bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint analysis of informatively interval-censored failure time and panel count data
Authors: Wang Shuying , Wang Chunjie , Song Xinyuan , Xu Da
Published: July 2022

Interval-censored failure time and panel count data, which frequently arise in medical studies and social sciences, are two types of important incomplete data. Although methods for their joint analysis have been available in the literature, they did not consider the observation process, which may depend on the failure time and/or panel count of interest. This study considers a three-component joint model to analyze interval-censored failure time, panel counts, and the observation process within a unique framework. Gamma and distribution-free frailties are introduced to jointly model the interdependency among the interval-censored data, panel count data, and the observation process. We propose a sieve maximum likelihood approach coupled with Bernstein polynomial approximation to estimate the unknown parameters and baseline hazard function. The asymptotic properties of the resulting estimators are established. An extensive simulation study suggests that the proposed procedure works well for practical situations. An application of the method to a real-life dataset collected from a cardiac allograft vasculopathy study is presented.
A Scripted Sexuality: Media, Gendered Sexual Scripts, and Their Impact on Our Lives
Authors: Ward L. Monique , Rosenscruggs Danielle , Aguinaldo Erick R.
Published: July 2022

Gendered sexual scripts reflect the culture’s expectations for how women and men interact in courtship and romantic relationships. These expectations prioritize passivity and appearance for young women and assertiveness and emotional detachment for young men. Mainstream media are prominent forces contributing to these scripts, and significant evidence indicates that heavier media exposure is associated with greater acceptance of these expectations among U.S. youths. However, endorsing these scripts has significant implications for young people’s well-being, both as individuals and in their relationships. Stronger endorsement is linked to greater psychological distress, diminished sexual agency, and more dysfunctional beliefs about relationships. Additional concerns have emerged for African American youths, who must also negotiate culturally specific racialized gender stereotypes. Future research should expand to include new media platforms, more diverse populations, and potential positive scripts.
‘We now have Catholics and Blacks’: Whiteness in a Northern Irish rugby club
Authors: Kavanagh Thomas
Published: July 2022

Northern Ireland is often considered in terms of the two majority communities, Catholics and Protestants, and the inter-communal conflict which structured, and continues to structure, much of Northern Irish society. However, situated within often volatile situations, the small ethnic minority communities of Northern Ireland have often been overlooked. This article investigates a Northern Irish rugby club, and examines the way in which whiteness is normalised, racist discourses are dismissed, and the sectarian boundaries, which are normally so strongly maintained, are overlooked in the presence of ‘others.’ As such, this research offers a contemporary perspective of the way whiteness, racism and sectarianism intersect in Northern Irish society, and starts a conversation about the provision of sport for ethnic minority communities in Northern Ireland.
Comment: Balanced Salt Solutions for Critically Ill Patients: Nonplused and Back to Basics
Authors: Kasatkin Anton , Urakov Aleksandr
Published: July 2022

The analysis of trial results of the intravenous fluids pharmacodynamics revealed problems common to all studies, such as varying study designs, clinical discretion for treatments, and heterogeneous patients. We believe that in the methodology of future research it is also necessary to pay due attention to the actual rather than theoretical physicochemical parameters of the solutions used, such as osmolality, pH, and potential excess of bases. Paying attention to these parameters of intravenous fluids will be useful for assessing their role in producing pharmacodynamic effects in critically ill patients.
Differential Diagnosis of Cystic Lesions of the Spleen: A Review of Clinical, Imaging and Pathological Findings
Authors: Yocum Bianca Puello , Hwang Michael , Mesa Hector , Collins Katrina
Published: July 2022

Cystic lesions of the spleen are being noticed with increased frequency as “incidentalomas” during imaging work-up for unrelated causes. As a group, these lesions encompass pure cystic and mixed cystic and solid, benign and malignant processes that in general require a tissue sample for definitive diagnosis. In this review, we will describe the differential diagnosis of cystic lesions of the spleen, highlighting key imaging, clinical and pathologic findings.
Testing the Nonlinearity Assumption Underlying the Use of Reverse-Keyed Items: A Logical Response Perspective
Authors: Kam Chester Chun Seng , Meyer John P.
Published: July 2022

Researchers often assume a strong, linear relationship between regular- and reverse-keyed items, with responses on regular-keyed items (e.g., agree) perfectly mirroring those on reverse-keyed items (e.g., disagree). The current research challenges this received view and propounds a possible nonlinear relationship, partly due to the logical tendency of midlevel respondents to disagree with both types of items. In four examples (reported human height, job satisfaction, positive-negative affect, and self-esteem; total N = 50,544), a nonlinear model consistently explained additional item variance beyond a linear model. We further demonstrate that this relationship is moderated by item characteristics such as item extremity (job satisfaction) and item softening (self-esteem). Suboptimal modeling of the relationship may result in the apparent bidmensionality of a construct that characterizes regular- and reverse-keyed items as separate factors. User-friendly syntax for the examination of nonlinearity is provided to enhance the accessibility of the procedure.
Sparsity assisted intelligent recognition method for vibration-based machinery health diagnostics
Authors: Kong Yun , Han Qinkai , Chu Fulei
Published: July 2022

Vibration-based health diagnostics technique has shown great potentials to enhance the safety and reliability for many industrial rotary machinery. The emerging sparse representation classification (SRC) paradigm provides a promising tool for intelligent machinery health diagnostics. However, traditional SRC approaches neglect the useful priori information in rotary machinery vibration data, limiting the reconstruction ability and thus restricting their diagnostic accuracy. To address this issue, we present a novel sparsity assisted intelligent recognition (SAIR) methodology for vibration-based machinery health diagnostics. SAIR is constituted by two stages for dictionary design and intelligent recognition. In the dictionary design stage, SAIR exploits the useful priori information of the prediction shift-invariance property, to design class-specific dictionaries via an overlapping segmentation strategy. Additionally, this dictionary design strategy can leverage those local and nonlocal features within data segments. In the intelligent recognition stage, SAIR implements health state recognition by means of the sparsity-based health diagnostic strategy according to minimal sparse approximation errors. Finally, the feasibility and advantage of SAIR have been comprehensively evaluated for planetary gearbox health diagnostics, indicating that SAIR yields an overall diagnostic accuracy of 99.72%. Besides, comparative studies demonstrate that SAIR outperforms the advanced mainstream methods with better diagnostic accuracy and lower computation costs for vibration-based machinery health diagnostics.
“Zero Emission, Zero Compromises”: An Intersectional, Qualitative Exploration of Masculinities in Tesla’s Consumer Stories
Authors: Vivi Matteo , Hermans Anne-Mette
Published: July 2022

In light of gendered dynamics complicating masculine adoption of self-driving and electric vehicles (EV), we examine how Tesla’s video consumer stories envision masculinities within sociotechnical systems of automobility, exploring how corporate representations co-construct drivers and vehicles in gendered ways. Using multimodal critical discourse analysis, we show how the driver-car appropriates movement as a work of raced, gendered, age-dependent, and classed culture: EVs validate energy-soaked lifestyles in an age of climate change, enabling “green” enactments of fast, aggressive, and reckless styles of hegemonic driving performed by ecomodern masculinities; over-masculinized dynamics of techno-eroticism forge automated vehicles (AV) as technologically-advanced devices, crystallizing fantasies of men’s hegemonic love for technology within drivers’ mobility patterns. Tesla’s narratives sketch a future of mobility dominated by gendered sociotechnical adjustments, where neither energy-based nor technology-based reconfigurations of automobility spark critical conversations around reconfigurations of “behind-the-wheel” masculinities, leaving unquestioned what it means for them to demand space, speed, and comfort.
Failure initiation and progression of sandwich beams under cyclic bending tests
Authors: Ouled Ahmed Ben Ali Raja , Ben Abdeljelil Dorra , Chatti Sami
Published: July 2022

This study presents experimental results and analysis of failure of sandwich beams with steel face sheets and polyurethane core tested in three-point bending. Firstly, a series of experiences are conducted in order to obtain the mechanical properties of the metallic face sheets and the foam core. To model the foam behavior, quasi-cyclic tests were performed by increasing the punch stroke. An exponential model is proposed describing the variation of the elastic modulus as a function of the strain. Secondly, the quasi-static and quasi-cyclic bending tests are carried out leading to failure of the sandwich beam. The results of the quasi-cyclic bending show that the behavior of the sandwich beam is similar to the foam behavior in quasi-cyclic compression. Thirdly, a Finite Element Analysis (FEA) is performed in order to predict the observed foam fracture in bending test using a shear damage criterion for the foam core. The comparisons show a satisfactory agreement between the experimental results and the FEA predictions.
Barriers to Implementing a Cannabis Focused SBIRT in Adolescent Primary Care
Authors: Kristman-Valente Allison N , McCarty Carolyn A , Walker Denise D , Walker-Harding Leslie
Published: July 2022

Introduction:

The current study investigated providers’ perceived barriers, supports, and need for adopting a screening, brief intervention, and referral to treatment model (SBIRT) intervention related to cannabis reduction into their community based primary care clinics.

Methods:

Eleven pediatric primary care providers from regional community-based clinics participated in focus groups discussing a proposed adolescent cannabis use SBIRT reduction intervention, perceived need, and potential barriers to implementation within their clinic.

Results:

Seven primary themes emerged regarding barriers to implementing a cannabis reduction SBIRT in primary care including provider ambivalence to adolescent cannabis use.

Conclusion:

Further research is needed to understand evolving provider perceptions of adolescent cannabis use and how these views impact the adoption of SBIRT for the reduction of cannabis use among their adolescent patients.
The externalization of border control in the global South: The cases of Malaysia and Indonesia
Authors: Lee Maggy
Published: July 2022

Existing scholarship highlights the novel approaches and the capacity of northern states to control mass mobility by externalizing the border; outsource their control apparatus to migrant sending and transit countries; process and detain irregular arrivals in offshore locations; and expand the reach of sovereign powers extraterritorially. Significantly, the processes and outcomes of externalization are neither homogeneous nor uncontested. This article seeks to provide critical insights into the divergent nature of border externalization and contributes to a de-centring of northern-centric notions of the state’s role in border control by comparing how border control plays out in Malaysia and Indonesia under Australia’s externalization policy agenda. Their different border control outcomes reflect important intervening factors in the two countries’ internal (domestic political and economic realities; attitudes towards migrants and their control) and external (interstate geo-political relations) environment in shaping the situated meanings and the realities of border security building.
Modalities of the psychedelic experience: Microclimates of set and setting in hallucinogen research and culture
Authors: Hartogsohn Ido
Published: July 2022

Mid-20th-century American research on psychedelics evinced a stunning diversity of interpretations of hallucinogenic effects. While some researchers viewed psychedelics as invaluable tools for psychotherapy, others persisted in treating them as psychosis-inducing agents. As some groups considered psychedelics as catalysts for artistic creativity, others investigated their potential use as psychochemical weapons in the battlefield, or conversely as tools for spiritual ecstasy and revelation. This bewildering array of perceptions regarding the nature of hallucinogenic effects led to stark contrasts in the contexts (set and setting) of psychedelic research and experimentation, leading to wildly divergent outcomes and reports on the effects of the drugs, and strident disagreements between the actors in the field. Examining this remarkable historical moment of epistemological unclarity regarding psychedelics and their effects, this article describes how distinct scientific and cultural trends and moments of mid-20th-century America contributed to the creation of diverse microclimates of set and setting that reproduced investigator beliefs and attitudes and brought about a beguiling Pygmalion effect that left researchers befuddled and perplexed. I propose the concept of psychedelic modality to describe how distinct sociocultural microclimates lead to thematic aggregates in which distinct types of expectations, intentions as well as physical, social, and cultural environments all tend to cluster, producing characteristic outcomes and results. By exploring the historical context and consequences of the emergence of seven psychedelic modalities (psychotomimetic, military, psychotherapeutic, spiritual, artistic-creative, tech-innovative, and political) in mid-20th-century America, this article outlines the varieties of psychedelic experiences in their relationship with culture at large, and subcultures in particular.
The culturally and contextually sensitive assessment of mental health using a structured diagnostic interview (MINI Kid) for Syrian refugee children and adolescents in Lebanon: Challenges and solutions
Authors: Kyrillos Vanessa , Bosqui Tania , Moghames Patricia , Chehade Nicolas , Saad Stephanie , Abdul Rahman Diana , Karam Elie , Karam Georges , Saab Dahlia , Pluess Michael , McEwen Fiona S.
Published: July 2022

Elevated rates of mental health difficulties are frequently reported in conflict-affected and displaced populations. Even with advances in improving the validity and reliability of measures, our knowledge of the performance of assessment tools is often limited by a lack of contextualization to specific populations and socio-political settings. This reflective article aimed to review challenges and share lessons learned from the process of administering and supervising a structured clinical interview. We administered the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) and used the Clinical Global Impression (CGI) severity scale with N = 119 Syrian refugee children (aged 8–17) resident in ITSs in Lebanon. Qualitative data were derived from supervision process notes on challenges that arose during assessments, analyzed for thematic content. Five themes were identified: (1) practical and logistical challenges (changeable nature of daily life, competing demands, access to phones, temporary locations, limited referral options); (2) validity (lack of privacy, trust, perceptions of mental health, stigma, false positive answers); (3) cultural norms and meaning (impact of different meanings on answers); (4) contextual norms (reactive and adaptive emotional and behavioral responses to contextual stress); and (5) co-morbidity and formulation (interconnected and complex presentations). The findings suggest that while structured assessments have major advantages, cultural and contextual sensitivity during assessments, addressing practical barriers to improving accessibility, and consideration for inter-connected formulations are essential to help inform prevalence rates, treatment plans, and public health strategies.
Open Door Events: Positioning schools in urban post-compulsory education markets
Authors: Curran Marta , Castejón Alba , Manzano Martí
Published: July 2022

The aim of this paper is to explore the role of open-door events as key institutional devices to position schools in local education markets. The paper draws on data from a qualitative study based on observations in 25 open-door events in secondary schools in the city of Barcelona. The findings show, on the one hand, how promotional actions are mediated by a school’s position in the local hierarchy and by objectively unequal features in terms of the type of ownership, social composition and programs offered. On the other hand, the findings reveal how, from these unequal positions, schools display different logics of action aimed at providing information about their status among families and students from different social backgrounds. Overall, the paper presents a typology of schools that contributes to a better understanding of the hierarchy of the local education markets in the transition to upper secondary education.
Various Types of Negative Life Events Among Youth Predict Suicidal Ideation: A Cross-Sectional Study Based on Gender Perspective
Authors: Xin Moye , Petrovic Julia , Zhang Lijin , Böke Bilun Naz , Yang Xueyan , Xue Yuhang
Published: July 2022

We sought to investigate potential gender differences in various types of negative life events and suicidal ideation among Chinese high school and university students, as well as to analyze the interrelations between different types of negative life events and suicidal ideation among these young students. Participants were 2,018 high school and university students from northwestern China, who completed a demographics questionnaire and self-report measures of negative life events and suicidal ideation. Significant gender differences emerged in the types of negative life events reported and in students’ degree of suicidal ideation. Within each gender group, different types of negative life events were predictive of the intensity of suicidal ideation. The present study provides evidence of the role of negative life events in predicting adolescents’ and young adults’ suicidal ideation regardless of their gender. However, gender differences did emerge in the specific type of negative life events that were predictive of suicidal ideation. For males, greater reports of punishment and adaptation had a significant positive impact on the intensity of their suicidal ideation. For females, greater reports of academic stress, personal loss, interpersonal relationships, and adaptation were all significantly and positively predictive of their suicidal ideation. Parents’ marital status emerged as a significant indicator of suicidal ideation across genders, while age was significant negative predictor of suicidal ideation among females only.
Classifying colour differences in dyed fabrics using an improved hunger games search optimised random vector functional link
Authors: Zhang Xiaochun , Zhou Zhiyu
Published: July 2022

This study proposes an algorithm for classifying colour differences in dyed fabrics using random vector functional link (RVFL) optimised using an improved hunger games search (HGS) algorithm to replace the inefficient traditional classification methods. First, to prevent the HGS algorithm from easily arriving at the local optimal solution, we used the grey wolf optimiser (GWO) to generate the solution set of the HGS algorithm. Subsequently, to reduce the impact of the randomness of the input weight and hidden layer offset on the classification accuracy of RVFL, we used the improved HGS to optimise these two parameters of RVFL. Finally, the RVFL optimised using the improved HGS algorithm is used for classifying the colour differences of dyed fabrics. The performance of the proposed classification algorithm is compared with HGS algorithms improved using the whale optimiser, sine cosine algorithm, and Harris hawks optimiser. The results revealed that the proposed algorithm possesses several advantages, including the maximum, minimum, and average classification errors; good stability; and fast convergence.
Feedback linearization-based tracking control of a tilt-rotor with cat-trot gait plan
Authors: Shen Zhe , Ma Yudong , Tsuchiya Takeshi
Published: July 2022

With the introduction of the laterally bounded forces, the tilt-rotor gains more flexibility in the controller design. Typical feedback linearization methods utilize all the inputs in controlling this vehicle; the magnitudes as well as the directions of the thrusts are maneuvered simultaneously based on a unified control rule. Although several promising results indicate that these controllers may track the desired complicated trajectories, the tilting angles are required to change relatively fast or in large scale during the flight, which turns to be a challenge in application. The recent gait plan for a tilt-rotor may solve this problem; the tilting angles are fixed or vary in a predetermined pattern without being maneuvered by the control algorithm. Carefully avoiding the singular decoupling matrix, several attitudes can be tracked without changing the tilting angles frequently. While the position was not directly regulated in that research, which left the position-tracking still an open question. In this research, we elucidate the coupling relationship between the position and the attitude. Based on this, we design the position-tracking controller, adopting feedback linearization. A cat-trot gait is further designed for a tilt-rotor to track the reference; three types of references are designed for our tracking experiments: set point, uniform rectilinear motion, and uniform circular motion. The significant improvement with less steady state error is witnessed after equipping with our modified attitude–position decoupler. It is also found that the frequency of the cat-trot gait highly influenced the steady state error.
Social workers’ perceptions of assessing the parental capacity of parents with intellectual disabilities in child protection investigations
Authors: Norlin Jerry , Randell Eva
Published: July 2022

Parental capacity is one of the main aspects assessed by social workers as part of child protection investigations. The aim of this study is to explore the social workers' perceptions of assessing the parental capacity of parents with intellectual disabilities in child protection investigations. Four focus group interviews were conducted with twelve social workers in May-October 2021. Data were analysed using an inductive, conventional qualitative content analysis. One overarching theme, “Parental capacity in relation to the child's needs was assessed, not disability of parents” was created. Three main categories and ten sub-categories were identified exploring the social workers' perceptions of assessing parental capacity. The study shows that social workers perceive the assessment of parental capacity in parents with intellectual disabilities as demanding and complex, in which the assessment of what is good enough is perceived as the most difficult task.
At the intersection of two countries: A comparative critical analysis of COVID-19 communication in Australia and New Zealand
Authors: Theunissen Petra , Wolf Katharina
Published: July 2022

This research provides critical, comparative insights into the public communication responses employed by Australia and New Zealand during the first twelve months following the World Health Organization declaring COVID-19 a global pandemic. The two nations share a similar socio-political and cultural context, but despite being highlighted by the international media as early success stories, their public communication responses to the pandemic showed noteworthy differences. Borrowing from cultural studies, this paper applies the circuit of culture model and offers a snapshot in time that reinforces the importance of socio-cultural awareness when communicating intricate and challenging information. It supports the idea that a range of effective solutions to complex communication challenges are possible and may result in a similar outcome, including strengthened identities and national pride during uncertain times.
Updates on enhanced recovery after surgery for radical cystectomy
Authors: Lee Grace , Patel Hiren V. , Srivastava Arnav , Ghodoussipour Saum
Published: July 2022

Enhanced Recovery after Surgery (ERAS) is a multimodal pathway that provides evidence-based guidance for improving perioperative care and outcomes in patients undergoing surgery. In 2013, the ERAS society released its original guidelines for radical cystectomy (RC) for bladder cancer (BC), adopting much of its supporting data from colorectal literature. In the last decade, growing interest in ERAS has increased RC-specific ERAS research, including prospective randomized controlled trials (RCTs). Collective data suggest ERAS contributes to improved complication rates, decreased hospital length-of-stay, and/or time to bowel recovery. Various institutions have adopted modified versions of the ERAS pathway, yet there remains a lack of consensus on the efficacy of specific ERAS items and standardization of the protocol. In this review, we summarize updated evidence and practice patterns of ERAS pathways for RC since the introduction of the original 2013 guidelines. Novel target interventions, including use of immunonutrition, prehabilitation, alvimopan, and methods of local analgesia are reviewed. Finally, we discuss barriers to implementing and future steps in advancing the ERAS movement.
Embeddedness Beyond Borders: Examining the Autonomy of Chinese NGOs in Their Global Endeavours
Authors: Wang Ying
Published: July 2022

The internationalisation of Chinese non-governmental Organisations (NGOs) is an emerging phenomenon. As new international development actors, how independent are Chinese NGOs from the Chinese state? Based on interviews with eighteen Chinese NGOs and an analysis of secondary sources, the study finds that the internationalisation of Chinese NGOs is variegated rather than solely state-led. The state is not closely involved in much of the internationalisation processes of a majority of Chinese NGOs. However, all Chinese NGOs with overseas operations avoid overstepping a political boundary that is tacitly understood by both NGOs and the state. To explain the duality of both uniformity and diversity among Chinese NGOs, this study develops an embeddedness framework that disaggregates state influences into a primary layer of systemic regulatory guidance that affects all Chinese NGOs, and a secondary layer of influence over NGOs’ operations (initiation, financing, and implementation), within which the varying levels of governmental influence upon different NGOs lie.
MMP-10 Deficiency Effects Differentiation and Death of Chondrocytes Associated with Endochondral Osteogenesis in an Endemic Osteoarthritis
Authors: Zhang Dan , Deng Xingxing , Liu Yinan , Zhang Ying , Wang Hui , Zhang Meng , Fang Qian , Yi Chengfen , Zhao Xiaoru , Ma Tianyou , Wu Cuiyan , Chen Jinghong
Published: July 2022

Objective

The objective of this study was to determine the matrix metalloproteinase-10 (MMP-10) expression pattern and to assess how it contributes to endochondral osteogenesis in Kashin-Beck disease (KBD).

Design

The cartilages of KBD patients, Sprague-Dawley rats fed with selenium (Se)-deficient diet and/or T-2 toxin, and ATDC5 cells were used in this study. ATDC5 cells were induced into hypertrophic chondrocytes using a 1% insulin-transferrin-selenium (ITS) culture medium for 21 days. The expressions of MMP-10 in the cartilages were visualized by immunohistochemistry. The messenger RNA (mRNA) and protein expression levels were determined by real-time polymerase chain reaction (RT-PCR) and Western blotting. MMP-10 short hairpin RNA (shRNA) was transfected into hypertrophic chondrocytes to knock down the gene expression of MMP-10. Meanwhile, the cell death of MMP-10-knockdown chondrocyte was detected using flow cytometry.

Results

The expression of MMP-10 was decreased in the growth plates of children with KBD. A decreased expression of MMP-10 also was observed in the growth plates of rats fed with an Se-deficient diet and/or T-2 toxin exposure. The mRNA and protein expression levels of MMP-10 increased during the chondrogenic differentiation of ATDC5 cells. MMP-10 knockdown in hypertrophic chondrocytes significantly decreased the gene and protein expression of collagen type II (Col II), Col X, Runx2, and MMP-13. Besides, the percentage of cell apoptosis was significantly increased after MMP-10 knockdown in hypertrophic chondrocytes.

Conclusion

MMP-10 deficiency disrupts chondrocyte terminal differentiation and induces the chondrocyte’s death, which impairs endochondral osteogenesis in the pathogenesis of KBD.
Characteristics of tinnitus and factors influencing its severity
Authors: Chen Shanwen , Shen Xueqin , Yuan Jinjin , Wu Yu , Li Yifan , Tong Busheng , Qiu Jianxin , Wu Feihu , Liu Yehai
Published: July 2022

Background and Objectives:

There is a wealth of information regarding the treatment methods for tinnitus; however, the treatment available is unsatisfactory because of the following reasons: first, tinnitus has various etiologies and second, it has distinct heterogeneity among different individuals. Numerous studies have focused on understanding the causes of tinnitus severity, but the conclusions have been inconsistent. The purpose of the present study was to define factors that differentially influence subjectively perceived tinnitus severity.

Methods:

Clinical data of patients with chronic tinnitus who visited our outpatient clinic from April 2020 to April 2021 were collected. Tinnitus Handicap Inventory (THI) and Tinnitus Evaluation Questionnaire (TEQ) were used to evaluate tinnitus severity among patients, and the independent factors influencing the severity of tinnitus were investigated by performing univariate and multivariate stepwise regression analyses.

Results:

Eleven variables were associated with THI and TEQ scores, of which nine were identical. Multiple regression analyses results revealed that five variables had a significantly unique predictive effect on tinnitus severity based on THI and the TEQ scores. Three factors including Self-Rating Scale of Sleep (SRSS), change in loudness, and Self-Rating Anxiety Scale (SAS) were identical.

Conclusion:

Sleep status, anxiety level, and change in loudness in patients with chronic tinnitus were significantly correlated with severity of tinnitus. Follow-up studies should investigate the causal relationship between these factors and tinnitus severity.
Radiographic changes in ribs following clipping of patent ductus arteriosus in preterm infants
Authors: Hasan Rashed A , Kalaba Frank , Hesen Jacob Z , Hamid Kewan
Published: July 2022

Objectives:

There are no published reports on the rib abnormalities on the plain chest radiograph in preterm infants following surgical clipping of isolated patent ductus arteriosus. The purpose of this study was to describe changes in the ribs on the plain chest radiograph following surgical clipping of patent ductus arteriosus (surgery groups) in preterm infants compared to non-surgical closure of patent ductus arteriosus (control group).

Methods:

Data from preterm infants with patent ductus arteriosus clipping (surgery) via a left postero-lateral thoracotomy were compared with infants in whom the patent ductus arteriosus closed: spontaneously, with medications or use of an occlusive device (controls). Serial pre- and post-closure plain chest radiographs were randomly reviewed by a reader blinded to the route of closure and up to 1 year following the patent ductus arteriosus closure.

Results:

Of the total of 196 cases included in the study: 45 of the patent ductus arteriosus closed following treatment with medications, 8 cases closed with an occlusion device, 38 were closed surgically, and in 105 cases, the patent ductus arteriosus closed spontaneously. Compared to the pre-operative period, 36/38 (95%) infants in the surgery group had one or more of the following rib abnormalities: ipsilateral fourth and fifth rib fusion, narrowing of the ipsilateral fifth intercostal space, thinning of the ipsilateral fourth or fifth rib, or a combination of the above on the chest radiograph compared to 0% in the control group (p < 0.001).

Conclusion:

Radiographic rib abnormalities are common and appear in infancy following surgical clipping of patent ductus arteriosus in preterm infants. Further studies are needed to clarify the natural history of these abnormalities on thoracic cage and cardiopulmonary functions.
Undernutrition and associated factors among elderly people served in Public Servants Social Security Agency in Harar, Eastern Ethiopia
Authors: Mulugeta Gizeshwork , Dingeta Tariku , Mitiku Habtamu , Weldegebreal Fitsum
Published: July 2022

Objective:

Undernutrition in the elderly has adverse effects on physiological functions and various clinical outcomes. In Ethiopia, similar to many developing countries, there is a dearth of epidemiological data on the nutritional status of the elderly. This study aimed to assess the magnitude of undernutrition and associated factors among the elderly population enrolled in the Public Servants Social Security Agency in Harar, eastern Ethiopia.

Method:

A cross-sectional study was carried out among 337 elderly adults from June to August 2020. The Mini Nutritional Assessment Tool Short Form assessed the nutritional status of the elderly. Data were entered in Epi Data software version 3.1 and transferred to SPSS version 20 for analysis. Ordinal logistic regression assessed factors associated with undernutrition, using variables with a p value less than 0.05 as statistically significant.

Result:

The magnitude of undernutrition was 16.6% and 45.1% were at risk of undernutrition. Being unable to read and write (odds ratio (OR) = 3.64; 95% confidence interval (CI), 1.98–6.72), elderly with morbidities (OR = 2.05; 95% CI, 1.15–3.64), low dietary diversity score (OR = 3.52; 95% CI, 1.63–7.60), and elderly who were food insecure (OR = 0.59; 95% CI, 0.37–0.95) were significantly associated with undernutrition.

Conclusion:

The magnitude of undernutrition among the elderly is a public health issue. Independent predictors include educational status, morbidity, dietary diversity, and food insecurity. Intervention programs need to focus on the elderly’s nutrition, access to healthy foods, and other health issues.
A case of Kleine-Levin syndrome successfully treated with Escitalopram
Authors: Reddy Balaswamy , Prasad Sakshi , Das Soumitra
Published: July 2022

Kleine-Levin syndrome (KLS) is an extremely rare relapsing-remitting neuropsychiatric condition characterized by recurrent incidents of major hypersomnolence along with hyperphagia, hypersexual behavior, and mood or cognitive disturbances alternating with asymptomatic periods. Here, we present a case of a young male chiefly presenting with recurring episodes of acute onset behavioral changes. The patient’s episodes were characterized by repetitive incidents of prolonged sleep for more than 20 h, followed by social withdrawal and apathy. He was diagnosed with KLS because of the periodic patterns of hypersomnolence accompanied by other cognitive and mood disturbances and lacked characteristics of central hypersomnolence disorders or atypical depression. There are varying success rates among medications such as lithium, stimulants such as modafinil, antiepileptics such as carbamazepine and valproate. Similarly, the use of antidepressants such as tricyclic agents and selective serotonin reuptake inhibitors has largely been negative. Our case report addresses a patient with KLS who was successfully treated with 20 mg of Escitalopram.
A case of severe acidosis in a 12-month-old: Succinyl-CoA:3-ketoacid-CoA transferase deficiency with OXCT1 gene mutations
Authors: Dhammi Navjot , Essakow Jenna , Gallagher Renata , Gaw Cynthia
Published: July 2022

Succinyl-CoA:3-ketoacid CoA transferase (SCOT) deficiency is a rare autosomal recessive disorder that results in severe ketoacidosis due to a defect in ketone utilization. We describe a case of a 12-month-old infant presenting with severe metabolic acidosis, ketosis, and hyperammonemia, a combination of symptoms suggestive of an inborn error of metabolism. Genetic testing found our patient had a homozygous variant in the OXCT1 gene, c.1543A>G (p.Met515Val). This was the first identified case of SCOT deficiency at our institution. We share our acute management strategies for initial stabilization in the intensive care unit, as well as our approach to preventing morning ketosis after discharge using uncooked cornstarch.
Catheter-directed embolectomy for massive pulmonary embolism in a pediatric patient
Authors: Chan Shin Mei , Laage Gaupp Fabian M , Lee Jessica M , Pollak Jeffrey S , Khosla Akhil
Published: July 2022

Pulmonary embolisms can affect 0.9 in 100,000 children and carry high risk for mortality. However, management of pediatric pulmonary embolism is largely derived from adult studies and treatment often includes local or systemic thrombolytics or anticoagulation, which may pose unique bleeding risks in children and adolescents compared with adults. This report describes a case in which catheter-directed embolectomy was used to successfully manage a pediatric patient with high-risk/massive pulmonary embolism. This case suggests that catheter-directed embolectomy is an effective therapy in patients outside the adult population and more research is required to expand inclusion criteria for current catheter-directed embolectomy treatment paradigms. Moreover, this case emphasizes the need for dedicated pediatric pulmonary embolism response teams to best serve the pediatric population.
Conflicts, strategic divergences and the survival of economic groupings: Will China–India rivalry make BRICS obsolete?
Authors: Nuruzzaman Mohammed
Published: July 2022

This article probes the viability and survival of BRICS in the context of intensified China–India conflicts and strategic divergences. It argues that occasional eruptions of serious tensions in China–India relations, underpinned by their 1962 border war, threaten to make BRICS an ineffective or weak organization. The article shows that the threats to BRICS’s effectiveness as a new economic grouping originate from both countries’ strategies and counter-strategies to outperform and outbid each other in a number of critical geopolitical areas, most importantly South Asia, and the Indian Ocean Region. The absence of liberal institutional geoeconomic strategies in their bilateral relations to generate meaningful cooperation for mutual gains further exacerbates their conflicts, with clear implications for BRICS. The article discusses three policy implications for BRICS to function as an effective new economic grouping of the Global South—institutional reforms, a shift from geopolitical to liberal institutional geoeconomic strategy of cooperation, and a coordinated policy approach to global political and economic issues.
Paternal Postnatal Depression During COVID-19 Pandemic: The Role of Health Care Providers
Authors: Yazdanpanahi Zahra , Vizheh Maryam , Azizi Marzieh , Hajifoghaha Mahboubeh
Published: July 2022

Background:

The fast spread of COVID-19 can cause some psychological disorders for men. One of the psychological disorders is paternal postpartum depression (PPD). The aim of the present research was to review studies that have investigated paternal postpartum depression during the COVID-19 pandemic.

Materials and Methods:

For this narrative review, databases such as Google Scholar, Scientific Information Databases (SID), Magiran, PubMed, Web of Science, and Scopus were searched for the full texts of published studies in the Persian and English languages in the period of 2019 to 2021. Finally, 3 articles were selected and reviewed in this study.

Results:

The results of this review study were classified into 3 main categories such as (1) The psychological status of men during the COVID-19 pandemic, (2) The effect of paternal PPD on children’s development and family psychological status during the COVID-19 pandemic, and (3) The role of healthcare providers in the management of paternal PPD. The findings of the studies showed that paternal PPD increases the rate of child maltreatment, maternal depression, and domestic violence. The promotion of the interpersonal skills of healthcare providers with fathers suffering from depression or psychological problems is the determinant factor of successful results.

Conclusions:

The results showed that paternal PPD has a wide range of consequences in this pandemic. Therefore, it would be recommended that healthcare staff have close contact with families and screen fathers for paternal PPD during the COVID-19 pandemic.
Barriers to Expanding the National Health Insurance Membership in Indonesia: Who Should the Target?
Authors: Laksono Agung Dwi , Nantabah Zainul Khaqiqi , Wulandari Ratna Dwi , Khoiri Abu , Tahangnacca Minsarnawati
Published: July 2022

Background:

The Indonesian government initiated National Health Insurance (NHI) to reduce health service barriers. The study aimed to analyze specific targets for expanding the NHI’s membership in Indonesia.

Methods:

The study population was all populations in Indonesia. Meanwhile, the study involved a 47 644 weighted sample. The analyzed variables included NHI’s membership, residence, age, gender, education, employment, marital status, and wealth. The study employed binary logistic regression in the final step.

Results:

The urban population was 0.608 times less likely than the rural population to become a non-member of NHI. Aging younger was one of the barriers to becoming an NHI member, and the male gender is one of the barriers to becoming an NHI member. Meanwhile, the lower the education level, the greater the obstacles to becoming an NHI member in Indonesia. Besides, the unemployed population was 1.002 more likely than the employed population to become a non-member of NHI. The result shows that never married or married have a higher chance of becoming a non-member of NHI. Finally, all wealth status categories are more likely to become barriers to the most prosperous population becoming an NHI member.

Conclusions:

The study concluded that 7 population characteristics become specific targets for expanding NHI membership in Indonesia. The 7 characteristics are the population who live in rural areas, are young, male, poor education, unemployed, never married or married, and poor.
Promoting healthy lifestyle habits among participants in cancer screening programs: Results of the randomized controlled Sti.Vi study
Authors: Riggi Emilia , Baccini Michela , Camussi Elisa , Gallo Federica , Anatrone Caterina , Pezzana Andrea , Senore Carlo , Giordano Livia , Segnan Nereo
Published: July 2022

Background:

Unhealthy diets, physical inactivity, alcohol and tobacco consumption are among the leading risk factors for non-communicable diseases. It is estimated that around 40% of cancers could be prevented by adopting healthy lifestyles.

Design and methods:

The Stili di Vita (Sti.Vi) study was a randomized study for assessing the impact of healthy lifestyle interventions on anthropometric measures, metabolic parameters, and health outcomes among participants of cancer screening programs in Turin (Italy). Eligible women aged 50–54 years, invited to biennial mammography screening, and 58-years-old men and women, invited to a once-only sigmoidoscopy for colorectal cancer (CRC) screening were randomly allocated to Diet group (DG), Physical Activity group (PAG), Physical Activity plus Diet group (PADG), or control group (CG). Physical and eating habits, metabolic and anthropometric measurements, repeatedly collected, were the study outcomes. The active intervention, offered to participants assigned to the DG, PAG, and PADG arms, consisted of a basic module and an advanced module. The effect of the interventions was estimated through logistic regression or a difference in differences approach. A multiple imputation procedure was implemented to deal with missing values and q-values have been calculated in the presence of multiple hypothesis testing.

Results:

Out of the 8442 screened attendees, 1270 signed informed consent, while 1125 participants accomplished the baseline visit. Participants were equally distributed across the four treatments as following: 273 (24.3%) in DG, 288 (25.6%) in the PAG, 283 (25.1%) in PADG, and 281 (25%) in the CG. Participants assigned to DG or PADG increased their consumption of whole grains (OR = 1.77, 95% CI: 1.20–2.60 and OR = 1.55, 95% CI: 1.06–2.27, respectively) and legumes (OR = 1.77, 95% CI: 1.12–2.79 and OR = 2.24, 95% CI: 1.41–3.57, respectively), with respect to CG. The participants randomized to DG reduced processed meat and increased fruit consumption (OR = 2.57, 95% CI: 1.76–3.76 and OR = 2.38, 95% CI: 1.12–5.06, respectively). The effects were more evident in the CRC screening subgroup. No relevant difference was observed between PAG and CG. No impact was observed on physical activity habits.

Conclusions:

Our findings suggest that active interventions can increase awareness and induce diet changes. However, participation rate and compliance to the courses was quite low, innovative strategies to enhance participants’ retention are needed, with the ultimate goal of increasing awareness and inducing positive lifestyle changes.
The Forgotten and Misdiagnosed Care Transition: Live Discharge From Hospice Care
Authors: Wladkowski Stephanie P. , Wallace Cara L.
Published: July 2022

Every aspect of the United States healthcare industry presents transitions in care—hospitalizations, rehabilitation, long-term care placement—each requiring careful attention. With a goal of maintaining safety during a known point of vulnerability for patients, discharge planning is required in hospitals, skilled nursing facilities, and home health agencies under Medicare guidelines. Yet, no required discharge planning or clear guidelines are available for a discharge from hospice; it is a forgotten care transition in our healthcare system. Of the 1.6 million Medicare recipients hospices serve each year, hospices discharge 17.4% alive. Under Medicare regulations, if clinicians cannot document acceptable patient decline, then patients are decertified from hospice categorized as “no longer terminally ill”, otherwise known as a live discharge. These patients are often referred to as “not dying fast enough,” or “failure to die on time,” as ultimately, they are still dying, and they are still terminally ill, just not within the prescribed 6-month framework. This paper outlines what is known about the occurrences and experiences of live discharge from hospice care and provides suggestions for improving both practice and policy.