bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Historic Visitor Service Structures in the Interpretation of Natural and Scenic National Parks: Grand Canyon, Yellowstone, Yosemite
Authors: Szczesny David M. , Williams Pat Stephens , Darville Ray , McBroom Matthew
Published: April 2022

Historic buildings and visitor service infrastructure constructed in national parks may change the interpretive themes associated with those parks whose initial significance statements initially stated preservation of the area because of natural beauty. The sites selected for this study were Grand Canyon, Yosemite, and Yellowstone National Parks with results identifying five key themes: Connections to Visitors and Inhabitants from the Past, Democracy in the Parks, Rustic Architecture and Use of Native Materials, Development and Resource Preservation in the Parks: A Complex Relationship, and Promoting Awareness and Stewardship. It also considered how the diverse meanings associated with visitor service structures may help to establish deeper connections between the parks and visitors today. The results could help managers at national, state, and local parks with historic infrastructure better plan for visitor experiences and resource appreciation.
Single Position Lateral Lumbar Interbody Fusion With Posterior Instrumentation Utilizing Computer Navigation and Robotic Assistance: Retrospective case review and surgical technique considerations
Authors: Sinkov Vladimir , Lockey Stephen Daniel , Cunningham Bryan W.
Published: April 2022

Study Design

Retrospective cohort study.

Objective

To determine safety and short-term outcomes of single-position lateral lumbar interbody fusion (LLIF) with bilateral posterior instrumentation and robotic assistance. The article also describes surgical technique considerations for the procedure.

Methods

20 patients underwent single-position LLIF with posterior instrumentation and robotic assistance. The patients were followed for a minimum of 3 months post-operatively.

Results

Average operative time was 211 ± 34 minutes, average blood loss was 51.25 ± 17 cc’s, and average length of stay was 1.4 ± .75 days. There were no intraoperative complications, readmissions, revision surgeries, and no incidence of hardware malposition. Significant improvement in pain and ODI scores was noted at 3 month follow up.

Conclusions

The study demonstrated safety and short-term clinical efficacy of minimally invasive single-position lateral lumbar interbody fusion with bilateral posterior instrumentation utilizing robotic assistance and navigation. There are certain surgical technique considerations that must be followed to ensure optimal surgical workflow and predictable outcomes.
Alcor: Death Care Through Cryonics (Service After Death)!
Authors: Ahmed Jashim Uddin , Zabir Faseeha , Islam Quazi Tafsirul , Asif Gazi Mohammad , Ahmad Asma
Published: April 2022

After-death care service industry usually includes services of rituals that are associated with death, such as funerals, burials, and death memorials. Funeral homes and cemeteries are the most common types of business segments in this industry. Amidst the standard segments, a unique kind of segment is growing, and that is cryonics or cryopreservation. Alcor has been the market leader in the segment of cryopreservation because of their experience and unique services. The case aims to analyze the services and operations of Alcor. The analysis shows how Alcor achieves its success in the market with the help of its available resources.
SARS-CoV-2 and human retroelements: a case for molecular mimicry?
Authors: Koch Benjamin Florian
Published: April 2022

Background

The factors driving the late phase of COVID-19 are still poorly understood. However, autoimmunity is an evolving theme in COVID-19’s pathogenesis. Additionally, deregulation of human retroelements (RE) is found in many viral infections, and has also been reported in COVID-19.

Results

Unexpectedly, coronaviruses (CoV) – including SARS-CoV-2 – harbour many RE-identical sequences (up to 35 base pairs), and some of these sequences are part of SARS-CoV-2 epitopes associated to COVID-19 severity. Furthermore, RE are expressed in healthy controls and human cells and become deregulated after SARS-CoV-2 infection, showing mainly changes in long interspersed nuclear element (LINE1) expression, but also in endogenous retroviruses.

Conclusion

CoV and human RE share coding sequences, which are targeted by antibodies in COVID-19 and thus could induce an autoimmune loop by molecular mimicry.
Interprofessional care of patients with type 2 diabetes mellitus in primary care: family physicians’ perspectives
Authors: Torti Jacqueline M. I. , Szafran Olga , Kennett Sandra L. , Bell Neil R.
Published: April 2022

Background

There is a lack of understanding of the team processes and factors that influence teamwork and medication management practices in the care of patients with type 2 diabetes mellitus (T2DM). The purpose of the study was to explore physicians’ perspectives of barriers and facilitators to interprofessional care of patients with T2DM within team-based family practice settings.

Methods

This was a qualitative, descriptive study. Participants included physicians affiliated with a primary care network providing care to patients with T2DM in an interprofessional team-based primary care setting in Edmonton, Alberta, Canada. Participants’ contact information was obtained from the publicly available College of Physicians and Surgeons of Alberta and respective primary care network websites. Interview questions addressed physicians’ perspectives on factors or processes that facilitated and hindered the care and medication management of adult patients with T2DM in primary care team-based clinical practice. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis and a constant comparative approach.

Results

A total of 15 family physicians participated in individual interviews. Family physicians identified facilitators of interprofessional team-based care and medication management of patients with T2DM in three theme areas—access to team members and programs, knowledgeable and skilled health professionals, and provision of patient education by other health professionals. Two themes emerged as barriers to interprofessional care – lack of provider continuity and the loss of skills from delegation of tasks.

Conclusion

Family physicians perceive both benefits and risks to interprofessional team-based care in caring for patients with T2DM. Successful functioning of team-based care in family practice will require overcoming traditional professional roles.
Is diabetic striatopathy the culprit of seizures in a patient with ketotic hyperglycemia-induced hemichorea–hemiballismus?
Authors: Safan Abeer Sabry , Sharma Omna , Almasri Muna , D’Souza Ashton Ian , Suliman Omer
Published: April 2022

Background

Diabetic striatopathy is a rare neurological manifestation of nonketotic hyperglycemia that presents with contralateral hemichorea-hemiballismus. Presentation with concurrent seizures is rarely reported.

Clinical presentation

We report a case of diabetic striatopathy presenting with focal and generalized tonic-clonic seizures (GTCS) with right hemichorea-hemiballismus induced by a ketotic hyperglycemic state. Head MRI showed high T1-weighted signal intensity in the left lentiform nucleus with no significant diffusion restriction or postcontrast enhancement. The patient’s condition gradually improved, with seizure control on AEDs. Hemichorea-hemiballismus significantly improved with adequate blood sugar control and resolved with low-dose haloperidol.

Conclusions

Diabetic striatopathy presenting with hemichorea-hemiballismus and concurrent GTCS has been reported previously in two cases; however, it has never been reported in ketotic hyperglycemia. To the best of our knowledge, we herein report the first case report of focal and generalized seizures in a ketotic hyperglycemic state and mesial temporal sclerosis.
Antibiotic use by backyard food animal producers in Ecuador: a qualitative study
Authors: Waters William F. , Baca Martin , Graham Jay P. , Butzin-Dozier Zachary , Vinueza Lenin
Published: April 2022

Background

Antibiotics are increasingly used throughout the world in food animal production for controlling and preventing disease and for promoting growth. But this trend also has the potential for promoting antibiotic resistance, which represents a threat to human, animal, and environmental health. The use of antibiotics and the potential effects of antibiotic dependence has often been associated with large-scale food animal production. But rural households also engage in small-scale production, often operating literally in backyards. While some small-scale producers use veterinary antibiotics, many do not. This paper examines knowledge, attitudes, beliefs, and agricultural practices (KAP) that represent an alternative to dependence on antibiotics.

Methods

Qualitative field research was based on four focus group discussions (FGDs) with non-indigenous backyard food animal producers in four communities near Quito, Ecuador and two FGDs with veterinarians. FGDs were supplemented by structured observations and key informant interviews. They were recorded with digital audio devices and transcriptions were analyzed independently by two researchers using a three-stage coding procedure. Open coding identifies underlying concepts, while axial coding develops categories and properties, and selective coding integrates the information in order to identify the key dimensions of the collective qualitative data.

Results

Backyard food animal producers in the Ecuadorian highlands generally do not use antibiotics while rearing small batches of animals and poultry for predominantly non-commercial household consumption. Instead, they rely on low cost traditional veterinary remedies. These practices are informed by their Andean history of agriculture and a belief system whereby physical activity is a holistic lifestyle through which people maintain their health by participating in the physical and spiritual environment.

Conclusions

Backyard food animal producers in the Ecuadorian highlands implement complex strategies based on both economic calculations and sociocultural underpinnings that shape perceptions, attitudes, and practices. They use traditional veterinary remedies in lieu of antibiotics in most cases because limited production of food animals in small spaces contributes to a predictable household food supply, while at the same time conforming to traditional concepts of human and environmental health.
Evaluation of a new developed disposable and portable bronchoscopy system
Authors: Liang Zhixin , Zhou Guanzhou , Li Yi , Pan Fei , Zeng Jiaqi , Luan Zhe , Zhu Qiang , Xu Yi , Zhang Nana , Xiang Lei , Jia Yunxiao , Sun Gang , Yang Yunsheng
Published: April 2022

Background

Bronchoscopy is critical in the treatment of patients with coronavirus disease (COVID-19), and its use is associated with the challenges of stringent sterilization and virus transmission risk. We developed a disposable and portable bronchoscope (YunSendo-R) and compared its safety and function with those of current reusable and single-use bronchoscopes using an animal model.

Methods

We compared the YunSendo-R system with a commercially available reusable bronchoscope (Olympus, BF-H290) and single-use bronchoscope (Ambu, Ambu® aScope3™). Eight physicians used the three types of bronchoscopes to operate on Guangxi Bama mini pigs. Each operator performed bronchoscopy and completed a 10-point Likert scale questionnaire for evaluating visual ability and manoeuvrability. Operation time and scores were collected.

Results

Operation time had no significant differences among the three bronchoscopes. In visual ability, the YunSendo-R bronchoscope showed superior performance to the Ambu bronchoscope in image clarity, colour contrast, and illumination (P < 0.05) and no significant difference in performance compared with the Olympus bronchoscope (P > 0.05). The YunSendo-R bronchoscope had similar manoeuvrability to the Olympus bronchoscope and better scope tip flexibility than the Ambu bronchoscope (P > 0.05). No relevant complications were reported.

Conclusion

We have developed a new bronchoscopy system with the advantages of disposability and portability, which was effective and safe in an animal model. It has better visual ability than the Ambu bronchoscope and similar visual ability and manoeuvrability to the Olympus bronchoscope. The YunSendo-R bronchoscope is a promising device for clinical practice, especially in reusable-endoscope-transmitted infectious diseases such as COVID-19.
Scoliosis in dysplastic spondylolisthesis: a clinical survey of 50 young patients
Authors: Guo Xinhu , Guo Zhaoqing , Li Weishi , Chen Zhongqiang , Zeng Yan , Zhong Woquan , Li Zihe
Published: April 2022

Background

Dysplastic spondylolisthesis is a rare spinal deformity that occurs mainly in young patients. Although its sagittal parameters had been well stated, coronal abnormalities in these patients were poorly studied. The purposes of this study were: (1) to investigate the prevalence of scoliosis in dysplastic spondylolisthesis;(2) to assess scoliosis resolution or persistence after surgery; and (3) to propose a modified classification of scoliosis associated with dysplastic spondylolisthesis.

Methods

Fifty patients (average age 14.9 ± 5.6 years) diagnosed with dysplastic spondylolisthesis who underwent surgical treatment were followed up and their data were analyzed. Standing posteroanterior and lateral full spine radiographs were used to measure the coronal and sagittal parameters. Patients with scoliosis, which was defined as a coronal Cobb angle greater than 10°, were divided into three groups according to their curve characteristics: “independent” scoliosis (IS) group, spasm scoliosis (SS) group, and olisthetic scoliosis (OS) group. SS and OS were spondylolisthesis-induced scoliosis. The radiographic parameters and patient-reported outcomes were collected before and after surgery and compared between groups.

Results

The average slip percentage was 62.8% ± 23.1% and the average follow-up time was 51.5 ± 36.4 months (range 3–168 months). Twenty-eight of the 50 (56%) dysplastic spondylolisthesis patients showed scoliosis, of which 8 were IS (24.7° ± 15.2°), 11 were SS (13.9° ± 3.0°), and 9 were OS (12.9° ± 1.9°). By the last follow-up, no scoliosis resolution was observed in the IS group whereas all SS patients were relieved. Of the nine patients with OS, four (44.4%) had scoliosis resolution after surgery.

Conclusion

Distinguishing different types of scoliosis in dysplastic spondylolisthesis patients may help surgeons to plan treatment and understand prognosis. For patients with significant scoliosis, whether “independent” or spondylolisthesis-induced, treatment of spondylolisthesis should be performed first and scoliosis should be observed for a period of time and treated according to the corresponding principles.
C/EBP homologous protein promotes Sonic Hedgehog secretion from type II alveolar epithelial cells and activates Hedgehog signaling pathway of fibroblast in pulmonary fibrosis
Authors: Yang Xiaoyu , Sun Wei , Jing Xiaoyan , Zhang Qian , Huang Hui , Xu Zuojun
Published: April 2022

Background

Endoplasmic reticulum (ER) stress is involved in the pathological process of pulmonary fibrosis, including IPF. It affects a broad scope of cellular types during pulmonary fibrosis but the role in epithelial-mesenchymal crosstalk has not been fully defined. The present study aimed to investigate the effects of Shh secretion by ER  stress-challenged type II alveolar epithelial cells (AECII) on fibroblast and pulmonary fibrosis.

Methods

Conditioned medium (CM) from tunicamycin (TM)-treated AECII was collected and incubated with fibroblast. Short hairpin RNA (shRNA) was used for RNA interference of C/EBP homologous protein (CHOP). The effects of CHOP and HH signaling were evaluated by TM administration under the background of bleomycin-induced pulmonary fibrosis in mice.

Results

Both expression of CHOP and Shh in AECII, and HH signaling in mesenchyme were upregulated in IPF lung. TM-induced Shh secretion from AECII activates HH signaling and promotes pro-fibrotic effects of fibroblast. Interfering CHOP expression reduced ER stress-induced Shh secretion and alleviated pulmonary fibrosis in mice.

Conclusions

Our work identified a novel mechanism by which ER stress is involved in pulmonary fibrosis. Inhibition of ER stress or CHOP in epithelial cells alleviated pulmonary fibrosis by suppressing Shh/HH signaling pathway of fibroblasts.
Auxora vs. placebo for the treatment of patients with severe COVID-19 pneumonia: a randomized-controlled clinical trial
Authors: Bruen Charles , Al-Saadi Mukhtar , Michelson Edward A. , Tanios Maged , Mendoza-Ayala Raul , Miller Joseph , Zhang Jeffrey , Stauderman Kenneth , Hebbar Sudarshan , Hou Peter C.
Published: April 2022

Background

Calcium release-activated calcium (CRAC) channel inhibitors block proinflammatory cytokine release, preserve endothelial integrity and may effectively treat patients with severe COVID-19 pneumonia.

Methods

CARDEA was a phase 2, randomized, double-blind, placebo-controlled trial evaluating the addition of Auxora, a CRAC channel inhibitor, to corticosteroids and standard of care in adults with severe COVID-19 pneumonia. Eligible patients were adults with ≥ 1 symptom consistent with COVID-19 infection, a diagnosis of COVID-19 confirmed by laboratory testing using polymerase chain reaction or other assay, and pneumonia documented by chest imaging. Patients were also required to be receiving oxygen therapy using either a high flow or low flow nasal cannula at the time of enrolment and have at the time of enrollment a baseline imputed PaO2/FiO2 ratio > 75 and ≤ 300. The PaO2/FiO2 was imputed from a SpO2/FiO2 determine by pulse oximetry using a non-linear equation. Patients could not be receiving either non-invasive or invasive mechanical ventilation at the time of enrolment. The primary endpoint was time to recovery through Day 60, with secondary endpoints of all-cause mortality at Day 60 and Day 30. Due to declining rates of COVID-19 hospitalizations and utilization of standard of care medications prohibited by regulatory guidance, the trial was stopped early.

Results

The pre-specified efficacy set consisted of the 261 patients with a baseline imputed PaO2/FiO2≤ 200 with 130 and 131 in the Auxora and placebo groups, respectively. Time to recovery was 7 vs. 10 days (P = 0.0979) for patients who received Auxora vs. placebo, respectively. The all-cause mortality rate at Day 60 was 13.8% with Auxora vs. 20.6% with placebo (P = 0.1449); Day 30 all-cause mortality was 7.7% and 17.6%, respectively (P = 0.0165). Similar trends were noted in all randomized patients, patients on high flow nasal cannula at baseline or those with a baseline imputed PaO2/FiO2 ≤ 100. Serious adverse events (SAEs) were less frequent in patients treated with Auxora vs. placebo and occurred in 34 patients (24.1%) receiving Auxora and 49 (35.0%) receiving placebo (P = 0.0616). The most common SAEs were respiratory failure, acute respiratory distress syndrome, and pneumonia.

Conclusions

Auxora was safe and well tolerated with strong signals in both time to recovery and all-cause mortality through Day 60 in patients with severe COVID-19 pneumonia. Further studies of Auxora in patients with severe COVID-19 pneumonia are warranted.

Trial registration NCT04345614.
Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study
Authors: Hongo Takashi , Yamamoto Ryohei , Liu Keibun , Yaguchi Takahiko , Dote Hisashi , Saito Ryusuke , Masuyama Tomoyuki , Nakatsuka Kosuke , Watanabe Shinichi , Kanaya Takahiro , Yamaguchi Tomoya , Yumoto Tetsuya , Naito Hiromichi , Nakao Atsunori
Published: April 2022

Background

Post-extubation dysphagia (PED) is recognized as a common complication in the intensive care unit (ICU). Speech and language therapy (SLT) can potentially help improve PED; however, the impact of the timing of SLT initiation on persistent PED has not been well investigated. This study aimed to examine the timing of SLT initiation and its effect on patient outcomes after extubation in the ICU.

Methods

We conducted this multicenter, retrospective, cohort study, collecting data from eight ICUs in Japan. Patients aged ≥ 20 years with orotracheal intubation and mechanical ventilation for longer than 48 h, and those who received SLT due to PED, defined as patients with modified water swallowing test scores of 3 or lower, were included. The primary outcome was dysphagia at hospital discharge, defined as functional oral intake scale score < 5 or death after extubation. Secondary outcomes included dysphagia or death at the seventh, 14th, or 28th day after extubation, aspiration pneumonia, and in-hospital mortality. Associations between the timing of SLT initiation and outcomes were determined using multivariable logistic regression.

Results

A total of 272 patients were included. Of them, 82 (30.1%) patients exhibited dysphagia or death at hospital discharge, and their time spans from extubation to SLT initiation were 1.0 days. The primary outcome revealed that every day of delay in SLT initiation post-extubation was associated with dysphagia or death at hospital discharge (adjusted odds ratio (AOR), 1.09; 95% CI, 1.02–1.18). Similarly, secondary outcomes showed associations between this per day delay in SLT initiation and dysphagia or death at the seventh day (AOR, 1.28; 95% CI, 1.05–1.55), 14th day (AOR, 1.34; 95% CI, 1.13–1.58), or 28th day (AOR, 1.21; 95% CI, 1.07–1.36) after extubation and occurrence of aspiration pneumonia (AOR, 1.09; 95% CI, 1.02–1.17), while per day delay in post-extubation SLT initiation did not affect in-hospital mortality (AOR, 1.04; 95% CI, 0.97–1.12).

Conclusions

Delayed initiation of SLT in PED patients was associated with persistent dysphagia or death. Early initiation of SLT may prevent this complication post-extubation. A randomized controlled study is needed to validate these results.
HIV serostatus disclosure to sexual partner: a survey among women in Tehran, Iran
Authors: Pashaei Zahra , Oskouie Fatemeh , Moradi-Lakeh Maziar , Jahanfar Shayesteh , Haghani Shima
Published: April 2022

Background

Disclosure of HIV-positive status in women is associated with many factors. Consequently, status disclosure remains a challenge for Iranian women living with HIV. This study aimed to assess the prevalence, related factors, and reflections of HIV-positive status disclosure to a sexual partner(s) among Iranian women living with HIV.

Methods

A cross-sectional study was conducted on 170 HIV-seropositive women. Participants were selected from patients registered in the largest HIV clinic and HIV-positive club of Iran. The “HIV disclosure” questionnaire had 38-items and all the interviews were administered by the researcher. Data were analyzed using SPSS version 21.0 software. We used a logistic regression method to calculate the crude odds ratio (COR) and the adjusted odds ratio (AOR) for self-disclosure as the independent predictor variable and the dependent variable, respectively.

Results

One hundred and seventy HIV-positive women were enrolled. Most of them had disclosed their HIV status to at least one person (94.1%) and their sexual partners (86.5%). In the univariate analysis, being married (COR = 18.66, 95% CI 5.63–61.87), living with a sexual partner (COR = 4.72, 95% CI 1.92–11.62), being aware of sexual partners’ HIV status (COR = 6.20, 95% CI 1.79–21.49), and gaining the support of sexual partner (COR = 9.08, 95% CI 3.48–23.64) were associated with higher odds of HIV status disclosure. In the multivariate analysis, being aware of sexual partners’ HIV status, and gaining the support of sexual partners remained associated with HIV status disclosure. Most women reported a positive reflection from their sexual partners after disclosure, however, negative reflections from society were more common compared to sexual partners and family members.

Conclusion

This study shows high overall HIV disclosure proportions. It should be noted that a large number of women were infected by their sexual partners, especially by their spouses. The high rate of transmission in married people indicates an urgent need for more emphasis on appropriate prevention behaviors by infected partners.
Determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine and work-related variables among Iranian dentists: a cross-sectional study
Authors: Noori Fereshteh , Kazemeini Seyed-Kazem , Owlia Fatemeh
Published: April 2022

Background

Dentists are prone to professional burnout due to the nature of their work but this phenomenon could be prevented. Professional burnout has a great impact on different aspects of human life. No study has been published on determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine (TPM). The current study intends to touch upon this issue for the first time.

Methods

In order to conduct this Cross-Sectional study based on a randomized sampling method, 145 dentists completed the 22-item Maslach Burnout Inventory questionnaires (MBI), and the 20-item Salmannejad Mizaj questionnaire. The study started since February, 2020 and ended in August, 2020 in Yazd, Iran. A total of 120 valid questionnaires were collected, with a response rate of 82.76%. Data analysis was performed using descriptive statistics, mean and standard deviation, analytical tests (including student t-test, one-way analysis of variance) by Spss17 (Chicago, USA) software.

Results

Overall, 8.3% of responders had high emotional exhaustion, while 65.8% and 33.3% had moderate depersonalization and reduced personal accomplishment, respectively. With respect to the results, dentists with cold and dry temperaments experienced a higher level of burnout in emotional exhaustion while dentists with warm and wet temperaments had a higher level of burnout in depersonalization and reduced personal accomplishment dimensions. There was an insignificant difference between age, gender, work experience, number of working days per week, number of patients per day with the dimensions of burnout. Pearson correlation coefficient indicated there was a positive correlation between avoidance job and emotional exhaustion (r = − 0.22,p = 0.016).

Conclusion

Based on the findings, it may conclude there was no significant difference in professional burnout between different temperaments among dentists.
Maximising Grip on Deception and Disguise: Expert Sports Performance During Competitive Interactions
Authors: Ramsey Harry , Dicks Matt , Hope Lorraine , Reddy Vasu
Published: April 2022

Expert performers in fast-ball and combat sports continuously interact with their opponents and, if they are to be successful, adapt behaviour in order to gain an advantage. For example, disguise and deception are recognised as skilful behaviours that are employed to disrupt an opponent’s ability to successfully anticipate their actions. We contend that such skilled behaviour unfolds during the interaction between opposing players, yet typical research approaches omit and/or artificially script these interactions. To promote the study of skilled behaviour as it emerges during competitive interactions, we offer an account informed by contemporary ecological perspectives for shaping investigation into how deception and disguise can be used to gain an advantage over an opponent and the challenges it poses to anticipation. We propose that each player attempts to develop maximum grip on the interaction through exploiting information across multiple timescales to position themselves as to facilitate openness to relevant affordances. The act of deception can be understood as offering a misleading affordance that an opponent is invited to act on, imposing a significant challenge to an opponent’s ability to attain grip by manipulating the information available. Grounded in our ecological perspective, we emphasise the need for future investigation into: (1) the role of disguise for disrupting anticipation; (2) how deception can be employed to gain an advantage by manipulating information on multiple timescales, before detailing; (3) how opposing performers go beyond merely exploiting information and actively elicit information to deal with deception and disguise during an interaction.
Mediastinal irradiation and valvular heart disease
Authors: Patil Shivaraj , Pingle Srinath-Reddi , Shalaby Khalid , Kim Agnes S.
Published: April 2022

Anticancer therapy has the potential to cause unwanted cardiovascular side effects. Utilization of radiation therapy to treat tumors near the heart can result in radiation-induced valvular heart disease among other cardiovascular pathologies. The aim of this review is to describe the epidemiology, pathophysiology, risk prediction, non-invasive imaging modalities and management of radiation-induced valvular heart disease with a focus on pre-operative risk assessment and contemporary treatment options.
The role of patient and public involvement and engagement (PPIE) within the development of the EQ Health and Wellbeing (EQ-HWB)
Authors: Carlton Jill , Peasgood Tessa , Mukuria Clara , Johnson Julie , Ogden Margaret , Tovey Wade
Published: April 2022

Objectives

The value of patient and public involvement and engagement (PPIE) within the development and refinement of outcome measures is becoming increasingly recognized. The aim of this paper is to provide an overview of how PPIE was integrated within the development of a new measure designed for use in economic evaluations across health and social care, the EQ Health and Wellbeing (EQ-HWB™).

Methods

Four PPIE sessions were held at key stages. Discussions from each session and the outcome of any tasks were shared with the wider research team and used to help inform decision-making.

Results and discussion

PPIE covered several components of outcome measure development including; review of conceptual model; discussion on sub-domain inclusion; item refinement and reduction; pre-testing of items; selection of items for the measure; and design of the measure. Key learning points for future projects were highlighted including; consideration of practicalities, resources and logistics of PPIE activities; how sessions and activities are managed effectively; and how to managing expectations and communication from both researcher and PPIE perspectives.

Conclusions

The PPIE group provided invaluable insight into perspectives of future patients and carers. Their input was fed into a number of developmental stages. The formal involvement from the PPIE group meant that the voice of the general public was heard. This helped ensure the appropriateness of the design of the final measure.
Perceived communication effectiveness in implementation strategies: a measurement scale
Authors: Zhao Xiaoquan , Toronjo Heather , Shaw Cameron C. , Murphy Amy , Taxman Faye S.
Published: April 2022

Background

Communication-based activities and products (i.e., training programs, webinars) are a critical component of implementation strategies that relay information to various audiences. Audience perceptions of communication effectiveness contribute important insight into the processes and mechanisms through which an implementation effort may succeed or fail. To advance research on this front, a psychometrically sound instrument for measuring perceived communication effectiveness (PCE) is needed.

Methods

An expert panel identified the theoretical foundations and conceptual domains of PCE and drafted preliminary items. Five focus groups of correctional professionals who had recently completed an implementation leadership training reviewed the items and provided feedback for refinement. Revised items were then included in a survey-based evaluation of an ongoing eLearning curriculum designed to improve the practices used by front-line probation officers in supervising individuals in the field. The factorial structure of a final 6-item scale as well as its convergent, divergent, and predictive validity was evaluated using data from the evaluation surveys (Nfollow-up = 358, Nbaseline+follow-up = 159).

Results

Confirmatory factor analysis of the final scale of PCE demonstrated adequate fit. PCE was strongly correlated with measures of implementation outcomes (acceptability, r = .819, p < .001; appropriateness, r = .809, p < .001; and feasibility, r = .754, p < .001), yet uncorrelated with a scale of need to evaluate (r = − .051, p = .422), demonstrating both convergent and divergent validities. The predictive validity of PCE was evidenced by significant associations between PCE and key training outcomes, including perceived staff use of evidence-based practices (β = .230, p < .05), agency climate (β = .261, p < .05), and value concordance (β = .209, p < .05), after controlling for baseline values and other confounders.

Conclusions

The PCE scale is psychometrically sound and can be a useful tool for gauging audience receptivity to and the potential impact of communication-based implementation activities and products.
Acoustic emission-based damage localization using wavelet-assisted deep learning
Authors: Barbosh Mohamed , Dunphy Kyle , Sadhu Ayan
Published: April 2022

Acoustic Emission (AE) has emerged as a popular damage detection and localization tool due to its high performance in identifying minor damage or crack. Due to the high sampling rate, AE sensors result in massive data during long-term monitoring of large-scale civil structures. Analyzing such big data and associated AE parameters (e.g., rise time, amplitude, counts, etc.) becomes time-consuming using traditional feature extraction methods. This paper proposes a 2D convolutional neural network (2D CNN)-based Artificial Intelligence (AI) algorithm combined with time–frequency decomposition techniques to extract the damage information from the measured AE data without using standalone AE parameters. In this paper, Empirical Mode Decomposition (EMD) is employed to extract the intrinsic mode functions (IMFs) from noisy raw AE measurements, where the IMFs serve as the key AE components of the data. Continuous Wavelet Transform (CWT) is then used to obtain the spectrograms of the AE components, serving as the “artificial images” to an AI network. These spectrograms are fed into 2D CNN algorithm to detect and identify the potential location of the damage. The proposed approach is validated using a suite of numerical and experimental studies.
Impact of sustained virologic response in regression of portal hypertension in Egyptian patients with hepatitis C virus-associated cirrhosis and portal hypertension
Authors: Faheem Heba Ahmed , Abdulmeged Nannes Adel , Hussein Hany Aly , Elmoursi Ahmed Abdelaziz , Elnaggar Heba T-allah Mohammed Yousry , Ghait Ramy Samir
Published: April 2022

Background

Portal hypertension (PH) is a common consequence in hepatitis C virus cirrhotic patients. With interferon alpha-based therapy, SVR was linked to improved PH and fibrosis regression. SVR to oral antiviral regimens is linked to reduced portal pressure in patients with clinically significant portal hypertension (CSPH) at baseline. However, CSPH continues in most of the patients. This study aims to assess the reversibility and/or improvement of PH in Egyptian patients with HCV-related cirrhosis and CSPH after achieving SVR with DAAs. The second aim is to evaluate performance of the noninvasive markers of fibrosis in prediction of the presence and/or reversibility of the CSPH in correlation to radiological and endoscopic parameters.

Subjects and methods

We evaluated noninvasive parameters, radiological and endoscopic signs of PH at baseline, and/or SVR 24 and SVR 48 post-DAA therapy in 40 patients with cirrhosis and CSPH (group A) and another 40 patients with cirrhosis only (group B).

Results

In group A, the spleen diameter decreased from baseline (15.74 ± 1.53 cm), and SVR 24 (15.48 ± 1.51), to SVR 48 (15.35 ± 1.49 cm). No ascites detected at SVR 48 in 62.5%. Portal vein diameter and portal vein blood velocity reduced to 13.53 ± 1.07 mm and 14.14 ± 2.2 cm/s at SVR 48, with reversibility of hepatic vein waveform towards the triphasic pattern. Medium to large esophageal varices regressed from 52.5% to 2.5%, and up to 70% of patients showed no EVs at SVR 48. In group A, 24 patients showed complete reversibility of CSPH, and 16 patients showed improvement of CSPH. Child-Pugh score, FIB-4 index, King’s score, and Lok index revealed higher significance for detection of the presence of PH. Child-Pugh score, PC/SD ratio, and Lok index revealed higher significance for detection of reversibility of PH.

Conclusion

We concluded that CSPH improved after SVR with DAAs and completely regressed in some patients. Upon predicting the presence of PH, Child-Pugh score, FIB-4 index, King’s score, and Lok index were the most significant noninvasive scores. While for predicting the reversibility of PH, Child-Pugh score, PC/SD ratio, and Lok index were the most significant scores.
Anesthetic Management of a Patient With S-Adenosylhomocysteine Hydrolase Deficiency: A Case Report
Authors: Van Gorkom Cori R. , Black Emily D. , Karlik Joelle B.
Published: April 2022

S-adenosylhomocysteine hydrolase (AHCY) deficiency is a rare congenital disorder in methionine metabolism with minimal guidelines regarding anesthetic management. This case report describes a 19-year-old man presenting for a liver biopsy in interventional radiology due to a history of elevated aminotransferases and creatine kinase. He received dextrose-containing fluids and a total intravenous anesthetic to avoid rhabdomyolysis and hyperkalemia. Anesthetic goals for patients with AHCY deficiency should focus on avoiding rhabdomyolysis, minimizing postoperative ventilatory compromise, monitoring for potential coagulopathy, and providing anxiolysis.
A Special Approach for Stereotactic Radiofrequency Thermocoagulation of Hypothalamic Hamartomas With Bilateral Attachments to the Hypothalamus: The Transthird Ventricular Approach to the Contralateral Attachment
Authors: Shirozu Hiroshi , Masuda Hiroshi , Kameyama Shigeki
Published: April 2022

BACKGROUND:

Disconnection surgery for the treatment of epileptic hypothalamic hamartomas (HHs) is strategically difficult in cases with complex-shaped HHs, especially with bilateral hypothalamic attachments, despite its effectiveness.

OBJECTIVE:

To evaluate the feasibility of a new approach for stereotactic radiofrequency thermocoagulation (SRT) using penetration of the third ventricle (SRT-TT) aiming to disconnect bilateral hypothalamic attachments in a single-staged, unilateral procedure.

METHODS:

Ninety patients (median age at surgery, 5.0 years) who had HHs with bilateral hypothalamic attachments and were followed for at least 1 year after their last SRT were retrospectively reviewed.

RESULTS:

Thirty-three patients underwent SRT-TT as initial surgery. Of the 58 patients after mid-2013 when SRT-TT was introduced, 33 underwent SRT-TT and 12 (20.7%) required reoperation (ReSRT), whereas 20 of 57 patients (35.1%) without SRT-TT underwent reoperation. Reoperation was required in significantly fewer patients after mid-2013 (n = 12 of 58, 20.7%) than before mid-2013 (n = 15 of 32, 46.9%) (P = .01). Final seizure freedoms were not different between before and after mid-2013 (gelastic seizure freedom, n = 30 [93.8%] vs n = 49 [84.5%] and other types of seizure freedom, n = 21 of 31 [67.7%] vs n = 32 of 38 [84.2%]). Persistent complications were less in SRT-TT than in ReSRT using the bilateral approach, but not significantly. However, hormonal replacement was required significantly more often in ReSRT using the bilateral approach (4 of 9, 44.4%) than in SRT-TT (3 of 32, 9.4%) (P = .01).

CONCLUSION:

SRT-TT enabled disconnection of bilateral attachments of HHs in a single-staged procedure, which reduced the additional invasiveness of reoperation. Moreover, SRT-TT reduced damage to the contralateral hypothalamus, with fewer endocrinological complications than the bilateral approach.
Monitoring Responses to Basic Military Training with Heart Rate Variability
Authors: CORRIGAN SEAN LATIMER , BULMER SEAN , ROBERTS SPENCER S. H. , WARMINGTON STUART , DRAIN JACE , MAIN LUANA C.
Published: April 2022

Introduction

Heart rate variability (HRV) has shown sensitivity to the acute stressors experienced by defense personnel. This study examines the suitability of overnight HRV as a repeated measure of allostatic load in defense personnel.

Methods

Daily measures of sleep, cognitive load, and perceived exertion were reported for the 12-wk duration of basic military training (BMT) in 48 recruits. Physical activity, subjective well-being, and HRV were measured weekly. The natural log of the root mean square of successive differences of interbeat intervals (Ln RMSSD) and the Ln RMSSD to interbeat interval ratio (Ln RMSSD:RRi ratio) during predicted slow wave sleep were used for HRV. Physical performance was assessed via the 20-m shuttle run and maximal push-up test in weeks 2 and 8 of BMT with predicted V̇O2 peak values calculated.

Results

Predicted V̇O2 peak increased from 42.6 ± 4.5 to 48.0 ± 2.7 mL·kg−1·min−1 (P < 0.001). Ln RMSSD was elevated in weeks 7 and 10, and the Ln RMSSD:RRi ratio was elevated in week 10 above all other weeks (P < 0.05). An increase in perceived exertion (F = 9.10, P = 0.003) and subjective fatigue (F = 6.97, P = 0.009), as well as a reduction in V̇O2 peak (F = 7.95, P = 0.009), individually predicted an increase in Ln RMSSD. The best predictive model of Ln RMSSD included perceived exertion (F = 8.16, P = 0.005), subjective fatigue (F = 8.49, P = 0.004), the number of awakenings during sleep (F = 7.79, P = 0.006), and the change in V̇O2 peak (F = 19.110, P < 0.001).

Conclusions

HRV was predicted by subjective recruit responses to BMT workloads rather than objective measures of physical activity. Improvements in cardiorespiratory fitness depicted recruits who experienced enough stress to facilitate physiological adaptation, which was reflected by a reduction in HRV during BMT. Monitoring HRV and HRV in relation to interbeat interval length may provide a better tool for determining allostatic load than HRV alone.
Tacklers’ Head Inertial Accelerations Can Be Decreased by Altering the Way They Engage in Contact with Ball Carriers’ Torsos
Authors: EDWARDS SUZI , GARDNER ANDREW J. , TAHU TIMANA , FULLER GORDON , STRANGMAN GARY , LEVI CHRISTOPHER R. , IVERSON GRANT L. , TUCKER ROSS
Published: April 2022

Purpose

This study aimed to investigate how four types of successfully executed, legal front-on, one-on-one torso tackles influence the tacklers’ and ball carriers’ inertial head kinematics.

Methods

A total of 455 successful front-on, one-on-one torso tackle trials completed by 15 rugby code players using three-dimensional motion capture were recorded. Tackles differed with respects to the height of the contact point on the ball carrier’s torso. A series of mixed general linear models were conducted.

Results

The tackler sustained the highest peak resultant linear (P < 0.001) and angular (P < 0.01) head accelerations when contacting the lower torso to execute a “dominant” tackle compared with mid or upper torso, although these latter tackle types had the lowest ball carrier inertial head kinematics. When executing a “smother” tackle technique, a significant decrease in peak resultant linear head acceleration was observed with a vertical “pop” then lock action used, compared with the traditional upper torso tackling technique (P < 0.001).

Conclusions

Modifying the tackler’s engagement with a ball carrier’s torso, with respect to height and technical execution, alters the inertial head kinematics of the tackler and the ball carrier. The traditional thinking about optimal tackle technique, as instructed, may need to be reevaluated, with the midtorso being a potential alternative target contact height, whereas changes in tackle execution may be relatively protective for tacklers when executing either a dominant or smother tackle. This study provides critical scientific evidence to underpin revised coaching tackling technique interventions that might enhance player safety. Tackles in which the tackler contacts the ball carrier around the midtorso region, rather than lower torso, produce the lowest acceleration and thus may contribute to reducing head injury risk for the tackler.
Landslide Susceptibility Assessment of Heraklion Prefecture in Crete, Greece
Authors: Adam Sofia , Athinelis Ioannis , Krassakis Pavlos , Nomikou Paraskevi
Published: April 2022

The purpose of this particular study is the assessment of landslide susceptibility of Heraklion prefecture area of Crete Island through geospatial analysis in order to present the general susceptibility zonation, so that it may be used as a basis in future extensive and detailed landslide susceptibility research, which will lead to the prevention of possible future landslides. In order to accomplish this task, it is essential to study the geological, geomorphological, geotectonic, hydrological and hydrogeological characteristics of the area, as well as the land use and compare this information with real landslide occurrence data from the study area. Based on this study it became clear that the area is defined by medium to very steep slopes and a geotechnical and geological setting that are extremely favorable for landslides. These reasons, as well as the fact that this prefecture is known to be the most densely populated prefecture of Crete Island created great interest in this area for research of this kind to prevent the loss of human life and the structural damage of properties. In order to study the landslide susceptibility of Heraklion prefecture, firstly, a geodatabase, which includes the landslide inventory, was created. The landslide inventory is consisted of previous landslides, which were collected from related geotechnical reports with all the essential spatial and descriptive information (such as locations and causes of the landslides). Furthermore, the necessary raster and vector data for the geospatial analysis of the area were obtained. Because the landslide susceptibility is a multifactorial problem it was decided to use a relating method to the problem’s nature, which was the methodology of the Analytical Hierarchy Process (AHP), as it is a simple and widely used method for similar studies, which makes it a great tool for this introductory study. In addition, this method was implemented in a GIS environment. For the purpose of the study, ten (10) triggering factors that cause landslides were defined, followed by the creation of a landslide susceptibility assessment map of the study area, depending on the influence of each factor. In accordance with this map, the highest susceptibility mostly corresponds to the mountainous regions of the prefecture. Finally, the success evaluation of the landslide susceptibility model was determined based on the frequency of landslide occurrences of the medium, high, and very high susceptibility zones. Consequently, the model was characterized as 90.48% successful, according to bibliography and the landslide inventory.