bluuebunny/crossref_metadata_2025 huggingface dataset:
Fused filament fabrication of biodegradable polylactic acid reinforced by nanoclay as a potential biomedical material
Authors: Mihankhah Peyman , Azdast Taher , Mohammadzadeh Hurieh , Hasanzadeh Rezgar , Aghaiee Soroush
Published: September 2021

Fused filament fabrication (FFF) is one of the most common 3D printing techniques having considerable potential in various fields such as pharmaceutical, medical, aerospace, and automotive. One of the impediments of FFF components is their lower mechanical performance compared with those from conventional fabrication methods. This work aims to investigate the effect of adding nanoclay due to being nontoxic to the biodegradable polylactic acid (PLA) polymer matrix for medical applications. PLA granules were melt-compounded by a twin-screw extruder with nanoclay at 2 and 4 wt.%, and then, PLA and PLA/nanoclay filaments were produced using a single-screw extruder. An L9 orthogonal array of the Taguchi approach was utilized as the design of the experiment tool to study the process in detail considering nanoclay content, nozzle temperature and raster angle as material and processing parameters. The dispersion of nanoclay in the PLA matrix was assessed by X-ray diffraction test. The results indicated that the tensile strength was enhanced by 4.6% and 15.3% using the addition of 2 and 4 wt.% of nanoclay, respectively. The microscopic observations showed that the bonding between the rasters and between the contours and rasters was improved by increasing the temperature, and consequently, led to higher tensile strength values. The results revealed that the tensile strength of 38.9 MPa was obtained at the optimum condition.
Bifurcation and stability of resonance of electric vehicle powertrain: Focus on the influence of electromagnetic parameters
Authors: Han Qingzhen , Niu Shiqin , He Lei
Published: September 2021

The influence of the electromagnetic parameters on the torsional dynamics of the electric vehicle powertrain is studied by considering the electromechanical coupling effect. By adding the electromagnetic torque on the drive side, the powertrain is simplified as nonlinear drive-shaft model. The number, stability, and bifurcation conditions of the equilibrium points of the nonlinear drive-shaft model are deduced. Based on the averaged equations and the amplitude-frequency response equation, the stability and bifurcation conditions, such as fold bifurcation and Hopf bifurcation, of the resonance curve are discussed. The influence of electromagnetic parameters on the torsional dynamics is studied by simulation. It is shown that with the change of the parameters, the number as well as the stability of the equilibrium points may be changed which is affected by fold bifurcation. It is also shown that the resonance curve may lose its stability when fold bifurcation happens. By limiting the parameters in the region without fold bifurcation, the unstable dynamics of the resonance curve can be controlled.
Unboxing the Black Box: Demystifying the Impact of Consumers’ Psychological Motivations on Their Perception of Online Advertising
Authors: Singh Seema , Ahlluwalia Sarika
Published: September 2021

In a quest to reap the potential of the internet as an advertising media, marketers are increasing the share of online advertising in their promotion mix. But very less is known about factors impacting the consumers’ perception of online advertising. Psychological factors play an important role in developing the consumers perception, the present study extends the concept in the domain of online advertising.

For this, the present study has developed a hypothesized model containing two layers. Layer one consists of a conceptual framework based on the literature review and second layer comprised of testing the relationships between consumers psychological motivations and their perception of online advertising.

For the purpose, information, convenience, entertainment and social interaction are considered as psychological motivations of using the internet. The consumers’ perception of online advertising has been measured in terms of information value, entertainment value, trustworthiness, offensiveness and incentives. A purposive survey was conducted in Delhi NCR and the data was analysed using SEM in SAS Proc Calis (9). The findings suggest that psychological motivations of using the internet significantly impact the consumers’ perception of online advertising.
Football Fitness - a figurational study of a new type of leisure football as a meaningful activity for men
Authors: Frydendal Stine , Pedersen Line Kremmer , Ottesen Laila Susanne , Thing Lone Friis
Published: September 2021

This article offers a nuanced exploration of Football Fitness (FF), a newer ‘sport for all' concept carried out in associative sport clubs in Denmark. The aim of the study was to examine FF as a meaningful leisure activity for men. Seven focus group interviews were conducted with 26 heterogeneous male FF players aged 24 to 76. Data were analysed by means of thematic network analysis within the interpretive tradition. Drawing on figurational sociology, more specifically Elias and Dunning’s perspective on leisure sport as a quest for excitement, and Connell’s theory of masculinities, we present three elements of the empirical material all highlighting the social significance of the FF concept. 1: The men’s fight for recognition in the club, 2: Competition as a play element and 3: Social bonding and sport as a male preserve. The findings of the study demonstrate a hegemony of multiple masculinities in football clubs. The play-pleasure values associated with the FF concept does not receive much recognition compared to traditional competitive football. Consequently, the FF players feel like the strange newcomers, experiencing being regarded as outsiders compared to the established players in the clubs. Our study indicates that organisational change do not automatically generate cultural change when implementing health-promotion initiatives such as FF.
Damage growth and failure detection in hybrid fiber composites using experimental in-situ optical strain measurements and smoothing element analysis
Authors: Tabrizi Isa Emami , Kefal Adnan , Zanjani Jamal Seyyed Monfared , Yildiz Mehmet
Published: September 2021

In previous study the failure initiation and development in hybrid fiber laminates was successfully monitored and determined. In current investigation a novel damage monitoring approach is proposed for hybrid laminates by combining different optical strain measurement techniques namely digital image correlation (DIC), fiber Bragg grating sensors (FBG) and infrared thermography (IRT) with smoothing element analysis (SEA). This viable experimental procedure eliminates the effects of global/local nature of optical strain measurement systems on heterogeneous damage accumulation and is a two-step approach. First, all optical sensing systems together with conventional strain gauges are utilized concurrently to indicate the differences in the measured strains and monitor damage accumulation under tensile loading. This demonstrates how failure events disturb the measurement capabilities of optical systems, which can cause a miscalculation of hybrid effect in hybrid-fiber laminates. The second step involves the utilization of SEA algorithm for discretely measured DIC displacements to predict a realistic continuous displacement/strain map and rigorously mitigate the inherent noise of the full field optical system. Remarkably, for large deformation states in hybrid composites, the combination of SEA/DIC enables early prediction of susceptible damage zones at stress levels 30% below material strength.
Evaluation of the Impact of Prior-to-Admission Sleep Aid Prescribing Practices on Sleep and Delirium in the Intensive Care Unit
Authors: Chudow Melissa , Paradiso Vittorio , Silva Nicole , Collette Jillian
Published: September 2021

Background:

Sleep disruptions in the intensive care unit (ICU) may lead to complications such as delirium. There is limited evidence addressing how sleep aid use before and during ICU admission affects outcomes.

Objective:

The purpose of this study is to evaluate the impact of prior-to-admission sleep aid prescribing practices in the ICU on delirium and sleep outcomes.

Methods:

A retrospective review was conducted of adult patients admitted to any ICU from January to June 2018 receiving a sleep aid prior to admission. Patients were categorized based on sleep aid continuation, discontinuation, or alteration during the ICU admission. The primary end point was the incidence of delirium. Secondary end points included the incidence of sleep-wake cycle disturbances, delirium scores, and ICU length of stay.

Results:

A total of 291 patients were included with 109 in the continued group, 121 in the discontinued group, and 61 in the altered group. There was a similar incidence of delirium at 24 hours ( P = 0.71), 48 hours ( P = 0.60), 72 hours ( P = 0.25), and 5 days ( P = 0.48) after ICU admission. There was also no statistical difference in sleep-wake cycle disturbances or delirium scores at any time point. ICU length of stay was similar between the groups.

Conclusion and Relevance:

The incidence of delirium and sleep-wake cycle disturbances was not affected by differences in prior-to-admission sleep aid prescribing patterns during ICU admission.
Telehealth and the Psychiatric Mental Health Nurse Practitioner: Beyond the COVID-19 Pandemic
Authors: Zemlak Jessica L. , Wilson Patty , VanGraafeiland Brigit , Rodney Tamar
Published: September 2021

OBJECTIVE:

Examine the advantages, disadvantages, and challenges of telehealth for the psychiatric mental health nurse practitioner (PMHNP) in practice and student education. Describe areas for future research and policy development regarding telehealth in PMHNP practice and training during and beyond the COVID-19 pandemic.

METHODS:

Review current evidence, standards of practice, and education for the PMHNP.

RESULTS:

Recent rapid pandemic-related shifts in utilization of telehealth for clinical practice and student education have highlighted the advantages, disadvantages, and areas in need of additional study.

CONCLUSIONS:

Postpandemic telehealth care delivery will likely persist or expand. PMHNPs must advocate for high practice and education standards.
Evaluation of choroidal thickness in children with acute asthma attack by optical coherence tomography
Authors: Kurultay Isil , Sancakli Ozlem
Published: September 2021

Objective:

To evaluate the change in central choroidal thickness in children with asthma attack before and after treatment with β2 agonists.

Materials and methods:

About 100 eyes of 50 patients (5–17 years old) with visual acuity of 20/20 who had no retinal, choroidal, and systemic comorbidity were examined by enhanced depth optical coherence tomography (EDI-OCT) before and after asthma attack treatment. Sixty eyes of 30 healthy children of similar age and gender were evaluated as the control group. The central choroidal thickness, peak expiratory flow (PEF), forced expiratory volume 1(FEV1), oxygen saturation, and heart rate were evaluated.

Results:

The mean age of the patients was 9.2 ± 3.1 years, and the mean saturation values of patients was 97.2 ± 1.3 before treatment, and it increased to 98.3 ± 0.9 after treatment with a statistically significant difference. The mean FEV1 values were 80.8 ± 15.2 before, and 92.7 ± 12.9 after the treatment and PEF values were 75.9 ± 18.6 before and 89.3 ± 18.9 after treatment. This differences were statistically significant ( p < 0.001). The average choroidal thickness before the treatment were 310.4 ± 34.2 μm and decreased to 302.7 ± 34.4 μm after the treatment, this decrease was statistically significant ( p < 0.001). The mean choroidal thickness of the control group was 303.0 ± 7.3 μm and compared to the pre-treatment and post-treatment values, it was more similar to the post-treatment values, although there was no statistically difference.

Conclusion:

In our study, it was shown that choroidal thickness was significantly reduced in children with asthma who received attack treatment with β2 agonists, and it was similar to the control group after the treatment.
The Brexit deterrent? How member state exit shapes public support for the European Union
Authors: Hobolt Sara B , Popa Sebastian Adrian , Van der Brug Wouter , Schmitt Hermann
Published: September 2021

What are the effects on public support for the European Union (EU) when a member state exits? We examine this question in the context of Britain's momentous decision to leave the EU. Combining analyses of the European Election Study 2019 and a unique survey-embedded experiment conducted in all member states, we analyse the effect of Brexit on support for membership among citizens in the EU-27. The experimental evidence shows that while information about the negative economic consequences of Brexit had no significant effect, positive information about Britain's sovereignty significantly increased optimism about leaving the EU. Our findings suggest that Brexit acts as a benchmark for citizens’ evaluations of EU membership across EU-27, and that it may not continue to act as a deterrent in the future.
Issues that mobilize Europe. The role of key policy issues for voter turnout in the 2019 European Parliament election
Authors: Braun Daniela , Schäfer Constantin
Published: September 2021

In light of the unexpectedly high turnout in the 2019 European Parliament election, we explore how major transnational policy issues mobilize voters in European electoral contests. Based on the analysis of two data sets, the Eurobarometer post-election survey and the RECONNECT panel survey, we make three important observations. First, European citizens show a higher tendency to participate in European Parliament elections when they attribute greater importance to the issues ‘climate change and environment’, ‘economy and growth’, and ‘immigration’. Second, having a more extreme opinion on the issue of ‘European integration’ increases people's likelihood to vote in European elections. Third, the mobilizing effect of personal issue importance is enhanced by the systemic salience that the respective policy issue has during the election campaign. These findings show the relevance of issue mobilization in European Parliament elections as well as its context-dependent nature.
Temperature glass and conductivity behavior of epoxy deproteinized natural rubber in ternary blend of EDPNR/PMMA/LiCF3SO3
Authors: Hang Trịnh Thị , Mahendra I Putu , Thang Tran Manh , Kawahara Seiichi , Nghia Phan Trung
Published: September 2021

The temperature glass behavior of epoxy deproteinized natural rubber/polymethylmethacrylate/lithium trifluoromethanesulfonate (EDPNR/PMMA/LiCF3SO3) and the conductivity behavior of EDPNR in the ternary blends were studied by DSC and multichannel potentiostat. The DSC result revealed the temperature glass of the EDPNR was shifted to the right with the increase of lithium salt amount in these binary blends composition. However, in the ternary blends of EDPNR/PMMA/LiCF3SO3 the temperature glass revealed the miscibility of these ternary blends. Two different temperature glass values were obtained when the ratio of EDPNR in EDPNR/PMMA was less than 80 wt.%. The ionic conductivity of EDPNR could be improved by increasing the amount of lithium salt up to 35 wt.%, after this amount the ionic conductivity of EDPNR was significantly decreased. While in the ternary blends, the highest ionic conductivity value was found at the ratio 80/20 of EDPNR/PMMA. Furthermore, the factors influencing the temperature glass and conductivity behavior of EDPNR were systematically studied in this work. The results demonstrated an intimate correlation between temperature glass and conductivity behavior of EDPNR.
Mental Health Contributors Among Transgender People in a Non-WEIRD Society: Evidence From China
Authors: Spielmann Julia , Feng Siqi , Briley Daniel A. , Stern Chadly
Published: September 2021

Transgender people face numerous social hurdles and consequently report elevated rates of mental health problems. However, little research has examined whether established mental health findings generalize to experiences of transgender people outside of Western contexts. In an analysis of the 2017 Chinese Transgender Population General Survey ( N = 1,106), we examined how discrimination and environmental support in a school context related to mental health and self-harm among transgender people. We found that more frequent school discrimination was associated with worse mental health and increased self-harm. Further, perceived environmental support was associated with better mental health but was unrelated to self-harm. These relations did not differ based on whether people were “out” about being transgender at school or between men and women. These findings highlight nuance in the experiences of transgender people outside of Western contexts and hold implications for developing effective social interventions.
Digital phenotyping and data inheritance
Authors: Green Sara , Svendsen Mette N.
Published: September 2021

Proponents of precision medicine envision that digital phenotyping can enable more individualized strategies to manage current and future health conditions. We problematize the interpretation of digital phenotypes as straightforward representations of individuals through examples of what we call data inheritance. Rather than being a digital copy of a presumed original, digital phenotypes are shaped by larger data collectives that precede and continuously change how the individual is represented. We contend that looking beyond the individual is crucial for understanding the factors that can ‘bend’ digital mirrors in specific directions. Since algorithms used for digital profiling are based on historical data, their predictions often inherit and increase the values and perspectives of past data practices. Moreover, the data legacies we leave behind today may return as so-called ‘data phantoms’ that conflict with the interests of the individual and contest who and what the ‘original’ is.
General Practitioners’ Practice premises and Risk of Viral Cross-Transmission: A French Observational Multicenter Study
Authors: Daubert Guillaume , Gillet Gregoire , Guet Laurence , Marini Helene , Merle Veronique
Published: September 2021

Background:

The common areas of general practitioners’ practices (eg, reception, secretariat, waiting room, toilets) are places at risk of cross-transmission of viral diseases such as COVID-19, however risk is poorly documented.

Aim:

To evaluate the risks of viral cross-transmission in general practitioners’ practices based on the organization of the common areas of the premises.

Design and setting:

Cross-sectional multicenter observational study in randomly selected general practitioners’ practices in a French department (Seine-Maritime). The practices were included in 4 strata (1, 2, 3–5, or ≥6 general practitioners).

Method:

Each practice was visited and a questionnaire describing practice organization, cleaning of the premises, screening of high-risk patients was completed on site and observation of the premises).

Results:

Data collection started in December 2019 and was discontinued due to the national lockdown related to the global SARS-CoV-2 pandemic. Eighty-two practices were analyzed. A hydroalcoholic solution was available in 7.3% of practices and surgical masks in 1.2%. In a majority of waiting rooms, the minimum distance between chairs facing each other was >2 m (78.0%), but was more frequently 1 m for chairs at 90° (53.7%). Overall, 79.3% of waiting rooms could be properly ventilated and waste bins were present in 23.9% of cases. A cleaning protocol was reported in 39.2% of practices.

Conclusion:

The COVID-19 epidemic allowed the national dissemination of standard precautions. It will be interesting to monitor over the next few years whether the renewed consideration of standard precautions to prevent viral cross-contamination will be maintained over time.
Long noncoding RNAs: emerging regulators of normal and malignant hematopoiesis
Authors: Qiu Yi , Xu Mingjiang , Huang Suming
Published: September 2021

Genome-wide analyses have revealed that long noncoding RNAs (lncRNAs) are not only passive transcription products, but also major regulators of genome structure and transcription. In particular, lncRNAs exert profound effects on various biological processes, such as chromatin structure, transcription, RNA stability and translation, and protein degradation and localization, that depend on their localization and interacting partners. Recent studies have revealed that thousands of lncRNAs are aberrantly expressed in various cancer types, and some are associated with malignant transformation. Despite extensive efforts, the diverse functions of lncRNAs and molecular mechanisms in which they act remain elusive. Many hematological disorders and malignancies primarily result from genetic alterations that lead to the dysregulation of gene regulatory networks required for cellular proliferation and differentiation. Consequently, a growing list of lncRNAs has been reported to be involved in the modulation of hematopoietic gene expression networks and hematopoietic stem and progenitor cell (HSPC) function. Dysregulation of some of these lncRNAs has been attributed to the pathogenesis of hematological malignancies. In this review, we summarize current advances and knowledge of lncRNAs in gene regulation, focusing on recent progress on the role of lncRNAs in CTCF/cohesin-mediated 3-dimensional genome organization and how such genome folding signals, in turn, regulate transcription, HSPC function, and transformation. This knowledge will provide mechanistic and translational insights into HSPC biology and myeloid malignancy pathophysiology.
Urinothorax, another complication of bladder tumor: case report
Authors: Nedjim Saleh Abdelkerim , Abdi El Mostapha , Hagguir Hissein , Moataz Amine , Dakir Mohamed , Debbagh Adil , Aboutaieb Rachid
Published: September 2021

Background

Rupture of the fornix is a rare and serious urological complication of obstructive pathologies. The main cause is ureteral stone, but rarely a bladder tumor. Described complications of fornix rupture are superinfection, perirenal abscesses and even sepsis, but not urinothorax.

Case presentation

Patient of 56 years old, active and chronic smoker, was hospitalized for anemia and obstructive renal failure on a non-documented bladder tumor; clinically, he was presented with hematuria and an intense right loin pain associated with homolateral basithoracic pain and dyspnea. The CT scan without injection showed a right perirenal collection with bilateral renal dilatation on endo-vesical tumor and a right pleural effusion of less abundance. The ratio of pleural fluid creatinine to blood creatinine was greater than 1, confirming urinothorax. As an emergency, a percutaneous nephrostomy was performed. After clinical stabilization, the patient underwent a trans-urethral resection of the bladder and derivation by a double j stent. The ultimate evolution was favorable.

Conclusions

Beyond the metabolic complications secondary to obstructions, mechanical complications, which can also be fatal, must be included.
Novel nanoformulation of disulfiram with bacterially synthesized copper oxide nanoparticles for augmenting anticancer activity: an in vitro study
Authors: Abu‑Serie Marwa M. , Eltarahony Marwa
Published: September 2021

Background

Disulfiram (DS), in the presence of copper (Cu), exhibited potent broad anticancer activity. However, its clinical application is limited due to the poor solubility and stability. Hence, a novel nanocombination of DS with bacterially synthesized copper oxide nanoparticles (CuO NPs) was prepared herein to improve the anticancer efficacy of the typical DS–Cu complex. Our design utilized the nanocharacterization and prooxidant effect-mediated anticancer activity of CuO NPs which may lead to enhanced cellular uptake and thus improved anticancer efficacy of this unique nanocomplex.

Results

The characterized DS–CuO NPs exhibited high stability in serum and the strongest selective anticancer activity, with the lowest half-maximum inhibitory concentration (IC50 < 15 nM), against human breast, lung and liver cancer cells, by >10-fold, compared to DS–Cu, CuO NPs and Cu. Importantly, DS–CuO NPs revealed better synergistic anticancer effect and higher cellular uptake than DS–Cu. Moreover, this novel nanocomplex showed higher prooxidant effect-mediated apoptosis and anti-metastatic potential. This was accomplished by elevating cellular reactive species content with inhibiting the antioxidant defenders (functional marker of cancer stem cells (aldehyde dehydrogenase) and nuclear factor erythroid 2-related factor2), matrix metallopeptidase 9 and NF-κB as well as enhancing p53 expression.

Conclusion

All of the aforementioned findings verified that this novel nanocomplex was capable of improving the therapeutic index of the conventional DS–Cu complex. The potent selective anticancer activity of this promising nanomedicine merits further investigation, as a separate future study, using animal models as preliminary step before its clinical application.

Graphic abstract
Positive selection of skeleton-related genes during duck domestication revealed by whole genome sequencing
Authors: Zhu Tao , Qi Xin , Chen Yu , Wang Liang , Lv Xueze , Yang Weifang , Zhang Jianwei , Li Kaiyang , Ning Zhonghua , Jiang Zhihua , Qu Lujiang
Published: September 2021

Background

Domestication alters several phenotypic, neurological, and physiological traits in domestic animals compared to those in their wild ancestors. Domestic ducks originated from mallards, and some studies have shown that spot-billed ducks may have also made minor genetic contributions to domestication. Compared with the two ancestral species, domestic ducks generally differ in body size and bone morphology. In this study, we performed both genomic and transcriptomic analyses to identify candidate genes for elucidating the genetic mechanisms underlying phenotypic variation.

Methods

In this study, the duck genome data from eight domestic breeds and two wild species were collected to study the genetic changes during domestication. And the transcriptome data of different tissues from wild ducks and seven domestic ducks were used to reveal the expression difference between wild and domestic ducks.

Results

Using fixation index (Fst) algorithm and transcriptome data, we found that the genes related to skeletal development had high Fst values in wild and domestic breeds, and the differentially expressed genes were mainly enriched in the ossification pathway. Our data strongly suggest that the skeletal systems of domestic ducks were changed to adapt to artificial selection for larger sizes. In addition, by combining the genome and transcriptome data, we found that some Fst candidate genes exhibited different expression patterns, and these genes were found to be involved in digestive, immune, and metabolic functions.

Conclusions

A wide range of phenotypic differences exists between domestic and wild ducks. Through both genome and transcriptome analyses, we found that genes related to the skeletal system in domestic ducks were strongly selected. Our findings provide new insight into duck domestication and selection effects during the domestication.
Inter-chromosomal k-mer distances
Authors: Kafri Alon , Chor Benny , Horn David
Published: September 2021

Background

Inversion Symmetry is a generalization of the second Chargaff rule, stating that the count of a string of k nucleotides on a single chromosomal strand equals the count of its inverse (reverse-complement) k-mer. It holds for many species, both eukaryotes and prokaryotes, for ranges of k which may vary from 7 to 10 as chromosomal lengths vary from 2Mbp to 200 Mbp. Building on this formalism we introduce the concept of k-mer distances between chromosomes. We formulate two k-mer distance measures, D1 and D2, which depend on k. D1 takes into account all k-mers (for a single k) appearing on single strands of the two compared chromosomes, whereas D2 takes into account both strands of each chromosome. Both measures reflect dissimilarities in global chromosomal structures.

Results

After defining the various distance measures and summarizing their properties, we also define proximities that rely on the existence of synteny blocks between chromosomes of different bacterial strains. Comparing pairs of strains of bacteria, we find negative correlations between synteny proximities and k-mer distances, thus establishing the meaning of the latter as measures of evolutionary distances among bacterial strains. The synteny measures we use are appropriate for closely related bacterial strains, where considerable sections of chromosomes demonstrate high direct or reversed equality. These measures are not appropriate for comparing different bacteria or eukaryotes.

K-mer structural distances can be defined for all species. Because of the arbitrariness of strand choices, we employ only the D2 measure when comparing chromosomes of different species. The results for comparisons of various eukaryotes display interesting behavior which is partially consistent with conventional understanding of evolutionary genomics. In particular, we define ratios of minimal k-mer distances (KDR) between unmasked and masked chromosomes of two species, which correlate with both short and long evolutionary scales.

Conclusions

k-mer distances reflect dissimilarities among global chromosomal structures. They carry information which aggregates all mutations. As such they can complement traditional evolution studies , which mainly concentrate on coding regions.
An optimised protocol for detection of SARS-CoV-2 in stool
Authors: Li Tianqi , Garcia-Gutierrez Enriqueta , Yara Daniel A. , Scadden Jacob , Davies Jade , Hutchins Chloe , Aydin Alp , O’Grady Justin , Narbad Arjan , Romano Stefano , Sayavedra Lizbeth
Published: September 2021

Background

SARS-CoV-2 has been detected in stool samples of COVID-19 patients, with potential implications for faecal-oral transmission. Compared to nasopharyngeal swab samples, the complexity of the stool matrix poses a challenge in the detection of the virus that has not yet been solved. However, robust and reliable methods are needed to estimate the prevalence and persistence of SARS-CoV-2 in the gut and to ensure the safety of microbiome-based procedures such as faecal microbiota transplant (FMT). The aim of this study was to establish a sensitive and reliable method for detecting SARS-CoV-2 in stool samples.

Results

Stool samples from individuals free of SARS-CoV-2 were homogenised in saline buffer and spiked with a known titre of inactivated virus ranging from 50 to 750 viral particles per 100 mg stool. Viral particles were concentrated by ultrafiltration, RNA was extracted, and SARS-CoV-2 was detected via real-time reverse-transcription polymerase chain reaction (RT-qPCR) using the CDC primers and probes. The RNA extraction procedure we used allowed for the detection of SARS-CoV-2 via RT-qPCR in most of the stool samples tested. We could detect as few as 50 viral particles per 100 mg of stool. However, high variability was observed across samples at low viral titres. The primer set targeting the N1 region provided more reliable and precise results and for this primer set our method had a limit of detection of 1 viral particle per mg of stool.

Conclusions

Here we describe a sensitive method for detecting SARS-CoV-2 in stool samples. This method can be used to establish the persistence of SARS-CoV-2 in stool and ensure the safety of clinical practices such as FMT.
Hereditary hemorrhagic telangiectasia with liver cirrhosis: a case report
Authors: Xu Linxia , Xu Feng , Wang Qizhi , Ke Xiquan
Published: September 2021

Background

Hereditary hemorrhagic telangiectasia is an autosomal dominant hereditary hemorrhagic disease. Its main feature is an abnormal structure of the blood vessel wall. Cirrhosis of the liver is a common chronic progressive disease with one or more causes in which diffuse liver damage occurs after long-term or repeated injury. Liver cirrhosis can cause dilation of gastrointestinal capillaries. Many patients with hereditary hemorrhagic telangiectasia accompanied by gastrointestinal vascular malformations and liver cirrhosis may be diagnosed only with liver cirrhosis if the clinician does not pay attention to physical examination findings and family history. Moreover, general treatment measures, such as blood transfusion, iron supplementation, and application of hemostatic drugs, are less effective for bleeding in patients with hereditary hemorrhagic telangiectasia than in those with liver cirrhosis alone.

Case presentation

Here, we report the rare case of a 75-year-old Chinese man who was admitted to the hospital with repeated melena and epistaxis. He was diagnosed with unexplained liver cirrhosis, which was later confirmed as hereditary hemorrhagic telangiectasia. Subsequently, we implemented the treatment intervention of oral thalidomide combined with gastrointestinal argon plasma coagulation. A follow-up of more than 8 months showed that the treatment effect was excellent.

Conclusions

If patients with liver cirrhosis and gastrointestinal vascular malformations also have a family history of epistaxis, special attention should be paid to targeted physical examination results, and the possibility of hereditary hemorrhagic telangiectasia should be considered. Moreover, for patients with hereditary hemorrhagic telangiectasia and both gastrointestinal bleeding caused by gastrointestinal capillaries and repeated epistaxis, when other general treatment measures are ineffective, thalidomide combined with gastrointestinal argon plasma coagulation may be an effective intervention.
A typology of caregiving spouses of geriatric patients without dementia: caring, worried, desperate
Authors: Gehr Thomas Johann , Freiberger Ellen , Sieber Cornel Christian , Engel Sabine Alexandra
Published: September 2021

Background

An increasing number of older people in Germany receive care at home from family members, particularly from spouses. Family care has been associated not only with subjective burden but also with negative effects on caregivers’ health. A heterogeneous group, caregivers are confronted with individual situational demands and use different available coping strategies. To date, little is known about the relationship between burden and coping by spousal caregivers, particularly in the context of geriatric patients without dementia.

Objectives

The aim of this study is to explore the burden and coping strategies of caregiving spouses of geriatric patients without dementia and with a hospitalization within the last year. To help explore this population, a typology is presented that has been based on reported perceptions of home care burden and individual coping strategies. Furthermore, a case study is presented for each type of spousal caregiver.

Methods

The study used a concurrent mixed method design with a sample of nine spousal caregivers (mean age: 78.9 years). Four women and five men were recruited in an acute hospital setting during the TIGER study. Quantitative data were collected using a self-questionnaire and qualitative data were gathered through nine problem-centered interviews with spousal caregivers. The latter were subsequently analyzed utilizing the structured content analysis method. The data were then summarized to nine individual cases. Finally, the results were clustered using the empirically grounded construction of types and typologies. Each type of spousal caregiver is presented by a case study.

Results

Three types of caregiving spouses were identified: “The Caring Partner”, “The Worried Manager” and “The Desperate Overburdened”. These types differ primarily in the level of subjective burden and caregiving stress, the coping strategies, the motivation for caregiving, and expressed emotions.

Conclusions

The development of this new typology of caregiving spouses could help health care professionals better understand caregiving arrangements and thus provide more targeted advice.

Trial registration

The TIGER study was registered with clinicaltrials.gov:NCT03513159. Registered on April 17, 2018.
The full spectrum of ethical issues in pediatric genome-wide sequencing: a systematic qualitative review
Authors: Eichinger Johanna , Elger Bernice S. , Koné Insa , Filges Isabel , Shaw David , Zimmermann Bettina , McLennan Stuart
Published: September 2021

Background

The use of genome-wide sequencing in pediatric medicine and research is growing exponentially. While this has many potential benefits, the normative and empirical literature has highlighted various ethical issues. There have not been, however, any systematic reviews of these issues. The aim of this systematic review is to determine systematically the spectrum of ethical issues that is raised for stakeholders in in pediatric genome-wide sequencing.

Methods

A systematic review in PubMed and Google Books (publications in English or German between 2004 and 2021) was conducted. Further references were identified via reference screening. Data were analyzed and synthesized using qualitative content analysis. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or when two principles come into conflict.

Results

Our literature search retrieved 3175 publications of which 143 were included in the analysis. Together these mentioned 106 ethical issues in pediatric genome-wide sequencing, categorized into five themes along the pediatric genome-wide sequencing lifecycle. Most ethical issues identified in relation to genome-wide sequencing typically reflect ethical issues that arise in general genetic testing, but they are often amplified by the increased quantity of data obtained, and associated uncertainties. The most frequently discussed ethical aspects concern the issue of unsolicited findings.

Conclusion

Concentration of the debate on unsolicited findings risks overlooking other ethical challenges. An overarching difficulty presents the terminological confusion: both with regard to both the test procedure/ the scope of analysis, as well as with the topic of unsolicited findings. It is important that the genetics and ethics communities together with other medical professions involved work jointly on specific case related guidelines to grant the maximum benefit for the care of the children, while preventing patient harm and disproportionate overload of clinicians and the healthcare system by the wealth of available options and economic incentives to increase testing.
Investigating the impact of COVID-19 lockdown on adults with a recent history of recurrent major depressive disorder: a multi-Centre study using remote measurement technology
Authors: Leightley Daniel , Lavelle Grace , White Katie M. , Sun Shaoxiong , Matcham Faith , Ivan Alina , Oetzmann Carolin , Penninx Brenda W. J. H. , Lamers Femke , Siddi Sara , Haro Josep Mario , Myin-Germeys Inez , Bruce Stuart , Nica Raluca , Wickersham Alice , Annas Peter , Mohr David C. , Simblett Sara , Wykes Til , Cummins Nicholas , Folarin Amos Akinola , Conde Pauline , Ranjan Yatharth , Dobson Richard J. B. , Narayan Viabhav A. , Hotopf Mathew ,   On behalf of the RADAR-CNS Consortium
Published: September 2021

Background

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes a clinical illness Covid-19, has had a major impact on mental health globally. Those diagnosed with major depressive disorder (MDD) may be negatively impacted by the global pandemic due to social isolation, feelings of loneliness or lack of access to care. This study seeks to assess the impact of the 1st lockdown – pre-, during and post – in adults with a recent history of MDD across multiple centres.

Methods

This study is a secondary analysis of an on-going cohort study, RADAR-MDD project, a multi-centre study examining the use of remote measurement technology (RMT) in monitoring MDD. Self-reported questionnaire and passive data streams were analysed from participants who had joined the project prior to 1st December 2019 and had completed Patient Health and Self-esteem Questionnaires during the pandemic (n = 252). We used mixed models for repeated measures to estimate trajectories of depressive symptoms, self-esteem, and sleep duration.

Results

In our sample of 252 participants, 48% (n = 121) had clinically relevant depressive symptoms shortly before the pandemic. For the sample as a whole, we found no evidence that depressive symptoms or self-esteem changed between pre-, during- and post-lockdown. However, we found evidence that mean sleep duration (in minutes) decreased significantly between during- and post- lockdown (− 12.16; 95% CI − 18.39 to − 5.92; p <  0.001). We also found that those experiencing clinically relevant depressive symptoms shortly before the pandemic showed a decrease in depressive symptoms, self-esteem and sleep duration between pre- and during- lockdown (interaction p = 0.047, p = 0.045 and p <  0.001, respectively) as compared to those who were not.

Conclusions

We identified changes in depressive symptoms and sleep duration over the course of lockdown, some of which varied according to whether participants were experiencing clinically relevant depressive symptoms shortly prior to the pandemic. However, the results of this study suggest that those with MDD do not experience a significant worsening in symptoms during the first months of the Covid − 19 pandemic.
Routine outcome measurement in adolescents seeking mental health services: standardization of HoNOSCA in Kenyan sample
Authors: Wambua Grace Nduku , Kumar Manasi , Falkenström Fredrik , Cuijpers Pim
Published: September 2021

Background

The evaluation of treatment outcomes is important for service providers to assess if there is improvement or not. The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) was developed for this use in child and adolescent mental health services. Outcome measurement in routine mental health services is limited. This paper evaluates the psychometric properties of the self and clinician rated versions of the HoNOSCA for routine use in child and adolescent mental health services in Kenya.

Methods

Using a prospective design, the clinician- and self-rated versions of the HoNOSCA and the Paediatric Symptom Checklist (PSC) were administered at the Youth Centre at the Kenyatta National Hospital in Nairobi. Initial ratings were obtained from adolescents 12-17 years (n = 201). A sample of 98 paired ratings with 2 follow-ups were examined for measurement of change over time.

Results

Our findings showed good reliability with the self-rated version of the HoNOSCA score, correlating well with the self-reported version of the PSC (r = .74, p < .001). Both versions correlated well at follow-up and were sensitive to change. Using factor analysis, the maximum likelihood factoring and Promax rotation resulted in a four-factor structure, which with a Kaiser–Meyer–Olkin measure of sampling adequacy of 0.8 explained 54.74% of total variance.

Conclusion

The HoNOSCA appears to be of value, and easy to use in routine settings. Our findings suggest further investigation with a larger sample.
Syndromic surveillance of female sexually transmitted infections in primary care: a descriptive study in Monastir, Tunisia, 2007─2017
Authors: Dhouib Wafa , Zemni Imen , Kacem Meriem , Bennasrallah Cyrine , Fredj Manel Ben , Abroug Hela , Grira Samia , Mastouri Maha , Belguith Asma Sriha
Published: September 2021

Background

Sexually Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. The aim of this study was to determine the incidence and trend of STIs during 11 years in Tunisia (2007–17).

Methods

We conducted a descriptive study including all women with curable STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) diagnosed with the syndromic approach in all basic health care centers of the Governorate of Monastir (Tunisia) from 2007 to 2017. Syndromes included, Pelvic Pain (PP), Vaginal Discharge (VD) and Genital Ulceration (GU).

Results

We analyzed 40,388 episodes of curable STIs with a crude incidence rate and age standardized incidence rate of 1393 (95% Confidence Interval (CI); 1348–1438) / 100,000 Person Year (PY) and 1328 (95%CI; 1284–1372) /100,000 PY respectively. The incidence rate showed a positive trend over 11 years for all age groups and syndromes. VD was the most common syndrome with a crude incidence rate of 1170/100,000 PY. For all syndromes, women aged 20 to 39 were the most affected age group (p < 0.001).

Conclusion

In conclusion, the incidence rate of STIs episodes among women diagnosed with the syndromic approach was high, consistent with the global evidence. Focusing on reviewing STIs surveillance system in low and middle-income countries could allow the achievement of the ending of STIs epidemics by 2030.
Stakeholder-engaged research: strategies for the prevention and control of overweight and obesity in Kenya
Authors: Wanjau Mary Njeri , Kivuti-Bitok Lucy W. , Aminde Leopold N. , Veerman J. Lennert
Published: September 2021

Background

This study was done as part of a larger study that aims to identify the most impactful and cost-effective strategies for the prevention and control of overweight and obesity in Kenya. Our objective was to involve stakeholders in the identification of the strategies that would be included in our larger study. The results from the stakeholder engagement are analyzed and reported in this paper.

Design

This was a qualitative study. A one-day stakeholder workshop that followed a deliberative dialogue process was conducted.

Participants

A sample of stakeholders who participate in the national level policymaking process for health in Kenya.

Outcome measure

Strategies for the prevention and control of overweight and obesity in Kenya.

Results

Out of the twenty-three stakeholders who confirmed attendance, fifteen participants attended the one-day workshop. The stakeholders identified a total of 24 strategies for the prevention and control of overweight and obesity in Kenya. From the ranking process carried out the top six strategies identified were: a research-based strategy for the identification of the nutritional value of indigenous foods, implementation of health promotion strategies that focus on the creation of healthy environments, physical activity behavior such as gym attendance, jogging, walking, and running at the individual level, implementation of school curricula on nutrition and health promotion, integration of physical education into the new Competency-Based Education policy, and policies that increase use of public transport.

Conclusion

The stakeholders identified and ranked strategies for the prevention and control of overweight and obesity in Kenya. This informs future overweight and obesity prevention research and policy in Kenya and similar settings.