bluuebunny/crossref_metadata_2025 huggingface dataset:
Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles
Authors: Paterson Katherine E. , Myint Phyo K. , Jennings Amy , Bain Lucy K.M. , Lentjes Marleen A.H. , Khaw Kay-Tee , Welch Ailsa A.
Published: June 2021

Background and Purpose—

Although some evidence has found that the Mediterranean diet (MD) is protective for stroke risk, few studies have investigated whether this relationship differs by sex or cardiovascular disease risk.

Methods—

We investigated the relationship between adherence to the MD score, estimated using 7-day dietary diaries and risk of incident stroke in an observational prospective population-based cohort study of 23 232 men and women (54.5% women) aged 40 to 77 years who participated in the European Prospective Investigation into Cancer study in Norfolk, United Kingdom. Risk of incident stroke was calculated using multivariable Cox regression, in the whole population, and also stratified by sex and cardiovascular disease risk profile, using the Framingham risk score.

Results—

During 17.0 years of follow-up (395 048 total person-years), 2009 incident strokes occurred. Risk of stroke was significantly reduced with greater adherence to the MD score (quartile 4 versus quartile 1 hazard ratio [HR], 0.83; 95% CI, 0.74–0.94;
P
-trend <0.01) in the whole population and in women (quartile 4 versus quartile 1 HR, 0.78; 95% CI, 0.65, 0.93;
P
-trend <0.01) but not in men (quartile 4 versus quartile 1 HR, 0.94; 95% CI, 0.79–1.12;
P
-trend =0.55). There was reduced risk of stroke in those at high risk of cardiovascular disease and across categories of the MD score (quartile 4 versus quartile 1 HR, 0.87; 95% CI, 0.76–0.99;
P
-trend =0.04). However, this was driven by the associations in women (quartile 4 versus quartile 1 HR, 0.80; 95% CI, 0.65–0.97;
P
-trend =0.02).

Conclusions—

Greater adherence to the MD was associated with lower risk of stroke in a UK white population. For the first time in the literature, we also investigated the associations between the MD score in those at both low and high risk of cardiovascular disease. Although the findings in our study were driven by the associations in women, they have implications for the general public and clinicians for prevention of stroke.
International Palaeoentomological Society Statement on unethical practices in describing new taxa
Authors: INTERNATIONAL PALAEOENTOMOLOGICAL SOCIETY
Published: June 2021

Taxonomy or biological systematics is the basic scientific discipline of biology, postulating hypotheses of identity and relationships, on which all other natural sciences dealing with organisms relies. Taxonomy as the scientific discipline that explores, discovers, interprets, represents, names, and organizes organic beings (Ebach et al., 2011), is one of the oldest biological disciplines. Taxonomy is a scientific discipline that has provided the universal naming and classification system of biodiversity for centuries and continues effectively to accommodate new knowledge (Thomson et al., 2018). However, taxonomic impediment, decrease in the number of taxonomists, lack of appreciation for this area of research is not only the problem for studies on Recent organisms and their diversity (Wägele et al., 2011; Britz et al., 2020; Vinarski, 2020; Raposo et al., 2021), but it is affecting seriously also research and studies on fossils, their taxonomy and their palaeodiversity.
ADDENDUM: Behavioural impacts on the taphonomy of dragonflies (Odonata) from the Lower Cretaceous Crato Formation, Brazil
Authors: BARLING NATHAN T. , HEADS SAM W. , MARTILL DAVID M.
Published: June 2021

In our recent paper discussing the impacts of dragonfly behaviour on their taphonomy from the Lower Cretaceous Crato Formation of Brazil (Barling et al., 2021), we figured eight specimens (Fig. 3, p. 145) illustrating dragonflies in various states of preservation. In the caption to this figure we listed the temporary laboratory numbers assigned to these specimens during the study (identified with the prefix “UOP-PAL-”) and not their permanent accession numbers. On completion of the study, all specimens were transferred to the Museu de Paleontologia Plácido Cidade Nuvens (MPPCD) at the Universidade Regional do Cariri in Crato, Brazil.
Combined Effect of ENSO and AO on Winter Temperatures of the Korean Peninsula on Subseasonal Time Scales
Authors: Kim Gaeun , Yang Sinil , Lee Woo-Seop
Published: June 2021

The combined effect of the El Niño–Southern Oscillation (ENSO) and Arctic Oscillation (AO) on the variability of boreal winter (December–February) temperature over South Korea is examined at the subseasonal time scale using subseasonal-to-seasonal (S2S) hindcast data. Daily hindcast data from the European Centre for Medium-Range Weather Forecasts (ECMWF) database is used. We selected the following six composite cases using a threshold of ±0.5 for each index: El Niño and positive AO (EP), El Niño and negative AO (EN), La Niña and positive AO (LP), La Niña and negative AO (LN), positive AO only (PA), and negative AO only (NA). Results from reanalysis data suggest the possibility of using these two climate factors as predictors for 1-month prediction of South Korea up to 4 weeks in advance. Thus, we confirmed that the ENSO plays a statistically significant role in strengthening (weakening) the AO influences on the temperature anomalies in the in phase (out of phase). For example, there is a significant increase (decrease) in mean temperature anomalies through positive (negative) geopotential height (GPH) anomalies and warm (cold) temperature advection over South Korea in the EP (LN) case. The ECMWF S2S hindcast demonstrated an acceptable ability to reproduce circulation patterns over East Asia up to 3 weeks in advance, and sufficiently predicted weekly mean temperature anomalies over South Korea in EP, LN, and PA cases.
The Use of Hemostatic Agents to Decrease Bleeding Complications in Breast Cancer Surgery
Authors: Bloom Joshua A. , Foroutanjazi Sina , Erlichman Zachary , Beqiraj Zhaneta , Jonczyk Michael M. , Persing Sarah M. , Chatterjee Abhishek
Published: June 2021

Introduction

Following breast cancer surgery, patients often require adjuvant radiation and chemotherapy for locoregional and systemic disease control. These procedures may result in postoperative complications, which may delay adjuvant therapy. To potentially decrease these complications, hemostatic agents may be used. This study evaluated the rate of postoperative bleeding complications and duration of Jackson-Pratt (JP) drain use in oncologic breast surgery with and without hemostatic agents.

Methods

After obtaining institutional review board approval, a retrospective chart review was performed. Patients who underwent oncoplastic breast surgery, mastectomy with or without expander/implant-based reconstruction, and subsequent reconstruction with expander to implant exchange were included. Data collected included indication for surgery, type of operation, use of hemostatic agent, specifically fibrin sealant (FS, EVICEL®, Ethicon, USA) or combination powder (CP, HEMOBLAST™ Bellows, biom’up, France), length of follow-up, time to JP drain removal, and post-operative complications (seroma, hematoma, or operating room (OR) takeback). This was a consecutive experience where initially no hemostatic agent was used, followed by use of FS, and then CP.

Results

The use of a hemostatic agent resulted in fewer bleeding complications and significantly decreased time until JP drain removal. Although not significant, subgroup analysis demonstrated that this was more pronounced in the CP group. JP drain duration was decreased among all procedures for CP compared to FS.

Conclusions

The use of hemostatic agents in oncologic breast surgery may result in decreased postoperative complications and significantly reduce time to JP drain removal.
Mobilizing Occupation for Social Transformation: Radical Resistance, Disruption, and Re-Configuration: Mobiliser l'occupation pour une transformation sociale : résistance radicale, perturbation et reconfiguration
Authors: Rudman Debbie Laliberte
Published: June 2021

Background.

Given the sociopolitical roots of widening occupational, social, and health inequities, it is imperative that occupational therapy move forward in mobilizing occupation for social transformation.

Purpose.

Three key aims are addressed: articulating the imperative to mobilize occupation for social transformation; highlighting the political nature of occupation and occupational therapy; and providing guideposts for embracing a radical sensibility to inform moving forward in mobilizing occupation for social transformation.

Key issues.

Conditions of possibility within occupational therapy leave the profession ill equipped to enact social transformation. Enacting calls to mobilize occupation for social transformation requires radically reconfiguring these conditions of possibility to inform practices that resist, disrupt, and re-configure sociopolitical conditions perpetuating occupational inequities.

Implications.

Mobilizing occupation for social transformation holds much potential to contribute toward creating more equitable, humane societies. Realizing this potential involves committing to transforming our profession, as well as societal discourses, structures, systems, relations, and practices.
The Christian Funeral as Counter Witness
Authors: Long Thomas G.
Published: June 2021

The proliferation of unconventional death practices in North America, however innovative, is in part an expression of societal confusion about the nature of death and grief. If the church can recover the theological and liturgical fabric of funerals, reclaiming their main purpose as public confession rather than private pastoral care, Christian funerals can serve as a hopeful counter-witness to an uncertain culture.
Resurrecting the nepeš
Authors: Wright Jim
Published: June 2021

Our culture’s approach to dementia typically focuses on preserving the person as they once were. Mental exercises, special diets, and entire memory care facilities are designed to maintain the “previous person.” As important as this is to family and friends, it can be challenging and burdensome to the person who is living with dementia, a person who may not recall, or want to recall, their past life. This essay asserts that the emphasis on maintaining the previous person (and the resultant de-emphasis on honoring the new person) often results from a belief in our innate permanence, particularly the belief in our immortal, immutable soul. Because of this insistence on innate immortality, we tend to undervalue those who fail to live up to the expectations of permanence. The author calls for a renewed emphasis on nepeš, ancient Israel’s concept of the mortal, fleeting human life. By acknowledging our impermanence, we may be able to better identify with and value those who live with dementia and design environments that honor and enable people who are becoming someone new.
Beyond Language and Academics: Investigating Teachers’ Preparation to Promote the Social-Emotional Well-Being of Emergent Bilingual Learners
Authors: Heineke Amy J. , Vera Elizabeth M.
Published: June 2021

In recent years, institutions have responded to changing school populations by preparing teachers for the growing number of emergent bilingual learners (EBLs). But this preparation largely focuses on supporting students’ academic learning and language development, despite enhanced attention to social-emotional well-being in wider educational circles. This comparative case study seeks to understand whether and how teachers are prepared to facilitate this integral component of student learning in five schools with linguistically diverse populations and varied program models to serve EBLs. We first probe how teachers draw from various facets of their preparation to support EBLs’ social-emotional well-being, including teacher education, professional development, collaboration with colleagues, and personal experiences. We then consider teachers’ and students’ perspectives on the requisite expertise to facilitate well-being in classrooms. Findings provide insight for university, district, and school stakeholders seeking to enhance teacher preparation as a means to improve the educational experiences of EBLs.
A systematic review on sustainable agricultural practices among oil palm farmers
Authors: Abas Azlan , Er Ah Choy , Tambi Noordeyana , Yusoff Nur Hafizah
Published: June 2021

Oil palm farmers play an important role in ensuring oil palm cultivation can achieve sustainable agricultural practice. However, the best agricultural practices among oil palm farmers are yet to be known. This study aims to systematically review oil palm farmers’ sustainable practices. The present study integrated multiple research designs and the review was based on the published standard, namely ROSES (Reporting Standards for Systematic Evidence Syntheses). This study used Web of Science (WoS) as the main database in searching for the required articles. Based on the thematic analysis, this review has 5 (five) main themes, the sustainable practices, namely 1) land management, 2) waste management, 3) advanced technology implementation, 4) economic empowerment, and 5) social inclusion. The findings offer some basics on how to integrate oil palm farmers’ practices with scientific findings for the formation of the oil palm certification and policy besides providing some ideas on the role of the oil palm farmer in the sustainable development 2030 agenda.
Scientific Blogs as a Psychological Literacy Assessment Tool
Authors: Pownall Madeleine , Havelka Jelena , Harris Richard
Published: June 2021

Introduction: Psychological literacy is a pedagogic approach that promotes the application of psychology knowledge to address societal, ethical, and cultural problems. Statement of the Problem: Psychological literacy is considered to be a core outcome of a psychology undergraduate degree, and scholars have called for more “psychologically literate” forms of summative assessment to reflect this. Literature Review: Throughout the pedagogic literature, scientific blogs have been proposed as a form of assessment that encourages reflection, creative thinking, and perspective taking. Teaching Implications: Here, we discuss the utility of blog writing as a summative assessment which fosters psychological literacy by encouraging students to engage with the interplay between subject knowledge and real-world applications. Conclusion: We reflect upon our experiences of embedding of scientific blogs in two final-year modules at a UK university and offer a commentary in the context of psychological literacy undergraduate outcomes.
Jesus as News: Crises of Health and Overpopulation in Galilee
Authors: Taylor Joan E.
Published: June 2021

What made Jesus ‘news’? The key reason given in Mark and Matthew is that Jesus was an effective healer. In Q, likewise, Jesus fulfils John’s prediction of a Coming One who will baptize in Holy Spirit and fire by means of his healing mission. Luke complicates this slightly by emphasizing Jesus’ teaching on social justice, and John conceptualizes the healings as ‘signs’, but both also indicate that Jesus was news because he healed people. Thus, Galilee was in the grip of a chronic health crisis which people – both rich and poor – experienced as stress, and Jesus was news because he provided a solution. While being an exorcistic healer was not unusual, Jesus’ healing apparently was, both in its effectiveness and in its approach, involving physical touch. We now know that affective touch has a positive effect on the immune system. Disease crises in Galilee can be linked to the great density of its population, associated with widespread rural poverty and environmental degradation. Previous assessments of population in Galilee have hitherto been much too small.
Distributed adaptive event-triggered iterative learning controller based on a filtering network
Authors: Zhu Fengzeng , Peng Li
Published: June 2021

This paper develops a distributed adaptive event-triggered iterative learning controller over a filtering network for a class of tracking control systems. The proposed distributed control method is more robust than centralized control in terms of node failure and transmission constraints. In view of the limited network bandwidth, adaptive event-triggered mechanisms (AETMs) have been considered in the network communication process. The proposed AETM is characterized by introducing the dynamic threshold parameter, which provides benefits in data scheduling. The existence of filters and controllers is analyzed by Lyapunov stability theory and linear matrix inequality techniques, and their parameters are finally obtained. Moreover, some simulation results on a numerical example and a irrigation canal are presented to show the applicability of the obtained results.
Early Internal Branch of Superior Laryngeal Nerve Bifurcation Passes Through Double Thyroid Foramen
Authors: Paraskevas George K. , Poutoglidis Alexandros , Lazaridis Nikolaos , Anastasopoulos Nikolaos , Tsetsos Nikolaos
Published: June 2021

Internal branch of superior laryngeal nerve (ibSLN) provides sensory innervation mostly to the supraglottic part of the larynx and thus prevents aspiration during ingestion. Normally, it is distributed to the larynx after piercing the thyrohyoid membrane above the superior laryngeal artery. Multiple anatomical variations in the course of ibSLN have been reported. An early ibSLN bifurcation and course through double thyroid foramen constitutes an interesting anatomical variation that may easily lead to an injury during procedures in the thyroid gland and the larynx. Knowledge of the anatomical variability is essential in order to prevent surgical complications that could potentially impact the patient’s quality of life.
The “Living Soul” in People and Animals: Environmental Themes from Genesis 2
Authors: Gnuse Robert K.
Published: June 2021

Genesis 2 contains some powerful imagery germane to the discussion of environmental awareness and responsibility. Both humans and animals are described in Hebrew as nephesh hayya', a “living being,” but in English we translate the words differently to maintain our human superiority. We subsequently disown our oneness with the animal realm by brutalizing species of animals throughout the world. Likewise the human is put into the garden to “keep” or “protect” it, which is not what we have been doing with either the world or the animal kingdom.
How Structural Empowerment Boosts Organizational Resilience: A case study in the Dutch home care industry
Authors: van den Berg Jennifer , Alblas Alex , Blanc Pascale Le , Romme A. Georges L.
Published: June 2021

Previous work has demonstrated that structural forms of empowerment tend to enhance individual and team resilience. However, there is hardly any knowledge about how structural empowerment affects organizational resilience. Moreover, a widespread (though largely untested) assumption is that, in adverse times, power and authority need to be centralized at the top to enhance organizational resilience. This paper explores the effects of empowerment on organizational resilience in an in-depth case study of a Dutch home care organization, in which employees are structurally empowered. The findings from this case study suggest that structural empowerment positively affects organizational resilience, but that this effect is contingent upon a climate of psychological safety as well as top management’s sustained commitment to structural empowerment. We move beyond the extant conceptualization of psychological safety by demonstrating its inter-level nature in the context of structural empowerment, which operates across organizational levels when employees also engage in discussions on tactical and strategic issues. Overall, this study provides an in-depth understanding of how organizations can enhance their resilience by empowering their members, thus also challenging the common wisdom about centralizing power in adverse times.
Financial Inclusion and Quality of Life: Empirical Evidences from Indian States with Special Reference to West Bengal
Authors: Sen Avisek , Laha Arindam
Published: June 2021

The conceptual connection between financial inclusion and quality of life (QOL) can be realized by a two-way relationships. On the one hand, financial inclusion induces QOL, while an improvement in QOL facilitates in generating demand for financial services, on the other hand. Even though several studies seek to find out the role of finance in the well-being of the population (especially human development), this article concentrates on QOL to eliminate the financial attributes of development (as captured by income dimension in Human Development Index). In this sense, this study addresses the research gap in the existing literature by establishing the relationship between financial inclusion and QOL. Specifically, the article attempts to explain the two-way tie-up between the financial inclusion and the QOL in India in the context of Indian states, in general, and West Bengal, in particular. Canonical correlation (CC; a multivariate data analysis technique) is used to estimate the relation between the financial inclusion and QOL. Empirical results suggest that western and the southern Indian states excel in the attainment of education, health and other amenities-based indicators of QOL. The conditions of the eastern part of the country in case of financial inclusion and the QOL are not at all satisfactory. In case of West Bengal, Kolkata being the state capital is performing well in both the factors. CC results suggest a significant association between the financial inclusion and QOL across Indian states. The deposit account of financial inclusion indicator and the infant survival rate of QOL indicator are playing a pivotal role in the relationship (both the Indian states and districts of West Bengal as well). This article establishes the effectiveness of the demand following approach of financial inclusion than that of supply leading approach. As the demand-side aspect of financial inclusion is becoming more important to the policymakers, the next policy priority of financial inclusion measures could be the generation of awareness on the financial services through financial literacy.

JEL Codes: G2, O15, C39
Everyday experiences of digital financial inclusion in India's ‘micro-entrepreneur’ paratransit services
Authors: Baker Lucy
Published: June 2021

Self-employed labour in transportation is a notoriously precarious form of employment that occurs throughout many developing countries. In order to offset high-cost and insecure vehicle procurement arrangements, paratransit fare structures are formulated on the basis of a set of logics designed to maximise revenues. Although entrepreneurial, when these logics occur in conflict with public fare legislation, they are undertaken illegally, or informally, and are perceived as undesirable by policy makers and transport users. However, the underlying structures that necessitate these practices are seldom examined despite their significant effect on mobilities and the livelihood experiences of male entrepreneurs. This paper engages with critical literatures on the financialisation of poverty reduction to present financialisation as a class-based mechanism that, with the rapid increase of digital payment and ‘alternative’ credit scoring, structures micro-entrepreneurship and precarity in the neoliberal context of India. The paper argues that digitally enhanced financial inclusion techniques may steer low-income workers toward mainstream finance institutions modelled on the global economy. They enable profit to be generated by investors and private microfinance companies. However, new financial technologies do not do little to reduce the risk and expense of microfinance, nor do they increase micro-entrepreneurs' profit margins. Moreover, they threaten the informal practices entrepreneurs use to self-manage their financial precarity.
Removal From Activity After Sports- Related Concussion in Sex-Comparable Sports From the Michigan High School Athletic Association
Authors: Zynda Aaron J. , Petit Kyle M. , Anderson Morgan , Tomczyk Christopher P. , Covassin Tracey
Published: June 2021

Background:

Research has demonstrated that female athletes are more likely to report their sports-related concussion (SRC) symptoms compared with male athletes; however, it is unknown if these reporting behaviors correspond to immediate removal from activity in sex-comparable sports.

Purpose:

To compare the incidence of high school student-athletes removed and not removed from activity after SRC in sex-comparable sports in Michigan.

Study Design:

Descriptive epidemiology study.

Methods:

Participants included student-athletes diagnosed with SRC participating in Michigan High School Athletic Association–sponsored athletic activities (22 sex-comparable sports) between 2016 and 2019. All SRCs were recorded in the association’s Head Injury Reporting System (HIRS) by certified athletic trainers, administrators, or coaches. Removal from activity indicated that the student-athlete was removed from play at the time of an injury event. If the student-athlete reported that his or her suspected injury event occurred earlier during activity or if symptom onset was delayed, “not removed from activity” was entered into the HIRS. Incidence proportions were calculated by dividing SRCs not removed by total SRCs in each sport. Risk ratios were calculated by dividing the incidence proportions of girls not removed by boys not removed in each sport.

Results:

A total of 4418 (2773 female, 1645 male) SRCs were reported, with the most occurring in female soccer players (n = 1023). Overall, 515 girls and 243 boys were not removed from activity, resulting in incidences of 0.19 (95% CI, 0.17-0.20) and 0.15 (95% CI, 0.13-0.17), respectively. Across all sports, girls were 1.26 (95% CI, 1.09-1.45) times as likely to not be removed from activity compared with boys. Of the sports with the most SRCs—soccer, basketball, baseball/softball, and lacrosse—girls had 1.37 (95% CI, 1.09-1.72), 1.15 (95% CI, 0.89-1.47), 1.19 (95% CI, 0.77-1.84), and 1.35 (95% CI, 0.94-1.95) times the risk of not being removed, respectively.

Conclusion:

Girls were at greater risk of not being removed from activity compared with boys in sex-comparable sports. Results from this study should be incorporated into SRC education in Michigan and potentially elsewhere to inform affiliated personnel of potential sex differences and protect female student-athletes from further harm.
Emerging self-assembling peptide nanomaterial for anti-cancer therapy
Authors: Zhu Lisheng , Shi Yangyang , Xiong Ying , Ba Li , Li Qiuting , Qiu Mengjun , Zou Zhenwei , Peng Gang
Published: June 2021

Recently it is mainly focused on anti-tumor comprehensive treatments like finding target tumor cells or activating immune cells to inhibit tumor recurrence and metastasis. At present, chemotherapy and molecular-targeted drugs can inhibit tumor cell growth to a certain extent. However, multi-drug resistance and immune escape often make it difficult for new drugs to achieve expected effects. Peptide hydrogel nanoparticles is a new type of biological material with functional peptide chains as the core and self-assembling peptide (SAP) as the framework. It has a variety of significant biological functions, including effective local inflammation suppression and non-drug-resistant cell killing. Besides, it can induce immune activation more persistently in an adjuvant independent manner when compared with simple peptides. Thus, SAP nanomaterial has great potential in regulating cell physiological functions, drug delivery and sensitization, vaccine design and immunotherapy. Not only that, it is also a potential way to focus on some specific proteins and cells through peptides, which has already been examined in previous research. A full understanding of the function and application of SAP nanoparticles can provide a simple and practical strategy for the development of anti-tumor drugs and vaccine design, which contributes to the historical transition of peptide nanohydrogels from bench to bedside and brings as much survival benefits as possible to cancer patients.
Heat transfer characteristics of nanofluids from a sinusoidal corrugated cylinder placed in a square cavity
Authors: Parvin Salaika , Roy Nepal Chandra , Saha Litan Kumar , Siddiqa Sadia
Published: June 2021

A numerical study is performed to investigate nanofluids' flow field and heat transfer characteristics between the domain bounded by a square and a wavy cylinder. The left and right walls of the cavity are at constant low temperature while its other adjacent walls are insulated. The convective phenomena take place due to the higher temperature of the inner corrugated surface. Super elliptic functions are used to transform the governing equations of the classical rectangular enclosure into a system of equations valid for concentric cylinders. The resulting equations are solved iteratively with the implicit finite difference method. Parametric results are presented in terms of streamlines, isotherms, local and average Nusselt numbers for a wide range of scaled parameters such as nanoparticles concentration, Rayleigh number, and aspect ratio. Several correlations have been deduced at the inner and outer surface of the cylinders for the average Nusselt number, which gives a good agreement when compared against the numerical results. The strength of the streamlines increases significantly due to an increase in the aspect ratio of the inner cylinder and the Rayleigh number. As the concentration of nanoparticles increases, the average Nusselt number at the internal and external cylinders becomes stronger. In addition, the average Nusselt number for the entire Rayleigh number range gets enhanced when plotted against the volume fraction of the nanofluid.
A review of additive manufacturing applications in ophthalmology
Authors: Pugalendhi Arivazhagan , Ranganathan Rajesh
Published: June 2021

Additive Manufacturing (AM) capabilities in terms of product customization, manufacture of complex shape, minimal time, and low volume production those are very well suited for medical implants and biological models. AM technology permits the fabrication of physical object based on the 3D CAD model through layer by layer manufacturing method. AM use Magnetic Resonance Image (MRI), Computed Tomography (CT), and 3D scanning images and these data are converted into surface tessellation language (STL) file for fabrication. The applications of AM in ophthalmology includes diagnosis and treatment planning, customized prosthesis, implants, surgical practice/simulation, pre-operative surgical planning, fabrication of assistive tools, surgical tools, and instruments. In this article, development of AM technology in ophthalmology and its potential applications is reviewed. The aim of this study is nurturing an awareness of the engineers and ophthalmologists to enhance the ophthalmic devices and instruments. Here some of the 3D printed case examples of functional prototype and concept prototypes are carried out to understand the capabilities of this technology. This research paper explores the possibility of AM technology that can be successfully executed in the ophthalmology field for developing innovative products. This novel technique is used toward improving the quality of treatment and surgical skills by customization and pre-operative treatment planning which are more promising factors.
Attitude and Alertness in Personality Traits: A Pathway to Building Entrepreneurial Intentions Among University Students
Authors: Biswas Abhijeet , Verma Rohit Kumar
Published: June 2021

The entrepreneurial intentions of individuals play a phenomenal role in establishment of new ventures, which in turn facilitates economic development. The study aims to identify the various dimensions of personality traits along with several other precursors of entrepreneurial intentions and investigates impact of the identified factors on entrepreneurial intentions of top five university students in India. The data for research were collected through a structured questionnaire employing a 7-point Likert scale based on purposive sampling technique. The identified constructs considered to be determinants of entrepreneurial intentions were need for achievement, locus of control, risk-taking propensity, innovativeness, self-efficacy, proactiveness, perseverance, entrepreneurial alertness and entrepreneurial attitude. The findings of the study reveal that ‘need for achievement’ was the most significant precursor of entrepreneurial intentions; whereas, ‘entrepreneurial alertness’ and ‘entrepreneurial attitude’ dimensions of personality traits were also found to have a positive correlation with entrepreneurial intentions of university students. Moreover, entrepreneurial alertness partially mediates the relationship between self-efficacy and proactiveness on the one hand and entrepreneurial intentions on the other.
Low-Dose Tocilizumab With High-Dose Corticosteroids in Patients Hospitalized for COVID-19 Hypoxic Respiratory Failure Improves Mortality Without Increased Infection Risk
Authors: Brosnahan Shari B. , Chen Xian Jie Cindy , Chung Juri , Altshuler Diana , Islam Shahidul , Thomas Sarun V. , Winner Megan D. , Greco Allison A. , Divers Jasmin , Spiegler Peter , Sterman Daniel H. , Parnia Sam
Published: June 2021

Background

Severe hypoxic respiratory failure from COVID-19 pneumonia carries a high mortality risk. There is uncertainty surrounding which patients benefit from corticosteroids in combination with tocilizumab and the dosage and timing of these agents. The balance of controlling inflammation without increasing the risk of secondary infection is difficult. At present, dexamethasone 6 mg is the standard of care in COVID-19 hypoxia; whether this is the ideal choice of steroid or dosage remains to be proven.

Objectives

The primary objective was to assess the impact on mortality of tocilizumab only, corticosteroids only, and combination therapy in patients with COVID-19 respiratory failure.

Methods

A multihospital, retrospective study of adult patients with severe respiratory failure from COVID-19 who received supportive therapy, corticosteroids, tocilizumab, or combination therapy were assessed for 28-day mortality, biomarker improvement, and relative risk of infection. Propensity-matched analysis was performed between corticosteroid alone and combination therapies to further assess mortality benefit.

Results

The steroid-only, tocilizumab-only, and combination groups showed hazard reduction in mortality at 28 days when compared with supportive therapy. In a propensity-matched analysis, the combination group (daily equivalent dexamethasone 10 mg and tocilizumab 400 mg) had an improved 28-day mortality compared with the steroid-only group (daily equivalent dexamethasone 10 mg; hazard ratio (95% CI) = 0.56 (0.38-0.84), P = 0.005] without increasing the risk of infection.

Conclusion and Relevance

Combination of tocilizumab and corticosteroids was associated with improved 28-day survival when compared with corticosteroids alone. Modification of steroid dosing strategy as well as steroid type may further optimize therapeutic effect of the COVID-19 treatment.
Investigating the Effectiveness of User Onboarding Solutions With Eye Tracking: A Case Study on Paint 3D
Authors: Megyeri Mária , Szabó Bálint
Published: June 2021

This article examines the user’s first experience with a new software application called the user onboarding process. In addition, we conducted a series of usability experiments with 18 participants, which were supported by eye tracking technology, to explore the effectiveness of different user onboarding solutions, exemplified by the newest version of Paint. We also explored users’ feedback on onboarding solutions in a series of interviews. The results showed that user onboarding solutions are generally effective, making it worthwhile for computer software companies to provide them to support new users’ activity as well as to increase the value of their products.
Pediatric Extra-Axial Chordoma: Case Report and Literature Review
Authors: Lee Sean , Halpern Jennifer L , Liang Jiancong
Published: June 2021

Extra-axial chordomas in the pediatric population are extremely rare and diagnostically challenging; only four cases have been previously reported with ages ranging from 13 to 20 years. We report a primary extra-axial chordoma involving the soft tissue directly dorsal and ulnar to proximal phalanx in the right thumb of a 12-year-old girl who presented with worsening right thumb pain for 1.5 years. The diagnosis was confirmed by excisional biopsy demonstrating proliferation of large, polygonal epithelioid cells with diffuse expression of pan-cytokeratin and brachyury. The patient required repeat excision for local recurrence seven months later. Since then, she has remained disease free through 15 months surveillance. Extra-axial chordomas share the same histopathological and immunohistochemical characteristics with their axial counterparts and should be considered in the differential diagnosis for any extra-axial bone or soft tissue mass with epithelioid morphology.
The Italian version of the Keratoconus Outcomes Research Questionnaire (KORQ): Translation and validation of psychometric properties
Authors: Ferrini Erica , Aleo Davide , Posarelli Chiara , Albert Timothy , Miccoli Mario , Orrù Graziella , Figus Michele
Published: June 2021

Purpose:

To develop and validate the Italian version of the Keratoconus Outcomes Research Questionnaire (KORQ).

Methods:

Cross-sectional validation study. Keratoconus patients with routine appointments at the outpatient clinic were consecutively enrolled in conjunction with a sample of non-keratoconus controls for comparison. The Italian translation from the original English version of the KORQ was administered to the patients together with the Italian version of the 25-item version of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). The reliability and validity of the Italian KORQ were assessed using standardized internationally accepted methods for cultural adaptation and validation of health-related quality of life measures.

Results:

One hundred patients were deemed eligible and completed the questionnaires. The Cronbach’s alpha coefficient for internal consistency ranged from 0.71 to 0.956 across the subscales. Spearman correlation coefficient and intraclass correlation coefficient of 0.98 showed excellent test-retest reliability. The control group had better scores on every subscale. Statistically significant correlations were found between the KORQ and analogous domain of the NEI VFQ-25 and with disease severity indicators, such as visual acuity, maximum keratometry, and steepest keratometry, thus demonstrating good construct and concurrent validity.

Conclusion:

The Italian version of the KORQ exhibited excellent internal consistency, test-retest reliability, validity, discriminatory power, and psychometric properties comparable with those of the original English version, and thus may be adopted as a powerful vision-targeted quality of life assessment tool for Italian keratoconus patients.
Performance of Regression Models as a Function of Experiment Noise
Authors: Li Gang , Zrimec Jan , Ji Boyang , Geng Jun , Larsbrink Johan , Zelezniak Aleksej , Nielsen Jens , Engqvist Martin KM
Published: June 2021

Background:

A challenge in developing machine learning regression models is that it is difficult to know whether maximal performance has been reached on the test dataset, or whether further model improvement is possible. In biology, this problem is particularly pronounced as sample labels (response variables) are typically obtained through experiments and therefore have experiment noise associated with them. Such label noise puts a fundamental limit to the metrics of performance attainable by regression models on the test dataset.

Results:

We address this challenge by deriving an expected upper bound for the coefficient of determination ( R2) for regression models when tested on the holdout dataset. This upper bound depends only on the noise associated with the response variable in a dataset as well as its variance. The upper bound estimate was validated via Monte Carlo simulations and then used as a tool to bootstrap performance of regression models trained on biological datasets, including protein sequence data, transcriptomic data, and genomic data.

Conclusions:

The new method for estimating upper bounds for model performance on test data should aid researchers in developing ML regression models that reach their maximum potential. Although we study biological datasets in this work, the new upper bound estimates will hold true for regression models from any research field or application area where response variables have associated noise.
The Effects of Maternal Interleukin-17A on Social Behavior, Cognitive Function, and Depression-Like Behavior in Mice with Altered Kynurenine Metabolites
Authors: Murakami Yuki , Imamura Yukio , Kasahara Yoshiyuki , Yoshida Chihiro , Momono Yuta , Fang Ke , Nishiyama Toshimasa , Sakai Daisuke , Konishi Yukuo
Published: June 2021

Viral infection and chronic maternal inflammation during pregnancy are correlated with a higher prevalence of autism spectrum disorder (ASD). However, the pathoetiology of ASD is not fully understood; moreover, the key molecules that can cross the placenta following maternal inflammation and contribute to the development of ASD have not been identified. Recently, the pro-inflammatory cytokine, interleukin-17A (IL-17A) was identified as a potential mediator of these effects. To investigate the impact of maternal IL-17A on offspring, C57BL/6J dams were injected with IL-17A-expressing plasmids via the tail vein on embryonic day 12.5 (E12.5), and maternal IL-17A was expressed continuously throughout pregnancy. By adulthood, IL-17A-injected offspring exhibited behavioral abnormalities, including social and cognitive defects. Additionally, maternal IL-17A promoted metabolism of the essential amino acid tryptophan, which produces several neuroactive compounds and may affect fetal neurodevelopment. We observed significantly increased levels of kynurenine in maternal serum and fetal plasma. Thus, we investigated the effects of high maternal concentration of kynurenine on offspring by continuously administering mouse dams with kynurenine from E12.5 during gestation. Obviously, maternal kynurenine administration rapidly increased kynurenine levels in the fetal plasma and brain, pointing to the ability of kynurenine to cross the placenta and change the KP metabolites which are affected as neuroactive compounds in the fetal brain. Notably, the offspring of kynurenine-injected mice exhibited behavioral abnormalities similar to those observed in offspring of IL-17A-conditioned mice. Several tryptophan metabolites were significantly altered in the prefrontal cortex of the IL-17A-conditioned and kynurenine-injected adult mice, but not in the hippocampus. Even though we cannot exclude the possibility or other molecules being related to ASD pathogenesis and the presence of a much lower degree of pathway activation, our results suggest that increased kynurenine following maternal inflammation may be a key factor in changing the balance of KP metabolites in fetal brain during neuronal development and represents a therapeutic target for inflammation-induced ASD-like phenotypes.
Adherence to Neuromuscular Electrical Stimulation Interventions for Muscle Impairment in Hip and Knee Osteoarthritis: A Systematic Review
Authors: Burgess Louise C , Taylor Paul , Wainwright Thomas W , Bahadori Shayan , Swain Ian D
Published: June 2021

Background:

Neuromuscular electrical stimulation (NMES) provides a promising approach to counteract muscle impairment in hip and knee osteoarthritis, and to expedite recovery from joint replacement surgery. Nonetheless, application into clinical orthopaedic practice remains limited, partly due to concerns regarding patient tolerance.

Objectives:

This systematic review aimed to quantify levels of adherence to NMES interventions for muscle impairment in hip and knee osteoarthritis and identify strategies to increase compliance.

Data Sources:

Randomised controlled trials (RCTs) were identified in a web-based literature review, completed in December 2020. The databases sourced included the Cochrane Library, CINAHL Complete, Medline Complete and PubMed.

Eligibility Criteria:

Studies were included if they were: (i) conducted in cohorts of adults with hip or knee osteoarthritis; (ii) a protocol of electrical muscle stimulation prescribed to treat muscle impairment; and (iii) reported intervention adherence or attrition rate. Data were extracted on adherence rate, reasons for non-adherence and potential strategies to increase adherence. Risk of bias was assessed using the Physiotherapy Evidence Database (PEDro) scale.

Results:

The search yielded 120 articles, of which 15 studies were considered eligible and included in the analysis (n = 922). All NMES treatment was applied to the quadriceps, with 1 study targeting the quadriceps and calves. The mean PEDRO score of the included studies was 6.80 out of a possible 10 (range 6-8). Mean adherence did not differ between groups receiving treatment with NMES (85% ± 12%) and control groups receiving voluntary exercise or education (84% ± 9%) ( P = .97). Reasons for non-adherence or attrition included a dislike of the device, dizziness, pain and discomfort. Strategies to increase adherence included NMES education, a familiarisation period, supervision, setting thresholds based upon patient tolerance, monitoring pain levels during stimulation and using built-in adherence trackers.

Conclusions:

This systematic review indicates that adherence to NMES interventions for muscle impairment in hip and knee osteoarthritis in clinical trials does not differ to control groups receiving education or voluntary exercise, and hence should not be a barrier to application in clinical practice.
Effects of tourism development on economic growth: An empirical study of China based on both static and dynamic spatial Durbin models
Authors: Liu Honghong , Xiao Ye , Wang Bin , Wu Dianting
Published: June 2021

This study applies the dynamic spatial Durbin model (SDM) to explore the direct and spillover effects of tourism development on economic growth from the perspective of domestic and inbound tourism. The results are compared with those from the static SDM. The results support the tourism-led-economic-growth hypothesis in China. Specifically, domestic tourism and inbound tourism play a significant role in stimulating local economic growth. However, the spatial spillover effect is limited to domestic tourism, and the spatial spillover effect of inbound tourism is not significant. Furthermore, the long-term effects are much greater than the short-term impact for both domestic and inbound tourism. Plausible explanations of these results are provided and policy implications are drawn.
Does the attribution of responsibilities modify the relationship between coping styles and mental health? A survey of Chinese adults during the COVID-19 pandemic
Authors: Fu Mingqi , Huang Ning , Hall Brian J , Shi Qiaoxin , Shahid Muhammad , Guo Jing
Published: June 2021

The COVID-19 pandemic is associated with Posttraumatic Stress Symptoms (PTSS) and self-reported Posttraumatic Growth (PTG) in the general population. This study used linear regressions for analyses, based on an online survey conducted during the COVID-19 lockdown among 2441 Chinese adults in February 2020. The results showed negative coping and attributing responsibilities to individuals were associated with more PTSS, while both positive and negative coping, as well as attributing responsibilities to individuals were related to more PTG. Moreover, attribution of responsibilities modified the association between coping and PTSS, but not PTG. These findings shed light on mental health interventions in a pandemic context.