bluuebunny/crossref_metadata_2025 huggingface dataset:
Atmospheric–Oceanic Processes over the Pacific Involved in the Effects of the Indian Summer Monsoon on ENSO
Authors: Lin Shuheng , Yang Song , He Shan , Fan Hanjie , Chen Jiaxin , Dong Wenjie , Wu Jiaxue , Guan Yuping
Published: May 2023

This study investigates the physical mechanisms responsible for the impacts of the Indian summer monsoon (ISM) on the evolution of El Niño–Southern Oscillation (ENSO), with a focus on understanding the monsoon-induced Pacific air–sea interactive processes. An observational analysis displays that a weaker-than-normal ISM can strengthen an ongoing El Niño event and weaken a La Niña event, and conversely for a stronger-than-normal ISM. A 1000-yr output from the Community Earth System Model version 2 is capable of reproducing this observed feature and is therefore used to explore the responsible ocean–atmosphere interactive processes involved. Results show that a weak ISM can cause a cyclonic circulation over the western North Pacific via stimulating atmospheric cold Kelvin waves, and conversely for a strong ISM. The westerly (easterly) wind anomalies on the southern flank of the anomalous cyclone (anticyclone) generate eastward (westward) current anomalies in the mixed layer and thus induce anomalous warm (cold) zonal advection. Furthermore, the wind anomalies excite oceanic downwelling (upwelling) Kelvin waves, which deepen (shoal) the thermocline in the equatorial eastern Pacific and result in anomalous warm (cold) vertical advection. A quantitative mixed layer heat budget analysis demonstrates that the influence of the monsoon-induced Pacific wind anomalies on ENSO is mainly achieved by changing the zonal advective feedback and thermocline feedback. This result is confirmed by model sensitivity experiments in which additional monsoon heating or cooling anomalies are imposed over the Indian region during the developing summer of an ENSO event.

Significance Statement

While previous studies have reported that the Indian summer monsoon (ISM) could influence the evolution of El Niño–Southern Oscillation (ENSO), this study is aimed at understanding the physical mechanisms for the Pacific air–sea interactive processes induced by the monsoon and their impact on ENSO. It is found that a weak and strong ISM can respectively induce an anomalous cyclonic and anticyclonic circulation over the western North Pacific. The wind anomalies on the southern flank of the anomalous circulation mainly change the zonal advective feedback and the thermocline feedback to affect ENSO development. This study provides a detailed physical explanation of how the ISM influences ENSO evolution.
Improving Post-procedure Outcomes With Clinical Care Pathway for Enteral Access
Authors: Miller Samuel M. , Abou-Azar Sara , Owusu Kent A. , Judson Benjamin L. , Rhodes Deborah , Morton John M.
Published: May 2023

Our health system introduced an enteral access clinical pathway (EACP) hoping to increase nutritionist consults and decrease presentation to the Emergency Department, readmission to the hospital, and overall hospital length of stay. We followed patients with short-term access (STA), longterm access (LTA), and short-long-term conversions (SLT) seen in the six months prior to the EACP launch (baseline group) and the six months after (performance group). The baseline cohort consisted of 2,553 patients and the performance cohort of 2,419 patients. Those in the performance group were more likely to receive a nutrition consult (52.4% vs 48.0%, P < .01), less likely to re-present to the ED (31.9% vs 42.6%, P < .001), and less likely to be readmitted to the hospital (31.0% vs 41.6%, P < .001. These findings suggest that the EACP may increase the likelihood of both expert-driven nutritional support and effective discharge planning for hospitalized patients.
Cost Variation in Bariatric Surgery Across the United States
Authors: Ng Ayesha P. , Bakhtiyar Syed Shahyan , Verma Arjun , Richardson Shannon , Kronen Elsa , Darbinian Khajack , Mabeza Russyan , Yetasook Amy , Benharash Peyman
Published: May 2023

Background

High costs have been cited as a barrier to utilization of bariatric surgery despite the increasing prevalence of obesity in the United States. The present work characterizes the center-level variation and risk factors for increased hospitalization costs following bariatric operations.

Study Design

The 2016-2019 Nationwide Readmissions Database was queried to identify all adults undergoing elective laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Random effects were estimated using Bayesian methodology and used to rank hospitals by increasing risk-adjusted center-level costs.

Results

Of an estimated 687,866 patients at an annual 2435 hospitals, 69.9% underwent SG and 30.1% RYGB, with median costs of $10,900 (interquartile range: 8600-14,000) and $13,600 (10,300-18,000), respectively. Hospitals in the highest tertile of annual SG and RYGB volume were associated with a $1500 (95% CI - 2,100, −800) and $3400 reduction in costs (95% CI -4,200, −2600). Approximately 37.2% (95% CI 35.8-38.6) of variation in hospitalization costs was attributable to the hospital. Hospitals in the top decile of center-level costs were associated with increased odds of developing complications (AOR 1.22, 95% CI 1.05-1.40) but not mortality.

Conclusion

The present work identified significant interhospital variation in the costs of bariatric operations. Further efforts to standardize costs may enhance the value of bariatric surgical care in the US.
Building Program Structures to Advance Vocational Research on Women
Authors: Flores Lisa Y. , Troyka Melinda , Lee Jinkoo
Published: May 2023

In this paper, we react to the systematic review of the women’s career development literature conducted by Fouad et al. in this issue. We identify a variety of structural barriers that we believe have contributed to the limited advancements of research in this area. In line with recent discussions within the profession, we highlight systemic approaches across the areas of vocational psychology teaching and training, advocacy and practice, and research that are aimed to promote future research on women and work.
(Dis)placing the foreign in early modern Europe: The example of Tasso's Gierusalemme
Authors: Tylus Jane
Published: May 2023

Torquato Tasso, Italy's foremost early modern poet, engaged with issues of otherness throughout his complicated life and career—in no small part because of his own itinerant and often marginalized status. His first try at what would eventually become his monumental Gerusalemme liberata—an unfinished poem he wrote when he was 16, called simply “Il Gierusalemme”—gives us a glimpse into an early attempt to define epic as a space for welcoming in the stranger. The stranger was as much a character for Tasso as it was a parola pellegrina or foreign word, the latter a particular obsession of Tasso's. Dedicated as he was to seeing the vernacular not as “just” Tuscan, but as capacious enough to include other dialects as well as Latin and neologisms, Tasso quickly found enemies in Florence's Accademia della Crusca, which insisted on a much purer view of the Italian tongue. By connecting Tasso's theory of hospitality to the questione della lingua as it was being fought over in late 16th-century Italy, this article argues for a capacious understanding of both this early experimental work of Tasso's, as well as his later poem.
Writing International Histories from Ordinary Places: Postcolonial Classrooms, Teachers, and Foreign Policy in Ghana, 1957–83
Authors: Prosperetti Elisa
Published: May 2023

This article examines the effects of foreign teachers on Ghanaian education during the 1960s and 1970s. It calls attention to the ways that foreign policy articulates with the lives of ordinary people in former colonies, an approach I call ‘writing international histories from ordinary places.’ At the intersection of globalized archival collections and local sources and scholarship, ‘ordinary places’ offer us new vantage points from which to approach the extraverted histories of the postcolonial world.
Nanoscale Dynamics of Streptococcal Adhesion to AGE-Modified Collagen
Authors: Leiva-Sabadini C. , Tiozzo-Lyon P. , Hidalgo-Galleguillos L. , Rivas L. , Robles A.I. , Fierro A. , Barrera N.P. , Bozec L. , Schuh C.M.A.P. , Aguayo S.
Published: May 2023

The adhesion of initial colonizers such as Streptococcus mutans to collagen is critical for dentinal and root caries progression. One of the most described pathological and aging-associated changes in collagen—including dentinal collagen—is the generation of advanced glycation end-products (AGEs) such as methylglyoxal (MGO)–derived AGEs. Despite previous reports suggesting that AGEs alter bacterial adhesion to collagen, the biophysics driving oral streptococcal attachment to MGO-modified collagen remains largely understudied. Thus, the aim of this work was to unravel the dynamics of the initial adhesion of S. mutans to type I collagen in the presence and absence of MGO-derived AGEs by employing bacterial cell force spectroscopy with atomic force microscopy (AFM). Type I collagen gels were treated with 10 mM MGO to induce AGE formation, which was characterized with microscopy and enzyme-linked immunosorbent assay. Subsequently, AFM cantilevers were functionalized with living S. mutans UA 159 or Streptococcus sanguinis SK 36 cells and probed against collagen surfaces to obtain force curves displaying bacterial attachment in real time, from which the adhesion force, number of events, Poisson analysis, and contour and rupture lengths for each individual detachment event were computed. Furthermore, in silico computer simulation docking studies between the relevant S. mutans UA 159 collagen-binding protein SpaP and collagen were computed, in the presence and absence of MGO. Overall, results showed that MGO modification increased both the number and adhesion force of single-unbinding events between S. mutans and collagen, without altering the contour or rupture lengths. Both experimental and in silico simulations suggest that this effect is due to increased specific and nonspecific forces and interactions between S. mutans UA 159 and MGO-modified collagen substrates. In summary, these results suggest that collagen alterations due to aging and glycation may play a role in early bacterial adherence to oral tissues, associated with conditions such as aging or chronic hyperglycemia, among others.
“Intersex” Does not Violate the Sex Binary
Authors: Rehman Rashad
Published: May 2023

This article supplements Julio Tuleda, Enrique Burguete, and Justo Aznar's “The Vatican opinion on gender theory” ( Linacre). It supplements their article by providing a stronger argument for the thesis that “intersex” does not violate binary sex in human beings. In their response to Timothy F. Murphy's criticism of “the Vatican's” (rightfully corrected as the Magisterium of the Catholic Church's) position on the sex binary, they argue subsidiarily that “intersex” does not violate the sex binary. However, their argument against Murphy as stated is implausible; however, I provide a much stronger argument for their conclusion that intersex does not violate the sex binary. I intend to perform this supplementation in two stages, assuming the reader's familiarity with “The Vatican opinion on gender theory.” First, I provide a broader background than Murphy's to the challenge that “intersex” conditions violate the sex binary, showing both how Murphy's criticism is unoriginal and how “intersex” both has been, and continues to be, misunderstood. Second, I problematize Tuleda’s argument, and offer the strongest argument for the conclusion that “intersex” does not violate the sex binary on purely secular/nonreligious grounds (addressing Murphy's complaint). I conclude that the Magisterium of the Catholic Church remains correct that sex is binary.

Julio Tuleda, Enrique Burguete, and Justo Aznar's “The Vatican opinion on gender theory” challenges Timothy Murphy's criticism of sex binarism as endorsed by the Catholic Church. This article strengthens their criticism by focusing on “intersex” conditions.
Development and Content Validation of the Swimming Competence Assessment Scale (SCAS): A Modified Delphi Study
Authors: Sundan Jon , Haga Monika , Lorås Håvard
Published: May 2023

The purpose of this study was to design and develop the Swimming Competence Assessment Scale (SCAS) to measure children’s aquatic skills as they align with the physical education curriculum for Norwegian primary schools. We conducted a three-round modified Delphi study involving 22 national experts in the aquatic profession. Experts reached consensus on scale items within an observation form and coding sheet based on a swimming proficiency test for measuring six aquatic skills: water entry, frontstroke swimming, surface dive, float/rest, backstroke swimming and water exit. Independent experts obtained high agreement (scale level: 88%, item level: 80–93%) on the relevance, representativeness, and clarity of the scale. Current results suggest that the SCAS is a valid instrument for researchers and practitioners to observe and record children’s aquatic proficiency for the purpose of screening and developing aquatic education.
Case Ascertainment of Sickle Cell Disease Using Surveillance or Single Administrative Database Case Definitions
Authors: Reeves Sarah L. , Horiuchi Sophia , Zhou Mei , Paulukonis Susan , Snyder Angela , Wilson-Frederick Shondelle , Hulihan Mary
Published: May 2023

Objective:

In the absence of access to surveillance system data, single-source administrative databases are often used to study health care utilization and health outcomes among people with sickle cell disease (SCD). We compared the case definitions from single-source administrative databases with a surveillance case definition to identify people with SCD.

Materials and Methods:

We used data from Sickle Cell Data Collection programs in California and Georgia (2016-2018). The surveillance case definition for SCD developed for the Sickle Cell Data Collection programs uses multiple databases, including newborn screening, discharge databases, state Medicaid programs, vital records, and clinic data. Case definitions for SCD in single-source administrative databases varied by database (Medicaid and discharge) and years of data (1, 2, and 3 years). We calculated the proportion of people meeting the surveillance case definition for SCD that was captured by each single administrative database case definition for SCD, by birth cohort, sex, and Medicaid enrollment.

Results:

In California, 7117 people met the surveillance case definition of SCD from 2016 through 2018; 48% of this group was captured by the Medicaid case definition and 41% by the discharge case definition. In Georgia, 10 448 people met the surveillance case definition of SCD from 2016 through 2018; 45% of this group was captured by the Medicaid case definition and 51% by the discharge case definition. These proportions differed by years of data, birth cohort, and length of Medicaid enrollment.

Practice Implications:

The surveillance case definition identified twice as many people with SCD as the single-source administrative database definitions during the same period, but trade-offs exist in using single administrative databases for decisions on policy and program expansion for SCD.
An Innovative Interprofessional Course in Ophthalmology and Low Vision for Occupational Therapy Students
Authors: Bell Alison , Bonafede Lucas , Lorch Arlene , Snitzer Melanie , Edmonds Scott A. , Levin Alex V.
Published: May 2023

Introduction: There is an increasing need for occupational therapists with the skills to provide low vision services, however, there is a lack of standardized training of low vision occupational therapy services. The purpose of this study is to design and evaluate a course for occupational therapy students to improve their skills and knowledge about ophthalmology and low vision. Methods: A multifaceted, 15-week curriculum using didactic learning, clinical experience, and reflective writing was created to instruct second-year occupational therapy students in ophthalmology and low vision. Participants included 19 occupational therapy students from Thomas Jefferson University. Each trainee participated in the course modules and then submitted their course evaluations and reflective writings for review. Participants evaluated their satisfaction with the course using a Likert-scale and open-ended comments. Reflective writing from each participant was reviewed by occupational therapy faculty authors (AB, AL). Results: Nineteen students participated in the course, with 19 (100%) of participants reporting being “satisfied” or “highly satisfied” with the course. Analysis of the reflective writings revealed three main themes: the impact of eye-related medical conditions on daily life, insight into the provider-patient interaction and relationship, and the potential role of the occupational therapist on the vision team as an agent to maximize patient adjustment and function. Discussion: This collaborative, multimodal interprofessional educational model can assist in training and sensitizing occupational therapy students in the areas of ophthalmology and low vision. Implications for Practitioners: This report provides a model for medical educators to utilize in the training of occupational therapy students.
Type I Thyroplasty or Fat Injection Laryngoplasty Versus Arytenoid Adduction: Effects of Surgery on Voice Recovery in Patients With Unilateral Vocal Fold Paralysis
Authors: Hasukawa Akihito , Mochizuki Ryuichi , Sakamoto Hiramori , Shibano Akira , Kitahara Tadashi
Published: May 2023

Objective: Type I (medialization) thyroplasty (MT), fat injection laryngoplasty (FIL), and arytenoid adduction (AA) are the 3 most common surgical treatments for unilateral vocal fold paralysis (UVFP). While MT and FIL involve medialization of the paralyzed vocal fold, the goal of AA is to reduce the glottal-level difference. The current study compared the effects of these surgical treatments on voice quality in patients with UVFP. Methods: This retrospective study included 87 patients with UVFP who underwent MT (n = 12), FIL (n = 31), AA (n = 6), or AA with MT (n = 38). Patients who underwent the former 2 surgical treatments were included in the thyroplasty (TP) group, while those who underwent the latter 2 were included in the AA group. Maximum phonation time (MPT), pitch period perturbation quotient (PPQ), amplitude perturbation quotient, and harmonic-to-noise ratio (HNR) were evaluated in all patients before and 1 month after surgery. Results: The TP group exhibited significant improvements in MPT ( P < .001) and PPQ ( P = .012), while the AA group exhibited significant improvements in all parameters ( P < .001). Before surgery, voice quality was significantly worse in the AA group than in the TP group for all measures. However, there were no significant differences between the groups after treatment. Conclusion: Surgeries in both groups were effective for voice recovery in patients with UVFP under the appropriate surgical selection. Our results also highlight the importance of preoperative evaluation and the potential value of etiology for selecting the appropriate procedure.
When Interdependence Backfires: The Coronavirus Infected Three Times More People in Rice-Farming Areas During Chinese New Year
Authors: Wei Xindong , Talhelm Thomas , Zhang Kaili , Wang Fengyan
Published: May 2023

Interdependent cultures around the world have generally controlled COVID-19 better. We tested this pattern in China based on the rice theory, which argues that historically rice-farming regions of China are more interdependent than wheat-farming areas. Unlike earlier findings, rice-farming areas suffered more COVID-19 cases in the early days of the outbreak. We suspected this happened because the outbreak fell on Chinese New Year, and people in rice areas felt more pressure to visit family and friends. We found historical evidence that people in rice areas visit more family and friends for Chinese New Year than people in wheat areas. In 2020, rice areas also saw more New Year travel. Regional differences in social visits were correlated with COVID-19 spread. These results reveal an exception to the general idea that interdependent culture helps cultures contain COVID-19. When relational duties conflict with public health, interdependence can lead to more spread of disease.
Boys’ Internalized Appearance-Related Norms from Different Socializers Uniquely, Negatively Relate to Wellbeing and Gender Beliefs
Authors: Nielson Matthew G. , Tolman Deborah , Martin Carol Lynn , Fraser Ashley M.
Published: May 2023

Much of the work on body image socialization masks the potentially unique influence of different socializers, yet clearer understanding of socialization mechanisms and ideological context aid intervention efforts. We explored how fathers, female peers, male peers, and adolescent boys themselves produce different levels of internalized appearance-related norms and how these socializer-specific norms differentially relate to wellbeing and beliefs related to gender identity. With a sample of early adolescent boys ( n = 260; M age = 11.44 years, SD age = .56, 64% White), we used SEM to investigate relations between internalized norms, wellbeing, and gender beliefs. We found that most boys internalized appearance-related norms, and that boys reported higher levels of norms from themselves than from fathers or peers. Internalized appearance-related norms from different socializers uniquely related to self-esteem, private/public regard of gender, and self-presentation expectations in peer interactions. This relational framework provides unique insights into boys’ experiences with their appearance and the role of different socializers.
Clinico-Etiologic Profile of Children and Adolescents with Drug-Resistant Epilepsy in a low-Resource Setting: 10 Years’ Experience
Authors: Kapoor Dipti , Garg Divyani , Beriwal Nitya , Sidharth  , Kumar Ashna , Mukherjee Sharmila B , Pemde Harish Kumar , Sharma Suvasini
Published: May 2023

Purpose: Nearly 25% to 30% of children with epilepsy develop drug-resistant epilepsy. Etiology of epilepsy, including drug-resistant epilepsy, varies with geographical region. Identifying paucity of etiologic data on drug-resistant epilepsy from our region and similar low-resource settings, we aimed to describe the clinical and etiologic profile of children and adolescents with drug-resistant epilepsy, to better inform region-specific concerns. Methods: A chart-based retrospective review covering 10 years (January 2011–December 2020) was conducted. Participants between 1 months and 18 years of age who fulfilled International League Against Epilepsy (ILAE) definition of drug-resistant epilepsy were enrolled. Clinical details, perinatal history, electroencephalography (EEG), magnetic resonance imaging (MRI), and other evaluation-based data were analyzed. Results: Five hundred ninety-three children (52.3% males) were enrolled. The median age at presentation was 63 (interquartile range [IQR] 12-72) months and median age at onset was 12 (IQR 2-18) months. The most frequent seizure type was generalized (76.6%). Of these, epileptic spasms (48.1%) were most frequent. Focal seizures comprised 22.9%. The predominant contributor to etiology was perinatal adverse events, including perinatal asphyxia (37.9%), neonatal hypoglycemic brain injury (15.6%), and neonatal sepsis/meningitis. Electroclinical syndromes were observed in 361 (60.9%) children. Of these, the most frequent were West syndrome (48%) and Lennox-Gastaut syndrome (6.2%). Conclusion: Perinatal brain injury and brain infections were the most common causes of drug-resistant epilepsy identified. These findings indicate an opportunity for reducing the burden of pediatric drug-resistant epilepsy in our region by instituting preventive measures, including improved perinatal care, promotion of institutional deliveries, optimized obstetric and neonatal care, and immunization for vaccine-preventable infections such as bacterial meningitis and Japanese B encephalitis.
Trends in the Epidemiology and Treatment of Pediatric-Onset Multiple Sclerosis in Alberta, Canada
Authors: Yearwood Camille , Wilbur Colin
Published: May 2023

Background

Fingolimod became the first disease-modifying therapy approved by Health Canada for pediatric multiple sclerosis in 2018, but the impact of that approval on treatment patterns in Canada is unknown. The aim of this study was to describe trends in the epidemiology and treatment of pediatric-onset multiple sclerosis in Alberta, Canada.

Methods

This study entailed a retrospective review of administrative health databases using 2 case definitions of multiple sclerosis. Those <19 years of age at a date of diagnosis between January 1, 2011, and December 31, 2020, were included. Incidence and prevalence estimates were calculated and stratified by sex and age cohort. Pharmacy dispenses of disease-modifying therapies were identified.

Results

106 children met one or both case definitions. In 2020, the age-standardized incidence using the 2 case definitions was 0.47 and 0.57 per 100 000, and the age-standardized prevalence was 2.84 and 3.41 per 100 000, respectively. Seventy-nine incident cases were identified, 38 (48%) of whom were dispensed a disease-modifying therapy prior to age 19 years. Injectables accounted for all initial pediatric disease-modifying therapy dispenses prior to 2019, whereas in 2019-2020 injectables accounted for only 3 of 15 (20%) initial dispenses, and instead B-cell therapies were the most common initial disease-modifying therapy (6 of 15, 40%). In 2020, B-cell therapies were the most common disease-modifying therapy dispensed overall (9 of 22 dispenses, 41%) followed by fingolimod (6 of 22, 27%).

Conclusion

The treatment of children with multiple sclerosis in Alberta has evolved, with a rapid shift in 2019 away from injectables to newer agents, although B-cell therapies—not fingolimod—are now most commonly dispensed.
Effects of raster angle and composition of layers on tensile and flexural properties of PLA-PLA/Al multimaterial manufactured by fused deposition modeling
Authors: Mazaheri Ali Safari , Abedini Vahid , Kami Abdolvahed
Published: May 2023

This paper fabricated two-material parts of neat PLA and PLA/40% Al composite by fused deposition modeling (FDM). The mechanical properties of this multi-material depend on the correct choice of 3D printing parameters. Thus, the effect of raster angle and composition of layers (both position and number of layers) on standard samples’ tensile and flexural properties were investigated. The 3D printed samples consisted of ten layers, each with a thickness of 0.3 mm. The full-factorial method is used for designing the experiments. In this design, the raster angle, number of composite layers, and position of the composite layers were set to (±45°, 0°/90°), (2, 4, and 6), and (top and mid), respectively. The results showed that the tensile strength decreases with the number of composite layers. Furthermore, it was found that the raster angle of 0°/90°, using just two composite layers and placing the composite layers in the top layers of the samples, provides the best tensile and flexural properties. Additionally, a scanning electron microscopy (SEM) investigation of the samples’ fractured sections revealed that the composite material exhibits ductile behavior when reinforced with Al particles. On the other hand, the presence of the particles aided in the formation and proliferation of cavities, eventually leading to the premature sample's failure.
Numerical investigation on the combined effects of pinching and rotation on the performance of a high-speed centrifugal compressor with a vaneless diffuser
Authors: Porika Niveditha , Das Shyama P , Prasad Bhamidi VSSS
Published: May 2023

Computational investigations are carried out on a high-speed centrifugal compressor with the vaneless diffuser to study the combined pinch and rotation effect. The axial inlet width of the rotating vaneless diffuser is reduced at diffuser inlet, either at the hub wall or at the shroud wall, or both the walls. The reduction is varied from 0% (base case) to 20% at an interval of 5%. Numerical simulations are conducted for different speed range by varying the rotating diffuser diameter ratio from 1.25–1.75. Among all these cases, the best performance of 25% increase in pressure recovery with uniform diffusion and 2.3% increase in isentropic efficiency is obtained with 15% shroud pinch at a diameter ratio of 1.375 at the design mass flow rate.
A hybrid machine learning approach for forecasting residential electricity consumption: A case study in Singapore
Authors: Neo Hui Yun Rebecca , Wong Nyuk Hien , Ignatius Marcel , Cao Kai
Published: May 2023

Ensuring effective forecasting of buildings' energy consumption is crucial in establishing a greater understanding and improvement of buildings' energy efficiency. In Singapore, domestic electricity usage in public residential buildings takes up a significant portion of the country's annual energy consumption. Having effective forecasting approaches is thus important in supporting relevant strategies and policy making. In this research, we proposed a hybrid approach that was based on a combination of building characteristics and urban landscape variables to predict residential housing electricity usage in Singapore. XGboost was also incorporated inside the hybrid approach as the preferred machine learning approach for energy consumption predictions. To demonstrate our proposed approach's predictive strength, the performance of our proposed hybrid machine learning approach was compared with two other models, Geographically Weighted Regression (GWR) model and the Random Forest (RF) model. Results showed that our proposed hybrid model had outperformed these abovementioned approaches with higher accuracy (r2 value of 0.9). The proposed approach had thus been effective in forecasting electricity consumption for public housing in Singapore, and it could also be utilised in other similar urban areas for future electricity consumption forecasting.
Women's health magazines and postfeminist healthism: A critical discourse analysis
Authors: Beijbom Mikaela , Fabricius Alexis , O’Doherty Kieran C.
Published: May 2023

Daily, millions of North American women turn to popular media, like women's health magazines, for health-related advice and information. “Magazines continue to be a popular medium” and, given their power and reach, remain an important site for critical analysis. In this article, we examine the ways in which three popular women's health magazines provide “health” advice to their readers. We first provide an overview of research in feminist media studies exploring postfeminist sensibility, healthism, and now a postfeminist healthism. We then conduct a critical discourse analysis of articles from all 30 issues of Health, Women's Health, and Shape magazines published in 2018. Our investigation of how the magazines portray what it means to have “good health,” suggests that health continues to be conflated with appearance. Moreover, health is presented as confusing, such that maintaining health requires expert help, and as purchasable, and thus linked to economic practices.
Cognitive dysfunction in patients with systemic lupus erythematosus. A cross-sectional study in a Brazilian sample
Authors: Borba Eduardo A , Scoto Dias Eduarda , Tercziany Vanzin José Henrique , Ferreira de Queiroz Junior Nelzi , dos Santos Thiago Alberto FG , Skare Thelma , Nisihara Renato
Published: May 2023

Background

Cognitive dysfunction (CD) is frequently found in patients with systemic lupus erythematosus (SLE) and contributes to impairment in the patient’s quality of life.

Aim

To study CD in a sample of patients and the possible associations with cumulative damage, disease activity, clinical/serological profile, and cumulative glucocorticoid dose.

Methods

Included in this study are 103 patients with SLE and 95 controls for cognitive performance through MoCA (Montreal Cognitive Assessment) and MMSE (Mini-Mental State Examination). Disease activity was measured by SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) and cumulative organ damage by SLICC/ACR/DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index). CES-D (Center for Epidemiological Studies-Depression) scale was used to evaluate depression. Data on clinical and serological profile, treatment, and cumulative glucocorticoid dose were also collected.

Results

Patients with SLE had worse performance in the MoCA ( p = 0.009) and MMSE ( p = 0.01) than controls. The MoCA results showed that visuospatial and abstraction domains ( p = 0.03 and p = 0.002, respectively) were impaired, and the MMSE results showed that language and spatial orientation were reduced ( p = 0.002 and p = 0.01, respectively) when compared to controls. Both questionnaires (MoCA with r = −0.29 and MMSE r = −0.21) correlated negatively with SLICC/ACR/DI and the MoCA with SLEDAI (r = −0.22). No associations were found with cumulative glucocorticoid dose, degree of depression, and clinical or serological profile.

Conclusions

According to the MoCA, visuospatial cognition and abstraction were impaired, and according to the MMSE, spatial orientation and language were impaired in patients with SLE. The CD was correlated with cumulative damage and disease activity. These findings demonstrate that both disease-activity and disease-injury associated CD is found broadly in SLE patients in a Brazilian population, supporting the prior reports of CD in other regional SLE populations.
Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India
Authors: Grover Sandeep , Sahoo Swapnajeet , Naskar Chandrima , Sharma Aman
Published: May 2023

Background

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with multiorgan involvement presenting with a myriad of symptoms, including neuropsychiatric symptoms. Although many studies have evaluated screening questionnaires based psychiatric morbidity, very few studies have used contemporary diagnostic criteria.

Objective

This study aimed to evaluate the prevalence of psychiatric disorders in patients with SLE admitted to a tertiary care hospital.

Methods

A total of 79 patients diagnosed with SLE for at least for 1 year, who were not in delirium were assessed by a qualified psychiatrist for psychiatric morbidity as per the International Classification of Diseases, 10th Revision (ICD-10) criteria. Additionally, these patients were assessed on Patient Health Questionnaire-9 (PHQ-9) item version, Patient Health Questionnaire-15 (PHQ-15) item version, Generalized Anxiety Disorder-7 item scale and Montreal Cognitive Assessment (MoCA).

Results

51% ( n = 40) of the participants were diagnosed with a psychiatric diagnosis, with depressive disorders being the most common, seen in 36.7% ( n = 29) of the participants. Additionally, 10% ( n = 8) participants were diagnosed with adjustment disorder and 2.5% ( n = 2) were diagnosed with anxiety (not otherwise specified). Only one patient was diagnosed with organic psychosis. On PHQ-9, 39.8% ( n = 33) were diagnosed with depression. 44.3% ( n = 35) expressed death wishes and/or suicidal ideations. On PHQ-15, 17.7% ( n = 14) of the participants scored for severe somatic distress (score >15). On GAD-7, 55.7% ( n = 44) screened positive for anxiety symptoms, but only 7.6% ( n = ) had a score of 15 or more to indicate severe anxiety. Nearly half ( n = 43; 52%) of the participants also had cognitive impairment as assessed on MoCA, with 13.3% ( n = 11) of the participants having scores indicating severe dementia.

Conclusions

Patients with SLE have a high prevalence of psychiatric comorbidities and should be routinely screened for psychiatric morbidity. They should be appropriately treated, to improve the overall treatment outcomes.
A Study of Hypertension and Related Biophysical and Health-related Lifestyle Behaviors in Patients Suffering from Schizophrenia
Authors: Sharma Akhilesh , Basera Devendra Singh , Suri Vikas , Singh Shubh Mohan
Published: May 2023

Background

Schizophrenia is a life-shortening disease. The standardized mortality ratio has been higher than that of the general population, and it has doubled what it was 3-4 decades ago. This rise is mostly attributed to the increased cardiovascular risk associated with high second-generation antipsychotic (SGA) use. Evidence from the first-generation antipsychotic (FGA) era shows a lower prevalence of hypertension (HTN) but data regarding SGAs is scarce.

Purpose

The purpose of the study was to assess the prevalence of HTN and related factors using standardized methodology in patients with schizophrenia on treatment with SGAs.

Methods

A cross-sectional study through convenient sampling was done. Blood pressure, anthropometry, physical activity, and health-related lifestyle factors were assessed using the standard World Health Organization (WHO) methodology of cardiovascular survey methods and the Global Physical Activity Questionnaire (GPAQ) version 2. The prevalence of HTN, obesity, inadequate physical activity, and other demographic and clinical correlates like antipsychotic use, duration of illness, and family history of non-communicable diseases (NCDs) were studied.

Results

The prevalence of HTN is 20.50%, and it increases with age. SGAs with the use of a single agent are the most common. In total, 45.50% of persons with schizophrenia have a positive family history of a NCD; 22.00% and 07.50% are current tobacco and alcohol users, respectively; and 70% have abdominal obesity, and 54% have generalized obesity. Waist circumference, obesity, and family history of NCDs are significant correlates of HTN. A family history of NCDs is the most significant predictor.

Conclusion

The prevalence of HTN is lower than that of the general population despite the high prevalence of SGA use, obesity, and inadequate physical activity.
Postmortem examination of equids >1-year-old with enterotyphlocolitis in Ontario: a retrospective descriptive study
Authors: Zakia Luiza S. , Arroyo Luis G. , Gomez Diego E. , Boerlin Patrick , Surette Michael G. , Lillie Brandon N.
Published: May 2023

Equine enterotyphlocolitis is an inflammatory process of the intestinal tract of horses that is associated with multiple etiologic agents and risk factors. Most clinical cases do not have an etiologic diagnosis. We describe here the pathogens detected and the histologic lesions found in horses with enterotyphlocolitis in Ontario that were submitted for postmortem examination, 2007–2019. We reviewed the medical records of 208 horses that fulfilled inclusion criteria. Cultures were positive in 67 of 208 (32%) equids for Clostridium perfringens, in 16 of 208 (8%) for Clostridioides difficile, and in 14 of 208 (7%) for Salmonella spp.; 6 of 208 (3%) were positive for Neorickettsia risticii by PCR assay. One horse was positive in a Rhodococcus equi PCR assay. All horses tested by PCR assay for equine coronavirus and Lawsonia intracellularis were negative. The histologic lesions were characterized as follows: 6 of 208 (3%) enteritis, 5 of 208 (2%) typhlitis, 104 of 208 (50%) colitis, 37 of 208 (18%) enterocolitis, 45 of 208 (22%) typhlocolitis, and 11 of 208 (5%) enterotyphlocolitis. We strongly recommend standardized testing of diarrheic horses during and/or after postmortem examination, as well as standardized reporting of histologic lesions in enterotyphlocolitis cases.
The temporal and affective structure of living systems: A thermodynamic perspective
Authors: Dengsø Mads J
Published: May 2023

Enactive approaches to cognitive science as well as contemporary accounts from neuroscience have argued that we need to reconceptualize the role of temporality and affectivity in minds. Far from being limited to special faculties, such as emotional mental states and timekeeping, these accounts argue that time and affect both constitute fundamental aspects of minds and cognition. If this is true, how should one conceptualize the relation between these two fundamental aspects? This paper offers a way to conceptualize and clarify the relation between temporality and affectivity when understood in this fundamental sense. In particular, the paper contributes to ongoing discussions of structural temporality and affectivity by combining enactive notions of self-maintenance with a thermodynamically informed view of the organization of living systems. In situating temporality and affectivity by way of their role for the maintenance of thermodynamic non-equilibrium, I will argue that temporality and affectivity should be regarded as two sides of the same coin—that is, two distinct ways of highlighting one and the same process. This process corresponds to the continued differentiation of organism and environment as functional poles of a living system. The temporal and affective structure of living systems may thus be seen as the warp and weft by which living systems maintain themselves in terms of thermodynamic non-equilibrium.
Ethics Beyond the Checklist: Fruitful Dilemmas Before, During, and After Data Collection
Authors: Nordtug Maja , Haldar Marit
Published: May 2023

In this article, we aim to contribute to current discussions about ethical conduct in qualitative research practice. We provide examples of how ethics is a recurring issue throughout a research process and not just an issue to safeguard procedurally. The examples on which we build our argument are based on three research projects from two countries, namely, Norway and Denmark, focusing on three different groups, namely, the elderly, parents, and children. Through our analyses of these ethical dilemmas, we aim to provide reflections on dilemmas encountered in three different qualitative research projects at three different stages, specifically before, during, and after data collection. We thus provide a way for researchers to frame their work with ethical dilemmas as a continuous process beyond the checklist. Furthermore, we frame complex ethical dilemmas as something not to avoid but as a continuous part of a fruitful analytical process.
Women's Experiences Accessing Mental Health Care in Australia After Sexual Violence in Adulthood
Authors: Isaac Sandra , McLindon Elizabeth , Hegarty Kelsey , Tarzia Laura
Published: May 2023

In Australia, at least one in every five women has experienced sexual violence since age 15. Research consistently links sexual violence with poor mental health, persisting long after the crisis period. Trauma-informed mental health support is therefore critical. This article draws on interviews with 29 women who had experienced sexual violence to understand their experiences accessing mental health services in Australia. Our findings suggest that, constrained by a biomedical model of care, mental health practitioners’ understanding of trauma generally, and sexual violence particularly, may be lacking. Further, women struggle to navigate a “maze” of services.
Evaluation of cancer drug infusion devices prior to the implementation of a compounding robot
Authors: Caron Guillaume , Vasseur Michèle , Courtin Justin , Masse Morgane , Décaudin Bertrand , Genay Stéphanie , Odou Pascal , Simon Nicolas
Published: May 2023

Introduction

Compounding robots are increasingly being implemented in hospital pharmacies. In our hospital, the recent acquisition of a robot (RIVATM, ARxIUM) for intravenous cancer drug compounding obliged us to replace the previously used infusion devices. The objective of the present study was to assess and qualify the new intravenous sets prior to their use in our hospital and prior to the implementation of the compounding robot.

Materials and Methods

The ChemoLockTM (ICU Medical) was compared with the devices used previously for compounding (BD PhaSealTM, Becton-Dickinson) and infusion (Connect-ZTM, Codan Medical). The connection/disconnection of infusion devices to/from 50 mL infusion bags was tested with a dynamometer (Multitest-i, Mecmesin). Leakage contamination was visualized by a methylene blue assay and was quantified in simulated pump infusions with 20 mg/mL quinine sulfate ( N = 36/group); after the analytical assay had been validated, quinine was detected by UV-spectrophotometry at 280 and 330 nm. Groups were compared using chi-squared or Mann–Whitney U tests.

Results

The connection/disconnection test showed that although all the devices complied with the current standard, there was a statistically significant difference in the mean ± standard deviation compression force (51.5 ± 11.6 for the Connect-ZTM vs. 60.3 ± 11.7 for the ChemoLockTM; p = 0.0005). Leaks were detected in 32 (29.1%) of the 110 tests of the ChemoLockTM. The contamination rates were also significantly different: 13.9% for the BD PhaSealTM versus 75.0% for the ChemoLockTM; p < 0.0001).

Discussion/conclusion

Our results showed that the new infusion device complied with current standards. However, the presence of contamination emphasizes the need for operators to use the recommended personal protective equipment. Further studies of contamination with cancer drugs are required.
Evaluation of two unilateral laryngoplasty techniques and their effect on arytenoid cartilage abduction in cats
Authors: Bonanno Giuseppe , White Robert N
Published: May 2023

Objectives

The aim of this study was to evaluate two unilateral laryngoplasty (arytenoid lateralisation) techniques for use in the surgical management of laryngeal paralysis in cats.

Methods

Left cricoarytenoid abduction (lateralisation) was performed in 20 ex vivo cat larynges; 10 following complete cricoarytenoid disarticulation (group LAA-dis) and 10 following no cricoarytenoid disarticulation (group LAA-nodis). For both groups, left arytenoid abduction (LAA) was measured in the resting and postoperative larynges using image analysis software. Measurements were evaluated using the Mann–Whitney U-test. For both groups, dorsal images of the postoperative larynges were assessed visually for evidence of epiglottic coverage of the entrance to the larynx.

Results

The mean percentage increase in LAA was 311.5% and 199.4% ( P <0.006) for group LAA-dis (complete cricoarytenoid disarticulation) and group LAA-nodis (no cricoarytenoid disarticulation), respectively. In both groups, there was no evidence of a lack of epiglottic coverage of the entrance of the larynx for any of the postoperative larynges.

Conclusions and relevance

Placement of a single, tensioned suture between the muscular process of the left arytenoid cartilage and the caudolateral aspect of the ipsilateral cricoid cartilage (unilateral cricoarytenoid lateralisation) resulted in abduction of the left arytenoid cartilage and a corresponding increase in the area of the rima glottidis on the operated side. The clinical significance of the difference in outcome between left cricoarytenoid abduction following complete cricoarytenoid disarticulation and abduction following no cricoarytenoid disarticulation remains unclear, and both might be considered appropriate for the surgical management of laryngeal paralysis in the cat.
Support recycling in additive manufacturing: A case study for enhanced wear performance of Ti6Al4V alloy
Authors: Yamanoglu Ridvan , Bahador Abdollah , Kondoh Katsuyoshi
Published: May 2023

The production of metals by additive manufacturing is developing rapidly. After production, support structures emerge as waste materials. In this study, Ti6Al4V support structures recycled from the selective laser melting process were consolidated by vacuum hot pressing. Spherical and irregularly shaped Ti6Al4V alloy particles were also used for the comparison as raw materials. All raw materials have been subjected to the same sintering process by hot pressing. The microstructures of the samples were carried out, and their dry sliding wear performance was studied. The samples produced from support structures showed the highest wear performance compared to the powder forms of raw materials. This study showed that the support structures from additive manufacturing could be recycled and transformed into full dense structures by pressure-assisted sintering techniques, and enhanced wear performance can be obtained.