bluuebunny/crossref_metadata_2025 huggingface dataset:
Rural-urban differences in food insecurity and associated cognitive impairment among older adults: findings from a nationally representative survey
Authors: Srivastava Shobhit , Muhammad T.
Published: April 2022

Introduction

Due to rapid urbanization, Covid-19 pandemic and increasing food prices, a higher rate of food insecurity has been observed in recent years in India. Thus, we aim to study the prevalence of food insecurity among older Indian adults and the association of food insecurity as a modifiable risk factor with late-life cognitive impairment.

Method

Data for this study were obtained from the recent release of the Longitudinal Ageing Study in India (2017–18). The total sample size for the study was 31,464 older adults aged 60 years and above. Cognitive functioning was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming) adapted from the cognitive module of the US Health and Retirement Study (HRS). Descriptive statistics along with cross-tabulation were presented in the study. Additionally, multivariable logistic regression analysis was used to fulfil the objectives of the study.

Results

It was found that 7.7% of older adults in rural areas reduced their size of meals due to unavailability (urban, 3.2%), 41.2% of them did not eat enough food of their choice (urban, 38.3%), 6.9% were hungry but did not eat food (urban, 2.6%), 5.0% did not eat for whole day (urban, 2.2%), and 6.9% lost weight due to lack of food in their household (urban, 2.9%). It was found that older adults who did not have enough food of their choice had significantly higher odds [AOR: 1.24; CI: 1.14, 1.35] of suffering from cognitive impairment in reference to their counterparts. Similarly, the older adults who were hungry but did not eat were 30% [AOR: 1.30; CI: 1.02, 1.73] more likely to suffer from cognitive impairment in reference to their counterparts. Interaction model revealed that older adults who had food insecurity in rural areas had higher odds of cognitive impairment than older adults who had food insecurity in urban areas.

Conclusion

The findings of the study highlight that the food security status in older adults may bring about greater challenges due to their limited economic resources. Interventions focusing on food security may have unintended positive impacts on late-life mental wellbeing as the older age is associated with higher cognitive deficits.
Availability of medical cannabis services by racial, social, and geographic characteristics of neighborhoods in New York: a cross-sectional study
Authors: Cunningham Chinazo O. , Zhang Chenshu , Hollins Maegan , Wang Melinda , Singh-Tan Sumeet , Joudrey Paul J.
Published: April 2022

Background

Within the United States (US), because racial/ethnic disparities in cannabis arrests continue, and cannabis legalization is expanding, understanding disparities in availability of legal cannabis services is important. Few studies report mixed findings regarding disparities in availability of legal cannabis services; none examined New York. We examined disparities in availability of medical cannabis services in New York. We hypothesized that New York census tracts with few Black or Hispanic residents, high incomes, high education levels, and greater urbanicity would have more medical cannabis services.

Methods

In this cross-sectional study, we used data from the 2018 US Census Bureau 5-year American Community Survey and New York Medical Marijuana Program. Main exposures were census tract characteristics, including urban–rural classification, percentage of Black and Hispanic residents, percentage of residents with bachelor’s degrees or higher, and median household income. Main outcomes were presence of at least one medical cannabis certifying provider and dispensary in each census tract. To compare census tracts’ characteristics with (vs. without) certifying providers and dispensaries, we used chi-square tests and t-tests. To examine characteristics independently associated with (vs. without) certifying providers, we used multivariable logistic regression.

Results

Of 4858 New York census tracts, 1073 (22.1%) had medical cannabis certifying providers and 37 (0.8%) had dispensaries. Compared to urban census tracts, suburban census tracts were 62% less likely to have at least one certifying provider (aOR = 0.38; 95% CI = 0.25–0.57). For every 10% increase in the proportion of Black residents, a census tract was 5% less likely to have at least one certifying provider (aOR = 0.95; 95% CI = 0.92–0.99). For every 10% increase in the proportion of residents with bachelor’s degrees or higher, a census tract was 30% more likely to have at least one certifying provider (aOR = 1.30; 95% CI = 1.21–1.38). Census tracts with (vs. without) dispensaries were more likely to have a higher percentage of residents with bachelor’s degrees or higher (43.7% vs. 34.1%, p < 0.005).

Conclusions

In New York, medical cannabis services are least available in neighborhoods with Black residents and most available in urban neighborhoods with highly educated residents. Benefits of legal cannabis must be shared by communities disproportionately harmed by illegal cannabis.
Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians
Authors: Luckett Tim , Roberts Mary , Smith Tracy , Garcia Maja , Dunn Sarah , Swan Flavia , Ferguson Caleb , Kochovska Slavica , Phillips Jane L. , Pearson Mark , Currow David C. , Johnson Miriam J.
Published: April 2022

Introduction

The battery-operated hand-held fan (‘fan’) is an inexpensive and portable non-pharmacological intervention for chronic breathlessness. Evidence from randomised controlled trials suggests the fan reduces breathlessness intensity and improves physical activity in patients with a range of advanced chronic conditions. Qualitative data from these trials suggests the fan may also reduce anxiety and improve daily functioning for many patients. This study aimed to explore barriers and facilitators to the fan’s implementation in specialist respiratory care as a non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD).

Methods

A qualitative approach was taken, using focus groups. Participants were clinicians from any discipline working in specialist respiratory care at two hospitals. Questions asked about current fan-related practice and perceptions regarding benefits, harms and mechanisms, and factors influencing its implementation. Analysis used a mixed inductive/deductive approach.

Results

Forty-nine participants from nursing (n = 30), medical (n = 13) and allied health (n = 6) disciplines participated across 9 focus groups. The most influential facilitator was a belief that the fan’s benefits outweighed disadvantages. Clinicians’ beliefs about the fan’s mechanisms determined which patient sub-groups they targeted, for example anxious or palliative/end-stage patients. Barriers to implementation included a lack of clarity about whose role it was to implement the fan, what advice to provide patients, and limited access to fans in hospitals. Few clinicians implemented the fan for acute-on-chronic breathlessness or in combination with other interventions.

Conclusion

Implementation of the fan in specialist respiratory care may require service- and clinician-level interventions to ensure it is routinely recommended as a first-line intervention for chronic breathlessness in patients for whom this symptom is of concern, regardless of COPD stage.
Reducing non-attendance in outpatient appointments: predictive model development, validation, and clinical assessment
Authors: Valero-Bover Damià , González Pedro , Carot-Sans Gerard , Cano Isaac , Saura Pilar , Otermin Pilar , Garcia Celia , Gálvez Maria , Lupiáñez-Villanueva Francisco , Piera-Jiménez Jordi
Published: April 2022

Background

Non-attendance to scheduled hospital outpatient appointments may compromise healthcare resource planning, which ultimately reduces the quality of healthcare provision by delaying assessments and increasing waiting lists. We developed a model for predicting non-attendance and assessed the effectiveness of an intervention for reducing non-attendance based on the model.

Methods

The study was conducted in three stages: (1) model development, (2) prospective validation of the model with new data, and (3) a clinical assessment with a pilot study that included the model as a stratification tool to select the patients in the intervention. Candidate models were built using retrospective data from appointments scheduled between January 1, 2015, and November 30, 2018, in the dermatology and pneumology outpatient services of the Hospital Municipal de Badalona (Spain). The predictive capacity of the selected model was then validated prospectively with appointments scheduled between January 7 and February 8, 2019. The effectiveness of selective phone call reminders to patients at high risk of non-attendance according to the model was assessed on all consecutive patients with at least one appointment scheduled between February 25 and April 19, 2019. We finally conducted a pilot study in which all patients identified by the model as high risk of non-attendance were randomly assigned to either a control (no intervention) or intervention group, the last receiving phone call reminders one week before the appointment.

Results

Decision trees were selected for model development. Models were trained and selected using 33,329 appointments in the dermatology service and 21,050 in the pneumology service. Specificity, sensitivity, and accuracy for the prediction of non-attendance were 79.90%, 67.09%, and 73.49% for dermatology, and 71.38%, 57.84%, and 64.61% for pneumology outpatient services. The prospective validation showed a specificity of 78.34% (95%CI 71.07, 84.51) and balanced accuracy of 70.45% for dermatology; and 69.83% (95%CI 60.61, 78.00) for pneumology, respectively. The effectiveness of the intervention was assessed on 1,311 individuals identified as high risk of non-attendance according to the selected model. Overall, the intervention resulted in a significant reduction in the non-attendance rate to both the dermatology and pneumology services, with a decrease of 50.61% (p<0.001) and 39.33% (p=0.048), respectively.

Conclusions

The risk of non-attendance can be adequately estimated using patient information stored in medical records. The patient stratification according to the non-attendance risk allows prioritizing interventions, such as phone call reminders, to effectively reduce non-attendance rates.
Diagnostic delay in soft tissue tumors: a single-center study of a university cancer center with a focus on health services research
Authors: Ballhause Tobias M. , Reiter Alonja , Korthaus Alexander , Frosch Karl-Heinz , Schlickewei Carsten W. , Priemel Matthias H.
Published: April 2022

Background

Lumps and soft tissue tumors (STT) are frequent reasons for consulting a physician. Most STT are benign, and lumps are not always associated with a tumor. MRI is the most advanced imaging modality to assist a provisional diagnosis of STT. Only a small fraction of STT is malignant, these soft tissue sarcomas are known for their aggressive growth.

The study aims to analyze the influence of the MRI report on the speed of treatment of patients with suspected STT.

Methods

This was a retrospective, longitudinal, single-center study from 2011–2020. We included adult patients who had biopsies or resections of masses suspicious for STT in MRI exams. MRI reports were classified as benign (I), intermediate/unclear (II), or malignant (III). For these cohorts, time was statistically analyzed from MRI scan to first contact with the University cancer center (UCC) and surgery. Furthermore, distance in kilometers from the patients´ home to the UCC was examined and compared to age and suspected malignancy.

Results

Three hundred two patients (♀130; ♂172) were included. Histologic analyses revealed 286 tumors. The average age of the patients was 54.7(SD: 16.2) years. Malignant tumors were more often suspected in older patients (p = 0.0098). Patients with a benign diagnosed tumor in MRI contacted the UCC after an average of 31.3 (SD: 47.8) days. In contrast, patients with suspicion of a malignant tumor contacted the UCC significantly earlier, after 14.1 days (SD: 17.1); p = 0.0098. Likewise, the time between first contact and biopsy/resection was 32.8 days (SD: 35.7) for suspiciously benign tumors, and potentially malignant tumors were treated significantly faster 14.8 (SD: 16.0) days; (p = 0.028). Patients traveled on average 47.5 km (range: 0.5–483) to contact a specialized physician at the UCC. Suspected degree of malignancy or patient´s age had no statistical influence on traveled distance.

Discussion

The treatment speed depended to a great extent on the suspected malignancy of the STT in the MRI report. The provisional diagnoses from the radiologist highly influenced the time delay between MRI scan and first contact to the UCC and surgical treatment. No discrimination of age or distance to the UCC was observed in this study.
Single-cell transcriptomics of the ventral posterolateral nucleus-enriched thalamic regions from HSV-1-infected mice reveal a novel microglia/microglia-like transcriptional response
Authors: Uyar Olus , Dominguez Juan Manuel , Bordeleau Maude , Lapeyre Lina , Ibáñez Fernando González , Vallières Luc , Tremblay Marie-Eve , Corbeil Jacques , Boivin Guy
Published: April 2022

Background

Microglia participate in the immune response upon central nervous system (CNS) infections. However, the role of these cells during herpes simplex encephalitis (HSE) has not been fully characterized. We sought to identify different microglia/microglia-like cells and describe the potential mechanisms and signaling pathways involved during HSE.

Methods

The transcriptional response of CD11b+ immune cells, including microglia/microglia-like cells, was investigated using single-cell RNA sequencing (scRNA-seq) on cells isolated from the ventral posterolateral nucleus (VPL)-enriched thalamic regions of C57BL/6 N mice intranasally infected with herpes simplex virus-1 (HSV-1) (6 × 105 PFUs/20 µl). We further performed scanning electronic microscopy (SEM) analysis in VPL regions on day 6 post-infection (p.i.) to provide insight into microglial functions.

Results

We describe a novel microglia-like transcriptional response associated with a rare cell population (7% of all analyzed cells), named “in transition” microglia/microglia-like cells in HSE. This new microglia-like transcriptional signature, found in the highly infected thalamic regions, was enriched in specific genes (Retnlg, Cxcr2, Il1f9) usually associated with neutrophils. Pathway analysis of this cell-type transcriptome showed increased NLRP3-inflammasome-mediated interleukin IL-1β production, promoting a pro-inflammatory response. These cells' increased expression of viral transcripts suggests that the distinct “in transition” transcriptome corresponds to the intrinsic antiviral immune signaling of HSV-1-infected microglia/microglia-like cells in the thalamus. In accordance with this phenotype, we observed several TMEM119+/IBA-I+ microglia/microglia-like cells immunostained for HSV-1 in highly infected regions.

Conclusions

A new microglia/microglia-like state may potentially shed light on how microglia could react to HSV-1 infection. Our observations suggest that infected microglia/microglia-like cells contribute to an exacerbated CNS inflammation. Further characterization of this transitory state of the microglia/microglia-like cell transcriptome may allow the development of novel immunomodulatory approaches to improve HSE outcomes by regulating the microglial immune response.
Huashan perioperative nursing program for stroke patients undergoing contralateral seventh cervical nerve transfer
Authors: Su Fan , Xu Ye , Wang Xiaoqian , Zhou Yiqun , Xu Wendong , Zhang Yaojin , Liu Ying
Published: April 2022

Background

A previous investigation regarding contralateral seventh cervical nerve transfer (CC7) revealed a novel and effective approach to improve arm function in patients with chronic spastic paralysis. The patients who underwent both CC7 and standard rehabilitation showed greater functional improvements and spasticity reductions than patients in the control group, who underwent rehabilitation only. Additional efforts are needed to maximize the benefits in patients and establishing a supporting nursing program is a promising method for achieving this goal.

Methods

The present Huashan nursing program was established in consideration of the following elements: providing routine perioperative care, ensuring surgical safety, and improving patient cooperation. Before surgery, psychiatric nursing, health education, and risk control were emphasized. After surgery, in addition to routine nursing and positioning, special attention was needed for targeted nursing in cases of postoperative adverse events. In addition, we performed descriptive statistical analysis of the clinical data of patients participating in the Huashan nursing program, focusing on postoperative adverse events. In total, 85 patients were included in the study, 10 of whom experienced adverse events, including severe pain (5, 5.88%), neck hematoma (2, 2.35%), dyspnea (2, 2.35%), and hoarseness (1, 1.18%). The above adverse events were alleviated through the targeted nursing care guided by the Huashan program.

Discussion

This article introduces the Huashan nursing program, which is based on preoperative evaluations, educational sessions, postoperative monitoring, and targeted nursing, for patients undergoing CC7. This nursing program helped promote and provided the opportunity to maximize the benefits of CC7.
Environmental factors in offspring of parents with mood disorders and their role in parent–child transmission: findings from a 14-year prospective high-risk study
Authors: Moulin Flore , Gholam Mehdi , Strippoli Marie-Pierre F. , Castelao Enrique , Merikangas Kathleen R. , Stapp Emma K. , Marquet Pierre , Aubry Jean-Michel , Plessen Kerstin J. , Di Giacomo Francesca , Glaus Jennifer , Pistis Giorgio , Lavigne Benjamin , Elowe Julien , Ranjbar Setareh , Preisig Martin , Vandeleur Caroline L.
Published: April 2022

Background

The factors involved in the transmission of mood disorders are only partially elucidated. Aside from genes, the family environment might play a crucial role in parent–child transmission. Our goals were to (1) assess the associations of parental bipolar disorder (BPD) and Major Depressive Disorder (MDD) with individual or shared family environmental factors, including traumatic events in offspring, parental separation, family cohesion and parental attitudes; and 2) test whether these factors were mediators of the association between exposure to parental mood disorders and the onset of these disorders in offspring.

Methods

The sample stems from an ongoing family high-risk study of mood disorders conducted in the French-speaking part of Switzerland. Given the strong impact of the age of onset of parental disorders on their transmission to children, parental disorders were dichotomized according to the onset (cut-off 21 years). Probands with early-onset (n = 30) and later-onset BPD (n = 51), early-onset (n = 21) and later-onset MDD (n = 47) and controls (n = 65), along with their spouses (n = 193) and offspring (n = 388; < 18 years on study inclusion), were assessed over a mean follow-up duration of 14 years (s.d: 4.6). The environmental measures were based on reports by offspring collected before the onset of their first mood episode.

Results

Offspring of probands with later-onset BPD and offspring of probands with both early-onset and later-onset MDD reported traumatic events more frequently than comparison offspring, whereas exposure to parental separation was more frequent in all groups of high-risk offspring. Moreover, several familial environment scores including parenting attitudes differed between offspring of probands with BPD and comparison offspring. However, none of these factors were mediators of the parent–child transmission of BPD. Among the environmental factors, traumatic events were shown to be modest mediators of the transmission of early-onset MDD.

Conclusions

Our data do not support the implication of the assessed environmental factors in the parent–child transmission of BPD. In contrast to BPD, traumatic events partially mediate the parent–child transmission of early-onset MDD, which has important implications for intervention and prevention. Early therapeutic efforts in offspring exposed to these events are likely to reduce their deleterious impact on the risk of subsequent MDD.
Tree and shrub recruitment under environmental disturbances in temperate forests in the south of Mexico
Authors: Gutiérrez Erick , Trejo Irma
Published: April 2022

Background

Recruitment after disturbance events depends on many factors including the environmental conditions of the affected area and the vegetation that could potentially grow in such affected areas. To understand the regeneration characteristics that occurs in temperate forests, we evaluated differences in the number of seedlings from trees and shrubs along an altitudinal gradient in Sierra Norte of Oaxaca, Mexico in different biological, climatic, edaphic, light, topographic, and disturbance regimes. Here, we aimed to test the hypothesis that the environmental disturbances influence on recruitment (positive or adverse influence). We sampled the vegetation to obtain recruitment and adult data, and species composition.

Results

We identified three disturbance regimes: areas affected by forest harvesting, areas exposed to pest management, and undisturbed areas. We identified 29 species of trees and shrubs (9 species of the genusPinus, 1 species of the genusAbies, 10 species of the genusQuercus,and 9 of other species of broadleaf). We found that both environmental conditions and disturbances influence the recruitment of vegetation in the study area. In particular, disturbances had a positive influence on the regeneration of oak and other broadleaf species by increasing the number of seedlings, and a negative influence on the regeneration of conifers by decreasing the recruitment. Because the recruitment of conifers is more likely in undisturbed areas (sites over 3050 m).

Conclusions

Environmental factors and anthropogenic disturbances can alter the recruitment of forests. Consequently, knowing which factors are key for the recruitment of vegetation is fundamental for decision-making processes. This is particularly relevant in areas as the one in this study because it provides knowledge to local people on vegetation recovery for a proper management of their biological resources.
Community pharmacy professionals’ practice in responding to minor symptoms experienced by pregnant women in Ethiopia: results from sequential mixed methods
Authors: Ayele Asnakew Achaw , Islam Md Shahidul , Cosh Suzanne , East Leah
Published: April 2022

Background

In countries with limited access to healthcare services, community pharmacists’ management of minor symptoms experienced by pregnant women could be beneficial in terms of alleviating the burden of other health professionals and cost of services. However, evidence is limited regarding the practice of community pharmacy professionals in responding to minor pregnancy-related symptoms more generally, particularly in Ethiopia.

Objective

The aim of this study was to evaluate actual and self-reported practice of community pharmacists in the management of minor symptoms during pregnancy in Ethiopia.

Methods

A sequential mixed method study using self-reported survey from 238 community pharmacists followed by 66 simulated client visits was conducted from March to July 2020 in six towns of the Amhara regional state in Ethiopia. Independent samples t-test and one-way Analysis of Variance was used to test the mean difference of practice score among subgroups of study participants.

Results

The self-reported survey showed that most community pharmacist would ‘always’ gather most symptom-related information particularly about ‘duration of symptoms,’ ‘frequency of symptoms,’ and ‘gestational age’ and provide medication-related information on ‘how to use the medication’ and ‘duration of use.’ The highest mean practice scores were observed in relation to information gathering about ‘gestational age’ and information provision on ‘how to use the medication.’ In contrast, the lowest mean practice scores were observed in relation to information gathering about ‘weight of the woman’ and information provision on ‘dosage form.’

However, the actual practice, as revealed by the simulated client visits, demonstrated that most community pharmacists would rarely gather symptom-related information nor provide medication-related information. In addition, dispensing of non-prescribed medications to pregnant women was also common. The extent of self-reported practice differed among subgroups of study participants.

Conclusions

This study highlights extent of practice of community pharmacy professionals during the management of minor symptoms in pregnancy in Ethiopia. Discrepancies of results between self-reported and actual practices of community pharmacy professionals were observed. The inadequate actual practice of symptom-related information gathering and medication-related information provisions needs considerations of implementing interventions to minimize potential harms.
Nonalcoholic fatty liver disease developed after pancreatoduodenectomy for solid pseudopapillary neoplasm in a 10-year-old girl: a case report
Authors: Sawai Toshio , Zuo Shogo , Terai Taichi , Nishiwada Satoshi , Nakagawa Kenji , Nagai Minako , Akahori Takehiro , Kanehiro Hiromichi , Sho Masayuki
Published: April 2022

Background

Solid pseudopapillary neoplasms of the pancreas are rare. Moreover, pancreatoduodenectomy (PD) and postoperative care are not common in pediatric surgery. Herein, we report a case of PD and nonalcoholic fatty liver disease (NAFLD) after PD and present a literature review.

Case presentation

A 10-year-old girl with a suspected liver tumor was referred to our hospital. Echography, enhanced computed tomography and magnetic resonance imaging showed that the tumor coexisted with the solid and cystic parts of the pancreatic head. Since the patient was a young woman and the imaging findings were consistent with that of pancreatic solid pseudopapillary neoplasms (SPNs), we diagnosed her with pancreatic SPN. Thereafter, PD was performed, and she was discharged 10 days after the operation. Although her postoperative course was mostly uneventful, she experienced few episodes of abdominal pain and diarrhea before hospital discharge. These symptoms subsequently became more frequent and severe. The patient was urgently readmitted to the hospital for watery steatorrhea and lower abdominal colic pain. Her serum aspartate aminotransferase and alanine aminotransferase levels were elevated, and a fatty liver was detected on echography. The patient was diagnosed with steatorrhea, peristaltic pain, and NAFLD after PD. Pancrelipase (containing pancreatic digestive enzymes), antidiarrheal agents, and probiotics were started. Dosage increase of these drugs reduced the defecation frequency and abdominal pain and switched diarrhea to loose stools. However, more lipids in meals or more meals caused diarrhea and abdominal pain. Therefore, the doses of these drugs were further increased, and another antidiarrheal agent, loperamide hydrochloride, was added. Exocrine pancreatic enzymes supplementation and careful follow-up should prevent NAFLD progression after PD. At present, the patient has occasional abdominal pain, but has tangible soft stools once or twice a day. Although echography still shows a mottled fatty liver, her hepatic enzymes are only mildly elevated.

Conclusions

Pediatric PD is rare, and residual pancreatic function is usually sufficient, unlike in adult cases. However, we experienced a case of NAFLD after PD for a pediatric pancreatic SPN, in which pancreatic enzyme supplementation effectively improved this condition. Further attention must be paid to worsening of NAFLD that can develop nonalcoholic steatohepatitis.
Can news-based economic sentiment predict bubbles in precious metal markets?
Authors: Maghyereh Aktham , Abdoh Hussein
Published: April 2022

This study examines the role of market sentiment in predicting the price bubbles of four strategic metal commodities (gold, silver, palladium, and platinum) from January 1985 to August 2020. It is the first to investigate this topic using sentiment indices, including news-based economic and consumer-based sentiments developed using different methods. We observed the role of sentiment as a reliable indicator of future bubbles for some metal commodities and found that bubbles were regularly concomitant with bearish sentiments for gold and platinum. Moreover, gold and palladium were the only commodities that experienced a bubble during the COVID-19 pandemic. Overall, our findings suggest inclusion of sentiment to the model that predicts the price bubbles of precious metals.
A robust, autonomous, volumetric quality assurance method for 3D printed porous scaffolds
Authors: Zhang Nicholas , Singh Srujan , Liu Stephen , Zbijewski Wojciech , Grayson Warren L.
Published: April 2022

Bone tissue engineering strategies aimed at treating critical-sized craniofacial defects often utilize novel biomaterials and scaffolding. Rapid manufacturing of defect-matching geometries using 3D-printing strategies is a promising strategy to treat craniofacial bone loss to improve aesthetic and regenerative outcomes. To validate manufacturing quality, a robust, three-dimensional quality assurance pipeline is needed to provide an objective, quantitative metric of print quality if porous scaffolds are to be translated from laboratory to clinical settings. Previously published methods of assessing scaffold print quality utilized one- and two-dimensional measurements (e.g., strut widths, pore widths, and pore area) or, in some cases, the print quality of a single phantom is assumed to be representative of the quality of all subsequent prints. More robust volume correlation between anatomic shapes has been accomplished; however, it requires manual user correction in challenging cases such as porous objects like bone scaffolds. Here, we designed porous, anatomically-shaped scaffolds with homogenous or heterogenous porous structures. We 3D-printed the designs with acrylonitrile butadiene styrene (ABS) and used cone-beam computed tomography (CBCT) to obtain 3D image reconstructions. We applied the iterative closest point algorithm to superimpose the computational scaffold designs with the CBCT images to obtain a 3D volumetric overlap. In order to avoid false convergences while using an autonomous workflow for volumetric correlation, we developed an independent iterative closest point (I-ICP10) algorithm using MATLAB®, which applied ten initial conditions for the spatial orientation of the CBCT images relative to the original design. Following successful correlation, scaffold quality can be quantified and visualized on a sub-voxel scale for any part of the volume.
Adaptive relay co-ordination using a busbar splitting approach for a system integrity protection scheme
Authors: Saikrishna Rajesh , Rajalwal Nilesh Kumar , Ghosh Debomita
Published: April 2022

Power system faults can often result in excessively high currents. If sustained for a long time, such high currents can damage system equipment. Thus, it is desirable to operate the relays in the minimum possible time. In this paper, a busbar splitting approach is used for adaptive relay setting and co-ordination purposes for a system integrity protection scheme (SIPS). Whenever a fault occurs, the busbar splitting scheme splits a bus to convert a loop into a radial structure. The splitting schemes are chosen such that the net fault current is also reduced. Busbar splitting eliminates the dependency upon minimum breakpoints set (MBPS) and reduces the relay operating time, thus making it adaptive. The proposed methodology is incorporated into the IEEE 14-bus and IEEE 30-bus systems with single and multiple fault conditions. The modeling and simulation carried out in ETAP, and the results of the proposed busbar splitting-based relay co-ordination are compared with the MBPS splitting-based relay co-ordination.
Racial and Ethnical Diversity Within the Neurosurgery Resident and Faculty Workforce in the United States
Authors: Asfaw Zerubabbel K. , Soto Elizabeth , Yaeger Kurt , Feng Rui , Carrasquilla Alejandro , Barthélemy Ernest J. , Tabani Halima , Berkalieva Asem , Mazumdar Madhu , McNeill Ian T. , Germano Isabelle M.
Published: April 2022

BACKGROUND:

Promoting workplace diversity leads to a variety of benefits related to a broader range of perspectives and insights. Underrepresented in medicine (URiM), including African Americans, Latinx, and Natives (Americans/Alaskan/Hawaiians/Pacific Islanders), are currently accounting for approximately 40% of the US population.

OBJECTIVE:

To establish a snapshot of current URiM representation within academic neurosurgery (NS) programs and trends within NS residency.

METHODS:

All 115 NS residencies and academic programs accredited by the Accreditation Council for Graduate Medical Education in 2020 were included in this study. The National Residency Matching Program database was reviewed from 2011 to 2020 to analyze URiM representation trends over time within the NS resident workforce. The academic rank, academic and clinical title(s), subspecialty, sex, and race of URiM NS faculty (NSF) were obtained from publicly available data.

RESULTS:

The Black and Latinx NS resident workforce currently accounts for 4.8% and 5.8% of the total workforce, respectively. URiM NSF are present in 71% of the Accreditation Council for Graduate Medical Education–accredited NS programs and account for 8% (148 of 1776) of the workforce. Black and Latinx women comprise 10% of URiM NSF. Latinx NSFs are the majority within the URiM cohort for both men and women. URiM comprise 5% of all department chairs. All are men. Spine (26%), tumor (26%), and trauma (17%) were the top 3 subspecialties among URiM NSF.

CONCLUSION:

NS has evolved, expanded, and diversified in numerous directions, including race and gender representation. Our data show that ample opportunities remain to improve URiM representation within NS.
Kickstand Rod With Asymmetric Pedicle Subtraction Osteotomy for Treatment of Adult Kyphoscoliosis With Severe Coronal Imbalance
Authors: Safaee Michael M. , Maloney Patrick R. , Deviren Vedat , Ames Christopher P.
Published: April 2022

BACKGROUND:

The kickstand rod has been described for the treatment of severe coronal imbalance. We present a modified description that combines an asymmetric pedicle subtraction osteotomy (PSO) for correction of severe kyphoscoliosis.

OBJECTIVE:

To describe the use of a temporary kickstand rod.

METHODS:

Type 1 osteotomies were performed across the main and fractional curves. An asymmetric PSO was performed at the apex of the main curve, and a kickstand rod placed on the concavity anchored from the ilium to a temporary connector above the main curve. Distraction was applied across the kickstand rod because the PSO was closed on the convexity. A permanent rod was placed contralateral to the kickstand, followed by replacement of the kickstand with a permanent rod and bilateral accessory rods.

RESULTS:

A 66-year-old man presented with kyphoscoliosis causing severe coronal and sagittal imbalance. He underwent L4-S1 anterior lumbar interbody fusion followed by T4-pelvis instrumented fusion the following day. Type 1 osteotomies were performed from T6-T12 to L3-S1 and an asymmetric PSO at L2. A temporary kickstand rod was used to distract across the concavity because the PSO was closed on the convexity. The patient achieved excellent clinical and radiographical results.

CONCLUSION:

When used in conjunction with appropriate osteotomies, the kickstand rod can aid in correction of severe coronal imbalance. Use of a temporary kickstand rod is technically easier and allows for correction of the main and fractional curves when used with an asymmetric PSO.
Modified OXIS classification for primary canines
Authors: Aarthi J , Muthu MS , Kirthiga M , Kailasam Vignesh
Published: April 2022

Background: A new classification called OXIS was proposed for categorising the interproximal contacts of primary molars, and its prevalence was established. The aim of this study was to establish the variations in interproximal contacts of primary canines and thereby modify the OXIS classification of primary molars to primary canines. Additionally, we aimed to estimate the applicability of modifications to primary anterior teeth.

Methods: A retrospective study was conducted with sectional die models obtained from a previous study of 1,090 caries-free children. Two calibrated examiners evaluated a total of 4,674 contacts from the occlusal aspect. The contacts were scored according to the former OXIS classification, with two modifications incorporated to encompass the morphological differences and rotations of primary canines and other primary anterior teeth.

Results: The most prevalent contact was O (62.1%), followed by X (19.6%), I (12.6%), S type I (4.1%), and S type II (1.6%). Inter-arch comparison by means of the Chi-square test revealed significant differences for all types of contacts (P < .001).

Conclusions: The interproximal contacts of canines were categorised as O, X, I, S I, and S II. The OXIS classification of primary molars was modified to befit the variations in primary canines. This study showed the presence of different types of contacts in primary canines. Identification of these contacts and their complexity has warranted a need for this to be studied as an inherent risk factor for caries risk assessment.
THE RUSSIAN FEDERATION PROPAGANDA NARRATIVES
Authors: Karpchuk Nataliia
Published: April 2022

The article seeks to research the propaganda narratives of the Russian Federation in Europe. The Russian Federation has a long “successful” history of creating propaganda narratives since Soviet times. Even today, it spreads national and grand narratives to influence the external and internal audience. The narrative method is used to analyse both the content and the structure of the stories. The author makes the conclusion that the main purpose of Russia’s propaganda narratives is to convince its citizens and the whole world of Russia’s indomitable greatness and power, as well as to demonstrate the degradation of Europe and the West in general. To form the image of an invincible fighter for Christian values, the only outpost of stability, development, security (at least in Europe), Russia promotes a grand narrative, which is disseminated through daily disinformation, fakes and propaganda messages. The article finds out how the EU counteracts these destructive influences, specifically owing to the activity of the EUvsDisinfo site.
DEVELOPMENT OF THE RUSSIAN ANTI ACCESS/ANTI DENIAL (A2/AD) CONCEPT AS A THREAT TO NATO AND POLAND
Authors: RADOMYSKI Adam Marek
Published: April 2022

This article presents an analysis of the development of the Russian Anti Access/Anti Denial concept – A2/AD. The considerations contained in this article focus on identifying the threats that the Russian A2/AD concept creates for NATO and Poland. This article compiles empirical data from scientific publications, formal strategic and doctrinal documents, which allowed to define the A2/AD category, specify its essence and characterize it through the prism of military and non-military forces and resources engaged by Russia in several important operational regions: the Kaliningrad Oblast, Crimea, Syria and the Arctic.The aim of this article is to evaluate the Russian Anti-Access/Anti Denial concept from the perspective of the threats it creates for NATO and Poland.The obtained research results allow us to make the conclusion that when assessing the current external conditions, effective opposition to the Russian A2/AD by NATO will be very difficult to implement. Increasing the capabilities in this area will probably require the individual member states to increase their defense spending, mainly on the modernization and development of their armed forces. In addition to increasing the financial expenditures, increasing the ability to counteract the Russian A2/AD will require proper coordination and integration of the activities of the entire NATO structure around one coherent operational concept. This applies not only to counteracting the Russian A2/AD in Europe but also in other regions of the world, which in the near future may become the theatre of military operations, both classic, asymmetric or hybrid.
India’s Vaccine Diplomacy: Role in New Order and Challenges
Authors: Bharti Simant Shankar , Bharti Sushant Shankar
Published: April 2022

The COVID-19 hit the world heartlessly. Throughout the worldwide lockdown was imposed, which is now considered as an economic lockdown. Since the World Health Organization (WHO) announced COVID-19 as a global pandemic on 11 March 2020, this involved the world in the development of vaccine breakthroughs. Until December 2020, many new vaccines have been rolling out for use, e.g., Pfizer, AstraZeneca, Moderna, COVAXIN, Sputnik V, and others. The vaccines were roll-out, the vaccine diplomacy came into vogue in the international scenario. However, there are many questions about the distribution and export of vaccines, which is considered one of the state’s soft power instruments to influence the relationship with other countries. Similarly, the purpose of this article is to trace India’s vaccine diplomacy and space in the new changing order from the perspective of soft power. Recently, the second wave of COVID-19 devastated India. Though, the study also explores the challenges and increasing role of China in South Asia. Vaccine diplomacy is an approach to the soft power theory in international relations. The case study and content analysis methods are applied here to explain the current vaccine diplomacy. The study finds that initially India strongly showed its vaccine diplomacy widely in its neighbourhood and other developing countries, but the second wave of COVID-19 weakened its position of not providing vaccines to its own home. To provide validity to an argument, vaccine diplomacy of India as a soft power instrument provides a framework for analyzing India’s role in the new world order.
I will only help if others tell me to do so! The simultaneous influence of injunctive and descriptive norms on donations
Authors: Gugenishvili Ilia , Colliander Jonas
Published: April 2022

To address the gaps in the understanding of how social norms can be used to increase charitable donations, we conducted two experiments with 347 participants. We demonstrated the following: (a) that the norms supporting or not supporting charitable donations influence donation intentions; (b) that injunctive norms (what the majority of people approve of) have stronger influences on donation intentions than descriptive ones (what the majority of people do); and (c) that when injunctive and descriptive norms do not align, they demotivate individuals to donate by reducing perceptions of collective efficacy. Our findings expand the literature on charitable donation, social norms and collective efficacy and offer insights for charitable organisations in terms of increasing donations by crafting convincing marketing content.
Fabrication of an all-silica microsphere-lens on optical fiber for free-space light coupling and sensing in extreme environments
Authors: Li Jiashun , Jia Pinggang , Qian Jiang , Wang Jun , An Guowen , Xiong Jijun
Published: April 2022

In this paper, an all-silica microsphere-lens was designed and fabricated on the fiber end face, which can effectively improve the coupling efficiency of free-space light. In the production process, a coreless silica fiber with specific length was spliced on the end face of the fiber and melted by a

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laser fusion splicer. Due to the effect of surface tension, the coreless silica fiber would form a microsphere-lens on the fiber end face and the diameter of the microsphere-lens could be adjusted by controlling the light-passing time of the

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laser fusion splicer. Through experiments, it can be found that the 3 dB bandwidth optical coupling distance of the microsphere-lens with a diameter of 270 µm is about 200 µm, and the focus depth is about 450 µm. In order to verify the feasibility of using the microsphere-lens in the fiber-optic Fabry–Perot sensors, a Fabry–Perot interferometer was constructed by using the microsphere-lens and the single-mode fiber end face. The experimental results showed that the interference spectrum of the Fabry–Perot interferometer has a good contrast ratio. Integrating the advantages of all-silica structure, simple manufacturing process, low cost, small size, and sturdy construction, the proposed microsphere-lens is expected to be a potential candidate for free-space light coupling and fiber-optic sensors in extreme environments.
Secrecy outage probability analysis in a free-space optical system based on partially coherent beams through anisotropic non-Kolmogorov turbulent atmosphere
Authors: Wu Hongyu , Ma Jing , Guo Pengzhen , Wang Qiang , Kang Dongpeng , Yang Jingkai , Wu Jiajie
Published: April 2022

In this paper, the secrecy outage probability of a partially coherent beam free-space optical communication system considering the combined effect of anisotropic non-Kolmogorov strong turbulent atmosphere and the eavesdropper’s position is investigated. The Fisher–Snedecor distribution is chosen to model the atmospheric turbulence because it is not only suitable for weak to strong turbulence conditions but is also mathematically simple. Based on the fading channel model and the generalized pointing error model, we derive analytical expressions for the lower bounded secrecy outage probability. Also, we obtain asymptotic closed-form expression at a high signal-to-noise regime. The obtained expressions are corroborated by Monte Carlo simulations. The calculation results based on the analytical expressions show that increasing the source coherence parameter makes the secrecy interruption probability performance first better and then worse for a given condition, and an optimal value is observed. The anisotropic coefficient and power law have a positive effect on the secrecy outage probability of the free-space optical communication system. Under the given conditions, the performance of the secrecy outage probability is significantly improved by the divergent beam, although the increased spot size at the receiver makes it easier for eavesdroppers to tap the link. The secrecy outage probability performance deteriorates as the vertical component of Bob, the jitter variance, and the refractive index structure constant increase.
Deterministic enhancement for bright-seeded Mach–Zehnder interferometer using low-noise feed-forward amplifiers
Authors: Chen Zhangyuan , Liao Dezheng , Xin Jun
Published: April 2022

We propose to use low-noise feed-forward amplifiers (LFAs) to enhance the phase sensitivity of a bright-seeded Mach–Zehnder interferometer (MZI). LFAs are performed on the two arms inside the MZI, which are based entirely on linear optics, off-line squeezed ancillary states, and homodyne detectors. We demonstrate the necessity of LFA-based topology in achieving sensitivity improvement beyond the standard quantum limit, compared with the deterministic linear amplification scheme. Remarkably, we find that the LFA-based MZI is advantageous over the standard MZI in robustness against the internal losses of the interferometer.