bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Resolution NWP Forecast Precipitation Comparison over Complex Terrain of the Sierras de Córdoba during RELAMPAGO-CACTI
Authors: Casaretto Gimena , Dillon Maria Eugenia , Salio Paola , Skabar Yanina García , Nesbitt Stephen W. , Schumacher Russ S. , García Carlos Marcelo , Catalini Carlos
Published: December 2021

Sierras de Córdoba (Argentina) is characterized by the occurrence of extreme precipitation events during the austral warm season. Heavy precipitation in the region has a large societal impact, causing flash floods. This motivates the forecast performance evaluation of 24-h accumulated precipitation and vertical profiles of atmospheric variables from different numerical weather prediction (NWP) models with the final aim of helping water management in the region. The NWP models evaluated include the Global Forecast System (GFS), which parameterizes convection, and convection-permitting simulations of the Weather Research and Forecasting (WRF) Model configured by three institutions: University of Illinois at Urbana–Champaign (UIUC), Colorado State University (CSU), and National Meteorological Service of Argentina (SMN). These models were verified with daily accumulated precipitation data from rain gauges and soundings during the RELAMPAGO-CACTI field campaign. Generally all configurations of the higher-resolution WRFs outperformed the lower-resolution GFS based on multiple metrics. Among the convection-permitting WRF Models, results varied with respect to rainfall threshold and forecast lead time, but the WRFUIUC mostly performed the best. However, elevation-dependent biases existed among the models that may impact the use of the data for different applications. There is a dry (moist) bias in lower (upper) pressure levels which is most pronounced in the GFS. For Córdoba an overestimation of the northern flow forecasted by the NWP configurations at lower levels was encountered. These results show the importance of convection-permitting forecasts in this region, which should be complementary to the coarser-resolution global model forecasts to help various users and decision-makers.
Exploring the Usefulness of Downscaling Free Forecasts from the Warn-on-Forecast System
Authors: Miller William J. S. , Potvin Corey K. , Flora Montgomery L. , Gallo Burkely T. , Wicker Louis J. , Jones Thomas A. , Skinner Patrick S. , Matilla Brian C. , Knopfmeier Kent H.
Published: December 2021

The National Severe Storms Laboratory (NSSL) Warn-on-Forecast System (WoFS) is an experimental real-time rapidly updating convection-allowing ensemble that provides probabilistic short-term thunderstorm forecasts. This study evaluates the impacts of reducing the forecast model horizontal grid spacing Δx from 3 to 1.5 km on the WoFS deterministic and probabilistic forecast skill, using 11 case days selected from the 2020 NOAA Hazardous Weather Testbed (HWT) Spring Forecasting Experiment (SFE). Verification methods include (i) subjective forecaster impressions; (ii) a deterministic object-based technique that identifies forecast reflectivity and rotation track storm objects as contiguous local maxima in the composite reflectivity and updraft helicity fields, respectively, and matches them to observed storm objects; and (iii) a recently developed algorithm that matches observed mesocyclones to mesocyclone probability swath objects constructed from the full ensemble of rotation track objects. Reducing Δx fails to systematically improve deterministic skill in forecasting reflectivity object occurrence, as measured by critical success index (CSIDET), a metric that incorporates both probability of detection (PODDET) and false alarm ratio (FARDET). However, compared to the Δx = 3 km configuration, the Δx = 1.5 km WoFS shows improved midlevel mesocyclone detection, as evidenced by its statistically significant (i) higher CSIDET for deterministic midlevel rotation track objects and (ii) higher normalized area under the performance diagram curve (NAUPDC) score for probability swath objects. Comparison between Δx = 3 km and Δx = 1.5 km reflectivity object properties reveals that the latter have 30% stronger mean updraft speeds, 17% stronger median 80-m winds, 67% larger median hail diameter, and 28% higher median near-storm-maximum 0–3-km storm-relative helicity.
Exploring the Differences in SPC Convective Outlook Interpretation Using Categorical and Numeric Information
Authors: Krocak Makenzie J. , Ripberger Joseph T. , Ernst Sean , Silva Carol L. , Jenkins-Smith Hank C.
Published: December 2021

While previous work has shown that the Storm Prediction Center (SPC) convective outlooks accurately capture meteorological outcomes, evidence suggests stakeholders and the public may misinterpret the categorical words currently used in the product. This work attempts to address this problem by investigating public reactions to alternative information formats that include the following numeric information: 1) numeric risk levels (i.e., “Level 2 of 5”) and 2) numeric probabilities (i.e., “a 5% chance”). In addition, it explores how different combinations of the categorical labels with numeric information may impact public reactions to the product. Survey data comes from the 2020 Severe Weather and Society Survey, a nationally representative survey of U.S. adults. Participants were shown varying combinations of the information formats of interest, and then rated their concern about the weather and the likelihood of changing plans in response to the given information. Results indicate that providing numeric information (in the form of levels or probabilities) increases the likelihood of participants correctly interpreting the convective outlook information relative to categorical labels alone. Including the categorical labels increases misinterpretation, regardless of whether numeric information was included alongside the labels. Finally, findings indicate participants’ numeracy (or their ability to understand and work with numbers) had an impact on correct interpretation of the order of the outlook labels. Although there are many challenges to correctly interpreting the SPC convective outlook, using only numeric labels instead of the current categorical labels may be a relatively straightforward change that could improve public interpretation of the product.

Significance Statement

The SPC convective outlook contains vital information that can help people prepare for a severe weather event. The categorical labels in this product are often ordered incorrectly by members of the public. This work shows using numeric levels or probabilities reduces the tendency for people to order the levels incorrectly.
High-Definition 3-D Exoscope for Micro-Laryngeal Surgery: A Preliminary Clinical Experience in 41 Patients
Authors: De Virgilio Armando , Costantino Andrea , Mercante Giuseppe , Ferreli Fabio , Yiu Phil , Mondello Tiziana , Sebastiani Daniela , Malvezzi Luca , Pellini Raul , Spriano Giuseppe
Published: December 2021

Objective:

The aim of this prospective clinical study is to evaluate the feasibility of the micro-laryngeal surgery (MLS) using a 3D operating exoscope (OE) in substitution to a conventional operating microscope (OM).

Methods:

A total of 41 consecutive patients were included (male: 26; median age: 55.0 years; IQR: 46.0-68.0). After each procedure, the surgeon and the scrub nurse were asked to fill out a tailored questionnaire on a 3-point Likert scale (1—not acceptable, 2—acceptable, 3—good) including 12 items.

Results:

The majority of the procedures were therapeutic (n = 31, 75.6%), while the remaining were diagnostic (n = 10, 24.4%). All surgeries were successfully completed without the support of the OM, and no complications or unwanted delays were detected. The majority of the individual items were judged “good” either by surgeons (n = 399, 81.1%) and scrub nurses (n = 287, 87.5%). The natural posture during the procedure, and the ease of use the joystick and focusing were the best-rated items by the surgeons.

Conclusions:

This study demonstrates the feasibility of MLS using the OE. Further comparative clinical studies are needed to clarify its real value in substitution to a conventional operating microscope and to better define advantages and disadvantages.
Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation
Authors: Hollis Alison N. , Ghodke Ameer , Farquhar Douglas , Buckmire Robert A. , Shah Rupali N.
Published: December 2021

Objectives:

Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis.

Methods:

A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed.

Results:

Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT ( P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation ( P = .042) in the multivariate analysis.

Conclusions:

Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis.
Public Perceptions of Child Sexual Exploitation Abroad: A Vignette Experiment on the Influence of Social Distance
Authors: Koning Anneke
Published: December 2021

This study examines the impact of social and spatial distance on public opinion about sexual exploitation of children. A randomized vignette experiment among members of a Dutch household panel investigated whether public perceptions of child sexual exploitation were more damning or more lenient when it occurred in a country closer to home, and explored theoretical explanations. The results show that offenses committed in the Netherlands or U.S. are overall perceived as more negative than those committed in Romania or Thailand. Social distance affects public perceptions about crime severity, and victims are attributed more responsibility in socially close than socially distant conditions. The study concludes that public perceptions are contingent upon the crime location, even when applied to child sexual exploitation.
COVID-19 feminist framework and biopsychosocial-spiritual perspective for social workers and mental health practitioners to manage violence, abuse, and trauma against children, women, BIPOC, and LGBTQIA+ during and post-COVID-19
Authors: Mukhtar Sonia
Published: December 2021

This article explains the integrated implementation of a COVID-19 Feminist Framework (CFF) and biopsychosocial-spiritual perspective (BPSS-P) on the inclusive equitability of social service providers, practitioners, and policy-developers on global platforms. Mechanisms of CFF and BPSS-P entail the process to address/mitigate institutional inequities, mental health issues, violation of human rights, race/sex/gender-based violence, abuse, and trauma amid COVID-19. This discourse is about raising consciousness, collective liberation, wellbeing, and equality for women, children, BIPOC, LGBTQIA+, and gender-diverse people. This article further discusses social workers and mental health practitioners’ uniqueness for short-term and long-term support for emotional, cognitive-behavioral, and psychosocial repercussions on the individual and community levels.
You Are What You Eat: Affirming Podcast and Subjective Wellbeing among African American Women
Authors: Robinson Yatesha D.
Published: December 2021

The purpose of this exploratory study was to investigate whether intentional exposure to affirming messages via podcast would lead to improvement in subjective wellbeing in a sample of African American women. This two-part study used a mixed-methods design to measure subjective wellbeing using the Multicultural Quality of Life Index and a series of focus groups. During Phase 1, participants rated and discussed culturally relevant affirmations that informed the development of the podcast intervention used in Phase 2. The results revealed that stressors such as microaggressions, mental distress, and competing demands justified the need for support. Participants indicated that the podcast intervention was an enriching experience that illuminated the necessity of restorative practices that heal and revitalize the spirit. The intervention led to positive behavior change; and these results demonstrated the podcast benefits, suggesting that intentional exposure to positive messages may help some African American women cope with life stressors.
Disaggregating Asian Race Reveals COVID-19 Disparities Among Asian American Patients at New York City’s Public Hospital System
Authors: Kalyanaraman Marcello Roopa , Dolle Johanna , Tariq Areeba , Kaur Sharanjit , Wong Linda , Curcio Joan , Thachil Rosy , Yi Stella S. , Islam Nadia
Published: December 2021

Objectives:

Data on the health burden of COVID-19 among Asian American people of various ethnic subgroups remain limited. We examined COVID-19 outcomes of people of various Asian ethnic subgroups and other racial and ethnic groups in an urban safety net hospital system.

Methods:

We conducted a retrospective analysis of 85 328 adults aged ≥18 tested for COVID-19 at New York City’s public hospital system from March 1 through May 31, 2020. We examined COVID-19 positivity, hospitalization, and mortality, as well as demographic characteristics and comorbidities known to worsen COVID-19 outcomes. We conducted adjusted multivariable regression analyses examining racial and ethnic disparities in mortality.

Results:

Of 9971 Asian patients (11.7% of patients overall), 48.2% were South Asian, 22.2% were Chinese, and 29.6% were in other Asian ethnic groups. South Asian patients had the highest rates of COVID-19 positivity (30.8%) and hospitalization (51.6%) among Asian patients, second overall only to Hispanic (32.1% and 45.8%, respectively) and non-Hispanic Black (27.5% and 57.5%, respectively) patients. Chinese patients had a mortality rate of 35.7%, highest of all racial and ethnic groups. After adjusting for demographic characteristics and comorbidities, only Chinese patients had significantly higher odds of mortality than non-Hispanic White patients (odds ratio = 1.44; 95% CI, 1.04-2.01).

Conclusions:

Asian American people, particularly those of South Asian and Chinese descent, bear a substantial and disproportionate health burden of COVID-19. These findings underscore the need for improved data collection and reporting and public health efforts to mitigate disparities in COVID-19 morbidity and mortality among these groups.
Not Just About Faces in Context: Face–Context Relation Moderates the Impact of Contextual Threat on Facial Trustworthiness
Authors: Mattavelli Simone , Masi Matteo , Brambilla Marco
Published: December 2021

Recent work showed that the attribution of facial trustworthiness can be influenced by the surrounding context in which a face is embedded: contexts that convey threat make faces less trustworthy. In four studies ( N = 388, three preregistered) we tested whether face–context integration is influenced by how faces and contexts are encoded relationally. In Experiments 1a to 1c, face–context integration was stronger when threatening stimuli were attributable to the human action. Faces were judged less trustworthy when shown in threatening contexts that were ascribable (vs. non-ascribable) to the human action. In Experiment 2, we manipulated face–context relations using instructions. When instructions presented facial stimuli as belonging to the “perpetrators” of the threatening contexts, no difference with the control (no-instructions) condition was found in face–context integration. Instead, the effect was reduced when faces were presented as “victims.” We discussed the importance of considering relational reasoning when studying face–context integration.
The Contingent Effects of Intrateam Abusive Behavior on Team Thriving and New Venture Performance
Authors: Hmieleski Keith M. , Cole Michael S.
Published: December 2021

This study sheds light on the dark side of entrepreneurship by examining how and under what conditions abusive behavior within new venture teams (NVTs) relates to new venture performance. Using a national (USA) random sample of NVTs, we find that the relationship of intrateam abusive behavior (i.e., degree to which NVT members exhibit “hostile” verbal behaviors toward each other) with new venture performance (i.e., sales and employment growth) is mediated by NVT thriving (i.e., level of vitality and learning exhibited within the NVT). Results further demonstrate that perceived competitive intensity of the industry moderates this relationship, with the indirect effect of intrateam abusive behavior on new venture performance (via thriving) being significantly less negative at high, than at low, levels of competitive intensity. We therefore conclude that perceived competitive threats to the survival of startups act to mitigate the otherwise deleterious effects of abusive behavior occurring within NVTs. These results broaden existing knowledge regarding the dark side of entrepreneurship by expanding the conversation on this topic to include the NVT and providing evidence for why some NVTs, but not others, are able to sustain the growth of their firms despite the occurrence of abusive behavior between their members.
Improvisation Based on Audience Requests: Pedagogical Possibilities of the Application “Sanka Play” for Performer and Audience Interaction in Elementary School Music Classes
Authors: Terauchi Daisuke
Published: December 2021

In 2017, I developed a computer application entitled “Sanka Play,” which enables audience members to participate in improvisational performances by making real-time requests to performers. In most cases of free improvisation, the audience atmosphere influences performers. While audience–performer interaction is generally nonverbal, Sanka Play allows timeous written verbal interaction. This study determines the positive pedagogical possibilities of using Sanka Play for elementary school music classes. It was expected that using Sanka Play for group improvisation activities in music classes would encourage various styles of expression among the students. Sanka Play was used in two fifth grade (age 10–11 years) music classes in a Japanese elementary school. Observation of class videos revealed that the application induced students to use various modes of expression, such as music, dance, theatrical acting, and even karate. Furthermore, various requests the students made not only improved performance in general but also helped highlight particular strengths in each student’s performing ability. The observations reveal Sanka Play’s pedagogical usefulness and several factors that teachers should consider when using the application. This research illustrates the possibilities of employing a new teaching approach to encourage students to creatively use their inherent expressive abilities.
ACO Women in the Second Half of the Twentieth Century: Transitions and Persisting Patterns
Authors: Nasrallah Rima
Published: December 2021

After the independence of Syria and Lebanon Protestant missionary work in the Middle East changed dramatically. The women missionaries who worked in the service of the ACO had to come to terms with new realities such as the social and political turmoil of decolonisation, missiological shifts, and partnership agreements with the local churches. Drawing on written memoirs and oral history sources, this article explores their female agency and leadership in a changing context. It also analyses the perception of these missionaries by local agents.
Decreased mobility, lack of social support, haemosiderosis and use of antidepressant medications may predict recurrent venous leg ulcers within 12 months of healing: A prospective longitudinal study
Authors: Finlayson KJ , Parker CN , Miller C , Edwards HE , Campbell J
Published: December 2021

Aim

To identify clinical, medical and psychosocial predictors of venous leg ulcer recurrence within 12 months of healing.

Methods

A multi-site study was conducted in Australia in community and hospital outpatient settings. Adults with venous leg ulcers were recruited within 4 weeks of healing and data were collected on preventative treatments and health, medical, clinical and psychosocial factors. Follow-up data on recurrences were collected every 3 months until ulcer recurrence, or until 12 months after healing pending which occurred first. Factors associated with time to recurrence were analysed using a Cox proportional hazards regression model.

Design

Secondary data analysis of a multi-site, prospective longitudinal study to validate a risk assessment tool for recurrence.

Results

A sample of 143 participants was recruited (51% male, M age = 73 years, SD 13.6). Almost half (49.6%) had an ulcer recurrence within 12 months, with a mean time to ulcer recurrence of 37 weeks ( SE 1.63, 95% CI 33.7–40.1). Factors measured at the time of healing that were significant independent predictors of recurrence were: prescribed antidepressant medications ( p = .035), presence of haemosiderosis ( p = .006), decreased mobility (longer sitting times) ( p = .007) and lower social support scale scores ( p = .002). Participants who wore compression systems providing 20 mmHg or higher for at least 5 days/week were less likely to recur, although not reaching statistical significance ( p = .06).

Conclusion

Results provide evidence that antidepressant medications, haemosiderosis, decreased mobility and lack of social support are risk factors associated with ulcer recurrence; therefore, these variables are modifiable and could guide early intervention.
Does group-based cognitive therapy improve functional ability, pain, catastrophic thoughts and quality of life in patients with persistent low back pain and psychological risk factors? A randomised controlled trial in a secondary care setting
Authors: Rolving Nanna , Agerbo Karina , Aalkjær Clausen Stine , Denby Kate Ane Rauff , Jacobsen Anna Puk , Langagergaard Vivian
Published: December 2021

Objective

To investigate the effects of a group-based cognitive behavioural intervention for patients with persistent low back pain (LBP) and psychological risk factors referred to secondary care.

Design

A randomised controlled trial.

Setting

Silkeborg Regional Hospital, Denmark.

Subjects

A total of 136 participants with chronic LBP and psychological risk factors.

Interventions

Participants were randomised to the standard care group, including examination by a rheumatologist and/or a physiotherapist, or the intervention group, including standard care plus a multidisciplinary group-based pain management programme.

Main measures

Patient-reported outcomes were collected at baseline and after 6 and 12 months. The primary outcome was disability (Roland Morris Disability Questionnaire). Secondary outcomes included low back pain intensity, pain catastrophising, health-related quality of life, and sick leave.

Results

Among 136 participants, 68 (mean age: 41.7 years (SD 11.8)) were randomised to standard care and 68 (mean age: 46.0 years (SD 10.8)) were randomised to the intervention group. Except for age, baseline characteristics were comparable between groups. 12-month follow-up was completed by 92.6% in the intervention group and 80.9% in the standard care group. Both groups achieved significant improvements on disability, with a reduction of −4.8 points (SD 6.1) in the intervention group compared to −3.7 points (SD 5.2), resulting in an insignificant difference between groups. No significant differences were found in the secondary outcomes.

Conclusion

A group-based pain management programme was no more effective than standard care for patients with persistent LBP and psychological risk factors.
Differences in goals of care discussion outcomes among healthcare professionals: an observational cross-sectional study
Authors: Ho Karen , Wang Krystyna , Clay Adam , Gibbings Elizabeth
Published: December 2021

Background:

Goals of care discussions ensure patients receive the care that they want. Recent studies have recognized the opportunity for allied health professionals, such as nurses, in facilitating goals of care discussions. However, the outcomes of such interventions are not well studied.

Aim:

To compare the outcomes of goals of care discussions led by physicians and nurses.

Design:

This is a retrospective cohort study of patients admitted to an Internal Medicine unit from January 2018 to August 2019. A comprehensive chart review was performed on a random sample of patients. Patient’s decision to accept or refuse cardiopulmonary resuscitation was recorded and analyzed. Analysis was stratified by patients’ comorbidity burden and illness severity.

Setting/Participants:

The study took place at a tertiary care center and included 200 patients. Patients aged ⩾ 18 were included. Patients who have had pre-existing goals of care documentation were excluded.

Results:

About 52% of the goals of care discussions were completed by nurses and 48% by physicians. Patients were more likely to accept cardiopulmonary resuscitation in nurse-led discussions compared to physician-led ones (80.8% vs 61.4%, p = 0.003). Multiple regression showed that patients with higher comorbidity burden (OR 0.71, 95% CI: 0.62–0.82), more severe illness (OR 0.89, 95% CI 0.88–0.99), and physician-led goals of care discussions (OR 0.30, 95% CI: 0.15–0.62) were less likely to accept cardiopulmonary resuscitation.

Conclusions:

There was a significant difference between the outcomes of goals of care discussions led by nurses and physicians. Patients were more likely to accept aggressive resuscitative measures in nurse-led goals of care discussions. Further research efforts are needed to identify the factors contributing to this discrepancy, and to devise ways of improving goals of care discussion delivery.
The impact on emotional well-being of being a palliative care volunteer: An interpretative phenomenological analysis
Authors: Coleman Helena , Sanderson-Thomas Andy , Walshe Catherine
Published: December 2021

Background:

Much palliative care provision relies on the support of volunteers. Attention is paid to the risks to professionals providing care, such as stress and burnout, but understanding if this is an issue for volunteers is little understood. It is important to understand the impact their role has on volunteers emotional well-being.

Aim:

To explore the experiences of palliative care volunteers and how the role impacted on their emotional well-being.

Design:

Interpretative phenomenological analysis, with data collected through semi-structured interviews.

Setting/participants:

Volunteers in patient-facing roles within palliative and end-of-life care services in the UK.

Results:

Volunteers ( n = 10) across three palliative and end-of-life care services. Four themes were developed: (1) it can be challenging; (2) it’s where I’m meant to be; (3) managing death; (4) the importance of connection. Challenges included frustrations and questioning themselves. Although difficult at times, volunteers expressed the importance of the role, doing well and that they benefitted too. They also had to manage death and discussed beliefs about life and death, acceptance and managing patients’ fears. Connection with the hospice, patients, staff and other volunteers was important, with a need for everyone to feel valued.

Conclusions:

Although there are psychosocial benefits for volunteers in their role, it is important to understand the challenges faced and consider ongoing support to help volunteers manage these challenges. This could be addressed through the consideration of coping mechanisms, further training and reflective practice for volunteers.
Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review
Authors: Gonella Silvia , Mitchell Gary , Bavelaar Laura , Conti Alessio , Vanalli Mariangela , Basso Ines , Cornally Nicola
Published: December 2021

Background:

Most people with dementia transition into nursing homes as their disease progresses. Their family caregivers often continue to be involved in their relative’s care and experience high level of strain at the end of life.

Aim:

To gather and synthesize information on interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes and provide a set of recommendations for practice.

Design:

Mixed-Methods Systematic Review (PROSPERO no. CRD42020217854) with convergent integrated approach.

Data sources:

Five electronic databases were searched from inception in November 2020. Published qualitative, quantitative, and mixed-method studies of interventions to support family caregivers of people with advanced dementia at the end of life in nursing home were included. No language or temporal limits were applied.

Results:

In all, 11 studies met the inclusion criteria. Data synthesis resulted in three integrated findings: (i) healthcare professionals should engage family caregivers in ongoing dialog and provide adequate time and space for sensitive discussions; (ii) end-of-life discussions should be face-to-face and supported by written information whose timing of supply may vary according to family caregivers’ preferences and the organizational policies and cultural context; and (iii) family caregivers should be provided structured psychoeducational programs tailored to their specific needs and/or regular family meetings about dementia care at the end of life.

Conclusion:

The findings provide useful information on which interventions may benefit family caregivers of people with advanced dementia at the end of life and where, when, and how they should be provided.
Communication strategies and persuasion as core components of shared decision-making for children with life-limiting conditions: A multiple case study
Authors: Popejoy Emma , Almack Kathryn , Manning Joseph C , Johnston Bridget , Pollock Kristian
Published: December 2021

Background:

Families and professionals caring for children with life-limiting conditions face difficult healthcare decisions. Shared decision-making is promoted in many countries, however little is known about factors influencing these processes.

Aim:

To explore the communication strategies used in shared decision-making for children with life-limiting conditions.

Design:

A longitudinal, qualitative, multiple-case study. Cases were centred around the child and parent/carer(s). Most cases also included professionals or extended family members. Data from interviews, observations and medical notes were re-storied for each case into a narrative case summary. These were subject to comparative thematic analysis using NVivo11.

Setting/participants:

Eleven cases recruited from three tertiary hospitals in England. 23 participants were interviewed (46 interviews). Cases were followed for up to 12 months between December 2015 and January 2017. 72 observations were conducted and the medical notes of nine children reviewed.

Findings:

Strategies present during shared decision-making were underpinned by moral work. Professionals presented options they believed were in the child’s best interests, emphasising their preference. Options were often presented in advance of being necessary to prevent harm, therefore professionals permitted delay to treatment. Persuasion was utilised over time when professionals felt the treatment was becoming more urgent and when families felt it would not promote the child’s psychosocial wellbeing.

Conclusions:

Communication strategies in shared decision-making are underpinned by moral work. Professionals should be aware of the models of shared decision-making which include such communication strategies. Open discussions regarding individuals’ moral reasoning may assist the process of shared decision-making.
An Efficient Method for Computing Expected Value of Sample Information for Survival Data from an Ongoing Trial
Authors: Vervaart Mathyn , Strong Mark , Claxton Karl P. , Welton Nicky J. , Wisløff Torbjørn , Aas Eline
Published: December 2021

Background

Decisions about new health technologies are increasingly being made while trials are still in an early stage, which may result in substantial uncertainty around key decision drivers such as estimates of life expectancy and time to disease progression. Additional data collection can reduce uncertainty, and its value can be quantified by computing the expected value of sample information (EVSI), which has typically been described in the context of designing a future trial. In this article, we develop new methods for computing the EVSI of extending an existing trial’s follow-up, first for an assumed survival model and then extending to capture uncertainty about the true survival model.

Methods

We developed a nested Markov Chain Monte Carlo procedure and a nonparametric regression-based method. We compared the methods by computing single-model and model-averaged EVSI for collecting additional follow-up data in 2 synthetic case studies.

Results

There was good agreement between the 2 methods. The regression-based method was fast and straightforward to implement, and scales easily to include any number of candidate survival models in the model uncertainty case. The nested Monte Carlo procedure, on the other hand, was extremely computationally demanding when we included model uncertainty.

Conclusions

We present a straightforward regression-based method for computing the EVSI of extending an existing trial’s follow-up, both where a single known survival model is assumed and where we are uncertain about the true survival model. EVSI for ongoing trials can help decision makers determine whether early patient access to a new technology can be justified on the basis of the current evidence or whether more mature evidence is needed.

Highlights

Decisions about new health technologies are increasingly being made while trials are still in an early stage, which may result in substantial uncertainty around key decision drivers such as estimates of life-expectancy and time to disease progression. Additional data collection can reduce uncertainty, and its value can be quantified by computing the expected value of sample information (EVSI), which has typically been described in the context of designing a future trial. In this article, we have developed new methods for computing the EVSI of extending a trial’s follow-up, both where a single known survival model is assumed and where we are uncertain about the true survival model. We extend a previously described nonparametric regression-based method for computing EVSI, which we demonstrate in synthetic case studies is fast, straightforward to implement, and scales easily to include any number of candidate survival models in the EVSI calculations. The EVSI methods that we present in this article can quantify the need for collecting additional follow-up data before making an adoption decision given any decision-making context.
Prolonged COVID-19 infection in a child with lymphoblastic non-Hodgkin lymphoma: which is the best management?
Authors: Gattuso Giovanna , Schiavello Elisabetta , Oltolini Chiara , Biassoni Veronica , Terenziani Monica , Chiaravalli Stefano , Podda Marta Giorgia , Meazza Cristina , Luksch Roberto , Ferrari Andrea , Casanova Michela , Sironi Giovanna , Bergamaschi Luca , Puma Nadia , Spreafico Filippo , Massimino Maura
Published: December 2021

During the coronavirus disease 2019 (COVID-19) pandemic, oncologists have managed patients at higher risk of having a severe course of this infection. This raises new questions about their correct management, as well as the difficulty of distinguishing tumor/treatments complications from those related to COVID-19. We report a case of an 11-year-old boy undergoing treatment for T-cell lymphoblastic lymphoma who experienced a prolonged COVID-19 course. Oncologic therapy was continued without significant changes compared to the initially planned treatment. No relevant complications occurred. COVID-19 convalescent plasma was administered, resulting in a positive antibody titer after 24 days.
Analysis of causes of failure of medical treatment in patients undergoing surgery for benign prostate enlargement
Authors: Anand Ajay , Gupta Narmada P , Dogra Prem Nath , Seth Amlesh
Published: December 2021

Background:

To analyse causes of failure of medical management in benign prostate enlargement (BPE) in patients who undergo surgery following medical treatment and to elucidate parameters which warrant for early surgical treatment.

Methods:

Records of 747 patients who underwent surgery for BPE were reviewed for prostate volume, median lobe enlargement, post void residual urine, duration and type of medical treatment given for BPE. We used univariate and multivariate analysis to find out significant parameters for medical treatment failure.

Results:

A total of 601 patients (80.45%) received medical treatment for their lower urinary tract symptoms (LUTS), for a duration ranging between 3 months and 2 years. Statistically significant difference was found between age, prostate volume, intravesical projection, PSA and acute urinary retention with failure of medical treatment.

Conclusions:

BPE patients with failure to respond with medical management within 3–6 months and/or associated with large size prostate, intravesical projection and raised serum PSA should better be offered surgical treatment.
Novel treatment for glance necrosis due to priapism; presentation and review of literature
Authors: Soleimani Abbas , Nazarpour Mohammad Javad , Akhavizadegan Hamed
Published: December 2021

Introduction:

Glans necrosis in association with priapism is very rare and its appropriate treatment is not known. There is a secondary cause in most cases.

Case description:

We treated a 65-year-old man with priapism and glans necrosis using a closed shunt (Winter), continuous penile irrigation with normal saline, and heparin for 48 h and waited for the necrotic area to resolve spontaneously. The treatment outcome was much better compared to previous cases in whom open surgery, irrigation with pure normal saline, and/or resection of the necrotic area were performed.

Conclusion:

In cases with priapism and glans ischemia, we recommend treating the condition with continuous covernose irrigation with heparinized saline and avoiding open surgery.
Impact modification of hybrid polypropylene composites with poly(vinyl alcohol) fibers
Authors: Várdai R , Ferdinánd M , Lummerstorfer T , Pretschuh C , Jerabek M , Gahleitner M , Faludi G , Móczó J , Pukánszky B
Published: December 2021

Polypropylene (PP) hybrid composites were prepared by the combination of three reinforcing (carbon, glass, and wood) and a synthetic (PVA) fiber. Tensile and impact testing, acoustic emission measurements, and scanning electron microscopy (SEM) were used for the characterization of the composites as well as to follow deformation and failure processes. The results obtained prove that the novel concept of using synthetic fibers for impact modification can be applied successfully also with PVA fibers. The extent of improvement in impact strength depends on fiber type and content, but also on interfacial adhesion which strongly influences the local deformation processes occurring around the fibers during fracture. Both the reinforcing and the synthetic fibers take part in these processes and contribute to energy consumption. Debonding and the subsequent plastic deformation of the matrix consumes energy the most efficiently, but the fracture of the PVA fibers also requires energy; thus, PVA fibers improve impact resistance both at poor and good adhesion. This approach allows the design of materials for structural applications; the combination of a stiffness of 4–6 GPa and an impact resistance of 20–25 kJ/m2 exceeds the properties of most PP composites available on the market.
Determination of the interfacial properties of carbon fiber reinforced polymers using nanoindentation
Authors: Zhu Jing , Lang Feng C , Wang Shi Y , Li Zhuo , Xing Yong M
Published: December 2021

The mechanical properties of the interphase play a key role in determining the overall performance of carbon fiber reinforced polymer (CFRP) composite materials. For this reason, it is important to develop a method to easily and precisely investigate the mechanical performance of the interphase of CFRP materials. In this work, the surface topography of the CFRP material was examined using scanning probe microscopy (SPM), which revealed the polished flat sample can meet the requirements of the nanoindentation testing. The local mechanical performance of the interphase of the CFRP was determined using nanoindentation based on the continuous stiffness measurement (CSM) method. The results show that the size of the interphase between the carbon fiber and the matrix is about 1.5 μm, and the corresponding modulus and hardness values were estimated to be 5–11 and 0.4–3.3 GPa, respectively, considering the fiber-bias effects. Mapping of the local mechanical properties of a selected area revealed that nanoindentation reproduced excellently the surface topography and characterized precisely the properties of the interphase between the carbon fibers and the matrix.
Light-weight carbon fiber/silver-coated hollow glass spheres/epoxy composites as highly effective electromagnetic interference shielding material
Authors: Chen Wei , Qin Yiliang , He Xingyang , Su Ying , Wang Jun
Published: December 2021

Highly effective electromagnetic interference shielding materials with light-weight feature are urgently demanded for releasing electromagnetic pollution. In this study, the hollow glass spheres were coated with silver particles to produce electrically conductive microspheres. The Carbon fiber/silver-coated hollow glass spheres (Ag@HGMs)/epoxy composites were manufactured by composites liquid molding process. The electromagnetic interference shielding properties of the composites were investigated in the X-band (8.2–12.4 GHz) range. The Ag@HGMs play a role in filling up the vacancy of the conductive network of carbon fibers in the composites, which not only form new conductive pathways but also act as bridges to connect CFs and provide additional channels for the electron transfer within the composites thus improving the electrical conductivity. The total shielding effectiveness (SET) increases with increasing Ag@HGMs loadings and the maximum SET is high as 88.1 dB. The increased SET dominated by absorption loss SEA is attributed to the high conductivity and multilayer construction of carbon fiber veil. The maximum specific SE of the carbon fiber/Ag@HGMs/epoxy composites can achieve 128.8 dB cm3/g, simultaneously the tensile strength and modulus can reach 95.6 MPa and 2.71 GPa, which provides a facile and promising strategy for designing and developing light-weight and high performance electromagnetic interference shielding materials.
Longitudinal Effects in the Effectiveness of Educational Virtual Field Trips
Authors: Zhao Jiayan , Wallgrün Jan Oliver , Sajjadi Pejman , LaFemina Peter , Lim Kenneth Y. T. , Springer Jan P. , Klippel Alexander
Published: December 2021

Virtual and immersive virtual reality, VR and iVR, provide flexible and engaging learning opportunities, such as virtual field trips (VFTs). Despite its growing popularity for education, understanding how iVR compared to non-immersive media influences learning is still challenged by mixed empirical results and a lack of longitudinal research. This study addresses these issues through an experiment in which undergraduate geoscience students attended two temporally separated VFT sessions through desktop virtual reality (dVR) or iVR, with their learning experience and outcomes measured after each session. Our results show higher levels of enjoyment and satisfaction as well as a stronger sense of spatial presence in iVR students in both VFTs compared to dVR students, but no improvement in learning outcomes in iVR compared to dVR. More importantly, we found that there exists a critical interaction between VR condition and repeated participation in VFTs indicating that longitudinal exposure to VFTs improves knowledge performance more when learning in iVR than through dVR. These results suggest that repeated use of iVR may be beneficial in sustaining students’ emotional engagement and compensating the initial deficiency in their objective learning outcomes compared to other less immersive technologies.
“Why Don’t They Just Move Closer?”: Adolescent Critical Consciousness Development in YPAR About Food Security
Authors: Anderson Amy J. , Baggett Hannah Carson , Andrzejewski Carey E. , Forbes Sean A.
Published: December 2021

The aim of this paper is to explore high school students’ critical consciousness development in the context of youth participatory action research (YPAR) focused on food security at an alternative school in Alabama. The YPAR project took place in an elective agriscience class with 10 students (Seven Black, two white, one Latino) who were in the 10th to 12th grades. Utilizing data from researcher notes, classroom observations, and archival classroom documents, we present students’ YPAR project outcomes to share their research-driven solutions to food insecurity in their community. Vignettes of classroom dialogue are also constructed to illustrate moments of reflection in the YPAR context about food security. We present three “critical moments,” or instances of social analysis, to illustrate how students’ individual-level attributions occurred alongside teacher dialogue and student-led investigation of structural inequities in the community. Findings illustrate how students’ nonlinear critical consciousness development consisted of reliance on individual-level attributions in classroom dialogue co-occurring with systems-thinking activities and other YPAR project outcomes. This paper has implications for research on the imperfect and wavering nature of adolescent critical consciousness development in YPAR.