bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 363: Examination of the Effects of Extracorporeal Cardiopulmonary Resuscitation on Sublingual Microcirculation in a Swine Model of Cardiac Arrest
Authors: McCracken Brendan M , Tiba Mohamad H , Cummings Brandon C , Colmenero Carmen I , Rojas-Pena Alvaro , Hala Pavel , Caceres Matias , Hsu Cindy H , Prater Aaron , VanZalen Jensyn J , Ward Kevin R , Bartlett Robert H , Neumar Robert W
Published: July 2021

Background:
Extracorporeal CPR (ECPR) is used to provide circulatory stability for organ perfusion and oxygen delivery (DO
2
) after refractory cardiac arrest (CA). Hemodynamic measurements during ECPR may not necessarily indicate adequate perfusion at the microcirculatory level where DO
2
, oxygen consumption (VO
2
), and oxygen exchange (O
2
ER) are most critical. In this study, we used sidestream dark-field imaging to measure total vessel density (TVD) to evaluate sublingual microcirculatory flow in a swine model of refractory CA and ECPR.

Hypothesis:
We hypothesize that TVD can provide real-time assessment of tissue perfusion during post-cardiac arrest ECPR that correlates with traditional measures of tissue oxygenation.

Methods:
Swine (8) were anesthetized and instrumented for hemodynamic monitoring. Ventricular fibrillation (VF) was induced and CPR initiated after 8min. CPR was administered using a combination of manual and mechanical chest compressions. During CPR the femoral vessels were instrumented for delivery of veno-arterial ECPR. ECPR was initiated 45min after arrest to simulate refractory CA. Sublingual TVD was measured at baseline and after 15min, 1, 2, and 3 hours of ECPR.

Results:
A one-way ANOVA showed significant difference between baseline TVD: 12.2(2.3)mm
-1
and at 3 hours into ECPR: 6.4(3.0)mm
-1
(p=0.005). TVD was highly correlated with circuit flow but not with Mean Arterial Pressure (MAP) (r=0.903, p=0.036; r=0.063, p=0.920). In addition, TVD was highly correlated with DO
2
, and lactate, (r= 0.897, p=0.039; r=-0.883, p=0.047) and moderately with VO
2
, O
2
ER, and ScvO
2
(r= 0.776, -0.370, 0.558) respectively.

Conclusion:
TVD appears to provide a reliable real-time assessment of tissue perfusion during post-cardiac arrest ECPR. The relationships between TVD and MAP, and TVD and flow also suggest that optimization of flow may be more important than optimizing pressure to achieve adequate tissue perfusion during ECPR.
Abstract 364: Association Between Cardiac Arrest to Start of Extracorporeal Cardiopulmonary Resuscitation and Outcome in Patients With Out-of-Hospital Cardiac Arrest Due to Acute Coronary Syndrome
Authors: Kawakami Shoji , Tahara Yoshio , Noguchi Teruo , Inoue Shujiro , Yasuda Satoshi
Published: July 2021

Background:
The proper timing of introducing extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome (ACS) has yet to be well-established.

Hypothesis:
The interval of start of ECPR from cardiac arrest is one of predictors of short-term survival in these particularly ill patients.

Methods:
Between June 2014 and December 2015, we enrolled a total of 13,491 Japanese OHCA patients who were transported to hospitals in a multicenter, prospective fashion (JAAM-OHCA registry). Following exclusion criteria, 72 patients with OHCA due to ACS who were introduced ECPR until return of spontaneous circulation and underwent emergent PCI and target temperature management were eligible for this study (median 59 years-old; 95% male). We investigated the relationship between the interval of start of ECPR or successfully coronary revascularization from cardiac arrest (collapse-to-ECPR or collapse-to-PCI interval) and the survival at 30 days.

Results:
Patients with survival at 30 days were 50% (n=36). Age, gender, the prevalence of patients with bystander CPR or ST-elevation and collapse-to-PCI interval were comparable between patients with/without survival. The survival patients had the higher prevalence of initial shockable rhythm and the shorter collapse-to-ECPR interval than those without survival (84 vs 57%, p=0.018; 50 vs 57 min, p=0.045). Receiver operating curve analysis indicated collapse-to-ECPR interval cutoff point of 50 min (area under the curve 0.66, sensitivity 54%, specificity 75%) and collapse-to-PCI interval cutoff point of 135 min (0.65, 64%, and 67%, respectively) for predicting survival at 30 days. Multivariate logistic regression analysis revealed initial shockable rhythm and collapse-to-ECPR interval as the independent predictors of survival (OR 5.71, p=0.015; OR 1.05, p=0.025, respectively).

Conclusion:
Collapse-to-ECPR interval is a significantly associated with 30 days survival in patients with OHCA due to ACS, while collapse-to-PCI interval is not independent predictor of survival in this study. These findings indicate that time management for start of ECPR from cardiac arrest can be essential for improving OHCA patients’ survival.
Abstract 365: Left Ventricular Wall Findings in Non-Electrocardiography-Gated Contrast-Enhanced Computed Tomography After Extracorporeal Cardiopulmonary Resuscitation
Authors: Sugiyama Kazuhiro , Miyazaki Kazuki , Ishida Takuto , Tanabe Takahiro , Hamabe Yuichi
Published: July 2021

Background:
Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory cardiac arrest. Computed tomography (CT) is often performed after ECPR for diagnosis of etiology and evaluation of complications. However, few studies have reported left ventricular wall findings in contrast-enhanced CT (CE-CT) after ECPR. This study examined the left ventricular wall CE-CT findings after ECPR, and evaluated the association between these findings and the results of coronary angiography and prognosis.

Method:
We evaluated out-of-hospital cardiac arrest patients who were treated with ECPR and then underwent both non-ECG gated CE-CT and coronary angiography at our center between January 2011 and April 2018. The left ventricular wall CE-CT findings at 90 s after contrast injection were classified as follows: homogeneously-enhanced (HE), left ventricular wall was homogeneously enhanced; segmental defect (SD), left ventricular wall was not segmentally enhanced according to coronary artery territory; total defect (TD), entire left ventricular wall was not enhanced; and others. Significant stenosis on coronary angiography, survival to hospital discharge, and successful weaning from extracorporeal membrane oxygenation (ECMO) were examined.

Results:
A total of 111 patients were eligible. Median age was 59 years, and 85 (77%) had initial shockable rhythm. A total of 37 (33%) survived to hospital discharge. HE was observed in 33 patients, SD in 41, TD in 15, and others in 22. Among 74 patients who underwent CT prior to coronary angiography, SD predicted significant stenosis, with sensitivity of 83% and specificity of 100%. Among all patients, 28 (85%) with HE, 15 (37%) with SD, and 3 (20%) with TD were weaned successfully from ECMO. In addition, 17 (52%) patients with HE, 10 (24%) with SD, and 2 (13%) with TD survived to hospital discharge.

Conclusion:
SD could predict coronary artery stenosis with good specificity. Patients with HE had higher success rates for weaning from ECMO. On the other hand, TD was associated with poor outcomes. The left ventricular wall findings in non-ECG gated CE-CT after ECPR might be useful in diagnosis and prognostication.
Legal Features of the Provisions of Unjust Enrichment in Jordanian Civil Law and Comparative Law
Authors: al-Fatlawi Sahib , al-Daboubi Derar
Published: July 2021

Unjust enrichment is considered one source of obligations, which stands in contrast to harmful acts as another source of obligation in the Jordanian Civil Code (JCC). The Unjust Enrichment Rule has developed historically from Roman law, through Islamic jurisprudence, then French law and jurisprudence to modern laws, such as that in Egypt influenced by French law. All these laws have recognised the Unjust Enrichment Rule as an independent source of obligation. Although the JCC was influenced by Islamic jurisprudence, Arab laws, such as the Egyptian Civil Code, and foreign-influenced Arab laws, its features distinguish it from other laws, either in terms of naming the source or the details related to its legal provisions. JCC’s special features need to be highlighted, defined and evaluated for comparison with other laws, i.e., proving beneficial when enacting a new JCC or defining it as unique rather than a copy of other precedent Arab laws.
Good Faith Principle in Contract Law: A Comparative Study under Sharīʿah, Islamic Law Jurisdictions with Emphasis on Iranian Law
Authors: Shoarian Ebrahim , Jafari Mahsa
Published: July 2021

Unlike civil law jurisdictions, the good faith principle in Islamic law is a notion not directly discussed, the foundations of which this article seeks to root out through an analysis of related, but distinct, Islamic law doctrines. As such, since Islamic law is a significant source of codification and adjudication in many Islamic countries, the perspective of some MENA countries as well as Iran towards good faith is also explored. In practice, courts and tribunals could invoke the good faith principle where Islamic law or Islamic-based laws govern the contractual relationships. This article contends that good faith permeates every sphere of a contractual relationship, particularly negotiation under Islamic law.
Citizen Wayn? The Struggle of Parliament in Contemporary Jordan
Authors: Esber Paul Maurice
Published: July 2021

This article is part of the Special Issue “Parliaments in the Middle East and North Africa: A Struggle for Relevance.” Because the politics of citizenship is felt at all stages of the parliamentary process, the very question of parliamentary relevance itself cannot be answered without reference to the citizenry. That Jordan’s citizenship regime influences and impedes parliamentary politics is explored through two cases. The first being decentralization, understood as a relocating of tasks, decision-making and mandates from a centralized location to different, more localized levels. The second study focuses on the uprisings occurring from May 30, 2018 against the draft domestic tax law introduced to parliament by the government of then-Prime Minister Hani al-Mulki. Both cases are implicated in the Kingdom’s parliamentary politics, and their selection is a conscious move away from election analysis. Taken together they elucidate how citizenship is a key battleground on which any future emancipation/development of parliament will be fought.
Event Types and (In)Directness of Causation in Akan
Authors: Duah Reginald Akuoko , Osam E. Kweku , Amfo Nana Aba A.
Published: July 2021

This paper presents a proposal on the form-function correlation between direct causation and non-periphrastic causatives on one hand, and indirect causation and periphrastic causatives on the other hand. The study argues that notions of direct and indirect causation are actually features of event types of causation and vary across different event types. We present five event types of causation found in Akan causatives and isolate their properties with regard to the causer, causee, control of resultant state/event and (in)direct physical contact between causer and causee. We show that in Akan, all types of causatives, lexical, cause-effect SVC and analytic causatives can encode any of the major event types of causation. Consequently, rather than mapping causative expressions with notions of direct or indirect causation, we analyze (in)directness of causation as a feature of event types of causation, not of causative expressions themselves. Thus, although the form-function correlation in causatives may hold in some languages we argue that (in)direct causation is not encoded separately in causative forms and constructions.
A new species of bamboo-feeding leafhopper genus Myittana from India (Hemiptera: Cicadellidae)
Authors: RAMAIAH MOGILI , MESHRAM NARESH M.
Published: July 2021

A new bamboo leafhopper species, Myittana (Myittana) bidentata sp. nov. is described and illustrated from India (Pantnagar, Uttarakhand). The new species is similar to Myittana (Myittana) distincta but can be distinguished by its large size (7.8 mm long) and the male genital structure. An annotated species checklist of the genus and key to species of the subgenus Myittana (Myittana) are also provided.
Description of the female Apocolotois smirnovi (Romanoff, 1885) (Lepidoptera: Geometridae, Ennominae), with comments on the biology and distribution of the species
Authors: JAPARIDZE LASHA-GIORGI , MALKIEWICZ ADAM , SANAKOEVA ALISA , TSULAIA MARIAM , BULBULASHVILI NATALIA , ÕUNAP ERKI
Published: July 2021

The hitherto unknown female of Apocolotois smirnovi (Romanoff, 1885) is described based on two specimens from Tbilisi, Georgia. To date, only males of this rare Transcaucasian species were known. The results of DNA barcoding are presented, larva and pupa of A. smirnovi are figured, and the biology and distribution of the species are commented on.
1. Anthropology, Useful and Scientific
Authors: Boyer Pascal
Published: July 2021

This presents, very briefly, the project of a cultural anthropology that is informed by evolutionary biology, psychology and economics. This “consilient” version of the social sciences, to adopt EO Wilson’s terminology, is based on the idea that we cannot understand human cultures in their diversity and commonalities, without this perspective. The introduction then provides a brief survey of the volume.
Effect of national cultural dimensions and consumption rates on stigma toward alcohol and substance use disorders
Authors: Simha Aditya , Ahmed Sana , Prasad Ramakrishna , Dinesh Akshay S. , Kandasamy Arun , Rao Naren P
Published: July 2021

Background:

Despite the notion of stigma as a socio-cultural process with the concept rooted in social space rather than in individual space, global studies examining impact of cultural differences on stigma toward substance use disorders are lacking.

Aim:

In this study, we aim to study the influence of national culture differences on stigma toward alcohol and substance use disorders.

Methods:

We analyzed individual-level data from 68,041 respondents from 49 countries on stigma toward alcohol and substance use disorders. We examined the effect of the national culture dimensions and national alcohol and substance consumption rates on stigma toward alcohol and substance use disorders using hierarchical linear modeling.

Results:

Our hierarchical linear modeling results indicate that cultural dimensions and consumption rates significantly influence stigma. We found significant positive associations between stigma toward AUD and institutional collectivism and assertiveness, but a negative association with future orientation dimension. Like AUD, stigma toward SUD was also positively associated with institutional collectivism and assertiveness, but negatively associated with power distance.

Conclusions:

The study findings have immense implications for national interventions to decrease stigma and influence policy making.
An Exploratory Model of Family Resilience Processes and Functioning: A Cultural Perspective of the Semai Indigenous Communities in Perak, Malaysia
Authors: Chua Ryan Yumin , Kadirvelu Amudha , Yasin Shajahan , Park Miriam Sang-Ah
Published: July 2021

Given the challenges experienced by the Semai indigenous communities in Perak, Malaysia, and their distinct cultural beliefs, it is important to understand the role of the social and cultural networks in their resilience processes. In particular, further attention needs to be paid to how their families function and shape their beliefs about their lives, as there might be key mechanisms and processes that differ from existing general conceptualizations of family. This grounded theory analysis of 23 Semai Orang Asli (indigenous) community members established a model of the Semai’s family conceptualization and functioning. Findings revealed that the Semai’s concept of family encompasses an extensive network of individuals with their shared relationship with nyenang (spirit ancestors) and cultural heritage, which in turn leads them to have a deep sense of shared family identity and connectedness. This worldview guided the Semai’s family processes and functioning, captured by the following five dimensions: sharing obligations and responsibilities, making collective decisions, prioritizing community’s welfare, sharing of knowledge and resources, and willingness to work with everyone. These factors facilitate a conducive and supportive environment aimed at maintaining existing family relationships. This model can guide the development of culturally specific programs that promote and strengthen indigenous family relationships and resilience.
Anaphylactoid reaction to dextran 40 during general anesthesia in two domestic pigs
Authors: Yoshida Kota
Published: July 2021

This report describes two cases of dextran-induced anaphylactoid reaction (DIAR), with and without cutaneous signs that appeared after administration of dextran 40 during general anesthesia in domestic pigs. Dextran was administered intravenously to 59 pigs that underwent general anesthesia for routine medical device training, and two pigs developed sudden, severe hypotension and decreased end-tidal CO2 level and arterial oxygen saturation within a few minutes after the start of dextran 40 infusion. A systemic cutaneous lesion presenting as flushing and urticaria was observed in case 1, whereas no skin lesions were found despite persistent observation in case 2. Cases 1 and 2 recovered with thoracic wall compression and an intravenous injection of epinephrine (0.02 mg) and hydrocortisone sodium succinate (250 mg). After DIAR treatment, no complications were observed, and the pigs were euthanized with an intravenous injection of thiopental sodium (1.0 g) when the training program was completed. This case report discusses the appearance of DIAR after dextran 40 administration during general anesthesia in domestic pigs, which is similar to DIAR in humans. However, the incidence of DIAR in this study was much higher than that in humans, suggesting that dextran 40 should not be used in domestic pigs.
Assessing Proprioception in an Older Population: Reliability of a Protocol Based on Active Movement Extent Discrimination
Authors: Antcliff Susan , Welvaert Marijke , Witchalls Jeremy , Wallwork Sarah B. , Waddington Gordon
Published: July 2021

Proprioceptive ability – the sense of where body parts are located in space - is one of many factors thought to affect falls risk among the elderly. Active movement extent discrimination is an approach to measuring proprioception that is administered in an ecologically valid testing environment to better reflect the exercise of proprioceptive skills in daily life. The Active Movement Extent Discrimination Apparatus (AMEDA) was developed to objectively measure this proprioceptive discrimination. However, the current absolute identification testing protocol is cognitively demanding, and it yields results that are insufficiently reliable to assess performance at the individual level. The objectives of this pilot study were to test the reliability and feasibility of a proposed new AMEDA testing protocol and to explore how performance related to cognitive ability and any perceived dysfunction in the foot or ankle. We tested 42 participants (aged 19 – 94 years) three times on the ankle AMEDA using a newly developed protocol that asked participants to report whether a given angle of ankle inversion was shallower or deeper than the immediately preceding inversion. Participants also completed the Stroop test, as a measure of cognitive ability, and two validated questionnaires for identifying foot or ankle dysfunction (the Cumberland Ankle Instability Tool and the Foot and Ankle Ability Measure). The proportion of correct responses for the AMEDA test showed the expected sigmoid shape of the psychometric function as signal strength increased. The intraclass correlation coefficient measured over the three tests was 0.65 (95% confidence interval: 0.49 - 0.78), suggesting moderate reliability. We found a positive and statistically significant correlation between AMEDA performance and Stroop results but no relationship between the AMEDA score and questionnaire-measured foot or ankle dysfunction. This study confirmed that the alternative testing protocol was simple to administer and easily understood by participants.
Evaluation of rail terminals in container ports using simulation: A case study
Authors: Sadeghi Moein , Bagheri Morteza , Pishvaee Mir Saman
Published: July 2021

The purpose of this research is to define the bottlenecks in a port’s rail container transport process and simulate the proposed scenarios in a real port using the lean-railroading approach. After visiting the selected port and holding several meetings with the authorities, all functions relating to containers have been identified. Each section’s arrival and departure times were used in this analysis for all containers shipped by rail in 2017, including 19,000 records. The data was accomplished by the processing time of transferring the containers between the railway areas and the port berth. The value stream map (VSM) related to the processes was prepared using the lean approach, the current port situation and proposed scenarios were simulated using the AnyLogic software. The results showed that the two proposed solutions effectively reduced time and costs by up to 20%. The research port also could increase the rail share to 8% without spending on infrastructure. Nevertheless, the rail container terminal warehouse will be a significant bottleneck for the port by growing the load operations. Reducing the turnover of the wagon will also halve the required number of wagons in the network. Therefore, it is recommended that a framework be established to direct freight to rail transport through the Ports Organization by meeting the infrastructure and operational requirements of the port and through the Railroad Company by launching the scheduled freight train and providing the required fleets.
Post-studentification? Promises and pitfalls of a near-campus urban intensification strategy
Authors: Revington Nick
Published: July 2021

The concentration of students in neighbourhoods through processes of studentification has often precipitated conflicts with other residents centred on behavioural issues and perceived neighbourhood decline. Dominant policy responses have been exclusive in nature, attempting to restrict where students can live or to encourage them to live in purpose-built student accommodation in designated areas. Drawing primarily on interviews with key informants in Waterloo, Canada, I examine a process of ‘post-studentification’ where non-student residents are instead integrated into student-dominated neighbourhoods through urban intensification, promoted by an alternative policy approach. I outline this process and its links to other forms of urban change. Despite the promise of a more inclusive strategy to mitigate the challenges of studentification, I find that post-studentification is subject to several pitfalls related to local planning objectives, local contingencies and inequalities with respect to class, age and gender.
Minimum 2-Year Functional Outcomes of Patients Undergoing Capsular Autograft Hip Labral Reconstruction
Authors: Kucharik Michael P. , Abraham Paul F. , Nazal Mark R. , Varady Nathan H. , Meek Wendy M. , Martin Scott D.
Published: July 2021

Background:

There is a paucity of literature on arthroscopic capsular autograft labral reconstruction.

Purpose:

To report midterm functional outcomes for patients undergoing acetabular labral repair with capsular autograft labral reconstruction.

Study Design:

Case series; Level of evidence, 4.

Methods:

This is a retrospective case series of prospectively collected data on patients who underwent arthroscopic acetabular labral repair by the senior surgeon between March 2013 and August 2018. The inclusion criteria for this study were adult patients aged 18 years or older who underwent primary hip arthroscopy for arthroscopic capsular autograft labral reconstruction. Exclusion criteria were <2 years of postoperative follow-up, elective disenrollment from study before 2-year follow-up, or repeat ipsilateral hip surgery before 2-year follow-up. Intraoperatively, patients underwent capsular autograft hip labral reconstruction if they were found to have a labrum with hypoplastic tissue (width <5 mm), complex tearing, or frank degeneration of native tissue. Clinical outcome data consisted of patient-reported outcome measures.

Results:

A total of 97 hips (94 patients) met the inclusion criteria with a mean final follow-up of 28.2 months (95% CI, 26.0-30.4). Patients had a mean age of 39.0 years (95% CI, 36.8-41.2) with a mean body mass index of 25.8 (95% CI, 24.9-26.7). When compared with baseline (40.4 [95% CI, 36.7-44.2]), the mean international Hip-Outcome Tool-33 (iHOT-33) scores were significantly greater at 3-month (60.9 [95% CI, 56.8-64.9]; P < .001), 6-month (68.8 [95% CI, 64.7-72.9]; P < .001), 12-month (73.2 [95% CI, 68.9-77.5]; P < .001), and final (76.6 [95% CI, 72.4-80.8]; P < .001) follow-up. At 2-year follow-up, 76.3%, 65.5%, and 60.8% of patients’ iHOT-33 scores exceeded clinically meaningful outcome thresholds for minimally clinically important difference (MCID), patient-acceptable symptomatic state, and substantial clinical benefit, respectively.

Conclusions:

In this study of 97 hips undergoing arthroscopic labral repair with capsular autograft labral reconstruction, we found favorable outcomes that exceeded the MCID thresholds in the majority of patients at a mean 28.2 months’ follow-up. Future studies should compare outcomes between this technique and other methods of autograft and allograft reconstruction to determine differences in patient-reported outcomes, donor-site morbidity, and complications.
Tribological and nanomechanical responses of 3D microstructured polypropylene matrix using interpenetrated graphene-carbon nanotubes
Authors: Uyor UO , Popoola API , Popoola OM , Aigbodion VS
Published: July 2021

This study utilized 1D carbon nanotubes (CNTs) and 2D graphene nanosheets (GNs) in preparation of 3D microstructured polypropylene (PP) nanocomposites with improved anti-wear and nanomechanical responses. The nanocomposites fabricated through melt compounding using Haake Rheomixer showed well dispersed nanoparticles in the matrix due to the aid of PP grafted maleic anhydride (PP-g-MA) coupling agent. The developed PP-CNTs-GNs hybrid nanocomposite showed lower coefficient of friction compared to the pure PP and its nanocomposites containing individual CNTs and GNs. PP-1CNTs-1GNs hybrid nanocomposite had lower wear rate of about 1.01 × 10−5 mm3/mN compared to 8.9 × 10−5 mm3/mN, 4.2 × 10−5 mm3/mN, and 4.8 × 10−5 mm3/mN measured for the pure PP, PP-3CNTs and PP-3GNs nanocomposites, respectively. The PP-1CNTs-1GNs nanocomposite respectively showed reduction in mass loss of about 78.7%, 62.2%, and 69.1% when related to the pure PP, PP-3CNTs and PP-3GNs nanocomposites. Maximum hardness and elastic modulus of about 153 MPa and 2.7 GPa were measured for PP-3CNTs-1GNs hybrid nanocomposite, while about 86.4 MPa and 1.5 GPa were recorded for the pure PP, respectively. The enhanced properties of the hybrid nanocomposites are due to the good synergetic effect of CNTs-GNs and the formation of 3D microstructures in the PP matrix with relaxed molecular chains and network hardening of the PP matrix.
Nursing Knowledge in the Doctor of Nursing Practice Curriculum
Authors: Flanagan Jane , Turkel Marian C. , Roussel Linda , Smith Marlaine
Published: July 2021

The goal of Doctor of Nursing Practice (DNP) education is to prepare advanced practice nurse leaders for the practice setting. Accordingly, it is imperative that DNP education is grounded in nursing theoretical knowledge. The purpose of this project was to examine the presence of nursing theoretical knowledge within DNP programs across the United States. A retrospective approach was used to review publicly available information on the webpages of a sample of DNP programs accredited by the Commission on Collegiate Nursing Education (CCNE) to determine if nursing theoretical knowledge guided DNP programs. Demographic information was also collected. A sample of 100 CCNE accredited programs revealed a lack of nursing theoretical knowledge visible within DNP programs. It is unclear how DNPs are being prepared to be practice leaders guided by nursing theoretical knowledge. Nursing leaders must develop policies to assure that nursing knowledge is core in DNP programs.
Ribbons of Belonging
Authors: Schmidt Bunkers Sandra
Published: July 2021

This article addresses a sense of belonging as living the ribbons of commitment and responsibility with community. Belonging will be explored through the lens of recognized philosophers, the three principles of humanbecoming, the humanbecoming community model, and selected community occurrences.
Investigating the incremental forming capabilities of extra deep drawn steel
Authors: Kumar Pavan , Priyadarshi Satwik , Tandon Puneet
Published: July 2021

Incremental Sheet Forming (ISF) is a sheet metal forming process, which relies on minimum part-specific tooling. Extra Deep Drawn (EDD) steel has been used for making door inners, dash panels, bodyside inners, etc. due to its good weldability and relatively low yield strength. However, to date very limited work is reported on ISF of EDD steel. Besides, no work, which exhaustively discusses the practicability of EDD steel for effectual incremental forming of components, is found to be reported. The present work discusses the ISF of EDD steel sheets and examines the limitations of ISF in forming the parts out of 1.0 mm thick EDD steel sheets. Two geometries, i.e., ellipsoidal cone (with varying wall angle) and truncated cone (with constant wall angle) were used as test cases to evaluate the formability of EDD steel sheets, in terms of Critical Wall Angle (CWA). Further, the formability of EDD steel with ISF is evaluated using both strain-based and stress-based forming limit curves. The thickness distribution, geometrical accuracy, forming forces, and surface roughness and hardness are evaluated in the formed components. The work, through numerical simulations and experimental analyses, investigates the process capabilities of ISF to form the EDD steel sheets in terms of formability, thickness distribution, geometrical accuracy, forming forces, and surface roughness and hardness to ascertain the scope of the proposed process.
Are Preschoolers’ Neurobiological Stress Systems Responsive to Culturally Relevant Contexts?
Authors: Ip Ka I , Felt Barbara , Wang Li , Karasawa Mayumi , Hirabayashi Hidemi , Kazama Midori , Olson Sheryl , Miller Alison , Tardif Twila
Published: July 2021

Adults are biologically responsive to context, and their responses to particular situations may differ across cultures. However, are preschoolers’ biological systems also responsive to situational contexts and cultures? Here, we show that children’s neurobiological stress responses, as indexed by salivary cortisol, are activated and responsive to psychosocial stressors relevant to their sociocultural emphases. By examining cortisol changes across different contexts among 138 preschoolers living in the United States, China, and Japan, we found that an achievement-related stressor elicited an increased cortisol response among Chinese preschoolers, whereas interpersonal-related stressors elicited an increased cortisol response among Japanese preschoolers. By contrast, U.S. preschoolers showed decreased cortisol responses after these stressors but consistently higher levels of anticipatory responses to separation at the beginning of each session. Our findings suggest that children’s neurobiological stress systems may be a critical biological mechanism allowing societal-level cultural phenomena to be embodied in individual-level responses, even among preschoolers.
SHORT Syndrome: Systematic Appraisal of the Medical and Dental Phenotype
Authors: Mubeen Suhaym , Gibson Clara , Mubeen Raiyan , Mansour Sahar , Evans Robert D.
Published: July 2021

Introduction:

SHORT syndrome is a rare autosomal dominant condition described by its acronym of short stature, hyperextensibility of joints and/or inguinal hernia, ocular depression, Rieger abnormality, and teething delay. Individuals have a distinct progeroid craniofacial appearance with a triangular face, frontal bossing, hypoplastic or thin alae nasi, large low-set ears, and mandibular retrognathia.

Objectives:

To systematically appraise the literature and update the clinical phenotype with emphasis on the dental condition.

Design:

A systematic literature search was carried out to update the clinical phenotype, identifying reports of individuals with SHORT syndrome published after August 2015. The same search strategy but not limited to publication date was carried out to identify reports of the dental phenotype. Two independent reviewers screened 1937 articles with 55 articles identified for full-text review.

Results:

Nineteen individuals from 11 families were identified. Facial dysmorphism including ocular depression, triangular shaped face, frontal bossing, large low-set ears, and micrognathia were the most consistent features followed by lipodystrophy, insulin resistance, and intrauterine growth restriction. Teething delay, microdontia, hypodontia, and enamel hypoplasia have all been reported.

Conclusion:

Features that comprise the SHORT acronym do not accurately or completely describe the clinical phenotype. The craniofacial appearance is one of the most consistent features. Lipodystrophy and insulin resistance may also be considered cardinal features. After teething delay, enamel hypoplasia and microdontia are the most common dental manifestations. We present recommendations for the dental and orthodontic/orthognathic management of individuals with SHORT syndrome.
The Prevalence and Nature of Violence Against Women Experiencing Homelessness: A Quantitative Study
Authors: Calvo Fran , Watts Beth , Panadero Sonia , Giralt Cristina , Rived-Ocaña Mercè , Carbonell Xavier
Published: July 2021

Individuals experiencing homelessness—an extreme form of social exclusion—have considerably higher risk of being victims of violence than the general population. We analyze the episodes of violence suffered by 504 individuals experiencing homelessness in Spain, as well as the differences between men and women. The results indicate high levels of violence and suggest that gender (specifically, being a woman) is the primary factor driving exposure to violence among this group. Highlighting the reality of women experiencing homelessness can help social, mental health, and addiction services adjust responses to better address the needs of this group and offer comprehensive care.
A Link between Psychopathy Affect and Instrumentality in Homicide
Authors: Sohn Ji Seun , Raine Adrian , Hong Young-Oh
Published: July 2021

This study tests the hypothesis that psychopathy is more associated with instrumental homicides than mixed and reactive homicides, and explores relationships between Psychopathy Checklist-Revised (PCL-R) facet/item scores and different forms of homicide: instrumental ( n = 130), mixed ( n = 103), and reactive ( n = 219) homicides. Instrumental homicides scored higher on facet 2 ( p < .01) but scored lower on facet 4 ( p < .1) compared to reactive homicides, whereas no facet scores differed between mixed and reactive homicides. Among the items of facet 2 (affective), remorselessness (item 6), and callousness (item 8) were predictive of instrumental homicide.
A system level computational model for thermo-tribological functioning of high-performance racing transmission with dry sump lubrication
Authors: Fatourehchi Ehsan , Mohammadpour Mahdi
Published: July 2021

Dry sump lubrication is a key feature in transmission systems of high-performance racing applications. While it provides adequate oil for gears contact, it reduces churning losses. Moreover, provision of continuous oil for gear contacts under harsh conditions during a race, makes dry sump lubrication systems more reliable. One of the most important aspects of any dry sump system is the assessment of its thermo-tribological performance and its capability to remove the generated heat from highly loaded high-shear gear contacts. In this paper, a multi-physics integrated numerical method of a dry sump transmission, considering a system approach is presented. The method provides a validated predictive tool to assess thermal functioning of dry sump lubrication systems.
The strength of weak bonds: Substituting bodily copresence in diplomatic social bonding
Authors: Wheeler Nicholas J. , Holmes Marcus
Published: July 2021

One of the central puzzles in the study of diplomacy is why some interactions between leaders result in positive social bonds, while others are mired in distrust and hostility. Recent research in the field of microsociology, the study of everyday interactions, most notably the pioneering research of American sociologist Randall Collins, suggests several critical ingredients for a successful interaction, including bodily copresence. In this article we interrogate this claim and provide theoretical reasons why textual communication may serve as a proxy for copresence in leader interactions. We demonstrate that while copresence, in the form of face-to-face interaction, is required for strong bond formation, mediated interaction in the form of letters can serve to create weak social bonds. The strength of weak bonds is in the reduction of distrust and the gradual development of trust that can be critical to the de-escalation of crises. Empirically, we explore our argument in two hard cases for social bond formation: the letters exchanged between Nikita Khrushchev and John F. Kennedy during the Cuban Missile Crisis and the interactions, both textual and face-to-face, between Mikhail Gorbachev and Ronald Reagan at the end of the Cold War. We conclude by pointing toward an interdisciplinary research agenda on the determinants of social bond formation in diplomacy.
Proficiency in the Norwegian language and self-reported health among 12 immigrant groups in Norway: A cross-sectional study
Authors: Kjøllesdal Marte K.R. , Gerwing Jennifer , Indseth Thor
Published: July 2021

Background:

Migration presents numerous significant changes in a person’s life, physically, emotionally and socially. How health develops in the host country depends on a range of factors, including language proficiency. We aimed to investigate associations between language proficiency and health.

Methods:

Statistics Norway carried out the Living Conditions Survey for Immigrants (2016), conducting telephone (82%) or face-to-face (18%) interviews with immigrants (two or more years of residence) from 12 countries. The survey collected data on self-reported proficiency in the Norwegian language, health and socio-economic variables, and included 4077 people aged 16–66 years.

Results:

In logistic regression models adjusted for age, sex and duration of residence, poor or medium self-reported Norwegian proficiency, as compared to good, was associated with poorer health outcomes, including lower odds of self-rated health (odds ratio (OR)=0.46; 95% confidence interval (CI) 0.39–0.54) and higher odds of hypertension (OR=1.74; 95% CI 1.34–2.26), back or neck pain (OR=1.52; 95% CI 1.28–1.80), mental health problems (OR=1.34; 95% CI 1.09–1.65), sleep disturbances (OR=1.51; 95% CI 1.23–1.86) and being overweight (OR=1.20; 95% CI 1.03–1.40). Adjustment for socio-economic status attenuated the associations, but further adjustments for perceived discrimination and lifestyle (smoking and physical activity) did not further alter the estimates.

Conclusions:

Host language proficiency has implications for health among immigrants. Equitable access to health services and quality of care requires adjustment to the language level needs of patients. Facilitating language learning for immigrants may be vital in providing access to health services and supporting newcomers in being more active participants in managing their health.
Mental health, substance abuse, prison victimization and suicide attempts amongst incarcerated women
Authors: Caravaca-Sánchez Francisco , Barry Tom J. , Aizpurua Eva , Ricarte Jorge Javier
Published: July 2021

Worldwide, incarcerated women are known to suffer adverse experiences that might increase the risk of suicide attempts during incarceration. The present investigation examines the prevalence of suicide attempts amongst incarcerated women in Spain and the factors associated with this. Between January and March of 2017 a total of 174 women, enrolled from two prisons in the southeast of Spain, completed anonymous self-report measures of demographic variables, penitentiary and sentence-related variables, mental distress (including depression, anxiety and stress), perceived social support, substance use (including alcohol, cannabis, cocaine, amphetamine, heroin and hallucinogens), prison victimization (property, verbal, physical and sexual victimization) and suicide attempts. Overall, 15.5 percent of women reported they had attempted suicide during their current incarceration. Compared with women who did not report suicide attempts, multivariate analysis showed that women reporting suicide attempts were more likely to report lower education levels, in-prison substance use, victimization and higher levels of mental distress. In order to prevent suicide amongst incarcerated women, victimization in all its forms, emotional distress and drug abuse in women with lower education levels should be considered highly targetable variables.
Beta-Catenin Signaling Pathway: Perhaps We Should Start Exploring it for Diabetic Foot Ulcer Healing?
Authors: Papanas Nikolaos , Popovic Djordje S.
Published: July 2021

Diabetic foot ulcers (DFUs) remain a common debilitating and costly complication of diabetes mellitus. Indeed, despite all efforts and emerging technologies, many DFUs are difficult to heal and frequently recur. Thus, novel therapeutic approaches are urgently needed. Specific targeting of different molecular and cellular pathways implicated in wound healing emerges as an attractive therapeutic modality to improve outcomes. One of the novel pathways that carry this potential is the wingless-type mouse mammary tumor virus integration site family/beta-catenin signaling pathway (WβcSP). It plays an important role in different stages of wound healing, including inflammation, proliferation, and remodeling. Potential therapeutic implications of WβcSP activation include producing agonists and/or blocking its endogenous inhibitors. Thus, we should perhaps start exploring potential ways of its therapeutic implication to improve DFU healing.
Exploring the Role of Virtual Reality to Support Clinical Diabetes Training—A Pilot Study
Authors: Mallik Ritwika , Patel Mayank , Atkinson Ben , Kar Partha
Published: July 2021

Background:

It is estimated that 16 to 25% of patients in hospital have diabetes and 1 in 25 inpatients with Type 1 Diabetes develop diabetic ketoacidosis (DKA). It is vital that non-specialist doctors recognize and appropriately manage diabetes emergencies. Simulation training is increasingly being used in healthcare and virtual reality (VR) based educational resources is transforming medical education. This study aimed to evaluate the use of virtual reality to help non-specialist clinicians manage clinical scenarios related to diabetes.

Methods:

This pilot project, titled ‘DEVICE’ (Diabetes Emergencies: Virtual Interactive Clinical Education) was developed in collaboration with Oxford Medical Simulation. Fully interactive immersive VR scenarios were created to stimulate real life diabetes emergencies. Users then received personalized feedback and performance metrics. Feedback surveys were provided before and after the participation in the VR scenario. Kirkpatrick’s training evaluation model was used.

Results:

Thirty-nine participants from 2 hospitals in UK provided feedback up to 3 months after attending the VR education sessions. Overall feedback was extremely positive, and participants found this immersive teaching experience very helpful. After use of virtual reality scenarios, the mean trainee confidence in managing DKA (on an 8-point Likert scale) increased from 3.92 (3.38-4.47) 95% CI to 5.41 (4.79-6.03) 95% CI (statistically significant). The VR study demonstrates Kirkpatrick level 3 in the follow up survey.

Conclusion:

VR based training scenarios in this pilot project increased confidence in managing diabetes emergencies and demonstrated positive changes in their behavior. VR education is a safe, useful and a well-liked training tool for diabetes emergencies.
Typical MRI‑pattern suggests peak maturation of the ACI graft 2 years after third‑generation ACI: a systematic review
Authors: Lordache Edna A. , Roberston Emma L. , Hirschmann Anna , Hirschmann Michael T.
Published: July 2021

Objectives:

The purpose of the present article was (1) to systematically review the current literature and (2) to collect data regarding the postoperative magnetic resonance imaging (MRI) appearance of third-generation autologous chondrocyte implantation (ACI) grafts and (3) to provide an overview of imaging findings at various postoperative time points.

Methods:

A systematic review of the literature in Medline (Pubmed) and Embase was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Articles which reported the post-operative MRI morphological outcomes following the use of third-generation ACI for treatment of knee cartilage lesions were included. All MRI results were allocated to six different time intervals: ≤ 3 months, > 3–6 months, > 6 months–1 year, > 1 year–2 years, > 2–5 years and > 5 years after surgery.

Results:

A total of 22 studies were included and the study populations ranged from 13 to 180 patients adding up to a total of 951 patients. Parameters such as defect fill, border integration, surface contour, graft morphology and integrity of the subchondral lamina all improve gradually with a peak two years following surgery suggesting complete graft maturation at this time point. After this peak, a statistically insignificant decline is noted for most of the parameters. Signal intensity was found to gradually shift from hyperintense to isointense in the first 36 months and to hypointense later on. Contrarily, subchondral bone edema is not only a postoperative feature of the procedure but also can reappear or persist up to ten years after surgery. As graft failures can appear after two years, consequently, the MRI composite score is also affected.

Conclusion:

Recurring patterns in postoperative MRI appearance were observed in certain parameters including defect filling, graft signal intensity and structure, border integration of the graft while parameters like subchondral bone tend to be unpredictable. Given the heterogenous findings in terms of clinical correlation, and relating that aspect to the patterns found in this review, an MRI is justified at three months, one year, two years and five years after surgery, unless the clinical symptomatology and individual patient needs dictate otherwise.