bluuebunny/crossref_metadata_2025 huggingface dataset:
Time-Restricted Salutary Effects of Blood Flow Restoration on Venous Thrombosis and Vein Wall Injury in Mouse and Human Subjects
Authors: Li Wenzhu , Kessinger Chase W. , Orii Makoto , Lee Hang , Wang Lang , Weinberg Ido , Jaff Michael R. , Reed Guy L. , Libby Peter , Tawakol Ahmed , Henke Peter K. , Jaffer Farouc A.
Published: January 2021

Background:

Up to 50% of patients with proximal deep vein thrombosis (DVT) will develop the postthrombotic syndrome characterized by limb swelling and discomfort, hyperpigmentation, skin ulcers, and impaired quality of life. Although catheter-based interventions enabling the restoration of blood flow (RBF) have demonstrated little benefit on postthrombotic syndrome, the impact on the acuity of the thrombus and mechanisms underlying this finding remain obscure. In experimental and clinical studies, we examined whether RBF has a restricted time window for improving DVT resolution.

Methods:

First, experimental stasis DVT was generated in C57/BL6 mice (n=291) by inferior vena cava ligation. To promote RBF, mice underwent mechanical deligation with or without intravenous recombinant tissue plasminogen activator administered 2 days after deligation. RBF was assessed over time by ultrasonography and intravital microscopy. Resected thrombosed inferior vena cava specimens underwent thrombus and vein wall histological and gene expression assays. Next, in a clinical study, we conducted a post hoc analysis of the ATTRACT (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) pharmacomechanical catheter-directed thrombolysis (PCDT) trial (NCT00790335) to assess the effects of PCDT on Venous Insufficiency Epidemiological and Economic Study quality-of-life and Villalta scores for specific symptom-onset-to-randomization timeframes.

Results:

Mice that developed RBF by day 4, but not later, exhibited reduced day 8 thrombus burden parameters and reduced day 8 vein wall fibrosis and inflammation, compared with controls. In mice without RBF, recombinant tissue plasminogen activator administered at day 4, but not later, reduced day 8 thrombus burden and vein wall fibrosis. It is notable that, in mice already exhibiting RBF by day 4, recombinant tissue plasminogen activator administration did not further reduce thrombus burden or vein wall fibrosis. In the ATTRACT trial, patients receiving PCDT in an intermediate symptom-onset-to-randomization timeframe of 4 to 8 days demonstrated maximal benefits in Venous Insufficiency Epidemiological and Economic Study quality-of-life and Villalta scores (between-group difference=8.41 and 1.68, respectively,
P
<0.001 versus patients not receiving PCDT). PCDT did not improve postthrombotic syndrome scores for patients having a symptom-onset-to-randomization time of <4 days or >8 days.

Conclusions:

Taken together, these data illustrate that, within a restricted therapeutic window, RBF improves DVT resolution, and PCDT may improve clinical outcomes. Further studies are warranted to examine the value of time-restricted RBF strategies to reduce postthrombotic syndrome in patients with DVT.
Gonadal cycle of the blue crab Portunus segnis (Forskål, 1775) (Decapoda, Portunoidea) in the Mediterranean Sea off Alexandria, Egypt
Authors: Gaber Ibrahim , Luisetto Mauro , Latyshev Oleg
Published: January 2021

Adults of Portunus segnis were captured from Ras el Tin beach on the Mediterranean Sea at Alexandria, Egypt, from January to December 2017. Male crabs are present in higher density in the sea during fall and winter, while female crabs are more common during spring and summer. Sex ratios were calculated as follows: number of males or females/total number of crabs. The calculated sex ratios were subjected to a Chi-square test according to the equation: , where O represents the observed frequency and E the expected frequency. One-way analysis of variance shows differences in the carapace size (length and width) and the weight of males and females during the four seasons. The hepatosomatic index of male crabs ranges from 9.1-9.25 in winter months, 8.7-7.9 in fall, being lower, 3.12-2.25, in spring and 5.96-4.13 in summer. The hepatosomatic index of female crabs is 8.9-3.9 in spring, 9.2-7.9 in summer, shifts lower to 5.1-3.2 in fall and to 4.2-1.5 in winter. The gonadosomatic index of female crabs is 0.12-8.2 in spring, 0.20-13.9 in summer and decreases to 0.66-7.8 in fall and 0.18-4.7 in winter. Ovaries and testes were isolated, fixed, and prepared for histological examination. The testicular lobes are surrounded by simple epithelium with haemolymph filling the interspaces. Seminiferous ducts are inserted in the testicular lobes. Spermatogenesis and spermiogenesis are described. The vas deferens is usually filled with spermatophores. Spermatophore formation begins in the testis near the vas deferens. Near the base of the penes there is glandular tissue. This study proposes the classification of the ovarian maturation into five stages: Stage I, Immature ovary with primary and secondary oogonia; Stage II, early maturing ovary with germ cells in different maturation phases; Stage III, mature ovary with vitellogenic oocytes and germ cells; Stage IV, maturing ovary with oocytes I, II and fully mature oocytes; and Stage V, ovary in regeneration. The wall of the spermatheca consists of a stratified squamous epithelium.
First record of the symbiotic palaemonid shrimp Hamodactylus boschmai Holthuis, 1952 (Decapoda, Caridea) from Korea
Authors: Park Jin-Ho , Lee Damin , Park Taeseo
Published: January 2021

Here, the symbiotic palaemonid shrimp Hamodactylus boschmai is recorded from Korean waters for the first time, based on specimens collected from different invertebrate hosts by trimix diving at depths of between 45 and 60 m in Jejudo Island. This species can readily be distinguished from its congeners by the presence of a distinct supraorbital tooth, the proximal segment of the antennular peduncle having a single tooth on the distolateral margin, the presence of a denticulate lamina along the entire cutting edge of the fingers of the first pereiopod chela, and the chela of the second pereiopods having a strongly hooked tip on the movable finger. An illustrated description, colour photographs, and a comparison of partial mitochondrial cytochrome c oxidase subunit I gene sequences are provided.
The Scent of the Righteous vs. the Scent of the Wicked: Body Odor as a Social Indicator of Morality in Rabbinic Literature
Authors: Shemesh Abraham Ofir
Published: January 2021

Perceiving the odor emitted by one’s body or clothes as a manifestation of moral identity is a cross-cultural sociological and literary phenomenon. Odors were perceived as a mark that set social boundaries and they made it possible to distinguish between groups of people by their status or identity. In the Christian, Muslim, and Bahai traditions holy people, such as prophets, martyrs, and shahids, were perceived or described as smelling good. In Jewish cultural discourse, smell is a sociological-religious indicator that distinguishes, whether symbolically or realistically, between the good and the corrupt. The term “foul smell” is mentioned in association with negative people, mainly with regard to sexual promiscuity. In contrast, a good fragrance is emblematic of the Patriarchs (Abraham), people with stringent sexual morals (Joseph), and Torah scholars.
Sforno’s Threefold Approach to the Torah’s Structure
Authors: Sklarz Miriam
Published: January 2021

Classical exegetes’ exploration of structure and order in the Pentateuch is generally perceived as part of an internal-Jewish debate. However, in an exceptional testimonial, the introduction to R. Ovadiah Sforno’s Torah commentary describes a polemic against the Torah grounded in a claim about the Torah’s disorderliness. Responding to this critique, Sforno set out to uncover the Torah’s logical order. His efforts to elucidate the Torah’s order and structure include three aspects: he points to a circular structure that is repeated seven times in Genesis-Numbers, he systematically links the independent legal sections in Deuteronomy, and he discusses the Torah’s division into five separate books. While methodically addressing the question of order, Sforno also offers a response to fundamental theological issues at the center of the interfaith polemic.
Ideation
Authors: Quade Stefanie , Schlüter Okke
Published: January 2021

DesignAgility is an adaptation of the design thinking method and was developed to meet the specific needs of the publishing industry and the media sector in general. The authors of the eponymous book embedded DesignAgility into an agile framework that allows its users to effectively develop and implement media innovations with a small team. This sample chapter of the book focuses on Ideation and describes the qualified brainstorming and idea-generating in the innovation process. The needs of the users aka the ‘personas’ are reflected in so-called ‘user stories’. Through refinement the ideas are developed into possible product or service features. The chapter describes detailed steps from preparation to procedure and includes a checklist of how to easily follow the instructions for ideation. The visualization of the DesignAgility process shows where this step has to be taken within the whole innovation process.
Teaching Journalism in the Age of Trump
Authors: Winston Diane
Published: January 2021

How can we teach journalism in the age of Trump, and what does public theology have to do with it?
The Semiotics of the Medical Face Mask: East and West
Authors: Leone Massimo
Published: January 2021

After a concise survey of the state of the art on the semiotics of the mask and on studies in humanities and social sciences about medical face masks, the essay provides anecdotic evidence about differences in the semiotics of medical face masks in Europe and in the ‘Far East’, especially Japan, China, and Korea; it proposes a semiotic grid for decoding the phenomenology and meaning of the medical face mask; it concludes with some general observations on the change of the meaning of the face during the current pandemic.
The ‘Neutral’ – the Semiotic Paradigm of Sinogram
Authors: Meng Hua , Gong Xuemei
Published: January 2021

Redefining Roland Barthes’ term ‘The neutral’ as ‘the neutrality and dissolution of the dualistic opposition’, this paper argues that Chinese characters are quasi-characters, quasi-signs, and neuter. The unique paradigm of Chinese characters is revealed by comparing the neuter phenomena of ‘centrifugalisation’ and ‘centripetalisation’ between pictures and characters, thus highlighting the significance of such a paradigm to contemporary semiotic studies.
The missing link: Rhyncogonus Sharp in the Gambier Islands (Coleoptera, Curculionidae, Entiminae, Rhyncogonini)
Authors: RAMAGE THIBAULT
Published: January 2021

The genus Rhyncogonus Sharp, 1885, is represented in French Polynesia by 65 species found in the Austral, Marquesas, Society and Tuamotu archipelagos. Hitherto unknown from the fifth archipelago of French Polynesia, the Gambier Islands, a new species of Rhyncogonus has been discovered by the botanist Jean-François Butaud on Motu Teiku, a small island never previously investigated for plants and insects. Rhyncogonus duhameli sp. nov. is here described and illustrated.
Effect of MicroRNA-26a Targeting mCTGF on Calcification of Vascular Smooth Muscle Cells Through Regulating Osteoprotegerin/Receptor Activator of NF-kB/Receptor Activator of Nuclear Factor Kappa-B Ligand Signaling Pathway
Authors: Zhang Zhe , Cheng Jing , Yang Zhen
Published: January 2021

To explore the effect of microRNA-26a targeting mCTGF on inhibiting the calcification of vascular smooth muscle cells (VSMCs) through OPG/RANK/RANKL signaling pathway. VSMCs were isolated and cultured by adherent method. The morphology of VSMCs was observed under microscope and the
surface antigen was identified by flow cytometry. The calcification of VSMCs was detected using alizarin red S staining and oil red O staining. microRNA-26a level in supernatant of cultured VSMCs was detected by ultracentrifugation method. The binding site between microRNA-26a and 3′-UTR
of mCTGF was predicted by bioinformatics software; VSMCs were induced to be calcified and verified by the luciferase reporter gene assay. The mRNA and protein expressions of OPG/RANK/RANKL signaling pathway were measured by qRT-PCR and Western blotting. Normal VSMCs were assigned into normal
group (normal VSMCs were treated with the exosomes secreted by normal VSMCs), CKD group (normal VSMCs were treated with the exosomes secreted by VSMCs in mice with chronic kidney disease (CKD)) and CKD/overexpressed mCTGF group (normal VSMCs were treated with the exosomes secreted by VSMCs
in CKD mice and meanwhile treated with overexpressed mCTGF) followed by analysis of OPG/RANK/RANKL signaling level by qRT-PCR and ALP activity. VSMCs grew against the wall and showed a long fusiform shape. Calcification and adipogenesis of VSMCs was found under different induction conditions.
microRNA-26a level in the supernatant of VSMCs in CKD group was significantly higher than normal group; after microRNA-26a bound to of mCTGF, mCTGF level in the CKD/overexpressed mCTGF group was significantly lower. The expression of OPG/RANK/RANKL signaling pathway was significantly decreased
in the CKD/overexpressed mCTGF group. Meanwhile, OPG/RANK/RANKL signaling protein was increased significantly after treatment of exosomes secreted by VSMCs in CKD mice. mCTGF is the target gene of microRNA-26a and microRNA-26a can target mCTGF to regulate exosomes secretion by VSMCs and OPG/RANK/RANKL
signaling to inhibit the calcification of VSMCs.
Post-Tonsillectomy Bleeding: A National Perspective
Authors: Dhaduk Nehal , Rodgers Ashley , Govindan Aparna , Kalyoussef Evelyne
Published: January 2021

Objectives:

Tonsillectomy is one of the most common otolaryngologic procedures. Hemorrhage after tonsillectomy is one of the most feared complications by surgeons and patients alike. The objective of this study was to analyze the risk factors associated with an increase in post-tonsillectomy hemorrhage in the pediatric population using a large national database.

Methods:

The Kids’ Inpatient Database (KID) from 2000 to 2012 was queried for patients between the ages of 1 to 17 years with post-tonsillectomy hemorrhage. Univariate and multivariate analyses were performed to obtain trends in patient demographics, comorbidities, and hospital information.

Results:

Overall 45 940 pediatric cases of tonsillectomy were identified of which 5470 (11.9%) resulted in postoperative hemorrhage. Patients with postoperative hemorrhage were significantly older with mean age of 8.62 (±4.75) compared to all patients. Females were found to have higher rates of hemorrhage when compared to males 14.6% versus 11.5% ( P < .001). The rate of white patients who had hemorrhage was 16.3% ( P < .001). The most common comorbidities significantly associated with hemorrhage were fluid and electrolyte disorders (6.6% P < .001), deficiency anemia (3.8%; P < .001), and coagulopathy (2.7%; P < .001). Urban nonteaching hospitals had higher rates of hemorrhage (19.6%; P < .001) and the Northeast was the most common region (15.2%; P < .001). On multivariate analysis, older patients and white ethnicity showed a significantly increased risk of hemorrhage. Patients with pre-existing comorbidities such as coagulopathy, deficiency anemia, and fluid and electrolyte disorders circulation were also found to have higher odds ratios of bleeding.

Conclusion:

Postoperative hemorrhage is a common complication following tonsillectomy with a rate of 11.9% in this study. A higher rate of hemorrhage was seen with increasing age, white race, and males overall, as well as patients with fluid and electrolyte disorders. Urban non-teaching hospitals and the Northeast region also saw increased rates of hemorrhage.
‘Open for Business’ but Bankrupt: Currencies, the ‘New Dispensation’ and the Zimbabwean Economy
Authors: Nyamunda Tinashe
Published: January 2021

The paper examines the Mnangagwa government’s economic policies in Zimbabwe. It looks at its ‘new’ dispensation economic policies, passed off as creating a middle-income economy by 2030. The study suggests that these policies, encapsulated in the ‘open for business’ rhetoric, were designed to create an image of political and economic reform. However, efforts to mask the ZANU-PF government’s unmistakable authoritarian traits failed. It is increasingly apparent that there is no significant departure in economic policies from the previous Mugabe regime. Zimbabwe’s crisis endures as the technocrats fail to resolve the monetary crisis and the economy continues to collapse.
Effect of carbon nanotubes modified with different concentrations of rare earth lanthanum on the mechanical and tribological properties of epoxy composites
Authors: Jiang Mingren , Cheng Xianhua
Published: January 2021

Rare earth modified acidified carbon nanotubes were prepared by functionalization of acidified carbon nanotubes with different concentrations of LaCl3. The modification results were characterized by Fourier-transform infrared and X-ray photoelectron spectroscopy. The rare earth successfully increases the surface activity of the acidified carbon nanotubes. Polymer matrix composites were prepared by using the rare earth modified acidified carbon nanotubes as the reinforcement in epoxy matrix. Mechanical properties were analyzed by Zwick Z100 testing machine and the tribological behaviors were test by multifunctional tribological tester. Compared with pure epoxy (epoxy resin), the mechanical strength of the best composite sample was increased by 50–120%, the coefficient of friction was reduced by 19.4% and the wear rate was reduced by approximately 40 times. The experimental results show that the RE concentration of 0.2–0.3 wt% has the most obvious influence on the properties of polymer composites. The mechanism of rare earth reinforcement in polymer matrix is analyzed and suggested.
Tweeting Stigma: An Exploration of Twitter Discourse Regarding Medications Used for Both Opioid Use Disorder and Chronic Pain
Authors: Dekeseredy Patricia , Sedney Cara L. , Razzaq Bayan , Haggerty Treah , Brownstein Henry H.
Published: January 2021

We examined the content of tweets on the social media site Twitter to better understand the contemporary discourse about medications for opioid use disorder (MOUD), how this chat contributes to the pervasive underpinnings of drug addiction, chronic pain stigma, and the impact it has on demand and availability of treatment. A retrospective review of tweets over 3 months containing keywords buprenorphine, naltrexone, methadone, or bupe was conducted resulting in 5,068 tweets. A content analysis was carried out focusing on a subset of tweets. Themes emerged from including suspicion and conspiracy theories about MOUD, and frustration and lack of control over their treatment options. Other tweets shared stigmatizing language and attitudes related to OUD/MOUD (e.g., “Junkies”). Twitter is a rich source of data reflecting thoughts, opinions, and sentiments entities regarding MOUD. However, this information can contain malicious comments that perpetuate stigma for people with OUD and result in avoidance of treatment.
Colorism and Physical Health: Evidence from a National Survey
Authors: Monk Ellis P.
Published: January 2021

This study uses nationally representative data to extend a steadily growing body of research on the health consequences of skin color by comparatively examining the consequences of perceived ingroup and outgroup skin color discrimination (perceived colorism) for physical health among African Americans. Using a comprehensive set of measures of physical health, I find that perceived ingroup colorism is significantly associated with worse physical health outcomes among African Americans. Notably, the magnitude of ingroup colorism’s associations with most of these outcomes rivals or even exceeds that of major lifetime discrimination, everyday discrimination, and perceived outgroup colorism. These findings compellingly suggest the inclusion of perceived colorism measures in future survey data collection efforts.
Social networks and farming resilience
Authors: Bruce Ann , Jackson Cornell , Lamprinopoulou Chrysa
Published: January 2021

The resilience of food systems, including agricultural systems, has become a high profile issue in the face multiple disease, environmental and social challenges. Much of agriculture takes place in remote locations where social networks, or connections between individual actors, have been implicated in increasing resilience. We examine a case study of Orkney, Scotland, a remote rural location, using interviews and Social Network Analysis. This case study provides evidence indicative of resilient patterns of social networks, emphasising the importance of schools, transport links and livestock markets in creating and maintaining these networks. These domains are rarely included in agricultural policy, highlighting the need for wider framing of questions. Our research suggests Social Network Analysis is a fruitful avenue for investigating resilience of agricultural systems that can identify hitherto hidden elements.
Place-Oriented or People-Oriented Concepts for Destination Loyalty: Destination Image and Place Attachment versus Perceived Distances and Emotional Solidarity
Authors: Tasci Asli D.A. , Uslu Abdullah , Stylidis Dimitrios , Woosnam Kyle Maurice
Published: January 2021

Many studies have modeled several different concepts to explain destination loyalty; however, none have integrated place-oriented (e.g., destination image, place attachment) and people-oriented concepts (e.g., cultural distance, social distance, and emotional solidarity) for their relative influences on loyalty. The current study tested the influence of destination image (place-oriented) and perceived distances (people-oriented) as antecedents of place attachment (place-oriented) and emotional solidarity (people-oriented) for their relative influences on destination loyalty. Survey data collected from both domestic ( n=260) and international ( n=250) visitors to a city in Turkey, Antalya, revealed that place-oriented concepts (cognitive and affective destination images and place attachment) are better predictors of destination loyalty than people-oriented concepts (cultural distance, social distance, and emotional solidarity). Together, they explain about half of the variance in destination loyalty, 42% in past loyalty and 60% in future loyalty.
Pregnant woman from southern Peru with rabies infection who delivered a healthy baby
Authors: Zarate Arturo A , Sanchez Moises , Flores-Lovon Kevin , Tello Mercedes , Gutierrez Ericson L , López-Ingunza Ricardo
Published: January 2021

Rabies in pregnancy is rare with a high mortality. We report a pregnant woman who developed urban rabies from the bite of an infected dog. An emergency Cesarean section was performed at 31 weeks of gestation, and a premature baby was delivered who survived and did not develop rabies. The mother, however, suffered a rapid clinical deterioration and was admitted to intensive care where a Milwaukee protocol was followed. The patient survived 19 months but developed severe neurological sequelae secondary to rabies encephalitis and finally died of respiratory failure.
The COVID-19 Preventive Behaviors Index: Development and Validation in Two Samples From the United Kingdom
Authors: Breakwell Glynis M. , Fino Emanuele , Jaspal Rusi
Published: January 2021

Monitoring compliance with, and understanding the factors affecting, COVID-19 preventive behaviors requires a robust index of the level of subjective likelihood that the individual will engage in key COVID-19 preventive behaviors. In this article, the psychometric properties of the COVID-19 Preventive Behaviors Index (CPBI), including its development and validation in two samples in the United Kingdom, are described. Exploratory and confirmatory factor analyses were performed on data from 470 participants in the United Kingdom who provided demographic information and completed the Fear of COVID-19 Scale, the COVID-19 Own Risk Appraisal Scale (CORAS) and the CPBI. Results showed that a unidimensional, 10-item model fits the data well, with satisfactory fit indices, internal consistency and high item loadings onto the factor. The CPBI correlated positively with both fear and perceived risk of COVID-19, suggesting good concurrent validity. The CPBI is a measure of the likelihood of engaging in preventive activity, rather than one of intention or actual action. It is adaptable enough to be used over time as a monitoring instrument by policy makers and a modeling tool by researchers.
Infective endocarditis of a native quadricuspid aortic valve
Authors: Ascaso María , Pruna-Guillen Robert , Hernández-Meneses Marta , Sandoval Elena , Quintana Eduard
Published: January 2021

Quadricuspid aortic valve complicated with infective endocarditis is an uncommon clinical scenario. The indications for surgery and medical management do not differ from other types of aortic valve endocarditis. Commonly present structural abnormalities pose an increased risk of complete heart block and coronary occlusion during valve replacement. We present a case of quadricuspid aortic valve complicated with infective endocarditis, with surgical images of the valve.
Multiple endocrine neoplasia type 1 with refractory hypoglycemia and lung and liver metastases: a case report
Authors: Wang Yong , Zhang Hui
Published: January 2021

Background

Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant genetic disease. MEN1 with multiple endocrine adenomatosis complicated by multiple endocrine tumors is often misdiagnosed or missed. Herein, we describe the first reported case of refractory hypoglycemia and liver and lung metastases in a patient with MEN1. Case presentation: A 40-year-old man presented with a 3-month history of intermittent palpitations, fatigue, and sweating. The patient had a history of prolactinoma resection and refractory hypoglycemia 2 years earlier. Analyses of blood samples showed a decrease in random and fasting blood glucose and an increase in prolactin (PRL). Computed tomography (CT) and magnetic resonance imaging scans revealed two substantial masses in the pancreas and large masses in the liver and lung. Positron emission tomography-CT images showed hypermetabolic masses in the pancreatic body and tail. The liver and lung lesions were also hypermetabolic. The pancreatic lesion was surgically removed, and pathology confirmed that the mass was MEN1. The liver and lung masses were confirmed as metastatic tumors.

Conclusion

If clinicians better understand MEN1, they can obtain a detailed patient and family history during the initial visit, allowing earlier diagnosis and intervention and improved prognosis.
Relationship between serum cystatin-c and coronary lesion severity in coronary artery disease patients with a normal glomerular filtration rate
Authors: Pan Junqiang , Sun Xifeng , Zhang Pengjie , Chen Haichao , Lin Jing
Published: January 2021

Objective

Cardiovascular disease is a major cause of death. This study evaluated the relationship between serum cystatin-c and coronary lesion severity in coronary artery disease (CAD) patients with a normal glomerular filtration rate.

Methods

Nine hundred and fifty-nine patients were retrospectively included and divided into non-CAD and CAD groups according to coronary angiography results. CAD patients were classified into three groups by Gensini score tertiles. Multivariable logistic regression was used to study the relationship between serum cystatin-c and coronary lesion severity.

Results

Serum cystatin-c levels were significantly higher in CAD patients than in non-CAD patients. Correlation analysis revealed significant correlations between serum cystatin-c levels with the Gensini score and the number of diseased vessels. The area under the receiver operating characteristic curve of serum cystatin-c was 0.544 and 0.555 for predicting a high Gensini score and three-vessel disease, respectively. Multivariate stepwise regression analysis demonstrated that the serum cystatin-c level was an independent predictor of a high Gensini score [odds ratio (OR) = 2.177, 95% confidence interval (CI) 1.140–3.930] and three-vessel disease (OR = 1.845, 95% CI 0.994–3.424) after adjusting for the conventional CAD risk factors.

Conclusions

Serum cystatin-c was elevated in CAD patients and may be an independent predictor of CAD severity.
Experimental and numerical study on crack propagation and coalescence in rock-like materials under compression
Authors: Li Xiaojing , Bai Yifan , Chen Xudong , Zhao Xinning , Lv Mingying
Published: January 2021

The discontinuous crack surface in a rock affects the stability of the whole rock system. The experiments in this paper were carried out by prefabricating rock-like specimens with different types of flaws, then the specimens were tested under uniaxial compression. Moreover, based on the theory of particle flow, PFC2D software was used for numerical simulation, and the comparative analysis of the experimental and simulative results was carried out to obtain the crack initiation sequence, propagation phenomenon, and failure mode of rock specimens with different flaw types. The results indicated that the wing crack started at the tip of flaw and the form of crack assumed split failure, followed by shear failure caused by the secondary crack. The tensile failure degree decreases and the influence of shear failure increases with the increase of flaw angle. The wing crack and secondary initiation stress value is 35%–55% and 85%–95% of the peak stress value. Crack coalescence appeared in adjacent flaws of rock-like specimens with multiple parallel single flaws, single-cross flaws and double-cross flaws, and the coalescence phenomenon always occurs when the stress peak value is reached. With the number of flaws increasing, the splitting failure of rock-like specimens became more and more serious, the splitting failure of double cross-flaw specimen is the most serious. As for the specimen with single-cross flaw, the wing crack would be produced at the tip of the flaw with larger obliquity. The results of this paper may offer certain reference value for the study on the mechanism of rock crack.
Valuation of Life With Disability: An International Comparison Study in Vietnam, Peru, and Haiti
Authors: Spiegel Elizabeth , Nesbit Kathryn C. , Altenor Ketly , Nguyen Hoa Thi , Tran Ly , Hermosa Angela Quiñonez , Martin Holly , Oettingen Julia von , Treleaven Emily , Partridge John Colin
Published: January 2021

The authors measured perceived quality of life for 4 disabilities among 450 adults in 3 resource-limited countries, measuring mean utilities using time trade-off, and surveying participants on 35 sociocultural characteristics to compare utilities for disabilities by country and examine associated sociocultural characteristics. Mean utilities were >0 for mild and moderate, but <0 for severe and profound. Utilities differed across countries ( P = .007, .000, .017, .000 for mild, moderate, severe, profound, respectively). Vietnamese utilities correlated with residence ( P = .03, moderate), education ( P = .03, severe), and number of children ( P = .03, moderate). Peruvian utilities correlated with education ( P = .05, mild; P = .05, severe), experience with disability ( P = .001, mild), gender ( P = .04, moderate; P = .03, profound), number of hospitalizations ( P = .04, severe). In Haiti, the only correlate was rejection ( P = .02, moderate). Culture-specific variables differentially shape perceptions of disability in developing countries, thereby affecting cost-effectiveness calculations. Given substantially negative perceptions, reducing major disability would improve cost-effectiveness of health-policy decisions more than reducing mortality.
“They Did Not Pay Attention or Want to Listen When We Spoke”: Women’s Experiences in a Trafficking-Specific Shelter in Cambodia
Authors: Cordisco Tsai Laura , Lim Vanntheary , Nhanh Channtha , Namy Sophie
Published: January 2021

Human trafficking is a global challenge that violates fundamental human rights. While the risk factors and health impacts of human trafficking have been well documented, the potential for survivors’ resilience is far less understood. In Southeast Asia, the majority of trafficking-specific services have historically been concentrated in shelters, and yet evidenced-based protocols for shelter services are lacking. This study aligns with the growing literature that emphasizes the importance of feminist and trauma-informed services to support the long-term well-being of survivors of human trafficking. Drawing on qualitative data collected over a 6-year period, the analysis foregrounds the lived experiences and perspectives of 10 women who resided in the same trafficking-specific shelter. Six core themes emerged: being labeled as a victim of human trafficking despite contesting this classification, feeling forced to live in the shelter, a strong desire to leave the shelter environment, disempowering engagement with staff, lack of professionalism among staff, and limitations in vocational services. Collectively, these participant narratives reflect a marked divergence from feminist principles and illustrate the potential for recreating conditions that curtail women’s agency and cause harm within the shelter system. We conclude with a discussion of the implications for a feminist approach to shelter-based service delivery and practice.
Stewart-Williams and Halsey argue persuasively that gender bias is just one of many causes of women’s underrepresentation in science
Authors: Ceci Stephen J , Kahn Shulamit , Williams Wendy M
Published: January 2021

Stewart-Williams and Halsey provide an unusually broad synthesis of the enormous literature on gender gaps in hiring, letters of recommendation, mathematical and spatial abilities, email appointment-making, people vs things orientation, within-gender variability, salaries, occupational preferences, and employment discrimination. They argue that sociocultural factors, while important, cannot by themselves account for the entirety of these gaps. In addition, they argue that factors resulting from evolutionary origins, cognitive ability gaps at the extreme right tail of the distribution, and underlying gender differences in abilities, preferences, and values are needed to explain why women are less well represented in the most math-intensive fields. In our commentary, we reprise our own recent synthesis (unpublished) of gender gaps in six domains (letters of recommendation, academic hiring, salaries, teaching evaluations, journal acceptance rates, grant funding success) and put our results in the context of these authors' arguments.
Vehicle coupled bifurcation analysis of steering angle and driving torque
Authors: Wang Xianbin , Shi Shuming
Published: January 2021

The mechanism of vehicle dynamics steering bifurcation has almost been confirmed. But the present steering bifurcation mechanism cannot explain the bifurcation phenomena caused by the driving torque. As a result, the vehicle coupled bifurcation analysis of the steering angle and driving torque has not been studied. Based on the five degrees of freedom (5DOF) vehicle system dynamics model with driving torque involved, the vehicle dynamics equilibriums under different driving torque and driving mode were searched by a hybrid method in this paper. The hybrid method combined the real-coded Genetic Algorithm with Quasi-Newton gradient method. According to the definition of static bifurcation of nonlinear systems, the equilibrium bifurcation of 5DOF vehicle system was confirmed. Then, the 5DOF vehicle system model was transformed into autonomous equation with the front wheel steering angle as intermediate variable. From the two aspects of constant steering angle amplitude and constant driving torque, the bifurcation diagrams of different driving mode were calculated. The vehicle coupled bifurcation characteristics of steering angle and driving torque were analyzed. The results show that the values of the driving torque will directly affect the bifurcation characteristics of vehicle dynamics system. The coupled feature of the front wheel steering angle and driving torque effect on vehicle bifurcation is obvious.
Learning by Drawing Visual Representations: Potential, Purposes, and Practical Implications
Authors: Ainsworth Shaaron E. , Scheiter Katharina
Published: January 2021

The technique of drawing to learn has received increasing attention in recent years. In this article, we will present distinct purposes for using drawing that are based on active, constructive, and interactive forms of engagement. In doing so, we hope to show that drawing to learn should be widely used and that there is good evidence to support its use in many situations. To make the most of these distinct purposes, teachers should note that what learners draw matters and that this needs to be assessed in relation to task demands. Drawing to learn will also require learners to be supported to engage meaningfully in ways that are matched to these pedagogical purposes.
Enfleshing the Spirit through Avatar Performance: Objecthood as Resistance in Women Preachers—Rachel Baker, Jarena Lee, and Florence Spearing Randolph
Authors: Casey Emilie
Published: January 2021

In this article, I take up Uri McMillan’s work in Embodied Avatars to rethink the subject–object relationship in women’s preaching. In performance art, the subject (the artist) fashions herself into an object (the art). I stretch the performance art genre to include preachers Rachel Baker, Jarena Lee, and Florence Spearing Randolph, arguing that these women have strategically performed objecthood to navigate gendered and racialized constraints in Christian proclamation. Examining these three women preachers through the lens of performing objecthood opens up theological understandings of how the Spirit works in a world marked by social sin (sexism and racism). Contrary to theologians who describe submission to the Spirit as self-effacement, I show how submission to the Spirit can counter worldly authorities, while enabling women preachers to transform perceptions of gender and race in a liberative way.
Conscientious objection to medical assistance in dying in rural/remote nursing
Authors: Panchuk Julia , Thirsk Lorraine M
Published: January 2021

In 2016, the Supreme Court of Canada legalized medical assistance in dying in Canada. Similar to jurisdictions where this has been a more long-standing option for end-of-life care, the Supreme Court’s decision in Canada included a caveat that no healthcare provider could be compelled to participate in medical assistance in dying. The Canadian Nurses Association, in alignment with numerous ethical guidelines for healthcare providers around the globe, maintains that nurses may opt out of participation in medical assistance in dying if they conscientiously object to this procedure. The realities of implementing medical assistance in dying are still unfolding. One area that has received little attention in the literature thus far is the ability of nurses who aid with, rather than administer, medical assistance in dying to conscientiously object. This is particularly significant in rural and remote areas of Canada where geographic dispersion and limited numbers of nursing staff create conditions that limit the ability to transfer care or call on a designated team. Exercising conscientious objection to medical assistance in dying in rural and remote areas, by way of policies developed with an urban focus, is one example of how the needs of rural nurses and patients may not be met, leading to issues of patient access to medical assistance in dying and retention of nursing staff. To illustrate the complexities of nurses’ conscientious objection to medical assistance in dying in a rural setting, we apply an ethical decision-making framework to a hypothetical case scenario and discuss the potential consequences and implications for future policy. Realizing that conscientious objection may not be a viable option in a rural or remote context has implications for not only medical assistance in dying, but other ethically sensitive healthcare services as well. These considerations have implications for policy in other jurisdictions allowing or considering medically assisted deaths, as well as other rural and remote areas where nurses may face ethical dilemmas.
Psychiatry after-hours: factors impacting workload and workflow
Authors: Thomson Alisha , McDermott Brett
Published: January 2021

Objective:

The study evaluated the workload and workflow of registrars engaged in a psychiatry after-hours roster, quantified their perceptions of this experience and provided recommendations for system redesign.

Method:

Multiple sources of information, including medical student observers and telephone logs, quantified the tasks performed during shifts. Registrars completed a satisfaction questionnaire.

Results:

After-hours shifts often started with a lack of attendance of key clinicians at handover. Tasks handed over and completed during shifts varied; there was very little difference between evening, weekends and night shifts except for the higher likelihood of seclusion reviews on weekends. Registrars experienced a significant and complex workload including emergency department and ward reviews, and admissions. Workflow interruptions were frequent; the high number of phone calls and critical incidence warrant further investigation. Registrars were confident in their own ability, but had less confidence in other key clinicians. Many registrars did not discuss after-hours work during supervision.

Conclusions:

The after-hours experience of psychiatry registrars at a university hospital is arduous and includes a wide range of clinical tasks. This activity is an essential service provision undertaking as well as a training activity. This must be weighed against the impact of after-hours work on registrar well-being.
‘I can see clearly now’: clarifying the role of psychiatry in global disaster
Authors: Pridmore William
Published: January 2021

Objective:

First, to review the principles and practice of disaster psychiatry, in light of recent global events. Second, to identify opportunities for research.

Method:

A literature review of the MEDLINE database, UpToDate and the Cochrane Library was conducted. Reference lists were also reviewed.

Results:

Psychiatrists are well-positioned to contribute to positive outcomes at all stages of the disaster response. These contributions derive from their roles as doctors, mental illness specialists and clinical leaders.

Conclusion:

A novel framework for the psychiatrist’s contributions was proposed. Specific knowledge of disaster psychiatry may be worthwhile, and establishment of a public disaster psychiatry centre is reasonable. Research should further examine the role of tele-psychiatry and pursue a best practice for community and front-line employee psychological preparedness.
Seismic performance evaluation of multi-story CBFs equipped with SMA-friction damping braces
Authors: Qiu Canxing , Liu Jiawang , Teng Jun , Li Zuohua , Du Xiuli
Published: January 2021

Shape memory alloys (SMAs) gained increasing attentions from the perspective of seismic protection, primarily because of their excellent superelasticity, satisfactory damping and high fatigue life. However, the superelastic strain of SMAs has an upper limit, beyond which the material completes the austenite to martensite phase transformation and is followed by noticeable strain hardening. The strain hardening behavior would not only induce high force demand to the protected structures, but also cause unrecoverable deformation. More importantly, the SMAs may fracture if the deformation demand exceeds their capacity under severe earthquakes. In the case of installing SMA braces (SMABs) in the multi-story concentrically braced frames (CBFs), the material failure would lead to the malfunction of SMABs and this further causes building collapse. The friction mechanism could behave as a “fuse” through capping the strength demand at a constant level. Therefore, this paper suggests connecting the SMAB with a friction damper to achieve a novel brace, i.e. the SMA-friction damping brace (SMAFDB). A proof-of-concept test was carried out on a homemade specimen and the test results validated the novel brace behaves in a desirable manner. In addition, to explore the seismic response characteristics of the SMAFDB within structures, a six-story CBF equipped with SMAFDBs was designed and compared against those incorporated with SMABs or friction damping braces (FDBs) at the frequently occurred earthquake (FOE), design basis earthquake (DBE) and maximum considered earthquake (MCE). The comparative results show the SMAFDB is superior to the counterparts. Under the FOE and DBE ground motions, the SMAFDBs successfully eliminated residual deformations as the SMABs do, and achieved identical maximum interstory drift as the FDBs. Under the MCE ground motions, the SMAFDBs not only well addressed the brace failure problem that was possibly encountered in the SMABs, but also better controlled residual deformation than the FDBs.
Palliative Care Services in the NeuroICU: Opportunities and Persisting Barriers
Authors: Morris Michael , Mroz Emily L. , Popescu Cristina , Baron-Lee Jacqueline , Busl Katharina M.
Published: January 2021

Background:

End-of-life (EOL) supportive care, including palliative and hospice services, is an area of increasing importance in critical care. Neurointensivists face unique challenges in providing timely supportive care to terminally ill patients expected to expire in the NeuroICU.

Objective:

This study explored the extent of effective utilization of, and recorded barriers to, palliative and hospice services in a dedicated 30-bed NeuroICU at a large academic medical center.

Design:

A retrospective chart review of patients who expired in the NeuroICU was conducted. The timeline from patient admission to arrival of palliative care services was traced. Qualitative review of chart notes was used to identify barriers to provision of palliative services.

Setting:

A total of 330 patients expired in the NeuroICU during the study period, including 176 from the neurology and 154 from the neurosurgical service.

Results:

Across services, 146 expired patients were never referred to palliative care or hospice services. Of those referred, over one-third were referred more than 4 days past admission to the NeuroICU. On average, patients were referred with less than 1 day before expiration. Common barriers to referral for supportive services were documented (e.g., patient expected to expire, family declined service).

Conclusions:

Despite benefits of palliative care and an in-hospital hospice opportunity, we identified lack of referral, and particularly delays in referral to services as significant barriers. Our study highlights these as missed opportunities for patients and families to receive maximum benefits from these services. Future research should solidify triggers for EOL services in this setting.
A Foot in Both Worlds: Navigating the Landscapes of P–12 Education Postdoctorate
Authors: Greene Jennifer L. R. , Cote Heather Katz , Koperniak Matt , Stanley Laura Moates
Published: January 2021

Doctoral programs in music education typically require a multiyear residency with an expected career trajectory leading to higher education. However, with low-residency online programs (LROPs) increasingly available, graduates may choose to remain in P–12 education. In this collaborative autoethnography, we examined our stories as four P–12 teachers who earned doctorates through a LROP. We framed learning as a pathway into a community of practice wherein an individual navigates the professional landscape. There was a particular focus on how each teacher’s identity was shaped as we negotiated higher education and P–12 education worlds. We also considered the motivations behind pursuing a doctorate to provide insight about the needs of LROP graduates with a foot in both worlds.