bluuebunny/crossref_metadata_2025 huggingface dataset:
Vehicle Detection for Vision-Based Intelligent Transportation Systems Using Convolutional Neural Network Algorithm
Authors: Khalifa Othman O. , Wajdi Muhammad H. , Saeed Rashid A. , Hashim Aisha H. A. , Ahmed Muhammed Z. , Ali Elmustafa Sayed
Published: March 2022

Vehicle detection in Intelligent Transportation Systems (ITS) is a key factor ensuring road safety, as it is necessary for the monitoring of vehicle flow, illegal vehicle type detection, incident detection, and vehicle speed estimation. Despite the growing popularity in research, it remains a challenging problem that must be solved. Hardware-based solutions such as radars and LIDAR are been proposed but are too expensive to be maintained and produce little valuable information to human operators at traffic monitoring systems. Software based solutions using traditional algorithms such as Histogram of Gradients (HOG) and Gaussian Mixed Model (GMM) are computationally slow and not suitable for real-time traffic detection. Therefore, the paper will review and evaluate different vehicle detection methods. In addition, a method of utilizing Convolutional Neural Network (CNN) is used for the detection of vehicles from roadway camera outputs to apply video processing techniques and extract the desired information. Specifically, the paper utilized the YOLOv5s architecture coupled with k-means algorithm to perform anchor box optimization under different illumination levels. Results from the simulated and evaluated algorithm showed that the proposed model was able to achieve a mAP of 97.8 in the daytime dataset and 95.1 in the nighttime dataset.
Experimental Study of Seepage Characteristics of Filling Structures in Deep Roadway
Authors: Shi Shaoshuai , Zhu Xiangxiang , Cao Zhiguo , Bu Lin , Wen Zhijie , Zhou Zongqing , Guo Weidong , Zhao Ruijie
Published: March 2022

In order to study the seepage failure mechanism of roadway filling medium consisting of cohesive soil under complex hydrogeological conditions, a large-scale triaxial stress-seepage test system was utilized to investigate the influence of kaolin content and seepage loading rate on the seepage characteristics of filling medium. Through the analysis on the variation rules of sand loss and particle size distribution, the seepage characteristics and whole process of seepage instability of filling medium were explored in depth. It is concluded that (1) The seepage instability process of filling medium can be categorized into three stages: the initiation loss of fine clay, the accelerating loss of soil, and the stable status of soil loss. (2) The seepage failure process rate is proportional to the seepage loading rate and inversely proportional to the content of kaolin. (3) The kaolin and sand content of remaining mixture presented initial>bottom>middle>top status. The research results have guidance value for exploring the instability evolution mechanism of filling medium in deep roadway.
Effects of Exergaming on Physical and Cognitive Outcomes of Older Adults Living in Long-Term Care Homes: A Systematic Review
Authors: Chu Charlene H. , Quan Amanda My Linh , Souter Allison , Krisnagopal Archanaa , Biss Renée K.
Published: March 2022

Background: Aging is often associated with increasing functional decline as measured by deterioration in mobility and activities of daily living. Older adults (OAs) living in residential long-term care (LTC) homes in particular may not engage in regular physical exercise, significantly increasing their risk of further cognitive and functional decline. Exergaming may hold promise for OAs by combining exercise and technology-based gaming systems, but evidence for its use in LTC is unknown. Methods: A systematic review was conducted to summarize the effects of exergaming interventions on physical, cognitive, and quality of life (QoL) outcomes for OAs (>65 years of age) living in LTC. Results: Twenty-one studies involving 657 OAs living in LTC met the inclusion criteria. Most studies were associated with a high risk of bias and many used uncontrolled designs and small samples. Across studies, exergame interventions were associated with preliminary benefits relative to control conditions on standardized measures of physical outcomes (e.g., Timed Up & Go, 5-meter gait speed). No consistent effects were found for cognitive and QoL outcomes. Conclusions: Exergames might be a promising intervention to benefit the physical health of OAs (>65 years) living in LTC, but more research is required to determine the effects of exergaming on physical health, as well as cognitive and QoL outcomes. More specifically, larger and more methodologically robust evaluations are needed.
Minimal Critical Region and Genes for a Typical Presentation of Langer-Giedion Syndrome
Authors: Favilla Bianca Pereira , Burssed Bruna , Yamashiro Coelho Érika Mitie , Perez Ana Beatriz Alvarez , de Faria Soares Maria de Fátima , Meloni Vera Ayres , Bellucco Fernanda Teixeira , Melaragno Maria Isabel
Published: March 2022

Langer-Giedion syndrome (LGS) is caused by a contiguous deletion at 8q23q24, characterized by exostoses, facial, ectodermal, and skeletal anomalies, and, occasionally, intellectual disability. LGS patients have been diagnosed clinically or by routine cytogenetic techniques, hampering the definition of an accurate genotype-phenotype correlation for the syndrome. We report two unrelated patients with 8q23q24 deletions, characterized by cytogenomic techniques, with one of them, to our knowledge, carrying the smallest deletion reported in classic LGS cases. We assessed the pathogenicity of the deletion of genes within the 8q23q24 region and reviewed other molecularly confirmed cases from the literature. Our findings suggest a 3.2-Mb critical region for a typical presentation of the syndrome, emphasizing the contribution of the TRPS1, RAD21, and EXT1 genes’ haploinsufficiency, and facial dysmorphisms as well as bone anomalies as the most frequent features among patients with LGS. We also suggest a possible role for the CSMD3 gene, whose deletion seems to contribute to central nervous system anomalies. Since studies performing such correlation for LGS patients are limited, our data contribute to improving the ge­notype-phenotype characterization for LGS patients.
Early Variation of Respiratory Indexes to Predict Death or ICU Admission in Severe Acute Respiratory Syndrome Coronavirus-2-Related Respiratory Failure
Authors: Maraziti Giorgio , Becattini Cecilia
Published: March 2022

Background: In severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-related respiratory failure, the prognostic value of clinically based or blood-gas-based respiratory indexes is unclear. Objectives: We aimed to assess the prognostic value of Respiratory Index (RI, oxygen saturation [SpO2]/respiratory rate [RR]), RR-oxygenation index (ROX, SpO2/fraction of inspired oxygen [FiO2]/RR), partial pressure of oxygen (PaO2)/FiO2 ratio (P/F), or standard PaO2/FiO2 ratio (STP/F) at admission and of their variation during hospitalization in SARS-CoV-2-related respiratory failure. Methods: In 100 consecutive patients hospitalized due to SARS-CoV-2-related respiratory failure, we assessed the association of RI, ROX, P/F and STP/F, and death; secondary outcome was the composite of 7-day death or intensive care unit (ICU) admission. Results: ROX <3.85 at admission (hazard ratio [HR] 2.95, 95% confidence interval [CI] 1.29–6.77) and decreasing RI or P/F during hospitalization (RI: HR 1.05, 95% CI: 1.00–1.09; P/F: HR 1.01, 95% CI: 1.00–1.02) were predictors of in-hospital death. RI ≤3.8, ROX <3.85, and P/F <100 at admission were predictors for death or ICU admission (RI: HR 3.77, 95% CI: 1.30–10.98; ROX: HR 4.56, 95% CI: 1.90–10.96; P/F: HR 7.37, 95% CI: 1.59–34.2). The decrease of RI (HR 1.14, 95% CI: 1.03–1.25), ROX (HR 1.45, 95% CI: 1.11–1.88), P/F (HR 1.08, 95% CI: 1.01–1.15), or STP/F (HR 1.05, 95% CI: 1.01–1.08) during hospitalization was associated with 7-day death or ICU admission. Conclusions: In patients with SARS-CoV-2-related respiratory failure, easy-to-calculate clinically based respiratory indexes at admission and their variation during hospital stay can be used to assess and monitor the risk for death or ICU admission.
Pathogenic Variants in MAP3K1 Cause 46,XY Gonadal Dysgenesis: A Review
Authors: Ostrer Harry
Published: March 2022

Pathogenic variants in the MAP3K1 gene are an important cause of 46,XY non-syndromic partial and complete gonadal dysgenesis, accounting for at least 4% of cases. Inheritance occurs in a sex-limited, autosomal dominant fashion with virtually complete penetrance in 46,XY individuals. 46,XX carriers appear to have normal fertility and no developmental abnormalities. Pathogenic variants occur almost exclusively within known domains of the MAP3K1 protein, facilitating annotation when identified. Where studied, these variants have been modeled to alter the local MAP3K1 folding and surface domains and have been shown to alter interactions with known binding partners. The net effect of these variants is to increase phosphorylation of downstream targets ERK1, ERK2, and p38, resulting in multiple gain-of-function effects interfering with testis determination and enabling ovarian determination.
Relationship between Birth Weight, Early Growth Rate, and Body Composition in 5- to 7-Year-Old Children
Authors: Gätjens Isabel , Fedde Svenja , Schmidt Steffen Christian Ekkehard , Hasler Mario , Plachta-Danielzik Sandra , Müller Manfred James , Bosy-Westphal Anja
Published: March 2022

Background: Programing of body composition during intrauterine growth may contribute to the higher risk for cardio-metabolic disease in individuals born small or large for gestational age (SGA, LGA). Compensations of intrauterine growth by catch-up or catch-down postnatal growth may lead to adverse consequences like a thin-fat phenotype. Methods: The impact of (i) birth weight as well as (ii) the interaction between birth weight and catch-up or catch-down growth during the first 2 years of life on fat-free mass index (FFMI) and fat mass index (FMI) in 3,204 5–7-year-old children were investigated using Hattori’s body composition chart. Body composition results were compared to appropriate for gestational age (AGA) birth weight with the same body mass index (BMI). Results: In total, 299 children at age 5–7 years were categorized as SGA, 2,583 as AGA, and 322 as LGA. When compared to AGA-children, BMI at 5–7 years of age was higher in LGA-children (15.5 vs. 16.2 kg/m2; p < 0.001) but not different in SGA-children. Compared to AGA with the same BMI, LGA was associated with higher FMI and a lower FFMI in 5–7-year-old girls. This phenotype was also seen for both sexes with catch-down growth during the first 2 years of life whereas catch-up growth prevented the higher FMI and lower FFMI per BMI. By contrast, SGA was associated with a higher FFMI and lower FMI in 5–7-year-old boys compared to AGA boys with the same BMI. This phenotype was also seen with catch-down growth in both genders whereas catch-up growth in girls led to more gain in FMI per BMI. Conclusion: LGA with a compensatory catch-down postnatal growth may be a risk factor for the development of disproportionate gain in fat over lean mass whereas SGA with a catch-down postnatal growth seems to favor the subsequent accretion of lean over fat mass. A higher propensity of lean mass accretion during postnatal growth in boys compared to girls explains sex differences in these phenotypes.
Chronische Atemwegserkrankungen und neurodegenerative Erkrankungen: Ein Leitfaden für den praktizierenden Kliniker
Authors: Falsetti Lorenzo , Viticchi Giovanna , Zaccone Vincenzo , Tarquinio Nicola , Nobili Lorenzo , Nitti Cinzia , Salvi Aldo , Moroncini Gianluca , Silvestrini Mauro
Published: March 2022

Chronische Atemwegserkrankungen stellen eine weltweite Epidemie dar. Ihre Inzidenz und Prävalenz in der Weltbevölkerung nimmt zu, und insbesondere bei älteren Menschen treten sie häufig in Verbindung mit anderen Krankheiten auf, was häufig zu einen Status hoher klinischer Komplexität. Fachärzte für Neurologie, Innere Medizin und Pneumologen sollten sich des gemeinsamen Hintergrunds dieser Erkrankungen bewusst sein, um den komorbiden Zustand des Patienten richtig zu behandeln und die Therapie unter Berücksichtigung möglicher Überschneidungen zu optimieren. In dieser Übersichtsarbeit konzentrieren wir uns auf die Beziehungen zwischen chronischen Atemwegserkrankungen und chronischen neurodegenerativen Erkrankungen auf verschiedenen Ebenen; wir untersuchen die gemeinsamen Risikofaktoren und die Wechselwirkungen zwischen den Erkrankungen, die Indikationen für die Untersuchung der Atemfunktion bei neurodegenerativen Erkrankungen und die Wechselwirkungen zwischen Pathologie und Pathologie sowie zwischen Medikamenten und Pathologie bei Patienten, die sowohl von chronischen neurologischen als auch von respiratorischen Krankheiten betroffen sind.
Particularidades Históricas e Sociais do Entrelaçamento Entre Capitalismo, Questão Social e Políticas Públicas no Brasil.
Authors: Carretero Gustavo Henrique
Published: March 2022

O artigo tem como objetivo discutir a relação entre capitalismo, questão social e políticas sociais no Brasil. Ele tem como referência o materialismo histórico dialético. Nele é destacada a condição tardo-periférica do país no desenvolvimento capitalista e como o passado colonial ainda assombra a realidade nacional até a contemporaneidade. São destacadas algumas características da formação social brasileira que mediam a implantação e características do capitalismo nacional. As principais manifestações da questão social no país estão atreladas pobreza, exclusão, subalternidade, super-exploração do trabalho, passivação das lutas sociais e o precário sistema de proteção social. Nesse contexto a questão social é tratada historicamente no país como questão de polícia e não política. Apenas com a constituição de 1988 os país passa aspirar políticas públicas mais universalizantes. Entretanto, a constituição é promulgada em período da crise fiscal do Estado e sua “efetivação” se dá sobre o viés de políticas neoliberais. Assim, o sistema de proteção social brasileiro se configura historicamente como incompleto, focalizado e particularista.
Duration of Graft Cold Ischemia Does Not Affect Outcomes in Pediatric Heart Transplant Recipients
Authors: Scheule Albertus M. , Zimmerman Grenith J. , Johnston Joyce K. , Razzouk Anees J. , Gundry Steven R. , Bailey Leonard L.
Published: March 2022

Background

Utilizing donor hearts with prolonged graft ischemia may extend the donor pool.

Methods and Results

The medical records of 363 infants and children, aged 1 day to 17 years, transplanted at Loma Linda University between November 1985 and March 2001, were retrospectively reviewed. Fourteen children received organs with prolonged ischemic times (>8 hours)(PIT) compared with 14 with short ischemic times (≤90 minutes)(SIT). There were no significant differences when comparing donors for gender, age, weight, cause of death, or duration of cardiopulmonary resuscitation. Preoperative donor shortening fraction (%), as determined by echocardiography, was significantly higher in the SIT group (44.5 versus 36.5%;
P
=0.006). There were no significant differences between PIT and SIT recipients when comparing age at transplant, weight at transplant, waiting time, weight mismatch, postoperative days on ventilator, duration of inotropic support, and hospital stay. Cardiopulmonary bypass time was significantly longer in the PIT group (140.5 versus 80.5 minute;
P
=0.001). Median length of follow-up for both groups was approximately 5 years. Five grafts were lost in the PIT group; 7 were lost in the SIT group, with 1 early graft loss in each group. Significant posttransplant coronary artery disease was diagnosed in 2 recipients in each group (PIT: 80 and 42; SIT: 84 and 67 months posttransplant). There was no significant difference between groups in actuarial graft survival. Number of rejection episodes and hospital readmissions during the first posttransplantation year did not differ significantly between groups.

Conclusion

Late outcomes were not adversely affected by donor hearts preserved by single dose cold crystalloid cardioplegia with greater than 8 hours of cold ischemia.
Preoperative Use of Enoxaparin Compared With Unfractionated Heparin Increases the Incidence of Re-Exploration for Postoperative Bleeding After Open-Heart Surgery in Patients Who Present With an Acute Coronary Syndrome
Authors: Jones Heath U. , Muhlestein Joseph B. , Jones Kent W. , Bair Tami L. , Lavasani Farangis , Sohrevardi Mahtab , Horne Benjamin D. , Doty Donald , Lappe Donald L.
Published: March 2022

Background

Enoxaparin has become an attractive therapy for use during acute coronary syndrome (ACS) because of its potential superior efficacy over unfractionated heparin (UFH), its longer activity, and its subcutaneous route of administration. However, because a significant number of patients presenting with ACS may be sent directly to open heart surgery while still on anticoagulation, it is important to understand any potential bleeding risks that may be associated with the use of enoxaparin under these circumstances.

Methods

From 1998 to 2001, 1159 consecutive patients presenting with an acute coronary syndrome who received either UFH (n=1008) or enoxaparin (n=151) before proceeding to open heart surgery for urgent therapy during the same hospitalization were included in this study. Incidence of perioperative bleeding as evidenced by the units of blood products (packed red blood cells or platelets) transfused or the need for surgical re-exploration for postoperative bleeding was recorded.

Results

Average age was 65±11 and 67±11 years for patients receiving UFH and enoxaparin, respectively (
P=
0.005). Seventy-five percent of those receiving UFH and 64% of those receiving enoxaparin (
P
<0.005) were males. After discharge, the incidence of rehospitalization for hemorrhage requiring return to surgery for re-exploration was 7.9% in the enoxaparin group and 3.7% in the UFH group (adjusted hazard ratio=2.6,
P
=0.03). The use of blood products did not differ between groups (UFH=2.7±6.5 U and enoxaparin=2.3±4.5 U;
P
=NS).

Conclusion

The preoperative use of enoxaparin compared with UFH in patients presenting with an ACS who undergo open-heart surgery during the same hospitalization is associated with a significantly increased incidence of re-exploration for postoperative bleeding. Further study is needed to understand the mechanism of this phenomenon and to develop appropriate guidelines to address this potentially important issue.
Breast Arterial Calcification: a Novel Cardiovascular Risk Enhancer Among Postmenopausal Women
Authors: Iribarren Carlos , Chandra Malini , Lee Catherine , Sanchez Gabriela , Sam Danny L. , Azamian Farima Faith , Cho Hyo-Min , Ding Huanjun , Wong Nathan D. , Molloi Sabee
Published: March 2022

Background:

Breast arterial calcification (BAC), a common incidental finding in mammography, has been shown to be associated with angiographic coronary artery disease and cardiovascular disease (CVD) outcomes. We aimed to (1) examine the association of BAC presence and quantity with hard atherosclerotic CVD (ASCVD) and global CVD; (2) ascertain model calibration, discrimination and reclassification of ASCVD risk; (3) assess the joint effect of BAC presence and 10-year pooled cohorts equations risk on ASCVD.

Methods:

A cohort study of 5059 women aged 60-79 years recruited after attending mammography screening between October 2012 and February 2015 was conducted in a large health plan in Northern California, United States. BAC status (presence versus absence) and quantity (calcium mass mg) was determined using digital mammograms. Prespecified end points were incident hard ASCVD and a composite of global CVD.

Results:

Twenty-six percent of women had BAC >0 mg. After a mean (SD) follow-up of 6.5 (1.6) years, we ascertained 155 (3.0%) ASCVD events and 427 (8.4%) global CVD events. In Cox regression adjusted for traditional CVD risk factors, BAC presence was associated with a 1.51 (95% CI, 1.08–2.11;
P
=0.02) increased hazard of ASCVD and a 1.23 (95% CI, 1.002–1.52;
P
=0.04) increased hazard of global CVD. While there was no evidence of dose-response association with ASCVD, a threshold effect was found for global CVD at very high BAC burden (95th percentile when BAC present). BAC status provided additional risk stratification of the pooled cohorts equations risk. We noted improvements in model calibration and reclassification of ASCVD: the overall net reclassification improvement was 0.12 (95% CI, 0.03–0.14;
P
=0.01) and the bias-corrected clinical-net reclassification improvement was 0.11 (95% CI, 0.01–0.22;
P
=0.04) after adding BAC status.

Conclusions:

Our results indicate that BAC has potential utility for primary CVD prevention and, therefore, support the notion that BAC ought to be considered a risk-enhancing factor for ASCVD among postmenopausal women.
Prognostic Role of Pulmonary Function in Patients With Heart Failure With Reduced Ejection Fraction
Authors: Chang Hao‐Chih , Huang Wei‐Ming , Yu Wen‐Chung , Cheng Hao‐Min , Guo Chao‐Yu , Chiang Chern‐En , Chen Chen‐Huan , Sung Shih‐Hsien
Published: March 2022

Background

Both ventilatory abnormalities and pulmonary hypertension (PH) are frequently observed in patients with heart failure with reduced ejection fraction. We aim to investigate the association between ventilatory abnormalities and PH in heart failure with reduced ejection fraction, as well as their prognostic impacts.

Methods and Results

A total of 440 ambulatory patients (age, 66.2±15.8 years; 77% men) with left ventricular ejection fraction ≤40% who underwent comprehensive echocardiography and spirometry were enrolled. Total lung capacity, forced vital capacity, and forced expiratory volume in the first second were obtained. Pulmonary arterial systolic pressure was estimated. PH was defined as a pulmonary arterial systolic pressure of >50 mm Hg. The primary end point was all‐cause mortality at 5 years. Patients with PH had significantly reduced total lung capacity, forced vital capacity, and forced expiratory volume in the first second. During a median follow‐up of 25.9 months, there were 111 deaths. After accounting for age, sex, body mass index, renal function, smoking, left ventricular ejection fraction, and functional capacity, total lung capacity (hazard ratio [HR] per 1 SD, 0.66; 95% CI per 1 SD, 0.46–0.96), forced vital capacity (HR per 1 SD, 0.64; 95% CI per 1 SD, 0.48–0.84), and forced expiratory volume in the first second (HR per 1 SD, 0.72; 95% CI per 1 SD, 0.53–0.98) were all significantly correlated with mortality in patients without PH. Kaplan‐Meier curve demonstrated impaired pulmonary function, defined as forced expiratory volume in the first second ≤58% of predicted or forced vital capacity ≤65% of predicted, was associated with higher mortality in patients without PH (HR, 2.85; 95% CI, 1.66–4.89), but not in patients with PH (HR, 1.05; 95% CI, 0.61–1.82).

Conclusions

Ventilatory abnormality was more prevalent in patients with heart failure with reduced ejection fraction with PH than those without. However, such ventilatory defects were related to long‐term survival only in patients without PH, regardless of their functional status.
Electrophysiological and behavioral responses of blister beetle Mylabris pustulata to plant volatiles
Authors: Nebapure Suresh , Kumar Sanitya
Published: March 2022

Plant volatiles, constitutive or induced, are perceived by insect pests to locate the host plant and also by natural enemies to locate the host insect. These plant volatiles can be utilized to develop attractive or repellant lures for pest management. Studies were carried out to identify the plant volatiles which are induced in pigeonpea, Cajanus cajan (L.) Huth due to the herbivory of blister beetle, Mylabris pustulata. The volatiles from healthy uninfested pigeonpea plants and blister beetle-infested plants were collected using the dynamic headspace collection method with Porapaq Q (80-100 mesh) as adsorbent. Using gas chromatography-mass spectrometry, 28 compounds were identified from uninfested pigeonpea plants whereas 16 compounds were identified from infested plants. A qualitative analysis showed that α-pinene and 3-hexen-2-one were exclusively detected in infested plants and (Z)-3-hexen-1-yl acetate and acetophenone were released in higher quantities from infested plants than from uninfested one. Electrophysiological evaluation of these volatiles along with other plant volatiles showed that blister beetle antennae eliciting higher responses to eucalyptol at a 1-μg dose, to nerol at a 10-μg dose and to benzyl acetate at 100- and 1000-μg doses. Beetle traps with lures of eucalyptol, benzaldehyde, benzyl acetate, and nerol attracted a very small number of blister beetle adults, suggesting the need for further efforts to standardize lure load and trap design.
Vincetoxicum junzifengense (Apocynaceae), a new species from Fujian, China: Evidence from morphological and molecular analyses
Authors: YE BAO-JIAN , TU XIONG-DE , ZHOU CHENG-YUAN , LIU BIN , CAO XUE-FEN , CHEN SHI-PIN
Published: March 2022

Vincetoxicum junzifengense from Fujian Province in Southeast China is described and illustrated. This new species is similar to V. versicolor and V. stauntonii, but it differs by its climber life form, pubescent lanceolate leaf, triangular corolla lobe, dentate corona lobe, and ovoid pollinium. Phylogenetic analysis using the nuclear (ITS) and three plastid (trnT-L, trnG and psbA-trnH) DNA sequences reveals that V. junzifengense is close to V. versicolor and V. yonakuniense.
Factors Affecting Public Opinion on the Denial of Healthcare to Transgender Persons
Authors: Doan Long , Grace Matthew K.
Published: March 2022

Between one-fifth and a third of people who are transgender have been refused treatment by a medical provider due to their gender identity. Yet, we know little about the factors that shape public opinion on this issue. We present results from a nationally representative survey experiment ( N = 4,876) that examines how common justifications issued by providers for the denial of healthcare, and the race and gender identity of the person being denied care, intersect to shape public opinion concerning the acceptability of treatment refusal. We find that religious objections are viewed as less acceptable compared to a medical justification, in this case, inadequate training. However, the difference between religious objections and inadequate training is larger when the person being denied healthcare is White or Asian than when the person is Black or Latinx. Analysis of open-ended responses indicates the modest effect of doctor’s rationale on attitudes toward treatment refusal with respect to Black and Latinx patients is partially attributable to a racialized, free-market logic. Respondents were more likely to advocate for a doctor’s fundamental right to refuse service when evaluating Black and Latinx patients compared to White patients. We discuss the implications of these findings for intersectional approaches to trans studies and future public opinion research.
Effect of seawater aging on impact behavior of glass fiber/epoxy laminates with drilled holes
Authors: Rubio-González Carlos , Hernández-Santos Maximiliano , José-Trujillo Eduardo , Rodríguez-González Julio Alejandro
Published: March 2022

During their service life, composite marine structures made up of glass fiber reinforced polymers are susceptible to be affected by environmental and loading conditions such as seawater and low velocity impacts which can cause them severe structural damage. Based on this fact and concern, the present work investigates the influence of seawater aging on impact behavior of glass fiber/epoxy composite laminates with and without drilled holes. To achieve this goal, glass fiber/epoxy laminates were manufactured by resin transfer molding and then cut into specimens for low velocity impact testing. Before impact tests, specimens were immersed in artificial seawater at 70°C for 1464 h. After that time, dry (before seawater aging) and wet (after seawater aging) specimens were tested at 10 and 15 J impact energies using a drop-weight impact tower. The results of accelerated seawater aging confirmed that the presence of drilled holes in composites does not influence on their moisture absorption content and diffusion coefficient. The impact test results showed that the impact properties of wet specimens are significantly lower respect to dry specimens. It was found that the peak force of wet specimens displays a reduction of approximately 40% with respect to the dry specimens as a consequence of moisture absorption which causes plasticization of the polymeric matrix. Ultrasonic C-scan inspection showed that damage area of wet specimen increased up to 250% compared to that of dry specimen. Fractographic analyses by scanning electron microscopy and X-ray computerized tomography revealed that low velocity impact in composite laminates produced damage mechanisms associated to matrix cracking, fiber/matrix debonding, fiber breakage, and delamination, which were more prominent in laminates with drilled holes and subjected to a previous seawater exposition.
To the mutual benefit of the member states. Nordic transnational road cooperation, 1956–1966
Authors: Eriksson Martin
Published: March 2022

This article deals with the Nordic Council as a cooperation organ for building transnational roads outside of the E-road network during the period 1956–1966. The Nordic experience of planning and interconnecting transnational roads is related to the United Nations Economic Commission for Europe (ECE) and the development of the E-road network. It is noted that whereas the E-road network built on an ambition within the ECE to create mutual understanding and fraternity between the European nations, the Nordic Council viewed roads as instruments to deal with shared economic and social problems. Another difference is that while the member states of the ECE interacted with societal groups and expert organisations during the interconnection of the E-road network, such actors did not participate directly with the Nordic Council. The inter-Nordic stream of technical expertise was primarily channelled through the national road administrations which cooperated to interconnect the trans-Nordic network.
The workload of a medical examiner service at an acute National Health Service hospital during the COVID-19 pandemic: The Norfolk & Norwich University Hospital experience
Authors: Payne-James Jason , Parapanos Louise , Carpenter Katie , Lopez Berenice
Published: March 2022

The COVID-19 pandemic commenced in March 2020. In May 2019, a new Medical Examiner system was introduced to scrutinise deaths of patients dying within acute National Health Service Trusts. The Coronavirus Act 2020 which came into force in March 2020 modified certification of death requirements. Newly formed Medical Examiner Services were advised they could suspend scrutiny during the pandemic. The Norfolk & Norwich University Hospital Medical Examiner Service (NNUH MES) continued to scrutinise patient deaths throughout. This study summarises the workload of the NNUH MES from 1st June 2020 to 31st May 2021 over which period 2856 deaths were recorded and 2687 scrutinised by the Medical Examiners.
From dialogue to activism: How to get Generation Z and Millennials to participate in the multifaith movement in Australia
Authors: Smith Geraldine
Published: March 2022

This article examines why young people rarely participate in the activities, initiatives, and organisations of the multifaith movement in Australia. It will discuss five issues which impede Generation Z and Millennials from engaging in the multifaith movement by drawing on previous studies on these generations and interview data with multifaith activists in Australia. There is a significant portion of Generation Z and Millennials who have hybrid religious identities, identify as nonreligious, and/or stand at the margins of religious institutions. Yet, this is incompatible with the dialogue model which assumes that its participants are unambiguous full members of their religious tradition who are imbued with the legitimacy of their institution and endowed with the role of a representative. If multifaith activists shifted the focus from dialogue to activist, relational, and humanitarian aspects of the multifaith movement, it may empower young people to participate in a way that reflects their experiences, concerns, and goals.
Cross-Cultural Adaptation and Psychometric Evaluation of the Educational Content Validation Instrument in Health
Authors: Cazorla-Calderón Sergio , Romero-Sánchez José Manuel , Fernández-García Elena , Paloma-Castro Olga
Published: March 2022

Healthcare professionals often use multimedia patient education media, but not all have the same content quality. This study aimed to cross-culturally adapt the Educational Content Validation Instrument in Health to the Spanish setting and assess its psychometric properties. A methodological validation study was carried out between January and September 2020. Data collection took place from May to June 2020. A translation, back translation, committee review, and pre-testing was carried out. Subsequently, reliability (internal consistency), and validity (factorial and convergent) were assessed by requiring 210 Healthcare Professionals to complete the instrument based on video material. In addition, a refinement of the instrument was conducted based on the modification indexes. The instrument showed adequate internal consistency, although some redundancy in the items (α = .93). Exploratory factor analysis suggested a unifactorial structure that explained an adequate variance (47.37%). Convergent validity was poor (r = .11; P = .05). After analysis, 6 items were deleted without impairing the validity results and eliminating redundancy. Therefore, a 12-item version of the instrument was created. It can help to assess more objectively the contents of the materials prescribed, facilitating the choice of those of higher quality and potentially improving their patients’ health outcomes. Further studies are needed to confirm the previous results and reassess some of the shortcomings.
Advances in Artificial Intelligence to Diagnose Otitis Media: State of the Art Review
Authors: Ngombu Stephany , Binol Hamidullah , Gurcan Metin N. , Moberly Aaron C.
Published: March 2022

Objective

Otitis media (OM) is a model disease for developing, validating, and implementing artificial intelligence (AI) techniques. We aim to review the state of the art applications of AI used to diagnose OM in pediatric and adult populations.

Data Sources

Several comprehensive databases were searched to identify all articles that applied AI technologies to diagnose OM.

Review Methods

Relevant articles from January 2010 through May 2021 were identified by title and abstract. Articles were excluded if they did not discuss AI in conjunction with diagnosing OM. References of included studies and relevant review articles were cross‐referenced to identify any additional studies.

Conclusion

Title and abstract screening resulted in full‐text retrieval of 40 articles that met initial screening parameters. Of this total, secondary review articles (n = 7) and commentary‐based articles (n = 2) were removed, as were articles that did not specifically discuss AI and OM diagnosis (n = 5), leaving 25 articles for review. Applications of AI technologies specific to diagnosing OM included machine learning and natural language processing (n = 23) and prototype approaches (n = 2).

Implications for Practice

This review emphasizes the utility of AI techniques to automate and aid in diagnosing OM. Although these techniques are still in the development and testing stages, AI has the potential to improve the practice of otolaryngologists and primary care clinicians by increasing the efficiency and accuracy of diagnoses.
Postoperative and 1‐Year Functional Outcomes After Free Flap Surgery Among Patients 80 Years or Older
Authors: Davis Kyle P. , Kompelli Anvesh , Gardner James Reed , Mohler Samantha , Gammill Sarah , King Deanne , Vural Emre , Sunde Jumin , Moreno Mauricio Alejandro
Published: March 2022

Objective

To evaluate the postoperative and 1‐year functional outcomes after free flap surgery among patients ≥80 years old.

Study Design

Retrospective chart review.

Setting

Single tertiary care center.

Methods

We conducted a retrospective review of 596 patients who underwent head and neck ablation and reconstruction with free tissue over a 7‐year period. Patients ≥80 years of age were included.

Results

Fifty patients were ≥80 years old, with an average age of 83.7 years. Ninety‐day mortality was 12.0%, and those who died were of older age (87.5 vs 83.1 years, P =. 036). Prior radiation therapy (odds ratio, 6.8 [95% CI, 1.1‐42.7]) and a Charlson Comorbidity Index ≥3 (odds ratio, 10.0 [95% CI, 1.5‐67.0]) were associated with an increased risk of 90‐day mortality. Overall 21 (42.0%) patients experienced a 30‐day complication; 7 (14.0%) were readmitted within 30 days; and 5 (10.0%) underwent additional flap‐related operations. Flap failure occurred in 2 (4.0%) patients. Before surgery, 45 (90%) patients were living independently or within assisted living; among these, 19.5% declined to dependent functional status at 90‐day follow‐up. At 90 days, 2 (8.3%) of 24 patients remained tracheostomy dependent, and 20 (66.7%) of 30 patients required feeding tube supplementation. Among 42 patients, 36 (85.7%) had unrestricted or modified oral diets at 90 days. Charlson Comorbidity Index ≥2 was associated with an increased risk of 1‐year mortality (odds ratio, 5.1 [95% CI, 1.4‐18.6]).

Conclusion

The potential for functional decline and risk of 90‐day mortality should be discussed with patients aged ≥80 years.
Feasibility of parents promoting fruit-infused water to reduce preschool children’s sugar-sweetened beverage consumption
Authors: Quelly Susan B. , Eckhoff Dawn O. , Luzincourt Geraldine , Garcia Jeanette , Smith Sharlene
Published: March 2022

Background: Increasing water and decreasing sugar-sweetened beverage (SSB) consumption in preschoolers provide a strategy to reduce lifelong obesity risks. Aim: To determine feasibility/acceptability and examine preliminary findings of an innovative intervention for preschooler parents to promote fruit-infused water (FIW) to decrease SSB intake. Methods: Fourteen parents of preschoolers completed a pre-intervention survey, attended a presentation with a FIW demonstration/taste-testing, received pitchers/strainers, cutting boards, and FIW recipes/instructions, and received 8 supportive text messages over one month. Feasibility/acceptability was determined from analyzing parents’ responses about participating. Descriptive statistics were conducted to analyze pre-/post-intervention survey data. Results: Three themes emerged: “Healthy Option Alternative”; “Feasible to Make FIW at Home”; and “Benefits for Parents”. Preliminary findings from ten parents completing both pre-/post-intervention surveys indicated a decrease in preschoolers’ total SSB amount/kcal intake, and an increase in parent self-efficacy and FIW knowledge/consumption. Conclusion: Preliminary findings provide valuable feasibility/acceptability information to guide a larger future study
Surgery for delayed leaflet impingement after transcatheter closure of a paravalvular leak associated with an aortic pseudoaneurysm
Authors: Fiore Antonio , Piscitelli Mariantonietta , Rabia Amel , Folliguet Thierry , Nappi Francesco , Gallet Romain
Published: March 2022

Background: Paravalvular leak (PVL) is a recognized and challenging complication after surgical or transcatheter valve replacement. The transcatheter closure of PVL has become the first-line treatment in clinical practice when the procedure is not contraindicated. Transcatheter PVL closure rests on a complex procedure and complications still occur in approximately 9% of patients. Case Report: We describe the case of a delayed mechanical prosthetic leaflet impingement after transcatheter closure of a paravalvular leak associated with a Valsalva pseudoaneurysm that required an urgent surgery. Conclusion: Aorta–left ventricle communication could be a relative contraindication to be assessed on a case-by-case basis, but transcatheter closure does not preclude subsequent attempt for surgical repair and outcome.
Civic engagement in serious illness, death, and loss: A systematic mixed-methods review
Authors: D’Eer Louise , Quintiens Bert , Van den Block Lieve , Dury Sarah , Deliens Luc , Chambaere Kenneth , Smets Tinne , Cohen Joachim
Published: March 2022

Background:

New public health approaches to palliative care such as compassionate communities aim to increase capacity in serious illness, death, and loss by involving civic society. Civic engagement has been described in many domains of health; a description of the characteristics, processes, and impact of the initiatives in palliative care is lacking.

Aim:

To systematically describe and compare civic engagement initiatives in palliative care in terms of context, development, impact, and evaluation methods.

Design:

Systematic, mixed-methods review using a convergent integrated synthesis approach. Registered in Prospero: CRD42020180688.

Data sources:

Six databases (PubMed, Scopus, Sociological Abstracts, WOS, Embase, PsycINFO) were searched up to November 2021 for publications in English describing civic engagement in serious illness, death, and loss. Additional grey literature was obtained by contacting the first authors. We performed a quality appraisal of the included studies.

Results:

We included 23 peer-reviewed and 11 grey literature publications, reporting on nineteen unique civic engagement initiatives, mostly in countries with English as one of the official languages. Initiatives involved the community in their development, often through a community-academic partnership. Activities aimed to connect people with palliative care needs to individuals or resources in the community. There was a variety of evaluation aims, methods, outcomes, and strength of evidence. Information on whether or how to sustain the initiatives was generally lacking.

Conclusions:

This is the first review to systematically describe and compare reported civic engagement initiatives in the domain of palliative care. Future studies would benefit from improved evaluation of impact and sustainability.
Apology–forgiveness cycle in restorative justice, but how?
Authors: Suzuki Masahiro , Jenkins Tamera
Published: March 2022

The apology–forgiveness cycle is a simple but powerful process for conflict resolution. Given the prevalence of apology and forgiveness in restorative justice (RJ), the apology–forgiveness cycle may take place. However, there is a lack of theoretical understanding of the relationship between apology and forgiveness in the RJ processes. After identifying key elements and impediments of the apology–forgiveness cycle during RJ meetings based on the existing literature, we develop a theoretical model of the apology–forgiveness cycle during RJ encounters. This typology explains how the apology–forgiveness cycle is intertwined with the RJ process, subsequently facilitating, blocking, and changing its sequence. There are four cycles: (1) apology facilitating forgiveness, (2) apology without forgiveness, (3) forgiveness promoting apology, and (4) forgiveness without apology. We conclude by offering future directions for research on the apology–forgiveness cycle in RJ.
Cerebrovascular responses to somatomotor stimulation in Parkinson’s disease: A multivariate analysis
Authors: Barnes Sam C , Panerai Ronney B , Beishon Lucy , Hanby Martha , Robinson Thompson G , Haunton Victoria J
Published: March 2022

Parkinson’s disease (PD) is a common neurodegenerative disorder, yet little is known about cerebral haemodynamics in this patient population. Previous studies assessing dynamic cerebral autoregulation (dCA), neurovascular coupling (NVC) and vasomotor reactivity (VMR) have yielded conflicting findings. By using multi-variate modelling, we aimed to determine whether cerebral blood flow (CBF) regulation is impaired in PD patients.

55 healthy controls (HC) and 49 PD patients were recruited. PD subjects underwent a second recording following a period of abstinence from their anti-Parkinsonian medication. Continuous bilateral transcranial Doppler in the middle cerebral arteries, beat-to-beat mean arterial blood pressure (MAP; Finapres), heart rate (HR; electrocardiogram), and end-tidal CO2 (EtCO2; capnography) were measured. After a 5-min baseline period, a passive motor paradigm comprising 60 s of elbow flexion was performed. Multi-variate modelling quantified the contributions of MAP, ETCO2 and neural stimulation to changes in CBF velocity (CBFV). dCA, VMR and NVC were quantified to assess the integrity of CBF regulation.

Neural stimulation was the dominant input. dCA, NVC and VMR were all found to be impaired in the PD population relative to HC (p < 0.01, p = 0.04, p < 0.01, respectively). Our data suggest PD may be associated with depressed CBF regulation. This warrants further assessment using different neural stimuli.
Prioritizing Bus Routes for Electrification: GIS-Based Multi-Criteria Analysis Considering Operational, Environmental, and Social Benefits and Costs
Authors: Emami Behnam Davazdah , Song Ying , Khani Alireza
Published: March 2022

Society today is enjoying an unprecedented level of human mobility but is also confronting environmental degradation resulting from fossil fuel consumption and greenhouse gas emissions. The electrification of bus transit systems is recognized as one of the practical solutions to mitigate air pollution and other externalities of increased mobility. However, the implementation of an e-bus system requires the purchase of e-buses and the development of charging infrastructure. To reduce costs and maximize benefits, it is crucial to develop an integrated strategy during the planning stage. This study applies a GIS-based multi-criteria decision analysis approach to determine the candidate bus routes to convert from diesel-powered to electric-driven. This framework appraises not only the characteristics of bus routes but also the possibility of deploying charging infrastructures in bus terminals. Fourteen common criteria are used to evaluate the main considerations of bus electrification, including economic, environmental, and social benefits and costs. The analytic hierarchy process and the technique of order preference similarity to the ideal solution are employed to determine the criteria weights and the route ranking, respectively. The bus network of Twin Cities, MN, U.S., is used as a study case to present the proposed approach. Sensitivity analysis is included to identify the overall top 10 bus routes. The result shows that this method can use widely available open data to select top candidate routes that meet multiple criteria.