bluuebunny/crossref_metadata_2025 huggingface dataset:
Data-driven thinking for measuring the human experience in the built environment
Authors: Tunçer Bige , Benita Francisco
Published: June 2021

This article introduces a methodology to implement Data-driven Thinking in the context of urban design. We present the results of a case study based on a 7-day workshop with 10 participants with landscape design and architecture background. The goal of the workshop was to expose participants to Data-driven Thinking through experimental design, multi-sensor data collection, data analysis, visualization, and insight generation. We evaluate their learning experience in designing an experimental setup, collecting real-time immediate environmental and physiological body reactions data. Our results from the workshop show that participants increased their knowledge about measuring, visualizing and understanding data of the surrounding built environment.
Evaluation of Diadochokinesis in Greek Preschoolers With Speech Sound Disorders Using a Diadochokinetic Rates Protocol
Authors: Tafiadis Dionysios , Zarokanellou Vasiliki , Voniati Louiza , Prentza Alexandra , Drosos Konstantinos , Papadopoulos Angelos , Ziavra Nafsika
Published: June 2021

The study aimed at evaluating the diadochokinetic (DDK) skills of Greek-speaking preschool children with phonological disorder (PD) by means of a structured evaluation protocol and at proposing cut-off points for children at risk of speech impairment. The participants were 36 children with PD and 60 typically developing (TD) peers. The groups were matched on age and gender. The PD group performed significantly slower than the TD group in all speech DDK tasks but not in the oral-motor tasks. The ROC analysis showed a statistically significant positive discrimination for all speech tasks. The internal consistency of the protocol was excellent (Cronbach’s α = .844), while complex stimuli showed a better discriminatory ability. The obtained results agree with Dodd’s classification for speech sound disorders (SSDs). Different types of speech stimuli must be included in the evaluation of DDK performance as a clinical predictor for preschoolers with SSDs who face difficulties in speech maturation.
Patient Reported Traditional Chinese Medicine Spleen Deficiency Syndrome (TCM-SDS) Scale for Colorectal Cancer: Development and Validation in China
Authors: Sun Lingyun , Mao Jun J. , Yan Yunzi , Xu Yun , Yang Yufei
Published: June 2021

Introduction:

Spleen Deficiency Syndrome (SDS) is recognized as one of the most common Traditional Chinse Medicine (TCM) syndromes in patients with colorectal cancer (CRC). However so far there is no existing patient-reported outcome (PRO) to evaluate SDS. Our study aimed to develop and validate a PRO TCM-SDS scale for CRC in China.

Methods:

We developed an initial 8-item TCM-SDS scale for CRC based on literature review and consultation with experts. We then pilot tested the scale ( n = 40) and performed item revision. We conducted a survey study among CRC patients from oncology clinics at a TCM Hospital to further determine the reliability and validity of the scale.

Results:

Among 100 patients finally enrolled and analyzed in the survey study, 46% were female with median age of 60 years old, 77% had left side tumors and 23% had stage IV disease. Factor loading indicated that there were three domains within TCM-SDS scale. The final TCM-SDS scale involves 5 items including “I feel loss of appetite,” “I feel abdomen fullness,” “I feel my arms and legs lack strength,” “I feel short of breath when talking,” and “My stool is formless” (Cronbach’s alpha coefficient 0.76). We calculated the total score of the scale by summing the 5 individual items and normalizing them to a value maximum of 10, with higher scores indicating greater burden of spleen deficiency syndrome. The average spleen deficiency score for all patients was 3.55 ± 1.54. Among them, those who had stage IV disease had higher scores than stage I-III patients (4.30 vs 3.38, P = .015). Test-retest reliability after 2 weeks showed Pearson coefficient of 0.67 and all items were highly related ( P < .001). Compared with healthy controls, CRC patients had significantly higher spleen deficiency scores (3.55 vs 3.23, P = .045).

Conclusion:

The patient-reported TCM-SDS scale for CRC showed adequate initial reliability and validity. The development of the scale provided an outcome measurement tool, which could facilitate future studies to better evaluate the role of TCM in treating CRC.
Effectiveness of Herbal Medicine for Leukopenia/Neutropenia Induced by Chemotherapy in Adults with Colorectal Cancer: A Systematic Review and Meta-analysis
Authors: Yan Shao-Hua , Feng Shuo , Xu Yun , Yan Yun-Zi , He Bin , Sun Ling-Yun , Pang Bing , Liu Wen-Jia , Xu Yu-Ying , Zhao Na , Tang Mo , Chen Yue , Yu Ming-Kun , Yang Yu-Fei
Published: June 2021

Objective:

To evaluate the effectiveness of Chinese Herbal Medicine (CHM) on leukopenia/neutropenia induced by chemotherapy in adults with colorectal cancer (CRC).

Methods:

Eight electronic databases were searched from their inception to June 2020. Randomized controlled trials with clarified sequence generation were qualified. Two reviewers independently conducted the screening and data extraction. Methodological quality was assessed using the Risk of Bias tool. RevMan 5.4 was applied to the meta-analysis.

Results:

Twenty-seven studies involving 1867 participants were qualified, of which 26 were included in the quantitative synthesis. Meta-analysis showed that CHM significantly reduced the incidence of leukopenia induced by chemotherapy (RR = 0.69; 95% CI 0.59-0.82), as well as the grade 3/4 leukopenia (RR = 0.71; 95% CI 0.55-0.90). Meanwhile,CHM decreased the occurrence of neutropenia (RR = 0.52, 95% CI 0.35-0.77), especially for the grades 3/4 neutropenia (RR = 0.42, 95% CI 0.27-0.64). Twenty-six of the included studies focused on the adverse events related to CHM.

Conclusion:

CHM may relieve neutropenia/leukopenia induced by chemotherapy in adults with colorectal cancer.
“I Wanted to Be There as a Father, but I Couldn’t”: A Qualitative Study of Fathers’ Experiences of Postpartum Depression and Their Help-Seeking Behavior
Authors: Pedersen Sarah Christine , Maindal Helle Terkildsen , Ryom Knud
Published: June 2021

Postpartum depression (PPD) is one of the most common mental health problems among new parents. Past studies have examined PPD in women; however, the condition is less understood in men. This study aimed to explore the lived experiences of men or fathers with PPD and to understand the barriers and facilitators of help-seeking among fathers with PPD. Eight fathers with PPD were interviewed and data were subsequently analyzed through interpretative phenomenological analysis. The fathers perceived fatherhood as an overwhelming experience and feelings of inadequacy and powerlessness were two of the main themes in the fathers’ experiences of PPD. The feeling of inadequacy and powerlessness was related to the fathers’ expectations for themselves and their role as a father. The fathers’ sense of inadequacy and powerlessness sometimes turned into anger and frustrations. In addition, the fathers experienced a variety of contributing stressors around the birth of their child. Further, the analysis revealed how the fathers’ help-seeking behavior was influenced by five contributing factors: recognition and perception of depressive symptoms; knowledge and beliefs about PPD; taboo, stigma and conforming to masculine norms; the fathers’ partner; screening and perinatal healthcare services. Paternal PPD has a significant impact on the fathers’ wellbeing and everyday lives. Findings indicate that parents-to-be may benefit from education on paternal PDD, and they highlight the importance of screening for paternal PPD and support tailored to the needs of fathers with signs of PPD.
L-Arginine reduces downstream vascular contractility after flow-diverting device deployment: A preliminary study in a rabbit model
Authors: Ayers-Ringler Jennifer , Kolumam Parameswaran Praveen , Khashim Zenith , Dai Daying , Ding Yong-Hong , Kallmes David F , Kadirvel Ramanathan
Published: June 2021

Background

Flow diverters (FDs) are an effective treatment for intracranial aneurysms, though not free from hemorrhagic complications. A previous study demonstrated increased vascular contractility after FD-implantation as a potential mechanism of distal complications. Our study aimed to investigate whether L-arginine medication affects vascular contractility following FD deployment in a rabbit model.

Methods

FDs were implanted in the aorta of normal rabbits (+FD, n = 10), with sham-operated aorta as controls (n = 5). L-Arginine was given in the drinking water (2.25% L-arginine hydrochloride) of half of the +FD animals (+FD/+Arg). Force contraction vascular contractility studies were performed on the aortic rings proximal and distal to the FD using an organ bath. Total eNOS, eNOS(pS1177), eNOS(pT495), COX-2, and S100A4 were quantified by western analysis on total protein lysates from aortic segments, normalizing to GAPDH.

Results

Mean vascular contractility was 53% higher in distal relative to proximal aortic segments (P = 0.0038) in +FD animals, but were not significantly different in +FD/+Arg animals, or in sham-operated controls. The +FD animals expressed significantly reduced levels of eNOS(pS1177) than sham-operated controls (P = 0.0335), while both the +FD and +FD/+Arg groups had reduced levels of eNOS(pT495) relative to sham-operated controls (P = 0.0331 and P = 0.0311, respectively).

Conclusion

These results suggest that L-arginine medication reduces distal vascular contractility after FD treatment via nitric oxide production and thus might mitigate risk for downstream complications.
Influence of nozzle outlet diameter on the atomization process of zirconia dry granulation
Authors: Yu Dongling , Zhu Zuoxiang , Zhou Jiangen , Liao Dahai , Wu Nanxing
Published: June 2021

In order to predict the atomization characteristics of the atomization process of zirconia dry granulation accurately, the influence of nozzle outlet diameter on the atomization characteristics of the atomization process of zirconia dry granulation is analyzed. The VOF method and RNG k-ε turbulence model are applied to numerically analyze the flow field of pressure-swirl nozzles with different outlet diameters of the atomization process of zirconia dry granulation, and the effects of outlet diameters on the spray cone angle, liquid film thickness, pressure distribution and velocity distribution are analyzed. The result shows that when the outlet diameter is increased from 3 to 4 mm, the diameter of air core and the outlet velocity of atomized liquid are increased, the spray cone angle is increased from 30.5° to 59.7° while the liquid film thickness is decreased, but when the outlet diameter is increased to 5 mm, the diameter of air core and the outlet velocity of atomized liquid are decreased, the spray cone angle is decreased to 27.6°, while the thickness of liquid film is decreased. The spray cone angle, moisture content of zirconia particles corresponding to nozzles with different outlet diameters are measured by the design of atomization experiment platform and the microstructure of zirconia particles are observed, which verifies the correctness of numerical analysis. Taking the atomization performance of nozzle into consideration, the pressure-swirl nozzle with the outlet diameter of 4 mm is better suitable for the atomization process of zirconia dry granulation.
Review of form 483s and warning letters to pharmaceutical manufacturers issued by USFDA
Authors: Saini Chandan , Miglani Ashish , Musyuni Pankaj , Aggarwal Geeta
Published: June 2021

Regular inspections are carried out to ensure system conformity by the Food and Drugs Regulatory Authority (FDA) of the United States one of the most stringent regulatory authorities in the world. The inspectors send Form 483 to the management after the inspection, detailing the inappropriate conditions. Because the FDA guidelines are difficult to comply with, a company can contravene the regulations. If any significant infringements can affect the protection, quality, effectiveness, or public health of the drug is identified, the FDA issues advice to the company. Warning Letters (WL) shall be an official notification of non-compliance with federal law within a period to be issued by manufacturer, clinician, distributor, or responsible person in the company. The delivery of a letter has a considerable impact on the company's reputation and position in the market. Inadequate WL reactions could lead to a refusal, import denial, memorandum or even conviction and order. A brief study was conducted in this document of Form 483 and WL for four years (2017–2020) on an understanding the regulatory provisions.
Quality of life of stroke survivors: A cross-sectional study of association with functional independence, self-reported fatigue and exercise self-efficacy
Authors: Ogwumike Omoyemi O , Omoregie Abimbola A , Dada Olumide O , Badaru Umaru M
Published: June 2021

Objectives

Stroke is a leading cause of disability and one of the most debilitating conditions especially in the developing world. Rehabilitation focuses on improving functional ability which may enhance quality of life (QoL). The aims of this study were to investigate the association between QoL and each of functional independence (FI), self-reported fatigue (SRF) and exercise self-efficacy (ESE) in stroke survivors.

Methods

This is a descriptive cross-sectional survey, documenting QoL, FI, SRF and ESE of stroke survivors seen at the physiotherapy outpatient clinics of two health care facilities in Oyo state, Nigeria. Descriptive and inferential statistics were used to analyse the data with significance level set at 0.05.

Results

Participants were 110 stroke survivors (64 males; 46 females) aged 60.9 ± 11.9 years. Significant associations were found between QoL and each of FI and ESE (p < 0.01) while no significant association was observed for SRF. FI strongly predicts good QoL in stroke survivors (OR = 16.34; p < 0.01) and high ESE is a determinant of QoL (OR = 6.46; p = 0.04). Stroke survivors with SRF were less likely to report good QoL.

Discussion

Functional independence and exercise self-efficacy were directly associated with QoL and were also major predictors of good QoL in stroke survivors.
Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
Authors: Lopez Sabela Rodriguez , Mangır Naşide
Published: June 2021

Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the muscle layer; however, the etiology and pathogenesis is still enigmatic. It has been suggested that mast cell activation, defects in the glycosaminoglycan layer, non-functional proliferation of bladder epithelial cells, neurogenic inflammation, microvascular abnormalities in the submucosal layer, autoimmunity and infectious causes may cause BPS/IC. Available treatment options include general relaxation techniques, patient education, behavioral treatments, physical therapy, multimodal pain therapy, oral (amitriptyline, cimetidine, hydroxyzine) and intravesical treatments (heparin, lidocaine, hyaluronic acid and chondroitin sulfate), hydrodistension and other more invasive treatments. Available treatments are mostly not based on a high level of evidence. Lack of understanding of disease mechanisms has resulted in lack of targeted therapies on this area and a wealth of empirical approaches with usually inadequate efficacy. The aim of this article is to review the available evidence on the pathophysiological mechanisms of BPS/IC as they relate to available treatment options.
Voluntary sector interventions to address loneliness and mental health in older people: taking account of emotional, psychological and social wellbeing
Authors: Dayson Chris , Harris Catherine , Woodward Abigail
Published: June 2021

Aims:

(1) To explore the relationship between loneliness and mental health in older people accessing interventions delivered through the voluntary sector. (2) To understand how these interventions can take account of mental health, discussing the relative strengths of a number of different one-to-one and group-based interventions.

Methods:

Qualitative case study of Age Better in Sheffield (ABiS), an initiative to address loneliness and isolation among older people (aged above 50). 37 beneficiaries of voluntary sector interventions participated in the study: 17 had accessed a one-to-one intervention and 20 had accessed group-based activities.

Results:

One-to-one therapeutic interventions are beneficial when loneliness is associated with low psychological and emotional wellbeing stemming from trauma and other complex pre-existing issues that have left individuals unable to build social relationships and networks. One-to-one peer-to-peer interventions are beneficial for individuals whose loneliness is linked to low psychological and emotional wellbeing but for whom their issues are less complex. Group-based interventions are beneficial when loneliness is linked to social wellbeing and individuals want to build social networks and relationships and contribute to their community. Participants should be supported to access other forms of support if the benefits of the initial intervention are to be sustained.

Conclusions:

There is an interconnected relationship between loneliness and the emotional, psychological and social components of mental health that should be taken into account in the design of interventions. A range of one-to-one and group-based interventions are necessary to meet the varying needs and circumstances of older people experiencing loneliness. Public health commissioners should invest in an ecosystem of voluntary organisations providing different types of loneliness intervention if the epidemic of loneliness is to be addressed.
Accuracy and Stability of a Subcutaneous Flash Glucose Monitoring System in Critically Ill Patients
Authors: Naraba Hiromu , Goto Tadahiro , Tokuda Mitsuhiro , Sonoo Tomohiro , Nakano Hidehiko , Takahashi Yuji , Hashimoto Hideki , Nakamura Kensuke
Published: June 2021

Background:

Flash glucose monitoring (FGM) systems can reduce glycemic variability and facilitate blood glucose management within the target range. However, in critically ill patients, only small ( n < 30) studies have examined the accuracy of FGM and none have assessed the stability of FGM accuracy. We evaluated the accuracy and stability of FGM in critically ill patients.

Method:

This was a single-center, retrospective observational study. We included a total of 116 critically ill patients who underwent FGM for glycemic control. The accuracy of FGM was assessed as follows using blood gas glucose values as a reference: (1) numerical accuracy using the mean absolute relative difference, (2) clinical accuracy using consensus error grid analysis, and (3) stability of accuracy assessing 14-day trends in consensus error grid distribution.

Results:

FGM sensors remained in situ for a median of 6 [4, 11] days. We compared 2014 pairs of measurements between the sensor and blood gas analysis. Glucose values from the sensor were consistently lower, with a mean absolute relative difference of 13.8% (±16.0%), than those from blood gas analysis. Consensus error grid analysis demonstrated 99.4% of the readings to be in a clinically acceptable accuracy zone. The accuracy of FGM was stable across the 14 days after device insertion.

Conclusions:

FGM had acceptable reliability and accuracy to arterial blood gas analysis in critically ill patients. In addition, the accuracy of FGM persisted for at least 14 days. Our study promotes the potential usefulness of FGM for glycemic monitoring in critically ill patients.
The Effects of Additional Local-Mixing Compartments in the DISST Model-Based Assessment of Insulin Sensitivity
Authors: Lam Nicholas , Murray Rua , Docherty Paul D. , Te Morenga Lisa , Chase J. Geoffrey
Published: June 2021

Background:

The identification of insulin sensitivity in glycemic modelling can be heavily obstructed by the presence of outlying data or unmodelled effects. The effect of data indicative of local mixing is especially problematic with models assuming rapid mixing of compartments. Methods such as manual removal of data and outlier detection methods have been used to improve parameter ID in these cases, but modelling data with more compartments is another potential approach.

Methods:

This research compares a mixing model with local depot site compartments with an existing, clinically validated insulin sensitivity test model. The Levenberg-Marquardt (LM) parameter identification method was implemented alongside a modified version (aLM) capable of operator-independent omission of outlier data in accordance with the 3 standard deviation rule. Three cases were tested: LM where data points suspected to be affected by incomplete mixing at the depot site were removed, aLM, and LM with the more complex mixing model.

Results:

While insulin parameters identified in the mixing model differed greatly from those in the DISST model, there were strong Spearman correlations of approximately 0.93 for the insulin sensitivity values identified across all 3 methods. The 2 models also showed comparable identification stability in insulin sensitivity estimation through a Monte Carlo analysis. However, the mixing model required modifications to the identification process to improve convergence, and still failed to converge to feasible parameters on 5 of the 212 trials.

Conclusions:

The mixing compartment model effectively captured the dynamics of mixing behavior, but with no significant improvement in insulin sensitivity identification.
Autologous Matrix-Induced Chondrogenesis (AMIC) for Isolated Retropatellar Cartilage Lesions: Outcome after a Follow-Up of Minimum 2 Years
Authors: Waltenspül Manuel , Suter Cyrill , Ackermann Jakob , Kühne Nathalie , Fucentese Sandro F.
Published: June 2021

Purpose

To evaluate autologous matrix-induced chondrogenesis (AMIC) for isolated focal retropatellar cartilage lesions and the influence of patellofemoral (PF) anatomy on clinical outcomes at a minimum of 2-year follow-up.

Methods

Twenty-nine consecutive patients (31 knees) who underwent retropatellar AMIC with a mean age of 27.9 ± 11.0 years were evaluated at a follow-up averaging 4.1 ± 1.9 years (range, 2-8 years). Patient factors, lesion morphology, and patient-reported outcome measures, including Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, Kujula score, and visual analogue scale (VAS) score were collected. PF anatomy was assessed on pre- and postoperative imaging, and subsequently correlated to outcome scores and failure to determine risk factors for poor outcome.

Results

At final follow-up, the AMIC graft failed in 4 cases (12.9%) at a mean follow-up of 21 ± 14.1 months. Patients with failed grafts had a significantly smaller patellar and Laurins’s PF angle than patients whose graft did not fail ( P = 0.008 and P = 0.004, respectively). Concomitant corrective surgery for patellar instability was performed in 29 knees (93.5%). Grafts that did not fail presented with an average Kujala score of 71.3 ± 16.9, KOOS Pain of 76.2 ± 16.6 and Tegner scores of 4.2 ± 1.8. The patellar angle was significantly associated with the patient’s satisfaction level ( r = 0.615; P < 0.001).

Conclusion

AMIC for retropatellar cartilage lesions in combination with concomitant corrective surgery for patellar instability results in low failure rate with satisfactory clinical outcome and patient satisfaction of almost 80% at mid-term follow-up. As most failures occurred in patients without concurrent tibial tubercle osteotomy and both a smaller patellar and Laurins’s PF angle were associated with less favorable outcome, this study supports the growing evidence for the need of unloading retropatellar cartilage repair, when indicated.

Level of Evidence

Case series; level of evidence, 4.
Resistant hypertension: Prevalence and profile of patients followed in a university ambulatory
Authors: Moura Ana Flávia , Moura-Neto José A , Rodrigues Cibele Isaac Saad , Miranda Mariana O , Carvalho Tulio Coelho , Paschoalin Carvalho Nathalia Pereira , Souza Edison , Moura-Jr José A , Cruz Constança Margarida S
Published: June 2021

Background:

Hypertension affects about 36 million Brazilians. It is estimated that 10%–20% of these have resistant hypertension. These patients are at an increased risk of early target organ damage, as well as cardiovascular and renal events.

Objective:

To estimate the prevalence of resistant hypertension in a specialized outpatient clinic, to describe the sociodemographic and clinical characteristics of these patients, and to identify possible factors associated with resistant hypertension.

Methods:

Data collection from medical records of hypertensive patients treated using oral antihypertensive drugs in optimized doses at a specialized university clinic from March 2014 to December 2014, after ethical approval statement. All patients were using appropriate antihypertensive drugs in optimized doses and assisted at a teaching-assistance clinic of internal medicine of the Bahiana School of Medicine and Public Health in Brazil.

Results:

A total of 104 patients were enrolled and 31.7% (n = 33) had criteria for resistant hypertension. Of the total participants, 75.7% were female and 54.8% were black or brown. The average age was 61.7 years (SD ± 10.1). In the resistant hypertension group, 63.6% had diabetes, compared to 32.4% in the hypertension group. Among resistant hypertensive patients, 51.5% had dyslipidemia. Regarding drug treatment, 75.8% of the resistant hypertension group and 51.4% of the hypertension group used statins. Among patients with resistant hypertension, 90.9% used angiotensin II receptor blockers and 66.7%, dihydropyridine calcium channel blockers. In the resistant hypertension group, 75.8% used beta-blockers, against 25.4% in the hypertension group.

Conclusion:

The prevalence of hypertension was higher than that described in the global literature, which may be associated with the high percentage of black and brown (“pardos”) patients in the population studied, and also because the study was performed in a specialized outpatient clinic.
Hepatitis B surface antigen and associated factors among mothers who had antenatal care contact in Attat Hospital, southern Ethiopia
Authors: Geda Yohannes Fikadu , Desse Hailu , Gesesse Molalegn Mesele , Berhe Tamirat Melis
Published: June 2021

Introduction:

Hepatitis B virus is a viral infection which can cause both acute and chronic liver disease. Predominately, this virus transmitted through the mother-to-child route. It is an endemic disease in low-resource setting countries like Ethiopia.

Objective:

Therefore, this study was used to assess magnitude and associated factors of hepatitis B surface antigen among pregnant mothers, who had antenatal care in Attat Hospital.

Method:

The cross-sectional study was conducted from 1 September 2019 to 30 January 2020. The data were collected from serological testing in laboratory and interview in antenatal care on 422 pregnant mothers. The data were entered into Epi Data version 3.1 and exported to SPSS version 24.0 for further analysis. Variables on bivariate analysis at p < 0.25 were taken to multivariate analysis. A p value of less than 0.05 on multivariate analysis was considered significant.

Result:

From 438 total samples, 422 respondents were participated and the mean age of the participants was 25.4 years (standard deviation ± 4.85). Magnitude of hepatitis B surface antigen was 10.9% (95% confidence interval: 8.3, 14.0). Respondents whose occupation was in government or self-employed were 67% (adjusted odds ratio = 0.33, 95% confidence interval: 0.12, 0.91) and whose number of gravidity was 3 and below were 79% (adjusted odds ratio = 0.21, 95% confidence interval: 0.04, 0.68) less likely to have hepatitis B surface antigen. Respondents who respond that hepatitis B surface antigen has cured were 1.52 times (adjusted odds ratio = 1.52, 95% confidence interval: 1.7, 9.4) more likely to have hepatitis B surface antigen. Respondents who answered hepatitis B surface antigen has vaccine were 57% (adjusted odds ratio = 0.43, 95% confidence interval: 0.05, 0.75) less likely to have hepatitis B surface antigen.

Conclusion:

Magnitude of hepatitis B surface antigen among mothers who were on antenatal care in Attat Hospital was high compared to other studies. Being employed in government or self-employed, gravida 3 and below, those who think that the disease has vaccine and those who think hepatitis B surface antigen was curable were statistically significant factors. Health promotion should be an important recommendation to be done by the hospital.
Epidemiology of hypertension in selected towns of Wollega zones, Western Ethiopia, 2019: A community-based cross-sectional study
Authors: Mosisa Getu , Regassa Bikila , Biru Bayise
Published: June 2021

Introduction:

Hypertension remains an emerging public health problem globally, particularly in developing countries. Age, income level, obesity, alcohol consumption, smoking, vegetables and fruit consumption, physical activity and chat chewing were some risk factors of hypertension. However, there are limited data on the epidemiology of hypertension in Ethiopia. This study aimed to assess Epidemiology of Hypertension among the community of selected towns of Wollega zones.

Methods:

A community-based cross-sectional study was conducted from 1 to 30 June 2019 in selected towns of Wollega zones. A multistage sampling technique was used to select 840 study participants. Data were collected using the WHO STEP wise approach. The data were coded and entered into EpiData 3, and exported to SPSS version 20.0 for analysis. Bivariate and multivariable logistic regression analyses were conducted. Statistical significance was declared at p-value < 0.05.

Results:

The study included a total of 838 respondents with a response rate of 99.7%. The prevalence of hypertension was found to be 189 (22.6%) (95% confidence interval = 19.9%–25.2%). Of this, 108 (12.9%) and 81 (9.7%) of female and male were hypertensive, respectively. Age groups of 30–44 years (adjusted odds ratio = 2.65 (1.43, 4.89)), 45–59 years (adjusted odds ratio = 3.55 (1.79, 7.04)), above 60 years (adjusted odds ratio = 2.97 (1.43, 6.18)), having history of alcohol consumption (adjusted odds ratio = 4.29 (2.4, 7.66)), involving in vigorous physical activity (adjusted odds ratio = 0.096 (0.028, 0.33)), not walking to and from the work (adjusted odds ratio = 13.12 (8.34, 20.67)), being overweight (adjusted odds ratio = 1.98 (1.21, 3.25)), inadequate fruits serving per day (adjusted odds ratio = 2.93 (1.75, 4.88)) were significantly associated with hypertension.

Conclusion:

The prevalence of hypertension was found to be high in the study area. Older age, alcohol consumption, not engaging in vigorous activity, physical inactivity, being overweight and inadequate intake of fruits were found to be risk factors for hypertension. Therefore, health care providers should provide extensive health education and promotion on recommended lifestyle modification to tackle the burden of hypertension.
Irrational drug use and its associated factors at Debre Markos Referral Hospital’s outpatient pharmacy in East Gojjam, Northwest Ethiopia
Authors: Melku Legese , Wubetu Muluken , Dessie Bekalu
Published: June 2021

Objectives:

Half of all drugs are used irrationally around the world, and about half of patients take their medications correctly. Inappropriate use of drugs leads to antibiotic resistance, medication therapy problems, and an increase in drug costs. This study aimed to assess irrational drug use and its associated factors at the outpatient pharmacy of Debre Markos Referral Hospital.

Methods:

A hospital-based cross-sectional study was used. Systematic random sampling was used as a sampling technique. The data were collected with a structured checklist. The data were entered into EPI Data Version 3.1 and analyzed using SPSS version 20. Descriptive statistics and logistic regression analysis were used for data analysis.

Results:

The average number of drugs per patient encounter was 2.14. The prevalence of antibiotics use per encounter was 39.3%. Polypharmacy was detected in 62.2% of prescriptions, and injections were prescribed in 13% of prescriptions. The percentage of drugs prescribed with a generic name was 95.5%. In multivariable logistic regression, comorbidities, professionals’ training, and prescribers’ experience were significantly associated with polypharmacy. Patient age, comorbidity, presence of chronic disease, professionals training, and type of diseases were significantly associated with antibiotic prescribing.

Conclusion:

Our findings revealed there were practices of polypharmacy and antibiotics overuse. Continuous seminars and training on rational prescribing and periodic prescription surveys are recommended to prevent irrational drug use.
Factors associated with knowledge, attitude, and practice of COVID-19 among health care professional’s working in South Wollo Zone Hospitals, Northeast Ethiopia
Authors: Bitew Gedamnesh , Sharew Mequannent , Belsti Yitayeh
Published: June 2021

Objectives:

This study is aimed to assess factors associated with knowledge, attitude, and practice of COVID-19 among health care professional’s working in South Wollo Zone Hospitals, Northeast Ethiopia.

Methods:

Institution-based cross-sectional study was conducted among 422 health care professionals from 10 July to 10 August 2020, at the South Wollo Zone. A pre-tested self-administered structured questionnaire was used to collect the data. Both bi- and multi-variable logistic regressions were fitted to identify variables significantly associated with the outcome variables. Adjusted odds ratios with 95% confidence interval and p-value < 0.05 were used to determine significant factors.

Results:

About 92.4%, 64%, and 55% of the respondents had good knowledge, favorable attitude, and good practices toward corona virus disease, respectively. Being female (adjusted odds ratio = 0.23, confidence interval: 0.10, 0.56), age ⩾ 35 years (adjusted odds ratio = 0.14, confidence interval: 0.22, 0.84), being unmarried (adjusted odds ratio = 0.20, confidence interval: 0.70, 0.59), getting information from radio and television (adjusted odds ratio = 6.02, confidence interval: 2.09, 17.36), having average monthly income 93.55–163.67 USD (adjusted odds ratio = 8.00, confidence interval: 0.94, 33.10), and average monthly income > 163.70 USD (adjusted odds ratio = 11.41, confidence interval: 1.41, 15.23) were significantly associated with good knowledge about COVID-19. In addition, being unmarried (adjusted odds ratio = 0.70, confidence interval: 0.49, 0.97), having bachelor of science degree and above (adjusted odds ratio = 1.87, confidence interval: 2.24, 2.83), and getting information from seminars and workshops (adjusted odds ratio = 0.59, confidence interval: 0.35, 0.98) had association with good practice toward COVID-19 prevention and control method.

Conclusion:

More than 90% of the health care workers have good knowledge; nearly half of the respondents had unfavorable attitudes and poor practice toward COVID-19. The findings imply that the government and other stakeholders should implement further strategies for enhancing to change health care professional’s attitude and encourage to practice prevention and control methods.
A first report of tumour-tracking radiotherapy with helical tomotherapy for lung and liver tumours: A double case report
Authors: Okada Wataru , Doi Hiroshi , Tanooka Masao , Sano Keisuke , Nakamura Kenji , Sakai Yusuke , Shibata Mayuri , Tanaka Masahiro
Published: June 2021

There are only a limited number of previous reports on clinical cases using tumour tracking with tomotherapy. Therefore, we present two cases of patients treated with tumour tracking with tomotherapy. First, a 74-year-old man with an inoperable lung cancer type T1bN0M0 underwent stereotactic body radiotherapy at a total dose of 48 Gy in four fractions. Second, a 68-year-old man with hepatocellular carcinoma with a portal venous tumour thrombosis and history of liver stereotactic body radiotherapy with fiducial marker implantation received radiotherapy at a total dose of 48 Gy in 20 fractions. The results of patient-specific quality assurance and tracking radiotherapy were sufficient to irradiate tumours. Tumour tracking with tomotherapy successfully delivered radiation in a total of 24 treatment fractions in both patients. Tumour tracking with tomotherapy is feasible in lung and liver cancer treatment. This study’s findings suggest the clinical use of tumour tracking with tomotherapy.
A massive postoperative stroke caused by a carotid thrombus that occurred during the surgical repair of an aortic dissection
Authors: Nemoto Hiroko , Uchida Keiji , Minami Tomoyuki , Yasuda Shota , Cho Tomoki , Masuda Munetaka
Published: June 2021

A 59-year-old man with no prior neurological deficits developed a massive stroke during the repair of a double-barreled acute type A aortic dissection with major entry in the ascending aorta and an occluded brachiocephalic artery. As right cerebral ischemia was alleviated by the circle of Willis, the patient was alert and conscious preoperatively. Nevertheless, the thrombus in the right carotid artery induced a severe postoperative right cerebral embolism. In conclusion, occlusion of the carotid artery is a risk factor of postoperative severe stroke, even in patients without neurological symptoms preoperatively.
Analysis of allergen profile in patients sensitized to canine allergen and potential Can f 5 cross-reactivity with human PSA
Authors: Ukleja-Sokołowska Natalia , Lis Kinga , Żbikowska-Gotz Magdalena , Adamczak Rafał , Bartuzi Zbigniew
Published: June 2021

Can f 5 allergy and possible cross-reactivity with human semen in which there are significant amounts of prostate-specific antigen (PSA) are particularly interesting aspects of allergy to dog. The objective of the study was to confirm cross-reactivity between human PSA and Can f 5 in a study of canine sensitised women. A total of 100 women (aged 18–73, 41 on average) with a positive history of animal fur allergy or positive skin prick tests to canine allergens were selected. Levels of Immunoglobulin E (IgE) specific to Can f 1, Can f 2, Can f 3, Can f 5 were determined. Patients with increased concentration of sIgE Can f 5 were selected for further inhibition testing using polystyrene microplate ELISA test coated with human PSA. In the studied population, allergy to Can f 5 dominated (52.3% of patients with increased concentration of canine-specific IgE were allergic to this allergenic component). In all analyzed cases, the concentration of IgE Can f 5 decreased after incubation on the ELISA plate coated with human PSA. The minimum decrease in concentration was 10.44%, the maximum was 37.73%, the average decrease was 21.6%. No statistically significant influence of the presence or absence of allergenic sIgE Can f 5 in blood serum on the occurrence of symptoms after intercourse was found. The study confirmed the moderate ability of Can f 5 to cross-react with human PSA sIgE, which may be clinically significant in some women. At the same time, symptoms of an allergy to male semen do not constitute a typical clinical presentation of allergy to Can f 5.
COVID Arm: Delayed Hypersensitivity Reactions to SARS-CoV-2 Vaccines Misdiagnosed as Cellulitis
Authors: Lindgren Aleksandra L. , Austin Andrea Hui , Welsh Kathleen M.
Published: June 2021

The term “COVID arm” has been coined to describe a harmless delayed hypersensitivity reaction occurring approximately a week after administration of the novel SARS-CoV-2 mRNA vaccine. It appears as a red, warm, pruritic, indurated, or swollen area in the vicinity of the vaccine site. These reactions, especially if accompanied by systemic symptoms, have been mistaken for cellulitis. We report 3 cases of COVID arm, 2 of which were mistaken for cellulitis. Distinguishing features of COVID arm from cellulitis include pruritus as a common finding, occurrence approximately a week after vaccination, a lack of progression of symptoms, rapid response to topical steroids, and/or spontaneous resolution usually over 4 to 5 days.

Practice Points:

• Patients receiving SARS-CoV-2 vaccines may experience delayed hypersensitivity reactions characterized by erythema, swelling, and itching occurring near the vaccination site (COVID arm), approximately a week after vaccination.

• Clinicians can distinguish SARS-CoV-2 vaccine reactions from cellulitis by the time of onset (approximately a week vs 5 days), by the lack of progression of symptoms, and resolution over 4 to 5 days.

• Severe cases of COVID arm may be treated with topical steroids.
Deployment of Rhetorical and Literary Tropes in Ewa-ọma Festival Performances of Nkporo, South-East Nigeria
Authors: Egwu Anya Ude , Igwebuike Ebuka Elias , Abonyi Chinasa
Published: June 2021

African traditional drama has been researched from several perspectives. But there are hardly studies fully focusing on the deployment of language to achieve performance goals in particular performances. This failure may have roots in the widely held assumption that verbal language (dialogue) is not a serious element of African traditional drama. Studying language in particular performances will show that there are instances of full and effective deployment of verbal communication in the African traditional drama. This article, therefore, studies language in ewa-ọma performances. Using basic literary appreciation and critical analysis methods, with a new historicist bias, the literary and rhetorical components of language are identified and analyzed according to their space-time relevance in two performances, to demonstrate the manner of realization of dialogue and (inter)weaving of literary and rhetorical strategies. Literary tropes and rhetorical devices are effectively deployed in well-developed dialogues to achieve a satirical goal in the performances.
In-regime manager: China’s strategy against nuclear India
Authors: Lee Kihyun , Kim Jangho , Ji Yeon-jung
Published: June 2021

This paper examines China’s strategy toward India’s emergence as a nuclear weapons state that reflects boundary work and delineates Beijing’s bond and boundaries of solidarity among member states in the nuclear nonproliferation regime. China’s preferred approach toward India is to maintain an asymmetrical position, to continue with a group-based resistance, and to leverage the scope of conflicts. While many previous studies indicate that China’s foreign policy toward India was an offshoot of a Cold War rivalry and its competition with the United States, with which we agree, this study explores how China’s India policy has shaped a border zone that requires a separate risk management approach. Our study has two findings: First, while Beijing perceives India’s threat as moderate, there has been an increase in New Delhi’s capability to create greater space for future bargaining tasks. Second, to keep India’s threat circumscribed, China has built a challenge-proof group arrangement that proposes a group-binding policy agenda, thus lowering the diplomatic cost for members in the current regime structure. Thus far, Beijing’s strategic action has been more cost-beneficial than India’s counterapproach. Overall, this case study indicates that a regime matters between two competing global powers.
Magnetic Flux Leakage Course of Inner Defects and Its Detectable Depth
Authors: Wu Jianbo , Wu Wenqiang , Li Erlong , Kang Yihua
Published: June 2021

As a promising non-destructive testing (NDT) method, magnetic flux leakage (MFL) testing has been widely used for steel structure inspection. However, MFL testing still faces a great challenge to detect inner defects. Existing MFL course researches mainly focus on surface-breaking defects while that of inner defects is overlooked. In the paper, MFL course of inner defects is investigated by building magnetic circuit models, performing numerical simulations, and conducting MFL experiments. It is found that the near-surface wall has an enhancing effect on the MFL course due to higher permeability of steel than that of air. Further, a high-sensitivity MFL testing method consisting of Helmholtz coil magnetization and induction coil with a high permeability core is proposed to increase the detectable depth of inner defects. Experimental results show that inner defects with buried depth up to 80.0 mm can be detected, suggesting that the proposed MFL method has the potential to detect deeply-buried defects and has a promising future in the field of NDT.
NiCo2S4 Nanocrystals on Nitrogen-Doped Carbon Nanotubes as High-Performance Anode for Lithium-Ion Batteries
Authors: Han Haisheng , Song Yanli , Zhang Yongguang , Kalimuldina Gulnur , Bakenov Zhumabay
Published: June 2021

In recent years, the development of lithium-ion batteries (LIBs) with high energy density has become one of the important research directions to fulfill the needs of electric vehicles and smart grid technologies. Nowadays, traditional LIBs have reached their limits in terms of capacity, cycle life, and stability, necessitating their further improvement and development of alternative materials with remarkably enhanced properties. A nitrogen-containing carbon nanotube (N-CNT) host for bimetallic sulfide (NiCo2S4) is proposed in this study as an anode with attractive electrochemical performance for LIBs. The prepared NiCo2S4/N-CNT nanocomposite exhibited improved cycling stability, rate performance, and an excellent reversible capacity of 623.0 mAh g–1 after 100 cycles at 0.1 A g–1 and maintained a high capacity and cycling stability at 0.5 A g–1. The excellent electrochemical performance of the composite can be attributed to the unique porous structure, which can effectively enhance the diffusivity of Li ions while mitigating the volume expansion during the charge–discharge processes.
Associations of novel 24-h accelerometer-derived metrics with adiposity in children and adolescents
Authors: Dygrýn Jan , Medrano María , Molina-Garcia Pablo , Rubín Lukáš , Jakubec Lukáš , Janda David , Gába Aleš
Published: June 2021

Background

Further research is required to explore the associations between 24-h movement behaviours and health outcomes in the paediatric population. Therefore, this study aimed to examine the associations between novel data-driven 24-h activity metrics and adiposity among children and adolescents.

Methods

The sample included 382 children (8–13 years) and 338 adolescents (14–18 years). The average acceleration (AvAcc) of activity, intensity gradient (IG), and metrics representing the initial acceleration for the most active time periods of the 24-h cycle were calculated from raw acceleration data. Adiposity measures included body mass index z-score, fat mass percentage (FM%), and visceral adipose tissue (VAT). Data analysis was performed using multiple linear regression adjusted for wear time, sex, maternal education level, and maternal overweight and obesity.

Results

Children demonstrated higher values in all 24-h activity metrics than did adolescents (p < 0.001 for all). For children, the initial acceleration for the most active 2, 5, 15, and 30 min of the 24-h cycle were negatively associated with FM% (p ≤ 0.043 for all) and VAT (p <0.001 for all), respectively. For adolescents, the IG was negatively associated with FM% (p = 0.002) and VAT (p = 0.007). Moreover, initial acceleration for the most active 2, 5, 15, 30, 60, and 120 min were associated with FM% (p ≤ 0.007 for all) and with VAT (p ≤ 0.023 for all).

Conclusions

The intensity distribution of activity and initial acceleration for the most active 2, 5, 15, 30, 60, and 120 min within the 24-h cycle are beneficial for the prevention of excess adiposity in the paediatric population.