bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Impact of Lymphocyte-to-C-Reactive Protein Ratio in Patients Who Underwent Surgical Resection for Pancreatic Cancer
Authors: Iseda Norifumi , Iguchi Tomohiro , Hirose Kosuke , Itoh Shinji , Honboh Takuya , Sadanaga Noriaki , Matsuura Hiroshi
Published: August 2022

Background

Increasing evidence indicates that increased systemic inflammation is correlated with poorer cancer-specific survival in various cancer types. This study aimed to evaluate the prognostic value of various combinations of inflammatory factors in patients who underwent surgical resection for pancreatic cancer (PC).

Methods

We retrospectively analyzed 97 consecutive patients with PC who underwent pancreatectomy. We assessed the predictive impact for recurrence using a combination of 5 inflammatory markers and focused on the lymphocyte-C-reactive protein ratio (LCR) to elucidate its prognostic and predictive value for recurrence-free survival (RFS) and overall survival (OS) in univariate and multivariate analyses using the Cox proportional hazards model.

Results

Low preoperative LCR was correlated with low serum hemoglobin, low serum albumin concentration, high frequency of microscopic vascular invasion, and high frequency of microscopic perineural invasion. The low LCR group had significantly worse RFS and OS. Lower preoperative LCR was an independent predictor of shorter RFS and OS in this cohort.

Discussion

Preoperative LCR is a novel and convenient prognostic marker for patients with PC. Patients with low LCR may require more favorable intensive therapy.
Phone and Self: How Smartphone Use Increases Preference for Uniqueness
Authors: Song Camilla Eunyoung , Sela Aner
Published: August 2022

One of the most dramatic shifts in recent years has been consumers’ increased use of smartphones for making purchases and choices—but does using a smartphone influence what consumers choose? This article shows that, compared with using a personal computer (PC), making choices using a personal smartphone leads consumers to prefer more unique options. The authors theorize that because smartphones are considerably more personal and private than PCs, using them activates intimate self-knowledge and increases private self-focus, shifting attention toward individuating personal preferences, feelings, and inner states. Consequently, making choices using a personal smartphone, compared with a PC, tends to increase the preference for unique and self-expressive options. Six experiments and several replications examine the effects of personal smartphone use on the preference for unique options and test the underlying role of private self-focus. The findings have important implications for theories of self-focus, uniqueness seeking, and technology’s impact on consumers, as well as tangible implications for many online vendors, brands, and researchers who use mobile devices to interact with their respective audiences.
The influence of formaldehyde removal finishing on fogging characteristics and properties of polyester fabrics
Authors: Yu Chunxiao , Jiang Feng
Published: August 2022

The air quality in the vehicle indoor microenvironment has been of particular public concern because of its harmful effect on the human body. The volatile and semivolatile organic compounds in the vehicle indoor air can condense onto the cooler surface of the windshield, potentially creating a visibility and safety problem for the driver. This paper aimed to prepare multifunctional polyester fabrics with formaldehyde removal properties and low fogging degrees. The formaldehyde removal finishing of polyester fabrics was carried out with different formaldehyde removal agents using the pad-dry-cure method. The influence of formaldehyde removal finishing on the formaldehyde removal efficiency, fogging degree and some related performances of polyester fabrics are studied. The results show that the fogging degree increased (lower than standard values: 2 mg) after finishing with formaldehyde removal agents FK-1, FK-2, FK-3, FK-5, and FK-6. The formaldehyde removal rate of polyester fabrics after finishing was above 75%, and the performances of water repellence, softening behavior, color fastness were maintained. Our approach provides an easy method for use in vehicle indoor air purification systems and the finished fabrics can be applied to various applications such as home, automobile, office, and industry.
Unnecessary Cesarean Section Delivery Causes Risk to Both Mother and Baby: A Commentary on Pregnancy Complications and Women’s Health
Authors: Nahar Zabun , Sohan Md. , Hossain Md. Jamal , Islam Md. Rabiul
Published: August 2022

In Bangladesh, 3.6 million babies are born each year. But the country is now facing a quickly rising rate of cesarean section (C-section) utilization. Here about 50% of total deliveries are institutional. Among them, two-thirds are in private care facilities, where the rate of C-sections is very high (83%). The present C-section rate is 2.5 times higher than in the previous decades. In Bangladesh, many physicians from private facilities are recommending C-section regardless of the mother’s physical condition and the position of the fetus. Therefore, mothers are more likely to choose C-section delivery who receive antenatal care from a private facility. Moreover, several socio-economic and demographic factors might be responsible for these increased C-section deliveries. Also, many private hospitals prefer C-section delivery due to their profit-making tendency. The unnecessary C-section delivery causes risk to both mother and baby Also, the high prevalence of C-section in Bangladesh is putting women’s health at risk. Therefore, the government healthcare authorities should ensure proper utilization of C-section facilities and encourage people for normal births at any health facility. Also, they can develop a national guideline for the use of C-sections and normal delivery depending on the physical condition of the mother and fetus.
Trees, stolen gods, and becoming Egyptian: Reading Genesis missionally
Authors: Tompkins Andrew
Published: August 2022

This article attempts to add to missiological discussions by rereading some selected passages from the life of Abraham, Jacob, and Joseph using a missional hermeneutic. I have chosen Genesis 12:6–7 and 13:18, which record Abraham’s forms of worship and dwelling among important groves of trees, as a potential example of worshipping God in a plural society in the public sphere and as a potentially helpful example for worshipping God today in the public sphere. I then turn to the struggle of Jacob and his family’s connection to deities other than Yahweh in their journey away from Laban toward God found in Genesis 31:19, 32, and 35:2–4. The final part of this article will discuss Joseph in Egypt, more specifically his full acceptance as an Egyptian as found in Genesis 41:45, 50; 42:8; 43:32 and his use and practice of Egyptian rituals as a part of his daily life as demonstrated in Genesis 44:5, 15, and 44:31–34. I hope this article will on the missiological issues presented as well as on the potential of Genesis to inform the ongoing discussions of missiology, especially in the construction of robust biblically faithful theology of mission work. Reading the Bible from a missional hermeneutic is a relatively new hermeneutical phenomenon that is still in the process of development. This article is one version of how this hermeneutic can aid biblical studies and how missiological studies can reread the text in meaningful ways.
The Refugee Paradox During Wartime in Europe: How Ukrainian and Afghan Refugees are (not) Alike
Authors: De Coninck David
Published: August 2022

Since Russia invaded Ukraine in March 2022, Ukrainians have been displaced from their country in record pace and in massive numbers. Although some have been displaced within Ukraine, most have fled to Poland, Moldova, and other European countries. The European and American public’s reaction to these large refugee numbers has been overwhelmingly positive, with outpourings of humanitarianism and solidarity. This reaction stands in stark contrast with the apprehensive and rather negative reactions from Europeans toward Afghan refugees following the Taliban’s violent takeover in May 2021. In this IMR Dispatch from the Field, I reflect on the similarities and differences in reactions to Ukrainian refugees in the current crisis and Afghan refugees following the Taliban takeover in May 2021. Despite important similarities between these two refugee groups, there are, I argue, various reasons why the European and American public may feel closer to Ukrainian than Afghan refugees or why they perceive the former to be more deserving of aid. I highlight the role of symbolic threat, a conscience collective, and ethnicity. Furthermore, the looming fear of the aggressor in this conflict (Russia) may play a larger role in the European and American public’s reactions than in other refugee crises.
Support me in the good times too: Interpersonal emotion regulation, perceived social support, and loneliness among mothers of children with autism spectrum disorder
Authors: Laslo-Roth Roni , George-Levi Sivan , Ben-Yaakov Lital
Published: August 2022

Although loneliness is an experience that mothers of children with autism spectrum disorder (ASD) may face, it has not been widely explored. Having a supportive social environment that is also effective in emotion regulation may provide feelings of security necessary for one to feel less lonely. The present study examined loneliness levels among mothers of children with ASD (vs. without ASD) and explored interpersonal resources (interpersonal emotion regulation and perceived social support) that might contribute to reduced loneliness. One-thousand-seven-hundred-and-83 mothers of children (546 with ASD, 1,237 without) completed a series of questionnaires. Mothers of children with ASD (vs. without ASD) reported higher levels of loneliness and lower levels of interpersonal emotion regulation efficacy for positive emotions and lower levels of perceived social support. A serial mediation model indicated that interpersonal factors fully mediated the association between being a mother of a child with ASD (vs. without) and loneliness. Moreover, a moderation mediation model showed that the tendency to approach others in order to regulate positive emotions moderated the association between perceived efficacy of such regulation and mothers’ loneliness. Interpersonal emotion regulation for positive emotions and perceived social support may contribute to reduced loneliness, especially among mothers of children with ASD.
Organizational support for the potentially traumatic impact of video evidence of violent crime in the criminal justice system: ‘We’re almost making more victims’
Authors: Birze Arija , Regehr Cheryl , Regehr Kaitlyn
Published: August 2022

As graphic video evidence becomes a standard element in the investigation and prosecution of violent crime, criminal justice organizations must consider and address exposure to and impact of this potentially traumatizing workplace material for criminal justice professionals. Using a discovery-oriented qualitative design and a long-interview method of data collection, this study explores organizational responses to the exposure of criminal justice professionals to a growing volume of video evidence of violent crime. Repeated exposure to high-quality video evidence has the effect of placing criminal justice professionals in the midst of traumatic events, resulting in responses that are akin to trauma contagion. However, organizational awareness and the acceptance of trauma and support systems have not kept pace with the exponential rise in exposure, often being deployed when the person is no longer able to continue in their role. As a result, affected individuals may over-rely on equally affected colleagues for support, intensifying the cycle of trauma contagion. Organizational responses to reduce trauma contagion and the psychological burden on professionals working with video evidence of violent crime should occur at three levels: prevention through moderating exposure; preparation through creating a culture of awareness and acceptance; and intervention through systematic and formal supports.
A Study of Driver Eye-Glancing Behavior at Two Different Types of Unsignalized Intersections Based on SHRP2 NDS Data
Authors: Zhang Beijia , Zhou Huaguo , Quan Li , Liu Pan
Published: August 2022

The study aimed to analyze driver visual workload at unsignalized intersections with wide medians on high-speed divided highways. The study focused on two types of traffic movements: direct left-turns from minor roads at conventional intersections and right-turns followed by U-turn movements at restricted crossing U-turn (RCUT) intersections. A total of 430 left-turn trips and 40 right-turn followed by U-turn trips were collected from the Second Strategic Highway Research Program Naturalistic Driving Study database. Researchers analyzed the data from driver eye-glancing videos, demographic information, and driving history. The entropy rate of each trip was calculated as an indicator of the driver's visual workload and was treated as the dependent variable for the statistical analysis. Entropy rate is the metric of the randomness associated with drivers’ scanning patterns. The higher the entropy rate, the higher the workload. A comparative study of these two movements at these two types of intersections was conducted. Statistical analyses indicated that drivers at RCUT intersections engaged in less random scanning and longer average fixation and spent more than 70% of the time looking forward during the whole movement. Younger drivers at both types of intersections had higher entropy rates. Additionally, drivers at conventional intersections with higher annual average daily traffic (≥30,000) had higher entropy rates. These results could provide a better understanding of driver workload and its safety implications at different types of unsignalized intersections.
Analysis of Temporal Stability of Contributing Factors to Truck-Involved Crashes at Work Zones in South Carolina
Authors: Ahmed Fahim , Siddiqui Chowdhury K. A. , Huynh Nathan
Published: August 2022

This study examines factors that contributed to truck-involved work zone crash injury in South Carolina, a state which experienced a rise in the number of injury crashes from 2014 to 2018. The outcome of interest is injury or property damage only (PDO) crashes. A binary logit model is developed using South Carolina statewide work zone crash data from 2014 to 2018. It considers various factors, including vehicle, crash, roadway, environment, day and time, and driver-related characteristics. Of particular interest to this study is the temporal stability of the contributing factors from year to year so that a long-term mitigating strategy can be developed. To this end, the test for parameter transferability is used, and it confirms that separate models should be used for each year, except for 2014. The only factor found to be temporally stable across all years (i.e., statistically significant in 2015–2018 models) is airbag deployment. Given that nearly all the factors are temporally unstable, an importance measure is introduced to enable transportation agencies to rank factors and develop countermeasures that target persistent contributing factors. Based on the importance measure, the top three ranked factors that contributed to work zone truck-involved crash injury in South Carolina from 2015 to 2018 are: (i) airbags deployed, (ii) tie between rear-end crashes and crashes on primary roadways, and (iii) crashes in dark conditions.
Experimental testing of fracture fixation plates: A review
Authors: Zhang Shiling , Patel Dharmesh , Brady Mark , Gambill Sherri , Theivendran Kanthan , Deshmukh Subodh , Swadener John , Junaid Sarah , Leslie Laura Jane
Published: August 2022

Metal and its alloys have been predominantly used in fracture fixation for centuries, but new materials such as composites and polymers have begun to see clinical use for fracture fixation during the past couple of decades. Along with the emerging of new materials, tribological issues, especially debris, have become a growing concern for fracture fixation plates. This article for the first time systematically reviews the most recent biomechanical research, with a focus on experimental testing, of those plates within ScienceDirect and PubMed databases. Based on the search criteria, a total of 5449 papers were retrieved, which were then further filtered to exclude nonrelevant, duplicate or non-accessible full article papers. In the end, a total of 83 papers were reviewed. In experimental testing plates, screws and simulated bones or cadaver bones are employed to build a fixation construct in order to test the strength and stability of different plate and screw configurations. The test set-up conditions and conclusions are well documented and summarised here, including fracture gap size, types of bones deployed, as well as the applied load, test speed and test ending criteria. However, research on long term plate usage was very limited. It is also discovered that there is very limited experimental research around the tribological behaviour particularly on the debris’ generation, collection and characterisation. In addition, there is no identified standard studying debris of fracture fixation plate. Therefore, the authors suggested the generation of a suite of tribological testing standards on fracture fixation plate and screws in the aim to answer key questions around the debris from fracture fixation plate of new materials or new design and ultimately to provide an insight on how to reduce the risks of debris-related osteolysis, inflammation and aseptic loosening.
Young people don’t tend to ask for help more than once: Child and adolescent psychiatrists’ views on ailing mental health services for young New Zealanders
Authors: Every-Palmer Susanna , Grant Marion L , Thabrew Hiran
Published: August 2022

Objectives

To explore the views of New Zealand doctors working in child and adolescent psychiatry regarding the state of public mental health services.

Methods

All practicing child and adolescent psychiatrists/advanced trainees were electronically surveyed in August 2021. Quantitative and qualitative analysis of feedback was undertaken.

Results

Almost 100 specialists responded, an 80% response rate. High levels of dissatisfaction with current services and future service plans were identified. Content analysis identified an overarching theme that child and adolescent services were under great pressure, with subthemes of increased demand, a stretched workforce and social issues driving complex presentations. Recommendations were made for addressing workforce, service design and wider issues.

Conclusions

Multiple measures are needed to improve currently ailing child mental health services, including urgently expanding the number of psychiatrists and other clinical staff.
Early Radiographic and Clinical Outcomes of a Novel, Fixed-Bearing Fourth-Generation Total Ankle Replacement System
Authors: Kim Jaeyoung , Rajan Lavan , Bitar Rogerio , Caolo Kristin , Fuller Robert , Henry Jensen , Deland Jonathan , Ellis Scott J. , Demetracopoulos Constantine
Published: August 2022

Background:

The Cadence Total Ankle System is a 2-component, fixed-bearing fourth-generation total ankle arthroplasty (TAA) system that was introduced for clinical use in 2016. The purpose of this study was to report non–inventor, non–industry funded survivorship, radiographic and clinical outcomes, and early complications following use of this implant at a minimum of 2 years.

Methods:

This single-center retrospective study included patients who underwent TAA by 2 surgeons with this novel fixed-bearing system between January 2017 and September 2018. Forty-eight patients were evaluated at an average of 33.6 months. Radiographic outcomes included preoperative and postoperative tibiotalar angle on anteroposterior radiographs of the ankle, sagittal tibial angle (STA) on lateral radiographs of the ankle, and periprosthetic lucency formation and location. Revision and reoperation data were collected, and patient-reported outcomes were assessed using Patient Reported Outcomes Measurement Information System (PROMIS). Subgroup analysis assessed associations between preoperative deformity, postoperative implant alignment, PROMIS scores, and periprosthetic lucency formation.

Results:

Survivorship of implant was 93.7%, with 3 revisions, 1 due to infection and 2 due to loosening of the implant (1 tibial and 1 talar component). Three patients had reoperations (6.3%): 2 for superficial infection and 1 for gutter debridement due to medial gutter impingement. Fifteen patients (35.8%) developed periprosthetic lucencies, all on the tibial side. PROMIS scores improved after surgery in all domains except Depression. Patients with significant postoperative periprosthetic lucency had worse postoperative PROMIS Physical function scores than patients without lucency ( P < .05).

Conclusion:

This study demonstrated excellent minimum 2-year clinical and radiographic outcomes and low revision and reoperation rates of this new fourth-generation TAA system. Future studies with longer follow-up, especially on patients with periprosthetic lucency, are necessary to investigate the long-term complications and understand the long-term functional and radiographic outcomes of this implant.
Visual Social Media and Black Activism: Exploring How Using Instagram Influences Black Activism Orientation and Racial Identity Ideology Among Black Americans
Authors: Li Minjie
Published: August 2022

During the civil unrest emphasizing the Black Lives Matter movement amid the COVID-19 pandemic, Instagram was widely adopted by activists, journalists, and the general audience to disseminate and gather information about critical social issues and protests. Through a survey sampling Black Instagram users ( N = 402), this study examined how Black people’s use of Instagram and its specific features—Instagram Carousel, Instagram Live, Instagram Story, standard post, and comment section—influenced their Black activism orientation, in-app activism engagement, and Black racial identity ideology. The results indicated that, along with Instagram use, Instagram network politicalness, diversity, and authenticity are also important predictors.
Children Translating When Reading Dual-Language Books
Authors: Domke Lisa M.
Published: August 2022

This mixed-methods study analyzed how elementary-school children translated while reading Spanish-English dual-language books (DLBs). Specifically, it investigated the types of strategies students used to translate words in DLBs, strategies’ success, and differences in strategy use based on grade, home language(s), and oral reading accuracy. Sixty-three Spanish-English biliterate third and fifth graders participated in the study. Verbal protocols/think-alouds explaining their translation strategies were analyzed qualitatively using discourse analysis and quantitatively to establish trends. Findings suggest that strategies used most frequently by third graders and/or students with lower oral reading accuracies focused on textual features, whereas strategies used most frequently by fifth graders and/or students with higher accuracies were informed by linguistic knowledge. Results discuss how strategies reflect developing metalinguistic knowledge, linguistic assumptions, and ways that participants drew upon their linguistic repertoires to translate and engage in translanguaging. Also discussed are instructional implications for supporting biliteracy development and for dual-language programs.
Determinants of the implementation of an artificial intelligence-supported device for the screening of diabetic retinopathy in primary care – a qualitative study
Authors: Held Linda A. , Wewetzer Larisa , Steinhäuser Jost
Published: August 2022

Diabetic retinopathy is a microvascular complication of diabetes mellitus that is usually asymptomatic in the early stages. Therefore, its timely detection and treatment are essential. First pilot projects exist to establish a smartphone-based and AI-supported screening of DR in primary care. This study explored health professionals’ perceptions of potential barriers and enablers of using a screening such as this in primary care to understand the mechanisms that could influence implementation into routine clinical practice. Semi-structured telephone interviews were conducted and analysed with the help of qualitative analysis of Mayring. The following main influencing factors to implementation have been identified: personal attitude, organisation, time, financial factors, education, support, technical requirement, influence on profession and patient welfare. Most determinants could be relocated in the behaviour change wheel, a validated implementation model. Further research on the patients’ perspective and a ranking of the determinants found is needed.
Using Economic Diaries in an Ethnographic Study: What They Can Tell About the Financial and Daily Lives of Male and Female Sex Workers in Mombasa
Authors: Igonya Emmy Kageha , Nencel Lorraine , Sabelis Ida , Kimemia Grace
Published: July 2022

This article has two objectives: first, to contribute to the academic understanding of the relationship of money with sex work by going beyond purely instrumentalist conceptualizations; and second, to inform interventions aiming to empower sex workers’ economically. Qualitative research was conducted to better understand the financial lives of sex workers in Mombasa, Kenya. The article draws largely on a participatory method using 12 economic diaries accompanied by 30 informal discussions. We complement the economic diaries with 24 in-depth interviews, key informant interviews and participant observations conducted between 2014 and 2017. We found that sex workers’ savings, spending, and earning practices were highly influenced by stigma, mobility and economic insecurity. We also found that sex workers gave substantial meaning to the idea of ‘quick money’, which reflected their daily financial strategies. The likelihood for development interventions to succeed will increase when sex workers are directly involved and not just recipients in programmes; furthermore, that programmes adequately recognize and address the needs and desires of sex workers and understand the socio-economic dynamics shaping sex work. In this article, these socio-economic factors revealed through the process and method of participants’ writing economic diaries.
Consumer Insights into Changing Water Consumption Behavior: A Social Marketing Formative Study
Authors: Ibrahim Ali , Rundle-Thiele Sharyn , Almestarihi Ra’d
Published: August 2022

Background and Situation Analysis

The United Nations has announced serious global water crises at the beginning of the 21st century. In the United Arab Emirates (UAE), the problem of water shortage is more significant than in other parts of the world, due to lack of the natural freshwater resources and extremely harsh weather. All of this compounded with the highest individual water consumption in the world; the average consumption per capita is 500 L a day, around 82% above the global average.

Focus of the Article

The main objectives of this study were to gain insights about factors that might impact residents water consumption behavior and open more avenues for using social marketing to influence residents’ behaviors.

Research question

The research questions are: RQ1: What beliefs are held about the UAEs current water situation? RQ2: What are the current water consumption behaviors of UoS residents? RQ3: What would facilitate lower water consumption?

Importance to the Social Marketing Field

The importance of this study is to develop a model which may be employed to change individual water consumption behavior using social marketing principles

Method

A case study methodology was applied to collect data from the University of Sharjah for this study, using the focus groups method. A convenience sample of six focus groups with a total of 39 participants of students, faculty members, administrative staff, and other stakeholders formed the basis of the current study.

Results

This study revealed that the residents lacked accurate knowledge about the water situation inside the country. In addition, consumers showed mismatch between their religious beliefs and actual consumption behaviors.

Recommendations for research/or practice

More studies and research should take place in this field, especially in connection with personal behavior issues where individuals need encouragement and incentives to change underlying habits, such as over-consumption of water, obesity, and road accidents.
Reliability, Availability, Maintainability, and Dependability analysis of Tube-wells Integrated with Underground Pipelines in agricultural fields for irrigation
Authors: Kumar Ashish , Saini Monika , Patil Rajkumar Bhimgonda , Al-Dahidi Sameer , Mellal Mohamed Arezki
Published: August 2022

Reliability, Availability, Maintainability, and Dependability (RAMD) study of Tube-wells Integrated with Underground Pipelines (TIUP) is crucial as they are the backbone of the irrigation system. This study is carried out with an objective to perform RAMD analysis, and Failure Modes and Effects Analysis (FMEA) unified with the development of a novel stochastic model using Markovian approach to estimate the Steady-State Availability (SSA) of the TIUP. A real case study of a conventional TIUP system has been performed to validate theoretical and practical results of the proposed model. The failure and repair rates of all subsystems followed exponential distribution, and their impact on system/subsystem’s availability and other reliability measures has been investigated. All the repairs are perfect and random variables associated with failure and repair rates are statistically independent. The centrifugal pump and power supply units are the most critical components as far as reliability and maintainability aspects. The labor also plays a critical role in the operation of the TIUP system.
‘If you had taken the lead…’ – a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students
Authors: Rieffestahl Anne Marie , Mogensen Hanne O. , Morcke Anne Mette , Risør Torsten
Published: August 2022

Objectives

To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients’ experiences relate to trust.

Methods

Twenty-one video-recorded sessions of patients’ feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes.

Results

In the patients’ feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe.

Discussion

The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust.
Principlism and citizen science: the possibilities and limitations of principlism for guiding responsible citizen science conduct
Authors: Baard Patrik , Sandin Per
Published: August 2022

Citizen science (CS) has been presented as a novel form of research relevant for social concerns and global challenges. CS transforms the roles of participants to being actively involved at various stages of research processes, CS projects are dynamic, and pluralism arises when many non-professional researchers take an active involvement in research. Some argue that these elements all make existing research ethical principles and regulations ill-suited for guiding responsible CS conduct. However, while many have sought to highlight such challenges from CS, few have discussed principles per se providing the foundation for regulations. In this article we will investigate the possibilities of midlevel principlism in guiding responsible CS conduct. Principlism has the potential of accommodating many of the concerns taken to reduce the relevance of existing principles.
Reliability evaluation of repairable systems considering component heterogeneity using frailty model
Authors: Brown Bodunrin , Liu Bin , McIntyre Stuart , Revie Matthew
Published: August 2022

The failure processes of heterogeneous repairable systems with minimal repair assumption can be modelled by nonhomogeneous Poisson processes. One approach to describe an unobserved heterogeneity between systems is to multiply the intensity function by a positive random variable (frailty term) with a gamma distribution. This approach assumes that the relative frailty distribution among survivors is independent of age. Where systems are being continuously repaired and modified, the frailty distribution may be dependent on the system’s age. This paper investigates the application of the inverse Gaussian (IG) frailty model for modelling the failure processes of heterogeneous repairable systems. The IG frailty model, which combines the power law model and inverse Gaussian distribution, assumes that the relative frailty distribution among survivors becomes increasingly homogeneous over time. We develop the maximum likelihood for the IG frailty model, a method for event prediction, and investigate the effect of accuracy of the IG estimator and mis-specification of the frailty distribution through a simulation study. The mean estimates of the scale and shape parameters of the intensity function are examined for bias and efficiency loss. We find that the developed estimator is robust to changes in the input parameters for a relatively large sample sizes. We investigate the robustness of selecting an IG compared with a gamma frailty model. The developed IG model is applied to real data for illustration showing an improvement on existing models.
Antitumor Effects of Chelerythrine: A Literature Review
Authors: Kang Kai , Jiang Hanbing , Zhang Shujun , Cheng Binglin
Published: August 2022

Chelerythrine (CHE), one of the main active components of the medicinal plant, Chelidonium majus, (Figure 1) Botanical authority is traditionally used as a natural medicine for its significant antitumor activity. The relevant literature on the antitumor activity of CHE has been reviewed to provide a theoretical basis for further study and utilization. This review aimed to provide new ideas for developing tumor-targeted drugs.
Ready or not? An exploration of university students’ online learning readiness and intention to use during COVID-19 pandemic
Authors: Hoang Diem TN , Hoang Thinh
Published: August 2022

The outbreak of COVID-19 pandemic since the last days of 2019 has led to school closure worldwide and forced institutions at all levels to move to online or distance learning. This study was conducted to explore university students’ readiness to such a sudden situational shift to online learning. We surveyed 1304 online-learning students in a higher education institution in Vietnam. Through exploratory factor analyses, we identified three dimensions of online learning readiness (OLR): online learning motivation, online learning self-efficacy beliefs, and online self-directed learning. We then conducted multiple regression analyses to investigate the predictive power of different students’ individual characteristics and perceptions on OLR, and the impacts of the three OLR dimensions on students’ intention to use online learning (IU). Our results suggested that students’ perceived facilitating conditions and their online learning experience were the significant predictors of OLR. Furthermore, online learning motivation was the construct that exerted the strongest influence on IU, compared to other OLR constructs. The study highlights the need for improving facilitating conditions to support students’ OLR. It also suggests enhancing the usefulness and enjoyment that students perceive from online learning to improve their willingness to use this learning channel.
A Machine Learning Approach to Predicting Higher COVID-19 Care Burden in the Primary Care Safety Net: Hispanic Patient Population Size a Key Factor
Authors: Goldstein Evan V. , Wilson Fernando A.
Published: August 2022

Introduction

The federal government legislated supplemental funding to support community health centers (CHCs) in response to the COVID-19 pandemic. Supplemental funding included standard base payments and adjustments for the number of total and uninsured patients served before the pandemic. However, not all CHCs share similar patient population characteristics and health risks.

Objective

To use machine learning to identify the most important factors for predicting whether CHCs had a high burden of patients diagnosed with COVID-19 during the first year of the pandemic.

Methods

Our analytic sample included data from 1342 CHCs across the 50 states and D.C. in 2020. We trained a random forest (RF) classifier model, incorporating 5-fold cross-validation to validate the RF model while optimizing the model's hyperparameters. Final performance metrics were calculated following the application of the model that had the best fit to the held-out test set.

Results

CHCs with a high burden of COVID-19 had an average of 65.3 patients diagnosed with COVID-19 per 1000 patients in 2020. Our RF model had 80.9% accuracy, 80.1% precision, 25.0% sensitivity, and 98.1% specificity. The percentage of Hispanic patients served in 2020 was the most important feature for predicting whether CHCs had high COVID-19 burden.

Conclusions

Findings from our RF model suggest patient population race and ethnicity characteristics were most important for predicting whether CHCs had a high burden of patients diagnosed with COVID-19 in 2020, though sensitivity was low. Enhanced support for CHCs serving large Hispanic patient populations may have an impact on addressing future COVID-19 waves.
Complication Rates Are Similar Between Patients Aged <50 and >50 Years in Calcaneus Fractures Treated With the Sinus Tarsi Approach
Authors: Reed Logan A. , Mihas Alexander , Andrews Nicholas A. , Agarwal Abhinav , Wall Kevin C. , Spitler Clay A. , Johnson Michael D.
Published: August 2022

Background:

The sinus tarsi (ST) approach for calcaneus fractures has gained popularity in recent years with an increased interest in shifting to less invasive approaches for calcaneal fracture fixation allowing for adequate fixation if complications do not arise. Although the ST approach has gained acceptance as standard for calcaneus fracture fixation, the literature surrounding early complications rates based on age differences for this specific approach and pathology is lacking. The objective of this study was to determine if rates of complications based on age varied for patients undergoing open reduction and internal fixation (ORIF) of closed calcaneus fractures using the ST approach.

Methods:

A retrospective review of patients undergoing ORIF for closed calcaneus fractures from 2012 to 2020 was performed. Inclusion criteria were based on an age greater than 18 years, surgical management of a closed calcaneus fracture using a ST approach, requirement of a preoperative computed tomographic scan, and a minimum of 180 days’ follow-up. Patients were divided into 2 groups: those aged <50 years and those aged >50 years.

Results:

A total of 196 fractures were included with 114 fractures in the <50-year age group and 82 fractures in the >50-year age group. Mean age was 34.2 and 59.7 years in the younger and older groups, respectively. The older group had similar rates of wound dehiscence (1.2% vs 4.4%, P = .204), superficial surgical site infection (1.2% vs 2.6%, P = .490), deep infection (9.8% vs 7.9%, P = .648), and nonunion (4.9% vs 3.5%, P = .633) compared with the younger group. Rates of 30-day readmission, unplanned reoperation, and symptomatic hardware were not significantly different. Postoperative Bohler and Gissane angles were not significantly different between both groups.

Conclusion:

Older patients with intraarticular calcaneus fractures treated via the ST approach maintain complication rates similar to those in younger individuals.

Level of Evidence:

Level III, retrospective study.
Initial Impact of the COVID-19 Pandemic on a US Orthopaedic Foot and Ankle Clinic
Authors: Mehta Nabil , Hur Edward S. , Michalski Joseph , Fitch Ashlyn A. , Sayari Arash J. , Bohl Daniel D. , Holmes George B.
Published: August 2022

Background:

In the United States, the COVID-19 pandemic led to a nationwide quarantine that forced individuals to adjust their daily activities, potentially impacting the burden of foot and ankle disease. The purpose of this study was to compare diagnoses made in an orthopaedic foot and ankle clinic during the shelter-in-place period of the COVID-19 pandemic to diagnoses made during the same months of the previous year.

Methods:

A retrospective review of new patients presenting to the clinics of 4 fellowship-trained orthopaedic foot and ankle surgeons in a major United States city was performed. Patients in the COVID-19 group presented between March 22 and July 1, 2020, during the peak of the quarantine for this city. Patients in the control group presented during the same period of 2019. Final diagnosis, chronicity of symptoms (acute: ≤1 month), and mechanism of disease were compared between groups.

Results:

A total of 1409 new patient visits were reviewed with 449 visits in the COVID-19 group and 960 visits in the control group. The COVID-19 group had a significantly higher proportion of ankle fractures (8.7% vs 5.4%, P = .020) and stress fractures (4.2% vs 2.2%, P = .031), but a smaller proportion of Achilles tendon ruptures (0.7% vs 2.5%, P = .019). The COVID-19 group had a higher proportion of acute injuries (35.4% vs 23.5%, P < .001).

Conclusion:

There was a shift in prevalence of pathology seen in the foot and ankle clinic during the COVID-19 pandemic, which may reflect the adoption of different activities during the quarantine period and reluctance to present for evaluation of non-urgent injuries.

Level of Evidence:

Level III, retrospective cohort study.
Is ecology anti-urban? Urban ideas and imaginaries across one hundred years of ecological publications
Authors: Flaminio Silvia , Cavin Joëlle Salomon , Moretti Marco
Published: August 2022

This paper investigates urban imaginaries conveyed in publications in ecology over the past century. We examine some urban ecologists’ view that urban areas have been disregarded by ecology due to negative views on cities and urbanisation. Inspired by previous work on imaginaries in social and cultural geography and political ecology, and by textual data analysis methods, we adopted a methodological framework that applies both quantitative and qualitative methods in the analysis of a corpus of 960 articles (published 1922–2018) drawn from 10 long-standing international journals in ecology. Our hypothesis is that ecology has embraced an anti-urban imaginary that is manifested in urban invisibility as well as the recurrent expression of negative ideas about cities (constituting an ‘anti-urban bias’). Our results partially confirm this hypothesis. We show that until the 1970s only a few papers were published on cities. We identify nine main themes relating to cities around which ideas about cities have been constructed (threats, pests, refuges, fragmentation, gradients, pollution, homogenisation, planetary urbanisation, and planning) and show how these ideas have been mobilised in the articles since the 1920s. We discuss the way in which these evolving ideas reflect a move from an essentially anti-urban imaginary to a more complex and ambivalent one. This shift coincides with the rise of the idea of planetary urbanisation in ecological publications, increasing recommendations regarding urban planning, and more generally, growing conceptual debates on the ecological impact of cities.
Physical Spaces for Campus Sexual Violence Prevention: A Conceptual Model
Authors: McMahon Sarah , Banyard Victoria L. , Peterson N. Andrew , Cusano Julia , Brown Qiana L. , Farmer Antoinette Y.
Published: August 2022

As a part of socio-ecological approaches to campus sexual violence prevention, there is a call for greater attention to the role of the environment. Despite this, physical space, an aspect of the built environment, is understudied. There is a lack of models for the ways physical space can help facilitate prevention efforts on campus. Disciplines such as criminology have put forth theories such as crime prevention through environmental design, which offer a foundation for application to college campuses but which require modification. The current model draws from reviews of research, theory, and critiques of work on the prevention and the physical environment to present a strengths-centered, social justice–based model for campuses to incorporate the consideration of physical spaces into sexual violence prevention planning.
It’s Just the Fact It’s Against Us: The Role of Social Determinants of Health in Young Children’s Caregivers’ Preventive Health Behaviors
Authors: Fleary Sasha A. , Joseph Patrece L. , Dimaano Pauline B. , Dougherty Ailish
Published: August 2022

Persistent racial-, ethnic-, and income-related disparities in health outcomes for children suggest that there is still much to do to develop interventions that are responsive to communities’ needs. Cultural health capital, the health-related attitudes, beliefs, and behaviors needed to engage in a healthy lifestyle, is acquired throughout childhood and informs adult preventive health behaviors (PHBs). However, primary caregivers’ social determinants of health (SDH) dictate the opportunities they have for building children’s cultural health capital. Given that targeted, responsive interventions and policies to promote PHB in young children are needed, the purpose of this study was to explore how caregivers with varying SDH define preventive health and what affects their engagement in PHBs for themselves and their children. Six focus groups with primary caregivers of young children ( N = 37, 89% female, mean age = ∼37.9 years old, ∼36% White) were conducted at community organizations. Data were analyzed using a deductive approach, and emergent themes were categorized by types of SDH (downstream, upstream, or both) within each focus group. Focus groups were categorized into three clusters based on participants’ SDH and access to resources: high-resource, low-income/moderate-resource, and low-income/low-resource. Caregivers’ definitions of preventive health were rooted in upstream and downstream determinants and differed by cluster. All clusters identified money and access to resources as barriers to engaging in PHBs and acknowledged that structural inequity impacted access to resources. Policies, programs, and structural change to address systemic barriers and mistrust in systems are vital to reduce disparities in health outcomes for children.