bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurophysiological comparative response to clinical and surgical treatment of the ulnar neuropathy in leprosy
Authors: Borela Marianna Cossi Monseff , Cury Filho Milton , Kirchner Daniel Rocco , Salgado Manuel Henrique , Virmond Marcos da Cunha Lopes , Garbino José Antonio
Published: May 2021

Leprosy  neuropathy  may  develop  into  subacute  and  chronic  inflammatory  scenarios, called reactions, which may cause entrapments in the anatomic tunnels.  Objective: This study describes the late nerve conduction findings  in patients with ulnar neuropathy at the elbow that were submitted to clinical and surgery treatments.  Methods: A total of 27 nerves  of  21  patients  with  borderline  leprosy  during  type  1  (reversal)  reaction  were selected in a non- competing retrospective cohort for three years. The nerves with treated clinically   active   neuropathy (Group   A1) were   randomized   for   inclusion   of   surgical treatment (Group A2) after one month of clinical treatment without clear signs of clinical and neurophysiological improvement. Fifteen nerves were randomly chosen for surgery while  12  were  clinically  treated,  after  steroids  treatment  without  expected  response. Nerve conduction was measured before and after treatment on four occasions. Results: The authors observed significant improvement in the following variables in the surgically treated nerves: compound motor action potential amplitude (CMAP) at elbow and above elbow and conduction velocity (CV) along the forearm.  Conclusion: The improvement of CMAP amplitudes and conduction velocity (CV) along the forearm express the late effect of nerve decompression. Persistence of temporal dispersion (TD) along  the  elbow  was  related  to  the  new  reaction  or  to  incomplete  surgical  solution. However, moderate  reduction  in  CV  along  the  elbow,  without  TD,  was  considered an indication  of na expected  partial  remyelination.  Previous  gradation  of  the  nerve  lesion  based  on  the CMAP amplitude was related to the most severe results.
Associação entre aspectos físicos-funcionais, comportamentais e de saúde com o medo de cair em idosos comunitários
Authors: Canever Jaquelini Betta , Danielewicz Ana Lúcia , Avelar Núbia Carelli Pereira de
Published: May 2021

Fear of falling is defined as an exacerbated concern in carrying out daily activities. Knowledge of factors associated with fear of falling may contribute to the development of multidimensional strategies that aim to reduce future falls in the elderly. Objective: To verify the association of physical-functional, health and behavioral aspects with the fear of falling of community-dwelling older adults. Methods: This was a cross-sectional study with a probabilistic random sample composed of 308 community-dwelling older men and women. The outcome variable was fear of falling and the predictor variables were behavioral aspects assessed by self-report (history of falls and self-perceived health) and health aspect (depressive symptoms). The physical-functional aspects included probable sarcopenia and mobility. Results: Higher chances of being afraid of falling were observed in the elderly who had a history of falls (OR: 1.87; 95% CI: 1.10; 3.19), negative self-perceived health (OR: 3.35; 95% CI : 1.87; 6.00), depressive symptoms (OR: 3.24; 95% CI: 1.88; 5.57), sarcopenia (OR: 4.22; 95% CI: 2.51; 7.09) and low mobility (OR: 4.19; 95% CI: 2.19; 7.99) when compared to those who did not have the same conditions. Conclusion: History of falls, poor self-perception of health, depressive symptoms, sarcopenia and low mobility were associated with fear of falling in elderly community members.
Satisfaction and meaning in life for persons with traumatic spinal cord injury
Authors: Castro Fabiana Faleiros Santana , Bimbatti Karina de Fátima , Carvalho Adriane Aparecida Gonçalves de , Gonçalves Mariele Lenhari , Lopes Filipe Gustavo , Schutt William
Published: May 2021

Objective: To analyze meaning in life, satisfaction with life, and the influence of sociodemographic variables in Brazilians with Spinal Cord Injury (SCI). This was a quantitative, cross-sectional, and descriptive study. Participants: Adults with traumatic SCI. Methods: The data were collected through the Survey Monkey platform using the Meaning in Life Questionnaire and the Satisfaction With Life Scale; the sample was composed of adults 18 years old or older with Traumatic SCI. Results: Most of the participants were male (75.5%), with a mean age of 36.22. The average score on the Satisfaction With Life Scale was 21.26, which corresponds to the Slightly satisfied category. The mean scores, respectively, for search and presence of meaning in life were 22.61 and 25.32, indicating that most participants find life meaningful even though they don’t explicitly search for meaning. There were significant associations between satisfaction with life and the meaning in life. Conclusion: In the rehabilitation process for people with Traumatic SCI, the assessment of satisfaction and the meaning of life must be managed together along with other psychological variables. Considering the complex life context of people suffering from a Traumatic SCI, there is a need for both holistic and individualized understanding during the rehabilitation process.
Effect of Exercise Interventions on Health-Related Quality of Life After Stroke and Transient Ischemic Attack
Authors: Ali Ali , Tabassum Dina , Baig Sheharyar S. , Moyle Bethany , Redgrave Jessica , Nichols Simon , McGregor Gordon , Evans Katherine , Totton Nikki , Cooper Cindy , Majid Arshad
Published: May 2021

Exercise interventions have been shown to help physical fitness, walking, and balance after stroke, but data are lacking on whether such interventions lead to improvements in health-related quality of life (HRQoL). In this systematic review and meta-analysis, 30 randomized controlled trials (n=1836 patients) were found from PubMed, OVID MEDLINE, Web of Science, CINAHL, SCOPUS, The Cochrane Library, and TRIP databases when searched from 1966 to February 2020 that examine the effects of exercise interventions on HRQoL after stroke or transient ischemic attack. Exercise interventions resulted in small to moderate beneficial effects on HRQoL at intervention end (standardized mean difference, −0.23 [95% CI, −0.40 to −0.07]) that appeared to diminish at longer-term follow-up (standardized mean difference, −0.11 [95% CI, −0.26 to 0.04]). Exercise was associated with moderate improvements in physical health (standardized mean difference, −0.33 [95% CI, −0.61 to −0.04]) and mental health (standardized mean difference, −0.29 [95% CI, −0.49 to −0.09]) domains of HRQoL while effects on social or cognitive composites showed little difference. Interventions that were initiated within 6 months, lasted at least 12 weeks in duration, involved at least 150 minutes per week, and included resistance training appeared most effective. Exercise can lead to moderate beneficial effects on HRQoL and should be considered an integral part of stroke rehabilitation.
The Impossibility of Automating Ambiguity
Authors: Birhane Abeba
Published: May 2021

On the one hand, complexity science and enactive and embodied cognitive science approaches emphasize that people, as complex adaptive systems, are ambiguous, indeterminable, and inherently unpredictable. On the other, Machine Learning (ML) systems that claim to predict human behaviour are becoming ubiquitous in all spheres of social life. I contend that ubiquitous Artificial Intelligence (AI) and ML systems are close descendants of the Cartesian and Newtonian worldview in so far as they are tools that fundamentally sort, categorize, and classify the world, and forecast the future. Through the practice of clustering, sorting, and predicting human behaviour and action, these systems impose order, equilibrium, and stability to the active, fluid, messy, and unpredictable nature of human behaviour and the social world at large. Grounded in complexity science and enactive and embodied cognitive science approaches, this article emphasizes why people, embedded in social systems, are indeterminable and unpredictable. When ML systems “pick up” patterns and clusters, this often amounts to identifying historically and socially held norms, conventions, and stereotypes. Machine prediction of social behaviour, I argue, is not only erroneous but also presents real harm to those at the margins of society.
Smoke-water and smoke-isolated butenolide (KAR1) induce the biosynthesis of tanshinones in endophytic fungus Trichoderma atroviride D16 isolated from Salvia miltiorrhiza
Authors: Zhou Jie , Xu Zi-Xin , Ran Zhi-Fang , Fang Lei , Guo Lan-Ping
Published: May 2021

Although treatments of smoke-water (SW) have been successfully used for promoting seed germination as well as plant growth, less reports have been documented on the influence of SW on the production of secondary metabolites in endophytes isolated from medicinal plants. The study investigated the effects of SW and its active compound butenolide (KAR1) on the accumulation of lipophilic tanshinones in endophyte Trichoderma atroviride D16 isolated from Salvia miltiorrhiza. Results showed that the mycelia of T. atroviride D16 treated with SW and KAR1 displayed a significant increase (P < 0.05) in the content of tanshinone I, which was evaluated with 2.26-fold (SW) and 1.86-fold (KAR1) of the control on 20 d after treatment. Comparing with the control, the treatment of SW and KAR1 resulted in a significant increase in the content of tanshinone IIA, and the highest levels were observed to be 31.87% (SW 1:2000, v/v) and 17.77% (KAR1 at 10-9 M) on 20 d after treatment. These findings imply the possibility of using SW and KAR1 for enhancing the biosynthesis of tanshinones in T. atroviride D16, and enrich the application of smoke water in the medicinal plant field.
Anthurium gallardoae and Xanthosoma isabellanum (Araceae), two new species from coastal Ecuador
Authors: CORNEJO XAVIER , CROAT TOM
Published: May 2021

Anthurium gallardoae and Xanthosoma isabellanum, two new species of Araceae endemic to coastal Ecuador, both originally collected sterile in Manabí and Guayas provinces, respectively, and kept in cultivation until flowering at home in the city Guayaquil are here formally described and illustrated.
Postoperative Complications Associated With Intra- Versus Extracorporeal Anastomosis for Laparoscopic Right Colectomy
Authors: Ishizuka Mitsuru , Shibuya Norisuke , Takagi Kazutoshi , Hachiya Hiroyuki , Tago Kazuma , Shimizu Takayuki , Matsumoto Takatsugu , Aoki Taku , Kubota Keiichi
Published: May 2021

Objective

To compare the postoperative complications of intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA) in patients undergoing laparoscopic right colectomy (LRC).

Background

Although several studies have compared postoperative complications of ICA and ECA after LRC, most were retrospective studies.

Methods

We performed a comprehensive electronic search of the literature to identify studies that compared postoperative complications between ICA and ECA in patients who underwent LRC. We performed meta-analysis using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) of experiencing complications, and we analyzed heterogeneity using I2 statistics.

Results

Fifteen studies consist of randomized controlled trials, case-control studies, and propensity score matching studies involving a total of 3219 patients who underwent LRC were included. Among 1377 patients who received ICA, 255 (18.5%) had postoperative complications, whereas among 1652 patients who received ECA, 373 (22.6%) had such complications. The results of the meta-analysis revealed that ICA was associated with a significantly reduced risk of postoperative complications (RR, .73; 95% CI: .57-.95; P = .02; I2 = 57%) compared with ECA. Although there was no significant difference between the 2 groups in risk of anastomotic leakage (RR, .67; 95% CI: .39-1.17; P = .16; I2 = 8%), there was a significant difference between them in risk of surgical site infection (RR, .50; 95% CI: .34-.71; P = .0002; I2 = 0%).

Conclusions

Intracorporeal anastomosis is associated with a reduced risk of postoperative complications compared with ECA in patients undergoing LRC.
Science Diplomacy at the International Atomic Energy Agency: Isotope Hydrology, Development, and the Establishment of a Technique
Authors: Adamson Matthew
Published: May 2021

This essay examines the International Atomic Energy Agency’s (IAEA’s) role in the entry of hydrological isotopic analysis techniques into the developing world. The notion of using radioisotopic tracers for hydrological study came from the initiative of individual scientists, many of whom were interested in measuring the uptake of hydrogen-bomb deposited tritium in the global environment. Their proposals to include isotope hydrology among the range of IAEA activities sparked debate in the IAEA Scientific Advisory Committee and Board of Governors. At stake was not merely the future support of the technique, but the diplomatic role of the IAEA as a provider of atomic energy to the developing world, the relationship of the IAEA to other international institutions, and the articulation of what ‘peaceful uses of atomic energy’ really meant. In the end, the IAEA opted to render conditional support for the landmark Global Network of Isotopes in Precipitation and undertook sponsorship of expert panels that brought together isotope specialists and hydrologists. As the essay shows, the IAEA’s agenda for isotope hydrology was not only a matter of technology, linked to instrumentation and technique. As a form of policy entrepreneurship, it also gave the IAEA a new diplomatic role in the larger network of international institutions.
Training for policy capacity: A practitioner’s reflection on an in-house intervention for civil servants, students, and post-secondary graduates in Canada
Authors: Cameron Bobby Thomas
Published: May 2021

A substantial amount of scholarly work focuses on conceptualizing, theorizing and studying the policy capacity of governments. Yet, guidance for practitioners on developing policy capacity training programs is lacking. In this article, I reflect on my experience as a public servant in the provincial government of Prince Edward Island where I designed and implemented the Policy Capacity Development and Mentorship Program for civil servants, recent graduates and students. In this article, I offer a descriptive overview of the framework and logic of the program and discuss how I integrated policy capacity theory. This article may serve other practitioners who seek to implement similar programs in their respective organizations and provides a base for future interventions. The article also offers thoughts on practitioner-led collaboration with academics and recommendations for those who would like to establish similar programs in their organizations.
Using Dyadic Modeling in Nursing Research: Introduction of Theory and Application
Authors: Zhao Xiang , Prandstetter Katharina , Foran Heather M.
Published: May 2021

Use of dyadic modeling in nursing has theoretical and practical importance, as the interpersonal processes related to health behaviors can be captured. Theoretical models focusing on dyadic coping with chronic illness and illness management are established in family nursing. However, few studies utilized dyadic designs in empirical research, as most studies are patient-centric or care partner-centric. With theoretical elaborations and examples, we first review how conventional health models have been extended using a dyadic perspective and then briefly review the major dyadic frameworks in nursing. Five frequently used dyadic models are described with examples from health and nursing research fields. Statistical applications and cultural considerations are reviewed. We conclude that dyadic modeling provides a useful lens for nursing research but continues to be underutilized.
Ovarian epithelioid angiosarcoma complicating pregnancy: a case report and review of the literature
Authors: Peng Xiaotong , Duan Zhi , Yin Hongling , Dai Furong , Liu Huining
Published: May 2021

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.
Living with myalgic encephalomyelitis/chronic fatigue syndrome: Experiences of occupational disruption for adults in Australia
Authors: Bartlett Chelsea , Hughes Julie L , Miller Laura
Published: May 2021

Introduction

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a poorly understood, highly stigmatised health condition that has widespread impacts on the individual. Currently, there is limited understanding of the ME/CFS experience from an occupational perspective within Australia. This study aimed to explore the lived experience of ME/CFS and subsequent disruption to occupational participation for adults living in Australia.

Methods

Using descriptive case study design, five participants with ME/CFS in Australia completed semi-structured interviews. Reflexive thematic analysis was used to analyse the qualitative data.

Findings

Themes identified were organised using the Person-Environment-Occupation model. Participants reported systemic changes to previous levels of physical, cognitive and affective functioning, resulting in significant occupational disruption and poor well-being. Occupational prioritisation was followed by a loss of occupations starting with leisure, then productivity and eventually self-care. Environmental barriers to participation included stigma and misunderstanding of ME/CFS, financial hardship, lack of appropriate health services and strains on personal support networks and relationships.

Conclusion

Changes to occupational performance following the onset of ME/CFS caused significant occupational disruption and resulted in limited participation which narrowed over time. There is a clear role for occupational therapy to intervene early to prevent significant negative impacts on occupational participation for people with ME/CFS.
Processing strategy for high strength Ni-based hybrid composite clad on SS 316L steel through microwave heating
Authors: Kaushal Sarbjeet , Singh Satnam , Gupta Dheeraj
Published: May 2021

Processing of nickel-based high strength composites and alloys is a difficult and thought-provoking task. In this work, a strategy of heating through microwaves radiation is utilized to process the high strength hybrid Ni-based composite clad on SS 316L steel surface containing 15% (WC-8Co) and 5% Mo. The premixed composite powder was placed on the steel surface and irradiated with domestic microwave applicator having 2.45 GHz fixed frequency and 900 W power. The hybrid clad was successfully developed within 12–15 min of microwave exposure. The processed clad was subjected to various metallurgical and mechanical characterizations to understand the microstructures and phase changes. Microstructural analysis study revealed that the clad of ∼0.85 mm thickness was obtained and presence of dispersed reinforced particles of WC-8Co and Mo in nickel matrix were observed. Some inter-metallic phases of W2C, Ni2Mo4C, Ni4W and NiSi2 were observed in the clad. The average microhardness of the composite clad was712 ± 58 HV. The microwave processed clad exhibited a flexural strength of 852 ± 6 MPa with deformation index of 35 × 10−5 mm/N. Further, the sliding wear study revealed that the sliding velocity of 1.0 m/s favoured the formation of oxide tribo layers. The various mechanisms of wear revealed by the analysis of worn-out surfaces were abrasion, adhesion, surface pull-out and deformation of surfaces. The microwave processed clad revealed significant improvement in wear resistance in comparison to the steel substrate.
Redesign of a Transfusion Issue Form Using Human Factors Science
Authors: Barg-Walkow Laura , Annen* Kyle
Published: May 2021

Blood transfusions are common procedures but are high risk for patient safety. Verification of the correct blood unit for the patient, assessments of the patient for symptoms of transfusion reactions, and quick responses to suspected reactions are the main interventions to ensure this process are safe. Each of these steps is aided by the transfusion issue form. We identified opportunities to use human factors principles to redesign and evaluate the form. We provide a discussion of the specific design changes and methods to facilitate use in other contexts.
Assessing Authentic Diversity in the Human Factors and Ergonomics Society: Part 1
Authors: Chiou Erin K. , Roscoe Rod D.
Published: May 2021

This article is Part 1 of a two-part series reflecting on diversity within the Human Factors and Ergonomics Society (HFES) and how the pursuit of “authentic” diversity is essential to HFES’s overarching goals for inclusion and equity. In Part 1, authentic diversity is discussed – what it means and what it might look like. Through this lens of authentic diversity, recent member demographics are reported. Part 1 concludes with a discussion about HFES’s growth potential, as a professional home for future scholars and practitioners, and the importance of measuring, documenting, and tracking organizational diversity and inclusion efforts across time.
A simulation study of excitation contour of a linear trap with spatial harmonics
Authors: Konenkov NV
Published: May 2021

The process of nonlinear resonant excitation of ion oscillations in a linear trap is studied. There is still no detailed simulation of the resonance peak in the literature. We propose to use the excitation contour to describe the collective ion resonance. The excitation contour is a resonant mass peak obtained by the trajectory method with the Gaussian distribution of the initial coordinates and velocities. The following factors are considered: excitation time, low order hexapole and octopole harmonics with amplitudes A3 and A4, the depth of the initial ion cloud position. These multipoles are used for selective ion ejection from linear ion trap. All these factors affect the ion yield and the shape of the contours. Obtained data can be useful for control of such processes as ion fragmentation, ion isolation, ion activation, and ion ejection. Simulated resonance peaks are important for the theoretical description of the ion collective nonlinear resonances.
Progress Toward Obtaining Seizure Freedom With New Medications in Older Adults
Authors: Birnbaum Angela
Published: May 2021

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Malperfusion in Acute Type A Aortic Dissection: Management Strategies
Authors: Jaffar-Karballai Mona , Tran Tien Thuy , Oremakinde Oyinkan , Zafar Somama , Harky Amer
Published: May 2021

Over the decades, it has been well established that malperfusion complicates a number of acute type A aortic dissection (ATAAD) patients. Of the many complications that arise from ATAAD is malperfusion, which is the result of true lumen compression secondary to the dissection, and it is one of the most dangerous complications. Left untreated, malperfusion can eventually compromise circulation to the vascular beds of almost all vital organs. Clinicians must consider the diagnosis of malperfusion promptly following a diagnosis of acute aortic dissection. The outcomes post-surgery for patients with ATAAD with concomitant malperfusion remains poor, despite mortality for aortic surgery improving over time. Optimal management for ATAAD with associated malperfusion has yet to be implemented, further research is warranted to improve the detection and management of this potentially fatal pathology. In this review, we explore the literature surrounding the complications of malperfusion in ATAAD and the various symptom presentations, investigations, and management strategies available.
Clinical trials site recruitment optimisation: Guidance from Clinical Trials: Impact and Quality
Authors: Zahren Christine , Harvey Sonia , Weekes Leanne , Bradshaw Charlotte , Butala Radhika , Andrews John , O’Callaghan Sally
Published: May 2021

Background/Aims:

Participants are integral to the success of any clinical research study, yet participant recruitment into clinical trials poses ongoing and complex challenges. It is widely accepted and recognised that clinical trial sites often find it difficult to meet recruitment goals, both in terms of accrual targets and timelines. This can impact the validity of trials or cause major delays for research. There are very few frameworks available to clinical trial sites to improve recruitment. The GREET project (Guidance to Recruitment: Examining Experiences at clinical Trial sites) sought to identify barriers to recruitment and produce formal guidance to optimise recruitment outcomes.

Methods:

Clinical Trials: Impact and Quality, a collaborative of sector stakeholders, convened a project team with comprehensive knowledge of the Australian clinical trials sector to undertake the GREET project. The project scope included exploration of recruitment issues at a site level across all phases of clinical trials and all types of trial sites. The scope excluded upstream issues such as protocol design and general public clinical trial awareness, participant retention and elements of recruitment outside a site’s capacity to directly influence or control. The project team’s extensive knowledge and experience conducting clinical trials in Australia was used to collaboratively identify a list of 24 key barriers and 12 enablers to site recruitment which formed the basis of the project. Key stakeholder groups were surveyed to challenge project team assumptions. A national and international environmental scan and literature review was conducted to identify best-practice recruitment solutions.

Results:

A total of 343 people responded to a survey sent to sites, sponsors, and contract research organisations, and 162 people responded to a survey sent to consumers via consumer networks. The key barriers and enablers initially identified by the project team aligned with the key outcomes of the surveys, which in turn assisted in the development of best-practice recommendations in the form of a Clinical Trial Site Recruitment Guide. Recommendations were grouped into four key themes; conducting accurate study feasibility; proactive planning during start-up; selecting optimal recruitment methods; and participant involvement. Early intervention was identified as a key facilitator in maximising improved recruitment outcomes. The GREET Clinical Trial Site Recruitment Guide is publicly accessible on the Clinical Trials: Impact and Quality website.

Conclusion:

Participant recruitment challenges experienced at a site level are widespread and varied, and there is no universal recruitment solution. However, this project identified that there are interventions and assessments that can be proactively implemented and selectively applied to facilitate improved recruitment outcomes.
Pregnancy-related death disparities in non-Hispanic Black women
Authors: Crandall Katherine
Published: May 2021

While the rate of pregnancy-related death steadily increases in the United States, this tragic outcome is disproportionately devastating US-born non-Hispanic Black women at a rate that is three to four times that of their White and non-Black Hispanic counterparts. These disparities persist despite controlling for variables such as socioeconomic status, education levels, and geographical location. Pregnancy-related deaths in Black women are largely cardiovascular in etiology, and while these complications also occur in women of other ethnic backgrounds, they often are more severe and more deadly in Black women. This population often lacks adequate prenatal care likely because they face personal and structural barriers. Reversal of barriers during the prenatal period, the implementation of medical protocols during delivery, and the assurance of close follow-up during the postpartum year are vital in improving outcomes. This article will detail seven specific concerns within perinatal care and pregnancy-related death, and offer potential solutions to addressing them. Pregnancy-related death in Black women is not as an isolated event, but rather is one adverse outcome that exists on a broad spectrum of adverse outcomes. Now is the time to reckon with the reality that our nation’s Black women are dying at a disproportionate rate compared to women of other ethnicities due to pregnancy-related complications and suffering lifelong consequences even if they escape this fatal outcome. This is a call to action to understand this deeply devastating, multi-factorial issue so we may strive to eliminate this highly preventable and tragic event altogether.
Optimal adaptive inspection and maintenance for redundant systems
Authors: Lin Chaochao , Pozzi Matteo
Published: May 2021

Optimal exploration of engineering systems can be guided by the principle of Value of Information (VoI), which accounts for the topological important of components, their reliability and the management costs. For series systems, in most cases higher inspection priority should be given to unreliable components. For redundant systems such as parallel systems, analysis of one-shot decision problems shows that higher inspection priority should be given to more reliable components. This paper investigates the optimal exploration of redundant systems in long-term decision making with sequential inspection and repairing. When the expected, cumulated, discounted cost is considered, it may become more efficient to give higher inspection priority to less reliable components, in order to preserve system redundancy. To investigate this problem, we develop a Partially Observable Markov Decision Process (POMDP) framework for sequential inspection and maintenance of redundant systems, where the VoI analysis is embedded in the optimal selection of exploratory actions. We investigate the use of alternative approximate POMDP solvers for parallel and more general systems, compare their computation complexities and performance, and show how the inspection priorities depend on the economic discount factor, the degradation rate, the inspection precision, and the repair cost.
Efectos de las acciones de prevención y control del SARS-CoV-2: la importancia de tender puentes entre la salud pública y las intervenciones para la atención de las violencias de género
Authors: Gómez López Claudia
Published: May 2021

La Organización Mundial de la Salud (OMS) respalda la cuarentena como uno de los mecanismos más efectivos para el control del SARS-CoV-2. Sin embargo, dicha medida en salud pública trae consigo impactos diferenciados. Las cifras de Bogotá, Distrito Capital de Colombia, evidencian que esta medida entra en conflicto con la garantía y la no vulneración de otros derechos. Una vez instaurada en Bogotá la cuarentena obligatoria, el número de reportes de casos de violencia contra las mujeres aumentó en más del 200%. El Distrito, consciente del riesgo que supone para las mujeres el aislamiento social en convivencia con el (los) agresor(es), activó cinco intervenciones para la prevención de las violencias, el acompañamiento a las víctimas y la mitigación del riesgo feminicida. Las intervenciones implementadas pusieron de manifiesto que, pese a los avances normativos y de política pública, es necesario fortalecer, durante la pandemia y en el largo plazo, la respuesta institucional a las violencias de género, en términos de activación y flexibilización de la ruta de atención, fortalecimiento del sistema de protección y, en particular, la articulación interinstitucional e intersectorial para dar una respuesta integral que derive en el restablecimiento de derechos. La experiencia de Bogotá insta al diálogo entre las acciones en salud y los derechos fundamentales en el marco de la atención a una crisis social y de salud, y a trascender las intervenciones clínicas y epidemiológicas dando lugar a estrategias más integrales, en términos de bienestar poblacional.
The role of cognitive and affective flexibility in individual differences in the experience of experimentally induced heat pain
Authors: Meesters Astrid , Vancleef Linda M. G. , Peters Madelon L.
Published: May 2021

Adaptation to the context in which we experience pain requires cognitive flexibility (CF) and affective flexibility (AF). Deficits in both flexibility types may be precursors of more intense and prolonged pain. This study aimed to examine the relation between CF and AF, and the experience of experimentally induced pain. Furthermore, correlations between behavioral and self-report measures of flexibility were explored. CF and AF were assessed with task-switching paradigms, using neutral (numbers ranging from 1 to 9, excluding 5) or affective stimuli (positive and negative pictures), respectively. Pain sensitivity measures, such as pain threshold (°C), pain tolerance (°C), and retrospective pain experience ratings (Visual Analog Scale) were assessed for an experimentally induced heat pain stimulus. Self-reported CF was measured with a questionnaire. Results demonstrated no associations between the flexibility constructs and any of the pain outcome measures. Correlations between the behavioral and self-report measures of CF were absent or weak at best. Current results are discussed against the background of methodological considerations and prior empirical research findings, suggesting the contribution of AF in especially the recovery from pain.
Capnocytophaga gingivalis Bacteremia After Upper Gastrointestinal Bleeding in Immunocompromised Patient
Authors: Lawal Folake J. , Baer Stephanie L.
Published: May 2021

Odontogenic bacteremia, most commonly involving gram-positive oral flora, can result from daily self-care practices or professional dental procedures. Though usually transient and quickly cleared by the immune system, the presence of periodontal disease increases the frequency of exposure and risk of persistence of oral-systemic infections. Comorbidities such as asplenia, alcoholism, and immunocompromise increase the risk of complications of hematogenous spread and severe systemic illness. Capnocytophaga is a genus of anaerobic fastidious gram-negative bacilli, which is a common member of human oral flora, and its density is proportional to mass of dental plaques and periodontal diseases. Capnocytophaga spp that colonize humans are less virulent and are uncommon causes of bacteremia when compared with the Capnocytophaga typical of canines. C gingivalis has been rarely reported as a cause of disease in immunocompromised or immunocompetent hosts. In this article, we present a case of an immunocompromised 70-year-old man with poor oral hygiene, on methotrexate and prednisone for rheumatoid arthritis and sarcoidosis, who was admitted for chronic obstructive pulmonary disease exacerbation and developed C gingivalis bacteremia and septic shock after an episode of upper gastrointestinal bleeding. Poor oral hygiene in our patient is believed to have increased his risk as an immunocompromised patient to developing C gingivalis bacteremia. This case highlights the importance of oral care in immunocompromised patients especially while hospitalized, and those about to receive transplant, chemotherapy, or on immune modulators.
Comparing individual and population differences in minute ventilation/carbon dioxide production slopes using centile growth curves and log-linear allometry
Authors: Nevill Alan M. , Myers Jonathan , Kaminsky Leonard A. , Arena Ross , Myers Tony D.
Published: May 2021

Identifying vulnerable groups and/or individuals’ cardiorespiratory fitness (CRF) is an important challenge for clinicians/researchers alike. To quantify CRF accurately, the assessment of several variables is now standard practice including maximal oxygen uptake (VʹCO2) and ventilatory efficiency, the latter assessed using the minute ventilation/carbon dioxide production (VʹE/VʹCO2) slope. Recently, reference values (centiles) forVʹE/VʹCO2slopes for males and females aged 20 to 80 have been published, using cardiopulmonary exercise testing (CPX) data (treadmill protocol) from the Fitness Registry and the Importance of Exercise National Database (FRIEND Registry).

In the current observational study we provide centile curves for the FRIEND RegistryVʹE/VʹCO2slopes, fitted using the generalised additive model for location, scale and shape (GAMLSS), to provide individuals with a more precise estimate of where theirVʹE/VʹCO2slopes fall within the population. We also confirm that by adopting allometric models (incorporating a log transformation), the resulting ANCOVAs provided more normal and homoscedastic residuals, with superior goodness-of-fit using the Akaike information criterion (AIC)=14 671 (compared with traditional ANCOVA's AIC=15 008) that confirms allometric models are vastly superior to traditional ANCOVA models.

In conclusion, providing sex-by-age centile curves rather than referring to reference tables for ventilatory efficiency (VʹE/VʹCO2slopes) will provide more accurate estimates of where an individual's particularVʹE/VʹCO2slope falls within the population. Also, by adopting allometric models researchers are more likely to identify real and valid inferences when analysing population/group differences inVʹE/VʹCO2slopes.
High but stable incidence of adult-onset asthma in northern Sweden over the last decades
Authors: Räisänen Petri , Backman Helena , Hedman Linnea , Andersson Martin , Stridsman Caroline , Kankaanranta Hannu , Ilmarinen Pinja , Andersen Heidi , Piirilä Päivi , Lindberg Anne , Lundbäck Bo , Rönmark Eva
Published: May 2021

Background

The prevalence of asthma has increased both among children and adults during the latter half of the 20th century. The prevalence among adults is affected by the incidence of asthma not only in childhood but also in adulthood. Time trends in asthma incidence have been poorly studied.

Aims

The aim of this study was to review the incidence of adult-onset asthma from 1996 to 2006 and 2006 to 2016 and compare the risk factor patterns.

Methods

In the Obstructive Lung Disease in Northern Sweden (OLIN) studies, two randomly selected population-based samples in the 20–69-year age group participated in postal questionnaire surveys about asthma in 1996 (n=7104, 85%) and 2006 (n=6165, 77%). A 10-year follow-up of the two cohorts with the same validated questionnaire was performed, and 5709 and 4552 responded, respectively. Different definitions of population at risk were used in the calculations of asthma incidence. The protocol followed a study performed between 1986 and 1996 in the same area.

Results

The crude incidence rate of physician-diagnosed asthma was 4.4 per 1000 person-years (men 3.8, women 5.5) from 1996 to 2006, and 4.8 per 1000 person-years (men 3.7, women 6.2) from 2006 to 2016. When correcting for possible under-diagnosis at study entry, the incidence rate was 2.4 per 1000 person-years from 1996 to 2006 and 2.6 per 1000 person-years from 2006 to 2016. The incidence rates were similar across age groups. Allergic rhino-conjunctivitis was the main risk factor for incident asthma in both observation periods (risk ratio 2.4–2.6).

Conclusions

The incidence of adult-onset asthma has been stable over the last two decades and has remained at a similar level since the 1980s. The high incidence contributes to the increase in asthma prevalence.
Anesthetic effect of different doses of butorphanol in patients undergoing gastroscopy and colonoscopy
Authors: Lv Shun , Sun Defeng , Li Jinglin , Yang Lin , Sun Zhongliang , Feng Yan
Published: May 2021

Background

This study aimed to investigate the anesthetic effect of butorphanol with different doses in patients undergoing gastroscopy and colonoscopy.

Methods

480 patients undergoing gastroscopy and colonoscopy were recruited and randomly divided into four groups to receive different doses of butorphanol (Group A = 2.5 μg/kg, Group B = 5 μg/kg, Group C = 7.5 μg/kg and Group D = 10 μg/kg). Butorphanol was administered 5 min before propofol infusion. The primary outcome was the incidence of body movement. Secondary outcomes were postoperative recovery time, length of stay in the Post-Anesthesia Care Unit (PACU), the total dose of propofol, and the incidence of intraoperative hypoxemia, propofol injection pain, cough, postoperative nausea and vomiting, drowsiness, and dizziness.

Results

The incidence of body movement and the dose of propofol in Group C and D were lower than those in Group A and B (P < 0.05). The incidence and intensity of propofol injection pain and the incidence of cough in Group B, C, and D were lower than those in Group A (P < 0.05). The length of stay in PACU and the incidence of postoperative drowsiness and dizziness were higher in Group D than in Group A, B, and C (P < 0.05).

Conclusion

Intravenous pre-injection of 7.5 μg/kg butorphanol with propofol can be the optimal dosage for patients undergoing gastroscopy and colonoscopy.

Trial registration: Trial registration: Chinese Clinical Trial Registry, ChiCTR2000031506. Registered 3 April 2020—Retrospectively registered, http://www.medresman.org.cn.
The polyphenol/saponin-rich Rhus tripartita extract has an apoptotic effect on THP-1 cells through the PI3K/AKT/mTOR signaling pathway
Authors: Tlili Hajer , Macovei Anca , Buonocore Daniela , Lanzafame Manuela , Najjaa Hanen , Lombardi Anita , Pagano Andrea , Dossena Maurizia , Verri Manuela , Arfa Abdelkarim Ben , Neffati Mohamed , Doria Enrico
Published: May 2021

Background

Hyperactivation of mechanistic target of rapamycin (mTOR) signaling pathway is involved in the regulation of cellular growth, proliferation, and more in general, is a common phenomenon in most types of cancers. Thus, natural substances targeting this pathway can be of great therapeutic potential in supporting the treatment of tumor patients. Rhus tripartita (Ucria) Grande is a plant growing in desertic areas which is traditionally used for the treatment of several diseases in Tunisia. In the present work, the biochemical profile of the main compounds present in the plant leaf extract was determined and the anti-leukemic potential of the plant extracts against acute monocytic leukaemia (AML) THP-1 cells was investigated.

Methods

After HPLC identification of some phenolic compounds present in the plant extract and the quantification of saponin content, the cytotoxic effect of Rhus tripartita extracts on THP-1 cell culture was evaluated using the colorimetric MTT assay for cell viability. THP-1 cells were incubated with medium containing the relative IC50 concentrations of total plant extract, saponin extract and some standard compounds (rutin (R); kaempferol (K); mixture of catechin, epicatechin, and epicatechin-gallate (CEEG); ellagic acid (EA). Finally, qRT-PCR and western blotting analysis were used to evaluate the effect of some flavonoids present in a crude extract of polyphenols and the total extract of saponins on cell survival and apoptosis.

Results

Analysis of expression level of some gene (PIK3CA, PTEN, AKT1, mTOR, EIF4E, RPS6KB1, and TSC1) involved in the mTOR pathway and the phosphorylation of S6 and AKT proteins allowed to observe that a total Rhus tripartita extract and some of the compounds found in the extract controls THP-1 cell proliferation and apoptosis via regulation of the PI3K-Akt-mTOR signaling pathway.

Conclusion

Rhus tripartita-induced inhibition of cell cycle and induction of apoptosis may involve the mTOR pathway. Therefore, Rhus tripartita extract may be a useful candidate as a natural anti-cancer drug to support the treatment of AML.
EYA2 suppresses the progression of hepatocellular carcinoma via SOCS3-mediated blockade of JAK/STAT signaling
Authors: Liu Ze-Kun , Li Can , Zhang Ren-Yu , Wei Ding , Shang Yu-Kui , Yong Yu-Le , Kong Ling-Min , Zheng Nai-Shan , Liu Ke , Lu Meng , Liu Man , Hu Cai-Xia , Yang Xiao-Zhen , Chen Zhi-Nan , Bian Huijie
Published: May 2021

Background

Somatic mutations are involved in hepatocellular carcinoma (HCC) progression, but the genetic mechanism associated to hepatocarcinogenesis remains poorly understood. We report that Eyes absent homolog 2 (EYA2) suppresses the HCC progression, while EYA2(A510E) mutation identified by exome sequencing attenuates the tumor-inhibiting effect of EYA2.

Methods

Whole-exome sequencing was performed on six pairs of human HCC primary tumors and matched adjacent tissues. Focusing on EYA2, expression level of EYA2 in human HCC samples was evaluated by quantitative real-time PCR, western blot and immunohistochemistry. Loss- and gain-of-function studies, hepatocyte-specific deletion of EYA2 (Eya2−/−) in mice and RNA sequencing analysis were used to explore the functional effect and mechanism of EYA2 on HCC cell growth and metastasis. EYA2 methylation status was evaluated using Sequenom MassARRAY and publicly available data analysis.

Results

A new somatic mutation p.Ala510Glu of EYA2 was identified in HCC tissues. The expression of EYA2 was down-regulated in HCC and associated with tumor size (P = 0.001), Barcelona Clinic Liver Cancer stage (P = 0.016) and tumor differentiation (P = 0.048). High level of EYA2 was correlated with a favorable prognosis in HCC patients (P = 0.003). Results from loss-of-function and gain-of-function experiments suggested that knockdown of EYA2 enhanced, while overexpression of EYA2 attenuated, the proliferation, clone formation, invasion, and migration of HCC cells in vitro. Delivery of EYA2 gene had a therapeutic effect on inhibition of orthotopic liver tumor in nude mice. However, EYA2(A510E) mutation led to protein degradation by unfolded protein response, thus weakening the inhibitory function of EYA2. Hepatocyte-specific deletion of EYA2 in mice dramatically promoted diethylnitrosamine-induced HCC development. EYA2 was also down-regulated in HCC by aberrant CpG methylation. Mechanically, EYA2 combined with DACH1 to transcriptionally regulate SOCS3 expression, thus suppressing the progression of HCC via SOCS3-mediated blockade of the JAK/STAT signaling pathway.

Conclusions

In our study, we identified and validated EYA2 as a tumor suppressor gene in HCC, providing a new insight into HCC pathogenesis.