bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of International and Local School Teachers’ Perceptions and Enactments of Humility in Hong Kong
Authors: Harrison Mark , Briffett-Aktaş Carla , Ying Ji , Tsui Gordon , Cheng Anna Susanne , Jackson Liz
Published: September 2023

While humility has been widely explored philosophically and psychologically, there is little research on humility in educational settings. Based on semi-structured interviews with teachers from local and international schools, we investigated the role of humility in the pedagogy and wider contexts of schools in Hong Kong. Both international and local teachers regarded humility as being important for education, but they conceptualized and enacted it differently, reflecting the high power distance of Hong Kong’s Confucian heritage culture and teacher-centeredness of traditional Chinese education, and the more social constructivist form of pedagogy in international education. These findings provide a lens to understand how teaching and teacher-student relations are shaped by cultural, pedagogical, and educational philosophies and practices in different educational settings.
Overview of Pediatric Procalcitonin Testing Patterns in a Tertiary Care Children’s Hospital
Authors: Swartz Sheila , Beneschott Natalya , Zembles Tracy , Anibaba Fatima , Lo Stanley , Havens Peter , Mitchell Michelle
Published: September 2023

The use of procalcitonin (PCT) has grown over the past decade with increasing reliance on the test to rule out bacterial infection. We retrospectively reviewed the medical records of children <18 years old hospitalized at a tertiary care children’s hospital from 2017 to 2019 who had PCT testing performed during their admission. Of 4135 PCT levels collected on 1530 children, 982 (23.7%) were diagnostically low and 1993 (48.1%) were diagnostically elevated. Pediatric intensive care, with 6% of total hospital patients, obtained 41.4% of tests. Thirty-one (2%) patients had an average of 27 PCT levels per patient, accounting for 20% of all tests. Many children had symptoms for which testing is not indicated (eg, skin complaints). The differences in PCT testing by service, inappropriate patterns of repeat testing, and testing performed in patients for whom it is not indicated may identify targets for diagnostic stewardship.
Diasporic multiculturalism
Authors: Fittante Daniel
Published: September 2023

Noting an overreliance on North American and European-based understandings of race and ethnicity, many sociologists have called for research in new spaces. But the same conceptual and regional limitations apply to several other studies. One example of this is multiculturalism. Scholars tend to associate multiculturalism with international migration and ethnic pluralism. As such, they typically study multiculturalism in the most ethnically diverse (and often most affluent) countries – that is, in Europe and North America. But international migration does not always result in ethnic pluralism. For example, diasporic return migration often leads to the convergence of internally diverse co-ethnic populations in ethnically homogeneous nation-states. The diasporic ‘returnees’, who were born outside of their perceived homelands, come through targeted migration policies, face various levels of discrimination, and yet contribute significantly to the economic development and cultural diversity of the countries to which they relocate. As such, this article argues that the multiculturalization of monoethnic nationhood is substantially driven by diasporic return migration. In exploring diasporic multiculturalism, the article draws from data collected in Yerevan, Armenia.
Heuristic algorithms based optimal tuning of FOLQI controller for quadruple tank process under disturbance conditions
Authors: Mohankumar Rajamani-Selvaraj , Selvaganesan Narayanasamy , Jayakumar Madhavanpillai , Sathishkumar Perumal
Published: September 2023

Design of centralised disturbance rejection controllers for an highly interacting MIMO quadruple tank process is tedious. Recently, centralised disturbance rejection Fractional Order LQI (FOLQI) controller is designed for such system to meet the desired specifications with better performance than various disturbance rejection controllers that are available in the literature. In this paper, an optimisation problem is formulated to obtain the optimal parameters of FOLQI controller providing minimum control effort by applying various widely used heuristic methods like Cuckoo Search (CS), Accelerated Particle Swarm Optimisation (APSO) and FireFly (FF) algorithms. A detailed simulation study is carried out to compare the performance of the FOLQI and Integer Order LQI (IOLQI) controllers obtained by these heuristic algorithms under disturbance and parameter uncertainty conditions. From the simulation study it is inferred that (i) FOLQI controller provides better time domain specifications % Mp, ts and J in comparison to IOLQI controllers and (ii) FF tuned FOLQI and IOLQI controllers provide better robustness characteristics compared to CS and APSO tuned controllers.
The rise and fall of political outsiders: Political opportunity structure and (de-)mobilization in Paraguay (2008–2012)
Authors: Hatab Shimaa
Published: September 2023

Unlike left outsiders in contexts of steadfast traditional opposition in Latin America, Fernando Lugo refrained from intensifying the conflict with the political establishment and mobilizing subaltern groups to push through progressive policies after winning the 2008 elections. Ultimately, conservative interests pushed through impeachment proceedings and forced him out of office prematurely, and Lugo yielded to their will instead of using the interbranch stalemate to instigate popular resistance. For their part, the popular sectors did not mobilize to pressure the Lugo government, nor did they stand firmly against the president’s impeachment. The article aims to answer why Lugo flopped as a political broker and why Paraguayans did not mobilize to Lugo’s defense by developing a two-level argument that combines the institutional supply side that determines the actors’ mobilization capacity and the demand side of movement issue-framing that conditions actors’ willingness to mobilize. First, the organizational and representative pathologies of the left parties persisted into Lugo’s reign and curtailed the capacity of the mobilization brokers to forge ties between otherwise separate organizations in society and to serve as a veto gate in power centers. Second, community leaders and social actors did not engage in active issue-framing processes to construct new meanings to orient their collective action. The article draws on interview data, public opinion polls, and archival works to substantiate the argument and contributes to social movement literature by highlighting the role of political leadership’s strategic choices and its interactions with opponents and allies (inside and outside power centers) in realizing favorable political opportunity and remolding clientelistic ties to mobilize social constituencies.
Disease, Scapegoating, and Social Contexts: Examining Social Contexts of the Support for Racist Naming of COVID-19 on Twitter
Authors: Lu Yun
Published: September 2023

In early 2020, when COVID-19 began to spread in the United States, many Twitter users called it the “Chinese virus,” blaming racial outgroups for the pandemic. I collected tweets containing the “Chinese virus” derivatives posted from March to August 2020 by users within the United States and created a data set with 141,290 tweets published by 50,695 users. I calculated the ratio of users who supported the racist naming of COVID-19 per county and merged Twitter data with the county-level census. Multilevel regression models show that counties with higher COVID-19 mortality or infection rates have more support for the racist naming. Second, the mortality and infection rates effects are stronger in counties with faster minority growth. Moreover, it is mainly in poor counties that minority growth enlarges the effects of infection and mortality rates. These findings relate to the theories on disease-induced xenophobia and the debate between conflict and contact theories.
Evaluating rearing behaviour as a model-specific pain indicator in mouse osteotomy models
Authors: Wolter Angelique , Jirkof Paulin , Thöne-Reineke Christa , Rapp Anna E , Lang Annemarie
Published: September 2023

To assess pain in mouse models of bone fractures, currently applied assessment batteries use combinations of clinical signs with spontaneous behaviours and model-specific behaviours, including walking and weight-bearing behaviour. Rearing behaviour – an upright position on the hindlimbs – has a motivational and an ambulatory component. Thus, rearing behaviour might have the potential to be an indicator for model-specific pain in mouse fracture models. To date, the assessment of rearing behaviour in bone fracture models using mice is only scarcely described. In this study, we aimed to determine whether the duration of rearing behaviour is affected by osteotomy of the femur in male and female C57BL/6N mice with external fixation (rigid vs. flexible) and could be an additional sign for model-specific pain, such as the presence of limping. Rearing duration was significantly decreased after osteotomy in male and female mice at 24 h, 48 h and 72 h, but was not affected by anaesthesia/analgesia alone. In male mice, the relative rearing duration increased over 72 h (both fixations) and at 10 days in the rigid fixation group but remained significantly lower in the flexible fixation group. In contrast, in female mice, no increase in rearing duration was observed within 72 h and at 10 days post-osteotomy, independent of the fixation. We did not identify any association between relative rearing time and presence or absence of limping. In summary, our results do not provide sufficient evidence that altered rearing behaviour might be an indicative sign for pain in this model.
Gaussian mixture model sample selection strategy–based active semi-supervised soft sensor for industrial processes
Authors: Luo Xing , Lei Qi , Wang Huirui
Published: September 2023

Soft sensors have become reliable tools for estimating difficult-to-measure target variables in modern industrial processes. In order to make full use of labeled and unlabeled samples, an active semi-supervised soft sensor modeling method is proposed, which combines active learning and semi-supervised learning to maximize model performance and minimize the laboratory analysis cost of expanding the labeled sample data set. First, manifold regularization is introduced into the deep extreme learning machine (DELM) algorithm to form a semi-supervised DELM that improves the performance of a model trained with unlabeled samples. Then, considering non-Gaussian processes and the error information between the predicted and true values, an active sample selection strategy based on error Gaussian mixture model is developed. Using this strategy, the most uncertain and representative unlabeled samples are selected for labeling, and thereby expanding the labeled sample data set. Finally, the effectiveness of the proposed method is verified using industrial debutanizer process data.
Impact of inter-observer variability on first axillary level dosimetry in breast cancer radiotherapy: An AIRO multi-institutional study
Authors: Leonardi Maria Cristina , Pepa Matteo , Zaffaroni Mattia , Vincini Maria Giulia , Luraschi Rosa , Vigorito Sabrina , Morra Anna , Dicuonzo Samantha , Mazzola Giovanni Carlo , Gerardi Marianna Alessandra , Zerella Maria Alessia , Cante Domenico , Petrucci Edoardo , Borzì Giuseppina , Marrocco Maristella , Chieregato Matteo , Iadanza Luciano , Lobefalo Francesca , Valenti Marco , Cavallo Anna , Russo Serenella , Guernieri Marika , Malatesta Tiziana , Meaglia Ilaria , Liotta Marco , Palumbo Isabella , Marcantonini Marta , Mezzenga Emilio , Falivene Sara , Arrichiello Cecilia , Barbero Maria Paola , Ivaldi Giovanni Battista , Catalano Gianpiero , Vidali Cristiana , Giannitto Caterina , Ciabattoni Antonella , Meattini Icro , Aristei Cynthia , Orecchia Roberto , Cattani Federica , Jereczek-Fossa Barbara Alicja
Published: September 2023

This study quantified the incidental dose to the first axillary level (L1) in locoregional treatment plan for breast cancer. Eighteen radiotherapy centres contoured L1-L4 on three different patients (P1,2,3), created the L2-L4 planning target volume (single centre planning target volume, SC-PTV) and elaborated a locoregional treatment plan. The L2-L4 gold standard clinical target volume (CTV) along with the gold standard L1 contour (GS-L1) were created by an expert consensus. The SC-PTV was then replaced by the GS-PTV and the incidental dose to GS-L1 was measured. Dosimetric data were analysed with Kruskal-Wallis test. Plans were intensity modulated radiotherapy (IMRT)-based. P3 with 90° arm setup had statistically significant higher L1 dose across the board than P1 and P2, with the mean dose (Dmean) reaching clinical significance. Dmean of P1 and P2 was consistent with the literature (77.4% and 74.7%, respectively). The incidental dose depended mostly on L1 proportion included in the breast fields, underlining the importance of the setup, even in case of IMRT.
Prevalence and predictors of long-term opioid use following orthopaedic surgery in an Australian setting: A multicentre, prospective cohort study
Authors: Liu Shania , Stevens Jennifer A , Collins Ashleigh E , Duff Jed , Sutherland Joanna R , Oddie Morgan D , Naylor Justine M , Patanwala Asad E , Suckling Benita M , Penm Jonathan
Published: September 2023

Opioid analgesics prescribed for the management of acute pain following orthopaedic surgery may lead to unintended long-term opioid use and associated patient harms. This study aimed to examine the prevalence of opioid use at 90 days after elective orthopaedic surgery across major city, regional and rural locations in New South Wales, Australia. We conducted a prospective, observational cohort study of patients undergoing elective orthopaedic surgery at five hospitals from major city, regional, rural, public and private settings between April 2017 and February 2020. Data were collected by patient questionnaire at the pre-admission clinic 2–6 weeks before surgery and by telephone call after 90 days following surgery. Of the 361 participants recruited, 54% (195/361) were women and the mean age was 67.7 years (standard deviation 10.1 years). Opioid use at 90 or more days after orthopaedic surgery was reported by 15.8% (57/361; 95% confidence interval (CI) 12.2–20%) of all participants and ranged from 3.5% (2/57) at a major city location to 37.8% (14/37) at an inner regional location. Predictors of long-term postoperative opioid use in the multivariable analysis were surgery performed at an inner regional location (adjusted odds ratio 12.26; 95% CI 2.2–68.24) and outer regional location (adjusted odds ratio 5.46; 95% CI 1.09–27.50) after adjusting for known covariates. Long-term opioid use was reported in over 15% of patients following orthopaedic surgery and appears to be more prevalent in regional locations in Australia.
Institutional differences in Old-Greek and Theodotionic Susanna
Authors: Krause Andrew R.
Published: September 2023

Despite the elaborative nature of Theodotionic Susanna, it is not merely an expansion. The narrative details of the different versions betray consistent institutional differences. One notable difference is the near elimination of the public synagogue as a place of assembly, and instead this source speaks of a more generalized, associational assembly that meets in Joachim’s house. The Theodotionic version’s associational, domestic assembly space is closer to the polity of a diasporic collegia assembly. Conversely, in the Old Greek, the perverse elders preside over an assembly building, which is at one point designated as “the synagogue of the city” (OG Sus 28). The Old Greek’s emphasis on a civic synagogue is closer to Palestinian Jewish texts, despite the exilic setting of this story. While such institutional designations are more of a spectrum than a binary difference, such difference in outlook offers invaluable data regarding the contexts of the two versions of this Danielic composition and the parallel presentation of these two different types of synagogues at such an early date is significant.
Atoning for the land in the writings of Early Judaism
Authors: Feldman Ariel
Published: September 2023

This paper explores the references to atonement for the land in Early Jewish literature. The notion that sexual misconduct, idolatry, and bloodshed defile the land is well known from such scriptural texts as Lev 18:6–25, 27 and Num 35:33–34. Recent biblical scholarship distinguishes between ritual and moral impurities and places the defilement of the land within the latter category. For such moral impurities, the Torah makes no provision for a ritual removal. And yet, the book of Jubilees and Genesis Apocryphon depict Noah as offering a sacrifice to atone for the earth immediately after the Flood. Moreover, 1QWords of Moses (1Q22) in its description of the Day of Atonement mentions an atonement for the land. Finally, such sectarian texts as Community Rule (S), Rule of the Congregation, and 4QMiscellaneous Rules (4Q265) depict the sectarian community(ies) as atoning for the land. Looking closely at all these sources, this paper suggests that underlying all of them is a shared halakhic tradition that land can and should be atoned for by means of a sacrifice.
Associations of Home-Based Screen Time and Its’ Changes With Follow-up Body Mass Index in Chinese Preschool-Aged Children
Authors: Ye Sunyue , Zhu Yilin , Jiang Jieying , Fan Qilin
Published: September 2023

This study aimed to explore the associations of screen time (ST) and its’ changes with follow-up body mass index (BMI) in preschool children. Parents of 805 preschoolers participated in our study at baseline and were followed up after 1 year in China. Linear regression models were used to analyze the dynamic relationship between ST and BMI in preschool children. A total of 662 preschoolers, including 342 boys (51.7%) and 320 girls (48.3%) were followed up. The changes in ST (from the initial ≤1 h/day to >1 h/day at follow-up vs keep ≤1 h/d, β(SE) = 0.21(0.09), P = .016) and follow-up ST of preschool children (>1 h/d vs ≤1 h/d, β(SE) = 0.17(0.07), P = .013) were significantly associated with an increase in the preschoolers’ z-scored BMI at follow-up after adjusting for potential confounding factors. We concluded that the unfavorable change in ST was associated with increased BMI in preschool children.
Exploring the Potential of Comics for Science Communication: A Study on Conveying COVID-19 Vaccine Safety Information to Black Americans
Authors: Li Nan , Brossard Dominique , Yang Shiyu , Barolo Gargiulo Leonardo
Published: September 2023

This study examined the effectiveness of using comics to communicate scientific information on COVID-19 vaccine safety to Black Americans. Although the effects of comics on interest, recall, and information sharing intention were not significant compared to expository texts and infographics, comics featuring abstract, racially ambiguous characters facilitated greater learning among participants with lower knowledge of COVID-19 vaccines, as opposed to comics with realistic representations of Black individuals. Furthermore, the effects of comics varied depending on individuals’ interest in comic reading. These findings highlight the potential of comics in science communication, but their design and target audience should be carefully considered.
Wooden sandwich panels with auxetic core for furniture - experimental and numerical analysis
Authors: Zhong Yanan , Ren Yi , Zhang Jijuan , Zhang Zhongfeng
Published: September 2023

Honeycomb panels manufactured from wood and paper materials promote a high-value utilization of wood resources. However, the poor mechanical properties and uncommon thicknesses (32 and 40 mm) of paper honeycomb panels limit their application and promotion in the panel furniture industry. Hence, numerous attempts have been made to develop high-strength and low-density wood sandwich composites for the frames and partitions of cabinet furniture. This paper describes a method for manufacturing lightweight sandwich panels (18 mm thickness) with auxetic cores, made of fast-growing poplar. The mechanical properties of the panels and the negative Poisson's ratio of the perforated sheet cores were determined by three-point bending and uniaxial compression tests. The lower density, higher modulus of elasticity, and bending strength suggest that the developed panel is a good substitute for traditional wood-based panels. A numerical model for panels in bending tests is proposed and validated against the experimental analysis results. These investigations facilitate further research into optimizing the sandwich panel structure and its applicability in the architectural and furniture industry.
Distinguishing Types of Sexual Assault Among Young People: A Latent Class Analysis Approach
Authors: Frøyland Lars Roar , Stefansen Kari , Andersen Patrick Lie
Published: September 2023

Scientific evidence on the incident-specific characteristics of sexual assault during youth is limited. Using latent class analysis, this article contributes to this research agenda by (1) developing a typology of sexual assaults by both peers and adults and (2) examining how assault types are associated with adverse life outcomes. The analysis is based on 1,402 cases of sexual assault reported in two population-based surveys among 18–19-year-olds in Norway. Six latent classes of assault were identified: (1) peer sexual contact while intoxicated (33.3%), (2) peer sexual penetration while intoxicated (25.5%), (3) severe violent assault by peer (15.1%), (4) assault in romantic relationship (13.0%), (5) severe pressure by younger adult (7.4%) and (6) assault by older adult (5.7%). All assault types were related to adverse outcomes in the realms of mental and physical health, social relationships and substance use, with the most adverse outcomes in the class containing severe violent assaults.
Role of bilingual guides in access to health care among Indigenous Wayuu population of Colombia
Authors: Mignone Javier , Suárez Aguilar Beda , Hinds Aynslie , Duarte Yercine , Ospina Dorian , Gómez Vargas John Harold
Published: September 2023

Anas Wayuu is an Indigenous-led non-profit health insurance organization in Colombia. It provides health care coverage to approximately 220,000 people, mostly Indigenous Wayuu, the largest Indigenous population in Columbia, living in La Guajira, the northeast region of the country, and in neighboring Venezuela. Anas Wayuu offers several intercultural health initiatives, among them the inclusion of bilingual guides for Wayuu families. The objective of the study was to describe the use of Anas Wayuu’s bilingual guides and determine whether use was associated with access and quality of care. A 34-item survey was conducted in 2020 to 2021 with a final sample of 2,113 Anas Wayuu enrollees and non-enrollees. Study findings demonstrated the relevance of bilingual guides programming. They suggested that bilingual guides improved individual’s capabilities to navigate the health care system, increased access to care, and increased their experience of quality of care. The findings strengthen the case for Indigenous self-governance over health care.
MicroRNAs Regulate Tumorigenesis by Downregulating SOCS3 Expression: An In silico Approach
Authors: Al-Asadi Sura , Mansour Hiba , Ataimish Ahmed Jwaid , Al-Kahachi Rusul , Rampurawala Jamila
Published: September 2023

Tumor microenvironment is characterized by the occurrence of significant changes due to disrupted signaling pathways that affect a broad spectrum of cellular activities such as proliferation, differentiation, signaling, invasiveness, migration, and apoptosis. Similarly, a downregulated suppressor of cytokine signaling 3 (SOCS3) promotes increased JAK/STAT function due to aberrant cytokine signaling, which results in increased cell proliferation, differentiation, and migration. Multiple carcinomas including breast cancer, prostate cancer, hepatocellular carcinoma, pancreatic cancer, and colorectal cancer involve the disruption of SOCS3 expression due to microRNA overexpression. MicroRNAs are small, conserved, and non-coding RNA molecules that regulate gene expression through post-transcriptional inhibition and mRNA destabilization. The aim of this study was to identify putative microRNAs that interact with SOCS3 and downregulate its expression. In this study, miRWalk, TargetScan, and miRDB were used to identify microRNAs that interact with SOCS3, whereas RNA22 was utilized to identify the binding sites of 238 significant microRNAs. The tertiary structures of shortlisted microRNAs and SOCS3 regions were predicted through MC Sym and RNAComposer, respectively. For molecular docking, HDOCK was used, which predicted 80 microRNA-messengerRNA complexes and the interactions of the top 5 shortlisted complexes were assessed. The complexes were shortlisted on the basis of least binding affinity score and maximum confidence score. This study identifies the interactions of known (miR-203a-5p) and novel (miR-6756-5p, miR-6732-5p, miR-1203, miR-6887-5p) microRNAs with SOCS3 regions due to their maximum interactions. Identifying the interactions of these microRNAs with SOCS3 will significantly advance the understanding of oncomiRs (miRNAs that are associated with cancer development) in tumor development due to their influence on SOCS3 expression. These insights will assist in future studies to understand the significance of miRNA-SOCS3-associated tumor development and progression.
Subjective well-being among Chinese breast cancer patients: The unique contributions of death anxiety, self-esteem, and social support
Authors: Yang Kairong , Ren Yinpeng , Peng Wenya , Wang Xiangyu , Du Xiaopeng , Wang Jing , Jiang Jiang
Published: September 2023

Previous studies have indicated that cancer patients may have a lower level of subjective well-being (SWB); nevertheless, the underlying factors for this phenomenon remain insufficiently investigated. Based on the characteristics of Chinese breast cancer patients and the unique culture, this study explored the independent contributions of death anxiety, self-esteem, and social support to SWB from the protective and risk perspectives. A cross-sectional survey recruited 514 females with breast cancer and collected participants’ demographic and the above variables. The results found that death anxiety independently predicted SWB in a negative direction (β = −0.36, p < 0.001). In addition, self-esteem (β = 0.38, p < 0.001) and social support (β = 0.14, p < 0.001) also had the unique positive effects on SWB. These findings offer new insights into strengthening breast cancer patients’ SWB, for instance, using relevant interventions to reduce death anxiety and improve self-esteem and social support.
Development and evaluation of a Chinese short-form of the Sleep-related Behaviors Questionnaire in Hong Kong Chinese adults using item response theory
Authors: Chung Harry Ka-shing , Louie Krisya , Chan Wai Sze
Published: September 2023

Insomnia-related safety behaviors are behaviors that aim to mitigate the negative consequences of insomnia but inadvertently perpetuate insomnia. This study aimed to develop and evaluate a Chinese short-form of the sleep-related behavior questionnaire (SRBQ-SF), a self-report measure of insomnia-related safety behaviors, using item response theory. The Chinese version of the original SRBQ was completed by 536 Chinese-speaking adults with clinically significant insomnia. The automatic item selection procedure of the Mokken scaling analysis was used to develop and evaluate the SRBQ-SF. A 23-item SRBQ-SF consisting of a 14-item reduced engagement and avoidance subscale (SRBQ-REA) and a 9-item preoccupation with sleep subscale (SRBQ-PS) was derived. Classical test theory-based estimates showed that the SRBQ-REA and SRBQ-PS had good internal consistency and acceptable convergent and discriminant validities, and they were only weakly correlated with each other. We recommend the use of the SRBQ-REA and SRBQ-PS separately to assess two dimensions of safety behaviors in the study and treatment of insomnia in Chinese-speaking adults.
Digital play on children’s terms: A child rights approach to designing digital experiences
Authors: Livingstone Sonia , Ólafsson Kjartan , Pothong Kruakae
Published: September 2023

Children have the right to play (UN Convention on the Rights of the Child, 1989), yet their opportunities to play on their own terms (free play) are under pressure, including online. Drawing on an analysis of the qualities of children’s free play across time and cultures, a nationally representative survey of UK 6- to 17-year olds compared their experiences of play across digital and non-digital contexts to identify design features that enhance or undermine children’s digital play and propose evidence-based recommendations for digital products and services likely to be used by children. Children viewed digital play more critically than non-digital play although both were judged poorly on key qualities of ‘intrinsically motivated’, ‘voluntary’, ‘risk-taking’ and ‘safety’. Logistical regression analysis shows that rights-respecting design features contribute to children’s enjoyment of digital play more than premium or freemium designs do, thus supporting Playful by Design recommendations that can benefit children.
Art and emplacement in Northern Ireland
Authors: Downey Hilary , Sherry John F
Published: September 2023

We explore the relationship between placeways and public art in the case of ephemeral architecture entitled “Temple,” installed in Northern Ireland in 2015. Synthesizing our own published ethnographies of the event, we employ a method we call auto-meta-ethnography to discover a grounded theory of emplacement that synergizes prior work undertaken on the concept of -scapes. We emphasize conjuncture over disjuncture and probe the isomorphism of cultural flows. We examine the imbrication of the installation in a cluster of -scapes we label landscape, mythscape, brandscape, giftscape, griefscape, artscape, and Templescape, together which comprise a chorography of the Temple’s emplacement. These micrometaphors provide more precision and nuance to existing macrometaphors, illuminate the intimate intermingling of -scapes, and illustrate the synergy their propinquity occasions.
Why Do Politicians Not Act Upon Citizens’ Deliberations? Evidence From Iceland
Authors: Pálsdóttir Valgerður Björk , Gherghina Sergiu , Tap Paul
Published: September 2023

Politicians are expressing increasing support for deliberative practices around the world. However, knowledge about their actions beyond expressing support is scarce. To address this gap in the literature, this article aims to explain why politicians do not pick up the results arising from deliberative practices and integrate them into their policies. Our analysis focuses on the 2019 deliberation in Iceland as the most likely case in which we would expect such a process to occur. We use original data from 25 semi-structured interviews conducted in 2021 with Icelandic MPs elected at the national level, which also cover all the party leaders of the eight parliamentary parties in the 2017–2021 term in office. The reflexive thematic analysis finds that, irrespective of their ideological affiliation, politicians are critical of deliberative practices both in procedural and substantive terms. They display a strong belief that political representation achieved through elections must be the rule of the democratic game. As such, deliberation is considered redundant since citizens already have many ways to participate in representative democracy.
Intravascular Ultrasound-Guided Versus Angiography-Guided Endovascular Therapy for Femoropopliteal Artery Disease: A Scoping Review
Authors: Meng Wenzhuo , Guo Julong , Pan Dikang , Guo Lianrui , Gu Yongquan
Published: September 2023

Objective:

The objective of this study was to summarize whether the application of additional intravascular ultrasound (IVUS) can change the outcomes of endovascular treatment in femoropopliteal atherosclerotic lesions compared with conventional angiography alone based on the existing study and evidence.

Methods:

Studies published until September 2022 were searched from PubMed, Embase, and Cochrane databases using the methods of combination of Medical Subject Headings and free text words. The outcomes included in these studies were primary patency rate or restenosis rate and freedom from clinically driven target lesion revascularization (cdTLR) rate, and most studies were concerned about the 12-month results. Two independent authors conducted the process of study selection. And the pooled analysis was attempted.

Results:

Finally, the inclusion criteria were met by 4 studies (1 randomized controlled trial and 3 retrospective studies) involving 1160 patients. IVUS played its role in measuring lesions and/or guiding wiring passage. Most of the included studies showed that IVUS could achieve a higher 12-month primary patency rate (from 70% to 90%) and higher 12-month freedom from cdTLR rate (from 83.9% to 94.7%) than angiography. The tentative pooled analysis also showed that IVUS significantly improved the 12-month primary patency rate (OR: 2.21, 95%CI: [1.38–3.55], p=0.001) and the 12-month freedom from cdTLR rate (OR: 1.70, 95%CI [1.04–2.78], p=0.03) compared with angiography alone.

Conclusions:

Intravascular ultrasound-guided endovascular treatment of femoropopliteal artery lesions may have its own advantages such as higher primary patency rate and freedom from cdTLR rate at 12 months. As a novel technology, IVUS is expected to become another beneficial option to guide clinicians performing endovascular therapy in addition to angiography and may achieve better clinical outcomes. More prospective and high-quality studies are needed in the future to investigate the role of IVUS in the process of femoropopliteal artery lesions endovascular treatment.

Clinical Impact

This review summarized a few available studies to promote understanding of IVUS and reveal its potential. This novel technology shows the possibility of achieving better clinical outcomes than angiography in femoropopliteal artery lesions endovascular therapy such as higher 12-month primary patency rate shown in some studies. Currently, it is important to consider suitable technologies applied to individualized treatment. IVUS seems to provide clinicians additional option in clinical practice and benefit patients well in the future. And it needs us to conduct more high-quality studies to explore its roles and advantages in endovascular treatment.
Transvenous Access for Emergent Thoracic and Thoracoabdominal Aortic Aneurysm Repair in Patients Without Femoral Access
Authors: Grandi Alessandro , Gronert Catharina , Panuccio Giuseppe , Rohlffs Fiona , Yousef al Sarhan Daour , Kölbel Tilo
Published: September 2023

Purpose:

To describe the technique of transvenous access for emergent endovascular repair of thoracic and thoracoabdominal aneurysms exemplified with 2 cases.

Technique:

Transvenous access to the aorta is described as an alternative access method to deliver aortic endografts in emergency situations. A 68-year-old female patient with severely compromised iliac and subclavian artery access was treated for a ruptured extent V thoraco-abdominal aortic aneurysm with a t-Branch (Cook Medical, Bjaeverskov, Denmark) delivered through a transcaval access. To avoid severe aortocaval shunting a balloon-expandable covered stent was deployed through a carotid access due to severe bilateral subclavian ostial stenosis. A 71-year-old man with an acute type B aortic dissection and bilateral narrow long-segment stenting of the iliac arteries was treated with a physician-modified thoracic endovascular aortic repair using an arteriovenous fenestration created at the level of the common iliac artery. We describe the access creation by fenestration using a transseptal needle.

Conclusion:

Transvenous access for thoracic and thoraco-abdominal aortic aneurysm repair is safe and feasible in selected emergent cases.

Clinical Impact

A transvenous approach may be helpful in selected patients when an endovascular repair needs to be performed but no arterial femoral access is available. This approach proved to be feasible even with large-bore introducer sheaths, taking its place in the armamentarium of the vascular surgeon for emergent complex endovascular aortic repairs.
Oral microbiota in human health and disease: A perspective
Authors: Santacroce Luigi , Passarelli Pier Carmine , Azzolino Domenico , Bottalico Lucrezia , Charitos Ioannis Alexandros , Cazzolla Angela Pia , Colella Marica , Topi Skender , Godoy Franklin Garcia , D’Addona Antonio
Published: September 2023

The evolution of medical knowledge about oral microbiota has increased awareness of its important role for the entire human body health. A wide range of microbial species colonizing the oral cavity interact both with each other and with their host through complex pathways. Usually, these interactions lead to a harmonious coexistence (i.e. eubiosis). However, several factors – including diet, poor oral hygiene, tobacco smoking, and certain medications, among others – can disrupt this weak homeostatic balance (i.e. dysbiosis) with potential implications on both oral (i.e. development of caries and periodontal disease) and systemic health. This article is thus aimed at providing an overview on the importance of oral microbiota in mediating several physiological and pathological conditions affecting human health. In this context, strategies based on oral hygiene and diet as well as the role of probiotics supplementation are discussed.
Molecular and environmental contributors to neurological complications in sickle cell disease
Authors: Karkoska Kristine A , Gollamudi Jahnavi , Hyacinth Hyacinth I
Published: September 2023

Sickle cell disease (SCD) is an inherited hemoglobinopathy in which affected hemoglobin polymerizes under hypoxic conditions resulting in red cell distortion and chronic hemolytic anemia. SCD affects millions of people worldwide, primarily in Sub-Saharan Africa and the Indian subcontinent. Due to vaso-occlusion of sickled red cells within the microvasculature, SCD affects virtually every organ system and causes significant morbidity and early mortality. The neurological complications of SCD are particularly devastating and diverse, ranging from overt stroke to covert cerebral injury, including silent cerebral infarctions and blood vessel tortuosity. However, even individuals without evidence of neuroanatomical changes in brain imaging have evidence of cognitive deficits compared to matched healthy controls likely due to chronic cerebral hypoxemia and neuroinflammation. In this review, we first examined the biological contributors to SCD-related neurological complications and then discussed the equally important socioenvironmental contributors. We then discuss the evidence for neuroprotection from the two primary disease-modifying therapies, chronic monthly blood transfusions and hydroxyurea, and end with several experimental therapies designed to specifically target these complications.
A Person-Centered Perspective on Physical Activity-Related Barriers Perceived by Male Fluctuators 50 Plus: A Cross-Sectional Study
Authors: Strobl Helmut , Herrmann-Johns Anne , Loss Julika , Hable Robert , Tittlbach Susanne
Published: September 2023

Men aged 50 or older (50 plus) represent a hard-to-reach target group for health-enhancing physical activity (PA) interventions. However, a considerable percentage of men 50 plus do not entirely fail to achieve the PA milestones set by the World Health Organization (WHO) guidelines. They show fluctuating PA behavior, influenced by various barriers hindering or preventing regular PA participation. As “one-size-fits-all” behavioral change interventions are only partially effective in specific subgroups, it is essential to tailor PA promotion measures to the particular needs of male fluctuators 50 plus. The standardized questionnaire included validated instruments measuring participants’ current stage of behavioral change, their perceived barriers to PA, questions on selected psychosocial correlates of PA, and sociodemographic variables. Out of 1,013 participants, 133 men (13.1%) classified themselves as fluctuators. Using a person-centered approach, we formed groups with similar intra-individual relevant barrier profiles using hierarchical cluster analysis (Ward method) followed by k-means clustering. We identified four clusters. Cluster 1 ( n = 31) involves men predominantly perceiving physical constraints. Cluster 2 ( n = 33) represents men lacking self-motivation and struggling with their weaker selves. Men in Cluster 3 ( n = 51) primarily indicate professional and private obligations that prevent them from being physically active. Finally, men in Cluster 4 ( n = 18) miss appropriate sports courses that meet their individual needs. Our findings support identifying individually tailored strategies designed to promote regular PA in male fluctuators 50 plus. Further research is required to determine the effectiveness of this approach in improving adherence to PA guidelines and corresponding health-enhancing effects for men 50 plus.
Insight and non-insight problem solving: A heart rate variability study
Authors: Stuyck Hans , Demeyer Febe , Bratanov Christo , Cleeremans Axel , Van den Bussche Eva
Published: September 2023

Occasionally, problems are solved with a sudden Aha! moment (insight), while the mundane approach to solving problems is analytical (non-insight). At first glance, non-insight appears to depend on the availability and taxation of cognitive resources to execute the step-by-step approach, whereas insight does not, or to a lesser extent. However, this remains debated. To investigate the reliance of both solution types on cognitive resources, we assessed the involvement of the prefrontal cortex using vagally mediated heart rate variability (vmHRV) as an index. Participants ( N = 68) solved 70 compound remote associates word puzzles solvable with insight and non-insight. Before, during, and after solving the word puzzles, we measured the vmHRV. Our results showed that resting-state vmHRV (trait) showed a negative association with behavioural performance for both solution types. This might reflect inter-individual differences in inhibitory control. As the solution search requires one to think of remote associations, inhibitory control might hamper rather than aid this process. Furthermore, we observed, for both solution types, a vmHRV increase from resting-state to solution search (state), lingering on in the post-task recovery period. This could mark the increase of prefrontal resources to promote an open-minded stance, essential for divergent thinking, which arguably is crucial for this task. Our findings suggest that, at a general level, both solution types share common aspects. However, a closer analysis of early and late solutions and puzzle difficulty suggested that metacognitive differentiation between insight and non-insight improved with higher trait vmHRV, and that a unique association between trait vmHRV and puzzle difficulty was present for each solution type.
Muscle redistribution technique for expressing motion intention in patients with wrist-level amputation
Authors: Yang Yong , Wang Qining , Wei Qipei
Published: September 2023

This study reports the preliminary results of a technique for redistributing muscles at the wrist in the stump of hand amputees by suturing the tendons to the dermis. The technique has the potential to improve control of hand prostheses by detecting movement intentions.
Preventing and treating delirium in clinical settings for older adults
Authors: Faeder Morgan , Hale Elizabeth , Hedayati Daniel , Israel Alex , Moschenross Darcy , Peterson Melanie , Peterson Ryan , Piechowicz Mariel , Punzi Jonathan , Gopalan Priya
Published: September 2023

Delirium is a serious consequence of many acute or worsening chronic medical conditions, a side effect of medications, and a precipitant of worsening functional and cognitive status in older adults. It is a syndrome characterized by fluctuations in cognition and impaired attention that develops over a short period of time in response to an underlying medical condition, a substance (prescribed, over the counter, or recreational), or substance withdrawal and can be multi-factorial. We present a narrative review of the literature on nonpharmacologic and pharmacologic approaches to prevention and treatment of delirium with a focus on older adults as a vulnerable population. Older adult patients are most at risk due to decreasing physiologic reserves, with delirium rates of up to 80% in critical care settings. Presentation of delirium can be hyperactive, hypoactive, or mixed, making identification and study challenging as patients with hypoactive delirium are less likely to come to attention in an inpatient or long-term care setting. Studies of delirium focus on prevention and treatment with nonpharmacological or medication interventions, with the preponderance of evidence favoring multi-component nonpharmacological approaches to prevention as the most effective. Though use of antipsychotic medication in delirium is common, existing evidence does not support routine use, showing no clear benefit in clinically significant outcome measures and with evidence of harm in some studies. We therefore suggest that antipsychotics be used to treat agitation, psychosis, and distress associated with delirium at the lowest effective doses and shortest possible duration and not be considered a treatment of delirium itself. Future studies may clarify the use of other agents, such as melatonin and melatonin receptor agonists, alpha-2 receptor agonists, and anti-epileptics.
Calcified deep somatic soft tissue leiomyoma of the leg: A case report
Authors: Senga Kazunori , Ikegami Masachika , Koiwa Sora , Takamiya Akihiro , Motoi Toru
Published: September 2023

Deep somatic soft tissue leiomyoma is a rare benign smooth muscle tumor, with around 60 cases reported thus far in the literature. Herein, we report a huge leiomyoma in deep somatic soft tissue with massive calcification in the peroneus longus muscle. A 29-year-old male patient presented with a hard, spindle-shaped, 15-cm-diameter mass of the left lower leg. Plain radiography showed marked calcification within the lesion, and magnetic resonance imaging revealed a well-circumscribed lesion with strong contrast enhancement within the peroneus longus. A core needle biopsy was performed to rule out a soft tissue sarcoma, and deep somatic soft tissue leiomyoma was preoperatively diagnosed. A marginal excision was performed, and the patient recovered without event and has been recurrence-free for 16 months. As far as we know, the present soft tissue leiomyoma was one of the largest to be documented, the previously reported cases being up to 14 cm in maximum diameter. Leiomyomas of deep somatic soft tissue should be included in the differential diagnosis of a huge, deep-seated tumor with marked calcification as well as sarcomas, especially in younger patients.
Purtscher-like retinopathy with serous macular detachment in a case of acute pancreatitis: A case report
Authors: Sharma Sadhana , Parajuli Sanket , Karki Pratap , Joshi Sagun Narayan
Published: September 2023

A 28-year-old male hospitalized with a diagnosis of acute pancreatitis presented with sudden onset of blurred vision in both eyes after 48 h of admission. Visual acuity was counting fingers in both eyes. Fundus examination revealed multiple cotton wool spots and intraretinal hemorrhages typical of Purtscher’s retinopathy. Optical coherence tomography macula showed serous macular detachment. In 8 weeks follow-up, visual acuity improved to 6/18 oculus dexter (OD) and 6/60 oculus sinister (OS) with resolution of fundus lesions and resorbed subretinal fluid. Purtscher-like retinopathy, though rare should be considered as a differential in all cases with vision loss in acute pancreatitis. This particular case highlights the significance of a thorough examination of the fundus by an ophthalmologist in identifying this infrequent condition that is often overlooked.