bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences of Quality Perinatal Care During the US COVID‐19 Pandemic
Authors: Basile Ibrahim Bridget , Kennedy Holly Powell , Combellick Joan
Published: August 2021

Introduction

Quality perinatal care is recognized as an important birth process and outcome. During the coronavirus disease 2019 (COVID‐19) pandemic, quality of perinatal care was compromised as the health care system grappled with adapting to an ever‐changing, uncertain, and unprecedented public health crisis.

Methods

The aim of this study was to explore the quality of perinatal care received during the COVID‐19 pandemic in the United States. Data were collected via an online questionnaire completed by people who gave birth in the United States after March 15, 2020. The questionnaire included the Mothers on Respect Index and the Mothers Autonomy in Decision Making validated measures. Low‐quality perinatal care was defined as decreased respect and/or autonomy in the perinatal care received. Responses were geocoded by zip code to determine COVID‐19 case‐load in the county on the date of birth. Multivariate regression analyses described associations between respect and autonomy in decision‐making for perinatal care and levels of COVID‐19 outbreak across the United States.

Results

Participants (N = 707) from 46 states and the District of Columbia completed the questionnaire. As COVID‐19 cases increased, participants’ experiences of autonomy in decision‐making for perinatal care decreased significantly (P = .04). Participants who identified as Black, Indigenous, and people of color, those who had an obstetrician provider, and those who gave birth in a hospital were more likely to experience low‐quality perinatal care. Those with a midwife provider or who had a home birth were more likely to experience high‐quality perinatal care in adjusted models.

Discussion

Variability in experiences of high‐quality perinatal care by sociodemographic characteristics, birth setting, and provider type may relate to implicit bias, structural racism, and inequities in maternal health and COVID‐19 outcomes for birthing people from marginalized communities.
Interventions to Increase Moderate‐to‐Vigorous Physical Activity in Elementary School Physical Education Lessons: Systematic Review
Authors: Wong Lan S. , Gibson Ann‐Marie , Farooq Abdulaziz , Reilly John J.
Published: August 2021

BACKGROUND

This systematic review aimed to synthesize recent evidence on interventions to increase moderate‐to‐vigorous physical activity (MVPA) content of physical education (PE) in children age 8 to 11.

METHODS

A search of 6 databases was conducted in December 2019. Controlled intervention studies were included so long as they used objective measures of MVPA. Methodological quality was assessed using the appropriate Joanna Briggs Institute (JBI) Checklist. Random effects meta‐analysis was used where appropriate.

RESULTS

Of the 5459 records, only 5 studies met all inclusion criteria, reporting on 1452 participants; 3 quasi‐experimental studies and 2 RCTs. All 5 eligible studies reported favorable intervention effects. Meta‐analysis was possible from 4/5 studies: the mean difference between intervention and control groups at follow‐up was +14.3% of lesson time in MVPA (confidence interval [CI] 2.7 to 25.8).

CONCLUSIONS

Efforts to increase the MVPA content of elementary school PE are achievable. Two studies employed PE specialist teachers and 1 study used an expert instructor as their intervention, 2 studies worked with the class teachers using self‐determination theory. All studies focused on health (MVPA) outcomes and included either “fitness infusions” or physically active games to engage students' in physical activities and increase their activity level.
Using cognitive interviewing to bridge the intent‐interpretation gap for nutrition coverage survey questions in India
Authors: Ashok Sattvika , Kim Sunny S. , Heidkamp Rebecca A. , Munos Melinda K. , Menon Purnima , Avula Rasmi
Published: August 2021

Designing survey questions that clearly and precisely communicate the question's intent and elicit responses based on the intended interpretation is critical but often undervalued. We used cognitive interviewing to qualitatively assess respondents' interpretation of and responses to questions pertaining to maternal and child nutrition intervention coverage. We conducted interviews to cognitively test 25 survey questions with mothers (N = 21) with children less than 1 year in Madhya Pradesh, India. Each question was followed by probes to capture information on four cognitive stages—comprehension, retrieval, judgement, and response. Data were analysed for common and unique patterns across the survey questions. We identified four types of cognitive challenges: (1) retention of multiple concepts in long questions: difficulty in comprehending and retaining questions with three or more key concepts; (2) temporal confusion: difficulty in conceptualizing recall periods such as “in the last 6 months” as compared to life stages such as pregnancy; (3) interpretation of concepts: mismatch of information being asked, meaning of certain terms and intervention scope; and (4) understanding of technical terms: difficulty in understanding commonly used technical words such as “breastfeeding” and “antenatal care” and requiring use of simple alternative language. Findings from this study will be useful for stakeholders involved in survey design and implementation, especially those conducting large‐scale household surveys to measure coverage of essential nutrition interventions.
Patient‐present teaching in the clinic: Effect on agency and professional behaviour
Authors: Cheema Bavenjit , Li Meredith , Ho Daniel , Amari Erica , Buckley Heather , Canfield Carolyn , Cuncic Cary , Nimmon Laura , Van Enk Anneke , Veerapen Kiran , Wisener Katherine M. , Holmes Cheryl Lynn
Published: August 2021

Background/Purpose

Although much has been written about the medical learning environment, the patient, who is the focus of care, is rarely the focus in this literature. The purpose of this study was to explore the role of the patient as an active participant with agency in the medical learning environment from the standpoint of the learner, the attending physician, and most importantly, the patient. We hoped to gain insights into the mechanisms that can reinforce professional values such as patient‐centred and respectful behaviours in a patient‐present learning environment.

Methods

We conducted this study in an ambulatory internal medicine clinic using ‘patient‐present’ clinic visits. All case presentations occurred in examination rooms with the patient. We invited participants (attending physicians, undergraduate and postgraduate learners, patients and family members) to participate in semistructured interviews after each clinic visit to explore the impact of the patient‐present learning environment. We recruited 34 participants in the study; 10 attending physicians, 12 learners, 10 patients and 2 family members. We analysed the data deductively using a conceptual framework of agency.

Summary/Results

We identified three major insights: (1) Patients felt engaged and valued opportunities to be heard; (2) Attending physicians and learners reported a more respectful learning environment and a positive though challenging teaching and learning experience; and (3) A hidden curriculum emerged in a performance‐based view of professional behaviour.

Conclusions

Patient‐present teaching engaged patients and enhanced their agency by recasting the patient as the central focus within the healthcare encounter. We identified a tension between performing and learning. This study adds new insights to the concept of patient centredness and professionalism from the perspectives of all participants in the medical teaching and learning environment.
Barostat or syringe‐assisted sensory biofeedback training for constipation with rectal hyposensitivity: A randomized controlled trial
Authors: Rao Satish S. C. , Yan Yun , Erdogan Askin , Coss‐Adame Enrique , Patcharatrakul Tanisa , Valestin Jessica , Nag Ayyala Deepak
Published: August 2021

Background

Rectal hyposensitivity (RH) is a well‐known pathophysiological dysfunction in chronic constipation. Whether biofeedback training improves RH and restores bowel function is unknown.

Aim

To investigate the efficacy of barostat‐assisted sensory training (BAST) with syringe‐assisted sensory training (SAST) in patients with RH in a randomized controlled trial.

Methods

Patients with RH and chronic constipation (Rome III) were randomized to receive 6 biweekly sessions of BAST or SAST. Verbal/visual feedback was provided during repeated rectal distensions to improve defecation desire/urge and first sensations with either 10‐cm balloon connected to barostat (BAST) or 4‐cm balloon connected to syringe and manometry probe (SAST). Sensory thresholds, bowel symptoms, and therapist and patient's rating of treatments were compared. The primary outcome (responders) was the improvement in ≥2 sensory thresholds.

Results

Sixty‐six patients were enrolled: 32 received BAST, 34 received SAST, and 56 completed study. There were significantly more responders in BAST group than SAST (78% vs. 53%, p = 0.0320). Rectal sensation normalized in 81% with BAST compared to 56% with SAST (p = 0.0270). When compared to baseline, desire and urge to defecate thresholds and bowel satisfaction improved with BAST (p = 0.0013; p = 0.0002; p = 0.0001) and SAST (p = 0.0012; p = 0.0001; p < 0.0001) and number of complete spontaneous bowel movements with BAST (p = 0.0029) but without inter‐group differences. Therapists rated BAST as superior to SAST (p < 0.0001), but patients rated both equally.

Conclusions

Sensory biofeedback training was effective and significantly improved rectal sensation and constipation symptoms. Although both techniques were useful, the novel BAST was more efficacious and easier to administer for treating RH.
Automatic assessment of human gastric motility and emptying from dynamic 3D magnetic resonance imaging
Authors: Lu Kun‐Han , Liu Zhongming , Jaffey Deborah , Wo John M. , Mosier Kristine M. , Cao Jiayue , Wang Xiaokai , Powley Terry L.
Published: August 2021

Background

Time‐sequenced magnetic resonance imaging (MRI) of the stomach is an emerging technique for non‐invasive assessment of gastric emptying and motility. However, an automated and systematic image processing pipeline for analyzing dynamic 3D (ie, 4D) gastric MRI data has not been established. This study uses an MRI protocol for imaging the stomach with high spatiotemporal resolution and provides a pipeline for assessing gastric emptying and motility.

Methods

Diet contrast‐enhanced MRI images were acquired from seventeen healthy humans after they consumed a naturalistic contrast meal. An automated image processing pipeline was developed to correct for respiratory motion, to segment and compartmentalize the lumen‐enhanced stomach, to quantify total gastric and compartmental emptying, and to compute and visualize gastric motility on the luminal surface of the stomach.

Key Results

The gastric segmentation reached an accuracy of 91.10 ± 0.43% with the Type‐I error and Type‐II error being 0.11 ± 0.01% and 0.22 ± 0.01%, respectively. Gastric volume decreased 34.64 ± 2.8% over 1 h where the emptying followed a linear‐exponential pattern. The gastric motility showed peristaltic patterns with a median = 4 wave fronts (range 3–6) and a mean frequency of 3.09 ± 0.07 cycles per minute. Further, the contractile amplitude was stronger in the antrum than in the corpus (antrum vs. corpus: 5.18 ± 0.24 vs. 3.30 ± 0.16 mm;p < 0.001).

Conclusions & Inferences

Our analysis pipeline can process dynamic 3D MRI images and produce personalized profiles of gastric motility and emptying. It will facilitate the application of MRI for monitoring gastric dynamics in research and clinical settings.
Long‐term personalized low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome
Authors: Staudacher Heidi M. , Rossi Megan , Kaminski Thomas , Dimidi Eirini , Ralph Frances S. E. , Wilson Bridgette , Martin Lee D. , Louis Petra , Lomer Miranda C.E , Irving Peter M. , Whelan Kevin
Published: August 2021

Background

Short‐term trials demonstrate the low FODMAP diet improves symptoms of irritable bowel syndrome (IBS) but impacts nutrient intake and the gastrointestinal microbiota. The aim of this study was to investigate clinical symptoms, nutrient intake, and microbiota of patients with IBS 12 months after starting a low FODMAP diet.

Methods

Participants enrolled in a previous short‐term clinical trial and who had been through structured FODMAP restriction, reintroduction, and personalization were invited to participate in a follow‐up study at one time point at 12 months. Gastrointestinal symptoms, stool output, dietary intake, and quality of life were recorded. Stool samples were collected and analyzed for microbiota (qPCR) and short‐chain fatty acids (SCFA). Data were compared with baseline (prior to any intervention in the original clinical trial) using non‐parametric statistics.

Key Results

Eighteen participants were included in the study. Adequate relief of symptoms occurred in 5/18 (28%) at baseline and increased to 12/18 (67%) following long‐term personalized low FODMAP diet (p = 0.039). There was a reduction in IBS‐SSS total score between baseline (median 227, IQR 99) and long term (154, 89; p < 0.001). Bifidobacteria abundance was not different between baseline (median 9.29 log10 rRNA genes/g, IQR 1.45) and long term (9.20 log10 rRNA genes/g, 1.41; p = 0.766, q = 0.906); however, there were lower concentrations of total SCFA, acetate, propionate, and butyrate.

Conclusions

In this long‐term analysis, two thirds of patients reported adequate relief of symptoms after 12 months of personalized low FODMAP diet that did not result in differences from baseline in Bifidobacteria. FODMAP reintroduction and personalization may normalize some of the effects of short‐term FODMAP restriction.
Eldecalcitol inhibits the progression of oral cancer by suppressing the expression of GPx‐1
Authors: Lu Yupu , Kou Yuying , Gao Yuan , Yang Panpan , Liu Shanshan , Zhang Fan , Li Minqi
Published: August 2021

Objectives

This study aimed to investigate the role of eldecalcitol in the progression of oral squamous cell carcinoma and to explore the related mechanism.

Materials and Methods

The effects of eldecalcitol on the proliferation, cell cycle, apoptosis, and migration of oral cancer cells (SCC‐15 and CAL‐27) were evaluated with cell counting kit‐8, flow cytometry, quantitative real‐time polymerase chain reaction, western blotting, and scratch assay. Mouse xenograft tumor model was established to further confirm the role of eldecalcitol in the progression of oral cancer. Immunohistochemistry, quantitative real‐time polymerase chain reaction, and western blotting were used to detect glutathione peroxidase‐1 expression in oral cancer tissue and cells treated with eldecalcitol.

Results

Eldecalcitol was found to inhibit the proliferation and migration of SCC‐15 and CAL‐27 cells significantly, block the cell cycle in the G0/G1 phase, and enhance the apoptosis. In addition, glutathione peroxidase‐1 was downregulated by eldecalcitol and acted as an important medium of eldecalcitol in inhibiting the proliferation and migration of SCC‐15 and CAL‐27 cells, as well as promoting their apoptosis.

Conclusions

Eldecalcitol may inhibit the progression of oral cancer by suppressing the expression of glutathione peroxidase‐1, which may provide new insight into the application of eldecalcitol as a potential anti‐cancer drug.
A discursive study exploring the professional identities of registered nurses employed in older person residential care settings
Authors: McGuire Niamh , Evans William , Brosnan Mary
Published: August 2021

Background

The phenomenon of an ageing population is being experienced globally requiring the ongoing provision of residential care services. A large number of registered nurses work in these settings; however, many challenges exist in their recruitment and retention.

Objectives

To explore professional identities and emerging discourses of registered nurses working in older person residential care settings.

Methods

This study employed a discursive‐based research methodology with a central focus on the role language, and discourses play in identity construction. Fourteen in‐depth narrative interviews were completed with registered nurses in residential care settings in the Republic of Ireland. Thematic analysis was underpinned by a critical discursive psychology framework.

Results

Four key identities and related discourses emerged: ‘skilled professional identity’, ‘person‐centred identity’, ‘subordinate identity’ and ‘product of healthcare reform identity’. Discourses presented contrasting professional identities held by nurses in residential care settings; on the one hand, they employed positive professional and person‐centred discourses, while on the other hand, tensions associated with healthcare reform and a subordinate identity exist.

Conclusions

This study presents unique insights into how registered nurses in residential care construct their professional identity and in doing so, enhances opportunities to promote recruitment and marketing in this setting. Equally, the challenges and opportunities of healthcare reform require sensitive management so that the professional identity of nurses working in residential care is enhanced and protected.

Implications for practice

How registered nurses working in residential care settings view their professional identity directly impacts on attitudes and behaviours and the subsequent delivery of care. Greater understanding and insight into how they construct their professional identity may enhance recruitment and retention initiatives. Study results also provide an opportunity for policymakers and service providers to create more positive working environments that promote professional identity development for this nursing group.
Health and education passport and the role of the foster care public health nurse
Authors: Carabez Rebecca
Published: August 2021

Aim

The aim of this study is to explore the practical use of Health and Education Passport (HEP) for children in foster care and the role of the Foster Care Public Health Nurse (FCPHN) in tracking health and education records.

Background

Children in foster care have complex health problems and experience frequent changes in home and school placements that result in gaps documentation. California mandates an HEP for every child in foster care.

Design

Utilizing an online survey, PHNs describe their agency's use of the HEP, reported how they obtain health and education records for the HEP.

Results

Social workers, PHNs and mental health providers were main HEP users, less so for foster parents and youth who age out of foster care. The HEP was used at medical and dental visits. PHNs reported little to no participation in updating educators. The HEP may be most useful when the child moves to a new placement or school.

Conclusion

The HEP is a critical document that ties a fragmented health history together.

Relevance to Clinical Practice

This study describes the foster care PHN role in updating the HEP and accessing health services and establishing a medical home.
Annual dynamics of Zymoseptoria tritici populations in wheat cultivar mixtures: A compromise between the efficacy and durability of a recently broken‐down resistance gene?
Authors: Orellana‐Torrejon Carolina , Vidal Tiphaine , Boixel Anne‐Lise , Gélisse Sandrine , Saint‐Jean Sébastien , Suffert Frédéric
Published: August 2021

Cultivar mixtures slow polycyclic epidemics but may also affect the evolution of pathogen populations by diversifying the selection pressures exerted by their plant hosts at field scale. We compared the dynamics of natural populations of the fungal pathogen Zymoseptoria tritici in pure stands and in three binary mixtures of wheat cultivars (one susceptible cultivar and one cultivar carrying the recently broken‐down Stb16q gene) over two annual field epidemics. We combined analyses of population “size” based on disease severity, and of population “composition” based on changes in the frequency of virulence against Stb16q in seedling assays with more than 3000 strains. Disease reductions were observed in mixtures late in the epidemic, at the whole‐canopy scale and on both cultivars, suggesting the existence of a reciprocal protective effect. The three cultivar proportions in the mixtures (0.25, 0.5, and 0.75) modulated the decrease in (a) the size of the pathogen population relative to the two pure stands, (b) the size of the virulent subpopulation, and (c) the frequency of virulence relative to the pure stand of the cultivar carrying Stb16q. Our findings suggest that optimal proportions may differ slightly between the three indicators considered. We argue potential trade‐offs that should be taken into account when deploying a resistance gene in cultivar mixtures: between the dual objectives “efficacy” and “durability,” and between the “size” and “frequency” of the virulent subpopulation. Based on current knowledge, it remains unclear whether virulent subpopulation size or frequency has the largest influence on interepidemic virulence transmission.
Cell wall thickness and composition are related to photosynthesis in Antarctic mosses
Authors: Roig‐Oliver Margalida , Douthe Cyril , Bota Josefina , Flexas Jaume
Published: August 2021

Cell wall thickness (Tcw) has been proposed as an important anatomical trait that could determine photosynthesis through land plants' phylogeny, bryophytes being the plant group presenting the thickest walls and the lowest photosynthetic rates. Also, it has recently been suggested that cell wall composition may have the potential to influence both thickness and mesophyll conductance (gm), representing a novel trait that could ultimately affect photosynthesis. However, only a few studies in spermatophytes have demonstrated this issue. In order to explore the role of cell wall composition in determining both Tcw and gm in mosses, we tested six species grown under field conditions in Antarctica. We performed gas exchange and chlorophyll fluorescence measurements, an anatomical characterization, and a quantitative analysis of cell wall main composition (i.e., cellulose, hemicelluloses and pectins) in these six species. We found the photosynthetic rates to vary between the species, and they also presented differences in anatomical characteristics and in cell wall composition. Whilst gm correlated negatively with Tcw and pectins content, a positive relationship between Tcw and pectins emerged, suggesting that pectins could contribute to determine cell wall porosity. Although our results do not allow us to provide conclusive statements, we suggest for the first time that cell wall composition—with pectins playing a key role—could strongly influence Tcw and gm in Antarctic mosses, ultimately defining photosynthesis.
The color of corrections: Racial politics and prison privatization
Authors: Butz Adam M. , Fording Richard C.
Published: August 2021

Privatizing the administration of American prisons represents a popular tool of correctional governance. In turn, policy and public administration researchers are routinely studying the consequences of prison privatization on criminal justice outcomes such as recidivism rates and prisoner complaints. However, much less attention has been paid to the antecedents of privatization decisions occurring across states, in particular how racial determinants might be influencing privatization outcomes. Building upon existing policy research with theories of social construction and negative racial classification, we argue that privatization debates over corrections management become more racialized when Black prisoners comprise a larger share of the state prison population, predicting higher overall levels of privatization usage. We further argue that this Black prisoner presence‐privatization relationship is context‐specific and conditioned by two additional variables: (1) levels of mass racial stereotyping and (2) partisan composition of state government. The statistical analysis demonstrates that racial determinants do significantly influence state prison privatization decisions and in complex ways as theorized. In states where Blacks make up a larger share of the prison population, privatization usage is found to be higher. Additionally, in line with theoretical expectations, Black prisoner presence is associated with increased privatization levels most strongly in states where citizenries hold heightened levels of racial fear and Republicans have increased legislative presence. This research is of keen interest to scholars of public policy and management, who could pay more heed to the ways in which race influences decisions around administrative structuring and outcomes for taxpayers and clients.
Shared decision making in gynaecological oncology; a challenge in an ageing population
Authors: Sbai Magda , Jasper Emily , Martin Fionna , Rajkumar Savithri , Montes Ana , Jeyarajah Jeyanjali , Harari Danielle , Partridge Judith
Published: August 2021

Key content

Gynae‐oncology patients are increasingly older and living with frailty and multimorbidity, resulting in higher rates of perioperative or treatment‐associated adverse outcomes.

Collaborative shared decision making (SDM), where healthcare professionals and patients work in partnership to reach a treatment decision, can be used to engage patients in treatment decisions.

Comprehensive geriatric assessment (CGA), a multidimensional, interdisciplinary process assessing medical, psychological and functional capabilities, can inform individualised management and SDM in older gynae‐oncology patients with complex conditions.

Evidence is emerging for the use of CGA to inform individualised management and underpin integrated care pathways and SDM for older people. This methodology is advocated in NHS England’s Cancer Strategy through integrated pathways for older cancer patients with geriatrician involvement.

Using clinical case studies, this review contextualises the application of SDM through CGA in older patients with gynaecological malignancy.

Learning objectives

Know that SDM takes proposed risks and benefits into account, together with projected disease progression with and without treatment and patient preferences.

Understand that limitations to SDM in older people include the effects of multimorbidity, cognitive impairment and frailty, limited data on long‐term clinician and patient‐reported outcomes and frequent exclusion of older people from research trials.
Faith, values, and metaphysical positionality in qualitative research
Authors: Johnsen Sarah , Fitzpatrick Suzanne
Published: August 2021

Positionality has long been a preoccupation for qualitative researchers within and beyond geography. Reflexive assessments of positionality typically examine the ways in which a researcher’s sociodemographic identifiers such as gender, age, ethnicity, dis/ability, sexuality, and/or the intersections between these affect research encounters, processes, and outcomes. Religion rarely features in such interrogations, and then usually only in relation to participants’ ethnic or racial affiliations. Drawing on experiences conducting a study exploring the role of faith‐based organisations in welfare provision for homeless people in the UK, this paper focuses on the related (but not synonymous) issue of metaphysical stance, that is, belief or non‐belief in the existence of God(s). It argues that metaphysical stance should be regarded as a sui generis aspect of positionality, which fits into none of the identity categories typically considered but is deserving of separate analysis with respect to its ethical and practical implications. Further to this, it contends that extreme diplomacy and discretion are required when exploring issues as inherently value‐laden as the moral frameworks underpinning welfare approaches. This is especially true when participants’ views divide in part along theist/atheist lines, such that religious and policy “literacy” are valuable attributes for researchers negotiating these sensitive terrains in the field.
Factors affecting successful ultrasound‐guided injection into the podotrochlear bursa using a palmarolateral approach
Authors: Espinosa‐Mur Pablo , Whitcomb Mary Beth , Kass Philip H. , Vanslambrouck Lothar , Galuppo Larry D.
Published: August 2021

Objective

To evaluate potential factors affecting ultrasonographic visibility of the suprasesamoidean region and the success rate of ultrasound‐guided injection (USGI) into the podotrochlear bursa (PB).

Study Design

Ex vivo, experimental study.

Animals

24 cadaveric forelimbs.

Methods

The PB was distended with 0, 1, or 2 ml of iodinated contrast material and saline under radiographic guidance. Ultrasonographic visibility of the suprasesamoidean region and PB was graded before and after distention with the limb loaded in three positions (vertical, cranial and caudal). Two operators with different experience levels performed an USGI into the PB with methylene blue (12 limbs each [four limbs with each of three volumes of PB distension]) using a palmarolateral approach and caudal foot placement. Limbs were frozen and sectioned to assess accuracy.

Results

Ultrasonographic visibility scores of the suprasesamoidean region (p = .0081) and PB (p < .0001) were improved using a caudal foot placement. Higher visibility grades of the suprasesamoidean region were associated with higher injection success rate (p = .047). The injection success was 75% (9/12) for the experienced versus 41.6% (5/12) for the less experienced operator (p = .14). PB distension improved visibility during caudal foot placement (p = .013) but not injection success rates (p = .78).

Conclusion

Caudal foot placement enhances visibility of the PB and suprasesamoidean region. Limbs with poor visibility of the suprasesamoidean region are more likely to undergo a failed USGI.

Clinical Significance

The lateral USGI approach should be performed only in cases of optimal visibility. The reported success rates support the technical challenge of PB injections.
A Physics-Informed Two-Level Machine-Learning Model for Predicting Melt-Pool Size in Laser Powder Bed Fusion
Authors: Ren Yong , Wang Qian , Michaleris Panagiotis (Pan)
Published: August 2021

Laser powder bed fusion (L-PBF) additive manufacturing (AM) is one type of metal-based AM process that is capable of producing high-value complex components with a fine geometric resolution. As melt-pool characteristics such as melt-pool size and dimensions are highly correlated with porosity and defects in the fabricated parts, it is crucial to predict how process parameters would affect the melt-pool size and dimensions during the build process to ensure the build quality. This paper presents a two-level machine-learning (ML) model to predict the melt-pool size during the scanning of a multitrack build. To account for the effect of thermal history on melt-pool size, a so-called (prescan) initial temperature is predicted at the lower-level of the modeling architecture and then used as a physics-informed input feature at the upper-level for the prediction of melt-pool size. Simulated data sets generated from the autodesk'snetfabbsimulation are used for model training and validation. Through numerical simulations, the proposed two-level ML model has demonstrated a high prediction performance, and its prediction accuracy improves significantly compared to a naive one-level ML without using the initial temperature as an input feature.
The Causes of Asymmetric Deformation of Surface Roughness Asperities in Elastohydrodynamic Lubrication Contacts
Authors: Kaneta Motohiro , Matsuda Kenji , Nishikawa Hiroshi
Published: August 2021

This paper provides the main causes of asymmetric or directional deformation of surface roughness based on a transient non-Newtonian thermal elastohydrodynamic lubrication (EHL) model, where the contact materials have different thermal conductivities and elastic moduli. In order to obtain the actual shape of the surface asperity, the surface shapes of contact bodies are evaluated separately. It is clarified that the asymmetric deformation of the asperities appears due to two causes. One depends on the slide-roll ratio (SRR) and the difference in thermal conductivity between contact materials, and the other is caused by the contact pressure between the asperities through the oil film.
A Continuum Dislocation Dynamics Crystal Plasticity Approach to Irradiated Body-Centered Cubic α-Iron
Authors: Pitts Stephanie A. , Jiang Wen , Pizzocri Davide , Barker Erin I. , Zbib Hussein M.
Published: August 2021

Radiation-induced embrittlement of reactor pressure vessel (RPV) steels can potentially limit the operating life of nuclear power plants. Over extended exposure to radiation doses, these body-centered cubic (BCC) irons demonstrate irradiation damage. Here, we present a continuum dislocation density (CDD) crystal plasticity model to capture the interaction among dislocations and self-interstitial atom (SIA) loops in α-iron. We demonstrate the importance of modeling cross slip using a combined stochastic Monte Carlo approach and the role of slip system strength anisotropy in capturing stochastic cross slip interactions. Through these captured interactions, the CDD crystal plasticity model can capture both the stress response and the physical evolution of dislocations on different slip system planes. Single-crystal verification experiments are used to calibrate the CDD crystal plasticity model, and a set of simplified polycrystalline simulations demonstrates the model’s ability to capture the stress response from tensile experiments on α-iron.
The Relations Between Physical Activity Level, Executive Function, and White Matter Microstructure in Older Adults
Authors: Gogniat Marissa A. , Mewborn Catherine M. , Robinson Talia L. , Jean Kharine R. , Miller L. Stephen
Published: August 2021

The population of older adults is increasing, indicating a need to examine factors that may prevent or mitigate age-related cognitive decline. The current study examined whether microstructural white matter characteristics mediated the relation between physical activity and executive function in older adults without any self-reported psychiatric and neurological disorders or cognitive impairment (N = 43, mean age = 73 y). Physical activity was measured by average intensity and number of steps via accelerometry. Diffusion tensor imaging was used to examine microstructural white matter characteristics, and neuropsychological testing was used to examine executive functioning. Parallel mediation models were analyzed using microstructural white matter regions of interest as mediators of the association between physical activity and executive function. Results indicated that average steps was significantly related to executive function (β = 0.0003,t = 2.829,P = .007), while moderate to vigorous physical activity was not (β = 0.0007,t = 1.772,P = .08). White matter metrics did not mediate any associations. This suggests that microstructural white matter characteristics alone may not be the mechanism by which physical activity impacts executive function in aging.
Amorphous anion-rich titanium polysulfides for aluminum-ion batteries
Authors: Lin Zejing , Mao Minglei , Yang Chenxing , Tong Yuxin , Li Qinghao , Yue Jinming , Yang Gaojing , Zhang Qinghua , Hong Liang , Yu Xiqian , Gu Lin , Hu Yong-Sheng , Li Hong , Huang Xuejie , Suo Liumin , Chen Liquan
Published: August 2021

Amorphous anion-rich materials would offer a previously unexplored solution for high-capacity Al-ion storage.
Street lighting has detrimental impacts on local insect populations
Authors: Boyes Douglas H. , Evans Darren M. , Fox Richard , Parsons Mark S. , Pocock Michael J. O.
Published: August 2021

Direct evidence shows that artificial light at night reduces caterpillar abundance and disrupts larval behavior and development.
Response of Methanogen Communities to the Elevation of Cathode Potentials in Bioelectrochemical Reactors Amended with Magnetite
Authors: Gao Kailin , Wang Xin , Huang Junjie , Xia Xingxuan , Lu Yahai
Published: August 2021

Converting CO
2
to CH
4
through bioelectrochemistry is a promising approach to the development of green energy biotechnology. This process, however, requires low cathode potentials, which entails a cost.
Emergence of Multiple SARS-CoV-2 Antibody Escape Variants in an Immunocompromised Host Undergoing Convalescent Plasma Treatment
Authors: Chen Liang , Zody Michael C. , Di Germanio Clara , Martinelli Rachel , Mediavilla Jose R. , Cunningham Marcus H. , Composto Kaelea , Chow Kar Fai , Kordalewska Milena , Corvelo André , Oschwald Dayna M. , Fennessey Samantha , Zetkulic Marygrace , Dar Sophia , Kramer Yael , Mathema Barun , Germer Soren , Stone Mars , Simmons Graham , Busch Michael P. , Maniatis Tom , Perlin David S. , Kreiswirth Barry N.
Published: August 2021

Over a year of the COVID-19 pandemic, distinct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineages have arisen in multiple geographic areas around the world. SARS-CoV-2 variants of concern (VOCs), i.e., B.1.1.7 (alpha), B.1.351 (beta), P.1 (gamma), and B.1.617.2 (delta), harboring mutations and/or deletions in spike protein N-terminal domain (NTD) or receptor-binding domain (RBD) regions showed evidence of increased transmissibility and disease severity and possible reduced vaccine efficacy.
Identification and Characterization of Human Norovirus NTPase Regions Required for Lipid Droplet Localization, Cellular Apoptosis, and Interaction with the Viral P22 Protein
Authors: Yen Ju-Bei , Chen Lee-Wen , Wei Ling-Huei , Hung Chien-Hui , Wang Shie-Shan , Lin Chun-Liang , Chang Pey-Jium
Published: August 2021

Human noroviruses (HuNVs) are the major agent of global gastroenteritis outbreaks. However, due to the lack of an efficient cell culture system for HuNV propagation, functions of the viral-encoded proteins in host cells are still poorly understood.
Deubiquitination and Activation of the NLRP3 Inflammasome by UCHL5 in HCV-Infected Cells
Authors: Ramachandran Akshaya , Kumar Binod , Waris Gulam , Everly David
Published: August 2021

HCV infection induces inflammation leading to fibrosis, cirrhosis, and cancer. The current study identifies the mechanisms leading to the activation of the NLRP3 inflammasome in hepatocytes, which is an important site of viral replication.
The Cultivation Method Affects the Transcriptomic Response of Aspergillus niger to Growth on Sugar Beet Pulp
Authors: Garrigues Sandra , Kun Roland S. , Peng Mao , Gruben Birgit S. , Benoit Gelber Isabelle , Mäkelä Miia , de Vries Ronald P.
Published: August 2021

Understanding the interaction between filamentous fungi and their natural and biotechnological environments has been of great interest for the scientific community. Submerged cultures are preferred over solid cultures at a laboratory scale to study the natural response of fungi to different stimuli found in nature (e.g., carbon/nitrogen sources, pH).
Fifteen-minute consultation: The approach to the febrile child
Authors: Philbin Deirdre , Hall Dani
Published: August 2021

Febrile children presenting to the emergency department pose unique challenges. This article highlights the importance of identifying children at particular risk of serious bacterial infection (SBI) using risk factors, red flags and appropriate investigations. Emergency clinicians must be aware of the risk factors for SBI in febrile children, including young age, ill-appearing children and those with complex comorbidities or immunodeficiency. The presence of red flags in febrile children should immediately alert concern and prompt senior clinician review. This article also discusses the appropriate use of investigations and their role in complementing clinical assessment. When discharging children home after emergency department assessment, safety netting should be undertaken to ensure parents are aware when to seek further medical opinion. The presence of a prolonged fever of 5 days or longer should alert suspicion and usually requires further investigation.
Computed tomography-occult discoligamentous instability following blunt cervical spine trauma
Authors: Brooks Christopher Alan , Dower Ashraf , Donnellan Christopher , Donnellan Michael , Abraszko Renata
Published: August 2021

Plain CT is routinely ordered following blunt trauma of the cervical spine, and performs well in the exclusion of significant bony injuries. MRI is reserved for cases of suspected neural or posterior ligamentous compromise, and when other imaging modalities are contraindicated. There are patients however, with unremarkable radiology, and without suggestive clinical features, who are later found to have significant discoligamentous instability. In this report, we present two such cases. In both instances, worsening neurological symptoms prompted follow-up imaging, that demonstrated interval development of sub-axial cervical spondylolisthesis, requiring surgery and instrumentation. We identify and discuss radiological features that may be associated with occult discoligamentous injury, and highlight them as avenues for future research. These may prove useful in stratifying at-risk patients for further imaging in the acute setting.
Primary presentation of sarcoidosis with profound bilateral sensorineural hearing loss
Authors: Pandey Gargi , McClenaghan Fiona , Nash Robert
Published: August 2021

We present a case of a 7-year-old Afro-Caribbean girl presenting with rapidly progressive bilateral sensorineural hearing loss. She was found to have an elevated Angiotensin converting enzyme (ACE) and mediastinal lymphadenopathy containing non-caseating granulomas with multinucleate giant cells, in keeping with sarcoidosis. Cranial imaging demonstrated labyrinthitis. She underwent urgent bilateral cochlear implantation with rehabilitation of hearing sufficient to restart education within 1 month.
Endometriosis of the sciatic nerve masquerading as lumbar spondylosis in a 40-year-old Chinese woman
Authors: Nair Ankith , Yang Jian Tao , Xu Dan , Zhu Qing-Tang
Published: August 2021

A 40-year-old Chinese woman presented with a 4-year history of lower back pain and left lower leg sciatica. The patient had previously tried different modalities of treatments, including massage, acupuncture, ultrasound, alternative Bowen therapy and nonsteroidal anti-inflammatory drugs (NSAIDs), all of which only provided temporary relief. On presentation to a tertiary hospital, careful and comprehensive history taking found that the sciatica pattern of pain always coincided with menstruation. An MRI identified a thickened left sciatic nerve, with surgery confirming sciatic nerve endometriosis. The case highlights the importance of comprehensive history taking in accurately diagnosing a rare aetiology of sciatica with subsequent prompt surgical intervention to avoid severe disability as well as follow-up treatment to prevent recurrence.
Healthy Parent Carers programme: mixed methods process evaluation and refinement of a health promotion intervention
Authors: Lloyd Jenny , Bjornstad Gretchen , Borek Aleksandra , Cuffe-Fuller Beth , Fredlund Mary , McDonald Annabel , Tarrant Mark , Berry Vashti , Wilkinson Kath , Mitchell Siobhan , Gillett Annette , Logan Stuart , Morris Christopher
Published: August 2021

Objectives

Parent carers of children with special educational needs or disability are at risk of poorer mental and physical health. In response to these needs, we codeveloped the ‘Healthy Parent Carers’ (HPC) programme. This study examined the views and experiences of participants in the HPC feasibility trial to inform programme refinement.

Intervention, setting and participants

HPC is a peer-led group-based intervention (supported by online materials) for primary carers of disabled children, encouraging behaviours linked with health and well-being. It was delivered by two lead and six assistant peer facilitators in six community sites (one lead and one assistant per group) in South West England over six or 12 sessions. Control participants had online materials only. The trial involved 47 intervention and 45 control parent carers (97% female and 97% white) and eight facilitators (one male).

Design

A preplanned mixed methods process evaluation using questionnaires and checklists (during and after the intervention), qualitative interviews with participants after intervention (n=18) and a focus group with facilitators after trial.

Results

HPC was highly acceptable to participants and facilitators and experiences were very positive. Participants reported that the programme increased awareness of what parent carers could and could not change and their self-efficacy to engage in health-promoting behaviours. The intended mechanisms of action (social identification and peer support) matched participants’ expectations and experiences. Control participants found the online-only programme flexible but isolating, as there were no opportunities to share ideas and problem solve with peers, the key function of the programme. Areas for improvement were identified for programme content, facilitator training and delivery.

Conclusion

HPC was acceptable, well received and offers considerable potential to improve the health of parent carers. Under the pandemic, the challenge going forward is how best to maintain reach and fidelity to function while delivering a more virtual programme.

Trial registration number

ISRCTN15144652.
Relevance of anthropometric measurements as predictors of prevalent diabetes type 2: a cross-sectional study on a Norwegian population
Authors: Hasselgren Anton , Karmacharya Biraj Man , Stensdotter Ann-Katrin
Published: August 2021

Objectives

The objective was to determine the predictive potential of anthropometric indices to screen prevalent diabetes mellitus type 2 in a Norwegian population.

Design

This is a cross-sectional design to determine the potential association of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and body mass index (BMI) with prevalent diabetes mellitus type 2 through logistic regression analysis. Receiver operating characteristic (ROC) curves were used to determine the predictive potential of the anthropometric indices. Youden’s index was applied to determine the optimal cut-off points for each anthropometric index.

Setting

This study used cross-sectional data from the populations-based Health Study in Nord-Trøndelag which invited all citizens in the county above 20 years of age.

Participants

This study included all those who were non-pregnant and had complete data (N=50 042), 98.5% of the participants. The sample is to be considered representative for the population of Norway.

Primary and secondary outcome measures

OR and ROC of the potential association between diabetes mellitus type 2 and anthropometric indices were the main planned and performed outcome measures.

Results

The results suggest that the anthropometric indices performed differently within the Norwegian population with WHR and WHtR being the stronger predictor with (ROC) of 0.746 (0.735 to 0.757) and 0.741 (0.730 to 0.752). The predictive potential for the investigated anthropometric indices was generally stronger for women than men.

Conclusion

Anthropometric indices of size BMI and the highly correlated WC are less associated with prevalent diabetes mellitus type 2 than WHR (WC adjusted for hip circumference) or WHtR (WC adjusted for height) in a Norwegian population.