bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Non-performing Assets Using Non-parametric Test: Indian Scheduled Commercial Banks
Authors: Mishra Bhabani , Rath S. S.
Published: August 2021

Galloping levels of impaired assets slowly destroy the economy by throwing it into a major financial crisis. The current article studies recent trends and compositions of stressed assets among 45 selected Indian commercial banks. The non-parametric test (Kruskal–Wallis) is applied to know whether there exists any difference in the movement of gross non-performing assets ratios and net non-performing assets ratios (NNPAs) among bank groups and individual banks. The group-wise comparative study shows that a significant difference exists in the movement of NNPA ratio only between foreign banks and public sector banks and between private banks and public sector banks. Significant differences also exist among the individual banks in foreign and private bank groups. The Games–Howell post-hoc test finds that some pairs of banks have significant differences. The current financial downswing attributed to pandemic has increased the chances of fraudulency and sporadic default events and enhanced the problem of bad loans. Amalgamations of State Bank of India with its associates in 2017 and Bank of Baroda with Dena Bank and Vijaya Bank in 2019 have shown falls in stressed assets that possibly foreshow the future furtherance in asset quality of other four anchor banks that are merged with six banks, with effect from April 2020.

JEL: G21, G34
Living creatures, humankind, and the history of who we are
Authors: Mojica Laura
Published: August 2021

Breathing Life into Biology is a brave attempt to do science while wearing its values on its sleeves. It is written under the commitment that life is intrinsically valuable, and its value has to be taken seriously in doing biology. Stewart defends a conception of life in which every living organism has a subjective point of view from which it makes sense of the world. Under this conception and the commitment that life is valuable in itself, the book presents the story of life from its origin and our history as humankind. However, the book is more successful in presenting the former than the latter. Yet Stewart’s conception of enaction opens the possibility for cognitive science and his conception of what makes us human enables us to embrace the histories and the forms of life of those who have been systematically silenced.
Amplitude modulation control method for bursting dynamics under time-delayed feedback
Authors: Yu Yue , Wang Ning , Chen Zhenyu
Published: August 2021

Time-delayed feedback control is one of the important active control methods for complex dynamical behaviors in nonlinear systems. Yet its relationship and effectiveness on multiple time scale dynamics need to be further explored. As a purpose to gain insight into such complexity, we investigate the effectiveness of amplitude modulation in controlling (suppressing or enhancing) bursting oscillations in a classical mechanical oscillator with time-delayed feedback. It is shown how the presence of delay can change the amplitude of the singular cycle oscillations, or suppress them altogether. The results are compared to the conventional periodic perturbation method. In many cases, the amplitudes of periodic solutions under delayed feedback are easier to satisfy the technical requirements. If the delayed feedback is added, stable periodic bursting can be easily accomplished. Therefore, we demonstrate that an effective vibration modulation for bursting dynamics is possible if appropriate time delay and feedback gains are chosen.
Arts and Humanities Interventions for Flourishing in Healthy Adults: A Mixed Studies Systematic Review
Authors: Shim Yerin , Jebb Andrew T. , Tay Louis , Pawelski James O.
Published: August 2021

The arts and humanities have enriched human life in various ways throughout history. Yet, an analysis of empirical research into the effects of arts and humanities engagement remains incomplete, calling for a systematic and integrative understanding of the role of arts and humanities in promoting human flourishing. The present study used a mixed studies systematic review approach to integrating recent evidence from 27 intervention studies on the effectiveness of arts and humanities interventions on psychological flourishing of healthy adults. Our final dataset both represented quantitative and qualitative data on real-world interventions that encompassed a range of arts and humanities domains, including music, theater, visual arts, and integrative arts. A separate quantitative and qualitative data synthesis on study characteristics and psychological flourishing outcomes and a meta-integration of both types of evidence were conducted. Overall, arts and humanities interventions were associated with positive changes in a range of psychological flourishing outcomes, with overlapping quantitative and qualitative evidence for emotional, social, and sense of self outcomes. A secondary analysis explored key contextual and implementation features that contributed to effectiveness. Recommendations for future research and practice are provided based on our review.
Economic And Environmental Impact Of The Tourism Carrying Capacity: A Local-Based Approach
Authors: Garau Giorgio , Carboni Donatella , Karim El Meligi Andrea
Published: August 2021

The design and the evaluation of sustainable tourism policies require involving all the actors in the decision-making process. One of the critical aspects at the regional level is the absence of a clear definition of instruments and methodologies able to involve all the actors and to meet different policy targets. The aim of this study is to assess the economic and environmental impact of the tourism carrying capacity by proposing a framework able to deal with multiple variables. To this end, a social accounting matrix is built for a local area composed by four municipalities within the Sardinia region (Italy), and then it is used as a reference frame to implement the extended multisectoral model. Such an approach will provide results, on visitors flow recorded in the Asinara National Park, in terms of value added and CO2 emissions changes.
Increased Systolic Blood Pressure Mediates the Relationship Between Urate and Gout Risk in Indonesia: A Novel Application of a Partial Least Squares-Structural Equation Model
Authors: Dyah Kurniasari Maria , Karwur Ferry Fredy , Rayanti Rosiana Eva , Huruta Andrian Dolfriandra , Lin Yu Huei , Weng Shuen Fu , Tsai Hsiu Ting
Published: August 2021

Background:

Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout.

Objective:

We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model.

Method:

A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting.

Result:

We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48–7.09) and an AOR of 4.44 (95% CI: 3.07 –6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02–0.08], p < 0.001).

Conclusion:

Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.
Competitiveness in the visitor economy: A systematic literature review
Authors: Kim Yoo Ri , Liu Anyu , Williams Allan M
Published: August 2021

Competitiveness is a well-discussed research topic in various disciplines and fields, amongst which competitiveness in the visitor economy is a prominent research stream. With rapid transformations in the visitor economy, destinations, regions, sectors and businesses have had to adapt – with varying degrees of success – to internal and external changes, significantly affecting their competitiveness. Existing studies are dominantly based on a few pioneering models and indicators and relatively few empirically challenge the assumed causality of competitiveness factors at different scales. This article, therefore, conducts a systematic literature review of competitiveness in the visitor economy post-2005 and examines the intellectual and conceptual structures of the extant literature as a platform to identify knowledge gaps and emerging trends and perspectives for future research.
‘It is not good for the person to be alone’: The capabilities approach and the right to communicate
Authors: Schejter Amit M
Published: August 2021

For decades, attempts have been made to define a ‘right to communicate’. The rise of media technologies, which are characterized by abundance of channels and information, interactivity, mobility, and multimediated messaging, has allowed to rethink this right in a context converging traditional media and telecommunications and referring to communicating as an essential human capability. Applying Amartya Sen’s capabilities approach to communications, we argue that communicating is a capability required to realize such functionings as participating in political, cultural, social, educational, and commercial life and is essential to promote belonging to a collective. The ‘negative’ right to free speech should be replaced by a positive right to communicate, which should include free speech, access to information, privacy, and utilization of communications in order to belong to a community.
National narcissism and support for voluntary vaccination policy: The mediating role of vaccination conspiracy beliefs
Authors: Cislak Aleksandra , Marchlewska Marta , Wojcik Adrian Dominik , Śliwiński Kacper , Molenda Zuzanna , Szczepańska Dagmara , Cichocka Aleksandra
Published: August 2021

We investigate the relationship between vaccination hesitancy and the way people feel about their national groups. Antivaccination attitudes are associated with conspiracy beliefs, which have been linked to group-based defensiveness. Thus, we hypothesized that defensiveness about one’s national identity, operationalized as collective narcissism measured in relation to one’s national group, might be related to antivaccination attitudes. We found that national narcissism, but not national identification, predicted support for a voluntary vaccination policy both in a general population sample ( N = 361) and among visitors of antivaccination discussion forums ( N = 178). In two further studies involving national quota samples, national narcissism was also related to vaccination conspiracy beliefs ( N = 1,048), and these beliefs mediated its association with support for a voluntary vaccination policy ( N = 811). By highlighting the link between antiscience attitudes and collective narcissism, we demonstrate that group defensiveness can be linked to support for decisions that may undermine the health and well-being of present and future ingroup members.
A deep neural network-based vehicle re-identification method for bridge load monitoring
Authors: Zhang Yufeng , Xie Junxin , Peng Jiayi , Li Hui , Huang Yong
Published: August 2021

The accurate tracking of vehicle loads is essential for the condition assessment of bridge structures. In recent years, a computer vision method that is based on multiple sources of data from monitoring cameras and weight-in-motion (WIM) systems has become a promising strategy in bridge vehicle load identification for structural health monitoring (SHM) and has attracted increasing attention. The implementation of vehicle re-identification, namely, the identification of the same vehicle from images that were captured at different locations or time instants, is the key topic of this study. In this study, a vehicle re-identification method that is based on HardNet, a deep convolutional neural network (CNN) specialized in picking up local image features, is proposed. First, we obtain the vehicle point feature positions in the image through feature detection. Then, the HardNet is employed to encode the point feature image patches into deep learning feature descriptors. Re-identification of the target vehicle is achieved by matching the encoded descriptors between two images, which are robust toward scaling, rotation, and other types of noises. A comparison study of the proposed method with three published vehicle re-identification methods is performed using vehicle image data from a real bridge, and the superior performance of our proposed method is demonstrated.
Producing anti-regime protest news in a polarized and clientelistic media system: A frame building approach
Authors: Camaj Lindita
Published: August 2021

This study examines media coverage of the 2019 anti-government protests in Montenegro. Based on 13 in-depth interviews and a quantitative content analysis, the data shed light on ways in which democratization struggles are manifested via protest framing in a polarized media system. This paper argues that media clientelism, as manifested through political parallelism and media instrumentalization, provides a better theoretical and analytical framework to understand not only the influence of structural factors that determine protest coverage, but also the role of ideology and journalism cultures embraced at the individual level. This framework is helpful to understand the role of media in democratic struggle not only in emerging and defective democracies, but also in increasingly polarizing societies in the West.
One union, different futures? Public preferences for the EU's future and their explanations in 10 EU countries
Authors: Goldberg Andreas C , van Elsas Erika J , de Vreese Claes H
Published: August 2021

Most studies of public opinion towards the European Union focus on attitudes regarding the past and present of the European Union. This study fills a gap by addressing attitudes towards the European Union's future. We expand on a recently developed approach measuring preferences for eight concrete future European Union scenarios that represent the ongoing political and public debate, employing original survey data collected in 2019 in 10 European Union countries. We assess cross-national differences in the distribution of future European Union preferences, as well as in citizens’ motivations to prefer different variants of Europe in the future. The findings show citizens’ fine-grained future European Union preferences, which are meaningfully related to common explanations of European Union support. We also find cross-national differences linked to countries’ structural position within the European Union.
Caregiver–provider communication about pain in persons with dementia
Authors: Riffin Catherine , Patrick Karlee , Lin Sylvia L. , Carrington Reid M. , Herr Keela , Pillemer Karl A.
Published: August 2021

Background

Pain in older persons with dementia is both under-detected and under-managed. Family caregivers can play an important role in addressing these deficiencies by communicating their care recipient’s symptoms and behaviors to medical providers, but little is known about how caregivers and providers approach pain-related discussions in the context of dementia. The goal of this study was to explore how ambulatory care providers and family caregivers of persons with dementia view pain communication.

Methods

In-depth, semi-structured interviews were conducted with family caregivers ( n = 18) and healthcare providers involved in dementia care ( n = 16). Interviews focused on three specific content areas: (1) caregivers’ roles in communicating about pain in persons with dementia, (2) challenges experienced when communicating about pain in persons with dementia, and (3) strategies and recommendations for optimizing communication in this context. All interviews were audio-recorded, transcribed, and analyzed using the constant comparative method of data analysis.

Results

Caregivers and providers described various roles that caregivers assumed in communication processes, such as serving as historians, interpreters, and advocates. They identified two key features of problematic communication—receipt of inadequate information and interpersonal conflict about the care recipient’s pain—and articulated how ambiguity around pain and dementia, as well as preexisting beliefs and emotions, contributed to communication challenges. They also offered several suggestions to improve caregiver–provider communication processes, including the use of (1) written records to enhance the accuracy of caregivers’ reports and ensure that providers had specific information to inform symptom management and treatment plans, (2) pain scales and follow-up discussions to establish baseline data and clarify treatment recommendations, and (3) collaboration and rapport-building strategies to validate the caregivers’ contributions and maximize a team-based decision-making.

Conclusion

Receipt of inadequate information and interpersonal conflict are key challenges to caregiver–provider communication regarding pain in persons with dementia. Written records, pain scales, and rapport-building strategies may help to address these challenges.
High-Precision Quantitative Analysis Reveals Carcinoembryonic Protein Expression Differs Among Colorectal Cancer Primary Foci and Metastases to Different Sites
Authors: Zhu Yazhen , Zhang Qin , Wei Chengjiang , Hu Ying , Gong Han , Liu Yi , Lai Hao , Feng Yan , Lin Yuan
Published: August 2021

The expression of carcinoembryonic protein (CEA) is an important biological marker and therapeutic target in colorectal cancer (CRC). CEA expression heterogeneity confers resistance to CEA-targeting immunotherapy antibodies. Thus, quantification of the CEA-positive cell ratio among all tumor cells would be important in identifying patients that would benefit from CEA-targeted therapies. However, the proportion of tumor cells that express CEA within primary and metastasized tumors at different sites has not been studied. Therefore, the present study aimed to determine CEA positive cell proportion in paired CRC primary foci, liver metastases, and lymph node (LN) metastases, and whether proportion of CEA positive cell differs among colorectal cancer primary foci, liver metastases, and LN metastases from 26 patients. The CEA expression was detected by immunohistochemical assay. Then we set up a quantification approach to quantify the proportion of CEA-positive cells based on the TissueGnostics (TG) system. Then the proportion of CEA positive cells were measured and compared among primary foci, liver metastases, and LN metastases. As a result, the proportion of CEA positive tumor cells was slightly higher in liver metastases than in primary foci (89.8% ± 2.71% vs 82.1% ± 5.05%, P < 0.001). The proportion of CEA-positive cells was significantly lower in LN metastases than in primary foci (82.3% ± 4.32% vs 70.28% ± 5.04%, P < 0.001). In 8 cases with matched CRC primary foci, liver metastases, and LN metastases, the proportions of CEA proportion in liver metastasis was the highest, followed by primary foci and LNs metastasis. In conclusion, this study provided an new approach for quantification of CEA positive cell in tumors and proved the percentage of CEA-positive cells varied in different metastases.
A Gender Perspective on Sick Leave Among Young Adults – Barriers and Resources for Return to Work as Experienced by Young Employees and Managers: A Protocol for a Qualitative Study
Authors: Olsson Caroline , Tinnerholm Ljungberg Helena , Björk Brämberg Elisabeth , Jensen Irene , Nybergh Lotta
Published: August 2021

Introduction: About 20% of the working-age population in the average OECD country is suffering from a mental disorder. The prevalence rates are especially high among young adults and women. Young adults need to deal with challenges connected to growing up and entering the labour market, their young age often leaving them with little experience and a low level of preparedness for failure. Moreover, young women and men are confronted with gender norms and expectations that have been found to affect both sick leave and return to work. While managers have been shown to have a significant impact on the well-being of employees, few studies investigate the experiences of both employees and managers in relation to sick leave and return to work among youth. The aim of this study is to investigate perceived causes of sick leave owing to common mental disorders as well as barriers to and resources for return to work for young employees, from the perspectives of both employees and managers. Furthermore, differences and similarities in the patterns of experiences of women and men will be analyzed. Methods and analysis: This study has a qualitative research design. Data will consist of individual interviews with employees aged 19–29 and managers in female- and male-dominated occupations in a Swedish setting. The participants will be recruited using a purposive sampling strategy. The interviews will be analysed in two steps: firstly, a conventional content analysis will be conducted. Secondly, a gender analysis focusing social relations and gender order will be applied to interpret the data by examining differences and similarities in the patterns of experiences of women and men.
Adherence to a generic medicine policy: A developing country's experience
Authors: Nkansah Samuel , Bearden Frank C , Frempong-Ainguah Faustina , Nkansah Florence Amah
Published: August 2021

Escalating pharmaceutical expenditure is a global phenomenon, and Ghana has not been spared. To attend to the increasing cost of healthcare resulting from the high cost of drugs, the government of Ghana took a strategic decision to reduce its expenditure on healthcare without compromising the quality of care. The government directed that all medicines be prescribed by their generic names only at all health facilities. The purpose of this study is to assess the extent to which physicians adhere to the policy by assessing physicians' generic medicine prescribing patterns across the healthcare system in selected facilities in the Greater Accra Region. Questionnaires were administered to 87 physicians in 13 selected health facilities in Ghana. The results were analyzed using SPSS. The study's findings revealed that 74.7% of physicians adhere to the policy, and there is a likely

relationship between knowledge of the policy and its implementation. Also, there is no significant relationship between health facility, physician's experience, disease diagnosis stage, and the prescribing of generic medicines. There is a need for regular review of the policy with aggressive and wellstructured in-service training on the subject and the introduction of pharmacists' substitution rights.
The Arctic as a “Strategic” and “Important” Chinese Foreign Policy Interest: Exploring the Role of Labels and Hierarchies in China’s Arctic Discourses
Authors: Andersson Patrik
Published: August 2021

Research confirms that China is becoming more engaged in the Arctic. However, international relations scholarship often extrapolates from relatively few instances of activity to wide-ranging claims about Chinese priorities. Fortunately, Chinese political discourse is organised by labels that allow us to study how the Arctic is classified and ranked along China’s other foreign policy priorities. This article analyses two such classifications – “important maritime interest” and “strategic new frontier,” exploring how they have come about, what they mean, and how they add political priority to the Arctic. It argues that hierarchies are constructed in two ways: by adding gradients and by including/excluding in categories of priority. It views categories as performative: they not only convey information about character and relative importance of interests but are also used for achieving different objectives. By focusing on foreign policy classifications, the article contributes to a more nuanced and precise understanding of China’s Arctic interests.
Effects of Fluticasone Exhalation Delivery System in Patients With Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review
Authors: Wu Dawei , Huang Tianhao , Wei Yongxiang
Published: August 2021

Background

Nasal sprays with corticosteroids deliver medication to the restricted areas including anterior and inferior parts of the nasal cavity. The fluticasone exhalation delivery system (EDS-FLU) has recently been proved to improve care by increasing superior/posterior intranasal corticosteroid deposition.

Objective

This study aims to evaluate the efficacy of EDS-FLU in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

Methodology

A systematic literature review using Pubmed, Embase, Cochrane Library, and Web of Science was conducted to identify studies assessing the effect of EDS-FLU on outcomes in patients with CRSwNP.

Results

Of the initial 108 abstracts reviewed, 4 full-text articles were included. The 22-item sinonasal outcome test scores were significantly decreased in patients with CRSwNP after receiving EDS-FLU twice a day (93, 186, or 372 μg) for 16 weeks when compared with exhalation delivery system (EDS)-placebo (all P < .001). Patients with CRSwNP reported significant improvement of smell after receiving twice daily EDS-FLU twice a day (93, or 372 μg) for 4 weeks when compared with EDS-placebo (all P < .05). The proportions of patients achieving ≥1-point improvement in total polyp grade were significantly higher in EDS-FLU group and dose dependent, with the highest rates in the 372 μg group. The proportions of patients achieving polyp elimination were significantly higher in EDS-FLU group with the highest rates in the 372 μg group.

Conclusion

This is the first systematic review of the clinical outcomes in patients with CRSwNP treated with EDS-FLU. EDS-FLU produced significant improvements regarding the quality of life, smell, and endoscopic assessment of polyp grade.
Characterization of Macroporous Polycaprolactone/Silk Fibroin/Gelatin/Ascorbic Acid Composite Scaffolds and In Vivo Results in a Rabbit Model for Meniscus Cartilage Repair
Authors: Abpeikar Zahra , Moradi Lida , Javdani Moosa , Kargozar Saeid , Soleimannejad Mostafa , Hasanzadeh Elham , Mirzaei Seyed Abbas , Asadpour Shiva
Published: August 2021

Objective

Meniscus injuries in the inner avascular zone have weak intrinsic self-healing capacity and often progress to osteoarthritis. This study focused on evaluating the effects of polycaprolactone/silk fibroin/gelatin/ascorbic acid (PCL/SF/Gel/AA) composite scaffolds seeded with adipose-derived mesenchymal stem cells (ASCs), in the meniscus repair.

Design

To this end, composite scaffolds were cross-linked using N-hydroxysuccinimide and 1-ethyl-3-(3-dimethyl-aminopropyl)-1-carbodiimide hydrochloride. Scaffolds were then characterized by scanning electron microscope, mechanical tests, total antioxidant capacity, swelling, and toxicity tests.

Results

The PCL/SF/Gel/AA scaffolds exhibited suitable mechanical properties. Furthermore, vitamin C rendered them the highest antioxidant capacity. The PCL/SF/Gel/AA scaffolds also showed good biocompatibility and proliferation for chondrocytes. Moreover, the PCL/SF/Gel/AA scaffold seeded with allogeneic ASCs was engrafted in New Zealand rabbits who underwent unilateral punch defect in the medial meniscus of the right knee. After 2 months postimplantation, macroscopic and histologic studies for new meniscus cartilage were performed.

Conclusions

Our results indicated that the PCL/SF/Gel/AA composite scaffolds seeded with allogeneic ASCs could successfully improve meniscus healing in damaged rabbits.
Directed stimulation of the dentato-rubro-thalamic tract for deep brain stimulation in essential tremor: a blinded clinical trial
Authors: Middlebrooks Erik H , Okromelidze Lela , Carter Rickey E , Jain Ayushi , Lin Chen , Westerhold Erin , Peña Ashley B , Quiñones-Hinojosa Alfredo , Uitti Ryan J , Grewal Sanjeet S
Published: August 2021

Objective

Observational studies utilising diffusion tractography have suggested a common mechanism for tremor alleviation in deep brain stimulation for essential tremor: the decussating portion of the dentato-rubro-thalamic tract. We hypothesised that directional stimulation of the dentato-rubro-thalamic tract would result in greater tremor improvement compared to sham programming, as well as comparable improvement as more tedious standard-of-care programming.

Methods

A prospective, blinded crossover trial was performed to assess the feasibility, safety and outcomes of programming based solely on dentato-rubro-thalamic tract anatomy. Using magnetic resonance imaging diffusion-tractography, the dentato-rubro-thalamic tract was identified and a connectivity-based treatment setting was derived by modelling a volume of tissue activated using directional current steering oriented towards the dentato-rubro-thalamic tract centre. A sham setting was created at approximately 180° opposite the connectivity-based treatment. Standard-of-care programming at 3 months was compared to connectivity-based treatment and sham settings that were blinded to the programmer. The primary outcome measure was percentage improvement in the Fahn–Tolosa–Marín tremor rating score compared to the preoperative baseline.

Results

Among the six patients, tremor rating scores differed significantly among the three experimental conditions ( P=0.030). The mean tremor rating score improvement was greater with the connectivity-based treatment settings (64.6% ± 14.3%) than with sham (44.8% ± 18.6%; P=0.031) and standard-of-care programming (50.7% ± 19.2%; P=0.062). The distance between the centre of the dentato-rubro-thalamic tract and the volume of tissue activated inversely correlated with the percentage improvement in the tremor rating score (R2=0.24; P=0.04). No significant adverse events were encountered.

Conclusions

Using a blinded, crossover trial design, we have shown the technical feasibility, safety and potential efficacy of connectivity-based stimulation settings in deep brain stimulation for treatment of essential tremor.
Changes in Patient Satisfaction Scores During the Early COVID-19 Pandemic
Authors: Maher Dermot P , Hess Demere , Edwards Chevaune , Allen Lisa
Published: August 2021

The coronavirus disease 2019 (COVID-19) pandemic has caused a rapid and widespread application of telemedicine services in the outpatient setting. Prior to COVID-19, patient satisfaction was measured with Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Survey (CG-CAHPS) and was then measured with the Press Ganey telemedicine survey. Both surveys ask about a patient’s likelihood to recommend a particular medical practice, which is a useful, but imperfect, surrogate for overall satisfaction. The purpose of this analysis was to identify any changes in patient satisfaction scores with the implementation of telemedicine services. A retrospective analysis of our institution’s experience during the early months of the COVID-19 pandemic compared to the months immediately prior to the pandemic was conducted. The percent of patients with a “Top box” response to survey questions regarding their likelihood to recommend a medical practice were compared. A total of 14 430 CG-CAHPS results collected in November 2019 through February 2020 were compared to 22 009 telemedicine survey results collected between March and May 2020. In general, most medical specialties incorporated telemedicine but suffered a decrease in their patient’s likelihood to recommend a medical practice during the first few months of the pandemic. However, the magnitude of this decrease was variable by medical specialty. Physical medicine and rehabilitation and pain medicine had relatively poor scores prior to the pandemic which did not statistically change. Oncology was the sole medical specialty that continued to have unchanged high patient satisfaction scores. These data provide insights for the refinement of telemedicine.
Increases in Psychological Flexibility Mediate Relationship Between Acute Psychedelic Effects and Decreases in Racial Trauma Symptoms Among People of Color
Authors: Davis Alan K. , Xin Yitong , Sepeda Nathan D. , Garcia-Romeu Albert , Williams Monnica T.
Published: August 2021

Background

Previous research showed acute psychedelic effects were associated with decreases in racial trauma (RT) symptoms among black, indigenous, and people of color (BIPOC). Among samples comprised primarily of white participants, positive outcomes of psychedelic experiences have been mediated by increases in psychological flexibility. Therefore, we examined whether changes in psychological flexibility from before to after a psychedelic experience mediated the relationship between acute psychedelic effects and changes in RT symptoms among BIPOC.

Methods

This cross-sectional online survey study included 313 BIPOC (mean age = 33.1; SD = 11.2; female = 57%). A multiple linear regression analysis was used to examine the association between acute psychedelic effects and decreases in RT symptoms in a nonclinical setting; a path analysis was used to explore whether changes in psychological flexibility mediated this relationship.

Results

Acute insight and challenging effects were significantly ( p < .001) associated with decreases in RT symptoms following a psychedelic experience. Increases in psychological flexibility partially mediated relationships between greater intensity of psychological insight and less intensity of challenging experiences and decreases in RT symptoms ( ps<.001).

Conclusion

This research suggests psychedelics confer potential benefits in decreasing RT symptoms among BIPOC and psychological flexibility may be an important mediator of these effects. Future research should test this hypothesis in a longitudinal clinical trial among BIPOC.
In Type 2 Diabetes Mellitus Patients, the Atherogenic Index of Plasma as a Marker of Coronary Artery Diseases
Authors: Al-Shaer Muhammed Hossam , Elzaky Manar Mostafa , Farag El Sayed Mohamed , Saad Mostafa Osama Mohamed
Published: August 2021

One-third of all deaths globally are caused by cardiovascular disease (CVD), and this percentage is predicted to climb as CVD risk factors become more widespread. Primary prevention of risk factors is the most fundamental duty in dealing with the CVD epidemic. The link between atherogenic index of plasma (AIP) and other CVD risks among university workers was investigated among study participants in order to demonstrate that AIP, not lipid profile, is a better predictor of CVDs. They discovered a link between AIP and CVD risk variables (body mass index, visceral fat, body fat, total cholesterol, low density lipoprotein cholesterol, triglyceride, glucose, and high density lipoprotein cholesterol) in people with type 2 diabetes. This comparative study was carried out in Cardiology Department, Zagazig University Hospitals. This study included 140 type 2 diabetes mellitus patients. They were classified into 2 main groups:

Group 1: 70 patients with type 2 diabetes who had coronary artery disease (CAD).

Group (2): 70 type 2 diabetes individuals with no indicators of CAD (admitted complaining of symptoms of angina or CA showing no significant stenotic lesions).

Regarding study explained it has showed that AIP outperforms standard lipid indicators in predicting the likelihood ofdeveloping CADs in people with type 2 diabetes. In addition, the value of AIP in diabetic and prediabetic patients for predicting future CVD is being investigated. They came to the conclusion that AIP is an excellent predictor of future CVD in those with diabetes and those who are prediabetic.
Lateral Retinaculum Lengthening and Medial Patellofemoral Ligament Reconstruction With Adductor Sling Technique
Authors: Martinez-Cano Juan Pablo , Gomez-Sierra Maria Antonia , Castelo Andreu , Mejía Fernando Manuel
Published: August 2021

Background:

There are multiple ways of reconstructing the medial patellofemoral ligament (MPFL), including dynamic techniques that fix the graft to the adductor magnus tendon. We present this technique associated to an increasingly common surgery used as adjuvant in some patients with patellar instability, lateral retinaculum lengthening.

Indications:

Recurrent patellar dislocation with medial laxity and lateral tightness/lateral tilt.

Technique Description:

This is double bundle MPFL reconstruction with anterior tibialis tendon allograft. Both autograft or allograft may be used, with a minimum length of 15 cm. The graft is fixed to the proximal third of the patella, passing as a sling under the adductor magnus tendon where it is fixed with sutures and returns to the patella. The patellar fixation includes a 10 to 15 mm deep and 4 to 4.5 mm diameter tunnel in the proximal third with suture stitches to the soft tissues in the entrance of the tunnel, plus an anterior periostic tunnel for the second bundle in the proximal third of the patella fixed with suture stitches. Meanwhile, the lateral retinaculum is incised longitudinally into a superficial and deep layer, in order to lengthen it the desired length.

Results:

The expected outcome of the procedure is to have a stable patellofemoral joint, with patients that gain the lost function and may return to sport without recurrence of patellar dislocation.

Discussion/Conclusion:

This is a simple, cheap, and reproducible technique that corrects both medial laxity and lateral tightness for patients with recurrent patellar dislocation.
Design of computer experiments for developing seismic surrogate models
Authors: Burton Henry , Xu Hongquan , Yi Zhengxiang
Published: August 2021

Surrogate models are growing in popularity within the earthquake engineering community because of their ability to increase the efficiency of computationally intensive tasks. This article examines the design of computer experiments (DoCE) for the purpose of developing seismic surrogate models. Two categories of DoCE approaches are discussed while underscoring the benefits and drawbacks of specific methods. Further insight is provided through an illustrative case study that develops surrogate models to predict the median collapse capacity and expected annual losses in single-family woodframe buildings with cripple walls. The implications of the chosen DoCE method on the predictive performance and efficiency (in terms of the required number of explicit simulations) of the associated surrogate models are closely examined. The results show that both factorial and Latin hypercube designs [Formula: see text] do not perform well when different approaches are used to generate the training and testing sets (i.e. out-of-design-type testing). An efficient hybrid design that combines an orthogonal array-based composite design with a small number of [Formula: see text] samples is shown to produce a surrogate model with superior predictive performance.
The mineralogy of the historical Mochalin Log REE deposit, South Urals, Russia. Part IV. Alexkuznetsovite-(La), La2Mn(CO3)(Si2O7), alexkuznetsovite-(Ce), Ce2Mn(CO3)(Si2O7) and biraite-(La), La2Fe2+(CO3)(Si2O7), three new isostructural minerals and a definition of the biraite group
Authors: Kasatkin Anatoly V. , Zubkova Natalia V. , Pekov Igor V. , Chukanov Nikita V. , Škoda Radek , Agakhanov Atali A. , Belakovskiy Dmitriy I. , Britvin Sergey N. , Yu. Pushcharovsky Dmitry
Published: August 2021

Three new isostructural minerals, alexkuznetsovite-(La), ideally La2Mn(CO3)(Si2O7), alexkuznetsovite-(Ce) Ce2Mn(CO3)(Si2O7) and biraite-(La) La2Fe2+(CO3)(Si2O7), were discovered in polymineralic nodules from the Mochalin Log REE deposit, South Urals, Russia. The new minerals form anhedral grains up to 0.3 mm × 0.4 mm [alexkuznetsovite-(La)], 0.5 mm × 0.9 mm [alexkuznetsovite-(Ce)] and 0.2 mm × 1.2 mm [biraite-(La)] embedded in granular aggregates consisting of different REE minerals [allanite-(Ce)/-(La), bastnäsite-(Ce)/-(La), fluorbritholite-(Ce), perbøeite-(Ce)/-(La), percleveite-(Ce)/-(La) and törnebohmite-(Ce)/-(La)]. All three new species are brown to dark brown, translucent in thin fragments, with white streak, vitreous lustre and Mohs’ hardness of ~5. Dcalc = 4.713 [alexkuznetsovite-(La)], 4.687 [alexkuznetsovite-(Ce)] and 4.682 [biraite-La)] g⋅cm–3. Their empirical formulae, calculated on the basis of 2 Si and 10 O apfu, are: alexkuznetsovite-(La): (La0.98Ce0.89Nd0.10Pr0.05)Σ2.02Mn2+0.50Fe2+0.29Ca0.12Mg0.03(CO3)0.94(HCO3)0.06 (Si2O7); alexkuznetsovite-(Ce): (Ce0.96La0.78Nd0.16Pr0.07)Σ1.97Th0.01Mn2+0.50Fe2+0.33Ca0.14Mg0.02(CO3)0.93(HCO3)0.07(Si2O7); and biraite-(La): (La0.95Ce0.87Nd0.08Pr0.04)Σ1.94Th0.01Ca0.12Fe2+0.44Mn2+0.38Mg0.07(CO3)0.88(HCO3)0.12(Si2O7). The new minerals are monoclinic, P21/c and Z = 4. The unit-cell parameters of alexkuznetsovite-(La)/alexkuznetsovite-(Ce)/biraite-(La) are: a = 6.5642(3)/6.5764(4)/6.5660(10), b = 6.7689(3)/6.7685(4)/6.7666(11), c = 18.7213(10)/18.7493(15)/18.698(3) Å, β = 108.684(6)/108.672(8)/108.952(16)° and V = 788.00(7)/790.66(10)/785.7(2) Å3. The crystal structures are solved from single-crystal X-ray diffraction data; R = 0.0628 [alexkuznetsovite-(La)], 0.0589 [alexkuznetsovite-(Ce)] and 0.1193 [biraite-(La)]. A new biraite group is defined; it includes isostructural biraite-(Ce) and the three new minerals described herein. The rootname alexkuznetsovite is given in honour of the Russian mineral collector Alexey M. Kuznetsov (born 1962) who provided samples in which all three new minerals were found. The Levinson's suffix-modifier -(La) or -(Ce) indicates the predominance of La or Ce among REE in the mineral. Biraite-(La) is named as an analogue of biraite-(Ce) with La prevailing among REE.
Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma in Taiwan
Authors: Hsu Ming-Hung , Wang Wen-Lun , Chen Tzu-Haw , Tai Chi-Ming , Wang Hsiu-Po , Lee Ching-Tai
Published: August 2021

Background

Endoscopic submucosal dissection (ESD) is gradually turning into the standard treatment for superficial esophageal squamous cell carcinoma (SESCC), however, the long-term outcomes have hardly ever been reported outside Japan.

Method

We consecutively recruited patients with SESCC who had received ESD treatment at E-Da Hospital. The demographics, pathological characteristics, and Lugol staining background pattern (type A or B: none or < 10 small Lugol-voiding lesions [LVLs]; type C or D: > 10 small or multiform LVLs) were collected, and then correlated to outcomes and survival.

Results

Total of 229 lesions were enrolled and the mean lesion size was 3.28 ± 1.69 (range 1–10) cm. 72% of the lesions had a type C-D Lugol staining background pattern. After ESD, the en bloc and R0 resection rates were 93.9% and 83.5%, respectively. Forty-nine subjects developed complications, including six (2.6%) with major bleeding, two (0.9%) with perforation, and 41 (17.9%) with strictures. Pathological staging showed that 19 cases had deep submucosal cancer invasion and subsequently received adjuvant therapies. During a mean follow-up period of 52.6 (range 3–146) months, 41 patients developed metachronous recurrence. The patients with a type C-D Lugol staining background pattern were associated with a higher risk of recurrence than those with few LVLs (log-rank P = 0.019). The 10-year survival rate was more than 90%, and only eight patients died of ESCC.

Conclusion

ESD has excellent long-term outcomes but a high risk of metachronous recurrence. The Lugol staining pattern over the background mucosa could offer the risk stratification of metachronous recurrence.
Kikuchi-Fujimoto disease presenting in a patient with SARS-CoV-2: a case report
Authors: Racette Samuel D. , Alexiev Borislav A. , Angarone Michael P. , Bhasin Ajay , Lima Kaitlin , Jennings Lawrence J. , Balasubramanian Senthil , Matsuoka Akihiro J.
Published: August 2021

Background

We present a yet to be described association of SARS-CoV-2 infection with Kikuchi-Fujimoto disease.

Case presentation

A 32-year-old physician with history of SARS-CoV-2 infection presented to the emergency department with 2 weeks of fever, chills, and right sided cervical lymphadenopathy. He was treated empirically for presumed folliculitis with worsening of symptoms leading to repeat presentation to the emergency department.

Extensive workup was unrevealing of an infectious cause and needle biopsy of the lesion was unrevealing. An excisional lymph node biopsy revealed follicular hyperplasia with necrotic foci showing abundance of histiocytes at the edge of necrosis with CD8 predominance of T-cells. Final diagnosis was deemed to be Kikuchi-Fujimoto disease. Antibiotic therapy was discontinued, and the patient’s symptoms resolved with steroid therapy and expectant management.

Conclusions

This is the first report of a patient developing Kikuchi-Fujimoto disease following SARS-CoV-2 infection. Clinicians should be aware of Kikuchi-Fujimoto disease as a possibility when approaching patients with hyper-inflammatory states who present with cervical lymphadenopathy.
Advance care planning preferences in Chinese nursing home residents: results from two cross-sectional studies in Hong Kong and Taiwan
Authors: Xu Xinyi , Tu Shu-Wen , Lin Chia-Chin
Published: August 2021

Background

The proportion of hospital deaths has declined in the past few decades, while the proportions of nursing home deaths have increased. This trend of increasing deaths in long-term care facilities underlines the importance of improving end-of-life care provisions in these settings to meet individual preferences and needs. Under these circumstances, a comprehensive understanding of end-of-life care preferences in local nursing home residents can help healthcare professionals and policymakers develop strategies to increase the advance directive completion rate and quality of care. This study aimed to explore and compare advance directive and end-of-life care preferences of nursing home residents in Hong Kong and Taiwan.

Methods

A structured questionnaire was developed by the research team to investigate advance directive and end-of-life care preferences in older Chinese nursing home residents. Nursing home residents with frail or pre-frail status and over the age of 64 were invited to participate in the study, and information on demographics, functional status, advance directive experiences, and end-of-life care expectations was collected through questionnaire interviews.

Results

A total of 325 eligible participants from 32 facilities completed the survey, including 238 older residents in Hong Kong and 87 in Taiwan. A significantly lower proportion of the Hong Kong residents had completed an advance directive compared with the Taiwanese (3 vs. 13%, p = 0.001). Among participants who did not have an advance directive, 46% of the Taiwanese participants said they would consider completing one in the future, compared with 20% of the Hong Kong participants (p < 0.001). A total of 79% of the Hong Kong participants and 80% of the Taiwanese participants responded that prolonging life in the given hypothetical dying scenario was “not important” (p = 0.76). Only 14% of participants in Hong Kong and 18% of participants in Taiwan reported prior occurrence of end-of-life care discussions with family members or health professionals (p = 0.37).

Conclusions

This paper adds evidence in support of improving end-of-life communication and the advance directive completion rate in nursing homes in Hong Kong and Taiwan. Further research is necessary to explore cross-cultural differences in end-of-life preferences and its applications in predicting decision-making and the quality of end-of-life care.