bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of lee waves on the Southern Ocean circulation
Authors: Yang Luwei , Nikurashin Maxim , Hogg Andrew McC. , Sloyan Bernadette M.
Published: July 2021

Lee waves play an important role in transferring energy from the geostrophic eddy field to turbulent mixing in the Southern Ocean. As such, lee waves can impact the Southern Ocean circulation and modulate its response to changing climate through their regulation on the eddy field and turbulent mixing. The drag effect of lee waves on the eddy field and the mixing effect of lee waves on the tracer field have been studied separately to show their importance. However, it remains unclear how the drag and mixing effects act together to modify the Southern Ocean circulation. In this study, a lee wave parameterization that includes both lee wave drag and its associated lee-wave-driven mixing is developed and implemented in an eddy-resolving idealized model of the Southern Ocean to simulate and quantify the impacts of lee waves on the Southern Ocean circulation. The results show that lee waves enhance the baroclinic transport of the Antarctic Circumpolar Current (ACC) and strengthen the lower overturning circulation. The impact of lee waves on the large-scale circulation are explained by the control of lee wave drag on isopycnal slopes through their effect on eddies, and by the control of lee-wave-driven mixing on deep stratification and water mass transformation. The results also show that the drag and mixing effects are coupled such that they act to weaken one another. The implication is that the future parameterization of lee waves in global ocean and climate models should take both drag and mixing effects into consideration for a more accurate representation of their impact on the ocean circulation.
Giftedness, Gender Identities, and Self-Acceptance: A Retrospective Study on LGBTQ+ Postsecondary Students
Authors: Lo C. Owen , Hu Shun-Fu , Sungur Hasan , Lin Ching-Hui
Published: July 2021

In a recent position statement, the National Association of Gifted Children argued the importance of providing equitable treatment of Lesbian, Gay, Bisexual, Transgender, Queer and other sexual and gender minority individuals (LGBTQ+) gifted youth to help them maximize their potential. However, there are very few empirical studies focusing on the intersection of giftedness and gender identities. Little is known regarding these students’ experience at, and outside of, school. Focusing on the individual process of gender identity development and self-acceptance, we interviewed nine LGBTQ+ postsecondary students in North America (aged between 19 and 29 years) who are graduates of an academically focused high school in Turkey. In particular, we studied their ways of thinking, stress coping strategies, and environmental factors that may have enabled their self-acceptance of LGBTQ+ identities. Findings of the study show that the mental health of LGBTQ+ is a function of individual factors (e.g., coping strategies), structural factors (e.g., a homophobic sociocultural environment), and the context. The findings also indicate the benefits of complexity and reflectiveness in thinking, metacognition and the ability to separate identity labels from identities, enabled by high school peer support, liberal curriculum and classroom discussions, and access to information during adolescence.
Democracy, Culture and Cancer Patients’ Willingness to Pay for Healthcare Services: A Meta-analysis
Authors: Chaikumbung Mayula
Published: July 2021

Cancer is one of the leading causes of death globally and expenditure associated with cancer is quite high. Efficient resource allocation needs information on economic evaluations of healthcare interventions. The purposes of the study are to provide a comprehensive overview of cancer patients’ willingness to pay (WTP) for healthcare services and to investigate the influence of democracies, culture dimensions, and other factors on WTP. A meta-analysis was conducted using PubMed, Scopus, and Google Scholar to identify all studies of stated preference approach to estimate cancer patients’ WTP healthcare services. A set of criteria was constructed for selecting relevant studies. A total of 79 studies were related to selection criteria and held sufficient information for the purposes of meta-analysis. A total of 393 estimates of WTP from 79 healthcare valuation studies were pooled to identify the links between WTP and influential factors. The findings suggest that values of benefits in healthcare services are higher in more democratic nations, but they are lower in cultural traits that are stronger indulgence and uncertainty avoidance. Further, the types of cancer matter. Compared to breast cancer, WTP is higher for skin cancer, yet lower for liver cancer and lymphoma. A higher national income and public health expenditure increase WTP for healthcare services, while a higher death rate by cancer leads to lower values of healthcare benefits.
The Sober Professor: Reflections on the Sober Paradox, Sober Phobia, and Disclosing an Alcohol Recovery Identity in Academia
Authors: Burns Victoria F.
Published: July 2021

Fueled by stigma, individuals in, or seeking recovery from addiction struggle with disclosure across personal and professional life domains. Guided by the concepts of stigma and alcogenic environments, this paper explores the risks, benefits, and paradoxes of disclosing an alcohol addiction recovery identity from the perspective of an assistant professor in a Canadian university context. It argues that disclosure can be a promising way to strengthen personal recovery, combat self and public stigma, help build community, model authenticity and transparency in teaching and research roles, shift university drinking culture, and provide a safer environment for others to disclose and/or seek help for addiction. Policy and practice recommendations are provided.
Embodied Engagements: Body Mapping in a Sociology of Sexuality Classroom
Authors: Fields Jessica , Johnson Stephanie , MacFife Bex , Roach Patricia , steinfeld era
Published: July 2021

Using a collaborative autoethnographic approach, we discuss body mapping as an embodied pedagogical practice for teaching sexuality. Body mapping centers stigmatized bodies through guided visual, oral, and textual self-representation. We begin by discussing embodied pedagogies and the bind of representation (ideas grounded in the work of feminists of color) in teaching and learning about sexuality. We then consider three body mapping experiences: in a sexuality education graduate seminar ( seminar mapping), as a remote synchronous practice ( remote mapping), and as a solo practice ( solo mapping). We explore challenges in representation, embodied difference, and the im/possibility of mapping the sexual. Finally, we consider the implications and applications of body-mapping exercises for sexualities classrooms.
Architecture in Eighteenth-Century East and Southeast Asia Chinese Quarters
Authors: Luengo Pedro
Published: July 2021

Chinese quarters developed significantly during the eighteenth century along the coasts of East and Southeast Asia, exhibiting a common urban milieu in cities such as Manila, Batavia, Hoi An, and Nagasaki. Sharing similarities, they can be found both in states ruled by Asians and by Europeans, allowing for a comparison. This paper aims to prove that urban and architectural approaches of Chinese enclaves in these ports were similar in the eighteenth century and clearly referenced historic water towns of southern China. To do this, historical plans and textual sources of the aforementioned four overseas cities will be used. These results aim to be valuable as an historical basis for studies on acculturation processes in contemporary Chinese quarters.
The evolving perspectives on the Chinese labour regime in Africa
Authors: Ofosu George , Sarpong David
Published: July 2021

This article explores the logics, persistence and evolution of perspectives on the Chinese labour regime in Africa. Studies find that Chinese firms’ labour practices engender abuse via casualisation of labour, low remuneration, and a general lack of adherence to occupational safety. Contrarian studies however demonstrate variations among Chinese firms’ labour practices as mediated by the labour dynamics of host countries, labour specificities and industrial capitalism dynamics. The article concludes by questioning the ‘talent gap’ dynamic in Africa in relation to Chinese firms’ managerial hiring practices and calls for an engaged scholarship on how Chinese investment in Africa’s human resource base is altering the ‘talent gap’ phenomenon.
Are Multiple Tests Necessary for Salivary Pepsin Detection in the Diagnosis of Laryngopharyngeal Reflux?
Authors: Wang Jiasen , Li Jinrang , Nie Qian , Zhang Ran
Published: July 2021

Objectives

To evaluate the necessity of multiple salivary pepsin tests within a day when diagnosing laryngopharyngeal reflux.

Study Design

Prospective cohort study.

Setting

Tertiary hospitals.

Methods

A total of 138 patients with signs and/or symptoms associated with laryngopharyngeal reflux were included. Salivary pepsin was detected on the day of 24‐hour pH monitoring, and the results of salivary pepsin detected once in the morning and multiple times in 1 day were compared with the results of pH monitoring.

Results

Among the 138 patients, pH monitoring results were positive in 112. Salivary pepsin was positive in 47 cases in the morning, which was not consistent with the results of pH monitoring (kappa value = 0.117). With the pH monitoring results as the standard, the salivary pepsin detected once in the morning had a sensitivity of 38.4% (43/112) and a specificity of 84.6% (22/26) for the diagnosis of laryngopharyngeal reflux. When salivary pepsin was detected multiple times per day, 102 patients tested positive. The consistency with pH monitoring was moderate (kappa value = 0.587). The sensitivity was 86.6% (97/112), and the specificity was 80.8% (21/26). Of the 97 patients with positive results from pH monitoring and salivary pepsin detected multiple times a day, 54 had negative findings for a single detection in the morning, indicating that 55.7% (54/97) of the true positive cases were missed.

Conclusion

Although a single detection of salivary pepsin in the morning is more economical, the sensitivity is too low, and it is necessary to detect it multiple times a day.
Current Barriers in Pursuing Otolaryngology as an Osteopathic Applicant and Proposed Goals for the Future
Authors: Farsar Cameron J. , Quesada Pompeyo R. , Brown Jason R.
Published: July 2021

The osteopathic (DO) medical profession has seen a substantial increase in popularity, evident by the drastic increase in the DO physician workforce and increasing number of DO graduates in the United States. Osteopathic medical schools have historically been primary care focused, resulting in a majority of their graduates pursuing practice in those specialties. This focus may be inadvertently creating a disadvantageous environment for DO students who aim to pursue specialized or traditionally competitive fields in medicine. Otolaryngology is a prime example of osteopathic underrepresentation, as there is currently a significantly low percentage of DO residents in otolaryngology residency programs and practicing DO otolaryngologists. Given the recent American Council on Graduate Medical Education (ACGME) and American Osteopathic Association (AOA) merger between osteopathic and allopathic (MD) residency programs, it is of great value to further discuss avenues for progress and mitigation of barriers.
Driving While Impaired and Riding with an Impaired Driver among Recent Latinx Immigrants
Authors: Romano Eduardo , Sanchez Mariana , Taylor Eileen P. , Babino Rosa
Published: July 2021

The overarching aim of this study is to assess driving while impaired by alcohol (DWI) and riding with an impaired driver (RWID) rates among young adult Latinx immigrants to Miami-Dade County, Florida, within a year of arrival in the U.S.A. More specifically, this study aims to: (i) describe the demographic and socioeconomic characteristics of Latinx immigrants to Miami-Dade County within a year of arrival; (ii) examine their alcohol use, DWI, and RWID; and (iii) identify factors influencing these behaviors. This study uses baseline data from an ongoing National Institutes of Health-funded longitudinal study examining drinking and driving trajectories among young adult recent Latinx immigrants to Miami-Dade County. During the baseline assessment, retrospective pre-immigration data and post-immigration data were obtained via personal interviews. Inclusion criteria included being a Latinx immigrant, 18–34 years old, who recently immigrated (within one year before baseline assessment) to the U.S.A. from a Latin American country with the intention of staying in the U.S.A. for at least three years beyond baseline. Respondent-driven sampling was applied. Results showed that since arriving in the U.S.A. approximately 6.3% of all participants had engaged in DWI at least once and 20% reported RWID. Although household income and being male were significant factors, the factor that influenced post-immigration DWI/RWID the most was pre-immigration DWI (odds ratio = 13.1) and pre-immigration RWID (odd ratio = 24.5). Interventions aimed to prevent recent immigrants from engaging in DWI and RWID should take cultural factors and pre-immigration behaviors into account.
Can we still be at home? Agnes Heller and China
Authors: Qilin Fu
Published: July 2021

This paper offers a short history of Agnes Heller’s relationship to China through three aspects: imaginative aesthetic enjoyment, real encounters with Chinese cultural spectacles and actual audiences, and the construction of an academic community through creative dialogue. These discussions suggest that Heller felt at home in China. Although Heller has passed away, a home for us remains in her work through remembering her and engaging further with her writings.
131I-radioisotope modified in PEGylation metal organic frameworks for sensitization in refractory differentiated thyroid cancer treatment
Authors: Jiang Shuai , Yu Miao , Wang Haoyang , Han Songqi , Cheng Mengfei , Zhang Shuo , Liu Jiahui , Wang Xinghua , Dong Mei
Published: July 2021

Radiation therapy for cancer can lead to off-target toxicity and can be ineffective against refractory differentiated thyroid cancer. The nanoscale metal organic frameworks (NMOFs) have shown great potential in cancer diagnostic and treatment due to their advantages in the aspect of structural diversities, high intrinsic biodegradability and drug-loading capacities. Here, we provide that intratumoral injection, in mouse of refractory differentiated thyroid cancer.

In this work, we used the therapeutic 131I radioisotope modified Zr-MOF (Zr-MOF@131I) with aim to enable long-term relief of tumour therapy, which has successfully eliminated tumour at ralatively low radioactivity doses. Polyethylene glycol (PEG) was coated into Zr-MOF and, as a result, circulation time was significantly improved by intratumoral injection. These findings therefore suggest that nanoparticles could be used in vivo combined therapy. On injection, while it is a highly effective drug for radioisotope, Zr-MOF with attenuation ability could apply for a radio-sensitizer to enhance inner radiotherapy (RT). The local therapy, which uses only biocompatible components, might enable new strategies for local tumour treatments. These could be further combined with systemic therapeutic responses for the inhibition of refractory differentiated thyroid cancer and the prevention of tumour recurrence in patients.
Intimate Partner Violence among Canadian Muslim Women
Authors: Alghamdi Maryam S. , Lee Bonnie K. , Nagy Gabriela A.
Published: July 2021

An examination of the interaction of pre- and post-migration stressors is critical to understanding Canadian Muslim immigrant women’s experience of intimate partner violence (IPV). This study uses a dominant qualitative design, supplemented by quantitative data to understand eight Canadian Muslim immigrant women’s experience of IPV from six countries of origin. Five themes were identified: (a) childhood exposure to trauma and violence, (b) iron cage of society, (c) the fusion of love and violence, (d) post-migration challenges and assistance, and (e) toll and consequences of IPV. These themes are described to illustrate the trajectory in the development of IPV and the participants’ eventual decision to leave their relationship. Pre-migration experiences included adverse childhood experiences, family history of IPV, and difficulty with help-seeking for IPV. Post-migration challenges of language difficulties, lack of social connections, internalized familial patriarchal values, and sexism influenced women’s help-seeking and decision-making. Results from this sample suggested that immigrant Muslim women are likely more affected by IPV in comparison to Canadian-born Muslim women, experienced more stressors, less support, delayed help-seeking process, and more serious mental health consequences. Quantitative measures revealed negative effects of IPV on women’s mental and overall health. The roles of ethnic communities, religious institutions, law enforcement, and service providers in supporting Canadian Muslim women with experience of IPV are discussed.
Pietro Pacifico Gamondi (1914-1993), tropical physician and ethnologist. A protagonist of medical research in the middle of the 20th century
Authors: Pezzoni Barbara , Larentis Omar , Birkhoff Jutta M , Gorini Ilaria
Published: July 2021

Pietro Pacifico Gamondi was a tropical physician, who was one of the main protagonists of medical research during the 20th century. His training as a doctor first saw him in Rome following doctor Aldo Castellani. Gamondi then left for Lisbon, London, and the extra-European countries that have characterized his path as a doctor and as a man. In fact, he traveled to Indonesia and Africa, where took care of the population, combining European and local medicine. In this contribution, we wanted to remember the figure of a man who dedicates his life to tropical medicine and to the care of others.
Comparison of attitude of nurses and nursing students toward euthanasia
Authors: Khatony Alireza , Fallahi Masoud , Rezaei Mansour , Mahdavikian Somayeh
Published: July 2021

Background:

Euthanasia is a controversial issue in many countries. However, there is little evidence about attitudes of nurses and nursing students toward euthanasia.

Research aims:

The present study aimed to compare nurses and nursing students' attitudes toward euthanasia.

Research design:

This is a descriptive cross-sectional study.

Participants and research context:

Using census sampling, 390 nurses and 125 nursing students were enrolled in this study.

Methods:

Data were collected using a socio-demographic questionnaire and Euthanasia Attitude Scale that included 20 items that sought to record participants’ level of agreement with euthanasia based on a Likert-type scale.

Ethical considerations:

Objectives of the study were stated for all samples, and emphasized the confidentiality of their specifics and responses, and informed written consent was obtained from all participants.

Findings:

The mean score of nurses and nursing students’ attitudes about euthanasia was 3.14 ± 0.26 and 3.22 ± 0.24 out of 5, respectively. The majority of nurses ( n = 250, 65.78%) and nursing students ( n = 97, 80.83%) had a positive attitude toward euthanasia. There was a significant statistical difference between the attitudes of nurses and nursing students to euthanasia ( p = .005).

Discussion:

The results indicated that the majority of students and nurses had a positive attitude regarding euthanasia.

Conclusion:

It was recommended to conduct more studies on euthanasia in Iran.
Somatic-Type Yolk Sac Tumor Arising as a Predominant Component of Bladder Urothelial Carcinoma
Authors: Collins Katrina , Alkashash Ahmad M. , Hwang Michael , Kaimakliotis Hristos Z. , Cheng Liang , Idrees Muhammad T.
Published: July 2021

Germ cell differentiation has been described in association with somatic tumors arising from several organ systems; rare cases arising from urothelium have been reported. Here we present a 62-year-old male with a remote history of lung cancer, a left adrenal gland mass, and a 5.6 cm left bladder wall mass; cystoscopy demonstrated a large papillary mass on the left anterior bladder wall. A transurethral resection specimen was sent for review in consultation and showed extensive papillary structures with thin fibrovascular cores lined by neoplastic cells with clear cytoplasm. These neoplastic cells were diffusely positive for pancytokeratin, CDX2 (caudal-type homebox 2), SALL4 (sal-like transcription factor 4), glypican-3, AFP (alpha-fetoprotein), while negative for PAX-8 (paired box gene 8), NKX3.1 (NK3 homeobox 1), PSA (prostate specific antigen), TTF-1 (thyroid transcription factor 1), Napsin A, inhibin, and OCT4 (octamer-binding transcription factor 4). Conventional urothelial conventional carcinoma and focal squamous differentiation were also identified as minor components. Urothelial carcinoma was focally positive for GATA3 (GATA-binding protein 3) and p63; SALL4 and glypican-3 were negative. Overall findings supported a yolk sac tumor with a smaller component of squamous cell carcinoma (<1%). Subsequent cystectomy showed similar morphologic features and immunoprofile in addition to foci of urothelial carcinoma and urothelial carcinoma in situ. No chromosome 12p abnormalities were identified by fluorescent in-situ hybridization study. A diagnosis of yolk sac tumor derived from urothelial carcinoma was made. Yolk sac tumor should be considered in the differential diagnosis of a high-grade urothelial carcinoma, particularly when glandular or other unusual architectural patterns are present. A somatic origin with underlying genomic instability similar to what has been described in the uterus and ovaries is suggested.
Origins of Values Differences: A Two-Level Analysis of Economic, Climatic and Parasite Stress Explanations in the Value Domain
Authors: Fischer Ronald
Published: July 2021

What variables are associated with cross-cultural differences in values at the individual level? In this study, the statistical effect of variables associated with ecological demands and available economic and cognitive resources on self-reported values are investigated in two independent samples to test the replicability of effects. Values are operationalized using a 10-item version inspired by Schwartz’ value theory. The effects of national wealth, climatic demands, availability of cool water, and parasite stress at the national level are used to predict value scores of individuals within nations using nationally representative data from all inhabited continents ( k = 49 and k = 58; Ns = 64,491 and 81,991). Using mixed-effect models, new insights into individual- and nation-level dynamics in value scores are provided. First, the paper extends previous cultural theories to the individual level by investigating the effects of education and personal income as individual-level resources. Both personal income and education have strong direct effects on value scores. Second, higher education acts as a cognitive resource which turns climatic demands into challenges, effectively unpackaging nation-level theorizing with individual level dynamics. Third, contrary to previous nation-level research, parasite stress was not a significant predictor of individual-level values. Forth, supporting recent theorizing, individuals located in cool water regions reported significantly higher self-transcendence values. Fifth, the effects of wealth on openness values were convergent and reinforcing across levels (higher wealth is associated with more openness values), but operated in opposing directions for self-transcendence values (national wealth is associated with self-transcendent values, individual wealth is associated with self-enhancing values). The current patterns suggest that cultural research needs to pay more attention to individual versus nation-level dynamics and increase replication efforts with independent samples.
Including Medical Footage and Emotional Content in Organ Donation Educational Videos for Latinx Viewers
Authors: Wall Stephen P. , Castillo Patricio , Shuchat Shaw Francine , Norman Elizabeth , Martinez-Lopez Natalia , Lopez-Rios Mairyn , Paulino Hehidy , Homer Bruce , Plass Jan L. , Ravenell Joseph E.
Published: July 2021

We assessed whether videos with medical footage of organ preservation and transplantation plus sad, unresolved, or uplifting stories differentially affect deceased organ donor registration among clients in Latinx-owned barbershops and beauty salons. In a 2 × 3 randomized controlled trial, participants ( N = 1,696, mean age 33 years, 67% female) viewed one of six videos. The control portrayed a mother who received a kidney (uplifting), excluding medical footage. Experimental videos included medical footage and/or showed a mother waiting (unresolved) or sisters mourning their brother’s death (sad). Regression models assessed relative impact of medical footage and storylines on: (1) registry enrollment, (2) donation willingness stage of change, and (3) emotions. Randomization yielded approximately equal groups relative to age, sex, education, religion, nativity, baseline organ donation willingness, beliefs, and emotions. Overall, 14.8% of participants registered. Neither medical footage, sad, nor unresolved stories differentially affected registration and changes in organ donation willingness. Sad and unresolved stories increased sadness and decreased positive affect by ~0.1 logits compared with the uplifting story. Educational videos about organ donation which excluded or included medical footage and varying emotional valence of stories induced emotions marginally but did not affect viewers’ registration decisions differently. Heterogeneity of responses within video groups might explain the attenuated impact of including medical footage and varying emotional content. In future work, we will report qualitative reasons for participants’ registration decisions by analyzing the free text responses from the randomized trial and data from semistructured interviews that were conducted with a subset of participants.
Measuring Early Childhood Educators’ Physical Activity and Sedentary Behavior–Related Self-Efficacy: A Systematic Review of Tools
Authors: Szpunar Monika , Bruijns Brianne , Tucker Patricia
Published: July 2021

Early childhood educators’ (ECEs) self-efficacy is often predictive of their ability and likelihood of promoting healthy activity behaviors in childcare settings. To date, ECEs’ physical activity and sedentary behavior–related self-efficacy has been measured in a variety of ways in childcare-based research, creating difficulty when comparing across studies. To identify the different approaches ECEs’ self-efficacy is assessed, the current study aimed to compare all existing tools that quantitatively measure physical activity and sedentary behavior–related self-efficacy of pre- and in-service ECEs. Seven online databases were searched for original, peer-reviewed, English-written journal articles. Articles were deemed eligible if they employed a tool which measured physical activity and/or sedentary behavior–related self-efficacy of pre- or in-service ECEs. A total of 16 studies were included in this review, and 13 unique tools were identified. All tools measured task self-efficacy ( n = 13), while only 1 tool measured barrier self-efficacy, and approximately half of the tools ( n = 7; 54%) reported on the validity and reliability. Great variability existed among the self-efficacy items included in the tools; however, common constructs included: teaching/leading physical activity, fundamental movement skill development, and physical activity programming. Very few tools mentioned sedentary behavior ( n = 2) and outdoor/risky play ( n = 2). Given the low number of studies that tested validity and reliability of their self-efficacy tools, the lack of consideration for barrier self-efficacy, and the paucity of tools that fully encompassed physical activity, sedentary behavior, and outdoor play considerations for ECEs, future research is needed to validate a new, reliable tool.
Preclinical Safety Assessment and Toxicokinetics of Apitegromab, an Antibody Targeting Proforms of Myostatin for the Treatment of Muscle-Atrophying Disease
Authors: Welsh Brian T. , Cote Shaun M. , Meshulam Deborah , Jackson Justin , Pal Ajai , Lansita Janice , Kalra Ashish
Published: July 2021

Myostatin is a negative regulator of skeletal muscle and has become a therapeutic target for muscle atrophying disorders. Although previous inhibitors of myostatin offered promising preclinical data, these therapies demonstrated a lack of specificity toward myostatin signaling and have shown limited success in the clinic. Apitegromab is a fully human, monoclonal antibody that binds to human promyostatin and latent myostatin with a high degree of specificity, without binding mature myostatin and other closely related growth factors. To support the clinical development of apitegromab, we present data from a comprehensive preclinical assessment of its pharmacology, pharmacokinetics, and safety across multiple species. In vitro studies confirmed the ability of apitegromab to inhibit the activation of promyostatin. Toxicology studies in monkeys for 4 weeks and in adult rats for up to 26 weeks showed that weekly intravenous administration of apitegromab achieved sustained serum exposure and target engagement and was well-tolerated, with no treatment-related adverse findings at the highest doses tested of up to 100 mg/kg and 300 mg/kg in monkeys and rats, respectively. Additionally, results from an 8-week juvenile rat study showed no adverse effects on any endpoint, including neurodevelopmental, motor, and reproductive outcomes at 300 mg/kg administered weekly IV. In summary, the nonclinical pharmacology, pharmacokinetic, and toxicology data demonstrate that apitegromab is a selective inhibitor of proforms of myostatin that does not exhibit toxicities observed with other myostatin pathway inhibitors. These data support the conduct of ongoing clinical studies of apitegromab in adult and pediatric patients with spinal muscular atrophy (SMA).
Trendelenburg position for internal jugular vein catheterization: A systematic review and meta-analysis
Authors: Garcia-Leal Mariana , Guzman-Lopez Santos , Verdines-Perez Adrian Manuel , de Leon-Gutierrez Humberto , Fernandez-Rodarte Bernardo Alfonso , Alvarez-Villalobos Neri Alejandro , Martinez-Garza Javier Humberto , Quiroga-Garza Alejandro , Elizondo-Omaña Rodrigo Enrique
Published: July 2021

To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was performed. Studies that evaluated the cross-sectional area (CSA) and anteroposterior (AP) diameter of the right internal jugular vein (RIJV) with ultrasonography in supine and any degree of head-down tilt (Trendelenburg position) were analyzed. A total of 22 articles (613 study subjects) were included. A >5° Trendelenburg position statistically increases RIJV CSA and AP diameter. Further inclination from 10° does not statistically benefit IJV size. This position should be recommended for CVC placement, when patient conditions allow it, and US-guided cannulation is not available.
Value of information of structural health monitoring with temporally dependent observations
Authors: Nielsen Jannie S
Published: July 2021

A Bayesian approach is often applied when updating a deterioration model using observations from inspections, structural health monitoring, or condition monitoring. The observations are stochastic variables with probability distributions that depend on the damage size. Consecutive observations are usually assumed to be independent of each other, but this assumption does not always hold, especially when using online monitoring systems. Frequent updating using dependent measurements can lead to an over-optimistic assessment of the value of information when the measurements are incorrectly modeled as being independent. This article presents a Bayesian network modeling approach for the inclusion of temporal dependency between measurements through a dependency parameter and presents a generic monitoring model based on the exceedance of thresholds for a damage index. Additionally, the model is implemented in a computational framework for risk-based maintenance planning, developed for maintenance planning for wind turbines. The framework is applied for a numerical experiment, where the expected lifetime costs are found for strategies with monitoring with and without dependency between observations, and also for the case where dependency is present but is neglected when making decisions. The numerical experiment and associated parameter study show that neglecting dependency in the decision model when the observations are in fact dependent can lead to much higher costs than expected and to the selection of non-optimal strategies. Much lower costs (down to one quarter) can be obtained when the dependency is properly modeled. In the case of temporally dependent observations, an advanced decision model using a Bayesian network as a simple digital twin is needed to make monitoring feasible compared to only using inspections.
Versatility of the Posterior Interosseous Artery Flap: Emphasis on Powering Up the Toe Transfer
Authors: Lee GiJun , Kim BumSik , Jeon Neunghan , Yoon JungSoo , Hong Ki Yong , Lim SooA , Eo SuRak
Published: July 2021

Background:

Reverse-flow posterior interosseous artery (rPIA) flap is an excellent tool for restoration of defects in the hand and upper extremity, sparing the main arteries to the hand. Its reliability has been well established.

Materials and Methods:

Fifty-one cases of rPIA flap involving 49 patients were retrospectively reviewed. The inclusion criteria were age, sex, etiology, size and location of the defect, flap size, number of perforators included, pedicle length, flap inset, donor site coverage, complications, and ancillary procedures.

Results:

This study included 44 men and 5 women, ranging in age between 10 and 73 years. The subjects had soft tissue defects of the hand and upper extremity mainly due to traumatic injuries, including scar contractures of the first web space in 18 cases, thumb amputations in 6 cases, and congenital defects in 1 case. Among the 51 rPIA flap elevations, 3 cases involved flap failure due to the absence of proper pedicle. A fasciocutaneous pattern was observed in 45 cases and a myocutaneous pattern in 3 cases. In 5 cases of unplantable thumb amputations, the rPIA flap was performed for arterial inflow to the secondary toe-to-thumb transfer. Venous congestion of varying degrees was noted in 7 cases involving partial necrosis in 2 cases. During the mean 17 months of follow-up, patients were generally satisfied with the final outcomes.

Conclusion:

The rPIA flap can be used not only for soft tissue coverage of the hand and upper extremity but also as a recipient arterial pedicle for a secondary toe-to thumb transfer.
Scoring Lifestyle Medicine Goals With FIFA 2022—An Opportunity to Strike Big!
Authors: Doraiswamy Sathyanarayanan , Cheema Sohaila , Sheikh Javaid I. , Mamtani Ravinder
Published: July 2021

Qatar is one of the few countries in the world with a dedicated national sports day. Qatar believes that sport is one of the best tools to promote a healthy lifestyle to help curb the growing burden of non-communicable diseases (NCDs). With the well-established positive health effects of soccer on cardiovascular, metabolic, and musculoskeletal conditions, the vision of the FIFA World Cup 2022™ hosted by Qatar to use the power of soccer to “open the door of an amazing world experience” is praiseworthy. With NCDs accounting for 70% of deaths in Qatar, there exists a perfect opportunity to promote healthy lifestyles to prevent, treat, and reverse NCDs. We believe that the FIFA World Cup 2022™ presents an opportunity that could contribute to generating valuable evidence on the lifestyle benefits of such large-scale events. This event comes at an opportune moment for countries in the region to make their health systems lifestyle-sensitive. FIFA World Cup 2022™ could just be the tipping point in the region that establishes the role of sports in mitigating the burden of NCDs. With the impact of COVID-19 on persons with pre-existing NCDs, the urgency for addressing the “syndemic” cannot be overemphasized and sport can be the lifestyle medicine.
Knowledge and the News: An Investigation of the Relation Between News Use, News Avoidance, and the Presence of (Mis)beliefs
Authors: Damstra Alyt , Vliegenthart Rens , Boomgaarden Hajo , Glüer Kathrin , Lindgren Elina , Strömbäck Jesper , Tsfati Yariv
Published: July 2021

While increasing scholarly attention has been devoted to news avoidance, there are only few studies taking the distinction between intentional and unintentional news avoidance into consideration, and none that has investigated the linkage between the two types of news avoidance and knowledge about politics and society. To fill this void, this study explores this relationship while distinguishing between knowledge related to uncontested issues and knowledge related to issues that have been subject to public controversies (climate change, vaccination, genetically modified organisms, crime, and immigration). Relying on a large-scale survey among Swedish citizens conducted in 2020 ( N = 2,160), we find that the relationship with patterns of news use is substantially different across these types of beliefs. Among other things, the results suggest that knowledge of uncontested issue domains is positively related to news use, but knowledge of contested issue domains is not. The intentional avoidance of news is only negatively related to knowledge of contested issues. Taken together, the results suggest that the mechanisms driving beliefs related to uncontested versus contested issues are substantially different.
Conceptual ECCE Happiness Framework for Preschools: To Introduce Importance of Happiness to Promote Social and Emotional Competence in Preschool Children
Authors: Kaur Jasleen , Sharma Anupam
Published: July 2021

The primary objective of this article is to create a conceptual Early Childhood Care and Education (ECCE) happiness framework for preschool children in India. Although happiness is regarded as one of the key elements that influence early childhood development, an effective happiness framework does not exist for preschools in rural and socio-economically disadvantaged areas in the state of Punjab in India. Therefore, based on research gaps and existing literature, a conceptual framework has been developed to promote social and emotional competence among preschool children through the happiness intervention. The article also discusses (a) the concepts of happiness, and social and emotional competence; (b) the importance of happiness in preschool; (c) the association between happiness and social-emotional competence of preschool children; and (d) the role of preschool teachers in implementing the framework. Future implementation of this framework in the preschools of India will help overcome the limitation that exists in regard to its validation.
Immediate Pain Relief at Time of Corticosteroid Injection for Idiopathic Adhesive Capsulitis as a Predictor of Eventual Outcomes
Authors: Lesevic Milos , Awowale John T. , Moran Thomas E. , Diduch David R. , Brockmeier Stephen F. , Werner Brian C.
Published: July 2021

Background:

Corticosteroid injection and physical therapy remain the mainstay of treatment for idiopathic adhesive capsulitis of the shoulder; however, a certain percentage of patients will not improve using these interventions and will require manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA).

Purpose:

To evaluate whether the immediate pain reduction after fluoroscopic-guided, mixed anesthetic-corticosteroid injection for idiopathic adhesive capsulitis is related to the eventual need for LOA/MUA or a repeat glenohumeral steroid injection.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This single-institution study involved patients undergoing fluoroscopic glenohumeral corticosteroid injection for a diagnosis of idiopathic adhesive capsulitis between 2010 and 2017. Included were patients with a minimum of 1-year postinjection follow-up and visual analog scale (VAS) pain scores from immediately before and after the injection. The primary analysis was the relationship between patients with an immediate change in VAS score after injection and those who underwent LOA/MUA. A repeat glenohumeral injection was also evaluated as an outcome. Receiver operator characteristic curves and a multivariate binomial logistic regression analysis were performed.

Results:

Overall, 739 shoulders in 728 patients (mean age, 52.6 years; 68% women) were included, of which 38 (5.1%) underwent LOA/MUA and 209 (28%) underwent repeat injections. The immediate change in the VAS score was not significantly associated with the eventual need for LOA/MUA. Preinjection VAS and immediate postinjection VAS scores were not significant predictors of eventual LOA/MUA or subsequent injection. For all 3 predictors, the area under the receiver operator characteristic curve classified them as extremely poor discriminators.

Conclusion:

The immediate pain response to a fluoroscopic-guided glenohumeral injection for idiopathic shoulder adhesive capsulitis was not predictive of the eventual need for LOA/MUA or subsequent injection. Patients can be counseled that even if their initial pain response to an injection is poor, they still have an excellent chance of avoiding surgery, as the overall rate of LOA/MUA was low (5.1%).
Pulmonary metastasectomy in renal cell carcinoma: Predictive and prognostic elements from paired histopathological analysis of primary tumors and respective metastases
Authors: Bersanelli Melissa , Buti Sebastiano , Gnetti Letizia , Varotti Elena , Carbognani Paolo , Rusca Michele , Leonardi Francesco , Campanini Nicoletta , Ziglioli Francesco , Dadomo Clara Indira , Pilato Francesco Paolo , Ventura Luigi , Braggio Cesare , Bocchialini Giovanni , Cortellini Alessio , Brunelli Matteo , Rapacchi Elena , Camisa Roberta , Caruso Giuseppe , Silini Enrico Maria , Maestroni Umberto , Ampollini Luca
Published: July 2021

Objective:

To identify histopathological and immunophenotypical features with potential predictive or prognostic value in patients undergoing pulmonary metastasectomy from renal cell carcinoma (RCC).

Methods:

We retrospectively collected all consecutive patients undergoing pulmonary metastasectomy from RCC after prior nephrectomy. Paired samples of primary tumors and corresponding pulmonary metastases were analyzed, revising histopathological features and testing C-MET, mTOR, and PD-L1 by immunohistochemistry.

Results:

A total of 25 patients were included. Median overall survival (mOS) from metastasectomy was 5.5 years (95% CI = 1.9–9.1). The laterality of metastases had a significant predictive value, with median relapse-free survival (mRFS) from metastasectomy not reached (NR) at mean follow-up (FU) of 60.8 months for left lung involvement, mRFS of 52.9 months (95% CI = 0–145.5) for the right lung and 6.4 months (95% CI = 1.7–11) for bilateral metastases ( p = 0.028). Primary RCC with positive expression of mTOR had higher mOS after metastasectomy than negative cases ( p < 0.001), NR at mean FU of 4.3 years versus mOS of 2 years (95% CI = 0.7–3.3), respectively. PD-L1 positivity on intra-tumor (TILs) and peri-tumor (RILs) infiltrating lymphocytes of metastases was related to higher OS, NR versus 2 years (95% CI = 1.2–2.7, p = 0.003), and NR versus 1.4 years (95% CI = 0.2–2.6, p = 0.012), respectively. The shorter was the surgical interval, the more probably the metastases had high c-MET expression (>70%) ( p = 0.007) and PD-L1 expression >10% on TILs ( p = 0.024).

Conclusions:

mTOR positivity on primary RCC could be a favorable prognostic factor to select patients for pulmonary metastasectomy. The positive impact of PD-L1 expression on immune cells is opposite to the well-known negative prognostic value of PD-L1 on tumor cells in RCC.
First Case Report of an Unusual Fungus (Sporopachydermia lactativora) Associated with a Pulmonary Infection in a Drug Injection User
Authors: Al Dallal Hiba A , Narayanan Siddharth , Jones Christopher M , Lockhart Shawn R , Snyder James W
Published: July 2021

In contrast to a robust literature on known pathogenic fungi such as Cryptococcus and Aspergillus species that cause pulmonary infections, reports of the uncommon genus Sporopachydermia causing infections are very limited. We present the first case report describing the fungus, Sporopachydermia lactativora as a likely cause of pneumonia in a patient with a history of polysubstance abuse and injection drug use (IDU). The patient recovered following antifungal treatment. The organism was recovered from a blood culture, 3 days post collection. Although CHROMagar was of little value, only yeast-like organisms were observed on cornmeal agar. The organism was not in the matrix-assisted laser desorption/ionization—time of flight (MALDI-TOF) mass spectrometry database. Definitive identification was achieved using the ribosomal DNA (rDNA) sequence analysis by targeting the ITS1 (internal transcribed spacer 1) region. This case report is intended to promote awareness of this fungus as a potential pathogen, by providing new information that has not yet been reported in the literature, and prompts physician awareness to suspect a fungal infection when managing patients with a history of IDU as a potential source of unique environmental organisms not previously encountered, warranting more comprehensive diagnosis and treatment options.
System-wide seismic vulnerability of aging multiple-span multiple-girder bridges in low-to-moderate seismic hazard regions
Authors: Lens M.EERI John E , Dewoolkar Mandar M , Hernandez M.EERI Eric M
Published: July 2021

This article describes the approach, methods, and findings of a quantitative analysis of the seismic vulnerability in low-to-moderate seismic hazard regions of the Central and Eastern United States for system-wide assessment of typical multiple span bridges built in the 1950s through the 1960s. There is no national database on the status of seismic vulnerability of bridges, and thus no means to estimate the system-wide damage and retrofit costs for bridges. The study involved 380 nonlinear analyses using actual time-history records matched to four representative low-to-medium hazard target spectra corresponding with peak ground accelerations from approximately 0.06 to 0.3 g. Ground motions were obtained from soft and stiff site seismic classification locations and applied to models of four typical multiple-girder with concrete bent bridges. Multiple-girder bridges are the largest single category, comprising 55% of all multiple span bridges in the United States. Aging and deterioration effects were accounted for using reduced cross-sections representing fully spalled conditions and compared with pristine condition results. The research results indicate that there is an overall low likelihood of significant seismic damage to these typical bridges in such regions, with the caveat that certain bridge features such as more extensive deterioration, large skews, and varied bent heights require bridge-specific analysis. The analysis also excludes potential damage resulting from liquefaction, flow-spreading, or abutment slumping due to weak foundation or abutment soils.