bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental Health of Employed Family Caregivers in Canada: A Gender-Based Analysis on the Role of Workplace Support
Authors: Li Lun , Lee Yeonjung , Lai Daniel W.L.
Published: February 2022

This study examines the effect of gender differences in mental health outcomes among employed family caregivers, focusing on the role of workplace support in balancing work and caregiving. Guided by the social role theory, this study analyzes nationally representative data from the 2012 Canada General Social Survey, with a sample of 2,426 participants. Women experience worse mental health outcomes than men when they require employment adjustment to fulfill their caregiving responsibilities. Workplace support could offset the negative effects of employment adjustment on mental health either directly or indirectly through family–work conflict, but gender difference is apparent in terms of the effect of workplace support. In general, women require more supportive workplace than men. Further study of the effects of various types of workplace support on the mental health among women who are employed family caregivers, and on more tailored support, is recommended.
Pediatric Sleep Disturbances and Symptoms of Depression in Older Adults
Authors: Stahl Sarah T. , Insana Salvatore P. , Martica H. Hall  , Buysse Daniel J.
Published: February 2022

We investigated the association between retrospectively reported sleep disturbances during childhood and adolescence and current symptoms of depression and anxiety in older adults. Participants included 116 older adults ( M age  =  68 years [ SD  =  6.4 years]) who completed a battery of sleep and psychological assessments. We tested two multivariate regression models using age, sex, race, physical illness burden, insomnia status, and pediatric sleep disturbances as correlates of depressive symptoms and anxiety symptoms. Pediatric sleep disturbances were significantly associated with greater depressive symptomatology ( β  =  0.247, p  =  .010), independent of current insomnia status. Medium effect sizes were reported. Our results suggest that pediatric sleep disturbances may be a biobehavioral signal for the development of poor emotional health across the lifespan. Future research should identify critical windows of development when sleep disturbances might be most impactful on emotional health trajectories.
Teaching vocabulary to adolescents with language disorder: Perspectives from teachers and speech and language therapists
Authors: Lowe Hilary , Henry Lucy , Wallinger Josephine , Joffe Victoria
Published: February 2022

Children with language disorder frequently experience difficulties with vocabulary acquisition, and these difficulties often persist into adolescence. The literature indicates that clinical studies tend to investigate phonological-semantic approaches, whereas educational studies focus on the derivation of meaning within a literacy context. Little is known about whether the practices of speech and language therapists and teachers reflect these findings from the literature. The current paper reports on a survey which gathered information from speech and language therapists and mainstream secondary school teachers, about their current practice concerning vocabulary support for adolescents, aged 11–16, who have language disorder. An online questionnaire was distributed through teaching and speech and language therapy professional networks. The aim of the study was to establish which specific strategies were used in practice by speech and language therapists and mainstream secondary school teachers to teach vocabulary to adolescents with language disorder, and which strategies were the most effective. Responses were obtained from 127 speech and language therapists and 47 mainstream secondary school teachers in the UK. Speech and language therapists were more likely than mainstream secondary school teachers to teach phonological awareness and semantic feature analysis as strategies for developing vocabulary skills. Both professions used literacy-related strategies as well as strategies for independent word learning such as the derivation of meaning from morphology and context. Increased joint working and training opportunities would further develop the knowledge and skills of both mainstream secondary school teachers and speech and language therapists, enabling theoretically-grounded and relevant vocabulary support for this group of adolescents.
AURORA, a multi-sensor dataset for robotic ocean exploration
Authors: Bernardi Marco , Hosking Brett , Petrioli Chiara , Bett Brian J , Jones Daniel , Huvenne Veerle AI , Marlow Rachel , Furlong Maaten , McPhail Steve , Munafò Andrea
Published: February 2022

The current maturity of autonomous underwater vehicles (AUVs) has made their deployment practical and cost-effective, such that many scientific, industrial and military applications now include AUV operations. However, the logistical difficulties and high costs of operating at sea are still critical limiting factors in further technology development, the benchmarking of new techniques and the reproducibility of research results. To overcome this problem, this paper presents a freely available dataset suitable to test control, navigation, sensor processing algorithms and others tasks. This dataset combines AUV navigation data, sidescan sonar, multibeam echosounder data and seafloor camera image data, and associated sensor acquisition metadata to provide a detailed characterisation of surveys carried out by the National Oceanography Centre (NOC) in the Greater Haig Fras Marine Conservation Zone (MCZ) of the U.K in 2015.
Investigations on formability of tailor laminated sheets in single point incremental forming
Authors: Kumar Gautam , Maji Kuntal
Published: February 2022

In this article, formability of tailor laminated sheets in single point incremental forming (SPIF) is investigated using forming limit curve (FLC) and maximum formable wall angle determined theoretically and incremental sheet forming tests. Two different sheet materials namely aluminum alloy AA5083 and polycarbonate were laminated in two different configurations, that is, AA5083/PC, and AA5083/PC/AA5083. FLCs were determined for the laminated sheets using deformation instability method and compared to that of the base sheets. It was observed that formability of the laminated sheets was higher than that of the PC and AA5083 sheets for plane strain case. The maximum formable wall angle was determined by varying the wall angle till the onset of fracture through deforming the sheet into square pyramid shapes. Deformation depths at the onset of fracture for the incrementally formed laminated sheets got decreased with the increase of forming wall angle. Optical macrographs of the cross-sections of the deformed laminated sheets with maximum forming wall angles were taken, and variations of sheet thicknesses along the center line of the deformed sheets were compared for the different cases. Higher triaxiality of AA5083/PC/AA5083 sheet results in lower formability compared to AA5083/PC sheet obtained from membrane analysis. Formation of bump structure due to delamination during SPIF of laminated sheets could be avoided using proper selection of tool path.
Machining-path mapping from free-state to clamped-state for thin-walled parts
Authors: Ma Jian-wei , Ye Tao , Wang Jian , Yan Hui-teng , Liu Yuanchang
Published: February 2022

Thin-walled parts with curved surface are widely used in industrial applications and the high-quality machining is still a major problem because of the low stiffness. By using the machining-path obtained from the design model of thin-walled parts with curved surface, the machining accuracy requirement may easily not be met due to the springback of clamping deformation when the machining process is finished. It is a novel idea that when the machining-path mapping from free-state to clamped-state is realized based on the clamping deformation, the final machining-path of thin-walled parts can be re-designed to directly ensure the machining accuracy requirement after the fixture is released. Based on the concomitant thought of curved surface and the elastic deformation theory of thin shell in this study, the mathematical model for the machining-path mapping from free-state to clamped-state is established for the thin-walled parts with curved surface. Then, the corresponding relationship of cutter contact (CC) points is calculated by grid mapping. Finally, the machining-path for the thin-walled parts with curved surface is re-designed under the clamped-state. Taking a thin-walled cylinder workpiece as an example, the experiment results show that the proposed method can achieve the avoiding purpose for the machining error caused by clamping deformation. These research achievements are of vital importance for realizing high-quality machining of the thin-walled parts with curved surface.
Amorphous silica glass nano-grooving behavior investigated using molecular dynamics method
Authors: Lin Yuan-Ching , Wu Chung-Yen
Published: February 2022

This work uses molecular dynamics to simulate the grooving behavior of optical silica glass. The amorphous SiO2 (silica glass) was fabricated using a melting-quenching process, and the critical cut depth, and mechanism of the chip formation, were explored using a molecular dynamics simulation. The analytical results indicated that the tool edge radius affected the critical cut depth and roughness of the machined surface. A larger tool edge radius had a larger equivalent negative rake angle at the same depth of cut, causing a larger critical cut depth, while producing a smoother machined surface. In addition, the uncut chip thickness affected the tangential force and thrust force distribution weighting of the tool. The temperature field analysis revealed that a groove formed by the chip formation mechanism resulted in a higher workpiece temperature, causing the brittle material to exhibit ductile cutting behavior during the nanogrooving process. However, grooves formed by the scratching-indenting mechanism had a lower workpiece temperature.
Model-reference adaptive sliding mode control of longitudinal speed tracking for autonomous vehicles
Authors: Jo Ara , Lee Hyunsung , Seo Dabin , Yi Kyongsu
Published: February 2022

This paper presents a longitudinal speed control algorithm using a model-reference adaptive sliding mode control (ASMC) scheme for an autonomous vehicle in various driving environments using only wheel speed sensors. The proposed algorithm could control the vehicle’s speed not using parameter estimators but using an adaptation technique. The parameter adaptation laws were designed to compensate for the changes in the environmental disturbances and model uncertainties. Moreover, the upper bound of unknown disturbances, that were not compensated by the adaptation algorithm, was estimated using radial basis function neural network (RBFNN). The sliding mode controller updated the upper bound from the RBFNN and obtained robustness without knowing the bound in advance. Adaptive equivalent control input was also defined to compensate for zero-throttle acceleration varying with speed. This input could enhance the mode switch smoothly between throttle and brake control. We conducted computer simulations and vehicle tests under various driving environments to evaluate the performance of the proposed algorithm. In the simulation result, the average tracking error of the proposed algorithm was 0.718 kph, and the maximum change rate of the error due to the disturbances was 11%. The improvements were 55% and 68%, respectively, compared to the PID control. The average error in the vehicle test result was 0.414 kph, which was improved by 48% compared to the PID control in the test track. The results demonstrate that the proposed algorithm ensures desirable tracking performance under environmental disturbances and model uncertainties.
Pain as Social Glue: A Preregistered Direct Replication of Experiment 2 of Bastian et al. (2014)
Authors: Prochazka Jakub , Parilakova Katarina , Rudolf Patrik , Bruk Vojtech , Jungwirthova Rut , Fejtova Sara , Masaryk Radomir , Vaculik Martin
Published: February 2022

Bastian et al. (2014) found that sharing a painful experience promoted later intergroup cooperation. In Bastian et al.’s second experiment, 62 participants were assigned to groups of two to six people each. They performed either two painful or two painless tasks and then played an economic game. The present study consisted of two replications of the experiment: The first was a nonpreregistered pilot study ( N = 153 students from the Czech Republic), and the second was a preregistered direct replication ( N = 158 students from Slovakia). Important deviations from the original procedure were that (a) gender homogeneity of the small groups was balanced across the conditions and (b) the number of participants in each small group was fixed at three. No relevant effect of shared pain on cooperation emerged. The findings indicate that the true effect of shared pain on cooperation obtained in the original study may have been an overestimate or that the effect is not generally valid across various contexts.
HeartFull: Feasibility of an Integrated Program of Care for Patients with Advanced Stage of Heart Failure
Authors: Steinberg Leah , Isenberg Sarina R. , Mak Susanna , Meaney Christopher , Lokuge Bhadra , Arvanitis Jennifer , Goldman Russell , Wegier Pete , Husain Amna F.
Published: February 2022

Introduction: Patients at an advanced stage of heart failure (AHF), specifically chronic severe symptomatic heart failure defined as New York Heart Association III/IV with hospitalization in the year prior, have high mortality, healthcare utilization, and low palliative care involvement. Objectives: The primary objectives were to determine the feasibility of recruiting patients and engaging cardiology and palliative healthcare providers in a program of integrated care for AHF (HeartFull); the proportion of patients who died in non-acute care settings. Secondary objectives were to describe patient-reported outcomes and pre-post comparison of healthcare utilization. Methods: Patients were recruited from an urban academic hospital with expert heart failure care and a 24/7 inpatient and home palliative service. Utilization, disposition, and surveys were collected monthly for up to 20 months. Results: Of 46 patients referred, 30 (65%) agreed to participate, 27 died during the study period, 19 (70%) died in non-acute care settings, while 8 (30%) died in hospital. We found no significant difference in pre- and post-intervention rates of hospitalization (RR .715; CI .360, 1.388; P = .3180), nor emergency visits (RR .678; CI .333, 1.338; P = .2590), but both trended downward. No significant changes were observed in patient-reported outcomes. Conclusion: In an urban academic hospital with palliative care, it was feasible to implement an integrated program for AHF. Patients died at home or in a palliative care unit at rates similar to palliative oncology patients and at higher rates than the general AHF population. HeartFull is now part of clinical practice.
Online survey to determine client perceptions of feline chronic lower airway disease management: response to therapy, side effects and challenges encountered
Authors: Paulin Mathieu V , Caney Sarah MA , Cosford Kevin L
Published: February 2022

Objectives

The first aim of this survey was to report client experiences associated with the administration of common medications, particularly glucocorticoids and bronchodilators, in managing cats with feline lower airway disease (FLAD). The second aim was to ascertain client perception of response to treatment and level of satisfaction.

Methods

This was a prospective cross-sectional study. An online survey was distributed worldwide to cat owners caring for cats with a chronic cough. Only cats reported to have FLAD were included.

Results

A total of 153 complete responses describing cats with FLAD were analyzed. Glucocorticoids and bronchodilators were the predominantly prescribed therapeutics for 140/153 (92%) and 80/153 (52%) of FLAD cats, respectively. Oral and inhalant administration routes were reported most commonly: glucocorticoids (64% oral and 75% inhalant) and bronchodilators (21% oral and 88% inhalant). A review of how air quality could be improved was conducted for 54% of cats. Almost half (43%) of owners reported adverse effects secondary to glucocorticoid administration, the most frequent being polyphagia (26%) and polydipsia (21%). Only 10% of owners reported bronchodilator-associated side effects, with restlessness (9%) being the most common. Difficulties giving glucocorticoid or bronchodilator tablets orally were reported for 33% and 71% of owners, respectively. Glucocorticoid or bronchodilator inhalant therapies were difficult to administer for 28% and 31% of owners, respectively. Frequency and severity of coughing were significantly lower after at least 2 months of treatment, with median numerical input on a slider scale (0–100) of 48 and 42 before, and 10 and 7 after treatment, respectively ( P <0.0001). Median numerical input of owner satisfaction was 83%.

Conclusions and relevance

Despite significant improvements in client-reported responses to treatment, challenges associated with the administration of medications and their adverse effects still exist. Promoting awareness of client experiences can facilitate appropriate follow-up, guidance and empathy to further optimize outcomes.
Liquid Biopsy: A Distinctive Approach to the Diagnosis and Prognosis of Cancer
Authors: Hirahata Tetsuyuki , ul Quraish Reeshan , Quraish Afraz ul , ul Quraish Shahan , Naz Munazzah , Razzaq Mohammad Abdul
Published: February 2022

Cancer is a leading cause of morbidity and mortality worldwide. Over the past decades, the concept of precision cancer medicine has emerged as a novel approach in the field of oncology that aims to tailor the most effective treatment options to each individual cancer patient based on the genetic profile of the tumor of each individual patient. Recently, tissue biopsy has become an essential part of cancer care and is widely used to characterize the tumor. However, tissue biopsy techniques face different challenges due to their invasiveness, cost, time, and adversity in potential sampling due to tissue heterogeneity. To overcome these issues, a non-invasive approach has developed, which is known as liquid biopsy. It is a simple, fast, and worthwhile technique based on the analysis of circulating tumor DNA (which is a fraction of cfDNA), circulating tumor cells (CTCs), and other tumor-derived material in blood plasma. This review provides an overview of the concept of liquid biopsy and briefly discusses the role of ctDNA and CTC analysis as tools for early diagnosis and prognosis of cancer. In this review, we also speculate on the advantages of liquid biopsy as opposed to tissue biopsy and postulate that liquid biopsy may be a comprehensive approach to overcome the current limitations associated with costly, invasive, and time-consuming tissue biopsy.
The health-related quality of life of children with multiple sclerosis is mediated by the health-related quality of life of their parents
Authors: O’Mahony Julia , Banwell Brenda , Laporte Audrey , Brown Adalsteinn , Bolongaita Lady , Bar-Or Amit , Yeh E Ann , Marrie Ruth Ann
Published: February 2022

Background:

We previously found that children with the chronic disease multiple sclerosis (MS) reported lower health-related quality of life (HRQoL) when compared to children who experienced the transient illness termed monophasic acquired demyelinating syndromes (monoADS). Parents of children with MS also reported lower HRQoL.

Objectives:

We evaluated whether parental HRQoL mediated the relationship between the diagnosis of MS and the HRQoL of affected children. To ascertain the effect of an MS diagnosis, we compared children with MS to those with monoADS.

Methods:

Children were enrolled in a prospective multi-site Canadian study. Random effects models evaluated whether parental HRQoL mediated the relationship between the diagnosis of MS and the HRQoL of affected children, adjusting for child and family characteristics.

Results:

207 parent-child dyads (65 MS; 142 monoADS) completed HRQoL questionnaires. When we modeled the child’s HRQoL adjusting for covariates, but not the parent’s HRQoL, the diagnosis of MS associated with lower HRQoL of the child ( p = 0.004). When we added parental HRQOL to the model, the association between the diagnosis of MS and the child’s HRQoL diminished ( p = 0.13).

Conclusions:

Parental HRQoL mediated the relationship between the diagnosis of MS and the HRQoL of affected children, emphasizing the importance of family-centered care.
The effectiveness of guideline to improve intercultural sensitivity in cross-cultural management
Authors: Li Xin , Longpradit Panchit
Published: February 2022

This study employed Kolb’s experiential learning cycle to investigate whether experiential learning could gain effective results via cross-cultural management theories in teaching and learning. Data from experts was collected to design a teaching program, which was then implemented with the Intercultural Senility Scale to compare between the experimental and control groups using a quasi-experiment research design. Finally, using a focus group discussion, the experts’ opinions were collected for an effective guideline development. The results revealed in the proposed teaching program that elements of the experiential learning such as curricular, teaching environments, and teaching pedagogies should be taken into account by educational stakeholders. The implementation of the teaching program found to have made a positive effect and suggested that a recommended guideline for various stakeholders should make full use of formal, non-formal, and informal learning. Formal education is effective in conceptualizing abstract values and assumptions for explicit culture, while non-formal and informal education are effective in gaining experiences for implicit culture, which then becomes a base for forming abstract values and assumptions.
The Intergluteal Fat Stripe in Patients With Hip Abductor Tears
Authors: Beicker Clint R. , Hudspeth L. Jared , Shanley Ellen , Tokish John M. , Folk Jason
Published: February 2022

Background:

With a hip abductor tendon tear, widening of the intergluteal space, or “fat stripe,” is a characteristic change seen in and around the gluteus medius and minimus.

Purpose:

To determine the relationship of the intergluteal fat stripe in hips with pathologic abductor tears compared with the contralateral side and to evaluate the association of fat stripe size with hip-specific patient-reported outcome measures.

Study Design:

Case series; Level of evidence, 4.

Methods:

Of the 43 patients (42 female, 1 male; mean age, 56.6 years; range, 38-85 years) who underwent endoscopic gluteus medius repair, 19 met inclusion criteria of preoperative bilateral hip magnetic resonance imaging (MRI) scans and 2-year follow up. A single board-certified fellowship-trained orthopaedic surgeon (J.F.), who was blinded to outcomes, evaluated the MRI scans to measure the intergluteal fat stripe on the operative and nonoperative sides. The 2-year postoperative International Hip Outcome Tool (iHOT-12) and modified Harris Hip Score (mHHS) values were analyzed to determine their relationship to the size of the fat stripe. Statistical analysis was performed using a paired t test, and associations were determined using Pearson product correlation as well as nonparametric measurements.

Results:

The size of the intergluteal fat stripe differed significantly between the operative and nonoperative sides. The area of the fat stripe on the operative side was 645.73 ± 513.09 mm2, and on the nonoperative side it was 313.47 ± 360.71 mm2, an average of 332.36 mm2 greater than the nonoperative side ( P = .02). The width of the fat stripe was 9.10 ± 4.60 mm on the operative side and 5.15 ± 3.87 mm on the nonoperative side, 3.95 mm greater than the nonoperative side ( P < .01). There was no correlation between the width or area of the fat stripe on the operative side and iHOT-12 or mHHS values at 2-year follow-up.

Conclusion:

The study findings indicated that the intergluteal fat stripe is significantly wider and has a significantly larger area in hips with abductor tears compared with unaffected hips. This did not correlate with 2-year patient-reported outcomes.
Presoaking ACL Grafts in Vancomycin Decreases the Frequency of Postoperative Septic Arthritis: A Cohort Study of 29,659 Patients, Systematic Review, and Meta-analysis From the SANTI Study Group
Authors: Carrozzo Alessandro , Saithna Adnan , Ferreira Alexandre , Guy Sylvain , Chadli Lamine , Monaco Edoardo , Pérez-Prieto Daniel , Bohu Yoann , Vieira Thais Dutra , Sonnery-Cottet Bertrand
Published: February 2022

Background:

Presoaking anterior cruciate ligament (ACL) grafts in vancomycin has been reported to reduce the occurrence of septic arthritis (SA). However, strong recommendations for its universal use have been precluded by concerns regarding the fragility of previous meta-analyses.

Purpose:

The primary objective was to investigate whether presoaking ACL grafts in vancomycin was associated with a reduction in the rate of SA in a large series of patients. The secondary objective was to perform an updated systematic review and meta-analysis to determine the efficacy of vancomycin in reducing the rate of SA.

Study Design:

Cohort study and systematic review; Level of evidence, 3.

Methods:

A retrospective analysis of patients who underwent primary ACL reconstruction (ACLR) at our institution was undertaken. Rates of postoperative SA were determined and analyzed according to whether patients had received grafts presoaked in vancomycin. A systematic review of the literature and meta-analysis was performed. Odds ratios (ORs) for the risk of SA were calculated according to the inverse variance approach. Results were presented using forest plots, funnel plots, and the fragility index.

Results:

A total of 5300 patients underwent primary ACLR during the study period. The rate of SA was 0.34% (11/3228) in the control group and 0.05% (1/2072) in the presoaked group. There was a 5-fold greater risk of SA in patients who did not receive grafts presoaked in vancomycin (OR, 5.13 [95% CI, 1.16-48.30]; P = .04). Overall, 11 studies were included in the systematic review (29,659 ACLR procedures). The meta-analysis demonstrated a significantly greater risk of SA in those patients who did not receive grafts presoaked in vancomycin (OR, 14.39 [95% CI, 5.90-35.10]; fragility index = 23). This finding held true for the subpopulation receiving hamstring tendon grafts (fragility index = 16), but only a trend was demonstrated for bone–patellar tendon–bone grafts.

Conclusion:

The meta-analysis demonstrated that presoaking ACL grafts in vancomycin was associated with significant reductions in the rates of SA when all graft types were analyzed together. This finding held true specifically for hamstring tendon autografts. The fragility index of these findings allows for a strong recommendation for the universal use of vancomycin presoaking. However, it should be noted that only a trend toward reduced SA rates was demonstrated with presoaking bone–patellar tendon–bone autografts in vancomycin.
Perceptual Evaluations of Plant-Dyed and Industrial-Dyed Cotton Fabrics Based on Kansei Engineering
Authors: Yin Wei , Xu Bugao
Published: February 2022

This study explored the perceptual cognition of differently dyed fabrics among consumers and compared perceptual evaluations of dyed fabrics made of various materials using basic theoretical knowledge of Kansei engineering and clothing materials. SPSS software was used for statistical analysis of the survey data of 100 college students to determine the characteristics of dyed cotton fabric. The results of the perceptual evaluations of plant-dyed and industrial-dyed fabrics are discussed. The most representative characteristics of cotton fabrics, core evaluation vocabulary, and perceptual evaluation factors of plant-dyed and industrial-dyed cotton fabrics were determined by the semantic difference method and cluster analysis. The relationship between the perceptual image word pairs (i.e. vision, touch, smell, health, and value) and each type of dyed fabrics was studied.
Degradation of Synthetic Dyes with Plant-Produced Manganese Peroxidase and Commercial Laccase
Authors: Byrd Joshua D. , Hood Elizabeth E.
Published: February 2022

Contamination of the environment directly impacts animal, plant, and human health, as well as agricultural production. A potential solution tested in this work incorporates the use of enzymes from fungi, manganese (Mn) peroxidase (MnP) and laccase, to degrade pollutants. Unfortunately, the MnP is too expensive to produce (more than US$24,000 per gram) to be used in remediation applications. MnP from a corn kernel biofactory can be produced in large amounts, and at <US$5 per gram, would be cost-effective in this application and resolve pollution issues. Two formulations of recombinant MnP from the corn kernel production system and commercial fungal laccase have been tested for degradation of synthetic dyes in an aqueous environment. Numerous concentrations of four synthetic azo or anthraquinone dyes were used. All dyes were partially or completely degraded by both enzymes.
Does Exposure to Noise During Military Service Affect the Progression of Hearing Loss with Increasing Age?
Authors: Moore Brian C. J. , Lowe David A.
Published: February 2022

It is traditionally believed that the effects of exposure to noise cease once the exposure itself has ceased. If this is the case, exposure to noise relatively early in life, for example during military service, should not affect the subsequent progression of hearing loss. However, recent data from studies using animals suggest that noise exposure can accelerate the subsequent progression of hearing loss. This paper presents new longitudinal data obtained from 29 former male military personnel. Audiograms obtained at the end of military service were compared with those obtained at least five years later. Rates of change of hearing threshold level (HTL) in dB/year were compared with those expected from ISO7029 (2017) for men at the 50th percentile. The results are consistent with the hypothesis that noise exposure during military service accelerates the progression of hearing loss for frequencies where the hearing loss is absent or mild at the end of military service, by about 1.7 dB/year on average for frequencies from 3 to 8 kHz, but has no effect on or slows the progression of hearing loss for frequencies where the hearing loss exceeds about 50 dB. Acceleration appears to occur over a wide frequency range, including 1 kHz. There remains a need for further longitudinal studies using larger sample sizes. Longitudinal studies are also needed to establish whether exposure to other types of sounds, for example at rock concerts or from work in heavy industries, affects the subsequent progression of hearing loss.
Socio-Ecologic Perspective: Barriers Complicating Post-Intensive Care Syndrome Mitigation
Authors: Zbar Ross I.S.
Published: February 2022

Objective:Post-intensive care syndrome (PICS) is a phenomenon whereby survivors of an intensive care unit (ICU) admission subsequently experience issues with physical, cognitive, or mental health status persisting beyond the acute hospitalization. Risk factors for developing PICS include prolonged mechanical ventilation with sedation and immobility. PICS is a devastating illness that negatively alters the life path of many individuals with tremendous economic impact. Methods: This qualitative study employed a grounded theory approach to understand the systemic barriers blocking mitigation and treatment of PICS in all seven ICUs across Essex County, New Jersey (NJ) through semi-scripted interviews conducted with 11 members of the healthcare teams with at least one from each site. Thematic analysis was performed with open, axial, and selective coding. Results: Applying socio-ecologic viewpoint to data illustrate significant barriers on both an interpersonal and organizational level that decrease the operationalization of PICS mitigation measures as identified by healthcare providers. Of those interviewed, eight (73%) were physicians and the remaining were nurses. Significant thematic issues included understanding the risk factors of PICS but feeling powerless to institute mitigation efforts; experiencing lack of enthusiasm due to the absence of institutionalized mitigation protocols; noting frustration about closing the gap between academic recommendations and the ability to operationalize these appropriately; and feeling unable to effectuate meaningful change. Conclusion: Providing education to the target population and healthcare provider stakeholders regarding the barriers against PICS mitigation can alter the status quo.
Supporting an Athlete With Breast Cancer: A Case Report
Authors: Barry Aisling , Mina Daniel Santa , Langelier David M. , Wong Philip , Anne Koch C.
Published: February 2022

For cancer survivors who also identify as athletes, a rigorous exercise that was once part of their daily routine and fundamental to their physical, psychological, and potentially financial well-being, may be temporarily or permanently altered in ways that exacerbate cancer-related changes in quality of life. This report presents an illustrative case of an endurance athlete who underwent breast cancer treatment and her subsequent return to high-performance, high elevation sport. We identify gaps in oncology research and patient educational tools to counsel athletes with cancer regarding the acute and long-term effects of cancer treatment and possibility of returning to a precancer level of fitness and performance. The report also highlights the need to tailor individualized cancer care treatment, rehabilitation, and the ability to preempt potential clinical and psychological side effects that may substantially impact training and competition.
Comprehensive knowledge about HIV/AIDS and associated factors among women of reproductive age in sub-Saharan Africa: a multilevel analysis using the most recent demographic and health survey of each country
Authors: Teshale Achamyeleh Birhanu , Yeshaw Yigizie , Alem Adugnaw Zeleke , Ayalew Hiwotie Getaneh , Liyew Alemneh Mekuriaw , Tessema Zemenu Tadesse , Tesema Getayeneh Antehunegn , Worku Misganaw Gebrie , Alamneh Tesfa Sewunet
Published: February 2022

Background

Women of reproductive age in sub-Saharan African (SSA) share the greatest burden of the HIV/AIDS epidemic. Comprehensive knowledge about HIV is seen as pivotal in combating the epidemic. Therefore, this study aimed to assess comprehensive knowledge about HIV/AIDS and associated factors among women of reproductive age in sub-Saharan Africa.

Objective

To examine comprehensive knowledge about HIV/AIDS and associated factors among women of reproductive age in sub-Saharan Africa.

Methods

We used the most recent SSA countries Demographic and Health Surveys (DHS) data. To assess comprehensive knowledge, a composite score of six separate questions (can get HIV by witchcraft or supernatural means, can reduce risk of getting HIV by using condoms during sex, reduce the risk of getting HIV by having one sex partner only, can get HIV from mosquito bites, can get HIV by sharing food with a person who has HIV/AIDS, and a healthy-looking person can have HIV) was used. Those who answered all six questions correctly were considered to have comprehensive knowledge. To assess the factors associated with comprehensive knowledge of HIV/AIDS, we used a multilevel binary logistic regression model since the data had hierarchical nature.

Results

In this study, the comprehensive knowledge about HIV/AIDS was 38.56% (95% CI: 38.32, 38.75). Both individual and community-level factors were associated with comprehensive knowledge about HIV/AIDS. Among individual-level factors, older age, having primary and above educational level, being from wealthy households, contraceptive use, listening to the radio, and reading newspaper were associated with higher odds of comprehensive knowledge about HIV/AIDS. Being from urban areas and the Eastern African region were the community-level factors that were associated with higher odds of comprehensive knowledge about HIV/AIDS.

Conclusion

The study found that comprehensive knowledge of HIV/AIDS is low. Individual and community-level factors were associated with comprehensive knowledge of HIV/AIDS. Therefore, giving special attention to those young women, women who had no formal education, those from poor socioeconomic status, and those who are from remote areas could decrease the epidemics of HIV/AIDS by increasing the comprehensive knowledge about HIV/AIDS. Besides, it is better to strengthen media campaigns regarding HIV/AIDS to increase comprehensive knowledge about HIV/AIDS.
Novel detection of mutation in the TECPR2 gene in a Chinese hereditary spastic paraplegia 49 patient: a case report
Authors: Guan Yalin , Lu Hui , Zuo Wenchao , Wang Xiaodan , Wang Shimin , Wang Xinping , Liu Feng , Jia Kun , Gao Rui , Wu Hao , Shi Zhihong , Ji Yong
Published: February 2022

Background

Hereditary spastic paraplegia 49 (HSP49) is an autosomal recessive genetic disease first discovered in 2012; and which the mutation primarily affects Bukharian Jewish patients.

Case presentation

The present case reports the first instance of HSP49 detected in China. The patient had normal mental development and good athletic ability before 10 years old and presented with instable temperature, mental retardation, spastic ataxia, and paroxysmal convulsions. Genetic diagnosis was based on detection of whole exons and two heterozygous variants in the exon region of the TECPR2 gene: c.1729C > T and c.4189G > A. Mutations at these two sites have not been previously reported.

Conclusions

This case expands the gene mutation spectrum and clinical phenotypic characteristics of autosomal recessive HSP in China; moreover, it indicates differences in the clinical phenotype of HSP49 in different ethnicities. In addition, this reported provides further evidence regarding the effectiveness of targeted next-generation sequencing technology in improving the efficiency and diagnostic rate of genetic diagnosis of HSP.
Effects of Medicare comprehensive medication review on racial/ethnic disparities in nonadherence to statin medications among patients with Alzheimer’s Disease: an observational analysis
Authors: Browning Jamie A. , Tsang Chi Chun Steve , Dong Xiaobei , Wan Jim Y. , Chisholm-Burns Marie A. , Finch Christopher K. , Tsao Jack W. , Liu Colin , Wang Junling
Published: February 2022

Background

Alzheimer’s Disease (AD) is the mostcommon cause of dementia, a neurological disorder characterized by memory loss and judgment impairment. Hyperlipidemia, a commonly co-occurring condition, should be treated to prevent associated complications. Medication adherence may be difficult for individuals with AD due to the complexity of AD management. Comprehensive Medication Reviews (CMRs), a required component of Medicare Part D Medication Therapy Management (MTM), have been shown to improve medication adherence. However, many MTM programs do not target AD. Additionally, racial/ethnic disparities in MTM eligibility have been revealed. Thus, this study examined the effects of CMR receipt on reducing racial/ethnic disparities in the likelihood of nonadherence to hyperlipidemia medications (statins) among the AD population.

Methods

This retrospective study used 2015-2017 Medicare data linked to the Area Health Resources Files. The likelihood of nonadherence to statin medications across racial/ethnic groups was compared between propensity-score-matched CMR recipients and non-recipients in a ratio of 1 to 3. A difference-in-differences method was utilized to determine racial/ethnic disparity patterns using a logistic regression by including interaction terms between dummy variables for CMR receipt and each racial/ethnic minority group (non-Hispanic Whites, or Whites, as reference).

Results

The study included 623,400 Medicare beneficiaries. Blacks and Hispanics had higher statin nonadherence than Whites: Compared to Whites, Blacks’ nonadherence rate was 4.53% higher among CMR recipients and 7.35% higher among non-recipients; Hispanics’ nonadherence rate was 2.69% higher among CMR recipients and 7.38% higher among non-recipients. Differences in racial/ethnic disparities between CMR recipients and non-recipients were significant for each minority group (p < 0.05) except Others. The difference between Whites and Hispanics in the odds of statin nonadherence was 11% lower among CMR recipients compared to non-recipients (OR = 0.89; 95% Confidence Interval = 0.85-0.94 for the interaction term between dummy variables for CMR and Hispanics). Interaction terms between dummy variables for CMR and other racial/ethnic minorities were not significant.

Conclusions

Receiving a CMR was associated with a disparity reduction in nonadherence to statin medications between Hispanics and Whites among patients with AD. Strategies need to be explored to increase the number of MTM programs that target AD and promote CMR completion.
Measuring medically unjustified hospitalizations in Switzerland
Authors: Eggli Yves , Halfon Patricia , Piaget-Rossel Romain , Bischoff Thomas
Published: February 2022

Background

Inappropriate use of acute hospital beds is a major topic in health politics. We present here a new approach to measure unnecessary hospitalizations in Medicine and Pediatrics.

Methods

The necessity of a hospital admission was determined using explicit criteria related to the recorded diagnoses. Two indicators (i.e. “unjustified” and “sometimes justified” stays) were applied to more than 800,000 hospital stays and a random sample of 200 of them was analyzed by two clinicians, using routine data available in medical statistics. The validation of the indicators focused on their precision, validity and adjustment, as well as their usefulness (i.e. interest and risk of abuse).

Results

Rates, adjusted for case mix (i.e. age of patient, admission planned or not), showed statistically significant differences among hospitals. Only 6.5% of false positives were observed for “unjustified stays” and 17% for “sometimes justified stays”. Respectively 7 and 12% of stays had an unknown status, due to a lack of sufficiently precise data. Considering true positives only, almost one third of medical and pediatric stays were classified as not strictly justified from a medical point of view in Switzerland. Among these stays, about one fifth could have probably been avoided without risk. To enable a larger ambulatory shift, recommendations were made to strengthen the ambulatory care, notably regarding post-emergency follow-up, cardiac and pulmonary functions’ monitoring, pain management, falls prevention, and specialized at-home services that should be offered.

Conclusion

We recommend using “unjustified stays” and “sometimes justified stays” indicators to monitor inappropriate hospitalizations. The latter could help the planning of reinforced ambulatory care measures to pursue the ambulatory shift. Nonetheless, we clearly advise against the use of these two indicators for hospitals financing purposes.
Common DNA methylation changes in biliary tract cancers identify subtypes with different immune characteristics and clinical outcomes
Authors: Qiu Zhiquan , Ji Jun , Xu Yu , Zhu Yan , Gao Chunfang , Wang Guoqiang , Li Chengcheng , Zhang Yuzi , Zhao Jing , Wang Chenyang , Wen Xiaofang , Zhang Zhou , Li Bingsi , Zhang Zhihong , Cai Shangli , Li Bin , Jiang Xiaoqing
Published: February 2022

Background

DNA methylation-associated studies on biliary tract cancer (BTC), including cholangiocarcinoma (CCA) and gallbladder cancer (GBC), may improve the BTC classification scheme. We proposed to identify the shared methylation changes of BTCs and investigate their associations with genomic aberrations, immune characteristics, and survival outcomes.

Methods

Multi-dimensional data concerning mutation, DNA methylation, immune-related features, and clinical data of 57 CCAs and 48 GBCs from Eastern Hepatobiliary Surgery Hospital (EHSH) and 36 CCAs in the TCGA-CHOL cohort were analyzed.

Results

In our cohort including 24 intrahepatic CCAs (iCCAs), 20 perihilar CCAs (pCCAs), 13 distal CCAs (dCCAs), and 48 GBCs, 3369 common differentially methylated regions (DMRs) were identified by comparing tumor and non-tumor samples. A lower level of methylation changes of these common DMRs was associated with fewer copy number variations, fewer mutational burden, and remarkably longer overall survival (OS, hazard ratio [HR] = 0.07, 95% confidence interval [CI] 0.01–0.65, P = 0.017). Additionally, a 12-marker model was developed and validated for prognostication after curative surgery (HR = 0.21, 95% CI 0.10–0.43, P < 0.001), which exhibited undifferentiated prognostic effects in subgroups defined by anatomic location (iCCAs, d/pCCAs, GBCs), TNM stage, and tumor purity. Its prognostic utility remained significant in multivariable analysis (HR = 0.26, 95% CI 0.11–0.59, P = 0.001). Moreover, the BTCs with minimal methylation changes exhibited higher immune-related signatures, infiltration of CD8+ lymphocytes, and programmed death-ligand 1 (PD-L1) expression, indicating an inflamed tumor immune microenvironment (TIME) with PD-L1 expression elicited by immune attack, potentially suggesting better immunotherapy efficacy.

Conclusions

In BTCs, DNA methylation is a powerful tool for molecular classification, serving as a robust indicator of genomic aberrations, survival outcomes, and tumor immune microenvironment. Our integrative analysis provides insights into the prognostication after curative surgery and patient selection for immunotherapy.
Skeletal-dental features in 33 bull terrier dogs
Authors: Martins Monica C. , Valadares Sara A. , Gawor Jerzy P. , Mestrinho Lisa A.
Published: February 2022

Background

The Bull terrier breed has been reported in the veterinary literature to suffer frequent dental and skeletal malocclusions. In this retrospective case series, we report skeletal-dental anomalies in a group of 33 Bull terriers presented for a dental consultation.

Results

Out of 33 dogs examined, 24 cases had full mouth radiography or Cone-beam computed tomography performed. Eruption and development abnormalities observed were as follows: hypodontia in 54.1% (13/24), eruption changes in 29.2% (7/24), and tooth shape abnormalities in 33.3% (8/24). All dogs presented with some type of dental or skeletal malocclusion: neutroclusion was the most common (66.7% of the animals), followed by mandibular mesioclusion (18.8%), maxillo-mandibular asymmetry (9.4%), and mandibular distoclusion (6.3%). Dental abnormalities noted included rotation of mandibular and maxillary premolar teeth, distal displacement of the incisor teeth, lingual displacement of the mandibular canine teeth, and absence of mandibular premolar and molar teeth. Lingual displacement of mandibular canine teeth was associated with malocclusion causing trauma (odds ratio 7.1, 95% confidence interval [1.4 to 36.1], p = 0.024).

Conclusions

Malocclusions and tooth shape abnormalities were found to be the most frequent finding in this group of Bull terriers. Although these findings cannot be generalized to the global population further studies are needed to observe the true expression of these anomalies in the general breed population.