bluuebunny/crossref_metadata_2025 huggingface dataset:
An Objective Measure of Decisional Clarity to Assess Decision Aid Effectiveness in Situations with Equipoise: A Randomized Trial
Authors: Witt Jessica K.
Published: March 2022

Background

Decision aids can help patients make medical decisions, which is especially advantageous in situations with equipoise. However, when there is no correct answer, it is difficult to assess whether a decision aid is helpful. The goal of this research is to propose and validate an objective method for measuring decision aid effectiveness by quantifying the clarity participants achieved when making decisions.

Design

The measure of decisional clarity was tested in a convenience sample of 131 college-aged students making hypothetical decisions about 2 treatment options for depression and anxiety. The treatments varied with respect to potential benefits and harms. Information was presented numerically or with an accompanying data visualization (an icon array) that is known to aid decision making.

Results

Decisional clarity was better with the icon arrays. Furthermore, the results showed that decisional clarity can be used to identify situations for which patients will be more likely to struggle making their decision. These included situations for which financial considerations were relevant to the decision and situations for which the probabilities of potential benefits were higher.

Limitations

The measure of decisional clarity and the situations identified as lacking clarity should be validated with a larger, more representative sample.

Conclusions

These findings demonstrate that decisional clarity can be used to both empirically evaluate the effectiveness of a decision aid as well as test factors that can cloud clarity and disrupt medical decision making.

Implications

Researchers and medical providers interested in developing decision aids for situations with equipoise can use decisional clarity as an objective measure to assess the effectiveness of their decision aid. Financial considerations and higher probabilities may also cloud judgments.

Highlights

An objective measure of decisional clarity is supported. Decisional clarity can be used to evaluate decision aids in the context of equipoise for which there is no objectively correct choice. Decisional clarity can also be used to identify scenarios for which patients are likely to struggle to make a medical decision.
Socially Responsible (Macro-Social) Marketing
Authors: Kennedy Ann-Marie , Smith Johnpaul
Published: March 2022

In Laczniak and Shultz’s (2021) article explicating Socially Responsible Marketing (SRM), they provide the argument for marketers (and their organizations) to act to benefit society. Organizations should actively seek, when given the opportunity, to increase positive social outcomes through addressing wicked problems. Those objectives are shared by social marketers and macro-social marketers ( Kennedy 2016 ). The authors state that SRM is most important for commercial marketers as social marketers inherently incorporate social values into their work. However, this does not take into account ethical issues ( Kennedy and Santos 2019 ; Eagle 2009 ) and the increasing controversy surrounding behavior change. We argue that SRM is both necessary and applicable to social marketers within a macro-social marketing context. We first explain the need for such an approach in social marketing. Next, we discuss ethical approaches to social marketing in order to establish the appropriateness of distributive justice and any additional ethical approaches. Finally, we apply each guiding element (Corporate Citizenship, Stakeholder Orientation, and Social and Ecological Sustainability) to the context of macro-social marketing, with a brief statement on the applicability of constructive engagement and the necessity for future research in that area.
Macromarketing Our Way to a Zero-carbon Future
Authors: Helm Sabrina , Little Vicki
Published: March 2022

The role of marketing in climate change is one of the most pressing, and yet understudied, issues of our time. While climate change forms part of the wider sustainability canon, it transcends issues-based scholarship. Macromarketers are ideally suited to taking on this challenge. This special section takes a step towards addressing the current shortfall in knowledge by creating the first collection of macromarketing work addressing marketing's role in the climate emergency. Reflecting the nature of sustainability (nascent, complex, diffuse, diverse), the three papers take widely different approaches; examining the interactions between markets, communities and the environment. Drawing on action research, case study and experimental data, the author teams explore systems interactions in fishing communities, marketing strategy in the fashion industry, and anti-consumption initiatives in social media respectively. The guest editors call on all marketers to build on this important work, and to help pivot our discipline towards a necessary zero carbon future.
Safety, efficacy, and mid-term oncological outcomes of computed tomography-guided cryoablation of T1 renal cancer
Authors: Duus Louise A , Junker Theresa , Rasmussen Benjamin S , Bojsen Jonas A , Pedersen Allan L , Anthonsen Andrea , Lund Lars , Pedersen Michael , Graumann Ole
Published: March 2022

Background

Cryoablation is a promising minimally invasive, nephron-sparing treatment of small renal carcinoma (RCC) in co-morbid patients.

Purpose

To assess the safety, efficacy, and cancer-specific outcomes of computed tomography (CT)-guided cryoablation of stage T1 (RCC).

Material and Methods

A retrospective evaluation of 122 consecutive patients with 128 tumors treated with cryoablation during 2016–2017. All patients had biopsy-verified T1 RCC.

Results

Median age was 69 years (IQR=59–76); 69% were male. Median tumor size was 26 mm (± 20–33); 9% were stage T1b. Mean follow-up time was 36.3±12.0 months. In total, 14 (11%) procedures led to complications, of which 4 (3%) were intraoperative, 5 (4%) appeared ≤30 days and 5 (4%) >30 days after treatment. Major complications arose after 4 (3%) procedures. Statistically significant associations were found between major complications and stage T1b ( P = 0.039), RENAL score ( P = 0.010), and number of needles used in cryoablation ( P = 0.004). Residual tumor was detected after 4 (3%) procedures and 5 (4%) tumors had local tumor progression. Of 122 patients, 3 (2%) advanced to metastatic disease. Significant statistical associations were found between local tumor progression and T1b stage tumors and number of needles used in cryoablation ( P = 0.05 and P = 0.004, respectively). For patients with T1a tumors, the one- and three-year disease-free survival was 98% and 95%, respectively, and for T1b 100% after one year and 75% after three years.

Conclusions

This study showed that cryoablation is a safe and effective treatment of stage T1 RCC and suggests that in selecting candidates for cryoablation of RCC, the tumor characteristics are more critical than patients’ baseline health status.
Empathy but not musicality is at the root of musical reward: A behavioral study with adults and children
Authors: Carraturo Giulio , Ferreri Laura , Vuust Peter , Matera Flavia , Brattico Elvira
Published: March 2022

Music is one of the most pleasurable human experiences. However, the determinants of the variation in individual sensitivity to musical reward are not yet fully unraveled. Empathy has been identified as a determinant of musical affect, including consciously experiencing pleasure from listening to sad music. Additionally, higher musical expertise may enhance pleasurable responses to music, whereas aging decreases individual sensitivity to musical pleasure. We conducted a study to investigate the contribution of empathy and musical abilities on musical pleasure, measured by Interpersonal Reactivity Index, Musical Ear Test, and Barcelona Musical Reward Questionnaire, respectively. To this purpose, we performed a developmental comparison between 48 children (9–11 years old) and 42 adults (18–32 years old). Our findings suggest that individual sensitivity to musical reward is positively correlated with empathy trait in both adults and children, but not with musical abilities. However, when inserted in a regression model including empathy, musical abilities are also predictive of musical reward, but only among adults. These results show that empathy plays a crucial role in determining the individual sensitivity to music reward, whereas musical abilities are less influential. More broadly, this study contributes to shed light on the determinants of the emotional responses to music affect.
When craft kicks back: Embryo culture as knowledge production in the context of the transnational fertility industry
Authors: Helosvuori Elina , Homanen Riikka
Published: March 2022

The multibillion-dollar fertility industry promotes standardization in in vitro fertilization laboratories. Transnational pharmaceutical and biotechnological giants distribute a wide range of fertility products, from embryo culture mediums and incubator technologies to add-ons such as time-lapse embryo monitoring. These technologies are designed to standardize and automate knowledge production regarding embryonic viability. More effective knowledge production enables the more effective selection of embryos for transfer, which in turn leads to more future babies and enables economic scaling-up. Drawing on two multi-sited ethnographic studies at eight fertility clinics in Finland during 2013–2020, this article discusses how knowledge about embryos is produced in the processes and practices of embryo culture. We argue that automation and standardization in clinical practice are not always perceived as economically desirable. Sometimes standard technologies do not replace hands-on knowledge production, although they may transform it. The technologies are also perceived as modifying the object of knowledge itself in undesired or unnecessary ways. In such cases, concerns are raised regarding the best interests of patients, embryos and future babies, who might be better served by masterful laboratory craftwork. We conclude that embryo culture is not only a site of knowledge production – one that aims to make babies and parents through standard and craftwork knowledge practices – but also a site of multiple bio-economies of assisted reproduction, some of which resist automation and standardization.
Mega-urban politics: Analyzing the infrastructure turn through the national state lens
Authors: Shatkin Gavin
Published: March 2022

Recent studies have focused attention on the proliferation of plans in the Global South for massive infrastructure investment to accelerate peri-urbanization and link together networks of proximate cities. This paper proposes that a focus on the national politics of the infrastructure push is an essential starting point to understand this trend, both because the national state plays a constitutive role in the processes that are shaping emerging urbanity, and because national states are themselves being transformed by this moment. In pursuing infrastructure-driven extended urbanization, national state actors seek to capitalize on moments of opportunity presented by shifts in the investment priorities of transnational financial actors, and by advances in infrastructure and logistics technologies, to gain power through the formation of political regimes based on economic growth and the distribution of rents from land development. Hence extended urbanization proceeds not as a gradual and linear process, but is instead marked by waves of disruptive and politically contentious reforms and plans intended to enable real estate, infrastructure, and logistics megaprojects. The current wave of political projects around extended urbanization is marked by distinct features, including the increasingly fragmented and decentered nature of transnational finance, and geopolitical dynamics associated with the emergence of an increasingly polycentric global order. It is consequently marked by geopolitical competition to shape emergent state agendas of extended urbanization, and by increasing variegation in the models of infrastructure-driven extended urbanization that state actors adopt. The paper illustrates these arguments with examples from Southeast Asia's mega-urban regions.
A review of international education literature: Interdisciplinary and discovery challenges
Authors: Saubert Shanna , Cooper Liz
Published: March 2022

The discovery of relevant research in the field of international education can be difficult due to the nature of the field and how scholarly work is indexed. This article presents a review of published international education literature to identify key topics and publication patterns, along with potential gaps and inequities in current scholarly discourse. Using the keywords “international education” and “global education,” the analyses focus on records retrieved from Web of Science. Of the 1492 peer-reviewed journal articles reviewed (published from 1991 to 2017), the analyses revealed only 705 articles relevant to the field of international education. Additional analyses of bibliometric data show a significant increase in international education publication over the past two decades; evolving trends regarding topical foci and methods; and publication disparities regarding national contexts and languages outside the Global North/anglophone-dominated discourse. The article concludes with recommendations to improve discoverability, better connect various areas of international education research, and expand scholarly discourse to include more diverse representation.
On not knowing and paying attention: How to walk in a possible world
Authors: Ingold Tim
Published: March 2022

Knowledge and wisdom often operate at cross-purposes. In particular, wisdom means turning towards the world, paying attention to the things we find there, while with knowledge we turn our backs on them. Knowledge thrives on certainty and predictability. But in a certain world, where everything is joined up, nothing could live or grow. If a world of life is necessarily uncertain, it also opens up to pure possibility. To arrive at such possibility, however, we have to rethink the relation between doing and undergoing, or between intentional and attentional models of action. I show how attention cuts a road longitudinally through the transverse connections between intentions and their objects. Where intention is predictive, attention is anticipatory. And if the other side of prediction is the failure of ignorance, the other side of anticipation is the possibility of not knowing. The idea that predictive knowledge demands explication perpetuates the equation of not-knowing with ignorance. Education, science and the state are powerful machines for the production of ignorance. I argue, however, that ignorance and not-knowing are entirely different things. In a world of life, not-knowing betokens not ignorance but the wisdom that lies in attending to things.
Virtual care and health technology assessment considerations
Authors: Cooper-Jones Brit , Mason Jeff , Kamel Chris , Mittmann Nicole , Dunfield Lesley
Published: March 2022

The COVID-19 pandemic resulted in a rapid adoption of virtual care. Virtual care existed before the pandemic for specific conditions and circumstances. Health Technology Assessment (HTA) of virtual care evaluated clinical and cost-effectiveness to inform decisions about the optimal use prior to the pandemic but the necessary implementation of virtual care during the pandemic meant HTA was not feasible prior to adoption. The questions for HTA no longer focused on clinical or cost-effectiveness and focused on implementation considerations. Health technology assessment post-adoption of virtual care included questions such as the appropriate medical conditions for virtual care, training, billing, patient and clinician perspectives and experiences, and equity of access. Moving forward, it is important for HTA organizations to identify new and emerging virtual care technologies, explore early and other types of evidence, assess the potential impact on the healthcare system, and explore the operational considerations.
High-Risk Contexts for Violence Against Women: Using Latent Class Analysis to Understand Structural and Contextual Drivers of Intimate Partner Violence at the National Level
Authors: Brown Laura J , Lowe Hattie , Gibbs Andrew , Smith Colette , Mannell Jenevieve
Published: March 2022

Introduction: Intimate partner violence (IPV) affects 1 in 3 women and poses a major human rights threat and public health burden, yet there is great variation in risk globally. Whilst individual risk factors are well-studied, less research has focussed on the structural and contextual drivers of IPV and how these co-occur to create contexts of high risk. Methods: We compiled IPV drivers from freely-accessible global country-level data sources and combined gender inequality, natural disasters, conflict, colonialism, socioeconomic development and inequality, homicide and social discrimination in a latent class analysis, and identified underlying ‘risk contexts’ based on fit statistics and theoretical plausibility (N=5,732 country-years; 190 countries). We used multinomial regression to compare risk contexts according to: proportion of population with disability, HIV/AIDS, refugee status, and mental health disorders; proportion of men with drug use disorders; men’s alcohol consumption; and population median age (N=1,654-5,725 country-years). Finally, we compared prevalence of physical and/or sexual IPV experienced by women in the past 12 months across risk contexts (N=3,175 country-years). Results: Three distinct risk contexts were identified: 1) non-patriarchal egalitarian, low rates of homicide; 2) patriarchal post-colonial, high rates of homicide; 3) patriarchal post-colonial conflict and disaster-affected. Compared to non-patriarchal egalitarian contexts, patriarchal post-colonial contexts had a younger age distribution and a higher prevalence of drug use disorders, but a lower prevalence of mental health disorders and a smaller refugee population. IPV risk was highest in the two patriarchal post-colonial contexts and associated with country income classification. Conclusions: Whilst our findings support the importance of gender norms in shaping women’s risk of experiencing IPV, they also point towards an association with a history of colonialism. To effectively address IPV for women in high prevalence contexts, structural interventions and policies are needed that address not only gender norms, but also broader structural inequalities arising from colonialism.
Assessment and selection of filler compounds for radiopaque PolyJet multi-material 3D printing for use in clinical settings
Authors: Shannon Alice , O’Sullivan Kevin J , Clifford Seamus , O’Sullivan Leonard
Published: March 2022

The aim of this research was to assess a selection of radiopaque filler compounds for increasing radiopacity in a resin suitable for Polyjet multi-material 3D printing. A radiopaque resin has potential applications in medicine to produce patient-specific anatomical models with realistic radiological properties, training aids, and skin contacting components such as surgical or procedural guides that require visibility under fluoroscopy. The desirable filler would have a high level of radiopacity under ionising imaging modalities, such as X-ray, CT, fluoroscopy or angiography. Nine potential filler compounds were selected based on atomic number and handling risk: barium sulphate, bismuth oxide, zirconium oxide, strontium oxide, strontium fluoride, strontium carbonate, iodine, niobium oxide and tantalum oxide. The fillers were evaluated using selected criteria. A weighted material selection matrix was developed to prioritise and select a filler for future 3D printing on a multi-material 3D printer. Zirconium oxide was the highest scoring filler compound in the material selection matrix, scoring 4.4 out of a maximum of 5. MED610TM resin doped with zirconium oxide was shown to be UV curable, and when cured is non-toxic, environmentally friendly, and has the ability to display antimicrobial properties. In terms of radiopacity, a sample with thickness 1.5 mm of MED610™ resin doped with 20 wt.% zirconium oxide produced X-ray radiopacity equivalent to 3 mm of aluminium. Zirconium oxide was selected using the material selection matrix. This radiopaque resin can be used to produce anatomical models with accurate radiological properties, training aids or skin contacting devices that require visibility under ionising imaging modalities. The 3D printing validation run successfully demonstrated that the material selection matrix prioritised a filler suitable for radiopaque multi-material 3D printing.
Psychoanalysis, thermodynamics, and the matter of scarcity: A genealogy of Freud’s death drive hypothesis
Authors: Massot Arthur
Published: March 2022

In his 1920 essay, “Beyond the Pleasure Principle,” Freud (1920/1955a) introduced the death drive hypothesis, according to which “the aim of all life is death” (p. 38). I shall not discuss the truth value of this hypothesis here; instead, I trace its genealogy in order to understand it as a moment in the history of modern Western societies. First, I present Freud’s metapsychology, and in particular its economic dimension, the death drive being central to this dimension. Second, I retrace the history of the concept of energy and of the formulation of the laws of thermodynamics in the 19th century. Energetics and thermodynamics are shown to have been important to the Freudian economic dimension. Further, I show that for 19th-century scientists, the concern for energy reflected a socioeconomic preoccupation with the matter of scarcity. Lastly, I argue that Freud’s relationship to energy, as expressed in the death drive hypothesis, also reflected a certain relationship of Western countries to scarcity in the era of the second industrial revolution.
International Students in Norway: Satisfaction, Coping and Social Networks
Authors: Wiers-Jenssen Jannecke
Published: March 2022

In this paper we consider the experiences of international students studying in Norway, analysing data from more than 5,000 survey respondents. Variations according to students’ region of origin and whether they are full degree students or exchange students are the focus. Students report a high level of overall satisfaction, exchange students in particular, and the vast majority of students are content with the quality of teaching. Students from the African continent report being more content than others, despite struggling somewhat more with academic demands and having weaker social networks, something they have in common with Asian students. Multivariate analyses show that type of mobility (full degree cf. exchange), region of origin, coping with academic demands, satisfaction with teaching and interaction with Norwegians are predictors of overall satisfaction with studying in Norway. The patterns observed are assumed to be related to prior experiences and expectations.
Implications of Dorsalis Pedis Artery Anatomical Variants for Dorsal Midfoot Surgery
Authors: Tonogai Ichiro , Tsuruo Yoshihiro , Sairyo Koichi
Published: March 2022

Background:

The dorsalis pedis artery (DPA) usually branches into the arcuate artery (AA) from its lateral side which in turn crosses the bases of the lateral four metatarsals. The DPA then passes into the first interosseous space, where it divides into the first metatarsal artery and the deep plantar artery. In this study, we aimed to determine the extent of variation in the DPA and the distance between the AA and the tarsometatarsal (TMT) joint with the aim of reducing the risk of vascular complications arising from dorsal midfoot surgery.

Methods:

In 29 fresh cadaveric feet, we examined the course of the DPA and the distance between the AA and the TMT joint on computed tomography images with barium sulfate contrast.

Results:

The DPA was observed to have a standard course in 11 of the 29 cases (37.9%) but did not give rise to the AA and lateral tarsal artery or branches of the plantar arterial arch supplying to the second to fourth metatarsal spaces in 10 of 29 cases (34.5%). The mean closest distance from the TMT joint to the AA at the second, third, and fourth metatarsal level in the sagittal plane was 11.4, 14.6, and 17.1 mm, respectively.

Conclusion:

We found substantial variation in the arterial anatomy of the DPA system across the dorsal midfoot.

Clinical Relevance:

The risk of pseudoaneurysm and frank arterial disruption may be mitigated if the surgeon is aware of the variations of the course of the DPA when performing dorsal midfoot surgery.
Officer-Involved Killings and the Repression of Protest
Authors: Burch Traci
Published: March 2022

This article explores the likelihood that officer-involved killings affect protest. Analyzing respondents to the Collaborative Multiracial Political Survey (CMPS) reveals no increases in protest activity between treatment groups exposed to officer-involved killings in their local area prior to participating in the survey and control groups who were exposed to officer-involved killings after survey participation overall. In fact, local exposure to Black victims appears to repress protest, but only among young Black respondents. This effect depends on the characteristics of the victim and the incident, as killings of low threat Black victims do not seem to repress protest.
An asymptotic modeling and resolution framework for morphology evolutions of multiple-period post-buckling modes in bilayers
Authors: Fu Chenbo , Cheng Zhe , Wang Ting , Xu Fan
Published: March 2022

A stiff thin film bonded to a compliant substrate initially buckles into wrinkles, following with some intricate advanced instability modes when the compression exceeds higher thresholds. Here, we present an asymptotic modeling and resolution framework to quantitatively predict and continuously trace secondary bifurcation transitions in the non-linear post-buckling region. An advantage of this framework, besides its applicability to finite-strain deformations, is its asymptotic consistency with the three-dimensional (3D) field equations and interface continuity conditions in a pointwise manner. Based on our model, we reveal intricate post-buckling responses involving successive advanced mode transitions, i.e., period-doubling, period-tripling, period-quadrupling, ridge, and hierarchical wrinkles in film–substrate bilayers upon excess compression. Apart from modulus ratio, pre-stretch and pre-compression of the substrate can alter surface morphology of film–substrate bilayers. With substrate pre-compression, a bilayer may eventually involve into a period-tripling or period-quadrupling mode. We observe hierarchical wrinkles and ridges in films attached on pre-stretched substrates. With high substrate pre-tension and modulus ratio, a novel pattern, namely, periodic ridges, appears at the secondary bifurcation. Fundamental understanding and quantitative prediction of non-linear morphology evolutions of soft bilayers play important roles in rational designs of wrinkle-tunable functional surfaces.
Investigating the potential disease-modifying and neuroprotective efficacy of exercise therapy early in the disease course of multiple sclerosis: The Early Multiple Sclerosis Exercise Study (EMSES)
Authors: Riemenschneider Morten , Hvid Lars G , Ringgaard Steffen , Nygaard Mikkel Karl Emil , Eskildsen Simon Fristed , Gaemelke Tobias , Magyari Melinda , Jensen Henrik Boye , Nielsen Helle Hvilsted , Kant Matthias , Falah Masoud , Petersen Thor , Stenager Egon , Dalgas Ulrik
Published: March 2022

Background:

Potential supplemental disease-modifying and neuroprotective treatment strategies are warranted in multiple sclerosis (MS). Exercise is a promising non-pharmacological approach, and an uninvestigated ‘window of opportunity’ exists early in the disease course.

Objective:

To investigate the effect of early exercise on relapse rate, global brain atrophy and secondary magnetic resonance imaging (MRI) outcomes.

Methods:

This randomized controlled trial ( n = 84, disease duration <2 years) included 48 weeks of supervised aerobic exercise or control condition. Population-based control data (Danish MS Registry) was included ( n = 850, disease duration <2 years). Relapse rates were obtained from medical records, and patients underwent structural and diffusion-kurtosis MRI at baseline, 24 and 48 weeks.

Results:

No between-group differences were observed for primary outcomes, relapse rate (incidence-rate-ratio exercise relative to control: (0.49 (0.15; 1.66), p = 0.25) and global brain atrophy rate (−0.04 (−0.48; 0.40)%, p = 0.87), or secondary measures of lesion load. Aerobic fitness increased in favour of the exercise group. Microstructural integrity was higher in four of eight a priori defined motor-related tracts and nuclei in the exercise group compared with the control (thalamus, corticospinal tract, globus pallidus, cingulate gyrus) at 48 weeks.

Conclusion:

Early supervised aerobic exercise did not reduce relapse rate or global brain atrophy, but does positively affect the microstructural integrity of important motor-related tracts and nuclei.
Predicting health behaviors across Belgium and France during the first wave of COVID-19 pandemic
Authors: Schmitz Mathias , Wollast Robin , Bigot Alix , Luminet Olivier
Published: March 2022

The objective of the current research was to investigate how a series of psychological factors may underlie two COVID-19 health behaviors, and how a contextual factor (country of residence) could shape their influence. Cross-sectional results from the first pandemic wave ( NBelgium = 4878, NFrance = 1071) showed that handwashing and social contacts limitation are predicted by a unique set of psychological variables that holds across Belgium and France, despite their distinct lockdown-policies strictness. In practice, policy-makers could leverage on these unique predictors and fine-tune their strategies accordingly to promote adherence to each measure while generalizing it across similar nations.
The spectrum of attitudes towards the spectrum of autism and its relationship to psychological distress in mothers of children with autism
Authors: Ferenc Kinga , Byrka Katarzyna , Król Magdalena Ewa
Published: March 2022

Attitude of mothers towards their children’s autism may play a role in mothers’ psychological well-being. We investigated the predictive value of how mothers understand autism (as a neurodivergence or a developmental disorder) on their psychological distress. A group of 371 mothers of children on the autism spectrum participated in this study. We found that understanding autism as a neurodivergence was related to lower psychological distress in mothers, even after controlling for the level of autism symptoms. However, when controlling for caregiver burden, their attitude towards autism was no longer significant in explaining their psychological distress. These findings suggest that the way mothers understand autism may be important for their psychological adjustment. However, it also suggests that mothers of children on the autism spectrum may adopt different attitudes towards autism, depending on their child’s level of autism symptoms and the caregiver burden.

Lay abstract

Mothers of children on the autism spectrum experience high levels of emotional distress. Mothers cope with stress by having their own thoughts and opinions about their children. In this study, we tested whether the way mothers perceive autism may contribute to the level of distress they feel. Some mothers see autism as a developmental disorder that needs to be cured, but some see autism as a type of mind that needs to be accepted. Our findings showed that mothers who see autism more as a type of mind are generally less stressed. But we also showed that it matters how severe are the child’s symptoms, and how heavy was the perceived burden of caring for the child. These results imply that it is worth working on attitudes towards autism to help mothers cope better. But at the same time, we argue that mothers should not be judged for their perceptions of autism, as there is a huge spectrum of a child’s characteristics and family’s life circumstances.
Investigations into EGR dilution tolerance in a pre-chamber ignited GDI engine
Authors: Rohwer Johannes , Han Taehoon , Shah Ashish , Rockstroh Toby
Published: March 2022

EGR is a useful means to improve fuel economy in spark-ignited gasoline engines, especially under part-load conditions by means of reducing throttling losses. There is also a significant reduction in NOx emissions due to the reduced peak cylinder temperatures. However, the ability of conventional spark ignition systems to reliably ignite dilute mixtures limits the dilution tolerance due to the onset of combustion instability. In this study, an active pre-chamber system was evaluated at part load condition with various EGR rates using a regular grade full boiling range gasoline. A premixed air-fuel mixture was supplied to the pre-chamber, which assists in scavenging the residual mass fractions to enable reliable ignition of EGR dilute mixtures in the main combustion chamber. A range of pre-chamber injection, air-fuel mixture formulation, and ignition timing strategies were evaluated during the EGR sweeps. In addition, 0-D and 1-D simulations were conducted in GT-Power to assess the thermodynamic state and composition in the pre-chamber, as well as estimate the jet momentum at the various dilution rates. The active pre-chamber extended the EGR dilution limit from 20% for conventional SI to above 30%, with a higher pre-chamber flow rate (more scavenging) resulting in increased combustion stability. A tradeoff between the jet momentum and spark timing was observed when analyzing the GT-Power simulations and the pre-chamber jet momentum was found to decrease with increasing EGR rate. At unstable high EGR operation, no relation could be found between the pre-chamber indicated data and main chamber combustion stability.
College student engagement in OER design projects: Impacts on attitudes, motivation, and learning
Authors: Trust Torrey , Maloy Robert W , Edwards Sharon
Published: March 2022

Open educational resources (OER), which are teaching, learning, and research materials that are openly licensed, are growing in popularity in higher education. Previous studies have focused on faculty and student perceptions and use of OER. In this study, we examined how actively engaging students as curators and designers of OERs through project-based learning as part of an open educational practice shaped students’ attitudes, motivation, and learning. This paper presents post-course survey data collected from 69 undergraduate and graduate students from six different courses that featured OER design projects, including: (1) A digital media online course; (2) Online tools for teaching and learning website; (3) History/social studies wiki pages; (4) Campus resources film project; (5) Professional learning networks for educators online course; and (6) Teaching with technology eBook. Findings indicate that shifting students’ roles from consumers to curators and creators of OERs increased motivation, improved attitudes about learning, aided the achievement of course learning objectives, and supported the development of valuable skills for 21st century success.
Evaluation of Efficacy and Tolerance of Radical Radiotherapy and Radiochemotherapy in Treatment of Locally Advanced, Unresectable Rectal Cancer
Authors: Kraszkiewicz M. , Napieralska A. , Wydmański J. , Suwiński R. , Majewski W.
Published: March 2022

Background: A retrospective evaluation of tolerance and efficacy of two schemes of neoadjuvant treatment in patients (pts) with unresectable rectal cancer: radiochemotherapy (CRT) and radiotherapy (RT), including conventional and accelerated hyperfractionation. Material and Method: A total of 145 consecutive pts with unresectable, locally advanced rectal cancer. The schemes used are RT in 73 (50%) or CRT in 72 (50%). In CRT, 54 Gy in 1.8 Gy fractions was given with chemotherapy, In the RT group, conventional fractionation (CFRT) and hyperfractionated accelerated radiotherapy (HART). HART was introduced at first as an alternative to CFRT, after radiobiological studies suggesting a therapeutic gain of hyperfractionation in other cancers, and second to administer relatively high dose needed in unresectable cancer, which is not feasible in hypofractionation because of critical organs sensitivity to high fraction doses (fd). HART was an alternative option in pts with medical contraindications to chemotherapy and to shorten overall treatment time with greater radiobiological effectiveness than CFRT. Results: Objective response (OR) in the RT and CRT group was 60% versus 75%. Resection rate (RR) in RT and CRT: 37% versus 65%. Tumor mobility and laparotomy-based unresectability were significant factors for OR. Performance status (PS), tumor mobility, and neoadjuvant treatment method were significant for RR.
PIxel-Level Segmentation of Bladder Tumors on MR Images Using a Random Forest Classifier
Authors: Li Ziqi , Feng Na , Pu Huangsheng , Dong Qi , Liu Yan , Liu Yang , Xu Xiaopan
Published: March 2022

Objectives: Regional bladder wall thickening on noninvasive magnetic resonance (MR) images is an important sign of developing urinary bladder cancer (BCa), and precise segmentation of the tumor mass is an essential step toward noninvasive identification of the pathological stage and grade, which is of critical importance for the clinical management of patients with BCa. Methods: In this paper, we proposed a new method based on the high-throughput pixel-level features and a random forest (RF) classifier for the BCa segmentation. First, regions of interest (ROIs) including tumor and wall ROIs were used in the training set for feature extraction and segmentation model development. Then, candidate regions containing both bladder tumor and its neighboring wall tissue in the testing set were segmented. Results: Experimental results were evaluated on a retrospective database containing 56 patients postoperatively confirmed with BCa from the affiliated hospital. The Dice similarity coefficient (DSC) and average symmetric surface distance (ASSD) of the tumor regions were adopted to quantitatively assess the overall performance of this approach. The results showed that the mean DSC was 0.906 (95% confidential interval [CI]: 0.852-0.959), and the mean ASSD was 1.190 mm (95% CI: 1.727-2.449), which were higher than those of the state-of-the-art methods for tumor region separation. Conclusion: The proposed Pixel-level BCa segmentation method can achieve good performance for the accurate segmentation of BCa lesion on MR images.
Robotically-assisted neuro-endovascular procedures: Single-Center Experience and a Review of the Literature
Authors: Costa Matias , Tataryn Zachary , Alobaid Abdullah , Pierre Clifford , Basamh Mohammed , Somji Mohamed , Loh Yince , Patel Akshal , Monteith Stephen
Published: March 2022

Introduction

Robotics could expand treatment of rapidly progressive pathologies such as acute ischemic stroke, with the potential to provide populations in need prompt access to neuro-endovascular procedures.

Methods

Robotically-assisted (RA) neuro-endovascular procedures (RANPs) performed at our institution were retrospectively examined (RA-group, RG). A control group of manual neuro-endovascular procedures was selected (manual group, MG). Total operating room (OR) time, procedural time, contrast media use, fluoroscopy time, conversion from RA to manual control, procedural success, and complication rates were compared. A learning curve was identified.

Results

Forty-one (41) RANPs were analyzed. Ages ranged from 20–82 y.o. Indications included diagnostic cerebral angiography (37), extracranial carotid artery stenting (3), and transverse sinus stent (1). Total OR time was longer in RG (median 86 vs. 71 min, p < 0.01). Procedural time (median 56 vs. 45 min, p = 0.12), fluoroscopy time (median 12 vs. 12 min, p = 0.69) and contrast media usage (82 vs. 92 ml, p = 0.54) were not significantly different. Patient radiation exposure was similar, considering similar fluoroscopy times. Radiation exposure and lead apron use were virtually absent for the main surgeon in RG. Procedural success was 83% and conversion from RA to manual control was 17% in RG. No treatment-related complications occurred. A learning curve showed that, after the fifth procedure, procedural times reduced and stabilized.

Conclusions

This series may contribute to further demonstrating the safety and feasibility of RANPs. RANPs can potentially reduce radiation exposure and physical burden for health personnel, expand acute cerebrovascular treatment to underserved areas, and enhance telementoring. Prospective studies are necessary for results to be generalized.
Comparison of meshfree displacement and stress error recovery of finite element solutions using moving least squares interpolation
Authors: Ahmed Mohd. , Singh Devinder , AlQadhi Saeed , Alrefae Majed A
Published: March 2022

The moving least square (MLS) interpolation based the recovery procedures have been successfully applied to recover the finite element solution errors in the analysis of elastic plates and pipes problems and can be advantageously applied for large deformation and fracture problems. The study presents the displacement and stress error recovery characteristics in the error estimation analysis employing Moving Least Squares interpolation approach. The study considers quartic spline, cubic spline, and exponential weight function with three different order of basis function in Moving Least Squares interpolation based error recovery analysis. The displacement/stress errors in finite element solution are quantified in energy norm. The cylinder and plate benchmark examples using triangular and quadrilateral elements are analyzed to compare the convergence, effectivity and adaptively improved meshes obtained using the various displacement/stress recovery procedures. The study shows that cubic spline weight function and quadratic basis function found to perform better in MLS based meshfree recovery technique for stress as well as displacement errors recovery of finite element solution. It is observed from the study that increasing the order of basis function will enhance the error estimation quality that is, rate of convergence become faster with improved effectivity of the results. The increase in convergence rate with the increase of the order of basis function is more in displacement recovery technique as compared to stress recovery technique. It is observed in the analysis of benchmark example with linear triangular meshing that the error reduction using meshfree MLS interpolation based displacement and stress recovery is about 10% and 150% respectively for the displacement and stress recovery over the mesh dependent least square based displacement and stress recovery. The study concludes that the effectiveness and efficiency of meshfree displacement/stress error recovery technique strongly depends on the weight and basis functions of MLS method to recover the errors.
The neural network terminal sliding mode control for the 3-RRC parallel robot
Authors: Guo Min , Chen Errui , Yan Minqi
Published: March 2022

In this paper, the 3 degrees of freedom (3-DOF) parallel robot (3-RRC) is taken as the research object. The Lagrange method is used to establish the reduced order dynamic equations of three branch chains. On the basis of the U-K (Udwadia-Kalaba) equation, the analytical expressions of ideal and non-ideal constrained forces are obtained. Then the complete dynamic model of 3-RRC parallel robot is established. In order to achieve high precision control of 3-RRC parallel robot, and fully considering the uncertainty of non-ideal constrained force and chattering problem in terminal sliding mode control algorithm, the neural network is used to adaptively adjust the gain of switching function and achieve universal approximation of the unknown non-ideal constrained force. The neural network terminal sliding mode control algorithm is proposed for the complete dynamic model of 3-RRC parallel robot, and the stability of the control system is proved by Lyapunov theorem. Finally, the simulation research is conducted on the 3-RRC parallel robot. Simulation results show that the tracking precision of angle positions and non-ideal constrained forces are all reached 10−2 order, which realize the high precision control of the 3-RRC parallel robot, weaken the chattering phenomenon, and verify the correctness and effectiveness of the proposed dynamic model and control algorithm.
The development of lexical competition in written- and spoken-word recognition
Authors: Apfelbaum Keith S , Goodwin Claire , Blomquist Christina , McMurray Bob
Published: March 2022

Efficient word recognition depends on the ability to overcome competition from overlapping words. The nature of the overlap depends on the input modality: spoken words have temporal overlap from other words that share phonemes in the same positions, whereas written words have spatial overlap from other words with letters in the same places. It is unclear how these differences in input format affect the ability to recognise a word and the types of competitors that become active while doing so. This study investigates word recognition in both modalities in children between 7 and 15. Children complete a visual-world paradigm eye-tracking task that measures competition from words with several types of overlap, using identical word lists between modalities. Results showed correlated developmental changes in the speed of target recognition in both modalities. In addition, developmental changes were seen in the efficiency of competitor suppression for some competitor types in the spoken modality. These data reveal some developmental continuity in the process of word recognition independent of modality but also some instances of independence in how competitors are activated. Stimuli, data, and analyses from this project are available at: https://osf.io/eav72 .
Developing guidance for the management of intraoperative anaesthetic machine failure
Authors: Milne Benjamin , Prior Kate
Published: March 2022

Intraoperative anaesthetic machine failure represents an immediate risk to patient safety, as well as risking long-term harm in the form of accidental awareness under general anaesthesia. Currently, there is no widely accepted consensus guidance for the management of such an event. Based upon institutional experiences of anaesthetic machine failure and the principles of delivering good-quality care under emergency scenarios, we devised a single-sheet guideline for management of this event. This guidance assigns clear roles in the management of the event, identifies the key priorities for immediate care, and makes provisions for ensuring ongoing high-quality care following the event. Discussion is given to the rationale for the key components, and the importance of involving the whole perioperative team in developing such guidance. Further discussion involves the crucial elements of local implementation, making sure that guidance is location and personnel specific. Key future steps in this important patient safety project are also discussed.
Considerations for women with COVID-19 admitted to hospital
Authors: Coad Felicity , Frise Charlotte
Published: March 2022

The number of pregnant women being admitted with severe COVID-19 infection and dying has increased with each wave of the pandemic. These women often present unique challenges to the medical and obstetric teams given the changes in physiology that occur in pregnancy, affecting assessment and management, as well as the practical difficulties such as the ideal location of care. Whilst the basis of treatment remains the same, there are nuances to caring for pregnant women that need considerable thought and multidisciplinary collaboration. Obstetricians, neonatologists, midwives, intensivists, anaesthetists and physicians may all be involved at some point, depending on the gestation and severity of illness. Implementing a COVID-19 in pregnancy guideline or checklist for your hospital will help ensure pregnant women are managed in a safe and timely manner. Here described are some key recommendations to help in the management of pregnant women admitted with COVID-19.