bluuebunny/crossref_metadata_2025 huggingface dataset:
Paediatric patients with Cushing disease and negative pituitary MRI have a higher risk of nonremission after transsphenoidal surgery
Authors: Tatsi Christina , Bompou Maria E. , Flippo Chelsi , Keil Meg , Chittiboina Prashant , Stratakis Constantine A.
Published: August 2021

Objective

Diagnostic workup of Cushing disease (CD) involves imaging evaluation of the pituitary gland, but in many patients no tumour is visualised. The aim of this study is to describe the association of magnetic resonance imaging (MRI) findings with the postoperative course of paediatric and adolescent patients with CD.

Patients

Patients with a diagnosis of CD at less than 21 years of age with MRI evaluation of the pituitary before first transsphenoidal surgery were included.

Measurements

Clinical, imaging and biochemical data were analysed.

Results

One hundred and eighty‐six patients with paediatric or adolescent‐onset CD were included in the study. Of all patients, 127 (68.3%) had MRI findings consistent with pituitary adenoma, while the remaining had negative or inconclusive MRI. Patients with negative MRI were younger in age and had lower morning cortisol and adrenocorticotropin levels. Of 181 patients with data on postoperative course, patients with negative MRI had higher odds of not achieving remission after the first surgery (odds ratio = 2.6, 95% confidence intervals [CIs] = 1.1–6.0) compared to those with positive MRI. In patients with remission after first transsphenoidal surgery, long‐term recurrence risk was not associated with the detection of a pituitary adenoma in the preoperative MRI (hazard risk = 2.1, 95% CI = 0.7–5.8).

Conclusions

Up to one‐third of paediatric and adolescent patients with CD do not have a pituitary tumour visualised in MRI. A negative MRI is associated with higher odds of nonremission after surgery; however, if remission is achieved, long‐term risk for recurrence is not associated with the preoperative MRI findings.
The role of visits and parent–child relationship quality in promoting positive outcomes for children of incarcerated parents
Authors: Kremer Kristen P. , Christensen Kirsten M. , Stump Kathryn N. , Stelter Rebecca L. , Kupersmidt Janis B. , Rhodes Jean E.
Published: August 2021

In the current study, we sought to determine the effects of parent visits on a range of psychological outcomes among children of incarcerated parents. Drawing on data from the Mentoring Children of Incarcerated Parents Enhancement Demonstration Project, a recent, large‐scale evaluation of mentoring programme practices, we hypothesized that ongoing contact would lead to an improved parent–child relationship which, in turn, would promote a range of psychosocial outcomes in children. Results of a structural equation model (n = 228) revealed a significant positive association between child's frequency of visits with their incarcerated parent and child–parent relationship quality, which in turn, was significantly associated with the child's life purpose and depression/loneliness. Findings from the current study shed light on the importance of children's visits with their incarcerated parent for later psychological outcomes.
Efficacy of personal pharmacogenomic testing as an educational tool in the pharmacy curriculum: A nonblinded, randomized controlled trial
Authors: Grace Chloe , Larriva Marti M. , Steiner Heidi E. , Marupuru Srujitha , Campbell Patrick J. , Patterson Hayley , Cropp Cheryl D. , Quinn Dorothy , Klimecki Walter , Nix David E. , Warholak Terri , Karnes Jason H.
Published: August 2021

Personal genomic educational testing (PGET) has been suggested as a strategy to improve student learning for pharmacogenomics (PGx), but no randomized studies have evaluated PGET’s educational benefit. We investigated the effect of PGET on student knowledge, comfort, and attitudes related to PGx in a nonblinded, randomized controlled trial. Consenting participants were randomized to receive PGET or no PGET (NPGET) during 4 subsequent years of a PGx course. All participants completed a pre‐survey and post‐survey designed to assess (1) PGx knowledge, (2) comfort with PGx patient education and clinical skills, and (3) attitudes toward PGx. Instructors were blinded to PGET assignment. The Wilcoxon Rank Sum test was used to compare pre‐survey and post‐survey PGx knowledge, comfort, and attitudes. No differences in baseline characteristics were observed between PGET (n = 117) and NPGET (n = 116) participants. Among all participants, significant improvement was observed in PGx knowledge (mean 57% vs. 39% correct responses; p < 0.001) with similar results for student comfort and attitudes. Change in pre/post‐PGx knowledge, comfort, and attitudes were not significantly different between PGET and NPGET groups (mean 19.5% vs. 16.7% knowledge improvement, respectively; p = 0.41). Similar results were observed for PGET participants carrying a highly actionable PGx variant versus PGET participants without an actionable variant. Significant improvement in Likert scale responses were observed in PGET versus NPGET for questions that assessed student engagement (p = 0.020) and reinforcement of course concepts (p = 0.006). Although some evidence of improved engagement and participation was observed, the results of this study suggest that PGET does not directly improve student PGx knowledge, comfort, and attitudes.
Reflections on implementing the Sendai Framework in the Asia‐Pacific: beyond adding disability inclusion to disaster risk reduction
Authors: Kusumowardoyo Chrysant L. , Tamtomo Kristian
Published: August 2021

Following the adoption of the Sendai Framework for Disaster Risk Reduction 2015–2030, an increasing number of disability‐inclusive disaster risk reduction (DiDRR) projects have been implemented by disaster risk reduction (DRR) organisations together with organisations of persons with disabilities (OPDs). Yet, as this paper argues, the general approach of DiDRR is still predominantly based on a DRR perspective. Consequently, the OPDs involved in DiDRR often include additional project components to address their broader issues while also implementing DRR. This paper draws on the experiences of two pioneer DiDRR programmes: the Community Resilience Programme in the Philippines from 2015–18; and the Putting Sendai Framework into Action programme in the Asia‐Pacific from 2017–20. It outlines the differences between the viewpoints of DRR organisations and OPDs on implementing DiDRR. In conclusion, the paper suggests that DiDRR initiatives should accommodate the broader disability issues raised by OPDs to achieve more meaningful disability inclusion in DRR.
A novel application of the Lego® Serious Play® methodology in mental health research: Understanding service users' experiences of the 0‐19 mental health model in the United Kingdom
Authors: Vusio Frane , Thompson Andrew , Birchwood Max
Published: August 2021

Aim

The 0‐19 model is an example of a service that has been retransformed in line with UK's recent policies. However, there is limited qualitative research exploring young people's experiences with the accessibility and acceptability of retransformed models through more participatory qualitative approaches. This study aimed to understand service users' experiences of accessibility and acceptability with the 0‐19 model and its service provision. In addition, we also aim to outline the process and application of the Lego® Serious Play® methodology to the context of children and young people's mental health research and reflect on the usefulness of this novel approach and its potential for further research use.

Methods

A qualitative methodology based on the Lego® Serious Play® approach was used to investigate service users' perceptions of the accessibility and acceptability of the 0‐19 model. This novel approach is viewed as a facilitator of engagement, which also stimulates critical thinking and reflective practice. All interviews were thematically analysed.

Results

Seven participants constructed 14 models and provided metaphorical narratives for them besides engaging in group discussions. Thematic analysis of the participants' models and narratives resulted in six identified themes: accessibility, doors into the unknown, let it out, overcoming obstacles, less is sometimes better and satisfaction with the 0‐19 model and its provision.

Conclusion

Participants in this study perceived the 0‐19 model as acceptable and, to a degree, accessible. Participants identified a range of barriers to accessibility, such as inconvenient locations, long waiting and inflexible working times.
Aridity and geochemical drivers of soil micronutrient and contaminant availability in European drylands
Authors: Moreno‐Jiménez Eduardo , Orgiazzi Alberto , Jones Arwyn , Saiz Hugo , Aceña‐Heras Sara , Plaza César
Published: August 2021

Dryland soils provide different societal and environmental services, such as food supply and biodiversity support. In Europe, most of the dryland areas are devoted to agriculture. In the next decades, both European and worldwide drylands are expected to suffer with increased intensity due to the expected climate change‐derived rise in aridity. Many studies have focussed on aridity‐induced changes in major nutrients in drylands, but little is known of the impact of environmental and biogeochemical factors on micronutrients with critical roles in life, and as inorganic contaminants with ecotoxicological implications. We analysed and explored drivers of total and available concentrations of micronutrients (Co, Cu, Fe, Mo, Mn, Ni and Zn) and contaminants (As, Cd and Pb) in 148 soil samples collected from European drylands covering a wide range of aridity and of other geochemical parameters. The availability of micronutrients increased with their total content, decreased with pH and was enhanced by organic C content. Aridity decreased the availability of Fe, a key element in human diet. Our findings also highlight the scarcity of this micronutrient in European drylands, as well as of some other important micronutrients like Zn and Mo in agricultural soils. Total content was the main driver of the availability of Cd and Pb, and organic matter exerted synergistic effects on contaminant release. Our data show the need for precise management practices to be incentivised by agricultural and environmental policies in order to ensure micronutrient supply and avoid contamination, thus maintaining adequate levels of agricultural productivity and simultaneously preserving dryland ecosystems.

Highlights

Drylands are important for food production in Europe and sensitive to climate change.

The occurrence of metals in European Union dry soils and the drivers influencing them were studied.

Some micronutrients (Fe, Mo and Zn) were scarce while contaminants were abundant.

SOC, pH and clays were the main drivers of element availability; aridity reduced Fe.

Agricultural practises are needed to ensure nutrient supply and prevent contamination.
Differences in the functional responses of four invasive and one native crayfish species suggest invader‐specific ecological impacts
Authors: Chucholl Franziska , Chucholl Christoph
Published: August 2021

Invasive non‐native species represent a leading threat to global freshwater biodiversity and non‐native crayfish species frequently cause extensive ecological damage. However, the extent to which their impact: (1) depends on invader identity and (2) differs from the natural state with native crayfish remains unclear. Comparison of the functional responses of invasive and native species represents a promising approach in this regard.

Here, we explored whether four invasive crayfish species (calico crayfishFaxonius immunis, spiny‐cheek crayfishFaxonius limosus, signal crayfishPacifastacus leniusculus, and marbled crayfishProcambarus virginalis) in European freshwaters and the most widespread native species (noble crayfishAstacus astacus) overlap in function in their potential effects on key resources of benthic food webs. First, the impact on gammarids and zebra mussels was assessed by means of comparative functional response analysis using the functional response ratio as impact metric; second, the consumption of macrophytes (Charasp.) and detritus (leaf litter) was quantified and compared using feeding experiments.

Both invader‐ and resource‐specific effects were observed. Invasive calico crayfish and signal crayfish exhibited the strongest per capita effects on gammarids and zebra mussels, respectively, with functional response ratios being 2‐fold higher than those of native noble crayfish. Marbled crayfish showed an intermediate effect on both prey species, whereas spiny‐cheek crayfish had lower impacts than noble crayfish. In the feeding experiment, calico crayfish consumed the highest amount of detritus, while the consumption of macrophytes did not differ among the five crayfish species.

Our work demonstrates as‐yet unrecognised differences in functional responses among the four North American crayfish invaders and the European noble crayfish. The lack of congruence across the observed impacts suggests a mostly species‐specific pattern and stresses the importance of species and resource identity when considering the ecological impact of crayfish. An initial assessment of invader‐specific potential impacts positions calico crayfish and signal crayfish among the most impactful invaders.
Forest conversion to plantations: A meta‐analysis of consequences for soil and microbial properties and functions
Authors: Wang Ying , Chen Liang , Xiang Wenhua , Ouyang Shuai , Zhang Taidong , Zhang Xiulan , Zeng Yelin , Hu Yanting , Luo Gongwen , Kuzyakov Yakov
Published: August 2021

Primary or secondary forests around the world are increasingly being converted into plantations. Soil microorganisms are critical for all biogeochemical processes in ecosystems, but the effects of forest conversion on microbial communities and their functioning remain unclear. Here, we conducted a meta‐analysis to quantify the impacts that converting forests to plantations has on soil microbial communities and functioning as well as on the associated plant and soil properties. We collected 524 paired observations from 138 studies globally. We found that conversion leads to broad range of adverse impacts on soils and microorganisms, including on soil organic carbon (−24%), total nitrogen (−29%), bacterial and fungal biomass (−36% and −42%, respectively), microbial biomass carbon (MBC, −31%) and nitrogen (−33%), and fungi to bacteria ratio (F:B, −16%). In addition, we found impacts on the ratio of MBC to soil organic C (qMBC, −20%), microbial respiration (−18%), N mineralization (−18%), and enzyme activities including β‐1,4‐glucosidase (−54%), β‐1,4‐N‐acetylglucosaminidase (−39%), and acid phosphatase (ACP; −34%). In contrast, conversion to plantations increases bacterial richness (+21%) and microbial metabolic quotient (qCO2, +21%). The effects of forest conversion were consistent across stand ages, stand types, and climate zone. Soil C and N contents as well as the C:N ratio were the main factors responsible for the changes of microbial C, F:B, and bacterial richness. The responses of qCO2, N mineralization, and ACP activity were mainly driven by the reductions in F:B, MBC, and soil C:N. Applying macro‐ecology theory on ecosystem disturbance in soil microbial ecology, we show that microbial groups shifted from K to r strategists after conversion to plantations. Our meta‐analysis underlines the adverse effects of natural forests conversion to plantations on soil microbial communities and functioning, and suggests that the preservation of soil functions should be a consideration in forest management practices.
Individual size distributions across North American streams vary with local temperature
Authors: Pomeranz Justin P. F. , Junker James R. , Wesner Jeff S.
Published: August 2021

Parameters describing the negative relationship between abundance and body size within ecological communities provide a summary of many important biological processes. While it is considered to be one of the few consistent patterns in ecology, spatiotemporal variation of this relationship across continental scale temperature gradients is unknown. Using a database of stream communities collected across North America (18–68°N latitude, −4 to 25°C mean annual air temperature) over 3 years, we constructed 160 individual size distribution (ISD) relationships (i.e. abundance size spectra). The exponent parameter describing ISD’s decreased (became steeper) with increasing mean annual temperature, with median slopes varying by ~0.2 units across the 29°C temperature gradient. In addition, total community biomass increased with increasing temperatures, contrary with theoretical predictions. Our study suggests conservation of ISD relationships in streams across broad natural environmental gradients. This supports the emerging use of size‐spectra deviations as indicators of fundamental changes to the structure and function of ecological communities.
Social network participation towards enactment of self‐care in people with chronic obstructive pulmonary disease: A qualitative meta‐ethnography
Authors: Welch Lindsay , Sadler Euan , Austin Anthony , Rogers Anne
Published: August 2021

Background

How people with chronic obstructive pulmonary disease (COPD) engage with supportive social networks to enhance self‐care is not understood. The personal rationales for participation in socially directed support have not been addressed in the literature. To determine how people with COPD identify, engage and participate in socially supportive self‐care practices, we conducted a systematic review and meta‐ethnography of qualitative studies.

Methods

A systematic literature search was conducted between June 2010 and June 2021. Of 3536 articles, 8 fulfilled the inclusion criteria. Using a meta‐ethnography approach to the qualitative synthesis, new concepts were derived from the data to identify aligning themes and develop a conceptual model.

Findings

Interpretations from the papers yielded concepts of (1) accountability and personal responsibility in self‐care, (2) valued positive relationships with clinicians, (3) understanding of illness through shared and personal experiences and (4) acknowledging social networks in fostering self‐care engagement in people with COPD. The independence‐experience (Index) model of synthesized (third order) interpretations highlighted the processes of social networks and self‐care practices: (a) fear or avoidance of dependency, (b) learning from experiences of adaptive self‐care behaviours and (c) including valued practices in self‐care. Self‐care strategies are formed through illness experiences and relatable social encounters.

Conclusion

The model derived from the third‐order interpretations is a framework to describe socially supported self‐care and can be used to direct future self‐care strategies and target interventions for people with COPD.

Patient or Public Contribution

The findings and model were presented to the long‐term conditions patient and public involvement group. The manuscript is coauthored by a public representative.
Evaluation of Japanese people's perception of risk information for making decisions to receive influenza and rubella vaccinations
Authors: Yasuhara Natsuko , Okamoto Sawako , Hamada Miki , Uehara Keita , Obana Naoya , Imamura Tomoaki
Published: August 2021

Background

Generally, vaccination uptake in Japan lags behind World Health Organization targets.

Objective

This study aimed to understand how risk information and advice affect intention to receive vaccinations.

Methods

This study had a within‐subjects design. An online survey based on the Health Belief Model was sent to 2501 Japanese individuals (≧20 years) to assess the intention to be vaccinated for influenza and rubella after receiving minor and severe risk information and hypothetical advice about each vaccine. Regression analysis was used to measure changes in intentions to receive each vaccination after being provided with (1) risk information about each vaccine and (2) hypothetical encouragement and discouragement to be vaccinated.

Main Outcomes

The main outcomes included changes in vaccination intentions from baseline.

Results

Forty‐one percent (N = 1030) of those sent the survey completed it. At baseline, 43% and 65% of the respondents intended to have influenza and rubella vaccinations, respectively. Being provided with information about severe risks and susceptibility increased the intention to have the influenza vaccination among females in their 40s. Receiving inaccurate and discouraging information from one's mother significantly decreased the intention to have the rubella vaccination. Women 50 and older were more likely to intend not to have vaccination for rubella. Severe risk information decreased rubella vaccination intention in all age groups, except women in their 30s and 40s (p < .05).

Conclusion

For both vaccinations, older individuals demonstrated vaccine hesitancy. This group requires tailored messaging to help them understand their vulnerability (to influenza) and their role in transmission (for rubella) to encourage uptake of essential vaccinations.

Patient or Public Contribution

Members of the Japanese public responded to our online questionnaire on vaccination risk.
Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety
Authors: Newman Bronwyn , Joseph Kathryn , Chauhan Ashfaq , Seale Holly , Li Jiadai , Manias Elizabeth , Walton Merrilyn , Mears Stephen , Jones Benjamin , Harrison Reema
Published: August 2021

Background

Patients are increasingly being asked for feedback about their healthcare and treatment, including safety, despite little evidence to support this trend. This review identifies the strategies used to engage patients in safety during direct care, explores who is engaged and determines the mechanisms that impact effectiveness.

Methods

A systematic review was performed of seven databases (CINAHL, Cochrane, Cochrane‐Central, Embase, ISI Web of Science, Medline, PsycINFO) that included research published between 2010 and 2020 focused on patient engagement interventions to increase safety during direct care and reported using PRISMA. All research designs were eligible; two reviewers applied criteria independently to determine eligibility and quality. A narrative review and realist synthesis were conducted.

Results

Twenty‐six papers reporting on twenty‐seven patient engagement strategies were included and classified as consultation (9), involvement (7) and partnership (11). The definitions of ‘patient engagement’ varied, and we found limited details about participant characteristics or interactions between people utilizing strategies. Collaborative strategy development, a user‐friendly design, proactive messaging and agency sponsorship were identified as mechanisms to improve engagement about safety at the point of direct care.

Conclusions

Agency sponsorship of collaboration between staff and patients is essential in the development and implementation of strategies to keep patients safe during direct care. Insufficient details about participant characteristics and patient–provider interactions limit recommendations for practice change. More needs to be learned about how patients are engaged in discussions about safety, particularly minority groups unable to engage with standard information.

Patient or Public Contribution

Review progress was reported to the CanEngage team, including the consumer steering group, to inform project priorities (PROSPERO CRD42020196453).
Epstein–Barr virus reactivation influences clonal evolution in human herpesvirus‐8‐related lymphoproliferative disorders
Authors: Granai Massimo , Facchetti Mattia , Mancini Virginia , Goedhals Jacqueline , Sherriff Alicia , Mundo Lucia , Bellan Cristiana , Amato Teresa , Sorrentino Ester , Ungari Marco , Raphael Martine , Leoncini Lorenzo , Facchetti Fabio , Lazzi Stefano
Published: August 2021

Background

Human herpesvirus‐8 (HHV8) is a lymphotropic virus associated with different lymphoproliferative disorders, including primary effusion lymphoma (PEL), multicentric Castleman’s disease (MCD), diffuse large B‐cell lymphomas, not otherwise specified, and the rare entity known as germinotropic lymphoproliferative disorder (GLPD). In PELs and GLPD the neoplastic cells also contain Epstein–Barr virus (EBV). In addition, occasional cases with atypical and overlapping features among these entities have been recognised, suggesting that the spectrum of the HHV8‐related lesions may not be fully characterised.

Aims

Here, we report two cases of lymphoproliferative disorder associated with HHV8 and EBV that further expand the spectrum of HHV8/EBV‐positive lymphoproliferative disease.

Methods and results

Case 1 represented HHV8/EBV‐positive extracavitary nodal PEL followed by pleural PEL. The striking characteristic of this case was the almost focal and intrasinusoidal localisation of the neoplastic cells and the association with Castleman’s disease features. In the second case, we found the entire spectrum of HHV8‐related disorders, i.e. MCD, GLPD, and PEL, coexisting in the same lymph node, underlining the variability, possible overlap and evolution among these entities. Both cases were well analysed with immunohistochemistry, determination of the EBV latency programme, and molecular analysis for clonality of immnoglobulin genes. In both patients, the disease followed an unexpected indolent course, both being still alive after 8 and 12 months, respectively.

Conclusion

Our findings represent further evidence of the overlap among HHV8/EBV‐positive lymphoproliferative disorders, and underline a grey zone that requires further study; they further confirm the experimental evidence that lytic EBV replication influences HHV8‐related tumorigenesis.
Chems4EU: chemsex use and its impacts across four European countries in HIV‐positive men who have sex with men attending HIV services
Authors: Whitlock Gary G. , Protopapas Konstantinos , Bernardino Jose I. , Imaz Arkaitz , Curran Adrian , Stingone Christof , Shivasankar Sivapatham , Edwards Sarah , Herbert Sophie , Thomas Konstantinos , Mican Rafael , Prieto Paula , Nestor Garcia Jorge , Andreoni Massimo , Hill Samantha , Okhai Hajra , Stuart David , Bourne Adam , Conway Katie
Published: August 2021

Introduction

Chemsex in a European context is the use of any of the following drugs to facilitate sex: crystal methamphetamine, mephedrone and gamma‐hydroxybutyrate (GHB)/gamma‐butyrolactone (GBL) and, to a lesser extent, cocaine and ketamine. This study describes the prevalence of self‐reported recreational drug use and chemsex in HIV‐positive men who have sex with men (MSM) accessing HIV services in four countries. It also examines the problematic impacts and harms of chemsex and access to chemsex‐related services.

Methods

This is a cross‐sectional multi‐centre questionnaire study of HIV‐positive MSM accessing nine HIV services in the UK, Spain, Greece and Italy.

Results

In all, 1589 HIV‐positive MSM attending HIV services in four countries completed the questionnaire. The median age of participants was 38 years (interquartile range: 32–46 years) and 1525 (96.0%) were taking antiretroviral therapy (ART). In the previous 12 months, 709 (44.6%) had used recreational drugs, 382 (24.0%) reported chemsex and 104 (6.5%) reported injection of chemsex‐associated drugs (‘slamsex’). Of the 382 engaging in chemsex, 155 (40.6%) reported unwanted side effects as a result of chemsex and 81 (21.2%) as a result of withdrawal from chemsex. The reported negative impacts from chemsex were on work (25.1%, 96), friends/family (24.3%, 93) and relationships (28.3%, 108). Fifty‐seven (14.9%) accessed chemsex‐related services in the past year, 38 of whom (67%) felt the service met their needs.

Discussion

A quarter of participants self‐reported chemsex in the past 12 months. There were high rates of harms from chemsex across all countries, including negative impacts on work, friends/family and relationships. Although a minority of those engaging in chemsex accessed support, most found this useful.
Study on the effect of text direction and temporal focus on advertising persuasiveness
Authors: Xi Yue , Wang Yudie , Jiang Yushi , Wang Yedi
Published: August 2021

Global brands are benefiting from the rapidly growing demand in China. Text displayed both vertically and horizontally is common in Chinese advertisements. The skillful use of text direction can effectively improve advertising persuasiveness. Using two studies, we find that the descriptions of an advertisement that are displayed vertically (vs. horizontally) result in enhanced advertising persuasiveness among consumers who focus on the past. In contrast, the reverse holds for consumers who focus on the future. Furthermore, the results show that consumers' sense of “feeling right” mediates the interaction effect. In addition, we demonstrate how product category plays a vital role in the three‐way interaction effects between product category, temporal focus, and text direction on “feeling right.” Compared with utilitarian products, vertical descriptions of hedonic products enhance consumers' sense of “feeling right” when they are in the past‐focus condition. Our findings enrich advertising theory and practice. Meanwhile, we also elucidate the effects of text direction on Chinese advertising.
Population‐based assessment of risks for severe COVID‐19 disease outcomes
Authors: Zerbo Ousseny , Lewis Ned , Fireman Bruce , Goddard Kristin , Skarbinski Jacek , Sejvar James J. , Azziz‐Baumgartner Eduardo , Klein Nicola P.
Published: August 2021

Among approximately 4.6 million members of Kaiser Permanente Northern California, we examined associations of severe COVID‐19 with demographic factors and comorbidities. As of July 23, 2021, 16 182 had been hospitalized, 2416 admitted to an ICU, and 1525 died due to COVID‐19. Age was strongly associated with hospitalization, ICU admission, and death. Black persons and Hispanic ethnicity had higher risk of death compared with Whites. Among the comorbidities examined, Alzheimer's disease was associated with the highest risk for hospitalization (aHR 3.19, CI: 2.88–3.52) and death (aHR 4.04, CI: 3.32–4.91). Parkinson's disease had the second highest risk of death (aHR = 2.07, CI: 1.50–2.87).
Simulating the macroeconomic impact of expansion in total government expenditure on the economy of Nigeria
Authors: Gbaka Solomon , Iorember Paul Terhemba , Abachi Philip Terhemen , Obute Christopher Obilikwu
Published: August 2021

This study examines the impact of further expansion in government spending in Nigeria for the period of 1970–2016. Using a simulation analysis, the model divides the economy into five blocks which corresponds with five key sectors: government, price, supply, external, and monetary/financial sectors of the economy. The simulation scenario involves the average annual increase in total government expenditure, based on the projections of the Economic Recovery and Growth Plan (ERGP) of the Federal Government of Nigeria. The results reveal positive and negative shocks across the sectors. Specifically, the results indicate that the policy fuels the growth of non‐oil output/export and real gross domestic product, suggesting the sensitivity of output to government expenditure. It further reveals a generally positive reaction from the monetary/financial sector variables, worsens inflationary pressure and exchange rate volatility crisis, while the manufacturing sector output also witnesses a significant fall. This study concludes that fiscal expansion in the form of public expenditure would yield a positive impact on the various sectors of the Nigerian economy, and that it would particularly serve as a veritable tool for achieving the diversification drive of the government. Overall, the study confirms the relative efficacy of fiscal policy in Nigeria. The study recommends sustained increase in government expenditure vis‐a‐vis fiscal discipline via the institutionalised regulatory framework. The economy should also be consciously diversified from oil to a non‐oil‐based economy.
Tourism‐induced pollutant emissions in Mediterranean countries: Evidence from panel causality analysis
Authors: Ozcan Ceyhun Can , Bekun Festus Victor , Nazlioglu Saban
Published: August 2021

There are ample studies that document the tourism‐led growth for single countries and/or a specific region. The nexus on international tourist arrival‐induced pollutant emissions and energy consumption has been ongoing in the related literature. This is pertinent, given its inherent implications for environmental sustainability. This study explores the growth impact of international tourist arrivals on quality of the environment in terms of a causality relationship for 16 selected Mediterranean countries by a multivariate framework; this is based on tourism‐led growth and the tourism‐induced pollutant emissions model for annual data from 1995 to 2014. Our model, therefore, explores the dynamic causal links between tourism, growth, energy, and the environment. We employ the panel causality technique (Emirmahmutoglu and Kose 2011) that allows for heterogeneity and correlations across cross‐sections. The data shows correlation among international tourism, economic growth, energy consumption, and pollutant emission. The findings from the causality analysis support the evidence on tourism‐induced pollutant emissions and energy consumption as well as the validity of the tourism‐led growth hypothesis. The findings also suggest that international tourism is a catalyst for energy consumption and economic growth, which translates into pollutant emissions, implying insightful policy prescriptions.
The residue of theocracy in contemporary democracies: A comparative study
Authors: Zafirovski Milan
Published: August 2021

The article re‐examines residues of theocracy in contemporary western and related democracies such as OECD countries. It outlines a model of theocracy composed of four elements. These elements are, first, extreme religiosity and religious fanaticism and closure; second, suppression of knowledge and scientific progress and perpetuation of anti‐science, irrationalism; third, a state‐favoured Church as the agent of political power, coercion, repression, war; and fourth, accumulation and redistribution of economic resources to support religion. The model is represented in the format of the functionalist AGIL scheme. Considering evidence, the model of theocracy is found to fit reasonably well for certain, primarily highly religious and conservative, countries. Conversely, it does not fit many other countries, especially less religious and more liberal societies. The article aims to contribute to a better understanding of the relationship between religion and politics in contemporary societies, and outlines directions for further research.
Strategies to manage cognitive dissonance when experiencing resistiveness to care in people living with dementia: A qualitative study
Authors: Mortensen Anne Helene , Stojiljkovic Marko , Lillekroken Daniela
Published: August 2021

Aims

To explore the experiences of healthcare personnel when they face resistiveness to care in people living with dementia in nursing homes.

Design

The study has a qualitative explorative design.

Methods

Three focus group interviews were conducted in June 2019. A total of 16 nurses and other healthcare personnel employed in three different nursing homes participated. A semi‐structured interview guide was used during the focus group interviews. Data were transcribed verbatim and analysed using an inductive qualitative content analysis.

Results

The analysis generated one overarching category—‘Tension when facing resistiveness to care’, which describes the discomfort healthcare personnel experienced when confronted with resistiveness to care in people with dementia—and two other categories: ‘Attitude change’ and ‘Changing behaviour’, which describes their strategies to reduce and/or manage the discomfort. Four subcategories—‘Changing the mindset’, Conceptual shift’, Stepping back’ and ‘Not giving up’—described the actions taken by healthcare personnel to manage or reduce their cognitive dissonance.

Conclusion

The strategies used to manage or reduce cognitive dissonance provide a new understanding of how healthcare personnel choose to approach resistiveness to care in people living with dementia.

Impact

This study addresses cognitive dissonance, a discomfort experienced by healthcare personnel when facing resistiveness to care from people living with dementia. To reduce their dissonance, the participants employed several strategies, including coercive measures, when providing care. The theory of cognitive dissonance may help explain why healthcare personnel sometimes choose to employ coercive measures while providing care.
Understanding embodied immersion in technology‐enabled embodied learning environments
Authors: Xu Xinhao , Kang Jina , Yan Lili
Published: August 2021

Objective

The aim of this current paper is to investigate the salient embodiment features in the empirical studies on technology‐enabled embodied learning environments (TEELEs), and to contribute a comprehensive conceptual framework to direct the understanding and the designing of TEELEs – to embody and how to embody.

Method

In this thematic paper, we carefully selected and reviewed 28 empirical studies (peer‐reviewed journal articles published in the recent decade between 2010 and 2020) on TEELEs, and analyzed their salient features concerning embodiment.

Results and Implications

Synthesizing the characteristics distilled from the selected studies, we propose the conceptual framework of embodied immersion, which consists of three major dimensions, namely, physical, sensory, and cognitive immersions. Eight factors – means of embodiment, amount of motoric movements, point of view, media effects, haptic effects, operational congruency, learning congruency, and personalization – contribute to these three dimensions, and are carefully articulated, discussed, and explicated. The discussions around the embodied immersion framework are rooted in the concepts of presence, immersion, and agency. We regard our framework as a trinity borrowing the ingredients from each of those three that will guide through the understanding and the designing of TEELEs.
Enhancing learning engagement during COVID‐19 pandemic: Self‐efficacy in time management, technology use, and online learning environments
Authors: Heo Heeok , Bonk Curtis J. , Doo Min Young
Published: August 2021

Background

Due to the global COVID‐19 pandemic, online learning became the only way to learn during this unprecedented crisis. This study began with a simple but vital question: What factors influenced the success of online learning during the COVID‐19 pandemic with a focus on online learning self‐efficacy?

Objectives

The purpose of this study was to examine the structural relationship among self‐efficacy (SE) in time management, SE in technology use, SE in an online learning environment, and learning engagement.

Methods

The participants of the study were 1205 undergraduates who were enrolled in a residential undergraduate program in South Korea in spring semester, 2020. The online survey was administered to collect data for this research and the survey results were analyzed using structural equation modeling.

Results and Conclusions

SE in technology use had a significant but negative influence on learning engagement and had a positive impact on SE in an online learning environment. SE in time management had a significant positive impact on SE in an online learning environment and learning engagement. SE in an online learning environment also significantly influenced learning engagement.

Implications

SE in technology use itself did not enhance learning engagement. In addition, indirect effects of SE in technology use and SE in time management on learning engagement through SE in an online learning environment were confirmed in this study. This indicates the influential role of SE in an online learning environment on learning engagement of online learners.
Autistic spectrum traits detection and early screening: A machine learning based eye movement study
Authors: Lin Yiqi , Gu Yating , Xu Yekai , Hou Shumeng , Ding Ruyi , Ni Shiguang
Published: August 2021

Problem

Autism spectrum disorders (ASD) are pervasive neurodevelopmental disorders and generally accompanied by social disorders, verbal or nonverbal communication defects, inability to concentrate and other negative symptoms that affect the autistic person's normal life. However, traditional screening methods are time‐consuming and public health resources are limited.

Methods

This study proposed a novel technique that combined eye‐movement data and machine learning algorithms for predicting autistic traits. We converted raw eye movement data into features, trained and tested a model for early screening.

Findings

In the preliminary experiment, 107 participants (average age = 24.84 ± 5.24 years) wore HTC Vive to watch a VR scene for 15–20 s. We explored eight classification models, among which the ensemble model performed best, with 0.73 accuracy, 0.68 precision, 0.81 recall, 0.74 F1‐score, and an area under the curve of 0.90. And in the test experiment, 22 participants (average age = 12.68 ± 7.61 years) diagnosed as ASD took the experiment and the ensemble model showed a recall of 0.77. Eye movement data is an effectively distinguishable tool and we find that the proportion of time to observe figure and animal region continuously can distinguish participants with obvious and unobvious autistic traits effectively in the model.

Conclusion

This study focuses on the detection of autistic traits, and proposes a more objective and faster method for undertaking early screening, which provides possibilities to save precious time to intervene and alleviate its symptoms before making a definite diagnosis.
Heat transfer modeling of shrimp in tunnel type individual quick freezing system
Authors: Narsaiah Kairam , Bedi Vansh , Ghodki Bhupendra M , Goswami Tridib Kumar
Published: August 2021

Cryogenic freezers are commonly used for quick freezing of high‐value food products at a lower temperature. These freezers offer improved overall product quality and reduced dehydration and drip losses. An accurate prediction of heat transfer during the food freezing process is useful in deciding proper production, design, handling procedure, and amount of cryogen required. In this study, computational fluid dynamics (CFD) was used for numerical modeling of heat transfer phenomena in a freezing system during individual quick freezing (IQF) of shrimp. The residence time of shrimp in the developed IQF tunnel freezer was determined using modified Plank's equation and verified by experimentations. Modeling was done in two zones of the freezer: (i) Precooling zone containing cold liquid nitrogen (LN2) vapors that were utilized for precooling of incoming shrimp and (ii) freezing zone where LN2 was sprayed on shrimp before exiting freezer. Simulations of heat transfer in shrimp were performed using the Ansys CFD software at seven different locations of the IQF tunnel freezer. Results revealed that the core temperature of shrimp decreased from 304.5 K to 263 K as it passes through the freezer. In general, as compared to other segments of shrimp, core temperature of shrimp was the highest while the top portion was minimal. Dynamics of velocity distribution, thermal profile, and spray modeling results of cryogen in the freezer supported simulation model of shrimp. Overall, numerical modeling results are consistent (≤5% variation) with experimental values.

Practical Applications

The cryogenic freezer is widely preferred to obtain a superior quality of frozen food products owing to minimal defects (cracking and break down), drip loss, and freezing time compared to traditional mechanical freezers. The inefficient utilization of cryogen and handling issues results in a higher cost of food products frozen with IQF technology. Thus, an insight into heat transfer phenomena in cryogenic freezers may lead to improvement in the design, efficient utilization of cryogen, reduction of freezing time, and improvement in overall product quality. In conclusion, these would aid in reducing the cost of the technology.
Packaging environmental impact on seafood supply chains: A review of life cycle assessment studies
Authors: Almeida Cheila , Loubet Philippe , da Costa Tamíris Pacheco , Quinteiro Paula , Laso Jara , Baptista de Sousa David , Cooney Ronan , Mellett Sinead , Sonnemann Guido , Rodríguez Carlos José , Rowan Neil , Clifford Eoghan , Ruiz‐Salmón Israel , Margallo María , Aldaco Rubén , Nunes Maria Leonor , Dias Ana Cláudia , Marques António
Published: August 2021

Packaging is fundamental for food preservation and transportation but generates an environmental burden from its production and end‐of‐life management. This review evaluates packaging contribution to the environmental performance of seafood products. Life cycle assessment (LCA) studies were evaluated by both qualitative and quantitative analysis. The qualitative analysis assessed how direct (e.g., packaging material) and indirect impacts (e.g., influence on seafood loss and waste) have been considered, while the quantitative analysis evaluated packaging contribution to products’ weight and climate change impact. Qualitative analysis revealed that seafood LCAs focus mainly on direct environmental impacts arising from packaging materials, for which some articles conducted sensitivity analysis to assess materials substitution. Recycling was found to be the most common recommendation to diminish direct potential environmental impacts arising from packaging end‐of‐life. However, standardized recovery rates and other end‐of‐life options (e.g., reuse), should be considered. Quantitative analysis revealed that cans' production contributes significantly to the overall climate change impact for canned products. On average, it contributes to 42% of a product's climate change impact and 27% of a product's weight. Packaging has a lower contribution when considering freezing, chilling, and other post‐harvesting processing. It represents on average less than 5% of a product's climate change impact (less than 1 kg CO2 eq/kg) and 6% of a product's weight. Packaging material production is more relevant to aluminum, tinplate, and glass than for plastic and paper. Therefore, it is essential to accurately include these materials and their associated processes in inventories to improve the environmental assessment of seafood products.