bluuebunny/crossref_metadata_2025 huggingface dataset:
Palmdelphin Regulates Nuclear Resilience to Mechanical Stress in the Endothelium
Authors: Sáinz-Jaspeado Miguel , Smith Ross O. , Plunde Oscar , Pawelzik Sven-Christian , Jin Yi , Nordling Sofia , Ding Yindi , Aspenström Pontus , Hedlund Marie , Bastianello Giulia , Ascione Flora , Li Qingsen , Demir Cansaran Saygili , Fernando Dinesh , Daniel Geoffrey , Franco-Cereceda Anders , Kroon Jeffrey , Foiani Marco , Petrova Tatiana V. , Kilimann Manfred W. , Bäck Magnus , Claesson-Welsh Lena
Published: October 2021

Background:

PALMD (palmdelphin) belongs to the family of paralemmin proteins implicated in cytoskeletal regulation. Single nucleotide polymorphisms in the
PALMD
locus that result in reduced expression are strong risk factors for development of calcific aortic valve stenosis and predict severity of the disease.

Methods:

Immunodetection and public database screening showed dominant expression of PALMD in endothelial cells (ECs) in brain and cardiovascular tissues including aortic valves. Mass spectrometry, coimmunoprecipitation, and immunofluorescent staining allowed identification of PALMD partners. The consequence of loss of PALMD expression was assessed in small interferring RNA-treated EC cultures, knockout mice, and human valve samples. RNA sequencing of ECs and transcript arrays on valve samples from an aortic valve study cohort including patients with the single nucleotide polymorphism rs7543130 informed about gene regulatory changes.

Results:

ECs express the cytosolic
PALMD-KKVI
splice variant, which associated with RANGAP1 (RAN GTP hydrolyase activating protein 1). RANGAP1 regulates the activity of the GTPase RAN and thereby nucleocytoplasmic shuttling via XPO1 (Exportin1). Reduced PALMD expression resulted in subcellular relocalization of RANGAP1 and XPO1, and nuclear arrest of the XPO1 cargoes p53 and p21. This indicates an important role for PALMD in nucleocytoplasmic transport and consequently in gene regulation because of the effect on localization of transcriptional regulators. Changes in EC responsiveness on loss of
PALMD
expression included failure to form a perinuclear actin cap when exposed to flow, indicating lack of protection against mechanical stress. Loss of the actin cap correlated with misalignment of the nuclear long axis relative to the cell body, observed in
PALMD
-deficient ECs,

Palmd
−/−

mouse aorta, and human aortic valve samples derived from patients with calcific aortic valve stenosis. In agreement with these changes in EC behavior, gene ontology analysis showed enrichment of nuclear- and cytoskeleton-related terms in
PALMD
-silenced ECs.

Conclusions:

We identify RANGAP1 as a PALMD partner in ECs. Disrupting the PALMD/RANGAP1 complex alters the subcellular localization of RANGAP1 and XPO1, and leads to nuclear arrest of the XPO1 cargoes p53 and p21, accompanied by gene regulatory changes and loss of actin-dependent nuclear resilience. Combined, these consequences of reduced
PALMD
expression provide a mechanistic underpinning for PALMD’s contribution to calcific aortic valve stenosis pathology.
Prognostic Value of Transthoracic Doppler Echocardiography Coronary Flow Velocity Reserve in Patients With Asymmetric Hypertrophic Cardiomyopathy
Authors: Tesic Milorad , Beleslin Branko , Giga Vojislav , Jovanovic Ivana , Marinkovic Jelena , Trifunovic Danijela , Petrovic Olga , Dobric Milan , Aleksandric Srdjan , Juricic Stefan , Boskovic Nikola , Tomasevic Miloje , Ristic Arsen , Orlic Dejan , Stojkovic Sinisa , Vukcevic Vladan , Stankovic Goran , Ostojic Miodrag , Djordjevic Dikic Ana
Published: October 2021

Background

Microvascular dysfunction might be a major determinant of clinical deterioration and outcome in patients with hypertrophic cardiomyopathy (HCM). However, long‐term prognostic value of transthoracic Doppler echocardiography (TDE) coronary flow velocity reserve (CFVR) on clinical outcome is uncertain in HCM patients. Therefore, the aim of our study was to assess long‐term prognostic value of CFVR on clinical outcome in HCM population.

Methods and Results

We prospectively included 150 HCM patients (82 women; mean age 48±15 years). Patients’ clinical characteristics, echocardiographic and CFVR findings (both for left anterior descending [LAD] and posterior descending artery [PD]), were assessed in all patients. The primary outcome was a composite of: HCM related death, heart failure requiring hospitalization, sustained ventricular tachycardia and ischemic stroke. Patients were stratified into 2 subgroups depending on CFVR LAD value: Group 1 (CFVR LAD>2, [n=87]) and Group 2 (CFVR LAD≤2, [n=63]). During a median follow‐up of 88 months, 41/150 (27.3%) patients had adverse cardiac events. In Group 1, there were 8/87 (9.2%), whereas in Group 2 there were 33/63 (52.4%,
P
<0.001 vs. Group 1) adverse cardiac events. By Kaplan‐Meier analysis, patients with preserved CFVR LAD had significantly higher cumulative event‐free survival rate compared to patients with impaired CFVR LAD (96.4% and 90.9% versus 66.9% and 40.0%, at 5 and 8 years, respectively: log‐rank 37.2,
P
<0.001). Multivariable analysis identified only CFVR LAD≤2 as an independent predictor for adverse cardiac outcome (HR 6.54; 95% CI 2.83–16.30,
P
<0.001), while CFVR PD was not significantly associated with outcome.

Conclusions

In patients with HCM, impaired CFVR LAD (≤2) is a strong, independent predictor of adverse cardiac outcome. When the aim of testing is HCM risk stratification and CFVR LAD data are available, the evaluation of CFVR PD is redundant.
Naricolax holinorum sp. nov. (Copepoda, Cyclopoida, Bomolochidae) parasitic in the nasal cavity of the blackhead seabream Acanthopagrus schlegelii (Bleeker, 1854) (Pisces, Sparidae) in Japan
Authors: Izawa Kunihiko
Published: October 2021

Naricolax holinorum sp. nov. is described based on specimens of both sexes recovered from the nasal cavity of Acanthopagrus schlegelii (Bleeker, 1854) (Pisces, Sparidae) in Japan. This species was erroneously redescribed first as N. atypicus Ho, Do & Kasahara, 1983 by Ho & Lin (2005) based on specimens of the female collected from the nasal cavity of A. schlegelii in Taiwan.
Revision of the genus Lopesiodinia Prado, 1973 (Diptera: Odiniidae) with description of three new species, and a key to the extant Neotropical genera and species of Traginopinae
Authors: TÔRRES ALICE , RAFAEL JOSÉ A. , GAIMARI STEPHEN D. , LIMEIRA-DE-OLIVEIRA FRANCISCO
Published: October 2021

The Neotropical genus Lopesiodinia Prado is represented by two species, L. diversa Prado (Brazil: Rio de Janeiro) and L. alvarengai Prado (Brazil: Pará). The genus is reviewed here, and three new species are described and illustrated: Lopesiodinia marcusi sp. nov. (Brazil: Amazonas, Maranhão), L. argentata sp. nov. (Brazil: Amazonas) and L. pontarolloi sp. nov. (Brazil: Amazonas, Maranhão). A key to identify the subfamilies and extant genera and the species of Traginopinae from the Neotropical Region is presented.
Utilizing Ice Core and Climate Model Data to Understand Seasonal West Antarctic Variability
Authors: Goddard Paul B. , Tabor Clay R. , Jones Tyler R.
Published: October 2021

Reconstructions of past West Antarctic Ice Sheet (WAIS) climate rely on the isotopologues of water recorded in ice cores which extend the local surface temperature record back tens of thousands of years. Here, we utilize continuous flow sampling and novel back-diffusion techniques with the WAIS Divide ice core (WDCobs) to construct a seasonal record of the δ18O value of the precipitation (δ18Op) at the time of deposition from 1980-2000. We then use a water isotope enabled global climate model, iCESM1, to establish seasonal drivers of WAIS climate and of δ18Op variability at the WAIS Divide location to compare with the WDCobs and MERRA2 reanalysis data. Our results show that the WAIS seasonal climate variability is driven by the position and strength of the Amundsen Sea Low (ASL) caused by variations in the Southern Annual Mode and the two Pacific-South American patterns (PSA1 and PSA2). The largest year-to-year seasonal δ18Op anomalies at the WAIS Divide location occur with respect to PSA2 during austral winter (JJA) as a result of an eastward displacement of the ASL that shifts the associated onshore winds towards the Weddell Sea, reducing temperatures and precipitation near the WAIS Divide location. Additionally, the iCESM1 experiment suggests that changes to the moisture path from the source to the WAIS Divide location is an important driver of seasonal WDCobs δ18Op variability. This work highlights the potential of using a single ice core to reconstruct past WAIS climate at seasonal timescales.
Probabilistic Predictions from Deterministic Atmospheric River Forecasts with Deep Learning
Authors: Chapman William E. , Delle Monache Luca , Alessandrini Stefano , Subramanian Aneesh C. , Ralph F. Martin , Xie Shang-Ping , Lerch Sebastian , Hayatbini Negin
Published: October 2021

Deep-learning (DL) postprocessing methods are examined to obtain reliable and accurate probabilistic forecasts from single-member numerical weather predictions of integrated vapor transport (IVT). Using a 34-yr reforecast, based on the Center for Western Weather and Water Extremes West-WRF mesoscale model of North American West Coast IVT, the dynamically/statistically derived 0–120-h probabilistic forecasts for IVT under atmospheric river (AR) conditions are tested. These predictions are compared with the Global Ensemble Forecast System (GEFS) dynamic model and the GEFS calibrated with a neural network. In addition, the DL methods are tested against an established, but more rigid, statistical–dynamical ensemble method (the analog ensemble). The findings show, using continuous ranked probability skill score and Brier skill score as verification metrics, that the DL methods compete with or outperform the calibrated GEFS system at lead times from 0 to 48 h and again from 72 to 120 h for AR vapor transport events. In addition, the DL methods generate reliable and skillful probabilistic forecasts. The implications of varying the length of the training dataset are examined, and the results show that the DL methods learn relatively quickly and ∼10 years of hindcast data are required to compete with the GEFS ensemble.
One more has been killed: Implications for service provision for persons with intellectual disability in recent Hong Kong
Authors: Mei Yin Lee
Published: October 2021

A tragedy occurred recently in Hong Kong as the attack of COVID-19 rocked the whole society. This brief note intends to call for local and international discussions about difficult cases caused by the infection control measures. Current social distancing practice requires social work practitioners to detect high-risk cases not only for those living alone but also for those living together, and to assess the risks to care. In addition, social workers should join forces with stakeholders’ associations to advocate suitable and sufficient service provision in order to enhance well-being of families of children with intellectual disabilities.
Four Principles for Cultivating Alternate Cultural Paradigms in Psychology: Summary Reflections on Innovative Contributions
Authors: Gone Joseph P.
Published: October 2021

The contributors to this special issue have demonstrated the potency and promise of cultivating Alternate Cultural Paradigms (ACPs) in psychology that reflect and express the lived realities of non-White communities in America. Based on my past research engagement with several distinct American Indian and First Nations communities, I offer for consideration four principles for psychologists who seek to further cultivate ACPs: (a) attend independently to culture and power, (b) anchor conceptual abstractions in empirical examples, (c) complicate stock oppositions and essentialisms, and (d) integrate emancipation with application. Adoption of these four principles should assist with the development of robust ACPs that accurately reflect the lived experiences of non-White communities. The promotion of these in psychology represents the exciting possibility for a more just and equitable future in which the injuries of White racism are remedied and all Americans are granted equal opportunities to live and thrive in self-determined fashion.
Regulatory networks and regional human rights governance: A study of the European Network of National Human Rights Institutions
Authors: Lacatus Corina
Published: October 2021

Transnational regional networks of regulatory bodies play a prominent role in complex systems of human rights governance. Despite their growing importance, we still have much to learn about the roles regional networks play as regulatory stewards in the field of human rights. I draw on the literature about regulatory stewardship to analyse a recently formalised regulatory network operating in Europe – the European Network of National Human Rights Institutions. The analysis proposes a model of global governance for human rights that includes networks of national human rights institutions as intermediaries. Moreover, it draws on some of the main concepts of network analysis to assesses the European network’s development into a ‘network administrative organisation’ and applies the model of regulatory stewardship to analyse the institutional network’s use of hierarchical and managerial stewardship to: support its member institutions; stimulate intra-network communication and learning; gain access to international networks; and to shape the regional human rights agenda.
Developing Video Vignettes for Tourism Research: Protocol and Quality Indicators
Authors: Chen Nan , Hsu Cathy H. C. , L. Pearce Philip
Published: October 2021

Video vignettes are information-rich stimuli using audio and visual presentations to elicit viewer responses. Though rarely used in tourism research, messages delivered via video vignettes are arguably more engaging and realistic than written vignettes. This paper aims to develop clear guidelines for producing video vignettes and evaluating such efforts. A rigorous four-step procedure for producing authentic and valid video vignettes is created and implemented. The examined context involves an exploration of stereotypes shared by Hong Kong residents of Mainland Chinese tourists. A total of 10 video vignettes are developed and used as stimuli in 26 semi-structured interviews. Qualitative and quantitative appraisals are conducted to create and test the protocol and quality indicators. Recommendations are made based on the lessons learned from the validation process. The path toward the creation of video vignettes can provide directions for other tourism research inquiries, such as tourist interactions, embodied experiences, and mutual gaze.
Guaranteed cost controller for discrete time-delayed systems with actuator saturation
Authors: Srivastava Aditi , Negi Richa , Kar Haranath
Published: October 2021

The problem of guaranteed cost (GC) control using static-state feedback controllers for uncertain linear discrete time-delayed systems subjected to actuator saturation is studied in this paper. The stability analysis of closed-loop systems is carried out using a Lyapunov-Krasovskii functional. Conditions for the existence of state-feedback GC controllers are developed using a linear matrix inequality (LMI)-based criterion. The approach ensures a sufficient performance bound over all the acceptable parameter uncertainties. The scheme of the optimal GC controller problem is framed as a convex optimization problem with LMI constraints. The design of GC controllers for discrete-time systems subjected to actuator saturation without considering the effect of state-delay is also discussed. The effectiveness of the proposed approach is illustrated using suitable examples.
Dynamic output feedback sliding mode control for uncertain linear systems
Authors: Feng Jiehua , Zhao Dongya , Yan Xing-Gang , Spurgeon Sarah K
Published: October 2021

In this paper, a class of uncertain linear systems with unmatched disturbances is considered, where the nominal system representation is allowed to be non-minimum phase. A sliding surface is designed which is dependent on the system output, observed state, and estimated uncertain parameters. A linear coordinate transformation is introduced so that the stability analysis of the reduced-order sliding mode dynamics can be conveniently performed. A robust output feedback sliding mode control (OFSMC) is then designed to drive the considered system state to reach the sliding surface in finite time and maintain a sliding motion thereafter. A simulation example for a high incidence research model (HIRM) aircraft is used to demonstrate the effectiveness of the proposed method.
The Explanatory Generalized Graded Unfolding Model: Incorporating Collateral Information to Improve the Latent Trait Estimation Accuracy
Authors: Joo Seang-Hwane , Lee Philseok , Stark Stephen
Published: October 2021

Collateral information has been used to address subpopulation heterogeneity and increase estimation accuracy in some large-scale cognitive assessments. The methodology that takes collateral information into account has not been developed and explored in published research with models designed specifically for noncognitive measurement. Because the accurate noncognitive measurement is becoming increasingly important, we sought to examine the benefits of using collateral information in latent trait estimation with an item response theory model that has proven valuable for noncognitive testing, namely, the generalized graded unfolding model (GGUM). Our presentation introduces an extension of the GGUM that incorporates collateral information, henceforth called Explanatory GGUM. We then present a simulation study that examined Explanatory GGUM latent trait estimation as a function of sample size, test length, number of background covariates, and correlation between the covariates and the latent trait. Results indicated the Explanatory GGUM approach provides scoring accuracy and precision superior to traditional expected a posteriori (EAP) and full Bayesian (FB) methods. Implications and recommendations are discussed.
Freedom Behind Bars: The central role of emotions in naturalizing an analogy for social change
Authors: Farchi Tomás , Logue Danielle , Fernández Pablo , Vassolo Roberto
Published: October 2021

In this paper we examine how a socially innovative solution to a complex social problem is able to overcome entrenched disadvantage and division and sustain itself within an existing institution. We explore how a rugby team in a high-security prison in Argentina has become an organizational response that substantially transformed prisoners’ lives in and out of jail, allowing inmates to reclaim many critical aspects of their humanity and dramatically reducing recidivism. We examine rugby as an analogy for new models of behaviours and identities in the context of extreme disadvantage, and surface the specific emotional work required to make the analogy generative. The findings from our in-depth case study reveal three reinforcing mechanisms in the workings of an analogy – resonating, resignifying and collective generativity – and in doing so provide a novel crescive model of how analogies may sustain change emotionally, cognitively and behaviorally over time, and ultimately achieve positive transformational effects in extreme social contexts.
Imagining Futures: Theorizing the Practical Knowledge of Future-making
Authors: Thompson Neil Aaron , Byrne Orla
Published: October 2021

The study of future-making – how practitioners make and enact imagined futures – has become a cornerstone for understanding the temporal dynamics of organization, strategy and entrepreneurship. This article investigates the texture of practical knowledge that enables entrepreneuring practitioners to jointly address the challenges inherent to future-making. We conduct a video ethnography of a business modelling programme producing 79 hours of audio-visual recordings. Using multimodal conversation analysis, we unpack different forms of practical knowledge that simultaneously binds practitioners in a web of mutual expectations and establishes modes of thinking and acting for the creation of imagined futures. This contributes to existing studies by demonstrating that the discursive, embodied and material dimensions of future-making are fundamentally entangled within textures of practical knowledge. Consequently, we shift the mode of theorizing towards non-representationalism, which opens up new frontiers for future research to observe, participate and reflect with practitioners on the textures of practical knowledge constitutive of future-making in different circumstances and contexts.
Proceedings of the 2021 National Toxicology Program Satellite Symposium
Authors: Elmore Susan A. , Choudhary Shambhunath , Krane Gregory A. , Plumlee Quinci , Quist Erin M. , Suttie Andrew W. , Tokarz Debra A. , Ward Jerrold M. , Cora Michelle
Published: October 2021

The 2021 annual National Toxicology Program (NTP) Satellite Symposium, entitled “Pathology Potpourri,” was the 20th anniversary of the symposia and held virtually on June 25th, in advance of the Society of Toxicologic Pathology’s 40th annual meeting. The goal of this symposium was to present and discuss challenging diagnostic pathology and/or nomenclature issues. This article presents summaries of the speakers’ talks along with select images that were presented to the audience for voting and discussion. Various lesions and topics covered during the symposium included differentiation of canine oligodendroglioma, astrocytoma, and undefined glioma with presentation of the National Cancer Institute’s updated diagnostic terminology for canine glioma; differentiation of polycystic kidney, dilated tubules and cystic tubules with a discussion of human polycystic kidney disease; a review of various rodent nervous system background lesions in control animals from NTP studies with a focus on incidence rates and potential rat strain differences; vehicle/excipient-related renal lesions in cynomolgus monkeys with a discussion on the various cyclodextrins and their bioavailability, toxicity, and tumorigenicity; examples of rodent endometrial tumors including intestinal differentiation in an endometrial adenocarcinoma that has not previously been reported in rats; a review of various rodent adrenal cortex lesions including those that represented diagnostic challenges with multiple processes such as vacuolation, degeneration, necrosis, hyperplasia, and hypertrophy; and finally, a discussion of diagnostic criteria for uterine adenomyosis, atypical hyperplasia, and adenocarcinoma in the rat.
United Nations Policy on Sexual Exploitation and Abuse: Problematizations and Performances
Authors: Harrington Carol
Published: October 2021

The United Nations’(UN) response to reports of UN personnel perpetrating sexual violence proclaims “zero-tolerance for sexual exploitation and abuse (SEA).” Drawing on Carol Bacchi's “what's the problem represented to be (WPR)?” framework, this article unpacks how UN policy solutions represent the problem of SEA. It explores the discursive effects of the UN's problematization of SEA drawing on Sara Ahmed's analysis of audit systems and non-performativity within performance cultures. It scrutinizes the Secretary-General's reports on SEA data and policy documents, including training and risk assessment materials. The analysis shows that UN policy problematizes SEA as transactional sex, inevitable in conditions of poverty and gender inequality. Solutions individualize perpetrators as rule-breakers subject to discipline and generalize victims as among the many impacted by SEA globally. Such solutions situate the UN as the answer to, rather than cause of, SEA and restore a narrative of the UN as defender of the vulnerable.
Relationships among Antecedents, Processes, and Outcomes for Shared Decision Making: A Cross-Sectional Survey of Patients with Lumbar Degenerative Disease
Authors: Chen Chia-Hsien , Chuang Hsin-Yi , Lee Yen , Elwyn Glyn , Hou Wen-Hsuan , Kuo Ken N.
Published: October 2021

Background

Among musculoskeletal disorders, lumbar degenerative disease (LDD) is the leading cause of total disability-adjusted life years globally. Clinical guidelines for LDD describe multiple treatment options in which shared decision making becomes appropriate.

Objectives

To explore the relationships among measures of decision antecedents, process, and outcomes in patients with LDD.

Methods

Patients with LDD were recruited from outpatient clinics in a teaching hospital in Taiwan and administered surveys to collect measures of decision antecedents, processes, and outcomes. Multiple linear regression was conducted to assess the association between decision antecedents and the decision making process. Hierarchical linear regression was conducted to assess the relationships among decision antecedents, the decision making process, and decision outcomes.

Results

A total of 132 patients (mean age, 61 years) completed the survey. After adjustment for personal factors, 2 decision antecedents (namely, decision making self-efficacy and readiness) significantly predicted patients’ experiences of engaging in shared decision making (SDM). Decision making readiness and process were associated with fewer decisional conflicts and greater decision satisfaction.

Limitations

Models derived from cross-sectional surveys cannot establish causal relationships among decision antecedents, decision making processes, and decision outcomes.

Conclusions

Our results support the SDM framework, which proposes relationships among decision antecedents, the decision making process, and decision outcomes.
The Food-entrainable Oscillator Is a Complex of Non-SCN Activity Bout Oscillators Uncoupled From the SCN Circadian Pacemaker
Authors: Nishide Shinya , Suzuki Yohko , Ono Daisuke , Honma Sato , Honma Ken-ichi
Published: October 2021

The food-entrainable oscillator, which underlies the prefeeding activity peak developed by restricted daily feeding (RF) in rodents, does not depend on the circadian pacemaker in the suprachiasmatic nucleus (SCN) or on the known clock genes. In the present study, to clarify the roles of SCN circadian pacemaker and nutrient conditions on the development of prefeeding activity peak, RF of 3-h daily feeding was imposed on four groups of adult male mice for 10 cycles at different circadian times, zeitgeber time (ZT)2, ZT8, ZT14, and ZT20, where ZT0 is the time of lights-on in LD12:12. Seven days after the termination of RF session with ad libitum feeding in between, total food deprivation (FD) for 72 h was imposed. Wheel-running activity and core body temperature were measured throughout the experiment. Immediately after the RF or FD session, the PER2::LUC rhythms were measured in the cultured SCN slices and peripheral tissues. Not only the buildup process and magnitude of the prefeeding activity peak, but also the percentages of nocturnal activity and hypothermia developed under RF were significantly different among the four groups, indicating the involvement of light entrained circadian pacemaker. The buildup of prefeeding activity peak was accomplished by either phase-advance or phase-delay shifts (or both) of activity bouts comprising a nocturnal band. Hypothermia under FD was less prominent in RF-exposed mice than in naïve counterparts, indicating that restricted feeding increases tolerance to caloric restriction as well as to the heat loss mechanism. RF phase-shifted the peripheral clocks but FD did not affect the clocks in any tissue examined. These findings are better understood by assuming multiple bout oscillators, which are located outside the SCN and directly drive activity bouts uncoupled from the circadian pacemaker by RF or hypothermia.
Rheological and mechanical properties of polypropylene/grape skin fiber composites
Authors: Agrawal Pankaj , Lima Priscila A , Cavalcanti Shirley N , Silva Moacy P , Freitas Daniel MG , Alves Amanda M , Brito Gustavo F , Mélo Tomás JA
Published: October 2021

The use of natural fibers as fillers in polymer matrix composites is an alternative for reusing the fruit wastes that originated from the food industry. This work aimed to evaluate the effect of grape skin fiber (GSF) on the rheological and mechanical properties of polypropylene/GSF (PP/GSF) composites. The composites were prepared by extrusion followed by injection molding and characterized by rheological, morphological, and mechanical properties. Rheological measurement results showed an increase in viscosity at low frequencies. The relaxation time of the PP/GSF composites increased by about 415% with the increase in the GSF content from 1 to 3 phr. Capillary rheometry results indicated that the processability of PP was not compromised with the addition of GSF. Morphology analysis by scanning electron microscopy (SEM) indicated a good interaction between the PP matrix and GSF and a good dispersion/distribution of the fibers in the PP matrix. The impact strength decreased by about 14 and 17% with the addition of 1 and 3 phr, respectively, of GSF to PP whereas the elastic modulus remained almost unchanged.
Democracy and Capitalism in the Interregnum: Trump’s Failed Self-Coup and After
Authors: Antonio Robert J.
Published: October 2021

This paper addresses Trump’s failed self-coup, its authoritarian backwash, and threats to democracy. It analyzes his handling of the coronavirus pandemic, which contributed to his 2020 election loss and deepened the political polarization that led to the January 6 Capitol insurrection. The essay also discusses how the forty-year acceleration of economic inequality and sociopolitical de-democratization generated a legitimacy crisis of the hegemonic, neoliberal regime that opened way for Trumpist ethnoracial nationalism. The Trump presidency and pandemic increased the intensity of the political-economic contradictions and transparency of the attenuated relationship of democracy and capitalism. In the consequent “interregnum,” fundamental threats to democratic electoral institutions persist, yet a clear, realistic vision of an alternative democratic regime and the political bloc to bring it into being have yet to be forged. The fate of American democracy rides on overcoming the remarkable denial and normalization of the Trump coup attempt and on forging new safeguards for electoral institutions. Preventing a recurrence, however, requires a progressive transformation of Trumpism’s de-democratized seedbed – neoliberal capitalism.
Distinct features of youth-onset primary antiphospholipid syndrome
Authors: Baleeiro Carla , Duran Camila SC , Signorelli Flavio , Balbi Gustavo GM , Bonfá Eloisa , Andrade Danieli CO
Published: October 2021

Background

Characteristics of primary APS (PAPS) in the youth population have never been studied. In contrast with children, pregnancy is genuinely relevant in the youth age, and understanding clinical characteristics of PAPS patients within this specific age stratum may also provide insights regarding the well-known risk of poor obstetric outcomes during the adolescence.

Objective

To evaluate clinical and laboratory characteristics of patients with youth-onset PAPS (15–24 years) and compare them with adult-onset PAPS (over 24 years old).

Methods

This was a cross-sectional study derived from two rheumatology outpatient clinics. Patients who fulfilled Sidney criteria and who were 15 years of age or older at disease onset were included. Secondary APS patients were excluded. We subdivided patients into two groups: youth- (15–24 years) and adult-onset (over 24 years) and compared them regarding demographic characteristics, criteria and non-criteria manifestations, cardiovascular risk factors, and aPL status. For the pregnancy outcomes analysis, ever-pregnant patients were divided in three groups: youth-onset, early adult-onset (25–34 years), and late adult-onset (35–49 years).

Results

A total of 250 consecutive PAPS patients were included. Groups had a comparable female and Caucasian distribution. We found a similar disease duration (14.0±7.9 vs 17.0±10.1 years, p = 0.079) and similar rates of thrombotic arterial (34.2% vs. 42.0%, p = 0.250) and venous events (69.7% vs. 69.5%, p = 0.975) between them. Skin ulcers were more frequent in the youth-onset group (17.1% vs. 4.0%, p = 0.001), whereas nephropathy was less common (1.3% vs. 8.0%, p = 0.039). No differences were observed for the other criteria and non-criteria manifestations. The adult-onset group presented more frequently with hypertension ( p = 0.002), hyperlipidemia ( p = 0.008), and smoking ( p = 0.003). The youth-onset group presented a higher frequency of obstetric events as the first manifestation of PAPS (30.3% vs. 21.7%, p = 0.005), with worse pregnancy outcomes, namely, fetal death (58.5% vs. 46.4% vs. 24.1%, p = 0.012) and premature delivery (35.8% vs. 19.0% vs. 10.3%, p = 0.016). Of note, all groups had a comparable number of pregnancies (2.81±2.52 vs 2.74±2.07, p = 0.899).

Conclusion

This study provides novel evidence that youth-onset PAPS presents a higher frequency of obstetric complications as its first manifestation, with an increased risk of fetal death and preterm delivery. Early recognition of this condition by obstetricians is essential to improve prognosis.
Chronic Illness Management in Culturally and Linguistically Diverse Patients: Exploring the Needs, Access, and Understanding of Information
Authors: Lambert Sylvie , Loban Ekaterina , Li Jane , Nghiem Tracy , Schaffler Jamie , Maheu Christine , Dubois Sylvie , Folch Nathalie , Gélinas-Phaneuf Elisa , Laizner Andréa Maria
Published: October 2021

In Canada, people from culturally and linguistically diverse (CALD) backgrounds are at a greater risk of developing a chronic illness, and are more likely to experience adverse health effects and challenges in accessing high-quality care compared with Canadian-born individuals. This, in part, has been attributed to having inadequate access to information and resources needed to manage their illness(es). A qualitative descriptive design and inductive content analysis were used to explore the information needs of 24 CALD patients with chronic illnesses. Participants identified medical, lifestyle, and psychosocial information needs. How much information was needed depended on such antecedents as illness trajectory, severity, and perception. Most information needs remained unmet. A number of communication strategies were identified to bridge language barriers that go beyond translation and are based on effective health education strategies. Findings can help health care professionals better identify CALD patients’ information needs and provide strategies that go beyond translation.
Comparison of Computed Tomography, Traction, and Inverted Grayscale Radiographs for Understanding Pilon Fracture Morphology
Authors: Eken Gokay , Misir Abdulhamit
Published: October 2021

Background:

There have been no studies evaluating the usefulness of grayscale radiographs in extremity fractures. We aimed to compare the ability and reliability of traction radiographs vs traction grayscale inversion radiographs to detect fracture fragment and comminution zones in comminuted tibia pilon fractures.

Methods:

Plain radiographs and grayscale inversion images of 60 patients with Orthopaedic Trauma Association/AO Foundation type C3 fracture were evaluated by 20 observers (15 orthopaedic surgeons and 5 radiologists) after traction had been applied. The anterolateral, posterolateral, and medial malleolar fragments, as well as the lateral, central, and medial column comminution zones, were identified by all physicians. Computed tomography scan images were used as the “gold standard” against which plain radiographs and grayscale inversion image interpretation were measured. Intra- and interobserver reliability and correct identification of fracture fragments and comminution zones were evaluated.

Results:

The interobserver reliability for 3 of the fracture fragments and comminution zones on the traction plain radiographs was moderate, whereas it was substantial on traction grayscale inversion radiographs. The lateral comminution zones ( P = .001) and presence or absence of posterolateral fragments ( P < .001) were significantly better identified in grayscale inversion radiographs compared to standard radiographs.

Conclusion:

After traction was applied, we found grayscale inversion radiographs are superior to plain radiographs in the identification of posterolateral fragment and lateral zone of comminution in comminuted intraarticular pilon fractures.

Level of Evidence:

Level III, retrospective case series.
A Mixed Methods Population Health Approach to Explore Radon-Induced Lung Cancer Risk Perception in Canada
Authors: Khan S. M. , Gomes J. , Chreim S.
Published: October 2021

Background

Radon is a predominant indoor air pollutant and second leading cause of lung cancer in radon-prone areas. Despite the gravity of the health risk, residents in Canada have inadequate perception and taken minimal protective actions. Better perception of a risk motivates people to take preventive measures. Scholarship about radon health risk perception is lacking in Canada. We applied a mixed methods population health approach to explore the determinants shaping perception and actions of a resident population in Canada.

Methods

We conducted mixed surveys (n = 557) and qualitative bilingual interviews (n = 35) with both homeowners and tenants of Ottawa–Gatineau areas. The study explored residents' risk perception and adaptations factors. Descriptive, correlational and regression analyses described and established associations between quantitative variables. Thematic, inductive analyses identified themes in the qualitative data. A mixed methods analysis triangulated both results to draw a holistic perception of the health risk.

Results

Residents’ quantitative perceptions of radon health risk, smoking at home, synergistic risk perception, social influence and care for family were associated significantly with their intention to test for radon levels in their home, actual testing and mitigation. These results were explained further with the qualitative findings. Residents who had dual cognitive and emotional awareness of the risk were motivated enough to take preventive actions. Caring for family, knowing others who contracted lung cancer and financial capability were enablers, whereas lack of awareness and homeownership, cost of mitigation and stigma were obstacles to preventive actions. We also explored the dual subjective and objective aspects of risk perception that are influenced by micro- and macro-level determinants.

Conclusions

Inducing protective action to reduce risk requires comprehensive population-level interventions considering dual perceptions of the risk that can modify the risk determinants. Future research can explore the dual aspects of risk perception and unequal distribution of the risk factors.
Coordinating Systems of Care for HIV and Opioid Use Disorder: A Systematic Review of Enablers and Barriers to Integrated Service Access, and Systems and Tools Required for Implementation
Authors: Duffy Malia , Ghosh Anna , Geltman Ana , Mahaniah Gabriel Kieto , Higgins-Biddle Molly , Clark Michele
Published: October 2021

Individuals who have HIV who also use drugs experience increased age-matched morbidity and mortality in comparison with those with HIV who do not use drugs. A systematic review was conducted to describe models of integrated HIV and opioid use disorder (OUD) services, enablers of and barriers to integrated service access, and the coordinated systems and tools at the state and service delivery levels required for implementation. Database searches yielded 235 candidate articles, of which 22 studies met the inclusion criteria. Analysis found that integrated programs operated with minimal coordinated policy and systems guidance at the state level. Service delivery systems and tools used for integration, including use of integrated protocols, risk assessment tools, case management tools, and referral systems, were similar across integration models. Concerted efforts to coordinate state-level systems and develop supportive policies, guidelines, and standardized tools may facilitate integration at the service delivery level.
A Qualitative Study of Arab-American Perspectives on Intimate Partner Violence in Dearborn, Michigan
Authors: Khan Angubeen G. , Eid Neda , Baddah Lama , Elabed Layla , Makki Mona , Tariq Madiha , King Elizabeth J. , Kusunoki Yasamin
Published: October 2021

Few studies explore how intimate partner violence (IPV) affects Arab Americans. Through focus groups with stakeholders from an Arab-centered health organization and semistructured interviews with Arab-American female clients (18–65 years), we explore how IPV affects Arab-American women and factors that impede and facilitate their access to support services. We find that IPV is a critical concern among Arab Americans and that generational status, educational attainment, and support from family, friends, or religious leaders were perceived to influence access to IPV support services. This study has implications for developing culturally sensitive IPV interventions for Arab-American women.
Food Choice With Economic Scarcity and Time Abundance: A Qualitative Study
Authors: Folta Sara C. , Anyanwu Oyedolapo , Pustz Jennifer , Oslund Jennifer , Penkert Laura Paige , Wilson Norbert
Published: October 2021

Consumers with low income in the United States have higher vulnerability to unhealthy diets compared with the general population. Although some literature speculates that scarcity is an explanation for this disparity, empirical evidence is lacking. We conducted a qualitative study of food choice to explore whether scarcity-related phenomena, such as tunneling and bandwidth tax, may contribute to unhealthy dietary choices. We used participant-driven photo elicitation ( n = 18) to investigate the food choice behaviors of individuals living in the greater Boston area who met the federal guidelines for poverty. Participants took photos at the point of food acquisition for 1 month, after which we interviewed them using a semistructured interview guide with the photos as prompts. Thematic coding was used for analysis. Respondents had relative time abundance. Two major themes emerged: participants used a set of strategies to stretch their budgets, and they highly prioritized cost and preference when making food choices. The extreme focus on obtaining food at low cost, which required time and effort, was suggestive of tunneling. We found no evidence of the bandwidth tax. Our findings raise the hypothesis of scarcity as a continuum: when individuals experience multiple resource constraints, they experience scarcity; whereas people with very limited finances and relative time abundance may instead be in a prescarcity condition, with a hyperfocus on a scarce resource that could lead to tunneling as constraints increase. Additional studies are needed to understand whether and how tunneling and bandwidth tax emerge, independently or together, as people face different levels and types of scarcity.
Cognitions That Support Concussion Reporting in Collegiate Athletes: An Analysis of a Worksheet Activity
Authors: Kneavel Meredith , Ernst William
Published: October 2021

Background

Sports related concussions continue to be a public health concern and improving reporting behavior a focus of educational programs. While educational programs have addressed changes in knowledge of concussion symptoms, it has been challenging to design educational programs which have lasting effects on reporting behavior.

Aims

The current analysis describes an intervention in which thoughts about reporting behavior are actively written down in a worksheet exercise to “pre-arm” athletes with cognitions designed to enhance reporting behavior prior to the injury event.

Method

A total of 503 male and female college athletes participating in collision (football, field hockey, ice hockey, lacrosse, and soccer) and contact sports (baseball, basketball, and softball) from 7 colleges/universities competing across all three NCAA divisions provided data collected during a randomized trial of a peer concussion education program.

Results

Qualitative analysis revealed 10 themes that would improve reporting including short-term benefits, faster recover, safe and healthy return to play, reporting helps the team, reporting protects the brain, risk aversion, long-term benefits, coach will be supportive, teammates will be supportive and understanding, and academic performance will be affected.

Discussion

Athletes had awareness of key risks involved in concussions and understood both short- and long-term consequences.

Conclusion

These findings have important implications for understanding how to change athletes’ thoughts about reporting concussions.
Risk of Depression Among MMT Patients: Does Coping Strategies and Perceived Social Support Play a Role?
Authors: Wahab Suzaily , Chun Keat Tee , Azmi Amirul Danial , Mahadevan Raynuha , Muhamed Ramli Eni Rahaiza , Kian Boon Law
Published: October 2021

Introduction:

Patients receiving methadone maintenance therapy (MMT) experience higher level of stress and are at greater risk of developing mental health problems such as depression which could potentially affect both quality of life and treatment outcomes. This cross-sectional study is aimed at understanding the relationship between psychosocial factors such as social support, coping, and depression among patients receiving MMT in a Malaysian Hospital.

Methods:

One hundred and ninety-six patients attending MMT program were recruited. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depression, Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess participants’ perceived social support, and the Brief COPE questionnaire was used to assess coping strategies. The diagnosis of depression was made using Mini-International Neuropsychiatric Interview (MINI).

Results:

About 13.8% of our sample were diagnosed with depression. From our analysis, it was found that having higher levels of perceived social support (OR = 0.462, 95% CI 0.238-0.899, P < .05), the use of active and emotion focused coping mechanism (OR = 0.231, 95% CI 0.095-0.565, P < .005), and support seeking and self-distraction coping mechanism (OR = 0.196, 95% CI 0.074-0.521, P < .001) was associated with lower likelihood of depression. On the contrary, the use of dysfunctional coping strategies such as denial, behavioral disengagement, and self-blame was associated with increased likelihood of depression (OR = 9.384, 95% CI 3.081-28.581, P < .001).

Conclusion:

Active and emotion focused along with support and self-distraction coping strategies, and higher levels of perceived social support may serve as a buffer against depression in patients receiving MMT.
Durability of no evidence of disease activity-3 (NEDA-3) in patients receiving cladribine tablets: The CLARITY extension study
Authors: Giovannoni Gavin , Singer Barry A , Issard Delphine , Jack Dominic , Vermersch Patrick
Published: October 2021

Background:

No evidence of disease activity (NEDA-3) is a patient-centric outcome increasingly used as the goal of multiple sclerosis treatment.

Objective:

Determine treatment durability of cladribine tablets beyond 2 years considering the variable bridging interval of 0.1–116.0 weeks between CLARITY and CLARITY Extension.

Methods:

Between CLARITY and CLARITY Extension, patients transitioned from cladribine tablets 3.5 mg/kg to placebo (CP3.5 group, n = 98) or continued further treatment with cladribine tablets 3.5 mg/kg (CC7.0 group, n = 186). Treatment assignment was randomized and blinded in both CLARITY and CLARITY Extension.

Results:

The 2-year NEDA-3 in CLARITY Extension (encompassing both years of CLARITY Extension) was 29.6% in the CP3.5 group and 32.8% in the CC7.0 group. There was no evidence that treatment effect differed with varying bridging intervals. For patients in the CP3.5 group with a bridging interval of ⩽48 weeks, 1 year NEDA-3 (the first year of CLARITY Extension) was 44.4% (28/63) compared with 31.4% (11/35) in patients with a bridging interval of >48 weeks.

Conclusion:

Treatment with cladribine tablets in CLARITY, followed by either placebo or cladribine tablets in CLARITY Extension, produced sustained benefits for NEDA-3 and its constituent elements for a follow up period up to 6 years from CLARITY baseline.