bluuebunny/crossref_metadata_2025 huggingface dataset:
Vibration stability analysis of cantilever structure based on symbolic regression algorithm and modal analysis method
Authors: Jiang Xuchu , Zhang Hu , Li Ying , Jiang Wei , Mao Xinyong , Lin Hai , Zhang Biao
Published: May 2021

The vibration stability of cantilever mechanism under high-speed rotation directly affects the positioning accuracy. Modal analysis method is usually used to study the vibration stability. However, the traditional experimental modal analysis (EMA) method needs to measure the impulse excitation, while the operational modal analysis (OMA) method needs to satisfy the assumption of white noise. Therefore, the existing modal analysis methods cannot be applied to the study of vibration stability of high-frequency cantilever mechanism. In this paper, the symbolic regression (SR) algorithm is combined with the EMA method, and the robustness analysis and feasibility verification are carried out under the condition of adding noise. The validation of the new method is divided into two parts. In the first part, a three degree of freedom (DOF) linear model is constructed, and the modal parameters identified by SR method and state space method are compared. In the second part, the method is applied to identify the modal parameters of stepped bar. The results are compared with the results of LMS (Siemens’ Testlab). Based on the time-domain response signal only, the modal parameters are extracted by SR, and the main vibration frequency is extracted from the response signal. The system simulation and experimental results show the method provides a possibility to analyze the vibration stability of cantilever structure.
Sphygmomanometer-induced hemostasis following iatrogenic guidewire perforation during lower extremity angioplasty
Authors: Chait Jesse , Ostrozhynskyy Yuriy , Marks Natalie , Singh Nikita , Hingorani Anil , Ascher Enrico
Published: May 2021

Objectives

Iatrogenic guidewire perforation is a well-known complication of lower extremity angioplasty that is often benign or can be easily treated with endovascular techniques. However, perforations that occur in arterial side branches may be more challenging to manage. If bleeding persists, open surgery and fasciotomy may be required to evacuate the resulting hematoma and prevent compartment syndrome. These subsequent procedures increase morbidity and, if the angioplasty was performed in the outpatient setting, necessitate patient transfer to a hospital. To address these challenges, we describe a non-invasive hemostasis technique involving serial sphygmomanometer cuff inflations over the affected site in a series of five patients who experienced this complication at our office.

Methods

We retrospectively reviewed the medical records of consecutive patients undergoing lower extremity angioplasty that were found to have an arterial guidewire perforation on completion angiogram at our outpatient center between February 2012 and February 2017. Patients found to have iatrogenic guidewire perforations were administered intravenous protamine sulfate and were transferred to the surgical recovery room. Patients received ibuprofen or acetaminophen for pain management. A blood pressure cuff was placed around the site of perforation, and patients received serial cuff inflation cycles with repeated examinations of both limbs until patients reported cessation of pain and there were no signs of a developing hematoma. Patients were observed for two hours before they were discharged home. A follow-up duplex ultrasound examination was completed within one week of the intervention.

Results

Over the course of five years, 536 angioplasties were performed at our outpatient office. Five of these patients experienced iatrogenic guidewire perforation (0.93%). Perforations occurred in branches of the anterior or posterior tibial artery. All of these patients were successfully managed with the aforementioned hemostasis technique. None of these patients required transfer to a hospital for further management, and no complications were reported at follow-up.

Conclusions

Complications of iatrogenic guidewire perforations in lower extremity arterial side branches can be safely and effectively managed by applying external compression around the affected site with an automatic blood pressure cuff.
Dynamic visual servoing with Kalman filter-based depth and velocity estimator
Authors: Chang Ting-Yu , Chang Wei-Che , Cheng Ming-Yang , Yang Shih-Sian
Published: May 2021

Camera calibration error, vision latency, nonlinear dynamics, and so on present a major challenge for designing the control scheme for a visual servoing system. Although many approaches on visual servoing have been proposed, surprisingly, only a few of them have taken into account system dynamics in the control design of a visual servoing system. In addition, the depth information of feature points is essential in the image-based visual servoing architecture. As a result, to cope with the aforementioned problems, this article proposes a Kalman filter-based depth and velocity estimator and a modified image-based dynamic visual servoing architecture that takes into consideration the system dynamics in its control design. In particular, the Kalman filter is exploited to deal with the problems caused by vision latency and image noise so as to facilitate the estimation of the joint velocity of the robot using image information only. Moreover, in the modified image-based dynamic visual servoing architecture, the computed torque control scheme is used to compensate for system dynamics and the Kalman filter is used to provide accurate depth information of the feature points. Results of visual servoing experiments conducted on a two-degree of freedom planar robot verify the effectiveness of the proposed approach.
Factors Influencing the Attitude Toward Anti-Littering Behavior
Authors: Singh Jagwinder , Kaur Ranjit
Published: May 2021

Guided by the health belief model (HBM), the present study attempts to assess the influence of three major constructs of HBM namely perceived threat, perceived barriers, and perceived benefits on the attitude toward anti-littering behavior. In total, 750 individuals were interviewed at 34 locations across the states of New Delhi and Punjab in a field survey. Empirical research had been conducted through confirmatory factor analysis in AMOS 21.0 to classify the predictors of the four constructs according to their relative significance using the natural gaps in standardized regression weight values. Subsequently, path analysis has been used to test a series of hypotheses concerning the direct effects of perceived threat, perceived barriers, and perceived benefits on attitude toward anti-littering behavior. The findings of the study reveal that perceived barriers and perceived benefits have a significant influence on the attitude, whereas perceived threat does not have a significant influence on the attitude.
Does Cortical Inhibition Explain the Correlation Between Bistable Perception Paradigms?
Authors: Jagtap Abhilasha R. , Brascamp Jan W.
Published: May 2021

When observers view a perceptually bistable stimulus, their perception changes stochastically. Various studies have shown across-observer correlations in the percept durations for different bistable stimuli including binocular rivalry stimuli and bistable moving plaids. Previous work on binocular rivalry posits that neural inhibition in the visual hierarchy is a factor involved in the perceptual fluctuations in that paradigm. Here, in order to investigate whether between-observer variability in cortical inhibition underlies correlated percept durations between binocular rivalry and bistable moving plaid perception, we used center-surround suppression as a behavioral measure of cortical inhibition. We recruited 217 participants in a test battery that included bistable perception paradigms as well as a center-surround suppression paradigm. While we were able to successfully replicate the correlations between binocular rivalry and bistable moving plaid perception, we did not find a correlation between center-surround suppression strength and percept durations for any form of bistable perception. Moreover, the results from a mediation analysis indicate that center-surround suppression is not the mediating factor in the correlation between binocular rivalry and bistable moving plaids. These results do not support the idea that cortical inhibition can explain the between-observer correlation in mean percept duration between binocular rivalry and bistable moving plaid perception.
German children’s art during World War I
Authors: Kay Carolyn
Published: May 2021

My article considers German wartime propaganda and pedagogy from 1914 to 1916, which influenced young schoolchildren (aged 5–14) to create drawings and paintings of Germany’s military in World War I. In this art, the children drew bodies of German soldiers as tough, heroic, on the move, armed with powerful weapons, and part of a superior military movement; their enemies (French, Russian, British soldiers) embodied disorder, backwardness, ineptitude, and deadly weakness. The artwork by these schoolchildren thus reveals the intense propaganda of the war years, and the children’s tendency to see the German military as the most accomplished combatant in the war. During the first two years of the war, in the primary schools of the nation, many children did such art under the supervision of teachers who passionately embraced the nation and the war cause. Within the classroom, teachers directed students to imagine the war by drawing scenes of battles, including the sinking of the Lusitania. Some of these teachers had been influenced by the Kunsterziehungsbewegung (the arts’ education movement) and thus encouraged children’s creativity in art of the war years. In this pedagogical wartime environment the young student became actively engaged in creative learning and study about the war, expressing romantic ideas of the indomitable German soldier and sailor. My research has involved analysis of over 250 school drawings done by children aged 10–14 in a school in Wilhelmsburg, near Hamburg, in 1915. I analyze the depiction of the German forces in six of these sources and also consider the history of art instruction in German schools. Furthermore, I address the ways in which historians can analyze children’s art as a historical document for understanding the child’s experience.
Trends in benzodiazepine receptor agonists use and associated factors in the Belgian general older population: analysis of the Belgian health interview survey data
Authors: Pétein Catherine , Spinewine Anne , Henrard Séverine
Published: May 2021

Background:

Benzodiazepine receptor agonists (BZRA), which include benzodiazepines and z-drugs, are commonly prescribed for insomnia and anxiety in older adults, and used often long term. Yet, the risk–benefit ratio of BZRA use in older adults may be unfavorable and many recommendations suggest avoidance or a maximal treatment duration of 4 weeks. The aim of this study was to describe trends of BZRA use in older adults and associated factors.

Methods:

Using data from the Belgian Health Interview Survey in 2004 ( n = 3594), 2008 ( n = 2917), and 2013 ( n = 2048), prevalence standardized for age, sex, and region were calculated to assess trends of BZRA use in people ⩾65 years. Analysis of associated factors to BZRA use was performed using a sub-sample of 2013 data for which variables assessing sleeping disorder and anxiety disorder were not missing ( n = 1286). Variables from seven main topics were explored using multivariate logistic regression: socio-demographic factors, geriatric factors, comorbidities, subjective health and mental health indicators, social health indicators, medication use and healthcare services use.

Results:

Overall, standardized prevalence of BZRA use decreased significantly between 2004 and 2013 [22% to 18%, prevalence difference (95% confidence interval, CI): −4.0% (−6.8; −1.3)]. Factors associated with BZRA use in multivariable analysis included female gender [adjusted odds ratio (aOR) (95%CI) : 1.62 (1.14; 2.29)], poor mental health [aOR (95%CI): 1.73 (1.13–2.63)] a fall in the past 12 months [aOR (95%CI): 1.52 (1.02; 2.26), reporting a sleeping disorder [aOR (95%CI): 1.92 (1.35; 2.72)], polypharmacy [aOR (95%CI): 2.51 (1.75; 3.60)], and trazodone use [aOR (95%CI): 4.05 (1.64; 10.21)].

Conclusion:

Despite an encouraging decline observed from 2004 to 2013, BZRA use remained highly prevalent in Belgian older adults. Promotion of alternatives to BZRA in treatment of sleeping problems need to be continued. Among BZRA older users, women, the oldest (⩾85 years) and high-risk subgroups should be targeted in deprescribing interventions.
COVID-19-Induced Hoarding Intention Among the Educated Segment in Indonesia
Authors: Syahrivar Jhanghiz , Genoveva Genoveva , Chairy Chairy , Manurung Siska Purnama
Published: May 2021

The media commonly reports panic buying amid the COVID-19 pandemic. Panic buying occurs when people engage in hoarding of basic needs as well as protective materials, which drives scarcity and price increases. There are four variables integrated in this study which are COVID-19-induced hoarding intention, COVID-19-related attitude, COVID-19-related knowledge, and health locus of control. This study gathered 265 university professors from 25 prominent public and private universities in Indonesia. To our best knowledge, this is the first study that discusses hoarding intention during the pandemic among the educated segment. Structural Equation Modeling (SEM analysis) via AMOS software was employed to test the hypotheses. This study reveals that (a) a better knowledge about the COVID-19 pandemic increases vigilance toward the COVID-19 pandemic and (b) a higher external health locus of control increases the COVID-19-induced hoarding intention. The theoretical contributions as well as managerial implications of this study, especially to policy makers, are provided.
Exploring Occupational Health Professionals Understanding and Needs in Regard to Total Worker Health (TWH)
Authors: Olszewski Kimberly A. , Wolf Debra M. , Wenskovitch John
Published: May 2021

Background:

Occupational health professionals (OHPs) are in a unique position to impact the health and well-being of employees at work and outside of work. One way of achieving this holistic health goal is to integrate the concept of Total Worker Health® (TWH) into the organization’s culture. It is critical for OHPs to develop the ability to incorporate TWH into their practices, yet there are gaps in our understanding of OHP’s attitudes toward change and toward TWH, their level of TWH knowledge, and the number of OHPs who have adopted TWH.

Methods:

An electronic survey was administered to a national sample of 4,777. This cross-sectional study used Qualtrics to record survey responses measuring knowledge of TWH, attitude toward change, resistance to change, transformational leadership ability, perception of organizational readiness, and leadership commitment.

Findings:

The total sample size was 253 (5.3%). Most respondents were bachelors prepared nurses (75.1%) with greater than 10 years’ experience (71.5%) and employed in manufacturing (42.6%). Approximately 74% ( n = 125) of respondents knew about TWH, but did not have a program in place or were unsure of the existence of one. A high percentage (74.0%) were open to implementing TWH, had favorable attitudes toward change ( M = 3.9 on a 5-point Likert-type scale), but needed education on how to move forward (56.0%).

Conclusions/Application to Practice:

Findings suggest that most OHPs know about TWH, but generally have not adopted the TWH concept at their worksites. However, they are open to implementing TWH programs and have favorable attitudes toward change.
Do Adult Spinal Deformity Patients Undergoing Surgery Continue to Improve From 1-Year to 2-Years Postoperative?
Authors: Zuckerman Scott L. , Lai Christopher S. , Shen Yong , Cerpa Meghan , Lee Nathan J. , Kerolus Mena G. , Ha Alex S. , Buchanan Ian A. , Devin Clinton J. , Lehman Ronald A. , Lenke Lawrence G.
Published: May 2021

Objective:

Evaluate clinical improvement as measured by patient-reported outcomes (PROs) during the 1 to 2-year interval.

Study Design:

Retrospective Cohort.

Methods:

A single-institution registry of ASD patients undergoing surgery was queried for patients with ≥6 level fusions. Demographics and radiographic variables were collected. PROs collected were the ODI and SRS-22r scores at: preoperative, 1-year and 2-years. Outcome measures of clinical improvement during the 1-2 year time interval were: 1) group medians, 2) percent minimum clinically important difference (MCID), and 3) percent minimal symptom scale (MSS)(ODI < 20 or SRS-pain + function >8). Wilcoxon rank-sum tests, chi-squared tests, Kruskal-Wallis tests, and logistic regression were performed.

Results:

157 patients undergoing ASD surgery with minimum of 1-year follow-up were included. Mean age was 53.2 and mean instrumented levels was 13.1. Preoperative alignment was: Neutral Alignment (NA) 49%, Coronal Malalignment (CM) 17%, Sagittal Malalignment (SM 17%), and Combined Coronal/Sagittal Malalignment (CCSM) 18%. Preoperative to 1-year, and preoperative to 2-years, all ODI/SRS-22r significantly improved ( P < .001). In all patients, the only significant improvement in PROs between 1-and 2-year postoperative were those reaching ODI MCID (69% 1-year vs. 84% 2-years; P < .001). Subgroup analysis: ≥55 years had an improved median ODI (18 vs. 8; P = .047) and an improved percent achieving ODI MCID (73% vs. 84%, P = .048). CCSM patients experienced significant improvement in SRS-appearance score (75% vs. 100%; P = .050), along with those with severe preoperative SM >7.5 cm (73% vs. 100%; P = .032).

Conclusions:

Most ASD patients experience the majority of PRO improvement by 1-year postoperative. However, subsets of patients that may continue to improve up to 2-years postoperative include patients ≥55 years, combined coronal/sagittal malalignment, and those with severe sagittal malalignment ≥7.5 cm.
Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools
Authors: Meeks Lisa M , Case Ben , Stergiopoulos Erene , Evans Brianna K , Petersen Kristina H
Published: May 2021

Introduction:

Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied.

Methods:

In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size.

Results:

Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size.

Discussion:

Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.
Pulsed Nd:YAG laser machining of nitinol: An experimental investigation
Authors: Muralidharan B. , Prabu K. , Rajamurugan G.
Published: May 2021

Nickel–Titanium (Ni-Ti) shape memory alloy, commonly called nitinol alloys, finds its primary application in the production of biomedical implants, mainly because of itsrare properties such asshape memory, superelasticity and superior biocompatibility. Laser cutting is anon-traditional machining process for the production ofparts with close tolerances andcomplex geometry. Electrical discharge machining (EDM) of nitinol is associated with more heat-affected zone (HAZ) and recast layer thickness. This article aims to study nitinol’s machining characteristics by alaser source with good beam quality to have a less HAZ, recast layer and striations. Experiments were designed and carried out using central composite designs (CCD) by a pulsed Nd:YAG laser. Analysis based on the different parameters chosen was conducted to determine the parameters; effects, including laser power, frequency and cutting speed concerning the surface roughness. From the results, it is observed that the presence of HAZ is measured up to1. 48 mm from the machined surface. The topography analysis reveals that the striation is identified at high speeds, with less pulse overlapping by columnar micro channels, which can be reduced at high pulse frequency.
Fabrication of microfluidic channel of polydimethylsiloxane using X-ray lithography and its surface nanostructuring
Authors: Mondal Puspen , Saundarkar Shweta , Khantwal Nitin , Tiwari Pragya , Srivastava A. K.
Published: May 2021

The microfluidic devices have attracted considerable attention for their wide range of applications in healthcare, disease diagnosis, and environmental monitoring. We present the fabrication technique, surface wetting, and bonding of a polydimethylsiloxane (PDMS) microfluidic device that will be used as an electroosmotic micromixerfor biomolecules. This technique essentially requires micromold preparation and casting of PDMS. The hardened mold was fabricated on SU-8 using X-ray lithography (XRL) beamline, BL-7, Indus-2 as the synchrotron radiation source at Raja Ramanna Centre for Advanced Technology(RRCAT). The PDMS casting and thermal cross-linking was performed by spin-coating, followed by heating with specific thermocycle. This cross-linked PDMS was bonded with smooth surfaces that were treated with different reactive plasmas using a deep reactive-ion etching (DRIE) system. In a micro fluidic channel, the flow is usually a highly ordered laminar flow and due to lack of turbulence the mixing is very difficult for larger molecules such as peptides, proteins and high-molecular-weight nucleic acids.

Here, we propose a microscale mixing device where active mixers are moved by external forces, such as an applied electric field. The dimensions of the fabricated device were generated through computer simulation using the finite-element based COMSOL Multiphysics 5. 4 software. The hydrophobic nature of PDMS hinders the mobility of biomolecules through the microchannel. In this work, plasma-induced surface wettability of PDMS with application of sulfur hexafluoride (SF6) and oxygen (O2) gas recipes was investigated. As a result, the SF6 plasma–treated microchannels became stable hydrophilic and exhibited an increased adhesion or reduced air-bubble trapping during filling with aqueous solutions.
Applying an equity lens to characterizing the process and reasons for an adaptation to an evidenced-based practice
Authors: Aschbrenner Kelly A , Mueller Nora M , Banerjee Souvik , Bartels Stephen J
Published: May 2021

Background:

Adaptations to evidence-based practices (EBPs) are common but can impact implementation and patient outcomes. In our prior research, providers in routine care made a fidelity-inconsistent adaptation to an EBP that improved health outcomes in people with serious mental illness (SMI). The purpose of this study was to characterize the process and reasons for the adaptation using a framework for reporting adaptations and modifications to EBPs, with a focus on equity.

Methods:

This study used qualitative data collected during a national implementation of the InSHAPE EBP addressing obesity in persons with SMI. We reviewed transcripts from five behavioral health organizations that made a successful fidelity-inconsistent adaptation to a core component of InSHAPE that was associated with cardiovascular risk reduction. We coded the data using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) with an emphasis on exploring whether the adaptation addressed inequities in using the EBP related to social determinants of health.

Results:

Across the five agencies, the fidelity-inconsistent adaptation was characterized as unplanned and reactive in response to challenges InSHAPE teams experienced delivering the intervention in community fitness facilities as intended. In all cases, the goal of the adaptation was to improve intervention access, feasibility, and fit. Social and economic disadvantage were noted obstacles to accessing fitness facilities or gyms among participants with SMI, which led agencies to adapt the program by offering sessions at the mental health center.

Conclusion:

Findings from this study show the advantages of applying a health equity lens to evaluate how obstacles such as poverty and discrimination influence EBP adaptations. Recommendations can also assist researchers and community partners in making proactive decisions about allowable adaptations to EBPs.

Plain Language Summary

Adaptations to evidence-based practices (EBPs) are common but can impact implementation and patient outcomes. Understanding why adaptations are made to EBPs by organizations and providers during implementation can help inform implementation strategies designed to guide adaptations that improve outcomes. We found that social and economic factors were driving inequities in access to a core intervention component of an EBP, which led agencies to adapt an EBP in a way that model developers considered to be inconsistent with fidelity but improved patient outcomes. These findings contribute to the growing literature on equitable implementation and adaptation by highlighting the advantages of considering when and how fidelity-inconsistent adaptations to an EBP may be in the service of reducing inequities in access to and use of EBPs for health disparity groups.
The Relationships Between Diabetes Self-Care, Diabetes Time Management, and Diabetes Distress in Women With Type 2 Diabetes Mellitus
Authors: Summers-Gibson Lisa
Published: May 2021

Purpose

The purpose of this study was to examine the relationships between and among diabetes self-care, diabetes time management, and diabetes distress in women with type 2 diabetes mellitus (T2DM).

Methods

A descriptive correlational design with a total of 188 participants completed 3 valid and reliable instruments to measure the main study variables, the Diabetes Self-Management Questionnaire, the Diabetes Time Management Questionnaire, and the Diabetes Distress Scale, in an uncontrolled, natural setting using mix-mode surveys (electronic and paper). Survey responses were analyzed using several descriptive, bivariate, and multivariate analyses.

Results

Diabetes time management was the strongest, statistically significant, unique contributor to explaining self-care. The regression model showed that diabetes time management demonstrated a large effect size and that diabetes distress demonstrated a small effect size.

Conclusions

The 2 predictor variables among diabetes self-care in women showed diabetes time management had a stronger effect size compared to diabetes distress. This is the first known study to measure the influence of diabetes time management on diabetes self-care and to examine the relationship between and among diabetes time management and diabetes distress. Diabetes time management, an understudied variable in individuals with T2DM, has the potential to be a contributor to improve patient outcomes.
Training in interventional pulmonology: the European and US perspective
Authors: Lee Hans J. , Corbetta Lorenzo
Published: May 2021

As the breadth of interventional pulmonology continues to expand, training in this discipline gains further importance. Interventional pulmonology training in the USA and Europe has common roots and similar concepts; however, there are variations in its delivery. We discuss the similarities, differences, challenges and goals of interventional pulmonology training in both continents. Collaboration and exchange of experiences between the USA and Europe are fundamental to entering the new era of competency/mastery training to implement a multidimensional approach to procedure-related education.
The respiratory microbiome and nontuberculous mycobacteria: an emerging concern in human health
Authors: Thornton Christina S. , Mellett Madeline , Jarand Julie , Barss Leila , Field Stephen K. , Fisher Dina A.
Published: May 2021

Nontuberculous mycobacteria (NTM) are diverse microbial species encompassing commensals and pathogens with the ability to cause pulmonary disease in both immunocompetent and immunocompromised individuals. In contrast toMycobacterium tuberculosis, which has seen a reduction in disease rates in developed countries, the incidence and prevalence of NTM disease is increasing. NTM are difficult to treat with standard antimicrobial regimens and may contain both virulence and antibiotic-resistance genes with potential for pathogenicity. With the advent of molecular techniques, it has been elucidated that these organisms do not reside in isolation and are rather part of a complex milieu of microorganisms within the host lung microbiome. Over the last decade, studies have highlighted the impact of the microbiome on host immunity, metabolism and cell–cell communication. This recognition of a broader community raises the possibility that the microbiome may disrupt the balance between infection and disease. Additionally, NTM disease progression and antimicrobial therapy may affect the healthy steady state of the host and function of the microbiome, contributing to further dysbiosis and clinical deterioration. There have been limited studies assessing how NTM may influence the relationship between microbiome and host. In this review, we highlight available studies about NTM and the microbiome, postulate on virulence mechanisms by which these microorganisms communicate and discuss implications for treatment.
Successful treatment of a patient with recurrent infection of Chromobacterium violaceum
Authors: Lang Lijuan , Wang Menglei , Huang Xiaowen , Zhou Hao , Zhou Zaigao , Huang Liang , Zheng Huanxin , Zeng Kang , Li Li
Published: May 2021

Background

Chromobacterium violaceum (C. violaceum) is a Gram-negative saprophytic bacterium that is widespread in tropical and subtropical environments, and belongs to conditional pathogenic bacteria. Human infection with C. violaceum is rare, and this can be fatal when the diagnosis and treatment are delayed, especially recurrent infection patients. Since clinicians lack the knowledge for C. violaceum, rapid diagnosis and early appropriate antimicrobial treatment remains challenging.

Case presentation

A 15-year-old male student was hospitalized for dark abscess, pustules, severe pain in both legs, and fever for 11 days. There were pustules with gray-white pus and red infiltrating plaques on the back, and the subcutaneous nodules could be touched in front of both tibias, with scab, rupture and necrotic tissue of the lower limb. The patient’s condition rapidly progressed. Therefore, next-generation sequencing (NGS), pustular secretion and blood culture were concurrently performed. The final diagnosis for this patient was C. violaceum infection by NGS. However, no bacterial or fungal growth was observed in the pustular secretion and blood culture. After 4 weeks of treatment, the patient was discharged from the hospital without any complications associated with C. violaceum infection.

Conclusion

Rapid diagnosis and early appropriate antimicrobial treatment is the key to the successful treatment of C. violaceum infection, especially in patients with sepsis symptoms. This case highlights that NGS is a promising tool for the rapid diagnosis of C. violaceum infection, preventing the delayed diagnosis and misdiagnosis of C. violaceum infection in patients who tested negative for pustular secretion and blood culture.
Predictors of placental malaria in Upper West Regional Hospital-Ghana
Authors: Mwin Pascal Kingsley , Kuffuor Afreh , Nuhu Kaamel , Okine Rafiq , Kubio Chrysantus , Wurapa Frederick , Osei Francis Adjei , Afari Edwin
Published: May 2021

Background

Placental malaria (PM) poses life-threatening complications to pregnant women as they are at increased risk of maternal and perinatal morbidity and mortality associated with malaria. This study examined the factors associated with placental malaria in the Upper West Regional Hospital (UWR).

Methods

A cross-sectional hospital-based study was carried out among pregnant women delivering at Upper West Regional Hospital. A cross-sectional screening survey was conducted from January 2019 to April 2019. Three hundred eligible mothers were consecutively recruited. A record review of their maternal and child history was assessed using a checklist. Placental blood samples were taken for microscopy to determine placental malaria parasitemia. Logistic regression analysis was done to determine the factors associated with placental malaria at 95 % confidence level.

Results

The proportion of mothers with placental malaria was 7 % (21/300), (95 % CI, 4.3–10.5 %).Plasmodium falciparumwas the only species identified in those with PM. Majority of the women 66.7 % (14/21) with placental malaria had parasite density in the range 501 to 5,000 parasites/µL. Obstetric and health service factors that were significantly associated with placental malaria were gravidity and antenatal care (ANC) attendance. Primigravida (aOR = 3.48, 95 %CI = 1.01–12.01) and having less than 4 ANC attendance (aOR = 9.78, 95 %CI = 2.89–33.11) were found to be significantly associated with placental malaria.

Conclusions

The proportion of women with PM was relatively low. Primigravid mothers reporting less than 4 ANC visits had the highest risk of placental malaria. Expectant mothers should be encouraged to attend at least 4 ANC visits prior to delivery.
Evaluation of clinical value and potential mechanism of MTFR2 in lung adenocarcinoma via bioinformatics
Authors: Chen Cheng , Tang Yang , Qu Wen-Dong , Han Xu , Zuo Jie-Bin , Cai Qing-Yong , Xu Gang , Song Yong-Xiang , Ke Xi-Xian
Published: May 2021

Background

Mitochondrial fission regulator 2 (MTFR2) was involved in the progression and development of various cancers. However, the relationship between MTFR2 with lung adenocarcinoma (LUAD) had not been reported. Herein, this study analyzed the clinical significance and potential mechanisms of MTFR2 in LUAD via bioinformatics tools.

Results

We found that the level of MTFR2 was increased, and correlated with sex, age, smoking history, neoplasm staging, histological subtype and TP53 mutation status in LUAD patients. Kaplan-Meier survival analysis showed LUAD patients with increased MTFR2 had a poor prognosis. In addition, univariate COX regression analysis showed neoplasm staging, T stage, distant metastasis and MTFR2 level were risk factors for the prognosis of LUAD. A total of 1127 genes were coexpressed with MTFR2, including 840 positive and 208 negative related genes. KEGG and GSEA found that MTFR2 participated in the progression of LUAD by affecting cell cycle, DNA replication, homologous recombination, p53 signaling pathway and other mechanisms. The top 10 coexpressed genes, namely CDK1, CDC20, CCNB1, PLK1, CCNA2, AURKB, CCNB2, BUB1B, MAD2L1 and BUB1 were highly expressed, and were associated with poor prognosis in LUAD.

Conclusions

Consequently, we elucidated MTFR2 was a biomarker for diagnosis and poor prognosis in LUAD, and might participate in the progression of LUAD via affecting cell cycle, DNA replication, homologous recombination and p53 signaling pathway.
Depressive symptoms associated with COVID-19 preventive practice measures, daily activities in home quarantine and suicidal behaviors: Findings from a large-scale online survey in Bangladesh
Authors: Islam Md. Saiful , Tasnim Rafia , Sujan Md. Safaet Hossain , Ferdous Most. Zannatul , Sikder Md. Tajuddin , Masud Jakir Hossain Bhuiyan , Kundu Sourav , Tahsin Promi , Mosaddek Abu Syed Md. , Griffiths Mark D.
Published: May 2021

Background

The world is facing a public health emergency situation caused by the COVID-19 pandemic. Psychological wellbeing among individuals worldwide has been negatively affected by the pandemic especially in low- and middle-income countries such as Bangladesh. The present study aimed to assess the estimate of depressive symptoms and investigated its associations with COVID-19 preventive practice measures, daily activities in home quarantine, and suicidal behaviors in a large-scale Bangladeshi online survey.

Methods

An online-based cross-sectional survey was widely distributed to Bangladeshi citizens. A total of 13,654 participants (61.0% male; mean age = 24.0 years [SD = 6.0]; age range 18–65 years) completed the survey between May and June (2020). The survey included socio-demographics and COVID-19-related questions, along with lifestyle, suicidal, and psychometric measures. Hierarchical regression was performed to determine significant associations between depression and examined variables.

Results

The estimate of depressive symptoms during the COVID-19 pandemic was 43.5%. Based on hierarchical regression analysis, depression was significantly associated with not engaging in COVID-19 preventive measures, daily activities in home quarantine (e.g., playing videogames), and suicidal behaviors.

Conclusions

Depressive symptoms appeared to be high during the COVID-19 pandemic in Bangladesh. To fight against the pandemic, mental health issues as well as physical health issues need to be taken into consideration.
Prevention of overweight and obesity in a Norwegian public health care context: a mixed-methods study
Authors: Westergren T. , Fegran L. , Jørstad Antonsen A. , Timenes Mikkelsen H. , Hennig C. B. , Stamnes Köpp U. M.
Published: May 2021

Background

Greater understanding about the prevention and treatment of overweight and obesity in preschool children within public health care is needed. This study assessed the impact of The First Steps module in routine primary health care including mapping of height/weight and diet followed by parental counselling of healthy habits on overweight and obesity in children aged 2 to 7 years. Further, we explored the experiences of public health nurses (PHNs) with the module.

Methods

Body weight and height obtained in 2014 and 2016 were extracted retrospectively for 676 children from the health records of children at 2, 4, or 6 years of age in five child health centers in Southern Norway. Sex- and age-adjusted body mass index (BMI) z-scores and weight status classifications were calculated according to the International Obesity Task Force reference values. Impact was assessed as change in mean BMI z-scores for children with under-, normal-, and overweight, respectively, and as proportion of children with overweight and obesity. In focus groups, PHNs described their experiences with the practical application of the module. Focus group transcripts were analyzed using Braun and Clarke’s thematic analysis.

Results

Mean BMI z-scores decreased from 2014 to 2016 in overweight children (− 0.26) and increased in children with under- (0.63) and normal weight (0.06), whereas the proportion of children with overweight and obesity was stable. PHNs believed that the module provides them with new tools that are useful for addressing the intricacies of childhood obesity. They described counseling sessions with families as “moving upstream in a river” and that overweight and obesity may be one of many complex challenges for these families.

Conclusions

Mean BMI z-score decreased in children with overweight during the 2 years after initiation of The First Steps module. PHNs considered the module as useful for addressing children’s overweight and obesity, which was perceived as one of several complex challenges for most of these families. Specialist and evidence-based support is needed to address overweight and obesity in children in primary care. Further research should focus on integrating the issues relating to overweight and obesity within other family problems.
Effects of eccentric exercises on improving ankle dorsiflexion in soccer players
Authors: Lagas Iris Femmigje , Meuffels Duncan E. , Visser Edwin , Groot Floor P. , Reijman Max , Verhaar Jan A.N. , de Vos Robert-Jan
Published: May 2021

Purpose

The purpose of this study was to determine the effect of targeted eccentric calf muscle exercises compared to regular training on ankle dorsiflexion in healthy adolescent soccer players with a decreased ankle dorsiflexion.

Methods

Male adolescent players (aged 14–21 years) from two professional soccer clubs were evaluated with the Weight Bearing Dorsiflexion Lunge Test (WBDLT) at baseline and after 12 weeks of this prospective controlled study. One club served as the control group and the other as the intervention group. Players with decreased ankle dorsiflexion (WBDLT) ≤ 10 cm) performed stretching and eccentric calf muscle exercises three times per week next to regular training in the intervention group, and performed only regular training in the control group. Primary outcome was the between-group difference in change in WBDLT between baseline and 12 weeks.

Results

Of 107 eligible players, 47(44 %) had a decreased ankle dorsiflexion. The WBDLT (± standard deviation) increased in the intervention group from 7.1 (± 1.8) to 7.4 (± 2.4) cm (95 % Confidence Interval (CI)[-0.493 to 1.108], p = 0.381) and in the control group from 6.1 (± 2.4) to 8.2 (± 2.9) cm (95 % CI [1.313 to 2.659], p < 0.001). The difference in change of WBDLT between both groups was statistically significant (95 % CI [-2.742 to -0.510], p = 0.005).

Conclusions

Targeted eccentric calf muscle exercises do not increase ankle dorsiflexion in healthy adolescent soccer players. Compared to regular training, eccentric exercises even resulted in a decreased calf muscle flexibility.

Trial registration

This trial was registered retrospectively on the 7th of September 2016 in The Netherlands Trial Register (ID number: 6044).
The association between subclinical hypothyroidism and TPOAb positivity with infertility in a population-based study: Tehran thyroid study (TTS)
Authors: Birjandi Batul , Ramezani Tehrani Fahimeh , Amouzegar Atieh , Tohidi Maryam , Bidhendi Yarandi Razieh , Azizi Feriedoun
Published: May 2021

Background

Thyroid autoimmunity(TAI) is the most prevalent autoimmune condition in women of fertile age. There are increasing data regarding the association of thyroid dysfunction and thyroid autoimmunity with adverse pregnancy outcomes but there is no consensus regarding infertility and TPOAb positivity; thus we aimed to evaluate the association between thyroid TPOAb positivity and infertility in females and males in a population-based study (TTS).

Methods

Cross-sectional study of 3197 female and male participants in Tehran Thyroid Study (TTS) at the framework of the Tehran Lipid and Glucose Study (TLGS). Data included biochemical measurements and a self-administered questionnaire.

Results

A total of 12,823 cases in phase 4, 3719 cases (2108 female and 1611 male) were analyzed. The mean TSH of the infertile female and male was 2.52 ± 2.68 μIU/ml and 3.24 ± 10.26 μIU/ml respectively. The TPO median(IQR) of women with and without a history of infertility were 6.05 (3.30–13.96)and 6.04 (3.17–11.15);(P = 0.613), they were 5.08 (3.20–125.68) and 5.31 (3.93–125.68);(P = 0.490) in male participants, respectively. Results of crude and adjusted logistic regression analysis of the development of infertility by thyroid function and TPOAb, except for fT4 in male subjects, depicted no association between infertility and other variables in both crude and adjusted models.

Conclusion

Based on the result, thyroid autoimmunity was not associated with infertility in both females and males.
Palliative Performance Scale and survival in patients with cancer and non-cancer diagnoses needing a palliative care consultation: a retrospective cohort study
Authors: Prompantakorn Patcharaporn , Angkurawaranon Chaisiri , Pinyopornpanish Kanokporn , Chutarattanakul Lalita , Aramrat Chanchanok , Pateekhum Chanapat , Dejkriengkraikul Nisachol
Published: May 2021

Background

Palliative Performance Scale (PPS) has been frequently used to estimate the survival time of palliative care patients. The objective was to determine the associations between the PPS and survival time among cancer and non-cancer patients in Thailand.

Methods

This is a retrospective cohort study. All in-patient adults who received a palliative care consultation at Chiang Mai University Hospital between 1 July 2018 to 31 July 2019 were included in the study and were followed-up until 26 June 2020. The Palliative Performance Scale was assessed using the validated Thai-Palliative Performance Scale for Adults. Survival analysis was used to determine the association between the Palliative Performance Scale and survival time among cancer and non-cancer patients.

Results

Out of 407 patients, 220 were male (54.1%). There were 307 cancer patients (75.4%) and 100 non-cancer patients (24.6%). The PPS and survival time in cancer patients were significantly correlated. Cancer patients with PPS 10, 20, 30, 40–60, and 70–80% had a median survival time of 2, 6, 13, 39, and 95 days, respectively. Non-cancer patients with PPS 10, 20, and 30% had a median survival time of 8, 6, and 24 days, respectively.

Conclusions

While useful for estimating survival time for cancer patients, other factors should be taken into account in estimating the survival time for non-cancer patients.
Up-regulation of long non-coding RNA CYTOR induced by icariin promotes the viability and inhibits the apoptosis of chondrocytes
Authors: Wang Guoyou , Zhang Lei , Shen Huarui , Hao Qi , Fu Shijie , Liu Xia
Published: May 2021

Background

Icariin (ICAR) is the main effective component extracted from epimedium, and is reported to have the potential to treat osteoarthritis (OA). However, its pharmacological function on chondrocytes has not been fully clarified.

Methods

Different doses of ICAR were used to treat chondrocyte cell lines, including CHON-001 and ATDC5. Then the expressions of different lncRNAs were measured by qRT-PCR. Interleukin-1β (IL-1β) was used to simulate the inflammatory response environment of chondrocytes. Overexpression plasmids and short hairpin RNAs of lncRNA CYTOR were used to construct gain-of-function and loss of function models. CCK-8 was conducted to determine the cell viability. Flow cytometry was used to detect the apoptosis of chondrocytes. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the contents of inflammatory factors (IL-6, IL-8, TNF-α) in the supernatant of the chondrocytes.

Results

Compared with other lncRNAs, CYTOR was changed most significantly in both CHON-001 and ATDC5 cells after treatment with ICAR. ICAR promotes the viability and inhibits the apoptosis of CHON-001 and ATDC5 cells induced by IL-1β, accompanied with reduced levels of inflammatory factors. Overexpression of CYTOR facilitated the viability of chondrocytes, while repressed their apoptosis and inflammatory response. What’s more, knockdown of CYTOR reversed the protective effects of ICAR on chondrocytes.

Conclusion

CYTOR was a pivotal lncRNA involved in the protective function of ICAR on chondrocytes.