bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of low-dose exposure of aluminium oxide nanoparticles in Swiss albino mice: Histopathological changes and oxidative damage
Authors: De Arpita , Ghosh Swarupa , Chakrabarti Manoswini , Ghosh Ilika , Banerjee Ritesh , Mukherjee Anita
Published: August 2020

Rapid growth in the use of aluminium oxide nanoparticles (Al2O3 NPs) in various fields such as medicine, pharmacy, cosmetic industries, and engineering creates concerns since the literature is replete with data regarding their toxicity in living organisms. The objective of the present study was to demonstrate the potential toxicological manifestations of repeated exposure to Al2O3 NP at low doses in vivo. In the present study, Al2O3 NP was orally administered at 15, 30 or 60 mg kg−1 body weight for 5 days to Swiss albino male mice. A battery of well-defined assays was undertaken to evaluate aluminium (Al) bioaccumulation, haematological and histological changes, oxidative damage and genotoxicity. Physico-chemical characterisation demonstrated increases in hydrodynamic diameter along the concentration gradient of Al2O3 NP dispersed in MilliQ water. Brain, liver, spleen, kidney and testes showed high Al retention levels. Histopathological lesions were prominent in the brain and liver. Al2O3 NP treatment increased levels of lipid peroxidation and decreased glutathione content in the test organs at all dose levels. The enzyme activities of catalase and superoxide dismutase were also significantly altered. DNA damage quantified using the comet assay was markedly increased in all the soft organs studied. Anatomical abnormalities, redox imbalance and DNA damage were positively correlated with Al retention in the respective organs. Size, zeta potential and colloidal state might have contributed to the bio-physico-chemical interactions of the NPs in vivo and were responsible for the non-linear dose response. The overall data indicate that Al2O3 NP exposure may result in adverse health consequences, inclusive of but not limited to disturbed redox homeostasis, hepatocellular toxicity, neurodegeneration and DNA damage.
Institutional Ethnography and the Materiality of Affect: Affective Circuits as Indicators of Other Possibilities
Authors: Talbot Debra
Published: August 2020

Many studies have utilized institutional ethnography (IE) to reveal the social relations that govern how things are put together at the frontline of work, particularly in the public sector and education. The focus has generally been on restrictive practices associated with accountability regimes of new public management. Less analytic attention has been paid, however, to discovering ways in which workers are finding how it can be otherwise. Revisiting the data from a longitudinal study, originally conducted as an IE, provided an opportunity to trace the influence of affect in relation to teachers’ practices. Grounded in empirical data, this article makes a case for the methodological innovation of tracing the work done by affect, as part of an IE, in order to reveal possibilities for resistance.
AD-Related CSF Biomarkers Across Distinct Levels of Cognitive Impairment: Correlations With Global Cognitive State
Authors: Ibarra Romel , Radanovic Marcia , Pais Marcos V. , Talib Leda L. , Forlenza Orestes V.
Published: August 2020

Aim:

Associations between cerebrospinal fluid (CSF) biomarkers of Alzheimer’s disease (AD) with the severity of cognitive impairment are unclear. We examined the correlations between CSF biomarkers and cognitive performance in the AD continuum.

Methods:

We studied 143 elderly patients: cognitively unimpaired (n = 51), mild cognitive impairment (MCI) amnestic (n = 55) and nonamnestic (n = 20), and mild AD (n = 17) assessed with the Cambridge Cognitive Test (CAMCOG). We correlated total CAMCOG and its subdomains with CSF Aβ42, T-tau, p-tau levels, and Aβ42/p-tau.

Results:

In the total sample, T-tau and Aβ42/p-tau correlated with the total CAMCOG ( P < .01); all biomarkers correlated with memory ( P < .001); T-tau correlated with language ( P < .01).

Conclusion:

Memory and T-tau levels may be the most suitable parameters to reflect cognitive/CSF biomarker correlations. At present, such correlations are of little use in routine clinical practice.
Surface-treated short sisal fibers and halloysite nanotubes for synergistically enhanced performance of polypropylene hybrid composites
Authors: Krishnaiah Prakash , Manickam Sivakumar , Ratnam Chantara Thevy , Raghu MS , Parashuram L , Prashantha K , Jeon Byong-Hun
Published: August 2020

Polypropylene (PP) composites were prepared by reinforcing with suitable hybrid fillers such as short sisal fibers treated with an alkali and high-intensity ultrasound (HIU) and halloysite nanotubes (HNTs) modified with 3-aminopropyltriethoxysilane. The synergistic effect of surface-treated short sisal fibers and silane-grafted HNTs were systematically evaluated through morphological, mechanical, dynamic mechanical, and thermal characterization. Alkali and HIU treatments of short sisal fibers drastically enhanced the interaction between sisal fibers and silane-grafted HNTs, which improved the interfacial adhesion between the filler system and the PP matrix. Scanning electron microscopic images indicated the continuity and smoothness of the hybrid composite surfaces. Dynamic mechanical analysis confirmed improved interactions between the hybrid filler system and the matrix, leading to significantly enhanced storage modulus in the hybrid composites. Therefore, the interfacial adhesion between the fillers and the matrix plays a significant role in improving the mechanical, dynamic mechanical, and thermal properties of polymer composites.
High-performance polyacrylonitrile-based pre-oxidized fibers fabricated through strategy with chemical pretreatment, layer-by-layer assembly, and stabilization techniques
Authors: Sun Xiaolu , Li Songqi , Du Mingyue , Huang Fenglin , Zhang Weidong , Wei Qufu , Cai Yibing
Published: August 2020

Novel high-performance polyacrylonitrile (PAN)-based pre-oxidized fibers (i.e. OPFHA-MEA-L) with improved thermal stability and flame-retardant and mechanical properties were designed and made from the pristine PAN fibers through chemical pretreatment with hydroxylamine hydrochloride (HA) and monoethanolamine (MEA) aqueous solutions, then coated with chitosan (CS) and sodium tripolyphosphate (STPP) via layer-by-layer (LbL) assembly, and finally followed by stabilization in the air. The morphological structure, flammability, and thermal and mechanical properties of fabricated OPFs were systemically investigated. The results indicated that the PAN fibers after chemical pretreatment with HA and MEA had a large amount of hydrophilic groups. It would facilitate the increase of pre-oxidation degree for PAN fibers during stabilization and the deposition of positively and negatively charged CS-STPP flame-retardant coating. The fabricated OPFs (i.e. OPFHA-MEA-10) demonstrated superior comprehensive properties with charred residue of about 68.2%, breaking strength of about 295.1 N, breaking elongation of 12.6%, and limiting oxygen index value of about 41.5%, respectively, contributing to the improved thermal stability and flame-retardant and mechanical properties. It is envisioned that this innovative type of high-performance OPFs could be utilized for potential applications as flame retardant and in high temperature filtration.
Flow analysis on the ventral gap of a paper airplane
Authors: Chang Min , Feng Xiaoyu , Zhang Yang , Zhang Xu , Bai Junqiang
Published: August 2020

It is a challenging work to design micro aerial vehicle with great aerodynamic performance because the tiny wingspan at low-Reynolds-number cannot provide lift efficiently. The aerodynamic configuration of a classic delta-wing paper airplane is investigated in the present work with numerical method to discover its potential for micro aerial vehicle designs. Furthermore, the effect of the ventral gap on the aerodynamic characteristics of the paper airplane is investigated herein. The stall angles of attack reach 37.5° and 40°, respectively, for ventral opened configuration and the closed one, and the maximum lift coefficient reaches 1.49 and 1.46. The ventral-opened configuration has negative pitching moment coefficient (−0.01431) even at 37.5° while the closed one has a positive coefficient (0.01402). The reason may be the gap leads to a strong back-flow vortex before the trailing edge in the ventral gap which produces a strong nose-down moment. Generally, the ventral gap improves lift and dramatically influences the longitudinal stability compared with the one without it.
Deformation and damage evolution of a full-scale adhesive joint between a steel bracket and a sandwich panel for naval application
Authors: Jaiswal Pankaj R , Kumar R Iyer , Saeedifar M , Saleh MN , Luyckx Geert , De Waele W
Published: August 2020

The increasing interest for the application of adhesive joints in naval superstructures motivates researchers to gain an in-depth understanding of the mechanical behaviour and failure mechanisms of these joints. This work reports on an experimental study of the deformation behaviour and damage evolution of a full-scale multi-material joint using different instrumentation techniques. Adhesively bonded joints of steel to sandwich panel components have been subjected to quasi-static tensile tests during which the global deformation of the joint and local strain distributions were monitored using digital image correlation (DIC). During one particular tensile test, fibre optic Bragg sensors (FBG) were also applied to the specimen’s surface at different locations in order to quantify the evolution of local strains. Additionally, acoustic emission (AE) sensors were installed in order to monitor damage initiation and evolution with increasing levels of imposed deformation. This test showcased adhesive failure at the interface of the steel adherend and the adhesive, while cohesive failure was observed within the adhesive and skin failure at the interface between adhesive and the composite skin of the sandwich panel. The post-mortem observed failures modes were compared to the acoustic events that originated during the test due to damage initiation and propagation within the joint. The evolution of the different sensor signals, i.e. the damage expressed as cumulative AE energy and local strains measured with Bragg sensors and DIC, are mutually compared and acceptable correlation is found.
Stress intensification factor, sustained stress index and flexibility factor analysis of large D/T elbows
Authors: Jaćimović Nikola , Ivančić Zdravko , Stamenić Mirjana , Ivošević Miloš
Published: August 2020

Paper presents new equations for calculation of stress intensification factors, sustained stress indices and flexibility factors for large diameter-to-thickness ratio elbows (i.e.,[Formula: see text]). The proposed equations overcome the need for pipe stress engineers to use numerical analyses in order to evaluate the piping which falls outside of the scope of typically used piping design codes. Regression analysis of the newly proposed equations is based on an extensive numerical database developed specifically for purposes of this paper, alongside with the data (both numerical and empirical) found in the open literature. Proposed equations prove to be a better fit to the database than the existing equations and have been shown to be applicable not only for large pipes, but also for normal piping (having[Formula: see text]) typically found in industrial plants. In case of the adoption of the proposed procedure, it is implied that the proposed equations should be applied to all the bends within a piping system subject to the analysis and not only to the selected bends.
Dynamic response of a high-speed train under a type of gust with different durations
Authors: Sun Zhuang , Dai Huanyun , Gan Feng , Zhang Tingting , Gao Hao , Cui Litong
Published: August 2020

In order to study the effect of different gust durations on the safety of a high-speed train passing by a wind-break breach at a speed of 120 km/h, the root locus method is used to analyze the suspension modes of the train under different speeds. The original gust is obtained based on the Unsteady Reynolds-averaged Navier-Stokes (URANS) model when the train passes by a 12 m breach between two windbreaks with a normal crosswind speed of 32 m/s. A group of scaling factors for stretching and compressing the time windows is applied to change the gust duration without changing the amplitude. The results show that when the gust duration is close to the natural period of the suspension system, the train responses and derailment coefficient of the train can be amplified. As the attack angles of the first and second wheelset are still in the clockwise direction when overlooking the wheelset, the first wheelset is more vulnerable than the second wheelset. When the gust duration is longer than the natural period of lower sway, the initial fluctuation of the train response can be relieved.
Differences in the effects of China’s new energy vehicle industry policies on market growth from the perspective of policy mix
Authors: Xiong Yongqing , Qin Shufeng
Published: August 2020

Regarding the characteristics of policy mix and its effectiveness, no complete consensus currently exists. This paper divides the new energy vehicle (NEV) industry policies issued by the Chinese government from 2009 to 2018 into two types: the supply-side and demand-side policy mix. From the three dimensions of comprehensiveness, consistency and balance, we applied the state space method to construct a time-varying parameter model and analyzed the differences in the overall and dynamic impact of the NEV policy mix characteristics on market growth. The results show that the three characteristics differ in their overall impact: comprehensiveness has the largest impact, followed by consistency, and balance has the smallest impact. The dynamic impact of the comprehensiveness and consistency characteristics of the two types of policy mix fluctuates greatly and presents clear differences in the stage effect. The dynamic impact of the balance characteristic is relatively stable, but this characteristic has little dynamic impact on market growth. The NEV industry policy design should fully consider the characteristics of the policy mix and the differences of this policy mix in terms of market development stage and region.
The Manichean division in children’s experience: Developmental psychology in an anti-Black world
Authors: Adams-Wiggins Karlyn R. , Taylor-García Daphne V.
Published: August 2020

Recent research in developmental psychology situates human development in ecological systems. While culturally sensitive variants of ecological systems theory take important strides in identifying how racialization structures the world in which youth develop, limits remain for critical researchers interested in humanity transformation projects. A fundamental error is being made when modern/colonial capitalist Man remains the unquestioned representative of the human. Accordingly, we discuss the case of anti-Blackness in the ecology of Black youth’s development and its origins with the natural slave, arguing that the child–adult trajectory is distorted for Black youth. We argue that anti-Blackness is inextricably tied to capitalism’s historical development and that developmental psychologists concerned with humanization can adopt a decolonial attitude in service of that goal. For developmental psychologists concerned with humanity transformation, we propose a step back from the dominant approach in developmental psychology to better afford an actional stance.
Arbutin prevents alterations in mitochondrial and lysosomal enzymes in isoproterenol-induced myocardial infarction: An in vivo study
Authors: Sivasangari S , Asaikumar L , Vennila L
Published: August 2020

The present study demonstrated the protective effects of arbutin (ARB) on hyperlipidemia, mitochondrial, and lysosomal membrane damage and on the DNA damage in rats with isoproterenol (ISO)-induced myocardial infarction (MI). Rats were pretreated with ARB (25 and 50 mg/kg body weight (bw)) for 21 days. After pretreatment with ARB, MI was induced by subcutaneous injection of ISO (60 mg/kg bw) for two consecutive days at an interval of 24 h. The levels of TC, TG, and FFA were increased and decreased the level of PL in the heart tissue of ISO-induced MI rats. Very-low-density lipoprotein cholesterol and low-density lipoprotein cholesterol were increased while high-density lipoprotein cholesterol was decreased in the plasma of ISO-administered rats. A heart mitochondrial fraction of the ISO rats showed a significant decrease in the activities of mitochondrial enzymes isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, succinate dehydrogenase, and malate dehydrogenase. The activities of lysosomal enzymes (β-glucosidase, β-glucuronidase, α-galactosidase, β-galactosidase, cathepsin-B, and cathepsin-D) were increased significantly in the heart tissue homogenate of disease control rats. In ISO-induced MI, rat’s significant increase in the percentage of tail DNA and tail length, and a decrease in the level of head DNA were also observed. ARB administration to MI rats brought all these parameters to near normality, showing the protective effect of ARB against MI in rats. The results of this study demonstrated that the 50 mg/kg bw of ARB shows higher protection than 25 mg/kg bw against ISO-induced damage.
Identification of geographical origin of TPFD based on handheld NIR spectroscopy and PLSDA
Authors: Sedjoah Rita-Cindy Aye-Ayire , Han Bangxing , Yan Hui
Published: August 2020

The present study is focused on the identification of geographical origin (Zhejiang, Yunnan and Anhui, China) of Dendrobium officinale’s dried stem called Tiepi fengdou by mean of the handheld near-infrared spectrometer. Raw data were preprocessed to reduce unwanted spectral variations by the first-order derivative followed by standard normal variate transformation, and partial least squares discriminant analysis model was developed for calibration. The results showed that more than 90% of the origins were identified. Therefore, it is possible to classify the geographical origin of Tiepi fengdou by the use of the handheld near-infrared spectrometer for effective quality control.
A variance shrinkage method improves arm-based Bayesian network meta-analysis
Authors: Wang Zhenxun , Lin Lifeng , Hodges James S , MacLehose Richard , Chu Haitao
Published: August 2020

Network meta-analysis is a commonly used tool to combine direct and indirect evidence in systematic reviews of multiple treatments to improve estimation compared to traditional pairwise meta-analysis. Unlike the contrast-based network meta-analysis approach, which focuses on estimating relative effects such as odds ratios, the arm-based network meta-analysis approach can estimate absolute risks and other effects, which are arguably more informative in medicine and public health. However, the number of clinical studies involving each treatment is often small in a network meta-analysis, leading to unstable treatment-specific variance estimates in the arm-based network meta-analysis approach when using non- or weakly informative priors under an unequal variance assumption. Additional assumptions, such as equal (i.e. homogeneous) variances for all treatments, may be used to remedy this problem, but such assumptions may be inappropriately strong. This article introduces a variance shrinkage method for an arm-based network meta-analysis. Specifically, we assume different treatment variances share a common prior with unknown hyperparameters. This assumption is weaker than the homogeneous variance assumption and improves estimation by shrinking the variances in a data-dependent way. We illustrate the advantages of the variance shrinkage method by reanalyzing a network meta-analysis of organized inpatient care interventions for stroke. Finally, comprehensive simulations investigate the impact of different variance assumptions on statistical inference, and simulation results show that the variance shrinkage method provides better estimation for log odds ratios and absolute risks.
Amelioration of Nicotine-Induced Osteoarthritis by Platelet-Derived Biomaterials Through Modulating IGF-1/AKT/IRS-1 Signaling Axis
Authors: Lo Wen-Cheng , Dubey Navneet Kumar , Tsai Feng-Chou , Lu Jui-Hua , Peng Bou-Yue , Chiang Pao-Chang , Singh Abhinay Kumar , Wu Chia-Yu , Cheng Hsin-Chung , Deng Win-Ping
Published: August 2020

Besides inhalation, a few studies have indicated that the uptake of nicotine through air or clothing may be a significant pathway of its exposure among passive smokers. Nicotine is well known to exert various physiological impacts, including stimulating sympathetic nervous system, causing vascular disturbances, and inducing cell death. Therefore, we aimed to establish whether exposure of nicotine could induce articular cartilage degeneration in a mouse model of osteoarthritis (OA). We specifically assessed dose-dependent effect of nicotine in vitro to mimic its accumulation. Further, during the in vivo studies, mice subcutaneously administered with nicotine was examined for OA-associated pathologic changes. We found that nicotine significantly suppressed chondrocytes and chondrogenic markers (Sox, Col II, and aggrecan). Nicotine-treated mice also showed altered knee joint ultrastructure with reduced Col II and proteoglycans. After corroborating nicotine-induced OA characteristics, we treated this pathologic condition through employing platelet-derived biomaterial (PDB)-based regenerative therapy. The PDB significantly suppressed OA-like pathophysiological characteristics by 4 weeks. The mechanistic insight underlying this therapy demonstrated that PDB significantly restored levels of insulin-like growth factor 1 (IGF-1) signaling pathway proteins, especially pIGF-1 R, pAKT, and IRS-1, regulating extracellular matrix synthesis by chondrocytes. Taken together, the PDB exerts regenerative and reparative activities in nicotine-mediated initiation and progression of OA, through modulating IGF-1/AKT/IRS-1 signaling axis.
Tophaceous pseudogout in a 12-year-old dog, with a review of applicable laboratory tests
Authors: Henschen Brittani R. , Lewin-Smith Michael R. , Mouser Pamela J. , Jenkins Hazel M. , Strausborger Stacy L. , Fetsch John F. , LaDouceur Elise E. B.
Published: August 2020

Pseudogout, also known as calcium pyrophosphate dihydrate (CPPD) deposition disease or chondrocalcinosis, is caused by crystalline deposits of CPPD within the extracellular matrix of articular hyaline cartilage and fibrocartilage, and within articular and periarticular connective tissue. Using a variety of laboratory techniques, we diagnosed pseudogout in the right hindlimb digit V of a 12-y-old Standard Poodle. Histologically, the joint, bone, tendon, and dermis were expanded and effaced by masses of mineralized, rhomboid crystals surrounded by macrophages, multinucleate giant cells, fibrous connective tissue, and chondroid and osseous matrix. Rhomboid crystals exhibiting weak-positive birefringence were identified under polarized light using a first-order red compensator filter. Scanning electron microscopy with energy-dispersive x-ray analysis (SEM-EDXA) revealed that the rhomboid crystals were composed of calcium, phosphorus, and oxygen. Fourier-transform infrared (FTIR) microspectroscopy confirmed the presence of calcium pyrophosphate. In dogs, tophaceous pseudogout, which was the variant of pseudogout in our case, occurs as a single, tumor-like periarticular mass that can be invasive and mimic neoplasia. Having ancillary confirmatory testing (SEM-EDXA and FTIR), particularly in unusual histologic scenarios, such as tophaceous pseudogout in dogs, is desirable for confirming the correct diagnosis, even though it is available only at certain reference centers. The pathogenesis of pseudogout is unknown.
Contextualizing the Cultural Factors Associated With Cancer Care in Nigeria: An Ethnonursing Study
Authors: Nwozichi Chinomso Ugochukwu , Musah Khadijat Toyin , Madu Amarachi Marie , Guino-o Theresa A. , Arungwa Oluwatosin Taiwo , Jimoh Mutiu Alani
Published: August 2020

Introduction: Culture and care are two important phenomena of particular concern to transcultural nursing. Cancer care is generally affected by certain cultural factors that influence how cancer patients experience diseases and seek and utilize care services. This study aimed to explore the cultural factors that affect cancer care in a Nigerian cancer care institution. Method: This study adopted an ethnonursing method involving participant observation and individual interviews. The study was conducted in the oncology unit of University College Hospital, Nigeria. Seven nurses and six patients were key participants, while four physicians, three ward assistants, and six patients’ relatives constituted the general participants. Result: Two themes and five patterns were identified. Participants described how the interplay of several cultural factors influenced or inhibited cancer care. Findings revealed significant influence of kinship, family, and social structure as well as the roles played by cultural beliefs, values, and practices in cancer care in Nigeria. Discussion: Cultural factors need to be considered broadly for the efforts toward prevention, early diagnosis, and treatment of cancer to be effective in Nigeria.
Transition Into Adulthood With Autism Spectrum Disorders: A Longitudinal Population Cohort Study of Socioeconomic Outcomes
Authors: Beenstock Michael , Pinto Ofir , Rimmerman Arie
Published: August 2020

This longitudinal population cohort study tracks the transition of 1,405 adolescents with autism spectrum disorders (ASDs) into adulthood, and highlights functional and social skills as core predictors of social outcomes (tertiary education, civic volunteering, and employment). Applying regression methods with sample selectivity to administrative data records obtained from Israel’s National Insurance Institute, we show that these outcomes are not highly correlated, suggesting that the high/low functioning dichotomy frequently used to categorize individuals with ASD is not supported by these data. We show that there is no causal relation between civic volunteering at an earlier stage and subsequent participation in tertiary education. This suggests that the traditional sequential model of developmental disability does not apply to ASD, and that the social-functional model of disability seems more applicable. We also show that functional and social severity vary inversely with year of diagnosis, due probably to the application of more liberal diagnostic standards. Disability among successive birth cohorts has been decreasing and is expected to decrease further in the future. Parents’ income has only a modest beneficial association with the transition into adulthood, and socioeconomic environments have no effect at all. Findings are discussed with respect to policy and practice.
From NCLB to ESSA: Implications for Teacher Preparation and Policy
Authors: Green Ambra L. , McKenzie Jennifer , Lewis Timothy J. , Poch Apryl L.
Published: August 2020

With the 2001 reauthorization of the Elementary and Secondary Education Act (ESEA), the term highly qualified teacher (HQT) became an important component of teacher licensure, including for special educators. However, when ESEA was reauthorized in 2015 as the Every Student Succeeds Act (ESSA), the highly qualified regulations were removed. The purpose of this study was to look back at the historical record of policy implementation of HQT and compare the record across states to provide implications for teacher preparation and licensure policy in the era of ESSA. This was accomplished through a review of the history of special education teacher licensure and completion of a comprehensive analysis of state licensure requirements under the Individuals with Disabilities Education Improvement Act. Despite a general consistency across three domains (i.e., degree, examination, and licensure) of the highly qualified statute, inconsistencies among states at both the elementary and secondary levels of special educator licensure may yield significant challenges related to the impact of teacher quality on student outcomes. Better understanding of these challenges is important as policymakers will be better able to make decisions regarding what teachers need to know prior to entering the field to meet students’ needs and generate student achievement.
Challenges in Serious Game Design and Development: Educators’ Experiences
Authors: Dimitriadou Anastasia , Djafarova Naza , Turetken Ozgur , Verkuyl Margaret , Ferworn Alexander
Published: August 2020

Background.

Relatively little is known about the role of educators in serious game design and development and their experiences with serious game implementation. We investigate educators’ perceived challenges deriving from their involvement as subject matter experts during the serious game development trajectory.

Methods.

A secondary analysis of data collected through an exploratory survey about serious game design and development approaches was carried out. The sample included 41 educators from post-secondary education institutions across North America. An in-depth analysis of qualitative data revealed educators’ roles in game development, the challenges they faced, and the strategies they deployed in serious game design, development, and implementation.

Results.

Educators, as serious game designers, perceived challenges to be administrative, design-related, attitudinal, and communicative. Strategies deployed to overcome challenges during the concept development, pre-production, and production stages of game design include the creation of games that balance learning and fun, and enhanced team collaboration through cultural mediation. During the post-production stage, although challenges are acknowledged and some strategies, such as improving the usability of a game, are deployed, a clear pattern in challenges and mitigating strategies could not be observed.

Conclusion.

Serious game design and development can be improved by nurturing diversity of ideas and adopting creative design and development methodologies. Serious game implementation can be improved by devising effective administrative and attitudinal strategies, and incorporating diversity of ideas into target curricula. Additionally, clear directives about usability should be devised, and academic objectivity towards serious games needs to be be created. Strategies to achieve these goals should focus on developing trust between target users, the technical development team, and educators as serious game implementers.
Civics Education for Students With Learning Disabilities and Emotional and Behavioral Disorders
Authors: Garwood Justin D. , Ciullo Stephen , Wissinger Daniel R. , McKenna John W.
Published: August 2020

Significant disparities in civics achievement between students with disabilities and their peers constitute an urgent need to support and improve civics education and outcomes for students receiving special education services related to emotional and behavioral disorders (EBD) and learning disabilities (LD). In the documented instances when social studies interventions are evaluated by researchers in schools for students with EBD or LD, the focus is most often on geography, history, and text-based content acquisition and comprehension. However, the information learned during civics instruction most directly prepares students for active participation in their communities.
Improving Instruction in Co-Taught Classrooms to Support Reading Comprehension
Authors: Wexler Jade
Published: August 2020

This unique special issue features five articles that provide guidance for middle school special education and general education content-area co-teachers on how to implement enhanced co-teaching models including specialized literacy instruction and best practices for co-teachers (e.g., co-planning; using station teaching to differentiate instruction). The authors of each article were part of a research team that conducted a 2015–2018 development and innovation professional development project funded by the U.S. Department of Education, Institute of Education Sciences, Project CALI (Content Area Literacy Instruction). Project CALI resulted in the development of the CALI professional development designed to provide co-teachers guidance on how to implement a set of evidence-based literacy practices (i.e., the CALI instructional framework) to improve outcomes for students with learning disabilities (LD) in co-taught classes. Authors in this special issue use examples from the CALI professional development to illustrate each practice.
Influence of Life Satisfaction on Quality of Life: Mediating Roles of Depression and Anxiety Among Cardiovascular Disease Patients
Authors: Mei Songli , Qin Zeying , Yang Yang , Gao Tingting , Ren Hui , Hu Yueyang , Cao Ruilin , Liang Leilei , Li Chuanen , Tong Qian
Published: August 2020

The present study aimed to determine the mediating effects of depression and anxiety on the association between life satisfaction and quality of life. We used the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and EuroQol Five Dimensions Questionnaire (EQ-5D) to measure depression, anxiety, and quality of life, respectively. A single question was used to measure the life satisfaction of participants. Life satisfaction was significantly related with depression ( r = −0.17), anxiety ( r = −0.18), and quality of life ( r = 0.19). Depression and anxiety were also related to quality of life. Depression and anxiety had full mediating effects (β = −0.274; β = −0.208) on the association between life satisfaction and quality of life. For those with poor life satisfaction, people were more likely to have high level of depression and anxiety, which in turn experienced poor quality of life.
Decompressive Cranial Vault Remodeling in Osteosclerotic Robinow Syndrome
Authors: Herman Paul I. , Marji Fady P. , Anstadt Erin E. , Dvoracek Lucas A. , Goldstein Jesse A. , Pollack Ian F. , Losee Joseph E.
Published: August 2020

We present a novel application of endocranial burr contouring for cranial vault expansion as a surgical adjunct during decompressive craniectomy in patients with cranial osteosclerosis. A 16-year-old female with osteosclerotic Robinow syndrome complicated by slit ventricle syndrome presented with refractory intracranial hypertension following external ventricular drain placement. Symptoms included severe headaches and altered mental status. Given the severe intracranial volume restriction secondary to massive calvarial thickening (2.5 cm), the patient was taken to the operating room for urgent surgical decompression. After frontal and parietal craniectomy, burr and osteotome contouring were used to remove two-thirds of the endocranial calvarial bone flap thickness resulting in a 9% cranial vault expansion while preserving an overall normal head size. There were no immediate postoperative complications. At over 3 years postoperatively, the patient had reduced headaches, maintained adequate shunt function, and has not required further vault reconstruction.
Mandibular Reconstruction Following Central Giant Cell Granuloma Resection in Primary Dentition: A Case for the Use of a Costochondral Graft
Authors: Khavanin Nima , White Marissa J. , Walsh Jonathan M. , Steinberg Jordan P.
Published: August 2020

Central giant cell granuloma is a benign, intraosseous lesion that may affect the pediatric craniofacial skeleton, particularly the mandible. When surgery is indicated, the role of the craniofacial surgeon is to ameliorate the sequelae of ablative surgery by restoring facial symmetry, ensuring appropriate postoperative occlusion, and allowing for adequate interincisal opening, all in the setting of a growing craniofacial skeleton. Herein, we report the case of a 3-year-old female presenting for reconstruction after resection of the right hemimandible proximal to the unerupted first permanent molar. We highlight the various reconstructive challenges associated with mandibular reconstruction during primary dentition and make a case for the use of a costochondral graft, with a successful outcome demonstrated at 2 years of follow-up.
Purposeful tool use in early lithic technologies
Authors: Baber Chris , Janulis Klint
Published: August 2020

Tool use can be considered in terms of purposeful behaviour. This emphasis on ‘purpose’ hides a host of assumptions about the nature of cognition and its relationship with physical activity. In particular, a notion of ‘purpose’ might assume that this is teleological which, in turn, requires a model of a desired end state of an action that can be projected onto the environment. Such a model is fundamental to traditional descriptions of cognition and a version of this can be found in the ‘template’ theory of stone-tool production (i.e. where the maker of the tool has a model in mind and attempts to reproduce this model in stone). Against this cognitive perspective, a number of approaches have been proposed that share their roots in the work of Gibson (i.e. ecological psychology) or Bernstein (i.e. dynamic systems). From these perspectives, ‘purpose’ is not a matter of a projection but opportunity; put simply, an action is performed until it need not be performed further. Trivial though this might sound, it has implications for how we define purpose and how this might apply to our understanding of tool use. We argue from a dynamic systems perspective and demonstrate the use of tools to crack bones for marrow extraction.
Health Care Project Improvement Design
Authors: Gardner Angela F. , Kindratt Tiffany B. , Orcutt Venetia L. , Griffith Patrice , Sandon Lona , Salinas Heather , Reed Gary , Fowler Raymond L.
Published: August 2020

The purpose was to measure faculty members’: (1) knowledge of quality improvement and patient safety (QIPS), (2) attitudes and beliefs about their own QI skills, and (3) self-efficacy toward participating in, leading, and teaching QIPS. Faculty completed an online survey. Questions assessed demographic and academic characteristics, knowledge, attitudes/beliefs, and self-efficacy. Knowledge was measured using the Quality Improvement Knowledge Assessment Tool–Revised (QIKAT-R). Participants provided free-text responses to questions about clinical scenarios. Almost half of participants (n = 236) self-reported that they were moderately or extremely comfortable with QIPS skills. Few were very (20%) or most (15%) comfortable teaching QIPS. Ninety-one participants attempted the QIKAT-R, and 78 participants completed it. The mean score was 16.6 (SD = 5.6). Despite positive attitudes and beliefs about their own QIPS skills, study results demonstrate a general lack of knowledge among surveyed faculty members. Faculty development efforts are needed to improve proficiency in participating, leading, and teaching QIPS projects.
Marriage Counseling and Couple Therapy With Celebrity and High-Profile Clients
Authors: Canfield Brian S.
Published: August 2020

This article examines marriage counseling and couple therapy with celebrity and high-profile clients. Issues and considerations commonly encountered when working with this population are presented along with ethical considerations and strategies for helping couples who are in the “public eye” bring about desired changes within an often unique and challenging relational and social context.
Parenting, Major Choice Motivation, and Academic Major Satisfaction Among Filipino College Students: A Self-Determination Theory Perspective
Authors: Nerona Randolfh R.
Published: August 2020

Guided by Self-Determination Theory (SDT), this study examined the relationships among parenting (autonomy-supportive and controlling), major choice motivations (autonomous and controlled), and academic major satisfaction with a sample of 525 Filipino college students. Consistent with the hypotheses, the results of structural equation modeling indicated that perceived autonomy-supportive and controlling parenting were positively associated with autonomous and controlled major choice motivations, respectively. In addition, autonomous and controlled major choice motivations differentially predicted academic major satisfaction. Findings also revealed that while autonomous major choice motivation mediated the relation between autonomy-supportive parenting and academic major satisfaction, controlled major choice motivation mediated the association between controlling parenting and academic major satisfaction. Practical implications and directions for future research are discussed.
Improving the Measurement of Functional Somatic Symptoms With Item Response Theory
Authors: Acevedo-Mesa Angélica , Tendeiro Jorge Nunes , Roest Annelieke , Rosmalen Judith G. M. , Monden Rei
Published: August 2020

More than 40 questionnaires have been developed to assess functional somatic symptoms (FSS), but there are several methodological issues regarding the measurement of FSS. We aimed to identify which items of the somatization subscale of the Symptom Checklist–90 (SCL-90) are more informative and discriminative between persons at different levels of severity of FSS. To this end, item response theory was applied to the somatization scale of the SCL-90, collected from a sample of 82,740 adult participants without somatic conditions in the Lifelines Cohort Study. Sensitivity analyses were performed with all the participants who completed the somatization scale. Both analyses showed that Items 11 “feeling weak physically” and 12 “heavy feelings in arms or legs” were the most discriminative and informative to measure severity levels of FSS, regardless of somatic conditions. Clinicians and researchers may pay extra attention to these symptoms to augment the assessment of FSS.
Prevalence and Predictors of Out-of-Target LDL Cholesterol 1 to 3 Years After Myocardial Infarction. A Subanalysis From the EYESHOT Post-MI Registry
Authors: Silverio Angelo , Benvenga Rossella Maria , Piscione Federico , Gulizia Michele M. , Meessen Jennifer M. T. A. , Colivicchi Furio , Nardi Federico , Baldi Cesare , Galasso Gennaro , Vecchione Carmine , Di Lenarda Andrea , Gabrielli Domenico , De Luca Leonardo
Published: August 2020

Background:

There is an incomplete understanding of the prevalence and predictors of attainment of low-density lipoprotein cholesterol (LDL-C) goal after myocardial infarction (MI).

Aim:

To evaluate the prevalence of achievement of LDL-C goal of 70 mg/dL, to identify the baseline features associated with suboptimal lipid control, and to assess the use of LDL-C-lowering drug therapies (LLT) beyond the first year after MI.

Methods:

The EYESHOT Post-MI was a prospective, cross-sectional, Italian registry, which enrolled patients presenting to cardiologist 1 to 3 years after MI. In this retrospective post-hoc analysis, patients were categorized in 2 groups according to the achievement or not of the LDL-C goal of 70 mg/dL. Univariable and multivariable logistic regression analyses were performed to identify the baseline features associate with LDL-C≥70 mg/dL.

Results:

The study population included 903 patients (mean age 65.5 ± 11.5 years). Among them, LDL-C was ≥70 mg/dL in 474 (52.5%). Male sex ( P = 0.031), hypertension ( P = 0.024), prior percutaneous coronary intervention ( P = 0.016) and high education level ( P = 0.008) were higher in the LDL-C <70 group. At multivariable analysis, low education level was an independent predictor of LDL-C≥70 mg/dL (OR:1.582; 95%CI, 1.156-2.165; P = 0.004). Conversely, hypertension increased the probability to achieve the LDL-C goal (OR:0.650; 95%CI, 0.443-0.954; P = 0.028). Among off-target patients, LLT was not modified in the majority of cases (67.3%), intensified in 85 (18.6%), and actually reduced in 63 patients (13.8%).

Conclusions:

In patients presenting to cardiologists 1 to 3 years from the last MI event, LDL-C is not under control in a large proportion of patients, particularly in those with a low education level or without hypertension. LLT is underused in this very-high-risk setting.
Missing the Mark: The Complexity of African American Dementia Family Caregiving
Authors: Brewster Glenna S. , Bonds Kalisha , McLennon Susan , Moss Karen O. , Epps Fayron , Lopez Ruth Palan
Published: August 2020

Alzheimer’s disease and related dementias (ADRDs) have a significant impact on families. Family nurses are in an ideal position to address the needs of families affected by ADRD. However, to be most effective, family nurses and researchers need culturally appropriate theories to guide practice and research. On November 17, 2018, five nurse researchers presented findings of their research with African American families at the Gerontological Society of America’s annual meeting. The results reported and the lively discussion that ensued suggested that the current paradigms framing research and practice with African American families affected by ADRD may not be adequate. There is a need to consider culturally congruent, family-centered theories to guide research and practice with this population of families.
Evaluating Skin Sensitization Via Soft and Hard Multivariate Modeling
Authors: Silva Filipa A. L. S. , Brites Gonçalo , Ferreira Isabel , Silva Ana , Miguel Neves Bruno , Costa Pereira Jorge L. G. F. S. , Cruz Maria T.
Published: August 2020

Allergic contact dermatitis is the most frequent manifestation of immunotoxicity in humans with a prevalence rate of 15% to 20% over general population. Skin sensitization is a complex end point that was for a long time being evaluated using animal testing. Great efforts have been made to completely substitute the use of animals and replace them by integrating data from in vitro and in chemico assays with in silico calculated parameters. However, it remains undefined how to make the best use of the cumulative data in such a way that information gain is maximized and accomplished with the fewest number of tests possible. In this work, 3 skin sensitization prediction models were considered: one to discriminate sensitizers from non-sensitizers, considering a 2-level scale; one according to the GHS, considering a 3-level scale; and the other to categorize potency in a 6-level scale, according to available human data. We used a data set of known human skin allergens for which in vitro, in chemico, and in silico descriptors where available to build classifiers based on soft and hard multivariate modeling. Model building, optimization, and refinement resulted in 100% accuracy in distinguishing between sensitizers and non-sensitizers. The same model was able to perform the characterization, in 3 and 6 levels, respectively, with 98.8 and 97.5% accuracy. Combining data from in vitro and in chemico tests with in silico descriptors is relatively simple to implement and some predictors are fitting the adverse outcome pathway for skin sensitization.
Chondroid and Osseous Metaplasia of the Central Fibrous Body in Adolescent Hearts with Mutations in TNNI3 and TNNT2 genes
Authors: Carreon Chrystalle Katte , Sanders Stephen P , Ashworth Michael T
Published: August 2020

The histological spectrum of the central fibrous body (CFB) of the heart, particularly in humans, is not fully characterized. Herein, we describe the presence of cartilage and bone within the CFB of 2 explanted heart specimens from patients with known mutation-driven cardiomyopathy involving the TNNI3 and TNNT2 genes, review the existing literature on the identified variants particularly TNNI3 (p.Asn185Thrfs*14) and TNNT2 (p.Arg141Trp), and provide insights into the plausible nature of such histopathological observation based on animal studies and the few reported cases in humans.