bluuebunny/crossref_metadata_2025 huggingface dataset:
Implant-supported Dental Prosthesis and Orthognathic Surgery for Rehabilitation of Patients with Obstructive Sleep Apnea
Authors: Santana Sandro Isaías , Santana Breno de Souza Pedro , Rocha Flaviana Soares , Rodrigues Átila Roberto
Published: May 2022

Among the treatment options for Obstructive Sleep Apnea (OSA) we have surgery to correct dentofacial deformities. OSA patients are routinely and predictably submitted to surgical treatment for dentofacial deformities. Frequently, orthognathic surgery and osseointegrated implants may be necessary to enable fixed rehabilitation. Patients submitted to orthognathic surgery have a transient decrease in blood supply after maxillary and mandibular osteotomy procedures, which can impair the results in these cases. This case report aimed to present and discuss the conflicting situation of an OSA patient in need of orthognathic surgery and dental implants. The treatment consisted of: (1) extraction of all teeth; (2) complete rehabilitation of the upper and lower jaw with dental implants and prosthesis without compensation; (3) bimaxillary orthognathic surgery to re-establish the maxillomandibular relationship and increase the upper airway volume. This rehabilitation sequence was a safe alternative for a case of Class II OSA, and rapidly achieved a final restoration with enhanced esthetics, functionality, biomechanics, maintenance of oral hygiene, and patient satisfaction.
Fatores associados ao perfil psicossocial de mulheres durante o pré – natal
Authors: Gomes Franco Celso da Silva , Aragão Francisca Bruna Arruda , Serra Liana Linhares Lima , Chein Maria Bethânia Costa , Cunha José Herinque da Silva , Pires Franciele Kavafara , Lopes Fernanda Ferreira
Published: May 2022

Objetivo: analisar os fatores associados ao perfil psicossocial de mulheres durante o pré-natal no Hospital Universitário – Unidade Materno Infantil da Universidade  Federal do Maranhão – HUUFMA.  Métodos: estudo transversal realizado com 160 gestantes sem limite de faixa etária, atendidas no Ambulatório de Obstetrícia do HUUFMA no período de março a outubro de 2017. A avaliação do perfil psicossocial foi mensurada por meio do Prenatal Psychosocial Profile (PPP-VP).  Resultados: a maioria das gestantes, cerca de 41,25% (66), possui somente o Ensino Médio completo, faixa etária de 15 a 35 anos , cerca de 65,66% (105), no último trimestre gestacional 46,25% (74), a maior parte primigesta, 60% (96), com menos de seis consultas pré-natais realizadas, 67,52% (108). Quanto ao trimestre gestacional, não houve significância estatística com os constructos do PPP-VP, relativo à paridade, as multíparas foram as que mais evidenciaram estresse e o teste de Tukey demonstrou que as multíparas tiveram mais estresse quando comparada com as nulíparas. Conclusão: é pertinente inferir que, em relação ao trimestre gestacional, não houve influência relativa aos  constructos do perfil psicossocial, porém ao se relacionar paridade, a situação contrária foi observada, principalmente em multíparas, onde o maior número de partos refletia diretamente no nível desajustado do estresse, sendo assim é necessária uma maior atenção a essas questões para uma assistência pré-natal adequada.
Fatores associados ao maior risco de ulceração nos pés de indivíduos com Diabetes mellitus
Authors: Zörrer Luís Augusto Barbosa Franco , Gianini Viktor Cleto Morais , Safar Guilherme Maciel , Silva Marcela Maria Carvalho , Coradassi Tatiane , Esmanhotto Bruno Bertoli
Published: May 2022

Objetivo: Diante da alta prevalência do Diabetes Mellitus, o estudo se propõe a identificar os fatores associados ao maior risco de desenvolver úlceras nos membros inferiores. Métodos: O trabalho foi exploratório-descritivo, transversal e com abordagem quantitativa. A amostra foi composta por pacientes com Diabetes acima de 18 anos de um serviço de saúde particular e um público. A coleta de dados ocorreu através de anamnese, exame físico e procura em prontuário. A análise estatística foi realizada pelo Programa SPSS 20.0. Resultados: Obteve-se 102 participantes no estudo, destes, 67,6% apresentaram critérios diagnósticos para Polineuropatia Simétrica Distal. Os fatores associados ao risco de ulceração foram: o envelhecimento, a maior duração da Diabetes, hipertensão, doença arterial periférica e a presença de sintomas típicos da Polineuropatia. Conclusão: É necessário investir na prevenção de úlceras em indivíduos com Diabetes através de educação em saúde e acompanhamento por profissionais da saúde.
Espirometria e oscilometria de impulso durante internação por exacerbação pulmonar aguda em escolares com fibrose cística
Authors: Castilho Tayná , Wamosy Renata Maba Gonçalves , Schivinski Camila Isabel Santos
Published: May 2022

Objetivo: avaliar o comportamento de parâmetros do sistema respiratório durante internação para antibioticoterapia intravenosa (AIV) como tratamento da exacerbação pulmonar aguda (EPA) em escolares com fibrose cística (FC). Métodos: estudo do tipo analítico observacional, before-after, realizado no Hospital Infantil Joana de Gusmão, Florianópolis – Santa Catarina. Foram incluídas crianças com diagnóstico de FC, entre seis e 15 anos, em internação para tratamento da exacerbação pulmonar aguda, no início (T1), durante (T2) e ao final (T3) da internação foi conduzida avaliação de escores específicos de EPA, dados antropométricos e realizada avaliação dos parâmetros do sistema respiratório pelo sistema de oscilometria de impulso (IOS) e espirometria. Foram obtidos, em prontuário, dados de colonização bacteriana, genótipo, gravidade da doença (Escore de Schwachman-Doershuk-ESD) e espirometria mais recente em estabilidade clínica. Aplicou-se o teste Shapiro-Wilk para análise da distribuição dos dados e os testes ANOVA de medidas repetidas, teste de Friedman, teste T pareado e Wilcoxon, com nível de significância de 5%. Resultados: participaram 16 crianças/adolescentes (68.8% meninas, 12.88±1.67anos). Houve aumento dos parâmetros da espirometria e dados antropométricos (p<0.005) no T3, bem como redução dos escores de EPA e do X5 (p<0.005) no T3. Conclusão: os dados apresentados nesse trabalho mostram melhora dos escores de EPA, dados antropométricos, parâmetros da espirometria e do parâmetro de recolhimento elástico do IOS (X5).
Sociodemographic, clinical, epidemiological and care aspects of children and adolescents treated for retinoblastoma in Brazil
Authors: Bochi Gabriela Silva , Silva Alicia Natali Ferreira da , Messias Maria Izabel Pereira , Melo Jessica Luanda Lemos , Sawada Namie Okino , Oliveira Fabiana Lucio de , Nascimento Murilo César do
Published: May 2022

Introduction: Retinoblastoma greatly impacts the affected children and adolescents and their families. Epidemiological approaches to this form of cancer in Brazil are scarce, and this gap motivated this study. Objectives: This study aimed to describe the sociodemographic, clinical, epidemiological, and care characteristics of children and adolescents treated for retinoblastoma in Brazil and analyze whether there is any association between them. Methods: It is a cross-sectional, descriptive-analytical study, carried out with accompanying family members of children and adolescents treated for retinoblastoma in Brazil, sampled by snowball sampling, via a web survey, based on a semi-structured questionnaire elaborated by the authors, shared on social media. Results: The children and adolescents were represented by 129 accompanying family members from the five largest regions of Brazil. Low education level, housewifery, and low family income were associated with exclusive care provided by the Unified Health System, while low family income was associated with the use of ocular prosthesis post retinoblastoma. Conclusion: The identified odds ratio indicated the importance of family members’ sociodemographic aspects for the clinical, epidemiological and care outcomes of the children and adolescents treated. Public healthcare services were the most used for oncology care, which endorses the relevance of the Unified Health System for children, adolescents, and their family members who have been impacted by retinoblastoma in the country.
Fatores preditores do desfecho do Teste de Provocação Oral na Alergia à Proteína do Leite de Vaca: in natura vs. alimentos processados
Authors: Leitão Lia Maria Bastos Peixoto , Ferreira Janáira Fernandes Severo , Motoyama Paula Vitória Pereira , Teixeira  Filho Manuel Sampaio , Nogueira Hildênia Baltasar Ribeiro , Bessa Olivia Andrea Alencar Costa
Published: May 2022

Objetivos: Descrever uma população de crianças com alergia à proteína do leite de vaca (APLV) IgE mediada, submetidas ao teste de provocação oral (TPO) com alimentos processados vs. in natura, e comparar características clínico-epidemiológicas e laboratoriais, avaliando preditores de desfecho ao uso dessas diferentes apresentações de proteína. Métodos: Estudo transversal ambulatorial de alergia em hospital terciário em Fortaleza, Ceará. A coleta dos dados foi realizada entre outubro de 2018 a setembro de 2019. O questionário foi preenchido com os dados epidemiológicos, clínicos e laboratoriais encontrados no prontuário; amostra total de 49 crianças, com APLV IgE mediada tolerantes ao TPO com alimentos processados ou in natura. Resultados: Na comparação das características clinico-epidemiológicas das populações tolerantes a alimentos in natura vs. processados (respectivamente), a maioria apresentou dados semelhantes, como sexo masculino (60% vs. 57,9%), etnia parda (73,3% vs. 68,4%), idade gestacional a termo (80% vs. 77,8%), sem intercorrências durante a gestação (58,3% vs. 80,0%) ou parto (70% vs. 78,9), média de idade materna (32 anos vs. 35 anos), escolaridade materna (ensino médio completo - 43,3% vs. 47,4%), idade de início dos sintomas de APLV entre 1 e 6 meses (76,7% vs. 68,4%), aleitamento materno exclusivo entre 4 e 6 meses (60% vs. 68,45%), histórico de alergia familiar alimentar (73% vs. 68,4%), sendo as principais comorbidades alérgicas as respiratórias (38,9% vs. 35,7%) e alimentares (38,9% vs. 35,7%). Em relação aos dados laboratoriais, a maioria das frações de proteína no grupo tolerante a alimentos in natura e a alimentos processados apresentou valores ≤ 10 kU/L. Foi constatado que a idade materna (p = 0,006) e a idade de introdução de fórmula complementar (p = 0.020) se correlacionam de forma estatisticamente significante no grupo de pacientes tolerantes a alimentos processados. Conclusões: Foi observado que a idade materna (p = 0,006) e a idade de introdução de fórmula complementar (p=0.020) se correlacionam de forma estatisticamente significante no grupo de pacientes tolerantes alimentos processados. Os dados laboratoriais seguiram distribuição proporcionais entre os dois grupos, com maior frequência de valores ≤ 10 kU/L para todas as frações de proteína do leite de vaca, sem significância estatística. Estudos populacionais semelhantes em populações APLV IgE mediada são importantes caracterizando melhor esse fenótipo e otimizar ferramentas diagnósticas e protocolos de tratamento. Destaca-se também o papel da terapia baked, que auxilia na aquisição de tolerância a diferentes apresentações da PLV de forma mais breve, melhorando, portanto, a qualidade de vida desses pacientes.
A review of the spider genus Iberina (Araneae, Hahniidae)
Authors: RŮŽIČKA VLASTIMIL
Published: May 2022

The spider genus Iberina has been reviewed and an updated description of the genus is presented. A key to the genera of the subfamily Hahniinae and to the species of Iberina is given. The genus Iberina now includes five species. The following new synonymy is proposed: Iberina caeca Georgescu & Sarbu, 1992 = Iberina microphthalma (Snazell & Duffey, 1980) new synonymy. Iberina ljovuschkini Pichka, 1965 is only known from females. It is considered to be a species inquirenda and its name declared a nomen dubium.
Comparison of off-axis angle on the low velocity impact behaviors for carbon-fiber-reinforced polymer laminates
Authors: Pei Ning , Wu Qi , Long Lianchun
Published: May 2022

Three types of composite specimens with different off-axis angles after indentation were subjected to progressive tensile loading, and the results showed that although the tensile strength is reduced with an increase in off-axis fiber orientation angle, such off-axial structure can enhance the impact-resistance capacity. An acoustic emission (AE) signals analysis showed that data can be divided into categories that correlate with three damage modes. The AE peak frequency characteristics of each damage mode were also identified for both specimens with and without indentation, and the results also showed that indentation can change the order of appearance of different damage modes during loading. Additional characterization was provided by using Micro-computed tomography (Micro-CT) during a progressive tensile loading process, and the CT images provided visualization of damage location and evolution in the composites, with the data exhibiting good correlations with the AE data for defect prediction. The use of AE and Micro-CT technology was shown to effectively characterize composite damage evolution, and such data can potentially serve as a reference for the structural health monitoring (SHM) of such composites when used in structures.
The Development of Executive Functions in High-Level Female Soccer Players
Authors: Beavan Adam , Spielmann Jan , Ehmann Paul , Mayer Jan
Published: May 2022

Executive functions (EFs) are higher-level cognitive functions that help keep an individual’s goal-oriented thoughts and actions aligned. While many studies have shown the importance of EFs in sport, a limitation in this literature is that female participants have been underrepresented. In this mixed-longitudinal study, we examined the development of EFs in a cohort of high performing female athletes. We collected data over five seasons in a large sample of 175 female soccer players (aged 12–29 years old) from the U14 - senior age groups of a professional German soccer club. Players undertook a large battery of cognitive tasks aimed at measuring higher-level cognitive functioning: a sustained attention task, a stop-signal task, a Go-No-go test, an N-Back Test, and both a 180°- and 360°-multiple-object tracking task. We used linear and non-linear mixed effect regressions to examine the relationship between age and EFs. Second order polynomial curves explained many of these relationships between age and EFs compared to their linear relationships. Negatively accelerated curves reveal that these players’ cognitive abilities mainly developed before players reached early adulthood, with a performance plateau evident at around 21 years of age. Age explained low to moderate proportions of the variance in EFs (<1–50%), while cognitive development across playing positions was not a strong contributor to this variance ( M = 2.1, SD = 2.1%). We concluded that age has a negatively accelerated relationship with EFs in female soccer players that does not differ between playing positions. These data support the idea that athletes require only a reasonable level of EF ability to perform at the highest level of their sport. Our research raises new questions regarding the validity of current EF measurement methods for inferring information about in-game use of these cognitive abilities.
Comparison of National Vulnerability Indices Used by the Centers for Disease Control and Prevention for the COVID-19 Response
Authors: Wolkin Amy , Collier Sarah , House John S. , Reif David , Motsinger-Reif Alison , Duca Lindsey , Sharpe J. Danielle
Published: May 2022

Objective:

Vulnerability indices use quantitative indicators and geospatial data to examine the level of vulnerability to morbidity in a community. The Centers for Disease Control and Prevention (CDC) uses 3 indices for the COVID-19 response: the CDC Social Vulnerability Index (CDC-SVI), the US COVID-19 Community Vulnerability Index (CCVI), and the Pandemic Vulnerability Index (PVI). The objective of this review was to describe these tools and explain the similarities and differences between them.

Methods:

We described the 3 indices, outlined the underlying data sources and metrics for each, and discussed their use by CDC for the COVID-19 response. We compared the percentile score for each county for each index by calculating Spearman correlation coefficients (Spearman ρ).

Results:

These indices have some, but not all, component metrics in common. The CDC-SVI is a validated metric that estimates social vulnerability, which comprises the underlying population-level characteristics that influence differences in health risk among communities. To address risk specific to the COVID-19 pandemic, the CCVI and PVI build on the CDC-SVI and include additional variables. The 3 indices were highly correlated. Spearman ρ for comparisons between the CDC-SVI score and the CCVI and between the CCVI and the PVI score was 0.83. Spearman ρ for the comparison between the CDC-SVI score and PVI score was 0.73.

Conclusion:

The indices can empower local and state public health officials with additional information to focus resources and interventions on disproportionately affected populations to combat the ongoing pandemic and plan for future pandemics.
The Genius of Feminism: Cavellian Moral Perfectionism and Feminist Political Theory
Authors: Drews Lucas Sarah
Published: May 2022

Work on Stanley Cavell in contemporary political theory tends to foreground Cavell’s reading of Emersonian moral perfectionism, but this aspect of Cavell’s thought is often left out of feminist readings of his work. In this paper, I give an overview of Cavell’s importance to political theory, and I also trace two Cavellian-inspired feminisms: Sandra Laugier’s ordinary language inflected ethics of care and Toril Moi’s understanding of feminist theory as the close and careful reading of examples. I argue that Cavellian-Emersonian moral perfectionism enhances these feminist readings of Cavell because it helps us explain certain practices in feminist activism, such as resisting conformity, acknowledging the limits of our understanding and being receptive to other members of our feminist community.
The just price and the gains from exchange
Authors: Maffettone Pietro
Published: May 2022

The paper explores a general framework for thinking about the idea of the just price. The approach is grounded in a basic aspect of the nature of exchange, namely, that the latter usually occurs when both parties believe they will be better off as a result. Put differently, an exchange is normally performed because both parties stand to gain something from it. The distributive question that arises from this observation is how one ought to divide such gains. The connection with the idea of the just price is not necessarily an obvious one, yet it is relatively straightforward. Assuming that an exchange involves money (or any unit of account), the price at which two agents transact will correspond to a specific division of the gains from the transaction. Conversely, any specification of a fair division of the gains from exchange individuates a specific price as the just or fair price. The paper analyzes the main features of this approach to the determination of the just price, explains one of its main virtues, defends it against an alleged weakness and criticizes as inadequate two of its traditional interpretations. The upshot of the discussion is that while the idea that the just price of a transaction depends on how the latter divides the gains from exchange does not suffer from general flaws and is in fact characterized by an important good making feature, the two principal ways in which it has been deployed are implausible.
Evaluation of a shortened version of the Action Research Arm Test (ARAT) for upper extremity function after stroke: The Mini-ARAT
Authors: Daghsen Lina , Fleury Lisa , Bouvier Justine , Zavanone Chiara , Dupont Sophie , Hummel Friedhelm Christoph , Rosso Charlotte
Published: May 2022

Objectives

(i) to create a shortened version of the Action Research Arm Test scale, (ii) to investigate its psychometric properties compared to the original scale and (iii) to externally validate it within an independent cohort.

Design

Prospective longitudinal cohort study.

Settings

Two University Hospitals (France, Switzerland).

Participants

47 patients with poststroke motor deficits of the upper limb coming from two different sites were included and divided into two cohorts (n = 22 for the construction cohort; n = 25 for the validation cohort).

Main Measures

We used the first cohort to build the Mini-ARAT by shortening the Action Research Arm Test scale on the basis of ceiling/floor effects and collinearity of the subscales. We studied its reliability, validity, and responsiveness and performed an external validation with the second cohort.

Results

The Mini-ARAT consisted of 2 subscales from the original Action Research Arm Test scale (Grip and Pinch). Internal consistency (α = 87) and inter-rater reliability (0.99, 95% CI: 0.98–0.99, p < 0.01) were good and similar to those of the Action Research Arm Test scale. The Minimal Clinically Important Difference of the Mini-ARAT was 9 points. The predictive validity in the construction and validation cohorts showed good correlation between the Mini-ARAT at baseline and the Fugl Meyer at 3 months (rho, 95% CI: 0.77, 0.49–0.90, p < 0.01, and 0.58, 0.19–0.96, p < 0.01).

Conclusion

The Mini-ARAT is a time-effective tool able to capture the dynamics of motor deficits with high reliability and consistency, providing excellent information about residual motor functions, which is critically important for clinical and research purposes.
Occupational therapists’ perspectives on current practice in chronic pain and sleep disturbances
Authors: McVeigh J , Crozier Molly , Macinnes Venetia , Morris-McCall Jazmine , Stewart Sophie , Hick Shannon , Thompson Craig
Published: May 2022

Background

Chronic pain and sleep disturbances are often co-morbid. Sleep disturbances can negatively affect self-care occupations, cognition, mood, emotional functioning and physical wellbeing.

Aim

To explore occupational therapists’ experience working with clients with chronic pain and sleep difficulties.

Method

Semi-structured interviews were conducted with 11 occupational therapists with experience working with clients with sleep disturbances and chronic pain.

Findings

The relationship between sleep disturbances and chronic pain was described as being complex and multifaceted. Participants believed they were uniquely placed to work with clients experiencing these two conditions. They felt inadequately equipped to treat sleep disturbances and chronic pain. Participants indicated that best practice required multiple interventions and a team-based approach. Finally, the participants noted that sleep disturbances and chronic pain are a growing area of practice.

Conclusion

The findings suggest that occupational therapists tailor their intervention strategies to be early, multi-pronged and individualised. Institutional barriers need to be addressed to further develop occupational therapists’ skill set when working in the areas of sleep and chronic pain. Further research to support the interventions currently used in practice to treat these two conditions is needed.
Pharmacist-Led Deprescribing for Patients With Polypharmacy and Chronic Disease States: A Retrospective Cohort Study
Authors: Chan Mabel , Plakogiannis Roda , Stefanidis Abraham , Chen Mandy , Saraon Tajinderpal
Published: May 2022

Background: Current literature and practice have demonstrated that pharmacists have an integral role in deprescribing. However, research regarding their impact on patients with chronic diseases is limited. Objective: To assess the impact of a pharmacist-led intervention on deprescribing inappropriate medication for patients with chronic diseases within a four-month study period compared to patients receiving usual care. Methods: This study was conducted at NYU Langone Health. Patients of the intervention group were referred by a provider and met the criteria of polypharmacy, required chronic disease states management, were nonadherent to medications, had poor health literacy, or required titration for heart failure (HF) guideline directed medical therapy. Results: A total of 142 patients were reviewed over a two-year period. At the end of the study period, the median number of medications for the two respective groups was similar (11 [4 – 30] vs 11 [2 – 23]). The pharmacist-led intervention had on average one medication deprescribed (m = −1.00, sd = 2.57), whereas the control group had on average .44 additional medications (m = 0.44, sd = 3.32) prescribed. Furthermore, the intervention group presented statistically significant differences (P = 0.046) regarding their diastolic blood pressure after the pharmacists’ intervention (m = 72.69, sd = 11.64). Most importantly, patients with HF presented statistically significant improvement in their ejection fractions after the intervention (m = 41.46%, sd = 19.28%). Conclusion: The pharmacist-led intervention resulted in significant discontinuation of medications for patients in the intervention group compared to those in the usual care group within four-months.
Unknown input observer-based fault diagnosis of speed sensors in dual clutch transmission
Authors: Mo Jinchao , Qin Datong , Liu Yonggang
Published: May 2022

Speed sensors in the dual clutch transmission (DCT) play an essential role in designing the vehicle launching and gear shifting strategy. The speed information can also be used to monitor whether the DCT system operates normally. The vehicle performance will degrade rapidly once the speed sensor occurs fault, which may lead to poor driving experience. With increasing working hours and poor working environment, the speed sensors are prone to failure. In order to monitor the sensor failure, this article proposes a robust speed sensor fault diagnosis algorithm based on an unknown input observer (UIO). First, the dynamic model of a DCT powertrain is constructed which captures the internal and external disturbance in the system. Based on the dynamic model, a sensor fault detection algorithm is presented by designing an UIO. Second, a set of UIOs is developed to identify which sensor occurs fault. Finally, a sensor fault estimation method using the UIO is proposed. Simulation results reveal that the speed sensor faults can be detected, isolated and estimated, which may further be used for fault-tolerant control of a DCT system.
Simulation of the inherent structural irregularities of high-speed railway turnouts based on a virtual track inspection method
Authors: Sun Xu , Wang Ping , Xu Jingmang , Xu Fei , Gao Yang
Published: May 2022

Track geometry parameters measured by a track recording car at a turnout are often hard to interpret due to the concomitant geometric complexity, especially for a high-speed railway turnout whose running edge is not interrupted. The virtual track inspection (VTI) method integrated with a multibody system model is proposed to reveal the longitudinal level and alignment of high-speed railway turnouts when the train passes in the main line and in the branch line. Firstly, the principle of inertial measurement and its implementation in MBS are introduced. Then, the VTI method is applied to the vehicle-turnout dynamics using a single-layered co-running track model and validated on tangent and curved tracks in the spatial and wavelength domain. Zero-phase Filters for wavelength ranges 3–25 m and 1–5 m are necessary to eliminate interference from long waves, and to better identify the switch and crossing, respectively. Finally, the effect of different track foundations is studied, including the two-layered co-running track model and the finite element model on the VTI method.
Improving Critical Care Nurses Perceived Self-Efficacy in Providing Palliative Care: A Quasi-Experimental Study
Authors: DeFusco Christina , Lewis Auriel , Cohn Tanya
Published: May 2022

Background

Palliative care is a service that focuses on quality of life and symptom management. It is particularly important for patients with chronic disease. Palliative care in general is an underutilized service for various reasons. Many nurses have only learned about palliative care from experience and express a need for more education.

Purpose

This study focused on educating critical care nurses on palliative care through online training videos. This quasi-experimental study aims to determine if an online palliative care educational program improves critical care nurses’ self-efficacy in providing palliative care.

Procedures

The study was conducted using a pre-survey and post-survey that was created with a validated tool called the Palliative Care Self-Efficacy Scale. In between the surveys, the respondents were directed to online education.

Main Findings

The overall Palliative Care Self-Efficacy Scale showed a median score of the Palliative Care Self-Efficacy Scale increased from pre education (Md=38) to post-education (Md = 43.5), z = -4.868, p <.001, with a large effect size (r = -.76).

Principal Conclusions

The majority of critical care nurses have received some form of palliative care education. Online resources similar to the VitalTalk videos and handouts provide added education and improve perceived self-efficacy in providing palliative care in both psychosocial and symptom management aspects of care. The data suggests that improvements to access to education can be done by employers. Further studies can be done to assess current access to palliative care education in undergraduate nursing programs.
Weakening-strengthening evolution law of concrete flexural strength under sulfate attack
Authors: Chen Tingwei , Chen Jiankang , Chen Jinhan
Published: May 2022

For plain concrete materials, the degradation of concrete by seawater is mainly reflected in the corrosion of sulfate ions. In this study, the variation in the flexural strength of concrete specimens with different water-cement ratios under different sulfate concentrations for 470 days is explored, and the effect of sulfate environment on the decay of flexural strength of concrete with corrosion time is experimentally examined. The results show that the evolution of flexural strength can be divided into three stages: strength attenuation stage, strength recovering stage and strength re-attenuation stage. According to the experimental results, the mechanism of strength attenuation, rebound and re-attenuation is established. Combining the chemical reaction rate equations of continued hydration, delayed growth of ettringite and growth of hydroxy-AFm, a new model for the flexural strength degradation of concrete under sulfate corrosion is proposed. Further, the influence of water-cement ratio and corrosive sulfate solution concentration on the flexural strength of concrete is analyzed. Since the ability of concrete to resist sulfate corrosion can be different for different corrosion systems, a unified method is proposed for evaluating the sulfate corrosion resistance of concrete.
Photoscreening for amblyopia risk factors assessment in young children: A systematic review with meta-analysis
Authors: Ferreira André , Vieira Rita , Maia Sofia , Miranda Vasco , Parreira Ricardo , Menéres Pedro
Published: May 2022

Purpose

Amblyopia is a leading cause of preventable and treatable vision loss in the pediatric population. Instrument-based screening of amblyopia-risk factors is being widely adopted but the audit of its results is still lacking. We sought to review the existing evidence regarding the outcomes of photoscreening applied to children under the age of three years.

Methods

A three-database search (Pubmed, ISI Web of Science, and Scopus) was performed from inception to March 2021. A meta-analysis of proportions was conducted to summarize the referral rate, untestable rate and positive predictive value (PPV).

Results

Thirteen studies were selected among 705 original abstracts. The quantitative analysis included twelve studies enrolling 64,041 children. Of these, 13% (95%CI: 7–19%) were referred for further confirmation of the screening result. Astigmatism was the most common diagnosis both after screening and after ophthalmologic assessment of referred children. The pooled untestable rate and PPV were 8% (95%CI: 3–15%) and 56% (95%CI: 40–71%), respectively.

Conclusion

There is no global consensus on the optimal age, frequency or what magnitude of refractive error must be considered an amblyopia-risk factor. Optimization of referral criteria is therefore warranted.
A study of the influence of orifice diameter on a Dual Mode, Turbulent Jet Ignition engine through variable engine speed
Authors: Ayele Yidnekachew , Stuecken Thomas , Schock Harold
Published: May 2022

The increasingly strict worldwide emission regulations for internal combustion engines force car manufacturers to exploit innovative combustion technologies. One expects a change from pure thermal engines to more advanced internal combustion engine. A high engine compression ratio with high EGR dilution has an impact on increasing engine efficiency. A compelling concept to burn diluted combustion can be a DM-TJI combustion system, which consists of a pre-chamber and main chamber connected with one or more small orifices. This technology effectively achieves diluted combustion by improving engine dilution tolerance and knock performance. This paper focused on the impact of engine speed with variation in pre-chamber nozzle orifice diameter. Experiments were conducted with three different pre-chamber nozzle orifice diameters of 1.25, 1.5, and 1.75 mm with an engine speed range from 1500 to 2300 rpm. A numerical analysis was conducted to investigate the nozzle orifice diameter effect on the engine speed beyond 2500 rpm. Engine speed variation affects the performance of each orifice’s diameters. Small orifice diameter performs better for lower engine speed, and large orifice diameter performs better for higher engine speed. The 1.25 mm orifice diameter provided fast combustion. However, when the engine speed increases, the combustion stability suffers. Orifice diameter of 1.5 mm has better combustion stability in all tested speed ranges and higher efficiency in the speed range of 1500–2000 rpm, with a maximum indicated efficiency of 44.18%. The 1.75 mm orifice diameter performs better in the high engine speed ranges between 2100 and 2300 rpm, with a maximum indicated efficiency of 44.56% at an engine speed of 2300 rpm. This study has demonstrated the capability of the DM-TJI system to work with a high level of EGR dilution (up to 45%) and delivered a better indicated efficiency than the conventional spark ignition engines.
20(22)Z and 20(22)E Dammarane Saponins From the Roots of Panax pseudoginseng Wall.
Authors: Hung Hoang Van , Tan Luc Quang , Hoang Nguyen Huy , Huu Tai Bui , Van Kiem Phan
Published: May 2022

Panax pseudoginseng Wall. is famous as a traditional Vietnamese medicinal plant used to promote health and aid in cancer treatment. From the roots of this plant, 1 new (1) and 4 known (2-5) Δ20(22)-dammarane-type triterpenoid glycosides were isolated by various chromatographic methods. Their chemical structures were determined as 3β,6α,12β-trihydroxydammarane-( Z)-20(22),24-diene 6 -O-β-D-glucopyranoside (1), 3β,6α,12β-trihydroxy-dammar-( E)-20(22),25-diene 6 -O-β-D-glucopyranoside (2, ginsenoside Rh4), ginsenoside Rg5 (3), 3β,12β-dihydroxydammarane-( E)-20(22),24-diene 6 -O-β-D-xylopyranosyl-(1→2)-β-D-glucopyranoside (4), and 3β,12β-dihydroxydammarane-( E)-20(22),24-diene 6 -O-α-L-rhamnopyranosyl-(1→2)-β-D-glucopyranoside (5). The E/ Z-Δ20(22) configurations in the dammarane compounds were further evidenced by 1D and 2D NMR data.
A Public Service? Mediatization of the Olympic Games in Croatia and Slovenia
Authors: Ličen Simon , Antunovic Dunja , Bartoluci Sunčica
Published: May 2022

The Olympic Games are the largest mediated sporting mega-event, and broadcasters are instrumental in ensuring their exposure and financial viability. In the digital era, the Olympics navigate technological and societal changes that contest the values of sport, carry political and economic implications, and shape the relationship between the organizers and nation states. These interdependencies vary by global regions. This study examines the mediatization of sport as manifested in digital Olympic content published on Facebook during the Tokyo Olympics by public service media (PSM) in Croatia and Slovenia—two countries inconsistently assigned to either Central and Eastern Europe or Southeast Europe. These PSM face a host of challenges, including rising media rights costs, digitalization, and political interference, while continuing to broadcast the Olympics. On their Facebook pages, contest-related updates were the primary type of content, general news and especially human interest content was rare, critical posts were virtually non-existent, and “home” athletes were politicized conspicuously. Mediatization in this region seems delayed, facilitates event-focused and decontextualized sport content, and appears central in promoting patriotic narratives. On social media, broadcasters perpetuate problematic practices characteristic of sport media and only partially fulfill the roles traditionally ascribed to PSM.
Gods in Patnakalam: Tradition and Modernity in Colonial Art
Authors: Jaipuriar Saumya Garima
Published: May 2022

The appearance of Hindu gods was an essential feature of various indigenous Indian art tradition. The rise of hybrid Indo-Western art schools, notably Patnakalam heralded a fundamental shift in the way gods appeared in art and the meaning their iconography carried. This may be understood as one of the ways in which a kind of modernity took shape in nineteenth century Indian art.
Impact of the COVID-19 Pandemic on Patient Fertility Care
Authors: DSouza Karen N , Orellana Minerva , Ainsworth Alessandra J , Cummings Gabrielle , Riggan Kirsten A , Shenoy Chandra C , Allyse Megan A
Published: May 2022

The effects of the COVID-19 pandemic on the healthcare system have been widespread, with many institutions in the United States pausing elective procedures to redirect resources to critical care. Fertility care and assisted reproductive procedures were classified as elective procedures and similarly paused. We conducted qualitative interviews with patients and/or their partners ( n = 25 female patients; n = 3 male partners) receiving care at a fertility clinic in the Midwest to understand patient appraisal of COVID-19 risk on the resumption of care following a month-long closure of an infertility clinic, and patient agreement with the clinic closure. Interview transcripts were thematically analyzed from a grounded theory approach. Study participants reported an increased sense of urgency due to the delay in fertility procedures. This urgency often superseded concerns of potential COVID-19 infection, motivating patients to continue fertility treatment during a pandemic. In hindsight, some participants did not agree with the clinic's closure and treatment cessation, feeling that these steps negatively interrupted time-sensitive reproductive goals. Patient responses highlight the need for additional resources to support decision-making during times of crisis. Triaging patients based on time-sensitivity of treatment instead of a total shutdown respects patient autonomy for continuing treatment amidst uncertain COVID-19-impact.
The association between the serum uric acid to creatinine ratio and all-cause mortality in elderly hemodialysis patients
Authors: Ding Zhihui , Fan Yao , Yao Chunlei , Gu Liubao
Published: May 2022

Background

Elderly hemodialysis patients have a higher rate of mortality than nonelderly hemodialysis patients. Recent studies shown that the serum uric acid to creatinine ratio (SUA/Scr) was associated with all-cause mortality in general adults. The purpose of the present study was to investigate the association between the SUA/Scr and all-cause and cardiovascular disease mortality among elderly hemodialysis patients.

Methods

A total of 222 patients (≥ 60 years) who received hemodialysis more than 8 h per week at Taizhou Second People’s Hospital for at least 3 months were enrolled in the present study from January 2015 to December 2019. Clinical characteristics including age, sex and height et. al, were obtained from the hemodialysis database. The laboratory data, including albumin (ALB), total cholesterol (TC), serum uric acid (SUA), serum creatinine (Scr) and so on, were collected before hemodialysis and analyzed by automatic biochemical analyzer. Survival information was recorded during the follow-up period. Multiple Cox regression was carried out to analyze the association between SUA/Scr and all-cause mortality. The survival rate of each group was calculated by the Kaplan–Meier method, and the ratio of survival curves was analyzed by the log-rank test. The contribution of SUA/Scr for predicting all-cause mortality risk was evaluated by net reclassification improvement (NRI).

Results

During the 19-month observation period, 78 patients died. Individuals in the nonsurviving group had significantly older ages (P < 0.001), body mass index (BMI) (P = 0.004), serum creatinine (P = 0.005) and prealbumin (P = 0.006) than surviving patients. After adjusting for age, sex, BMI, prealbumin, dialysis vintage, dialysis frequency, single-pool Kt/V (spKt/V), DM, hypertension and comorbidities, a higher ratio of SUA/Scr was independently associated with a higher risk of all-cause mortality (HR: 1.292; 95% CI: 1.013–1.648; P = 0.039). The predict value on all-cause mortality of SUA/Scr was superior to SUA (additive NRI = 0.214, P = 0.015) and Scr (additive NRI = 0.476, P < 0.001) among elderly hemodialysis patients.

Conclusion

The serum uric acid to creatinine ratio is strongly associated with all-cause mortality in elderly hemodialysis patients which is more predictive than SUA or Scr alone.
Understanding public attitudes to death talk and advance care planning in Northern Ireland using health behaviour change theory: a qualitative study
Authors: Graham-Wisener L. , Nelson A. , Byrne A. , Islam I. , Harrison C. , Geddis J. , Berry E.
Published: May 2022

Objectives

Advance care planning is a key preparatory step in ensuring high-quality palliative and end of life care, and should be considered as a process, beginning with community-level conversations among lay persons. There is, however, indication that death talk among community-dwelling adults is not occurring, and there is a dearth of research examining why this is the case. This study aims to provide the first examination of barriers and facilitators to talking about death and dying among the general population in a UK region (Northern Ireland), and to provide a novel application of health behaviour change theory towards developing a theoretical understanding of the sources of this behaviour.

Methods

The study involved qualitative analysis of responses (n = 381 participants) to two open-ended questions within a cross-sectional online survey, with recruitment via social media of adults currently living in Northern Ireland. Reflexive thematic analysis was conducted on open text responses per question, with the barriers and facilitators mapped on to health behaviour change models (the Behaviour Change Wheel COM-B and the Theoretical Domains Framework).

Results

The findings evidence a myriad of barriers and facilitators to engaging in death talk, with themes aligning to areas such as lack of acceptance of death in social contexts and fear of upsetting self or others, and a need to improve interpersonal communication skills for facilitating conversations and improve knowledge of the existing services around death and dying. A theoretical understanding of the drivers of death talk is presented with findings mapped across most components of the COM-B Behaviour Change Model and the Theoretical Domains Framework.

Conclusions

This study contributes to a small but emergent research area examining barriers and facilitators to talking about death and dying. Findings from this study can be used to inform new public health programmes towards empowering adults to have these conversations with others in their community towards upstreaming advance care planning.
Smoking related attention alteration in chronic obstructive pulmonary disease-smoking comorbidity
Authors: Zeng Feiyan , Hong Wei , Zha Rujing , Li Ying , Jin Chen , Liu Ying , Liu Hao , Liu Mengqiu , Liu Mei , Xu Fei , Hu Daiju , Song Hongwen , Wu Haiyan , Yu Yongqiang , Zhang Xiaochu
Published: May 2022

Background

Chronic obstructive pulmonary disease (COPD) is a respiratory disease that causes a wide range of cognitive impairments. Although COPD-Smoking comorbidity is common, the relationship between smoking and cognitive function in COPD-Smoking comorbidity remains unclear. This study aimed to investigate the effect of smoking on cognitive function like attention in COPD-Smoking patients.

Methods

In this study, we used the Montreal Cognitive Assessment (MoCA) scale and resting-state functional magnetic resonance imaging (fMRI) to explore the effect of smoking on attention in patients with COPD.

Results

Behavioral analysis revealed that among patients with COPD the smokers had a shorter course of COPD and showed a worse attention performance than the non-smokers. Resting-state fMRI analysis revealed that among patients with COPD smokers showed lower regional homogeneity (ReHo) value of the fusiform gyrus than non-smokers. Importantly, the ReHo of the fusiform gyrus is positively associated with attention and mediates the effect of smoking on attention in COPD.

Conclusions

In summary, our study provides behavioral and neurobiological evidence supporting the positive effect of smoking on attention in COPD. This may be helpful for understanding and treating COPD and even other diseases comorbid with smoking.
Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
Authors: Li Yichen , Yang Yong , Yuan Jia , Huang Lieyu , Ma Yong , Shi Xuefeng
Published: May 2022

Background

Health insurance plays a significant role in reducing the financial burden for lung cancer patients. However, limited research exists regarding the differences in medical costs for lung cancer patients with different insurance schemes across different cities. We aimed to assess disparities in lung cancer patients’ costs by insurance type and city–specific insurance type.

Methods

Claim data of China Urban Employees’ Basic Medical Insurance (UEBMI) and Urban Residents’ Basic Medical Insurance (URBMI) between 2010 and 2016 were employed to investigate differences in medical costs. This study primarily applied descriptive analysis and a generalized linear model with a gamma distribution and a log link.

Results

In total, 92,856 lung cancer patients with inpatient records were identified, with Renminbi (RMB) 11,276 [6322–20,850] (median [interquartile range]) medical costs for the UEBMI group and RMB 8303 [4492–14,823] for the URBMI group. Out–of–pocket (OOP) expenses for the UEBMI group was RMB 2143 [1108–4506] and RMB 2975 [1367–6275] for the URBMI group. The UEBMI group also had significantly higher drug costs, medical service costs, and medical consumable costs, compared to the URBMI group. Regarding city-specific insurances, medical costs for the UEBMI and the URBMI lung cancer patients in Shanghai were RMB 9771 [5183–16,623] and RMB 9741 [5924–16,067], respectively. In Xianyang, the medical costs for UEBMI and URBMI patients were RMB 11,398 [6880–20,648] and RMB 9853 [5370–24,674], respectively. The regression results showed that the UEBMI group had 27.31% fewer OOP expenses than the URBMI group did, while patients in Xiangyang and Xianyang had 39.53 and 35.53% fewer OOP expenses, respectively, compared to patients in Shanghai.

Conclusions

Compared with the URBMI patients, the UEBMI lung cancer patients obtained more or even better health services and had reduced financial burden. The differences in insurances among cities were greater, compared to those among insurances within cities, and the differences in OOP expenses between cities were greater compared to those between UEBMI and URBMI. Our results called for further reform of China’s fragmented insurance schemes.