bluuebunny/crossref_metadata_2025 huggingface dataset:
When a Sibling Has Autism: Narrative Review of Interventions for Typically Developing Siblings
Authors: Godara Karishma , Patil Vaibhav , Phakey Nisha
Published: July 2023

Being a typically developing sibling to a child with autism spectrum disorder (ASD-Sib) can be associated with several behavioral and mental health problems. With this understanding, researchers are beginning to focus on sibling-oriented interventions. This review seeks to evaluate the current literature on such interventions. We searched digital databases and identified eight relevant studies. The sample (n = 247) had an age range of 4–16 years. The outcomes were generally positive, with improvements in different facets of ASD-Sibs. Results differed due to varied intervention styles, outcome variables, methods, and samples. Our findings highlight the potential for improvement in ASD-Sib’s knowledge of autism and their psychological functioning and hence call for further research with robust methods.
An exploration of the self-care practices of foster carers in Australia
Authors: Gowan Mia , Peel Nicole , Elcombe Emma , Blythe Stacy
Published: July 2023

Practising self-care is vital for foster carers to cope with the stresses of the caring role, provide the best care possible and continue in their task. This current study contributes to emerging research on the self-care practices of foster carers in Australia and worldwide. It used an exploratory design, surveying 148 foster carers about their self-care and conducting individual, semi-structured interviews enabling nine of them to elaborate on their self-care experiences. The results indicate that while the participants sometimes engage in self-care and value it as a way of maintaining their wellbeing and increasing their caregiving capacity, they face several barriers to doing this. These include the multiple responsibilities of the foster carer role, children’s commitments, employment and finances. Facilitators of self-care include social and family support, contact with other carers and carer respite. Foster care agencies and the out-of-home care system should aim to meet the self-care needs of carers by providing increased support, resources and education.
Influence of Staphylococcus epidermidis on Collagen Crimp Patterns of Soft Tissue Allograft
Authors: Blunt Koral M. , Bentkowski Brett N. , Milliron Eric , Cavendish Parker , Qin Charles , Magnussen Robert A. , Stoodley Paul , Flanigan David C.
Published: July 2023

Background:

Postoperative infections, commonly from Staphylococcus epidermidis, may result in anterior cruciate ligament graft failure and necessitate revision surgery. In biomechanical studies, S. epidermidis has been shown to establish biofilms on tendons and reduce graft strength.

Purpose/Hypothesis:

The goal of this study was to determine the effect of bacterial bioburden on the collagen structure of tendon. It was hypothesized that an increase in S. epidermidis biofilm would compromise tendon crimp, a pattern necessary for mechanical integrity, of soft tissue allografts.

Study design:

Controlled laboratory study.

Methods:

Cultures of S. epidermidis were used to inoculate tibialis anterior cadaveric tendons. Conditions assessed included 5 × 105 colony-forming units or concentrated spent media from culture (no living bacteria). Incubation times of 30 minutes, 3 hours, 6 hours, and 24 hours were utilized. Second-harmonic generation imaging allowed for visualization of collagen autofluorescence. Crimp lengths were determined using ImageJ and compared based on incubation time.

Results:

Incubation time positively correlated with increasing S. epidermidis bioburden. Both fine and coarse crimp patterns lengthened with increasing incubation time. Significant coarse crimp changes were observed after only 30-minute incubations ( P < .029), whereas significant fine crimp lengthening occurred after 6 hours ( P < .0001). No changes in crimp length were identified after incubation in media lacking living bacteria.

Conclusion:

The results of this study demonstrate that exposure to S. epidermidis negatively affects collagen crimp structure. Structural alterations at the collagen fiber level occur within 30 minutes of exposure to media containing S. epidermidis.

Clinical Relevance:

Our study highlights the need for antimicrobial precautions to prevent graft colonization and maximize graft mechanical strength.
Experiences of Sexual and Reproductive Health Care Access for Women and Nonbinary People With Early Psychosis: Towards an Integrated Perspective of Service Users and Clinicians
Authors: Barker Lucy C. , Zaheer Juveria , Hussain Zakia , France Julia , Rodriguez Ananka , Lubotzky-Gete Shakked , Berkhout Suze , Dmytryshyn Robert , Dunn Sheila , Gupta Renu , Hosseiny Fardous , Sirotich Frank , Soklaridis Sophie , Voineskos Aristotle N. , Vigod Simone N.
Published: July 2023

Objective

Individuals with psychosis are at elevated risk of adverse sexual and reproductive health (SRH) outcomes, and not receiving adequate SRH care. SRH is important for youth, yet little is known about SRH care access and experiences among those with early psychosis. This study explored SRH care experiences among women and nonbinary individuals with early psychosis.

Method

We conducted semistructured qualitative interviews with 19 service users (cisgender and transgender women, nonbinary individuals) receiving care in 2 early psychosis programs in Ontario, Canada. We also conducted semistructured interviews and focus groups with 36 clinicians providing SRH or mental health care to this population. Participants were asked about SRH care access/provision experiences and the interplay with psychosis. Using a social interactionist orientation, a thematic analysis described and explained service user and clinician perspectives regarding SRH care.

Results

Amongst both service users and clinician groups, common themes developed: (a) diversity of settings: SRH services are accessed in a large range of spaces across the health care system, (b) barriers in nonpsychiatric SRH care settings: psychosis impacts the ability to engage with existing SRH services, (c) invisibility of SRH in psychiatric settings: SRH is rarely addressed in psychiatric care, (d) variability of informal SRH-related conversations and supports, and cutting across all of the above themes, (e) intersecting social and cultural factors impacted SRH services access.

Conclusions

SRH is important for health and wellbeing; improvements are urgently needed across the healthcare system and within early psychosis programs to meet this population's multifaceted SRH needs.
The role of Kupffer cell activation in immune liver damage induced by trichloroethylene associated with the IFN-γ/STAT1 signaling pathway
Authors: Zhou Si-fan , Xu Qiong-ying , Yang Yi , Xie Hai-bo , Zhang Jia-xiang , Zhu Qi-xing
Published: July 2023

Trichloroethylene (TCE) is a metal detergent commonly used in industry that can enter the human body through the respiratory tract and skin, causing occupational medicamentosa-like dermatitis due to TCE (OMDT) and multiple organ damage, including liver failure. However, the pathogenesis of liver injury remains unclear. Kupffer cells (KCs) are important tissue macrophages in the body because the polarization of KCs plays a crucial role in immune-mediated liver injury. However, the mechanism of KCs polarization in TCE-induced immune liver injury has not been thoroughly elucidated. In this study, we investigated the effect of TCE-induced KCs polarization on liver function and signal transduction pathways using the TCE sensitization model developed by our group. BALB/c mouse skin was exposed to TCE for sensitization, and an increase in the expression of M1 macrophage-specific markers (CD16/CD32, iNOS), M1 macrophage-specific cytokines IL-1β, and IFN-γ, P-JAK-1 and P-STAT1 levels were also found to be dramatically increased. When using low doses of gadolinium trichloride (GdCl3), the expression of these proteins and mRNA was significantly reduced. This phenomenon indicates that GdCl3 blocks TCE-induced polarization of KCs and suggests that the IFN-γ/STAT1 signaling pathway may be involved in the polarization process of KCs. These findings clarify the relationship between the polarization of KCs and immune liver injury and highlight the importance of further study of immune-mediated liver injury in TCE-sensitized mice.
Corticomuscular Coherence in Children with Unilateral Cerebral Palsy: A Feasibility and Preliminary Protocol Study
Authors: Gangwani Rachana R. , Mark Jasper I. , Vaughn Rachel M. , Holland Holly , Thorpe Deborah E. , Alexander Joshua J. , Surkar Swati M. , Cassidy Jessica M.
Published: July 2023

Objective This study assessed the feasibility of corticomuscular coherence measurement during a goal-directed task in children with unilateral cerebral palsy while establishing optimal experimental parameters. Methods Participants (Manual Ability Classification System levels I-III) completed a submaximal isometric goal-directed grip task during simultaneous electroencephalography and electromyography (EMG) acquisition. Results All participants (n = 11, 6 females, mean age 11.3 ±2.4 years) completed corticomuscular coherence procedures. Of the 40 trials obtained per extremity, an average of 29 (n = 9) and 27 (n = 10) trials were retained from the more- and less-affected extremities, respectively. Obtaining measurement stability required an average of 28 trials per extremity. Conclusion Findings from this work support the feasibility of corticomuscular coherence measurement in children with unilateral cerebral palsy. Acquiring 28 to 40 corticomuscular coherence trials per extremity is ideal. The experimental parameters established in this work will inform future corticomuscular coherence application in pediatric unilateral cerebral palsy.
Biomineralization of carboxymethyl cellulose-sodium alginate infused with cellulose nanocrystals for bone regeneration
Authors: Bakhiet Etdal , Mohamat Johari Nur Fatini Ilyana , Jahir Hussain Fathima Shahitha , Zulkifli Farah Hanani
Published: July 2023

The development of novel tissue constructs from both natural and synthetic biopolymers has attracted widespread attention among researchers, prior to its excellent outcomes in bone tissue regeneration. This research aims to investigate the biocompatibility of carboxymethyl cellulose (CMC)/sodium alginate (SA) embedded with cellulose nanocrystals (CNC) and its surface response due to the biomineralization process as potential implant material. The CMC/SA were prepared with and without CNC using water as the only solvent. It was then freeze-dried for up to 72 h before being further immersed in simulated body fluid (SBF) for comparative studies. Morphological observation by scanning electron microscope (SEM) showed that CMC/SA/CNC (SBF) displayed a spherical apatite structure amid interconnected porous materials with an average particle diameter between 95 and 148 nm. The apatite crystal indicated the existence of calcium (Ca) and phosphorus (P) elements, which was confirmed by energy dispersive X-ray analysis (EDX). All scaffolds showed a porosity of up to 90.13% with a moderate degradation rate and a water absorption value of up to 1100%. Overall, all scaffolds had open, interconnected pore sizes ranging from 40 to 400 µm. Attenuated total reflection – Fourier Transform Infrared (ATR-FTIR) spectroscopy and thermogravimetric analysis (TGA) curve showed a new existing peak and lower decomposition rate, respectively, for SBF-treated scaffolds. Stress-strain curve disclosed the highest tensile stress of CMC/SA/CNC (SBF) at 16.2 MPa and 15.75% strain effect. Preliminary in vitro cytotoxicity studies performed with human foetal osteoblast (hFOB) cells showed that cytocompatibility was more evident on CMC/SA/CNC (SBF) scaffolds. This study showed that scaffold-embedded CNC with SBF treatment could be hit upon as material selection for bone tissue engineering.
Predictive Performance for Hospital Mortality of SAPS 3, SOFA, ISS, and New ISS in Critically Ill Trauma Patients: A Validation Cohort Study
Authors: Roepke Roberta Muriel Longo , Besen Bruno Adler Maccagnan Pinheiro , Daltro-Oliveira Renato , Guazzelli Renata Mello , Bassi Estevão , Salluh Jorge Ibrain Figueira , Damous Sérgio Henrique Bastos , Utiyama Edivaldo Massazo , Malbouisson Luiz Marcelo Sá
Published: July 2023

Background: It is not known whether anatomical scores perform better than general critical care scores for trauma patients admitted to the intensive care unit (ICU). We compare the predictive performance for hospital mortality of general critical care scores (SAPS 3 and SOFA) with anatomical injury-based scores (Injury Severity Score [ISS] and New ISS [NISS]). Methods: Retrospective cohort study of patients admitted to a specialized trauma ICU from a tertiary hospital in São Paulo, Brazil between May, 2012 and January, 2016. We retrieved data from the ICU database for critical care scores and calculated ISS and NISS from chart data and whole body computed tomography results. We compared the predictive performance for hospital mortality of each model through discrimination, calibration, and decision-curve analysis. Results: The sample comprised 1053 victims of trauma admitted to the ICU, with 84.2% male patients and mean age of 40 (±18) years. Main injury mechanism was blunt trauma (90.7%). Traumatic brain injury was present in 67.8% of patients; 43.3% with severe TBI. At the time of ICU admission, 846 patients (80.3%) were on mechanical ventilation and 644 (64.3%) on vasoactive drugs. Hospital mortality was 23.8% (251). Median SAPS 3 was 41; median maximum SOFA within 24 h of admission, 7; ISS, 29; and NISS, 41. AUROCs (95% CI) were: SAPS 3 = 0.786 (0.756-0.817), SOFA = 0.807 (0.778-0.837), ISS = 0.616 (0.577-0.656), and NISS = 0.689 (0.649-0.729). In pairwise comparisons, SAPS 3 and SOFA did not differ, while both outperformed the anatomical scores ( p < .001). Maximum SOFA within 24 h of admission presented the best calibration and net benefit in decision-curve analysis. Conclusions: Trauma-specific anatomical scores have fair performance in critically ill trauma patients and are outperformed by SAPS 3 and SOFA. Illness severity is best characterized by organ dysfunction and physiological variables than anatomical injuries.
Influences of laser and plasma surface treatments on the primer paint adhesion for PPS/CF thermoplastic composite laminates
Authors: Atlioglu Merve , Kaynak Cevdet
Published: July 2023

For Poly(phenylene sulfide)/Carbon Fiber (PPS/CF) thermoplastic composite laminates, the main purpose of this study was to evaluate effects of “laser” and “plasma” surface treatments on the adhesion performance of primer painting by comparing with “untreated” and traditional “sandblasted” samples. For this purpose, after surface characterization of untreated and treated samples by Wettability, SEM, Surface Roughness, XPS and FTIR analyses; adhesion characteristics of an industrial primer paint applied onto PPS/CF surfaces were evaluated by using two different industrial methods: “Cross-cut Adhesion” tests and “Three-point Bending Adhesion” tests. Compared to the Untreated samples, it was observed that all surface treated samples could be assigned with the “best” primer adhesion grade of GT0. Moreover, surface treated samples had at least two times more maximum “Separation Load” with “cohesive” separation mechanism of primer paint layers. The success of the Sandblasted samples was due to efficient mechanical interlocking mechanism. For the Laser treated samples, adhesion performance was partly due to the mechanical interlocking and partly due to the chemical interactions; while for the Plasma treated samples it was mainly chemical bonding mechanism.
A semi-Markov multistate cure model for estimating intervention effects in stepped wedge design trials
Authors: Sundin Phillip Taylor , Aralis Hilary , Glenn Beth , Bastani Roshan , Crespi Catherine M
Published: July 2023

Multistate models are useful for studying exposures that affect transitions among a set of health states. However, they can be challenging to apply when exposures are time-varying. We develop a multistate model and a method of likelihood construction that allows application of the model to data in which interventions or other exposures can be time-varying and an individual may to be exposed to multiple intervention conditions while progressing through states. The model includes cure proportions, reflecting the possibility that some individuals will never leave certain states. We apply the approach to analyze patient vaccination data from a stepped wedge design trial evaluating two interventions to increase uptake of human papillomavirus vaccination. The states are defined as the number of vaccine doses the patient has received. We model state transitions as a semi-Markov process and include cure proportions to account for individuals who will never leave a given state (e.g. never receive their next dose). Multistate models typically quantify intervention effects as hazard ratios contrasting the intensities of transitions between states in intervention versus control conditions. For multistate processes, another clinically meaningful outcome is the change in the percentage of the study population that has achieved a specific state (e.g. completion of all required doses) by a specific point in time due to an intervention. We present a method for quantifying intervention effects in this manner. We apply the model to both simulated and real-world data and also explore some conditions under which such models may give biased results.
Book review: Samwiri Lwanga Lunyiigo, Uganda an Indian Colony 1897–1972
Authors: Dua Aarshi
Published: July 2023

Samwiri Lwanga Lunyiigo, Uganda an Indian Colony 1897–1972, The African Studies Bookstore, 2021, pp. 224, ₹1547.
Marshall Plan and International Development Strategy: Perspectives from African Underdevelopment
Authors: Onah Celestine Chijioke , Aloysius Aduma , Amujiri Benjamin
Published: July 2023

All that mankind seeks from the dawn of civilisation to this epoch is sustainable development (SD). Due to a lack of SD, Second World War broke out and devastated Europe and retrogressed her to the status of underdevelopment. To recue Europe from the ruins, the U.S. introduced Marshall Plan (MP)—a programme of actions and projects with huge financial aid aimed at reviving and restoring Europe from the aftermaths of the war. Through MP, Europe ‘miraculously’ recovered and developed again within a brief period, and since then, Europe has been sustaining the development till date. The article argued that MP did not restore Europe because of the huge amount committed to it as many scholars claim. Rather, because of the already-built political economy of quality human resource/capital, politico-administrative capabilities and patriotism already in existence. Unlike the third world countries that have received their own versions of MP in foreign aids, programmes, loans, projects, and so on, without commiserate development.
Balancing through Technonationalism and its Impact on India’s National Innovation System: A Case Study of Techgentsia
Authors: Rugmini Devi M  , Mammen Jeffin Thomas , R Girish Kumar
Published: July 2023

A nation’s competitive advantage in the modern world is determined by its access to emerging technologies like artificial intelligence, 5G and cloud computing. This competition has led to the imposition of neo-mercantilist policies to promote and protect domestic industries and substantially reduce foreign investments in the technology sector, especially from rival countries. This phenomenon, termed technonationalism, and the reasons for its emergence in the contemporary world and its variants across major economies are analysed using the neo-realist framework of international relations, particularly the theory of internal balancing. An attempt is made to trace the existence of technonationalism in India by examining six overarching policies of the government. The article elucidates how technonationalism drives the national innovation system in a country through the case study of Techgentsia, an Indian company whose software products are promoted by the Government of India towards strengthening India’s national security. It concludes that India’s technonationalist policies are driven by the heightened threat perception in the international system.
Treatment of lateral ankle instability patient-specific remnant approach
Authors: Borbon Carlo Angelo V
Published: July 2023

Lateral ankle instability is one of the most common problems seen in the orthopaedic setting. Proper diagnosis is essential in order to provide the ideal treatment for these patients. All patients are subjected to nonoperative management in the form of functional rehabilitation. For those, however, who did not respond well to therapy, surgical treatment is then recommended. There are several surgical techniques available which have been meticulously studied and discussed in previous articles. The focus of this paper is on the author’s perspective on choosing the surgical technique based on the quality of the anterior talofibular ligament and calcaneofibular ligament remnants. All patients are subjected to a diagnostic arthroscopy, where the remnant is assessed. The procedure then of doing an all-arthroscopic, open Modified Brostrom or anatomic reconstruction is then chosen based on this initial assessment
Instability of the distal tibiofibular syndesmosis
Authors: Vohra Rajeev , Singh Avtar , Thorat Babaji , Patel Dharmesh
Published: July 2023

The distal tibiofibular syndesmosis (DTFS) is more frequently injured than previously thought. Early diagnosis and appropriate treatment is essential to avoid long term complications like chronic instability, early osteoarthritis and residual pain. Management of these injuries require a complete understanding of the anatomy of DTFS, and the role played by the ligaments stabilizing the DTFS and ankle. High index of suspicion, appreciating the areas of focal tenderness and utilizing the provocative maneuvers help in early diagnosis. In pure ligamentous injuries radiographs with stress of weight bearing help to detect subtle instability. If these images are inconclusive, then further imaging with MRI, CT scan, stress examination under anesthesia, and arthroscopic examination facilitate diagnosis. An injury to syndesmosis frequently accompanies rotational fractures and all ankle fractures need to be stressed intra-operatively under fluoroscopy after fixation of the osseous components to detect syndesmotic instability. Non-operative treatment is appropriate for stable injuries. Unstable injuries should be treated operatively. Anatomic reduction of the syndesmosis is critical, and currently both trans-syndesmotic screws and suture button fixation are commonly used for syndesmotic stabilization. Chronic syndesmotic instability (CSI) requires debridement of syndesmosis, restoration of ankle mortise with or without syndesmotic stabilization. Arthrodesis of ankle is used a last resort in the presence of significant ankle arthritis. This article reviews anatomy and biomechanics of the syndesmosis, the mechanism of pure ligamentous injury and injury associated with ankle fractures, clinical, radiological and arthroscopic diagnosis and surgical treatment.
Subtalar instability
Authors: Tan Chin Yik , Thevendran Gowreeson
Published: July 2023

Subtalar instability is a confusing yet important condition in patients with lateral ankle instability. The author will explore subtalar kinematics, and how they are closely related to the joint stability of the subtalar joint, both with respect to its intrinsic ligaments and its extrinsic ligaments. As subtalar instability is difficult to diagnose, this article will provide readers with a better understanding of its clinical presentation. Discussions will also include useful radiographic modalities and the most recent evidence regarding their accuracy. The last section discusses surgical options and what the readers need to know in order to make a decision.
Parents’ Perception of Barriers to the Comprehensive Management of Children With Cleft Lip and Palate in Bogota, Colombia
Authors: González-Carrera María Clara , Ruiz Jaime Alberto , Mora-Díaz Ingrid Isabel , Pereira de Souza David , Restrepo-Pérez Luis Fernando , Bendahan Zita , Bautista Gloria Rocío , Díaz-Báez David
Published: July 2023

Object

To identify the perception of barriers to the comprehensive management of cleft lip and palate (CLP) by parents/caregivers of Colombian children with this condition.

Setting and Sample Population

Fifty parents/caregivers of children with CLP under 12 years attending a center specialized in the management of craniofacial congenital conditions in Bogota, Colombia.

Materials and Methods

This study consisted of 2 phases: a quantitative phase (descriptive cross-sectional) and a qualitative phase (focus group [FG]). Chi-square and Fisher exact tests were used to analyze the association variables. The barriers and alternative ways to overcome barriers were analyzed in the FG.

Results

Comprehensive management was mostly defined as access to multiple treatments (54%), and this concept was expanded in the FG toward understanding CLP at all levels. Monoparental families spend their income on treatments (29%) than nuclear families (0%) ( P = .001). All parents with high education levels were familiar with healthcare centers specialized in CLP as opposed to 66.7% of parents with basic primary education ( P < .05). Regarding the timeliness of appointments, 12.2% of parents earning between 1 and 2 minimum wages reported some kind of difficulty, whereas those earning less than one minimum wage reported difficulties in 66.7% of cases ( P = .046).

Conclusions

All participants reported barriers, which increased or decreased depending on their socioeconomic status. The FG allowed the discussion of alternatives to overcome barriers, such as structural, solidarity, and self-management actions.
The Implications of Laterality in Unilateral Cleft Lip Reconstruction: A Global Survey of Cleft Surgeons
Authors: Chadha Ambika , Bradley Daniel , Fell Matthew , Fernanda Maria , Bustamante Atenas , Chong David
Published: July 2023

Objective

To explore the impact of directional laterality in complete Unilateral Cleft Lip (UCL) amongst the global cleft surgeon community

Design

Cross-sectional survey study.

Setting

Global distribution of online survey distributed in English and Spanish.

Participants

Cleft surgeons from around the world.

Main outcome measures

Survey participant perception of the impact of laterality on: (1) cleft presentation (2) surgical challenge and (3) surgical outcomes.

Results

Responses were received from 453 cleft surgeons located in 54 countries around the world. 221 (49%) had previously considered differences in patients presenting with a left- versus right-sided UCL. 95 (21%) considered right-sided clefts more difficult to reconstruct, 37 (8%) reported left-sided clefts to be more difficult and 321 (71%) reported no difference in difficulty between the cleft sides. Higher volume cleft surgeons, characterised by those reporting cleft as their principal area of practice and performing >20 cleft operations per year, were more likely to have both previously considered differences in laterality in cleft and to report right-sided unilateral cleft lip to be more difficult to primarily reconstruct. 395 (87%) did not consider surgical outcomes to be influenced by cleft laterality.

Conclusions

This survey reports perceptions on cleft laterality from a large body of global surgeons and suggests a trend for increased difficulty in right-sided compared to left-sided cleft lip reconstruction, where such laterality-associated difficulty is perceived.
Risk of Bleeding Associated With Outpatient Use of Rivaroxaban in VTE Management at a National Referral Hospital in Western Kenya
Authors: Njuguna Dennis , Nwaneri Francis , Prichard Allyson C. , Manji Imran , Kigen Gabriel , Busakhala Naftali , Nyanje Samuel , O’Neil Emily , Pastakia Sonak D.
Published: July 2023

There is limited data on the bleeding safety profile of direct oral anticoagulants, such as rivaroxaban, in low- and middle-income country settings like Kenya. In this prospective observational study, patients newly started on rivaroxaban or switching to rivaroxaban from warfarin for the management of venous thromboembolism (VTE) within the national referral hospital in western Kenya were assessed to determine the frequency of bleeding during treatment. Bleeding events were assessed at the 1- and 3-month visits, as well as at the end of follow-up. The International Society of Thrombosis and Hemostasis (ISTH) and the Bleeding Academic Research Consortium (BARC) criteria were used to categorize the bleeding events, and descriptive statistics were used to summarize categorical variables. Univariate and multivariate logistic regression model was used to calculate unadjusted and adjusted associations between patient characteristics and bleeding. The frequency of any type of bleeding was 14.4% (95% CI: 9.3%-20.8%) for an incidence rate of 30.9 bleeding events (95% CI: 20.1-45.6) per 100 patient-years of follow-up. The frequency of major bleeding was 1.9% while that of clinically relevant non-major bleeding was 13.8%. In the multivariate logistic regression model, being a beneficiary of the national insurance plan was associated with a lower risk of bleeding, while being unemployed was associated with a higher bleeding risk. The use of rivaroxaban in the management of VTE was associated with a higher frequency of bleeding. These findings warrant confirmation in larger and more targeted investigations in a similar population.
Spaced Apart: Autoethnographies of Access Throughout the COVID 19 Pandemic
Authors: Dokumaci Arseli , Bessette-Viens Raphaelle , Goberdhan Nicholas , Lucas Simone , Mazowita Amy , Stainton Jessie
Published: July 2023

In this article, we present six autoethnographies of lives marked by crisis that reflect on the issues of access, very broadly defined, that the COVID 19 pandemic has raised or redefined for each of us. As the time of crisis has made access concerns more and more evident it also exposes how access is not an issue just for disabled people, but for all lives. Drawing on recent scholarship in disability studies that critically interrogates access through an intersectional lens, we take this unexpected unveiling as an occasion to further tease out the complexities, ambiguities, and messiness of access.
Unmasked: COVID-19, Face Coverings, and Navigating Dis/Abling Spaces and Cultures
Authors: Thomas Gareth M. , White Lauren
Published: July 2023

During the COVID-19 pandemic, policies have been established that have exempted some disabled people from wearing a face covering in public spaces. Yet, despite the introduction of such policies, disabled people have reported being challenged and abused for not wearing one. Drawing upon key ideas and tropes from disability studies and the sociology of the everyday, we sketch out the adverse effects and ambiguities caused by the pandemic relating to the use of face coverings, along with how emerging cultural norms and notions of shame are publicly mobilized to police conduct. Touching on themes of access, materiality, in/visibility, and in/exclusion, we conclude that face coverings are simply another artifact through which disabled people are read, judged, and excluded in public life. We also contend that face coverings, and the controversy surrounding their use, are another example of how disabled people have been overlooked, disregarded, and disproportionately affected by the COVID-19 pandemic.
The Rehabilitation Hospital as a “Parenthetical Bubble-Shell”: Adjusting to Disability Within the Covid-19 Crisis
Authors: Sanmiquel-Molinero Laura
Published: July 2023

This essay contrasts the experiences of hospitalization and transition from hospital to home of people who have recently acquired a spinal cord injury (SCI) and the health professionals who work with them before and during pandemic-related restrictions. These experiences are analyzed through the theoretical frameworks of liminality and intersectional Critical Disability Studies. Drawing on narrative-ethnographic data collected in Spain, I illustrate that the rehabilitation hospital is conceived as a “parenthetical bubble-shell” the boundedness and permeability of which was radically altered during lockdown. First, I discuss how this transformed the way people with an SCI adjust to new ways of approaching space and time in hospital settings. Second, I explore how lockdown impacted key processes of “discharge preparation.” Third, I argue that the intersection between ability, gender, and social class modulates the extent to which exiting the hospital before and during the pandemic represented an ongoing crisis.
Positive and challenging themes in parents’ perceptions of their relationships with their child with autism: Comparison between mothers and fathers
Authors: Moshe Shir , Oppenheim David , Slonim Michal , Hamburger Lior , Maccabi Yael , Yirmiya Nurit
Published: July 2023

Most studies of how parents of children with autism view the parent–child relationship used self-report questionnaires and focused on challenges. This study broadened the lens by interviewing parents using open-ended questions that provide an opportunity to raise challenging but also positive experiences. Seventy-five mother–father dyads were interviewed individually about their own and their spouses’ relationships with their preschooler, and content analyses of their responses revealed nine relationship themes. In descending order, the themes mentioned most frequently by mothers were “Security and Closeness,” “Love,” and “Tenderness and Sensitivity,” and by fathers were “Pleasure in Joint Activities,” “Security and Closeness,” and “Guidance.” Positive themes were more common than challenging themes. Finally, more mothers mentioned the themes “Love,” “Tenderness and Sensitivity,” “High Involvement and Care,” and “Difficulties” than did fathers, whereas more fathers mentioned the themes “Guidance,” “Pleasure in Joint Activities,” and “Limited Time with Child” than did mothers. The findings portray a nuanced view of the parenting experience of mothers and fathers of preschoolers with autism.

Lay Abstract

Most studies of how parents of children with autism see the parent–child relationship used questionnaires completed by the parents and focused on challenges. This study broadened the lens by interviewing parents using open-ended questions that provide an opportunity to raise challenging but also positive experiences. Seventy-five mother-father dyads were interviewed individually about their own and their spouses’ relationships with their preschooler, and we found nine relationship themes. In descending order, the themes mentioned most frequently by mothers were “Security and Closeness,” “Love,” and “Tenderness and Sensitivity,” and by fathers were “Pleasure in Joint Activities,” “Security and Closeness,” and “Guidance.” Positive themes were more common than challenging themes. Finally, more mothers mentioned the themes “Love,” “Tenderness and Sensitivity,” “High Involvement and Care,” and “Difficulties” than did fathers, whereas more fathers mentioned the themes “Guidance” and “Pleasure in Joint Activities” than did mothers. The findings portray a nuanced view of the parenting experience of mothers and fathers of preschoolers with autism.
Mediating menopause: Feminism, neoliberalism, and biomedicalisation
Authors: Orgad Shani , Rottenberg Catherine
Published: July 2023

Menopause is currently a ‘hot’ topic in the UK. This article examines the Channel 4 television documentary Davina McCall: Sex, Myths and the Menopause as a key cultural text in the current UK ‘menopause moment’, demonstrating how the programme both reflects and contributes to the broader trend of menopause's growing visibility and the emerging menopause market. We begin by situating Davina within broader social, cultural and economic processes which provided a conducive context for the show's largely positive reception, and which constitute some of the key forces fuelling menopause's heightened public profile more broadly. We then move to investigate the discourses that Davina draws upon, mobilises and highlights. Our analysis shows how the programme invokes feminist terms, while discussing crucial structural conditions that underpin the continued stigma and shame around menopause. At the same time, we demonstrate that there is a striking disconnect between the structural inequalities that the documentary highlights and its consistent emphasis on individualised and privatised solutions. This disconnect, we argue, provides important insight into the dominant forces currently animating the current menopause moment in the UK. We conclude by underscoring how even the more recent critical renditions of menopause have thus far remained largely curtailed by biomedical and neoliberal logics.
Assessment of design and location of an active prechamber igniter to enable mixing-controlled combustion of ethanol in heavy-duty engines
Authors: Zeman Jared , Yan Ziming , Bunce Michael , Dempsey Adam
Published: July 2023

This numerical study focuses on assessing the key design parameters of interest for use of an active prechamber igniter as an ignition assistance device to enable mixing-controlled combustion (MCC) of ethanol (E100) in a heavy-duty Caterpillar C9.3B engine. Computational fluid dynamic (CFD) simulations of a baseline diesel and prechamber retrofitted C9.3B at a gross indicated mean effective pressure (IMEPg) of 5 bar and 1800 rpm are carried out using CONVERGE. In particular, the sizing of the prechamber volume, sizing of total orifice cross sectional area (orifice diameter), and location of the prechamber relative to a centrally mounted common rail direct injector are varied to discern the appropriate operational and design characteristics to achieve robust ignition assistance at the selected conditions. Simulation results indicate that use of an active prechamber igniter with E100 as a standalone fuel source can replicate ignition delays and thermal efficiencies similar to diesel combustion at the same engine boundary conditions, thus not requiring any changes to the engine’s air handling system. Igniter mounting location, orifice sizing, and jet targeting were found to have the strongest influence on ignition assistance with preference toward larger orifice diameters that appropriately located heating contributions in near vicinity to the direct injector.
Extended dialogues in establishing children-teacher play: The pattern of initiation–challenge–extension (ICE)
Authors: Kultti Anne
Published: July 2023

In studies of classroom discourse in early childhood education and care (ECEC), a dominance of the communicative pattern of initiation, response, follow-up (IRF) is shown, and a need of knowledge about extensive dialogue for meaning making is argued. In the present study, communication between children and teacher(s) in play is consider as a form educational discourse mediating language learning. The study, informed by a sociocultural perspective aims to contribute to the knowledge of pattern of establishing a pedagogical dialogue in play activities. What characterizes the communication establishing a joint play in which children come to participate in extensive dialogues is clarified through reanalyzing video-documented data from a project concerning play, learning and teaching in ECEC. The analysis implies a pattern of ICE: children initiating a play (I)—a teacher challenging the initiative (C)—children expanding the content (E). The function of challenging is understood as the critical contribution for opening for and expanding the children’s verbal participation. A conclusion of changing the follow-up from evaluating to expanding in a pedagogical dialogue is recommended to study further in different contexts.
Dialectical Behaviour Therapy Enhanced Habit Reversal Training: A Clinical Case of Childhood-Onset Trichotillomania in an Adult With Impulsive Personality Features
Authors: Shamsudeen Sheeba , Kannekanti Prasad
Published: July 2023

Research has recognised the psychosocial impairments linked to Trichotillomania (TTM) and established a relationship between problematic hair-pulling and affective regulation. Significant relationships between pulling triggers, their severity, and emotional dysregulation have also been predicted. The current case focused on the efficacy of combined DBT (Dialectical Behaviour Therapy) and HRT (Habit Reversal Training) in a client with TTM and Impulsive Personality features. The client received 11 weekly sessions of DBT-enhanced HRT, which took 3 months to complete. Following the end of this acute treatment phase, four maintenance sessions (two sessions per month) were delivered. The maintenance of treatment benefits was assessed using self-report measures and therapist observations at four time points: at pre-treatment, after the acute treatment phase (at the end of 3 months), and then at a 3-month and a 6-month follow-up. The intervention results suggested a substantial reduction in hair-pulling, hair regrowth in affected parts of the scalp, and self-reported improvements in mood. The study also shows preliminary evidence of DBT-enhanced HRT’s efficacy in a client with TTM and Impulsive Personality features, suggesting the importance of addressing personality structures and distressing emotional regulation that cause functional impairment during TTM treatment.
Beginning the Quilt: A Polyvocal and Diverse Collective Seeking New Forms of Knowledge Production
Authors: Ortega Yecid , Passi April Leigh , dela Cruz John Wayne N. , Nii Owoo Mama Adobea , Cale Beatrice , Sarkar Mela
Published: July 2023

This article contributes to scholarship on collaborative knowledge-making by documenting our methodological experiences of conducting multiple ethnographies and the emergence of what we describe as a methodology of quilting and vulnerability. We borrowed from critical and decolonial frameworks for knowledge production and knowledge dissemination to

reflect on the organic processes that we implemented to document our polyphonic conversations about the challenges, passions and perspectives of being educational researchers and language teachers. We argue for the use of dialogical interactions, using “quilting” as an aesthetic representation of lived experiences and as a medium through which knowledge creation becomes democratized and supported by interdisciplinary scholarship. In this article, we demonstrate the utility of a methodology of vulnerability in learning about the complexities involved with negotiating identities in collective work in the field of language education. We use the metaphor of the quilting bee to theorize vulnerability in collaborative knowledge production. The ultimate goal of this paper is to inspire educators and researchers to explore other forms of studying themselves and their relationships with their identities, cultures, and languages, especially from international contexts. In the end, as an emerging research collective, we advocate questioning and challenging whose voices are being heard and the power relations involved in collaborative and interdisciplinary research processes.
Evaluation of vascular density and structural changes in inflammatory bowel diseases
Authors: Bilgin Sinan , Tüzün Ahmet Yekta
Published: July 2023

Introduction

The two most common types of inflammatory bowel disease (IBD) are ulcerative colitis (UC) and Crohn’s disease (CD). Although these diseases mainly affect the intestinal system, they can also affect other systems, especially the vascular system. The objective of this study is to evaluate ocular microvascular and structural changes in IBD.

Methods

A total of 42 patients with IBD (22 UC and 20 CD) followed in the gastroenterology clinic and 42 healthy controls matched for gender and age were enrolled in the study. All participants underwent optical coherence tomography angiography. Macular vessel density, central retinal, and choroidal thicknesses were measured.

Results

No significant differences were observed between IBD patients and control subjects as regards superficial vascular plexus density, deep vascular plexus density, and choriocapillaris vascular density, retinal and choroidal thickness in the macular area ( p > .05). Although not statistically significant, vascular density generally increased. On the other hand, retinal and choroidal thickness were decreased.

Conclusion

It could be said that there is a reactive increase in retinal vascular density and a decrease in retinal and choroidal thickness as a result of atherosclerotic changes in IBD.
Design of girth welding system based on tungsten inert gas welding
Authors: Chen Lei , Liu Jizhong , Hu Lei
Published: July 2023

This article studies the multi-layer and multi-pass welding of the circumferential weld in the thick pipe welding of an aviation enterprise, based on the static characteristics of the welding arc, through data calculations and experiments to verify the relationship between arc voltage and arc length, proposes to use the arc voltage controller to accurately adjust the arc voltage in real time, improve the welding stability, use the welding torch wiggler to expand the welding fusion width, meet the adaptive adjustment of the wide weld, and build the main control system based on programmable logic controller (PLC) control. Integrating all subsystems and put them into the actual production of the enterprise, significantly improves the production efficiency of parts welding, reduces welding defects, and improves the quality of aviation parts.
Group Formation and the Evolution of Human Social Organization
Authors: De Dreu Carsten K. W. , Gross Jörg , Romano Angelo
Published: July 2023

Humans operate in groups that are oftentimes nested in multilayered collectives such as work units within departments and companies, neighborhoods within cities, and regions within nation states. With psychological science mostly focusing on proximate reasons for individuals to join existing groups and how existing groups function, we still poorly understand why groups form ex nihilo, how groups evolve into complex multilayered social structures, and what explains fission–fusion dynamics. Here we address group formation and the evolution of social organization at both the proximate and ultimate level of analysis. Building on models of fitness interdependence and cooperation, we propose that socioecologies can create positive interdependencies among strangers and pave the way for the formation of stable coalitions and groups through reciprocity and reputation-based partner selection. Such groups are marked by in-group bounded, parochial cooperation together with an array of social institutions for managing the commons, allowing groups to scale in size and complexity while avoiding the breakdown of cooperation. Our analysis reveals how distinct group cultures can endogenously emerge from reciprocal cooperation, shows that social identification and group commitment are likely consequences rather than causes of group cooperation, and explains when intergroup relations gravitate toward peaceful coexistence, integration, or conflict.