bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal Cycle of Gravity Wave Potential Energy Densities from Lidar and Satellite Observations at 54° and 69°N
Authors: Strelnikova Irina , Almowafy Marwa , Baumgarten Gerd , Baumgarten Kathrin , Ern Manfred , Gerding Michael , Lübken Franz-Josef
Published: February 2021

We present gravity wave climatologies based on 7 years (2012–18) of lidar and Sounding of the Atmosphere using Broadband Emission Radiometry (SABER) temperatures and reanalysis data at 54° and 69°N in the altitude range 30–70 km. We use 9452 (5044) h of lidar observations at Kühlungsborn [Arctic Lidar Observatory for Middle Atmosphere Research (ALOMAR)]. Filtering according to vertical wavelength (λz < 15 km) or period (τ < 8 h) is applied. Gravity wave potential energy densities (GWPED) per unit volume (EpV) and per unit mass (Epm) are derived. GWPED from reanalysis are smaller compared to lidar. The difference increases with altitude in winter and reaches almost two orders of magnitude around 70 km. A seasonal cycle of EpV with maximum values in winter is present at both stations in nearly all lidar and SABER measurements and in reanalysis data. For SABER and for lidar (with λ < 15 km) the winter/summer ratios are a factor of ~2–4, but are significantly smaller for lidar with τ < 8 h. The winter/summer ratios are nearly identical at both stations and are significantly larger for Epm compared to EpV. Lidar and SABER observations show that EpV is larger by a factor of ~2 at Kühlungsborn compared to ALOMAR, independent of season and altitude. Comparison with mean background winds shows that simple scenarios regarding GW filtering, etc., cannot explain the Kühlungsborn–ALOMAR differences. The value of EpV decreases with altitude in nearly all cases. Corresponding EpV-scale heights from lidar are generally larger in winter compared to summer. Above ~55 km, EpV in summer is almost constant with altitude at both stations. The winter–summer difference of EpV scale heights is much smaller or absent in SABER and in reanalysis data.
Explicit versus Parameterized Convection in Response to the Atlantic Meridional Mode
Authors: Paccini Laura , Hohenegger Cathy , Stevens Bjorn
Published: February 2021

This study investigates whether the representation of explicit and parameterized convection influences the response to the Atlantic meridional mode (AMM). The main focus is on the precipitation response to the AMM-SST pattern, but possible implications for the atmospheric feedback on SST are also examined by considering differences in the circulation response between explicit and parameterized convection. On the basis of analysis from observations, SST composites are built to represent the positive and negative AMM. These SST patterns, in addition to the March–May climatology, are prescribed to the atmospheric ICON model. High-resolution simulations with explicit convection (E-CON) and coarse-resolution simulations with parameterized convection (P-CON) are used over a nested tropical Atlantic Ocean domain and a global domain, respectively. Our results show that a meridional shift of about 1° in the precipitation climatology explains most of the response to the AMM-SST pattern in simulations both with explicit convection and with parameterized convection. Our results also indicate a linearity in the precipitation response to the positive and negative AMM in E-CON, in contrast to P-CON. Further analysis of the atmospheric response to the AMM reveals that anomalies in the wind-driven enthalpy fluxes are generally stronger in E-CON than in P-CON. This result suggests that SST anomalies would be amplified more strongly in coupled simulations using an explicit representation of convection.
Global Soil Water Estimates as Landslide Predictor: The Effectiveness of SMOS, SMAP, and GRACE Observations, Land Surface Simulations, and Data Assimilation
Authors: Felsberg Anne , De Lannoy Gabriëlle J. M. , Girotto Manuela , Poesen Jean , Reichle Rolf H. , Stanley Thomas
Published: February 2021

This global feasibility study assesses the potential of coarse-scale, gridded soil water estimates for the probabilistic modeling of hydrologically triggered landslides, using Soil Moisture Ocean Salinity (SMOS), Soil Moisture Active Passive (SMAP), and Gravity Recovery and Climate Experiment (GRACE) remote sensing data; Catchment Land Surface Model (CLSM) simulations; and six data products based on the assimilation of SMOS, SMAP, and/or GRACE observations into CLSM. SMOS or SMAP observations (~40-km resolution) are only available for less than 20% of the globally reported landslide events, because they are intermittent and uncertain in regions with complex terrain. GRACE terrestrial water storage estimates include 75% of the reported landslides but have coarse spatial and temporal resolutions (monthly, ~300 km). CLSM soil water simulations have the added advantage of complete spatial and temporal coverage, and are found to be able to distinguish between “stable slope” (no landslide) conditions and landslide-inducing conditions in a probabilistic way. Assimilating SMOS and/or GRACE data increases the landslide probability estimates based on soil water percentiles for the reported landslides, relative to model-only estimates at 36-km resolution for the period 2011–16, unless the CLSM model-only soil water content is already high (≥50th percentile). The SMAP Level 4 data assimilation product (at 9-km resolution, period 2015–19) more generally updates the soil water conditions toward higher landslide probabilities for the reported landslides, but is similar to model-only estimates for the majority of landslides where SMAP data cannot easily be converted to soil moisture owing to complex terrain.
Understanding the response of tropical cyclone structure to the assimilation of synthetic wind profiles
Authors: Bucci Lisa R. , Majumdar Sharanya J. , Atlas Robert , Emmitt G. David , Greco Steve
Published: February 2021

This study examines how varying wind profile coverages in the tropical cyclone (TC) core, near-environment and broader synoptic environment affect the structure and evolution of a simulated Atlantic hurricane through data assimilation. Three sets of observing system simulation experiments (OSSEs) are examined in this paper. The first experiment establishes a benchmark for the case study specific to the forecast system used by assimilating idealized profiles throughout the parent domain. The second presents how TC analyses and forecasts respond to varying the coverage of swaths produced by polar-orbiting satellites of idealized wind profiles. The final experiment assesses the role of TC inner-core observations by systematically removing them radially from the center. All observations are simulated from a high-resolution regional “Nature Run” of a hurricane and the tropical atmosphere, assimilated an Ensemble Square-Root Kalman Filter and the Hurricane Weather and Research Forecast (HWRF) regional model. Results compare observation impact to the analyses, domain-wide and TC centric error statistics, and TC structural differences among the experiments. The study concludes that the most accurate TC representation is a result of the assimilation of collocated and uniform thermodynamic and kinematics observations. Intensity forecasts are improved with increased inner core wind observations, even if the observations are only available once daily. Domain-wide root-mean-square errors are significantly reduced when the TC is observed during a period of structural change, like rapid intensification. The experiments suggest the importance of wind observations and the role of inner-core surveillance when analyzing and forecasting realistic TC structure.
Developing the guidelines for managing autonomous vehicle flows on congested highways: A case study of MD-100
Authors: Rao Ranteg S , Yoon Park Sung , Chang Gang-Len
Published: February 2021

Recognizing the need for responsible highway agencies to effectively manage emerging autonomous vehicles (AV) flows in contending with daily recurrent congestion, this study presents a systematic procedure for understanding the impacts of AV flows on traffic conditions under different AV behavioral mechanisms (i.e., car-following and lane-changing), and different penetration rates. Research results show that the presence of AV flows, depending on their adopted behavioral mechanisms, may have significant (either positive or negative) impacts on the overall traffic conditions. Hence, it is essential for responsible highway agencies to have proper operational guidelines to manage and coordinate AV flows. To demonstrate the proposed methodology, this study has carried out extensive simulation experiments using a congested segment of the MD-100 network (a multilane highway segment located in Maryland) under various AV penetration rates and observable behavioral patterns. The collected Measures of Effectiveness highlight that at each AV penetration level there exists a set of optimal behavioral patterns for the AV flows to coordinate with non-AV flows via the Vehicle to Infrastructure or Vehicle to Vehicle infrastructure so as to maximize the roadway capacity and minimize the resulting highway congestion.
Incidental Teaching of Conversational Skills for Students With Autism Spectrum Disorder
Authors: Blackwell William , Stockall Nancy
Published: February 2021

This article describes a process for the incidental teaching of conversation skills to students with autism spectrum disorder (ASD) in inclusive settings. The incidental teaching of conversation skills is an effective naturalistic intervention for assisting students with ASD to improve their social communication skills. Special educators and other stakeholders can implement this strategy by following the RACTF process: 1) recruit and prepare team members, 2) assess and identify target conversational skills, 3) identify natural cueing conditions and times to focus on target skills, 4) introduce and teach the target skills, and 5) fade prompts and practice the target skills in new settings. By improving the conversation skills of students with ASD, students have a higher likelihood of establishing peer relationships and becoming engaged, active participants in the classroom and other school environments.
Is a 7-Item Combination from the YLS/CMI an Effective Screening Strategy for Risk to Reoffend? Findings from a Cross-National Study
Authors: Basto-Pereira Miguel , Villanueva Lidón , Peterson-Badali Michele , Pimentel Alberto , Quintas Jorge , Cuervo Keren , Hoge Robert D. , Skilling Tracey A.
Published: February 2021

Several brief screening measures for youth risk to reoffend have been developed; however, these measures have been tested primarily in high-income English-speaking countries and their predictive validity is limited. A recent study proposed a screening strategy using a combination of seven items from the Youth Level of Service/Case Management Inventory (YLS/CMI). Predictive validity for this strategy was better than that reported in studies of previously developed screening tools. In the current study, the predictive validity of this strategy was examined across samples of justice-involved youth from two countries: Canada ( N = 196) and Portugal ( N = 2,348). The full version of the YLS/CMI was completed and recidivism data were collected over a 2-year period. Results support the predictive validity of this strategy, with area under the curve (AUC) values (.69–.74) very similar to those found in the full version in each country, both in the full samples, and for both genders.
Preoperative detection of pleural adhesions using pocket-sized ultrasound
Authors: Sano Atsushi , Hiranuma Ayako , Nagashima Makoto
Published: February 2021

Background

Although preoperative detection of pleural adhesions is important in thoracic surgery, it is not widely performed. We report the availability of a pocket-sized ultrasound device for the preoperative detection of pleural adhesions.

Methods

Between September 2019 and September 2020, pleural adhesions were assessed preoperatively using a pocket-sized ultrasound device in 62 patients who underwent thoracic surgery. Evaluations were performed using the Vscan Dual Probe on the wards or just before surgery in the operating theater. We used a linear probe to scan the chest wall where the incision was scheduled, and evaluated the sliding sign. We compared ultrasound results with intraoperative findings.

Results

Of the 62 patients, the sliding sign was observed in 58 patients, 56 of whom demonstrated no pleural adhesions intraoperatively. The sensitivity was 96.6%. Four patients were negative for the sliding sign; of these, three had pleural adhesions and one did not. The specificity was 75.0%. Among all 62 patients, the diagnostic accuracy of ultrasound for pleural adhesions was 95.2%. False negatives were caused by loose adhesions. False positives were caused by the absence of vertical lines on ultrasound. Accuracy was not influenced by the timing of the test.

Conclusions

A pocket-sized ultrasound device was useful for the preoperative detection of pleural adhesions in thoracic surgery.
Radiomics analysis enables fatal outcome prediction for hospitalized patients with coronavirus disease 2019 (COVID-19)
Authors: Ke Zan , Li Liang , Wang Li , Liu Huan , Lu Xuefang , Zeng Feifei , Zha Yunfei
Published: February 2021

Background

In December 2019, a rare respiratory disease named coronavirus disease 2019 (COVID-19) broke out, leading to great concern around the world.

Purpose

To develop and validate a radiomics nomogram for predicting the fatal outcome of COVID-19 pneumonia.

Material and Methods

The present study consisted of a training dataset (n = 66) and a validation dataset (n = 30) with COVID-19 from January 2020 to March 2020. A radiomics signature was generated using the least absolute shrinkage and selection operator (LASSO) Cox regression model. A radiomics score (Rad-score) was developed from the training cohort. The radiomics model, clinical model, and integrated model were built to assess the association between radiomics signature/clinical characteristics and the mortality of COVID-19 cases. The radiomics signature combined with the Rad-score and the independent clinical factors and radiomics nomogram were constructed.

Results

Seven stable radiomics features associated with the mortality of COVID-19 were finally selected. A radiomics nomogram was based on a combined model consisting of the radiomics signature and the clinical risk factors indicating optimal predictive performance for the fatal outcome of patients with COVID-19 with a C-index of 0.912 (95% confidence interval [CI] 0.867–0.957) in the training dataset and 0.907 (95% CI 0.849–0.966) in the validation dataset. The calibration curves indicated optimal consistency between the prediction and the observation in both training and validation cohorts.

Conclusion

The CT-based radiomics nomogram indicated favorable predictive efficacy for the overall survival risk of patients with COVID-19, which could help clinicians intensively follow up high-risk patients and make timely diagnoses.
Mast Cell Tumors and Histiocytomas in Domestic Goats and Diagnostic Utility of CD117/c-Kit and Iba1 Immunohistochemistry
Authors: O’Neill T. William , Löhr Christiane V.
Published: February 2021

Cutaneous round cell tumors in goats present a diagnostic challenge. In this article, we provide a description of caprine cutaneous mast cell tumors (MCT) and histiocytomas, and report on the validation of anti-human antibodies to CD117/KIT and Iba1 by immunohistochemistry on a range of caprine tissues. Cells immunolabeled for CD117/KIT included resident mast cells in normal lung and skin, interstitial cells of Cajal (intestine), and neuronal cell bodies (brain). Cells immunolabeled for Iba1 included resident macrophages in many tissues including normal lung, dendritic cells (hemolymphatic tissues), Kupffer cells, and microglia. Of 5 cutaneous MCT, only one had metachromasia of cytoplasmic granules; however, neoplastic cells of all 5 MCT had positive immunolabeling for CD117/KIT. The CD117/KIT immunolabeling pattern was predominately focal paranuclear in 3 cases, and cytoplasmic or membranous in 1 case each. Two histiocytomas were identified and had strong positive immunolabeling for Iba1 but not CD117/KIT. All 7 cutaneous round cell tumors described herein occurred in goats less than 4 years of age; the 2 cutaneous histiocytomas were in goats less than 14 months of age. Neither of the cutaneous histiocytomas recurred within 24 months of surgical removal.
From Their Angle: A Look at the Emotional World of Defense Attorneys Who Represent Sex Offenders
Authors: Shechory Bitton Mally , Mashiach Anat
Published: February 2021

This research focused on how defense attorneys who represent sex offenders perceive their work with them and whether this representation affects their daily life and mental well-being. Fifteen defense attorneys working for the Public Defender’s Office in Israel were interviewed using a semi-structured interview. The findings indicated two major issues related to defense attorney perception of their work: (1) the distinctiveness of representing sex offenders due to their unique characteristics and (2) the emotional impact of working with sex offenders. The findings suggest complex effects and implications of working with sex offenders. In the interviews, participants reiterated their attempt to remain objective and nonjudgmental. Even so, they also described a wide range of feelings in the face of exposure to sex offenses and their job of defending sex. Feelings of anger, disgust, and revulsion at the offenses co-existed with feelings of pity and empathy for the offender. These descriptions constitute significant support for the emotional cost to attorneys and their consequent distress. Feelings of wariness, loss of trust, and emotional detachment were described as part of coping with exposure to the disturbing nature of sex offenses. In addition, participants noted how these feelings impact daily interactions with their own children.
Living versus deceased kidney transplantation: Comparison of complications
Authors: Fakhr Yasseri Ali Mohammad , Namdari Farshad , Gooran Shahram , Ahmadi Ayat , Dehghani Sanaz , Asadi Mahboobeh , Mehrsay Abdolrasol , Pourmand Gholamreza , Dialameh Hossein
Published: February 2021

Introduction:

It is assumed that the outcome of kidney transplantation from living donors is more favorable than deceased donors. However, over the years there has been an overall improvement in transplant survival from both living and deceased donors. In this article we have evaluated and compared the most recent results in living and deceased donor kidney transplantations.

Patients and Methods:

Four hundred and forty six patients underwent kidney transplantation in our center from September 2009 to March 2014. The patients divided in two groups living (group A) and deceased (group B) donor transplantation groups. The patients were followed until September 2016. Acute rejection, graft survival, delayed graft function, renal artery thrombosis, graft nephrectomy, ureterocutaneous fistula, postoperative hypertension, mortality, hospital stay, hyperlipidemia, post transplantation diabetes and lymphocele rate measured and compared in two groups.

Results:

Most variables were not different between the two groups except lymphocele and delayed graft function. Lymphocele was more prevalent in group A (13.8% vs 3.1%, p-value = 0.02) and delayed graft function results were more desirable in living donor transplantation group (group B).

Conclusion:

Although, delayed graft function was less common in transplantation from living donors, short, and long term graft survival was not significantly different in this study.
The character of residential cooktop fires
Authors: Hu Yue , Chen Jian , Bundy Matthew , Hamins Anthony
Published: February 2021

A series of experiments was conducted to investigate the global preignition and combustion characteristics of corn oil heated in 9.7 to 26 cm diameter pans by a residential electric-coil element cooktop. For comparison, torch-ignited gasoline, heptane, and corn oil experiments were conducted in the same configuration except without the heating element energized. Heating oil on a typical electric cooktop leads to vaporization and generation of an aerosol cloud followed by autoignition. The evolution of the light-extinction coefficient before autoignition is measured and shown to be related to the pan diameter and initial fuel mass. Continued heating leads to enhanced vaporization of the burning oil and growing fires with the peak heat release rate, radiative heat flux, radiative fraction, and peak flame height larger than the gasoline fires regardless of pan diameter. CO and soot yields, and the CO/CO2 ratio are measured to decrease with pan diameter.
Using Three Social Network Analysis Approaches to Understand Computer-Supported Collaborative Learning
Authors: Ouyang Fan
Published: February 2021

Sharing the same philosophy of “relations matter” with computer-supported collaborative learning (CSCL), social network analysis (SNA) has become a common methodology in the CSCL research. In this research, I use SNA methods from relational ties, network modes, and integrated methods perspectives to understand attributes of relations in CSCL. I design, conduct, and evaluate three SNA analytics on the same dataset from an online course to understand CSCL entities, relations, and processes. This online collaborative discussion in this course stresses students’ knowledge inquiry, construction, and building through peer interactions. Results show that compared to traditional SNA methods, these three SNA approaches can reveal more detailed, richer picture of the collaborative learning processes, particularly, the interactional, multi-modal, and temporal aspects. Moreover, these SNA approaches are generalizable for understanding similar CSCL settings. Based on the results, this research proposes methodological implications to further apply and develop SNA in the CSCL field.
Biphasic Calcium Phosphate Microparticles Mixed With Autologous Blood: Application for the Reconstruction of a Large Mandibular Bone Defect in a Dog
Authors: Girard Nicolas , Cauvin Edouard R. J. , Gauthier Olivier , Gault Simon
Published: February 2021

Large mandibular bone defects can be difficult to treat in dogs, with a high risk of mal or nonunion due to instability and risk of infection. This case report describes the use of autologous clotted blood mixed with biphasic calcium phosphate microparticles to fill a defect in a nonunion fracture and promote bone regeneration in a dog using a 2-stage surgical approach. This new method was designed and tried in a dog with a chronic, unstable mandibular fracture associated with a large sequestrum. Initial treatment involved debridement of the lesion, then the oral wound and oral vestibule were reconstructed in 2 layers. Four weeks later a second stage surgery allowed placement of a pre-contoured maxillofacial plate to bridge the defect, which was filled with a blood/biphasic calcium phosphate compound implant. Cone-beam computed tomography was used prior to the initial surgery for preoperative planning and 3-D printing of a mandibular template for plate contouring. CT was subsequently used to document the healing process, using a bone density measurement tool to assess bone regeneration. Radiographic evidence suggestive of osseointegration was observed within 6 months with effective filling of the defect and restoration of alveolar ridge continuity. A return to normal and atraumatic occlusion was considered excellent. Cone-beam computed tomography was found useful to document radiographic evidence of osseointegration, bone regrowth and remodeling. This case report is to serve as a proof-of-concept study and should be followed by a prospective evaluation.
Enhanced dielectric properties and thermostability in polyimide composites with core-shell structured polyimide@BaTiO3 nanoparticles
Authors: Deng Wei , Ren Guanguan , Wang Wenqi , Cui Weiwei , Luo Wenjun
Published: February 2021

Polymer composites with high dielectric constant and thermal stability have shown great potential applications in the fields relating to the energy storage. Herein, core-shell structured polyimide@BaTiO3 (PI@BT) nanoparticles were fabricated via in-situ polymerization of poly(amic acid) (PAA) and the following thermal imidization, then utilized as fillers to prepare PI composites. Increased dielectric constant with suppressed dielectric loss, and enhanced energy density as well as heat resistance were simultaneously realized due to the presence of PI shell between BT nanoparticles and PI matrix. The dielectric constant of PI@BT/PI composites with 55 wt% fillers increased to 15.0 at 100 Hz, while the dielectric loss kept at low value of 0.0034, companied by a high energy density of 1.32 J·cm−3, which was 2.09 times higher than the pristine PI. Moreover, the temperature at 10 wt% weight loss reached 619°C, demonstrating the excellent thermostability of PI@BT/PI composites. In addition, PI@BT/PI composites exhibited improved breakdown strength and toughness as compared with the BT/PI composites due to the well dispersion of PI@BT nanofillers and the improved interfacial interactions between nanofillers and polymer matrix. These results provide useful information for the structural design of high-temperature dielectric materials.
Quality of Reported Earnings: An Empirical Study of Indian Banking Industry
Authors: Mangala Deepa , Singla Neha
Published: February 2021

Earnings management (EM) practices by bank managers can prove to be very precarious in smooth running of the financial system of a country. The failure of financial system shocks the entire economy. The present paper aims to assess the quality of earnings in the Indian banking industry. EM is estimated by employing a bank-specific model that measures EM through loan loss provision (LLP) and realized security gains and losses (RSGL). The findings exhibit that public banks practice income increasing and private banks practice income decreasing EM, whereas, combined result reinforces the practice of income decreasing EM. The results indicate that public sector banks use both LLP and RSGL to manage earnings whereas private sector banks increasingly rely on RSGL. Further, direction of EM is gauged by classifying EM on the basis of quartiles. This study has implication for regulators, investor and depositors. Regulators should be stricter regarding policies of LLP. Apart from earnings, investor and depositors should be considered other measures of stability of banks like capital adequacy ratio because earnings may be manipulated.
Mindfulness-Based Stress Reduction and Hope in Women Participating in Alternative Sentencing Programs
Authors: McIntosh Heather Chancellor , Kezbers Krista , Nichols Rachel , Hellman Chan
Published: February 2021

Purpose:

Alternative sentencing programs for women with nonviolent drug offenses may provide opportunities to change the life trajectories of women and their families. The primary purpose of this study was to assess whether a mindfulness-based stress reduction (MBSR) intervention could improve levels of hope following treatment. A second objective was to assess whether MBSR intervention could influence perceived stress, self-compassion, and mindfulness.

Methods:

Participants attended a 6-week mindfulness class, with outcomes measured using pretest–posttest survey comparison.

Results:

Paired sample t tests showed improvements in hope, stress, self-compassion, and mindfulness following treatment.

Discussion:

Community-based intervention models, such as MBSR therapy in alternative sentencing programs, may alleviate negative psychological impacts experienced by female offenders. These results align with previous research that suggests participants may see improved ability to regulate emotions following MBSR therapy. This research indicates that MBSR therapy, for women in alternative sentencing programs, may promote hope as a learned psychological skill.
Parent–Infant Interventions to Promote Parental Sensitivity During NICU Hospitalization: Systematic Review and Meta-Analysis
Authors: Lavallée Andréane , De Clifford-Faugère Gwenaëlle , Ballard Ariane , Aita Marilyn
Published: February 2021

This systematic review and meta-analysis examined the effectiveness of parent–infant interventions for parents of preterm infants on parental sensitivity compared to standard care or active comparators. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration ID: CRD42016047083). Database searches were performed from inception to 2020 to identify eligible randomized controlled trials. Two review authors independently selected studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias assessment tool and quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) guidelines. A total of 19 studies ( n = 2,111 participants) were included and 14 were suitable to be pooled in our primary outcome meta-analysis. Results show no significant effect of parent–infant interventions over standard care or basic educational programs, on parental sensitivity. Results may not necessarily be due to the ineffectiveness of the interventions but rather due to implementation failure or high risk of bias of included studies.
A Parent-Implemented Gross Motor Intervention for Young Children with Disabilities
Authors: Yang Hsiu-Wen , Meadan Hedda , Ostrosky Michaelene M.
Published: February 2021

Children with disabilities often experience gross motor delays. Adults, including parents, can play a crucial role in supporting children’s motor development. However, a limited number of research studies have focused on building parents’ capacity to support their young children’s motor skill development. The purpose of this study was to examine the effects of a training and coaching program on parent implementation of prompting procedures and children’s gross motor skills. A multiple-probe single-case design across three parent–child dyads was used to evaluate the effectiveness of the intervention. The findings show that parents learned how to implement prompting procedures with high fidelity. In addition, the parents reported improvements in their children’s gross motor performance.
Effect of an Educational Comic Story about Preoperative Orientation on Information and Anxiety Level of Children Undergoing Surgery
Authors: Hamza Taha Sara Mustafa , Hassan El-Sayed Rabab El-Sayed
Published: February 2021

Surgery is considered a stressful experience for children because of their unfamiliarity with the environment and medical procedures. Anxiety interferes with anesthesia induction and results in many complications. Comic stories produce cognitive control by developing realistic expectations and correcting misperceptions and misbeliefs. This study aimed to assess the effect of an educational comic story about preoperative orientation on the information and anxiety levels of children undergoing surgery. A quasi-experimental design was used. The study was conducted at Mansoura University Children’s Hospital, Egypt. A structured interview questionnaire, self-report anxiety scale, and an observational behavioral scale were used for data collection. The results revealed highly statistically significant differences in information, self-reported anxiety, and observed anxiety between the pre and post-tests ( p = .000). Moreover, a negative linear correlation between children’s preoperative anxiety and information level was demonstrated.
The Impact of Body Weight and Renal Function on the Risk of Bleeding With Direct Oral Anticoagulants in Atrial Fibrillation
Authors: Whittemore Hannah , Posen Andrew K. , Hellenbart Erika L. , Groo Vicki , Wenzler Eric , Tilton Jessica J.
Published: February 2021

Background:

Atrial fibrillation (AF) increases the risk of stroke and direct oral anticoagulants (DOACs) are first-line agents for prevention. Gaps in the literature cause reluctance in prescribing DOACs for patients with renal dysfunction and/or extremes in body weight.

Objective:

To evaluate the impact body weight and renal function have on major and clinically relevant nonmajor (CRNM) bleeding events and ischemic strokes in AF patients receiving a DOAC.

Methods:

This retrospective cohort study included adults with nonvalvular atrial fibrillation (NVAF) or atrial flutter (AFL) receiving a DOAC ≥12 months. The primary outcome was a composite of major and CRNM bleeding events. Secondary outcomes included ischemic stroke and risk factors for bleeding events.

Results:

Of the 233 patients analyzed, 25 patients experienced a bleeding event. Patients who bled weighed 10 kg less ( P = 0.043) than those who did not and had a higher HASBLED score ( P = 0.003). Multivariate logistic regression identified weight ( P = 0.048), serum creatinine (SCr; P = 0.027), and HASBLED score ( P = 0.024) as the significant predictors for experiencing a bleed. Three patients experienced a stroke.

Conclusion and Relevance:

This study demonstrates an association between higher baseline SCr, elevated HASBLED score, and lower weight, with an increased risk of bleeding in patients with NVAF or AFL receiving a DOAC. These findings add to prescribing considerations when initiating DOACs. Closer monitoring is advised for patients with significant renal dysfunction and/or low body weight, even with renal dose adjustments.
Risk Assessment and Outcome of Venous Thromboembolism in Pediatric Population in an Academic Care Center of a Low-Middle Income Country
Authors: Sadiq Muhammed Wahhaab , Ukrani Ronika Devi , Arif Aiman , Akbar Inaara , Altaf Sadaf , Moiz Bushra
Published: February 2021

Venous thromboembolism (VTE) is a recognized complication of hospital stay in young patients in many developed countries, but such an information is largely unavailable from a low middle-income country (LMIC). This study aimed at identifying the frequency, risk factors, treatment options and outcome of deep venous thrombosis/pulmonary embolism (DVT/PE) in pediatric population in a tertiary care center from a LMIC. International classification of disease, ninth revision (ICD-9) was used to identify VTE in patients aged 0-18 years during January 2011 to September 2019. In-house computerized system was used to collect data for demographics, clinical and laboratory details. SPSS version 19 was used to analyzed data. The study was approved by Institutional ethical review committee (3872-Pat-ERC-15). During the study period, 134617 pediatric patients were hospitalized, DVT/PE was observed in 77 unique patients (47 males and 30 females) with a median (IQR) age of 14 (5-16) years equivalent to 5.9 VTE events /10,000 hospital admissions. Malignancy, community acquired infections and autoimmune diseases were the predominant risk factors (75%) in adolescent age-group while surgery for congenital heart anomalies was the primary reason (71%) in infants. Overall, lower extremity thrombosis was the most frequent (51%) followed by pulmonary embolism (25%). and upper extremity thrombosis (24%). Enoxaparin and unfractionated heparin were mainly used to treat VTE and all-cause mortality was 13% in the cohort studied. We observed substantial VTE events in pediatric patients during their hospital stay in a tertiary care center of a low-middle income country.
Efficacy of plasmapheresis as treatment for bilateral hyperviscosity syndrome related retinopathy in multiple myeloma
Authors: Merz Tommaso , Marchesoni Ivan , Caminiti Giulia , Romanelli Federica
Published: February 2021

Purpose:

To report a case of good clinical response to plasmapheresis as therapy for a bilateral hyperviscosity syndrome related retinopathy in a young patient with undiagnosed multiple myeloma (MM).

Methods:

Case report.

Results:

A 48-year-old caucasian man, previously diagnosed with monoclonal gammopathy of undetermined significance (MGUS), presented for medical attention for back ache and vision decrease, worst in the left eye. Ophthalmological examination revealed presence of bilateral CRVO-like retinopathy which raised the hypothesis of hyperviscosity syndrome (HVS). After confirmation of MM diagnosis, plasmapheresis were promptly begun. The right eye regained a good visual acuity and an anatomical restoration already notable 5 days from the first plasmapheresis.

Conclusions:

Fundoscopy lead to diagnosis of HVS, it is therefore advisable in all patients with MM in order to perform plasmapheresis as soon as possible if necessary. In case of atypical CRVO, haematological and inflammatory causes, should be always ruled out.
Aspirin monotherapy is a suitable standard thromboprophylactic agent following total hip arthroplasty
Authors: Borton Zakk M , Bhangoo Navjot S , Quah Conal SL , Stephen Arthur B , Howard Peter W
Published: February 2021

Introduction:

Aspirin is increasingly recognised as an efficacious thromboprophylactic agent with a superior safety profile compared to alternatives. Following our institution’s previously published experience we implemented a risk-stratified protocol utilising aspirin as standard. We now present retrospective review of standard use of aspirin on fatal pulmonary embolism, all-cause mortality, and venous thromboembolism (VTE) following total hip arthroplasty (THA).

Methods:

A consecutive series of elective THAs was identified. Prospectively maintained databases were analysed to yield demographic data and identify deaths or readmission data. Patients who died within 90 postoperative days underwent review of the complete medical record.

Results:

4204 THAs were included in the study cohort. VTE prophylaxis prescription was available in 3805. 2560 received aspirin (67.3%), 1049 enoxaparin (27.6%) and 193 warfarin (5.1%); there were no differences in 90-day all-cause mortality ( p = 0.780) or VTE ( p = 1) between groups

Conclusion:

Our large series continues to demonstrate that aspirin for thromboprophylaxis following THA is effective in risk-stratified patients. Furthermore, we demonstrate that introduction of a departmental protocol establishing aspirin as standard practice was not associated with increased mortality or incidence of thromboembolism. Taken in conjunction with our previous cohort our series encompasses 11,420 consecutive THAs. There has been a single death following fatal PE in the aspirin group (0.02%) compared to 5 in the LMWH group (0.2%) and 1 in the warfarin group (0.06%). We join calls for large-scale randomised controlled trials to elucidate the place of aspirin in VTE prevention following hip arthroplasty.
Local infiltration analgesia does not have benefits in fast-track hip arthroplasty programmes: a double-blind, randomised, placebo-controlled, clinical trial
Authors: Bernaus Marti , Novellas Marga , Bartra Agustí , Núñez Jorge H , Anglès Francesc
Published: February 2021

Background:

Multimodal analgesia regimes including local infiltration analgesia (LIA) have been successfully applied in fast-track hip arthroplasty programmes. LIA’s contribution to the analgesic effect in hip arthroplasty has been questioned. Our study sought to determine the analgesic efficacy of LIA in THA surgery in a fast-track programme.

Methods:

Patients diagnosed with hip osteoarthritis scheduled for arthroplasty were randomised to receive LIA (120 ml ropivacaine 0.2% plus epinephrine 0.5 µ/ml) or saline as a part of a multimodal analgesia regime. The surgical team, the nursing staff, and patients were all blinded regarding patient allocation throughout the study. The primary outcome was pain assessed as a continuous variable using the visual analogue scale (VAS) at 4, 8, 24 and 48 hours postoperatively. Secondary outcomes included the amount of analgesic rescue consumption, complications and length of hospital stay.

Results:

A total of 63 patients were interviewed and agreed to participate in the study. No statistically significant differences were found between groups for pain measurements at 4, 8, 12, 24 and 48 hours after surgery. There were also no differences in rescue medication consumption, complications, or length of stay.

Conclusions:

Our results suggest LIA (ropivacaine plus epinephrine, single shot) has no effect in pain management and has not shown benefits for early ambulation in primary THA surgery. Further research is needed to establish the optimal multimodal analgesia regime for THA fast-track programmes.

Clinical trial registration:

Clinicaltrials.gov (NCT03513276).
Depression and multiple sclerosis: A bidirectional Mendelian randomisation study
Authors: Binzer Stefanie , Jiang Xia , Hillert Jan , Manouchehrinia Ali
Published: February 2021

Depression is common in multiple sclerosis (MS); however, the underlying mechanism for the relationship remains unknown. In this study, we examined a putative causal relationship between depression and MS using a bidirectional Mendelian randomisation (MR) framework. Using the latest genome-wide association study data available, 168 non–major histocompatibility complex (MHC) independent variants associated with MS and 96 independent genetic variants associated with depression susceptibility were used. Maximum likelihood, weighted median, inverse variance weighted method and MR-Egger regression analyses were performed. There was no significant risk for the development of MS in persons carrying variants associated with depression or for risk of depression in individuals who are genetically susceptible to MS.
Toward a conceptual model for successful transgender aging
Authors: Sloan Steffany , Benson Jacquelyn J
Published: February 2021

Transgender older adults have been subject to life-long stigma and marginalization, resulting in significant social and health consequences. Despite these challenges, this population commonly reports thriving in later life. In order to attend to nuanced experiences of older transgender adults, theoretical models of successful aging must reflect complexities presented by gender minority status. In order to address theoretical gaps, a systematic qualitative meta-synthesis was conducted to summarize findings across the body of qualitative transgender aging research. Findings indicated that transgender older adults conceptualize successful aging through the process of embracing gender identity. Themes were identified to conceptualize successful transgender aging such as gender expression, shedding internalized stigma, and championing a resilience mindset. Implications for social work practice are provided, suggesting a more comprehensive understanding of both challenges and resilience factors amongst the aging transgender population.
The Potential Role of IL1RAP on Tumor Microenvironment-Related Inflammatory Factors in Stomach Adenocarcinoma
Authors: Lv Qing , Xia Qinghua , Li Anshu , Wang Zhiyong
Published: February 2021

This study was performed to investigate the role of interleukin-1 receptor accessory protein (IL1RAP) in stomach carcinoma in vitro and in vivo, determine whether IL1RAP knockdown could regulate the development of stomach carcinoma, and elucidate the relationship between IL1RAP knockdown and inflammation by tumor microenvironment-related inflammatory factors in stomach carcinoma. We first used TCGA and GEPIA systems to predict the potential function of IL1RAP. Second, western blot and RT-PCR were used to analyze the expression, or mRNA level, of IL1RAP at different tissue or cell lines. Third, the occurrence and development of stomach carcinoma in vitro and in vivo were observed by using IL1RAP knockdown lentivirus. Finally, the inflammation of stomach carcinoma in vitro and in vivo was observed. Results show that in GEPIA and TCGA systems, IL1RAP expression in STAD tumor tissue was higher than normal, and high expression of IL1RAP in STAD patients had a worse prognostic outcome. Besides, GSEA shown IL1RAP was negative correlation of apopopsis, TLR4 and NF-κB signaling pathway. We also predicted that IL1RAP may related to IL-1 s, IL-33, and IL-36 s in STAD. The IL1RAP expression and mRNA level in tumor, or MGC803, cells were increased. Furthermore, IL1RAP knockdown by lentivirus could inhibit stomach carcinoma development in vitro and in vivo through weakening tumor cell proliferation, migration, invasion, therefore reducing tumor volume, weight, and biomarker levels, and increasing apoptotic level. Finally, we found IL1RAP knockdown could increase inflammation of tumor microenvironment-related inflammatory factors of stomach carcinoma, in vitro and in vivo. Our study demonstrates that IL1RAP is possibly able to regulate inflammation and apoptosis in stomach carcinoma. Furthermore, TLR4, NF-κB, IL-1 s, IL-33, and IL-36 s maybe the downstream target factor of IL1RAP in inflammation. These results may provide a new strategy for stomach carcinoma development by regulating inflammation.
I Read It Online: Understanding How Undergraduate Students Assess the Accuracy of Online Sources of Health Information
Authors: Dissen Anthony , Qadiri Qudratullah , Middleton Charles J.
Published: February 2021

Online sources of health information are a significant means by which the public educates itself about health and wellness. The purpose of this study is to investigate how undergraduate students evaluate and assess health-related websites for accuracy, as well as the self-reported factors used in identifying whether a website is an accurate source of information. One hundred and fifty-seven students participated by reviewing a series of 10 health-related websites and indicated whether they believed the website to be an accurate source of health information. Students completed an open-ended question to self-report how they made this determination. Results indicate that students were not able to accurately distinguish between credible sources of web-based health information and those sources that were previously categorized as not being credible sources. Analysis of self-reported qualitative feedback gave rise to 6 factors used to determine the accuracy of the websites reviewed. While students report using these factors, and these factors are consistent with previous research, this does not appear then to be translating to successful determination of a source’s accuracy. Educating students in proper fact-checking and evaluation skills may be warranted to develop a generation of individuals who can be said to have better health literacy.
Nonlinear dynamic load analysis of aviation spline coupling with mass eccentricity and misalignment
Authors: Xue Xiangzhen , Huo Qixin , Liu Jian , Jia Jipeng
Published: February 2021

Most of the time, mass eccentricity, and misalignment exist at the same time with aviation spline coupling working. Therefore, in this paper, the function of dynamic meshing force between multi-teeth and a non-linear dynamic model of involute spline coupling system in aero-engine with mass eccentricity and misalignment were presented. And then, the non-linear dynamic meshing force of spline coupling in aero-engine on different misalignment and mass eccentricity was investigated. The result shows that when the mass eccentricity and the misalignment are both small, the aviation involute spline coupling can run steady. And with the increase of mass eccentricity or misalignment, the dynamic load coefficient of the aviation involute spline coupling gradually increase. At the same time, as the mass eccentricity or misalignment increases, some teeth suffer more load, some teeth suffer less load, and some teeth are out of engagement so that they do not suffer any load. The running state of spline coupling becomes more and more unstable.