bluuebunny/crossref_metadata_2025 huggingface dataset:
Enriched Optimization Algorithm for Effective Skin Disease Prediction Using Soft Computing Techniques
Authors: Suresh Kumar R. , Dhanagopal R. , Sasi Kumar S.
Published: March 2022

In recent years, a usual worldwide problem is a skin disease—the diagnostics of infection and skin disease prediction based on the data mining techniques. The precise and cost-effective treatments obtain a technologybased data mining system that can consider making the right decision.
Depends on data, there are 34 UCI datasets have in the skin disease prediction. All of the datasets are not much important when predicting the skin disease problem. In this study, the essential datasets to be analyzed because they only give the best accuracy in skin disease prediction. For
an outstanding selection of allocation, to propose a novel feature selection approaches, Enriched Fruitfly Optimization Algorithm (EFOA), and Ensemble Classifiers that are helps for an early stage of skin disease prediction. A hybrid technique through the three essential hybrid feature selection
approaches such as Chi-Square method, Information Gain method, and Principal Component Analysis (PCA) methods that are combined for better feature selection results. Based on the skin disease dataset, the resultant feature selection approach generated the reduced data subset. Then, the Enriched
Fruitfly Optimization Algorithm (EFOA) offers the optimization of reduced data subset. Here, the accuracy estimation is the vital factor to optimize the effective and best prediction of skin disease affected regions. Afterward, the classification performs to classify the EFOA based optimized
result by using the six different classification methods. Where, the classification helps to analyze the optimized results, which offers the better classification procedure. To predict the base learner’s performance, to utilize the Naive Bayesian, K-Nearest Neighbour, Decision Tree,
Support Vector Machine, Random Forest, and Multilayer Perceptron (MLP) to classify the optimized result. Then, the ensemble techniques used to analyze the classifier’s results through the 3 different methods like Bagging, Boosting, Stacking, added on the base learners to improve the
proposed work. Based on the performance, the base learners’ performance is larger than the input dataset. The base learner’s parameters are essential to calculate the accuracy of skin disease prediction performance. The performance of the proposed method will take and compare to
each base learner, and the performance shows the accurate skin disease prediction improvement with other existing methods.
Laplace Angular Displaced Secure Data Transmission for Internet of Things Based Health Care Systems
Authors: Srinivasan P. , Kannagi A. , Rajendiran P.
Published: March 2022

The Internet of Things (IoT) has changed the world into a more physically connected, ensuring higher order applications. As smart devices and patients surrounding are able to freely communicate with each other, more chances and conveniences are brought to us. However, as the information
is kept inside these devices is revealed and distributed, security and privacy concerns call for an effective safeguarding process more than ever. Secured data transmission with higher voluminous data indulging with noisy instances, the computational cost and overhead incurred remains the
major issues for IoT based health care system. The complexity of the inferred model may increase, and thereby the overall secured data transmission accuracy of the model may decrease. In this work, the above said issues are addressed via secure data transmission method, in order to minimize
the computational cost and overhead incurred during transmission of large data and also improve the data transmission accuracy with minimum running time. The method is called as Delay-aware and Energy-efficient Laplace Angular Displacement (DE-LAD). The DE-LAD method involves three steps.
They are data collection, data communication and data transmission. First data collection is performed via delayaware and energy-efficient model. Second data communication is said to be established using pairing-free Laplace Estimator, minimizing computational complexity involved during data
collection. Finally, secured data transmission is achieved via Angular Displacement. Moreover, in WSN, the security of data being transmitted is calculated for IoT-based healthcare system. The simulation results of DE-LAD method provides enhanced performance in terms of security and complexity
as compared to conventional methods.
Compatibility and Physical Properties of Dexamethasone-Ondansetron Intravenous Admixture
Authors: Suknuntha Krit , Wattanapoka Kotchakorn , Poonpattanachai Pilor , Titipornwanich Natanan , Sripakdee Warunsuda
Published: March 2022

Purpose: This work aimed at evaluating the impact of different concentrations and final volumes on the compatibility and physical properties of dexamethasone-ondansetron intravenous (IV) admixture. Methods: The IV admixture of dexamethasone-ondansetron was prepared at different concentrations using normal saline solution as solvent. The final volume of the IV admixture was prepared at 50 and 100 ml. Turbidity was measured as an indicator of physical compatibility of the IV admixture of dexamethasone-ondansetron using UV-visible spectrophotometer and the pH of the IV admixture was measured on day 0, 7,14, and, 21 as an index of chemical stability. Also, the particle size and potential molecular interactions of the admixtures were determined using particle size analyzer and Fourier Transform infrared spectrometry analysis, respectively. Additionally, the effect of preservatives on the IV admixture was also evaluated. Results: Precipitation was observed for mixtures with amounts of dexamethasone and ondansetron exceeding 8 and 16 mg, respectively, in a final volume of 50 ml. For all mixtures with final volume of 100 ml, clear solutions void of any precipitates were observed. The pH of the solution had no effect on the precipitation of the dexamethasone-ondansetron during storage up to 21 days. Analyses of the precipitate formed revealed the presence of molecular interactions between dexamethasone and ondansetron. The benzyl alcohol used as a preservative affected the compatibility of the IV admixture compatibility. Conclusion: Thus, for the preparation of clear, physically compatible normal saline solutions of dexamethasone-ondansetron IV admixture, the maximum amounts of the respective drugs should not exceed 8 and 16 mg in total volume of 50 ml or 20 and 16 mg in a final volume of 100 ml.
Analyzing the Cultural Contradictions of Authenticity: Theoretical and Managerial Insights from the Market Logic of Conscious Capitalism
Authors: Thompson Craig J. , Kumar Ankita
Published: March 2022

This research analyzes the cultural contradictions of authenticity as they pertain to the actions of consumers and marketers. The authors’ conceptualization diverges from the conventional assumption that the ambiguity manifest in the concept of authenticity can be resolved by identifying an essential set of defining attributes or by conceptualizing it as a continuum. Using a semiotic approach, the authors identify a general system of structural relationships and ambiguous classifications that organize the meanings through which authenticity is understood and contested in a given market context. They demonstrate the contextually adaptable nature of this framework by analyzing the authenticity contradictions generated by the cultural tensions between “conscious capitalism”—a market logic that encompasses both global brands and small independent businesses, such as a farm-to-table restaurant or an organic food co-op—and the elitist critique. The Slow Food movement provides a case study for analyzing how consumers, producers, and entrepreneurs who identify with conscious capitalist ideals understand these disauthenticating, elitist associations and the strategies they use to counter them. The authors conclude by discussing implications of the analysis for theories of authenticity and for managing the authenticity challenges facing conscious capitalist brands.
The Hippocratic Oath
Authors: Stigall William
Published: March 2022

The Hippocratic Oath is the oldest and wisest description of our profession. It contains profound wisdom on the nature of health, healing, and the relationships both within and without that are necessary to the good practice of medicine. The practices described in its lines are antidotes for much of what ails modern medicine.
Contingency Management and SARS-CoV-2 Testing Among People Who Inject Drugs
Authors: Cioffi Camille C. , Kosty Derek , Capron Christopher G. , Tavalire Hannah F. , Barnes Robert C. , Mauricio Anne Marie
Published: March 2022

Objectives:

People who inject drugs (PWID) are especially vulnerable to morbidity and mortality as a result of SARS-CoV-2 infection because of social and physical health vulnerabilities. Routine testing for SARS-CoV-2 is critical to reduce transmission. Contingency management—the provision of tangible rewards to reinforce positive behavior—can promote the use of health services among PWID. Evidence is scarce on the utility of contingency management to promote SARS-CoV-2 testing. The objective of this study was to evaluate the effectiveness of contingency management to increase testing among PWID.

Methods:

SARS-CoV-2 testing was implemented at 9 syringe exchange program sites in partnership with an Oregon-based nonprofit organization for 5 weeks without contingency management and for 6 weeks with contingency management (a $10 financial incentive for testing) from February 1 through mid-April 2021. We measured rates of testing among syringe exchange program clients before and after implementation of contingency management.

Results:

Before contingency management, SARS-CoV-2 testing occurred during approximately 131 of 1410 (9.3%) client encounters, and 123 of 997 (12.3%) unique clients were tested. During contingency management, testing occurred during approximately 571 of 1756 (32.5%) client encounters, and 407 of 1151 (35.4%) unique clients were tested. Rates of testing increased from 0.04 (SD, 0.04) before contingency management implementation to 0.25 (SD, 0.15) after implementation ( t8 = −3.88; P = .005; Cohen d = 1.46).

Conclusions:

Contingency management facilitated uptake of SARS-CoV-2 testing among PWID. Contingency management may be an effective strategy for improving communicable disease testing beyond testing for SARS-CoV-2 and for improving vaccine uptake among PWID and warrants additional research.
Fabricated leg mannequin for the pressure measurement of compression stockings
Authors: Li Qing , Sun Guangwu , Chen Yu , Chen Xiaona , Shen Yunping , Xie Hong , Li Yanmei
Published: March 2022

Different lower limbs and devices used for the contact pressure measurement of the compression stocking make a significant difference to the precise contact pressure value. This study aimed to fabricate a novel soft leg mannequin based on the standard-sized wooden leg mannequin, but closer to the human leg with soft tissue and bones and to evaluate further the performance of the fabricated leg mannequin. The contact pressure exerted by the graduated compression stocking was measured by the fabricated leg mannequin at four different locations along six different cross-sections. Comparing the contact pressure measured by the fabricated leg mannequin, the standard-sized wooden leg mannequin and human legs, the fabricated leg mannequin has a similar pattern to human legs, and contact pressure exerted by the wooden leg mannequin was far higher than that of human legs. In addition, the local contact pressure measured by the fabricated leg mannequin also has a remarkable agreement with that of human legs. Moreover, there was a signiﬁcant Spearman rank correlation between the contact pressure measured by the fabricated leg mannequin and the human leg. Therefore, the performance of the fabricated leg mannequin can be consistent with the human leg, which enables the fabricated leg mannequin to replace the standard-sized wooden leg mannequin for standard tests.
Bounding Causes of Effects With Mediators
Authors: Dawid Philip , Humphreys Macartan , Musio Monica
Published: March 2022

Suppose X and Y are binary exposure and outcome variables, and we have full knowledge of the distribution of Y, given application of X. We are interested in assessing whether an outcome in some case is due to the exposure. This “probability of causation” is of interest in comparative historical analysis where scholars use process tracing approaches to learn about causes of outcomes for single units by observing events along a causal path. The probability of causation is typically not identified, but bounds can be placed on it. Here, we provide a full characterization of the bounds that can be achieved in the ideal case that X and Y are connected by a causal chain of complete mediators, and we know the probabilistic structure of the full chain. Our results are largely negative. We show that, even in these very favorable conditions, the gains from positive evidence on mediators is modest.
Contingent resistance: The politics of waste commons in neoliberal Delhi
Authors: Calleja Olivia
Published: March 2022

This article examines Delhi’s neoliberal regime of solid waste management and the evolving and hybrid trajectory of appropriation that it gives rise to. Working with a commons/enclosure framework, I analyse how the privatisation of waste management unfolds amidst complex waste work community relations and dense labour politics to create contingent and unanticipated scenarios that modify the enclosure of waste. Specifically, I observe that circuits of exchange have developed in the shadow of privatised waste infrastructure and allow materials of value to escape into the informal recycling economy, despite modernisation blueprints planning for their capture by capitalist agents. This messy configuration urges us to nuance our comprehension of accumulation by dispossession in the context of Indian cities. In this article, I argue that variegated practices of commoning and enclosing underlie these everyday arrangements and the compromises on which they rest. This approach allows us to consider how (neo-) customary rights over the resources of waste and labour networks reconfigure under neoliberal regimes to condition the enclosing of waste commons. Finally, I suggest that situated histories and caste politics emerge as central features to understand the capitalist transformation of waste systems.
A Qualitative Exploration of Strategic Trauma and Abuse Recovery: A Spiritually Integrated Treatment to Address Trauma
Authors: Temple Michell , Kerlin Ann Marie
Published: March 2022

This article provided a brief overview of the Strategic Trauma and Abuse Recovery System (STARS), including its theoretical foundation, theory of change, and the process of the treatment model. STARS is a spiritually integrated treatment model first developed in a Christian counseling environment. We desired to learn if the clients who had completed this therapy were able to describe the process of therapy and whether those descriptions would align with the treatment model as described. Nine ( N = 9) participants who had successfully completed STARS participated in this qualitative study which reviewed the process of therapy. Our findings indicated close fidelity to the treatment model. Participants reported improvement in mental health symptoms, improvement in relationships, and improvement in spiritual well-being.
Prevalence and predictive factors of malnutrition in Thai children with congenital heart disease and short-term postoperative growth outcomes
Authors: Sethasathien Saviga , Silvilairat Suchaya , Sittiwangkul Rekwan , Makonkawkeyoon Krit , Kittisakmontri Kulnipa , Pongprot Yupada
Published: March 2022

Background: Growth restriction is still a common problem in children with congenital heart disease (CHD). Evidence demonstrates that performing cardiac surgery in appropriate timing may result in better growth outcome. Aim: To investigate prevalence and associated factors of malnutrition in pediatric patients with CHD who underwent cardiac surgery. In addition, post-operative growth outcomes at two weeks following cardiac surgery were also assessed. Methods: A retrospective cohort study was conducted in pediatric patients who underwent cardiac surgery at Chiang Mai University Hospital between January and September 2014. Results: One hundred patients with a median age of 28.5 months (range 14–62 months) were enrolled. Two-third of these patients had at least one form of malnutrition before receiving surgical treatment while wasting, stunting and combined wasting-stunting accounted for 23%, 28%, and 15% of patients, respectively. Multiple logistic regression analysis demonstrated that congestive heart failure-related symptoms were significantly associated with increasing risk of malnutrition (adjusted OR 4.4; 95% CI 1.78–11.26, p = 0.001). Two weeks after hospital discharge, wasting patients with regardless of stunting had significantly improved weight for height (WHZ) and weight for length Z-scores (WLZ) compared to growth parameters at the time of cardiac surgery, p = 0.012 and p < 0.001, respectively. Conclusion: The prevalence of acute and chronic malnutrition in pediatric patients with CHD who underwent cardiac surgery was very high in this study. Children with congestive heart failure had a four-time at risk of undernutrition. In short-term, cardiac surgery may mitigate acute malnutrition of these patients.
What do inmates in Slovak prisons read?
Authors: Hladký Juraj
Published: March 2022

A pioneering survey of library and reading preferences of prisoners in the oldest Slovak male prison in the town Leopoldov was performed and historical details are also mentioned. The library contains more than 7000 books and more than half of the regular readers (>10 books/year) among prisoners appreciate the library's richness and genre richness. The gratifying finding was that 70% of respondents perceive books as a source of information and a form of self-education. Interestingly, the textbook of English language for self-education was 6th the most borrowed book in the Leopoldov Prison and this or other education books were among the ten most borrowed books in other prisons. Data on the library richness and use by inmates in 14 Slovak prisons were collected and showed a library size of 1080–8849 books with a theoretical average ratio of 7.88 books/inmate. The real exchange ratio was 6.86 books/reader. The most preferred genre was crime by domestic and foreign authors. The results are also compared with few available studies from other countries.
A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis—application of D-dimer and fibrinogen testing
Authors: Liu Qiang , Chen Wei , Wang Yong-Li , Wang Zheng-Yu , Peng Zhi-Qing , Xiang Jian-Feng , Chen Liang , Pan Yu-Cheng , Sha Yan
Published: March 2022

Background

Catheter-directed thrombolysis (CDT) is one of the main treatment methods for acute deep venous thrombosis (DVT), which has the characteristics of long treatment time and large dosage of thrombolytic drugs. In the absence of good monitoring methods, problems such as low thrombolytic efficiency and high risk of bleeding are easy to occur.

Objective

To evaluate the value of D-dimer (D-D) and fibrinogen (FIB) testing as a thrombolysis-monitoring method during CDT for acute DVT.

Methods

Twenty patients with acute DVT were divided into group A and group B. During CDT, the D-D and FIB testing every 8 h were used in group A, and the venography and FIB testing every 24 h in group B. The thrombolysis rate, thrombolysis time, urokinase dosage, and X-ray radiation dose were compared.

Results

The thrombolysis rate in group A was significantly higher than that in group B ( p < 0.05), but the number of venography and radiation dose were significantly lower than those in group B ( p < 0.05).

Conclusion

D-D and FIB testing can improve the thrombolysis rate, reduce the risk of bleeding, and decrease the number of angiograms and X-ray radiation dose during CDT.
Visual Sensitivity in Complex Regional Pain Syndrome and Fibromyalgia: An Online Study
Authors: Ten Brink Antonia F. , Bultitude Janet H.
Published: March 2022

Perceptual anomalies can provide insights into underlying pathologies even when they are not the main symptom of many clinical conditions. Complex regional pain syndrome (CRPS) and fibromyalgia are chronic pain conditions associated with changes in the central nervous system, possibly leading to enhanced visual sensitivity. It is unclear whether this occurs more than for people with other types of pain. We examined visual sensitivity elicited by different stimuli and in daily life, through an online study of people with CRPS ( n = 57), fibromyalgia ( n = 74), other pain ( n = 50), and no pain ( n = 89). Respondents rated changes in pain, discomfort, or distress from viewing patterns with different spatial frequencies (lower-order visual processing), and reversible figures (bistable images; higher-order visual processing). We assessed visual sensitivity in daily life using the Leiden Visual Sensitivity Scale and Visual Discomfort Scale. Respondents with CRPS or fibromyalgia reported more visual discomfort than pain-related and pain-free controls while viewing striped patterns and a circle, with no effect of spatial frequency. They reported more pain while viewing a nonreversible square, but not reversible figures (Necker Cube, Duck/Rabbit). Finally, they reported more daily visual sensitivity than pain-related and pain-free controls. Suppressing visual cortical activity might benefit people with CRPS or fibromyalgia.
Your Work Is Not International Relations
Authors: Abu-Bakare Amal
Published: March 2022

This is an eight-page reflection piece on gatekeeping in IR knowledge production and the politics that goes into presenting national racial contestations as issues unworthy of international study and consideration. Premised on a personal experience of scholastic rejection, this commentary is a reflective intervention concerning the state of the field and the imperial connotations of methodological disciplinarity – the process in which IR research is restricted within disciplinary borders because of scholastic endeavours to keep the discipline pure. Here, using anti-imperial thought, I press for deeper consideration and re-evaluation of how academics come to decide which experiences of the world should be deemed worthy of global recognition and where the boundaries of IR should come to an end.
Patients views on which return-to-work outcomes should be prioritised: A nominal group technique focus group
Authors: Bridger Kay , Kellezi Blerina , Kendrick Denise , Kettlewell Jade , Holmes Jain , Timmons Stephen , Andrews Isabel , Fallon Stephen , Radford Kate
Published: March 2022

Objective

Injuries can have a long-lasting effect on ability to return to work, but there is little research on which outcomes are most important to patients. This study aims to identify and prioritise return-to-work outcomes important to patients for evaluating vocational rehabilitation interventions.

Methods

Nominal group technique focus group with trauma patients.

Results

Focus group participants ( n = 6) included mostly traumatic brain injuries, a range of occupation types, ages and both genders. Participants identified and prioritised their eight most important outcomes which were: sense of purpose and life satisfaction, understanding the impact of injury, assessment of readiness to return to work, using SMART (specific, measurable, achievable, relevant and time-bound) goals, facilitated reintegration to work, assessing capacity to return to work, collaboration between key stakeholders and improved employer and employee knowledge. Many of these were measures of the process of, rather than change outcomes of vocational rehabilitation.

Conclusions

The range of outcomes identified by trauma patients highlights the complex process of return to work and the need for vocational rehabilitation evaluations to incorporate a broader range of outcomes. Measures of the process of vocational rehabilitation are also important to trauma patients and should be included in such evaluations.
Optimization of design and fatigue simulations for an electric assisted bicycle frame using uniform design and grey relational analysis
Authors: Lee Sen-Yung , Jiang Cho-Pei , Lee Cheng-Kang , Huang Wei-Han , Cheng Yung-Chang
Published: March 2022

The electric assisted bicycle is the new transportation tool in the 21st century. The proposal of this article is to upgrade the fatigue safety factor for an electric assisted bicycle frame by integrating the uniform design, Kriging interpolation, entropy weighting method, grey relational analysis, and genetic algorithm. According to EN 15194 standard, the main objective function, the fatigue safety factor for an electric assisted bicycle frame is examined by ANSYS/Workbench software under three fatigue testing simulations. Five geometry parameters of an electric assisted bicycle frame are nominated to be the improved control factors. Since all control factors are continuous in the design space, the uniform design is certainly developed to construct a series of simulation experiments. For each model in the uniform design table, the fatigue finite element analysis is utilized to calculate the fatigue safety factor. Applying the multi-objective optimization procedure, the optimal design version of an electric bicycle frame has been obtained. For the fatigue safety factor, the revised design model has a maximum improvement of 19.59% when compared to the original design. Summery, the fatigue safety factor has been effectively elevated by executing the innovative multi-objective optimization procedure for an electric assisted bicycle frame system.
Drive-Leg Kinematics During the Windup and Pushoff Is Associated With Pitching Kinetics at Later Phases of the Pitch
Authors: Fava Anthony W. , Downs Talmage Jessica L. , Plummer Hillary A. , Oliver Gretchen D.
Published: March 2022

Background:

Inconsistent findings exist between drive-leg ground-reaction forces (GRFs) and pitching mechanics. Previous literature has largely reported drive-leg mechanics and GRFs at the start of the pushoff phase for their role in initiating force development. Little research has assessed drive-leg kinematics that includes a pitcher’s windup motion to determine its effects on subsequent phases in the pitching motion.

Purpose/Hypothesis:

The primary aim was to analyze the relationship between drive-leg knee valgus angle during the windup and subsequent pitching mechanics. We hypothesized that the drive-leg knee valgus angle during the early portion of the pitching motion would alter later phases’ pitching mechanics. A secondary aim was to assess GRFs to determine if the drive-leg knee valgus angle was associated with changes in force. We hypothesized that an increased drive-leg knee valgus angle would increase GRFs during the pitching motion.

Study Design:

Descriptive laboratory study.

Methods:

A total of 17 high school baseball pitchers (mean age, 16.1 ± 0.9 years; mean height, 180.0 ± 4.8 cm; mean weight, 75.5 ± 7.5 kg) volunteered for the study. Kinematic data and GRFs were collected using an electromagnetic tracking system and force plates. Pitchers threw maximal-effort fastballs from a mound at regulation distance. The drive-leg knee valgus angle was analyzed during the windup and pushoff phases of the pitch to determine its effects on other biomechanical variables throughout the pitching motion.

Results:

There was a significant relationship between drive-leg knee valgus angle during the windup ( Fchange 1,12) = 16.13; P = .002; R2 = 0.695) and lateral GRF in the arm-cocking phase. Additionally, there was a significant relationship between drive-leg knee valgus angle during pushoff ( Fchange(2,11) = 10.21; P = .003; R2 = 0.716) and lateral GRF in the arm-cocking phase and pitching-elbow valgus moment in the acceleration phase.

Conclusion:

Drive-leg knee valgus angle during the windup and pushoff had a significant relationship with drive-leg GRF and pitching-elbow valgus moment at later stages of the pitching cycle.

Clinical Relevance:

Assessments of drive-leg kinematics during the windup and pushoff may be useful in identifying inefficient movement patterns that can have an effect on the direction of a pitcher’s drive-leg force contribution, which can lead to increased forces on the throwing elbow.
The Effects of in-Home Respite Care on the Burden of Caregivers in Taiwan
Authors: Liao Yi-Han , Ku Li-Jung Elizabeth , Liu Li-Fan , Li Chung-Yi
Published: March 2022

The utilization rate of respite care in Taiwan is low, and past studies that evaluated the effects of in-home respite care on caregiver burden are few. This two-wave panel study used Taiwan’s long-term care plan 1.0 database and included 2342 care recipient–caregiver dyads who used home services to examine the impact of in-home respite care on caregiver burden. Propensity score matching was used to select 323 in-home respite service users matched with 646 nonusers as control groups (1:2 matching). The mixed effect model was applied to estimate the effects of receiving in-home respite care on caregiver burden. Results showed that compared with those of nonusers, caregiver burden scores of service users decreased significantly after receiving in-home respite care for more than 14 days (adjusted B = −0.14, SE = 0.05). The government should prioritize increasing the number of days of in-home respite care for those in need to reduce the caregiver burden.
First Step Next: A Best-Evidence Synthesis of Replication Randomized Controlled Trials From 2009 to 2021
Authors: Frey Andy J. , Small Jason W. , Walker Hill M. , Mitchell Brandon , Seeley John R. , Feil Edward G. , Lee Jon , Forness Steven R.
Published: March 2022

Early intervention efforts have been effective in reducing disruptive behaviors and the probability of poor developmental outcomes. Early interventions include common practice elements to improve social functioning and decrease problem behaviors that disrupt the teaching-learning process. The First Step Next intervention has been well validated across early childhood and early elementary settings. In the present article, we provide a best-evidence synthesis of five randomized controlled replication studies between 2009 and 2021. Collectively, these studies show the intervention has resulted in small to large effect sizes and statistically significant improvements, compared with students randomized to control conditions, on multiple indicators of prosocial and problem behavior. The current synthesis focuses on a range of outcomes across elementary and preschool populations, as well as implementation fidelity and social validity ratings, to help school professionals in determining whether First Step Next might be useful in their efforts to support students at risk of school failure.
2,2′,4,4′-Tetrabromodiphenyl ether disrupts spermatogenesis in mice by interfering with the ER-Nrf1-Tfam-mitochondria pathway
Authors: Huang Shaoping , Xia Jiangyan , Zhang Xinxin , Zhou Tao , Wang Jing , Liu Tong , Xu Siyi , Liang Geyu
Published: March 2022

2,2′,4,4′ -tetrabromodiphenyl ether (BDE47), a well-known endocrine disruptor of the estrogen receptor (ER) is toxic to the mitochondria and spermatogenesis. This study aimed to explore the mechanism of BDE47 on spermatogenesis in mammals. Adult male Institute of Cancer Research (ICR) mice were gavaged daily with BDE47 (0, 1, or 10 mg/kg bw) for 8 weeks. Testicular weight, sperm production and motility, morphology of spermatogenic cells, nuclear respiratory factor 1 (Nrf1) level, and its expression in testes were determined. In vitro, cell viability, and key molecules in the ER-Nrf1-mitochondrial transcription factor A (Tfam)-mitochondria pathway in the immortalized mouse spermatogonia line (GC1) were determined at 48 h and 0–5 h after exposure; RNA interference (RNAi) was also performed to verify that the decreased Nrf1 was associated with mitochondrial dysfunction and the impaired viability of germ cells. The results indicated that BDE47 impaired testis weight and spermatogenesis, impaired mitochondria and germ cells, and decreased Nrf1 in the testes of mice. In vitro, after 48 h exposure, BDE47 reduced cell viability, Nrf1 protein, and mRNA of Nrf1, Tfam, ATP synthase subunit β (Atp5b), and cytochrome c oxidase subunit I (mt-CO1) in GC1 while also reducing mRNA of Nrf1 and Tfam promptly (from 1 to 5 h) after exposure. Furthermore, Nrf1 RNA interference decreased viability and mitochondrial function in GC1. These results indicated that BDE47 disrupts spermatogenesis in mice, probably by interfering with the ER-Nrf1-Tfam-mitochondria pathway, and Nrf1 is a target molecule of BDE47 estrogen receptor.
Increased Mortality and Costs Associated with Adverse Events in Intensive Care Unit Patients
Authors: Cantor Nathan , Durr Kevin M. , McNeill Kylie , Thompson Laura H. , Fernando Shannon M. , Tanuseputro Peter , Kyeremanteng Kwadwo
Published: March 2022

Background: Adverse events (AEs) are defined as unintended complications occurring to patients as a result of medical care. AEs are especially prevalent in the intensive care unit (ICU) setting and may lead to negative patient outcomes. Although many studies have examined the impact of AEs on patient outcomes, few have investigated their associated costs. Methods: The study population consisted of 17 173 adult patients (≥18 years of age) who were admitted to the ICU at The Ottawa Hospital (TOH) between 2011 and 2016. AEs were categorized using an established International Classification of Diseases 10th revision (ICD-10) patient safety indicators (PSI) system for AE detection. Logistic regression was performed to determine the association between AEs and in-hospital outcomes, including mortality. In addition, we constructed a generalized linear model to assess the independent association between AEs and total hospital costs. Results: Patients who experienced an AE had longer total hospital and ICU lengths of stay, required more invasive ICU interventions, had more complex discharge plans, and experienced higher rates of in-hospital mortality compared to those who did not experience an AE. Average total hospital costs and ICU-specific costs were higher among patients who experienced an AE ($72 718; $46 715) relative to their counterparts ($20 543; $16 217), but the per day cost was comparable in both groups. After controlling for age, sex, patient comorbidities, and illness severity, AEs were significantly associated with an increased odds of mortality (OR = 1.13, 95% CIs = 1.04, 1.22) and total average costs (Cost Ratio = 1.04, 95% CIs = 1.06, 1.08). The most impactful AE subtypes from a cost- and patient-perspective were hospital-acquired infections (HAI) and cardiac-related AEs. Conclusion: Incidence of AEs among ICU patients is associated with higher patient mortality and elevated costs. Specific causes of these AEs should be investigated, with further protocols and interventions developed to reduce their occurrence.
Knowledge of Galactagogue Use During Breastfeeding in Australia: A Cross Sectional Online Survey
Authors: McBride Grace McKenzie , Stevenson Robyn , Zizzo Gabriella , Rumbold Alice R , Amir Lisa H , Keir Amy K , Grzeskowiak Luke Edward
Published: March 2022

Background:

Galactagogues have been used for centuries to induce, maintain, or increase a mother’s milk supply. Recently, there has been an apparent increase in utilization and promotion of galactagogues, largely in the absence of data regarding their efficacy and safety. However, there is limited contemporary evidence about knowledge of these substances in the community or how and where individuals seek information.

Research Aim:

To evaluate knowledge about galactagogue use during breastfeeding among birth parents, including recognition of specific substances, perceptions of safety, and common information sources.

Method:

An online, prospective, cross-sectional survey of Australian birthing parents ( N = 2055) who were currently breastfeeding or had previously breastfed their infants was conducted from September to December 2019. The survey included questions about recognition of galactagogues, perceptions of safety, and information-seeking behaviors.

Results:

Among participants, 47% ( n = 882) were primiparous and 65% ( n = 1,219) were currently breastfeeding. The most recognized galactagogues included lactation cookies (89%; n = 1,828), brewer's yeast (79%; n = 1,629), fenugreek (74%; n = 1,519), and domperidone (69%; n = 1,420). Respondents cited the internet (52%; n = 1,066), lactation support providers (46%; n = 951), midwives (42%; n = 873), general practitioners (39%; n = 802), and social media (35%; n = 714) as common information sources. Lactation support providers and breastfeeding helplines were commonly rated as helpful; whereas, general practitioners and community pharmacists were often rated as unhelpful. While most participants perceived galactagogues to be safe, herbal or dietary galactagogues were perceived to be safer than pharmaceutical galactagogues.

Conclusions:

Our Australian community survey of individuals with current or previous breastfeeding experience identified widespread recognition of galactagogue use, with participants reporting a broad range of information-seeking behaviors and generally perceiving galactagogues as being safe to use.
Triple diffusion with heat transfer under different effects on magnetized hyperbolic tangent nanofluid flow
Authors: Arif Uzma , Memon M. Asif , Saif Rai Sajjad , El-Shafay A.S. , Nawaz Muhammad , Muhammad Taseer
Published: March 2022

The core objective of the presented analysis is to explore the mixed convection and magnetohydrodynamics effects on tangent hyperbolic nanofluid flow generated by elongating surface. Mechanisms of thermal radiation and chemical reaction are incorporated in energy and concentration equations respectively. Moreover, the Soret-Dufour phenomenon is also taken into consideration. Mathematical formulation is floated under the assumption of boundary layer theory. Formulated partial differential (PD) system reduces into nonlinear ordinary differential (OD) system with the help of suitable transformations which has been solved with a technique named finite element method (FEM) and outcomes are justified through grid-free and convergence phenomenon. The characteristics of numerous effective parameters are displayed graphically and discussed. Furthermore, the physical quantities like local Nusselt number, Sherwood number and skin friction coefficient are tabulated numerically and analyzed. Solute concentration profile [Formula: see text] shown reverse trend for distinct values of [Formula: see text] and [Formula: see text] [Formula: see text] diminishes whereas [Formula: see text] boosted the [Formula: see text].
Thirty-day readmission rates in a cohort of people living with HIV in southern Brazil, 2015 to 2017
Authors: Jardim Bruno A , Jardim Tyane AP , França João CB , Breda Giovanni L , Pavanelli Giovana M , Pavanelli Alberto M , Milano Sibele S , Ribeiro Clea EL , Raboni Sonia M
Published: March 2022

Background

The intense use of antiretroviral therapy (ART) has reduced morbidity and mortality of HIV infection. In Brazil, the specific contribution of diseases related to HIV infection leading to hospital admission and readmission is not well known.

Aims

The study aimed to determine the clinico-epidemiological profile, 30-day readmission rate, and factors associated with this outcome in a cohort of adults with HIV infection in southern Brazil.

Methods

Unicentric retrospective cohort, with data collection through the review of medical records and databases.

Results

We analyzed 574 index hospitalizations and 451 individuals. Of these, 57.6% were men and the mean (±SD) age was 42.2 ± 12.3 years. Only 43.4% used ART regularly and low CD4 count and high frequency of detectable viral load were observed. HIV/AIDS-related diseases were identified in 55.2%, and tuberculosis was the most frequent etiology leading to index hospitalization. We found a 30-day readmission rate of 11.5% and hospitalization for HIV/AIDS-related illness was associated with a higher risk for the outcome.

Conclusions

These findings highlight the need to expand resources for prevention, early diagnosis, retention, and treatment of people living with HIV in the region to reduce HIV/AIDS-associated diseases and possibly minimize consequent hospital readmission of these individuals.
‘Yeah, this one will be a good one’, or Tacit knowledge, prophylaxis and the border: Exploring everyday health security decisionmaking
Authors: Ferhani Adam J
Published: March 2022

Approaching health security from a practice-theoretical perspective, this article advances our understanding of the everyday and locality in health security decisionmaking, and is guided by the following two questions: How is it determined when a health security threat is likely to be present at a point of entry? What knowledge informs everyday health security decisions at borders? Markedly little is known about health security decisionmaking, though conventional wisdom tells us that health security decisions are based on stringent processes and – importantly – anchored in epidemiological knowledge. The assumed primacy of epidemiological knowledge in health security decisionmaking is well illustrated by the SARS-CoV-2 pandemic: evidence-based responses emerged globally following sophisticated epidemiologic investigation. Are health security decisions always rooted in epidemiology? A 12-month period of non-participant observation of Port Health Officers – who, under the auspices of the 2005 International Health Regulations, are responsible for numerous prophylactic measures at the UK border – gives a unique, privileged entry point for understanding the health security decisionmaking process and tells a story that both questions the centrality of epidemiology and foregrounds the role of tacit knowledge and intuition in health security decisionmaking. This article, which draws on insights from the science and technology studies literature on tacit knowledge, shows how observed health risk taxonomies and corollary decisions in prophylactic border security are predicated almost exclusively on hunches and ‘just knowing’ that something ‘doesn’t feel right’.
Older patients’ perspectives on illness and healthcare during the early phase of the COVID-19 pandemic
Authors: Jøranson Nina , Heggestad Anne Kari Tolo , Breievne Grete , Bruun-Olsen Vigdis , Heiberg Kristi Elisabeth , Myrstad Marius , Hylen Ranhoff Anette , Lausund Hilde
Published: March 2022

Background

Equal access to healthcare is a core principle in Norway’s public healthcare system. The COVID-19 pandemic challenged healthcare systems in the early phase – in particular, related to testing and hospital capacity. There is little knowledge on how older people experienced being infected with an unfamiliar and severe disease, and how they experienced the need for healthcare early in the pandemic

Aim

To explore the experiences of older people infected by COVID-19 and their need for testing and hospitalisation.

Research design

An explorative and descriptive approach, with qualitative interviews conducted in October 2020.

Participants and research context

Seventeen participants above 60 years of age hospitalised due to COVID-19 during spring 2020 were recruited 6 months after discharge.

Ethical considerations

Ethical approval was granted by the Regional Committee for Medical and Health Research Ethics in South-Eastern Norway (155425).

Findings

The main finding was that the informants experienced vulnerability and arbitrariness. This finding was supported by three sub-themes: experiences with a severe and unfamiliar disease, the strict criteria and the importance of someone advocating needs.

Discussion

Participants described varying access to healthcare. Those who did not meet the national criteria to be tested or hospitalised struggled against the system. Findings reveal arbitrary access to healthcare, in contrast to Norway’s ethical principle of fair and just access to health services. Moreover, to access and receive necessary healthcare, informants were dependent on their next-of-kin’s advocacy.

Conclusion

Even when dealing with an unfamiliar disease, health professionals’ assessments of symptoms must be performed with an ethical obligation to applicate competent appraisal and the exercise of discernment; this is in line with care ethics and ethical standards for nurses. These perspectives are a significant part of caring and the intension of doing good.
Lockdown Stringency and an Assessment of the Trajectory of COVID-19 Pandemic in India*
Authors: Mandala Padma
Published: March 2022

Since COVID-19 was declared a pandemic in March 2020, countries across the world have imposed lockdowns to curtail transmission of the disease. The objective of the present article is to use statistical tools to assess how lockdown policies and stringency affected the spread of the pandemic in India. The method of principal component analysis is used for dimensionality reduction and to track the trajectory of the pandemic in the two-dimensional space. The analysis identifies four phases in the trajectory of the pandemic. A composite measure of the pandemic is constructed to see how it correlates with the stringency index. While results show a negative and statistically significant relationship between the composite index of the pandemic and the stringency index over the entire period of the study, the phase-wise analysis gives useful insights. In particular, the phase in which the pandemic index declined even as stringency index declined and the phase of sudden onset of second wave with a consequent increase in stringency measures indicate the need for policies for better management of the pandemic. Tracking new epidemiological variants of the virus and geographically localized stringency measures rather than national level lockdowns are possible ways to balance health and economy.
The Real Story Behind Maternal Health of North Korea
Authors: Oh Seung Jin , Han Jungjin
Published: March 2022

Introduction:

Despite the emphasis on more systematic and high-quality health care services in the maternal period, a high maternal mortality rate in developing countries is still reported. North Korea, one of the closed countries in the world, is no exception. This study aimed to explore the maternal health experiences in North Korea.

Methodology:

Qualitative content analysis suggested by Graneheim and Lundman was used to analyze the data of 10 female North Korean defectors.

Results:

Three categories were derived: pregnancy without self-determination rights, a huge gap between the policies on maternal protection and the reality, and discriminatory childbirth and postpartum care. The theme was “perilous existence of maternal health.”

Discussion:

We highlighted the need for awareness of maternity protection led by health care professionals such as nurses to guarantee Universal Health Coverage as a human right for North Korean women.