bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and simulation analysis of impact-resistant flexible drill pipe for rock-breaking rig
Authors: Gao Kangping , Xu Xinxin , Shi Ning , Jiao Shengjie
Published: August 2021

In the process of drilling and coring by the rock-breaking rig, the drill rod is affected by the intermittent impact force, which reduces the efficiency of the rig to break the rock and increases the cost of the drilling and coring. Therefore, it is very important to improve the impact resistance of the drill pipe during the rock-breaking process. To achieve this goal, a flexible design of the drill pipe was carried out, and a dynamical model of the drilling rig based on a series elastic actuator was established. Considering the dynamic performance of the system, a torque feedforward link is introduced and a control model based on the force source is established. The influence of the equivalent inertia of the transmission system and the series elastic actuator damping coefficient on the system stability was analyzed by drawing the frequency domain characteristic curve of the system. By using the control and Simulink simulation software, the electromechanical simulation of the model is carried out, and the torque step tracking response of the system is obtained. A torque feedforward link is introduced to establish the control model of the system based on force source. Through dynamic simulation software ADAMS, dynamic and static impact simulation experiments were carried out on the system. The results show that when a force of 200 N is applied to the output end of the drill pipe in the tangential direction, the maximum moments received by the joint under static and dynamic environments are 34.1 N·m and 57.9 N·m, respectively. When the impact force disappears, the time required for the flexible drill pipe to reach a stable state is only 0.15 s, which verifies that the series elastic actuator–based drill pipe model can alleviate the impact of the external environment and protect the internal structure of the rig.
Long non-coding RNA Down syndrome cell adhesion molecule-anti-sense 1 promotes gastric carcinoma cell proliferation and migration by regulating the miR-204/TPT1 axis
Authors: Wang Nan , Yang Ying , Jia Guo-Zhan , Wang Ke , Zhou Shuai , Zhang Bo , Zhang Zhan-Sheng , Qiao Qing , He Xian-Li
Published: August 2021

Background: Several recent studies have suggested that the long non-coding RNA (lncRNA) DSCAM-AS1 (Down syndrome cell adhesion molecule - anti-sense 1) is aberrantly expressed in many malignancies. Purpose: In this study, we aimed to explore the the role of DSCAM-AS1 in gastric carcinoma. Research Design: Expression of DSCAM-AS1 mRNA, miR-204, and TPT1 (Tumor Protein, Translationally-Controlled 1) were detected using quantitative real-time polymerase chain reaction (qRT-PCR). Proliferation and apoptosis of GC cells were determined using the CCK-8 cell counting assay and flow cytometry. The rate of cell migration and invasion was determined using a transwell assay. The relationships between DSCAM-AS1, miR-204, and TPT1 were predicted and confirmed using a dual-luciferase reporter assay. Expression of TPT1 protein was quantified by Western blot. Results: In this study, we found that DSCAM-AS1 was significantly overexpressed in GC tissues and cell lines. Functional experiments indicated that GC cells with DSCAM-AS1 silencing exhibited a dynamic reduction in proliferation and migration. We identified miR-204 as a target of DSCAM-AS1 and found that it targeted TPT1 in GC cells, which further led to decreased expression of miR-204 in GC tissues and cell lines. A rescue assay revealed that knocked-down DSCAM-AS1 hindered GC progression, which was reversed upon miR-204 downregulation or TPT1 overexpression. Conclusion: We conclude that DSCAM-AS1 is expressed as a tumor oncogene in GC progression, modulated via the miR-204/TPT1 axis. These findings indicate the potential of DSCAM-AS1 as a therapeutic target for GC prevention.
How Much Do They Make? A Systematic Review of Income Generated From Begging
Authors: Reinhard Daniel
Published: August 2021

Panhandling income has not been well reviewed, though doing so would be beneficial for several reasons. Understanding beggar income may aid in addressing misconceptions about the activity, clarify the financial motivation for organized or forced begging, and allow for clearer comparisons to other kinds of shadow work like prostitution, binning, or selling drugs. This study presents a systematic review of panhandling income by using Preferred Reporting Items for Systematic Reviews and Meta-Analysis and PROSPERO guidelines to aid in identifying, screening, assessing, and including research that provides quantitative income information about panhandling. Income is adjusted for inflation, and international studies are converted to USD via standard exchange rate and via purchasing power parity values. Ultimately, 38 studies are included for final analysis. The 38 studies are divided into United States specific ( n = 15) and all other countries ( n = 23). In adjusted 2020 USD, the economic yield from panhandling is most often  $2–$16 per hour, $20–$60 per day, and $200–$500 per month, substantial variation exists. Economic comparisons to other forms of shadow work and future research directions are provided.
Informal Hierarchy Strength Changes and Their Effect on Performance
Authors: Evans Karoline , Sanner Bret
Published: August 2021

Despite qualitative evidence suggesting that changes in informal hierarchy strength likely impact performance, informal hierarchy strength changes have received little theoretical or empirical attention. We address this by extending structural adaptation theory (SAT) to develop and test a theoretical model of why informal hierarchy strength changes and how those changes impact performance. Building on SAT’s principle that teams can become more ordered following stimulation, we propose that pressure subsequently increases informal hierarchy strength. In project teams where pressure starts low and increases at the midpoint, informal hierarchy should weaken early in project life and strengthen after the midpoint. We also extend SAT’s asymmetric adaptability principle to consider not just the direction but also the rate of the changes. We hypothesize that sharply strengthening informal hierarchy harms performance, but informal hierarchy strengthening gradually improves performance. SAT also implies that gradual change is promoted by inclusive discussions. Because most influential extraverts tend to squelch inclusive discussions where most influential neurotics tend to be inclusive, teams with most influential extraverts strengthen their informal hierarchy quickly where teams with most influential neurotics strengthen their informal hierarchy gradually. We find support for our theoretical model using longitudinal data and client performance ratings on self-managed project teams. Our results contribute to SAT by showing its application to informal, unplanned changes and introducing the rate of change to its asymmetric adaptability principle. Our findings also highlight the importance of shifting informal hierarchy strength research away from the predominant static approach and toward studying informal hierarchy strength changes.
The Intersection of Counseling Microskills and Qualitative Interviewing and Reporting in the Study of Sensitive Topics
Authors: LaChenaye Jenna M. , McCarthy Shannon
Published: August 2021

Sensitive topics evaluation presents both a maze and a minefield to qualitative evaluators due to their complexity and their potential to create areas of misanalysis. For novice and experienced qualitatve practitioners alike, the evaluator can find the task of broaching complex content and developing trusting relationships to be serious methodological hurdles. In particular, the exercise of exploring and analyzing sensitive topics may increase strain as the evaluator seeks to access the abstract and intangible aspects of often distressing subjective content. To assist qualitative evaluators in overcoming these hurdles, the authors propose a collaborative analysis approach informed by counseling strategies and reflecting skills.
Factors associated with the effectiveness of part-time patching for intermittent exotropia in children
Authors: Choi Heeyoung , Kim Su Jin , Jung Jaeho , Lee Ji-Eun , Kim Sang Yoon , Lee Seung Uk
Published: August 2021

Purpose:

To evaluate the factors associated with the efficacy of low-dose part-time patching in children with intermittent exotropia (IXT).

Methods:

In this prospective observational study, we enrolled 186 patients diagnosed with IXT. Outcome measures included office based control scales, magnitude of exo-deviation, and stereoacuity at near and distance after daily patching for 2 h. We analyzed the clinical data and demographic factors association with improvement of IXT.

Results:

The study was completed by 152 subjects of total enrolled patients on a consecutive basis followed up for 1 year. Decrease in the magnitude of exo-deviation, improvement of control, and or gain of stereoacuity were observed in 31.6% patients of the recruited subjects after part-time patching. Multivariate analyses showed that prognostic factors determining improvement to part-time patching included convergence insufficiency (CI) type IXT ( p = 0.016), poor distance stereopsis ( p = 0.044), and large exotropic deviation at distance ( p = 0.025).

Conclusions:

CI-type exotropia, large distance magnitude of exo-deviation, or poor distance stereopsis appear to be associated with a better response to part-time patching. Therefore low dose part-time patching may be a useful non-surgical treatment alternative to delay surgery in these cases.
Glocalised research design: exploring the encounter between Indigenous and Western methodologies among the Maasai Pastoralists in Monduli, Tanzania
Authors: Pesambili Joseph Christopher
Published: August 2021

Drawing upon my experience of researching the encounter between Indigenous and Western knowledge among the Maasai in Monduli, Tanzania, I reflect on theoretical and practical aspects of a glocalised research design as an alternative methodological approach to Indigenous research. I explore how the design is embodied in the Maasai’s concept of enkigúɛ́ná (meeting) both as an ontological and epistemological framework for engaging diverse worldviews and knowledge systems in meaningful ways. The experience from the fieldwork shows that not only does the glocalised design offer possibilities for decolonising research and knowledge production but also it provides a dialogical space for co-constructing knowledge between the researcher, research assistants, and participants. The glocalised design offers new insights into the importance of research at the encounter where two knowledge systems constantly in tension, meet, interrogate, and negotiate with each other through a productive dialogue to enhance mutual understanding and create new knowledge.
Deconstructing legitimized racism on Haida Gwaii
Authors: McGuire Michaela M
Published: August 2021

In this critical commentary, I examine the manifestation of racial tensions on Haida Gwaii—an archipelago in what is now known as Canada—between settlers and citizens of the Haida Nation. Racism has been entrenched and legitimized over generations leaving its implications unquestioned. When settler communities border colonially imposed reserves, racialized boundaries and tensions result. Indigenous claims to the land and to self-determination call into question the legitimacy of colonialism and subsequently reinforce the us versus them mentality. The assertion of Haida Nationhood and self-determination disrupts the rhetoric of settler superiority. Haida peoples are deemed a threat needing to be controlled. Challenging racialized hierarchies, settler complacency, and racism in all its manifestations is an integral component to ensuring that the next generation of Haida citizens can live freely without fear of the pain of racism, ignorance, and shame.
Euroscepticism as a radical left party strategy for success
Authors: Wagner Sarah
Published: August 2021

The European Union has gained salience as an issue in political debate. Recent literature shows that successful radical right-wing parties are frequently in opposition to European integration. This article looks at how radical left-wing parties’ positions on EU integration affect their electoral support. It argues that radical left parties can mobilize voters in their favour through positioning in opposition to EU integration because this allows voters to combine their left-wing economic and anti-EU preferences. Using expert and individual-level survey data, this research demonstrates that radical left-wing parties that position themselves against EU integration are more likely to gain individuals’ vote choice. This finding is surprising, given that traditionally radical left-wing parties are defined through their economic, rather than their non-economic, positions. This article demonstrates that variation in positioning around non-economic issues such as EU integration can explain differences in voter support across radical left-wing parties.
Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives
Authors: Drennan Vari M , Collins Linda , Allan Helen , Brimblecombe Neil , Halter Mary , Taylor Francesca
Published: August 2021

Objective

A major issue facing all health systems is improving population health while at the same time responding to both growing patient numbers and needs and developing and retaining the health care workforce. One policy response to workforce shortages has been the development of advanced clinical practice roles. In the context of an English national policy promoting such roles in the health service, we explored senior managers’ and senior clinicians’ perceptions of factors at the organization level that support or inhibit the introduction of advanced clinical practice roles. The investigation was framed by theories of the diffusion of innovation and the system of professions.

Methods

We conducted a qualitative interview study of 39 senior manager and clinicians in 19 National Health Service acute, community, mental health and ambulance organizations across a metropolitan area in 2019.

Results

Small numbers of advanced clinical practice roles were reported, often in single services. Four main influences were identified in the development of advanced clinical practice roles: staff shortages (particularly of doctors in training grades) combined with rising patient demand, the desire to retain individual experienced staff, external commissioners or purchasers of services looking to shape services in line with national policy, and commissioner-funded new roles in new ambulatory care services and primary care. Three factors were reported as enabling the roles: finance for substantive posts, evidence of value of the posts, and structural support within the organization. Three factors were perceived as inhibiting developing the roles: confusion and lack of knowledge amongst clinicians and managers, the availability of finance for the roles, and a nervousness (sometimes resistance) to introducing the new roles.

Conclusions

While the national policy was to promote advanced clinical practice roles, the evidence suggested there was and would continue to be limited implementation at the operational level. Development scenarios that introduced new monies for such roles reduced some of the inhibiting factors. However, where the introduction of roles required funding to move from one part of a service to another, and potentially from one staff group to another, the growth of these roles was and is likely to be contested. In such scenarios, research and business evidence of relative advantage will be important, as too will be supporters in powerful positions. The paucity of publicly available evidence on the effectiveness of advanced clinical practice roles across the specialties and professions in different contexts requires urgent attention.
Multi-scale theta* algorithm for the path planning of unmanned surface vehicle
Authors: Han Xu , Zhang Xianku
Published: August 2021

Theta* algorithm is a searching-based path planning algorithm that gives an optimal path with more flexibility on route angle than A* method. The dynamics of USV is characterized by large inertia, so that larger turning angle is preferred. In view of the shortcomings of traditional Theta* algorithm, such as being hard to balance overall situation and details in long-distance planning, and lacking of waypoint replacement scheme when a waypoint is unreachable, it is inappropriate to make long-distance planning through Theta* algorithm directly. In order to ensure safe navigation for unmanned surface vehicle (USV), this paper proposes a multi-scale Theta* algorithm to solve these defects. Simulation result manifests the proposed scheme can provide a path clear of obstacles with several fold reduction in time consumption. The proposed planning method simplifies path planning process and contributes to the development of marine transportation.
Experimental and numerical investigation on draping behaviour of woven carbon fabric
Authors: Santhanakrishnan Balakrishnan Venkateswaran , Yellur Manoja Rao , Roesch Janina Juliane , Ulke-Winter Lars , Seidlitz Holger
Published: August 2021

In the liquid composite moulding (LCM) process, fabric is draped over the mould surface and a resin is injected under pressure to develop a composite laminate. Wrinkling is one of the most common flaws that occurs during the draping of the fabric. Wrinkling of the fabric within the composite could severely reduce the quality of the finished composite laminate. Thus, to develop a high-quality composite laminate, exact prediction of fabric wrinkling behaviour is necessary. The aim of the paper is to investigate the draping behaviour of carbon fabric. Carbon fabric with an areal density of 245 g/m2 is used in the study. Both experimental and numerical investigations were performed. An experimental setup was developed to predict the draping behaviour of the carbon fabric used in the study. LS-DYNA/Explicit solver is used to achieve macro level draping simulation. Material model MAT_REINFORCED_THERMOPLASTIC [MAT_249] offers the possibility to simulate the forming behaviour of a thermoplastic material. To simulate dry fabrics using MAT_249, a very low properties are used for the matrix in the material model. To capture the forming behaviour of fabric, an intensive material characterization has been performed. Tensile and shear properties of the fabrics were determined using uniaxial and picture frame tests, respectively. Influence of the position of the integration points from the mid surface on bending behaviour is studied and calibrated using a simple test.
Nonhealing Leg Ulcer as the Presentation of Sarcoidosis: A Case Report
Authors: Shatnawi Nawaf J. , Al-Zoubi Nabil A. , Al-Bakkar Lujain A. , Gharaibeh Laith M. , Hamouri Shadi
Published: August 2021

Chronic leg ulcers (CLUs) are common, with increasing prevalence in the elderly population. Circulatory dysfunctions are responsible for 90% to 95% of all causes, while 5% to 10% of CLUs are associated with underlying chronic systemic disorders. Sarcoidosis is a complex multisystemic disease characterized by noncaseating granulomas affecting mainly the pulmonary system, with cutaneous manifestation in 25% to 30% of cases. However, ulcerative sarcoidosis (US) is a rare form of cutaneous sarcoidosis. Pyoderma gangrenosum (PG) is an uncommon, chronic inflammatory noninfectious skin disease affecting different body parts. The ulcerative form of PG is rarely reported in association with sarcoidosis.

We aim to report a 44-year-old female patient with a history of hypertension and varicose veins, presenting with a CLU for more than 18 months. Ulcer tissue biopsy showed noncaseating granuloma with abscess formation suggestive of sarcoidosis; however, PG could not be ruled out. Mediastinal lymph node biopsy was consistent with sarcoidosis. The leg ulcer had complete healing within 4 months by local wound management, negative pressure wound therapy, and split-thickness skin grafting without immunosuppressive treatment to achieve wound healing.
Bird Medicine: Falconry as a Spiritual Salve
Authors: Antoni Heather E.
Published: August 2021

This paper is a personal reflection on the healing aspect of falconry. This is a particular style of bird medicine that offers healing in the personal, communal, environmental and transcendental realms. The ways in which this is so, are discussed from the perspective of falconry as a spiritual salve.
Experiencing Shame: How Does Gender Affect the Interpersonal Dynamics of Restorative Justice?
Authors: Scheuerman Heather L. , Keith Shelley
Published: August 2021

Although reintegrative shaming theory suggests that, in comparison to males, females are more interdependent and thus susceptible to reintegrative rather than disintegrative shaming, it is unclear how gender affects the type of shame experienced when considering interpersonal dynamics within restorative justice conferences. The involvement of the community within these conferences may affect how offenders are viewed, especially when considering the stigma female offenders experience for violating legal and gender norms. Using data from the Reintegrative Shaming Experiments, we find that interdependency conditions how gender affects the experience of shaming based on the type of others with whom offenders are interdependent.
The prognostic significance of microRNA-221 in hepatocellular carcinoma: An updated meta-analysis
Authors: Liu Wenfeng , Hu Keshu , Zhang Feng , Lu Shenxin , Chen Rongxin , Ren Zhenggang , Yin Xin
Published: August 2021

Background

Recently, microRNA-221 has been found to be abnormally expressed in hepatocellular carcinoma; however, its clinical value has not been summarised. This meta-analysis aimed to assess the prognostic significance of miR-221 in hepatocellular carcinoma.

Material and Methods

PubMed, Science Direct, Web of Science, Scopus, Ovid MEDLINE, EMbase, Google Scholar, the Cochrane Library, CNKI, CBM, VIP and Wanfang databases were searched for eligible articles. The endpoints included overall survival, progression-free survival, recurrence-free survival, metastasis-free survival, disease-free survival. Hazard ratios with 95% confidence intervals were used to explore the relationship between miR-221 expression and clinical survival results of liver cancer patients. Subgroup analysis and sensitivity analysis were performed. Begg’s test and Egger’s test were conducted to evaluate publication bias.

Results

A total of nine studies including 607 patients were recruited for this meta-analysis. The pooled hazard ratios displayed that high miR-221 expression was remarkably associated with poorer overall survival (hazard ratio = 1.91, 95% confidence interval: 1.53–2.38, p ＜ 0.01) and unfavourable progression-free survival/recurrence-free survival/metastasis-free survival/disease-free survival (hazard ratio = 2.02, 95% confidence interval: 1.58–2.57, p ＜ 0.01). The results of Begg’s test and Egger’s test did not exhibit obvious publication bias.

Conclusions

High expression of miR-221 can predict poor outcome of hepatocellular carcinoma. miR-221 can be used as a promising prognostic biomarker of hepatocellular carcinoma.
Effects of fatty acid nitroalkanes on signal transduction pathways and airway macrophage activation
Authors: Wilkinson Melissa L , Gow Andrew J
Published: August 2021

Fatty acid nitroalkenes are reversibly-reactive electrophiles that are endogenously detectable at nM concentrations and display anti-inflammatory, pro-survival actions. These actions are elicited through the alteration of signal transduction proteins via a Michael addition on nucleophilic cysteine thiols. Nitrated fatty acids (NO2-FAs), like 9- or 10-nitro-octadec-9-enolic acid, will act on signal transduction proteins directly or on key regulatory proteins to cause an up-regulation or down-regulation of the protein’s expression, yielding an anti-inflammatory response. These responses have been characterized in many organ systems, such as the cardiovascular system, with the pulmonary system less well defined. Macrophages are one of the most abundant immune cells in the lung and are essential in maintaining lung homeostasis. Despite this, macrophages can play a role in both acute and chronic lung injury due to up-regulation of anti-inflammatory signal transduction pathways and down-regulation of pro-inflammatory pathways. Through their propensity to alter signal transduction pathways, NO2-FAs may be able to reduce macrophage activation during pulmonary injury. This review will focus on the implications of NO2-FAs on macrophage activation in the lung and the signal transduction pathways that may be altered, leading to reduced pulmonary injury.
Perioperative complications and outcomes in patients with paraplegia undergoing rotator cuff repair
Authors: L Boettcher Marissa , Oldenburg Kirsi S , Neel Garrett , Kunkle Bryce , Eichinger Josef K , Friedman Richard J
Published: August 2021

Background

Patients with paraplegia often experience chronic shoulder pain due to overuse. We sought to determine if these patients have an increased prevalence of perioperative complications and higher rates of re-admissions and rotator cuff re-tears relative to able-bodied controls following rotator cuff repair (RCR).

Methods

We queried the NRD (2011–2018) to identify all patients undergoing primary RCR (n = 34,451) and identified cohorts of matched paraplegic and non-paraplegic patients (n = 194 each). We compared demographic factors, comorbidity profiles, perioperative complication rates, length of stay, revision rates, and re-admission rates between the two groups.

Results

Patients with paraplegia had lower rates of chronic obstructive pulmonary disease (p = 0.02), hypertension (p = 0.007), congestive heart failure (p = 0.027), obesity (p < 0.001), and prior myocardial infarction (p = 0.01). Additionally, patients with paraplegia experienced higher rates of urinary tract infections (11.9% vs. 2.1%, p < 0.001), lower rates of acute respiratory distress syndrome (0% vs. 3.1%, p = 0.041), and had a longer length of stay (4-days vs. 1-day, p < 0.001). Revision rates were similar for the two groups.

Conclusions

Compared to matched controls, patients with paraplegia were found to have similar demographic characteristics, less comorbidities, similar perioperative complication rates, and similar revision rates. These findings address a gap in the literature regarding surgical management of shoulder pain in patients with paraplegia by providing a matched comparison with a large sample size.
From a political to a judicial approach to extradition: A case for the consolidation of the requesting State’s rights in domestic extradition procedures
Authors: Julié William , Menegon Sophie , Fauvarque Juliette
Published: August 2021

This article purports to analyze the role conferred to the requesting State in domestic extradition procedures. Despite the existence of a judicial control over extradition, the majority of States included in this study continue to view extradition as a political prerogative of the executive and leave the requesting State with little or no means to defend its request. This article argues in favor of the consolidation of the role of judicial authorities in the determination of extradition requests, along with a reinforcement of the requesting State’s ability to participate in this process.
Mouse model of experimental pulmonary hypertension: Lung angiogram and right heart catheterization
Authors: Xiong Mingmei , Jain Pritesh P. , Chen Jiyuan , Babicheva Aleksandra , Zhao Tengteng , Alotaibi Mona , Kim Nick H. , Lai Ning , Izadi Amin , Rodriguez Marisela , Li Jifeng , Balistrieri Angela , Balistrieri Francesca , Parmisano Sophia , Sun Xin , Valdez‐Jasso Daniela , Shyy John Y‐J. , Thistlethwaite Patricia A. , Wang Jian , Makino Ayako , Yuan Jason X.‐J.
Published: August 2021

Pulmonary arterial hypertension is a progressive and fatal disease and rodents with experimental pulmonary hypertension (PH) are often used to study pathogenic mechanisms, identify therapeutic targets, and develop novel drugs for treatment. Here we describe a hands‐on set of experimental approaches including ex vivo lung angiography and histology and in vivo right heart catheterization (RHC) to phenotypically characterize pulmonary hemodynamics and lung vascular structure in normal mice and mice with experimental PH. We utilized Microfil polymer as contrast in our ex vivo lung angiogram to quantitatively examine pulmonary vascular remodeling in mice with experimental PH, and lung histology to estimate pulmonary artery wall thickness. The peripheral lung vascular images were selected to determine the total length of lung vascular branches, the number of branches and the number of junctions in a given area (mm−2). We found that the three parameters determined by angiogram were not significantly different among the apical, middle, and basal regions of the mouse lung from normal mice, and were not influenced by gender (no significant difference between female and male mice). We conducted RHC in mice to measure right ventricular systolic pressure, a surrogate measure for pulmonary artery systolic pressure and right ventricle (RV) contractility (RV ± dP/dtmax) to estimate RV function. RHC, a short time (4–6 min) procedure, did not alter the lung angiography measurements. In summary, utilizing ex vivo angiogram to determine peripheral vascular structure and density in the mouse lung and utilizing in vivo RHC to measure pulmonary hemodynamics are reliable readouts to phenotype normal mice and mice with experimental PH. Lung angiogram and RHC are also reliable approaches to examine pharmacological effects of new drugs on pulmonary vascular remodeling and hemodynamics.
The Environmental Impacts of Digital Health
Authors: Thompson Maddy
Published: August 2021

Digital health interventions are widely celebrated due to their low-cost nature and ability to provide tailored person-centred care in communities worldwide. As coronavirus disease-19 has rapidly accelerated their growth and reach, interest in global ethical questions surrounding digital health is growing. However, the global environmental implications of digital health have been overlooked. This commentary draws attention to the environmental impacts of digital health devices and communication networks, as well as the data produced by digital health activities. Unless serious attention is paid to greening digital health practices, the rise of digital health will significantly contribute to environmental change, and thus create outcomes of ill-health.
The Role of the Health Coach in a Global Pandemic
Authors: Jordan Meg A
Published: August 2021

Background

While medical teams were perplexed about the novel SARS-CoV-2 infection, transmission and impairment of organ systems and immune function, viral infections spread worldwide. Complex intersectional issues of co-morbidities coupled with marginalized, diverse ethnic/racial populations emerged as significant risks to contracting severe COVID-19.

Objective

Since a healthy lifestyle is fundamental for lowering risk to chronic diseases, public health initiatives to manage this and future pandemics should include strategies that assist individuals to improve health status through targeted behavior changes. This conceptual paper builds a case for certified professional health coaches as primary actors in future preventive strategies, with expanded skills in addressing social determinants of health and “next generational” cultural competencies.

Methods

This concept paper primarily synthesizes fast-tracked research in 2020 regarding the demographic impact of COVID-19, specifically those groups suffering the highest morbidity and mortality rates. Exploring these intersectional issues through a conceptual lens provides strategies for certified health coaches to contribute their expertise in behavioral change within the larger contextual settings of racial/ethnic disparities and social inequities.

Results

As the co-morbidities and other chronic conditions related to COVID-19 among individuals and families in low-income communities are worsened by dual forces (lifestyle/behavioral choices and ingrained structural inequities), adding the support of certified health coaches to build trust, provide more convenient access to address vaccine hesitancy, and dispell falsehoods, is an effective means for advancing health and wellbeing. Group coaching and one-on-one coaching can work in tandem with public health initiatives for reducing chronic disease burden and addressing social determinants of health (SDoH). Skills are identified in coaching SDoH with expanded cultural competencies for health coaches.

Conclusion

Certified professional health coaches can make a positive impact on general risk reduction of chronic diseases within ethnic/racial minorities, thereby supporting population health in facing future contagions with greater health resilience.
A Person-Centered Analysis of Craving in Smoking-Cue-Exposure Research
Authors: Sayette Michael A. , Goodwin Madeline E. , Creswell Kasey G. , Esmacher Hannah J. , Dimoff John D.
Published: August 2021

Smoking-cue-exposure research offers a powerful method to examine craving, test new interventions, and identify at-risk smokers. Meta-analyses consistently show smoking-cue exposure increases craving levels. By focusing on mean levels, however, investigators fail to consider person-centered analyses addressing the percentage of smokers responding to cue exposure with increased urge. We conducted preregistered analyses of the percentages of 672 nicotine-deprived daily smokers (pooled from seven studies) who reported target levels of urge before and during smoking-cue exposure. Sixty-nine percent of smokers increased their ratings during cue exposure. Note that 31% of nonresponders reported a maximal urge before cue exposure, which precluded their classification as a responder using traditional cue-reactivity analyses and suggests that traditional analyses underreport cue-reactivity effects. An alternative, peak-provoked-craving analysis revealed the effectiveness of cue exposure to generate potent urges (more than three quarters of the sample reported at least 70% of scale maximum). Further research integrating person-centered analyses into the craving literature promises to advance addiction theory and research.
Obsessive Compulsive Symptoms Are Associated With Heightened Avoidance of Low-Probability, High-Aversion Threats: A Preliminary Test of the Improbable-Catastrophe Hypothesis
Authors: Hunt Christopher , Degeneffe Nikki , Bixby Johanna , Lissek Shmuel
Published: August 2021

Although symptoms of obsessive compulsive disorder (OCD) may vary markedly, they often involve a fear of consequences that are both catastrophic and highly improbable (e.g., contracting HIV from a doorknob). Accordingly, a heightened sensitivity to what we refer to as improbable catastrophes may represent an underlying feature of OCD, yet this possibility awaits experimental validation. To fill this gap, 78 undergraduates with wide-ranging levels of OCD symptom severity completed a fear-conditioning paradigm designed to elicit varying degrees of perceived threat probability/aversiveness to test whether OCD symptoms predict heightened reactivity to unlikely, high-aversion threats. Consistent with predictions, participants with higher OCD symptoms were more avoidant of low-probability, high-aversion threats and also exhibited greater threat expectancy and physiological reactivity to more improbable threats in general. These findings implicate excessive avoidance of improbable catastrophes and heightened reactivity to unlikely threats more generally as underlying features of OCD.
Book review: Praveen Jha, Avinash Kumar, and Yamini Mishra (Eds.) (2020). Labouring Women: Issues and Challenges in Contemporary India
Authors: Siwach Twinkle
Published: August 2021

Praveen Jha, Avinash Kumar, and Yamini Mishra (Eds.) (2020). Labouring Women: Issues and Challenges in Contemporary India. Hyderabad: Orient BlackSwan. ISBN 9789390122073, 343 pp., ₹775
An Ecolinguistic Discourse Approach to Teaching Environmental Sustainability: Analyzing Chief Executive Officer Letters to Shareholders
Authors: Ainsworth Judith
Published: August 2021

This article argues for using discourse analysis in business and management curricula to increase language awareness. To that end, an ecolinguistic discourse analysis approach (Stibbe, 2015a) for teaching sustainability is proposed. The article first explores sustainability discourse in two chief executive officer letters to shareholders followed by a classroom implementation enabling students to practise discourse analytical skills. Students examined vocabulary, hedging, modals, abstract and concrete representation, and social actors. Linguistic features were interpreted to reveal communicators’ underlying ideologies. This systematic analytical approach allows students to reflect on communication processes and how these processes can be used strategically when communicating in organizational contexts.
Association Between Age and Ethnicity with Pediatric Clinical Outcomes in COVID-2019
Authors: Snowden Jessica , Patwardhan Anjali
Published: August 2021

The novel coronavirus SARS-CoV-2 (COVID-19) has infected people across the world, including an increasing number of children in the United States (U.S.). The epidemiology of pediatric infection in the U.S. and how it influences clinical outcomes is still being characterized. In this study, we describe a cohort of 989 children with laboratory-confirmed SARS-CoV-2 infection. Children under age 20 in a statewide health system with SARS-CoV-2 infection, defined by positive PCR testing, between February 1 and August 30, 2020 were included in this observational cohort study. Data extracted from the medical record included age, demographic information, clinical illness severity, hospital stay, and comorbidities. Analysis included descriptive statistics and Chi-square as appropriate. Nine hundred and eighty-children met inclusion criteria for this study, ranging from 1 month to 20 years in age. Most children (62.4%) were asymptomatic at the time of diagnosis and children over the age of 2 were significantly more likely to be asymptomatic at diagnosis than younger children ( P < .05). Hispanic children were significantly more likely to be symptomatic at the time of diagnosis (56.3% asymptomatic; P < .05). The high proportion of children with asymptomatic infection emphasizes the importance of understanding the unique role of children in the pandemic. Older children are more likely to be asymptomatic, but also more likely to experience severe or critical illness when symptoms do develop. Hispanic children were more likely to be symptomatic at diagnosis, highlighting the importance of culturally specific outreach to vulnerable communities.
The change of anterior chamber angle parameters after cataract surgery in diabetic patients
Authors: Bayat Alper Halil , Akpolat Cetin
Published: August 2021

Purpose:

The purpose of this study is to investigate the change of anterior chamber angle morphology after cataract surgery in patients with type 2 diabetes mellitus (DM2) using anterior segment optical coherence tomography (AS-OCT).

Methods:

In this prospective and comparative study, 57 eyes of the patients with cataract were investigated. The patients were divided into two groups. The DM2 group included cataractous type 2 diabetic patients without diabetic retinopathy ( n = 30) and the non-DM2 group included nondiabetic participants with cataract ( n = 27). The AS-OCT examinations were performed at baseline and 1 month after the cataract surgery. The corrected distance visual acuity (CDVA), intraocular pressure (IOP), angle-opening distance at 500 µm (AOD-500) and trabecular iris space area at 500 µm (TISA-500), and scleral spur angle (SSA) in temporal quadrant were analyzed.

Results:

The mean age, sex, and axial length values were similar in both groups ( p > 0.05 for all). The CDVA was significantly improved in both groups ( p < 0.001). The mean AOD-500, TISA-500, and SSA were increased and the mean IOP was decreased after cataract surgery in both groups ( p < 0.001 for all). There were not any statistically significant intergroup differences in CDVA, IOP, and AS-OCT measurements between the DM2 and non-DM2 groups ( p > 0.05 for all).

Conclusion:

Cataract surgery showed significant increases in mean anterior chamber angle parameters and reductions in IOP values in both diabetic and nondiabetic patients without intergroup significant differences. These results suggested the safety and effectiveness of cataract surgery, especially regarding anterior chamber angle parameters and so IOP changes.
Dissemination, use, and impact of a community-based, conversational advance care planning intervention: ripple effects of the Swedish DöBra cards
Authors: Eneslätt Malin , Helgesson Gert , Tishelman Carol
Published: August 2021

Introduction & Aim:

Despite increasing interest in community-based advance care planning interventions, few studies investigate the societal impact of such initiatives. The DöBra cards, a Swedish adaptation of the GoWish cards, were first used for advance care planning conversations in a participatory action research project and later, due to popular demand, made available for purchase by the general public. We explore how the DöBra cards were disseminated and used publicly, to understand their impact in the community.

Methods:

We used Ripple Effects Mapping to follow three dissemination ripples, based on interviews with 20 participants, analyzed with directed content analysis.

Findings:

Key factors influencing dissemination of the DöBra cards included ‘champions’ with a mandate within their context or organization, policy documents including use of the cards, media coverage, and presentations of the cards in various settings. The DöBra cards were adapted for use individually and in groups in different private, professional, and organizational settings. Perceived benefits of the cards included acting as an icebreaker in initiating end-of-life conversations and having preformulated statements to reflect upon. Other positive experiences included discussions on different interpretations of card statements, thus opening new perspectives regarding end-of-life. The DöBra cards functioned both as means to raise end-of-life issues in different contexts, and as an end in themselves, for example, by facilitating advance care planning conversations for those with serious disease. Impact also included personal development and strengthening of private and professional relationships, with potential to affect end-of-life care.

Conclusion:

The broad dissemination of the DöBra cards influenced capacity-building in dealing with end-of-life issues in communities, as the topic of dying and death was brought to agendas in new contexts.
Methodology for adaptation of the ASH Guidelines for Management of Venous Thromboembolism for the Latin American context
Authors: Neumann Ignacio , Izcovich Ariel , Alexander Kendall E. , Castano Jenny , Plovnick Robert , Kunkle Robert , Zhang Yuan , Aguilar Ricardo , Basantes Guillermo León , Casais Patricia , Colorio Cecilia C. , Guillermo Esposito María Cecilia , García Lázaro Pedro P. , Pereira Jaime , Meillon-García Luis A. , Rezende Suely Meireles , Serrano Juan Carlos , Tejerina Valle Mario L. , Schünemann Holger
Published: August 2021

Background: From 2017 to 2020, the American Society of Hematology (ASH) collaborated with 12 hematology societies in Latin America to adapt the ASH guidelines on venous thromboembolism (VTE).

Objective: To describe the methods used to adapt the ASH guidelines on venous thromboembolism.

Methods: Each society nominated 1 individual to serve on the guideline panel. The work of the panel was facilitated by the 2 methodologists. The methods team selected 4 of the original VTE guidelines for a first round. To select the most relevant questions, a 2-step prioritization process was conducted through an on-line survey and then through in-person discussion. During an in-person meeting in Rio de Janeiro, Brazil, from 23 April through 26 April 2018, the panel developed recommendations using the ADOLOPMENT approach. Evidence about health effects from the original guidelines was reused, but important data about resource use, accessibility, feasibility, and impact in health equity were added.

Results: In the guideline accompanying this paper, Latin American panelists selected 17 questions from an original pool of 49. Of the 17 questions addressed, substantial changes were introduced for 5 recommendations, and remarks were added or modified for 12 recommendations.

Conclusions: By using the evidence from an international guideline, a significant amount of work and time were saved; by adding regional evidence, the final recommendations were tailored to the Latin American context. This experience offers an alternative to develop guidelines relevant to local contexts through a global collaboration.
Hospital workers mental health during the COVID-19 pandemic: methods of data collection and characteristics of study sample in a university hospital in Milan (Italy)
Authors: Fattori A , Cantù F , Comotti A , Tombola V , Colombo E , Nava C , Bordini L , Riboldi L , Bonzini M , Brambilla P
Published: August 2021

Background

The COVID-19 pandemic is currently a severe challenge for healthcare workers, with a considerable impact on their mental health. In order to focus preventive and rehabilitation measures it’s fundamental to identify risk factors of such psychological impairment. We designed an observational longitudinal study to systematically examine the psychological wellbeing of all employees in a large University Hospital in Italy, using validated psychometric scales in the context of the occupational physician’s health surveillance, in collaboration with Psychiatric Unit.

Methods

The study started after ethical approval in August 2020. For each worker, the psychological wellbeing is screened in two steps. The first level questionnaire collects sociodemographic characteristics, personal and occupational COVID-19 exposure, worries and concerns about COVID-19, general psychological discomfort (GHQ-12), post-traumatic stress symptoms (IES-R) and anxiety (GAD-7). Workers who score above the cut-off in at least one scale are further investigated by the second level questionnaire composed by PHQ-9, DES-II and SCL-90. If second level shows psychological impairments, we offer individual specialist treatment (third level). We plan to follow-up all subjects to monitor symptoms and possible chronicization; we aim to investigate potential risk factors through univariate analysis and multivariate logistic regressions.

Results

Preliminary results refer to a sample of 550 workers who completed the multi-step evaluation from August to December 2020, before vaccination campaign started. The participation rate was 90%. At first level screening, 39% of the subjects expressed general psychological discomfort (GHQ-12), 22% post-traumatic stress symptoms (IES-R), and 21% symptoms of anxiety (GAD-7). Women, nurses, younger workers, subjects with COVID-19 working exposure and with an infected family member showed significantly higher psychological impairment compared to colleagues. After the second level screening, 12% and 7% of all workers showed, respectively, depressive and dissociative symptoms; scorings were significantly associated with gender and occupational role. We are currently extending sample size and evaluating subjects over a period of further 12 months.

Conclusions

The possibility to perform a systematic follow-up of psychological wellbeing of all hospital workers, directly or indirectly exposed to pandemic consequences, constitutes a unique condition to detect individual, occupational, and non-occupational risk factors for psychological impairment in situations of prolonged stress, as well as variables associated with symptoms chronicization.