bluuebunny/crossref_metadata_2025 huggingface dataset:
Well-Being and Mental Health of Students during the COVID-19 Pandemic
Authors: Holm-Hadulla Rainer M. , Klimov Margaritha , Juche Tilman , Möltner Andreas , Herpertz Sabine C.
Published: September 2021

Background: During the COVID-19 pandemic, a decrease in well-being and an increase in mental health problems were registered in medical and psychotherapeutic practices, counseling centers, and clinics. According to previous studies, younger people and women seemed to be particularly affected. The aim of this study was to describe mental health problems of students and to draw consequences for the further handling of pandemics and other crises. Method: Students at the University of Heidelberg, a typical German “full university,” were surveyed online using internationally comparable screening instruments like the Well-Being Index (WHO-5) and the Patient Health Questionnaire (PHQ). In addition, the students had the opportunity to describe in a narrative form their well-being and to make suggestions how to improve their situation. Results: Out of a population of 27,162 students who were contacted by email, 2,137 students completed the questionnaire. The salient finding is that according to the WHO-5 Well-Being Index, 72.2% of the respondents feel seriously impaired in their well-being. This corresponds to the finding that 75.8% of the respondents in the PHQ-D show indications of at least one syndrome diagnosis. Depression was found in 41.8% of the respondents in the PHQ-D. Indications of moderate to severe and severe depressive syndromes were present in 31.8%. Signs of somatoform syndromes are found in 25.4% and of anxiety syndromes in 20.0%. 1,089 students gave narrative reports on how they were feeling and made suggestions for improvement. About 75% reported severely reduced well-being. Their main complaints were loneliness and depression and lack of recognition for their specific academic and life situation during the pandemic. By far, the largest proportion of students supposed that their mental health issues were caused and/or intensified by the pandemic-related social contact restrictions. The vast majority of them made reasonable suggestions for controlled relaxation of contact restrictions. Conclusions: Students suffer severely from the pandemic-related social restriction. In respect to future pandemic outbreaks or other crises leading to social isolation, the dramatic consequences of social lockdowns should be taken into account. Under pandemic conditions, we especially should support persons lacking social networks.
Association of Rosacea With Cardiovascular Disease: A Retrospective Cohort Study
Authors: Choi Daein , Choi Sungjun , Choi Seulggie , Park Sang Min , Yoon Hyun‐Sun
Published: September 2021

Background

There is emerging evidence that rosacea, a chronic cutaneous inflammatory disease, is associated with various systemic diseases. However, its association with cardiovascular disease (CVD) remains controversial. We aimed to investigate whether patients with rosacea are at increased risk of developing CVD.

Methods and Results

This retrospective cohort study from the Korean National Health Insurance Service‐Health Screening Cohort included patients with newly diagnosed rosacea (n=2681) and age‐, sex‐, and index year–matched reference populations without rosacea (n=26 810) between 2003 and 2014. The primary outcome was subsequent CVD including coronary heart disease and stroke. Multivariable Cox regression analyses were used to evaluate adjusted hazard ratios for subsequent CVD adjusted for major risk factors of CVD. Compared with the reference population (13 410 women; mean [SD] age, 57.7 [9.2] years), patients with rosacea (1341 women; mean [SD] age, 57.7 [9.2] years) displayed an increased risk for CVD (adjusted hazard ratios, 1.20; 95% CI, 1.03–1.40) and coronary heart disease (adjusted hazard ratios, 1.29; 95% CI, 1.05–1.60). The risk for stroke was not significantly elevated (adjusted hazard ratios, 1.12; 95% CI, 0.91–1.37).

Conclusions

This study suggests that patients with rosacea are more likely to develop subsequent CVD. Proper education for patients with rosacea to manage other modifiable risk factors of CVD along with rosacea is needed.
Measuring and Improving Consistency in Pretrained Language Models
Authors: Elazar Yanai , Kassner Nora , Ravfogel Shauli , Ravichander Abhilasha , Hovy Eduard , Schütze Hinrich , Goldberg Yoav
Published: September 2021

Consistency of a model—that is, the invariance of its behavior under meaning-preserving alternations in its input—is a highly desirable property in natural language processing. In this paper we study the question: Are Pretrained Language Models (PLMs) consistent with respect to factual knowledge? To this end, we create ParaRel🤘, a high-quality resource of cloze-style query English paraphrases. It contains a total of 328 paraphrases for 38 relations. Using ParaRel🤘, we show that the consistency of all PLMs we experiment with is poor— though with high variance between relations. Our analysis of the representational spaces of PLMs suggests that they have a poor structure and are currently not suitable for representing knowledge robustly. Finally, we propose a method for improving model consistency and experimentally demonstrate its effectiveness.1
Compressing Large-Scale Transformer-Based Models: A Case Study on BERT
Authors: Ganesh Prakhar , Chen Yao , Lou Xin , Khan Mohammad Ali , Yang Yin , Sajjad Hassan , Nakov Preslav , Chen Deming , Winslett Marianne
Published: September 2021

Pre-trained Transformer-based models have achieved state-of-the-art performance for various Natural Language Processing (NLP) tasks. However, these models often have billions of parameters, and thus are too resource- hungry and computation-intensive to suit low- capability devices or applications with strict latency requirements. One potential remedy for this is model compression, which has attracted considerable research attention. Here, we summarize the research in compressing Transformers, focusing on the especially popular BERT model. In particular, we survey the state of the art in compression for BERT, we clarify the current best practices for compressing large-scale Transformer models, and we provide insights into the workings of various methods. Our categorization and analysis also shed light on promising future research directions for achieving lightweight, accurate, and generic NLP models.
Singapore Paediatric Resuscitation Guidelines 2021
Authors:   Paediatric Subcommittee 2016‒2021, Singapore Resuscitation and First Aid Council, Ong GYK , Ngiam N , Tham LP , Mok YH , Ong JSM , Lee KP , Ganapathy S , Chong SL , Pek JH , Chew SY , Lim YC , Shen GQS , Kua J , Tan J , Ng KC
Published: September 2021

We present the 2021 Singapore Paediatric Resuscitation Guidelines. The International Liaison Committee on Resuscitation’s Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, which was published in October 2020, and the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council, were reviewed and discussed by the committee. These recommendations were derived after deliberation of peer-reviewed evidence updates on paediatric resuscitation and took into consideration the local setting and clinical practice.
Singapore Advanced Cardiac Life Support Guidelines 2021
Authors: Ching CK , Leong BSH , Nair P , Chan KC , Seow E , Lee F , Heng K , Sewa DW , Lim TW , Chong DTT , Yeo KK , Fong WK , Anantharaman V , Lim SH
Published: September 2021

Advanced cardiac life support (ACLS) emphasises the use of advanced airway management and ventilation, circulatory support and the appropriate use of drugs in resuscitation, as well as the identification of reversible causes of cardiac arrest. Extracorporeal cardiopulmonary resuscitation and organ donation, as well as special circumstances including drowning, pulmonary embolism and pregnancy are addressed. Resuscitation does not end with ACLS but must continue in post-resuscitation care. ACLS also covers the recognition and management of unstable pre-arrest tachy- and bradydysrhythmias that may deteriorate further.
Singapore First Aid Guidelines 2021
Authors: Zarisfi F , Pek JH , Oh JHH , Loke JH , Lim SH
Published: September 2021

The Singapore Resuscitation and First Aid Council is updating the guidelines for first aid based on the latest evidence-based review from the International First Aid Taskforce Consensus on Science with Treatment Recommendations published in 2020. This is part of the regular updating of standards of care and training for first aid. This article presents some of the updated evidence-based approaches to first aid treatments in common emergencies such as asthma, chronic bronchitis, anaphylaxis, shock, unresponsiveness, seizure, heat disorders, ingested poisons, bleeding, head and spinal injury, bites and dental injuries. These updated treatments will be incorporated into the Standard and Child First Aid course syllabus in Singapore.
Religious Minority Rights and their Satisfaction in Pakistan
Authors: Akram Muhammad , Nasar Asim , Rehman Abid
Published: September 2021

The study investigates the satisfaction of religious minorities in Pakistan subject to government policies and attitudes of the Muslim majority. A cross-sectional study design was used to collect data from 120 respondents living in rural areas in Pakistan. Descriptive statistics and the Pearson correlation coefficient were used to measure the relatedness of essential factors of freedom of expression, opportunity in government services, security of unprotected assembly, prejudice in relationship with Muslims and welcomeness in Muslim neighbourhoods. Yeh’s Index of Satisfaction was used to measure the satisfaction level of religious minorities with government policies and attitudes of the Muslim majority. The study findings revealed that religious minorities are least satisfied with their citizenship rights in Pakistan, which poses various questions to government policies and legislation. Further, they were also least satisfied with the attitudes of the Muslim majority with whom they must interact in their everyday life.
Recognition of the Ainu as an Indigenous People in Japan: Legal Implications for their Right to Traditional Salmon Fishing
Authors: Hossain Kamrul
Published: September 2021

The Japanese government legally recognized the Ainu as an Indigenous People in 2019. While the legislation is a step forward, it does not provide the Ainu with concrete rights applicable to Indigenous Peoples as those rights are set out in international legal standards, articulated in several human rights instruments and authoritative statements issued by both United Nations organs and the international treaty monitoring bodies. The most common issue concerning Indigenous Peoples’ rights is the practice of traditional livelihoods linked to their lands and resources. Particularly for coastal communities, traditional fishing has been recognized as an important livelihood for sustaining the people’s culture and their ethnic and cultural identity. This article explores the traditional fishing right of the Ainu, which has recently become a point of conflict given that existing local regulations jeopardize the right. The article critically examines the compatibility of the provisions of the conflicting local and national regulations.
The Trial of Jesus before Pilate in the Fourth Gospel
Authors: Young Norman H.
Published: September 2021

This article proceeds through a series of integrated sections. First, the problem of the Fourth Gospel’s (FG) positioning of the scourging of Jesus and the Roman soldiers’ mocking of him in the midst of the trial is compared with Mark’s account of the trial. Second, by drawing on contemporary sources the methods of Roman crucifixion are examined to provide a guide for interpreting the Biblical data. Third, the efforts to harmonize the FG with the other Gospels by suggesting it referred to a lighter lashing are examined and found wanting. The next four sections develop John’s approach to the Trial as a drama; not as fiction, but as a creative reshaping of his data. By placing the mocking as well as the scourging of Jesus prior to Pilate’s handing him over to be crucified allows the FG to climax the drama with Jesus finally exiting from the praetorium to face his accusers for the first time as their King (Messiah).
Long-headed predators in Cretaceous amber—fossil findings of an unusual type of lacewing larva
Authors: ZIPPEL ANA , KIESMÜLLER CHRISTINE , HAUG GIDEON T. , MÜLLER PATRICK , WEITERSCHAN THOMAS , HAUG CAROLIN , HÖRNIG MARIE K. , HAUG JOACHIM T.
Published: September 2021

Lacewing larvae (Neuroptera) are known to be fierce predators which are morphologically highly specialised for a raptorial lifestyle. Mandibular-maxillary stylets are characteristic for all larvae of this group; these stylets can be extraordinarily massive. Despite these distinct sucking-piercing stylets, also other extreme features occur in some ingroups, such as an extremely elongated neck. In larvae of thread-winged lacewings (Crocinae) the neck can reach up to about one third of the body length; they are also called ‘long-necked antlions’. Even though the larvae of living neuropteran species show a variety of conspicuous morphologies today, indeed 100 million years ago, in the Cretaceous, Neuroptera seems to have had an even more “experimental phase”. Several larval specimens are known so far especially in Myanmar, Spanish and Lebanese amber from the Cretaceous with unique and unusual character combinations not found in any group living today. We describe here ten new fossil findings of one of these types of larvae with elongated head capsule in Myanmar amber, previously only known from a single specimen. We compared the head shapes of the new specimens with those of 190 specimens of other lacewing larvae and discuss further implications of our findings, especially making functional comparisons with long-necked antlions.
Technique of Cross-Clamping of Descending Thoracic Aorta During Emergency Department Thoracotomy
Authors: Degiannis Elias , Degiannis Konstantinos , Doll Dietrich
Published: September 2021

Cross-clamping of the descending thoracic aorta is one of the operative maneuvers, that can be necessitated in an Emergency Department Thoracotomy and it is important for the Emergency Department medical staff to theoretically familiarize itself with its technique before need arises.
Psychiatric well-being among men leaving prison reporting a history of injecting drug use: A longitudinal analysis
Authors: Stewart Ashleigh C , Cossar Reece , Lee Wilkinson Anna , Scott Nick , Dietze Paul , Quinn Brendan , Kinner Stuart A , Aitken Campbell , Walker Shelley , Curtis Michael , Butler Tony , Ogloff James R. P. , Stoové Mark
Published: September 2021

Background:

Community reintegration from prison is typically stressful, with several health and social outcomes impacting psychiatric well-being during this time, often exacerbated among individuals with histories of drug use. Longitudinal data was used to assess change in psychiatric well-being over 2 years following release from prison among men who reported a recent history of injecting drug use.

Methods:

Data for this study come from the Prison and Transition Health cohort study of 400 men recruited in prison prior to release and followed up over three time points. Psychiatric well-being was assessed using the 12-item General Health Questionnaire. We calculated change in individual General Health Questionnaire scores between interviews and identified covariates associated with General Health Questionnaire score using linear mixed-effects regression.

Results:

Data from 690 follow-up interviews among 326 participants were included in analyses. There was considerable variation in individuals’ General Health Questionnaire scores. Moving accommodation frequently and frequent illicit drug injections were associated with an increase in General Health Questionnaire score (i.e. decline in psychiatric well-being). Two or more prior adult imprisonment episodes, social supports and past month primary healthcare attendance were associated with a decrease in General Health Questionnaire score.

Conclusion:

Our findings identify health, social and structural influences on psychiatric well-being after release from prison that can inform re-entry programmes to support community reintegration.
Sentencing Add-Ons and Implications for Disparities in a Guidelines State
Authors: Strange C. Clare , Cochran Joshua C. , Wooldredge John , Feldmeyer Ben
Published: September 2021

This study examined whether and how discretionary sentencing add-ons (i.e., secondary charges, victim injury points, firearms/weapons points, drug trafficking enhancements) contribute to disparities. We examined add-ons that increase sentencing points and so contribute to a defendant “scoring to prison.” We analyzed: (1) the degree to which add-ons explain racial and ethnic disparities in imprisonment (mediation); and (2) whether add-ons are more adverse for minority defendants (moderation). We did not find that add-ons “explain” racial differences in the use of prison sentences. We did find, however, that some add-ons, particularly those that signal “dangerousness,” are racially/ethnically disparate in their consequences. The findings raise questions about the role of court discretion in perpetuating racial and ethnic disparities.
Soluble interleukin-2 receptor as a predictive and prognostic marker for patients with familial breast cancer
Authors: Gonda Kenji , Horita Shoichiro , Maejima Yuko , Takenoshita Seiichi , Shimomura Kenju
Published: September 2021

The incidence of breast cancer increases annually, and it has become common within families of breast cancer patients. Interleukin-2 activates cytotoxic T lymphocytes, which are important for cancer immunity. To identify markers of increased familial breast cancer risk, soluble interleukin-2 receptor levels and immunologic factors were investigated in familial breast cancer and non-familial breast cancer patients. Of 106 untreated breast cancer patients in this study, 24 had familial breast cancer and 82 had non-familial breast cancer. The patients’ soluble interleukin-2 receptor, interleukin-10, vascular endothelial growth factor, interleukin-17, regulatory T cell, myeloid-derived suppressor cell, white blood cell, and C-reactive protein levels, and their neutrophil-to-lymphocyte ratios were measured, and their prognoses were compared according to the soluble interleukin-2 receptor levels. Additionally, postoperative tissues from the patients with high soluble interleukin-2 receptor levels were stained with programmed cell death ligand 1 and cluster of differentiation 8. The soluble interleukin-2 receptor level in the familial breast cancer patients was significantly higher, and it showed significantly stronger correlations with the neutrophil-to-lymphocyte ratio and the interleukin-10, vascular endothelial growth factor, interleukin-17, regulatory T cell, myeloid-derived suppressor cell, white blood cell, and C-reactive protein levels, than in the non-familial breast cancer patients. The regulatory T cell and myeloid-derived suppressor cell levels were significantly higher in the patients with high soluble interleukin-2 receptor levels, and the overall survival and disease-free-survival rates were significantly worse for the familial breast cancer patients than for the non-familial breast cancer patients. Triple-negative breast cancer tissues from the familial breast cancer patients with high soluble interleukin-2 receptor levels stained well for programmed cell death ligand 1 and cluster of differentiation 8. Soluble interleukin-2 receptor levels can be used to predict the prognosis of familial breast cancer patients. Prospectively identifying patients who are less likely to have non-familial breast cancer is vital for improving their overall survival.
Association between admission serum procalcitonin and the occurrence of acute kidney injury in patients with septic shock: A retrospective cohort study
Authors: Hu Qinghe , Zhang Yaqing , Xu Hongying , Zhu Lina , Chen Lingzhi , Hao Cuiping
Published: September 2021

Background:

Procalcitonin (PCT) is an effective and sensitive diagnostic biomarker that can facilitate the early detection of infection and septicemia, but whether it can similarly be utilized to predict the development of acute kidney injury (AKI) in patients suffering from septic shock remains to be established. Herein, the relationship between serum PCT at admission and the onset of AKI in septic shock patients was thus evaluated following adjustment for other potential covariates.

Methods:

This was a retrospective cohort study of 303 septic shock patients treated in a Chinese hospital between May 2015 and May 2019. All patients in whom PCT levels were measured on admission and who did not exhibit AKI or chronic kidney disease at the time of admission were assessed for AKI development within one week following intensive care unit (ICU) admission as per the KDIGO criteria. The relationship between serum PCT at admission and AKI incidence was then assessed for these patients.

Results:

These 303 patients were an average of 64 years old, and were 59.7% male. Of these patients, 50.5% developed AKI within the first 7 days following ICU admission. A dully-adjusted binary logistic regression analysis revealed PCT levels at admission to be associated with AKI following adjustment for potential confounding factors (odds ratio (OR) = 1.01, 95%CI (1.01,1.02), p = 0.0007). Receiver operating characteristic curve analysis further indicated that a PCT cutoff level of 52.59 ng/ml at admission was able to predict the incidence of AKI with respective sensitivity and specificity values of 50% and 84%. Interaction analysis revealed no significant interactive relationship between PCT and AKI, suggesting that serum PCT levels represent an early predictor of AKI incidence in septic shock patients.

Conclusions:

Serum PCT at the time of admission can be used as a predictor of AKI in patients suffering from septic shock.
Managing Street-Level Bureaucrats’ Performance by Promoting Professional Behavior Through HRM
Authors: van Berkel Rik , Penning de Vries Julia , Knies Eva
Published: September 2021

This article connects human resource management (HRM) research to studies of street-level bureaucracies and public professionals. It investigates the intermediary role of professional behavior in the HRM–individual performance link in the context of public human service organizations. The article hypothesizes that human resources (HR) practices, aimed at enhancing street-level workers’ abilities, motivation, and opportunities, strengthen these workers’ professional behavior; that professional behavior and individual performance are positively related; and that professional behavior mediates the relationship between HR practices and individual performance. The analysis of findings from a survey study of street-level workers in local welfare agencies implementing welfare-to-work policies in the Netherlands shows support for the mediating role of professional behavior in the HRM–individual performance chain. Based on this evidence, the article concludes that the professional behavior of street-level workers in public human service organizations deserves scrutiny of both HRM scholars and HR practitioners who are interested in promoting the performance of public professionals.
Improving Work–Life Balance for Female Civil Servants in Law Enforcement: An Exploratory Analysis of the Federal Employee Paid Leave Act
Authors: Yu Helen H.
Published: September 2021

In late 2019, Congress passed the Federal Employee Paid Leave Act (FEPLA) establishing parental leave for most federal civilian employees. The new law provides up to 12 weeks of paid leave within 12 months after the birth, adoption, or foster placement of a child occurring on or after October 1, 2020. Despite its recent enactment, this study draws on survey data from 224 civil servants across 39 federal law enforcement agencies to examine the implications of FEPLA for improving work–life balance in the federal sector. Findings suggest that FEPLA will likely improve work–life balance for female civil servants. However, women may also be afraid to use FEPLA due to perceived loss of future promotional opportunities or other workplace visibilities.
Sexual Arenas, Alcohol (Ab)use, and Predatory Leadership: Facilitators of US Military Sexual Violence
Authors: Buscha Connie
Published: September 2021

Scholars argue that, historically, military women have not been considered equals to men in kinship and, therefore, have and will likely continue to experience more violence and greater fear of violence. The All-Volunteer Force (AVF) may even foster military sexual violence through sexual arenas in work-home spaces, alcohol (ab)use fueling sexual encounters between colleagues, and predatory leadership. This exploratory, grounded theory study captures insights of women veterans ( n = 20) entering service between 1964 and 2016. Full inclusion is alleged, yet military women are objectified and “othered,” targets of sex-based attention, predation, and violence. From these data, military sexual violence (MSV) characterizes the AVF. To mitigate this, a renewed commitment to the US military’s historical ideal of altruistic care is necessary to realize the full inclusion of women and reduce if not eliminate military sexual violence.
Impact of COVID-19 Campus Closure on Undergraduates
Authors: Telli Olufunmilayo , Mountcastle Lindsey , Jehl Brianna L. , Munoz-Osorio Angel , Dahlquist Lynnda M. , Jayasekera Ashani , Dougherty Aryn , Castillo Raquel , Miner Kollin
Published: September 2021

Background

The COVID-19 pandemic resulted in an abrupt transition from in-person to online learning in Spring 2020.

Objective

The purpose of this study was to identify the impact of the transition on undergraduates during the period following the campus closure.

Method

131 psychology undergraduate students completed an online survey of how the COVID-19 closure had impacted their academics, online learning environment, and traumatic stress symptoms (using the Posttraumatic Stress Disorder Checklist for the DSM-5).

Results

Most participants reported increased academic difficulty compared to before closure. Approximately 30% reported elevated traumatic stress symptoms. Greater traumatic stress was associated with greater difficulty completing assignments, more limited access to the internet and quiet places to study, and greater sibling-care responsibilities.

Conclusions

The acute transition to online instruction posed academic and emotional challenges to many students, especially those from environments with competing demands or less access to academic supports. Follow-up evaluation is needed to determine whether these difficulties have persisted in subsequent semesters of online instruction.

Teaching Implication

Instructors should anticipate the emotional and academic needs of students who are relatively unfamiliar with online instruction and consider ways to minimize negative environmental impacts and increase access to mental health resources.
A Transcanal Endoscopic Approach for Management of Pulsatile Tinnitus due to High-Riding Dehiscent Jugular Bulb
Authors: Hung David Shang-Yu , Lee Wei-Ting , Li Yi-Lu , Wu Jiunn-Liang
Published: September 2021

Pulsatile tinnitus (PT) caused by a high-riding dehiscence jugular bulb (HDJB) is a rare but treatable otology disease. There are several managements include transcatheter endovascular coil embolization, transvenous stent–assisted coil embolization, or resurfacing the dehiscent bony wall of high jugular bulb under the use of microscope. Among those options, surgical resurfacing of HDJB might be an effective and safe choice with less destruction. However, previous studies approached middle ear cavity via microscope can only provide a lateral, indirect view, while resurfacing the vessel through a transcanal endoscopic ear surgery (TEES) approach may give surgeon a direct and easy way to manage HDJB. In this report, we presented a case of 40-year-old woman with HDJB and shared our clinical consideration and reasoning of the surgical management of PT via a transtympanic approach by TEES rather than a transmastoid approach.
The Coming Out Experiences of Gifted, LGBTQ Students: When, to Whom, and Why Not?
Authors: Tuite Jo , Rubenstein Lisa DaVia , Salloum Serena J.
Published: September 2021

The purpose of this exploratory study was to examine the coming out experiences of gifted LGBTQ (lesbian, gay, bisexual, transgender, and questioning or queer) alumni from a residential gifted high school. First, we found that gifted LGBTQ alumni ( N = 106) realized their sexual orientation/gender identity around 16.6 years old, which is similar to the general population. The year of high school graduation did not correlate with the age of initial realizations, or when they shared. On average, when the participants did share, they waited 2.1 years to share with friends and 3.4 years to share with family. Furthermore, they felt more comfortable sharing within the residential gifted high school than in their home schools. In general, LGBTQ alumni felt more autonomous, competent, and connected to the residential school. Finally, participants reported many barriers to coming out, including both internal struggles (e.g., uncertain themselves) and social fears (e.g., fear of alienation or harassment). These findings can provide guidance for school personnel as they develop effective, support systems.
Characterization of the Nonendocrine Cell Populations in Human Embryonic Stem Cell–Derived (hESC) Islet-Like Clusters Posttransplantation
Authors: Jensen Nikolai K. , Ingvorsen Camilla , Petersen Dorthe R. , Pereira Maria J. , Lu Tess T. H. , Alsted Thomas J. , Kirkegaard Jeannette S. , Keane Kevin A.
Published: September 2021

Islet-like clusters derived from human embryonic stem cells (hESC) hold the potential to cure type 1 diabetes mellitus. Differentiation protocols of islet-like clusters lead to the generation of minor fractions of nonendocrine cells, which are mainly from endodermal and mesodermal lineages, and the risk of implanting these is unclear. In the present study, the histogenesis and the tumorigenicity of nonendocrine cells were investigated in vivo. Immunodeficient mice were implanted under the kidney capsule with islet-like clusters which were derived from differentiation of cells batches with either an intermediate or poor cell purity and followed for 8 or 26 weeks. Using immunohistochemistry and other techniques, it was found that the intermediate differentiated cell implants had limited numbers of small duct-like cysts and nonpancreatic tissue resembling gastrointestinal and retinal pigmented epithelium. In contrast, highly proliferative cystic teratomas were found at a high incidence at the implant site after 8 weeks, only in the animals implanted with the poorly differentiated cells. These findings indicate that the risk for teratoma formation and the amount of nonpancreatic tissue can be minimized by careful in-process characterization of the cells and thus highlights the importance of high purity at transplantation and a thorough ex-vivo characterization during cell product development.
Phthalate Toxicity in Rats and Its Relation to Testicular Dysgenesis Syndrome in Humans
Authors: Willson Cynthia J.
Published: September 2021

This work describes the relevance of toxicology studies of environmental chemicals, with a focus on phthalates, for a hypothesis that certain human male reproductive disorders and diseases have a common etiology of disturbance of normal development in utero. The “Testicular Dysgenesis Syndrome” hypothesis in humans has parallels in male reproductive tract abnormalities and microscopic lesions reported for phthalate toxicity in rats. Additionally, this work describes the histological findings of abnormal testicular development (testicular dysgenesis) in rats as compared to those in humans, as well as potential findings in rats at different ages, from the embryo to the adult.
One-stage thoracoscopic resection of bilateral bronchiectasis
Authors: Wu Ming-Ho , Wu Han-Yun
Published: September 2021

Objective

To evaluate the results of one-stage thoracoscopic resection of bilateral bronchiectasis.

Methods

Between June 2009 and December 2020, there were 23 patients selected for one-stage thoracoscopic resection of bilateral bronchiectasis. Their average age was 58.5 (36–73). Female patients were more common, accounting for 17 (74%). Preoperatively, 17 (74%) patients mainly presented with hemoptysis and the other 6 (26%) patients with purulent sputum.

Results

In these 23 patients, a total of 121 segments were resected, with an average of 5.26 segments, ranging from 3 to 9 segments. Five of 17 patients with massive hemoptysis underwent ligation of bronchial arteries in addition to lung resections. The average operating time was 271 min, ranging from 145 to 500 min. The average blood loss was 108 ml, ranging from 20 to 600 ml. The average postoperative hospital stay was 8 days, ranging from 3 to 20 days. There was no surgical morbidity or surgical death. Hemoptysis and purulent sputum of all patients was almost controlled after surgery.

Conclusion

One-stage thoracoscopic resections of bilateral localized bronchiectasis could be well-tolerated and safe for these selected patients. The one-stage operation could shorten the course of treatment.
Preintervention imaging and intraoperative management care of the hypertrophic obstructive cardiomyopathy patient
Authors: Moreno Garijo Jacobo , Ibáñez Cristina , Perdomo Juan M , Abel Martin D , Meineri Massimiliano
Published: September 2021

With an estimated overall mortality of less than 1 percent per year, hypertrophic cardiomyopathy, is the most common genetic cardiomyopathy. Intraoperative transesophageal echocardiography is the standard of care for assessing patients with hypertrophic obstructive cardiomyopathy undergoing surgical septal myectomy, allowing surgical planning, intraoperative hemodynamic monitoring, and postprocedural assessment of the repair, including detection of immediate complications. At various phases during surgical septal myectomy, the changing hemodynamic conditions may lead to worsening or improvement in left ventricle outflow tract obstruction by change in preload or afterload, systolic anterior motion of the mitral valve, or sympathetic stimulation. These characteristics represent unique challenges in the management of these patients, requiring a comprehensive understanding of the management of all the conditions required to decrease the left ventricle outflow tract gradient avoiding obstruction, which include the maintenance of sinus rhythm, adequate rate avoiding tachycardia and bradycardia, and avoidance of systemic hypotension preserving preload and afterload, with adequate vasoactive agents. The aim of this review is to summarize the perioperative assessment and management of patients undergoing hypertrophic obstructive myopathy surgery.
Study on information patients with vision impairment receive from ophthalmologists in Japan
Authors: Nara Risa , Sato Yukie , Masuda Yusuke , Misono Masamitsu , Tanida Koichi
Published: September 2021

The purpose of this study was to determine whether people with visual impairment in Japan are provided with useful information by their ophthalmologist while being notified of their disability, and what information is needed by these individuals upon being diagnosed. An analysis of the responses from 197 respondents revealed that only 30.45% had been provided information by their ophthalmologist upon being diagnosed, while 69.55% patients were not provided any information. When asked about the form of media they used to receive information, the most frequently used was the internet (16.68%). As web accessibility is not sufficient in Japan, making information media accessible to the visually impaired is a challenge. Finally, when asked about the type of information they would like to be provided, the most common answer was information about peer support. This suggests that ophthalmologists are expected to (1) understand the needs of the visually impaired and (2) provide information appropriately and promptly.
Perfusion profile evaluated by severity-weighted multiple Tmax strata predicts early neurological deterioration in minor stroke with large vessel occlusion
Authors: Gwak Dong-Seok , Choi WooChan , Kwon Jung-A , Shim Dong-Hyun , Kim Yong-Won , Hwang Yang-Ha
Published: September 2021

Minor stroke due to large vessel occlusion (LVO) is associated with poor outcomes. Hypoperfused tissue fate may be more accurately predicted by severity-weighted multiple perfusion strata than by a single perfusion threshold. We investigated whether poor perfusion profile evaluated by multiple Tmax strata is associated with early neurological deterioration (END) in patients with minor stroke with LVO. Ninety-four patients with a baseline National Institute of Health Stroke Scale score ≤5 and anterior circulation LVO admitted within 24 hours of onset were included. Tmax strata proportions (Tmax 2–4 s, 4–6 s, 6–8 s, 8–10 s, and >10 s) against the entire hypoperfusion volume (Tmax >2 s) were measured. The perfusion profile was defined as the shift of the distribution of the Tmax strata proportions towards worse hypoperfusion severity compared with that of the entire cohort using the Wilcoxon-Mann-Whitney generalised odds ratio (OR); its performance to predict END was tested. The area under the curve of perfusion profile was 0.785 (95% confidence interval [CI]: 0.691–0.878, p < 0.001). Poor perfusion profile (generalised OR >1.052) was independently associated with END (adjusted OR 13.42 [95% CI: 4.38–41.15], p < 0.001). Thus, perfusion profile with severity-weighted multiple Tmax strata may predict END in minor stroke and LVO.
History of non-physician anaesthesia providers in Papua New Guinea: from heil tultuls to Anaesthetic Scientific Officers
Authors: Loughnan Terence E , Cooper Michael G , Wake Pauline B , Aigeeleng Harry
Published: September 2021

The most recent estimates, published in 2016, have indicated that around 70% of anaesthesia providers in Papua New Guinea are non-physician anaesthetic providers and that they administer over 90% of anaesthetics, with a significant number unsupervised by a physician anaesthetist. Papua New Guinea has a physician anaesthetist ratio estimated to be 0.25 per 100,000 population, while Australia and New Zealand have a ratio of 19 physician anaesthetists per 100,000, which is 75 times that of Papua New Guinea. To reach a ratio of seven per 100,000, recommended as the minimum acceptable by the Lancet Commission in 2016, there will need to be over 35 practitioners trained per annum until 2030, at a time when the average annual numbers of recent years are less than three physicians and less than five non-physician anaesthetic providers. We review the development of anaesthesia administered by non-physician indigenous staff and the stages of development from heil tultuls, dokta bois, liklik doktas, native medical assistants, aid post orderlies, and Anaesthetic Technical Officers up to the current Anaesthetic Scientific Officers having attained the Diploma in Anaesthetic Science from the University of Papua New Guinea.
Water Film Depth Prediction Model for Highly Textured Pavement Surface Drainage
Authors: Pourhassan Alireza , Gheni Ahmed A. , ElGawady Mohamed A.
Published: September 2021

Water film depth (WFD) is an important factor for road traffic safety because of its direct connection with skid resistance, hydroplaning speed, and the tendency of splash and spray. Increasing the pavement macrotexture reduces WFD. However, existing models for WFD prediction have not been developed on highly textured surfaces such as chip seal. Furthermore, the rainfall intensities used for developing most of these models were relatively low, leaving no or low WFD on chip seal surfaces. To propose a WFD prediction model suitable for highly textured surfaces and to consider the effect of surface material type, an experimental study was conducted with 154 different combinations of mean texture depth (MTD), surface material type, surface slope, drainage length, and rainfall intensity. The tests were carried out on chip seal specimens using a full-scale rainfall simulator. Test results from 1,784 WFD readings indicated that the Gallaway and PAVDRN models were not accurate for highly textured surfaces used in this study with MTD ranging from 0.05 to 0.20 in. Two experimental models were, therefore, proposed to predict the WFD; both models displayed a significantly higher correlation between the measured and predicted WFD compared with the existing models. Furthermore, the eco-friendly rubberized chip seal showed an enhanced drainage capability compared with conventional chip seal, especially in low slopes, because of the hydrophobic nature of crumb rubber versus the hydrophilic character of mineral aggregates. Accordingly, the proposed model incorporated a term to consider the effect of surface material type.
Mobility-as-a-Service: Simulation of Multi-Modal Operations in Low-Density Cities
Authors: El-Agroudy Mohamed , Abou-Senna Hatem , Radwan Essam
Published: September 2021

In the case of the low-density city, empirical evidence continuously demonstrates that transit investment is not a magic bullet. Desirable outcomes are not guaranteed and are often dependent on development density and other urban characteristics. Mobility-as-a-service (MaaS) presents a new approach: a digital platform providing access to multi-modal travel alternatives and totally comprehensive integrated trip-making, planning, and payment services. Review of the literature highlights shortcomings in traditional transportation planning by examining aspects of multi-modal planning such as adoption, parterships, operations, integration, capacity implications, and impact analyses. To enhance the practice of multi-modal planning, the following experiment evaluates various performance measures and inter-modal interactions on International Drive in Orlando, Florida, U.S., via D- and I-optimal experimental designs in a simulated MaaS network. Alternative scenarios are developed comparing varied modal shares across five travel modes: personal vehicles, transit, ridesourcing (or ride-hailing), micro-mobility, and walking. The modal effects are analyzed to highlight the strengths and weakness of each mode under a variety of congestion conditions. While transit enjoys the lowest impact per person, ridesourcing demonstrates adverse effects across all measures. Based on the novel interactions of transit and ridesourcing with directional demand, strategies are outlined for optimizing ridesourcing-transit integration to reduce route travel time, queuing, and overall network delay. The performance impacts of curbside facilities are also discussed for improved multi-modal integration at the street level. These findings are applied to propose a framework for effective planning and implementation of mobility services in low-density cities, focused on operations, city-level connectivity, and curbside management.
Non-Symmetric Spatial-Temporal Network for Bus Origin–Destination Demand Prediction
Authors: Wang Liqin , Dong Yongfeng , Wang Yizheng , Wang Peng
Published: September 2021

Urban public transport has become a preferred choice for alleviating traffic congestion. The bus passenger OD (origin–destination) demand prediction based on bus operational data is the key technology to realize urban intelligent transportation system. However, most of the existing bus OD demand prediction methods only considered regional passengers. The problem of the OD demand prediction based on historical OD matrices of bus lines is still not easy to implement, exceptionally, which is suitable for most of the urban bus lines. This paper presents a non-symmetric spatial-temporal network (NSTN) based on convolutional neural network (CNN) and convolutional long short-term memory (ConvLSTM) network to predict bus OD. NSTN contains the station spatial component (SSC) module and the spatial-temporal component (STC) module. SSC consists of two CNNs to learn the OD features and the DO (destination-origin) features, respectively. To make the prediction shift to the OD features, the non-symmetric input is designed. STC extracts spatial-temporal features based on ConvLSTM. Compared with other methods, NSTN has the best performance measured by symmetric mean absolute percentage error (SMAPE) and root mean square error (RMSE), where its SMAPE falls by 4.3 percentage points to 16.4 percentage points and RMSE falls by 23.1 percentage points to 69.9 percentage points. Experimental results on other bus lines show that NSTN has strong generalization ability.
Minimizing Total Logistics Cost for Long-Haul Multi-Stop Truck Transportation
Authors: Kay Michael G. , Karagul Kenan , Şahin Yusuf , Gunduz Gurhan
Published: September 2021

Whenever there is sufficient demand, companies generally prefer the full truckload (TL) option for long-distance transport, resulting in large and less frequent shipment operations that can be costly if inventory carrying costs are high. Less than truckload (LTL) is another option for transport when carrying costs are high and/or there is insufficient demand. Shipment consolidation provides another option that combines many of the benefits of both TL and LTL. Shipment consolidation is a cost-effective transport solution that combines different size shipments into a single truckload. Combining many loads as a single load brings together economies of scale and potential savings. Traditional routing techniques that minimize distance are not suitable for shipments that have different origins and destinations because it can be beneficial to travel further to minimize overall transport and inventory cost, or what is termed total logistics cost (TLC). Effective consolidation of multi-stop routes to minimize TLC requires routing procedures that are more computationally intensive to find beneficial combinations of loads into consolidated shipments. In this study, we have developed a saving-based procedure to determine consolidated route sequences that minimize the TLC of shipments. Twenty-one data sets were produced using real city coordinates and population densities in North Carolina to demonstrate the effectiveness of the procedure. The solutions of the proposed method are compared with the solutions of the traditional Clarke and Wright (C-W) algorithm. Although the traditional C-W algorithm provides very fast solution times, the proposed method has produced much better solution values.
Public Transportation and Social Movements: Learning from the Hong Kong Anti-Extradition Bill Protests
Authors: Chan Ho-Yin , Ma Hanxi , Zhou Jiangping
Published: September 2021

In this article, we address the public transportation system’s resilience in social movements, which has been under-explored in transportation scholarship. On the one hand, public transportation enables mass mobilization of people and materials and large-scale public engagement in political/social events in transit-reliant cities like Hong Kong. On the other hand, public transportation can be an instrument for both the government and event participants—the former interferes with the public transportation service provision to manage and mitigate the adverse impacts of social movements it perceives on society, whereas the latter disrupt public transportation services or vandalize and damage related facilities to express their discontent and to put pressure on the former. The dynamic resilience of the public transportation system against the above backdrop warrants more in-depth exploration. We incorporate both supply and demand shocks to theorize resilience as a public transportation system’s capability to return to a new equilibrium between the supply and demand after a disturbance. The theoretical approach is illustrated using empirical data and publicly available materials concerning the 2019 Anti-Extradition Law Amendment Bill movement in Hong Kong.