bluuebunny/crossref_metadata_2025 huggingface dataset:
Population genetic structure of Raffaelea quercus‐mongolicae indicates a recent fungal introduction event to Jeju Island from inland areas of South Korea
Authors: Lee Dong‐Hyeon , Jung Jae‐Min , Seo Sang‐Tae
Published: June 2021

Raffaelea quercus‐mongolicae, a mycangial symbiont of a wood‐boring ambrosia beetle, Platypus koryoensis (Coleoptera: Curculionidae: Platypodidae), has been associated with the mass mortality of Korean oak trees in South Korea. Systemic wilt from the inoculation of oak trees with R. quercus‐mongolicae has caused significant damage to forest ecosystems in the country. Despite the continued spread of this fungus across the country since the first discovery of the disease, little is known regarding its biology. During a recent survey carried out to investigate the status of oak wilt diseases on Jeju Island, South Korea, visible signs of bark beetle attack, including bark beetle frass and galleries, were consistently observed in Quercus serrata, and R. quercus‐mongolicae was successfully recovered from the trees. To determine whether the pathogen was introduced from inland areas of the country to Jeju Island, the genetic diversity and population structure of R. quercus‐mongolicae isolates collected from various geographical regions and hosts in the country were investigated using a combination of eight microsatellite markers designed from the genome of the fungus in this study. The results showed lower levels of genetic diversity for the population from Jeju Island compared to those from inland areas of the country. This suggests that a limited number of individuals were recently introduced to Jeju Island, resulting in a new disease problem in the area.
Exploring the utility of movement parameters to make inferences about dynamic interactions in moving objects
Authors: Miller Jennifer A.
Published: June 2021

“Dynamic interactions” in animals are inter‐individual interactions defined by proximity in both space and time and are important for understanding spatial behaviors such as mating, predation, and territoriality, as well as phenomena such as disease spread. Dynamic interactions are typically quantified by analyzing GPS locations as points or by examining the paths that are inferred as trajectories between subsequent points. Current path‐based approaches measure movement similarity in terms of step length and azimuth, which is associated with a relatively narrow conceptualization of interaction (e.g., traveling together). This research explores how other, more complex movement parameters may differ with proximity to another individual; if proximity‐related movement differences can be detected, this information can be used to generate new dynamic interaction metrics. This approach was first tested using simulated movement data with known interaction properties, then applied to 10 black‐backed jackal (Canis mesomelus) dyads in Etosha National Park, Namibia. In general, an individual's movement was often different when it was close to another individual, suggesting that dynamic interaction can potentially be inferred by analyzing movement parameters. Movement parameters that describe directional persistence, speed, and change performed better, but there was considerable variation across movement parameters, proximity, and individuals.
Survey of In-Service Teacher Education in Slovakia Focused on Inclusive Education and Work with Pupils with Special Educational Needs
Authors: Osvaldová Zuzana , Vrabcová Veronika
Published: June 2021

Nowadays, teachers encounter many students in schools that show different deviations from the norm; therefore, they need to know how to choose the right approach for the students. Teachers should be equipped with the pedagogical knowledge and skills that would enable them to adopt the most suitable method for each pupil. The survey aims to map the current offer of continuing professional development programmes in Slovakia and the Czech Republic for the teachers of lower secondary schools focused on inclusive education and work with students with special educational needs. Through a study of the relevant available documents, we found out that in the Slovak Republic, there are 14 certified educational programmes for lower secondary school teachers dealing with this issue, of which 10 are innovative, 3 updating and 1 of specialization nature. All programmes are part of formal education. In the Czech Republic, we have identified six educational programmes that address this issue.
Cross Section and Fission Yields Induced Uncertainty in the Water–Water Energetic Reactor-440 Burnup Calculation
Authors: Vrban Branislav , Čerba Štefan , Lüley Jakub , Osuský Filip , Nečas Vladimír
Published: June 2021

The properties of nuclear fuel depend on the actual isotopic composition which develops during a reactor operation. In practice, the prediction accuracy of burnup calculations serves as the basis for the future precise estimation of a core lifetime and other safety-based core characteristics. The present study quantifies nuclear data induced uncertainties of nuclide concentrations and multiplication factors in water–water energetic reactor (VVER)-440 fuel depletion analysis. The well-known SCALE system and the TRITON sequence are used with the NEWT deterministic solver in the SAMPLER module that implements stochastic techniques to assess the uncertainty in computed results. The propagation of uncertainties in neutron cross section and fission yields is studied through the depletion calculation of 2D heterogeneous VVER-440 fuel assembly with an average enrichment of 4.87 wt % of 235U and six gadolinium rods with 3.35% of Gd2O3. In the paper, fixed nominal depletion conditions are based on the real operational data of the Slovak nuclear power plant Bohunice unit 4 during cycle 30. In total, 250 cases with uncertain parameters are computed and the results are evaluated by an auxiliary tool.
Functional Evaluation of a Personalized Orthosis for Knee Osteoarthritis: A Motion Capture Analysis
Authors: Huber Martin , Eschbach Matthew , Kazerounian Kazem , Ilies Horea
Published: June 2021

Orthotic treatments for knee osteoarthritis (OA) typically rely on simple mechanisms such as three-point bending straps and single-pin hinges. These commonly prescribed braces cannot treat bicompartmental knee OA, do not consider the muscle weakness that typically accompanies the condition, and employ hinges that restrict the knee's natural biomechanics. Utilizing a novel, personalized joint mechanism in conjunction with magnetorheological dampers, we have developed and evaluated a brace which attempts to address these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the thigh muscles in shock absorption, and interfering minimally with gait kinematics. Two healthy volunteers were chosen to test the system's basic functionality through gait analysis in a motion capture laboratory. Combining the collected kinematic and force-plate data with data taken from sensors onboard the brace, we integrated the brace and leg system into a single inverse dynamics analysis, from which we were able to evaluate the effect of the brace design on the subjects' knee loads and moments. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. Taken in total, the outcome of this study supports additional investigation into the system's clinical effectiveness, and suggests that further refinement of the techniques presented in this paper could open the doors to more effective OA treatment through patient specific braces.
J and CTOD-Based Tensile Strain Capacity Prediction for Pipelines With a Surface Crack in Girth Weld
Authors: Jang Youn-Young , Huh Nam-Su , Kim Ik-Joong , Kim Young-Pyo
Published: June 2021

Long-distance pipelines for the transport of oil and natural gas to onshore facilities are mainly fabricated by girth welding, which has been considered as a weak location for cracking. Pipeline rupture due to crack initiation and propagation in girth welding is one of the main issues of structural integrity for a stable supply of energy resources. The crack assessment should be performed by comparing the crack driving force with fracture toughness to determine the critical point of fracture. For this reason, accurate estimation of the crack driving force for pipelines with a crack in girth weld is highly required. This paper gives the newly developed J-integral and crack-tip opening displacement (CTOD) estimation in a strain-based scheme for pipelines with an internal surface crack in girth weld under axial displacement and internal pressure. For this purpose, parametric finite element analyses have been systematically carried out for a set of pipe thicknesses, crack sizes, strain hardening, overmatch, and internal pressure conditions. Using the proposed solutions, tensile strain capacities (TSCs) were quantified by performing crack assessment based on crack initiation and ductile instability and compared with TSCs from curved wide plate tests to confirm their validity.
Individual and Combined Association Between Healthy Lifestyle Habits With Muscle Strength According to Cardiovascular Health Status in Adults and Older Adults
Authors: de Lima Tiago R. , González-Chica David A. , D’Orsi Eleonora , Sui Xuemei , Silva Diego A.S.
Published: June 2021

Background: The authors aimed to identify the effect of adherence to healthy lifestyle habits on muscle strength (MS) according to a distinct health status. Methods: Longitudinal analysis using data from 2 population-based cohorts in Brazil (EpiFloripa adult, n = 862, 38.8 [11.4] y—6 y of follow-up length; EpiFloripa Aging, n = 1197, 69.7 [7.1] y—5 y of follow-up length). MS was assessed by handgrip strength (kgf). Information assessed by questionnaire regarding adequate physical activity levels, regular consumption of fruit and vegetables, low alcohol consumption, and nonsmoking habits were analyzed in the relationship with MS according to the health status. The participants were grouped into 3 health status categories: (1) with cardiovascular disease (CVD); (2) at risk of CVD (abdominal obesity or overweight/obesity, high blood pressure, hyperglycemia, and dyslipidemia); and (3) healthy individuals (without CVD and risk of CVD). Results: Simultaneous adherence of 4 healthy lifestyle habits was directly associated with MS among healthy individuals (β = 10.0, 95% CI, 2.0–18.0, SE = 4.0), at risk of CVD (β = 5.5, 95% CI, 0.3–12.6, SE = 3.6), and those with CVD (β = 11.4, 95% CI, 5.8–16.7, SE = 2.8). Conclusions: Adopting a healthy lifestyle can contribute to increased MS in adults and older adults, regardless of health status.
From Sport Psychology to Sport and Exercise Psychology: A 40-year Update
Authors: Gill Diane L. , Reifsteck Erin J. , Madrigal Leilani
Published: June 2021

As part of the 40th anniversary of the publication of Brooks’s (1981)Perspectives on the Academic Discipline of Physical Education, the authors offer an update on the Sport Psychology chapter, including key developments, topics, and issues in sport and exercise psychology. They begin with an overview of the 1981 chapter and state of sport psychology as described during that time. Then, in the main part of the article, they go through each of the main topics as presented in the 1981 chapter—highlighting what’s gone, what’s stayed, what’s changed, and what’s new. In the final section, they discuss the current state of sport and exercise psychology and end with their aspirations for sport and exercise psychology.
Physical Activity and Public Health: Four Decades of Progress
Authors: Keadle Sarah K. , Bustamante Eduardo E. , Buman Matthew P.
Published: June 2021

Over the past 40 years, physical activity (PA) and public health has been established as a field of study. A robust evidence base has emerged demonstrating that participation in recommended amounts of PA results in a wide array of physical and mental health benefits. This led to the establishment of federal and global PA guidelines and surveillance programs. Strong evidence supports the efficacy of individual-level (e.g., goal setting) and environmental (e.g., policies) interventions to promote PA. There has also been progress in establishing a skilled and diverse workforce to execute the work of PA and public health. Looking forward, major challenges include stemming the obesity and chronic disease epidemics, addressing health inequities, and diversifying the workforce. Given the known benefits of PA and the availability of evidence-based interventions, efforts now must focus on implementing this knowledge to improve population health and reduce inequities through PA.
Lacrimal gland budding requires PI3K-dependent suppression of EGF signaling
Authors: Wang Qian , Tao Chenqi , Hannan Abdul , Yoon Sungtae , Min Xuanyu , Peregrin John , Qu Xiuxia , Li Hongge , Yu Honglian , Zhao Jean , Zhang Xin
Published: June 2021

The intracellular PI3K, MAPK, and mTOR network controls morphogenesis by regulating the distribution of cell surface receptors.
Long-term reliable physical health monitoring by sweat pore–inspired perforated electronic skins
Authors: Yeon Hanwool , Lee Haneol , Kim Yeongin , Lee Doyoon , Lee Youngjoo , Lee Jong-Sung , Shin Jiho , Choi Chanyeol , Kang Ji-Hoon , Suh Jun Min , Kim Hyunseok , Kum Hyun S. , Lee Jaeyong , Kim Daeyeon , Ko Kyul , Ma Boo Soo , Lin Peng , Han Sangwook , Kim Sungkyu , Bae Sang-Hoon , Kim Taek-Soo , Park Min-Chul , Joo Young-Chang , Kim Eunjoo , Han Jiyeon , Kim Jeehwan
Published: June 2021

Artificial auxetic sweat ducts enable electronic skin sensors to perform reliable and noninvasive health monitoring over a week.
An autonomous excavator system for material loading tasks
Authors: Zhang Liangjun , Zhao Jinxin , Long Pinxin , Wang Liyang , Qian Lingfeng , Lu Feixiang , Song Xibin , Manocha Dinesh
Published: June 2021

An autonomous excavator system (AES) operates in the real world over long time periods.
Borrelia afzelii Infection in the Rodent Host Has Dramatic Effects on the Bacterial Microbiome of Ixodes ricinus Ticks
Authors: Hamilton Phineas T. , Maluenda Elodie , Sarr Anouk , Belli Alessandro , Hurry Georgia , Duron Olivier , Plantard Olivier , Voordouw Maarten J.
Published: June 2021

Many blood-sucking arthropods transmit pathogens that cause infectious disease. For example,Ixodes ricinusticks transmit the bacteriumBorrelia afzelii, which causes Lyme disease in humans.
Evidence of a Streamlined Extracellular Electron Transfer Pathway from Biofilm Structure, Metabolic Stratification, and Long-Range Electron Transfer Parameters
Authors: Jiménez Otero Fernanda , Chadwick Grayson L. , Yates Matthew D. , Mickol Rebecca L. , Saunders Scott H. , Glaven Sarah M. , Gralnick Jeffrey A. , Newman Dianne K. , Tender Leonard M. , Orphan Victoria J. , Bond Daniel R.
Published: June 2021

Current-producing biofilms in microbial electrochemical systems could potentially sustain technologies ranging from wastewater treatment to bioproduction of electricity if the maximum current produced could be increased and current production start-up times after inoculation could be reduced. Enhancing the current output of microbial electrochemical systems has been mostly approached by engineering physical components of reactors and electrodes.
Cooccurring Activities of Two Autotrophic Pathways in Symbionts of the Hydrothermal Vent Tubeworm
Riftia pachyptila
Authors: Leonard Juliana M. , Mitchell Jessica , Beinart Roxanne A. , Delaney Jennifer A. , Sanders Jon G. , Ellis Greg , Goddard Ethan A. , Girguis Peter R. , Scott Kathleen M.
Published: June 2021

Previous to this study, the activities of the rCAC and CBB in
R. pachyptila
had largely been inferred from “omics” studies of
R. pachyptila
without direct assessment of
in situ
conditions prior to collection. In this study,
R. pachyptila
was maintained and monitored in high-pressure aquaria prior to measuring its CO
2
fixation parameters.
Diagnostic Accuracy of SARS-CoV-2 Rapid Antigen Detection Testing in Symptomatic and Asymptomatic Children in the Clinical Setting
Authors: L’Huillier Arnaud G. , Lacour Matthieu , Sadiku Debora , Gadiri Mehdi A. , De Siebenthal Loraine , Schibler Manuel , Eckerle Isabella , Pinösch Selina , Kaiser Laurent , Gervaix Alain , Glangetas Alban , Galetto-Lacour Annick , Lacroix Laurence
Published: June 2021

Antigen-based rapid diagnostic tests (RDTs) are used in children despite the lack of data. We evaluated the diagnostic performance of the Panbio-COVID-19 Ag Rapid Test Device (P-RDT) in children.
Implementation of SARS-CoV2 Screening in K–12 Schools Using In-School Pooled Molecular Testing and Deconvolution by Rapid Antigen Test
Authors: Pollock Nira R. , Berlin David , Smole Sandra C. , Madoff Lawrence C. , Brown Catherine , Henderson Kelsey , Larsen Elizabeth , Hay Jeremiah , Gabriel Stacey , Gawande Atul A. , Lennon Niall J.
Published: June 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) testing is one component of a multilayered mitigation strategy to enable safe in-person school attendance for the K–12 school population. However, costs, logistics, and uncertainty about effectiveness are potential barriers to implementation.
A Laboratory Exercise Simulating Antibody and Antigen Reactions of the Ouchterlony Double Immunodiffusion Assay Using Inorganic Salts
Authors: Mujtaba Mustafa G. , Baliban Tara , Bhagu Jamini , Herrera Michael
Published: June 2021

The Ouchterlony double immunodiffusion assay is a serological technique used in the detection of antibodies and antigens for diagnostic purposes and also used in immunology laboratory courses as a common teaching assay where students observe the geometrical precipitation line patterns that form in the agarose, elucidating degrees of homology between antigens. In this classical technique, students must wait several hours to days to obtain results when protein antigens and antibodies are used.
Inquiry-Driven Bioinformatics Laboratory Research Module: Metagenomic Study of Student Oral Microbes
Authors: Ho Pao Chrystal , Choi Sou-Cheng T. , Lok Shu Yun , Dorrough Storm , Abelseth Connie , Shelton Joyce , Rentas Angelo
Published: June 2021

American Society for Microbiology Curriculum Guidelines highlight the importance of enabling students to think critically and learn by doing research. Moreover, information in biology, especially genetics and biotechnology, increases too rapidly for instructors to teach everything.
African Swine Fever Virus E120R Protein Inhibits Interferon Beta Production by Interacting with IRF3 To Block Its Activation
Authors: Liu Huisheng , Zhu Zixiang , Feng Tao , Ma Zhao , Xue Qiao , Wu Panxue , Li Pan , Li Shasha , Yang Fan , Cao Weijun , Xue Zhaoning , Chen Hongjun , Liu Xiangtao , Zheng Haixue
Published: June 2021

African swine fever is a highly contagious animal disease affecting the pig industry worldwide, which has brought enormous economic losses. Infection by the causative agent, African swine fever virus (ASFV), causes severe immunosuppression during viral infection, contributing to serious clinical manifestations.
Novel Host Recognition Mechanism of the K1 Capsule-Specific Phage of
Escherichia coli
: Capsular Polysaccharide as the First Receptor and Lipopolysaccharide as the Secondary Receptor
Authors: Gong Qianwen , Wang Xuhang , Huang Haosheng , Sun Yu , Qian Xinjie , Xue Feng , Ren Jianluan , Dai Jianjun , Tang Fang
Published: June 2021

It has been speculated that CPS is the main receptor of K1-specific phages belonging to
Siphoviridae
. In recent years, a new type of K1-specific phage belonging to
Myoviridae
has been reported, but its host recognition mechanisms remain unknown.
The Histone Deacetylases MoRpd3 and MoHst4 Regulate Growth, Conidiation, and Pathogenicity in the Rice Blast Fungus Magnaporthe oryzae
Authors: Lin Chaoxiang , Cao Xue , Qu Ziwei , Zhang Shulin , Naqvi Naweed I. , Deng Yi Zhen
Published: June 2021

HDACs (histone deacetylases) regulate various aspects of growth, development, and pathogenesis in plant-pathogenic fungi. Most members of HDAC classes I to III have been functionally characterized, except for orthologous Rpd3 and Hst4, in the rice blast fungus
Magnaporthe oryzae
.
Structure and Long-Term Stability of the Microbiome in Diverse Diatom Cultures
Authors: Barreto Filho Marcelo Malisano , Walker Melissa , Ashworth Matt P. , Morris J. Jeffrey
Published: June 2021

Natural microbial communities are extremely complex, with many more species coexisting in the same place than there are different resources to support them. Understanding the forces that allow this high level of diversity has been a central focus of ecological and evolutionary theory for many decades.
Characterization of Selected Plant Growth-Promoting Rhizobacteria and Their Non-Host Growth Promotion Effects
Authors: Fan Di , Smith Donald L.
Published: June 2021

There are pressing needs to reduce the use of agrochemicals, and PGPR are receiving increasing interest in plant growth promotion and disease protection. This study follows up our previous report that the four newly isolated rhizobacteria promote the growth of
Arabidopsis thaliana
.
Henry De la Beche’s pioneering paleoecological illustration, Duria antiquior
Authors: Sharpe* Tom , Clary* Renee M.
Published: June 2021

In late 1829 or early 1830, Henry Thomas De la Beche (1796–1855), in collaboration with William Buckland (1784–1856), published Duria antiquior [A more ancient Dorsetshire], the earliest known paleoecological illustration of ancient life. De la Beche’s interpretation was based largely on fossils then recently uncovered from Lower Jurassic (Lias) rocks near Lyme Regis on the south coast of England. Many of these were brought to scientific attention by local fossil collector and dealer Mary Anning (1799–1847). De la Beche published Duria antiquior as a lithograph, copies of which were sold as a fundraiser for Anning, who was then in straitened circumstances. Duria antiquior represented a new style of paleontological illustration that pioneered a new scientific genre addressing the history of nature and an innovative viewpoint where the observer glimpses lifeforms through the water. Other authors modified and adopted De la Beche’s visionary illustration, and the style became commonplace in popular geological publications in the later nineteenth century. Duria antiquior can be acknowledged as the pioneering graphic from which fossil organisms’ reconstructions and modern computer-generated paleoecosystem animations trace their origins.
Late diagnosis of chronic hypocalcemia due to autoimmune hypoparathyroidism
Authors: Teisseyre Maxime , Moranne Olivier , Renaud Sophie
Published: June 2021

Hypoparathyroidism is most often the result of postsurgical damage to the parathyroid glands but may occasionally be autoimmune hypoparathyroidism. In the latter context, activating antibodies directed against the calcium‐sensing receptor (CaSR) have been described. We hereby present the case of a patient suffering from chronic recurrent muscle cramps and paresthesia, presenting for a seizure due to hypocalcaemia. After eliminating the possibility of a genetic disorder, we searched for autoimmune hypoparathyroidism as there was no obvious cause of hypoparathyroidism. The search for anti-CaSR antibodies was positive. There was no argument for autoimmune polyendocrine syndrome type 1 so we concluded that it was isolated autoimmune hypoparathyroidism caused by activating antibodies to the CaSR. The patient was treated with vitamin D and calcium supplementation. The search for complications of hypoparathyroidism and hypercalciuria revealed basal ganglia calcification. The patient’s hypocalcaemia is now being kept under control with oral supplementation.
Remote robotic endovascular thrombectomy for acute ischaemic stroke
Authors: Singer Justin , VanOosterhout Stacie , Madder Ryan
Published: June 2021

Background

In acute ischaemic stroke, endovascular thrombectomy (ET) significantly reduces disability compared with thrombolytic therapy, but access to ET is currently limited. Leveraging telerobotic technology to disseminate neurosurgical expertise could increase access to ET. This proof-of-concept evaluation was performed to determine whether remote robotic ET (RRET), wherein an offsite neurosurgeon and an onsite interventional cardiologist collaboratively use telerobotics to perform ET, is technically feasible.

Methods

An ex vivo model of RRET was constructed by establishing a network connection between a robotic drive in a simulation laboratory and a robotic control unit 5 miles away. Using onsite assistance from an interventional cardiologist in the simulation laboratory, an offsite neurosurgeon used the robotic controls to attempt RRET on a fluid-filled silicone model of human vasculature containing simulated thrombus material in the left middle cerebral artery (MCA).

Results

From the offsite location 5 miles away, the neurosurgeon used the robotic system to successfully navigate a guidewire from the carotid artery to simulated thrombus in the MCA. Under the direction of the neurosurgeon, the onsite interventional cardiologist then successfully manually advanced an aspiration catheter over the guidewire to the thrombus, removed the guidewire and performed aspiration.

Conclusions

In this proof-of-concept evaluation, the technical feasibility of RRET was demonstrated in an ex vivo model and was collaboratively performed by an offsite neurosurgeon and an onsite interventional cardiologist. This report supports the design of future studies to determine if RRET could be used to increase access to ET for patients with acute ischaemic stroke.
Clinician perceptions of common mental disorders before and after implementation of a consultation-liaison psychiatry service: a longitudinal qualitative study in government-operated primary care settings in Penang, Malaysia
Authors: Russell Vincent , Loo Ching Ee , Walsh Aisling , Bharathy Arokiamary , Vasudevan Umadevi , Looi Irene , Smith Susan M
Published: June 2021

Objectives

To explore primary care clinician perceptions of barriers and facilitators in delivering care for common mental disorders (CMD) before and after implementation of a consultation-liaison psychiatry service (Psychiatry in Primary Care (PIPC)) in government-operated primary care clinics and to explore the clinicians’ experience of the PIPC service itself.

Design

This longitudinal qualitative study was informed by the Normalisation Process Model and involved audiotaped semi-structured individual interviews with front-line clinicians before (Time 1) and after (Time 2) the PIPC intervention. The Framework Method was used in the thematic analysis of pre/post interview transcripts.

Setting

Two government-operated primary care clinics in Penang, Malaysia.

Participants

17 primary care medical, nursing and allied health staff recruited purposely to achieve a range of disciplines and a balanced representation from both clinics.

Intervention

Psychiatrists, accompanied by medical students in small numbers, provided one half-day consultation visit per week, to front-line clinicians in each clinic over an 8-month period. The service involved psychiatric assessment of patients with suspected CMDs, with face-to-face discussion with the referring clinician before and after the patient assessment.

Results

At Time 1 interviewees tended to equate CMDs with stress and embraced a holistic model of care while also reporting considerable autonomy in mental healthcare and positively appraising their current practices. At Time 2, post-intervention, participants demonstrated a shift towards greater understanding of CMDs as treatable conditions. They reported time pressures and the demands of key performance indicators in other areas as barriers to participation in PIPC. Yet they showed increased awareness of current service deficits and of their potential in delivering improved mental healthcare.

Conclusions

Despite resource-related and structural barriers to implementation of national mental health policy in Malaysian primary care settings, our findings suggest that front-line clinicians are receptive to future interventions designed to improve the mental healthcare capacity.
Supporting active ageing before retirement: a systematic review and meta-analysis of workplace physical activity interventions targeting older employees
Authors: Merom Dafna , Stanaway Fiona , Gebel Klaus , Sweeting Joanna , Tiedemann Anne , Mumu Shirin , Ding Ding
Published: June 2021

Objective

With the growing representation of older adults in the workforce, the health and fitness of older employees are critical to support active ageing policies. This systematic review aimed to characterise and evaluate the effects on physical activity (PA) and fitness outcomes of workplace PA interventions targeting older employees.

Design

We searched Medline, PreMedline, PsycInfo, CINAHL and the Cochrane Controlled Register of Trials (CENTRAL) for articles published from inception to 17 February 2020. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes.

Results

Titles and abstracts of 8168 records were screened, and 18 unique interventions were included (3309 participants). Twelve studies were randomised controlled trials (RCTs). Seven interventions targeted multiple risk factors (n=1640), involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1127), and seven (n=235) focused only on PA. Interventions overwhelmingly targeted aerobic PA, compared with only four interventions targeting strength and/or balance (n=106). No studies involved screening for falls/injury risk, and only two interventions targeted employees of low socioeconomic status. Computation of effect sizes (ESs) was only possible in a maximum of three RCTs per outcome. ESs were medium for PA behaviour (ES=0.25 95% CI −0.07 to 0.56), muscle strength (ES=0.27, 95% CI −0.26 to 0.80), cardiorespiratory fitness (ES=0.28, 95% CI −22 to 0.78), flexibility (ES=0.50, 95% CI −0.04 to 1.05) and balance (ES=0.74, 95% CI −0.21 to 1.69). Grading of Recommendations Assessment, Development and Evaluation criteria-rated quality of evidence was ‘low’ due to high risk of bias, imprecision and inconsistency.

Conclusions

The lack of high-quality effective workplace PA interventions contrasts the importance and urgency to improve the health and fitness in this population. Future interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.

PROSPERO registration number

CRD42018084863. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=84863).
Long-term effectiveness of group-based diabetes self-management on glycosylated haemoglobin for people with type 2 diabetes in community: a protocol of systematic review and meta-analysis
Authors: Xia Zhang , Jiang Ying-ying , Shang Wei-jing , Guo Hai-jun , Mao Fan , Dong Wen-lan , Dong Jian-qun
Published: June 2021

Introduction

The rapid rise in the prevalence of diabetes has a negative impact on patients’ quality of life. Diabetes self-management group education is cost-effective and efficient for patients to control blood glucose. However, there are no consistent standards for self-management group education, and its long-term effects (≥12 months) are unclear. Although a few systematic reviews evaluated the long-term effects, they did not make clear provisions on the content of self-management, and the number and sample size of included studies were small, which may lead to misclassification bias and reporting bias. Therefore, we plan to conduct this systematic review to evaluate the long-term effects of self-management group education and determine the effects of different self-management characteristics on glycosylated haemoglobin (HbA1c).

Methods and analysis

We will retrieve Chinese databases (Wanfang, Chinese Hospital Knowledge Warehouse) and English databases (PubMed, ScienceDirect, EMBASE, Web of Science, Bailian Platform, Cochrane Central Register of Controlled Trials, Google Scholar) for randomly controlled trials and cluster randomly controlled trials of which participants are adults with type 2 diabetes mellitus. We will manually search citation lists and trial registries, and consult authors to obtain relevant articles. The retrieval time range will be from the establishment of the database to July 2020 to avoid omitting relevant studies. The primary outcome will be HbA1c. The secondary outcomes will be fasting plasma glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference and death event. Two reviewers will independently conduct article screening and assessment of risk of bias, with a third reviewer arbitrating if necessary. We will give priority to the use of meta-analysis to evaluate the pooled effects of all outcomes. For the outcomes of unrecognised sources of heterogeneity, missing data and less than three related studies, narrative synthesis approach will be used.

Ethics and dissemination

Ethical approval is not required for this systematic review. We plan to present the findings in a peer-reviewed scientific journal, relevant and responsible organisations, and training meetings.

PROSPERO registration number

CRD42020209011.
Healthcare use during COVID-19 and the effect on psychological distress in patients with chronic cardiopulmonary disorders in the Netherlands: a cross-sectional study
Authors: Pouwels Beau D C , Simons Sami O , Theunissen Maurice , Peters Madelon L , Schoenmaekers Janna J , Bekkers Sebastiaan C , van den Beuken-van Everdingen Marieke H J
Published: June 2021

Objectives

The COVID-19 pandemic caused a massive shift in the focus of healthcare. Such changes could have affected health status and mental health in vulnerable patient groups. We aimed to investigate whether patients with chronic pulmonary and cardiac diseases had experienced high levels of psychological distress during the COVID-19 pandemic in the Netherlands.

Design

A cross-sectional study.

Setting

COVID-19 pandemic-related changes in healthcare use, health status and psychological distress were investigated among patients with chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF) and congestive heart failure (CHF), using an online nationwide survey.

Participants

680 patients completed the survey. COPD was the most often reported diagnosis 334 (49%), followed by congestive heart failure 219 (32%) and PF 44 (7%). There were 79 (12%) patients with primary diagnosis ‘other’ than chronic cardiopulmonary disease, who also completed this survey.

Interventions

Psychological distress was assessed via the DASS-21 score (Depression Anxiety Stress Scale). Moreover, specific worries and anxieties regarding COVID-19 were explored.

Results

The frequency of contact with healthcare professionals changed in 52%. Changes in treatment were reported in 52%. Deterioration in health status was self-reported in 39%. Moderate to extremely severe levels of depression, anxiety and stress was observed in 25.8%, 28.5% and 14%, respectively. Over 70% reported specific worries and anxieties, such as about their own health and fear of being alone. Both the deterioration in health status and increased levels of anxiety were significantly (p<0.001, p<0.006) associated with changes in treatment. Exploratory analyses indicated that lack of social support may further increase anxiety.

Conclusion

Healthcare use changed during the COVID-19 pandemic in the Netherlands. It was associated with a decrease in health status, and increased psychological stress among patients with chronic cardiopulmonary disorders. Provision of healthcare should be more sensitive to the mental health needs of these patients during subsequent COVID-19 waves.
Association between community deprivation and practising health behaviours among South Korean adults: a survey-based cross-sectional study
Authors: Jang Bich Na , Youn Hin Moi , Lee Doo Woong , Joo Jae Hong , Park Eun-Cheol
Published: June 2021

Objectives

This study aimed to determine the association between community deprivation and poor health behaviours among South Korean adults.

Design

This was a survey-based cross-sectional study.

Setting and participants

Data of 224 552 participants from 244 communities were collected from the Korea Community Health Survey, conducted in 2015.

Primary and secondary outcome measures

We defined health behaviours by combining three variables: not smoking, not high-risk drinking and walking frequently. Community deprivation was classified into social and economic deprivation.

Results

Multilevel logistic analysis was conducted to determine the association of poor health behaviours through a hierarchical model (individual and community) for the 224 552 participants. Among them, 69.9% did not practice healthy behaviours. We found that a higher level of deprivation index was significantly associated with higher odds of not-practising healthy behaviours (Q3, OR: 1.15, 95% CI: 1.00 to 1.31; Q4 (highest), OR: 1.22, 95% CI: 1.06 to 1.39). Economic deprivation had a positive association with not-practising health behaviours while social deprivation had a negative association.

Conclusion

These findings imply that community deprivation levels may influence individual health behaviours. Accordingly, there is a need for enforcing the role of primary healthcare centres in encouraging a healthy lifestyle among the residents in their communities, developing national health policy guidelines for health equity and providing financial help to people experiencing community deprivation.
Smoking cessation using preference-based tools among socially disadvantaged smokers: study protocol for a pragmatic, multicentre randomised controlled trial
Authors: El-Khoury Fabienne , El Aarbaoui Tarik , Héron Mégane , Hejblum Gilles , Métadieu Brigitte , Le Faou Anne-Laurence , Ibanez Gladys , Melchior Maria
Published: June 2021

Introduction

Many smoking cessation aids such as nicotine replacement treatments and e-cigarettes have been proven effective in aiding smoking cessation attempts. Encouraging smokers with low socioeconomic position (SEP) to choose their smoking aid tool based on their preferences, and giving that tool free of charge, might increase the odds of smoking cessation. This trial examines the effectiveness of the ‘STOP’ (Sevrage Tabagique à l’aide d’Outils dédiés selon la Préférence: Smoking cessation using preference-based tools), a preference-based smoking cessation intervention for smokers with low SEP.

Methods and analysis

The STOP study is a randomised, multicentre, controlled trial (RCT). Smokers with low SEP and wishing to quit will be randomised to either the intervention or the control group (standard care). Participants in the intervention group will be asked to choose between different types of nicotine substitutes (patches, inhalers, gum, tablets, etc) and/or an electronic cigarette which will be delivered free of charge to aid their smoking cessation attempt.

The primary outcome will be smoking abstinence at 6 months after inclusion, defined as self-reported 7-day point prevalence of tobacco abstinence. Secondary outcomes include the total number of days of abstinence at 6 months after inclusion, 7-day point prevalence tobacco abstinence at 1 and 3 months after inclusion and number of relapses.

The study will also include an economic evaluation, and a process evaluation using a mixed methods approach.

Ethics and dissemination

The study was approved by the ‘Île de France II’ Institutional Review Board on 8 September 2020 (CPP Île de France II; Ref No: 20.01.31.65528 RIPH2 HPS), and results will be published in a peer-reviewed journal.

Trial registration number

NCT04654585.
Exploring the impact of the COVID-19 pandemic on doctors’ core workplace needs: a qualitative study of internal medicine trainees in Scotland
Authors: Kerins Joanne , Hamilton Ailsa Lauren , Pringle Jemma , Farquhar Fiona , Tallentire Victoria Ruth
Published: June 2021

Objectives

This study aimed to explore how the COVID-19 pandemic has impacted the workplace core needs of internal medicine (IM) trainees in Scotland.

Design

This qualitative study used an observational approach of interprofessional workshops combined with subsequent individual interviews with IM trainees. Workshops and interviews were audiorecorded, transcribed verbatim and analysed utilising NVivo software. Template analysis was used with the Autonomy/control, Belonging and Competence (ABC) of doctors’ core needs outlined in the 2019 General Medical Council report Caring for doctors, caring for patients as a conceptual lens for the study.

Setting

The national IM boot camp in Scotland includes a 2-hour interprofessional workshop which is trainee led and explores current challenges in the workplace, including the impact of the pandemic on such relationships.

Participants

Twelve workshops, involving 72 trainees, were included with ten trainees taking part in the subsequent interview process. Trainees representing all four regions in Scotland were involved.

Results

Trainees described all core needs having been impacted by the pandemic. They described a loss of autonomy with emergency rotas but also through a pervasive sense of uncertainty. The data revealed that work conditions improved initially with additional resources which have since been removed in some areas, affecting trainees’ sense of value. Analysis found that belonging was affected positively in terms of increased camaraderie but also challenged through inability to socialise. There were concerns regarding developing competence due to a lack of teaching opportunities.

Conclusions

Using the ABC of doctor’s core needs as a conceptual framework for this study highlighted the impact of the COVID-19 pandemic on all domains for IM trainees in Scotland. It has highlighted an opportunity to foster the renewed sense of camaraderie among healthcare teams, while rebuilding work conditions to support autonomy and competence.
Integrated palliative medicine in public oncology: a 10-year review
Authors: Chan Sik Kwan , Lam Tai Chung , Choi Horace Cheuk-Wai , Tsang Ka Chun , Yuen Kwok-Keung , Soong Inda , Wong Kam Hung , Lui Louisa , Lo Sing Hung , Tong Macy , Lo Raymond , Lam Po Tin , Lam Wai Man , Li Bryan
Published: June 2021

Objectives

The rapid ageing population of Hong Kong has a high demand on oncology and palliative care (PC) service. This study was the first territory-wide assessment in Hong Kong to assess the palliative service coverage in patients with advanced cancer in the past decade.

Methods

Cancer deaths of all 43 public hospitals of Hong Kong were screened. Randomly selected 2800 cancer deaths formed a representative cohort in all seven service clusters of Hospital Authority at 4 time points (2006, 2009, 2012, 2015). Individual patient records were thoroughly reviewed. Predictors of PC coverage was evaluated in univariable and multivariable analyses.

Results

From 2006 to 2015, PC coverage improved steadily from 55.4% to 68.9% (p<0.001). Median time of referral to PC service to death was 25 days (IQR: 53). For duration of inpatient PC, the median time was 22 days (IQR: 44) and it was stable over the past 10 years. Median time of referral to outpatient service to death was 74 days (IQR: 144) and there was an improvement observed (p<0.05). The current system was highly heterogeneous that PC varied between 9.8% and 84.8% in different hospitals depending on the PC service infrastructure. Multivariable Cox model identified patients associated with lower PC coverage: male, <50, rapid disease deterioration and staying in hospitals without multidisciplinary team clinic and designated palliative bed support (all p<0.01).

Conclusion

There was concrete achievement in palliative service development in the past decade. Heterogeneity and late service provision should be addressed in future.
Vertebroplasty for osteoporotic vertebral fracture
Authors: Roux Christian , Cortet Bernard , Bousson Valérie , Thomas Thierry
Published: June 2021

Appropriate care of patients with a recent painful osteoporotic vertebral fracture (VF) requires immobilisation, analgesics and spinal orthoses. Some VFs are however responsible for disabling pain and prolonged bed rest. In this context, vertebroplasty techniques have been proposed with a large benefit in case series and open-label randomised studies, but lack efficacy in three among four double-blind randomised studies. The objectives of the treatment of a recent painful VF are to relieve pain and to preserve mechanical conditions. With this in mind, we report an experts’ opinion paper on the indications for vertebroplasty and research agenda for clinical studies.
Green banana flour supplementation improves obesity-associated systemic inflammation and regulates gut microbiota profile in mice fed high-fat diets
Authors: Rosado Carolyne Pimentel , Rosa Victor Hugo Cordeiro , Martins Bruna Cadete , Soares Aruanna Cajaty , Almo André , Monteiro Elisa Bernardes , Mulder Alessandra da Rocha Pinheiro , Moura-Nunes Nathália , Daleprane Julio Beltrame
Published: June 2021

This study evaluated the effect of green banana flour (GBF) consumption on obesity-related conditions in mice fed high-fat diets. GBF was prepared using stage 1 green banana pulp, which was dehydrated and milled. Mice were fed a control diet (n = 20; 10% of energy from lipids) or a high-fat diet (n = 20; 50% of energy from lipids). After 10 weeks, mice were divided into 4 groups based on feed: standard chow (SC; n = 10), standard with 15% GBF (SB; n = 10), high-fat diet (HF; n = 10) and high-fat diet with 15% GBF (HFB; n = 10) for 4 weeks. HFB exhibited lower gains in body weight (–21%; p < 0.01) and in all fat pads (p < 0.01) compared with the HF group. SC, SB, and HFB showed smaller retroperitoneal white adipose tissue diameters (p < 0.001). SB and HFB-treated mice showed lower levels of leptin, IL-6, and TNF-α compared with the SC and HF groups (p < 0.01). In the GBF-fed groups, there was a reduction in the abundance of Firmicutes (SB: –22%; HFB: –23%) and an increase in Bacteroidetes (SB: +25%; HFB: +29%) compared with their counterparts. We demonstrated that GBF consumption attenuated inflammation and improved metabolic status, adipose tissue remodeling, and the gut microbiota profile of obese mice.

Novelty: Green banana flour (GBF) consumption, rich in resistant starch, regulates body weight in mice fed high-fat diets. GBF consumption improves fat pad distribution in mice fed high-fat diets. GBF improves obesity-associated systemic inflammation and regulates gut microbiota profile in mice fed high-fat diets.
Changes in shipping navigability in the Canadian Arctic between 1972 and 2016
Authors: Copland Luke , Dawson Jackie , Tivy Adrienne , Delaney Frances , Cook Alison
Published: June 2021

There have been rapid recent reductions in sea ice age and extent in the Canadian Arctic, but little previous analysis of how this has impacted the navigability of Arctic shipping. In this study we analyze how navigability changed over the period 1972–2016 by converting Canadian Ice Service ice charts to shipping navigability charts for different hull strength classifications based on the Arctic Ice Regime Shipping System. Analysis focuses on the southern route of the Northwest Passage, and the Arctic Bridge route across Hudson Bay, for changes in early-season (∼25 June), mid-season (∼3 September), and late-season (∼15 October) conditions. Results reveal that there has been a marked easing in shipping navigability for all vessels over the past decade, driven by reductions in the area and age of sea ice, particularly across the southern route of the Northwest Passage. Both medium (Type B) and little (Type E) ice strengthened vessels were able to transit the full length of this route in the middle part of the shipping season in 2012–2016, but not in 1972–1976 or 1992–1996.