bluuebunny/crossref_metadata_2025 huggingface dataset:
Peak Systolic Blood Pressure During the Exercise Test: Reference Values by Sex and Age and Association With Mortality
Authors: Assaf Yazan , Barout Ahmad , Alhamid Ahmad , Al-Mouakeh Ahmad , Barillas-Lara Maria Irene , Fortin-Gamero Sonia , Bonikowske Amanda R. , Pepine Carl J. , Allison Thomas G.
Published: April 2021

We sought to update norms for peak systolic blood pressure (SBP) on the graded exercise test and examine its prognostic value in patients without baseline cardiovascular disease. Mayo graded exercise test data (1993–2010) were reviewed for nonimaging tests using Bruce protocol, selecting Minnesota residents 30 to 79 years without baseline cardiovascular disease. We formed a pure cohort of patients without factors significantly affecting peak SBP to determine peak SBP percentile norms by age and sex. Then we divided the full cohort of patients into 5 groups based on peak SBP percentiles: low (<10th), borderline low (10th–25th), referent (25th–75th), borderline high (75th–90th), and high (>90th). The relationship between peak SBP and mortality was tested using Cox regression adjusting for age, sex, and comorbidities affecting peak SBP or mortality. We identified 20 760 eligible patients with 7313 females (35%) and mean age 51.5±10.7 years. Our pure cohort included 7810 patients. Over 12.5±5.0 years follow-up, there were 1582 deaths, including 541 cardiovascular deaths. In the fully adjusted model, low-peak SBP was associated with increased total mortality (heart rate, 1.41 [1.19–1.66],
P
<0.0001) and cardiovascular mortality (heart rate, 1.54 [1.16–2.03],
P
=0.001), while borderline low-peak SBP was associated with increased cardiovascular mortality only (heart rate, 1.36 [1.02–1.81],
P
=0.027). High peak SBP was associated with increased total mortality only in the age-sex adjusted model (heart rate, 1.18 [1.02–1.36],
P
=0.026), not after full adjustment. We conclude that low exercise peak SBP is an independent predictor of higher total and cardiovascular mortality.
Cathodal Transcranial Direct Current Stimulation in Acute Ischemic Stroke: Pilot Randomized Controlled Trial
Authors: Pruvost-Robieux Estelle , Benzakoun Joseph , Turc Guillaume , Marchi Angela , Mancusi Rossella Letizia , Lamy Catherine , Domigo Valérie , Oppenheim Catherine , Calvet David , Baron Jean-Claude , Mas Jean-Louis , Gavaret Martine
Published: April 2021

Background and Purpose:

In acute stroke, preventing infarct growth until complete recanalization occurs is a promising approach as an adjunct to reperfusion therapies to reduce infarct size and improve outcome. In rodent models, cathodal transcranial direct current stimulation (C-tDCS) decreases peri-infarct depolarizations and reduces infarct volume. We hypothesized that C-tDCS would nonpharmacologically reduce infarct growth in hyperacute middle cerebral artery territory stroke patients receiving reperfusion therapy.

Methods:

STICA (Cathodal Transcranial Direct Stimulation in Acute Middle Cerebral Artery Stroke) was a pilot single-center, double-blind, 2-arms 1:1 randomized trial evaluating the safety, feasibility, and efficacy of C-tDCS versus sham stimulation in patients eligible for recanalization therapies. Magnetic resonance imaging was obtained both on admission and 24 hours later. The primary end point was 24-hour infarct growth. Secondary outcomes were (1) National Institutes of Health Stroke Scale score difference between day 7 and admission and (2) 3-month modified Rankin Scale score.

Results:

Forty-five patients were randomized. Median magnetic resonance imaging-to-C-tDCS start time was 45 minutes; C-tDCS was started before completion of recanalization procedure in all patients. The intervention proved feasible in all patients. No major adverse effects occurred in either group. There was no significant difference between active and sham groups for any end point. However, an apparent trend towards smaller infarct growth in the C-tDCS arm was observed in the whole group (unadjusted median difference [IC
95%
]: −2.2 mL [−12.2 to 1.5]) and in the prespecified subsamples with moderate-to-severe stroke and large vessel occlusion (−5.7 mL [−21.6 to 2.6] and −7.7 mL [−24.2 to 2.6], respectively).

Conclusions:

C-tDCS was feasible and well tolerated. No significant difference was found between the active and sham groups. However, the data suggest potential benefits of C-tDCS in patients with National Institutes of Health Stroke Scale score of >10 or large vessel occlusion. Using the observed effect size and standard α=5% and β=20%, samples of 102 and 86, respectively, can be estimated for future trials in patients with these characteristics. Randomized trials particularly targeting these populations may be warranted.
Negotiating Assimilation and Hybridity
Authors: Hoon (云昌耀) Chang-Yau , Sahrifulhafiz Shawatriqah
Published: April 2021

This paper explores the ways in which Bruneians who are born into a Chinese-Malay family define their identity, how the state classifies them in terms of “race,” how they negotiate their bicultural practices, and what challenges they face while growing up in the liminal space of inbetweenness. Considering the hegemonic force of assimilation enforced by various state apparatuses, the article critically discusses the ways in which Chinese-Malays negotiate the space between assimilation and hybridity. By examining the experience of between and betwixt among these biracial subjects, the article alludes to the different forces that define the boundaries of exclusion and inclusion, belonging and non-belonging in Brunei Darussalam.
Understanding Intraethnic Diversity
Authors: Wang (王斌) Bing , Zhou (周敏) Min
Published: April 2021

This paper fills a scholarly gap in the understanding of intraethnic diversity by way of a case study of the formation of a Taiwanese American identity. Drawing on a review of the existing scholarly literature and data from systematic field observations, as well as secondary data including ethnic organizations’ mission statements and activity reports, we explore how internal and external processes intersect to drive the construction of a distinct Taiwanese American identity. The study focuses on addressing three interrelated questions: (1) How does Taiwanese immigration to the United States affect diasporic development? (2) What contributes to the formation of a Taiwanese American identity? (3) In what specific ways is the Taiwanese American identity sustained and promoted? We conceive of ethnic formation as an ethnopolitical process. We argue that this ethnopolitical process involves constant negotiation and action in multiple spaces beyond nation-state boundaries. We show that immigration dynamics and homeland politics interact to create diversified rather than homogenized patterns of diasporic development and ethnic identification. The lifting of martial law in 1987 and democratization in Taiwan since then have led to increased public support for Taiwanization and Taiwanese nationalism in Taiwan. Rising nationalism in the homeland has in turn invigorated efforts at constructing an ethnonational – Taiwanese American – identity in the diaspora through proactive disidentification from the Chinese American community and civic transnationalism. This ethnopolitical identity is re-affirmed through cultural reinvention, outreach and networking, and appropriation of Taiwan indigenous cultures and symbols. We conclude by discussing the complexity of diasporic development and identity formation.
Proguithera caspersi, a new cavernicolous thread-legged bug species (Hemiptera: Heteroptera: Reduviidae: Emesinae) from Hainan, China
Authors: CHEN ZHUO , LI HU , CAI WANZHI
Published: April 2021

The thread-legged bug genus Proguithera Wygodzinsky, 1966 is recorded from China for the first time, and a new species, P. caspersi sp. nov., is described and illustrated. The new species is cavernicolous and was collected on the walls of a cave together with another emesine species Myiophanes tipulina Reuter, 1881. The type species of the genus, P. drescheri (Wygodzinsky, 1966), is re-diagnosed based on the examination of the holotype. An updated key to species of the Guithera–Lutevula genus group is provided.
Description of a new species, nymphs of two known species and a new record of Miroculis Edmunds, 1963 (Ephemeroptera: Leptophlebiidae) from Brazil
Authors: RAIMUNDI ERIKCSEN AUGUSTO , DOMÍNGUEZ EDUARDO , SALLES FREDERICO FALCÃO
Published: April 2021

Miroculis is one of the most diversified Neotropical genera of Leptophlebiidae in South America with 26 species currently known. In this work we describe a new species of Miroculis based on imagos from Amazonas, and the unknown nymphs of Miroculis (Miroculis) caparaoensis and Miroculis (Ommaethus) misionensis, both associated with imagos. In addition, Miroculis (Ommaethus) misionensis is recorded for the first time from Brazil.
Technology of animation in multimedia courseware of mechanical drawing
Authors: Shen Yucheng , Lu Wei
Published: April 2021

With the rapid development of Internet technology in China, mechanical drawing plays a more and more important role in social development and practice. The main purpose is to use the course of mechanical drawing to accurately represent the appearance, size, principle and technology of the machine. It is often called the language of communication in the industry. In order to make mechanical drawing better applied and practiced, and to make maximum use of Internet technical resources, the establishment of multimedia courseware teaching mechanism is the development trend of mechanical drawing.In order to adapt to the trend of network information, based on the multimedia environment, this paper studies the application of animation technology in mechanical drawing teaching, and constructs a small multimedia teaching platform. Through the explanation of animation courseware, students can better understand the making and principle of mechanical drawing, and cultivate students' divergent thinking. The teaching platform combines teaching material knowledge with practice to deepen students' understanding of the basic content of mechanical drawing. Finally, the rationality and practicability of the system are analyzed by investigating the platform users. The results show that the application of animation technology in mechanical drawing teaching is reasonable and practical.
The Dilemmas of Self-Assertion: Chinese Political Constitutionalism in a Globalized World
Authors: Brang Lucas
Published: April 2021

Political constitutionalism emerged on the Chinese academic scene in the mid-2000s as a countermovement to the rights-based, court-centered, and textual mainstream in Chinese constitutional scholarship. On the surface, it has launched a biting and sophisticated critique of academic and institutional Westernization and reasserted a sense of Chinese constitutional particularity. However, contrary to its intellectual self-representation as a genuinely Chinese phenomenon, the movement’s academic formation, methodological agenda, and theoretical vocabulary are inseparable from global ideological trends and draw heavily on European and American precedents. Consequently, the movement is troubled by a set of performative contradictions. These include the contradiction between its transnational genealogy and nationalist agenda; its pluralist theoretical makeup and anti-pluralist political rhetoric; as well as its putatively value-neutral sociological methodology and the politically selective application of said methodology. These antinomies, I argue, speak to the recurring dilemmas of “national” self-assertion in a globalized world.
Fractional order system modelling with Legendre wavelet multi-resolution analysis
Authors: Wang Zishuo , Wang Chunyang , Liang Shuning , Niu Qifeng , Ma Shuai
Published: April 2021

This paper proposes a method of fractional order system (FOS) modelling with Legendre wavelet multi-resolution analysis. The proposed method expands the input and output signals of the system in the form of a Legendre wavelet, and constructs the Legendre wavelet integration operational matrix by use of a block-pulse function. To address the problem of the considerable volume of system identification data and system noise in practical engineering applications, the multi-resolution characteristics of the wavelet are combined to build a wavelet integration operational matrix from the multi-scale space. By continuously discarding the high-frequency information to reduce the length of the identification data, the identification speed of the system is accelerated and the influence of noise on the identification accuracy is reduced. In addition, the least squares method is used to find the optimal order in the identification interval and further accelerate the FOS modelling process. The proposed method rapidly identifies the FOS parameters with high accuracy, and is thus feasible for engineering applications. Its effectiveness is verified by simulation and photoelectric stabilized sighting platform experiment.
Identification of the ZEB2 gene as a potential target for epilepsy therapy and the association between rs10496964 and ZEB2 expression
Authors: Wang Shitao , Wang Dan , Cai Xuemei , Wu Qian , Han Yanbing
Published: April 2021

Objective

An association between the rs10496964 polymorphism and the ZEB2 gene has not yet been reported, and the role of ZEB2 in epilepsy therapy is also unclear. The aims of this research were to evaluate the role of ZEB2 in the therapy of epilepsy and to explore the association between rs10496964 and ZEB2 expression.

Methods

We used the expression quantitative trait loci (eQTL) dataset resource from the Brain eQTL Almanac to evaluate the association between rs10496964 and ZEB2 expression in human brain tissue. Pathway and process enrichment analysis, protein–protein interaction analysis, and PhosphoSitePlus® analysis were then performed to further evaluate the role of ZEB2 in the therapy of epilepsy.

Results

The rs10496964 polymorphism was found to regulate the expression of ZEB2 in human brain tissue. The ZEB2 protein interacts with the targets of approved antiepileptic drugs, and a post-translational acetylation modification of ZEB2 was associated with an epilepsy drug therapy.

Conclusion

Our findings suggest that ZEB2 may be involved in the therapy of epilepsy, and rs10496964 regulates ZEB2 expression in human brain tissue.
Musical pantophagy: Is there an effect on changes in preference resulting from repeated exposure?
Authors: Johnston Rebecca R , Childers Gina M
Published: April 2021

The purpose of this research was to examine the effects of musical pantophagy, classical music consumption, and initial receptivity to select musical examples on changes in preference rating resulting from a program of repeated exposure. Participants included undergraduate students enrolled in a section of music appreciation at a large Southeastern university ( n = 67). Data were collected using a research designed preference rating measure (PRM) administered during a 5-week period within which there were eight test measures. Participants were divided into quartiles. Pre- to post-test measures resulted in a general positive trend for all participants. Comparisons of Q1 (lowest pantophagy) and Q3 (highest pantophagy) on PRMs 1–8 yielded no differences between groups, and PRM 8 was significantly different from PRM 1 for both groups. The same comparisons for Q1 (non-Classical music consumption) indicated significant difference with large effect size and for Q1 (lowest initial receptivity) indicated significant difference. Results suggest that regardless of musical pantophagy, repetition is an effective means by which to increase affective response to music, and that students who do not currently consume formal art music and who have low initial receptivity may report greater increases in affective response to music over time.
The effects of setting and music on the intention to participate in out-of-school music classes: An experimental video vignette study
Authors: Smolarczyk Kathrin , Wießnet Verena , Birnbaum Lisa , Kröner Stephan
Published: April 2021

There is a discrepancy between a high inherent value of extracurricular music classes and a low proportion of low-socioeconomic status (SES) male participants. However, evidence on how to match out-of-school music classes to students’ preferences is lacking. Thus, we assessed the attractiveness of different versions of such classes via an experimental video vignette study featuring a 2 × 2-factor (setting × music; each with high vs. low proximity to informal youth culture) between-subjects design with N = 244 students (Grade 5–10). We assessed the intention to participate as criterion, and gender, age, and SES (highest International Socio-Economic Index [HISEI] quartile) as control variables. A hierarchical regression showed a positive effect of music associated with youth culture on intention and no effect of the setting. Female (and older) students displayed higher intention than male (and younger) students. The single effect involving HISEI was a significant interaction of music and SES, which resulted from high-SES adolescents being especially motivated for classes with music associated with youth culture. Thus, to motivate boys and older students in particular, special consideration should be given to the appropriate design and marketing of music classes. However, music close to youth culture might be especially beneficial for adolescents with high rather than low SES.
A rare cause of hydronephrosis: Leiomyoma of the ureter and a literature review
Authors: Kilic Furkan Umut , Micoogullari Uygar , Altinova Serkan
Published: April 2021

Introduction:

Leiomyomas of the genitourinary tract are rare and their manifestation in the ureter is even rarer. To our knowledge, only 14 cases of leiomyoma of the ureter have been reported worldwide since 1955, therefore this case will be 15th.

Case presentation:

We present a rare case of primary leiomyoma of the right ureter. Ureteroscopy did not show any abnormal findings in the ureteral mucosa. The primary leiomyoma was resected with distal ureterectomy and partial cystectomy that was followed with ureteroneocystostomy due to extraluminal mass that caused hydronephrosis and back pain.

Conclusion:

Although rare, we believe that leiomyoma should be considered in the differential diagnoses of well-circumscribed ureteral masses and kidney-sparing surgery should be performed.
What Characterizes Vulnerability? Interdisciplinary Perspectives on Service Provision for Survivors of Sexual Assault
Authors: Bach Maria Hardeberg , Hansen Nina Beck , Hansen Maj
Published: April 2021

Although research indicates that specialized sexual assault (SA) services are effective in terms of promoting postassault recovery and improving legal outcomes, little is known about how to best support survivors facing co-occurring difficulties and inequalities (e.g., preexisting mental health issues, substance abuse, poverty). This deficiency in knowledge was also expressed by service providers at Danish SA centers (SACs), who described this using the term “vulnerable survivors.” Therefore, the present study aims to address this knowledge gap by exploring (a) how service providers understand vulnerability in the context of SA and (b) how service provision is currently approached for these survivors. Interviews were conducted with 18 service providers representing five professional groups (psychologists, social workers, forensic doctors, nurses, police) and analyzed using Interpretative Phenomenological Analysis. A total of eight themes emerged from the analysis, including service providers’ descriptions of what characterizes vulnerability in survivors and broader perspectives on service provision for these survivors. Survivors considered least likely to attain desired supports were also those perceived to be most vulnerable with regards to risk and experiences surrounding sexual victimization (e.g., individuals with preexisting mental health issues). Service providers also believed that a large proportion of those served experience ongoing vulnerabilities that are difficult to manage within existing support models. The results thus suggest that survivors’ needs cannot be met if vulnerabilities are overlooked or ignored. At the same time, the concept of vulnerability warrants caution since vulnerabilities are often placed within individual survivors, but the formal support system also appears vulnerable in its ability to meet the diverse needs and priorities of those served. The implications for SA services across the globe are discussed, including a need for more individually tailored and trauma-informed responses to SA that simultaneously address co-occurring difficulties and inequalities in survivors.
An Implementation Framework for Telemedicine to Address Noncommunicable Diseases in Thailand
Authors: Chattranukulchai Pairoj , Thongtang Nuntakorn , Ophascharoensuk Vuddhidej , Muengtaweepongsa Sombat , Angkurawaranon Chaisiri , Chalom Kittiphan , Supungul Somruethai , Thammatacharee Jadej , Kittikhun Suneerat , Shantavasinkul Prapimporn Ch , Leelahavarong Pattara , Rawdaree Petch , Tangsawad Sasithorn , Pitayarangsarit Siriwan , Kanaderm Chanikarn , Assawamakin Anunchai , Roubsanthisuk Weranuj , Sukonthasarn Apichard
Published: April 2021

To maintain the continuity of noncommunicable disease (NCD) services and ascertain the health outcomes of patients with NCDs during the COVID-19 (coronavirus disease 2019) outbreak in Thailand, various telemedicine services have been developed. To achieve this determination, the implementation framework has been constructed based on recommendations from multidisciplinary experts (Thai NCD Collaboration Group). Within the framework, all key elements are illustrated with their priority and expected collaborations. Ultimately, active collaborations from multi-stakeholders are vitally important to ensure that telemedicine services for NCDs will finally become practical, successful, and sustainable.
On the deformation of micromorphic elastic beams
Authors: Ieşan D
Published: April 2021

This paper is concerned with the deformation of beams in the framework of the linear theory of micromorphic elastic solids. First, the plane strain of anisotropic and homogeneous elastic cylinders is investigated. Existence and uniqueness results are presented. Then, Saint-Venant’s problem for micromorphic beams is formulated. A method is established to reduce the extension, bending and torsion to the study of some plane problems. Finally, the deformation of beams loaded on the lateral surface is investigated. As a special case, the solution of the flexure problem is obtained. The method is used to study the deformation of a micromorphic rod subjected to a uniform pressure on the lateral surface.
Immigration trials and international crimes: Expressing justice and performing race
Authors: Palmer Nicola
Published: April 2021

This article examines the performative collisions between the wrong of genocide and the invocation of this international crime as a means to secure carceral control of borders. Drawing on courtroom observations, legal transcripts and the media coverage of an immigration trial in the United States, the article explores the performative relationship between international criminal law and immigration law. It argues that this relationship helped to construct and racialize the category of the ‘criminalized migrant’ while establishing the perceived ‘civility’ of criminal law as a primary means of enacting domestic border control. While race was never made explicit in the trial, it emerged in a fractured but significant way, as the horror of the Rwandan genocide against the Tutsi reinforced the wrong of violating immigration law.
Receiving and resisting: Toward a market-driven cultural hybridity
Authors: Guldin Rachel
Published: April 2021

This study proposes an approach to cultural hybridity that centers the market, not geopolitical borders or regions, as the driving force of cultural hybridization. In this model, cultural hybridity manifests on a continuum between market-receptive hybridity, which incorporates cultural characteristics of the dominant market, and market-resistant hybridity, which limits the influence of cultural characteristics of the dominant market. To illustrate, this study identifies market strategies and examines how Colombian musician Shakira and Mexican musician Lila Downs employ various practices to create market-receptive and market-resistant cultural hybridity across their careers. This market-driven approach to hybridity decenters the countries of the Global North, contributes to ongoing efforts to undo the historical homogenization of the Global South, and works to explain cultural hybridity as the result of markets, not countries, allowing the framework to be applied within or across regions.
Epidemiology of Concussion in the National Football League, 2015-2019
Authors: Mack Christina D. , Solomon Gary , Covassin Tracey , Theodore Nicholas , Cárdenas Javier , Sills Allen
Published: April 2021

Background:

Concussion in American football, and specifically the National Football League (NFL) is a major area of interest and key focus for injury prevention. Complete and accurate characterization of when, how, and to whom these injuries occur can facilitate injury reduction efforts. Existing studies of concussion in the NFL use publicly available data, potentially limiting data quality and the inferences that can be made.

Hypothesis:

Concussion incidence in the NFL decreased across the 2015-2019 seasons.

Study Design:

Descriptive epidemiology study.

Level of Evidence:

Level 4.

Methods:

Concussion incidence, including counts, one-season risk, and rates per game and player-plays, among active NFL players from 2015 to 2019 is described by year, season, play type, and roster position.

Results:

A total 1302 concussions were identified from 2015 to 2019 among 1004 players. Of these, 80% occurred in NFL games. The average annual incidence of in-season game concussions changed over the study period, from 230.7 per season (2015-2017) to 177.0 per season (2018-2019); this represented a 23% decrease in game settings ( P < 0.01). Practice concussions fluctuated across the years of the study from 38 to 67 per season (average = 50.8/season). There were 70.6 concussions per 100 preseason games, which was slightly higher than the regular season rate per game of 61.7. Overall, there were 790 regular season game concussions across 4,657,243 player-plays and 114,428 player-games during the 5-year study. In regular season games, the majority of concussions were sustained on running and passing plays (n = 119/season), and the highest average rate per play occurred on kickoffs (0.69/100 plays). Defensive secondary (cornerbacks, safeties, and generic defensive backs) and offensive line incurred the most concussions, and the highest rates of concussion were among tight ends and wide receivers.

Conclusion and Relevance:

Concussions in the NFL are a key focus for player safety. Concussion reduction strategies were implemented before 2018, after which there was a sustained 2-year decrease in concussion incidence, providing a new benchmark from which to work toward further injury reduction.
Model-based reconstruction algorithm in the detection of acute trauma-related lesions in brain CT examinations
Authors: De Vito Andrea , Maino Cesare , Lombardi Sophie , Ragusi Maria , Talei Franzesi Cammillo , Ippolito Davide , Sironi Sandro
Published: April 2021

Background and purpose

To evaluate the added value of a model-based reconstruction algorithm in the assessment of acute traumatic brain lesions in emergency non-enhanced computed tomography, in comparison with a standard hybrid iterative reconstruction approach.

Materials and methods

We retrospectively evaluated a total of 350 patients who underwent a 256-row non-enhanced computed tomography scan at the emergency department for brain trauma. Images were reconstructed both with hybrid and model-based iterative algorithm. Two radiologists, blinded to clinical data, recorded the presence, nature, number, and location of acute findings. Subjective image quality was performed using a 4-point scale. Objective image quality was determined by computing the signal-to-noise ratio and contrast-to-noise ratio. The agreement between the two readers was evaluated using k-statistics.

Results

A subjective image quality analysis using model-based iterative reconstruction gave a higher detection rate of acute trauma-related lesions in comparison to hybrid iterative reconstruction (extradural haematomas 116 vs. 68, subdural haemorrhages 162 vs. 98, subarachnoid haemorrhages 118 vs. 78, parenchymal haemorrhages 94 vs. 64, contusive lesions 36 vs. 28, diffuse axonal injuries 75 vs. 31; all P<0.001). Inter-observer agreement was moderate to excellent in evaluating all injuries (extradural haematomas k=0.79, subdural haemorrhages k=0.82, subarachnoid haemorrhages k=0.91, parenchymal haemorrhages k=0.98, contusive lesions k=0.88, diffuse axonal injuries k=0.70). Quantitatively, the mean standard deviation of the thalamus on model-based iterative reconstruction images was lower in comparison to hybrid iterative one (2.12 ± 0.92 vsa 3.52 ± 1.10; P=0.030) while the contrast-to-noise ratio and signal-to-noise ratio were significantly higher (contrast-to-noise ratio 3.06 ± 0.55 vs. 1.55 ± 0.68, signal-to-noise ratio 14.51 ± 1.78 vs. 8.62 ± 1.88; P<0.0001). Median subjective image quality values for model-based iterative reconstruction were significantly higher ( P=0.003).

Conclusion

Model-based iterative reconstruction, offering a higher image quality at a thinner slice, allowed the identification of a higher number of acute traumatic lesions than hybrid iterative reconstruction, with a significant reduction of noise.
Game Spacing and Density in Relation to the Risk of Injuries in the National Hockey League
Authors: Blond Benjamin N. , Blond Joshua B. , Loscalzo Paul J.
Published: April 2021

Background:

Ice hockey has significant workload demands. Research of other sports has suggested that decreased rest between games as well as an increased workload may increase the risk of injuries.

Purpose:

To evaluate whether condensed game schedules increase the frequency and severity of injuries in the National Hockey League (NHL).

Study Design:

Descriptive epidemiology study.

Methods:

Data were obtained from publicly available online sources on game schedules and injuries for all NHL teams for the 2005-2006 through 2018-2019 seasons. Injury rates (per team per game) and the proportion of severe and nonsevere injuries were determined. The game-spacing analysis assessed the risk of injuries in relation to the number of days between games played (range, 0-≥6 days). The game-density analysis assessed the risk of injuries in relation to the number of games played within 7 days (range, 1-5 games). Results were assessed by analysis of variance, the post hoc Tukey test, and the chi-square test of distribution.

Results:

The game-spacing analysis included 33,170 games and 7224 injuries, and a significant group difference was found ( P = 1.44×10–5), with the post hoc test demonstrating an increased risk of injuries when games were spaced with <1 day of rest. There was no significant difference in the ratio of severe to nonsevere injuries. The game-density analysis included 33,592 games and 10,752 injuries, and a significant group difference was found ( P = 8.22×10–48), demonstrating an increased risk of injuries with an increased number of games in all conditions except for the comparison between 4 versus 5 games in 7 days. There was also a significant difference in injury severity ( P = .008), indicating that the least dense condition had a higher ratio of severe to nonsevere injuries compared with the other game-density conditions. Finally, the game-density analysis was repeated after excluding games played with <1 day of rest, and the finding of increased injury rates with increasingly condensed schedules remained significant ( P = 9.52×10–46), with significant differences between all groups except for the comparison between 1 versus 2 games in 7 days.

Conclusion:

We found that a condensed schedule and <1 day of rest between games were associated with an increased rate of injuries in the NHL. These findings may help in the design of future game schedules.
On Democracy in Iran in the Islamic Republic Era: A Knowledge-based Social Outline
Authors: Mirzanejad Morteza , Amerian Sirous , Partow Negar
Published: April 2021

Iranians’ struggle for democracy has dominated the contemporary history of the country for the last century. These attempts have often resulted in the emergence of authoritarian regimes rather than institutionalizing democracy in the body of the state. Scholars and politicians often consider the process of institutionalism of democracy in Iran to be a top-down approach toward political reform. The literature on the topic either focuses on economics and its associated politics or industrialization and legal reform as keys to success but often ignores the social foundations of institutionalism of democracy and, in the process, undermines their roles. Transition to democracy in Iran requires a social context based on Habermas’ “Tripartite of Knowledge,” and these conditions democratize the construction of a social system that prioritizes rational inquiry, socio-moral knowledge, and sociopolitical knowledge, and the need is to form a democratic society in line with the realization of political democratization.
The Virtual Care Experience of Patients Diagnosed With COVID-19
Authors: Raffan Freya , Anderson Teresa , Sinclair Tim , Shaw Miranda , Amanatidis Sue , Thapa Rajip , Nilsson Sarah Jane , Jagers Dianna , Wilson Andrew , Haigh Fiona
Published: April 2021

Virtual models of care are seen as a sustainable solution to the growing demand for health care. This paper analyses the experience of virtual care among patients diagnosed with COVID-19 in home isolation or health hotel quarantine using a patient-reported experience questionnaire. Results found that patients respond well to virtual models of care during a pandemic. Lessons learned can inform future developments of virtual care models.
What Can Sociology Say About Grit? A Cross-Cultural Exploration of the Relationships between Socioeconomic Status, Sense of Control, and Grit
Authors: Kwon Hye Won
Published: April 2021

Despite growing interest from the public, little attention has been directed toward grit in sociology. By disaggregating grit into its component factors (i.e., perseverance of effort and consistency of interest) on the basis of a measurement test, the author examines the potentially contrasting relations of grit to socioeconomic status. Using survey data from the United States and South Korea, the author finds that those with higher socioeconomic status partially translate their structural advantages into grit, particularly into the perseverance-of-effort dimension of grit in South Korea, via their stronger beliefs in personal control over their lives (i.e., sense of control). This study also reveals a negative association between one’s own or parental education and the consistency-of-interest dimension of grit, suggesting that stick-to-it-iveness can be a potential supplementary psychological resource for those who may lack other resources.
The complexity of early diagnostic decision making: A follow-up study of young children with language difficulties
Authors: Jansen Rianne , Maljaars Jarymke , Zink Inge , Steyaert Jean , Noens Ilse
Published: April 2021

Background & aims

Due to the complexity of early diagnostic decision making, we examined the predictive value of an early diagnostic classification and early abilities on later best estimate diagnosis for 22 clinically referred children with language difficulties.

Methods and procedures

Four years after initial evaluation (Time 1), the clinical files of these children were reviewed. A best-estimate (BE) diagnosis of language disorder (LD), intellectual disability (ID), or autism spectrum disorder (ASD) was established, with ASD being most common.

Outcomes and results

Early clinical classifications were relatively unstable or difficult to establish at a young age. The magnitude of children’s cognitive and receptive language delay was a significant predictor of a later BE diagnosis of ID and LD respectively. A BE diagnosis of ASD, by contrast, could not be predicted from children’s early social communication problems nor the presence of restricted and repetitive behaviors and interests.

Conclusions

Taken together, the results of this study suggest that language difficulties can be an early marker of a neurodevelopmental disorder which is often not identified at the age of first referral.

Implications

Eligibility for treatment should, therefore, be based on biopsychosocial case formulation rather than DSM or ICD diagnostic classification.

What this paper adds?

In this study a dimensional approach was used to characterize the abilities of young children referred with mild to profound receptive and/or expressive language difficulties. Later on, a categorical approach was adopted to establish best estimate diagnoses. Our clinical, broadly defined sample reflects the heterogeneous intake of young children referred for diagnostic assessment. Other studies on diagnostic stability often only focus on one diagnostic category (and are explicitly excluding children with specific other diagnoses), not taking into account the difficulties of early differential diagnostic decision making and stability across different categories over time. Investigations of differential diagnosis within a clinical group, instead of only differentiating children with a specific diagnosis from typically developing children, may be more informative for clinicians.
Crizanlizumab for the Prevention of Vaso-Occlusive Pain Crises in Sickle Cell Disease
Authors: Stevens Debra L. , Hix Meri , Gildon Brooke L.
Published: April 2021

Objective: To review the efficacy and safety of crizanlizumab (Adakveo) in the prevention of vaso-occlusive pain crises in sickle cell disease. Data Sources: An English-language literature search of PubMed, MEDLINE, and Ovid (1946 to January 2021) was completed using the terms crizanlizumab, SEG101, SelG1, and sickle cell disease. Manufacturer prescribing information, article bibliographies, and data from clinicaltrials.gov were incorporated in the reviewed data. Study Selection/Data Extraction: All studies registered on clinicaltrials.gov were incorporated in the reviewed data. Data Synthesis: Crizanlizumab is the first monoclonal antibody approved for sickle cell disease to reduce the frequency of vaso-occlusive crises. One phase 2 clinical trial and a post hoc analysis of the trial have been published. Relevance to Patient Care and Clinical Practice: Crizanlizumab is a monthly intravenous infusion approved by the Food and Drug Administration for patients with sickle cell disease 16 years of age and older to reduce the frequency of vaso-occlusive crises. Conclusion: Crizanlizumab appears to be an efficacious therapy for patients with sickle cell disease to reduce the frequency of vaso-occlusive crises. Concerns include drug cost and administration. Long-term benefits and risks have not been determined.
Sonographic Clues in Suspicion of Compartment Syndrome in a Lower Extremities Venous Study: A Case Study
Authors: Noh Cassey Y.
Published: April 2021

Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body. The dangerously high pressure in compartment syndrome impedes the flow of blood to and from the affected tissues. It can be an emergency, requiring surgery to prevent a permanent injury. In this case study, a lower extremities venous examination was performed on a male patient suspected of having compartment syndrome, as an incidental finding. Sonographic evaluation of the right leg revealed the absence of popliteal and small saphenous veins, and acute thrombus in the posterior tibial veins. The evaluation further revealed an incidental finding of double pseudo-aneurysm in the popliteal fossa, which was suspected for increasing the excessive compartmental pressure. This unique case study presents sonographical evaluation strategies when compartment syndrome is suspected.
Fluid inclusions in amethyst quartz of different geological environments from Brazil
Authors: Heinis Dias Coralie , de Sá Carneiro Chaves Mario Luiz , Figueiredo e Silva Rosaline Cristina , Dutra Gomes Sylvio
Published: April 2021

Fluid-inclusion studies were conducted on amethyst quartz from three different geological environments: basalt cavities; hydrothermal veins; and granitic pegmatites of Eastern Brazil, to understand the conditions of amethyst crystallisation in each of these environments. In samples from basalt cavities, fluid inclusions are exclusively one-phase aqueous types suggesting a low-temperature formation environment. Crystals from the two other environments show that fluid inclusions can be either one-phase aqueous, two-phase aqueous, three-phase aqueous carbonic, or three-phase aqueous with the presence of precipitated solid halite. The carbonic composition of the system H2O–CO2–NaCl was confirmed by Raman spectroscopic analysis and suggests a metamorphic or magmatic fluid source. Fluid inclusions trapped in samples from hydrothermal veins reveal at least two different fluid generations based on homogenisation temperatures. The first generation has minimum trapping temperatures between 249°C and 391°C. The second generation of lower temperature fluids has minimum trapping temperatures varying from 82°C to 203°C. Fluid inclusions of this group record eutectic temperatures that indicate the presence of Ca and Fe cations in addition to Na. Fluid inclusions trapped in amethyst from a pegmatite body have moderate salinity values between 15 and 25 eq. wt.% NaCl, thus reflecting the elevated salt content in pegmatite-forming fluids. In this sample, the first fluid generation is represented by aqueous fluid inclusions with minimum trapping temperatures ranging from 268°C to 375°C. The estimated eutectic temperatures, generally below –50°C, indicate the presence of Ca cations in addition to Na. Minimum trapping temperatures correspond to temperatures of late-to-post-pegmatitic hydrothermal stages. The second generation records minimum trapping temperatures between 125°C and 247°C. Amethyst from both hydrothermal veins and pegmatite environments contain solid inclusions of hematite, an indication that the mineralising fluid was Fe rich and thus, possibly magmatic in origin.
Breathlessness in COPD: linking symptom clusters with brain activity
Authors: Finnegan Sarah L. , Harrison Olivia K. , Harmer Catherine J. , Herigstad Mari , Rahman Najib M. , Reinecke Andrea , Pattinson Kyle T.S.
Published: April 2021

Background

Current models of breathlessness often fail to explain disparities between patients' experiences of breathlessness and objective measures of lung function. While a mechanistic understanding of this discordance has thus far remained elusive, factors such as mood, attention and expectation have all been implicated as important modulators of breathlessness. Therefore, we have developed a model to better understand the relationships between these factors using unsupervised machine learning techniques. Subsequently we examined how expectation-related brain activity differed between these symptom-defined clusters of participants.

Methods

A cohort of 91 participants with mild-to-moderate chronic obstructive pulmonary disease (COPD) underwent functional brain imaging, self-report questionnaires and clinical measures of respiratory function. Unsupervised machine learning techniques of exploratory factor analysis and hierarchical cluster modelling were used to model brain–behaviour–breathlessness links.

Results

We successfully stratified participants across four key factors corresponding to mood, symptom burden and two capability measures. Two key groups resulted from this stratification, corresponding to high and low symptom burden. Compared with the high symptom burden group, the low symptom burden group demonstrated significantly greater brain activity within the anterior insula, a key region thought to be involved in monitoring internal bodily sensations (interoception).

Conclusions

This is the largest functional neuroimaging study of COPD to date, and is the first to provide a clear model linking brain, behaviour and breathlessness expectation. Furthermore, it was possible to stratify participants into groups, which then revealed differences in brain activity patterns. Together, these findings highlight the value of multimodal models of breathlessness in identifying behavioural phenotypes and for advancing understanding of differences in breathlessness burden.
A rare case of difficult airway management in a Klippel-Feil syndrome pediatric patient with osseous torticollis undergone orthopedic surgery
Authors: Zhang Xiaoqing , Wang Jun , Liu Yajie , Li Zhengqian , Han Bin
Published: April 2021

Background

Orthopedic surgery for cervical torticollis poses potential threat to airway management both in tracheal intubation and extubation. Klippel-Feil syndrome (KFS) is a complex syndrome of osseous and visceral anomalies. The anatomical characteristics of KFS might have significant implications for airway management.

Case presentation

This is a rare case of an 8-year-old boy presenting with osseous torticollis, congenital occipito-atlantal deformity, congenital basilar invagination and KFS undergone elective torticollis correction surgery. Though with difficulty, tracheal intubation was successfully performed. Extubation failed twice on postoperative day 2 and 10, and required tracheostomy. Based on radiological findings, we speculated that prolonged airway edema accounted for the main reason of the failed extubation, the hypertrophic tonsil and occipito-cervical fusion resulted in reduced oropharyngeal space and limited cervical range of motion. Moreover, the Chiari malformation and KFS complicated the airway condition and lead to prolonged airway obstruction. The tracheostomy casing was removed 1 month later.

Conclusions

Cautions should be taken in extubation of pediatric patients undergone major osseous torticollis surgery. Reintubation should be prepared in case of failed extubation. Severe post-operative airway edema, complicated with hypertrophic tonsil, the structural abnormalities in the oropharyngeal cavity, and occipito-cervical deformities constituted the decreased oropharyngeal space and resulted in failed extubation. For severe airway compromise and prolonged intubation, tracheostomy should be considered.