bluuebunny/crossref_metadata_2025 huggingface dataset:
Lateral Ligament Reconstruction With Hamstring Graft for Ankle Instability: Outcomes for Primary and Revision Cases
Authors: Eble Stephanie K. , Hansen Oliver B. , Patel Karan A. , Drakos Mark C.
Published: July 2021

Background:

Optimal treatment for patients with severe ankle instability or failed previous ankle stabilization is not well defined, and newer techniques have limited presence in the literature.

Purpose/Hypothesis:

The purpose of this study was to evaluate clinical and radiographic outcomes after modified anatomic lateral ligament reconstruction using hamstring auto- or allograft in primary cases versus revision cases. We hypothesized that patients undergoing a revision procedure would demonstrate inferior patient-reported and radiographic outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent modified anatomic lateral ligament reconstruction by a single surgeon between 2010 and 2017 were identified. Indications included failure of previous ankle stabilization or severe ankle laxity. Patients completed preoperative and minimum 1-year postoperative Foot and Ankle Outcome Score (FAOS) surveys. They also underwent pre- and postoperative stress radiographs using the Telos Stress Device.

Results:

A total of 41 patients (42 ankles) were identified. The mean age was 32.1 years, and 36 patients (88%) were women. There were 25 primary procedures and 17 revision procedures. Hamstring autograft was utilized in 35 ankles and hamstring allograft in 7 ankles. A total of 34 patients (83%) provided postoperative patient-reported outcome scores at a mean of 26 months (range, 12-65 months). When comparing primary versus revision procedures, revision patients had significantly lower FAOS Pain (77.14 vs 90.66; P = .009), Sports (63.46 vs 82.16; P = .008), and Quality of Life (53.53 vs 76.70; P = .002) scores. In total, 34 patients (83%) had stress radiographs at a mean of 14 months (range, 3-62 months) postoperatively. Revision patients also had lower, though statistically insignificant, postoperative talar tilt measurements on average (5.73° vs 7.10°; P = .252), and pre- to postoperative change in talar tilt was not significantly different between groups (−4.94° vs −7.03°; P = .415).

Conclusion:

Revision procedures had significantly lower postoperative patient-reported outcome scores and lower talar tilt compared with patients undergoing a primary procedure, although the pre- to postoperative change in the talar tilt was not significantly different between groups.
Sibling Inequalities in Overweight and the Role of Mother’s Education: Evidence From the Indonesian Family Life Survey
Authors: Kunto Yohanes Sondang , Bras Hilde
Published: July 2021

Background:

Previous studies have shown that sibling inequalities in overweight vary across contexts. Furthermore, research on the extent to which parental factors such as mother’s education can compensate for or reinforce such disparities is considerably rare.

Objective:

This study analyzes to what extent and how the chances of overweight among children (0-19 years of age) vary systematically by gender, birth order, and number of siblings. We also look at whether mother’s education buffers or aggravates sibling inequalities in overweight.

Methods:

Data were from the fifth wave of the Indonesian Family Life Survey-5 2014/2015, which comprised 6723 children born in 4784 families. We applied within-family centered birth order dummies to disentangle the effects of birth order from those of number of siblings. Cluster-robust logistic regressions were conducted.

Results:

Overweight occurred more in eldest and youngest children, and in children of smaller families. Mother’s education amplified sibling inequalities. Odds of overweight in children increased along with more years of education the mothers had. This was greater for boys and eldest children. Further analyses indicated that boys whose mothers spent more years in school consumed high-calorie foods more often.

Conclusion:

The overall results indicate that mother’s education aggravates sibling inequalities in overweight. Nutrition interventions to reduce overweight in children should target the eldest and the youngest children and children of smaller families. Mothers who had more school years, and particularly their sons, should also be in the target group. Boys should be advised to consume high-calorie foods less often.
The Association of Body Image Perception With Dietary and Physical Activity Behaviors Among Adolescents in Indonesia
Authors: Niswah Ilyatun , Rah Jee Hyun , Roshita Airin
Published: July 2021

Background:

Growing evidence highlights the linkage between body image, eating, and exercise behaviors among adolescents.

Objective:

This study aims to determine the association between body image perception, nutritional status, and dietary and physical activity behaviors among adolescents in Indonesia.

Methods:

A cross-sectional household survey was conducted among a representative sample (n = 2160) of adolescent girls and boys aged 12 to 18 years in Klaten and Lombok Barat districts. The association between adolescents’ body image, their diets, and physical activity patterns was determined using complex samples Cox’s regression analysis. Separate multivariate models were developed for adolescent girls and boys.

Results:

Physical appearance was considered important to nearly all adolescents. Approximately 11% of girls and 14% of boys were overweight or obese, the majority of whom (∼70%) correctly perceived themselves as overweight or obese. More of overweight or obese adolescents felt unhappy about their perceived weight than their thin counterparts. With respect to the overweight/obese girls, the adolescents’ perceptions of being overweight or obese was associated with a 63% reduction in the prevalence of overweight/obese girls consuming fatty snacks, such as deep-fried crackers (adjusted prevalence ratio (PR): 0.37, 95% confidence interval (CI): 0.19-0.71) and a 40% reduction in the prevalence of overweight/obese girls engaging in moderate-intensity physical activity (adjusted PR: 0.60, 95% CI: 0.38-0.94), after adjusting for potential confounders. No association between body image and eating and physical activity behaviors was observed among adolescent boys.

Conclusions:

Body image may be one of the most important determinants of dietary and physical activity behaviors, and thus future efforts to foster healthy eating and physical activity behaviors among Indonesian adolescents need to address body image concerns.
Frequent Consumption of Micronutrient-Rich Foods Is Associated With Reduced Risk of Anemia Among Adolescent Girls and Boys in Indonesia: A Cross-Sectional Study
Authors: Knijff Marthe , Roshita Airin , Suryantan Julia , Izwardy Doddy , Rah Jee Hyun
Published: July 2021

Background:

Anemia is a global public health concern. Its devastating consequences include impaired cognitive and motor development, reduced work productivity, and adverse birth outcomes, all of which apply to adolescents, as well as adults and children.

Objective:

This study aimed to examine the determinants of anemia in Indonesian adolescent girls and boys from Klaten and Lombok Barat districts.

Methods:

A total of 2150 adolescents who participated in a cross-sectional household survey were included in the analysis. The dietary intake of adolescents was assessed using a 7-day food frequency questionnaire. The relationship between anemia status, dietary intake, and other hypothesized determinants was assessed for adolescent girls and boys on a separate basis, using complex samples Cox regression analysis. Variables were selected for inclusion in multivariate models if they were significantly associated with the dependent variable in univariate models ( P < .05).

Results:

The prevalence of anemia among adolescent girls and boys was 19% and 5%, respectively. In multivariate analyses, frequent consumption of animal-based iron-rich foods was significantly associated with a lower risk of anemia (prevalence ratio [PR]: 0.59; 95% CI: 0.36-0.97) among adolescent girls, whereas a higher intake of vitamin A-rich fruits and vegetables was associated with a reduced risk of anemia (PR: 0.41; 95% CI: 0.20-0.85) among adolescent boys, after adjustment for all potential confounders.

Conclusions:

Increased consumption of iron- and vitamin A-rich foods through the implementation of gender-responsive Social Behaviour Change Communication (SBCC) interventions is warranted. This should be coupled with improved coverage and quality of iron and folic acid supplementation programs in adolescents.
Knowledge Gaps in Understanding the Etiology of Anemia in Indonesian Adolescents
Authors: van Zutphen Kesso Gabrielle , Kraemer Klaus , Melse-Boonstra Alida
Published: July 2021

Background:

Anemia is a public health problem among adolescents in Indonesia. Strategies to prevent or treat anemia should be tailored to local conditions, taking into account its specific etiology and prevalence in a given setting and population group.

Objective:

This review aims to (1) identify and synthesize the current knowledge on the etiology of anemia among adolescents in Indonesia, (2) reveal knowledge gaps in this area, and (3) suggest directions for future research and programmatic work.

Methods:

We systematically searched PubMed, Web of Science, Scopus, Medline, and WorldCat databases for peer-reviewed journal articles to identify which etiological factors were related to anemia among Indonesian adolescents. Research papers were reviewed and included in the review according to inclusion criteria.

Results:

Of 13 studies, 8 showed that anemia was associated with iron deficiency; 4 are suggestive of vitamin A deficiency; and 2 of folic acid deficiency. Five studies underscore different etiological determinants for anemia, such as malaria, protein and energy malnutrition, vitamin B2 deficiency, calcium, and vitamin C deficiency. Based on these findings, we developed a framework on knowledge gaps on the etiology of anemia among adolescents in Indonesia, divided in 3 levels of knowledge: (1) significant knowledge gaps, (2) knowledge gaps, and (3) established knowledge.

Conclusions:

The knowledge gaps around the etiology of anemia among Indonesian adolescents are significant. Our framework emphasizes the need for further research across all etiological factors, namely inadequate nutritional intake and absorption, genetic hemoglobin disorders, infection and inflammation, and menstrual disorders.
Adolescent Nutrition—Developing a Research Agenda for the Second Window of Opportunity in Indonesia
Authors: Sparrow Robert , Agustina Rina , Bras Hilde , Sheila Grace , Rieger Matthias , Yumna Athia , Feskens Edith , Melse-Boonstra Alida
Published: July 2021

Background:

Recently, adolescence has been identified as a second window of opportunity for the correction of nutritional inadequacies. However, there is a lack of knowledge on evidence-based integrated nutrition strategies for adolescents in Indonesia.

Objective:

To provide a research agenda and the prioritization of research actions to tackle outstanding knowledge gaps on adolescent nutrition in Indonesia.

Methods:

A preliminary set of research topics was listed based on a desk study of the academic literature and policy documents. Second, a stakeholder meeting was held to further identify and discuss research topics related to adolescent nutrition in Indonesia. Third, an online survey was conducted in which respondents were asked to indicate priority research themes for the next 3 to 5 years and to rank a total of 23 research questions.

Results:

Most (52%) of the respondents who returned the survey (n = 27) prioritize research on implementation and program evaluation, while 30% prefer descriptive and explanatory research, and 19% place priority with intervention and discovery research. However, when we followed up with specific topics for each of these broad research areas, a more nuanced picture emerged, with intervention and discovery research taking a more prominent standing.

Conclusions:

In order to support the design, implementation, and effectiveness of integrated nutrition programs for Indonesian adolescents, in-depth studies should question the best intervention strategies, modes of delivery, and long-term outcomes, while nationwide and disaggregated data should investigate associations and trends over time and identify vulnerable groups.
School Canteens in Selected Areas in Indonesia: A Situation Analysis
Authors: Rachmadewi Asrinisa , Soekarjo Damayanti , Maehara Masumi , Alwi Basyrah , Mulati Erna , Rah Jee Hyun
Published: July 2021

Background:

The school canteen has a massive impact on the dietary intake and nutritional status of school-age children and adolescents. This study aimed at assessing the current situation of school canteens in selected areas in Indonesia and relevant knowledge, attitudes, and behaviors of school-going children and adolescents.

Methods:

A qualitative study was implemented in a purposive sample of 18 schools in Klaten and West Lombok districts with 2 comparison schools in Jakarta and Klaten. Focus group discussions and in-depth interviews were conducted with a wide range of stakeholders to collect information on nutrition knowledge, food preferences, related policies and governance, and opinions toward school canteens. Data were analyzed using thematic synthesis and narrative analysis.

Results:

Specific government guidelines on healthy foods and beverages to be sold in canteens are not yet in place. Many canteens had inadequate infrastructure and were managed informally, with limited rules, monitoring, and supervision. Although healthy options including vegetables and fruits were available in most canteens, unhealthy foods and beverages were abundant and cheap. Lack of awareness of the importance of nutrition of school-age children and adolescents was pervasive among all stakeholders. Personal preference and availability were main drivers of the students’ food choices.

Conclusions:

Concerted multisectoral and multistakeholders’ efforts are warranted to improve the quality of school canteens in Indonesia by developing a comprehensive relevant guideline, improving the capacity of related stakeholders and service providers, enhancing the implementation and monitoring, and generating demand for healthy canteens.
Household Water Insecurity Affects Child Nutrition Through Alternative Pathways to WASH: Evidence From India
Authors: Choudhary Neetu , Schuster Roseanne C. , Brewis Alexandra , Wutich Amber
Published: July 2021

Background:

Household water security matters greatly for child nutrition outcomes in the global South. Water’s role in sanitation/hygiene, via diarrheal disease, is cited as a primary mechanism here. Yet, the relationship between Water along with Sanitation and Hygiene (WASH) and child stunting remains inconclusive. Water-related mechanisms outside of the traditional scope of WASH might assist with explaining this.

Objective:

We aim to test the mediating role of reduced dietary diversity as an additional potential mechanism in linking worse household water access to increased risk of early childhood stunting, separating its effects from sanitation and diarrhea among children (as a proxy for hygiene) and taking into account regional water availability.

Method:

We use nationally representative India Demographic and Health Survey (2015-16) data for 58 038 children aged 6 to 23 months, applying generalized structural equation modelling to estimate water’s direct and indirect effects (as mediated through dietary diversity and access to sanitation) on a child’s likelihood of being stunted.

Results:

Suboptimal water access is significantly associated with elevated likelihood of child stunting. More than 30% of the effect is indirect. In the context of low water access and availability, children’s dietary diversity alone mediates more than 20% of its total effect on child stunting.

Conclusion:

Beyond the WASH mechanisms, household water access affects child stunting indirectly, mediated through its impacts on children’s dietary diversity. These mediating effects are also moderated by regional water availability. Water interventions in low-water regions should help reduce children’s risk of nutrition-related stunting in households with lowest water access.
Evaluation of Rocuronium Continuous Infusion in Critically Ill Patients During the COVID-19 Pandemic and Drug Shortages
Authors: Aldhaeefi Mohammed , Dube Kevin M. , Kovacevic Mary P. , Szumita Paul M. , Lupi Kenneth E. , DeGrado Jeremy R.
Published: July 2021

Background: Limited data exist to support the use of rocuronium continuous infusions in the intensive care unit (ICU). Objective: To evaluate the dosing and monitoring of adult patients who received rocuronium for hypoxemic respiratory failure during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This was a retrospective, single-center study from March 1, 2020 to May 31, 2020. We identified all adult patients admitted to any ICU who received rocuronium via continuous infusion. Patients were excluded if they received rocuronium for <6 hours. The main outcome of this study was to determine the median rocuronium maintenance continuous infusion rate in the ICU. Secondary outcomes of this study included the initial continuous infusion rate, duration of therapy, cumulative dose, frequency and median of rocuronium boluses, time to resolution of neuromuscular blockade, and the relationship between the hourly administration rates of rocuronium and train-of-four (TOF) assessments. Results: Seventy-one patients and 97 paralytic infusions were included. Fifty-nine patients (83%) were positive for SARS CoV-2. Of the 97 rocuronium infusions, the median dose at initiation was 3 (3–5) mcg/kg/min and duration of infusion was 45 (23.6–92.5) hours. The median continuous infusion maintenance rate was 4.3 (2.8–7.2) mcg/kg/min. There was a negligible correlation between the dose of rocuronium and the TOF results (r = .04). A total of 1775 TOFs were assessed, of which 46.2% were over-paralyzed, 35.7% well-paralyzed, and 18.1% under-paralyzed. Conclusions: The initial and maintenance infusion doses in our analysis were lower than what have been previously referenced.
A multi-mode electric vehicle range estimator based on driving pattern recognition
Authors: Mao Lang , Fotouhi Abbas , Shateri Neda , Ewin Nathan
Published: July 2021

Limited driving range and availability of charging infrastructures are still among the main barriers of adoption of electric vehicles (EVs) in the market. Combination of those limiting factors causes ‘range anxiety’ in EV users. While different EV battery technologies and charging infrastructures are under development, one short-term solution to reduce EV users’ range anxiety is to provide the EV user with an accurate range estimation. In this study, an EV range estimation technique is proposed that recognises the current driving pattern and then classifies it into one of the predefined clusters (driving modes). The future energy consumption per kilometre is then tuned according to the average energy consumption of each cluster. Having an updated energy consumption rate, the EV range is calculated based on the battery state-of-charge. Different features are considered for driving pattern clustering where ‘average speed’ and ‘average power’ were identified as the best choices for this application. The effectiveness of the proposed EV range estimator is validated using real driving data that gives an average error of 9% in EV energy consumption estimation ahead.
Compression properties and optimization design of SLM Ti6Al4V square pore tissue engineering scaffolds
Authors: Shi Xiaoquan , Sun Yazhou , Wang Pengju , Ma Ziyang , Liu Haitao , Ning Haohao
Published: July 2021

The tissue engineering technology provides a new way to solve bone defect. Porous scaffolds supply support and adhesion space for cells. Design of pore structure of scaffolds is one of the key points in tissue engineering scaffolds, because the structure affects the performance of scaffolds directly. In this paper, mechanical properties of square porous Ti6Al4V scaffolds are studied. By finite element simulation, it can be found that the support structure in vertical direction assumes main force, so the structure can be optimized through relative density mapping (RDM) method. The modified arch structures can improve bearing effect of structure with the same porosity. The designed structures are obtained by selective laser melting. Results of compressive strength indicate that the compressive strength decreases with the increase of porosity. When the porosity is between 40% and 60%, the error of compressive strength calculated by Gibson–Ashby model is below 8%. Moreover, the optimized structure clears a better bearing effect, and the bearing capacity can be increased by 20%–30% under the same porosity.
Compliance in Ambulatory Assessment Studies: Investigating Study and Sample Characteristics as Predictors
Authors: Ottenstein Charlotte , Werner Linda
Published: July 2021

Ambulatory assessment (AA) studies are becoming more and more popular. However, it can be challenging to motivate participants to comply with study protocols. The aim of the present study was to investigate possible predictors of compliance in AA studies with diverse samples and study designs. To do so, we extracted compliance information, study characteristics, and sample characteristics from 488 previously published studies. The average compliance across the studies was rather high. The total number of measurement occasions and the number of study days were negatively related to the compliance rate. Moreover, a higher percentage of healthy controls in clinical studies was associated with a higher compliance rate. By contrast, other study characteristics (e.g., the amount of financial compensation) and sample characteristics (clinical vs. healthy sample) were not related to compliance. The findings have implications for the design of future AA studies.
Evaluation of the AV7909 Anthrax Vaccine Toxicity in Sprague Dawley Rats Following Three Intramuscular Administrations
Authors: Rao Veena V. , Godin C. Steven , Lacy Michael J. , Inglefield Jon R. , Park Sukjoon , Blauth Bruna , Reece Joshua J. , Ionin Boris , Savransky Vladimir
Published: July 2021

AV7909 is a next-generation anthrax vaccine under development for post-exposure prophylaxis following suspected or confirmed Bacillus anthracis exposure, when administered in conjunction with the recommended antibacterial regimen. AV7909 consists of the FDA-approved BioThrax® vaccine (anthrax vaccine adsorbed) and an immunostimulatory Toll-like receptor 9 agonist oligodeoxynucleotide adjuvant, CPG 7909 . The purpose of this study was to evaluate the potential systemic and local toxicity of AV7909 when administered via repeat intramuscular injection to the right thigh muscle (biceps femoris) to male and female Sprague Dawley rats. The vaccine was administered on Days 1, 15, and 29 and the animals were assessed for treatment-related effects followed by a 2-week recovery period to evaluate the persistence or reversibility of any toxic effects. The AV7909 vaccine produced no apparent systemic toxicity based on evaluation of clinical observations, body weights, body temperature, clinical pathology, and anatomic pathology. Necrosis and inflammation were observed at the injection sites as well as in regional lymph nodes and adjacent tissues and were consistent with immune stimulation. Antibodies against B. anthracis protective antigen (PA) were detected in rats treated with the AV7909 vaccine, confirming relevance of this animal model for the assessment of systemic toxicity of AV7909. In contrast, sera of rats that received saline or soluble CPG 7909 alone were negative for anti-PA antibodies. Overall, 3 intramuscular immunizations of Sprague Dawley rats with AV7909 were well tolerated, did not induce mortality or any systemic adverse effects, and did not result in any delayed toxicity.
Household level heterogeneity in the income elasticities of demand for international leisure travel
Authors: Stråle Jonathan
Published: July 2021

This article deepens the understanding of household level heterogeneity of income elasticities of demand for international leisure travel. This is done through the use of Swedish household level expenditure data which together with censored quantile regression allows for estimation of income elasticities based on relative consumption levels. In addition, an analysis of how the distribution of income elasticities was affected by the 2008 financial crisis is made. Results show a great heterogeneity in the estimated income elasticities, with income elasticities being the largest for the households who consume relatively little of the good, and a small positive effect of the financial crisis on the estimated distribution of income elasticities. These results can be used by policy makers, as well as managers in the tourism industry, to predict and influence the demand of international tourism at a more detailed level. The results also go in line with theoretical predictions and give further insight in market penetration as well as an ongoing structural change in the demand for international tourism.
Sharing dark sides on game service platforms: Disruptive behaviors and toxicity in DOTA2 through a platform lens
Authors: Gandolfi Enrico , Ferdig Richard E
Published: July 2021

Toxicity continues to have a strong presence in online environments. This is particularly true for digital entertainment like online games. Toxicity is an important topic as it impacts game development, consumption, popularity, public perception, and player health and well-being. Most of the existing literature on toxicity in gaming is descriptive and exploratory; it often sets out to map milestones and inherent drivers of toxicity. In this article, an alternative perspective is advanced, drawing from a foundation in media and culture studies. Data (streaming online chat, user-generated content, and forum discussions) were collected daily for 4 weeks from Twitch.tv and Steam channels about the popular online game DOTA 2. Results were processed with a content analysis relying on the driving concepts of toxicity and social affordance. The case study and related platforms were selected for their relevance and pertinence with the theme addressed. Findings point to peculiar interactive patterns in framing, supporting, and overturning toxicity and resulting harassment in these extended settings. Implications are noteworthy for scholars and practitioners who intend to shed light on how diffused audiences negotiate toxicity in digital gaming and beyond.
Arab Israeli EFL teachers’ perceptions and practices vis-à-vis teaching higher-order thinking skills: A complicated relationship
Authors: Assaly Ibtihal , Jabarin Abdelnaser
Published: July 2021

Higher-order thinking skills (HOTS) have been an integral part of the English language curriculum in the Israeli school system since 2013, when questions that needed HOTS were added to the matriculation exams in all modules. Teachers subsequently have been responsible for integrating such questions into their teaching. The study aims to investigate the cognitive levels of questions posed by 13 Arab Israeli EFL teachers while teaching reading comprehension in heterogeneous tenth-grade classrooms. It also seeks to reveal the teachers’ perceptions with respect to teaching HOTS, and the challenges they face while doing so. Data were gathered by means of a classroom observation checklist and semi-structured interviews. The results show that the teachers tended to emphasize lower-order rather than higher-order questions. The findings of the thematic analysis of interviewees’ answers indicate that while the teachers have positive perceptions about teaching HOTS, they nevertheless face significant challenges. Factors hindering HOTS implementation include the teachers, the students, the system, and certain social norms. This implies the need for training courses to develop teachers’ knowledge about HOTS and to ensure successful implementation in the English language classroom.
Access to intervene. An ethnographic study of public health practices targeting health inequalities
Authors: Høybye Mette Terp , Holt Ditte Herring , Rod Morten Hulvej
Published: July 2021

Much public health research has devoted attention to the question of how interventions aimed at reducing health inequalities can access so-called “hard-to-reach” populations. This work has generally reflected an instrumentalist approach, which implies the preexistence of particular target groups characterized by specific public health problems. The key research interests are to find ways to effectively alleviate health inequalities and to identify the best ways to intervene to address disparate health problems among certain groups of people. Based on ethnographic research with public health officers in four Danish municipalities, this article turns the issue on its head by examining how public health officers gain access to intervene in practice and, as part of this process, define and delineate target groups and public health problems. Through detailed descriptions of two ethnographic cases, we develop the argument that public health interventions carry with them moral differentiations that may contradict the overall intention of reducing health inequalities. We adopt a theoretical perspective developed by Lakoff and Collier, suggesting that public health interventions can be understood as “regimes of living.” This leads us to the conclusion that the practices of gaining access result in the production of unforeseen target groups and new moral configurations where the value of health becomes linked to other types of value, most importantly economic value. For public health officers, the complicated issue of gaining access to intervene is not simply a matter of finding practical solutions; it also defines and delineates the scope of public health itself.
Perceived stress is related to lower blood pressure in a Swedish cohort
Authors: Miguet Maud , Olivo Gaia , Ciuculete Diana-Maria , Elmståhl Sölve , Lind Lars , Schiöth Helgi B.
Published: July 2021

Aims:

General psychosocial stress and job strain have been related to blood pressure (BP) with conflicting results. This study sought to explore the contribution of several lifestyle factors in the relation between general psychosocial stress, job strain and BP.

Methods:

This cross-sectional study investigated the association of general stress and job strain with systolic BP (SBP) and diastolic BP in a sample of 9441 employed individuals from the EpiHealth cohort. General stress was measured by the Perceived Stress Scale. Job strain was assessed with the Job Content Questionnaire, assessing two dimensions of job strain: psychological job demand and decision latitude. Linear regression and sensitivity analysis were performed.

Results:

At the uncorrected model, general stress, job demand and decision latitude were all inversely associated with SBP. After further adjustment for lifestyle and health parameters, only general stress was associated with SPB (β coefficient: −0.103; 95% confidence interval −0.182 to 0.023).

Conclusions:

General stress is associated with lower SBP independently of lifestyle in middle-aged adults. Our findings point towards a major contribution for job-unrelated stressors in determining SBP and support the pivotal role of lifestyle behaviours and health status in modulating the effect of stress on BP, calling for a careful selection of confounders.
Does sustainable consumption make consumers happy?
Authors: Ramos-Hidalgo Encarnación , Diaz-Carrion Rosalia , Rodríguez-Rad Carlos
Published: July 2021

The importance of ethical behavior in consumers has never been so evident, and in recent years, researchers have generated a great deal of knowledge about ethical consumption. The search for happiness in consumption has been a recurrent line of research by academics of the management and, mainly, the marketing fields. Our study analyses the relationship between ethical and sustainable behavior in consumption and the achievement of consumer happiness. Employing structural equations, the findings of the study suggest that there is a positive relationship between consumers’ predisposition toward sustainable behavior and happiness. In addition, the findings indicate that, when there are reasons to justify unethical behavior in consumption, the consumer also manages to be happier. Important implications for theory and practice are derived from the results. Emphasizing the benefits of sustainable consumption for enhancing happiness might instigate sustainable consumption, especially in the case of those consumers who do not have a positive attitude toward sustainable consumption.
Study Protocol of CBT-AP Trial: A Randomized Controlled Trial of Cognitive Behavioral Therapy Integrated with Activity Pacing for Fatigued Breast Cancer Patients Undergoing Chemotherapy
Authors: Getu Mikiyas Amare , Chen Changying , Wang Panpan , Yohannes Elleni , Seife Edom , Panpan Cui
Published: July 2021

Purpose:

This paper reports the methodology for undertaking a randomized controlled trial to assess the combined effect of cognitive behavioral therapy (CBT) and activity pacing on fatigue experienced by breast cancer patients undergoing chemotherapy.

Method:

Fifty-eight patients experiencing severe fatigue will be randomized to a CBT group or usual care group. The intervention will be given for 6 sessions by a trained oncology nurse. Primary and secondary outcome measures will be assessed at baseline, the sixth week of intervention and at the third month post intervention. The primary outcome measure is fatigue (Brief Fatigue Inventory) and secondary outcome measures include depression (Patient Health Questionnaire) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire). The protocol is designed using the SPIRIT guidelines which is one of the EQUATOR checklists.

Discussion:

This is the first RCT that will determine the efficacy of CBT by integrating with activity pacing to reduce fatigue among breast cancer patients receiving chemotherapy. The intervention design is novel in addressing multiple precipitating and perpetuating factors of fatigue and integrated with activity pacing in CBT.

Conclusion:

If the intervention is effective, this therapeutic approach can be incorporated into a routine health care for breast cancer patients receiving chemotherapy.

Trial registration:

The study have been registered in Pan-African Clinical Trial Registry (website) on August 24, 2020. The trial registration number is PACTR202008881026130.
A Self-Empowered Upper Limb Repetitive Engagement Program to Improve Upper Limb Recovery Early Post-Stroke: Phase II Pilot Randomized Controlled Trial
Authors: Chin Lay Fong , Hayward Kathryn S. , Chai Audrey Lik Ming , Brauer Sandra G.
Published: July 2021

Background. Time outside therapy provides an opportunity to increase upper limb (UL) use during post-stroke hospitalization. Objective. To determine if a self-directed UL program outside therapy (Self-Empowered UL Repetitive Engagement, SURE) was feasible and to explore the potential effect of the SURE program on UL use and recovery. Methods. Twenty-three patients from an inpatient rehabilitation center who were ≤21 days post-stroke and had a Fugl Meyer UL (FMUL) score ≤50 and a positive motor evoked potential (MEP+) response were randomized (stratified by impairment) to either experimental group (SURE: individualized, UL self-exercise and use outside therapy for 6 hours/week for 4 weeks) or control group (education booklet). Feasibility was evaluated by program adherence, dropout rate, adverse events, and satisfaction. Potential effect was measured by paretic UL use via accelerometry weekly during the intervention, FMUL and Action Research Arm Test (ARAT) at baseline (Week 0), post-intervention (Week 4), and follow-up (Week 8 and Week 16). Results. Adherence to SURE was high: 87% program completion (mean 313±75 repetitions/day). There were no dropouts, no adverse events related to SURE, and patient satisfaction averaged 7.8/10. Experimental participants achieved an additional hour of UL use daily (range: .3–1.2 hours/day) compared to control. Significant improvements in FMUL and ARAT were observed in both groups from Week 0 to Week 4 and to Week 8 ( P ≤ .002), which were maintained to Week 16. There were no differences between groups ( P ≥ .119). Conclusions. SURE was a feasible self-directed program that increased UL use in MEP+ individuals with moderate-severe impairment early post-stroke. Further studies with larger sample sizes and potentially higher dose are required to determine efficacy.
A new method on motion planning for mobile robots using jump point search and Bezier curves
Authors: Zhang Ben , Zhu Denglin
Published: July 2021

Innovative applications in rapidly evolving domains such as robotic navigation and autonomous (driverless) vehicles rely on motion planning systems that meet the shortest path and obstacle avoidance requirements. This article proposes a novel path planning algorithm based on jump point search and Bezier curves. The proposed algorithm consists of two main steps. In the front end, the improved heuristic function based on distance and direction is used to reduce the cost, and the redundant turning points are trimmed. In the back end, a novel trajectory generation method based on Bezier curves and a straight line is proposed. Our experimental results indicate that the proposed algorithm provides a complete motion planning solution from the front end to the back end, which can realize an optimal trajectory from the initial point to the target point used for robot navigation.
Prehemorrhage antiplatelet use in aneurysmal subarachnoid hemorrhage and impact on clinical outcome
Authors: Sebök Martina , Hostettler Isabel C , Keller Emanuela , Rautalin Ilari M , Coert Bert A , Vandertop William P , Post René , Sardeha Ali , Tjerkstra Maud A , Regli Luca , Verbaan Dagmar , Germans Menno R
Published: July 2021

Background

Literature is inconclusive regarding the association between antiplatelet agents use and outcome after aneurysmal subarachnoid hemorrhage.

Aims

To investigate the association between clinical outcome and prehemorrhage use in aneurysmal subarachnoid hemorrhage patients as well as the impact of thrombocyte transfusion on rebleed and clinical outcome.

Methods

Data were collected from prospective databases of two European tertiary reference centers for aneurysmal subarachnoid hemorrhage patients. Patients were divided into “antiplatelet-user” and “non-user” according to the use of acetylsalicylic acid prior to the hemorrhage. Primary outcome was poor clinical outcome at six months (Glasgow Outcome Scale score 1–3). Secondary outcomes were in-hospital mortality and impact of thrombocyte transfusion.

Results

Of the 1033 patients, 161 (15.6%) were antiplatelet users. The antiplatelet users were older with higher incidence of cardiovascular risk factors. Antiplatelet use was associated with poor outcome and in-hospital mortality. After correction for age, sex, World Federation of Neurosurgical Societies score, infarction and heart disorder, pre-hemorrhage acetylsalicylic acid use was only associated with poor clinical outcome at six months (adjusted OR 1.80, 95% CI 1.08–3.02). Thrombocyte transfusion was not associated with a reduction in rebleed or poor clinical outcome.

Conclusion

In this multicenter study, the prehemorrhage acetylsalicylic acid use in aneurysmal subarachnoid hemorrhage patients was independently associated with poor clinical outcome at six months. Thrombocyte transfusion was not associated with the rebleed rate or poor clinical outcome at six months.
Non-negative sparse Laplacian regularized latent multi-view subspace clustering
Authors: You Cong-Zhe , Shu Zhen-Qiu , Fan Hong-Hui
Published: July 2021

Recently, in the area of artificial intelligence and machine learning, subspace clustering of multi-view data is a research hotspot. The goal is to divide data samples from different sources into different groups. We proposed a new subspace clustering method for multi-view data which termed as Non-negative Sparse Laplacian regularized Latent Multi-view Subspace Clustering (NSL2MSC) in this paper. The method proposed in this paper learns the latent space representation of multi view data samples, and performs the data reconstruction on the latent space. The algorithm can cluster data in the latent representation space and use the relationship of different views. However, the traditional representation-based method does not consider the non-linear geometry inside the data, and may lose the local and similar information between the data in the learning process. By using the graph regularization method, we can not only capture the global low dimensional structural features of data, but also fully capture the nonlinear geometric structure information of data. The experimental results show that the proposed method is effective and its performance is better than most of the existing alternatives.
A propensity score-weighted comparison between adalimumab originator and its biosimilars, ABP501 and SB5, in inflammatory bowel disease: a multicenter Italian study
Authors: Barberio Brigida , Cingolani Linda , Canova Cristina , Barbieri Giulia , Sablich Renato , Urbano Maria Teresa , Bertani Lorenzo , Costa Francesco , Bodini Giorgia , Demarzo Maria Giulia , Ferronato Antonio , Buda Andrea , Melatti Piera , Massimi Davide , Savarino Edoardo Vincenzo , Zingone Fabiana
Published: July 2021

Background:

Adalimumab is an effective and safe biological drug for the treatment of inflammatory bowel disease (IBD). Nowadays, several biosimilar agents are available, but data regarding their efficacy and safety in patients with IBD are still lacking. We aimed to compare the effectiveness and tolerability between adalimumab originator, ABP501 and SB5 biosimilars in patients with IBD in the short term (after induction and after 6 months of treatment) through a propensity score-weighted multicenter cohort study.

Methods:

We included 156 patients with IBD, 69 patients with ulcerative colitis and 87 patients with Crohn’s disease (CD) receiving ABP501 or SB5 biosimilars from January 2019 to April 2020 for moderate-to-severe disease. For comparison, a group of age- and sex-matched patients treated with adalimumab originator was used. We collected clinical and biochemical data after induction and at 6 months of treatment. Endoscopic data were recorded only at baseline.

Results:

Overall, clinical benefit was achieved by 86.4% and 85.3% after induction and at 6 months, respectively, without a statistically significant difference between the three treatment groups ( p = 0.68 and p = 0.46). However, after induction, we found significant differences between the two types of the disease (ulcerative colitis or CD, p = 0.004), with a greater clinical benefit achieved by patients with CD. Also, the therapeutic optimization rate between the three drugs was not statistically significant different ( p = 0.30). All treatments showed a good safety profile, with only 10 patients who needed to stop therapy because of adverse events.

Conclusion:

Adalimumab biosimilars seem to be as effective and safe as the originator in patients with IBD. Surely, they represent a great opportunity to reduce the costs of biological therapies, however larger and longer real-life studies are necessary.
Quantitation of Synthetic Cannabinoid Receptor Agonists in Postmortem Blood Using a Single Point Calibration
Authors: Sharp Phoebe , Hudson Simon , Morley Stephen R.
Published: July 2021

Synthetic cannabinoid receptor agonists (SCRA) share minimal structural similarities to tetrahydrocannabinol or themselves. Due to their heterogeneous structures and the rapid appearance and disappearance of new SCRA on the drug scene, the quantitation of SCRA has not been attempted extensively. We present a wide series of SCRA concentrations based on a single-point calibration using peak height ratios for the extracted ion chromatogram of the protonated precursor ion against that of the internal standard. These concentrations are viewed as indicative only given the use of a single concentration “calibrator” based on the response of a deuterated analogue of a structurally related compound. What is of note, is that, despite the potential differences in potency the majority of SCRA seem to have relatively similar concentrations in postmortem cases.
Mixed Evidence for Interactive Effects of Outgroup Proportions and Intergroup Contact on Racial Bias in the United States
Authors: Rae James R. , Skinner-Dorkenoo Allison L. , Reiman Anna-Kaisa , Schmid Katharina , Hewstone Miles
Published: July 2021

Dominant majority-group members living in areas with larger proportions of outgroup members tend to express more ingroup bias. However, prior research has rarely considered this in tandem with the bias-reducing effects of intergroup contact or tested whether outgroup proportions have similar effects for oppressed minority-group members. In two preregistered studies, we tested whether contact moderates the association between outgroup proportions and ingroup bias among White and Black Americans (total N > 75,000). As hypothesized, more Black residents in an area predicted greater explicit (but not implicit) ingroup bias among White respondents who reported low (but not high) contact with Black people. By contrast, more White residents in an area predicted lower explicit (but not implicit) ingroup bias among Black respondents regardless of intergroup contact with White people. We qualify previous findings by demonstrating that the association between outgroup proportions and ingroup bias depends on one’s group membership and level of intergroup contact.
Harmonious Relations: Relational Interdependence Moderates Affective Reactivity to Interpersonal Stressors
Authors: Naqvi Jeanean B. , Helgeson Vicki S.
Published: July 2021

Negative social interactions have been linked to worse psychological health. However, individuals’ perceptions of negative interactions may depend on relational interdependent self-construal or how much they define the self in terms of their close relationships. The current analysis examined whether the effect of three different stressors on daily mood is moderated by having a relational self-construal. Participants ( N = 833) from a national, community-based study reported relational self-construal, the experience of three types of stressors, negative affect, and positive affect on 8 consecutive days. Compared to less relationally interdependent individuals, more relationally interdependent individuals experienced a greater increase in negative affect from the prior day when an interpersonal conflict occurred but a lesser increase in negative affect from the prior day when an interpersonal conflict was avoided. These results suggest that the type of interpersonal stressor determines whether self-construal is a risk factor or protective factor for psychological health.
Tweeting About Climate: Which Politicians Speak Up and What Do They Speak Up About?
Authors: Yu Chao , Margolin Drew B. , Fownes Jennifer R. , Eiseman Danielle L. , Chatrchyan Allison M. , Allred Shorna B.
Published: July 2021

This study examines tweets ( N = 1,103,119) sent by 638 US politicians regarding climate change ( N = 10,135). Using data reflecting the risks faced and opinions held by their constituents, the extent to which politicians lead—tweeting about climate change for those most at risk, called trusteeship—or follow—tweeting about climate change for those who are already concerned, called playing to the crowed—is examined. Results reveal that while Democrats generally tweet about climate change more often than Republicans, within each party, tweeting frequency is mostly explained by the level of concern in a politicians’ constituency. Objective risks faced by constituents play no role. Analysis of behavior across different office levels—federal, state, and local—also shows that while federal politicians are more partisan, state and local politicians play to the crowd to a greater degree. Analysis of the tweets shows the politicians’ unequal engagement leads to over-representations of some topics (e.g., “calls for action”) and under-representations of other topics (e.g., criticizing fossil fuels and deniers).