bluuebunny/crossref_metadata_2025 huggingface dataset:
Resettling Afghan and Iraqi interpreters employed by Western armies: The Contradictions of the Migration–Security Nexus
Authors: de Jong Sara
Published: December 2021

This article develops a novel analytical framework for capturing the multiple, competing configurations that the migration-security nexus invokes in discourse and practice, combining insights from critical migration and security scholarship. The framework’s application is illustrated with an empirical case study of the protection and relocation of Afghan and Iraqi former local interpreters and other locally employed civilians working for Western armies. The analysis demonstrates that locally employed civilians (LECs) are simultaneously considered security actors in the East and security risks in the West, the ‘best and brightest’ causing brain drain and potential terrorists when crossing borders, both ‘model migrants’ and threats to western values. By uncovering the nexus’s multiple configurations and its contradictions, the framework supports the project of denaturalizing the migration-security nexus, while also showing that the discourses and practices justified through its various configurations include the legitimation of border violence and the denial of protection to migrants.
Resuscitation Decisions for Extremely Premature Infants: A UK NICU Experience
Authors: Peterson Jennifer , Kahvo Mia , Tharumakunarajah Ramiyya , Malik Nabiah , Ranganna Ranganath
Published: December 2021

Background:

Improvements in extreme preterm infant outcomes have led to an increasing recognition of the importance of antenatal optimization and delivery room (DR) management strategies for these infants.

Methods:

Retrospective cohort evaluation of every infant born at 22+0 to 25+6 weeks gestation in St Mary’s tertiary NICU between 2008 and 2018. Aiming to evaluate utilization of chest compressions and resuscitation medications during DR-resuscitation of extremely premature infants.

Results:

This study found that 90% of infants 22+0 to 22+6 weeks did not receive antenatal steroids. Whereas, for infants born between 23+0 and 23+6 weeks gestation, 75% did receive antenatal steroids. This difference is significant ( P value = .00006). This study shows there is a predisposition to not provide DR-chest compressions (DR-CC) and/or adrenaline (DR-CC+/−A) to extremely preterm For infants that received DR-CC, there was no statistically significant increase in death and no clear association with poorer long-term outcomes in survivors.

Conclusions:

Marked differences in provision of perinatal care were found dependent on gestational age. If infants are inadequately prepared for delivery and resuscitative measures are not fully utilized, it cannot be clear whether subsequently increased rates of death in the lower gestational age groups are solely due to gestational age or are influenced by the lack of preparative management.
Is there a missing-middle in Australian mental health care?
Authors: Looi Jeffrey CL , Kisely Stephen R , Allison Stephen , Bastiampillai Tarun
Published: December 2021

Objective

The term ‘missing-middle’ has been prominent in discourse relating to provision of mental health care in Australia, particularly by proponents of non-governmental youth mental health services such as headspace and related adult services. We investigate whether there is an empirical basis for use of the ‘missing-middle’ term, founded on qualitative and quantitative research.

Conclusions

Despite the widespread use of the term ‘missing-middle’ for advocacy in Australia, there is a lack of research characterising the epidemiological characteristics of the group. The validity of advocacy predicated on the basis of the ‘missing-middle’ care-gap should be reconsidered. Research, such as systematic service mapping and health needs assessment, is a necessary foundation for evidence-based mental healthcare policy, planning and implementation. Without such research, vital government funds may be deployed to ‘missing-middle’ programmes that may not improve Australian public health outcomes.
Effect of a mindfulness programme training on mental toughness and psychological well-being of female athletes
Authors: Ajilchi Bita , Mohebi Mahmoud , Zarei Sahar , Kisely Steve
Published: December 2021

Objectives

Research has shown that mindfulness in athletes is associated with positive outcomes. We therefore assessed the effect of mindfulness training on increasing mental toughness (MT) and psychological well-being (PWB).

Methods

This was a parallel-group, pre-and post-test, randomised controlled pilot trial. Forty-five female athletes from Iranian universities in Tehran were randomly assigned into experimental ( n = 23) and control groups ( n = 22). Forty-two completed the trial. The mindfulness training group received the Mindfulness–Acceptance–Commitment programme for 7 weeks. All subjects completed the Mindfulness Inventory for Sport (MIS), Sports Mental Toughness Questionnaire and PWB Scale. Data were analysed using mixed analysis of variance.

Results

Mindfulness training increased mindfulness in the experimental group ( p < 0.01). In turn, increased mindfulness led to increased MT and PWB at 2-month follow-up ( p < 0.05).

Conclusions

Given that mindfulness training may increase the MT and PWB of athletes, these techniques should be considered for inclusion in sports coaching.
The impact of COVID-19 lockdown on the well-being of clients of a specialist personality disorder service
Authors: Heidari Parvaneh , Broadbear Jillian H , Cheney Lukas , Dharwadkar Nitin P , Rao Sathya
Published: December 2021

Objective

The aim of this study was to investigate the well-being of people with severe borderline personality disorder (BPD) during the first wave of COVID-19 social restrictions.

Method

Clients of an outpatient specialist personality disorder clinic ( n = 77) were invited to the study. An online survey was conducted including a range of open-ended questions exploring well-being and the Coronavirus Anxiety Scale (CAS) which assesses ‘coronaphobia’. Qualitative data were analysed using inductive content analysis with NVivo software. CAS data were analysed descriptively using SPSS version 25.

Results

Thirty-six surveys were completed (48% response rate). Many participants experienced significant challenges to their overall well-being during lockdown although some reported improvements in psychosocial functioning. Three participants (8.3%) experienced clinically significant ‘coronaphobia’.

Conclusion

The self-reported physical and mental health of participants with BPD demonstrated resilience, suggesting that the capacity to maintain treatment via telehealth helped to mitigate many of the adverse aspects of social restrictions. This study was conducted during the first wave of social restrictions; subsequent studies will reveal longer-term effects of extended community lockdowns.
Improving services for those who serve: A private practice initiative to improve psychiatric care for first responder and military patients
Authors: Jamalulhak Amir Izzat , Galletly Cherrie , Ford Nick
Published: December 2021

Objectives

Professional isolation and limited opportunities for multidisciplinary collaborations are well-recognised challenges for psychiatrists in private practice. This narrative paper describes the development of a private practice group to assist first responders (FRs) and military patients located in Adelaide, South Australia. The aims included both peer review, and interdisciplinary communication and collaboration. Relevant personnel in the ambulance, police and fire services, military and veterans’ groups, and the compensation system, participated in monthly meetings. Lack of timely access to psychiatric care for FR and military patients was identified as a problem and an expedited referral service was established.

Conclusions

The Closing the Gap Group was established in 2017. The terminology refers to the gap between treating psychiatrists and the complex organisations that manage the workplace context for FR/military patients. This initiative provides a template for private practice innovations to improve psychiatrists’ skills and knowledge, along with better engagement and understanding between private psychiatrists and relevant community organisations.
Implications of COVID-19 on the Loneliness of Older Adults in Residential Care Homes
Authors: Ho Ken H. M. , Mak Agnes K. P. , Chung Rosenna W. M. , Leung Doris Y. L. , Chiang Vico C. L. , Cheung Daphne S. K.
Published: December 2021

With little understandings on the loneliness of older adults in residential care homes structured by social contact restrictions, the provision of person-centered care was jeopardized during the pandemic. This study employed hermeneutic phenomenology to explore the lived experiences of loneliness of this population during a 5-month period of the COVID-19 pandemic. We conducted unstructured face-to-face interviews with 15 older adults living in seven residential care homes. Thematic analysis was guided by Van Manen’s approach. The essence of loneliness was uncovered as “A deprived sense of self-significance in a familiar world contributes to older adult’s disconnection with prior commitments.” A sub-theme “From collapse to dissolution of self-understanding” revealed how COVID-19 structured their loneliness. Another sub-theme, “Restoring meanings by establishing connections with entities” illustrated the ways to mitigate loneliness during the pandemic. Activities fostering alternative self-interpretation are important to protect older adults against loneliness.
Characteristics and Experiences of Parents of Children with Learning and Attention Disabilities and Autism Spectrum Disorder: A Mixed Methods Study
Authors: Chad-Friedman Emma , Kuhlthau Karen A. , Millstein Rachel A. , Perez Giselle K. , Luberto Christina M. , Traeger Lara , Proszynski Jacqueline , Park Elyse
Published: December 2021

Parents of children with learning and attention disorders (LAD) and autism spectrum disorder (ASD) experience chronic parenting stress due to the challenges in raising a child with special needs. We used a mixed methods design to examine characteristics and experiences of stress and coping among parents of children with LAD and ASD. We conducted 20 semi-structured focus group interviews with parents of children with LAD ( n = 11) and ASD ( n = 9) and administered a battery of self-report measures of stress and coping to parents of LAD ( n = 53) and ASD ( n = 51) enrolled in a pilot trial. Qualitative findings showed that parents of children with LAD and ASD largely experienced similar sources of stress, but with different intensities due to their children's different difficulties. Quantitative findings reflected high levels of distress among parents of children with LAD and ASD, with parents of children with ASD demonstrating higher distress and poorer overall sleep quality. Stressors experienced by parents of children with ASD arose from more overt challenges associated with having a child with more visible challenges. Parents of children with LAD experienced more subtle challenges of having a child who is less overtly impaired. Findings will aid in the development of targeted stress management interventions.
Intra- and Interobserver Reliability of the New Classification System of Progressive Collapsing Foot Deformity
Authors: Lee Hee Young , Barbachan Mansur Nacime Salomao , Lalevée Matthieu , Dibbern Kevin N. , Myerson Mark S. , Ellis Scott J. , Femino John E. ,   Progressive Collapsing Foot Deformity Consensus Group, de Cesar Netto Cesar
Published: December 2021

Background:

Historical concept of flatfoot as posterior tibial tendon dysfunction (PTTD) has been questioned. Recently, the consensus group published a new classification system and recommended renaming PTTD to Progressive Collapsing Foot Deformity (PCFD). The new PCFD classification could be effective in providing comprehensive information on the deformity. To date, there has been no study reporting intra- and interobserver reliability and the frequency of each class in PCFD classification.

Methods:

This was a single-center, retrospective study conducted from prospectively collected registry data. A consecutive cohort of PCFD patients evaluated from February 2015 to October 2020 was included, consisting of 92 feet in 84 patients. Classification of each patient was made using characteristic clinical and radiographic findings by 3 independent observers. Frequencies of each class and subclass were assessed. Intraobserver and inteobserver reliabilities were analyzed with Cohen kappa and Fleiss kappa, respectively.

Results:

Mean sample age was 54.4, 38% was male and 62% were female. 1ABC (25.4%) was the most common subclass, followed by 1AC (8.7%) and 1ABCD (6.9%). Only a small percentage of patients had isolated deformity. Class A was the most frequent component (89.5%), followed by C in 86.2% of the cases. Moderate interobserver reliability (Fleiss kappa = 0.561, P < .001, 95% CI 0.528-0.594) was found for overall classification. Very good intraobserver reliability was found (Cohen kappa = 0.851, P < .001, 95% CI 0.777-0.926).

Conclusion:

Almost half (49.3%) of patients had a presentation dominantly involving the hindfoot (A) with various combinations of midfoot and/or forefoot deformity (B), (C) with or without subtalar joint involvement (D). The new system may cover all possible combinations of the PCFD, providing a comprehensive description and guiding treatment in a systematic and individualized manner, but this initial study suggests an opportunity to improve overall interobserver reliability.

Level of Evidence:

Level III, retrospective diagnostic study.
Association Between Opioid Use and Diabetes in Patients With Ankle Fracture Repair
Authors: Song Wenye , Shibuya Naohiro , Jupiter Daniel C.
Published: December 2021

Background:

Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Ankle fracture patients with diabetes may experience prolonged healing, higher risk of hardware failure, an increased risk of wound dehiscence and infection, and higher pain scores pre- and postoperatively, compared to patients without diabetes. However, the duration of opioid use among this patient cohort has not been previously evaluated. The purpose of this study is to retrospectively compare the time span of opioid utilization between ankle fracture patients with and without diabetes mellitus.

Methods:

We conducted a retrospective cohort study using our institution’s TriNetX database. A total of 640 ankle fracture patients were included in the analysis, of whom 73 had diabetes. All dates of opioid use for each patient were extracted from the data set, including the first and last date of opioid prescription. Descriptive analysis and logistic regression models were employed to explore the differences in opioid use between patients with and without diabetes after ankle fracture repair. A 2-tailed P value of .05 was set as the threshold for statistical significance.

Results:

Logistic regression models revealed that patients with diabetes are less likely to stop using opioids within 90 days, or within 180 days, after repair compared to patients without diabetes. Female sex, neuropathy, and prefracture opioid use are also associated with prolonged opioid use after ankle fracture repair.

Conclusion:

In our study cohort, ankle fracture patients with diabetes were more likely to require prolonged opioid use after fracture repair.

Level of Evidence:

Level III, prognostic.
Embodied Mindfulness Questionnaire: Scale Development and Validation
Authors: Khoury Bassam , Vergara Rodrigo C. , Sadowski Isabel , Spinelli Christina
Published: December 2021

Recently developed mindfulness scales have integrated aspects of the body in measuring mindfulness unlike other established scales. However, these scales focused solely on body awareness and did not embrace all aspects of mindfulness and the body. Specifically, they did not integrate embodiment in mindfulness. The proposed Embodied Mindfulness Questionnaire (EMQ) aims to operationalize the proposed notion of “embodied mindfulness” by grounding it into five dimensions, each representing a set of skills that can be cultivated through training and practice: (a) Detachment from Automatic Thinking, (b) Attention and Awareness of Feelings and Bodily Sensations, (c) Connection with the Body, (d) Awareness of the Mind-Body Connection, and (e) Acceptance of Feelings and Bodily Sensations. The EMQ items were developed through consultations with a panel of eight graduate students and a group of 10 experts in the field. Results from a series of three studies supported the proposed five subscales of EMQ and suggested that these subscales are independent and supported by convergent and discriminant evidence. In addition, results suggested that scores of EMQ subscales are different in terms of sensitivity to mindfulness training or meditation practice and experience. Limitations, as well as theoretical and practical implications of the EMQ subscales, are thoroughly discussed.
She Asked for It: Hardcore Porn, Sexism, and Rape Myth Acceptance
Authors: Borgogna Nicholas C. , Lathan Emma C. , McDermott Ryon C.
Published: December 2021

The present study examined pornography viewing, rape myth acceptance, and sexist attitudes. Data came from 392 male and 903 female participants. Multigroup SEM indicated neither pornography viewing, nor hardcore pornography viewing, were related to rape myth acceptance when controlling for sexist attitudes among men. Wald tests indicated hostile sexism to be a significantly stronger predictor of all rape myths examined compared to pornography viewing or hardcore pornography viewing in men and women. Latent variable interaction analyses suggested hardcore pornography viewing as a significant exacerbating factor for the relationship between hostile sexism and “she asked for it” rape myths across genders.
Asparaginase activity monitoring and management of asparaginase hypersensitivity reactions in Canada
Authors: Pike Meghan , Kulkarni Ketan , MacDonald Tamara
Published: December 2021

Introduction

Pegaspargase can cause anti-asparaginase antibody formation, which can decrease its effectiveness without causing any clinically apparent reaction (silent inactivation). When a patient has silent inactivation, a switch to Erwinia anti-asparaginase is warranted, but there is currently a global shortage of Erwinia. The only way to identify silent inactivation is to measure an asparaginase level. However, routine asparaginase level monitoring is not currently standard of care at all Canadian centers. This study aims to identify variations in practice regarding asparaginase level monitoring and Erwinia use.

Methods

A 21-item survey was developed using OPINIO software and distributed to all Pediatric Hematology–Oncologists in Canada from February to October 2020.

Results

Respondents represented 15 hospitals across each region of Canada (response rate = 52%). Only 39.2% of respondents reported routinely measuring asparaginase levels, yet 53% of respondents have modified therapy from pegaspargase to Erwinia in up to half of their patients. The most common reason for not measuring asparaginase levels was not knowing how to use levels clinically (25.5%). There was variation in the timing of levels and their target.

Conclusions

We identified substantial variation in asparaginase activity monitoring practices across Canada. Therefore, future research should aim to develop a national practice guideline on asparaginase activity monitoring.
Intraocular lens power calculation in virgin eyes: Accuracy of the Barrett Universal II formula and a Ray tracing software
Authors: Fernández-Rosés Joaquim , Lamarca José , Piñero David P. , Barraquer Rafael I.
Published: December 2021

Purpose

To compare the accuracy of Sirius ray tracing software with the Barrett Universal II formula for intraocular lens power prediction in virgin eyes.

Methods

Retrospective case series including 86 eyes that have undergone uneventful cataract surgery with SN60WF implantation. The median absolute error, mean prediction error, variance, and the percentage of eyes within ± 0.25 D, ± 0.50 D, ± 0.75 D, and ± 1.00 D of the prediction error in refraction were calculated. The correlation of prediction error with different baseline parameters was investigated.

Results

No differences were found between the median absolute error of the Barrett Universal II formula (0.226 D) and the ray tracing software with different intraocular lens centerings; apex (0.331 D), limbus (0.345 D), and pupil (0.342 D) ( p = 0.084). The variance, from lowest to highest, was the Barrett Universal II (0.144 D2), ray tracing-limbus (0.285 D2), ray tracing-pupil (0.285 D2), and ray tracing-apex (0.287 D2) ( p = 0.027). The Barrett Universal II formula showed a higher percentage of eyes within ± 0.25 D (56.98%), ± 0.50 D (82.56%), and ± 0.75 D (93.02%) compared to ray tracing software ( p < 0.01). A significant correlation between the prediction error of the Barrett Universal II formula and corneal diameter (r = 0.322, p = 0.002) and pupil diameter (r = 0.230, p = 0.033) was found. Also, a positive correlation between the prediction error of Sirius ray tracing and axial length ( p < 0.001) and pupil diameter ( p = 0.01) was found.

Conclusion

There is a trend of the Barrett Universal II formula to be more accurate than Sirius ray tracing software for intraocular lens power calculation in virgin eyes. This should be confirmed in future prospective comparative studies.
Budd-Chiari syndrome: An unusual complication of an internal jugular tunneled dialysis catheter
Authors: Stefan Gabriel , Stancu Simona , Zugravu Adrian , Predescu Laura , Cinca Simona , Mircescu Gabriel
Published: December 2021

Budd-Chiari syndrome due to the tip of an internal jugular tunneled dialysis catheter malposition in inferior vena cava or hepatic vein is a rare complication. We aimed to present our experience and compare it with the previous reports to highlight the clinical features and the optimal management. A 57-year-old female with history of ANCAp vasculitis, treated by hemodialysis in the last 2 years on a right internal jugular vein tunneled catheter was admitted for pain in the right upper quadrant. A subacute Budd-Chiari syndrome due to catheter malposition was diagnosed. The catheter was removed, and a new tunneled hemodialysis line was inserted in the right internal jugular vein with the tip at the junction of right atrium with superior vena cava. Anticoagulation with apixaban 2.5 mg twice daily was started after catheter replacement and the patient was discharged. At 1 month follow-up the patient had no symptoms, and the ultrasound revealed the absence of the thrombus in the inferior vena cava. Imagining monitoring for malposition after insertion or in a clinical context suggestive for Budd-Chiari syndrome is essential for early diagnosis and treatment. In our case, anticoagulation with apixaban and prompt catheter replacement resulted in Budd-Chiari syndrome resolution.
Integrating Health Behavior Theories to Predict Intention to Get a COVID-19 Vaccine
Authors: An Pham Le , Nguyen Han Thi Ngoc , Dang Hop Thi Bich , Huynh Quynh Ngoc Ho , Pham Binh Duong Uyen , Huynh Giao
Published: December 2021

COVID-19 vaccines are put forward as the most promising solution for combatting the COVID-19 pandemic. This study aims to assess the willingness to get vaccinated against COVID-19 by using the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) as a theoretical framework. A self-administered questionnaire was considered among Vietnamese adult patients between March and May 2021. The dependent variable was a COVID-19 vaccine acceptance, the hierarchical multivariable regression was done to assess the fit of the predictor model and the associations of variables. A total of 462 participants completed the questionnaire, with 80.5% vaccination intention. A model containing demographics, as well as HBM and TPB variables, demonstrated to be a predictor of intention to receive a COVID-19 vaccine, interpreting 39% of the variance (adjusted R2 = 0.39). For HBM and TPB constructs, respondents were more likely to accept vaccination if they had higher level of cues to action, self-efficacy, and a lower level of the perceived barriers (all P < .001). The theoretical framework provided a predictor of intention to get a COVID-19 vaccine, which is important for elaborating intervention plans to ensure the success of conducting mass vaccination campaigns.
Platform Politics: The Emergence of Alternative Social Media in India
Authors: Bhat Prashanth
Published: December 2021

Widespread dissemination of hate speech on corporate social media platforms such as Twitter, Facebook, and YouTube has necessitated technological companies to moderate content on their platforms. At the receiving end of these content moderation efforts are supporters of right-wing populist parties, who have gained notoriety for harassing journalists, spreading disinformation, and vilifying liberal activists. In recent months, several prominent right-wing figures across the world were removed from social media - a phenomenon also known as ‘deplatforming’- for violating platform policies. Prominent among such right-wing groups are online supporters of the Hindu nationalist Bharatiya Janata Party (BJP) in India, who have begun accusing corporate social media of pursuing a ‘liberal agenda’ and ‘curtailing free speech.’ In response to deplatforming, the BJP-led Government of India has aggressively promoted and embraced Koo, an indigenously developed social media platform. This commentary examines the implications of this alternative social platform for the online communicative environment in the Indian public sphere.
Temperature studies using positron lifetime spectroscopy of the subsurface zone in pure titanium exposed to a dry sliding test
Authors: Dryzek Jerzy
Published: December 2021

The report presents the positron annihilation studies of subsurface zone generated in pure titanium exposed to a long period dry sliding test. The total depth of the subsurface zone induced is detected at about 250 µm. Only dislocations and vacancy clusters which consist of two or three vacancies are observed in this zone. Their concentration decreases with the depth, especially at the depth above 100 µm. Despite the long duration of the sliding test, no clear signs indicating the presence of a tribolayer were observed. This was confirmed also by observation of annealing of defects in this zone at different depths. The lack of the tribolayer is in contrast to the research done so far for other metals.
The effect of tourism source market structure on international tourism revenues in Turkey
Authors: Ağazade Seymur
Published: December 2021

The current study calculates an indicator of tourism source market structure and investigates its impact on international tourism revenues in Turkey. This structure may influence the tourism performance through its consequences on the competitiveness and risk structure of the sector. The calculation of tourism source market structure in this study is based on the normalized Herfindahl–Hirschman Index and number of tourists by nationality. The ARDL co-integration framework is the method used and the estimation covers the period between January 2008 and September 2019. The calculated tourism source market structure indicator showed decreasing trend in the research period indicating that the tourism source market diversified in some extent. The co-integration is supported, and in the long-term model a 1% decrease in the tourism source market concentration found to increase international tourism revenues by 1.9078%. Furthermore, the error correction model indicated that it takes 7.16 months for deviations from the long-run relationship to return to the equilibrium.
The experiences of adolescents diagnosed with functional gastrointestinal disorders: An interpretative phenomenological analysis
Authors: Woodham Amy , David Annabel L. , Cooper Myra , Cordwell Jacinta
Published: December 2021

The aim of this study was to provide a qualitative perspective of adolescents’ experiences of functional gastrointestinal disorders. In-depth semi structured interviews were conducted with eleven adolescents aged 11–16. The transcripts were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified: 1) The journey to diagnosis: the good, the bad and the unknown; 2) Making sense of ‘functional’: the search for meaning; and 3) To share or conceal?: the impact of anticipated stigma on peer disclosure. The themes highlighted a complex process of meaning-making, with limited information about their diagnosis impacting on approaches to self-management and peer disclosure. Findings suggest adolescents would benefit from developmentally appropriate information and resources about the biopsychosocial aetiology of their presentation. It is considered that this may lead to greater self-efficacy in self-management of symptoms and reduce potential for perceived and self-stigma. Further implications for clinical practice and future research are discussed.
“You’re selling a brand”: Marketing commercial sex online
Authors: Abel Gillian
Published: December 2021

Sex work has undergone a change, with the rise of the internet economy with more ‘middle class’ sex workers coming into the industry. In this paper, I explore the social status hierarchy within online direct-contact commercial sex work in New Zealand. I draw on findings from an in-depth qualitative investigation of online sex work, undertaken between 2017 and 2018. I took a participatory approach, working closely with NZPC – Aotearoa New Zealand Sex Workers’ Collective to provide an understanding of two interrelated issues: the role web platforms play in shaping the social status of sex workers who advertise for clients online; and how sex workers brand and market themselves online. The findings suggest that sex workers strive to represent themselves as authentic in their marketing to enhance social status. Furthermore, the web platform on which over 90% of indoor sex workers in New Zealand advertise has embedded a status system among sex workers through the advertising packages they offer. Social status has thus become the most powerful marketing tool indoor direct-contact sex workers have to stand out from their competitors and attract sufficient clients to make a liveable income.
Interval of restitution coefficient for chattering in impact damper
Authors: Li Zongqi , Du Yanchen
Published: December 2021

Based on the impact damper, a dynamic model of a non-fixed constrained collision system was established. The coefficient of restitution is used as the main control parameter to analyze the system’s periodic movement and its bifurcation region. The chattering movement characteristics of the system were revealed. The interval of restitution coefficient for the chattering of collision system under various mass ratio and frequency ratio was obtained. The results show that the chattering phenomenon occurs in the collision system when the coefficient of restitution is greater than 0.5; as the mass ratio decreases, the interval of restitution coefficient for chattering continues to expand; as the frequency increases, the interval of restitution coefficient for chattering narrows.
The Singapore Green Plan 2030: Analysing its implications on law and the legal industry in Singapore
Authors: Chng Kenny , Ong Ken Wei
Published: December 2021

While sustainability has always been an important policy imperative in Singapore, the advent of the Singapore Green Plan 2030 marks a significant development in this regard. Announced in February 2021, the Green Plan represents a concerted national-level strategic shift towards advancing the sustainability agenda in Singapore. With sustainable development now being a ‘major policy priority’, it is inevitable that the Green Plan will have important legal implications, each of which will be identified and analysed in this paper. More broadly, however, the paper also suggests that the Green Plan will open up valuable opportunities for environmental law to receive greater attention and become a mainstream legal discipline in Singapore.
Treatment of severe mandibular deficiency following TMJ ankyloses by distraction osteogenesis and orthodontic treatment with microimplants
Authors: Kim Ho-Jin , Park Hyo-Sang
Published: December 2021

Severe mandibular deficiency caused by temporomandibular joint (TMJ) ankyloses produces functional and aesthetic problems that require complicated long-term treatment. In this case report, we describe the benefits of using microimplant mechanics for controlling the direction of distraction during distraction osteogenesis and for performing the movement of teeth. We also present its remarkable results and long-term stability. A 20-year-old girl presented with a convex profile due to severe mandibular retrognathia after a history of several TMJ surgeries for bilateral TMJ ankyloses. Mandibular distraction osteogenesis (MDO) was performed, and elastics were placed between the microimplants to control the direction of distraction. Subsequently, after retraction of the maxillary anterior teeth and distalisation of the whole mandibular dentition, the facial profile was markedly improved, and good interdigitation was obtained. The six-year follow-up retention and overall stability were satisfactory with good interdigitation and jaw function.
Gotta know why! Preliminary evidence supporting a theory of virtue learning as applied to intellectual curiosity
Authors: Orona Gabe Avakian
Published: December 2021

Virtue education is gaining popularity in institutions of higher education. Given this growing interest, several theoretical accounts explaining the process of virtue learning have emerged. However, there is scant empirical evidence supporting their applicability for intellectual virtue. In this study, we apply a theory of virtue learning to the development of intellectual curiosity among undergraduates. We find that learning why virtue is relevant and important to one’s education is consistently and moderately correlated with increases in intellectual curiosity across time points and analytic approaches. A weaker yet still positive association is found with increases in knowledge of intellectual curiosity. The implications of these results connect with pedagogical recommendations stressed across intellectual and moral virtue education.
Diffusing capacity in chronic obstructive pulmonary disease assessment: A meta-analysis
Authors: Ni Yingmeng , Yu Youchao , Dai Ranran , Shi Guochao
Published: December 2021

To achieve a multidimensional evaluation of chronic obstructive pulmonary disease (COPD) patients, the spirometry measures are supplemented by assessment of symptoms, risk of exacerbations, and CT imaging. However, the measurement of diffusing capacity of the lung for carbon monoxide (DLCO) is not included in most common used models of COPD assessment. Here, we conducted a meta-analysis to evaluate the role of DLCO in COPD assessment.

The studies were identified by searching the terms “diffusing capacity” OR “diffusing capacity for carbon monoxide” or “DLCO” AND “COPD” AND “assessment” in Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Scopus, and Web of Science databases. The mean difference of DLCO % predict was assessed in COPD patient with different severity (according to GOLD stage and GOLD group), between COPD patients with or without with frequent exacerbation, between survivors and non-survivors, between emphysema dominant and non-emphysema dominant COPD patients, and between COPD patients with or without pulmonary hypertension.

43 studies were included in the meta-analysis. DLCO % predicted was significantly lower in COPD patients with more severe airflow limitation (stage II/IV), more symptoms (group B/D), and high exacerbation risk (group C/D). Lower DLCO % predicted was also found in exacerbation patients and non-survivors. Low DLCO % predicted was related to emphysema dominant phenotype, and COPD patients with PH.

The current meta-analysis suggested that DLCO % predicted might be an important measurement for COPD patients in terms of severity, exacerbation risk, mortality, emphysema domination, and presence of pulmonary hypertension. As diffusion capacity reflects pulmonary ventilation and perfusion at the same time, the predictive value of DLCO or DLCO combined with other criteria worth further exploration.
A retrospective review of Achromobacter species and antibiotic treatments in patients with primary ciliary dyskinesia
Authors: Holgersen Mathias G , Marthin June K , Johansen Helle K , Nielsen Kim G
Published: December 2021

Objectives: Primary ciliary dyskinesia (PCD) is a rare congenital disease with defective mucociliary clearance causing frequent and often persistent pulmonary infections. Achromobacter species are opportunistic pathogens renowned for the difficulty of effective treatments and deteriorating effects on lung function. We aimed to describe the occurrence, treatment, and rate of successful eradication of Achromobacter species in patients with PCD. Methods: We retrospectively reviewed 18 years of historical microbiological samples and 10 years of electronic health records for PCD patients in Denmark. Results: We included 136 patients. Twenty-six patients had isolates of Achromobacter species. On average, 5% of the cohort had at least one annual isolate. Infections became persistent in 38% with a median length of 6.6 years leading to a significant number of antibiotic treatments. Resistance toward tobramycin and ciprofloxacin was prevalent. Overall, successful eradication was achieved in 62% of patients. We found the course of lung function significantly worse during persistent Achromobacter species infection than during the two preceding years, but not different to the course in unaffected age-matched controls. Conclusion The prevalence of Achromobacter species in patients with PCD is in line with what has been reported in cystic fibrosis and can occur transiently, intermittently, or develop into a serious persistent lung infection associated with long-term antibiotic treatment.
Factors in Toddlers With Late Language Emergence in a Middle-Income South African Sample
Authors: Kraamwinkel Elmien , Kritzinger Alta
Published: December 2021

Late language emergence (LLE) may result from genetic and environmental factors. Little is known about environmental factors in LLE in South Africa. The study describes the nature of differences in language functioning between toddlers with LLE and without LLE, and which factors were associated with LLE in a middle-income area in South Africa. Toddlers, ages 24 to 36 months with LLE ( n = 20) were matched with a control group (CG, n = 21) for household income, age, gender, maternal education, and parental employment. The research group (RG) showed moderate delays in expressive and receptive language, and play skills, while the controls exhibited no delay. Significant differences in early feeding history and multilingual exposure were found between the groups. As far as known, it is the first study utilizing a South African middle-income sample indicating that multilingual exposure may play a role in LLE. The study focuses the attention on environmental factors that are potentially modifiable in LLE.
Caution: Air Embolism Related to Heli-Fx EndoAnchor System in Zone 2 Thoracic Aneurysm Repair
Authors: Rosu Cristian , Ruz Ricardo , Overbeek Charles , Elkouri Stéphane
Published: December 2021

Purpose

We report a case of significant air embolization to the ascending aorta immediately following deployment of EndoAnchors in the aortic arch during a procedure to correct a type 1A endoleak.

Case report

The novel Heli-Fx EndoAnchor system (Medtronic Vascular, Santa Rosa, CA, USA) was used to deploy helical anchors in the distal aortic arch during a procedure to correct a type 1A endoleak following Zone 2 thoracic endovascular aortic repair of a saccular proximal descending thoracic aorta aneurysm (DTAA). The patient developed ST-segment elevations principally in the inferior leads and severe hypotension moments after EndoAnchor deployment at the proximal edge of the endograft. Transesophageal echocardiogram revealed severe right ventricular hypokinesis and a large amount of air in the ascending aorta. Subsequent management and clinical and radiological 30-day follow-up is presented in addition to a review of the literature and ex vivo testing with the Heli-Fx system to examine potential causes and solutions.

Conclusion

Precautions, such as pressurized saline infusion to the side port of guiding sheath, should be used whenever manipulating catheters and sheaths such as the EndoAnchor system in the aortic arch to prevent this potentially lethal complication.
Unapologetic Educational Research: Addressing Anti-Blackness, Racism, and White Supremacy
Authors: Pasque Penny A. , Patton Lori D. , Gayles Joy Gaston , Gooden Mark Anthony , Henfield Malik S. , Milner H. Richard , Peters April , Stewart D-L
Published: December 2021

We explore “ Unapologetic Educational Research: Addressing Anti-Blackness, Racism, and White Supremacy” to engage scholars in thinking about and reflecting on what it means to conduct qualitative research from a standpoint that honors Black lives in the research process while also disrupting racism and white supremacy. First, we unapologetically take up topics including engaging “diversity” in qualitative research, interrogating the etic perspective in the “new” focus on race, using critical perspectives to inform research and practice, examining the racialization of positionality, focusing on Black women educational leaders, and engaging schools and communities. Next, we engage in dialogue with each other to push ourselves—and you/the reader—to think more deeply about the serious and potentially dangerous implications of our research decisions. Given the unprecedented historical present we are all experiencing in our lifetime, we are committed to shifting the landscape of qualitative research as well as using research to shift our sociopolitical context toward racial equity and justice.
DEAD-box Helicase 27 Promotes Hepatocellular Carcinoma Progression Through ERK Signaling
Authors: Xiaoqian Wang , Bing Zhang , Yangwei Li , Yafei Zhi , Tingting Zhang , Yi Wang , Qingjun Li , Suxia Luo , Ling Zhang , Bo Wang , Peng Zheng
Published: December 2021

Introduction: DEAD-box helicase 27 (DDX27) belongs to DEAD-Box nucleic acid helicase family. The function of DDX27 in hepatocellular carcinoma (HCC) remain enigmatic. In light of this, we tried to investigate the regulatory role and underlying mechanism of DDX27 in HCC. Materials and methods: DDX27 expression levels were detected by qRT-PCR, Western blot and immunohistochemistry assays in HCC tissues and cells. Colony formation, CCK-8, growth curve, wound healing and transwell assays were conducted to investigate the effect of DDX27 on the proliferation and metastasis of HCC cells. RNA-sequencing was performed to detect the effect of DDX27 on downstream signaling pathway. The effect of DDX27 on HCC progression was evaluated using in vivo murine xenograft model. Results: we found an increased expression of DDX27 in HCC tissues with comparison to its para-tumor tissues. The high expression levels of DDX27 were associated with poor prognosis in HCC patients. DDX27 upregulation promoted cell metastasis. Mechanistic studies suggested that DDX27 overexpression induces the major vault protein (MVP) expression and enhances the phosphorylation levels of ERK1/2. Inhibition of ERK pathway impaired the cellular metastastic abilities induced by DDX27. The induction of DDX27 in HCC progression was further confirmed from tumors in mouse model. Conclusion: our results disclose a novel mechanism by which DDX27 enhances ERK signaling during HCC progression. DDX27 might be used in targeted therapy for HCC patients.
Triggered kV Imaging During Spine SBRT for Intrafraction Motion Management
Authors: Koo Jihye , Nardella Louis , Degnan Michael , Andreozzi Jacqueline , Yu Hsiang-hsuan M. , Penagaricano Jose , Johnstone Peter A. S. , Oliver Daniel , Ahmed Kamran , Rosenberg Stephen A. , Wuthrick Evan , Diaz Roberto , Feygelman Vladimir , Latifi Kujtim , Moros Eduardo G. , Redler Gage
Published: December 2021

Purpose: To monitor intrafraction motion during spine stereotactic body radiotherapy(SBRT) treatment delivery with readily available technology, we implemented triggered kV imaging using the on-board imager(OBI) of a modern medical linear accelerator with an advanced imaging package. Methods: Triggered kV imaging for intrafraction motion management was tested with an anthropomorphic phantom and simulated spine SBRT treatments to the thoracic and lumbar spine. The vertebral bodies and spinous processes were contoured as the image guided radiotherapy(IGRT) structures specific to this technique. Upon each triggered kV image acquisition, 2D projections of the IGRT structures were automatically calculated and updated at arbitrary angles for display on the kV images. Various shifts/rotations were introduced in x, y, z, pitch, and yaw. Gantry-angle-based triggering was set to acquire kV images every 45°. A group of physicists/physicians(n = 10) participated in a survey to evaluate clinical efficiency and accuracy of clinical decisions on images containing various phantom shifts. This method was implemented clinically for treatment of 42 patients(94 fractions) with 15 second time-based triggering. Result: Phantom images revealed that IGRT structure accuracy and therefore utility of projected contours during triggered imaging improved with smaller CT slice thickness. Contouring vertebra superior and inferior to the treatment site was necessary to detect clinically relevant phantom rotation. From the survey, detectability was proportional to the shift size in all shift directions and inversely related to the CT slice thickness. Clinical implementation helped evaluate robustness of patient immobilization. Based on visual inspection of projected IGRT contours on planar kV images, appreciable intrafraction motion was detected in eleven fractions(11.7%). Discussion: Feasibility of triggered imaging for spine SBRT intrafraction motion management has been demonstrated in phantom experiments and implementation for patient treatments. This technique allows efficient, non-invasive monitoring of patient position using the OBI and patient anatomy as a direct visual guide.
Brucella aortitis managed with debridement, extra-anatomical bypass, and long-term antimicrobial therapy
Authors: Perry John , Alslaim Hossam , Agarwal Gautam
Published: December 2021

Objectives

This report aims to review the management and outcomes of Brucella-associated mycotic aortic aneurysms.

Methods

This is a retrospective chart review at a tertiary-level healthcare system. IRB approval was waived per policy.

Results

We describe a case of Brucella aortitis acquired from habitual contact with wild hogs. Clinical presentation included lower back pain and elevated white blood cell count. Diagnosis was confirmed with imaging showing an infrarenal abdominal aortic aneurysm and serology revealing elevated Brucella antibodies titers. The patient was initially managed with endovascular aortic repair and combined oral and intravenous antibiotics therapy. He then underwent explanation and extra-anatomical bypass due to symptomatic periaortic infection and interval development of type I endoleak. The patient was asymptomatic after his final operation at 24 months of follow-up and remained on suppressive oral antibiotic therapy.

Conclusions

An aortic aneurysm secondary to Brucella is a rare entity. A detailed history of long-term exposure to animals may be a clue to obtain serologic testing. Operative debridement and re-establishing of reliable blood flow combined with long-term antibiotic suppression are the mainstay of treatment.