bluuebunny/crossref_metadata_2025 huggingface dataset:
SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients
Authors: Conway D.I. , Culshaw S. , Edwards M. , Clark C. , Watling C. , Robertson C. , Braid R. , O’Keefe E. , McGoldrick N. , Burns J. , Provan S. , VanSteenhouse H. , Hay J. , Gunson R. ,   Dental COVID-19 Surveillance Survey Group
Published: March 2021

Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium–containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%–0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.
Irrigation Advisory Services: Farmers preferences and willingness to pay for innovation
Authors: Altobelli Filiberto , Marta Anna Dalla , Heinen Marius , Jacobs Claire , Giampietri Elisa , Mancini Marco , Cimino Orlando , Trestini Samuele , Kranendonk Remco , Chanzy Andre , Debolini Marta , Courault Dominique , Kanecka-Geszke Ewa , Kasperska-Wolowicz Wiesława , Blanco-Velázquez Francisco José , Anaya-Romero María , De Witt Marlene , de Clercq Willem , Espejo Antonio Diaz , Hernandez-Santana Virginia , Caracciolo Francesco , Giudice Teresa Del
Published: March 2021

Irrigation Advisory Services (IAS) are powerful management instruments aiming to achieve the best efficiency in irrigation water use. So far the literature on farmers’ preferences for a specific scheme design of IAS’ characteristics and the related willingness to pay (WTP) is scant. This study provides evidence on farmers’ preference towards six attributes related to the IAS configuration by using a hypothetical choice experiment. Data were collected from an original survey among 108 farmers from Spain, The Netherlands, Italy, Poland and South Africa. Moreover, we investigated the interplay between these preferences and the individual risk attitude (elicited through a lottery task) as a novel contribution. On average, the results suggest a clear farmers’ preference, especially for receiving weather forecasts from the service and for the feature related to water data recording; as the opposite, on average, crop water requirement seems irrelevant. Finally, we found that farmers’ WTP for the different IAS services varies across countries and, in some cases, also according to the individual risk attitude.
The selection of outgas temperature for shale in low-pressure N2 adsorption: An evidence from thermogravimetry
Authors: Gu Yuantao , Wan Quan , Li Xiaoxia
Published: March 2021

Low-pressure N2 adsorption (LPNA) could provide quantitative data for characterizing the pores in gas shale. However, the inconsistencies of outgas temperature have caused significant deviations in LPNA experiments. To explore the effects of outgas temperature on pore characteristics, two shale samples of Lower Cambrian Niutitang formation from Northern Guizhou, China, were collected for LPNA experiments and thermogravimetry-fourier transform infrared (TG-FTIR) spectroscopy. The samples were outgassed at six temperatures: 80°C, 100°C, 150°C, 200°C, 250°C, 300°C. Larger adsorbed volumes were presented in the isotherms at higher outgas temperatures. Similar regularity is obtained from the relationship between specific surface area, micropore volume and outgas temperature. Comprehensive analysis of TG-FTIR and LPNA at different outgas temperature indicated that at lower outgas temperatures (from 80°C to 100°C), the free water was unlikely to be removed completely, and resulted in large amounts of micropores couldn’t be accessed. An excessive outgas temperature might expulse liquid hydrocarbons or decompose organic matter (from 200°C to 300°C), and could lead to the generation of micropores. When the sample were outgassed at 150°C, TG-FTIR analysis indicated that the sample composition unchanged and a better removal of free water happened. Therefore, 150°C should be a suitable outgas temperature for shale in LPNA experiments. The findings in this research not only provide reliable evidence for the selection of outgas procedure in LPNA for shale, but clarify the important effects of free water and volatile materials on pore accessibility in shale.
Mitral valve repair using the daVinci surgical system after MitraClip failure
Authors: Nakamae Kosuke , Oshitomi Takashi , Takaji Kentaro , Uesugi Hideyuki
Published: March 2021

Reports of mitral valve replacement after MitraClip removal have increased; however, surgical re-intervention is risky due to patients’ frailty and comorbidities. We report a case of mitral valve repair after MitraClip failure using the daVinci surgical system for a 55-year-old man with many comorbidities and two previous cardiac surgeries. The daVinci surgical system allows detailed handling with high-resolution visualization and endowrist instruments that provide surgeons with clear three-dimensional images and stabilized handling. This procedure enables us to remove the MitraClip precisely while preserving the mitral valve leaflet.
The Europeanness of the 2019 European Parliament elections and the mobilising power of European issues
Authors: Braun Daniela
Published: March 2021

Less researched than the second-order character of elections to the European Parliament (EP) is the ‘Europeanness’ of European elections and its implications for voter participation in these elections. This article aims to fill this gap by studying the Europeanness of the public debate in the run-up to the 2019 EP elections and the mobilising power of European issues in these electoral contests. In doing this, we draw on a new data set covering intriguing aspects of the 2019 EP elections. The findings of the empirical analysis of media and survey data indicate that the elections to the EP were more European contests than ever before in the history of these elections – yet this is not true in the same way for all of the countries under consideration. Moreover, the Europeanness of electorates, measured as genuine orientations towards EU politics, matters for electoral participation and thus has the power to mobilise citizens. Nonetheless, national factors still play an important role in these elections. These findings are insightful for the future assessment of EP elections and the scholarly debate over multi-level electoral politics in Europe.
Use of webinar tools for teaching and learning by library and information professionals in Nigeria
Authors: Idhalama Ogagaoghene Uzezi , Igbinovia Magnus Osahon , Ezeabasili Chioma Augusta
Published: March 2021

The study investigated the use of webinar tools for teaching and learning by library and information professionals in Nigeria. The research objectives were to determine the level of ICT skills for webinar utilisation possessed by library and information professionals in Nigeria; ascertain the devices used for participating in webinars by Nigerian library and information professionals; ascertain the webinar platforms used by library and information professionals, and two others. The study adopted the descriptive survey research design and structured questionnaire was adopted as instrument for data collection. The instrument was converted to an online survey using online Google forms which was posted on the Nigerian Library Association (NLA) platform soliciting responses from members of the platform. The survey response summary showed that 109 library and information professionals participated in the study. The data were retrieved and analysed using descriptive statistics of tables, frequency, percentages, mean and standard deviation. The findings revealed that the level of librarians’ ICT skills regarding webinar participation is high (3.40 grand mean), and the majority of LIS professionals studied in Nigeria used smart phone and laptop devices for webinar participation, followed by tablets. Most of the respondents use Zoom, followed by Youtube as platforms for participation in webinars and two other findings. It was concluded that webinars play a very significant role, therefore full adoption and use of webinars in all learning institutions in Nigeria should be encouraged.
The benefits and challenges of embedding specialist palliative care teams within homeless hostels to enhance support and learning: Perspectives from palliative care teams and hostel staff
Authors: Armstrong Megan , Shulman Caroline , Hudson Briony , Brophy Niamh , Daley Julian , Hewett Nigel , Stone Patrick
Published: March 2021

Background:

People residing in UK homeless hostels experience extremely high rates of multi-morbidity, frailty and age-related conditions at a young age. However, they seldom receive palliative care with the burden of support falling to hostel staff.

Aim:

To evaluate a model embedding palliative specialists, trained as ‘homelessness champions’, into hostels for two half-days a month to provide support to staff and residents and facilitate a multidisciplinary approach to care.

Design:

An exploratory qualitative design.

Setting/participants:

Four homeless hostels in London, UK, including nine hostel managers/support staff and seven palliative care specialists (five nurses and two social workers).

Results:

Benefits to introducing the model included: developing partnership working between hostel staff and palliative care specialists, developing a holistic palliative ethos within the hostels and improving how hostel staff seek support and connect with local external services. Challenges to implementation included limited time and resources, and barriers related to primary care.

Conclusion:

This is the first evaluation of embedding palliative care specialists within homeless hostels. Inequity in health and social care access was highlighted with evidence of benefit of this additional support for both hostel staff and residents. Considering COVID-19, future research should explore remote ways of working including providing in-reach support to homelessness services from a range of services and organisations.
Risk factors for postoperative hypocalcaemia after thyroidectomy: A systematic review and meta-analysis
Authors: Chen Zhimei , Zhao Qiyuan , Du Jinlei , Wang Ya , Han Rongrong , Xu Caijuan , Chen Xiaofang , Shu Min
Published: March 2021

Objective

A meta-analysis to investigate the risk factors for postoperative hypocalcaemia after thyroidectomy in adult patients.

Methods

A systematic search of publications in the electronic databases (PubMed®, The Cochrane Library, Web of Science, OVID and Embase®) from inception to June 2020 was conducted. Screening of titles, abstracts and full texts and data extraction were independently performed by two authors. The OR was selected as the pooled estimate.

Results

The analysis included 23 studies. Twelve significant risk factors for postoperative hypocalcaemia were identified: hypoparathyroidism, OR 5.58; total thyroidectomy, OR 3.59; hypomagnesaemia, OR 2.85; preoperative vitamin D deficiency, OR 2.32; female sex, OR 1.49; thyroid malignancy, OR 1.85; thyroiditis, OR 1.48; substernal multinodular goitres, OR 1.70; parathyroidectomy, OR 1.58; central compartment neck dissection, OR 1.17; modified radical neck dissection, OR 1.57; and central neck dissection, OR 1.54.

Conclusions

This meta-analysis provides moderate-to-high quality evidence that the 12 risk factors were predictive of postoperative hypocalcaemia, which should be monitored closely before thyroidectomy.
Association of dyslipidaemia with osteoporosis in postmenopausal women
Authors: Zhang Lingnan , Liu Qilong , Zeng Xianshang , Gao Wenshan , Niu Yanan , Ma Xiaoyong , Xie Huijun , Zhou Xiaozhe , Yu Weiguang , Xu Guixing
Published: March 2021

Objective

To assess the association of dyslipidaemia with osteoporosis in postmenopausal women.

Methods

Data from 160 postmenopausal women with newly diagnosed osteoporosis (osteoporosis group) and 156 healthy controls (control group) were retrospectively reviewed from 2016 to 2020. The primary outcomes were laboratory values assessed by a multivariate binary logistic regression model.

Results

Factors that greatly increased the risk of being in the osteoporosis group included high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) levels. The osteoporosis group had lower HDL and higher LDL levels than the control group. A multivariate binary logistic regression model showed that lower HDL and higher LDL levels were the only variables that were significantly associated with osteoporosis (odds ratio 1.86, 95% confidence interval: 3.66–4.25 and odds ratio 1.47, 95% confidence interval: 1.25–2.74, respectively).

Conclusion

Low HDL and high LDL levels may be associated with the occurrence of osteoporosis in postmenopausal women.
Feline Spongy Encephalopathy With a Mutation in the ASPA Gene
Authors: Takaichi Yuta , Chambers James K. , Shiroma-Kohyama Moeko , Haritani Makoto , Une Yumi , Yamato Osamu , Nakayama Hiroyuki , Uchida Kazuyuki
Published: March 2021

Canavan disease is an autosomal recessive leukodystrophy caused by mutations in the gene encoding aspartoacylase (ASPA), which hydrolyses N-acetylaspartate (NAA) to acetate and aspartate. A similar feline neurodegenerative disease associated with a mutation in the ASPA gene is reported herein. Comprehensive clinical, genetic, and pathological analyses were performed on 4 affected cats. Gait disturbance and head tremors initially appeared at 1 to 19 months of age. These cats eventually exhibited dysstasia and seizures and died at 7 to 53 months of age. Magnetic resonance imaging of the brain revealed diffuse symmetrical intensity change of the cerebral cortex, brainstem, and cerebellum. Gas chromatography–mass spectrometry analysis of urine showed significant excretion of NAA. Genetic analysis of the 4 affected cats identified a missense mutation (c.859G>C) in exon 6 of the ASPA gene, which was not detected in 4 neurologically intact cats examined as controls. Postmortem analysis revealed vacuolar changes predominantly distributed in the gray matter of the cerebrum and brain stem as well as in the cerebellar Purkinje cell layer. Immunohistochemically, these vacuoles were surrounded by neurofilaments and sometimes contained MBP- and Olig2-positive cells. Ultrastructurally, a large number of intracytoplasmic vacuoles containing mitochondria and electron-dense granules were detected in the cerebral cortex. All 4 cats were diagnosed as spongy encephalopathy with a mutation in the ASPA gene, a syndrome analogous to human Canavan disease. The histopathological findings suggest that feline ASPA deficiency induces intracytoplasmic edema in neurons and oligodendrocytes, resulting in spongy degeneration of the central nervous system.
Development of Pedestrian Recall Versus Actuation Guidelines for Pedestrian Crossings at Signalized Intersections
Authors: Cesme Burak , Furth Peter G. , Casburn Ryan , Lee Kevin
Published: March 2021

At signalized intersections, pedestrian phases can be configured as recall or pushbutton actuated. While pedestrian recall results in a moderate reduction in pedestrian delay because, with recall, a pedestrian arriving during the time nominally reserved for the Walk interval will be served immediately rather than waiting to be served in the next cycle, it can also lead to longer cycle lengths, increasing delay for all users, including pedestrians. This research explores the impact of pedestrian recall along a coordinated-actuated arterial for pedestrians crossing the mainline (i.e., crossing the coordinated phase) to provide pedestrian recall versus actuation guidelines for agencies. The guidance was developed with the aim of balancing pedestrian delay with operational efficiency for vehicles. Two criteria were considered while developing the guidance: (1) pedestrian demand; and (2) vehicular green time duration for the concurrent vehicle phase that is parallel to the pedestrian crossing. VISSIM microsimulation software was used on a real network in Fairfax County, Virginia to model the effects of pedestrian recall and actuation. Results showed that pedestrian recall should be considered when pedestrian demand is large enough that there is a pedestrian call in most cycles (pedestrian probability in a given cycle is greater than 0.6 or pedestrian volume per cycle is greater than 0.9). The guidance also suggests setting pedestrian phases on recall when the length of the vehicular green for the concurrent phase is long enough in most cycles that a pedestrian phase would fit without constraining the signal cycle length.
Costs and benefits of recycling PVC contaminated with the legacy hazardous plasticizer DEHP
Authors: Brignon Jean-Marc
Published: March 2021

Reusing materials is an attractive option for circular economy and can also reduce emissions of greenhouse gases and pollutants. However, recycling raises questions regarding the potential risks to human health or the environment when hazardous legacy chemical additives of materials are also recycled, instead of the recent and less hazardous additives of virgin materials. To address this trade-off, this study developed a model to calculate the total external cost of material supply, considering the health and environmental impacts of all industrial steps (e.g. virgin material production, incineration, and recycling), and the health effects of recycling chemicals present in the material. The model is coupling material flow analysis, life-cycle analysis, and environmental economics to compare different recycling policies. It is applied for all illustrative purposes to soft PVC and DEHP in France. Results show that recycling of materials is in the long-term positive despite the prolongation of the presence of hazardous additives in materials. The time when the recurring environmental benefits of recycling offset the negative impacts on human health of recycling the additives is very sensitive to the health impact of additives. This approach can improve the harmonization between recycling and circular economy policies, and as a framework to confirm the relevance and size treatments to remove additives from materials during recycling.
The peritoneal dialysis orders objective structured clinical examination (OSCE): A formative assessment for nephrology fellows
Authors: Prince Lisa K , Y’Barbo Brian C , Nee Robert , Yuan Christina M ,   for the Nephrology Education Research and Development Consortium (NERDC)
Published: March 2021

Background:

Peritoneal dialysis (PD) management is a fundamental nephrology skill, especially with the recent emphasis on home dialysis. We report a prospective multicentre cohort study of a formative objective structured clinical examination (OSCE) assessing competence in managing PD-associated bacterial peritonitis, using the unified model of construct validity.

Methods:

The OSCE was developed by the principal investigators and reviewed by two subject matter experts. The test committee (eight nephrologists and one PD nurse) assessed test item difficulty/relevance and determined passing score. There were 22 test items (7 evidence-based/standard-of-care questions). Passing score was 16/22 (73%). No item had median relevance less than ‘important’, and all were easy to medium difficulty. Content validity index was 0.91. Preliminary validation (16 board-certified volunteers): mean score was 19 ± 2, with 94% (15/16) passing. Kappa = 0.85 [95% confidence interval (CI) 0.77–0.94]. Cronbach’s α = 0.70.

Results:

Eighty-seven fellows (16 programmes) were tested; 67% passed. Fellows scored significantly less than validators: 17 ± 3 versus 19 ± 2, p < 0.001 [95% CI 1.2–3.6]. Eighty-six per cent of evidence-based/standard-of-care questions were answered correctly by validators versus 54% by fellows; p < 0.001. Ninety-three per cent of fellows recognized that sufficient criteria were present to diagnose peritonitis, but only 17% correctly indicated all three. Seventy-seven per cent recognized peritonitis-associated ultrafiltration failure, but only 17% prescribed 21 days of antibiotic treatment for gram-negative peritonitis. Eighty-five per cent of fellows surveyed agreed/strongly agreed that the OSCE was useful in self-assessing proficiency. Second-year in-training examination and OSCE scores were positively correlated (Pearson’s r = 0.57, p < 0.00).

Conclusions:

The OSCE may be used to formatively assess fellow proficiency in managing PD-associated peritonitis.
Signs as borders and borders as signs
Authors: Tateo Luca , Marsico Giuseppina
Published: March 2021

This article focuses on bordering as a fundamental semiotic process of human psychological functioning. First, we discuss similarities between semiosis and bordering and explore their relationships. In the perspective of cultural psychology of semiotic dynamics, psychic life is a process of purposeful production and interpretation of signs, carried out through cycles of culturally guided, selective internalization and externalization. Signs and borders are not only entities “out there”: they emerge in the purposeful movement of the organism in the course of future-oriented action in everyday life. Second, we discuss borders in mind and society as particular types of signs, through which humans regulate their own and others’ conduct. Finally, we propose a general genetic law of bordering development: borders are first conceived as tools created and established by humans as interpsychic activities. Later, the sign is internalized and begins to regulate psychological functioning. It also becomes a psychological tool for dealing with other humans and with the environment.
Therapeutic effects of myocardin-related transcription factor A (MRTF-A) knockout on experimental mice with nonalcoholic steatohepatitis induced by high-fat diet
Authors: Zhang Lei , Li Hua-Long , Zhang Ding-Ding , Cui Xiao-Chun
Published: March 2021

Objective:

To explore the effects of myocardin-related transcription factor A (MRTF-A) knockout on mice with nonalcoholic steatohepatitis (NASH) induced by high-fat diet (HFD).

Methods:

Normal-fat diet (NFD) or HFD was fed to MRTF-A-knockout (MRTF-A−/−) and wild-type (WT) mice for 16 weeks. Liver histopathological status was observed using Hematoxylin and Eosin (HE) staining, Oil Red O staining, Sirius Red staining, and Immunohistochemical staining. The mRNA and protein levels in liver tissues were measured through quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot.

Results:

Compared with WT + HFD group, mice in MRTF-A−/− + HFD group were decreased in body weight, blood glucose, plasma insulin, liver TG and NAFLD activity score (NAS), with liver function recovery. Besides, compared with HFD-fed WT mice, HFD-fed MRTF-A−/− mice were improved in hepatic fibrosis, accompanied by decreased collagen content (%) and down-regulated expressions of α-SMA, COL1A2, TGFβ1, and SMAD3. In mice fed with HFD, the expression of MCP-1, CCR2, F4/80 and CD68 declined in liver tissues of MRTF-A−/− mice as compared with WT mice. Besides, in hepatic macrophages isolated from HFD-fed mice, the observed increased expression of TNF-α, IL-1β, MCP-1, as well as decreased expression of CCR2. Compared with WT + HFD group, MRTF-A−/− + HFD group mice were decreased regarding NF-κB p65 in liver tissues.

Conclusion:

MRTF-A knockout reduced macrophage infiltration, down-regulated NF-κB p65 expression, and ameliorated inflammation and fibrosis of liver tissues in mice, thereby becoming a potential therapeutic target for NASH treatment.
Bone marrow mesenchymal stem cells-derived exosomes reduce apoptosis and inflammatory response during spinal cord injury by inhibiting the TLR4/MyD88/NF-κB signaling pathway
Authors: Fan Liying , Dong Jun , He Xijing , Zhang Chun , Zhang Ting
Published: March 2021

Spinal cord injury (SCI) is one of the most common destructive injuries, which may lead to permanent neurological dysfunction. Currently, transplantation of bone marrow mesenchymal stem cells (BMSCs) in experimental models of SCI shows promise as effective therapies. BMSCs secrete various factors that can regulate the microenvironment, which is called paracrine effect. Among these paracrine substances, exosomes are considered to be the most valuable therapeutic factors. Our study found that BMSCs-derived exosomes therapy attenuated cell apoptosis and inflammation response in the injured spinal cord tissues. In in vitro studies, BMSCs-derived exosomes significantly inhibited lipopolysaccharide (LPS)-induced PC12 cell apoptosis, reduced the secretion of pro-inflammatory factors including tumor necrosis factor (TNF)-α and IL (interleukin)-1β and promoted the secretion of anti-inflammatory factors including IL-10 and IL-4. Moreover, we found that LPS-induced protein expression of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear transcription factor-κB (NF-κB) was significantly downregulated after treatment with BMSCs-derived exosomes. In in vivo studies, we found that hindlimb motor function was significantly improved in SCI rats with systemic administration of BMSCs-derived exosomes. We also observed that the expression of pro-apoptotic proteins and pro-inflammatory factors was significantly decreased, while the expression of anti-apoptotic proteins and anti-inflammatory factors were upregulated in SCI rats after exosome treatment. In conclusion, BMSCs-derived exosomes can inhibit apoptosis and inflammation response induced by injury and promote motor function recovery by inhibiting the TLR4/MyD88/NF-κB signaling pathway, which suggests that BMSCs-derived exosomes are expected to become a new therapeutic strategy for SCI.
Fatigue in patients with systemic lupus erythematosus and neuropsychiatric symptoms is associated with anxiety and depression rather than inflammatory disease activity
Authors: Monahan Rory C , Beaart-van de Voorde Liesbeth JJ , Eikenboom Jeroen , Fronczek Rolf , Kloppenburg Margreet , Middelkoop Huub AM , Terwindt Gisela M , van der Wee Nic JA , Huizinga Tom WJ , Steup-Beekman Gerda M
Published: March 2021

Introduction

We aimed to investigate risk factors for fatigue in patients with systemic lupus erythematosus (SLE) and neuropsychiatric symptoms in order to identify potential interventional strategies.

Methods

Patients visiting the neuropsychiatric SLE (NPSLE) clinic of the Leiden University Medical Center between 2007–2019 were included. In a multidisciplinary consensus meeting, SLE patients were classified as having neuropsychiatric symptoms of inflammatory origin (inflammatory phenotype) or other origin (non-inflammatory phenotype). Fatigue was assessed with the SF-36 vitality domain (VT) since 2007 and the multidimensional fatigue inventory (MFI) and visual analogue scale (VAS) since 2011. Patients with a score on the SF-36 VT ≥1 standard deviation (SD) away from the mean of age-related controls of the general population were classified as fatigued; patients ≥2 SD away were classified as extremely fatigued. Disease activity was measured using the SLE disease activity index-2000. The influence of the presence of an inflammatory phenotype, disease activity and symptoms of depression and anxiety as measured by the hospital anxiety and depression scale (HADS) was analyzed using multiple regression analyses corrected for age, sex and education.

Results

348 out of 371 eligible patients filled in questionnaires and were included in this study . The majority was female (87%) and the mean age was 43 ± 14 years. 72 patients (21%) had neuropsychiatric symptoms of an inflammatory origin. Fatigue was present in 78% of all patients and extreme fatigue was present in 50% of patients with an inflammatory phenotype vs 46% in the non-inflammatory phenotype. Fatigue was similar in patients with an inflammatory phenotype compared to patients with a non-inflammatory phenotype on the SF-36 VT (β: 0.8 (95% CI −4.8; 6.1) and there was less fatigue in patients with an inflammatory phenotype on the MFI and VAS (β: −3.7 (95% CI: −6.9; −0.5) and β: −1.0 (95% CI −1.6; −0.3)). There was no association between disease activity and fatigue, but symptoms of anxiety and depression (HADS) associated strongly with all fatigue measurements.

Conclusion

This study suggests that intervention strategies to target fatigue in (NP)SLE patients may need to focus on symptoms of anxiety and depression rather than immunosuppressive treatment.
Systematic review of digital and non-digital non-pharmacological interventions that target quality of life and psychological outcomes in adults with systemic lupus erythematosus
Authors: Chang Angela , Winquist Nathan W , Wescott Annie B , Lattie Emily G , Graham Andrea K
Published: March 2021

Background

Patients with systemic lupus erythematous (SLE) experience psychological comorbidities and impaired quality of life (QOL). We conducted a systematic review to examine the efficacy of non-pharmacological interventions for improving psychological outcomes and/or QOL in patients with SLE. To expand on a previous systematic review in this area and enhance our understanding of efficacious interventions for this population, our search included quasi-experimental and experimental studies of interventions delivered or supported by remote methods (including digitally) or in person.

Methods

A comprehensive literature search was conducted with a research librarian using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered before data extraction on the international prospective register of systematic reviews PROSPERO Web site (CRD42020154962). The search included controlled-vocabulary and title/abstract terms related to non-pharmacological interventions for SLE published through October 2019 in MEDLINE (Ovid), Cochrane Library databases (Wiley), Embase (Elsevier), CINAHL (EBSCO), PsycINFO (EBSCO), Web of Science (Clarivate), ACM Digital (Association of Computer Machinery), and IEEE Xplore. Studies were synthesized using a systematic narrative synthesis framework. Risk of bias was assessed.

Results

Twenty-three studies were included: 21 randomized controlled trials and two quasi-experimental studies. Non-pharmacological diet, physical activity, psychological, and course-based interventions improved QOL and psychological outcomes, and were delivered in traditional settings (e.g., hospital) or remotely. No studies assessing digital non-pharmacological interventions were identified in our search. Quality assessments showed serious risk of bias for the two quasi-experimental studies, and high risk of bias in a subset of experimental studies.

Conclusions

Non-pharmacological interventions benefit patients with SLE. Future research should include more representative samples in rigorous evaluations and consider ways to incorporate digital technologies to increase accessibility.
Non-monotone transformation of biomarkers
Authors: Adimari Gianfranco , To Duc-Khanh , Chiogna Monica
Published: March 2021

We comment here on a recent paper in this journal, on a non-monotone transformation of biomarkers aimed at improving diagnostic accuracy. We highlight that, in a binary classification problem, the proposed transformation finds its motivation in the Neyman–Pearson lemma, so that the underlying approach is very general and it is applicable to many parametric families, other than the normal one.
DC electrical conductivity retention and acetone/acetaldehyde sensing on polythiophene/molybdenum disulphide composites
Authors: Husain Ahmad , Ahmad Sharique , Ansari Shahid Pervez , Ansari Mohammad Omaish , khan Mohammad Mujahid Ali
Published: March 2021

In this study, polythiophene (PTh) and a series of polythiophene/molybdenum disulphide (PTh/MoS2) composites were prepared by in-situ chemical oxidative polymerization method using anhydrous ferric chloride (FeCl3) as an oxidant and chloroform (CHCl3) as a solvent. The successful formation of PTh and PTh/MoS2 composites were confirmed by various techniques such as Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM) and transmittance electron microscopy (TEM). DC electrical conductivity and acetone/acetaldehyde sensing studies were carried out by a four-in-line probe device. PTh/MoS2 composites exhibited significantly improved DC electrical conductivity and acetone/acetaldehyde sensing properties as compared to PTh. The electrical properties were investigated in terms of initial conductivity (i.e. conductivity at room temperature) as well as retention of conductivity, i.e. stability under isothermal and cyclic ageing conditions. The maximum initial conductivity, along with the highest conductivity retention, was observed for PTh/MoS2-2 (PTh/MoS2 composite comprising 10% MoS2 with respect to the weight of thiophene monomer). The initial DC electrical conductivity of PTh, PTh/MoS2-1, PTh/MoS2-2 and PTh/MoS2-3 was found to be 5.72 × 10−5 Scm−1, 4.03 × 10−4 Scm−1, 1.09 × 10−3 Scm−1 and 8.96 × 10−4 Scm−1, respectively. The sensing performance at room temperature has been studied in terms of % sensing response, response/recovery time. All the PTh/MoS2 composites based sensors performed much better than PTh. The % sensing response of PTh, PTh/MoS2-1, PTh/MoS2-2 and PTh/MoS2-3 based pellet-shaped sensors towards acetone/acetaldehyde were affirmed as 30.6/22.9, 69.9/47.3, 93.7/70.3, 78.1/65.1, respectively. The purposed sensing mechanism involved the adsorption of acetone/acetaldehyde vapours on the surface of the sensors where electronic interaction between lone pair of electrons on oxygen atoms of the carbonyl group and charge carriers of PTh was responsible for the change in conductivity.
Perceived Health Status and its Correlates among Middle-Aged Laotians
Authors: Kang Younhee , Yi Kyungock , Lee Gunjeong , Kim Yuri , Kang Minah , Kim Boeun , Hur Yujin , Choi Yookyung , Park Sumin
Published: March 2021

The purpose of this study is to identify the determinants of perceived health status among Laotian aged 40 to 59. A total of 922 men or women in their 40’s or 50’s living in Vientiane Capital and Province, Lao People’s Democratic Republic were included in the study. Hierarchical multiple regression was used to analyze the data. Perceived health status was negatively correlated with chance health locus of control and physical symptom frequency and positively correlated with doctors health locus of control. Age, drinking, difficulty in health utilization, physical activity, physical symptom frequency, and doctors health locus of control explained 23.5% of the variance in perceived health. To prevent the non-communicable disease, action should be taken not only at the individual level but also at the healthcare system level. In the health care fields, the targeted intervention based on the findings of this study should be devised.
Optimal parametric design of delayless subband active noise control system based on genetic algorithm optimization
Authors: Long Guo , Wang Yawen , Lim Teik C
Published: March 2021

Active noise control systems are generally application-specific, and an appropriate algorithm with an optimal configuration is desirable in the first stage of active noise control system design and deployment. This study presents a design of the subband active noise control system with optimal parameters for a practical broadband active noise control. Although the delayless subband active noise control has gained wide attention for broadband noise cancellation, an optimal design remains a challenge because of the complex interplay between multiple factors such as spectral leakage, delay and weight stacking distortion subject to a number of configurable parameters, and weight stacking method. The configurable parameters can hardly be optimized independently because the active noise control performance depends on the combined configuration. A simple near black box active noise control algorithm optimization model is thus established by incorporating the genetic algorithm optimization into the parametric design of the delayless subband algorithm. The automated process does not require an understanding of the performance characteristics for different parameters. The significance of applying the automated genetic algorithm optimization to the complex multiparameter nonlinear active noise control design is revealed by numerical simulations, particularly for the multichannel low-frequency broadband active noise control system configured with the delayless subband algorithms. This provides a way for the optimal parametric design of subband active noise control before being used in a practical complex scenario.
Microencapsulation of probiotics in finger millet milk complex to improve encapsulation efficiency and viability
Authors: Anitha D Priscilla Mercy , Sellamuthu Periyar Selvam
Published: March 2021

This study aimed to assess the effectiveness of finger millet milk complex (almond gum with maltodextrin) to encapsulate the isolated Lactobacillus strains. The wall materials were optimized based on its encapsulation efficiency, antioxidant activity, total phenol content and encapsulation yield. The strains were spray-dried at the optimized condition: 120 °C inlet temperature, maltodextrin 30% and almond gum 1.5%. Survival count of microencapsulated Lactobacillus plantarum RS09 and RS23 strains were 7.91 and 7.83 CFU/g respectively. Viability of microencapsulated strains and free cells under low pH, bile salt, simulated gastric juice and intestinal juice were assessed. Strain RS09 exhibited the highest viable count. Addition of almond gum and finger millet milk increased the phenolic content and offered a protective effect to the strains during spray drying. Results also showed that the powders were amorphous with partial irregularities and a smooth surface with less dents. Hence, they could be used as potential encapsulating agents during spray drying.
Exploring Secondary Teachers’ Actual and Perceived Praise and Reprimand Use
Authors: Floress Margaret T. , Beaudoin Melissa M. , Bernas Ronan S.
Published: March 2021

The present study aimed to identify a way for educators to improve the accuracy of their praise and reprimand reflections to ultimately improve their ability to set, monitor, and evaluate their use of praise and reprimand. To do this, teachers’ natural use of praise and reprimand (in the absence of intervention) were compared with their perceived use. A 20-min direct observation was collected from 66 middle and high school teachers to obtain praise and reprimand rates. Following the observation, teachers reported their perceived use of praise and reprimand. A t test and analysis of variance (ANOVA) were used to determine differences between praise and reprimand types. Correlations were used to determine the relation between perceived and actual praise and reprimand use. Statistical results indicated teachers used more general praise (GP) than behavior-specific praise and more mild reprimand than any other reprimand type. Teachers’ actual and perceived use of GP were positively correlated, as were teachers’ actual and perceived use of mild, gestural, and total reprimand. Furthermore, teachers with a greater difference between their actual and perceived praise also had a greater difference between their actual and perceived reprimand use. Future research and implications of these findings are discussed.
Evaluation of corneal endothelium using specular microscopy in patients with obstructive sleep apnea syndrome
Authors: Songur Murat Serkan , İntepe Yavuz Selim , Aslan Bayhan Seray , Bayhan Hasan Ali , Şahin Ender , Çiftçi Bülent
Published: March 2021

Purpose:

In the present study we evaluate the corneal endothelium using specular microscopy in patients with obstructive sleep apnea syndrome (OSAS).

Methods:

The study included a total of 100 patients including 35 patients with mild OSAS, 34 patients with moderate OSAS and 31 patients with severe OSAS, and the right eyes of 30 patients as a control group. Patients were examined to exclude the possibility of ocular diseases. Cellular density in the cornea epithelium (cell/mm2), corneal thickness (µ), percentage of hexagonal cells (%) and the coefficient of variation were evaluated using a specular microscope.

Results:

Corneal thickness was significantly decreased in all OSAS groups when compared to the control group ( p = 0.002), while no significant difference was identified among the OSAS groups. The corneal endothelial cell density, percentage of hexagonal cells and coefficient of variation were significantly different between the OSAS groups and the control group ( p < 0.001).

Conclusion:

More significant impairments were noted in the corneal endothelium of the patients in the OSAS group than in the control group, and specular microscopy is in valuable in the follow-up and treatment of such patients.
Efficacy and safety of blepharoptosis repair after incisional glaucoma surgery
Authors: Song Allisa J , Khanna Cheryl L , Jamali Sepideh , Roddy Gavin W , Wagner Lilly H
Published: March 2021

Purpose:

There is an increased risk for development of blepharoptosis after incisional glaucoma surgery. Data on safety and efficacy of ptosis repair in this group of patients in limited. The goal of this study is to evaluate outcomes and identify potential risk factors for failure of ptosis repair in eyes with history of incisional glaucoma surgery.

Methods:

A retrospective chart review was performed of all patients who underwent incisional glaucoma surgery, specifically trabeculectomy or implantation of glaucoma drainage device (GDD), and subsequent ptosis repair at a single institution from 2009 to 2019. Ptosis surgery outcomes were compared to a control group who underwent ptosis repair after cataract surgery.

Results:

Seventy-eight eyes of 64 patients were included in the glaucoma surgery group. The rate of severe ptosis (margin reflex distance 1 ⩽ 0 mm) among glaucoma surgery patients was higher compared to control (35 of 78 (44.9%) vs 23 of 82 (28.6%). Ptosis repair was successful in 59 of 78 eyes (75.6%), which was similar to control. Risk for revision surgery was increased more than five-fold in the GDD group compared to control. There were no cases of early or late bleb-related complications.

Conclusions:

Ptosis repair can be performed safely in patients after incisional glaucoma surgery. Müller muscle conjunctival resection and external levator advancement are equally effective. Patients with history of GDD should be advised about the potentially increased risk of need for revision surgery.
Alemtuzumab treatment in Denmark: A national study based on the Danish Multiple Sclerosis Registry
Authors: Theodorsdottir Asta , Debrabant Birgit , Magyari Melinda , Kant Matthias , Rasmussen Peter V , Malmberg Carl-Fredrik , Norberg Iver A , Hansen Victoria , Bech Danny , Schmidt Mathias F , Schreiber Karen , Frederiksen Jette L , Sellebjerg Finn , Illes Zsolt
Published: March 2021

Objective:

To investigate clinical outcomes in a real-world setting in the complete population-based cohort of alemtuzumab-treated MS patients in Denmark.

Methods:

Data were retrieved from The Danish Multiple Sclerosis Registry between 2009 and 2019. Demographic and disease-specific patient parameters related to treatment history, efficacy, and safety outcomes were assessed at baseline and during follow-up visits.

Results:

A total of 209 patients (78% female) started treatment with alemtuzumab during the study period with 3.1 ± 1.4 years follow-up. After 2 years, 75% of patients were relapse-free compared to 48% the year before alemtuzumab ( p < 0.001). The annual number of relapses was reduced by 69% in year 4 compared with the year prior alemtuzumab. More active disease before alemtuzumab increased the annual hazard rate for relapse (HR: 2.88, p < 0.001). The Expanded Disability Status Scale (EDSS) score remained stable or improved in 81% of patients after 2 years. The need for an additional treatment course was associated with higher number of relapses in the year before alemtuzumab (odds ratio (OR) = 1.95, p = 0.001).

Conclusion:

In a country with primarily escalation strategy, relapse rate reduction was maintained for 5 years, and EDSS stabilized/improved in majority of patients. Higher relapse rate 1 year before alemtuzumab increased the odds for additional courses. Novel serious AEs were not observed.
Characteristics analysis of the new flexible ring gear for helicopter reducer
Authors: Hu Shengyang , Fang Zongde , Xu Yingqiang , Guan Yabin , Shen Rui
Published: March 2021

As a key component of the vibration generation and transmission of planetary transmission system, the design of ring gear will directly affect the vibration of the system. After considering the advantages and disadvantages of the traditional ring gear structure, the new flexible ring gear was designed by scholars and applied to helicopter reducer. There is a dearth of reported analysis in the meshing characteristics of the new flexible ring gear, which leads to the blind selection of the ring gear. By building an accurate parametric finite element model, the meshing characteristics of the new flexible ring gear and the difference in dynamic characteristics between the new flexible ring gear and the traditional ring gear are obtained. The analysis shows that the new ring gear is superior to the traditional ring gear in many aspects, but it also has the characteristic of unbalance loading on the tooth surface. In addition, a test method is proposed to accurately measure the load sharing coefficient and dynamic load factor of planetary transmission and the simulation results of flexible ring gear are verified by comparison.
Studying how tourism is done: A practice approach to collaboration
Authors: Chimirri Daniela
Published: March 2021

This article seeks to contribute to empirically grounded theoretical conceptualizations of “collaboration,” by offering a practice-theoretical take on both tourism and one of its pillars: daily tourism actor collaboration. It argues that practice theory offers an important approach to investigating tourism in applied situations. This is empirically illustrated by drawing on data material generated via interviews and life map methodology during four fieldwork stays in West, South, and East Greenland. By focusing on “what happens on the ground,” this article unfolds the ontological complexity of collaborative practices as heterogeneous and constantly emerging, disappearing, and shifting, a complexity which challenges the notion of collaboration as strategical tool for tourism planning and development. As an alternative, the practice theory approach presented here offers a more viable, concretely situated alternative to investigating the phenomenon of tourism as collaborative action.