bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytogenetics of the Simulium arcticum complex (Diptera: Simuliidae)
Authors: SHIELDS GERALD F.
Published: September 2021

Descriptions of chromosomal rearrangements, geographic distributions and frequencies of nine siblings and 28 cytotypes of the Simulium arcticum Malloch complex are presented. Findings are based on six data sets that include approximately 21,000 chromosomally analyzed larvae from throughout the known geographic range of S. arcticum. This is the largest chromosomal data set for any North American complex of black flies. This summary emphasizes the need to chromosomally analyze taxa of black flies since this type of analysis can result in, not only, a better understanding of the number of taxa in a complex and their relationships but also, it may help to understand the initial stages of reproductive isolation within otherwise morphologically identical groups. Geographically, the streams of eastern Alaska, the entire province of the Yukon and northern Mexico should be sampled. Taxonomically the many cytotypes should be tested for reproductive status when they occur in sympatry with other siblings and cytotypes of the complex. Finally, comparative multi-omic research would be useful.
Attributing Compound Events to Anthropogenic Climate Change
Authors: Zscheischler Jakob , Lehner Flavio
Published: September 2021

Extreme event attribution answers the question of whether and by how much anthropogenic climate change has contributed to the occurrence or magnitude of an extreme weather event. It is also used to link extreme event impacts to climate change. Impacts, however, are often related to multiple compounding climate drivers. Because extreme event attribution typically focuses on univariate assessments, these assessments might only provide a partial answer to the question of anthropogenic influence to a high-impact event. We present a theoretical extension to classical extreme event attribution for certain types of compound events. Based on synthetic data, we illustrate how the bivariate fraction of attributable risk (FAR) differs from the univariate FAR depending on the extremeness of the event as well as the trends in and dependence between the contributing variables. Overall, the bivariate FAR is similar in magnitude or smaller than the univariate FAR if the trend in the second variable is comparably weak and the dependence between both variables is moderate or high, a typical situation for temporally co-occurring heat waves and droughts. If both variables have similarly large trends or the dependence between both variables is weak, bivariate FARs are larger and are likely to provide a more adequate quantification of the anthropogenic influence. Using multiple climate model large ensembles, we apply the framework to two case studies, a recent sequence of hot and dry years in the Western Cape region of South Africa and two spatially co-occurring droughts in crop-producing regions in South Africa and Lesotho.
Evaluating Foehn Occurrence in a Changing Climate Based on Reanalysis and Climate Model Data Using Machine Learning
Authors: Mony Christoph , Jansing Lukas , Sprenger Michael
Published: September 2021

This study explores the possibilities of employing machine learning algorithms to predict foehn occurrence in Switzerland at a north Alpine (Altdorf) and south Alpine (Lugano) station from its synoptic fingerprint in reanalysis data and climate simulations. This allows for an investigation on a potential future shift in monthly foehn frequencies. First, inputs from various atmospheric fields from the European Centre for Medium-Range Weather Forecasts (ECMWF) interim reanalysis (ERAI) were used to train an XGBoost model. Here, similar predictive performance to previous work was achieved, showing that foehn can accurately be diagnosed from the coarse synoptic situation. In the next step, the algorithm was generalized to predict foehn based on the Community Earth System Model (CESM) ensemble simulations of a present-day and warming future climate. The best generalization between ERAI and CESM was obtained by including the present-day data in the training procedure and simultaneously optimizing two objective functions, namely, the negative log loss and squared mean loss, on both datasets, respectively. It is demonstrated that the same synoptic fingerprint can be identified in CESM climate simulation data. Finally, predictions for present-day and future simulations were verified and compared for statistical significance. Our model is shown to produce valid output for most months, revealing that south foehn in Altdorf is expected to become more common during spring, while north foehn in Lugano is expected to become more common during summer.
Occupational Competence and Activities of Daily Living Performance in Bronchial Asthma
Authors: Güzel Hüsna , Saglam Melda , Pekcetin Serkan , Yagli Naciye Vardar , Boyacı Hasim
Published: September 2021

Background. Activity restriction is one of the most common symptoms reported by people living with bronchial asthma. Purpose. The study aimed to determine occupational competence and values in people living with bronchial asthma and compare with the occupational competence and activities of daily living (ADL) of healthy controls. Methods. Twenty individuals with asthma and 20 healthy controls were enrolled. Occupational competence and values were assessed using the Occupational Self-Assessment (OSA) questionnaire. Restriction of ADL was determined using the London Chest ADL Scale. Findings. Occupational competence was lower, and all London Chest ADL scores were significantly higher in asthma individuals compared to controls ( p < .05). The most affected parameters reported by asthma individuals on the OSA were the ability to concentrate, perform physical tasks, work toward goals, and use abilities effectively. Implications. Evaluating occupational competence in people living with bronchial asthma is important to identify their occupational problem areas and provide appropriate interventions.
How war-related deprivation affects political participation: Evidence from education loss in Liberia
Authors: Liu Shelley X
Published: September 2021

How does civil war affect citizen engagement with democracy? Civilians who live through warfare face numerous disruptions to everyday life that can have permanent effects on political engagement even after peace is achieved. This article analyzes the role of depressed living standards resulting from education loss during the Liberia Civil War as a case study of war-related deprivation. I argue that the negative effects of war on education and economic outcomes clash with the expectations that citizens have for postwar democracy, with adverse consequences for political participation. I demonstrate support for this argument using a mixed methods approach, combining qualitative interviews with census, voting, and Afrobarometer survey data. I leverage a difference-in-differences identification strategy to causally identify the negative impact of conflict on human capital for a generation of young adults, and on the downstream consequences of disruptions in education on political participation. Results indicate that children who were of school age during the civil war are differentially less likely to have any formal schooling by the end of the war. I further find that educational deficiencies disproportionately decrease postwar job prospects, breeding resentment against the newly elected government. This extends to political participation: those who lost out on educational opportunities due to war exhibit lower political engagement and less desire to engage with democratic processes.
Redacting Acts: The Acts of the Apostles in the Three-Year Lectionaries
Authors: Connell Martin
Published: September 2021

The representation of the Acts of the Apostles in the three-year lectionaries—the Roman Catholic Ordo Lectionum Missae (OLM) and the Protestant Revised Common Lectionary (RCL)—favors the first half of the twenty-eight-chapter book over its second half. The OLM prescribes nine times more verses from the first half than from the second half, and the RCL prescribes four times more. This article compares the proportion of Acts in the lectionaries to the other twenty-six books of the New Testament, shows when in the three-year lectionary cycle readings from Acts are proclaimed, presents how much of each of the twenty-eight chapters of Acts appears in the lectionaries, hypothesizes about why the second half of Acts is slighted, and argues that the church’s liturgical tradition is weakened by muting significant passages about post-resurrection eucharists.
Suicide in primary care: How to screen and intervene
Authors: Dixon Mark A , Hyer Steven M , Snowden David L
Published: September 2021

Suicide is significant public health concern within the United States. Research results are mixed about the effectiveness of universal screening and interventions with patients who are at-risk for suicide. Primary care is a logical intervention point to mitigate risk among patients in each of these areas. The Department of Veterans Affairs and Department of Defense have developed comprehensive guidelines for the assessment and management of suicidal patients. This approach involves specific screening tools, risk stratification by categories and interventions used by clinicians to help reduce risk levels in their patients. This article aims to provide a model, built on the principles of these guidelines, which primary care physicians can use to identify, assess and intervene with patients who are at-risk for suicide.
IRTGUI: An R Package for Unidimensional Item Response Theory Analysis With a Graphical User Interface
Authors: Yildiz Huseyin
Published: September 2021

In the last decade, many R packages were published to perform item response theory (IRT) analysis. Some researchers and practitioners have difficulty in using these functional tools because of their insufficient coding skills. The IRTGUI package provides these researchers a user-friendly GUI where they can perform unidimensional IRT analysis without coding skills. Using the IRTGUI package, person and item parameters, model and item fit indices can be obtained. Dimensionality and local independence assumptions can be tested. With the IRTGUI package, users can generate dichotomous data sets with customizable conditions. Also, Wright Maps, item characteristics and information curves can be graphically displayed. All outputs can be easily downloaded by users.
Permanent Temporality: Race, Time, and the Materiality of Romanian Identity Cards
Authors: Plájás Ildikó Zonga
Published: September 2021

Documents, in particular identity cards, mediate relationships between individuals and institutions. Their materiality matters and actively impacts how states govern populations and their movements. In this paper, I examine one such object, the Romanian identity card. Focusing on its temporality and agency, I explore how objects and technological procedures enact race. In Romania, people without an address or proof of residence—many of them members of segregated Roma communities living in deep poverty—can only receive a temporary identity card, the Carte de Idenititate Provizorie (CIP). CIP holders do not enjoy full citizenship and are deprived of various rights, such as the right to travel without a passport within the European Union. They are also exposed to heightened surveillance as they must apply annually for a new CIP. Starting from the material object of the CIP, I explore how race comes into being as a relation at the intersection of various temporalities that are folded into the rules and bureaucratic practice entailed in its issue. I offer the concept of “permanent temporality” to analyze how racialization occurs in practices of governing people and their movement in Europe.
Film distribution by video streaming platforms across Southeast Asia during COVID-19
Authors: Changsong Wang , Kerry Lucyann , Marta Rustono Farady
Published: September 2021

The pandemic of COVID-19, which forced cinema theaters to close and left exhibitors without revenue over a long period, may have dramatically changed the film business and its future. This paper seeks to examine the changing dynamic of film distribution through video streaming in the Southeast Asia region as a result of the impact of the pandemic. Some films may be chosen for video streaming media platforms as their alternative option for release into theatrical distribution. This pandemic also has changed film-viewing habits and behaviors among audiences. Several news reports have substantiated that Southeast Asian viewers are streaming more online video content due to COVID-19. As a result of the pandemic it appears that there is an accelerated shift to streaming media platforms across Southeast Asia countries. Local streaming platforms feed users their unique and culturally distinctive locally produced content which could be distinguished from that offered by global players. In 2020, some new streaming media platforms were launched for distributing film content to their targeted markets locally and internationally. Through the use of a review of trade and business press as well as interview, this paper attempts to identify and present areas of regional change and regional players which deserve systematic discussion and analysis.
Surveillance, race, and social sorting in the United Arab Emirates
Authors: Ziadah Rafeef
Published: September 2021

The United Arab Emirates (UAE) has made headlines for its use of mass surveillance technologies against UAE residents, as well as opponents externally. Under the guise of protecting national security, there has been a proliferation of state-led initiatives to monitor public spaces and online activity across the UAE, making the country an important laboratory for advanced surveillance tools. This article takes as a starting point that despite claims to being race-neutral and scientific, surveillance technologies have an embedded racial bias and operate according to context to (re)produce forms of state control and racial social relations. Reviewing the introduction of multiple surveillance technologies, this article traces the rationales used to racially order space and define deviance in the UAE context, emphasising questions of race, migration status and labour, to understand how the state defines, codifies, and regulates an ethno-racial hierarchy.
Shoulder pain in a patient with renal cell carcinoma? Suprascapular neuropathy caused by bone metastasis of renal cell carcinoma: A case report
Authors: Noh Jeong-Se , Kim Dong Hyun , Chun Seong-Min , Choi Yoon-Hee
Published: September 2021

Background:

Pain management is crucial in palliative care for patients with advanced cancer. Here, we report a case of shoulder pain in a patient with renal cell carcinoma.

Case presentation:

A 36-year-old male diagnosed metastatic renal cell carcinoma presented with pain and weakness on left shoulder for more than 6 months. Physical examination showed limited range of motion and atrophic changes on supraspinatus and infraspinatus muscles. Weakness in shoulder abduction and external rotation was also noted.

Possible courses of action:

In this case, suprascapular neuropathy, adhesive capsulitis of shoulder and metastatic lesions involving shoulder joint were suspected.

Formulation of a plan:

We planned imaging studies including X-ray, bone scan, magnetic resonance imaging, and electrodiagnostic studies.

Outcome:

Imaging and electrodiagnostic studies showed suprascapular neuropathy by bone metastasis. Conservative treatment including injection and rehabilitation therapy reduced the patient’s pain and improved the range of motion limitation.

Lessons from the case:

Clinicians should be aware that bone metastasis in patients with advanced cancer can cause suprascapular neuropathy, shoulder pain and shoulder dysfunction.

View on research problems, objectives, or questions generated by the case:

More research is expected on development of an early surveillance model, barriers to cancer pain management, communication from patients’ perspectives.
Beclin-1 is a novel predictive biomarker for canine cutaneous and subcutaneous mast cell tumors
Authors: Knight Britta J. , Wood Geoffrey A. , Foster Robert A. , Coomber Brenda L.
Published: September 2021

Mast cell tumors (MCTs) are the most common skin tumor of the dog, and accurately predicting their clinical behavior is critical in directing patient therapy, as they range from benign lesions to a fatal systemic disease. Grading is useful for prognosis, but it cannot predict the behavior of all MCTs. We hypothesized that biomarker immunolabeling in tumor tissues would correlate with patient morbidity and mortality. A clinically annotated tissue microarray (TMA) of primary, recurrent, and metastatic (to lymph node) canine dermal and subcutaneous MCTs was created. Some dogs whose MCTs were included in the TMA did not receive adjunctive treatment after surgical excision of the MCT, whereas others were treated with one or a combination of chemotherapy, radiation, or oral toceranib. Immunohistochemistry for beclin-1, an autophagy protein, was performed followed by digital image analysis. Beclin-1 immunolabeling was higher in recurrent tumors (mean H-score 110.8) than primary MCTs (mean H-score 73.5), and highest in lymph node metastases (mean H-score 138.5) with a significant difference in means ( P < .001). While beclin-1 level was not prognostic, it was strongly predictive for survival after adjunctive treatment; dogs with high beclin-1-expressing tumors showed poorer survival compared to those with low beclin-1-expressing tumors (HR = 5.7, P = .02), especially in Kiupel high-grade tumors (HR = 16.3, P = .01). Beclin-1 immunolabeling was the only significant predictive factor by multivariable analysis ( P = .04). These findings may improve our ability to predict the response to adjunctive therapy. Importantly, these data suggest that autophagy inhibitors may be useful in improving response to treatment for dogs with high-grade MCTs.
Ability of Medial Patellofemoral Ligament Reconstruction to Overcome Lateral Patellar Motion in the Presence of Trochlear Flattening: A Cadaveric Biomechanical Study
Authors: Vinod Amrit V. , Hollenberg Alex M. , Kluczynski Melissa A. , Marzo John M.
Published: September 2021

Background:

Medial patellofemoral ligament (MPFL) reconstruction is an established operative procedure to restore medial restraining force in patients with patellar instability. In the setting of a shallow sulcus, it is unclear whether an isolated MPFL reconstruction is sufficient to restore patellofemoral stability.

Hypothesis:

Progressively increasing the sulcus angle would have an adverse effect on the ability of an MPFL reconstruction to restrain lateral patellar motion.

Study Design:

Controlled laboratory study.

Methods:

Seven fresh-frozen human cadaveric knees were harvested and prepared for experimentation. Each specimen was run through the following test conditions: native, lateral retinacular release, lateral retinacular repair, MPFL release, MPFL reconstruction, and MPFL reconstruction with trochlear flattening. Four 3-dimensional printed wedges (10°, 20°, 30°, and 40°) were created to insert beneath the native trochlea to raise the sulcus angle incrementally and simulate progressive trochlear flattening. For each test condition, the knee was positioned at 0°, 15°, 30°, and 45° of flexion, and the force required to displace the patella 1 cm laterally at 10 mm/s was measured. Group comparisons were made with repeated measures analysis of variance.

Results:

In the setting of an MPFL reconstruction, as the trochlear groove was incrementally flattened, the force required to laterally displace the patella progressively decreased. A 10° increase in the sulcus angle significantly reduced the force at 15° ( P = .01) and 30° ( P = .03) of knee flexion. The force required to laterally displace the patella was also significantly lower at all knee flexion angles after the addition of the 20°, 30°, and 40° wedges ( P≤ .05). Specifically, a 20° increase in the sulcus angle reduced the force by 29% to 36%; a 30° increase, by 35% to 43%; and a 40° increase, by 40% to 47%.

Conclusion:

Despite an MPFL reconstruction, the force required to laterally displace the patella decreased as the sulcus angle was increased in our cadaveric model.

Clinical Relevance:

An isolated MPFL reconstruction may not be sufficient to restore patellar stability in the setting of a shallow or flat trochlea. Patients with an abnormal sulcus angle may have recurrent instability postoperatively if treated with an isolated MPFL reconstruction.
Arthroscopic Centralization for Lateral Meniscal Injuries Reduces Laxity in the Anterior Cruciate Ligament–Reconstructed Knee
Authors: Nakamura Tomomasa , Marshall Brandon D. , Price Taylor M. , Mao Yongtao , Linde Monica A. , Koga Hideyuki , Smolinski Patrick , Fu Freddie H.
Published: September 2021

Background:

A lateral meniscal (LM) disorder is one factor that causes rotational laxity after anterior cruciate ligament (ACL) reconstruction (ACLR). There are different types of irreparable meniscal disorders, one of which is a massive meniscal defect.

Hypothesis/Purpose:

The purpose of this study was to evaluate the kinematic effects of arthroscopic centralization on an irreparable LM defect. The hypothesis was that arthroscopic centralization for an irreparable LM defect with concomitant ACLR would improve knee rotational stability.

Study Design:

Controlled laboratory study.

Methods:

A total of 14 fresh-frozen human cadaveric knees were tested in 4 states: (1) intact ACL and intact lateral meniscus, (2) reconstructed ACL and intact lateral meniscus, (3) reconstructed ACL and lateral meniscus defect, and (4) reconstructed ACL and centralized lateral meniscus. Anatomic ACLR was performed using an 8 mm–diameter hamstring tendon graft. An LM defect (20% of the anteroposterior length) was created arthroscopically, and arthroscopic centralization was performed. Kinematics were analyzed using a 6 degrees of freedom robotic system under 4 knee loads: (1) an 89.0-N anterior tibial load, (2) a 5.0-N·m external rotation tibial torque, (3) a 5.0-N·m internal rotation tibial torque, and (4) a simulated pivot-shift load with a combined 7.0-N·m valgus and 5.0-N·m internal rotation tibial torque.

Results:

LM centralization reduced anterior tibial translation similar to that of the ACLR intact LM state under anterior tibial loading (~2 mm at 30° of flexion) and showed 40% to 100% of tibial displacement in the 4 knee states under simulated pivot-shift loading. The procedure overconstrained the knee under internal rotation tibial torque and simulated pivot-shift loading.

Conclusion:

Arthroscopic centralization reduced knee laxity after ACLR for a massive LM defect in a cadaveric model.

Clinical Relevance:

In cases involving irreparable LM injuries during ACLR, consideration should be given to arthroscopic centralization for reducing knee laxity. However, the procedure may overconstrain the knee in certain motions.
Examining the Role of National Context: Do Country Conditions During Childhood Impact Perpetration of Dating Violence in Emerging Adulthood?
Authors: Davis Maxine , Ombayo Bernadette , Gilbar Ohad
Published: September 2021

The link between individual experiences in early childhood or adolescence years and future dating violence (DV) perpetration has been well established and explored across various populations. However, little is known on a worldwide scale, about the association between national conditions during childhood, like overall well-being or status of women in that nation, and perpetration of DV in emerging adulthood. Applying life-course theory and a socioecological framework to data from the International Dating Violence Study and country index scores, this study examines whether the overall well-being of a country during childhood affects the perpetration of DV in emerging adulthood. We also examine if the national status of women during childhood moderates the association between overall well-being of a country during childhood and DV perpetration in emerging adulthood, all while controlling for the individual effects of gender, violence approval, criminal history, neglect history, and anger management. The study’s sample size included 4,280 people from 19 countries. Men reported less likelihood of perpetrating DV compared to women. Cross national comparative analysis revealed a significant interaction effect between country well-being and women status on DV perpetration (β = 0.69, p < .05) at the national level. When women’s status was low or moderate, the well-being status showed an inverse effect on the probability of DV perpetration, but this direction switched in the face of high women’s status. Contrary to previous research, higher women status may contribute to increased intimate partner violence (IPV) perpetration. Our findings underscore the existence of context-specific social conditions in relationship to IPV. Broad implications of the findings, potential explanations and directions for future research are discussed.
Influence of different blade numbers on the performance of “saddle zone” in a mixed flow pump
Authors: Ji Leilei , Li Wei , Shi Weidong , Tian Fei , Li Shuo , Agarwal Ramesh
Published: September 2021

In order to study the effect of different numbers of impeller blades on the performance of mixed-flow pump “saddle zone”, the external characteristic test and numerical simulation of mixed-flow pumps with three different impeller blade numbers were carried out. Based on high-precision numerical prediction, the internal flow field and tip leakage flow field of mixed flow pump under design conditions and stall conditions are investigated. By studying the vorticity transport in the stall flow field, the specific location of the high loss area inside the mixed flow pump impeller with different numbers of blades is located. The research results show that the increase in the number of impeller blades improve the pump head and efficiency under design conditions. Compared to the 4-blade impeller, the head and efficiency of the 5-blade impeller are increased by 5.4% and 21.9% respectively. However, the increase in the number of blades also leads to the widening of the “saddle area” of the mixed-flow pump, which leads to the early occurrence of stall and increases the instability of the mixed-flow pump. As the mixed-flow pump enters the stall condition, the inlet of the mixed-flow pump has a spiral swirl structure near the end wall for different blade numbers, but the depth and range of the swirling flow are different due to the change in the number of blades. At the same time, the change in the number of blades also makes the flow angle at 75% span change significantly, but the flow angle at 95% span is not much different because the tip leakage flow recirculates at the leading edge. Through the analysis of the vorticity transport results in the impeller with different numbers of blades, it is found that the reasons for the increase in the values of the vorticity transport in the stall condition are mainly impacted by the swirl flow at the impeller inlet, the tip leakage flow at the leading edge and the increased unsteady flow structures.
Content Validity of an Integrated Yoga Module for Practice During Remission in Relapsing–Remitting Multiple Sclerosis Patients
Authors: Palukuru Sreedhar , Patil Suchitra S. , Nagarathna R. , Singh Amit , Nibedita K. S.
Published: September 2021

Background:

Some investigations point to the beneficial effects of yoga in alleviating the motor and cognitive dysfunctions in multiple sclerosis (MS) patients by using varying combinations of physical, breathing, and meditative practices of yoga. There is a need for a validated yoga module with a holistic approach that can be used as a standardized protocol by researchers and therapists.

Purpose:

To develop and validate an integrated yoga module for practice in relapsing–remitting MS patients to improve their quality of life.

Methods:

We did a thorough review of the literature for the development of the yoga module. We formed an expert group with 24 experts and a neurologist and used two rounds of interactive Delphi method to combine their opinion to obtain content validity of the module through online structured questionnaire prepared for the purpose on a Google Form. We incorporated all suggestions obtained by the experts. The final module (60 min per session, twice a day, five days per week) included warm-up exercises, customized asanas, relaxation techniques, and OM meditation. Advice on yogic diet and discussion using yogic concepts for stress management also form a part of the holistic approach to yoga lifestyle modification.

Results:

Analysis divulged that 30 out of 39 practices exhibited a content validity ratio value greater than or equal to 0.42.

Conclusion:

The study has shown good content validity of the integrated yoga module. Future clinical studies are being planned to rule the feasibility and reliability of this module.
Twenty-First-Century Hyper-power, China or USA: Is Demography the Determinant?
Authors: Gaan Narottam
Published: September 2021

In the aftermath glow of the end of the Cold War was seen faintly the swaggering footsteps of a triumphant USA ready to architect a new world attic with the mortars and bricks of its own politico-economic ideology. But the engendered vibe and euphoria bedecking America proved to be ephemeral with its dismal economic straits, failure of overseas military adventurism, terrorist attack on its trade center and loosening grip over global events, rise of other powers, and unwillingness of the world to kowtow to American lines. China, in contrast, showed ascendancy in economic growth, rising productive forces, military modernization, and ambitious global designs, giving rise to the neorealist zero-sum understanding that eclipsing USA has lent to the ascent of China in the global scene. But this kind of analysis is mostly founded on traditional paradigm of politico-military and economic power. What is primarily ignored or marginalized in the analysis of power structure in global politics is the demography, that is, aging population structure. The present article focuses on aging population structure of the USA, China and other great powers and tries to challenge this traditionally ingrained understanding of power structure and holds on to the view that if the current population structure is any indication, America will rule the roost in global politics.
An eLearning program to prepare residents for a rotation in pediatric emergency medicine: A qualitative study
Authors: Tyebally Arif , Dong Chaoyan
Published: September 2021

Background:

To meet ACGME-I (Accreditation Council for Graduate Medical Education–International) training and duty hour requirements, we converted our 3-week-long pediatric emergency medicine induction program to an eLearning program.

Objectives:

The study aimed to identify areas of the eLearning program residents perceived useful and the components that helped them prepare for clinical work.

Methods:

The qualitative study took place in a tertiary pediatric emergency department. Twenty-seven residents from family medicine, emergency medicine, and pediatric medicine participated in focus group discussions to explore how they perceived the eLearning program helped prepare them for work. The interviews were audio-recorded, and transcripts were analyzed and coded into categories and themes.

Results:

Four themes emerged from the data analysis: residents’ access to the eLearning program, instructional methods, eLearning design elements, and supplementary learning. Residents valued autonomy to control their pace of learning and use online features that matched their preferred learning styles. Design features such as the use of questions and quizzes helped stimulate learning, but attention had to be paid to the order of questions in the modules and the format of the questions. Written guidelines served as a good reference for learners and face-to-face sessions accompanying the eLearning program helped reinforce knowledge and offered opportunities to interact with faculty members to clarify questions.

Conclusion:

Systematic planning focusing on access, instructional methods, and design is essential when creating eLearning programs for residency training. eLearning programs can be enhanced by the incorporation of team-based learning and having accompanying written content to reference.
“So Glad to Be Home”: Experiences of Money Follows the Person Participants After Transitioning Out of an Institution
Authors: Kellett Kathy , Ligus Kaleigh , Robison Julie
Published: September 2021

This study examined qualitative data from participants who transitioned from institutional to community living through the Money Follows the Person (MFP) Rebalancing Demonstration in Connecticut. As part of the MFP quality of life survey, 1,566 participants provided qualitative feedback about their experiences at 6-, 12-, and 24-month time points after transition. Maslow’s Hierarchy of Needs serves as a thematic framework to analyze the data. In their open-ended comments, many participants underscored the efficacy of the program and offered constructive feedback; some people also reported barriers and challenges to community living. While MFP participants generally report high satisfaction with the program, both in Connecticut and nationally, some participants identified areas of unmet need, including housing, transportation, and workforce issues. Findings have the potential to expand stakeholders’ understanding of participants’ needs and facilitate policies to improve services and supports for older adults and people living with disabilities who return to community living following institutionalization.
Becoming One with the Neighborhood: Collaborative Art, Space-Making, and Urban Change in Izmir Darağaç
Authors: Kılınç Kıvanç , Pasin Burkay , Varinlioğlu Güzden
Published: September 2021

Darağaç is a former industrial, lower-income neighborhood in Turkey’s third-largest city, Izmir. In 2015 several artists settled in the area and started a nonprofit initiative called the Darağaç Collective (DC). DC has since organized numerous art events and exhibitions, receiving considerable interest and publicity. Yet, to date, the changes in Darağaç’s material landscapes have been subtle, and the area remains ungentrified, unlike similar examples in Turkey. This article argues that the collaborative art practice spearheaded by DC played a major role in the preservation of the neighborhood’s urban texture. The artists became neighbors with the residents, benefited from the expertise of mechanics, and drew inspiration from the site, while the local community has contributed to the production, exhibition, and appreciation of artworks. Thus, art has become a tool for sociability and a catalyst for interpersonal, cultural, and cross-class exchanges, which could offer an alternative route to art-led urban change in Turkey.
Does official development assistance promote tourism demand for donor countries? Evidence from Switzerland
Authors: Lopez Luciano , Bianchi Giuliano , Chen Yong
Published: September 2021

This study estimates the effect of official development assistance (ODA) on tourism demand of recipient countries for donor countries. We analyzed a panel dataset of 15 recipient countries of Switzerland’s aid from 2005 to 2017, for which data are available. We used both tourist arrivals at lodging establishments, particularly hotels, in Switzerland and hotel nights as proxies for recipient countries’ tourism demand in Switzerland. Using a modified gravity model of trade for empirical testing, we found that an increase of every US$1000 ODA to recipient countries would generate 3.6 tourist arrivals and almost four hotel nights in the following year, after controlling for the effects of GDP and population of recipient countries, the exchange rate and the distance between recipient countries and Switzerland, and trade facilitators. We conclude that ODA generates a positive externality on donor countries, namely, that recipient countries incline to increase their imports from donor countries, at least partially in the form of inbound tourism in donor countries.
Exploring the role of telehealth: A novel approach to group-based smoking cessation treatment for men incarcerated in a rural state prison
Authors: Valera Pamela , Malarkey Sarah , Smith Nadia , McLaughlin Christopher
Published: September 2021

Introduction

Tobacco smoking remains an important public health issue in the United States (US), specifically among people who are incarcerated. There is little to no information about smoking behaviors of incarcerated people in rural areas and there is a lack of resources for smoking cessation interventions in rural settings. Telehealth might be efficient for delivering care to incarcerated people in rural areas. The purpose of this study was to determine the feasibility of delivering group-based smoking cessation treatment via telehealth to incarcerated male smokers in a rural prison.

Methods

A 6-week group-based smoking cessation treatment program was conducted with 1-month follow up. Video conferencing was used from Weeks 2–5 to deliver treatment. A cross-sectional survey was administered collecting measures including criminal justice experience, smoking behaviors, withdrawal and triggers, mental health, physical health, and substance use. Baseline exhaled carbon monoxide (CO) levels were collected at Session 1, and a final CO level at Session 6 and 1-month follow-up.

Results

Twenty ( n = 20) incarcerated male smokers were recruited from a rural prison facility. The majority of the inmates were White (85%). Approximately, 80% of the inmates smoked about 20 or more cigarettes per day, and on average smoked for 28 years (SD = 9). Most inmates scored a moderate or high dependence score on the Fagerström Test for Nicotine Dependence.

Conclusion

Telehealth programs such as video conferencing smoking cessation treatment ought to be implemented to reduce tobacco-related disparities among incarcerated smokers housed in rural prisons.
Patient narratives of hope in stem cell technologies: Trust in biomedicine and the body’s natural ability to heal itself
Authors: DePalma Lindsay J , Olsen Lauren D , Evans John H
Published: September 2021

The scholarship on patient hope in biomedical technologies describes two narratives of hope: the biomedical and the individual. The biomedical narrative represents patients’ beliefs that the institution of science will eventually produce treatment for their disease, whereas the individual narrative represents patients’ beliefs that they can alter their prognosis through affective and behavioral modifications. The distinct analytical categories of “biomedical” and “individual,” however, fail to account for the fact that patient hope has been found to be much more complex. Building upon extant literature, we contribute to the understanding of the complexity of patient hope in biomedical technologies by examining a case that highlights interdependencies between the biomedical and individual narratives: hope in stem cell technologies (SCTs). We draw upon interviews with patients with Parkinson’s Disease, and find two narratives of hope: a biomedical narrative, as captured above, and an additional hybrid narrative, which we call a nature narrative. The nature narrative reflects patients’ beliefs that scientists will eventually create SCTs that will allow their individual body to naturally heal itself, which combines a biomedical and an individual narrative.
The Optimum Level of Income Inequality in South Asia: An Econometric Analysis
Authors: Khatun Fahmida , Saadat Syed Yusuf
Published: September 2021

Inequality in the distribution of income can be beneficial or detrimental for economic growth depending on the level of inequality. This study advocates that when income inequality is low, increase in income inequality increases economic growth, whereas when income inequality is high, increase in income inequality decreases economic growth. The level of inequality that maximizes economic growth is defined as the optimum level of income inequality. This article attempts to determine the optimum level of income inequality for South Asia through an econometric analysis. It uses panel data from Bangladesh, India, Nepal, Pakistan and Sri Lanka, over a 34-year period to undertake a systematic investigation using panel instrumental variables techniques. The results of this study confirm that an optimum level of income inequality does exist, and occurs at a Gini coefficient value of 0.4492. Thus, this research empirically confirms that the relationship between income inequality and economic growth is non-linear. Further calculations show that for an economy that is at the optimum level of income inequality, the per capita gross domestic product can be expected to double within approximately 13 years, provided all other factors are held constant. However, a change in the Gini coefficient by 0.10 units in either direction—higher or lower—away from the optimum level, can increase the number of years for the per capita gross domestic product to double by 55 to 57 years, depending on the method of approximation.

JEL: D31, D63, O15, O40
An HL7 FHIR and GraphQL approach for interoperability between heterogeneous Electronic Health Record systems
Authors: Mukhiya Suresh Kumar , Lamo Yngve
Published: September 2021

Heterogeneities in data representation and care processes create interoperability complexity among Electronic Health Record systems (EHRs). We can resolve such data and process level heterogeneities by following consistent healthcare standards like Clinical Document Architecture (CDA), OpenEHR, and HL7 FHIR. However, these standards also differ at the structural and implementation level, making interoperability more complex. Hence, there is a need to investigate mechanisms that can resolve data level heterogeneity to achieve semantic data interoperability between heterogeneous systems. As a solution to this, we offer an architecture that utilizes a resource server based on GraphQL and HL7 FHIR that establishes communication between two heterogeneous EHRs. This paper describes how the proposed architecture is implemented to achieve interoperability between two heterogeneous EHRs, HL7 FHIR and OpenMRS. The presented approach establishes secure communication between the EHRs and provides accurate mappings that enable timely health information exchange between EHRs.
The epistemological commitments of modes: opportunities and challenges for science learning
Authors: Fredlund Tobias , Beate Remmen Kari , Knain Erik
Published: September 2021

Meaning making in science is supported by different modes, such as spoken and written language, images and gestures, all of which have different affordances. The epistemological commitments of modes are affordances that cannot be avoided. This article investigates how the epistemological commitments of modes affect possibilities for learning. Video data was collected from a learning activity where upper secondary students drew and explained an experiment representing the greenhouse effect. The analysis uses the variation theory of learning, which assumes that students learn when they notice new aspects of objects of learning by experiencing variation against an invariant background. Such variation can be created through the representations used. Findings show that, in the learning activity, variation was created in a range of modes. Some of the variation, particularly with regards to radiation, was due to the epistemological commitments of drawing. However, these aspects of radiation went unnoticed by the students, possibly because several aspects varied simultaneously. The teacher then helped the students to become aware of certain variation. Implications for the teaching and learning of science when taking the epistemological commitment of different modes into consideration include both challenges, such as when unintended variation is created, and opportunities, such as when spontaneously occurring variation can be taken up for discussion.
Does Nubility Indicate More Than High Reproductive Value? Nubile Primiparas’ Pregnancy Outcomes in Evolutionary Perspective
Authors: Lassek William D. , Gaulin Steven J. C.
Published: September 2021

The idea that human males are most strongly attracted to traits that peak in women in the nubile age group raises the question of how well women in that age group contend with the potential hazards of a first pregnancy. Using data for 1.7 million first births from 1990 U.S. natality and mortality records, we compared outcomes for women with first births (primiparas) aged 16–20 years (when first births typically occur in forager and subsistence groups) with those aged 21–25 years. The younger primiparas had a much lower risk of potentially life-threatening complications of labor and delivery and, when evolutionarily novel risk factors were controlled, fetuses which were significantly more likely to survive despite lower birth weights. Thus, nubile primiparas were more likely to have a successful reproductive outcome defined in an evolutionarily relevant way (an infant of normal birth weight and gestation, surviving to one year, and delivered without a medically necessary cesarean delivery). This suggests that prior to the widespread availability of surgical deliveries, men who mated with women in the nubile age group would have reaped the benefit of having a reproductive partner more likely to have a successful first pregnancy.
Effects of Acupuncture and Moxibustion on Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Gao Yu , Ma Tingting , Han Mei , Yu Mingwei , Wang Xiuhui , Lv Yiren , Wang Xiaomin
Published: September 2021

Objective:

The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the effects of acupuncture and moxibustion (AM) in women with breast cancer-related lymphedema (BCRL).

Methods:

We retrieved RCTs published before January 24, 2021, from the MEDLINE, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP (VIP), and Wanfang databases. RCTs that compared acupuncture and/or moxibustion intervention with other treatments were included. A random effects or fixed effects model was used based on the heterogeneity findings. Study quality was evaluated using the Cochrane risk of bias tool.

Results:

We included 14 RCTs in the analyses, of which 4 RCTs adopted acupuncture, 4 RCTs used moxibustion, and the rest used both. AM significantly reduced arm circumference at the elbow crease compared to routine care (Mean deviation (MD) = −7.26, 95% confidence interval (CI) = −8.30 to −6.21, P < .00001). There was a significant difference between AM and diosmin tablets in the effective index for upper limb lymphedema (MD = 24.68, 95% CI = 24.82-30.53, P < .00001), the range of motion of the shoulder during protraction (MD = 6.77, 95% CI = 2.81-10.73, P = .0008), and adduction (MD = 4.17, 95% CI = 1.02-7.32, P = .01). There was a significant difference between moxibustion and pneumatic circulation (MD = −0.51, 95% CI = −0.85 to −0.17, P = .003) in the visual analog score (VAS) for swelling. Finally, compared to the blank control, acupuncture reduced the VAS for pain (MD = −1.33, 95% CI = −1.52 to −1.15, P < .00001; heterogeneity ( I2) = 0%, P = .57).

Conclusion:

Our results suggest that AM is effective in the treatment of BCRL. AM may reduce arm circumference at the elbow crease (compared to routine care), increase effective index for upper limb lymphedema (compared to oral diosmin tablets), improve the range of motion of the shoulder during protraction and adduction (compared to oral diosmin tablets), and decrease the VAS for both swelling (compared to pneumatic circulation) and pain (compared to blank control).