bluuebunny/crossref_metadata_2025 huggingface dataset:
Discursive Strategies and Sequenced Institutional Change: The Case of Marriage Equality in the United States
Authors: Mariani Giulia , Verge Tània
Published: June 2021

Building on historical and discursive institutionalism, this article examines the agent-based dynamics of gradual institutional change. Specifically, using marriage equality in the United States as a case study, we examine how actors’ ideational work enabled them to make use of the political and discursive opportunities afforded by multiple venues to legitimize the process of institutional change to take off sequentially through layering, displacement, and conversion. We also pay special attention to how the discursive strategies deployed by LGBT advocates, religious-conservative organizations and other private actors created new opportunities to influence policy debates and tip the scales to their preferred policy outcome. The sequential perspective adopted in this study allows problematizing traditional conceptualizations of which actors support or contest the status quo, as enduring oppositional dynamics lead them to perform both roles in subsequent phases of the institutional change process.
Life and freedom from the law of sin and death: A Hongkonger’s reflection
Authors: Sun Poling
Published: June 2021

Since the Reformation, the significance of the death of Jesus has been understood as a soteriology that is personal and inward. This article suggests that, while the traditional-doctrinal articulations are important, Paul had his eyes on the Roman Empire, the propaganda and oppression of which were legitimized as law and constructed a world that was sinful and a means of death. The significance of Jesus’s death and, therefore, the gospel is more than “a gospel of sin management” but is an exposure of the sin of a power and a call to struggle for freedom through suffering. This article illustrates this reading with an account of recent developments in Hong Kong.
The Silence of Saturday: Luke 23:50-56 (A Sermon)
Authors: Hunt Greg
Published: June 2021

Holy Week naturally centers its attention on Good Friday and Easter Sunday. When pondering the good news of God’s liberating love in Christ, everything culminates in Jesus’s crucifixion and resurrection. Not surprisingly, then, Holy Saturday gets short shrift. The gospels themselves have little to say about it, and Christian tradition does nothing of note to mark what it means. The following message, which in its original form was presented as part of an ecumenical Holy Week series, invites worshipers into the pregnant pause of “silent Saturday,” there to lay lives bare in the aftermath of Christ’s death. In the spirit of the first followers of Jesus, for whom resurrection could scarcely be imagined, those with imaginations and willingness to do so can confess their sins, their fears, their frustrations, their doubts. Against the backdrop of today’s yearnings for justice, they can bring their suffering, exhaustion, and disappointment, as well, and find in introspection the gifts of relinquishment and hope.
Influence of lacing bars on the buckling capacity of four-legged latticed columns considering geometric imperfections
Authors: Li Yinqi , Liu Feng , Cheng Wenming
Published: June 2021

The buckling behavior of latticed columns had been widely investigated based on the theory of Euler, Engesser and Timoshenko shear beam. Although these methods had been formulated and proved to be accurate in case of special assumptions, the influences of lacing bars on the buckling behavior of latticed columns were unclear. This paper modeled a general four-legged latticed column to study the influence of the cross-section characteristics of lacing bars along with their imperfections on the buckling capacity of latticed columns. Three loading conditions and four geometric imperfect models were built to testify the performance of lacing bars. To calculate the buckling load of latticed columns with imperfections accurately, advanced nonlinear analytical procedures using Newton-Raphson incremental-iterative method (ANAP-NR) and Risk arc-length incremental-iterative method (ANAP-Risk) were developed, and then validated by FE software ABAQUS. The current data in the paper show the maximum variation on the critical buckling load of latticed columns, caused by the cross-section area, the bending moment of inertia outer lacing plane, and the imperfections of lacing bars, could reach 68%, 30%, and 25%. The analytical results indicate the great importance of lacing bars on the buckling capacity of latticed columns.
Haitian parishioners in a Chilean parish: The role of Haitian Catholicism and ethnic cultural features
Authors: Orellana Felipe
Published: June 2021

The following research seeks to understand the religious life of a Haitian community in a Chilean parish. The main objectives try to identify (a) the reproduction of Haitian Catholicism in a Chilean parish and (b) the interrelationship with the Chilean community and society through participation in the parish life by Haitian parishioners. The research uses a qualitative framework with participant observations of the Sunday Masses and religious and social activities developed in the parish. The sample is composed of Haitian parishioners that are regular participants of the Masses and activities. The main findings show that the Haitian community is not alone or isolated from Chilean parishioners and society. The participation in ‘integration’ Masses and cultural activities are examples of activities for both Haitians and Chileans. Finally, the language is a tool for remembering the Haitian Mass but not a mechanism for isolating the Haitian community.
Critical Commentary: Beyond growth and density: Recentring the demographic drivers of urban health and risk in the global south
Authors: Duminy James
Published: June 2021

Debates within urban studies concerning the relationship between urbanisation and infectious disease focus on issues of urban population growth, density, migration and connectivity. However, an effective long-term risk and wellbeing agenda, without which the threat of future pandemics cannot be mitigated, must also take account of demographic forces and changes as critical drivers of transmission and mortality risk within and beyond cities. A better understanding of the dynamics of fertility, mortality and changing age structures – key determinants of urban decline/growth in addition to migration – provides the foundation upon which healthier cities and a healthy global urban system can be developed. The study of how basic demographic attributes and trends are distributed in space and how they interact with risks, including those of infectious disease, must be incorporated as a priority into a post-COVID-19 urban public health agenda. This perspective concurs with recent debates in urban studies emphasising the demographic drivers of urban change. Moreover, it raises critical questions about the microbial and environmental emphasis of much research on the interface of urban health and governance.
Belongingness and National Belonging among Youth in Hong Kong
Authors: Jang Sung Tae , Halse Christine , Lee Daphnee Hui Lin , Hon Queenie Chun Ki
Published: June 2021

This study examined the multiplicative associations of the social categories of ethnicity (Hong Kong Chinese, mainland Chinese, or ethnic minorities), gender, and socioeconomic status (SES) with overall belongingness (to one’s self, personal networks, and society) and national belonging to China among youth (aged 18–24 years) in Hong Kong. Our analysis revealed similar levels of overall belongingness and national belonging among ethnic minority youth relative to Hong Kong Chinese youth. The intersectionality of mainland Chinese female youth determined a higher degree of belongingness compared with their male counterparts and Hong Kong Chinese female youth. Although SES was positively associated with belongingness, it was not significantly associated with national belonging to China. We provided explanations of these patterns and recommends policy strategies to strengthen individual and national belongingness.
The Challenge of Dental Education After COVID-19 Pandemic – Present and Future Innovation Study Design
Authors: Clemente Miguel Pais , Moreira André , Pinto João Correia , Amarante José Manuel , Mendes Joaquim
Published: June 2021

The present work suggests research and innovation on the topic of dental education after the COVID-19 pandemic, is highly justified and could lead to a step change in dental practice. The challenge for the future in dentistry education should be revised with the COVID-19 and the possibility for future pandemics, since in most countries dental students stopped attending the dental faculties as there was a general lockdown of the population. The dental teaching has an important curriculum in the clinic where patients attend general dentistry practice. However, with SARS-CoV-2 virus, people may be reluctant having a dental treatment were airborne transmission can occur in some dental procedures. In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are extremely important. Therefore, dental education has to adapt the curriculum to embrace new technology devices, instrumentations systems, haptic systems, simulation based training, 3D printer machines, to permit validation and calibration of the technical skills of dental students.
A Resource-Based Typology of Dynamic Capability: Managing Tourism in a Turbulent Environment
Authors: Jiang Yawei , Ritchie Brent W. , Verreynne Martie-Louise
Published: June 2021

This study develops a typology of dynamic capabilities to advance knowledge on how tourism organizations can manage disruptive external changes. It uses the context of a natural disaster. The article goes beyond a simple classification of organizational activities in responding to crises/disasters to create a typology of 12 dynamic capabilities. The typology is based on three dimensions that align with the disaster life cycle, source of resources, and deployment of resources. This study also provides empirical explanations for each type of dynamic capability, using qualitative data collected from 40 in-depth interviews with tourism organizations and other stakeholders across two years. Several practical implications and future research directions are provided based on the findings and limitations of the study.
The Relational Dynamics of Becoming Popular Feminist Subjects: The World March of Women and Rural/Peasant Women’s Organizing in Brazil in the 2000s
Authors: Masson Dominique , Beaulieu Bastien Elsa
Published: June 2021

The constitution and consolidation of rural and peasant women as popular feminist subjects in Brazil are the result not only of processes internal to these constituencies but also of relational dynamics involving cross-class and cross-movement popular activist organizations. Since the end of the 1990s, organizations and activists identifying with the World March of Women in western Rio Grande do Norte and at the national scale have consciously engaged with rural and peasant women and assisted them in becoming and consolidating themselves as popular feminist subjects. Relational dynamics have also been important in the (unfinished) process of transforming, extending, and deepening the dual meaning of “popular feminism” in Brazil.

A constituição e consolidação das mulheres rurais e camponesas como sujeitos feministas populares no Brasil são o resultado não apenas de processos internos desses grupos, mas também das dinâmicas relacionais que envolvem organizações ativistas populares de classes e movimentos. Desde o final da década de 1990, organizações e ativistas que se identificam com a Marcha Mundial das Mulheres da região Oeste do Rio Grande do Norte e em escala nacional têm se engajado conscientemente com as mulheres rurais e camponesas, ajudando as mesmas a se tornarem e consolidarem como sujeitos feministas populares. As dinâmicas relacionais têm sido importantes também no processo (incompleto) de transformação, extensão e aprofundamento do duplo significado de “feminismo popular” no Brasil.
Public Value Is Unknowable; Public Authority Makes Every Government Decision a Wicked Problem
Authors: Prebble Mark
Published: June 2021

Knowability is the ability to identify a preferable course of action with sufficient confidence to justify adopting that course. This article shows it is not possible to judge the value of a public value proposition with sufficient confidence to justify the use of public authority. The indeterminacy of public value is shown by demonstrating that the necessary conditions to justify a public value proposition include that the evidence sustaining it is not impossible, circular, or unsubstantiated opinion. Those criteria are applied to an exhaustive set of possible concepts of public value, all of which fail at least one of those conditions so public value is unknowable. The implication is not that government is impossible, but that it requires humility, discourse, and compromise.
The Diagnostic Yield of Excisional Biopsy in Cervical Lymphadenopathy: A Retrospective Analysis of 158 Biopsies in Adults
Authors: Bassiouni Mohamed , Kang Gyeongphill , Olze Heidi , Dommerich Steffen , Arens Philipp
Published: June 2021

Objectives:

Cervical lymph nodes are the most common site of peripheral lymphadenopathy. The underlying etiologies are usually benign and self-limiting but may include malignancies or other severe life-threatening diseases. The aim of the current study was to investigate the various underlying pathologies of cervical lymphadenopathy as assessed by the diagnostic yield of excisional lymph node biopsies of the neck in a tertiary adult practice. The evaluation was performed in light of previous literature and regional epidemiological patterns.

Methods:

Retrospective analysis of hospital charts of 158 adult patients who underwent an excisional biopsy for suspected cervical lymphadenopathy at a tertiary referral head and neck service between January 2017 and December 2019.

Results:

The most common underlying pathology was unspecific and/or reactive lymphadenitis in 44.5% of specimens, followed by malignant disease in 38.6% of cases. An age above 40 years was significantly correlated with an increased likelihood of malignant disease. Lower jugular and posterior triangle lymph nodes showed higher malignancy rates than other groups (100% and 66.7%, respectively). The overall surgical complication rate was 2.5%.

Conclusions:

The results of the current study serve as an indicator of the variety of etiologies causing cervical lymphadenopathy. In particular, given the increasing incidence of malignant diseases in recent decades, the findings should alert physicians to the importance of lymph node biopsy for excluding malignancy in persistent cervical lymphadenopathy especially in older adults. The findings emphasize the value of excisional lymph node biopsy of the neck as a useful diagnostic tool in adult patients with peripheral lymphadenopathy.
Returnee Directors and Corporate Tax Avoidance
Authors: Chen Jia , Chen Dongjie , Liu Li , Wang Zhong
Published: June 2021

This study evaluates the effect of returnee directors on corporate tax avoidance by using data on publicly listed Chinese companies from 2000 to 2012. Returnee directors grow up in China and then study or work abroad before returning home to be listed firms’ board directors. We use the introduction of provincial policies toward attracting skilled individuals with foreign experience as an instrumental variable for Returnee directors, which is the fraction of returnee directors divided by the total number of directors within a firm. Using quantile regression, we find a positive relation between Returnee directors and corporate tax avoidance for low levels of tax avoidance but a negative relation for high levels of tax avoidance. The result is robust to a battery of tests. The relation between returnee directors and tax avoidance is stronger for state-owned enterprises (SOEs) than non-SOEs and stronger for returnees who hold MBA degrees, possess a background in accounting or auditing, or are independent directors than other returnees.
Virtual reality and celebrity humanitarianism: Rashida Jones in Lebanon
Authors: Irom Bimbisar
Published: June 2021

The paper brings together two segments of contemporary humanitarian practice – celebrity advocacy and virtual reality (VR) – in order to more fully comprehend the relationship between emergent technologies and humanitarian advocacy efforts. Numerous VR documentaries intended to immerse audiences into the full experience of “distant suffering” have been crafted for audiences in the global North. Between 2015 and 2019, the United Nations invested in at least 21 VR documentaries covering crisis situations around the world. VR’s popularity is premised on the promise of bringing spectators and “distant sufferers” together through immersive experiences. Performances of humanitarian advocacy use traditional representational tools of Western humanitarian discourse. This leads to the question whether advocacy efforts using immersive VR flatten real and material differences that exist between sufferers and spectators in safe zones through the “illusion of co-suffering”? To what extent do such experiences risk “improper distance” by translating the irreducible alterity of other lives into familiar terms?
Beyond correlation: Towards matching strategy for causal inference in Information Science
Authors: Dong Xianlei , Xu Jiahui , Bu Yi , Zhang Chenwei , Ding Ying , Hu Beibei , Ding Yang
Published: June 2021

Correlation has become a fundamental method for information science. However, correlations are limited in making concrete decisions. In this article, we detail how causal inference could be utilised in the field of information science. There are six main steps of implementing matching for causal inference, namely, selecting candidate control variables, determining control variables, calculating similarities among all samples, forming control group, examining the performance of control group and estimating causal effects. As an example, this article applies causal inference to investigate whether Nobel Physics award increases the after-award citations. The method is presented in a step-by-step manner so that researchers can reproduce our analysis in the future.
Environment and its Forms of Knowledge: The Regulation of Genetically Modified Crops in India
Authors: Aga Aniket
Published: June 2021

A fierce controversy over genetically modified (GM) crops has been raging in India for over two decades. Analyzing India’s regulatory regime for GM crops, this article focuses on the modes through which state bureaucracies know the environment. It argues that two epistemologies - scientific and legal-administrative – underpin environment protection. By unraveling the course of regulatory disputes, I demonstrate that bureaucracies are not just hierarchically divided but are also segmented by horizontal, functional specializations. There is thus an inherent ambiguity lodged between environment as a technical discourse and as statecraft. This ambiguity both fosters and constrains democratic participation in policy decisions and can even partially disrupt power relations in unanticipated ways.
Examining the associations between a posteriori dietary patterns and obesity indexes: Systematic review of observational studies
Authors: Koutras Yiannis , Chrysostomou Stavri , Poulimeneas Dimitrios , Yannakoulia Mary
Published: June 2021

Background:

Few reports on the association of population-derived dietary patterns with excess body weight, using the approach of a systematic review currently exist.

Aim:

The aim of the present systematic review was to identify dietary patterns associated with body mass index (BMI), body weight (BW)/BMI change, weight status and weight loss maintenance status.

Methods:

Using MEDLINE (via PubMed) and EBSCO Host databases, we systematically reviewed studies from 1980 to 2020, which included men and women, aged ≥18 years. Primary outcome was BMI or the longitudinal change of individuals’ BW or BMI, or weight status (normal weight/overweight/obesity) or weight loss maintenance status. We included observational studies, with or without a prospective design. Studies which met the inclusion criteria were evaluated based on the Newcastle–Ottawa Scale; only a posteriori dietary patterns were evaluated.

Results:

Twenty-six studies were eligible for inclusion in the current analysis. The results indicate a relationship between adherence to a lacto-vegetarian dietary pattern, characterized by high intake of fruits, vegetables, whole grains, unprocessed cereals, dairy and low intake of high-fat foods and sweets, and longitudinal change of individuals’ BW or BMI, or the risk of overweight/obesity.

Conclusions:

Promotion of this healthy dietary pattern, as an alternative to focusing on specific nutrients or foods, may be a promising approach to be included in future long-term weight maintenance interventions.
The impact of attachment threat on mental state identification: The mediating role of negative emotion and the moderating role of attachment styles
Authors: Tang Qingting , Liu Ying , Wang Tianyu , Chen Xu
Published: June 2021

We conducted two experimental studies to explore the mediating role of negative emotion and the moderating role of attachment styles when predicting mental state identification (MSI) in threatening contexts. The Chinese version of “Reading the Mind in the Eyes Task” (RMET) was used as a proxy for MSI. In Study 1, 123 participants were recruited to complete the RMET task after “recall-writing” threat inductions. In Study 2, we recruited another sample ( N = 121) and examined the effect of threats with induced cognitive loads on MSI. The results indicate that attachment threat induction can affect MSI performance through negative emotional arousal. The indirect threat effects were moderated by attachment styles; in the first stage, the mediated path effect was stronger for participants with higher attachment anxiety levels (Study 1), and in the second stage, it was stronger for participants with higher AV levels, under cognitive loads (Study 2) but independent of age and childhood trauma. These findings can contribute to a better understanding of how and when attachment threat increases the risk of MSI disruption. It suggests that, diminishing the negative impacts of attachment threat may require first training individuals to regulate emotions and promoting their attachment security.
Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis
Authors: Reid Gregory , Mork Constantin , Gahl Brigita , Appenzeller-Herzog Christian , von Segesser Ludwig K , Eckstein Friedrich , Berdajs Denis A
Published: June 2021

Objectives:

The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation.

Methods:

This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE. The primary endpoint was mortality at the hospital stay and at follow-up. Pooled incidence of defined endpoints was calculated by using random effects models.

Results:

A total of 35 retrospective studies that included 3260 patients were analyzed. 30 days mortality was in favour of isolated LVAD implantation 6.74% (1.98–11.5%) versus 31.9% (19.78–44.02%) p = 0.001 in LVAD with temporary need for RVAD. During the hospital stay the incidence of major bleeding was 18.7% (18.2–19.4%) versus 40.0% (36.3–48.8%) and stroke rate was 5.6% (5.4–5.8%) versus 20.9% (16.8–28.3%) and was in favour of isolated LVAD implantation. Mortality reported at short-term as well at long-term was 19.66% (CI 15.73–23.59%) and 33.90% (CI 8.84–59.96%) in LVAD respectively versus 45.35% (CI 35.31–55.4%) p ⩽ 0.001 and 48.23% (CI 16.01–80.45%) p = 0.686 in LVAD/RVAD group respectively.

Conclusion:

Implantation of a temporary RVAD is allied with a worse outcome during the primary hospitalization and at follow-up. Compared to isolated LVAD support, biventricular mechanical circulatory support leads to an elevated mortality and higher incidence of adverse events such as bleeding and stroke.
Monitoring nociception and awareness during palliative sedation: A systematic review
Authors: Dieudonné Rahm Nathalie , Morawska Ghizlaine , Pautex Sophie , Elia Nadia
Published: June 2021

Background:

Providing unawareness and pain relief are core elements of palliative sedation. In addition to clinical scales, nociception and electroencephalogram-based depth of sedation monitoring are used to assess the level of consciousness and analgesia during sedation in intensive care units and during procedures.

Aim:

To determine whether reported devices impact the outcomes of palliative sedation.

Design:

Systematic review and narrative synthesis of research published between January 2000 and December 2020.

Data sources:

Embase, Google Scholar, PubMed, CENTRAL, and the Cochrane Library. All reports describing the use of any monitoring device to assess the level of consciousness or analgesia during palliative sedation were screened for inclusion. Data concerning safety and efficacy were extracted. Patient comfort was the primary outcome of interest. Articles reporting sedation but that did not meet guidelines of the European Association for Palliative Care were excluded.

Results:

Six reports of five studies were identified. Four of these were case series and two were case reports. Together, these six reports involved a total of 67 sedated adults. Methodological quality was assessed fair to good. Medication regimens were adjusted to bispectral index monitoring values in two studies, which found poor correlation between monitoring values and observational scores. In another study, high nociception index values, representing absence of pain, were used to detect opioid overdosing. Relatives and caregivers found the procedures feasible and acceptable.
Deep learning-based identification of acute ischemic core and deficit from non-contrast CT and CTA
Authors: Wang Chengyan , Shi Zhang , Yang Ming , Huang Lixiang , Fang Wenxing , Jiang Li , Ding Jing , Wang He
Published: June 2021

The accurate identification of irreversible infarction and salvageable tissue is important in planning the treatments for acute ischemic stroke (AIS) patients. Computed tomographic perfusion (CTP) can be used to evaluate the ischemic core and deficit, covering most of the territories of anterior circulation, but many community hospitals and primary stroke centers do not have the capability to perform CTP scan in emergency situation. This study aimed to identify AIS lesions from widely available non-contrast computed tomography (NCCT) and CT angiography (CTA) using deep learning. A total of 345AIS patients from our emergency department were included. A multi-scale 3D convolutional neural network (CNN) was used as the predictive model with inputs of NCCT, CTA, and CTA+ (8 s delay after CTA) images. An external cohort with 108 patients was included to further validate the generalization performance of the proposed model. Strong correlations with CTP-RAPID segmentations ( r = 0.84 for core, r = 0.83 for deficit) were observed when NCCT, CTA, and CTA+ images were all used in the model. The diagnostic decisions according to DEFUSE3 showed high accuracy when using NCCT, CTA, and CTA+ (0.90±0.04), followed by the combination of NCCT and CTA (0.87±0.04), CTA-alone (0.76±0.06), and NCCT-alone (0.53±0.09).
Leptomeningeal collateral activation indicates severely impaired cerebrovascular reserve capacity in patients with symptomatic unilateral carotid artery occlusion
Authors: Sebök Martina , Niftrik Christiaan Hendrik Bas van , Lohaus Niklas , Esposito Giuseppe , Amki Mohamad El , Winklhofer Sebastian , Wegener Susanne , Regli Luca , Fierstra Jorn
Published: June 2021

For patients with symptomatic unilateral internal carotid artery (ICA) occlusion, impaired cerebrovascular reactivity (CVR) indicates increased stroke risk. Here, the role of collateral activation remains a matter of debate, whereas angio-anatomical collateral abundancy does not necessarily imply sufficient compensatory flow provided. We aimed to further elucidate the role of collateral activation in the presence of impaired CVR. From a prospective database, 62 patients with symptomatic unilateral ICA occlusion underwent blood oxygenation-level dependent (BOLD) fMRI CVR imaging and a transcranial Doppler (TCD) investigation for primary and secondary collateral activation. Descriptive statistic and multivariate analysis were used to evaluate the relationship between BOLD-CVR values and collateral activation. Patients with activated secondary collaterals exhibited more impaired BOLD-CVR values of the ipsilateral hemisphere (p = 0.02). Specifically, activation of leptomeningeal collaterals showed severely impaired ipsilateral hemisphere BOLD-CVR values when compared to activation of ophthalmic collaterals (0.05 ± 0.09 vs. 0.12 ± 0.04, p = 0.005). Moreover, the prediction analysis showed leptomeningeal collateral activation as a strong independent predictor for ipsilateral hemispheric BOLD-CVR. In our study, ipsilateral leptomeningeal collateral activation is the sole collateral pathway associated with severely impaired BOLD-CVR in patients with symptomatic unilateral ICA occlusion.
Uncertainty Analysis in Intervention Impact on Health Inequality for Resource Allocation Decisions
Authors: Yang Fan , Duarte Ana , Walker Simon , Griffin Susan
Published: June 2021

Cost-effectiveness analysis, routinely used in health care to inform funding decisions, can be extended to consider impact on health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates socioeconomic differences in model parameters to capture how an intervention would affect both overall population health and differences in health between population groups. In DCEA, uncertainty analysis can consider the decision uncertainty around on both impacts (i.e., the probability that an intervention will increase overall health and the probability that it will reduce inequality). Using an illustrative example assessing smoking cessation interventions (2 active interventions and a “no-intervention” arm), we demonstrate how the uncertainty analysis could be conducted in DCEA to inform policy recommendations. We perform value of information (VOI) analysis and analysis of covariance (ANCOVA) to identify what additional evidence would add most value to the level of confidence in the DCEA results. The analyses were conducted for both national and local authority-level decisions to explore whether the conclusions about decision uncertainty based on the national-level estimates could inform local policy. For the comparisons between active interventions and “no intervention,” there was no uncertainty that providing the smoking cessation intervention would increase overall health but increase inequality. However, there was uncertainty in the direction of both impacts when comparing between the 2 active interventions. VOI and ANCOVA show that uncertainty in socioeconomic differences in intervention effectiveness and uptake contributes most to the uncertainty in the DCEA results. This suggests potential value of collecting additional evidence on intervention-related inequalities for this evaluation. We also found different levels of decision uncertainty between settings, implying that different types and levels of additional evidence are required for decisions in different localities.
Wedging of vertebral bodies at the thoracolumbar spine in healthy individuals on whole body MRI screening: correlation with disc degeneration and disc herniation
Authors: Kim Jinhui , Park Hee Jin , Kim Myung Sub , Kim Ji Na , Choi Yoon Jung , Rho Myung Ho , Park Ji Yeon
Published: June 2021

Background

There have been no reports on the relationship between wedging of vertebral bodies at the thoracolumbar spine and disc herniation in healthy individuals on magnetic resonance imaging (MRI).

Purpose

To investigate the degree of wedging of vertebral bodies at the thoracolumbar spine in healthy individuals who underwent whole-body (WB) MRI. We also assessed the correlation between wedging and adjacent disc pathology.

Material and Methods

This retrospective study comprised 200 healthy patients who underwent WB MRI as part of a regular health check from January 2019 to February 2019. We measured anterior and posterior vertical heights of each vertebral body between T10 and L2. The ratio of anterior height to posterior height (APR) was calculated, and we evaluated disc degeneration or disc herniation using WB MRI.

Results

The APR of T10 was significantly higher than at the other levels ( P < 0.05), and the APR of L1 was significantly lower ( P < 0.05). Men had a significantly smaller APR than women at T12 to L2 ( P < 0.05). Regarding the relationship between APR and disc degeneration, the group without disc degeneration had a higher APR, with statistical significance at T12, L1, and L2. Regarding the relationship between APR and disc herniation, the group without disc herniation had a higher APR, with statistical significance at T11, T12, L1, and L2.

Conclusion

Wedging of vertebral bodies is most prominent at L1. Although the values were statistically significant only at some levels, the patients with disc degeneration or herniation had more prominent wedge deformity of thoracolumbar spine.
Hyaluronan-mediated motility receptor expression functions as a prognostic biomarker in uterine carcinosarcoma based on bioinformatics analysis
Authors: Sun Hui , Ma Li , Chen Jie
Published: June 2021

Objective

Uterine carcinosarcoma (UCS) is a rare, aggressive tumour with a high metastasis rate and poor prognosis. This study aimed to explore potential key genes associated with the prognosis of UCS.

Methods

Transcriptional expression data were downloaded from the Gene Expression Profiling Interactive Analysis database and differentially expressed genes (DEGs) were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses using Metascape. A protein–protein interaction network was constructed using the STRING website and Cytoscape software, and the top 30 genes obtained through the Maximal Clique Centrality algorithm were selected as hub genes. These hub genes were validated by clinicopathological and sequencing data for 56 patients with UCS from The Cancer Genome Atlas database.

Results

A total of 1894 DEGs were identified, and the top 30 genes were considered as hub genes. Hyaluronan-mediated motility receptor (HMMR) expression was significantly higher in UCS tissues compared with normal tissues, and elevated expression of HMMR was identified as an independent prognostic factor for shorter survival in patients with UCS.

Conclusions

These results suggest that HMMR may be a potential biomarker for predicting the prognosis of patients with UCS.
Comparison of high-flow nasal oxygen cannula therapy versus a standard oxygen face mask in patients with hypostatic pneumonia
Authors: Song Yamei , Zhang Jinchao , Xing Jia , Wang Ning , Wang Jing
Published: June 2021

Objective

We assessed the clinical effects of high-flow nasal cannula (HFNC) oxygen therapy and a standard oxygen atomizer mask on the respiratory tract in patients with hypostatic pneumonia.

Methods

We included patients with hypostatic pneumonia in this retrospective cohort study. Patients were provided continuous airway humidification by continuous oxygen atomization using either an HFNC or standard oxygen mask. Arterial blood gas analysis, the dyspnea score, inflammatory-related parameters, and adverse events of patients in the two groups were compared.

Results

Fifty-five patients had HFNC delivery and 57 had a standard oxygen atomizer mask. After 7 days of treatment, patients in the HFNC group had a higher partial pressure of arterial blood oxygen/fraction of inspired oxygen ratio (268.12±28.44 vs 238.28±30.04) and lower partial pressure of arterial blood carbon dioxide (38.02±8.84 vs 49.27±7.84 mmHg) than those in the standard oxygen mask group. The dyspnea score and inflammatory-related parameters in the HFNC group were significantly lower than those in the standard oxygen mask group. The incidence of adverse events was lower in the HFNC group than in the standard oxygen mask group.

Conclusion

HFNC therapy relieves clinical symptoms more quickly than a standard oxygen mask and reduces the incidence of adverse events.
Young people’s Perception of Group Climate in Juvenile Justice Centers in an Australian State, a Pilot Study
Authors: van Miert Veronique S.L. , Dekker Anna L. , van der Helm Peer , Robinson Murray
Published: June 2021

There is ample evidence to demonstrate that a positive group climate in juvenile justice centers contributes to improvements in motivation for positive behavior and reducing incidents and even recidivism. Being provided opportunities for growth and development and being actively supported by well-trained staff creates a positive atmosphere and minimal repression. Such a pedagogical group climate is strongly related to fulfilling the basic psychological needs of the young people and is promoted by relational security. Following a series of challenging situations inside youth justice centers in Australia, we explored the opportunities for investing in staff training on awareness of basic psychological needs of these young people and introducing the concept of an open, positive group climate. This study reports the results of an explorative measurement of perceived group climate in four units of two juvenile justice centers in Victoria (Australia). The young people ( N = 57) were provided with the Prison Group Climate Instrument. The results of the group climate research and a cross-cultural comparison show that there are inherent strengths but also important opportunities for improvement in the group climate experienced by young people. Recommendations to improve the group climate are discussed in this paper.
Enhancing physical geography schools outreach: Insights from co-production and storytelling narratives
Authors: Adamson Kathryn , Lane Timothy , De Meyer Kris , Carney Matthew , Oppenheim Leonora , Panitz Sina , Price Hannah , Smith Emma , Watson Gregory
Published: June 2021

Global environmental change is one of the most pressing issues facing future generations. Equipping schoolchildren with a clear understanding of physical geography is therefore a key educational priority. Effectively engaging schoolchildren with complex scientific ideas can be challenging, but with the appropriate tools, scientists can play a valuable role in developing meaningful science communication experiences. Climate Explorers addressed these issues by forging a collaboration between physical geography and social science academics, and 320 UK school students and their teachers in seven primary (elementary) schools. Using insights from co-production techniques and storytelling, the project aimed to 1) produce new open access, online climate science education resources, and 2) test co-production and storytelling approaches to physical geography science engagement. Our findings demonstrated that school children responded especially well to working with ‘real life’ scientists, where meaningful and memorable educational interactions were forged through the use of narratives, personal experiences and tailored language. Here we summarise our approach, and provide templates that can be readily applied by scientists working across the physical geography spectrum anywhere in the world. The flexibility of the templates means that they can be adapted and developed for a range of formats, from small-scale community workshops to national-scale educational initiatives, for delivery both in-person or online. We hope that our approach will provide a springboard to transform and enhance physical geography science communication more broadly.
Blood Flow Restriction Training for the Shoulder: A Case for Proximal Benefit
Authors: Lambert Bradley , Hedt Corbin , Daum Joshua , Taft Carter , Chaliki Kalyan , Epner Eden , McCulloch Patrick
Published: June 2021

Background:

Although blood flow restriction (BFR) is becoming increasingly popular in physical therapy and athletic training settings, little is known about the effects of BFR combined with low-intensity exercise (LIX) on muscles proximal to the site of occlusion.

Hypothesis/Purpose:

Determine whether LIX combined with BFR applied distally to the shoulder on the brachial region of the arm (BFR-LIX) promotes greater increases in shoulder lean mass, rotator cuff strength, endurance, and acute increases in shoulder muscle activation compared with LIX alone. We hypothesized that BFR-LIX would elicit greater increases in rotator cuff strength, endurance, and muscle mass. We also hypothesized that the application of BFR would increase EMG amplitude in the shoulder muscles during acute exercise.

Study Design:

Controlled laboratory study.

Methods:

32 healthy adults were randomized into 2 groups (BFR group, 13 men, 3 women; No-BFR group, 10 men, 6 women) who performed 8 weeks of shoulder LIX (2 times per week; 4 sets [30/15/15/fatigue]; 20% maximum) using common rotator cuff exercises (cable external rotation [ER], cable internal rotation [IR], dumbbell scaption, and side-lying dumbbell ER). The BFR group also trained with an automated tourniquet placed at the proximal arm (50% occlusion). Regional lean mass (dual-energy x-ray absorptiometry), isometric strength, and muscular endurance (repetitions to fatigue [RTF]; 20% maximum; with and without 50% occlusion) were measured before and after training. Electromyographic amplitude (EMGa) was recorded from target shoulder muscles during endurance testing. A mixed-model analysis of covariance (covaried on baseline measures) was used to detect within-group and between-group differences in primary outcome measures (α = .05).

Results:

The BFR group had greater increases in lean mass in the arm (mean ± 95% CI: BFR, 175 ± 54 g; No BFR, –17 ± 77 g; P < .01) and shoulder (mean ± 95% CI: BFR, 278 ± 90 g; No BFR, 96 ± 61 g; P < .01), isometric IR strength (mean ± 95% CI: BFR, 2.9 ± 1.3 kg; No BFR, 0.1 ± 1.3 kg; P < .01), single-set RTF volume (repetitions × resistance) for IR (~1.7- to 2.1-fold higher; P < .01), and weekly training volume (weeks 4, 6-8, ~5%-22%; P < .05). Acute occlusion (independent of group or timepoint) yielded increases in EMGa during RTF (~10%-20%; P < .05).

Conclusion:

Combined BFR-LIX may yield greater increases in shoulder and arm lean mass, strength, and muscular endurance compared with fatiguing LIX alone during rotator cuff exercises. These findings may be due, in part, to a greater activation of shoulder muscles while using BFR.

Clinical Relevance:

The present study demonstrates that BFR-LIX may be a suitable candidate for augmenting preventive training or rehabilitation outcomes for the shoulder.
Evaluation of the Intact Anterior Talofibular and Calcaneofibular Ligaments, Injuries, and Repairs With and Without Augmentation: A Biomechanical Robotic Study
Authors: Larkins Christopher G. , Brady Alex W. , Aman Zachary S. , Dornan Grant J. , Haytmanek Craig T. , Clanton Thomas O.
Published: June 2021

Background:

Acute ankle sprains are common injuries. The anterior talofibular (ATFL) and calcaneofibular ligaments (CFL) are the most injured lateral structures. However, controversy exists on the optimal surgical treatment when the injury is both acute and severe or becomes chronic and unstable. Studies have evaluated the biomechanics of these ligaments, but no studies have robotically evaluated injury effects and surgical treatment of ATFL or ATFL and CFL injuries.

Purpose:

To quantitatively evaluate biomechanical effects of ATFL and CFL lesions, ATFL repair, ATFL and CFL repair, and augmentation of ATFL on ankle stability.

Study Design:

Controlled laboratory study.

Methods:

Ten nonpaired cadaveric ankles were tested using a 6 degrees of freedom robot. Each ankle underwent testing in the following states sequentially: (1) intact, (2) ATFL cut, (3) CFL cut, (4) ATFL repair + CFL cut, (5) ATFL repair + CFL repair, and (6) ATFL repair with augmentation with suture tape + CFL repair. Testing included 88 N anterior drawer and 5 N·m varus talar tilt tests at 0° and 30° of plantarflexion, and 88 N Cotton test at 0° of plantarflexion.

Results:

After all surgical treatments ankles still had increased laxity compared with intact state testing, except after augmented ATFL repair + CFL repair in anterior drawer testing at 30° of plantarflexion ( P = .393). Sectioning the CFL caused a significant increase in talar tilt compared with the ATFL cut state at 0° ( P < .001) and 30° of plantarflexion ( P < .001), but no increase in anterior drawer or Cotton tests.

Conclusion:

Complete native stability may not be attainable at time zero repair with the tested treatments. The option that best returned stability in anterior translation was augmented ATFL repair with nonaugmented CFL repair. The importance of the CFL as a primary ligamentous stabilizer for talar tilt was confirmed.

Clinical Relevance:

Evaluating lateral ankle stability and treatment with a 6 degrees of freedom robot should help delineate optimal treatment options. Findings in this study show that none of the repair methods at time zero restored kinematics to the intact state. Of the tested states, the augmented ATFL repair with CFL repair was the best option for controlling anterior translation at time zero. The importance of addressing the CFL to correct talar tilt instability was suggested as was the importance of a period of immobilization before beginning protected rehabilitation. The benefit of ATFL repair augmentation with suture tape is in limiting the postoperative motion in an anterior drawer motion to just 0.5 to 1 mm, but there was no significant improvement to talar tilt even with CFL repair, suggesting that further consideration should be given to CFL augmentation in future studies.
Stop blaming external factors: A historical-sociological argument
Authors: Schneider Jesper W. , Horbach Serge P. J. M. , Aagaard Kaare
Published: June 2021

With this commentary we respond to Olof Hallonsten’s recent plea to stop evaluating science. In particular, we challenge two central premises of Hallonsten’s argument, regarding both the scope of his argument and the claim that ‘exogenous’ metric evaluation of science on its own explains failures of the current scientific enterprise to produce certified knowledge. Even though we acknowledge that ‘external’ evaluation mechanisms of science likely amplify problematic practices within science, they do not suffice to explain the crisis situation sketched out by Hallonsten and others. Instead, we make a plea to the academic community to introspect on its own practices. We argue that, to an overwhelmingly degree, these research practices shape the reward and quality assurance system of science. Discussing the formal and informal quality assurance mechanisms of science, we conclude that the apparent crisis in science is cultural and organizational, deeply internally rooted, and inseparable from researchers’ daily practices and personal responsibility. Most importantly, this concerns the central role of the academic community in controlling and evaluating how science is practiced, how merit is defined, and how decisions of promotion and rewards are made.