bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the attitude of surgical trainees towards virtual reality simulation: A national cross-sectional questionnaire study
Authors: Khatkar Harman , Ferro Ashley , Kotecha Sanjeev , Prokopenko Max , Evans Ashish , Kyriakides Jonathon , Botterill Jonathan , Sangha Miljyot Singh , See Abbas , Kerstein Ryan
Published: May 2022

Background

We performed a cross sectional study to determine the attitudes of surgical trainees and medical students towards virtual reality (VR) simulation in surgical training. A survey was devised through an iterative process before distribution to surgical trainees, foundation year doctors and medical students through online platforms.

Methods

The survey was disseminated within the United Kingdom through social media and email correspondence, in co-operation with national surgical organisations. 91 trainees responded from a variety of clinical specialities.

Results

VR technology in surgical training was viewed positively, with 91.3% of trainees agreeing that VR should be both an adjunct in surgical training as well as a competency-based assessment tool. Barriers to access were present, with access notably more challenging for senior surgeons.

Conclusion

Virtual reality surgical simulation in surgical training is beginning to emerge as a genuine high-fidelity, low-risk solution to the lack of surgical case volume trainees are currently experiencing.
Religion, the i-zation of society and COVID-19
Authors: Possamai Adam
Published: May 2022

With the advancement of new technologies, instrumental rationality, as described by Weber and Ritzer, has been carried further towards the self in a process described as the i-zation of society. This is in elective affinity with the expansion of digital capitalism which is aligned with recent global and transnational developments. Religion has not been left untouched and has adapted itself, if not embraced, these changes brought by neoliberalism. This article argues that with the advent of COVID-19, we can observe an acceleration and intensification of these affinities which are currently further altering the religious ‘digitalscape’.
Black Male Brilliance as (Ill)Legible: Challenging and Changing Societal and Educational Narratives
Authors: Smith Martin P. , Johnson Marcus W. , Owens Lela
Published: May 2022

In this study, we examine how race and racism impact the schooling of African American males by analyzing the first-person perspective of hip-hop superstar, Nasir “Nas” Jones. We selected Nas due to his unique yet prevalent educational trajectory and perspectives. Critical race theory is employed as a framework as well as notions of Sankofa methodology and literary analysis to investigate his music, documentaries, and an open letter whereby he critiques the public school system while providing academic ideas to engage and inspire Black students. Studies about Black males routinely focus on their subpar academic performance with the intention of “correcting” these behaviors. We utilize the experiences of Nas to reframe the conversation and provide nuanced insight into Black educational experiences instead of perpetuating recycled, bleak narratives. This article concludes with suggestions for educators to better serve African American males in the Pre K-12 academic context.
Collaborative care for mental health in South Africa: a qualitative systematic review
Authors: Truter Zelda Marthani
Published: May 2022

Collaborative care for mental health is a strategy that restructures the roles of health care providers, and sectors outside of health care provision, to encourage a team-based approach in dealing with mental illness. Previous research proposed a collaborative care strategy to make mental health care more accessible and culturally appropriate. This study systematically reviewed the available literature to produce a summary of collaborative care in the context of mental health care in South Africa. More specifically, the aims were to document existing efforts towards collaboration and highlight barriers and challenges associated with collaborative care in mental health care in South Africa. This review was conducted in accordance with PRISMA guidelines. South African studies published in English between 2002 and October 2021 were considered for inclusion. Twenty-five studies with heterogeneous study designs were included in this review and analysed using a thematic synthesis approach. Collaborative care models hold promise for closing the mental health treatment gap and providing culturally appropriate mental health care in South Africa. However, despite progress made, several challenges remain in the implementation of collaborative policies. Four main strategies were identified to improve the implementation of collaborative care models in South Africa. These included (1) redirecting resources and improving infrastructure, (2) formalising roles and relationships and improving leadership, (3) improving communication and supervisory structures, and (4) improving training and education. This review offers valuable recommendations for South African mental health care policy that might also be useful for other resource-constrained countries.
Comparing Undergraduate Student Participation in Online Discussion Boards Hosted on Reddit and Canvas
Authors: Neff Andrew S. , Mischel Jenny , Yang Evan
Published: May 2022

Background

Instructors often try to promote student engagement with discussion boards in learning management systems (LMS) like Canvas. Although convenient, alternatives like the social media platform Reddit may be more effective.

Method

A non-randomized controlled trial compared the use of Canvas and Reddit in two sections of two undergraduate psychology courses ( N = 77). Engagement was measured as the number and word-count of posts and responses and complemented with self-reported data.

Results

There was no difference between platforms in total number of posts or replies. In one course, the average word count per post was higher in Reddit than Canvas ( r = .44). However, in the other course, the average word count per post ( r = .47) and per reply ( r = .39) was significantly lower in Reddit. Neither course observed a significant difference in students’ perceived value of the discussion board.

Conclusion

This study provided no consistent evidence that Reddit supports student engagement relative to Canvas, and combined with additional survey data, it is possible that hosting the discussion board on Reddit may even be detrimental.

Teaching Implications

Given the issues we identified with moving discussion boards to Reddit, and the benefits of using Canvas, we recommend using a traditional LMS like Canvas.
Sex Differences in Presentation and Surgical Outcomes From a Prospective Multicenter Chronic Rhinosinusitis Study
Authors: Asokan Annapoorani , Mace Jess C. , Rice John D. , Smith Timothy L. , Soler Zachary M. , Ramakrishnan Vijay R.
Published: May 2022

Objective

Despite extensive research into chronic rhinosinusitis (CRS) epidemiology, presentation, and outcomes, there is scant knowledge on sex‐specific differences. The objective of this study was to identify differences between male and female patients with CRS in baseline disease severity at presentation, choice for surgery vs continued medical treatment, and postoperative response.

Study Design

We evaluated data on demographic and health characteristics, clinical objective disease measures, and sinus‐specific and general health patient‐reported outcome measures.

Setting

Secondary analysis of prospective multicenter outcome study.

Methods

Comparison of cohort characteristics and baseline and postoperative measures was performed with a t test, chi‐square test of independence, or Fisher exact test. Within‐subject improvement was compared between sexes with a linear mixed model.

Results

Females reported worse quality of life on presentation and postsurgery, despite experiencing less severe disease by standard clinical measures. Overall, females and males showed similar within‐subject improvement after surgery. However, certain quality of life domains and disease measures showed sex‐specific improvement. Females demonstrated greater within‐subject improvement in SF6D‐derived health utility and the SNOT‐22 ear and facial, psychological, and sleep subdomains, although this did not reach statistical significance for the overall cohort.

Conclusion

Incorporating data on sex‐specific differences may be important to personalize CRS treatment decision making. The discordance between patient‐reported and clinical measures in CRS has been demonstrated in other pathologies and appears to be exaggerated by sex. Biological and psychological bases for sex‐specific differences in CRS manifestations are an intriguing topic for further research.
Postpartum depression: A role for psychedelics?
Authors: Jairaj Chaitra , Rucker James J
Published: May 2022

Background:

Postpartum depression (PPD) is a major public health concern and has, at its core, a sense of maternal ‘disconnection’ – from the self, the infant, and the support system. While PPD bears similarities with MDD, there is increasing evidence for its distinct nature, especially with the unique aspect of the mother-infant relationship. Current treatment modalities for PPD, largely based on those used in major depressive disorder (MDD), have low remission rates with emerging evidence for treatment resistance. It is, therefore, necessary to explore alternative avenues of treatment for PPD.

Objective:

In this narrative review, we outline the potential therapeutic rationale for serotonergic psychedelics in the treatment of PPD, and highlight safety and pragmatic considerations for the use of psychedelics in the postpartum period.

Methods:

We examined the available evidence for the treatment of PPD and the evidence for psychedelics in the treatment of MDD. We explored safety considerations in the use of psychedelics in the postpartum period.

Results:

There is increasing evidence for safety, and encouraging signals for efficacy, of psilocybin in the treatment of MDD. Psilocybin has been shown to catalyse a sense of ‘reconnection’ in participants with MDD. This effect in PPD, by fostering a sense of ‘reconnection’ for the mother, may allow for improved mood and maternal sensitivity towards the infant, which can positively impact maternal role gratification and the mother-infant relationship.

Conclusion:

Psychedelic assisted therapy in PPD may have a positive effect on the mother-infant dyad and warrants further examination.
Effects of cannabidiol on simulated driving and cognitive performance: A dose-ranging randomised controlled trial
Authors: McCartney Danielle , Suraev Anastasia S , Doohan Peter T , Irwin Christopher , Kevin Richard C , Grunstein Ronald R , Hoyos Camilla M , McGregor Iain S
Published: May 2022

Background:

Cannabidiol (CBD), a major cannabinoid of Cannabis sativa, is widely consumed in prescription and non-prescription products. While CBD is generally considered ‘non-intoxicating’, its effects on safety-sensitive tasks are still under scrutiny.

Aim:

We investigated the effects of CBD on driving performance.

Methods:

Healthy adults ( n = 17) completed four treatment sessions involving the oral administration of a placebo, or 15, 300 or 1500 mg CBD in a randomised, double-blind, crossover design. Simulated driving performance was assessed between ~45–75 and ~210–240 min post-treatment (Drives 1 and 2) using a two-part scenario with ‘standard’ and ‘car following’ (CF) components. The primary outcome was standard deviation of lateral position (SDLP), a well-established measure of vehicular control. Cognitive function, subjective experiences and plasma CBD concentrations were also measured. Non-inferiority analyses tested the hypothesis that CBD would not increase SDLP by more than a margin equivalent to a 0.05% blood alcohol concentration (Cohen’s dz = 0.50).

Results:

Non-inferiority was established during the standard component of Drive 1 and CF component of Drive 2 on all CBD treatments and during the standard component of Drive 2 on the 15 and 1500 mg treatments (95% CIs < 0.5). The remaining comparisons to placebo were inconclusive (the 95% CIs included 0 and 0.50). No dose of CBD impaired cognition or induced feelings of intoxication ( ps > 0.05). CBD was unexpectedly found to persist in plasma for prolonged periods of time (e.g. >4 weeks at 1500 mg).

Conclusion:

Acute, oral CBD treatment does not appear to induce feelings of intoxication and is unlikely to impair cognitive function or driving performance (Registration: ACTRN12619001552178).
Pentazocine with rectal diclofenac versus pentazocine alone for pain relief following caesarean delivery in Enugu, Nigeria: A randomized controlled trial
Authors: Ofor Ifeanyichukwu Jude , Enebe Joseph Tochukwu , Ofor Nwadiuto Emmanuela , Onyia Christian Nnaemeka , Omeke Chidimma Akudo , Nevo Calistus Obiora , Enyinna Perpetua Cleopatra , Awkadigwe Fredrick Ikenna , Eleje George Uchenna , Ezugwu Frank Okechukwu
Published: May 2022

Objective

To measure postoperative pain relief following the use of rectal diclofenac combined with intramuscular pentazocine compared with intramuscular pentazocine alone in patients undergoing a caesarean delivery.

Methods

This single-blind randomized controlled trial enrolled pregnant women that had a caesarean section at the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria. Study participants were randomized to receive either 100 mg of rectal diclofenac given every 12 h plus 30 mg of intramuscular pentazocine given every 6 h (group A) or 60 mg of intramuscular pentazocine given every 6 h (group B). The primary outcome was the level of pain as measured using a visual analogue scale. The secondary outcomes were the level of satisfaction with pain relief and need for rescue analgesia.

Results

A total of 200 participants were randomized equally into the two groups. Participants in group A had significantly better pain control and satisfaction over the 48 h after surgery compared with group B. Significantly more of group B required rescue analgesia for breakthrough pain compared with group A.

Conclusion

Rectal diclofenac combined with intramuscular pentazocine was significantly better at controlling pain compared with pentazocine alone in the first 48 h following caesarean section. Trial registration number: PACTR202107706925314 at www.pactr.org on 28 July 2021.
GFRP reinforced high performance glass–bolted joints: Development of a simplified finite element-based method for analysis
Authors: Achintha Mithila
Published: May 2022

This paper presents the development of finite element (FE)-based computational models that can be used for predicting the failure load of GFRP-reinforced annealed and heat-strengthened glass–bolted joints. Stress analysis of a single-bolt, single-glass-piece case was first carried out in order to develop the computational models and to establish an appropriate failure criterion for the GFRP-reinforced glass–bolted joints. The computational models were then calibrated against the experimental results reported in a previous experimental study involving reference and reinforced double-lap tension joint test specimens. The paper shows that the failure of both reference and reinforced glass–bolted joints can be predicted using the maximum principal-tensile-stress-based failure of glass. The results also confirm that the use of adhesively bonded GFRP reinforcement has potential to increase the load capacity of the reinforced glass–bolted joints compared to the reference glass–bolted joints.
Optimum synthesis of four-bar mechanisms considering clearance-induced uncertainty
Authors: Ding Jianzhong , Dong Yang , Liu Xueao , Wang Chunjie
Published: May 2022

This paper presents a multi-objective optimization model for the motion synthesis of four-bar mechanisms considering the effects of revolute joint clearances. A geometric method is proposed to compute the maximum clearances-induced positioning and orientation errors. The proposed error modeling method is validated using a simple example, and the results reveal its advantages of high accuracy and fast computation compared with the widely used existing methods. A multi-objective optimization model is developed to design the four-bar mechanism with the best accuracy. The positioning and orientation errors are modeled separately and equally. Moreover, three constraints are included in the optimization to ensure that the synthesized mechanism is a compact crank-rocker or double-crank mechanism free from branch and order defects. A study case of synthesizing a four-bar mechanism passing through 6 motion points is investigated to illustrate the proposed method. Finally, conclusions and a brief discussion are given.
Comparison and investigation of inverse identification techniques for the material properties of a brake disc through experimental and numerical modal analysis
Authors: Balcı Özgün , Yavuz Akif , Özkan Muammer , Sen Osman T
Published: May 2022

In the present study, a fast and accurate procedure for the inverse identification of material properties of a brake disc is proposed through the results of numerical and experimental modal analyses, where a particular attention is given to different objective functions and weighting. First, experimental and numerical modal analyses are conducted to obtain the natural frequencies and corresponding mode shapes. Second, design of experiment (DoE) methods are utilized to generate the meta-model of natural frequency results that are calculated numerically through finite element methods (FEMs). Several FEM simulations are run by altering critical material properties (density, Young’s modulus, and Poisson’s ratio) as independent variables according to the determined sample points by DoEs. Third, a second-degree response surface model is built by using linear regressions of simulation results. Predictive accuracies of two DoEs are investigated by the analysis of the residuals between FEM and meta-model results. Fourth, three different objective functions are adopted and used with 10 and 16 natural frequencies, with and without weighting, and compared with each other to investigate the effectiveness of functions and weighting for the particular problem. The sequential quadratic programming method is preferred for the minimization of the objective functions. As opposed to the related literature, weights of the objective functions are determined by variances of natural frequencies measured at different locations of the disc which are already required to obtain mode shapes. Therefore, a computationally and experimentally low-cost and fast identification process is attained. The results showed that the use of weights usually improves the accuracy of identification. Changing the number of included natural frequencies in the optimization process, where the third objective function is used, has a significant effect, especially on the identification of the Poisson’s ratio. Finally, a good correlation is achieved between experimental and computational frequencies updated by the optimum properties.
Understanding the Transnational Care Arrangements: Experiences in Nonparental Care in the Case of the Filipino Transnational Families
Authors: Ballaret Jeffrey R.
Published: May 2022

Transnational familyhood involves care reconfiguration and shifting roles among Filipino migrants and the family left-behind. This study investigates how experiences and practices of transnational care arrangements are negotiated from the perspective of the nonparental carers. It specifically aims to understand its dynamics and patterns in shaping care relationships, normative familial values and the hope to reconstitute the family amidst migration-induced care. Results of the study showed that the grandmothers of the migrating parents were commonly entrusted with child fostering and reliance, which to encompass mediation in the relationship of migrant parents and left-behind children. As they shoulder majority of caregiving responsibilities, they often face differing burdens of caregiving, mediation and ageing. The lived realities and socio-cultural facet of grandparent-caregiving reveal their unconditional love to the migrants’ family, thus enduring the challenges of navigating transnational parenting. The critical role of grandparents as nonparental carers in the case of Filipino transnational families demands greater recognition in the development of programs and policies to highlight an integrated family and health assistance responsive to them in the areas of transnational care arrangements, care sharing, collaboration and the shifting responsibilities and expectations. It is hoped to cultivate stronger family connectedness and intimacy.
Writing-With a Parasite Dis/Coloring One’s Skin: Toward Inquiries of Change
Authors: Jonker Francois
Published: May 2022

In this article, I explore the potential emerging from writing-with a parasite (Pityriasis Versicolor) living on my skin at the time of writing. My parasite and I respond to the invitation to engage with Sarah Truman’s techniques for thinking about research-creation and Aaron M. Kuntz’s conception of methodological parrhesia. Together, we co-parasite (through para-citation, perhaps?), jointly and diffractively between the pages of Truman and Kuntz so as to experiment with our own situated entanglement and intra-actions with the process of inquiry by asking: how might we engage inquiry, not as a mode of static and distanced observation but as a process of change attuned to our own material intermingling? We do so by posing questions about emergence: (a) How might we activate the productive tensions between situated knowledges and the notion of emergence? (2) How might we engage the ever-emergent material-relational dimension of inquiry through an in-actment of “middling”? (c) How might we conceive of inquiry as the practice of parrhesia—a mode of care-full truth-making with-in emergence?
State-specific Prevalence and Factors Associated With Current Marijuana, ENDS, and Cigarette use Among US Adults With Asthma
Authors: Ebrahimi Kalan Mohammad , Bursac Zoran , Jebai Rime , Zare Samane , Li Wei , Gautam Prem , Rahman Abir , Ward Kenneth D , Ben Taleb Ziyad
Published: May 2022

Background

The use of marijuana (MJ), combustible cigarettes (hereafter cigarettes), and electronic nicotine delivery systems (ENDS) is widespread among United States (US) adults and linked to worsening respiratory symptoms, especially among adults with asthma. This study examined state-specific prevalence and factors associated with MJ, ENDS, and cigarette use among US adults with asthma.

Methods

We analyzed data of 41 974 adults aged ≥18 years having self-reported current asthma from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). We reported weighted prevalence to account for complex survey design and performed multivariable logistic regression models to examine factors associated with current use of MJ, ENDS, and cigarettes.

Results

Overall prevalence of current MJ, ENDS, and cigarette use among adults with asthma was 14.5%, 6.6%, and 27.2%, respectively. Our results showed the US states and territories with highest and lowest use prevalence for MJ (California: 23.6% vs Guam: 3.2%), ENDS (Indiana: 12.8% vs North Dakota: 4.0%), and cigarettes (West Virginia: 42.1% vs Guam: 12.3%). Both MJ and ENDS users were more likely to be male, younger, and live in an urban area, but MJ users were more likely and ENDS users less likely to be Non-Hispanic (NH) American Indian/Alaskan Native. Cigarette users were more likely to be older, have at least 1 health condition, and were less likely to be NH Black or Hispanic and college-educated.

Conclusion

Many US adults with asthma use MJ, ENDS, and cigarettes. Our findings provide insights for clinicians about the urgent need for effective interventions to reduce tobacco and MJ use among adults with asthma.
Gaussian process regression for active sensing probabilistic structural health monitoring: experimental assessment across multiple damage and loading scenarios
Authors: Amer Ahmad , Kopsaftopoulos Fotis
Published: May 2022

In the near future, Structural Health Monitoring (SHM) technologies will be capable of overcoming the drawbacks in the current maintenance and life-cycle management paradigms, namely, cost, increased downtime, less-than-optimal safety management paradigm and the limited applicability of fully-autonomous operations. One of the most challenging tasks is structural damage quantification. Existing quantification techniques face accuracy and/or robustness issues when it comes to varying operating and environmental conditions. In addition, the damage/no-damage paradigm of current industrial frameworks does not offer much information to maintainers on the ground for proper decision-making. In this study, a novel structural damage quantification framework is proposed based on the widely-used Damage Indices (DIs) and Gaussian Process Regression Models (GPRMs) in order to overcome the aforementioned shortcomings. The proposed framework takes a simple approach to the damage quantification problem by using DI values for training, and provides confidence bounds on the estimated states. In addition, the proposed method is shown to quantify multiple structural states simultaneously from incoming DI test points. This framework is applied to three test cases: a Carbon Fibre-Reinforced Plastic (CFRP) coupon with attached weights as simulated damage, an aluminum coupon with a notch and an aluminum coupon with attached weights as simulated damage under varying loading states. The novel state prediction method presented herein is applied to single-state quantification in the first two test cases, as well as the third one assuming the loading state is known. Finally, the proposed method is applied to the third test case assuming neither the damage size nor the load is known in order to predict both simultaneously from incoming DI test points. In applying this framework, two forms of GPRMs (standard and variational heteroscedastic) are used in order to critically assess their performance with respect to the three test cases.
Local Ozone Therapy in Complex Treatment of Venous Leg Ulcers: Ozone therapy for venous leg ulcers
Authors: Pasek Jarosław , Szajkowski Sebastian , Cieślar Grzegorz
Published: May 2022

A significant health problem in many countries of the world is the occurrence of hard to heal leg ulcers. In recent years modern methods of physical medicine in comprehensive treatment have been used often including ozone therapy. The study included 54 patients, 25 male and 29 female in age between 39 and 87 years (mean age: 66.7 ± 11.9 years) with venous leg ulcers who underwent a cycle of local ozone therapy. The progress in wound healing was evaluated by computerized planimetry and pain intensity was assessed with use a visual analog scale (VAS) . As a result of the applied local ozone therapy a statistically significant reduction of the ulcer area was achieved from median 7.1 (5.6-9.4) cm2 to 4.4 (3-7) cm2 ( P = .000001), which was on median 38.74 (27.27-51.42)% compared to the baseline values ​​before the start of the therapy. In 2 patients (3.7%) the ulcers were completely healed. 18 patients (33.3%) achieved a reduction in ulcer area of ​​more than 50% of the baseline value and the remaining 34 patients (63%) also achieved a reduction in ulcer area. A statistically significant in the percentage of surface area was observed in the group of 19 patients suffering from > 5 years of age compared to the group of 35 patients suffering from ≤5 years (median 50 (32.03-67.16)% versus 33.96 (23.71-45); P = .033178), while percentage changes in ulcer surface area did not differ significantly between all other subgroups of patients. There was also a statistically significant reduction in the intensity of pain in VAS scale in all patients, median 6 (5-7) points before treatment versus 4.4 (3-7) points after treatment, P = .000001). Local ozone therapy of venous leg ulcers accelerate the healing process of ulcers in objective planimetric assessment and reduce the intensity of pain ailments.
Preparation of plasticized spinning polyacrylonitrile fibers using 1-butyl-3-methylimidazolium chloride: A review
Authors: Li Xiang , Dang Xiaonan
Published: May 2022

Ionic liquid, as a green solvent, has been widely used in high-tech fields. One of the uses is an excellent plasticizer for polymers, and a good plasticizing effect can be achieved for these polymers. 1-butyl-3-methylimidazolium chloride ([Bmim]Cl) is a kind of ionic liquid, it possesses low melting point, strong polarity, high temperature stability, and other characteristics, which can be used as a highly effective plasticizer for polyacrylonitrile (PAN) to achieve plasticized spinning. In this review, for PAN fibers, plasticizing mechanism, raw material preparation, spinning process adjustment, structural chemical change, and fiber properties were summarized. At the same time, the related reports on plasticized spinning PAN composite fibers were reviewed as well. The field that has not yet been studied in depth was also discussed in this paper. It is hoped that this paper will provide an important basis for those people who will be engaged in further study on plasticized spinning PAN (PAN composite) fibers.
Re-Imagining the Data Collection and Analysis Research Process by Proposing a Rapid Qualitative Data Collection and Analytic Roadmap Applied to the Dynamic Context of Precision Medicine
Authors: Smith James , Braithwaite Jeffrey , O’Brien Tracey A. , Smith Stephanie , Tyrrell Vanessa J. , Mould Emily V. A. , Long Janet C. , Rapport Frances
Published: May 2022

Our implementation science study focuses on implementing a new way of practice and offers methodological specificity about how to rapidly investigate an individually tailored precision medicine intervention. A qualitative study advancing a new methodology for speedily identifying barriers and enablers to implementation in the context of childhood cancer. Data were collected through rapid ethnography, coded using the Consolidated Framework for Implementation Research, and analysed by Sentiment Analysis. Thirty-eight data collection events occurred during 14 multidisciplinary tumour board meetings, 14 curation meetings, and 10 informal conversations. Sentiment Analysis distilled Consolidated Framework for Implementation Research codes to reveal key barriers and enablers to implementation. A traffic light labelling system has been used to present levels of positivity and negativity (green for strong enablers and red for strong barriers), highlighting levels of concern regarding implementation. Within the intervention design characteristics, “Adaptability” was the strongest enabler and “Design quality and safety” the strongest barrier. Among the contextual factors: “Networks and communication” were the strongest enabler, and “Available resources” were the strongest barrier. Overall, there was a higher percentage of negative sentiment towards intervention design characteristics and contextual factors than positive sentiment, while more concerns were raised about intervention design factors than contextual factors. This study offers a rapid qualitative data collection and analytic methodological roadmap for establishing barriers and enablers to a paediatric precision medicine intervention.
Validation and comparison of multiple risk scores for prediction of symptomatic intracerebral hemorrhage after intravenous thrombolysis in VISTA
Authors: Wang Yanan , Liu Junfeng , Wu Qian , Cheng Yajun , Liu Ming ,   on behalf of the VISTA Collaborators
Published: May 2022

Background and aims:

Prediction models/scores may help to identify patients at high risk of symptomatic intracerebral hemorrhage (sICH) after intravenous thrombolysis. We aimed to validate and compare the performance of different prediction models for sICH after thrombolysis using direct model estimation in the Virtual International Stroke Trials Archive (VISTA).

Methods:

We searched PubMed for potentially eligible prediction models from inception to 1 June 2019. Simple and practical models/scores were validated in VISTA. The primary outcome was sICH based on two criteria (National Institute of Neurological Diseases and Stroke, NINDS; Safe Implementation of Thrombolysis in Stroke-Monitoring Study, SITS-MOST) and the secondary outcome was parenchymal hematoma (PH). The discrimination performance of each model was evaluated using area under the curve (AUC) and calibration was evaluated by Hosmer–Lemeshow goodness-of-fit tests.

Results:

We found 13 prediction models and five models (HAT, MSS, SPAN-100, GRASPS and THRIVE) were finally validated in VISTA. A total of 1884 participants were eligible for our study, of whom the proportion with sICH was 4.6% (87/1884) per NINDS and 3.9% (73/1884) per SITS-MOST, and with PH was 11.3% (213/1884). MSS and GRASPS had the greatest predictive ability for sICH (NINDS criteria: MSS AUC 0.7, 95% CI 0.63–0.77, p < 0.001; GRASPS AUC 0.69, 95% CI 0.63–0.76, p < 0.001; SITS-MOST criteria: MSS, AUC 0.76, 95% CI 0.68–0.85, p < 0.001; GRASPS, AUC 0.79, 95% CI 0.71–0.87, p < 0.001). Similar results were found for PH (MSS AUC 0.68, 95% CI 0.64–0.73, p = 0.017; GRASPS AUC 0.68, 95% CI 0.63–0.72, p = 0.017). The calibration of each model was almost good.

Conclusion:

MSS and GRASPS had good discrimination and calibration for sICH and PH after thrombolysis as assessed in VISTA. These two models could be used in clinical practice and clinical trials to identity individuals with high risk of sICH.
Combining classical molecular docking with self-consistent charge density-functional tight-binding computations for the efficient and quality prediction of ligand binding structure
Authors: Al-Ansi Amar Y , Lu Haorui , Lin Zijing
Published: May 2022

To improve the successful prediction rate of the existing molecular docking methods, a new docking approach is proposed that consists of three steps: generating an ensemble of docked poses with a conventional docking method, performing clustering analysis of the ensemble to select the representative poses, and optimizing the representative structures with a low-cost quantum mechanics method. Three quantum mechanics methods, self-consistent charge density-functional tight-binding, ONIOM(DFT:PM6), and ONIOM(SCC-DFTB:PM6), are tested on 18 ligand-receptor bio-complexes. The rate of successful binding pose predictions by the proposed self-consistent charge density-functional tight-binding docking method is the highest, at 67%. The self-consistent charge density-functional tight-binding docking method should be useful for the structure-based drug design.
A hybrid maintenance policy with fixed periodic structure and opportunistic replacement
Authors: Melo Yan R , Cavalcante Cristiano AV , Scarf Phil , Lopes Rodrigo S
Published: May 2022

We model a maintenance policy with fixed periodic structure that is a hybrid of periodic inspection and opportunistic replacement. The policy is applicable to geographically remote systems such as offshore wind farms. The policy has three phases. Initially, there is an inspection phase to identify early defects. This is followed by a wear out phase during which corrective replacements are performed. Preventive replacement occurs at the end of this phase. The novelty of the model is an opportunistic phase, which overlaps with the latter part of the corrective phase, when preventive replacement is executed early if an opportunity arises. In this way, we model the reality in which remote systems with high logistics costs and restricted access may benefit from opportunistic visits for maintenance. Using a numerical example, we analyse the behaviour of the decision variables for a range of values of the parameters common to such systems. These parameters relate to: component heterogeneity; restricted access; default (failure to execute a planned action); arrival of opportunities and other standard parameters in a maintenance cost model. Specifically, our results indicate when opportunities can have a significant impact on the cost-rate of the optimum policy, but that leveraging opportunities cannot achieve a very high availability. Generally, we demonstrate that maintenance planning should be flexible when factors beyond the control of the maintainer impact maintenance effectiveness.
Atomization characteristics of a bluff body-assisted sonic twin-fluid atomizer
Authors: Sikka Raghav , Vågsæther Knut , Bjerketvedt Dag , Lundberg Joachim
Published: May 2022

This study examines the gas dynamic effect and atomization behaviour of the sonic bluff body-assisted twin-fluid atomizer with three distinct geometry configurations based on cone distances (Lc) as 6.0 mm, 8.0 mm, and 10.0 mm. The atomization characteristics of these atomizers employing a 280 µm annular liquid sheet with a central bluff body (cone) are compared based on a range of air and liquid flow rates. The spray-bluff body impacted secondary atomization was characterized through volume-normalized droplet size distribution (DSD) & cumulative droplet distribution, excentricity plots, Sauter mean diameter (SMD), and relative span factor (Δ). When plotted for a given liquid flow rate, the DSD & cumulative droplet distribution becomes more uniform with the increase in the airflow rate independent of the cone distance (Lc). Excentricity plots exhibited high excentricity droplets at the spray centreline and a large fraction of nearly spherical droplets at off-centre spray locations. SMD and RSF (Δ) showed opposite trends when plotted against the air-to-liquid ratio (ALR) as SMD increases while RSF decreases with radial locations, respectively. When plotted for all radial locations, Sauter mean diameter (D32) and relative span factor (Δ) show a cluster formation. Larger SMD values correspond to lower RSF (Δ) values and vice-versa.
The silver lining behind the dark cloud: Exploring the psycho-social factors impacting successful adaptation during the COVID-19 pandemic
Authors: Singh Tushar , Mittal Shalini , Sharad Shivantika , Bhanot Divya , Das Sreeja , Varma Rahul , Kaur Harleen , Merwal Udisha , Arya Yogesh K , Verma Sunil K , Jaiswal Aishwarya , Bharti Benkat Krishna
Published: May 2022

While most studies have been reporting the psychological issues being faced by the public due to the global spread of coronavirus and sudden restrictions and changes accompanying it, the present study attempted to explore dynamic human experiences during the COVID-19 pandemic and resultant lockdown, so as to understand the psycho-social factors that acted as adaptive resources or as buffers to maintain a stable mental state amidst this crisis. In-depth telephonic interviews with 30 participants were conducted to explore their experiences in dealing with the COVID-19 pandemic and the lockdown. Thematic analysis performed to identify the positive and protective factors that helped people adapt in a healthy way revealed that although the initial response of the participants to the pandemic was “optimistic bias” followed by downplaying the seriousness of the issue, later they demonstrated increased realization and acceptance to the seriousness of the situation. Upon realizing the situation, their positive psychological resources acted as a buffer against the ill effects of the pandemic, and they used both cognitive and behavioral coping. The study clearly demonstrates that crisis in life is not just a source of stress, anxiety, and uncertainty but also an opportunity to test one’s psychological resources to learn and grow.
Age and Fieldwork Experience Increase Brazilian University Students’ Ability to Identify Wild Mammals
Authors: Silva André Bastos da , Sales Francisco Arlan de , Ferreira Luciana Nobre de Abreu , Andrade Juliana Ramos de , Souto Wedson de Medeiros Silva , Lopes Clarissa Gomes Reis
Published: May 2022

A lack of engagement with the natural environment can reduce awareness of issues surrounding environmental and biodiversity conservation. Therefore, to increase students’ awareness, science teachers should develop activities related to biodiversity, bringing students into closer connection with the natural environment. This study evaluated the ability of 115 Brazilian university students’ to identify native and alien wild mammals. Patterns in university students’ ability to identify species were predicted by a combination of variables (university-level, age, gender, experience linked to countryside, family farming, fishing, and hunting). Students correctly identified alien mammals more frequently than native mammals. We found distinct groups of species in function of students’ experience (university-level, age group, fishing, and hunting). In addition, we found that the correct identification of native species was mainly associated with older male students who go regularly to the countryside, and participate in activities linked to farming, fishing, and hunting. Our findings support those from previous studies that show fieldwork classes are essential to increase the contact of an increasingly urbanized society with the local natural environment. We suggest that inclusion of fieldwork is necessary for the development of university students’ awareness regarding the richness of native mammal species and consequently, the importance of their conservation.
Short Bones, Renal Stones, and Diagnostic Moans: Hypercalcemia in a Girl Found to Have Coffin-Lowry Syndrome
Authors: Tise Christina G. , Matalon Dena R. , Manning Melanie A. , Byers Heather M. , Grover Monica
Published: May 2022

Pathogenic variants in RPS6KA3 are associated with Coffin-Lowry syndrome (CLS), an X-linked semidominant disorder characterized by intellectual disability, stimulus-induced drop attacks, distinctive facial features, progressive kyphoscoliosis, and digit anomalies in hemizygous males. Heterozygous females may also have features of CLS; however, there can be considerable phenotypic variation, often attributed to ratios of X-inactivation in various tissue types. Although skeletal anomalies and short stature are hallmarks of CLS, hypercalcemia has not been reported. Here we describe a 30-month-old girl with gross motor delays, short stature, dysmorphic features, bilateral duplicated renal collecting systems, and no family history of hypercalcemia who required multiple admissions for idiopathic hypercalcemia necessitating bisphosphonate infusions at 12.5 and 15 months of age. A maternally inherited likely-pathogenic variant in RPS6KA3 was identified by trio exome sequencing, consistent with the diagnosis of CLS in the proband and her mother. Maternal history was notable only for decreased height compared to first-degree relatives, bilateral genu valgum, and a bicornuate uterus; she was later found to also have a partially duplicated left renal collecting system. Subsequent X-inactivation studies in blood aligned with the phenotypic variation between mother and daughter. Although hypercalcemia is not a reported feature in CLS, there is evidence of interrupted osteoblast differentiation, providing a potential mechanism for hypercalcemia in this genetic condition. The hypercalcemia in this case may represent a severe presentation of an unrecognized clinical feature in CLS that resolves with age. This case further highlights the intrafamilial phenotypic variation of CLS among females, suggesting X-inactivation as the underlying mechanism, and demonstrates the value of exome sequencing in patients for whom a genetic disorder is highly suspected but not identified despite thorough evaluation.
Media as an Instrument of Reflection or Distortion of the Real Life Problems of Muslim Women in India
Authors: Shabir Aamina , Khan Tanveer Ahmad
Published: May 2022

The relationship between women and media in terms of the portrayal of the former in the latter has been a contested one. It has been an area of interest and scrutiny for academicians in general and feminists in particular. However, despite being laden with the xenophobic undercurrent, Muslim women’s depiction has not been addressed with much academic curiosity and seriousness. Muslim women per se represent a category defined by the intersection of gendered and Islamophobic vulnerabilities. The disadvantage of Muslim women has also cropped into media, with representation dominated by voiceless and docile images, primarily seen as a victim of her religion and the men folk. In the Indian scenario, the trend is quite the same with women from this marginalised community seen as victims of Muslim personal law, practices such as Hijab and polygamy, and immediate prey of the conservative and patriarchal Muslim men, which is the popular stereotype surrounding the latter. This depiction at the theoretical level can be understood as a manifestation of Edward Said’s concept of orientalism, which defines the othering of Muslims at various levels, including the institution of media perpetuating the anti-Muslim bias. Within this larger framework of orientalism, othering and intersectionality, this article seeks to the inconsistency in the actual issues faced by women of the community and those defined in the television news media.
How I Teach It: Endoscopic Evaluation of Hiatal Hernia
Authors: Katz Philip O. , Ghosh Gaurav
Published: May 2022

Hiatal herniation, migration of the gastric cardia from the abdomen cephalad into the chest are commonly present in patients with esophageal symptoms in particular gastroesophageal reflux disease. Three of the four hernia types (sliding type 1 and type 2 or 3 paraesophageal) can be diagnosed by upper endoscopy. Though hernias can also be diagnosed by barium esophagram, computed tomography, and high-resolution manometry, upper endoscopy offers the best opportunity for the foregut physician to carefully assess the patient for hernia size and type, the presence of Cameron lesions in patients with occult anemia and to evaluate the hiatus (flap valve) fully by assessment of the Hill grade in retroflexion. Accurate description of the hiatus in the endoscopy report is invaluable in communication between gastroenterologist and surgeon managing patients with esophageal disease. This “How I teach it” (and video) offers an approach to assessment of the esophageal hiatus during the endoscopic examination.
High surface IgM levels associate with shorter response to ibrutinib and BTK bypass in patients with CLL
Authors: Chiodin Giorgia , Drennan Samantha , Martino Enrica A. , Ondrisova Laura , Henderson Isla , del Rio Luis , Tracy Ian , D’Avola Annalisa , Parker Helen , Bonfiglio Silvia , Scarfò Lydia , Sutton Lesley-Ann , Strefford Jonathan C. , Forster Jade , Brake Oliver , Potter Kathleen N. , Sale Benjamin , Lanham Stuart , Mraz Marek , Ghia Paolo , Stevenson Freda K. , Forconi Francesco
Published: May 2022

Chronic lymphocytic leukemia (CLL) cells have variably low surface IgM (sIgM) levels/signaling capacity, influenced by chronic antigen engagement at tissue sites. Within these low levels, CLL with relatively high sIgM (CLLhigh) progresses more rapidly than CLL with low sIgM (CLLlow). During ibrutinib therapy, surviving CLL cells redistribute into the peripheral blood and can recover sIgM expression. Return of CLL cells to tissue may eventually recur, where cells with high sIgM could promote tumor growth. We analyzed time to new treatment (TTNT) following ibrutinib in 70 patients with CLL (median follow-up of 66 months) and correlated it with pretreatment sIgM levels and signaling characteristics. Pretreatment sIgM levels correlated with signaling capacity, as measured by intracellular Ca2+ mobilization (iCa2+), in vitro (r = 0.70; P < .0001). High sIgM levels/signaling strongly correlated with short TTNT (P < .05), and 36% of patients with CLLhigh vs 8% of patients with CLLlow progressed to require a new treatment. In vitro, capacity of ibrutinib to inhibit sIgM-mediated signaling inversely correlated with pretherapy sIgM levels (r = −0.68; P = .01) or iCa2+ (r = −0.71; P = .009). In patients, sIgM-mediated iCa2+ and ERK phosphorylation levels were reduced by ibrutinib therapy but not abolished. The residual signaling capacity downstream of BTK was associated with high expression of sIgM, whereas it was minimal when sIgM expression was low (P < .05). These results suggested that high sIgM levels facilitated CLL cell resistance to ibrutinib in patients. The CLL cells, surviving in the periphery with high sIgM expression, include a dangerous fraction that is able to migrate to tissue and receive proliferative stimuli, which may require targeting by combined approaches.