bluuebunny/crossref_metadata_2025 huggingface dataset:
Urbanity as a City's Heritage
Authors: Rautenberg Michel
Published: October 2022

Urbanity has been a key concept to describe western cities since the beginning of the 20th century. But the importance of urbanity is no longer self-evident in global cities since the pivotal moment of 1980/90, when we witnessed the acceleration of flux, the emergence of megacities and the transformation of capitalism. At the same time, urban heritage became of greater interest. Then, as urbanity weakened, it began to be defended by public policies, local commitments and activists in a new way: as collective memories and palimpsest traces. In this article, I consider two examples in the French city of Saint-Etienne to illustrate the heritagization of urbanity: an exhibition about the memory of Algerian miners, and the dramatic demolition of a high-rise building that created a great stir because of its local symbolic significance. These two examples show that urbanity keeps a great place in the imaginary of urban dwellers, including the elites. From a general point of view, we try to preserve the values that we attach to cities, perhaps more than trying to preserve the cities themselves.
Experiment, simulation, optimization design, and damage detection of composite shell of hydrogen storage vessel-A review
Authors: Li Wenbo , Lv Hong , Zhang Lijun , He Pengfei , Zhang Cunman
Published: October 2022

The composite shell of composite high pressure hydrogen storage vessel (CHPHSV) is the main structure in bearing inner pressure. Its failure will lead to leakage or burst of CHPHSV, which will cause serious safety problem and economic losses. So the security of CHPHSV has always been a key and difficult problem in academia and industry, which restricts the large-scale application of hydrogen. In this paper, the failures of composite shell of type III, type IV, and type V vessels are reviewed in experiment study, simulation method, optimization design, and damage detection, focusing on the burst modes (safe or unsafe), the influence of hydrogen-thermo-stress field, and the epistemic uncertainty. Firstly, the burst modes, failure behavior, test method, and influencing factors are summarized in the experiment study, and experiment for type V composite pressure vessel is discussed. Secondly, the simulation method is reviewed in the aspect of first ply failure (FPF) analysis and last ply failure (LPF) analysis. The damage evolution of safe burst mode and unsafe burst mode is summarized. Besides, the influence of hydrogen-thermo-stress field and the uncertainty characteristic are also reviewed. Moreover, simulations of micro-crack and permeability for type V composite pressure vessels are summarized. Then, the optimization design methods based on deterministic parameters and uncertain parameters are reviewed. Finally, the damage detection methods of the composite shell of CHPHSV are summarized. The experiment, numerical simulation, and optimization are important for design of the composite vessel, and the damage detection can significantly reduce the degree of uncertainty and maintenance safety. In the future research, precise model considering multiple damage modes, hydrogen-thermo-stress field effect should be established for simulation of safe and unsafe burst mode. Uncertain quantization should be studied for burst pressure with combination of stochastic uncertainty and epistemic uncertainty. Besides, the robust design method based on the reliability of CHPHSV considering the epistemic uncertainty of design parameters should be established for a larger safety margin.
Coping and Connecting through Creativity in the Neighborhood Realm during COVID-19
Authors: Pfeiffer Deirdre , Ehlenz Meagan , Saadaoui Rababe
Published: October 2022

This research addresses how the COVID-19 pandemic affected neighborhood engagement by exploring the use of streets, sidewalks, and driveways as sociable spaces for informal and uncoordinated creative expression. We assessed practices occurring in three diverse City of Phoenix neighborhoods before and during the pandemic through visual analysis. We show that residents used these spaces in novel and more intensive ways during the pandemic, including for self-care and care of others, celebrations, children’s play, and property-spanning games and communication. These findings reveal the importance of these interstitial spaces in helping neighbors to cope and connect during societal disruptions.
The Moral Discourse of Free Speech: A Virtual Ethnographic Study
Authors: Goldman-Hasbun Julia
Published: October 2022

Freedom of speech has long been considered an essential value in democracies. However, its boundaries concerning hate speech continue to be contested across many social and political spheres, including governments, social media websites, and university campuses. Despite the recent growth of so-called free speech communities online and offline, little empirical research has examined how individuals embedded in these communities make moral sense of free speech and its limits. Examining these perspectives is important for understanding the growing involvement and polarization around this issue. Using a digital ethnographic approach, I address this gap by analyzing discussions in a rapidly growing online forum dedicated to free speech (r/FreeSpeech subreddit). I find that most users on the forum understand free speech in an absolutist sense (i.e., it should be free from legal, institutional, material, and even social censorship or consequences), but that users differ in their arguments and justifications concerning hate speech. Some downplay the harms of hate speech, while others acknowledge its harms but either focus on its epistemic subjectivity or on the moral threats of censorship and authoritarianism. Further, the forum appears to have become more polarized and right-wing-dominated over time, rife with ideological tensions between members and between moderators and members. Overall, this study highlights the variation in free speech discourse within online spaces and calls for further research on free speech that focuses on first-hand perspectives.
Mechanical characteristics and failure morphology of FFF-printed poly lactic acid composites reinforced with carbon fibre, graphene and MWCNTs
Authors: Jain Akash , Mishra Adit , Dubey Abhinav Kumar , Kumar Akash , Sahai Ankit , Sharma Rahul Swarup
Published: October 2022

Fused Filament Fabrication (FFF) is the most prevalent additive manufacturing technique, which involves extruding a softened thermoplastic filament through the nozzle of a heated extruder. For improving the mechanical properties of the FFF-printed PLA parts one of the options is to add reinforcing material, such as carbonaceous materials or metal particles. The present study deals with analysing and comparing mechanical properties of carbon fibre reinforced poly lactic acid (CF-PLA), graphene reinforced PLA (Gr-PLA) and multi walled carbon nano tubes reinforced PLA (MWCNTs-PLA) composites by FFF. The selected process parameters used in this study are raster angle (0°, 45°, 90°), feed rate (20 mm/s, 40 mm/s, 60 mm/s) and layer height (0.1 mm, 0.15 mm, 0.2 mm) and based on different combinations, elongation at break, modulus and tensile strength are examined. MWCNTs-PLA exhibits overall maximum tensile strength, 37.438 MPa with 15.384% elongation at break for layer height 0.1 mm, raster angle 0° and feed rate 20 mm/s as compared to other selected specimens. Fractography analysis is also done to better understand the failure modes of specimens. To examine the dependency of the tensile strength on the process parameters, ANOVA, Taguchi’s L9 array Design of Experiment (DOE) is utilized indicating that layer height has the highest contribution of 56.713% for Gr-PLA, but raster angle has the highest contribution of 54.899% and 76.16% for CF-PLA and MWCNTs-PLA, respectively. This work will help in better understanding of how different parameters effects the material properties for PLA composites.
Volunteer Retirement and Well-Being in Older Adults: A Longitudinal Study
Authors: Russell Allison R. , Boen Courtney E. , Handy Femida
Published: October 2022

The extant literature on volunteering has focused primarily on the many benefits of volunteering for older adults. However, the question rarely investigated is whether these benefits dissipate when older adults retire from their volunteering. Given the U.S. policy context wherein volunteering is promoted as a solution to the problems of aging, this research investigates the association between the loss of one’s volunteering role through retirement and well-being. Utilizing three waves of the U.S.-based National Social Life, Health, and Aging Project (NSHAP) (2005–2016) and a fixed-effects modeling approach, we find that the well-being of older adults, measured as self-reported health, happiness, and depressive risk, is negatively associated with volunteer retirement. Our study contributes to the literature on well-being and volunteering for older adults and is the first study focusing on this critical transition point in the life of older volunteers. In addition, policymakers and organizations must broaden their focus to include not only the recruitment and retention of older adult volunteers but also the transition out of volunteering that many of them will eventually face.
Clarifying Core Elements of New Testament Normativity
Authors: Finegan Thomas
Published: October 2022

An intriguing though little noticed trend within moral theology over the last half century or so is the move towards re-conceptualising moral norms previously considered mandatory into ideals. The ideal-normative turn has been taken by official Catholic and Anglican ecclesial documents, in both cases as regards the closely related matters of marital permanence and extra/post-marital unions. Yet the turn has occurred with little or no scrutiny of the distinction at its heart, that between ideal and mandatory norms. This article applies the distinction to an analysis of New Testament moral normativity, with particular focus on teachings on marriage. Through this examination core elements of New Testament normativity are clarified and the credibility of the ideal-normative turn as it pertains to marital permanence is thereby challenged.
The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: A case-control study
Authors: Namara Daphine , Schwartz Jeremy I , Tusubira Andrew K , McFarland Willi , Birungi Caroline , Semitala Fred C , Muddu Martin
Published: October 2022

Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is need for rigorous studies to validate this association in the face of increasing DTG use and burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case–control study to assess the risk of hyperglycemia associated with use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia while controls had no hyperglycemia as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. Analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96–25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18–35, aOR 12.38, 95% CI 3.79–40.50) and hypertension (aOR 5.78, 95% CI 2.53–13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.
A retrospective analysis of bone loss in tenofovir-emtricitabine therapy for HIV PrEP
Authors: Chang Joseph , Do Duy , Delgado Hector , Kanimian Natalie , Huynh An
Published: October 2022

Background

Tenofovir-Emtricitabine (TDF-FTC) is known to cause bone loss in about 1–3% of HIV treated patients. Current studies lack evidence in minority groups and long-term bone loss effects in PrEP patients.

Setting

To address the risk of osteopenia/osteoporosis in patients on TDF-FTC therapy for HIV PrEP and to address the breakthrough incidence of HIV.

Methods

A retrospective analysis was performed in Kaiser Permanente patients from 2012–2021. Patients on TDF-FTC for PrEP without any prior history of osteopenia/osteoporosis ( N = 7698) were analyzed to determine the relationship between PrEP adherence and osteopenia/osteoporosis. Descriptive statistics and Cox proportional hazards model were used to compare and analyze patient characteristics between those who developed osteopenia/osteoporosis and those who didn’t.

Results

3% were found to have osteopenia/osteoporosis. Patients who developed osteopenia/osteoporosis were more likely to have a proportion of days covered (PDC) ratio ≥90%, older, had history of Hep B, DM, CVD, CKD, hypertension, and baseline eGFR ≥90 mL/min/1.73 m2. Kaplan-Meier curve showed the event-free rate of osteopenia/osteoporosis decreased with time, with a greater reduction in patients with high adherence. Survival analysis showed only PDC of ≥90% was significantly associated with the risk of osteopenia/osteoporosis when adjusted. No incidence of HIV infection was detected.

Conclusions

This retrospective cohort analysis showed that TDF-FTC offered superior PrEP protection. Although high PrEP adherence ensured protection from HIV infection, it was significantly associated with a higher risk of developing osteopenia/osteoporosis. These findings suggest that routine check-ups for osteopenia/osteoporosis may be needed.
Risk Factors of Venous Thromboembolism in Patients With Lung Cancer Before Surgery: A Case Control Study
Authors: Zhang Fangyuan , Liu Lifeng , Sha Yongsheng
Published: October 2022

Objective

This study aimed to investigate the risk factors of venous thromboembolism (VTE) in admitted patients with lung carcinoma before surgery.

Methods

We conducted a retrospective case-control study of 94 preoperative lung cancer patients with VTE between January 2017 to December 2020. Each VTE patients was randomly matched with 2 control patients according to residence and gender. The clinical characteristics and related laboratory test results between the groups were compared by univariate analysis, while the risk factors of VTE in preoperative patients with lung cancer were analyzed using multivariate logistic regression analysis.

Results

Patients aged ≥60 years, a history of arrhythmia, homocysteine>15ummol/L, Fibrinogen (FIB) >4 g/L and D-dimer>500 ng/mL were found to be associated with an increased risk of VTE by univariate analysis. The multivariate logistic regression analysis revealed that age ≥60 years (OR=10.985), FIB >4 g/L (OR=8.861) and D-Dimer >500 ng/mL (OR=6.613) were independent risk factors for VTE in patients with lung carcinoma before surgery (P<.05).

Conclusion

For preoperative patients with lung cancer, the independent risk factors of VTE included age ≥60 years, FIB >4 g/L and D-Dimer >500 ng/mL. As for these patients, prophylactic anticoagulant therapy should be considered before surgery.
“I’m Not Just the Nonbiological Parent”: Encountering, Strategizing, and Resisting Asymmetry and Invalidation in Genetic/ Gestational Parent Status Among LGBTQ Parents
Authors: Goldberg Abbie E. , Allen Katherine R.
Published: October 2022

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) families have expanded our understanding of who counts as family, to include legal as well as chosen ties. Yet, nonbiological parents in LGBTQ families are vulnerable to invalidation and erasure in social institutions, including health care, legal, and educational settings, where genetic and gestational linkages are privileged. The current study was guided by a queer phenomenological perspective to examine how LGBTQ parents experience and respond to dominant norms related to family relatedness and membership and thus queer the family. This mixed-methods study sampled 250 LGBTQ parents (including cisgender women and trans/nonbinary participants) to examine the question: In what ways does genetic asymmetry matter for families? The qualitative and quantitative analyses yielded three primary findings that revealed experiences of erasure and discrimination, as well as proactive strategies and active resistance used to counteract these difficulties. Themes were organized by (a) encountering marginalization and invalidation: health care, schools, and beyond; (b) strategic actions and discursive practices toward parental equality; and (c) confronting and resisting the need for legal, symbolic, and parenting strategies. This study documents ways in which nonbiological LGBTQ parents, in particular, embrace and resist societal norms for biological connectedness. Implications for nursing professionals include our finding that reproductive and perinatal contexts were particular sites of invalidation, necessitating education about the range of queer, nonbiological, and trans/nonbinary parents so that all parents are included in professional health care encounters.
Challenges and strategies in the psychiatric care of the ultra-Orthodox Jewish population: A thematic analysis of 18 psychiatrist interviews
Authors: Bloch Aaron M. , Gabbay Ezra , Gerber Linda M. , Dickerman Anna Lopatin , Knowlton Samantha , Fins Joseph J.
Published: October 2022

Despite the importance of accessible psychiatric care for the ultra-Orthodox Jewish community, prior research has characterized how stigma and suspicion of secular institutions limit mental healthcare utilization by this population. No study, however, has interviewed a cohort of psychiatrists to identify commonly encountered challenges or successfully employed strategies in the care of ultra-Orthodox Jewish psychiatric patients who have overcome these barriers to present for care. We recruited by snowball sampling from a sample of convenience 18 psychiatrists affiliated with the Weill Cornell Department of Psychiatry, experienced in the care of ultra-Orthodox Jewish patients. Each participant was engaged in a 20–45-min, semi-structured interview, which was subsequently transcribed, de-identified, and analyzed with combined deductive and inductive thematic analysis. We identified 12 challenges and 11 strategies as particularly significant in psychiatric work with ultra-Orthodox Jewish patients at every phase of treatment, including rapport-building, history-taking, diagnostic formulation, and achieving concordance with patient and family. These challenges and strategies revolved around themes of community stigma, an extended family-patient-community team, cross-cultural communication, culture-related diagnostic complexity, transference/countertransference, and conflicts between Jewish law /community norms and treatment protocol. Psychiatrists caring for ultra-Orthodox Jewish patients face a range of complex challenges stemming from factors unique to ultra-Orthodox Jewish religion, culture, and family/community structure. However, they have also identified strategies to manage these challenges and provide culturally sensitive care. Further research is necessary to directly elicit perspectives from within the ultra-Orthodox Jewish community and validate our initial findings.
Analysis of a cross groove constant velocity joint mechanism designed for high performance racing conditions
Authors: Simpson Matthew , Dolatabadi Nader , Morris Nick , Rahmani Ramin , Jones David , Craig Christopher
Published: October 2022

Constant Velocity Joint (CVJ) mechanisms enable torque transmission between two shafts at a fixed or variable angle. Cross groove CVJs are typically used in high performance automotive applications due to their versatility and light weight. Critical failure modes, such as pitting or abrasive wear, occur due to the harsh tribological conditions at ball reversals. In this research, an existing mathematical model is developed further for the case of cross groove CVJs including an accurate contact mechanics model. The developed model is validated against a published data set from literature. Surface topography of worn raceways are experimentally measured and the results from the developed model are corroborated with the measured surface parameters. This improved model shows the correlations between predicted contact force variation and wear scar depths during ball reversals, hitherto not reported in the literature.
Influence of nano-TiO2 particles on the microstructure, mechanical and wear behaviour of AA7178 alloy matrix fabricated by stir casting technique
Authors: Bharat Nikhil , Bose PSC
Published: October 2022

The current study focuses on the influence of varying wt% of nano-TiO2 particles (1%, 2% and 3%) on the microstructure, mechanical and tribological properties of AA7178 alloy matrix composite produced by stir casting method. The grain boundaries of the prepared composites were revealed using an optical microscope. The uniform distribution of nano-TiO2 particles in the alloy matrix was observed by scanning electron microscope. X-ray diffraction verified the existence of reinforced nano-TiO2 particulates in the samples, and microstructural images revealed a consistent distribution of reinforcements in the matrix. The formation of more refined grains from coarser grains was observed using electron backscatter diffraction analysis. The texture analysis revealed the presence of dominant A and A2* components with a maximum intensity of 5.137. Fractography disclosed that the reinforcements did not peel away from the alloy matrix, and the form of failure was both brittle and ductile. Abrasive wear was observed for the worn-out surface of the nanocomposites. It was observed that by increasing wt% of TiO2 nanoparticles, the mechanical and tribological properties of the alloy matrix increased compared to the base alloy. The optimum mechanical and tribological properties were obtained at 2 wt% of nano-TiO2 particulates.
Asking students about their fit with the university: A response surface analysis of demands-abilities fit
Authors: Bohndick Carla , Breetzke Jonas , Rosman Tom
Published: October 2022

Perceived fit of students is one of the most prominent predictors of study success in higher education, but when assessed directly, it provides lots of room for interpretation for the respondents. This is also true for perceived demands-abilities fit (e.g. how do one’s abilities fit with study demands), which has particularly high associations with study success. We, therefore, investigated (1) how students combine demands and abilities when asked about their perceived demands-abilities fit and (2) which demands and abilities they have in mind when asked about their perceptions of fit in an unspecific manner. We obtained data on the perceived fit of N = 595 university students from four German-speaking countries and analyzed them using response surface analysis. The results indicate that (1) perceived demands-abilities fit does not correspond to the congruence of perceived demands and perceived abilities when the latter two are measured separately, but rather reflects a strong linear effect of the abilities. Furthermore, they show that (2) the specific demands and abilities do not influence the way how demands and abilities are combined to a fit score, but that there are differences in the amount of explained variance between the specific demands and abilities. The results speak for a new interpretation of prior findings and challenge the contemporary understanding of perceived fit. For example, perceived fit and self-efficacy might be more closely associated than previously assumed. When striving to enhance perceived fit, practitioners should thus focus on fostering individual abilities and their perceptions.
Comparative analysis of mRNA and inactivated COVID-19 vaccines: A study from Faisalabad district of Pakistan
Authors: Ul Munamm Syed Ata , Nadeem Iftikhar , Mahdi Noor , Saqlain Muhammad , Rana Zaid Khalid , Khatana Usman Feroze , Bhatty Umer Mustansir , Navayogaarajah Visakan , Khan Fatimah Mahsal , Ur Rasool Masood
Published: October 2022

Background:

Pakistan has vaccinated over 122 million people. The two vaccines in widespread use are inactivated (BBIBP-CorV & Sinovac) and mRNA forms (BNT162b2 & mRNA-1273). The primary aim of this study was to compare these two forms of vaccines against unvaccinated individuals collectively and then to see which one is more efficacious.

Methods:

Case–control study design was used to compare the efficacy of inactivated and mRNA vaccines against symptomatic infection, hospitalisations and mortality due to Severe Acute Respiratory Syndrome Coronavirus 2 between vaccinated and unvaccinated individuals. We derived recovery time from illness for both vaccines. Furthermore, we also compared the vaccines against similar parameters (symptomatic disease, hospitalisations and mortality). We calculated crude odds ratios for each dependent variable. p value of 0.05 or below was considered significant.

Results:

Vaccinated individuals were significantly protected from hospitalisations and mortality compared to unvaccinated individuals ( p < 0.001). There was no difference in protection from symptomatic disease ( p = 0.28), hospitalisations ( p = 0.59) and mortality ( p = 0.53) between two forms of vaccines. mRNA vaccine had better recovery time than all other vaccines ( p < 0.001).

Discussion:

Our study showed that vaccinated individuals are at low risk of hospitalisations and mortality even without a booster and both vaccine forms are equally effective at preventing hospitalisations and mortality.
Computed tomography-based body composition measures in COPD and their association with clinical outcomes: A systematic review
Authors: Nicholson John M , Orsso Camila E , Nourouzpour Sahar , Elangeswaran Brenawen , Chohan Karan , Orchanian-Cheff Ani , Fidler Lee , Mathur Sunita , Rozenberg Dmitry
Published: October 2022

Background

Computed tomography (CT) is commonly utilized in chronic obstructive pulmonary disease (COPD) for lung cancer screening and emphysema characterization. Computed tomography-morphometric analysis of body composition (muscle mass and adiposity) has gained increased recognition as a marker of disease severity and prognosis. This systematic review aimed to describe the CT-methodology used to assess body composition and identify the association of body composition measures and disease severity, health-related quality of life (HRQL), cardiometabolic risk factors, respiratory exacerbations, and survival in patients with COPD.

Methods

Six databases were searched (inception-September 2021) for studies evaluating adult COPD patients using thoracic or abdominal CT-muscle or adiposity body composition measures. The systematic review was conducted in accordance with the PRISMA guidelines.

Results

Twenty eight articles were included with 15,431 COPD patients, across all GOLD stages with 77% males, age range (mean/median 59–78 years), and BMI range 19.8–29.3 kg/m2. There was heterogeneity in assessment of muscle mass and adiposity using thoracic ( n = 22) and abdominal ( n = 8) CT-scans, capturing different muscle groups, anatomic locations, and adiposity compartments (visceral, subcutaneous, and epicardial). Low muscle mass and increased adiposity were associated with increased COPD severity measures (lung function, exercise capacity, dyspnea) and lower HRQL, but were not consistent across studies. Increased visceral adiposity ( n = 6) was associated with cardiovascular disease or risk factors (hypertension, hyperlipidemia, and diabetes). Low muscle CSA was prognostic of respiratory exacerbations or mortality in three of six studies, whereas the relationship with increased intermuscular adiposity and greater mortality was only observed in one of three studies.

Conclusion

There was significant variability in CT-body composition measures. In several studies, low muscle mass was associated with increased disease severity and lower HRQL, whereas adiposity with cardiovascular disease/risk factors. Given the heterogeneity in body composition measures and clinical outcomes, the prognostic utility of CT-body composition in COPD requires further study.
“Flesh”
Authors: Lee Grace Jahng
Published: October 2022

This poem invites the reader to contemplate themes of immigration, parental caregiving, aging, and motherdaughter relationships. To view the original version of this poem, see the supplemental material section of this article online.
Effectiveness and cost-effectiveness of an intensive and abbreviated individualized smoking cessation program delivered by pharmacists: A pragmatic, mixed-method, randomized trial
Authors: Phillips Leslie C.E. , Nguyen Hai , Genge Terri L. , Maddigan W. Joy
Published: October 2022

Background:

Tobacco use is the leading preventable cause of morbidity and mortality in Canada. Smoking cessation programs (SCPs) that are effective, cost-effective and widely available are needed to help smokers quit. Pharmacists are uniquely positioned to provide such services. This study compares the abstinence rates between 2 pharmacist-led SCPs and the cost-effectiveness between these and a comparator group. The study was conducted in St. John’s, Newfoundland and Labrador.

Methods:

This pragmatic, mixed-method trial randomized smokers to either an existing intensive SCP or a new abbreviated SCP designed for community pharmacies. The primary outcome was 6-month abstinence rates. Cost-effectiveness was determined using abstinence rates for the SCPs and a comparator group. Incremental costs per additional quit were calculated for the trial duration, and incremental costs per life-year gained were estimated over a lifetime.

Results:

Quit rates for the SCPs were 36% (intensive) and 22% (abbreviated) ( p = 0.199). Incremental costs per life-year gained for the SCPs were $1576 (intensive) and $1836 (abbreviated). The incremental costs per additional quit, relative to the comparator group, for the SCPs were $1217 (intensive) and $1420 (abbreviated).

Discussion:

Both SCPs helped smokers quit, and quit rates exceeded those reported for a comparator group that included a general population of adult smokers (~7%). The incremental costs per additional quit for both SCPs compare favourably to those reported for other initiatives such as quit lines and hospital-based interventions.

Conclusion:

Pharmacist-led smoking cessation programs are effective and highly cost-effective. Widespread implementation, facilitated by remuneration, has potential to lower smoking prevalence and associated costs and harms.
Demographics of Canadian strength and conditioning coaches
Authors: Foley Jordan K , Erickson Karl T , McGowan Erin L , Behm David G
Published: October 2022

Canadian strength and conditioning (S&C) coaches demographic characteristics are unknown but are necessary to assess the current state of the field. A sample of 215 Canadian S&C coaches were recruited through the Canadian Strength and Conditioning Association's newsletter, the National Strength and Conditioning Association's (NSCA) Canadian Facebook group, and the principal investigator's professional network. Mean age of the sample was 34.1 years (±8.6) years, 77.7% were male, and 90.7% did not consider themselves to be a visible minority. Participants most commonly reported working in the private sector (34.9%), at a university (19.1%), and with provincial or national sport organizations (19.1%). The most common salary range reported was $40,001–$50,000 and $50,001–$60,000 (Canadian dollars) at 13.5% each. The most common certifications reported by Canadian S&C coaches was the NSCA-Certified Strength and Conditioning Specialist (CSCS) (84.4%). The highest education obtained was reported as Bachelor's (54.9%) and Master's degrees (37.8%), and 83.6% reported having degrees directly related to the field of S&C. The archetype demographics of Canadian S&C coaches presented as mid-thirties, male, non-visible minority, with a Bachelor's degree, and the NSCA–CSCS certification. The definition of these characteristics will inform future Canadian S&C coaches, mentors, and inform future research in this area.
Quercetin and Luteolin may be the New Effective Drugs for Radiation Pneumonitis: Based on a Systems Pharmacology
Authors: Zhang Mengmei , Li Guangcai , Hu Huaqing , Yi Mu , Li Yang , Luo Jihang , Tang Yan , Xu Guangmin , Yang Ze , Liu Xiao
Published: October 2022

Background: The occurrence of radiation pneumonia not only affects the efficacy of radiotherapy, but also seriously threatens the health of patients undergoing radiotherapy for lung cancer. Studies have suggested that a feining granule is a potentially effective drug for the treatment of radiation pneumonitis, but its mechanism and main components are still unclear. Our study used bioinformatics methods to analyze the main drug Aster tataricus L. f. in feining granules and aims to gain the main mechanism in the treatment of radiation pneumonitis. Methods: Analyzed the effective drug components and targets of A tataricus through the Traditional Chinese Medicine Systems Pharmacology website. And obtained gene targets related to radiation pneumonia through the website of OMIM, Genecard, and Disgenet. Protein–protein interaction (PPI), gene ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of the obtained drugs and gene-related targets were conducted. Verify the effects of small molecule drugs on corresponding targets by conducting molecular docking experiments. Results: In total, 193 targets were identified for 13 molecules of A tataricus, and 897 genes were identified to be related to radiation pneumonia. Finally, we obtained 111 genes by crossing drug and disease-related target genes. Using PPI, GO, and KEGG analysis, we found TP53, HSP90AA1, RELA, JUN, AKT1, mitogen-activated protein kinase 1 ( MAPK1), tumor necrosis factor ( TNF), and interleukin-6 ( IL-6) are the most critical genes, which were mainly focused on the GOs of DNA-binding transcription factor, RNA polymerase II-specific DNA-binding transcription factor and protein serine/threonine kinase activity, and the pathways of lipids and atherosclerosis, advanced glycation end products and their receptors, and IL-17. Conclusion: Through molecular docking experiments, it was found that the small molecules of quercetin and luteolin bind tightly to RELA and JUN proteins. We reveal the mechanism of action of A tataricus in the treatment of radiation pneumonia. Quercetin and luteolin may be effective small molecules for radiation pneumonitis.
Beliefs, emotions, and usage of information and communication technologies in distance learning during the COVID-19 pandemic: Health sciences students’ perspectives
Authors: Green Gizell , Shorer Tali
Published: October 2022

Objectives

First, to examine Health Sciences students’ discipline, educational level, number of online courses taken, and emotions regarding distance learning; second, to explore a model in which information and communication technologies' (ICT) beliefs serve as mediators among ICT's emotions and ICT usage.

Methods

This is a cross-sectional study. Participants consisted of 210 students from the School of Health Sciences at the University. Perceptions toward ICTs in Teaching-Learning Process Scale and Computer Emotion Scale were used.

Results

Nursing students report significantly more ICT-related negative emotions than Management of Health Systems students. Students who took a low or medium number of online courses report significantly more ICT-related positive emotions than students who took a high number of online courses. In addition, ICT-related beliefs did not mediate the effects of ICT-related positive emotions and ICT usage but did mediate ICT-related negative emotions and ICT usage.

Conclusions

The digital tools in online courses should be appropriately combined with the learning method, and course content. It requires not only a solid technical foundation but also an educational mentality, as well as an adjustment period.
Chronic Lateral Ankle Instability Treated With Tendon Allografting: A Preliminary Comparison of Arthroscopic and Open Anatomic Ligament Reconstruction
Authors: Yang Kai-Chiang , Chen Pei-Yu , Loh Chieh , Tzeng I-Shiang , Chang Shun-Min , Wang Chen-Chie
Published: October 2022

Background:

Roughly 30% of patients with chronic lateral ankle instability (CLAI) have long-lasting painful instability requiring surgical intervention. Ligament reconstruction with the traditional open method and using tendon allografts can provide sufficient mechanical stability for severe CLAI. Arthroscopic ligament reconstruction with tendon allograft has recently been introduced to treat CLAI.

Purpose:

In this study, we describe an arthroscopic ligament reconstruction procedure involving the use of the tendon allograft for patients with CLAI, and we compare the efficacy of this procedure with open ligament reconstruction with tendon allograft.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We enrolled 10 patients (4 men and 6 women) with CLAI (mean age, 37.3 years; range, 16-57 years) who underwent arthroscopic ligament reconstruction with tendon allografting between November 2017 and June 2019. The control group consisted of 10 patients who received open tendon allograft reconstruction. Preoperative and 2-year postoperative functional outcomes were evaluated using the American Orthopaedic Foot & Ankle Society ankle-hindfoot scale (AOFAS), Karlsson Ankle Functional Score (KAFS), pain visual analog scale (VAS), 12-Item Short Form Health Survey (SF-12), and Tegner activity score (TAS).

Results:

The mean operative time was 118 and 110 minutes in the arthroscopic and open groups, respectively. At 2-year follow-up, scores on the AOFAS improved significantly compared with preoperatively, from 71.3 to 96.4 ( P = .006) in the arthroscopic group, and from 68.6 to 96.7 ( P = .005) in the open group. The postoperative AOFAS, VAS, KAFS, and SF-12 scores did not differ significantly between the 2 groups; however, the TAS score was significantly higher in the arthroscopic reconstruction group compared with in the open group (7 vs 6.1, respectively; P = .01).

Conclusion:

Arthroscopic ligament reconstruction with tendon allografting resulted in sufficient ankle stability and no donor-site morbidity. This procedure can yield similar functional outcomes to open reconstruction technique and may be an option for the management of CLAI.
Responsiveness of the Post-Concussion Symptom Scale to Monitor Clinical Recovery After Concussion or Mild Traumatic Brain Injury
Authors: Langevin Pierre , Frémont Pierre , Fait Philippe , Roy Jean-Sébastien
Published: October 2022

Background:

The Post-Concussion Symptom Scale (PCSS) is used to assess the number and intensity of symptoms after a concussion/mild traumatic brain injury. However, its responsiveness to monitor clinical recovery has yet to be determined.

Purpose:

To evaluate the responsiveness of the PCSS to change and longitudinal validity in patients with persistent postconcussive symptoms as well as to explore the responsiveness of other clinical outcome measures to monitor recovery of physical symptoms in patients with persistent postconcussive symptoms.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Patients with persistent symptoms after a concussion (N = 109) were evaluated using self-reported questionnaires at baseline and after a 6-week rehabilitation program. The program consisted of an individualized symptom-limited aerobic exercise program combined with education. Questionnaires included the PCSS, Neck Disability Index (NDI), Headache Disability Inventory (HDI), Dizziness Handicap Inventory (DHI), and Numeric Pain Rating Scale (NPRS) related to 1) neck pain and 2) headache. Internal responsiveness was evaluated using the effect size (ES) and standardized response mean (SRM), and external responsiveness was determined with the minimal clinically important difference (MCID) calculated using a receiver operating characteristic curve. The global rating of change was used as the external criterion. Pearson correlations were used to determine the longitudinal validity.

Results:

The PCSS was highly responsive (ES and SRM, >1.3) and had an MCID of 26.5 points (of 132) for the total score and 5.5 (of 22) for the number of symptoms. For longitudinal validity, low to moderate correlations were found between changes in PCSS and changes in NDI, HDI, and DHI. The NDI, HDI, DHI, and NPRS were also highly responsive (ES and SRM, >0.8).

Conclusion:

All questionnaires including the PCSS were highly responsive and can be used with confidence by clinicians and researchers to evaluate change over time in a concussion population with persistent symptoms.
A bayesian approach to model the underlying predictors of early recurrence and postoperative death in patients with colorectal Cancer
Authors: Mahmoudi Leila , Fallah Ramezan , Roshanaei Ghodratollah , Asghari-Jafarabadi Mohammad
Published: October 2022

Objective

This study aimed at utilizing a Bayesian approach semi-competing risks technique to model the underlying predictors of early recurrence and postoperative Death in patients with colorectal cancer (CRC).

Methods

In this prospective cohort study, 284 patients with colorectal cancer, who underwent surgery, referred to Imam Khomeini clinic in Hamadan from 2001 to 2017. The primary outcomes were the probability of recurrence, the probability of Mortality without recurrence, and the probability of Mortality after recurrence. The patients ‘recurrence status was determined from patients’ records. The Bayesian survival modeling was carried out by semi-competing risks illness-death models, with accelerated failure time (AFT) approach, in R 4.1 software. The best model was chosen according to the lowest deviance information criterion (DIC) and highest logarithm of the pseudo marginal likelihood (LPML).

Results

The log-normal model (DIC = 1633, LPML = -811), was the optimal model. The results showed that gender(Time Ratio = 0.764: 95% Confidence Interval = 0.456–0.855), age at diagnosis (0.764: 0.538–0.935 ), T3 stage (0601: 0.530–0.713), N2 stage (0.714: 0.577–0.935 ), tumor size (0.709: 0.610–0.929), grade of differentiation at poor (0.856: 0.733–0.988), and moderate (0.648: 0.503–0.955) levels, and the number of chemotherapies (1.583: 1.367–1.863) were significantly related to recurrence. Also, age at diagnosis (0.396: 0.313–0.532), metastasis to other sites (0.566: 0.490–0.835), T3 stage (0.363: 0.592 − 0.301), T4 stage (0.434: 0.347–0.545), grade of differentiation at moderate level (0.527: 0.387–0.674), tumor size (0.595: 0.500–0.679), and the number of chemotherapies (1.541: 1.332–2.243) were the significantly predicted the death. Also, age at diagnosis (0.659: 0.559–0.803), and the number of chemotherapies (2.029: 1.792–2.191) were significantly related to mortality after recurrence.

Conclusion

According to specific results obtained from the optimal Bayesian log-normal model for terminal and non-terminal events, appropriate screening strategies and the earlier detection of CRC leads to substantial improvements in the survival of patients.
Post-fracture serum cytokine levels are not associated with a later diagnosis of complex regional pain syndrome: a case-control study nested in a prospective cohort study
Authors: Parkitny Luke , McAuley James H , Herbert Robert D. , Di Pietro Flavia , Cashin Aidan G , Ferraro Michael C , Moseley G. Lorimer
Published: October 2022

Background

Complex Regional Pain Syndrome (CRPS) is a disabling pain disorder that is most common after a distal limb fracture. While the acute systemic immune response to the injury is thought to play a role in the development of CRPS, this hypothesis has never been tested directly. Thus, we evaluated whether elevated levels of circulating pro-inflammatory cytokines early after a fracture were associated with the development of CRPS.

Methods

We conducted a case-control study nested within a prospective cohort study. Individuals with wrist and/or hand fractures were recruited from specialist hand units. Baseline clinical data were obtained from participants within 28 days of fracture. CRPS status was determined 16 weeks after the fracture using a two-stage diagnostic process. Cytokine assays were obtained from all cases (defined using the Budapest criteria) and a random sample of those who did not have CRPS at 16 weeks. We calculated odds ratios with 95% confidence intervals to determine the risk of CRPS associated with the expression of each of 25 cytokines.

Results

Baseline data were collected for 702 consenting participants, of whom 535 provided blood samples. Follow-up at 16 weeks was 97.2%. 15 (2.2% of the cohort) met the Budapest CRPS criteria and 69 (including those who met the Budapest criteria; 9.8%) met the International Association for the Study of Pain (IASP) CRPS criteria. In all of the primary analyses (using Budapest criteria) and 49/50 secondary analyses (using IASP criteria), 95% confidence intervals for the association between cytokine levels and the risk of subsequently developing CRPS included the null value (OR = 1). However, the confidence intervals were wide.

Conclusion

There was no evidence that early post-injury expression of systemic cytokines was associated with a CRPS diagnosis 16 weeks after injury. This study does not provide support for the hypothesis that innate immune activation has a determinative role in the development of CRPS.
The effect of steroid administration on fetal diaphragm function
Authors: Ozdemir Fatma , Acmaz Gokhan , Madendag Yusuf , Madendag Ilknur Col , Muderris Iptisam Ipek
Published: October 2022

Background

Antenatal steroid administrations lead to not only accelerated lung maturation, improved blood gas measurements but also lung dynamics and lung compliance. This study aimed to investigate structural and functional changes in diaphragm after antenatal steroid administration.

Methods

The 79 volunteers were divided into 2 groups according to presence of preterm delivery. Betamethasone (CelestoneR) 12 mg intramuscularly was routinely administered to pregnancies complicated with preterm delivery between 28th -34th weeks of gestation. Same dose was repeated 24 h later. In all patients, diaphragm thickness, diaphragmatic excursion and costophrenic angle were measured in both the inspirium and expirium stage of respiration. This is an observational cross-sectional study.

Results

Diaphragm thickness, diaphragmatic excursion and diaphragm thickening fraction parameters were improved but costophrenic angle was not different 7 days after steroid administration. Diaphragm thickness, diaphragmatic excursion and costophrenic angle changes during inspiration and expiration stage after 7 days of betamethasone treatment reflects the effect of steroid administration on diaphragm muscle. Comparisons of the differences that occur after steroid rescue protocol were done by subtracting the diaphragm thickness, diaphragmatic excursion and costophrenic angle parameters before the treatment from the diaphragm thickness, diaphragmatic excursion and costophrenic angle parameters 7 days after steroid treatment respectively.

Conclusion

Diaphragm became more mobile in patients with preterm labor, 7 days after steroid administration. This situation reflects positive effect of steroid administration on diaphragm function.