bluuebunny/crossref_metadata_2025 huggingface dataset:
From data mining to wisdom mining
Authors: Khan Salma , Shaheen Muhammad
Published: July 2021

The knowledge gained from data mining is highly dependent on the experience of an expert for further analysis to increase effectiveness and wise decision-making. This mined knowledge requires actionability enhancement before it can be applied to real-world problems. The literature highlights the reasons that emerged the need to incorporate human wisdom in decision-making for complex problems. To solve this problem, a domain called ‘Wisdom Mining’ is recommended, proposing a set of algorithms parallel to the algorithms proposed by the data mining. In wisdom mining, a process to extract wisdom needs to be defined with less influence from an expert. This review proposed improvements to data mining techniques and their applications in the real world and emphasised the need to seek ways to harness wisdom from data. This study covers the diverse definitions and different perspectives of wisdom within philosophy, psychology, management and computer science. This comprehensive literature review served as a foundation for constructing a wise decision framework that aided in identifying the wisdom factors like context, utility, location and time. The inclusion of these wisdom factors in existing data mining algorithms makes the transition from data mining to wisdom mining possible. This research includes the relationship between these two mining process that facilitated further elucidation of the wisdom mining process. Potential research trends in the domain are also seen as a potential endeavour to improve the analysis and use of data.
Air leak with COVID-19 – A meta-summary
Authors: Nasa Prashant , Juneja Deven , Jain Ravi
Published: July 2021

Introduction

There are various reports of air leaks with coronavirus disease 2019 (COVID-19). We undertook a systematic review of all published case reports and series to analyse the types of air leaks in COVID-19 and their outcomes.

Methods

The literature search from PubMed, Science Direct, and Google Scholar databases was performed from the start of the pandemic till 31 March 2021. The inclusion criteria were case reports or series on (1) laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, (2) with the individual patient details, and (3) reported diagnosis of one or more air leak syndrome (pneumothorax, subcutaneous emphysema, pneumomediastinum, pneumoperitoneum, pneumopericardium).

Results

A total of 105 studies with 188 patients were included in the final analysis. The median age was 56.02 (SD 15.53) years, 80% males, 11% had previous respiratory disease, and 8% were smokers. Severe or critical COVID-19 was present in 50.6% of the patients. Pneumothorax (68%) was the most common type of air leak. Most patients (56.7%) required intervention with lower mortality (29.1% vs. 44.1%, p = 0.07) and intercostal drain (95.9%) was the preferred interventional management. More than half of the patients developed air leak on spontaneous breathing. The mortality was significantly higher in patients who developed air leak with positive pressure ventilation (49%, p < 0.001) and required escalation of respiratory support (39%, p = 0.006).

Conclusion

Air leak in COVID-19 can occur spontaneously without positive pressure ventilation, higher transpulmonary pressures, and other risk factors like previous respiratory disease or smoking. The mortality is significantly higher if associated with positive pressure ventilation and escalation of respiratory support.
Occupational Challenges in Physicians with Substance Use Disorder: A Qualitative Study
Authors: Shadakshari Darshan , Muliyala Krishna Prasad , Jayarajan Deepak , Kandasamy Arun
Published: July 2021

Background:

Substance use disorders (SUDs) in physicians impact their professional responsibilities toward patients. Understanding the difficulties of physicians with SUDs would facilitate early identification and reduce the complications they face in various domains, particularly in settings where there are no physician-health care programs. In this background, we aimed to understand the challenges physicians with SUDs face at their workplace.

Methods:

Qualitative in-depth interviews of 21 physicians receiving treatment from a tertiary care addiction medicine center for their SUD were conducted and, based on the transcripts from the interview after coding and recoding, through inductive content analysis, themes and subthemes were identified.

Results:

The following occupational challenges were identified: direct consequences of the psychoactive effect of the substance, adverse effects on clinical care and service delivery, impairment in regularity and punctuality, changes in the physicians’ behaviors, changes in the work environment and diverse responses of colleagues and the hospital administration toward substance use-related actions, ethical issues at workplace, and effects on career growth.

Conclusions:

SUDs in physicians have a significant impact on their functioning at work, affecting patient care, interpersonal relationships as well as career growth. Knowledge of occupational challenges among physicians with SUD will help us in understanding the severity of the problem.
Ethical Issues in Dementia Research
Authors: Chandra Mina , Harbishettar Vijay , Sawhney Harbandna , Amanullah Shabbir
Published: July 2021

Dementia is a global public health issue with an urgent need for developing newer and more effective treatment strategies. Research in the area of dementia, however, poses unique ethical and legal challenges. Epidemiological studies, studies on pharmacological and non-pharmacological interventions have to deal with obtaining consent from persons with cognitive impairments, those from diverse cultural groups and need to contend with privacy and confidentiality issues. The caregiver support intervention research has not yet translated into policy change and effective clinical care. Biomedical research that involves invasive procedures may not translate into short- or long-term therapeutic benefits but is necessary research. Palliative care research in dementia has to deal with ethical issues involving people at end-of-life research. Proposed research may not receive approval, citing necessary safeguards to the vulnerable older people against invasive studies even when it is least invasive. This article aims to review the ethical aspects for safeguarding vulnerable older people with dementia and the potential challenges in conducting dementia research from a researcher’s perspective.

Some of the safeguards for ethical research include determining capacity to consent, obtaining advanced directives in early stages and proxy consent from caregivers, obtaining informed consent in cognitively impaired individuals. Future research policies need to consider the logistics of involving older people in research, enhancing caregiver support, and encouraging supportive decision-making. It will also need to address developing capacity assessment tools while addressing advanced care planning that will ensure the well-being of subjects in research.

Background:

Dementia has become a global public health issue, with hospitalization rates being 65% higher in seniors with dementia than others. 1 , 2 The pressures on healthcare systems mean an urgent need to develop robust preventive and treatment strategies for dementia, which requires multidisciplinary research. However, the patient’s stage of illness and ability to engage in discussions around the merits of participating in research and caregiver concerns is an important aspect of dementia research. Hence, dementia research poses unique ethical challenges compared to populations with other diseases, which has led to the evolution of an ethical framework for dementia research. This article aims to review and give a viewpoint on the ethical aspects for safeguarding vulnerable older people with dementia and the potential challenges in conducting dementia research from a researcher’s perspective.
Deep-learning-based attenuation correction in dynamic [15O]H2O studies using PET/MRI in healthy volunteers
Authors: Puig Oriol , Henriksen Otto M , Andersen Flemming L , Lindberg Ulrich , Højgaard Liselotte , Law Ian , Ladefoged Claes N
Published: July 2021

Quantitative [15O]H2O positron emission tomography (PET) is the accepted reference method for regional cerebral blood flow (rCBF) quantification. To perform reliable quantitative [15O]H2O-PET studies in PET/MRI scanners, MRI-based attenuation-correction (MRAC) is required. Our aim was to compare two MRAC methods (RESOLUTE and DeepUTE) based on ultrashort echo-time with computed tomography-based reference standard AC (CTAC) in dynamic and static [15O]H2O-PET. We compared rCBF from quantitative perfusion maps and activity concentration distribution from static images between AC methods in 25 resting [15O]H2O-PET scans from 14 healthy men at whole-brain, regions of interest and voxel-wise levels. Average whole-brain CBF was 39.9 ± 6.0, 39.0 ± 5.8 and 40.0 ± 5.6 ml/100 g/min for CTAC, RESOLUTE and DeepUTE corrected studies respectively. RESOLUTE underestimated whole-brain CBF by 2.1 ± 1.50% and rCBF in all regions of interest (range −2.4%– −1%) compared to CTAC. DeepUTE showed significant rCBF overestimation only in the occipital lobe (0.6 ± 1.1%). Both MRAC methods showed excellent correlation on rCBF and activity concentration with CTAC, with slopes of linear regression lines between 0.97 and 1.01 and R2 over 0.99. In conclusion, RESOLUTE and DeepUTE provide AC information comparable to CTAC in dynamic [15O]H2O-PET but RESOLUTE is associated with a small but systematic underestimation.
Correlation of 18F-FDG PET/CT SUVmax with clinical features, D-dimer and LDH in patients with primary intestinal lymphoma
Authors: Zhou Shuo , Chen Wenxin , Lin Meifu , Chen Guobao , Chen Cailong , Huo Chong , Du Xueming
Published: July 2021

Objective

To investigate the characteristics of fluorine-18-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake value (SUVmax) in primary intestinal lymphoma (PIL) and its correlation with D-dimer and lactate dehydrogenase (LDH).

Methods

Fifty-two patients diagnosed with PIL from June 2016 to December 2019 were analyzed. All patients underwent 18F-FDG PET/CT. The relationships between SUVmax and different pathological subtypes, clinical stages and risk grades were analyzed. The correlations between SUVmax and Ki-67, LDH and D-dimer were determined. Additionally, PET/CT imaging results were collected from 35 patients with primary intestinal cancer (PIC) and compared with the imaging features of PIL.

Results

SUVmax was significantly different between PIL and PIC groups and various PIL pathological subgroups. Patients in the high-risk PIL group had markedly higher SUVmax values than the intermediate-risk and low-risk groups. A significant positive correlation was observed between SUVmax and Ki-67 in patients with PIL. SUVmax was significantly different between the elevated and normal D-dimer groups. D-dimer showed a positive correlation with SUVmax.

Conclusion

18F-FDG PET/CT SUVmax reflects the aggressiveness of lymphoma to a certain degree, is correlated with Ki-67 and determines the risk grades of PIL. Moreover, it facilitates differential diagnosis, clinical staging and treatment based on D-dimer levels.
The relationship between extracurricular music activity participation and music and Chinese language academic achievements of primary school students in China
Authors: Guo Hui , Yuan Wen , Fung C Victor , Chen Fumei , Li Yanfang
Published: July 2021

In this study, we explored the relationship between extracurricular (formal and informal) music activity participation and music and Chinese language academic achievements of primary school students in China. Fourth graders ( N = 10,958) reported their demographic information and extracurricular music activity participation, and completed two standardized academic achievement tests, one on music and another on the Chinese language. Results showed that students’ music activity participation was related to higher music academic achievement after controlling for gender, school location, and family socioeconomic status. The effect of students’ informal music activity participation on their music academic achievements was greater than that of students’ formal music activity participation. Remarkably, students’ informal music activity participation was also positively related to their Chinese language academic achievement, while formal music activity participation showed a negative correlation with academic achievement in Chinese language. Findings contributed to an increased understanding of the influence of different kinds of extracurricular music activities on students’ academic developments.
Freeway Network Travel Time Reliability Analysis Methodology and Software Tool Development
Authors: Sun Wei , Washburn Scott S.
Published: July 2021

Applications in the field often require analysis of freeway travel time reliability (TTR) at the network level. While micro-simulation is suitable for performing network-level analysis, the computational burden can become unreasonable when TTR analysis is factored in. As for macro-simulation, most network analysis studies often use simplified link performance functions to represent the travel time and flow relationship. Such functions are not generally sensitive to the range of geometric and traffic conditions that can influence freeway facility operations. This research extends the Highway Capacity Manual (HCM) freeway TTR analysis methodology to the network level. The proposed freeway network TTR analysis methodology generates scenarios that represent the impacts of origin–destination (OD) demand variations, weather events, incident events, and work zone events on freeway network travel time. For each scenario, the methodology performs user equilibrium (UE) traffic assignment and the HCM freeway facility core methodology is applied to represent the travel time and flow relationship. The method of successive average approach is applied to solve the UE traffic assignment. Finally, scenario travel times (and/or other performance measures) are aggregated into various distributions of interest, such as the network-, facility-, and OD-level distributions, and TTR performance measures are calculated at the three different levels. A software tool is developed using C# language on the .NET Framework. The software tool provides a convenient and efficient approach for transportation planners and researchers to conduct the freeway network TTR analysis, which helps to bridge the gap between research and practice.
Examination of Sleep and Obesity in Children and Adolescents in the United States
Authors: Chehal Puneet Kaur , Shafer Livvy , Cunningham Solveig Argeseanu
Published: July 2021

Purpose:

This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US.

Design:

Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children’s Health.

Setting:

US, national.

Subjects:

Children ages 10-17 years (n = 34,640)

Measures:

Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts.

Analysis:

Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics.

Results:

An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time.

Conclusion:

Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.
“A Bowl of Vegetables With Someone You Love”: Faith, Health and Workplace Well-Being
Authors: Terry Paul E.
Published: July 2021

Worksite health and well-being initiatives will ideally be integrated with employers’ efforts to address diversity, equity and inclusion issues. Social Determinants of Health (SDOH) include race, class, community health, income and other variables that companies can play a role in ameliorating. As much as spirituality is commonly espoused as a component of a holistic approach to health promotion, making space to discuss faith and health remains an uncommon strategy in the workplace wellness movement. Recognizing the value on investment (VOI) in wellness has eclipsed a return on investment as a driver of an employer’s well-being strategy. This editorial argues that making space for learning about faith and health will intersect in vital ways with anti-racism work, diversity programs and similar efforts to eliminate health inequities, address SDOH and bolster the VOI of worksite well-being initiatives. A fictional dialogue between executives is used to review these issues and related literature.
Hospital complications among older adults: Better processes could reduce the risk of delirium
Authors: Moura Junior Valdery , Westover M Brandon , Li Feng , Kimchi Eyal , Kennedy Maura , Benson Nicole M , Moura Lidia Maria , Hsu John
Published: July 2021

Using observational data and variation in hospital admissions across days of the week, we examined the association between ED boarding time and development of delirium within 72 hours of admission among patients aged 65+ years admitted to an inpatient neurology ward. We exploited a natural experiment created by potentially exogenous variation in boarding time across days of the week because of competition for the neurology floor beds. Using proportional hazard models adjusting for socio-demographic and clinical characteristics in a propensity score, we examined the time to delirium onset among 858 patients: 2/3 were admitted for stroke, with the remaining admitted for another acute neurologic event. Among all patients, 81.2% had at least one delirium risk factor in addition to age. All eligible patients received delirium prevention protocols upon admission to the floor and received at least one delirium screening event. While the clinical and social-demographic characteristics of admitted patients were comparable across days of the week, patients with ED arrival on Sunday or Tuesday were more likely to have had delayed floor admission (waiting time greater than 13 hours) and delirium (adjusted HR = 1.54, 95%CI:1.37–1.75). Delayed initiation of delirium prevention protocol appeared to be associated with greater risk of delirium within the initial 72 hours of a hospital admission.
Parabolic Life: Toward an Ethics of God’s Apocalypse
Authors: Ziegler Philip G.
Published: July 2021

Christian ethicist Nancy Duff has suggested that an apocalyptic hearing of the gospel elicits a parabolic understanding of the Christian moral life. How might the theological basis and rationale of this claim be elaborated? What is it about human life funded by the gospel of God’s apocalypse in Jesus Christ that makes ‘parable’ an apt description of the quality of its action? And how might these notions be elaborated to enrich our understanding of responsible moral action more generally? This article explores these questions by way of a running conversation with the work of J. Louis Martyn, Christopher Morse and Paul Ricoeur. It concludes by showing the salience of these themes in relation to Bonhoeffer’s later reflections upon the distinctive quality of Christian life in the wreckage of Christendom. Overall, the solid currency of a parabolic construal of the character of Christian moral action for the present pursuit of theological ethics is recommended.
Shift quality optimization control of power shift transmission based on particle swarm optimization–genetic algorithm
Authors: Xia Guang , Chen Jianshan , Tang Xiwen , Zhao Linfeng , Sun Baoqun
Published: July 2021

A clutch control strategy is proposed to improve the shift quality of power shift transmission and solve the power cycle phenomenon in the shifting process. The strategy effectively avoids the power cycle phenomenon by analyzing the change in the transmission torque and the relationship between the rotating speed of the driving and driven disks of a shifting clutch. The evaluation indexes of the shift quality of power shift transmission are sliding friction power loss, impact degree, and torque oscillation amplitude. Particle swarm optimization (PSO), combined with a genetic algorithm, is used to optimize the shift quality of power shift transmission, solving the problem in which basic PSO frequently converges to the local optimal solution. Simulations and experiments are performed on the optimization results. The simulation and test results show that the proposed control strategy can ensure that the rotating speed of the driving disk is always higher than that of the driven disk when the clutch is insliding and wearing states. Thus, this control strategy effectively avoids power cycle when shifting and improves shift quality.
Machining of B1914 nickel-based superalloy using wire electrical discharge machining
Authors: Mouralova Katerina , Polzer Ales , Benes Libor , Bednar Josef , Zahradnicek Radim , Prokes Tomas , Fiala Zdenek , Fries Jiri
Published: July 2021

The unconventional technology of wire electrical discharge machining is a key engineering technology, designed primarily for machining of conventionally difficult machine materials. One of them is nickel alloys, which are majorly used in the aerospace and energy industries. The subject of research in this study was specifically the B1914 nickel-based superalloy, which was subjected to many analyses leading to an overall optimization of its machining using wire electrical discharge machining. In order to determine the effect of machine parameters setup (pulse off time, gap voltage, discharge current, pulse on time and wire feed) on cutting speed, topography, morphology, surface and subsurface layer quality, an extensive Box–Behnken design experiment consisting of 46 rounds was carried out. The analyses of the condition of the surface and subsurface layers were performed, including their chemical composition and changes caused by wire electrical discharge machining. It was found out that the factors like pulse off time, discharge current and pulse on time have the greatest effect on the cutting speed, although from the point of view of surface topography the parameter pulse off time is not significant. The remaining two parameters cause the cutting speed to act against the surface topography i.e. with the increasing cutting speed, the surface topography gets worse and vice versa.
The New Baloch Militancy: Drivers and Dynamics
Authors: Wani Shakoor Ahmad
Published: July 2021

Since the early 2000, Balochistan is yet again embroiled in a cobweb of violence after a hiatus of more than two decades. The Baloch nationalist militancy began to reinvigorate after the seizure of power by General Pervez Musharraf in 1999. Musharraf marginalised the moderate Baloch nationalists and repressed dissident voices. The differences over power and resource sharing escalated quickly into a full-blown armed struggle once Musharraf used indiscriminate force to subdue opposition against his regime. This article examines the proximate and long-term structural factors that led to the resurgence of armed militancy at the turn of the twenty-first century. It analyses the new drivers and dynamics of the present conflict that make it more virulent and lend it a distinctive character.
Expert pianists’ practice perspectives: A production and listening study
Authors: Loimusalo Nina Johanna , Huovinen Erkki
Published: July 2021

The purpose of this study was to investigate how professional pianists practice music for a concert, and whether their individual cognitive orientations in such practice processes can be identified accurately from the resulting performances. In Study I, four pianists, previously found to be skilled music memorizers, practiced and performed a short piece by André Jolivet over the course of two weeks, during which their practice strategies were studied using semi-structured interviews, and analyses of practice diaries, practice activities, and eye-movement data. The results indicate that the pianists used similar basic strategies but had different cognitive orientations, here called “practice perspectives,” consistent with each individual, in that they focused on different kinds of information while practicing. These practice perspectives may be related to skills and habits in using imagery and music analysis, as well as to professional and educational background. In Study II, 34 piano teachers listened to recordings of the concert performances and evaluated them against 12 statements representing the four practice perspectives identified in Study I. The results did not support the prediction that practice perspectives would be correctly detected by listeners. Nonetheless, practice perspectives can be used to highlight potentially vast differences between the ways in which individual professional classical musicians conceptualize music and make it meaningful to themselves and others. They could be used in the context of music education to increase musicians’ knowledge of different practice strategies and the ability to develop their own preferred working methods.
Testosterone Deficiency, Long-Term Testosterone Therapy, and Inflammation
Authors: Zhang Xiao , Zhao Hongwei , Horney Jennifer , Johnson Natalie , Saad Farid , Haider Karim Sultan , Haider Ahmad , Xu Xiaohui
Published: July 2021

Objectives:

We aimed to evaluate the association of testosterone deficiency with inflammation and how long-term testosterone therapy affects inflammation biomarkers over time.

Methods:

We conducted a 2-component study. First, we conducted a cross-sectional study using the recently released 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to examine the association between testosterone deficiency and inflammation biomarkers including high sensitivity C-reactive protein (hsCRP), liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the US general population. Then we conducted a longitudinal study to investigate the longitudinal effect of testosterone therapy on inflammation biomarkers and the risk of cardiovascular events, using data from 776 hypogonadal men based on a registry study in Germany with up to 11 years’ follow-up.

Results:

The adjusted odds ratios (ORs) describing the associations between testosterone deficiency and hsCRP ≥ 3mg/L, ALT > 40U/L, and AST > 40U/L were 1.81 ( P-value < 0.001), 1.46 ( P-value = 0.009), and 0.99 ( P-value = 0.971), respectively. In the control group, CRP, ALT, and AST levels increased by 0.003 (95%CI: −0.001, 0.007) mg/L, 0.157 U/L (95%CI: 0.145, 0.170), and 0.147 (95%CI: 0.136, 0.159) U/L per month, while in the treatment group, CRP, ALT, and AST levels decreased by 0.05 (95%CI: −0.055, −0.046) mg/L, 0.142 U/L (95%CI: −0.154, −0.130), and 0.148 (95%CI: −0.158, −0.137) U/L per month.

Conclusion:

Testosterone deficiency was associated with an increased level of inflammation; long-term testosterone therapy alleviated inflammation among hypogonadal men, which may contribute to the reduced cardiovascular risk. Future large trials are warranted to confirm our observational study findings.
Membrane tension determines the geometry of donut-shaped transcellular holes
Authors: Torbati Mehdi , Agrawal Ashutosh
Published: July 2021

Bacteria and leukocytes employ donut-shaped transcellular holes in plasma membrane to cross the endothelial barrier. How these fused holes are regulated in a double-bilayer system is currently poorly understood. Here we use membrane physics to present a universal relationship that determines the geometry of the donut-shaped holes. Our study reveals that hole radius is determined by plasma membrane tension via a commonly used critical length scale [Formula: see text] defined by flexural stiffness ([Formula: see text]) and in-plane tension ([Formula: see text]). This relationship suggests that the hole diameter increases with a reduction in membrane tension, a finding aligned with the experimental observations but in contrast with the main current model in the literature.
Outcome of thoracolumbar surgical feline intervertebral disc disease
Authors: Fowler Kayla M , Pancotto Theresa E , Werre Stephen R , Beasley Michaela J , Kay William , Neary Casey P
Published: July 2021

Objectives

The aim of this study was to evaluate the outcome and prognosis of thoracolumbar feline intervertebral disc disease (IVDD) treated by surgical decompression.

Methods

This was a multi-institutional retrospective study evaluating the age, breed, sex, body weight, presenting complaint, neuroanatomic diagnosis at presentation, diagnostic imaging results, surgery performed and the overall outcome at discharge and at recheck. Bivariable associations between variables were assessed using the Kruskal–Wallis test (age and grade of IVDD at presentation) and Fisher’s exact test (grade of IVDD at presentation and outcome).

Results

A total of 35 cats met the inclusion criteria for the study. The most frequently reported clinical sign was difficulty walking (54.2%). The majority of cats presented with an L4–S3 localization (57%). The most common site of intervertebral disc herniation (IVDH) was at L6–L7 (34%). The majority of feline patients that received surgery had a positive outcome at the time of discharge (62.5%; n = 20/32) and at the time of the 2-week recheck (91.3%; n = 21/23). No association was identified between the age of the patient and the grade of IVDD. No association was identified between the presenting grade of IVDD and the clinical outcome at the time of discharge or at the time of recheck evaluation.

Conclusions and relevance

Cats undergoing spinal decompressive surgery for thoracolumbar IVDH appear to have a favorable prognosis independent of the initial presenting grade of IVDD. A larger sample size and a longer length of follow-up is necessary to obtain statistical associations between the presenting grade of IVDD and overall clinical outcome.
Free vibration analysis of three-layer thin cylindrical shell with variable thickness two-dimensional FGM middle layer under arbitrary boundary conditions
Authors: Miao Xue-Yang , Li Chao-Feng , Jiang Yu-Lin , Zhang Zi-Xuan
Published: July 2021

In this paper, a unified method is developed to analyze free vibrations of the three-layer functionally graded cylindrical shell with non-uniform thickness. The middle layer is composed of two-dimensional functionally gradient materials (2D-FGMs), whose thickness is set as a function of smooth continuity. Four sets of artificial springs are assigned at the ends of the shells to satisfy the arbitrary boundary conditions. The Sanders’ shell theory is used to obtain the strain and curvature-displacement relations. Furthermore, the Chebyshev polynomials are selected as the admissible function to improve computational efficiency, and the equation of motion is derived by the Rayleigh–Ritz method. The effects of spring stiffness, volume fraction indexes, configuration on of shell, and the change in thickness of the middle layer on the modal characteristics of the new structural shell are also analyzed.
Vulnerability, legal need and technology in England and Wales
Authors: Newman Daniel , Mant Jess , Gordon Faith
Published: July 2021

This paper explores legal need and legal advice in England and Wales during the COVID-19 pandemic. It uses the lens of vulnerability theory to examine the ways in which this crisis exposed pre-existing fragilities between the state and its relationship with the advice sector, and the individuals who experience social welfare problems. The paper commences by exploring Fineman’s vulnerability thesis and its application to those experiencing social welfare-related issues, as well as the vulnerability of the systems operating to give advice. The paper then considers the specific context of the COVID-19 pandemic and the impact on needs, and the ability of the sector to meet these needs. Drawing on policy documents, reports and three case studies from law centres in England and Wales, it discusses the concept of legal need and the realities being experienced. These case studies assist us in being able to critically consider the topics of vulnerability, changing needs and the role that technology is, and can play during the pandemic and beyond. Lastly, the paper points to the need for a critical consideration of the sustainability and format of legal advice in addressing legal need in the post-COVID-19 landscape.
How the Norwegian population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown
Authors: Mæland Silje , Bjørknes Ragnhild , Lehmann Stine , Sandal Gro Mjeldheim , Hazell William , Rabben Åsgeir Kjetland , Vedaa Øystein , Skogen Jens Christoffer , Fadnes Lars Thore
Published: July 2021

Aims

The aim of this study was to examine how the Norwegian general adult population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown. We assessed quarantine, symptoms, social distancing, home office/school, work status, social contact and health-care contact through digital access and knowledge.

Methods

A cross-sectional survey was performed of 29,535 adults (aged 18–99) in Norway after six weeks of non-pharmaceutical interventions in March/April 2020.

Results

Most participants found the non-pharmaceutical interventions to be manageable, with 20% of all adults and 30% of those aged <30 regarding them as acceptable only to some or a limited degree. Sixteen per cent had been quarantined, 6% had experienced symptoms that could be linked to COVID-19 and 84% practiced social distancing. Eleven per cent reported changes in the use of health and social services. Three-quarters (75%) of those who had mental health or physiotherapy sessions at least monthly before the pandemic reported a reduction in their use of these services. A substantial reduction was also seen for home nursing, hospital services and dentists compared to usage before the non-pharmaceutical interventions. Immigrants were more likely to experience a reduction in follow-up from psychologists and physiotherapy. With regard to the use of general practitioners, the proportions reporting an increase and a reduction were relatively equal.

Conclusions

The non-pharmaceutical interventions were perceived as manageable by the majority of the adult general population in Norway at the beginning of the COVID-19 pandemic. A substantial proportion of adults <30 years old experienced difficulties with social distancing, and those >70 years old lacked the digital tools and knowledge. Further, immigrant access to health services needs monitoring and future attention.
Integration of ophthalmology in ocular trauma to improve patient care: A narrative review
Authors: Bartimote Christopher , Fraser Clare L , Watson Stephanie
Published: July 2021

Introduction

Ocular trauma can cause significant morbidity and is a leading cause of unilateral blindness. In multi-trauma, life- and sight-threatening injuries can co-occur causing increased complexity in the assessment and management of ocular injuries as the competing priorities in the severely injured must be balanced. We conducted a narrative review to determine how ophthalmology may be further integrated into a trauma service and/or the organisation of an ocular trauma service.

Methods

The literature was reviewed via EMBASE, MEDLINE, CINAHL and Google Scholar utilising comprehensive search strategies and keyword searches. Our review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Results

The search yielded 437 articles, 30 studies met selection criteria and were included in the review. The included literature comprised guidelines, observational studies and reviews of registry data from Australia, England, the United States, Singapore, Iran and Israel.

Conclusion

The Australian Trauma Model has clear guidelines for referral of trauma patients to ensure appropriate care of the severely injured. However, there are no clear guidelines for the integration of ophthalmology into trauma. Therefore, early referral to ophthalmology and streamlining of referral pathways of specialist care would improve the care of patients with ocular trauma.
Management of isolated greater trochanteric fractures of the hip – Experience from a major trauma centre over a 24-month period
Authors: Patange Subbarao Sheethal Prasad , Manoharan Gopikanthan , Roberts Philip J
Published: July 2021

Introduction

Isolated greater trochanteric fractures (IGTfs) of the femur are uncommon. At least 10% of these fractures have an occult intertrochanteric extension. Mobilisation too early without care can lead to fracture propagation, requiring surgical fixation. There is no definite consensus in the literature on how to manage initially diagnosed IGTf with potential occult intertrochanteric extension. We reviewed the management of IGTf in our major trauma centre (MTC) and propose a management flow chart.

Methods

The electronic notes and images for all IGTf admitted under or referred to the orthopaedic team at a MTC, from June 2015 to July 2017, were reviewed. Data were collected on fracture pattern and diagnostic imaging modalities. Periprosthetic fractures were excluded.

Results

1550 neck of femur fracture patients were admitted over the 2-year period; 790 patients (51%) had a fracture around the intertrochanteric region and 49 (3.2%) were diagnosed with a IGTf on plain radiographs. 98% of patients had further imaging after initial plain film radiographs, and 58% of all IGTf were shown to have an intertrochanteric extension. Overall 16/49 patients (32.7%) needed an operation.

Conclusions

An IGTf not crossing the medullary canal into the calcar (i.e >50% of the diameter) does not require surgical fixation and can be managed with analgesia and supervised mobilisation. The 30-day mortalities in both operative and non-operative groups were similar at 2% and 2.2%, respectively. Overall mortality is half of the total neck of femur fracture population (4.1%) in our MTC. We propose a management flow chart for this patient cohort.
A novel algorithm for significantly increasing the fiber volume fraction in the reconstruction model with large fiber aspect ratio
Authors: Li Zeyang , Liu Zhao , Xue Yongbo , Zhu Ping
Published: July 2021

Geometric reconstruction is an important precondition for the computational micromechanics analysis of chopped fiber reinforced composites. When fiber aspect ratio increases, the maximum fiber volume fraction in reconstruction model reduces rapidly because of jamming limit, which greatly limits the application of reconstruction methods. A novel algorithm is proposed to significantly increase the fiber volume fraction in the reconstruction model of the chopped fiber reinforced composites with large fiber aspect ratio. The algorithm is made up of two stages. At the first stage, fibers are packed into the sublayers of initial filling space to preliminarily design fiber orientation distribution. The unidirectional arrangement of fibers is adopted to achieve high fiber volume fraction. At the second stage, a new multi-step fiber shaking strategy is used to introduce randomness into reconstruction model. The high fiber volume fraction over 30% is achieved within the wide range of fiber aspect ratio from 50 to 200 while the results of the existing methods are not more than 10%, showing the remarkable increase of the fiber volume fraction under large fiber aspect ratio. The proposed algorithm is verified by the statistical results of the four representative microstructural characteristics from reconstruction model and realistic material.
Art-Contemplation: A Tool for Spiritual Care in the Pediatric Department?
Authors: Topper Elizabeth D.
Published: July 2021

Facilitated contemplation of artwork has been found to be a valuable tool in the spiritual care encounter with adult patients. No reports were found on art-contemplation as a tool in the spiritual care of the pediatric population. This article is a preliminary report of facilitated art-contemplation as a portal to spiritual care encounters with hospitalized children and adolescents, their families and the staff. A series of such encounters is presented, and future direction discussed.
Explainable artificial intelligence for education and training
Authors: Fiok Krzysztof , Farahani Farzad V , Karwowski Waldemar , Ahram Tareq
Published: July 2021

Researchers and software users benefit from the rapid growth of artificial intelligence (AI) to an unprecedented extent in various domains where automated intelligent action is required. However, as they continue to engage with AI, they also begin to understand the limitations and risks associated with ceding control and decision-making to not always transparent artificial computer agents. Understanding of “what is happening in the black box” becomes feasible with explainable AI (XAI) methods designed to mitigate these risks and introduce trust into human-AI interactions. Our study reviews the essential capabilities, limitations, and desiderata of XAI tools developed over recent years and reviews the history of XAI and AI in education (AIED). We present different approaches to AI and XAI from the viewpoint of researchers focused on AIED in comparison with researchers focused on AI and machine learning (ML). We conclude that both groups of interest desire increased efforts to obtain improved XAI tools; however, these groups formulate different target user groups and expectations regarding XAI features and provide different examples of possible achievements. We summarize these viewpoints and provide guidelines for scientists looking to incorporate XAI into their own work.
‘The end begins’: Law (Nomos) and Nature (Physis) as Genre: For Peter Fitzpatrick: In Memoriam
Authors: Motha Stewart
Published: July 2021

This essay reflects on Peter Fitzpatrick’s treatment of modern law as a problem of genre. It draws inspiration from his reading of Jacques Derrida’s “Law of Genre” to suggest the urgent need to unsettle the distinction between law and nature ( nomos and physis).
Mate‐pair sequencing identifies a cryptic BMPR2 mutation in hereditary pulmonary arterial hypertension
Authors: Chalmers Sarah J. , Murphy Stephen J. , Thompson Laura L. , Hoppman Nicole L. , Smadbeck James B. , Balcom Jessica R. , Harris Faye R. , Frantz Robert P. , Vasmatzis George , E. Wylam Mark
Published: July 2021

Current guidelines suggest screening all patients with idiopathic pulmonary arterial hypertension for genetic aberrations, particularly mutations in Bone Morphogenic Protein Receptor Type II (BMPR2), the gene most commonly implicated in the pathogenesis of PAH. Herein, we present a novel technique used to identify a pathogenic germline BMPR2 alteration in a 36‐year‐old female and family members with hereditary pulmonary arterial hypertension who each screened negative by standard cytogenetics and molecular genetics testing.
Impella flow pump reinsertion after axillary graft thrombectomy: Technical points in replacing axillary Impella
Authors: Haddad Osama , Jacob Samuel , Ung Ryan L , Goswami Rohan M , Patel Parag C , Pham Si M , Sareyyupoglu Basar
Published: July 2021

Axillary Impella devices are increasingly employed for long-term support of patients with systolic heart failure and shock. Axillary access allows for awake support and ambulation, which carries an inherent risk of disconnection or malposition. We report a series of two cases where device replacement due to dysfunction and malposition can be completed safely through the original axillary graft using axillary graft thrombectomy, given that the clot burden could be a major source of morbidity to the patient.
COVID-19 Restrictions Presented Opportunities and Challenges for Plastic Surgery Residents
Authors: Zaidman Maya , Al-Shaqsi Sultan , Yeung Celine , Novak Christine B. , Dengler Jana
Published: July 2021

Background:

Restrictions placed during the COVID-19 pandemic to prevent viral spread led to substantial changes in surgical resident education. The aim of this study was to assess the positive and negative impact of COVID-19 on plastic surgery education and training and provide recommendations for continued competency.

Methods:

A cross-sectional online survey of plastic surgery residents across Canada was used to evaluate the impact of COVID-19 on clinical exposure, experience with virtual education, and long-term impact of COVID-19 on surgical training.

Results:

This study included 61 plastic surgery residents (40% participation rate). Common educational modalities used during COVID-19 included online seminars (95%) and workshops (58%). Teaching sessions were effective if structured around patient cases (72%), recorded (66%), and limited to 1 hour (64%). There were mixed reactions towards online education sessions; residents reported feeling grateful (54%), motivated (38%), enthusiastic (28%), overwhelmed (41%), pressured to participate (23%), and anxious (13%). There were significantly less residents who felt that their clinical exposure was sufficient during (21%) versus before (72%) pandemic restrictions ( P < .001). Overall, 87% of residents felt that the pandemic had a negative impact on their training, surgical skill development, fellowship plans, and job prospects.

Conclusions:

During the initial wave of COVID-19, residents faced altered educational opportunities, which elicited positive and negative emotions with concern regarding surgical skill development and impact on future career plans. Characterizing early educational impact on residency training to identify opportunities for change is worthwhile as the overall effect of the pandemic is ongoing and remains uncertain.
Freedom of Movement: Studying Women’s Mobility in North India
Authors: Mehta Vidisha , Sai Harish
Published: July 2021

‘Freedom of movement’ is an integral component of women’s empowerment. However, according to the National Family Health Survey–4 (2015–2016), only 41 per cent of women in India enjoy complete mobility. This article examines women’s mobility as a function of factors within the household—specifically a woman’s relation to the household head—and its physical location, particularly whether it is located within a rural or an urban area. Using Bayesian inference techniques, we find that daughters-in-law are the least mobile, while spouses are the most. Additionally, we find that women are the most mobile when visiting the market and least mobile when visiting relatives. We also find that women from urban areas are more mobile than those in rural areas. The study goes on to enumerate the value of being able to move without any restrictions on employment. We establish that mobility is positively correlated with work. The article contributes to the limited research on urban women’s mobility and agency and how it varies with household practices and spatial location.