bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Influenza and Pneumococcal Vaccination Among Participants in the Women’s Health Initiative
Authors: Fix Jonathan , Donneyong Macarius M. , Rapp Stephen R. , Sattari Maryam , Snively Beverly M. , Wactawski-Wende Jean , Gower Emily W.
Published: March 2022

Objective:

Older adults typically experience higher rates of severe disease and mortality than the general population after contracting an infectious disease. Vaccination is critical for preventing disease and severe downstream outcomes; however, vaccination rates among older adults are suboptimal. We assessed predictors associated with pneumococcal and seasonal influenza vaccination among older women.

Methods:

We used data from the Women’s Health Initiative, a nationwide cohort of women. We ascertained seasonal influenza and pneumococcal vaccination status through a questionnaire administered in 2013. We limited analyses to women aged ≥65 years at questionnaire administration. We used logistic regression to estimate associations between demographic, lifestyle, and health-related factors and vaccination and explored stratification by race.

Results:

Of participants who responded to each question, 84.3% (n = 60 578) reported being vaccinated for influenza and 85.5% (n = 59 015) for pneumonia. The odds of reporting influenza vaccination were significantly lower among non-Hispanic Black participants than among non-Hispanic White participants (odds ratio [OR] = 0.53; 95% CI, 0.49-0.58), women with no health insurance versus private health insurance (OR = 0.61; 95% CI, 0.54-0.68), and women living in rural versus urban settings (OR = 0.84; 95% CI, 0.73-0.96). Current smoking, lower education levels, and having comorbid conditions were associated with lower likelihood of being vaccinated for influenza (than not); past pneumonia diagnosis and being currently married were associated with a higher likelihood. We observed similar associations for pneumococcal vaccination coverage.

Conclusions:

These findings reinforce the need to enact policy and implement programs to improve access to, education and awareness about, and provider recommendations for these critical disease-prevention tools. Results from our study should guide strategies for SARS-CoV-2 vaccination.
Knowledge of Human Papillomavirus and Cervical Cancer Among Low-Income Women in New Jersey
Authors: Silvera Stephanie A. Navarro , Kaplan Alejandra M. , Laforet Priscila
Published: March 2022

Objectives:

Although much research has been conducted on knowledge and awareness of the connection between human papillomavirus (HPV) and cervical cancer risk among university students, few studies have examined these associations among low-income populations. We examined knowledge of HPV and cervical cancer risk among racially and ethnically diverse low-income women.

Methods:

We used a cross-sectional study design to recruit and interview 476 low-income women in New Jersey from November 1, 2013, through February 28, 2016. We used multivariate logistic regression to determine whether knowledge of HPV and its association with cervical cancer risk differed by race and ethnicity.

Results:

Compared with non-Hispanic White women, Hispanic (odds ratio [OR] = 0.37; 95% CI, 0.18-0.77) and non-Hispanic Black (OR = 0.38; 95% CI, 0.19-0.77) women were significantly less likely to report having heard of HPV. Of women who had ever heard of HPV (n = 323), non-Hispanic Black women were significantly less likely (OR = 0.44; 95% CI, 0.21-0.89) than non-Hispanic White women to report knowing that HPV can be associated with cervical cancer.

Conclusions:

Given the higher rates of HPV infection among non-Hispanic Black and Hispanic women, these results suggest a need to improve education about risks of HPV among low-income populations. These messages need to include information on the connection between HPV and cervical cancer and must be provided in culturally and linguistically appropriate ways.
Clinical Profile and Outcomes of Diabetic Ketoacidosis during the COVID-19 Pandemic in North India
Authors: Kiran Ravindran , Saroch Atul , Pannu Ashok Kumar , Sharma Navneet , Dutta Pinaki , Kumar Mohan
Published: March 2022

Although recent data have shown a declining trend in mortality in diabetic ketoacidosis (DKA), the outcomes are likely to be different during the coronavirus (COVID-19) pandemic. We conducted a prospective cohort study to evaluate the spectrum and outcomes of adult DKA during the pandemic and document differences in DKA patients with or without COVID-19. A total of 169 patients (mean age 44 years) were admitted at the Emergency Department of PGIMER, Chandigarh (India), from January 2020 to June 2021. The precipitating factors were noncompliance with antidiabetic therapy (77.5%), infections (62.7%), and noninfectious conditions (21.3%). Thirty-nine (23.1%) patients had COVID-19, including 31 with severe infection. DKA severity and resolution, ventilator requirement, hospital stay, and mortality were similar in the patients with or without COVID-19. In-hospital mortality was 39.6% (n = 67). The independent mortality predictors were ventilator requirement ( p-0.000), an infection trigger ( p-0.049), and hyperosmolarity ( p-0.048). DKA mortality is increased significantly during the pandemic.
What’s Going On: “Partisan” Worries, and Desires to Discuss Trump-Era Events in School
Authors: Pollock Mica , Yoshisato Mariko
Published: March 2022

Background/Context:

This article explores how the classic U.S. educator effort to stay politically “nonpartisan” when teaching became particularly complicated in an era of spiking K–12 harassment, when government officials openly targeted and denigrated populations on the basis of race, national origin, gender, sexuality, and religion. We share research on a pilot (2017–2019) of #USvsHate, an “anti-hate” initiative we designed and studied with K–12 educators and students in the politically mixed region of San Diego, California.

Purpose/Objective/Research Question/Focus of Study:

#USvsHate sought to respond to a national spike in bigotry, harassment, and hate crimes by inviting “anti-hate” learning and messaging in an explicitly nonpartisan manner. Analyzing educator interviews and student focus groups from the project pilot, we explore a core tension raised throughout #USvsHate participation: Some participating educators feared that such work to include “all” as equally valuable would seem partisan to critics and so be deemed off-limits. We focus on this tension in part to support educators continuing to grapple with it in a deeply divided country.

Population/Participants/Subjects:

Pilot participants came from 12 diverse districts in our region, including 53 teachers and 427 students who submitted anti-hate messages to contests, with more than 3,300 students participating overall. We interviewed piloting K–12 teachers (18) and students (30) from traditional public schools and public charter schools.

Research Design:

Unlike more structured interventions, #USvsHate’s core shared experience is its open-ended invitation to “anti-hate” teaching and messaging. As ethnographically trained researchers, we spent spring 2018 and the 2018–2019 school year studying experiences of #USvsHate’s lessons and messaging efforts, feeding input continually back into project design in a participatory process. Teachers and students joined interviews and focus groups voluntarily. We also talked with dozens more teachers in design sessions and recruitment gatherings.

Data Collection and Analysis:

We used discourse analysis techniques piloted in studies on race talk to identify trends in participants’ responses and across individuals, coding for a key phrase found in focus group data: Across schools, students stated that #USvsHate offered a necessary chance to discuss “what’s going on.”

Conclusions/Recommendations:

Students interviewed considered it obviously educators’ professional responsibility to address current incidents of denigration, harassment, bigotry, and threats targeting groups in schools, communities, and society—all of which they termed simply “what’s going on.” Educators agreed but that feared “anti-hate” work now might be deemed partisan and so off-limits to educators. We explore the deep complexity of this worry—and we explore educators’ and students’ attempting to discuss current events of harm as simply part of educators’ jobs.
Black English and Mathematics Education: A Critical Look at Culturally Sustaining Pedagogy
Authors: Ortiz Nickolaus Alexander , Ruwe Dalitso
Published: March 2022

Background/Context:

The popularity surrounding culturally sustaining pedagogy (CSP) is notable primarily within language and literacy content areas but is also making its rounds in other disciplines. Because of its assumed objectivity and status, the mathematics discipline has long been a site of disrupting or perpetuating inequity and thus warrants our focus in thinking about how any pedagogical framework influences the success of Black students. We question whether the ideology undergirding CSP is beneficial to the ways in which we seek to educate Black mathematics learners through a philosophy of mathematics education that prioritizes language, and Black English more specifically.

Purpose/Objective:

The objective of this theoretical paper is to take a closer look at the shift in education research that has drawn attention away from asset-based frameworks, like culturally relevant pedagogy (CRP) or culturally responsive teaching, to focus on CSP. We seek to address how Black children may be positioned by the ideologies proposed in CSP, particularly in the way that culture, and Blackness in itself, is performed. Our goal is to highlight potential oversights in this framework and to discuss whether CSP represents a viable solution for Black students, particularly in regard to their mathematics education.

Research Design:

We elucidate the genesis of CSP and establish its roots as in tension with a Black ontology by tracing the theoretical origins of two scholars known best for its conceptualization.

Findings/Results:

Conceptualizers of CSP build on Ben Rampton’s work using the concept of “language crossing” and “styling the other,” to level critiques at CSP based on their studies of ritual insults in battle rap and use of African American Language in schools with multiethnic youth. Although it is true that people engage in language-crossing processes quite often, we question whether these actions of language crossing support claims about the eradication of cultural ownership, and at what cost Black people lose these aspects of culture.

Conclusions/Recommendations:

There are valuable lessons learned from Paris’s undertaking, but what Ladson-Billings provided in her theory of CRP was a more powerful conceptualization of improving education for Black students across multiple content areas because of the ways in which it forgoes the often conservative stance on language proffered in the theoretical ideologies of CSP. Discourse and language are inherently significant aspects of mathematics teaching and learning, and Black English is one possible entry into culturally relevant mathematics.
A tripartite model of federalism
Authors: Geenens Raf , De Schutter Helder
Published: March 2022

The classical account of federalism is bipartite. Federal systems are understood to have a dual nature: on the one hand, there is the central government, and on the other hand, there are the constituent units. We argue instead for a tripartite model of federalism. In this model, a third institutional pillar is added to federal systems. This third pillar deals exclusively with matters related to the institutional architecture of the system. We argue for tripartite federalism on three grounds: a tripartite structure would be better suited to accommodate political communities where citizens might currently feel misrecognized by the central government, it would provide a more efficient way to adjust the federal architecture and it would be able to do so in a more democratic manner. We conclude our article with a reflection on the distance between our ideal-typical tripartite model and actual reality.
Calling the news fake: The underlying claims about truth in the post-truth era
Authors: Hainscho Thomas
Published: March 2022

This article deals with the question about the conditions for someone to call something ‘fake news’. It examines cases in which something is called fake news and analyses these cases from an ordinary language point of view as speech acts. Doing so, the analysis explains fake news as the expression of a dissent. The analysis avoids problems of recent attempts to provide a definition of fake news and argues against the view that fake news belong to a so-called post-truth era. The conclusion of the article is that it is not possible to call something fake news without having unyielding convictions about the truth.
Vascular anomalies: diagnostic features and step-wise approach
Authors: Das Abanti , Goyal Ankur , Sangwan Ankit , Kumar Atin , Bhalla Ashu Seith , Kandasamy Devasenathipathy , Chauhan Shashank
Published: March 2022

The first part of this review article emphasized correct nomenclature, classification systems, and imaging algorithm of vascular anomalies. The second part of the review discusses the individual entities, highlighting the characteristic clinico-radiological features of the commonly encountered ones. A step-wise algorithmic approach is also proposed for the evaluation of a suspected case of vascular anomaly.
Epileptic manifestations, pathophysiology, and imaging characteristics of non-ketotic hyperglycaemia: a review of the literature and a report of two cases with irreversible cortical vision loss
Authors: Peddawad Dhanashree
Published: March 2022

The purpose of this review is to create more awareness regarding the epileptic manifestations of non-ketotic hyperglycaemia, which are not widely recognised, and to assist understanding of the pathophysiology involved. Given that type II diabetes is one of the common causes of morbidity worldwide, it is important to appreciate the various neurological manifestations of non-ketotic hyperglycaemia.

Here, I present two cases and review the existing literature. Both patients developed irreversible vision loss, which is a novel finding because only transient visual defects have previously been reported. The review includes a detailed discussion of the pathophysiology and characteristic magnetic resonance imaging (MRI) findings of patients with defects in cerebral lobar regions, which were associated with a variety of clinical manifestations. These manifestations can be ascribed to epileptic phenomena involving various parts of the cerebrum.

Hyperglycaemia can lead to the irreversible loss of vision. Early diagnosis and treatment on the basis of the clinical features and characteristic MRI findings are important to avoid an epilepsia partialis continua-like state and irreversible visual impairment.
Special case of a patient in the blast phase of chronic myeloid leukemia successfully treated with tocilizumab during critical SARS-CoV-2 infection
Authors: Bouchlarhem Amine , Es-saad Ounci , Haddar Leila , Lamzouri Oussama , Elaidouni Ghizlane , Mimouni Hamza , Bkiyar Houssam , Housni Brahim
Published: March 2022

The medical care of patients with hematological malignancies who develop coronavirus disease 2019 (COVID-19) has been a major challenge during the current pandemic. We herein describe a patient in the blast phase of chronic myeloid leukemia who was hospitalized for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient was successfully treated with tocilizumab, and intubation was avoided. The severity of SARS-CoV-2 infection is mostly related to a severe acute respiratory distress syndrome that develops secondary to cytokine release syndrome, and interleukin 6 is the main cytokine involved in cytokine release syndrome. Very few reports have described the use of tocilizumab in patients with hematologic malignancies who develop SARS-CoV-2 infection, although a few cases of patients with multiple myeloma have been reported. To our knowledge, however, this is the first report of a SARS-CoV-2–infected patient in the blast phase of chronic myeloid leukemia who had a favorable response to treatment with tocilizumab. The management of patients with hematological malignancies who become infected with SARS-CoV-2 is a major challenge for practitioners, necessitating more specific research in this direction.
Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems
Authors: Benedeto-Stojanov Daniela , Bjelaković Milica , Stojanov Dragan , Aleksovski Boris
Published: March 2022

Objective

We aimed to identify the clinical, biochemical, and endoscopic features associated with in-hospital mortality after acute upper gastrointestinal bleeding (AUGIB), focusing on cross-validation of the Glasgow-Blatchford score (GBS), full Rockall score (RS), and Cedars-Sinai Medical Center Predictive Index (CSMCPI) scoring systems.

Methods

Our prospective cross-sectional study included 156 patients with AUGIB. Several statistical approaches were used to assess the predictive accuracy of the scoring systems.

Results

All three scoring systems were able to accurately predict in-hospital mortality (area under the receiver operating characteristic curve [AUC] > 0.9); however, the multiple logistic model separated the presence of hemodynamic instability (state of shock) and the CSMCPI as the only significant predictive risk factors. In compliance with the overall results, the CSMCPI was consistently found to be superior to the other two systems (highest AUC, highest sensitivity and specificity, highest positive and negative predictive values, highest positive likelihood ratio, lowest negative likelihood ratio, and 1-unit increase in CSMCPI associated with 6.3 times higher odds of mortality), outperforming the GBS and full RS.

Conclusions

We suggest consideration of the CSMCPI as a readily available and reliable tool for accurately predicting in-hospital mortality after AUGIB, thus providing an essential backbone in clinical decision-making.
Effects of early rehabilitation on functional outcomes in patients after coronary artery bypass graft surgery: a randomized controlled trial
Authors: Han Peipei , Yu Hairui , Xie Fandi , Li Ming , Chen Xiaoyu , Yu Xing , Li Jing , Liu Xiangjing , Shao Bohan , Liu Jianjun , Liu Yaping , Liu Zhigang , Liu Xiaocheng , Guo Qi
Published: March 2022

Objective

This study evaluated the effectiveness, feasibility, and safety of early rehabilitation for patients after coronary artery bypass graft (CABG) surgery.

Methods

In a three-arm randomized controlled trial, patients who underwent CABG from January 2018 to June 2018 were randomly assigned to one of three groups: (i) usual care (UC group); (ii) UC + single general ward rehabilitation (SGR group); and (iii) UC + general ward rehabilitation and intensive care unit (ICU) rehabilitation (IGR group). The primary outcome was the Barthel Index scores.

Results

The Barthel Index score for UC (75.3 ± 12.1) was significantly lower than that of both SGR (86.2 ± 14.1) and IGR (89.1 ± 15.5). There was no significant difference in the Barthel Index scores between the SGR and IGR groups. Statistically significant differences were found in the length of ICU stay and post-operative hospital stay but not in post-operative pulmonary complications (PPC) or atrial fibrillation between the three groups.

Conclusion

Early rehabilitation implemented during ICU stay and on the general ward resulted in significant improvements in functional independence and could be a safe part of routine care post-CABG.
Fully Automated Algorithm for Light Pole Detection and Mapping in Rural Highway Environment Using Mobile Light Detection and Ranging Point Clouds
Authors: Gouda Maged , Shalkamy Amr , Li Xinyi , El-Basyouny Karim
Published: March 2022

The widespread use of light detection and ranging (LiDAR) data provides a promising source for the automatic detection and inventory of roadside assets. One of the essential elements in roadside furniture is light poles. There is limited research on the mapping of light poles using point-cloud data on rural highways. In this environment, the placement of light poles within roadside clear zones often poses a safety concern, as they are related to an increased risk of collisions. Only a limited number of studies have explored the relationship between light poles and safety because of the time-consuming and labor-intensive practices of collecting light pole assets data using traditional manual methods. This paper proposes an automated approach to mapping the locations of light poles. First, the scanning vehicle trajectory is extracted, smoothed, and then used to segment the point-cloud data into smaller overlapped batches of data. Several filters are applied to extract pole-like objects from the data. The segments are combined back together, and a density-based clustering algorithm is used to group the remaining points into clusters. A geometric filter is finally applied to extract light poles. The model is tested on 28 km of data on three rural highways in Alberta, Canada. The proposed algorithm is found to be accurate relative to previous studies, with average precision, recall, and F1 scores exceeding 98% for the test segments. The proposed work can assist in the automation of light pole inventory and road safety audits by transportation agencies.
Low-Cost Connected Work Zone Devices with Simplified Architecture
Authors: Vorhes Glenn , Noyce David
Published: March 2022

Connected work zone devices for safety, traffic monitoring, and performance evaluation are important assets in road construction projects. Challenges for implementation and connectivity present a barrier to their use and full realization of benefits. Typical connected work zone devices require dedicated cellular modems with monthly data charges for each device. The numerous connections or proprietary platforms hinder integration with a central advanced traffic management system. The described architecture presents considerable costs in data ownership and security concerns. This paper presents an alternative architecture wherein many inexpensive monitoring and incident detection devices read and process sensor data and communicate information by radio link to a single internet-connected hub that forwards information to a central server. The server then notifies client applications that support work zone monitoring and incident response. From a field test of the radio units in an active work zone, the effective transmission range was found to be 3 km. All devices in a work zone up to 6 km in length could be serviced by a single internet-connected base receiver station centered within it. Prototype devices were created using readily and inexpensively available sensors and microcontrollers. An example dashboard was created to show real-time work zone device and sensor information on a mapping interface. This project shows how use of connected work zone devices can be expanded at low cost using commonly available hardware and skills with a simplified architecture and encapsulated complexity from the standpoint of work zone management personnel while retaining data ownership.
Development of a Test Level 3 Approach Guardrail Transition to Steel Tube Bridge Rail
Authors: Rasmussen Jennifer D. , Rosenbaugh Scott K. , Faller Ronald K. , Bielenberg Robert W.
Published: March 2022

A Manual for Assessing Safety Hardware (MASH) Test Level 3 (TL-3) approach guardrail transition (AGT) was designed to connect the Midwest Guardrail System to a MASH TL-4 steel tube bridge rail, designated Steel Railing, Type IL-OH. The AGT connection consisted of a 34 in. tall thrie-beam AGT, HSS8 × 6 × ¼ transition tube rails that aligned with the lower and middle bridge rail tubes, and new connection hardware designed to prevent vehicle snag during impacts. The new AGT connection was evaluated using a combination of LS-DYNA finite element analysis software and full-scale crash testing in accordance with MASH TL-3 impact criteria. The critical impact points were selected using LS-DYNA for MASH test nos. 3-20 and 3-21. In test SBRTR-1, a 2,404 lb small car struck the AGT at a speed of 64.6 mph, an angle of 25.2°, and at a location 21.3 in. upstream from the last transition post. In test SBRTR-2, a 5,007 lb quad cab pickup truck struck the AGT at a speed of 62.7 mph, an angle of 24.9°, and at a location 15.9 in. upstream from the last transition post. The small car and pickup truck were both contained and redirected and the tests resulted in a successful evaluation according to MASH TL-3 safety performance criteria. Implementation guidance for the new AGT in various configurations is provided.
Arthroscopic Rotator Cuff Repair Augmentation With Autologous Microfragmented Lipoaspirate Tissue Is Safe and Effectively Improves Short-term Clinical and Functional Results: A Prospective Randomized Controlled Trial With 24-Month Follow-up
Authors: Randelli Pietro S. , Cucchi Davide , Fossati Chiara , Boerci Linda , Nocerino Elisabetta , Ambrogi Federico , Menon Alessandra
Published: March 2022

Background:

Autologous microfragmented lipoaspirate tissue has been recently introduced in orthopaedics as an easily available source of nonexpanded adipose-derived mesenchymal stem cells. Autologous microfragmented lipoaspirate tissue is expected to create a suitable microenvironment for tendon repair and regeneration. Rotator cuff tears show a high incidence of rerupture and represent an ideal target for nonexpanded mesenchymal stem cells.

Purpose:

To evaluate the safety and efficacy of autologous lipoaspirate tissue in arthroscopic rotator cuff repair.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

Consecutive patients referring to the investigation center for surgical treatment of magnetic resonance imaging–confirmed degenerative posterosuperior rotator cuff tears were assessed for eligibility. Those who were included were randomized to receive a single-row arthroscopic rotator cuff repair, followed by intraoperative injection of autologous microfragmented adipose tissue processed with an enzyme-free technology (treatment group) or not (control group). Clinical follow-up was conducted at 3, 6, 12, 18, and 24 months; at 18 months after surgery, magnetic resonance imaging of the operated shoulder was obtained to assess tendon integrity and rerupture rate.

Results:

An overall 177 patients were screened, and 44 (22 per group) completed the 24-month follow-up. A statistically significant difference in favor of the treatment group in terms of Constant-Murley score emerged at the primary endpoint at 6-month follow-up (mean ± SD; control group, 76.66 ± 10.77 points; treatment group, 82.78 ± 7.00 points; P = .0050). No significant differences in clinical outcome measures were encountered at any of the other follow-up points. No significant differences emerged between the groups in terms of rerupture rate, complication rate, and number of adverse events.

Conclusion:

This prospective randomized controlled trial demonstrated that the intraoperative injection of autologous microfragmented adipose tissue is safe and effective in improving short-term clinical and functional results after single-row arthroscopic rotator cuff repair.

Registration:

NCT02783352 (ClinicalTrials.gov identifier).
The Effects of Virtual Reality Infused Instruction on Elementary School Students’ English-Speaking Performance, Willingness to Communicate, and Learning Autonomy
Authors: Sally Wu Yu-Han , Alan Hung Shao-Ting
Published: March 2022

Virtual Reality (VR) has been used to enhance EFL learners’ speaking skills due to its immersive and interactive features. This study thus investigated the effects of VR on elementary school students' English-speaking performance and such affective variables as their willingness to communicate (WTC) and learning autonomy. Fifty-six EFL sixth graders participated in a tour in a museum. When learning and practicing dialogues and vocabulary related to the museum, students in the experimental group ( n = 28) were guided with Cospaces, a VR software package, with VR headsets, while their counterparts ( n = 28) were guided with pictures only. Instruments included a validated speaking test on (1) pronunciation, fluency, and intonation and (2) grammar and lexical use, adopted questionnaires on WTC and learning autonomy, and semi-structured interviews. Results demonstrated that VR significantly increased students’ grammar and lexical use in their speaking performance, but not their pronunciation, fluency and intonation, WTC, or learning autonomy.
Optimal HEV cooling system design through a computer-aided virtual development chain
Authors: Baysset Guillaume , Chessé Pascal , Chalet David , Lefebvre Alain
Published: March 2022

To reduce CO2 and pollutant emissions, automotive manufacturers tend to turn increasingly toward electrified powertrains solutions, such as Hybrid Vehicles (HEV). Model Based System Engineering (MBSE) and computational tools are useful to support the development of HEV systems. System architectures need to be investigated to find optimal solutions regarding multiple possible goals constraints (fuel consumption, CO2 emissions, etc.). In this study, a novel global optimization framework is proposed to enable an automated cooling system optimization. The methodology starts with a set of components, design rules, and system requirements to search and automatically generate all the admissible cooling system architectures. System architectures are generated by a concept of decision tree. The decision tree algorithm is coupled to a design rules database to avoid exploring solutions that do not satisfy system requirements. Hydraulic models are automatically built for each system architecture generated to optimize head losses and minimize the pump consumption. For the most interesting solutions, 3D piping geometrical data (lengths, angles, and curve radius) are automatically drawn by a 3D optimization tool. Piping geometrical data are integrated in GT-SUITE thermo-hydraulic simulation models automatically built to evaluate the most interesting cooling system architectures generated. The best candidates are identified by a multi-criteria decision-making strategy. A first case of conventional vehicle cooling system is studied. Results on the given example indicate that the difference of energy consumption on WLTC cycle between the best performing architecture and the worst one is 69%.
Final Results of Allogeneic Adipose Tissue–Derived Mesenchymal Stem Cells in Acute Ischemic Stroke (AMASCIS): A Phase II, Randomized, Double-Blind, Placebo-Controlled, Single-Center, Pilot Clinical Trial
Authors: de Celis-Ruiz Elena , Fuentes Blanca , Alonso de Leciñana María , Gutiérrez-Fernández María , Borobia Alberto M. , Gutiérrez-Zúñiga Raquel , Ruiz-Ares Gerardo , Otero-Ortega Laura , Laso-García Fernando , Gómez-de Frutos Mari Carmen , Díez-Tejedor Exuperio
Published: March 2022

Acute ischemic stroke is currently a major cause of disability despite improvement in recanalization therapies. Stem cells represent a promising innovative strategy focused on reduction of neurologic sequelae by enhancement of brain plasticity. We performed a phase IIa, randomized, double-blind, placebo-controlled, single-center, pilot clinical trial. Patients aged ≥60 years with moderate to severe stroke (National Institutes of Health Stroke Scale [NIHSS] 8–20) were randomized (1:1) to receive intravenous adipose tissue–derived mesenchymal stem cells (AD-MSCs) or placebo within the first 2 weeks of stroke onset. The primary outcome was safety, evaluating adverse events (AEs), neurologic and systemic complications, and tumor development. The secondary outcome evaluated treatment efficacy by measuring modified Rankin Scale (mRS), NIHSS, infarct size, and blood biomarkers. We report the final trial results after 24 months of follow-up. Recruitment began in December 2014 and stopped in December 2017 after 19 of 20 planned patients were included. Six patients did not receive study treatment: two due to technical issues and four for acquiring exclusion criteria after randomization. The final study sample was composed of 13 patients (4 receiving AD-MSCs and 9 placebo). One patient in the placebo group died within the first week after study treatment delivery due to sepsis. Two non-treatment-related serious AEs occurred in the AD-MSC group and nine in the placebo group. The total number of AEs and systemic or neurologic complications was similar between the study groups. No injection-related AEs were registered, nor tumor development. At 24 months of follow-up, patients in the AD-MSC group showed a nonsignificantly lower median NIHSS score (interquartile range, 3 [3–5.5] vs 7 [0–8]). Neither treatment group had differences in mRS scores throughout follow-up visits up to month 24. Therefore, intravenous treatment with AD-MSCs within the first 2 weeks from ischemic stroke was safe at 24 months of follow-up.
The Perceptual Magic of Binocular Rivalry
Authors: Blake Randolph
Published: March 2022

Binocular rivalry (BR) refers to the spontaneous, unpredictable fluctuations in visual awareness provoked by dissimilar stimulation of the two eyes. Reports of the phenomenon date back several centuries, but interest in BR has exploded in recent years as researchers in diverse disciplines—psychology, neuroscience, medicine, philosophy—have found reasons to study it. New ideas about BR have emerged, sparking controversies about its neural bases, which may be resolved thanks to new methodological developments. This essay provides a synopsis of some key empirically determined aspects of BR as well as an overview of theoretical developments in this field. Work published during the past decade or so is emphasized (and explicitly referenced); earlier key findings are mentioned and referenced in the annotated bibliography included in the Supplemental Material.
Experiences of Disease Adaptation in Patients With Heart Failure: A Qualitative Study
Authors: Zhao Qiuge , Zhang Jie , Ye Yi , Chen Cancan , Fan Xiuzhen
Published: March 2022

This study aimed to explore the experiences of adaptation in heart failure (HF) patients according to the Roy adaptation model. A qualitative study was conducted between December 2020 and March 2021 in China. A total of 21 patients with HF were recruited at of two general hospitals. Semi structured face-to-face interviews were conducted with each participant. NVivo 11 was used to encode the transcription and thematic analysis was preformed to analyze the transcripts. Eleven minor themes emerged from the data, namely unbalanced nutrition, inappropriate activities, unrestricted liquid intake, excessive sodium intake, worrying about the future, negative emotions, poor spiritual aspect, unable to fulfill social roles, forced to stop work, interpersonal alienation, and less communication with friends or family. Most participants with HF experienced poor disease adaptation. The themes that emerged offer a new perspective on the experiences of disease adaptation in patients with HF.
Supporting LGBTQ+ Students: A Focus Group Study with Junior High School Nurses
Authors: Laiti Minna , Pakarinen Anni , Parisod Heidi , Hayter Mark , Sariola Salla , Salanterä Sanna
Published: March 2022

LBGTQ+ students often miss the support and information they need in the school nursing, but little is known about junior high school (JHS) nurses’ work with LGBTQ+ students. 15 JHS nurses were interviewed in focus groups about their perceptions of supporting LGBTQ+ students. Four interconnected themes were identified with inductive thematic analysis: (1) JHS nurses’ professional identity and practice; (2) Recognition of sexual and gender diversity in school; (3) Family acceptance process; and (4) LGBTQ+ students as school nursing clients. JHS nurses self-identified as accepting professionals, but having limited skills, knowledge, and education needed in supporting LGBTQ+ students. Supporting LGBTQ+ students is a complex phenomenon, and to enhance JHS nurses’ competence in providing care for these students, sexual and gender diversity needs to be included in evidence-based nursing information sources, covered in nursing education, and the school needs to be secured as LGBTQ+ safe place.
Breast Implant Capsule-Associated Squamous Cell Carcinoma: Report of 2 Patients
Authors: Whaley Rumeal D. , Aldrees Rana , Dougherty Rae E. , Prieto Granada Carlos , Badve Sunil S. , Al Diffalha Sameer
Published: March 2022

Breast implant augmentation is a low-risk procedure with few life-threatening complications. Capsular contracture and rupture/leakage of the implant are the most common complications encountered. Malignant breast implant augmentation-associated lesions are rare, with anaplastic large cell lymphoma being the most common. Squamous cell carcinomas associated with breast implant augmentation are exceedingly rare, with only eight patients reported. Breast implant capsule-associated squamous cell carcinoma occurs in patients with long standing breast implant augmentations (>11 years). We report two additional patients with breast implant capsule-associated squamous cell carcinoma. Review of the literature reveals that invasion beyond the breast implant capsule into the adjacent tissue by the squamous cell carcinoma appears to have negative prognostic implications, and possibly warrants close clinical follow-up.
The Hospice Algorithm: Capitalizing on Death and Dying
Authors: Cabin William
Published: March 2022

There is extensive literature on the significance of financial incentives in the Hospice Medicare Benefit (HMB) and the growth of proprietary ownership of hospices in the United States. A literature review indicates a paucity of information on hospice nurses’ perceptions of the impact of the HMB’s financial structure on care planning and delivery decisions. This article presents background on the topic and an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 48 hospice nurses from 6 different hospices between December 1, 2018, and January 31, 2020, in the New York City metropolitan area. Six themes emerged from the interviews: finances are the guiding principle in care planning and service delivery decisions; appropriate patient selection allows hospices to maximize profit by maximizing length of stay (LOS) and minimizing service utilization; balancing patient care needs, cost, and LOS is a challenge; live discharge decisions save money, but can compromise care; the Interdisciplinary Team (IDT) is where most major decisions are made regarding patient care and finances; and money drives patient care decisions, regardless of ownership type.
Influence of exposure to microbial ligands, immunosuppressive drugs and chronic kidney disease on endogenous immunomodulatory gene expression in feline adipose-derived mesenchymal stem cells
Authors: Creamer Danielle G , Schmiedt Chad W , Bullington Anna Claire , Caster Courtney M , Schmiedt Jennifer M , Hurley David J , Berghaus Roy D
Published: March 2022

Objectives

Feline autologous mesenchymal stem cells (MSCs) show promise for immunomodulatory activity, but the functional impact of chronic kidney disease (CKD), concurrent immunosuppressive drug administration or infection is unknown. The study objectives compare endogenous cytokine gene expression (interleukin [IL]-6, IL-10, IL-12p40, IL-18 and transforming growth factor beta [TGF-β]) in adipose-derived MSCs (aMSCs) from cats with and without CKD, following in vitro exposure to microbial ligands and treatment with common immunosuppressive drugs.

Methods

Previously obtained aMSCs, phenotype CD44+, CD90+, CD105+ and MHCII–, from cats with (n = 6) and without (n = 6) CKD were compared via real-time PCR (RT-PCR) for immunomodulatory gene expression. aMSCs were exposed in vitro to lipopolysaccharide (LPS), peptidoglycan or polyinosinic:polycytidylic acid (Poly I:C), simulating bacterial or viral exposure, respectively. aMSCs were also exposed to ciclosporin, dexamethasone or methotrexate. Gene expression was measured using RT-PCR, and Cq was utilized after each run to calculate the delta cycle threshold.

Results

aMSCs isolated from healthy and CKD cats showed no significant differences in gene expression in the five measured cytokines. No significant changes in measured gene expression after drug treatment or microbial ligand stimulation were observed between normal or CKD affected cats. Proinflammatory genes (IL-6, IL-12p40 and IL-18) showed altered expression in aMSCs from both groups when compared with the same cells in standard culture after exposure to methotrexate. Poly I:C altered IL-6 and TGF-β gene expression in aMSCs from both healthy and CKD cats when compared with the same cells in standard culture.

Conclusions and relevance

The five genes tested showed no statistical differences between aMSCs from healthy or CKD cats. There was altered cytokine gene expression between the control and treatment groups of both healthy and CKD cats suggesting feline aMSCs have altered function with immunosuppressive treatment or microbial ligand exposure. Although the current clinical relevance of this pilot study comparing brief exposure to select agents in vitro in aMSCs from a small number of cats is unknown, the study highlights a need for continued investigation into the effects of disease and concurrent therapies on use of cell-based therapies in feline patients.
A Proactive, Systematic Approach to Building the Capacity of Technical Assistance Providers
Authors: Kenworthy Tara , Domlyn Ariel , Scott Victoria C. , Schwartz Randy , Wandersman Abraham
Published: March 2022

Technical assistance (TA) is a major capacity building strategy used by the government sector to promote health outcomes in the United States. However, there is minimal literature about how to develop TA provider capacities. This article describes a systematic and proactive approach for developing TA provider capacity, referred to as Technical Assistance for Technical Assistance Providers (TAFTAP), which draws on three implementation science frameworks (Interactive Systems Framework for Dissemination and Implementation, Getting To Outcomes, and R = MC2). We present an application of TAFTAP within a federal agency providing a readiness-informed TA approach to health departments of states, territories, and tribal areas implementing comprehensive tobacco prevention control programs. Pilot data suggest that TAFTAP is a promising approach for improving the quality of TA delivery. At the end of the 2-year project period, TAFTAP recipients provided generally positive qualitative feedback about the support they received. They chose to sustain the readiness-informed TA by incorporating it into a future funding announcement. Downstream state-level TA grantee recipients reported positive outcomes (e.g., accelerated progress, enjoying more one-on-one time with TA providers) from receiving the TA innovation from TAFTAP recipients. We suggest that funding agencies and training and TA centers consider this approach to bolster the capacity and motivation of TA providers for downstream benefit to health and human services staff and their clients. Practical steps for employing TAFTAP to advance health outcomes are included in this article.
Factors Affecting Functional Recovery After Volar Locking Plate Fixation for Distal Radius Fractures
Authors: Hosokawa Takafumi , Tajika Tsuyoshi , Suto Morimichi , Chikuda Hirotaka
Published: March 2022

Background:

There is still no certainty about factors delaying functional recovery after surgery, although volar locking plate (VLP) fixation is the mainstay of treatment for distal radius fractures (DRFs), and several good postoperative recoveries have been reported. The purpose of this study was to investigate factors affecting functional recovery after VLP fixation for DRF.

Methods:

The subjects included 104 patients (84 females, 20 males, mean age: 63.2 ± 13.8 years) treated with VLP fixation for DRF, who could be followed for 1 year. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, grip strength, and range of motion of the wrist joint were measured at 3, 6, and 12 months postoperatively, and the primary outcome was the QuickDASH score. A multiple regression analysis adjusted for age and sex was used to analyze factors affecting functional recovery at 12 months.

Results:

A multiple regression analysis showed that the factors that significantly influenced the QuickDASH score at 1 year postoperatively were the grip strength ratio to the uninjured side, dominancy of the injured hand, and postoperative ulnar variance, in descending order of involvement. Trauma energy, history of diabetes, fracture type, complications, and range of motion were not included in the model.

Conclusions:

Smaller grip strength, dominant-hand injury, and larger postoperative ulnar variance significantly worsened the QuickDASH score at 1 year postoperatively. In order to achieve satisfactory functional recovery at 1 year after surgery, we confirmed that it is important to surgically achieve smaller postoperative ulnar variance and increase grip strength.
Patient characteristics predicting prolonged length of hospital stay following robotic-assisted radical prostatectomy
Authors: Hajj Albert El , Labban Muhieddine , Ploussard Guillaume , Zarka Jabra , Abou Heidar Nassib , Mailhac Aurelie , Tamim Hani
Published: March 2022

Objective:

The objective of this study is to determine the preoperative patient characteristics predicting prolonged length of hospital stay (pLOS) following robotic-assisted radical prostatectomy (RARP).

Methods:

The National Surgical Quality Improvement Program (NSQIP) database was used to select patients who underwent RARP without other concomitant surgeries between 2008 and 2016. Patients’ demographics, comorbidities, and laboratory markers were collected to evaluate their role in predicting pLOS. The pLOS was defined as length of stay (LOS) >2 days. A multinomial logistic regression was constructed adjusting for postoperative surgical complications to assess for the predictors of pLOS.

Results:

We obtained data for 31,253 patients of which 20,774 (66.5%) patients stayed ⩽1 day, 6993 (22.4%) patients stayed for 2 days, and 3486 (11.2%) patients stayed for >2 days. Demographic variables – including body mass index (BMI) <18.5: odds ratio (OR) = 2.8, 95% confidence interval (CI) = [1.7–4.8]; smoking: OR = 1.2, 95% CI = [1.1–1.4]; and dependent functional status: OR = 3.1, 95% CI = [1.6–6.0] – were predictors of pLOS. Comorbidities – such as heart failure: OR = 4.6, 95% CI = [2.0–10.8]; being dialysis dependent: OR = 2.7, 95% CI = [1.4–5.0]; and predisposition to bleeding: OR = 2.0, 95% CI =  [1.5–2.7] – were the strongest predictors of extended hospitalization. In addition, pLOS was more likely to be associated with postoperative bleeding, renal, or pulmonary complications.

Conclusion:

Preoperative patient characteristics and comorbidities can predict pLOS. These findings can be used preoperatively for risk assessment and patient counseling.