bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges faced by preservice and novice teachers in implementing student-centred models: A systematic review
Authors: Silva Rita , Farias Cláudio , Mesquita Isabel
Published: March 2021

The purpose of this study was to unpack the challenges and constraints encountered by preservice and novice teachers when implementing student-centred models, and to describe the methodological characteristics of research conducted on this topic between 2004 and 2020. The procedure had a three-step approach: (a) searching for publications in electronic databases; (b) selecting studies based on inclusion criteria; and (c) refining this selection to identify research-based papers. 29 articles were selected, most of which were from Europe and North America. The most researched model was Sport Education, and studies considering novice teachers were scarce. The predominant methodology across studies involved multiple qualitative data sources and inductive analysis. Our major finding was the identification of three themes reflecting distinct challenges to the implementation of student-centred models: (a) teacher-related challenges (i.e. pervasive beliefs, occupational socialization, managerial- and instruction-related); (b) student-related challenges (i.e. student resistance to engaged participation in student-centred models); and (c) external challenges (i.e. context- and environment-related). Physical education teacher education should invest in training preservice teachers to: (a) manage the dynamics of students’ cooperative interactions and peer-assisted learning; (b) design developmentally appropriate small-sided games and problem-solving contexts, and (c) scaffold the gradual transfer of responsibility to students for their engagement in persistent learning team activities. Longer studies and the inclusion of student perspectives will be particularly valuable for future investigations.
The impact of explicit strategy instruction on EFL secondary school learners’ reading
Authors: Chinpakdee Muthita , Gu Peter Yongqi
Published: March 2021

This article reports findings from a larger research project which aimed to promote learner autonomy among Thai secondary school learners of English as a foreign language (EFL) through strategy-based instruction (SBI). The study involved 30 learners from an intervention class and 32 learners from a comparison class. Nine strategies were introduced to the intervention class learners over a semester with the purpose of helping them develop essential skills for strategic and autonomous language learning. This article focuses on examining how explicit teaching of strategies in class affected learners’ reading scores and approaches to reading. It also observes the effects of SBI on learners’ perceptions of their ability to read English. Findings from the pre-, post- and delayed reading tests and think-aloud reading sessions showed significant increase in the intervention class learners’ reading test scores and their enhanced strategic approaches to reading. Group interviews further revealed learners’ positive attitudes towards English reading and increased confidence in their ability to manage their reading process independently. This article argues that explicit strategy instruction can help language learners develop essential strategic skills to process English texts. It also discusses how SBI can be effectively implemented in language classrooms.
Science under Covid-19’s magnifying glass: Lessons from the first months of the chloroquine debate in the French press
Authors: Schultz Émilien , Ward Jeremy K.
Published: March 2021

Since the beginning of the Covid-19 pandemic, all hopes are turned towards science. In this article, we put forward a qualitative analysis of how the French national press covered the issue of chloroquine and hydroxychloroquine during the first months, with a focus on the descriptions of the scientific world. We show that during epidemic outbreaks the various tensions existing within the scientific world are more likely to be presented to the public. In their coverage of hydroxychloroquine, journalists shed light on a variety of aspects of contemporary medical research, ranging from the way scientists approach a given drug, the stages of research on medical treatments, the types of proofs used and the institutional make-up of biomedical research. But in doing so they also presented a series of tensions and disagreements which devolved into public accusations of scientific misconduct and anti-science behaviours.
Public perceptions of how alcohol consumption is dealt with in Swedish and Norwegian health care
Authors: Karlsson Nadine , Skagerström Janna , O’Donnell Amy , Abidi Latifa , Thomas Kristin , Nilsen Per , Lid Torgeir Gilje
Published: March 2021

Aims:

The aims of this study were to evaluate and compare popular beliefs and attitudes regarding alcohol conversations in healthcare in Sweden and Norway; and to explore which factors were associated with different levels of support for alcohol-prevention work in the two countries.

Methods:

Population-based cross-sectional surveys were conducted in Sweden ( n = 3000) and Norway ( n = 1208). Logistic regression was used to identify the characteristics of participants who were supportive of routine alcohol screening and brief intervention delivery.

Results:

A higher proportion of Swedish respondents agreed to a large extent that healthcare professionals should routinely ask about alcohol consumption. In addition, a higher proportion of Swedish respondents compared to respondents from Norway agreed that healthcare providers should only ask about patient’s alcohol consumption if this was related to specific symptoms. There were similar correlates of being supportive of routine alcohol screening and brief intervention delivery in both countries. Support was lower in both countries amongst moderate and risky drinkers, and among single adults or those on parental leave, but higher amongst older individuals. Having had an alcohol conversation in healthcare increased the level of support for alcohol prevention in routine healthcare among risky drinkers.

Conclusions:

There is a high level of support for preventative alcohol conversations in routine healthcare in Norway and Sweden, although there was a lower proportion of respondents who were positive to alcohol prevention in routine healthcare in Norway compared to Sweden. Experiencing alcohol conversation may positively affect risky drinkers’ attitudes towards and support for alcohol prevention. Thus, more frequent alcohol conversations in routine healthcare may also result in increased level of support for alcohol prevention among risky drinkers.
Political implications of disconnection on social media: A study of politically motivated unfriending
Authors: Zhu Qinfeng , Skoric Marko M
Published: March 2021

This study examines the political implications of social media through the lens of digital disconnectivity. Specifically, it focuses on politically motivated unfriending and examines its influence on individuals’ political engagement, namely political expression and information consumption on social media. Furthermore, considering the importance of minority–majority relations for understanding disconnection phenomena, we investigate whether the impact of unfriending is more pronounced among opinion minorities than majorities. Using a two-wave panel survey conducted in the post-Umbrella Movement Hong Kong, we find that politically motivated unfriending predicts an increased level of political expression, but that it is only significant among people who perceive themselves as holding minority opinions. At the same time, we find no relationship between unfriending and information consumption on social media. Based on the findings, we discuss the implications of unfriending for building digital “safe spaces” and its distinct role in promoting political engagement in times of political conflicts.
Technology appropriation and Mapuche self-communication: An interpretation of indigenous e-communication in Chile
Authors: Rivera Claudio A Maldonado , del Valle Rojas Juan A
Published: March 2021

The use and appropriation of digital information and communication technologies by Mapuche communicators and activists has turned into a new process of political and identity innovation in the context of the Chilean–Mapuche intercultural and interethnic conflict. This study aims to understand the Mapuche intercultural dialogue. Based on a corpus of semi-structured interviews with Mapuche communicators, we interpret and analyze their discourses in relation to the dissemination and/or analysis of the indigenous digital informative media. The results are built upon the valorization and recognition of the mediations that the Mapuche agents develop around their own e-communication praxis. This interpretation derives from applying theoretical–conceptual categories which have enabled us to address technological, technopolitical, (inter)cultural, and communicative dimensions regarding the Mapuche e-communication work.
Numerical investigation on the effect of the vessel rolling angle and period on the energy harvest
Authors: Li Boyang , Zhang Rui , Yang Qingyong , Zhang Baoshou , Wang Longjin
Published: March 2021

In order to harvest effectively the mechanical energy produced in the process of vessel rolling, an energy harvest unit installed on the vessel is designed to utilize the mechanical energy. Firstly, the structure of the unit is proposed, and the relevant mathematical model is established. The solution of the mathematical model is given by Newmark- β method. Then, the influence of vessel rolling period and angle on the unit’s power and related parameters of the block is studied by MATLAB simulation. The results show that when the vessel is rolling, the energy harvest unit has a considerable power generation effect, the rolling period and angle of the vessel have a great impact on the power of the unit. Under the condition of the same period, the vessel with a larger rolling angle corresponds to larger peak gravity component, peak angular displacement, peak linear velocity of block and average power of the unit. In addition, under the same sea conditions, numerical simulations carried out on the rolling motion of 70,000, 100,000, and 150,000-ton bulk vessels and related parameters of the unit, indicating that the instantaneous power of the unit is not uniform in actual sea conditions, but it can output power continuously.
Investigation on the data augmentation using machine learning algorithms in structural health monitoring information
Authors: Tan Xuyan , Sun Xuanxuan , Chen Weizhong , Du Bowen , Ye Junchen , Sun Leilei
Published: March 2021

Structural health monitoring system plays a vital role in smart management of civil engineering. A lot of efforts have been motivated to improve data quality through mean, median values, or simple interpolation methods, which are low-precision and not fully reflected field conditions due to the neglect of strong spatio-temporal correlations borne by monitoring datasets and the thoughtless for various forms of abnormal conditions. Along this line, this article proposed an integrated framework for data augmentation in structural health monitoring system using machine learning algorithms. As a case study, the monitoring data obtained from structural health monitoring system in the Nanjing Yangtze River Tunnel are selected to make experience. First, the original data are reconstructed based on an improved non-negative matrix factorization model to detect abnormal conditions occurred in different cases. Subsequently, multiple supervised learning methods are introduced to process the abnormal conditions detected by non-negative matrix factorization. The effectiveness of multiple supervised learning methods at different missing ratios is discussed to improve its university. The experimental results indicate that non-negative matrix factorization can recognize different abnormal situations simultaneously. The supervised learning algorithms expressed good effects to impute datasets under different missing rates. Therefore, the presented framework is applied to this case for data augmentation, which is crucial for further analysis and provides an important reference for similar projects.
Early Surgical Intervention in Amniotic Band Sequence for Upper Extremity Motor Nerve Palsies: A Case Report
Authors: Mohan Ashwathi S. , Russo Stephanie A. , Pet Mitchell A.
Published: March 2021

Urgent surgical intervention for amniotic band sequence (ABS) is currently indicated for concerns of vascular compromise and progressive lymphedema. Peripheral motor nerve palsies are rare, and reports of surgical intervention in these cases describe persistent motor dysfunction. We report band release and ulnar, median, and radial nerve decompression in a 1-week-old with a severe upper extremity constriction band and signs of ulnar nerve motor dysfunction. A literature review on nerve exploration and outcomes of patients with motor nerve palsy from ABS was performed. Early evidence of ulnar motor function was observed at 5.5-month follow-up. Previous reports of nerve decompression for upper extremity constriction bands with motor nerve palsy document poor recovery after interventions beginning at 3 months of age. In this case, band release and nerve decompression were undertaken at 7 days of age, and we observed early motor recovery. This finding suggests that very early surgical intervention in the neonate may facilitate nerve recovery in appropriate candidates.
Anatomy of a rape: Sexual violence and secondary victimization scripts in U.S. film and television, 1959–2019
Authors: Hogan Jackie
Published: March 2021

The rape law reform movement in the U.S. has made significant progress since the 1970s. All fifty U.S. states and the District of Columbia have now made changes to their rape statutes. Nonetheless, the incidence of reported rape has increased substantially since the 1970s, and rape conviction rates have remained frustratingly low. Such statistical evidence suggests that amending legal statutes has not proven sufficient to curb endemic sexual violence in the U.S. Effective prevention requires a deeper understanding of rape culture, the conglomeration of discourses, ideologies, and practices that normalize sexual assault. Of particular interest here are mass mediated representations of rape, and their power to authorize or critique sexual violence, its root causes, and its consequences. This paper interrogates and seeks to disrupt rape culture by critically analyzing three media texts with narratives based on real-world cases of sexual violence and secondary victimization, the films Anatomy of a Murder, 1959 and The Accused, 1988 and the Netflix miniseries Unbelievable, 2019. With roughly thirty years between these texts, they provide snapshots of shifting attitudes and practices around sexual violence and secondary victimization in the U.S., from the pre-reform era to the #MeToo era. The analysis reveals some heartening changes but also some disturbing continuities in the real-world ideas and practices that media texts reflect and amplify.
Remaining useful life prediction method for machine tools based on meta-action theory
Authors: Mu Zongyi , Ran Yan , Zhang Genbao , Wang Hongwei , Yang Xin
Published: March 2021

Remaining useful life (RUL) is a crucial indictor to measure the performance degradation of machine tools. It directly affects the accuracy of maintenance decision-making, thus affecting operational reliability of machine tools. Currently, most RUL prediction methods are for the parts. However, due to the interaction among the parts, even RUL of all the parts cannot reflect the real RUL of the whole machine. Therefore, an RUL prediction method for the whole machine is needed. To predict RUL of the whole machine, this paper proposes an RUL prediction method with dynamic prediction objects based on meta-action theory. Firstly, machine tools are decomposed into the meta-action unit chains (MUCs) to obtain suitable prediction objects. Secondly, the machining precision unqualified rate (MPUR) control chart is used to conduct an out of control early warning for machine tools’ performance. At last, the Markov model is introduced to determine the prediction objects in next prediction and the Wiener degradation model is established to predict RUL of machine tools. According to the practical application, feasibility and effectiveness of the method is proved.
Advances in Insulin Pump Infusion Sets Symposium Report
Authors: Zhang Jennifer Y. , Shang Trisha , Chattaraj Sarnath , Cohen Ohad , Heschel Matthias , Vigersky Robert A. , Heinemann Lutz , Nørgaard Kirsten , Svensson Jannet , Buckingham Bruce , Klonoff David C.
Published: March 2021

Continuous subcutaneous insulin infusion (CSII) is becoming increasingly used for achieving target glycemic control as well as providing flexibility in lifestyle. In a widely used version of CSII, the insulin pump itself is attached to one end of an insulin infusion set (IIS), which delivers insulin via a thin flexible plastic tube to the patient’s body via a cannula or needle that is inserted under the skin at the other end of the IIS. Despite the increased use of CSII by patients with diabetes, there have been few recent advances in IIS technology, especially when compared to the many recent advances made in insulin pump technology and in insulin pharmacokinetics. To discuss recent developments in, and future plans for IIS development, Diabetes Technology Society virtually hosted the Advances in Insulin Pump Infusion Sets Symposium on December 1, 2020. This symposium featured experts in the field of IISs, including representatives from Medtronic and ConvaTec (which are two manufacturers that are currently developing IISs), Stanford University, Steno Diabetes Center Copenhagen, and Science Consulting in Diabetes. The webinar’s six speakers covered (1) patient burden, (2) extended wear technology, and (3) future directions in IIS development.
Treatment Outcomes in Aspirin-Exacerbated Respiratory Disease Based on the 12-Item Short Form Survey
Authors: Locke Tran B. , Sweis Auddie M. , Douglas Jennifer E. , Ig-Izevbekhai Kevin I. , Stevens Elizabeth M. , Civantos Alyssa M. , McCarty Elizabeth B. , Kumar Ankur , Kohanski Michael A. , Kennedy David W. , Palmer James N. , Bosso John V. , Adappa Nithin D.
Published: March 2021

Background

Aspirin-exacerbated respiratory disease (AERD) is optimally managed by endoscopic sinus surgery (ESS) followed by aspirin therapy after desensitization (ATAD). Most AERD quality of life (QOL) studies use the 22-item Sinonasal Outcomes Test (SNOT-22), which focuses predominantly on sinonasal outcomes.

Objective

This study seeks to assess QOL outcomes in AERD patients after ESS and ATAD via the 12-item Short Form Survey (SF-12), a well-validated QOL measure for general health status of chronic conditions.

Methods

Retrospective review of 112 AERD patients who underwent ESS followed by ATAD at our institution between 2016 and 2019. SF-12 was collected preoperatively, postoperatively/pre-AD, and serially post-AD (1–3, 4–6, 7–12, and >12 months). Optum® PRO CoRE software was used to compare data to national norms. ANOVA was performed comparing physical component summary (PCS), mental component summary (MCS) and eight health domains (physical functioning, role physical, general health, bodily pain, vitality, social functioning, role emotional, and mental health).

Results

AERD patients showed improvement in PCS scores across all timepoints after ESS and ATAD (p = 0.004). When stratified by gender, women demonstrated an improvement in PCS scores (p = 0.004). Within the domains, there were significant improvements in social functioning (SF), role physical (RP), and bodily pain (BP) at all timepoints (SF: p = 0.006; RP: p = 0.005; BP: p < 0.001).

Conclusions

AERD patients undergoing ESS and ATAD show improvement in physical QOL and 3 of the 8 health domains as measured by the SF-12. Future studies can use the SF-12 to study the impact of AERD treatment versus other chronic diseases and health demographics.
Retrospective cross sectional analysis of demographic disparities in outcomes of CPR performed by EMS providers in the United States
Authors: Hill Tess , Weber Thomas , Roberts Marshall , Garzon Hernando , Fraga Alvaro , Wetterer Craig , Puglisi Jose
Published: March 2021

Objective

To investigate demographic disparities in prehospital cardiopulmonary resuscitation (CPR) initiation and successful outcomes of patients with out-of-hospital cardiac arrest (OHCA) treated by emergency medical services (EMS) providers.

Methods

We analyzed the National Emergency Medical Service Information Systems (NEMSIS) 2017 database, analyzing patient gender, age and race against CPR initiation and Return of Spontaneous Circulation (ROSC). The analysis was performed for a subset of patients who received bystander interventions (n = 3,362), then repeated for the whole cohort of patients (n = 5,833).

Results

Within the subgroup of patients that received CPR or AED application prior to the arrival of the paramedics, a logistic regression for CPR initiation rates as a function of race, gender and age reported the following adjusted odds ratios: African American (AA) to White 0.570 (95%CI [0.419, 0.775]), Hispanic to White 0.735 (95%CI [0.470, 1.150]); female to male 0.768 (95%CI [0.598, 0.986]); senior to adult 0.708 (95%CI [0.545, 0.920). Similarly, a logistic regression of ROSC as a function of race, gender and age reported the following adjusted odds ratios: AA to White 0.652 (95%CI [0.533, 0.797]) Hispanic to White 1.018 (95%CI [0.783, 1.323]); female to male 0.887 (95%CI [0.767, 1.025]); senior to adult 0.817 (95%CI [0.709, 0.940]). Similar trends existed in the entire cohort of patients.

Conclusions

These results suggest that there are discrepancies in patient care during cardiopulmonary arrest performed by EMS for OHCA, inviting further exploration of healthcare differences in the prehospital EMS approach to OHCA.
A Qualitative Exploration of Implementation, Adaptation, and Sustainability of a School-Based Physical Activity Intervention: Move for Well-Being in School
Authors: Christiansen Lars B. , Clausen Kristine , Smedegaard Søren , Skovgaard Thomas
Published: March 2021

School-based physical activity can promote health and improve learning outcomes, but efforts to increase school physical activity have had limited success. This study evaluates the sustainability of a multicomponent school-based physical activity intervention and identifies important factors for implementation and sustainability. Results are based on focus group interviews with 18 teachers at five implementing schools 10 months after the termination of the intervention period. The intervention comprised components related to physical education, recess, and the classroom, and focuses on inclusion for all students. The descriptive analysis of the interviews shows that the intervention is sustained with variation, and activities are adapted differently at the five schools. The deductive content analysis, based on the Framework for Effective Implementation, reveals several important factors for sustainable implementation: School management plays an important role in setting a long-term perspective and giving the intervention priority by securing the necessary organizational infrastructure for implementation and sustainability. The teachers must find the intervention advantageous and to have clear requirements, which entail convincing communication and education by both external and internal intervention advocates. A collective start-up with training and easy-to-use materials should gradually be altered toward individual feedback and development of teachers’ personal curriculum.
Investigating the Adoption Factors of Cryptocurrencies—A Case of Bitcoin: Empirical Evidence From China
Authors: Nadeem Muhammad Athar , Liu Zhiying , Pitafi Abdul Hameed , Younis Amna , Xu Yi
Published: March 2021

The share of electronic transactions in the global payments continues to increase all around the globe. In the recent years, cryptocurrencies (also known as a system of electronic transaction) have caught significant attention from governments, policymakers, and practitioners worldwide. Cryptocurrencies as an innovative method of exchanges without any physical form boast several potential benefits such as speedy transactions, cross-border usage, low transaction fee, transparency, high security, anonymity, and privacy, and thus are expected to bring huge revolution in the future economic system. This study aims to investigate the adoption factors of Bitcoin, a most known cryptocurrency in China. Based on Technology Acceptance Model, a research framework has been developed to test the proposed hypotheses. The data have been collected via a survey questionnaire from 385 Chinese respondents. The findings show that the perceived ease of use and the perceived usefulness have a positive relationship with the intention to use Bitcoin. The perceived usefulness mediates the relationship between the perceived ease of use and the intention to use Bitcoin. Furthermore, the results reveal that the transaction processing and the perceived ease of use have significant impacts on the perceived usefulness. However, the security and control shows an insignificant effect on the perceived usefulness. This study contributes to the growing literature of Bitcoin and offers valuable information to individual users (payees), fund managers (investors), and companies/businesses (receiving Bitcoin as a payment method). Research implications and limitations are also discussed.
Exploring the Factors Affecting the Behavioral Intention of Visitors in Wine Festival: The Case of China Dalian International Wine and Dine Festival
Authors: Kabiraj Sajal , Upadhya Amitabh , Vij Anu
Published: March 2021

Wine-related festivals and events have emerged as a unique tourism product bringing not only economic value but also enhancing the brand image of a destination. China being the third largest wine-consuming country in the world has been organizing wine and food focused festivals which are participated by the residents as well as international visitors. Considering the size and scope of these events in China, this study explores the motivation behind participation in the wine festivals and investigates the influence of motivation factors on the perception of festivalscape, satisfaction, and behavioral intentions. The constructs of the study were framed after a thorough review of the literature. The findings of the study revealed that while primary and secondary motivations have a positive effect on the perception of food and wine, generic features, and fun; only primary motivation has a positive effect on satisfaction, whereas secondary motivation has a negative effect on satisfaction. It was also found that the perception of wine & food and fun has a positive impact on satisfaction, while the perception of generic features has no effect on satisfaction. The behavioral intentions were also found to be positively affected by satisfaction.
Tibial Tunnel Placement in ACL Reconstruction Using a Novel Grid and Biplanar Stereoradiographic Imaging
Authors: Montreuil Julien , Saleh Joseph , Cresson Thierry , De Guise Jacques A. , Lavoie Frédéric
Published: March 2021

Background:

Nonanatomic graft placement is a frequent cause of anterior cruciate ligament reconstruction (ACLR) failure, and it can be attributed to either tibial or femoral tunnel malposition. To describe tibial tunnel placement in ACLR, we used EOS, a low-dose biplanar stereoradiographic imaging modality, to create a comprehensive grid that combines anteroposterior (AP) and mediolateral (ML) coordinates.

Purpose:

To (1) validate the automated grid generated from EOS imaging and (2) compare the results with optimal tibial tunnel placement.

Study Design:

Descriptive laboratory study.

Methods:

Using EOS, 3-dimensional models were created of the knees of 37 patients who had undergone ACLR. From the most medial, lateral, anterior, and posterior points on the tibial plateau of the EOS 3-dimensional model for each patient, an automated and personalized grid was generated from 2 independent observers’ series of reconstructions. To validate this grid, each observer also manually measured the ML and AP distances, the medial proximal tibial angle (MPTA), and the tibial slope for each patient. The ideal tibial tunnel placement, as described in the literature, was compared with the actual tibial tunnel grid coordinates of each patient.

Results:

The automated grid metrics for observer 1 gave a mean (95% CI) AP depth of 54.7 mm (53.4-55.9), ML width of 75.0 mm (73.3-76.6), MPTA of 84.9° (83.7-86.0), and slope of 7.2° (5.4-9.0). The differences with corresponding manual measurements were means (95% CIs) of 2.4 mm (1.4-3.4 mm), 0.5 mm (–1.3 to 2.2 mm), 1.2° (–0.4° to 2.9°), and –0.4° (–2.1° to 1.2°), respectively. The correlation between automated and manual measurements was r = 0.78 for the AP depth, r = 0.68 for the ML width, r = 0.18 for the MPTA, and r = 0.44 for the slope. The center of the actual tibial aperture on the plateau was a mean of 5.5 mm (95% CI, 4.8-6.1 mm) away from the referenced anatomic position, with a tendency toward more medial placement.

Conclusion:

The automated grid created using biplanar stereoradiographic imaging provided a novel, precise, and reproducible description of the tibial tunnel placement in ACLR.

Clinical Relevance:

This technique can be used during preoperative planning, intraoperative guidance, and postoperative evaluation of tibial tunnel placement in ACLR.
How Patients Choose a Laryngologist: A Pilot Stated Preference Study
Authors: Fischman Victoria , Wittenberg Eve , Song Sungjin A. , Huston Molly N. , Franco Ramon A. , Song Phillip C. , Naunheim Matthew R.
Published: March 2021

Objective

Patients consider many factors when deciding how to receive medical care. This study used best‐worst scaling (BWS), a technique novel to otolaryngology, to quantitatively examine preferences among patients choosing a laryngologist. Our objective was to quantify in a pilot cohort the relative importance patients place on a variety of attributes when seeking a laryngologist.

Study Design

BWS survey.

Setting

Academic voice clinic.

Methods

New patients were recruited to take a computerized BWS survey developed using attributes derived from patient input, expert opinion, and literature review. Attributes were grouped into 4 categories: physician reputation, physician qualifications, hospital‐related factors, and other nonclinical factors. Responses were analyzed using multinomial logit regression to determine importance scores and associations with other variables.

Results

Eighty‐seven of 93 patients recruited participated (93.5% response rate). Physician qualifications were the most important attributes to patients, with specialty laryngology training receiving the highest importance score (20.8; 95% CI, 20.2 to 21.5; P <. 0001). Recommendations from referring physicians (15.6; 95% CI, 14.3 to 16.9) and use of cutting‐edge technology (11.9; 95% CI, 10.7 to 13.1) were the second and third most important, respectively. Least important were nonclinical factors, including wait time to get an appointment (4.3; 95% CI, 2.8 to 5.8) and convenience of office location (1.5; 95% CI, 0.9 to 2.1). Just over half of patients (51.2%) reported willingness to wait 4 weeks for an appointment with a laryngologist. Older patients were less concerned with convenience‐related factors.

Conclusion

Nonclinical factors were less important to patients than clinical factors, and laryngology‐specific training was paramount. Stated preference methodologies can elucidate underlying preferences and help providers make care more patient centered.
Assessing Change in Intervention Research: The Benefits of Composite Outcomes
Authors: Moreau David , Wiebels Kristina
Published: March 2021

Intervention research is often time- and resource-intensive, with numerous participants involved over extended periods of time. To maximize the value of intervention studies, multiple outcome measures are often included, either to ensure a diverse set of outcomes is being assessed or to refine assessments of specific outcomes. Here, we advocate for combining assessments, rather than relying on individual measures assessed separately, to better evaluate the effectiveness of interventions. Specifically, we argue that by pooling information from individual measures into a single outcome, composite scores can provide finer estimates of the underlying theoretical construct of interest while retaining important properties more sophisticated methods often forgo, such as transparency and interpretability. We describe different methods to compute, evaluate, and use composites depending on the goals, design, and data. To promote usability, we also provide a preregistration template that includes examples in the context of psychological interventions with supporting R code. Finally, we make a number of recommendations to help ensure that intervention studies are designed in a way that maximizes discoveries. A Shiny app and detailed R code accompany this article and are available at https://osf.io/u96em/ .
Responding to COVID-19’s impact on supervised family time: The supportive virtual family time model
Authors: Orlando Laura , Rousson Ashley N. , Barkan Susan , Greenley Kristen , Everitt Alyssa , Tajima Emiko A.
Published: March 2021

COVID-19 has put child wellbeing at risk, perhaps especially, for children and youth involved in the foster care system. For these children and youth, any stability they may have experienced since entering care has been disrupted and their contact with parents limited. A sudden shift to virtual only contact meant both parents and caregivers were in need of support to navigate these changes. This study reports on the rapid development and implementation of an eLearning and structured practice guide for visitation supervisors to help them facilitate virtual visits that promote parent-caregiver collaboration in support of the child. Over a four month period, April to August 2020, 140 people registered for the Supportive Virtual Family Time training. Of these participants, 101 (72%) completed a post-training survey which included an evaluation of the eLearning and assessment of the feasibility of implementing the model. Overall, participants were satisfied with the training content and delivery, agreed the training helped them develop new skills for interacting with parents and caregivers, and planned to start using the model right away. Given the ongoing and dynamic nature of the pandemic, there is likely continued need for virtual family time and training and support for supervisors who facilitate these interactions. It is critical these supports are timely, easily accessible, and include practice guidelines and resources that help practitioners facilitate and maintain youths’ critical attachments to their families. Given the potential benefits of supporting parent-caregiver collaboration, the model and accompanying materials address an overarching need in the field and remain relevant even after a return to in-person visitation.
The presence of emphysema on chest imaging and mid-life cognition
Authors: Henkle Benjamin E. , Colangelo Laura A. , Dransfield Mark T. , Hou Lifang , Jacobs David R. , Joyce Brian T. , Pistenmaa Carrie L. , Putman Rachel K. , Sidney Steve , Thyagarajan Bharat , Washko George R. , Yaffe Kristine , Kalhan Ravi , Kunisaki Ken M.
Published: March 2021

Background

Airflow obstruction is associated with cognitive dysfunction but studies have not assessed how emphysema, a structural phenotype of lung disease, might be associated with cognitive function independent from pulmonary function measured by spirometry. We aimed to determine the relationship between the presence of visually detectable emphysema on chest computed tomography (CT) imaging and cognitive function.

Methods

We examined 2491 participants, mean age of 50 years, from the Coronary Artery Risk Development in Young Adults study who were assessed for the presence of emphysema on chest CT imaging and had cognitive function measured 5 years later with a battery of six cognitive tests.

Results

Of those assessed, 172 (7%) had emphysema. After adjusting for age, sex, height, study centre, race, body mass index, education and smoking, visual emphysema was significantly associated with worse performance on most cognitive tests. Compared to those without emphysema, participants with emphysema performed worse on cognitive testing: 0.39sdunits lower (95% CI −0.53– −0.25) on the Montreal Cognitive Assessment, 0.27sdunits lower (95% CI −0.42– −0.12) on the Rey Auditory Verbal Learning Test, 0.29sdunits lower (95% CI −0.43– −0.14) on the Digit Symbol Substitution Test and 0.25sdunits lower (95% CI −0.42– −0.09) on letter fluency. Further adjustment for forced expiratory volume in 1 s (FEV1), peak FEV1and annualised FEV1decline did not attenuate these associations.

Conclusions

The presence of emphysema on chest CT is associated with worse cognitive function, independent of airflow obstruction. These data suggest that emphysema may be a novel risk factor for cognitive impairment.
Benefits of pulmonary rehabilitation in COVID-19: a prospective observational cohort study
Authors: Gloeckl Rainer , Leitl Daniela , Jarosch Inga , Schneeberger Tessa , Nell Christoph , Stenzel Nikola , Vogelmeier Claus F. , Kenn Klaus , Koczulla Andreas R.
Published: March 2021

Background

Coronavirus disease 2019 (COVID-19) can result in a large variety of chronic health issues such as impaired lung function, reduced exercise performance and diminished quality of life. Our study aimed to investigate the efficacy, feasibility and safety of pulmonary rehabilitation in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease.

Methods

Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive 3-week inpatient pulmonary rehabilitation programme were included in this prospective, observational cohort study. Several measures of exercise performance (6-min walk distance (6MWD)), lung function (forced vital capacity (FVC)) and quality of life (36-question short-form health survey (SF-36)) were assessed before and after pulmonary rehabilitation.

Results

50 patients were included in the study (24 with mild/moderate and 26 with severe/critical COVID-19). On admission, patients had a reduced 6MWD (mild: median 509 m, interquartile range (IQR) 426–539 m; severe: 344 m, 244–392 m), an impaired FVC (mild: 80%, 59–91%; severe: 75%, 60–91%) and a low SF-36 mental health score (mild: 49 points, 37–54 points; severe: 39 points, 30–53 points). Patients attended a median (IQR) 100% (94–100%) of all provided pulmonary rehabilitation sessions. At discharge, patients in both subgroups improved in 6MWD (mild/moderate: +48 m, 35–113 m; severe/critical: +124 m, 75–145 m; both p<0.001), FVC (mild/moderate: +7.7%, 1.0–17.8%, p=0.002; severe/critical: +11.3%, 1.0–16.9%, p<0.001) and SF-36 mental component (mild/moderate: +5.6 points, 1.4–9.2 points, p=0.071; severe/critical: +14.4 points, −0.6–24.5, p<0.001). No adverse event was observed.

Conclusion

Our study shows that pulmonary rehabilitation is a feasible, safe and effective therapeutic option in COVID-19 patients independent of disease severity.
Excess mortality and undertreatment in elderly lung cancer patients: treatment nihilism in the modern era?
Authors: Pham Jonathan , Conron Matthew , Wright Gavin , Mitchell Paul , Ball David , Philip Jennifer , Brand Margaret , Zalcberg John , Stirling Rob G.
Published: March 2021

Treatment of elderly patients with lung cancer is significantly hindered by concerns about treatment tolerability, toxicity and limited clinical trial data in the elderly; potentially giving rise to treatment nihilism amongst clinicians. This study aims to describe survival in elderly patients with lung cancer and explore potential causes for excess mortality.

Patients diagnosed with lung cancer in the Victorian Lung Cancer Registry between 2011–2018 were analysed (n=3481). Patients were age-categorised and compared using Cox-regression modelling to determine mortality risk, after adjusting for confounding. Probability of being offered cancer treatments was also determined, further stratified by disease stage.

The eldest patients (≥80 years old) had significantly shorter median survival compared with younger age groups (<60 years: 2.0 years; 60–69 years: 1.5 years; 70–79 years: 1.6 years; ≥80 years: 1.0 years; p<0.001). Amongst those diagnosed with stage 1 or 2 lung cancer, there was no significant difference in adjusted-mortality between age groups. However, in those diagnosed with stage 3 or 4 disease, the eldest patients had an increased adjusted-mortality risk of 28% compared with patients younger than 60 years old (p=0.005), associated with markedly reduced probability of cancer treatment, after controlling for sex, performance status, comorbidities and histology type (OR 0.24, compared with <60 years old strata; p<0.001).

Compared to younger patients, older patients with advanced-stage lung cancer have a disproportionately higher risk of mortality and lower likelihood of receiving cancer treatments, even when performance status and comorbidity are equivalent. These healthcare inequities could be indicative of widespread treatment nihilism towards elderly patients.
Safety data in randomised real-world evidence studies: Salford Lung Study learnings
Authors: Harvey Catherine , Woodcock Ashley , Vestbo J�rgen , Crim Courtney , Frith Lucy , Bakerly Nawar Diar , New John P. , Williams Claire , Elkhenini Hanaa , Majeed Nasir , Cardwell Glenn , Collier Susan , Jacques Loretta , Fletcher Joanne
Published: March 2021

Evidence to support clinical decision making must be based on safety data that have been captured, analysed and interpreted in a robust and reliable way. Randomised real-world evidence (RRWE) studies provide the opportunity to evaluate the use of medicines in patients and settings representative of routine clinical practice. However, elements that underpin the design of RRWE studies can have a significant impact upon the analysis, interpretation and implications of safety data.

In this narrative review, we use data from the Salford Lung Study; two prospective, 12-month, open-label, parallel-group, phase III randomised controlled trials conducted in primary care in the UK; to highlight the importance of capturing treatment modifications when attempting to evaluate safety events according to actual treatment exposure.

We demonstrate that analysing safety data by actual treatment received (
i.e.
accounting for the treatment modifications that occur routinely in the primary care setting) provides additional insight beyond analysing according to randomised treatment strategy only.

It is therefore proposed that understanding of safety data from RRWE trials can be optimised by analysing both by randomised group and by actual treatment received.
evALLution: making basic evolution concepts accessible to people with visual impairment through a multisensory tree of life
Authors: Laurentino Telma G. , Xavier Marisa , Ronco Fabrizia , Pina-Martins Francisco , Domingues Iolanda , Penha Bruno , Dias Marta , de Sousa Alexandra , Carrilho Tiago , Rodrigues Leonor R. , Pinheiro Carlota , Rato Daniela , Balata Duarte , Ayala-Botto Gonçalo , Matos Margarida , Campelo Maria , Botelho Rafael
Published: March 2021

Background

People with visual impairment have benefitted from recent developments of assistive technology that aim to decrease socio-economic inequality. However, access to post-secondary education is still extremelly challenging, especially for scientific areas. The under representation of people with visual impairment in the evolution research community is connected with the vision-based communication of evolutionary biology knowledge and the accompanying lack of multisensory alternatives for learning.

Results

Here, we describe the development of an inclusive outreach activity based on a multisensory phylogeny representing 20 taxonomic groups. We provide a tool kit of materials and ideas that allow both the replication of this activity and the adaptation of others, to include people with visual impairment. Furthermore, we provide activity evaluation data, a discussion of the lessons learned and an inclusive description of all figures and visual data presented.

The presented baseline data show that people with visual impairment indeed have lack of access to education but are interested in and apt to understand evolutionary biology concepts and predict evolutionary change when education is inclusive.

Conclusions

We show that, with creative investment, basic evolutionary knowledge is perfectly possible to be transmitted through multisensory activities, which everyone can benefit from. Ultimately, we hope this case study will provide a baseline for future initiatives and a more inclusive outreach community.
Effects of maternal exposure to arsenic on social behavior and related gene expression in F2 male mice
Authors: Htway Soe-Minn , Suzuki Takehiro , Kyaw Sanda , Nohara Keiko , Win-Shwe Tin-Tin
Published: March 2021

Background

Arsenic is a developmental neurotoxicant. It means that its neurotoxic effect could occur in offspring by maternal arsenic exposure. Our previous study showed that developmental arsenic exposure impaired social behavior and serotonergic system in C3H adult male mice. These effects might affect the next generation with no direct exposure to arsenic. This study aimed to detect the social behavior and related gene expression changes in F2 male mice born to gestationally arsenite-exposed F1 mice.

Methods

Pregnant C3H/HeN mice (F0) were given free access to tap water (control mice) or tap water containing 85 ppm sodium arsenite from days 8 to 18 of gestation. Arsenite was not given to F1 or F2 mice. The F2 mice were generated by mating among control F1 males and females, and arsenite-F1 males and females at the age of 10 weeks. At 41 weeks and 74 weeks of age respectively, F2 males were used for the assessment of social behavior by a three-chamber social behavior apparatus. Histological features of the prefrontal cortex were studied by ordinary light microscope. Social behavior-related gene expressions were determined in the prefrontal cortex by real time RT-PCR method.

Results

The arsenite-F2 male mice showed significantly poor sociability and social novelty preference in both 41-week-old group and 74-week-old group. There was no significant histological difference between the control mice and the arsenite-F2 mice. Regarding gene expression, serotonin receptor 5B (5-HT 5B) mRNA expression was significantly decreased (p < 0.05) in the arsenite-F2 male mice compared to the control F2 male mice in both groups. Brain-derived neurotrophic factor (BDNF) and dopamine receptor D1a (Drd1a) gene expressions were significantly decreased (p < 0.05) only in the arsenite-F2 male mice of the 74-week-old group. Heme oxygenase-1 (HO-1) gene expression was significantly increased (p < 0.001) in the arsenite-F2 male mice of both groups, but plasma 8-hydroxy-2′-deoxyguanosine (8-OHdG) and cyclooxygenase-2 (COX-2) gene expression were not significantly different. Interleukin-1β (IL-1β) mRNA expression was significantly increased only in 41-week-old arsenite-F2 mice.

Conclusions

These findings suggest that maternal arsenic exposure affects social behavior in F2 male mice via serotonergic system in the prefrontal cortex. In this study, COX-2 were not increased although oxidative stress marker (HO-1) was increased significantly in arsnite-F2 male mice.
Correction to: Quantum dots as targeted doxorubicin drug delivery nanosystems in human lung cancer cells
Authors: Ruzycka-Ayoush Monika , Kowalik Patrycja , Kowalczyk Agata , Bujak Piotr , Nowicka Anna M. , Wojewodzka Maria , Kruszewski Marcin , Grudzinski Ireneusz P.
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.