bluuebunny/crossref_metadata_2025 huggingface dataset:
Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign
Authors: Ovesen Christian , Jakobsen Janus Christian , Gluud Christian , Steiner Thorsten , Law Zhe , Flaherty Katie , Dineen Rob A. , Christensen Louisa M. , Overgaard Karsten , Rasmussen Rune S. , Bath Philip M. , Sprigg Nikola , Christensen Hanne ,   the TICH-2 Investigators
Published: May 2021

Background and Purpose:

The computed tomography angiography or contrast-enhanced computed tomography based spot sign has been proposed as a biomarker for identifying on-going hematoma expansion in patients with acute intracerebral hemorrhage. We investigated, if spot-sign positive participants benefit more from tranexamic acid versus placebo as compared to spot-sign negative participants.

Methods:

TICH-2 trial (Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage) was a randomized, placebo-controlled clinical trial recruiting acutely hospitalized participants with intracerebral hemorrhage within 8 hours after symptom onset. Local investigators randomized participants to 2 grams of intravenous tranexamic acid or matching placebo (1:1). All participants underwent computed tomography scan on admission and on day 2 (24±12 hours) after randomization. In this sub group analysis, we included all participants from the main trial population with imaging allowing adjudication of spot sign status.

Results:

Of the 2325 TICH-2 participants, 254 (10.9%) had imaging allowing for spot-sign adjudication. Of these participants, 64 (25.2%) were spot-sign positive. Median (interquartile range) time from symptom onset to administration of the intervention was 225.0 (169.0 to 310.0) minutes. The adjusted percent difference in absolute day-2 hematoma volume between participants allocated to tranexamic versus placebo was 3.7% (95% CI, −12.8% to 23.4%) for spot-sign positive and 1.7% (95% CI, −8.4% to 12.8%) for spot-sign negative participants (
P
heterogenity
=0.85). No difference was observed in significant hematoma progression (dichotomous composite outcome) between participants allocated to tranexamic versus placebo among spot-sign positive (odds ratio, 0.85 [95% CI, 0.29 to 2.46]) and negative (odds ratio, 0.77 [95% CI, 0.41 to 1.45]) participants (
P
heterogenity
=0.88).

Conclusions:

Data from the TICH-2 trial do not support that admission spot sign status modifies the treatment effect of tranexamic acid versus placebo in patients with acute intracerebral hemorrhage. The results might have been affected by low statistical power as well as treatment delay.

Registration:

URL:
http://www.controlled-trials.com
; Unique identifier: ISRCTN93732214.
Predicting 90-Day Outcome After Thrombectomy: Baseline-Adjusted 24-Hour NIHSS Is More Powerful Than NIHSS Score Change
Authors: Mistry Eva A. , Yeatts Sharon , de Havenon Adam , Mehta Tapan , Arora Niraj , De Los Rios La Rosa Felipe , Starosciak Amy K. , Siegler James E. , Mistry Akshitkumar M. , Yaghi Shadi , Khatri Pooja
Published: May 2021

Background and Purpose:

The National Institutes of Health Stroke Scale (NIHSS) measured at an early time point is an appealing surrogate marker for long-term functional outcome of stroke patients treated with endovascular therapy. However, definitions and analytical methods for an early NIHSS-based outcome measure that optimize power and precision in clinical studies are not well-established.

Methods:

In this post-hoc analysis of our prospective observational study that enrolled endovascular therapy-treated patients at 12 comprehensive stroke centers across the US, we compared the ability of 24-hour NIHSS, ΔNIHSS (baseline minus 24-hour NIHSS), and percentage change (NIHSS×100/baseline NIHSS), analyzed as continuous and dichotomous measures, to predict 90-day modified Rankin Scale (mRS) using logistic regression (adjusted for age, baseline NIHSS, glucose, hypertension, Alberta Stroke Program Early CT Score, time to recanalization, recanalization status, and intravenous thrombolysis) and Spearman ρ.

Results:

Of 485 patients in the BEST (Blood Pressure After Endovascular Stroke Therapy) cohort, 446 (92%) with 90-day follow-up data were included. An absolute 24-hour NIHSS, adjusted for baseline in multivariable modeling, had the highest predictive power of all definitions evaluated (aR
2
0.368 and adjusted odds ratio 0.79 [0.75–0.84],
P
<0.001 for mRS score 0–2; aR
2
0.444 and adjusted odds ratio 0.84 [0.8–0.86] for ordinal mRS). For predicting mRS score of 0–2 with a cut point, the second most efficient approach, the optimal threshold for 24-hour NIHSS score was ≤7 (sensitivity 80.1%, specificity 80.4%; adjusted odds ratio 12.5 [7.14–20],
P
<0.001), followed by percent change in NIHSS (sensitivity 79%, specificity 58.5%; adjusted odds ratio 4.55 [2.85–7.69],
P
<0.001).

Conclusions:

Twenty-four–hour NIHSS, adjusted for baseline, was the strongest predictor of both dichotomous and ordinal 90-day mRS outcomes for endovascular therapy-treated patients. A dichotomous 24-hour NIHSS score of ≤7 was the second-best predictor. Although ΔNIHSS, continuous and dichotomized at ≥4, predicted 90-day outcomes, absolute 24-hour NIHSS definitions performed better.
A molecular phylogeny and revision of the genus Pyropteron Newman, 1832 (Lepidoptera, Sesiidae) reveals unexpected diversity and frequent hostplant switch as a driver of speciation
Authors: BARTSCH DANIEL , PÜHRINGER FRANZ , MILLA LIZ , LINGENHÖLE ARTHUR , KALLIES AXEL
Published: May 2021

We here revise the genus Pyropteron Newman, 1832 using molecular and morphological analyses. Our data support the monophyly of Pyropteron with Synansphecia Căpușe, 1973 (syn. rev.) being its junior subjective synonym. Four taxa are described as new to science, Pyropteron minianiformis xerxes Bartsch, Pühringer, Lingenhöle & Kallies ssp. nov., Pyropteron hellenicum Bartsch, Pühringer, Lingenhöle & Kallies sp. nov., Pyropteron jordanicum Bartsch, Pühringer, Lingenhöle & Kallies sp. nov. and Pyropteron leucomelaena blaesii Bartsch, Pühringer, Lingenhöle & Kallies ssp. nov., and 4 species are raised to species rank, Pyropteron nigrobarbata (Rebel, 1916) stat. nov., Pyropteron icteropus (Zeller, 1847) stat. rev., Pyropteron euglossaeformis (Lucas, 1849) stat. rev. and Pyropteron erodiiphaga (Dumont, 1922) stat. rev. To stabilize the taxonomy, we designate neotypes for Pyropteron euglossaeformis stat. rev. and Pyropteron ceriaeformis (Lucas, 1849). Pyropteron pipiziformis (Lederer, 1855) comb. nov., is combined with Pyropteron for the first time. The identity of Pyropteron atlantis (Schwingenschuss, 1935), previously confused with Pyropteron borreyi (Le Cerf, 1922) is fixed. We treat Pyropteron muscaeformis lusohispanica Laštůvka & Laštůvka, 2007 syn. nov. as a synonym of Pyropteron koschwitzi (Špatenka, 1992), Pyropteron minianiformis aphrodite Bartsch, 2004 syn. nov. as a synonym of Pyropteron minianiformis destituta (Staudinger, 1894), Pyropteron muscaeformis occidentalis Joannis, 1908 syn. nov. as a synonym of Pyropteron muscaeformis (Esper, 1783), and Sesia lecerfi Oberthür, 1909 syn. nov. is considered a synonym of Bembecia ichneumoniformis ([Denis & Schiffermüller], 1775). Finally, we discuss a model whereby frequent switches in hostplant usage drive rapid speciation in the genus Pyropteron.
Nineteen new species of Alycaeidae from Myanmar and Thailand (Gastropoda: Caenogastropoda: Cyclophoroidea)
Authors: PÁLL-GERGELY BARNA , HUNYADI ANDRÁS , GREGO JOZEF , REISCHÜTZ ALEXANDER , AUFFENBERG KURT
Published: May 2021

Nineteen new species of the alycaeid genera Chamalycaeus, Dicharax, and Metalycaeus are described from Thailand and Myanmar: Chamalycaeus buaboke Páll-Gergely & A. Reischütz, n. sp., C. erawan Páll-Gergely & Hunyadi, n. sp., C. hirpex Páll-Gergely & A. Reischütz, n. sp., C. irmatallus Páll-Gergely, n. sp., C. krabiensis Páll-Gergely & A. Reischütz, n. sp., C. serratus Páll-Gergely & Auffenberg, n. sp., C. spiratus Páll-Gergely, n. sp., Dicharax (?) admirandus Páll-Gergely & Auffenberg, n. sp., D. cyclostoma Páll-Gergely, n. sp., D. ebrius Páll-Gergely & Auffenberg, n. sp., D. (?) gnomus Páll-Gergely, n. sp., D. mirounga Páll-Gergely, n. sp., D. ovatus Páll-Gergely & Auffenberg, n. sp., D. subroseus Páll-Gergely, n. sp., D. verrucosus Páll-Gergely & Hunyadi, n. sp., Metalycaeus anas Páll-Gergely & A. Reischütz, n. sp., M. aries Páll-Gergely & Auffenberg, n. sp., M. bicarinatus Páll-Gergely & Hunyadi, n. sp., M. pygmachos Páll-Gergely & Hunyadi, n. sp.                Alycaeus kengtungensis Godwin-Austen, 1914 is moved to the synonymy of Metalycaeus heudei (Bavay & Dautzenberg, 1900). We also report exact localities of Dicharax ataranensis (Godwin-Austen, 1914), Dicharax notus (Godwin-Austen, 1914), and Dicharax omissus (Godwin-Austen, 1914). The new records extend the known distribution of Chamalycaeus and Metalycaeus in Thailand.
Monte Carlo Modelling of Magnetic and Thermodynamic Features of Rb3CoCl5and Dy3Al5O12Magnetic Systems
Authors: Hendi A. , Bamuqaddam A. , Aldaghfag Shatha A. , Alkallas F. , Almoneef M. , Alanazi Meznah M. , Laref A. , Alsaif N. A. , Awad M. , Altowyan Abeer S. , Ortashi K. , AlZahrani J. S.
Published: May 2021

In our simulations, we considered two typical magnetic materials, while the first one includes the 3d-transition metal, such as cobalt which is responsible of the presence of magnetism in pyrochlore structure Rb3CoCl5. The second magnetic material was chosen to have 4f-rare earth metal, namely dysprosium that can induce magnetism in garnet material Dy3Al5O12. A general agreement was found between our results and the previous works. In our calculations, we employed the classical Ising model for the above mentioned realistic materials. We specifically studied the magnetic properties over a range of temperature including the critical temperature and above it. To understand the magnetic phase transition, the effect of magnetic field was involved in the classical Ising model.
Climatological sensitivities of shallow-cumulus bulk entrainment in continental and oceanic locations
Authors: Kirshbaum Daniel J. , Lamer Katia
Published: May 2021

Cumulus entrainment is a complex process that has long challenged conceptual understanding and atmospheric prediction. To investigate this process observationally, two retrievals are used to generate multi-year climatologies of shallow-cumulus bulk entrainment (ϵ) at two Atmospheric Radiation Measurement cloud observatories, one in the US southern Great Plains (SGP) and the other in the Azores archipelago in the eastern North Atlantic (ENA). The statistical distributions of ϵ thus obtained, as well as certain environmental and cloud-related sensitivities of ϵ, are consistent with previous findings from large-eddy simulations. The retrieved ϵ robustly increases with cloudlayer relative humidity and decreases in wider clouds and cloud ensembles with larger cloud-base mass fluxes. While ϵ also correlates negatively with measures of cloud-layer vigor (e.g., maximum in-cloud vertical velocity and cloud depth), the extent to which these metrics actually regulate ϵ (or vice-versa) is unclear. Novel sensitivities of ϵ include a robust decrease of ϵ with increasing subcloud wind speed in oceanic flows, as well as a decrease of ϵ with increasing cloud-base mass flux in individual cumuli. A strong land–ocean contrast in ϵ is also found, with median values of 0.5-0.6 km−1 at the continental SGP site and and 1.0-1.1 km−1 at the oceanic ENA site. This trend is associated with drier and deeper cloud layers, along with larger cloud-base mass fluxes, at SGP, all of which favor reduced ϵ. The flow-dependence of retrieved ϵ implies that its various sensitivities should be accounted for in cumulus parameterization schemes.
The Role of Background Meridional Moisture Gradient on the Propagation of the MJO over the Maritime Continent
Authors: Kang Daehyun , Kim Daehyun , Ahn Min-Seop , An Soon-Il
Published: May 2021

This study investigates the role of the background meridional moisture gradient (MMG) on the propagation of the Madden–Julian Oscillation (MJO) across the Maritime Continent (MC) region. It is found that the interannual variability of the seasonal mean MMG over the southern MC area is associated with the meridional expansion and contraction of the moist area in the vicinity of the MC. Sea surface temperature anomalies associated with relatively high and low seasonal mean MMG exhibit patterns that resemble those of the El Niño–Southern Oscillation. By contrasting the years with anomalously low and high MMG, we show that MJO propagation through the MC is enhanced (suppressed) in years with higher (lower) seasonal mean MMG, though the effect is less robust when MMG anomalies are weak. Column-integrated moisture budget analysis further shows that sufficiently large MMG anomalies affects MJO activity by modulating the meridional advection of the mean moisture via MJO wind anomalies. Our results suggest that the background moisture distribution has a strong control over the propagation characteristics of the MJO in the MC region.
Observing and quantifying ocean flow properties using drifters with drogues at different depths
Authors: Rypina Irina I. , Getscher Timothy R. , Pratt Lawrence J. , Mourre Baptiste
Published: May 2021

This paper presents analyses of drifters with drogues at different depths – 1, 10, 30, 50 m – that were deployed in the Mediterranean Sea to investigate frontal subduction and upwelling. Drifter trajectories were used to estimate divergence, vorticity, vertical velocity, and finite-size Lyapunov exponents (FTLEs), and to investigate the balance of terms in the vorticity equation. The divergence and vorticity are O(f) and change sign along trajectories. Vertical velocity is O(1 mm/s), increases with depth, indicates predominant upwelling with isolated downwelling events, and sometimes changes sign between 1 and 50 m. Vortex stretching is one of, but not the only, significant term in the vorticity balance. 2D FTLEs are 2 × 10−51/s after 1 day, twice larger than in a 400-m-resolution numerical model. 3D FTLEs are 50% larger than 2D FTLEs and are dominated by the vertical shear of horizontal velocity. Bootstrapping suggests uncertainty levels of ~10% of the time-mean absolute values for divergence and vorticity. Analysis of simulated drifters in a model suggests that drifter-based estimates of divergence and vorticity are close to the Eulerian model estimates, except when drifters get aligned into long filaments. Drifter-based vertical velocity is close to the Eulerian model estimates at 1 m but differs at deeper depths. The errors in the vertical velocity are largely due to the lateral separation between drifters at different depths, and partially due to only measuring at 4 depths. Overall, this paper demonstrates how drifters, heretofore restricted to 2D near-surface observations, can be used to learn about 3D flow properties throughout the upper layer of the water column.
Estimating Population Size of Criminals: A New Horvitz–Thompson Estimator under One-Inflated Positive Poisson–Lindley Model
Authors: Tajuddin Razik Ridzuan Mohd , Ismail Noriszura , Ibrahim Kamarulzaman
Published: May 2021

Many crime datasets often display an excess of “1” counts, arises when arrested criminals have the desire and ability to avoid subsequent arrests. In this study, a new Horvitz–Thompson (HT) estimator under one-inflated positive Poisson–Lindley (OIPPL) distribution which allow for one-inflation and the existence of heterogeneity in the data is developed to estimate the hidden population size of criminals. From the simulation study and applications to real crime datasets, the OIPPL is capable to provide an adequate fit to the datasets considered and the proposed HT estimator is found to produce a more precise estimate of the population size with a narrower 95% confidence interval as compared to several other contending estimators considered in this study.
On the Performance of Semi- and Nonparametric Item Response Functions in Computer Adaptive Tests
Authors: Falk Carl F. , Feuerstahler Leah M.
Published: May 2021

Large-scale assessments often use a computer adaptive test (CAT) for selection of items and for scoring respondents. Such tests often assume a parametric form for the relationship between item responses and the underlying construct. Although semi- and nonparametric response functions could be used, there is scant research on their performance in a CAT. In this work, we compare parametric response functions versus those estimated using kernel smoothing and a logistic function of a monotonic polynomial. Monotonic polynomial items can be used with traditional CAT item selection algorithms that use analytical derivatives. We compared these approaches in CAT simulations with a variety of item selection algorithms. Our simulations also varied the features of the calibration and item pool: sample size, the presence of missing data, and the percentage of nonstandard items. In general, the results support the use of semi- and nonparametric item response functions in a CAT.
Communications satellites in Canadian security policy: History and prospects
Authors: Sloan Elinor
Published: May 2021

This article traces Canada’s early interest in space, before turning to its late 1960s decision to focus on a domestic, commercial/civilian communications satellite system in geostationary orbit and the subsequent decline in Canada’s military space efforts. It then highlights the wake-up call of the 1991 Gulf War, which demonstrated the critical importance of military communications satellites to future operations, and the steps Canada has taken to gain assured access to such satellites in the decades since. The final section outlines recent advances in low Earth orbit satellite communications (LEO satcom) and the ways in which these systems can address shortfalls in their geostationary cousins. Drawing reference to a new international security environment, it concludes that Canada should move expeditiously to incorporate LEO satcom into efforts to address the growing imperative of military satellite communications in the Canadian Arctic.
Anger, Anxiety, and Selective Exposure to Terrorist Violence
Authors: Huddy Leonie , Smirnov Oleg , Snider Keren L. G. , Perliger Arie
Published: May 2021

We examine the political consequence of exposure to widely available video content of terror violence. In a two-wave survey of Americans, we assess who is exposed to, and seeks out, terror-related video content in the first wave and then observe who decides to watch raw video footage of the Boston marathon terror attack in the second. We focus centrally on anxiety and anger as differing emotional reactions to the threat of terrorism and document their influence on exposure to terror violence. Anxiety generates avoidance of violent terror content whereas anger increases its consumption. Moreover, we find that anger increases exposure to violent terror content and in addition enhances support for punitive and retaliatory anti-terrorism policy. We discuss the implications of our findings for the broader dynamics of terrorist violence and the emotional basis of selective news exposure.
Police Perceptions of Police-Involved Overdose Outreach Program Effectiveness
Authors: Becker Laurie T.
Published: May 2021

This study surveys police officers from three New England states to examine the perceptions officers hold toward the effectiveness of police-involved overdose outreach programs, the variables that serve as significant predictors for perceptions of program effectiveness, and the extent to which attribution theory can explain these perceptions. The majority of officers displayed positive perceptions of program effectiveness, and eight significant predictors were identified, including attribution theory which showed significance in explaining why police officers perceive these programs as effective. As an increasing number of police departments take a service-centered approach to working with individuals with substance use disorder, police-involved overdose outreach programs are becoming more commonplace. From the results of this study, practitioners are able to identify variables that predict officers’ views of program effectiveness. Equipped with this knowledge, increasing the support of these related concepts will help to subsequently increase the likelihood of officers viewing these programs as effective.
Inequality for All and Activating Empowerment Amid Economic Despair
Authors: Kornbluth Jacob , Greene Eric , Gupta Nisha
Published: May 2021

In this edited interview, psychologists Eric Greene and Nisha Gupta converse with filmmaker Jacob Kornbluth about his documentary film Inequality for All (2013), which is a passionate argument on behalf of the middle class. The film features Robert Reich—professor, best-selling author, and Clinton cabinet member—as he demonstrates how the widening income gap has a devastating impact on the American economy. The film is an intimate portrait of a man whose lifelong goal remains protecting those who are unable to protect themselves, as Reich explains how the massive consolidation of wealth by a precious few threatens the viability of the American workforce and the foundation of democracy itself. In this dialogue with the film director, Kornbluth describes his personal socioeconomic background that inspired this project, his creative collaboration with Reich in attempt to evoke critical consciousness among the public about the truth of income inequality, and his vision of creating an emotionally intimate story that balances righteous despair and anger with a tone of political hope.
Wake-up call for a dysfunctional system: Employer perspectives on industrial relations in 2020
Authors: Barklamb Scott
Published: May 2021

This article addresses the key challenges of 2020 from the perspective of employers, how employers worked to respond to the pandemic and recession, and to position Australia’s industrial system for the future. It examines various key developments, positive and negative, from the perspective of employers throughout 2020, before concluding on the prospects for starting to genuinely reform Australia’s industrial relations system in 2021.
Re-Applying the Basic Psychological Needs in Exercise Scale to Various Portuguese Exercise Groups: An Analysis of Bifactor Models and Contextual Invariance
Authors: Rodrigues Filipe , Cid Luis , Teixeira Diogo , Monteiro Diogo
Published: May 2021

This research explored the nature of basic psychological needs in physical activity settings by applying relatively advanced methodological procedures for psychometric assessment. We first re-examined the Basic Psychological Needs in Exercise Scale (BPNES) by reviewing its applicability for physical activity domains among Portuguese respondents. We demonstrated the use of Bifactor Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM) and discussed the practical implications of these models. Next, we tested contextual measurement invariance in order to examine needs universality. Our participants were gym exercisers (n = 1935), physical education students (n = 1449), and athletes (n = 1631), all of whom completed the adapted and validated version of the scale in their respective practice physical activity domains. All models under analysis displayed acceptable to excellent fit; the bifactor ESEM model displayed the best fit. We conducted ancillary bifactor measures to assess scale dimensionality and found that the BPNES is best interpreted as a multidimensional instrument. Through testing for multigroup analysis, the bifactor ESEM did not show contextual invariance. In conclusion, the BPNES should be predominantly used as a multidimensional instrument when assessing basic needs in separate physical activity domains. Basic psychological needs are perceived differently between seemingly similar physical activity contexts. Researchers should measure basic needs as a global factor and use context validated sub-scales.
Designing flocked energy-absorbing material layers into sport and military helmet pads
Authors: Kim Yong K , Chalivendra Vijaya B , Lewis Armand Francis , Fasel Benjamin
Published: May 2021

A systematic study is reported on applying flocked energy-absorbing materials (FEAM) to designing sport and military helmet pad structures. An executed parametric study shows that the impact force absorbing (IFA) properties of FEAM elements are optimized when using (a) higher denier flock fiber (60 to 100 denier) and (b) longer flock fibers (3 to 4 mm length) at higher flock densities. Continuing work focuses on the importance of IFA/areal density ratios in helmet pad functional design. It is found that foam materials like vinyl-nitrile and ethylene vinyl acetate (EVA) inherently exhibit higher IFA/areal density (IFA/AD) ratios than FEAM material structures. With this finding, a new strategy for developing sport and military helmet pads was devised involving the combination of foam and FEAM layer elements. Here, the meritorious properties of foam materials (light weight and excellent IFA properties) and the excellent IFA and breathability (wearer comfort, sweat and heat management) properties of FEAM could be favorably encompassed. A plan was conceived and implemented whereby combination foam/FEAM test pads having high amounts of the high IFA/AD ratio VN-600 or EVA foam layer component were impact tested. By gradually introducing the more comfortable, breathable, body-heat managing FEAM layers into the helmet pad structure, some “trade-off” helmet pad configurations were designed and evaluated. Experiments showed that helmet pad designs having not more than 40% to 50% FEAM content should produce adequate IFA/AD ratio “trade-off” property helmet pad configurations.
The relationship between school-basic psychological need satisfaction and frustration, academic engagement and academic achievement
Authors: Buzzai Caterina , Sorrenti Luana , Costa Sebastiano , Toffle Mary Ellen , Filippello Pina
Published: May 2021

The main purpose of this study is to investigate how students’ perceptions of need satisfaction and need frustration at school are indirectly associated with academic achievement through academic engagement. A modified version of the Basic Psychological Need Satisfaction and Frustration Scale was used to assess these needs in a school-based context. The study sample consisted of 551 students, comprising 299 males (54.3%) and 252 females (45.7%), with an average age of 16.19 years (SD = 1.49). The results suggested autonomy satisfaction and relatedness satisfaction are positively correlated with academic engagement, autonomy frustration is negatively correlated with academic engagement, and, moreover, academic engagement is associated with increased academic achievement. The results of this study highlight the importance of developing specific training programs to promote a school environment that pays attention to students’ psychological needs.
Depression and anxiety among school adolescent females: A national study from Jordan
Authors: AlAzzam Manar M. , AL-Sagarat Ahmad Y. , Abdel Razeq Nadin M. , Alsaraireh Faris A.
Published: May 2021

Depression and anxiety are major mental health concerns among adolescent females within the school community and inflect many implications for psychological service providers in schools. The aims of this descriptive correlational study are to estimate the prevalence of anxiety and depression among high school adolescent females in Jordan, and to determine the contributing factors associated with depression and anxiety. Data were collected using self-report questionnaires from a clustered stratified sample of 405 high school females attending public schools in Jordan. Severe levels of depression and anxiety were reported by 25.7% and 21% of high school adolescent females, respectively. Education challenges and having a history of health problems contributed to having higher levels of depression and anxiety among the high school adolescent females. School mental health services regarding adolescent females mental health should be activated and supported through policies and legislation in Jordan.
The Moth-Eaten Mandible: Osteomyelitis
Authors: Omami Galal
Published: May 2021

Inflammatory lesions such as osteomyelitis of the jaw may share some of the radiographic features of malignancy; however, a demonstrable dental cause for it usually exists. In addition, inflammatory lesions generally stimulate a sclerotic bone reaction, which is uncommon in malignancy. The imaging modality of choice for aiding in the differential diagnosis is computed tomography imaging because of its ability to clearly delineate sequestra and periosteal new bone formation.
What Does the Public Prefer Versus What Is the Public Ready to Forgo?
Authors: Kaplan Giora , Connelly Yaron
Published: May 2021

The present study uses a novel approach to assess the publics’ ability to cope with priority setting and rationing in health care by asking what the public is willing to forego. Items for disinvestment were presented in three separated dimensions: Categories of medical care, quality of service, and items representing social values. A telephone survey was conducted among a representative sample of the Israeli public (N = 609). The response rate was 51%. We identify a few items that a high proportion of the population express readiness to forgo: a drug for smoking cessation, budgets for improving appearance and comfort in medical facilities, and a product for preventing surgical scars. Furthermore, over a quarter of the public was ready to forgo many other items. We found that less than 10% justified their selection in terms of “personally not important to me,” while most respondents evaluated the items they chose to forgo as “less effective or less essential in comparison to others.” The study found that most respondents, when exposed to a range of health system components, were able to identify at least one item that they will be willing to forgo in a time of economic crisis.
Hyaluronic Acid Concentration in Female Vocal Folds With Reinke’s Edema
Authors: de Melo Lins Cristiana Vanderlei , Maciel Martins João Roberto , Kobayashi Elsa Yoko , Korn Gustavo Polacow , Park Sung Woo , Mororó Welber Chaves , De Biase Noemi Grigoletto
Published: May 2021

Objective

The aim of the present study was to investigate hyaluronic acid (HA) concentrations in vocal folds among patients with Reinke’s edema.

Study Design

Prospective and experimental study.

Setting

Single tertiary center.

Methods

An HA binding protein isolated from bovine nasal cartilage was used to identify and isolate the HA from samples. Plates coated with biotin‐conjugated binding protein and streptavidin‐europium conjugate were sequentially incubated with 18 Reinke’s edema samples and 11 female vocal fold cover samples from cadavers (the superficial layer of the lamina propria; control group). After the release of europium from streptavidin in enhancement solution, final fluorescence was measured in a fluorometer.

Results

The mean HA concentration in Reinke’s edema vocal folds was significantly higher than that in the control vocal folds (9.2 × 103 vs 0.9 × 103µg/g).

Conclusion

Vocal fold covers affected by Reinke’s edema present a higher concentration of HA than do vocal fold covers with no edema.
Critical Review and Consensus Statement for Neural Monitoring in Otolaryngologic Head, Neck, and Endocrine Surgery
Authors: Scharpf Joseph , Liu Jeffrey C. , Sinclair Catherine , Singer Michael , Liddy Whitney , Orloff Lisa , Steward David , Bonilla Velez Juliana , Randolph Gregory W.
Published: May 2021

Background

Enhancing patient outcomes in an array of surgical procedures in the head and neck requires the maintenance of complex regional functions through the protection of cranial nerve integrity. This review and consensus statement cover the scope of cranial nerve monitoring of all cranial nerves that are of practical importance in head, neck, and endocrine surgery except for cranial nerves VII and VIII within the temporal bone. Complete and applied understanding of neurophysiologic principles facilitates the surgeon’s ability to monitor the at‐risk nerve.

Methods

The American Academy of Otolaryngology–Head and Neck Surgery (AAO‐HNS) identified the need for a consensus statement on cranial nerve monitoring. An AAO‐HNS task force was created through soliciting experts on the subject. Relevant domains were identified, including residency education, neurophysiology, application, and various techniques for monitoring pertinent cranial nerves. A document was generated to incorporate and consolidate these domains. The panel used a modified Delphi method for consensus generation.

Results

Consensus was achieved in the domains of education needs and anesthesia considerations, as well as setup, troubleshooting, and documentation. Specific cranial nerve monitoring was evaluated and reached consensus for all cranial nerves in statement 4 with the exception of the spinal accessory nerve. Although the spinal accessory nerve’s value can never be marginalized, the task force did not feel that the existing literature was as robust to support a recommendation of routine monitoring of this nerve. In contrast, there is robust supporting literature cited and consensus for routine monitoring in certain procedures, such as thyroid surgery, to optimize patient outcomes.

Conclusions

The AAO‐HNS Cranial Nerve Monitoring Task Force has provided a state‐of‐the‐art review in neural monitoring in otolaryngologic head, neck, and endocrine surgery. The evidence‐based review was complemented by consensus statements utilizing a modified Delphi method to prioritize key statements to enhance patient outcomes in an array of surgical procedures in the head and neck. A precise definition of what actually constitutes intraoperative nerve monitoring and its benefits have been provided.
Quality Improvement in Otolaryngology–Head and Neck Surgery: Developing Registry‐Enabled Quality Measures From Guidelines for Cerumen Impaction and Allergic Rhinitis Through a Transparent and Systematic Process
Authors: Michel Jeremy J. , Schwartz Seth R. , Dawson Douglas E. , Denneny James C. , Erinoff Eileen , Dhepyasuwan Nui , Rosenfeld Richard M.
Published: May 2021

Background and Significance

Quality measurement can drive improvement in clinical care and allow for easy reporting of quality care by clinicians, but creating quality measures is a time‐consuming and costly process. ECRI (formerly Emergency Care Research Institute) has pioneered a process to support systematic translation of clinical practice guidelines into electronic quality measures using a transparent and reproducible pathway. This process could be used to augment or support the development of electronic quality measures of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO‐HNSF) and others as the Centers for Medicare and Medicaid Services transitions from the Merit‐Based Incentive Payment System (MIPS) to the MIPS Value Pathways for quality reporting.

Methods

We used a transparent and reproducible process to create electronic quality measures based on recommendations from 2 AAO‐HNSF clinical practice guidelines (cerumen impaction and allergic rhinitis). Steps of this process include source material review, electronic content extraction, logic development, implementation barrier analysis, content encoding and structuring, and measure formalization. Proposed measures then go through the standard publication process for AAO‐HNSF measures.

Results

The 2 guidelines contained 29 recommendation statements, of which 7 were translated into electronic quality measures and published. Intermediate products of the guideline conversion process facilitated development and were retained to support review, updating, and transparency. Of the 7 initially published quality measures, 6 were approved as 2018 MIPS measures, and 2 continued to demonstrate a gap in care after a year of data collection.

Conclusion

Developing high‐quality, registry‐enabled measures from guidelines via a rigorous reproducible process is feasible. The streamlined process was effective in producing quality measures for publication in a timely fashion. Efforts to better identify gaps in care and more quickly recognize recommendations that would not translate well into quality measures could further streamline this process.
Cochlear Implantation Hearing Outcome in Ménière’s Disease
Authors: Chien Chen‐Yu , Kulthaveesup Anan , Herrmann Barbara S. , Rauch Steven D.
Published: May 2021

Objective

The aim of this study was to evaluate the hearing outcome of cochlear implantation in patients deafened by Ménière’s disease.

Study Design

Retrospective single‐institution study.

Setting

Tertiary medical center.

Methods

Our institutional database of 1400 patients with cochlear implants was reviewed to identify cases with deafness due to Ménière’s disease. Twenty‐nine patients were identified: 24 with unilateral and 5 with sequential bilateral cochlear implants. Pre‐ and postoperative speech recognition scores and medical data were extracted from the medical record and analyzed.

Results

Overall the mean difference between pre‐ and postoperative speech recognition after >1 year was 56% (95% CI, 47.08%‐64.92%). The mean preoperative monosyllabic word score was 9.5%, and the mean postoperative scores at 1 month, 3 months, 6 months, 1 year, and >1 year were 37.1%, 46.1%, 54.1%, 59.1%, and 66.8%, respectively. Cochlear implantation resulted in improved word scores in all patients regardless of prior medical or surgical treatment (endolymphatic sac, labyrinthectomy). The mean postoperative hearing improvement in patients aged <70 and ≥70 years was 65.26% (95% CI, 54.79%‐75.73%) and 40.00% (95% CI, 27.22%‐52.77%). Postoperative word scores in patients with bilateral cochlear implants were not significantly different between the first and second implanted ears or between the monoaural and binaural testing conditions.

Conclusion

Cochlear implant in patients deafened by Ménière’s disease significantly improves word recognition scores regardless of whether medical or surgical treatment is used prior to implantation. The potential improvement in word recognition scores decreases after age 70 years.
Real world coronary artery ostia full accessibility after last generation transcatheter aortic valve implantation
Authors: Rigatelli Gianluca , Zuin Marco , Roncon Loris , Nanjiundappa Aravinda , Daggubati Ramesh
Published: May 2021

Aim

We evaluate, performing a pooled meta-analysis, the current coronary artery accessibility rate in transcatheter aortic valve implantation (TAVI) patients during the follow-up. Full coronary artery accessibility after TAVI has not been adequately addressed by the current literature.

Methods

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data on coronary artery access were obtained from the ratio between in the full coronary engagement (n) and the number of coronary angiography and/or percutaneous coronary intervention (N). Data were synthesized using random-effects meta-analyses.

Results

Out of 7048 TAVI patients, 276 (3.9%) (mean age 76.8 years, 111 (40.2%) females) were analysed. Full coronary artery accessibility for coronary angiographies and percutaneous coronary interventions were obtained in 83.0% (95% confidence interval (CI): 0.66–0.92, p = 0.001, I2: 88.2%) and 96.0% (95% CI: 0.90–0.98, p < 0.0001, I2: 0) of cases (p for difference  < .0.001). Left coronary artery (n = 219) was easily fully engaged compared to the right one (90.9% (95% CI: 0.80–0.96, p < 0.0001, I2: 58.4% and 82.0% (95% CI: 0.60–0.93, p = 0.006, I2: 83.2%), respectively, (p for difference  < 0.001). Using age as moderator variable, meta-regression revealed a positive and negative correlation with coronary artery accessibility in patients treated with Sapien-Edwards (p = 0.008) and CoreValve (p = 0.010) platforms, respectively. Conversely, a negative correlation (p = 0.01) was found between coronary artery accessibility and mean time after Sapien-Edwards platform implantation (p = 0.01).

Conclusions

Full coronary artery accessibility during coronary angiographies and/or percutaneous coronary interventions results suboptimal for both coronary artery ostia and worse for right compared to left coronary artery after TAVI.
Introduction to the special issue: Relationships in the time of COVID-19
Authors: Bevan Jennifer L. , Lannutti Pamela J.
Published: May 2021

This introduction describes the background for the special issue entitled “Relationships in the Time of COVID-19: Examining the Effects of the Global Pandemic on Personal Relationships.” It also examines reasons for conducting interdisciplinary research on COVID-19 and personal relationships, and previews first articles published in the special issue.
Audio-visual input for learning L2 vocabulary and grammatical constructions
Authors: Muñoz Carmen , Pujadas Geòrgia , Pattemore Anastasiia
Published: May 2021

This article addresses the benefits of audio-visual input for learning second language (L2) vocabulary and grammatical constructions. Specifically, it explores the role of frequency, the effects of subtitles and captions, and the mediating role of learner proficiency on language gains in two longitudinal studies. Study 1 targets vocabulary acquisition in two groups of adolescents with an elementary L2 proficiency level who view 24 episodes of a TV series spread weekly over a whole academic year, one group with subtitles (first language) and one with captions (second language). Study 2 targets grammar acquisition in two groups of university students with an intermediate proficiency level who view 10 episodes over five weeks, one group with captions and one without captions. Results of both studies show significant correlations between language gains and frequency in the input, but the size of the frequency effect appears to depend on the type of support provided by the on-screen text. The analyses also show no significant advantage of captions or subtitles for vocabulary learning at this proficiency level, a significant advantage of captions over no captions for grammatical constructions learning, as well as the significant role of proficiency. It is concluded that viewing audio-visual material leads to L2 learning and it can support learners in their preparation for study abroad and maximize their learning experience during their sojourn.
Glottalization and linking in the L2 speech of Czech learners of Spanish, Italian and Portuguese
Authors: Skarnitzl Radek , Čermák Petr , Šturm Pavel , Obstová Zora , Hricsina Jan
Published: May 2021

The use of linking or glottalization contributes to the characteristic sound pattern of a language, and the use of one in place of the other may affect a speaker’s comprehensibility and fluency in certain contexts. In this study, native speakers of Czech, a language that is associated with a frequent use of glottalization in vowel-initial word onsets, are examined in the second language (L2) context of three Romance languages that predominantly employ linking between words (Spanish, Italian and Portuguese). In total, 29 native speakers and 51 non-native learners were asked to read a short text in the respective language. The learners were divided into two groups based on their experience with the target language. A number of other factors were examined in a mixed-effects logistic regression model (segmental context, lexical stress, prosodic breaks, and the semantic status of the words). The main results show that, regardless of the target language, the more experienced (ME) learners displayed significantly lower rates of glottalization than the less experienced (LE) learners, but significantly higher rates than native speakers. The pedagogical implications of the results are discussed.
City region limits: Questioning city-centric growth narratives in medium-sized cities
Authors: Beel David , Jones Martin
Published: May 2021

In this paper, we consider the implications of applying the city region concept to a medium-sized city and whether such an application of a spatial and governmental policy is appropriate when the central city in question is also not necessarily economically dominant or connected to its wider city-region. This gives a deeper understanding to the process of subnational restructuring of the UK state via the production of city regions which has now been in progress since the 2010 Coalition Government. The primary focus governmentally and in academic literature has been on larger (English) city regions, but here we highlight how this has been applied in distinctive ways in devolved nations of the UK. To this end, we focus upon the case of the Swansea Bay City Region, based in South West Wales, looking through the lens of Welsh devolution and through the concept of the city-region as a scalar narrative for the delivery of economic development.
Assessment tools for problematic opioid use in palliative care: A scoping review
Authors: Lau Jenny , Mazzotta Paolo , Fazelzad Rouhi , Ryan Suzanne , Tedesco Alissa , Smith Andrew J. , Sud Abhimanyu , Furlan Andrea D. , Zimmermann Camilla
Published: May 2021

Background:

Screening for problematic opioid use is increasingly recommended in patients receiving palliative care.

Aim:

To identify tools used to assess for the presence or risk of problematic opioid use in palliative care.

Design:

Scoping review.

Data sources:

Bibliographic databases (inception to January 31, 2020), reference lists, and grey literature were searched to find primary studies reporting on adults receiving palliative care and prescription opioids to manage symptoms from advanced cancer, neurodegenerative diseases, or end-stage organ diseases; and included tools to assess for problematic opioid use. There were no restrictions based on study design, location, or language.

Results:

We identified 42 observational studies (total 14,431 participants) published between 2009 and 2020 that used questionnaires ( n = 32) and urine drug tests ( n = 21) to assess for problematic opioid use in palliative care, primarily in US ( n = 38) and outpatient palliative care settings ( n = 36). The questionnaires were Cut down, Annoyed, Guilty, and Eye-opener (CAGE, n = 8), CAGE-Adapted to Include Drugs (CAGE-AID, n = 6), Opioid Risk Tool ( n = 9), Screener and Opioid Assessment for Patients with Pain (SOAPP; n = 3), SOAPP-Revised ( n = 2), and SOAPP-Short Form ( n = 5). Only two studies’ primary objectives were to evaluate a questionnaire’s psychometric properties in patients receiving palliative care. There was wide variation in how urine drug tests were incorporated into palliative care; frequency of abnormal urine drug test results ranged from 8.6% to 70%.

Conclusion:

Given the dearth of studies using tools developed or validated specifically for patients receiving palliative care, further research is needed to inform clinical practice and policy regarding problematic opioid use in palliative care.