bluuebunny/crossref_metadata_2025 huggingface dataset:
Action Imagery and Observation in Neurorehabilitation for Parkinson’s Disease (ACTION-PD): Development of a User-Informed Home Training Intervention to Improve Functional Hand Movements
Authors: Bek Judith , Holmes Paul S. , Craig Chesney E. , Franklin Zoë C. , Sullivan Matthew , Webb Jordan , Crawford Trevor J. , Vogt Stefan , Gowen Emma , Poliakoff Ellen
Published: July 2021

Background. Parkinson’s disease (PD) causes difficulties with hand movements, which few studies have addressed therapeutically. Training with action observation (AO) and motor imagery (MI) improves performance in healthy individuals, particularly when the techniques are applied simultaneously (AO + MI). Both AO and MI have shown promising effects in people with PD, but previous studies have only used these separately. Objective. This article describes the development and pilot testing of an intervention combining AO + MI and physical practice to improve functional manual actions in people with PD. Methods. The home-based intervention, delivered using a tablet computer app, was iteratively designed by an interdisciplinary team, including people with PD, and further developed through focus groups and initial field testing. Preliminary data on feasibility were obtained via a six-week pilot randomised controlled trial (ISRCTN 11184024) of 10 participants with mild to moderate PD (6 intervention; 4 treatment as usual). Usage and adherence data were recorded during training, and semistructured interviews were conducted with participants. Exploratory outcome measures included dexterity and timed action performance. Results. Usage and qualitative data provided preliminary evidence of acceptability and usability. Exploratory outcomes also suggested that subjective and objective performance of manual actions should be tested in a larger trial. The importance of personalisation, choice, and motivation was highlighted, as well as the need to facilitate engagement in motor imagery. Conclusions. The results indicate that a larger RCT is warranted, and the findings also have broader relevance for the feasibility and development of AO + MI interventions for PD and other conditions.
An Exploratory Investigation into the Roles of Critical Care Response Teams in End-of-Life Care
Authors: Kwong Adrienne , Chenail Stephanie , Sarti Aimee , Thompson Laura H. , Nguyen Marlena Dang , Kyeremanteng Kwadwo , Hartwick Michael
Published: July 2021

Background. Critical Care Response Teams (CCRTs) represent an important interface between end-of-life care (EOLC) and critical care medicine (CCM). The aim of this study was to explore the roles and interactions of CCRTs in the provision of EOLC from the perspective of CCRT members. Methods. Twelve registered nurses (RNs) and four respiratory therapists (RTs) took part in focus groups, and one-on-one interviews were conducted with six critical care physicians. Thematic coding using a modified constructivist grounded theory approach was used to identify emerging themes through an iterative process involving a four-member coding team. Results. Three main perspectives were identified that spoke to CCRT interactions and perceptions of EOLC encounters. CCRT members felt that they provide a unique skill set of multidisciplinary expertise in treating critically ill patients and evaluating the utility of intensive care treatments. However, despite feeling that they possessed the skills and resources to deliver quality EOLC, CCRT members were ambivalent with respect to whether EOLC was a part of their mandate. Challenges were also identified that impacted the ability of CCRTs to deliver quality EOLC. Conclusions. This research aids in understanding for the first time CCRT roles in EOLC from the perspectives of individual CCRT members themselves. While CCRTs provide unique multidisciplinary expertise to evaluate the utility of intensive care treatments, opportunities exist to support CCRTs in EOLC, such as dedicated EOLC training, protocols for advance care planning, documentation, and transitions to palliative care.
A Polylobar Nucleus Identifying and Extracting Method for Leukocyte Counting
Authors: Chen Jin , Cao Yiping , Gao Jie , An Haihua
Published: July 2021

Accurate counting of leukocytes is an important method for diagnosing human blood diseases. Because most nuclei of neutrophils and eosinophils are polylobar, it is easily confused with the unilobar nuclei in nucleus segmentation. Therefore, it is very essential to accurately identify and determine the polylobar leukocytes. In this paper, a polylobar nucleus identification and extracting method is proposed. Firstly, by using the Otsu threshold and area threshold method, the nuclei of leukocytes are accurately segmented. According to the morphological characteristics of polylobar leukocytes, the edges of the mitotic polylobar leukocytes are detected, and the numbers of polylobar leukocytes are determined according to the minimal distance rule. Therefore, the accurate counting of leukocytes can be realized. From the experimental results, we can see that using the Otsu method and the area threshold to segment the polylobar nuclear leukocytes, the segmentation ratio of the leukocyte nucleus reached 98.3%. After using the morphological features, the polylobar nuclear leukocytes can be accurately counted. The experimental results have verified the feasibility and practicability of the proposed method.
Forensic Analysis of Social Networking Applications on an Android Smartphone
Authors: Menahil Anoshia , Iqbal Waseem , Iftikhar Mohsin , Shahid Waleed Bin , Mansoor Khwaja , Rubab Saddaf
Published: July 2021

Smartphone users spend a substantial amount of time in browsing, emailing, and messaging through different social networking apps. The use of social networking apps on smartphones has become a dominating part of daily lives. This momentous usage has also resulted in a huge spike in cybercrimes such as social harassing, abusive messages, vicious threats, broadcasting of suicidal actions, and live coverage of violent attacks. Many of such crimes are carried out through social networking apps; therefore, the forensic analysis of allegedly involved digital devices in crime scenes and social apps installed on them can be helpful in resolving criminal investigations. This research is aimed at performing forensic investigation of five social networking apps, i.e., Instagram, LINE, Whisper, WeChat, and Wickr on Android smart phones. The essential motivation behind the examination and tests is to find whether the data resides within the internal storage of the device or not after using these social networking apps. Data extraction and analysis are carried out using three tools, i.e., Magnet AXIOM, XRY, and Autopsy. From the results of these experiments, a considerable amount of essential data was successfully extracted from the examined smartphone. This useful data can easily be recovered by forensic analysts for future examination of any crime situation. Finally, we analyzed the tools on the basis of their ability to extract digital evidences from the device and their performance are examined with respect to NIST standards.
Efficacy of Neoadjuvant Chemotherapy DOX and XELOX Regimens for Patients with Resectable Gastric or Gastroesophageal Junction Adenocarcinoma
Authors: Tian Yuan , Zhao Qun , Li Yong , Fan Liqiao , Zhang Zhidong , Zhao Xuefeng , Tan Bibo , Wang Dong , Yang Peigang
Published: July 2021

Purpose. This paper is aimed at comparing the short-term efficacy of the combination of docetaxel, oxaliplatin, and capecitabine (DOX) with the combination of oxaliplatin and capecitabine (XELOX) as neoadjuvant chemotherapy regimens for the treatment of patients with resectable gastric or gastroesophageal junction adenocarcinoma. Methods. A total of 300 patients aged 20-60 years with resectable gastric or gastroesophageal junction adenocarcinoma who were evaluated with cT3/4Nany were randomly assigned into 3 groups: DOX group (

n
=
100

, treated with neoadjuvant DOX plus adjuvant XELOX), XELOX group (

n
=
100

, treated with perioperative XELOX), and surgery group (

n
=
100

, treated with adjuvant XELOX). Results. A total of 93, 92, and 95 patients were enrolled in the DOX, XELOX, and surgery groups, respectively. The pathological complete response (pCR) rate was 16.1% in the DOX group and 4.3% in the XELOX group (

P
=
0.008

). There were 56 (61.3%) patients in the DOX group who presented with surgical complications, 22 (23.9%) patients in the XELOX group, and 37 (38.9%) patients in the surgery group. The most common grade 3-4 adverse events in these three groups were neutropenia (32.3%, 30.4%, and 21.1%), leucopenia (21.5%, 22.8%, and 15.8%), nausea (15.1%, 16.3%, and 12.6%), and fatigue (10.8%, 7.6%, and 8.4%). Conclusions. Neoadjuvant DOX is an effective and feasible regimen and might represent an option for young and middle-aged patients with locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma.
5G Edge Computing Enabled Directional Data Collection for Medical Community Electronic Health Records
Authors: Yan Xiaoqiang , Ren Xiaogang
Published: July 2021

It is important to promote the development and application of hospital information system, community health service system, etc. However, it is difficult to realize the intercommunication between various information systems because it is not enough to realize the in-depth management of health information. To address these issues, we design the 5G edge computing-assisted architecture for medical community. Then, we formulate the directional data collection (DDC) problem to gather the EMR/HER data from the medical community to minimize the service error under the deadline constraint of data collection deadline. Moreover, we design the data direction prediction algorithm (DDPA) to predict the data collection direction and propose the data collection planning algorithm (DCPA) to minimize the data collecting time cost. Through the numerical simulation experiments, we demonstrate that our proposed algorithms can decrease the total time cost by 62.48% and improve the data quality by 36.47% through the designed system, respectively.
The Use of CytoSorb Therapy in Critically Ill COVID-19 Patients: Review of the Rationale and Current Clinical Experiences
Authors: Ruiz-Rodríguez Juan Carlos , Molnar Zsolt , Deliargyris Efthymios N. , Ferrer Ricard
Published: July 2021

The COVID-19 pandemic has led to the biggest global health crisis of our lifetime. There is accumulating evidence that a substantial number of critically ill COVID-19 patients exhibit a dysregulated host response manifesting as cytokine storm or cytokine release syndrome, which in turn contributes to the high observed rates of mortality. Just as in other hyperinflammatory conditions, extracorporeal cytokine removal may have potential beneficial effects in this subgroup of COVID-19 patients. The CytoSorb blood purification device is the most extensively investigated cytokine removal platform with considerable evidence suggesting that early intervention can provide rapid hemodynamic stabilization and improvement in vital organ functions. The purpose of this review is to provide an overview of the pathophysiological background of hyperinflammation in COVID-19 and to summarize the currently available evidence on the effects of hemoadsorption in these patients.
Variable Speed Limit Control Method of Freeway Mainline in Intelligent Connected Environment
Authors: Wang Xingju , Zhang Rongqun , Gou Yang , Liu Jiayu , Zhao Lin , Li Yanting
Published: July 2021

Freeway is an important component of transportation system. Bottleneck areas on freeway reduce driving safety and traffic efficiency. The development of intelligent connected technology provides a new idea for traffic management. In order to alleviate traffic congestion on the freeway bottleneck area, this paper proposes a variable speed limit (VSL) control method in intelligent connected environment. In this paper, the METANET model is improved by combining intelligent connected environment and VSL control theory. The total traffic capacity (TTC), total travel time (TTT), and total speed difference (TSD) are used to build multiobjective function. The microsimulation at SUMO by using the data from PeMS is employed as a case study to validate the proposed model. The results show that the VSL online control method in intelligent connected environment has better control effect. And the improvement is more obvious with increasing penetration rate of intelligent connected vehicle (ICV).
A Fusion Crossover Mutation Sparrow Search Algorithm
Authors: Tang Yanqiang , Li Chenghai , Li Song , Cao Bo , Chen Chen
Published: July 2021

Aiming at the inherent problems of swarm intelligence algorithm, such as falling into local extremum in early stage and low precision in later stage, this paper proposes an improved sparrow search algorithm (ISSA). Firstly, we introduce the idea of flight behavior in the bird swarm algorithm into SSA to keep the diversity of the population and reduce the probability of falling into local optimum; Secondly, we creatively introduce the idea of crossover and mutation in genetic algorithm into SSA to get better next-generation population. These two improvements not only keep the diversity of the population at all times but also make up for the defect that the sparrow search algorithm is easy to fall into local optimum at the end of the iteration. The optimization ability of the improved SSA is greatly improved.
Secure Patient Authentication Framework in the Healthcare System Using Wireless Medical Sensor Networks
Authors: Jan Saeed Ullah , Ali Sikandar , Abbasi Irshad Ahmed , Mosleh Mogeeb A. A. , Alsanad Ahmed , Khattak Hizbullah
Published: July 2021

Biosensor is a means to transmit some physical phenomena, like body temperature, pulse, respiratory rate, electroencephalogram (EEG), electrocardiogram (ECG), and blood pressure. Such transmission is performed via Wireless Medical Sensor Network (WMSN) while diagnosing patients remotely through Internet-of-Medical-Things (IoMT). The sensitive data transmitted through WMSN from IoMT over an insecure channel is vulnerable to several threats and needs proper attention to be secured from adversaries. In contrast to addressing the security of all associated entities involving patient monitoring in the healthcare system or ensuring the integrity, authorization, and nonrepudiation of information over the communication line, no one can guarantee its security without a robust authentication protocol. Therefore, we have proposed a lightweight and robust authentication scheme for the network-enabled healthcare devices (IoMT) that mitigate all the identified weaknesses posed in the recent literature. The proposed protocol’s security has been analyzed formally using BAN logic and ProVerif2.02 and informally using pragmatic illustration. Simultaneously, at the end of the paper, the performance analysis result shows a delicate balance of security with performance that is often missing in the current protocols.
TargetingEGFRExon 20 Insertions in Non–Small Cell Lung Cancer: Recent Advances and Clinical Updates
Authors: Meador Catherine B. , Sequist Lecia V. , Piotrowska Zofia
Published: July 2021

Approximately 10% of EGFR-activating mutations occur as in-frame insertion mutations in exon 20 of the EGFR kinase domain (EGFR ins20). EGFR ins20 mutations have not demonstrated the same sensitivity to early generations of EGFR tyrosine kinase inhibitors (TKI) as canonical activating EGFR mutations such as del19 and L858R. Development of effective therapies for this subset of patients has been challenging, but recent years have seen more rapid progress in these efforts. In this review, we describe the molecular and clinicopathologic features of EGFR ins20 mutations and summarize recent data on emerging therapies for patients with this subtype of EGFR-mutant non–small cell lung cancer (NSCLC).

Significance:

When activating mutations in EGFR were first discovered in lung cancer, the lack of sensitivity of tumors harboring EGFR ins20 mutations to early-generation EGFR TKIs resulted in this subset of EGFR-mutant tumors being initially classified as an untargetable or intrinsically resistant subpopulation. In addition, the diversity of mutations within EGFR exon 20 and resultant challenges identifying them on routine clinical genotyping tests led to underestimation of their frequency. However, recent scientific progress in targeting EGFR ins20 mutations as well as more effective identification of this clinical cohort has enhanced our ability to develop effective therapies for patients with this subtype of EGFR-mutant NSCLC.
Endobronchial Valve (Zephyr) Treatment in Homogeneous Emphysema: One-Year Results from the IMPACT Randomized Clinical Trial
Authors: Eberhardt Ralf , Slebos Dirk-Jan , Herth Felix J.F. , Darwiche Kaid , Wagner Manfred , Ficker Joachim H. , Petermann Christoph , Hübner Ralf-Harto , Stanzel Franz , Shargill Narinder S. , Valipour Arschang ,   for the IMPACT Study Team
Published: July 2021

Rationale: The long-term safety and effectiveness of bronchoscopic lung volume reduction with Zephyr endobronchial valves in subjects with severe homogeneous emphysema with little to no collateral ventilation beyond 3 months have yet to be established. Methods: Ninety-three subjects were randomized to either bronchoscopic lung volume reduction with Zephyr valves or standard of care (SoC) (1:1). Zephyr valve subjects were assessed at 3, 6, and 12 months. SoC subjects were assessed at 3 and 6 months; they were then offered crossover to Zephyr valve treatment. Results: The mean group difference (Zephyr valve – SoC) for change in FEV1 from baseline to 6 months was 16.3 ± 22.1% (mean ± SD; p < 0.001). Secondary outcomes showed the mean between-group difference for the six-minute walk distance of +28.3 ± 55.3 m (p = 0.016); St. George’s Respiratory Questionnaire, −7.51 ± 9.56 points (p < 0.001); modified Medical Research Council, −0.42 ± 0.81 points (p = 0.019); BODE index, −0.85 ± 1.39 points (p = 0.006); and residual volume of −430 ± 830 mL (p = 0.011) in favor of the Zephyr valve group. At 6 months, there were significantly more responders based on the minimal clinically important difference for these same measures in the Zephyr valve versus the SoC group. The clinical benefits were persistent at 12 months. The percentage of subjects with respiratory serious adverse events was higher in the Zephyr valve group compared to SoC during the first 30 days post-procedure but not statistically different for the Zephyr valve and SoC groups from 31 days to 6 months, and stable in the Zephyr valve group out to 12 months. There were 2 deaths in the SoC group in the 31-day to 6-month period and none in the Zephyr valve group out to 12 months. Conclusions: Bronchoscopic lung volume reduction with Zephyr valves in subjects with severe homogeneous emphysema and little to no collateral ventilation provides clinically meaningful change from baseline in lung function, quality of life, exercise capacity, dyspnea, and the BODE index at 6 months, with benefits maintained out to 12 months.
Skills and practices of pharmacy staff for dispensing of drugs with fiscalized substances in drugstores and pharmacies
Authors: Ceballos Mauricio , Llano Yaqueline , Salazar-Ospina Andrea , Madrigal-Cadavid Juliana , Pino-Marín Daniel , Amariles Pedro
Published: July 2021

OBJETIVE To evaluate the skills and practices of pharmacy staff during the dispensing of tramadol (drug with fiscalized substance) in drugstores and pharmacies in Medellin, Colombia. METHODS A cross-sectional study was performed. The simulated patient technique was used. The main outcomes included the information provided on the dispensed drug (tramadol), the use of tools to provide information, and the information provided on drug precautions and use recommendations. RESULTS We visited 305 drugstores and pharmacies. The average dispensing time was 2.3 min (SD 1.1 min). In nine drugstores and pharmacies (3.0%), tramadol was not dispensed because it was not in stock. In 17 drugstores and pharmacies (5.7%), the simulated patients were actively informed by the dispensing pharmacy staff; of these, 16 provided oral information and one provided oral and written information. Eight patients (2.7%) received information regarding tramadol use. However, 99% of patients were not informed about tramadol side effects such as dependence, sedation, or hypnosis, and none of the simulated female patients were informed on the precautions related to tramadol use during pregnancy or lactation. CONCLUSIONS Communication skills and appropriate practices of pharmacy staff are critical to patient self-care. However, this study shows their difficulty in counseling about precautions and use recommendations of drugs with fiscalized substances. These outcomes could inform future studies focusing on the rational use of these drugs in drugstores and pharmacies. It is necessary to improve the pharmacy staff competencies through continuing education programs, to facilitate access to information and training.
Left and Right Arcuate Fasciculi Are Uniquely Related to Word Reading Skills in Chinese-English Bilingual Children
Authors: Gao Yue , Meng Xiangzhi , Bai Zilin , Liu Xin , Zhang Manli , Li Hehui , Ding Guosheng , Liu Li , Booth James R.
Published: July 2021

Whether reading in different writing systems recruits language-unique or language-universal neural processes is a long-standing debate. Many studies have shown the left arcuate fasciculus (AF) to be involved in phonological and reading processes. In contrast, little is known about the role of the right AF in reading, but some have suggested that it may play a role in visual spatial aspects of reading or the prosodic components of language. The right AF may be more important for reading in Chinese due to its logographic and tonal properties, but this hypothesis has yet to be tested. We recruited a group of Chinese-English bilingual children (8.2 to 12.0 years old) to explore the common and unique relation of reading skill in English and Chinese to fractional anisotropy (FA) in the bilateral AF. We found that both English and Chinese reading skills were positively correlated with FA in the rostral part of the left AF-direct segment. Additionally, English reading skill was positively correlated with FA in the caudal part of the left AF-direct segment, which was also positively correlated with phonological awareness. In contrast, Chinese reading skill was positively correlated with FA in certain segments of the right AF, which was positively correlated with visual spatial ability, but not tone discrimination ability. Our results suggest that there are language universal substrates of reading across languages, but that certain left AF nodes support phonological mechanisms important for reading in English, whereas certain right AF nodes support visual spatial mechanisms important for reading in Chinese.
Sir 34:30 and Forensic Rhetoric in Augustine’s Conflict with the Donatists
Authors: Ployd Adam
Published: July 2021

The book of Sirach plays a larger part within Augustine’s theology than has hitherto been appreciated. This article helps fill this lacuna by examining the role of Sir 34:30 – “What does the bath profit one who is baptized by a dead man?” – in Augustine’s conflict with the Donatists. In addition to showing the significance of this verse within the conflict, I further argue that it allows us to espy the forensic rhetoric that shapes much of Augustine’s anti-Donatist polemic. In particular, I point to techniques of inventio that provide not merely stylistic but also argumentative forms and approaches that Augustine deploys on several fronts.
Reading (?) Vives in Sixteenth-Century Russia
Authors: Akopyan Ovanes
Published: July 2021

This article provides an annotated edition, along with an English translation, of a relatively neglected sixteenth-century Russian text claimed to be a response to Juan Luis Vives’s renowned commentary on Augustine’s De civitate Dei. The Words against Juan Luis Vives was composed by Maximus the Greek, who was a central figure in Russian culture during the first half of the sixteenth century. As this article demonstrates, Maximus’ text serves as a revealing summary of what constituted the negative attitude towards Renaissance thought at the Muscovite court. This article also investigates the grounds on which Maximus based his critical remarks; there is a strong argument to assume that Maximus had never, in fact, read Vives’s commentary on Augustine.
Evaluation of Global Wave Probabilities Consistent with Official Forecasts
Authors: Sampson Charles R. , Serra Efren A. , Knaff John A. , Cossuth Joshua H.
Published: July 2021

The U.S. Navy is keenly interested in analyses and predictions of waves at sea due to their effects on important tasks such as shipping, base preparedness and disaster relief. U.S. Tropical Cyclone (TC) Forecast Centers routinely disseminate wind probabilities consistent with official TC forecasts worldwide, but do not do the same for wave forecasts. These probabilities are especially important at longer leads where TC forecast accuracy diminishes. This work describes global wave probabilities consistent with both the official TC forecasts and their wind probabilities. Real-time runs for 84 TCs between May 2018 and March 2019, with probabilities generated for 12-ft and 18-ft significant wave heights are used to calculate verification statistics. This results in 347, 319, 261, 214, 155, and 112 verification cases at lead times of 1, 2, 3, 4, and 5 days where each verification case consists of a 20x20 degree latitude longitude grid around the verifying TC position. When compared with wave probabilities generated solely by a global numerical weather prediction model, the wind probability-based algorithm demonstrates improved consistency with official forecasts and provides additional benefits. Those benefits include an improved capability to discriminate between 12-ft and 18-ft significant wave events and non-events. The verification statistics also shows that the wind probability-based algorithm has a consistent high bias. How these biases can be reduced in future efforts is also discussed.
Occupational Therapists as Social Change Agents: Exploring Factors that Influence Their Actions
Authors: Picotin Jessica , Beaudoin Michaël , Hélie Sandrine , Martin Ann-Élisabeth , Carrier Annie
Published: July 2021

Background.

When acting effectively in their social change agent (SCA) role, occupational therapists can impact population health and occupational justice. However, empirical evidence of the influence of personal and environmental factors on their ability to act as SCAs is scarce.

Purpose.

To explore personal and environmental factors that influence the ability of occupational therapists to act as effective SCAs.

Method.

We conducted a descriptive interpretive qualitative study with 18 Québec occupational therapists recognized as successful SCAs. We collected data through semi-structured interviews with three focus groups and analyzed them thematically using a lexicon.

Findings.

We identified nine cross-cutting personal factors, including discovery, effective communication, and planning, that enable occupational therapists to act as successful SCAs. Six thematic groups of environmental factors facilitated or hindered their actions.

Implications.

To act effectively as SCAs, occupational therapists need to consider personal and environmental factors involved in their change project.
Neuromuscular Training and Motor Control in Youth Athletes: A Meta-Analysis
Authors: Williams Mark David , Ramirez-Campillo Rodrigo , Chaabene Helmi , Moran Jason
Published: July 2021

Our purpose in this review was to determine the effects of bodyweight-only neuromuscular training (NMT) programs on motor control of movement among youth athletes. We searched three electronic databases (CrossRef, Google Scholar, and PubMed), using the following inclusion criteria for selecting research studies: (a) healthy male and female participants aged 8-18 years who were engaged in organized sports; (b) interventions up to 16-weeks duration; (c) incorporation of a control group; and (d) interventions that utilized only exercises using participants’ body mass. We calculated pooled estimates of effect sizes (standardized mean difference) for changes in motor control across nine studies (12 comparisons) using the inverse-variance random effects model for meta-analyses and 95% confidence intervals. Among the nine studies included in our meta-analysis, there was a moderate, significant effect in favor of neuromuscular training programs (0.79 [95% CI: 0.38, 1.20], Z = 3.76 [ p = 0.0002]) on motor control. Heterogeneity was high and significant ( I2= 77% [ p = 0.00001]). Moderator analyses for age and stature revealed NMT programs to be more effective in younger, shorter, and lighter individuals. We found larger effect sizes in males, and for programs >8 weeks in duration. We concluded that the older and heavier an individual is, the less effective bodyweight-only NMT programs became, particularly for female participants. These results reinforce the notion that exercise to enhance motor control should be emphasized during pre-adolescence.
Estimating the Economic Impact of Tourism in the European Union: Review and Computation
Authors: Figini Paolo , Patuelli Roberto
Published: July 2021

The article investigates the economic contribution of tourism to the GDP. We review background methodologies, systematically collect data for EU countries, and develop a sound and ready-to-use procedure for computing indirect and total economic impacts. The routine is then applied to selected destinations for which a minimum standard in the quality of data from Tourism Satellite Accounts and Input–Output tables is met. Methodologically, the article provides a tool for estimating the total contribution of tourism to output, gross value added, and employment. Empirically, the comparison of results across EU economies shows a high degree of heterogeneity in the tourism share to GDP, which is critically discussed. Our procedure delivers a key tool to researchers, industry leaders, and policy makers willing to investigate income and employment consequences of scenarios differing in the evolution of tourism demand, something of high relevance in the COVID-19 era.
Incremental Validity of the Multidimensional Personality Questionnaire in the Preemployment Assessment of Police Officer Candidates
Authors: Sellbom Martin , Corey David M. , Ben-Porath Yossef S.
Published: July 2021

Guidelines for screening public safety personnel candidates, including law enforcement positions, incorporate the use of separate psychological tests for assessing normal and abnormal functioning. We evaluated the incremental validity of the Multidimensional Personality Questionnaire (MPQ)—a measure of normal personality traits—beyond the Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI-2-RF), a measure of psychopathology, using a sample of 1,687 candidates for law enforcement positions. They were clinically rated on 10 psychological suitability dimensions. For a subset of those who were subsequently hired as police officers ( n = 397), we also had post-hire outcome data. Using hierarchical nonlinear regression analyses, we found that the MPQ scales incremented the MMPI-2-RF scales in the prediction of 17 of 19 variables in this study. Our results indicate that the MPQ, as a measure of normal personality, provides unique information about psychological suitability and predicts negative post-hire outcomes in police candidates.
Inquiry-based environments for bio-signal processing training in engineering education
Authors: Adorno Dominique Persano
Published: July 2021

Active student engagement, teaching via experience in real-life settings and learning by doing, are pedagogical strategies appropriate to improve student-reasoning skills. By building models, performing investigations, examining and explaining experimental results, using theoretical and computational thinking, constructing representations, undergraduates can acquire a deeper understanding of fundamental disciplinary concepts while reinforcing transversal abilities. In this framework, Engineering courses should be designed with the final objective to develop practical skills, focusing on hands-on activities. This contribution presents two different inquiry-based learning environments recently experienced at the University of Palermo in the context of bioelectronic and biomedical Engineering. The first study describes a laboratory activity about digital ophthalmologic signal classification; the second laboratory focuses on the analysis of the prefrontal cortex activation during a memory task using functional Near InfraRed Spectroscopy (fNIRS). We introduce and discuss the learning workshops, with the research objective of improving current instruction and training in Engineering courses. Indeed, this contribution aims to suggest a conceptual framework in the form of a structured elective suite of modules tailored to meet the needs of Engineering graduates. The outcomes of both studies seem to highlight that self-directed learning activities could enhance students’ enthusiasm to learn and engagement in engineering investigations, contributing to improve the achievements of students and acquire a more effective learning approach.
Pay Factor Analysis for Highway Pavements through Percentage of Material within Specification Limits and Monte Carlo Simulation
Authors: Zhao Yunpeng , Goulias Dimitrios
Published: July 2021

Many state highway agencies (SHAs) have adopted pay adjustment provisions in their acceptance plans for construction and materials. In these payment adjustment acceptance plans, the percentage of material within specification limits (PWL) has been selected as the quality measure to relate production quality to pay factors, and pay equations are used to determine a pay factor for a lot based on PWL. Various pay equations have been proposed by the highway community for adoption in SHAs’ specifications. However, the effectiveness of these pay equations has not been fully evaluated. Another issue concerning the pay adjustment acceptance plans is the risk associated with single and multiple pay factors. The purpose of this study was to evaluate the effects of different pay equations commonly used by SHAs and the risks associated with pay adjustment acceptance plans. This was achieved by developing operating characteristic curves associated with various pay factors and expected pay curves and Monte Carlo simulation for assessing the effects in the long run. The methodology suggested in this paper is transferable elsewhere where similar materials and specifications are used for the acceptance of pavements.
“It’s like dying but not being dead” U.S. newspaper journalists cope with emotional and physical toll of job losses
Authors: Reinardy Scott , Zion Lawrie , Baines Annalise
Published: July 2021

Since 2008, U.S. newspaper jobs have been cut 51%, forcing journalists to seek new jobs and possibly careers. This study examined how journalists who lost their newspaper jobs (N = 306) navigated the emotional and physical toll of unemployment and adjusted to new work norms. Furthermore, this article examined how displaced journalists managed after returning to the workforce. Implications here might be indicators of what to expect for those who lost their jobs during the COVID-19 pandemic.
Prospective Clinical Trial Comparing IV Esmolol to IV Metoprolol in CT Coronary Angiography: Effect on Hemodynamic, Technical Parameters and Cost
Authors: Vimala Leena Robinson , Eifer Diego Andre , Karimzad Yasser , Paul Narinder S.
Published: July 2021

Background:

Intravenous [IV] esmolol, an alternative to IV metoprolol for coronary computed tomography angiography [CCTA], has shorter half-life that decreases the risk of prolonged hypotension. The primary aim was to prospectively compare IV esmolol alone to IV metoprolol alone for effectiveness in achieving heart rate [HR] of 60 beats per minute[bpm] during CCTA. The secondary aim was to compare hemodynamic response, image quality, radiation dose and cost.

Materials and Methods:

Institutional Review Board approved prospective randomized study of 28 CCTA patients medicated in a 1:1 blinded match with IV esmolol or IV metoprolol to achieve HR of 60 bpm. Serial hemodynamic response was measured at 6 specified times. Two cardiac radiologists independently scored the image quality.

Results:

Both IV esmolol and IV metoprolol achieved the target HR. IV esmolol resulted in significantly less profound and shorter duration of reduction in systolic blood pressure [BP] than IV metoprolol with a difference of -10, -14 and -9 mm Hg compared to -20, -26 and -25 mmHg at 2, 15 & 30 min respectively. No significant difference in HR at image acquisition, exposure window, radiation dose and image quality. Although IV esmolol was expensive, the overall cost of care was comparable to IV metoprolol due to shortened post CCTA observation period consequent to faster restoration of hemodynamic status.

Conclusion:

Comparison of IV esmolol and IV metoprolol demonstrate that both are effective in achieving the target HR but significantly faster recovery of HR and BP in patients who receive IV esmolol was found.
How Ready Are Young Adults to Participate in Community Service? An Application of the Transtheoretical Model of Behavior Change
Authors: Fenn Natalie , Reyes Cheyenne , Monahan Kathleen , Robbins Mark L.
Published: July 2021

Purpose:

Engaging in community service, or unpaid work intended to help people in a community, is generally associated with greater overall well-being. However, the process of beginning and maintaining community service engagement has been sparsely examined. The current study applied the Transtheoretical Model (TTM) of behavior change to understanding community service readiness among young adults.

Design:

Cross-sectional design using an online survey.

Setting:

Participants were undergraduate students recruited at a mid-sized Northeastern US university in Spring 2018.

Sample:

Participants ( N = 314) had a mean age of 20.36 years ( SD = 3.69), were primarily White (78%), female (72%), and from moderately high socioeconomic backgrounds (as measured by parental level of education).

Measures:

Socio-demographics including age, gender, race-ethnicity, and parental level of education; readiness, pros, cons, and self-efficacy for community service; civic engagement behavior; well-being.

Analysis:

Participants were classified into very low ( n = 62), low ( n = 59), moderate ( n = 92), high ( n = 46), and very high ( n = 55) readiness for community service groupings. A MANOVA was conducted to assess relationships between groupings and community service TTM constructs, civic engagement, and well-being.

Results:

There were significant differences between readiness groupings on all main outcome variables, F(20, 1012) = 10.34, p < .001; Wilks’ Λ = 0.54, η2 = .14. Post-hoc Games-Howell tests showed that those exhibiting higher levels of readiness reported fewer cons, greater pros, higher self-efficacy, more overall civic engagement, and greater well-being compared to lower readiness individuals.

Conclusion:

Consistent with previous TTM applications, self-efficacy and the importance of pros increased across readiness groupings while the importance of cons decreased. Study findings may be used to inform readiness-tailored interventional work for increasing community service. This area of study would benefit from longitudinal research examining community service readiness beyond the college environment.
Exploring Library Core Competencies: A Text Mining Study of American Library Association’s Job Advertisements From 2006 Through 2017
Authors: Yang Qinghong , Shi Zehong , Liu Yan Quan
Published: July 2021

Are core competency requirements for relevant positions in the library shifting? Applying natural language processing techniques to understand the current market demand for core competencies, this study explores job advertisements issued by the American Library Association (ALA) from 2006 to 2017. Research reveals that the job demand continues to rise at a rate of 13% (2006–2017) and that the requirements for work experience are substantially extended, diversity of job titles becomes prevalent, and rich service experience and continuous lifelong learning skills are becoming more and more predominant for librarians. This analytical investigation informs the emerging demands in the American job market debriefing the prioritization and reprioritization of the current core competency requirements for ALA librarians.
Feasibility of implementing a same-day electronic screening tool for clinical assessment to measure patient-reported outcomes for eliciting actionable information on adherence to HIV medication and related factors in a busy Canadian urban HIV clinic
Authors: Suri Shivali , Yoong Deborah , Short Duncan , Tan Darrell HS , Naccarato Mark , Crane Heidi M , Musten Alexandra , Fredericksen Rob J , Lober William B , Gough Kevin
Published: July 2021

Background: An optimal adherence to antiretroviral therapy (ART) is fundamental for suppression of HIV viral load and favourable treatment outcomes. Patient-reported outcomes (PROs) are effective tools for improving patient–provider communication and focusing providers’ awareness on current health problems. The objectives of this analysis were (1) to determine the feasibility of implementing an electronic screening tool to measure PROs in a Canadian HIV clinic to obtain information on ART adherence and related factors and (2) to determine the factors related to sub-optimal adherence. Methods: This implementation research with a convenience sample of 600 people living with HIV (PLWH) was conducted in a busy, academic, urban HIV clinic in Toronto, Canada. PLWH were approached to participate in PRO assessments just prior to their in-clinic appointments, including health-related domains such as mental health, housing, nutrition, financial stress and medication adherence, and responses were summarized on a single sheet available for providers to review. Feasibility of implementing PROs was assessed by quantifying response rate, completion rate, time taken and participation rate. Medication adherence was elicited by self-report of the percentage of prescribed HIV medications taken in the last month. Unadjusted and adjusted odds ratios were estimated from logistic regression models to identify factors associated with adherence of <95%. Results: Of the 748 PLWH invited to participate, 692 (participation rate: 92.5%) completed the PRO assessments as standard of care in clinic. Of these, 600 consented to the use of their PRO results for research and were included in this analysis. The average response rate to the ART-related questions was 96.8% and mean completion rate was 95.5%. The median time taken to complete the assessment was 12.0 (IQR = 8.4–17.3) min, adjusted 8.7 (IQR = 7.2–10.8) min. 445 (74.9%) of participants were male, and 153 (26.2%) reported dissatisfaction with ART. 105 (19.7%) of the PLWH reported ART adherence of <95%. Multivariable logistic regression identified the following risk factors for sub-optimal adherence: dissatisfaction with ART (OR = 2.30, 95% CI 1.38–3.83), not having a family doctor or not visiting a family doctor in last year (OR = 1.69, 95% CI 1.02–2.79). Conclusion: Collecting self-reported health information from PLWH through PROs in a busy urban clinic was feasible and can provide relevant information to healthcare providers on issues related to adherence. This has a potential to help in individualizing ambulatory care.
Maintaining subjectivity under coercion: Former patients’ experiences of being transformed into an object in psychiatric care
Authors: Sørås Emilie , Snipstad Øyvind Ibrahim Marøy
Published: July 2021

Coercion in psychiatric care may cause long-term negative effects such as trauma, reluctance to seek later treatment, as well as erosion of self-confidence and trust in one’s own feelings and thoughts. Based on data from a previous study and the theoretical framework developed by Hans Skjervheim, this article discusses how experiences with coercion may appear as a result of how the patients are approached and defined when involuntarily admitted. If patients admitted to involuntary psychiatric care are treated as objects they might respond by objectifying the professionals back or succumbing to the descriptions of themselves as sick. The latter may ultimately cause them to question their own sanity. In light of this, this paper argues that there is a need for an ongoing ethical discussion on how to find common ground between patients and health care workers, where both are viewed as subjects with knowledge and opinions worthy of respect.
Identification of bacteria in the tracheal swabs of farmed ostriches and their effect on the viability of influenza A virus
Authors: Abolnik Celia , Strydom Christine , Landman Debbie , Pieterse Reneé
Published: July 2021

Avian influenza surveillance is a requirement for commercial trade in ostrich products, but influenza A viruses (IAVs) have proven difficult to isolate from ostrich tracheal swabs that test positive using molecular methods. We hypothesized that microbes unique to the ostrich trachea propagate in the transport medium after sampling and affect viral viability. We cultured tracheal swabs from 50 ostriches on 4 farms in South Africa, and recovered and identified 13 bacterial, 1 yeast, and 2 fungal species. Dietzia sp. had not been identified previously in the oropharyngeal tract of a bird, to our knowledge. The bacteria were tested for antimicrobial susceptibility, and most aerobic species, except for Streptococcus sp. and Pseudomonas sp., were sensitive to enrofloxacin; all were susceptible to sulfonamide. Virus inhibition experiments determined that ostrich-source Streptococcus sp., Pantoea sp., and Citrobacter freundii produced extracellular metabolites that caused a substantial reduction in the IAV titers of 99.9%. Streptomyces, Corynebacterium, Staphylococcus, Arthrobacter gandavensis, Pseudomonas putida, and Acinetobacter spp. similarly reduced the viability of IAV from 77.6% to 24.1%. Dietzia appeared to have no effect, but Rothia dentocariosa, Rhodotorula spp., and Clostridium spp. slightly increased the viability of IAV by 25.9, 34.9, and 58.5%, respectively.
Effectiveness, Durability, and Safety of Dolutegravir and Lamivudine Versus Dolutegravir, Lamivudine, and Abacavir in a Real-Life Cohort of HIV-Infected Adults
Authors: Mendoza Inés , Lázaro Alicia , Torralba Miguel
Published: July 2021

Background:

Dolutegravir (DTG) plus lamivudine (2-DR) is suggested as an initial and switch option in HIV-1 treatment.

Objective:

To analyze the effectiveness, durability, and safety of 2-DR compared with DTG plus abacavir/lamivudine (3-DR).

Methods:

This was an observational, ambispective study that included all treatment-naïve (TN) and treatment-experienced (TE) patients who started 2-DR or 3-DR between July 1, 2018, and November 30, 2020. The primary end point was noninferiority, at 24 and 48 weeks, of 2-DR versus 3-DR regarding the percentage of patients with viral load (VL)≥50 and 200 copies/mL in TN (4% margin) and VL<50 and 200 copies/mL in TE (margin 12%). Durability of response, and safety were also measured.

Results:

242 patients were included (53 TN and 189 TE). Two TN patients on 2-DR had VL≥50 copies/mL and 1 had VL≥200 copies/mL at week 24. In TE patients on 2-DR, 90.2% achieved VL<200 copies/mL at week 24 (difference: 3.8%; 95% CI = −6.3% to 14%) and 91.8% at week 48 (difference: 0.06%; 95% CI = −9% to 10%), meeting noninferiority criteria. Among the 53 TN patients, only 1 VF was observed in 2-DR. In TN patients, the risk of treatment discontinuation was similar between groups (hazard ratio [HR] = 0.37; P = 0.15); similar rates were also found in TE patients (HR = 0.94; P = 0.85). TE patients on 2-DR showed a better safety profile compared with 3-DR patients ( P<0.001).

Conclusion and Relevance:

Our results did not show noninferiority in terms of virological effectiveness. Nevertheless, all effectiveness measures support the use of 2-DR in a real-life cohort of TN and TE. Additionally, durability and safety of 2-DR were confirmed to be similar to that of 3-DR.