bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects on suicidal risk: Comparison of clozapine to other newer medicines indicated to treat schizophrenia or bipolar disorder
Authors: Forte Alberto , Pompili Maurizio , Imbastaro Benedetta , De Luca Gabriele Pasquale , Mastrangelo Martina , Montalbani Benedetta , Baldessarini Ross J
Published: July 2021

Background:

Clozapine is the only treatment with regulatory-recognition of lowering suicidal risk, at least in schizophrenia patients. It remains uncertain whether such effects extend to other drugs for psychosis.

Methods:

We searched for reports on rates of suicidal behavior during treatment with clozapine and other modern drugs for psychosis (aripiprazole, olanzapine, risperidone, quetiapine, and ziprasidone) versus comparison or control treatments and analyzed the contrasts by random-effect meta-analysis to obtain pooled odds ratios (ORs) with 95% confidence intervals (CIs).

Results:

We identified 35 paired comparisons of modern drugs for psychosis versus comparison or control treatments in 18 reports. There was moderate overall superiority of all agents tested over alternatives (OR = 0.522, p = 0.004). With clozapine, this effect was large (OR = 0.229, p < 0.0001) and consistent (7/7 trials), but significant antisuicidal effects were not found with other drugs for psychosis in 28 other trials (OR = 0.941, p = 0.497). Apparent efficacy of specific agents ranked: risperidone ⩾ olanzapine ⩾ aripiprazole ⩾ ziprasidone ⩾ mixed drugs for psychosis ⩾ quetiapine, but none of these differences was significant.

Conclusions:

An ability of clozapine to reduce risk of suicides and attempts in schizophrenia patients appears to be a unique effect not shared with other modern medicines indicated for schizophrenia or bipolar disorder.
Imputing Parking Usage on Sparsely Monitored Areas Within Amsterdam Through the Application of Machine Learning
Authors: Schmidt Jeroen , Dugundji Elenna , Schotten Bas
Published: July 2021

Effective parking policy is essential for cities to reduce the demand their road networks experience and to combat their carbon footprints. Existing research in the application of machine learning to understand parking behavior assumes that cities have prohibitively expensive stationary parking sensors installed, while no research has yet attempted to use machine learning to impute for parking behavior using mobile probe data of sparsely monitored areas. To this end, this paper shows that it is indeed feasible to impute parking pressure (occupation as a percentage). Gradient boosted trees were found to perform the best with an R2 score of 0.20 and root mean squared error (RMSE) score of 0.087. This paper also found that three unique parking occupancy patterns exist in Amsterdam and that this information, in combination with neighborhood characteristics, has an impact on imputation under certain conditions.
Evaluation of an Advanced Driver-Assistance System to Reduce Pedestrian and Rear-End Crashes of Transit Vehicles
Authors: Hadi Mohammed , Islam Mohammad Atonu , Afreen Sohana , Wang Tao
Published: July 2021

This paper reports on the results of an evaluation of a rear-end and pedestrian crash warning system installed on transit agency buses with the goal of collecting and providing information to help agencies make decisions about investing in such systems. The results from this evaluation indicate that the tested crash warning system had a positive effect on improving the reaction times to rear-end and pedestrian conflicts and on increasing the yield of drivers to pedestrians. The results from the evaluation also indicate improvement in driver behavior as reflected by the increase in the time headway between vehicles, reduction in the number of alerts for both rear-end and pedestrian crashes, and the reduction in the number of hard brake events. However, bus operators’ acceptance of the system seems to be low, pointing to the need for additional outreach and education of the drivers on the system and its effectiveness. The results from the return-on-investment analysis show that although installing the system on every bus of the transit agency may not be cost-effective, installing the devices on only the buses that operate on the high-crash bus routes is cost-effective.
Development of a Novel Framework for Hazardous Materials Placard Recognition System to Conduct Commodity Flow Studies Using Artificial Intelligence AlexNet Convolutional Neural Network
Authors: Gaweesh Sherif , Khan Md Nasim , Ahmed Mohamed M.
Published: July 2021

Conducting hazardous materials (HAZMAT) commodity flow studies (CFS) is crucial for emergency management agencies. Identifying the types and amounts of hazardous materials being transported through a specified geographic area will ensure timely response if a HAZMAT incident takes place. CFS are usually conducted using manual data collection methods, which may expose the personnel to some risks by them being subjected to road traffic and different weather conditions for several hours. On other hand, the quality and accuracy of the collected HAZMAT data are affected by the skill and alertness of the data collectors. This study introduces a framework to collect HAZMAT transportation data exploiting advanced image processing and machine learning techniques on video feed. A promising convolutional neural network (CNN), named AlexNet was used to develop and test the automatic HAZMAT placard recognition framework. A solar-powered mobile video recording system was developed using high-resolution infra-red (IR) cameras, connected to a network video recorder (NVR) mounted on a mobile trailer. The developed system was used as the continuous data collection system. Manual data collection was also conducted at the same locations to calibrate and validate the newly developed system. The results showed that the proposed framework could achieve an accuracy of 95% in identifying HAZMAT placard information. The developed system showed significant benefits in reducing the cost of conducting HAZMAT CFS, as well as eliminating the associated risks that data collection personnel could face.
Mainstreaming Photo- and Video-Based Documentation as Method for Establishing a Level of Service Framework for the Mumbai Suburban Railway System
Authors: Nunes Leona , Rangwala Lubaina , Pai Madhav
Published: July 2021

The city of Mumbai has grown at an unprecedented rate, increasing the burden of mobility on its core public transport system, the Mumbai suburban railway network. The system is likely failing from “over-optimization,” with stations not designed to cater to the needs of a rapidly growing city, which has led to a steady surge in fatalities over the years, primarily in the metropolitan region beyond the city limits. Besides fatalities, research indicates that crowding has led to extreme fear and insecurity, especially in women and young commuters, with inappropriate behavior by fellow passengers causing them extreme discomfort. There is a need to decongest the Mumbai suburban rail network across the system and to gain a better measure of the extent of crowding in and around transit facilities. Concepts such as level of service (LOS) from the vantage point of crowding science can be used to address this need. However, there are two critical challenges. First, concepts developed in the Global North are inadequate to deal with the kind of commuter densities and complexities typical of cities like Mumbai. Secondly, conventional data gathering methods have proved to be time consuming, costly, and too inflexible to capture dynamic commuter behavior critical to the science of crowd management. This paper aims to address these two challenges by articulating a set of “inquiries” that can inform a localized framework and share learnings from the application of basic video and image processing. Thus, it proposes dynamic data capture methods that inform and enable a scientific planning process.
Perceived Neighborhood Conditions, Self-Management Abilities, and Psychological Well-Being Among Chinese Older Adults in Hawai’i
Authors: Zhang Keqing , Wu Bei , Zhang Wei
Published: July 2021

Using survey data collected from January to September 2018 ( N = 430), this study examined how neighborhood physical conditions and social cohesion were associated with psychological well-being via pathway of self-management abilities among Chinese older adults living in Honolulu, Hawai’i. Results showed that, for the whole sample, neighborhood physical conditions and social cohesion were significantly associated with psychological well-being, and the main associations were mediated by self-management abilities in the amount of 34% and 60%, respectively. Similar results were found for the foreign-born, whereas for the U.S.-born, psychological well-being was significantly related to neighborhood physical conditions only. Our findings reveal the importance of neighborhood conditions and individual psychological resources on psychological well-being of Chinese older adults.
Numerical treatment for Casson liquid flow in a microchannel due to porous medium: A hybrid nanoparticles aspects
Authors: Manohar Gombi Rachappa , Venkatesh Puttaswamy , Gireesha Bijjanal Jayanna , Ramesh Gosikere Kenchappa
Published: July 2021

In the current investigation a mathematical model is simplified to explore the numerical treatment for the thermal and flow behavior in a magneto hydrodynamics Casson fluid through a micro channel by taking [Formula: see text] nanoparticles. The combined effects of temperature jump, porous medium and velocity slip are incorporated. Using the dimensionless variables one can obtain the governing differential equations thereafter resolved numerically using RKF45 method. The velocity, temperature, skin friction and Nusselt number coefficient are addressed for different pertaining parameter. The upshots of the current investigation are visualized through graphically elucidation. Out comes shows that larger values of solid volume fraction decreases both velocity and temperature field. Furthermore drag coefficient is increases for increase in magnetic parameter, also hybrid nanofluid gives more impact than nanofluid.
The influence of ultrasonic vibration amplitude and magnetic field intensity on microstructural characteristics in laser drilling of Ti6Al4V
Authors: Raftar Omid Rohani , Amiri Soheil , Khajehzadeh Mohsen , Razfar Mohammad Reza
Published: July 2021

Nowadays, laser drilling has found extensive medical applications such as drilling of titanium implants. However, laser drilling of such implants has encountered several restrictions such as low penetration depth, high thickness of recast layer and heat affected zone (HAZ). Therefore, various approaches such as magnetic field and/or ultrasonic vibration aided laser drilling have been proposed to overcome these limitations; among them, few studies have been conducted considering the simultaneous effect of magnetic field and ultrasonic vibrations on microstructural characteristics. Therefore, in the present paper, the effects of magnetic field intensity and ultrasonic vibration amplitude (with a frequency of 28 kHz) have been investigated on the formed phases, thickness of recast layer and thickness of HAZ in laser drilling of Ti6Al4V. According to the obtained results, adding ultrasonic vibrations to the laser drilling process will lead to an average decrease of 29.40% and 28% respectively for the thickness of HAZ and recast layer. However, with the addition of a magnetic field (0.1 Tesla), the thicknesses of HAZ and recast layer were increased by 7% and 11%, respectively. Furthermore, increasing the ultrasonic vibration amplitude was associated with the increase in the acicular alpha phase (α′) as well as more dense, and fine-grained and uniform structure. This can be attributed to the strengthening of convective heat transfer mechanism and higher cooling rate. Additionally, by increasing the intensity of the magnetic field, the structure of the acicular alpha (α′) became finer and the density of lateral branches decreased.
Dynamic modeling, system identification and comparative study of various control strategies for a spatial parallel manipulator
Authors: Thomas Mervin Joe , George Shoby , Sreedharan Deepak , Joy ML , Sudheer AP
Published: July 2021

The significant challenges seen with the mathematical modeling and control of spatial parallel manipulators are its difficulty in the kinematic formulation and the inability to real-time control. The analytical approaches for the determination of the kinematic solutions are computationally expensive. This is due to the passive joints, solvability issues with non-linear equations, and inherent kinematic constraints within the manipulator architecture. Therefore, this article concentrates on an artificial neural network–based system identification approach to resolve the complexities of mathematical formulations. Moreover, the low computation time with neural networks adds up to its advantage of real-time control. Besides, this article compares the performance of a constant gain proportional–integral–derivative (PID), variable gain proportional–integral–derivative, model predictive controller, and a cascade controller with combined variable proportional–integral–derivative and model predictive controller for real-time tracking of the end-effector. The control strategies are simulated on the Simulink model of a 6-degree-of-freedom 3-PPSS (P—prismatic; S—spherical) parallel manipulator. The simulation and real-time experiments performed on the fabricated manipulator prototype indicate that the proposed cascade controller with position and velocity compensation is an appropriate method for accurate tracking along the desired path. Also, training the network using the experimentally generated data set incorporates the mechanical joint approximations and link deformities present in the fabricated model into the predicted results. In addition, this article showcases the application of Euler–Lagrangian formalism on the 3-PPSS parallel manipulator for its dynamic model incorporating the system constraints. The Lagrangian multipliers include the influence of the constraint forces acting on the manipulator platform. For completeness, the analytical model results have been verified using ADAMS for a pre-defined end-effector trajectory.
Timing and structure of early-Holocene climate anomalies inferred from north Chinese stalagmite records
Authors: Duan Wuhui , Ma Zhibang , Tan Ming , Cheng Hai , Edwards R. Lawrence , Wen Xinyu , Wang Xuefeng , Wang Lisheng
Published: July 2021

In this paper, a new decadal resolution stalagmite δ18O record covering 10.4–6.5 ka BP from Kulishu cave in Beijing, north China is presented in combination with the published stalagmite δ18O record covering 10.4–14.0 ka BP in the same cave. Five significant monsoon collapses were identified around 11.5, 11.0, 10.0, 9.4, and 8.2 ka BP as well as three smaller ones around 10.3, 9.0, and 8.6 ka BP. The weak monsoon episodes around 8.6 and 8.2 ka BP form the two-step structure of the 8.2 ka event. All monsoon collapses, coeval with the cooling in northern high-latitude records, are correlated with Lakes Agassiz-Ojibway outbursts. Thus, our data support the idea of freshwater forcing of abrupt climate anomalies during the early Holocene. Nevertheless, the decreased irradiance together with freshwater outburst may account for the 9.2/9.3 ka event, which is expressed more significantly in low-latitude records.
Recovery from memory failure when recalling a memorized performance: The role of musical structure and performance cues
Authors: Chaffin Roger , Ginsborg Jane , Dixon James , Demos Alexander P.
Published: July 2021

To perform reliably and confidently from memory, musicians must able to recover from mistakes and memory failures. We describe how an experienced singer (the second author) recovered from mistakes and gaps in recall as she periodically recalled the score of a piece of vocal music that she had memorized for public performance, writing out the music six times over a five-year period following the performance. Five years after the performance, the singer was still able to recall two-thirds of the piece. When she made mistakes, she recovered and went on, leaving gaps in her written recall that lengthened over time. We determined where in the piece gaps started ( losses) and ended ( gains), and compared them with the locations of structural beats (starts of sections and phrases) and performance cues ( PCs) that the singer reported using as mental landmarks to keep track of her progress through the piece during the sung, public performance. Gains occurred on structural beats where there was a PC; losses occurred on structural beats without a PC. As the singer’s memory faded over time, she increasingly forgot phrases that did not start with a PC and recovered at the starts of phrases that did. Our study shows how PCs enable musicians to recover from memory failures.
Validation study of canine serum cortisol measurement with the Immulite 2000 Xpi cortisol immunoassay
Authors: Korchia Jérémie , Freeman Kathleen P.
Published: July 2021

We report the results of validation of canine serum cortisol determination with the Immulite 2000 Xpi cortisol immunoassay (Siemens), with characterization of precision (CV), accuracy (spiking-recovery [SR] bias), and observed total error (TEo = bias + 2CV) across the reportable range, specifically at the most common interpretation thresholds for dynamic testing. Imprecision increased at increasing rate with decreasing serum cortisol concentration and bias was low, resulting in increasing TEo with decreasing serum cortisol concentration. Inter-laboratory comparison study allowed for determination of range-based bias (RB) and average bias (AB). At 38.6 and 552 nmol/L (1.4 and 20 μg/dL), between-run CV was 10% and 7.5%, respectively, and TEo ~30% and ~20%, respectively (TEo remained similar regardless of the considered bias: SR, RB, or AB). These analytical performance parameters should be considered in the interpretation of results and for future expert consensus discussions to determine recommendations for allowable total error (TEa). Importantly, the commonly used thresholds for interpretation of results were determined ~40 y ago with different methods of measurements and computation, hence updating is desirable. Quality control material (QCM) had between-run imprecision of 4% for QCM1 and 7% for QCM2; the bias was minimal for both levels. Acceptable QC rules are heavily dependent on the desired TEa for the QCM system (TEaQCM), itself limited by the desired clinical TEa. At low TEaQCM (20–33%), almost no rules were acceptable, whereas at high TEaQCM (50%), almost all rules were acceptable; further investigation is needed to determine which TEaQCM can be guaranteed by simple QC rules.
Disparities in Palliative Care Utilization Among Hospitalized People With Huntington Disease: A National Cross-Sectional Study
Authors: Sokol Leonard L. , Bega Danny , Yeh Chen , Kluger Benzi M. , Lum Hillary D.
Published: July 2021

Background:

People with Huntington’s disease (HD) often become institutionalized and more frequently die away from the home setting. The reasons behind differences in end-of-life care are poorly understood. Less than 5% of people with HD report utilization of palliative care (PC) or hospice services, regardless of the lack of curative therapies for this neurodegenerative disease. It is unknown what factors are associated with in-patient specialty PC consultation in this population and how PC might be related to discharge disposition.

Objectives:

To determine what HD-specific (e.g., psychosis) and serious illness-specific factors (e.g., resuscitation preferences) are associated with PC encounters in people with HD and explore how PC encounters are associated with discharge disposition.

Design:

We analyzed factors associated with PC consultation for people with HD using discharge data from the National Inpatient Sample and the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. An anonymized, cross-sectional, and stratified sample of 20% of United States hospitalizations from 2007 through 2014 were included using ICD-9 codes.

Results:

8521 patients with HD were admitted to the hospital. Of those, 321 (3.8%) received specialty PC. Payer type, (specifically private insurer or other insurer as compared to Medicare), income, (specifically the top quartile as compared to the bottom quartile), mortality risk, D.N.R., aspiration pneumonia, and depression were significantly associated with PC in a multivariate model. Among those who received PC, the odds ratio (OR) of discharge to a facility was 0.43 (95% CI, 0.32-0.58), whereas the OR of discharge to home with services was 2.25 (95% CI 1.57-3.23), even after adjusting for possible confounders.

Conclusions:

Among patients with HD, economic factors, depression, and serious illness-specific factors were associated with PC, and PC was associated with discharge disposition. These findings have implications for the adaptation of inpatient PC models to meet the needs of persons with HD.
Satisfaction and Expenditure in Wineries: A Prospect Theory Approach
Authors: Sellers Ricardo , Nicolau Juan Luis
Published: July 2021

Visitor satisfaction has been shown to be a critical determinant of visitor expenditure in wineries. Although the relationship between visitor satisfaction and expenditure in wineries has been investigated in previous literature, we have unearthed potential intricacies that emerge when this relationship is analyzed within the reference dependence framework of prospect theory. To fill this gap, we use segment-based reference points to capture the singularity of winery visitors, and results show that demographics and psychographics confirm reference dependence. When reference points are based on psychographics, loss aversion is confirmed (lowering visitor satisfaction has a greater negative impact on expenditure than the positive impact derived from increasing visitor satisfaction), while diminishing sensitivity is observed for losses (the effect of the variations in visitor satisfaction shifts depending on the distance from the individual’s reference point). Interestingly, when the reference points are obtained through demographics, loss aversion is reversed. Relevant managerial implications are outlined.
Can We Really Defund the Police? A Nine-Agency Study of Police Response to Calls for Service
Authors: Lum Cynthia , Koper Christopher S. , Wu Xiaoyun
Published: July 2021

The protests following the killing of George Floyd in the summer of 2020 led to contentious discussions and debates in many cities about policing, with some calling to “defund the police.” However, this debate has generally proceeded without adequate research about either the scale or nature of issues that the police handle and the potential consequences of the proposed reform efforts. To respond to this research gap, we analyze millions of 911 calls for service across nine U.S. agencies. We report on the types of calls for service that the police handle, including how frequently different calls arise, how much time agencies spend on different categories of calls, and the outcomes of those calls. We find that the amount and types of incidents for which people call the police are voluminous, with the vast majority not obviously transferable to other organizations or government sectors without significant resource expenditures or adjustments. However, if the police retain these responsibilities, they also need to reconsider how they can more effectively address community concerns.
An Intensive Educational Intervention Significantly Improves the Adoption of Single Fractionation Radiotherapy in Uncomplicated Bone Metastases
Authors: Donati Costanza M. , Nardi Elena , Galietta Erika , Alfieri Maria L. , Siepe Giambattista , Zamagni Alice , Buwenge Milly , Macchia Gabriella , Deodato Francesco , Cilla Savino , Strigari Lidia , Cammelli Silvia , Cellini Francesco , Morganti Alessio G.
Published: July 2021

Introduction:

An education strategy was employed in our department to increase the rate of patients with uncomplicated painful bone metastases undergoing single fractionation radiotherapy (SFRT). The purpose of this report is to analyze the results of this strategy over a 5 year period.

Materials and Methods:

In January 2015, two meetings were organized in our department. In the first, data from an audit on the current SFRT rate were shown. In the second, evidence of SFRT efficacy in the relief of pain from uncomplicated bone metastases was presented. In addition, during the weekly discussion of clinical cases, the opportunity to use the SFRT was systematically recalled. Using our institutional database, all patients treated with radiotherapy for uncomplicated painful bone metastases in the period between 2014 (year considered as a reference) and 2019 were retrieved. Data regarding treatment date (year), radiotherapy fractionation, and tumor, patients, and radiation oncologists characteristics were collected.

Results:

A total of 627 patients were included in the analysis. The rate of patients undergoing SFRT increased from 4.0% in 2014 to 63.5% in 2019 ( p < 0.001). At multivariable analysis, the delivery of SFRT was significantly correlated with older patients age (>80 years), lung cancer as the primary tumor, treatment prescribed by a radiation oncologist dedicated to palliative treatments, and treatment date (2014 vs 2015–2019).

Conclusions:

This retrospective single-center analysis showed that a simple but intensive and prolonged departmental education strategy can increase the rate of patients treated with SFRT by nearly 16 times.
College Completion in a No-Racial/Ethnic Majority Campus
Authors: Stokvis Namhee , Melara Robert D. , De Prabal K.
Published: July 2021

Despite evidence for the academic and psychological benefits of racial/ethnic minority (REM) students enrolling in minority-serving institutions, REM college students’ graduation rates have been consistently lower for White students across institutions. The current study examined REM graduation rates and associated risk factors in a campus with no-racial/ethnic majority (NRM). The findings indicated that (1) the graduation rates of REM (Black and Latinx) students were higher at the NRM institution than national averages, with little disparity in NRM graduation rates among racial/ethnic groups, (2) REM female students graduated at higher rates than Asian and White male students, and (3) self-reported stress and registration status predicted college completion. Moreover, traditional predictors, such as household income, gender, and parental education, were not associated with college completion. A separate analysis of graduation rates at colleges high versus low in racial/ethnic diversity also revealed little graduation disparity among racial/ethnic groups when diversity is relatively high. The results support the hypothesis that REM students thrive academically in educational settings where no single racial majority exists.
Transcranial Doppler Ultrasound Pre and Post Middle Cerebral Artery Stent Placement
Authors: Tran Vanessa T. , Moore Anne , Sekhar Laligam
Published: July 2021

This report describes a 42 year old male with a 5 year history of transient ischemic attacks (TIAs), migraines, previous strokes, and symptoms referable to a left middle cerebral artery (MCA) territory event. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) revealed severe stenoses in the proximal left MCA and proximal left anterior cerebral artery (ACA). Transcranial Doppler ultrasound/Transcranial Doppler imaging (TCD/TCI) and cerebral angiogram confirmed the stenoses with a mean flow velocity (MFV) at the proximal left MCA, with a velocity of 230 cm/s. A Wingspan Stent System stent was placed in the proximal left MCA. Cerebral angiogram and serial TCD examinations performed post stent placement showed a patent left MCA without stenosis and a MFV of 55 cm/s. The left ACA was occluded following proximal left MCA stent placement. This case highlights the usefulness of TCD in the assessment of the MCA and other basal cerebral arteries.
A review and analysis of product recall for pharmaceutical drug product
Authors: Miglani Ashish , Saini Chandan , Musyuni Pankaj , Aggarwal Geeta
Published: July 2021

The pharmaceutical industry's primary concern is to provide high-quality drug products to the general public, so drug recalls play an important role in maintaining the quality system by removing defective products from the market. Pharmaceutical product recalls are increasing at an alarming rate as a result of increased inspection rates and the introduction of modernization and the digital world into the industry, raising concerns for regulatory agencies and public health to focus on more stringent regulations to control future recalls of defective drug products. This article will provide an overview of recall procedures, their impact on the pharmaceutical industry, and the various steps taken to reduce pharmaceutical recalls.
Stimulant Therapy Utilization for Neurocognitive Deficits in Mild Traumatic Brain Injury
Authors: Coris Eric E. , Moran Byron , Sneed Kevin , Del Rossi Gianluca , Bindas Bradford , Mehta Shaan , Narducci Dusty
Published: July 2021

Context:

There are 3.8 million mild traumatic brain injuries (mTBIs) that occur each year in the United States. Many are left with prolonged life-altering neurocognitive deficits, including difficulties in attention, concentration, mental fatigue, and distractibility. With extensive data on the safety and efficacy of stimulant medications in treating attention deficit, concentration difficulties and distractibility seen with attention deficit disorder, it is not surprising that interest continues regarding the application of stimulant medications for the persistent neurocognitive deficits in some mTBIs.

Evidence Acquisition:

Studies were extracted from PubMed based on the topics of neurocognitive impairment, mTBI, stimulant use in mTBI, stimulants, and the association between attention deficit/hyperactivity disorder and mTBI. The search criteria included a date range of 1999 to 2020 in the English language.

Study Design:

Literature review.

Level of Evidence:

Level 4.

Results:

Currently, there is very limited literature, and no guidelines for evaluating the use of stimulant medication for the treatment of prolonged neurocognitive impairments due to mTBI. However, a limited number of studies have demonstrated efficacy and safety of stimulants in the treatment of neurocognitive sequelae of mTBI in the adult, pediatric, military, and athletic populations.

Conclusion:

There is limited evidence to suggest stimulant medication may be beneficial in patients with mTBI with persistent neurocognitive symtpoms. The decision to utilize stimulant medication for mTBI patients remains physician and patient preference dependent. Given the limited encouraging data currently available, physicians may consider stimulant medication in appropriate patients to facilitate the recovery of prolonged neurocognitive deficits, while remaining cognizant of potential adverse effects.
Sickle Cell Disease Care Planning for School Nurses
Authors: Morse Brenna L. , Carmichael Amanda E. , Bradford Veronica A. , Pollard Alyson L.
Published: July 2021

Schoolchildren with sickle cell disease (SCD) experience physiologic and psychologic stress that can affect school functioning, mental well-being, and physical health. Student needs are unique and individualized; however, school nurses can support students and families with SCD through comprehensive and thorough care planning efforts. In addition to components specific to individual prescriptions and other nonpharmacological therapies, school nurses should consider school access and inclusion, pain management, racism, and disease self-management when care planning. As a healthcare provider who may have several continuous years of near-daily contact with students, the school nurse is an imperative provider, educator, and advocate for students learning to manage their SCD and avoid the related complications and challenges.
Cognitive effects of vortioxetine in older adults: a systematic review
Authors: Bishop Makenna M. , Fixen Danielle R. , Linnebur Sunny A. , Pearson Scott M.
Published: July 2021

Many older adults experience a deterioration in cognitive function with aging, and this can have a negative impact on quality of life. Late-life depression has been linked to mild cognitive impairment and dementia, and treating depression with an agent that has procognitive effects could be beneficial. Vortioxetine is a novel antidepressant with a multimodal mechanism of action that works primarily via serotonin transporter inhibition, 5-HT1A receptor agonism and 5-HT3 receptor antagonism. A recent systematic review demonstrated procognitive effects of vortioxetine when indirectly compared with selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors in adults aged 18–65 years with major depressive disorder. While this systematic review demonstrated promising procognitive effects from vortioxetine, the included studies did not enroll older adults, who are at the highest risk of cognitive impairment. Therefore, our systematic review sought to investigate the effects of vortioxetine on cognitive functioning in patients over the age of 65 years. Three studies met the prespecified search criteria and were evaluated. Overall, these preliminary data suggest that vortioxetine has promising effects in improving cognition in older adults with depressive symptoms and may have a place in therapy in older adults with depression and/or cognitive impairment, including Alzheimer’s disease. Additional long-term studies that include more diverse populations with comorbidities and direct comparisons with other antidepressants are needed to fully understand the potential cognitive benefits in older adults.
Correlation between nasal nitric oxide and its metabolites, RANTES, IL-5 in allergic rhinitis
Authors: Zheng Tao , Jung Sen Min , Kang Hee Jeong , Kim Hyung Gu , Chung Jae Ho , Jeong Jin Hyeok
Published: July 2021

There have been two measurement methods for nasal nitric oxide (nNO): direct measurement of nNO and indirect measurement of NO metabolites or the NO synthase enzyme. The aim of this study is to investigate the difference in nNO between allergic rhinitis (AR) patients and the correlation of the direct measurement of nNO and indirect measurement of nNO metabolites, RANTES, and IL-5. Fifteen patients with AR, 15 patients with septal deviation as a control group were enrolled. We measured the nNO level using a chemiluminescence analyzer and the amount of NO metabolites, RANTES, and IL-5 in nasal lavage fluid using the ELISA method. Nasal NO levels were significantly higher in AR than the control (195.7 ± 39.6 vs 159.4 ± 25.8 ppb, P = 0.027). NO metabolites, IL-5, and RANTES levels were higher in AR, but there was no statistically significant difference. There was no significant correlation between nNO and nNO metabolites, RANTES, IL-5, and clinical parameters except for the olfactory test score in AR. There was a negative correlation between nNO and the olfactory test score in AR ( r = −0.590, P = 0.034). Nasal NO concentration increased in AR. However, nNO metabolites and IL-5, RANTES in nasal secretion did not show any correlation with nNO. Direct measurement of nNO could be a potentially useful biomarker of AR compared to indirect measurement of NO metabolites, cytokines, and chemokines in nasal secretion.
‘My devil womb’: Patients’ perspectives on, and understanding of, endometriosis: An observational cross-sectional study
Authors: Chilton Nadine , van Oudtshoorn Sarah , Pontré Jennifer , Karthigasu Krishnan , McElhinney Bernadette
Published: July 2021

Objective:

To gain insight into patients’ understanding of endometriosis, utilised sources of information on endometriosis and perceptions of available treatment options.

Design:

Observational cross-sectional study.

Setting:

Data were collected from an outpatient specialist endometriosis clinic within a tertiary hospital.

Participants:

New patients referred with symptoms suggestive of endometriosis.

Methods:

A paper based questionnaire was completed by new patients on their first presentation to the clinic.

Main outcome measures:

Patient understanding of symptoms and causes of endometriosis, types and expectations of treatment, and sources of information utilised by patients in researching endometriosis.

Results:

Approximately half of all included patients were unsure of the aetiology of endometriosis. Patients who relied on information from specialist gynaecologists were more optimistic about the outcome of surgical treatment, while those who relied on general practitioners were more optimistic about the outcome of medical treatment, when compared to those who sought information from online sources.

Conclusions:

Endometriosis is a chronic and debilitating condition, yet there is limited data available regarding both the sources of information that patients’ access, and their perceptions of the disease. Given the high proportion of patients in our study who lacked knowledge of endometriosis, and the negative correlation between the use of social media for information and perception of treatment, there is a clear need for improved access to evidence-based resources for patient education.
Mixed-Methods Analysis of a Validated Arthroscopic Knot-Tying Simulator With New Indirect Visualization Condition
Authors: Moran Kit , Rotenberg Carolyn , AlHussain Ahmed , Reda Bashar , Gordey Erin , Wong Ivan
Published: July 2021

Background:

Simulation provides low-risk opportunities for surgical trainees to learn and practice fundamental skills. One simulation tool for orthopaedics is the Arthroscopic Knot (ArK) Trainer, which has been validated as an effective simulation tool across multiple methodologies. Previous studies have investigated the ArK Trainer in its basic form using clear plexiglass, which allows direct visualization of tissue anchors.

Purpose:

Using a mixed-methods approach, we assessed and compared junior and senior trainees’ Seoul Medical Center (SMC) knot–tying performance under direct and indirect visualization.

Study Design:

Cross-sectional study.

Methods:

Fourteen orthopaedic surgery postgraduate trainees at a single medical school were recruited to participate. Trainees tied SMC knots using the Ark Trainer under direct and indirect visualization. A mixed-methods approach was used to evaluate knot-tying proficiency and characterize participants’ approach to knot-tying. Knot-tying proficiency was evaluated using validated tools: a task-specific checklist (TSC), a global rating scale (GRS), and a proficiency scale (PS). Participants’ approach to knot-tying was characterized using Likert-type questionnaires and semistructured interviews. An α level of .10 was set a priori owing to the small pool of trainees.

Results:

The 14 participants included 7 junior residents (postgraduate years [PGYs] 1 and 2) and 7 senior residents (PGY ≥3), of whom 3 were fellows (PGY 6). Senior trainees outperformed junior trainees on both versions of the ArK Trainer: clear (GRS, P = .055; PS, P = .075) and covered (TSC, P = .05). Overall, participants performed better under direct visualization conditions (GRS, P = .05). In semistructured interviews, significantly more senior trainees discussed relying on haptic cues while tying knots under direct visualization ( P = .021). The majority of trainees agreed that both versions of the ArK Trainer were realistic and appropriate practice formats for their level of training.

Conclusion:

Senior trainees were significantly more experienced than were junior trainees in arthroscopic skill and outperformed them on both configurations: direct (PS and GRS) and indirect (TSC) visualization. Experienced trainees were significantly more likely to report using tactile cues to aid knot-tying under indirect visualization. It is likely that inexperienced trainees rely more heavily on direct visualization and that the use of tactile cues may be an indicator of knot-tying proficiency. Trainees recommended progression from direct to indirect visualization configurations for inexperienced learners.
Theoretical and Practical Challenges to Stop Recidivism Among Juveniles: Three Cases Studies of Male Juveniles in Karachi, Pakistan
Authors: Khoso Abdullah , Kousar Umbreen
Published: July 2021

In Pakistan, research (within academia and outside of it) lacks discussion and analysis of the policy, legal, administrative, institutional issues, challenges and barriers in addressing recidivism among juveniles. Therefore, this article’s primary aim is to understand the different factors that prevent children from recidivism; or instead, they contribute to juveniles’ developing tendency to re-offend. Three children between 15 to 18 years of age were interviewed at the superintendent of the Youthful Offender Industrial School (YOIS) in Karachi; also, an interview was conducted with the Director Reclamation and Probation, Sindh. The findings reveal that partial legal and institutional provisions and arrangements exist to address recidivism. However, these provisions are not implemented to stop children from re-offending. The analysis also shows that detention exists, but they did not have rehabilitation programmes, whereas community-based rehabilitation did not exist. Instead, these places (institutions and communities) educate children on how the crimes are being committed. The study’s findings suggest serious policy measures to deal with recidivism among male juveniles through diverse programmes and training and sensitisation of the police and judicial officials and the community members.
Using Personal Stories to Enhance the Team Member Experience in Traditional and Online Teaching Modalities
Authors: Gavino Monica C. , Akinlade Ekundayo
Published: July 2021

Working effectively in diverse teams is an important competency for students entering the workforce. Yet as instructors we often witness dysfunctional teams in our courses. Therefore, the goal of this experiential exercise is to encourage students to build high-quality relationships with team members by fostering the development of a psychologically safe team climate early in the semester. Students share their personal stories and react to each other’s story. In doing so, they learn to understand, value, and respect team members’ life experiences. Guiding questions for the personal story exercise and the reaction, which can be used in traditional face-to-face, online, synchronous, or asynchronous classes, are provided. This experiential exercise answers the call for ways to create and build community both in in-person and on-line courses.
Toward a Bidirectional and Co-Constructed Mentorship: Rethinking the Mentor and Student–Teacher Relationship
Authors: Coppola Rick , Rocha Daniel J. , Woodard Rebecca
Published: July 2021

Cooperating teachers are vital in the professional development of teacher candidates. Yet, little research has been done to explore the generative and bidirectional nature of mentoring in the context of a student teaching-mentoring dyad—including the ways that teacher candidates are vital to the professional development of cooperating teachers. This case study addresses this gap by exploring the realized potential of adopting a transformative activist stance in relation to the mentoring of a preservice teacher candidate. The strategic partnering of a veteran teacher (Rick) and undergraduate teacher candidate (Daniel)—both committed to culturally sustaining pedagogies—created an opportunity to reimagine the student teaching experience in one English language arts classroom. Through collaborative reflection and artifact analysis, we examine our roles in contributing to bidirectional mentorship that stressed innovative collaboration rather than adaptation to existing power differentials.
ShakeMap operations, policies, and procedures
Authors: Wald David J , Worden C Bruce , Thompson Eric M , Hearne Michael
Published: July 2021

The US Geological Survey’s ShakeMap is used domestically and globally for post-earthquake emergency management and response, engineering analyses, financial instruments, and other decision-making activities. Recent developments in the insurance, reinsurance, and catastrophe bond sectors link payouts of potentially hundreds of millions of dollars to ShakeMap products. Similarly, building codes, post-earthquake building damage forensic evaluations, and geotechnical evaluations often rely on estimated peak response-spectral values for site-specific evaluations that may lead to costly analyses, retrofits, or other expenditures. Given such activities, financial, engineering, and other technical users demand processing specifications and a metadata trail for actuarial, escrow, and forensic purposes for each significant earthquake. Recent inquiries include how and why maps change with time, how to interpret metadata, and how to obtain the creation and update history of various map layers. Similarly, the collection of ShakeMap scenarios and historical ShakeMaps—either created in earlier versions or rerun as part of the latest version of the ShakeMap Atlas—warrant a full explanation of the inputs, processing, and archiving given their contribution to fragility curve development and loss model calibration. For these reasons, in addition to event-specific ShakeMap metadata and a comprehensive online ShakeMap Manual, we have crafted this practice paper to answer several of the most frequently asked technical questions. We also describe an application programming interface (API) for accessing site-specific shaking metrics and their uncertainties for earthquake forensic purposes in a consistent fashion. In all, we describe the advantages of employing ShakeMaps for these critical purposes as well as describe their limitations and uncertainties, offering an extensive set of instructions and disclaimers that can be referenced by ShakeMap users.
Association of lung clearance index with survival in individuals with cystic fibrosis
Authors: Kurz Johanna Manuela , Ramsey Kathryn Angela , Rodriguez Romy , Spycher Ben , Fischer Biner Reta , Latzin Philipp , Singer Florian
Published: July 2021

Background

The lung clearance index (LCI) assesses global ventilation inhomogeneity and is a sensitive biomarker of airway function in cystic fibrosis (CF) lung disease. We examined the association of LCI with the risk of death or lung transplantation (LTx) in individuals with CF.

Methods

We performed a retrospective analysis in a cohort of individuals with CF aged ≥5 years with LCI and forced expired volume in 1 s (FEV1) measurements performed between 1980 and 2006. The outcome was time until death or LTx. We used the earliest available LCI and FEV1values in a Cox proportional hazards regression adjusted for demographic and clinical variables. For sensitivity analyses, we used the mean of the first three LCI and FEV1measurements, stratified the cohort based on age, and investigated individuals with normal FEV1.

Results

In total, 237 individuals with CF with a mean (range) age of 13.9 (5.6–41.0) years were included. The time-to-event analysis accrued 3813 person-years and 94 (40%) individuals died or received LTx. Crude hazard ratios were 1.04 (95% CI 1.01–1.06) per 1.0 z-score increase in LCI and 1.25 (95% CI 1.11–1.41) per 1.0 z-score decrease in FEV1. After adjusting LCI and FEV1mutually in addition to sex, age, body mass index and number of hospitalisations, hazard ratios were 1.04 (95% CI 1.01–1.07) for LCI and 1.12 (95% CI 0.95–1.33) for FEV1. Sensitivity analyses yielded similar results and using the mean LCI strengthened the associations.

Conclusions

Increased ventilation inhomogeneity is associated with greater risk of death or LTx. Our data support LCI as novel surrogate of survival in individuals with CF.