bluuebunny/crossref_metadata_2025 huggingface dataset:
Both the domain-general and the mentalising processes affect visual perspective taking
Authors: Pesimena Gabriele , Soranzo Alessandro
Published: April 2022

People’s attention cannot help being affected by what others are looking at. The dot-perspective task has been often employed to investigate this visual attentional shift. In this task, participants are presented with virtual scenes with a cue facing some targets and must judge how many targets are visible from their own or the cue perspective. Typically, this task shows an interference pattern: Participants record slower reaction times (RTs) and more errors when the cue is facing away from the targets. Interestingly, this occurs also when participants take their own perspective. Two accounts contend the explanation of this interference. The mentalising account focuses on the social relevance of the cue, while the domain-general account focuses on the directional features of the cue. To investigate the relative contribution of the two accounts, we developed a Social_Only cue, a cue having only social features and compared its effects with a Social+Directional cue, which had both social and directional features. Results show that while the Social+Directional cue generates the typical interference pattern, the Social_Only cue does not generate interference in the RTs, only in the error rate. We advance an integration between the mentalising and the domain-general accounts. We suggest that the dot-perspective task requires two processes: an orienting process, elicited by the directional features of the cue and measured by the RTs, and a decisional process elicited by the social features of the cue and measured also by the error rate.
Alcohol consumption messages in Korean dramas: the globalization of South Korean drinking norms
Authors: Pasupathy Rubini , Gho Jaesook , Duhart Brittany , Queen Courtney
Published: April 2022

South Korea has one of the highest rates of monthly alcohol consumption, high-risk drinking, and alcohol-related problems. Global viewers of Korean dramas consume messages about the cultural norms regarding alcohol consumption. There is limited data on the portrayal of alcohol in Korean dramas. The purpose of this embedded mixed methods study is to explore the nature of the portrayal of alcohol consumption in Korean dramas. Content analysis was conducted on a random selection of six drama series. The portrayal of alcohol consumption is ubiquitous, with a reference to alcohol approximately every 12 minutes of programming. The primary messages include the ritualistic importance of alcohol, the over consumption of alcohol by males and females, alcohol as a stress reliever, alcohol as a relationship facilitator, intoxication as a positive valence, unrealistic consequences of intoxication, males as reliable caretakers of intoxicated females, and nondepiction of driving while intoxicated. The results of this study further our understanding of the frequency of the portrayal of alcohol and the prevailing messages about alcohol consumption and intoxication in Korean dramas.
Reusable sanitary napkins in rural India: a remote quality improvement project for adolescent girls promoting menstrual hygiene health during the COVID-19 pandemic
Authors: Ciardi Sassone Samantha , Silva Susan , Metzger Jed , Fisher Nevan , Mohan Ambily , Felsman Irene
Published: April 2022

Medical and public health research supports an ongoing need for health promotion in meeting menstrual hygiene needs, including menstrual hygiene management (MHM) education and the adoption of reusable sanitary napkins. This quality improvement project focuses on menstruation education for adolescent girls in rural Tamil Nadu, India and the promotion of reusable sanitary napkins. Results indicate a significant improvement in MHM knowledge, confidence in managing menstruation, adoption of reusable sanitary napkins, and a decrease in missed school days. These findings support global recommendations for health promotion in India.
Arthroscopic debridement for acute hemorrhagic subacromial bursitis following COVID-19 vaccine administration: A case report
Authors: Mayer Erik N , Gajewski Christopher R , Bernthal Nicholas M , Jensen Andrew R
Published: April 2022

The rapid rollout of vaccinations in response to the COVID-19 pandemic has led to their widespread distribution and administration throughout the world. The benefit of these vaccinations in preventing the spread of the disease and diminishing symptoms in patients who contract COVID-19 has been fervently studied and reported. While vaccinations remain an effective and generally safe method of limiting disease transmission and virus-related mortality, vaccine administration is not completely without risk. Shoulder injuries related to vaccine administration (SIRVA) have been described with previously available vaccines but have yet to be widely reported in the COVID-19 vaccination population. We present a case report of a young, high-functioning patient who presented with acute subacromial bursitis after COVID-19 vaccine administration due to improper vaccination technique. The patient was treated with arthroscopic shoulder surgery and had near immediate relief of shoulder symptoms.
Extensive Phytochemical Assessment of Dendrobium fimbriatum Hook (Orchidaceae)
Authors: Favre-Godal Quentin , Hubert Jane , Kotland Alexis , Garnier Delphine , Beaugendre Camille , Gourguillon Lorène , Urbain Aurelie , Lordel-Madeleine Sonia , Choisy Patrick
Published: April 2022

Dendrobium fimbriatum Hook is an important medicinal and ornamental orchid that may lead to important drugs and cosmetics. In this study, 2 analytical strategies were combined to describe the detailed composition of a hydroethanolic extract of the whole plant. The CARAMEL approach, based on centrifugal partition chromatography and nuclear magnetic resonance data interpretation, allowed the rapid dereplication of 21 major constituents, mainly including polyols, nucleosides, zwitterionic compounds, phenolic compounds, and organic acids. Further semipreparative high-performance liquid chromatography and spectroscopic analyses led to the isolation of 6 additional compounds; 4 phenanthrenes (plicatol B, hircinol, plicatol A, and plicatol C), 1 bibenzyl (3′,4-dihydroxy-3,5′-dimethoxybibenzyl), and 1 furostanol saponin (protodioscin), as well as a new phenanthrene derivative, plicatol D. A total of 28 metabolites were structurally elucidated, among which 23 are described for this species for the first time.
Spatiotemporal Coexistence of Mesopredators and Their Prey in a Defaunated Neotropical Rainforest
Authors: Flores-Martínez José Juan , Coates Rosamond , Sánchez-Cordero Víctor , Ríos-Solís Jesús Alejandro , Luna-Olivera Beatriz Carely , Ramírez-Ibáñez Marcelino , Lavariega Mario C.
Published: April 2022

Background and Research Aims

Forest loss and fragmentation have a negative impact on large-sized predators and prey, whose populations are reduced or extirpated locally. We explored the spatiotemporal coexistence of the mesopredators (< 15 kg) coyote, ocelot, and white-nosed coati, with their potential prey (< 15 kg) Mexican agouti, lowland paca, and collared peccary in a defaunated rainforest.

Methods

We used two-species occupancy-detection models between mesopredators and their potential prey, overlap index of circular models, and latency time measurements to evaluate temporal and spatial segregation and habitat use of species.

Results

Presence of ocelot and coyote was influenced by an increase in the detectability and occupancy of the Mexican agouti. Among most mesopredator–prey species pairs, the correlation for both the capture rates at camera-trap stations and the 1-hr intervals were mainly moderate or low. Some mesopredator–prey species pairs showed low or inverse correlations suggesting species avoidance. The Mexican agouti exhibited a significant negative correlation with the presence of mesopredators. The coyote and ocelot showed a positive correlation with their use of low use trails by people.

Conclusions

Spatiotemporal tolerance was observed among mesopredator omnivores and prey herbivores. High temporal overlap of ocelots and potential prey (lowland paca) was observed compared to other tropical forests holding large-sized predators, suggesting behavioral shifts for increasing mesopredator–prey encounters. Furthermore, mesopredator coexistence was mediated by a displacement in the temporal peaks of activity and spatial segregation among species.

Implications for Conservation

Defaunated tropical forests need protection to ensure the conservation of remaining species and their ecological interactions.
Is Hogarth’s ‘Line of Beauty’ really the most beautiful? An empirical answer after more than 250 years
Authors: Hübner Ronald , Ufken Emily
Published: April 2022

Since the Renaissance, different line types have been distinguished by artists and art theorists. However, it took another hundreds of years until the British artist William Hogarth attributed different degrees of beauty to them. Particularly, in his book “The Analysis of Beauty” (1753) he depicted seven waving lines, declared line number 4 as the most beautiful, and called it the “line of beauty”. Until today, the line of beauty has a persistently strong influence in many areas such as landscape art and design, calligraphy, furniture design, architecture, dance, etc. It is astonishing that Hogarth's assumptions have never been empirically tested. Therefore, we asked participants to rate Hogarth's lines by their beauty. As a result, line number 4 was indeed the most preferred, although number 5 was judged similarly. An analysis revealed that curvature was nonlinearly related to beauty and explains more than 90% of the variance in the mean aesthetic judgments.
Mundane citizenship on the move: A counter-public response to inbound shopping tourism via mobile social media applications use
Authors: Ting Tin-yuet
Published: April 2022

Using digital ethnography to examine the daily mobile (micro)blogging (moblogging) practices of local residents as they confronted a wave of inbound shopping tourists in pre-Covid-19 pandemic Hong Kong, this article explores how the latest mode of mundane citizenship emerges from the communicative mobility of urban dwellers equipped with mobile phones and social media applications (apps). Recent research on the role of mobile devices and social media apps in citizen participation has focused on more visible forms of civic–political events, such as protests and voting, and tended to neglect the effects of mobile communication performed during banal travel and quotidian activities. This article offers an alternative reading of the relevance of mobile social media (MSM) in contemporary public lives by examining how they open up new temporalities and spatialities for counter-public engagement in the contexts of mundane urban mobility. The findings demonstrate various moblogging practices that entail modalities of counter-public engagement that traverse the personal, proto-political, and communal, and reveal how local residents used these modalities to articulate alternative public agendas, connect acts of consumer activism, and perform communal belonging vis-à-vis inbound shopping tourism amid their daily routines and modest journeys. Focusing on mobile socialities enabled by smartphones and networking apps, this article explicates how contemporary moblogging can, on the one hand, extend people's capacity to engage in citizen talk and connective action, while on the other hand, allow them to flexibly connect and contribute personal photobiographies and narratives to counter-public communities. By unpacking the novel pathways to citizen participation, it offers insights into new ways in which everyday mobile communication can be transformed into public involvement, albeit often in agonistic and emotional forms, and the role of MSM in this process.
Adopting low dose CT in evaluating renal calculi-progress from 2008-18 in a large UK tertiary hospital
Authors: Raynor Richard , Rajesh Arumugam
Published: April 2022

Background:

Computed tomography (CT) of the urinary tract is a commonly performed investigation and it is crucial to adhere to low dose protocols to avoid unnecessary radiation burden.

Aims:

To review the adoption of low-dose techniques over time, defined as a dose length product (DLP) < 200mGy.cm, in a large teaching hospital over three locations with 12 CT scanners.

Methods:

Data were obtained from the radiology information system for exams completed under the coding for unenhanced CT evaluation for renal calculi between 14 Feb 2008 and 31 December 2018. Examinations where the DLP was not correctly recorded, was below 40mGy.cm, or where the equipment used could not be identified were excluded. The distribution of doses and the median DLP per scanner was calculated.

Results:

In all, 20,080 studies were available across 12 CT scanners in the 10- year period. The average Median DLP has reduced from 501mGy.cm in 2008 to 178mGy.cm in 2018.

Conclusions:

Improvements in CT technology and implementation of low-dose protocols have resulted in significantly lower doses for evaluation of kidney stones since 2008. Although this study demonstrates significant variation between scanners, the overall adoption of low dose techniques is excellent.

Level of evidence:

Not applicable
Measuring intraobserver and intermethod reliability of endometriotic cyst volumes: A comparison between MRI and 3D transvaginal ultrasound in endometriosis
Authors: Bergwerff Jasmijn , Schreurs Anneke M. F. , Lier Marit C. I. , van Waesberghe Jan Hein T. M , van der Houwen Lisette E. E. , Mijatovic Velja
Published: April 2022

Objectives:

To identify the intraobserver and intermethod reliability of three-dimensional transvaginal ultrasound (3D-TVUS) using the software VOCAL and XI VOCAL compared with magnetic resonance imaging (MRI) for volumetric measurement of ovarian endometrioma.

Methods:

The intermethod and intraobserver reliability of endometrioma volumes were assessed in 16 women diagnosed with endometriosis through laparoscopy with histologic confirmation and presenting with uni- or bilateral endometriomas. In total, volumes of 23 endometriomas were assessed with two-dimensional and three-dimensional transvaginal ultrasound and 6 mm magnetic resonance imaging. Examinations took place at two moments in one menstrual cycle: day 2–4 (T0) and day 20–22 (T1).

Results:

The intraclass correlation for intraobserver reliability is good to very good for all three techniques ranging from the lowest value of 0.953 to the highest of 1.000. MRI has the most narrow limits of agreement (−3.93 to 4.53), followed by XI VOCAL (−5.16 to 5.65) while VOCAL has the widest limits of agreement (−10.22 to 11.39). Intraclass correlations are poor in the comparison of XI VOCAL to MRI, moderate between VOCAL and XI VOCAL, and good for the comparison between VOCAL and MRI. Limits of agreement vary per technique. When comparing 3D imaging techniques with 2D TVUS, XI VOCAL versus 2D TVUS provide the smallest limits of agreement.

Conclusions:

MRI and XI VOCAL provide the best intraobserver reliability. The different imaging techniques are not interchangeable. As TVUS is a more readily available and cost-efficient imaging technique the usage of XI VOCAL is advised.
Correlation of Press Ganey Scores With Early Patient Satisfaction After Anterior Cruciate Ligament Reconstruction
Authors: Kung Justin E. , Zhang Tina , Weir Tristan B. , Schneider Matheus B. , Aneizi Ali , Leong Natalie L. , Packer Jonathan D. , Meredith Sean J. , Henn R. Frank
Published: April 2022

Background:

Patient satisfaction metrics are commonly used to assess the quality of health care and affect reimbursement. The Press Ganey Ambulatory Surgery (PGAS) is a satisfaction survey that has emerged as a prominent quality assessment tool; however, no data exist on whether PGAS scores correlate with early postsurgical satisfaction during the PGAS survey administration period in patients who underwent anterior cruciate ligament reconstruction (ACLR).

Purpose:

To determine if PGAS scores correlate with measures of satisfaction and patient-reported outcomes (PROs) at 2 weeks postoperatively in ACLR patients.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

A retrospective review of patients who underwent ACLR at a single institution was performed. Patients who completed the PGAS survey and PROs at 2 weeks postoperatively were included in the study. Surgical satisfaction was measured with the Surgical Satisfaction Questionnaire (SSQ-8), and PROs included 6 Patient-Reported Outcomes Measurement Information System domains. Bivariate analysis between PGAS and PRO scores was conducted using the Spearman rank correlation coefficient ( r S).

Results:

Of the 716 patients who received the PGAS survey after ACLR, 81 patients completed the survey, and 39 patients also completed PROs and were included in the study. Total converted (mean scaled score) and “top box” (percentages of questions with highest rating selected) PGAS scores showed no significant correlations with the SSQ-8 ( r S =–0.24; P = .14). There were no significant correlations between SSQ-8 and PGAS domain scores except for a negative correlation with Facility domain top box scores ( r S =–0.33; P = .04), meaning that patients with higher surgical satisfaction had lower PGAS Facility scores. Total PGAS (converted and top box scores) and PGAS domain scores showed no significant correlation with any of the other PROs.

Conclusion:

PGAS scores showed no significant positive correlation with surgical satisfaction, function, pain, mental health, activity, or expectations of surgery in patients 2 weeks after ACLR. This suggests little to no relationship between PGAS score and surgical satisfaction in the early recovery period after ACLR.
Socioeconomic Status and Toothbrushing in Indigenous and Non-Indigenous Australian Children
Authors: Fernando C. , Ha D.H. , Do L.G. , Tadakamadla S.K.
Published: April 2022

Introduction:

Dental caries in children is a multifactorial and complex condition. Toothbrushing helps maintain good oral hygiene and delivers fluoride. However, determinants of toothbrushing could vary based on Indigenous status.

Objective:

This study aimed to assess the association between socioeconomic status and adequate toothbrushing practice (brushing twice or more a day) in Indigenous and non-Indigenous Australian children.

Methods:

Data were acquired from the National Child Oral Health Survey (NCOHS) 2012 to 2014. NCOHS administered questionnaires to parents of a representative sample of 24,215 Australian children aged 5 to 14 y recruited using a complex sampling method. Data on the frequency of toothbrushing and socioeconomic status were collected through the questionnaires. Statistical analysis was conducted progressively from bivariate to multivariable regression modeling, stratified by Indigenous status.

Results:

Just over half of Indigenous children and over two-thirds of non-Indigenous children reported adequate toothbrushing. The prevalence of adequate brushing (twice or more a day) was 42% (95% confidence interval [CI], 1.10–1.84) higher among children with an overseas-born parent than those with Australian-born parents. Among non-Indigenous children, sex and age, parents’ country of birth, number of children in the family, and other family socioeconomic indicators (education, income, private health insurance) were associated with adequate toothbrushing. The prevalence of adequate brushing was 1.09 (95% CI, 1.03–1.15) and 1.15 (95% CI, 1.10–1.21) times higher when their parent possessed vocational training and tertiary education, respectively, compared to those children whose parents had school-level education.

Conclusions:

There were differences in patterns of socioeconomic disparities for toothbrushing practices between Indigenous and non-Indigenous Australian children.

Knowledge Transfer Statement:

To promote positive toothbrushing practices in children, dental clinicians and public health professionals must be aware of the determinants of toothbrushing practices. Socioeconomic disparities in toothbrushing frequency were more apparent in non-Indigenous children. These results will help develop population-specific interventions that tackle the determinants to help improve oral hygiene behavior in Indigenous and non-Indigenous children.
Remembering the Present: Maps, Identity and Memory in Naga Politics
Authors: Achumi Ilito H.
Published: April 2022

The article maps the changes in the geographies, political ideologies and splintered identities that has brought about uncertainty in the assumed homogenous category ‘Naga identity’. It investigates the influence of geographies in the ideological dilemmas and political engagements of the Nagas, and discusses how collective memory, nostalgias, desires and emotions tied to the Naga’s past implicates upon the conceptualisations of Naga identity. The article maps the collective memory of the World Wars, 1947, 1963 and how these remembering impacts upon the identity politics of the Nagas. Collective remembering and forgetting plays a pivotal role in the identification processes of their genealogies, brotherhood and clans. Today, the geo-body of Nagaland and its geographical division into central, eastern and western reflects the present political alliances of the Nagas. Naga’s political alliances and formations of Eastern Naga People’s Organisation, Tenyimia Nagas and Central Nagaland Tribes Council is a clear case of reconstructing political identity along the culture and geographies of Naga society. Discussions on the political life of the Nagas post 1947 and after 1963, the birth of a new state and post 1990s, brings out the compelling inter-linkages of Naga identity, Culture, Politics, Geography and collective memory.
Under the Sentence of Caste: Twin Peak Dalit Massacres in the Siwalik
Authors: Acharya Nirmal
Published: April 2022

The Communist Party of Nepal (Maoist) launched the ‘People’s War’ from 1996 to 2006. The 10-year long insurgency in Nepal claimed over 13, 000 lives, and left over 1, 300 missing. As the Maoists professed themselves as a vanguard of a rebellion against the structural inequalities, they lured the members of the Dalit community into their ideology, and drafted many of them in the People’s Liberation Army (PLA). State security forces, on the other hand, in a rapid escalation, targeted Dalit as Maoists or their allies. The shift in combat strategy of the Maoists in 2001, and the counter-insurgency tactics resulted in an increase of human rights violations against Dalit in the western hinterlands. By a qualitative interviewing of 17 Dalit families, of the two adjoining villages of west Nepal, of which 20 men were killed in two separate incidents by then Royal Nepal Army (RNA) in 2002, this article expounds the broad structural issues, the liberation and security discourses, and the local geography-time susceptibility of the families as the targets of state power enmeshed in the massacres as narrated by the family members, the contexts and grounds that culminated in the two events, and the social aftermath.
‘This place is a bus stop’: Temporalities of Zimbabwean migrant men waiting at a Zimbabwe-South Africa border transit shelter
Authors: Vanyoro Kudakwashe
Published: April 2022

This article explores how temporal disruptions at international borders shape immobile bodies’ experiences and modes of waiting by focusing on irregular Zimbabwean migrant men at the Zimbabwe-South Africa border who have arrived in South Africa but are restricted in moving further into the interior. It argues that waiting is a component of both governing these migrants as well as them seeking agency through the relationship between time, space and humanitarianism in this border regime. This shows how immobilities at ‘carceral junctions’ can be conceptualised as in time as much as in space. The article is based upon four months of ethnographic field research at the ‘I Believe in Jesus Church’ men's shelter in the border town of Musina. The intersections of immobility and temporal agency in this article contribute to a growing body of work that shows that the relationship between resistance and domination in waiting is ambivalent. This article also troubles assumptions about immobility as an experience that leads the inhabitants of humanitarian camps as well as carceral time-spaces to realise the status of ‘bare life’. While imposed forces make assumptions about the future precarious, the precariousness of the future also creates multiple and new possibilities.
Camps by design: Architectural spectacles of migrant hostipitality
Authors: Katz Irit
Published: April 2022

Detention camps, ‘hospitality’ centres and other carceral facilities created to contain people ‘on the move’ are usually formed in familiar spatial arrangements such as prefabricated shelters organised in a grid layout. Over the recent years, however, a number of these facilities were architecturally designed in distinct formations while being presented as attractive spaces of care and support. By examining two such facilities created in different contexts and scales – the Holot detention camp in Israel’s Negev desert and the French urban Centre Humanitaire Paris-Nord – this paper analyses their spatial and political meaning in relation to the ways they were designed, managed, and presented to the public. Unlike minimal spaces of provision or spaces of participatory design in contexts of displacement, which might encourage the spatial agency of displaced people and the reworking of their political subjectivities, the paper shows how these architecturally designed facilities, with their spectacular form and infrastructural function, doubly objectify their residents. While the spectacular designs of these facilities frame irregular migrants as separated and temporary ‘guests’ who become the objects for the distant gaze of their ‘hosts’, their infrastructural spaces produce the migrants as constantly moving racialised bodies which are the objects of ongoing processes of concentration, categorisation, and circulation. These designed facilities, the paper argues, create visually identified and clearly defined spectacles of both hospitality and hostility, or in Derrida’s term, of hostipitality, through which irregular migrants are included by their receiving societies as only objectified, distant, and temporary guests.
The immune microenvironment shapes transcriptional and genetic heterogeneity in chronic lymphocytic leukemia
Authors: Sun Clare , Chen Yun-Ching , Martinez Zurita Aina , Baptista Maria Joao , Pittaluga Stefania , Liu Delong , Rosebrock Daniel , Gohil Satyen Harish , Saba Nakhle S. , Davies-Hill Theresa , Herman Sarah E. M. , Getz Gad , Pirooznia Mehdi , Wu Catherine J. , Wiestner Adrian
Published: April 2022

In chronic lymphocytic leukemia (CLL), B-cell receptor signaling, tumor–microenvironment interactions, and somatic mutations drive disease progression. To better understand the intersection between the microenvironment and molecular events in CLL pathogenesis, we integrated bulk transcriptome profiling of paired peripheral blood (PB) and lymph node (LN) samples from 34 patients. Oncogenic processes were upregulated in LN compared with PB and in immunoglobulin heavy-chain variable (IGHV) region unmutated compared with mutated cases. Single-cell RNA sequencing (scRNA-seq) distinguished 3 major cell states: quiescent, activated, and proliferating. The activated subpopulation comprised only 2.2% to 4.3% of the total tumor bulk in LN samples. RNA velocity analysis found that CLL cell fate in LN is unidirectional, starts in the proliferating state, transitions to the activated state, and ends in the quiescent state. A 10-gene signature derived from activated tumor cells was associated with inferior treatment-free survival (TFS) and positively correlated with the proportion of activated CD4+ memory T cells and M2 macrophages in LN. Whole exome sequencing (WES) of paired PB and LN samples showed subclonal expansion in LN in approximately half of the patients. Since mouse models have implicated activation-induced cytidine deaminase in mutagenesis, we compared AICDA expression between cases with and without clonal evolution but did not find a difference. In contrast, the presence of a T-cell inflamed microenvironment in LN was associated with clonal stability. In summary, a distinct minor tumor subpopulation underlies CLL pathogenesis and drives the clinical outcome. Clonal trajectories are shaped by the LN milieu, where T-cell immunity may contribute to suppressing clonal outgrowth. The clinical study is registered at clinicaltrials.gov as NCT00923507.
Dynamic Finite Element Modeling and Simulation of Soft Robots
Authors: Ding Liang , Niu Lizhou , Su Yang , Yang Huaiguang , Liu Guangjun , Gao Haibo , Deng Zongquan
Published: April 2022

Soft robots have become important members of the robot community with many potential applications owing to their unique flexibility and security embedded at the material level. An increasing number of researchers are interested in their designing, manufacturing, modeling, and control. However, the dynamic simulation of soft robots is difficult owing to their infinite degrees of freedom and nonlinear characteristics that are associated with soft materials and flexible geometric structures. In this study, a novel multi-flexible body dynamic modeling and simulation technique is introduced for soft robots. Various actuators for soft robots are modeled in a virtual environment, including soft cable-driven, spring actuation, and pneumatic driving. A pneumatic driving simulation was demonstrated by the bending modules with different materials. A cable-driven soft robot arm prototype and a cylindrical soft module actuated by shape memory alley springs inspired by an octopus were manufactured and used to validate the simulation model, and the experimental results demonstrated adequate accuracy. The proposed technique can be widely applied for the modeling and dynamic simulation of other soft robots, including hybrid actuated robots and rigid-flexible coupling robots. This study also provides a fundamental framework for simulating soft mobile robots and soft manipulators in contact with the environment.
The challenges of integrating signposting into general practice: qualitative stakeholder perspectives on care navigation and social prescribing in primary care
Authors: Brunton Lisa , Tazzyman Abigail , Ferguson Jane , Hodgson Damian , Nelson Pauline A.
Published: April 2022

Background

A national policy focus in England to address general practice workforce issues has led to a commitment to employ significant numbers of non-general practitioner (GP) roles to redistribute workload. This paper focuses on two such roles: the care navigation (CN) and social prescribing link worker (SPLW) roles, which both aim to introduce ‘active signposting’ into primary care, to direct patients to the right professional/services at the right time and free up GP time. There is a lack of research exploring staff views of how these roles are being planned and operationalised into general practice and how signposting is being integrated into primary care.

Methods

The design uses in-depth qualitative methods to explore a wide range of stakeholder staff views. We generated a purposive sample of 34 respondents who took part in 17 semi-structured interviews and one focus group (service leads, role holders and host general practice staff). We analysed data using a Template Analysis approach.

Results

Three key themes highlight the challenges of operationalising signposting into general practice: 1) role perception – signposting was made challenging by the way both roles were perceived by others (e.g. among the public, patients and general practice staff) and highlighted inherent tensions in the expressed aims of the policy of active signposting; 2) role preparedness – a lack of training meant that some receptionist staff felt unprepared to take on the CN role as expected and raised patient safety issues; for SPLW staff, training affected the consistency of service offer across an area; 3) integration and co-ordination of roles – a lack of planning and co-ordination across components of the health and care system challenged the success of integrating signposting into general practice.

Conclusions

This study provides new insights from staff stakeholder perspectives into the challenges of integrating signposting into general practice, and highlights key factors affecting the success of signposting in practice. Clarity of role purpose and remit (including resolving tensions inherent the dual aims of ‘active signposting’), appropriate training and skill development for role holders and adequate communication and engagement between stakeholders/partnership working across services, are required to enable successful integration of signposting into general practice.
Characteristics and determinants of loss to follow-up among tuberculosis (TB) patients who smoke in an industrial state of Malaysia: a registry-based study of the years 2013-2017
Authors: Sharani Zatil Zahidah , Ismail Nurhuda , Yasin Siti Munira , Zakaria Yuslina , Razali Asmah , Demong Nur Atiqah Rochin , Mohammad Mariam , Ismail Zaliha
Published: April 2022

Background

The increased risk of loss to follow-up among TB smokers raises concern over the secondary spread within the community. This study aimed to determine the factors associated with loss to follow-up among TB patients who smoke.

Methods

All registered TB patients who smoke in the state of Selangor between 2013 and 2017 via the Malaysian Tuberculosis Information System (MyTB) database were included for analysis. TB patients who smoke were considered those who are “current smoker” during the notification, while loss to follow-up was defined as a TB patient who had interrupted treatment for 2 months or longer. There were 3 main variable domains included for analysis: sociodemographic profiles, disease profiles, and comorbidities. Logistic regression analysis was used to identify determinants of loss to follow-up among TB patients who smoke.

Results

A total of 14.1% (N = 813) of TB patients who smoke loss to follow-up. The determinants of loss to follow-up among TB smokers were working age population aged 32-41 and 42-53 years old (AOR 1.08; 95%CI 1.23,2.08) and (AOR 1.44; 95%CI 1.11,1.87) respectively, Malaysian nationality (AOR 2.34; 95%CI 1.66,3.30), patients staying in urban area (AOR 1.55; 95% CI 1.23,1.97), income level less than RM2160 (AOR 1.59; 95% CI 1.14,2.20), un-employed (AOR 1.30; 95%CI 1.09-1.55), have low education level i.e., secondary school education, primary school education and no formal education (AOR 1.60; 95%CI 1.22,2.10), (AOR 1.73; 95%CI 1.16,2.57) and (AOR 2.29; 95% CI 1.57,3.33) respectively, previously treated TB cases (AOR 2.19; 95% CI 1.71,2.81), active TB case detection methods (AOR 2.06; 95%CI 1.40,3.02), moderate lesion x-ray (AOR 1.60; 95%CI 1.13,2.27) and HIV positive (AOR 1.36; 95%CI 1.02,1.82). All the significant factors gave rise to the final model of determinants, with a predictability of 67.2% (95% CI 65.0,69.3).

Conclusions

The high proportion of loss to follow-up among TB patients who smoke highlight the importance of providing early risk detection that examines the three main domains of risk factors such as socioeconomic, disease profiles and comorbidities. Potential integrated intervention should aim to reduce the proportion of smoking among TB patients through the stop smoking programme together with directly observed therapy (DOT).
Effects of periodontal clinical database software in resident training during COVID-19 pandemic: a prospective observational study
Authors: Zhu Wenjun , Feng Rongmei , Fu Yun
Published: April 2022

Background

Dental residents in Guangdong, China, had fewer medical practice opportunities because of the pandemic of COVID-19. This study aimed to evaluate whether a case-based learning (CBL) approach using a periodontal clinical database software (PCDS) could improve residents' achievement in the exam of the standardized residency training (SRT) program.

Methods

Forty-four dental residents volunteered and completed this trial. Within 12 weeks, all residents admitted periodontal patients 5 days a week and participated in a case-based learning course using PCDS once a week. Two online case-based examinations were used to evaluate their diagnostic and therapeutic performance before and after training. The total accuracy rate of examinations and the accuracy rate of subitems were analyzed using paired samples T-test. The Bonferroni correction is used for multiple testing adjustments, and p < 0.05 was considered statistical significance.

Results

After training, the total accuracy rate of SRT exams raised from 65 to 76%. There was a significant difference in the accuracy rate before and after training (Mean = 0.103, SD = 0.141, p < 0.001). The accuracy of radiographic examination (type of alveolar bone absorption and hard tissue lesion of tooth) and making treatment plan was significantly improved after training (p < 0.005). However, residents' performance in diagnosing periodontitis and predicting the prognosis of affected teeth was not improved.

Conclusions

The PCDS and CBL method effectively improved the residents' achievement in SRT examination, especially in identifying the type of resorption of alveolar bone and the hard tissue lesion of a tooth by radiographic examination and making an appropriate treatment plan for a periodontitis patient. More effective teaching approaches are needed to improve residents' accuracy of diagnosis of periodontitis using the 2018 classification in China.
Mechanisms of neuroinflammation in hydrocephalus after intraventricular hemorrhage: a review
Authors: Holste Katherine G. , Xia Fan , Ye Fenghui , Keep Richard F. , Xi Guohua
Published: April 2022

Intraventricular hemorrhage (IVH) is a significant cause of morbidity and mortality in both neonatal and adult populations. IVH not only causes immediate damage to surrounding structures by way of mass effect and elevated intracranial pressure; the subsequent inflammation causes additional brain injury and edema. Of those neonates who experience severe IVH, 25–30% will go on to develop post-hemorrhagic hydrocephalus (PHH). PHH places neonates and adults at risk for white matter injury, seizures, and death. Unfortunately, the molecular determinants of PHH are not well understood. Within the past decade an emphasis has been placed on neuroinflammation in IVH and PHH. More information has come to light regarding inflammation-induced fibrosis and cerebrospinal fluid hypersecretion in response to IVH. The aim of this review is to discuss the role of neuroinflammation involving clot-derived neuroinflammatory factors including hemoglobin/iron, peroxiredoxin-2 and thrombin, as well as macrophages/microglia, cytokines and complement in the development of PHH. Understanding the mechanisms of neuroinflammation after IVH may highlight potential novel therapeutic targets for PHH.
Dosimetric feasibility of moderately hypofractionated/dose escalated radiation therapy for localised prostate cancer with intensity-modulated proton beam therapy using simultaneous integrated boost (SIB-IMPT) and impact of hydrogel prostate-rectum spacer
Authors: Ahmad Khalil Dalia , Jazmati Danny , Geismar Dirk , Wulff Jörg , Bäumer Christian , Kramer Paul Heinz , Steinmeier Theresa , Schulze Schleitthoff Stefanie , Plaude Sandija , Bischoff Martin , Tschirdewahn Stephan , Hadaschik Boris , Timmermann Beate
Published: April 2022

Purpose

To examine the dosimetric feasibility of hypofractionated/dose escalated radiation therapy in patients with localized prostate carcinoma using simultaneous integrated boost intensity-modulated proton beam therapy (SIB-IMPT) in absence or presence of prostate-rectum spacer.

Methods

IMPT technique was implemented in 23 patients with intermediate- and high-risk prostate cancer treated at West German Proton Therapy Centre from March 2016 till June 2018, using SIB technique prescribing 60 GyRBE and 72 GyRBE in 30 fractions to PTV1 (prostate and seminal vesicle) and PTV2 boost (prostate and proximal seminal vesicle), respectively. In 15 patients, a transperineal injection of hydrogel was applied prior to radiotherapy to increase the distance between prostate and rectum. Planning and all treatments were performed with a 120 ml fluid-filled endorectal balloon customised daily for each patient. For each patient, 2 lateral IMPT beams were implemented taking a field-specific range uncertainty (RU) into account. Dose volume histograms (DVH) were analyzed for PTV2, PTV2 with range uncertainty margin (PTV2RU), rectum, bladder, right/left femoral heads, and penile bulb. For late rectal toxicities, the normal tissue complication probabilities (NTCP) were calculated using different biological models. A DVH- and NTCP-based dosimetric comparison was carried out between non-spacer and spacer groups.

Results

For the 23 patients, high-quality plans could be achieved for target volume and for other organs at risk (OARs). For PTV2, the V107% was 0% and the Dmax did not exceed 106.2% of the prescribed dose. The volume PTV2RU covered by 95% of the dose ranged from 96.16 to 99.95%. The conformality index for PTV2RU was 1.12 ± 0.057 and the homogeneity index (HI) was 1.04 ± 0.014. Rectum Dmax and rectal volume receiving 73–50 Gy could be further reduced for the spacer-group. Significant reductions in mean and median rectal NTCPs (stenosis/necrosis, late rectal bleeding ≥ 2, and late rectal toxicities ≥ 3) were predicted for the spacer group in comparison to the non-spacer group.

Conclusion

Hypofractionated/dose escalated radiotherapy with SIB-IMPT is dosimetrically feasible. Further reduction of the rectal volumes receiving high and medium dose levels (73–50 Gy) and rectal NTCP could be achieved through injection of spacers between rectum and prostate.
Degos disease complicated by constrictive pericarditis in remote phase: a case report
Authors: Tadokoro Yuki , Kitamura Tadashi , Horai Tetsuya , Miyaji Kagami
Published: April 2022

Background

Degos disease, also known as malignant atrophic papulosis, is characterised by cutaneous manifestations due to chronic thrombo-obliterative vasculopathy. There have been reports of the rare late-onset Degos disease complicated by constrictive pericarditis (CP). This study reports a case of CP caused by Degos disease that developed 20 years after diagnosis.

Case presentation

A 62-year-old woman who had been taking aspirin for 20 years for Degos disease was hospitalised for worsening of heart failure. The patient was diagnosed with CP and underwent pericardiectomy. Pathological findings suggested the involvement of Degos disease. The postoperative course was uneventful, and her heart failure and Degos disease did not worsen.

Conclusions

The study findings suggests that Degos disease can cause long-term CP. Aspirin effectively inhibited the progression of Degos disease, and surgical treatment was necessary when heart failure due to CP was refractory to treatment.
Pragmatic trials can address diagnostic controversies: recent lessons from gestational diabetes
Authors: Raymond Jean , Long Hélène , Darsaut Tim
Published: April 2022

Objective

The aim of the paper is to discuss how a pragmatic definition could change our conception of diagnosis, using gestational diabetes mellitus (GDM) as an example.

Study design

We review the diagnostic controversy that followed an observational study showing a linear relationship between maternal glycaemia and adverse pregnancy outcomes and the resolution proposed 15 years later by a recent pragmatic trial comparing two screening approaches (one- vs two-step) with different diagnostic thresholds.

Results

The pragmatic trial involved approximately 24,000 women. The one-step screening strategy using lower GDM thresholds diagnosed twice as many women with GDM, but pregnancy outcomes were not different. We examine how the pragmatic approach integrates research into practice and defines the meaning of a diagnosis according to patient outcomes. The approach is ethically and scientifically sound as compared to the previous methodology, where observational research separated from care gave a theoretical definition of GDM that may have misled medical practice for two decades.

Conclusion

Pragmatic research integrated into practice can revolutionize our conception of medical diagnosis in the best medical interest of patients.
Association between depression and mortality in persons with asthma: a population-based cohort study
Authors: Lin Ping , Li Xiaoqian , Liang Zongan , Wang Ting
Published: April 2022

Background

The relation between depression and mortality in patients with asthma is not well known. This study aimed to assess the impact of depression on mortality in asthmatic patients in US adults.

Methods

This observational study used data from the 2005 to 2014 National Health and Nutrition Examination Survey (NHANES). Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). We used survey-weight adjusted Cox proportional hazard models to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between depression and all-cause mortality.

Results

A total of 1865 participants with asthma were included in this study. Among them, 264 (14.16%) had depressive symptoms. During 9970 person-years of follow-up, there were 24 (9.1%) deaths in 264 patients with depression compared with 100 (6.3%) deaths in 1601 patients without depression. For unadjusted analyses, depression was associated with an increased risk of all-cause mortality (HR, 2.22 [95% CI 1.32–3.73]). This association was persistent after adjustment for age, sex, race/ethnicity, and body mass index (HR, 2.71 [95% CI 1.58–4.66]). However, we did not observe a significant association between depression and mortality after controlling for extensive co-morbidities (HR, 1.92 [95% CI 0.82–4.45]). Subgroup analyses further revealed that depression was an independent risk factor for mortality only in the females (HR, 3.78 [95% CI 1.17, 12.26]) but not all asthmatic patients.

Conclusions

The present study suggested that depressive disorder was common in asthmatic patients and depression in asthmatic patients was associated with a higher mortality rate. Depression was an independent risk factor for mortality in female patients.
Infliximab therapy of relapsing tracheal stenosis in a pediatric patient with granulomatosis with polyangiitis: a case report
Authors: Schnell Alexander , Ruppel Renate , Tremel Christina , Galiano Matthias , Meßbacher Maria-Elena , Krickau Tobias
Published: April 2022

Background

Granulomatosis with polyangiitis is a granulomatous, necrotizing small-vessel vasculitis affecting both children and adults. However, subglottic tracheal stenosis appears more frequently in the pediatric cohort. To date, granulomatosis with polyangiitis is often treated with steroids, cyclophosphamide, azathioprine, or rituximab, but tumor-necrosis-factor-α-antagonistic drugs are increasingly gaining significance in treatment of refractory cases.

Case presentation

We report the case of a 15-year-old Caucasian male diagnosed with proteinase-3-positive granulomatosis with polyangiitis with acute shortness of breath. X-ray and magnet resonance imaging showed extensive subglottic narrowing. Forced expiratory volume in 1 s was reduced to 50% of age norm, with massively increased effective airway resistance. The patient initially responded very well to high-dose steroids and maintenance therapy with azathioprine. He was subsequently treated with four doses of rituximab, and levels of proteinase 3 antibodies normalized. After 6 months of clinical remission, the patient presented again with acute respiratory symptoms. Again, he was treated with high-dose steroids, but showed poor clinical response this time. Therefore, we decided to commence a tumor-necrosis-factor-α-antagonistic treatment with infliximab, under which our patient achieved clinical remission and normalization of lung function parameters.

Conclusions

The use of tumor-necrosis-factor-α-antagonistic agents might be a promising alternative for the treatment of refractory tracheal stenosis in pediatric patients with granulomatosis with polyangiitis.