bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on performance of rigid-hoop-reinforced multi-DOF soft actuator
Authors: Sun Jin , Zhang Daozhou , Zhang Yang , Zhu Xinglong , Xi Juntong , Zhang Yu-Dong
Published: June 2021

In order to improve the bearing capacity of soft actuators, this article presents the development of the rigid-hoop-reinforced (spring or steel hoop) multi-DOF soft actuator. The actuator is composed of a rotary module with spring reinforcement on the silicone rubber-based body and a bending module with steel hoop reinforcement on the body. Compared with fiber-reinforced actuators, the bearing capacities of rigid-hoop-reinforced actuators made of 65Mn spring steel are improved. The radial and the axial bearing capacity for the bending module and the rotary module is raised by 29.6%, 28.2%, 30.6%, 49.6% respectively; under the same pressure, the spring-reinforced interval increases the maximum rotary angle of the rotary module, the steel hoop-reinforced interval increases the maximum bending angle of the bending module; with the same reinforcement type, the bending module with reinforcement interval of 10 mm has good bending characteristics that the bending angle changes with the pressure gently; the lower the hardness of silicone rubber base body, the better the adaptability and flexibility of the actuator, and the higher the hardness, the greater the bearing capacity of the actuator. Due to the above advantages, the rigid-hoop-reinforced multi-DOF soft actuator can be applied to medical devices which need high load-carrying capacity.
State, market, and the manufacturing of war memory: China’s television dramas on the War of Resistance against Japan
Authors: Wang Yi , Chew Matthew M.
Published: June 2021

Remembering the War of Resistance against Japan is central to China’s memory and identity politics. By focusing on the production of China’s War of Resistance television dramas, this study analyzes how collective memory is shaped by market actors and their interactions with the state. The first substantive section investigates how commercial media and the state cooperate in the production of War of Resistance television dramas. The second explicates how market actors undermine the state’s ideological imperatives by adding entertainment content to repackage war memory, which then conflicts with the propagandistic task. This study contributes to introducing the market factor to research on the remembering of War of Resistance in China and enriching the political economy of memory approach by examining an authoritarian state-capitalist case, which is centrally characterized by these cooperative and conflictual relations between the state and the market.
Screening of MRSA colonization in patients undergoing total joint arthroplasty
Authors: Valverde Villar AM , Gutiérrez del Álamo Oms J , Neira Borrajo I , de Miguel Fernández S , Flox Benítez P , Llopis Miró R
Published: June 2021

Background:

Periprosthetic infection is commonly caused by Staphylococcus aureus and, if resistant to methicillin (MRSA), is associated with increase in severity and costs to patient and healthcare systems. MRSA colonizes 1–5% of the population, therefore using a screening and decolonisation protocol the risk of periprosthetic infection could be reduced. The objective of our study is to report the results of a preoperative MRSA screening and management protocol utilised at our hospital.

Methods:

All patients undergoing a total joint arthroplasty at our hospital were preoperatively screened for MRSA colonization with swab samples of five different locations. Exposure to risk factors were investigated in colonised patients and they were treated for 5 days prior surgery with nasal mupirocin, chlorhexidine sponges and oral tablets.

Results:

During the 48 months of the study, MRSA colonisation was identified in 22 (1.01%) of 2188 patients operated. The culture was positive only in the nasal swab in 55 patients. In five patients the nasal culture was negative, but they had another positive swab culture (three in the groin and two perianal). None of the patients reported a history of recent antibiotic treatment or hospitalization.

Conclusion:

At our institution, the prevalence of MRSA colonisation is 1.01% in patients undergoing hip and knee arthroplasty. Interestingly, our screening protocol included samples from five different anatomic locations, and it is important to highlight that we found patients with negative nares culture and positive cultures in other locations. Therefore, the number of carriers may be underdiagnosed if only nasal samples are obtained.

Level of evidence:

IV
Transformative health promotion: what is needed to advance progress?
Authors: Barry Margaret M.
Published: June 2021

Transformative health promotion actions are needed to achieve health equity and the Sustainable Development Goals (SDGs), advance human and planetary wellbeing, and ensure that we build back better post-COVID-19. Health policies and systems need to be aligned with the values, principles and strategies of health promotion and investment made in strengthening essential health promotion functions. This paper considers how transformative health promotion can be advanced, by reflecting critically on what progress needs to be made and the structures and processes that are required to strengthen health promotion at a systems level. Progress in implementing health promotion is variable, and there is a general lack of investment in developing the necessary health promotion systems for substantive progress to be made. Key enablers and system requirements for comprehensive health promotion are examined, including the following critical elements: (i) effective advocacy for the concept and practice of health promotion; (ii) enabling policy structures for universal health promotion actions on a cross-sectoral basis; (iii) effective implementation systems, support mechanisms and workforce capacity for multisectoral health promotion action; (iv) investment in innovative research methods and knowledge translation to inform transformative health promotion approaches. In strengthening capacity to implement transformative health promotion actions, political will needs to be mobilized to ensure that dedicated and sustainable funding is made available, and the organizational and workforce capacity to deliver effective health promotion interventions is in place. The International Union for Health Promotion and Education (IUHPE) plays a central role in advancing transformative health promotion through mobilising and supporting its global members and partners in strengthening health promotion systems.
IL4-10 Fusion Protein Shows DMOAD Activity in a Rat Osteoarthritis Model
Authors: van Helvoort E.M. , de Visser H.M. , Lafeber F.P.J.G. , Coeleveld K. , Versteeg S. , Weinans H.H , Popov-Celeketic J. , Eijkelkamp N. , Mastbergen S.C.
Published: June 2021

Objective

Ideally, disease-modifying osteoarthritis (OA) drugs (DMOAD) should combine chondroprotective, anti-inflammatory, and analgesic effects in a single molecule. A fusion protein of interleukin-4 (IL-4) and IL-10 (IL4-10 FP) possesses these combined effects. In this study, the DMOAD activity of rat IL4-10 FP (rIL4-10 FP) was tested in a rat model of surgically induced OA under metabolic dysregulation.

Design

rIL4-10 FP was produced with HEK293F cells. Bioactivity of purified rIL4-10 FP was determined in a whole blood assay. Male Wistar rats ( n = 20) were fed a high-fat diet (HFD) to induce metabolic dysregulation. After 12 weeks, OA was induced according to the Groove model. Two weeks after OA induction, rats were randomly divided into 2 groups and treated with 10 weekly, intra-articular injections of either rIL4-10 FP ( n = 10) or phosphate buffered saline (PBS; n = 10). Possible antibody formation was evaluated using ELISA, cartilage degeneration and synovial inflammation were evaluated by histology and mechanical allodynia was evaluated using the von Frey test.

Results

Intra-articular injections with rIL4-10 FP significantly reduced cartilage degeneration ( P = 0.042) and decreased mechanical allodynia ( P < 0.001) compared with PBS. Only mild synovial inflammation was found (nonsignificant), limiting detection of putative anti-inflammatory effects. Multiple injections of rIL4-10 FP did not induce antibodies against rIL4-10 FP.

Conclusion

rIL4-10 FP showed chondroprotective and analgesic activity in a rat OA model with moderate cartilage damage, mild synovial inflammation, and pain. Future studies will need to address whether less frequent intra-articular injections, for example, with formulations with increased residence time, would also lead to DMOAD activity.
Linking Self-Reported Social Distancing to Real-World Behavior During the COVID-19 Pandemic
Authors: Gollwitzer Anton , McLoughlin Killian , Martel Cameron , Marshall Julia , Höhs Johanna M. , Bargh John A.
Published: June 2021

In an effort to combat COVID-19 and future pandemics, researchers have attempted to identify the factors underlying social distancing. Yet, much of this research relies on self-report measures. In two studies, we examine whether self-reported social distancing predicts objective distancing behavior. In Study 1, individuals’ self-reported social distancing predicted decreased mobility (assessed via smartphone step counts) during the COVID-19 pandemic. While participants high in self-reported distancing (+1 SD) exhibited a 33% reduction in daily step counts, those low in distancing (−1 SD) exhibited only a 3% reduction. Study 2 extended these findings to the group level. Self-reported social distancing at the U.S. state level accounted for 20% of the variance in states’ objective reduction in overall movement and visiting nonessential services (calculated via the GPS coordinates of ∼15 million people). Collectively, our results indicate that self-reported social distancing tracks actual social distancing behavior.
Moving beyond four walls and forming a learning community for speaking practice under the auspices of Facebook
Authors: Duong Quynh PT , Pham Thinh N
Published: June 2021

There is a paucity of opportunities for Vietnamese EFL students to use and practise English speaking skills both inside and outside the classroom, attributing to students’ lack of interest and motivation in improving their speaking skills. Given that learning can be distributed across a multitude of formal and informal settings, the social and informal features of Facebook serve as potentially ubiquitous support for students to productively practise and use the target language. To date, however, much of the discussion of the promising incorporations of Facebook into EFL teaching and learning repertoire remains largely in writing and intercultural communicative effectiveness, with an evident scarcity of empirical research on students’ speaking practice. This qualitative study was conducted with 10 Vietnamese EFL learners, aiming to examine whether the Facebook-based learning community articulated any educational potentials for EFL speaking practice. The findings revealed that there were three features of the Facebook-based learning community, including flexible access, shared visions and values and collaborative relationships, which were beneficial for the members to maintain learning motivation, be more engaged in peer collaboration and co-construct essential knowledge for speaking practice. The findings suggested that the Facebook-based learning community could serve as a means for promoting more speaking practice among Vietnamese EFL learners.
Renal cancer: Key studies for FRCS (Urol)
Authors: Grimes NG , Dunn IB
Published: June 2021

The aim of this article is to summarise key studies relevant to Part 2 of the FRCS (Urol) examination.
Social Networking Sites’ Gag Order: Commercial Content Moderation’s Adverse Implications for Fundamental Sexual Rights and Wellbeing
Authors: Spišák Sanna , Pirjatanniemi Elina , Paalanen Tommi , Paasonen Susanna , Vihlman Maria
Published: June 2021

This article critically investigates the reasoning behind social media content policies and opaque data politics operations regarding sexual visual social media practices and sexual talk, asking what is at stake when social media giants govern sexual sociability on an international scale. Focusing on Facebook, in particular, this article proposes an alternative perspective for handling various expressions of sexuality in social media platforms by exploring the wide-ranging ramifications of community standards and commercial content moderation policies based on them. Given that sexuality is an integral part of human life and as such protected by fundamental human rights, we endorse the freedom of expression as an essential legal and ethical tool for supporting wellbeing, visibility, and non-discrimination. We suggest that social media content policies should be guided by the interpretive lens of fundamental human rights. Furthermore, we propose that social media content policies inclusive of the option to express consent to access sexual content are more ethical and just than those structurally erasing nudity and sexual display.
A Topology of Twitter Tactics: Tracing the Rhetorical Dimensions and Digital Labor of Networked Publics
Authors: Alfonzo Paige
Published: June 2021

This study draws from the broad range of cross-disciplinary theories examining digitally networked action (DNA) to offer a rhetorical topology that traces the repeated patterns of communication and digital actions marking the formation and maintenance of protest counterpublics. Grounded in the concepts of collective identity building and network theory, the rhetorical characteristics and digital tactics that scholars have uncovered over the past 10 years were synthesized into a series of a priori classifications (i.e., topoi). These topoi were then applied to the exploration of how Black Lives Matter (BLM) activists used Twitter in service of protest. While the topoi constituting the topology guided the analysis, this study also details the unique and contextually specific personalized communication styles, protest action approaches, and digital affordances used by BLM advocates to constitute a movement that has brought the persistent oppression of Black individuals living in the United States to the forefront of political conversation. This approach sheds light on the elements contributing to the subject positions that encouraged others to commit to BLM as well as provides a resource for those seeking to integrate unified findings from studies focused on the nexus of digital media and social movements in their work.
Space, Place, and the Self: Reimagining Selfies as Thirdspace
Authors: Koliska Michael , Roberts Jessica
Published: June 2021

The rise of digital and visual communication has brought an increased focus to the places that people occupy. While places are created through various meaning-making processes, one way of establishing the meaning of a place is by inserting oneself into spaces by taking selfies. The places depicted in selfies may reflect a desire to associate oneself with the place, to make a statement challenging that place or the dominant meaning associated with it, or to create new meaning concerning the place and the self. Drawing on the concepts of Thirdspace and heterotopias, we proffer a framework for the practice of taking and sharing selfies that depict a place. We argue that people colonize points in space to reproduce, counter, or mix the meanings of places. People then both draw from and contribute to the construction of places and are motivated to “place” themselves to provide alternative or personalized perspectives of these places but also to represent their self.
A Hierarchical Taxonomy of Psychopathology (HiTOP) Primer for Mental Health Researchers
Authors: Conway Christopher C. , Forbes Miriam K. , South Susan C.
Published: June 2021

Mental health research is at an important crossroads as the field seeks more reliable and valid phenotypes to study. Dimensional approaches to quantifying mental illness operate outside the confines of traditional categorical diagnoses, and they are gaining traction as a way to advance research on the causes and consequences of mental illness. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a leading dimensional research paradigm that synthesizes decades of data on the major dimensions of psychological disorders. In this article, we demonstrate how to use the HiTOP model to formulate and test research questions through a series of tutorials. To boost accessibility, data and annotated code for each tutorial are included at OSF ( https://osf.io/8myzw ). After presenting the tutorials, we outline how investigators can use these ideas and tools to generate new insights in their own substantive research programs.
High Predictive Accuracy of Negative Schizotypy With Acoustic Measures
Authors: Cohen Alex S. , Cox Christopher R. , Cowan Tovah , Masucci Michael D. , Le Thanh P. , Docherty Anna R. , Bedwell Jeffrey S.
Published: June 2021

Negative schizotypal traits potentially can be digitally phenotyped using objective vocal analysis. Prior attempts have shown mixed success in this regard, potentially because acoustic analysis has relied on small, constrained feature sets. We employed machine learning to (a) optimize and cross-validate predictive models of self-reported negative schizotypy using a large acoustic feature set, (b) evaluate model performance as a function of sex and speaking task, (c) understand potential mechanisms underlying negative schizotypal traits by evaluating the key acoustic features within these models, and (d) examine model performance in its convergence with clinical symptoms and cognitive functioning. Accuracy was good (> 80%) and was improved by considering speaking task and sex. However, the features identified as most predictive of negative schizotypal traits were generally not considered critical to their conceptual definitions. Implications for validating and implementing digital phenotyping to understand and quantify negative schizotypy are discussed.
The Hitchhiker’s Guide to Computational Linguistics in Suicide Prevention
Authors: Ophir Yaakov , Tikochinski Refael , Brunstein Klomek Anat , Reichart Roi
Published: June 2021

Suicide, a leading cause of death, is a complex and a hard-to-predict human tragedy. In this article, we introduce a comprehensive outlook on the emerging movement to integrate computational linguistics (CL) in suicide prevention research and practice. Focusing mainly on the state-of-the-art deep neural network models, in this “travel guide” article, we describe, in a relatively plain language, how CL methodologies could facilitate early detection of suicide risk. Major potential contributions of CL methodologies (e.g., word embeddings, interpretational frameworks) for deepening that theoretical understanding of suicide behaviors and promoting the personalized approach in psychological assessment are presented as well. We also discuss principal ethical and methodological obstacles in CL suicide prevention, such as the difficulty to maintain people’s privacy/safety or interpret the “black box” of prediction algorithms. Ethical guidelines and practical methodological recommendations addressing these obstacles are provided for future researchers and clinicians.
Computer-Assisted Navigation Is Associated With Decreased Rates of Hardware-Related Revision After Instrumented Posterior Lumbar Fusion
Authors: Bovonratwet Patawut , Gu Alex , Chen Aaron Z. , Samuel Andre M. , Vaishnav Avani S. , Sheha Evan D. , Gang Catherine H. , Qureshi Sheeraz A.
Published: June 2021

Study Design:

Retrospective cohort study.

Objective:

To (1) define utilization trends for navigated instrumented posterior lumbar fusion (PLF), (2) compare reasons and rates of revision at 30-day, 60-day, 90-day, and 1-year follow-up, and (3) compare 90-day perioperative complications between navigated versus conventional instrumented PLF.

Methods:

Patients who underwent navigated or conventional instrumented PLF were identified from the Humana insurance database using the PearlDiver Patient Records between 2007-2017. Usage of navigation was characterized. Patient demographics and operative characteristics (number of levels fused, interbody usage) were compared between the 2 treatment groups. Propensity score matching was done and comparisons were made for revision rates at different follow-up periods (categorized by reasons) and other 90-day perioperative complications.

Results:

This study included 1,648 navigated and 23 429 conventional instrumented PLF. Navigated cases increased over the years studied to approximately 10% in 2017. Statistical analysis after propensity score matching revealed significantly lower rates of hardware-related revision at 90-day follow-up in the navigated cohort (0.49% versus 1.15%, P = .033). At 1-year follow-up, the navigated cohort continued to have significantly lower rates of hardware-related revision (1.70% versus 2.73%, P = .044) as well as all cause revision (2.67% versus 4.00%, P = .032). There were no statistical differences between the 2 cohorts in any of the 90-day perioperative complications studied, such as cellulitis and blood transfusion ( P > .05 for all).

Conclusions:

These findings suggest that navigation is associated with reductions in hardware-related revisions after instrumented PLF. However, these results should be interpreted cautiously in the setting of potential confounding by other unmeasured variables.
Determinants of Success in Single- and Multi-Digit Replant
Authors: Zhang Zach , Credico Peter , Bristol Sean , Macadam Sheina
Published: June 2021

Purpose: Understanding the variables that influence success in digital replant surgery is essential to guide clinical decision-making and to counsel patients. The purpose of this study was to determine the replant success rate and identify predictors of success at our tertiary care centre. Methods: This was a single centre, retrospective cohort study of consecutive patients who underwent digital replantation from January 2000 to September 2018. Adult patients with flexor zone I to III amputations were included. Patient demographics, comorbidities, injury pattern, operative data, and post-operative care were reviewed. The primary outcome was survival of the replanted digit at discharge. Results: A total of 146 patients met inclusion criteria. Of these, 100 had single-digit replants and 46 underwent multi-digit replants for a total of 220 digits. The success rate was 71%. Predictors of success included sharp mechanism of injury (P < .01), incomplete amputation (P < .01), amputation proximal to zone I flexor level (P = .02), post-operative acetylsalicylic acid use (P < .01), absence of leech use (P = .05), and absence of operative re-exploration (P < .01). Daytime replants had similar outcome compared to nighttime replants despite having increased ischemia time (7.9 ± 3.9 hours vs 6.8 ± 2.6 hours, P = .02). However, daytime operative time (7.8 ± 3.7 hours) was significantly shorter than nighttime replant time (9.6 ± 5.9 hours, P = .01). Conclusion: Sharp amputation, intact venous drainage, proximal amputation, and acetylsalicylic acid use were associated with replant survival and are factors to consider when managing patients for digital replantation. Leech therapy and operative re-exploration were associated with poor outcome. Nighttime replants required significantly longer operative time than daytime replants despite similar survival outcome.
Merkel Cell Carcinoma With Isolated Pancreatic Metastasis
Authors: Lingamaneni Prasanth , Laswi Hisham , Krbanjevic Aleksandar , Moturi Krishna , Katiyar Vatsala , Gupta Shweta
Published: June 2021

Merkel cell carcinoma (MCC) is a highly aggressive cutaneous neuroendocrine carcinoma, frequently associated with distant metastasis. However, recurrence of MCC manifesting with only pancreatic involvement is exceedingly rare. A 53-year-old man presented to our institution with abdominal discomfort 3 months after initial resection of chest wall MCC. Imaging revealed lesions in the pancreas and peripancreatic lymph nodes. Pathology obtained through endoscopic ultrasound confirmed recurrence of MCC. He underwent chemotherapy with cisplatin and etoposide, resulting in a complete resolution of the pancreatic lesions. Unfortunately, he passed away from sudden cardiac arrest while being in remission from MCC. Immunohistochemistry is crucial in differentiating MCC from primary pancreatic glandular and neuroendocrine tumors. While there are no definitive guidelines in the management of pancreatic lesions associated with MCC, checkpoint inhibitor immunotherapy is increasingly being used.
Incidence of Associated Lesions of Multiligament Knee Injuries: A Systematic Review and Meta-analysis
Authors: Kim Seong Hwan , Park Yong-Beom , Kim Boo-Seop , Lee Dong-Hoon , Pujol Nicolas
Published: June 2021

Background:

The incidence of concomitant injuries, including meniscal and cartilage injuries, has not been adequately reported in previous studies on multiligament knee injury (MLKI) because their primary focal points have been the degree of ligament injury, treatment strategy, involvement of other soft tissues, and neurovascular injury.

Purpose:

To analyze the incidence of associated lesions in MLKIs, including medial and lateral meniscal injuries, cartilage lesions, and complications.

Study Design:

Systemic review; Level of evidence, 4.

Methods:

The PubMed, Embase, Cochrane Library, CINAHL, and Scopus databases were searched between inception and April 30, 2020. Studies were included if they reported the incidence rates of medial and/or lateral meniscal tears and cartilage injuries in cases of MLKIs. For the meta-analysis, data were extracted on clinical outcomes measured according to the number of medial and/or lateral meniscal tears, cartilage injuries, and complications.

Results:

A total of 45 studies were included in the MLKI analysis (3391 patients). The pooled rate of medial meniscal tears was 30.4% (95% CI, 24.1%-37.1%; P < .0001; I 2 = 85.8%). The pooled rate of lateral meniscal tears was 27.5% (95% CI, 20.3%-35.3%; P < .0001; I 2 = 89.6%). The pooled rate of cartilage injuries was 27.5% (95% CI, 22.1%-33.3%; P < .0001; I 2 = 86.8%). The pooled rates of peroneal nerve injuries, vascular injuries, and arthrofibrosis were 19.2% (95% CI, 14.2%-24.7%; P < .001; I 2 = 81.3%), 18.4% (95% CI, 13.2%-24.3%; P < .0001; I 2 = 81.0%), and 11.2% (95% CI, 8.1%-14.7%; P = .0018; I 2 = 54.0%), respectively.

Conclusion:

The pooled rates of meniscal tears and cartilage injuries concomitant with MLKIs were high, ranging from 27% to 30%, and the pooled rates of peroneal nerve injury, vascular injury, and arthrofibrosis were considerable, ranging from 11% to 19%. The influence of these associated lesions on clinical results should be evaluated in future clinical studies.
Design of a randomised, double-blind, crossover, placebo-controlled trial of effects of sildenafil on cerebrovascular function in small vessel disease: Oxford haemodynamic adaptation to reduce pulsatility trial (OxHARP)
Authors: Webb Alastair , Werring David , Dawson Jesse , Rothman Alex , Lawson Amy , Wartolowska Karolina
Published: June 2021

Background

Cerebral small vessel disease (SVD) is associated with increased cerebrovascular pulsatility, endothelial dysfunction, and impaired vascular reactivity. Vasodilating phosphodiesterase inhibitors may improve cardiovascular pulsatility and reactivity, and potentially reduce progression of SVD. Hypothesis: Sildenafil, a PDE5 inhibitor, will reduce cerebrovascular pulsatility and increase cerebrovascular reactivity compared to placebo, and is non-inferior to cilostazol, a PDE3 inhibitor.

Methods

OxHARP is a randomised, double-blind, crossover trial of sildenafil 50 mg thrice daily, cilostazol 100 mg twice daily and placebo in 75 patients with mild to moderate small vessel disease and a previous lacunar or cryptogenic stroke or TIA. Participants undergo a physiological assessment at baseline and on each treatment, including transcranial Doppler ultrasound (TCD, DWL DopplerBox) to assess cerebrovascular pulsatility and reactivity to 4–6% carbon dioxide. In up to 60 patients, cerebrovascular pulsatility, perfusion and reactivity will also be assessed by MRI.

Outcome measures

The primary outcome is difference in middle cerebral artery pulsatility (Gosling’s Pulsatility Index, PI) after 3 weeks of sildenafil versus placebo. Secondary outcomes including non-inferiority of sildenafil vs cilostazol in effects on PI, percentage increase in MCA blood flow velocity and BOLD-fMRI response during inhalation of 4–6% carbon dioxide.

Discussion

Reduction in cerebral pulsatility and increased cerebrovascular reactivity during treatment with sildenafil would indicate potential benefit to prevent progression of SVD, suggesting a need for trials with clinical outcomes. Trial Registration OxHARP is registered with ClinicalTrials.org, NCT03855332
Multiscale accessibility and urban performance
Authors: Kaplan Nir , Burg David , Omer Itzhak
Published: June 2021

Accessibility is fundamentally thought to be related to functional, economic, and social performances of cities and geographical systems and, therefore, constitutes an essential aspect for spatial planning. Previous studies focused on cities or metropolitan scales, often disregarding their position within regional and national systems, which can greatly affect their performance. Although accessibility at various spatial scales has been examined, the studies focused on accessibility patterns at different scales, with no reference to the level of accessibility of cities over local, regional, and national scales simultaneously, i.e. multiscale accessibility. This study aims to elucidate the multiscale accessibility level of individual cities and examine its relationship to urban performance in the urban system of Israel. Spatial accessibility was analyzed using the space syntax methodology for the entire national road network across multiple geographic scales—from the local to the national scale. Based on three distinct spatial accessibility systems identified, a unique multiscale accessibility profile was created for individual cities in Israel. Subsequently, each city’s multiscale accessibility profiles were examined against urban performance indicators determined from urban scaling theory. We found that the superiority of cities characterized by high accessibility level plays a role not only for a specific scale but also over scales and spatial systems. Moreover, most urban performance indicators related to the multiscale accessibility profiles of cities, while some multiscale accessibility profiles can be related to over- or under-performance of cities. The findings suggest that pervasive accessibility across spatial scales is inherently connected to urban performance and may indicate on the implementation and interpretation of accessibility. These findings may assist in various aspects of spatial planning at various scales.
Financial Conflicts of Interest Among Systematic Review Authors Investigating Interventions for Achilles Tendon Ruptures
Authors: Cole W. Tanner , Hillman Cody , Corcoran Adam , Anderson J. Michael , Weaver Michael , Torgerson Trevor , Hartwell Micah , Vassar Matt
Published: June 2021

Background:

The primary aim of our study was to evaluate the effects of undisclosed financial conflicts of interest in Achilles tendon rupture repair–focused systematic reviews.

Methods:

Following a cross-sectional study design, we searched MEDLINE and Embase for Achilles tendon rupture repair systematic reviews. We performed screening and data extraction in a blind, triplicate fashion. Each systematic review was evaluated on the individual characteristics of the study, presence of undisclosed and disclosed conflicts of interest, favorability of results and conclusions, and the relationship between conflicts of interest and the favorability of results and conclusions.

Results:

Our search produced 172 total systematic reviews pertaining to Achilles tendon rupture repair; of those, only 12 were included in our study. Undisclosed conflicts of interest were found in half (6/12) of the included reviews. However, no significant association was found between conflict of interest and the favorability of results and conclusions.

Conclusion:

Undisclosed conflicts of interests were discovered in a large percentage of our sample. This lack of disclosure did not appear to increase the likelihood of the systematic review results or conclusions reporting favorability of the intervention being investigated.

Level of Evidence:

Level II.
Longitudinal rates of hospital adverse events that contributed to death in Norway and Sweden from 2013 to 2018
Authors: Deilkås Ellen Tveter , Haugen Marion , Risberg Madeleine Borgstedt , Narbuvold Hanne , Flesland Øystein , Nylén Urban , Rutberg Hans
Published: June 2021

Objectives

In this paper, we explore and compare types and longitudinal trends of hospital adverse events in Norway and Sweden in the years 2013–2018 with special reference to AEs that contributed to death.

Design

Acute care hospitals in both countries performed medical record reviews on randomly selected medical records from all eligible admissions. Analysis: Comparison between Norway and Sweden of linear trends from 2013–2018, and percentage rates of admissions with at least one AE according to types and severities.

Setting

Norway and Sweden have similar socio-economic and demographic characteristics, which constitutes a relevant context for cooperation, comparison and mutual learning. This setting has promoted the use of GTT to monitor national rates of AEs in hospital care in the two countries.

Participants

53 367 medical records in Norway and 88 637 medical records in Sweden were reviewed.

Results

13.2% of hospital admissions in Norway and 13.1% in Sweden were associated with an AE of all severities (E-I). 0.23% of hospital admissions in Norway and 0.26% in Sweden were associated with an AE that contributed to death (I). The differences between the two countries were not statistically significant.

Conclusions

There were no significant differences in overall rates (E-I) of AEs in Norway and Sweden, nor in rates of AEs that contributed to death (I). There was no significant change in AEs or fatal AEs in either country over the six-year time period.
Sleep Related Abnormal Sexual Behaviors: Uncommon yet Grave!
Authors: Gupta Ravi , Kumar Niraj
Published: June 2021

Sexual activities during sleep have been reported by some people, often along with the amnesia for the same. Such activities, when involuntary, may arise because of disorders of arousal or may be attributed to sleep related seizures. However, differentiation between the two etiological factors and, also from voluntary acts committed during sleep-period is important not only for the management of disorders but for medicolegal purpose! Subjective information as well gathered by the patients, bed-partners or victims as objective measures, namely polysomnography, long-term video EEG, and neuroimaging techniques may be helpful in achieving the same.
A convolutional neural network-based regression model to infer the epigenetic crosstalk responsible for CG methylation patterns
Authors: Au Yeung Wan Kin , Maruyama Osamu , Sasaki Hiroyuki
Published: June 2021

Background

Epigenetic modifications, including CG methylation (a major form of DNA methylation) and histone modifications, interact with each other to shape their genomic distribution patterns. However, the entire picture of the epigenetic crosstalk regulating the CG methylation pattern is unknown especially in cells that are available only in a limited number, such as mammalian oocytes. Most machine learning approaches developed so far aim at finding DNA sequences responsible for the CG methylation patterns and were not tailored for studying the epigenetic crosstalk.

Results

We built a machine learning model named epiNet to predict CG methylation patterns based on other epigenetic features, such as histone modifications, but not DNA sequence. Using epiNet, we identified biologically relevant epigenetic crosstalk between histone H3K36me3, H3K4me3, and CG methylation in mouse oocytes. This model also predicted the altered CG methylation pattern of mutant oocytes having perturbed histone modification, was applicable to cross-species prediction of the CG methylation pattern of human oocytes, and identified the epigenetic crosstalk potentially important in other cell types.

Conclusions

Our findings provide insight into the epigenetic crosstalk regulating the CG methylation pattern in mammalian oocytes and other cells. The use of epiNet should help to design or complement biological experiments in epigenetics studies.
Genome-wide characterization of LTR retrotransposons in the non-model deep-sea annelid Lamellibrachia luymesi
Authors: Aroh Oluchi , Halanych Kenneth M.
Published: June 2021

Background

Long Terminal Repeat retrotransposons (LTR retrotransposons) are mobile genetic elements composed of a few genes between terminal repeats and, in some cases, can comprise over half of a genome’s content. Available data on LTR retrotransposons have facilitated comparative studies and provided insight on genome evolution. However, data are biased to model systems and marine organisms, including annelids, have been underrepresented in transposable elements studies. Here, we focus on genome of Lamellibrachia luymesi, a vestimentiferan tubeworm from deep-sea hydrocarbon seeps, to gain knowledge of LTR retrotransposons in a deep-sea annelid.

Results

We characterized LTR retrotransposons present in the genome of L. luymesi using bioinformatic approaches and found that intact LTR retrotransposons makes up about 0.1% of L. luymesi genome. Previous characterization of the genome has shown that this tubeworm hosts several known LTR-retrotransposons. Here we describe and classify LTR retrotransposons in L. luymesi as within the Gypsy, Copia and Bel-pao superfamilies. Although, many elements fell within already recognized families (e.g., Mag, CSRN1), others formed clades distinct from previously recognized families within these superfamilies. However, approximately 19% (41) of recovered elements could not be classified. Gypsy elements were the most abundant while only 2 Copia and 2 Bel-pao elements were present. In addition, analysis of insertion times indicated that several LTR-retrotransposons were recently transposed into the genome of L. luymesi, these elements had identical LTR’s raising possibility of recent or ongoing retrotransposon activity.

Conclusions

Our analysis contributes to knowledge on diversity of LTR-retrotransposons in marine settings and also serves as an important step to assist our understanding of the potential role of retroelements in marine organisms. We find that many LTR retrotransposons, which have been inserted in the last few million years, are similar to those found in terrestrial model species. However, several new groups of LTR retrotransposons were discovered suggesting that the representation of LTR retrotransposons may be different in marine settings. Further study would improve understanding of the diversity of retrotransposons across animal groups and environments.
Hypertensive crisis in patients with obstructive sleep apnea-induced hypertension
Authors: Khamsai Sittichai , Chootrakool Apichart , Limpawattana Panita , Chindaprasirt Jarin , Sukeepaisarnjaroen Wattana , Chotmongkol Verajit , Silaruks Songkwan , Senthong Vichai , Sittichanbuncha Yuwares , Sawunyavisuth Bundit , Sawanyawisuth Kittisak
Published: June 2021

Background

Hypertensive crisis is an urgent/emergency condition. Although obstructive sleep apnea (OSA) in resistant hypertension has been thoroughly examined, information regarding the risk factors and prevalence of hypertensive crisis in co-existing OSA and hypertension is limited. This study thus aimed to determine prevalence of and risk factors for hypertensive crisis in patients with hypertension caused by OSA.

Methods

The inclusion criteria were age of 18 years or over and diagnosis of co-existing OSA and hypertension. Those patients with other causes of secondary hypertension were excluded. Patients were categorized by occurrence of hypertensive crisis. Factors associated with hypertensive crisis were calculated using multivariate logistic regression analysis.

Results

There were 121 patients met the study criteria. Of those, 19 patients (15.70%) had history of hypertensive crisis. Those patients in hypertensive crisis group had significant higher systolic and diastolic blood pressure at regular follow-ups than those without hypertensive crisis patients (177 vs. 141 mmHg and 108 vs. 85 mmHg; p value < 0.001 for both factors). After adjusted for age, sex, and Mallampati classification, only systolic blood pressure was independently associated with hypertensive crisis with adjusted odds ratio (95% CI) of 1.046 (1.012, 1.080).

Conclusions

The prevalence of hypertensive crisis in co-existing OSA and hypertension was 15.70% and high systolic blood pressure or uncontrolled blood pressure associated with hypertensive crisis in patients with OSA-associated hypertension.
Non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio serve as a predictor for coronary collateral circulation in chronic total occlusive patients
Authors: Li Ya , Chen Xin , Li Shu , Ma Yulin , Li Jialing , Lin Mingying , Wan Jing
Published: June 2021

Objective

The present study investigated the potential correlation between non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (non-HDL-C/HDL) and the formation of coronary collateral circulation (CCC) in coronary artery disease cases with chronic total occlusive (CTO) lesions.

Methods

Two experienced cardiologists identified and selected patients with CTO lesions for retrospective analysis. The 353 patients were divided into a CCC poor formation group (Rentrop 0–1 grade, n = 209) and a CCC good formation group (Rentrop 2–3 grade, n = 144) based on the Cohen-Rentrop standard. A comparison of non-HDL-C/HDL ratios between the two groups was performed. The Spearman test was used to obtain the correlation between the cholesterol ratio and Rentrop grade. Independent predictors of CCC were analyzed using logistic regression. Receiver operating characteristic (ROC) curve analysis was also performed to quantify the predictive value of research indicator.

Results

The non-HDL-C/HDL ratio in the CCC poor formation group was elevated markedly compared to the CCC good formation group [( 3.86 ± 1.40) vs ( 3.31 ± 1.22), P = 0.000]. The Spearman test results indicated that non-HDL-C/HDL negatively correlated with Rentrop grade (r = − 0.115, P = 0.030). Multivariate logistic regression analysis showed that non-HDL-C/HDL ratio was an independent predictor of CCC formation (OR = 1.195, 95%CI = 1.020–1.400, P = 0.027). The area under the curve of ROC for detecting CCC poor formation was 0.611 (95% CI: 0.551–0.671, P = 0.000) with an optimal cut-off value of 2.77.

Conclusion

Non-HDL-C/HDL negatively correlated with the formation of CCC and served as an independent predictor of CCC formation, which may be used as a biomarker for the evaluation of CCC.
Advanced cognitive impairment among older nursing home residents
Authors: Gracner Tadeja , Stone Patricia W. , Agarwal Mansi , Sorbero Mark , Mitchell Susan L , Dick Andrew W.
Published: June 2021

Background

Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD.

Methods

This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions.

Results

Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days).

Conclusions

There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.
Psychometric properties of the Persian version of the Physical Activity Scale for the Elderly (PASE)
Authors: Hatami Omid , Aghabagheri Mahdi , Kahdouei Somayeh , Nasiriani Khadijeh
Published: June 2021

Background

Old age is associated with reduced physical ability. It is necessary to measure and evaluate the physical activity of older people. Implementing appropriate requires a valid and reliable tool. Physical Activity Scale for the Elderly (PASE) is the frequently used self-reported physical activity assessment for older adults. Therefore, this study aimed to determine the translation validity and reliability of the Persian version of the Physical Activity Scale for the Elderly.

Methods

This study is a methodological, descriptive applied research was conducted on 300 older people. The translation process of the English version of PASE into Persian was carried out according to the process of translation and adaptation of scale recommended by the World Health Organization. The reliability of the scale was examined by calculating the Cronbach’s alpha, Pearson, and intraclass correlation coefficient (ICC). The reliability and validity of the scale were evaluated by following the “Consensus-Based Standards for the Selection of Health Status Measurement Instruments” (COSMIN) checklist. To assess the face and content validity, impact score (IS), the content validity ratio (CVR), and the content validity index (CVI) were determined. A confirmatory factor analysis was also performed.

Results

The experts approved the quality of the Persian version of PASE. The reliability was calculated with a Cronbach’s alpha of 0.94, an ICC of 0.99, and a test-retest correlation coefficient of 0.94. The qualitative and quantitative face validity of all questions by expert judgment and IS of greater than 1.5 was considered. Also, CVR and CVI scores of all questions were higher than 0.6 and 0.79, respectively. Confirmatory factor analysis revealed a good fit for the original three-factor structure.

Conclusions

The Persian or Farsi version of PASE was shown to have acceptable validity and reliability. This tool is suitable for measuring the physical activity level in the Persian elderly language special in clinical environments and therapeutic interventions.