bluuebunny/crossref_metadata_2025 huggingface dataset:
Circadian Rhythm, Clock Genes, and Hypertension: Recent Advances in Hypertension
Authors: Costello Hannah M. , Gumz Michelle L.
Published: October 2021

Accumulating evidence suggests that the molecular circadian clock is crucial in blood pressure (BP) control. Circadian rhythms are controlled by the central clock, which resides in the suprachiasmatic nucleus of the hypothalamus and peripheral clocks throughout the body. Both light and food cues entrain these clocks but whether these cues are important for the circadian rhythm of BP is a growing area of interest. The peripheral clocks in the smooth muscle, perivascular adipose tissue, liver, adrenal gland, and kidney have been recently implicated in the regulation of BP rhythm. Dysregulation of the circadian rhythm of BP is associated with adverse cardiorenal outcomes and increased risk of cardiovascular mortality. In this review, we summarize the most recent advances in peripheral clocks as BP regulators, highlight the adverse outcomes of disrupted circadian BP rhythm in hypertension, and provide insight into potential future work in areas exploring the circadian clock in BP control and chronotherapy. A better understanding of peripheral clock function in regulating the circadian rhythm of BP will help pave the way for targeted therapeutics in the treatment of circadian BP dysregulation and hypertension.
The Association of Age at Diagnosis of Hypertension With Brain Structure and Incident Dementia in the UK Biobank
Authors: Shang Xianwen , Hill Edward , Zhu Zhuoting , Liu Jiahao , Ge B. Zongyuan , Wang Wei , He Mingguang
Published: October 2021

Little is known about whether the association of hypertension with brain volume and dementia is modified by an individual’s age at their diagnosis of hypertension. Our analysis was based on the UK Biobank with baseline data collected between 2006 and 2010. Brain magnetic resonance imaging was used to measure brain volumes between 2014 and 2019. Dementia was ascertained using hospital inpatient, mortality, and self-reported data until 2021. We randomly selected a control participant for each hypertensive participant stratified by hypertension diagnosis age using propensity score. The cohort comprised 11 399 individuals with hypertension and 11 399 controls for the brain volume analysis and 124 053 individuals with hypertension and 124 053 controls for the dementia analysis. Individuals with hypertension diagnosed at ages <35 (β (95% CI, −10.83 [−19.27 to −2.39] mL), 35 to 44 (−6.82 [−12.18 to −1.46] mL), and 45 to 54 years (−3.77 [−6.91 to −0.64] mL) had smaller total brain volume compared with the corresponding controls in the multivariable analysis. Similarly, hypertension diagnosed in early- and mid-life was independently associated with smaller volumes of gray matter, peripheral cortical gray matter, and white matter. Over a median follow-up of 11.9 years, 4626 cases of incident all-cause dementia were documented. Individuals with hypertension diagnosed at 35 to 44 years of age only (hazard ratio [95% CI]: 1.61 [1.31–1.99]) had a higher risk of all-cause dementia compared with the corresponding controls after adjustment for covariates. Hypertension diagnosed in young adulthood or mid-life, but not late life is associated with smaller brain volumes and an increased risk of dementia.
Arteriosclerosis, Atherosclerosis, and Cardiovascular Health: Joint Relations to the Incidence of Cardiovascular Disease
Authors: Vasan Ramachandran S. , Pan Stephanie , Larson Martin G. , Mitchell Gary F. , Xanthakis Vanessa
Published: October 2021

Aging is associated with an increased prevalence of subclinical atherosclerosis and stiffening of the arterial walls (arteriosclerosis). These 2 coexisting conditions are mitigated by the presence of ideal cardiovascular health (optimal levels of fasting blood glucose, cholesterol, resting blood pressure, body mass index, no smoking, good dietary quality, and regular physical activity). We hypothesized that the concomitant presence of subclinical atherosclerosis (coronary artery calcification), arteriosclerosis (higher carotid-femoral pulse wave velocity), and suboptimal cardiovascular health is associated with increased risk of cardiovascular disease relative to the absence of these 3 conditions. We tested our hypothesis in the community-based Framingham Heart Study cohort (N=2580, mean age 52 years, 49% women). We classified participants based on (1) the presence versus absence of coronary artery calcium; (2) higher (>sex-specific median) carotid-femoral pulse wave velocity; (3) poor cardiovascular health (score 0–7). Thus, participants could have no abnormalities (referent group), 1, 2, or 3 suboptimal measures. We used Cox regression to relate the number of suboptimal measures (0–3) to the incidence of cardiovascular disease during follow-up (median 14 years). Cardiovascular disease incidence rates/1000 person-years in groups with 0 to 3 suboptimal measures were 1.93 (95% CI, 1.28–2.90), 4.68 (95% CI, 3.48–6.29), 8.93 (95% CI, 6.99–11.41), and 18.26 (95% CI, 14.65–22.77), respectively. Compared with the group with no abnormalities, corresponding multivariable-adjusted hazards ratios for cardiovascular disease were 1.81, 2.18, and 3.71, respectively (
P
<0.05 for all). Our observations suggest that the conjoint presence of atherosclerosis, arteriosclerosis, and poor cardiovascular health substantially elevates cardiovascular disease risk, whereas their absence denotes low risk.
Complex Profiles of Cerebrovascular Disease Pathologies in the Aging Brain and Their Relationship With Cognitive Decline
Authors: Lamar Melissa , Leurgans Sue , Kapasi Alifiya , Barnes Lisa L. , Boyle Patricia A. , Bennett David A. , Arfanakis Konstantinos , Schneider Julie A.
Published: October 2021

Background and Purpose:

Cerebrovascular disease (CVD) pathologies including vessel disease (atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy) and tissue injury (macroinfarcts and microinfarcts) each contribute to Alzheimer and other forms of dementia. CVD is often a complex mix of neuropathologies, with little known about the frequencies of differing combinations or their associations with cognition.

Methods:

We investigated 32 possible CVD combinations (3 types of vessel disease and 2 types of tissue injury) using autopsy data from 1474 decedents (≈88 years at death; 65% female) of Rush Alzheimer’s Disease Center studies. We determined frequencies of all 32 CVD combinations and their relationships with global and domain-specific cognitive decline using mixed-effect models adjusted for demographics, neuropathologies, time before death, and interactions of these variables with time.

Results:

Of the 1184 decedents with CVD neuropathology (80% of the total sample), 37% had a single CVD (67–148 decedents/group) while 63% had mixed CVD profiles (11–54 decedents/group). When considered as 2 distinct groups, the mixed CVD profile group (but not the single CVD profile group) showed a faster cognitive decline across all domains assessed compared with decedents without CVD neuropathology. Most mixed CVD profiles, especially those involving both atherosclerosis and arteriolosclerosis, showed faster cognitive decline than any single CVD profile considered alone; specific mixed CVD profiles differentially associated with individual cognitive domains.

Conclusions:

Mixed CVD, more common than single CVD, is associated with cognitive decline, and distinct mixed CVD profiles show domain-specific associations with cognitive decline. CVD is not monolithic but consists of heterogenous person-specific combinations with distinct contributions to cognitive decline.
National Institutes of Health Stroke Scale: comparison of original and modified versions for Singapore culture
Authors: Lim Shu Han , Guek Tai Yan , Woon Fung Peng , Tay Deirdre Danyi , Ho Shu Swen , Ng Szu Chyi , De Silva Deidre Anne
Published: October 2021

Introduction:

The National Institutes of Health Stroke Scale (NIHSS), originally designed in the United States of America, contains items on dysphasia and dysarthria that are deemed culturally unsuitable for the Singapore context. We compared the error rates of dysphasia objects, dysphasia phrases and dysarthria words between the original and alternative items in a cohort of Singaporean subjects without dysphasia or dysarthria.

Methods:

In this prospective study, 140 English-speaking Singaporean subjects without impairments of dysphasia or dysarthria had an assessment of NIHSS items 9 and 10 using the original and alternative items. Paired analyses were conducted for comparison of error rates.

Results:

The error rates were high for four original dysphasia objects (Hammock: 62.9%, Cactus: 38.6%, Feather: 23.6%, Glove: 20.7%) and significantly lower for alternative items (Snail: 5%, Horse: 1.4%, Hanger: 1.4%, Car: 0%) (P < 0.001). For dysphasia phrases and dysarthria words, the error rates were low and there were no differences in error rates between the original and alternative items.

Conclusion:

There are cultural issues with several dysphasia objects in the original NIHSS as evidenced by the high error rates, which were lowered with more culturally suitable alternatives. This study formed a basis to derive a more suitable version of the NIHSS for English-speaking subjects in Singapore.
Association of the FRAIL scale with rehabilitation outcomes in the community hospital setting
Authors: Jiang Jeffrey , Han Audrey Yan Yi , Goh Joel
Published: October 2021

Introduction:

Frailty is associated with adverse health outcomes and can be measured using the FRAIL scale. In Singapore, its use has been studied in tertiary hospitals but not in community hospitals. A tool to predict rehabilitation outcomes would allow for better risk stratification and allocation of resources. We aimed to determine whether the FRAIL scale is associated with rehabilitation outcomes in patients admitted to the community hospital setting, where post-acute care and rehabilitation are primarily delivered.

Methods:

This was a retrospective cohort study. The FRAIL scale was utilised to screen 560 older adults who were admitted to a community hospital for rehabilitation. Data were analysed to determine the relationship between baseline characteristics and frailty status, with rehabilitation outcome measures of absolute functional gain, rehabilitation effectiveness, rehabilitation efficiency, length of stay and discharge destination.

Results:

The combined score of the FRAIL scale showed significant negative association with absolute functional gain (P < 0.001), rehabilitation effectiveness (P < 0.001) and rehabilitation efficiency (P < 0.001), whereas it was positively associated with increased length of stay (P < 0.05) and a need for continued support in increased care settings (P < 0.001). Individual components of the FRAIL scale, in particular, the ‘fatigue’, ‘ambulation’ and ‘loss of weight’ components, appeared to be highly associated with rehabilitation effectiveness and efficiency, especially among pre-frail patients.

Conclusion:

The utility of the FRAIL scale as an indicator of frailty status and its association with rehabilitative outcomes in the post-acute care setting were demonstrated. Moreover, the FRAIL scale may better predict the rehabilitative progress of pre-frail patients.
Decadal comparison (1950–2020) of benthic marine flora from Central and Southern Vietnam
Authors: BELOUS OKSANA S. , TITLYANOV EDUARD A. , TITLYANOVA TAMARA V.
Published: October 2021

The benthic flora of Central and Southern Vietnam and its historical changes between 1950 and 2020 were studied. Three collections were compared: collection A (1950–1970), collection B (1980–2000) and collection С (2000–2020). In all collections (1950–2020), a total of 702 macroalgal taxa and their forms have been found, including 386 red (55%), 142 brown (20%) and 174 green (25%) algal taxa. A comparison of the collections has shown significant changes in species compositions of the marine flora during the period (the maximum similarity of the benthic flora of the three compared collections was about 63%). In each taxonomic group of macrophytes, there was a proportional replacement of some species by others. It is suggested that the revealed decadal changes in the marine flora of Central and Southern Vietnam are natural, periodic (seasonal, annual or perennial) and regulated by internal factors of the ecosystem.
A UK national audit of the laboratory investigation of phaeochromocytoma and paraganglioma
Authors: Boot Christopher , Toole Barry , Harris Sharman , Tetlow Lisa , Wassif Wassif S
Published: October 2021

Background

Phaeochromocytomas and paragangliomas (PPGL) are catecholamine secreting tumours associated with significant morbidity and mortality. Timely diagnosis and management are essential. A range of laboratory tests can be utilised in the investigation of PPGL. There is scope for significant variation in practice between centres. We aimed to investigate how the laboratory investigation of PPGL is performed in laboratories across the United Kingdom.

Methods

A questionnaire consisting of 21 questions was circulated to Clinical Biochemistry laboratories in the United Kingdom via the Association for Clinical Biochemistry and Laboratory Medicine office. The survey was designed to allow audit against Endocrine Society Guidelines on the Investigation and Management of PPGL and to obtain information on other important aspects not included in these guidelines.

Results

Responses were received from 58 laboratories and the data were compiled. The majority of laboratories use either urine or plasma metanephrines in first-line testing for PPGL, although a number of different combinations of biochemistry tests are utilised in different centres. All laboratories measuring metanephrines or catecholamines in-house use LC or LC-MS/MS methods. There are some marked differences between laboratories in urine metanephrines reference ranges used and sample requirements.

Conclusions

There is evidence of good practice in UK laboratories (as assessed against Endocrine Society Guidelines) such as widespread use of urine/plasma metanephrines and appropriate analytical methodologies used. However, there is also evidence of variations in practice in some areas that should be addressed.
Five Important Parental Involvement Variables that Affect Young Children’s Mathematical Achievements: A Comparative Study
Authors: Alreshidi Ahmed Mubarak , Alsharif Khalid Mohammed , Kandeel Refat Abdelsamad Abouelgheat
Published: October 2021

Success in mathematics has been shown to increase career opportunities; thus, improving student learning in mathematics is vital for educational policymakers. This study investigated the effects of five parental involvement variables on young children’s mathematical achievements in 10 countries, including seven Arab countries, and found significant effects for all of them. Students who attended pre-primary education achieved higher mathematics scores compared to those who did not. Students who had been helped with or had their homework reviewed fewer times by their parents achieved significantly higher scores than those who had been helped or checked on more frequently. Students who had not attended any extra lessons to excel over or keep up with classmates achieved significantly higher scores. Students whose parents had university degrees attained significantly better results. Finally, students whose parents had higher expectations achieved significantly better results. These results have implications to enhance students’ mathematical achievements in Arab countries.
A Neural Networks Approach to Determine Factors Associated With Self-Reported Discomfort in Picking Tasks
Authors: Haj Mahmoud Olfa , Pontonnier Charles , Dumont Georges , Poli Stéphane , Multon Franck
Published: October 2021

Objective

A neural networks approach has been proposed to handle various inputs such as postural, anthropometric and environmental variables in order to estimate self-reported discomfort in picking tasks. An input reduction method has been proposed, reducing the input variables to the minimum data required to estimate self-reported discomfort with similar accuracy as the neural network fed with all variables.

Background

Previous works have attempted to explore the relationship between several factors and self-reported discomfort using observational methods. The results showed that this relationship was not a simple linear relationship. Another study used neural networks to model the function returning reported discomfort according to static posture, age, and anthropometrics variables. The results demonstrated the model’s ability to predict reported discomfort. But all the available variables were used to design the neural network.

Method

Eleven subjects carried-out picking tasks with various masses (0, 1, 3 kg) and imposed duration (5, 10, or 15 s). Continuous REBA score, anthropometric and environmental data were computed, and subjects’ discomfort were collected. The data set of this work consisted in the computed continuous REBA score, anthropometric, environmental data and collected subjects’ discomfort.

Results

The results showed that the correlation between the estimated and experimental tested data was equal to 0.775 when using all the 14 available variables. After data reduction, only 6 variables were left, with a very close performance when predicting discomfort.

Conclusion

A neural network approach has been proposed to estimate self-reported discomfort according to a minimum set of postural, anthropometric and environmental variables in picking tasks.

Application

This method has the potential to support ergonomists in workstation designing processes, by adding discomfort prediction to virtual manikins’ behaviors in simulation tools.
Self-Regulation of Driving Behavior Under the Influence of Cannabis: The Role of Driving Complexity and Driver Vision
Authors: Ortiz-Peregrina Sonia , Oviedo-Trespalacios Oscar , Ortiz Carolina , Anera Rosario G.
Published: October 2021

Objective

This study analyzed the self-regulation behaviors of drivers under the influence of cannabis and its relationship with road complexity and some driver traits, including visual deterioration.

Background

Cannabis is the illicit drug most often detected in drivers; its use results in significant negative effects in terms of visual function. Self-regulation behaviors involve the mechanisms used by drivers to maintain or reduce the risk resulting from different circumstances or the driving environment.

Methods

Thirty-one young, occasional cannabis users were assessed both in a baseline session and after smoking cannabis. We evaluated the visual function (visual acuity and contrast sensitivity) and driver self-regulation variables of both longitudinal and lateral control as the speed adaptation and standard deviation of lateral position (SDLP).

Results

Visual function was significantly impaired after cannabis use. Recreational cannabis use did not result in self-regulation, although some road features such as curved roads did determine self-regulation. Male participants adopted mean faster driving speeds with respect to the speed limit. Driver age also determined better lateral control with lower SDLPs. In addition, visual impairment resulting from cannabis use (contrast sensitivity) was linked with self-regulation by changes in longitudinal and lateral control.

Conclusion

Contrast sensitivity could be a good indicator of individual visual status to help determine how drivers self-regulate their driving both in normal conditions and while under the influence of cannabis.

Application

The findings provide new insights about driver self-regulation under cannabis effects and are useful for policy making and awareness campaigns.
Trust upset: Redefining the terms of trust in maintaining exchange relations
Authors: Qi Xiaoying
Published: October 2021

In contractual relations, malfeasance is subject to sanction by formal institutions. Trust is widely held to be an informal basis of non-contractual exchange, in which breaches of trust lead to exposure, resulting in the perpetrator’s loss of reputation and likely exclusion from future exchanges. The present article, on the other hand, shows that breaches of trust may lead to neither of these outcomes. Interview data reported here show that individuals who experience violations of agreement may develop coping strategies that do not include exposure of betrayal, confronting the trust-breaker, or retaliation. A contribution of the present article is to show that these differences can be conceptualized as involving two possible strategies by the betrayed party: one involving retaliation, directed to public disclosure of the betrayer’s unreliability and possible expulsion from future exchanges; the other is self-management, in which betrayal leads to the betrayed modifying their expectations and behaviour. A second contribution is to show how trust may be sociologically understood as a continuous process, requiring renegotiation, rearticulation, and even redefinition, rather than as a resolved and final commitment.
Effects of a Disability Simulation Activity on the Achievement, Efficacy, Attitudes, and Interests of Preservice Professionals
Authors: Hollo Alexandra , Brigandi Carla B. , Jelsema Casey M. , Shi Mingming
Published: October 2021

Introduction: Disability simulation activities are commonly used for various purposes in higher education; however, instructors may be unaware of controversies regarding their use. The purpose of this research was to assess the effects of an activity using low vision goggles to simulate visual impairment in the context of an undergraduate course in special education. We highlight the need for instructors to consider the appropriateness of disability simulation activities given possible countertherapeutic effects. Methods: In this cluster-randomized trial, 11 classes (248 students) of preservice education and related services professionals were randomized to experimental (lecture + simulation) or control (lecture only) conditions. During a single class session, all students received basic information about visual impairment and watched a video on being a human guide. Students in the experimental group then practiced guiding and being guided while wearing low vision goggles. At the end of class, students completed three Likert-type surveys and later completed a quiz using publisher-developed materials. Results: Results showed individuals in the experimental group reported higher levels of interest and enjoyment than those in the control condition; however, there were no statistically significant differences in attitudes toward persons with visual impairments, confidence or self-efficacy for working with students with visual impairments, content knowledge, or perceptions of activity usefulness. Discussion: Findings of positive engagement in the absence of harmful effects indicate that disability simulation activities should be neither promoted nor denigrated wholesale; instead, instructors must weigh carefully potential benefits and drawbacks. Discussion includes considerations for professional education programs in using such simulations to promote skill acquisition via positive and respectful learning experiences. Implications for practitioners: Instructors who use disability simulation activities are encouraged to consider whether to discontinue this practice or incorporate principles recommended by the disability community and assess outcomes to ensure they are not perpetuating harmful stereotypes.
Surgical septal myectomy for hypertrophic cardiomyopathy. The Iranian experience
Authors: Ghavidel Alireza Alizadeh , Alizadehasl Azin , Khalilipur Ehsan , Amirghofran Ahmadali , Nezhadbahram Hanieh , Azarfarin Rasoul
Published: October 2021

Introduction

Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary heart muscle disorder characterized by significant myocardial hypertrophy. we assessed perioperative and long-term follow-up data of Iranian HOCM patients who underwent SM in 2 pioneering centers.

Methods

Clinical data of patients with HOCM septal myectomy are collected. Thirty-day outcome and long-term follow-up data for recurrence of gradient and mortality are reported.

Results

Ninety-six patients in two different centers enrolled in the study. Most patients of 52 patients in center 1 were male (34/52 [65.3%]).and the mean age was of 36.7  ±  19 years. Syncope before admission was reported in 5.7%, the mean left ventricular ejection fraction on admission was 53  ±  8%, the mean left ventricular outflow tract gradient was 66.3  ±  20.4 mm Hg, and the mean preoperativeseptal thickness was 25.4  ±  6.7 mm. A redo SM was performed in 3 patients (5.8%), mitral valve repair in 5 patients (9.6%), and atrioventricular repair in 5 patients (9.6%). A residual systolic anterior motion was detected in 4 patients (7.7%), the mean postoperative septal thickness was 19  ±  6 mm (25.1% septal thickness reduction), and in-hospital mortality was 5.8% (n  =  3). A longer-term follow-up showed death in 3 patients (5.8%) and late recurrent left ventricular outflow tract obstruction in 1 patient.

Conclusions

Transaortic myectomy is an effective surgery with acceptable early and late mortality rates. Improvements in functional status are seen in almost all patients. Appropriate SM is crucial to a good clinical outcome. Long-term survival is excellent and cardiac sudden death is extremely rare after a good surgical treatment.
Innovative techniques of left atrial exposure in minimally invasive mitral valve repair
Authors: Pham Dat T , Le Thanh N , Doan Hung Q
Published: October 2021

Various atrial retractors have been developed to achieve optimal exposure of mitral valve in minimally invasive surgery. We introduce our technique of only using retraction sutures to expose mitral valve. This method is simple, efficient, and provides good exposure of the left atrium without causing traumatic injury.
Chaphamaparvovirus antigen and nucleic acids are not detected in kidney tissues from cats with chronic renal disease or immunocompromised cats
Authors: Michel Adam O. , Donovan Taryn A. , Roediger Ben , Lee Quintin , Jolly Christopher J. , Monette Sébastien
Published: October 2021

Chronic kidney disease (CKD) is a common cause of morbidity and mortality in domestic cats, but the cause is still largely elusive. While some viruses have been associated with this disease, none have been definitively implicated as causative. Recently, Rodent chaphamaparvovirus 1 was recognized as the cause of murine inclusion body nephropathy, a disease reported for over 40 years in laboratory mice. A novel virus belonging to the same genus, Carnivore chaphamaparvovirus 2, was recently identified in the feces of cats with diarrhea. The goal of this study was to investigate the possible role of chaphamaparvoviruses including members of Rodent chaphamaparvovirus 1 and Carnivore chaphamaparvovirus 2 in the development of feline CKD. The presence of these viruses was retrospectively investigated in formalin-fixed paraffin-embedded feline kidney samples using polymerase chain reaction, in situ hybridization, and immunohistochemistry. Cats were divided into 3 groups: normal ( N = 24), CKD ( N = 26), and immunocompromised ( N = 25). None of the kidney tissues from any of the 75 cats revealed the presence of chaphamaparvovirus DNA, RNA, or antigen. We conclude that viruses belonging to the chaphamaparvovirus genus are unlikely to contribute to the occurrence of feline CKD.
Biophysical properties of electrospun chitosan-grafted poly(lactic acid) nanofibrous scaffolds loaded with chondroitin sulfate and silver nanoparticles
Authors: Júnior Alexandre F , Ribeiro Charlene A , Leyva Maria E , Marques Paulo S , Soares Carlos R J , Alencar de Queiroz Alvaro A
Published: October 2021

The aim of this work was to study the biophysical properties of the chitosan-grafted poly(lactic acid) (CH-g-PLA) nanofibers loaded with silver nanoparticles (AgNPs) and chondroitin-4-sulfate (C4S). The electrospun CH-g-PLA:AgNP:C4S nanofibers were manufactured using the electrospinning technique. The microstructure of the CH-g-PLA:AgNP:C4S nanofibers was investigated by proton nuclear magnetic resonance (1H-NMR), scanning electron microscopy (SEM), UV-Visible spectroscopy (UV-Vis), X-ray diffraction (XRD), and Fourier transform infrared (ATR-FTIR) spectroscopy. ATR-FTIR and 1H-NMR confirm the CH grafting successfully by PLA with a substitution degree of 33.4%. The SEM measurement results indicated apparently smooth nanofibers having a diameter range of 340 ± 18 nm with porosity of 89 ± 3.08% and an average pore area of 0.27 μm2. UV-Vis and XRD suggest that silver nanoparticles with the size distribution of 30 nm were successfully incorporated into the electrospun nanofibers. The water contact angle of 12.8 ± 2.7° reveals the hydrophilic nature of the CH-g-PLA:AgNP:C4S nanofibers has been improved by C4S. The electrospun CH-g-PLA:AgNP:C4S nanofibers are found to release ions Ag+ at a concentration level capable of rendering an antimicrobial efficacy. Gram-positive bacteria ( S.aureus) were more sensitive to CH-g-PLA:AgNP:C4S than Gram-negative bacteria ( E. coli). The electrospun CH-g-PLA:AgNP:C4S nanofibers exhibited no cytotoxicity to the L-929 fibroblast cells, suggesting cytocompatibility. Fluorescence microscopy demonstrated that C4S promotes the adhesion and proliferation of fibroblast cells onto electrospun CH-g-PLA:AgNP:C4S nanofibers.
Precision open-loop control of piezoelectric actuator
Authors: Nie Zhigang , Cui Yuguo , Huang Jun , Wang Yiqiang , Chen Tehuan
Published: October 2021

Due to space constraints, some micro-assemblies and micro-operating systems cannot install sensors, so it is challenging to achieve closed-loop control. For this reason, a precision open-loop control strategy for piezoelectric actuators is proposed. Firstly, based on the PI model and the proposed threshold partition method, the hysteresis model of the piezoelectric actuator with rate-dependent and few operators is established. Then the hysteresis error of the piezoelectric actuator is compensated by the inverse model obtained. Secondly, the creep model of the logarithmic piezoelectric actuator with simple expression and few parameters is established. Then, a creep controller without demand inverse is designed to compensate for the creep error of the piezoelectric actuator. Finally, a ZVD (Zero Vibration Derivative) input shaping method with good robustness is given to eliminate the oscillation generated by the piezoelectric actuator under the action of the step signal. The experimental results show that the displacement error of piezoelectric actuator is reduced from −9.07 to 9.46 μm to −1.22 to 1.78 μm when the maximum displacement is 120 μm after hysteresis compensation; after creeping compensation, within the action time of the 1200 s, the displacement creep of the piezoelectric actuator was reduced from 5.5 μm before compensation to 0.3 μm; after the oscillation control, the displacement overshoot of the piezoelectric actuator is reduced to 0.6% of that before control.
Is Symptom Screening Useful for Identifying COVID-19 Infection in School Settings? Georgia, USA
Authors: Swanson Megan , Hast Marisa , Burnett Eleanor , Oraka Emeka , Kimball Anne , Morris Elana , Marcet Paula L. , Almendares Olivia , Franklin Rachel , Mehari Lemlem , McCloud Jazmyn , Kirking Hannah L. , Tate Jacqueline E. , Scott Colleen
Published: October 2021

This study’s goal was to characterize the utility of symptom screening in staff and students for COVID-19 identification and control of transmission in a school setting. We conducted a secondary analysis of cross-sectional data for staff, students and associated household members in a Georgia school district exposed to COVID-19 cases who received RT-PCR testing and symptom monitoring. Among positive contacts, 30/49 (61%) of students and 1/6 (17%) of staff reported no symptoms consistent with COVID-19. Symptom sensitivity was 30% in elementary students and 42% in middle/high students. Fifty-three percent (10/19) of symptomatic positive contacts had at least one household member test positive for SARS-CoV-2 compared with 50% (10/20) of asymptomatic positive contacts. The absence of symptoms in children is not indicative of a lack of SARS-CoV-2 infection or reduced risk of infection for associated household members. Testing all close contacts of people with COVID-19 in schools is needed to interrupt transmission networks.
Climate Change and Young People in Uganda: A Literature Review
Authors: Mugeere Anthony , Barford Anna , Magimbi Paul
Published: October 2021

The disruptions of anthropogenic climate change are increasingly severe. People living in sub-Saharan Africa are especially exposed to these risks, and amongst them young people. It is well established that climate disruptions have the potential to halt education, displace populations, and wreck infrastructure. This rigorous literature review focuses on climate change in the landlocked East African country of Uganda, demographically the world’s third youngest country, where young people struggle to get by due to insufficient work opportunities. Extended to other countries in the Eastern and Central African region, the review considers what is known about the intersection of youth livelihoods and climate change; young people’s susceptibility to climate disruption due to limited resources and livelihood options; and the constraints around their responses. The review findings suggest the need for substantial youth informed interventions to bolster young people’s economic resilience and adaptive capacity given the worsening climate change and prolonged population growth.
Parental Attitudinal and Behavioral Change Associated With Prevention-Focused Parenting Education: An Interpretive Description
Authors: Benzies Karen M. , Kurilova Jana , van der Merwe Mathilde
Published: October 2021

Prevention-focused parenting education programs (P-FPEPs) provide knowledge and support to parents to strengthen parent–child relationships, enhance parental and family well-being, and promote healthy child development. The positive impact of such programs on child health and development is well documented. Yet, how P-FPEPs influence parents remains unclear. The objective of this study was to explore parental perceptions of changes associated with participation in a P-FPEP. We analyzed data using interpretive description with qualitative responses from 459 parents who participated in nine different P-FPEPs in a large Canadian city. Participation in a P-FPEP changed parents’ relationships with themselves, their children, their partners, and their community. Participants’ relationship with themselves as parents changed as they recognized the value of self-care without guilt, gained knowledge of typical child development, and developed greater confidence in their parenting. Positive changes in participants’ relationships with their children were facilitated by better understanding the perspective of the child, improving communication, feeling more connected to their child, and changing parenting behavior. For many participants, the relationship with their partner improved when they learned about different parenting styles and began communicating more openly. Participants’ relationships with the larger community were strengthened as they experienced a sense of normalization of their parenting experiences, developed connections with other parents, and learned about community resources. Independent of any specific program curriculum or structure, change associated with P-FPEPs focused on how a shift in understanding and attitudes changed relationships and consequently changed parenting behavior.
Development and Evaluation of an Online Toolkit for Managers of 9-1-1 Emergency Communications Centers to Reduce Occupational Stress
Authors: Meischke Hendrika , Rogers Megan , Manchanda Sarah , Sears Jeanne M. , Revere Debra , Grewal Riana , Beaton Randal
Published: October 2021

This article describes the development and evaluation of an online workplace stress reduction toolkit for use by managers of 9-1-1 emergency communication centers (ECCs). A three-step process for development and testing of digital learning resources was used: (1) establishing need and focus through ECC manager stakeholder engagement, (2) pretesting of the toolkit with the target ECC manager audience, and (3) toolkit utilization and evaluation. The toolkit was developed in close partnership with stakeholders throughout the entire process. Toolkit usage was documented via registration data. The evaluation utilized an online survey that included closed and open-ended questions, which were analyzed using descriptive statistics and qualitative thematic analysis. Over a 20-month period, 274 people registered for the toolkit and, of those, 184 (67%) accessed the content. Respondents to the evaluation survey ( N = 156) scored the toolkit highly on satisfaction, self-efficacy, and perceived utility measures. Survey respondents reported intent to apply toolkit content through the following: providing organizational resources to help workers take better care of themselves (41%); creating a lower stress worksite environment (35%) and sharing resources with staff to (1) reduce stress (19%), (2) support conflict resolution (21%), and (3) prevent and/or stop bullying (17%). In delivering actionable content to ECC managers, the toolkit shows promise in addressing and mitigating occupational stress in ECCs. Further research needs to determine the relationship of this strategy for reducing ECC stress.
Comparison of Long-Term Efficacy in S-1 and Capecitabine With Oxaliplatin as Adjuvant Chemotherapy for Patients With Gastric Cancer After Curative Surgery: A Retrospective, Single-Center Observational Study
Authors: Oh Sung E. , An Ji Y. , Choi Min-Gew , Lee Jun H. , Sohn Tae S. , Bae Jae M.
Published: October 2021

Purpose: Various adjuvant chemotherapies have been introduced for gastric cancer patients after gastrectomy with D2 lymph node dissection. Although the mainstream regimen of adjuvant chemotherapy in Korea includes S-1 monotherapy (TS-1) and capecitabine with oxaliplatin (XELOX), few studies have compared the long-term efficacies of these 2 regimens. Methods: Between January 2010 and June 2017, 2021 patients were diagnosed with gastric cancer and underwent curative resection with adjuvant chemotherapy at our institution. Of 1461 patients with stage IB-III gastric cancer, 825 received TS-1 and 636 received XELOX as adjuvant chemotherapy. We retrospectively reviewed their medical records and analyzed the postoperative 5-year overall survival (OS) and disease-free survival (DFS) of these 2 groups. Results: The patients in the XELOX group had more advanced stage of cancer than the TS-1 group (stages III and II: 56.6% and 43.1%, respectively, in XELOX and 35.3% and 57.0% in TS-1; P < .001). The DFS did not differ significantly between the 2 study groups at any pathologic stage. The OS differed significantly only at pathologic stages IIA ( P  = .024) and IIB ( P  = .015). In a multivariate analysis of stage II patients, type of regimen was an independent prognostic factor of OS (XELOX vs TS-1; hazard ratio: 0.47, 95% confidence interval: 0.25-0.89, P  = .021). Conclusion: There were similar long-term efficacies between these 2 regimens in advanced gastric cancer patients who underwent curative surgery. However, the XELOX regimen might be favorable for OS of stage II patients.
Effect of TRPM2-Mediated Calcium Signaling on Cell Proliferation and Apoptosis in Esophageal Squamous Cell Carcinoma
Authors: Wang Xingbang , Xiao Yong , Huang Mingming , Shen Bing , Xue Haowei , Wu Kaile
Published: October 2021

Esophageal squamous cell carcinoma (ESCC) is the sixth leading cause of death due to cancer, indicating that finding new therapeutic targets or approaches for ESCC treatment is imperative. Transient Receptor Potential cation channel subfamily M, member 2 (TRPM2) is a calcium-permeable, nonselective cation channel that responds to reactive oxygen species (ROS), which are found in the tumor microenvironment and are important regulators of tumorigenesis, cell proliferation, apoptosis, and the therapeutic response. Here, we used immunohistochemical analysis of tumor tissue derived from patients with ESCC to find that the TRPM2 channel protein expression level was increased in tumor tissue compared with adjacent normal tissue. Intracellular calcium concentration measurements, western blotting, and ROS and cell viability assays were used with a human ESCC cell line (TE-1 cells) to find that TRPM2 participated in the ROS hydrogen peroxide-induced increase in intracellular calcium. This increased calcium inhibited cell proliferation and enhanced apoptosis. Pretreatment of cells with the anticancer agent 5-fluorouracil (5-FU) significantly increased ROS production, which potentiated TRPM2-mediated calcium signaling, decreased cell proliferation, and increased apoptosis in TE-1 cells, suggesting that the therapeutic effect of 5-FU in ESCC cells may be mediated by the TRPM2 channel-mediated calcium influx. These findings offer a potential treatment target and provide mechanistic insight into the therapeutic effects of 5-FU in patients with ESCC.
Sticking to What Matters: A Matched Comparative Study of Fibrin Glue and Mechanical Fixation for Split-Thickness Skin Grafts in the Lower Extremity
Authors: Othman Sammy , Messa Charles A. , Elfanagely Omar , Bormann Bradford , Mellia Joseph A. , Broach Robyn B. , Kovach Stephen J. , Fischer John P.
Published: October 2021

Background: Split-thickness skin grafts (STSGs) remain a valuable tool in the reconstructive surgeons’ armamentarium. Staple or suture mechanical fixation (MF) serves as the gold standard of care, though fibrin glue (FG) has gained popularity as a fixation modality. We compare STSG outcomes following application of FG versus MF through a study of lower extremity wounds. Methods: A retrospective review (2016-2019) of patients who underwent a STSG was performed. Two cohorts consisting of patients undergoing a STSG with FG or MF (suture or staple) were matched according to wound size, wound location, and body mass index. Results: A total of 67 patients with 79 wounds were included (FG: n = 30, wounds = 39; MF: n = 37; wounds = 40). There was no significant difference between groups regarding time to 100% graft take (FG: 39 days, MF: 35.1 days; P < .384) or 180-day graft complications (FG: 10.3%, MF: 15%; P < .737). Adjusted operative time for FG (51.8 min) was lower than for MF cases (67.5 min) at a level that approached significance ( P < .094). FG patients were significantly less likely to require a postoperative wound vacuum-assisted closure (VAC) (FG: 16.7%; MF: 76.7%; P < .001) and required a significantly lower number of 30-day postoperative visits (FG: 1.5 ± .78 visits; MF: 2.5 ± .03 visits; P < .001). The MF group had higher mean aggregate charges ($211,090) compared with the FG group (mean: $149,907), although these were not statistically significant ( P > .05). Conclusion: The use of FG for STSG shows comparable clinical outcomes to MF, with a significantly decreased need for postoperative wound VAC, the number of 30-day postoperative visits, and a lower wound-adjusted operative time.
Towards Open Science for the Qualitative Researcher: From a Positivist to an Open Interpretation
Authors: Class Barbara , de Bruyne Miguel , Wuillemin Claire , Donzé Dimitri , Claivaz Jean-Blaise
Published: October 2021

This reflection by a qualitative researcher stems from a concrete experience with data handling in a funded research project. The researcher followed Open Research Data guidelines and found optimal solutions to pseudonymise data, but this later evolved into a deep epistemological questioning on praxis. During the first phase of the project, a tailor-made software was developed with help from librarians and an IT professional to automate the pseudonymisation of the 150 data chunks generated by 16 students, 3 tutors and 3 decision makers. In the second phase of the project, this experience sparked questions about the meaning of such data handling and interpretations of Open Science, which led the researcher to suggest a framework for the professional development of qualitative researchers in their understanding of Open Science. The article raises awareness of normative frameworks in institutional data handling practices and calls for active contributions to defining qualitative research in an Open Science perspective, particularly taking as a reference the recent draft recommendation by UNESCO (2020)
Self-efficacy in disadvantaged communities: Perspectives of healthcare providers and clients
Authors: Hardman Ruth , Begg Stephen , Spelten Evelien
Published: October 2021

Objective

Most chronic disease self-management interventions emphasise the integral role of self-efficacy in achieving behaviour change. We explored the applicability of this model in a low-income setting, from the perspective of both patients and clinicians.

Methods

Interviews with multimorbid patients and their health providers at two rural community health centres in Victoria, Australia. We used a phenomenological methodology, exploring themes of confidence to manage health, outcome expectations and goals.

Results

Many assumptions in which the self-efficacy model is grounded did not apply to this population. Past experiences and resource constraints, especially poverty and healthcare access, influenced confidence, expectations and the ability to achieve desired outcomes.

Discussion

The focus of traditional self-management support on individual behaviour change disadvantages rural low-income patients, who face barriers related to life experience and resource constraints. For this group, self-management support needs to return to its roots, moving away from a narrow conception of behaviour change and reinstating the role of ‘support’ into ‘self-management support’ interventions. Health providers working in rural low-income settings should recognise the limits inherent in self-efficacy focussed interventions and think broadly about engaging with their clients in whatever way supports them to find a life with meaning and purpose.
Healthcare professionals’ experiences during Operation Ancient Babylon in Iraq: A qualitative study
Authors: Calamassi Diletta , Pucci Christabel , Bambi Stefano
Published: October 2021

Background

Healthcare professionals are usually employed in civilian inpatient and outpatient settings but can also work in countries experiencing military conflict.

Aims

To explore the lived experiences of healthcare professionals during the operation “Ancient Babylon” in Iraq to understand their feelings and problems encountered.

Methods

Hermeneutic phenomenological study. In-depth interviews of nine nurses and one physician who took part in the operation between 2003 and 2006 were performed. Data from the collected narrations were analyzed to identify recurrent themes.

Results

Seven main themes emerged: “Living in an extreme setting,” “Living in a theatre of war,” “Strong emotions,” “The team as a family,” “A professional development experience,” “An eye-opening experience,” and “Advice for anyone who wants to join such a mission”. The experience was perceived as physically challenging and emotionally difficult. The relationship between colleagues was strong. It was based on reciprocal trust, enthusiasm, and compensated for the sense of distance that the participants felt from their own families.

Conclusion

Advice and recommendations for those who are interested in pursuing similar experiences: they must develop decision-making skills, be able to rely on one’s own abilities, have good professional training to fall back on, participate in exercises and simulations before the mission, and also be adaptable and innovative, flexible and able to stay mentally grounded.