bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance assessment of straight and linearly tapered rotors through wind tunnel investigation for off-grid applications
Authors: Siram Ojing , Sahoo Niranjan
Published: February 2022

The development of commercial wind turbine (WT) blade often accompanies many challenges due to its complex design process, geometric configuration and associated cost. In this backdrop, the article tries to put forward the applicability of a much simpler form of WT blades, which could be used in place of blade element momentum theory (BEMT) based turbine blades. In the present investigation, four small-scale horizontal-axis wind turbines model rotors having NACA0012 as its sectional profile has been designed and tested. The three model rotors opted to have straight and linearly tapered (SLT) blades, have been chosen in reliance on their simplicity and ease of fabrication. They are differentiated based on the root chord to tip chord ratio as M1 (1:1), M2 (5:3) and M3 (5:2), and subsequently compared with a BEMT rotor of a similar operational configuration. The wind tunnel investigation shows that the power coefficient for M1 is higher than M2 and M3. The favourable models M1 and M2 are capable of capturing power coefficient of, 37% and 24%. respectively, of the Betz-Joukowsky limit while operating at blade pitch angle less than 30°. Based on their operational characteristics, it is suggested to operate the modelled SLT rotors in the potential generation phase of the power characteristics curve to avoid a sudden drop in the rotor rotational speed.
Knockdown of the Long Noncoding RNA TUG1 Suppresses Retinoblastoma Progression by Disrupting the Epithelial–Mesenchymal Transition
Authors: Wang Hongyi , Zhang Zhen , Zhang Yue , Li Li
Published: February 2022

Taurine-upregulated gene 1 (TUG1) is a long noncoding RNA (lncRNA) that has previously been linked to the development and progression of several cancer types. Its expression and mechanistic role in retinoblastoma (RB), however, remains to be established. Herein, we found that RB tissue samples exhibited TUG1 upregulation. RB cell lines similarly exhibited marked TUG1 upregulation. Real-time cellular analysis (RTCA) and colony formation assays were then used to gauge RB cell proliferation, while transwell assays were conducted to assess the metastatic and invasive potential of these cells. In these assays, TUG1 upregulation was found to promote RB cell proliferative, migratory, and invasive activity while inducing the epithelial–mesenchymal transition (EMT). Subsequent quantitative real-time polymerase chain reaction (qPCR) and Western blotting indicated that this lncRNA functions at least in part by influencing the expression of Notch signaling pathway genes, which were downregulated following TUG1 knockdown in RB cells. Together, these data suggested that TUG1 can promote RB cell malignancy via the Notch signaling and EMT pathways, contributing to negative patient outcomes.
Migrant Labor Supply Chains: Architectures of Mobile Assemblages
Authors: Silliman Bhattacharjee Shikha
Published: February 2022

This paper explores the potential for Assemblage Theory to supplement current approaches to studying labor migration in law and the social sciences. Based upon a study of women's migration for garment and domestic work in India, I lay out the labor supply chain assemblage (LSCA) as a framework for understanding how workers find employment across multi-site, dynamic trajectories. Migration into temporary employment requires workers to move between jobs on an ongoing basis. Accordingly, studying labor supply chains as fluid assemblages defined by labor market conditions, component elements, and various agents provides a methodology for analyzing frequent job searches, across recruitment geographies, that include a range of recruitment actors. By accommodating temporal, territorial, and relational analysis, this approach provides insight into how labor migration processes for migrant garment and domestic workers in India articulate with the development of markets, working conditions, and social hierarchies – including on the basis of gender and caste.
Elevated Tacrolimus Levels at Time of Diagnosis of COVID-19 Compared to Baseline Among Hospitalized Organ Transplant Recipients
Authors: Mecadon Krista , Hardesty Anna , Vieira Kendra , Rogers Ralph , Merhi Basma , Osband Adena J. , Bayliss, MD George , Gohh Reginald , Morrissey Paul , Farmakiotis Dimitrios
Published: February 2022

Background:

The effect of COVID-19 on immunosuppressant drug levels in organ transplant recipients (OTRs) has not been adequately studied.

Objective:

To study the effect of COVID-19 on tacrolimus trough levels (primary outcome) in OTRs and the association of the later with acute kidney injury, bacterial infection, and oxygen requirements.

Methods:

We studied adult (>18-year-old) hospitalized OTRs with COVID-19, who were receiving tacrolimus between 3/1 and 12/16/2020.

Results:

Among 30 OTRs, 67% were men, 90% had a kidney transplant. Median age was 60.5 (interquartile range [IQR]: 45-68) years, median time from transplant 36 (IQR: 20-84) months. Tacrolimus troughs were higher on admission for COVID-19 than baseline (average over 6 months prior) ( P = .001). Eighteen patients (60%) had admission tacrolimus trough >10, 5 (17%) >20 ng/mL. Patients with diarrhea had borderline higher tacrolimus troughs, compared to those without diarrhea ( P = .09). Organ transplant recipients with a tacrolimus trough >10 ng/mL were more likely to have elevated aspartate aminotransferase on admission ( P = .01) and require supplemental oxygen. ( P = .026).

Conclusion and Relevance:

Tacrolimus trough levels were elevated in most OTRs with COVID-19 at the time of hospital admission, compared to baseline. Potential mechanisms are diarrhea and hepatic involvement in COVID-19. In OTRs with COVID-19, including outpatients, immunosuppressant drug levels should be closely followed; management of immunosuppression should be individualized.
Validation of the German Five-Factor Narcissism Inventory and Construction of a Brief Form Using Ant Colony Optimization
Authors: Jauk Emanuel , Olaru Gabriel , Schürch Eva , Back Mitja D. , Morf Carolyn C.
Published: February 2022

Narcissism is a multifaceted construct commonly conceptualized as comprising grandiose and vulnerable aspects in a two-factor model. While the manifold correlates of these aspects imposed a challenge for research on the structure of narcissism, recent models converge in a three-factor structure of agentic-extraverted, antagonistic, and neurotic aspects, capturing variance in different conceptualizations and correlates of narcissism. We construct and validate a German adaptation of the Five-Factor Narcissism Inventory (FFNI), a measure assessing these aspects based on the Five-Factor Model. In eight samples ( N = 2,921), we found the German FFNI to align with both, two- and three-factor models. The factors display good criterion validity with other narcissism measures, (non-)clinical personality dimensions, interpersonal styles, and (mal-)adaptive adjustment. Neurotic and antagonistic narcissism discriminated between individuals with/without mental disorder diagnoses, and displayed a characteristic profile in incarcerated offenders. Since the FFNI is comprehensive but long, we constructed a 30-item brief form (FFNI-BF) optimizing the internal structure and external validity using ant colony optimization. The FFNI-BF displayed good psychometric characteristics and similar, in certain aspects even advantageous criterion validity. We conclude that the German FFNI validly measures key aspects of narcissism, and the FFNI-BF captures these in a concise manner.
Investigating Potential Drug-Drug Interactions in Pediatric and Adolescent Patients Receiving Chemotherapy
Authors: Daignault Chelsea , Sauer Hannah E. , Lindsay Holly , Alonzo Amy , Foster Jennifer
Published: February 2022

Introduction

Pediatric and adolescent oncology patients admitted to receive chemotherapy are at risk for drug-drug interactions (DDI). While adult literature has quoted this risk to be as high as 95% of encounters, the literature in pediatrics is limited. This is a single-center, retrospective chart review of DDI in hospitalized pediatric oncology patients.

Methods

All patients admitted to Texas Children's Hospital for chemotherapy were included. Medications ordered during the hospitalization were evaluated by Lexicomp® Drug Interactions Tool. Interactions classified as D or X or interactions rated a C including a chemotherapeutic agent were independently reviewed by three clinicians for clinical relevance. Medications associated with central nervous system (CNS) depression or QTc prolongation were counted separately.

Results

Of 100 admissions evaluated, 100% had a flagged interaction. There were a total of 12 X-rated interactions, 8 D-rated interactions, and 12 C-rated interactions with a chemotherapeutic agent found to be clinically relevant. Thirty-three percent of admissions had 4 or more QTc prolonging medications ordered. Twenty-four percent of admissions had 3 or more prescribed CNS depressants. In total 49% of admissions were found to have at least 1 clinically-significant DDI.

Conclusions

This study exemplifies the risk of drug-drug interactions in children and young adults admitted to the hospital for chemotherapy. We demonstrated a high rate of flagged interactions with about half of admissions found to have a potentially clinically-significant DDI. Concomitant use of multiple QTc prolonging and CNS depressant medications was also prevalent, indicating a need to evaluate monitoring practices.
Angioscopic Findings of Stenosis Versus Occlusion in Femoropopliteal Artery Disease
Authors: Tashiro Kazuma , Mori Hiroyoshi , Tezuka Takahiro , Omura Ayumu , Wada Daisuke , Sone Hiromoto , Takei Yosuke , Sasai Masahiro , Sato Tokutada , Suzuki Hiroshi
Published: February 2022

Background:

Despite the increase in the number of patients with peripheral artery disease (PAD), the pathophysiology is not fully elucidated. Recently, angioscopy with a 0.48-megapixel equivalent resolution camera became available for patients with PAD. We aimed to compare the plaque component between native stenosis and occlusion in the femoropopliteal artery using this modality.

Materials and Methods:

Thirty-two consecutive patients who underwent endovascular treatment for native femoropopliteal artery disease with angioscopy were studied. The major angioscopic classifications of each lesion were defined as follows: atheromatous plaque (AP) was defined as luminal narrowing without any protrusion, calcified nodule (CN) was defined as a protruding bump with surface irregularity, a mainly reddish thrombus was defined as organizing thrombus (OG), and organized thrombus (OD) was defined by more than half of the thrombus showing a whitish intima-like appearance.

Results:

A total of 34 lesions (stenosis, n=18; occlusion, n=16) from 32 patients were included. All stenotic lesions showed AP or CN (n=8 [44%], n=10 [56%], respectively), whereas all occluded lesions showed OG or OD (n=5 [31%], n=11 [69%], respectively), which amounted to a statistically significant difference (p<0.001). In occluded lesions, stiff wires (>3 g) were required to cross all lesions classified as OD, whereas this was not always necessary for lesions classified as OG (11 [100%] of 11, 1 [25%] of 5, respectively; p=0.04). Yellow color plaques were observed to a similar degree in all angioscopic classifications. Major adverse limb events, defined as amputation and any reintervention at 12 months, were highly variable, depending on the angioscopic findings, and tended to be more frequently observed in CN and OD (13% in AP, 40% in CN, 0% in OT, and 36% in OD, p=0.25).

Conclusion:

Angioscopy revealed varying components in stenosis and occlusion with different degrees of clinical impact. This may provide new information on the pathophysiology of PAD.
Outcomes of Stented vs Nonstented Femoropopliteal Lesions Treated With Drug-Coated Balloon Angioplasty
Authors: Giannopoulos Stefanos , Strobel Aaron , Rudofker Eric , Kovach Christopher , Kokkosis Angela A. , Armstrong Ehrin J.
Published: February 2022

Purpose:

Drug-coated balloon (DCB) angioplasty has been increasingly used for the treatment of lower limb peripheral artery disease (PAD). However, bail-out stenting may be necessary in cases of suboptimal angioplasty. This study investigated the outcomes of femoropopliteal disease treated with DCB with/without bail-out stenting.

Materials and Methods:

This was a single-center retrospective study enrolling 166 consecutive patients (DCB+stent: n=81 vs DCB: n=85) with 253 femoropopliteal lesions (DCB+stent: n=99 vs DCB: n=154) treated with DCB with/without stenting. Bail-out stenting was performed at the operator discretion for postangioplasty dissections or otherwise suboptimal angiographic result (>30% residual stenosis). Cox regression analysis was performed to examine the outcomes of DCB with/without stenting during 2-year follow-up.

Results:

The baseline clinical characteristics were similar between the 2 groups. About half of the patients presented with critical limb ischemia, with most of the lesions located at the superficial femoral artery. The overall mean lesion length was 147±67 mm. The most frequent bail-out stent types were bare metal stents (BMS) (53.5%) followed by drug-eluting stents (DES) (41.4%). Lesions requiring bail-out stenting were on average longer (177±67 mm vs 127±59 mm; p<0.01) and on average had higher prevalence of flow-limiting postangioplasty dissections. The overall procedural success rate was 94% without any differences between the 2 groups. Both the stented and nonstented treatment modalities were effective and safe, demonstrating similar rates of 2-year freedom from major adverse limb event (stented: 71.3% vs nonstented: 64.4%) and 2-year freedom from target lesion revascularization (stented: 77.1% vs nonstented: 72.3%) during following up. The use of DES as bail-out therapy was associated with a lower risk of 2-year death compared with the use of BMS (DES: 97.2% vs BMS: 75.8%; p=0.01).

Conclusion:

Drug-coated balloon with bail-out stenting is a viable treatment option for cases of suboptimal DCB results, promising similar efficacy with DCB-alone procedures. However, as the patency of stents at the femoropopliteal segment may be a challenge due to the biomechanical stress of the artery, the efficacy of DCB+bail-out stenting should be further evaluated. In addition, future studies are needed to determine which grades of post-DCB dissections should be treated and optimize current bail-out strategies.
Structure and properties of bast fiber of Alchornea Davidii Franch based on chemical alkali degumming and biological enzyme degumming
Authors: Zhao Lei , Zhao Jumei , Jiang Weiqing , Yao Guixiang , Zhou Bin , Zhou Hongtao , Wei Li
Published: February 2022

In this work, the effects of degumming treatment on the structure and properties of OS-BADF were discussed. Alkali degumming and biological enzyme degumming were used to obtain AD-BADF and BED-BADF respectively. Spinnability index, thermal property, macromolecular structure, bending property and antibacterial property of OS-BADF (Original Sample of Bast Fiber of Alchornea Davidii Franch), AD-BADF (Alkali Degummed Bast Fiber of Alchornea Davidii Franch), and BED-BADF (Biological Enzyme degummed Bast Fiber of Alchornea Davidii Franch) were tested. The surface morphology of the above three kinds of fiber was analyzed by SEM. The results showed that the main component of degummed OS-BADF was cellulose, and the fiber had stripes in longitudinal direction, and kidney ellipsoid, irregular polygon in the cross section. After degumming treatment, the fineness of fiber decreased obviously and reached the spinnability index. Non-cellulose substances in OS-BADF can be removed by degumming. SEM observation showed that AD-BADF and BED-BADF became smoother after degumming. Compared with AD-BADF, BED-BADF had finer linear density, better thermal stability and higher antibacterial property. The equivalent flexural modulus and flexural rigidity of AD-BADF and BED-BADF were decreased compared with OS-BADF. In particular, the equivalent flexural modulus and the flexural rigidity of BED-BADF were mostly reduced, which indicated that BED-BADF became thinner and softer. The initial thermal decomposition temperature and the highest thermal decomposition temperature of AD-BADF and BED-BADF had been significantly increased. And -OH (free group) decreased significantly after degumming treatment. The testing results of the antibacterial properties of the three blended fabrics showed that the antibacterial properties of AD-BADF and BED-BADF were improved. Compared with AD-BADF, the antibacterial properties of BED-BADF were improved significantly. On the one hand, this research can provide a basis for technological research for the development of ADF (Alchornea Davidii Franch) bast fiber blended yarn and its textile product development. On the other hand, because of the high mechanical properties of ADF bast fiber, it also provides new development idea for the development of natural high-performance fiber reinforcement composites.
The “Golden Age” of Behavior Genetics?
Authors: Charney Evan
Published: February 2022

The search for genetic risk factors underlying the presumed heritability of all human behavior has unfolded in two phases. The first phase, characterized by candidate-gene-association (CGA) studies, has fallen out of favor in the behavior-genetics community, so much so that it has been referred to as a “cautionary tale.” The second and current iteration is characterized by genome-wide association studies (GWASs), single-nucleotide polymorphism (SNP) heritability estimates, and polygenic risk scores. This research is guided by the resurrection of, or reemphasis on, Fisher’s “infinite infinitesimal allele” model of the heritability of complex phenotypes, first proposed over 100 years ago. Despite seemingly significant differences between the two iterations, they are united in viewing the discovery of risk alleles underlying heritability as a matter of finding differences in allele frequencies. Many of the infirmities that beset CGA studies persist in the era of GWASs, accompanied by a host of new difficulties due to the human genome’s underlying complexities and the limitations of Fisher’s model in the postgenomics era.
Clinical Outcomes of Primary Subarachnoid Hemorrhage: An Exploratory Cohort Study from Sudan
Authors: Al-Mistarehi Abdel-Hameed , Elsayed Muaz A. , Ibrahim Rihab M. , Elzubair Tarig Hassan , Badi Safaa , Ahmed Mohamed H. , Alkhaddash Raed , Ali Musaab K. , Khader Yousef S. , Alomari Safwan
Published: February 2022

Background

Although Subarachnoid Hemorrhage (SAH) is an emergency condition, its epidemiology and prognosis remain poorly understood in Africa. We aim to explore the clinical presentations, outcomes, and potential mortality predictors of primary SAH patients within 3 weeks of hospitalization in a tertiary hospital in Sudan.

Methods

We prospectively studied 40 SAH patients over 5 months, with 3 weeks of follow-up for the symptomatology, signs, Glasgow coma scale (GCS), CT scan findings, and outcomes. The fatal outcome group was defined as dying within 3 weeks.

Results

The mean age was 53.5 years (SD, 6.9; range, 41–65), and 62.5% were women. One-third (30.0%) were smokers, 37.5% were hypertensive, two-thirds (62.5%) had elevated blood pressure on admission, 37.5% had >24 hours delayed presentation, and 15% had missed SAH diagnosis. The most common presenting symptoms were headache and neck pain/stiffness, while seizures were reported in 12.5%. Approximately one-quarter of patients (22.5%) had large-sized Computed Tomography scan hemorrhage, and 40.0% had moderate size. In-hospital mortality rate was 40.0% (16/40); and 87.5% of them passed away within the first week. Compared to survivors, fatal outcome patients had significantly higher rates of smoking (50.0%), hypertension (68.8%), elevated presenting blood pressure (93.8%), delayed diagnosis (56.2%), large hemorrhage (56.2%), lower GCS scores at presentation, and cerebral rebleeding ( P < 0.05 for each). The primary causes of death were the direct effect of the primary hemorrhage (43.8%), rebleeding (31.3%), and delayed cerebral infarction (12.5%).

Conclusions

SAH is associated with a high in-hospital mortality rate in this cohort of Sudanese SAH patients due to modifiable factors such as delayed diagnosis, hypertension, and smoking. Strategies toward minimizing these factors are recommended.
New Methods and the Study of Vulnerable Groups: Using Machine Learning to Identify Immigrant-Oriented Nonprofit Organizations
Authors: Ren Cheng , Bloemraad Irene
Published: February 2022

Many migrants are vulnerable due to noncitizenship, linguistic or cultural barriers, and inadequate safety-net infrastructures. Immigrant-oriented nonprofits can play an important role in improving immigrant well-being. However, progress on systematically evaluating the impact of nonprofits has been hampered by the difficulty in efficiently and accurately identifying immigrant-oriented nonprofits in large administrative data sets. We tackle this challenge by employing natural language processing (NLP) and machine learning (ML) techniques. Seven NLP algorithms are applied and trained in supervised ML models. The bidirectional encoder representations from transformers (BERT) technique offers the best performance, with an impressive accuracy of .89. Indeed, the model outperformed two nonmachine methods used in existing research, namely, identification of organizations via National Taxonomy of Exempt Entities codes or keyword searches of nonprofit names. We thus demonstrate the viability of computer-based identification of hard-to-identify nonprofits using organizational name data, a technique that may be applicable to other research requiring categorization based on short labels. We also highlight limitations and areas for improvement.
Effect of nanofillers on polyurethane/polystyrene matrix nanocomposites: Characteristics and forthcoming developments
Authors: Kausar Ayesha
Published: February 2022

Polyurethane and polystyrene are significant thermoplastic polymers having unique physical properties. This article considers the research trials on the fabrication, remarkable features, and technical applications of the polyurethane/polystyrene nanocomposites. The carbonaceous nano particles and inorganic nanofillers used with the polyurethane/polystyrene blend or copolymer are carbon nanotube, graphene, nanoclay, silica nanoparticles, and others. The considerable improvements in the physical properties of the polyurethane/polystyrene blend may occur through the nanofiller addition. The physical or covalent interactions between the blend or copolymer components and nanofillers may also positively affect the nanocomposite properties. The fabrication strategies used for the polyurethane/polystyrene nanocomposites include solution method, in situ method, melt blending, and several nanocomposite processing approaches. The structure, morphology, electrical conductivity, thermal stability, mechanical strength, and several other physical properties of the high performance polyurethane/polystyrene nanocomposites have been explored. Major application areas identified are shape memory, membrane, and gas transport properties.
Physical activity end-points in trials of chronic respiratory diseases: summary of evidence
Authors: Rist Cassie , Karlsson Niklas , Necander Sofia , Da Silva Carla A.
Published: February 2022

Background

Physical activity contributes to improving respiratory symptoms. However, validated end-points are few, and there is limited consensus about what is a clinically meaningful improvement for patients. This review summarises the evidence to date on the range of physical activity end-points used in COPD, asthma and idiopathic pulmonary fibrosis (IPF) whilst evaluating their appropriateness as end-points in trials and their relation to patients’ everyday life.

Methods

Trials reporting physical activity end-points were collected using Citeline's database Trialtrove; this was supplemented by searches in PubMed.

Results

The daily-patient-reported outcome (PRO)active and clinical visit-PROactive physical activity composite end-points appeared superior at capturing the full experience of physical activity in patients with COPD and were responsive to bronchodilator intervention. Time spent in moderate-to-vigorous physical activity is a recently validated end-point for IPF that correlates with exercise capacity and quality of life. Step count appears the best available physical activity measure for asthma, which consistently declines with worse disease status. However, evidence suggests a time lag before significant improvement in step count is seen which may reflect the impact of human behaviour on physical activity.

Conclusions

Physical activity represents a challenging domain to accurately measure. This is the first review evaluating physical activity measures used specifically within the respiratory field. Whilst physical activity can be effectively captured using PROactive in patients with COPD, this review highlights the unmet need for novel patient-focused end-points in asthma and IPF which would offer opportunities to develop efficacious medicines with impact on patients’ therapeutic care and quality of life.
Reliability of translaryngeal airway resistance measurements during maximal exercise
Authors: Fretheim-Kelly Zoe , Engan Mette , Clemm Hege , Andersen Tiina , Heimdal John-Helge , Strand Eric , Halvorsen Thomas , Røksund Ola , Vollsæter Maria
Published: February 2022

Objective

Exercise-induced laryngeal obstruction is an important cause of exertional dyspnoea. The diagnosis rests on visual judgement of relative changes of the laryngeal inlet during continuous laryngoscopy exercise (CLE) tests, but we lack objective measures that reflect functional consequences. We aimed to investigate repeatability and normal values of translaryngeal airway resistance measured at maximal intensity exercise.

Methods

31 healthy nonsmokers without exercise-related breathing problems were recruited. Participants performed two CLE tests with verified positioning of two pressure sensors, one at the tip of the epiglottis (supraglottic) and one by the fifth tracheal ring (subglottic). Airway pressure and flow data were continuously collected breath-by-breath and used to calculate translaryngeal resistance at peak exercise. Laryngeal obstruction was assessed according to a standardised CLE score system.

Results

Data from 26 participants (16 females) with two successful tests and equal CLE scores on both test sessions were included in the translaryngeal resistance repeatability analyses. The coefficient of repeatability (CR) was 0.62 cmH2O·L−1·s−1, corresponding to a CR% of 21%. Mean±sdtranslaryngeal airway resistance (cmH2O·L−1·s−1) in participants with no laryngeal obstruction (n=15) was 2.88±0.50 in females and 2.18±0.50 in males. Higher CLE scores correlated with higher translaryngeal resistance in females (r=0.81, p<0.001).

Conclusions

This study establishes translaryngeal airway resistance obtained during exercise as a reliable parameter in respiratory medicine, opening the door for more informed treatment decisions and future research on the role of the larynx in health and disease.
Respiratory symptoms of Swiss people with primary ciliary dyskinesia
Authors: Goutaki Myrofora , Hüsler Leonie , Lam Yin Ting , Koppe Helena M. , Jung Andreas , Lazor Romain , Müller Loretta ,   Swiss PCD Research Group, Pedersen Eva S.L. , Kuehni Claudia E.
Published: February 2022

Background

Mostly derived from chart reviews, where symptoms are recorded in a nonstandardised manner, clinical data about primary ciliary dyskinesia (PCD) are inconsistent, which leads to missing and unreliable information. We assessed the prevalence and frequency of respiratory and ear symptoms and studied differences by age and sex among an unselected population of Swiss people with PCD.

Methods

We sent a questionnaire that included items from the FOLLOW-PCD standardised questionnaire to all Swiss PCD registry participants.

Results

We received questionnaires from 74 (86%) out of 86 invited persons or their caregivers (median age 23 years, range 3–73 years), including 68% adults (≥18 years) and 51% females. Among participants, 70 (94%) reported chronic nasal symptoms; most frequently runny nose (65%), blocked nose (55%) or anosmia (38%). Ear pain and hearing problems were reported by 58% of the participants. Almost all (99%) reported cough and sputum production. The most common chronic cough complications were gastro-oesophageal reflux (n=11; 15%), vomiting (n=8; 11%) and urinary incontinence (n=6; 8%). Only nine (12%) participants reported frequent wheeze, which occurred mainly during infection or exercise, while 49 (66%) reported shortness of breath, and 9% even at rest or during daily activities. Older patients reported more frequent nasal symptoms and shortness of breath. We found no difference by sex or ultrastructural ciliary defect.

Conclusion

This is the first study to describe patient-reported PCD symptoms. The consistent collection of standardised clinical data will allow us to better characterise the phenotypic variability of the disease and study disease course and prognosis.
Assessing Dutch women’s experiences of labour and birth: adaptations and psychometric evaluations of the measures Mothers on Autonomy in Decision Making Scale, Mothers on Respect Index, and Childbirth Experience Questionnaire 2.0
Authors: Peters L. L. , van der Pijl M. S. G. , Vedam S. , Barkema W. S. , van Lohuizen M. T. , Jansen D. E. M. C. , Feijen-de Jong E. I.
Published: February 2022

Background

The Mothers Autonomy in Decision Making Scale (MADM) assesses women’s autonomy and role in decision making. The Mothers on Respect Index (MORi) asseses women’s experiences of respect when interacting with their healthcare providers. The Childbirth Experience Questionnaire 2.0 assesses the overall experience of childbirth (CEQ2.0). There are no validated Dutch measures of the quality of women’s experiences in the intrapartum period. Therefore, the aim of this study was to evaluate the psychometric properties of these measures in their Dutch translations.

Methods

The available Dutch versions of the MADM and MORi were adapted to assess experiences in the intrapartum period. The CEQ2.0 was translated by using forward-backward procedures. The three measures were included in an online survey including items on individual characteristics (i.e. maternal, birth, birth interventions). Reliability was assessed by calculating Cronbach’s alphas. Mann-Whitney, Kruskal Wallis or Student T-tests were applied where appropriate, to assess discrimination between women who differed on individual characteristics (known group validity). We hypothesized that women who experienced pregnancy complications and birth interventions would have statistically lower scores on the MADM, MORi and CEQ2.0, compared with women who had healthy pregnancies and physiological births. Convergent validity was assessed using Spearman Rank correlations between the MADM, MORi and/or CEQ2.0. We hypothesized moderate to strong correlations between these measures. Women’s uptake of and feedback on the measures were tracked to assess acceptability and clarity.

Results

In total 621 women were included in the cross sectional study. The calculated Cronbach’s alphas for the MADM, MORi and CEQ, were ≥ 0.77. Knowngroup validity was confirmed through significant differences on all relevant individual characteristics, except for vaginal laceration repair. Spearman Rank correlations ranged from 0.46-0.80. In total 98% of the included women out of the eligible population completed the MADM and MORi for each healthcare professional they encountered during childbirth. The proportions of MADM and MORi-items which were difficult to complete ranged from 0.0-10.8%, 0.6-2.7%, respectively.

Conclusions

The results of our study showed that the Dutch version of the MADM, MORi and CEQ2.0 in Dutch are valid instruments that can be used to assess women’s experiences in the intrapartum period.
Combined consideration of body mass index and waist circumference identifies obesity patterns associated with risk of stroke in a Chinese prospective cohort study
Authors: Cong Xiangfeng , Liu Shaobo , Wang Wenjuan , Ma Jixiang , Li Jianhong
Published: February 2022

Background

In China, few studies have examined the relationship between the combination of body mass index and waist circumference and the risk of stroke. Moreover, the relationship may also be different in different genders. Thus, we investigated the association between the combination of body mass index and waist circumference and the risk of stroke in Chinese.

Methods

This prospective cohort study included 36 632 participants aged 18 to 90 years. Participants were recruited from 60 surveillance sites (25 urban sites and 35 rural sites) across China in 2010 China Chronic Disease Risk Factor Surveillance, and followed up in 2016-2017. Incident cases of stroke were identified through questionnaires (including the basis of clinical diagnosis, imaging tests, time of diagnosis, diagnosis unit) and Cardiovascular Event Report System. Risk factors for stroke were collected at baseline using questionnaire, physical measurements and laboratory tests. Cox proportional hazards regression models were used to generate adjusted hazard ratios and 95%CI. All analyses were duplicated by gender stratification.

Results

During 6.42 ± 0.50 years of follow-up, 1 333 (597 males, 736 females) stroke events were observed among the 27 112 participants who did not have cardiovascular diseases at baseline. Compared with the general population who have normal weight or underweight with normal WC, those who have normal weight or underweight with abdominal obesity (adjusted hazard ratios 1.45, 95%CI 1.07-1.97 in males; 0.98, 95%CI 0.78-1.24 in females), overweight with abdominal obesity (1.41, 95%CI 1.14-1.75 in males; 1.33, 95%CI 1.10-1.61 in females), obesity with abdominal obesity (1.46, 95%CI 1.11-1.91 in males; 1.46, 95%CI 1.17-1.81 in females). Overweight with normal WC was found to be not statistically significant for both males and females (all P>0.05). Subgroup analysis found a multiplicative interaction between age and anthropometric group in females (P for interaction <0.05). Sensitivity analysis results did not change. In the subjects with CVD risk factors, we found a similar relationship as in the general population .

Conclusions

Combined assessment of body mass index and waist circumference identifies obesity patterns associated with stroke risk.
Task-specific fear influences abnormal trunk motor coordination in workers with chronic low back pain: a relative phase angle analysis of object-lifting
Authors: Fujii Ren , Imai Ryota , Shigetoh Hayato , Tanaka Shinichiro , Morioka Shu
Published: February 2022

Background

Pain-related fear influences impaired trunk movement (e.g., limited movement of range and velocity), but it is unclear how fear relates to trunk motor coordination (e.g., a more “in-phase” upper-lower trunk motion pattern). We conducted the present study to: (1) identify the motor coordination pattern of the in-phase upper-lower lumbar movements during the lifting, and (2) determine how pain-related fear is related to the trunk coordination pattern in workers with chronic low back pain (CLBP).

Methods

We examined 31 male workers with CLBP (CLBP group) and 20 healthy controls with no history of CLBP (HC group). The movement task was lifting a box, the weight of which was 10, 30%, or 50% of the subject’s body weight. We used a 3D motion capture system to calculate the mean absolute relative phase angle (MARP) angle as an index of coordination and the mean deviation phase (DP) as an index of variability. We used a numerical rating scale to assess the subjects’ task-specific fear.

Results

The MARP angle during trunk extension movement in the 50% condition was significantly decreased in the CLBP group compared to the HCs; i.e., the upper lumbar movement was more in-phase with the lower lumbar movement. The hierarchical multiple regression analysis results demonstrated that a decreased MARP angle was associated with high task-specific fear.

Conclusions

A more ‘in-phase’ upper-lower lumbar movement pattern was predicted by task-specific fear evoked when performing a work-related activity. Our findings suggest that an intervention for task-specific fear may be necessary to improve an individual’s impaired trunk motor coordination.
Qualitative study of willingness and demand for participation in decision-making regarding anticoagulation therapy in patient undergoing heart valve replacement
Authors: Zang YaNing , Liu ShanShan , Chen YuHong
Published: February 2022

Background

Promoting patient participation in decision-making aims to maintain the partnership between doctors and patients, reflect the patients’ goals, values, and preferences, and achieve patient-centered care. Realizing patient-centered care, shared collaboration between doctors and patients, and the decision-making process that considers the patients’ priorities and goals are the keys to high-quality health care. Therefore, it is indispensable to analyze the patients’ willingness to participate in the decision-making process and related participation needs regarding anticoagulation treatment for patients undergoing valve replacement.

Purpose

To analyze the patients’ willingness to participate in the decision-making process and the participation needs of patients undergoing mechanical cardiac valve replacement in the process of anticoagulation therapy to provide a basis for promoting patients' participation in decision-making.

Methods

Using phenomenological research methods, data were collected through semistructured interviews. Patients were interviewed after mechanical valve replacement from June to August 2021 in a Grade A hospital in Nanjing. Data were analyzed according to the Colaizzi phenomenology method.

Results

Three major themes were identified from the data: strong willingness to participate but low actual participation, supportive needs, and family members’ participation.

Conclusions

This study guided interventions to encourage patients who underwent heart valve replacement to participate in the decision-making process. From the patient's perspective, obtaining support in the decision-making process and caregiver enthusiasm is important. This study prompted thoughts about the use of auxiliary tools and provided a reliable basis for constructing decision-making auxiliary programs to guide clinical practice.
Exploring the barriers and facilitators to non-medical prescribing experienced by pharmacists and physiotherapists, using focus groups
Authors: Graham-Clarke Emma , Rushton Alison , Marriott John
Published: February 2022

Background

Non-medical prescribing (NMP) was introduced into the United Kingdom to enhance patient care and improve access to medicines. Early research indicated that not all non-medical prescribers utilised their qualification. A systematic review described 15 factors influencing NMP implementation. Findings from a recent linked Delphi study with independent physiotherapist and pharmacist prescribers achieved consensus for 1 barrier and 28 facilitators. However, item ranking differed for pharmacist and physiotherapist groups, suggesting facilitators and barriers to NMP differ depending on profession. The aim of this study was to further explore the lived experiences of NMP by pharmacists and physiotherapists.

Method

Study design and analytical approach were guided by Interpretative Phenomenology Analysis principles. Focus groups (November and December 2020) used the ‘Zoom®﻿’ virtual platform with pharmacist and physiotherapist prescribers. Each focus group followed a topic guide, developed a priori based on the Delphi study results, and was audio recorded digitally. Transcripts underwent thematic analysis and data were visualised using a concept map and sunburst graph, and a table of illustrative quotes produced. Research trustworthiness was enhanced through critical discussion of the topic guide and study findings by the research group and by author reflexivity. The study is reported in line with COREQ guidelines.

Results

Participants comprised three physiotherapists and seven pharmacists. Five themes were identified. The most frequently mentioned theme was ‘Staff’, and the subtheme ‘Clinical team’, describing the working relationship between participants and team members. The other themes were ‘Self’, ‘Governance’, ‘Practical aspects’ and ‘Patient care’. Important inter-dependencies were described between themes and subthemes, for example between ‘Governance’ and ‘Quality and Safety’. Differences were highlighted between the professions, some relating to the way each profession practises (for example decision making), others to the way the prescribing role had been established (for example administration support).

Conclusions

The key finding of collaborative working with the clinical team emphasises its impact on successful implementation of NMP. Themes may be inter-dependent, and inter-profession differences were identified. Specifically designed prescribing roles were beneficial for participants. For full NMP benefits to be realised all aspects of such roles must be fully scoped, before recruiting or training non-medical prescribers.
Early recognition of child abuse through screening indicators at the emergency department: experience of a tertiary urban pediatric hospital
Authors: Offidani Caterina , Villani Alberto , Reale Antonino , Marchili Maria Rosaria , Aufiero Lelia Rotondi , Moras Patrizio , Lodise Maria , Raucci Umberto , Barbieri Maria Antonietta , Raponi Massimiliano
Published: February 2022

Background

Emergency Departments play a pivotal role in detecting cases of child abuse. Despite the efforts made in the past decades on the need for a screening method for the early detection of abuse victims, a unique instrument shared by the international scientific community has not been made. These instruments should be able to help recognizing whether it is necessary to further investigate the child’s condition. The aim of the study is to illustrate the screening indicators in use since 2010 in the Emergency Department of the Bambino Gesù Children’s Hospital to early recognise the victims of abuse and the modifying process of the screening tool undertaken over the years.

Methods

We retrospectively analyzed the process that led to the editing of the indicators of child abuse in use nowadays at the Bambino Gesù Children's Hospital. We codified three clinical pathways to apply in case of suspected abuse. Furthermore, we investigated the medical records of screening-positive accesses in the Paediatric Emergency Department of the Bambino Gesù Children's Hospital from January 2008 to October 2020.

Results

An estimation of positive screening, regarding the type of abuse suspected, and the number of accessed in ED was made, resulting in a cohort of 956 patients. In 2010 we created a list of 14 items grouped in three clusters: anamnestic declarations or incongruences, carelessness/neglect and evident lesions at physical examination. Positivity to one of the items allows the actuation of the investigating protocol named as clinical pathway.In 2013, after three years of experience, the criteria were edited to increase specificity. The application of screening led to a median number of 82 suspected cases/year from 2013 to 2020.

Conclusion

A screening tool is essential and productive for the early recognition of victims of abuse. An in-deep analysis of suspected cases through a standardized method, such as the clinical pathway, allowed reaching the diagnosis in a more accurate and precise manner.
The triangle of inequality in dental services: arguments for a new conceptual framework
Authors: Ghanbarzadegan Arash , Bastani Peivand , Balasubramanian Madhan , Brennan David , Jamieson Lisa
Published: February 2022

This short communication paper aimed to compile the main determinants of inequality in dental services by distinguishing between access, utilisation, and provision of dental services. Recent findings integrated, and a dedicated conceptual framework entitled “Triangle of inequality in dental services” has been suggested. These can contribute a rich knowledge in this area and open a new window for policymakers and researchers to seek applied interventions to decrease inequality and improve access and utilisation in communities. This paper aims to synthesise the available evidence and add value to the scope. It highlights a dedicated concept for inequality in dental services beyond other areas of public health.
From shallow to deep: some lessons learned from application of machine learning for recognition of functional genomic elements in human genome
Authors: Jankovic Boris , Gojobori Takashi
Published: February 2022

Identification of genomic signals as indicators for functional genomic elements is one of the areas that received early and widespread application of machine learning methods. With time, the methods applied grew in variety and generally exhibited a tendency to improve their ability to identify some major genomic and transcriptomics signals. The evolution of machine learning in genomics followed a similar path to applications of machine learning in other fields. These were impacted in a major way by three dominant developments, namely an enormous increase in availability and quality of data, a significant increase in computational power available to machine learning applications, and finally, new machine learning paradigms, of which deep learning is the most well-known example. It is not easy in general to distinguish factors leading to improvements in results of applications of machine learning. This is even more so in the field of genomics, where the advent of next-generation sequencing and the increased ability to perform functional analysis of raw data have had a major effect on the applicability of machine learning in OMICS fields. In this paper, we survey the results from a subset of published work in application of machine learning in the recognition of genomic signals and regions in human genome and summarize some lessons learnt from this endeavor. There is no doubt that a significant progress has been made both in terms of accuracy and reliability of models. Questions remain however whether the progress has been sufficient and what these developments bring to the field of genomics in general and human genomics in particular. Improving usability, interpretability and accuracy of models remains an important open challenge for current and future research in application of machine learning and more generally of artificial intelligence methods in genomics.
Altitude of pulsating arcs as inferred from tomographic measurements
Authors: Safargaleev Vladimir , Sergienko Tima , Hosokawa Keisuke , Oyama Shin-ichiro , Ogawa Yasunobu , Miyoshi Yoshizumi , Kurita Satoshi , Fujii Ryochi
Published: February 2022

Data from three all-sky cameras in Kiruna and Tjautjas (Sweden) were used to estimate the altitude of pulsating arc-like forms using optical tomography. The event under consideration occurred during the substorm recovery phase and comprised both periodic luminosity variation of the on/off type with repetition periods of 3–6 s (main pulsations) and faster scintillation (approximately 2 Hz) during the “on” phase of the main pulsations. It is found that (1) the altitudes of the pulsating auroral arcs decrease during “on” intervals from ~ 95 km to ~ 92 km and (2) for two closely spaced arcs, internal modulation took place only in the lowest arc. The results may be interpreted in the frame of the traditional mechanism assuming electron scattering via VLF-wave/particle interaction in the equatorial magnetosphere, while the internal modulation may also be alternatively interpreted in the frame of the less-often inferred mechanism of field-aligned acceleration somewhere between the equatorial plane and ionosphere.

Graphical Abstract