bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial neutrophil and lymphocyte ratio as a predictor of mortality and ICU admission after major trauma
Authors: Qiu Yunfei , Fitzgerald Mark , Mitra Biswadev
Published: October 2021

Introduction

The neutrophil-to-lymphocyte ratio (NLR) has been proposed as a marker of systemic inflammation in major trauma patients that is associated with in-hospital mortality. We aimed to determine the discriminative ability of initial NLR as a predictor of outcomes following major trauma.

Methods

This was a registry-based cohort study involving all major trauma patients meeting criteria for inclusion into the Alfred Health Trauma Registry who presented directly from the scene of injury over a 24-month period (January 2018 to December 2019). The initial NLR was calculated for each patient and was compared against the Shock Index (SI), lactate and Revised Trauma Score (RTS). Outcomes observed were mortality at hospital discharge and intensive care unit (ICU) admission. We assessed the predictive capacity of each test using the receiver operating characteristic (ROC) curve and performed area under the ROC curve (AUROC) analysis to compare their performance.

Results

Data were extracted for 1687 major trauma patients, of which 72% were male, the median age was 49 years (IQR 31–68) and most (90%) of patients presented after a blunt mechanism of injury. In-hospital mortality occurred in 165 (9.77%) patients, and 725 (42.92%) patients required ICU admission. The median NLR was 6.84 (IQR 3.89–11.52). Initial NLR performed poorly with an AUROC of 0.46 (95% confidence interval (CI): 0.40–0.52) for prediction of mortality and AUROC of 0.53 (95% CI: 0.50–0.56) for prediction of ICU admission. The AUROCs of initial NLR for both mortality at hospital discharge and ICU admission were significantly lower than SI, lactate and RTS.

Conclusion

Initial NLR was not predictive of outcomes in major trauma. NLR at other time-points may provide better predictive capacity for outcomes.
Drawing in-situ: Matters of care and representation in daily life with dementia
Authors: Cleeve Helena , Borell Lena , Rosenberg Lena
Published: October 2021

This article brings methodological insight into in-situ drawings as representations of daily life with dementia. As part of ethnographic fieldwork in dementia care units in a nursing home, drawings were made on site by a researcher. We suggest that the ambiguity of in-situ drawings, and the ensuing possibilities to disambiguate them, is valuable. Inspired by Asdal and Moser’s (2012) concept of “contexting,” we experimented with arranging the drawings with fieldnotes, discussing them with staff members, as well as with configuring multiple drawings and fieldnotes in sequences. This led to reflexive engagements with the drawings, creating space for discussing concerns in research practices and care practices. Switching between different forms of contexting produced tensions, revealing that what was cared for through the practices of researchers, staff members, and residents, diverged. In this way, we argue that contexting in-situ drawings may intervene in ways of knowing, caring for, and living with dementia.
‘If I could afford an avocado every day’: Income differences and ethical food consumption in a world of abundance
Authors: Salonen Anna Sofia
Published: October 2021

This study explores how ethical food consumption is framed in the accounts of ordinary people living in affluent societies, with a particular focus on income differences. Research on ethical consumption often associates ‘ethical’ with the consumption of certain predefined products. This study leaves the question of the content of ethical consumption open for empirical investigation. Further, instead of focusing only on the moment of purchasing, this study considers how people with different income levels relate to both food consumption and waste. The analysis draws from qualitative interviews with 60 people living in Canada and Finland. The analysis identified the techniques, subjects and norms through which the question ethical food consumption is posed by the informants and how they framed these issues with regard to income. The findings underline that ethical consumption is a socially constructed, contested and even internally contradictory discourse. Differences in income do not only mean differences in the role that money plays in food choices but also in what kind of consumption people consider worth pursuing. Further, differences in income dictate differences in how people are morally positioned vis-à-vis abundance. For people with a higher level of income, moral blame is asserted on wasteful consumption habits. For the people with a low income, in turn, it is ethically condemnable to refuse to rejoice at the abundance around us. The findings indicate that even in a society where the rhetoric of choice is prominent both as a right and as an obligation by which people ought to display ethical agency, the ethics of choice is tied to the resources available for consumption. People with a severely low income occasionally enjoy the trickling down of abundant treats and surprises. However, for them, occasional indulgence causes not only pleasure but also trouble.
Static strain-based identification of extensive damages in thin-walled structures
Authors: Silionis Nicholas E. , Anyfantis Konstantinos N.
Published: October 2021

Interest has been expressed during the past few years toward incorporating structural health monitoring (SHM) systems in ship hull structures for detecting damages that cause significant load-carrying reductions and subsequent load redistributions. The guiding principle of the damage identification strategy considered in this work is based upon measuring, through a limited number of sensors, the static strain redistributions caused by an extensive damage. The problem is tackled as a statistical pattern recognition one, and therefore, methods sourcing from machine learning (ML) are applied. The SHM strategy is both virtually and experimentally applied to a thin-walled prismatic geometry that represents an idealized hull form solely subjected to principal bending stresses (sagging/hogging). Damage modes causing extensive stress redistribution, are abstractly represented by a circular discontinuity. The damage identification problem is treated in a hierarchical order, initialized by damage detection and moving to an increasingly more localized prediction of the damage location. Training datasets for the ML tools are generated from numerical finite element simulations. Measurement uncertainty is propagated in the theoretical strains by information inferred from experimental data. Two different sensor architectures were assessed. An experimental programme is performed for testing the accuracy of the proposed damage identification strategy, yielding promising results and providing valuable insights.
Therapeutically leveraging GABAA receptors in cancer
Authors: Bhattacharya Debanjan , Gawali Vaibhavkumar S , Kallay Laura , Toukam Donatien K , Koehler Abigail , Stambrook Peter , Krummel Daniel Pomeranz , Sengupta Soma
Published: October 2021

γ-aminobutyric acid or GABA is an amino acid that functionally acts as a neurotransmitter and is critical to neurotransmission. GABA is also a metabolite in the Krebs cycle. It is therefore unsurprising that GABA and its receptors are also present outside of the central nervous system, including in immune cells. This observation suggests that GABAergic signaling impacts events beyond brain function and possibly human health beyond neurological disorders. Indeed, GABA receptor subunits are expressed in pathological disease states, including in disparate cancers. The role that GABA and its receptors may play in cancer development and progression remains unclear. If, however, those cancers have functional GABA receptors that participate in GABAergic signaling, it raises an important question whether these signaling pathways might be targetable for therapeutic benefit. Herein we summarize the effects of modulating Type-A GABA receptor signaling in various cancers and highlight how Type-A GABA receptors could emerge as a novel therapeutic target in cancer.
Power system parameter matching and particle swarm optimization of battery underground loader
Authors: Yi Sheng-Xian , Yang Zhong-Jiong , Zhou Li-Qiang , Liu Xiao-Yong
Published: October 2021

As part of the ongoing research into new energy technology, battery-powered underground loaders have emerged. However, there have been few studies on power system optimization and matching for these battery underground loaders to date. This paper, which takes a 3-m3 battery underground loader as its research object, determines the loader’s optimal operating point through study of the power response characteristics of the loader’s motor under various working conditions. The effects of different power batteries on the working conditions are analyzed, and the loader’s component parameters are matched. Additionally, an optimization model of the driving system of the battery underground loader is constructed. On the basis of the driving operation characteristics of the loader, the particle swarm optimization algorithm is proposed to optimize the operating conditions of the loader’s driving motor. The results show that the transmission ratio is reduced after optimization. The single-cycle energy consumption is reduced by approximately 1.98% and the number of cycles in the health status of the power battery’s state-of-charge increases by approximately 1.91%, which verifies the feasibility of use of the particle swarm algorithm in the loader optimization problem. This work can serve as a reference for related theoretical research on underground loaders.
How effective is cyanoacrylate closure in small saphenous vein insufficiency? A single center experience
Authors: Yiğit Görkem
Published: October 2021

Objectives

The present study was aimed to evaluate the efficacy and early outcomes of n-butyl cyanoacrylate (NBCA) ablation in small saphenous vein (SSV) insufficiency.

Methods

In this single-center, retrospective, single-arm study, NBCA ablation was performed in 80 patients with SSV insufficiency between September 2018 and May 2020. Primary outcomes (anatomic success rate and occlusion rate) and secondary outcomes (VCSS and AVVQ scores) of the patients were analyzed.

Results

No technical failure and device-related complications were encountered. Anatomic success rate was 100% after procedures. Each treated SSV was occluded on colored Doppler ultrasonography immediately after the procedure, and all veins remained occluded at 2 weeks after the procedure. Partial recanalization was observed in five patients at 12-month follow-up. Kaplan–Meier analysis revealed an occlusion rates at 6 months and 12 months follow-up were 97.5% and 93.75%, respectively. The mean pretreatment VCSS (4.72 ± 2.04) decreased to 1.61 ± 0.93, 0.87 ± 0.58, and 0.73 ± 0.52 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The mean pretreatment AVVQ score (11.92 ± 2.23) decreased to 8.2 ± 1.89, 4.2 ± 1.16, and 3.32 ± 1.19 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The Clinical, Etiologic, Anatomic, and Pathophysiology clinical classification at 12 months demonstrated a significant reduction in disease severity compared with preoperative values ( p < .001). There was no mortality and major adverse events including anaphylaxis and pulmonary thromboembolism (PTE) related to procedure after follow-ups. Moreover, there were no symptoms or signs of any sural nerve injury and no cases of skin necrosis, infection, or hyperpigmentation. In addition, no hematoma, deep venous thrombosis, and hypersensitivity reactions were observed. Phlebitis-like abnormal reaction was observed in three patients (3.8%).

Conclusions

In conclusion, in patients with SSV insufficiency, NBCA ablation with VenaBlock® system appears to be an effective and reliable treatment method. At the 12-month follow-up, the NBCA of SSVs showed a low recanalization rate and had a satisfactory improvement on the VCSS and AVVQ scores.
Pharmacists practising in family medicine groups: An evaluation 2 years after experiencing a virtual community of practice
Authors: Guénette Line , Maheu Anne , Vanier Marie-Claude , Dugré Nicolas , Rouleau Léonie , Roy-Petit Jacynthe , Lalonde Lyne
Published: October 2021

Background:

In 2018, a virtual community of practice (CoP) for pharmacists working in family medicine groups (FMGs) in Quebec province was developed. The aim of this CoP—called Réseau Québécois des Pharmaciens GMF (RQP GMF)—was to foster best practices by supporting FMG pharmacists. This study assesses the processes and outcomes of this CoP 2 years after its creation.

Methods:

We performed a cross-sectional web-based study from March to May 2020. All FMG pharmacists who were registered as members of the RQP GMF ( n = 326) were sent an invitation via a newsletter. The link to the questionnaire was also publicized in the CoP Facebook group. The questionnaire comprised a 38-item validated instrument assessing 8 dimensions of the CoP. A descriptive analysis was performed.

Results:

A total of 112 FMG pharmacists (34.4%) completed the questionnaire. Respondents agreed that the RQP GMF was a joint enterprise (mean score, 4.18/5), that members shared their knowledge (mean score, 3.94/5) and engaged mutually (mean score, 3.50/5) and that the RQP GMF provided support (mean score, 3.92/5) and capacity building (mean score, 4.01/5). In general, they were satisfied with the implementation process (mean score, 3.68/5) and with activities proposed (mean score, 3.79/5). A lower proportion of respondents agreed that their participation in the RQP GMF generated external impacts, which led to a smaller mean score (3.37/5) for this dimension.

Conclusion:

The RQP GMF, one of the first communities of practice for pharmacists practising in family medicine groups, attained most of the objectives initially intended by the CoP. These results will facilitate the adaptation of processes and activities to better fulfil members’ needs. Can Pharm J (Ott) 2021;154:xx-xx.
Post-heroic heroism: Embedded masculinities in media framing of Australian business leadership
Authors: Khan Maria Hameed , Williams Jannine , Williams Penny , French Erica
Published: October 2021

Over time, the relevance of heroic leadership to contemporary corporate environments has been questioned, with media coverage arguing there is a need for alternate, post-heroic forms of leadership. Using a multimodal media analysis, we show how two leading Australian business magazines frame leadership in response to this debate, identifying three distinct frames of leadership. The first frame emphasizes masculinized heroic leadership as normative which reinforces gendered assumptions through differential framing of men and women’s leadership. We then argue media (re)frames post-heroic leadership as a variation of heroic leadership through two further frames; by subsuming feminized attributes into the repertoire of heroic leadership as ‘softer masculinities’ and through the construction of a masculinized post-heroic hero, both applied exclusively to men’s leadership. This (re)framing of heroic leadership has significant implications for perceptions of credible contemporary business leadership.
Last Words of the Condemned: Christian-Humanist Rhetoric in the American Abolition Debate
Authors: Mattes Ari
Published: October 2021

Through the interrogation of recent analyses of the last words of people executed in the USA, this article critiques the popular abolitionist rhetoric that interprets last words in terms of evidence of sin and redemption. In reading the execution event in this way, the article suggests, these texts inadvertently celebrate and affirm the act of execution. Drawing on Gil Anidjar’s Blood (2014), the article suggests that this duality is in consonance with the history of modern Christianity as epitomised in the bonding of two events: the Eucharist and the Inquisition.
The synthesis and evaluation of the antitumor and antibacterial activity of two novel oxovanadium complexes
Authors: Wang Jing , Huang Bin , Wang Liqiang , Jiang Guijjuan , Cheng Jianxin , Xiong Yanshi , Wang Jintao , Liao Xiangwen
Published: October 2021

Two novel oxovanadium(IV) complexes ([VO(hntdtsc)(BPIP)] and [VO(hntdtsc)(MOPIP)] (hntdtsc = 2-hydroxy-1-naphthaldehydethiosemicarbazone, BPIP = 2-(4-bromophenyl)-imidazo[4,5- f]-1,10-phenanthroline, MOPIP = 2-(4-methoxyphenyl)-imidazo[4,5- f]1,10-phenanthroline), are synthesized and characterized. Subsequently, the Methyl Thiazolyl Tetrazolium (MTT) assay is used to investigate the antitumor activity of the ligand and two complexes in vitro.The results indicate that both complexes could significantly inhibit selected tumor cells (SH-SY5Y, MCF-7, and SK-N-SH). In addition, the antibacterial activity of VO(hntdtsc)(BPIP) against Staphylococcus aureus is further investigated. Interestingly, VO(hntdtsc)(BPIP) can efficiently attenuate S. aureus growth and abrogate α-hemolysin secretion and biofilm formation. The plasmid DNA cleavage activity of both complexes is also investigated. The results suggest that supercoiled plasmid DNA is efficiently cleaved after treatment with each complex, which might contribute to the biological activity of these oxovanadium(IV) complexes.
Analysis of “Multicenter Evaluation Study Comparing a New Factory-Calibrated Real-Time Continuous Glucose Monitoring System to Existing Flash Glucose Monitoring System”
Authors: Peyser Thomas
Published: October 2021

In an article in the Journal of Diabetes Science and Technology, Ji et al. report on the accuracy of a new factory calibrated continuous glucose monitoring system, the AiDEX CGM (Microtech Medical Company, Ltd., Hangzhou, China). This is the first report from a new manufacturer of a highly accurate factory calibrated CGM. The authors report that the accuracy of the AiDEX CGM is comparable to previous results from Abbott Diabetes Care and Dexcom. However, the study protocol was significantly different from previous studies. This study is the first of numerous studies likely from other manufacturers of CGM technology. It raises the question of how to evaluate sensor performance in the coming era of mass adoption of CGM and increased use of automated insulin delivery systems.
Association Between Self-Reported Kinesiophobia and Single-Leg Hop for Distance in Patients With ACL Reconstruction: A Systematic Review
Authors: Bakhsh Hadeel R. , Metikala Sreenivasulu , Billy Gregory G. , Vairo Giampietro L.
Published: October 2021

Context:

Psychological readiness is a significant factor in determining successful return to sport (RTS) and physical activities after anterior cruciate ligament (ACL) reconstruction. Knowing the influence of kinesiophobia on physical tests that are used to guide RTS, such as the single-leg hop for distance (SLHD), would contribute to advancing clinical practice.

Objective:

To investigate the association between kinesiophobia and SLHD performance in patients after ACL reconstruction.

Data Sources:

A comprehensive search strategy entailed surveying 6 databases for relevant articles published from January 2009 to March 2021.

Study Selection:

Articles published in English that were a minimum of level 3 evidence describing kinesiophobia, as measured by the Tampa Scale for Kinesiophobia, and related to SLHD performance in patients after ACL reconstruction.

Study Design:

Systematic review.

Level of Evidence:

Level 3.

Data Extraction:

Study characteristics, sample population demographics, instrument(s), or approach(s) used to assess kinesiophobia and SLHD performance, and corresponding results.

Results:

A total of 152 potential studies were identified, 106 studies underwent screening, 40 were reviewed in full, and 7 studies were included. Meta-analysis could not be performed because of differences in experimental design among studies and instances of missing outcome data. Currently, moderate evidence indicates patients with ACL reconstruction that exhibit less kinesiophobia perform better on the SLHD test.

Conclusion:

The outcomes of this review propose that sports health practitioners consider the influence of kinesiophobia on SLHD performance as a criterion for RTS and physical activities in patients after ACL reconstruction. Higher quality studies are necessary to establish the extent of association between these variables.
Effects of Training Frequency During a 6-Month Neuromuscular Training Intervention on Movement Competency, Strength, and Power in Male Youth
Authors: Lloyd Rhodri S. , Dobbs Ian J. , Wong Megan A. , Moore Isabel S. , Oliver Jon L.
Published: October 2021

Background:

Youth populations benefit from neuromuscular training; however, the extent to which training frequency, baseline fitness, and maturity status moderate the response to long-term neuromuscular training in male youth remains unclear.

Hypothesis:

Twice-weekly training (G2x) would induce larger improvements in movement competency and strength and power kinetics compared with once-weekly training (G1x). Maturity status and baseline fitness would also moderate the training response in strength and power kinetics.

Study Design:

Nonrandomized, repeated-measures design.

Level of Evidence:

Level 3

Methods:

Ninety-five male athletes of varying maturity status (pre– or post–peak height velocity) were divided into G2x, G1x, or control (CON) groups. Training groups received G2x or G1x for 28 weeks. Back squat assessment (BSA) movement competency and isometric mid-thigh pull (IMTP), squat jump (SJ), and countermovement jump (CMJ) kinetics were measured pre- and postintervention.

Results:

The G2x achieved significantly greater adaptations in BSA total score, IMTP allometrically scaled peak force (PFallo), IMTP peak rate-of-force development (PRFD), SJ PFallo and PRFD compared with G1x and CON ( P < 0.05; d = 0.3-0.9). Baseline fitness, training frequency and maturity status were significant predictors of IMTP PFallo ( R2 = 27.5%) and PRFD ( R2 = 42.9%), while a combination of training frequency and baseline fitness explained a small amount of variance in SJ PFallo ( R2 = 12.2%) and SJ PRFD ( R2 = 6.5%). There were no significant predictors of CMJ kinetics.

Conclusion:

G2x achieved significantly larger improvements in movement competency, isometric strength and concentric jump variables compared with G1x, with the training response greater in those youth with lower baseline fitness and more advanced maturity status.

Clinical Relevance:

Exposure to neuromuscular training twice-weekly elicits a greater response than G1x in young male athletes. Practitioners should take maturity status, training frequency, and baseline fitness levels of young male athletes into account when interpreting testing data, as these variables appear to moderate training responsiveness.
Effect of Exercise Training on 1,25(OH)2D Levels: The FIT-AGEING Randomized Controlled Trial
Authors: De-la-O Alejandro , Jurado-Fasoli Lucas , Castillo Manuel J. , Gutiérrez Ángel , Amaro-Gahete Francisco J.
Published: October 2021

Background:

Vitamin D deficiency is currently endemic worldwide and is considered as an important factor in the development of several chronic conditions. Physical exercise has been postulated as an auspicious strategy to counteract age-related disorders preventing premature mortality. However, the effects of chronic exercise training on 1,25-dihydroxyvitamin D [1,25(OH)2D] is unclear. This 12-week randomized controlled trial aimed to investigate the effects of different training modalities on 1,25(OH)2D in healthy sedentary adults.

Hypothesis:

Exercise training will increase 1,25(OH)2D in the study cohort.

Study Design:

Randomized controlled clinical trial.

Level of Evidence:

Level 1.

Methods:

A total of 89 healthy sedentary adults (53% women; 53.5 ± 4.9 years old) were enrolled in the FIT-AGEING study. The participants were randomized to (1) a control group (no exercise), (2) physical activity recommendation from the World Health Organization (PAR group), (3) high-intensity interval training (HIIT group), and (4) HIIT adding whole-body electromyostimulation training (HIIT + EMS). 1,25(OH)2D plasma levels were measured using a DiaSorin Liaison immunochemiluminometric analyzer.

Results:

Compared with the control group, 1,25(OH)2D increased in PAR (Δ = 10.99 ± 3.44 pg/mL; P = 0.01), HIIT (Δ = 11.63 ± 3.51 pg/mL; P = 0.009), and HIIT + EMS groups (Δ = 14.01 ± 3.59 pg/mL; P = 0.001) without statistical differences between them (all Ps > 0.1).

Conclusion:

In summary, the results show that a 12-week exercise intervention produced an increment of 1,25(OH)2D independently of age, sex, and exercise modality in healthy sedentary adults.

Clinical Relevance:

The implementation of physical exercise could be considered a strategy not only aiming to reverse the seasonal decrease of 1,25(OH)2D in winter explained by low sunlight exposure but also for obtaining subsequent increases of this hormone even in these a priori adverse conditions.
Investigating the Role of Low-FODMAP Diet in Improving Gastrointestinal Symptoms in Irritable Bowel Syndrome
Authors: Yang Jiahong , Lin Gina Ziruo , Li Xiao Ying , Wang Yu Tien , Loh Yet Hua
Published: October 2021

Background

A low–fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet (LFD) appeared to improve gastrointestinal symptoms in patients with Irritable Bowel Syndrome (IBS). However, evidence of its efficacy in Asia remains scarce.

Objectives

This study aims to investigate the clinical effectiveness of LFD intervention among Asian IBS patients and barriers to its adherence.

Methods

Patients with IBS who were instructed to follow LFD by dietitians at a tertiary hospital in Singapore between July 2013 and December 2014 were retrospectively reviewed. Severity scores of 19 gastrointestinal symptoms were recorded using an 11-point rating scale (0 = “no symptoms,” 10 = “extremely severe”) pre- and post-LFD intervention. Adherence to LFD was assessed based on patients’ diet history and a high-FODMAP food checklist.

Results

Eighty-two patients with a median follow-up of 5.8 weeks were investigated. The LFD adherence rate was 61.0% ( n = 50). Overall, statistically significant improvement was observed in 14 of 19 gastrointestinal symptoms (median difference = −2.0 to −0.5, p < .05). The proportion of patients who had improvement in 10 individual symptoms (defined as ≥1 point reduction in symptom severity rating) was significantly higher in LFD-adherent patients (67.5%–82.4%) than that of the non-adherent group (27.8%–55.0%). Reasons reported for non-adherence included “limited availability of low-FODMAP alternatives” ( n = 9), “limited understanding of LFD” ( n = 7), and “perceived lack of benefit” ( n = 4).

Conclusions

LFD intervention improved gastrointestinal symptoms in a cohort of Asian IBS patients. Limited access to low-FODMAP alternatives was the main barrier to adherence.
Circulating microRNA-194 levels in Chinese patients with diabetic kidney disease: a case–control study
Authors: Ma Ning , Xu Ning , Yin Dong , Zheng Ping , Liu Weiwei , Wang Guofeng , Hui Yuan , Zhang Jiping , Han Guanjun , Yang Chuanhui , Chen Yiting , Cheng Xingbo , Cheng Ming
Published: October 2021

Objective:

MicroRNAs (miRNAs) regulate gene expression and are involved in diabetic kidney disease (DKD) pathogenesis. We investigated circulating miRNA-194 levels as a biomarker of DKD prevalence and incidence, and the relationship between miRNA-194 and CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP).

Methods:

We recruited 136 type-2 diabetes mellitus (T2DM) patients at the First People’s Hospital of Lianyungang and 127 healthy individuals. Circulating miRNA-194 and CHOP levels were measured using quantitative reverse transcription qRT-PCR and enzyme-linked immunosorbent assay (ELISA), respectively. Anthropometric and biochemistry measurements were also made.

Results:

T2DM patients showed higher circulating miRNA-194 ( p = 0.029) and lower circulating CHOP ( p < 0.001) levels than controls. Circulating miRNA-194 levels were significantly higher in T2DM patients with a microalbumin/creatinine ratio (UmALB/Cr) ⩾ 300 mg/g ( p < 0.001). In addition, there were significant intergroup differences in the circulating CHOP concentrations ( p = 0.005). Bivariate analysis revealed that circulating miR-194 levels were negatively correlated with alpha-fetoprotein and CHOP levels ( r = −0.222, −0.301; p = 0.018, 0.001, respectively), but positively correlated with fasting glucose, UmALB/Cr, Cr, Cystatin C, quantitative insulin check index (QUICKI) ( r = 0.193, 0.446, 0.260, 0.339, and 0.250, respectively; p = 0.036, <0.001, 0.005, <0.001, and 0.006, respectively), particularly UmALB/Cr and Cystatin C ( p < 0.001). Logistic regression analysis after adjusting for covariates associated with UmALB/Cr identified duration of T2DM, systolic blood pressure, Cr, estimated glomerular filtration rate, and waist circumference as independent factors associated with T2DM patients with UmALB/Cr > 300 ( p = 0.030, 0.013, <0.001, <0.001, and 0.031, respectively).

Conclusion:

Circulating miRNA-194 levels could be a novel biomarker for DKD.
Exploring the drivers of malnutrition in West Africa from health and social science perspectives: A comparative methodological review
Authors: Salm Leah , Verstraeten Roosmarijn , Nisbett Nicholas , Booth Andrew
Published: October 2021

West Africa has a high burden of malnutrition and the drivers are often complex, highly context-specific, and cut across individual, social, political and environmental domains. Public health research most often considers immediate individual health and diet drivers, at the expense of wider considerations that may fall outside of a health agenda. The objective of this systematic mapping review is to map the broad drivers of malnutrition in West Africa, from public health and social science perspectives, and to evaluate the additional value of an interdisciplinary approach. Evidence was gathered from one public health (MEDLINE) and one social science (International Bibliography of Social Science) database using a detailed search syntax tailored to each disciplinary configuration. Literature was screened against pre-determined eligibility criteria and extracted from abstracts. Studies published in English or French between January 2010 and April 2018 were considered for inclusion. Driver categories (immediate, underlying and basic drivers) were coded against the UNICEF conceptual framework of malnutrition. A total of 358 studies were included; 237 were retrieved from the public health database and 124 from the social science database, 3 studies were included in both. The public health and social science literature document different drivers, with MEDLINE most often reporting immediate drivers of malnutrition and the International Bibliography of Social Science database reporting underlying and basic drivers. The combined literature offers more balanced representation across categories. An interdisciplinary approach proved successful in achieving complementarity in search results while upholding rigorous methods. We recommend that interdisciplinary approaches are utilised to bridge recognised gaps between defined disciplines.
English Language Classroom Anxiety and Enjoyment in Chinese Young Learners
Authors: Liu Meihua , Hong Min
Published: October 2021

The present large-scale mixed-method study examined English language classroom anxiety and enjoyment in Chinese young students in relation to gender and grade level. Quantitative and qualitative data were collected from 709 primary and secondary school students from a province in south China. Major findings were: (1) Around one third of the participants felt anxious when speaking English while more than half felt joyful in the English class. The same pattern applied for male and female students and those in grades 4 to 8; (2) significant gender difference in anxiety occurred in grade 4 and that in enjoyment occurred in grade 8; (3) the students tended to be more anxious and less joyful in the English class as their grade levels increased, with grade 7 being a dividing year of the (inverted) u-curve; (4) anxiety and enjoyment were significantly correlated with each other for students in grades 4 to 8; (5) both learner- and teacher-related variables were identified as causes for anxiety and enjoyment; and (6) the students reacted differently when feeling anxious or joyful in class: When feeling/becoming anxious, they often suffered a lot (e.g., becoming dumbfounded, sweating, trembling, and not knowing what to do or say, etc.); when feeling joyful, they often became more attentive and active in class and studied English harder. It is hence clear that English language classroom anxiety and enjoyment are two independent dimensions of emotion and that fostering positive emotions facilitates SL/FL learning.
The Role of Machine Learning in Digital Marketing
Authors: Ullal Mithun S. , Hawaldar Iqbal Thonse , Soni Rashmi , Nadeem Mohammed
Published: October 2021

Artificial Intelligence has been under researched. Machines with deep learning abilities can take digital marketing to new heights with their Artificial Intelligence making all the difference. This research aims to identify the outcomes from the study of Indian customer’s responses across varying demographics to machines and their abilities to sell, which will well be the future of digital marketing. We find that software developers need to build the architecture is partnership with digital marketers who use machines with deep learning by taking attitude of the customers, behavior and choices into consideration. This will unlock huge benefits to the companies as accurate information about customers will be easily available to the marketers in future. How the machines are going to perform under various conditions are explained using a causal model using regression models. SPSS version 24 and R software were used for analysing the data and data regarding the customer’s behaviors, their choices and emotions are collected and based on fuzzy-set qualitative comparative analysis (fsQCA) approach how they can be influenced to use the services of the machine, fsQCA is used to compare case oriented and variable oriented quantitative analysis.
Manipulation of the Involvement Load of L2 Reading Tasks: A Useful Heuristic for Enhanced L2 Vocabulary Development
Authors: Namaziandost Ehsan , Sawalmeh Murad Hassan Mohammed , Tilwani Shouket Ahmad , Ziafar Meisam , Arianti Arin , Hernández Ronald M. , Razzhivin Oleg Anatolevich , Ocaña-Fernández Yolvi , Fuster-Guillén Doris , Garay Jessica Palacios
Published: October 2021

Ensuring second language (L2) learners have an adequate breadth and depth of L2 vocabulary knowledge is a key pedagogical objective in L2 learning contexts. For this reason, establishing guiding principles that successfully enhance the efficacy of L2 vocabulary knowledge development is of strong importance. The current study investigated the value of applying principles from the Involvement Load Hypothesis (ILH) as part of a reading comprehension task among 40 intermediate English as a foreign language (EFL) students. Half of the group undertook a high involvement reading task, whereas the other half undertook a low involvement reading task. After the reading task, an unannounced Vocabulary Knowledge Scale test was administered to measure incidental vocabulary gains. Results showed the high involvement group remarkably outflanked the low involvement groups in terms of the target words learned from the reading task. A delayed post-test indicated that the retention of target word knowledge was more robust among the high involvement group, but that this difference did not maintain a level of statistical significance after 2 weeks. We conclude with suggestions about how EFL/ESL instructors can apply the principles of the ILH in efforts to systematically enhance learners’ L2 vocabulary knowledge.
Local Accreditation in Outpatient Care as an Alternative to Attract Foreign Patients to Colombian Medical Travel: A Case Study in the City of Barranquilla
Authors: de la Puente Pacheco Mario Alberto , de Oro Aguado Carlos Mario , Lugo Arias Elkyn , Rico Heidy , Cifuentes Diana
Published: October 2021

This article analyzes the contribution of the accreditation in outpatient care of the Colombian Institute of Technical Standards and Certification in the perception of satisfaction of patients treated in the city of Barranquilla (Colombia). Two groups of 67 participants underwent outpatient procedures at an accredited and non-accredited clinic. A quasi-experimental design based on a pre-test, post-test, and a focus group was applied to both groups. A t-test and a Tau Kendall correlation coefficient were applied. It was found that the patients treated in the accredited clinic were more satisfied in the time of consultation received, follow-up care, and the communication between them with their physicians and nurses. It was also found that each group had different preferences in the care received. This study contributes to knowing more about Colombian medical travel from case studies.
From Income Inequalities to Social Exclusion: The Impact of the Great Recession on Self-Rated Health in Spain During the Onset of the Economic Crisis
Authors: Sánchez-Moreno Esteban , Gallardo-Peralta Lorena
Published: October 2021

The impact of the Great Recession on health stands out due to its implications for the wellbeing of the population. The available empirical evidence suggests that macrosocial inequalities can be a central element in explaining differences in the impact of the crisis on the health of the population during its early years (2008–2011). Specifically, it is necessary to analyze the role played by the processes constituting a model of inequalities based on social exclusion. This study addresses the topic by using longitudinal data taken from the European Union statistics on income and living conditions (EU-SILC) survey ( n = 5.924), with a hierarchical structure of four measurement moments nested in 5,924 individuals nested in 17 regions. Variables from two levels of analysis are considered: individual and ecological (regional) variables. The findings show that personal socioeconomic status (income and education) are significantly associated with changes in self-rated health during the onset of the crisis. The findings for ecological variables show that the variables measuring exclusion (material deprivation and low work intensity) play a significant role in the explanation of inequalities in health and how they changed during the crisis. Both indicators are negatively associated with self-rated health, while the Gini index and the proportion of the population in long-term unemployment do not have a consistent significant effect. These findings support the hypothesis that there are higher risks to wellbeing in more unequal societies compared with more equal societies.
Exploring Pre-service Pre-primary EFL Teacher Beliefs about Teaching English to Very Young Learners: A Macau Case Study
Authors: Reynolds Barry Lee , Liu Sylvia , Milosavljevic Maja , Ding Chen , McDonald Jennifer
Published: October 2021

Research on the beliefs of pre-service and in-service English teachers at the primary, secondary, and tertiary levels has provided useful knowledge to teacher education curriculum designers. However, the beliefs of pre-service pre-primary English as a foreign language (EFL) teachers have not been addressed. Thus, a case study was conducted in one pre-primary education program at a public university in the Macau Special Administrative Region of China. Data was collected by providing participants ( N = 63) a writing prompt aimed at gathering their beliefs about the teaching and learning of English in the pre-primary context. Qualitative content analysis was used to analyze these written reflection reports of third-year pre-service pre-primary English teachers with the aim of uncovering their beliefs about teaching and learning EFL. Results showed the participants held beliefs about classroom practice, EFL learners and learning, pedagogical knowledge, teaching, content, goals of language teaching, the role of teaching, subject, schooling, hearsay, self, learning to teach, and the teacher education program. Most participants mentioned their beliefs about classroom practice, EFL learners and learning, and pedagogical knowledge, while very few participants wrote about self, learning to teach, or the teacher education program. While many of the beliefs held by the participants were found to be substantiated by early childhood education research, some unfounded beliefs were also uncovered. The results highlighted a need for curriculum designers to reconsider the education program’s ability to meet the needs of the pre-service teachers. Participants required additional training in English content knowledge, use as a medium of instruction, and pronunciation. The polarized view of teaching the mother tongue and EFL should be reconsidered in light of the current views on bilingualism and bilingual education.
Targeting Rule Implementation Decreases Concussions in High School Football: A National Concussion Surveillance Study
Authors: Obana Kyle K. , Mueller John D. , Saltzman Bryan M. , Bottiglieri Thomas S. , Ahmad Christopher S. , Parisien Robert L. , Trofa David P.
Published: October 2021

Background:

Concussions occur at higher rates in high school football as compared with all other high school sports. In 2014, the National Federation of State High School Associations implemented rules defining illegal contact against a defenseless player above the shoulders to reduce concussions in football players in the United States. To the best of our knowledge, rates of emergency department (ED)—diagnosed concussions of high school football players before and after the 2014 rule implementation have not been compared.

Hypothesis:

It was hypothesized that (1) there would be lower rates of helmet-to-helmet and helmet-to-body-part concussions after rule implementation and (2) alternative mechanisms of concussion would not differ, as these would be less influenced by rule implementation.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data from the National Electronic Injury Surveillance System (NEISS) were analyzed for high school football players 14 to 18 years old sustaining a concussion from January 1, 2009, to December 31, 2019. Data were collected on mechanism of injury, setting, and loss of consciousness. Raw data were used to calculate national estimates based on the assigned statistical sample weight of each hospital by the NEISS.

Results:

A total of 4983 (national estimate = 154,221) high school football concussions were diagnosed in US EDs; 58.8% of concussions occurred during competition and 41.2% during practice. Between 2009 and 2013 the rate of concussions diagnosed in EDs rose 10.7% as compared with a 6.2% decrease between 2015 and 2019 ( P = .04). Between 2009 and 2013, the rate of helmet-to-helmet concussions rose 17.6% as compared with a 5.6% decrease between 2015 and 2019 ( P = .03). There were no significant changes between other mechanisms of concussion before and after the 2014 rule implementation.

Conclusion:

We identified a decreased trend in overall and helmet-to-helmet high school football concussions diagnosed in the ED after implementation of the targeting rule. This study adds to the growing literature regarding the importance and efficacy of rule implementation in reducing sports-related concussions.
Color-Coding Print Versus Digital Technology to Teach Functional Community Knowledge to Rural Students With Autism and Complex Communication Needs
Authors: Robertson Colleen E. , Spooner Fred , Wood Charles L. , Pennington Robert C.
Published: October 2021

Post-school outcomes in the areas of health, safety, and independent living are poor among students with complex communication needs and autism spectrum disorder, particularly for those in rural areas. This study examined the comparative effects of print versus digital technology instruction on participants’ cumulative accuracy of answering Wh (who, what, where, and when) functional community knowledge comprehension questions during print and digital technology instructional sessions, with four high school–age students with moderate to severe intellectual disabilities and autism. Using a single-case research, alternating treatments design, the researchers provided instruction to the participants through a model-lead-test procedure with shared reading, color-coded vocabulary words, and adapted stories following a Fitzgerald Key Format, using print and digital technology instructional conditions. All participants made gains across conditions. Contributions to the research literature, limitations of the study, recommendations for future research, and implications for practice are discussed.
d-Serine produces antidepressant-like effects in mice through suppression of BDNF signaling pathway and regulation of synaptic adaptations in the nucleus accumbens
Authors: Chen Zhenzhen , Tang Zhenyu , Zou Ke , Huang Zhihong , Liu Liuer , Yang Yuanjian , Wang Wei
Published: October 2021

Objective

d-Serine is a crucial endogenous co-agonist of N-methyl-d-aspartate receptors (NMDARs) in the central nervous system and can affect the function of the brain derived neurotrophic factor (BDNF) system, which plays an essential role in modulating synaptic plasticity. The current study aimed to systematically evaluate the role and mechanisms ofd-serine in depressive behavior in nucleus accumbens (NAc).

Methods

d-Serine concentration in the chronic social defeat stress (CSDS) model in NAc was measured using high-performance liquid chromatography (HPLC). The antidepressant-like effects ofd-serine were identified using forced swim test (FST) and tail suspension test (TST) in control mice and then assessed in CSDS model. We applied social interaction and sucrose preference tests to identify the susceptibility of CSDS model. Western blotting was further performed to assess the changes of BDNF signaling cascade in NAc after CSDS andd-serine treatment. The BDNF signaling inhibitor (K252a) was also used to clarify the antidepressant-like mechanism ofd-serine. Moreover,d-serine effects on synaptic plasticity in NAc were investigated using electrophysiological methods.

Results

d-Serine concentration was decreased in depression susceptible mice in NAc.d-Serine injections into NAc exhibited antidepressant-like effects in FST and TST without affecting the locomotor activity of mice.d-Serine was also effective in CSDS model of depression. Moreover,d-serine down-regulated the BDNF signaling pathway in NAc during CSDS procedure. Furthermore, BDNF signaling inhibitor (K252a) enhanced the antidepressant effects ofd-serine. We also found thatd-serine was essential for NMDARs-dependent long-term depression (LTD).

Conclusion

d-Serine exerts antidepressant-like effects in mice mediated through restraining the BDNF signaling pathway and regulating synaptic plasticity in NAc.