bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal integration of photovoltaic distributed generation in electrical distribution network using hybrid modified PSO algorithms
Authors: Belbachir Nasreddine , Zellagui Mohamed , Lasmari Adel , El-Bayeh Claude Ziad , Bekkouche Benaissa
Published: October 2021

The satisfaction of electricity customers and environmental constraints imposed have made the trend towards renewable energies making them more essential due to their advantages as reducing power losses and ameliorating system’s voltage profiles and reliability. This article addresses the optimal location and size of multiple distributed generations (DGs) based on solar photovoltaic panels (PV) connected to electrical distribution network (EDN) using the various proposed hybrid particle swarm optimization (PSO) algorithms based on chaotic maps and adaptive acceleration coefficients. These algorithms are implemented to optimally allocate the DGs based PV (PV-DG) into EDN by minimizing the multi-objective function (MOF), which is represented as the sum of three technical parameters of the total active power loss (TAPL), total voltage deviation (TVD), and total operation time (TOT) of overcurrent relays (OCRs). The effectiveness of the proposed PSO algorithms were validated on both standards IEEE 33-bus, and 69-bus. The optimal integrating of PV-DGs into EDNs reduced the TAPL percentage by 56.94 % for the IEEE 33-bus and by 61.17 % for the IEEE 69-bus test system, enhanced the voltage profiles while minimizing the TVD by 37.35 % and by 32.27 % for two EDNs, respectively.
Digital agriculture based on big data analytics: a focus on predictive irrigation for smart farming in Morocco
Authors: Rabhi Loubna , Falih Noureddine , Afraites Lekbir , Bouikhalene Belaid
Published: October 2021

Due to the spead of objects connected to the internet and objects connected to each other, agriculture nowadays knows a huge volume of data exchanged called big data. Therefore, this paper discusses connected agriculture or agriculture 4.0 instead of a traditional one. As irrigation is one of the foremost challenges in agriculture, it is also moved from manual watering towards smart watering based on big data analytics where the farmer can water crops regularly and without wastage even remotely. The method used in this paper combines big data, remote sensing and data mining algorithms (neural network and support vector machine). In this paper, we are interfacing the databricks platform based on the apache Spark tool for using machine learning to predict the soil drought based on detecting the soil moisture and temperature.
Current mismatch reduction in charge pumps using regulated current stealing-injecting transistors for PLLs
Authors: Zulkalnain Mohd Khairi , Wong Yan Chiew
Published: October 2021

A charge pump for phase locked loops (PLL) with a novel current mismatch compensation technique is proposed. The proposed circuit uses a simple yet effective current stealing-injecting (CSI) technique and feedback to reduce mismatch between the negative-channel-metal-oxide (NMOS) and positive-channel-metal-oxide (PMOS) transistors. The current stealing transistor steals the current from a replica branch and mirrors it to the output where it is added to the output branch by the injecting transistor. A feedback mechanism is used to set the drain voltages of both branches to be equal and mitigate channel length modulation and ensure high accuracy. The proposed circuit was designed on Silterra 130nm technology and simulated using Cadence Spectre. The simulation results show that the proposed circuit yields a maximum of 0.107% and minimum of 0.00465% current mismatch while operating at a low supply voltage of 800mV for a range of 100mV to 700mV. The proposed design uses only one rail-to-rail op amp for compensating the mismatch and an addition of 4 transistors and utilizing 75% of the supply voltage for high voltage controlled oscillator (VCO) tuning range.
Development of smart parking system using internet of things concept
Authors: Puspitasari Dwi , Noprianto Noprianto , Afif Hendrawan Muhammad , Andrie Asmara Rosa
Published: October 2021

The growing number of vehicles in developing countries causes a slew of issues, including the parking system.The current parking system is mostly manual, requires human intervention as a security system, and does not provide information about available parking areas.Their problems cause nonoptimal parking management. Furthermore, it can lead to income loss and criminal acts. This study addresses one of the possible solutions by using the internet of things (IoT) concept. The parking system is built by utilizing a smart card, machine-to-machine (M2M) communication, and cloud monitoring. As a result, the smart parking system prototype has been provided. The parking system business process can be done automatically, and it provides a more secure parking security system. The proposed parking system architecture also provides a practical system. The system only took around 1 second to perform the data transmission between nodes.
Falling Through the Cracks: The Current Gap in the Health Care Transition of Patients With Kawasaki Disease
Authors: Dahdah Nagib , Kung Samuel C. , Friedman Kevin G. , Marelli Ariane , Gordon John B. , Belay Ermias D. , Baker Annette L. , Kazi Dhruv S. , White Patience H. , Tremoulet Adriana H. ,   the American Heart Association Rheumatic Fever, Endocarditis, Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young, and the Council on Arteriosclerosis, Thrombosis and Vascular Biology
Published: October 2021

Background

Health care transition (HCT) is a period of high vulnerability for patients with chronic childhood diseases, particularly when patients shift from a pediatric to an adult care setting. An increasing number of patients with Kawasaki disease (KD) who develop medium and large coronary artery aneurysms (classified by the American Heart Association according to maximal internal coronary artery diameter Z‐scores ≥5 and ≥10, respectively) are becoming adults and thus undergoing an HCT. However, a poor transition to an adult provider represents a risk of loss to follow‐up, which can result in increasing morbidity and mortality.

Methods and Results

This scientific statement provides a summary of available literature and expert opinion pertaining to KD and HCT of children as they reach adulthood. The statement reviews the existing life‐long risks for patients with KD, explains current guidelines for long‐term care of patients with KD, and offers guidance on assessment and preparation of patients with KD for HCT. The key element to a successful HCT, enabling successful transition outcomes, is having a structured intervention that incorporates the components of planning, transfer, and integration into adult care. This structured intervention can be accomplished by using the Six Core Elements approach that is recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians.

Conclusions

Formal HCT programs for patients with KD who develop aneurysms should be established to ensure a smooth transition with uninterrupted medical care as these youths become adults.
Knowledge, attitudes and practices towards COVID-19 among multiethnic elderly Asian residents in Singapore: a mixed-methods study
Authors: Aravindhan Amudha , Gan Alfred Tau Liang , Lee Ester Pei Xuan , Gupta Preeti , Man Ryan , Ho Kam Chun , Sung Sharon Cohan , Cheng Ching-Yu , Ling Moi Lin , Tan Hiang Khoon , Wong Tien Yin , Fenwick Eva Katie , Lamoureux Ecosse Luc
Published: October 2021

Introduction:

We investigated the knowledge, attitudes and practice (KAP) towards coronavirus disease 2019 (COVID-19) and its related preventive measures in Singaporeans aged ≥60 years.

Methods:

This was a population-based, cross-sectional, mixed-methods study (13 May 2020–9 June 2020) of participants aged ≥ 60 years. Self-reported KAP about ten symptoms and six government-endorsed preventive measures related to COVID-19 were evaluated. Multivariable regression models were used to identify sociodemographic and health-related factors associated with KAP in our sample. Associations between knowledge/attitude scores and practice categories were determined using logistic regression. Seventy-eight participants were interviewed qualitatively about the practice of additional preventive measures and data were analysed thematically.

Results:

Mean awareness score of COVID-19 symptoms was 7.2/10. The most known symptom was fever (93.0%) and the least known was diarrhoea (33.5%). Most participants knew all six preventive measures (90.4%), perceived them as effective (78.7%) and practised ‘wear a mask’ (97.2%). Indians, Malays and participants living in smaller housing had poorer mean scores for knowledge of COVID-19 symptoms. Older participants had poorer attitudes towards preventive measures. Compared to Chinese, Indians had lower odds of practising three out of six recommendations. A one-point increase in score for knowledge and attitudes regarding preventive measures resulted in higher odds of always practising three of six and two of six measures, respectively. Qualitative interviews revealed use of other preventive measures, for example, maintaining a healthy lifestyle.

Conclusions:

Elderly Singaporeans displayed high levels of KAP about COVID-19 and its related preventive measures, with a positive association between levels of knowledge/attitude and practice. However, important ethnic and socioeconomic disparities were evident, indicating that key vulnerabilities remain, which require immediate attention.
A qualitative study of motivations for non-suicidal self-injury in a sample of psychiatric outpatients in Singapore
Authors: Shahwan Shazana , Zhang Yunjue , Sambasivam Rajeswari , Ong Say How , Chong Siow Ann , Subramaniam Mythily
Published: October 2021

Introduction:

The popular notion that the need for attention drives non-suicidal self-injury (NSSI) serves to stigmatise rather than understand this warning sign of underlying psychological/psychiatric disorder. Despite the pervasiveness of NSSI in clinical and community settings, effective treatments for this behaviour are lacking. This qualitative research aims to understand the motivations of NSSI in adolescents/young adults in a mental health facility in Singapore.

Methods:

Semi-structured interviews were conducted with 20 outpatients (6 males, 14 females) of the Institute of Mental Health aged 17–29 years who had reported NSSI as part of an earlier survey. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. The main themes and sub-themes were identified and described.

Results:

A preponderance of motivations served intrapersonal emotion-regulating purposes, which were categorised as to: (a) release bottled-up feelings; (b) self-punish; (c) turn aggression inwards; (d) sensitise oneself; and (e) attain a sense of control and mastery. By contrast, a small subset of motivations served the interpersonal motivation of signaling one's distress, especially when the capacity for verbal expression was limited or attempts to verbalise distress were futile.

Conclusion:

Committing NSSI solely for attention-seeking is a myth that perpetuates the stigma and hinders those in need of psychological care from seeking appropriate treatment. NSSIs may be warning signs that indicate not only intrapersonal conflicts but external environments that are perceived unsafe to deal with these intrapersonal conflicts. An understanding of the underlying motives will facilitate better treatment of individuals presenting with NSSI.
Buddhist Ritual as “Connectionwork”: Aesthetics and Technologies of Mediating Religious Belonging
Authors: Williams-Oerberg Elizabeth
Published: October 2021

In September 2016, the Himalayan Buddhist festival Naropa 2016 took place in the Northwest Himalayan region of Ladakh, India. This article analyzes the spectacular aesthetics of the Naro Gyen Druk ritual, the focus of Naropa 2016. Drawing on ethnographic documentation of this ritual, I consider the role of ritual aesthetics in provoking affective, emotional, and bodily experiences among participants and their felt connections to the 12th Gyalwang Drukpa, the charismatic leader of the Drukpa Kagyü organization. I introduce the term “connectionwork” to emphasize how Buddhist conceptualizations of connections, drelwa (‘brel ba), bring to light how ritual and performances of charisma either work or fail to work in establishing religious belonging among Himalayan and international participants. Connectionwork helps to emphasize not only the work to organize and orchestrate religious rituals with the intention to institute religious belonging, but also the agential role that participants play in charismatic ritual performances.
Ottomans: Unwanted Immigrants in Brazil at the Beginning of the Twentieth Century
Authors: Genç Hamdi , Bozkurt İbrahim Murat
Published: October 2021

This article addresses the Ottoman migration to Brazil from current Lebanon and Syria. The article explores reasons for the migration, the Ottoman State’s attitude towards this migration and the measures taken to control it. It also analyses the socio-economic and political relations between the Ottoman State and Brazil, and the socio-economic situation of the Lebanese and Syrians who migrated to Brazil as well as the attitude of the Brazilian government. In addition, the article highlights the attitude of the Brazilian government to Lebanese and Syrian migrants. The article is mostly based on Ottoman archives accessed through the State Archives Department of the Turkish Presidency. These documents give a distinctive character to the article compared with other studies in this field, namely that it is one of very few focusing on migration from Lebanon and Syria to Brazil in the Ottoman period that uses archival resources of the country of emigration.
Revisiting the Pancreatic Fistula Risk Score: Clinical Nomogram Accurately Assesses Risk
Authors: Mohamed Abdimajid , Nicolais Laura , Fitzgerald Timothy L.
Published: October 2021

Objectives

Surgeons have created numerous iterations of the pancreatic fistula risk score (FRS) to predict risk for clinically relevant postoperative pancreatic fistula (CR-POPF). The multitude of often conflicting models makes it difficult for surgeons to apply data in clinical practice.

Methods

We conducted a retrospective cohort study utilizing National Surgical Quality Improvement Program data from 2015 to 2018. The study included patients undergoing pancreaticoduodenectomy. Missing data were resolved with multiple imputations.

Results

The study included 5975 patients; 1018 (17%) had a CR-POPF. On multivariate analysis, male sex (odds ratio (OR) 1.60 CI: 1.29-1.98 P < .001), obesity (OR 1.65 CI: 1.31-2.08 P < .001), and soft gland texture (OR 3.21 CI: 2.45-4.23 P < .001) were all associated with increased odds of a CR-POPF. Variables not associated with CR-POPF included diabetes, preoperative bilirubin, preoperative albumin, and American Society of Anesthesiologists (ASA) classification. On multivariate analysis, duct diameter >6 mm (OR .52 CI: .34-.77 P = .001), pancreatic adenocarcinoma pathology (OR .67 CI: .53-.84 P < .001), and neoadjuvant treatment (OR .71 CI: .51-.98 P = .042) were all associated with decreased odds of a CR-POPF. We constructed a clinically relevant nomogram from this model known as the Portland FRS. Model characteristics were superior to previously published FRS models. The area under the curve (AUC) for the Portland FRS was .72 (CI: .704-.737). In comparison, AUCs for the Alternative and Seoul FRS were .70 and .64, respectively.

Conclusion

Utilizing readily available clinical data, the Portland FRS can accurately predict the risk for pancreatic fistula. The nomogram may assist surgeons in patient counseling and perioperative management.
Way of Authoritarian Regional Hegemon? Formation of the RCEP From the Perspective of China
Authors: Tae Yoo In , Chong-Han Wu Charles
Published: October 2021

How has China contributed toward the conclusion of the Regional Comprehensive Economic Partnership (RCEP)? The extant literature tends to either undervalue China’s role or emphasizes the absence of China’s willingness to realize the RCEP. However, it is difficult to form region-wide multilateral preferential trade agreements (PTAs), such as RCEP, without any significant contribution from a regional hegemon, such as China. This paper, thus, argues that China has contributed significantly toward the conclusion of RCEP by engendering incentives for member countries to join through multiple cooperative structures. These cooperative structures involve China-led bilateral PTAs and international development forums, which include the Belt and Road Initiative and Asian Infrastructure Investment Bank. With the gradual shift from bilateral to multilateral PTAs and forum-linkage strategies, China turned to be more assertive in concluding the RCEP than in the early years of RCEP negotiations, as evidenced by the discourse of political and opinion leaders.
Down a Rabbit Hole: How Prior Media Consumption Shapes Subsequent Media Consumption
Authors: Woolley Kaitlin , Sharif Marissa A.
Published: October 2021

Consumers often become “stuck in a rabbit hole” when consuming media. They may watch several YouTube videos in the same category or view several thematically similar artistic images on Instagram in a row, finding it difficult to stop. What causes individuals to choose to consume additional media on a topic that is similar to (vs. different from) what they just experienced? The authors examine a novel antecedent: the consecutive consumption of multiple similar media. After viewing multiple similar media consecutively, more consumers choose to (1) view additional similar media over dissimilar media or (2) complete a dissimilar activity entirely, even when the prior consumption pattern is externally induced. The rabbit hole effect occurs because of increased accessibility of the shared category: when a category is more accessible, people feel immersed in it and anticipate that future options within that category will be more enjoyable. The authors identify three characteristics of media consumption that contribute to the rabbit hole effect by increasing category accessibility: similarity, repetition, and consecutiveness of prior media consumption. This research contributes to literature on technology, choice, and variety seeking, and it offers implications for increasing (vs. slowing) similar consumption.
Examining the Impact of eWOM-Triggered Customer-to-Customer Interactions on Travelers’ Repurchase and Social Media Engagement
Authors: Izogo Ernest Emeka , Mpinganjira Mercy , Karjaluoto Heikki , Liu Hongfei
Published: October 2021

Electronic word-of-mouth (eWOM) communication on social media has revolutionized how travelers search for and share information and how they interact with one another digitally. This research examines the effects of eWOM-triggered customer-to-customer (C2C) interactions on travelers’ post-eWOM behaviors (i.e., repurchase and customer engagement) in a cross-cultural context. Drawing upon cognitive dissonance theory, a scenario-based experiment was conducted using a sample of 461 African tourists with recent intracontinental travel experience. Our findings suggest that a customer’s repurchase intention and engagement in social media C2C interactions are significantly influenced when their eWOM is challenged by other customers. Compared with individualistic cultures, such a phenomenon is more effective in collectivistic cultures, particularly when a customer shares negative eWOM. Customers in collectivistic cultures are more likely to appreciate consensus with other customers, and they tend to expend more effort toward solving dissonance. The theoretical and managerial implications of these findings are discussed.
Gay Pride in the Urban New South: Politics, Neighborhood, and Community in Atlanta and Charlotte
Authors: Mims La Shonda
Published: October 2021

Atlanta, Georgia, and Charlotte, North Carolina, serve as urban centers of the Southeast and archetypal New South cities. In the last decades of the twentieth century, city and corporate leaders in Atlanta often welcomed the growth of gay visibility and the resulting queer tourism. While Charlotte’s leaders promoted growth and longed to be like Atlanta, they rebuffed queer visibility. For many queer people, Atlanta lived up to an oft-repeated maxim; it was a city too busy to hate. Charlotte’s pattern of significant and sustained growth throughout the twentieth century led to its well-chosen Chamber of Commerce slogan, labeling the city as a great place to make money, which proved true for many queer people. Still, this financial success did not equal support. City politicians often set aside opportunities to exploit the burgeoning gay market while rejecting Charlotte’s queer citizens wholesale.
The Audiometric Assessment of the Effectiveness of Surgical Treatment of Otosclerosis Depending on the Preoperative Incidence of Carhart’s Notch
Authors: Job Katarzyna , Wiatr Agnieszka , Skladzien Jacek , Wiatr Maciej
Published: October 2021

Objective: The presence of Carhart’s notch at 2000 Hz in otosclerosis links the changed bone conduction for this frequency with the otosclerotic process occurring in the oval window. The aim of this study is to perform an audiometric assessment of the effectiveness of surgical treatment of otosclerosis depending on the incidence of Carhart’s notch. Methods: The analysis included 116 patients treated surgically for the first time due to otosclerosis. Patients were divided into 4 groups depending on the occurrence of Carhart’s notch, determined by pure-tone audiometry (PTA) before the surgery and 36 months afterward. The mean value of bone conduction thresholds was calculated for 500 Hz, 1000 Hz, 2000 Hz, and 3000 Hz in the groups in which the Cahart’s notch was observed. This value of bone conduction (BC) was a reference point for further analysis in patients who had no preoperative or postoperative Carhart’s notch. Results: The analysis indicated that Cahart’s notch in preoperative PTA is a statistically significant improvement factor for average BC. It was found that over a longer observation period, the presence of Carhart’s notch has adverse effects on the size of the postoperative air-bone gap, and consequently on hearing improvement after surgical treatment. A comparison between patients from the two groups without preoperative Carhart’s notch found that no beneficial effects of the surgery on speech comprehension were observed regarding high-level sensorineural hearing loss (SNHL). Conclusions: (1) In a long-term observation post-stapedotomy, average BC values were found to improve. Nevertheless, the improvement is less evident in patients with preoperative Carhart’s notch. (2) Disappearance of Cahart’s notch after surgical treatment of otosclerosis is a good prognosis of improvement in speech audiometry. (3) Deep SNHL in the absence of Carhart’s notch in PTA constitutes a bad prognostic factor for improvement in speech audiometry in patients qualified for surgical treatment of otosclerosis.
Mediatisation and the construction of what is morally right and wrong in contemporary business
Authors: Frostenson Magnus , Grafström Maria
Published: October 2021

The recent discussion on mediatisation prompts questions about how it arises and how social spheres are marked by it. In this article, we use business as an example of a social sphere to show that the production of normativity by and through the media is a central aspect of mediatisation. The empirical case of the article is the Deepwater Horizon disaster. Six specific techniques were used by the media to construct the case as an instance of corporate misbehaviour that met public recognition. The techniques are instrumental in forming the predicament of a modern mediatised business sphere, it is argued.
Physical fitness changes induced by thermal aquatic standardized exercise in chronic venous disease patients
Authors: Menegatti Erica , Mandini Simona , Chi Yung-Wei , Mazzoni Gianni , Pagani Anselmo , Malagoni Anna Maria , Tessari Mirko , Costa Alfio Luca , Avruscio Giampiero , Zamboni Paolo , Gianesini Sergio
Published: October 2021

Background

Lack of physical activity represents a risk factor for both cardiovascular and chronic venous diseases (CVD), nevertheless a specific exercise protocol for CVD patient is still missing. This investigation was aimed to assess the impact of a standardized exercise protocol in a thermal water environment on physical fitness and quality-of-life (QoL) in CVD patients.

Methods

Sixteen (16) CVD patients performed 5 standardized exercise sessions in a thermal water pool. Before starting the exercise protocol, the cohort filled International Physical Activity Questionnaire (IPAQ) to determine their physical activity level. At baseline and at the end of the exercise program, leg volume, QoL, musculoskeletal and cardiovascular physical fitness were assessed by means of water plethysmography, validated questionnaire and functional test, blood pressure and heart rate at rest were also reported.

Results

All the patients were categorized as physically inactive: average activity time 235.6 (155.2) MET-minutes per week. At the end of the study, a significant leg volume reduction was found (−16%; p < .002). Significant improvement in lower limb strength (p < .0001), endurance (p < .006), rapidity and balance (p < .05) together with decrease in resting heart rate (−1.8%, p < .0001) and systolic blood pressure (−1.1%, p < .04) were reported, significant improvement in bodily pain (p < .0005) and social function (p < .002) QoL items were observed.

Conclusions

The proposed exercise protocol in thermal aquatic environment demonstrated to be an effective treatment modality improving both cardiovascular and musculoskeletal outcomes and QoL in sedentary CVD patients. Aquatic environment investigations require proper analysis of the various factors involved, in a standardized and reproducible way. The herein report can be a reference for further studies on different health related conditions.
Opioid-sparing effects of ketorolac in palliative care patients receiving opioids for chronic cancer-related pain: A systematic literature review
Authors: Butcher Belinda , Hutchings Elizabeth , Fazekas Belinda , Clark Katherine , Rowett Debra , Currow David
Published: October 2021

Background:

Standard of care in treatment of cancer-related pain involves opioids in combination with non-steroidal anti-inflammatory drugs (NSAID). Ketorolac, a NSAID, has demonstrated opioid-sparing effects in other clinical settings.

Aim:

This systematic literature review investigated ketorolac’s opioid-sparing effects in patients receiving opioids for chronic, cancer-related pain.

Design:

The primary outcome was total daily dose of opioids. Secondary outcomes included frequency of opioid use, use and frequency of ‘rescue’ medication and adverse events. Outcomes were described, and meta-analysed where possible. PROSPERO registration CRD42019130894.

Data sources:

Articles included original research, from any study phase or methodology, published in English in a peer-reviewed journal or conference between 1990 and 2020; included subjects >18 years; had chronic cancer-related pain and described the use of opioid-sparing effect of ketorolac.

Results:

Nine articles were included. While there was significant heterogeneity, ketorolac may have an opioid-sparing effect, with significant reductions in total daily dose of morphine observed in a single randomised controlled trial (SMD −4.30 mg, 95% CI −5.36 to −3.25), but the changes in the before and after studies were not statistically significant −0.46 mg (95% CI −1.14 to 0.22). Ketorolac was associated with greater likelihood of complete pain relief, but the data were heterogeneous. Insufficient data were available to analyse frequency of opioid use, or rescue medication requirements.

Conclusions:

Given the heterogeneity of the data, adequately powered, randomised controlled trials are required to establish any opioid-sparing effect of ketorolac. For patients not responding to conventional pain management, ketorolac may have a role in treatment augmentation.
Development and Validation of a Discrete Event Simulation Model to Evaluate the Cardiovascular Impact of Population Policies for Obesity
Authors: Arrospide Arantzazu , Ibarrondo Oliver , Castilla Iván , Larrañaga Igor , Mar Javier
Published: October 2021

Introduction

Our aim was to describe the development and validation of an obesity model representing the cardiovascular risks associated with different body mass index (BMI) categories, through simulation, designed to evaluate the epidemiological and economic impact of population policies for obesity.

Methods

A discrete event simulation model was built in R considering the risk of cardiovascular events (heart failure, stroke, coronary heart disease, and diabetes) associated with BMI categories in the Spanish population. The main parameters included in the model were estimated from Spanish hospital discharge records and the Spanish Health Survey and allowed both first-order and second-order (probabilistic sensitivity analysis) uncertainty to be programmed into the model. The simulation yielded the incidence and prevalence of cardiovascular events as validation outputs. To illustrate the capacity of the model, we estimated the reduction in cardiovascular events and cost-utility (incremental cost/incremental quality-adjusted life-years [QALYs]) of a hypothetical intervention that fully eliminated the cardiovascular risks associated with obesity and overweight.

Results

The Validation Status of Health-Economic decision models (AdViSHE) tool was applied. Internal validation plots showed adequate goodness of fit for the Spanish population. External validation was achieved by comparing the simulated and real incidence by age group for stroke, acute myocardial infarction, and heart failure. The intervention reduced the population hazard ratios of stroke, acute myocardial infarction, and heart failure to 0.81, 0.74, and 0.78, respectively, and added 0.74 QALYs to the whole population.

Conclusions

This obesity simulation model evidenced good properties for estimating the long-term epidemiological and economic impact of policies to tackle obesity in Spain. The conceptual model could be implemented for other counties using country-specific input data.
Concept2Robot: Learning manipulation concepts from instructions and human demonstrations
Authors: Shao Lin , Migimatsu Toki , Zhang Qiang , Yang Karen , Bohg Jeannette
Published: October 2021

We aim to endow a robot with the ability to learn manipulation concepts that link natural language instructions to motor skills. Our goal is to learn a single multi-task policy that takes as input a natural language instruction and an image of the initial scene and outputs a robot motion trajectory to achieve the specified task. This policy has to generalize over different instructions and environments. Our insight is that we can approach this problem through learning from demonstration by leveraging large-scale video datasets of humans performing manipulation actions. Thereby, we avoid more time-consuming processes such as teleoperation or kinesthetic teaching. We also avoid having to manually design task-specific rewards. We propose a two-stage learning process where we first learn single-task policies through reinforcement learning. The reward is provided by scoring how well the robot visually appears to perform the task. This score is given by a video-based action classifier trained on a large-scale human activity dataset. In the second stage, we train a multi-task policy through imitation learning to imitate all the single-task policies. In extensive simulation experiments, we show that the multi-task policy learns to perform a large percentage of the 78 different manipulation tasks on which it was trained. The tasks are of greater variety and complexity than previously considered robot manipulation tasks. We show that the policy generalizes over variations of the environment. We also show examples of successful generalization over novel but similar instructions.
Contrast-enhanced digital mammography and magnetic resonance imaging: reproducibility compared to pathologic anatomy
Authors: Liguori Alessandro , Depretto Catherine , Ciniselli Chiara Maura , Citterio Andrea , Boffelli Giulia , Verderio Paolo , Scaperrotta Gianfranco Paride
Published: October 2021

Purpose:

To compare the reproducibility between contrast-enhanced digital mammography (CEDM) and magnetic resonance imaging (MRI) with the postsurgical pathologic examination. In addition, the applicability of the Breast Imaging–Reporting and Data System (BI-RADS) lexicon of MRI to CEDM was evaluated for mass lesions.

Methods:

A total of 62 patients with a histologically proven diagnosis of breast cancer were included in this study, for a total of 67 lesions. Fifty-nine patients underwent both methods. The reproducibility between MRI vs CEDM and the reference standard (postoperative pathology) was assessed by considering the lesion and breast size as pivotal variables. Reproducibility was evaluated by computing the concordance correlation coefficient (CCC). Bland-Altman plots were used to depict the observed pattern of agreement as well as to estimate the associated bias. Furthermore, the pattern of agreement between the investigated methods with regard to the breast lesion characterization (i.e. mass/nonmass; shape; margins; internal enhanced characteristics) was assessed by computing the Cohen kappa and its 95% confidence interval (CI).

Results:

The reproducibility between MRI and the reference standard and between CEDM and the reference standard showed substantial agreement, with a CCC value of 0.956 (95% CI, 0.931–0.972) and 0.950 (95% CI, 0.920–0.969), respectively. By looking at the Bland-Altman analysis, bias values of 2.344 and 1.875 mm were observed for MRI and CEDM vs reference evaluation, respectively. The agreement between MRI and CEDM is substantial with a CCC value of 0.969 (95% CI, 0.949–0.981). The Bland-Altman analysis showed bias values of −0.469 mm when comparing CEDM vs MRI. Following the Landis and Koch classification criteria, moderate agreement was observed between the two methods in describing BI-RADS descriptors of mass lesions.

Conclusion:

CEDM is able to measure and describe tumor masses comparably to MRI and can be used for surgical planning.
Experiences of Older Adults During the 2020 COVID-19 Pandemic in the United States: An Initial Exploration of Nationally Representative Data at the Intersection of Gender and Race
Authors: Yamashita Takashi , Punksungka Wonmai , Van Vleet Samuel , Helsinger Abigail , Cummins Phyllis
Published: October 2021

Little is known about the overall experiences and feelings of diverse older populations during the 2020 COVID-19 pandemic. To provide the baseline information for future research and policy, this study analyzed the 2020 Health and Retirement Study COVID-19 project data ( n = 1782). More than 70% of older adults reported the following activities: watching TV (98%), reading (90%), using a computer and the internet (83%), gardening (82%), walking (75%), baking and cooking (73%), and praying (73%). Volunteering and attending community groups, which are known to benefit well-being, were unpopular (less than 8%). During the pandemic, older adults were generally satisfied with their lives, but more than half of them were concerned about their own health, family’s health, and future prospects. Our study also showed the differences in the experiences and feelings by gender and race as well as the intersection of gender and race in the United States.
Remote Learning Experience for Children With Developmental Disabilities During COVID-19 Pandemic in an Ethnically Diverse Community
Authors: Valicenti-McDermott Maria , O’Neil Molly , Morales-Lara Amy , Seijo Rosa , Fried Tammy , Shulman Lisa
Published: October 2021

Owing to the COVID-19 pandemic, K-12 education in New York City quickly transitioned to remote learning. We performed a structured interview with 50 consecutive families of children with developmental disabilities about their experience with remote learning 2 months after COVID-19 lockdown. We observed that setting up the remote learning system was challenging for families who were born outside of the United States, spoke limited English, or had a lower level of education. Though some special education supports were in place, remote learning for children with developmental disabilities led to gaps in their therapeutic services. Children with more severe developmental disabilities joined less than 2 hours of remote learning per day and had a decrease in their therapeutic services. Most children (80%) relied on their parents for education. Additionally, for low-income communities, with families who spoke languages other than English, remote learning revealed a new barrier to access: technology.
Gesture and legitimation in the anti-immigration discourse of Nigel Farage
Authors: Hart Christopher , Winter Bodo
Published: October 2021

Critical discourse analysis (CDA) increasingly recognises the role played by multiple semiotic modes in the discursive construction of social identities and inequalities. One embodied mode that has not been subject to any systematic analysis within CDA is gesture. An area where gesture has been extensively studied, and where it is shown to bear significant semiotic load in multimodal utterances, is cognitive linguistics. Here, we use insights from cognitive linguistics to provide a detailed qualitative analysis of gestures in a specific discursive context – the anti-immigration discourse of Nigel Farage. We describe the gestures that accompany a range of rhetorical tropes typical of anti-immigration discourses and critically analyse their role, alongside speech, in communicating prejudice and legitimating discriminatory action. Our analysis suggests that gesture is an important part of political discourse which is worthy of further investigation in future CDA research.
Insulin-like growth factor reduced against decabromodiphenyl ether-209–induced neurodevelopmental toxicity in vivo and in vitro
Authors: Yang Yuanxiang , He Qianyun , Zhang Zhengyu , Qi Chunli , Ding Lina , Yuan Tingting , Chen Yanhong , Li Zhihua
Published: October 2021

Objective

How to reduce the neurodevelopmental toxicity of decabromodiphenyl ether (PBDE-209) remains unclear. This study investigated neurodevelopmental toxicity of PBDE-209 and the protective effects of insulin-like growth factor-1 (IGF-1)

Methods

Pregnant Sprague–Dawley rats were treated with PBDE-209 and IGF-1, and the offspring were subjected to the Morris Water Maze test. Hippocampal neurons were cultured with PBDE-209 and IGF-1 or the PI3K inhibitor or MEK inhibitor for cell viability, apoptosis, immunofluorescence, and Western blot assays.

Results

Prenatal PBDE-209 exposure impaired the learning and memory ability of rats by delaying the mean latency to the platform compared, whereas prenatal treatment with IGF-1 treatment improved the learning and memory ability. In vitro, treatment of primary cultured hippocampal neural stem cells (H-NSCs) with PBDE-209 reduced cell proliferation and differentiation, but induced apoptosis. In contrast, IGF-1 treatment antagonized the cytotoxic effects of PBDE-209 in H-NSCs in vitro. At the gene level, IGF-1 inhibition of PBDE-209–induced cell cytotoxicity was through the activation of the PI3K/AKT and MEK/ERK signaling pathways in vitro because the effect of IGF-1 was blocked by the AKT inhibitor LY294002 and the ERK1/2 inhibitor PD98059.

Conclusion

Prenatal PBDE-209 exposure impaired the learning and memory ability of rats, whereas IGF-1 treatment was able to inhibit the neurodevelopmental toxicity of PBDE-209 by activation of the PI3K/AKT and ERK1/2 cell pathways.
Sexuality Education for Children and Youth With Autism Spectrum Disorder in Canada
Authors: Davies Adam W. J. , Balter Alice-Simone , van Rhijn Tricia , Spracklin Jennifer , Maich Kimberly , Soud Rsha
Published: October 2021

With no standardized approach to sexuality education among Canada’s 13 provinces and territories and the various curricula focusing on neurotypical and non-disabled children, educators have insufficient instruction and lack appropriate training on how to address sexuality education for children and youth with disabilities, particularly children and youth with autism spectrum disorder (ASD). This article provides the current context of sexuality education for children and youth with ASD in Canadian schools and guidance for more inclusive approaches with attention to three important areas: puberty, relationships, and gender and sexual diversity. Recommendations are offered to support more inclusive approaches to sexuality education, acknowledging that a one-size-fits-all approach is insufficient for children and youth with ASD. The recommendations focus on three goals: (a) moving beyond simple knowledge-based approaches to include skill-building; (b) including parents, autistic voices, and advocates in planning and ongoing conversations; and (c) providing supports for educators.
The Most Commonly Determined Nursing Diagnoses According to NANDA-I Taxonomy and Difficulties Using the Nursing Process in COVID-19 Outbreak
Authors: Tosun Hale , Tosun Ayşe , Ödül Özkaya Birgül , Gül Asiye
Published: October 2021

The study was planned to determine the most common nursing diagnoses according to NANDA International (NANDA-I) taxonomy and difficulties experienced in using of nursing process in COVID-19 outbreak. The sample of the descriptive cross-sectional study consisted of nurses cared for patients with COVID-19 ( n = 114). Average age of nurses is 26.86 ± 6.68. Commonly determined nursing diagnoses according to NANDA-I taxonomy in patients with COVID-19 were imbalanced nutrition (66.7%), impaired gas exchange (40.4%), insomnia (21.1%), acute confusion (31.6%), hopelessness (96.5%), difficulty playing caregiver (84.2%), anxiety (38.6%) willingness to strengthen religious bond (71.9%), risk for infection (64.9%), nausea (49.1%). Twenty-four-years old and younger, high school graduates, caring for intubated patients, and those who stated that they did not use nursing diagnosis had more difficulty in using nursing process (<0.05). The use of nursing diagnoses and process for patients with COVID-19 is extremely important in ensuring individual and qualified nursing care.
A Critical Examination of Preservice Music Teachers’ Writing on the edTPA Portfolio
Authors: Wagoner Cynthia L. , Juchniewicz Jay
Published: October 2021

The purpose of this study was to examine the relationship between participants’ edTPA writing and edTPA portfolio scores. Specific questions included (a) Is there a relationship between overall word count and total score on the edTPA? (b) Are individual task commentary word counts associated with specific task scores and total edTPA scores? and (c) Is there a relationship between edTPA-specific vocabulary and total score on the edTPA? Written artifacts from 67 music education students who completed the K–12 Performing Arts edTPA Portfolio were collected over a 4-year period. Correlations between word counts and task and total scores were positive and of modest to moderate strength, as was the correlation between edTPA vocabulary word use and total scores. These findings are interpreted in relation to a national K–12 Performing Arts edTPA portfolio average score of 45 and existing edTPA policies affecting music teacher education programs.
Iron Chelation Reduces DNA Damage in Sickle Cell Anemia
Authors: Al-Khateeb Rawan S. , Althagafy Hanan S. , ElAssouli Mohammad Zaki , Nori Dunya A. , AlFattani Mohammed , Al-Najjar Salwa A. , Al Amri Turki , Hashem Anwar M. , Harakeh Steve , Helmi Nawal
Published: October 2021

Sickle cell anemia (SCA) is a blood condition that causes severe pain. One of the therapeutic agents used for the treatment of SCA is hydroxyurea, which reduces the episodes of pain but causes DNA damage to white blood cells. The aim of this study was to evaluate the efficacy of the combination of hydroxyurea and iron chelation therapy in relation to the extent of DNA-associated damage. Blood samples were collected from 120 subjects from five groups. Various hematological parameters of the obtained serum were analyzed. The amount of damage caused to their DNA was detected using the comet assay and fluorescent microscopy techniques. The percentage of DNA damage in the group that was subjected to the combination therapy (target group) was 1.32% ± 1.51%, which was significantly lower ( P < .05) than that observed in the group treated with hydroxyurea alone (6.36% ± 2.36%). While the target group showed comparable levels of hemoglobin F and lactate dehydrogenase compared to the group that was treated with hydroxyurea alone, highly significant levels of transferrin receptors and ferritin were observed in the target group. The results of this study revealed that the administration of iron chelation drugs with hydroxyurea may help improve patients’ health and prevent the DNA damage caused to white blood cells due to hydroxyurea. Further studies are needed to better understand the underlying mechanisms that are involved in this process.
Prognostic Utility of Pretreatment Neutrophil-Lymphocyte Ratio in Advanced Larynx Cancer
Authors: Kotha Nikhil V , Voora Rohith S , Qian Alex S , Kumar Abhishek , Qiao Edmund M , Stewart Tyler F , Rose Brent S , Orosco Ryan K
Published: October 2021

Purpose:

Neutrophil-lymphocyte ratio has been explored as a prognosticator in several cancer types, but its association with larynx cancer outcomes is not well known. We aimed to identify an optimal NLR cutoff point and examine the prognostic utility of this biomarker in patients with locoregionally advanced larynx cancer treated with curative intent.

Methods:

In the Veterans Affairs’ (VA) national database, we identified patients with locoregionally advanced (T3-4N0-3M0) laryngeal squamous cell carcinoma diagnosed between 2000 and 2017 and treated with curative intent. NLR cutoff points were calculated using Contal/O’Quigley’s method. Outcomes of larynx cancer-specific survival (CSS), overall survival (OS), and non-larynx cancer survival (NCS) were evaluated in multivariable Cox and Fine-Gray models.

Results:

In 1047 patients, the optimal pretreatment NLR cutoff was identified as 4.17 - 722 patients with NLR ⩽ 4.17, 325 patients with NLR > 4.17. The elevated NLR cohort had a higher proportion of T4 disease (39.4% vs 28.4%), node positive disease (52.3% vs 43.1%), and surgical treatment (43.7% vs 35.2%). In multivariable analysis, NLR > 4.17 was independently associated with worse OS (HR 1.31, 95% CI 1.12-1.54, P = .001) and worse CSS (HR 1.46, 95% CI 1.17-1.83, P < .001), but not with NCS (HR 0.94, 95% CI 0.75-1.18, P = .58).

Conclusion:

In locoregionally advanced larynx cancer treated with curative intent, we identified elevated NLR to be associated with inferior OS and CSS. Further prospective studies are needed to investigate pretreatment NLR and our identified 4.17 cutoff as a potential larynx cancer-specific marker for this high risk population.