bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Acceptance of Advance Directives Between Millennials and Baby Boomer Generations: A Cross-Sectional Survey Study Among College Students and Their Relatives
Authors: Liang Yia-Wun , Lin Yu-Hsiu , Chen Su-Ting
Published: November 2021

Objectives: This study aims to explore the differentials of knowledge and attitude of advance directives (ADs) between millennials and baby boomer generations, and the effects of the intention to sign the advance directives. Methods: This is a cross-sectional study using a self-administered questionnaire to collect data from 325 students in a health-related college of a University of Science and Technology in Taiwan, and their parents, as total of 226, who are baby boomers. The statistical methods include descriptive statistics and inferential statistics. Results: Only 10 people from the 2 generations signed an AD. The multivariate logistic regression showed that baby boomer generation, AD knowledge, and AD attitude were significant positive associate of willingness to sign AD in the future. Conclusions: The government may enhance promotion of ADs among millennials and improve the connection between millennials’ knowledge of and attitude toward ADs, and their AD signing behavior.
A pioneering cruising enterprise: The North of Scotland, Orkney and Shetland Steam Navigation Company, 1886–1908
Authors: Williams David M.
Published: November 2021

Commercial cruising began around 1880. Underlying factors were the iron steamship that enabled scheduled sailings and larger, more comfortable vessels and growing incomes in industrialising countries that increased the potential market for tourism. Britain took the lead in cruising development. This article examines a pioneering enterprise, The North of Scotland, Orkney and Shetland Steamship Navigation Company – the name reflects its sphere of operation. In 1886, the company began providing cruise voyages out of Aberdeen and Leith. It offered a new product, cheap and short cruises to the Norwegian fjords. The success of the first season led to the ordering of a new vessel, the St Sunniva, specifically designed for cruising and arguably the first cruise ship. The Company operated cruises chiefly to the fjords, but also to the Baltic and the Mediterranean, completing a total of 224 cruises between 1886 and 1908. Such sustained participation was due to imaginative and efficient organisation. Press advertising, the employment of travel agents, block bookings and private charters were used to gain business. The Company's vessels employed local pilots and from early on carried ‘conductors’, who were forerunners of the ‘cruise director’. The Company's success and innovations encouraged other firms to enter the cruising market, notably large liner companies such as P&O, Union Castle and Royal Mail after 1900. These used much larger vessels with better, more luxurious facilities. The North of Scotland Company, with its smaller and older vessels, could not compete and it withdrew from cruising in 1908.
Reverse Bayesian Implications of p-Values Reported in Critical Care Randomized Trials
Authors: Nostedt Sarah , Joffe Ari R.
Published: November 2021

Background

Misinterpretations of the p-value in null-hypothesis statistical testing are common. We aimed to determine the implications of observed p-values in critical care randomized controlled trials (RCTs).

Methods

We included three cohorts of published RCTs: Adult-RCTs reporting a mortality outcome, Pediatric-RCTs reporting a mortality outcome, and recent Consecutive-RCTs reporting p-value ≤.10 in six higher-impact journals. We recorded descriptive information from RCTs. Reverse Bayesian implications of obtained p-values were calculated, reported as percentages with inter-quartile ranges.

Results

Obtained p-value was ≤.005 in 11/216 (5.1%) Adult-RCTs, 2/120 (1.7%) Pediatric-RCTs, and 37/90 (41.1%) Consecutive-RCTs. An obtained p-value .05–.0051 had high False Positive Rates; in Adult-RCTs, minimum (assuming prior probability of the alternative hypothesis was 50%) and realistic (assuming prior probability of the alternative hypothesis was 10%) False Positive Rates were 16.7% [11.2, 21.8] and 64.3% [53.2, 71.4]. An obtained p-value ≤.005 had lower False Positive Rates; in Adult-RCTs the realistic False Positive Rate was 7.7% [7.7, 16.0]. The realistic probability of the alternative hypothesis for obtained p-value .05–.0051 (ie, Positive Predictive Value) was 28.0% [24.1, 34.8], 30.6% [27.7, 48.5], 29.3% [24.3, 41.0], and 32.7% [24.1, 43.5] for Adult-RCTs, Pediatric-RCTs, Consecutive-RCTs primary and secondary outcome, respectively. The maximum Positive Predictive Value for p-value category .05–.0051 was median 77.8%, 79.8%, 78.8%, and 81.4% respectively. To have maximum or realistic Positive Predictive Value >90% or >80%, RCTs needed to have obtained p-value ≤.005. The credibility of p-value .05–.0051 findings were easy to challenge, and the credibility to rule-out an effect with p-value >.05 to .10 was low. The probability that a replication study would obtain p-value ≤.05 did not approach 90% unless the obtained p-value was ≤.005.

Conclusions

Unless the obtained p-value was ≤.005, the False Positive Rate was high, and the Positive Predictive Value and probability of replication of “statistically significant” findings were low.
The Relationship Between Urban Renewal and the Built Environment: A Systematic Review and Bibliometric Analysis
Authors: Wang Hao , Liu Na , Chen Junhua , Guo Shan
Published: November 2021

Urban renewal and the built environment have become two of the hottest topics in urban planning studies. Although existing literature has started to examine both of them from different perspectives, a comprehensive review with a bibliometric analysis is necessary to fully reveal the association between them. To overcome these gaps, this paper critically reviews the literature on urban renewal and the built environment and proposes a novel research framework to systematically understand the relationship between them. Based on 155 articles which were published between 2001 and 2020 collected from the Web of Science Core Collection Database, a bibliometric analysis offers the overall development and trajectory of the existing research, and a critical review fully analyzes the relationship between the two topics from three perspectives: main categories of urban renewal, multiple stakeholders, and economic, social and environmental development needs. To better clarify the interaction mechanism between urban renewal and the built environment and guide further research in this area, a future research agenda is also provided.
Neo-populist Fables: The Other World of A.V. Chayanov
Authors: Brass Tom
Published: November 2021

The political importance of Chayanov transcends his own time and space, influencing as it has done – and continues to do – both the debate about rural development in Third World countries and – more broadly – resurgent agrarian populist interpretations in academia and elsewhere. Less well known, but epistemologically as revealing of his politics, are his non-economic writings, particularly his contributions to the Gothic literary genre. Examined here, therefore, are three stories written pseudonymously by Chayanov, each of which is structured by the same discourse. All were composed over a short period just after the Bolsheviks took power in Russia, and reveal as a sub-text the political divergence and concomitant struggle between neo-populist and Bolshevik versions of societal development.
Surviving the Black Swan Event: How Much Reserves Should Nonprofit Organizations Hold?
Authors: Irvin Renée A. , Furneaux Craig W.
Published: November 2021

Organizational survival is a primary current focus, as the unforeseen economic effects of the pandemic ravage the civil sector. Over time, however, we turn to questions of resilience: How can organizations prepare for rare, but devastating, financial shocks? Three months of funds to cover operating expenses are often described as a suitable savings target. However, organizations differ greatly in their revenue volatility, which suggests that “3 months” may severely underestimate the reserves that certain organizations should hold. We measure revenue volatility and calculate reserve fund targets for 25 nonprofit subsectors, showing sharp differences in optimal savings levels ranging up to 1 year of total expenses. We also explore organizational characteristics associated with revenue volatility. We argue for a resilience strategy that goes beyond optimizing the contents of the revenue portfolio. Funders and nonprofit practitioners should consider the broader context of financial resilience that includes correctly sized reserves as a stabilizing force.
Examining Chinese Charitable Giving Under State Intervention: A Political Participation Perspective
Authors: Hu Ming , Kong Dejie
Published: November 2021

While it is prominent for governments across the globe to promote charitable giving, few governments directly intervene in charitable fundraising due to ethical and political risks. An exception is the Chinese government that has actively sought private donations. Using a national dataset of Chinese giving, this study explores from a general political participation perspective how individuals responded to different levels of state intervention in private charity. It finds that people made (a) voluntary donations (little state intervention) in relation to their social involvement and civic engagement, (b) suggested donations (e.g., the state called for donations) in relation to their civic participation and formal political participation, and (c) coerced donations (e.g., the state demanded donations) in relation to their personal bonds with the state. Thus, while appropriate state intervention seems productive, undue intervention may damage both charity and state legitimacy. Implications and suggestions for future research are included.
Tribological evaluation of piston ring/cylinder liner assembly in automotive engines using GNP as a lubricant additive
Authors: Singh Gurtej , Farooq Wani Mohammad , Wani Mohammad Marouf
Published: November 2021

Friction and wear are the main causes of energy dissipation in automotive engines. To minimize the frictional power losses, it is extremely important to improve the tribological characteristics of ring/liner assembly which accounts for almost 40–50% frictional power losses. The present study attempts to mitigate friction and wear of the ring/liner tribo-pair using GNP/SAE 15W40 nano-lubricant. To simulate the ring/liner interface, the tribological performance of nano-lubricants was assessed using a tribometer based on ASTMG181 standard under various operating conditions. The coefficient of friction (COF) and wear rate lowered using graphene nano-lubricants (GNL). The tribological results showed that friction coefficient, wear rate, and surface roughness of piston ring improved in the range 17.71%–42.33%, 25%–40.62%, and 61%, respectively, under GNL lubricating conditions during the boundary lubrication. Further, the characterization of wear tracks of piston ring and cylinder liner confirmed tribo-film formation on worn surfaces resulting in decreased COF and wear rate.
Effect of vanadium and rare earth (RE) oxide hardfacing on mechanical and sliding wear behavior of Fe based alloy
Authors: Vidyarthy Ravi S , Thapliyal Shivaraman , Dwivedi Dheerendra Kumar
Published: November 2021

Hardfacing is one of the preferred ways to prolong the life of machine components. In the current paper, efforts have been made to evaluate the flux composition on the hardness and wear behavior of a hard-faced surface. The shielded metal arc welding process was used to deposit the hardfacing layer over low carbon steel. Six different types of iron-based multicomponent flux compositions were developed using FeCr (25–30%), FeV (5%), FeMo (3–4 %), FeTi (2–3 %), Nb (3–4 %), and CeO2 (1–5 %) for hardfacing. The properties of the overlayer were examined using the microstructure study, hardness study, and abrasive wear test. Microstructural characterization was done using an optical microscope and field emission scanning electron microscope. X-ray diffraction was performed to examine the nature of precipitate formation. The worn-out surface and the debris were further examined, employing scanning electron microscopy to study the wear mechanism. The hard-faced surfaces revealed the presence of columnar and dendritic grains. Equiaxed grains were also observed in the sample, which was hard-faced with FeV. The hardness of the hard-faced surfaces was determined using the Vicker’s macro-hardness tester. A maximum hardness of 846.5 ± 2.5 HV was observed for weld overlay. The sliding wear behavior of the surface was investigated using an abrasive wear test performed on the pin-on-disk apparatus. The addition of vanadium to Fe-Cr-C hardfacing flux increased hardness and wear resistance between 3.5 and 6 times, respectively.
MHD radiative flow of Williamson nanofluid along stretching sheet in a porous medium with convective boundary conditions
Authors: Ullah Imran
Published: November 2021

Fluid heating and cooling is significant in a variety of industries, including power generation and transportation. Improvements in the thermal conductivity of the base fluid can also help in heat transmission. For this purpose, the effects of magneto hydrodynamics (MHD) and thermal radiation on mixed convection flow of Williamson nanofluid across a stretched sheet embedded in a porous medium in the presence of slip and convective boundary conditions is investigated. The Boungiorno model is adopted to analyze the impact of various dimensionless parameters on velocity, temperature, and nanoparticle concentration in the presence of slip and convective boundary conditions. The nonlinear governing equations are non-dimensionalized using similarity transformations, and the Keller box technique is utilized to solve them numerically. The current code is validated by generating numerical results for wall shear stress and compared them to previously published results. The comparison demonstrates that the outcomes are extremely similar. The results reveal that in the presence of a porous media, raising the magnetic and slip parameters reduced the nanofluid's velocity. It is also noticed that by increasing the radiation parameter, the heat and mass transfer rates on the surface of the stretching sheet are improved. In the presence of convective boundary conditions, the effect of Brownian motion and thermophoresis parameters on nanoparticle concentration was observed to be more profound.
Researchable Issues in Neonatal Jaundice
Authors: Guruprasad G. , Chawla Deepak , Agarwal Sunil
Published: November 2021

The incidence and severity of neonatal hyperbilirubinemia is much higher in India for various medical and system based reasons. In our country, the magnitude of bilirubin brain damage remains unquantified. This article highlights the gaps in knowledge and various research issues which need to be taken up to tackle this preventable cause of brain damage and hearing loss.
Research issues in surfactant replacement therapy
Authors: Nangia Sushma , Upadhyay Amit , Lal Prushotam
Published: November 2021

Respiratory distress syndrome (RDS) is most important cause of morbidity and mortality in preterm infants. Treatment modalities for RDS are surfactant replacement therapy (SRT), supplemental oxygen, nasopharyngeal continuous positive airway pressure (NP-CPAP) and mechanical ventilation. Surfactant is a life saving drug for infants with RDS but the cost of this therapy is still relatively high. Although surfactant has now became a standard of care in the management of RDS, still there are various critical issues which are to be settled regarding its mode or timing of administration, dose and type of surfactant to be used, use in conditions other than RDS and cost effectiveness. In scenario of countries like ours where the bruden of prematurity is increasing with improvements in high risk obstetrics case management. In the face of limited resources these issues of surfactant replacement therapy become more challenging. There is paucity of published literature from our country. These issues need to be undertaken for research in the country so than it can be tailored in best and most efficient way.
Surveillance for Healthcare associated Infections in Indian NICUs: Researchable Issues
Authors: Kumar Ashwani , Kumar Praveen
Published: November 2021

Systematic surveillance is the first and integral step of all infection control measures, especially in intensive care settings. Surveillance systems started evolving in developed countries nearly 40 years ago. With experience and wisdom gained, the surveillance methods have improved and become more standardized. It is now clearly recognized that all patients are not at equal risk. For fair comparisons over time within an unit and in between units, the denominator must take the underlying risk into account. Infection surveillance in the NICU presents a number of unique challenges regarding definitions and differing symptoms and signs in the neonate. Although the importance of surveillance is being increasingly recognized in our country and the methods of developed countries are being adopted, there are numerous issues which need local research. This is in view of the limited manpower and financial resources and different profile of organisms and their epidemiology.
Research issues in assessment and management of pain in newborns
Authors: Vani Shashi , Thakre Rhishikesh , Nimbalkar Somasekhar
Published: November 2021

Pain assessment and management is a neglected area in Indian NICUs. Only recently, the neonatologists and nurses have started paying attention to this aspect. This is also reflected in the miniscule quantity of research published on this topic from our country. This article raises several research issues in relation to pain in the newborn, specifically in Indian context.
Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
Authors: Palareti Gualtiero , Bignamini Angelo A. , Cini Michela , Li Young-Jun , Urbanek Tomasz , Madaric Juraj , Bouslama Kamel , Sokurenko German Y. , Andreozzi Giuseppe M. , Matuška Jiří , Mansilha Armando , Barinov Victor
Published: November 2021

Background

International guidelines recommend at least three months anticoagulation in all patients after acute venous thromboembolism (VTE) and suggest those with unprovoked events be considered for indefinite anticoagulation if the risk of recurrence is high and the risk of bleeding during treatment non-high. Other authors have recently argued against using a dichotomy unprovoked/provoked events to decide on anticoagulation duration and suggest instead using overall risk factors present in each patient as the basis for deciding.

Aim

This sub-analysis of the WHITE study aimed at assessing the reasons for the treatment decisions taken by doctors in different countries.

Results

1240 patients were recruited in 7 countries (China, Czechia, Poland, Portugal, Russia, Slovakia, and Tunisia). Anticoagulation was extended in 51.7% and 49.3% of patients with unprovoked or provoked events (n.s.); stopped in 15.4% versus 28.9% ( P < .0001), and changed to antithrombotic drugs (sulodexide or aspirin) in 32.9% versus 21.8% ( P < .0001). In the 430 subjects with isolated distal deep vein thrombosis (IDDVT) anticoagulation was stopped in 34.4%, continued in 37.0% (mainly those with post-thrombotic syndrome [PTS]) and switched to antithrombotics in the balance. High risk of recurrence was the most prevalent reason (>83% of cases) given to continue anticoagulation, regardless of nature and site of the index events, followed by risk of bleeding and presence of PTS signs.

Conclusion

On average, attending physicians estimated the risk of recurrence in real life conditions, and the consequent therapeutic decision, using all the information available, not limiting to the location or nature of the index event.
Diagnostic and Prognostic Significance of serum miR-18a-5p in Patients with Atherosclerosis
Authors: Teng PingPing , Liu Yonglei , Zhang Meng , Ji Wanli
Published: November 2021

Atherosclerosis (AS) is a common vascular disease with great harm. The current study examined the expression pattern of miR-18a-5p in AS patients, and explored its clinical values. 110 AS patients and 68 healthy controls were collected clinically, and the expression pattern of miR-18a-5p in the serum of AS patients was detected using qRT-PCR. All AS patients were followed up for five years to record the adverse cardiovascular events. ROC and Kaplan-Meier (K-M) curve were plotted to assess the diagnostic ability. The multiple Cox regression analysis was performed for independent influencing factors analysis. MiR-18a-5p was at high expression in AS patients, and showed positive correlation with the CIMT value ( r = 0.789, P < .001). ROC curve suggested the high diagnostic value of serum miR-18a-5p for AS, with the AUC of 0.894. The diagnostic specificity and sensitivity were 86.8% and 79.1%, respectively. K-M plot demonstrated that cases with high miR-18a-5p levels were more likely to suffer from cardiovascular events, and it is an independent influence factor for the poor clinical outcome. Serum miR-18a-5p serves as a promising biomarker for AS diagnosis, and is related to the occurrence of adverse cardiovascular events.
Exploring the possibilities of some selected flour blends for the development of bakery products: Comparison with some physicochemical and functional properties of wheat flour
Authors: Ugwuona Fabian , Ukom Anthony , Ejinkeonye Bridget , Obeta Nwamaka , Ojinnaka Maureen
Published: November 2021

This study explored the possibilities of some selected flour blends vis-a-vis the physicochemical and functional properties of wheat flour. Ten flour blends from potato starch, cassava, maize and soybean flours and wheat flour were made and evaluated for physicochemical, functional and anti-nutritional properties. The range of proximate values were for moisture (3.76%–6.67%), protein (4.33–8.96%), ash (1.35–1.96%), fat (3.37–4.88%), fibre (1.22–1.89%) and carbohydrate (78.35–84.94%), whereas wheat flour had moisture (9.45%), protein (11.31%), ash (2.54%), fat (3.78%), fibre (1.31%) and carbohydrate (73.90%). Cyanogenic glucoside, saponion and tannin contents increased with increase substitution of cassava and soybean flours. Pasting temperatures of flour blends ranged from 69.03 °C to 78.83 °C, while wheat flour had 78.05 °C. Peak, hot paste, breakdown, setback and cold paste viscosities were 1514–2822, 1036–1597, 487–1225, 580–884 and 1616–2461 cp in flour blends compared to 2361, 1360, 1001, 1079 and 2439 cp of wheat flour. Substitutions with soy flour decreased the peak, hot paste, breakdown and cold paste viscosities but increased the pasting temperatures. L*, a* and b* values ranged from 78.56 to 87.65, −0.34 to 0.71 and 10. 95 to 13.50 in flour blends while the wheat flour varied significantly at 2361.00, 1360.00 and 1001.00. The nutritional and pasting properties of some of flour blends were closely related to wheat flour and may be used for bakery requirements.
Accuracy of the indices of MS-39 anterior segment optical coherence tomography in the diagnosis of keratoconic corneas
Authors: Elkitkat Rania S , Rifay Yasser , Gharieb Hesham M , Ziada Hossam Eldin A
Published: November 2021

Purpose

To determine the normative and the cut-off values of various indices available in the MS 39 Anterior Segment Optical Coherence Tomography (MS-39 AS-OCT) for keratoconus (KC) diagnosis, and to detect the accuracy of the variable available parameters.

Methods

This cross sectional observational study was conducted at Dr Rifay Ophthalmology Center, Rabat, Morocco, on 172 eyes with KC (group 1) and 248 eyes of healthy controls (group 2). Participants were screened using MS-39 AS-OCT (CSO, Firenze, Italy). The investigated indices included: keratometric indices, pachymetric indices, elevation indices, Keratoconus Summary Indices (KSI), aberration indices, and epithelial mapping evaluation.

Results

Most of the studied indices were significantly different between both groups (P value <0.001). Twenty two indices had Area Under the Receiver Operating Curve (AUROC) values >0.950, eight of which were from the KSI. The indices with the highest AUROC values were: Root Mean Square (RMS) for the front corneal surface at 6 mm circle (AUROC = 0.996, and best cut-off >1.69 with sensitivity of 97.67% and specificity of 97.98%) and RMS per unit of area for the front surface at 6 mm circle (AUROC = 0.996, and best cut-off >0.06 with sensitivity of 97.67% and specificity of 97.98%). Epithelial thickness-derived metrics were not among the parameters with the highest accuracy.

Conclusions

This study presented the mean and the cut-off values for a plethora of parameters available in the MS-39 AS-OCT. The results of this study show that MS-39 AS-OCT is a valuable equipment for diagnosing keratoconic corneas, with a high accuracy detected for many parameters.
Assessment of the Toronto Psoriatic Arthritis Screen 2 as a Screening Tool for Psoriasis
Authors: Taylor Jennifer H. , Deo Maneka , Sutton Mitchell , Chandran Vinod , Shanmugarajah Sutha , Pereira Daniel , Gladman Dafna D. , Rosen Cheryl F.
Published: November 2021

Background

Psoriasis is a chronic inflammatory disease affecting multiple organ systems and resulting in reduced quality of life for many patients. A screening tool would be useful, particularly in underserviced or research settings with limited access to dermatologists. The Toronto Psoriatic Arthritis Screen, version 2 (ToPAS 2) is a validated screening tool for psoriatic arthritis containing questions specific for psoriasis.

Objectives

To evaluate the performance of skin-specific questions from ToPAS 2 for the diagnosis of psoriasis.

Methods

Participants aged >18 were recruited from Dermatology and Family Medicine clinics and completed the ToPAS 2 questionnaire prior to being examined by a dermatologist for psoriasis. Two scoring indexes were derived from the ToPAS 2 skin-related questions using backward selection regression models. Statistical analysis was performed using receiver operating characteristic (ROC) curves to measure their performances.

Results

Two hundred and fifty eight participants were recruited. 32 (12%) were diagnosed with psoriasis by dermatologist assessment. Index 1 includes all 5 skin-related questions from ToPAS 2, while Index 2 includes three of the five questions. Both indexes demonstrate high specificity (82% to 92%), sensitivity (69% to 84%), and excellent negative predictive value (NPV) (>95%) for a diagnosis of psoriasis. The overall discriminatory power of these models is 0.823 (Index 1) and 0.875 (Index 2).

Conclusions

Skin-related questions from ToPAS 2 have discriminatory value in detecting psoriasis, specifically questions relating to a family history, a prior physician diagnosis of psoriasis or a rash consistent with images of plaque psoriasis. This study is a valuable step in developing a screening tool for psoriasis.
Reduced expression of mitochondrial fumarate hydratase in progressive multiple sclerosis contributes to impaired in vitro mesenchymal stromal cell-mediated neuroprotection
Authors: Sarkar Pamela , Redondo Juliana , Hares Kelly , Bailey Steven , Georgievskaya Anastasia , Heesom Kate , Kemp Kevin C , Scolding Neil J , Rice Claire M
Published: November 2021

Background:

Cell-based therapies for multiple sclerosis (MS), including those employing autologous bone marrow-derived mesenchymal stromal cells (MSC) are being examined in clinical trials. However, recent studies have identified abnormalities in the MS bone marrow microenvironment.

Objective:

We aimed to compare the secretome of MSC isolated from control subjects (C-MSC) and people with MS (MS-MSC) and explore the functional relevance of findings.

Methods:

We employed high throughput proteomic analysis, enzyme-linked immunosorbent assays and immunoblotting, as well as in vitro assays of enzyme activity and neuroprotection.

Results:

We demonstrated that, in progressive MS, the MSC secretome has lower levels of mitochondrial fumarate hydratase (mFH). Exogenous mFH restores the in vitro neuroprotective potential of MS-MSC. Furthermore, MS-MSC expresses reduced levels of fumarate hydratase (FH) with downstream reduction in expression of master regulators of oxidative stress.

Conclusions:

Our findings are further evidence of dysregulation of the bone marrow microenvironment in progressive MS with respect to anti-oxidative capacity and immunoregulatory potential. Given the clinical utility of the fumaric acid ester dimethyl fumarate in relapsing–remitting MS, our findings have potential implication for understanding MS pathophysiology and personalised therapeutic intervention.
The ethical and medico-legal challenges of telemedicine in the coronavirus disease 2019 era: A comparison between Egypt and India
Authors: Ghitani Sara A , Ghanem Maha A , Alhoshy Hanaa S , Singh Jaskran , Awasthi Supriya , Kaur Ekampreet
Published: November 2021

Background

In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues.

Method

A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months (July and August 2020). A four-point Likert scale was used to collect data about background knowledge, training in telemedicine and ethical and medico-legal issues in telemedicine practice.

Results

The questionnaire was completed by 175 Egyptian and 51 Indian physicians from different specialties. A significantly higher percentage of Indian physicians practiced telemedicine than Egyptian physicians during the coronavirus disease 2019 era. Although most physicians had no specific training or licensing to practice telemedicine, most of them practiced telemedicine through their social media accounts. Ethical violations involving waiving patient consent were detected. Significant ethical violations to doctors, for example, blackmail, defamation, hate speech, accusations in a court and violations of privacy, were observed. Indian physicians (39.2%) and Egyptian physicians (24%) thought the penalties should be lower in telemedicine than in traditional practice. Finally, most participants would like to continue using telemedicine after the coronavirus disease 2019 era but with improvements.

Conclusions

Coronavirus disease 2019 changed the acceptance of telemedicine by physicians. Many ethical and legal issues need to be addressed and clarified using formal training before implementation and standardization of telemedicine services.
Privacy-preserving inpainting for outsourced image
Authors: Cao Fang , Sun Jiayi , Luo Xiangyang , Qin Chuan , Chang Ching-Chun
Published: November 2021

In this article, a framework of privacy-preserving inpainting for outsourced image and an encrypted-image inpainting scheme are proposed. Different with conventional image inpainting in plaintext domain, there are two entities, that is, content owner and image restorer, in our framework. Content owner first encrypts his or her damaged image for privacy protection and outsources the encrypted, damaged image to image restorer, who may be a cloud server with powerful computation capability. Image restorer performs inpainting in encrypted domain and sends the inpainted and encrypted image back to content owner or authorized receiver, who can acquire final inpainted result in plaintext domain through decryption. In our encrypted-image inpainting scheme, with the assist of Johnson–Lindenstrauss transform that can preserve Euclidean distance between two vectors before and after encryption, the best-matching block with the smallest distance to current block can be found and utilized for patch filling in Paillier-encrypted image. To eliminate mosaic effect after decryption, weighted mean filtering in encrypted domain is conducted with Paillier homomorphic properties. Experimental results show that our privacy-preserving inpainting framework can be effectively applied in secure cloud computing, and the proposed encrypted-image inpainting scheme achieves comparable visual quality of inpainted results with some typical inpainting schemes in plaintext domain.
Comparative analysis of cotton covered elastomeric hybrid yarns and denim fabric properties
Authors: Babaarslan Osman , Shahid Md Abul , Doğan Fatma B
Published: November 2021

In recent decades, consumer expectations and behavior have altered, focusing on more comfortable, well-fitting clothes. Wearing a slim-fitting garment helps to move more freely. Different elastomeric polymers are being introduced as a core constituent of the yarn to make denim fabric more comfortable during movement. The use of elastic material ensures that the material is stretchable and recoverable. The performance of several elastomeric hybrid yarns has been investigated in the first section of this study. Here, polyethylene terephthalate/polytrimethylene terephthalate (PET/PTT (T400®)), polytrimethylene terephthalate (PTT (Solotex®)), polybutylene terephthalate (PBT), and Lycra® (elastane) were used as the core component of the core and dual core-spun yarns. After that, 3/1 Z twill denim fabrics were made with these as weft yarns, and the fabric’s performance was assessed. It is found that dual core-spun yarns were shown to have lower strength than core-spun yarns, while it had a higher elongation value. PTT/PBT dual core-spun yarn had less unevenness and hairiness than yarn made solely of elastane. PBT in the core of the weft yarns provided strong strength, dimensional change, and stiffness qualities in the fabric. In contrast, elastane in the core of the weft yarns provided good elastic performance. Yarn and fabric performance for the hybrid yarns were statistically significant at a significance level of 0.05.
The scheme of delegation as a sensemaking framework in multi-academy trusts in England: Useful tool or constraint?
Authors: Baxter Jacqueline , Jewitt Katharine
Published: November 2021

Changes to the structure of English education because of decentralisation policy, particularly since 2010, have resulted in the creation of large groupings of schools – multi-academy trusts, organisations with multi-level governance structures, set out in schemes of delegation. Although the government has demanded absolute clarity on the role and remit of each part of the structure and the relationship and reporting between them, recent research suggests that there is little clarity or consistency in the role and function of board structures, with members often confused about their roles. This study draws on data from a funded project to examine: What level of consistency there is in multi-academy trust schemes of delegation, and what evidence is there that schemes of delegation align with sensemaking models of board members? The article concludes with a discussion on what the findings imply for use of schemes of delegation as useful tools for board member sensemaking in multi-academy trusts; revealing that although they can be useful tools for sensemaking, their usage varies a great deal between boards and board members.
Leading educational reconstruction in post-conflict Cambodia: Perspectives of primary school leaders
Authors: Kheang Thida
Published: November 2021

Despite the growing academic interests in educational leadership recently, hardly any of it has focused on post-conflict situations. This paper seeks to generate an understanding of the perspectives of primary school leaders in post-conflict Cambodia on the issues they face in the process of educational reconstruction and development and the strategies they adopt to deal with those issues. A qualitative research approach within the interpretivist paradigm was adopted to guide the study. Semi-structured interviews were used to collect data with 20 primary school leaders. Data were analysed using grounded theory data analysis methods, namely, open coding and analytic induction. The study argues that while there has been substantial progress in educational reconstruction generally in post-conflict Cambodia, primary school leaders face multiple issues in their day-to-day work. Some of the issues may be specifically attributed to the legacies of armed conflict and genocide while others may refer to the broader context of the developing world. The findings have implications for policy and practice in educational leadership and further research in the post-conflict and developing-country contexts.
Clinical presentation and maternal-fetal outcomes of Mirror Syndrome: A case series of 10 affected pregnancies
Authors: Mogharbel Hussain , Hunt Jennifer , D’Souza Rohan , Hobson Sebastian R
Published: November 2021

Background

Mirror Syndrome, also known as Ballantyne syndrome, is a rare condition with fewer than 120 cases described in the literature. A simultaneous edematous state of the mother, fetus and placenta is pathognomonic, with the maternal condition frequently presenting with signs and symptoms similar to that of preeclampsia.

Objective

Our aim was to add to the international body of literature through identification of all cases of Mirror Syndrome at two Canadian tertiary obstetric centres and characterize the maternal presentation, laboratory findings, and perinatal outcomes.

Methodology

We performed a retrospective chart review of all cases of fetal hydrops from two tertiary centres in Winnipeg (Manitoba, Canada) between 2000 and 2019. There were 276 cases of fetal hydrops during this period, of which 10 cases satisfied the diagnostic criteria for Mirror Syndrome where maternal and perinatal outcomes were analysed.

Results

The median gestational age at diagnosis with Mirror Syndrome was 23 weeks and 3 days of gestation and at birth was 25 weeks and 0 days of gestation. The majority of women were multiparous (80%) and had elevated maternal body mass index (median 33 kg/m2). The most common maternal clinical findings included weight gain (100%) and hypertension (90%). The most common laboratory findings included low hematocrit (100%), hypoalbuminemia (80%), anemia (70%) and hyperuricemia (70%). Structural anomalies were observed in 50% of cases, over half of the fetuses were stillborn (66.7%) and one quarter of pregnancies resulted in neonatal deaths (25%). The median time until maternal improvement of Mirror Syndrome was 2 days postpartum.

Conclusion

Mirror Syndrome affected 3.6% of all cases of fetal hydrops in our cohort, and showed associations with multiparity, elevated BMI, hemodilution, hypoalbuminemia, anemia and hyperuricemia. Delivery is frequently required for fetal and/or maternal indications and symptoms usually improved rapidly after delivery.
Collision mechanism of unmanned aerial vehicles onto glass panels
Authors: Choi Youngjun , Eon Lee Sang , Jung Jae-Wook , Hong Jung-Wuk
Published: November 2021

The international standards for safety glass design have been limited to the use of a soft body impactor representing a human body to estimate the accidental collision resistance. However, UAVs have recently emerged as a new collision source due to their increasingly widespread use. An evaluation protocol for UAV collision is required to secure the safety of the glass used for structural cladding. In this paper, the collision mechanism of unmanned aerial vehicles (UAVs) onto glass panels is investigated by conducting experiments. We evaluate the impact forces of UAV collision on the glass panels and verify the numerical simulations by comparing the resultant forces from the experiments. Using the verified numerical simulation, 72 different collision conditions (changing the impact angles and velocities, respectively) are modeled, including extreme collision conditions that could be infeasible in the real experiments under manual control. Through this study, complicated collision mechanisms are clarified and elucidated. Additionally, specific collision conditions that induce maximum and minimum threats are identified, which should assist the design of future structural cladding glass systems and the UAV operation discipline in urban areas.
Treatment patterns, testing practices, and outcomes in the pre-FLAURA era for patients with EGFR mutation-positive advanced NSCLC: a retrospective chart review (REFLECT)
Authors: Addeo Alfredo , Hochmair Maximilian , Janzic Urska , Dudnik Elizabeth , Charpidou Andriani , Płużański Adam , Ciuleanu Tudor , Donev Ivan Shterev , Elbaz Judith , Aarøe Jørgen , Ott René , Peled Nir
Published: November 2021

Introduction:

For epidermal growth factor receptor mutation-positive (EGFRm) non-small-cell lung cancer (NSCLC), EGFR-tyrosine kinase inhibitors (EGFR-TKIs) are the preferred first-line (1 L) treatment in the advanced setting. Osimertinib, a third-generation EGFR-TKI, received full approval in 2017 for second-line (2 L) treatment of EGFR T790M-positive NSCLC. The REFLECT study characterizes real-world treatment/testing patterns, attrition rates, and outcomes in patients with EGFRm advanced NSCLC treated with 1 L first-/second-generation (1G/2G) EGFR-TKIs before 1 L osimertinib approval.

Methods:

Retrospective chart review (NCT04031898) of European/Israeli adults with EGFRm unresectable locally advanced/metastatic NSCLC, initiating 1 L 1G/2G EGFR-TKIs 01/01/15–30/06/18 (index date).

Results:

In 896 patients (median follow-up of 21.5 months), the most frequently initiated 1 L EGFR-TKI was afatinib (45%). Disease progression was reported in 81%, including 10% (86/896) who died at 1 L. By the end of study, most patients discontinued 1 L (85%), of whom 33% did not receive 2 L therapy. From index, median 1 L real-world progression-free survival was 13.0 (95% confidence interval (CI): 12.3–14.1) months; median overall survival (OS) was 26.2 (95% CI: 23.6–28.4) months. 71% of patients with 1 L progression were tested for T790M; 58% were positive. Of those with T790M, 95% received osimertinib in 2 L or later. Central nervous system (CNS) metastases were recorded in 22% at index, and 15% developed CNS metastases during treatment (median time from index 13.5 months). Median OS was 19.4 months (95% CI: 17.1–22.1) in patients with CNS metastases at index, 24.8 months (95% CIs not available) with CNS metastases diagnosed during treatment, and 30.3 months (95% CI: 27.1, 33.8) with no CNS metastases recorded.

Conclusion:

REFLECT is a large real-world study describing treatment patterns prior to 1 L osimertinib availability for EGFRm advanced NSCLC. Given the attrition rates highlighted in the study and the impact of CNS progression on outcomes, offering a 1 L EGFR-TKI with CNS penetration may improve patient outcomes in this treatment setting.
No Strong Evidence of Stereotype Threat in Females: A Reassessment of the Meta-Analysis
Authors: Warne Russell T.
Published: November 2021

Recently, Picho-Kiroga (2021) published a meta-analysis on the effect of stereotype threat on females. Their conclusion was that the average effect size for stereotype threat studies was d = .28, but that effects are overstated because the majority of studies on stereotype threat in females include methodological characteristics that inflate the apparent effect size. In this response, I show that Picho-Kiroga et al. (2021) committed fundamental errors in their meta-analysis that undermine confidence in the article and warrant major corrections. But even if the data were not flawed, the conclusion that Picho-Kiroga et al. (2021) should have reached is that their results are most consistent with a population effect size of zero. There is no compelling evidence that stereotype threat is a real phenomenon in females.
A Real-World Analysis of High-Frequency 10 kHz Spinal Cord Stimulation for the Treatment of Painful Diabetic Peripheral Neuropathy
Authors: Chen Jeffrey L. , Hesseltine Andrew W. , Nashi Sara E. , Sills Shawn M. , McJunkin Tory L. , Patil Sandeep , Bharara Manish , Caraway David L. , Brooks Elizabeth S.
Published: November 2021

Background:

Diabetes is one of the most prevalent chronic health conditions and diabetic neuropathy one of its most prevalent and debilitating complications. While there are treatments available for painful diabetic peripheral neuropathy (pDPN), their effectiveness is limited.

Method:

This retrospective, multi-center, real-world review assessed pain relief and functional improvements for consecutive patients with diabetic neuropathy aged ≥18 years of age who were permanently implanted with a high-frequency (10 kHz) spinal cord stimulation (SCS) device. Available data were extracted from a commercial database.

Results:

In total 89 patients consented to being included in the analysis. Sixty-one percent (54/89) of participants were male and the average age was 64.4 years (SD = 9.1). Most patients (78.7%, 70/89) identified pain primarily in their feet or legs bilaterally. At the last assessment, 79.5% (58/73) of patients were treatment responders, defined as having at least 50% patient-reported pain relief from baseline. The average time of follow-up was 21.8 months (range: 4.3 to 46.3 months). A majority of patients reported improvements in sleep and overall function relative to their baseline.

Conclusions:

This real-world study in typical clinical practices found 10 kHz SCS provided meaningful pain relief for a substantial proportion of patients refractory to current pDPN management, similar to published literature. This patient population has tremendous unmet needs and this study helps demonstrate the potential for 10 kHz SCS to provide an alternative pain management approach.
Effects of Acute Alcohol Intake on Nasal Patency
Authors: Deng Yuzhoujia , Wang Chengshuo , Shen Shen , Yang Xiaozhe , Lou Hongfei , Zhang Luo
Published: November 2021

Background

Acute alcohol intake may influence nasal patency; however, there is lack of objective evidence.

Objective

The aim of this study was to evaluate the effects of acute alcohol intake on nasal patency employing both subjective and objective measures.

Methods

A total of 31 participants were classified into 2 groups of non-heavy drinkers (n = 17) and heavy drinkers (n = 14). Both groups consumed wine in 1 h and were assessed for subjective nasal symptoms and objective nasal patency, using rhinomanometry and acoustic rhinometry, at baseline and at 0.5, 2, and 6 h post-alcohol consumption.

Results

Alcohol consumption significantly increased nasal obstruction from baseline values in both heavy and non-heavy drinking groups. Total nasal volume (TNV) and the minimal cross-sectional area (MCA) were significantly decreased and nasal airway resistance (NAR) significantly increased from baseline values by 2 h post-alcohol consumption for both heavy and non-heavy drinking groups ( P < .05). Significant differences were found in TNV, MCA, and NAR between baseline and post-drinking in allergic rhinitis subjects; with no significant differences in MCA and NAR in subjects without allergic rhinitis. Pulse rate (PR) and temperature (T) were elevated, and blood pressure (BP) was decreased after alcohol consumption ( P < .05). Blood alcohol concentration (BAC) was not significantly correlated with nasal patency with regard to any subjective or objective measurement.

Conclusion

Acute alcohol consumption may impair nasal patency, independent of the amount consumed. Individuals with allergic rhinitis may be more prone to nasal obstruction after alcohol consumption than those without allergic rhinitis.