bluuebunny/crossref_metadata_2025 huggingface dataset:
No Difference in Morbidity or Mortality Between Octogenarians and Other Geriatric Burn Trauma Patients
Authors: Alpert Miriam , Grigorian Areg , Joe Victor , Chin Theresa L. , Bernal Nicole , Lekawa Michael , Satahoo Shevonne , Nahmias Jeffry
Published: April 2021

Background

Geriatric burn trauma patients (age ≥65 years) have a 5-fold higher mortality rate than younger adults. With the population of the US aging, the number of elderly burn and trauma patients is expected to increase. A past study using the National Burn Repository revealed a linear increase in mortality for those >65 years old. We hypothesized that octogenarians with burn and trauma injuries would have a higher rate of in-hospital complications and mortality, than patients aged 65-79 years old.

Methods

The Trauma Quality Improvement Program (2010-2016) was queried for burn trauma patients. To detect mortality risk a multivariable logistic regression model was used.

Results

From 282 patients, there were 73 (25.9%) octogenarians and 209 (74.1%) aged 65-79 years old. The two cohorts had similar median injury severity scores (16 vs. 15 in octogenarians, P = .81), total body surface area burned ( P = .30), and comorbidities apart from an increased smoking (12.9% vs. 4.1%, P = .04) and decreased hypertension (52.2% vs. 65.8%, P = .04) in the younger cohort. Octogenarians had similar complications, including acute respiratory distress syndrome, pulmonary embolism, deep vein thrombosis ( P > .05), and mortality (15.1% vs. 10.5%, P = .30), compared to the younger cohort. Octogenarians were not associated with an increased mortality risk (odds ratio 1.51, confidence interval 0.24-9.56, P = .67).

Discussion

Among burn trauma patients ≥65 years, age should not be a sole predictor for mortality risk. Continued research is necessary in order to determine more accurate approaches to prognosticate mortality in geriatric burn trauma patients, such as the validation and refinement of a burn-trauma-related frailty index.
Using a Back Exoskeleton During Industrial and Functional Tasks—Effects on Muscle Activity, Posture, Performance, Usability, and Wearer Discomfort in a Laboratory Trial
Authors: Luger Tessy , Bär Mona , Seibt Robert , Rieger Monika A. , Steinhilber Benjamin
Published: April 2021

Objective

To investigate the effect of using a passive back-support exoskeleton (Laevo V2.56) on muscle activity, posture, heart rate, performance, usability, and wearer comfort during a course of three industrial tasks (COU; exoskeleton worn, turned-on), stair climbing test (SCT; exoskeleton worn, turned-off), timed-up-and-go test (TUG; exoskeleton worn, turned-off) compared to no exoskeleton.

Background

Back-support exoskeletons have the potential to reduce work-related physical demands.

Methods

Thirty-six men participated. Activity of erector spinae (ES), biceps femoris (BF), rectus abdominis (RA), vastus lateralis (VL), gastrocnemius medialis (GM), trapezius descendens (TD) was recorded by electromyography; posture by trunk, hip, knee flexion angles; heart rate by electrocardiography; performance by time-to-task accomplishment (s) and perceived task difficulty (100-mm visual analogue scale; VAS); usability by the System Usability Scale (SUS) and all items belonging to domains skepticism and user-friendliness of the Technology Usage Inventory; wearer comfort by the 100-mm VAS.

Results

During parts of COU, using the exoskeleton decreased ES and BF activity and trunk flexion, and increased RA, GM, and TD activity, knee and hip flexion. Wearing the exoskeleton increased time-to-task accomplishment of SCT, TUG, and COU and perceived difficulty of SCT and TUG. Average SUS was 75.4, skepticism 11.5/28.0, user-friendliness 18.0/21.0, wearer comfort 31.1 mm.

Conclusion

Using the exoskeleton modified muscle activity and posture depending on the task applied, slightly impaired performance, and was evaluated mildly uncomfortable.

Application

These outcomes require investigating the effects of this passive back-supporting exoskeleton in longitudinal studies with longer operating times, providing better insights for guiding their application in real work settings.
Neuroergonomics on the Go: An Evaluation of the Potential of Mobile EEG for Workplace Assessment and Design
Authors: Wascher Edmund , Reiser Julian , Rinkenauer Gerhard , Larrá Mauro , Dreger Felix A. , Schneider Daniel , Karthaus Melanie , Getzmann Stephan , Gutberlet Marie , Arnau Stefan
Published: April 2021

Objective

We demonstrate and discuss the use of mobile electroencephalogram (EEG) for neuroergonomics. Both technical state of the art as well as measures and cognitive concepts are systematically addressed.

Background

Modern work is increasingly characterized by information processing. Therefore, the examination of mental states, mental load, or cognitive processing during work is becoming increasingly important for ergonomics.

Results

Mobile EEG allows to measure mental states and processes under real live conditions. It can be used for various research questions in cognitive neuroergonomics. Besides measures in the frequency domain that have a long tradition in the investigation of mental fatigue, task load, and task engagement, new approaches—like blink-evoked potentials—render event-related analyses of the EEG possible also during unrestricted behavior.

Conclusion

Mobile EEG has become a valuable tool for evaluating mental states and mental processes on a highly objective level during work. The main advantage of this technique is that working environments don’t have to be changed while systematically measuring brain functions at work. Moreover, the workflow is unaffected by such neuroergonomic approaches.
Risk assessment and its influencing factors of involuntary admission in patients with mental disorders in Shanghai, China
Authors: Ma Hua-Jian , Zheng Yu-Chen , Xie Bin , Shao Yang
Published: April 2021

Background:

The ‘risk criterion’ for involuntary admission (IA) has been adopted by Mental Health Law of the People’s Republic of China since 2013. How the new legal regulation influences daily practices in psychiatric institutes are still unclear.

Aims:

The present study sought to explore the application of risk criterion in IA cases; especially risk assessed by psychiatrists at admission and its influencing factors.

Method:

Socio-demographic and clinical data including risk assessment for admission of 3,529 involuntary admitted patients from two typical hospitals in Shanghai from 2013 to 2014 were consecutively collected. Personal information of psychiatrists who made admission assessment was collected separately.

Results:

Among the 3,529 cases, 1,890 (53.6%) were admitted because of actual harmful behaviors to self or others, while 1,639 (46.4%) were admitted with some kinds of risk, but 265 (7.5%) were admitted without any records on risk assessment checklists. Patients who were unemployed, of younger age, single status, diagnosed with schizophrenia were more likely to be admitted without any records on the checklist. Male gender, older age, and lower professional title are influencing factors that psychiatrists made no risk assessment records.

Conclusions:

The vast majority (92.5%) of risk assessment in IA patients were qualified in our study. In order to protect the legal rights of patients better, operational and reasonable procedures of risk assessment should be developed, such include more detailed rules to IA, systematic training of psychiatrists on IA assessment, mechanism improving doctor-patient relationship, and alternative mental health services for patients and so on.
Chhattisgarh community mental healthcare tele-mentoring program (CHaMP): Digitally driven initiative to reach the unreached
Authors: Ibrahim Ferose Azeez , Malathesh Barikar C , Gajera Gopi , Pandey Praveen , Nirisha P Lakshmi , Jyrwa Sonakshi , Kumar Channaveerachari Naveen , Manjunatha Narayana , Jain Sumi , Bairy Bhavya K , Bada Math Suresh
Published: April 2021

Objective:

Harnessing technology is one accepted method to leapfrog the barrier of inadequate trained human resources for mental health. The Chhattisgarh Community Mental Healthcare Tele-Mentoring Program (CHaMP) is a collaborative digitally driven initiative of the Government of Chhattisgarh (GOC) and the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru the aim of which is to train the Primary Care Doctors (PCDs) and Rural Medical Assistants (RMA) to identify, screen and treat/refer cases of mental health disorders presenting to the primary care settings ( n = 2150). The objective of this article is to give a brief overview of the initiative

Methods:

CHaMP consists of the following modules: (a) a brief on-site training (b) eLearning and Skill Development (eLSD) and (c) Collaborative Video Consultation (CVC). The latter two are andragogic training methods delivered digitally.

Results and conclusion:

From August 2019 to May 2020, 501 PCDs and RMAs have been covered. During this time, they have cared 15,000 patients suffering from mental illness, which hitherto was not the case. Technology that is easily available and usable has the potential to overcome the big hurdle of inadequate mental health human resources in India.
Local Government, Passive Defense and Aerial Bombardment in Barcelona during the Spanish Civil War, 1936–9
Authors: Messenger David A.
Published: April 2021

The bombardment of civilians from the air was a regular feature of the Spanish Civil War from 1936 to 1939. It is estimated some 15,000 Spaniards died as a result of air bombings during the Civil War, most civilians, and 11,000 were victims of bombing from the Francoist side that rebelled against the Republican government, supported by German and Italian aviation that joined the rebellion against the Republic. In Catalonia alone, some 1062 municipalities experienced aerial bombardments by the Francoist side of the civil war. In cities across Spain, municipal and regional authorities developed detailed plans for civilian defense in response to these air campaigns. In Barcelona, the municipality created the Junta Local de Defensa Passiva de Barcelona, to build bomb shelters, warn the public of bombings, and educate them on how to protect themselves against aerial bombardment. They mobilized civilians around the concept of ‘passive defense.’ This proactive response by civilians and local government to what they recognized as a war targeting them is an important and under-studied aspect of the Spanish Civil War.
Molecular sorption and diffusion of organic solvents through maleated rubber/layered silicate nanocomposites
Authors: Zemzem Mohamed , Vinches Ludwig , Hallé Stéphane
Published: April 2021

The aim of the study is to investigate barrier properties of a nanocomposite material against organic solvents. Molecular transport phenomena of three alcohols, namely methanol, ethanol and isopropanol, through a nitrile rubber-based nanocomposite, are carried out in temperatures ranging from 23 to 70°C. For each configuration, mass transfer kinetics are investigated for three different types of clay nanoparticles using mass uptake experiments. Maleated nanocomposites with enhanced dispersion morphology are also examined. Results show that all molecular transport parameters are generally susceptible to temperature variations. Sorption and diffusion coefficients noticeably increased as temperatures increased. Polymer/solvent interaction seems to be similarly affected. Molecular volume of the penetrant is observed to have an influence on molecule migration. Diffusion coefficients are likewise affected and decrease with the linear increase of molecular volume. The diffusion mechanism is slightly altered by this factor and the Fickian mode is maintained. When filling the rubbery matrix with layered silicates, sorption decreases at equilibrium. Its level drops even lower with the maleation of the nanocomposite. However, the diffusion coefficient exhibits a less systematic trend. Randomly filled nanocomposites appear to have higher diffusivity than neat rubber, but diffusion parameter considerably decreases after maleation, which emphasizes the nanoclay’s dispersion effect.
Biodegradable composites of waste expanded polystyrene with modified neem oil for packaging applications
Authors: Salini NG , Resmi BG , Antony Rosy
Published: April 2021

Polymer composite film containing expanded polystyrene wastes, poly (ethylene-co-vinyl acetate), epoxidized neem oil and cassava starch was prepared by solution casting technique. The composite film was characterized by FTIR, NMR, X-ray diffraction, and FESEM analysis. The thermal stability of the polymer composite film was studied by TGA and DSC. Melting point, glass transition temperature and cold-crystallization temperature of the composite films were found to decrease with increasing percentages of epoxidized neem oil plasticizer, which point towards the enhanced segmental mobility of the polymer chain. TGA results show that plasticization has enhanced the thermal stability of the polymer composite. The prepared films show improved percentage elongation with moderate tensile strength and Young’s modulus. Soil burial test was adopted to check the biodegradability. The lower values of water absorption indicate the water-resistant nature of the films. This green synthetic approach offers a simple means of up-cycling waste thermocol in a cost-effective manner which imparts partial biodegradability with potential for packaging film and eliminates the usage of toxic chemicals.
Time-dependent association between selective serotonin reuptake inhibitors and hospitalization due to hyponatremia
Authors: Mannheimer Buster , Falhammar Henrik , Calissendorff Jan , Skov Jakob , Lindh Jonatan D
Published: April 2021

Background:

Selective serotonin reuptake inhibitors (SSRIs) have a wide and increasing use for the treatment of depression and anxiety. Previous studies have indicated an increased risk of hyponatremia during the first months of treatment. We aimed to investigate the detailed time-course of SSRI-associated hyponatremia with a high temporal resolution, using registry data encompassing the total Swedish population.

Methods:

This was a population-based case control study using several national registers. Patients hospitalized with a principal diagnosis of hyponatremia ( n = 11,213) were compared with matched controls ( n = 44,801). Multivariable regression was applied to explore time-dependent associations between SSRIs and hospitalization due to hyponatremia.

Results:

Individuals initiating treatment with SSRIs were exposed to an immediately increased risk for hospitalization at week 1, reaching an adjusted odds ratio (aOR) (95% confidence interval) of 29 (19–46). The associations then gradually declined, reaching an aOR of 2.1 (1.0–4.2) by week 13. The aOR for individuals treated for longer than 13 weeks was 0.78 (0.71–0.85).

Conclusions:

This study revealed a dramatically increased risk of hyponatremia exclusively related to newly initiated treatment. Consequently, even subtle symptoms consistent with hyponatremia during the first weeks of SSRI treatment should prompt analysis of sodium levels. In patients treated with SSRIs for several months or years, other causes should primarily be sought in the event of hyponatremia.
Gastric tumorigenesis after radical resection combined with adjuvant chemotherapy for colorectal cancer: two case reports and a literature review
Authors: Li Tao , Liu Guoliang , Li Jiannan , Cui Jian , Wang Xinyu , Li Wei , Zhao Zeyun , Zhang Kai , Liu Tongjun
Published: April 2021

Radical resection with or without adjuvant chemotherapy is a common option for stage II and III colorectal cancer. Few reports exist regarding gastric tumorigenesis, including gastric cancer, gastric intraepithelial neoplasia, and gastric stromal tumor, in patients who received this protocol as the standard treatment for colorectal cancer. We present two cases of gastric tumorigenesis in patients with colorectal cancer following radical resection combined with adjuvant chemotherapy. Both patients underwent gastrectomy and D2 lymphadenectomy for their gastric tumors; neither patient developed recurrence up to 2 years after treatment. These cases indicate that patients should be monitored closely for gastric tumorigenesis after treatment for colorectal cancer. Early detection and active surgical treatment can provide satisfactory results for colorectal cancer followed by gastric tumorigenesis. Long-term follow-up and regular examinations, especially gastroscopy, are necessary to detect gastric tumorigenesis after colorectal cancer. The focus on monitoring colorectal cancer alone in colorectal cancer patients should be changed to include a broader range of cancers in addition to precancers and other tumors, such as gastric stromal tumor.
Spatio-Temporal Analysis of Freight Flows in Southern California
Authors: Rivera-Royero Daniel , Jaller Miguel , Kim Chang-Mo
Published: April 2021

This paper analyses the spatio-temporal patterns of freight flows in Southern California using weigh-in-motion (WIM) data between 2003 and 2015. The study explores the spatial relationships between truck volumes, load ratios, and gross vehicle weights for different vehicle classes, through econometric and centrographic analyses during the study period. Overall, the results confirmed the existence of the logistics sprawl phenomenon, highlighted the effect of the 2008 to 2009 major recession in the concentration of freight facilities and flows, indicated that the changes in flow patterns vary for different vehicle classes, and found low vehicle capacity utilization for light- (WIM classes 5–7) and medium- (WIM classes 8–10) heavy-duty trucks, though recently improving. These results are consistent with the growth in residential deliveries owing to e-commerce, showing increased light-heavy-duty trucks flows concentrated closer to the consumption areas, and experiencing larger flow reductions compared to heavy vehicle flows as the distance from the area increases; and showing that medium-heavy-duty vehicles used in both full-truck-load, and less-than-truck-load vocations are prevalent throughout the study area, whereas there is a trade-off between light- and heavy-heavy duty trucks (WIM classes 11–13) at the proximity, and the outskirts of the consumption markets, respectively. Moreover, the study shows the usefulness of the WIM data in identifying spatial and temporal dynamics in freight demand, providing additional information for planning, maintenance, and rehabilitation of the infrastructure. More importantly, the results, coupled with other evidence from the literature, show how major disruptions such as the recession significantly affect truck traffic.
The Normalization of Violence in Commercial Kitchens Through Food Media
Authors: Meiser Ellen T. , Pantumsinchai Penn
Published: April 2021

The Bureau of Labor Statistics estimates that there are 2.53 million cooks and chefs in the United States. Of those, one in four reports experiencing physical violence in the workplace—roughly 632,500 victims. While shocking, this figure fails to account for the psychological and sexual violence that also plagues commercial kitchens. Workplace harassment and bullying is not limited to the United States and has been documented in Scottish, English, Scandinavian, French, Malaysian, Korean, and Australian kitchens. Why is violence so prevalent in kitchens, and how has it become a behavioral norm? Using data from 50 in-depth interviews with kitchen workers and analysis of food media, this article shows that while kitchen workplace violence can be attributed to typical causes, such as occupational stress, there is an overlooked source: the normalization of violence through food media. By exploring television shows, like “Hell’s Kitchen,” and chef memoirs, like Bourdain’s Kitchen Confidential, readers will see how bullying and harassment are romanticized in these mediums, glorified as a product of kitchen subculture, and consequently normalized in the kitchen.
Roles of Psychological Distress and Social Support in the Relationship Between Childhood Maltreatment and Perceived Needs for Mental Health Care
Authors: Gao Tingting , Mei Songli , Li Muzi , Arcy Carl D’ , Meng Xiangfei
Published: April 2021

Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.
Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study
Authors: Klil-Drori Sivan , Phillips Natalie , Fernandez Alita , Solomon Shelley , Klil-Drori Adi J. , Chertkow Howard
Published: April 2021

Objective:

Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA).

Methods:

Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination.

Results:

Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%).

Conclusions:

Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.
Accountability as a Sub-Type of Justice: Reflections on ‘Obedience’ and ‘Religion’ in Aquinas’s Summa Theologiae
Authors: Case Brendan
Published: April 2021

This article proposes that we recognize ‘accountability’ as a forward-looking virtue, which disposes its possessors to live accountably in relation to those to whom they are rightly answerable, and which can be sub-divided into ‘particular accountability’, exercised within specific and limited relationships, and ‘ultimate accountability’, regarding the shape of one’s life as a whole. The article then proposes that these two forms of accountability find close analogues in two virtues which Thomas Aquinas described as ‘annexed to justice’, namely ‘obedience’ (accountability to human superiors) and ‘religion’ (accountability to God).
Public libraries as a vital social function or something we can do without in times of crises. The Swedish reaction to Covid-19
Authors: Rundqvist Elisabet
Published: April 2021

During the COVID-19 period, Swedish public libraries have gone through five phases, which diverge, noticeably from many other European countries. During the first phase of the pandemic, most public libraries stayed open. The week before Christmas 2020 most public libraries where temporally closed. The roll of public libraries in the local community was under debate, could the local community do without libraries?
Aging Increases Prosocial Motivation for Effort
Authors: Lockwood Patricia L. , Abdurahman Ayat , Gabay Anthony S. , Drew Daniel , Tamm Marin , Husain Masud , Apps Matthew A. J.
Published: April 2021

Social cohesion relies on prosociality in increasingly aging populations. Helping other people requires effort, yet how willing people are to exert effort to benefit themselves and others, and whether such behaviors shift across the life span, is poorly understood. Using computational modeling, we tested the willingness of 95 younger adults (18–36 years old) and 92 older adults (55–84 years old) to put physical effort into self- and other-benefiting acts. Participants chose whether to work and exert force (30%–70% of maximum grip strength) for rewards (2–10 credits) accrued for themselves or, prosocially, for another. Younger adults were somewhat selfish, choosing to work more at higher effort levels for themselves, and exerted less force in prosocial work. Strikingly, compared with younger adults, older people were more willing to put in effort for others and exerted equal force for themselves and others. Increased prosociality in older people has important implications for human behavior and societal structure.
The Governance of Complaints in UK Higher Education: Critically Examining ‘Remedies’ for Staff Sexual Misconduct
Authors: Bull Anna , Page Tiffany
Published: April 2021

Complaints processes and their governance in UK higher education (HE) have received little critical scrutiny, despite their expanded role under the increasing marketisation of HE. This article draws on interviews with students who attempted to make complaints of staff sexual misconduct to their HE institution. It outlines four groups among the interviewees according to the ‘remedy’ that they obtained, describing how most interviewees could not access the services of the Office of the Independent Adjudicator for Higher Education in England as they could not complete internal institutional complaints processes. The failure of most complainants to obtain remedy, and the difficult experiences of those who did, reveals the inadequacies of using an individualist, consumer-oriented model for addressing discrimination complaints in HE. The article also contributes to discussions of justice for sexual violence survivors, suggesting that community-oriented remedies are needed alongside formal administrative justice processes to address power-based sexual misconduct in institutions.
Reconsidering edgework theory: Practices, experiences, and structures
Authors: Kidder Jeffrey L
Published: April 2021

This article clarifies and revises the sociological theory of voluntary risk taking known as edgework. The concept has three distinct aspects: material practices, embodied experiences, and supporting structures. I first provide a critical summary of these aspects as they exist in the current literature. Second, I advocate for an approach to edgework through the analysis of symbolic practices. I argue that researchers can best understand the meaning of voluntary risk taking by studying how individuals discursively frame their actions. Given the ascendency of neoliberal ideology in contemporary Western societies, there is an increasing importance for research into risk (especially as it relates to the study of sports), and a cogent sociology of edgework can be an important component to such an intellectual endeavor.
Development of a Measure of State-Level Supports for School Nursing Services Delivery
Authors: Doremus Wendy A.
Published: April 2021

States have key roles and responsibilities in protecting and promoting the health of all of school-age youth. Though assessment and planning instruments exist to support quality school nursing service delivery at individual school building, community, and district levels, no comparable measure was available to assess state-level support for the delivery of quality school nursing. This project, conducted in three phases, resulted in the development of a novel measure to identify state-level infrastructure supports for school nursing services delivery. The State School Health Infrastructure Measure is comprised of seven domains with 24 indicators and demonstrated initial content validity and test–retest reliability. States can use this measure to self-assess, identify, benchmark, prioritize, and address state-level infrastructure strengths and gaps related to supporting the delivery of high-quality, equitable school nursing services.
The Insider Looking Out: Discovering the Real Me
Authors: Forber-Pratt Anjali J.
Published: April 2021

This article is an autoethnographic performative account based on my story as a transnational adopted academic disabled scholar of color finding my own sense of personal and professional “home.” The format was constructed based on my previous work of specific movie scenes and corresponding dialogue appearing throughout the text. The resulting piece showcases the journey and the struggles to find and to intentionally build my home in the academy using my complex identities as the foundation.
Oral silymarin formulation efficacy in management of AC-T protocol induced hepatotoxicity in breast cancer patients: A randomized, triple blind, placebo-controlled clinical trial
Authors: Moezian Ghazal Sadat Askarpour , Javadinia Seyed Alireza , Sales Soodabeh Shahid , Fanipakdel Azar , Elyasi Sepideh , Karimi Gholamreza
Published: April 2021

Background

Chemotherapeutic agents, with or without other drugs and radiation, may cause indirect or direct hepatotoxicity. Doxorubicin-induced hepatotoxicity (DIH) is a major health concern in cancer patients receiving this cytotoxic drug that is mostly resulted from the production of reactive oxygen species leading to transient or permanent liver damages. Silymarin, a flavonoid extracted from the Silybum marianum, exhibits antioxidant and anti-inflammatory activities.

Purpose

This study aimed to investigate the clinical efficacy of systemic administration of silymarin in management of chemotherapy induced hepatotoxicity in patients with non-metastatic breast cancer who received doxorubicin/cyclophosphamide-paclitaxel (AC-T) regimen. Material: In this randomized, triple blind, placebo-controlled clinical trial, 30 patients who received AC-T who fulfilled the inclusion criteria were randomly allocated to silymarin (n = 15) or placebo (n = 15) groups to receive oral silymarin 140 mg three times a day or placebo tablets, respectively. Fatty liver severity was assessed by liver ultrasound imaging and FibroScan® and also measurement of liver function tests before and after the intervention.

Results

There was a non-significant trend toward more severe liver involvement in placebo group comparing to the silymarin group after intervention based on ultrasonography (p = 0.083). Besides, in silymarin group, hepatic involvement grade based on ultrasonography considerably reduced after intervention (p = 0.012). However, no difference was found between two groups based on FibroScan and liver function tests.

Conclusion

Oral administration of silymarin could significantly reduce hepatotoxicity severity after 1 month of treatment in non-metastatic breast cancer patients treated with AC-T regimen.
A prospective sonographic evaluation of peripheral intravenous catheter associated thrombophlebitis
Authors: Mielke Nicholas , Johnson Steven , Karabon Patrick , Bahl Amit
Published: April 2021

Objective:

Thrombophlebitis associated with peripheral intravenous catheters (PIVCs) is a poorly described complication in the literature. Given limited accuracy of current assessment tools and poor documentation in the medical record, the true incidence and relevance of this complication is misrepresented. We aimed to identify risk factors in the development of thrombophlebitis using an objective methodology coupling serial diagnostic ultrasound and clinical assessment.

Methods:

We conducted a single-site, prospective observational cohort study. Adult patients presenting to the emergency department that underwent traditionally placed PIVC insertion and were being hospitalized with an anticipated length of stay greater than 2 days were eligible participants. Using serial, daily ultrasound evaluations and clinical assessments via the phlebitis scale, we identified patients with asymptomatic and symptomatic thrombosis. The primary goal was to identify demographic, clinical, and IV related risk factors associated with thrombophlebitis. Univariate and multivariate analyses were employed to identify risk factors for thrombophlebitis.

Results:

A total of 62 PIVCs were included between July and August 2020. About 54 (87.10%) developed catheter-related thrombosis with 22 (40.74%) of the thrombosed catheters were characterized as symptomatic. Multivariate cox regression demonstrated that catheter diameter relative to vein diameter greater than one-third [AHR = 5.41 (1.91, 15.4) p = 0.0015] and angle of distal tip of catheter against vein wall ⩾5° [AHR = 4.39 (1.39, 13.8) p = 0.0116] were associated with increased likelihood of thrombophlebitis.

Conclusions:

Our study found that the increased proportion of catheter relative to vein size and steeper catheter tip angle increased the risk of thrombophlebitis. Catheter size relative to vein size is a modifiable factor that should be considered when inserting PIVCs. Additional larger prospective investigations using objective methodologies are needed to further characterize complications in PIVCs.
Aerobic exercise for adolescent outpatients with persistent major depression: Feasibility and acceptability of moderate to vigorous group exercise in a clinically referred sample
Authors: Jarbin Håkan , Höglund Kristina , Skarphedinsson Gudmundur , Bremander Ann
Published: April 2021

Aims:

To assess feasibility and acceptability of exercise in clinically referred adolescents with major depression.

Methods:

Outpatients12 to 17 years with mild to moderate persistent depression participated in a supervised, pulse monitored, 14-week aerobic exercise but without control group. Primary outcome was adherence and secondary was clinician-rated Quick Inventory of Depressive Symptomatology – Adolescent (QIDS-A17-C), aerobic capacity, functioning, and well-being.

Results:

Twenty-one (66%) of 32 eligible adolescents with major depression with disease duration 2.4 (1.1–5.3) years and comorbid ADHD (71%) and anxiety disorders (62%) consented. Estimated maximum heart rate above 70% was achieved for mean 31.6 minutes, indicating that the intensity and duration of the exercise intervention was well received. Fourteen patients (67%) participated throughout the program and attended a median of 29 (81%, range 20–35) supporting satisfaction with the intervention by most patients. QIDS-A17-C score decreased compared to baseline at 15 weeks ( p < .001) and further at 1 year ( p < .001). Aerobic capacity improved during the intervention but was not maintained, while functioning improved and after 1 year also well-being.

Conclusion:

This 14 week moderate to vigorous aerobic exercise intervention was feasible and well accepted by most adolescents with persistent depression and extensive comorbidities.
Stress-responses to ostracism: Examining cortisol and affective reactivity to in-person and online exclusion
Authors: Filipkowski Kelly B , Jones Dusti R , Bernstein Michael J , Smyth Joshua M
Published: April 2021

Ostracism is associated with poor outcomes, but it is unclear if online versus in-person ostracism elicits divergent psychological and physiological responses. Participants ( N = 54) were randomly assigned to online or in-person ostracism, and provided pre- and post-ostracism measures of affect, self-esteem, self-feelings, and salivary cortisol. No significant changes in negative affect, self-esteem, or self-feelings emerged, nor were there differences by ostracism condition. Both ostracism conditions decreased positive affect (stronger online) and lowered cortisol. Extending prior work, ostracism appears to reliably decrease positive affect (especially online) but may not be threatening to the self; moreover, ostracism may reliably elicit acute cortisol declines.
Maximizing the benefits of peer interaction: Form-focused instruction and peer feedback training
Authors: Sippel Lieselotte
Published: April 2021

This classroom study investigated the effectiveness of form-focused instruction and peer feedback training to improve grammatical accuracy and thereby maximize learning opportunities during peer interaction. Eighty-seven third-semester learners of German were assigned to a PI group (peer interaction only), an FFI group (peer interaction and form-focused instruction), or a PFT group (peer interaction, form-focused instruction, and peer feedback training). During an instructional intervention over 3 class periods, participants in all 3 groups engaged in the same peer interaction activities, but only the FFI group and the PFT group received form-focused instruction on the grammatical target structure, the German present perfect tense. Critically, only the PFT group was trained to provide corrective feedback to peers. Results from a pretest and two posttests, all of which included an oral production task and an error correction task, showed that peer interaction was effective when combined with form-focused instruction, but more effective when peer feedback training was also provided to learners. These results underscore the importance of instruction on peer feedback for more successful peer interaction activities.
Individual differences in self-regulated learning: Exploring the nexus of motivational beliefs, self-efficacy, and SRL strategies in EFL writing
Authors: Teng Lin Sophie
Published: April 2021

This study examines the predictive effects of motivational beliefs and self-efficacy on multiple dimensions of self-regulated learning (SRL) strategies in English as a foreign language (EFL) writing. Undergraduate students ( n = 389) were recruited voluntarily from four universities in mainland China. They were invited to complete a set of questionnaires to measure their motivational beliefs (extrinsic and intrinsic goal orientation, task value, and control of learning belief), self-efficacy (linguistic self-efficacy, performance self-efficacy, and self-regulatory efficacy) and SRL strategies (cognition, metacognition, social behavior, and motivational regulation). Multiple regression analyses revealed that motivational beliefs had significant predictive effects on SRL strategies; among which task value and intrinsic goal orientation were significant predictors of nine sub-factors of SRL strategies. Self-efficacy was a strong predictor of metacognitive, cognitive, and motivational regulation strategies. While linguistic self-efficacy had a significant predictive power on text processing alone, self-regulatory efficacy generated a significant effect on a collection of SRL strategies including knowledge rehearsal, goal-oriented monitoring, idea planning, peer learning, and interest enhancement. Pedagogical implications are also discussed.
Subverting superhero and meiga imaginaries in street art narrative Fenómenas do rural
Authors: Carbajal-Carrera Beatriz
Published: April 2021

Heroic narratives are often biased towards a conceptualization of the rural/urban difference that positions rural identities at the margins. In particular, superhero stories have traditionally offered a vision of heroism assumed to be male, urban and young. How can post-rural contexts shaped by migration contest these narrative patterns? This article examines the street narrative of Fenómenas do rural, which recognizes older female rural identities and casts them as superheroines. Through a multimodal discourse analysis, I examine its contestation of heroic patterns, its recognition of older female rural identities and its creation of affiliation opportunities for the Galician community. I argue that this narrative stands as a reflection of the rurban (rural + urban) and the glocal (global + local) elements that subverts pre-existing canons in the superhero and the meiga (‘witch’) mythology imaginaries.
Facilitating Timely Institutional Review Board Review: Common Issues and Recommendations
Authors: Rodriguez Emily , Pahlevan-lbrekic Challace , Larson Elaine L.
Published: April 2021

Review of clinical research by institutional review boards (IRBs) is integral to the protection of human subjects and necessary for the conduct of legal and ethical research. Because such review is time and resource intensive, it is critical to identify common issues that contribute to delayed review and approval of research. Hence, the aim of this quality improvement project was to identify factors associated with long delays in IRB approval and identify potential strategies to streamline the review process. In collaboration with the human subjects research protection program at a large academic health center in the northeastern United States, we conducted a content analysis of minutes of convened IRB meetings for every new protocol (initial submission) approved between January and September 2019 that required greater than or equal to two full board reviews prior to approval ( n = 33). We also examined characteristics of new protocols that were reviewed less than twice at convened meetings during the same time frame ( n = 244). Using χ2 or Fisher's exact tests, the characteristics of protocols with multiple reviews by the convened IRBs were compared with those protocol submissions reviewed by the convened IRBs only once. Three factors significantly associated with increased delays were researcher conflict of interest (30% vs. 12%, respectively, p < .01), need for radiation safety evaluation (36% vs. 20%, respectively, p = .03), and protocols that were clinical trials (73% vs. 60%, respectively, p < .01). Other factors associated with delayed IRB approval were excessive technical jargon (93.94%, n = 31), inadequate description of data security or inability to meet data security requirements of the institution (75.76%, n = 25), protocol design affecting patient safety (57.58%, n = 19), and lack of clarity regarding compensation and payment or study duration ( n = 18, 54.54% each). Approaches to mitigate delays in approval and increase the efficiency and efficacy of the IRB process are recommended.
Lifestyle Medicine Prescriptions
Authors: Dysinger Wayne S.
Published: April 2021

Lifestyle Medicine prescriptions are a foundational component to the practice of Lifestyle Medicine. With expanding technology, prescriptions are moving from single sheets of paper to customizable ongoing feedback that encourages continuous dialogue and feedback between patient and provider.
Towards an Ọmọlúàbí code of research ethics: Applying a situated, participant-centred virtue ethics framework to fieldwork with disadvantaged populations in diverse cultural settings
Authors: Oyinloye Bukola
Published: April 2021

This paper presents a participant-centred virtue ethics approach, the Ọmọlúàbí moral-ethical framework, which moves beyond researcher-centred reflexivity to incorporate participants’ moral virtues within a broader research ethics framework. It demonstrates a methodical application of the framework during research with rural Yorùbá communities in Northcentral Nigeria through the principles of continuity; adherence to local and national processes; adaptation to local ways of being and doing; and provision of tangible benefit. After proposing a conceptual approach for participant-centred ethics, the paper explores the tensions and complexities that may occur when attempting to reconcile diverse ethical traditions and provides practical suggestions for researchers who wish to conduct moral and ethical fieldwork in similar contexts. Ultimately, the paper argues for an integration of participants’ values and virtues within research ethics in order to affirm diverse ethical and intellectual traditions.
Phase III randomized study of carboplatin pemetrexed with or without bevacizumab with initial versus “at progression” cerebral radiotherapy in advanced non squamous non-small cell lung cancer with asymptomatic brain metastasis
Authors: Monnet Isabelle , Vergnenègre Alain , Robinet Gilles , Berard Henri , Lamy Regine , Falchero Lionel , Vieillot Sabine , Schott Roland , Ricordel Charles , Chouabe Stephane , Thomas Pascal , Gervais Radj , Madroszyk Anne , Abdiche Samir , Chiappa Anne Marie , Greillier Laurent , Decroisette Chantal , Auliac Jean Bernard. , Chouaïd Christos ,   the GFPC 02-13 (METAL2) investigators
Published: April 2021

Background:

The role and timing of whole or stereotaxic brain radiotherapy (BR) in patients with advanced non-small cell lung cancer (aNSCLC) and asymptomatic brain metastases (aBMs) are not well established. This study investigates whether deferring BR until cerebral progression was superior to upfront BR for patients with aNSCLC and aBM.

Methods:

This open-label, multicenter, phase III trial, randomized (1:1) aNSCLC patients with aBMs to receive upfront BR and chemotherapy: platin–pemetrexed and bevacizumab in eligible patients, followed by maintenance pemetrexed with or without bevacizumab, BR arm, or the same chemotherapy with BR only at cerebral progression, chemotherapy (ChT) arm. Primary endpoint was progression-free survival (PFS), secondary endpoints were overall survival (OS), global, extra-cerebral and cerebral objective response rate (ORR), toxicity, and quality of life [ClinicalTrials.gov identifier: NCT02162537].

Results:

The trial was stopped early because of slow recruitment. Among 95 included patients, 91 were randomized in 24 centers: 45 to BR and 46 to ChT arms (age: 60 ± 8.1, men: 79%, PS 0/1: 51.7%/48.3%; adenocarcinomas: 92.2%, extra-cerebral metastases: 57.8%, without differences between arms.) Significantly more patients in the BR-arm received BR compare with those in the ChT arm (87% versus 20%; p < 0.001); there were no significant differences between BR and ChT arms for median PFS: 4.7, 95% confidence interval (CI):3.4–7.5 versus 4.8, 95% CI: 2.4–6.5 months, for median OS: 8.5, 95% CI:.6–11.1 versus 8.3, 95% CI:4.5–11.5 months, cerebral and extra-cerebral ORR (27% versus 13%, p = 0.064, and 30% versus 41%, p = 0.245, respectively). The ChT arm had more grade 3/4 neutropenia than the BR arm (13% versus 6%, p = 0.045); others toxicities were comparable.

Conclusion:

The significant BR rate difference between the two arms suggests that upfront BR is not mandatory in aNSCLC with aBM but this trial failed to show that deferring BR for aBM is superior in terms of PFS from upfront BR.