bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified stress field model for critical tearing strength of architectural coated fabrics
Authors: Zhang Xubo , Wu Minger
Published: June 2022

This report presents a new critical tearing strength prediction model, the modified stress field model. Firstly, the critical tearing strength of six coated fabrics is obtained using the single-edge notched tests. The results show that the warp and weft strength utilization of different coated fabrics is similar. Based on the test data, the prediction effects, parameter meanings, and basic properties of three models, namely Thiele’s empirical formula, the stress field model, and the modified stress field model, are discussed and compared. Then, the predicted results and properties of the three models in different crack ranges, specifically the small crack range, are compared, and their application scopes are verified. The two commonly used models lack the improved prediction effects in the small crack range that is provided by the modified stress field model. Finally, to reduce the workload while maintaining a certain accuracy, a crack combination of 3 mm + 15 mm is recommended, which is further confirmed using the root-mean-square error index. The prediction results of Thiele’s empirical formula and the modified stress field model under this crack combination are compared. The new model can still maintain good prediction effects even when extrapolating for small cracks using limited test data. Because of its precision and convenience, the proposed model may relatively facilitate the application of single-edge notched or uniaxial central tearing tests.
From Critical Race Theory to the January 6th Insurrection Speech: The High School Classroom and the Politics of Division
Authors: Walker Katrina M.
Published: June 2022

In the spring of 2021, conservative pundits and politicians renewed a decades-old attack on Critical Race Theory (CRT). Per usual, the attack intentionally misrepresented the nature and impact of CRT with the goal of derailing efforts to address systemic racial inequality. This push to maintain the status quo power structure is echoed in former President Trump’s January 6th speech urging his supporters to forcefully overturn the 2020 presidential election. In both cases, the politics of division and purposefully used misinformation are key tools. The high school classroom highlights these tools’ use. It is both a proxy space where larger social issues are focused and an actual space in which students are prepared to counter the pernicious effects of stoked division and misinformation. Based on experiences in a public high school’s 11th-grade World Literature class, this article explores how engagement with topical issues can equip students to recognize the politics of division and to be analytical and engaged citizens.
Analysis of Presentation and Outcomes in Acute Limb Ischemia Patients During COVID-19 State of Emergency
Authors: Siu Margaret , Lin Alex M. , Narvaez Vincent F. , Perez-Coulter Aixa , Norris Marc A. , Kronick Matthew D. , Hadro Neal C. , Kravetz Amanda J. , Ching Yiming A. , Morris Marvin E.
Published: June 2022

Background

During the COVID-19 pandemic, cardiovascular patients were found to be presenting to hospitals with myocardial infarctions and cerebrovascular accidents at progressed disease states. We noticed a parallel in acute limb ischemia (ALI) patients presenting during Massachusetts’ COVID-19 State of Emergency declaration. We question whether patients developed a hesitancy to seek medical attention at hospitals due to fear of COVID-19. Our objective was to compare acuity of ALI, interventions, and limb survival in patients presenting before, during, and after a state of emergency.

Methods

Four timeframes were set to compare patients presenting peri-2020 COVID-19 State of Emergency and patients presenting during a pre-pandemic era at a tertiary, academic institution. A reference period from 2019, Pre-State of Emergency period, State of Emergency period, and Post-State of Emergency period were designated. Patient characteristics, interventions, and outcomes data were collected. Unpaired t-test, ANOVA, and Chi-square statistical analyses were used.

Results

A total of 95 patients presenting with ALI were identified. Compared to Reference group, state of emergency group had more patients presenting with Rutherford Class III, 12.9% vs 35%, and less patient presenting with Class I, 45.1% vs 0%, P = .02. State of emergency group had more delayed presentations with ≥6 hours after symptom onset, 45% vs 85%, P = .01. Above-knee amputations were performed in 20% of patients during state of emergency and 31.6% for Post-State of Emergency, vs 6.5% in the Reference group; P = .03. There was no difference in intensive care unit admission, length of stay, or mortality between patients from different groups.

Conclusion

During a state of emergency, ALI patients were noted to present later from symptom onset, have greater disease severity, and more likely to undergo amputations. We suspect delay in presentation and limb lost to be attributed to reluctance to seek immediate medical attention.
Strengthening Democracy Through Knowledge Mobilization: Participedia – A Citizen-Led Global Platform for Transformative and Democratic Learning
Authors: Landry Julien , von Lieres Bettina
Published: June 2022

Participedia is a collaborative, digital learning tool for the co-production of knowledge about new forms of citizen participation across the world ( www.participedia.net ). In this paper, we analyse using the platform as a learning resource for adult learners who are democracy practitioners and for undergraduate students. We examine Participedia’s role in advancing transformative civic and democratic learning, and situate our analysis in the current context of democracy and civic space under strain globally. We argue that this pedagogy is crucial in the face of democratic erosion, growing inequality, increased polarization and the rise of right-wing populism. We discuss how Participedia’s multiple channels for learner engagement (e.g., critical case study analysis, self-directed research, reflective writing, case study development based on lived experience, collaborative fellowships) support critical and reflective democratic practice. We show how the Participedia platform contributes to transformative learning outcomes, in particular around social action, active citizenship, participation and democracy.
Characterization of Trapezial Pommel in Relation to Radiographic and Wear Patterns in Carpometacarpal Osteoarthritis
Authors: Bourdillon Alexandra T. , Shapiro Lauren , Kerkhof Faes D. , Segovia Nicole A. , Weiss Arnold-Peter , Ladd Amy L.
Published: June 2022

Background:

Trapezial pommel, or ulnar osteophyte positioned at the vertex of the saddle-shaped facet, is a consistent structural appearance in osteoarthritis (OA) of the first carpometacarpal. This study investigates its relation to radiographic measures (modified Eaton staging and thumb OA [ThOA] index) and wear patterns (trapezial surface morphology and cartilaginous eburnation).

Methods:

In all, 137 whole trapezia were explanted from 116 patients and evaluated for Eaton staging, morphology (saddle, cirque, or dish), and eburnation (degree of cartilaginous effacement) of the articular surface of the trapezium. In total, 131 Robert’s views and 126 stress views were reviewed by 2 blinded senior surgeons for ThOA index and pommel size. Statistical analyses included Spearman correlation and linear regression.

Results:

Standardized pommel size achieved good intrarater reliability (correlation coefficient: 0.80-0.98) and moderate interrater reliability (correlation coefficient: 0.60-0.67). The ThOA index and pommel size were significantly correlated across Robert’s ( rs = 0.51) and stress views ( rs = 0.64). The ThOA index better distinguished between stages compared with pommel size. All the radiographic measures inversely correlated with preserved cartilage and varied across morphologies. Pommel size differed significantly between dish and saddle, and the ThOA index was significantly different between all morphologies when using stress views.

Conclusions:

We reliably quantified the pommel feature and demonstrated significant correlations with other radiographic and topologic measures of arthritic disease. If future studies can demonstrate that the pommel is a pathogenic process in ThOA and its correction can curb disease progression, the identification of the pommel feature may help guide targeted intervention.
Transcultural Lifestyle Medicine in Type 2 Diabetes Care: Narrative Review of the Literature
Authors: González-Rivas Juan P. , Pavlovska Iuliia , Polcrova Anna , Nieto-Martínez Ramfis , Mechanick Jeffrey I.
Published: June 2022

Disparities in type 2 diabetes (T2D) care is a global problem across diverse cultures. The Dysglycemia-Based Chronic Disease (DBCD) model promotes early and sustainable interventions along the insulin resistance (stage 1), prediabetes (stage 2), T2D (stage 3), and complications (stage 4) spectrum. In this model, lifestyle medicine is the cornerstone of preventive care to reduce DBCD progression and the socioeconomic/biological burden of disease. A comprehensive literature review, spanning 2000 to 2021, was performed and 55 studies were included examining the effects of lifestyle medicine and their cultural adaptions with different prevention modalities. In stage 1, primordial prevention targets modifiable primary drivers (behavior and environment), unhealthy lifestyles, abnormal adiposity, and insulin resistance with educational and motivational health promotion activities at individual, group, community, and population-based scales. Primary, secondary, and tertiary prevention targets individuals with mild hyperglycemia, severe hyperglycemia, and complications, respectively, using programs that incorporate structured lifestyle interventions. Culturally adapted lifestyle change in primary and secondary prevention improved quality of life and biomarkers, but with a limited impact of tertiary prevention on cardiovascular events. In conclusion, lifestyle medicine with cultural adaptations is an integral part of preventive care in patients with T2D. However, considerable research gaps exist, especially for tertiary prevention.
Utility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke
Authors: Zakeri Amanda , Schreiber Craig , Shah Varun , VonEnde Elizabeth , Granger Jessica , Minnema Amy J , Constable Mark , Shujaat Taimur , Youssef Patrick , Powers Ciarán , Jankowitz Brian , Nimjee Shahid M.
Published: June 2022

Background

A number of large bore guide catheters are currently available for use in neuroendovascular surgery. This study represents a multi-institutional retrospective series of patients undergoing mechanical thrombectomy with the use of a TracStar Large Distal Platform (LDP) guide catheter and assessed its performance in vivo in 107 patients.

Objective

To review a multi-institutional initial experience with the TracStar LDP guide catheter during mechanical thrombectomy for emergent large vessel occlusion (ELVO).

Methods

A retrospective review was performed at two level one stroke centres to include all patients who underwent mechanical thrombectomy and had the TracStar LDP guide catheter used during the intervention.

Results

The TracStar LDP guide catheter was successfully used in 107 mechanical thrombectomies. In anterior circulation ELVO, the guide catheter advanced into the cavernous segment of the internal carotid artery in 62.6% (62/99) of cases. In posterior circulation cases, the guide catheter advanced to the basilar artery in 87.5% (7/8) of cases. A thrombolysis in cerebral infarction 2b or greater reperfusion was obtained in 90.7% (97/107). No complications occurred related to the TracStar LDP guide catheter. Three complications occurred with aspiration catheters including a small dissection that did not require further intervention and fracturing of the AXS Catalyst 6 catheter tip in two cases. No thromboembolic events occurred.

Conclusions

The TracStar LDP large bore guide catheter is safe and effective at navigating the tortuous vascular anatomy often encountered during mechanical thrombectomy for stroke. The flexible distal and stiffer proximal components provide a good combination of navigability and support for use in neuroendovascular interventions.
Developing a fast-track discharge protocol for patients with cerebral aneurysms treated via neuroendovascular techniques
Authors: Entezami Pouya , Rock Andrew K. , Topp Gregory P. , Heydari Ehsaun S. , Field Nicholas C. , Boulos Alan S. , Dalfino John C. , Yamamoto Junichi , Pilitsis Julie G. , Cherukupalli Divya , McCallum Sarah E. , Paul Alexandra R.
Published: June 2022

Introduction

As we emerge from the current pandemic, hospitals, staff, and resources will need to continue to adjust to meet ongoing healthcare demands. Lessons learned during past shortages can be used to optimize peri-procedural protocols to safely improve the utilization of hospital resources.

Methods

Retrospective review of patients who underwent elective endovascular intracranial aneurysm treatment was performed. Multivariable logistic regression was used to identify factors associated with patients who were able to be discharged within 24 h of elective procedures. Rates of complications (particularly readmission) were determined.

Results

330 patients underwent elective endovascular aneurysm treatment with 86 (26.1%) discharged within 24 h. Factors associated with earlier discharge included procedure years (2019–2021) and male sex. Patients were more likely to be discharged later (after 24 h) if they underwent stent-coil embolization or flow-diversion. There was no association between discharge timing and likelihood of readmission.

Discussion

Our review highlights the safety of earlier discharge and allowed us to prepare a fast-track protocol for same-day discharge in these patients. This protocol will be studied prospectively in the next phase of this study. As we gain more comfort with emerging, minimally invasive endovascular therapies, we hope to safely achieve same-day discharge on a protocolized and routine basis, reducing the demand of elective aneurysm treatments on our healthcare system.

Conclusion

We retrospectively demonstrate that early discharge following elective aneurysm treatment is safe in our cohort and provide a fast-track pathway based on these findings for other centers developing similar protocols.
The Theater of Qualitative Research: The Role of the Researcher/Actor
Authors: Collins Christopher S. , Stockton Carrie
Published: June 2022

If the world is a stage and life is a collection of scenes, there may be a great set of discoveries to make if a researcher thinks of society like an actor. The art of analysis and human understanding may too often be under the influence of scientific approaches to method. By applying methods of theater to that of qualitative research, we explore a set of concepts to identify the interplay between the interviewer as character and researcher as actor. Furthermore, we offer practical applications of theatrical methods to qualitative research to enhance self-awareness, understanding, and discovery that all work in tandem to enhance the art of qualitative research.
“Could You Help Me Die?”: On the Ethics of Researcher-Participant Relationship and the Limitations of Qualitative Research
Authors: Sperling Daniel
Published: June 2022

Qualitative research is beneficial for researchers and society, and even for the participants themselves. Yet, end-of-life qualitative research also entails unique challenges given the sensitive topic and questions relayed to the participants, and the participants’ requests of the researchers. This paper was written following ethical issues that arose while conducting in-depth interviews with Israeli members of the Swiss Dignitas Organization in 2019. The interviews enabled participants to air their thoughts on assisted suicide and gather information about related plans that were not available to the public due to various issues. Yet, during these interviews, I also found myself dealing with significant ethical dilemmas that I had not previously encountered, such as participants asking me to lie for them, or accompany them to Switzerland to fulfil their wishes. While the interviews served as a safe environment in which the participants could air their thoughts on the topic, they led me to reexamine the ethical limitations of qualitative research and the researcher-participant relationship (within and outside the research context). By analyzing three of these interviews, I attempted to answer the following research question: What do the ethics of qualitative research entail with regards to researcher-participant boundaries, as established in sensitive situations and that involve vulnerable populations in end-of-life situations? The analysis was conducted in line with the ethical mindfulness framework and combined theoretical analysis of the literature. My analysis indicates that while qualitative research encourages the establishing of a researcher-participant relationship through trust and rapport – especially on sensitive topics that involve vulnerable populations – the researcher must also ensure both participant and researcher safety, by establishing and maintaining boundaries, even post-research. Introspective ethical inquiry, triggered by participants, requires the researcher to be vulnerable, potentially resulting in emotional discomfort. It also mandates re-engaging with the participants on ethical meanings that stem from this process.
Prediction of postprocedural filter debris after transcarotid revascularization
Authors: Leckie Katherin , Tanaka Akiko , Madison Mackenzie K , Motaganahalli Raghu L , Fajardo Andres , Keyhani Arash , Keyhani Kourosh , Wang S Keisin
Published: June 2022

Objective

Transcarotid revascularization (TCAR) is a technique in which cerebral flow reversal is utilized as embolic protection during carotid stenting. The presence, or absence, of filter debris created during TCAR could potentially be a surrogate to characterize carotid lesions at high risk for embolization and, therefore, explored in this investigation.

Methods

A retrospective review of TCARs performed within the Indiana University and Memorial Hermann (McGovern Medical School at UTHealth) Health Systems to capture demographics and preoperative variables. A mixed effect multivariate logistic regression model was created to discern the best predictors of intraoperative filter debris.

Results

During the study period, from December 2015 to December 2021, we captured filter debris status in 693 of 750 patients containing 323 cases of filter embolization at case completion. With respect to demographics and indications, we found a higher incidence of neck radiation (2.7 vs. 7.1%, p = 0.01) and a more pronounced Charlson Comorbidity Index (CCI; 5.3 ± 0.3 vs 5.7 ± 0.3, p < 0.01) in the filter debris cohort while contralateral carotid occlusion (6.6 vs. 2.9%, p = 0.05) and clopidogrel usage (87.3 vs. 80.1%, p = 0.03) were less common. Longer intraoperative flow reversal (8.0 ± 1.2 vs 10.5 ± 1.2, p < 0.01) and fluoroscopy time (4.0 ± 0.6 vs 5.1 ± 0.6, p < 0.01) were also seen in those with filter debris. These findings remained when a mixed effect univariate logistic regression model was used to account for differences in filter debris reporting between locations. After multivariable modeling, we found that reverse flow time and CCI remained predictive of filter debris while the presence of a contralateral carotid occlusion was still protective.

Conclusion

In our combined experience, the creation of visible filter debris after TCAR seems to be independently associated with extended reverse flow time and elevated CCI while a contralateral carotid occlusion was protective.
Human interaction targets of SARS-CoV-2 spike protein: A systematic review
Authors: Faraji Seyed Nooreddin , Raee Mohammad Javad , Hashemi Seyed Mohamad Ali , Daryabor Gholamreza , Tabrizi Reza , Dashti Fateme Sadat , Behboudi Emad , Heidarnejad Kamran , Nowrouzi-Sohrabi Peyman , Hatam Gholamreza
Published: June 2022

Objectives:

The development of effective targeted therapy and drug-design approaches against the SARS-CoV-2 is a universal health priority. Therefore, it is important to assess possible therapeutic strategies against SARS-CoV-2 via its most interaction targets. The present study aimed to perform a systematic review on clinical and experimental investigations regarding SARS-CoV-2 interaction targets for human cell entry.

Methods:

A systematic search using relevant MeSH terms and keywords was performed in PubMed, Scopus, Embase, and Web of Science (ISI) databases up to July 2021. Two reviewers independently assessed the eligibility of the studies, extracted the data, and evaluated the methodological quality of the included studies. Additionally, a narrative synthesis was done as a qualitative method for data gathering and synthesis of each outcome measure.

Results:

A total of 5610 studies were identified, and 128 articles were included in the systematic review. Based on the results, spike antigen was the only interaction protein from SARS-CoV-2. However, the interaction proteins from humans varied including different spike receptors and several cleavage enzymes. The most common interactions of the spike protein of SARS-CoV-2 for cell entry were ACE2 (entry receptor) and TMPRSS2 (for spike priming). A lot of published studies have mainly focused on the ACE2 receptor followed by the TMPRSS family and furin. Based on the results, ACE2 polymorphisms as well as spike RBD mutations affected the SARS-CoV-2 binding affinity.

Conclusion:

The included studies shed more light on SARS-CoV-2 cellular entry mechanisms and detailed interactions, which could enhance the understanding of SARS-CoV-2 pathogenesis and the development of new and comprehensive therapeutic approaches.
A midline pelvic mass: Ovarian fibroma appearing vaginal in nature
Authors: Li Michael C , Polk Stuart L , Myers Ross A
Published: June 2022

Introduction:

Ovarian fibroma is an uncommon, benign, stromal neoplasm that is a mixture of collagen-producing mesenchymal cells. There are varying sonographic and computed tomography features described in literature of smaller scale studies.

Case Report:

We describe a case of an ovarian fibroma presenting as a midline pelvic mass mimicking a vaginal cuff tumour in a 67-year-old patient with surgical history of a hysterectomy. Computed tomography and ultrasound were utilised to evaluate the mass and guide management of the patient. The mass was initially suspected on CT-guided biopsy as a vaginal spindle cell epithelioma amongst other potential differential considerations. With robot-assisted laparoscopic surgery and histologic analysis, the true diagnosis of an ovarian fibroma was reached.

Discussion:

An ovarian fibroma is an uncommon, benign, stromal ovarian tumour, representing just 1-4% of all ovarian tumours. Its widely varying imaging features present a challenge when radiologically evaluating ovarian fibromas or pelvic tumours, as the differential diagnoses are extensive and ovarian fibromas are often misdiagnosed until surgical resection. We highlight the features of ovarian fibromas and the potential value of pelvic/transvaginal ultrasonography in management of ovarian fibroma and other pelvic masses.

Conclusion:

The use of computed tomography and ultrasound aided in the diagnostic and treatment pathway of this patient with a pelvic mass. There is high utility of sonography in evaluating such tumours to elucidate salient features, expedite diagnosis, and guide further management.
Abdominal aortic aneurysm growth rates in patients undergoing local ultrasound surveillance
Authors: Hornby-Foster Ian
Published: June 2022

Objectives:

Abdominal aortic aneurysm ultrasound surveillance varies between hospitals in the United Kingdom. University Hospitals Bristol and Weston adopt a 6-monthly surveillance interval for 4.5–4.9 cm abdominal aortic aneurysm, which is a deviation from nationally recommended 3-monthly intervals. Assessment of abdominal aortic aneurysm growth rate, and the concurrent impact of abdominal aortic aneurysm risk factors and medications prescribed for risk factors, may inform whether this change in surveillance intervals is safe and appropriate.

Methods:

This analysis was conducted retrospectively. A total of 1312 abdominal aortic aneurysm ultrasound scans from 315 patients between January 2015 and March 2020 were split into 0.5 cm groups, ranging from 3.0 to 5.5 cm. Abdominal aortic aneurysm growth rate was assessed with one-way analysis of variance. The impact of risk factors and risk factor medication on abdominal aortic aneurysm growth rate was analysed using multivariate and univariate linear regression and Kruskal–Wallis tests. Patient cause of death among surveillance patients was recorded.

Results:

Abdominal aortic aneurysm growth rate was significantly associated with increased abdominal aortic aneurysm diameter ( p < 0.001). There was a significant whole-group reduction in growth rate from 0.29 to 0.19 cm/year in diabetics compared to non-diabetics ( p = 0.02), supported by univariate linear regression ( p = 0.04). In addition, gliclazide patients had lower growth rate compared to patients not on the medication ( p = 0.04). One abdominal aortic aneurysm rupture occurred <5.5 cm resulting in death.

Conclusion:

Abdominal aortic aneurysm measuring 4.5–4.9 cm had a mean growth rate of 0.3 cm/year (± 0.18 cm/year). Therefore, mean growth rate and variability suggest patients are unlikely to surpass surgical threshold of 5.5 cm between the 6-monthly surveillance scans, supported by low rupture rates. This suggests the surveillance interval for 4.5–4.9 cm abdominal aortic aneurysm is a safe and appropriate deviation from national guidance. In addition, it may be pertinent to consider diabetic status when designing surveillance intervals.
Using Attachment and Biobehavioral Catch-up with young children with developmental delays: A multiple-baseline trial of attachment, sensitivity, and cortisol
Authors: Mohamed Ahmed Riaz , Sterkenburg Paula , Yeatman Joshua G. , van Rensburg Esmé , Schuengel Carlo
Published: June 2022

The Attachment and Biobehavioral Catchup intervention potentially offsets psychosocial risks facing dyads in which children have intellectual disability or developmental delays. In this single-case multiple-baseline study the efficacy of this intervention was tested across three such South African families. Maternal sensitivity, attachment security, and child affect regulation were measured weekly during a baseline and intervention period, using the Ainsworth Maternal Sensitivity Scales, Attachment Q-sort and salivary cortisol, respectively. Furthermore, post-intervention interviews invited parents’ and intervenors’ evaluations of the intervention. Visual analysis broadly indicated improvement in maternal sensitivity and attachment security across subjects over time following the introduction of the intervention, although randomisation tests were not statistically significant. Effects on affect regulation were not clearly observed and may have been influenced by case-specific variables. Parent-participants and intervenors also identified particularly helpful contributions from the intervention. Findings underscore the importance of individual-level effects evaluation, especially when implementing interventions outside the original population.
The Racialised ‘Second Existence’ of Class: Class Identification and (De-/Re-)construction across the British South Asian Middle Classes
Authors: Saini Rima
Published: June 2022

This article maps typologies of class identity for the UK-born South Asian middle classes. Using thematic analysis of interviews with 20 British South Asian professionals, it identifies culturally and socially situated forms of class (dis-)identification. It finds that ‘middle-class’ identity is not uncritically adopted or internalised by socially mobile British South Asians who, on the bases of objective socioeconomic markers, may be classified as such. Beyond existing research which has long established the dual material and symbolic nature of class, and the corresponding ‘fuzziness’ of class subjectivity, for the population of interest this can be attributed in large part to: (i) the rapid upward intergenerational social mobility of South Asian groups which is seen to defy British-specific forms of stratification and class reproduction and (ii) the racialisation of class where the symbolic power and subjective salience of middle-classness is mediated through Whiteness. In establishing this, this article argues for further theoretical and analytical reflection on the racialisation of class taking into account the ethnoracial specificities of culturally diverse ethnic minority populations.
Critical care drowning admissions in Southwest England 2009–2020, a retrospective study
Authors: Brayne Adam B , Jones William , Lee Adrienne , Chatfield-Ball Catherine , Kaye Duncan , Ball Matthew , Sacher Gorki ,   South West Anaesthetic Research Matrix (SWARM), Morgan Patrick
Published: June 2022

Aim

In the United Kingdom (UK), 600 deaths per annum are attributable to drowning. Despite this there is scarce critical care data on drowning patients globally. We describe drowning cases admitted to critical care units with a focus on functional outcomes.

Materials and Methods

Medical records for critical care admissions following a drowning event were retrospectively reviewed across six hospitals in Southwest England for cases presenting in the period between 2009 and 2020. Data was collected according to the Utstein international consensus guidelines on drowning.

Results

Forty-nine patients were included, 36 males and 13 females, including seven children. Median submersion duration was 2.5 min 20 cases were in cardiac arrest when rescued. At discharge 22 patients had preserved functional status, 10 patients had a reduced functional status. 17 patients died in hospital.

Conclusion

Admission to critical care following drowning is uncommon and associated with high rates of mortality and poor functional outcomes. We find that 31% of those who survived a drowning event subsequently required an increased level of assistance with their activities of daily living.
The Feelings of Goals Hypothesis: Emotional Feelings are Non-Conceptual, Non-Motoric Representations of Goals
Authors: Kron Assaf , Weksler Assaf
Published: June 2022

This paper proposes and develops the feelings of goals hypothesis (FGH). It has two aims: first, to describe the evolutionary function of emotional feelings (EFs), and second, to describe the content and the format of EFs. According to FGH, the evolutionary function of EFs is to enable motoric flexibility. Specifically, EFs are a component of a psychological mechanism that permits differential motoric reactions to the same stimulus. Further, according to FGH, EF is a special type of mental representation with the content of an action goal, and with a non-motoric, non-conceptual format. This paper thoroughly clarifies the assumptions underlying FGH and discusses its theoretical implications and empirical predictions.
Cerebral palsy
Authors: Vincent Maria
Published: June 2022

Cerebral palsy is a relatively common cause of physical and neurological disability. The health and care needs of people with cerebral palsy bring medical complexity and frequent contact with health professionals. The GP has a unique opportunity to provide continuity for the person throughout their life course and can be an important support for the patient and their carers during illness and periods of transition. This article aims to highlight the important clinical aspects of cerebral palsy and the principles of management, with an emphasis on the role of the GP.
Skeletal Muscle Manifestations and Creatine Kinase in COVID-19
Authors: Friedman Sarah A. , Charmchi Zeinab , Silver Michael , Jacoby Nuri , Perk Jonathan , Anziska Yaacov
Published: June 2022

Background and Purpose

Skeletal muscle symptoms and elevated creatine kinase (CK) levels have been consistently reported as part of the COVID-19 disease process. Previous studies have yet to show a consistent relationship between CK levels and skeletal muscle symptoms, disease severity, and death from COVID-19. The purpose of this study is to determine whether elevated CK is associated with a COVID-19 course requiring intubation, intensive care, and/or causing death. Secondary objectives: To determine if there is a relationship between elevated CK and (1) skeletal muscle symptoms/signs (2) complications of COVID-19 and (3) other diagnostic laboratory values.

Methods

This is a retrospective, single center cohort study. Data were collected from March 13, 2020, to May 13, 2020. This study included 289 hospitalized patients with laboratory-confirmed SARS-CoV-2 and measured CK levels during admission.

Results

Of 289 patients (mean age 68.5 [SD 13.8] years, 145 [50.2%] were men, 262 [90.7%] were African American) with COVID-19, 52 (18.0%) reported myalgia, 92 (31.8%) reported subjective weakness, and 132 (45.7%) had elevated CK levels (defined as greater than 220 U/L). Elevated CK was found to be associated with severity of disease, even when adjusting for inflammatory marker C-reactive protein (initial CK: OR 1.006 [95% CI: 1.002-1.011]; peak CK: OR 1.006 [95% CI: 1.002-1.01]; last CK: 1.009 [95% CI: 1.002-1.016]; q = .04). Creatine kinase was not found to be associated with skeletal muscle symptoms/signs or with other laboratory markers.

Conclusions

Creatine kinase is of possible clinical significance and may be used as an additional data point in predicting the trajectory of the COVID-19 disease process.
Purposeful and Ethical Early Childhood Teacher: The Underlying Values Guiding Finnish Early Childhood Education
Authors: Melasalmi Anitta , Hurme Tarja-Riitta , Ruokonen Inkeri
Published: June 2022

Purpose

The new Finnish National Core Curriculum for Early Childhood Education and Care (2018) strongly highlights pedagogical knowledge and practice, demanding teachers to develop their pedagogical thinking, evaluation, judgment, and operating culture. Since ethics is viewed as vital characteristics of the teaching profession, our objective is to make these complex ethical issues more visible to be subject to democratic discussion and change.

Design/Approach/Methods

The framework comprises a broad theory base of codes of ethics and professional codes of ethics of teaching. The research materials were national curricula of early childhood education and care (ECEC)- and pre-primary education. The eight-step qualitative analysis process was applied to identify and shed light on the codes of ethics laying the foundations for purposeful and ethical early childhood education (ECE) teacher.

Findings

The results indicate that through both theoretical lenses, the Finnish ECEC curricula comprise several ethical codes. For the future purposeful ECE teachers as ethical professionals, the results raise questions for further discussion. Particularly, issues related to the ethics of care, intellectual freedom, inquiry stance, and professional competence, and diversity may further enhance our ECEC curricula.

Originality/Value

During recent decades, the ethics concerning ECEC have gained increasing global attention. Particularly, there is a large international consensus considering ECEC as a prominent policy equalizing opportunities.
Treatment Variability and Complications Associated With Pediatric Lateral Ankle Injuries: A POSNA Quality, Safety, and Value Initiative Survey
Authors: Beck Jennifer J. , Carpenter Connor M. , West Nicole , Sabatino Meagan J. , Ellis Henry B.
Published: June 2022

Background:

Isolated pediatric lateral ankle injuries, including ankle sprain (AS) and nondisplaced Salter-Harris type 1 (SH-1) distal fibular fracture, are common orthopaedic sports-related injuries. Variability in treatment is suspected among pediatric orthopaedic surgeons. Complications from medical treatment or lack thereof have not been reported in this population.

Purpose:

The purpose of this study was to investigate treatment variability and associated complications after pediatric AS and SH-1 via a survey of members of the Pediatric Orthopaedic Society of North American (POSNA).

Study Design:

Cross-sectional study. Level of evidence, 5.

Methods:

A voluntary, anonymous survey was distributed to POSNA membership (approximately 1400 members) via email. Survey questions, specific to both grade 1 or 2 AS and nondisplaced or minimally displaced SH-1 injuries in skeletally immature patients, focused on initial evaluation, immobilization, return to sports, and complications. We analyzed variability both in treatment between AS and SH-1 injury and in respondent characteristics. For statistical analysis, chi-square or Fisher exact test was used for categorical variables, and analysis of variance was used for continuous variables.

Results:

The survey response rate was 16.4% (229/1400). Of the respondents, 27.7% used examination only to distinguish between AS and SH-1, whereas 18.7% performed serial radiography to aid with diagnosis. A controlled ankle motion boot or walking boot was the most common immobilization technique for both AS (46.3%) and SH-1 (55.6%); the second most common technique was bracing in AS (33.5%) and casting in SH-1 (34.7%). Approximately one-third of all respondents recommended either outpatient or home physical therapy for AS, whereas only 11.4% recommended physical therapy for SH-1 ( P < .01). Results showed that 81.2% of respondents reported no complications for SH-1 treatment and 87.8% reported no complications for AS treatment. Cast complications were reported by 9.6% for SH-1 and 5.2% for AS. Rare SH-1 complications included distal fibular growth arrest, infection, nonunion, late fracture displacement, and recurrent fracture.

Conclusion:

Significant variability was found in primary treatment of pediatric AS and SH-1 injuries. Rare complications from injury, treatment, and neglected treatment after SH-1 and AS were reported.
Training Actors’ Knowledge of the Lived Experience of People With Advanced Dementia
Authors: Timmerman Guus , Leest Judith
Published: June 2022

Do professional actors playing someone with dementia in training situations have knowledge of what it is like to be someone with dementia? And what knowledge? In preparation of a phenomenological study into the experience of people with advanced dementia in residential care, we interviewed four of these actors. Reflecting on their own experience with people with dementia and other experiences in their life enabled them to explore and find a reservoir of movements, gestures, postures, gazes, emotions, and responses from which they draw during their play. This reservoir is confirmed and refined in their playing persons with dementia. Their preparation, experience while playing, and reflection, validated by the response from caregivers, family members and people with dementia, make their knowledge as near as we can get to the experience of people with advanced dementia. Taking in this knowledge contributes to a larger repertoire to draw from in practising moral imagination.
Building Value through Sales Ethics
Authors: DeTienne Kristen Bell , Alessandri Alice , Aleo Alberto , Agle Brad
Published: June 2022

Ethical lapses seem to be at all-time highs, threatening company reputations and undermining consumer trust. Many sales associates feel forced into unethical behaviour. Ethics stress increases turnover, burnout and fatigue, and it decreases employee satisfaction. What if ethical sales practices could create value through increased sales, higher customer satisfaction and retention, more referrals and improved well-being for employees? Research shows companies need not sacrifice profits for ethics. In fact, companies with higher ethical standards experience greater customer loyalty, satisfaction and referrals. This article highlights key research findings and provides practical suggestions for creating an ethical culture.
Joule heating and thermal radiation impact on MHD boundary layer Nanofluid flow along an exponentially stretching surface with thermal stratified medium
Authors: Shankar Goud Bejawada , Dharmendar Reddy Yanala , Mishra Satyaranjan
Published: June 2022

The current investigation leads to the characterisation of the flow phenomena of hydromagnetic nanofluid thermal stratified through permeable medium due to the influence of the radiative heat energy. Additionally, the behaviour of chemical reaction, viscous as well as Joule dissipations enriches the flow profiles. The embedded system for the governing equation comprised of partial differential equations is distorted to nonlinear ordinary with the help of the similarity transformations. MATLAB software is used to implement numerical schemes such as the Runge-Kutta-Fehlberg methodology in conjunction with the shooting method. The effects of several non-dimensional factors on flow phenomena are shown graphically, and the simulated results for the rate coefficients are presented in tabular form. The results established are extremely closed and excellent concurrence with published work. The thermal boundary surface thickness is enhanced due to frictional heating with rising values of Eckert number. A rise in Dufour number leads to a reduction in temperature profile. In contrast, a rise in concentration leads to higher values of the Soret number.
From detention officer to detention monitor: Reflections on staff experiences of confinement
Authors: Caruana Steven , Johns Diana
Published: June 2022

In August 2019, a research workshop at the University of Melbourne brought together academics, practitioners, advocates, people with experience of living and working in confined settings to explore parallels between the spaces and practices of care and control in different places of confinement. A former immigration detention officer, later inspector and monitor of closed environments, joined the discussion. Along with other voices of ‘lived experience’, he offered a unique perspective on working in places where a ‘duty of care’ can mean less about how people should be treated or cared for, and more about guarding oneself and one’s employer against personal and institutional criticism. In the following conversation (with one of the editors of this Special Themed Collection of papers that arose from that workshop) he shares experiences of working in immigration detention, in both operational and oversight roles, and the tensions between the two. He reflects on cultures of suspicion and silence, bearing witness to experiences of violence and suffering, and what it means to be human in conditions of confinement.
Understanding school leaders and educators’ attitudes towards youth migrants: An experimental analysis
Authors: Arar Khalid , Saiti Anna , Anysiadou Melpomeni , Abo-Zaed Arar Eman
Published: June 2022

Due to the global economic and political crises in various regions of the world in recent years, the flow of migrants from countries with deeper structural problems to more developed countries has increased dramatically. At national level, education is the basis on which the values, philosophy, ideology, and culture of a nation are determined. Behavior is analyzed from both psychological and sociological perspectives. The purpose of the paper is, through an experimental analysis of Greek school leaders and educators in the upper level of secondary education, to investigate their attitudes towards young immigrants that attend Greek high schools and determine whether or not their behavior is being influenced by psychological or sociological aspects of the migration phenomenon. The experimental results are in accordance with both sociological and psychological perspectives for the chosen behaviors of school educators. It is clear that familiarity, experience and the exercise of educational policy are critical factors influencing teachers' attitudes towards young immigrants. No difference in behavior has been found except for a slightly more positive attitude towards emigration. In view of the above, recognizing the importance of more cohesive and socially protective educational policies and practices would have far-reaching consequences.
A review on microphase separation measurement techniques for polyurethanes
Authors: Gholami Mehdi , Haddadi-Asl Vahid , Jouibari Iman Sahebi
Published: June 2022

Polyurethanes (PUs) microstructure and characteristics is strongly affected by microphase separation that arises from the thermodynamic immiscibility between the hard and soft segments. The extent of phase separation as well as the morphology and size of the separated phase governs their mechanical, electrical, thermal, and functional properties. This review: (1) provides an insight into how phase separation affects PU properties, (2) explains methods used to study PU phase separation. We review approaches from the simplest one, that is, the transparency measurement, to the more advanced methods including the spectroscopic techniques (infrared, nuclear magnetic resonance spectroscopies and X-ray scattering), rheological instruments ( rheometrics mechanical spectrometer), and thermal analyses (differential scanning calorimetry). We also discuss the theoretical calculations and the molecular modeling used to study PU phase separation.
Usage of procalcitonin and sCD14-ST as diagnostic markers for postoperative spinal infection
Authors: Zhu Xi , Li Kaige , Zheng Jianping , Xia Gen , Jiang Feng , Liu Huan , Shi Jiandang
Published: June 2022

Objective

Identifying biomarkers for early diagnosis of postoperative spinal infection is essential to avoid complications after spine surgery. The presented study evaluated serum levels of procalcitonin (PCT), C-reactive protein (CRP), and soluble CD14 subtype (sCD14-ST) in patients who underwent spinal surgery to assess the diagnosis values of PCT and sCD14-ST.

Methods

Serum levels of PCT, CRP, and sCD14-ST were measured in 490 (289 male/201 female) patients who underwent spinal surgery (SS) before and 1 day after surgery. PCT and sCD14-ST levels of patients diagnosed with postoperative infection (PI) and patients diagnosed with postoperative non-infection (PN) were compared.

Results

Serum levels of PCT, CRP, and sCD14-ST were significantly increased after surgery (F = 58.393, P = 0.000). In patients diagnosed as having a PI, serum levels of PCT and sCD14-ST were positively correlated with each other (r = 0.90, P < 0.01) and with operation duration (r = 0.92, 0.88, P < 0.01). Receiver operating characteristic (ROC) models showed that both PCT (AUC = 0.817, optimal cutoff: 0.69 ng/ml, P = 0.000) and sCD14-ST (AUC = 0.824, optimal cutoff: 258.27 pg/ml, P = 0.000) can distinguish PI versus PN patients well.

Conclusion

Our results demonstrated that serum levels of PCT and sCD14-ST have the potential to be used as a diagnostic markers for postoperative spinal infection.