bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting perinatal outcomes with an obstructive sleep apnea screening tool
Authors: Seybold Dara J , Bracero Luis A , Power Peter , Koenig Zachary A , Calhoun Byron C , Bush Stephen
Published: October 2021

The objective was to determine if a screening tool for obstructive sleep apnea could be used to predict adverse perinatal outcomes. This was a prospective observational study of patients receiving prenatal care and universally screened for obstructive sleep apnea with the STOP Questionnaire (four questions related to Snoring, Tiredness during daytime, Observed apnea, and high blood Pressure). Confounding variables were included in a backwards logistic regression model to predict adverse perinatal outcomes. The study population of 442 women had positive STOP screens (64; 14.5%) associated with preterm delivery and neonatal intensive care unit admissions. For preterm delivery, history of preterm delivery was the strongest predictor with odds ratios of 4.2 (95% confidence interval 2.0–8.8; p < 0.001), followed by STOP, odds ratios 2.8 (95% confidence interval 1.4–5.8; p = 0.004) and nulliparity, odds ratios 2.3 (95% confidence interval 1.2–4.4; p = 0.013). A positive STOP was the only significant predictor for neonatal intensive care unit admissions, odds ratios 2.5 (95% confidence interval 1.1–5.7; p = 0.036). STOP screening test performance indicated low sensitivity but high specificity: preterm delivery (28.3%, 87.4%), neonatal intensive care unit admissions (27.3%, 86.6%), low birth weight (25.0%, 86.9%), and preeclampsia (16.7%, 85.6%). As a stand-alone tool, the STOP Questionnaire has limited performance, but could be explored in combination with other factors that might increase sensitivity to predict preterm delivery and neonatal intensive care unit admission.
When Are the Bigger Fish in the Small Pond Better Citizens? A Multilevel Examination of Relative Overqualification in Workgroups
Authors: Jahantab Farid , Vidyarthi Prajya R. , Anand Smriti , Erdogan Berrin
Published: October 2021

In this study, we extend overqualification research to employees' social context of workgroup membership. Drawing upon social comparison theory and integrating with social exchange theory, we contend that employees' relative overqualification (ROQ, defined as individual overqualification relative to other group members' overqualification perceptions) is associated with their relative standing with their leader (measured as LMXSC, leader–member exchange social comparison), which in turn relates to employees' organizational citizenship behaviors (OCB). Furthermore, we assert that workgroup structural attributes and individual values (leader span of control and power distance orientation) influence the ROQ–LMXSC–OCB relationship. Multilevel modeling using data from 243 employees nested in 36 workgroups suggested patterns of moderated mediation where leader span of control and employee power distance orientation moderate the indirect link between ROQ and OCB through LMXSC. That is, the indirect relationship between ROQ and OCB is stronger in workgroups with a narrow leader span of control and for employees high in power distance orientation. Implications and directions for meso- and group-level research are discussed.
Engagement of Families in the Care of Hospitalized Pediatric Patients: A Scoping Review
Authors: Jerofke-Owen Teresa A. , McAndrew Natalie S. , Gralton Karen S. , Totka Joan P. , Weiss Marianne E. , Fial Alissa V. , Sawin Kathleen J.
Published: October 2021

This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies ( N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse–patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing should focus on determining the core engaging health professional behaviors and engaged parent outcomes; extending the knowledge base related to mutually beneficial partnerships between families and health care teams; developing effectiveness studies to determine the optimal engaging actions by teams to achieve parent engagement; and measuring the influence of engagement on parent and infant/child outcomes.
Hybrid control of piezoelectric flexible manipulator based on Volterra filtered-xLMS algorithm
Authors: Pu Yuxue , Li Xiaobao , Zhang Fang
Published: October 2021

To suppress the nonlinear vibration of the flexible manipulator during motion, this article presents a hybrid control strategy based on a servo motor and a piezoelectric actuator. The dynamic model of the piezoelectric flexible manipulator is established first. To realize the trajectory tracking, a proportional derivative control method is used to schedule the control torque. Because the Volterra filter can approximate the nonlinear system model, a Volterra filtered-xLMS algorithm based on a second-order Volterra filter structure is proposed, by which the active nonlinear vibration control of flexible link is realized. Simulation results show that the proposed Volterra filtered-xLMS algorithm can not only make use of the advantages of the classical filtered-xLMS algorithm but also solve the problem of effective modeling of nonlinear secondary path. The proposed hybrid control strategy based on Volterra filtered-xLMS algorithm and proportional derivative control algorithm can improve the position accuracy of joint and effectively suppress the vibration response of the nonlinear flexible link. A piezoelectric flexible manipulator with PZT (lead zirconate titanate) sensor and actuator is designed to demonstrate the validity and efficiency of the proposed method by experiments. Experiment results demonstrate that the attenuation time of vibration response is reduced from 5 s to 1.5 s, the vibration response at the first-order frequency is reduced by 60%, and the proposed methodology has an important advantage in application of active vibration control of piezoelectric flexible manipulator.
PLAG1 Immunohistochemical Staining Is a Surrogate Marker for PLAG1 Fusions in Lipoblastomas
Authors: Warren Mikako , Tiwari Nishant , Sy Sabrina , Raca Gordana , Schmidt Ryan J , Pawel Bruce
Published: October 2021

Background

The hallmark of lipoblastoma is a PLAG1 fusion. PLAG1 protein overexpression has been reported in sporadic PLAG1-rearranged lipoblastomas.

Methods

We evaluated the utility of PLAG1 immunohistochemical staining (IHC) in 34 pediatric lipomatous tumors, correlating the results with histology and conventional cytogenetics, FISH and/or next generation sequencing (NGS) results.

Results

The study included 24 lipoblastomas, divided into 2 groups designated as “Lipoblastoma 1” with both lipoblastoma histology and PLAG1 rearrangement (n = 16) and “Lipoblastoma 2” with lipoblastoma histology but without PLAG1 cytogenetic rearrangement (n = 8), and 10 lipomas with neither lipoblastoma histology nor a PLAG1 rearrangement. Using the presence of a fusion as the “gold standard” for diagnosing lipoblastoma (Lipoblastoma 1), the sensitivity of PLAG1 IHC was 94%. Using histologic features alone (Lipoblastoma 1 + 2), the sensitivity was 96%. Specificity, as defined by the ability to distinguish lipoma from lipoblastoma, was 100%, as there were no false positives in the lipoma group.

Conclusions

Cytogenetics/molecular testing is expensive and may not be ideal for detecting PLAG1 fusions because PLAG1 fusions are often cytogenetically cryptic and NGS panels may not include all partner genes. PLAG1 IHC is an inexpensive surrogate marker of PLAG1 fusions and may be useful in distinguishing lipoblastomas from lipomas.
Giant Cell Myocarditis in Children: Elusive Giant Cells Might Not Be the Only Clue
Authors: Carreon Chrystalle Katte , Hagel Jonathon A. , Daly Kevin P. , Perez-Atayde Antonio R.
Published: October 2021

Giant cell myocarditis (GCM) is a form of fulminant myocarditis that is rapidly progressive and frequently lethal even in children. Over the course of 20 years, a definitive histopathologic diagnosis of GCM has been made at our institution in only two pediatric patients, and in neither instance was the diagnosis of GCM rendered on initial cardiac biopsy. We present the two patients and highlight the similarities in their clinical presentation and their challenging and inconclusive- albeit histologically similar- initial cardiac biopsy findings.
Secretory Carcinoma in Children and Young Adults: A Case Series
Authors: Simon Caroline T , McHugh Jonathan B , Rabah Raja , Heider Amer
Published: October 2021

Secretory carcinoma (SC), previously known as mammary analogue secretory carcinoma, is a rare salivary gland neoplasm that typically presents as a slow-growing painless lesion in the head and neck. SC occurs mainly in adults but has been described in children with the youngest reported patient diagnosed at five years of age. In children the gender distribution has been reported as female to male ratio of 1:1.2. SC is generally considered a low-grade malignancy with characteristic morphological features and immunological profile. SC also harbors ETV6-NTRK3 fusion (t(12;15)(p13:q25)). Surgical resection with or without lymph node dissection is the standard treatment, with generally favorable clinical outcomes. Here we present a single institution case series of six patients (ages 9-21) with SC and a review of the previously described pediatric cases. Our small series showed male predominance in pediatric patients with predominantly low-grade and stage tumors. All cases underwent complete surgical resections and when follow up is available there was no evidence of recurrences or metastases. To the best of our knowledge, this is the only SC case series comprised exclusively of pediatric and youth patients.
Incidental Delayed Diagnosis of Isolated Diffuse Ganglioneuromatosis Caused the Death of a 6-Year-Old Boy: Case Report
Authors: Mohammed Kheir Haya , Dayoub Mouhannad , Haidar Nour , Mansour Hanin , Omran Ammar , Ibrahim Ali , Alshehabi Zuheir
Published: October 2021

Intestinal diffuse ganglioneuromatosis is a rare, benign, neoplastic condition characterized by disseminated proliferation of neural elements. It has an established association with several systemic disorders including: multiple endocrine neoplasia IIB (MEN IIB) and von Recklinghausen’s disease. However, isolated GNs are very rare and sporadic. We report a case of a 6-year-old patient was referred to the emergency department due to a colon perforation during endoscopy. He then underwent sigmoidectomy and the pathologic studies revealed prominent signs of diffuse ganglioneuromatosis. Unfortunately, the patient died the day after because of the late diagnosis and treatment. Such presentation emphasizes the importance of considering diffuse ganglioneuromatosis, among other causes, in patients with intractable GI symptoms despite medical treatment.
Lubrication and stability enhancement by attaching superconducting magnetic force on non-contacting mechanical seals for reusable rocket turbopump
Authors: Xu Lushuai , Wu Jiu Hui , Wang Yunlei , Rafique Faisal , Xu Jimin , Yuan Xiaoyang
Published: October 2021

The purpose of this paper is to investigate the lubrication performance and stability improvement of rocket turbopump mechanical seals by attaching superconducting magnetic force. A comprehensive multiphysics numerical model is presented including microscale clearance flow, magnetic field, as well as three degrees of freedom dynamic motion. The Maxwell equation and modified Reynolds equation considering mass-conserving boundary conditions and turbulence flow were solved simultaneously at each time step to obtain the transient response of sealing parameters. Results indicate that the mechanical seal attaching superconducting magnetic force could dramatically improve carrying capacity and lubrication characteristics under heavy loading conditions, and it also has an appreciable effect on dynamic stability. It is worth exploring the application of superconducting magnetic force in reusable rockets and cryogenic equipment combined with its unique advantages.
Adhesive and normal stress-dependent dynamic friction of a gelatin hydrogel
Authors: Sinha Nitish , Singh Arun Kumar , Gupta Vinit , Katiyar Jitendra Kumar
Published: October 2021

Adhesion and friction of soft solids on hard surfaces are the important properties for a variety of practical applications. In the present study, Coulomb's law of friction is used for characterizing adhesive friction as well as normal stress-dependent dynamic friction of a gelatin hydrogel on a fixed glass surface. The experimental data, concerning normal stress-dependent dynamic friction of different shear velocity, are obtained from literature. It is observed that both components of friction increase with shear velocity. More importantly, the scaling law shows that adhesive stress varies almost linearly with corresponding coefficient of friction of the hydrogel. A dynamic friction model is also used to analyze the same experimental data to predict a negative normal stress at which dynamic friction reduces to zero, and this result matches closely with the experimental value.
Tourism and Gross Domestic Product short-run causality revisited: A symbolic transfer entropy approach
Authors: Camacho Maximo , Romeu Andres
Published: October 2021

We employ a symbolic transfer entropy panel data test in a large-scale data set to provide new insights on the worldwide short-term causality relations between growth and inbound tourists. Using a large data set on 145 countries from the World Bank Open Data website, we show that, despite the evidently strong correlation between these two magnitudes, claiming that the increases in inbound tourists Granger-cause positive shocks in GDP is not supported by the data. By contrast, the data seem to point out in the direction of a reverse causality in that it is GDP growth what drives international inbound tourists in the short run.

JEL classification

C12, C14, C33, C55.
Catheter-directed thrombolysis for deep vein thrombosis: 2021 update
Authors: Goldhaber Samuel Z , Magnuson Elizabeth A , Chinnakondepalli Khaja M , Cohen David J , Vedantham Suresh
Published: October 2021

Catheter-directed thrombolysis (CDT) has been utilized as an adjunct to anticoagulant therapy in selected patients with deep vein thrombosis (DVT) for approximately 30 years. CDT used to be limited to patients with DVT causing acute limb threat and those exhibiting failure of initial anticoagulation, but has expanded over time. Randomized trials evaluating the first-line use of CDT for proximal DVT have demonstrated that CDT does not produce a major reduction in the occurrence of post-thrombotic syndrome (PTS) and that it is poorly suited for elderly patients and those with limited thrombus extent or major risk factors for bleeding. However, CDT does offer selected patients with acute iliofemoral DVT improvement in reducing early DVT symptoms, in achieving reduction in PTS severity, and in producing an improvement in health-related quality of life (QOL). Clinical practice guidelines from medical and surgical societies are now largely aligned with the randomized trial results. This review offers the reader an update on the results of recently completed clinical trials, and additional guidance on appropriate selection of patients with DVT for catheter-directed thrombolytic therapy.
Key principles for an integrated intercultural literary pedagogy: An educational design research project on arts integration for intercultural competence
Authors: Schat Esther , van der Knaap Ewout , de Graaff Rick
Published: October 2021

Intercultural competence in foreign language teaching has gained importance in recent times. Although current work has highlighted the advantages of content and language integrated learning (CLIL) for intercultural development, little is known about its potential for teaching literature in secondary schools. Treating literature itself as an art form, the aim of this article is to formulate research-based design principles for an integrated intercultural literary pedagogy (IILP) that may foster intercultural competence through arts integration in foreign language classes. This article reports on the process of evaluating IILP-based pilot lesson materials in pre-university education in the Netherlands. Educational design research was applied as a method that encompasses the systematic study of designing, developing, and evaluating educational interventions through an iterative process of evaluation with stakeholders. Three iterations of formative evaluation were conducted, with additions to the tentative design principles following each of the first two iterations. The process resulted in a set of four refined principles. Results also illustrated the effectiveness of IILP-based lesson materials for intercultural competence. Although participating students encountered some difficulties relating to the functionality of the design, the students appreciated its social relevance and reported that the processing of literary texts through dialogic tasks with peers in the target language fostered intercultural language learning.
Human self-selection as a mechanism of human societal evolution: A critique of the cultural selection argument
Authors: Zhao Shanyang
Published: October 2021

Natural selection is the main mechanism that drives the evolution of species, including human societies. Under natural selection, human species responds through genetic and cultural adaptations to internal and external selection pressures for survival and reproductive success. However, this theory is ineffective in explaining human societal evolution in the Holocene and a cultural selection argument has been made to remedy the theory. The present article provides a critique of the cultural selection argument and proposes an alternative conception that treats human self-selection as an emergent mechanism of human societal evolution characterized by a new type of selection pressure and a separate fitness criterion. Specifically, the evolution of human societies is divided into two major periods, each driven by a different mode of selection: natural selection acting on genes and cultures for survival and reproductive success prior to the Neolithic Revolution, and human self-selection acting on cultures – and potentially genes as well – for thrival and prosperous living after the Neolithic Revolution. The conditions for the transition from the first mode of selection to the second and the implications of this transition for social research are also discussed.
The Association Between Revised Cardiac Risk Index and Postoperative Mortality Following Elective Colon Cancer Surgery: A Retrospective Nationwide Cohort Study
Authors: Hulme Rebecka Ahl , Forssten Maximilian Peter , Pourlotfi Arvid , Cao Yang , Bass Gary Alan , Matthiessen Peter , Mohseni Shahin
Published: October 2021

Introduction:

Despite improvements in the perioperative care during the last decades for oncologic colon resection, there is still a substantial risk for postoperative complications and mortality. Opportunities exist for improvement in preoperative risk stratification in this patient population. We hypothesize that the Revised Cardiac Risk Index, a user-friendly tool, could better identify patients with high postoperative mortality risks.

Methods:

A retrospective analysis of operated patients between the years 2007 and 2017 was undertaken, using the prospectively recorded Swedish Colorectal Cancer Registry, which has a 99.5% national coverage for all cases of colon cancer. Patients were cross-referenced with the Swedish National Board of Health and Welfare dataset, a government registry of mortality and comorbidity data. Revised Cardiac Risk Index (RCRI) scores were calculated for each patient and stratified into four groups (RCRI 1, 2, 3, ⩾ 4). A Poisson regression model with robust standard errors of variance was employed to correlate the 90-day postoperative survival with each level of the Revised Cardiac Risk Index.

Results:

A total of 24,198 patients met the study inclusion criteria. 90-day postoperative mortality increased from 2.4% in patients with RCRI 1 to 10.1% in patients with RCRI ⩾ 4 ( p < 0.001). Adjusted 90-day postoperative mortality increased linearly with an increasing RCRI, where an RCRI of 2, 3, and ≥ 4 respectively led to a 46%, 80%, and 167% increased risk of mortality compared to RCRI 1 ( p < 0.001).

Conclusions:

A strong association between an increasing Revised Cardiac Risk Index score and increased 90-day postoperative mortality risk was detected. The Revised Cardiac Risk Index may facilitate risk stratification of patients undergoing elective colon cancer surgery.
Gestural repair in Mandarin conversation
Authors: Regina Wu Ruey-Jiuan
Published: October 2021

Ever since Charles Goodwin’s seminal works on gaze, there has been a long-standing interest in Conversation Analysis in the interrelationship between talk and bodily conduct in the accomplishment of social action. Recently, a small but emerging body of research has explored the ways in which embodied conduct figures in the organization and operations of repair. In this article, I take up a similar theme and investigate the interaction between talk and iconic gestures in same-turn self-initiated repair in Mandarin conversation. The phenomenon I examine concerns the use of what I call “gestural repair.” The analysis focuses on how such repair can intertwine with talk in multi-stage operations in the progressivity and resolution of repair. The data are drawn from 50 hours of naturally-occurring conversations collected in China. Some unique features of such gestural repair observed in the Mandarin data are also discussed.
Young people engaging in event-based diaries: A reflection on the value of diary methods in higher education decision-making research
Authors: Baker Zoe
Published: October 2021

This paper reflects on the value of diary methods in the context of a qualitative, longitudinal narrative inquiry exploring the higher education decision-making of further education students in England. Event-based diaries were used alongside interviews and focus groups over a 14-month period to gain in-depth insights into the reasons and influences informing their decision-making trajectories. I explore the challenges, successful approaches and advantages of employing diary methods with young people in this context. Challenges consisted of maintaining participant engagement, which was overcome by combining methods and incorporating a reactive co-participatory element. Yet, a number of advantages emerged from participants' engagement with diary keeping which enhanced the richness of the data; this inspired deeper reflections on decision-making and influences and provided a private space for participants to disclose personal difficulties that could not be obtained via interviews.
Bleeding After LVAD Implant: If Things Do Not Add Up, Take a Look!
Authors: Park Sarah Y. , Plambeck Christopher , Joyce Lyle D. , Joyce David L.
Published: October 2021

A 63-year-old male underwent re-exploration after HVAD implantation due to persistent postoperative bleeding. We present an unusual cause of postoperative bleeding after LVAD implantation for which early re-exploration and consideration of unusual etiologies is appropriate.
Recovery Effect of a Rutin-Enriched Fraction Prepared From Forsythia koreana Flowers on Alloxan-Induced Pancreatic Islets in Zebrafish Larvae (Danio rerio)
Authors: Lee Yeong-Geun , Nam Youn Hee , Gwag Jung Eun , Ko Jung-Hwan , Seo Kyeong-Hwa , Lee Dae Young , Kang Se Chan , Kang Tong Ho , Baek Nam-In
Published: October 2021

A simple method to prepare a high-content rutin fraction from Forsythia koreana flowers (HRFK) is described. Rutin, isolated for the first time from the flowers, was identified from spectroscopic data including nuclear magnetic resonance, mass spectrometry, and infrared. As a result of HPLC quantitative analysis, the content of rutin was found to be 80.0 ± 0.02% in HRFK. Our previous study reported that F koreana MeOH extract (FK) significantly recovered alloxan-induced pancreatic islets in zebrafish. However, HRFK as well as rutin exhibited an enhanced anti-diabetic effect compared to FK in our latest experiments. In conclusion, HRFK, as well as rutin and FK, have potential as anti-diabetic agents.
Chemical Constituents Isolated from the Leaves of Toricellia angulata Oliv. var. intermedia (Harms.) Hu
Authors: Han Zhong-Yao , Zhou Fu-Jun , Guo Yuanqiang , Yang Zheng-Min , Cao Fang , Yu Yue-Sheng , Li Yan
Published: October 2021

In our survey on the chemical composition of Chinese folk medicines, nine compounds were isolated from methanol extract of the leaves of Toricellia angulata Oliv. var. intermedia (Harms.) Hu (Corniaceae). The structures of these compounds were elucidated on the basis of NMR data analysis, which were identified as dimethyl 2-(hydroxymethyl)-5-oxocyclohexane-1,4-dicarboxylate (1), methyl succinate (2), 5-hydroxymethyl-2-furfuraldehyde (3), 7-hydroxy-6-methoxycoumarin (4), loliolide (5), (8 S)-deca-2-trans-2,9-diene-4,6-diyn-1,8-diol (6), methyl malate (7), griselinoside (8), and methyl linoleate (9), respectively. Among them, compound 1 is a new cyclohexanone derivative and given a trivial name torriangulate A, while others are categorized to be organic acids (2, 7, and 9), a coumarin derivative (4), a terpene lactone (5), a polyacetylene (6), and an iridoid glycoside (8). Compounds 3–5 were isolated from this genus for the first time and compound 9 was first identified from this species. The discovered compounds with novel or known structures further reveal the chemical basis of T. angulata var . intermedia, which lays a foundation for the development of T. angulata var . intermedia used as a traditionally folk medicine.
Alkaloids From the Marine Fungus Lecanicillium fusisporum Using an Amino Acid-Directed Strategy
Authors: Huang Qin , Li Hou-Jin , Huang Chang-Bai , Wang Zi-Han , Lan Wen-Jian , Wang Lai-You
Published: October 2021

An amino acid-directed strategy has been developed to explore the potential of marine fungi to produce alkaloids. The marine fungus Lecanicillium fusisporum was cultured in glucose-peptone-yeast (GPY) medium to which were added L-tryptophan, L-phenylalanine, L-threonine, D, L-methionine, L-serine, L-lysine and L-valine. A new indole alkaloid, lecasporinoid (1), along with five known alkaloids (2−6) were discovered from the culture broth. The planar structure of lecasporinoid (1) was determined by HR-ESIMS, and 1D and 2D NMR spectroscopic data. The absolute configuration was established by optical rotation and 13C NMR calculations combining with a chemical synthetic approach.
A New β-Carboline Alkaloid From the Aerial Part of Hedyotis capitellata
Authors: Huyen Le Thi , Thu Hau Nguyen Thi , Vu Hoang Son , Lan Huyen Nguyen Thi , Huu Tai Bui , Nhiem Nguyen Xuan , Van Kiem Phan
Published: October 2021

A new β-carboline alkaloid, 10-hydroxy-capitelline (1) together with three known anthraquinones, hedanthroside B (2), hedanthroside C (3), and rubiadin (4) were isolated from the aerial part methanol extract of Hedyotis capitellata. Their structures were established by spectroscopic data (one-dimensional, two-dimensional nuclear magnetic resonance (1D, 2D-NMR) and high-resolution-electrospray ionization-mass spectrometry, HR-ESI-MS) and comparison with those reported in the literature. The anti-inflammatory activity of the isolated compounds is evaluated by their inhibition of nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. At a concentration of 20 µM, compounds 1 to 4 showed weak inhibitory effects on NO production with inhibitory values ranging from 1.2% to 23.9% compared to a value of 74.5% for the positive control compound, NG-monomethyl-L-arginine (L-NMMA).
Imaging findings of neurologic complications in lung transplantation: Review of a 9-year cohort
Authors: Marín-Díez Elena , Drake-Pérez Marta , Valle-San Román Natalia , Mora Cuesta Víctor Manuel , Hernández-Hernández Miguel Ángel , Marco de Lucas Enrique
Published: October 2021

Background

Lung transplantation (LT) requires complex multidisciplinary organization and constitutes a therapeutic option and a life-saving procedure. Although the number of lung recipients continues to increase, neurological complications and death rates following lung transplantation are still higher than desirable.

Purpose

This study aims to analyse the neuroimaging findings in a cohort of adult patients with LT.

Material and Methods

A retrospective cohort study of all lung transplant recipients (344 patients: 205 men and 139 women) at a single institution from January 2011 to January 2020. The collected data included demographic features, clinical data and evaluation of the imaging findings. We also recorded the date of neurological complication(s) and the underlying disease motivating lung transplantation.

Results

We found an elevated rate of neuroimaging findings in patients following LT with 32.6% of positive studies. In our cohort, the average time after LT to a neurological complication was 4.9 months post-transplant. Encephalopathy, critical illness polyneuropathy and stroke, in that order, were the most frequent neurological complications. Structural abnormalities in brain imaging were more often detected using MRI than CT for indications of encephalopathy and seizures.

Conclusions

LT recipients constitute an especially vulnerable group that needs close surveillance, mainly during the early post-transplant period.
Transient Noise Reduction Using a Deep Recurrent Neural Network: Effects on Subjective Speech Intelligibility and Listening Comfort
Authors: Keshavarzi Mahmoud , Reichenbach Tobias , Moore Brian C. J.
Published: October 2021

A deep recurrent neural network (RNN) for reducing transient sounds was developed and its effects on subjective speech intelligibility and listening comfort were investigated. The RNN was trained using sentences spoken with different accents and corrupted by transient sounds, using the clean speech as the target. It was tested using sentences spoken by unseen talkers and corrupted by unseen transient sounds. A paired-comparison procedure was used to compare all possible combinations of three conditions for subjective speech intelligibility and listening comfort for two relative levels of the transients. The conditions were: no processing (NP); processing using the RNN; and processing using a multi-channel transient reduction method (MCTR). Ten participants with normal hearing and ten with mild-to-moderate hearing loss participated. For the latter, frequency-dependent linear amplification was applied to all stimuli to compensate for individual audibility losses. For the normal-hearing participants, processing using the RNN was significantly preferred over that for NP for subjective intelligibility and comfort, processing using the RNN was significantly preferred over that for MCTR for subjective intelligibility, and processing using the MCTR was significantly preferred over that for NP for comfort for the higher transient level only. For the hearing-impaired participants, processing using the RNN was significantly preferred over that for NP for both subjective intelligibility and comfort, processing using the RNN was significantly preferred over that for MCTR for comfort, and processing using the MCTR was significantly preferred over that for NP for comfort.
Development of the Coronavirus Anxiety Model in the Elderly: Based on Hope and Health-Related Quality of Life With the Mediating Role of Perceived Social Support
Authors: Saleh Manijeh Hiwa , Rostami Mohammad , Ahmadboukani Soliman
Published: October 2021

This study examined the mediation role of perceived social support in the association between hope and health-related quality of life with coronavirus anxiety in the elderly. The research was conducted by descriptive method with a structural equations design. The population included all the over-60 elderly individuals residing in Sanandaj city, Iran, in 2021. Among them, 220 individuals were selected through available sampling method. To gather the data, the questionnaires of coronavirus anxiety, perceived social support, hope and health-related quality of life were used. Data analysis was conducted by using structural equations modeling and via SPSSv23 and AMOSv26 software. Data analysis indicated that there is a significant and negative relationship between hope, health-related quality of life, and perceived coronavirus anxiety among the elderly. Moreover, perceived social support plays a mediating role in the relationship of both hope and health-related quality of life with coronavirus anxiety. The present study provided an important insight regarding the mediating role of perceived social support in the relationship of hope and health-related quality of life with coronavirus anxiety the elderly. Through creating programs to hold suitable interventions for improving perceived social support, the COVID-19–related anxiety can be reduced during its prevalence.
Teaching Social Determinants of Health as the World Burns Down: Strategies Learned From Teaching in a Pandemic
Authors: Bess Kiana D. , Andrews Marcus , Lopez William D.
Published: October 2021

Social determinants of health (SDOH), or the conditions in which people are born, live, learn, work, and age, influence health behavior and health outcomes. Often, in health education and behavior literature, emphasis is placed on individual behavior. However, scholars are beginning to move more upstream and incorporate SDOH frameworks into public health research. Thus, teaching SDOH is necessary for the next generation of public health scholars. In the COVID-19 pandemic era, SDOH are more prominent than ever as we educate and advocate to increase health equity. We present four strategies on teaching SDOH to master-level candidates in a virtual “Zoom-fatigue” environment during high-profile world events such as the COVID-19 pandemic, racialized police violence, and a contested election.
Nursing Students’ Willingness and Confidence to Volunteer in a Pandemic
Authors: Al Gharash Hassan , Smith Morgan , Cusack Lynette
Published: October 2021

Introduction

The current coronavirus disease 2019 pandemic may result in shortages of health care workers in some areas of the health care system. With adequate support, nursing students could potentially play a role in easing health worker shortages.

Objective

To describe and explore nursing students’ willingness and confidence to contribute to the health care workforce during a pandemic.

Methods

A mixed-methods descriptive survey design was used to explore the perspectives of second-year nursing students at an Australian University. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using directed content analysis.

Results

A total of 280 nursing students were invited to complete the survey with a response rate of 32%. The majority of the participants showed moderate to high levels of willingness to volunteer in a pandemic. Of the participants, 50% reported slight confidence that their knowledge and skills would assist them during their volunteering. Reasons that influenced students’ willingness to volunteer included perception of lack of personal protective equipment, need for incentives, fear of transmitting infection to family members, barriers to volunteering, inadequate knowledge and skills to handle a pandemic situation, study and clinical placement arrangements, and disease hazardousness.

Conclusion

Most nursing students have a level of willingness to volunteer but low confidence that their knowledge and skills would assist them while volunteering in pandemic situations. Universities and health care organizations can benefit from these findings by developing strategies to increase students’ willingness to volunteer, as well as their confidence in their knowledge and skills.
COVID-19 Pandemic Impact on Nursing Student Education: Telenursing with Virtual Clinical Experiences
Authors: Hargreaves Linda , Zickgraf Petra , Paniagua Nikaesha , Evans Teena Lee , Radesi Lisa
Published: October 2021

Introduction

The COVID-19 pandemic affected nursing students dramatically when the clinical sites and the onsite classrooms closed to physical participation. This necessitated a move to virtual classrooms and virtual clinical experiences. Some nursing schools adopted telenursing to comply with their Board of Registered Nursing direct patient care requirements. Students value the hands-on nursing in a direct care facility and clinical instructors must replicate this in a virtual setting. This article discusses telenursing and Teach-Back processes with student active engagement that facilitates learning and meets the direct care requirement. The purpose is to share best practice ideas for clinical instructors to educate when clinical settings are unavailable.

Methods

This innovation includes examples from five clinical instructors when in-person clinicals were not available due to the COVID-19 pandemic. They used virtual teaching and telenursing for nursing students which complied with clinical requirements of preconference, clinical experience, and post-conference. Telenursing combines case studies or shared documents, student collaboration, and includes a patient or patient actor via telehealth. Clinical instructors present a patient history or case study and allow students time for preparation. Socratic questioning helps students focus on determining the correct questions to ask. Telenursing call to the patient and teach-back questioning validated patient learning. Following the call, the instructor leads a post-conference debrief and students independently document the call.

Conclusion

Five clinical instructors follow the process of pre-brief, case presentation, and debrief while students develop critical thinking, strong communication skills, documentation requirements, and utilize the nursing process of assessment, diagnosis, outcome, plan, interventions, and evaluation. Students will have future opportunities to develop hands-on skills as they return to the clinical setting.
How Asians React to Discrimination Does Not Depend on Their Party Identification
Authors: Leung Kristo , Cheng Ke , Zhang Junyao , Cheng Yipeng , Nguyen Cao Viet Hung , Ioku Shusuke , Kikuchi Masanori , Long Wen , Crabtree Charles
Published: October 2021

How do individuals respond to discrimination against their group? The authors help answer this normatively important question by conducting a survey with a large, national, quota-based sample of 2,482 Asians living in the United States during December 2020. In the survey, the authors provide respondents with truthful information about the increasing prevalence of anti-Asian discrimination in the United States during the coronavirus disease 2019 pandemic and ask them to write about what this makes them feel or think about life in America. Using automatic text analysis tools to analyze this rich, novel set of personal reflections, the authors show in this visualization that Asian reactions to discrimination do not meaningfully differ across partisan identification. These findings extend the large literature showing partisan differences in perceptions of racial discrimination and its effects by the general public and show at least one way in which partisan polarization does not influence American views.
Advanced Multimodal Communication Curriculum for Pediatric Residents
Authors: Marsh Melanie C , Reed Suzanne M , Mahan John D , Schneider Lydia , Fernandes Ashley K , Liao Nancy , Spears Isaac , Lauden Stephanie
Published: October 2021

Background

Medical educators juggle competing demands as they seek to integrate medical advancements and new technology with the call for earlier introduction to clinical experiences. Newer models of medical education place even greater emphasis on the importance of deliberate training of providers who can deliver compassionate patient-centered care. The need for adaptable, effective communication skills training has never been more relevant than now, in our high-tech and ever-evolving learning climate.

Methods

At a large pediatric academic center, we used Kern's six-step approach to complete a needs assessment, identify goals and learning preferences of trainees, and ultimately develop and evaluate a multimodal communication curriculum. This curriculum was rooted in the Accreditation Council for Graduate Medical Education's Pediatric Milestones, with the goal of enhancing knowledge, skills, and competency. Pediatric interns were randomized to either the new curriculum ( n = 19) or the existing didactic-based communication training ( n = 17) from 2019 to 2020. We evaluated the impact of the new and traditional curriculum through evaluations by expert facilitators, learner surveys, and faculty-assigned resident milestones.

Results

Many trainees self-identified performance gaps in communication skills at baseline. Eighteen residents attended 1 to 6 in-person deliberate practice workshops. Workshop participation by the residents varied over time due to a variety of factors. All residents, regardless of curricular exposure, showed statistically significant improvement in communication milestones from first to second year and those enrolled in the deliberate practice curriculum highly valued the workshops and coaching.

Discussion

Our curriculum demonstrates the value of deliberate practice opportunities for residents to gain skills in advanced communication. Residents appreciated this type of training and the time devoted to expand these skills. Lessons learned and barriers to implementation from this curriculum can be helpful for educators interested in integrating active, deliberate practice, simulation-based communication training into their current educational model.
Creating Value for a Sustainable Healthcare: The Role of Digital Platforms
Authors: Faggini Marisa , Bruno Bruna , Parziale Anna
Published: October 2021

Currently, healthcare is worldwide one of the most critical service domains, dealing with human being health and well-being. Its importance and significance are also reflected through the Agenda 2030 and its SDGs, which point to guarantee health and well-being for all at all ages. In this sense, this article aims to better investigate if and how specific paths of value creation contribute to healthcare sustainability. The analysis has been conducted assuming a system perspective, which led to approach those dynamics, supported digital technologies and platforms, that boost the sustainability of complex service systems such as healthcare. To this end, a case study analysis has been conducted, investigating the potential of a digital platform in boosting an ongoing path of value creation able to contribute to short- and long-term sustainability of healthcare domain and of the related services. The results of this analysis pointed out that digital platforms can acts as value generation enablers, paving the way for the definition of sustainable paths of value creation.
The permissible and the perverse: Indian geographies of interspecies sex
Authors: Dave Naisargi N , Gupta Alok Hisarwala
Published: October 2021

We argue in this paper that what separates permissible from perverse acts of killing, or sex with, an animal is a matter of material and symbolic space. We focus on interspecies sex –which is often, but not always, bound up with killing –to argue that what separates permissible from perverse acts of interspecies sex in India, or husbandry from bestiality, is where it occurs geographically in proximity to an upper-caste, anthropatriarchal imaginary of a Hindu nation. We argue that the state-sanctioned abattoir and its breeding facility are spaces of normalized exception, in which anthropatriarchal violences are relatively permissible, and on the same grounds as in the “human” space of the home. We trace interspecies sexual contact across spheres of bestiality, animal husbandry, petkeeping, and population control. We conclude with a queer bestial ethics of avowal, one that dispenses with anthopatriarchal innocence towards a more capacious embrace of the panspecies desire for touch and thriving.
Seiches and the slide/seiche dynamics; subcritical and supercritical subaquous mass flows and their deposits. Examples from Swiss Lakes
Authors: Siegenthaler Christoph
Published: October 2021

Four historically documented large and potentially dangerous lacustrine waves in Swiss lakes show that these waves have been seiches (standing waves) triggered by sublacustrine slides; a statement which is in accordance with the experience of seismologists who see earthquakes triggering seiches in lakes. Nevertheless, large historical waves in Switzerland have recently been modeled as progressive shallow water waves (tsunamis), probably because the slide/seiche dynamics are not known, and experiments with subaquatic slides fail to generate seiches in test–flumes. It appears that these tests exhibit a small shear–energy/slide–energy ratio ε, if compared with the situation in lakes. These facts incite a shear–stress lemma that states that ε is the constituent factor for the slide/seiche coupling. The structure of the subaqueous mass flow deposit (MFD) in lakes Lucerne and Geneva suggests the occurrence of subcritical and of supercritical slide flows. The former would generate a contortite, a MFD with contorted bedding, the latter a debrite (mudclast conglomerate). Potential slide energy considerations are used for an estimation of the amplitudes of large seiches produced by subaquatic slides, a proceeding that yields partly similar and partly very different results, as compared with numerical tsunami simulations.
Depression of lncRNA MINCR antagonizes LPS-evoked acute injury and inflammatory response via miR-146b-5p and the TRAF6-NFkB signaling
Authors: Gao Wei , Zhang Ying
Published: October 2021

Background

Inflammation plays an important role in the development of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The long non-coding RNA (lncRNA) MINCR is closely related to inflammation injury. This study was performed to explore the protective effects and mechanisms of MINCR in lipopolysaccharide (LPS)-induced lung injury and inflammation.

Methods

The expression levels of MINCR and miR-146b-5p in lung tissue status were detected by using quantitative real-time polymerase chain reaction (qRT-PCR), hematoxylin and eosin staining, immunohistochemical staining, and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Enzyme-linked immunosorbent assay and Western blotting analysis were used to detect the expression of inflammatory factors such as tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 in lung tissue. The relationship between MINCR, miR-146b-5p, and TRAF6 was explored using bioinformatics analysis and luciferase assay.

Results

The expression levels of MINCR were increased in a mouse model of LPS-induced ALI and small airway epithelial cells (SAECs). shMINCR resulted in increased cell viability and decreased apoptosis, which protected against LPS-induced cell damage. shMINCR can inhibit the formation of neutrophil extracellular traps, neutrophil numbers, myeloperoxidase activity, and the production of inflammatory cytokines IL-6, IL-1β, and TNF-α induced by LPS. The silencing of miR-146b-5p reversed the effects of MINCR on LPS-induced lung damage. Sh-MINCR decreased the expression levels of TRAF6 and p-P65 in LPS-induced SAECs and lung tissues. Co-transfection of sh-MINCR with miR-146b-5p inhibitor reversed the effect of sh-MINCR on the expression of TRAF6 and p-P65.

Conclusions

MINCR may induce alveolar epithelial cell injury and inflammation and aggravate the progression of ALI/ARDS through miR-146b-5p and TRAF6/NF-κB pathways, which would provide a promising target for the treatment of ALI/ARDS.