bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Mitigation Planning for Revenue Service Testing of Bus Automated Emergency Braking
Authors: Soule Heidi H. , Davis Adam , Krum Andrew , Wang Yinhai , Ke Ruimin , Valadez Dave , Sellers Dan , Roberts Steve , Fischer Luke , Lutin Jerome M.
Published: January 2021

In 2017, the Federal Transit Administration awarded Pierce Transit of Lakewood, WA, a $1.66 m grant for a bus collision avoidance and mitigation safety research and demonstration project. The project scope includes installation of an advanced technology package, the Pedestrian Avoidance Safety System (PASS) that uses light detection and ranging (LiDAR) sensors to trigger automated deceleration and braking. Thirty transit buses are being equipped with PASS and will be monitored using telematics to transmit and collect critical test data. The test plan includes collecting data while operating the buses in “stealth mode” with PASS detecting and logging events, but not activating brakes automatically or warning the drivers. At the conclusion of “stealth mode” operation, Pierce Transit will make a go/no-go decision on whether to activate PASS’s automatic deceleration and braking functionality for revenue service with passengers. This paper describes the risk mitigation process developed to determine if the system is safe enough to allow operation in revenue service. The process includes: broad stakeholder engagement, constituting an ad-hoc working group within Pierce Transit to advise executive management, development of decision-making criteria, consultation with state and federal officials on regulatory requirements and compliance, review of applicable standards and engineering test protocols, engineering consultations with the bus original equipment manufacturer, and road testing to simulate revenue service, collect data, and obtain feedback from drivers and maintainers.
Effects of Anxiety and Depression Measured via the Hospital Anxiety and Depression Scale on Early Pain and Range of Motion After Rotator Cuff Repair
Authors: Park Joo Hyun , Rhee Sung-Min , Kim Hyong Suk , Oh Joo Han
Published: January 2021

Background:

Preoperative anxiety and depression are independent predictors of clinical outcomes after arthroscopic rotator cuff repair. However, few studies have evaluated correlations between outcomes such as pain and range of motion (ROM) after arthroscopic rotator cuff repair and preoperative anxiety and depression.

Purpose:

To evaluate the effects of preoperative anxiety and depression, measured using the Hospital Anxiety and Depression Scale (HADS), on early pain and ROM after rotator cuff repair.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 144 consecutive patients who underwent arthroscopic rotator cuff repair were enrolled and divided into 2 groups according to HADS scores: group A, those with a healthy psychological status (n = 103; anxiety ≤7 and depression ≤7), and group B, those with psychological distress (n = 41; anxiety ≥8 or depression ≥8). Clinical outcomes were assessed using the visual analog scale for pain (pVAS) and ROM at 3 and 6 months postoperatively and annually.

Results:

There were no significant preoperative differences in age, sex, tear size, pVAS scores, and ROM. However, at 3 months postoperatively, group A showed significantly lower mean pVAS scores (2.2 ± 1.3 vs 3.4 ± 1.8, respectively; P = .001) and significantly higher mean forward flexion (146.4°± 23.0° vs 124.1°± 28.2°, respectively; P < .001) than group B, as well as significantly higher mean levels of internal rotation at the back (T11.5 ± 2.8 vs L1.9 ± 2.5, respectively; P < .001) and significantly higher mean external rotation (42.4°± 15.9° vs 35.2°± 16.8°, respectively; P = .019). At 6 months postoperatively, the mean pVAS score was still significantly lower in group A than in group B (0.8 ± 1.6 vs 1.8 ± 2.1, respectively; P = .016), but other ROM measurements had no significant differences. There was also no significant difference in clinical and functional outcomes at the final follow-up.

Conclusion:

Anxiety and depression negatively affected clinical outcomes after rotator cuff repair. Recovery from pain and of ROM after arthroscopic rotator cuff repair occurred more quickly in patients with a healthy psychological status. Therefore, assessments of preoperative psychological status should be emphasized to improve early clinical outcomes after arthroscopic rotator cuff repair.
Factors Affecting the Obesity Levels of Older Koreans Living Alone
Authors: Kim Ka Young , Noh Wonjung
Published: January 2021

This study investigated factors related to the obesity levels of older Koreans living alone. It used data from the Korean Longitudinal Study of Aging. Its participants comprised 819 people aged 65 years and older, living alone in Korea. Multiple logistic regression was performed to analyze the factors related to managing obesity at the individual, social, and environmental levels. In the obese group, social interaction was a significant factor on social level, whereas in the overweight group, regular exercise, social interaction, and region were the significant factors at the individual, social, and environmental levels, respectively. It was found that different approaches were needed depending on the level of obesity. In addition, this study identified that it was appropriate to approach the obesity management of older people living alone, in terms of individual, social, and environmental systems, based on the ecological perspective.
Case of Angular Blepharitis Caused by Demodex folliculorum
Authors: Luo Susan , Burkat Cat , van Landingham Suzanne W.
Published: January 2021

Angular blepharitis is inflammation of the eyelid skin at the lateral canthus, most commonly caused by Staphylococcus and Moraxella species. The Demodex mite is an external parasite that often infests the human eyelid margin and has been implicated in both anterior and posterior blepharitis. The authors describe the case of a 43-year-old female who presented for evaluation of a 3-month history of bilateral canthal eyelid irritation, consistent with angular blepharitis. This is a case report and review of relevant literature. Skin biopsy showed evidence of Demodex folliculorum infestation. Multiple D. folliculorum organisms were visualized within the hair follicles and on the surface, along with pockets of acute and chronic nongranulomatous inflammation surrounding hair follicles. The patient was treated with tea tree oil applied to her eyelids and eyelashes twice daily with complete resolution of symptoms. To our knowledge, this is the first report of angular blepharitis with histopathologic confirmation of Demodex infestation. In this discussion, we cover manifestations of the Demodex mite, angular blepharitis, and treatment options. Due to the lack of literature regarding this entity, we feel that it may be an underrecognized periocular and dermatologic condition that can lead to misdiagnosis, visits to multiple practitioners, and significant functional and cosmetic sequelae to the patient. Demodex infestation should be considered on the differential diagnosis for cases of refractory angular blepharitis, particularly when unresponsive to topical steroids. Based on results from treating Demodex anterior and posterior blepharitis and this case, treatment with tea tree oil should be considered.
Diagnostic Radiology Residency Assessment Tools: A Scoping Review
Authors: Tu Wendy , Hibbert Rebecca , Kontolemos Mario , Dang Wilfred , Wood Tim , Verma Raman , McInnes Matthew D. F.
Published: January 2021

Purpose:

The multifaceted nature of learning in diagnostic radiology residency requires a variety of assessment methods. However, the scope and quality of assessment tools has not been formally examined. A scoping review was performed to identify assessment tools available for radiology resident training and to evaluate the validity of these tools.

Methods:

A literature search was conducted through multiple databases and on-line resources. Inclusion criteria were defined as any tool used in assessment of radiology resident competence. Data regarding residents, evaluators and specifics of each tool was extracted. Each tool was subjected through a validation process with a customized rating scale using the 5 categories of validity: content, response process, internal structure, relations to other variables, and consequences.

Results:

The initial search returned 447 articles; 35 were included. The most evaluated competency being overall knowledge (31%), most common published journal was Academic Radiology (24%) ; evaluations were most commonly set in the United States (57%). In terms of validation, we found low adherence to modern integrated validity, with 34% of studies including a definition of validity. When specifically examining the 5 domains of validation evidence presented, most were either absent or of low rigor (70%). Only one study presented a modern definition of validation (3%, 1/35).

Conclusion:

We identified 35 evaluation tools covering a variety of competency areas. However, few of these tools have been validated. Development of new validated assessment tools or validation of existing tools is essential for the ongoing transition to a competency-based curriculum.
Kenotic Theologies and the Challenge of the ‘Anthropocene’: From Deep Incarnation to Interspecies Encounter
Authors: Robinson David S. , Wotochek Jennifer
Published: January 2021

As the detrimental effects of human agency loom large in the ‘Anthropocene’, theologians and philosophers have called for restraint by invoking the concept of kenosis. Although a ‘self-emptying’ form of life helps to counter the ways that humans are increasingly driving other species to extinction, we argue that such calls are often compromised by relying on notions of the Creator’s own attenuated or self-limited agency. They therefore trade in a competitive construal that is susceptible to the tendency of human agency to either displace, or project itself upon, all other agencies, inadvertently perpetuating the ‘human epoch’. In their place, we critically develop the new direction in kenotic theology that speaks of divine self-realization in history through ‘deep incarnation’. Our constructive proposal argues for a more thoroughgoing recognition of both the transcendence of divine agency and, as a corollary, the diverse agencies of our fellow creatures.
Effect of deposition thickness on microstructure and thermal behaviour of ZnO-Mg coated AISI 4140 for automotive applications
Authors: Ramkumar T , Selvakumar M , Mohanraj M , Senthilkumar AP , Narayanasamy P
Published: January 2021

In this research article, the detailed morphology characterization and thermal behaviour of AISI 4140 steel coated with ZnO-Mg were studied. Coating thickness of approximately ≈ 30, 60 and 90 µm were taken. The surface morphology of the coated samples was studied using Optical Microscope (OM) and Scanning Electron Microscope (SEM). Phases present in the coated samples were confirmed using X-Ray Diffraction Technique (XRD) and Raman Spectroscopy. Thermal properties of the coated samples such as thermal conductivity and thermal diffusivity were determined. In addition, specific heat of the coated samples was also identified. The samples with coating thickness of 30 µm exhibit enhanced thermal properties compared to other coated samples. The results reveal that ZnO-Mg coating can significantly improve the thermal properties of AISI 4140 steel, which can be a fair candidate material for automotive applications.
Improving the noise reduction performance of gangway bellows by using multilayered structures
Authors: Noh Hee-Min
Published: January 2021

Excessive interior noise in railway vehicles is a major cause of fatigue and discomfort for passengers. In particular, the between-cars sections of high-speed trains experience considerable interior noise due to the poor noise reduction performance of the bellows, which are primarily made of silicone rubber and thus have a lower density than that of other components, made of extruded aluminum. Therefore, the objective of this study was to improve the noise reduction performance of such bellows. First, the material properties of silicone rubber were analyzed. Based on the results, the noise transmission of a simple model was analyzed to determine approaches required to reduce the low-frequency interior noise of the between-cars sections. It was confirmed that the low-frequency noise could be reduced by incorporating a multilayered panel of silicone rubber. Therefore, multilayered structures were considered for incorporation in the interior space of the between-cars sections of an actual high-speed train. A curved driving simulation of the between-cars sections indicated that no interference occurs when applying the proposed approach. Furthermore, a comparative test regarding the noise reduction performance was conducted considering cases involving bellows with and without multiple layers. The results of the verification test demonstrated that the noise reduction performance when using the proposed approach was improved by 4 dB compared with that in the case involving the conventional bellows, and an improvement of 8 dB or more was observed for noise with a low-frequency of 100 Hz.
Does Choice Cause an Illusion of Control?
Authors: Klusowski Joowon , Small Deborah A. , Simmons Joseph P.
Published: January 2021

Previous research suggests that choice causes an illusion of control—that it makes people feel more likely to achieve preferable outcomes, even when they are selecting among options that are functionally identical (e.g., lottery tickets with an identical chance of winning). This research has been widely accepted as evidence that choice can have significant welfare effects, even when it confers no actual control. In this article, we report the results of 17 experiments that examined whether choice truly causes an illusion of control ( N = 10,825 online and laboratory participants). We found that choice rarely makes people feel more likely to achieve preferable outcomes—unless it makes the preferable outcomes actually more likely—and when it does, it is not because choice causes an illusion but because choice reflects some participants’ preexisting (illusory) beliefs that the functionally identical options are not identical. Overall, choice does not seem to cause an illusion of control.
Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review
Authors: Restrepo-Escobar Mauricio , Granda-Carvajal Paula A , Aguirre Daniel C , Hernández-Zapata Johanna , Vásquez Gloria M , Jaimes Fabián
Published: January 2021

Introduction

Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions.

Objective

To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature.

Methods

A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings’ archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model.

Results

We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic.

Conclusions

To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures. Protocol registration number: PROSPERO CRD42020171638.
Continuous(ly) missing outcome data in network meta-analysis: A one-stage pattern-mixture model approach
Authors: Spineli Loukia M , Kalyvas Chrysostomos , Papadimitropoulou Katerina
Published: January 2021

Appropriate handling of aggregate missing outcome data is necessary to minimise bias in the conclusions of systematic reviews. The two-stage pattern-mixture model has been already proposed to address aggregate missing continuous outcome data. While this approach is more proper compared with the exclusion of missing continuous outcome data and simple imputation methods, it does not offer flexible modelling of missing continuous outcome data to investigate their implications on the conclusions thoroughly. Therefore, we propose a one-stage pattern-mixture model approach under the Bayesian framework to address missing continuous outcome data in a network of interventions and gain knowledge about the missingness process in different trials and interventions. We extend the hierarchical network meta-analysis model for one aggregate continuous outcome to incorporate a missingness parameter that measures the departure from the missing at random assumption. We consider various effect size estimates for continuous data, and two informative missingness parameters, the informative missingness difference of means and the informative missingness ratio of means. We incorporate our prior belief about the missingness parameters while allowing for several possibilities of prior structures to account for the fact that the missingness process may differ in the network. The method is exemplified in two networks from published reviews comprising a different amount of missing continuous outcome data.
Synthesis of a multicomponent silica aerogel-containing nanocomposite for efficient sound absorption properties
Authors: Hamidi Mansoureh , Nassiri Parvin , Panahi Homayoon Ahmad , Taghavi Lobat , Bazgir Saeed
Published: January 2021

In this study, the sound properties of four types of nanocomposites have been investigated. To this end, the prepared samples were measured by the impedance tube model BSWA-SW 422, SW477. It was found that the Sound Absorption Coefficient (SAC) of all samples was increased at high frequencies relatively well. The highest SAC at medium and low frequencies was related to the nanocomposite D. The results of sound Transmission Loss (TL) of nanocomposites showed that the TL value for the nanocomposite D (optimum sample) was higher at all frequencies compared to other nanocomposites. The results confirmed that adding organic and mineral materials to the silica aerogel (SA) simultaneously improves its sound properties. By measuring the Sound Pressure Level (SPL) around the enclosure without optimum sample and with optimum sample in the four sound ranges, we found that using nanocomposite D can significantly reduce the noise. According to this study, SA/polyester nonwoven layer/pan nanofibers/nanoclay nanocomposite (nanocomposites D) have great sound absorption properties, which can be used in different environments.
Retrospective comparison between single reading plus an artificial intelligence algorithm and two-view digital tomosynthesis with double reading in breast screening
Authors: Graewingholt Axel , Duffy Stephen
Published: January 2021

Objective

To examine the breast cancer detection rate by single reading of an experienced radiologist supported by an artificial intelligence (AI) system, and compare with two-dimensional full-field digital mammography (2D-FFDM) double reading.

Materials and methods

Images (3D-tomosynthesis) of 161 biopsy-proven cancers were re-read by the AI algorithm and compared to the results of first human reader, second human reader and consensus following double reading in screening. Detection was assessed in subgroups by tumour type, breast density and grade, and at two operating points, referred to as a lower and a higher sensitivity threshold.

Results

The AI algorithm method gave similar results to double-reading 2D-FFDM, and the detection rate was significantly higher compared to single-reading 2D-FFDM. At the lower sensitivity threshold, the algorithm was significantly more sensitive than reader A (97.5% vs. 89.4%, p = 0.02), non-significantly more sensitive than reader B (97.5% vs. 94.4%, p = 0.2) and non-significantly less sensitive than the consensus from double reading (97.5% vs. 99.4%, p = 0.2). At the higher sensitivity threshold, the algorithm was significantly more sensitive than reader A (99.4% vs. 89.4%, p < 0.001) and reader B (99.4% vs. 94.4%, p = 0.02) and identical to the consensus sensitivity (99.7% in both cases, p = 1.0). There were no significant differences in the detection capability of the AI system by tumour type, grading and density.

Conclusion

In this proof of principle study, we show that sensitivity using single reading with a suitable AI algorithm is non-inferior to that of standard of care using 2D mammography with double reading, when tomosynthesis is the primary screening examination.
2D:4D and Self-Employment: A Preregistered Replication Study in a Large General Population Sample
Authors: Fossen Frank M. , Neyse Levent , Johannesson Magnus , Dreber Anna
Published: January 2021

The 2D: 4D digit ratio, the ratio of the length of the second finger to the length of the fourth finger, is often considered a proxy for testosterone exposure in utero. A recent study reported, among other things, an association between the left-hand 2D:4D and self-employment in a sample of 974 adults. In this preregistered study, we replicate the 2D:4D results on a sample of more than 2100 adults from the German Socioeconomic Panel-Innovation Sample (SOEP-IS). We find no statistically significant associations between 2D:4D and self-employment.
Vibration control of vehicle suspension with magneto-rheological variable damping and inertia
Authors: Li Wenfeng , Dong Xiaomin , Yu Jianqiang , Xi Jun , Pan Chengwang
Published: January 2021

To avoid the limitation of conventional vehicle magnetorheological (MR) suspension, a variable damping and inertia device is applied in the vehicle suspension with MR technology. A semi-active adaptive MR inerter (AMRI) is discussed. A quarter car suspension model with an AMRI installed in parallel with a double-ended MR damper (D-MRD) is considered. First, the vehicle suspension with variable damping and inertia is analyzed. The prototype of D-MRD and MR variable inertia flywheel (MRVIF) are fabricated and tested respectively. Then, the control model of D-MRD and MRVIF is developed on the basis of test data. An improved Fuzzy PID controller for the semi-active suspension with D-MRD and AMRI is formulated. Numerical simulation is investigated to validate the proposed variable damping and inertia device. The results demonstrate that the performance of the semi-active suspension with D-MRD and AMRI can achieve much better ride comfort than the semi-active suspension with only D-MRD or AMRI.
Study of a magnetic SMA-based energy harvester using a corrugated structure
Authors: Safari Omid , Zakerzadeh Mohammad Reza , Baghani Mostafa
Published: January 2021

In recent years demand for mobile electrical power has been increased and due to this application, energy harvester systems have been developed to convert mechanical energy into electrical energy using smart materials. In this investigation, a novel arrangement of an energy harvester using Magnetic Shape Memory Alloys (MSMAs) is developed. Elements of MSMA are attached to a corrugated beam and their roots are fixed. The way of harvesting energy from this system is based on conversion of vibration motion energy to the magnetic flux gradient. There is a number of copper coils that wrapped around the MSMA elements in a constant magnetic field. If strain or stress field is applied to the MSMA elements, the electrical current is induced to coils. The problem is studied with analytical methods, and for this purpose, MATLAB solver is used. To simulate the behavior of MSMA substance Kiefer and Lagoudas nonlinear model is used. To verify the results, these two arrangements have been analyzed in ABAQUS. To provide the material properties of MSMA elements, UMAT code has been used. It will be shown that size of this MSMA based energy harvester can become smaller with using corrugated beam structure instead of simple cantilever beam.
Cholinesterase Inhibitor Use in Patients With Dementia Admitted to a Palliative Care Unit
Authors: Perri Giulia-Anna , Wilson Jessica , Gardner Sandra , Berall Anna , Kirstein Anne , Khosravani Houman
Published: January 2021

Objectives:

Current guidelines suggest that patients with severe dementia on cholinesterase inhibitors (CHEIs) should discontinue their CHEIs by taper. This study aims to define the prevalence of patients admitted to a palliative care unit (PCU) with dementia on a CHEI and to determine whether these patients were tapered off their CHEIs according to current deprescribing guidelines.

Design:

This is a descriptive retrospective chart review that examined patients admitted to a PCU with dementia on a CHEI from January 2015 to June 2019.

Methods:

Individuals admitted to the PCU with a primary or comorbid diagnosis of dementia were identified. Their corresponding CHEI dose, frequency and discontinuation pattern were identified. Data were analyzed using descriptive statistics.

Results:

A total of 36 patients were admitted to the PCU with dementia on a CHEI (prevalence of 2.3%). The median length of stay was 21 days. For 31 of these patients, their CHEI was discontinued, only 9 of which had a taper. Of the 24 patients who discontinued their CHEI suddenly, 10 patients had an order to discontinue their CHEI in the last 2 days before their date of death.

Conclusion:

This study suggests that although patients admitted to a PCU with dementia have their CHEI discontinued, the discontinuation was done without a taper. In many cases the CHEIs were continued through the active stage of dying. Future work should explore reasons why PCU physicians are mostly late to taper CHEIs for patients admitted with dementia.
Sanctification in Coping From a Cultural Perspective
Authors: Ahmadi Fereshteh , Ahmadi Nader
Published: January 2021

Sanctification is an important phenomenon and should be of keen interest to those studying religious and spiritually oriented coping. Oddly enough, this phenomenon has not received a great deal of attention. One reason may be that sanctification does not directly apply to institutional religious involvement. Moreover, the sacred cannot easily be discerned in people’s coping experience. On important issue is also the lack of attention to the role of culture in coping. One of the researchers who has paid considerable attention to the concept of sanctification and has developed it from different perspectives is Kenneth Pargament. The aim of this article is give rise to a vital discussion on the role of sanctification in coping from a cultural perspective. In doing this, we will first introduce Pargament’s approach to religion and spirituality and then his view on sanctification and then we will put forward our own critique of some discussions on this subject, concluding with our own view.
A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder
Authors: Bondopadhyay Upasana , Diaz-Orueta Unai , Coogan Andrew N.
Published: January 2021

Objective:

Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD.

Methods:

Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD.

Results:

148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep.

Conclusion:

Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.
Effects of Teachers as Coaches for Paraprofessionals Implementing Functional Communication Training
Authors: Gregori Emily , Rispoli Mandy J. , Lory Catharine , Kim So Yeon , David Marie
Published: January 2021

Young children with intensive behavioral needs are often served by paraprofessionals, who are typically among the least trained and least supported staff in the school. While professional development opportunities to address challenging behavior are generally limited for special education teachers, such professional growth opportunities are often completely unavailable for paraprofessionals. The purpose of this study was to evaluate a program in which teachers served as coaches for paraprofessionals. Using a multiple-baseline design across paraprofessional-and-child dyads, we evaluated the effects of the teachers-as-coaches program on paraprofessional implementation fidelity and child engagement in challenging behavior and appropriate communication. The results showed that with teacher coaching, paraprofessionals increased their behavior intervention implementation fidelity to 100%. During the maintenance probes, two of the paraprofessionals implemented the intervention with 100% fidelity, and the third paraprofessional implemented the intervention with higher fidelity than baseline. Results also showed corresponding decreases in child challenging behavior and increases in appropriate communication. Implications for research and practice in supporting paraprofessionals are discussed.
Retrospective evaluation of refeeding syndrome in cats: 11 cases (2013–2019)
Authors: Cook Simon , Whitby Emily , Elias Neus , Hall Georgina , Chan Daniel L
Published: January 2021

Objectives

The aim of this study was to describe the clinicopathological findings, management and outcome of cats with refeeding syndrome (RS) following prolonged starvation.

Methods

Records from four referral hospitals were searched between May 2013 and November 2019 and retrospectively evaluated. Inclusion criteria were the presence of a risk factor for RS, such as severe weight loss or emaciation following a period of presumed starvation, hypophosphataemia or a delta phosphorous exceeding 30% reduction following refeeding, being treated on the basis of a clinical diagnosis of RS and one or more derangement of hypokalaemia, hypoglycaemia or hyperglycaemia.

Results

Eleven cats were identified, which had been missing for a median of 6 weeks (range 3–104 weeks). Mean ± SD percentage weight loss was 46% ± 7% (n = 8). Eight of 11 cats developed hypophosphataemia with a mean delta phosphorous of −47% ± 9%. All cats were documented to be hypokalaemic. During hospitalisation, 10/11 cats developed hyperglycaemia and 7/11 cats developed hypoglycaemia. Cardiovascular, gastrointestinal and neurological signs were common. Eight of 11 cats displayed new or progressive neurological deficits after refeeding, including mentation changes and cerebellar dysfunction. All cats became anaemic and seven cats required a blood transfusion. Eight cats survived to discharge after a mean of 14 ± 4 days of hospitalisation. Six cats developed acute kidney injury (AKI; International Renal Interest Society stage 1). The presence of AKI ( P = 0.024) was associated with non-survival and maximum bilirubin concentration was significantly higher in non-survivors ( P = 0.018).

Conclusions and relevance

Cats with RS in this cohort had been missing, presumed starved, for more than 3 weeks. In addition to hypophosphataemia and hypokalaemia, altered glucose homeostasis and organ damage involving the liver and kidneys were common. Cats with RS appear to have a good prognosis, but prolonged intensive care is required.
Psychological impact in the time of COVID-19: A cross-sectional population survey study during confinement
Authors: Castellano-Tejedor Carmina , Torres-Serrano María , Cencerrado Andrés
Published: January 2021

The transformation that COVID-19 has brought upon the world is unparalleled. The impact on mental health is equally unprecedented and yet unexplored in depth. An online-based survey was administered to 413 community-based adults during COVID-19 confinement to explore psychological impact and identify high risk profiles. Young females concerned about the future, expressing high COVID-related distress, already following psychological therapy and suffering from pre-existing chronic conditions, were those at highest risk of psychological impact due to the COVID-19 situation. Findings could be employed to design tailored psychological interventions in the early stages of the outbreak to avoid the onset/exacerbation of psychopathology.
A case study on shortage of evidence in wrongful convictions in China
Authors: Jiahong HE
Published: January 2021

The judiciary can only get to know the facts of a case that occurred in the past through limited evidence, and even with the shortage of evidence, the facts are fuzzy just like the moon on water. Wrongful convictions are very often based on a shortage of evidence and an ambiguity of facts. In those cases, judges face a dilemma in finding facts and applying rules of law. In order to prevent wrongful convictions, it is important to clarify the standard of evidence, to promote the legality of criminal investigation and to improve the assessment of evidence.
‘Cropped out’: The collaborative production of an accusation of racism
Authors: Rafaely Daniella
Published: January 2021

This article utilises the concept of ‘race trouble’ as an overarching framework for examining an interview between Ms Vanessa Nakate and a South African news broadcaster. The interview describes an incident involving Ms Nakate’s attendance at a global climate change conference and her exclusion from a media report about a press briefing that she held along with four other youth activists at the conference. The analysis focuses on the collaborative and interactional production of Ms Nakate’s claim that her exclusion was racially motivated and the discursive mechanisms by which race is mobilised as a common-sense explanation for the incident that occurred. My analysis demonstrates the sanctionability of producing an accusation of racism and identifies the rhetorical functions of stake and facticity in its production, and concludes with a discussion of the relevance of these findings in the context of studies on race and racism in interaction.
On the need for sustainable tourism consumption
Authors: Sharpley Richard
Published: January 2021

Sustainable tourism has remained the dominant tourism development paradigm within both academic and policy circles for more than three decades. However, little if any progress has been made towards implementing sustainable tourism in practice. Reflecting on this failure to achieve a more sustainable tourism sector, manifested not least in its increasing contribution to climate change, this paper argues that the problem lies in the continuing adherence to the economic growth model that underpins (sustainable) development policies in general and tourism development in particular. Highlighting the unsustainability of unabated growth, the paper goes on to suggest that the solution lies in the adoption of sustainable (reduced) levels of consumption. Yet, based on a recent exploratory study, voluntary limiting the consumption of tourism, even amongst the allegedly environmentally aware post-millennial generation, is an unlikely scenario. Hence, the path to sustainable tourism production and consumption lies only in effective regulation.
Using immersion research and people-driven design to improve behavior change programs
Authors: Jupp Dee
Published: January 2021

This research note describes the use of immersion research in combination with people-driven design as an alternative approach to tackling intransigent behavior change challenges. Using a case study from Indonesia where child stunting was prevalent despite diverse food availability, the four-step process of immersion research, immersion in immersion findings, people-driven design, and trialing is described. It highlights the need to change mindsets among design experts so that they forge a deeper connection with people and their circumstances and move from providing technocratic solutions for people to facilitating change processes which are practical, relatable, and are led by people themselves.
Optimal In Situ Fenestration Technique With Laser Perforation and Balloon Dilation for Aortic Stent-Grafts
Authors: Lin Jing , Rodriguez Limael E. , Nutley Mark , Jun Lu , Mao Ying , Parikh Niraj , Alie-Cusson Fanny , Zhang Ze , Wang Lu , Panneton Jean M. , Guidoin Robert
Published: January 2021

Purpose:

To evaluate the response of various stent-grafts after laser fenestration and dilation with noncompliant balloons to determine the optimal therapeutic combination for this treatment technique.

Materials and Methods:

Five aortic stent-grafts were evaluated ex vivo: the Bolton RelayPlus, Jotec E-vita Thoracic 3G, Medtronic Valiant, Cook Zenith Alpha, and Vascutek Anaconda. Small holes were created using an excimer laser with the grafts submerged in saline. Five rows of 5 fenestrations were created, 4 holes in each row were dilated once with a 6-, 8-, 10-, or 12-mm-diameter noncompliant balloon to the specified nominal pressure (one hole served as the control). The saline solution from each stent-graft was collected and qualitatively analyzed for debris. The fenestrations were evaluated under light and scanning electron microscopes. The maximum diameter and area for each fenestration were measured. The direction and length of tears were assessed.

Results:

The fenestration was feasible and reproducible in all the stent-grafts. The mean area of fenestration ranged from 7.63±1.63 to 14.75±0.73 mm2 when using balloons of 6- and 8-mm diameter, respectively. The 10- and 12-mm-diameter balloons caused a significant increase in area, variability, and tearing. The Anaconda graft tended to tear in the weft direction, while the other devices tore in the warp direction when using the 10- and 12-mm-diameter balloons. Dilation of the RelayPlus and Anaconda grafts with 6- and 8-mm-diameter balloons provided minimal tearing and precise fenestrations. Melted fiber remnants were observed after filtration of the saline solution for all devices.

Conclusion:

Laser fenestration and dilation with noncompliant balloons is a relatively simple and reproducible option for revascularization in urgent, complex aortic endovascular repairs. In our model, large balloons (ie, >10 mm) increased the destruction and tearing of the fabric. The maximum dilation recommended is 6 to 8 mm to avoid significant tears. Development of stent-grafts or novel fabrics designed explicitly for fenestration is needed to reduce potential complications.
Theory Before the Test: How to Build High-Verisimilitude Explanatory Theories in Psychological Science
Authors: van Rooij Iris , Baggio Giosuè
Published: January 2021

Drawing on the philosophy of psychological explanation, we suggest that psychological science, by focusing on effects, may lose sight of its primary explananda: psychological capacities. We revisit Marr’s levels-of-analysis framework, which has been remarkably productive and useful for cognitive psychological explanation. We discuss ways in which Marr’s framework may be extended to other areas of psychology, such as social, developmental, and evolutionary psychology, bringing new benefits to these fields. We then show how theoretical analyses can endow a theory with minimal plausibility even before contact with empirical data: We call this the theoretical cycle. Finally, we explain how our proposal may contribute to addressing critical issues in psychological science, including how to leverage effects to understand capacities better.
Stroke units in the Philippines: An observational study
Authors: Navarrro Jose C , Escabillas Cyrus , Aquino Abdias , Macrohon Christina , Belen Allan , Abbariao Maritoni , Cuasay Edna , Lao Annabelle , Sarfati Soccorro , Hiyadan John H , Reyes Fe delos , Salazar Gerald , Dadgardoust Pariessa , De leon-Gacrama Franchesca , Reandelar Macario
Published: January 2021

Background

In high-income countries, the management of stroke has changed substantially over the years with the advent of thrombolysis and endovascular treatment. However, in low-income countries, such interventions may not be available, or patients may come to the hospital outside the time window no longer qualified for this therapy. Most studies on stroke units were conducted in high-income countries. Unfortunately, there has been no local multicenter data with large patient numbers showing the effectiveness of stroke units in the Southeast Asian region.

Aim

To compare the outcomes of patients allocated to stroke units (based on accepted criteria) to those allocated to general neurology wards in the Philippines.

Methods

This is an open, prospective, parallel, observational comparative study of patients from 11 institutions in the Philippines. Patients were allocated either to the stroke unit or to the general neurology ward by the admitting physician based on the criteria suggested by the Stroke Trialist Collaboration Group. The primary outcome was to determine in-hospital mortality at three- and six months in both stroke units and general neurology wards. The secondary outcomes were determined by a dichotomized modified Rankin scale: (0–2) independent and (3–5) dependent.

Results

A total of 1025 patients were included in the study. In the primary outcome, a higher mortality rate (8.4% vs 1.0%) in the general neurology ward (p = 0.000) was seen. The six-month mortality rate was statistically significant and higher among patients admitted to the general neurology ward (3.1% vs 0.8%) (p = 0.009). Patients admitted to the stroke unit attained an independent functional outcome (mRS 0–2) as compared to the general neurology ward (73% vs 61.5%) (p = 0.000). Analysis of functionality at six months favored patients admitted in the stroke unit (88.5% vs 81.4%) as compared to the general neurology ward.

Conclusion

Patients specifically admitted to stroke units in the Philippines based on established criteria have better outcomes than those admitted to general neurology wards.
The mechanism of ions in pulmonary hypertension
Authors: Liu Guoyu , Fu Daiyan , Tian Heshen , Dai Aiguo
Published: January 2021

Pulmonary hypertension（PH）is a kind of hemodynamic and pathophysiological state, in which the pulmonary artery pressure (PAP) rises above a certain threshold. The main pathological manifestation is pulmonary vasoconstriction and remodelling progressively. More and more studies have found that ions play a major role in the pathogenesis of PH. Many vasoactive substances, inflammatory mediators, transcription‐inducing factors, apoptosis mediators, redox substances and translation modifiers can control the concentration of ions inside and outside the cell by regulating the activity of ion channels, which can regulate vascular contraction, cell proliferation, migration, apoptosis, inflammation and other functions. We all know that there are no effective drugs to treat PH. Ions are involved in the occurrence and development of PH, so it is necessary to clarify the mechanism of ions in PH as a therapeutic target for PH. The main ions involved in PH are calcium ion (Ca2+), potassium ion (K+), sodium ion (Na+) and chloride ion (Cl–). Here, we mainly discuss the distribution of these ions and their channels in pulmonary arteries and their role in the pathogenesis of PH.
Beta-Blockade in Intraseptal Anomalous Coronary Artery With Reversible Myocardial Ischemia
Authors: Doan Tam T. , Qureshi Athar M. , Sachdeva Shagun , Noel Cory V. , Reaves-O’Neal Dana , Molossi Silvana
Published: January 2021

Anomalous aortic origin of a left coronary artery (L-AAOCA) with an intraseptal course is a rare anomaly and can be associated with myocardial ischemia and sudden cardiac death. No surgical or medical intervention is known to improve patient outcomes. A 7-year-old boy with intraseptal L-AAOCA presented with nonexertional chest pain, syncope, and had reversible myocardial ischemia on provocative testing. The patient was started on β-blockade, following which his symptoms improved and resolved over a period of six years. A follow-up dobutamine stress magnetic resonance imaging no longer showed reversible ischemia, and cardiac catheterization with fractional flow reserve did not show coronary flow compromise.
Evolving Techniques for the Achievement of Optimal Long-Term Results After Tetralogy of Fallot Repair
Authors: Stellin Giovanni , Guariento Alvise , Vida Vladimiro L.
Published: January 2021

Several techniques designed to improve long-term results after repair of tetralogy of Fallot are described. We have recently embarked on a program focused on preserving the native pulmonary valve. Here, combined techniques are described in detail, including intraoperative pulmonary valve balloon dilatation, pulmonary valve reconstruction by delamination and resuspension of the leaflets, and pulmonary valve annulus augmentation. As with any other complex congenital heart disease, senior surgeons should select teaching cases, starting from the less severe side of the spectrum.