bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction and validation of a novel prognostic nomogram for patients with metastatic renal cell carcinoma: a SEER-based study
Authors: Lu Zhaoxiang , He Wei , Zhou Jun , Yang Cheng , Xiang Rong
Published: June 2022

Objective

We aimed to establish and validate nomograms to evaluate overall survival (OS) and cancer-specific survival (CSS) in patients with metastatic renal cell carcinoma (MRCC).

Methods

Between 2010 and 2015, the clinical information of patients with MRCC was selected using the Surveillance, Epidemiology, and End Results database. Two nomograms were constructed based on Cox regression analysis, and their prediction accuracy was evaluated by concordance index (C-index), receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).

Results

After propensity score matching, there were 568 patients with MRCC in the training group and 568 in the validation group. Multivariate analyses revealed that age, residence, pathology, T stage, N stage, surgery, and metastatic sites were independent prognostic factors for the OS and CSS of MRCC. The C-index and ROC curves indicated that the two nomograms of OS and CSS showed satisfactory discriminative power. Furthermore, DCA displayed that the nomograms achieved more clinical net benefit than the American Joint Committee on Cancer staging system.

Conclusion

We constructed and validated two effective prognostic nomograms for patients with MRCC that accurately predicted the probabilities of 1-, 2-, and 3-year OS and CSS.
An Independent Evaluation of the Diagnostic Accuracy of a Computer Adaptive Test to Predict Proficiency on an End of Year High-Stakes Assessment
Authors: Turner Megan I. , Van Norman Ethan R. , Hojnoski Robin L.
Published: June 2022

Star Math (SM) is a popular computer adaptive test (CAT) schools use to screen students for academic risk. Despite its popularity, few independent investigations of its diagnostic accuracy have been conducted. We evaluated the diagnostic accuracy of SM based upon vendor provided cut-scores (25th and 40th percentiles nationally) in predicting proficiency on an end of year state test in a sample of highly achieving grade three ( n = 210), four ( n = 217), and five ( n = 242) students. Specificity exceeded sensitivity across all grades and cut-scores. Acceptable levels of sensitivity and specificity were achieved in grade three and four but not grade five when using the 40th percentile.
Domestic Violence From a Child Perspective: Impact of an Immersive Virtual Reality Experience on Men With a History of Intimate Partner Violent Behavior
Authors: Seinfeld Sofia , Hortensius Ruud , Arroyo-Palacios Jorge , Iruretagoyena Guillermo , Zapata Luis E. , de Gelder Beatrice , Slater Mel , Sanchez-Vives Maria V.
Published: June 2022

Domestic violence has long-term negative consequences on children. In this study, men with a history of partner aggression and a control group of non-offenders were embodied in a child’s body from a first-person perspective in virtual reality (VR). From this perspective, participants witnessed a scene of domestic violence where a male avatar assaulted a female avatar. We evaluated the impact of the experience on emotion recognition skills and heart rate deceleration responses. We found that the experience mainly impacted the recognition of angry facial expressions. The results also indicate that males with a history of partner aggression had larger physiological responses during an explicit violent event (when the virtual abuser threw a telephone) compared with controls, while their physiological reactions were less pronounced when the virtual abuser invaded the victim’s personal space. We show that embodiment from a child’s perspective during a conflict situation in VR impacts emotion recognition, physiological reactions, and attitudes towards violence. We provide initial evidence of the potential of VR in the rehabilitation and neuropsychological assessment of males with a history of domestic violence, especially in relation to children.
Human Milk Antibody Response After Combining Two Different COVID-19 Vaccines: Mix-and-Match
Authors: Mulleners Sien J. , Juncker Hannah G. , van Gils Marit J. , van Goudoever Johannes B. , van Keulen Britt J.
Published: June 2022

Background

SARS-CoV-2-specific antibodies are secreted into human milk after women are vaccinated against COVID-19, which might protect the breastfed infant. Due to several reports of severe side-effects of the Oxford-AstraZeneca ChAdOx1 (AZD1222) vaccine against COVID-19, some lactating women followed a heterologous vaccination schedule consisting of the first dose of AZD1222 and a second dose of an mRNA-based vaccine. However, it is unclear whether this generates a significant SARS-CoV-2-specific antibody response in human milk.

Main Issue

To quantify the SARS-CoV-2-specific antibody response in human milk of two lactating women receiving a heterologous vaccination schedules: AZD1222 and mRNA-based vaccine (Pfizer-BioNTech [BNT162b2] and Moderna [mRNA-1273]).

Management

Both participants collected 16 samples of human milk longitudinally. SARS-CoV-2-specific Immunoglobulin A was measured using an enzyme-linked immunosorbent assay.

Conclusion

Based on our results, it could be suggested that heterologous vaccination with AZD1222 and an mRNA-based vaccine can elicit a significant SARS-CoV-2 specific IgA response in human milk.
Exercising positional power to advance and support women in leadership – conversations with men in higher education
Authors: Moodly Adéle L
Published: June 2022

The paper focuses on the South African Higher Education environment, engaging with men in leadership and their views on areas that have been identified as challenging in women's lived experiences and the advancement of women towards leadership. Men still dominate positions of leadership and as such, hold positional power and influence in transformation towards a more equitable and diverse leadership profile. Research in this area focuses predominantly on the voices of women, yet there is recognition that men should also exercise agency in this regard. Set within a framework of social justice, critical and social realism, the research considers whether men understand women's lived experiences and challenges of institutional culture, often described in gendered terms. It considers their perceptions of women as leaders, inclusive of their notions of leadership. It is an attempt to grapple with women's perpetual challenges in the Higher Education milieu and the globally persistent underlying barriers to women's advancement. A qualitative approach was adopted and six men in leadership positions were interviewed. Responses to open-ended questions, based on areas highlighted in the literature, were analysed using critical discourse analysis. The findings revealed that though men in leadership appeared to understand the challenges experienced by women, the deeper embedded (real) levels of patriarchy and institutional culture and the impact on women's lived experiences were not fully appreciated. The paper concludes that men's advocacy and agency, though not conclusively so, can be major game-changers in institutional culture and patriarchal practices. The appearance of a perpetual cycle of cultural and structural barriers, and a predominance of research on women's experiences of this cycle, led the researcher to engage with men in leadership to ascertain whether they recognise and comprehend this cycle and whether they exercise agency and advocacy in challenging the status quo.
EL Policy and Immigrant Politics: State and Federal Policy and Ever-EL Students’ Postsecondary Pathways
Authors: Callahan Rebecca M. , Jiang Lei , Núñez Anne-Marie
Published: June 2022

Although current and former English Learner (EL) or “ever-EL” students comprise one of the fastest-growing K-12 populations, we still know relatively little about the factors that influence their college-going. Using Perna’s seminal college-going model as a launching point, we propose a policy-driven empirical approach to explore how state and federal policy uniquely inform ever-EL students’ academic trajectories. This model considers how EL education policy is largely defined at the federal level but interpreted and implemented by state and local actors (i.e., the Lau and Castañeda cases). In addition, largely of immigrant origin, ever-EL students are directly affected by federal immigration policy as well as state immigrant policies. We suggest that the unique status of EL education in K-12 schools and the framing of immigrant-origin communities in federal and state policies make it necessary to consider both federal and state policy contexts in ever-EL college-going research.
On the development of gelcasting process for tungsten and its alloys
Authors: Panchal Ashutosh , Nandy TK , Singh AK
Published: June 2022

Gelcasting technique has been successfully used for the preparation of porous tungsten. Gel forming monomer (methacrylamide (MAM)) and Cross-linker (NN’-Methylenebisacrylamide (MBAM)) dissolved in water were used for gelcasting of green compacts of tungsten with 39% solid loading. Appropriate quantity of dispersant, initiator, and catalyst were used in order to obtain a uniform dispersion of tungsten particles and also control the polymerization process. Several issues related to dispersant selection, de-airing, de-bindering, sintering, and selection of mold material have been addressed in order to obtain a defect-free product. Theoretical density of the porous sintered tungsten pellets produced by gelcasting process is ∼85%. The average pore diameter and mean pore area are 3 µm and 16 µm2, respectively, which are specifically required for the cathode application. Complex shape components of pure tungsten have been successfully made using gelcasting technique for the first time.
New fractional-order proportional integral derivative semi-active control composite magnetorheological damping system
Authors: Zheng Cheng , Bao Zhongyu , Chen Bingsan , Wei Songma , Yan Xiaoyu , Hung Shangchao
Published: June 2022

In this paper, semi-active control analysis and research on the vibration reduction system of vibratory roller with nonlinear stiffness and fractional damping are carried out. A two-degree-of-freedom semi-vehicle mathematical model with nonlinear stiffness and fractional damping is established, and the fractional calculus operator in the model is approximated by using the Oustaloup filter algorithm. The vibration characteristics of passive control, proportional integral derivative control, and fractional-order [Formula: see text] control on the vibration reduction system of the vibratory roller are simulated and analyzed. Results show that the vibration reduction effect of the first-stage vibration reduction device of the vibratory roller is evidently improved by using fractional-order [Formula: see text] controller. Compared with traditional passive control, the parameters are increased by about 40%, and the vibration intensity evaluation grade of the vibratory roller can be improved by about one level, which provides a new idea for the research of the vibration reduction system of the vibratory roller.
Effects of nano filler powder during microwave-based joining of SS304 butt joints
Authors: Salot Sony , Sehgal Shankar , Pabla B. S. , Kumar Harmesh , Prakash Chander , Bahl Shashi , Saxena Kuldeep K
Published: June 2022

Filler powder plays an important role during microwave hybrid heating-based joining process. In this work, nano-size nickel powder has been taken as filler material for preparing SS304-SS304 butt joints. Effects of size of nickel powder on mechanical properties (strength and hardness) of joints have been investigated. Scanning electron microscope tests show that the joints possess uniform microstructure. Energy dispersive spectroscopy tests demonstrated the presence of elements (Chromium, iron, carbon, silicon, manganese, phosphorus) other than filler powder (Nickel) in the joint region thereby confirming complete melting of joint region and also transfer of carbon from graphite separator sheet to joint region during microwave processing. Micro-hardness test results showed that nano-size filler powder-based joints are less prone to surface wear than corresponding micro-size filler powder-based joints. Micro-tensile strength of nano-size nickel powder-based joints is also far better than micro-size filler powder-based joints.
The Added Value of Somatosensory Potential N70 in Neurological Prognosis After Coma by Acute Brain Structural Injury: A Retrospective Study
Authors: Arciniegas-Villanueva Andrea Victoria , Fernández-Diaz Eva María , González-García Emilio , Sancho-Pelluz Javier , Mansilla-Lozano David , Diaz-Maroto María Inmaculada , Segura Tomás
Published: June 2022

Background:

Coma after acute brain structural injury (ABI) are associated with high mortality and disability. Somatosensory evoked potentials (SSEP) N20 and N70 are used to predict prognosis.

Purpose:

We assessed the utility of SSEP (N20-N70) as an early indicator of long-term functional prognosis in these patients.

Methods:

We conducted a retrospective cohort study of patients admitted to the intensive care unit (ICU) with a diagnosis of coma after ABI (n=60). An SSEP study including N20 and N70 was performed 24–72 hours after coma onset. Functional recovery was evaluated 6 to 12 months later using the Modified Glasgow Scale (mGS). The study was approved by our local research ethics committee.

Results:

The absence of N20 (41% specificity=100%) or N70 (78%) was a strong indicator of a poor outcome. In contrast, the presence of N70 was an indicator of a good outcome (specificity=64.2% sensitivity=91.3%).

Conclusion:

SSEP N20 and N70 are useful early prognostic markers with high specificity (N20) and sensitivity (N70). N70 has potential additional value for improving the prediction of good functional outcomes in the long term.
Dynamics of Gig Work Economy: An Investigation of Worker Perspectives on Gig Work
Authors: V. Pillai Sini , Dev Drishya
Published: June 2022

Online technology has developed to an extent where traditional labor markets have transformed, creating opportunities for people and businesses to participate in the global marketplace by employing contract labor. Application-based transportation including ridesharing apps, food and commodity delivery platform apps, and other consumer-facing services brought in the concepts of flexible work reshaping gig work into the mainstream creating millions of jobs in the areas of operation. Even though the gig economy provides flexibility in work, the real situation of the gig workforce seems very complex. The article discusses the impacts of the gig economy on labor markets by identifying the challenges faced by gig workers in the online labor market and the impact of gig economy on their health and well-being. A detailed field research conducted among the gig workers in the state of Kerala aided examining the labor market trends, motives, and effect beyond the gig economy. It further supplemented developing specific actions to accelerate the development of the gig economy to ensure worker protection and safety needs in creating an inclusive economy.
Accounts from the backwoods: The role of accounting in an early Upper Canada settlement
Authors: Baker Ron
Published: June 2022

The founding of the town of Guelph, Ontario, was uncommon in that the town was established prior to the development of surrounding agricultural lands. This was done through an arrangement between the British government and a private, for-profit company. Grounded in agency theory, this study examines the establishment of the town and the role of accounting in its early development. The results show how the absence of accounting created a space in which the company's agent could operate in a way that promoted the well-being of the local population while adopting a long-term approach to shareholder wealth creation. This study highlights the insights that can be gained by investigating where accounting is absent and the importance of aligning accounting techniques with organisational and social objectives, particularly in the context of private companies acting on behalf of governments.
The Effectiveness of Active External Warming of Patient Concurrently With Ice Application on the Incision Site on Post-Thoracotomy Pain and Analgesic Consumption
Authors: Kol Emine , Ince Serpil , Erdoğan Abdullah , Karsli Bilge , Keskin Hakan , Özgür Nazmiye
Published: June 2022

The aim of study is to investigate the effects of active external warming of patient concurrently with application of ice to incision site on thoracotomy pain and analgesic consumption. The research is a quasi-experimental design with control and study groups. The study was conducted in 2018 and 2019. A total of 70 patients were included in the study: 35 in the control group and 35 in the study group. The mean verbal pain scale values were significantly lower in the intervention group (2.85 point) than in the control group (4.57 point; p < .001). Opioid consumption rate was high in control group patients (77.1% tramadol 30 mg; 45.7% morphine sulfate 5 mg) In contrast, the rate of opioid consumption was lower in patients in the intervention group (40% tramadol 30 mg; 17% morphine sulfate 5 mg). Active external warming and ice application on the incision area, could reduce the intensity of thoracotomy pain.
Validity and Reliability of the Korean Version of the Revised Self-Care of Heart Failure Index v7.2
Authors: Kim JinShil , Kim Kye Hun , Lim Young-Hyo , Heo Seongkum , Moon Keumyi , Oh Mi Sook , An Minjeong
Published: June 2022

The psychometric properties of the Korean version of the revised Self-Care of Heart Failure Index (SCHFI) remain undetermined; therefore, we aimed to evaluate the construct and convergent validity and reliability of the Korean version of the SCHFI in Korean patients with heart failure (HF). Using a cross-sectional design, 207 patients with HF provided data on self-care and self-efficacy in self-care for this psychometric testing. The confirmatory factor analysis supported the construct validity of the Korean version with a three-factor structure: Self-Care Maintenance, Symptom Perception, and Self-Care Management. Convergent validity was supported by the significant relationships between self-efficacy and each scale of the Korean version of the SCHFI ( r = .425–.549, p < .001). The reliability estimates were marginally adequate, with a Cronbach’s alpha of .655 to .776, McDonald’s omega of .710 to .836, and composite reliability coefficients of .704 to .834. The SCHFI was supported as a valid and reliable measure of self-care for Koreans with HF. However, the marginal levels of the Cronbach’s alpha coefficients still require validation in a larger sample.
Long-term Follow-up of Bilateral Cleft Lip and Palate: Incidence of Speech-Correcting Surgeries and Fistula Formation
Authors: Gustafsson Charlotta , Heliövaara Arja , Rautio Jorma , Leikola Junnu
Published: June 2022

While bilateral cleft lip and palate (BCLP) constitutes a clinical challenge for the whole cleft team, the ideal surgical protocol remains obscure. This study presents the long-term burden of care in terms of secondary surgeries, defined as fistula repair and speech-correcting surgeries (SCS), in a single center. Outcomes of two surgical protocols utilized over the years were also compared.

A retrospective single-center analysis of 81 non-syndromic children with complete BCLP born between 1990 and 2010. Two surgical protocols comprising single-stage and two-stage (delayed hard palate closure) procedures were compared. Outcome was analyzed at the time of alveolar bone grafting (ABG) and post-ABG.

Altogether 54 children (66.7%) had underwent secondary surgery by the time of bilateral ABG. At this point, 38.3% (n = 31) of patients had received SCS and 49.4% (n = 40) had undergone fistula repair. The corresponding incidences at the end of follow-up were 46.9% (n = 38) and 53.1% (n = 43). No significant difference emerged in SCS incidence between the 2 protocols; however, prior to ABG the single-stage protocol had a significantly lower need for fistula repair. Regarding the location of fistulas, some differences were observed, with the single-stage procedure more associated with anterior fistulas.

BCLP has a high surgical burden of care in terms of secondary surgeries, defined as SCS and fistula repair. In our experience, the single-stage protocol, particularly the two-flap technique, offers better results in the management of BCLP than the two-stage approach with a short delay in hard palate closure.
Investigating the Predictors of Marital Satisfaction: The Case of Iranian Women
Authors: Ghafaryan Shirazi Nazanin , Andrés Soledad , Ghafaryan Shirazi Yasaman , Kharamin Shirali
Published: June 2022

Previous studies have demonstrated that self-esteem and happiness play significant roles in couples’ levels of marital satisfaction. However, most of these studies findings are from Western countries; thereby, the extent to which these findings are generalizable across different languages and cultures is still an open question. This study aims to investigate the relationship between self-esteem and happiness with marital satisfaction in the sample of Iranian female students to fill this gap. Participants were 250 Iranian female students who completed Rosenberg's self-esteem, Oxford happiness, Pick and Andrade's marital satisfaction questionnaires. The results logistic regression showed that the odds of being satisfied in marriage increased with happiness and self-esteem. Happy individuals with high self-esteem had, respectively, 2.4 and 2.41 times more likely to have marital satisfaction than unhappy individuals with low levels of self-esteem. The demographic variables of participants such as age, number of children, and the length of the relationship did not predict marital satisfaction. The results are discussed in relation to psychological and cultural factors present in self-esteem and marital relationships in Iranian women.
Prognostic Significance of Tumour Budding and Desmoplastic Reaction in Intestinal-Type Gastric Adenocarcinoma
Authors: Pun Cherry , Luu Shelly , Swallow Carol , Kirsch Richard , Conner James R.
Published: June 2022

Objective. Tumour budding and desmoplastic reactions in peritumoural stroma are features of the tumour microenvironment that are associated with colorectal cancer prognosis but have not been as thoroughly examined in gastric cancer. We aimed to further characterize the prognostic role of tumour budding and desmoplastic reaction in gastric adenocarcinoma with intestinal differentiation. Methods. 76 curative gastrectomy specimens were identified, excluding post-neoadjuvant cases or cases with >50% diffuse-type histology. Tumour budding was defined and graded according to the International Tumor Budding Consensus Conference recommendations and desmoplastic reaction was classified as described by Ueno et al 2017. Tumour budding and desmoplastic reaction were analyzed for associations with pathologic features and clinical outcomes. Results. Tumour budding was associated with pT ( P < .001), pN ( P < .004), overall stage ( P < .001), LVI ( P < .001) and PNI ( P = .002). Desmoplastic reaction was associated with pT ( P < .001), pN ( P = .005), overall stage ( P = .031) and PNI ( P < .001), but not LVI. Survival analysis showed decreased overall survival (OS) and recurrence-free survival (RFS) for intermediate and high grade tumour budding ( P = .031, .014 respectively). Immature stroma was significantly associated with RFS but not OS. Neither tumour budding nor desmoplastic reaction were independent predictors of OS or RFS on multivariate analysis in this cohort. Conclusion. Tumour budding and desmoplastic reaction were associated with known pathologic risk factors. Prognostically, tumour budding was associated with OS and RFS while desmoplastic reaction was associated with RFS only. Our data suggest that tumour budding and desmoplastic reaction have prognostic value in intestinal-type gastric adenocarcinoma.
Preservation of poultry meat using Tetraclinis articulata essential oil during refrigerated storage
Authors: Salem Nidhal , Boulares Mouna , Zarrouk Youkabed , Kammoun Salma , Essid Rim , Jemai Mohamed , Djebbi Saida , Belloumi Souhir , Jalouli Selim , Limam Ferid , Sriti Jezia
Published: June 2022

Current study aims to evaluate the effect of essential oil on the conservation of chicken fillets. Following a screening, Tetraclinis articulata was selected for its antimicrobial ( Enterococcus feacalis ATCC 29212, MIC < 0.031 mg/mL) and antioxidant (IC50 = 1000 µg/mL) potentials with no cytotoxicity effect towards murine macrophage cells. The treatment of chicken fillets, especially with 200 ppm of T. articulata essential oil per 100 g of product reduced significantly ( p  <  0.05) lipid oxidation during 12 days of refrigerated storage. Microbial flora charges decreased significantly ( p  <  0.05) with a rate of 50.31% for 200 ppm of essential oil from the 6th day of storage. The acidity of treated fillets was lower than control samples (1.3 g/kg) from the 3rd day of storage. In addition, a clear effect was recorded by reducing water losses during cooking under the tested doses of essential oil. Withall, findings encouraged the use of T. articulata to extend poultry meat product shelf life.
The Fiscal Impact of the COVID-19 Pandemic on Subnational Governments: The Case of Russia
Authors: Alexeev Michael , Yushkov Andrey
Published: June 2022

This paper examines the fiscal consequences of the COVID-19 pandemic for subnational governments. In particular, we study how the pandemic affected the Russian regions in terms of budget revenues, expenditures, and federal transfers. We use a novel dataset and compare various monthly fiscal measures in 2020 prior to and during the pandemic to the corresponding measures in 2019, conditioning on regional actions in response to the pandemic, the health impact of the pandemic, and the potentially relevant regional characteristics. We document that small business tax collections declined the most in response to the pandemic-related restrictions, while unconditional discretionary transfers and health care expenditures rose the most. Also, we find that tax collections are positively associated with population mobility, controlling for the restrictions, suggesting that tax revenues were inversely affected by the degree of compliance with the restrictions. Finally, we outline some policy implications for the design of fiscal federalism and directions for future research.
The Fiscal Common Pool Problem, Municipal Mergers, and Spillovers
Authors: Akai Nobuo , Goto Tsuyoshi
Published: June 2022

Mergers of local governments, commonly referred to as municipal mergers, have been widely implemented to internalize spillover effects. Many empirical studies point out that municipalities change the intertemporal budget allocation by increasing their debt issuance before mergers and they consider that this debt issuance is induced by the “fiscal common pool problem” because of pooled budgets after mergers. However, this phenomenon has yet to be analyzed theoretically. Therefore, this paper examines the mechanism of increased debt issuance before municipal mergers. We compare the debt issuance in the merger case with the level in the socially optimal and nonmerger cases. We find that the amount of debt issuance is larger in the merger case than in both other cases. The difference vanishes when spillovers are perfect.
Peripartum and Postpartum Analgesia and Pain in Women Prescribed Buprenorphine for Opioid Use Disorder Who Deliver by Cesarean Section
Authors: O’Connor Alane B , Smith Joel , O’Brien Liam M , Lamarche Kaitlyn , Byers Nadine , Nichols Stephanie D
Published: June 2022

Aim:

Little is known about whether pain can be effectively managed in pregnant women with opioid use disorder (OUD) during delivery hospitalization, particularly those undergoing surgery and taking buprenorphine as medication for OUD (MOUD). To address this question, we compared pain scores and opioid analgesic utilization during delivery hospitalization in women taking their pre-hospital dose of buprenorphine who delivered by cesarean section to matched controls. To inform future research efforts, we also began to explore opioid analgesic utilization and pain scores by type of anesthesia as this variable is often not included in related literature.

Methods:

Retrospective matched cohort study of 46 women prescribed buprenorphine during pregnancy who delivered by cesarean section during a 7-year period.

Results:

When compared to matched controls, women taking their pre-hospital dose of buprenorphine undergoing cesarean section utilized more opioid analgesics as measured by morphine milligram equivalents (MME) (mean MME first 48 hours 153.0 mg vs 175.1 mg, respectively, P < .01) but had similar pain scores during delivery hospitalization. There was no difference in MME utilization by maternal dose of buprenorphine though sample sizes were small. Women on buprenorphine who received spinal anesthesia with morphine had mean pain scores that were 1.4 points lower ( P = .01) during the first 48 hours than women on buprenorphine receiving other methods of anesthesia.

Discussion And Conclusions:

Pregnant women taking their pre-hospital dose of buprenorphine throughout their surgical delivery hospitalization were able to achieve pain relief similar to women not on MOUD but had higher MME requirements. Our results add to the emerging body of evidence suggesting that individuals on MOUD can achieve adequate post-surgical pain management without adjusting their pre-hospital dose of buprenorphine. Further research is required to fully understand the optimal buprenorphine dosing regimen during surgical hospitalizations. Our results also provide important preliminary evidence that spinal anesthesia containing opioids can be used effectively in individuals with OUD requiring surgical intervention.
Intensive Care Unit Acquired Weakness Associated With Acute Severe Asthma
Authors: Borré-Naranjo Diana , Rodríguez-Yánez Tomás , Almanza-Hurtado Amilkar , Martínez-Ávila María Cristina , Dueñas-Castell Carmelo
Published: June 2022

Context:

Neuromuscular complications in the intensive care unit (ICU) are frequent, multifactorial, and clinically difficult to recognize during their acute phase. The physical examination is the starting point for identification.

Case Report:

We present a patient with a history of poorly controlled asthma who was admitted to the ICU with status asthmaticus. After 4 days of being under ventilatory support, he developed muscle weakness. The diagnostic approach made it possible to establish myopathic and neurological compromise through electrophysiology studies.

Conclusions:

ICU-acquired weakness (ICUAW) can bring long-term consequences, early identification, and management, as well as preventive measures, are essential to minimize chronic disability and morbidity.
Vibration-based Damage Localization and Quantification Framework of Large-Scale Truss Structures
Authors: Markogiannaki Olga , Arailopoulos Alexandros , Giagopoulos Dimitrios , Papadimitriou Costas
Published: June 2022

The use of structural health monitoring (SHM) systems on a regular basis is critical to achieve early damage detection, avoid unpredicted failures, and perform cost-effective maintenance planning. The main objective of this work is to present a model-based Damage Detection Framework for truss structural systems that uses output-only vibration measurements. Model-based methods provide much more comprehensive information about the condition of the monitored system than the data-driven and also allow the prediction of the location and level of damage. The measured vibration response of a healthy structural system under operational vibrations is employed to tune a parameterized FE model using state-of-the-art FE model updating techniques to obtain an optimal numerical model of the structural system. Based on the optimal FE model, a set of damaged FE models is generated for selected damage scenarios. A damage approximation approach that represents local damage with uniform stiffness reduction is also presented. In the Damage Detection Framework, the vibration data records for both the “healthy” and the “damaged” structure and the results from multiple numerical analysis on the “healthy” and the “damaged” FE models are used. The transmittance functions for the “healthy” and “damaged” states of the structure and the FE models are derived to calculate the damage indicators. Using these indicators, potentially damaged structural members are identified, grouped, and compared to finally locate the specific damaged member. The proposed framework provides both accurate damage localization and damage quantification using a limited number of sensors for unknown input excitation. Herein, the case study used is a laboratory steel truss bridge.
A Machine Learning Model Helps Process Interviewer Comments in Computer-assisted Personal Interview Instruments: A Case Study
Authors: Billington Catherine , Rivero Gonzalo , Jannett Andrew , Chen Jiating (Kristin)
Published: June 2022

During data collection, field interviewers often append notes or comments to a case in open text fields to request updates to case-level data. Processing these comments can improve data quality, but many are non-actionable, and processing remains a costly manual task. This article presents a case study using a novel application of machine learning tools to assist in the evaluation of these comments. Using over 5,000 comments from the Medical Expenditure Panel Survey, we built features that were fed to a machine learning model to predict a grouping category for each comment as previously assigned by data technicians to expedite processing. The model achieved high top-3 accuracy and was incorporated into a production tool for editing. A qualitative evaluation of the tool also provided encouraging results. This application of machine learning tools allowed a small but worthwhile increase in processing efficiency, while maintaining exacting standards for data quality.
Deep Learning for Patient-Specific Quality Assurance: Predicting Gamma Passing Rates for IMRT Based on Delivery Fluence Informed by log Files
Authors: Huang Ying , Pi Yifei , Ma Kui , Miao Xiaojuan , Fu Sichao , Zhu Zhen , Cheng Yifan , Zhang Zhepei , Chen Hua , Wang Hao , Gu Hengle , Shao Yan , Duan Yanhua , Feng Aihui , Zhuo Weihai , Xu Zhiyong
Published: June 2022

Objectives: In this study, we propose a deep learning-based approach to predict Intensity-modulated radiation therapy (IMRT) quality assurance (QA) gamma passing rates using delivery fluence informed by log files. Methods: A total of 112 IMRT plans for chest cancers were planned and measured by portal dosimetry equipped on TrueBeam linac. The convolutional neural network (CNN) based learning model was trained using delivery fluence as inputs and gamma passing rates (GPRs) of 4 different criteria (3%/3 mm, 2%/3 mm, 3%/2 mm, and 2%/2 mm) as outputs. Model performance for both validation and test sets was assessed using mean absolute error (MAE), mean squared error (MSE), root MSE (RMSE), Spearman rank correlation coefficients (Sr), and Determination coefficient ( R2) between the measured and predicted GPR values. Results: In the test set, the MAE of the prediction model were 0.402, 0.511, 1.724, and 2.530, the MSE were 0.640, 0.986, 6.654, and 9.508, the RMSE were 0.800, 0.993, 2.580, and 3.083, the Sr were 0.643, 0.684, 0.821, and 0.824 ( P < .001) and the R2 were 0.4110, 0.4666, 0.6677, and 0.6769 for 3%/3 mm, 3%/2 mm, 2%/3 mm, and 2%/2 mm, respectively. The MAE and RMSE of the prediction model decreased with stricter gamma criteria while the Sr and R2 between measured and predicted GPR values increased. Conclusions: The CNN prediction model based on delivery fluence informed by log files could accurately predict IMRT QA passing rates for different gamma criteria. It could reduce QA workload and improve efficiency in pretreatment QA. Our results suggest that the CNN prediction model based on delivery fluence informed by log files may be a promising tool for the gamma evaluation of IMRT QA.
The ACTION Centre as a Model for Patient Engagement and Knowledge Translation in Integrative Oncology Practice, Training, and Research
Authors: Carlson Linda E. , Karim Safiya , Labelle Laura E.
Published: June 2022

Integrative Oncology (IO) programs are increasingly emerging at cancer centers and universities worldwide; often these include some combination of clinical service, research, and/or training. However, one gap that often occurs is in moving research results into practice, due to complexities and differences between research and service delivery models and priorities. We recently created the ACTION (Alberta Complementary Therapy and Integrative Oncology) Centre with the goal of partnering with the provincial public health service to promote and facilitate evidence-based integrative oncology care throughout Alberta. The Centre bridges the silos of academia and clinical care by embodying 3 core principles, to be (1) Patient-oriented, (2) Collaborative, and (3) Evidence-based. The ACTION Centre oversees the implementation of clinical research and academic training, and supports the development of clinical services, as well as patient and provider education. The ACTION Centre has five components which include: (1) Patient and healthcare provider education; (2) Individualized IO consultation and treatment planning; (3) Supporting access to complementary therapies; (4) Clinical trials of IO interventions, and; (5) Student training through the TRACTION (Training in Clinical Trials and Integrative Oncology) program. We offer this model of shareholder collaboration in the hopes that other IO programs may be able to use it as a template to further their own progress, working collaboratively toward the ultimate goal of advancing evidence-based, comprehensive, integrative healthcare to improve the lives of people affected by cancer.
The Migration and Climate Change Nexus
Authors: Morales-Giner Pilar , Ramos Cristina
Published: June 2022

In recent years, the terms “climate refugee” or “environmental refugee” have featured heavily in news media and popular commentary. Often, such terms are accompanied by shockingly large numbers, referring to everything from current migration levels to future “climate refugee” predictions. While the topic of migration and climate change is of undoubted importance, these ways of approaching the issue oversimplify the complex reality of climate change and distort its relationship to migration. Moreover, by ignoring the various connections between migration and climate change, such narrow framings jeopardize prospects for creating policies that address the root causes leading people to leave their homes
Protective Arteriovenous Fistula in Traumatic Common Carotid Transection
Authors: Drevets Peter , Tien Lillie , Alslaim Hossam S , Holmes Kathryne , Agarwal Gautam
Published: June 2022

Penetrating injuries of the neck involving major vessels are associated with high morbidity and mortality. A traumatic arteriovenous (AV) fistula can provide a protective effect by decompressing the injured arterial structure and prevent massive blood loss and airway compression. We present a novel description of CCA (common carotid artery) transection with associated protective AV fistula. Protective AV fistulae have been uncommonly described, and to our knowledge, this is the first case involving carotid transection with associated protective AV fistula ultimately allowing lifesaving operative repair.
Economic development collaboration in public administration research: A systematic literature review
Authors: Chen Liu
Published: June 2022

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, this article investigates 85 articles on economic development collaboration in public administration research, published between 1990 and 2022. Economic development collaboration is the process of interaction among multiple economic development organizations in order to tackle economic development problems that cannot be resolved by single organizations. This systematic review demonstrates seven key aspects of economic development collaboration studies: (1) research questions, (2) collaboration types, (3) empirical designs and methods, (4) antecedents of economic development collaboration, (5) mechanisms of economic collaboration, (6) outcomes of economic development collaboration, and (7) research limitations. Based on these results, this article identifies strengths and weaknesses in economic development collaboration research and concludes with a future research agenda.
Women’s experiences of navigating chronic pain within the context of living with an episodic disability
Authors: Campbell Karen A , Ford-Gilboe Marilyn , Kennedy Kelly , Jackson Kim , Mantler Tara , Oudshoorn Abram
Published: June 2022

Objectives:

Of the 6.2 million Canadians aged 15 years or older who live with disability, 61% have disabilities that are not static or continuous. These dynamic conditions are known as episodic disabilities and many disproportionately experienced by women. Chronic pain is also a common feature associated with many episodic disabilities. The purpose of this article is to explore the experience of chronic pain for women living with episodic disabilities.

Methods:

This qualitative study draws on the tenets of interpretive description. Thirty women, with one or more episodic disabilities and chronic pain, participated in a semi-structured interview and answered questions about their chronic pain levels, using Von Korff et al.’s graded chronic pain scale.

Results:

Women experienced gendered treatment within the healthcare system and reported that they were frequently dismissed by their healthcare providers, most often physicians. Healthcare professionals’ practices around pain assessment were another common challenge for women. Women who were able to access financial support from government disability programs were more likely to access allied health professionals. Many of the holistic strategies that women researched and used to treat chronic pain were self-enacted. While diet, exercise, and other self-care activities are general health promotion strategies for all, they were seen as essential aspects of living that helped women have control over chronic pain and modifying the course of their episodic disability.

Conclusion:

Living with chronic pain and an episodic disability is complex. The findings of this study present the impact that gendered treatment in the healthcare system has on women who live with an episodic disability and experience chronic pain. It is evident that the current system did not meet the needs of the women in our study and system changes could result in better experiences, more disclosure of alternative therapies, and increase women’s agency in their care.
Gastrointestinal manifestations of SARS-CoV-2 infection in an Italian population of hospitalized patients
Authors: Milano Angelo , Efthymakis Konstantinos , D’Ardes Damiano , Tana Marco , Mazzotta Elena , De Febis Giulia , Laterza Francesco , Tarquini Pierluigi , Marini Enrico , Porreca Ettore , Cipollone Francesco , Neri Matteo
Published: June 2022

Background:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus enters the cells via angiotensin-converting enzyme 2 receptor; therefore, tissues expressing this receptor are potential targets for infection. Although many studies have observed gastrointestinal (GI) symptoms in coronavirus disease 2019 (COVID-19) patients, prevalence and clinical impact are still uncertain due to the heterogeneity of reports and obstacles to generalization.

Methods:

In this cross-sectional study, we included symptomatic patients requiring hospital admission, with a confirmed diagnosis of COVID-19 by nasopharyngeal polymerase chain reaction test, between 18 March and 30 May 2020. Demographic data, symptoms at onset, vital signs, and laboratory tests at admission were recorded.

Results:

In all, 300 patients were included (57%M, 43%F). GI symptoms were mainly diarrhea (13%), anorexia (4.3%), vomiting (3%), and abdominal pain (2.3%). Overall, males were younger (68 years versus 76 years; p = 0.01); patients with GI manifestations at disease onset required significantly faster hospital admission and showed larger GI complication rates. GI symptoms were associated with abnormal high aspartate aminotransferase and alanine aminotransferase serum titers, especially in male patients.

Conclusion:

Our study on an Italian population during the outbreak of the COVID-19 pandemic shows that GI symptoms are part of the spectrum of the SARS-CoV-2 infection and could be the only manifestations at disease onset. Although patients with GI symptoms were associated with faster hospital admission and liver involvement, prognosis was not affected.
Prediction of the generalization of myasthenia gravis with purely ocular symptoms at onset: a multivariable model development and validation
Authors: Li Feng , Zhang Hongbin , Tao Ya , Stascheit Frauke , Han Jiaojiao , Gao Feng , Liu Hongbo , Carmona-Bayonas Alberto , Li Zhongmin , Rueckert Jens-C. , Meisel Andreas , Zhao Song
Published: June 2022

Background:

About half of myasthenia gravis (MG) patients with purely ocular symptoms at onset progress to generalized myasthenia gravis (gMG).

Objectives:

To develop and validate a model to predict the generalization of MG at 6 months after disease onset in patients with ocular-onset myasthenia gravis (OoMG).

Methods:

Data of patients with OoMG were retrospectively collected from two tertiary hospitals in Germany and China. An accelerated failure time model was developed using the backward elimination method based on the German cohort to predict the generalization of OoMG. The model was then externally validated in the Chinese cohort, and its performance was assessed using Harrell’s C-index and calibration plots.

Results:

Four hundred and seventy-seven patients (275 from Germany and 202 from China) were eligible for inclusion. One hundred and three (37.5%) patients in the German cohort progressed from OoMG to gMG with a median follow-up time of 69 (32–116) months. The median time to generalization was 29 (16–71) months. The estimated cumulative probability of generalization was 30.5% [95% CI (confidence interval), 24.3–36.2%) at 5 years after disease onset. The final model, which was represented as a nomogram, included five clinical variables: sex, titer of anti-AChR antibody, status of anti-MuSK antibody, age at disease onset and the presence of other autoimmune disease. External validation of the model using the bootstrap showed a C-index of 0.670 (95% CI, 0.602–0.738). Calibration curves revealed moderate agreement of predicted and observed outcomes.

Conclusion:

The nomogram is a good predictor for generalization in patients with OoMG that can be used to inform of the individual generalization risk, which might improve the clinical decision-making.
Role of molecular imaging in the detection of localized prostate cancer
Authors: Galgano Samuel J. , West Janelle T. , Rais-Bahrami Soroush
Published: June 2022

Molecular imaging of prostate cancer continues to grow, with recent inclusion of several positron emission tomography (PET) radiotracers into the recent National Comprehensive Cancer Network guidelines and the US Food and Drug Administration approval of prostate-specific membrane antigen (PSMA)-targeted radiotracers. While much of the work for many of these radiotracers is focused on systemic staging and restaging in both newly diagnosed high-risk prostate cancer and biochemically recurrent disease patients, the potential role of molecular imaging for the detection of localized prostate cancer has not yet been fully established. The primary aim of this article will be to present the potential role for molecular imaging in the detection of localized prostate cancer and discuss potential advantages and disadvantages to utilization of both PET/computed tomography (CT) and PET/magnetic resonance imaging (MRI) for this clinical indication of use.