bluuebunny/crossref_metadata_2025 huggingface dataset:
Helping Teachers Understand and Mitigate Trauma in Their Classrooms
Authors: Burdick Lynn S. , Corr Catherine
Published: December 2021

Nine-year old Eliza is a student at Meadows Elementary School where she receives special education services for her diagnosis of Emotional Disturbance. Her teachers are working together to try to bring Eliza back into the classroom after weeks of time spent in the office with no contact with her peers. Mr. Jimenez and Ms. Landon are collaborating to incorporate trauma-informed practices into their classrooms in an attempt to address the absence of secure attachments and feelings of safety in Eliza’s life, as well as her inability to control her emotional responses. Creating a trauma-informed classroom benefits everyone but especially students with disabilities who have experienced trauma. In this paper we discuss the need for trauma-informed practices and strategies for making classroom environments more trauma-informed.
Learning from 2020: How the Challenges of Remote Teaching Reinforce the Need for Care-Informed Pedagogy
Authors: Hess Kimberly , McAuliffe Erin L. , Gleckman-Krut Miriam , Shapiro Shoshana
Published: December 2021

How did instructors design their sociology courses for remote teaching during the 2020–2021 academic year, and what challenges did they face in teaching those courses? To answer these questions, we surveyed lead instructors and graduate teaching assistants (n = 77) in the Sociology Department at the University of Michigan, supplemented by interviews with students and our experiences as remote course consultants. Through this case study, we found that instructors cited increased workload and lack of connection as challenges with remote teaching, in addition to pandemic-related struggles. Most instructors reported using either synchronous or a mix of synchronous and asynchronous instruction in course design, incorporating both formative and summative assessments, and implementing communication and community-building strategies to establish connections with and among students. We argue that these challenges and course designs highlight the importance of care-informed pedagogy to not only remote teaching in 2020–2021 but also sociology instruction in general.
Capital Account Liberalization and Firm Innovation: Worldwide Evidence
Authors: Hou Fangfang , Xu Xinpeng
Published: December 2021

This study investigates whether capital account liberalization, a leading characteristic of globalization, is associated with firms’ future innovation output. Employing a novel firm-level panel data set covering 41 countries over two decades, we show that capital account liberalization is significantly associated with higher corporate patenting activities, particularly for firms from innovation-intensive industries. Further analyses show that the effect is stronger among firms from economies in a better legal environment, signifying the important role of good institutional quality in facilitating the positive impact of liberalization. The effect is also stronger among firms with higher initial productivity, consistent with the “productivity” hypothesis, according to which bigger and more productive firms generate more innovation after liberalization. Our findings are robust to the use of various measurements, subsamples, and estimation models. This study provides global firm-level evidence of the real economic impact of financial globalization.
An Examination of Audit Quality Surrounding Within-Firm Engagement Office Changes
Authors: Greiner Adam J. , Higgs Julia L. , Smith Thomas J.
Published: December 2021

We examine the relation between within-firm office changes and audit quality in the United States. Our primary analysis documents a reduction in audit quality, measured using abnormal discretionary accruals and restatements, when the client is transferred to a smaller within-firm office (downsize effect). We are unable to find evidence that clients experience significant improvement in audit quality among transfers to a larger within-firm office (upsize effect). We then condition our sample on the change in the number of public clients of the receiving office to better understand the source of the underlying association. We find that our downsize effect is driven by offices experiencing a decrease in the number of public clients, suggesting that our main association is not entirely the result of resource constraints for the receiving office. We posit that this finding is consistent with audit quality deterioration among within-firm office changes to smaller offices driven, in part, by the receiving office’s inability to adequately overcome the knowledge transfer frictions that accompany a move to a new office. Our findings offer empirical evidence on consequences of within-firm office changes and are particularly relevant to regulators and preparers.
A Landscape of Subjective and Objective Stress in African-American Dementia Family Caregivers
Authors: Cothran Fawn A. , Chang Emily , Beckett Laurel , Bidwell Julie T. , Price Candice A. , Gallagher-Thompson Dolores
Published: December 2021

Stress is a significant part of daily life, and systemic social inequities, such as racism and discrimination, are well-established contributors of chronic stress for African Americans. Added exposure to the stress of caregiving may exacerbate adverse health outcomes. This secondary analysis describes subjective and objective stress in African American family caregivers, and relationships of subjective and objective stress to health outcomes. Baseline data from 142 African American dementia family caregivers from the “Great Village” study were described using means and frequencies; regression models and Pearson’s correlation were used to examine associations between demographics, social determinants of health, and health outcomes. Mixed models were used to examine change and change variation in cortisol. Most caregivers had moderate degrees of stress. Stress was associated with sleep disruption and depressive symptoms, and discrimination appeared to be an independent contributor to depressive symptoms. This work provides a foundation for interpreting subjective and objective indicators of stress to tailor existing multicomponent interventions.
Self-Harm Among Forensic Psychiatric Inpatients With Schizophrenia Spectrum Disorders: An Explorative Analysis
Authors: Kappes Johannes René , Huber David Alen , Kirchebner Johannes , Sonnweber Martina , Günther Moritz Philipp , Lau Steffen
Published: December 2021

The burden of self-injury among offenders undergoing inpatient treatment in forensic psychiatry is substantial. This exploratory study aims to add to the previously sparse literature on the correlates of self-injury in inpatient forensic patients with schizophrenia spectrum disorders (SSD). Employing a sample of 356 inpatients with SSD treated in a Swiss forensic psychiatry hospital, patient data on 512 potential predictor variables were retrospectively collected via file analysis. The dataset was examined using supervised machine learning to distinguish between patients who had engaged in self-injurious behavior during forensic hospitalization and those who had not. Based on a combination of ten variables, including psychiatric history, criminal history, psychopathology, and pharmacotherapy, the final machine learning model was able to discriminate between self-injury and no self-injury with a balanced accuracy of 68% and a predictive power of AUC = 71%. Results suggest that forensic psychiatric patients with SSD who self-injured were younger both at the time of onset and at the time of first entry into the federal criminal record. They exhibited more severe psychopathological symptoms at the time of admission, including higher levels of depression and anxiety and greater difficulty with abstract reasoning. Of all the predictors identified, symptoms of depression and anxiety may be the most promising treatment targets for the prevention of self-injury in inpatient forensic patients with SSD due to their modifiability and should be further substantiated in future studies.
Incorporating Health-Related Criteria for Project Scoring in Massachusetts
Authors: Deliali Aikaterini , Esenther Sarah , Frisard Christine , Bolduc Michael , Krevat Derek , Goins Karin Valentine , Lemon Stephenie , Pollitt Krystal Godri , Christofa Eleni
Published: December 2021

Transportation projects can affect health through multiple pathways—for example, by degrading air quality or encouraging active transportation. There is a need to incorporate health considerations in transportation decision-making to achieve health-related community goals. This paper presents highway project scoring criteria that allow for capturing the impact of transportation projects on health. These scoring criteria are organized into five groups—air quality, accessibility, equity, physical activity, and safety—to capture the multiple pathways that transportation interacts with health. The focus of this study was on updating the Massachusetts Department of Transportation Highway Division project scoresheet to incorporate health-related criteria. Evidence base, standards, and data needs based on which each criterion is assessed, as well as limitations, are summarized for each of the proposed criteria. The paper concludes with a discussion on the outcomes of the proposed changes as well as the transferability potential of the proposed criteria.
Effects From Expanding High-Speed Railway Network on Regional Accessibility and Economic Productivity in China
Authors: Fan Jing , Kato Hironori , Yang Zhongzhong , Li Ye
Published: December 2021

This paper reviews the historical evolution of China’s high-speed railway (HSR) network, evaluates improvements in accessibility, and analyzes the associations of improved accessibility with regional economic productivity, given regional heterogeneity. Three accessibility indicators were considered: average travel time to all prefectural level regions (ATT), average travel time to important cities (ATI), and daily accessible prefectural level regions. These indicators were used to quantify the development of the HSR network during two periods, from 2007 to 2012 and 2012 to 2018. First, the results revealed that, in the first period, the accessibility indicators of the east region improved the most, whereas in the second period, the west significantly improved. We subsequently analyzed the economic productivity and -equilibrium of the urban agglomerations affected by introducing the HSR. Those results suggested that the Triangle of Central China, Chengdu-Chongqing, and Central Guizhou urban agglomerations performed well as the HSR developed. The linkages between regional economic productivity and accessibility improvement were then measured using a multivariable regression with panel data. The results showed that the reduction of ATT and ATI significantly positively contributed to economic productivity at different geographical scales in China. Furthermore, ATT had a larger effect in the northeast and central regions, whereas ATI had a larger effect on the northeast and west regions.
Proposal for a Pivot-Based Vehicle Trajectory Clustering Method
Authors: Reyes Gary , Lanzarini Laura , Hasperué Waldo , Bariviera Aurelio F.
Published: December 2021

Given the large volume of georeferenced information generated and stored by many types of devices, the study and improvement of techniques capable of operating with these data is an area of great interest. The analysis of vehicular trajectories with the aim of forming clusters and identifying emerging patterns is very useful for characterizing and analyzing transportation flows in cities. This paper presents a new trajectory clustering method capable of identifying clusters of vehicular sub-trajectories in various sectors of a city. The proposed method is based on the use of an auxiliary structure to determine the correct location of the centroid of each group or set of sub-trajectories along the adaptive process. The proposed method was applied on three real databases, as well as being compared with other relevant methods, achieving satisfactory results and showing good cluster quality according to the Silhouette index.
Behavioral-Based Pedestrian Modeling Approach: Formulation, Sensitivity Analysis, and Calibration
Authors: Hani Hamdar Samer , Talebpour Alireza , D’Sa Kyla , Knoop Victor , Daamen Winnie , Treiber Martin
Published: December 2021

Pedestrians are among the travelers most vulnerable to collisions that are associated with high fatality and injury rates. The increasing rate of urbanization and mixed land-use construction make walking (along with other non-motorized travel) a predominant transportation mode with a wide variety of behaviors expected. Because of the inherent safety concerns seen in pedestrian transportation infrastructures, especially those with conflicting multimodal movements expected (crosswalks, transit platforms, etc.), it is important that pedestrian behavior is modeled as a risk-taking stochastic behavior that may lead to errors and thus collision formation. In previous work, the complexity and cost associated with building pedestrian models in a cognitive-based environment weighted down the construction of simulation tools that can capture pedestrian-involved collisions, including those seen in shared space environments. In this paper, a tool that will help evaluate the safety of pedestrian traffic is initiated: an extended modeling framework of pedestrian walking behavior is adopted while incorporating different physiological, physical, and decision-making elements. The focus is on operational decisions (i.e., path choices defined by longitudinal and lateral trajectories) with a pre-specified set of origins and destinations. The model relies on the prospect theory paradigm where pedestrians evaluate their acceleration and directional alternatives while considering the possibility of colliding with other “particles.” Using a genetic algorithm method, the new model is calibrated using detailed trajectory data. This model can be extended to model the interactions between a variety of different modes that are present in different mixed land-use environments.
Quantitative Assessment on Navigation Impact of the Controlled Waterway in the Upper Yangtze River Using Queuing Model
Authors: Li Wenjie , Wang Hao , Wan Yu , Du Hongbo , Xiao Yi , Yang Shengfa
Published: December 2021

As an important transportation link between eastern and western economic zones of China, the Yangtze River waterway has been globally ranked first in relation to freight volume since 2010, and the density of ship traffic has also increased significantly. However, the inland navigation system has been increasingly threatened by traffic congestion, which is more serious in the controlled waterways of the upper Yangtze River. In this study, the distribution laws of ship traffic flow and service time in the controlled waterway were analyzed, indicating that the traffic flow obeys the Poisson distribution, and the service time obeys a negative exponential distribution. Thereafter, by simplifying the queuing processes and rules, the M/M/1 queuing service model was established to calculate ship queuing indicators in a controlled waterway. It was found that the ship queuing indicators varied greatly among different controlled waterways. Compared with downstream ships, upstream ships usually had longer queuing lengths and times, which were also more affected by the increasing number of ship arrivals and service times. Consequently, a dimensionless loss coefficient was proposed to quantify the influence of the controlled waterway on the navigation capacity. As the service time and number of ships increased, the loss coefficient also increased. The results of this study could provide references for understanding the ship queuing problem, and thereby the assessment of navigation capacity and anchorage constructions in a controlled waterway.
Rigid and film bioplastics degradation under suboptimal composting conditions: A kinetic study
Authors: Ruggero Federica , Belardi Sara , Carretti Emiliano , Lotti Tommaso , Lubello Claudio , Gori Riccardo
Published: December 2021

The present research investigates the degradation rate of bioplastics under various composting conditions, including suboptimal ones. Lab-scale tests were carried out setting three variables: temperature (37°C–58°C), humidity (30%–60%) and duration of the thermophilic and the maturation phases (15–60 days). The composting tests were carried out following modified guideline ISO 20200:2015 and lasted for 60 days. Bioplastics in the synthetic waste matrix consisted of Mater-Bi® film biobags and PLA rigid teaspoons. A kinetic study was performed, resulting in faster degradation rates for film bioplastics (first-order kinetics with k = 0.0850–0.1663 d−1) than for rigid (0.0018–0.0136 d−1). Moreover, film bioplastics reached a complete degradation within the 60 days of the test. Concerning the rigid products, 90% degradation would be achieved in 2–3 years for mesophilic conditions. Finally, in the undersieve of 0.5 mm some microplastics were identified with the ImageJ software, mainly relatable to rigid (PLA) bioplastics. Overall, the results disclosed that the combination of mesophilic temperatures and absence of moistening slowed down both the degradation and the disintegration process of bioplastics.
Playing by the Rules? An Investigation of the Relationship Between Social Norms and Adolescents’ Hate Speech Perpetration in Schools
Authors: Wachs Sebastian , Wettstein Alexander , Bilz Ludwig , Krause Norman , Ballaschk Cindy , Kansok-Dusche Julia , Wright Michelle F.
Published: December 2021

Hate speech is often discussed and investigated as an online phenomenon, while hate speech among adolescents in the real world (e.g., in schools) has rarely been researched. Consequently, not much is known about potential interpersonal correlates and theoretical frameworks that might help us better understand why adolescents engage in hate speech in offline environments. To add to the literature, this study investigates hate speech perpetration among young people by utilizing the Social Cognitive Theory; more specifically, the association between witnessing and perpetrating hate speech in schools, and whether this relation is weakened or strengthened by anti-hate speech injunctive norms and deviant peer pressure. The sample consists of 1719 young people (45.1% boys, 53.6% girls, 1.3% gender diverse) between 11 and 18 years old ( Mage = 13.96; SD = .98) from 22 schools in Switzerland. Self-report questionnaires were administered to measure hate speech involvement and adolescents’ perception of social norms (i.e., anti-hate speech injunctive norms and deviant peer pressure). Multilevel regression analyses revealed that witnessing and perpetrating hate speech were positively associated. Moreover, injunctive anti-hate speech norms were negatively related and deviant peer pressure positively related to hate speech perpetration. Finally, increasing levels of injunctive anti-hate speech norms weakened the relation between witnessing and perpetrating hate speech, whereas higher levels of deviant peer pressure strengthened this association. The findings demonstrate that the Social Cognitive Theory is a useful framework for understanding hate speech perpetration in schools. The results also highlight the importance of taking into account social norms and interpersonal relationships (e.g., within the class) when designing anti-hate speech prevention programs and not focusing solely on intrapersonal factors.
Sexual and Gender Identity-Based Microaggressions: Differences by Sexual and Gender Identity, and Sex Assigned at Birth Among Dutch Youth
Authors: Kiekens Wouter J. , Kaufman Tessa M. L. , Baams Laura
Published: December 2021

Research describes several sexual and gender identity-based microaggressions that sexual and gender minority (SGM) people might experience. We aimed to examine the occurrence of different sexual and gender identity-based microaggressions among SGM youth and to identify differences by sexual and gender identity, and sex assigned at birth. Open-ended questions about daily experiences were coded for 16 types of sexual and gender identity-based microaggressions in two daily diary studies among Dutch SGM youth (Study 1: N = 90, M age = 17.64 SD = 1.78; Study 2: N = 393, M age = 18.36 SD = 2.65). Several types of microaggressions were identified, and there was sizable variability in the reported frequency. Overall, lesbian women and bisexual youth were less likely to report microaggressions than gay youth. Bisexual youth were less likely to report use of heterosexist or transphobic terminology than gay youth and youth assigned male at birth were less likely to report invalidation of LGBTQ identity than youth assigned female at birth. Last, gender minority youth were more likely to report familial microaggressions, invalidation of LGBTQ identity, and threatening behaviors than cisgender youth. Overall, this study provides empirical support using mixed qualitative and quantitative methods for theorized typologies of microaggressions among Dutch SGM youth.
Youth of Color Social Movements for Racial Justice: The Politics of Interrogating the School-to-Prison Pipeline
Authors: Welton Anjalé D. , Harris Tiffany Octavia
Published: December 2021

Youth social movements for racial justice, especially against police violence, are on the rise. And this broader policy landscape is reflective of how youth are addressing racism in policing in their local context. Therefore, by drawing upon scholarship related to Black Radicalism, activism, and social movements, this study examines how youth of color activists are fighting against the overpolicing of their schools and communities in two specific contexts: Wake County, North Carolina and Chicago, Illinois. This study demonstrates how context shapes youth of color social movement building, that youth are strategic in how they employ activism, and ultimately adults can either impede or help advance youth’s demands for justice.
Making waves: A cross-study analysis of young people’s participation arenas in Scotland’s schools
Authors: Cross Beth , Mannion Greg , Shanks Rachel
Published: December 2021

This article compares democratic participation research in Scottish schools over a 10-year period. The comparison reveals how ‘organic’ aspects of decision-making arise in arenas of school activity. We argue that research heretofore has focussed on pupil councils to the exclusion of more everyday embedded and embodied choices. Primary researchers in the studies revisited data, drawing on their respective theoretical frameworks, to consider how new materialist perspectives offer ways to attend differently to the recursive, relational dynamics of participation.
From STEM to PAVAM: A unified arts strategy for innovation, industrial and regional policy
Authors: Etzkowitz Henry , Kehl Leila Maria , Schofield Tatiana
Published: December 2021

The potential of the arts and sciences for economic and social development is under conceptualized. However, the recent development of STEM (science, technology, engineering, and mathematics), justifying increased support for training in the sciences, shows a parallel pathway forward for the arts. The arts are increasingly relevant to the economy, amenable to policy influence as well as an area of human activity in their own right. The authors posit a unified arts framework: PAVAM (performing arts, visual arts, and music), complementing STEM as the basis for a strategy of arts-based interdisciplinary “industrial” policy making. The growing salience of the arts as an industrial sector in the UK and USA is shown. By identifying sources and pathways of value creation from the arts, clear entry points for policy action become identifiable to promote innovation, entrepreneurship, and economic development. Comparative case studies suggest a typology of the arts’ potential as sources of creativity, innovation, and regional economic development.
Synthesis of novel poly(arylene ether amide) containing aliphatic ring for optical property
Authors: Luo Shajie , Dai Junyu , Ji Xiaoyu , Chen Jialin , Jiang Yue , Li Sixin , Mao Tianzi , Fan Xiaoxia
Published: December 2021

In this work, the monomer N, N′-bis(4-fluorobenzamide)dicyclohexyl methane (BFDCM) was synthesized successfully by 4-fluorobenzoylchloride and 4,4′-diaminodicyclohexylmethane through interfacial reaction, and then the monomer BFDCM and 1,4-benzenediol (HQ) or 4.4′-biphenol (BH) were used to prepare the novel poly(arylene ether amide) (HQ-BFDCM and BH-BFDCM) containing an aliphatic ring in the main chain by nucleophilic substitution in NMP solution. These two polymers exhibited the inherent viscosities ranging from 0.828 to 1.044 dL g−1, high glass-transition temperatures (Tg) of 214.1–235.0 °C, and weight-loss temperature (T5%) of 425.2–441.3 °C. The polymers HQ-BFDCM and BH-BFDCM could completely or partly dissolve in some polar solutions, such as NMP, DMF, and so on, and they showed moderate corrosion resistance. Additionally, the obtained polymers HQ-BFDCM and BH-BFDCM exhibited good optical property, and the optical transmittances of HQ-BFDCM and BH-BFDCM were 74% and 80% at 450 nm, respectively, which showed that they could be applied to the heat-resistant optical films.
G-computation and doubly robust standardisation for continuous-time data: A comparison with inverse probability weighting
Authors: Chatton Arthur , Borgne Florent Le , Leyrat Clémence , Foucher Yohann
Published: December 2021

In time-to-event settings, g-computation and doubly robust estimators are based on discrete-time data. However, many biological processes are evolving continuously over time. In this paper, we extend the g-computation and the doubly robust standardisation procedures to a continuous-time context. We compare their performance to the well-known inverse-probability-weighting estimator for the estimation of the hazard ratio and restricted mean survival times difference, using a simulation study. Under a correct model specification, all methods are unbiased, but g-computation and the doubly robust standardisation are more efficient than inverse-probability-weighting. We also analyse two real-world datasets to illustrate the practical implementation of these approaches. We have updated the R package RISCA to facilitate the use of these methods and their dissemination.
The Embodiment of Traditional Partería in the Colombian Pacific Region
Authors: Suárez-Baquero Daniel F. M. , Champion Jane D.
Published: December 2021

A Traditional Partera refers to a woman who assists, by traditional practices, women during gestation, birth, and reproductive life, aside of the formal health care system. Their practice, Traditional Partería, is considered a key ancestral cultural component in marginalized communities in Colombia. A comprehensive description of the essence of Colombian Traditional Partería is currently missing, and this practice is facing the loss of its body of knowledge. Here, we describe the essence of being a Colombian Traditional Partera. Eight Traditional Parteras participated in phenomenological interviews and body maps focused on their embodied conscious experience of being a Traditional Partera in Colombia. Seventeen general meaning units were identified and grouped in three embodied components (Head, Heart, and Hands) related to practice, knowledge, feelings, perceptions, context, and culture. We discuss philosophical reflections and implications of knowing other’s world perspectives, describing a sensitive triad central in the Traditional Partería practice.
On the Meaning of the “P Factor” in Symmetrical Bifactor Models of Psychopathology: Recommendations for Future Research From the Bifactor-(S−1) Perspective
Authors: Heinrich Manuel , Geiser Christian , Zagorscak Pavle , Burns G. Leonard , Bohn Johannes , Becker Stephen P. , Eid Michael , Beauchaine Theodore P. , Knaevelsrud Christine
Published: December 2021

Symmetrical bifactor models are frequently applied to diverse symptoms of psychopathology to identify a general P factor. This factor is assumed to mark shared liability across all psychopathology dimensions and mental disorders. Despite their popularity, however, symmetrical bifactor models of P often yield anomalous results, including but not limited to nonsignificant or negative specific factor variances and nonsignificant or negative factor loadings. To date, these anomalies have often been treated as nuisances to be explained away. In this article, we demonstrate why these anomalies alter the substantive meaning of P such that it (a) does not reflect general liability to psychopathology and (b) differs in meaning across studies. We then describe an alternative modeling framework, the bifactor-( S−1) approach. This method avoids anomalous results, provides a framework for explaining unexpected findings in published symmetrical bifactor studies, and yields a well-defined general factor that can be compared across studies when researchers hypothesize what construct they consider “transdiagnostically meaningful” and measure it directly. We present an empirical example to illustrate these points and provide concrete recommendations to help researchers decide for or against specific variants of bifactor structure.
Medical students’ psychological and behavioral responses to the COVID-19 pandemic: A descriptive phenomenological study
Authors: Mortazavi Forough , Ghardashi Fatemeh
Published: December 2021

On February 19, 2020, the Iranian government officially confirmed the first deaths due to COVID-19 and within a week, all universities were closed. The purpose of this study is to explore Iranian medical students' psychological and behavioral responses to the COVID-19 pandemic. This descriptive phenomenological study was conducted on 52 medical students. Data were collected using a purposive sampling method by means of synchronous virtual focus group discussions which were conducted using the WhatsApp messaging application. Data were analyzed using the MAXQDA software version 2020. Data analysis resulted in the emergence of three categories consisting of psychological responses to the pandemic and the behavioral and psychological responses to the quarantine. Most of the extracted themes are related to students’ psychological reactions to the pandemic. During the quarantine period, students suffered from uncertainty, experienced boredom, worried about delay in their graduation, and were concerned about losing employment opportunities. Medical students must be prepared for crisis situations like the present pandemic. We recommend that online courses and training programs be developed with the aim of offsetting the negative effects of university closure on students’ education and skill training.
Exploring the ecotourism service experience framework using the dimensions of motivation, expectation and ecotourism experience
Authors: Chan Jennifer Kim Lian , Saikim Fiffy Hanisdah
Published: December 2021

This study explores the ecotourism service experience framework by analysing ecotourists’ motivations and expectations, as well as the dimensions of ecotourism experiences. A total of 51 ecotourists were interviewed in person at ecotourist lodges in Lower Kinabatangan, Malaysia. Interview responses were analysed using thematic analysis, and a multi-data triangulation was carried out to identify key service experience dimensions guided by the co-creation concept. Findings reveal that motivations and expectations of ecotourists are connected to the dimensions of ecotourism experiences. Several findings reveal that key dimensions include ‘wildlife’, ‘nature/environment’ and ‘experiences driven from ecotourism activities’ (such as riverboat cruises and jungle trekking). Based on the interviews, these dimensions can be further interpreted and conceptualised as ‘education’, ‘aesthetic’, ‘escape’ and ‘entertainment’, similar to the four realms of experience in the experience economy model by Pine and Gilmore (1998 , 1999) . Hence, an ecotourism service experience framework, comprising both tangible and intangible elements, is proposed as a sound and practical approach to understanding ecotourism service experiences. This study offers empirical evidence and an innovative approach by identifying the ecotourism service experience dimensions and exploring a relevant framework, which was previously neglected. Ecotourism operators should utilise the four identified service experience dimensions to stage unique ecotourism experiences and enhance destination attractiveness and competitiveness. Experiential marketing can capitalise on these dimensions as innovative selling points and attract ecotourists, thus providing practical value in marketing ecotourism destinations.
Does Sleeve Gastrectomy Worsen Gastroesophageal Reflux Disease in Obese Patients? A Prospective Study
Authors: Balla Andrea , Palmieri Livia , Corallino Diletta , Meoli Francesca , Carlotta Sacchi Maria , Ribichini Emanuela , Pronio Annamaria , Badiali Danilo , Paganini Alessandro M.
Published: December 2021

Background

To evaluate the impact of laparoscopic sleeve gastrectomy (LSG) and gastric bypass (LGB) on gastroesophageal reflux disease (GERD).

Methods

GERD was evaluated by the Modified Italian Gastroesophageal reflux disease—Health-Related Quality of Life (MI-GERD-HRQL) questionnaire, pH-manometry, endoscopy, and Rx-esophagogram, before and 12 months after surgery. Based on these exams, patients without GERD underwent LSG, and patients with GERD underwent LGB.

Results

Thirteen and six patients underwent LSG and LGB, respectively. After LSG, the only statistically significant difference observed at pH-manometry was the median DeMeester score, from 5.7 to 22.7 (P = .0026). De novo GERD occurred in 6 patients (46.2%), with erosive esophagitis in one. The median MI-GERD-HRQL score improved from 3 to 0. Overall, nine patients underwent LGB, but three were lost to follow-up. Preoperative pH-manometry changed the surgical indication from LSG to LGB in 7 out of 9 patients (77.8%). Six patients who underwent LGB completed the study, and at pH-manometry, statistically significant differences were observed in the percentage of total acid exposure time, with the number of reflux episodes lasting >5 minutes and DeMeester score (P = .009). The median MI-GERD-HRQL score improved from 6.5 to 0. Statistically significant differences were not observed at endoscopy and Rx-esophagogram findings in both groups.

Conclusions

LSG has a negative impact on GERD, even in patients without preoperative GERD. LGB confirmed to be the intervention of choice in patients with GERD. Preoperative pH-manometry may identify patients with silent GERD, to candidate them to LGB rather than LSG. pH-manometry should be used more liberally to establish the correct surgical indication on objective grounds.
Laparoscopic-Guided Ropivacaine Trocar-Site Infiltration Can Improve Post-Operative Pain Control after Laparoscopic Adrenalectomy
Authors: Cavallaro Giuseppe , Polistena Andrea , Petramala Luigi , Gazzanelli Sergio , Crocetti Daniele , Iorio Olga , Iossa Angelo , Fiori Enrico , Bracale Umberto , De Toma Giorgio , Letizia Claudio
Published: December 2021

Background

There is no consensus on pain control in patients undergoing laparoscopy; nowadays, conventional therapy may be improved by transversus abdominis plane block. The aim of this evaluation is to investigate the role of laparoscopic-assisted trocar-site ropivacaine infiltration during adrenalectomy in pain control

Methods

This is a retrospective evaluation of a prospectively maintained database including patients undergoing adrenalectomy. Patients were divided into 2 groups: Group A patients received laparoscopic-assisted trocar-site infiltration of 7.5 mg/mL ropivacaine and Group B patients did not receive any infiltration. All patients received a 24-hour infusion of 20 mg morphine; pain was checked at 6, 24, and 48 hours after surgery by Visual Analogue Scale (VAS) score. A rescue analgesia by was given if VAS score was > 4 or on patient request.

Results

No differences in operative time, complications, and post-operative stay and no complications related to trocar-site infiltration were found. 6-hour and 48-hour VAS scores were not found to be significantly different between groups, even if a slight decrease in VAS score in Group A was reported. Group A showed significant reduction in VAS score at 24 hours (2.44 +/− .41 vs 3.01 +/− .78, P < .005) and in the number of patients requiring further analgesic drugs administration (40.6% vs 57.8%, P < .005)

Conclusions

Laparoscopic-guided trocar-site ropivacaine infiltration can be considered safe and effective in the management of post-operative pain and in the reduction of analgesic need in patients undergoing laparoscopic adrenalectomy. The retrospective nature of the study and the lack of a consistent series of patients require further evaluations.
Health and Access to Gender-Affirming Care During COVID-19: Experiences of transmasculine individuals and men assigned female sex at birth
Authors: D’Angelo Alexa B. , Argenio Kira , Westmoreland Drew A. , Appenroth Max N. , Grov Christian
Published: December 2021

Since the onset of the COVID-19 pandemic, global research has suggested that the pandemic has negatively affected lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) populations, including by limiting health care access. There is little research on the impact of COVID-19 among transmasculine persons and men assigned female sex at birth (AFAB) in the United States, who face unique health care challenges outside of the pandemic context. Between May and June of 2020, 20 transmasculine individuals and AFAB men who have sex with men participated in semi-structured interviews about their experiences during the early months of the COVID-19 pandemic. Participants were asked how the pandemic affected their access to health care, overall health, and well-being. Interviews were analyzed using an inductive, thematic approach. Participants reported reduced access to in-person health care, which in some cases meant overdue hormone-related bloodwork and unmet health care needs. Most participants reported that they were able to maintain their testosterone regimen, although some were concerned about future access, citing anxiety about potential shortages. Three participants reported canceled or deferred gender-affirming procedures, which they were uncertain would be rescheduled soon. Participants generally reported that the expansion of telehealth improved access to care, particularly for gender-affirming psychotherapy that was otherwise inaccessible or inconvenient prior to the pandemic. Other salient themes include the pandemic’s impact on health behaviors and daily routines. Although the COVID-19 pandemic created new challenges for maintaining health, it also expanded access to gender-affirming health care, largely through the expansion of telehealth. Our findings provide new insights for supporting the health of transmasculine individuals and AFAB men.
Systematic Reviews of Systematic Quantitative, Qualitative, and Mixed Studies Reviews in Healthcare Research: How to Assess the Methodological Quality of Included Reviews?
Authors: Rouleau Geneviève , Hong Quan Nha , Kaur Navdeep , Gagnon Marie‐Pierre , Côté José , Bouix-Picasso Julien , Pluye Pierre
Published: December 2021

Conducting a review of systematic reviews can be challenging, especially when combining systematic quantitative, qualitative and mixed studies reviews. In this methodological discussion paper, we propose (a) a typology for categorizing various types of review of reviews and (b) an exploration of criteria pertaining to three existing critical appraisal tools (ROBIS, AMSTAR 2, and MMSR) to identify those that could be adapted for qualitative and mixed studies reviews. Further work has to be done to develop methodological guidance in conducting, interpreting, and reporting reviews of reviews that combine qualitative and quantitative data.
Transcultural brand communication: Disneyland’s social media posts from USA to Hong Kong and Shanghai
Authors: Feng Wei , Wu Doreen D , Yi Li
Published: December 2021

The paper attends to the increasingly heated debate on the local, the global versus the glocal approaches in transcultural brand communication with an examination of how Disneyland performs emotional branding on social media across US to Hong Kong and Shanghai. Integrating insights from brand communication with linguistics, the present study develops a framework to examine how Disneyland builds emotional attachment of the public to the brand via brand personality appeals and use of interactional features. It is found that on a global-local continuum, brand personality traits exhibit strong globalization propensity whereas interactional features demonstrate strong localization tendency in Hong Kong and Shanghai. Variations also exist in the means of emotional branding between Hong Kong and Shanghai. Finally, the paper provides an account for the differences between Hong Kong and Shanghai and concludes that neither the local approach nor the global approach but the glocal approach can tackle the challenge of transcultural brand communication and that future studies in this area should be oriented further to uncovering the global-local nexus in the process.
Down-regulation of hsa_circ_0045474 induces macrophage autophagy in tuberculosis via miR-582-5p/TNKS2 axis
Authors: Wu Min , Liu Zhibin , Zhang Shaojun
Published: December 2021

Macrophage autophagy plays a major role in the control and elimination of invading Mycobacterium tuberculosis. However, the function and mechanism of circRNA on macrophage autophagy in tuberculosis remain unclear. Therefore, this study aimed to explore the role of circRNA underlying macrophage autophagy in tuberculosis. Quantitative real-time polymerase chain reaction was used to detect the expression of hsa_circ_0045474, miR-582-5p and TNKS2. Autophagy was detected by LC3B immunofluorescence and transmission electron microscopy. Dual-luciferase reporter assays were used to detect the relationship of miR-582-5p and hsa_circ_0045474 or TNKS2. Western blot was used to detect the expression of LC3-І and LC3-ІІ. The results showed that hsa_circ_0045474 was down-regulated in monocytes from patients with tuberculosis and induced autophagy in macrophages. hsa_circ_0045474 sponged miR-582-5p and negatively regulated miR-582-5p expression. Overexpression of miR-582-5p affected by hsa_circ_0045474 induced autophagy in macrophages. TNKS2 served as a target of miR-582-5p and down-regulation of TNKS2 induced autophagy in macrophages regulated by miR-582-5p. In conclusion, our results demonstrated that hsa_circ_0045474 down-regulation induced macrophage autophagy in tuberculosis via miR-582-5p/ TNKS2 axis, implying a novel strategy to treat the occurrence of active pulmonary tuberculosis caused by immune escape of M. tuberculosis.
Using an Online Disturbance Rejection and Anticipation System to Reduce Hyperglycemia in a Fully Closed-Loop Artificial Pancreas System
Authors: Corbett John P. , Garcia-Tirado Jose , Colmegna Patricio , Diaz Castaneda Jenny L. , Breton Marc D.
Published: December 2021

Introduction:

Hyperglycemia following meals is a recurring challenge for people with type 1 diabetes, and even the most advanced available automated systems currently require manual input of carbohydrate amounts. To progress toward fully automated systems, we present a novel control system that can automatically deliver priming boluses and/or anticipate eating behaviors to improve postprandial full closed-loop control.

Methods:

A model predictive control (MPC) system was enhanced by an automated bolus system reacting to early glucose rise and/or a multistage MPC (MS-MPC) framework to anticipate historical patterns. Priming was achieved by detecting large glycemic disturbances, such as meals, and delivering a fraction of the patient’s total daily insulin (TDI) modulated by the disturbance’s likelihood (bolus priming system [BPS]). In the anticipatory module, glycemic disturbance profiles were generated from historical data using clustering to group days with similar behaviors; the probability of each cluster is then evaluated at every controller step and informs the MS-MPC framework to anticipate each profile. We tested four configurations: MPC, MPC + BPS, MS-MPC, and MS-MPC + BPS in simulation to contrast the effect of each controller module.

Results:

Postprandial time in range was highest for MS-MPC + BPS: 60.73 ± 25.39%, but improved with each module: MPC + BPS: 56.95±25.83 and MS-MPC: 54.83 ± 26.00%, compared with MPC: 51.79 ± 26.12%. Exposure to hypoglycemia was maintained for all controllers (time below 70 mg/dL <0.5%), and improvement came primarily from a reduction in postprandial time above range (MS-MPC + BPS: 39.10 ± 25.32%, MPC + BPS: 42.99 ± 25.81%, MS-MPC: 45.09 ± 25.96%, MPC: 48.18 ± 26.09%).

Conclusions:

The BPS and anticipatory disturbance profiles improved blood glucose control and were most efficient when combined.
Treating Full Depth Cartilage Defects with Intraosseous Infiltration of Plasma Rich in Growth Factors: An Experimental Study in Rabbits
Authors: Torres-Torrillas Marta , Damiá Elena , Cerón José J. , Carrillo José M. , Peláez Pau , Miguel Laura , Del Romero Ayla , Rubio Mónica , Sopena Joaquín J.
Published: December 2021

Objective

Intraarticular (IA) administration of platelet-rich plasma (PRP) has been proposed as a new strategy to halt osteoarthritis (OA) progression. In patients with severe OA, its potential is limited because it is unable to reach the subchondral bone, so a new strategy is needed, and intraosseous (IO) infiltration has been suggested. The purpose is to assess the impact of IA together with IO infiltration of plasma rich in growth factors (PRGF) in serum hyaluronic acid (HA) and type II collagen cleavage neoepitope (C2C) levels.

Design

A total of 32 rabbits were included in the study and randomly divided into 2 groups: control and treatment. A 4-mm chondral defect was created in the medial femoral condyle and IA followed by IO infiltration were performed. Serum C2C and HA levels were measured using enzyme-linked immunosorbent assay (ELISA) tests before infiltration and 28, 56, and 84 days post-infiltration.

Results

Significant lower C2C serum levels were obtained in treatment group (IA + IO infiltration of PRGF) at 84 days post-infiltration than in control group (IA infiltration of PRGF + IO infiltration of saline solution), while no significant differences between groups were reported at any other study times. Regarding HA, at 56 days post-infiltration, greater significant levels were seen in the treatment group. However, at 84 days post-infiltration, no significant differences were obtained, although lower levels were reported in the treatment group.

Conclusions

Despite inconclusive, the results suggest that the combination of IA and IO infiltration with PRGF may enhance cartilage and subchondral bone regeneration, but further studies are needed.
Longitudinal cross-national perspectives on female desistance: The role of social and emotional capitals in female narrations of maintaining change
Authors: Österman Linnéa Anna Margareta
Published: December 2021

This paper offers a unique longitudinal qualitative perspective on a group of women maintaining desisting pathways in two different European countries: Sweden and England. Applying a social and emotional capital framework, with particular attention given to the friend and family connection, the paper aims to unveil how a resource perspective can enable a more nuanced view of the role of overlapping female identities and network management, the paradoxes of trust within these, and experiences of stigmatisation and emotional expenditure in female desistance narratives across time and space. The cross-national perspective brings to light the importance of situating the desistance process in the particular context in which it plays out, making visible how narratives may be structurally mediated by wider social, cultural, penal – and gendered – conditions and processes. These insights may, in turn, contribute to the identification of desistance support that have the potential to make female desistance paths less socially and emotionally costly.