bluuebunny/crossref_metadata_2025 huggingface dataset:
Mean corrected generalized estimating equations for longitudinal binary outcomes with report bias
Authors: Li Chao , Shen Ye , Xiao Qian , Rathbun Stephen L , Huang Hui , Guan Yongtao
Published: December 2021

Cocaine addiction is an important public health problem worldwide. Cognitive-behavioral therapy is a counseling intervention for supporting cocaine-dependent individuals through recovery and relapse prevention. It may reduce patients’ cocaine uses by improving their motivations and enabling them to recognize risky situations. To study the effect of cognitive behavioral therapy on cocaine dependence, the self-reported cocaine use with urine test data were collected at the Primary Care Center of Yale-New Haven Hospital. Its outcomes are binary, including both the daily self-reported drug uses and weekly urine test results. To date, the generalized estimating equations are widely used to analyze binary data with repeated measures. However, due to the existence of significant self-report bias in the self-reported cocaine use with urine test data, a direct application of the generalized estimating equations approach may not be valid. In this paper, we proposed a novel mean corrected generalized estimating equations approach for analyzing longitudinal binary outcomes subject to reporting bias. The mean corrected generalized estimating equations can provide consistently and asymptotically normally distributed estimators under true contamination probabilities. In the self-reported cocaine use with urine test study, accurate weekly urine test results are used to detect contamination. The superior performances of the proposed method are illustrated by both simulation studies and real data analysis.
A letter about Jean Fernel by Charles Sherrington and the mind–brain connection
Authors: Ambrose Charles T
Published: December 2021

In 1940 during the early phase of the Nazi aerial assault on Britain, the English neurophysiologist, C.S. Sherrington, age 83 years, had just published a philosophical work, Man on His Nature, and was researching the writings of Jean Fernel, a 16th century French physician . Sherrington’s study of Fernel stemmed from a common interest they shared in the association between the mind and the brain. This essay was prompted by a short letter penned by Sherrington in December 1940 and bound years later in his biography, The Endeavour of Jean Fernel, published in 1946. The letter requested information about a particular medical work by Fernel but also mentioned in passing Sherrington’s recent forced evacuation from his home in Ipswich, threatened by German bombing and invasion. The letter in the book invited a reprise of his remarkable career and a study of his last neurological concern – the mind–brain mystery.
Student perceptions of the classroom environment, student characteristics, and motivation for music lessons at secondary school
Authors: Papageorgi Ioulia , Economidou Stavrou Natassa
Published: December 2021

The literature suggests that there is often no alignment between student preferences and what and how it is taught in the music classroom. A total of 749 Cypriot secondary school students, aged 12 to 14 years, responded to a survey addressing enjoyment of music, motivation for school music lessons, and perceptions of the music classroom environment. The survey included a questionnaire with six subscales: Involvement, Affiliation, Teacher Support, Task Orientation, Order and Organization, and Rule Clarity. High ratings for Affiliation, Teacher Support, and Rule Clarity suggest that, overall, students’ perceptions of the classroom environment were positive. They were not uniform, but varied on the basis of student characteristics. Girls rated Rule Clarity higher than boys. Younger students tended to rate Task Orientation, Order and Organization, and Rule Clarity higher than older students. Higher-achieving students tended to rate Affiliation and Teacher Support higher. Older boys rated Involvement lower than younger boys, whereas older girls rated Involvement higher than younger girls. It can be inferred that boys experienced a gradual increase in perceived Affiliation as their achievement improved, although the pattern was less consistent for girls. Girls tended to report higher motivation for school music lessons than boys. Motivation was enhanced by classroom environments in which students experienced higher levels of enjoyment of music, engagement, and support from teachers. The findings show that the music classroom environment should be characterized by student engagement, clarity of rules, good organization, clear goals, teacher support, and affiliation between classmates.
Accounting for and accounts of death: Past, present and future possibilities
Authors: Moerman Lee , van der Laan Sandra
Published: December 2021

Despite being an inevitable consequence of living, accounting for and accounts of death are under-researched in the accounting history literature. In this article, we review this literature and find that only a few studies engage beyond a mere reference to death; and even fewer that attempt to account for or provide accounts of death. Those studies that attempt to provide an account fall into two broad categories. First, those that treat death as a transactional phenomenon; and second, those that call for some form of accountability for death, a phenomenon we term necroaccountability. Further, we highlight a third space where accounting and death coalesce in the business of death. Through this process, we identify opportunities to increase our knowledge of accounting and death by understanding the ways in which it has been conceptualised and mobilised in the past.
A Qualitative Exploratory Study of the Effects of Simulation on Nursing Students’ Self-Efficacy Beliefs for Using English for Professional Purposes
Authors: Karaçay Pelin , Zeybekoğlu Zuhal , Chizzo Jacob , Middlebrooks Amy K.
Published: December 2021

Background

The health sector has become more international than ever because of patients’ increased mobility and access to healthcare services. As a result, the ability to communicate in English has become critical for nursing students in countries where English is used as a foreign language.

Aim

This study aimed to highlight and understand the experiences of nursing students regarding the effect of simulation-based learning on their self-efficacy beliefs for using English for professional purposes.

Methods

The study was conducted with 28 third-year university nursing students enrolled in a required English course and participating in two nursing simulations conducted in English. Focus groups were conducted using semi-structured interview questions to elicit and understand the self-efficacy beliefs of nursing students for using English for professional purposes. The collected data were analyzed by using content analysis.

Results

The result of the study emerged under three themes: carrying out nursing duties by using professional discourse, building professional relationships with patients, and maintaining spontaneous conversations with patients. The overall results showed that while the students’ self-efficacy beliefs increased for performing standard nursing duties and establishing rapport with patients, no increase was observed in their self-efficacy beliefs for holding a prolonged conversation with the patient.

Conclusion

This study’s findings have implications for nursing programs in which English proficiency is considered an important program outcome for nurses who may be expected to work in both their own language and English.
A Case Report on Lateral Proboscis: A Rare Congenital Anomaly
Authors: Putri Indri Lakhsmi , Aditra Taufiqur Rakhim , Apriawan Tedy , Kuswanto Djoko , Dhafin Faizal Rezky , Hutagalung Magda Rosalina
Published: December 2021

Lateral proboscis is a rare congenital condition characterized by a cylindrical protuberance on the nasofrontal region accompanied by abnormal nasal development on the affected side. We aimed to describe the management of the lateral proboscis in staged repair. A 7-year-old girl came with a tube-like projection on the left medial canthal region and nasal agenesis on the ipsilateral side. She was diagnosed with lateral proboscis, left microphthalmia, lower eye lid coloboma, and asymmetry in the orbital region. The patient has undergone 3 major surgeries at our institution. The first surgery involved the deconstruction of the tube to form the left nasal body and nostril. The second operation involved trimming of the new nose form and the excision of the bony protrusion directly beneath the base of the pedicle through bifrontal craniotomy. The remaining bone defect was closed using a pericranial flap. The orbital floor was reconstructed using titanium mesh. The third operation involved nasal reconstruction using a costal cartilage graft to create a dorsal nasal and alar framework. The patient healed with no complications, had become less reserved and her grades improved significantly after the operation. Further appointments are being scheduled to evaluate growth distortion and the resulting facial asymmetry. Surgical correction will be planned thereafter to further reconstruct the facial features. Evaluation of patient is necessary to explore possible clinical outcomes and corresponding treatment options. Multidisciplinary management is highly recommended, involving plastic surgeons, neurosurgeons, ophthalmologists, pediatricians, and pediatric psychiatrists in order to improve patient's quality of life.
Global Cleft Lip and Palate Outreach: A Google Trends Analysis
Authors: Weissman Joshua P , Reddy Narainsai K , Shah Nikhil D , Gosain Arun K
Published: December 2021

Understanding patient awareness of cleft lip and/or palate (CL/P) and evaluating demand for necessary procedures may serve to better target future efforts in global outreach.

We utilized internet search query data from Google Trends for the terms: “cleft lip,” “cleft palate,” “cleft lip and palate,” “cleft surgery,” and “cleft repair” from January 2004 to January 2021. Relative search volumes (RSV) recorded for the top 5 highest displaying countries and top 3 available regions within those countries were compared against global outreach by Operation Smile and Smile Train, as measured by the number of patients treated. World Health Organization (WHO) indicators were used to validate the RSV values for each country and better understand the current infrastructure and need for cleft care in those countries.

Globally, there was an increase in RSV for the terms “cleft lip,” “cleft palate,” “cleft repair,” and “cleft surgery” between 2004 and 2021. For “cleft lip,” the countries with the highest displaying RSVs included: Ghana (100%), Zimbabwe (97%), Nepal (78%), the Philippines (64%), and Kenya (52%). Countries with high RSVs and moderate to high WHO indicators included Ghana, Kenya, India, Nigeria, and Zimbabwe. Countries with high RSVs and poor WHO indicators included Nepal and Pakistan. Some countries had specific regions with high search demand that are not currently targeted for global outreach.

Using Google Trends’ data may help find more feasible locations and targeted care for efforts in global outreach with better patient awareness and turnout where demand for CL/P is increasing.
Educating Gifted Children in Turkey: A Retrospective Analysis and the Current State
Authors: Bildiren Ahmet , Çitil Mahmut
Published: December 2021

The purpose of this study was to examine the education of gifted children in Turkey during 1923–2020 from an historical perspective and to evaluate the current practices in gifted education. Drawing from the literature review, we first report on the policies and the legal and corporate advancements implemented in the field of gifted education since the Declaration of the Republic. Subsequently, current practices in Turkey, including Science and Arts Centres, high schools for gifted students, and resource rooms, are evaluated. The results of a review of the relevant literature are discussed in the light of the current situation. In conclusion, it is understood that coherent and consistent policies in the field of gifted education have been developed more strongly in Turkey during the last 30 years, corporate advancements have also increased during this period, and scientific studies have gained an upward enhancement during the last 20 years. Despite all these advancements, it is concluded that current practices have still various deficiencies and should continue to be developed.
Epidemiological Trends of Breast Cancer in Southern Ethiopia: A Seven-Year Retrospective Review
Authors: Gebretsadik Achamyelesh , Bogale Netsanet , Negera Dereje. G
Published: December 2021

Introduction

African women are affected by cancer at an early age of their productivity. However, the exact prevalence and incidence of cancer, including breast cancer is not known in most sub-Saharan African countries, including Ethiopia because of lack of well-established cancer registry. This study aims to assess the epidemiology of breast cancer at Hawassa University Comprehensive Specialized Hospital (HUCSH), the biggest referral hospital with cancer treatment center serving the southern part of the country.

Methods

Retrospective review of charts of all patients with a diagnosis of breast cancer between 2013 and 2019 at HUCSH was conducted. A standardized questionnaire was used to collect relevant data that include sociodemographic, symptoms, type of diagnosis, treatment, and outcomes. Data were entered using epidata version 3.1 and analyzed using MS Excel and SPSS version 20.

Results

Five hundred fifty-nine (18.6%) breast cancer cases were retrieved in 7 years between 2013 and 2019. Of this, 548 (98%) were women. The median ages of the patents were 38 years. Invasive ductal carcinoma was the leading 309 (55.3%) histologic type followed by 185 (33.1%) lobular carcinoma. One hundred seventy-seven (31.7%) were moderately differentiated and 155 (27.7%) were poorly differentiated. Three hundred seventy-two (66.5%) were advanced breast cancer (Stages III and IV). Trends of breast cancer showed the case load is continuously increasing except with a slight reduction of cases in between 2015 and 2016. The majority were advanced breast cancer occurring at an early age by the time diagnosis made. Invasive ductal carcinomas were the predominant one. The trend also showed a continuous increment of cancer case load. Therefore, cancer registration center establishment, community awareness creation, and intensive early detection strategy are mandatory.
Effectiveness and safety of pembrolizumab monotherapy in patients with locally advanced or metastatic non-small-cell lung cancer
Authors: Tamayo-Bermejo Rocio , del Rio-Valencia Juan Carlos , Mora-Rodriguez Beatriz , Muñoz-Castillo Isabel
Published: December 2021

Introduction

Immunotherapy has become a standard treatment for lung cancer; the objective of this study was to evaluate the effectiveness, safety of pembrolizumab monotherapy in patients with advanced or metastatic non-small-cell lung cancer used in real-world clinical practice.

Material and methods

Retrospective observational study of every patient treated with pembrolizumab in our centre from January 2017 to June 2019. Outcomes collected: sex, age, Eastern Cooperative Oncology Group, programmed death receptor 1 level, previous metastatic line therapies, adverse events and smoking status.

Results

A total of 62 patients were reviewed. The median age was 62.34 ± 10.62 years, 48 (77.41%) were men and 91.93% of patients had Eastern Cooperative Oncology Group 0. The median dose administered was 170.5 mg (108 – 240 mg) and the median follow-up was 3 months (range: 1 – 38). A median of four cycles of pembrolizumab (range: 1 – 56) were administered as monotherapy. The reason for treatment discontinuation was mainly due to disease progression in 38.70% of patients or death in 30.64%. As first-line pembrolizumab monotherapy, median progression-free survival was 7.7 months (95% CI: 3.66 – 11.73) ( N = 33). With respect to patients who were treated in second–third-line treatment, median progression-free survival was 3.5 months (95% CI: 2.40 – 4.59) ( N=29). As to overall survival, pembrolizumab-treated patients as first-line treatment reached 19 months median OG (95% CI: 13.36 – 24.63) ( N = 33) and those treated in second–third-line treatment got 11 months (95% CI: 3.4 – 18.5). A total of 64.51% of patients presented some adverse events to pembrolizumab however, only, 9.38% of them were grade 3.

Conclusion

Pembrolizumab represents an effective and feasible alternative in terms of progression-free survival. It is a well-tolerated treatment option.
Three-dimensional thermo-electro-elastic field in one-dimensional hexagonal piezoelectric quasi-crystal weakened by an elliptical crack
Authors: Liu Yuwei , Tang Xuesong , Duan Peiliang , Wang Tao , Li Peidong
Published: December 2021

In this paper, an analytical solution is developed for the problem of an infinite 1D hexagonal piezoelectric quasi-crystal medium weakened by an elliptical crack and subjected to mixed loads on the crack surfaces. The mixed loads comprise the phonon pressure, phason pressure, electric displacement, and temperature increment, and the crack surfaces can be electrically permeable or impermeable. Based on a general solution, combined with the generalized potential theory, the steady-state 3D thermo-electro-elastic field variables in the quasi-crystal are obtained in terms of elliptic integral functions and elementary functions. Several important physical quantities on the cracked plane, such as the generalized crack surface displacements, normal stresses, and stress intensity factors, are derived in closed forms. An illustrative numerical calculation verifies the presented analytical solution and shows the distribution of the 3D thermo-electro-elastic field. It is indicated that the influence of the phason field on the result is pronounced, especially for the electric field variables, and the electric permeability of crack surfaces has a significant effect on the electric displacement intensity factor at the crack tip.
Transhepatic Tunneled Catheter Using Left Hepatic Vein: The Last Resort for Dialysis
Authors: Abaza Masa , Almehmi Sloan E , Almehmi Ammar
Published: December 2021

Vascular access is the Achilles tendon of hemodialysis and is considered the lifeline for patients with end stage renal disease. Arteriovenous fistulas and grafts are the preferred traditional access for performing dialysis therapy. However, some patients exhaust the traditional routes of dialysis vascular access for different reasons. In search for alternatives, other unusual vascular routes have been explored, such as transhepatic and translumbar approaches, as the last resort to preserve life in this unfortunate population. Here, we present the unusual case of a 66-year-old female who ran out of the traditional vascular access options and became catheter dependent via the right femoral vein. However, due to recurrent femoral catheter infections, extensive skin calciphylactic lesions and her body habitus, other routes were explored and the decision was to use the transhepatic approach. Traditionally, the right and middle hepatic veins are used to insert these catheters. However, the use of the left hepatic vein was not reported in the literature. Hence, in order to avoid the skin lesions seen in our patient, the dialysis catheter was inserted using the left hepatic vein. Overall, this case highlights the challenges of securing a reliable vascular access to perform dialysis therapy and brings attention to other vascular dialysis routes in certain clinical scenarios.
Post-vaccine COVID-19 in patients with multiple sclerosis or neuromyelitis optica
Authors: Januel Edouard , De Seze Jérôme , Vermersch Patrick , Maillart Elisabeth , Bourre Bertrand , Pique Julie , Moisset Xavier , Bensa Caroline , Maarouf Adil , Pelletier Jean , Vukusic Sandra , Audoin Bertrand , Louapre Céline , Beltran Stéphane , Berger Eric , Bigaut Kevin , Derache Nathalie , Gassama Salimata , Heinzlef Olivier , Kremer Laurent , Kerschen Philippe , Maurousset Aude , Ricigliano Vito A G , Garcia Pierre-Yves , Labauge Pierre
Published: December 2021

Introduction:

Recent studies suggested that anti-CD20 and fingolimod may be associated with lower anti-spike protein-based immunoglobulin-G response following COVID-19 vaccination. We evaluated if COVID-19 occurred despite vaccination among patients with multiple sclerosis (MS) and neuromyelitis optica (NMO), using the COVISEP registry.

Case series:

We report 18 cases of COVID-19 after two doses of BNT162b2-vaccination, 13 of which treated with anti-CD20 and four with fingolimod. COVID-19 severity was mild.

Discussion:

These results reinforce the recommendation for a third COVID-19 vaccine dose among anti-CD20 treated patients and stress the need for a prospective clinical and biological study on COVID-19 vaccine efficacy among MS and NMO patients.
Safety of home-based exercise for people with intermittent claudication: A systematic review
Authors: Waddell Alexander , Seed Sally , Broom David R , McGregor Gordon , Birkett Stefan T , Harwood Amy E
Published: December 2021

Intermittent claudication (IC) is a classic symptom of peripheral artery disease, with first line treatment being supervised exercise therapy (SET). Despite this, SET is frequently underutilised, and adherence is often poor. An alternative option are home-based exercise programmes (HBEP). Although HBEPs are well tolerated, to the authors’ knowledge, no research has assessed their safety. The aim of this review was to assess the safety of HBEPs in people living with IC. We performed an electronic search of the MEDLINE, CINAHL, and Cochrane Library databases. The main parameter of interest was complication rate, calculated as the number of related adverse events per patient-hours. Subanalysis was undertaken to determine differences in safety for studies that did and did not include pre-exercise cardiac screening, and for studies with exercise at low, moderate, and high levels of claudication pain. Our search strategy identified 8693 results, of which 27 studies were included for full review. Studies included 1642 participants completing 147,810 patient-hours of home-based exercise. Four related adverse events were reported, three of which were cardiac in origin, giving an all-cause complication rate of one event per 36,953 patient-hours. Three of these events occurred following exercise to high levels of claudication pain, and one occurred with pain-free exercise. One event occured in a study without cardiac screening. Based on the low number of related adverse events, HBEPs appear to be a safe method of exercise prescription for people with IC. Our results strengthen the rationale for providing alternative exercise options for this population. PROSPERO Registration No.: CRD42021254581
Influenza risk groups in Norway by education and employment status
Authors: Klüwer Birgitte , Rydland Kjersti Margrethe , Laake Ida , Todd Megan , Juvet Lene Kristine , Mamelund Svenn-Erik
Published: December 2021

Aims:

This study aimed to estimate the size of the risk group for severe influenza and to describe the social patterning of the influenza risk group in Norway, defined as everyone ⩾65 years of age and individuals of any age with certain chronic conditions (medical risk group).

Methods:

Study data came from a nationally representative survey among 10,923 individuals aged 16–79 years. The medical risk group was defined as individuals reporting one or more relevant chronic conditions. The associations between educational attainment, employment status, age and risk of belonging to the medical risk group were studied with logistic regression.

Results:

Nearly a fifth (19.0%) of respondents reported at least one chronic condition, while 29.4% belonged to the influenza risk group due to either age or chronic conditions. Being older, having a low educational level (comparing compulsory education to higher education, odds ratio (OR)=1.4, 95% confidence interval (CI) 1.2–1.8 among women, and OR=1.3, 95% CI 1.1–1.7 among men) and a weaker connection to working life (comparing disability pension to working full-time, OR=6.8, 95% CI 5.3–8.7 among women, and OR=6.5, 95% CI 4.9–8.5 among men) was associated with a higher risk of belonging to the medical risk group for severe influenza.

Conclusions:

This study indicates that the prevalence of medical risk factors for severe influenza is disproportionally distributed across the socio-economic spectrum in Norway. These results should influence both public funding decisions regarding influenza vaccination and communication strategies towards the public and health professionals.
Annual thermal performance assessment of a regenerative evaporative cooling system under different climate conditions in Mexico
Authors: Mitz-Hernandez Enrique , Gijón-Rivera Miguel , Rivera-Solorio Carlos I.
Published: December 2021

A numerical heat and mass transfer model with thermophysical properties dependent on the temperature, humidity ratio and atmospheric pressure was developed. The numerical model was verified and validated against literature, and it showed good agreements. The pseudo-transient model provides a low-cost computational tool to evaluate the potential and performance of a dew point evaporative cooling system for a wide range of extreme climate conditions (BWh, BSh, Cw and Aw from Köppen classification). A parametric analysis of different operational and design conditions in the evaporative cooler was conducted. Results show that there is an optimal channel length for given climatic conditions. The Dew-point evaporative cooling (DPEC) system showed that the best thermal performance corresponds to the climate very arid (Hermosillo – BWh) with 4018 comfort hours (83.1%) followed by the climate arid (Monterrey – BSh) with 3470 comfort hours (90.9%), the mild climate (Puebla – Cw) with 295 comfort hours (100%) and the warm climate (Cancun – Aw) with 3452 comfort hours (62.3%). Finally, an engineering correlation for constant atmospheric pressure and channel length was obtained ([Formula: see text] of 93%).
Joining of hybrid semi-finished products from sheet metal by orbital forming
Authors: Hetzel Andreas , Lechner Michael , Merklein Marion
Published: December 2021

Contrary demands like a reduction of carbon dioxide emissions and an increase in functionality are facing the manufacturing industry with growing challenges. When processing functional components, like synchronizer rings, conventional process chains, like shearing and subsequent joining, are reaching their limits due to an increased complexity of the components and a lack in efficiency, referring to the long process time. To meet these challenges, the strategy of lightweight construction combines the application of lightweight materials with efficient manufacturing processes and an innovative product design. One possibility within lightweight construction is the utilization of load-adapted hybrid components, featuring different material strength classes. In previous research, the process of orbital forming is used to manufacture semi-finished products with a varying thickness profile due to the specific radial material flow. This material flow should now be used to realize a permanent joint between materials of two different strength levels. Therefore, the process of orbital forming is modified to manufacture hybrid semi-finished products from a dual-phase steel DP600 and a naturally rigid aluminum alloy EN AW 5754, both with an initial thickness of 2.0 mm. Different joint geometries are cut by laser into a steel ring and the part is coaxially positioned around a basic aluminum disc inside a die and subsequently formed. The joint is investigated regarding the geometrical and mechanical properties, comparing a radial cross-section and the micro hardness distribution. In order to reveal the potential of orbital forming for a combined forming and joining operation, the axial as well as the peeling strength of the multi-material components are investigated and evaluated.
Diagnosis of interior damage with a convolutional neural network using simulation and measurement data
Authors: Bao Yanqing , Mahadevan Sankaran
Published: December 2021

Current deep learning applications in structural health monitoring (SHM) are mostly related to surface damage such as cracks and rust. Methods using traditional image processing techniques (such as filtering and edge detection) usually face difficulties in diagnosing internal damage in thicker specimens of heterogeneous materials. In this paper, we propose a damage diagnosis framework using a deep convolutional neural network (CNN) and transfer learning, focusing on internal damage such as voids and cracks. We use thermography to study the heat transfer characteristics and infer the presence of damage in the structure. It is challenging to obtain sufficient data samples for training deep neural networks, especially in the field of SHM. Therefore we use finite element (FE) computer simulations to generate a large volume of training data for the deep neural network, considering multiple damage shapes and locations. These computer-simulated data are used along with pre-trained convolutional cores of a sophisticated computer vision-based deep convolutional network to facilitate effective transfer learning. The CNN automatically generates features for damage diagnosis as opposed to manual feature generation in traditional image processing. Systematic parameter selection study is carried out to investigate accuracy versus computational expense in generating the training data. The methodology is demonstrated with an example of damage diagnosis in concrete, a heterogeneous material, using both computer simulations and laboratory experiments. The combination of FE simulation, transfer learning and experimental data is found to achieve high accuracy in damage localization with affordable effort.
Punitive by negligence? The myths and reality of penal nationalism in the Czech Republic
Authors: Drápal Jakub
Published: December 2021

Penal populism has repeatedly been described as influencing penal policies, with harsh penal practices presented as evidence of its influence. However, little attention has yet been paid to its role in the development of penal policies in post-authoritarian countries, which generally have large prison populations. Some minimal research has suggested that Central European countries were driven by penal nationalism following the 1989 revolutions. I examine this claim for the Czech Republic, using Garland (2013) 's framework of the five dimensions of a penal state. My analysis of political manifestoes shows that Czech politicians did not employ “law and order” rhetoric. The country's penal reforms were led by lenient penal elites. Nevertheless, a lack of analysis, coordination and sufficient funding resulted in a failure to properly identify or tackle the causes of the country's high imprisonment rate. Even though it gradually became more difficult to impose prison sentences, insufficient attention was paid to the length of the sentences Czech prisoners were serving. The large Czech prison population thus seems to be the result of state actors’ negligence, but not of penal populism nor of penal nationalism.
How to eat, drink and speak on non-invasive ventilation
Authors: Kinnear William , Dring Karah , Kinnear Katherine , Hansel Jane , Sovani Milind
Published: December 2021

We report our observations on six individuals with non-bulbar neuromuscular disorders using non-invasive ventilation (NIV), who were able to maintain adequate hydration and nutrition orally despite being ventilator-dependant. All had severe respiratory muscle weakness, with a vital capacity less than 500 mL and cough peak flow rate less than 250 L/min. Their median (range) age was 49 (23–64) years; they had been on NIV for 8 (2–24) years. We compared them with an age- and sex-matched normal control. Individuals with neuromuscular disorders needed to chew each mouthful of food significantly more times (median 44, range 18–120 chews) than normal controls (median 15, range 10–20 chews). They took longer to completely swallow a mouthful of food (median 37, range 24–100 s) compared to normal controls (median 14.5, range 10–21 s). Multiple swallows for each mouthful were seen in all neuromuscular individuals, but in only one normal control. Two individuals coughed after swallowing; both these subjects were clinically stable at the time of the study. The median number of NIV breaths associated with chest expansion for each mouthful was 11 (range 5–49). All subjects blocked some NIV breaths whilst eating. Before swallowing, they always waited until the expiratory phase of the NIV breath was complete; no post-swallow expiration was seen, whereas normal subjects invariably exhibited post-swallow expiration. All individuals were able to block several ventilator breaths whilst swallowing un-thickened liquids. The median (range) number of words between breaths was 5 (4–7) for the neuromuscular individuals on NIV, significantly fewer than 11 (8–13) for the matched controls. Eating, drinking and speaking are possible whilst on NIV. Use of cough-assist after eating is recommended, given the likelihood of silent aspiration.
Roads to Success: The Career Attainment Experiences of Lawyers With Visual Impairments in South Korea
Authors: Kwon Chang-kyu , An Soonok
Published: December 2021

Problem:

Disability issues have long been a topic at the margins of HRD research and have rarely been examined outside the United States context or with a focus on a specific disability type. Additionally, largely due to a homogeneous national culture, people with disabilities in South Korea experience unique barriers in career development.

Solution:

The authors report the findings of a multiple case study on the career attainment experiences of lawyers with visual impairments in South Korea. Data analyzed from interviews with five participants showed that various individual (perseverance, identity as a person with a visual impairment, self-advocacy, and strategic mindset) and social (family and peer support, reasonable accommodation, precedent, and having a leader with a vision for inclusion) factors contributed to their career attainment.

Stakeholders:

The findings of this study can aid organizational leaders, hiring managers, HRD practitioners in charge of providing reasonable accommodations, and educators of people with disabilities.
RORα and REV-ERBα are Associated With Clinicopathological Parameters and are Independent Biomarkers of Prognosis in Gastric Cancer
Authors: Wang Xiaoshan , Jia Ru , Chen Ke , Wang Jingjing , Jiang Kai , Wang Zhengguang
Published: December 2021

Retinoid-related orphan receptor alpha (RORα) and nuclear receptor subfamily 1 group D member 1 (REV-ERBα) play critical roles in many human cancers. Whether RORα and REV-ERBα expression levels are associated with clinical characteristics are poorly understood, and they may be independent predictors of overall survival (OS) and progression-free survival (PFS) in gastric cancer (GC). This study aimed to investigate the correlation of RORα and REV-ERBα expression levels with clinicopathological parameters, OS, and PFS in GC. Immunohistochemistry and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were employed to assess the expression levels of RORα and REV-ERBα, which were downregulated in GC tissues compared with normal gastric tissues ( P < .001; P < .001) and were associated with several clinicopathological parameters, including histological grade ( P = .032; P < .001), preoperative carcinoembryonic antigen (CEA) levels ( P = .004; P < .001), and tumor-node-metastasis (TNM) stage ( P = .015; P < .001). Additionally, low RORα and REV-ERBα expression levels were associated with poor OS and PFS in GC patients, respectively ( P < .001; P = .001). Furthermore, univariate Cox regression model analysis showed that histological grade ( P < .001; P < .001), preoperative CEA levels ( P < .001; P = .001), TNM stage ( P < .001; P < .001), lymph node metastasis ( P = .002; P = .002), RORα expression levels ( P = .001; P < .001), and REV-ERBα expression levels ( P < .001; P = .001) were associated with OS and PFS in GC. Multivariate Cox regression model analysis indicated that RORα expression levels and REV-ERBα expression levels are independent factors of OS and PFS in GC. Besides, RORα and REV-ERBα expression may be positively correlated (χ2 = 6.835; P = .009), and GC patients with both high RORα and REV-ERBα expression levels had the best prognosis. In conclusion, RORα and REV-ERBα may coparticipate in tumor activities and show potential to estimate the prognosis of GC.
Chaplain Leadership During COVID-19: An International Expert Panel
Authors: Szilagyi Csaba , Vandenhoeck Anne , Best Megan C. , Desjardins Cate Michelle , Drummond David A. , Fitchett George , Harrison Simon , Haythorn Trace , Holmes Cheryl , Muthert Hanneke , Nuzum Daniel , Verhoef Joost H. A. , Willander Erika
Published: December 2021

Chaplain leadership may have played a pivotal role in shaping chaplains’ roles in health care amidst the COVID-19 pandemic. We convened an international expert panel to identify expert perception on key chaplain leadership factors. Six leadership themes of professional confidence, engaging and trust-building with executives, decision-making, innovation and creativity, building integrative and trusting connections with colleagues, and promoting cultural competencies emerged as central to determining chaplains’ integration, perceived value, and contributions during the pandemic.
The effects of dry needling on the thumb: A case report
Authors: Voss Mitchell R , Donnay Rebecca L , Homa Jennifer K
Published: December 2021

Introduction

Dry needling has been identified as a potential intervention for a variety of diagnoses. Limited evidence exists to support the use of dry needling following surgical intervention of a distal radius fracture. This case report demonstrates the impact of dry needling in the thumb following a distal radius fracture.

Methods

The patient was a 31-year-old healthy female who sustained a distal radius fracture and required surgical intervention. The patient required a volar plate removal and extensor tenolysis. The patient attended traditional occupational therapy with one session of dry needling to assist in improving range of motion and decreasing pain.

Results

The patient benefited from the use of dry needling. The patient had no pain with functional grasping and pinching following dry needling and improved on the Kapandji score from eight to nine out of ten. The patient also reported a decrease in overall pain, from seven to two on the Numeric Pain Rating Scale.

Discussion

The patient benefited from dry needling in the thumb to improve both range of motion and pain symptoms. While the evidence is limited, dry needling may be an appropriate intervention to assist in recovery and reduce thumb pain following distal radius fractures.
Deep reinforcement learning-based rehabilitation robot trajectory planning with optimized reward functions
Authors: Wang Xusheng , Xie Jiexin , Guo Shijie , Li Yue , Sun Pengfei , Gan Zhongxue
Published: December 2021

Deep reinforcement learning (DRL) provides a new solution for rehabilitation robot trajectory planning in the unstructured working environment, which can bring great convenience to patients. Previous researches mainly focused on optimization strategies but ignored the construction of reward functions, which leads to low efficiency. Different from traditional sparse reward function, this paper proposes two dense reward functions. First, azimuth reward function mainly provides a global guidance and reasonable constraints in the exploration. To further improve the efficiency, a process-oriented aspiration reward function is proposed, it is capable of accelerating the exploration process and avoid locally optimal solution. Experiments show that the proposed reward functions are able to accelerate the convergence rate by 38.4% on average with the mainstream DRL methods. The mean of convergence also increases by 9.5%, and the percentage of standard deviation decreases by 21.2%–23.3%. Results show that the proposed reward functions can significantly improve learning efficiency of DRL methods, and then provide practical possibility for automatic trajectory planning of rehabilitation robot.
Application of artificial intelligence in non-alcoholic fatty liver disease and liver fibrosis: a systematic review and meta-analysis
Authors: Decharatanachart Pakanat , Chaiteerakij Roongruedee , Tiyarattanachai Thodsawit , Treeprasertsuk Sombat
Published: December 2021

Background:

The global prevalence of non-alcoholic fatty liver disease (NAFLD) continues to rise. Non-invasive diagnostic modalities including ultrasonography and clinical scoring systems have been proposed as alternatives to liver biopsy but with limited performance. Artificial intelligence (AI) is currently being integrated with conventional diagnostic methods in the hopes of performance improvements. We aimed to estimate the performance of AI-assisted systems for diagnosing NAFLD, non-alcoholic steatohepatitis (NASH), and liver fibrosis.

Methods:

A systematic review was performed to identify studies integrating AI in the diagnosis of NAFLD, NASH, and liver fibrosis. Pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and summary receiver operating characteristic curves were calculated.

Results:

Twenty-five studies were included in the systematic review. Meta-analysis of 13 studies showed that AI significantly improved the diagnosis of NAFLD, NASH and liver fibrosis. AI-assisted ultrasonography had excellent performance for diagnosing NAFLD, with a sensitivity, specificity, PPV, NPV of 0.97 (95% confidence interval (CI): 0.91–0.99), 0.98 (95% CI: 0.89–1.00), 0.98 (95% CI: 0.93–1.00), and 0.95 (95% CI: 0.88–0.98), respectively. The performance of AI-assisted ultrasonography was better than AI-assisted clinical data sets for the identification of NAFLD, which provided a sensitivity, specificity, PPV, NPV of 0.75 (95% CI: 0.66–0.82), 0.82 (95% CI: 0.74–0.88), 0.75 (95% CI: 0.60–0.86), and 0.82 (0.74–0.87), respectively. The area under the curves were 0.98 and 0.85 for AI-assisted ultrasonography and AI-assisted clinical data sets, respectively. AI-integrated clinical data sets had a pooled sensitivity, specificity of 0.80 (95%CI: 0.75–0.85), 0.69 (95%CI: 0.53–0.82) for identifying NASH, as well as 0.99–1.00 and 0.76–1.00 for diagnosing liver fibrosis stage F1–F4, respectively.

Conclusion:

AI-supported systems provide promising performance improvements for diagnosing NAFLD, NASH, and identifying liver fibrosis among NAFLD patients. Prospective trials with direct comparisons between AI-assisted modalities and conventional methods are warranted before real-world implementation.

Protocol registration:

PROSPERO (CRD42021230391)
Metabolomics facilitate the personalized management in inflammatory bowel disease
Authors: Chen Rirong , Zheng Jieqi , Li Li , Li Chao , Chao Kang , Zeng Zhirong , Chen Minhu , Zhang Shenghong
Published: December 2021

Inflammatory bowel disease (IBD) is a gastrointestinal disorder characterized by chronic relapsing inflammation and mucosal lesions. Reliable biomarkers for monitoring disease activity, predicting therapeutic response, and disease relapse are needed in the personalized management of IBD. Given the alterations in metabolomic profiles observed in patients with IBD, metabolomics, a new and developing technique for the qualitative and quantitative study of small metabolite molecules, offers another possibility for identifying candidate markers and promising predictive models. With increasing research on metabolomics, it is gradually considered that metabolomics will play a significant role in the management of IBD. In this review, we summarize the role of metabolomics in the assessment of disease activity, including endoscopic activity and histological activity, prediction of therapeutic response, prediction of relapse, and other aspects concerning disease management in IBD. Furthermore, we describe the limitations of metabolomics and highlight some solutions.
Completeness and accuracy of adverse drug reaction documentation in electronic medical records at a tertiary care hospital in Australia
Authors: McLachlan Gina , Broomfield Airley , Elliott Rohan
Published: December 2021

Background: A large proportion of patients presenting to hospitals have experienced a previous adverse drug reaction (ADR). Electronic medical records (EMRs) present an opportunity to accurately document ADRs and alert clinicians against inadvertent rechallenge where there is a pre-existing reaction. However, EMR systems are imperfect and rely on the accuracy of the data entered. Objective: To ascertain the completeness of ADR documentation and the accuracy of the classification of ADRs as allergy versus intolerance in the EMR at a major metropolitan hospital in Australia. Method: Cross-sectional audit of the ADR field of the EMR for a sample of patients on four different wards over 3 weeks to ascertain the completeness of ADR documentation and the accuracy of classification of ADRs. Results: Of the 264 patients assessed, 102 (38.6%) had a total of 210 ADRs documented in the EMR. Of these, 105 (50%) were considered to have complete documentation; 63/210 (30.0%) were missing a reaction description and 88/210 (41.9%) were missing severity information. For those ADRs with a reaction description ( n = 147), 97 (66.0%) were considered to be appropriately classified as allergy or intolerance. Conclusion: Incomplete and inaccurate ADR documentation was common. These findings highlight a need for optimising ADR documentation to improve appropriate medication use in hospital. Implications: Improved EMR design and education of healthcare workers on the importance of complete and accurate documentation of reactions are needed to improve completeness and accuracy of ADR classification.
The COVID-19 Pandemic and the Emergence of Vietnam as a Middle Power
Authors: Dinh Tinh Le , Thu Ngan Vu Thi
Published: December 2021

Limited capability and political will have caused the great powers to fail to demonstrate their global leadership in the fight against the COVID-19 pandemic, which has created greater room to manoeuvre for other countries to influence international affairs. Preliminary achievements in the fight against the COVID-19 crisis have buttressed the rising global status of small and medium-sized states, including Vietnam. Although Vietnam has recently been recognised as an emerging middle power, scepticism looms regarding whether this higher international status is beyond its capacity. We argue that the pandemic may act as a catalyst for Vietnam to further elevate its strategic role as a middle power on the international stage in the medium and long term.