bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual outcomes in advanced keratoconus using different strategies: Scleral lens, intracorneal ring segment and lamellar keratoplasty
Authors: Rocha Guilherme , Vieira Bruna Viana , Mendes Bárbara Mírian Silva , Iguma Camila Ishii , Silva Thairis Cássia Santana , de Sousa Luciene Barbosa , Tzelikis Patrick Frensel
Published: February 2021

Purpose:

To compare VA outcomes in patients with advanced keratoconus wearing SCL or after ICRS or DALK. In addition, determine the percentage of complimentary treatments after ICRS and DALK, and which of these was fitting a SCL, and final visual acuity (f-VA) results.

Methods:

Retrospective case series analyzed 55 eyes with advanced keratoconus fitted with SCL, or after ICRS or a DALK between 2010 and 2018. The variables analyzed were sex, age, UDVA, CDVA, SEQ, K-readings, and f-VA after complimentary treatments.

Results:

Twenty-eight eyes underwent a DALK, 14 were fitted with a SCL, and other 13 underwent ICRS insertion. Patients after DALK and after ICRS showed statistically significant improvement in UDVA and CDVA after surgery, with no difference between these groups. Patients fitted with SCL showed statistically higher CDVA improvement when compared to ICRS. After DALK and ICRS, respectively, nine eyes (32.14%) and seven eyes (53.85%) were fitted with SCL. Comparison between f-VA with SCL in three groups showed that the best result was achieved in DALK + SCL, with statistically significant difference to only SCL.

Conclusion:

We showed that the CDVA of eyes fitted with SCL without any surgical treatment was statistically better than CDVA of eyes after ICRS insertion. After DALK and ICRS insertion, many patients needed a complimentary treatment to improve CDVA. The most chosen treatment was fitting a SCL. After this, all eyes showed statistically significant improvement in f-VA, with statistically better results for DALK + SCL when compared to SCL fitted in advanced keratoconus without any surgical treatment.
Difficulty removing dialysis cuff catheter after its adhesion to the right atrium
Authors: Ogawa Tomonari , Inamura Megumi , Kawai Yuichiro , Yamamoto Ryo , Yasuda Kunihiko , Shimizu Taisuke , Tamaru Jun-ichi , Hasegawa Hajime
Published: February 2021

We describe the case of an elderly Japanese female who had experienced diabetic nephropathy since the year 20xx and had been undergoing dialysis treatment while receiving vascular access interventional therapy (VAIVT) for arteriovenous fistula (AVF) occlusion. The patient visited the clinic/hospital in 20xx+10 with the AVF occlusion; emergency VAIVT was performed but blood flow could not be resumed. The patient was not admitted and was treated as an outpatient, and thus a cuff catheter (Split stream catheter: SST28 cm, Medcomp) was inserted. An infection developed and was successfully treated with antibiotics. The dialysis treatment continued without issue. One year after the cuff catheter’s insertion, the patient was admitted due difficulty breathing. Despite continued dialysis treatment with the catheter, the patient died 15 days post-admission. The removal of the catheter proved to be difficult. An autopsy was approved, and the area around the catheter was examined. The adhesion of the catheter to the right atrium was observed, but no infection was detected in the bloodstream. This case illustrates that dialysis with the use of a cuff catheter can be effective.
Psychological Distress and Its Correlates among Newly Diagnosed People Living with HIV in Northwest Ethiopia: Ordinal Logistic Regression Analyses
Authors: Moges Nurilign Abebe , Adesina Olubukola Adeponle , Okunlola Micheal A , Berhane Yemane , Akinyemi Joshua Odunayo
Published: February 2021

Background:

Although there is a high burden of HIV in sub-Saharan Africa (SSA), studies on mental health issues among people living with HIV are scarce. The study addressed the transition to “test and treat” guidelines for HIV, which makes it unique regarding its evaluation of psychological distress amongst newly initiated people living with HIV in the test and treat era.

Methods:

We conducted a cross-sectional survey of 689 people newly diagnosed with HIV. Symptoms of psychological distress were measured using the Kessler-10 psychological distress assessment scale. Factors associated with psychological distress were captured using interviewer-administered questionnaires. Ordinal logistic regression analyses were employed to identify predictors of psychological distress.

Results:

The magnitude of psychological distress was 58.63% (95% CI = 55.2%-62.3%). The severity of the psychological distress of which, 17.42% had severe distress. Psychological distress was observed more among female patients (β = 0.47, AOR = 1.59, 95% CI = 1.12, 2.27), patients presented with opportunistic infections (β = 0.50, AOR = 1.65, 95% CI = 1.03, 2.66) and being non-working functional status (β = 0.99, AOR = 2.70, 95% CI = 1.64, 4.45). Moreover, patients who were malnourished (β = 0.46, AOR = 1.58, 95% CI = 1.09, 2.26), having good level of knowledge on HIV prevention (β = 0.59, 95% CI = 0.55, 0.39, 0.78), presented with sexually transmitted infection (β = 0.48, AOR = 1.61, 95% CI = 1.01, 2.58), history of alcohol use (β = 0.44, AOR = 1.55, 95% CI = 1.09, 2.21), perceived stigma (β = 0.08, AOR = 1.09 95% CI = 1.04, 1.15) and treated in health centers (β = 0.55, AOR = 1.74, 95% CI = 1.25, 2.41) had higher odds of psychological distress.

Conclusion:

The large majority of newly diagnosed HIV patients suffered from psychological distress. An increased vulnerability was observed among females, those with opportunistic and sexually transmitted infections, those having poor functional status and malnourished. Furthermore, HIV patients treated in health centers, those who had history of alcohol use and patients with high level of HIV related stigma are more negatively affected by the HIV diagnosis. Hence, all intervention strategies should target all the identified predictors.
Challenges in the Management of Thyrotoxicosis Associated with Atrial Fibrillation and Heart Failure: Two Case Reports
Authors: Sadiq Abid M , Chamba Nyasatu G
Published: February 2021

Background:

Thyrotoxicosis is a clinical syndrome with high amounts of free thyroid hormone levels causing elevated thyroid hormone function in body tissues. Prolonged effects of free thyroid hormones may lead to cardiac complications such as atrial fibrillation (AF) and heart failure (HF).

Case 1:

A 31-year-old female, was admitted due to difficulty in breathing, generalised body swelling and jaundice. She was dyspnoeic with an irregular heart rate, and presented with abnormal vitals, liver and thyroid function tests which were diagnostic for thyroid storm. She was managed over 32 days in-hospital stay with carbimazole, propranolol, hydrocortisone, digoxin and furosemide. Unfortunately, she was readmitted 6 months later with worsened HF symptoms and passed away.

Case 2:

A 57-year-old female, was admitted due to difficulty in breathing, bilateral lower limb swelling and jaundice. She was tachypnoeic with an irregular heart rate, and presented with abnormal liver enzymes and thyroid function tests which were diagnostic for thyrotoxicosis. She was managed with carbimazole, propranolol, digoxin and furosemide, and was discharged on the 6th hospital day.

Conclusion:

Prolonged untreated thyrotoxicosis increases the risk of AF and HF. Early and monitored treatment and follow-up of hyperthyroidism is key to the management of AF and HF in achieving a better outcome.
Virtual Reality Augmented Feedback Rehabilitation Associated to Action Observation Therapy in Buccofacial Apraxia: Case Report
Authors: Emedoli Daniele , Arosio Maddalena , Tettamanti Andrea , Iannaccone Sandro
Published: February 2021

Background:

Buccofacial Apraxia is defined as the inability to perform voluntary movements of the larynx, pharynx, mandible, tongue, lips and cheeks, while automatic or reflexive control of these structures is preserved. Buccofacial Apraxia frequently co-occurs with aphasia and apraxia of speech and it has been reported as almost exclusively resulting from a lesion of the left hemisphere. Recent studies have demonstrated the benefit of treating apraxia using motor training principles such as Augmented Feedback or Action Observation Therapy. In light of this, the study describes the treatment based on immersive Action Observation Therapy and Virtual Reality Augmented Feedback in a case of Buccofacial Apraxia.

Participant and Methods:

The participant is a right-handed 58-years-old male. He underwent a neurosurgery intervention of craniotomy and exeresis of infra axial expansive lesion in the frontoparietal convexity compatible with an atypical meningioma. Buccofacial Apraxia was diagnosed by a neurologist and evaluated by the Upper and Lower Face Apraxia Test. Buccofacial Apraxia was quantified also by a specific camera, with an appropriately developed software, able to detect the range of motion of automatic face movements and the range of the same movements on voluntary requests. In order to improve voluntary movements, the participant completed fifteen 1-hour rehabilitation sessions, composed of a 20-minutes immersive Action Observation Therapy followed by a 40-minutes Virtual Reality Augmented Feedback sessions, 5 days a week, for 3 consecutive weeks.

Results:

After treatment, participant achieved great improvements in quality and range of facial movements, performing most of the facial expressions (eg, kiss, smile, lateral angle of mouth displacement) without unsolicited movement. Furthermore, the Upper and Lower Face Apraxia Test showed an improvement of 118% for the Upper Face movements and of 200% for the Lower Face movements.

Conclusion:

Performing voluntary movement in a Virtual Reality environment with Augmented Feedbacks, in addition to Action Observation Therapy, improved performances of facial gestures and consolidate the activations by the central nervous system based on principles of experience-dependent neural plasticity.
Exploring the relationship between Airbnb and traditional accommodation for regional variations of tourism markets
Authors: Leick Birgit , Kivedal Bjørnar Karlsen , Eklund Mehtap Aldogan , Vinogradov Evgueni
Published: February 2021

The relationship between Airbnb-based and traditional accommodation is mainly documented for key tourist destinations with a large tourism sector, while there is almost no evidence on this for other destinations. This article focuses on regional variations in the relationship between Airbnb-based and traditional accommodation across primary and secondary tourist destinations in Norway. Through an exploratory cluster analysis and a panel vector autoregressive (PVAR) model with forecast error decomposition of shocks (unobserved effects), it finds evidence of spillovers from Airbnb-based accommodation to traditional accommodation in secondary destinations. The demand for traditional accommodation is positively affected by Airbnb demand in the long run. Interestingly, a smaller effect is found with the supply-side of regional tourism markets in the Norwegian secondary tourist destinations. The growth of Airbnb may, thus, spur growth in the general tourism sector in such less frequented destinations.
Analysis of stock returns of main European service and tourism companies
Authors: Jareño Francisco , Escribano Ana , Torres M Pilar
Published: February 2021

This research explores the sensitivity of the returns of some selected European companies to changes in the explanatory factors proposed during the sample period between January 2000 and December 2019. We focus on listed companies in the tourism and services sector and estimate an extension of the Fama and French five-factor model (2015) by applying the quantile regression approach. Specifically, this study starts from the Fama and French risk factors and adds the nominal interest rates, a momentum and momentum reversal factors and a traded liquidity factor. For robustness, this research divides the whole sample period into three sub-periods: pre-crisis, crisis and post-crisis. In line with the previous literature, the explanatory power of this factor model shows a U-shape, which is compatible with the highest R2 coefficients in the extreme quantiles, as well as in extreme stages of the economy, that is, in the bullish and bearish market states.
Use of single-bed rooms may decrease the incidence of hospital-acquired infections in geriatric patients: A retrospective cohort study in Central Denmark region
Authors: Gregersen Merete , Mellemkjær Anders , Foss Catherine H , Blandfort Sif
Published: February 2021

Objective

Patients accommodated in single-bed rooms may have a reduced risk of hospital-acquired infections (HAIs) compared to those in multi-bed rooms. This study aimed to examine the effect of single-bed accommodation on HAIs in older patients admitted to a geriatric ward.

Methods

A retrospective cohort study of patients admitted to geriatric wards in a university hospital in Central Denmark Region linked to a move to a newly built hospital, involving all consecutively admitted patients aged 65 years and over from 15 September to 19 December 2016 and a similar cohort admitted in the same three months in 2017. We compared the incidence of HAIs in patients in single-bed accommodation to those in multi-bed accommodation using retrospective review of electronic patient records, with all infections verified microbiologically or by X-ray with onset between 48 hours after admission to 48 hours after discharge from hospital.

Results

In total 446 patients were included. The incidence of HAIs in multi-bed accommodation was 30% compared to 20% in single-bed accommodation. The hazard ratio was 0.62 (95% Confidence Interval 0.43–0.91, p = 0.01) for single-bed accommodation. This finding remained robust after adjustment for age, sex, infection at admission, risk of sepsis, use of catheter, treatment with prednisone or methotrexate, and comorbidity index.

Conclusion

Accommodation in single-bed rooms appeared to reduce HAIs compared to multi-bed rooms in two geriatric wards. This finding should be considered as hypothesis-generating and be examined further using an experimental design.
Who should we ask about mental health symptoms in adolescents with CFS/ME? Parent-child agreement on the revised children’s anxiety and depression scale
Authors: Serafimova Teona , Loades Maria , Gaunt Daisy , Crawley Esther
Published: February 2021

Background:

One in three adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have mental health problems. Multi-informant perspectives are key to psychological assessment. Understanding parent-child agreement is crucial to accurate diagnosis, particularly where severe fatigue limits self-report.

Methods:

Agreement on the revised children’s anxiety and depression scale (RCADs) was assessed between parents and children with CFS/ME ( n = 93) using Bland-Altman plots, cross tabulations and regression analyses.

Results:

Diagnostic thresholds were met more frequently based on child-report. Parent- and child-report had similar sensitivity and specificity on RCADS compared to gold-standard diagnostic interviews. Regression analysis found similar accuracy between both reports. For anxiety diagnoses, odds ratio (OR) for child-report was 1.10 (CI = 1.06–1.14), and 1.10 (CI = 1.05–1.14) for parent-report. For depression, OR for child report was 1.26 (CI = 1.11–1.43), while for parent-report is was 1.25 (CI = 1.10–1.41). For total score, OR for child-report was 1.10 (CI = 1.05–1.13) while OR for parent-report was 1.09 (CI = 1.05–1.13).

Conclusions:

Reasonable agreement was observed between parent- and child-report of mental health symptoms in paediatric CFS/ME. While parent-report can facilitate psychological evaluation in CFS/ME, this is not a substitute for a child’s own report.
Why do selfies increase young women’s willingness to consider cosmetic surgery in China? The mediating roles of body surveillance and body shame
Authors: Lyu Zhenyong , Jiao Yanqiao , Zheng Panpan , Zhong Jun
Published: February 2021

The present study was designed to examine a possible two mediator model with both body surveillance and body shame mediating the association of selfie behavior with cosmetic surgery consideration in young adult women. A sample of 588 young adult women participated in this study and completed questionnaires regarding selfie behavior, body surveillance, body shame, and cosmetic surgery consideration. Results indicated that selfie behavior was positively related to cosmetic surgery consideration. In addition, the mediation analysis by PROCESS revealed that body surveillance and body shame mediated the relation between selfie behavior and cosmetic surgery consideration. These findings add to the extant literature by suggesting that selfie behavior may be a new experience of self-objectification, which provide new insights into the relation between selfie activities and cosmetic surgery consideration in young women.
‘It’s social interaction. . . but it’s not’: A qualitative study investigating the psycho-social experience of social media by individuals with a visual impairment
Authors: Hill Kirsty , Bennett Paul , Hunter Rachael
Published: February 2021

People with visual impairment (VI) may encounter psychosocial challenges including difficulties with socialisation/interpreting visual social cues. Social media (SM) may provide alternative means of socialisation but little is known about the experience of SM from their perspective. Semi-structured interviews with 10 individuals with VI who regularly use SM were analysed according to interpretative phenomenological analysis. Analysis yielded two overarching themes: social media and identity, and social connectedness. Participants described benefits of shared experience, feelings of enhanced control and challenges of SM which emphasise exclusion/inequality. Findings highlight a need for further research to understand/improve the online experience for people with VI.
Effect of temperature on the bond-slip between I-shaped steel and concrete
Authors: Wang Yuzhuo , Zhang Bingjie , Liu Ziqing , Gao Ying , Fu Chuanguo
Published: February 2021

This paper presents results from an experimental study on the effect of temperature on bond strength of I-shaped steel and concrete. Eleven concrete encased steel (CES) specimens were tested by home-made fire test furnace to evaluate bond strength at various constant high temperatures (20°C600°C). The test results showed that: (1) the trend of the bond-slip curves at high temperatures were much similar to that at room temperature. Compared with room temperature specimen, the ultimate bond load and the residual bond load of specimens at high temperatures were significantly decreased. The specimens with the higher temperature had the less ultimate bond load and residual bond load. (2) In the descending stage, the P-S curve of the specimens with higher temperatures had more flat slope. The P-S curve of the specimens at the temperatures higher than 250°C had invisible descending stage. The ultimate bond load of the specimen at 600°C left with only about 5% of that at room temperature. (3) The ultimate slippages (i.e. the slippage at the ultimate bond load) of specimens at high temperatures were larger than that at room temperature, and varied from 2 to 5 mm. (4) The calculation formulas of ultimate bond load, ultimate slippage, and residual bond load at different temperatures were presented, the constitutive equations of bond-slip at different temperatures were obtained, which will provide a reference for the fire-resistant design of concrete encased steel columns.
Visualization of diesel spray and combustion from lateral side of two-dimensional piston cavity in rapid compression and expansion machine, second report: Effects of injection pressure and interval of split injection
Authors: Fan Chengyuan , Nishida Keiya , Ogata Yoichi
Published: February 2021

The effect of split injection on the fuel spray and combustion processes in a rapid compression and expansion machine was investigated using the visualization process. A two-dimensional piston cavity, designed with the cross section of a reentrant piston, was installed in the combustion chamber to observe the combustion process from the lateral side. Combustion experiments were conducted with injection pressures of 80 MPa, 120 MPa, and 180 MPa and an O2 concentration of 15%. The spray/wall interaction, mixture distribution, and ignition location were investigated using the shadow method. Along with natural flame luminescence, different spray impinging behaviors on combustion process were studied. Furthermore, the combustion characteristics of in-cylinder pressure, apparent heat release rate, and combustion phase were recorded and analyzed simultaneously. The results showed that both high injection pressure and split injection with a longer interval effectively improved the combustion performance. In addition, when the pilot injection was advanced further, the injection interval had a larger influence in reducing soot generation, while the effect of high injection pressure on heat release decreased. Flame separation was found to occur at high injection pressures. It was observed that the flame separation caused by the strong spray momentum was beneficial for reducing soot generation owing to the greater fuel-air interaction area. The spray and combustion processes were investigated in detail, and the significant effects of different injection pressures and injection intervals on combustion performance with the split injection method were highlighted.
Focal Concerns and Police Decision Making in Sexual Assault Cases: A Systematic Review and Meta-Analysis
Authors: Lapsey David S. , Campbell Bradley A. , Plumlee Bryant T.
Published: February 2021

Sexual assault and case attrition at the arrest stage are serious problems in the United States. Focal concerns have increasingly been used to explain police decision making in sexual assault cases. Because of the popularity of the focal concerns perspective and potential to inform evidence-based training, a systematic review and meta-analysis are needed to condense the literature. In this study, we assess the overall strength of the relationship between focal concerns variables and police decisions to arrest in cases of sexual assault. Our assessment of the effects of focal concerns variables on arrest decision making in sexual assault cases followed the systematic review protocols provided by the Campbell Collaboration of Systematic Reviews. Specifically, we used the Campbell Collaboration recommendations to search empirical literature and used meta-analysis to evaluate the size, direction, and strength of the impact of focal concerns variables on arrest decisions. Our search strategy detected 14 eligible studies and 79 effect sizes. The meta-analysis found several robust and statistically significant correlates of arrest. In fact, each focal concerns concept produced at least one robust arrest correlate. Overall, focal concerns offers a strong approach for explaining police decisions in sexual assault cases. Although practical concerns and resource constraints produced the strongest arrest correlates, results show the importance of additional case characteristics in officers’ decision to arrest.
Astragalus Polysaccharide Injection (PG2) Normalizes the Neutrophil-to-Lymphocyte Ratio in Patients with Advanced Lung Cancer Receiving Immunotherapy
Authors: Tsao Shih Ming , Wu Tz Chin , Chen JiZhen , Chang Feichi , Tsao Thomos
Published: February 2021

Objectives:

The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in patients with cancer receiving immunotherapy. Recent studies have shown that a high NLR was associated with a poor response and decreased survival. However, there is no intervention to reverse abnormally high NLR and improve clinical outcomes. Astragalus polysaccharide injection (PG2) is an immunomodulatory therapy for cancer-related fatigue. This study aimed to examine whether PG2 might normalize the NLR and affect the overall survival of patients with lung cancer treated with immunotherapy.

Materials and Methods:

We retrospectively examined the medical records of patients with lung cancer treated with immune checkpoint inhibitors (ICIs) between October 1, 2015 and November 30, 2019. All patients received ICI combination chemotherapies, and some similarly received PG2 (Control vs PG2). The NLR was assessed before treatment and 6 weeks after ICI initiation, and the survival data was collected at least 4 years after treatment initiation for the first enrolled patient.

Results:

Fifty-three patients were included. Six weeks after ICI initiation, 91.3% of the patients in the PG2 group exhibited a predefined “Decrease or no change” in the NLR, which was 28% higher than that in the Control group (63.3%) ( P = .028). The NLR significantly decreased by 31.60% from baseline in the PG2 group ( P = .012), whereas it increased by 5.80% in the Control group ( P = .572). Six weeks after ICI treatment initiation, both groups had a median NLR of 3.73, and the overall survival was also similar (PG2 vs Control, 26.1 months vs 25.4 months, respectively); however, the PG2 group had a higher median baseline NLR than the Control group (PG2 vs Control, 4.51 vs 2.81, respectively).

Conclusion:

This study demonstrated that PG2 could normalize the NLR in patients with lung cancer receiving ICI combination treatments.
Pulling the Trigger: The Decision of Arming School Staff in a Large, Diverse School District
Authors: Kent Jennifer K. , Chris Curran F.
Published: February 2021

Based on events in Florida, this case explores issues that accompany the choice to arm school personnel as a means to address school violence and shootings. Readers consider the issue from the perspective of the school board of a large, diverse district and are presented with dilemmas while they consider the effectiveness, the political feasibility, the legality, the cost, and the potential unintended consequences of arming school personnel. The school board grapples with the complexity of making school safety decisions within the constraints of state policy while simultaneously being responsive to local budget constraints and a diverse set of stakeholders.
Burst pressure prediction of fiber-reinforced flexible pipes with arbitrary generatrix
Authors: Xu Guo-min , Shuai Chang-geng
Published: February 2021

Fiber-reinforced flexible pipes are widely used to transport the fluid at locations requiring flexible connection in pipeline systems. It is important to predict the burst pressure to guarantee the reliability of the flexible pipes. Based on the composite shell theory and the transfer-matrix method, the burst pressure of flexible pipes with arbitrary generatrix under internal pressure is investigated. Firstly, a novel method is proposed to simplify the theoretical derivation of the transfer matrix by solving symbolic linear equations. The method is accurate and much faster than the manual derivation of the transfer matrix. The anisotropy dependency on the circumferential radius of the pipe is considered in the theoretical approach, along with the nonlinear stretch of the unidirectional fabric in the reinforced layer. Secondly, the burst pressure is predicted with the Tsai-Hill failure criterion and verified by burst tests of six different prototypes of the flexible pipe. It is found that the burst pressure is increased significantly with an optimal winding angle of the unidirectional fabric. The optimal result is determined by the geometric parameters of the pipe. The investigation method and results presented in this paper will guide the design and optimization of novel fiber-reinforced flexible pipes.
Collaborative improvement of efficiency and noise of bionic vane centrifugal pump based on multi-objective optimization
Authors: Liu Houlin , Cheng Zhiming , Ge Zhipeng , dong liang , dai cui
Published: February 2021

The hydraulic and acoustic performance of centrifugal pump is closely related to hydraulic structure parameters, and they are contradictory. In order to solve this contradiction, this paper introduces the pit bionic structure, and proposes an optimization method based on multi-objective test design and response surface to improve the hydraulic and acoustic performance. Taking the bionic vane pit diameter, axial spacing and radial spacing as design variables. Taking the maximum hydraulic efficiency and total sound pressure level reduction of centrifugal pump as the corresponding objectives. The multiple regression response surface model was constructed to determine the optimal parameter combination of hydraulic performance and noise collaborative optimization. The optimization results were verified by numerical simulation and experimental test. The results show that the response surface multi-objective optimization method has high prediction accuracy, has obvious synergistic effect on the hydraulic and acoustic performance. The highest point of the efficiency curve after optimization is shifted to the direction of large flow, which widens the high efficiency working area of centrifugal pump. Under the rated condition, the hydraulic efficiency is increased by 3.03%, the efficiency increase rate is 4.21%, the total sound pressure level is reduced by 4.96 dB, and the noise reduction rate is 3.01%.
Improving educational quality through active learning: Perspectives from secondary school teachers in Malawi
Authors: Altinyelken Hülya Kosar , Hoeksma Mark
Published: February 2021

Addressing the learning crisis in low-income contexts remains a major concern. This paper analyses how active teaching and learning pedagogy (ATL) was implemented in secondary schools in Malawi to improve learning outcomes. Based on interviews with teachers and headteachers from five schools, the paper seeks to explore how ATL was understood and implemented, and what challenges were experienced from the perspectives of trained and untrained teachers. The findings reveal that ATL was positively viewed by all participants, as it was considered beneficial in improving students’ academic performance and skills development. All participants identified some key implementation challenges, including large classes, lack of materials, the use of English, long distance to school and poverty. The paper underscores the need to move away from a polarised view of pedagogy (direct instruction against ATL) and conceptualise active learning on a continuum.
The influence of social anxiety-provoking contexts on context reinstatement effects
Authors: Yeung Ryan C , Lee Christopher M , Fernandes Myra A
Published: February 2021

The context reinstatement (CR) effect is the finding that target stimuli are better remembered when presented in the same context as during initial encoding, compared with a different context. It remains unclear, however, whether emotional features of the context affect this memory benefit. In two experiments, we investigated whether the anxiety-provoking nature of a context scene might influence the CR effect. During encoding, participants viewed target faces paired with scenes validated as either highly anxiety-provoking or not, half of which contained other faces embedded within the scene. During retrieval, target faces were presented again with either the same or a new context scene. In Experiment 1, the expected CR effect was observed when the contexts were low-anxiety scenes or high-anxiety scenes without embedded faces. In contrast, the CR effect was absent when the contexts were high-anxiety scenes containing embedded faces. In Experiment 2, to determine whether the presence of embedded faces or the anxiety level of scenes reduced the CR effect, we included an additional context type: low-anxiety scenes with embedded faces. Once again, the CR effect was absent only when the context scene was highly anxiety-provoking with embedded faces: reinstating this context type failed to benefit memory for targets. Results suggest that the benefit to target memory via reinstating a context depends critically on emotional characteristics of the reinstated context.
Do eyes and arrows elicit automatic orienting? Three mutually exclusive hypotheses and a test
Authors: Besner Derek , McLean David , Young Torin
Published: February 2021

Eyes in a schematic face and arrows presented at fixation can each cue an upcoming lateralized target such that responses to the target are faster to a valid than an invalid cue (sometimes claimed to reflect “automatic” orienting). One test of an automatic process concerns the extent to which it can be interfered with by another process. The present experiment investigates the ability of eyes and arrows to cue an upcoming target when both cues are present at the same time. On some trials they are congruent (both cues signal the same direction); on other trials they are incongruent (the two cues signal opposite directions). When the cues are congruent a valid cue produced faster response times than an invalid cue. In the incongruent case arrows are resistant to interference from eyes, whereas an incongruent arrow eliminates a cueing effect for eyes. The discussion elaborates briefly on the theoretical implications.
Online inference making and comprehension monitoring in children during reading: Evidence from eye movements
Authors: Joseph Holly , Wonnacott Elizabeth , Nation Kate
Published: February 2021

Inference generation and comprehension monitoring are essential elements of successful reading comprehension. While both improve with age and reading development, little is known about when and how children make inferences and monitor their comprehension during the reading process itself. Over two experiments, we monitored the eye movements of two groups of children (age 8–13 years) as they read short passages and answered questions that tapped local (Experiment 1) and global (Experiment 2) inferences. To tap comprehension monitoring, the passages contained target words which were consistent or inconsistent with the context. Comprehension question location was also manipulated with the question appearing before or after the passage. Children made local inferences during reading, but the evidence was less clear for global inferences. Children were sensitive to inconsistencies that relied on the generation of an inference, consistent with successful comprehension monitoring, although this was seen only very late in the eye movement record. Although question location had a large effect on reading times, it had no effect on global comprehension in one experiment and reading the question first had a detrimental effect in the other. We conclude that children appear to prioritise efficiency over completeness when reading, generating inferences spontaneously only when they are necessary for establishing a coherent representation of the text.
The rise of illiberal memory
Authors: Rosenfeld Gavriel D
Published: February 2021

The essay seeks to explain how and why rightwing populists in Europe, North America, and beyond have developed an “illiberal” politics of memory in opposition to the global liberal memory culture of the past generation. After explaining the rise of “illiberal memory” as a byproduct of the rise of illiberal democracy since 2008, the essay advances a comprehensive typology of the movement’s overall objectives and tactics based on numerous empirical examples from different nations, including Germany, Russia, the United States, Israel, and India. It concludes with some reflections about how illiberal memory is likely to evolve in the future. The essay is the first to advance the concept of “illiberal memory” and present an overall theory of its origins and agenda.
Is central sensitization an important determinant of functional disability in patients with chronic inflammatory arthritides?
Authors: Adami Giovanni , Gerratana Elisabetta , Atzeni Fabiola , Benini Camilla , Vantaggiato Elisabetta , Rotta Denise , Idolazzi Luca , Rossini Maurizio , Gatti Davide , Fassio Angelo
Published: February 2021

Background:

Central sensitization (CS) is a condition characterized by a disproportionate response to pain stimuli. We sought to investigate the prevalence of CS in patients with inflammatory arthritides and its association with measures of disease activity and functional disability.

Methods:

We conducted an observational retrospective study in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) patients. We administered to all the subjects in the study the CS inventory (CSI), a questionnaire that has been used for the diagnosis of CS. Demographic and clinical characteristics were collected as well as measures or disease activity [i.e. Simple Disease Activity Index, Disease Activity Score in PsA (DAPSA)] and functional disability [Health Assessment Questionnaire Disability Index (HAQ-DI)]. Patients with fibromyalgia were excluded from the analyses. The primary outcome measure was the presence of functional disability as assessed by HAQ-DI >1.

Results:

We enrolled 150 patients with inflammatory arthritides (78 PsA and 72 RA). Prevalence of CS was observed in 35.3% of the overall sample (29% in RA, 42.9% in PsA). Binary logistic regressions showed a strong, independent and linear association between functional disability and CS in both PsA and RA patients. The strength of this association was greater in PsA than in RA.

Conclusion:

CS is an important determinant of functional disability in patients with chronic inflammatory arthritides. PsA appeared to be more vulnerable to CS. In addition, in the presence of CS, DAPSA did not adequately capture the occurrence of functional disability. Therefore, special attention should be paid to PsA patients, in whom the concomitant diagnosis of CS should be routinely ruled out.
Social Listening to Create Bespoke Customer Experiences: Best Practices for Hospitality Operators
Authors: LaTour Kathryn A. , Brant Ana
Published: February 2021

Most hospitality operators use social media in their communications as a means to communicate brand image and provide information to customers. Our focus is on a two-way exchange whereby a customer’s social posting is reacted to in real-time by the provider to enhance the customer’s current experience. Using social media in this way is new, and the provider needs to carefully balance privacy and personalization. We describe the process by which the Dorchester Collection Customer Experience (CX) Team approached its social listening program and share lessons to identify best practices for hospitality operators wanting to delight their customers through insights gained from social listening.
West Nile Neuroinvasive Disease With Atypical CSF Findings: A Case Report
Authors: Simon Devin
Published: February 2021

West Nile Neuroinvasive Disease (WNND) is a rare complication of West Nile Virus infection with the capability of mimicking other neurologic diseases. This infection should be considered in the differential diagnosis for patients presenting in the late summer months with altered mentation, fever, and focal neurologic deficits without an otherwise clear etiology. A 63-year-old male presented with acute onset fever, confusion, falls, ataxia, vertical nystagmus, and right leg weakness. Although magnetic resonance imaging of the brain and cervical spine were unremarkable, the lumbar spine revealed enhancement of ventral nerve roots in the cauda equina. Cerebrospinal fluid (CSF) analysis was significant for elevated protein without pleocytosis, which was more suggestive of albuminocytologic dissociation. Both serum and CSF IgM labs testing for West Nile Virus were positive. Despite a 5 day course of immunoglobulin therapy, his symptoms did not significantly improve. He eventually was transferred to inpatient rehabilitation for several days prior to returning home. This case highlights the variable presentations of acute West Nile Virus infection in the rare setting of neuroinvasive disease, which can make diagnosis difficult. The CSF analysis may also not always show results consistent with an acute viral infection, which can make determining the underlying etiology more challenging.
Refractory Heparin-Induced Thrombocytopenia in a Patient With Subarachnoid Hemorrhage—A Clinical Conundrum
Authors: Newton Faith , Glaser Kimberly , Reeves Jennifer , Sheperd Lyndsay , Ray Bappaditya
Published: February 2021

Heparin induced thrombocytopenia (HIT) often resolves with discontinuation of heparin/ heparinoid products. Severe HIT with platelet counts <20,000/µL and disseminated intravascular coagulation is frequently associated with consumptive coagulopathy and systemic thrombosis. Management of severe HIT in patients who fail to improve on discontinuing heparinoid products and argatroban infusion is not well established. We describe a patient admitted with aneurysmal subarachnoid hemorrhage (SAH) who developed severe autoimmune HIT, failed conventional anticoagulation therapy with argatroban and progressed to develop extensive deep venous thrombosis and limb ischemia. She was successfully treated using bivalirudin, immunomodulation with 2 cycles of intravenous immunoglobulin and immunosuppression with methylprednisolone. Refractory severe HIT among SAH patients is rare and pose several therapeutic challenges. We report successful treatment using alternate anticoagulant and immune suppression and modulation.
The Impact of Maxillary Expansion on Adults’ Nasal Breathing: A Systematic Review and Meta-Analysis
Authors: Calvo-Henriquez Christian , Megias-Barrera Joaquim , Chiesa-Estomba Carlos , Lechien Jerome R. , Maldonado Alvarado Byron , Ibrahim Badr , Suarez-Quintanilla David , Kahn Sandra , Capasso Robson
Published: February 2021

Objective

Nasal surgery fails to restore nasal breathing in some cases. Maxillary constriction is suggested as a major cause of failure. It is thought that maxillary constriction leads to the closure of the internal and external nasal valves. Moreover, it is well established in the literature that maxillary expansion, both in adults and children, increases upper airway volume. However, it is yet unclear whether maxillary expansion may improve nasal function. Review Methods: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors from the Rhinology Study Group of the Young Otolaryngologists section of the International Federation of Otorhinolaryngological Societies. Two authors extracted the data. The main outcome was expressed as the value (in variable units) prior to treatment (T0), after expansion procedures (T1), after the retention period (T2), and after a follow-up period (T3).

Results

A total of 10 studies (257 patients) met the inclusion criteria. The data pooled in the meta-analysis reveals a statistically significant reduction of 0.27 Pa/cm3/s (CI 95% 0.15, 0.39) in nasal resistance after palatal expansion As far as subjective changes are concerned, the pooled data for the change in the NOSE score shows a statistically significant mean reduction after maxillary expansion of 40.08 points (CI 95% 36.28, 43.89).

Conclusion

The initial available evidence is too limited to suggest maxillary expansion as a primary treatment option to target nasal breathing. However the data is encouraging with regards to the effect of maxillary expansion on nasal function. Further higher quality studies are needed in order to define clearer patient selection criteria, distinguish optimal techniques, and demonstrate long-term efficacy in long term follow up studies.
A tentative discussion of medical education and cultures of science
Authors: Chen Guoqiang
Published: February 2021

Medical education is an important part of health care. Many medical educators have thought deeply about it since the outbreak of COVID-19. Based on my own experience and thinking during the pandemic, I now believe more strongly in the importance of the cultures of medicine and science, which reflect the views of life amongst medical and scientific professionals. The two cultures derive from the lives of medical workers and scientists and manifest in their attitudes towards clinical practice, scientific research and teaching. They also embody the spirit, essence and philosophy of the medical and scientific professions – the common belief in seeking the truth and the common will to pursue kindness. Education today is not simply a matter of passing on knowledge. More importantly, the next generation shall inherit the scientific culture of seeking the truth, pursuing kindness and exploring beauty and humanity. This is crucial to medical education and clinical practice.
The uncertain Changshi: Historical evolution of Changshi courses in elementary schools in China’s mainland
Authors: Liu Bing , Chu Huiling
Published: February 2021

In addition to its relevance to the history of education, the study of changes in curriculum design also provides insights into changes in educational attitudes. This paper examines the historical evolution of the Changshi curriculum in China’s mainland, explains the concept of Changshi and its different understandings in Changshi or general knowledge courses, and then applies the concept to the narration and classification of history. It also includes a brief discussion on related issues.
Constructing scientific culture in the 5G era: Historical lessons from the first discovery of a virus
Authors: Zhou Cheng
Published: February 2021

This article examines how scientists from various periods, countries and disciplines worked together to identify the tobacco mosaic virus, which is a rod-shaped protein–RNA complex. The process by which that came about was one of persistent and reflective collective learning. Examination of this history reveals that under conditions in which repeated experiments were unable to be properly performed, and no adequate queries from within the scientific community or communications among scientists were available, highly uncertain novel phenomena were susceptible to inaccurate interpretations and predictions. In view of that, it is suggested that only by encouraging queries within the scientific community and embracing alternative opinions can differences in scientific understanding be calibrated to increase the number of fundamental scientific and technological innovations. Only by promoting academic democracy and establishing dialogue on the basis of equality can we prevent substantial deviations in scientific understanding, proposed by scientific authorities, from inhibiting scientific development. With respect to China, this article holds that, in the age of the internet and the dawning era of 5G, Chinese scientists ought to recognise and confront the limitations of scientific research, examine the cumulative nature of scientific understanding in a more general way, establish a dialogue mechanism among researchers on the basis of equality, allow for the inherent error-correction mechanism within the scientific community, and actively take part in the construction of scientific culture.
Studying Undergraduate Course Consideration at Scale
Authors: Chaturapruek Sorathan , Dalberg Tobias , Thompson Marissa E. , Giebel Sonia , Harrison Monique H. , Johari Ramesh , Stevens Mitchell L. , Kizilcec Rene F.
Published: February 2021

Elective curriculums require undergraduates to choose from a large roster of courses for enrollment each term. It has proven difficult to characterize this fateful choice process because it remains largely unobserved. Using digital trace data to observe this process at scale at a private research university, together with qualitative student interviews, we provide a novel empirical study of course consideration as an important component of course selection. Clickstream logs from a course exploration platform used by most undergraduates at the case university reveal that students consider on average nine courses for enrollment for their first fall term (<2% of available courses) and these courses predict which academic major students declare two years later. Twenty-nine interviews confirm that students experience consideration as complex and reveal variation in consideration strategies that may influence how consideration unfolds. Consideration presents a promising site for intervention in problems of equity, career funneling, and college completion.