bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulatory B cells in cancer
Authors: Michaud Daniel , Steward Colleen R. , Mirlekar Bhalchandra , Pylayeva‐Gupta Yuliya
Published: December 2020

Tumorigenesis proceeds through discrete steps where acquisition of genetic lesions and changes in the surrounding microenvironment combine to drive unrestricted neoplastic proliferation and metastasis. The ability of tumor‐infiltrating immune cells to promote tumor growth via the provision of signals that enable tumor cell survival and proliferation as well as contribute to immune suppression is an active area of research. Recent efforts have provided us with mechanistic insights into how B cells can positively and negatively regulate immune responses. Negative regulation of immune responses in cancer can be mediated by regulatory B cells and is often a result of increased production of cytokines that can directly and indirectly affect anti‐tumor immune function and cancer cell growth. Signals that lead to the expansion of regulatory B cells and the spectrum of their functional roles are not well understood and are the subject of active research by many groups. Here, we elaborate broadly on the history of regulatory B cells in cancer and summarize recent studies that have established genetic models for the study of regulatory B cell function and their potential for therapeutic intervention in the setting of solid cancers.
Effect of pulsed vacuum and laser microperforations on the potential acceleration of chicken meat marination
Authors: Ramírez Natalia , Vega‐Castro Oscar , Simpson Ricardo , Ramirez Cristian , Nuñez Helena
Published: December 2020

Chicken meat marination has become a fundamental process in the poultry industry since it provides a product with better sensory attributes. The objective of this study was to examine the effect ofCO2laser microperforation coupled with vacuum impregnation treatment on the marination processing time of chicken breasts and to mathematically analyze the marinade diffusion process using Fick's second law and an anomalous diffusion model. Cylindrical cuts of unmarinated chicken meat wereCO2‐laser microperforated with pores of 228 μm and marinated under vacuum pressure (15 kPa) with NaCl (3% wt/wt) and sodium tripolyphosphate (1% wt/wt) during 60 hr at6 ° C. The chicken:brine ratio was 1:11 wt/wt. Mass gain, moisture content, and salt concentration were determined over time; furthermore, effective diffusion coefficient (Deff) was obtained using Fick's second law and anomalous diffusion models. Marinade diffusion into chicken cuts was favored by microperforation combined with vacuum pulses, reduction processing time in 34%. TheDeffranged between1.46 × 10−10and2.08 × 10−10m2/sfor Fick's second law and between2.27 × 10−10and4.23 × 10−10m2/sαfor anomalous diffusion model, withα−values close to 1. In conclusion, the results showed no significant difference between the models, which was attributed to the homogeneity of the chicken tissue.

Practical Applications

Chicken meat marination has become a fundamental process in the poultry industry since it provides a product with better sensory attributes and shelf life than unmarinated chicken meat. Nevertheless, marination is a process that requires a long processing time to obtain a specified salt content in the meat. In this sense, laser microperforation of the meat is a treatment that when coupled with vacuum impregnation, can accelerate the marinating process of poultry meat. When simultaneously applying both technologies, the processing time was reduced by 6 hr compared with the control (almost 34%), which will allow a significant increase in plant productivity.
Socio‐demographic predictors of uptake of a virtual group weight management program during the COVID‐19 pandemic
Authors: Abbott Sally , Parretti Helen M. , Hazlehurst Jonathan , Tahrani Abd A.
Published: December 2020

Background

The COVID‐19 pandemic has had a significant adverse impact on the delivery of weight management programmes (WMPs), in order to ensure the safety of patients and healthcare professionals. Videoconferencing could provide safe remote access to group WMPs during the COVID‐19 pandemic. The objectives of this study were to determine the uptake of a virtual group WMP and its predictors.

Methods

All patients enrolled on a face‐to‐face group WMP, which constitutes part of a Tier 3 WMP delivered by the NHS, at the time of the COVID‐19 pandemic lockdown were invited to transfer to a virtual format of the group WMP. Baseline data included weight, BMI, age, gender, ethnicity and Index of Multiple Deprivation (IMD) quintile score. The outcomes were accept/decline transfer to the virtual group WMP. Logistic regression was performed to assess for predictors of uptake.

Results

The 315 participants were included, of which 72.1% (n = 227) accepted. After adjusting for gender, deprivation and BMI; older patients (OR 0.966, [95% CI 0.944, 0.989]; p = 0.003) and Black, Asian and Minority Ethnicity (BAME) patients (OR 0.460 [95% 0.248, 0.851]; p = 0.023) were less likely to accept the virtual group WMP.

Conclusion

Strategies aimed at improving uptake of group WMP among BAME and older adult groups are needed, particularly considering the increased risk of severe COVID‐19 in these two groups, and the links between obesity and poor COVID‐19 outcomes.
FUS regulates autophagy by mediating the transcription of genes critical to the autophagosome formation
Authors: Arenas Alexandra , Kuang Lisha , Zhang Jiayu , Kingren Meagan S. , Zhu Haining
Published: December 2020

Fused in sarcoma (FUS) is a ubiquitously expressed RNA/DNA‐binding protein that plays different roles in the cell. FUS pathology has been reported in neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Mutations in FUS have also been linked to a subset of familial ALS. FUS is mainly localized in the nucleus although it shuttles between the nucleus and the cytoplasm. ALS‐linked mutations cause the accumulation of the FUS protein in cytoplasm where it forms stress granule‐like inclusions. The protein‐ and RNA‐containing inclusions are reported to be positive of autophagosome markers and degraded by the autophagy pathway. However, the role of FUS in the autophagy pathway remains to be better understood. Using immunoblot and confocal imaging techniques in this study, we found that FUS knockout (KO) cells showed a decreased basal autophagy level. Rapamycin and bafilomycin A1 treatment showed that FUS KO cells were not able to initiate autophagy as efficiently as wild‐type cells, suggesting that the autophagosome formation is affected in the absence of FUS. Moreover, using immunoblot and quantitative PCR techniques, we found that the mRNA and protein levels of the genes critical in the initial steps of the autophagy pathway (FIP200, ATG16L1 and ATG12) were significantly lower in FUS KO cells. Re‐expressing FUS in the KO cells restored the expression of FIP200 and ATG16L1. Our findings demonstrate a novel role of FUS in the autophagy pathway, that is, regulating the transcription of genes involved in early stages of autophagy such as the initiation and elongation of autophagosomes.

image
Benefits of fractional radiofrequency treatment in patients with atrophic acne scars ‐ Literature review
Authors: Cucu Cristina , Butacu Alexandra‐Irina , Niculae Bogdan‐Dimitrie , Tiplica George‐Sorin
Published: December 2020

Objective

Acne scars carry a huge physical and psychological impact on people. This article aims to evaluate the role of fractional radiotherapy in treatment of atrophic acne scars. The main objective includes providing an up‐to‐date review of existing literature, presenting the most significant studies conducted in this field.

Methods

In order to study the impact of fractional radiotherapy on the appearance of atrophic acne scars, we conducted a search on Pubmed using the keywords “fractional radiotherapy”, combined with/or “acne”, “atrophic acne scars” and “acne scars” and found 75 papers, from which we selected 39.

Results

There are several therapeutic approaches for the improvement of acne scars with variable results and possible side effects. Fractional radiofrequency system has been used widely in the last years, as it turned out to be an effective treatment method, either in combination with other modalities, or alone.

Conclusion

There are no generalized clinical guidelines adopted to standardize atrophic acne scar treatment. The multiple therapeutic options available create a dilemma in choosing the proper method in order to enhance its efficacy and to minimize its risks. The accumulated experience in nonablative collagen stimulating devices like fractional radiofrequency has proven that thickening of interstitial fibers in the dermis is possible with a controlled thermal injury, without epidermal damage and development of side effects.
Leverage Dynamics without Commitment
Authors: DEMARZO PETER M. , HE ZHIGUO
Published: December 2020

We characterize equilibrium leverage dynamics in a trade‐off model in which the firm can continuously adjust leverage and cannot commit to a policy ex ante. While the leverage ratchet effect leads shareholders to issue debt gradually over time, asset growth and debt maturity cause leverage to mean‐revert slowly toward a target. Investors anticipate future debt issuance and raise credit spreads, fully offsetting the tax benefits of new debt. Shareholders are therefore indifferent toward the debt maturity structure, even though their choice significantly affects credit spreads, leverage levels, the speed of adjustment, future investment, and growth.
The burden of oral health problems in children with mental health disorders in the United States
Authors: Yusuf Zenab I. , Dongarwar Deepa , Yusuf Rafeek A. , Udoetuk Sade C. , Salihu Hamisu M.
Published: December 2020

Objectives

Mental health disorders (MHDs) are major public health concerns with increasing risk of morbidity and mortality among children. Oral health problems (OHPs) are receiving attention as associated comorbidities. This study assessed the burden of oral health problems in children aged 3–17 years with MHD in the United States.

Methods

Cross sectional analyses was performed using the National Survey of Children's Health database 2016–2017 containing information of 60,655,439 children. Weighted survey binomial logistic regression generating odds ratio for association between MHD and OHP were calculated. Weighted dose–response models captured incremental effects of MHD severity on oral health conditions. Population attributable risk (PAR) to quantify proportions of potentially avertable OHP as a result of intervention targeted at different levels of MHD severity were estimated.

Results

Prevalence of OHP among those with any MHD was 22.5 percent. Children with MHD were more likely to be non‐Hispanic White, living in poorer households, and having private health insurance P < 0.001. Dose–response analyses showed children with mild MHD were 85 percent more likely [OR = 1.85 (95% CI: 1.47–2.32)], and those with moderate/severe MHD 93 percent more likely (OR = 1.93, 95% CI: 1.50–2.49) to experience OHP, compared to children without MHD. Population attributable risk (PAR) revealed that if mild and moderate/severe MHD were improved by 75 percent, OHP would be averted in 152,206 children with mild and 255,851 with moderate/severe MHD, respectively.

Conclusion

Our results suggest that disparities persist among the pediatric population with MHD who suffer OHP in the United States.
Glycogenosis is common in nonalcoholic fatty liver disease and is independently associated with ballooning, but lower steatosis and lower fibrosis
Authors: Allende Daniela S , Gawrieh Samer , Cummings Oscar W , Belt Patricia , Wilson Laura , Van Natta Mark , Behling Cynthia A , Carpenter Danielle , Gill Ryan M , Kleiner David E , Yeh Mathew M , Chalasani Naga , Guy Cynthia D ,   NASH Clinical Research Network
Published: December 2020

Background/Aims

Glycogen synthesis and storage are normal hepatocyte functions. However, glycogenosis, defined as excess hepatocyte glycogen visible by routine H&E light microscopy, has not been well characterized in nonalcoholic fatty liver disease (NAFLD).

Methods

Glycogenosis in NAFLD liver biopsies was graded as “none”, “focal” (in <50% of hepatocytes), or “diffuse” (in ≥50% of hepatocytes). Clinical and pathological variables associated with glycogenosis were assessed. 2047 liver biopsies were prospectively analysed.

Results

In adults and children, any glycogenosis was present in 54% of cases; diffuse glycogenosis was noted in approximately 1/3 of cases. On multiple logistic regression analysis, adults with glycogenosis tended to be older (P = .003), female (P = .04), have higher serum glucose (P = .01), and use insulin (P = .02). Adults tended to have lower steatosis scores (P = .006) and lower fibrosis stages (P = .005); however, unexpectedly, they also tended to have more hepatocyte injury including ballooning (P = .003). On multiple logistic regression analysis, paediatric patients with glycogenosis were more likely to be Hispanic (P = .03), have lower body weight (P = .002), elevated triglycerides (P = .001), and a higher fasting glucose (P = .007). Paediatric patients with glycogenosis also had less steatosis (P < .001) than those without.

Conclusions

Glycogenosis is common in adult and paediatric NAFLD, and is associated with clinical features of insulin resistance. Glycogenosis is important to recognize histologically because it may be misinterpreted as ballooning, and when diffuse, confusion with glycogen storage disorders or glycogenic hepatopathy must be avoided. The newly observed dichotomous relationship between glycogenosis and increased liver cell injury but decreased steatosis and fibrosis requires further study.
Al‐Mg isotopic study of spinel‐rich fine‐grained CAIs
Authors: MacPherson Glenn J. , Krot Alexander N. , Nagashima Kazuhide
Published: December 2020

High‐precision SIMS analyses of seven spinel‐rich fine‐grained CAIs from the CV3 chondrites Efremovka, Kaba, and Vigarano and the LL3.0 chondrite Semarkona, two known to have volatility‐fractionated Group II REE patterns (likely condensates) and three more probably Group II, all give initial 26Al/27Al (26Al/27Al0) close to the solar system initial value of 5.2 × 10–5. Our data thus provide no evidence for multiple condensation events in the early solar system. Other work by Ushikubo et al. (2017) and Kawasaki et al. (2019a, 2019b) did find some similar inclusions whose values are significantly lower than the solar system initial value. Because the latter data are too few to indicate whether or not the lower ratios cluster or rather spread out over a range, more work will be required to determine if nebular condensation occurred following only a few major, punctuated thermal events or rather happened more frequently. Regardless, it is now clear that CAIs having the Group II REE pattern formed very early in solar system history, contemporaneous with the formation of CAIs having unfractionated REE patterns. Whatever the mechanism that formed Group II, it occurred under conditions that caused spinel to condense prior to (at a higher temperature than) melilite. This is contrary to the predictions of equilibrium nebular condensation.
Thinking with two brains: Student perspectives on the presentation of race in pre‐clinical medical education
Authors: Mosley Marcus P. , Tasfia Nowshin , Serna Kimberly , Camacho‐Rivera Marlene , Frye Victoria
Published: December 2020

Context

There is growing concern that during their education medical students come to believe that ‘race’ is a biological construct and that differential treatment of patients based on ‘race’ is clinically beneficial. How ‘race’ is presented to medical students may influence both their implicit biases and future clinical practices, potentially widening racial disparities in care.

Methods

We conducted in‐depth interviews with twenty‐two pre‐clinical mostly non‐White medical students attending a public medical school in a major metropolitan area in the northeastern United States. Interview content focused on how medical students experience the presentation of race in medical education, use race in their learning experiences, and envision using race as physicians in future clinical encounters. Transcripts were analysed using the framework method and emergent themes were identified.

Results

Participants described being most aware of the presentation of race in board‐style questions and least aware of the presentation of race during lectures. They described being aware of race in problem‐based learning (PBL) modules if the case revolved around a likely race‐disease association. They identified imprecision in how race was presented during lectures and insufficient explanations of causes of racial disparities in health. Participants described feeling ill‐prepared to obtain racial self‐identification and receiving mixed messages around the utility of race in diagnosing a patient. Participants reported experiences of cognitive dissonance around the presentation of race in board‐style questions and lectures.

Conclusions

Critical evaluation of the presentation of and instruction around ‘race’ is needed to address whether it is presented as a biological vs. social construct, the level of precision of racial categorisation in curricular content, and the causes of and mechanisms behind race‐disease associations. This has the potential to minimise false beliefs about race as a biological construct and the resultant negative impacts on clinical care. Future research could evaluate whether problem‐based or experiential (OSCE) learning, in contrast to board‐style questions and didactic lectures, are the most effective way to educate students around race in health and illness. Additionally, future research can investigate if the mission (ie social) and composition (Predominantly White Institution or Historically Black College/University) of the faculty impacts student experiences of the presentation of race.
Artificial intelligence and the future of nationalism
Authors: Goode J Paul
Published: December 2020

Artificial intelligence (AI) is spreading through all walks of life, promising social and economic disruptions that prompt comparisons with the Industrial Revolution. While there is growing interest in AI ethics and its implications for humanity, there has been surprisingly little consideration of its implications for national identities and nationalism. This paper argues that the transformation of citizens into population data is driving changes to state sovereignty and that the simultaneous competition between (and within) states and global corporations on a structural level and expansion of algorithmic population management on a quotidian level may crystallize in ways that are likely to produce nationalist responses. It concludes by proposing a number of causal mechanisms and hypotheses regarding the emergence and spread of “AI nationalism.” Scholars in nationalism studies can benefit substantially from embracing the study and applications of AI, though they ignore its development and spread at their peril.
Prolonged SARS‐CoV‐2 viral shedding in patients with chronic kidney disease
Authors: O'Sullivan Eoin D. , Lees Jennifer S. , Howie Katie L. , Pugh Dan , Gillis Keith A. , Traynor Jamie P. , Macintyre Iain , Mark Patrick B.
Published: December 2020

Recent World Health Organization guidance has aimed to provide pragmatic guidance acknowledging the role of sequential nasopharyngeal swabs taken >24 hours apart for SARS‐CoV‐2 in high‐risk populations. Patients with chronic kidney disease (CKD) are known to have an altered immune milieu which may be associated with a delay in viral clearance. Here, a cross‐sectional observational study of 138 patients admitted with SARS‐CoV‐2 infection at two large regional hospitals in Scotland, UK examined the median time to two consecutive negative nasopharyngeal swabs for SARS‐CoV‐2 in an inpatient population. The median time from admission to the first of two consecutive negative nasopharyngeal swabs was 18 days (range = 1‐44) in patients with CKD, compared with 11 days (range: 1‐71) in patients without CKD (P = .0007). Multivariable linear regression analysis using explanatory variables of age, sex, SARS‐CoV‐2 disease severity, key comorbidities and renal function showed that declining estimated glomerular filtration rate was independently associated with prolonged time to viral clearance. Our data suggest that patients with CKD who are admitted to hospital with SARS‐CoV‐2 take longer to achieve sequential negative nasopharyngeal swab reverse transcription‐polymerase chain reaction results than those without CKD. This has implications for renal service provision, discharge planning and hospital capacity as well as a direct impact on patients due to extended hospital stay, anxiety and stigmatisation.
Transition to renewable energy technologies and future prospects for oil‐exporting countries
Authors: Khan Samar , Shaheen Rozina
Published: December 2020

In the context of recent energy transition from hydrocarbon molecules to electrons, this research aims to examine the degree of substitution between renewable energy sources and fossil fuels through a dynamic framework of time‐varying parameters under state‐space model. For this purpose, this research selects four major oil‐importing countries and employs annual time series data for crude oil imports, gross domestic product, crude oil price, renewable energy consumption, population growth, real effective exchange rate and industrial production index for each country in the sample while covering the period 1991–2018. The estimates reveal positive and significant income, population and industrial production index elasticities for most of the countries in the sample. In addition, this research finds negative and statistically significant elasticity between renewable energy consumption and demand for imported crude oil for India, China and Japan, although magnitude is very small. However, there is insignificant and little substitution for US data. This research is unique as to our knowledge there is no such study available before and it provides insights for policymakers in oil‐exporting countries to develop sustainable long‐term diversification strategies to reduce reliance on oil revenues.
Referrals from community optometrists to the hospital eye service in England
Authors: Evans Bruce J W , Edgar David F , Jessa Zahra , Yammouni Robert , Campbell Peter , Soteri Kiki , Hobby Angharad , Khatoon Abeeda , Beg Amaad , Harsum Steven , Aggarwal Rajesh , Shah Rakhee
Published: December 2020

Purpose

In the UK, most referrals to the hospital eye service (HES) originate from community optometrists (CO). This audit investigates the quality of referrals, replies, and communication between CO and the HES.

Methods

Optometric referrals and replies were extracted from three practices in England. If no reply letter was found, the records were searched at each local HES unit, and additional replies or records copied. De‐identified referrals, replies and records were audited by a panel against established standards to evaluate whether the referrals were necessary, accurate and directed to the appropriate professional. The referral rate (RR) and referral reply rate (RRR) were calculated.

Results

A total of 459 de‐identified referrals were extracted. The RR ranged from 3.6%–8.7%. The proportion of referred patients who were seen in the HES unit was 63%–76%. From the CO perspective, the proportion of referrals for which they received replies ranged from 26%–49%. Adjusting the number of referrals for cases when it would be reasonable to expect an HES reply, RRR becomes 38%–62%. Patients received a copy of the reply in 3%–21% of cases. Referrals were made to the appropriate service in over 95% of cases, were judged necessary in 93%–97% and were accurate in 81%–98% of cases. The referral reply addressed the reason for the referral in 93%–97% and was meaningful in 94%–99% of cases. The most common conditions referred were glaucoma, cataract, anterior segment lesions, and neurological/ocular motor anomalies. The CO/HES dyad (pairing) in the area with the lowest average household income had the highest RR.

Conclusions

In contrast with the Royal College of Ophthalmologists/College of Optometrists joint statement on sharing patient information, CO referrals often do not elicit a reply to the referring CO. Replies from the HES to COs are important for patient care, benefitting patients and clinicians, and minimising unnecessary HES appointments.
Use of simulation practices in public or community health nursing: findings from mixed‐methods systematic review
Authors: Aslan Funda
Published: December 2020

Background

Simulation activities are valuable for nursing education and provide an experimental learning opportunity. However, simulation scenarios have focused on nursing education of traditional medical specialities, and limited research exists on simulation for community or public health nursing education.

Aims

This study aimed to explore the methods that are being used to increase the knowledge and skills of nursing students who work for public health nursing and the evidence about the effectiveness of simulation practices in public or community health nursing.

Methods

In this systematic review, a combination of keywords was selected from Medical Subject Headings based on which eight studies were found across Science Direct, Web of Science, EBSCO, Cochrane and PubMed databases between June 2018 and September 2018.

Findings

A total of eight studies were included in the mixed‐methods systematic review (two qualitative, two mixed‐methods and four quantitative studies). The students were satisfied with public health nursing simulation practices and had significant gains in the following activities: active learning, collaboration, critical thinking, teamwork, evaluating family and individual together, and practical communication skills.

Conclusion

The results of this review revealed that the experiences and gains of the nurses that they gain during their education process were essential, the numbers of simulation practices in the field of public health nursing were minimal, and they should be improved qualitatively.
Disruption of NAP1 genes in Arabidopsis thaliana suppresses the fas1 mutant phenotype, enhances genome stability and changes chromatin compaction
Authors: Kolářová Karolína , Nešpor Dadejová Martina , Loja Tomáš , Lochmanová Gabriela , Sýkorová Eva , Dvořáčková Martina
Published: December 2020

Histone chaperones mediate the assembly and disassembly of nucleosomes and participate in essentially all DNA‐dependent cellular processes. In Arabidopsis thaliana, loss‐of‐function of FAS1 or FAS2 subunits of the H3‐H4 histone chaperone complex CHROMATIN ASSEMBLY FACTOR 1 (CAF‐1) has a dramatic effect on plant morphology, growth and overall fitness. CAF‐1 dysfunction can lead to altered chromatin compaction, systematic loss of repetitive elements or increased DNA damage, clearly demonstrating its severity. How chromatin composition is maintained without functional CAF‐1 remains elusive. Here we show that disruption of the H2A‐H2B histone chaperone NUCLEOSOME ASSEMBLY PROTEIN 1 (NAP1) suppresses the FAS1 loss‐of‐function phenotype. The quadruple mutant fas1 nap1;1 nap1;2 nap1;3 shows wild‐type growth, decreased sensitivity to genotoxic stress and suppression of telomere and 45S rDNA loss. Chromatin of fas1 nap1;1 nap1;2 nap1;3 plants is less accessible to micrococcal nuclease and the nuclear H3.1 and H3.3 histone pools change compared to fas1. Consistently, association between NAP1 and H3 occurs in the cytoplasm and nucleus in vivo in protoplasts. Altogether we show that NAP1 proteins play an essential role in DNA repair in fas1, which is coupled to nucleosome assembly through modulation of H3 levels in the nucleus.
Topological and Geometric Synthesis of Compliant Mechanisms
Authors: Hetrick Joel A. , Kota Sridhar
Published: December 2020

Structural optimization of compliant mechanisms is a systematic and automated approach for synthesizing the topology (layout) of mechanisms given the motion requirements. Here, two optimization approaches are presented: one employing a traditional full ground structure and one utilizing a modular ground structure whose nodes are allowed to wander within specified ranges. For problems discretized by many elements, the modular ground structure effectively reduces the number of design variables and speeds design convergence. In addition, relocation of node coordinates allows for geometric variation within the topology (layout) design stage. Linear finite element analysis using truss elements is utilized along with a sequential quadratic programming algorithm to optimize the mechanisms. Derivation of an efficiency based objective formulation is presented to determine the optimal mechanism design which satisfies motion requirements while maximizing the transfer of energy through the mechanism. Calculation of design derivatives with respect to element cross-section area and node position is performed using the adjoint variable method which provides faster and more stable convergence over finite difference approaches. Design examples are presented which directly compare the performance of topology optimized designs for the fixed node full ground structure to the floating node modular ground structure.
Ortho-Planar Mechanisms
Authors: Parise John J. , Howell Larry L. , Magleby Spencer P.
Published: December 2020

This paper proposes a new class of mechanisms called ortho-planar mechanisms. Ortho-planar mechanisms have links that can be simultaneously located in a single plane with motion out of that plane. Advantages of ortho-planar mechanisms include that they can be very compact, compliant ortho-planar mechanisms can be fabricated from a single sheet of material, and micro mechanical devices can be fabricated using surface micromachining methods. The potential impact of this class of mechanism is demonstrated by discussing them in the context of compliant mechanisms, metamorphic mechanisms, and micro-electromechanical systems.
Modeling continuous source distributions in wave-based virtual acoustics
Authors: Bilbao Stefan , Ahrens Jens
Published: December 2020

All acoustic sources are of finite spatial extent. In volumetric wave-based simulation approaches (including, e.g., the finite difference time domain method among many others), a direct approach is to represent such continuous source distributions in terms of a collection of point-like sources at grid locations. Such a representation requires interpolation over the grid and leads to common staircasing effects, particularly under rotation or translation of the distribution. In this article, a different representation is shown, based on a spherical harmonic representation of a given distribution. The source itself is decoupled from any particular arrangement of grid points, and is compactly represented as a series of filter responses used to drive a canonical set of source terms, each activating a given spherical harmonic directivity pattern. Such filter responses are derived for a variety of commonly encountered distributions. Simulation results are presented, illustrating various features of such a representation, including convergence, behaviour under rotation, the extension to the time varying case, and differences in computational cost relative to standard grid-based source representations.
An ultrasonic method to measure stress without calibration: The angled shear wave method
Authors: Li Guo-Yang , Gower Artur L. , Destrade Michel
Published: December 2020

Measuring stress levels in loaded structures is crucial to assess and monitor structure health and to predict the length of remaining structural life. Many ultrasonic methods are able to accurately predict in-plane stresses inside a controlled laboratory environment but struggle to be robust outside, in a real-world setting. That is because these methods rely either on knowing beforehand the material constants (which are difficult to acquire) or require significant calibration for each specimen. This paper presents an ultrasonic method to evaluate the in-plane stress in situ directly, without knowing any material constants. The method is simple in principle, as it only requires measuring the speed of two angled shear waves. It is based on a formula that is exact for incompressible solids, such as soft gels or tissues, and is approximately true for compressible “hard” solids, such as steel and other metals. The formula is validated by finite element simulations, showing that it displays excellent accuracy, with a small error on the order of 1%.
Two Months of Using Global Recommendations for Physical Activity Had No Impact on Cognitive or Motor Functions in Overweight and Obese Middle-Aged Women
Authors: Zlibinaite Laura , Skurvydas Albertas , Kilikeviciene Sandra , Solianik Rima
Published: December 2020

Background: The effect of globally recommended levels of physical activity on cognition and motor behavior is not completely understood. Therefore, the main aim of this study was to assess the effect of 300 minutes per week of moderate-intensity aerobic exercise on cognitive and motor performance among overweight and obese working-age women.Methods: Overweight and obese participants aged 38–56 years were randomized to either a control or an experimental group performing aerobic exercise at 50% to 60% of the peak oxygen consumption for a 2-month period. Changes in aerobic fitness, cardiac autonomic function, brain-derived neurotropic factor levels, and cognitive and motor performance were assessed.Results: Although aerobic exercise reduced body weight (P < .05) and improved peak oxygen consumption (P < .05), the brain-derived neurotropic factor levels and cognitive and motor performance remained unchanged. Heart rate and blood pressure decreased (P < .05), whereas heart rate variability indices were not affected. No significant correlations between changes in heart rate variability indices and cognition were observed.Conclusions: Two months of moderate-intensity aerobic exercise decreased sympathetic activity and improved cardiovascular fitness but had no impact on cognition or motor control among these middle-aged, overweight, and obese women.
Recommendations for determining the validity of consumer wearable and smartphone step count: expert statement and checklist of the INTERLIVE network
Authors: Johnston William , Judice Pedro B , Molina García Pablo , Mühlen Jan M , Lykke Skovgaard Esben , Stang Julie , Schumann Moritz , Cheng Shulin , Bloch Wilhelm , Brønd Jan Christian , Ekelund Ulf , Grøntved Anders , Caulfield Brian , Ortega Francisco B , Sardinha Luis B
Published: December 2020

Consumer wearable and smartphone devices provide an accessible means to objectively measure physical activity (PA) through step counts. With the increasing proliferation of this technology, consumers, practitioners and researchers are interested in leveraging these devices as a means to track and facilitate PA behavioural change. However, while the acceptance of these devices is increasing, the validity of many consumer devices have not been rigorously and transparently evaluated. The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives to develop best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice consumer wearable and smartphone step counter validation protocol. A two-step process was used to aggregate data and form a scientific foundation for the development of an optimal and feasible validation protocol: (1) a systematic literature review and (2) additional searches of the wider literature pertaining to factors that may introduce bias during the validation of these devices. The systematic literature review process identified 2897 potential articles, with 85 articles deemed eligible for the final dataset. From the synthesised data, we identified a set of six key domains to be considered during design and reporting of validation studies: target population, criterion measure, index measure, validation conditions, data processing and statistical analysis. Based on these six domains, a set of key variables of interest were identified and a ‘basic’ and ‘advanced’ multistage protocol for the validation of consumer wearable and smartphone step counters was developed. The INTERLIVE consortium recommends that the proposed protocol is used when considering the validation of any consumer wearable or smartphone step counter. Checklists have been provided to guide validation protocol development and reporting. The network also provide guidance for future research activities, highlighting the imminent need for the development of feasible alternative ‘gold-standard’ criterion measures for free-living validation. Adherence to these validation and reporting standards will help ensure methodological and reporting consistency, facilitating comparison between consumer devices. Ultimately, this will ensure that as these devices are integrated into standard medical care, consumers, practitioners, industry and researchers can use this technology safely and to its full potential.
Trans-Atlantic aeromedical repatriation of multiple COVID-19 patients: a hybrid military–civilian model
Authors: Dagens Andrew Benjamin , Mckinnon J , Simpson R , Calvert C , Keast T , Hart N , Almond M
Published: December 2020

Here, we report the first known transcontinental aeromedical evacuation of a large number (55) of patients with known and suspected positive COVID-19. These patients were evacuated from Havana, Cuba, to the UK through MOD Boscombe Down as part of Operation BROADSHARE, the British military’s overseas response to COVID-19. We describe the safe transfer of patients with COVID-19 using a combined military–civilian model. In our view, we have demonstrated that patients with COVID-19 can be aeromedically transferred while ensuring the safety of patients and crew using a hybrid military–civilian model; this report contains lessons for future aeromedical evacuation of patients with COVID-19.
Workplace intervention programmes for decreasing alcohol use in military personnel: a systematic review
Authors: Watterson Jason R , Gabbe B , Rosenfeld J V , Ball H , Romero L , Dietze P
Published: December 2020

Introduction

Harmful or risky-single occasion drinking (RSOD) alcohol use in the military is a significant problem. However, most studies of interventions have focused on veterans, representing a missed opportunity for intervention with active military personnel. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, the aim of this systematic review was to analyse and synthesise the evidence related to workplace-based interventions for reducing alcohol use in active-duty military personnel.

Methods

Four electronic databases and reference lists of relevant articles were searched from database inception until 20 January 2020. This review focused on experimental and quasi-experimental studies of active-duty military personnel. Data extraction and methodological quality assessment were independently performed by two reviewers using a standardised checklist. A third reviewer was used to arbitrate the disputed studies for final selection.

Results

The search yielded seven studies from an initial 1582 records identified. A range of interventions were used in these studies (four randomised controlled trials, two non-randomised trials and one before and after cohort study), including web-based approaches, telephone-delivered interventions and individual and group-based face-to-face interventions. Seven studies found decreased drinking, measured using a range of outcomes, following the intervention. However, this was not sustained in the longer term in any of the studies.

Conclusions

The low methodological rigour of most studies limited the capacity to demonstrate the efficacy of the interventions studied. Given the importance of reducing harmful or RSOD use of alcohol in the military, future studies would benefit from improved methodological rigour including ensuring adequate study power, randomisation, selection of validated outcome measures, including measures other than consumption (eg, attitudinal measures), and longer-term follow-up. There is also a need to develop methods that ensure participant loss to follow-up is minimised.
The association between combined oral contraceptive use and overweight/obesity: a secondary data analysis of the 2016 Ethiopia Demographic and Health Survey
Authors: Endalifer Melese Linger , Diress Alen Gedefaw , Addisu Amanuel , Linger Bedilu
Published: December 2020

Objectives

In this study, we aimed to assess the association between combined oral contraceptive (OC) use and overweight/obesity among Ethiopian adult women of reproductive age.

Design, setting and participants

The data were extracted from the 2016 Ethiopia Demographic and Health Survey; these data were collected from nine regions and two city administrations. We analysed the data from a total of 11 018 women aged 18–49 years who met eligibility criteria.

Main outcome measures

We employed WHO criteria to classify the body mass index of women. Specifically we tested the association between combined OC utilisation with overweight/obesity after controlling for confounding variables.

Result

The prevalence of combined OC utilisation was 1.7% and the prevalence of overweight/obesity was 8.6% among adult women of reproductive age. Use of combined OC increases the odds of overweight/obesity by two times among adult women of reproductive age after controlling for potential confounders (adjusted OR=1.902 (1.064–3.399)).

Conclusion

In conclusion there is significant association between combined OC use and overweight/obesity. The findings have important implications for policymakers to design evidence based policy approachs to obesity prevention for women and at large for government to recognise the negative consequences of combined OC on women health.
Glenoid failure after total shoulder arthroplasty with cemented all-polyethylene versus metal-backed implants: a systematic review protocol
Authors: Zan Renato Aroca Aroca , Lazarini Rafael Fuchs , Matsunaga Fabio Teruo , Netto Nicola Archetti , Belloti João Carlos , Tamaoki Marcel Jun Sugawara
Published: December 2020

Introduction

Anatomical total shoulder arthroplasty (TSA) is an effective treatment adopted for patients with glenohumeral osteoarthritis (OA). The glenoid component failure is the main risk that occurs in this therapeutic choice; however, doubts remain regarding the selection of the best implant for avoiding complication. This systematic review aims to evaluate the glenoid component in TSA by comparing the complications of different types of implants.

Methods and analysis

A systematic review of randomised clinical trials or quasi-randomised trials will be performed by applying the Preferred Reporting Items for Systematic Review and Meta-Analysis protocols and comparing polyethylene (keeled and pegged) versus metal-backed implants in adult patients with glenohumeral OA. Our search strategy will be performed using MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE and Web of Science. Data management and extraction will be performed using a data withdrawal form and by analysing study method characteristics, participant characteristics, intervention characteristics, results and methodological domains. The database search will be performed by February 2021. The Grading of Recommendations Assessment, Development and Evaluation will be used for assessing the quality of evidence of each study selected; however, some critical and important outcomes were determined such as the shoulder function through functional scores (Constant-Murley and American Shoulder and Elbow Surgeons), complications represented by pain (Visual Analogue Scale), surgical revision, radiograph radiolucency and loosening. The confidence in estimated effects for these outcomes will be applied as the overall confidence. The outcomes will be defined as early or late, according to the postoperative follow-up of less than or greater than 1 year, respectively, for complications and radiographs. For the shoulder function, follow-ups will be divided into 6, 12 and 24 months. Heterogeneity is expected in systematic reviews; therefore, the selection of outcomes, as well as the sample size, and specific statistical analysis can lead to meta-analysis; however, if it fails, narrative evidence synthesis will be conducted. Other analyses such as descriptive, subgroup and sensitivity analyses will be performed whenever possible. This systematic review will, therefore, provide evidence concerning the best clinical practice for avoiding complications.

Ethics and dissemination

This study has been approved by the Institutional Review Board of Universidade Federal de São Paulo (protocols 0725/2017, 2.157.415 and 70473017.5.0000.5505), and the findings will be disseminated through peer-reviewed publication and conference presentations.

PROSPERO registration number

CRD42018079537.
Adult phenotype in Koolen-de Vries/KANSL1 haploinsufficiency syndrome
Authors: Amenta Simona , Frangella Silvia , Marangi Giuseppe , Lattante Serena , Ricciardi Stefania , Doronzio Paolo Niccolò , Orteschi Daniela , Veredice Chiara , Contaldo Ilaria , Zampino Giuseppe , Gentile Mattia , Scarano Emanuela , Graziano Claudio , Zollino Marcella
Published: December 2020

Background

Koolen-de Vries syndrome (KdVS) is a multisystem neurodevelopmental disorder caused by 17q21.31 deletions or mutations in KANSL1. It was mainly described in children.

Methods

A retrospective study on 9 subjects aged 19–45 years and revision of 18 literature patients, with the purpose to get insights into the phenotypic evolution with time, and into the clinical manifestations in adulthood.

Results

Seven patients had a 17q21.31 deletion and two a point mutation in KANSL1. All had intellectual disability, which was mild in five (56%) and moderate in four (44%). Epilepsy was diagnosed in four subjects (44%), with onset from 1 to 7 years and full remission before 9 years in 3/4 patients. Scoliosis affected seven individuals (77.7%) and it was substantially stable with age in 5/7 patients, allowing for simple daily activities. Two subjects had severely progressive scoliosis, which was surgically corrected. Overweight or true obesity did occur after puberty in six patients (67%). Behaviour abnormalities were recorded in six patients (67%). The facial phenotype slightly evolved with time to include thick eyebrows, elongated nose and pronounced pointed chin. Despite behaviour abnormalities, happy disposition and sociable attitudes were common. Half of patients had fluent language and were good at writing and reading. Rich language, although limited to single words or short sentences, and very limited or absent skills in writing and reading were observed in the remaining patients. Autonomy in daily activities and personal care was usually limited.

Conclusions

Distinctive features in adult KdVS subjects include intellectual disability, overweight/obesity, behaviour abnormalities with preserved social interest, ability in language, slight worsening of the facial phenotype and no seizures.