bluuebunny/crossref_metadata_2025 huggingface dataset:
The Ethics in Long-Term Care Model: Everyday Ethics and the Unseen Moral Landscape of Assisted Living
Authors: Kemp Candace L. , Lesandrini Jason , Craft Morgan Jennifer , Burgess Elisabeth O.
Published: October 2021

Assisted living (AL) communities are long-term care settings where people live, work, and visit, and where social relationships and care, including end-of-life care, are negotiated. Assisted living is fraught with uncertainty and conflict about values, especially given residents’ cognitive and physical frailty. These value-laden issues have implications for both resident and care partners’ experiences. Yet, almost no research has examined ethics in this complex care environment. In this article, we draw on and synthesize existing theory, research, and practice knowledge to offer a conceptual model and discuss case examples that highlight everyday ethical issues in AL. We conceptualize the moral decision-making process and hence the moral landscape of AL, as influenced by a myriad of multi-level factors that shape interpersonal encounters and decision-making involving residents and their care partners, which ultimately shape individuals’ actions and experiences in the setting. We conclude by discussing implications for research, policy, and practice.
Proceedings From the Conference on the Impact of Housing Affordability on Economic Development and Regional Labor Markets
Authors: Miller Sarah , Kiernan Katherine T.
Published: October 2021

Housing affordability is an important component of economic development. It affects several levers for regional growth, including business formation, through wealth building and influencing entrepreneurship. Housing affordability also affects location decisions—of both labor and employers. These proceedings document findings from research presented at a conference titled “The Impact of Housing Affordability on Economic Development and Regional Labor Markets” sponsored by the Federal Reserve Bank of Atlanta and the W.E. Upjohn Institute for Employment Research. The analysis presented at the conference suggests that higher-cost housing can trigger productive workers to leave markets and may limit the ability of workers, especially African American workers, to enter the labor market. At the same time, large economic development projects can displace workers. Research suggests that land use regulation is a driver of housing affordability; typically, higher levels of regulation lead to higher costs. Also, the efforts of economic developers affect local policies, like regulation and zoning, to attract firms. Discussion at the conference suggested housing issues be more integral to economic development policy and that new and expanded measures of housing affordability be used to track affordability.
Continuous Flow Peritoneal Dialysis: Assessment of Fluid and Solute Removal in a High-Flow Model of “Fresh Dialysate Single Pass”
Authors: Freida Philippe , Issad Belkacem
Published: October 2021

♦ Background

Growing concern over the limited capacity of the peritoneal dialysis (PD) system has revived interest in continuous flow peritoneal dialysis (CFPD), a modality in which continuous circulation of PD fluid is maintained at a high flow rate using two separate catheters or one dual-lumen catheter. The CFPD regimen contrasts the “inflow/outflow” regimen, which requires specific times devoted to filling and draining the peritoneum via a single-lumen catheter. Historical data established CFPD capabilities in providing higher solute clearance and ultrafiltration rate (UFR) using either an open loop system with a single pass of fresh PD fluid, or various external purifications of the spent dialysate.

♦ Objective

To compare, in patients with various peritoneal transport patterns, fluid and solute removal achieved during a standardized program of CFPD versus two control schedules: nightly intermittent peritoneal dialysis (NIPD) and nightly tidal peritoneal dialysis (NTPD). This study focused on small solute clearances and UFR using only isotonic PD solution (Dianeal PD1 1.36%; Baxter Healthcare, Castlebar, Ireland). The model of fresh dialysate, single pass, was used to optimize solute gradients and to characterize the impact of a continuous flow regimen on peritoneal transport characteristics.

♦ Methods

In a crossover trial, 4-hour CFPD sessions were performed at a fixed dialysate flow rate (100 mL/minute) in 5 patients being treated with automated PD. A hemofiltration monitor (BM25; Baxter Healthcare, Brussels, Belgium) was adapted to the CFPD technique. The peritoneal cavity was filled through a temporary second catheter and simultaneously drained using the permanent peritoneal access. Fluid and solute removal were compared to data obtained from a control period based on 8-hour sessions of NIPD or NTPD using 13 L of isotonic dialysate.

♦ Results

High-flow CFPD enhanced the diffusive transport coefficient compared with the alternative flow regimen in patients ranging from low to high transporters. Weekly creatinine clearance increased from 36.9 L (22.3 – 49.6 L) and 37.3 L (27.5 – 45.0 L) with NIPD and NTPD respectively, to 74.9 L (42.3–107.5 L) with CFPD. Mean UFR was 2.44 mL/min with CFPD versus 0.92 and 0.89 mL/min with NIPD and NTPD respectively. The mass transfer area coefficient (MTAC) of creatinine with CFPD was 2.5-fold that obtained from the peritoneal equilibration test data.

♦ Conclusion

Our results confirm that CFPD is highly effective in increasing fluid and solute removal. Furthermore, consistent with historical data, our findings indicate that the enhanced solute transfer is not due only to steeper solute gradients, but also depends on increased MTAC in a wide range of peritoneum transport characteristics.
Peritoneal Ultrafiltration and Serum Icodextrin Concentration during Dialysis with 7.5% Icodextrin Solution in Japanese Patients
Authors:   Icodextrin Study Group, Ota Kazuo , Akiba Takashi , Nakao Toshiaki , Nakayama Masaaki , Maeba Teruhiko , Park Min Sun , Tranaeus Anders , Yorioka Noriaki
Published: October 2021

♦ Objectives

To assess the efficacy and safety of icodextrin in Japanese patients and to investigate the relationship between net ultrafiltration (UF) during the long dwell and plasma oligosaccharides.

♦ Design

Open-labeled clinical trial involving patients on continuous ambulatory peritoneal dialysis (CAPD) receiving icodextrin during the 12-hour long dwell for 6 weeks, preceded by and followed by a 2-week baseline period and a follow-up period during which 1.36% glucose was used for the 8-hour long dwell.

♦ Setting

A prospective, randomized multicenter study done in tertiary medical centers.

♦ Patients

18 stable patients on CAPD for 3 months or longer.

♦ Main Outcomes Measures

Net UF (in milliliters), UF rate (in milliliters per hour), plasma oligosaccharides, serum osmolarity (in milliosmoles per liter), peritoneal absorption of icodextrin, and peritoneal clearances of icodextrin, creatinine, and urea were assessed. Adverse events, laboratory findings, and vital signs were also monitored.

♦ Results

Long-dwell net UF (544.4 ± 96.7 mL at day 3, p < 0.001; 309.4 ± 60.7 mL at week 4, p < 0.001; and 391.7 ± 61.1 mL at week 6, p< 0.001) and UF rate (48.2 ± 38.8 mL/hour at day 3, p < 0.001; 26.9 ± 22.1 mL/hr at week 4, p < 0.002; and 35.3 ± 22.9 mL/hr at week 6, p = 0.0002) were significantly greater during the icodextrin period than at baseline (-25.9 ± 46.0 mL and -2.2 ± 22.1 mL/hr, respectively). Plasma oligosaccharides reached steady state within 2 weeks, remained stable during the treatment period, and returned to baseline level 2 weeks after discontinuation of icodextrin. Serum osmolarity increased during the use of icodextrin by approximately 5 mOsm/L. No statistically significant relationship was found between plasma oligosaccharides and net UF. Peritoneal absorption of icodextrin (36.3% ± 5.1% at day 3,42.2% ± 5.9% at week 4, and 38.0% ± 6.3% at week 6) and peritoneal clearance of icodextrin (10.1 mL/minute at day 3,10.1 mL/min at week 4, and 10.3 mL/min at week 6) showed no major change over time. Serum sodium and serum chloride both decreased by 5 mEq/L with icodextrin but remained within the normal range during the treatment period and returned to baseline levels immediately after discontinuation. No serious adverse events were observed during the study.

♦ Conclusion

The results of this study do not support the hypothesis that an increased blood oligosaccharide level and the concomitant elevation in serum osmolarity have a negative impact on peritoneal UF. Therefore, the increase in plasma oligosaccharides appears to be too small to be of clinical significance.
The Efficacy of Silver-Ion Implanted Catheters in Reducing Peritoneal Dialysis-Related Infections
Authors: Crabtree John H. , Burchette Raoul J. , Siddiqi Rukhsana A. , Huen Isan T. , Hadnott Linda L , Fishman Arnold
Published: October 2021

♦ Background

Dialysis-related infections are the commonest cause of catheter loss and transfer to hemodialysis. Surface modifications of the catheter that reduce infections are of major importance.

♦ Objective

The efficacy of silver-ion treated catheters in reducing dialysis-related infections was tested.

♦ Methods

The study design was a prospective, randomized controlled trial. Patients were implanted with either a silver-treated study catheter or a control catheter. Prospective collection of data included infectious complications and catheter survival.

♦ Results

The subject groups were comprised of 67 silver-treated catheters and 72 control catheters. Demographic characteristics of the study and control groups were equal. Exit-site infection rates for the study group and control group (0.52 and 0.45 episodes/patient-year of dialysis respectively) were not different by Poisson regression analysis ( p > 0.4). Peritonitis rates were identical for the two groups (0.37 episodes/patient-year) and were not different by Poisson analysis ( p > 0.9). Antibiotic-free intervals between infections for the study and control groups were not significantly different for exit-site infections ( p = 0.58), peritonitis ( p = 0.44), or both infections combined ( p = 0.47). Actuarial analyses showed no differences between the groups in the probability of remaining free of exit-site infection ( p> 0.2) or peritonitis ( p > 0.7). Similarly, catheter survival was not significantly different between the groups ( p > 0.6).

♦ Conclusion

Surface modification of catheters with ion beam implantation of silver produced no clinical effect with respect to reducing dialysis-related infections.
Mesothelial Toxicity of Peritoneal Dialysis Fluids is Related Primarily to Glucose Degradation Products, Not to Glucose Per Se
Authors: Witowski Janusz , Bender Thorsten O. , Wisniewska–Elnur Justyna , Ksiazek Krzysztof , Passlick–Deetjen Jutta , Breborowicz Andrzej , Jörres Achim
Published: October 2021

♦ Objectives

High concentrations of glucose and/or formation of glucose degradation products (GDPs) during heat sterilization of peritoneal dialysis fluids (PDFs) are believed to be key factors in the limited biocompatibility of PDFs. We have previously shown that several identified GDPs can specifically impair human peritoneal mesothelial cell (HPMC) function. In the present study we aimed at differentiating the respective roles of glucose and GDPs in the toxicity of PDF to mesothelial cells.

♦ Methods

HPMCs were acutely pre-exposed to or incubated chronically in the presence of pH-neutral PDF sterilized by either heat (H-PDF) or filtration (F-PDF). In addition, HPMCs were treated with commercially available H-PDF manufactured either conventionally, that is, in single-chamber containers, or using novel dual-chamber bags that help to substantially decrease GDP formation. Functional assessment of HPMCs included viability, release of interleukin (IL)-6, and proliferation.

♦ Results

Viability and release of IL-6 from HPMCs pretreated with H-PDF (pH 7.3) for 1 to 4 hours were significantly reduced compared to cells exposed to corresponding F-PDF. Incubation in medium mixed (1:1) with H-PDF considerably impaired growth of HPMCs, and over a period of 10 days gradually decreased both the viability of HPMCs and their ability to generate IL-6. These effects were either absent from or significantly less in HPMCs exposed to F-PDF. Similar differences were observed when commercial GDP-containing H-PDFs were compared with newly designed H-PDFs free of GDPs.

♦ Conclusions

Impaired viability and function of HPMCs exposed to glucose-containing pH-neutral PDF is related predominantly to the presence of GDP and, to a significantly lesser extent, to the presence of glucose per se. Prevention of GDP formation during auto-claving markedly improves the biocompatibility of H-PDF with HPMCs.
Disparities in Subjective Cognitive Impairment by Sexual Orientation and Gender in a National Population Based Study of U.S. Adults, 2013–2018
Authors: Fredriksen-Goldsen Karen I. , Jung Hailey , Kim Hyun-Jun , Petros Ryan , Emlet Charles
Published: October 2021

Objectives: This is the first national population-based study to examine cognitive impairment disparities among sexual minority mid-life and older adults. Methods: Using the National Health Interview Survey (2013–2018), we compared weighted prevalence of subjective cognitive impairment by sexual orientation and gender, among those aged 45 plus, applying logistic regressions adjusting for age, income, education, race/ethnicity, and survey years. Results: Sexual minorities (24.5%) were more likely to have subjective cognitive impairment than heterosexuals (19.1%). Sexual minority women had higher odds of greater severity, frequency, and extent of subjective cognitive impairment. Sexual minorities were also more likely to report activity limitations resulting from cognitive impairment and were no more likely to attribute limitations to dementia or senility. Discussion: Cognitive health disparities are of particular concern in this historically and socially marginalized population. The investigation of explanatory factors is needed, and targeted interventions and policies are warranted to address cognitive challenges faced by sexual minorities.
Surgical Extraction of the Mandibular Canine Tooth in the Dog
Authors: Smith Mark M.
Published: October 2021

The mandibular canine tooth is one of the most difficult teeth to extract in the dog especially if the periodontium is healthy. Surgical extraction of this tooth may be performed from a buccal or lingual approach1–5. The lingual approach is described step-by-step.6
Nonlinear stability analysis and numerical continuation of bifurcations of a rotor supported by floating ring bearings
Authors: Amamou Amira
Published: October 2021

Floating ring bearings have been widely used, over the last decades, in rotors of automotive turbochargers because of their improved damping behavior and their good emergency-operating capabilities. They also offer a cost-effective design and have good assembly properties. Nevertheless, rotors with floating ring bearings show vibration effects of nonlinear nature induced by self-excited oscillations originating from the bearing oil films (oil whirl/whip phenomena) and may exhibit various nonlinear vibration effects which may cause damage to the rotor. In order to investigate these dynamic phenomena, this paper has developed a nonlinear model of a perfectly balanced rigid rotor supported by two identical floating ring bearings with consideration of their vibration behavior mainly governed by fluid dynamics. The dimensionless hydrodynamic forces of floating ring bearings have been derived based on the short bearing theory and the half Sommerfeld solution. Using the numerical continuation approach, different bifurcations are detected when a control parameter, the journal speed, is varied. Depending on the system’s physical parameters, the rotor can show stable or unstable limit cycles which themselves may collapse beyond a certain rotor speed to exhibit a fold bifurcation. Bifurcation analysis is performed to investigate the occurring instabilities and nonlinear phenomena. Such results explain the instabilities characteristics of the floating ring bearing in high-speed applications. It has also been found that the selection of the bearing modulus plays an important role in the characterization of the rotor stability threshold speed and bifurcation sequences. An understanding of the system’s nonlinear behavior serves as the basis for new and rational criteria for the design and the safe operation of rotating machines.
A new incremental calculated approach to predict maximum contact stress of compressed packer in large deformation
Authors: Fan Peng , Kuang Yuchun , Yang Bo
Published: October 2021

Compressed packer rubber is large deformation material, which endures biaxial contact friction between oil-pipe and casing-pipe in sitting and sealing process. Large-deformation theory analysis of rubber brings huge difficulties to solve, this is due to the material, geometry and contact non-linearity should be considered. In this article, the deformation of compressed packer rubber tube (CPRT) is divided into free deformation, unidirectional and bidirectional constrained deformations. Based on the theory of thick-wall-cylinder and the linear constitutive of rubber material segment, the CPRT mathematical model in different deformation processes is established and the influences of axial load, axial height of CPRT and contact friction coefficient of casing inner wall etc are considered. Based on incremental calculated approach, the mathematical model is solved. By comparing the results of the theoretical model with the results of finite element method and experimental results, it is found that the theoretical maximum contact stress is more conservative than the FEM and experimental solutions, so the sealing reliability of packer effectively predicted under the premise of allowable contact stress and the theoretical results can provide a lower limit reference value for the contact stress of the packer in the actual seal process. Meanwhile, the deviation of contact stress in FEM and theoretical value at z150 height of CPRT is among 1.13%∼4.90%, which can predict the contact stress in the compressed area near the stress concentration upper end-face of CPRT under the low friction factor, the results provide a reference for the compressed packer design.
Static analysis of thin-walled beams accounting for nonlinearities
Authors: Petrolo M , Nagaraj MH , Daneshkhah E , Augello R , Carrera E
Published: October 2021

This paper presents numerical results concerning the nonlinear analysis of thin-walled isotropic structures via 1 D structural theories built with the Carrera Unified Formulation (CUF). Both geometrical and material nonlinearities are accounted for, and square, C- and T-shaped beams are considered. The results focus on equilibrium curves, displacement, and stress distributions. Comparisons with literature and 3 D finite elements (FE) are provided to assess the formulation’s accuracy and computational efficiency. It is shown how 1 D models based on Lagrange expansions of the displacement field are comparable to 3 D FE regarding the accuracy but require considerably fewer degrees of freedom.
Organizational Performance in Banking Sector of Pakistan: Assessing the Impacts of Strategic Orientation and Organizational Culture
Authors: Ahmed Ammar , Ahmed Umair , Ismail Abdussalaam Iyanda , Rasool Yasir , Soomro Mustajab Ahmed
Published: October 2021

This study investigated the moderating effect of organizational culture on the relationships between organizational strategic orientation and organizational performance. Data were collected from 281 middle managers of the banking sector in Pakistan. Partial least squares structural equation modelling (PLS-SEM) was used to test the hypotheses. The results showed that strategic orientation and organizational culture have significant and positive impacts on the performance of the organization. Unexpectedly, organizational culture does not moderate the relationships between strategic orientation and performance. The findings of the study show that organizations that are strategically positioned as well as have a strong culture can be high-performing organizations. As there is a clear lack of research on the moderating effect of culture on the relationships between an organization’s strategic orientation and organizational performance, the current study fills this gap. Likewise, the present study highlights both practical and theoretical implications for the banking sector in Pakistan.
Modal reduction-based finite element method for nonlinear FG piezoelectric energy harvesters
Authors: Fatehi Parisa , Mahzoon Mojtaba , Farid Mehrdad , Parandvar Hassan
Published: October 2021

In this study, harvesting energy from a nonlinear functionally graded (FG) piezoelectric cantilever beam under harmonic excitation is investigated. The material properties of the piezoelectric are assumed to be a combination of piezo-ceramic and piezo-polymer materials for high performance and flexibility. The neutral axis is obtained in order to eliminate bending–stretching coupling. The geometrical nonlinearity and electromechanical coupling are incorporated in the coupled nonlinear equations that are derived using the generalized Hamilton’s principle and solved using the combination of modal reduction and finite element methods. The shooting method is employed to obtain steady-state periodic response of an FG nonlinear harvester with appropriate initial conditions. Also it is shown that at least two-mode approximation is required for accurate estimation of nonlinear response and harvested power. Using the method of nonlinear modal reduction, the unstable branches for frequency domain solution are estimated and the computational time is reduced considerably compared to full finite element method. A case study is also accomplished in detail to analyze the effects of base amplitude values and material distribution on harvested power and bandwidth.
Evaluation of subcutaneous daratumumab injections in the ambulatory care setting
Authors: Tam Andrew H. , Jung Yoonie , Young Rebecca , Huang Chiung-Yu , Wolf Jeffrey , Shah Nina , Wong Sandy W. , Martin Thomas G. , Lo Mimi
Published: October 2021

Introduction

Subcutaneous daratumumab is non-inferior to intravenous daratumumab for the treatment of multiple myeloma and significantly reduced incidence of systemic reactions. However, manufacturer for subcutaneous daratumumab has not provided guidance regarding optimal methods for monitoring for hypersensitivity reactions following subcutaneous daratumumab administration.

Methods

A retrospective analysis was performed in two cohorts of patients who received at least two doses of subcutaneous daratumumab for the treatment of plasma cell disorders: patients with previous exposure to intravenous daratumumab (dara-exposed) and patients without history of intravenous daratumumab (dara-naïve). The primary outcome was incidence of systemic and injection-site reactions following first dose of subcutaneous daratumumab. Secondary analysis included time to systemic and injection-site reactions, grading of adverse reaction, and incidence of second systemic reaction.

Results

Thirty-one patients were dara-naïve and 49 patients were dara-exposed. Differences in incidence of systemic (dara-naïve: 9.7% vs dara-exposed: 6.1%, p = 0.67) and injection-site reactions (dara-naïve: 12.9% vs dara-exposed: 14.3%, p = 0.99) did not reach statistical significance. Difference in median time to systemic reaction (dara-naïve: 3 h vs dara-exposed: 12 h, p = 0.18) was clinically important but did not reach statistical significance. Median time to injection-site reactions (dara-naïve: 6 h vs dara-exposed: 24 h, p = 0.03) was shorter in the dara-naïve cohort. No clinically meaningful difference was observed for incidence of second systemic reaction.

Conclusion

Most reactions were mild and did not require medical intervention. Following first subcutaneous daratumumab dose, monitoring for 3 h for dara-naïve patients and no monitoring time for dara-exposed patients for hypersensitivity reactions may be a safe and reasonable practice.
Sequence-Based Prediction of Plant Protein-Protein Interactions by Combining Discrete Sine Transformation With Rotation Forest
Authors: Pan Jie , Li Li-Ping , Yu Chang-Qing , You Zhu-Hong , Guan Yong-Jian , Ren Zhong-Hao
Published: October 2021

Protein-protein interactions (PPIs) in plants are essential for understanding the regulation of biological processes. Although high-throughput technologies have been widely used to identify PPIs, they are usually laborious, expensive, and suffer from high false-positive rates. Therefore, it is imperative to develop novel computational approaches as a supplement tool to detect PPIs in plants. In this work, we presented a method, namely DST-RoF, to identify PPIs in plants by combining an ensemble learning classifier-Rotation Forest (RoF) with discrete sine transformation (DST). Specifically, plant protein sequence is firstly converted into Position-Specific Scoring Matrix (PSSM). Then, the discrete sine transformation was employed to extract effective features for obtaining the evolutionary information of proteins. Finally, these optimal features were fed into the RoF classifier for training and prediction. When performed on the plant datasets Arabidopsis, Rice, and Maize, DST-RoF yielded high prediction accuracy of 82.95%, 88.82%, and 93.70%, respectively. To further evaluate the prediction ability of our approach, we compared it with 4 state-of-the-art classifiers and 3 different feature extraction methods. Comprehensive experimental results anticipated that our method is feasible and robust for predicting potential plant-protein interacted pairs.
Patient Assessments of the Factors Facilitating and Impeding User Involvement During the First Phase of Substance Abuse Treatment
Authors: Wenaas Merethe , Bahl Nina Kavita Heggen , Kiik Riina , Juberg Anne
Published: October 2021

User involvement in the first phase of treatment is essential for treatment satisfaction among patients with substance use disorders (SUDs). This study explores how patients perceive the first phase of specialized SUD treatment and identifies what promotes and inhibits user involvement. We used a qualitative approach, and semi-structured interviews were conducted with 14 informants admitted to a substance abuse treatment unit in central Norway. The analysis was inspired by a phenomenographical analysis approach, and 4 categories were identified as the core experiences of user involvement during the first phase of SUD treatment: (a) a new hold on life, (b) missing information, (c) the importance of a sense of community, and (d) ambivalence about the usefulness of the treatment. Overlapping elements with Aaron Antonovsky’s theoretical framework of salutogenesis were used to support the main findings. The study indicates that activating personal resources (eg, the ability to envision a different life), conveying information in a matter sensitive to patients’ current cognitive state, a sense of community, and therapeutic alliance are essential factors to promote user involvement in the first phase of specialized SUD treatment. Based on the findings, we suggest a salutogenesis approach to promote user involvement and provide several ways to employ this approach in the crucial first phase of specialized SUD treatment.
Untangling the Complexities of Substance Use Initiation and Recovery: Client Reflections on Opioid Use Prevention and Recovery From a Social-Ecological Perspective
Authors: Maina Geoffrey , Marshall Kerry , Sherstobitof Jordan
Published: October 2021

Background:

In Canada, the rate of opioid use, opioid use disorder (OUD), and associated mortality and morbidity are higher among Indigenous Peoples than the general population. Indigenous Peoples on medications for opioid use disorders (MOUD) often face distinct barriers that hinder their clinical progress, leading to treatment attrition.

Methods:

We used a social-ecological model to inquire into clients’ experiences with a history of treatment failure for OUD. We used exploratory qualitative research to engage 22 clients with a history of OUD treatment dropouts and who are currently on MOUD. In-depth, semi-structured interviews lasting an average of 30 minutes were conducted on-site.

Results:

We identified 4 themes from the study: (a) risk for substance use; (b) factors sustaining substance use; (c) factors leading to treatment, and (d) treatment failure and re-enrollment.

Conclusion:

Using a socio-ecological model helps to understand factors that influence an individual’s risk for OUD, decision to pursue treatment, and treatment outcomes. Furthermore, social ecological model also creates possibilities to develop supportive, multilevel interventions to prevent OUD risks and support for clients on MOUD. Such interventions include mitigating adverse childhood experiences, supporting families, and creating safe community environments.
Understanding the Pancreatic Islet Microenvironment in Cystic Fibrosis and the Extrinsic Pathways Leading to Cystic Fibrosis Related Diabetes
Authors: Al-Selwi Yara , Shaw James AM , Kattner Nicole
Published: October 2021

Cystic fibrosis (CF) is an autosomal recessive chronic condition effecting approximately 70 000 to 100 000 people globally and is caused by a loss-of-function mutation in the CF transmembrane conductance regulator. Through improvements in clinical care, life expectancy in CF has increased considerably associated with rising incidence of secondary complications including CF-related diabetes (CFRD). CFRD is believed to result from β-cell loss as well as insufficient insulin secretion due to β-cell dysfunction, but the underlying pathophysiology is not yet fully understood. Here we review the morphological and cellular changes in addition to the architectural remodelling of the pancreatic exocrine and endocrine compartments in CF and CFRD pancreas. We consider also potential underlying proinflammatory signalling pathways impacting on endocrine and specifically β-cell function, concluding that further research focused on these mechanisms may uncover novel therapeutic targets enabling restoration of normal insulin secretion.
A Pedagogue's Progress, the Cunningham Turn, and the Birth of Creator Studies
Authors: Craig David
Published: October 2021

As partners in an ongoing global research initiative over the past 6 years, Queensland University of Technology Distinguished Professor Stuart Cunningham and University of Southern California Clinical Professor David Craig mapped the rise of two competing communication and media industries, Social Media Entertainment and Wanghong. Alongside other vanguard scholars, Cunningham and Craig identified and framed the emergence of Creator Studies, an interdisciplinary field of studies focused on the dynamics of new forms of cultural production across social media platforms from diverse fields, methods, and epistemologies. These developments are described within a picaresque auto-ethnographic account of Cunningham's influence on the author's progression from Hollywood producer to scholar and pedagogue.
Flexural behavior of reinforced concrete beams strengthened by carbon fiber reinforced polymer using different strengthening techniques
Authors: Abed Riyam J , Mashrei Mohammed A , Sultan Ali A
Published: October 2021

The externally bonded reinforcement on grooves (EBROG) method is increasingly recognized as an alternative strengthening method that can overcome the debonding problem. This study aims to experimentally investigate the effectiveness of EBROG as compared to the conventional externally bonded reinforcement (EBR) method in strengthening reinforced concrete (RC) beams. Twelve RC beams have been tested under four point load bending. One of these beams has been designated as a reference beam, seven beams have been strengthened with carbon fiber reinforced polymer (CFRP) sheets, and four beams have been strengthened with CFRP laminates using EBROG or EBR methods. The effect of CFRP type, number of layers, as well as the type of strengthening methods on the flexural performance have been also investigated. The load, deflection, stiffness, and failure modes were recorded and discussed intensively. Overall, test results indicated that the flexural strength and stiffness of the strengthened specimens using EBR or EBROG methods increased compared to the control beam, where the increase in the load carrying capacity of beams strengthened using the EBR method ranged between 24.8 and 48.2% and by the EBROG method ranged between 31.7 and 76.7% of the control beam. The most interesting result obtained is that the failure mode of beams has been changed from debonding of CFRP material to rupture of CFRP in some samples strengthened by EBROG, which demonstrates the superior behavior of this strengthening technique as compared to the traditional strengthening using EBR.
A Course for Teaching and Learning About the Responsible Conduct of Research
Authors: Kalichman M.W. , Devereaux M.L. , Plemmons D.K.
Published: October 2021

Over the past 30 years, the scientific community has been increasingly challenged to provide the next generation of researchers with training in responsible conduct of research (RCR). Although RCR courses, workshops, and seminars are now routinely taught internationally, there is little uniformity in goals, content, pedagogy, duration, class size, or methods of assessment. The result is a mixed picture of effectiveness. In this manuscript, we describe goals, rationales, and features for a course tested and revised through well over 100 iterations. Based on our experience and that of others with whom we have shared this model, we propose this course as one that RCR instructors might readily and successfully adopt or adapt.
Eloquence-based reperfusion scoring and its ability to predict post-thrombectomy disability and functional status
Authors: Pressman Elliot , Sands Victoria , Flores Gabriel , Chen Liwei , Mhaskar Rahul , Guerrero Waldo R , Ren Zeguang , Mokin Maxim
Published: October 2021

Background

Angiographic reperfusion after endovascular thrombectomy in acute ischemic stroke is commonly graded using volume-based reperfusion scores such as the modified thrombolysis in cerebral infarct score. The location of non-reperfused regions is not included in modified thrombolysis in cerebral infarct score. We studied the predictive ability of an eloquence-based reperfusion score.

Methods

Consecutive cases of endovascular thrombectomy for anterior circulation strokes performed between January 2018 and April 2020 were included. Digital subtraction angiograms were reviewed by two blinded neurointerventionalist operators. Incomplete reperfusion was further classified by lobar regions lacking reperfusion to create various cohorts. Outcomes were graded four to seven days post-procedure with the National Institute of Health Stroke Scale (NIHSS) and 90 days post-procedure with the modified Rankin Scale.

Results

One hundred patients were identified. Via multivariate analysis, we found that frontal lobe non-reperfusion (mean difference (MD) = −1.60, p = 0.002) and occipital lobe non-reperfusion (MD = −1.68, p = 0.001) were associated with worse mental status improvement while left-sided stroke (MD = 2.02, p < 0.001) featured better improvement post-thrombectomy. Occipital lobe non-reperfusion (MD = −0.734, p = 0.009) was associated with the worse improvement of visual fields. The non-reperfusion of the frontal lobe was associated with a 1.732-worse NIHSS hemibody strength score (95% confidence interval (95%CI) = −3.39 to −0.072, p = 0.041). Worse improvement in NIHSS scores was found to be associated with frontal lobe non-reperfusion (MD = −5.34, 95%CI = −9.52 to −1.18, p = 0.013) and occipital lobe non-reperfusion (MD = −6.35, 95%CI = −10.4 to −2.31, p = 0.002). Odds of achieving modified Rankin Scale of 0–2 at 90 days were decreased with frontal lobe non-reperfusion (odds ratio (OR) = 0.279, 95%CI = 0.090–0.869, p = 0.028) and left laterality (OR = 0.376, 95%CI = 0.153–0.922, p = 0.033).

Conclusions

Eloquence-based reperfusion assessment is an important predictor for functional outcomes after thrombectomy.
Overcoming Limitations for Research During the COVID-19 Pandemic via the Communicative Methodology: The Case of Homelessness During the Spanish Home Confinement
Authors: Racionero-Plaza Sandra , Vidu Ana , Diez-Palomar Javier , Gutierrez Fernandez Nerea
Published: October 2021

Research on homelessness is a field of study in social sciences with a long and solid history. Several pieces of research have let us understand the life experiences and trajectories of these individuals, the challenges that they have faced, and the interventions conducted with them to address this inequality. Nonetheless, the research methodologies in those studies prove short in a situation such as the current COVID-19 pandemic. If we, researchers, are to prioritize social impact, we cannot wait for the pandemic to be overcome to employ those methodologies to investigate homelessness. If so doing, we would meet the needs of homeless people too late. Because social impact is at the forefront, if those methodological resources are not sufficient, then it is necessary to introduce additional ones. This article presents how to address this challenge via the employment of the communicative methodology of research, with the example of a qualitative investigation on how homeless people were attended during the lockdown in Spain in March 2020. The researchers could not meet these individuals on the streets by that time, yet their experiences during the lockdown and how they were being transformed were examined via on-line interviews with individuals voluntarily serving homeless people during home confinement. This methodological innovation in qualitative research is at the service of social impact and can be helpful to researchers investigating vulnerable groups in difficult times.
A customized percutaneous three-dimensional-printed guide for scaphoid fixation versus a freehand technique: a comparative study
Authors: Marcano-Fernández Francesc A , Berenguer Alexandre , Fillat-Gomà Ferran , Corderch-Navarro Sergi , Cámara-Cabrera Jaume , Sánchez-Flò Ricard
Published: October 2021

The aim of this study was to compare the accuracy and reliability of percutaneous fixation of minimally displaced scaphoid fractures using a customized three-dimensional (3-D)-printed guide with a conventional freehand method. A prospective cohort of ten patients underwent scaphoid fixation with the aid of a customized 3-D-printed guide. The final screw position, total surgery time (minutes) and fluoroscopy time (seconds) was compared with a retrospective cohort of ten patients who underwent fixation with a conventional technique. There were no differences in final screw position between both methods. The patients in which the 3-D guide was used had a surgery time reduction of 43% and a fluoroscopy time reduction of 52% compared with the control freehand group. The use of a customized 3-D-printed guide permits a fixation that is as accurate as the standard freehand technique, with reduction in surgical time and intraoperative radiation exposure.

Level of evidence: III
Black Mothering Legacies: Theorizing Lament as a Form of Justice Research
Authors: Guillory Nichole A.
Published: October 2021

I feel compelled by the moment to take up these questions: What does it mean to mother a Black child within/against this historical moment within/against the (carceral) United States? What does it mean to mother a Black child when the legacy of enslavement in the United States is still the basis for assessing the “worth” of you and your children? How do I determine justice for my/a/the Black child in this historical moment? How does this justice come to matter? My approach to critical qualitative research is best understood through Cynthia Dillard’s (2006) notion of “endarkened feminist epistemology” (p. 3). Here I trace a lineage of Black mothering praxis that has been enacted in response to injustice across different historical moments and geographical locations in the United States. This lineage focuses on Black mothers who have lost their children to state violence, when that violence is perpetrated by the state or when the state fails to mete out justice for the taking of Black life.
We Matter Too: Employing Counterstorytelling to Expose the Equity Paradoxes Arresting Mattering and Racial Healing Among Faculty of Color
Authors: James Marlon C. , Díaz Beltrán Ana C. , Williams John A. , Young Jemimah , Neshyba Mónica V. , Ogletree Quinita
Published: October 2021

The present article problematizes faculty relationships within academic departments by applying critical race theory (counterstorytelling) to generate equity cases promoting racial healing. These equity cases illustrate the utility of an emergent typology, the equity paradox. More specifically, the equity paradox describes the web of reprisals endured by faculty of color who advocate for the authentic actualization of university-sponsored diversity goals. Each case is a fictional collage of counterstories created by the co-authors and informed by actual events personally experienced or directly witnessed. This approach allowed for ample complexity, authenticity, and utility because many faculty of color will relate to aspects of these case studies. Simultaneously, administrators and colleagues will gain insights into how racism impacts their colleagues of color. We integrate the racial healing and mattering construct throughout the equity cases to illustrate how racism impacts the individual, communal, and systemic functioning of academic departments. We conclude with implications for departmental transformation to redress the social, emotional, and professional harm of racism and reconstruct professional environments that foster healing and mattering among faculty of color.
Feature selection from magnetic resonance imaging data in ALS: a systematic review
Authors: Kocar Thomas D. , Müller Hans-Peter , Ludolph Albert C. , Kassubek Jan
Published: October 2021

Background:

With the advances in neuroimaging in amyotrophic lateral sclerosis (ALS), it has been speculated that multiparametric magnetic resonance imaging (MRI) is capable to contribute to early diagnosis. Machine learning (ML) can be regarded as the missing piece that allows for the useful integration of multiparametric MRI data into a diagnostic classifier. The major challenges in developing ML classifiers for ALS are limited data quantity and a suboptimal sample to feature ratio which can be addressed by sound feature selection.

Methods:

We conducted a systematic review to collect MRI biomarkers that could be used as features by searching the online database PubMed for entries in the recent 4 years that contained cross-sectional neuroimaging data of subjects with ALS and an adequate control group. In addition to the qualitative synthesis, a semi-quantitative analysis was conducted for each MRI modality that indicated which brain regions were most commonly reported.

Results:

Our search resulted in 151 studies with a total of 221 datasets. In summary, our findings highly resembled generally accepted neuropathological patterns of ALS, with degeneration of the motor cortex and the corticospinal tract, but also in frontal, temporal, and subcortical structures, consistent with the neuropathological four-stage model of the propagation of pTDP-43 in ALS.

Conclusions:

These insights are discussed with respect to their potential for MRI feature selection for future ML-based neuroimaging classifiers in ALS. The integration of multiparametric MRI including DTI, volumetric, and texture data using ML may be the best approach to generate a diagnostic neuroimaging tool for ALS.
Thrombo-inflammatory biomarkers to predict sepsis outcome
Authors: Efat Alaa , Shoeib Sabry Abdallah , Arafa Ayman F , Dawod Ashraf Abdelraof , Abd ElHafez Mohamad A , Abd ElMohsen Essam A , Eladly Hany F , Ibrahim Reda A , Elkholy Aly
Published: October 2021

Background: Sepsis has been redefined recently as life-threatening organ dysfunction caused by dysregulated host responses to infection and septic shock. Soluble urokinase plasminogen activator receptor (SuPAR) and plasminogen activator inhibitor-1(PAI-1) concentration positively correlate to the activation level of the immune system, and are markers of disease severity and aggressiveness. Objective: The study aimed to identify the blood level of plasminogen activator inhibitor-1 (PAI-1) and soluble urokinase plasminogen activator receptor (SuPAR) in sepsis and its association with mortality. Patient and methods: This is an observational prospective study that enrolled 60 adult patients with sepsis (according to SOFA), admitted to Menoufia and Zagazig university hospitals during the period from December 2019 till October 2020. Plasminogen activator inhibitor-1 (PAI-1) and soluble urokinase plasminogen activator receptor (SuPAR) were checked in all participants. Results: SuPAR and PAI.1 were significant independent predictors of hospital mortality. SuPAR showed sensitivity 100%, specificity 95.9%, and accuracy 94% for prediction of early mortality at a cutoff value of 13.4(pg/ml). While, PAI-1 demonstrated sensitivity 100%, specificity 93.9%, and accuracy of 95% at a cutoff value of 122.5 for predicting mortality. Conclusion: PAI-1 and suPAR were significant predictors of hospital mortality among sepsis patients. The sample size was relatively small, which may have decreased the statistical power of the results of the present study. Hence, additional studies with large sample sizes are required for further validation of the present results.
Cor Triatriatum Dexter: A Rare Cause of Aneurysmal Right Atrium
Authors: Patel Mrinal , Vaidhya Nikunj , Patel Kartik , Sheth Megha , Mishra Amit
Published: October 2021

Cor triatriatum dexter (CTD) is a rare congenital cardiac anomaly with a diverse presentation in every age group. We report a case of CTD in a 36-year-old female who presented with palpitations due to giant right atrium (RA), which we managed successfully with surgical excision of the membrane and RA reduction.
Cor Triatriatum in Association With a Unique Form of Partial Anomalous Pulmonary Venous Connection
Authors: Capecci Lou , Mainwaring Richard D. , Olson Inger , Hanley Frank L.
Published: October 2021

Cor triatriatum may be associated with abnormalities of pulmonary venous anatomy. This case report describes a unique form of partial anomalous pulmonary venous connection. The patient presented at 5 weeks of age with symptoms of tachypnea and poor feeding. Echocardiography demonstrated cor triatriatum and partial anomalous pulmonary venous drainage of the right upper lung. The patient underwent urgent repair of cor triatriatum. It was elected to not address the partial anomalous pulmonary venous connection at that time. The patient returned at age 19 months for elective repair of the anomalous pulmonary venous connection. There was also a large vein connecting the right lower pulmonary veins to the superior vena cava. This was repaired by dividing the superior vena cava along a vertical axis to redirect the flow of the anomalous pulmonary veins through the connecting vein to the left atrium. This report describes the anatomy and surgical approach to a unique form of anomalous pulmonary venous connection.