bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of aspartame- and sugar-sweetened soft drinks on postprandial metabolism
Authors: Pearson Regis C. , Green Edward S. , Olenick Alyssa A. , Jenkins Nathan T.
Published: November 2021

Aim: We compared the impact of artificially- and sugar-sweetened beverages co-ingested with a mixed meal on postprandial fat and carbohydrate oxidation, blood glucose, and plasma insulin and triglyceride concentrations. Methods: Eight college-aged, healthy males completed three randomly assigned trials, which consisted of a mixed macronutrient meal test with 20oz of Diet-Coke (AS), Coca-Cola (NS), or water (CON). One week separated each trial and each participant served as his own control. Resting energy expenditure (REE) via indirect calorimetry, blood pressure, and blood samples were obtained immediately before, 5, 10, 30, 60, 120, and 180 min after meal and beverage ingestion. A two-way (treatment × time) repeated-measures ANOVA was conducted to assess REE, fat and carbohydrate oxidation rates, blood glucose, and plasma insulin and triglyceride concentrations. Results: There was a significant main effect of treatment on total fat oxidation (P = 0.006), fat oxidation was significantly higher after AS (P = 0.006) and CON (P = 0.001) compared to following NS. There was a significant main effect of treatment on total carbohydrate oxidation (P = 0.005), carbohydrate oxidation was significantly lower after AS (P = 0.014) and CON (P = 0.001) compared to following NS. Plasma insulin concentration AUC was significantly lower after AS (P = 0.019) and trended lower in CON (P = 0.054) compared to following NS. Conclusion: Ingestion of a mixed meal with an artificially-sweetened beverage does not impact postprandial metabolism, whereas a sugar-sweetened beverage suppresses fat oxidation and increases carbohydrate oxidation compared to artificially-sweetened beverage and water.
Free-breathing contrast-enhanced multiphase MRI of the liver in patients with a high risk of breath-holding failure: comparison of compressed sensing-accelerated radial and Cartesian acquisition techniques
Authors: Choi Eun Sun , Kim Jin Sil , Nickel Marcel Dominik , Sung Jae Kon , Lee Jeong Kyong
Published: November 2021

Background

Knowing the advantages and disadvantages of each magnetic resonance (MR) technique, would allow us to choose a sequence better suited in patients with a high risk of breath-holding failure.

Purpose

To compare the image quality of free-breathing contrast-enhanced multiphase MR imaging (MRI) using incoherent Cartesian k-space sampling combined with a motion-resolved compressed sensing reconstruction (XD-VIBE) and Golden-Angle Radial Sparse Parallel MRI (GRASP).

Material and Methods

A total of 67 patients were included. Overall image quality, motion artifacts, and liver edge sharpness on arterial and portal-venous phase were evaluated by two radiologists. We evaluated the signal intensity ratio between liver in the late arterial phase to aorta at peak enhancement and the detection rate of hypervascular lesions.

Results

Overall image quality, artifact, and liver edge sharpness scores of XD-VIBE and GRASP were not significantly different ( P = 0.070–0.397). Four (reviewer 1, 12.1%) and seven patients (reviewer 2, 21.2%) received non-diagnostic quality in the XD-VIBE group whereas one patient (reviewer 2, 2.9%) received non-diagnostic quality in the GRASP group. The ratio between the aorta and liver signal for GRASP was significantly higher than that of XD-VIBE (0.32 ± 0.10 vs. 0.47 ± 0.13; P < 0.001). The hypervascular lesion detection rate of XD-VIBE (86.7%) was higher than that of GRASP (57.1%) in the arterial phase without a statistically significant difference ( P = 0.081).

Conclusion

Overall image quality of XD-VIBE and GRASP were not significantly different. More XD-VIBE examinations were rated non-diagnostic. On the other hand, the relative liver parenchymal enhancement to the aorta in the late arterial phase of GRASP was higher than that of XD-VIBE, which potentially leads to lower detectability of hypervascular lesions on arterial phase images.
The role of ultrasonography in diagnosing hourglass-like fascicular constriction(s) of the anterior interosseous nerve
Authors: Wang Tiezheng , Qi Hengtao , Wang Dehua , Wang Zengtao , Bao Shougang , Teng Jianbo
Published: November 2021

Background

In the past, the diagnosis of hourglass-like fascicular constriction(s) of the anterior interosseous nerve mostly depended on electrophysiological examination, by which the location could not be diagnosed. There are few studies on the evaluation of hourglass-like fascicular constriction(s) by ultrasonography.

Purpose

To evaluate the role of ultrasonography in the diagnosis of hourglass-like fascicular constriction(s) of the anterior interosseous nerve.

Material and Methods

A retrospective analysis of 12 patients with hourglass-like fascicular constriction(s) of the anterior interosseous nerve was carried out, and the characteristics of the high-frequency ultrasonographic images were summarized and compared with surgical exploration.

Results

The 12 cases of hourglass-like fascicular constriction(s) of the anterior interosseous nerve were all located in the median nerve of the distal upper arm, including nine cases of single hourglass-like fascicular constriction and three cases of multiple hourglass-like fascicular constrictions. High-frequency ultrasonography can accurately locate the hourglass-like fascicular constriction(s) of the anterior interosseous nerve and the extent of neuropathy. The ultrasonographic images of hourglass-like fascicular constriction(s) of the anterior interosseous nerve showed single or multiple hourglass-like change(s) in the median nerve of the distal upper arm. The nerve fascicles on both sides of the affected nerve with hourglass-like change thickened.

Conclusions

High-frequency ultrasonography could be a reliable, convenient, and non-invasive diagnostic imaging method for hourglass-like fascicular constriction(s) of the anterior interosseous nerve.
Aorta unfolding index as an indicator for coronary artery disease severity
Authors: Sakrana Amal Abdelsattar , Abdel khalek Abdel Razek Ahmed , Ibrahim Bedier Abdelnaby Ahmed , Khedr Mohamed Khedr Doaa
Published: November 2021

Background

Aortic unfolding index (AUI) is an independent predictor of cardiovascular events, yet there is scarcity in the literature on its association with the severity of coronary artery disease (CAD).

Purpose

To investigate the correlation between aortic unfolding and coronary artery disease severity score.

Material and Methods

The study included 115 patients with various degrees of CAD who underwent invasive coronary angiography and were retrospectively studied. AUI derived from non-contrast computed tomography (CT) of the chest was correlated to the Gensini score describing the CAD severity. Its sensitivity and specificity in the detection of severe stenosis were examined at various cutoff points.

Results

CAD severity was significantly correlated with the patient age and AUI. On multivariate regression analysis, AUI was an independent predictor of severe CAD. The best cutoff value was ≥66, with 94.9% sensitivity and 81.6% specificity.

Conclusion

AUI ≥66 was a predictor of severe CAD independent of the patient age.
Clinical application of three-dimensional transvaginal ultrasonography in the diagnosis of intrauterine adhesions
Authors: Jiang Xinkui , Chen Xiaofeng , Li Jiangtao , Wang Weiqi , Li Jing
Published: November 2021

Objective

The present study aimed to evaluate the diagnostic accuracy of three-dimensional transvaginal ultrasonography (3D-TVS) for intrauterine adhesions (IUA).

Methods

We performed a retrospective cohort study. A total of 500 women aged 19 to 46 years with uterine lesions who received treatment from the Department of Obstetrics and Gynecology were enrolled. Endometrial 3D imaging was conducted to obtain the display plane and 3D-TVS parameters. Patients also underwent hysteroscopy for a definitive diagnosis.

Results

For diagnosing IUA, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of 3D-TVS were 98.8%, 90.8%, 91.4%, 98.7%, and 94.8%, respectively. For diagnosing a submucosal myoma, the sensitivity, specificity, PPV, NPV, and overall accuracy of 3D-TVS were 88.2%, 97.9%, 88.2%, 97.9%, and 96.4%, respectively. For diagnosing endometrial polyps, the sensitivity, specificity, PPV, NPV, and overall accuracy of 3D-TVS were 94.7%, 96.8%, 92.9%, 97.7%, and 96.2%, respectively.

Conclusions

Before hysteroscopy, 3D-TVS, as a method of screening, has great value for comparing differences before and after treatment, and for evaluating therapeutic effects.
Italian pediatric and adult oncology communities join forces for a national project dedicated to adolescents and young adults with cancer
Authors: Ferrari Andrea , Quarello Paola , Mascarin Maurizio , Luigi Banna Giuseppe , Toss Angela , Sironi Giovanna , Zecca Marco , Cinieri Saverio , Alessandro Peccatori Fedro
Published: November 2021

Adolescents and young adults with cancer have substantially different clinical and psychological needs compared to those of pediatric patients and of older adult patients. We describe the development of an Italian national project dedicated to adolescents and young adults with cancer.
Morphology and cyclooxygenase-2 and renin expression in the kidney of young spontaneously hypertensive rats
Authors: Mondragón-Huerta Carmen G. , Bautista-Pérez Rocío , Baiza-Gutman Luis A. , Escobar-Sánchez María L. , Valle-Mondragón Leonardo Del , Salas-Garrido Carlos Gerardo , Castro-Moreno Patricia , Ibarra-Barajas Maximiliano
Published: November 2021

The kidneys play an important role in blood pressure regulation under normal and pathological conditions. We examined the histological changes and expression patterns of cyclooxygenase-2, renin, and (pro)renin receptor (PRR) in the renal cortex of prehypertensive spontaneously hypertensive rats (SHRs) and Wistar Kyoto rats (WKYs). Moreover, blood pressure and plasma urea, creatinine, angiotensin II, and angiotensin (1–7) levels were measured. The results showed that both strains had similar blood pressure and plasma urea and creatinine levels. The glomerular area, basement membrane thickness, collagen fiber content, and arterial wall thickness were greater in SHRs than in WKYs. By immunohistochemistry, cyclooxygenase-2 was localized in the macula densa and renal tubules of both strains. In SHRs, cyclooxygenase-2 was detected in a larger number of tubules, and the cortical expression of cyclooxygenase-2 was also increased. In both strains, PRR and renin were localized in the tubular epithelium and juxtaglomerular cells, respectively. In SHRs, PRR immunolocalization was increased in the glomerulus. The cortical expression of immature renin was markedly increased in SHRs compared to that in WKYs, while renin was significantly decreased. These changes were associated with higher plasma angiotensin II levels and lower plasma angiotensin (1–7) levels in SHRs. The results indicate that the kidneys of SHRs showed morphological changes and variations in cortical expression patterns of PRR, cyclooxygenase-2, and renin before the development of hypertension.
A novel approach to envisage effects of boron in P91 steels through Gleeble weld-HAZ simulation and impression-creep
Authors: Khajuria Akhil , Akhtar Modassir , Bedi Raman
Published: November 2021

This paper induced a novel methodology for the characterization of creep behavior of weld heat-affected zone (HAZ) for boron-free P91 (PM) and boron modified P91B (B-PM) steels. Gleeble-3800 thermo-mechanical simulator replicated specimens, representing coarse-grain HAZ (CGHAZ), fine-grained HAZ (FGHAZ), and inter-critical HAZ (ICHAZ). Short-term impression creep tests were conducted at 625°C/270-410MPa on PM/B-PM and their simulated HAZs after being subjected to post-weld heat treatment (PWHT) of 760°C/3 h. Microstructural characterization and local strain analyses were accomplished by electron back-scattered diffraction. Simulated microstructures of P91B-FG/ICHAZ after PWHT exhibited lath martensitic structure and large prior-austenite grain size as regards P91-FG/ICHAZ, correspondingly. Average values of local microstructural strain from local average misorientation were relatively high in B-PM and P91B-ICHAZ than PM and P91-ICHAZ, respectively. Similar observations were found for P91-CG/FGHAZ with their counterparts. Stress dependent steady-state creep-rate (SSCR) followed power-law for all specimens except PM. The minimum and maximum ranges of SSCR for P91B specimens were observed to be in a narrower range than P91 specimens. The value of stress exponent for all specimens was evaluated, and corresponding mechanisms were discussed. The analyses of microstructures and corresponding impression creep behavior of P91/P91B samples suggested that modification of 100 ppm boron to P91 steel improved creep-rupture ductility that delayed type IV failure at outer HAZ of P91 steel weldments.
Anaesthesia Trainees’ Exposure to Airway Management in an Australian Tertiary Adult Teaching Hospital
Authors: Clarke R. C. , Gardner A. I.
Published: November 2021

The purpose of this study was to estimate the exposure of trainees to airway management techniques in an Australian tertiary adult teaching hospital. Anaesthesia records for all patients over a 20-week period were reviewed and the following data were obtained: the presence of a trainee, the type of airway used, the grade of the laryngoscopic view and the use of non-standard laryngoscopy for intubation. Data was recorded contemporaneously and analysed retrospectively. The data was then extrapolated to give a yearly estimate of airway procedures per trainee. There were 28 full-time trainees in the department over the study period. The estimated mean number of standard intubations performed per trainee per year was 157.4, with 2.9% being grade 3 or 4 laryngoscopies. The estimated mean annual numbers for other airway techniques were: 1.2 fibreoptic intubations, 0.5 mask-only anaesthetics and 3.7 endobronchial double-lumen tubes. Our results suggest that trainees’ exposure to airway management techniques is not extensive. As there is no previous study to determine experience gained by trainees, we are unable to establish whether there has been a decrease in experience, however we believe this is likely. Although competency is difficult to assess, it may be that this data has implications for training, unsupervised practice and rostering. Experience in certain airway skills may need to be supplemented using techniques such as simulation.
3D Laser Triangulation and Deep Learning Approach to Tunnel Inspection
Authors: Fox-Ivey Richard , Petitclerc Benoit , Laurent John
Published: November 2021

Regular inspection of tunnel surfaces is an important practice from both a safety and tunnel asset management perspective. However, inspection for cracking and spalling is still predominantly a manual task, which is time consuming, subjective, and exposes on-foot staff to risk. This presentation will explore the use of 3D laser scanning technology and artificial intelligence to automate the inspection process with a Canadian metro case study being presented.
Resident Perspectives on Palliative Care at an Urban Teaching Hospital
Authors: Raman Uma , Ebby Cris G. , Ahmad Seherisch , Mukherjee Thayer , Yang Ellen , Fofah Onajovwe , Scolpino Anthony J. , Oleske James M.
Published: November 2021

Background: There has been an increasing need to address end of life (EOL) care and palliative care in an era when measures to extend life for terminal illnesses are often initiated without consideration of quality of life. Addressing the barriers for resident physicians to initiate EOL conversations with patients is an important step towards eliminating the disconnect between patient wishes and provider goals. Objective: To assess resident physician perspectives on initiating palliative care conversations with terminally ill patients at an urban teaching hospital. Methods: This paper solicited the experiences of pediatric, general surgery, and internal medicine residents through an anonymous survey to assess exposure to palliative care during training, comfort with providing palliative care, and barriers to implementing effective palliative care. Results: 45% of residents reported exposure to palliative care prior to medical training. Ninety-three percent of these residents reported being formally introduced to palliative care during medical training through formal lecture, although the majority reported also being exposed through either small group discussions or informal teaching sessions. Time constraints and lack of knowledge on how to initiate and continue conversations surrounding EOL care were the greatest barriers to effectively caring for patients with terminal illnesses. Residents concurred that either attending physicians or hospital-designated palliative care providers should initiate palliative care discussions, with care managed by an interdisciplinary palliative care team; this consensus demonstrates a potential assumption that another provider will initiate EOL discussions. Conclusions: This study evaluated the current state of physician training in EOL care and provided support for the use of experience-based training as an important adjunct to traditional didactic lectures in physician education.
Death lurks in grey seas: Experiences of the maritime crossing between Argentina and Europe during the First World War
Authors: Desiderato Agustín Daniel
Published: November 2021

In recent years, the repercussions of the First World War in Latin America have received increasing attention in the academic literature. However, the impact of the war at sea on the continent has not been exhaustively investigated. With the belligerents fighting for control of overseas communication and trade routes, passengers and sailors embarked on ocean liners and cargo ships to travel between South America and Europe. This article explores and analyses the experiences of those who crossed the Atlantic to and from the Argentine Republic. In so doing, it adds a Latin American dimension to the knowledge and understanding of the 1914–18 naval war.
Mughal port officials and European company-men: The dynamics of a commercial relationship in the seventeenth century
Authors: Khwaja Aasim
Published: November 2021

The description of the Mughals as a land-driven power that remained largely inert to maritime opportunities and challenges does not sufficiently explain their increasing reliance on the seaborne delivery of strategic goods such as horses, bullion and specialised military labour. In this context, the article focuses on the office of mutasaddi, which operationalised Mughal authority at the port of Surat. By analysing the interactions of mutasaddis with European trading companies, it is shown that the Mughal presence was central to the shaping of the maritime trajectory of the region. As long as the Mughal oversight was vigilant, the port officials dominated the Europeans. But once the Mughal presence came to be hollowed out, new forces set in that ultimately enabled the Europeans to turn the tables on the port officials.
Is Violence, Violence no Matter Where it Strikes? Adjudicated Boys, Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide
Authors: Van Wyk Judy A.
Published: November 2021

This study explores treating violence against others as a precursor to self-directed violence. It tests the utility of including violence against others in the measure of acquired capability to test assumptions from the interpersonal theory of violence. Four theoretical hypotheses are assessed that are consistent with the theory: (1) thwarted belongingness (parental abandonment and rejection) and perceived burdensomeness (exposure to parental interpersonal violence and child abuse) independently increase the likelihood of suicidal ideation; (2) the interaction of thwarted belongingness and perceived burdensomeness increases the likelihood of suicidal ideation controlling for other pertinent variables; (3) the three-way interaction of thwarted belongingness, perceived burdensomeness, and acquired capability (violence against others and prior suicidal attempts) increases the likelihood of suicidal attempts controlling for other pertinent variables; and (4) self-harm responds to the theoretical variables and similarly, to attempts. Subjects are court-adjudicated males (ages 13–18) who were residents for up to 1 year at the Ocean Tides School and rehabilitation center from 1975–2019. The data span 44 years and include 2195 youth. Depression, drug/alcohol use, race, ethnicity, socioeconomic status, and interaction terms between SES and race and SES and ethnicity are also examined. Backward conditional logistic regression analyses find mixed support for the hypotheses, but strong support for including violence against others in the concept of acquired capability. Support is also found for conceptualizing child abuse and exposure to parental interpersonal violence as perceived burdensomeness in tests of this theory as well as measures of depression. Major implications for programming in the treatment and rehabilitation of delinquent boys include conceptualizing and approaching violence against others as a precursor to suicidal attempts and other self-directed harm.
Postnatal Unit Experiences Associated With Exclusive Breastfeeding During the Inpatient Stay: A Cross-Sectional Online Survey
Authors: Tully Kristin P. , Smith Jacquana L. , Pearsall Marina S. , Sullivan Catherine , Seashore Carl , Stuebe Alison M.
Published: November 2021

Background:

Efforts to provide accessible and effective infant feeding support are advancing to set up new families to meeting their goals. However, data continue to be limited for understanding how inpatient postpartum support and experiences contribute to exclusive breastfeeding during hospitalization.

Research Aims:

To explore postnatal unit experiences including skin-to-skin contact, overnight support, rooming-in, responsive clinicians, and understandable communication that correlate with early infant feeding outcomes among a sample of mothers who intended to breastfeed.

Methods:

This was a prospective cross-sectional survey study. Through secure online survey, participants submitted ( N = 2,401) responses from November 2016 to May 2017 about their experiences with maternity healthcare and offered thoughts on the postnatal unit environment. Descriptive statistics were used to examine distributions of maternal characteristics, postpartum experience, and birthing facility characteristics.

Results:

Exclusive breastfeeding was positively correlated with the following postnatal unit experiences: mother did not ask that her infant be taken out of the postnatal unit room; infant staying in postnatal unit room except for treatment(s); mother got help from clinical staff when needed after pressing the call button; and nurse, midwife, and/or doctor always explained information to mother in ways that they understood.

Conclusion:

Postnatal unit experiences associated with exclusive breastfeeding during postpartum hospitalization were rooming in; parents who did not ask for their infant to be taken out of the unit room; whether mothers received timely help from clinical staff; and information was explained in a way they could understand.
Healthcare Professionals’ Breastfeeding Attitudes and Hospital Practices During Delivery and in Neonatal Intensive Care Units: Pre and Post Implementing the Baby-Friendly Hospital Initiative
Authors: Mäkelä Heli , Axelin Anna , Kolari Terhi , Kuivalainen Tuula , Niela-Vilén Hannakaisa
Published: November 2021

Background:

The Baby-Friendly Hospital Initiative represents a global effort to support breastfeeding. Commitment to this program has been associated with the longer duration and exclusivity of breastfeeding and improvements in hospital practices. Further, healthcare professionals’ breastfeeding attitudes have been associated with the ability to provide professional support for breastfeeding.

Research Aims:

To determine healthcare professionals’ breastfeeding attitudes and hospital practices before and after the implementation of the Baby-Friendly Hospital Initiative.

Methods:

Using a quasi-experimental pretest–posttest study design, healthcare professionals ( N = 131) from the single hospital labor and delivery, maternity care, and neonatal intensive care were recruited before and after the Baby-Friendly Hospital Initiative intervention during 2017 and 2019. Breastfeeding attitudes with the validated Breastfeeding Attitude Questionnaire, breastfeeding-related hospital practices, and background characteristics were collected.

Results:

The healthcare professionals’ breastfeeding attitude scores increased significantly after the implementation of the Baby-Friendly Hospital Initiative, difference = 0.16, (95% CI [0.13, 0.19]) and became breastfeeding favorable among all professional groups in each study unit. Positive changes in breastfeeding-supportive hospital practices were achieved. The infants had significantly more frequent immediate and uninterrupted skin-to-skin contact with their mothers. The rate of early breastfeeding, as well as the number of exclusively breastfed infants, increased.

Conclusions:

After the Baby-Friendly Hospital Initiative and Baby-Friendly Hospital Initiative for neonatal wards (Neo-BFHI) interventions were concluded, we found significant improvements in the breastfeeding attitudes of healthcare professionals and in breastfeeding-related care practices. This RCT was registered (0307-0041) with ClinicalTrials.gov on 03/03/2017.
Asynchronous ecological upheavals on the Western Mediterranean islands: New insights on the extinction of their autochthonous small mammals
Authors: Valenzuela Alejandro , Torres-Roig Enric , Zoboli Daniel , Pillola Gian Luigi , Alcover Josep Antoni
Published: November 2021

Comparative studies on extinction scenarios are an invaluable contribution to enhance our understanding of their patterns and mechanisms underpinning them. This paper presents new radiocarbon dates based on specimens of five extinct mammal species from Mallorca and Sardinia. The new evidence permits to reanalyse the extinction dynamics on both islands. Radiocarbon ages directly obtained on bone collagen from these species show evidence of different extinction patterns on Mallorca and Sardinia. For Mallorca the most reliable scenario is a mass extinction of all non-volant mammal species as an immediate consequence of the first human irruption on the island. However, for Sardinia, the extinction of autochthonous mammals lasted over several millennia. The new radiocarbon dates of the last occurrence of endemic mammals suggest a sequence of punctuated extinction events throughout the late Sardinian Holocene. These events are here tentatively related to successive human colonisation waves. The current lack of chronological dates for some Sardinian fossil mammals impedes to outline a more accurate pattern of extinction events. The present paper points that Mallorca have been more vulnerable than Sardinia to the external disturbances introduced by humans. We suggest that the capacity of each island to absorb external perturbations could be related to the island area, the duration of the isolated evolution and the degree of faunal complexity.
Ranking procedures for repeated measures designs with missing data: Estimation, testing and asymptotic theory
Authors: Rubarth Kerstin , Pauly Markus , Konietschke Frank
Published: November 2021

We develop purely nonparametric methods for the analysis of repeated measures designs with missing values. Hypotheses are formulated in terms of purely nonparametric treatment effects. In particular, data can have different shapes even under the null hypothesis and therefore, a solution to the nonparametric Behrens-Fisher problem in repeated measures designs will be presented. Moreover, global testing and multiple contrast test procedures as well as simultaneous confidence intervals for the treatment effects of interest will be developed. All methods can be applied for the analysis of metric, discrete, ordinal, and even binary data in a unified way. Extensive simulation studies indicate a satisfactory control of the nominal type-I error rate, even for small sample sizes and a high amount of missing data (up to 30%). We apply the newly developed methodology to a real data set, demonstrating its application and interpretation.
Bayesian variable selection in hierarchical difference-in-differences models
Authors: Normington James P , Lock Eric F , Murray Thomas A , Carlin Caroline S
Published: November 2021

A popular method for estimating a causal treatment effect with observational data is the difference-in-differences model. In this work, we consider an extension of the classical difference-in-differences setting to the hierarchical context in which data cannot be matched at the most granular level. Our motivating example is an application to assess the impact of primary care redesign policy on diabetes outcomes in Minnesota, in which the policy is administered at the clinic level and individual outcomes are not matched from pre- to post-intervention. We propose a Bayesian hierarchical difference-in-differences model, which estimates the policy effect by regressing the treatment on a latent variable representing the mean change in group-level outcome. We present theoretical and empirical results showing a hierarchical difference-in-differences model that fails to adjust for a particular class of confounding variables, biases the policy effect estimate. Using a structured Bayesian spike-and-slab model that leverages the temporal structure of the difference-in-differences context, we propose and implement variable selection approaches that target sets of confounding variables leading to unbiased and efficient estimation of the policy effect. We evaluate the methods’ properties through simulation, and we use them to assess the impact of primary care redesign of clinics in Minnesota on the management of diabetes outcomes from 2008 to 2017.
Impact of minimal sufficient balance, minimization, and stratified permuted blocks on bias and power in the estimation of treatment effect in sequential clinical trials with a binary endpoint
Authors: Lauzon Steven D , Zhao Wenle , Nietert Paul J , Ciolino Jody D , Hill Michael D , Ramakrishnan Viswanathan
Published: November 2021

Minimization is among the most common methods for controlling baseline covariate imbalance at the randomization phase of clinical trials. Previous studies have found that minimization does not preserve allocation randomness as well as other methods, such as minimal sufficient balance, making it more vulnerable to allocation predictability and selection bias. Additionally, minimization has been shown in simulation studies to inadequately control serious covariate imbalances when modest biased coin probabilities (≤0.65) are used. This current study extends the investigation of randomization methods to the analysis phase, comparing the impact of treatment allocation methods on power and bias in estimating treatment effects on a binary outcome using logistic regression. Power and bias in the estimation of treatment effect was found to be comparable across complete randomization, minimization, and minimal sufficient balance in unadjusted analyses. Further, minimal sufficient balance was found to have the most modest impact on power and the least bias in covariate-adjusted analyses. The minimal sufficient balance method is recommended for use in clinical trials as an alternative to minimization when covariate-adaptive subject randomization takes place.
An Empirical Exploration of MOOC Effectiveness Towards Participants’ Intention-Fulfilment and Learners’ Satisfaction
Authors: Pathak Ankita , Mishra Sunil
Published: November 2021

The research studied learner satisfaction and learner intention-fulfilment (IF) with the massive open online courses (MOOCs). Many authors have studied various prospects from the point of view of the developer. Retention and completion rate were studied by the authors but the satisfaction level of the students was untouched. The modern education system is more learner-centred which leads to lifelong learning. Lifelong learning focuses on the learner rather than the developer. The questionnaire was harvested among 177 MOOC participants. Various analyses such as mean, standard deviation, correlation, regression and analysis of variance (ANOVA) were applied with the help of statistical tool SPSS v26.0. The results reveal that the satisfaction level of the learner is affected positively by variables like online self-regulated learning which includes goal setting, behavioural variables and perceived course usability. Further, the satisfaction level of the participant is not dependent upon gender and age. Also, the previous learning experience of the participant does not affect their IF.
Entrepreneurial Competencies, Institutional Voids and Performance of Small and Medium Enterprises: Evidence from an Emerging Economy
Authors: Kovid Raj K. , Bhati Babita , Sharma Gunjan Mohan
Published: November 2021

The entrepreneurs leverage their competence to exploit the entrepreneurial opportunities in a market leading to improved firm performance. This study investigates the relationship between entrepreneurial competences and financial and non-financial performances of small and medium enterprises (SMEs). It further investigates whether presence of institutional voids moderates this relationship. Using the survey method, the data were collected from owner-cum-founder of 204 SMEs from manufacturing sector, in the National Capital Region of India, an emerging economy. A structured questionnaire was used to capture the data. The results suggest that entrepreneurial competence significantly affects the financial performance of the firm whereas it has insignificant effect on the non-financial performance. Further, institutional voids moderate the relationship between entrepreneurial competence and non-financial performance of the firms whereas it does not show any moderating effect on the relationship between entrepreneurial competence and financial performance of SMEs. This study does have some managerial implications for entrepreneurs who can use their competencies to the fullest while working around institutional voids. This study contributes to advance the understanding about the role of institutional voids in influencing the relation of entrepreneurial competence with SMEs’ performance.
Research issues in neonatal seizures
Authors: Venkataseshan S. , Murki Srinivas , Jain Naveen
Published: November 2021

Neonatal seizures are a common and serious problem. There are many management related issues that have no sufficient evidence to support current practices. Most units in the world do not have facilities to monitor EEG at the time “seizures” occur. Also non - availability of trained personnel who can interpret neonatal EEG further limits diagnosis to clinical observation. There is a need for a tool that is easier to use and interpret and also to develop clinical diagnostic algorithms that may allow diagnosis of seizures with reasonable accuracy. Newer AEDs are being used more often with the expectation of being better with respect to the developing brain; but most haven't been tested systematically. The thresholds for starting AED, escalating therapy and discontinuing seizures are not based on evidence. There is a need to report longer follow ups in these vulnerable neonates. The document explores possible areas of research in neonatal seizures and proposes models that may be useful for a developing country.
Oxygen therapy in newborns
Authors: Dalai Shamsher S. , Kumar Rajesh , Singh Daljit
Published: November 2021

After more than half a century of use of oxygen in neonates, there are many areas related to oxygen therapy in neonates in which the available information based on current evidence remains inadequate. To address the knowledge gaps that prevent optimal, evidence-based care in this critical field, National Neonatology forum, India is bringing out a set of guidelines on Oxygen therapy in neonates. The present article, which is based on these guidelines, proposes to review oxygen therapy in neonates including what is presently known on this topic, gaps in knowledge and researchable issues.
Research issues in the Follow up of high risk neonates
Authors: Mukhopadhyay Kanya , Suryawanshi Pradeep , Pandit Anand
Published: November 2021

Very low birth weight (VLBW) babies are at risk of long term growth and neurodevelopmental disabilities. There is plenty of literature available from western countries however unfortunately very scanty data is available from our country. Our babies are different than babies born in the west due to differences in racial, cultural and socioeconomic factors. Hence we need to have our own data for the long term growth and neurodevelopment of our VLBW babies. We are proposing the following guidelines to formulate the long term follow up studies for high risk newborns.
Researchable issues in care of normal newborn, neonatal transport, hypoglycemia, CPAP, cranial ultrasonography and blood component therapy
Authors: Saini Shiv Sajan , Kumar Praveen
Published: November 2021

This article presents a summary of the current knowledge gaps and research questions related to care of normal newborn, neonatal transport, hypoglycemia, CPAP, cranial ultrasonography and blood component therapy.
The Welfare State in India: From Segmented Approach to Systems Approach in Social Protection
Authors: Duggirala Aditya , Kumar Rohit
Published: November 2021

Social protection in India is segmented with multiple programmes applying different targeting methods to design and implementation, providing varied benefits and covering different groups of the population. Such approach to social protection has policy implications for not only India but also for other emerging countries following similar path. A shift to a systems approach to social protection is required to provide comprehensive coverage over the life course of an individual while improving equity and efficiency. In this article, we introduce the welfare state in India, provide a comparative analysis of various programmes, challenges posed by the segmented approach to social protection including barrier to emergency responses and some reforms to consider to move to a systems approach to social protection. We highlight how integrating and consolidation of programmes in the same area, leveraging digital technology and unique identification number, creation of a single database, etc., can speedup progressive universalism.
IIB or not IIB, part 1: retrospective evaluation of Kenney–Doig categorization of equine endometrial biopsies at a veterinary diagnostic laboratory and comparison with published reports
Authors: Westendorf Jane , Wobeser Bruce , Epp Tasha
Published: November 2021

The Kenney–Doig scale is a histopathology categorization (grading) system often used as the standard for assessing endometrial disease and communicating prognostic fertility information for equine breeding prospects. We investigated how Kenney–Doig categories compared within the same institution and across different institutions to determine if observer variability may contribute to category frequencies. We conducted a retrospective analysis of all equine endometrial submission records between 1998 and 2018 at the Western College of Veterinary Medicine (WCVM) and Prairie Diagnostic Services (PDS). Of 726 biopsies, we found the following category distribution: 46 of 726 (6.3%) I, 307 of 726 (42.3%) IIA, 326 of 726 (44.9%) IIB, and 47 of 726 (6.5%) III. We also conducted a review of the literature and included 6 studies reporting Kenney–Doig category distributions. Chi-square analysis showed significant differences between the category distribution found at WCVM and PDS and the category distribution reported in the 6 studies. To account for differences in mare populations, individual category distributions were generated for 5 pathologists at the WCVM and PDS. The Fisher exact test among these 5 Kenney–Doig categories revealed significant differences in category tendencies, suggesting that observer variation affects the use of the scale. Our results suggest that there is a need for prospective inter-rater and intra-rater agreement studies of the repeatability of the Kenney–Doig scale.
Beyond Fundamental Dimensions of Mood in Predicting Depressive Symptoms and Suicidal Ideation in Victims of Interpersonal Violence: Examining the Role of Dispositional Optimism in Chinese Females With and Without Experience of Victimization
Authors: Du Yifeng , Chang Olivia D. , Li Mingqi , Kwon Misu
Published: November 2021

The present study tested a prediction model involving affectivity and dispositional optimism as predictors of suicide risk (i.e., depressive symptoms and suicidal ideation) in young adult Chinese females with and without prior interpersonal violence (IPV) victimization (294 nonvictimized and 94 victimized females). Results of hierarchical regression analyses indicated that negative affectivity was a significant predictor of both depressive symptoms and suicidal ideation for Chinese females, regardless of IPV victimization. Beyond affectivity, dispositional optimism was found to further add to the prediction model of depressive symptoms in both groups, but only for suicidal ideation in the IPV victimized group.
Guidance for management of free-roaming community cats: a bioeconomic analysis
Authors: Benka Valerie A , Boone John D , Miller Philip S , Briggs Joyce R , Anderson Aaron M , Slootmaker Christopher , Slater Margaret , Levy Julie K , Nutter Felicia B , Zawistowski Stephen
Published: November 2021

Objectives

This study used computer simulation modeling to estimate and compare costs of different free-roaming cat (FRC) management options (lethal and non-lethal removal, trap–neuter–return, combinations of these options and no action) and their ability to reduce FRC population abundance in open demographic settings. The findings provide a resource for selecting management approaches that are well matched for specific communities, goals and timelines, and they represent use of best available science to address FRC issues.

Methods

Multiple FRC management approaches were simulated at varying intensities using a stochastic individual-based model in the software package Vortex. Itemized costs were obtained from published literature and expert feedback. Metrics generated to evaluate and compare management scenarios included final population size, total cost and a cost efficiency index, which was the ratio between total cost and population size reduction.

Results

Simulations suggested that cost-effective reduction of FRC numbers required sufficient management intensity, regardless of management approach, and greatly improved when cat abandonment was minimized. Removal yielded the fastest initial reduction in cat abundance, but trap–neuter–return was a viable and potentially more cost-effective approach if performed at higher intensities over a sufficient duration. Of five management scenarios that reduced the final population size by approximately 45%, the three scenarios that relied exclusively on removal were considerably more expensive than the two scenarios that relied exclusively or primarily on sterilization.

Conclusions and relevance

FRCs present a challenge in many municipalities, and stakeholders representing different perspectives may promote varying and sometimes incompatible population management policies and strategies. Although scientific research is often used to identify FRC impacts, its use to identify viable, cost-effective management solutions has been inadequate. The data provided by simulating different interventions, combined with community-specific goals, priorities and ethics, provide a framework for better-informed FRC policy and management outcomes.
Value of ocular trauma score in predicting the incidence of secondary glaucoma after closed globe injury
Authors: Hou Xu , Guo Xinxing , Cui Zhili , Wang Yusheng , Zhou Jian , Hu Dan
Published: November 2021

Aim

To analyze the visual acuity (VA) and the incidence of secondary glaucoma among patients with closed globe injury (CGI). To determine the correlations between the ocular trauma score (OTS) with surgery rate, and evaluate the applicability of OTS in secondary glaucoma prediction and treatment.

Methods

We conducted a retrospective review of 265 patients (265 eyes) with CGI admitted to Xijing Hospital between January 2014 and December 2016. The clinical characteristics; VA, IOP, injury zone, surgery, and IOP-lowering medications were collected at the initial visit and at six months. The patients with secondary glaucoma were scored and assessed by the OTS system. The correlation of the anti-glaucoma surgery with the OTS was evaluated. The difference in the number of IOP-lowering medications between the initial visit and six months was analyzed.

Results

The average age of the patients was 33.5 ± 20.7 years with 80.8% being males. The final VA outcome improved in its totality after treatment. 35 patients developed glaucoma, with an incident rate of 13.2% over six months. All glaucoma patients had an injury in zone I and II, and 12 of them had an injury in zone III. The severity of the OTS category showed a strong correlation with the anti-glaucoma surgery rate. After the surgical intervention, the number of IOP-lowering medications in OTS category 2, 3, and 4 significantly reduced.

Conclusions

The OTS has predictive value in the incidence of secondary glaucoma after CGI. A patient with a low score is more likely to develop secondary glaucoma and might require surgical intervention.
Wide-field swept source optical coherence tomography evaluation of posterior segment changes in highly myopic eyes
Authors: Meng Li-Hui , Yuan Ming-Zhen , Zhao Xin-Yu , Yu Wei-Hong , Chen You-Xin
Published: November 2021

Background

To investigate the features in the posterior pole of highly myopic (HM) eyes using a wide-field high-resolution swept source optical coherence tomography (SS OCT).

Methods

This observational cross-sectional study involved 262 eyes of 139 patients, who were diagnosed as HM and had consecutively been examined by SS OCT in the Ophthalmology Department of the Peking Union Medical College Hospital between March 2019 and December 2019. The characteristics of OCT images were documented and analyzed.

Results

In our study, SS OCT could demonstrate the entire layer of the choroid and detect the sclera in all eyes. The mean subfoveal retinal/choroidal/scleral thickness were 204.84 ± 119.86 μm, 92.80 ± 75.78 μm and 394.734 ± 123.09 μm, respectively. 138 eyes (52.67%) had posterior precortical vitreous pocket. Myopic foveoschisis was detected in 110 eyes (41.98%), and significantly associated with the presence of posterior staphyloma. 36 eyes (13.74%) had DSM in our study, of which 8 eyes (22.22%) showed a round dome, 16 (44.44%) were horizontal oval-shaped, 9 (25%) were vertical oval-shaped and 3 (8.34%) were oblique oval-shaped. Both SFCT and SFST were inversely and significantly associated with age and refractive errors. Macular neovascularization was significantly correlated with intrascleral vessels. Different deformation of the sclera and posterior staphyloma were vividly identified on SS OCT images.

Conclusions

This study provided a relatively comprehensive picture of posterior pole in HM eyes. Such good visualization of ocular fundus provided by wide-field SS OCT could be useful for the therapy option, disease condition monitoring and pathogenesis investigation.