bluuebunny/crossref_metadata_2025 huggingface dataset:
Multivariate CNN‐LSTM Model for Multiple Parallel Financial Time‐Series Prediction
Authors: Widiputra Harya , Mailangkay Adele , Gautama Elliana
Published: October 2021

At the macroeconomic level, the movement of the stock market index, which is determined by the moves of other stock market indices around the world or in that region, is one of the primary factors in assessing the global economic and financial situation, making it a critical topic to monitor over time. As a result, the potential to reliably forecast the future value of stock market indices by taking trade relationships into account is critical. The aim of the research is to create a time‐series data forecasting model that incorporates the best features of many time‐series data analysis models. The hybrid ensemble model built in this study is made up of two main components, each with its own set of functions derived from the CNN and LSTM models. For multiple parallel financial time‐series estimation, the proposed model is called multivariate CNN‐LSTM. The effectiveness of the evolved ensemble model during the COVID‐19 pandemic was tested using regular stock market indices from four Asian stock markets: Shanghai, Japan, Singapore, and Indonesia. In contrast to CNN and LSTM, the experimental results show that multivariate CNN‐LSTM has the highest statistical accuracy and reliability (smallest RMSE value). This finding supports the use of multivariate CNN‐LSTM to forecast the value of different stock market indices and that it is a viable choice for research involving the development of models for the study of financial time‐series prediction.
Approaches to Repair of Penetrating Injuries of the Proximal, Mid, and Distal Esophagus
Authors: Castater Christine , Nguyen Jonathan , Perez Matthew , Butler Caroline , Meyer Courtney , Todd Samuel Rob , Sciarretta Jason , Smith Randi , Archer-Arroyo Krystal , Grant April
Published: October 2021

Introduction

Traumatic esophageal injuries represent less than 10% of traumatic injuries. Penetrating injuries represent an even smaller but more lethal percent. Esophageal injuries can be cervical, thoracic, or abdominal with decreasing frequency. Cervical and thoracic esophageal injuries represent >80% of these injuries and are more morbid. Morbidity and mortality are increased with delayed identification. Although diagnosis can be hard, management is similar despite location.

Cases

We present 3 cases of esophageal injuries to the cervical, thoracic, and abdominal esophageal segments with descriptions on diagnosis, repair, and management differences

Discussion

Despite low incidence of penetrating esophageal injuries, morbidity and mortality are extremely high, especially with associated injuries. Early identification and treatment is paramount. Anatomical knowledge is necessary for successful surgical management. Primary repair in 2 layers should be attempted whenever possible including musical closure with absorbable suture. Flaps, diversions, wide drainage, and feeding tube access should always be key surgical considerations. Flaps can include sternocleidomastoid muscle for cervical injuries, intercostal muscle, diaphragm, and pericardium for thoracic injuries and “Thal” gastric flaps for gastroesophageal junction and abdominal injuries. Successful identification and management can lead to increased survival
Confidence in Merit-Based Public Administration in the Context of Right-Wing Authoritarian Populism
Authors: Simon Christopher A. , Moltz Michael C.
Published: October 2021

The rise of right-wing authoritarian populism (RWAP) challenges modern democratic governance and the legitimacy of a career-service, nonpartisan, merit-based public administration—hallmarks of modern democratic institutions. Using citizen survey data collected for the first 2 years of the Trump presidency, this study finds that some core features of RWAP are negatively related to confidence in public administration. Generally speaking, the populist tendency appears to be a significant source of negative affect toward public administration.
What’s the Hold Up? The FDA’s Delayed Implementation of Menu-Labeling Policy
Authors: Feng Wenhui , Fox Ashley M.
Published: October 2021

Calorie labeling on menus became a federal law in 2010 but was not implemented until 2018, 8 years after adoption. This study reconstructs the history of the federal menu-labeling mandate using a process-tracing approach and finds that the delays in implementation resulted not from direct agency capture by the regulated industry, but rather from a system of indirect influence whereby lawmakers continue to influence policy-making even after adoption. Excessive legislative control can contribute to substantial implementation delays that undermine legislative intent. However, administrative agencies can serve as trustees to hold elected officials accountable to their own policy commitments.
The Lack of Robustness of a Statistic Based on the Neyman–Pearson Lemma to Violations of Its Underlying Assumptions
Authors: Sinharay Sandip
Published: October 2021

Drasgow, Levine, and Zickar (1996) suggested a statistic based on the Neyman–Pearson lemma (NPL; e.g., Lehmann & Romano, 2005, p. 60) for detecting preknowledge on a known set of items. The statistic is a special case of the optimal appropriateness indices (OAIs) of Levine and Drasgow (1988) and is the most powerful statistic for detecting item preknowledge when the assumptions underlying the statistic hold for the data (e.g., Belov, 2016Belov, 2016; Drasgow et al., 1996). This paper demonstrated using real data analysis that one assumption underlying the statistic of Drasgow et al. (1996) is often likely to be violated in practice. This paper also demonstrated, using simulated data, that the statistic is not robust to realistic violations of its underlying assumptions. Together, the results from the real data and the simulations demonstrate that the statistic of Drasgow et al. (1996) may not always be the optimum statistic in practice and occasionally has smaller power than another statistic for detecting preknowledge on a known set of items, especially when the assumptions underlying the former statistic do not hold. The findings of this paper demonstrate the importance of keeping in mind the assumptions underlying and the limitations of any statistic or method.
Microbubble technology for natural rubber latex foam production: The use of various gas-filled microbubbles
Authors: Katkeaw Kuntida , Khangkhamano Matthana , Kokoo Rungrote
Published: October 2021

In recent years, microbubble technology has attracted great attention in many application fields including water treatment, food processing, oil recovery, surface cleaning, and therapeutic applications. In this paper, microbubbles (MBs) of air, nitrogen, and argon were applied to produce natural rubber latex foams (NRLFs). The bubbles were generated by flowing the gas through a porous diffuser and latex. The effect of gas source on cellular structure, density, elasticity, indentation hardness, and flammability of the bubbled foams was discussed. Argon MBs offered the latex foams with fine cell diameters and uniform cell size distribution resulting in enhanced elasticity and physical properties of the foams. Indentation hardness index and limiting oxygen index value depended significantly on the gas used. By using the microbubble technique, the future prospects in NRLF production can be expected due to its ability in controllable cellular structure.
Dirty laundry: The nature and substance of seeking relationship help from strangers online
Authors: Entwistle Charlotte , Horn Andrea B. , Meier Tabea , Boyd Ryan L.
Published: October 2021

Interpersonal relationships are vital to our well-being. In recent years, it has become increasingly common to seek relationship help through anonymous online platforms. Accordingly, we conducted a large-scale analysis of real-world relationship help-seeking to create a descriptive overview of the nature and substance of online relationship help-seeking. By analyzing the demographic characteristics and language of relationship help-seekers on Reddit ( N = 184,631), we establish the first-ever big data analysis of relationship help-seeking and relationship problems in situ among the general population. Our analyses highlight real-world relationship struggles found in the general population, extending beyond past work that is typically limited to counseling/intervention settings. We find that relationship problem estimates from our sample are closer to those found in the general population, providing a more generalized insight into the distribution and prevalence of relationship problems as compared with past work. Further, we find several meaningful associations between relationship help-seeking behavior, gender, and attachment. Notably, numerous gender differences in help-seeking and romantic attachment emerged. Our findings suggest that, contrary to more traditional contexts, men are more likely to seek help with their relationships online, are more expressive of their emotions (e.g., discussing the topic of “heartache”), and show language patterns generally consistent with more secure attachment. Our analyses highlight pathways for further exploration, providing even deeper insights into the timing, lifecycle, and moderating factors that influence who, what, why, and how people seek help for their interpersonal relationships.
Time trends in the prevalence of Helicobacter pylori infection in patients with peptic ulcer disease: a single-center retrospective study in Shanghai
Authors: Zhang Wei , Liang Xiao , Chen Xiaoyu , Ge Zhizheng , Lu Hong
Published: October 2021

Objective

The present study aimed to investigate the recent trends in Helicobacter pylori infection associated with peptic ulcer disease in a large population in Shanghai.

Methods

We analyzed the medical records of all patients who had undergone upper gastrointestinal endoscopy (EGD) for uninvestigated dyspepsia at Ren Ji Hospital between 2013 and 2019 to determine the prevalence of H. pylori infection in patients with peptic ulcers.

Results

Peptic ulcers were found in 40,385 of the 383,413 patients who underwent EGD during the study period. Over the 7-year study period, the annual prevalence of H. pylori among patients receiving EGD declined from 32.2% to 26.5%. H. pylori was present in 60% of ulcers and the incidence was higher (66.9%) in duodenal compared with gastric ulcers (48.5%). The proportion of H. pylori-associated gastric ulcers declined from 52.2% to 49.3% and that of H. pylori-positive duodenal ulcers declined from 70.0% to 63.9%.

Conclusion

The prevalence of H. pylori-positive peptic ulcers, mainly duodenal ulcers, fell from 2013 to 2019. However, the proportion of non- H. pylori-associated peptic ulcer disease increased, especially in elderly people, possibly due to the use of nonsteroidal anti-inflammatory drugs. Further research is needed to confirm this hypothesis.
Surgical repair of a coronary artery aneurysm associated with coronary artery fistula – a case report
Authors: Špunda Rudolf , Horák Jan , Tomašov Pavol , Lambert Lukáš , Špaček Miroslav , Slautin Andrey , Prskavec Tomáš , Lindner Jaroslav
Published: October 2021

Coronary artery aneurysm is a relatively rare disorder that is usually discovered as a secondary finding in patients undergoing coronary artery angiography. Coronary artery fistulas are relatively more frequent than rare aneurysms and are often associated with other cardiac abnormalities. The etiology of aneurysms is mostly atherosclerotic, and they are less frequently associated with other acquired or congenital diseases, such as Kawasaki disease, connective tissue diseases, septic emboli, arteritis, and iatrogenic disease. We report a 70-year-old woman with a rare combination of a coronary artery aneurysm associated with a coronary artery fistula, which drained into the pulmonary artery. The diagnosis of our patient was made by selective coronary angiography and confirmed by computed tomography angiography. The patient was treated surgically because of the symptomatic course of the disease.
Diagnostic parameters of the AF Genital System® for detection of Mycoplasma hominis and Ureaplasma urealyticum
Authors: Tjoa Enty , Joon Shikha , Moehario Lucky H.
Published: October 2021

Objective

The prevalence of Mycoplasma hominis and Ureaplasma urealyticum (genital mycoplasma) amongst Indonesian women is poorly understood because of limited availability of diagnostic techniques. We sought to compare the diagnostic parameters of the AF Genital System® with those of culture methods and PCR as the gold standard for identification of M. hominis and U. urealyticum in vaginal swab specimens.

Methods

This was an observational diagnostic study. Eighty-eight specimens were collected from patients with abnormal vaginal discharge. Detection of M. hominis and U. urealyticum was performed using the AF Genital System®, culture methods, and PCR.

Results

Compared with PCR and culture methods, respectively, the AF Genital System® had sensitivities of 66.6% and 57% ( M. hominis) and 55.5% and 77.8% ( U. urealyticum). Compared with PCR and culture methods, respectively, the AF Genital System® had specificities of 82.9% and 86.5% ( M. hominis) and 82.3% and 84.8% ( U. urealyticum).

Conclusion

The sensitivity of the AF Genital System® for detection of M. hominis and U. urealyticum from vaginal swab samples was lower than that of PCR, but specificity was reasonably good (82% to 83%).
Primary soft tissue chondroma of the posterior mediastinum: a rare case report and literature review
Authors: Fang Shengru , Liu Lianzi , Zhang Min , Pan Nannan , Gao Wanjun , Pan Jinbin , Liu Junpeng
Published: October 2021

A chondroma is a common benign cartilaginous tumor. However, a primary soft tissue chondroma of the posterior mediastinum is very rare. We herein report a case involving a 51-year-old man with a posterior mediastinal mass. The mass was dissected by thoracoscopy through the eighth intercostal space. Pathological examination led to a definitive diagnosis of a primary mediastinal chondroma with no criteria of malignancy. Preoperative diagnosis of a posterior mediastinal soft tissue chondroma is not easy because of its rarity and lack of typical features other than calcification. When a posterior mediastinal well-circumscribed soft tissue mass contains calcification and shows no obvious enhancement, the possibility of a soft tissue chondroma should be considered.
Welfare of Anaesthesia Trainees Survey 2019
Authors: Downey Gregory B , McDonald Jane M , Downey Ryan G , Garnett Peter BJ
Published: October 2021

This survey was designed to investigate levels of stress, anxiety and depression, and to identify factors exacerbating or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists training scheme. In addition, the survey investigated levels of personal healthcare, some working conditions, and reports of bullying and reported discrimination along with stigmatisation of mental health issues in this cohort. Psychological distress was assessed using the Kessler psychological distress scale (K10). An electronic survey was sent to 1310 randomly selected registrars, and 417 (32%) responses were received. The majority of respondents (67%) reported being satisfied or very satisfied with their job and training. However, 31% had K10 scores indicating high or very high levels of distress. Eleven percent reported being currently on treatment for anxiety and/or depression. Major stressors were examinations, job prospects, critical incidents and fear of making errors. Forty-five percent of respondents reported having experienced bullying during anaesthesia training, 25% discrimination and 7% sexual harassment. Twenty-six percent reported an excessive workload and 21% reported that they felt their workload compromised patient safety. Forty-two percent reported that they would avoid seeking help for anxiety or depression and 50% reported that they thought revealing mental health problems would jeopardise their careers. The results of this survey demonstrate a high incidence of psychological distress, and high levels of bullying and discrimination, as well as stigmatisation of mental ill health among respondents. Appropriate education, a review of assessment tools, effective management of bullying and discrimination, a review of working conditions, and destigmatisation of mental illness appear to be indicated.
Continuity of Care and Successful Hospital Discharge of Older Veterans With Dementia
Authors: Lei Lianlian , Cai Shubing , Conwell Yeates , Fortinsky Richard H. , Intrator Orna
Published: October 2021

Background

Care transitions are frequent among patients with dementia. This study aimed to estimate the impact of continuity of care (COC) on successful community discharge after hospitalization.

Methods

National Veterans Health Administration data linked to Medicare claims in fiscal years 2014–2015. Community-dwelling older veterans with dementia with an acute hospitalization were included ( n = 31,648). COC was measured by the Bice-Boxerman Continuity of Care (BBC) index (0–1). Association of COC before hospitalization on successful community discharge was examined separately among veterans discharged to the community directly and through post-acute care facilities.

Results

Veterans with a 0.1 higher BBC were 4.6% ( p = .06) more likely to have successful direct community discharge; but BBC had no demonstrable effect when discharge was through post-acute care facilities.

Conclusion

Better COC may have impact at improving successful direct community discharge, although the effect is small and the type I error rate (statistical significance) was 6%.
A review of fabrication and properties of spark plasma sintered tungsten carbide based advanced composites
Authors: Dar Yunis Ahmad , Sheikh Nazir Ahmad
Published: October 2021

The high-performance tool materials have been inevitably used for most of the cutting tool applications where high reliability and difficult to cut materials are of major demand. The cemented carbides and its composites offer an excellent combination of the properties where it can be used for tool materials due to its high wear resistance, high hardness at elevated temperatures, and considerable fracture toughness. However to obtain optimum values of mechanical properties and uniformly distributed ultrafine grains, a number of new fabrication techniques, alteration in the content of cemented carbide composition, and variation in the parameters of fabrication process have been employed. This review paper will come in handy for researchers and scientists working on advanced cemented carbides and spark plasma sintering as it overviews the recent work done on tungsten carbide composites using the novel spark plasma sintering technique considering different process parameters in order to achieve ultrafine microstructures of sintered specimens, enhanced mechanical properties of composites in addition to energy as well as time saving considerations. The thorough review of various research papers revealed that the parameters of the sintering (sintering temperature, applied pressure, surrounding environment), additives in sintering (both content and composition), reinforcement of cemented carbide with other materials, nano-filler/whisker addition, partial or complete removal of metallic phase from the cemented carbide affect the properties of sintered specimens and their calculated as well as optimum setting can provide an excellent combination of properties desired in cutting tool operations.
Reconstruction of severe acetabular bone defects with porous metal augment in total hip arthroplasty: A finite element analysis study
Authors: Li Pengyu , Tang Hao , Liu Xiaoyu , Chen Zhenxian , Zhang Xiaogang , Zhou Yixin , Jin Zhongmin
Published: October 2021

This study aims to evaluate the reconstructive stability for Paprosky III acetabular defects after total hip arthroplasty using three different reconstruction strategies with trabecular metal (TM) augments. The acetabular bone defects examined were located in the ilium, the sciatic ramus and the pubic ramus. Different scenarios of acetabular reconstructions were simulated, including the non-reconstruction model (NRM), the complete reconstruction model (CRM), the two-point reconstruction model (TRM) and the superior edge reconstruction model (SRM). A primary hip replacement model (HRM) was also investigated to compare the initial stability with different reconstruction models. The gait cycle was incorporated in the model to investigate the dynamic variation within the contact mechanics parameters. By comparing the SRM and the TRM, the acetabular cup translation was more pronounced when the superior defect on the acetabulum remained unfixed. Comparison of the acetabular cup displacement and the interface micromotion of both HRM and CRM demonstrated that the prosthetic implant provided good support for the reconstructed acetabulum. With the use of a press-fit cup, the cup displacement was reduced remarkably, while its Von-Mises stress increased significantly. The results show that the CRM was the best reconstruction option. In terms of acetabular defects, future improvements should focus on the reconstructive stability in stress concentration areas, to ensure no significant stress-shielding or other factors contributing to loosening of the prosthesis.
Inter-classifier comparison for upper extremity EMG signal at different hand postures and arm positions using pattern recognition
Authors: Asghar Ali , Khan Saad Jawaid , Azim Fahad , Shakeel Choudhary Sobhan , Hussain Amatullah , Niazi Imran Khan
Published: October 2021

The utilization of surface EMG and intramuscular EMG signals has been observed to create significant improvement in pattern recognition approaches and myoelectric control. However, there is less data of different arm positions and hand postures available. Hand postures and arm positions tend to affect the combination of surface and intramuscular EMG signal acquisition in terms of classifier accuracy. Hence, this study aimed to find a robust classifier for two scenarios: (1) at fixed arm position (FAP) where classifiers classify different hand postures and (2) at fixed hand posture (FHP) where classifiers classify different arm positions. A total of 20 healthy male participants (30.62 ± 3.87 years old) were recruited for this study. They were asked to perform five motion classes including hand grasp, hand open, rest, hand extension, and hand flexion at four different arm positions at 0°, 45°, 90°, and 135°. SVM, KNN, and LDA classifier were deployed. Statistical analysis in the form of pairwise comparisons was carried out using SPSS. It is concluded that there is no significant difference among the three classifiers. SVM gave highest accuracy of 75.35% and 58.32% at FAP and FHP respectively for each motion classification. KNN yielded the highest accuracies of 69.11% and 79.04% when data was pooled and was classified at different arm positions and at different hand postures respectively. The results exhibited that there is no significant effect of changing arm position and hand posture on the classifier accuracy.
#AllCatsAreBeautiful: Ambient affiliation and the visual-verbal representation and appreciation of cats in online subversive discourses
Authors: Fryer Daniel Lees
Published: October 2021

This paper investigates the topics and affiliations associated with the hashtag #AllCatsAreBeautiful on the social media platform Twitter. Drawing on concepts from social semiotics (systemic functional theory) and critical animal studies, the paper identifies a number of potentially overlapping topics or fields, including anti-policing, the commodification of nonhuman animals, gender and sexism, and body image or body-shaming, as well as a more general positive appreciation or admiration of cats. The paper discusses how people position themselves in relation to those topics, through patterns of ideational and attitudinal meanings, and how cats are represented and appreciated visually, verbally and intersemiotically. Cats, in this context, play an important role in struggles for social justice, symbolizing freedom and resistance as well as love and solidarity. #AllCatsAreBeautiful highlights topics or spaces around which bonds can be made and communities of shared values or interests can be co-constructed.
The detection of illicit cryptocurrency mining farms with innovative approaches for the prevention of electricity theft
Authors: Dindar B. , Gül Ö.
Published: October 2021

Illegal use of electricity is very common in cryptocurrency mining farms, as energy bills are the most important component of the cost of cryptocurrency production. In this case, it raises the issue of how to detect illegal cryptocurrency mining. Innovative approaches are needed to identify data centers that illegally mine cryptocurrencies. This study proposes the use of unique noise and/or harmonic features of cryptocurrency generating machines to detect illegal cryptocurrency mining farms. Within the scope of this study, the characteristic harmonics originating from the data centers were determined by performing field tests on the neutral line of the electrical grid. In this study, it has been shown that electricity distribution companies can detect illegal cryptocurrency data centers using potential illegal electricity by monitoring energy quality data. Legal permissions can be obtained easily for detailed examination and detection in cryptocurrency data centers of using illegal electricity. With the proposed innovative approach, the time taken to detect illegal cryptocurrency mining farms using illegal electricity is reduced.
After the adoption of Renewable Portfolio Standards: Go greener or back to grey?
Authors: Jang Sojin
Published: October 2021

Renewable Portfolio Standards (RPS) is a state-level policy that mandates renewable energy supply or sales goals in the U.S. In some states like California, Hawaii, and Oregon, renewable energy production goals have become more stringent since adoption and 50% or more electricity is projected to come from renewable energy sources in these states. In contrast, Ohio, Kansas, and West Virginia retracted or even repealed their RPS policies. Less is known, however, about the determinants of post-RPS adoption decisions relative to the amount of empirical and theoretical knowledge accumulated on the drivers of RPS policy adoption. Accordingly, this study conducted a cross-case analysis in order to explore the drivers of RPS repeal in West Virginia and RPS expansion in Oregon through semi-structured interviews of state legislators, secondary data, and literature review. Findings indicate that state government ideology frames views about environmental and economic issues and the effectiveness of RPS, and ultimately guide the directions of policy revisions. More specifically, West Virginia’s RPS repeal effort was initiated by Republican state legislators who were determined to terminate RPS since the beginning of the new legislative session. On the other hand, RPS expansion in Oregon was the output of strategic negotiation between two parties and largely driven by a bottom-up effort from cities and counties, citizens, and environmental organizations.
Inference on the overlap coefficient: The binormal approach and alternatives
Authors: Franco-Pereira Alba María , Nakas Christos T , Reiser Benjamin , Pardo María Carmen
Published: October 2021

The overlap coefficient ([Formula: see text]) measures the similarity between two distributions through the overlapping area of their distribution functions. Given its intuitive description and ease of visual representation by the straightforward depiction of the amount of overlap between the two corresponding histograms based on samples of measurements from each one of the two distributions, the development of accurate methods for confidence interval construction can be useful for applied researchers. The overlap coefficient has received scant attention in the literature since it lacks readily available software for its implementation, while inferential procedures that can cover the whole range of distributional scenarios for the two underlying distributions are missing. Such methods, both parametric and non-parametric are developed in this article, while R-code is provided for their implementation. Parametric approaches based on the binormal model show better performance and are appropriate for use in a wide range of distributional scenarios. Methods are assessed through a large simulation study and are illustrated using a dataset from a study on human immunodeficiency virus-related cognitive function assessment.
Hidden in Plain Sight: Men’s Lived Experiences With Sexual Violence as College Students
Authors: Carlisle Zachary T. , Schmitz Rachel M.
Published: October 2021

Men’s experiences with sexual violence is an understudied topic within sociological literature. Despite the few past research endeavors that have focused on men, little is known regarding the ways that men college students grapple with their lived experiences with sexual violence. Using a sample of 29 active men college students, semi-structured interviews were conducted in order to investigate the ways in which men conceptualize their experiences with sexual violence in their own words. Results indicate that masculinity is intimately connected to sexual violence victimhood, as men can consider themselves victims, but in very distinct ways. Masculinity also acts as a sort of “buffer,” in that many men who were interviewed for this research describe their experiences with sexual violence in ways that are similar to women’s experiences, but they also express difficulty in accurately framing these experiences using linguistic framing mechanisms. Future directions for research are also explored.
Dome Supramalleolar Osteotomies for the Treatment of Ankle Pain with Opposing Coronal Plane Deformities Between Ankle and the Lower Limb
Authors: Kim Jaeyoung , Henry Jensen K. , Kim Ji-Beom , Lee Woo-Chun
Published: October 2021

Background:

The dome-type osteotomy is a powerful technique for deformity correction of the limb. However, there is limited information about the utility of dome supramalleolar osteotomy (SMO) in ankle joint preservation surgery. This study aimed to describe the technique and indications for dome SMO in distal tibial malalignment.

Methods:

Twenty-three patients (23 ankles) who underwent dome SMO with a 2-year follow-up were reviewed. Dome SMO was indicated when there were opposing deformities in the ankle and lower limb mechanical axis (ie, varus ankle deformity with valgus lower limb alignment and vice versa) where inherent translation following conventional wedge-type osteotomies could worsen the deformity of the entire lower limb. Patients were divided into 2 groups based on preoperative ankle alignment: the varus ankle group (n = 11) and the valgus ankle group (n = 12). The radiographic correction was assessed using 6 parameters from weightbearing ankle and hindfoot alignment views. In addition, the lower limb mechanical axis was assessed with ankle center deviation (ACD) from the hip-knee (HK) line on the whole limb radiograph, and the weightbearing line (WBL) point was measured to identify changes in the weightbearing load within the ankle joint.

Results:

Preoperatively, the varus ankle group had varus ankle deformity (tibiotalar angle [TTA], 76.5 ± 5.8 degrees) with valgus lower limb mechanical axis, whereas the valgus ankle group had valgus ankle deformity (TTA, 99.1 ± 4.5 degrees) with varus lower limb mechanical axis alignment. Postoperatively, a significant improvement in the ankle alignment and the lower limb mechanical axis was observed in both groups. The ACD significantly changed toward the HK line, suggesting an improved lower limb mechanical axis, and the WBL point showed a significant shift of the weightbearing axis toward the uninvolved area within the ankle joint.

Conclusion:

Dome SMO demonstrated a successful correction of local deformity while simultaneously realigning the hip-knee-ankle axis toward neutral. Additionally, an effective load shifting toward an uninvolved area within the ankle joint was observed.

Level of Evidence:

Level IV, case series.
Available information about paediatric use of onco-haematological drugs authorized by EMA since 2016
Authors: Lasala Ruggero , Santoleri Fiorenzo , Zanon Davide , Romagnoli Alessia , Abrate Paolo , Costantini Alberto , Musicco Felice
Published: October 2021

Background

The treatment options available to children with cancer are limited. This is why for more than 10 years, the European Medicine Agency (EMA) has stated that all drugs to be marketed must be tested on the paediatric population in accordance with the Paediatric Investigation Plan (PIP). The objective of this study is to make a cross sectional analysis of the information related to the use of cancer drugs authorised on the European market in the paediatric population.

Method

The European Public Assessment Reports and PIPs have been considered. The following data were extracted for onco-haematological drugs approved since 2016: paediatric indications, information about the paediatric population in the Summary of Product Characteristics (SmPC) and presence and characteristics of PIPs. A descriptive analysis of the characteristics of the drugs was made from the point of view of the paediatric population.

Results

Forty-eight drugs with onco-haematological indications have been authorised for marketing since 2016, 7 (15%) of these have paediatric indications. Two (4%) drugs have no paediatric indication but have information related to the paediatric population within SmPC. Forty-one (85%) drugs have no reference to the paediatric population in SmPC. Seventeen (35%) drugs out of 48 do not have PIPs and 11 have been granted a waiver to present the results of paediatric studies. The other 19 active ingredients have a total of 28 PIPs.

Conclusion and relevance

Most of the onco-haematological drugs approved by EMA since 2016 have neither paediatric indications nor mentions about paediatric use in SmPC. PIPs represent an opportunity, but demand for the paediatric population is still huge.
Virtual reality, YouTube, or social media? Assessing promotional effects on tourism destination
Authors: Chang Hsuan Hsuan
Published: October 2021

This study investigated how virtual reality affects the tourism image and flow experience compared with YouTube videos and Facebook and travel pages and examined the moderating effect of the acceptance of new technologies on the relationship between tourism marketing effects and different communication tools. The virtual reality group exhibited higher levels of advertisement effects, tourism image, and four flow factors (friendliness, telepresence, interactivity, and realness) compared with YouTube and Facebook groups. A two-way analysis of variance test revealed a significant interaction between the type of marketing tools and the acceptance of new technologies with respect to the tourism image, a flow-friendly experience, and a flow interactivity experience.
Shifts in demographics and mental health co-morbidities among gender dysphoric youth referred to a specialist gender dysphoria service
Authors: Morandini James S , Kelly Aidan , de Graaf Nastasja M , Carmichael Polly , Dar-Nimrod Ilan
Published: October 2021

Past research has identified shifts in the demographics and co-occurring mental health issues of youth referred to certain gender dysphoria services. The present study examined shifts in demographics (age, sex and social transition status), social adversity (bullying experiences and abuse) and psychological functioning (mood, anxiety, suicidality and autism spectrum disorder) at time of referral (of both children and adolescents) to the Gender Identity Development Service, London between the years of 2012 and 2015. Patients were 782 children and adolescents (M = 13.94, SD = 2.94, range 4–17; 63.8% assigned female at birth). Little change in sex ratio or age was observed between these two time points. However, we observed greater rates of depression and anxiety of birth-assigned females (but not birth-assigned males) in the more recent cohort, at the same time that reported social adversity (bullying and abuse) was falling. Also, of interest, the proportion of young people who had partially or fully socially transitioned prior to contact with the service had increased overtime. We discuss potential factors driving these shifts and their implications for supporting recent cohorts of gender diverse young people.
Increased risk of child maltreatment and mental health problems among adolescents with restrictions regarding choice of future partner: Results from a Swedish school-based survey
Authors: Bengtsson Dennis , Landberg Åsa , Jernbro Carolina
Published: October 2021

Background: Honour-related violence and oppression is a violation of human rights and a public health problem. Oppression can be manifested by not being allowed to choose future partners and can increase the risk of abuse and mental health problems. Aims: The aim of this study was to investigate associations between restrictions regarding choice of future partner (RCP), child maltreatment and mental health problems among adolescents in Sweden. Methods: The study was based on cross-sectional data, including a nationally representative sample of 4741 pupils from grade nine in primary school and second year in high school. Pearson’s chi-square tests and binary logistical regression analyses adjusting for socio-demographic factors were conducted. Results: RCP was significantly associated to child maltreatment, including poly-victimisation, and mental health problems. In the adjusted analysis, an increased risk for all types of maltreatment, poly-victimisation (adjusted odds ratio (aOR) 10.2, confidence interval (CI) 5.6–18.4), self-harm (aOR 1.9, CI 1.1–3.2) and suicide attempt (aOR 2.4, CI 1.3–4.7) were shown in adolescents exposed to RCP compared to non-exposed. Conclusions: There is an increased risk of child maltreatment including poly-victimisation and mental health problems among adolescents exposed to RCP compared to non-exposed. The study emphasizes the matter as a public health problem requiring immediate preventive measures to ensure the rights of children and adolescents.
The diagnosis of asthma. Can physiological tests of small airways function help?
Authors: Almeshari Mohammed A , Stockley James , Sapey Elizabeth
Published: October 2021

Asthma is a common, chronic, and heterogeneous disease with a global impact and substantial economic costs. It is also associated with significant mortality and morbidity and the burden of undiagnosed asthma is significant. Asthma can be difficult to diagnose as there is no gold standard test and, while spirometry is central in diagnosing asthma, it may not be sufficient to confirm or exclude the diagnosis. The most commonly reported spirometric measures (forced expiratory volume in one second (FEV1) and forced vital capacity assess function in the larger airways. However, small airway dysfunction is highly prevalent in asthma and some studies suggest small airway involvement is one of the earliest disease manifestations. Moreover, there are new inhaled therapies with ultrafine particles that are specifically designed to target the small airways. Potentially, tests of small airways may more accurately diagnose early or mild asthma and assess the response to treatment than spirometry. Furthermore, some assessment techniques do not rely on forced ventilatory manoeuvres and may, therefore, be easier for certain groups to perform. This review discusses the current evidence of small airways tests in asthma and future research that may be needed to further assess their utility.
COVID-19 Vaccine Acceptability Among Clients and Staff of Homeless Shelters in Detroit, Michigan, February 2021
Authors: Meehan Ashley A. , Yeh Michael , Gardner Annette , DeFoe Tiera L. , Garcia Alberto , Vander Kelen Patrick , Montgomery Martha P. , Tippins Ashley E. , Carmichael Andrea E. , Gibbs, CHW Rachael , Caidi Hayat , Mosites Emily , Rehman Najibah
Published: October 2021

Understanding COVID-19 vaccine acceptability among clients and staff of homeless shelters can inform public health efforts focused on communicating with and educating this population about COVID-19 vaccines and thus improve vaccine uptake. The objective of this study was to assess COVID-19 vaccine acceptability and uptake among people in homeless shelters in Detroit, Michigan. A cross-sectional study was conducted from February 9 to 23, 2021. Seventeen homeless shelters were surveyed: seven male-only, three male/female, and seven women and family shelters. All clients and staff aged ≥18 years and able to complete a verbal survey in English or with a translator were eligible to participate; of the 168 individuals approached, 26 declined, leaving a total sample of 106 clients and 36 staff participating in the study. The median client and staff ages were 44 and 54 years, respectively. Most participants (>80%) identified as non-Hispanic Black or African American. Sixty-one (57.5%) clients and 27 (75.5%) staff had already received or planned to receive a COVID-19 vaccination. Twelve (11.3%) clients and four (11.1%) staff were unsure, and 33 (31.1%) clients and five (13.9%) staff did not plan to get vaccinated. Reasons for hesitancy were concerns over side effects (29 clients [64.4%] and seven staff [77.8%]) and unknown long-term health impacts (26 clients [57.8%] and six staff [66.7%]). More than half of the clients had already received or planned to receive the vaccine. Continuing efforts such as vaccine education for hesitant clients and staff and having accessible vaccine events for this population may improve acceptability and uptake.
Addressing Adultification of Black Pediatric Patients in the Emergency Department: A Framework to Decrease Disparities
Authors: Koch Amie , Kozhumam Arthi
Published: October 2021

Systematic racism and structural discrimination in the United States are factors that have negatively affected the health of Black individuals and families. One form of racism that often goes unrecognized and yet has a profound negative impact on the health and safety of Black children is adultification. Adultification occurs when children are perceived, or treated, as being older than they are. We implemented the Racism as a Root Cause framework to identify ways health care providers and health care systems can work to dismantle inequities and address the adultification of Black children in the emergency department (ED). A shift to change policies, systems, and environments in the ED begins with recognition of blind spots through training, communication, and reflection. Utilizing methods to identify adultification and racism, such as the ICD-10-CM Diagnosis Code Z60.5 Target of (perceived) adverse discrimination and persecution, can assist providers in recognizing the prevalence of racism and discrimination. To reduce the harms of inequities, injustice, and impacts of racism on Black children in the ED, it is essential to use trauma-informed care in all interactions. It is crucial for all employees of the ED to understand that adultification is extremely prevalent, hard to recognize, and causes harm to the health of Black children and their families. Without conscious efforts to decrease the pervasiveness and detriment of adultification bias, the repercussions of such racism will continue to perpetuate medical mistrust and negative health care experiences for Black children and families.
Enhancing Seebeck coefficient and electrical conductivity of polyaniline/carbon nanotube–coated thermoelectric fabric
Authors: Amirabad Reza , Ramazani Saadatabadi Ahmad , Pourjahanbakhsh Mohammad , Siadati M Hossein
Published: October 2021

In this work, flexible thermoelectric fabrics, polyester/yarn fabrics coated with polyaniline/carbon nanotube (PANI/CNT) nanocomposite, were fabricated by sequential processing: (I) polyaniline/carbon nanotube nanocomposites preparation by a one-step in-situ polymerization and (II) dip coating of a mixture solution of CNT-doped PANI on a polyester/yarn fabric. Nanocomposites were synthesized with various CNT content (0.5, 2.5, 5, and 10 wt%) and characterized using different methods. The Seebeck coefficient and electrical conductivity measurements were used to determine their thermoelectric properties. The results revealed significant improvement in both electrical conductivity and the Seebeck coefficient with the addition of CNT. The electrical conductivity increased from 0.011 to 0.1345 S/cm with the increment of CNT from 0.5 to 10 wt%. The highest Seebeck coefficient of 11.4 μV/K was observed for the sample containing 5 wt% CNT at 338 K where the maximum power factor of 1.598×10−3 μWm−1K−2 was obtained for the fabric coated with nanocomposite containing 10 wt% CNT.
Tangled: Black Hair and Texturism in Ethnodrama
Authors: Rowe Kernysha L.
Published: October 2021

Black hair and hair texture are part of the racial battleground for social justice. Few issues exist more invisibly than the mistreatments of Black hair and hair texture, one’s hairstyle and hair follicle curl pattern(s), respectively. Limited research about Black women in the workplace cite hair discrimination but fail to unearth realities of Black, higher education professional women with natural hair. Structured in autoenthograpy, this article presents tensions associated with Black hair and hair texture that inherit societal mistreatments. Using Black Feminist Thought as a theoretical paradigm, research findings are presented in ethnodrama, while blurring narrative genres and art-based research.
Acute Cortisol Profile Associations With Cognitive Impairment After Severe Traumatic Brain Injury
Authors: Barton David J. , Kumar Raj G. , Schuster Alexandria A. , Juengst Shannon B. , Oh Byung-Mo , Wagner Amy K.
Published: October 2021

Background

Cognitive impairments commonly occur after traumatic brain injury (TBI) and affect daily functioning. Cortisol levels, which are elevated during acute hospitalization for most individuals after severe TBI, can influence cognition, but this association has not been studied previously in TBI.

Objective

We hypothesized that serum and cerebral spinal fluid (CSF) cortisol trajectories over days 0–5 post-injury are associated with cognition 6-month post-injury.

Methods

We examined 94 participants with severe TBI, collected acute serum and/or CSF samples over days 0–5 post-injury, and compared cortisol levels to those in 17 healthy controls. N = 88 participants had serum, and n = 84 had CSF samples available for cortisol measurement and had neuropsychological testing 6 months post-injury. Group based trajectory analysis (TRAJ) was used to generate temporal serum and CSF cortisol profiles which were examined for associations with neuropsychological performance. We used linear regression to examine relationships between cortisol TRAJ groups and both overall and domain-specific cognition.

Results

TRAJ analysis identified a high group and a decliner group for serum and a high group and low group for CSF cortisol. Multivariable analysis showed serum cortisol TRAJ group was associated with overall cognitive composites scores ( P = .024) and with executive function ( P = .039) and verbal fluency ( P = .029) domain scores. CSF cortisol TRAJ group was associated with overall cognitive composite scores ( P = .021) and domain scores for executive function ( P = .041), verbal fluency ( P = .031), and attention ( P = .034).

Conclusions

High acute cortisol trajectories are associated with poorer cognition 6 months post-TBI.