bluuebunny/crossref_metadata_2025 huggingface dataset:
The study of intelligent scheduling algorithm oriented to complex constraints and multi-process roller grinding workshop
Authors: Li Hanyang , Wang Chao , Jiang Sheng , Liu Sheng , Rong Yiming , Li Xuekun
Published: November 2020

Roller grinding workshop is a typical multi-unit and multi-task manufacturing scenario, which is aimed to repair the surface damage of the rollers caused by the rolling process, so that the rollers can be reused. Due to the process complexity of roller grinding workshop and the large volume and weight of the roller, hoisting and transportation mode with multiple cranes is required. Consequently, the scheduling of the roller grinding workshop needs to consider both the task sequencing in time and the noninterference of the multi-crane trajectory in space. In this paper, the intelligent scheduling of roller grinding workshop is studied based on the characteristics of complex tasks and space-time coupling constraints. Firstly, the scheduling basis is established based on priority rules and process constraints. In order to solve the scheduling problem under the space-time coupling constraints, the position coordinate system is established, and then the algorithms of crane position tracking and cooperative motion without interference are developed. Further, considering the transportation time of crane and its out of sync time point with the processes, the intelligent decision and scheduling algorithm are developed based on the dynamic priority strategy defined to realize scheduling, including time decision, crane decision, and process decision. With the developed intelligent scheduling algorithm applied, the simulation of the roller grinding workshop is conducted under three combinations of priority strategy and noninterference strategy to verify algorithm performance. Under the guarantee of crane noninterference during the full production, the efficiency is improved by 22.1% compared with the existing processing mode of industry. Additionally, EPTR (effective process time rate) based on dynamic priority strategy and noninterference strategy B is up to 100% to avoid intervals between two processes in the scheduling. The dynamic priority developed in this paper reveals more efficiency than MOR principle, while with the strategy B the CUR (crane utilization rate) can be improved more than 20% under the condition of enough machines which facilitates to obtain shorter makespan than strategy A. The intelligent scheduling algorithm developed guarantees the effectiveness and rationality of scheduling with multi-unit and multi-task under the complex constraints. Finally, in order to realize the automatic and intelligent operation of the roller grinding workshop, the management software of the roller grinding workshop is developed by integrating the intelligent scheduling algorithm, which realizes the intelligent production, monitoring, and management of the roller grinding workshop during the full production cycle.
Multi-input multi-output fractional-order control of an underactuated continuum mechanism
Authors: Deutschmann Bastian , Monje Concepción A , Ott Christian
Published: November 2020

This article treats the design and implementation of a multi-input multi-output fractional-order controller for a nonlinear system composed of a tendon-driven continuum mechanism. As the continuum can be deformed along all Cartesian directions, it is suitable for the application as a flexible neck of a humanoid robot. In this work, a model-based control approach is proposed to control the position of the head, that is, the rigid body attached to the top of the continuum mechanism. Herein, the system is modeled as a rigid body on top of a nonlinear Cartesian spring, with an experimentally obtained deflection characteristic which provides a simple and real-time capable model. By nonlinear feedback, the output dynamics are linearized and decoupled, which enables the design of single-input single-output fractional-order controllers for the regulation of each output independently. The design of a fractional-order [Formula: see text] controller is discussed to incorporate robustness and a fast transient response. The proposed control approach is tested in several experiments on the real system.
Multi-robot informative path planning in unknown environments through continuous region partitioning
Authors: Dutta Ayan , Bhattacharya Amitabh , Kreidl O Patrick , Ghosh Anirban , Dasgupta Prithviraj
Published: November 2020

We consider the NP-hard problem of multirobot informative path planning in the presence of communication constraints, where the objective is to collect higher amounts of information of an ambient phenomenon. We propose a novel approach that uses continuous region partitioning into Voronoi components to efficiently divide an initially unknown environment among the robots based on newly discovered obstacles enabling improved load balancing between robots. Simulation results show that our proposed approach is successful in reducing the initial imbalance of the robots’ allocated free regions while ensuring close-to-reality spatial modeling within a reasonable amount of time.
Synthesis of hydroxy-α-sanshool
Authors: Zhou Jianjun , Xiao Yan , Chen Taiping , Gao Jiyu , Huang Wencai , Li Zicheng
Published: November 2020

Hydroxy-α-sanshool was synthesized in a 13% overall yield through eight steps, which included two Wittig reactions that were used to form the carbon skeleton with ethyl 2-oxoacetate and 2 E,4 E-hexadienal being reacted with the appropriate ylides. Impurities in the processes could easily be separated. Ethyl 6-hydroxy-2Z-hexenoate was converted to its E-isomer with catalysis by I2 and 2E,6Z,8E,10E-dodecatetraenoic acid was crystallized from a solution in 1% ethyl acetate in n-hexane.
Comparisons of new body load and metabolic power average workload indices between starters and non-starters: A full-season study in professional soccer players
Authors: Nobari Hadi , Praça Gibson Moreira , Clemente Filipe Manuel , Pérez-Gómez Jorge , Carlos Vivas Jorge , Ahmadi Mina
Published: November 2020

The aim of this study was to compare the weekly average training monotony new body load (wTMNBL) and strain (wTSNBL), as well as the weekly average training monotony metabolic power average (wTMMPA) and strain (wTSMPA) between four periods of a season (preseason, early-season, mid-season, and end-season), considering starters and non-starters. Twenty-one professional soccer players (age: 28.27 ± 3.78 years) were monitored throughout a season in the highest level of professional football Premier League in Iran. Data were captured by Global Positioning System (GPS) devices. Independent samples T-tests were applied to analyze the between-group differences for all dependent derived-GPS variables for the full season and its different periods (preseason, early-season, mid-season, and end-season). Based on the amount of time attending in match and training, players were divided into two groups (starters and non-starters) each week. The magnitude of the between-group difference revealed a very large significant greater weekly average TMNBL ( p<0.001, d = −2.42), TSNBL ( p<0.001; d = −2.74), TMMPA ( p<0.001; d =–2.79) and TSMPA ( p<0.001; d = −3.27) for starters when compared to non-starters during the early-season. The findings also revealed a very large significant difference when starters were compared to non-starters during the mid-season (TMNBL: p<0.001, d = −2.89; TSNBL: p<0.001, d = −2.99; TMMPA: p<0.001, d = −3.28; and TSMPA: p<0.001, d = −3.25) and end-season (TMNBL: p<0.001, d = −2.89; TSNBL: p<0.001, d = −3.07; TMMPA: p<0.001, d = −3.16; and TSMPA: p<0.001, d = −3.58). In summary, the results of this study revealed that starters present regularly higher values of NBL, MPA-based weekly training monotony, and training strain than non-starters. This result must be taken into account when planning weekly workloads for these groups. Specifically, starters might experience high values of external workloads because of match-related demands. Therefore, weekly adjustments in their training workload are required to reduce injury risk.
Reliability of a Three-Dimensional Wound Camera and Correlation With Routine Ruler Measurement in Diabetes-Related Foot Ulceration
Authors: Lasschuit Joel Willem Johan , Featherston Jill , Tonks Katherine Thuy Trang
Published: November 2020

Background:

In an era of increasing technology and telehealth utilization, three-dimensional (3D) wound cameras promise reliable, rapid, and touch-free ulceration measurements. However, reliability data for commercially available devices in the diabetes foot service setting is lacking. We aimed to evaluate the reliability of diabetes-related foot ulceration measurement using a 3D wound camera in comparison to the routinely used ruler and probe.

Method:

Participants were prospectively recruited from a tertiary interdisciplinary diabetes foot service. Ulcerations were measured at each visit by two blinded observers, first by ruler and probe, and then using a 3D wound camera twice. Reliability was evaluated using intraclass correlation coefficients (ICC). Measurement methods were compared by Pearson correlation.

Results:

Sixty-three ulcerations affecting 38 participants were measured over 122 visits. Interobserver reliability of ruler measurement was excellent for estimated area (ICC 0.98, 95% CI 0.97-0.98) and depth (ICC 0.93, 95% CI 0.90-0.95). Intraobserver and interobserver reliability of the 3D wound camera area was excellent (ICC 0.96, 95%CI 0.95-0.97 and 0.97 95% CI 0.96-0.98, respectively). Depth was unrecordable in over half of 3D wound camera measurements, and reliability was inferior to probe measurement. Area correlation between methods was good ( R = 0.88 and 0.94 per observer); however, depth correlation was poor ( R = 0.49 and 0.65).

Conclusions:

3D wound cameras offer practical advantages over ruler-based measurement. In diabetes-related foot ulceration, the reliability and comparability of area measurement was excellent across both methods, although depth was more reliably obtained by the probe. These limitations, together with cost, are important considerations if implementing this technology in diabetes foot care.
Selective Exposure During Uprisings: Examining the Public’s News Consumption and Sharing Tendencies During the 2019 Lebanon Protests
Authors: Melki Jad , Kozman Claudia
Published: November 2020

This study examines selective exposure and trust during uprisings. It studies major uses of traditional and social media and assesses the public’s trust in these media and their engagement in sharing news. Focusing on the October 2019 Lebanon uprising, the research surveys thousand Lebanese individuals using a nationally representative probability sample. The findings provide support for selective exposure theory beyond the Western context, particularly for people undergoing stressful political change. The findings also provide support to the robustness of issue publics as a theoretical construct that predicts selective exposure to pro-attitudinal news content, as well as support for attitude strength and attitude importance as two separate predictors.
Taking the Pulse: Looking for the Poetic and Performative in Terrorism and Hate
Authors: Alexander Bryant Keith , Weems Mary E.
Published: November 2020

This performative dialogue focuses on the authors’ collaborative process in constructing the Special Issue— “June 12, 2016: Terrorism and Hate in Orlando, America (Poetic and Performative Responses),” Qualitative Inquiry, 23.7: 483-571.
Physical Activity and Sedentary Behavior During COVID-19: Trajectory and Moderation by Personality
Authors: Stephan Yannick , Terracciano Antonio , Luchetti Martina , Aschwanden Damaris , Lee Ji Hyun , Sesker Amanda A. , Strickhouser Jason E. , Sutin Angelina R.
Published: November 2020

The present study examined the relation between personality and changes in physical activity and sedentary behaviors during the acute phase of the 2019 coronavirus disease (COVID-19) pandemic. Personality was assessed prior to the coronavirus crisis in the Understanding America Study (UAS, N = 6,702) and the Psychological, Behavioral, and Social Response (PBSR) to the coronavirus pandemic ( N = 3,992) study. Physical activity was assessed 4 times from March 2020 to May 2020 in the UAS, and sedentary behavior was assessed 3 times from January 2020 to April 2020 in the PBSR. Higher neuroticism was associated with less increase in physical activity, whereas higher conscientiousness and agreeableness were related to a steeper increase in physical activity over time in the UAS. In the PBSR, higher neuroticism and lower extraversion, agreeableness, and conscientiousness were related to higher average sedentary behavior. This study provides new evidence that personality predicts behavioral responses to the COVID-19 crisis.
Effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients in the Kurdistan region of Iraq
Authors: Farag Halgord Ali M , Baqi Hardi Rafat , Qadir Syamand Ahmed , El Bilbeisi Abdel Hamid , Hamafarj Kawa Khwarahm , Taleb Mahmoud , El Afifi Amany
Published: November 2020

Objective:

This study was employed to assess the effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients.

Method:

This cross-sectional study was conducted among a representative sample, which was selected using a census survey of hypertensive patients (both gender, aged 25–50 years, on regular antihypertensive drugs (atenolol: 50 mg orally once a day)), during Ramadan month that was falling in April to May 2020. The patients were receiving care at Halabja hospital in the Kurdistan region of Iraq. All patients were assessed in two phase’s baseline (a week before Ramadan) and end stage (a week after Ramadan), using anthropometric indices, physical examination, biochemical tests, and a structured questionnaire. Statistical analysis was performed using SPSS version 21.

Results:

A total of 120 hypertensive patients were included in the study (50% females and 50% males), with a mean age of 37.5 ± 6.6 years. The major finding of our study was the significant decrease in blood pressure (P < 0.001). Furthermore, the body weight, body mass index, and waist circumference of the participants decreased after Ramadan fasting in a significant approach (P < 0.001 for all). However, for the lipid profile components, the total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol change persisted not statistically significant (P > 0.05), while only triglyceride decreased drastically after Ramadan fasting (P < 0.001).

Conclusion:

Ramadan fasting could contribute in the improvement of blood pressure and lowers triglyceride levels, body weight, body mass index, and waist circumference of adult hypertensive patients.
Assessment of handwritten prescriptions from Saudi Arabia according to international guidelines
Authors: Youssef Souhib Mohammed , Zaghloul Mohamed Saddik , Ahmed Mohammed Fayez , Barmo Abdul Nasser Ahmed , Mehdi Asghar Mehdi Muhammed , Saquib Nazmus
Published: November 2020

Objective:

Prescription dispensing services are not digitalized in the majority of governmental hospitals and private clinics in Saudi Arabia, which makes them prone to error. We aimed to evaluate handwritten prescriptions in a region in Saudi Arabia for consistency and accuracy according to international guidelines.

Methods:

A sample of handwritten prescriptions (dated 2016 or 2017) from selected pharmacies in the Al-Qassim region (n = 556) were evaluated for missing information on items related to prescriber, patient, and medication according to the World Health Organization and Food and Drug Administration guidelines.

Results:

We found that the prescriber’s name and contact information were missing in two-thirds of the prescriptions (66%). Patients’ addresses were always missing (100%). No prescription contained medication warnings; a majority lacked information on mode of administration (68%) and methods to avoid refilling (66%).

Conclusion:

Saudi Arabia should take a multipronged approach, including digitalization of prescription dispensing services, in both public and private health care facilities in order to reduce prescription errors.
Impact of diet on health and longevity in London 1850–1880
Authors: Greaves Peter
Published: November 2020

This study examines the impact of diet on health in different districts of mid-19th century London. Surveys of London diets and living condition were compared with mortality data between 1851 and 1880. Despite an abundance of fresh foods reaching London, the very poor labouring population living in the inner boroughs between 1850 and 1861 had great difficulty obtaining sufficient nourishment because of its cost. This population showed high death rates from infectious diseases, notably pulmonary tuberculosis, which was endemic and is typically associated with poor nutrition. This high death rate was exacerbated by more deaths from gastrointestinal infections associated with a polluted water supply from the river Thames. By contrast, the poor in the outer suburbs enjoyed both more nutritious diets and cleaner water which was associated with lower death rates comparable to those in rural Britain. Outer suburbs retained a relatively rural life-style associated with cleaner water and an abundance of locally grown food. In the following two decades, there was a significant reduction in the death rates from gastrointestinal infections in the inner boroughs which correlated with the major improvements in London’s water supply. The decline in death rates from tuberculosis and other infectious disease was inconsistent and increased in some boroughs, suggesting patchy economic improvement and a persisting limited ability of many of London’s poor to afford a nutritious diet.
Eight-Year Medical Education Program: Retrospect and Prospect of the High-Level Medical Talent Training in China
Authors: Wu (吴红斌) Hongbin , Xie (谢阿娜) Ana , Wang (王维民) Weimin
Published: November 2020

Purpose:

The 8-year medical education program (EYMEP) is China’s path to training high-level medical talents. In retrospect, this study systematically reviewed the developmental process of China’s EYMEP. The status quo and characteristics, and threats and challenges, were analyzed, along with the program’s prospects.

Design/Approach/Methods:

This study analyzed relevant textual materials and policy documents dating back to the time of hosting of China’s EYMEP, as well as conducted various specific interviews and field trips.

Findings:

The exploration of China’s high-level medical talent training has been conducted over a century. EYMEP can be divided into five periods: the Only Host Period, the Duplication Pilot Host Period, the Expansion Period, the Joint Exploration Period, and the In-Depth Promotion Period. Currently, there are 14 universities and institutes hosting the EYMEP approved by the Ministry of Education of the People’s Republic of China. However, they differ greatly in training ideas and goals, enrollment processes, and training phases. China’s EYMEP is faced with some external threats and internal challenges. In the future, China’s EYMEP should consider five aspects.

Originality/Value:

In the new era of the reform and development of China’s medical education, a systematic review of the development of EYMEP in China is of great significance to the promotion of high-level medical talent training in China. Meanwhile, the exploration course of China’s high-level medical talent training represented by the EYMEP may be an enlightenment for other countries, especially developing countries like China, in their training of high-level medical talents.
Unpacking the Relationship Between Teachers’ Perceptions of Professional Learning Communities and Differentiated Instruction Practice
Authors: Wan Sally Wai-Yan
Published: November 2020

Purpose:

This exploratory study investigates the relationship between teachers’ perceptions of professional learning communities (PLCs) and their differentiated instruction (DI) practice in a Hong Kong primary education context.

Design/Approach/Methods:

Three subsidized primary schools participated in the study. A total of 121 teachers completed surveys regarding their perceptions of PLC engagement and DI practice.

Findings:

Using principal component analysis, three dimensions of PLC engagement were identified: student learning, reflective dialogue, and shared and supportive leadership. Two distinctive PLC engagement profiles were generated based on cluster analysis: high PLC engagement and low PLC engagement. Teachers’ PLC engagement profiles were correlated with their DI practices.

Originality/Value:

The findings have implications for fostering teacher engagement in PLCs. Increased teacher participation in PLCs has great potential for promoting the use of DI.
Perspectives of Public and Private Primary Healthcare Users in Two Regions of Albania on Non-Clinical Quality of Care
Authors: Gabrani Jonila , Schindler Christian , Wyss Kaspar
Published: November 2020

Background:

Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyze perceptions of users of primary healthcare as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider.

Methods:

A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along with 8 non-clinical domains of quality of care. The data of 954 patients were analyzed through descriptive statistics and linear mixed regression models.

Results:

Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean score was reported for the domain “communication” (3.75) followed by “dignity” (3.65), while the lowest mean scores were given for “choice” (2.89) and “prompt attention” (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in “coordination of care” (2.90 vs 2.12, P < .001). In contrast, private outpatient clinics were judged significantly better than urban PHC clinics in “confidentiality” (3.77 vs 3.38, P = .04) and “quality of basic amenities” (3.70 vs 3.02, P < .001). “Autonomy” was reported as least important attribute of quality.

Conclusion:

While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to raise the awareness on autonomy and the involvement of patients’ aspects concerning their health.
Cryptocurrencies: Hedging Opportunities From Domestic Perspectives in Southeast Asia Emerging Markets
Authors: Susilo Didik , Wahyudi Sugeng , Pangestuti Irene Rini Demi , Nugroho Bayu Adi , Robiyanto Robiyanto
Published: November 2020

Previous studies have shown that cryptocurrencies could hedge equities. However, most of those studies did not take into account the recent cryptocurrencies bubbles in 2018 and domestic currencies. Therefore, this research aimed to study whether the hedge effectiveness of cryptocurrencies still exists. This research used five cryptocurrencies (bitcoin, ethereum, monero, ripple, and litecoin), equity indices (Indonesia, Malaysia, Vietnam, Thailand, and the Philippines), and iShares ETF MSCI World (developed world). Commodities-based hedging using iShares S&P GSCI Commodity-Indexed Trust was also analyzed as a comparison. The asymmetric generalized dynamic conditional correlation (AG-DCC) GARCH showed that one cryptocurrency could not significantly and consistently hedge equities while five equally weighted cryptocurrencies could marginally hedge equities. Meanwhile, the classical minimum variance model also showed that the hedge effectiveness of cryptocurrencies was insignificantly positive. Equity traders could add cryptocurrencies into portfolios when the purpose was to maximize the Sharpe ratio instead of hedging. Overall, commodities were the better hedge for Southeast Asia emerging markets.
Osteosynthesis of intertrochanteric fractures by PFN and DHS – A prospective randomized comparative study
Authors: Das Pulin Bihari , Singh Anurag , Lenka Bhabani Shankar , Pani Sunit
Published: November 2020

Introduction:

As the geriatric population increases, the incidence of intertrochanteric fractures (ITF) has also increased significantly. There are various modalities to treat these fractures. In this study our aim is to analyse outcomes of Proximal Femoral Nail (PFN) in comparison to those of Dynamic Hip Screw (DHS) for the treatment of ITF.

Materials and Methods:

This study was carried out during 2017–20. 150 patients of unstable ITF (AO type 31-A2, 31-A3) in elderly were randomly divided into two groups of 75 each and were treated either by DHS or PFN and were followed up regularly.

Results:

The results were compared between the groups and statistical analyses were performed. The results were assessed with Harris Hip Score(HHS) & Parker Palmer mobility score (PPMS) which were better in PFN group.

Conclusion:

PFN is a better fixation device for unstable ITF (31 A2 and 31 A3) in elderly patients.
Expectant Fathers’ Social Determinants of Health in Early Pregnancy
Authors: Neri Mini Fernanda , Saltzman Jaclyn A. , Simione Meg , Luo Man , Perkins Meghan E. , Roche Brianna , Blake-Lamb Tiffany , Kotelchuck Milton , Arauz-Boudreau Alexy , Davison Kirsten , Taveras Elsie M.
Published: November 2020

This cross-sectional, descriptive study examined unmet social and economic needs and health information requests of low-income, expecting fathers who participated in the First 1000 Days program. The First 1000 Days is a systems-level intervention aiming to prevent obesity among low-income mothers and infants across 3 community health centers in Greater Boston, MA, USA. Fathers who attended their partner’s first prenatal care visit were invited to complete a program survey during early pregnancy. Among 131 fathers surveyed, 45% were white, 21% were Hispanic/Latino, 55% were foreign-born, and 69% reported an annual income under $50 000. Fathers reported elevated levels of food insecurity (18%) and 33% were unaware of someone that could provide a $50 loan; however, over 85% of fathers knew someone that could provide non-financial social support. Fathers requested information about pregnancy, birth preparation, and fatherhood. Findings support addressing fathers’ unmet needs during pregnancy and providing father-specific perinatal information.
Engaging Students via Nearpod® in Synchronous Online Teaching
Authors: Wang Jiunwen , Chia Ivy
Published: November 2020

There is a mass movement toward conducting classes online due to the coronavirus situation. The call for new ways to engage students in a synchronous online course is especially urgent. Given that most face-to-face classes in physical settings have been cancelled, it is imperative that instructors know how to engage students in online lessons so as to maximize their engagement and learning. This article documents how a cloud-based educational application known as Nearpod® can be used in conjunction with video conferencing tools to effectively engage students in a synchronous online class. It provides information on how a lesson can be set up, including how a lesson will be experienced from a student’s perspective. The advantages and disadvantages of Nearpod are also explored.
Classification of residential buildings into spatial patterns of urban growth: A morpho-structural approach
Authors: Perez Joan , Ornon Alexandre , Usui Hiroyuki
Published: November 2020

This paper presents a methodological protocol that combines a structural and a morphological approach to classify residential buildings into spatial patterns of urban growth. Variography analysis is employed to endogenously detect thresholds of building agglomerations, subsequently used as distance parameters for series of morphological closings over the distribution of the building centroids. The different bounding regions ultimately allow classifying new residential buildings into different categories according to their degrees of clustering/scattering and to their locations within/without existing urban structures and within/without recent urban sprawl. The protocol, developed for areas where suburbs tend to proliferate, is tested on a region in southern France using residential buildings in 2002, 2017, and those that appeared between these two dates. It successfully classified the new buildings into the following categories: “clustered infill urban densification”, “scattered infill urban densification”, “low-density edge-expansion”, “compact edge-expansion”, “low-density scattered urban development”, and “leapfrog urban development” thus showing that new residential buildings are not contributing to urban sprawl and development in a similar fashion. Open access is provided to the source code and to the test region data.
Arthrofibrosis of the Ankle
Authors: Velasco Brian Timothy , Patel Shalin S. , Broughton Kimberly K. , Frumberg David B. , Kwon John Y. , Miller Christopher P.
Published: November 2020

Arthrofibrosis is a common, but often overlooked, condition that imparts significant morbidity following injuries and surgery to the foot and ankle. The most common etiologies are related to soft tissue trauma with subsequent fibrotic and contractile scar tissue formation within the ligaments and capsule of the ankle. This leads to pain, alterations in gait, and ankle dysfunction. Initial treatment often includes extensive physical therapy, however, if severe enough surgical options exist. Although the literature regarding ankle arthrofibrosis is scarce, this review article provides a greater understanding of the pathogenesis of arthrofibrosis and describes the current and future therapeutic options to treat fibrotic joints. Level of Evidence: Level V, expert opinion.
Pulmonary alveolar microlithiasis
Authors: Kosciuk Patrick , Meyer Cristopher , Wikenheiser-Brokamp Kathryn A. , McCormack Francis X.
Published: November 2020

Pulmonary alveolar microlithiasis (PAM) is a fascinating rare lung disease that is associated with the accumulation of hydroxyapatite microliths within the lumen of the alveolar spaces. In most patients, PAM is discovered incidentally on radiographs performed for other purposes, and the typical disease course is characterised by slowly progressive respiratory insufficiency over decades. Recent genetic analyses that have revealed that the deficiency of the sodium-phosphate cotransporter NPT2B is the cause of PAM have enabled the development of powerful animal models that inform our approach to disease management and treatment. Here we review the epidemiology and molecular pathophysiology of PAM, as well as the diagnostic approach, clinical manifestations, radiographic and pathologic features, and clinical management of the disease. Although there are no proven treatments for PAM, progress in our understanding of disease pathogenesis is providing insights that suggest strategies for trials.
Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis
Authors: de Boer Geertje Maria , Żółkiewicz Jakub , Strzelec Konrad Piotr , Ruszczyński Marek , Hendriks Rudi W. , Braunstahl Gert-Jan , Feleszko Wojciech , Tramper-Stranders Gerdien. A.
Published: November 2020

Wheezing and asthma are a growing cause of morbidity in children and adults. Treatment is aimed at prevention of disease exacerbations and preservation of lung function. Respiratory viruses are involved in ∼40–60% of exacerbations. Bacterial lysates prevent recurrent respiratory tract infections and might reduce exacerbations. Moreover, immunomodulatory effects have been observed in human and animal studies.

Here we aimed to assess the effects of bacterial lysate therapy on preschool wheezing episodes and asthma exacerbation frequency. We performed a systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and a meta-analysis using Cochrane Review Manager. Out of 2016 retrieved articles, 22 studies were included, of which five provided sufficient data for a meta-analysis.

The use of bacterial lysates showed a decrease of both wheezing episodes (mean difference −2.35 (−3.03– −1.67), p<0.001) and asthma exacerbations in children (mean difference −0.90 (−1.23– −0.57), p<0.001). Additionally, antibiotic use was reduced, and the duration of wheezing episodes was also decreased. No data for adults with asthma are currently available. The immunomodulatory effect seems to be dependent on increased T-helper (Th)1-cell activation and Th2-cell suppression.

These favourable effects of bacterial lysates indicate that they show promise as add-on therapy in preschool wheezing and childhood asthma.
A comparison of pre-operative urine culture with intra-operative stone culture: a prospective observational study
Authors: Gupta Abhimanyu , Vyas Nachiket , Sharma Govind , Priyadarshi Shivam , Maghnani Deepak , Swain Prafulla Kumar
Published: November 2020

Background

It is well known that urinary calculi are associated with urinary tract infections. Post-operative sepsis is one of the major complications after various endourological procedures for stone surgeries. These episodes of sepsis occur even in negative urine cultures. Stones have been found to harbour bacteria which on fragmentation causes bacteremia and sepsis. Thus, usual practice of pre-operative urine culture cannot truly predict the occurrence of post-operative sepsis. It also seems logical that intra-operative stone cultures could guide us for early management of such episodes of sepsis. The purpose of this study was to determine if there exists any association between urine and stone cultures in patients undergoing endourological stone surgeries.

Methods

This is a prospective comparative observational study, in patients undergoing endoscopic procedures for calculus in urinary tract. Mid-stream urine cultures were obtained 3 to 5 days prior to surgery and crushed stone culture during the surgery. Comparison was then made between the two with respect to positivity, location of calculus and bacterial flora.

Results

A total of 122 cases of urolithiasis were included, in which 30 (24.59%) cases had a positive urine culture, whereas 62 (50.82%) patients were positive for stone culture. This significant difference was maintained only in renal stones on subset analysis (p value < 0.0001). Both cultures were positive in only 15% of cases, and bacteriological analysis showed same organism in just 6.5% of cases. In our study, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of urine culture against the stone culture were 29.03%, 80%, 60%, 52.17% and 54.09%.

Conclusion

The results of our study suggests that pre-operative urine cultures have a poor predictive value and accuracy for infective organism in the renal stone. Therefore, stone culture should be included in routine protocols during renal endourologic surgery for stones.
Temporal salt stress-induced transcriptome alterations and regulatory mechanisms revealed by PacBio long-reads RNA sequencing in Gossypium hirsutum
Authors: Wang Delong , Lu Xuke , Chen Xiugui , Wang Shuai , Wang Junjuan , Guo Lixue , Yin Zujun , Chen Quanjia , Ye Wuwei
Published: November 2020

Background

Cotton (Gossypium hirsutum) is considered a fairly salt tolerant crop however, salinity can still cause significant economic losses by affecting the yield and deteriorating the fiber quality. We studied a salt-tolerant upland cotton cultivar under temporal salt stress to unfold the salt tolerance molecular mechanisms. Biochemical response to salt stress (400 mM) was measured at 0 h, 3 h, 12 h, 24 h and 48 h post stress intervals and single-molecule long-read sequencing technology from Pacific Biosciences (PacBio) combined with the unique molecular identifiers approach was used to identify differentially expressed genes (DEG).

Results

Antioxidant enzymes including, catalase (CAT), peroxidase (POD), superoxide dismutase (SOD) were found significantly induced under temporal salt stress, suggesting that reactive oxygen species scavenging antioxidant machinery is an essential component of salt tolerance mechanism in cotton. We identified a wealth of novel transcripts based on the PacBio long reads sequencing approach. Prolonged salt stress duration induces high number of DEGs. Significant numbers of DEGs were found under key terms related to stress pathways such as “response to oxidative stress”, “response to salt stress”, “response to water deprivation”, “cation transport”, “metal ion transport”, “superoxide dismutase”, and “reductase”. Key DEGs related to hormone (abscisic acid, ethylene and jasmonic acid) biosynthesis, ion homeostasis (CBL-interacting serine/threonine-protein kinase genes, calcium-binding proteins, potassium transporter genes, potassium channel genes, sodium/hydrogen exchanger or antiporter genes), antioxidant activity (POD, SOD, CAT, glutathione reductase), transcription factors (myeloblastosis,WRKY,Apetala 2) and cell wall modification were found highly active in response to salt stress in cotton. Expression fold change of these DEGs showed both positive and negative responses, highlighting the complex nature of salt stress tolerance mechanisms in cotton.

Conclusion

Collectively, this study provides a good insight into the regulatory mechanism under salt stress in cotton and lays the foundation for further improvement of salt stress tolerance.
Attitudes to physical healthcare in severe mental illness; a patient and mental health clinician qualitative interview study
Authors: Butler Joseph , de Cassan Simone , Turner Phil , Lennox Belinda , Hayward Gail , Glogowska Margaret
Published: November 2020

Background

People with severe mental illness experience physical health significantly worse than the general population. Physical health monitoring is shared between primary care and secondary mental healthcare services, though there is debate whether mental health teams should provide more physical healthcare. The views of mental health clinicians and patients with mental illness towards physical healthcare provision are unclear.

Aims

To explore the attitudes of Community Mental Health Team (CMHT) clinicians and patients experiencing severe mental illness towards physical healthcare and its provision.

Design and setting

Qualitative study in a CMHT setting.

Methods

Interviews were carried out with CMHT clinicians and patients with severe mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis.

Results

There were 14 patients and 15 clinicians recruited. Patients varied in their awareness of the association between physical and mental health, but were engaged in physical health monitoring. Clinicians were aware of the importance of physical healthcare but reported barriers to provision, including lack of training, resource constraints and uncertainty in their role. There was no consensus in either group regarding how physical healthcare should be provided, with diverse attitudes expressed for why CMHTs should and shouldn’t provide more physical healthcare.

Conclusions

Increasing physical healthcare provision from mental health teams requires healthcare-related barriers be addressed, but it remains unclear whether CMHT clinicians or patients believe this to be a solution.
The role of physical and cognitive function in performance of activities of daily living in patients with mild-to-moderate Alzheimer’s disease – a cross-sectional study
Authors: Clemmensen Frederikke K , Hoffmann Kristine , Siersma Volkert , Sobol Nanna , Beyer Nina , Andersen Birgitte B , Vogel Asmus , Lolk Annette , Gottrup Hanne , Høgh Peter , Waldemar Gunhild , Hasselbalch Steen G , Frederiksen Kristian S
Published: November 2020

Background

Several factors may play a role in the ability of patients with Alzheimer’s disease to perform activities of daily living (ADL). The aim of this study was to examine the impact of different aspects of physical performance and cognitive functions on ADL in patients suffering from mild-to-moderate Alzheimer’s disease.

Methods

We conducted secondary analyses on cross-sectional baseline data from the randomized controlled multicentre study “Preserving quality of life, physical health and functional ability in Alzheimer’s Disease: The effect of physical exercise” (ADEX). In total, 185 AD patients (76 women and 109 men), with a mean age on 70,4 years, were included. Data from physical performance tests (Astrand cycle test, Timed up & Go (TUG), Sit to Stand test (STS)) and cognitive tests (Mini Mental Status Examination (MMSE), Symbol Digit Modalities Test (SDMT), Stroop Color and Word test (Stroop)) were used. Their associations with ADL, measured on the ADCS-ADL scale was assessed in multivariable regression analyses.

Results

SDMT and MMSE had significant, moderate correlations with total ADL (SDMT: r = 0.33, MMSE: r = 0.42) and instrumental ADL (SDMT: r = 0.31, MMSE: r = 0.42), but not with basic ADL. Adjusting for age and sex, the associations between SDMT and MMSE to total ADL and instrumental ADL persisted. No significant associations were found between Astrand, TUG, STS or Stroop and total ADL, basic ADL or instrumental ADL.

Conclusion

Total ADL and instrumental ADL are associated with cognitive functions, including executive function. No significant association between examined physical performance parameters and ADL functions was observed, and consequently does not support an impact of physical function on ADL functions in patients with mild-to-moderate Alzheimer’s disease and relatively well-preserved physical function. Strategies aimed to improve cognition may be better suited to improve ADL function in patients with mild-to-moderate Alzheimer’s disease.

Trial registration

NCT01681602. Registered 10 September 2012, retrospectively registered.
Can an mhealth clinical decision-making support system improve adherence to neonatal healthcare protocols in a low-resource setting?
Authors: Amoakoh Hannah Brown , Klipstein-Grobusch Kerstin , Agyepong Irene Akua , Amoakoh-Coleman Mary , Kayode Gbenga A. , Reitsma J. B. , Grobbee Diederick E. , Ansah Evelyn K.
Published: November 2020

Background

This study assessed health workers’ adherence to neonatal health protocols before and during the implementation of a mobile health (mHealth) clinical decision-making support system (mCDMSS) that sought to bridge access to neonatal health protocol gap in a low-resource setting.

Methods

We performed a cross-sectional document review within two purposively selected clusters (one poorly-resourced and one well-resourced), from each arm of a cluster-randomized trial at two different time points: before and during the trial. The total trial consisted of 16 clusters randomized into 8 intervention and 8 control clusters to assess the impact of an mCDMSS on neonatal mortality in Ghana. We evaluated health workers’ adherence (expressed as percentages) to birth asphyxia, neonatal jaundice and cord sepsis protocols by reviewing medical records of neonatal in-patients using a checklist. Differences in adherence to neonatal health protocols within and between the study arms were assessed using Wilcoxon rank-sum and permutation tests for each morbidity type. In addition, we tracked concurrent neonatal health improvement activities in the clusters during the 18-month intervention period.

Results

In the intervention arm, mean adherence was 35.2% (SD = 5.8%) and 43.6% (SD = 27.5%) for asphyxia; 25.0% (SD = 14.8%) and 39.3% (SD = 27.7%) for jaundice; 52.0% (SD = 11.0%) and 75.0% (SD = 21.2%) for cord sepsis protocols in the pre-intervention and intervention periods respectively. In the control arm, mean adherence was 52.9% (SD = 16.4%) and 74.5% (SD = 14.7%) for asphyxia; 45.1% (SD = 12.8%) and 64.6% (SD = 8.2%) for jaundice; 53.8% (SD = 16.0%) and 60.8% (SD = 11.7%) for cord sepsis protocols in the pre-intervention and intervention periods respectively. We observed nonsignificant improvement in protocol adherence in the intervention clusters but significant improvement in protocol adherence in the control clusters. There were 2 concurrent neonatal health improvement activities in the intervention clusters and over 12 in the control clusters during the intervention period.

Conclusion

Whether mHealth interventions can improve adherence to neonatal health protocols in low-resource settings cannot be ascertained by this study. Neonatal health improvement activities are however likely to improve protocol adherence. Future mHealth evaluations of protocol adherence must account for other concurrent interventions in study contexts.
The magnitude of adherence to option B plus program and associated factors among women in eastern African countries: a systematic review and meta-analysis
Authors: Tsegaye Reta , Etafa Werku , Wakuma Bizuneh , Mosisa Getu , Mulisa Diriba , Tolossa Tadesse
Published: November 2020

Background

Despite coverage and benefits associated with the prevention of mothers to child transmission (PMTCT) services, mothers’ adherence to option B plus is still a challenge. Though few primary studies are available on the magnitude of adherence to option B plus and factors associated in Eastern African countries, they do not provide strong evidence in helping policymakers to address suboptimal adherence to option B plus. Therefore, this systematic review and meta-analysis was intended to estimate the pooled magnitude of adherence to option B plus program and associated factors among women in Eastern African countries.

Methods

PubMed, Medline, HINARI, Cochrane library, the Web of Science, and Google Scholar were searched for studies reported on the magnitude of adherence to option B plus among women in Eastern African countries. The search terms used were “option B plus”, “magnitude”, “prevalence”, “PMTCT”, “ART adherence”, “associated factors”, “all lists of Eastern African countries” and their combination by Boolean operators. The effect sizes of the meta-analysis were the magnitude of adherence to option B plus and the odds ratio of the associated factors. STATA/SE V14 was used for statistical analysis, and publication bias was assessed using funnel plots and Egger’s test.

Results

Fourteen studies having total participants of 4883 were included in the systematic review and meta-analysis. Using the random effect model, the pooled prevalence of adherence to option B plus was 71.88% (95% CI: 58.54–85.23%). The factors associated with good adherence to option B plus PMTCT program were partner support (Adjusted odds ratio (AOR) = 4.13; 95% CI: 2.78–6.15), received counseling services (AOR = 4.12, 95% CI: 2.81–6.02), disclosure of HIV status to partner (AOR = 4.38; 95% CI: 1.79–10.70), and clinical stage of HIV/AIDS I/II (AOR = 2.62; 95% CI: 1.53–4.46).

Conclusion

The level of adherence to option B plus program in Eastern African countries was generally sub-optimal. Thus, a coordinated effort is needed to raise the number of mothers to be tested, and early treatment initiation for HIV positive mothers before the disease advances. Furthermore, counseling services for couples on the importance of early treatment initiation and adherence to medications must be given due attention.