bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of exclusive breastfeeding in the first six months: four consecutive surveys in a tertiary hospital in Lithuania
Authors: Jakaitė Vaidilė , Peštenytė Aurelija , Zakarevičienė Jolita , Sniečkuvienė Vilija , Žitkutė Viktorija , Ramašauskaitė Diana , Domža Gintautas
Published: February 2021

Background

There are little up-to-date data available on the duration of exclusive breastfeeding in Lithuania. The aim of our study was to examine the factors that could influence exclusive breastfeeding during the first 6 months of life.

Methods

In 2016, a survey was conducted at the Obstetrics and Gynecology Clinic of Vilnius University Hospital, Santaros Klinikos. Women in postnatal wards were opportunistically offered questionnaires and later followed up by telephone interviews at 6 weeks, 3 months, and 6 months postpartum. We used binary logistic regression to determine the factors that impacted exclusive breastfeeding during the first 6 months following childbirth.

Results

Of 475 eligible women that were approached, a total of 447 women were recruited, with response rates of 76.1, 71.4 and 67.0% at 6 weeks, 3 months, and 6 months postpartum, respectively. The prevalence of exclusive breastfeeding through the 6 month postpartum period was 39.8%. Exclusive breastfeeding during days 2 to 4 postpartum was positively influenced by factors such as a natural childbirth, the practice of breastfeeding on demand and maternal self-confidence in breastfeeding. Subsequently, exclusive breastfeeding on demand in the immediate postpartum period and exclusive breastfeeding for up to 3 months were associated with successful exclusive breastfeeding up to 6 months. However, the adverse factors that limited the success and duration of exclusive breastfeeding included free samples of human milk substitutes or advertising at primary healthcare centers 6 weeks after childbirth, pacifier use 6 months after childbirth, as well as amniotomy for labor induction.

Conclusions

Our research demonstrated that exclusive breastfeeding is impacted in both directions by a range of factors during particular periods after delivery. One of the novel findings was the adverse influence of amniotomy for labor induction on exclusive breastfeeding rates. Taking into account diverse factors influencing exclusive breastfeeding and the absence of a single way to promote it, there is a crucial need to increase the incidence of exclusive breastfeeding until infants reach the age of 6 months.
Full recovery of elective orthopedic surgery in the age of COVID-19: an 8-month retrospective cohort study
Authors: Lou Teng-fei , Ren Zun , Sun Zheng-hua , Wang Wei , Fan Cun-yi
Published: February 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has led to dramatic disruptions to orthopedic services. The purpose of this study is to quantify the reinstatement of elective orthopedic surgeries of our institution in Shanghai, China, and share our first-hand experiences of how this region is managing the post-outbreak period.

Methods

The number of patients receiving elective orthopedic surgeries was analyzed in the timeframe of 8 months since the start of the pandemic (from January 20 to September 16) and compared with the patients receiving the same treatment during the same period in 2019. And a detailed workflow for handling patients about to receive elective surgeries in the COVID-19 post-outbreak period was described.

Results

The number of the selective surgeries in the first 3 months only accounted for 31.72% of the same period in 2019 (p = 0.0031), and the ratio reached 97.47% when it came to the last 5 months (p > 0.9999). The selective surgeries even surpassed the pre-epidemic level in months 7 and 8. And the difference of the surgeries was not significant in the whole eight observed months between 2019 and 2020 (p = 0.1526). No health care providers or hospitalized patients in orthopedic departments in Shanghai have been infected nosocomially.

Conclusions

Elective orthopedic surgeries have been fully recovered from the COVID-19 pandemic in our institution, and the new normalcy established during the post-outbreak period helped this region co-exist with the impact of the virus well.

Trial registration

Retrospectively registered, registration number: ChiCTR2000039711, date of registration: November 6, 2020
The impact of COVID-19 on the management and outcomes of patients with proximal femoral fractures: a multi-centre study of 580 patients
Authors: Wignall Alice , Giannoudis Vasileios , De Chiranjit , Jimenez Andrea , Sturdee Simon , Nisar Sohail , Pandit Hemant , Gulati Aashish , Palan Jeya
Published: February 2021

Background

On the 11th March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. Multiple new guidelines were proposed and existing models of social, domestic and hospital care altered. Most healthcare systems were largely unprepared for this, and the pandemic has tested their adaptability. This study aimed to assess the impact of COVID-19 on the demographics, presentation, clinical management and outcomes of patients with proximal femoral (hip) fractures comparing them to a similar cohort of patients admitted a year earlier.

Methods

This retrospective multi-centre cohort study compared all patients admitted with hip fractures between 1st March and 30th May 2019 (group PC: pre-COVID-19) with hip fracture patients admitted over the same time period during the pandemic in 2020 (group C: COVID-19). The data was obtained from the hospitals’ local and National Hip Fracture Databases. Mortality data was checked with the Office for National Statistics (ONS). Primary outcomes were time to theatre, in-patient length of stay and 30-day mortality.

Results

A total of 580 patients were included (304 group PC, 276 group C). Patient demographics including Charlson Comorbidity Index and Nottingham Hip Fracture Scores were broadly similar across the two cohorts. There was a significant reduction in the percentage of total hip replacements (11 to 5%,p= 0.006) in group C. There was an increase in conservative management (1 to 5%,p= 0.002) in group C. Time to theatre was significantly delayed in group C (43.7 h) vs group PC (34.6 h) (p≤ 0.001). The overall length of hospital stay was significantly longer in group PC (16.6 days) vs group C (15 days) (p= 0.025). The 30-day mortality rate in group C was 9.8% compared to 8.2% in group PC (p= 0.746), but for COVID-19 (+) patients, it was significantly higher at 38.2% vs 5.8% in COVID-19 (−) patients (p< 0.001).

Conclusion

This is one of the largest multi-centre comparative cohort study in the literature to date examining the impact of the COVID-19 pandemic on the management of hip fracture patients. Whilst mortality rates were similar in both groups, COVID-19-positive patients were almost seven times more likely to die, reflecting the seriousness of the COVID-19 infection and its sequelae in such elderly, vulnerable patients.
A novel closed technique for ultrasound-guided plantar fascia release with a needle: review of 107 cases with a minimum follow-up of 24 months
Authors: Iborra A. , Villanueva M. , Sanz-Ruiz P. , Martin Antonio , Noriega Concepción
Published: February 2021

Background

This study aims to analyze the clinical outcome of a new ultrasound-guided surgery for partial plantar fasciotomy performed with a needle for treatment of plantar fasciitis.

Methods

We performed a retrospective review of 107 patients diagnosed with plantar fasciitis who underwent ultrasound-guided release of the plantar fascia.

The series included 62 males (57.9%) and 45 females (42.1%) treated between April 2014 and February 2018, with a mean follow-up of 21.05 ± 10.96 months (7–66) and a minimum follow-up of 24 months. The mean age was 48.10 ± 10.27 years (27–72).

Clinical assessments and ultrasound examination were carried out before treatment, after 1 week, and then after 1, 3, 12, and 24 months. The clinical assessment was based on a visual analog scale and the Foot and Ankle Disability Index.

Results

Heel pain improved in 92.5% (99) of patients, but not in 7.4% (8 patients). In the group of patients whose heel pain improved, 9 experienced overload on the lateral column and dorsum of the foot, which improved with the use of plantar orthoses and a rehabilitation program. We recorded no nerve complications (e.g., paresthesia), vascular injuries, or wound-related problems.

Conclusion

Ultrasound-guided partial plantar fasciotomy with a needle is safe, since structures are under direct visualization of the surgeon and the risk of damage is minimal. Stitches are not necessary, and recovery is fast. Consequently, costs are low, and the patient can return to work quickly. This technique may represent a valid option for treatment of plantar fasciitis.
On the emergence of antibacterial and antiviral copper cold spray coatings
Authors: Sousa Bryer C. , Massar Christopher J. , Gleason Matthew A. , Cote Danielle L.
Published: February 2021

In this literature review, the antipathogenic properties and contact-mediated antibacterial and antiviral performance of copper cold spray surfaces are assessed and compared with alternative antimicrobial materials that are able to kill and/or inactivate infectious agents via direct contact. Discussion is also provided concerning the suitability of copper cold spray material consolidations as biocidal and viricidal surfaces that retain long-term functionality as a preventative measure against fomite transmission of pathogenic agents and hospital-acquired infections from contaminated high-touch surfaces. Numerable alternative antimicrobial coatings and surfaces that do not rely upon the oligodynamic action of copper are detailed. Given the ongoing need for recognition of said alternative antimicrobial materials by authoritative agencies, such as the U.S. Environmental Protection Agency, the relevant literature on non-copper-based antipathogenic coatings and surfaces are then described. Furthermore, a wide-ranging take on antipathogenic copper cold spray coatings are provided and consideration is given to the distinctive grain-boundary mediated copper ion diffusion pathways found in optimizable, highly deformed, copper cold spray material consolidations that enable pathogen inactivation on surfaces from direct contact. To conclude this literature review, analysis of how copper cold spray coatings can be employed as a preventative measure against COVID-19 was also presented in light of on-going debates surrounding SARS-CoV-2’s non-primary, but non-negligible, secondary transmission pathway, and also presented in conjunction with the inevitability that future pathogens, which will be responsible for forthcoming global pandemics, may spread even more readily via fomite pathways too.
Preclinical evaluation of the Hsp90 inhibitor SNX-5422 in ibrutinib resistant CLL
Authors: Chen Timothy L. , Harrington Bonnie , Truxall Jean , Wasmuth Ronni , Prouty Alexander , Sloan Shelby , Lehman Amy M. , Sampath Deepa , Orlemans Eric , Baiocchi Robert A. , Alinari Lapo , Byrd John C. , Woyach Jennifer A. , Hertlein Erin
Published: February 2021

B-cell receptor (BCR) antagonists such as the BTK inhibitor ibrutinib have proven to effectively target chronic lymphocytic leukemia (CLL) tumor cells, leading to impressive response rates in these patients. However patients do still relapse on ibrutinib, and the progressive disease is often quite aggressive requiring immediate treatment. Several strategies are being pursued to treat patients who relapse on ibrutinib therapy. As the most common form of relapse is the development of a mutant form of BTK which limits ibrutinib binding, agents which lead to degradation of the BTK protein are a promising strategy. Our study explores the efficacy of the Hsp90 inhibitor, SNX-5422, in CLL. The SNX Hsp90 inhibitor was effective in primary CLL cells, as well as B-cell lines expressing either BTK wild type or C481 mutant BTK, which has been identified as the primary resistance mechanism to ibrutinib in CLL patients. Furthermore the combination of SNX-5422 and ibrutinib provided a remarkable in vivo survival benefit in the Eμ-TCL1 mouse model of CLL compared to the vehicle or single agent groups (51 day median survival in the vehicle and ibrutinib groups versus 100 day median survival in the combination). We report here preclinical data suggesting that the Hsp90 inhibitor SNX-5422, which has been pursued in clinical trials in both solid tumor and hematological malignancies, is a potential therapy for ibrutinib resistant CLL.
Computed tomography assessment of PEEP-induced alveolar recruitment in patients with severe COVID-19 pneumonia
Authors:   GECOVID (GEnoa COVID-19) group, Ball Lorenzo , Robba Chiara , Maiello Lorenzo , Herrmann Jacob , Gerard Sarah E. , Xin Yi , Battaglini Denise , Brunetti Iole , Minetti Giuseppe , Seitun Sara , Vena Antonio , Giacobbe Daniele Roberto , Bassetti Matteo , Rocco Patricia R. M. , Cereda Maurizio , Castellan Lucio , Patroniti Nicolò , Pelosi Paolo
Published: February 2021

Background

There is a paucity of data concerning the optimal ventilator management in patients with COVID-19 pneumonia; particularly, the optimal levels of positive-end expiratory pressure (PEEP) are unknown. We aimed to investigate the effects of two levels of PEEP on alveolar recruitment in critically ill patients with severe COVID-19 pneumonia.

Methods

A single-center cohort study was conducted in a 39-bed intensive care unit at a university-affiliated hospital in Genoa, Italy. Chest computed tomography (CT) was performed to quantify aeration at 8 and 16 cmH2O PEEP. The primary endpoint was the amount of alveolar recruitment, defined as the change in the non-aerated compartment at the two PEEP levels on CT scan.

Results

Forty-two patients were included in this analysis. Alveolar recruitment was median [interquartile range] 2.7 [0.7–4.5] % of lung weight and was not associated with excess lung weight, PaO2/FiO2 ratio, respiratory system compliance, inflammatory and thrombophilia markers. Patients in the upper quartile of recruitment (recruiters), compared to non-recruiters, had comparable clinical characteristics, lung weight and gas volume. Alveolar recruitment was not different in patients with lower versus higher respiratory system compliance. In a subgroup of 20 patients with available gas exchange data, increasing PEEP decreased respiratory system compliance (median difference, MD − 9 ml/cmH2O, 95% CI from − 12 to − 6 ml/cmH2O, p < 0.001) and the ventilatory ratio (MD − 0.1, 95% CI from − 0.3 to − 0.1, p = 0.003), increased PaO2 with FiO2 = 0.5 (MD 24 mmHg, 95% CI from 12 to 51 mmHg, p < 0.001), but did not change PaO2 with FiO2 = 1.0 (MD 7 mmHg, 95% CI from − 12 to 49 mmHg, p = 0.313). Moreover, alveolar recruitment was not correlated with improvement of oxygenation or venous admixture.

Conclusions

In patients with severe COVID-19 pneumonia, higher PEEP resulted in limited alveolar recruitment. These findings suggest limiting PEEP strictly to the values necessary to maintain oxygenation, thus avoiding the use of higher PEEP levels.
MR CLEAN-LATE, a multicenter randomized clinical trial of endovascular treatment of acute ischemic stroke in The Netherlands for late arrivals: study protocol for a randomized controlled trial
Authors:   on behalf of the MR CLEAN-LATE investigators, Pirson F. A. V. ( Anne) , Hinsenveld Wouter H. , Goldhoorn Robert-Jan B. , Staals Julie , de Ridder Inger R. , van Zwam Wim H. , van Walderveen Marianne A. A. , Lycklama à Nijeholt Geert J. , Uyttenboogaart Maarten , Schonewille Wouter J. , van der Lugt Aad , Dippel Diederik W. J. , Roos Yvo B. W. E. M. , Majoie Charles B. L. M. , van Oostenbrugge Robert J.
Published: February 2021

Background

Endovascular therapy (EVT) for acute ischemic stroke due to proximal occlusion of the anterior intracranial circulation, started within 6 h from symptom onset, has been proven safe and effective. Recently, EVT has been proven effective beyond the 6-h time window in a highly selected population using CT perfusion or MR diffusion. Unfortunately, these imaging modalities are not available in every hospital, and strict selection criteria might exclude patients who could still benefit from EVT. The presence of collaterals on CT angiography (CTA) may offer a more pragmatic imaging criterion that predicts possible benefit from EVT beyond 6 h from time last known well. The aim of this study is to assess the safety and efficacy of EVT for patients treated between 6 and 24 h from time last known well after selection based on the presence of collateral flow.

Methods

The MR CLEAN-LATE trial is a multicenter, randomized, open-label, blinded endpoint trial, aiming to enroll 500 patients. We will investigate the efficacy of EVT between 6 and 24 h from time last known well in acute ischemic stroke due to a proximal intracranial anterior circulation occlusion confirmed by CTA or MRA. Patients with any collateral flow (poor, moderate, or good collaterals) on CTA will be included. The inclusion of poor collateral status will be restricted to a maximum of 100 patients. In line with the current Dutch guidelines, patients who fulfill the characteristics of included patients in DAWN and DEFUSE 3 will be excluded as they are eligible for EVT as standard care. The primary endpoint is functional outcome at 90 days, assessed with the modified Rankin Scale (mRS) score. Treatment effect will be estimated with ordinal logistic regression (shift analysis) on the mRS at 90 days. Secondary endpoints include clinical stroke severity at 24 h and 5–7 days assessed by the NIHSS, symptomatic intracranial hemorrhage, recanalization at 24 h, follow-up infarct size, and mortality at 90 days,

Discussion

This study will provide insight into whether EVT is safe and effective for patients treated between 6 and 24 h from time last known well after selection based on the presence of collateral flow on CTA.

Trial registration

NL58246.078.17, ISRCTN19922220, Registered on 11 December 2017
The Eagle effect in the Wolbachia-worm symbiosis
Authors: Bulman Christina A. , Chappell Laura , Gunderson Emma , Vogel Ian , Beerntsen Brenda , Slatko Barton E. , Sullivan William , Sakanari Judy A.
Published: February 2021

Background

Onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis) are two human neglected tropical diseases that cause major disabilities. Mass administration of drugs targeting the microfilarial stage has reduced transmission and eliminated these diseases in several countries but a macrofilaricidal drug that kills or sterilizes the adult worms is critically needed to eradicate the diseases. The causative agents of onchocerciasis and lymphatic filariasis are filarial worms that harbor the endosymbiotic bacterium Wolbachia. Because filarial worms depend on Wolbachia for reproduction and survival, drugs targeting Wolbachia hold great promise as a means to eliminate these diseases.

Methods

To better understand the relationship between Wolbachia and its worm host, adult Brugia pahangi were exposed to varying concentrations of doxycycline, minocycline, tetracycline and rifampicin in vitro and assessed for Wolbachia numbers and worm motility. Worm motility was monitored using the Worminator system, and Wolbachia titers were assessed by qPCR of the single copy gene wsp from Wolbachia and gst from Brugia to calculate IC50s and in time course experiments. Confocal microscopy was also used to quantify Wolbachia located at the distal tip region of worm ovaries to assess the effects of antibiotic treatment in this region of the worm where Wolbachia are transmitted vertically to the microfilarial stage.

Results

Worms treated with higher concentrations of antibiotics had higher Wolbachia titers, i.e. as antibiotic concentrations increased there was a corresponding increase in Wolbachia titers. As the concentration of antibiotic increased, worms stopped moving and never recovered despite maintaining Wolbachia titers comparable to controls. Thus, worms were rendered moribund by the higher concentrations of antibiotics but Wolbachia persisted suggesting that these antibiotics may act directly on the worms at high concentration. Surprisingly, in contrast to these results, antibiotics given at low concentrations reduced Wolbachia titers.

Conclusion

Wolbachia in B. pahangi display a counterintuitive dose response known as the “Eagle effect.” This effect in Wolbachia suggests a common underlying mechanism that allows diverse bacterial and fungal species to persist despite exposure to high concentrations of antimicrobial compounds. To our knowledge this is the first report of this phenomenon occurring in an intracellular endosymbiont, Wolbachia, in its filarial host.

Graphical Abstract
Seasonal patterns and spatial variation of Borrelia burgdorferi (sensu lato) infections in Ixodes ricinus in the Netherlands
Authors: Hartemink Nienke , van Vliet Arnold J. H. , Gort Gerrit , Gassner Fedor , Jacobs Frans , Fonville Manoj , Takken Willem , Sprong Hein
Published: February 2021

Background

The incidence of Lyme borreliosis varies over time and space through as yet incompletely understood mechanisms. In Europe, Lyme borreliosis is caused by infection with a Borrelia burgdorferi (s.l.) genospecies, which is primarily transmitted by a bite of Ixodes ricinus nymphs. The aim of this study was to investigate the spatial and temporal variation in nymphal infection prevalence of B. burgdorferi (s.l.) (NIP), density of questing nymphs (DON) and the resulting density of infected nymphs (DIN).

Methods

We investigated the infection rates in I. ricinus nymphs that were collected monthly between 2009 and 2016 in 12 locations in the Netherlands. Using generalized linear mixed models, we explored how the NIP, DON and DIN varied during the seasons, between years and between locations. We also determined the genospecies of the Borrelia infections and investigated whether the genospecies composition differed between locations.

Results

The overall NIP was 14.7%. A seasonal pattern in infection prevalence was observed, with higher estimated prevalences in the summer than in the spring and autumn. This, combined with higher nymphal densities in summer, resulted in a pronounced summer peak in the estimated DIN. Over the 7.5-year study period, a significant decrease in infection prevalence was found, as well as a significant increase in nymphal density. These two effects appear to cancel each other out; the density of infected nymphs, which is the product of NIP × DON, showed no significant trend over years. Mean infection prevalence (NIP, averaged over all years and all months) varied considerably between locations, ranging from 5 to 26%. Borrelia genospecies composition differed between locations: in some locations almost all infections consisted of B. afzelii, whereas other locations had more diverse genospecies compositions.

Conclusion

In the Netherlands, the summer peak in DIN is a result of peaks in both NIP and DON. No significant trend in DIN was observed over the years of the study, and variations in DIN between locations were mostly a result of the variation in DON. There were considerable differences in acarological risk between areas in terms of infection prevalence and densities of ticks as well as in Borrelia genospecies composition.

Graphical Abstract
Spatio-temporal impacts of aerial adulticide applications on populations of West Nile virus vector mosquitoes
Authors: Holcomb Karen M. , Reiner Robert C. , Barker Christopher M.
Published: February 2021

Background

Aerial applications of insecticides that target adult mosquitoes are widely used to reduce transmission of West Nile virus to humans during periods of epidemic risk. However, estimates of the reduction in abundance following these treatments typically focus on single events, rely on pre-defined, untreated control sites and can vary widely due to stochastic variation in population dynamics and trapping success unrelated to the treatment.

Methods

To overcome these limitations, we developed generalized additive models fitted to mosquito surveillance data collected from CO2-baited traps in Sacramento and Yolo counties, California from 2006 to 2017. The models accounted for the expected spatial and temporal trends in the abundance of adult femaleCulex(Cx.)tarsalisandCx. pipiensin the absence of aerial spraying. Estimates for the magnitude of deviation from baseline abundance following aerial spray events were obtained from the models.

Results

At 1-week post-treatment with full spatial coverage of the trapping area by pyrethroid or pyrethrin products,Cx. pipiensabundance was reduced by a mean of 52.4% (95% confidence intrval [CI] − 65.6, − 36.5%) while the use of at least one organophosphate pesticide resulted in a mean reduction of 76.2% (95% CI − 82.8, − 67.9%). ForCx. tarsalis, at 1-week post-treatment with full coverage there was a reduction in abundance of 30.7% (95% CI − 54.5, 2.5%). Pesticide class was not a significant factor contributing to the reduction. In comparison, repetition of spraying over three to four consecutive weeks resulted in similar estimates forCx. pipiensand estimates of somewhat smaller magnitude forCx. tarsalis.

Conclusions

Aerial adulticides are effective for achieving a rapid short-term reduction of the abundance of the primary West Nile virus vectors,Cx. tarsalisandCx. pipiens. A larger magnitude of reduction was estimated inCx. pipiens, possibly due to the species’ focal distribution. Effects of aerial sprays onCx. tarsalispopulations are likely modulated by the species’ large dispersal ability, population sizes and vast productive larval habitat present in the study area. Our modeling approach provides a new way to estimate effects of public health pesticides on vector populations using routinely collected observational data and accounting for spatio-temporal trends and contextual factors like weather and habitat. This approach does not require pre-selected control sites and expands upon past studies that have focused on the effects of individual aerial treatment events.

Graphical Abstract
Systemic cross-talk between brain, gut, and peripheral tissues in glucose homeostasis: effects of exercise training (CROSSYS). Exercise training intervention in monozygotic twins discordant for body weight
Authors: Heiskanen Marja A. , Honkala Sanna M. , Hentilä Jaakko , Ojala Ronja , Lautamäki Riikka , Koskensalo Kalle , Lietzén Martin S. , Saunavaara Virva , Saunavaara Jani , Helmiö Mika , Löyttyniemi Eliisa , Nummenmaa Lauri , Collado Maria C. , Malm Tarja , Lahti Leo , Pietiläinen Kirsi H. , Kaprio Jaakko , Rinne Juha O. , Hannukainen Jarna C.
Published: February 2021

Background

Obesity and physical inactivity are major global public health concerns, both of which increase the risk of insulin resistance and type 2 diabetes. Regulation of glucose homeostasis involves cross-talk between the central nervous system, peripheral tissues, and gut microbiota, and is affected by genetics.Systemic cross-talk between brain, gut, and peripheral tissues in glucose homeostasis: effects of exercise training (CROSSYS)aims to gain new systems-level understanding of the central metabolism in human body, and how exercise training affects this cross-talk.

Methods

CROSSYS is an exercise training intervention, in which participants are monozygotic twins from pairs discordant for body mass index (BMI) and within a pair at least the other is overweight. Twins are recruited from three population-based longitudinal Finnish twin studies, including twins born in 1983–1987, 1975–1979, and 1945–1958. The participants undergo 6-month-long exercise intervention period, exercising four times a week (including endurance, strength, and high-intensity training). Before and after the exercise intervention, comprehensive measurements are performed in Turku PET Centre, Turku, Finland. The measurements include: two positron emission tomography studies (insulin-stimulated whole-body and tissue-specific glucose uptake and neuroinflammation), magnetic resonance imaging (brain morphology and function, quantification of body fat masses and organ volumes), magnetic resonance spectroscopy (quantification of fat within heart, pancreas, liver and tibialis anterior muscle), echocardiography, skeletal muscle and adipose tissue biopsies, a neuropsychological test battery as well as biosamples from blood, urine and stool. The participants also perform a maximal exercise capacity test and tests of muscular strength.

Discussion

This study addresses the major public health problems related to modern lifestyle, obesity, and physical inactivity. An eminent strength of this project is the possibility to study monozygotic twin pairs that share the genome at the sequence level but are discordant for BMI that is a risk factor for metabolic impairments such as insulin resistance. Thus, this exercise training intervention elucidates the effects of obesity on metabolism and whether regular exercise training is able to reverse obesity-related impairments in metabolism in the absence of the confounding effects of genetic factors.

Trial registration

ClinicalTrials.gov,NCT03730610. Prospectively registered 5 November 2018.
An overview of touchless 2D fingerprint recognition
Authors: Priesnitz Jannis , Rathgeb Christian , Buchmann Nicolas , Busch Christoph , Margraf Marian
Published: February 2021

Touchless fingerprint recognition represents a rapidly growing field of research which has been studied for more than a decade. Through a touchless acquisition process, many issues of touch-based systems are circumvented, e.g., the presence of latent fingerprints or distortions caused by pressing fingers on a sensor surface. However, touchless fingerprint recognition systems reveal new challenges. In particular, a reliable detection and focusing of a presented finger as well as an appropriate preprocessing of the acquired finger image represent the most crucial tasks. Also, further issues, e.g., interoperability between touchless and touch-based fingerprints or presentation attack detection, are currently investigated by different research groups. Many works have been proposed so far to put touchless fingerprint recognition into practice. Published approaches range from self identification scenarios with commodity devices, e.g., smartphones, to high performance on-the-move deployments paving the way for new fingerprint recognition application scenarios.This work summarizes the state-of-the-art in the field of touchless 2D fingerprint recognition at each stage of the recognition process. Additionally, technical considerations and trade-offs of the presented methods are discussed along with open issues and challenges. An overview of available research resources completes the work.
Core components of infection prevention and control programs at the facility level in Georgia: key challenges and opportunities
Authors: Deryabina Anna , Lyman Meghan , Yee Daiva , Gelieshvilli Marika , Sanodze Lia , Madzgarashvili Lali , Weiss Jamine , Kilpatrick Claire , Rabkin Miriam , Skaggs Beth , Kolwaite Amy
Published: February 2021

Background

The Georgia Ministry of Labor, Health, and Social Affairs is working to strengthen its Infection Prevention and Control (IPC) Program, but until recently has lacked an assessment of performance gaps and implementation challenges faced by hospital staff.

Methods

In 2018, health care hospitals were assessed using a World Health Organization (WHO) adapted tool aimed at implementing the WHO’s IPC Core Components. The study included site assessments at 41 of Georgia’s 273 hospitals, followed by structured interviews with 109 hospital staff, validation observations of IPC practices, and follow up document reviews.

Results

IPC programs for all hospitals were not comprehensive, with many lacking defined objectives, workplans, targets, and budget. All hospitals had at least one dedicated IPC staff member, 66% of hospitals had IPC staff with some formal IPC training; 78% of hospitals had IPC guidelines; and 55% had facility-specific standard operating procedures. None of the hospitals conducted structured monitoring of IPC compliance and only 44% of hospitals used IPC monitoring results to make unit/facility-specific IPC improvement plans. 54% of hospitals had clearly defined priority healthcare-associated infections (HAIs), standard case definitions and data collection methods in their HAI surveillance systems. 85% hospitals had access to a microbiology laboratory. All reported having posters or other tools to promote hand hygiene, 29% had them for injection safety. 68% of hospitals had functioning hand-hygiene stations available at all points of care. 88% had single patient isolation rooms; 15% also had rooms for cohorting patients. 71% reported having appropriate waste management system.

Conclusions

Among the recommended WHO IPC core components, existing programs, infrastructure, IPC staffing, workload and supplies present within Georgian healthcare hospitals should allow for implementation of effective IPC. Development and dissemination of IPC Guidelines, implementation of an effective IPC training system and systematic monitoring of IPC practices will be an important first step towards implementing targeted IPC improvement plans in hospitals.
An empirical Bayesian approach to incorporate directional movement information from a forage fish into the Arnason-Schwarz mark-recapture model
Authors: Bishop Mary A. , Bernard Jordan W.
Published: February 2021

Background

Over the past two decades, various species of forage fish have been successfully implanted with miniaturized acoustic transmitters and subsequently monitored using stationary acoustic receivers. When acoustic receivers are configured in an array, information related to fish direction can potentially be determined, depending upon the number and relative orientation of the acoustic receivers. However, it can be difficult to incorporate directional information into frequentist mark-recapture methods. Here we show how an empirical Bayesian approach can be used to develop a model that incorporates directional movement information into the Arnason-Schwarz modeling framework to describe survival and migration patterns of a Pacific herring (Clupea pallasii) population in coastal Alaska, USA.

Methods

We acoustic-tagged 326 adult Pacific herring during April 2017 and 2018 while on their spawning grounds in Prince William Sound Alaska, USA. To monitor their movements, stationary acoustic receivers were deployed at strategic locations throughout the Sound. Receivers located at the major entrances to the Gulf of Alaska were arranged in parallel arrays to determine the directional movements of the fish. Informative priors were used to incorporate the directional information recorded at the entrance arrays into the model.

Results

A seasonal migratory pattern was found at one of Prince William Sound’s major entrances to the Gulf of Alaska. At this entrance, fish tended to enter the Gulf of Alaska during spring and summer after spawning and return to Prince William Sound during the fall and winter. Fish mortality was higher during spring and summer than fall and winter in both Prince William Sound and the Gulf of Alaska.

Conclusions

An empirical Bayesian modeling approach can be used to extend the Arnason-Schwarz modeling framework to incorporate directional information from acoustic arrays to estimate survival and characterize the timing and direction of migratory movements of forage fish.
Using process data to understand problem-solving strategies and processes for drag-and-drop items in a large-scale mathematics assessment
Authors: Jiang Yang , Gong Tao , Saldivia Luis E. , Cayton-Hodges Gabrielle , Agard Christopher
Published: February 2021

In 2017, the mathematics assessments that are part of the National Assessment of Educational Progress (NAEP) program underwent a transformation shifting the administration from paper-and-pencil formats to digitally-based assessments (DBA). This shift introduced new interactive item types that bring rich process data and tremendous opportunities to study the cognitive and behavioral processes that underlie test-takers’ performances in ways that are not otherwise possible with the response data alone. In this exploratory study, we investigated the problem-solving processes and strategies applied by the nation’s fourth and eighth graders by analyzing the process data collected during their interactions with two technology-enhanced drag-and-drop items (one item for each grade) included in the first digital operational administration of the NAEP’s mathematics assessments. Results from this research revealed how test-takers who achieved different levels of accuracy on the items engaged in various cognitive and metacognitive processes (e.g., in terms of their time allocation, answer change behaviors, and problem-solving strategies), providing insights into the common mathematical misconceptions that fourth- and eighth-grade students held and the steps where they may have struggled during their solution process. Implications of the findings for educational assessment design and limitations of this research are also discussed.
Mass fractionation of Rb and Sr isotopes during laser ablation-multicollector-ICPMS: in situ observation and correction
Authors: Yim Sung-Gyun , Jung Min-Ji , Jeong Youn-Joong , Kim Yeongmin , Cheong Albert Chang-sik
Published: February 2021

Background

One of the most critical issues concerning in situ mass spectrometry lies in accounting for elements and molecules that overlap target isotopes of analytical interest in a sample. This study traced the instrumental mass fractionation of Rb and Sr isotopes during laser ablation-multicollector-inductively coupled plasma mass spectrometry (LA-MC-ICPMS) to obtain reliable 87Sr/86Sr ratios for high-Rb/Sr samples.

Findings

In the LA-MC-ICPMS analysis, Kr interferences were corrected using Ar and He gas blanks measured without ablating material. Contributions from doubly charged Er and Yb ions were corrected using the intensities of half masses and isotopic compositions reported in the literature. After Kr correction, the calculated 166Er2+ intensity of NIST SRM 610 approached the measured intensity at mass 83, and the 173Yb2+/171Yb2+ ratio agreed with the recommended value within error ranges. Kr- and REE2+-stripped peak intensities were further corrected for Rb interference. Use of the Sr mass bias factor for the calculation of measured 87Rb/85Rb yielded 87Sr/86Sr ratios consistent with the recommended and expected values for low-Rb/Sr materials, such as NIST SRM 616, modern shark teeth, and plagioclase collected from Jeju Island, but failed to account for the 87Rb interference from high-Rb/Sr materials including NIST SRM 610 and SRM 612. We calculated in situ mass bias factor of Rb from the known 87Sr/86Sr ratios of the standards and observed a correlation between Rb and Sr mass fractionation, which allowed inference of the Rb bias from the standard run. Reliable 87Sr/86Sr and 85Rb/86Sr ratios were obtained for SRM 610 and SRM 612 using the inferred mass bias factor of Rb calculated by the standard bracketing method.

Conclusions

This study revealed that Rb and Sr isotopes behave differently during LA-MC-ICPMS and suggests the potential usefulness of the standard bracketing method for measuring the Rb–Sr isotopic compositions of high-Rb/Sr materials.
Analyzing a faculty online learning community as a mechanism for supporting faculty implementation of a guided-inquiry curriculum
Authors: Price Edward , Lau Alexandra C. , Goldberg Fred , Turpen Chandra , Smith P. Sean , Dancy Melissa , Robinson Steve
Published: February 2021

Background

Adoption and use of effective, research-based instructional strategies (RBISs) for STEM education is less widespread than hoped. To promote further use of RBISs, the propagation paradigm suggests that developers work with potential adopters during the development process, and provide ongoing support after adoption. This article investigates the impact of a faculty online learning community (FOLC) as a professional development mechanism for supporting faculty adopting a research-based curriculum. A FOLC uses video conference technology and online platforms to connect geographically dispersed faculty with similar backgrounds (e.g., physics faculty) and supports their teaching development. In the context of a specific FOLC, this article seeks to determine the outcomes the FOLC achieves, and how.

Results

Analysis of a FOLC meeting identified opportunities for rich, complex social interaction centered on the research-based curriculum. By functioning as a sounding board for ideas, a space to share experiences, a source of affective support, and a venue for troubleshooting, the FOLC mediates the achievement of a range of outcomes related to implementation of the curriculum. Survey results indicate that members feel a sense of community in the FOLC and that it provides encouragement through teaching challenges. Further results indicate participants’ increased confidence in using the curriculum; familiarity with the curriculum structure and content; increased knowledge of pedagogical techniques; reflection on teaching practices in the curriculum; and use of pedagogical techniques aligned with the curriculum’s core principles. Emerging evidence supports more distal outcomes, including student learning, persistence in using the curriculum, reflection in teaching practice across courses taught, and use of research-based pedagogy in other courses.

Conclusions

The propagation paradigm emphasizes the need for ongoing support for adopters of RBISs. The FOLC model provides participating faculty with ongoing support through participation in a community and is an effective support mechanism for adopters of a research-based curriculum. In this study, FOLC members are increasing their knowledge and use of pedagogical techniques in the curriculum-specific course and beyond. This is facilitated by the opportunities in the FOLC for troubleshooting, idea sharing, and receiving encouragement through challenges. This model has the potential to support adopters of additional educational innovations.
Correction to: Prerequisites for artificial intelligence in further education: identification of drivers, barriers, and business models of educational technology companies
Authors: Renz André , Hilbig Romy
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
Evaluation of working memory in relation to cochlear implant consonant speech discrimination
Authors: El Ghazaly Mai M. , Mourad Mona I. , Hamouda Nesrine H. , Talaat Mohamed A.
Published: February 2021

Background

Speech perception in cochlear implants (CI) is affected by frequency resolution, exposure time, and working memory. Frequency discrimination is especially difficult in CI. Working memory is important for speech and language development and is expected to contribute to the vast variability in CI speech reception and expression outcome. The aim of this study is to evaluate CI patients’ consonants discrimination that varies in voicing, manner, and place of articulation imparting differences in pitch, time, and intensity, and also to evaluate working memory status and its possible effect on consonant discrimination.

Results

Fifty-five CI patients were included in this study. Their aided thresholds were less than 40 dBHL. Consonant speech discrimination was assessed using Arabic consonant discrimination words. Working memory was assessed using Test of Memory and Learning-2 (TOMAL-2). Subjects were divided according to the onset of hearing loss into prelingual children and postlingual adults and teenagers. Consonant classes studied were fricatives, stops, nasals, and laterals. Performance on the high frequency CVC words was 64.23% ± 17.41 for prelinguals and 61.70% ± 14.47 for postlinguals. These scores were significantly lower than scores on phonetically balanced word list (PBWL) of 79.94% ± 12.69 for prelinguals and 80.80% ± 11.36 for postlinguals. The lowest scores were for the fricatives. Working memory scores were strongly and positively correlated with speech discrimination scores.

Conclusions

Consonant discrimination using high frequency weighted words can provide a realistic tool for assessment of CI speech perception. Working memory skills showed a strong positive relationship with speech discrimination abilities in CI.
Psychological distress in the Greek general population during the first COVID-19 lockdown
Authors: Karaivazoglou Katerina , Konstantopoulou Georgia , Kalogeropoulou Maria , Iliou Theodoros , Vorvolakos Theofanis , Assimakopoulos Konstantinos , Gourzis Philippos , Alexopoulos Panagiotis
Published: February 2021

Background

SARS-CoV-2 has rapidly spread worldwide, threatening public health and financial and social life.

Aims

The current study's aim was to determine the prevalence of psychological distress and post-traumatic stress symptoms in the Greek population during the first COVID-19 lockdown, and to detect potential correlates.

Method

An anonymous online survey was conducted between 10 April and 4 May 2020, to collect information regarding people's psychological functioning and COVID-19-related perceptions.

Results

A total of 1443 individuals completed the survey; 293 (20%) reported clinically significant anxiety symptoms, 188 (12.9%) reported clinically significant depressive symptoms and 506 (36.4%) suffered from definite post-traumatic stress disorder. Anxiety symptoms were independently associated with female gender (β = 1.281, 95% CI 0.808–1.755, P < 0.001), educational level (β = −1.570, 95% CI −2.546 to −0.595, P = 0.002), perceived severity (β = −1.745, 95% CI −3.146 to −0.344, P = 0.015) and COVID-19-related worry (β = 7.633, 95% CI 6.206–9.060, P < 0.001). Depressive symptoms were strongly correlated with educational level (β = −1.298, 95% CI −2.220 to −0.377, P = 0.006), perceived severity (β = −1.331, 95% CI −2.579 to −0.082, P = 0.037) and COVID-19-related worry (β = 4.102, 95% CI 2.769–5.436, P < 0.001). Finally, post-traumatic stress symptoms were linked to female gender (β = 6.451, 95% CI 4.602–8.299, P < 0.001), educational level (β = −5.737, 95% CI −9.479 to −1.996, P = 0.003), psychiatric history (β = −4.028, 95% CI −6.274 to −1.782, P < 0.001) and COVID-19-related worry (β = 23.865, 95% CI 18.201–29.530, P < 0.001).

Conclusions

A significant percentage of the population reported clinically important anxiety, depressive and post-traumatic stress symptoms. Women, less-educated individuals and people with a psychiatric history appeared more vulnerable to the pandemic's psychological impact.