bluuebunny/crossref_metadata_2025 huggingface dataset:
How Would a Permanently Refundable Child and Dependent Care Credit Affect Eligibility, Benefits, and Incentives?
Authors: Pepin Gabrielle
Published: April 2022

The federal Child and Dependent Care Credit (CDCC) subsidizes child care costs for working families. Before 2021, the CDCC was nonrefundable, so only families with positive tax liability after other deductions benefited. I estimate how CDCC eligibility, benefits, and marginal tax rates would change if the credit were made permanently refundable. Under refundability, some 5 percent of single parents gain eligibility and receive on average over $1,000 annually. Eligibility increases are largest among Black and Hispanic households. Increases in marginal tax rates among moderate-income taxpayers are small.
Fiscal Decentralization and the Composition of Local Government Expenditure: Evidence from South Korea
Authors: Park Jinsol
Published: April 2022

The implicit idea underlying theories of fiscal federalism is that fiscal decentralization can change the composition of government expenditure. That is, regardless of whether decentralization enables governments to more readily reflect citizen preferences regarding spending categories or fosters a race to the bottom with reduced taxation and public service levels, change in the composition of government expenditure may ensue. This study indirectly tests the impact of decentralization with respect to allocative efficiency by examining the relationship between fiscal decentralization and expenditure composition. Utilizing data from 224 local governments in South Korea over the period 2008–2018, the study finds that fiscal decentralization exerts downward pressure on welfare expenditure and that it tends to shift spending from the current to the capital account. Specifically, it finds that it is mainly revenue-side decentralization that affects the allocation of government expenditure.
Impact of Unmet Privacy Expectations Across Information, Time, and Space: Evidence from Four Countries
Authors: Swani Kunal , Milne George R.
Published: April 2022

Globally, consumers and firms are negotiating rising privacy expectations. This article advances research by developing a multidimensional privacy measure that captures the idea of privacy as an expectation to be left alone through control and access of their personal information, time, and space. Drawing on boundary regulation perspectives from law and environmental psychology, the authors conceptualize, develop, and measure the meeting privacy expectations (MPE) scale. Six studies show the reliability and stability of the 12-item MPE scale in depicting the three subdimensions and in meeting reliability and validity criteria. The results indicate that the MPE scale is not only distinct from previously established privacy scales but also a better predictor of behavioral intentions. Moreover, the scale is invariant across different cultures and influences cognitive trust and emotional violation. The authors find that meeting privacy expectations vary in their levels and outcomes cross-culturally. Marketers can use the MPE scale to globally track, assess, manage, and plan for meeting the changing consumer privacy expectations. The MPE scale is a good candidate to address the rising public policy issues related to privacy.
Neurophysiological Measures in Hospitality and Tourism: Review, Critique, and Research Agenda
Authors: Lei Ming , Chen Wei , Wu Jianshe , Zhang Yingying , Lv Yan
Published: April 2022

This paper provides a critical review of studies using neurophysiological measures in tourism and hospitality. Among 145 articles covering 20 years of research, 16 studies applied either electroencephalography (EEG), functional magnetic resonance imaging (fMRI), or skin conductance (SC) measures in tourism and hospitality settings. Results show that, in general, (1) EEG studies investigated the relationships between EEG components and attention/emotion induced by destination advertisements; (2) fMRI studies examined the correlation between brain area activation and behavior (e.g., visit intention); and (3) SC studies focused on emotional responses to tourism stimuli. Neurophysiological techniques are theoretically and practically useful in tourism and hospitality: these tools uncover subjects’ objective, unbiased, and real-time responses to provide academic insight and guide industry practitioners’ decisions. Directions for future research are proposed along with solutions to address the current limitations of neuroscience measures in tourism and hospitality applications.
Evaluation of macular function and morphology following accelerated collagen cross-linking in progressive keratoconus
Authors: Dettoraki M , Droutsas K , Lazaridis A , Moschos MM
Published: April 2022

Purpose

To assess any changes in macular function and morphology in patients with progressive keratoconus undergoing accelerated corneal cross-linking (CXL).

Methods

This prospective case series included 9 eyes of 8 patients with progressive keratoconus undergoing CXL using a high intensity accelerated protocol (9 mW/cm2 for 14 min) with a total surface dose of 7.5 J/cm2. Visual acuity assessment, slit lamp biomicroscopy, dilated fundoscopy, corneal tomography, multifocal electroretinography (mfERG) and spectral domain optical coherence tomography scan were performed at baseline, 2 weeks and 6 weeks postoperatively.

Results

Uncorrected and corrected distance visual acuity did not change significantly at 2 weeks and 6 weeks following accelerated CXL compared to baseline. Retinal response density (RRD) of mfERG significantly decreased at 2 weeks postoperatively compared to baseline (p = 0.008) but did not differ from the baseline value at 6 weeks postoperatively in the fovea (ring 1) (p = 0.95). Similarly, P1 latency significantly decreased at 2 weeks (p = 0.04) but did not change at 6 weeks (p = 1.00) postoperatively compared to baseline in the fovea. No changes in RRD or P1 latency were observed in the retinal rings surrounding the fovea (rings 2 to 5). Central foveal thickness did not change at 2 weeks and 6 weeks postoperatively compared to baseline (p = 0.53 and p = 0.93, respectively).

Conclusions

A short-term reversible decrease in macular electrical activity without any structural changes seems to occur after accelerated CXL in patients with progressive keratoconus. The return of macular response to the preoperative values shows the safety of the CXL protocol.
Bilateral macular retinitis in patients with presumed rift valley fever from Sudan: A case series
Authors: Fouad Yousef A. , Mekkawy Mahmood O. , Sallam Ahmed B.
Published: April 2022

Background

Epidemic retinitis occurs seasonally following febrile infections in endemic regions. Rift valley fever (RVF) is endemic to Sudan, with a recent outbreak starting in 2019.

Methods

Retrospective case series of 3 patients travelling from Sudan with post-febrile retinitis, and with a history and clinical picture suggestive of RVF retinitis.

Results

The three patients were adult males with underlying medical conditions and underwent fundus fluorescein angiography that confirmed bilateral retinitis and occlusive vasculitis involving the posterior pole. Optical coherence tomography showed distortion of the macular layers. Case 2 presented 1 month following febrile illness and had retinal thinning, with optical coherence tomography angiography showing marked reduction in vessel density.

Conclusion

We present multimodal imaging data of three cases with presumed RVF retinitis from a recent outbreak in Sudan. The unavailability of standardized methods of testing for RVF, as is the case for most epidemic retinitis-causing pathogens, makes the diagnosis challenging.
Sodium hyaluronate 0.30% ocular gel versus sodium hyaluronate 0.18% eye drop in the treatment of moderate to severe dry eye disease
Authors: Calonge Margarita , Sahyoun Marwan , Baillif Stéphanie , Gain Philippe , Paw Ewa , Mearza Ali , Cochener Béatrice
Published: April 2022

Purpose

Compare 0.30% sodium hyaluronate (0.30%HA) ocular gel with 0.18%HA eye drops in terms of improvement of ocular signs and symptoms, in patients with moderate to severe dry eye disease (DED).

Methods

This was a multicentric, randomized, investigator-masked, non-inferiority, comparative study conducted over 84 days. Three visits were scheduled, testing fluorescein corneal and conjunctival staining (Oxford and Van Bijsterveld scores), tear film break-up time (TBUT), Schirmer test, DED symptoms, 5-Item-Dry-Eye-Questionnaire (5-DEQ), patient and investigator satisfaction and frequency of instillation.

Results

At Day 35 (D35) and Day 84 (D84), both groups (n = 35 each) had a significant improvement in corneal staining (p < 0.001) with no inter-group difference. Van Bijsterveld score improved earlier (D35) for 0.30%HA suggesting a faster effect on conjunctival epithelium healing. There was no difference between the two concentrations in terms of TBUT or Schirmer improvements; however, the Schirmer test increase was only significant for 0.30%HA at D35 (p = 0.040). At D35 and D84, both groups showed similar improvements of DED symptoms and DEQ-5 score. Furthermore, treatment satisfaction was similar for the 2 formulations suggesting that daily use of 0.30%HA do not cause gel-related blurred vision disturbances. Frequency of instillation was similar for both groups.

Conclusion

Our study demonstrates the non-inferiority of 0.30%HA gel compared to 0.18%HA solution in patients with moderate to severe DED. Because of its gel formulation and higher HA concentration providing prolonged comfort without causing visual disturbances, 0.30%HA gel might be adapted for bedtime use or during the day in more severe conditions.
Effects of anxiety on sedation among pediatric patients undergoing esophagogastroduodenoscopy
Authors: Choi You Jin , Park Eun Jin , Lee Yoo Min , Kim Soon Chul , Kang Ben , Lee Kyung Jae , Jang Hyo-Jeong , Lee Eun Hye , Kim Ju Young , Choi So Yoon , Jin Kim Hyun , Kang Yunkoo , Choe Byung-Ho , Lee Jeewon , Yi Dae Yong
Published: April 2022

We investigated whether the severity of anxiety among children undergoing endoscopy could affect sedation. We prospectively recruited patients under 18 years of age who were scheduled to undergo esophagogastroduodenoscopy (EGD). Baseline anxiety was evaluated using the Spence Children’s Anxiety Scale (SCAS). Our analysis considered the type and dose of sedative drugs, degree of sedation, and complications associated with sedation according to the scale score. The mean total SCAS T-scores and each subscale score were significantly higher in the 6–12-year age group. The mean T-score among patients who exhibited irritability during EGD was higher than that among other patients, with significant differences in the Total, Obsessive Disorder, Panic Agoraphobia and General Anxiety subscales. The midazolam doses of children exhibiting irritability were more likely to need higher ( p = 0.006). Other sedation-related complications were not associated with the T-scores in each subscale. Total sleep time was not associated with any T-score subscales. Anxiety levels were significantly higher among 6–12-year-olds and children exhibiting irritability. Anxiety was often associated with irritability, difficulties achieving adequate sedation during EGD, and additional sedative drug administration. We recommend higher doses or more potent drugs to facilitate endoscopy for children with high anxiety levels.
‘Do you feel well or unwell?’ A study on children’s experience of estimating their nausea using the digital tool PicPecc
Authors: Esplana Linda , Olsson Malin , Nilsson Stefan
Published: April 2022

Research with childhood cancer has progressed greatly in recent years, resulting in much improved treatment that is more intensive. However, with this new treatment children often experience negative symptoms, and research shows that nausea is a symptom that most affects them. Pictorial support in person-centred care for children (PicPecc) is a digital picture-based tool for children who undergo treatment due to their cancer diagnosis and helps them more effectively communicate and self-report their symptoms and emotions. The aim of the study was to investigate children’s experience of (i) using mHealth in nausea management and (ii) their acceptability of using an application (App). Semi-structured interviews were conducted with eight children aged five to fifteen years. Data were analysed with qualitative content analysis. The findings were presented in three categories: 1) Communicating feelings, 2) Playfulness generated in motivation and 3) App adaptable to children’s capabilities. Using an App contributed to new opportunities for the children to participate in their care. They experienced their treatment in different ways and used different strategies to manage and distract themselves from their symptoms. Using the PicPecc App can increase healthcare staff’s understanding of how children experience nausea when they undergo chemotherapy.
Craft fields and the temporal structures of quilting
Authors: Hosking Sara , Scott Michael
Published: April 2022

This article develops a Bourdieusian-inspired structuralist model of how craft and commerce intersect. Through interpretative engagement with targeted interviews (n = 17) of ‘serious leisure’ quilters drawn from a larger quantitative survey (n = 440), we find that attitudes to pattern sharing suspends the field between commercial and communitarian poles. Unlike fine art and popular culture fields, where the usurpation of dominant styles leads to a succession temporality, quilting evinces a stasis: communitarian and circular temporalities of reciprocity and inclusion counterpose commoditization, notions of just (market) rewards, and their linear temporality. Developing from this chiastic – crosswise – structure, we argue craft's temporal organization of materials and actors differentiates quilting from art and other cultural forms; what is new is old; what is old is new. Generalizing this analysis, we suggest craft fields can appear unchanging due to the co-constituting, yet unresolvable, symbolic oppositions between commercial and communitarian temporalities.
Producing Nollywood portal films: Navigating precarity through informal social relations and hope
Authors: Simon Godwin Iretomiwa
Published: April 2022

This article examines the production practices that underpin the production of portal films in the Nigerian video film industry (Nollywood). Following the recent surge in the number of streaming portals focusing on the distribution of Nollywood films, a nascent video on demand (VOD) market has been created. This new market has given rise to a crop of filmmakers who now produce straight-to-portal films. This article draws on semi-structured interviews with 30 industry stakeholders comprising producers, directors, writers, and streaming executives. Adopting a critical media industry studies approach, I argue that, in the face of pervasive precarity in the Nollywood VOD market, portal filmmakers adopt informal social relations and ‘hope labour’ in navigating productions and ensuring the market is sustained. The article contributes to extant research on Nollywood's production dynamics and extends existing debates about precarity in cultural industries through a less-studied context like Nollywood.
Hybrid nested sampling method for identifying the uncertainty of the high-dimensional updating parameters in Bayesian structural model updating
Authors: Xu Xikun , Hong Yu , Chen Liangjun , Gou Hongye , Pu Qianhui
Published: April 2022

Bayesian inference is a practical and straightforward approach to quantifying the uncertainty of the model parameters in structural finite element model updating. Sampling methods are frequently used to estimate the uncertainty of the selected updating parameters in a statistically principled way. Generally, uncertainty can be described by global optimum, local optimum, expectation, variance, and marginal probability density function (PDF). However, it is rare to see model updating methods focusing on studying the high-dimensional distribution of the updating parameters due to the computational cost. This paper develops a hybrid nested sampling method to identify the global optimum and high-dimensional confidence interval simultaneously. The proposed method samples the posterior PDF by shrinking the range of the live sample set layer by layer and achieves the global optimum guided by a hybrid search strategy. Finally, the performance of the proposed method was investigated by numerical simulations and an actual shear-type structure’s model test. After analysis and comparison, the results show that the proposed method performs very well in accuracy and robustness.
COVID-19: Detecting depression signals during stay-at-home period
Authors: Tshimula Jean Marie , Chikhaoui Belkacem , Wang* Shengrui
Published: April 2022

The new coronavirus outbreak has been officially declared a global pandemic by the World Health Organization. To grapple with the rapid spread of this ongoing pandemic, most countries have banned indoor and outdoor gatherings and ordered their residents to stay home. Given the developing situation with coronavirus, mental health is an important challenge in our society today. In this paper, we discuss the investigation of social media postings to detect signals relevant to depression. To this end, we utilize topic modeling features and a collection of psycholinguistic and mental-well-being attributes to develop statistical models to characterize and facilitate representation of the more subtle aspects of depression. Furthermore, we predict whether signals relevant to depression are likely to grow significantly as time moves forward. Our best classifier yields F-1 scores as high as 0.8 and surpasses the utilized baseline by a considerable margin, 0.173. In closing, we propose several future research avenues.
Investigation on clinch riveting process with different material combinations
Authors: Wu Jinliang , Chen Chao
Published: April 2022

Clinch riveting is a new joining process originating from clinching. The presence of rivets greatly enhances the shearing load of joints. However, conventional rivet is deformable, which may increase technological intricacy consequently. In this article, clinch riveting with rigid rivets was proposed, and the effects of sheet material combinations on the mechanical properties of joints were researched. Four sheet material combinations, involving two kinds of aluminum alloy (AA5052 and AA1060), were utilized to produce the clinch riveted joints. The joining quality was evaluated in four aspects: tensile load, shearing load, failure mode, and absorbed energy in shearing tests. Tensile and shearing tests were implemented to obtain the static load of joints. Results showed that both sheet materials and the geometrical parameters of joints were key factors determining the mechanical properties of joints. During the joining of different materials, the joint with a high-strength sheet on the top exhibited greater static load and absorbed energy than the joint with a low-strength sheet on the top. Neck fracture, button separation, and mixed failure could be observed in tensile tests. In shearing tests, all joints failed at the neck parts.
“The knife needs the intention of the heart” The construction of ethnic and moral boundaries in Israeli slaughterhouses
Authors: Ben-Yonatan Anat
Published: April 2022

This study examines aspects of ethnic, religious, and moral boundary work among Jewish-Israeli kosher slaughterers based, on 35 in-depth interviews, four ethnographic observations, informal conversations, and other secondary sources such as video footage of the slaughter sites gathered between 2014 and 2019. In Israel, the self-proclaimed sovereign homeland of the Jewish people, being Jewish means being part of the political, ethnic, and religious hegemony. While being stigmatized for doing dirty work, the Jewish slaughterers’ workplace setting groups them with menial laborers from a minority ethnic group, both physically and organizationally. The stigma associated with animal killing in Israel encourages the slaughterers to distinguish themselves from other workers by engaging in boundary work. Within the workplace setting, this boundary work occurs around various aspects of intersecting identities: racio-ethnic, national, religious, and professional. Furthermore, this boundary work is fueled by various organizational mechanisms such as the slaughter site’s spatial architecture, differential wage structure, and the use of tools and technologies. While these workplace conditions are determined by the employers, they are constantly restructured and reinforced by the slaughterers to assert their moral superiority vis-a-vis other workers. While exploring these organizational mechanisms, I conceptualize the Jewish slaughter knife as a boundary-maintaining object. I claim that the slaughterers constantly leverage these material, symbolic, and discursive resources to morally segregate the two workers’ groups and the morally tainted aspects of slaughter, such as violence and cruelty, to the ‘Arab’ others. Meanwhile, the prevailing Jew–Arab tensions and the popular symbolic representation of the Arabs ensures that these behaviors are treated as an inherent racio-ethnic trait, thereby reinforcing these boundaries.
Flow-noise characteristics of turbocharger compressors with rotational balance cuttings
Authors: Kim Sang Hyun , Park Tae Seon
Published: April 2022

To correct the balance of the rotating assembly of a turbocharger, some parts of the compressor wheel are removed by cutting. A numerical investigation of the turbulent flows and flow noises produced by compressor wheels modified with such cutting parts was performed by a turbulence model and detached-eddy simulations. For the 6-cutting case, 0, 2, 4, and 6 circular cuttings and two additional—rectangular and triangular—shapes were used.

To investigate the effects of the balance cuttings in a compressor wheel, the evaluation process using computational fluid dynamics was tried. It was found that the fluid forces due to the various wheel shapes have the potential to restore the eccentricity by approximately 50%. Severe variations of velocity, pressure, and turbulent kinetic energy in the interspace between the wheel and volute were observed. In particular, the wavelike patterns of pressure and turbulent kinetic energy were intensified for the modified wheels. The turbulent kinetic energy of the 6-cutting case had a dominant frequency at approximately 3000 Hz. The spectrum of the sound-pressure level of the modified compressor wheels exhibited the features of buzz-saw noise. The flow fields suggested that this feature of the sound pressure is related to the tip-clearance flow affected by the balance cuttings. In addition, the acoustic pressure and flow characteristics of the different types of modified compressor wheels were discussed and the resulting acoustic power was evaluated.
Saving the Shaker Lakes: How an Alliance between Two Wealthy Suburbs and Cleveland’s Black Mayor Stopped the Clark Freeway
Authors: Dawson Virginia P.
Published: April 2022

In the 1960s, the suburbs of Cleveland Heights and Shaker Heights protested the routing of an Interstate highway through their historic park. Known as the Clark Freeway, I-290 was meant to connect downtown Cleveland with the newer suburbs located beyond the city’s outer beltway. Fearing irreparable damage to their communities, a group of garden club women and a committee of citizen activists brought pressure on county, state, and federal officials to delay route selection. However, only after Cleveland Mayor Carl Stokes joined the fight, did Governor James Rhodes summon the political will to cancel the highway.
Right-Sided Chylothorax: A Case Report of an Uncommon Manifestation After Cervical Debranching Thoracic Endovascular Aneurysm Repair
Authors: Sasaki Hanae , Kowatari Ryosuke , Kondo Norihiro , Taguchi Ryo , Minakawa Masahito
Published: April 2022

A 70-year-old man was admitted to our hospital with a thoracic aortic aneurysm. He underwent elective thoracic endovascular aneurysm repair with left common carotid artery-left subclavian artery bypass via the left supraclavicular approach. During the bypass, the thoracic duct was injured and ligated. On postoperative day 3, the patient complained of dyspnea. Chest radiography revealed a massive right-sided pleural effusion. On postoperative day 5, he was diagnosed with right-sided chylothorax and underwent chest tube insertion. The next day, a left-sided chylothorax was noted, and chest tube drainage was performed. Conservative management, including nil per os and subcutaneous octreotide (300 μg/day) injection, was carried out for 2 weeks; subsequently, the chylothorax improved. This report highlights the diagnostic challenge of right-sided chylothorax after debranching thoracic endovascular aneurysm repair.
Participants’ Perspectives of Their Involvement in Medical Device Trials: A Focus Groups Study
Authors: Kitchen William R. , Downey Candice L. , Brown Julia M. , Jayne David G. , Randell Rebecca
Published: April 2022

Background

Medical technologies have the potential to improve quality and efficiency of healthcare. The design of clinical trials should consider participants’ perspectives to optimise enrolment, engagement and satisfaction. This study aims to assess patients’ perceptions of their involvement in medical device trials, to inform the designs of future medical technology implementation and evaluation.

Methods

Four focus groups were undertaken with a total of 16 participants who had participated in a study testing hospital inpatient remote monitoring devices. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis.

Results

Four main themes emerged: patients’ motivations for participating in medical device research; patients’ perceptions of technology in medicine; patients’ understanding of trial methodology; and patients’ perceptions of the benefits of involvement in medical device trials. The appeal of new technology is a contributing factor to the decision to consent, although concerns remain regarding risks associated with technology in healthcare settings. Perceived benefits of participating in device trials include extra care, social benefits and comradery with other participants seen using the devices, although there is a perceived lack of confidence in using technology amongst older patients.

Conclusion

Future device trials should prioritise information sharing with participants both before and after the trial. Verbal and written information alongside practical demonstrations can help to combat a lack of confidence with technology. Randomised trials and those with placebo- or sham-controlled arms should not be considered as barriers to participation. Study results should be disseminated to participants in lay format as soon as possible, subject to participant permission.
Endovascular Thrombectomy With or Without Intravenous Thrombolysis: A Meta-Analysis of Randomized Controlled Trials
Authors: Ishfaq Muhammad F. , Gulraiz Sana , Huang Wei , Lobanova Iryna , Martin Renee H. , French Brandi R. , Siddiq Farhan , Gurkas Erdem , Aytac Emrah , Gomez Camilo R. , Qureshi Adnan I.
Published: April 2022

Background

We performed this meta-analysis of randomized clinical trials to compare the outcomes in patients treated with endovascular thrombectomy who receive prior intravenous thrombolysis with those who do not receive such treatment. Recently, one randomized trial reported outcomes to address this issue, so timely update of meta-analysis is needed to determine the value of administering intravenous thrombolysis before endovascular thrombectomy.

Materials and methods

Four randomized clinical trials are included in our meta-analysis. We calculated pooled odds ratios and 95% CIs using random-effects models. The primary efficacy endpoint was a favorable outcome defined by a modified Rankin Scale score of 0 (no symptoms), 1 (no significant disability), or 2 (slight disability) at 90 days post-randomization. Secondary endpoints analyzed were any intracerebral hemorrhage, symptomatic intracerebral hemorrhage, and mortality.

Results

Of the 1633 patients randomized, the proportion of patients who achieved a favorable outcome was similar between endovascular thrombectomy alone and combined approach with intravenous thrombolysis and endovascular thrombectomy (1631 patients analyzed; odds ratio 1.02; CI 0.84–1.25; p = 0.83). Risk of any intracerebral hemorrhage was significantly lower among those randomized to endovascular thrombectomy alone (1633 patients analyzed; odds ratio 0.75; CI 0.57–0.99; p = 0.04). Rates of symptomatic intracerebral hemorrhage (p = 0.36) and mortality (p = 0.62) were not significantly different between the two groups.

Conclusions

Compared with endovascular thrombectomy preceded by intravenous thrombolysis, endovascular thrombectomy resulted in similar rates of favorable outcome with a lower rate of intracerebral hemorrhage. A large phase 3 trial is required to conclusively demonstrate equivalency of both approaches to guide future practice.
Economic analysis of n-butyl cyanoacrylate compared with ethylene vinyl alcohol copolymer liquid embolic embolization of brain arteriovenous malformations (bAVMs) from a US hospital perspective
Authors: Satti Sudhakar R. , Kottenmeier Emilie , Khaled Alia , Wright George W.J. , Cameron Heather L.
Published: April 2022

Background

In US hospitals, the liquid embolic systems (LESs) n-butyl cyanoacrylate (n-BCA) and ethylene vinyl alcohol copolymer (EVOH) are used for brain arteriovenous malformation (bAVM) embolization to achieve presurgical devascularization. The aim of this study was to perform an economic analysis comparing four techniques for bAVM embolization based on LES, ancillary device, and angiography suite time costs.

Methods

An economic model was developed comparing the embolization costs for n-BCA, EVOH with the plug and push technique, EVOH with detachable-tip microcatheters, and EVOH with balloon microcatheters. Per procedure costs were calculated for bAVMs with one to four pedicles. Annual cohort analyses were performed to evaluate the potential impact for low and high-volume centers. Sensitivity analyses were performed to determine cost drivers.

Results

The analyses showed that the n-BCA technique was the least costly of the four techniques. Total per procedure costs for one to four embolized pedicles ranged from $5941 to $10,074 for the n-BCA technique, $8428 to $30,345 for the EVOH balloon microcatheter technique, $12,711 to $47,477 for the EVOH plug and push technique, and $13,900 to $52,233 for the EVOH detachable-tip microcatheter technique. Cohort analyses costs for 52 annual cases ranged from $308,953 to $523,838 with the n-BCA technique and from $722,816 to $2,716,096 with the EVOH detachable-tip microcatheter technique.

Conclusions

Procedure costs associated with n-BCA are lower than those with each of the three EVOH techniques examined. Future cost analyses should compare the costs of new LES products once available.
The relationship between lower extremity amputation and body mass index
Authors: Al Yafi Motaz , Nasif Abdullah , Glosser Logan D , Ren Gang , Ahemd Ayman , Nazzal Munier , Osman Mohamed
Published: April 2022

Objectives

Non-traumatic lower extremity amputation (LEA) is associated with significant morbidity and mortality. Diabetes mellitus (DM) and peripheral vascular disease (PVD) are associated with increased risk for LEA. As such, DM and PVD account for 54% of all LEA’s, performed in the United States annually. As obesity is highly associated with both DM and PVD, our study sought to explore the relationship between LEA and obesity defined by BMI.

Methods

Using the National Inpatient Sample (NIS) database, a retrospective review of patients who underwent non-traumatic LEA (LEA) between 2008 and 2014 was performed. The International Classification of Diseases 9th edition (ICD-9) codes were utilized to determine the diagnoses, comorbidities, and procedures. Patient BMIs were classified as follows: Non-obese [BMI <30], Obesity class I [BMI 30–34.9], Obesity class II [BMI 35–39.9], and Obesity class III [BMI ≥40]. Predictors for LEA were compared between groups using chi-square test and binary logistic regression to identify possible underlying factors associated with LEA. We also conducted a multivariate analysis to measure the effect of multiple variables on LEA.

Results

We identified 16,259 patients with non-traumatic LEA and a mean age of 59.9 years. Rate of amputation in females was lower than males at 0.35% vs 0.87% respectively ( p < 0.001). Of patients that underwent amputation there was a V-shape trend based on BMI, with 30.4% in non-obese patients, 18.2% in obesity class I, 17.3% in obesity class II, and 34.1% in obesity class III. The incidence of diabetes increased with obesity class, while the incidence of PVD decreased. Interestingly, of those with DM there was an inverse relationship between amputation rate and BMI class, with LEA rates in non-obese versus obesity class III patients were 1.63% vs 0.98% respectively ( p < 0.001). Similarly, patients who had both diabetes and PVD showed a downward trend in LEA rate as obesity class increased; non-obese patients had a LEA rate of 8.01%, while obesity class III had 4.65% ( p < 0.001). Patients in higher income bracket have lower odds of LEA (OR 0.77, p < 0.001) compared to the lowest income patients. Also, patients with comorbidities such as PVD (OR 10.78), diabetes (OR 5.02), renal failure (OR 1.41), and hypertension (OR 1.36) had higher odds to get an LEA ( p < 0.001). Individuals with obesity class III are almost at half the odds (OR 0.52) to get an LEA compared to non-obese ( p < 0.001).

Conclusions

Higher BMI and female gender are protective factors against lower extremity amputation. Factors that predisposing to LEA include lower household income and certain comorbidities such as PVD, diabetes, renal failure, and hypertension. These findings warrant further research to identify patients at high risk for LEA and help develop management guidelines for targeted populations.
The transcription factor CCAAT/enhancer-binding protein β in spinal microglia contributes to pre-operative stress-induced prolongation of postsurgical pain
Authors: Jiang Ming , Huang Yulin , Hu Lijun , Wu Hao , Liu Yue , Ni Kun , Zhang Xiaokun , Sun Yu’e , Gu Xiaoping
Published: April 2022

Prolongation of postsurgical pain caused by pre-operative stress is a clinically significant problem, although the mechanisms are not fully understood. Stress can promote the pro-inflammatory activation of microglia, and the transcription factor CCAAT/enhancer-binding protein (C/EBP) β regulates pro-inflammatory gene expression in microglia. Therefore, we speculated that C/EBPβ in spinal microglia may have critical roles in the development of chronic postsurgical pain. Accordingly, in this study, we used a single prolonged stress (SPS) procedure and plantar incisions to evaluate the roles of C/EBPβ in postsurgical pain. Our experiments showed that SPS exposure prolonged mechanical allodynia, increased the expression of C/EBPβ and pro-inflammatory cytokines, and potentiated the activation of spinal microglia. Subsequently, microinjection of C/EBPβ siRNA attenuated the duration of SPS-prolonged postoperative mechanical allodynia and inhibited microglial activation in the spinal cord. Conversely, mimicking this increase in C/EBPβ promoted microglial activation via pretreatment with a pre-injection of AAV5-C/EBPβ, leading to prolongation of postsurgical pain. Overall, these results suggested that spinal microglia may play key roles in prolongation of postsurgical pain induced by pre-operative stress and that C/EBPβ may be a potential target for disease treatment.
Does It Mean We are American? A “Figured Worlds” Approach To Young Children’s Identity as Second-Generation Iraqi Refugees in the United States
Authors: Mehta Eleanor X.
Published: April 2022

This article draws on data from a participatory visual ethnography exploring the identities of two second-generation Iraqi refugee boys living in a southern state of the United States. It describes multiple “figured worlds” ( Holland, et al., 1998 ) as the context of identity negotiation in the lives of these children. Findings also reveal multi-layered fluidity among figured worlds, children’s authoring in negotiating figured worlds, and the possible influence of the family’s pre-migration trauma on identity. The article argues that to support the well-being of second-generation refugee children and their families, we need to understand the multiplicity of refugee children’s identity and how children construct their figured worlds using resources from their multiple communities.
Treatment of locally aggressive benign bone tumors by means of extended intralesional curettage without chemical adjuvants
Authors: Yenigül Ali Erkan , Sofulu Ömer , Erol Bülent
Published: April 2022

Objectives:

The aim of this study is to present the clinical, oncological, and functional results of locally aggressive benign bone tumors treated with extended intralesional curettage without the use of adjuvant in a tertiary orthopedic oncology center.

Method:

A total of 172 patients treated with surgical curettage and high-speed burrs for the diagnosis of aneurysmal bone cyst, giant cell tumor, osteoblastoma, chondroblastoma, and chondromyxoid fibroma were included in the study. Demographic, radiological, and clinical data of the patients were analyzed.

Results:

One-hundred seventy two patients (101 (59%) female and 71 (41%) male) with a mean age of 23 years (6–84). The mean follow-up period was 48 months (18–108). In the study, a total of 8 (4.6%) patients had postoperative complications, 17 (9.9%) patients had recurrence in the postoperative period. Diameter greater than 5 cm was found to be a risk factor for recurrence (p < 0.004). The probability of developing complications was found to be significantly higher in patients with recurrence (p < 0.001). There was no significant relationship between recurrence and age, tumor type, and tumor stage.

Conclusion:

Successful treatment results can be obtained with extended surgical curettage, high-speed burr, and cauterization without the use of chemical adjuvants in locally aggressive bone tumors.
The socioeconomic impact of multiple sclerosis in France: Results from the PETALS study
Authors: Bouleau A , Dulong C , Schwerer CA , Delgrange R , Bouaou K , Brochu T , Zinai S , Švecová K , Sá MJ , Petropoulos A , Aly S , Labauge P
Published: April 2022

Background

Multiple sclerosis (MS) places a considerable financial burden on the society. However, data quantifying the contemporary cost burden in France are lacking.

Objective

This cost-of-illness study aimed to estimate the direct and indirect costs associated with MS in France.

Methods

Between October 2020-November 2020, 208 French adults with a confirmed diagnosis of MS were recruited via MSCopilot® (a new MS self-assessment digital solution) and several MS patient networks. Indirect costs were estimated using a combination of top-down and bottom-up approaches. Direct costs were retrieved from Assurance Maladie (i.e. national system of health insurance) publications. Out-of-pocket expenses (OOPEs) incurred by MS patients were also reported. All costs were expressed in €2020. Data from the survey were extrapolated to the overall French MS population.

Results

MS exerted an annual cost burden of €2.7 billion on the French society (indirect costs: €1.3 billion; direct costs: €1.4 billion). Mean annual costs were €27,164.7 per-patient, with indirect and direct costs accounting for 48.1% and 51.9% of the total annual costs, respectively. OOPEs contributed over €90 million to the total annual costs.

Conclusions

MS imposes a substantial cost burden on the French society, with approximately half of the total annual costs driven by indirect costs.
Integrating MOOCs in an Undergraduate English Course: Students’ and Teachers’ Perceptions of Blended Learning
Authors: Wu Huashan , Luo Shujuan
Published: April 2022

As blended learning pedagogy gains an increasing popularity in higher education, there is a need to continually report both students’ and instructors’ perceptions regarding blended learning in order to generate better learning outcomes. This paper examines how students and instructors perceived the incorporation of MOOCs in students’ blended learning experience and the challenges they encountered. A total of 122 second-year undergraduates enrolling in an English course were surveyed, and five students and three lecturers were interviewed. The finding shows that students had favorable attitudes toward this blended course, expressing a higher level of interaction, flexibility, a better understanding of the learning content, and a richer learning experience. The instructors confirmed the positive impacts of blended learning but also admitted blended teaching increased their time commitment to their jobs. The impediments met by students and instructors in the blended learning environment must be taken into consideration.
“I Know How to Manage My Time”: Refusal Strategies by EFL Nursing Students
Authors: Mohammad Abeer
Published: April 2022

Health professionals who come from different cultural backgrounds are required to interact competently and at the most acceptable communication level that meets the demands of the multicultural context in which English is the medium of communication. Lack of proper communication in such contexts can establish a hostile work environment. Thus, health programs should prepare students interactionally to operate within the work environment competently. A total of 42 nursing students in a Saudi university responded to a Discourse Completion Test. The data show that nursing students demonstrate a tendency to use direct refusal strategies, especially when refusing a request. The analysis also reveals problematic refusal semantic formulas used to address a higher-status person. Thus, diagnosing such communication issues can contribute to establishing a healthy work environment.
VAT Reform, Regional Ownership Structure, and Industrial Upgrading: Evidence From Firms in Northeast China
Authors: Shi Junguo , Yuan Xinyi , Sadowski Bert M. , Kou Kou , Hu Xuhua , Li Sihan , Dou Shanshan
Published: April 2022

We estimate the extent of the moderating effect of varying regional ownership structures on the relationship between the VAT reform and industrial upgrading in a panel differences-in-differences framework, using a natural experiment of the China’s 2004 value-added tax (VAT) reform pilot that introduces a permanent 17%-tax credit for fixed investment in six industries in the North-eastern regions. Results reveal that the VAT reform helps firms increase their capital-to-labor ratio, labor input, and labor productivity, indicating the positive effect of VAT reform on fixed asset renewal and industrial structure upgrading in the region. As for the role of regional ownership structure, the positive effects of the VAT reform on labor input and labor productivity are significantly suppressed in areas with large market shares of state-owned enterprises. In another words, the VAT reform significantly promotes industrial upgrading in areas with market-sensitive economies.
The effects of several operative parameters on the grafting of selected grafting agents on a polyamide six (PA6) fiber surface
Authors: Saleh Naeemeh Sadat , Ostad Movahed Saeed , Attarbashi Fuzieh
Published: April 2022

The previous research showed the anti-biofouling improvement of the polyamide six (PA6) fiber when grafted by 2-hydroxyethyl methacrylate (HEMA) individually, and in combination with acrylic acid (AA) known as dual monomers system. The effects of several operative parameters, including vessel reaction temperature and time, ultra violet (UV) pre-irradiation time, and also HEMA-AA mole ratios (for dual system) on the surface grafting of a PA6 fiber by HEMA and also, dual HEMA-AA system were studied. The studied grafting parameters were grafting degree ( D), grafting efficiency ( E), formed homo and or co-polymer ( Y), reaction extent ( K), and reaction ratio ( R). A pre-UV irradiation technique (PUVA) used for irradiation of the fibers. The results showed efficient polymerization and grafting reactions for the selected operative parameters. The increasing reaction temperature reduced the grafting of the HEMA and AA on the fiber surface. Instead, it accelerated the homo and or co-polymerization of the HEMA and AA monomers. The reaction time had the lowest effect on the homo and co-polymer formation of the used monomers in the studied dual HEMA-AA system. The increasing pre-UV irradiation time was beneficial for the grafting of the studied monomers on the PA6 fiber. The reason referred to increasing the number and concentration of the active sites on the fiber surface.
Middorsal Wrist Pain in the High-Level Athlete: Causes, Treatment, and Early Return to Play
Authors: Hanson Zachary C. , Lourie Gary M.
Published: April 2022

Wrist injuries in the competitive athlete are a common reason for evaluation related to an acute injury or after symptoms have become chronic. While radius- and ulna-sided wrist pain are common topics covered in the literature, middorsal wrist pain is more common than the available literature would suggest. Missed diagnoses and inadequate treatment can significantly increase athlete morbidity and delay return to play. The goal of this article was to review the differential diagnosis of middorsal wrist pain in the athlete and discuss the diagnosis, treatment, and early return to play for each condition.
Déjà Q in the Australian nightlife: ID scanners and violent crime in night-time entertainment districts
Authors: Piron Kurt M , Devilly Grant J
Published: April 2022

On July 1, 2017, the mandatory use of identification (ID) scanners as a prerequisite to licenced venue entry came into effect in all 15 major night-time entertainment districts (NEDs) across Queensland (Australia). This relatively contemporary situational crime prevention technique functions to (1) supplement traditional door-staff enforced control access and (2) increase personal accountability by reducing perceived anonymity inside licenced venues. The current study examined the association between the ID scanner legislation and violent crime rates in the Fortitude Valley NED (Brisbane, Queensland), a leading hotspot for street violence. Police crime data was examined one year before ID scanner enforcement, and one year after, with each year matched quarterly to test Pearson’s chi-square contingencies by time of year. Violent summary offences (less serious violent offences) increased substantially in the first three months following the ID scanner legislative change, while general summary offences (i.e., public nuisance) and indictable offences (e.g., assaults) remained statistically unchanged. The introduction of ID scanners was the only legislative change that occurred in the Fortitude Valley NED during data collection, suggesting a highly probable link to the observed spike in violent offences. Potential determinants of this upsurge in violence are discussed, including inefficient queue management and increased provocations for violence in queues to nightclubs resulting from the prolonged ID scanning process.