bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of COVID-19 on the health of the general and more vulnerable population and its determinants: Health care and social survey-ESSOC, study protocol
Authors: Sánchez-Cantalejo Carmen , Rueda Mª del Mar , Saez Marc , Enrique Iria , Ferri-García Ramón , Fuente Miguel De la , Villegas Román , Castro Luis , Barceló Maria Antònia , Daponte-Codina Antonio , Lorusso Nicola , Cabrera-León Andrés
Published: May 2021

Background : This manuscript describes the rationale and protocol of a real-world data (RWD) study entitled Health Care and Social Survey (ESSOC , Encuesta Sanitaria y Social ). The study’s objective is to determine the magnitude, characteristics, and evolution of the COVID-19 impact on overall health as well as the socioeconomic, psychosocial, behavioural, occupational, environmental, and clinical determinants of both the general and more vulnerable population. Methods: The study integrates observational data collected through a survey using a probabilistic, overlapping panel design, and data from clinical, epidemiological, demographic, and environmental registries. The data will be analysed using advanced statistical, sampling, and machine learning techniques. The study is based on several measurements obtained from three random samples of the Andalusian (Spain) population: general population aged 16 years and over, residents of disadvantaged areas, and people over the age of 55. Discussion: Given the current characteristics of this pandemic and its future repercussions, this project will generate relevant information on a regular basis, commencing from the beginning of the State of Alarm. It will also establish institutional alliances of great social value, explore and apply powerful and novel methodologies, and produce large, integrated, high-quality and open-access databases. The information described here will be vital for health systems in order to design tailor-made interventions aimed at improving the health care, health, and quality of life of the populations most affected by the COVID-19 pandemic.
Nonlinear Relationship Between HbA1c and Coronary Artery Calcium Score Progression: A Secondary Analysis Based on a Retrospective Cohort Study
Authors: Yu Jing , Gao Bo
Published: May 2021

ObjectiveSome previous studies was to clarify the correlation between glycated hemoglobin(HbA1c) and coronary heart disease (CHD) and the evidence regarding the correlation was still debated. However, there are fewer scientific dissertations about the correlation between HbA1c and coronary artery calcium score progression. Consequently, the present study was undertaken to explore the link of HbA1c on coronary artery calcium score progression in South Korea.MethodsThis study is a secondary analysis based on a retrospective cohort study. 8151 participants received a health check-up program at the Health Promotion Center of the Samsung Medical Center in Seoul, South Korea, from March 1, 2003 to December 31, 2013. We then used Cox proportional-hazards regression model to evaluate the independent relationship between HbA1c and coronary artery calcium score progression.ResultsAfter adjusting potential confounders (age, sex, BMI, height, weight, SBP, DBP, TC, LDL-C, HDL-C, triglycerides,smoking status, alcohol consumption, reflux esophagitis status, hypertension, diabetes, dyslipidemia, ischemic heart disease and cerebrovascular disease), non-linear relationship was detected between HbA1c and coronary artery calcium score progression, whose point was 5.8%. The effect sizes and the confidence intervals on the left and right sides of inflection point were 2.05 (1.85 to 2.27) and 1.04 (0.99 to 1.10) , respectively. Conclusion﻿The relationship between HbA1c and coronary artery calcium score progression is non-linear. HbA1c is positively related with coronary artery calcium score progression when HbA1c was less than 5.8%.
Decade-long remissions of leukemia sustained by the persistence of activated CD4+ CAR T-cells
Authors: Melenhorst Jan , Chen Gregory , Wang Meng , Porter David , Gao Peng , Bandyopadhyay Shovik , Pruteanu-Malinici Iulian , Nobles Christopher , Maji Sayantan , Frey Noelle , Gill Saar , Tian Lifeng , Kulikovskaya Irina , Gupta Minnal , Davis Megan , Fraietta Joseph , Brogdon Jennifer L. , Young Regina , Ambrose David , Chew Anne , Levine Bruce , Siegel Donald , Alanio Cécile , Wherry E. , Bushman Frederic , Lacey Simon , Tan Kai , June Carl
Published: May 2021

The adoptive transfer of T lymphocytes reprogrammed to target tumor cells has demonstrated significant potential in various malignancies. However, little is known about the long-term potential and the clonal stability of the infused cells. Here, we studied the longest persisting CD19 redirected chimeric antigen receptor (CAR) T cells to date in two chronic lymphocytic leukemia (CLL) patients who achieved a complete remission in 2010. CAR T-cells were still detectable up to 10+ years post-infusion, with sustained remission in both patients. Surprisingly, a prominent, highly activated CD4+ population developed in both patients during the years post-infusion, dominating the CAR T-cell population at the late time points. This transition was reflected in the stabilization of the clonal make-up of CAR T-cells with a repertoire dominated by few clones. Single cell multi-omics profiling via Cellular Indexing of Transcriptomes and Epitopes by Sequencing (CITE-Seq) with TCR sequencing of CAR T-cells obtained 9.3 years post-infusion demonstrated that these long-persisting CD4+ CAR T-cells exhibited cytotoxic characteristics along with strong evidence of ongoing functional activation and proliferation. Our data provide novel insight into the CAR T-cell characteristics associated with long-term remission in leukemia.
Lipoprotein Lipase Hydrolysis Products Induce Pro-Inflammatory Cytokine Expression in Triple-Negative Breast Cancer Cells
Authors: Tobin Alexandria J. , Noel Nicholas P. , Christian Sherri L. , Brown Robert J.
Published: May 2021

Objectives: Lipoprotein lipase (LPL) is an extracellular lipase that hydrolyzes triacylglycerols and phospholipids from lipoproteins. LPL is highly expressed in adipose tissue and expressed in some breast cancer cell lines. Hydrolysis products generated by LPL can be used by cells as components of the cell membrane, as an energy supply, or as signaling molecules. Therefore, LPL on or around cancer cells may contribute to breast cancer growth and progression. We hypothesized that hydrolysis products generated by LPL from total lipoproteins can promote pro-inflammatory cytokine secretion from breast cancer cells and/or affect viability. Results: Using cytokine arrays, we found that the secretion of seven cytokines was increased by MDA-MB-231 cells treated with lipoprotein hydrolysis products. An increased secretion of TNF-α and IL-6 was also seen by MDA-MB-468 cells, and an increase in IL-4 secretion was seen by MDA-MB-468 and SKBR3 cells. In contrast, MCF-7 cells showed a decreased secretion of only two cytokines. The changes to cytokine secretion profiles by the breast cancer cell types, including by non-cancerous MCF-10a breast cells, were independent of increased cell metabolic activity. Overall, these results provide information on how lipoprotein hydrolysis products within the tumor microenvironment might affect breast cancer cell viability and tumor progression.
Bioinformatic Analysis of Transcriptional Regulation by Nur77 in Central Nervous System and Immune System
Authors: Costa Montserrat Olivares , Faunes Fernando , Andrés María Estela
Published: May 2021

ObjectiveThe objectives of this work were to find genes regulated by Nur77 in neurons and to evaluate the possible common role of this transcription factor in neurons and lymphatic cells using published experimentally generated databases of ChIP-Seq and a microarray. We also characterized Nur77 binding throughout the genome. Results﻿We identified 113 Nur77 target genes in neuronal stem cells and 116 in neuronal cells. Cell adhesion and anchoring processes emerged as regulated by Nur77 in neurons and lymphatic cells. We found 9 common genes regulated by Nur77. Finally, we described a significant distribution of Nur77 binding sites in strong enhancers and active promoters. This work is a first step to understand the role of Nur77 and its common targets in neurons and immune cells.
Effects of artificial cycles with and without gonadotropin-releasing hormone agonist pretreatment on frozen embryo transfer outcomes in patients with adenomyosis
Authors: Li Muzi , Xu Lihong , Zhao Heng , Yan Lei , Du Yanbo
Published: May 2021

Gonadotropin-releasing hormone agonist(GnRH-a) is generally added to improve pregnancy outcomes of adenomyosis based hormone replacement therapy cycle. Our objective in this study is to investigate whether adding GnRH-a can obtain better pregnancy outcomes. In this retrospective analysis, a total of 341 patients with adenomyosis complicated in vitro fertilization-embryo transfer(IVF-ET) of the frozen embryo transfer (FET). The control group was only treated by hormone replacement therapy cycles to prepare emdometrium, and the study group was added GnRH-a before using hormone to adjust menstruation period. Based on the similar baseline values and embryological data, there was no significantly difference about their clinical pregnancy rates (40.63% vs 42.54%, P=0.72) and live birth rates (23.75% vs 23.75%, P=0.74) between the control group and the study group. Other secondary outcomes including clinical miscarriage rates, ectopic pregnancy rates, preterm pregnancy rates and term pregnancy rates did not show significant difference between the two groups. Compared with using hormone replacement therapy cycle alone, GnRH-a down-regulation based on hormone replacement therapy cycle may not increase the rates of clinical pregnancy and live birth rates in IVF-ET of FET for infertile patients with adenomyosis.
Successful Surgical Treatment of Traumatic Macular Hole With Total Rhegmatogenous Retinal Detachment in a Child- a Case Report
Authors: Cisiecki Sławomir , Boninska Karolina , Bednarski Maciej
Published: May 2021

Background: To investigate the surgical results and morphologic characteristics of pediatric traumatic macular hole with total rhegmatogenous retinal detachment.Case presentation: The 4-year-old-male patient underwent scleral buckling surgery combined with vitrectomy with the inverted ILM flap technique and silicon oil tamponade for five months. Complete ophthalmic examination was performed preoperatively and 7 days, 1, 3, 6, 9 and 12 months after surgery. Successful retinal reattachment was achieved and the macular hole was successfully closed. Visual acuity improved from Hand Motion at the initial visit to 20/80 (0.6 LogMAR) postoperatively.Conclusions: Scleral buckling surgery and vitrectomy with the inverted ILM flap technique appeared to give effective anatomical and functional results in this case.
Assessment of Multiple Water-Related Hazards under Changing Climate in An Urbanized Sub-Region of Yom River Basin, Thailand
Authors: Nitivattananon Vilas , Chao-amonphat Sutinee , Huang Jinliang
Published: May 2021

In the Chao Phraya River Basin, Thailand, water-related hazards, particularly river floods, flash floods and droughts, are increasingly causing damages to the local society, economy and environment due to changing climate and urbanization. As its impact, identification of key factors influencing the occurrence and severity of multiple water-related hazards at different temporal and spatial scales is therefore essential to further development of solutions for hazard reduction. The study identified through the analytic hierarchy process several key influence factors to water-related hazards, including precipitation, discharges, natural and green surface areas, and water storage, in the Upper Chao Phraya River basin, Thailand. These factors were then used for the assessments of individual and multiple hazards, as well as potential interventions for hazard reduction. A combination of several research methods was adopted for the hazard assessments, including simulation modelling, multi-criteria decision analysis, and spatial analysis based on both primary and secondary data sources. Eventually, spatial distribution of hazard levels at regional and local scales was mapped out to inform water-related multiple hazards and the potential of selected nature-based solutions to such hazards based on the data of specific years. It was found that increasing vegetation areas and having nature-based reservoirs can effectively improve water management in both wet and dry seasons, contributing to hazard reduction. It is expected that the assessments performed in this study can contribute to awareness-raising of water-related hazards and eventually enhance the preparedness of risk management in the studied areas.
Risk Factors Influencing Venous Cerebral Infarction after Meningioma Resection
Authors: cai qing , Wang Shoujie , Zheng Min , Wang Xuejiao , Liu Rong , Liu Liqin , Qin Huaizhou , Feng Dayun
Published: May 2021

Introduction Venous cerebral infarction is a serious complication after meningioma resection. To reduce the incidence of venous infarction, we identified risk factors for postoperative venous cerebral infarction after surgical resection of meningioma in patients with clinical symptoms.Methods The clinical and imaging data of 1127 patients with intracranial meningiomas who underwent resection in our hospital were retrospectively collected and analyzed. Venous cerebral infarction was evaluated by postoperative imaging and clinical manifestations. Univariate and multivariate analyses were performed to identify risk factors associated with venous cerebral infarction.Results Overall, 3.3% (37/1127) of patients experienced symptomatic venous cerebral infarction after meningioma resection. Multivariate analysis revealed superficial meningioma, moderate to severe peritumoral edema, peritumoral critical vein and WHO grade II-III as independent predictors of a postoperative venous cerebral infarction. After timely intervention, the symptoms were clearly alleviated in one month, and the prognosis was good, but injury to key veins could cause irreversible neurological disorders.Conclusions Intraoperative protection of veins is the primary way to prevent venous cerebral infarction. The present study identified several significant and independent risk factors for postoperative venous infarction, thereby enabling the identification of high-risk patients who require special attention during clinical and surgical management.
Single Incision Thenar Muscle Reconstruction Using the Free Functional Pronator Quadratus Flap
Authors: Aman Martin , Boecker Arne H. , Thielen Mirjam , Mueller Camillo T. , Bigdeli Amir K. , Kneser Ulrich , Harhaus Leila
Published: May 2021

Background:Injuries to the thenar muscle mass or the thenar branch of the median nerve and resulting loss of thumb opposition lead to a massive impairment of hand function. For decades, reconstructive approaches were based on tendon transfers. To broaden the reconstructive repertoire, we present the free functional pronator quadratus flap as a viable alternative for functional reconstruction and provide a specification for its indication.We demonstrate our surgical technique to a single incision reconstruction using the free functional pronator quadratus flap. Based on a series of three patients, which were analyzed for hand function using Kapandji’s score and the angle of Bourrel, grip strength and nerve conduction velocity in a two year follow up, we present an indication algorithm.Results:After successful reinnervation of all flaps, we found an improvement of Kapandji’s score from 4.3 ± 0.94 preoperatively, to 8.7 ± 0.47 after two years. Accordingly, the angle of Bourrel decreased from 75.75 ± 3.45 degrees to 36.96 ± 3.68 degree. Grip strength also improved from 14 ± 2.2 kg to 26.2 ± 1.2 kg. No impairment of wrist pronation was observed.Conclusion:We found excellent functional recovery of thumb opposition and strength, showing similar or even superior results compared to results from tendon transfers. With the benefit of a single incision surgery and therefore minimal donor site morbidity, this free functional muscle transfer is a viable alternative to classic tendon transfers.
The Investigation of the Optimization Scheme of the Low-cycle Fatigue Cropping Based on the Acoustic Emission Technique
Authors: Ren Yujian , Li Jingxiang , Dong Yuanzhe , Jin Dong , Zhao Shengdun
Published: May 2021

High efficiency and good section quality are two main objectives of metal bar cropping. A suitable control method can help to achieve both goals. An investigation of the control method of low-cycle fatigue cropping (LCFC) based on the acoustic emission (AE) technique has been proposed in this study. Ring-down counts and kurtosis are used to monitor the whole process of LCFC. The results showed that kurtosis is more suitable for monitoring the LCFC process and as a critical parameter to optimize the control method than ring-down counts in the noisy factory environment.Moreover, three types of materials are studied in this experiment; by combine with the AE results, macroscopic images and microscopic images of sections, characteristics of various LCFC stages are obtained. The results also indicated reduce the area of the transient fracture zone is the key to improve the section quality. Reducing the load frequency before the unstable crack propagation stage will beneficial to realize the goals. Based on the evaluation of kurtosis, an optimized control method is presented, and two control parameters: transient time T and the critical value of the slope of kurtosis C are determined. For 16Mn, 1045 and Al 6061, the T is 5s, 10s, and 1s, respectively. For 16Mn, 1045, and Al 6061, the C is 100, 300, and 0, respectively. Two parameters, h and S, are used to evaluate the section quality and four control strategies are compared. The results indicate the optimal control methods can improve the section quality effectively. The influence trend of reducing loading frequency is investigated by further comparison. It can be seen as the frequency decreases, the efficiency of the section quality improving decreases. In order to realize the optimal results, different control strategies are adopted for different materials. Strategy 1 (high frequency is 20Hz，high frequency thought the whole process), strategy 2 (high frequency is 20Hz，low frequency is 8.33Hz), and strategy 3 (high frequency is 20Hz，low frequency is 6.67Hz) is suitable for Al 6061, 1045, and 16Mn, respectively.
Key Residues of Bacillus Thuringiensis Cry2Ab for Oligomerization and Pore-Formation Activity
Authors: Pan Zhi-Zhen , Xu Lian , Liu Bo , Chen Qing-Xi , Zhu Yu-Jing
Published: May 2021

As a pore-forming toxin, oligomerization and pore-formation were both required for the mode of action of Cry toxins. Previous studies revealed that Domain I helices α4-α5 were involved in oligomerization of Cry2Ab, while the active residues in charge of Cry2Ab aggregation remained ambiguous. In present studies, we built 20 Cry2Ab alanine mutants site directed in helices α4-α5 and demonstrated that mutants N151A, T152A, F157A, L183A, L185A and I188A blocked the assembly of 250 kDa oligomers, suggesting that those residues were key residues for Cry2Ab oligomerization. As expected, those variants severely reduced the insecticidal activity against P. xylostella which was similar to our previous reports. Furthermore, we found that the pore-forming activities of non-oligomerization mutants sharply decreased compared to wild-type Cry2Ab. Taken together, our data comprehensively identified key residues for Cry2Ab for the first time and emphasized that oligomerization was closely related to insecticidal activity and pore-forming activity in Cry2Ab.
The light-to-nutrient ratio in alpine lakes: different scenarios of bacterial nutrient limitation and community structure in lakes above and below the treeline
Authors: Su Yaling , Du Yingxun , Xing Peng
Published: May 2021

The light-to-nutrient hypothesis proposes that under high light-to-nutrient conditions, bacteria tend to be limited by phosphorus (P), while under relatively low light-to-nutrient conditions, bacteria are likely driven towards carbon (C) limitation. Exploring whether this light-to-nutrient hypothesis is fitting for alpine lakes has profound implications for predicting the impacts of climatic and environmental changes on the structures and processes of aquatic ecosystems in climate-sensitive regions. We investigated the environmental conditions and bacterioplankton community compositions of 15 high-elevation lakes (7 above and 8 below treeline). High light-to-nutrient conditions (denoted by the reciprocal value of the attenuation coefficient (1/K) to total phosphorus (TP)), high chlorophyll a (Chl a) concentrations, low TP concentrations and low ratios of the dissolved organic carbon concentration to the dissolved total nitrogen concentration (DOC: DTN) were detected in above-treeline lakes. Significant positive correlations between the bacterioplankton community compositions with 1/K:TP ratios and Chl a concentrations indicated that not only high light energy but also nutrient competition between phytoplankton and bacteria might induce P limitation for bacteria. In contrast, low light-to-nutrient conditions and high allochthonous DOC input in below-treeline lakes lessen P limitation and C limitation. The most abundant genus, Polynucleobacter, was significantly enriched and more diverse oligotypes of Polynucleobacter OTUs were identified in the below-treeline lakes, indicating the divergence of niche adaptations among Polynucleobacter oligotypes. The discrepancies in the light-to-P ratio and the components of organic matter between the above-treeline and below-treeline lakes have important implications for the nutrient limitation of bacterioplankton and their community compositions.
Early Pregnancy Peripheral Blood DNA Methylation and Risk of Gestational Diabetes Mellitus: A Nested Case-Control Study
Authors: Wang Xiaolei , Huang Jin , Long Sisi , Lin Huijun , Zhang Na , Tian Mengyuan , Wu Xinrui , An Rongjing , Ma Shujuan , Tan Hongzhuan
Published: May 2021

Introduction:

Genome-wide DNA methylation profiling has been used to identify CpG sites relevant to gestational diabetes mellitus (GDM). However, these sites have not been verified in larger samples. Here, our aim was to evaluate the changes in target CpG sites in the peripheral blood of pregnant women with GDM in their first trimester.
Research Design and Methods:

This nested case-control study examined a large cohort of women with GDM in early pregnancy (10–15 weeks; n = 80). Target CpG sites were extracted from related published literature and bioinformatics analysis. The DNA methylation levels at 337 CpG sites located in 27 target genes were determined using MethylTarget™ sequencing. The best cut-off levels for methylation of CpG sites were determined using the generated ROC curve. The independent effect of CpG site methylation status on GDM was analyzed using conditional logistic regression.
Results

Methylation levels at 6 CpG sites were significantly higher in the GDM group than in controls, whereas those at 7 CpG sites were significantly lower (P < 0.05). The area under the ROC curve at each methylation level of the significant CpG sites ranged between 0.593 and 0.650 for GDM prediction. After adjusting for possible confounders, the hypermethylation status of candidate sites cg68167324 (OR = 3.168, 1.038–9.666) and cg24837915 (OR = 5.232, 1.659–16.506) was identified as more strongly associated with GDM; conversely, the hypermethylation of sites cg157130156 (OR = 0.361, 0.135–0.966) and cg89438648 (OR = 0.206, 0.065–0.655) might indicate lower risk of GDM.
Conclusions

The methylation status of target CpG sites in the peripheral blood of pregnant women during the first trimester is associated with GDM pathogenesis, and has potential as a predictor of GDM.
Implicit Sustainable Development Theories Obscure Disproportionate Impacts from Climate-related Extreme Events: Example from Hurricane Michael and Housing Losses on Florida’s Forgotten Coast
Authors: Boda Chad Stephen , Scown Murray , Faran Turaj
Published: May 2021

A central challenge for sustainable development (SD) is how societies are to avoid, minimize or address impacts from anthropogenic climate change. However, competing perspective on “what should be sustained” lead to widely different understandings of what mitigation, adaptation and loss and damage entail and how best to approach them. We provide a novel conceptual and empirical comparison of two contrasting SD-based theoretical approaches to the study of impacts from climate-related extreme events: Capital Theory and Human Development. We use our analysis of immediate residential property value and housing capacity impacts caused by Hurricane Michael in Gulf County, Florida, to demonstrate how the theory used to assess and interpret impacts greatly affects the identification of whom and where is considered to be objectively “most impacted”. From our comparative analysis and discussion, we conclude that, while currently underutilized, Human Development is the more advanced approach to SD oriented climate-impact research and policy when compared to Capital Theory.
Early-stage Studies to Larger-scale Trials: Investigators’ Perspectives on Scaling-Up Childhood Obesity Interventions
Authors: von Klinggraeff Lauren , Dugger Roddrick , Okely Anthony , Lubans David , Jago Russ , Burkart Sarah , Weaver R. Glenn , Armstrong Bridget , Beets Michael W
Published: May 2021

Background: Pilot/feasibility studies play an important role in the development and refinement of behavioral interventions by providing information about feasibility, acceptability, and potential efficacy. Despite their importance and wide-spread use, the approaches taken by behavioral scientists to scale-up early-stage studies to larger-scale trials has received little attention. The aim of our study was to understand the role that pilot studies play in the development and execution of larger-scale trials.Methods: We conducted interviews with behavioral interventionists identified in a systematic review as the lead author of a published pilot study that had also published larger-scale trial on a topic related to childhood obesity. Questions were asked about the role of pilot studies in developing larger-scale trials and the challenges encountered when scaling-up an intervention based upon pilot findings. Data were coded and analyzed using an inductive analytic approach to identify themes.Results: 24 Interventionists (54% women, 37-70 yrs old, mean 20 years since terminal degree) completed a total of 148 pilot studies across their careers (mean 6.4, range 1-20), of which 59% were scaled-up. Scaling was described as resource intensive and pilot work was considered essential to successfully competing for funding by 63% of the sample (n=15). When asked to define a high-quality pilot study, interventionists described studies that allowed them to evaluate components of their intervention (e.g., acceptability, feasibility) and study parameters (e.g., sample size, measures). Interventionists expressed that more process implementation measures, different study designs, and additional iterations could improve decisions to scale-up. Most agreed that pilot studies were likely to produce inflated estimates of potential efficacy though only nine interventionists provided potential solutions for decreasing inflated measures of efficacy. Suggested major causes of inflated effects included high levels of oversight in pilot studies (e.g., researcher support), reliance on subjective measures, and utilizing convenience or highly motivated samples. Potential solutions included designing pilots for real-world implementation, only conducting randomized controlled pilot studies, and pre-registering pilot studies. Conclusions: Pilot studies purposes are multifaceted and deemed essential to obtaining funding for larger-scale trials. Clarifying the form and function of preliminary, early-stage research may enhance the productive utilization of early-stage studies and reduced “voltage drop”.
Adolescent pregnancy and current contraceptive use among adolescent and young women aged 16-24 years in Durban and Soweto, South Africa
Authors: Beksinska Malgorzata , Closson Kalysha , Smit Jenni , Dietrich Janan , Hornschuh Stefanie , Smith Patricia , Nduna Mzikazi , Brockman Mark , Ndung’u Thumbi , Gray Glenda , Kaida Angela
Published: May 2021

Background
High rates of adolescent pregnancies in South Africa continues to be a pressing public health concern. This study examines (1) the prevalence of current contraceptive use; and (2) the independent association between adolescent pregnancy and effective contraception use.
Methods
This study uses baseline cross-sectional data from a youth-centered sexual and reproductive health (SRH) cohort study among youth (aged 16–24) in Soweto and Durban (2011–2017). Among 207/253 females reporting consensual sexual activity, crude and adjusted logistic regression examine associations between ever having an adolescent pregnancy (aged 15–19) or pregnancy at age 20–24 (ref no pregnancy) and effective contraception use (barrier and/or hormonal methods) in the last 6 months.
Results
Over one-third (34.3%, n = 71) of females reported a history of adolescent pregnancy and 13.0% (n = 27) had a pregnancy at age 20–24. Nearly all (95.9%, n = 94) first pregnancies were unintentional. Current effective contraceptive use was reported by 74.6% (n = 53) with an adolescent pregnancy, 66.6% (n = 18) of those pregnant at 20–24 years, and 46.8% (n = 51) of never pregnant females (p < 0.001). All effective contraceptive users pregnant at 20–24 years and 83% (n = 44) of the adolescent pregnancy group reported using hormonal methods vs. 52.9% (n = 27) of never pregnant females. In the adjusted model, a history of adolescent pregnancy was associated with 3.45 (95%CI = 1.75–6.82) times greater odds of effective contraceptive use (vs. no pregnancy).
Conclusion
suggest that adolescent females are accessing effective methods of contraception including hormonal methods only after a pregnancy event, highlighting the need for earlier provision of youth-friendly SRH services.
A General Theory of Polymer Ejection Tested in a Quasi Two-Dimensional Space
Authors: Hsiao Pai-Yi , Chen Wei-Yei
Published: May 2021

A general ejection theory of polymer is developed in a two- and three-dimensional space.A polymer is confined initially in a cavity and ejects spontaneously to the outer space through a nanopore channel without the help of any external stimulus. A reflective wall boundary is set at the pore entrance to prevent the falling of the head monomer of chain into the cavity. Three stages are distinguished in a process: (1) the entering stage, in which the head monomer enters the pore to search for a way to traverse the pore channel, (2) the main ejection stage, in which the chain body is transported from the cavity to the outer space, (3) the leaving stage, in which the tail monomer passes through and leaves the pore channel. Depending on the number of the monomers remaining in the cavity, the main ejection stage can be divided into the confined and the non-confined stages. The non-confined stage can be further split into the thermal escape and the entropic pulling stages. The Onsager's variational principle is used to derive the kinetics equation of ejection. The escape time is calculated from the corresponding Kramers' escape problem.Extensive molecular dynamics simulations are then performed in a quasi two-dimensional space to verify the theory. The variation of the ejection speed is carefully examined in a process. The decreasing behavior of the number of monomers in the cavity is studied in details. The scaling properties of the spending time at each processing stage are investigated systematically by varying the chain length, the cavity diameter, and the initial volume fraction of chain. The results of simulation support firmly the predictions of the theory, cross-checked in the studies of various topics. Together with the previous investigations in the three-dimensional space, the generalized theory is very robust able to explain the two seemly different phenomena, polymer ejection and polymer translocation, under the same theoretical framework in the two space dimensions.
Marginal and internal fit and intaglio surface trueness of interim crowns fabricated from tooth preparation of four finish line locations
Authors: Son Keunbada , Son Young-Tak , Lee Ji-Min , Lee Kyu-Bok
Published: May 2021

This study evaluated the marginal and internal fit and intaglio surface trueness of interim crowns fabricated from tooth preparation scanned at four finish line locations. The right maxillary first molar tooth preparation model was fabricated using a ceramic material and placed in four finish line locations (supragingival, equigingival, subgingival, and subgingival with a cord). Intraoral scanning was performed. Crowns were designed based on the scanned area. Interim crowns were fabricated using a stereolithography three-dimensional (3D) printer (N = 16 per location). Marginal and internal fit were evaluated with a silicone replica technique. Intaglio surface trueness was evaluated using a 3D inspection software. One-way analysis of variance and Tukey HSD test were performed for comparisons (α = 0.05). The marginal and internal fit showed significant differences according to locations (P < 0.05); the marginal fit showed the best results in the supragingival finish line (P < 0.05). Intaglio surface trueness was significantly different in the marginal region, with the highest value in the subgingival location (P < 0.05). Crowns fabricated on the subgingival finish line caused inaccurate marginal fit due to poor fabrication reproducibility of the marginal region. A supragingival finish line is recommended for interim crown fabrication using an intraoral scanner.
Quantum electron motion control in dielectric
Authors: Hui Dandan , Alqattan Husain , Yamada Shunsuke , Pervak Volodymyr , Yabana Kazuhiro , Hassan Mohammed
Published: May 2021

Attosecond science capitalizes on the extreme nonlinearity of strong fields, driven by few-cycle pulses, to attain attosecond temporal resolution and give access to the electron motion dynamics of matter in real-time. Here, we measured the electronic delay response of the dielectric system triggered by a strong field of few-cycle pulses to be in the order of 425 ± 98 as. Moreover, we exploited the electronic response following the strong driver field to demonstrate all-optical light field metrology with attosecond resolution. This field sampling methodology provides a direct connection between the driver field and the induced ultrafast dynamics in matter. Also, we demonstrate the quantum electron motion control in dielectric using synthesized light waveforms. This on-demand electron motion control realizes the long-anticipated ultrafast optical switches and quantum electronics. This advancement promises to increase the limiting speed of data processing and information encoding to rates that exceed 1 petabit/s, opening a new realm of information technology.
An Evaluation of the Feasibility of Implementing a Novel Tobacco Dependence Treatment Program for High-risk Individuals Into Clinical Practice Within a Community Mental Health Center
Authors: Hogan Tory , Quisenberry Amanda , Breitborde Nicholas , Moe Aubrey , Ferketich Amy
Published: May 2021

Background: Individuals with serious mental illnesses experience deaths related to smoking at a higher prevalence than individuals without a serious mental illness. Traditional smoking cessation programs are often not effective among individuals with chronic mental disorders. Little is known about how to implement a tobacco cessation treatment programs for this at-risk population within a community health centers. The current study used qualitative methods to examine the factors that may enhance or impede the delivery of a novel tobacco cessation treatment for smokers with a psychotic-spectrum disorder diagnosis in an integrated care community health center. Methods: Using purposeful sampling, we conducted 22 semi-structured interviews with primary care providers, mental health providers, addiction counselors, case managers, intake specialists, schedulers, pharmacists, and administrative staff at employed at the organization. Interviews were transcribed and themes were identified through a rich coding process. Results: We identified environmental factors, organizational factors, provider factors and patient factors which describe the potential factors which may enhance or impede the implementation of a smoking cessation program at the integrated care community health center. Most notably we identified that community mental health centers looking to implement a smoking cessation program for individuals with chronic mental health disorders should ensure that the incentives for providers to participate align with the program’s objectives. Lastly, organizations should invest in educating providers to address stigma related to smoking cessation and nicotine use. Conclusions: The findings of our study provide valuable insight for administrators to consider when implementing a smoking cessation program in an integrated care community health center. Our findings provide public health practitioners with potential considerations that should be discussed when designing and implementing a smoking cessation program for individuals with chronic mental disorders.
An observational study on Assessment of disease activity in Rheumatoid Arthritis patients using Patient based Disease Activity Score 2 (PDAS 2)
Authors: Singh Harpreet , Giri Somdatta , Kumar Hemant , Yonzone Pratibha , Khatkar Mahima
Published: May 2021

Objective
To assess the utility of Patient Based Disease Activity Score 2 (PDAS 2) in assessing the disease activity in Rheumatoid arthritis (RA).
Methods
A prospective cohort study was conducted on 80 patients of RA. The demographic and clinical characteristics of the patients were recorded. They were assessed for disease activity using “Disease Activity Score 28” (DAS 28), “Clinical Disease Activity Index” (CDAI) and PDAS 2 score at baseline (M0), at 2 months (M2) and at 4 months(M4) while they were on treatment. Data was analyzed for correlation of PDAS-2 with other scores and internal reliability. P < 0.05 was considered for statistical significance.
Results
The mean age was 40.13\(\pm\) 11.74 years with 70 females and 10 males. There was significant reduction in DAS28, CDAI and PDAS 2 score over 4 month follow up (all scores’ p values < 0.001). Internal reliability (as assessed by Cronbach’s Alpha) of PDAS 2 was 0.578. PDAS 2 showed significant correlation with DAS28 at M0, M2 and M4 (r = 0.792, 0.757 and 0.669 respectively, p value < 0.001) and CDAI (r = 0.861, 0.832 and 0.695 respectively, p value < 0.001). Overall there was a significant agreement between DAS 28 and PDAS 2 (K = 0.788,p < 0.001) and between CDAI and PDAS 2 (K = 0.766,p < 0.001).
Conclusion
PDAS-2 score can be routinely used in the clinical practice owing to its correlation with DAS-28/CDAI and because of the advantage that it assessed the patients’ daily living activities.
A new quantitative evaluation system for distal radioulnar joint instability using a three-dimensional electromagnetic sensor
Authors: Mukohara Shintaro , Mifune Yutaka , Inui Atsuyuki , Nishimoto Hanako , Yamaura Kohei , Yoshikawa Tomoya , Shinohara Issei , Hoshino Yuichi , Nagamune Kouki , Kuroda Ryosuke
Published: May 2021

Background The accurate assessment of distal radioulnar joint (DRUJ) instability is still challenging as there is no established objective evaluation method. This study aimed to develop a noninvasive measurement method using a three-dimensional electromagnetic sensor system (EMS) to quantitatively assess and characterize the normal DRUJ movement in healthy volunteers. Methods The DRUJ movement was mimicked using both a block model and saw bone. Movement of the models was measured by EMS, and the accuracy and reproducibility of the measurements were assessed. The movement was evaluated in 14 healthy volunteers (7 men and 7 women) by three hand surgeons. Measurement was done in a sitting position with the elbow flexed and the forearm pronated. One sensor each was attached to the distal radial shaft and the ulnar head. The examiners fixed the distal radius and moved the ulnar head from the dorsal to the volar side, measuring the dorsovolar ulnar head translation. The intraclass and interrater correlation coefficients (ICCs) were calculated using the average values of the measurements. The differences between the dominant and non-dominant sides and between men and women were also assessed. Results The accuracy and reproducibility assessment results of the EMS showed high accuracy and reproducibility. The ICC (1,5) for the intra-rater reliability was 0.856, and the ICC (2,5) for inter-rater reliability was 0.868. The mean ulnar head translation and difference between dominant and non-dominant sides were 6.00 ± 1.16 mm (Mean ± SD) and -0.12 ± 0.40 mm, respectively. There were no significant differences between any of the parameters.Conclusions A new measurement method using EMS could evaluate DRUJ movement with high accuracy, reproducibility, and intra- and inter-rater reliability. In healthy volunteers, the dorsovolar ulnar head translation was 6.00 mm. The difference between the dominant and non-dominant sides was < 1.0 mm with no significant difference. EMS provided an objective, non-invasive, real-time assessment of dynamic changes in the DRUJ. These findings could be useful in the treatment of patients with DRUJ instability.
Factors Associated with Knowledge, Attitude, and Practices of Physicians related to Autism spectrum disorder in Romania
Authors: Rahbar Mohammad H , Dobrescu Iuliana , Gillani Shezeen , Hessabi Manouchehr , Kim Sori , Stancu Mihaela , Rad Florina
Published: May 2021

Background
An inadequate level of general knowledge of physicians regarding mental health, including Autism Spectrum Disorder (ASD) not only could have adverse effects on affected individuals’ health and quality of life, but also could further delay its diagnosis and initiation of timely interventions. The purpose of this survey was to assess the level of knowledge, attitudes, and practices (KAP) of physicians regarding ASD in Romania and identify their associated factors.
Methods
For conducting this cross-sectional survey, investigators in the US collaborated with faculty at “Carol Davila” University of Medicine and Pharmacy (UMF) and developed a questionnaire by modifying similar questionnaires used in Pakistan and Turkey, to assess KAP of physicians and specialists regarding ASD in Romania. The Questionnaire was administered to a convenient sample of 383 practicing physicians or specialists. Exploratory Factor Analysis on 12 variables revealed five composite sub-scores: stigma, potential causes, children’s behavior, misconceptions, and educational needs associated with ASD knowledge. We determined the variables associated additively or interactively with KAP regarding ASD by applying General Linear Models to the five sub-scores as dependent variables.
Results
Approximately 75% of the responding physicians were female and more than 80% were over the age of 30 years. The majority (73%-94%) of physicians in Romania have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians (age < 35 years) were more knowledgeable about potential causes of ASD than older physicians, age ≥ 35 years, (adjusted mean sub-scores: 2.70 vs. 2.13, P = 0.04, adjusted for the “type of medical school attended” and “city where the clinic is located”), while older physicians knew more about the behavior of children with ASD (P = 0.02). We found a significant interaction between source of ASD knowledge and (city where the clinic is located) in relation to knowledge of the physicians’ regarding stigma related to ASD. There were no significant interactions in relation to the physician’s knowledge of behaviors of children with ASD.
Conclusion
Though Romanian physicians are knowledgeable about ASD, greater attention is needed on symptoms, causes, and awareness of stigma and misconceptions surrounding ASD.
Status of pulmonary fungal infections among individuals with clinical signs of pulmonary tuberculosis at a University Teaching Hospital in Southwestern Uganda.
Authors: Njovu Israel Kiiza , Musinguzi Benson , Mwesigye James , Kassaza Kennedy , Turigurwa Joseph , Nuwagira Edwin , Bazira Joel , Kabanda Taseera , Mpeirwe Moses , Ampaire Lucas , Mutekanga Andrew , Kiguli James , Achan Beatrice , Itabangi Herbert
Published: May 2021

Background: Pulmonary mycoses are very important diseases of the respiratory tract and are responsible for significant morbidity and mortality rates worldwide. However less attention has been paid to them. In this study we determined the prevalence of pulmonary mycoses and their aetiological agents among individuals with clinical signs of pulmonary tuberculosis at Mbarara Regional Referral Hospital (MRRH). Method: This was a Laboratory based cross sectional survey in which 113 participants were recruited. Sputum samples were corrected from each study participant. To each sample the following tests were done; Sabouraud Dextrose Agar (SDA) Culture, GeneXpert and Potassium hydroxide (KOH). Fungal growth of filamentous fungi and yeasts were further examined with LPCB and Germ tube respectively. Generated data was analysed using R studio. Results: Out of 113 participants, 80 (70.8%) had pulmonary mycoses whilst those with pulmonary tuberculosis were 5 (4.4%). C. albicans 22.58% and Aspergillus species 17.20%) were the most aetiological agents for pulmonary mycoses identified among others. Of those who were TB GeneXpert positive, 2 (1.77%) of them were co-infected with pulmonary mycoses. We established a prevalence of 57 (71.3%) for PFI, 3 (60.0%) for MTB in HIV sero positive patients and 18 (22.5%) for PFI, 0 (0.00%) for MTB in HIV sero negative patients. On the other hand, 2 (100%) sero positive patients were co-infected with both PFI and MTB.Conclusion: Our findings highlight the medical importance of pulmonary fungal infections among patients suspected for TB. Importantly, the aetiological diversity established here is rich enough to suggest precise examination using different methods. Established scope of aetiological agents is predominated by opportunistic fungi which when superimposed on to certain underlying conditions such as TB, their effects can be fatal. Therefore this possibility presents a need to employ appropriate strategies for prevention, diagnosis, and management in TB suspects.
EDGAR GRAEFF E A ARQUITETURA MODERNA EM PASSO FUNDO/RS
Authors: Giglioli Adilson , Christie Oliveira de Almeida Caliane , Aniceto Kujawa Henrique
Published: May 2021

O artigo apresenta uma análise morfológica do projeto arquitetônico e da inserção urbana da residência Rômulo Teixeira, projetada pelo arquiteto e urbanista Edgar Albuquerque Graeff, no centro da cidade de Passo Fundo/RS. Graeff desenvolveu ao longo de sua trajetória profissional, um importante legado no tocante à arquitetura e urbanismo. Em linhas gerais, sua atuação se caracteriza pela linguagem moderna de seus projetos, que, em grande parte, foram obras que tiveram ligação com o processo de modernização dos centros urbanos, como é o caso da residência em estudo. Nesse sentido, será apresentada uma breve contextualização, a fim de compreender sua formação e trajetória profissional e de que forma as referências da chamada Escola Carioca foram incorporadas em seus projetos de arquitetura. Ademais, será apresentada a residência através de plantas baixas e imagens in loco que auxiliaram no entendimento da obra e na catalogação das características modernas presentes na identidade projetual do profissional. Destaca-se a importância da realização deste artigo pelo registro e análise de obra residencial deste importante arquiteto gaúcho, dentre tantas do seu vasto repertório de obras, que foram significativas contribuições para a história urbana e modernização de Passo Fundo, a partir da década de 1950. Por meio das análises foi possível notar que, de fato, a residência Rômulo Teixeira é um exemplar da Arquitetura e Urbanismo Moderno, na qual, os volumes que a constitui obra articulam-se entre si num jogo de contrastes e sobreposições.