bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of end-of-life vehicles management in 31 European countries: A LMDI analysis
Authors: Korica Predrag , Cirman Andreja , Žgajnar Gotvajn Andreja
Published: January 2022

In 2018, a total of 6,083,000 end-of-life vehicles (EVLs) with a total weight of 6,732,000 tonnes (including waste parts) were generated in the European Union. These vehicles are a subject of particular attention because of their bulky mass, the hazardous components they contain, and the valuable materials present. This article analyses the quantities of ELVs and parts of ELVs that have been recycled, energy recovered, disposed, and reused to assess the impact of the changes in these management options on the total quantities managed. The analysis covered the statistical data on EVLs in 31 European countries for the period 2006–2018, using a new extended version of the logarithmic mean divisia index (LMDI) analysis model, which allows analysts to compare and analyse different waste management options simultaneously. The results show that the changes in the waste intensities and household final consumption expenditure were the greatest drivers of changes in the total quantities managed, while changes in the quantities recycled, energy recovered, disposed of, and reused had the least impact. All countries met or were close to meeting the targets during the period analysed. Changes in the total quantities of waste managed depended on the economic activity, which influenced the quantities of ELVs generated and their subsequent management.
The management of personal protective equipment during the COVID-19 pandemic: The case of the province of Quebec
Authors: Beaulieu Martin , Roy Jacques , Rebolledo Claudia , Landry Sylvain
Published: January 2022

Like other Canadian provinces, Quebec managed shortages of Personal Protective Equipment (PPE) in the early weeks of the COVID-19 pandemic. Two years later, with hindsight, what lessons can we learn from this logistics crisis? It is precisely to better understand the decisions made by the supply chain players in the province of Quebec that this paper was written. To fully understand the events, this paper first describes the Quebec healthcare system. Then it retraces the series of events and actions during the first wave, at a time when it was most challenging to procure PPE. It also specifies the main characteristics of the supply chain in the Quebec healthcare sector. Finally, it analyzed these data to come up with recommendations to help public decision makers adopt better supply chain management practices.
Luddites of the Twenty-First Century? The Influence of Trade Unions in Hard Coal Mining on Sector Reforms in Poland and the Czech Republic
Authors: Kubin Tomasz
Published: January 2022

There are only two European Union (EU) states where hard coal is still mined: Poland and the Czech Republic. One of the key interest groups in the hard coal mining industry are trade unions. They are particularly strong in this sector, almost entirely controlled by the state, in Poland—without their approval, it is in fact impossible to implement any significant reforms. The main goal of the article is to explain the influence of trade unions operating in the hard coal mining sector in Poland and the Czech Republic on the results of the reforms of this sector carried out in 2015–2019. The framework for empirical analysis is the theoretical output on interest groups and the power resources approach. Measuring the influence of an interest group on the decision-making process is one of the greatest challenges in research on interest groups. However, the empirical analysis allows us to conclude that the purposes of mining trade unions both in Poland and in the Czech Republic were consistent, that the shape of the reforms introduced in 2015–2019 was convergent with these goals, and that the activity of trade unions had a very big impact on these reforms. However, in the long run, hard coal mining in Europe is in decline and trade unions are only trying to stop what is inevitable.
Dysexecutive Behaviors Mediate the Relationship Between Functional Impairment and Caregiver Burden in Mild Cognitive Impairment
Authors: Chapman Kimberly R. , Tremont Geoffrey
Published: January 2022

Mild cognitive impairment (MCI) is often accompanied by executive dysfunction (ED), dysexecutive behaviors (DB), and functional impairment (FI). The respective contributions of ED, DB, and FI to caregiver burden in MCI are not well understood. The present study hypothesized that while all factors would predict caregiver burden in MCI, ED and family-reported DB would account for greater variance in caregiver burden and mediate the relationship between FI and caregiver burden. In our sample (n = 94), linear regression revealed that FI and DB predicted caregiver burden, but that DB predicted caregiver burden above and beyond the contribution of FI. DB mediated the relationship between FI and caregiver burden. These results add to a body of work demonstrating that presence of DB and FI are distressing to family members, even in mild disease stages. Because DB may account for the relationship between FI and caregiver burden, early identification of family members reporting DB in the person with MCI is imperative so that supports can be made available.
Investigation on the surface roughness modeling and analysis for ultra-precision diamond turning processes constrained by the complex multisource factors
Authors: Fu Siyuan , Yang Hong , Sun Shouli , Zhang Min , Liu Youhai , Zhang Yongbin , Jiang Zhong , Pan Long
Published: January 2022

Ultra-precision machining is widely used in the manufacturing of national defense and sophisticated civil products because of its high precision, nearly no surface damage and other advantages. The surface roughness of a workpiece is the key indicator of ultraprecision machining technology, which is affected by many factors in the process of machining. However, the existing surface roughness prediction model only considers a single error factor between the tool and workpiece, lacking comprehensive consideration of multisource error factors. Therefore, based on the research of the single error factor, multisource errors that affect the surface roughness of a workpiece in machining was investigated in this paper. A prediction model of workpiece surface roughness under multisource error affecting was established to improve the accuracy of prediction models. According to the vibration model, the sensitive direction of roughness can be determined. In the axial direction, the error of each point on the surface is superimposed with the theoretical surface shape to obtain the final surface profile. The three-dimensional morphology was established and the two-dimensional topography can be obtained by intercepting the three-dimensional topography. The roughness simulation value is obtained by extracting the peak value of each point of the two-dimensional topography. A single-point diamond turning experiment is performed to verify the simulation models. The result concluded from the experiment is compared with the simulation result, showing that the error between the simulation and the experiment is less than 4%, which is of great significance to optimizing machining process parameters and improving machining precision of workpiece surfaces for ultraprecision single point diamond turning.
Creativity and cognition in fiction by teenage learners of English
Authors: Kokkola Lydia , Rydström Ulla
Published: January 2022

Learning a foreign language provides an entry point into the lives of cultural ‘others’, as does the reading of realistic fiction. Responding to the challenges of both tasks requires concerted cognitive effort, but also creativity. First, individuals need to override the automatic tendency to prioritise their own point of view and then, at least temporarily, imagine themselves into another’s position. When reading fiction, focalisation determines whose views the readers can access, but point of view is implicit in all language. L2 learners need to recognise and imitate the world view implicit in the target language. In this article, we present both skills – empathy and mimicry – as acts of creative cognition that develop from responding to literature. This article examines works of fiction written by 15–16-year-old Swedish learners of English in response to a short story by Salman Rushdie. The story contains culturally specific information, and the ending encourages readers to recognise their own assumptions alongside the focalising character. The study draws on cognitive narratology to examine the Swedish learners’ fiction in terms of empathy and mimicry. The aims of the analyses are to determine how the short story and task design promote creative cognition, and to identify where the learners reveal a lack of understanding or an over-reliance on stereotypes.
COVID-19 Pandemic is an Eye-Opener for Academicians to Use the Technology in the Teaching–Learning Process
Authors: Senthil Kumaran Velayutham , Periakaruppan Ramanathan M.
Published: January 2022

Few things exist in life from the beginning but you don't realize until they become a habit. Education is also one of those things which cannot be exempted from this. The lockdown forced most of the academicians to take some determining decisions and new interests to revamp the teaching–learning process. The objective of this study is to analyze the impact of technology in teaching–learning process before and after a pandemic. This analysis is done by statistical tests using paired t-test and z-test by collecting data from students and teachers. Results show that this pandemic is an eye-opener for academicians to use the technology in teaching–learning process.
Subband reinforced adaptive feedback control algorithm in mechanical vibration control
Authors: Ren Mingke , Xie Xiling , Zhang Zhiyi
Published: January 2022

In mechanical vibration control, the conventional least mean square (LMS)-based adaptive feedback control algorithm can hardly lead to a satisfying suppression of tonal vibrations when the disturbance is composed of multiple harmonics. The convergence rate of the conventional LMS-based adaptive feedback algorithm is analyzed, and it is revealed that the convergence rate is significantly affected by the magnitude product of the control channel and the disturbance. The smaller the magnitude product, the slower the convergence speed. Based on this analysis, a subband reinforced adaptive feedback control algorithm is proposed to increase the convergence rate in the frequency band of weak controllability. In this algorithm, the components of slow convergence rate are first extracted from the error signal with subband filters and then controlled independently to achieve fast attenuation. The role of these subband filters is to increase the magnitude product of associated components. Numerical and experimental results have shown that the reinforced adaptive control algorithm is effective and the tonal components, including those of weak controllability, are suppressed almost in the whole frequency range. The proposed algorithm can achieve better vibration attenuation than the conventional LMS-based adaptive feedback algorithm when the disturbance contains multiple harmonics.
Acquired Hemophilia A following Pfizer-BioNTech SARS CoV-2 mRNA vaccine, successfully treated with prednisolone and rituximab
Authors: Murali Aarya , Wong Philip , Gilbar Peter J. , Mangos Hilda M.
Published: January 2022

Introduction

Acquired haemophilia A (AHA) is a rare bleeding disorder, characterised by the presence of autoantibodies to clotting factor VIII (FVIII). AHA can be idiopathic or occur in the context of malignancy, autoimmune disease, drugs, or pregnancy. Recently, cases of AHA following both COVID-19 infection and vaccination have been reported.

Case report

We report the case of a 95-year-old female who was immunised with the Pfizer-BioNTech SARS CoV-2 mRNA vaccine, with doses given three weeks apart. Spontaneous bruising over her extremities appeared one week after the initial dose, with hospital admission occurring three weeks after the second. Examination revealed a large haematoma on the dorsum of the right hand with resultant bleeding and widespread ecchymoses. Investigations confirmed a diagnosis of AHA.

Management and outcome

Initial management included high dose prednisolone, recombinant Factor VIII and tranexamic acid. There was no significant clinical improvement after three days, so intravenous rituximab 100 mg weekly for four weeks was commenced. The activated partial thromboplastin time (aPTT) normalised after two doses and Factor VIII level reached 0.68U/ml on day + 22. The patient was successfully discharged from hospital after 37 days.

Discussion

Four cases of AHA following administration of COVID mRNA vaccines (Pfizer and Moderna) have been documented. AHA should be a differential in patients presenting with bleeding following COVID-19 vaccination, in the presence of a normal platelet count. Rapid recognition, prompt initiation of immunosuppressive treatment and rigorous supportive cares are required to minimise morbidity and mortality.
Entrepreneurship and misconducting behaviors: A conceptual model of institutional divergence
Authors: Sottini Andrea , Cannatelli Benedetto Lorenzo
Published: January 2022

Over the last decades, scholars considered entrepreneurship as synonymous with thinking “outside of the box” and breaking the status quo. In this view, entrepreneurs are often viewed as heroes that try to improve the status quo. However, not all entrepreneurial rule-breaking are legal or moral a priori. The business landscape depicts a number of entrepreneurial ventures holding rebellious and anti-social postures. Despite the relevance of such a phenomenon, the motives and the dynamics beyond how and why some entrepreneurs deliberately diverge from laws and social norms has been overlooked. Accordingly, we introduce a novel conceptual model and framework using four propositions that contributes to the extant literature in two ways: first, we propose a logic through which entrepreneurs consciously diverge from legal and legitimate institutions, and second, we introduce antecedents and moderating variables explaining the behaviors of disobeying regulations and moral codes by leveraging cognitive and institutional theories. Finally, practical implications of the proposed model for entrepreneurs, policymakers, and business educators are discussed.
Influence of the spark plug mounting angle on spark ignition process at different flow velocities
Authors: Ren Fangsi , Takehara Naoto , Nakaya Shinji , Tsue Mitsuhiro , Adachi Ryo , Suganuma Kunihiko
Published: January 2022

Influences of the spark-plug mounting angle on the spark ignition of gasoline-air mixtures in high velocity flows were investigated in a combustion chamber connected at the end of a rapid compression machine. Gasoline-air mixture with an air excess ratio of 1.9 was combusted. A spark plug was mounted on the combustor wall at angles of −30°, −15°, 0°, 15°, and 30°. Flow velocity at the spark plug was varied from 5 to 20 m/s by adjusting the driving pressure of the piston. Time resolved spark-discharge voltage and current were measured with a voltage and a current probe, and the discharge energy was calculated using them. Behaviors of the discharge channel were observed optically with a high-speed video camera in addition to simultaneous measurements of OH* chemiluminescence from the flame kernel with the other high-speed video camera. The results showed that the averaged induction time of flame kernel initiation increased monotonously with an increase in the plug mounting angle from −30° to 30° in flows with velocities of 5 and 10 m/s. However, the increasing trend became less obvious with velocities of 15 and 20 m/s, involving with larger variation in induction time. Discharge duration became shorter with an increase in the plug mounting angle regardless of the same setup. Negative mounting angle resulted in frequent short-circuits/restrikes at the early phase. On the other hand, positive mounting angles resulted in a longer discharge channel length, higher energy deposition before the first restrike and longer induction time of the first restrike. Although the discharge channel at positive mounting angles elongates along with the flow, the early flame kernel was developed toward the center of the swirl. Thereafter, flame propagated outward from the central region, where the flow speed was lower than the downstream area. Negative mounting angle led to a more oval flame kernel shape and the propagation closer to combustion chamber wall, which showed a shorter induction time of flame kernel initiation in the cases of 5 and 10 m/s. However, fragments of the flame kernel tended to be formed due to frequent short-circuits with the velocities of 15 and 20 m/s. This resulted in the large variation of the induction time.
The Early IT ecosystem: Re-envisioning dual credit, college access and affordability, and teachers as professionals
Authors: Chamberlain Leah M , Said Hazem
Published: January 2022

The Early Information Technology ecosystem (Early IT) developed at a large R1 university in the Midwest has created a direct linkage between K-12, higher education, and industry, eliminating barriers throughout the pipeline for students. The program was created within a unique policy window, with the shortage of IT talent in the workforce converging with both the call for computer science education at the K-12 level and for dual credit options to reduce the cost of higher education. The limited capacity of K-12 schools to meet these demands on their own resulted in a window of opportunity for disruptive policy innovation. This opportunity resulted in a program that is broadening participation in computing and meeting the call for a scalable and sustainable talent pipeline, but that also serves as evidence for the potential of transformational change across various education policy domains. We use early successes in the program to highlight potential futures in the areas of dual credit, college access and affordability, and teacher professionalism.
Monitoring and modulation of the tumor microenvironment for enhanced cancer modeling
Authors: Head Tristen , Cady Nathaniel C
Published: January 2022

Cancer treatments utilizing biologic or cytotoxic drugs compose the frontline of therapy, and though gains in treatment efficacy have been persistent in recent decades, much work remains in understanding cancer progression and treatment. Compounding this situation is the low rate of success when translating preclinical drug candidates to the clinic, which raises costs and development timelines. This underperformance is due in part to the poor recapitulation of the tumor microenvironment, a critical component of cancer biology, in cancer model systems. New technologies capable of both accurately observing and manipulating the tumor microenvironment are needed to effectively model cancer response to treatment. In this review, conventional cancer models are summarized, and a primer on emerging techniques for monitoring and modulating the tumor microenvironment is presented and discussed.
“Connectedness” between people with intellectual disabilities and challenging behaviour and support staff: Perceptions of psychologists and support staff
Authors: Tournier T , Hendriks AHC , Jahoda A , Hastings RP , Embregts PJCM
Published: January 2022

The tacit practical knowledge of psychologists and support staff to foster a real connection between support staff and people with intellectual disabilities and challenging behaviour was explored. Therefore, six dyads comprising individuals with intellectual disabilities and challenging behaviour and their support staff were video recorded during joint engagement in an activity. To tap into the implicit knowledge of professionals about when staff have ‘a real connection’ with a person with an intellectual disability, 10 psychologists and 10 support staff were asked to pinpoint these moments in the pre-recorded video compilation. They also shared their interpretations about what they considered to be a real connection. The results displayed that participants designated real connections as occurring when they noticed concrete interactions taking place. Based on thematic analysis of the data, four themes were identified that encapsulated what professionals deemed to be a real connection. In conclusion: joint engagement in an activity appears to be a context that fosters opportunities for real connection. Furthermore, support staff should adopt a sensitive attitude and create a safe atmosphere, to establish real connections.
Delayed inflammation decrease is associated with mortality in Tocilizumab-treated critically ill SARS-CoV-2 patients: A retrospective matched-cohort analysis
Authors: Urbina Tomas , Lavillegrand Jean-Rémi , Garnier Marc , Mekinian Arsene , Pacanowski Jerome , Mario Nathalie , Dumas Guillaume , Hariri Geoffroy , Pilon Antoine , Darrivère Lucie , Fartoukh Muriel , Guidet Bertrand , Maury Eric , Leblanc Judith , Chantran Yannick , Fain Olivier , Lacombe Karine , Voiriot Guillaume , Ait-Oufella Hafid
Published: January 2022

Little is known about the immuno-inflammatory response to Tocilizumab and its association with outcome in critically-ill SARS-CoV2 pneumonia. In this multicenter retrospective cohort of SARS-CoV-2 patients admitted to three intensive care units between March and April 2020, we matched on gender and SAPS II 21 Tocilizumab-treated patients to 42 non-treated patients. Need for mechanical ventilation was 76% versus 79%. IL-6, C-reactive protein, and fibrinogen had been collected within the first days of admission (T1), 3 d (T2) and 7 d (T3) later. Tocilizumab-treated patients had persistently higher IL-6 plasma levels and persistently lower C-Reactive protein and fibrinogen levels. Among Tocilizumab-treated patients, baseline levels of inflammatory biomarkers were not different according to outcome. Conversely, C-reactive protein and fibrinogen decrease was delayed in non-survivors. C-Reactive protein decreased at T1 in survivors (45 [30–98] vs 170 [69–204] mg/l, P < 0.001) but only at T2 in non-survivors (37 [13–74] vs 277 [235–288], P = 0.03). Fibrinogen decreased at T2 in survivors (4.11 [3.58–4.69] vs 614 [5.61–7.85] g/l, P = 0.005) but not in non-survivors (4.79 [4.12–7.58] vs 7.24 [6.22–9.24] g/l, P = 0.125). Tocilizumab treatment was thus associated with a persistent both increase in plasma IL-6, and decrease in C-reactive protein and fibrinogen. Among Tocilizumab-treated patients, the decrease in inflammatory biomarkers was delayed in non-survivors.
Clozapine augmentation with cariprazine for negative symptoms: a case series and literature review
Authors: Oloyede Ebenezer , Clark Ivana , Mace Shubhra , Whiskey Eromona , Taylor David
Published: January 2022

Only about 50% of patients with treatment-resistant schizophrenia respond to clozapine, and many more patients continue to experience ongoing and prominent negative symptoms. These negative symptoms, for which there are limited pharmacological options, may represent the greatest barrier to functional recovery. Cariprazine is a novel antipsychotic drug that is a partial agonist at dopamine D2 and D3 receptors with preferential binding to the D3 receptor, antagonism of 5HT2B receptors, and partial agonism at 5HT1A receptors. Cariprazine is currently licenced for the treatment of schizophrenia in Europe and the United States and has also been approved for bipolar disorder in the United States. There is a limited body of evidence to suggest clinical effectiveness as an augmentation strategy for negative symptoms in those treated with clozapine. In this case series, we present five cases of successful treatment of negative symptoms by clozapine combined with cariprazine in treatment-resistant psychosis.
‘Childrenese’: A Pilot Survey on the Choice of Language in a Paediatric Dental Setting
Authors: Hennigan Mairead , Hamilton Alice , Busuttil-Naudi Antoniella
Published: January 2022

To ensure good communication with paediatric patients, members of the dental team typically avoid dental jargon by using appropriate substitution of words. This language of word replacement is sometimes termed ‘Childrenese’. This survey was carried out to collect a formulary of perceived effective and ineffective word replacements from paediatric dental team members. It assesses the impact of factors such as age and gender on the respondents’ word choice. The formulary aims to aid general dental practitioners in communicating with paediatric dental patients.
IADT 2020 Guidelines: What should the dental professional know?
Authors: Bennett Reuben , Loo Yi , Ilyas Nabeel
Published: January 2022

Traumatic dental injuries are a common occurrence among children. Effective acute and long-term management of traumatic dental injuries can improve patient outcomes, especially in the paediatric patient. It is important that all dental professionals follow up-to-date, evidence-based guidance when treating patients. This article aims to highlight the main changes in the 2020 International Association of Dental Traumatology (IADT) Guidelines for Evaluation and Management of Traumatic Dental Injuries, to ensure that all dental professionals are fully aware of current guidelines and are managing patients appropriately.
The Influence of Childhood Trauma and Masculine Ideology on Teacher Ratings of Student Risk Behavior
Authors: Liang Christopher T. H. , Liu Lian , Beachy Sara , Bhatt Nisha
Published: January 2022

Masculine ideology and adverse childhood experiences (ACEs) are associated with student risk behaviors. With data from a sample of eighth-grade students, this study used hierarchical linear regression to examine the relationships between household ACEs, masculine ideology, and teacher-reported student risk behaviors. Results indicated that household ACEs were associated with higher academic and social risk behavior, while greater endorsement of masculine ideology was associated with higher academic risk behavior. We discuss implications for research and practice.
Questions of Context: Reading a Century of German Mission Theology
Authors: Muck Terry C.
Published: January 2022

A review essay of John G. Flett and Henning Wrogemann, Questions of Context: Reading a Century of German Mission Theology. This work is a carefully selected and edited collection of German mission writing of roughly the past century. The texts selected address mission contextualization, that is, ecumenical interactions among different sectors of World Christianities as they pertain to mission. Together the readings, along with the editors’/authors’ commentary, show the history and content of German missiological approach(es) to contextualized mission. As such, it is a textbook appropriate for courses in the theology of mission, religious pluralism, intercultural theology, and World Christianity.
Calciolangbeinite-O, a natural orthorhombic modification of K2Ca2(SO4)3, and the langbeinite–calciolangbeinite solid-solution system
Authors: Pekov Igor V. , Zubkova Natalia V. , Galuskina Irina O. , Kusz Joachim , Koshlyakova Natalia N. , Galuskin Evgeny V. , Belakovskiy Dmitry I. , Bulakh Maria O. , Vigasina Marina F. , Chukanov Nikita V. , Britvin Sergey N. , Sidorov Evgeny G. , Vapnik Yevgeny , Pushcharovsky Dmitry Yu.
Published: January 2022

Calciolangbeinite, ideally K2Ca2(SO4)3, exists in two modifications, cubic and, first described in the present paper, orthorhombic. They are topologically-similar polymorphs which can be designated as calciolangbeinite-C and calciolangbeinite-O. Calciolangbeinite-O is the first natural orthorhombic langbeinite-like sulfate. It clearly differs from calciolangbeinite-C in the powder X-ray diffraction pattern, optical data and Raman spectrum. Calciolangbeinite-O is found in sublimates of the active Arsenatnaya fumarole at the Tolbachik volcano, Kamchatka, Far Eastern Region, Russia and in pyrometamorphic rocks of the Hatrurim Complex at Jabel Harmun, Judean Desert, Palestinian Autonomy and Har Parsa, Negev Desert, both in Israel. Calciolangbeinite-C is known only in fumarole sublimates at Tolbachik. Calciolangbeinite forms a continuous solid-solution system with langbeinite K2Mg2(SO4)3. The majority of the system is represented by cubic phases, and only members with compositions K2(Ca2.0–1.9Mg0.0–0.1)(SO4)3 have orthorhombic symmetry under room-temperature conditions. The crystal structure of calciolangbeinite-O was studied on a single crystal, chemically very close to K2Ca2(SO4)3, from Tolbachik (R1 = 2.75%). The unit-cell parameters are: a = 10.3330(2), b = 10.5027(2), c = 10.1763(2) Å, V = 1104.37(4) Å3 and Z = 4; space group is P212121. Calciolangbeinite-O is a low-temperature modification of K2Ca2(SO4)3 belonging to the K2Cd2(SO4)3 structure type whereas calciolangbeinite-C (space group P213), a high-temperature modification, has the langbeinite-type structure. The significant Mg admixture in calciolangbeinite-C from Tolbachik probably stabilises its cubic structure at room temperature. In both high-temperature fumaroles and pyrometamorphic rocks calciolangbeinite crystallises in the cubic modification, and during cooling its chemical variety close to the end-member K2Ca2(SO4)3 undergoes phase transition to calciolangbeinite-O, whereas the Mg-enriched varieties of the mineral remain calciolangbeinite-C.
Prevalence and associated risk factors of hypertension and pre-hypertension among the adult population: findings from the Dubai Household Survey, 2019
Authors: Mamdouh Heba , Alnakhi Wafa K. , Hussain Hamid Y. , Ibrahim Gamal M. , Hussein Amal , Mahmoud Ibrahim , Alawadi Fatheya , Hassanein Mohamed , Abdullatif Mona , AlAbady Kadhim , Farooq Sabya , Sulaiman Nabil
Published: January 2022

Background

Minimal data is available on the prevalence and correlates of hypertension and prehypertension in Dubai. The study aims to measure the prevalence of hypertension and pre-hypertension and the associated socio-demographic characteristics, behavioral risk factors and comorbidities among the adult population of Dubai.

Methods

This study used data from the Dubai Household Health Survey, 2019. A cross-sectional population survey based on a complex stratified cluster random design. The total eligible sample included 2530 adults (18+). Sociodemographic and behavioral factors were considered as independent covariates. The main study outcome variables, pre-hypertension and hypertension, were ordinal, with normotension as the reference group.

Results

The overall prevalence of hypertension in adults was 32.5% (38.37% in males and 16.66% in females). Prehypertension was prevalent in 29.8% of adults in Dubai (28.85% in males and 32.31% in females). The multivariate logistic regression analysis revealed that age groups, gender, occupation, and high Body Mass Index were significantly associated with a higher risk of hypertension at the level of P < 0.05. No clear trend toward a higher correlation of hypertension was noted with the increase in age, except after the age of 50 years. Males were five- times more likely to be hypertensive than females. Participants enrolled in skilled and service works had a five times higher risk of hypertension, compared with the reference group (professionals). Obese subjects had a 5.47-times greater correlation of hypertension compared with normal-weight subjects. Physically active individuals were less likely to develop hypertension. For the correlates with prehypertension in the present analysis, skilled and service workers and those working in elementary jobs had a higher risk of prehypertension, compared with the reference group (professionals) Individuals with a status of overweight were associated with a higher prevalence of prehypertension compared with people of normal weight.

Conclusions

This study showed a high prevalence of prehypertension and hypertension among adults in Dubai. Some socio-demographic and behavioral risk factors were correlated with prehypertension and hypertension among the studied population. Interventions aiming at increasing public awareness about such risk factors are essential.
Early marriage, stressful life events and risk of suicide and suicide attempt: a case–control study in Iran
Authors: Fakhari Ali , Allahverdipour Hamid , Esmaeili Elham Davtalab , Chattu Vijay Kumar , Salehiniya Hamid , Azizi Hosein
Published: January 2022

Background

Early Marriage (EM) and associated Stressful Life Events (SLEs) and consequences such as psychological and physical well-being issues can lead to suicide and suicide attempts (SA). The study aimed to investigate the risk of suicide and SA among early married people who experienced SLEs.

Methods

A case–control study was conducted based on the registry for suicide in Malekan county in Iran during 2016–18. Cases included 154 SAs and 32 suicides. Simultaneously, 201 outpatients from the emergency department were chosen as controls. Holms and Rahe life event questionnaire was used to assess SLEs. Sub-group analysis (Mantel–Haenszel) by sex and age groups and multiple logistic regression were used to calculate adjusted Odds Ratios (ORs) with 95% Confidence Intervals (CIs) for the association between EM and suicide risk after adjusting for the potential confounders.

Results

The proportion (female vs male) of EM among suicides, controls, and SAs was 31.25% (18.7 vs 12.5%), 15.92% (11.9 vs 4.0%), and 13.0% (11.7 vs 1.3%), respectively. In subgroup analyses by sex, EM was associated with an increased risk of suicide in both females and males 2.64 and 2.36 times, respectively. Likewise, subgroup analysis by age groups revealed that EM increased suicide risk in subjects aged 10–15 years, while no association was found for age groups of 26–40 and > 40. After adjusting for the potential confounders, EM (OR: 3.01; 95% CI: 1.15 -7.29), financial problems (OR = 4.50; 95% CI: 1.83 -9.07), and family problems (OR = 2.60; 95% CI: 1.19—9.59), were associated with an increased risk of suicide. However, no association was found between EM, various types of SLEs, and the risk of SA.

Conclusions

We found EM and SLEs were correlated with suicide risk, while no evidence found that EM increased the risk of SA. Progress in reducing EM and addressing its serious consequences can occur by a stronger political commitment and by sharing the experiences and voices of the early married. Our study provided preliminary findings to guide future studies; however, methodological and longitudinal studies are needed to understand and address the effect of EM on suicidal behaviors.
Parents’ lived experience of adolescents’ repeated non-suicidal self-injury in China: a qualitative study
Authors: Wang Xu , Huang Xuehua , Huang Xia , Zhao Wenting
Published: January 2022

Background and objectives

The prevalence of non-suicidal self-injury (NSSI) is high among adolescents. Parents have significant impact on the development of NSSI. Many quantitative studies have demonstrated the relationship between parental factors such as parenting behaviors and adolescents’ NSSI. However, few studies have explored parents’ responses and adolescent-parent reciprocal interaction during repeated NSSI. This study aimed to explore parents’ cognition, behaviors and adolescent-parent reciprocal interaction during repeated NSSI.

Methods

This is a phenomenological study. By purposive sampling, 24 parents of adolescents with repeated NSSI were recruited from a child and adolescent psychiatric ward in a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using thematic analysis.

Findings

Three themes were identified: parents’ attribution, perceptions and coping behaviors of NSSI. Chronic stress of adolescents and triggers of NSSI were associated with parental expectations. Parents initially perceived NSSI as a manifestation of puberty, a way of making needs met or a coping strategy of negative emotions, and gradually realized that it was a condition requiring psychological assistance. Parents’ coping behaviors of NSSI were divided into 4 stages, namely denial, dissuasion, reflection and adaptation, and working as a team. To be more specific, parents’ coping strategies at dissuasion stage included criticizing and conciliating, while those at reflection and adaptation stage included neglecting, avoiding conflicts and increasing control.

Conclusions

These findings suggest that adjusting parents’ expectation and negative perceptions of NSSI is beneficial to reduce adolescent-parent conflict and adolescents’ inner conflict and prevent NSSI. Furthermore, it’s necessary to publicize NSSI related knowledge to promote the early detection and treatment of NSSI.
Dietary practices, food purchasing, and perceptions about healthy food availability and affordability: a cross-sectional study of low-income Malaysian adults
Authors: Eng Chee Wen , Lim Shiang Cheng , Ngongo Carrie , Sham Zhi Hao , Kataria Ishu , Chandran Arunah , Mustapha Feisul Idzwan
Published: January 2022

Background

Malaysia has the highest rate of overweight and obesity among Asian countries. Obesity is increasing particularly among low-income populations. This study aimed to assess dietary practices among low-income adults in urban communities, including gender and ethnic variation, to inform the development of locally tailored, evidence-based interventions for health promotion.

Methods

This cross-sectional study was conducted from August to December 2020. Stratified sampling was employed to recruit 2983 low-income adults from households in the bottom 40% of the economic spectrum (B40) at six public, low-cost housing flats in the Federal Territory of Kuala Lumpur, Malaysia. Face-to-face interviews were conducted using a structured questionnaire to understand dietary practices, perceptions of healthy food availability and affordability, and factors affecting food purchasing decisions.

Results

A staggering 89.5% of B40 adults were found to not consume adequate daily amounts of fruits and vegetables. In addition, 68.1% reported consuming sugar-sweetened beverages at least once per week, including commercially packed ready-to-drink beverages, sugar-added self-prepared drinks, and premixed drinks. Intake was statistically significantly higher among men (71.7%), Malays (70.3%), and Indians (69.9%). Bread and other commercially baked goods were the most common processed foods, and 52.9% of respondents consumed it at least once per week. Majorities reported that healthy foods were moderately available and priced. The top three reported factors affecting food purchase choices were price (79.4%), availability (75%), and taste (73%).

Conclusions

Adults in low-cost housing communities have unhealthy dietary patterns with low intake of fruits and vegetables and high intake of ultra-processed foods and calorie-dense local foods, with variations across gender and ethnicity. The study highlighted the need for educating low-income families on diet-disease relationships and possibilities for inexpensive, healthy eating that rely on minimally processed fresh foods. Policymakers engaging the food industry are advised to consider how to increase the affordability and availability of healthy foods in low-income communities in urban areas.
Comparison between modified facet joint fusion and posterolateral fusion for the treatment of lumbar degenerative diseases: a retrospective study
Authors: Li Zhimin , Li Zheng , Chen Xin , Han Xiao , Li Kuan , Li Shugang
Published: January 2022

Objective

To investigate the safety and effectiveness of modified facet joint fusion in the treatment of lumbar degenerative diseases and compare them with those of posterolateral fusion.

Methods

A total of 77 adult patients with lumbar degenerative disease diagnosed from January 2017 to February 2019 were considered for the present retrospective, nonrandomized, and controlled study. The patients were divided into two groups according to the fusion technique used during the surgery: the posterolateral fusion (PLF) group (n = 42) and the modified facet joint fusion (MFF) group (n = 35). The fusion rate, Oswestry Disability Index (ODI) score, visual analog scale (VAS) score for back pain and leg pain, Japanese Orthopedic Association (JOA) score, European Quality of Life–5 Dimensions (EQ-5D) score, length of hospital stay, length of operation, intraoperative blood loss, cost of hospitalization, complications and reoperations were compared between the 2 groups.

Results

All patients underwent a successful surgery, and all were followed up. No significant differences were found in age, sex, BMI, length of hospital stay, length of operation or cost of hospitalization. There were no significant differences in the preoperative or postoperative ODI or in the VAS, JOA, and EQ-5D scores between the MFF and PLF groups. However, the fusion rate of MFF group was higher than that of the PLF group (P < 0.05). What’s more, the MFF group had less intraoperative blood loss than the PLF group (P < 0.05). Complications related to iatrogenic nerve injury, vascular injury, epidural hematoma, intravertebral infection, and internal fixation did not occur in either group. None of the patients required reoperation.

Conclusions

Modified facet joint fusion is safe and efficient in the treatment of lumbar degenerative disease. The fusion rate of MFF was higher than PLF. The intraoperative blood loss of MFF was less than that of PLF. In addition, the therapeutic effect of MFF was not worse than that of PLF. Therefore, the MFF technique can be promoted in clinical treatment.
HyperCKemia associated with acupuncture: a case report and review of the literature
Authors: Tan Xiaochan , Liu Wei , Du Yuzheng , Meng Xianggang , Shi Xuemin
Published: January 2022

Background

Acupuncture therapy has been widely used as an alternative therapy to treat multiple diseases, such as sequelae of stroke, pain, facial paralysis and so on. In recent years, few adverse events related to acupuncture treatment have been reported, among which hematoma, bleeding and dizziness are the main manifestations. However, to date, there have been no existing cases reported the association between acupuncture therapy and asymptomatic/pauci-symptomatic hyperCKemia.

Case presentation

We report a patient who developed hyperCKemia during 5 sessions of acupuncture at different frequencies. After stopping acupuncture treatment for 1 month, follow-up showed a significant downward trend in serum creatine kinase (sCK). However, after that this patient started to get acupuncture treatment again in order to improve the sequelae of stroke. Meantime, the sCK rose again.

Conclusion

HyperCKemia may associated with acupuncture therapy. All kinds of adverse events of acupuncture should be recorded comprehensively and objectively so as to improve the safety standard system of acupuncture therapy.
Impact of birth tourism on health care systems in Calgary, Alberta
Authors: Brar Simrit , Kale Mruganka , Birch Colin , Mattatall Fiona , Vaze Medini
Published: January 2022

Background

Birth tourism refers to non-resident women giving birth in a country outside of their own in order to obtain citizenship and/or healthcare for their newborns. We undertook a study to determine the extent of birth tourism in Calgary, the characteristics and rationale of this population, and the financial impact on the healthcare system.

Methods

A retrospective analysis of 102 women identified through a Central Triage system as birth tourists who delivered in Calgary between July 2019 and November 2020 was performed. Primary outcome measures were mode of delivery, length of hospital stay, complications or readmissions within 6 weeks for mother or baby, and NICU stay for baby.

Results

Birth Tourists were most commonly from Nigeria (24.5%). 77% of Birth Tourists stated that their primary reason to deliver their baby in Canada was for newborn Canadian citizenship. The average time from arrival in Calgary to the EDD was 87 days. Nine babies required stay in the neonatal intensive care unit (NICU) and 3 required admission to a non NICU hospital ward in first 6 weeks of life, including 2 sets of twins. The overall amount owed to Alberta Health Services for hospital fees for this time period is approximately $694 000.00.

Conclusion

Birth Tourists remain a complex and poorly studied group. The process of Central Triage did help support providers in standardizing process and documentation while ensuring that communication was consistent. These findings provide preliminary data to guide targeted public health and policy interventions for this population.
Prediction of long-term kinetics of vaccine-elicited neutralizing antibody and time-varying vaccine-specific efficacy against the SARS-CoV-2 Delta variant by clinical endpoint
Authors: Chen Xinhua , Wang Wei , Chen Xinghui , Wu Qianhui , Sun Ruijia , Ge Shijia , Zheng Nan , Lu Wanying , Yang Juan , Rodewald Lance , Yu Hongjie
Published: January 2022

Background

Evidence on vaccine-specific protection over time, in particular against the Delta variant, and protection afforded by a homologous third dose is urgently needed.

Methods

We used a previously published model and neutralization data for five vaccines—mRNA-1273, BNT162b2, NVX-CoV2373, V01, and CoronaVac— to evaluate long-term neutralizing antibody dynamics and predict time-varying efficacy against the Delta variant by specific vaccine, age group, and clinical severity.

Results

We found that homologous third-dose vaccination produces higher neutralization titers compared with titers observed following primary-series vaccination for all vaccines studied. We estimate the efficacy of mRNA-1273 and BNT162b2 against Delta variant infection to be 63.5% (95% CI: 51.4–67.3%) and 78.4% (95% CI: 72.2–83.5%), respectively, 14–30 days after the second dose, and that efficacy decreases to 36.0% (95% CI: 24.1–58.0%) and 38.5% (95% CI: 28.7–49.1%) 6–8 months later. Fourteen to 30 days after administration of homologous third doses, efficacy against the Delta variant would be 97.0% (95% CI: 96.4–98.5%) and 97.2% (95.7–98.1%). All five vaccines are predicted to provide good protection against severe illness from the Delta variant after both primary and homologous third dose vaccination.

Conclusions

Timely administration of third doses of SARS-CoV-2-prototype-based vaccines can provide protection against the Delta variant, with better performance from mRNA vaccines than from protein and inactivated vaccines. Irrespective of vaccine technology, a homologous third dose for all types of vaccines included in the study will effectively prevent symptomatic and severe COVID-19 caused by the Delta variant. Long-term monitoring and surveillance of antibody dynamics and vaccine protection, as well as further validation of neutralizing antibody levels or other markers that can serve as correlates of protection against SARS-CoV-2 and its variants, are needed to inform COVID-19 pandemic responses.