bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction value of the LACE index to identify older adults at high risk for all-cause mortality in South Korea: a nationwide population-based study
Authors: Cho Eunbyul , Lee Sumi , Bae Woo Kyung , Lee Jae-ryun , Lee Hyejin
Published: February 2022

Background

As a tool to predict early hospital readmission, little is known about the association between LACE index and all-cause mortality in older adults. We aimed to validate the LACE index to predict all-cause mortality in older adults and also analyzed the LACE index outcome of all-cause mortality depending on the disease and age of the participants.

Methods

We used the National Health Insurance Service (NHIS) cohort, a nationwide claims database of Koreans. We enrolled 7491 patients who were hospitalized at least once between 2003 and 2004, aged ≥65 years as of the year of discharge, and subsequently followed-up until 2015. We estimated the LACE index using the NHI database. The Cox proportional hazards model was used to estimate the hazard ratio (HR) for all-cause mortality. Furthermore, we investigated all-cause mortality according to age and underlying disease when the LACE index was ≥10 and < 10, respectively.

Results

In populations over 65 years of age, patients with LACE index ≥10 had significantly higher risks of all-cause mortality than in those with LACE index < 10. (HR, 1.44; 95% confidence interval, 1.35–1.54). For those patients aged 65–74 years, the HR of all-cause mortality was found to be higher in patients with LACE index≥10 than in those with LACE index < 10 in almost all the diseases except CRF and mental illnesses. And those patients aged ≥75 years, the HR of all- cause mortality was found to be higher in patients with LACE index ≥10 than in those with LACE index < 10 in the diseases of pneumonia and MACE.

Conclusion

This is the first study to validate the predictive power of the LACE index to identify older adults at high risk for all-cause mortality using nationwide cohort data. Our findings have policy implications for selecting or managing patients who need post-discharge management.
Differential associations of visual memory with hippocampal subfields in subjective cognitive decline and amnestic mild cognitive impairment
Authors: Huang Yanlu , Huang Lin , Wang Yifan , Liu Yuchen , Lo Chun-Yi Zac , Guo Qihao
Published: February 2022

Background

Although previous studies have demonstrated that the hippocampus plays a role in verbal memory, the role of hippocampal subfields in visual memory is uncertain, especially in those with preclinical Alzheimer's disease (AD). This study aimed to examine relationships between hippocampal subfield volumes and visual memory in SCD (subjective cognitive decline) and aMCI (amnestic mild cognitive impairment).

Methods

The study sample included 47 SCD patients, 62 aMCI patients, and 51 normal controls (NCs) and was recruited from Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Visual memory was measured by the subtests of BVMT-R (Brief Visuospatial Memory Test-Revised), PLT (Pictorial Learning Test), DMS (Delayed Matching to Sample), and PAL (Paired Associates Learning). Hippocampal subfield volumes were estimated using FreeSurfer software (version 6.0). We modeled the association between visual memory and relative hippocampal subfield volumes (dividing by estimated total intracranial volume) using Pearson's correlation and linear regression.

Results

Compared with the NC group, patients with SCD did not find any relative hippocampal subregion atrophy, and the aMCI group found atrophy in CA1, molecular layer, subiculum, GC-ML-DG, CA4, and CA3. After adjusting for covariates (age, sex, and APOE ε4 status) and FDR (false discovery rate) correction of p (q values) < 0.05, in NC group, DMS delay matching scores were significant and negatively associated with presubiculum (r = -0.399, FDR q = 0.024); in SCD group, DMS delay matching scores were negatively associated with CA3 (r = -0.378, FDR q = 0.048); in the aMCI group, BVMT-R immediate recall scores were positively associated with CA1, molecular layer, subiculum, and GC-ML-DG (r = 0.360–0.374, FDR q < 0.036). Stepwise linear regression analysis confirmed the association.

Conclusions

Our results indicate a different and specific correction of visual memory with relative hippocampal subfield volumes between SCD and aMCI. The correlations involved different and more subfields as cognitive decline. Whether these associations predict future disease progression needs dynamic longitudinal studies.
Pathological right ventricular changes in synthesized electrocardiogram in end-stage renal disease patients and their association with mortality and cardiac hospitalization: a cohort study
Authors: Daralammouri Yunis , Qaddumi Jamal , Ayoub Khubaib , Abu-Hantash Doaa , Al-sadi Mai Arafat , Ayaseh Rofayda M. , Azamtta Murad , Sawalmeh Osama , Hamdan Zakaria
Published: February 2022

Background

Right ventricular (RV) function is an important prognostic predictor for end-stage renal disease (ESRD) patients. Non-invasive evaluation of RV function by simple electrocardiogram (ECG) is not yet evident. The purpose of this article was to investigate the presence and association of pathological right ventricular changes in synthesized ECG with cardiac hospitalization and mortality.

Methods

A prospective cohort study of 137 ESRD patients (mean age: 56 years) were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. Synthesized ECG was done right before the hemodialysis (HD) session. The pathological right ventricular changes were recorded for each patient. The relationship between pathological RV changes and mortality, cardiac and non-cardiac hospitalization was assessed through a 6-months follow-up period.

Results

Right ventricular Q wave was found in 2.2% of patients, while right ventricular ST elevation was found in 0.7% of patients, and right ventricular negative T wave was found in 0.7% of patients. During the 6-month period of follow-up, 36 (26.3%) patients were hospitalized, nine patients (6.6%) due to cardiac causes. A total of 8 (5.83%) patients died, out of those 4 patients (2.91%) due to cardiac causes. Using Fisher’s exact test, there was a significant association between pathological abnormalities in synthesized ECG and hospitalization among hemodialysis patients, (p = 0.047). Pathological changes in synthesized ECG were less prevalent in non-cardiac hospitalizations than in cardiac hospitalizations.

Conclusions

The presence of pathological RV synthesized ECG changes can predict cardiac hospitalization in ESRD patients. Synthesized ECG is a good available tool that can be easily performed in ESRD patients. To determine whether Synthesized ECG can be used as a screening tool for pathological RV changes in a dialysis patients, more research with a larger number of patients and a longer follow-up period is required.
Intra-cerebellar schwannoma with various degenerative changes: a case report and a systematic review
Authors: Takeuchi Yasuhide , Arakawa Yoshiki , Yokoo Hideaki , Mikami Yoshiki , Terada Yukinori , Yoshida Kazumichi , Miyamoto Susumu , Haga Hironori
Published: February 2022

Background

Intra-cranial schwannomas account for less than 8% of brain tumors, among which more than 80% arise from the vestibular nerve. Intra-cerebellar schwannomas are extremely rare. Several cases have been previously reported but without remarkable degenerative changes on histology.

Case presentation

A 61-year-old man presented with worsening disorientation, and an imaging study revealed a cystic lesion (6.5 cm in the largest diameter) in the left hemisphere of the cerebellum accompanied by a mural nodule (2.5 cm) located just inside the skull with enhancement and focal calcification, in addition to hydrocephalus. The lesion was more than 5 mm from the left acoustic nerve. The patient underwent gross total resection. Pathological examination revealed remarkable degenerative changes with various morphological features. Tumor cells were pleomorphic with rich cytoplasm containing numerous eosinophilic granules. Blood vessels and extracellular matrix showed remarkable hyalinization. Immunohistochemical staining revealed that the tumor cells were positive for S-100 protein and negative for Olig2. The tumor was diagnosed as a schwannoma with marked degenerative changes.

Conclusions

The present case is discussed with reference to a systematic review of previous reports of intra-cerebellar schwannoma. Intra-cerebellar schwannoma should be included in the differential diagnosis of cystic lesions with heterogeneous histopathological morphology in the cerebellum.
The association between the health-related physical fitness and inhibitory control in preschool children
Authors: Li Yiyan , Zhou Tang , Lu Yanhua , Sang Menghao , Liu Jiajia , He Xiaolong , Quan Minghui
Published: February 2022

Background

Inhibitory control develops rapidly during the preschool stage, and development of inhibitory control in this period is significant for the healthy growth of the future. However, most studies paid more attention to children and adolescents in recent years, but less focus on preschool children. Therefore, the purpose of this study was to explore the association between the health-related physical fitness and inhibitory control in preschool children.

Methods

This cross-sectional study was based on a baseline data from randomized controlled trial by cluster sampling(including 128 preschoolers, 70 boys, 58girls).The health-related physical fitness T-score (HPFT) was obtained by adding standard scores of six indicators: body mass index, handgrip strength, standing long jump, one-leg balance, 2 × 10 m shuttle run test, and 20 m shuttle run test. Inhibitory control was assessed using the flanker task and reflected by reaction time and accuracy.

Results

A total of 120 preschoolers were included in the final statistical analysis. After adjusting the confounders, HPFT was associated with reaction time (β=-2.49 ms, 95%CI: -4.22, -0.75). Similarly, a negative association was observed between one-leg balance and reaction time (β=-12.04 ms, 95%CI: -18.94, -5.15), and between 20 m shuttle run test and reaction time (β=-23.28 ms, 95%CI: -37.00, -9.56). Compared with the participants in the lowest tertile, HPFT (β=-158.74, 95%CI: -309.63, -7.84), one-leg balance (β=-267.25 ms, 95%CI: -420.71, -113.79) and 20 m shuttle run test (β=-215.58 ms, 95%CI: -374.67, -56.49) were all negatively associated with reaction time of those in the highest tertile.

Conclusions

Negative relationships between HPFT and RT of the inhibitory control were observed in preschoolers. To have better inhibitory control, it’s suggested that HPFT of preschoolers should be at least 249. These findings are of great significance for the early improvement of HPFT and the development of inhibitory control in preschool children.
Rare cause of neonatal apnea from congenital central hypoventilation syndrome
Authors: Tovichien Prakarn , Rattananont Krittin , Kulthamrongsri Narathorn , Chanvanichtrakool Mongkol , Yangthara Buranee
Published: February 2022

Background

Congenital central hypoventilation syndrome (CCHS) is a rare condition caused by mutations in the Paired-Like Homeobox 2B (PHOX2B) gene. It causes alveolar hypoventilation and autonomic dysregulation. This report aimed to raise awareness of this rare cause of neonatal apnea and hypoventilation as well as described the diagnostic work up to confirm the diagnosis in resource-limited setting where polysomnography for neonate is unavailable.

Case presentation

A late preterm female newborn born from a non-consanguineous primigravida 31-year-old mother had desaturation soon after birth followed by apnea and bradycardia. After becoming clinically stable, she still had extubation failure from apnea without hypercapnic ventilatory response which worsened during non-rapid eye movement (NREM) sleep. After exclusion of other etiologies, we suspected congenital central hypoventilation syndrome and sent genetic testing. The result showed a PHOX2B gene mutation which confirmed the diagnosis of CCHS. We gave the patient’s caregivers multidisciplinary home respiratory care training including tracheostomy care, basic life support, and simulation training for respiratory problem solving. Then, the patient was discharged and scheduled for follow-up surveillance for associated conditions.

Conclusion

Diagnosis of CCHS in neonates includes the main clue of the absence of
hypercapnic ventilatory response which worsens during non-rapid eye movement
(NREM) sleep after exclusion of other causes. Molecular testing for PHOX2B
gene mutation was used to confirm the diagnosis.
Work-related psychosocial demands related to work organization in small sized companies (SMEs) providing health-oriented services in Germany – a qualitative analysis
Authors: Wagner Anke , Tsarouha Elena , Ög Eylem , Preiser Christine , Rieger Monika A. , Rind Esther
Published: February 2022

Background

Micro, small and medium-sized enterprises (SMEs) represent the majority of businesses in the EU. Little is known about psychosocial demands faced by company owners, managers, and employees in SMEs, especially in the health and service sector. The current study aimed to identify which psychosocial demands related to work organization are reported by managers and employees in the health and service sector, and if managers and employees differ in their perspective on these psychosocial demands.

Methods

We conducted nine single interviews and two focus group discussions with seven company owners and managers as well as eleven employees from six different German companies between January and February 2020. The psychosocial factors of the psychosocial risk assessment of the Joint German Occupational Safety and Health Strategy (GDA) served as a framework for data collection and analysis. The interview material was analysed using Mayring’s method of qualitative content analysis.

Results

We identified four prevailing work-related psychosocial demands related to work organization among managers and employees: (1) possibilities and time for recovery after work, (2) communication and cooperation, (3) work intensity, and (4) interruptions, and prioritization. According to the managers, they were confronted with a lack of possibilities and time for recovery after work. They report issues related to inadequate communication and cooperation affecting the entire company team, and also face high work intensity and frequent interruptions and prioritization. Employees reported a clearer division between work and private life. However, they also face periods of high work intensity, frequent interruptions and the need for prioritization.

Conclusion

Managers and employees in SMEs in the health and service sector would benefit from evidence-based and evaluated tailored interventions and approaches for improved work organization. Further studies are needed to support managers and employees in SMEs in the health and service sector in facing and handling work-related psychosocial demands like lack of possibilities and time for recovery after work, high work intensity or frequent interruptions.
Prevalence of Segond fractures associated with anterior cruciate ligament injuries and their influence on knee joint stability; A case-control study
Authors: Kumahara Ryotaro , Kimura Yuka , Sasaki Shizuka , Sasaki Eiji , Maeda Shugo , Tsukada Harehiko , Yamamoto Yuji , Tsuda Eiichi , Ishibashi Yasuyuki
Published: February 2022

Background

The purpose of this study was to determine the prevalence of Segond fractures and to compare knee stability between patients undergoing primary anterior cruciate ligament (ACL) reconstruction with and without Segond fractures pre- and postoperatively.

Methods

A total of 712 patients who underwent primary ACL reconstruction between 2014 and 2019. Exclusion criteria included patients with multi-ligament knee injuries, skeletally immature patients, osteoarthritis in the knee, combined surgery of high tibial osteotomy, lack of data, and loss to follow-up for at least 2 years. Segond fractures were confirmed using plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Patients with Segond fractures were classified into Group S and without Segond fractures into Group N. Pre- and postoperative Lachman grades, pivot-shift grades, and assessment of side-to-side differences in anterior stability were evaluated.

Results

Five hundred and forty patients included in this study. There were 22 patients with Segond fractures. Of these, all 22 cases (4.1%) were identified on CT, but only 20 cases (3.7%) were identified on MRI and 18 cases (3.3%) on plain radiographs. There was no significant difference in preoperative Lachman grade or pivot-shift grade between Groups S and N (p = 0.662, p = 0.677, respectively). There was no significant difference in postoperative Lachman grade or pivot-shift grade between Groups S and N (p = 0.685, p = 0.390, respectively). There were no significant differences in preoperative (p = 0.398) or postoperative (p = 0.546) side-to-side differences of anterior stability between Groups S and N.

Conclusions

Segond fractures were confirmed in 4.1% of the cases on CT scans among patients undergoing primary ACL reconstruction. Segond fractures did not affect preoperative or 2-year follow-up evaluations of knee stability. From these results, we concluded that Segond fractures did not affect the clinical outcomes of the primary ACL reconstruction and that it may not be necessary to treat Segond fractures.
Time to entry point and distal locking of intramedullary nails: a methodological phantom study comparing biplanar and uniplanar surgical imaging
Authors: Ström Peter , Hailer Nils P. , Wolf Olof
Published: February 2022

Background

Intramedullary nailing is the method of choice for diaphyseal fractures of the femur and tibia and is also commonly used to treat trochanteric hip fractures. Perioperative imaging is essential for visualising adequate reduction, achieving an optimal entry point (EP) and performing distal locking (DL) of intramedullary nails. This methodological study aims to compare biplanar and uniplanar imaging in some steps of intramedullary nailing.

Methods

We used a biplanar preassembled imaging device (Biplanar™ 600s, Swemac Imaging) and a uniplanar imaging device (Ziehm Solo FD, Ziehm Imaging) to measure procedural and radiation times for antegrade and retrograde femoral and antegrade tibial nailing in fully soft flexible tissue encased legs with radiopaque sawbones (SKU:1515–7-11, Sawbones Europe, Malmö, Sweden). Four orthopaedic surgeons with different levels of experience performed all procedures in all three phantoms with both image techniques in random order, producing in total 12 EPs and nailings with DL with each imaging device. Time to EP, radiation times, time to DL for both devices and the number of swings of the uniplanar device for the two procedures were measured. Comparisons between the biplanar and uniplanar systems with a paired-samples t-test were conducted.

Results

Using the biplanar device, time to optimal EP was shorter for retrograde femoral (26 s (SD15) vs 35 s (SD13), p = 0.01) and for antegrade tibial nailing (23 s (SD13) vs 49 s (SD24), p = 0.001). No statistically significant differences in time to EP, radiation time or time to DL were found for antegrade femoral nailing. A median of two swings of the uniplanar device was needed to obtain optimal EP for all procedures.

Conclusions

Biplanar imaging slightly but statistically significantly reduced time to EP for retrograde femoral and antegrade tibial nailing in this methodological study comparing biplanar and uniplanar imaging techniques. Biplanar imaging can reduce time and radiation exposure when defining the EP around the knee in intramedullary nailing procedures, but the clinical relevance of these time savings remain to be defined. For antegrade femoral nailing we found no clear benefit with biplanar imaging in the investigated steps of nailing.
Cost effectiveness analysis of total laparoscopic hysterectomy versus total abdominal hysterectomy for uterine fibroids in Western China: a societal perspective
Authors: Yang Jinjuan , Fan Xiaojing , Gao Jianmin , Li Dan , Xu Yongjian , Chen Gang
Published: February 2022

Background

As a common female pelvic tumor, uterine fibroids remain the leading cause for hysterectomy in China. Hysterectomy provides a good surgical treatment of uterine fibroids, and it guarantees the removal of all uterine fibroids without lower risk of recurrence. This study compares the cost effectiveness of total laparoscopic hysterectomy (TLH) versus total abdominal hysterectomy (TAH) for women with uterine fibroids from a societal perspective.

Methods

An economic analysis was conducted in 392 patients (TLHn = 75; TAHn = 317), including all relevant costs over a 12-month time horizon. Primary outcome was major surgical complications; secondary outcomes were postoperative discomfort symptoms and time of return to normal activities. Clinical, outcomes and costs data were collected from medical records, telephone survey and financial information system. Generalized linear models were used to assess costs and outcomes differences between the two groups. Incremental cost effectiveness ratio (ICER) was used to estimate the cost effectiveness.

Results

Mean direct costs were $2,925.71 for TLH, $2,436.24 for TAH, respectively. Mean indirect costs were $1,133.22 for TLH, $1,394.85 for TAH, respectively. Incremental societal costs were $256.86 (95%CI: 249.03–264.69). Mean differences in outcome were: 4.53% (95%CI: 4.35–4.71) for major surgical complications; 6.75% (95%CI: 6.45–7.05) for postoperative discomfort symptoms; 1.27 (95%CI: 1.23–1.30) weeks for time to return to normal activities. ICER of TLH was $5,669.16 (95%CI: 5,384.76–5,955.56) per complication averted, $3,801.54 (95%CI: 3,634.81–3,968.28) per postoperative discomfort symptoms averted and $202.96 (95%CI: 194.97–210.95) per week saved to return to normal activities.

Conclusions

TLH is cost effective compared with TAH in preventing additional complications based on our estimated conservative threshold in China. The findings provide useful information for researchers to conduct further cost effectiveness analysis based on prospective study which can provide stronger and more evidence, in China. In addition, the data may be useful for Chinese health care policy-makers and medical insurance payers to make related health care decisions.
Translation and validation of Indonesian version of Pediatric Quality of Life Inventory™ (PedsQL™) Neuromuscular Module
Authors: Wiwaha Guswan , Sari Dian M. , Biben Vitriana , Sunjaya Deni K. , Hilmanto Dany
Published: February 2022

Background

The Pediatric Quality of Life™ 3.0 Neuromuscular Module is an instrument to assess health-related quality of life (HRQoL) among children with neuromuscular diseases (NMDs) aged 2–18 years. This study aimed to determine whether the PedsQL™ 3.0 Neuromuscular Module Indonesian Version is valid and reliable.

Methods

This study used the Indonesian translation of the PedsQL™ 3.0 Neuromuscular Module after getting formal permission from the inventor, and the translation process followed the Mapi linguistic translation guidelines. This study administered the PedsQL™ 3.0 Neuromuscular Module Indonesian Version to 84 parents and 71 children. In addition, we used the Rasch model to analyze the psychometric properties.

Results

The reliability of the total scale of the PedsQL™ Neuromuscular Module Indonesian Version shows good to very good criteria. On the parent proxy-report, Cronbach alpha was 0.95, person reliability was 0.84, item reliability was 0.93, person separation was 2.32, item separation was 3.61, person strata separation was 4 levels, and item strata separation was 5 levels. On the child self-report, Cronbach alpha was 0.93, person reliability was 0.81, item reliability was 0.81, person separation was 2.08, item separation was 2.06, person strata separation was 3 levels, and item strata separation was 3 levels. The total scale of the PedsQL Neuromuscular Module Indonesian Version shows fair to good construct validity in parent proxy-report (explained variance 51.9%; unexplained variance 8.4%) and child self-report (explained variance 40.9%; unexplained variance 12.6%). There were no misfit items in the parent proxy-report (infit 0.66–1.49; outfit 0.51–1.81; point measure correlation 0.36–0.93) and child self-report (infit 0.53–1.65; outfit 0.50–1.73; point measure correlation 0.31–0.90) identified by the Rasch models.

Conclusions

The PedsQL™ 3.0 Neuromuscular Modul Indonesian Version is a valid and reliable instrument in measuring HRQoL in Indonesian children with neuromuscular diseases.
Evidence of accelerated epigenetic aging of breast tissues in patients with breast cancer is driven by CpGs associated with polycomb-related genes
Authors: Rozenblit Mariya , Hofstatter Erin , Liu Zuyun , O’Meara Tess , Storniolo Anna Maria , Dalela Disha , Singh Vineet , Pusztai Lajos , Levine Morgan
Published: February 2022

Purpose

Age is one of the strongest risk factors for the development of breast cancer, however, the underlying etiology linking age and breast cancer remains unclear. We have previously observed links between epigenetic aging signatures in breast/tumor tissue and breast cancer risk/prevalence. However, these DNA methylation-based aging biomarkers capture diverse epigenetic phenomena and it is not known to what degree they relate to breast cancer risk, and/or progression.

Methods

Using six epigenetic clocks, we analyzed whether they distinguish normal breast tissue adjacent to tumor (cases) vs normal breast tissue from healthy controls (controls).

Results

The Levine (p = 0.0037) and Yang clocks (p = 0.023) showed significant epigenetic age acceleration in cases vs controls in breast tissue. We observed that much of the difference between cases and controls is driven by CpGs associated with polycomb-related genes. Thus, we developed a new score utilizing only CpGs associated with polycomb-related genes and demonstrated that it robustly captured epigenetic age acceleration in cases vs controls (p = 0.00012). Finally, we tested whether this same signal could be seen in peripheral blood. We observed no difference in cases vs. controls and no correlation between matched tissue/blood samples, suggesting that peripheral blood is not a good surrogate marker for epigenetic age acceleration.

Conclusions

Moving forward, it will be critical for studies to elucidate whether epigenetic age acceleration in breast tissue precedes breast cancer diagnosis and whether methylation changes at CpGs associated with polycomb-related genes can be used to assess the risk of developing breast cancer among unaffected individuals.
Serum Thioredoxin-80 is associated with age, ApoE4, and neuropathological biomarkers in Alzheimer’s disease: a potential early sign of AD
Authors: Goikolea Julen , Gerenu Gorka , Daniilidou Makrina , Mangialasche Francesca , Mecocci Patrizia , Ngandu Tiia , Rinne Juha , Solomon Alina , Kivipelto Miia , Cedazo-Minguez Angel , Sandebring-Matton Anna , Maioli Silvia
Published: February 2022

Background

Thioredoxin-80 (Trx80) is a cleavage product from the redox-active protein Thioredoxin-1 and has been previously described as a pro-inflammatory cytokine secreted by immune cells. Previous studies in our group reported that Trx80 levels are depleted in Alzheimer’s disease (AD) brains. However, no studies so far have investigated peripheral Trx80 levels in the context of AD pathology and whether could be associated with the main known AD risk factors and biomarkers.

Methods

Trx80 was measured in serum samples from participants from two different cohorts: the observational memory clinic biobank (GEDOC) (N = 99) with AD CSF biomarker data was available and the population-based lifestyle multidomain intervention trial Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) (N = 47), with neuroimaging data and blood markers of inflammation available. The GEDOC cohort consists of participants diagnosed with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and AD, whereas the FINGER participants are older adults at-risk of dementia, but without substantial cognitive impairment. One-way ANOVA and multiple comparison tests were used to assess the levels of Trx80 between groups. Linear regression models were used to explore associations of Trx80 with cognition, AD CSF biomarkers (Aβ42, t-tau, p-tau and p-tau/t-tau ratio), inflammatory cytokines, and neuroimaging markers.

Results

In the GEDOC cohort, Trx80 was associated to p-tau/t-tau ratio in the MCI group. In the FINGER cohort, serum Trx80 levels correlated with lower hippocampal volume and higher pro-inflammatory cytokine levels. In both GEDOC and FINGER cohorts, ApoE4 carriers had significantly higher serum Trx80 levels compared to non-ApoE4 carriers. However, Trx80 levels in the brain were further decreased in AD patients with ApoE4 genotype.

Conclusion

We report that serum Trx80 levels are associated to AD disease stage as well as to several risk factors for AD such as age and ApoE4 genotype, which suggests that Trx80 could have potential as serum AD biomarker. Increased serum Trx80 and decreased brain Trx80 levels was particularly seen in ApoE4 carriers. Whether this could contribute to the mechanism by which ApoE4 show increased vulnerability to develop AD would need to be further investigated.

Trial registration

ClinicalTrials.govNCT01041989. Registered on 4 January 2010—retrospectively registered
Compressed spectrum sensing for grant-free NOMA based internet of vehicles
Authors: Zhang Liang , Li Zengqi , Jia Min
Published: February 2022

With the development of communication technology, non-orthogonal multiple access (NOMA) technology is proposed to meet the requirements of high throughput and low latency in massive machine type communication (mMTC) of Internet of Vehicles (IoV). In grant-free NOMA based IoV, mMTC has the characteristics of sparse active users at the same time, which makes the detection and recovery of user information critical. In this paper, considering the sparsity of active users in mMTC, we present a new block sparsity method under compressed sensing model that enables us to detect activity of users and recover user information with high accuracy and low complexity. The recovered algorithm used in our study is known as block sparse ISD algorithm, which exploits block sparse structure based on the ISD algorithm. The simulation results show that the proposed method is able to realize more performance gains in sparse signal recovery than traditional algorithm.
Environmental and economic impact of cloudburst-triggered debris flows and flash floods in Uttarakhand Himalaya: a case study
Authors: Sati Vishwambhar Prasad , Kumar Saurav
Published: February 2022

This paper examines the environmental and economic impact of cloudburst-triggered debris flow and flash flood in four villages of Uttarkashi district, Uttarakhand Himalaya. On 18th July 2021 at 8:30 p.m., a cloudburst took place on the top of the Hari Maharaj Parvat, which triggered a huge debris flows and flash floods, affecting 143 households of four villages of downstream areas. Immediately after the cloudburst occurred, the authors visited four affected villages—Nirakot, Mando, Kankrari, and Siror. A structured questionnaire was constructed and questions were framed and asked from 143 heads of affected households on the impact of debris flows and flash floods on people’s life, settlements, cowsheds, bridges, trees, forests, and arable land in and around the villages. The volume of debris, boulders, pebbles, gravels, and mud was assessed. It was noticed that all four villages got lots of destructions in terms of loss of life—people and animals, and property damage—land, crops, and infrastructural facilities. This study shows that the location of the settlements along with the proximity of the streams, which are very violent during the monsoon season, has led to the high impact of debris flow on the affected villages. We suggest that the old inhabited areas, which are located in the risk zones, can be relocated and the new settlements can be constructed in safe places using suitability analyses.
Creative students in self-paced online learning environments: an experimental exploration of the interaction of visual design and creativity
Authors: Rosar Michaela , Weidlich Joshua
Published: February 2022

Creativity is an increasingly recognized construct in technology-enhanced learning. However, our understanding of how creativity interacts with the design of online learning environments to affect learning experiences is still limited. For example, do creative students benefit from different learning environment designs than those benefitting their less creative peers? This experimental study (N = 187) explores this question by investigating the visual design of a self-paced online learning environment, specifically the degree of visual structure, in relation to students' creativity. Creativity was measured in different ways, along the lines of vocational/study choice, self-reported personality and behavior, and creative production. Students were randomly assigned to either a visually unstructured (experimental group) or a visually highly structured (control group) learning environment. They reported their preference, impulse for activation, and situational motivation after the learning experience. Results indicate interaction effects consistent with the role of creativity in perception and learning. More specifically, creative students reported more motivation after learning in an unstructured environment, whereas non-creative students reported relatively better learning experiences in the highly structured condition. These results contribute to resolving previous conflicting findings from separated studies, yet some ambiguities remain. Results and implications are discussed, and recommendations for future research are laid out.
A qualitative assessment tool for innovative waste logistics scenarios: a case study for Flanders
Authors: Willems Jeffrey , Pauwels Tom , van Hassel Edwin , Vanelslander Thierry , Sel Steve
Published: February 2022

With new, innovative logistics tools and frameworks coming to the market rather quickly, developing a decision support framework to assess its value before carrying out extensive, quantitative economic assessment studies and large-scale implementation is necessary. This paper focuses on developing a qualitative decision support framework—aiding the deployment of successful tools in the logistics landscape and avoiding high sunk costs without added value. Resulting in a qualitative tool based on a literature review and industry expert interviews. The derived parameter impact model assesses the importance of different parameters, allowing to find opportunities without the need for extensive information and/or investments. Therefore, the parameter impact model was applied to three different cases of waste logistics located in Flanders: (1) the use of telemetry (i.e., the use of sensors to identify the filling rate of waste collection points remotely), (2) small waste compactors on the business side, and (3) inland waterways to transport waste to treatment centers. The qualitative results can vary depending on the specific case, establishing the fundament for future innovations.
A micro-credentialing methodology for improved recognition of HE employability skills
Authors: Maina Marcelo Fabián , Guàrdia Ortiz Lourdes , Mancini Federica , Martinez Melo Montserrat
Published: February 2022

Increasingly, among international organizations concerned with unemployment rates and industry demands, there is an emphasis on the need to improve graduates’ employability skills and the transparency of mechanisms for their recognition. This research presents the Employability Skills Micro-credentialing (ESMC) methodology, designed under the EPICA Horizon 2020 (H2020) project and tested at three East African universities, and shows how it fosters pedagogical innovation and promotes employability skills integration and visibility. The methodology, supported by a competency-based ePortfolio and a digital micro-credentialing system, was evaluated using a mixed-method design, combining descriptive statistics and qualitative content analysis to capture complementary stakeholder perspectives. The study involved the participation of 13 lecturers, 169 students, and 24 employers. The results indicate that the ESMC methodology is a promising approach for supporting students in their transition from academia to the workplace. The implementation of the methodology and the involvement of employers entails rethinking educational practices and academic curricula to embed employability skills. It enables all actors to broaden their understanding of the relationship between higher education and the business sector and to sustain visibility, transparency, and reliability of the recognition process. These findings indicate that there are favourable conditions in the region for the adoption of the approach, which is a meaningful solution for the stakeholder community to address the skills gap.
Autism and attachment disorders – how do we tell the difference?
Authors: Davidson Claire , Moran Heather , Minnis Helen
Published: February 2022

Clinicians assessing children with autism are sometimes faced with a dilemma, especially if there is a definite or suspected history of abuse or neglect: is this autism or attachment disorder? This is important because the attachment disorders (reactive attachment disorder and disinhibited social engagement disorder) are thought to be caused by abuse or neglect, whereas autism is not. We discuss the Coventry Grid, a clinical tool aiming to aid differentiation between autism and attachment disorders. We examine the small body of empirical studies focusing on this differential diagnosis and find that the Coventry Grid can be regarded as an evidence-based tool. We also discuss preliminary findings regarding a relatively unstructured observational method involving two assessors who engage the child in jokes and playful social dilemmas, which might help clinicians elicit the information required to complete the Coventry Grid.
Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature
Authors: DeLeo Kristiana , Maconick Lucy , McCabe Rose , Broeckelmann Eva , Sheridan Rains Luke , Rowe Sarah , Johnson Sonia
Published: February 2022

Background

Mental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what could be improved, and those of carers and healthcare staff, is key to developing better services.

Aims

We aimed to synthesise the relevant qualitative literature.

Method

Five databases were searched. Eligible studies included service users with a diagnosis of personality disorder and their carers or relevant staff, focused on crisis responses and used a qualitative design. Data were analysed with thematic synthesis.

Results

Eleven studies were included, most focusing on emergency departments. Four meta-themes emerged: (a) acceptance and rejection when presenting to crisis care: limited options and lack of involvement of carers; (b) interpersonal processes: importance of the therapeutic relationship and establishing a framework for treatment; (c) managing recovery from a crisis: clear recovery plan and negotiating collaboration; and (d) equipping and supporting staff: training and emotional support.

Conclusions

Our findings suggest that emergency departments have major limitations as settings to provide crisis care for people with complex emotional needs, but there is a lack of research exploring alternatives. The quality of the therapeutic relationship was central to how care was experienced, with collaborative and optimistic staff highly valued. Staff reported feeling poorly supported in responding to the needs of this population. Research looking at experiences of a range of care options and how to improve these is needed.
The impact of maternal depressive symptoms and traumatic events on early childhood mental health in conflict-affected Timor-Leste
Authors: Rees Susan J. , Mohsin Mohammed , Klein Louis , Steel Zachary , Tol Wietse , Dadds Mark , Eapen Valsamma , da Costa Zelia , Savio Elisa , Tam Natalino , Silove Derrick
Published: February 2022

Background

Longitudinal studies are needed to examine the association between maternal depression, trauma and childhood mental health in conflict-affected settings.

Aims

To examine maternal depressive symptoms, trauma-related adversities and child mental health by using a longitudinal path model in conflict-affected Timor-Leste.

Method

Women were recruited in pregnancy. At wave 1, 1672 of 1740 eligible women were interviewed (96% response rate). The final sample comprised 1118 women with complete data at all three time points. Women were followed up when the index child was aged 18 months (wave 2) and 36 months (wave 3). Measures included the Edinburgh Postnatal Depression Scale, lifetime traumatic events and the Child Behaviour Checklist. A longitudinal path analysis examined associations cross-sectionally and in a cross-lagged manner across time.

Results

Maternal depressive symptom score was associated with child mental health (cross-sectional association at wave 2, β = 0.35, P < 0.001; cross-sectional association at wave 3, β = 0.33, P < 0.001). The maternal depressive symptom score at wave 1 was associated with child mental health at wave 2 (β = 0.12, P < 0.001), and the maternal depressive symptom score at wave 2 showed an indirect association with child mental health at wave 3 (indirect standardised coefficient 0.23, P < 0.001). There was a time-lagged relationship between child mental health at wave 2 and maternal depression at wave 3 (β = 0.08, P = 0.02).

Conclusions

Maternal depressive symptoms are longitudinally associated with child mental health, and traumatic events play a role. Maternal depression symptoms are also affected by child mental health. Findings suggest the need for skilled assessment for depression, trauma-informed maternity care and parenting support in a post-conflict country such as Timor-Leste.
Nonopioid Analgesics for the Perioperative Geriatric Patient: A Narrative Review
Authors: Wilson Sylvia H. , Wilson P. Ryan , Bridges Kathryn H. , Bell L. Hannah , Clark Carlee A.
Published: February 2022

Management of acute perioperative pain in the geriatric patient can be challenging as the physiologic and pharmacokinetic changes associated with aging may predispose older patients to opioid-related side effects. Furthermore, elderly adults are more susceptible to postoperative delirium and postoperative cognitive dysfunction, which may be exacerbated by both poorly controlled postoperative pain and commonly used pain medications. This narrative review summarizes the literature published in the past 10 years for several nonopioid analgesics commonly prescribed to the geriatric patient in the perioperative period. Nonopioid analgesics are broken down as follows: medications prescribed throughout the perioperative period (acetaminophen and nonsteroidal anti-inflammatory drugs), medications limited to the acute perioperative setting (N-methyl-D-aspartate receptor antagonists, dexmedetomidine, dexamethasone, and local anesthetics), and medications to be used with caution in the geriatric patient population (gabapentinoids and muscle relaxants). Our search identified 1757 citations, but only 33 specifically focused on geriatric analgesia. Of these, only 21 were randomized clinical trials‚ and 1 was a systematic review. While guidance in tailoring pain regimens that focus on the use of nonopioid medications in the geriatric patient is lacking, we summarize the current literature and highlight that some nonopioid medications may extend benefits to the geriatric patient beyond analgesia.
Developing a Prediction Model for Identification of Distinct Perioperative Clinical Stages in Spine Surgery With Smartphone-Based Mobility Data
Authors: Ahmad Hasan S. , Yang Andrew I. , Basil Gregory W. , Joshi Disha , Wang Michael Y. , Welch William C. , Yoon Jang W.
Published: February 2022

BACKGROUND:

Spine surgery outcomes assessment currently relies on patient-reported outcome measures, which satisfy established reliability and validity criteria, but are limited by the inherently subjective and discrete nature of data collection. Physical activity measured from smartphones offers a new data source to assess postoperative functional outcomes in a more objective and continuous manner.

OBJECTIVE:

To present a methodology to characterize preoperative mobility and gauge the impact of surgical intervention using objective activity data garnered from smartphone-based accelerometers.

METHODS:

Smartphone mobility data from 14 patients who underwent elective lumbar decompressive surgery were obtained. A time series analysis was conducted on the number of steps per day across a 2-year perioperative period. Five distinct clinical stages were identified using a data-driven approach and were validated with clinical documentation.

RESULTS:

Preoperative presentation was correctly classified as either a chronic or acute mobility decline in 92% of patients, with a mean onset of acute decline of 11.8 ± 2.9 weeks before surgery. Postoperative recovery duration demonstrated wide variability, ranging from 5.6 to 29.4 weeks (mean: 20.6 ± 4.9 weeks). Seventy-nine percentage of patients ultimately achieved a full recovery, associated with an 80% ± 33% improvement in daily steps compared with each patient's preoperative baseline (P = .002). Two patients subsequently experienced a secondary decline in mobility, which was consistent with clinical history.

CONCLUSION:

The perioperative clinical course of patients undergoing spine surgery was systematically classified using smartphone-based mobility data. Our findings highlight the potential utility of such data in a novel quantitative and longitudinal surgical outcome measure.
TRPM2 causes sensitization to oxidative stress but attenuates high-temperature injury in the sea anemone Nematostella vectensis
Authors: Ehrlich Wiebke , Gahan James M. , Rentzsch Fabian , Kühn Frank J. P.
Published: February 2022

In humans, the cation channel TRPM2 (HsTRPM2) has been intensively studied because it is involved in oxidative stress-mediated apoptosis and also contributes to temperature regulation. The gating mechanism of TRPM2 is quite complex, with a C-terminally localized enzyme domain playing a crucial role. The analysis of orthologues of TRPM2, in particular from the distantly related marine invertebrate Nematostella vectensis (NvTRPM2), revealed that during evolution, the functional role of the endogenous enzyme domain of TRPM2 has undergone fundamental changes. In this study, we investigated whether these evolutionary differences also apply to the physiological functions of TRPM2. For this purpose, we generated a TRPM2 loss-of-function mutation in N. vectensis and compared the phenotypes of wild-type and mutant animals after exposure to either oxidative stress or high temperature. Our results show that under standard culture conditions, mutant animals are indistinguishable from wild-type animals in terms of morphology and development. However, exposure of the two experimental groups to different stressors revealed that TRPM2 causes sensitization to oxidative stress but attenuates high-temperature injury in N. vectensis. Therefore, NvTRPM2 plays opposite roles in the cellular response to these two different stressors. These findings reveal a similar physiological spectrum of activity of TRPM2 in humans and N. vectensis and open up the possibility of establishing N. vectensis as a model organism for the physiological function of TRPM2.