mpina Maxmillian , Daubenberger Claudia , Aitchison John D. , Stuart Ken
Published: July 2021

Background

Vaccination with radiation-attenuated Plasmodium falciparum sporozoites is known to induce protective immunity. However, the mechanisms underlying this protection remain unclear. In this work, two recent radiation-attenuated sporozoite vaccination studies were used to identify potential transcriptional correlates of vaccination-induced protection.

Methods

Longitudinal whole blood RNAseq transcriptome responses to immunization with radiation-attenuated P. falciparum sporozoites were analysed and compared across malaria-naïve adult participants (IMRAS) and malaria-experienced adult participants (BSPZV1). Parasite dose and method of delivery differed between trials, and immunization regimens were designed to achieve incomplete protective efficacy. Observed protective efficacy was 55% in IMRAS and 20% in BSPZV1. Study vaccine dosings were chosen to elicit both protected and non-protected subjects, so that protection-associated responses could be identified.

Results

Analysis of comparable time points up to 1 week after the first vaccination revealed a shared cross-study transcriptional response programme, despite large differences in number and magnitude of differentially expressed genes between trials. A time-dependent regulatory programme of coherent blood transcriptional modular responses was observed, involving induction of inflammatory responses 1–3 days post-vaccination, with cell cycle responses apparent by day 7 in protected individuals from both trials. Additionally, strongly increased induction of inflammation and interferon-associated responses was seen in non-protected IMRAS participants. All individuals, except for non-protected BSPZV1 participants, showed robust upregulation of cell-cycle associated transcriptional responses post vaccination.

Conclusions

In summary, despite stark differences between the two studies, including route of vaccination and status of malaria exposure, responses were identified that were associated with protection after PfRAS vaccination. These comprised a moderate early interferon response peaking 2 days post vaccination, followed by a later proliferative cell cycle response steadily increasing over the first 7 days post vaccination. Non-protection is associated with deviations from this model, observed in this study with over-induction of early interferon responses in IMRAS and failure to mount a cell cycle response in BSPZV1.
Improvement of skin lesions in corticosteroid withdrawal-associated severe eczema by multicomponent traditional Chinese medicine therapy
Authors: Uzun Serife , Wang Zixi , McKnight Tory A. , Ehrlich Paul , Thanik Erin , Nowak-Wegrzyn Anna , Yang Nan , Li Xiu-Min
Published: July 2021

Rationale

We recently showed that multicomponent traditional Chinese medicine (TCM) therapy had steroid-sparing effects in moderate-to-severe eczema. We sought to evaluate TCM effects in severe eczema in a 7-year-old male with refractory disease and corticosteroid withdrawal syndrome.

Methods

Prior to referral, the patient had been treated since infancy with increasingly intensive standard of care, including high-dose topical and systemic corticosteroid and antibiotic therapy and was unable to tolerate further steroid treatment. The patient was administered a combination of oral and topical TCM for 17 months following discontinuation of his steroid regimen. His overall medical condition was assessed by SCORAD criteria and laboratory evaluations of serum IgE, absolute eosinophil count, and liver and kidney function tests.

Results

The patient showed rapid improvement of clinical measures of disease after starting TCM therapy, with marked improvement of sleep quality within the first week, complete resolution of itching, oozing, and erythema at 2 weeks, and a 79% and 99% decrease in his SCORAD values after one month and 3–6 months of TCM, respectively. Serum total IgE decreased by 75% (from 19,000 to 4630 (kIU/L), and absolute eosinophil counts decreased by 60% (from 1000 to 427 cells/μL) after 12 months of treatment. The patient did not require oral or topical steroids during the 17-month trial of TCM. TCM was tapered without complications. His dermatologic manifestations continued to be well-controlled 3 months after discontinuation.

Conclusion

This case study suggests TCM should be further evaluated in controlled clinical studies of patients with severe, refractory eczema and steroid withdrawal syndrome.
Iatrogenic fracture during shoulder dislocation reduction: characteristics, management and outcomes
Authors: Pan Xiaohui , Yao Yong , Yan Hongyong , Wang Jun , Dai Lei , Qu Xincong , Fang Zuyi , Feng Feng , Zhou Yan
Published: July 2021

Background

Shoulder dislocation and the cases of iatrogenic fractures during manual reduction are becoming increasingly common. The aim of this study was to investigate the characteristics, management, and patient outcomes of iatrogenic proximal humeral fracture during the manual reduction of shoulder dislocation.

Methods

A retrospective and multi-center study was performed to identify all patients presenting with shoulder dislocation from January 2010 to January 2020. The sex and age of patients, associated injuries, first-time or habitual shoulder dislocation, type of anesthesia, time from injury to revision surgery, and functional outcomes were analyzed.

Results

A total of 359 patients with a mean age of 62.1 ± 7.3 years (range 29–86 years) were included. Twenty-one patients (female/male ratio 17:4) with an average age of 66.3 ± 9.7 years (range 48–86 years) were identified with a post-reduction iatrogenic fracture. Female cases with greater tuberosity fractures (GTF) were more likely than male cases to have iatrogenic fractures during reduction (P = 0.035). Women aged 60 years or older experienced more iatrogenic fractures during manual reduction (P = 0.026). Closed reduction under conscious sedation was more likely than that under general anesthesia to have iatrogenic fractures (P = 0.000). A total of 21 patients underwent open reduction and internal fixation (ORIF) when iatrogenic fractures occurred. The mean follow-up period was 19.7 ± 6.7 months (range 12–36 months). The mean Neer scores were 80.5 ± 7.6 (range 62–93), and the mean visual analog score (VAS) was 3.3 ± 1.5 (range 1–6). Significant differences were observed in the Neer score and VAS with the time (more or less 8 h) from injury to revision surgery (P < 0.05).

Conclusion

A high risk of iatrogenic proximal humeral fracture is present in shoulder dislocation with GTF in senile females without general anesthesia. ORIF performed in a timely manner may help improve functional outcomes in the case of iatrogenic injury.
Family member incarceration and coping strategies during the COVID-19 pandemic
Authors: Testa Alexander , Fahmy Chantal
Published: July 2021

Background

The disproportionately high rate of incarceration and COVID-19 cases during the summer of 2020 in the United States contributed to a set of circumstances that has produced considerable public health concerns as correctional facilities have emerged as significant COVID-19 hot spots. During the COVID-19 pandemic, having a family member incarcerated can be an especially stressful experience. This study assesses how concern about an incarcerated family member contracting COVID-19 impacts diverse coping strategies.

Results

Data are from a survey of individuals who have a family member incarcerated in Texas (N = 365). Ordinary least squares regression is used to examine the association between concern about an incarcerated family member contracting COVID-19 and coping strategies. Findings demonstrate that higher levels of concern for an incarcerated person’s wellbeing during the COVID-19 pandemic is associated with dysfunctional coping mechanisms, but not adaptive or functional coping strategies.

Conclusions

Results suggest appropriate systemic responses by correctional administrations and public health practices can help mitigate dysfunctional coping mechanisms by family members during infectious disease outbreaks in correctional facilities.
Health professionals’ perception of pharmaceuticals procurement performance in public health facilities in Southwestern Ethiopia
Authors: Negera Gotuma , Merga Hailu , Gudeta Tadesse
Published: July 2021

Background

Pharmaceutical’s procurement is a core component of logistics management, and has a significant influence on product availability, and total supply chain costs. In Ethiopia, there are few studies on this topic where almost all of them were from suppliers’ perspectives and entirely quantitative. This study, therefore, aimed to assess health professionals’ perceptions about pharmaceuticals procurement performance in public health facilities in southwest Ethiopia.

Methods

A facility-based cross-sectional study complemented with a qualitative method was conducted from March 20 and April 30, 2019. We collected the quantitative data through self-administered structured questionnaires from pharmacy staff and document review using checklists. EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. Descriptive statistics were done for quantitative data. Qualitative data were gathered through face-to-face in-depth interviews and analyzed using thematic analysis technique.

Results

Regarding respondents’ perception of accountability in pharmaceutical procurement, 110 (57.9%) agreed or strongly agreed that their facilities adopt and use standard treatment guidelines and facility-specific medicine lists. Concerning competitiveness, 139 (62.6%) of the participants either disagreed or strongly disagreed that their facilities used formal suppliers’ qualifications based on service reliability and financial capacity. Regarding efficiency, 146 (76.8%) disagreed or strongly disagreed that their facilities develop a mechanism for prompt, reliable payment to lower medicine prices. The qualitative analysis identified staff workforce and competency, budget shortages, suppliers’ uncertainty, and pharmaceutical non-availability as challenges for procurement management performance.

Conclusion

The results indicated that participants perceived procurement performance of their facilities as poor. Therefore, staff development, fundraising options, monitoring and evaluation, coordination and collaboration can improve procurement practice and performance.
Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study
Authors: Yu Yue , Yao Ren-Qi , Zhang Yu-Feng , Wang Su-Yu , Xi Wang , Wang Jun-Nan , Huang Xiao-Yi , Yao Yong-Ming , Wang Zhi-Nong
Published: July 2021

Background

The clinical efficiency of routine oxygen therapy is uncertain in patients with acute heart failure (AHF) who do not have hypoxemia. The aim of this study was to investigate the association between oxygen therapy and clinical outcomes in normoxemic patients hospitalized with AHF using real-world data.

Methods

Normoxemic patients diagnosed with AHF on ICU admission from the electronic ICU (eICU) Collaborative Research Database were included in the current study, in which the study population was divided into the oxygen therapy group and the ambient-air group. Propensity score matching (PSM) was applied to create a balanced covariate distribution between patients receiving supplemental oxygen and those exposed to ambient air. Linear regression and logistic regression models were performed to assess the associations between oxygen therapy and length of stay (LOS), and all-cause in-hospital as well as ICU mortality rates, respectively. A series of sensitivity and subgroup analyses were conducted to further validate the robustness of our findings.

Results

A total of 2922 normoxemic patients with AHF were finally included in the analysis. Overall, 42.1% (1230/2922) patients were exposed to oxygen therapy, and 57.9% (1692/2922) patients did not receive oxygen therapy (defined as the ambient-air group). After PSM analysis, 1122 pairs of patients were matched: each patient receiving oxygen therapy was matched with a patient without receiving supplemental oxygen. The multivariable logistic model showed that there was no significant interaction between the ambient air and oxygen group for all-cause in-hospital mortality [odds ratio (OR) 1.30; 95% confidence interval (CI) 0.92–1.82; P = 0.138] or ICU mortality (OR 1.39; 95% CI 0.83–2.32; P = 0.206) in the post-PSM cohorts. In addition, linear regression analysis revealed that oxygen therapy was associated with prolonged ICU LOS (OR 1.11; 95% CI 1.06–1.15; P <  0.001) and hospital LOS (OR 1.06; 95% CI 1.01–1.10; P = 0.009) after PSM. Furthermore, the absence of an effect of supplemental oxygen on mortality was consistent in all subgroups.

Conclusion

Routine use of supplemental oxygen in AHF patients without hypoxemia was not found to reduce all-cause in-hospital mortality or ICU mortality.
Characterization of multi-scale ionospheric irregularities using ground-based and space-based GNSS observations
Authors: Peng YuXiang , Scales Wayne A , Hartinger Michael D , Xu Zhonghua , Coyle Shane
Published: July 2021

Ionospheric irregularities can adversely affect the performance of Global Navigation Satellite System (GNSS). However, this opens the possibility of using GNSS as an effective ionospheric remote sensing tool. Despite ionospheric monitoring has been undertaken for decades, these irregularities in multiple spatial and temporal scales are still not fully understood. This paper reviews Virginia Tech’s recent studies on multi-scale ionospheric irregularities using ground-based and space-based GNSS observations. First, the relevant background of ionospheric irregularities and their impact on GNSS signals is reviewed. Next, three topics of ground-based observations of ionospheric irregularities for which GNSS and other ground-based techniques are used simultaneously are reviewed. Both passive and active measurements in high-latitude regions are covered. Modelling and observations in mid-latitude regions are considered as well. Emphasis is placed on the increased capability of assessing the multi-scale nature of ionospheric irregularities using other traditional techniques (e.g., radar, magnetometer, high frequency receivers) as well as GNSS observations (e.g., Total-Electron-Content or TEC, scintillation). Besides ground-based observations, recent advances in GNSS space-based ionospheric measurements are briefly reviewed. Finally, a new space-based ionospheric observation technique using GNSS-based spacecraft formation flying and a differential TEC method is demonstrated using the newly developed Virginia Tech Formation Flying Testbed (VTFFTB). Based on multi-constellation multi-band GNSS, the VTFFTB has been developed into a hardware-in-the-loop simulation testbed with external high-fidelity global ionospheric model(s) for 3-satellite formation flying, which can potentially be used for new multi-scale ionospheric measurement mission design.
Characteristics of colistin-resistant Escherichia coli from pig farms in Central China
Authors: Peng Zhong , Zhang Xiaoxue , Li Xiaosong , Hu Zizhe , Li Zugang , Jia Chaoying , Dai Menghong , Tan Chen , Chen Huanchun , Wang Xiangru
Published: July 2021

The emergence and dissemination of colistin resistance in Enterobacteriaceae mediated by plasmid-borne mcr genes in recent years now pose a threat to public health. In this study, we isolated and characterized colistin-resistant and/or mcr-positive E. coli from pig farms in Central China. Between 2018 and 2019, 594 samples were collected and recovered 445 E. coli isolates. Among them, 33 with colistin resistance phenotypes and 37 that were positive for mcr genes were identified, including 34 positive for mcr-1, one positive for mcr-3, and two positive for both mcr-1 and mcr-3. An insertion of nine bases (“CTGGATACG”) into mcr-1 in four mcr-positive isolates led to gene dysfunction, and therefore did not confer the colistin resistance phenotype. Antimicrobial susceptibility testing revealed that 37 mcr-positive isolates showed severe drug resistance profiles, as 50% of them were resistant to 20 types of antibiotics. Multilocus sequence typing revealed a heterogeneous group of sequence types in mcr-positive isolates, among which ST10 (5/37), ST156 (5/37), and ST617 (4/37) were the predominant types. Plasmid conjugation assays showed that mcr-carrying plasmids of 25 mcr-positive isolates were conjugated with E. coli recipient, with conjugation frequencies ranging from 1.7 × 10-6 to 4.1 × 10-3 per recipient. Conjugation of these mcr genes conferred a colistin resistance phenotype upon the recipient bacterium. PCR typing of plasmids harbored in the 25 transconjugants determined six types of plasmid replicons, including IncX4 (14/25), FrepB (4/25), IncI2 (3/25), IncHI2 (2/25), FIB (1/25), and IncI1 (1/25). This study contributes to the current understanding of antibiotic resistance and molecular characteristics of colistin-resistant E. coli in pig farms.