bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Circadian Rhythmicity and Photoperiodism in Closely Related Species of Blow Flies: External Coincidence, Maternal Induction, and Diapause at Northern Latitudes
Authors: Saunders David
Published: November 2021

This review compares adult locomotor activity rhythms and photoperiodic induction of diapause in 3 common species of blow fly, Calliphora vicina, Lucilia sericata, and Protophormia terraenovae. Activity rhythms were broadly similar in all 3 species, although P. terraenovae is much less sensitive to constant light inducing arrhythmicity. Photoperiodic induction of diapause, on the other hand, varies more widely between species. C. vicina and L. sericata overwinter in a larval diapause induced by autumnal short days (long nights) acting both maternally and directly upon the larvae. P. terraenovae, on the other hand, shows an adult (reproductive) diapause induced by short daylength and low temperature experienced by the larvae. In the Nanda-Hamner protocol, C. vicina shows 3 clear peaks of high diapause incidence in cycle lengths close to 24, 48, and 72 h, without dampening and therefore suggesting a photoperiodic mechanism based on a self-sustained circadian oscillator acting in a clock of the external coincidence type. Entrainment of the locomotor activity rhythm to extended Nanda-Hamner photocycles, as well as to LD cycles close to the limits of the primary range of entrainment, demonstrates that overt circadian rhythmicity may act as ‘hands’ of the otherwise covert photoperiodic system, as suggested by Bünning, nearly 8 decades ago. In 24 h LD cycles, both locomotor activity rhythms and the photoperiodic oscillator are set to constant phase (CT 12) at light-off, so that the photoperiodic clock measures changes in nightlength by the coincidence (or not) of dawn light with a ‘photoinducible phase’ late in the subjective night (at about CT 21.5 h) as photoperiod changes with the seasons. Apparent differences between quantitative and qualitative photoperiodic responses are discussed.
It Went Downhill From There: The Spillover Effect from Previous Customer Mistreatment on Frontline Employees’ Service Delivery
Authors: Yue Yumeng , Wang Karyn L. , Groth Markus
Published: November 2021

Research indicates that a customer’s service experience is shaped by their past experiences with the firm. However, the extent to which past experiences with customers shape frontline service employees’ delivery of services has not been examined. We propose that the analysis of service encounters as discrete, independent units ignores possible linkages between customer experiences via frontline employees. Adopting a resource spill-over perspective across two studies, we find that employees’ experience of customer mistreatment compromised their subsequent service delivery. Using an experiment in Study 1, we find that these effects are mediated by changes in the employee’s self-control capacity. Using a field sample in Study 2, we find that these effects are moderated by the employee’s dispositional self-control capacity and their motivation to commit to display rules. Our findings show how service encounter outcomes can be shaped by distal service events and call for a more holistic understanding of the forces that shape service encounter outcomes. In particular, by highlighting the potential consequences, our findings challenge conventional work protocols that compel employees to persevere despite their experience of mistreatment. By detailing the mediating and moderating mechanisms of mistreatment spill-over in service organizations, we highlight the recovery mechanisms and practices that enable FLEs to remain resilient despite negative encounters with customers.
Influence of different environments on the sliding friction of Ultra-high-molecular-weight polyethylene (UHMWPE)
Authors: Zivic Fatima , Adamovic Dragan , Mitrovic Slobodan , Grujovic Nenad , Tanaskovic Jovan , Stojadinovic Ivan
Published: November 2021

Dynamic friction coefficient (COF) of the reciprocating sliding contact of the conventional UHMWPE, was investigated in four different environments (dry contact; distilled water; pure Ringer's solution and with PMMA particles), at five values of low normal load (0.1–1 N) and three values of sliding speed (4 - 12 mm/s). Significant differences of COF values occurred at the lowest load (0.1 N), whereas sliding speed did not influence COF values. Addition of PMMA particles in Ringer's solution produced significant increase of COF values, especially at the lowest load of 0.1 N. For the dry contact and the highest load (1 N), steady state was reached shortly after the beginning of the test and friction coefficient had uniform behaviour. In the case of wet environment and the lowest load, steady state was not reached and the friction coefficient exhibited non-reproducible random behaviour. According to the Hertz theory, 0.5 N load corresponded to the elastic stress of 48.7 MPa, thus surpassing the values of the elastic limits, hardness and true yield stress of the UHMWPE, and the behaviour of the friction coefficient was drastically different below and above this load value. It can be assumed that below the 0.5 N load, viscoelastic response, accompanied with plastic deformation is dominant, with transition to mainly plastic deformation for the higher loads.
Roleplay, realpolitik and ‘great powerness’: the logical distinction between survival and social performance in grand strategy
Authors: Blagden David
Published: November 2021

States exist in an anarchic international system in which survival is the necessary precursor to fulfilling all of their citizens’ other interests. Yet states’ inhabitants – and the policymakers they empower – also hold social ideas about other ends that the state should value and how it should pursue them: the ‘role’ they expect their state to ‘play’ in international politics. Furthermore, such role-performative impulses can motivate external behaviours inimical to security-maximization – and thus to the state survival necessary for future interest-fulfilment. This article therefore investigates the tensions between roleplay and realpolitik in grand strategy. It does so through interrogation of four mutual incompatibilities in role-performative and realpolitikal understandings of ‘Great Powerness’, a core – but conceptually contested – international-systemic ordering unit, thereby demonstrating their necessary logical distinctiveness. The argument is illustrated with brief case studies on the United States, China, France, the United Kingdom, Germany and Japan. Identification of such security-imperilling role motives thus buttresses neoclassical realist theory; specifically, as an account of strategic deviation from the security-maximizing realist baseline. Such conclusions carry important implications for both scholarship and statecraft, meanwhile. For once we recognize that roleplay and realpolitik are necessarily distinct incentive structures, role motives’ advocates can no longer claim that discharging such performative social preferences necessarily bolsters survival prospects too.
“We always report under pressure”: Professionalism and journalistic identity among regional journalists in a conflict zone
Authors: Shah Sayyed Fawad Ali , Ginossar Tamar , Ittefaq Muhammad
Published: November 2021

This study explores how regional journalists in Pakistan conceptualize journalistic professionalism, how they perceive their journalistic identities, and how local socio-political and economic realities shape their professional identification. Analysis of interviews with 33 journalists working in Pakistan’s Pakhtunkhwa province indicated a tension between striving for professionalism as defined by Western journalistic standards and meeting the demands of their local conditions. Participants described professionalism as providing clear, accurate, objective, and ethical coverage of issues. However, constraints including unavailability of funding, the need to hold multiple jobs, threats to personal safety, and absence of education and training prevented them from meeting their professional goals. The journalists discursively negotiated and constituted their professional identities in response to the conditions in their respective areas.
The influence of work-family conflict on social worker job satisfaction
Authors: Jia Cindy Xinshan , Fu Chengzhe
Published: November 2021

The current study employed the Stress-Strain-Outcome model to understand the structural process of work support, work-family conflict (WFC), burnout, and job satisfaction among Chinese social workers. Using structural equation modeling, we employed a survey dataset of 1,414 social workers to estimate how burnout mediated the influences of work support and WFC on job satisfaction.

Findings

The results revealed that WFC directly promotes all three dimensions of burnout (i.e., depersonalization, emotional exhaustion, and reduced personal accomplishment), and indirectly impairs job satisfaction through the partial mediation of emotional exhaustion and reduced personal accomplishment, net of role stresses or other demographic characteristics. Work support eased burnout and promoted job satisfaction.

Applications

We highlight that WFC is a noteworthy job stressor impairing social workers’ vocational health. Possible initiatives to promote social support and prevent such stressors are recommended.
Intimate partner violence in Pakistan: Ethical implications in an emergency case
Authors: Khan Anum , Ahmed Fahad , Demir Müge , İlgili Önder
Published: November 2021

In developing countries, the patriarchal social construct, unsatisfactory legal protection, and underlying cultural bias against women have resulted in increasing intimate partner violence, which largely goes unaddressed, undocumented, and unreported in healthcare settings. This case study presents a common scenario of intimate partner violence and carefully analyzes its ethical implications in an emergency case at a tertiary care hospital in Karachi, Pakistan. In this study, basic ethical principles are used to discuss important ethical challenges faced daily by healthcare workers in the medical, social, and legal context. It further highlights the dire need of patient education, safety, and a solid framework for addressing, documenting, and reporting intimate partner violence for healthcare workers.
Higher Expression of WT1 With Lower CD58 Expression may be Biomarkers for Risk Stratification of Patients With Cytogenetically Normal Acute Myeloid Leukemia
Authors: Chen Cunte , Chen Zhuowen , Chio Chi Leong , Zhao Ying , Li Yongsheng , Liu Zhipeng , Jin Zhenyi , Wu Xiuli , Wei Wei , Zhao Qi , Li Yangqiu
Published: November 2021

Background: Cytogenetics at diagnosis is the most important prognostic factor for adult acute myeloid leukemia (AML), but nearly 50% of AML patients who exhibit cytogenetically normal AML (CN-AML) do not undergo effective risk stratification. Therefore, the development of potential biomarkers to further define risk stratification for CN-AML patients is worth exploring. Methods: Transcriptome data from 163 cases in the GSE12417-GPL96 dataset and 104 CN-AML patient cases in the GSE71014-GPL10558 dataset were downloaded from the Gene Expression Omnibus database for overall survival (OS) analysis and validation. Results: The combination of Wilms tumor 1 ( WT1) and cluster of diffraction 58 ( CD58) can predict the prognosis of CN-AML patients. High expression of WT1 and low expression of CD58 were associated with poor OS in CN-AML. Notably, when WT1 and CD58 were used to concurrently predict OS, CN-AML patients were divided into three groups: low risk, WT1low CD58high; intermediate risk, WT1high CD58high or WT1low CD58low; and high risk, WT1high CD58low. Compared with low-risk patients, intermediate- and high-risk patients had shorter survival time and worse OS. Furthermore, a nomogram model constructed with WT1 and CD58 may personalize and reveal the 1-, 2-, 3-, 4-, and 5-year OS rate of CN-AML patients. Both time-dependent receiver operating characteristics and calibration curves suggested that the nomogram model demonstrated good performance. Conclusion: Higher expression of WT1 with lower CD58 expression may be a potential biomarker for risk stratification of CN-AML patients. Moreover, a nomogram model constructed with WT1 and CD58 may personalize and reveal the 1-, 2-, 3-, 4-, and 5-year OS rates of CN-AML patients.
A Campus Adaptive Resolution Model Targeted at Yellow-Zone Behavior (Cultural Breaches)
Authors: Viveiros Nélia , Cook Theodosia , Rennison Callie Marie
Published: November 2021

The usual campus responses to identity-based discrimination (gender, race, ethnicity, and pregnancy, for example) fail in addressing less severe forms of identity-based discrimination by mimicking adversarial processes found in the criminal justice system, focusing on formal investigation processes to address alleged violations. We advance a model that repairs yellow-zone behavior (cultural breaches) and argue that higher education campuses must look beyond traditional compliance-only responses toward an adaptable resolution model (ARM) grounded in restorative and mediation practices. An ARM model can mitigate and reduce yellow-zone behavior (cultural breaches) and related institutional betrayal and addresses harmful power dynamics.
Novel Use of an Internal Distractor for Metacarpal Lengthening
Authors: Bashour Laura E. , Hill Charles , Frommer Sarah A. , Henry Steven L.
Published: November 2021

Background

In patients who have had proximal digit amputation, metacarpal distraction osteogenesis is an option to improve digital length and function. One drawback is that traditional external distraction devices are large and cumbersome; the option of a low-profile internal device is therefore appealing. Internal distractors are commonly used in craniofacial reconstruction, but use in the hand has not been reported. We describe a case series of the novel use of an internal distractor in metacarpal lengthening.

Methods

In this single-center case series, patients who underwent metacarpal distraction by the senior author using a uniplanar internal distractor were reviewed, and indications, outcomes, and complications were analyzed.

Results

There were 5 cases in 4 patients (age range: 7-33 years). Indications were traumatic amputation in 4 cases and congenital hypoplasia in 1. All were successfully distracted, with a mean final length gain of 1.3 cm (range: 1.0-1.7 mm). Mean time from device placement to consolidation was 3.5 months. Complications included activation arm site infection in 2 cases, both occurring after the distraction period, necessitating device removal before full consolidation. In these cases, the device was removed after the distraction period and replaced with a Kirschner wire for stabilization through the consolidation period.

Conclusions

Metacarpal distraction was successfully achieved with an internal distraction device. Although infection was common, it occurred after the distraction period and did not preclude length gain. We feel that this low-profile device offers advantages over cumbersome external devices typically used for metacarpal lengthening.
How Can We Make Hand Surgery Carbon Neutral?
Authors: Borg Tiffanie-Marie
Published: November 2021

Background

Climate change is a major public health threat worldwide. Operating theaters are responsible for extensive waste production due to the resource-intensive nature of surgery, including hand surgery.

Methods

An online literature search was performed to ascertain the approaches that surgeons may undertake to positively impact the environment.

Results

Surgeons can make hand surgery more carbon neutral through various measures that have been categorized as pre-, intra-, and postoperative interventions. With all changes, the aims are to minimize waste and costs while optimizing patient outcomes.

Conclusions

Administrative obstacles to implementing pro-climate hospital changes may be overcome by also considering likely cost benefits with many environmentally friendly measures. New measures in hand surgery should consider patient safety, clinical efficacy, cost effectiveness, and the environmental impact.
Nutrition for Hospital Workers During a Crisis: Effect of a Plant-Based Dietary Intervention on Cardiometabolic Outcomes and Quality of Life in Healthcare Employees During the COVID-19 Pandemic
Authors: Kahleova Hana , Berrien-Lopez Rickisha , Holtz Danielle , Green Amber , Sheinberg Rosanne , Gujral Harpreet , Holubkov Richard , Barnard Neal D.
Published: November 2021

The study tested the effects of a vegan diet on cardiometabolic outcomes and quality of life among healthcare employees during the COVID-19 pandemic. Overweight hospital employees were enrolled and randomly assigned (in a 1:1 ratio) to an intervention group, which was asked to follow a low-fat vegan diet, or a control group, asked to make no diet changes. However, due to COVID-19 disruptions, all participants remained on their usual diets from March to June (12 weeks), creating a de facto control period, and all (n = 12) started the vegan diet with online classes in June, which continued for 12 weeks. Nine participants completed all final assessments. A crossover ANOVA was used for statistical analysis of differences in cardiovascular health during the control period and during the intervention. Despite the ongoing crisis, body weight decreased (treatment effect −5.7 kg [95% CI −9.7 to −1.7]; P = .01); fasting plasma glucose decreased (−11.4 mg/dL [95% CI −18.8 to −4.1]; P = .007); total and LDL-cholesterol decreased (−30.7 mg/dL [95% CI −53.8 to −7.5]; P = .02; and −24.6 mg/dL [−44.8 to −4.3]; P = .02, respectively); diastolic blood pressure decreased (−8.5 mm Hg [95% CI −16.3 to −.7]; P = .03); and quality of life increased ( P = .005) during the intervention period, compared with the control period. A vegan diet improved cardiometabolic outcomes and quality of life in healthcare workers at the height of the COVID-19 pandemic.
Conducting Cross-Cultural, Multi-Lingual and Multi-Country Focus Groups: Guidance for Researchers
Authors: Pinto da Costa Mariana
Published: November 2021

Conducting cross-cultural, multi-lingual and multi-country focus groups represents unique logistic and analytical challenges. However, there is little guidance for the necessary considerations required for such international focus groups. Based on the author’s experience of conducting such research, this publication documents the different stages of planning, fieldwork, analysis and dissemination, and how to mitigate possible challenges and overcome them. It is essential to set up an adequate research team with the linguist and cultural background required. All researchers should have the necessary training in qualitative methods and follow a standardised approach in the facilitation of focus groups across the different countries and in the analysis of the data, ideally in their original languages.
Connecting Theory to Methods in Longitudinal Research
Authors: Hopwood Christopher J. , Bleidorn Wiebke , Wright Aidan G. C.
Published: November 2021

Advances in methods for longitudinal data collection and analysis have prompted a surge of research on psychological processes. However, decisions about how to time assessments are often not explicitly tethered to theories about psychological processes but are instead justified on methodological (e.g., power) or practical (e.g., feasibility) grounds. In many cases, methodological decisions are not explicitly justified at all. The disconnect between theories about processes and the timing of assessments in longitudinal research has contributed to misspecified models, interpretive errors, mixed findings, and nonspecific conclusions. In this article, we argue that higher demands should be placed on researchers to connect theories to methods in longitudinal research. We review instances of this disconnect and offer potential solutions as they pertain to four general questions for longitudinal researchers: how time should be scaled, how many assessments are needed, how frequently assessments should occur, and when assessments should happen.
Comprehensive analysis of prognostic value of lymph node classifications in esophageal squamous cell carcinoma: a large real-world multicenter study
Authors: Wen Junmiao , Chen Jiayan , Chen Donglai , Jabbour Salma K. , Xue Tao , Guo Xufeng , Ma Haitao , Ye Fei , Mao Yiming , Shu Jian , Liu Yangyang , Lu Xueguan , Zhang Zhen , Chen Yongbing , Fan Min
Published: November 2021

Background:

We aim to assess the prognostic ability of three common lymph node–based staging algorithms, namely, the number of positive lymph nodes (pN), the lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) in patients with esophageal squamous cell carcinoma (ESCC).

Methods:

A total of 3902 ESCC patients treated at 10 Chinese institutions between 2003 and 2013 were included, along with 2465 patients from the Surveillance, Epidemiology, and End Results (SEER) database. The prognostic ability of the aforementioned algorithms was evaluated using time-dependent receiver operating characteristic (tdROC) curves, R2, Harrell’s concordance index (C-index), and the likelihood ratio chi-square score. The primary outcomes included cancer-specific survival (CSS), overall survival (OS), and CSS with a competing risk of death by non-ESCC causes.

Results:

LODDS had better prognostic performance than pN or LNR in both continuous and stratified patterns. In the multicenter cohort, the multivariate analysis showed that the model based on LODDS classification was superior to the others in predictive accuracy and discriminatory capacity. Two nomograms integrating LODDS classification and other clinicopathological risk factors associated with OS as well as cancer-specific mortality were constructed and validated in the SEER database. Finally, a novel TNLODDS classification which incorporates the LODDS classification was built and categorized patients in to three new stages.

Conclusion:

Among the three lymph node–based staging algorithms, LODDS demonstrated the highest discriminative capacity and prognostic accuracy for ESCC patients. The nomograms and novel TNLODDS classification based on LODDS classification could serve as precise evaluation tools to assist clinicians in estimating the survival time of individual patients and improving clinical outcomes postoperatively in the future.
Fear of COVID-19 and Its Association With Health Literacy in Elderly Patients
Authors: Yağar Fedayi
Published: November 2021

One of the groups most negatively affected by the epidemic process has been the elderly patients. In this process, it is of great importance to determine the fear levels of the patients and to evaluate the factors that may be related. With this approach, this study aimed to examine the relationship between the fear of COVID-19 and health literacy scores of elderly patients living in Kahramanmaraş City, Turkey. Another aim of the study was to investigate whether the participants’ COVID-19 fear change according to various socio-demographic characteristics. The convenience sampling method were used and 266 of valid samples were collected. Descriptive statistics, t-test, ANOVA, Pearson correlation analysis, simple and multiple linear regression analysis techniques were used. The results obtained from the study showed that COVID-19 fear status of the participants were moderate while the health literacy scores were low. Higher health literacy was associated with lower fear of COVID-19. In addition, it was determined that the fear of COVID-19 showed statistically significant differences according to education level, insurance status, smoking status, follow the news status and marital status. As a result, it has been observed that the level of health literacy can be effective in protecting elderly patients from fear. Longitudinal studies have been proposed to determine whether this relationship is causal or not.
Seeking healthcare services post-stroke: a qualitative descriptive study exploring family caregiver and stroke survivor perspectives in an asian setting
Authors: Tyagi Shilpa , Luo Nan , Tan Chuen Seng , Tan Kelvin Bryan , Tan Boon Yeow , Menon Edward , Venketasubramanian N. , Loh Wei Chin , Fan Shu Hui , Yang Kenneth Lam Thuan , Chan Audrey Swee Ling , Farwin Aysha , Lukman Zunairah Binti , Koh Gerald Choon-Huat
Published: November 2021

Aim

Exploration of the healthcare journey post-stroke is incomplete without acknowledging the crucial role of family caregivers. With limited literature documenting the role of caregivers in the healthcare journey post-stroke, we aimed to describe the healthcare experiences of family caregivers and stroke survivors across different caregiver identities in Singapore.

Methods

We conducted a qualitative descriptive study involving semi-structured interviews with transcripts analysed using thematic analysis. 26 stroke survivors and 35 family caregivers purposively sampled from multiple settings.

Results

Findings were summarized into seeking care and experience of healthcare encounters. Seeking care comprised of the following themes: factors influencing seeking care, decision to seek care and role of caregiver in seeking care. Experience of healthcare encounters comprised of the following themes: service around the patient, service with care and role of caregiver in healthcare encounters.

Conclusion

Multi-dimensional role of caregivers in healthcare experience emerged as a major finding. Unique to our Asian context, as per the participants’ accounts, family caregivers seemed to be central in healthcare decision-making for stroke survivors, with adult-child caregivers commonly reported being engaged in collaborative decision-making. While spousal caregivers preferred a relational healthcare experience, adult-child caregivers preferred a transactional one. Practical implications include equipping caregivers with skillset to make healthcare decisions, provision of supportive decision-making environment for caregivers and reinforcing communication aspects in the medical, nursing and allied healthcare curriculum to improve healthcare experience.
Pattern of internet use for pregnancy-related information and its predictors among women visiting primary healthcare in Qatar: a cross-sectional study
Authors: Al-Dahshan Ayman , Chehab Mohamad , Mohamed Ayatullah , Al-Kubaisi Noora , Selim Nagah
Published: November 2021

Background

Internet usage has been steadily increasing and the available online information for pregnant women today is immense.

Objective

This study aimed to investigate the prevalence of women who search for information relating to pregnancy on the internet and to identify predictors of this behavior among expecting women visiting primary health care (PHC) centers in Qatar.

Methods

A cross-sectional study was conducted at the antenatal clinics of six PHC centers in Qatar from June 1 to December 31, 2019. Pregnant women were recruited through a systematic random sampling technique. Participants were interviewed using a structured questionnaire. Descriptive and analytic statistics were used when appropriate. A multivariable logistic regression analysis was constructed to identify the predictors of internet use for pregnancy-related information.

Results

The study included 403 pregnant women (response rate: 87.9%). Most of them were in the 26–35 years age category (71.5%), in the second trimester (55.5%), and had 1–2 children at home (51.5%). The internet was the most common source (81.1%) of pregnancy-related information. The access to online information was mainly through websites (67.3%), mobile applications (48.3%), and social media platforms (39.7%). The most frequently searched topics online were fetal development (74.3%), diet during pregnancy (53.6%), and management of health problems (39.6%). The multivariable regression model identified the age group 26–35 years (AOR: 4.93; 95% CI: 2.14, 11.38), Arabs (AOR: 4.12; 95% CI: 2.03, 8.36), tertiary education (AOR: 5.22; 95% CI: 1.78, 15.33), being a housewife (AOR: 6.37; 95% CI: 1.44, 28.19), or employed (AOR: 5.56 95% CI: 1.31, 23.63), and having up to 2 children as independent predictors of internet use for pregnancy-related information.

Conclusion

The internet was a commonly used source of health information among pregnant women in Qatar. Internet use was significantly associated with the age group of 26–35 years, Arabs, higher level of education, being employed or a housewife, and having up to two children.
Optimum design of reference points distribution in three-dimensional reconstruction of dental model in intercuspal position
Authors: Wu Yujia , Hu Zhewen , Zhang Xinyue , Bai Hefei , Sun Yuchun , Fan Baolin
Published: November 2021

Purpose

The scanning of plaster models for three-dimensional (3D) construction requires their rigid fixation in the intercuspal position. Factors such as installation, motion, and scanning procedures influenced the accuracy of this method, which ultimately influence the results. Therefore, the present study attempted to provide an optimal and accurate method with less complex procedures and a more accessible equipment for determining the intercuspal relation in the 3D occlusal construction of dental models.

Methods

A pair of plastic mounting plates that could be directly attached to a mechanical articulator was designed and 3D printed. Nine axial hemispherical concaves were introduced on the axial surface of each plate. The rigidly fixed maxillary and mandibular dental models were scanned directly. The distances DR between nine pairs of concaves on both mounting plates adhered to the maxillary and mandibular sections of the articulator were measured using the three-coordinate measuring machine Faro Edge as the reference. The present study comprised seven test groups varying in number and location. Assessing the reference points from each of the seven groups performed the 3D construction. The Geomagic Studio software was used to construct the concaves of digital casts, and the distances DM between the pairs of concaves were measured as test values. Variable differences between DR and DM were analyzed.

Results

An optimum distribution scheme was obtained for reference point registration by quantitatively evaluating accuracy levels of the 3D constructions of different reference point distribution patterns. This scheme can serve as a reference for related studies and dental clinic operations.

Conclusions

Three-dimensional construction of the intercuspal relation during scanning of the maxillary and mandibular models with an accuracy of 0.046 mm ± 0.009 mm can be achieved using the improved design of mounting plates.
A survey of cancer care institutions in Nepal to inform design of a pain management mobile application
Authors: LeBaron Virginia , Adhikari Abish , Bennett Rachel , Chapagain Acharya Sandhya , Dhakal Manita , Elmore Catherine E. , Fitzgibbon Kara , Gongal Rajesh , Kattel Regina , Koirala Ganesh , Maurer Martha , Munday Daniel , Neupane Bijay , Sagar Sharma Krishna , Shilpakar Ramila , Shrestha Sudip , Thapa Usha , Zhang Hexuan , Dillingham Rebecca , Dutta Paudel Bishnu
Published: November 2021

Background

One way to improve the delivery of oncology palliative care in low and middle-income countries (LMICs) is to leverage mobile technology to support healthcare providers in implementing pain management guidelines (PMG). However, PMG are often developed in higher-resourced settings and may not be appropriate for the resource and cultural context of LMICs.

Objectives

This research represents a collaboration between the University of Virginia and the Nepalese Association of Palliative Care (NAPCare) to design a mobile health application (‘app’) to scale-up implementation of existing locally developed PMG.

Methods

We conducted a cross-sectional survey of clinicians within Nepal to inform design of the app. Questions focused on knowledge, beliefs, and confidence in managing cancer pain; barriers to cancer pain management; awareness and use of the NAPCare PMG; barriers to smart phone use and desired features of a mobile app.

Findings

Surveys were completed by 97 palliative care and/or oncology healthcare providers from four diverse cancer care institutions in Nepal. 49.5% (n = 48) had training in palliative care/cancer pain management and the majority (63.9%,n = 62) reported high confidence levels (scores of 8 or higher/10) in managing cancer pain. Highest ranked barriers to cancer pain management included those at the country/cultural level, such as nursing and medical school curricula lacking adequate content about palliative care and pain management, and patients who live in rural areas experiencing difficulty accessing healthcare services (overall mean = 6.36/10). Most nurses and physicians use an Android Smart Phone (82%,n = 74), had heard of the NAPCare PMG (96%,n = 88), and reported frequent use of apps to provide clinical care (mean = 6.38/10,n = 92). Key barriers to smart phone use differed by discipline, with nurses reporting greater concerns related to cost of data access (70%,n = 45) and being prohibited from using a mobile phone at work (61%;n = 39).

Conclusions

Smart phone apps can help implement PMG and support healthcare providers in managing cancer pain in Nepal and similar settings. However, such tools must be designed to be culturally and contextually congruent and address perceived barriers to pain management and app use.
Cumulative risk exposure and emotional symptoms among early adolescent girls
Authors: Demkowicz Ola , Panayiotou Margarita , Humphrey Neil
Published: November 2021

Background

From early adolescence, girls and women report the highest rates of emotional symptoms, and there is evidence of increased prevalence in recent years. We investigate risk factors and cumulative risk exposure (CRE) in relation to emotional symptoms among early adolescent girls.

Methods

We used secondary data analysis, drawing on data capturing demographic information and self-reported emotional symptoms from 8327 girls aged 11–12 years from the 2017 baseline data collection phase of the HeadStart evaluation. We used structural equation modelling to identify risk factors in relation to self-reported emotional symptoms, and collated this into a CRE index to investigate associations between CRE and emotional symptoms.

Results

Four risk factors were found to have a statistically significant relationship with emotional symptoms among early adolescent girls: low academic attainment, special educational needs, low family income, and caregiving responsibilities. CRE was positively associated with emotional symptoms, with a small effect size.

Conclusions

Results identify risk factors (outlined above) that are associated with emotional symptoms among early adolescent girls, and highlight that early adolescent girls experiencing a greater number of risk factors in their lives are likely to also experience greater emotional distress. Findings highlight the need for identification and targeted mental health intervention (e.g., individual or group counselling, approaches targeting specific symptoms), for those facing greater risk and/or with emergent symptoms.
Factors affecting retention in the Philippine National Rural Physician Deployment Program from 2012 to 2019: a mixed methods study
Authors: Flores Erika Louise L. , Manahan Edric Matthew R. , Lacanilao Miguel Paulo B. , Ladaw Isabella Ma. Beatriz T. , Mallillin Mico Martin B. , Mappatao Nikolai Thadeus Q. , Leonardia Juan Alfonso , Pepito Veincent Christian F.
Published: November 2021

Background

To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment.

Methods

A descriptive, mixed-methods, explanatory design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically.

Results

102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities.

Conclusions

A host of individual, work-related, local, national, and international factors influence the DTTB’s decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.
Bayesian modelling of population trends in alcohol consumption provides empirically based country estimates for South Africa
Authors: Cois Annibale , Matzopoulos Richard , Pillay-van Wyk Victoria , Bradshaw Debbie
Published: November 2021

Background

Alcohol use has widespread effects on health and contributes to over 200 detrimental conditions. Although the pattern of heavy episodic drinking independently increases the risk for injuries and transmission of some infectious diseases, long-term average consumption is the fundamental predictor of risk for most conditions. Population surveys, which are the main source of data on alcohol exposure, suffer from bias and uncertainty. This article proposes a novel triangulation method to reduce bias by rescaling consumption estimates by sex and age to match country-level consumption from administrative data.

Methods

We used data from 17 population surveys to estimate age- and sex-specific trends in alcohol consumption in the adult population of South Africa between 1998 and 2016. Independently for each survey, we calculated sex- and age-specific estimates of the prevalence of drinkers and the distribution of individuals across consumption categories. We used these aggregated results, together with data on alcohol production, sales and import/export, as inputs of a Bayesian model and generated yearly estimates of the prevalence of drinkers in the population and the parameters that characterise the distribution of the average consumption among drinkers.

Results

Among males, the prevalence of drinkers decreased between 1998 and 2009, from 56.2% (95% CI 53.7%; 58.7%) to 50.6% (49.3%; 52.0%), and increased afterwards to 53.9% (51.5%; 56.2%) in 2016. The average consumption from 52.1 g/day (49.1; 55.6) in 1998 to 42.8 g/day (40.0; 45.7) in 2016. Among females the prevalence of current drinkers rose from 19.0% (17.2%; 20.8%) in 1998 to 20.0% (18.3%; 21.7%) in 2016 while average consumption decreased from 32.7 g/day (30.2; 35.0) to 26.4 g/day (23.8; 28.9).

Conclusions

The methodology provides a viable alternative to current approaches to reconcile survey estimates of individual alcohol consumption patterns with aggregate administrative data. It provides sex- and age-specific estimates of prevalence of drinkers and distribution of average daily consumption among drinkers in populations. Reliance on locally sourced data instead of global and regional trend estimates better reflects local nuances and is adaptable to the inclusion of additional data. This provides a powerful tool to monitor consumption, develop burden of disease estimates and inform and evaluate public health interventions.
Chromosomal integration of Tn5253 occurs downstream of a conserved 11-bp sequence of the rbgA gene in Streptococcus pneumoniae and in all the other known hosts of this integrative conjugative element (ICE)
Authors: Santoro Francesco , Fox Valeria , Romeo Alessandra , Lazzeri Elisa , Pozzi Gianni , Iannelli Francesco
Published: November 2021

Background

Tn5253, a composite Integrative Conjugative Element (ICE) of Streptococcus pneumoniae carrying tet(M) and cat resistance determinants, was found to (i) integrate at specific 83-bp integration site (attB), (ii) produce circular forms joined by a 84-bp sequence (attTn), and (iii) restore the chromosomal integration site. The purpose of this study is to functionally characterize the attB in S. pneumoniae strains with different genetic backgrounds and in other bacterial species, and to investigate the presence of Tn5253 attB site into bacterial genomes.

Results

Analysis of representative Tn5253-carryng transconjugants obtained in S. pneumoniae strains with different genetic backgrounds and in other bacterial species, namely Streptococcus agalactiae, Streptococcus gordonii, Streptococcus pyogenes, and Enterococcus faecalis showed that: (i) Tn5253 integrates in rbgA of S. pneumoniae and in orthologous rbgA genes of other bacterial species, (ii) integration occurs always downstream of a 11-bp sequence conserved among streptococcal and enterococcal hosts, (iii) length of the attB site corresponds to length of the duplication after Tn5253 integration, (iv) attB duplication restores rbgA CDS, (v) Tn5253 produced circular forms containing the attTn site at a concentration ranging between 2.0 × 10−5 to 1.2 × 10−2 copies per chromosome depending on bacterial species and strain, (vi) reconstitution of attB sites occurred at 3.7 × 10−5 to 1.7 × 10−2 copies per chromosome. A database search of complete microbial genomes using Tn5253 attB as a probe showed that (i) thirteen attB variants were present in the 85 complete pneumococcal genomes, (ii) in 75 pneumococcal genomes (88.3 %), the attB site was 83 or 84 nucleotides in length, while in 10 (11.7 %) it was 41 nucleotides, (iii) in other 19 bacterial species attB was located in orthologous rbgA genes and its size ranged between 17 and 84 nucleotides, (iv) the 11-bp sequence, which correspond to the last 11 nucleotides of attB sites, is conserved among the different bacterial species and can be considered the core of the Tn5253 integration site.

Conclusions

A functional characterization of the Tn5253 attB integration site combined with genome analysis contributed to elucidating the potential of Tn5253 horizontal gene transfer among different bacterial species.
Evaluation method of node importance in temporal satellite networks based on time slot correlation
Authors: Xu Rui , Di Xiaoqiang , He Xiongwen , Qi Hui
Published: November 2021

Temporal satellite networks can accurately describe the dynamic process of satellite networks by considering the interaction relationship and interaction sequence between satellite nodes. In addition, the measurement of node importance in satellite networks plays a crucial role in understanding the structure and function of the network. The classical supra-adjacency matrix (SAM) temporal model identifies the key nodes in the temporal network to some extent, which ignores the differences of inter-layer connectivity relationships leading to the inability to reflect the dynamic variations of satellite nodes. Therefore, the evaluation method based on time slot correlation is proposed to measure the importance of satellite nodes in this paper. Firstly, the correlation coefficient of time slot nodes is defined to measure the coupling relationship of adjacent time slots. Secondly, the dynamic supra-adjacency matrix (DSAM) temporal network model is proposed considering the correlation between adjacent time slots and the characteristics of link time. Finally, the node importance ranking results in each time slot and a global perspective are obtained by utilizing the eigenvector centrality. Experimental simulations of the Iridium and Orbcomm constellations demonstrate that the DSAM method has a relatively accurate recognition rate and high stability.
On iterative techniques for estimating all roots of nonlinear equation and its system with application in differential equation
Authors: Shams Mudassir , Rafiq Naila , Kausar Nasreen , Agarwal Praveen , Park Choonkil , Mir Nazir Ahmad
Published: November 2021

In this article, we construct a family of iterative methods for finding a single root of nonlinear equation and then generalize this family of iterative methods for determining all roots of nonlinear equations simultaneously. Further we extend this family of root estimating methods for solving a system of nonlinear equations. Convergence analysis shows that the order of convergence is 3 in case of the single root finding method as well as for the system of nonlinear equations and is 5 for simultaneous determination of all distinct and multiple roots of a nonlinear equation. The computational cost, basin of attraction, efficiency, log of residual and numerical test examples show that the newly constructed methods are more efficient as compared to the existing methods in literature.
Designing for circular fashion: integrating upcycling into conventional garment manufacturing processes
Authors: Aus Reet , Moora Harri , Vihma Markus , Unt Reimo , Kiisa Marko , Kapur Sneha
Published: November 2021

This paper summarises the results of a more than 5-year practice-led study on the use of upcycling design and production methods in garment mass production. The efficiency of upcycling design approach is described by analysing the generation and potential use of various types of fabric leftovers from garment manufacturing. The results of this research show that depending on the size of the factory the fabric leftovers and textile waste generated in garment production ranges from 25–40% of the total fabric used. Experiments show that 50% of that material can be upcycled into new garments and for some types of leftover—mainly spreading loss and excess fabric—it can even be up to 80%. Implementing upcycling on the industrial level requires transparency to understand the waste created in garment production and create designs that suite the production system. It is important to consider that the upcycling design process differs from regular design—a garment is designed based on the parameters of the waste materials.