Test–Retest Reliability and Construct Validity of the German Translation of the Gait Outcome Assessment List (GOAL) Questionnaire for Children with Ambulatory Cerebral Palsy

The Gait Outcome Assessment List (GOAL) is a patient or caregiver-reported assessment of gait-related function across different domains of the International Classification of Functioning, Disability, and Health (ICF) developed for ambulant children with cerebral palsy (CP). So far, the questionnaire is only available in English. The aim of this study was to translate the GOAL into German and to evaluate its reliability and validity by studying the association between GOAL scores and gross motor function as categorized by the gross motor function classification system (GMFCS) in children with cerebral palsy (CP). The GOAL was administered to primary caregivers of n = 91 children and adolescents with CP (n = 32, GMFCS levels I; n = 27, GMFCS level II; and n = 32, GMFCS level III) and n = 15 patients were capable of independently completing the whole questionnaire (GMFCS level I). For assessing test–retest reliability, the questionnaire was completed for a second time 2 weeks after the first by the caregivers of n = 36 patients. Mean total GOAL scores decreased significantly with increasing GMFCS levels with scores of 71 (95% confidence interval [CI]: 66.90–74.77) for GMFCS level I, 56 (95% CI: 50.98–61.86) for GMFCS level II, and 45 (95% CI: 40.58–48.48) for GMFCS level III, respectively. In three out of seven domains, caregivers rated their children significantly lower than children rated themselves. The test–retest reliability was excellent as was internal consistency given the GOAL total score. The German GOAL may serve as a much needed patient-reported outcome measure of gait-related function in ambulant children and adolescents with CP.

EVALUATION OF THE ROOT CAUSE OF FAILURE IN A CRAWLER CRANE MACHINE USING HYBRID MCDM MODEL

A real-life case study has been presented in this paper, where a crawler crane machine is investigated for the root cause of failure, using an expert opinion-based technique which comprises of an integrated model which is based on an Intuitionistic Fuzzy TOPSIS model Exponential related function, and the intuitionistic entropy model. The main contribution and advantages of the proposed approach are in the use of a subjective and objective model for the computation of the criteria weight, which allows for complete assessment of the actual performance and value of each of the criteria. The application of the exponential-related function, which represent the aggregated effect of the positive and negative evaluations in the performance ratings of the alternatives based on the intuitionistic fuzzy set (IFS) data used. And finally, the method ranks all alternatives using the exponential-related function matrix, which accounts for the expert's attitudinal character, which a strong influencing factor in subjective assessments like the one used in some of the root cause of failure/reliability analysis.

FUNCTIONAL CALCULI FOR SECTORIAL OPERATORS AND RELATED FUNCTION THEORY

We construct two bounded functional calculi for sectorial operators on Banach spaces, which enhance the functional calculus for analytic Besov functions, by extending the class of functions, generalising and sharpening estimates and adapting the calculus to the angle of sectoriality. The calculi are based on appropriate reproducing formulas, they are compatible with standard functional calculi and they admit appropriate convergence lemmas and spectral mapping theorems. To achieve this, we develop the theory of associated function spaces in ways that are interesting and significant. As consequences of our calculi, we derive several well-known operator norm estimates and provide generalisations of some of them.

Progressive Domain Segregation in Early Embryonic Development and Underlying Correlation to Genetic and Epigenetic Changes

Chromatin undergoes drastic structural organization and epigenetic reprogramming during embryonic development. We present here a consistent view of the chromatin structural change, epigenetic reprogramming, and the corresponding sequence-dependence in both mouse and human embryo development. The two types of domains, identified earlier as forests (CGI-rich domains) and prairies (CGI-poor domains) based on the uneven distribution of CGI in the genome, become spatially segregated during embryonic development, with the exception of zygotic genome activation (ZGA) and implantation, at which point significant domain mixing occurs. Structural segregation largely coincides with DNA methylation and gene expression changes. Genes located in mixed prairie domains show proliferation and ectoderm differentiation-related function in ZGA and implantation, respectively. The chromatin of the ectoderm shows the weakest and the endoderm the strongest domain segregation in germ layers. This chromatin structure difference between different germ layers generally enlarges upon further differentiation. The systematic chromatin structure establishment and its sequence-based segregation strongly suggest the DNA sequence as a possible driving force for the establishment of chromatin 3D structures that profoundly affect the expression profile. Other possible factors correlated with or influencing chromatin structures, including transcription, the germ layers, and the cell cycle, are discussed for an understanding of concerted chromatin structure and epigenetic changes in development.

Altered synthesis of genes associated with short-chain fatty acids in the gut of patients with atrial fibrillation

Background The gut microbiota provides health benefits in humans by producing short-chain fatty acids (SCFAs), whose deficiency causes multiple disorders and inflammatory diseases. However, gut bacteria producing SCFAs in patients with atrial fibrillation (AF), an arrhythmia with increasing prevalence, have not been reported. To investigate major gut microbial organisms related to SCFA synthesis, SCFAs-associated KEGG orthologues (KOs), enzymatic genes, and potential producers were examined according to metagenomic data-mining in a northern Chinese cohort comprising 50 non-AF control and 50 AF patients. Results Compared with non-AF controls, individuals with AF had marked differences in microbial genes involved in SCFA-related synthesis, including 125 KOs and 5 SCFAs-related enzymatic genes. Furthermore, there were 10 species that harbored SCFA-synthesis related enzymatic genes, and were markedly decreased in the gut of AF patients. Notably, discriminative features about SCFA-synthesis related function, including 8 KOs (K01752, K01738, K00175, K03737, K01006, K01653, K01647 and K15023), 4 genes (menI, tesB, yciA and CO dehydrogenase acetyl-CoA synthase complex) and 2 species (Coprococcus catus and Firmicutes bacterium CAG:103), were selected as key factors based on LASSO analysis. Furthermore, PLS-SEM analysis showed that 72.8 and 91.14 % of the overall effects on gut microbiota diversity and key species on AF, respectively, were mediated by the key KOs. Meanwhile, 46.31 % of the total effects of SCFA-synthesis related function on left atrial enlargement was mediated by hsCRP. Upon incorporation of clinical properties in AF, the KO score was still significantly associated with AF incidence (OR = 0.004, P = 0.001). Conclusions The current study revealed that dysbiotic gut microbiota in AF is coupled with disrupted SCFA-synthesis related genes, characterized by decreased abundances of KEGG orthologues, synthesis enzymatic genes and harboring species.

Sedapp v2021: a nonlinear diffusion-based forward stratigraphic model for shallow marine environments

The formation of stratigraphy in shallow marine environments has long been an important topic within the geologic community. Although many advances have been made in the field of forward stratigraphic modeling (FSM), there are still some areas that can be improved in the existing models. In this work, the authors present our recent development and application of Sedapp, which is a new nonlinear open-source R code for FSM. This code uses an integrated depth–distance related function as the expression of the transport coefficient to underpin the FSM with more alongshore details. In addition to conventional parameters, a negative-feedback sediment supply rate and a differentiated deposition–erosion ratio were also introduced. All parameters were implemented in a nonlinear manner. Sedapp is a 2DH tool that is also capable of running 1DH scenarios. Two simplified case studies were conducted. The results showed that Sedapp not only assists in geologic interpretation but is also an efficient tool for internal architecture predictions.

Literature Review: Menopause and Sexual Disorders

Menopause is a permanent termination of the menstrual cycle caused by the loss of activity of ovarian follicles which is enforced when experiencing amenorrhea for 12 months. The mean age for women to stop menstruating was 51.5 years. The cause of menopause is a decrease in ovarian hormones. When the ovaries stop working and estrogen levels drop, a woman will experience several complaints such as changes in menstrual patterns, vasomotor, somatic, and psychological complaints, sleep disorders, sexual disorders, urogenital disorders, osteoporosis, and cardiovascular disease. Physical, psychological, social and cultural factors are factors that influence women’s sexual function. The ageing process is known to increase the prevalence of sexual dysfunction. Female sexual dysfunction prevalence is quite high, range from 38-85.2%. Sexual disorders can take many forms and clinical symptoms. Circulating estrogen levels have been shown to influence sexual desire, activity, experiences, and problems in sexually active postmenopausal women. Deficiency of estrogen will cause vaginal atrophy which can affect sexual dysfunction. Many factors influence sexual dysfunction, both biological and psychological, in postmenopausal women. The goal of managing sexual disorders in postmenopausal women is to maintain age-related function. Vulvovaginal complaints should be managed individualized and depends on the severity of symptoms, medical history and lifestyle of the patient.

Motivational interviewing with community-dwelling older adults after hip fracture (MIHip): protocol for a randomised controlled trial

IntroductionCommunity-dwelling people recovering from hip fracture have the physical capacity to walk in their community but lack the confidence to do so. The primary aim of this trial is to determine whether motivational interviewing increases time spent walking at 12 months in community-dwelling people after hip fracture compared with an attention placebo control group. Secondary aims are to evaluate cost effectiveness, patient and health service outcomes and to complete a process evaluation.Methods and analysisAn assessor-blinded parallel group randomised controlled design with embedded health economic evaluation and process evaluation will compare the effects of n=270 participants randomly allocated to an experimental group (motivational interviewing) or a control group (dietary advice). For inclusion, participants are aged ≥65 years, living at home independently within 6 months of discharge from hospital after hip fracture and able to walk independently and communicate with conversational English. Key exclusion criteria are severe depression or anxiety, impaired intellectual functioning and being medically unstable to walk. Participants allocated to the experimental group will receive 10 (8 weekly and 2 booster) telephone-based sessions of motivational interviewing to increase walking over 16 weeks. Participants allocated to the control group will receive an equivalent dose of telephone-based dietary advice. The primary outcome is daily time spent walking over 7 days assessed at weeks 0, 9, 26 and 52. Secondary outcomes include measures of psychological-related function, mobility-related function, community participation, health-related quality of life and falls. Health service utilisation and associated costs will be assessed. Process evaluation will assess the fidelity of the motivational interviewing intervention and explore contextual factors through semistructured interviews.Ethics and disseminationEthical approval obtained from Eastern Health (E19-002), Peninsula Health (50261/EH-2019), Alfred Health (617/20) and La Trobe University (E19/002/50261). The findings will be disseminated in peer-reviewed journals, conference presentations and public seminars.Trial registration numberACTRN12619000936123.