bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic incentive in enhancing community waste separation and collection: A panel data analysis in China
Authors: Sun Jie , Asari Misuzu
Published: June 2023

While incentive mechanisms have been proven to motivate residents to separate their waste, empirical research is still needed to determine whether this separation behaviour could be maintained over time. The main objective of this paper is to investigate waste separation management activities in the city of Dongying, China, as a case study to clarify how local community citizens’ waste separation participation and recycling activities change over time cross-sectionally under the influence of an economic incentive mechanism – PS. This study used least square dummy variable analysis to investigate local waste separation behaviour in 98 communities over 22 months. Results showed that community resident waste participation and recycling behaviour tend to grow in the early stages and gradually show saturation without growth in the middle and late stages. This result implies limitations to the incentive mechanism, such that it could only motivate a part of residents to participate in waste separation; for those unaffected by financial incentives, it was suggested that educational or compulsory means be used to make them separate their waste.
Market assessment to improve fibre recycling within the EU textile sector
Authors: Boschmeier Emanuel , Ipsmiller Wolfgang , Bartl Andreas
Published: June 2023

Clothing is one of the primary human needs, but today’s business models turned most apparel into a disposable product. As a matter of fact, the rising demand results in the production of Millions of tons of textile waste every year which is either landfilled, incinerated or exported, with only small amounts being recycled. One promising recycling attempt towards a circular economy in the apparel sector is fibre-to-fibre recycling, where end-of-use clothes serve as input material for the production of new fibres and, eventually, new apparel. In this work, together with fashion brands and a textile research organisation, a mapping of the market situation and the economic boundary conditions regarding textile fibre recycling are presented. Generally, fibre-to-fibre recycling technologies need more public attention and intensive research, and development is necessary as well as legislative instruments that encourage interest in textile recycling. The market situation for recycled fibres is promising and will tend to an increased demand in recycled fibres in the future. Mandatory certification ensures a sustainable product and fast fashion should be held back. Textile waste landfilling, export regulations as well as sustainable lifestyle education shall be considered by EU legislature to ensure that recycling materials are actually used and create a market pull for textile waste back into the industry.
Investigating Arts Education Effects on School Engagement and Climate
Authors: Bowen Daniel H. , Kisida Brian
Published: June 2023

There is a renewed focus on what constitutes a well-rounded education, as well as a growing interest in broader indicators of educational success, including social and emotional development and school engagement. However, identifying educational practices that improve such outcomes has proven elusive. We explore the role of arts education on a broad range of educational outcomes using administrative and survey data from Boston’s public schools. We find that students receiving the arts in school attend more, are more engaged, and their parents and teachers are more likely to participate and be engaged at school, with larger effects for students with individualized education plans, students with lower standardized test scores, and students with a history of chronic absenteeism. These findings call attention to the pivotal role of the arts in providing students with socially and emotionally supportive learning environments that enhance relationships between students and schools.
Effect of projectile’s nose shape on ballistic performance of ceramic/composite armour: A numerical study
Authors: Biswas Krishna , Datta Debasis
Published: June 2023

In the present study, finite element analysis were carried out to investigate the ballistic performance of Al2O3-Kevlar 29/epoxy armour system impacted by a 4340 steel projectile. The perforation capacity of a 10 mm thick target was studied against a blunt, ogive, and conical shaped projectile with a fixed diameter and mass of 7.56 mm and 10.7 gm, respectively. The simulations were carried out in Ansys/Autodyn by considering the projectile as a deformable body. The variation of the ballistic limit velocity (BLV) and energy, progressive damage of the target, and projectile deformation were studied comprehensively. It was found that the nose configuration of the projectile significantly influence the target’s ballistic performance. The perforation capacity of the blunt projectile was lower than the ogive and conical shape in all the velocity regimes. At higher impact velocity ( Vi >600 m/s), the target’s resistance was better against the ogive projectile than that of the sharp conical projectile. Interestingly, this phenomenon got reversed when the incident velocity nears the ballistic limit. Also, from the simulation results, it has been possible to obtain the optimum thicknesses of the components for a given total thickness of the armour.
Thinking Beyond COVID-19: How Has the Pandemic Impacted Future Time Horizons?
Authors: Fynes-Clinton Samuel , Addis Donna Rose
Published: June 2023

Older age is reportedly protective against the detrimental psychological impacts of the COVID-19 pandemic, consistent with the theory that reduced future time extension (FTE) leads to prioritization of socioemotional well-being. We investigated whether depression severity and pandemic-related factors (regional severity, threat, social isolation) reduce FTE beyond chronological age and whether these relationships differ between younger and older adults. In May 2020, we recruited 248 adults (younger: 18–43 years, older: 55–80 years) from 13 industrialized nations. Multigroup path analysis found that depression severity was a better predictor of FTE than the reverse association in both age groups, suggesting an affective foreshortening of future time. In both age groups, older age was protective against depression severity, and younger age was associated with heightened vulnerability to the negative impacts of pandemic-related factors. Future research should consider the complex interrelationships between FTE, age, and depression severity and the potential impacts of the broader psychosocial milieu.
The Costs of Paying Overt and Covert Attention Assessed With Pupillometry
Authors: Koevoet Damian , Strauch Christoph , Naber Marnix , der Stigchel Stefan Van
Published: June 2023

Attention can be shifted with or without an accompanying saccade (i.e., overtly or covertly, respectively). Thus far, it is unknown how cognitively costly these shifts are, yet such quantification is necessary to understand how and when attention is deployed overtly or covertly. In our first experiment ( N = 24 adults), we used pupillometry to show that shifting attention overtly is more costly than shifting attention covertly, likely because planning saccades is more complex. We pose that these differential costs will, in part, determine whether attention is shifted overtly or covertly in a given context. A subsequent experiment ( N = 24 adults) showed that relatively complex oblique saccades are more costly than relatively simple saccades in horizontal or vertical directions. This provides a possible explanation for the cardinal-direction bias of saccades. The utility of a cost perspective as presented here is vital to furthering our understanding of the multitude of decisions involved in processing and interacting with the external world efficiently.
“Professor Spearman has drawn over-hasty conclusions”: Unravelling psychometrics’ “Copernican Revolution”
Authors: Michell Joel
Published: June 2023

The significance of the dispute between Charles Spearman and Godfrey Thomson over the role of factor analysis in providing unambiguous evidence for Spearman’s two-factor theory has not been recognised for the crucial moment it actually was in the history of psychometrics. Thomson sketched an alternative to Spearman’s theory demonstrating that, factor analysis notwithstanding, there was no need to hypothesise that abilities are quantitative attributes. Spearman was blind to this fact and his stature within the discipline ensured that Thomson’s alternative was subsequently neglected. I argue that Spearman’s blindness was conditioned by his fealty to two idols of the age: the quantitative imperative and the psychometricians’ fallacy, both of which were secured in Spearman’s mind by his failure to fully understand the concept of measurement. Given his influence, Spearman’s blindness to the significance of Thomson’s critique was a cause of psychometrics’ relentless progress to becoming a pathological science.
An Inquiry into Households’ Confidence Levels in Various Institutions in India: A Temporal Assessment from the IHDS
Authors: Mishra Udaya Shankar , Mallick Hrushikesh , Padhi Balakrushna
Published: June 2023

This study attempts to assess the variations in households’ confidence levels in various sociopolitical institutions with varying socioeconomic and cultural characteristics across major Indian states based on two rounds of the India Human Development Survey ( IHDS-I, 2004–2005 ; IHDS-II, 2011–2012 ). It traces the presence of a lower confidence level of households in governance institutions compared with other institutions, implying a deficit of households’ confidence in this component against the overall confidence score, which marginally improves over time. The states of Jammu and Kashmir and Mizoram have a lower level of confidence score in governance and justice compared to other states. On analysing the socioeconomic determinants of households’ confidence in two rounds of the IHDS separately, this study observes that regional and economic factors are more significant in shaping the confidence levels of households than any other socioeconomic attributes.
A Unique Case Report of Meningeal Hamartoma Within Alveolar Cleft
Authors: Eaton Kelsey , Rozzelle Arlene
Published: June 2023

This case report demonstrates a rare finding of a pediatric patient with Morning Glory anomaly and Moyamoya Disease with a palatal meningeal hamartoma discovered as a mass within a previously repaired incomplete cleft of the alveolus. Oral meningeal hamartomas are exceedingly rare with only two palatal cases described and none within a cleft palate or alveolus. These findings prompt a review of oral hamartomas with meningeal subclassification. Further discussion describes the relationship of the proposed origins of meningeal hamartomas within the setting of cleft palate development.
Comparison of the Efficacy and Safety of Rivaroxaban and Low Molecular Heparin in Preventing Venous Thromboembolism in Inpatient Cancer Patients
Authors: Wu Shuyi , Guan Chengfu , Chang Sijie , Wang Chunhua , Zhang Jinhua
Published: June 2023

Background:

There are few studies on using rivaroxaban and low molecular heparin (LMWH) to prevent venous thromboembolism (VTE) in hospitalized cancer patients.

Objective:

We conducted a retrospective study to evaluate the efficacy and safety of rivaroxaban versus LMWH for the primary prevention of VTE in inpatient cancer patients.

Methods:

Information on patients was collected through 6-month follow-up and medical record inquiries. Clinical outcomes included VTE, total bleeding, thrombosis, major bleeding, minor bleeding, all-cause death, and a composite endpoint of bleeding, thrombosis, and death.

Results:

A total of 602 hospitalized cancer patients were included in this study. During 6 months of follow-up, there were 26 VTE events (8.6%), 42 total bleeding events (7.0%), 62 all-cause deaths (10.3%), and 140 composite endpoints (23.3%). After adjusting for various confounding factors, there were no significant differences between the rivaroxaban and LMWH for VTE events (OR = 0.851, 95% CI [0.387-1.872], P=0.688), total bleeding (OR = 1.690, 95% CI [0.768-3.719], P = 0.192], thrombosis events (OR = 0.919, 95% CI [0.520-1.624], P = 0.772], major bleeding (OR = 0.276, 95% CI [0.037-2.059], P = 0.209), all-cause death (OR = 0.994, 95% CI [0.492-2.009], P = 0.987), and composite endpoints (OR = 0.994, 95% CI [0.492-2.009], P = 0.987), while minor bleeding (OR = 3.661 95% CI [1.000-7.083], P = 0.050) was significantly higher in the rivaroxaban than in the LMWH.

Conclusions and Relevance:

In thromboprophylaxis in inpatient cancer patients, rivaroxaban has a similar rate of VTE and bleeding events as LMWH. Our results may provide a reference for the clinical use of rivaroxaban to prevent VTE in hospitalized cancer patients.
Fumarate Hydratase-Deficient Leiomyoma of the Uterine Corpus: Comparative Morphologic Analysis of Protein-Deficient Tumors With and Without Pathogenic Germline Fumarate Hydratase Gene Mutations
Authors: Shi Wangpan , Liu Yu , Aisagbonhi Omonigho , Roma Andres A. , Hasteh Farnaz , Zare Somaye Y. , Fadare Oluwole
Published: June 2023

Deficiency of fumarate hydratase (FH) protein expression in uterine corpus leiomyomas may be attributable to either germline or somatic mutations of the FH gene, the former being definitional for the hereditary leiomyomatosis and renal cell cancer syndrome. The authors assess whether, using previously reported FH-associated morphologic features, FH protein-deficient uterine corpus leiomyomas associated with a pathogenic germline mutations of the FH gene (group 1) are distinguishable from FH protein-deficient uterine corpus leiomyomas without such mutations (and whose FH protein loss is presumed to be attributable to somatic/epigenetic inactivation or other unknown phenomena: group 2). Groups 1 and 2 were compared regarding a variety of clinicopathologic features, including 7 core “FH-associated” tumoral morphologic features: staghorn vasculature; alveolar-type edema; bizarre nuclei; chain-like tumor nuclei; hyaline cytoplasmic globules; prominent nucleoli, intranuclear inclusions, and perinucleolar halos; and prominent eosinophilic/fibrillary cytoplasm. Among 2418 patients diagnosed with uterine corpus leiomyoma during the study period, FH-associated morphologic features were reported in 1.5% (37 patients), and FH immunohistochemistry was performed in 29 (1.19%). Fourteen (48.27%) of the 29 patients showed FH protein deficiency by immunohistochemistry. Twelve patients underwent germline testing, of which 8 (66.7%) were classified as group 1 and 4 (33.3%) as group 2. FH protein-deficient tumors were larger (10.44 vs 4.08 cm, P  =  0.01) and associated with younger patients (42.05 vs 47.97, P  =  0.004) than 370 randomly selected uterine leiomyoma controls. Groups 1 and 2 showed no significant differences in patient age and tumor size. In group 1 tumors, the FH-associated morphologic features were generally present diffusely; all group 1 tumors displayed ≥5 FH-associated features, whereas all group 2 tumors displayed <5 FH-associated features (means 6.5  ±  0.53 vs 3.5  ±  1.00, P < 0.001). Notably, eosinophilic/fibrillary cytoplasm and alveolar-type edema were each significantly more prevalent in group 1 tumors than group 2 tumors ( P  =  0.018 for both). No single morphologic feature was found to be completely sensitive and specific in making the distinction between group 1 and 2 tumors. Our findings suggest that groups 1 and 2 are unlikely to be morphologically distinguishable by individual morphologic features. Whether there is a combination of features that can reliably make this distinction is unclear and will require additional studies with larger cohorts.
The Fate of Delayed Unions After Isolated Ankle Fusion
Authors: Lause Gregory E. , Parker Emily B. , Stupay Kristen L. , Chiodo Christopher P. , Bluman Eric M. , Martin Elizabeth A. , Miller Christopher P. , Smith Jeremy T.
Published: June 2023

Background:

Nonunion remains the most common major complication of ankle arthrodesis. Although previous studies have reported delayed union or nonunion rates, few have elaborated on the clinical course of patients experiencing delayed union. In this retrospective cohort study, we sought to understand the trajectory of patients with delayed union by determining the rate of clinical success and failure and whether the extent of fusion on computed tomography scan (CT) was associated with outcomes.

Methods:

Delayed union was defined as incomplete (<75%) fusion on CT between 2 and 6 months postoperatively. Thirty-six patients met the inclusion criterion: isolated tibiotalar arthrodesis with delayed union. Patient-reported outcomes were obtained including patient satisfaction with their fusion. Success was defined as patients who were not revised and reported satisfaction. Failure was defined as patients who required revision or reported being not satisfied. Fusion was assessed by measuring the percentage of osseous bridging across the joint on CT. The extent of fusion was categorized as absent (0%-24%), minimal (25%-49%), or moderate (50%-74%).

Results:

We determined the clinical outcome of 28 (78%) patients with mean follow-up of 5.6 years (range, 1.3-10.2). The majority (71%) of patients failed. On average, CT scans were obtained 4 months after attempted ankle fusion. Patients with minimal or moderate fusion were more likely to succeed clinically than those with “absent” fusion ( P = .040). Of those with absent fusion, 11 of 12 (92%) failed. In patients with minimal or moderate fusion, 9 of 16 (56%) failed.

Conclusion:

We found that 71% of patients with a delayed union at roughly 4 months after ankle fusion required revision or were not satisfied. Patients with less than 25% fusion on CT had an even lower rate of clinical success. These findings may help surgeons in counseling and managing patients experiencing a delayed union after ankle fusion.

Level of Evidence:

Level IV, retrospective cohort study.
Peripapillary vessel density in healthy people, primary open-angle glaucoma, and normal-tension glaucoma
Authors: Arish Mohammad , Momeni-Moghaddam Hamed , Alborzi Moniba , Maleki Alireza , Daneshvar Ramin , Heidari Hamid-Reza
Published: June 2023

Objective

To compare peripapillary vessel density using optical coherence tomography angiography (OCT-A) in eyes of healthy people, primary open-angle glaucoma (POAG), and normal-tension glaucoma (NTG).

Methods

Thirty patients with POAG, 27 patients with NTG, and 29 healthy individuals in the control group were assessed. Capillary vessels in peripapillary retinal nerve fiber layer (RNFL) represented by whole image RPC (radial peripapillary capillary) density in an AngioDisc scan 4.5 × 4.5 mm centered on the optic disc, and ONH morphological variables (disc area, rim area, cup to disc area ratio (CDR)), and average peripapillary RNFL thickness were measured.

Results

Differences in mean RPC, RNFL, disc area, rim area, and CDR between the groups were statistically significant (P < 0.05). The difference in RNFL thickness and rim area was not significant between NTG and healthy groups, while RPC and CDR showed a statistically significant difference between all pairs. The vessel density in the POAG group was 8.25% and 11.7% lower compared to the NTG and healthy groups, respectively; while the mean difference was less (2.97%) for the NTG and healthy group. In the POAG group, 67.2% of the variation in RPC can be explained by a model containing CDR and RNFL thickness, and in normal eyes 38.8% of the changes using a model containing RNFL.

Conclusion

The peripapillary vessel density is reduced in both types of glaucoma. The vessel density in NTG was significantly lower than in the healthy eyes, despite the lack of significant difference in RNFL thickness and neuroretinal rim area between them.
Voices from a pandemic: Understanding how young adults on the autism spectrum use computer-mediated communication
Authors: Ritzman Mitzi J , Subramanian Roma
Published: June 2023

This study investigated the benefits and challenges of computer-mediated communication use among a sample of young adults who identify with the autism spectrum via semistructured interviews. The interviews revealed that participants enjoyed using computer-mediated communication technologies (e.g. Discord, Facebook, Steam, and Zoom) to fulfill various social gratifications, as found in previous research. They appreciated that computer-mediated communication supports neurodiversity in social communication by altering the communication environment in various ways, such as the inclusion of asynchronous options and decreased sensory input. However, it is noteworthy that several mentioned that computer-mediated communication could not replace in-person interaction because it makes deep social connection difficult. Participants also discussed negative attributes of computer-mediated communication such as promoting social comparison and instant gratification. The findings are inherently valuable to learning more about young adults’ use of technology for social communication. In addition, they provide insight into how to integrate technology into the design of interventions to support the development of social connections among individuals who identify with autism.

Lay abstract

This study investigated the benefits and challenges of online communication use among a sample of young adults who identify on the autism spectrum via semi-structured interviews. The interviews revealed that participants enjoyed using online forms of communication for social purposes. Participants appreciated how this type of communication changes the social environment in ways that support neurodiversity, such as the static nature of the communication context and decreased sensory input. However, some participants noted that online communication could not replace inperson interaction because it makes deep social connection difficult. Participants also discussed negative attributes of online communication such as promoting social comparison and instant gratification. The findings are inherently valuable to learning more about young adults’ use of technology for social communication. In addition, this information may provide insight into how to integrate technology into the design of interventions to support the development of social connections among individuals who identify on the autism spectrum.
O Pedrón: time and a stone in northwest Iberia
Authors: Van Dyke Ruth M
Published: June 2023

The granite block of O Pedrón, a recarved Roman altar to Neptune, is an object of veneration at the church of St. James in the town of Padrón along the Camino de Santiago in Galicia, northwest Iberia. I use this enchanting object as a vehicle for thinking about materials, assemblages, and time, engaging with ideas drawn from Bergson, Benjamin, Deleuze, and Husserl. I describe how O Pedrón has participated in events across two millennia: the Roman colonization of Iron Age Iberia; the medieval creation of the cult of Santiago; and a contemporary push for tourism. The concept of assemblage helps us visualize the sensory, emotional, political, and other dimensions connected with the stone. The emergent properties of assemblages move not only forward but backward in time, in a process characterized by Husserl and Gell as protension and retension.
Philosophy, hidden in slogans: The case of relaxedness of Slovenian educational system
Authors: Vezjak Boris
Published: June 2023

Slogans in education are designed to promote educational goals. One of the finest remarkable examples in Slovenian history demonstrates that political slogans can sometimes cover a whole range of social areas and operate as a central ideologeme, through which a very specific political and educational ambition was promoted in an otherwise inarticulate way. The concept of relaxedness (in Slovenian sproščenost), taken from the philosophy of Martin Heidegger and his notion of Die Gelassenheit (releasement), after the victory of the right-wing SDS (Slovenian Democratic Party) party in 2004 is perhaps one of the best illustrations in Slovenian politics of how an ideology, in this case a philosophically inspired one, operated already through the slogan and, above all, through its semantically ambiguous and undefined content. The sproščenost of the Slovenian school, as it was named, became a motto for political change within the educational system as well, where the very essence of it manifested through complete vagueness or, in other words, openness to meaning. In line with the uncommon slogan ‘Za sproščeno Slovenijo’ (‘For a relaxed Slovenia’) the SDS, as the leading opposition party in Slovenian history, not only won the elections for the first time, but also tried to completely transform the social and political space in the country. The Slovenian example shows how a unique political slogan can occupy the whole social field, including education, with its effects, thus creating a specific political and at the same time educational moment in its social action.
“Better Than Any DARE Program”: Qualitative Analysis of Adolescent Reactions to EVALI Television Storylines
Authors: Hoffman Beth L. , Sidani Jaime E. , Miller Elizabeth , Manganello Jennifer A. , Chu Kar-Hai , Felter Elizabeth M. , Burke Jessica G.
Published: June 2023

Introduction. Research suggests that awareness of e-cigarette, or vaping, product-use associated lung injury (EVALI) among adolescents is associated with increased harm perception of e-cigarettes. The depiction of EVALI on three primetime medical dramas offers an opportunity to examine the use of these storylines for tobacco prevention education. Methods. We conducted four focus groups with seventh- and eighth-grade students at an urban middle school. Participants viewed three clips of scenes followed by a facilitated discussion as to the influence of the clips on knowledge and perceptions of e-cigarettes and the use of clips for tobacco prevention education. Two research assistants double-coded notes from the focus groups using a qualitative content analysis approach. Results. Our final sample included 78 adolescents; we obtained self-reported demographic information for 75. The majority of participants were 13 to 14 years of age (82.7%) and identified as cisgender female (52.0%) and Black (52.0%). No participants had knowledge of EVALI prior to viewing the clips. Comments made both during and after watching suggest the clips may have reinforced knowledge and perceptions of harm; participants stated that the clips could be a useful intervention tool. Viewing the clips also generated unprompted discussion about flavored products, tobacco advertising, other television programs, and marijuana. Conclusions. Clips featuring the depiction of EVALI on medical dramas may be an effective tool for raising awareness of e-cigarette use-related harms. These results offer a promising first step for future collaborative research between public health, adolescents, and schools to develop tobacco prevention education utilizing these clips.
Chocolate Touch Versus Lutonix Drug-Coated Balloon for Femoropopliteal Lesions in Diabetes: The Chocolate Touch Study
Authors: Böhme Tanja , Zeller Thomas , Shishehbor Mehdi H. , Werner Martin , Brodmann Marianne , Parise Helen , Holden Andrew , Lichtenberg Michael , Parikh Sahil A. , Kashyap Vikram S. , Pietras Cody , Tirziu Daniela , Beschorner Ulrich , Krishnan Prakash , Niazi Khusrow A. , Wali Andreas U. , Lansky Alexandra J.
Published: June 2023

Background:

The randomized Chocolate Touch Study demonstrated that in patients undergoing treatment of femoropopliteal artery lesions, the Chocolate Touch drug-coated balloon (DCB) was safe and had superior efficacy at 12 months compared with the Lutonix DCB. We report the prespecified diabetes subanalysis comparing outcomes among patients with and without diabetes mellitus (DM).

Methods:

Patients with claudication or ischemic rest pain (Rutherford class 2–4) were randomized to Chocolate Touch or Lutonix DCB. The primary efficacy endpoint was DCB success defined as primary patency at 12 months (peak systolic velocity ratio <2.4 by duplex ultrasound without clinically driven target lesion revascularization in the absence of bailout stenting). The primary safety endpoint was freedom from major adverse events at 12 months, a composite of target limb-related death, major amputation, or reintervention.

Results:

A total of 313 patients (38% DM [n=119]) were randomized to either Chocolate Touch (n=66/152) or Lutonix DCB (n=53/161). Among patients with DM, DCB success was 77.2% and 60.5% (p=0.08), and in non-DM patients, DCB success was 80% and 71.3% (p=0.2114) for the Chocolate Touch and Lutonix DCB, respectively. The primary safety endpoint was similar for both cohorts regardless of DM status (interaction test, p=0.96).

Conclusions:

This randomized trial demonstrated similar safety and efficacy for the treatment of femoropopliteal disease with the Chocolate Touch DCB compared with using the Lutonix DCB regardless of DM status at 12 months.

Clinical Impact

This substudy of the Chocolate Touch Study demonstrated similar safety and efficacy for treatment of femoropopliteal disease of the Chocolate Touch DCB compared with the Lutonix DCB regardless of diabetes (DM) status at 12 months. Endovascular therapy has become the therapy of choice for the treatment of most symptomatic femoropopliteal lesions regardless of DM status. These results give clinicians another option when treating femoropopliteal disease in this high-risk patient population.
Voluntary Deep Inspiration Breath-Hold (VDIBH) Whole-Breast Irradiation Assisted by Optical Surface Monitoring System (OSMS) in Patients With Left-Sided Breast Cancer: A Prospective Phase II Study
Authors: Zhang Jiang-Hu , Li Tan-Tan , Qin Shi-Rui , Liu Zhi-Qiang , Chen Si-Ye , Song Yong-Wen , Tang Yu , Jing Hao , Fang Hui , Zhao Xu-Ran , Jin Jing , Liu Yue-Ping , Tang Yuan , Qi Shu-Nan , Li Ning , Chen Bo , Lu Ning-Ning , Li Ye-Xiong , Wang Shu-Lian
Published: June 2023

Objectives: To investigate the dosimetric advantages of the voluntary deep inspiration breath-hold technique assisted by optical surface monitoring system for whole breast irradiation in left breast cancer after breast-conserving surgery and verify the reproducibility and acceptability of this technique. Methods: Twenty patients with left breast cancer receiving whole breast irradiation after breast-conserving surgery were enrolled in this prospective phase II study. Computed tomography simulation was performed during both free breathing and voluntary deep inspiration breath-hold for all patients. Whole breast irradiation plans were designed, and the volumes and doses of the heart, left anterior descending coronary artery, and lung were compared between free breathing and voluntary deep inspiration breath-hold. Cone beam computed tomography was performed for the first 3 treatments, then weekly during voluntary deep inspiration breath-hold treatment to evaluate the accuracy of the optical surface monitoring system technique. The acceptance of this technique was evaluated with in-house questionnaires completed by patients and radiotherapists. Results: The median age was 45 (27-63) years. All patients received hypofractionated whole breast irradiation using intensity-modulated radiation therapy up to a total dose of 43.5 Gy/2.9 Gy/15f. Seventeen of the 20 patients received concomitant tumor bed boost to a total dose of 49.5 Gy/3.3 Gy/15f. Voluntary deep inspiration breath-hold showed a significant decrease in the heart mean dose (262 ± 163 cGy vs 515 ± 216 cGy, P < .001) and left anterior descending coronary artery (1191 ± 827 cGy vs 1794 ± 833 cGy, P < .001). The median delivery time of radiotherapy was 4 (1.5-11) min. The median deep breathing cycles were 4 (2-9) times. The average score for acceptance of voluntary deep inspiration breath-hold by patients and radiotherapists was 8.7 ± 0.9 (out of 12) and 10.6 ± 3.2 (out of 15), respectively, indicating good acceptance by both. Conclusions: The voluntary deep inspiration breath-hold technique for whole breast irradiation after breast-conserving surgery in patients with left breast cancer significantly reduces the cardiopulmonary dose. Optical surface monitoring system–assisted voluntary deep inspiration breath-hold is reproducible and feasible and showed good acceptance by both patients and radiotherapists.
Raptor Preys on mTOR Imbalance in Tuberous Sclerosis
Authors: Ramamurthy Aishwarya , Carvill Gemma Louise
Published: June 2023

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Anti-Seizure Medications on Trial Again: Accused of Parkinson’s Disease!
Authors: Sarkis Rani A.
Published: June 2023

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Myanmar’s budgetary punctuations before and after the 2011 budget reforms: Budget incrementalism and punctuated equilibrium theory
Authors: Myaing Win Thiri , Lim Seunghoo
Published: June 2023

Myanmar has implemented budget reforms to decentralize its budgeting processes, and this study intends to investigate how those reforms have affected its allocation patterns based on budget incrementalism and punctuated equilibrium theory. We empirically analyzed the government’s spending in seven sectors over 19 years. We found that political and institutional changes have different effects on different sectors. The sectors that the government paid attention to and set as highly prioritized policies showed more punctuation. After the reform, the government paid more attention to capital budgets to achieve its political goals, leading to more punctuation in the capital budget. We also examined the directions and frequencies of budget punctuation before and after the reform by extending the punctuated equilibrium theory literature based on both corrective and trend models. Different budget punctuation patterns were observed with different frequencies across sectors due to the unique characteristics of each sector and changing policy priorities over time.
Poverty and Suicidal Ideation Among Hispanic Mental Health Care Patients Leading up to the COVID-19 Pandemic
Authors: Goldstein Evan V. , Bailey Elise V. , Wilson Fernando A.
Published: June 2023

Introduction: Suicide rates have risen in Hispanic communities since 2015, and poverty rates among Hispanics often exceed the national average. Suicidality is a complex phenomenon. Mental illness may not alone explain whether suicidal thoughts or behaviors will occur; it remains uncertain how poverty affects suicidality among Hispanic persons with known mental health conditions. Our objective was to examine whether poverty was associated with suicidal ideation among Hispanic mental healthcare patients from 2016 to 2019. Methods: We used de-identified electronic health record (EHR) data from Holmusk, captured using the MindLinc EHR system. Our analytic sample included 4,718 Hispanic patient-year observations from 13 states. Holmusk uses deep-learning natural language processing (NLP) algorithms to quantify free-text patient assessment data and poverty for mental health patients. We conducted a pooled cross-sectional analysis and estimated logistic regression models. Results: Hispanic mental health patients who experienced poverty had 1.55 greater odds of having suicidal thoughts in a given year than patients who did not experience poverty. Conclusion: Poverty may put Hispanic patients at greater risk for suicidal thoughts even when they are already receiving treatment for psychiatric conditions. NLP appears to be a promising approach for categorizing free-text information on social circumstances affecting suicidality in clinical settings.
COVID-19 and Collective Transformation: Changes in Online Nursing Faculty Pedagogical Practices
Authors: Christoffers Collette , Bano Sara , Gorz Melissa
Published: June 2023

Our study explored the experiences of fully online nursing faculty during COVID-19. Using Mezirow’s transformative learning theory and Hoggan’s typology as our framework, we engaged in qualitative hermeneutic phenomenology, interviewing 10 online nursing faculty members to learn about their experiences teaching online during the pandemic. Results from our findings suggest COVID-19 was a collective disorienting dilemma. While working through this disorienting dilemma, faculty discovered the importance of both collaboration and professional development in the sense-making process. Furthermore, faculty pedagogical practices transformed as flexibility and compassion emerged as a necessary part of supporting students during the pandemic.
Sub-anaesthetic dose of propofol attenuates mechanical allodynia in chronic post-ischaemic pain via regulation of PTEN/PI3K/IL-6 signalling
Authors: Leung Siu Yi Doreen , Meng Fei , Liu Jingjing , Liu Aijia Jessica , Ng Hei Lui Lhotse , Cheung Chi Wai , Sau Ching Wong Stanley
Published: June 2023

Background: Propofol is an intravenous anaesthetic drug that has been shown to reduce inflammatory pain. Complex regional pain syndrome (CRPS) type I is a pain condition characterized by autonomic, motor and sensory disturbance. The chronic post-ischaemic pain (CPIP) model is a well-established model to recapture CRPS-I syndromes pre-clinically by non-invasive ischaemic-reperfusion (IR) injury. In this study, we investigated the analgesic effects of propofol and underlying mechanisms in mitigating CRPS pain using the CPIP model. Methods: Sub-anaesthetic dose of propofol (25 mg/kg) was intravenously delivered to the CPIP model and sham control. Nociceptive behavioural changes were assayed by the von Frey test. Molecular assays were used to investigate expression changes of PTEN, PI3K, AKT and IL-6 underlying propofol-mediated analgesic effects. Pharmacological inhibition was applied for PTEN/PI3K/AKT pathway manipulation. Results: Both pre- and post-operative administration of propofol attenuated mechanical allodynia induced by CPIP. Propofol could modulate PTEN/PI3K/AKT signalling pathway by increasing active PTEN and reducing phosphorylated PI3K, phosphorylated AKT and IL-6 expression in the spinal dorsal horn, which promoted pain relief in the CPIP model. Inhibition of PTEN with bpV abolished the analgesic effects produced by propofol in CPIP mice. Conclusion: Sub-anaesthetic dose of propofol administration resulted in the activation of PTEN, inhibition of both PI3K/AKT signalling and IL-6 production in the spinal cord, which dramatically reduced CPIP-induced pain. Our findings lay the foundation in using propofol for the treatment of CRPS with great therapeutic implications.
A case of severe pneumonia caused by Legionella longbeachae with positive results by a Legionella urinary antigen detection kit
Authors: Shinomiya Shohei , Tanaka Takuya , Shionoya Ikuyo , Mura Tatsuki , Nakase Keisuke , Takahara Yutaka , Oikawa Taku , Mizuno Shiro
Published: June 2023

Legionella longbeachae is a Legionella bacteria often detected in soil, and is known as a rare cause of Legionella infections in Japan. In addition, detection of this Legionella species is often overlooked due to negative results from Legionella urinary antigen tests, which could lead to errors in the therapeutic approach. An 80-year-old woman was admitted to our hospital because of fever and dyspnea. Her blood tests showed elevated white blood cells, increased C-reactive protein and transaminases, and hyponatremia. Chest computed tomography showed dense consolidation in the right lung. We diagnosed Legionella pneumonia because the Legionella urinary antigen test was positive on the day after her admission. The patient was intubated and mechanically ventilated on the third day of hospitalization, because of respiratory failure. However, her condition did not improve and she died on the 10th day after admission. After her death, L. longbeachae was detected from sputum culture from her tracheal tube, and was diagnosed as the causative organism of her pneumonia. L. longbeachae infection reportedly rarely produces positive urinary antigen test results. Our experience suggests that the urinary antigen test using Ribotest Legionella might be able to detect Legionella spp. other than L. pneumophila.
Ethical and Medico-Legal Considerations with Aesthetic Dentistry Involving the Aesthetic Zone
Authors: Rattan Raj , D’Cruz Len
Published: June 2023

The bedrock of delivering cosmetic dentistry remains good communication underpinned by a clear and transparent consent process. This article looks at this while exploring the ethical and risk management issues that have started to challenge the profession. While patients’ demand for cosmetic dentistry has exploded, this article explores the ethical conundrums faced by these treatments against the backdrop of whether their happiness is affected by their image.
The importance of trusting conditions for organizations’ readiness to implement mHealth to support healthy lifestyle behaviors: An interview study within Swedish child and school healthcare
Authors: Fagerström Maria , Löf Marie , Müssener Ulrika , Thomas Kristin
Published: June 2023

Objective

To explore perceptions among nurses, managers, and policymakers regarding organizational readiness to implement mHealth for the promotion of healthy lifestyle behaviors in child and school healthcare.

Methods

Individual semi-structured interviews with nurses ( n = 10), managers ( n = 10), and policymakers ( n = 8) within child and school healthcare in Sweden. Inductive content analysis was used for data analysis.

Results

Data showed that various trust-building aspects in health care organizations may contribute to readiness to implement mHealth. Several aspects were perceived to contribute trusting conditions: (a) how health-related data could be stored and managed; (b) how mHealth aligned with current organizational ways of working; (c) how implementation of mHealth was governed; and (d) camaraderie within a healthcare team to facilitate use of mHealth in practice. Poor capability to manage health-related data, as well as lack of governance of mHealth implementation were described as dealbreakers for readiness to implement mHealth in healthcare organizations.

Conclusions

Healthcare professionals and policymakers perceived that trusting conditions for mHealth implementation within organizations were central for readiness. Specifically, governance of mHealth implementation and the ability to manage health-data produced by mHealth were perceived critical for readiness.
Saying something with nothing: Refusal, avoidance and resistance in participant non-response
Authors: Lockwood Nina , Scott Susie
Published: June 2023

The relational processes of dialogue in biographical storytelling extend beyond manifest tales. Untold stories of unlived experience are also composed with an audience in mind and performed as communicative acts. This paper considers how and why research participants in a Mass Observation Archive study declined to respond to a life-writing task. Drawing on the sociology of nothing, we argue that their patterns of non-response were motivated by subjective intent and constitute meaningful social action. Despite having little or nothing to say about the substantive content of the topic, these participants told us plenty about how they felt about the challenging methodological process. In their accounts, we identified three modes of disengagement: commissive refusal, omissive avoidance and ambivalent resistance. Respectively, these involved consciously dismissing the task with reference to morals and values; surface amenability masking an evasion of deeper engagement; and confused, uncertain vacillation between approach and retreat. We explore the intrapsychic and interpersonal relational dynamics at play in each of these narrative modes and consider the authorial power of saying ‘no’.
Enhancing Diabetes Health Outcomes Among Haitian Migrants Living in Dominican Bateyes
Authors: Molina Rosalia , Enriquez Maithe
Published: June 2023

Purpose

The purpose of this study was to better understand the factors that influence the ability of batey adults to self-manage their type 2 diabetes mellitus (T2DM).

Methods

A qualitative descriptive approach was used to conduct in-depth, individual interviews in Spanish. Participants (n = 12) were health care workers and members of a nongovernmental organization (NGO) that provides direct diabetes care to batey residents via free, pop-up, mobile medical clinics. Conventional content analysis was used to identify categories and common themes in the data.

Results

Participants described daily existence in the bateyes as a constant “scarcity of resources.” Additionally, four themes and one subtheme emerged that participants felt impacted diabetes health outcomes and the ability of NGO health care workers to provide diabetes care.

Conclusions

NGO members, while committed to serve and improve health outcomes for the batey population, often felt overwhelmed. Findings from this qualitative descriptive study may be used to inform novel interventions, which are needed, to enhance the diabetes outcomes of the batey residents who are living with T2DM. In addition, strategies are needed to build diabetes care infrastructure in the batey community.
Enkurin: a novel marker for myeloproliferative neoplasms from platelet, megakaryocyte, and whole blood specimens
Authors: Seetharam Sumanth Mosale , Liu Yi , Wu Jason , Fechter Lenn , Murugesan Kanagavel , Maecker Holden , Gotlib Jason , Zehnder James , Paulmurugan Ramasamy , Krishnan Anandi
Published: June 2023

Impaired protein homeostasis, though well established in age-related disorders, has been recently linked with the pathogenesis of myeloproliferative neoplasms (MPNs). However, little is known about MPN-specific modulators of proteostasis, thus impeding our ability for increased mechanistic understanding and discovery of additional therapeutic targets. Loss of proteostasis, in itself, is traced to dysregulated mechanisms in protein folding and intracellular calcium signaling at the endoplasmic reticulum (ER). Here, using ex vivo and in vitro systems (including CD34+ cultures from patient bone marrow and healthy cord/peripheral blood specimens), we extend our prior data from platelet RNA sequencing in patients with MPN and discover select proteostasis-associated markers at RNA and/or protein levels in each of platelet, parent megakaryocyte, and whole blood specimens. Importantly, we identify a novel role in MPNs for enkurin (ENKUR), a calcium mediator protein originally implicated only in spermatogenesis. Our data reveal consistent ENKUR downregulation at both RNA and protein levels across specimens from patients with MPN and experimental models (including upon treatment with thapsigargin, an agent that causes protein misfolding in the ER by selective loss of calcium), with a concomitant upregulation of a cell cycle marker, CDC20. Silencing of ENKUR using short hairpin RNA in CD34+–derived megakaryocytes further confirms this association with CDC20 at both RNA and protein levels and indicates a likely role for the PI3K/Akt pathway. Together, our work sheds light on enkurin as a novel marker of MPN pathogenesis and indicates further mechanistic investigation into a role for dysregulated calcium homeostasis and ER and protein folding stress in MPN transformation.