bluuebunny/crossref_metadata_2025 huggingface dataset:
Library café or elsewhere: usage of study space by different majors under contemporary technological environment
Authors: Zhou Jiafeng , Lam Ernest , Au Cheuk Hang , Lo Patrick , Chiu Dickson K.W.
Published: September 2021

Purpose

As current university students may access information for their study anytime, anywhere with ubiquitous mobile technologies, this research re-examines the roles of study space in students' learning and campus life.

Design/methodology/approach

A survey was conducted to collect students' opinions and habits regarding the usage of different study spaces. Results in three different academic majors (science and engineering, arts and business) of a comprehensive international university were compared.

Findings

The authors’ findings showed a more diversified space usage among students, with the library café increasingly important in students' learning and life while learning commons remain important. However, there were only minor differences among these three study majors towards the learning and entertaining spaces, as these students generally apply inquiry-based learning.

Originality/value

While some researches have investigated students' usage of university and library learning spaces, few studies have focused on the study space issue in Hong Kong or other metropolises in the East under the current mobile learning environment. This study's insights could help libraries and universities improve the management of their physical spaces to meet student needs.
Professionals harnessing experiential knowledge in Dutch mental health settings
Authors: Karbouniaris Simona , Weerman Alie , Dunnewind Bea , Wilken Jean Pierre , Abma Tineke A.
Published: September 2021

Purpose

This study aims to explore the perspectives of mental health professionals who are in a process of integrating their own experiential knowledge in their professional role. This study considers implications for identity, dilemmas and challenges within the broader organization, when bringing experiential knowledge to practice.

Design/methodology/approach

As part of a participatory action research approach, qualitative methods have been used, such as in-depth interviews, discussions and observations during training and project team.

Findings

The actual use of experiential knowledge by mental health care professionals in their work affected four levels: their personal–professional development; the relation with service users; the relation with colleagues; and their position in the organization.

Research limitations/implications

Because of its limited context, this study may lack generalisability and further research with regard to psychologists and psychiatrists, as well as perceptions from users, is desirable.

Social implications

According to this study, social change starts from a bottom-up movement and synchronously should be facilitated by top-down policy. A dialogue with academic mental health professionals seems crucial to integrate this source of knowledge. Active collaboration with peer workers and supervisors is desired as well.

Originality/value

Professionals with lived experiences play an important role in working recovery-oriented, demonstrating bravery and resilience. Having dealt with mental health distress, they risked stigma and rejections when introducing this as a type of knowledge in current mental health service culture. Next to trainings to facilitate the personal–professional process, investments in the entire organization are needed to transform governance, policy and ethics.
Consumer values, online purchase behaviour and the fashion industry: an emerging market context
Authors: Adeola Ogechi , Moradeyo Adenike Aderonke , Muogboh Obinna , Adisa Isaiah
Published: September 2021

Purpose

This study examines consumer online purchase behaviour in the Nigerian fashion industry.

Design/methodology/approach

A cross-sectional study was conducted with a total useable sample size of 241 respondents contacted through on-site visitation. Descriptive and inferential statistics were used to test the influence of customer value on online purchase behaviour in the fashion industry.

Findings

Consumer values are categorised into terminal (happiness, love and satisfaction) and instrumental (time-saving, price-saving discount, service convenience and merchandise assortment) values. The findings show that both values have significant influence on online consumer purchase behaviour, while fashion consciousness moderates the relationship between consumer values and online purchase behaviour.

Practical implications

Online fashion retailers should focus on increasing the terminal and instrumental values of their products and making available goods that meet the needs of different generational cohorts in society.

Originality/value

Studies have examined various factors, for example, consumer values that are determinants of consumer online purchase in the fashion industry; however, there has been limited focus on the nature of fashion and online purchasing in emerging markets, particularly those in Sub-Saharan Africa.
Caves, crevices and cooling capacity: Roost microclimate predicts heat tolerance in bats
Authors: Czenze Zenon J. , Smit Ben , van Jaarsveld Barry , Freeman Marc T. , McKechnie Andrew E.
Published: September 2021

The microsites that animals occupy during the rest phase of their circadian activity cycle influence their physiology and behaviour, but relatively few studies have examined correlations between interspecific variation in thermal physiology and roost microclimate. Among bats, there is some evidence that species exposed to high roost temperatures (Troost) possess greater heat tolerance and evaporative cooling capacity, but the small number of species for which both thermal physiology and roost microclimate data exist mean that the generality of this pattern remains unclear.

Here, we test the hypothesis that bat heat tolerance and evaporative cooling capacity have co‐evolved with roost preferences. We predicted that species occupying roosts poorly buffered from high outside environmental temperature exhibit higher heat tolerance and evaporative cooling capacity compared to species inhabiting buffered roosts in which Troost remains well below outside conditions.

We used flow‐through respirometry to investigate thermoregulation at air temperatures (Ta) approaching and exceeding normothermic body temperature (Tb) among six species with broadly similar body mass but differing in roost microclimate (hot vs. cool roosts). We combined these data with empirical measurements of Troost for each study population.

Hot‐roosting species tolerated Ta ~4°C higher than cool‐roosting bats before the onset of loss of coordinated locomotion and non‐regulated hyperthermia. The evaporative scope (i.e. ratio of maximum evaporative water loss [EWL] to minimum thermoneutral EWL) of hot‐roosting species (16.1 ± 2.4) was substantially higher than that of cool‐roosting species (5.9 ± 2.4). Maximum evaporative cooling capacities (i.e. evaporative heat loss/metabolic heat production) of hot‐roosting species were >2, while the corresponding values for cool‐roosting species were ≤1.

The greater heat tolerance and higher evaporative cooling capacity of hot‐roosting species compared with those occupying cooler roosts reveal variation in bat evaporative cooling capacity correlated with roost microclimate, supporting the hypothesis that thermal physiology has co‐evolved with roost preference.

A free Plain Language Summary can be found within the Supporting Information of this article.
Endorsement of stereotypes of older adults, older men, and male leaders predict expected job performance, voting stance, and voting intentions in the 2020 U.S. presidential election
Authors: Monahan Caitlin , Lytle Ashley , Inman Elizabeth , Apriceno Marybeth , Macdonald Jamie , Levy Sheri R.
Published: September 2021

The 2020 U.S. Presidential Election offered a unique opportunity to examine how stereotypes of older adults, older men, and male leaders impact expectations of candidate job performance and intentions to vote for Biden or Trump. This online study involved 500 college students from two universities from September 30th until November 3 (Election Day). A Biden model and a Trump model were tested for the relationships among (a) stereotypes from public discourse with (b) expectations of candidates/ presidential performance with (c) voting stance (pro‐ and anti‐Biden vs. pro‐ and anti‐Trump) and (d) intentions to vote for Biden/Trump. As expected, for the Biden model, endorsement of older adult (lesser endorsement of senile, unhealthy), male leadership (greater endorsement of assertive and collaborative, lesser endorsement of uncaring), and older male stereotypes (greater endorsement of elder statesman and family‐focused) predicted greater expectations of Biden's performance, which predicted pro‐Biden and anti‐Trump stances and ultimately voting intentions for Biden. As expected, for the Trump model, endorsement of older adult (lesser endorsement of senile), male leadership (greater endorsement of assertive, collaborative, lesser endorsement of immoral and uncaring), and older male stereotypes (greater endorsement of elder statesman) predicted greater expectations of Trump's performance, which predicted pro‐Trump and anti‐Biden stances and ultimately voting intentions for Trump. Taken together, these results suggest examining relevant categories of stereotypes associated with candidates and voting stances provides a fuller picture of voting behavior toward multiple candidates vying for office in addition to political ideology and voting intentions.
The rise of deep learning and transformations in bioactivity prediction power of molecular modeling tools
Authors: Bule Mohammed , Jalalimanesh Nafiseh , Bayrami Zahra , Baeeri Maryam , Abdollahi Mohammad
Published: September 2021

The search and design for the better use of bioactive compounds are used in many experiments to best mimic compounds' functions in the human body. However, finding a cost‐effective and timesaving approach is a top priority in different disciplines. Nowadays, artificial intelligence (AI) and particularly deep learning (DL) methods are widely applied to improve the precision and accuracy of models used in the drug discovery process. DL approaches have been used to provide more opportunities for a faster, efficient, cost‐effective, and reliable computer‐aided drug discovery. Moreover, the increasing biomedical data volume in areas, like genome sequences, medical images, protein structures, etc., has made data mining algorithms very important in finding novel compounds that could be drugs, uncovering or repurposing drugs and improving the area of genetic markers‐based personalized medicine. Furthermore, deep neural networks (DNNs) have been demonstrated to outperform other techniques such as random forests and SVMs for QSAR studies and ligand‐based virtual screening. Despite this, in QSAR studies, the quality of different data sources and potential experimental errors has greatly affected the accuracy of QSAR predictions. Therefore, further researches are still needed to improve the accuracy, selectivity, and sensitivity of the DL approach in building the best models of drug discovery.
Educational concerns and awareness level among dental hygiene students during the COVID‐19 pandemic
Authors: Mutluay Abidin Talha , Mutluay Merve
Published: September 2021

Objective

This study aimed to evaluate the educational concerns and awareness level among dental hygiene students during the COVID‐19 pandemic.

Materials and Methods

A questionnaire, created via Google Forms, was sent electronically to 240 dental hygiene students from Turkey, of which 223 replied to the survey. The questionnaire was divided into 4 parts and consisted of 24 close‐ended questions.

Results

The main symptoms of COVID‐19 were correctly recognized by 71% of the students, and 40.2% of the students were aware of the transmission routes. Of all, 77.1% of the students expressed fear of getting infected, 96.9% believed that they would more likely get infected while performing dental procedures, and 91% believed that dental hygienists’ cross‐contamination risk was high. Furthermore, 69.5% of the students stated that their undergraduate education process was negatively affected, 59.6% appreciated ongoing online education, and 31.8% wanted face‐to‐face clinical internships.

Conclusions

Although most of the students were aware of the transmission routes and preventive measures of COVID‐19, concerns regarding disease transmission among them remain. Students appreciated the ongoing online education and believed that face‐to‐face education is risky during this current pandemic. However, they believe that this process can adversely affect their professional knowledge and especially practical skills. A balance must be struck between sustaining an effective dental hygiene education process and containing the spread of COVID‐19.
Indispensable role of mitochondria in maintaining the therapeutic potential of curcumin in acute kidney injury
Authors: Li Ling , Liu Shuyun , Zhou Yijie , Zhao Meng , Wang Yizhuo , Wang Chengshi , Lou Peng , Huang Rongshuang , Ma Liang , Lu Yanrong , Fu Ping , Liu Jingping
Published: September 2021

Acute kidney injury (AKI) is a serious disease for which effective therapeutic agents are required. The capacity of curcumin (CUR) to resolve renal inflammation/oxidative stress and mitochondrial damage has been reported, but crosstalk between these effects and the consequence of this crosstalk remain elusive. In this study, a hypoxia/reoxygenation (H/R)‐induced renal tubular epithelial cell (TEC) injury model and an ischaemia/reperfusion (I/R)‐induced mouse AKI model were treated with CUR with or without mitochondrial inhibitors (rotenone and FCCP) or siRNA targeting mitochondrial transcription factor A (TFAM). Changes in mitochondrial function, inflammation, the antioxidant system and related pathways were analysed. In vitro, CUR suppressed NFκB activation and cytokine production and induced NRF2/HO‐1 signalling in TECs under H/R conditions. CUR treatment also reduced mitochondrial ROS (mtROS) and mitochondrial fragmentation and enhanced mitochondrial biogenesis, TCA cycle activity and ATP synthesis in damaged TECs. However, the anti‐inflammatory and antioxidant effects of CUR in damaged TECs were markedly abolished upon mitochondrial disruption. In vivo, CUR treatment improved renal function and antioxidant protein (NRF2 and SOD2) expression and reduced oxidative stress (8‐OHdG), tubular apoptosis/death, cytokine release/macrophage infiltration and mitochondrial damage in the kidneys of AKI mice. In vitro, the anti‐inflammatory and antioxidant effects of CUR in damaged kidneys were impaired when mitochondrial function was disrupted. These results suggest mitochondrial damage is a driving factor of renal inflammation and redox imbalance. The therapeutic capacity of CUR in kidneys with AKI is primarily dependent on mitochondrial mechanisms; thus, CUR is a potential therapy for various diseases characterized by mitochondrial damage.
WI12Rhg1 interacts with DELLAs and mediates soybean cyst nematode resistance through hormone pathways
Authors: Dong Jia , Hudson Matthew E.
Published: September 2021

The soybean cyst nematode (SCN) is one of the most important causes of soybean yield loss. The major source of genetic resistance to SCN is the Rhg1 repeat, a tandem copy number polymorphism of three genes. The roles of these genes are only partially understood. Moreover, nematode populations virulent on Rhg1‐carrying soybeans are becoming more common, increasing the need to understand the most successful genetic resistance mechanism. Here, we show that a Rhg1‐locus gene (Glyma.18G02270) encoding a wound‐inducible protein (WI12Rhg1) is needed for SCN resistance. Furthermore, knockout of WI12Rhg1 reduces the expression of DELLA18, and the expression of WI12Rhg1 is itself induced by either JA, SA or GA. The content of the defence hormone SA is significantly lower whilst GA12 and GA53 are increased in WI12Rhg1 knockout roots compared with unedited hairy roots. We find that WI12Rhg1 directly interacts with DELLA18 (Glyma.18G040000) in yeast and plants and that double knockout of DELLA18 and its homeolog DELLA11 (Glyma.11G216500) significantly reduces SCN resistance and alters the root morphology. As DELLA proteins are implicated in hormone signalling, we explored the content of defence hormones (JA and SA) in DELLA knockout and unedited roots, finding reduced levels of JA and SA after the knockout of DELLA. Additionally, the treatment of DELLA‐knockout roots with JA or SA rescues SCN resistance lost by the knockout. Meanwhile, the SCN resistance of unedited roots decreases after the treatment with GA, but increases with JA or SA. Our findings highlight the critical roles of WI12Rhg1 and DELLA proteins in SCN resistance through interconnection with hormone signalling.
Examining the indirect effects of embodied learning on adaptability: The mediating roles of challenge stressors and psychological capital
Authors: Lee Jean S. K. , David Emily M.
Published: September 2021

We examined the efficacy of embodied learning for augmenting leader psychological capital—a latent construct reflecting hope, optimism, self‐efficacy, and resilience. To do so, we leveraged the literature on embodied cognition and the challenge‐hindrance stressor framework to better understand how involving both the body and mind during learning (i.e., embodied learning) can lead to heightened perceptions of challenge stressors, which then result in greater psychological capital. We also expected that higher levels of psychological capital relate to greater subsequent adaptability on the job. We tested these predictions in two quasi‐experimental field studies. Study 1 included a sample of 141 executive MBA students and Study 2 included a sample of 163 working managers. In both studies, the disembodied learning condition consisted of classroom training. The embodied learning condition included an outdoor adventure training component (including an 88 km hiking race and various team challenges) conducted in the Gobi Desert in Study 1 and in a nature park in Study 2. The results of the first study revealed that participants in the embodied learning group experienced higher post‐learning psychological capital than those in the disembodied learning group and that psychological capital mediated the relationship between learning approach and peer‐rated adaptability 6 months later. Study 2 replicated the positive relationship between embodied learning and post‐learning psychological capital and extended it by showing that challenge stressors mediated this relationship.
Germination of small tropical seeds has distinct light quality and temperature requirements, depending on microhabitat
Authors: Carvalho A. S. R. , de Andrade L. G. , de Andrade A. C. S.
Published: September 2021

The coexistence of plant species in tropical rainforests is related to specific abiotic resources, varying according to the occurrence microhabitat of each species. Light quality is the main abiotic factor influencing germination of small seeds; however, studies often do not discriminate its effect from that of light irradiance. This study compared specific requirements for seed germination of ten small‐seeded species, with restricted occurrence in only one of three contrasting microhabitats: forest understorey, edge of clearings and open areas.

Laboratory experiments were carried out to test temperature regime (constant or fluctuating), light quality (R:FR) and light irradiance (PAR), which reproduce high and low conditions commonly found in the microhabitats.

Seed germination of all species occurred between 20 and 30 °C, only seeds of open area species were able to germinate at 35 °C and no species required alternating temperatures to germinate. Irrespective of species and microhabitat, a decrease in the R:FR reduced the germination percentage; however, there were differences in the capacity to germinate at low R:FR. The values of R:FR50% were higher for open area and edge species (0.441–0.345) than for understorey species (0.181–0.109), with few exceptions. For all species and most of the tests, germination was not influenced by PAR.

Light quality is the most important light signal for germination of small seeds; irradiance has little effect. Our results suggest two distinct patterns of germination for small‐seeded species: open area and edge species are light‐demanding and require high R:FR to germinate, while understorey species are shade‐tolerant and germinate at low R:FR. These differences are responsible for distinct microhabitat occurrence and help to explain the coexistence of species in tropical forests.
Genetic Algorithm and Deep Learning to Explore Parametric Trends in Nucleate Boiling Heat Transfer Data
Authors: McClure Emma R. , Carey Van P.
Published: September 2021

Exploring parametric effects in pool boiling is challenging because the dependence of the resulting surface heat flux is often nonlinear, and the mechanisms can interact in complex ways. Historically, parametric effects in nucleate boiling processes have been deduced by fitting relations obtained from physical models to experimental data and from correlated trends in nondimensionalized data. Using such approaches, observed trends are often influenced by the framing of the analysis that results from the modeling or the collection of dimensionless variables used. Machine learning strategies can be attractive alternatives because they can be constructed either to minimize biases or to emphasize specific biases that reflect knowledge of the system physics. The investigation summarized here explores the use of machine learning methods as a tool for determining parametric trends in boiling heat transfer data and as a means for developing methods to predict boiling heat transfer. Results are presented that demonstrate how a genetic algorithm and deep learning can be used to extract heat flux dependencies of a binary mixture on wall superheat, gravity, Marangoni effects, and pressure. The results provide new insight into how gravity and Marangoni effects interact in boiling processes of this type. The results also demonstrate how machine learning tools can clarify how different mechanisms interact in the boiling process, as well as directly providing the ability to predict heat transfer performance for nucleate boiling. Each technique demonstrated clear advantages depending on whether speed, accuracy, or an explicit mathematical model was prioritized.
Numerical Study on the Dynamic Performance of Combined Sensible-Latent Heat Packed-Bed Thermocline Tank
Authors: ELSihy ELSaeed Saad , Xu Chao , Du Xiaoze
Published: September 2021

Thermal energy storage (TES) using thermocline technology with phase change materials (PCM) is a promising technique for peak-shaving operation in cogeneration units. One of the disadvantages of this connotation is the use of the highly cost PCM capsules in a water tank. To circumvent this issue, a new thermocline tank connotation is proposed. The tank is packed with a mixture of solid filler pills and PCMs capsules, forming a multi-layered packed-bed system. A transient concentric-dispersion model is developed to assess the dynamic performance of a solid-PCM multi-layered packed-bed (SPMLPB) tank. The influences of the PCMs volume fraction (VF) and the charge and discharge dimensionless cutoff temperatures criterion on the dynamic performance have been investigated. The results show that the VF of PCMs influences the system's behavior, in terms of both energy storage and release. As the PCMs volume fraction increases from 10% to 40%, the amount of energy storage, energy release, and latent utilization ratio increased by 82.65%, 73.94%, and 55%, respectively, while the overall exergy efficiency drops by 6.3%. Besides, increasing both the charge and discharge cutoff temperatures criterion (STch*/STdisch*) enhances the total utilization ratio and energy recovered. When STch* increases from 0.27 to 0.7, the total utilization ratio and energy recovered increased by 63.63% and 28.67%, respectively, by maintains STdisch*=0.26.
Stratified Shear-Thinning Fluid Flow Past Tandem Cylinders in the Presence of Mixed Convection Heat Transfer With a Channel-Confined Configuration
Authors: Dwivedi Ajay Raj , Dhiman Amit , Sanyal Aniruddha
Published: September 2021

The article examines the consequence of thermal buoyancy-driven cross-flow and heat transfer for shear-thinning power-law fluids on the tandem orientation of two cylinders. Finite volume methodology is used to investigate the effect of the gap ratio (2.5 ≤ S/D ≤ 5.5), power-law index (0.2 ≤ n ≤ 1), and Richardson number (0 ≤ Ri ≤ 1) on flow and thermal output parameters at Reynolds number Re = 100 and Prandtl number Pr = 50 in a confined channel. An unprecedented jump has been witnessed in the flow/thermal parameters at the critical gap ratio (critical spacing). At forced convection (Ri = 0), this critical spacing keeps on increasing with shear-thinning character, from S/D = 3.9 (at n = 1) to 4.9 (at n = 0.2). On the contrary, an increase in shear-thinning characteristic leads to a decrease in critical spacing from S/D = 3.9 (at n = 1) to 2.8 (at n = 0.4) for Ri = 1 (mixed convection). The heat transfer rate increases with shear-thinning behavior, with a maximum heat transfer, noted at n = 0.2. A higher unprecedented increment for flow/thermal parameters is seen at critical spacing for the downstream cylinder than the upstream cylinder. At the highest gap ratio, the output parameters for the upstream cylinder approximate that of an isolated cylinder. The time-variant fluctuations in lift coefficients for a shear-thinning flow in a tandem arrangement provide a new understanding of coshedding and extended body flow regimes.
Fluid Forces and Vortex Patterns of an Oscillating Cylinder Pair in Still Water With Both Fixed Side-by-Side and Tandem Configurations
Authors: Li Ang , Shi Shengmin , Fan Dixia
Published: September 2021

Models of cylinders in the oscillatory flow can be found virtually everywhere in the marine industry, such as pump towers experiencing sloshing load in a liquefied natural gas ship liquid tank. However, compared to the problem of a cylinder in the uniform flow, a cylinder in the oscillatory flow is less studied, let alone multiple cylinders. Therefore, we experimentally and numerically studied two identical circular cylinders oscillating in the still water with either a side-by-side or a tandem configuration for a wide range of Keulegan–Carpenter number and Stokes number β. The experimental result shows that the hydrodynamic performance of an oscillating cylinder pair in the still water is greatly altered due to the interference between the multiple structures with different configurations. In specific, compared to the single cylinder case, the drag coefficient is greatly enhanced when two cylinders are placed side-by-side at a small gap ratio, while dual cylinders in a tandem configuration obtain a smaller drag coefficient and oscillating lift coefficient. In order to reveal the detailed flow physics that results in significant fluid forces alternations, the detailed flow visualization is provided by the numerical simulation: the small gap between two cylinders in a side-by-side configuration will result in a strong gap jet that enhances the energy dissipation and increases the drag, while due to the flow blocking effect for two cylinders in a tandem configuration, the drag coefficient decreases.
Experimental Study of Single-Slope Solar Still Coupled With Nanofluid-Based Volumetric Absorption Solar Collector
Authors: Singh Jagteshwar , Mittal M. K. , Khullar Vikrant
Published: September 2021

In the present endeavor, a conventional single-slope solar still has been modified to improve its performance by coupling it with a novel nanofluid-based volumetric absorption solar collector (NBVASC). A low-cost and thermally stable nanofluid (prepared by dispersing functionalized carbon soot nanoparticles extracted from used engine oil into paraffin oil) having high solar weighted absorptivity has been employed to volumetrically absorb the incident solar energy. This additional absorbed solar energy is provided to the solar still by circulating a heat transfer fluid in a closed loop through serpentine type heat exchangers placed inside the NBVASC and the solar still. The experiments were performed from May to July 2020, and the results of the experiments conducted on May 25 and June 9, 2020, are reported. Extensive on-sun experiments reveal that coupling NBVASC to the conventional still could lead to substantial performance enhancements—distillate productivity, thermal efficiency, and night distillate improved by 75.3%, 66.9%, and 33.9%, respectively. More importantly, solar still coupled to NBVASC was found to perform better at an optimum nanoparticle concentration of 1.25 mlL−1 (20.75% higher distillate productivity) than the solar still coupled to a surface absorption-based collector (with paraffin oil as the working fluid)—truly establishing the benefits of volumetric absorption over surface absorption under the given set of conditions. Overall, the present study represents a noteworthy step forward in realizing efficient solar energy-driven desalination systems for remote underdeveloped areas.
Considerations for the Stressors of Sexual Minority Identity and How It Affects Mental Health for Those Who Identify as LBGTQ+
Authors: Cartwright Lorin A. , Neal Timothy
Published: September 2021

An area that has not been closely considered in the sporting world is the mental health effects on the competitive athletes who identify as Lesbian, bisexual, gay, transgender, queer/questioning (LBGTQ+) and thus, experience discrimination because of their sexual identity. Considerations include concepts an athletic trainer should keep in mind when caring for patients/athletes who identify as LBGTQ+. This article reviews the mental health impact of sexual minority identity stress on LBGTQ+ individuals, steps to address discrimination for those in athletics who identify as LBGTQ+, legal ramifications in the workplace for the LBGTQ+ individual, and the tragic consequences when LBGTQ+ individuals lack coping skills for stress and pursue suicide as a way to cope. Strategies are provided to improve the outcomes, prevent suicide, and create an environment of inclusivity.
Racial attention deficit
Authors: Levine Sheen S. , Reypens Charlotte , Stark David
Published: September 2021

Americans make poor decisions because they ignore their Black peers; a large experimental study shows and suggests a remedy.
Plasma lipids and growth faltering: A longitudinal cohort study in rural Gambian children
Authors: Gonzales Gerard Bryan , Brals Daniella , Sonko Bakary , Sosseh Fatou , Prentice Andrew M. , Moore Sophie E. , Koulman Albert
Published: September 2021

Plasma lipids are associated with growth in the first 2 years of life among children at high risk of growth faltering.
The Middle-Late Cretaceous Zagros ophiolites, Iran: Linking of a 3000 km swath of subduction initiation fore-arc lithosphere from Troodos, Cyprus to Oman
Authors: Moghadam H.S. , Li Q.L. , Griffin W.L. , Chiaradia M. , Hoernle K. , O’Reilly S.Y. , Esmaeili R.
Published: September 2021

New trace-element, radiogenic Sr-Nd-Pb isotopic and geochronological data from Middle-Late Cretaceous Zagros ophiolites of Iran give new insights into the tectono-magmatic history of these supra-subduction zone (SSZ)-type ophiolites. The distribution of Middle-Late Cretaceous SSZ-type ophiolites in Iran comprises two parallel belts: (1) the outer Zagros ophiolitic belt and (2) the inner Zagros ophiolitic belt. These Middle-Late Cretaceous ophiolites were generated by seafloor spreading in what became the fore-arc and back-arc during the subduction initiation event and now define a ~3000-km-long belt from Cyprus to Turkey, Syria, Iran, the UAE, and Oman. The Zagros ophiolites contain complete (if disrupted) mantle and crustal sequences. Mantle sequences from both outer-belt and inner-belt ophiolites are dominated by dunites, harzburgites, and lherzolites with minor chromitite lenses. Peridotites are also intruded by gabbros and a variety of mafic to minor felsic (plagiogranite and dacite) dikes. Crustal rocks comprise ultramafic-mafic cumulates as well as isotropic gabbros, sheeted dike complexes, pillowed and massive lavas, and felsic rocks. Our new zircon U-Pb ages indicate that the outer-belt and inner-belt ophiolites formed near coevally during the Middle-Late Cretaceous; 100–96 Ma for the outer belt and 105–94 Ma for the inner belt. Both incompatible-element ratios and isotopic data confirm that depleted mantle and variable contributions of subduction components were involved in the genesis of outer-belt and inner-belt rocks. Our data for the outer belt and inner belt along with those from better-studied ophiolites in Cyprus, Turkey, the UAE, and Oman lead to the conclusion that a broad, ~3000-km-long swath of fore-arc lithosphere was created during Middle-Late Cretaceous time.
Can compliment and complaint data inform the care of individuals with chronic subdural haematoma (cSDH)?
Authors: Jones Katherine , Davies Benjamin , Stubbs Daniel J , Komashie Alexander , Burnstein Rowan M , Hutchinson Peter , Santarius Thomas , Joannides Alexis J
Published: September 2021

Objectives

To explore the frequency and nature of complaints and compliments reported to Patient Advice and Liaison (PALS) in individuals undergoing surgery for a chronic subdural haematoma (cSDH).

Design

A retrospective study of PALS user interactions.

Subjects

Individuals undergoing treatment for cSDH between 2014 and 2019.

Methods

PALS referrals from patients with cSDH between 2014 and 2019 were identified. Case records were reviewed and data on the frequency, nature and factors leading up to the complaint were extracted and coded according to Healthcare Complaints Analysis Tool (HCAT).

Results

Out of 531 patients identified, 25 (5%) had a PALS interaction, of which 15 (3%) were complaints and 10 (2%) were compliments. HCAT coding showed 8/15 (53%) of complaints were relationship problems, 6/15 (33%) a management problem and 1/15 (7%) other. Of the relationship problems, 6 (75%) were classed as problems with communication and 2 (25%) as a problem with listening. Of the compliments, 9/10 (90%) related to good clinical quality and 1/10 (10%) to staff–patient relationship. Patients were more likely to register a compliment than family members, who in turn were more likely to register a complaint (p<0.005). Complaints coded as a relationship problem had 2/8 (25%) submitted by a patient and 6/8 (75%) submitted by a relative.

Conclusions

Using the HCAT, routinely collected PALS data can easily be coded to quantify and provide unique perspective on tertiary care, such as communication. It is readily suited to quality improvement and audit initiatives.
Questionnaire-based service evaluation of the efficacy and usefulness of SEREN: a structured education programme for children and young people diagnosed with type 1 diabetes mellitus
Authors: D'Souza Rashmi Sarah , Ryan Matthew , Hawkes Esther , Baker Claire , Davies Yvonne , R-Screen Judith , Price Jonathan , Pryce Rebekah , D'Souza Nirupa A
Published: September 2021

Objectives

To evaluate the usefulness and effectiveness of a new structured education module for children with type 1 diabetes: StructuredEducationReassuringEmpoweringNurturing(SEREN) ‘Diabetes at Diagnosis’.

Design

Retrospective questionnaire-based service evaluation.

Setting

12/14 paediatric diabetes centres across Wales took part.

Participants

Children diagnosed with type 1 diabetes 1 year before (pre-SEREN group) and 1 year after the introduction of SEREN (post-SEREN group) were selected using a national diabetes register.

Resource

‘Diabetes at Diagnosis’ delivers structured education to empower children and families with self-management of type 1 diabetes.

Evaluation

Primary outcomes were patient-reported effectiveness and user-friendliness of the educational resources and quality of life (PedsQL). Age-appropriate child and parent questionnaires were provided. Clinical outcomes included glycated haemoglobin (HbA1c) at 6 and 12 months, service engagement and diabetes-related hospital admissions in the first year.

Results

89/106 responded pre-SEREN and 108/115 post-SEREN, with no demographic differences at diagnosis. Parent scores for educational package evaluation significantly improved post-SEREN, with a non-significant trend towards improved results in children. PedsQL scores were similar. There was no change in HbA1c overall. Subgroup analyses at 12 months showed a trend towards a lower HbA1c in key stage 1–2 (62 vs 58 mmol/mol, p=0.06) and increased HbA1c in key stage 3–4 (56 vs 66 mmol/mol, p=0.009). There were no differences in hospital admissions or missed clinic appointments.

Conclusions

This is an evaluation of the only standardised type 1 diabetes structured education programme in use for children throughout Wales. This module improved parent-reported outcomes and showed a non-significant trend towards improved usefulness in children, without a difference in a PedsQL scores overall. Ongoing evaluation of the cohort who received subsequent SEREN modules may show the long-term benefit of the programme.
Putrefaction in the pandemic: a comparative study of the frequency of advanced decomposition change in coronial autopsies since the start of the COVID-19 pandemic
Authors: Estrin-Serlui Theodore , Osborn Michael
Published: September 2021

Aims

The aim of this study is to evaluate whether there has been a significant change in the frequency of markedly decomposed bodies having coronial autopsies since the UK’s first COVID-19 lockdown.

Methods

We compared coronial autopsies (n=263) performed by one pathologist at a central London mortuary in the 1 year before and after 23 March 2020 by analysing their autopsy reports and coronial documentation.

Results

We have shown that there has been a significant increase of 70.5% (p=0.001) in the frequency of markedly decomposed bodies having coronial autopsies since the first lockdown. This is associated with a 38% increase (p=0.0001) in the rate of those dying at home and a 52.4% decrease (p=0.00003) in the rate of those dying in hospital who go on to have a coronial autopsy in our facility. Our results suggest that the most significant factor behind the increased frequency in advanced decomposition change since the first lockdown is this increase in coronial autopsies for deaths at home relative to deaths in hospital.

Conclusion

Our results support the idea that perimortem social isolation will lead to an increased frequency of advanced decomposition changes seen at autopsy. We suggest that it could be possible to use the frequency of advanced postmortem decomposition change in a population as a surrogate marker for social isolation in future studies. Our study also illustrates a changing environment where the increasing prevalence of postmortem decomposition changes could affect the accuracy of autopsy reports and the medicolegal consequences thereof.
Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial
Authors: Woo Jae Hee , Lee Hyun Jung , Oh Hye-Won , Lee Jong Wha , Baik Hee Jung , Kim Youn Jin
Published: September 2021

Background and objectives

A single injection interscalene block (ISB) is a common regional analgesic technique in patients undergoing arthroscopic shoulder surgery. However, rebound pain after ISB resolution may reduce its overall benefit. Our primary aim was to assess whether perineural dexamethasone reduces the intensity and incidence of rebound pain in patients undergoing arthroscopic shoulder surgery under general anesthesia combined with a preoperative single injection ISB.

Methods

The patients were randomly assigned to receive single injection ISB using either 0.5% ropivacaine (control) or 0.5% ropivacaine containing 5 mg of dexamethasone. The primary outcomes were the pain score difference before and after ISB resolution, and the incidence of rebound pain. The secondary outcomes were the onset and duration of rebound pain, the presence of sleep disturbances due to postoperative pain, the first time when an analgesic was requested, and pain scores at various predefined time points.

Results

Pain increase following ISB resolution was lower in the dexamethasone group compared with the control group (4.5±2.4 and 6.9±2.2, respectively, p<0.001). The incidence of rebound pain was significantly lower in the dexamethasone group compared with the control group (37.1% and 82.9%, respectively, p<0.001). The controls experienced greater sleep disturbance during the postoperative period compared with those who received ISB with perineural dexamethasone.

Conclusions

Perineural dexamethasone added to ISB using ropivacaine led to a much smoother resolution of ISB, reflected in a significantly smaller increase in pain after block resolution, a lower incidence of rebound pain and a lower sleep disturbance during the first postoperative week.

Trial registration number

Clinical Trial Registry of Korea (KCT0004418).
Multiple myeloma and malignant lesions: a potential risk factor for local anesthetic systemic toxicity
Authors: Lim Victoria M , Barney Taylor , Jayaraman Arun L
Published: September 2021

Background

Multiple myeloma is a cancer of plasma cells that often leads to complications including osteolytic bone lesions, nephropathy and neuropathy. Multiple myeloma is only one etiology of many cancer pain conditions that may necessitate interventional pain treatment when refractory to multimodal medications. Notably, local anesthetic systemic toxicity is a rare but life-threatening complication of local anesthetic administered for these interventions.

Case presentation

A 50–60-year-old woman presented with multiple myeloma complicated by chronic bone pain and in an acute pain crisis. A fluoroscopic-guided L4–5 epidural catheter was placed with clinical doses of bupivacaine for comfort to undergo MRI of the spine. Soon after, she became tachycardic, tachypneic and hypoxic requiring non-invasive positive pressure airway support. As this respiratory distress was attributed to a large pleural effusion, a pigtail catheter was inserted in the intensive care unit with submaximally dosed lidocaine infiltration. She then developed a left bundle branch block followed by cardiovascular collapse minimally responsive to high-dose inotrope and vasopressor support. Lipid emulsion was started with dramatic therapeutic response and recovery to baseline. A CT of the thoracolumbar spine showed worsening extensive lytic lesions throughout all vertebral bodies and ribs from diffuse myeloma.

Conclusions

Patients with oncologic lesions focal to the thoracolumbar spine may be at higher risk for local anesthetic systemic toxicity from palliative epidurals due to increased cancer-related angiogenesis. Likewise, local anesthetic infiltration for procedures near any malignant sites could have a similar risk and may require lower initial fractionated dosages with increased vigilance.
Preferences for chlamydia testing and management in Hong Kong: a discrete choice experiment
Authors: Ong Jason J , Fairley Christopher K , Hocking Jane S , Turner Katy M E , Booton Ross , Tse Desiree , Wong William W C W
Published: September 2021

Objectives

As most chlamydia cases are asymptomatic, regular testing and timely management may be necessary for control. We aimed to determine the preferences of people living in Hong Kong for chlamydia testing and management services.

Methods

An online panel of sexually active individuals living in Hong Kong completed the survey with two discrete choice experiments (DCEs). The first DCE examined the preferred attributes of a chlamydia testing service (cost, location, appointment time, speed of results, delivery of results and availability of other STI testing). The second DCE examined the preferred attributes of a chlamydia management service (cost, access to patient-delivered partner therapy, location, travel time, type of person consulted and attitude of staff).

Results

In total, 520 individuals participated: average age 36.8 years (SD 9.9), 40% males and 66% had a bachelor’s degree or higher. Choosing to test was most influenced by cost, followed by speed of results, delivery of results, extra STI testing, appointment available and the least important was the location of testing. Choosing to attend for management was most influenced by staff’s attitude, followed by cost, who they consult, access to patient-delivered partner therapy, travel time and the least important was treatment location.

Conclusion

To design effective chlamydia testing and management services, it is vital to respond to patient needs and preferences. For people living in Hong Kong, cost and staff attitude were the most important factors for deciding whether to test or be managed for chlamydia, respectively.
Using systems science to advance health equity in tobacco control: a causal loop diagram of smoking
Authors: Mills Sarah D , Golden Shelley D , O’Leary Meghan C , Logan Paige , Hassmiller Lich Kristen
Published: September 2021

Objectives

Develop and use a causal loop diagram (CLD) of smoking among racial/ethnic minority and lower-income groups to anticipate the intended and unintended effects of tobacco control policies.

Methods

We developed a CLD to elucidate connections between individual, environmental and structural causes of racial/ethnic and socioeconomic disparities in smoking. The CLD was informed by a review of conceptual and empirical models of smoking, fundamental cause and social stress theories and 19 qualitative interviews with tobacco control stakeholders. The CLD was then used to examine the potential impacts of three tobacco control policies.

Results

The CLD includes 24 constructs encompassing individual (eg, risk perceptions), environmental (eg, marketing) and structural (eg, systemic racism) factors associated with smoking. Evaluations of tobacco control policies using the CLD identified potential unintended consequences that may maintain smoking disparities. For example, the intent of a smoke-free policy for public housing is to reduce smoking among residents. Our CLD suggests that the policy may reduce smoking among residents by reducing smoking among family/friends, which subsequently reduces pro-smoking norms and perceptions of tobacco use as low risk. On the other hand, some residents who smoke may violate the policy. Policy violations may result in financial strain and/or housing instability, which increases stress and reduces feelings of control, thus having the unintended consequence of increasing smoking.

Conclusions

The CLD may be used to support stakeholder engagement in action planning and to identify non-traditional partners and approaches for tobacco control.
Reaction force of gravitational radiation in an effective-one-body theory based on the post-Minkowskian approximation
Authors: Sun Manman , Chen Shuai , He Xiaokai , Jing Jiliang
Published: September 2021

Effective-one-body (EOB) theory based on the post-Newtonian (PN) approximation presented by Buonanno and Damour plays an important role in the analysis of gravitational wave signals. Based on the post-Minkowskian (PM) approximation, Damour introduced another novel EOB theory which will lead to theoretically improved versions of the EOB conservative dynamics and might be useful in the upcoming era of high signal-to-noise-ratio gravitational-wave observations. Using the 2PM effective metric obtained by us recently, in this paper we study the radiation reaction force experienced by the particle with the help of the energy-loss-rate, which is an important step to construct the EOB theory based on the PM approximation.