bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Hoffman’s Exercise in Postnatal Mothers With Grade 1 Inverted Nipples
Authors: Thurkkada Anju Philip , Rajasekharan Nair Salini , Thomas Sara , Sreelekha Parvathy , Sanu Soumya Kadakkuzha , Chandran Parvathy R , Pillai Sreekanth Gopinathan
Published: June 2022

Background:

Breastfeeding provides perfect nutrition for infants. The inverted nipples in mothers make breastfeeding more challenging. Besides surgical approaches, non-pharmacological interventions are also gaining importance.

Research Aim:

To evaluate the effectiveness of Hoffman’s exercise on breastfeeding among postnatal mothers with grade I inverted nipples.

Method:

A quantitative approach with a parallel arm randomized controlled trial was used in the study. Postnatal mothers were screened for inverted nipples using a pinch test. Participants with at least one inverted nipple (Grade 1) were randomly allocated into two groups: the experimental group (supported with Hoffman’s exercise; n = 28, 50.9% ) and the control group (without Hoffman’s exercise; n = 27, 49.1%). The pre-test data, including demographics, nipple length, and breastfeeding assessment, were collected. Breastfeeding assessment was evaluated using the Bristol Breastfeeding Assessment Tool (BBAT). On the 3rd day, the post-test data, including nipple length and Breastfeeding Assessment, were collected among the groups.

Results:

The BBAT assessment was significantly higher in the post-test compared to that of the pre-test in the participants provided with Hoffman’s exercise. The nipple length was found to be higher in participants provided with Hoffman’s exercise. Furthermore, the variables—including age, gravida, nipple problems, and delivery type—were not found to have any significant effect with either pre-test or post-test levels of breastfeeding.

Conclusions:

Hoffman’s exercise was found to be an effective method to improve breastfeeding in Grade 1 nipple-inverted among post-natal mothers. This nipple exercise is inexpensive, easy to follow, and results in the successful initiation of breastfeeding.

Clinical Trial Registry and Registration Number:

CTRI/2019/05/019279, May 23, 2019 (retrospectively registered)
Politics of the Debtfare State: Repoliticizing the Czech Debt Enforcement Order and Its Limits
Authors: Šitera Daniel
Published: June 2022

In Czechia, one of the statistically most equal and least indebted states, almost one-tenth of its (mostly low-income) population is entrapped in debt enforcement proceedings. I foreground such a contradiction to investigate the politics of the debtfare state in East-Central Europe (ECE). This nuances the scholarship on the repolitization of the ECE neoliberal state by populist forces and their instrumentalization of its middle-class welfare state strategies in the 2010s. Identifying the Czech debt enforcement industry as a leading poverty industry in ECE, I explore its depoliticizing origins in the Debt Enforcement Order (DEO), a flagship legal framework regulating the creditor–debtor–bailiff relations. Interpreting the political struggle over the DEO-centered debtfare state strategy, I then trace its limited repolitization since the mid-2010s, which redirects its reforms from their original pro-creditor and -bailiff prioritization to a prioritization of low-income debtors. This politics complements the repolitization of the neoliberal state beyond populism.
Nonlinear effects of a new mesh-type rail pad on the coupled vehicle-slab track dynamics system under extremely cold environment
Authors: Zhai Zhihao , Zhu Shengyang , Yuan Xuancheng , He Zhenxing , Cai Chengbiao
Published: June 2022

Nonlinear dynamic behavior of a new mesh-type rail pad on the vehicle-slab track coupled system is investigated considering the influences of frequency and amplitude dependence in extremely cold environment. The frequency dependence of the new mesh-type rail pad is modeled by a fractional derivative viscoelastic element while a frictional component considers the amplitude dependence. Laboratory tests are performed to investigate the frequency and amplitude dependent performance of the rail pad and to determine key model parameters. Temperature factor and Mooney-Rivlin strain energy density are also introduced to simulate the mechanical properties of the rubber material of rail pad in low temperature environments. Further, the proposed nonlinear model for the rail pad is implemented in a coupled vehicle-slab track dynamics model to investigate the complicated nonlinear effects of the rail pad due to the dependence of the temperature, amplitude and frequency. The analysis indicates that the dynamic stiffness and damping of the mesh-type rail pads increase with the frequency increases. The proposed model for the mesh-type rail pad enables a more accurate dynamic simulation of vehicle-slab track system in extremely cold environment than the traditional Kelvin-Voigt model which overestimates the wheel rail force, rail vibration acceleration and other indicators at 3.15 Hz–40 Hz and 250 Hz–500 Hz, while underestimates these indicators at 50 Hz–125 Hz.
Backstepping sliding mode fault-tolerant control for the wind turbine system with disturbance observer
Authors: Ma Chenyuan , He Xinlin , Xie Beibei , Sun Weipeng , Zhao Daoli , Liao Weili
Published: June 2022

To guarantee the safe and stable operation of wind farms, this article establishes a backstepping sliding mode fault-tolerant controller for the wind turbine system to surmount uncertain problems, including actuator gain–bias faults, system modeling errors, and external stochastic disturbances. The nonlinear disturbance observer is employed for the stochastic disturbances, which can online estimate and compensate the external disturbance term. In addition, the backstepping control strategy is introduced to reduce the complexity of fault-tolerant controller design. Subsequently, combining the backstepping control algorithm and nonlinear disturbance observer, a disturbance observer-based backstepping sliding mode fault-tolerant control approach is applied for the wind turbine system. Thereinto, the terminal attractor is employed, which is mainly utilized to improve the convergence rate of the sliding surface and reduce the chattering phenomenon. The stability of the wind power closed-loop control system is rigorously verified via Lyapunov stability theory, which can obtain satisfactory control performance. Finally, numerical simulation results demonstrate that the proposed control approach can guarantee that the system state quickly reaches stability within 6–8 s, and the steady-state adjustment time is greatly reduced to 50%–62% when compared with the proportional–integral–derivative control and sliding mode control.
Adjusting for time of infection or positive test when estimating the risk of a post-infection outcome in an epidemic
Authors: Seaman Shaun R , Nyberg Tommy , Overton Christopher E , Pascall David J , Presanis Anne M , De Angelis Daniela
Published: June 2022

When comparing the risk of a post-infection binary outcome, for example, hospitalisation, for two variants of an infectious pathogen, it is important to adjust for calendar time of infection. Typically, the infection time is unknown and positive test time used as a proxy for it. Positive test time may also be used when assessing how risk of the outcome changes over calendar time. We show that if time from infection to positive test is correlated with the outcome, the risk conditional on positive test time is a function of the trajectory of infection incidence. Hence, a risk ratio adjusted for positive test time can be quite different from the risk ratio adjusted for infection time. We propose a simple sensitivity analysis that indicates how risk ratios adjusted for positive test time and infection time may differ. This involves adjusting for a shifted positive test time, shifted to make the difference between it and infection time uncorrelated with the outcome. We illustrate this method by reanalysing published results on the relative risk of hospitalisation following infection with the Alpha versus pre-existing variants of SARS-CoV-2. Results indicate the relative risk adjusted for infection time may be lower than that adjusted for positive test time.
Morphology and physico-mechanical properties of poly (methyl methacrylate)/polystyrene/polypropylene ternary polymer blend and its nanocomposites with organoclay: The effect of nature of organoclay and method of preparation
Authors: Rostami Amir , Vahdati Mehdi , Nowrouzi Mohsen , Karimpour Mohammadreza , Babaei Amir
Published: June 2022

This work presents the role of organoclay type (hydrophilic C30B vs hydrophobic C15A) and feeding mode (sequential vs. simultaneous) on a model ternary blend system poly (methyl methacrylate)/polystyrene/polypropylene (PMMA/PS/PP, 80/05/15). The rheological and thermal properties of these nanocomposites are linked to their morphology, which is mainly controlled by the preparation method and the nature of the organoclays. Using oscillatory shear rheology and dynamic mechanical analyses, both organoclays were shown to be mainly localized in the PMMA matrix. However, the more polar C30B showed a greater affinity toward the matrix. Studying the morphology using electron microscopy revealed that at 1 wt% of the organoclays, the original core-shell morphology of the blend was retained regardless of the feeding sequence. At 3 wt% of the organoclays, however, the core-shell morphology was only retained in the case of C30B-based nanocomposites prepared using sequential feeding mode. In the other cases, the increased solid-like behavior of the PS phase prevented the formation of a shell. Overall, it was shown that the feeding sequence and the affinity of organoclays towards different blend components determined their localization and therefore the eventual morphology of the nanocomposite.
Book review: Krishna Kumar, Smaller Citizens: Writings on the Making of Indian Citizens
Authors: Tilak Jandhyala B. G.
Published: June 2022

Krishna Kumar, Smaller Citizens: Writings on the Making of Indian Citizens. Orient BlackSwan, 2021, ₹395, xvii + 149 pp. ISBN: 9789354420901 (Paperback).
VPI Management in SATB2 Syndrome: Use of MRI to Evaluate Anatomy and Physiology in Non-Cleft VPI
Authors: Perry Jamie L. , Williams Jessica L. , Snodgrass Taylor D. , Sitzman Thomas J.
Published: June 2022

This clinical case study describes the velopharyngeal anatomy and physiology in a patient who presented with SATB2-associated syndrome (SAS) and velopharyngeal insufficiency (VPI) in the absence of an overt cleft palate. The clinical presentation, treatment, outcome, and the contribution of anatomical findings from MRI to surgical treatment planning for this rare genetic disorder, SAS, are described. This case study contributes to our current understanding of the anatomy and physiology of the velopharyngeal mechanism in an individual born with SAS and non-cleft VPI. It also details the changes following bilateral buccal myomucosal flaps in this patient.
Using an online journal club to improve Asian speakers’ comfort in using English to discuss and understand research papers written in English
Authors: Tsuchiya Masami , Saeteaw Manit , Subongkot Suphat , Tharnpanich Trai , Konmun Jitprapa , Nasu Izumi , Shimanuki Yumiko , Tsuchitani Toshiaki , Ezura Mio , Hashiguchi Koji , Bryan Jeffrey C , Kawazoe Hitoshi
Published: June 2022

Introduction

This study aimed to evaluate the participants’ comfort in understanding research papers written in English and discussing such research in English via an Asian online journal club.

Methods

A self-administered online survey was delivered to seven journal club meeting attendees from July 2020 to July 2021. A customer satisfaction analysis was performed to assess the association between the participants’ perspectives on program logistics and satisfaction.

Results

The recovery rate was 37.0% (44/119). After participating in the journal club, the median scores of critical appraisal skills, knowledge and/or pharmaceutical care skills in clinical practice, and discussion skills in English (assessed using a seven-point Likert scale) improved significantly (compared to pre-participation median scores) from 4 (interquartile range [IQR]: 3–5) to 5 (IQR: 4–6), 5 (IQR: 4–5) to 5 (IQR: 5–6), and 4 (IQR: 2–5) to 5 (IQR: 3–5), respectively ( P < 0.0001). The respondents also expressed great appreciation for the benefits and overall qualities of the journal club. Additionally, regarding patient care behavior after participation in the journal club, 34 (77.3%), 17 (38.6%), 16 (36.4%), and 14 (31.8%) respondents reported improvement in “drug information services,” “patient assessments,” “patient counseling,” and “multidisciplinary rounds,” respectively. Customer satisfaction analysis revealed that sharing information, mutual discussion, a shift system of presenters and co-chairs, and session duration should be improved as a matter of highest priority.

Conclusion

The findings suggest that our program could be helpful for Asian pharmacists, pharmacy students, and faculty members of the department of pharmacy.
Correlates of Moderate-to-Vigorous Physical Activity in Children With Physical Illness and Physical–Mental Multimorbidity
Authors: Bedard Chloe , King-Dowling Sara , Obeid Joyce , Timmons Brian W. , Ferro Mark A.
Published: June 2022

This study measured physical activity (PA) and explored its correlates among children with multimorbidity (co-occurring chronic physical and mental illness; MM) versus those with chronic physical illness only (PI). This study used baseline data from the Multimorbidity in Children and Youth Across the Life Course (MY LIFE) study, an on-going cohort study following 263 children with a PI 2 to 16 years of age (mean age: 9.8 years, SD = 4.0; 47.7% female). PA was measured using accelerometry, and demographic and psychosocial variables were collected using questionnaires. Of the 55 children with MM and the 85 with PI with valid accelerometer data, 38.1% and 41.2%, respectively, met average daily PA guidelines. Correlates of moderate-to-physical PA (MVPA) among children with MM were age, ρ(53) = −0.45, p = .001, body mass index (BMI), ρ(48) = −0.28, p = .04, self-perceived behavioral conduct, ρ(24) = −0.45, p = .02, physical health-related quality of life, ρ(51) = 0.56, p < .001, and peer support, ρ(52) = 0.27, p = .04. Correlates of MVPA among children with PI were age, ρ(83) = −0.40, p < .001, sex, ρ(83) = −0.26, p = .01, self-perceived social competence, ρ(31) = 0.42, p = .02, self-perceived athletic competence, ρ(31) = 0.48, p = .005, physical health-related quality of life, ρ(83) = 0.34, p = .001, participation in community sport, ρ(31) = 0.41, p = .02, and family functioning, ρ(83) = 0.26, p = .02. These results demonstrate that children with PI and MM are insufficiently active and their PA is correlated with demographic and psychosocial factors.
Why the left has more to lose from ideological convergence than the right
Authors: Grant Zack P , Tilley James
Published: June 2022

Why are many traditional governing parties of advanced democracies in decline? One explanation relates to public perceptions about mainstream party convergence. Voters think that the centre-left and -right are increasingly similar and this both reduces mainstream partisan loyalties and makes room for more radical challengers. Replicating and extending earlier studies, we provide evidence supporting this view. First, observational analysis of large cross-national surveys shows that people who place major parties closer together ideologically are less likely to be mainstream partisans, even when holding constant their own ideological proximity to their party. Second, a survey experiment in Germany suggests that this relationship is causal: exposure to information about policy convergence makes mainstream partisan attachments weaker. Importantly, we advance previous discussions of the convergence theory by showing that, in both our studies, ideological depolarisation is most detrimental to mainstream centre-left partisan attachments. We suggest that this is due to differing party histories.
Considerations of the built environment for autistic individuals: A review of the literature
Authors: Black Melissa Heather , McGarry Sarah , Churchill Lynn , D’Arcy Emily , Dalgleish Julia , Nash Isabelle , Jones Alisala , Tse Tin Yan , Gibson Jane , Bölte Sven , Girdler Sonya
Published: June 2022

Until recently, built environments have been designed exclusively to meet the needs of neurotypical populations; however, there is increasing recognition of the need to make built environments more accommodating for neurodiverse populations, including autistic individuals. This scoping review aims to comprehensively explore and synthesise this literature on the internal built environment for autistic individuals providing recommendations for designers, policymakers and clinicians. Five electronic databases were searched, resulting in a total of 28 studies being reviewed. Recommendations are provided for design and construction, lighting, sound, aesthetics, temperature and air quality. While in its early stages, evidence demonstrating the impact that particular qualities of light, colour, sound and spatial planning have on the human sensorium is emerging. In turn, this new knowledge is informing design decisions that are progressing interior environments towards inclusivity. Understanding the positive and negative impacts of decisions made in the design of the built environment has the potential to facilitate the participation and inclusion of autistic individuals.

Lay abstract

Factors related to the interiors of buildings, including the layout of rooms, colours, smells, noises, temperature, ventilation, colour and clutter, among other things, can change the way we interact with our environment and the people around us. Autistic individuals can have differences in processing sensory information and may find aspects of the built environment (BE) over-whelming and difficult to navigate. We reviewed the existing literature exploring the BE and autism. This study found that it is possible to make changes to the BE to create more inclusive and friendly environments for everyone, including autistic individuals. Findings from this study provide clear recommendations that can be used by interior designers, architects, builders, and clinical practitioners to make a positive difference. Key recommendations include using simple spatial layouts, compartmentalising and zoning spaces into specific activity sections and providing retreat spaces. The thoughtful placement of windows and blinds and the installation of dimmable lights, for example, will allow users to manage or reduce sensory over-stimulation caused by lights. Similarly, we recommend creating soundproofing and sound absorbent materials to reduce background noise and sound levels. We also recommend using neutral or simple colour palettes and restrained use of patterns. Finally, and most importantly, the BE needs to be flexible and adaptable to meet the unique needs of each person. This study provides a starting point for design guidelines and recommendations towards making a difference to the everyday experiences of the interiors of buildings.
‘As straight as they come’: Expressions of masculinities within digital sex markets
Authors: Rand Helen M
Published: June 2022

The research presented in this paper supports claims by feminists and queer theorists that there are numerous and diverse sex/gender/desire categories (Bem, 1995). Taken from a broader digital ethnography of digital sex markets in the United Kingdom, the findings are based on ten in-depth interviews with those who identified as men or ‘gender flexible’ and who buy and/or sell sex within digital markets. The participants featured in this paper used digital sex markets as a space to explore and express non-normative/subversive sexual and gender identities. Yet for many of them, these subversive acts were bounded by the market, so they were able to uphold masculine heterosexual identities outside of sex markets. The relative privacy of digital sex markets empowered them to maintain heterosexist power, reducing the social risks of stigmatisation and ostracisation associated with subversive sexual and gender identities. The thematic analysis revealed the limitations of heteronormative and homonormative labels and assumptions of sex work relations, thus, prompting the need to write this paper. Framing sex markets in narrow binary terms, as either homosexual or heterosexual markets, or research participants as customers or workers do not reflect the fluidity and diversity evident in this small yet revealing sample. The study shows multiple and fluid expressions of sex/gender/desire; and a duality in market roles as workers and/or customers amongst men engaged in digital sex markets.
Institutional and organizational capabilities as drivers of internationalisation: Evidence from emerging economy SMEs
Authors: Rahman Mahfuzur , Hack-Polay Dieu , Shafique Sujana , Igwe Paul
Published: June 2022

Internationalisation, the notion of cross border business, has become one of the key strategies for growth for small and medium enterprises (SMEs) in developing countries in recent years. Although many SMEs have used internationalisation strategies, there remains a gap of understanding the relative importance of factors influencing SMEs internationalisation particularly from developing countries perspectives. Drawing on the Resource Based View of the firm (RBV) theory, this research develops and validates the dimensions and sub-dimensions of the drivers of internationalisation. The study further identifies the relative importance of these dimensions from a developing country context. The study used a questionnaire survey to collect primary data from 212 Bangladeshi SMEs based on area wise cluster sampling. This study used partial least square based structural model (PLS-SEM) to assess the key drivers for foreign market entry by developing country SMEs. The findings confirm that the drivers of internationalisation represent a hierarchical construct consisting of three primary and eight sub-dimensions. The study suggests that SME internationalisation in a developing country is contingent upon two categories of capabilities: critical organisational capabilities or resources (linked to internal processes largely associated with human resources) and critical institutional capabilities (associated with state level provision and the cultural fabric).
Evaluation of a Standardized Tacrolimus Therapeutic Drug Monitoring Protocol in Stable Kidney Transplant Recipients
Authors: Ky Trung Q. , Silas Norman P. , Taylor Robin M , Barakat Abdurahman O. , Harb Rawan , Laviste Nathan C. , Park Jeong M.
Published: June 2022

Introduction: Transplant nurse coordinators have assisted in accurately adjusting tacrolimus doses under a collaborative practice agreement for kidney transplant recipients in the early post-operative period. This study evaluated the efficiency of a standardized tacrolimus therapeutic drug monitoring (TDM) protocol in stable outpatient recipients. Design: We conducted a single-center, retrospective study of adult patients who received a kidney transplant at least 3 years ago and were taking immediate-release tacrolimus. Before September 2019, transplant coordinators consulted transplant providers for management of all tacrolimus trough levels (Pre-Arm). Under the standardized protocol, coordinators directly responded to out-of-range tacrolimus trough levels (Post-Arm). The primary outcome was the time to intervention for out-of-range levels. Secondary outcomes included adverse events, time in therapeutic range, coefficient of variation (CV), and protocol compliance. Results: Of 1712 levels (from 174 patients), 259 levels (15.1%) were out-of-range. The overall time to intervention was 13.2 hours shorter (95% CI: -26.4 to -0.1 hours; P = 0.048) in the Post-Arm. There was no rejection, graft loss, or death during the study period. The time in therapeutic range was 89.3% (17.6%) vs 89% (19.4%; P = 0.816) and CV was 19.7% (15.8%) vs 18.4 (10.7%; P = 0.358) in the Pre-Arm and Post-Arm, respectively. Within the Post-Arm, the protocol required coordinators to independently intervene on 96 out-of-range levels (65.8%), which were accurately addressed 57.5% of the time. Conclusion: Implementation of a standardized TDM protocol improved efficiency without compromising major clinical outcomes or intrapatient variability (IPV) of tacrolimus levels for stable kidney recipients in the outpatient setting.
The effect of ultrasound on environmentally extraction and dyeing of wool yarns
Authors: Hosseinnezhad Mozhgan , Gharanjig Kamaladin , Adeel Shahid , Rouhani Shohreh , Imani Homan , Razani Narjes
Published: June 2022

Reducing pollution in various industries such as textile is very important. In this paper, two parallel methods were used to reduce pollution of the process and application of dye. The first approach was the selection of plant-based dyes (Madder with the botanical name of Rubia tinctorum and Reseda with botanical name of Reseda odorata) and the application of a tannin-based mordant (pomegranate peel with botanical name of Punica granatum). The second approach was extraction and dyeing in ultrasound media. The extraction efficiency of madder, Reseda, and pomegranate peel in water with the ultrasound-assisted method was 23%, 33%, and 29%, respectively. In this paper, the meta-mordanting method was used for mordanting procedure, and to compare the results, Cu (copper) was selected as the mineral mordant. Extracts were identified by FTIR method. Yarns’ changes in the process of mordanting and dyeing are investigated using two methods, FTIR and SEM. The effect of changing the concentration of mordant and dyes with the amount of K/S were evaluated and the K/S value of dyed samples illustrated that increasing the dye concentration of the dye increases the amount of K/S. The color fastness properties of all samples were investigated using the ISO standards.
Physical health effects of sedentary behaviour on adults with an intellectual disability: A scoping review
Authors: Lynch Louise , McCarron Mary , Eustace-Cook Jessica , Burke Éilish , McCallion Phillip
Published: June 2022

This literature review was designed to establish the effects of sedentary behaviour on the physical health of adults with an intellectual disability. Sedentary behaviour is defined as any waking behaviour characterized by an energy expenditure of ≤1.5 METs while in a sitting, lying or reclining posture. An extensive search was executed in six databases: EMBASE, Medline, CINAHL, PsycINFO, ASSIA and Web of Science. Following screening, 18 articles remained for inclusion in the review. A thematic analysis using the Braun and Clarke six step process resulted in the identification of seven broad health areas. Studies showed a prevalence of obesity, multimorbidity and metabolic syndrome as well as elevated levels of sedentary behaviour in adults with an intellectual disability. This literature review demonstrated that sedentary behaviour could be a contributor to the poor health which is common in adults with an intellectual disability. However to date the body of evidence does not confirm a cause-and-effect relationship.
Memories, piety and formation of civil religions: Do revolutionary youth sing along with the memory machine in Iran?
Authors: Saramifar Younes
Published: June 2022

Memories of wars and constantly living with them become the measure of citizenhood, revolutionary commitments and piety remembering, where an incessant state-sponsored memory machine frames memory as a civil religion. This article argues that memories, remembering and mnemonic acts become the forces that hold a civil religion together, and then explains how mnemonic subjects/remembering individuals contribute to a civil religion through consumption of memories. I ground my argument in anthropological explorations of how the Iranian state choreographs a memory machine that collects, publishes and circulates memories of the Iran–Iraq War (1980–1988). The memory machine tries to inspire postwar generations with an Islamic model of piety, invent a militarized civil religion and inculcate the revolutionary youth into it. However, the Iranian revolutionary youth use memories of the war as ‘wiggle rooms’ to reshape the state-choreographed civil religion without expressing either dissent or absolute compliance. Ethnographically, I highlight that the revolutionary youth’s compliance may seem blind obedience but on the contrary, their compliance is an agentive attempt to resist subtly, find individuated sovereignty and craft mnemonic subjectivities under authoritarian conditions.
Negative Affect, Affect Regulation, and Food Choice: A Value-Based Decision-Making Analysis
Authors: O’Leary Daniel , Smith Angela , Salehi Elaheh , Gross James J.
Published: June 2022

Maladaptive eating is one of the greatest threats to health and well-being in the 21st century. Psychological factors that drive maladaptive eating are of interest as they may offer low-cost intervention targets. One such factor is negative affect. If negative affect does lead to maladaptive eating, interventions that reduce negative affect should lead to improved eating and food choice. One relevant class of techniques is affect regulation strategies. In the present research, we use survey data and a value-based decision-making task to demonstrate that negative affect is associated with maladaptive eating and food choice. We find that negative affect decreases the weight that participants place on the health benefits of food. We also show that teaching participants to use reappraisal to downregulate negative affect leads to healthier food choices. These findings indicate that reappraisal applied to incidental negative affect may be an effective method for improving eating and food choice.
Missing a case of nitrous oxide toxicity
Authors: Trowbridge Paul , Poland Cara
Published: June 2022

Nitrous oxide is a highly lipid-soluble molecule, which can produce euphoria and calming effects through noncompetitive antagonism of the N-methyl-D-aspartate (NMDA) glutamate receptor and agonism of the y-aminobutyric acid (GABA) A receptor. It can also produce toxicities likely through inactivation of methylcobalamin (vitamin B12) with subsequent neurological, psychiatric, and other sequelae that may be mistaken for other clinical entities. We present a classic presentation of nitrous oxide toxicity, which was missed and urgently referred to infectious diseases with concerns for an infectious neuromyelitis. Knowing the constellation of symptoms and findings and maintaining a high index of suspicion are key to diagnosing nitrous oxide toxicity, which can otherwise easily be missed. Cessation of use, B12 supplementation, and supportive measures such as occupational and physical therapy are helpful for maximizing long-term beneficial outcomes.
Correlation between hysterosalpingography diagnosis and final hysterolaparoscopy with dye-test diagnosis in women with utero-tubal infertility: A cross-sectional study of the implication for which test should be the first-line investigation
Authors: Igbodike Emeka Philip , Badejoko Olusegun Olalekan , Fasubaa Olusola Benjamin , Ibitoye Bolanle Olubunmi , Loto Olabisi Morebise , Ikechebelu Joseph Ifeanyichukwu , Eleje George Uchenna , Onwuegbuna Arinze Anthony , Okpala Boniface Chukwuneme , Umeononihu Osita Samuel , Ogelle Onyecherelam Monday
Published: June 2022

Objective:

To assess the accuracy of hysterosalpingography in diagnosis of uterine and/or tubal factor infertility, using hysterolaparoscopy with dye test as the gold standard with an implication for which test should be the first-line investigation.

Methods:

A prospective cross-sectional study of 96 women who underwent hysterosalpingography and hysterolaparoscopy with dye test. All women within reproductive age group with utero-tubal infertility who underwent both hysterosalpingography and hysterolaparoscopy with dye-test procedure were included. The outcome measures were proportions of tubal blockage and intrauterine pathology. Individual and overall mean accuracy were calculated for hysterosalpingography, using hysterolaparoscopy with dye test as the gold standard. Patient had procedure of hysterosalpingography first and both laparoscopic surgeons and patients were blinded to the outcome of hysterolaparoscopy with dye test until analysis. Statistical significance was set at p < 0.05.

Results:

Overall, 128 women were assessed for eligibility while 96 women finally completed the study. Hysterosalpingography demonstrated diagnostic accuracy of 77.8% (p < 0.001), 76.3% (p < 0.001) and 78.3% (p < 0.001) for right, left and bilateral tubal blockage, respectively. Overall accuracy of hysterosalpingography tubal factor assessment was 77.4 ± 0.8% (95% confidence interval = 76.5% to 78.4%). Hysterosalpingography showed an accuracy of 85.7%, 86.6% and 76.7% for right, left and bilateral hydrosalpinx, respectively, given overall diagnostic accuracy of 83.0 ± 5.1% (95% confidence interval = 77.9% to 88.1%). Overall accuracy of hysterosalpingography in diagnosing intrauterine pathology was 68.5 ± 9.8% (95% confidence interval = 53.9% to 83.1%).

Conclusion:

Hysterosalpingography detects tubal blockade and intrauterine pathology poorly compared to hysterolaparoscopy with dye test. Hysterosalpingography may face unpredictable clinical situations biased by technological error, leading to unsuccessful evaluation and uncertain diagnosis. Although the cost-effectiveness, risk of surgery or anaesthesia flaws hysterolaparoscopy with dye test. Hysterosalpingography should not be the first-line utero-tubal assessment tool rather hysterolaparoscopy with dye test.
Building the hospital intelligent twins for all-scenario intelligence health care
Authors: Cheng Weibin , Lian Wanmin , Tian Junzhang
Published: June 2022

The COVID-19 pandemic has accelerated a long-term trend of smart hospital development. However, there is no consistent conceptualization of what a smart hospital entails. Few hospitals have genuinely reached being “smart,” primarily failing to bring systems together and consider implications from all perspectives. Hospital Intelligent Twins, a new technology integration powered by IoT, AI, cloud computing, and 5G application to create all-scenario intelligence for health care and hospital management. This communication presented a smart hospital for all-scenario intelligence by creating the hospital Intelligent Twins. Intelligent Twins is widely involved in medical activities. However, solving the medical ethics, protecting patient privacy, and reducing security risks involved are significant challenges for all-scenario intelligence applications. This exploration of creating hospital Intelligent Twins that can be a worthwhile endeavor to assess how to inform evidence-based decision-making better and enhance patient satisfaction and outcomes.
Pros and cons when using collaborative data analysis in nursing research: A discussion paper
Authors: Tind Anitha M. , Bernsdorf Line , Delmar Charlotte , Hoeck Bente
Published: June 2022

This discussion paper presents a discussion of pros and cons when using collaborative data analysis in nursing research, exemplified by our own attempt to include registered nurses from clinical practice in the analytical process of textual data. As the nursing profession covers diverse practices and roles, incorporating perspectives from these in nursing research is essential, to produce research that is recognizable and usable to both practice, education and academia. We therefore set out to try out a practical consultancy-style approach to collaborative data analysis in nursing research. The attempt proved to have several pros, few considerations and no cons.
Differences in the Assessment of Safe and Risky Driving Behaviors: Pedestrians Versus Drivers
Authors: Alonso Francisco , Esteban Cristina , Faus Mireia , Useche Sergio A.
Published: June 2022

Interactions between pedestrians and drivers are an important traffic safety issue. Psycho-social factors such as thoughts, perceptions and attitudes toward other people can be reliable predictors of riskier or safer behaviors among road users. The aim of this study was to assess how frequently participants perceive that drivers perform safe and risky road behaviors through drivers’ self-reported behavior and pedestrians and other drivers’ external perceptions. The results show that pedestrians assess the road behaviors of drivers in a seriously negative way. Meanwhile, drivers perceive their own behaviors as more appropriate than those performed by the rest of drivers. Women attribute more favorable assessments to other users’ road behavior. Similarly, older drivers do the same, and consider themselves “safer” users. On the contrary, younger drivers report a higher frequency of self-rated unsafe behaviors. The study highlights the importance of working on the awareness of self-rated road behaviors. Road safety interventions and programs in Spain must consider the differences related to gender and age.
Changes in Dynamic Postural Stability After ACL Reconstruction: Results Over 2 Years of Follow-up
Authors: Brophy Robert H. , Schafer Kevin A. , Knapik Derrick M. , Motley John , Haas Amanda , Matava Matthew J. , Wright Rick W. , Smith Matthew V.
Published: June 2022

Background:

The anterior cruciate ligament (ACL) is crucial for knee proprioception and postural stability. While ACL reconstruction (ACLR) and rehabilitation improve postural stability, the timing in improvement of dynamic postural stability after ACLR remains relatively unknown.

Purpose:

To evaluate changes in dynamic postural stability after ACLR out to 24 months postoperatively.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients undergoing ACLR were prospectively enrolled, and dynamic postural stability was assessed within 2 days before surgery, at 3-month intervals postoperatively to 18 months, then at 24 months. Measurements were made on a multidirectional platform tracking the patient’s center of mass based on pelvic motion. The amount of time the patient was able to stay on the platform was recorded, and a dynamic motion analysis score, reflecting the patient’s ability to maintain one’s center of mass, was generated overall and in 6 independent planes of motion.

Results:

A total of 44 patients with a mean age of 19.7 ± 6.2 years completed the study protocol. Overall mean dynamic postural stability improved significantly at 3, 6, 9, and 12 months after surgery, with continued improvement out to 24 months. Notable improvements occurred in medial/lateral and anterior/posterior stability from baseline to 6 months postoperatively, while internal/external rotation and flexion/extension stability declined initially after surgery from baseline to 3 months postoperatively before stabilizing to the end of the study period.

Conclusion:

Overall dynamic postural stability significantly improved up to 12 months after ACLR. Improvement in postural stability occurred primarily in the medial/lateral and anterior/posterior planes of motion, with initial decreases in the flexion/extension and internal/external rotational planes of motion.
Evaluating the Safety of Trough Versus Area Under the Curve (AUC)-Based Dosing Method of Vancomycin With Concomitant Piperacillin-Tazobactam
Authors: Karas Cassandra , Manning Kyle , Childress Darrell T. , Covington Elizabeth W. , Manis Melanie M.
Published: June 2022

Background: Vancomycin and piperacillin-tazobactam (VPT) is a common antibiotic combination used in hospitals, and there has been increasing data indicating that the combination is associated with increased rates of acute kidney injury (AKI). It is unclear if the dosing method of vancomycin would mitigate the risk of AKI seen with VPT. Objective: To observe and compare incidence of AKI in patients on VPT when using the trough-based dosing method versus the area-under-the-curve (AUC)-based dosing method. Methods: This was a multi-center, retrospective, observational study at 3 community hospitals. Adults receiving at least 48 hours of VPT were included. Patients with severe renal dysfunction, pregnant patients, prisoners, and patients with central nervous system infections, or malignancy were excluded. The primary outcome was incidence of AKI as defined by the Infectious Disease Society of America (IDSA) criteria. Results: A total of 300 patients were included in the study; 150 patients in both the trough and AUC groups. A total of 23 patients (15%) in the trough group and 17 patients (11%) in the AUC group met the primary outcome (odds ratio [OR]: 0.7058, 95% confidence interval [CI]: [0.3603, 1.3826], P = .3098). Conclusion and Relevance: The incidence of AKI was lower in the AUC group compared with the trough group; however, this was not significant. The results of our study suggest that there is no difference between incidence of AKI when using trough- or AUC-based dosing in those receiving VPT. Because of the small sample size and retrospective nature of the study, more data are needed.
CGRP and PACAP-38 play an important role in diagnosing pediatric migraine
Authors: Liu Junhui , Wang Guan , Dan Yuan , Liu Xinjie
Published: June 2022

Background

An increasing number of studies have suggested that the important role of vasoactive peptides, such as pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) and calcitonin gene-related peptide (CGRP), in the pathophysiology of migraine seems undeniable in adults, but studies in pediatric migraine patients remain scarce. We prospectively investigated CGRP and PACAP-38 plasma levels in children with migraine during ictal and interictal periods and compared the results between migraine patients with aura and without aura. We were the first to explore the diagnostic value of a combination of CGRP and PACAP-38.

Methods

Seventy-six migraine patients aged 4–18 years and seventy-seven age-matched healthy children were included in the study. Plasma vasoactive peptides were measured using the enzyme-linked immunosorbent assay (ELISA). Differences and correlations of groups were analyzed using the independent samples t-test, analysis of variance (ANOVA), Mann-Whitney U test, and multiple linear regression. We also performed logistic regression and receiver operating characteristic curve (ROC) analyses to evaluate the diagnostic value of CGRP and PACAP-38 in pediatric migraine.

Results

PACAP-38 and CGRP levels in migraine patients during the ictal and interictal periods were higher than those in controls (p < 0.001). PACAP-38 and CGRP levels in migraine patients with aura and without aura were higher than those in controls (p < 0.001). PACAP-38 and CGRP were independent risk factors in diagnosing pediatric migraine (adjusted OR (PACAP-38) =1.331, 95% CI: 1.177–1.506, p < 0.001; adjusted OR (CGRP) = 1.113, 95% CI: 1.064–1.165, p < 0.001). Area Under Curve (AUC) comparison: Combination (0.926) > CGRP (0.869) > PACAP-38 (0.867).

Conclusions

Our study found almost the same changes in CGRP and PACAP levels in pediatric migraine, suggesting that CGRP and PACAP-38 may work together to play an integral role in pediatric migraine. Higher CGRP levels were found in the ictal phase than in the interictal phase and with aura group than without aura group, indicating that CGRP may take part in the formation of pain and aura. Moreover, ROC and logistic regression analyses suggested that CGRP and PACAP-38 are good indicators to diagnose pediatric migraine, and the combination of CGRP and PACAP-38 was valuable in diagnosing pediatric migraine and differentiating pediatric migraine from non-migraine headaches.

Trial registration

The study has been registered at the Chinese Clinical Trial Registry (ChiCTR2100043157).
Genome-wide identification of BAM (β-amylase) gene family in jujube (Ziziphus jujuba Mill.) and expression in response to abiotic stress
Authors: Ma Yaping , Han Yaru , Feng Xuerui , Gao Handong , Cao Bing , Song Lihua
Published: June 2022

Background

Elevated temperature and drought stress have substantial impacts on fruit quality, especially in terms of sugar metabolism and content. β-Amylase (BAM) plays a critical role in regulating jujube fruit sugar levels and abiotic stress response. Nevertheless, little is known about the regulatory functions of the BAM genes in jujube fruit.

Results

Nine jujube BAM genes were identified, clustered into four groups, and characterized to elucidate their structure, function, and distribution. Multiple sequence alignment and gene structure analysis showed that all ZjBAM genes contain Glu-186 and Glu-380 residues and are highly conserved. Phylogenetic and synteny analysis further indicated that the ZjBAM gene family is evolutionarily conserved and formed collinear pairs with the BAM genes of peach, apple, poplar, Arabidopsis thaliana, and cucumber. A single tandem gene pair was found within the ZjBAM gene family and is indicative of putative gene duplication events. We also explored the physicochemical properties, conserved motifs, and chromosomal and subcellular localization of ZjBAM genes as well as the interaction networks and 3D structures of ZjBAM proteins. A promoter cis-acting element analysis suggested that ZjBAM promoters comprise elements related to growth, development, phytohormones, and stress response. Furthermore, a metabolic pathways annotation analysis showed that ZjBAMs are significantly upregulated in the starch and sucrose metabolism, thereby controlling starch-maltose interconversion and hydrolyzing starch to maltose. Transcriptome and qRT-PCR analyses revealed that ZjBAMs respond positively to elevated temperature and drought stress. Specifically, ZjBAM1, ZjBAM2, ZjBAM5, and ZjBAM6 are significantly upregulated in response to severe drought. Bimolecular fluorescence complementation analysis demonstrated ZjBAM1-ZjAMY3, ZjBAM8-ZjDPE1, and ZjBAM7-ZjDPE1 protein interactions that were mainly present in the plasma membrane and nucleus.

Conclusion

The jujube BAM gene family exhibits high evolutionary conservation. The various expression patterns of ZjBAM gene family members indicate that they play key roles in jujube growth, development, and abiotic stress response. Additionally, ZjBAMs interact with α-amylase and glucanotransferase. Collectively, the present study provides novel insights into the structure, evolution, and functions of the jujube BAM gene family, thus laying a foundation for further exploration of ZjBAM functional mechanisms in response to elevated temperature and drought stress, while opening up avenues for the development of economic forests in arid areas.
Prevalence and prognosis of left ventricular diastolic dysfunction in community hypertension patients
Authors: Zhou Dan , Yan Mengqi , Cheng Qi , Feng Xiaoxuan , Tang Songtao , Feng Yingqing
Published: June 2022

Left ventricular diastolic dysfunction (LVDD) is common in hypertension and is a predictor of increased cardiovascular risk, however the effect of LVDD, detected by new guideline, on major adverse cardiac events (MACE) is unknown in hypertensive patients without known cardiovascular disease. The present study aims to evaluate LVDD in a community hypertension cohort study and assess the effect of LVDD on MACE. we studied 283 asymptomatic nonischemic patients with hypertension who had baseline echocardiogram between 2012 and 2014. Patients were followed for MACE (myocardial infarction, coronary revascularization procedures, heart failure, stroke, all-cause mortality) with mean follow-up of 5.4 years. A Cox proportional hazards model was used to assess the association of LVDD with MACE. At baseline, 35 of the 283 hypertensions were diagnosed with LVDD (12.3%) and 25 patients were women (15.5%). Women had higher frequency of LVDD than men (8%). During follow-up, there were 26.6% patients occurring MACE in the LVDD group at baseline, 9.9% patients occurring MACE in the group with normal diastolic function. In multivariable Cox regression analyses, LVDD was a stronger predictor of MACE (HR: 2.5; 95% CI: 1.20 to 5.25; c- statistics 0.805) than E/e′ ratio (HR: 1.13; 95% CI: 1.04 to 1.22). LVDD was strongly associated with MACE in hypertension patients.