bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of dieless hydroforming process for manufacturing of variable cross section tubular structures
Authors: E Chandrasekar , Mukherjee Manidipto , Singh Dilpreet , Subramanian Chidambaram
Published: May 2022

The dieless hydroforming is a type of manufacturing method that forms materials using pressurised hydraulic fluid rather than dies and presses as in traditional hydroforming, resulting in significant cost savings. The dieless hydroforming of tubular structures with variable cross section has received little attention, indicating that more research is needed in this area. Therefore, this article investigated dieless hydroforming of low carbon steel material with fluid pressures ranging from 10 to 50 bar and sheet thicknesses ranging from 1 to 2.5 mm to produce tubular structures with variable cross section. The main goal is to comprehend the deformation characteristics in relation to the parameters, as well as the impact of deformation on the microstructural and mechanical behaviour. The inflation and contraction patterns of hydroformed structures are numerically determined using the finite element method at various parameters and then compared to experimental results which show a good correlation. Plastic deformation induced grain refinement in all deformed samples, as compared to as-received material. The sample hydroformed at 30 bar and with a thickness of 2.5 mm showed higher yield strength (291 MPa), tensile strength (404 MPa) and elongation (48%) than the other samples. Hydroformed tubular structures with variable cross section are created and used in electric poles to hold solar panels after the process repeatability is tested and found to be highly repeatable with greater than 97% accuracy.
Change of thermophysical parameters of polypropylene-metal oxide nanocomposite (polypropylene + ZrO2) after electric field influence
Authors: Ibrahimova Hijran S , Shirinova Habiba A. , Rzayev Rovnag M , Rahimova Konul E , Mustafayeva Esmira M
Published: May 2022

In this work, the influence of an electric field on thermophysical properties of the PP+ZrO2 nanocomposites has been investigated. Changes in thermograms before and after applying an electric field (EFI) have been studied depending on the filler percentage in the polymer matrix. After EFI a new, weak maximum at the temperature range of 100–130°С of the thermograms for all concentrations of the filler was observed. Thermophysical parameters of the nanocomposite sample have been calculated for different values of electric field strengths that were applied are calculated depending on the effect of the ETP.
An Unexpected Journey: The Lived Experiences of Patients with Long-Term Cognitive Sequelae After Recovering from COVID-19
Authors: Loft Mia I. , Foged Eva M. , Koreska Mai
Published: May 2022

This current study explored the lived experiences of patients with long-term cognitive sequelae after recovering from COVID-19. A qualitative design with in-depth interviews and an analysis inspired by Ricoeur’s interpretation theory was utilised. Contracting COVID-19 and suffering long-term sequelae presented as a life-altering event with significant consequences for one’s social, psychological and vocational being in the world in the months following the infection. Patients living with long-term cognitive sequelae after COVID-19 were in an unknown life situation characterised by feelings of anxiety, uncertainty and concerns about the future, significantly disrupting their life trajectory and forcing them to change their ways of life. While awaiting studies on treatment, symptom management and recovery after persistent sequelae of COVID-19, clinicians and researchers may find inspiration in experiences of other health conditions with similar phenomenology, such as ME/chronic fatigue syndrome and chronic headaches.
Varieties of Awe in Science Communication: Reflexive Thematic Analysis of Practitioners’ Experiences and Uses of This Emotion
Authors: Silva Luna Daniel , Bering Jesse M.
Published: May 2022

Awe is a valued emotion in science communication and assumes a variety of functions in relation to the cultural mandates of the various spaces where it is represented. Based on a reflexive thematic analysis of interviews with 22 science communication practitioners, we constructed seven themes referencing this emotion’s various sociocultural roles in this space. These included the functions of awe in entertainment, curiosity, admiration, revelation, and connection. Drawing from a constructionist view of emotions, we argue that these varieties of awe co-construct many of the differing, and sometimes conflicting, mandates that circulate in the culture of science communication.
Finite-time convergence of perturbed nonlinear systems using adaptive barrier-function nonsingular sliding mode control with experimental validation
Authors: Mofid Omid , Amirkhani Saeed , Din Sami ud , Mobayen Saleh , Vu Mai The , Assawinchaichote Wudhichai
Published: May 2022

In this study, an adaptive barrier procedure is combined with nonsingular sliding mode control (SMC) technique at the aim of the fast stabilization of nonlinear system with external disturbances. It is verified that the barred function-based control law leads to the fast convergence of state errors to a region near origin. Furthermore, the suggested method eradicates the requirement for the knowledge of upper bounds of exterior perturbations which are frequently required in SMC scheme. The stability analysis confirms fast convergence of the error states to a predetermined region. In order to demonstrate the validity of the planned method, a mass-spring system is examined as the case study. Finally, simulation and experimental outcomes on a mass-spring system are given to prove the efficacy and success of the advised methodology.
A Modulation Signal Bispectrum Enhanced Squared Envelope for the detection and diagnosis of compound epicyclic gear faults
Authors: Xu Yuandong , Feng Guojin , Tang Xiaoli , Yang Shixi , Gu Fengshou , Ball Andrew D
Published: May 2022

Epicyclic gearboxes are prevalent in a variety of important engineering systems such as automotive, aerospace, wind turbines, civil equipment and industrial robots owing to the merits of compact structure and high power density. To ensure the productivities of such important systems, condition monitoring techniques are being actively studied to resolve the challenge of varying transmission paths and multiple modulations in vibration signals acquired from ring gear housing. This paper proposes a new Modulation Signal Bispectrum (MSB) Enhanced Squared Envelope method to analyse the vibration signals acquired by a special On-Rotor Sensing (ORS) transducer that is mounted on the shaft of an epicyclic gearbox. A vibration signal model of ORS measurements from epicyclic gearboxes is presented to show the multiple modulation influences. Moreover, inevitable noise influences are also investigated on the conventional squared envelope and the state-of-the-art spectral correlation analysis. On this base, MSB is introduced to suppress these influences for accurately extracting equally spaced harmonics in the squared envelope and is then integrated to isolate fault signatures, allowing effective fault detection and diagnosis of epicyclic gearboxes, which lead to novel contributions of an MSB Enhanced Squared Envelope (MSB-ESE) approach. An experimental study of compound epicyclic gear faults was conducted to demonstrate the superior performance of MSB-ESE along with the special ORS technique in detecting and diagnosing the compound faults on sun and planet gears.
Using nano technology for imparting PET/C blended fabric new functional performance properties
Authors: Al-Balakocy NG , Hassan TM , Aly SY , Abd Elsalam SH , Elshakankery Mahmoud Hamouda
Published: May 2022

This article, discuss the effect of finishing polyester/cotton blended fabric (PET/C) with alkali and Titanium dioxide nanoparticles (TiO2 NPs) simultaneously. The treatment conditions such as NaOH and TiO2 NPs concentrations, reaction temperature and duration will be investigated. The effect of addition NPs on alkaline treatment conditions will prove through weight loss and carboxylic content. The ability of PET/C fabrics for loading with NPs during alkaline treatment was investigated by using SEM, EDX, and FTIR measurements. The effect of finishing of PET/C blended fabric with the suggested method on antimicrobial activity and ultraviolet protection was investigated. The simultaneous finishing of PET/C blended fabrics with alkali and TiO2 NPs showed excellent ultraviolet protection and high antimicrobial activity against Gram-positive ( Bacillus mycoides), Gram-negative ( Escherichia coli), and nonfilamentous fungus ( Candida albicans). The functional performance imparted to PET/C fabrics by the suggested approach are durable in repeated laundering processes, even after five Launder-Ometer washes.
Collaborative optimization of bushing installation angle and bushing stiffness of torsion beam suspension to improve the handing stability of the whole vehicle
Authors: Gao Jin , Han Peifeng
Published: May 2022

Both the bushing installation angle and bushing stiffness of torsion beam suspension have important and complex effects on suspension characteristics and vehicle handling stability. For improving the vehicle handling stability by optimizing the two, this paper systematically analyzes the influence mechanism of the bushing installation angle and bushing stiffness of the torsion beam suspension on the suspension C characteristic. The nonlinear relationship between the bushing installation angle and the steady-state characteristics index in the local design space is discussed. The influence mechanism of the bushing installation angle and bushing stiffness on the frequency response characteristics is deeply analyzed, the variation relationship of the frequency characteristic index at the low frequency of 0.5 Hz under different bushing installation angles and bushing stiffnesses is obtained. Finally, the bushing stiffness, which has a great influence on the frequency characteristics, and the bushing installation angle are taken as the optimization variables, and the frequency characteristic index is taken as the optimization goal, and the multi-objective collaborative optimization of the frequency characteristic is carried out with the help of genetic algorithm. From the comparative analysis of transient and steady-state characteristics before and after optimization, it can be seen the vehicle handling stability has been improved.
A Chinese boy with familial Duchenne muscular dystrophy owing to a novel hemizygous nonsense mutation (c.6283C>T) in an exon of the DMD gene
Authors: Li Xing-Chuan , Wang Song , Zhu Jia-Rui , Yin Yu-Shan , Zhang Ni
Published: May 2022

Duchenne muscular dystrophy is a severe, X-linked, progressive neuromuscular disorder clinically characterised by muscle weakening and extremely high serum creatine kinase levels. A 1-year-old Chinese patient was diagnosed with early-onset Duchenne muscular dystrophy. Next-generation gene sequencing was conducted and the Sanger method was used to validate sequencing. We identified a novel nonsense mutation (c.6283C>T) in DMD that caused the replacement of native arginine at codon 2095 with a premature termination codon (p.R2095X), which may have had a pathogenic effect against dystrophin in our patient’s muscle cell membranes. We discovered a novel nonsense mutation in DMD that will expand the pathogenic mutation spectrum for Duchenne muscular dystrophy.
Smooth and Hard or Beautiful and Elegant? Experts’ Conceptual Structure of the Aesthetics of Materials
Authors: Marschallek Barbara E. , Jacobsen Thomas
Published: May 2022

The present study’s aim was to examine whether interindividual differences in levels of expertise influence the aesthetic processing of materials. In particular, we elucidated experts’ conceptual structure of the aesthetics of different materials using a free list task and compared it to recent non-expert data. To this end, we asked 401 architects, designers, and interior designers to list adjectives that could be used to describe the aesthetics of materials. The experts listed a large number of sensorial as well as aesthetically evaluative terms. As measured in a supplementary study, a slight majority of the listed terms had a neutral valence, followed by a large proportion of positive terms. The term beautiful, frequently the preeminent term in aesthetics, was by no means one of the most relevant terms in both studies. The results suggest that the conceptual structure of the aesthetics of materials is multifaceted and expressive, and, to some extent, influenced by expertise. Furthermore, the findings indicate that concepts underlying materials aesthetics differ from other domains.
Mothers’ Understanding of Brain Development in Early Childhood: A Qualitative Study in Brazil
Authors: Yakuwa Marina Sayuri , Pancieri Letícia , Neill Sarah , de Mello Débora Falleiros
Published: May 2022

To analyze mothers’ understanding of child brain development and their stimulus practices with children in the first months of life. Qualitative research, with 18 Brazilian mothers, over 18 years of age, used semi-structured interviews to identify their perspectives on important healthcare outcomes, based on reflexive thematic analysis. Mother’s accounts displayed little understanding of child brain development, focusing on the development of neuropsychomotor skills. There was relative uncertainty about the daily care practices that would provide appropriate child stimuli, through which to provide promotion and protection of child development. Maternal knowledge about child brain development indicates a need to strengthen parenting practices in early childhood. Expanding this knowledge and practices can contribute to parental caregivers being immediate providers of child development, to detect vulnerabilities and early difficulties. In addition, this approach would promote involvement in daily care and increase shared responsibility in the construction of strengthened executive functions for good child development.
“From Birth to Death, From Beginning to End”: Participant Experience and the Meaning of Research Participation in a Longitudinal Birth Cohort Study
Authors: Rönkä Anna Reetta
Published: May 2022

Research participants are vital for the success of a birth cohort study. Despite their scientific importance and large participant numbers, research on participant experience in birth cohort studies is scarce. This study explores participant experience, its different dimensions and meaning of the experience for the participants’ lives. The data comes from the Northern Finland Birth Cohort 1966. In total, 49 semi-structured interviews were conducted with participants having full participation records and then subjected to qualitative content and thematic analysis. According to the findings, the participant experience is multidimensional, consisting of four dimensions; personal, relational, societal, and scientific. The experience evoked both positive and negative feelings and a sense of belongingness. Motivations to continue, perceived benefits of the study, consequences of participation, and the theme of trust were grouped under the four dimensions. The meaning of the study participation, and the level of personal investment and involvement in the study varied a lot among active study participants, forming a continuum from a very strong to a weak. The findings of this study contribute to the theoretical conceptualization of the participant experience. They help to better understand the participant’s perspective, and the different aspects that participating in a longitudinal research project may entail as a subjective and a relational experience. The results may contribute to research design and aid in enhancing participant satisfaction. That is important, as conducting high-quality research depends on motivated and committed research participants.
Disseminated Nontuberculous Mycobacterium Presenting as Chronic Diarrhea and Wasting
Authors: Singh Manasi , Heincelman Marc
Published: May 2022

Infections due to nontuberculous mycobacterium (NTM) are important in chronically immunosuppressed populations and are a particular threat to solid organ transplant recipients (SOT). However, they are not a common occurrence and have protean manifestations, making it important that clinicians maintain a high degree of suspicion in the correct patient population. Mycobacterium avium complex (MAC) usually presents with pulmonary involvement in immunocompetent population and disseminated disease in SOT patients with fever of unknown origin, lymphadenopathy, and cutaneous lesions being part of the well-known presentation. It is not commonly described as causing severe diarrhea. Here, we present an interesting case of a patient with a kidney and pancreas transplant who presented with debilitating wasting and chronic diarrhea. Biopsies and cultures confirmed MAC. To our knowledge, this is the first case report of MAC causing severe wasting diarrhea in renal transplant patients. The patient was treated with a multidrug regimen. Given the rare presentation of MAC presenting as chronic diarrhea, the treatment regimen is not standardized and infectious disease specialists should be involved early on. Up to 30% of renal transplant patients infected with NTM lose graft function and 20% die. Unfortunately, our patient suffered both these outcomes.
2021 Kazanjian Lecture: Caring for Children With Facial Anomalies—Inspiring the Next Generation
Authors: Gosain Arun K. , Gutowski Kristof S.
Published: May 2022

Varaztad Kazanjian stood for innovation in plastic surgery, serving as a founder of many of the craniomaxillofacial principles practiced today. However, we have seen attrition in career interest toward craniofacial and pediatric plastic surgery as trainees progress from medical school to early career. We explore several aspects of our specialty that could help reinvigorate enthusiasm for our specialty and the retention of young surgeons. We begin by judging career success and defining the patient population we wish to serve. We examine several areas by which our specialty can be perceived as more attractive to young surgeons, to include early mentorship and maintaining these mentoring relationships beyond the training period. We emphasize the need to diversify our trainees and include them in efforts to expand innovation in our specialty. We discuss the need to champion craniofacial and pediatric plastic surgery as mission-critical to our institutions, involve trainees and young surgeons in advocacy efforts on behalf of our patients, and involve trainees and young surgeons in global health efforts. We discuss how to structure our divisions to make craniofacial and pediatric plastic surgery an inviting environment that welcomes new participants, rather than making them feel they are working their way through an “old boys’ club.” Innovation alone will not sustain our specialty unless we mentor the next generation to want to continue in the line of innovation that drew us to this specialty.
Simultant: simultaneous curve fitting of functions and differential equations using analytical gradient calculations
Authors: Kirkegaard Julius B.
Published: May 2022

Background

The initial step in comparing mathematical models to experimental data is to do a fit. This process can be complicated when either the mathematical models are not analytically solvable (e.g. because of nonlinear differential equations) or when the relation between data and models is complex (e.g. when some fitting parameters must be shared between many data sets).

Results

We introduce Simultant, a software package that allows complex fitting setups to be easily defined using a simple graphical user interface. Fitting functions can be defined directly as mathematical expressions or indirectly as the solution to specified ordinary differential equations. Analytical gradients of these functions, including the solution of differential equations, are automatically calculated to provide fast fitting even for functions with many parameters. The software enables easy definition of complex fitting setups in which parameters can be shared across both data sets and models to allow simultaneous fits to be performed.

Conclusions

Simultant exploits differentiable programming and simplifies modern fitting approaches in a unified graphical interface.
Antimicrobial resistance in urinary pathogens and culture-independent detection of trimethoprim resistance in urine from patients with urinary tract infection
Authors: Somorin Yinka M. , Weir Nichola-Jane M. , Pattison Sally H. , Crockard Martin A. , Hughes Carmel M. , Tunney Michael M. , Gilpin Deirdre F.
Published: May 2022

Background

Although urinary tract infections (UTIs) are extremely common, isolation of causative uropathogens is not always routinely performed, with antibiotics frequently prescribed empirically. This study determined the susceptibility of urinary isolates from two Health and Social Care Trusts (HSCTs) in Northern Ireland to a range of antibiotics commonly used in the treatment of UTIs. Furthermore, we determined if detection of trimethoprim resistance genes (dfrA) could be used as a potential biomarker for rapid detection of phenotypic trimethoprim resistance in urinary pathogens and from urine without culture.

Methods

Susceptibility of E. coli and Klebsiella spp. isolates (n = 124) to trimethoprim, amoxicillin, ceftazidime, ciprofloxacin, co-amoxiclav and nitrofurantoin in addition to susceptibility of Proteus mirabilis (n = 61) and Staphylococcus saprophyticus (n = 17) to trimethoprim was determined by ETEST® and interpreted according to EUCAST breakpoints. PCR was used to detect dfrA genes in bacterial isolates (n = 202) and urine samples(n = 94).

Results

Resistance to trimethoprim was observed in 37/124 (29.8%) E. coli and Klebsiella spp. isolates with an MIC90 > 32 mg/L. DfrA genes were detected in 29/37 (78.4%) trimethoprim-resistant isolates. Detection of dfrA was highly sensitive (93.6%) and specific (91.4%) in predicting phenotypic trimethoprim resistance among E. coli and Klebsiella spp. isolates. The dfrA genes analysed were detected using a culture-independent PCR method in 16/94 (17%) urine samples. Phenotypic trimethoprim resistance was apparent in isolates cultured from 15/16 (94%) dfrA-positive urine samples. There was a significant association (P < 0.0001) between the presence of dfrA and trimethoprim resistance in urine samples containing Gram-negative bacteria (Sensitivity = 75%; Specificity = 96.9%; PPV = 93.8%; NPV = 86.1%).

Conclusions

This study demonstrates that molecular detection of dfrA genes is a good indicator of trimethoprim resistance without the need for culture and susceptibility testing.
Challenges faced by patients with dyslipidemia and systemic arterial hypertension in Brazil: a design of the patient journey
Authors: Faria-Neto Jose Rocha , Yarleque Carlos , Vieira Luiz Fernando , Sakane Eliane Naomi , Santos Raul D.
Published: May 2022

Background and objective

Non-communicable diseases like systemic arterial hypertension (SAH) and dyslipidemia are poorly studied in terms of patient journey aspects. This semi-systematic review provides evidence synthesis for the management of SAH and dyslipidemia in Brazil and also discusses challenges faced by patients at the local level along with a suggested care approach by local experts.

Methods

A semi-systematic review using both structured literature databases (Embase and Medline) and unstructured scientific records (WHO, IPD, MOH and Google) on hypertension and dyslipidemia in the English language from 2010 to 2019 was performed by reviewers. After two-level screening based on pre-defined criteria, patient journey touchpoints and prevalence information were extracted from the included articles. Data gaps were bridged through the insights of local experts.

Results

Prevalence of hypertension and dyslipidemia in Brazil were 23% and 40.8%, respectively. Awareness of dyslipidemia was found in a larger proportion (58.1%) than in SAH (22.2%). Similarly, screening for hypertension (97%) and dyslipidemia (55.4%) were found to be effective, while treatment was (62.9%) and (30.0%) for hypertension and dyslipidemia, respectively.

Conclusion

There were important gaps on patient awareness and treatment of dyslipidemia and hypertension. Limited patient education, regional disease distribution, and treatment allocation, along with limited resources for diagnosis and treatment are the key challenges.
Inference following multiple imputation for generalized additive models: an investigation of the median p-value rule with applications to the Pulmonary Hypertension Association Registry and Colorado COVID-19 hospitalization data
Authors: Bolt Matthew A. , MaWhinney Samantha , Pattee Jack W. , Erlandson Kristine M. , Badesch David B. , Peterson Ryan A.
Published: May 2022

Background

Missing data prove troublesome in data analysis; at best they reduce a study’s statistical power and at worst they induce bias in parameter estimates. Multiple imputation via chained equations is a popular technique for dealing with missing data. However, techniques for combining and pooling results from fitted generalized additive models (GAMs) after multiple imputation have not been well explored.

Methods

We simulated missing data under MCAR, MAR, and MNAR frameworks and utilized random forest and predictive mean matching imputation to investigate a variety of rules for combining GAMs after multiple imputation with binary and normally distributed outcomes. We compared multiple pooling procedures including the “D2” method, the Cauchy combination test, and the median p-value (MPV) rule. The MPV rule involves simply computing and reporting the median p-value across all imputations. Other ad hoc methods such as a mean p-value rule and a single imputation method are investigated. The viability of these methods in pooling results from B-splines is also examined for normal outcomes. An application of these various pooling techniques is then performed on two case studies, one which examines the effect of elevation on a six-minute walk distance (a normal outcome) for patients with pulmonary arterial hypertension, and the other which examines risk factors for intubation in hospitalized COVID-19 patients (a dichotomous outcome).

Results

In comparison to the results from generalized additive models fit on full datasets, the median p-value rule performs as well as if not better than the other methods examined. In situations where the alternative hypothesis is true, the Cauchy combination test appears overpowered and alternative methods appear underpowered, while the median p-value rule yields results similar to those from analyses of complete data.

Conclusions

For pooling results after fitting GAMs to multiply imputed datasets, the median p-value is a simple yet useful approach which balances both power to detect important associations and control of Type I errors.
Optical biopsy for esophageal squamous cell neoplasia by using endocytoscopy
Authors: Shimoda Yoshihiko , Shimizu Yuichi , Takahashi Hiroaki , Okahara Satoshi , Miyake Takakazu , Ichihara Shin , Tanaka Ikko , Inoue Masaki , Kinowaki Sayoko , Ono Masayoshi , Yamamoto Keiko , Ono Shoko , Sakamoto Naoya
Published: May 2022

Background

Endocytoscopy (ECS) enables microscopic observation in vivo for the gastrointestinal mucosa; however, there has been no prospective study in which the diagnostic accuracy of ECS for lesions that have not yet undergone histological diagnosis was evaluated. We conducted a surveillance study for patients in a high-risk group of esophageal squamous cell carcinoma (ESCC) and evaluated the in vivo histological diagnostic accuracy of ECS.

Methods

This study was a multicenter prospective study. We enrolled 197 patients in the study between September 1, 2019 and November 30, 2020. The patients first underwent white light imaging and narrow band imaging, and ultra-high magnifying observation was performed if there was a lesion suspected to be an esophageal tumor. Endoscopic submucosal dissection (ESD) was later performed for lesions that were diagnosed to be ESCC by ECS without biopsy. We evaluated the diagnostic accuracy of ECS for esophageal tumorous lesions.

Results

ESD was performed for 37 patients (41 lesions) who were diagnosed as having ESCC by ECS, and all of them were histopathologically diagnosed as having ESCC. The sensitivity [95% confidence interval (CI)] was 97.6% (87.7–99.7%), specificity (95% CI) was 100% (92.7–100%), diagnostic accuracy (95% CI) was 98.9% (94.0–99.8%), positive predictive value (PPV) (95% CI) was 100% (91.4–100%) and negative predictive value (NPV) (95% CI) was 98.0% (89.5–99.7%).

Conclusions

ECS has a high diagnostic accuracy and there were no false positives in cases diagnosed and resected as ESCC. Optical biopsy by using ECS for esophageal lesions that are suspected to be tumorous is considered to be sufficient in clinical practice.
Does diabetes mellitus increase the incidence of early thrombosis in deep vein following unicompartmental knee arthroplasty: a retrospective cohort study
Authors: Jiao Xufeng , Li Zheng , An Shuai , Huang Jiang , Feng Mingli , Cao Guanglei
Published: May 2022

Background

Many patients following unicompartmental knee arthroplasty (UKA) also suffer from diabetes mellitus, which may lead to an increased likelihood of postoperative deep venous thrombosis (DVT). Therefore, we evaluated whether DVT incidence would increase 3 days following UKA in diabetic patients.

Methods

Patients who underwent UKA from August 2018 to September 2021 in our hospital were retrospectively included. Age, gender, body mass index, hypertension, mode of anesthesia, surgery time, intraoperative blood loss, tourniquet pressure and time, and glycosylated hemoglobin concentration were recorded as confounders. We compared the incidence and type of DVT between non-diabetic and diabetic patients and evaluated the effect of glycosylated hemoglobin levels on DVT.

Results

Of all the 224 patients, 96 had diabetes and 128 did not. Within 3 days after surgery, DVT occurred in 25 cases in the diabetic group and 17 cases in the non-diabetic group (p < 0.05), and the difference mainly exists in the lower limbs on the surgical side. Logistic regression analysis demonstrated that the risk of DVT in the diabetic group was 4.50 times higher compared with the non-diabetic group. For every 1 unit increase of glycosylated hemoglobin, the incidence of DVT increased 2.35 times. Differences in age, gender, body mass index, hypertension, mode of anesthesia, surgery time, intraoperative blood loss, tourniquet pressure, and time between the two groups were not significant.

Conclusions

The incidence of DVT in diabetic patients within 3 days after UKA was significantly higher than that in non-diabetic patients and was proportional to the concentration of glycosylated hemoglobin.
Antimicrobial use in Sweden during the COVID-19 pandemic: prescription fill and inpatient care requisition patterns
Authors: Nakitanda Aya Olivia , Karlsson Pär , Löfling Lukas , Cesta Carolyn E. , Odsbu Ingvild
Published: May 2022

Background

Increased and inappropriate antimicrobial use are the key drivers of the emergence of antimicrobial resistance, and there have been widespread concerns around potential antimicrobial misuse, overuse and their consequences during the COVID-19 pandemic. To better understand the impact of the pandemic on antimicrobial use, particularly in light of the resurgence of COVID-19 cases since the summer of 2020, we assessed trends in antimicrobial prescription fills and hospital requisitions in Sweden during 2020 against those of preceding years.

Methods

We performed a descriptive study using population-based data from the Swedish Prescribed Drug Register and the Swedish e-Health Agency. The weekly number of prescriptions filled and the total volume sold to inpatient care institutions in defined daily doses (DDDs) per 1000 inhabitants for systemic antibacterials (Anatomical Therapeutic Chemical therapeutic subgroup J01 excluding J01XX), antimycotics (J02), antivirals (J05) and antiprotozoals (P01) were computed and evaluated from time series graphs. A time series linear regression with ordinary least squares (OLS) estimation was used to model 2015–2019 data and predict the expected number of prescriptions filled and volumes sold in DDDs per 1000 inhabitants during 2020 with 95% confidence limits.

Results

From mid-March 2020, the weekly rate of antibiotic and antiprotozoal prescriptions filled plummeted to unprecedentedly low levels for the rest of the year; while unprecedentedly high numbers of antiviral prescriptions were filled weekly between mid-February and mid-March 2020. There was a net reduction in annual dispensing of antibiotics by 17%; of antiprotozoals by 21%; and of antivirals by 0.3% during 2020 compared to 2019. Inpatient care requisitions of antiprotozoals and antibiotics surged to 6-year highs during March 2020, resulting in a 127% increase in DDDs of antiprotozoals sold from 2019. The volume of antibiotics and antivirals sold to inpatient care institutions in 2020 decreased by 3% and 13% compared to 2019, respectively.

Conclusions

The overall decline in antimicrobial prescriptions filled in Sweden during 2020 were in part, collateral dividends of the COVID-19 pandemic.
Mast cell marker gene signature in head and neck squamous cell carcinoma
Authors: Cai Zhimou , Tang Bingjie , Chen Lin , Lei Wenbin
Published: May 2022

Background

Mast cells can reshape the tumour immune microenvironment and greatly affect tumour occurrence and development. However, mast cell gene prognostic and predictive value in head and neck squamous cell carcinoma (HNSCC) remains unclear. This study was conducted to identify and establish a prognostic mast cell gene signature (MCS) for assessing the prognosis and immunotherapy response of patients with HNSCC.

Methods

Mast cell marker genes in HNSCC were identified using single-cell RNA sequencing analysis. A dataset from The Cancer Genome Atlas was divided into a training cohort to construct the MCS model and a testing cohort to validate the model. Fluorescence in-situ hybridisation was used to evaluate the MCS model gene expression in tissue sections from patients with HNSCC who had been treated with programmed cell death-1 inhibitors and further validate the MCS.

Results

A prognostic MCS comprising nine genes (KIT, RAB32, CATSPER1, SMYD3, LINC00996, SOCS1, AP2M1, LAT, and HSP90B1) was generated by comprehensively analysing clinical features and 47 mast cell-related genes. The MCS effectively distinguished survival outcomes across the training, testing, and entire cohorts as an independent prognostic factor. Furthermore, we identified patients with favourable immune cell infiltration status and immunotherapy responses. Fluorescence in-situ hybridisation supported the MCS immunotherapy response of patients with HNSCC prediction, showing increased high-risk gene expression and reduced low-risk gene expression in immunotherapy-insensitive patients.

Conclusions

Our MCS provides insight into the roles of mast cells in HNSCC prognosis and may have applications as an immunotherapy response predictive indicator in patients with HNSCC and a reference for immunotherapy decision-making.
Correlation between ultrawide-field fluorescence contrast results and white blood cell indexes in diabetic retinopathy
Authors: Huang Lili , Li Lele , Wang Min , Zhang Dongmei , Song Yu
Published: May 2022

Background

Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes. DR involves a state of systemic inflammation, and chronic inflammation can promote microvascular and macrovascular diseases in diabetic patients and accelerate disease progression. Ultrawide-field FFA (UWFA) systems are increasingly being used to examine a wider retina. The aim of this study was to explore the correlation between the different manifestations of retinopathy under UWFA and the systemic indicators of white blood cells in patients with diabetic retinopathy.

Methods

This retrospective study included the hospitalized DR patients in the Department of Ophthalmology and Endocrinology of the Affiliated Hospital 2 of Nantong University between January 2016 and March 2019. This study examined the correlations between the UWFA examination results and glycated hemoglobin (HbA1c), routine blood tests,and the neutrophil-to-lymphocyte ratio of patients with clinically diagnosed DR during hospitalization.

Results

A total of 115 patients with DR (53 females and 62 males) were included (199 eyes: 102 right eyes and 97 left eyes). UWFA revealed that most eyes (77.4%) had grade 4 microvascular leakage, 52.8% had grade 0 capillary non-perfusion area, 59.3% had grade 0 neovascularization, and 92.0% had grade 0 fibrous proliferative membranes. Microvascular leakage was correlated with the NLR (r = 0.186, P = 0.027). Capillary non-perfusion area was correlated with the monocyte ratio (r = 0.144, P = 0.042) and the eosinophil ratio (r = 0.123, P = 0.044). Neovascularization was correlated to the monocyte ratio (r = 0.324, P = 0.018). Finally, the fibrous proliferative membrane was correlated to the monocyte ratio (r = 0.418, P = 0.002). Only the eosinophil ratio was independently associated with proliferative DR (odds ratio = 1.25, 95% confidence interval: 1.04–1.51, P = 0.018).

Conclusion

The results of UWFA imaging in patients with DR are correlated with white blood cell population indexes. The eosinophil ratio was independently associated with proliferative DR.
Effect of bilateral inferior oblique partial myectomy on V pattern exotropia with inferior oblique overaction
Authors: Yang Tianke , Chen Chunwen , Ma Wenxiu , Duan Yubing , Zhu Qin , Yao Jingyan
Published: May 2022

Purpose

To compare the effect of bilateral inferior oblique partial myectomy on V-pattern exotropia patients with bilateral symmetric inferior oblique overaction (IOOA) and asymmetric IOOA.

Methods

This was a retrospective study including 53 V-pattern exotropia patients with bilateral IOOA of all grades who underwent bilateral inferior oblique partial myectomy. Success was defined as the elimination of the IOOA and the collapse of the V pattern at the final follow-up. The fovea-disc angle (FDA) and V-pattern exotropia were compared before and after surgery.

Results

This study included 53 V-pattern exotropia patients, containing 29 patients with symmetric IOOA (Group I) and 24 patients with asymmetric IOOA (Group II). The last follow-up ranged from 3 to 16 months (mean of 5 months). After myectomy, 3 eyes in Group I and 2 eyes in Group II were observed with residual grade 1 IOOA. The surgical success rates of IOOA correction in Group I and Group II were 96% and 95%, respectively. The difference was not statistically significant (P = 0.808). V-pattern exotropia collapsed with residual 2 (min. 0, max. 6) PD for Group I and 2 (min. 0, max. 10) PD for Group II, and there was a statistically significant difference between pre- and postoperative V-pattern exotropia in the two groups (P = 0.000). No inferior oblique (IO) underaction or antielevation syndrome (AES) was found in either group. The average preoperative FDA of the right eye and the left eye was (8.93 ± 4.34)° and (10.86 ± 4.27)° in Group I and (9.08 ± 4.92)° and (11.00 ± 5.69)° in Group II. There was a significant difference in preoperative FDA between the right eye and the left eye in the two groups (Group I p = 0.029; Group II p = 0.038).

Conclusions

Bilateral inferior oblique partial myectomy can bring “symmetric” effectiveness in the correction of IOOA and FDA. It can potentially be used as a safe and successful treatment for V-pattern exotropia with bilateral IOOA. In addition, the FDA may be a promising index for evaluating fundus extorsion.
Accessibility and interventions of crisis resolution teams: a multicenter study of team practices and team differences in Norway
Authors: Ruud Torleif , Holgersen Katrine Høyer , Hasselberg Nina , Siqveland Johan
Published: May 2022

Background

Components of crisis resolution teams’ (CRTs) practices have been defined in recommendations and a fidelity scale, and surveys have reported how team leaders describe CRT practices. However, studies on CRTs have not measured and reported details of the crisis intervention provided to individual service users. The present study aimed to measure how various components of CRT practice were provided to individual service users and differences in practice between CRTs.

Methods

The study was exploratory and part of a prospective multicenter pre-post project on outcome of CRT treatment in Norway. Accessibility and intervention components of 25 CRTs were measured for 959 service users at the first contact after referral and in 3,244 sessions with service users. The data on CRT practice components were analyzed with descriptive statistics and factor analyses, and differences between teams were analyzed using ANOVA and calculating the proportion (intraclass correlation coefficient) of total variance that was due to differences between teams.

Results

One-third of the service users had their first session with the CRT the day of referral and another third the following day. Treatment intensity was mean 1.8 sessions the first week, gradually decreasing over subsequent weeks. Three of ten sessions were conducted in the service user’s home and six of ten in the team’s location. Eight of ten sessions took place during office hours and two of ten in the evening. The CRT provided assessment and psychological interventions to all service users. Family involvement, practical support, and medication were provided to two of ten service users. Between CRTs, significant differences were identified for a substantial proportion of practice components and especially for several aspects of accessibility. Cluster analysis identified two clusters of CRTs with significant differences in accessibility but no significant differences in the use of intervention components.

Conclusions

Measurements of accessibility and interventions provided to individual service users gave a detailed description of CRT practices and differences between teams. Such measurements may be helpful as feedback on clinical practice, for studying and comparing crisis resolution team practices, and in future studies on the association between different outcomes and potential critical elements of crisis interventions.
Changing the home visiting research paradigm: models’ perspectives on behavioral pathways and intervention techniques to promote good birth outcomes
Authors: Duggan Anne K. , Bower Kelly M. , Spinosa Ciara Z. , O’Neill Kay , Daro Deborah , Harding Kathryn , Ingalls Allison , Kemner Allison , Marchesseault Crista , Thorland William
Published: May 2022

Background

The US is scaling up evidence-based home visiting to promote health equity in expectant families and families with young children. Persistently small average effects for full models argue for a new research paradigm to understand what interventions within models work best, for which families, in which contexts, why, and how. Historically, the complexity and proprietary nature of most evidence-based models have been barriers to such research. To address this, stakeholders are building the Precision Paradigm, a common framework and language to define and test interventions and their mediators and moderators. This observational study used portions of an early version of the Precision Paradigm to describe models’ intended behavioral pathways to good birth outcomes and their stance on home visitors’ use of specific intervention technique categories to promote families’ progress along intended pathways.

Methods

Five evidence-based home visiting models participated. Model representatives independently completed three structured surveys focused on 41 potential behavioral pathways to good birth outcomes, and 23 behavior change technique categories. Survey data were used to describe and compare models’ intended behavioral pathways, explicit endorsement of behavior change technique categories, expectations for home visitors’ relative emphasis in using endorsed technique categories, and consistency in endorsing technique categories across intended pathways.

Results

Models differed substantially in nearly all respects: their intended pathways to good birth outcomes (range 16–41); the number of technique categories they endorsed in any intended pathway (range 12–23); the mean number of technique categories they endorsed per intended pathway (range 1.5–20.0); and their consistency in endorsing technique categories across intended pathways (22%-100% consistency). Models were similar in rating nearly all behavior change technique categories as at least compatible with their model, even if not explicitly endorsed.

Conclusions

Models successfully used components of the Precision Paradigm to define and differentiate their intended behavioral pathways and their expectations for home visitors’ use of specific technique categories to promote family progress on intended pathways. Use of the Precision Paradigm can accelerate innovative cross-model research to describe current models and to learn which interventions within home visiting work best for which families, in which contexts, why and how.
The ENJOY MAP for HEALTH: Exercise interveNtion outdoor proJect in the cOmmunitY for older people—More Active People for HEALTHier communities: a study protocol
Authors: Levinger Pazit , Dunn Jeremy , Abfalter Emma , Dow Briony , Batchelor Frances , Garratt Stephanie , Diamond Neil T , Hill Keith D.
Published: May 2022

Background

Physical activity is important to maintain health in older age, with physical activity in the outdoors providing mental and physical health benefits for all age groups. One way by which older people can engage in physical activity in the outdoors is through using suitable age-friendly outdoor exercise equipment, the Seniors Exercise Park. The ENJOY MAP for HEALTH aims to evaluate the effect of the Seniors Exercise Park installation and associated capacity building activities on park visitation, park-based physical activity by older people and delivery of community physical activity programs.

Method

This study is a quasi-experimental (natural experiment) with pre and post study design evaluating the effect of age-friendly outdoor spaces with specialised outdoor exercise equipment on older people’s physical activity and wellbeing in six Victorian municipalities (local governments/councils). Each council will undergo four stages (site construction and development, promotion and marketing, capacity building and training, evaluation and sustainability). Several activities and methods will be employed from stage one through stage four to evaluate the potential impact of the age-friendly outdoor spaces on physical activity and wellbeing and will comprise the following elements: site observation and equipment utilisation, face to face intercept surveys, development of an online access monitor and community building activities.

Discussion

The project is expected to result in a significant change in the physical outdoor environment for the participating councils and communities whereby older people and other community members will be able to engage in safe physical and social activity programs, socialise more and hence improve the overall wellbeing of older people.

Trial registration

This trial is retrospectively registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12621000965808. Date registered 23/07/2021.