bluuebunny/crossref_metadata_2025 huggingface dataset:
Microcrystalline paclitaxel-coated balloon for revascularization of femoropopliteal artery disease: Three-year outcomes of the randomized BIOPAC trial
Authors: Nowakowski Przemysław , Uchto Wojciech , Hrycek Eugeniusz , Kachel Mateusz , Ludyga Tomasz , Polczyk Filip , Żurakowski Aleksander , Kaźmierczak Paweł , Granada Juan F , Nowakowska Iwona , Kiesz Radosław S , Milewski Krzysztof P , Buszman Paweł E , Buszman Piotr P
Published: March 2021

The aim of the BIOPAC trial was to determine long-term safety and efficacy of a novel microcrystalline paclitaxel-coated balloon (mcPCB) with a biocompatible polymer as an excipient in the treatment of occlusive femoropopliteal lesions. In this first-in-human prospective controlled randomized trial, 66 patients with femoropopliteal, symptomatic (Rutherford stages 2B to 5) occlusive arterial disease were randomized to either mcPCB (study group) or POBA (plain old balloon angioplasty) (control group) on a 1:1 basis. Late lumen loss (LLL) at 6 months was the primary endpoint of the study and serious adverse events (SAE: death, amputation, repeated revascularization) were considered a composite secondary endpoint. Routine angiography was scheduled for all study subjects at 6-month follow-up; outpatient appointments were scheduled at 12 and 36 months after intervention. At 6 months, the LLL was 63% lower in the mcPCB group compared to the POBA group (0.52 ± 1.2 vs 1.39 ± 1.1 mm; psup < 0.01). Binary restenosis occurred in 23% vs 52% of patients ( p = 0.02). At 3 years, the prevalence of SAE was significantly lower in the mcPCB group (33.3 vs 63.3%; p = 0.02), which mainly resulted from a twofold reduction in target vessel revascularization rate (28.6 vs 59.3%; p = 0.02). The difference in mortality was nonsignificant (7.4 vs 14.3%; p = 0.42). Patients with mcPCB were less symptomatic and less likely to adhere to secondary prevention measures. In this pivotal trial, a novel mcPCB proved superior to POBA concerning LLL at 6-month follow-up, and SAE at 12 months. This result was sustained up to 3 years. There was no difference between groups regarding mortality. ClinicalTrials.gov Identifier: NCT02145065
Music therapy in the early detection and indicated prevention in persons at risk of bipolar disorders: State of knowledge and potential
Authors: Haugwitz Beate
Published: March 2021

Bipolar disorders are among the most severe mental illnesses. The onset of the disorder is frequently preceded by phases with subsyndromal symptoms. In Germany, psychiatric early detection centres provide prevention services for help-seeking young people which focus on risk research. This article considers how music therapy contributes to the indicated prevention of bipolar disorders in preparation for a qualitative research study. The article presents a narrative literature review on research into early detection and prediction in bipolar disorders and approaches to prevention. The rationale for the use of music therapy in this context is discussed, with consideration of research questions leading to the next stage of the study.
Home telemonitoring for chronic disease management: Perceptions of users and factors influencing adoption
Authors: Li Jane , Varnfield Marlien , Jayasena Rajiv , Celler Branko
Published: March 2021

Home telemonitoring has been used as a solution to support the care of individuals living with chronic disease. While effectiveness of telemonitoring have been widely studied, more research is needed to understand the perceptions among patients and clinicians in incorporating telemonitoring into their daily routine and practices. This paper presents an investigation of patients’ and clinicians’ experiences in a care augmenting telemonitoring service, their perceived impact delivered through the service, and clinicians’ perceptions on how the service was introduced in their organizations. This work was embedded in a large multi-site trial of home telemonitoring using a mixed method approach for evaluation. Interviews with clinicians involved in the study were conducted at multiple time points during the trial. Questionnaires were administered to clinicians and patients at the end of the trial. Results showed that both patients and clinicians recognized the benefits of patient empowerment through telemonitoring, and patient-clinician interactions. Results identified the needs of a dedicated telemonitoring clinical care coordinator role, guidelines that translate telemonitoring services into clinical pathways and engagement of different healthcare providers, especially general practitioners, to support the integration of telemonitoring into chronic disease management programs and long-term organizational strategic plans.
News gap in a digital news environment: Calibrating editorial importance from user-rated news quality and identifying user characteristics that close the news gap
Authors: Choi Sujin
Published: March 2021

While previous studies have found a clear gap between users’ news preferences and editors’ news choices, whether a similar user–editor gap exists when it comes to news quality evaluations remains an open question. We therefore conducted a nation-wide survey of 7810 South Korean users, collected online social indicators from a digital news platform, and asked users and editors to evaluate the quality of 1500 news articles and rank-order these articles’ editorial importance, respectively. Even after controlling for users’ news preferences and news genres, we found that users distinguished news articles quality in a manner comparable to that of editors. Our analysis also showed that users with higher issue involvement, issue knowledge, or ideological strength tended to rate news quality similar to editors. Moreover, we found that ideological strength served as an alternative cognitive schema for issue knowledge for individuals who lacked sufficient knowledge to assess news quality.
Exhaust valve phasing controllers for cold start NOx emissions reduction in heavy duty diesel engines
Authors: Salehi Rasoul , Middleton Robert J
Published: March 2021

In this paper, early exhaust valve opening (EVO) is applied to a diesel engine for fast warm up of the selective catalytic reduction (SCR) system with the ultimate goal of tailpipe NOx emissions reduction. By advancing EVO from top dead center, the exhaust gas temperature increases and the exhaust flow reduces, influencing the enthalpy available to warm up the SCR, and the engine-out NOx emissions increase or decrease depending on the engine’s operating conditions. Therefore, proper management of EVO is required to ensure that (1) engine-out NOx emissions do not increase when the SCR catalyst is cold; (2) heat transfer to the SCR increases and it warms up faster than the baseline operation (without EVO phasing); and (3) fuel consumption increase is minimal. A novel model predictive controller (MPC) is proposed for this application, assuming a limited preview of the drive cycle is available. For the MPC, an optimization objective function is applied such that a sequential warm up strategy can be implemented for the aftertreatment system catalysts. Using this technique, the prediction horizon for effective thermal management of the slow SCR system is reduced. In addition, a rule-based logic is offered as an alternative to the predictive controller to calculate the EVO trajectory with less computational power. Observations based on optimization problems solved by dynamic programing (DP) were used to develop the rule-based controller. Both the rule-based logic and model-based MPC are tested with a detailed high fidelity one-dimensional model in a model-in-the-loop simulator. Results indicate the potential of an EVO phasing system with the proposed controllers to reduce tailpipe NOx by 10% and 25% for the world harmonized transient cycle (WHTC) and federal test procedure (FTP), respectively. The rule-based controller has been found to be sensitive to the test drive cycle while the model based MPC shows a consistent performance, that is, independent of the test trajectory.
Can the six dimensions of Marketing Promotion enhance performance in the international shipbuilding industry?
Authors: Mascaraque-Ramírez Carlos , Para-González Lorena
Published: March 2021

The objective of this research is to analyse the degree of implementation of the six dimensions of Marketing Promotion in shipbuilding sector and the relationship between this degree and performance. The combined analysis of all Marketing Promotion dimensions identifies an improvement in performance of the companies that have made the greatest effort in terms of Promotion, being this influence mainly notable among Asian competitors. The specific study of each dimension detects similar efforts conducted by shipyards in terms of Personal sale, Sales promotion and Sponsorship, while it reveals differences in the use of Advertising, Public Relations and Direct Marketing techniques.
Autologous Heterogeneous Skin Construct Closes Traumatic Lower Extremity Wounds in Pediatric Patients: A Retrospective Case Series
Authors: Mundinger Gerhard S. , Stalder Mark W. , Lee James , Patterson Charles W. , Sharma Silpa , Womac Daniel J. , Sopko Nikolai A. , Swanson Edward W.
Published: March 2021

Lower extremity traumatic wounds pose unique challenges in pediatric patients, including vessel caliber, compliance with postoperative instructions, parental concerns about multiple operations, and long-term function. An autologous heterogeneous skin construct (AHSC) has demonstrated the ability to cover avascular structures and regenerate full-thickness functional skin. The objective of this study is to report our experience using AHSC in a cohort of pediatric trauma patients. This study is a noncontrolled, retrospective cohort analysis of all pediatric patients (<19 years of age) treated with AHSC for lower extremity traumatic wounds with at least one exposed deep structure (tendon, bone, and/or joint) at a single institution between May 1, 2018, and April 1, 2019. Seven patients with 10 traumatic wounds met inclusion criteria. The median follow-up time was 11.8 months. Five patients were male (71%); the median age was 7 years (range = 2-15 years). Average wound size was 105 cm2. All wounds achieved coverage of exposed structures and epithelial closure in a median of 13 and 69 days, respectively. There were no donor site complications and no reoperations required. All patients returned to normal activity, ambulate without limp, can wear shoes normally, and have normal tendon gliding. AHSC covered exposed structures and achieved closure within a single application in complex traumatic lower extremity wounds in a pediatric cohort.
Can EEG Abnormalities be a Biomarker of Epileptogenesis?
Authors: Gotman Jean
Published: March 2021

[Box: see text]
Toxicity and Informal Living in Esmeraldas, Ecuador
Authors: Hernández Maricarmen
Published: March 2021

This article follows Lety and her family, who were part of the first wave of settlers that established the 50 Casas neighborhood—a once informal community—in Esmeraldas, Ecuador, located near a petrochemical complex. From the outset, the residents of 50 Casas routinely dealt with, and continue to deal with, all the problems associated with living in an urban, informal settlement: lack of services, poor infrastructure, high poverty rates, and insecurity. However, on top of that, the 50 Casas residents also deal with the toxic exposures associated with the refinery.
The Arab Spring Protests
Authors: Charrad Mounira M. , Zarrugh Amina , Ha Hyun Jeong
Published: March 2021

In this photo essay, the authors examined over 3,500 photos of the early phase of the 2011 Arab Spring protests in Tunisia, Egypt, and Libya, to capture the meanings that protestors brought to the fore.
Return to Fanon
Authors: Burawoy Michael
Published: March 2021

Articulating the dangers and the possibilities of decolonization, Frantz Fanon’s The Wretched of the Earth, loomed large over African studies in the 1960s and 1970s. With its arousing language, its gripping descriptions, and its compelling argument, it traverses seamlessly between the psychological and the structural, between alienation and domination. Yet, it passes lightly over the connecting tissue, the social processes that are the entry point for ethnography. In this essay, the author sketches Fanon’s theory of decolonization, how it shaped one of his ethnographies of postcolonial Zambia, and ends with reflections on its significance today.
Association of Accelerometer-Measured Physical Activity and Cardiovascular Health in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Vásquez Priscilla M. , Durazo-Arvizu Ramon A. , Marquez David X. , Argos Maria , Lamar Melissa , Odoms-Young Angela , Gallo Linda C. , Sotres-Alvarez Daniela , Castañeda Sheila F. , Perreira Krista M. , Vidot Denise C. , Isasi Carmen R. , Gellman Marc D. , Daviglus Martha L.
Published: March 2021

Introduction:

Evidence regarding the associations between accelerometer-measured moderate-vigorous physical activity (MVPA) and cardiovascular health (CVH) indicators among Hispanic/Latino adults are unavailable.

Methods:

Examined cross-sectional data from 12,008 Hispanic/Latino adults aged 18–74 years participating in the Hispanic Community Health Study/Study of Latinos. Accelerometer-measured MVPA was assessed categorically and dichotomously per 2008 PA guidelines. Adverse and ideal CVH indicators were determined by standard cut-points for blood glucose, total cholesterol, blood pressure, body mass index (BMI), and smoking. A composite of low CV risk, defined as achieving all ideal CVH indicators, was included. Adjusted Poisson regression models and complex survey design methods were used for all analyses.

Results:

Compared to high MVPA, lower MVPA categories were associated with higher prevalence of all adverse CVH indicators, except hypertension, and with lower prevalence of low CV risk and ideal blood glucose, blood pressure, and BMI. Similarly, non-adherence to PA guidelines was associated with a higher prevalence of diabetes (16%), hypercholesterolemia (9%), obesity (28%), and smoking (9%); and lower prevalence of low CV risk (24%), ideal blood glucose (6%), ideal blood pressure (6%), and ideal BMI (22%).

Conclusion:

Overall, high accelerometer-measured MVPA and meeting PA guidelines were associated with favorable CVH in Hispanic/Latino adults.
PD-1-inhibitor pembrolizumab for treatment of progressive multifocal leukoencephalopathy
Authors: Möhn Nora , Wattjes Mike P. , Adams Ortwin , Nay Sandra , Tkachenko Daria , Salge Friederike , Heine Johanne , Pars Kaweh , Höglinger Günter , Respondek Gesine , Stangel Martin , Skripuletz Thomas , Jacobs Roland , Sühs Kurt-Wolfram
Published: March 2021

The reactivation of human JC polyoma virus (JCPyV) results in lytic infection of oligodendrocytes and neuronal cells. The corresponding clinical picture is called progressive multifocal leukoencephalopathy (PML) and results mostly from a disease-related or drug-induced immunosuppression. The opportunistic brain infection leads to a progressive demyelination of multiple areas of the central nervous system. Patients can present with various neurological deficits ranging from slight motoric symptoms to marked aphasia or reduced vigilance. Currently, there is no effective causal therapy for PML. Survival depends on the ability to achieve timely immune reconstitution. If the immune system cannot be restored, PML progresses rapidly and often ends fatally within months. Recently, some evidence for positive response has been reported in patients treated with immune checkpoint inhibitor therapy. Here, we provide a case series of three PML patients with underlying hematological malignancies who were treated with anti-PD-1-antibody pembrolizumab at Hannover Medical School. All patients received an extensive diagnostic follow-up including cerebrospinal fluid analysis, brain imaging, and lymphocyte-phenotyping via flow cytometry. Our patients had very different outcomes, with the only patient showing a specific anti-JCPyV immune response in the sense of an increased JCPyV antibody index clearly benefiting most from the treatment. Our results partly support the hypothesis that anti-PD-1 therapy may represent a promising treatment option for patients with PML. However, there is a current lack of pre-therapeutic stratification regarding the therapeutic response rates. Before larger studies can be initiated to further evaluate the efficacy of anti-PD-1 antibodies in PML, it is imperative to develop a reliable strategy for selecting suitable patients.
A randomized, multicenter phase II study comparing efficacy, safety and tolerability of two dosing regimens of cisplatin and pemetrexed in patients with advanced or metastatic non-small-cell lung cancer
Authors: Metzenmacher Martin , Kopp Hans-Georg , Griesinger Frank , Reinmuth Niels , Sebastian Martin , Serke Monika , Waller Cornelius Florian , Thomas Michael , Eggert Jochen , Schmid-Bindert Gerald , Hoiczyk Mathias , Christoph Daniel Christian , Kimmich Martin , Deuß Burkhard , Seifert Stephanie , Held Swantje , Schuler Martin , Herold Thomas , Breitenbuecher Frank , Eberhardt Wilfried Ernst Erich
Published: March 2021

Background:

Pemetrexed and cisplatin is a first-line standard in non-squamous non-small-cell lung cancer without targetable mutations. It became the backbone of checkpoint-inhibitor–chemotherapy combinations. Single high doses of cisplatin pose toxicity risks and require hyperhydration, potentially prolonging outpatient application. The aim of this study was to compare efficacy, safety and tolerability of split-dose cisplatin with the standard schedule.

Methods:

Patients with metastatic non-squamous non-small-cell lung cancer were randomly assigned to up to six 21-day cycles of pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 on day 1 (arm A), or pemetrexed 500 mg/m2 (day 1) and cisplatin 40 mg/m2 (day 1 + 8, arm B), followed by pemetrexed maintenance. Primary endpoint was objective response rate. Secondary objectives were overall survival, progression-free survival, time to progression, treatment compliance, toxicity profile, and quality of life.

Results:

We enrolled 130 patients (129 evaluable). Median cycle numbers in A and B were six (1–6) and five (1–6). Dose intensities were comparable between arms. More patients in A received pemetrexed maintenance (24.2% versus 11.1%). With 16 (24.2%) in A and 19 (30.2%) patients in B achieving objective responses [odds ratio 0.74 (0.34–1.62), p = 0.55] the primary endpoint was met. Overall survival was not different between arms (median 14.4 versus 14.9 months); [HR = 1.07; (0.68–1.68), p = 0.78]. Median progression-free survival was 7.0 months in A and 6.2 months in B [HR = 1.63; (1.17–2.38); p = 0.01]. Adverse events of CTCAE grade ⩾3, particularly hematological, were more frequent in B. No difference in grade 4 and 5 infections between arms was noted. Treatment-related asthenia and nausea/vomiting of any grade were more frequent in A. Global health status, fatigue and constipation measured on day 1 of cycle 4 demonstrated superior scores in B.

Conclusion:

Pemetrexed and split-dose cisplatin is safe and effective. Advantages of split-dose cisplatin with regard to specific toxicities allow personalization of this important chemotherapy backbone.

Trial Registration:

European Clinical Trials Database (EudraCT) number 2011-001963-37.
Glycated Hemoglobin Measurement: Comparison of Three Methods Versus High Performance Liquid Chromatography
Authors: Chaila María Zulema , Viniegra Matías , Gagliardino Juan José , Martínez Alfredo , Simesen de Bielke María Gabriela , Frusti Mauro , Monaco Luis , Salgado Pablo , Buso Carlos , Gonzalez Claudio Daniel , Commendatore Víctor Francisco
Published: March 2021

Background:

HbA1c result provide information on metabolic control in diabetes mellitus (DM) and could also be used for its diagnosis. For its determination, the laboratory must be certified by the National Glycohemoglobin Standardization Program (NGSP) or the International Federation of Clinical Chemistry (IFCC) and comply with a strict quality control program.

Aims:

To determine the correlation and agreement between HbA1c results measured by three analytical methods (enzymatic, turbidimetric, and capillary electrophoresis) versus HPLC.

Methods:

Method comparison—1245 samples from equal number of subjects at 45 Association of High Complexity Laboratories (Asociación de Laboratorios de Alta Complejidad—ALAC) centers, centralizing sample processing and operator. Statistical analysis—analysis of variance (ANOVA) and nonparametric Friedman ANOVA test for related samples, means, and medians. Correlation and concordance—Pearson’s correlation and linear regression, intraclass correlation coefficient (Passing and Bablock and Bland and Altman).

Results:

The comparison of mean values obtained by the four methods showed statistically significant, but clinically irrelevant, differences: HbA1c by HPLC versus Electrophoresis 0.06% (0.42 mmol/mol) P = .000 (± 1.96 DS -0.070 -0.047), Enzymatic 0.087% (1 mmol/mol) P = .000 (± 1.96 DS 0.077 0.098), Turbidimetric 0.056% (0.38 mmol/mol) P = 0.000 (± 1.96 DS -0.067 -0.044). Their concordance showed intraclass correlation of single measures of 0.982 P < .001 (95% CI 0.987 - 0.9838).

Conclusions:

The three methods present low variability and high correlation versus the HPLC.
Machine Learning-Based Anomaly Detection Algorithms to Alert Patients Using Sensor Augmented Pump of Infusion Site Failures
Authors: Meneghetti Lorenzo , Dassau Eyal , Doyle Francis J. , Del Favero Simone
Published: March 2021

Background:

Personal insulin pumps have shown to be effective in improving the quality of therapy for people with type 1 diabetes (T1D). However, the safety of this technology is limited by the possible infusion site failures, which are linked with hyperglycemia and ketoacidosis. Thanks to the large availability of collected data provided by modern therapeutic technologies, machine learning algorithms have the potential to provide new way to identify failures early and avert adverse events.

Methods:

A clinical dataset ( N = 20) is used to evaluate a novel method for detecting real-time infusion site failures using unsupervised anomaly detection algorithms, previously proposed and developed on in-silico data. An adapted feature engineering procedure is introduced to make the method able to operate in the absence of a closed-loop (CL) system and meal announcements.

Results:

In the optimal configuration, we obtained a performance of 0.75 Sensitivity (15 out of 20 total failures detected) and 0.08 FP/day, outperforming previously proposed literature algorithms. The algorithm was able to anticipate the replacement of the malfunctioning infusion sets by ~2 h on average.

Conclusions:

On the considered dataset, the proposed algorithm showed the potential to improve the safety of patients treated with sensor-augmented pump systems.
Technologies for Diabetes Self-Monitoring: A Scoping Review and Assessment Using the REASSURED Criteria
Authors: Zafra-Tanaka Jessica Hanae , Beran David , Vetter Beatrice , Sampath Rangarajan , Bernabe-Ortiz Antonio
Published: March 2021

Background:

Self-management is an important pillar for diabetes control and to achieve it, glucose self-monitoring devices are needed. Currently, there exist several different devices in the market and many others are being developed. However, whether these devices are suitable to be used in resource constrained settings is yet to be evaluated.

Aims:

To assess existing glucose monitoring tools and also those in development against the REASSURED which have been previously used to evaluate diagnostic tools for communicable diseases.

Methods:

We conducted a scoping review by searching PubMed for peer-review articles published in either English, Spanish or Portuguese in the last 5 years. We selected papers including information about devices used for self-monitoring and tested on humans with diabetes; then, the REASSURED criteria were used to assess them.

Results:

We found a total of 7 continuous glucose monitoring device groups, 6 non-continuous, and 6 devices in development. Accuracy varied between devices and most of them were either invasive or minimally invasive. Little to no evidence is published around robustness, affordability and delivery to those in need. However, when reviewing publicly available prices, none of the devices would be affordable for people living in low- and middle-income countries.

Conclusions:

Available devices cannot be considered adapted for use in self-monitoring in resource constraints settings. Further studies should aim to develop less-invasive devices that do not require a large set of components. Additionally, we suggest some improvement in the REASSURED criteria such as the inclusion of patient-important outcomes to increase its appropriateness to assess non-communicable diseases devices.
Bad-Alys and the Bad-Folx: Edge-Dwelling, Hope and How to Get Your Voice Heard
Authors: Mendus Alys
Published: March 2021

I attended a symposium on “Bad Girls” at the International Congress of Qualitative Inquiry (ICQI) 2018, looking for inspiration on how to make sense of myself and academia. When I asked, “How can I be a Bad Girl now?” I was told to go and get a job and get published. This autoethnographic piece shares stories of Bad-Alys, an Early Career Researcher trying to get published and finding her place as an academic. This paper was written to inspire the potentiality of change by exploring the concept of multiple selves from Etherington and Speedy, moving away from a binary to position Bad-Folx alongside Barad’s concept of entanglement; as activists and edge-dwellers within qualitative research. This is a paper of hope, offering ways to move-with the current-accepted paradigm of the academy by taking control of your doings as Ahmed would argue, through vignettes of collaborative inquiry, re-envisioning the use of conference spaces and self-publishing.
School Counselor Perceptions of Preparation and Importance of College and Career Readiness Counseling
Authors: Novakovic Alexandra , Patrikakou Eva N. , Ockerman Melissa S.
Published: March 2021

This study addresses school counselors’ perceptions of the importance of college and career readiness counseling and their preparedness to implement aspects of such counseling with students and families. Results from surveying school counselors in a large urban district serving a diverse, low-income student population indicated that school counselors did not believe they were well prepared to provide many aspects of college and career readiness counseling, although they perceived that each area was important to their work with students and families. We discuss implications for training school counselors in college and career readiness counseling.
Impact of Price Promotion, Corporate Social Responsibility, and Social Media Marketing on Word of Mouth
Authors: Hanaysha Jalal Rajeh
Published: March 2021

The purpose of this article was to test the effects of social media marketing, corporate social responsibility, and price promotion on word of mouth in the fast-food industry. Only a few scholars tested the mutual effect of the selected factors on word of mouth for global fast-food brands, mainly in the Asian region. The data were gathered from several fast-food restaurants’ visitors at different spots in east coast Malaysia through a survey tool. All of the filled questionnaires were analyzed using partial least square method. The analysis revealed that corporate social responsibility and social media marketing have a significant positive impact on consumers’ word of mouth. The findings also established that price promotion has a significant positive impact on word of mouth. These results enrich our understandings with regards to the importance of these marketing strategies in shaping word of mouth for fast-food restaurants in Malaysia.
Diabetes Insipidus and Concomitant Myocarditis: A Late Sequelae of COVID-19 Infection
Authors: Sheikh Abu Baker , Javed Nismat , Sheikh Abdul Ahad Ehsan , Upadhyay Shubhra , Shekhar Rahul
Published: March 2021

Severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019 (COVID-19), which has become a global pandemic. Apart from the mild features of the disease, long-term complications involve many systems including both endocrine and cardiovascular systems. Myocarditis, secondary to COVID-19, has become a well-known complication of the disease. However, endocrine complications are generally not common, particularly isolated pituitary abnormalities. There is one other report of diabetes insipidus developing as a late sequela of COVID-19. In this article, we report a case of a young male who presented with features of myocarditis but developed diabetes insipidus on day 7 of admission as a long-term complication after recovery from COVID-19 infection. His laboratory test results at the time of developing the complication revealed a high serum sodium level and low urine osmolality. The patient recovered on administration of desmopressin and was discharged after 16 days of hospitalization.
“Lighten This Burden of Ours”: Acceptability and Preferences Regarding Injectable Antiretroviral Treatment Among Adults and Youth Living With HIV in Coastal Kenya
Authors: Simoni Jane M. , Beima-Sofie Kristin , Wanje George , Mohamed Zahra H. , Tapia Kenneth , McClelland R. Scott , Ho Rodney J. Y. , Collier Ann C. , Graham Susan M.
Published: March 2021

Background:

Long-acting injectable (LAI) antiretroviral therapy (ART) may offer persons living with HIV (PLWH) an attractive alternative to pill-based treatment options, yet acceptability data remain scant, especially in sub-Saharan Africa.

Methods:

We conducted 6 focus group discussions with PLWH, including key stake holder groups, and analyzed data with content analysis.

Results:

Initial reactions to the idea of LAI-ART were often positive. The primary advantages voiced were potential to facilitate improved adherence and alleviate the burden of daily pill-taking while avoiding inadvertent disclosure and HIV stigma. Potential side effects were a particular concern of the women. Most participants preferred clinic-based administration over self-injections at home due to concerns about safety, privacy, and potential need for refrigeration.

Conclusions:

LAI-ART may be acceptable in Kenya, provided injections are infrequent and delivered in a clinic setting. However, HIV stigma, fear of potential side effects, and limited clinical capacity would need to be addressed.
Complaints and Satisfaction of Patients in Psychiatric Hospitals: The Case of Israel
Authors: Semyonov-Tal Keren
Published: March 2021

The main objective of the research is to advance knowledge in the field of patient experience. First, the research provides a classification of verbal responses by patients to an open-ended question (using content analysis) into distinct categories of concerns and complaints; and second, it examines (using regression analysis) the extent to which different types of complaints exert a differential impact on the level of patient satisfaction. The content analysis reveals that patient voice extends across a wide variety of issues, including complaints regarding physical conditions of the facility, quality of food, cleanliness, caregiver attitudes, availability of medical staff, lack of communication with staff, malpractice, and lack of privacy and respect. Linear regression analysis reveals that patients who complained about the hospitalization experience, especially complaints about interpersonal relations, are less likely to express satisfaction regarding hospitalization. The findings underscore the importance of patient’s complaints for understanding patient satisfaction (or dissatisfaction) with hospitalization. Patients’ complaints, especially in the area of interpersonal relations, are found to be consequential for the patient level of satisfaction.
Cardiac Amyloidosis Wild Type (ATTR-CAwt) and Associated Cardiac Arrhythmias: A Case Report and Literature Review
Authors: Nagarakanti Rangadham , Sankaramangalam Kesavan , Nagarakanti Sindhu , Moin Danyaal , Dulnuan Kenneth , Iyer Deepa B.
Published: March 2021

Cardiac amyloidosis wild type (ATTR-CAwt) is often the underdiagnosed cause of heart failure with preserved ejection fraction (HFpEF) and has a high mortality rate. There is usually a long delay between the appearance of clinical signs and the diagnosis of ATTR-CAwt but a short duration between diagnosis and death. ATTR-CAwt was associated with significant clinical arrhythmias. We report a case of ATTR-CAwt, the process of its diagnosis, and the associated clinical arrhythmias and their management. We also reviewed the literature of this underdiagnosed and potentially fatal condition and the current existing therapies.
COVID-19 pandemic-induced physical inactivity: the necessity of updating the Global Action Plan on Physical Activity 2018-2030
Authors: Amini H. , Habibi S. , Islamoglu A. H. , Isanejad E. , Uz C. , Daniyari H.
Published: March 2021

To prevent and reduce inactivity, the World Health Organization (WHO) designed a global plan called Global Action Plan on Physical Activity 2018–2030 (GAPPA) in 2017. In this plan and according to the state of physical activity in 2016, actions and goals were set. However, the world is facing a COVID-19 pandemic, which has affected various aspects of lifestyle, including physical activity. Some studies have shown that physical activity reduced during the pandemic. For this reason, the WHO should review the GAPPA and update goals and actions according to the state of physical activity in 2020.
Enhancing backcross programs through increased recombination
Authors: Tourrette Elise , Falque Matthieu , Martin Olivier C.
Published: March 2021

Background

Introgression of a quantitative trait locus (QTL) by successive backcrosses is used to improve elite lines (recurrent parent) by introducing alleles from exotic material (donor parent). In the absence of selection, the proportion of the donor genome decreases by half at each generation. However, since selection is for the donor allele at the QTL, elimination of the donor genome around that QTL will be much slower than in the rest of the genome (i.e. linkage drag). Using markers to monitor the genome around the QTL and in the genetic background can accelerate the return to the recurrent parent genome. Successful introgression of a locus depends partly on the occurrence of crossovers at favorable positions. However, the number of crossovers per generation is limited and their distribution along the genome is heterogeneous. Recently, techniques have been developed to modify these two recombination parameters.

Results

In this paper, we assess, by simulations in the context ofBrassicaceae, the effect of increased recombination on the efficiency of introgression programs by studying the decrease in linkage drag and the recovery of the recurrent genome. The simulated selection schemes begin by two generations of foreground selection and continue with one or more generations of background selection. Our results show that, when the QTL is in a region that initially lacked crossovers, an increase in recombination rate can decrease linkage drag by nearly ten-fold after the foreground selection and improves the return to the recurrent parent. However, if the QTL is in a region that is already rich in crossovers, an increase in recombination rate is detrimental.

Conclusions

Depending on the recombination rate in the region targeted for introgression, increasing it can be beneficial or detrimental. Thus, the simulations analysed in this paper help us understand how an increase in recombination rate can be beneficial. They also highlight the best methods that can be used to increase recombination rate, depending on the situation.
Y-LineageTracker: a high-throughput analysis framework for Y-chromosomal next-generation sequencing data
Authors: Chen Hao , Lu Yan , Lu Dongsheng , Xu Shuhua
Published: March 2021

Background

Y-chromosome DNA (Y-DNA) has been used for tracing paternal lineages and offers a clear path from an individual to a known, or likely, direct paternal ancestor. The advance of next-generation sequencing (NGS) technologies increasingly improves the resolution of the non-recombining region of the Y-chromosome (NRY). However, a lack of suitable computer tools prevents the use of NGS data from the Y-DNA studies.

Results

We developed Y-LineageTracker, a high-throughput analysis framework that not only utilizes state-of-the-art methodologies to automatically determine NRY haplogroups and identify microsatellite variants of Y-chromosome on a fine scale, but also optimizes comprehensive Y-DNA analysis methods for NGS data. Notably, Y-LineageTracker integrates the NRY haplogroup and Y-STR analysis modules with recognized strategies to robustly suggest an interpretation for paternal genetics and evolution. NRY haplogroup module mainly covers haplogroup classification, clustering analysis, phylogeny construction, and divergence time estimation of NRY haplogroups, and Y-STR module mainly includes Y-STR genotyping, statistical calculation, network analysis, and estimation of time to the most recent common ancestor (TMRCA) based on Y-STR haplotypes. Performance comparison indicated that Y-LineageTracker outperformed existing Y-DNA analysis tools for the high performance and satisfactory visualization effect.

Conclusions

Y-LineageTracker is an open-source and user-friendly command-line tool that provide multiple functions to efficiently analyze Y-DNA from NGS data at both Y-SNP and Y-STR level. Additionally, Y-LineageTracker supports various formats of input data and produces high-quality figures suitable for publication. Y-LineageTracker is coded with Python3 and supports Windows, Linux, and macOS platforms, and can be installed manually or via the Python Package Index (PyPI). The source code, examples, and manual of Y-LineageTracker are freely available athttps://www.picb.ac.cn/PGG/resource.phpor CodeOcean (https://codeocean.com/capsule/7424381/tree).
Transcriptional expression of secondary resistance genes ccdB and repA2 is enhanced in presence of cephalosporin and carbapenem in Escherichia coli
Authors: Baishya Somorita , Deshamukhya Chandrayee , Wangkheimayum Jayalaxmi , Das Bhaskar Jyoti , Anbarasu Anand , Talukdar Anupam Das , Bhattacharjee Amitabha , Choudhury Manabendra Dutta
Published: March 2021

Background

The issue of carbapenem resistance in E.coli is very concerning and it is speculated that cumulative effect of both primary resistance genes and secondary resistance genes that act as helper to the primary resistance genes are the reason behind their aggravation. Therefore, here we attempted to find the role of two secondary resistance genes (SRG) ccdB and repA2 in carbapenem resistance in E. coli (CRE). In this context influential genes belonging to secondary resistome that act as helper to the primary resistance genes like blaNDM and blaCTX-M in aggravating β-lactam resistance were selected from an earlier reported in silico study. Transcriptional expression of the selected genes in clinical isolates of E.coli that were discretely harboring blaNDM-1, blaNDM-4, blaNDM-5, blaNDM-7 and blaCTX-M-15 with and without carbapenem and cephalosporin stress (2 μg/ml) was determined by real time PCR. Cured mutants sets that were lacking (i) primary resistance genes, (ii) secondary resistance genes and (iii) both primary and secondary resistance genes were prepared by SDS treatment. These sets were then subjected to antibiotic susceptibility testing by Kirby Bauer disc diffusion method.

Results

Out of the 21 genes reported in the in silico study, 2 genes viz.repA2 and ccdB were selected for transcriptional expression analysis. repA2, coding replication regulatory protein, was downregulated in response to carbapenems and cephalosporins. ccdB, coding for plasmid maintenance protein, was also downregulated in response to carbapenems except imipenem and cephalosporins. Following plasmid elimination assay increase in diameter of zone of inhibition under stress of both antibiotics was observed as compared to uncured control hinting at the reversion of antibiotic susceptibility by the-then resistant bacteria.

Conclusion

SRGs repA2 and ccdB help sustenance of blaNDM and blaCTX-M under carbapenem and cephalosporin stress.
Healthcare professionals’ perspective on treatment burden and patient capacity in low-income rural populations: challenges and opportunities
Authors: Hardman Ruth , Begg Stephen , Spelten Evelien
Published: March 2021

Background

The challenges of chronic disease self-management in multimorbidity are well-known. Shippee’s Cumulative Complexity Model provides useful insights on burden and capacity factors affecting healthcare engagement and outcomes. This model reflects patient experience, but healthcare providers are reported to have a limited understanding of these concepts. Understanding burden and capacity is important for clinicians, since they can influence these factors both positively and negatively. This study aimed to explore the perspectives of healthcare providers using burden and capacity frameworks previously used only in patient studies.

Methods

Participants were twelve nursing and allied health providers providing chronic disease self-management support in low-income primary care settings. We used written vignettes, constructed from interviews with multimorbid patients at the same health centres, to explore how clinicians understood burden and capacity. Interviews were recorded and transcribed verbatim. Analysis was by the framework method, using Normalisation Process Theory to explore burden and the Theory of Patient Capacity to explore capacity.

Results

The framework analysis categories fitted the data well. All participants clearly understood capacity and were highly conscious of social (e.g. income, family demands), and psychological (e.g. cognitive, mental health) factors, in influencing engagement with healthcare. Not all clinicians recognised the term ‘treatment burden’, but the concept that it represented was familiar, with participants relating it both to specific treatment demands and to healthcare system deficiencies. Financial resources, health literacy and mental health were considered to have the biggest impact on capacity. Interaction between these factors and health system barriers (leading to increased burden) was a common and challenging occurrence that clinicians struggled to deal with.

Conclusions

The ability of health professionals to recognise burden and capacity has been questioned, but participants in this study displayed a level of understanding comparable to the patient literature. Many of the challenges identified were related to health system issues, which participants felt powerless to address. Despite their awareness of burden and capacity, health providers continued to operate within a single-disease model, likely to increase burden. These findings have implications for health system organisation, particularly the need for alternative models of care in multimorbidity.
High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study
Authors: Tago Masaki , Katsuki Naoko E. , Yaita Shizuka , Nakatani Eiji , Yamashita Shun , Oda Yoshimasa , Yamashita Shu-ichi
Published: March 2021

Background

The statistical validities of the official Japanese classifications of activities of daily living (ADLs), including bedriddenness ranks (BR) and cognitive function scores (CFS), have yet to be assessed. To this aim, we evaluated the ability of BR and CFS to assess ADLs using inter-rater reliability and criterion-related validity.

Methods

New inpatients aged ≥75 years were enrolled in this hospital-based prospective observational study. BR and CFS were assessed once by an attending nurse, and then by a social worker/medical clerk. We evaluated inter-rater reliability between different professions by calculating the concordance rate, kappa coefficient, Cronbach’s α, and intraclass correlation coefficient. We also estimated the relationship of the Barthel Index and Katz Index with the BR and CFS using Spearman’s correlation coefficients.

Results

For the 271 patients enrolled, BR at the first assessment revealed 66 normal, 10 of J1, 15 of J2, 18 of A1, 31 of A2, 37 of B1, 35 of B2, 22 of C1, and 32 of C2. The concordance rate between the two BR assessments was 68.6%, with a kappa coefficient of 0.61, Cronbach’s α of 0.91, and an intraclass correlation coefficient of 0.83, thus showing good inter-rater reliability. BR was negatively correlated with the Barthel Index (r = − 0.848, p < 0.001) and Katz Index (r = − 0.820, p < 0.001), showing justifiable criterion-related validity.

Meanwhile, CFS at the first assessment revealed 92 normal, 47 of 1, 19 of 2a, 30 of 2b, 60 of 3a, 8 of 3b, 8 of 4, and 0 of M. The concordance rate between the two CFS assessments was 70.1%, with a kappa coefficient of 0.62, Cronbach’s α of 0.87, and an intraclass correlation coefficient 0.78, thus also showing good inter-rater reliability. CFS was negatively correlated with the Barthel Index (r = − 0.667, p < 0.001) and Katz Index (r = − 0.661, p < 0.001), showing justifiable criterion-related validity.

Conclusions

BR and CFS could be reliable and easy-to-use grading scales of ADLs in acute clinical practice or large-scale screening, with high inter-rater reliabilities among different professions and significant correlations with well-established, though complicated to use, instruments to assess ADLs.

Trial registration

UMIN000041051 (2020/7/10).
Poor health-related physical fitness performance increases the overweight and obesity risk in older adults from Taiwan
Authors: Ho Chien-Chang , Lee Po-Fu , Chen Hui-Ling , Tseng Ching-Yu , Hsieh Xin-Yu , Chiu Chih-Hui
Published: March 2021

Background

The purpose of the present study was to investigate the associations between health-related physical fitness performance and overweight/obesity risk among Taiwanese healthy older adults.

Methods

A secondary dataset from the nationwide survey was applied in this study. Data from a total of 21,630 respondents aged 65–96 years were collected in this study. Demographic characteristics, life habits, perceived health status, anthropometric assessments, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis.

Results

The results indicated that overweight and obesity significantly associated with health-related physical fitness performance in the Taiwanese older adult population. In particular, the upper extremity muscular endurance scores of older adults with poor activity and physical fitness scores revealed obesity as a critical indicator of health-related physical fitness performance.

Conclusions

Future studies can use muscle quality or body fat classification to predict obesity in older adults, which could more precisely portray the relationship between obesity and health-related physical fitness performance.