bluuebunny/crossref_metadata_2025 huggingface dataset:
Read it on Reddit: Homogeneity and Ideological Segregation in the Age of Social News
Authors: Duguay Philippe A.
Published: April 2021

This article empirically revisits the idea of ideological segregation and homogeneity in social networks with an exhaustive analysis of the website Reddit.com . Using a computer-assisted analysis on a corpus of multiple billion comments, it studies the relation between the tone of comments and three political topics, immigration, macroeconomics and defense. Looking at the standard deviation of the average tone of users and communities over time on these specific topics, results show an overall trend toward more ideological heterogeneity as a product of new users’ influx, while multiple communities studied and long-term users show a trend toward homogeneity. Results also show that digital heuristics, such as upvotes and downvotes, illustrate a far greater diversity of opinion than a study solely on published comments could let on.
Development of a Remote Public Health Advanced Pharmacy Practice Experience in Response to COVID-19
Authors: Kiles Tyler Marie , Hagemann Tracy , Felts Brianna , Crill Catherine
Published: April 2021

Objectives:

In order to meet the needs of the COVID-19 public health crisis and to actively engage students in patient care opportunities, the University of Tennessee Health Science Center College of Pharmacy in partnership with the Tennessee Health Department, developed a remote Public Health Advanced Pharmacy Practice Experience (APPE) Elective. The objectives of this paper are to describe the development of and students’ experiences and learning outcomes during the elective. Faculty preceptor and experiential administrator’s perspectives are also described.

Methods:

This month-long APPE was developed in mid-March and delivered in April and May of 2020. The students volunteered in-person with the State of Tennessee COVID-19 Hotline call centers and conducted topic discussions and assignments virtually with a remote preceptor.

Results:

A total of 16 students completed this rotation experience. Student ratings of the experience were positive, and their knowledge improved in all topic areas. Students collectively completed approximately 700 hours manning the COVID-19 hotline and logged over 1,000 phone calls.

Conclusions:

In a time of unprecedented disruption to experiential learning, the development of this unique public health APPE directly benefited the college, the students, and the citizens of our state. The APPE described in this paper could be replicated in additional waves of the pandemic or adapted for similar disaster response.
Tobacco Use and Secondhand Smoke Exposure Among Older Adults in India
Authors: Mbulo Lazarous , Murty Komanduri S. , Zhao Luhua , Smith Tenecia , Palipudi Krishna
Published: April 2021

Objectives: Current tobacco use (CTU) and secondhand smoke (SHS) exposure among older adults in India (≥60 years) are prevalent in India and indicate the importance of addressing associated factors. Methods: Pooled Global Adult Tobacco Survey India 2009–2010 and 2016–2017 data ( n = 17,299) for older adults examined prevalence of CTU and SHS exposure at home and/or in public places and associated socioeconomic and demographic correlates. Results: CTU among older adults in India was 44.6%, and SHS exposure at home and public places were 20.0% and 30.0%, respectively. Men, younger age-group, rural, lower education, lower wealth index, and lower knowledge were independently associated with CTU. Men, rural, lower education, lower wealth index, CTU, and lower knowledge were independently associated with SHS exposure at home. Men, younger age, and rural residence were associated with SHS exposure in public places. Conclusion: CTU and SHS exposure among older adults in India suggest targeted interventions to address associated social and demographic factors.
Capturing Subjective Age, Subjective Life Expectancy, and Their Links With Older Adults’ Health: The Dutch Longitudinal Aging Study Amsterdam
Authors: Deeg Dorly J. H. , Timmermans Erik J. , Kok Almar A. L.
Published: April 2021

Objectives: This study compares the associations of two subjective lifetime perspectives, subjective age (SA) and subjective life expectancy (SLE), with physical performance, self-rated health, and depressive symptoms. Methods: 64 91-year-old participants were selected from three waves of the Longitudinal Aging Study Amsterdam (2008/09, 2011/12, 2015/16; n = 1822 participants, n = 3500 observations) that included graphical and numerical measures of SA and SLE. We used generalized estimating equations to examine their associations with health. Results: Associations of SA/SLE with health were weaker for physical performance than for self-rated health and depressive symptoms. The associations of SA and SLE with physical performance were of similar magnitude but with self-rated health depended on the type of measure. Depressive symptoms, instead, showed a stronger association with SA than with SLE. Graphical measures showed weaker associations than numerical measures. Discussion: The way in which subjective lifetime perspectives and health are conceptualized and measured influences the strength of their associations.
Grandchild Caregiving and Cognitive Health Among Grandparents in Rural South Africa
Authors: Jennings Elyse A. , Farrell Meagan T. , Kobayashi Lindsay C.
Published: April 2021

Objectives: We investigate how caregiving for grandchildren is associated with cognitive function among rural South Africans, and whether the association differs by gender. We further investigate whether measures of physical activity or social engagement mediate this association. Methods: Data were from interviews with 3668 Black, South African grandparents in the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa” study, conducted between 2014 and 2015. Results: We find that caregiving grandparents have better cognitive function than non-caregiving grandparents, and this association does not differ by grandparent gender. Although grandchild caregiving is associated with physical activity and social engagement measures, and some of these measures are associated with cognitive function, we do not find conclusive evidence of mediation. Discussion: Providing care for grandchildren may stimulate cognitive function for both grandmothers and grandfathers. Neither physical activity nor social engagement explains the association between caregiving and cognitive function.
High-Capacity Donors’ Preferences for Charitable Giving
Authors: Alston Mackenzie , Eckel Catherine , Meer Jonathan , Zhan Wei
Published: April 2021

How can charities solicit high-capacity donors to provide the funds for matching grants and leadership gifts? In conjunction with Texas A&M University’s fundraising organizations, we conducted a field experiment to study whether high-income donors respond to nonpersonal solicitations. We also designed the experiment to test the impact of allowing for directed giving on the giving behavior of high-income donors and their willingness to direct their donations toward overhead costs. High-income donors are not responsive to letters or emails, regardless of whether they have the option to direct giving; we cannot conclude, therefore, that giving behavior is different for those who could direct giving compared with those who could not. Our results highlight the difficulties of motivating some high-income donors, especially when only impersonal communication is used.
Comparison of tool wear during friction stir welding of Al alloy and Al-SiC metal matrix composite
Authors: Bist Ashish , Saini JS , Sharma Vikas
Published: April 2021

Aluminum matrix composites have received considerable attention due to their high specific strength and specific stiffness, high hardness, and wear resistance along with being light in weight. These composites are preferably joined using friction stir welding process. The major concern in friction stir welding is the wear of the welding tool pin which is the backbone of the process. The wear is due to the prolonged contact between the tool and the harder reinforcements in the composite materials. The present work deals with the study of tool wear and its surface roughness with respect to different selected friction stir welding parameters such as rotational speed, transverse speed, length of weld, and different composition of Aluminum composite. It was found that the total amount of material removed from the tool and the surface roughness of the tool is in direct proportion to the rotational speed of the tool and the length of the weld but inversely proportional to the transverse rate. The increase in wt.% of SiC reinforcement leads to the higher tool wear but reduces the surface roughness of the tool.
Design and kinematic analysis of a novel rehabilitative robotic walking simulation device
Authors: Kose Kemal Cem , Ozgoren M Kemal , Tekce Ferzende , Doner Nimeti
Published: April 2021

This paper presents an original rehabilitative robotic walking simulation device. As a novel feature, it can duplicate the walking motion of the feet completely by including the motion of the metatarsophalangeal joints as well. It is also adjustable to different foot sizes and gait parameters such as speed, step length, and foot elevation. The presented device comprises two identical mechanisms that simulate the right and left feet. Each mechanism is designed as a planar parallel manipulator with three degrees of freedom and thus its platform (i.e. foot plate) can duplicate the sagittal-plane motion of a foot completely. A prototype of the device is already built, patented, and tested by several people, two of whom are physiotherapists. In the paper, the inverse and forward kinematic analyses of each parallel manipulator are also presented. The inverse kinematic analysis is carried out based on a typical gait cycle data of a healthy person gathered from the related literature. The results of the inverse kinematic analysis are then used as reference trajectory data in testing the device with different healthy people at different speeds.
Feelings of Culpability: Just Following Orders Versus Making the Decision Oneself
Authors: Malter Maayan S. , Kim Sonia S. , Metcalfe Janet
Published: April 2021

In five experiments ( N = 1,490), participants were asked to imagine themselves as programmers of self-driving cars who had to decide how to program the car to respond in a potential accident: spare the driver or spare pedestrians. Alternatively, participants imagined that they were a mayor grappling with difficult moral dilemmas concerning COVID-19. Either they, themselves, had to decide how to program the car or which COVID-19 policy to implement (high-agency condition) or they were told by their superior how to act (low-agency condition). After learning that a tragic outcome occurred because of their action, participants reported their felt culpability. Although we expected people to feel less culpable about the outcome if they acted in accordance with their superior’s injunction than if they made the decision themselves, participants actually felt more culpable when they followed their superior’s order. Some possible reasons for this counterintuitive finding are discussed.
The comprehensive sourcebook for modern NIR spectroscopy: A commentary on “Near-Infrared Spectroscopy Theory, Spectral Analysis, Instrumentation, and Applications”
Authors: Beć Krzysztof B , Grabska Justyna , Huck Christian W
Published: April 2021

The instrumentation, methods and applications of near-infrared spectroscopy has advanced remarkably in the last decade, in which near-infrared spectroscopy has successfully progressed at multiple directions and faced new challenges. Thus, gaps inevitably appeared in the coverage provided by renowned and handy cornerstone textbooks focused on near-infrared spectroscopy that were published in the past. A demand grew in near-infrared spectroscopy community for a new state-of-the-art textbook. With aim to satisfy such need, a go-to-book for background theory, applications and tutorial “Near-Infrared Spectroscopy Theory, Spectral Analysis, Instrumentation, and Applications” was prepared. That full-scale project, edited by Yukihiro Ozaki, Christian Huck, Satoru Tsuchikawa and Søren B. Engelsen, comprises of 23 chapters contributed by scholars and practitioners pushing the frontier of near-infrared spectroscopy. The chapters scope on newly opened pathways, major breakthroughs in basic science and applications as well as revisit several other topics. The sourcebook is intended for a wide range of readers from graduate students to scientists and engineers in both academia and industry. In this article, we sketch the main features of the newly released sourcebook with aim to help the community members in deciding whether this book should find its place in their library.
mRNA expression analysis confirms CD44 splicing impairment in systemic lupus erythematosus patients
Authors: Latini Andrea , Novelli Lucia , Ceccarelli Fulvia , Barbati Cristiana , Perricone Carlo , De Benedittis Giada , Conti Fabrizio , Novelli Giuseppe , Ciccacci Cinzia , Borgiani Paola
Published: April 2021

Background

Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease characterized by several immunological alterations. T cells have a peculiar role in SLE pathogenesis, moving from the bloodstream to the peripheral tissues, causing organ damage. This process is possible for their increased adherence and migration capacity mediated by adhesion molecules, such as CD44. Ten different variant isoforms of this molecule have been described, and two of them, CD44v3 and CD44v6 have been found to be increased on SLE T cells compared to healthy controls, being proposed as biomarkers of disease and disease activity. The process of alternative splicing of CD44 transcripts is not fully understood. We investigated the mRNA expression of CD44v3 and CD44v6 and also analyzed possible CD44 splicing regulators (ESRP1 molecule and rs9666607 CD44 polymorphism) in a cohort of SLE patients compared to healthy controls.

Methods

This study involved 18 SLE patients and 18 healthy controls. Total RNA and DNA were extracted by peripheral blood mononuclear cells. The expression study was conducted by quantitative RT-polymerase chain reaction, using SYBR Green protocol. Genotyping of rs9666607 SNP was performed by direct sequencing.

Results

CD44v6 mRNA expression was higher in SLE patients compared to healthy controls (p = 0.028). CD44v3/v6 mRNA ratio in healthy controls was strongly unbalanced towards isoform v3 compared to SLE patients (p = 0.002) and decreased progressively from healthy controls to the SLE patients in remission and those with active disease (p = 0.015). The expression levels of CD44v3 and CD44v6 mRNA correlated with the disease duration (p = 0.038, Pearson r = 0.493 and p = 0.038, Pearson r = 0.495, respectively). Splicing regulator ESRP1 expression positively correlated with CD44v6 expression in healthy controls (p = 0.02, Pearson r = 0.532) but not in SLE patients. The variant A allele of rs9666607 of CD44 was associated with higher level of global CD44 mRNA (p = 0.04) but not with the variant isoforms.

Conclusions

In SLE patients, the increase in CD44v6 protein correlates with a higher transcript level of this isoform, confirming an impairment of CD44 splicing in the disease, whose regulatory mechanisms require further investigation.
Prevalence and treatment conditions for hypertension and dyslipidaemia complicated with systemic lupus erythematosus: A multi-centre cross-sectional study
Authors: Saito Mayu , Yajima Nobuyuki , Yanai Ryo , Tsubokura Yumi , Ichinose Kunihiro , Yoshimi Ryusuke , Ohno Shigeru , Sada Ken-ei
Published: April 2021

Objective

This study aimed to assess the prevalence and actual treatment conditions for hypertension and dyslipidaemia complicated with systemic lupus erythematosus (SLE).

Methods

This was a cross-sectional study. We established the lupus registry of nationwide institutions (LUNA), a multi-centre cohort of SLE patients in Japan. From February 2016 to July 2018, 597 SLE patients were registered in the LUNA. We evaluated the incidence of hypertension and dyslipidaemia and analysed the risk factors for hypertension and dyslipidaemia by logistic regression analysis.

Results

Overall, 597 patients were enrolled in the study. The median age was 44 years, and 88.0% of the patients were female. Among all the patients, 92.9% used prednisolone. The prevalence of hypertension and dyslipidaemia was 43.9% and 54.7%, respectively. Among the patients receiving medication for hypertension, 24.7% exhibited insufficient control (systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg), and among those receiving medication for hyperlipidaemia, 48.1% showed insufficient control (low-density lipoprotein cholesterol >140 mg/dL or triglyceride >150 mg/dL). The risk factors for hypertension were age, body mass index (BMI), disease duration, past maximum dose of prednisolone, and renal involvement, whereas those for dyslipidaemia were age and BMI.

Conclusion

About half of the patients had hypertension or dyslipidaemia, and a considerable number of cases were poorly controlled despite medication. Our data suggest that physicians should treat SLE activity as well as its complications, especially the common risk factors for atherosclerosis.
A fast and low-cost approach to quality control of alcohol-based hand sanitizer using a portable near infrared spectrometer and chemometrics
Authors: Silva Adenilton C da , Ribeiro Lívia PD , Vidal Ruth MB , Matos Wladiana O , Lopes Gisele S
Published: April 2021

The use of alcohol-based hand sanitizers is recommended as one of several strategies to minimize contamination and spread of the COVID-19 disease. Current reports suggest that the virucidal potential of ethanol occurs at concentrations close to 70%. Traditional methods of verifying the ethanol concentration in such products invite potential errors due to the viscosity of chemical components or may be prohibitively expensive to undertake in large demand. Near infrared (NIR) spectroscopy and chemometrics have already been used for the determination of ethanol in other matrices and present an alternative fast and reliable approach to quality control of alcohol-based hand sanitizers. In this study, a portable NIR spectrometer combined with classification chemometric tools, i.e., partial least square discriminant analysis (PLS–DA) and linear discriminant analysis with successive algorithm projection (SPA–LDA) were used to construct models to identify conforming and non-conforming commercial and laboratory synthesized hand sanitizer samples. Principal component analysis (PCA) was applied in an exploratory data study. Three principal components accounted for 99% of data variance and demonstrate clustering of conforming and non-conforming samples. The PLS–DA and SPA–LDA classification models presented 77 and 100% of accuracy in cross/internal validation respectively and 100% of accuracy in the classification of test samples. A total of 43% commercial samples evaluated using the PLS–DA and SPA–LDA presented ethanol content non-conforming for hand sanitizer gel. These results indicate that use of NIR spectroscopy and chemometrics is a promising strategy, yielding a method that is fast, portable, and reliable for discrimination of alcohol-based hand sanitizers with respect to conforming and non-conforming ethanol concentrations.
Strategic Communication in Health and Development: Concepts, Applications and Programming
Authors: Gupta Deepak , Jai P Narain , Yadav S. J.
Published: April 2021

Significance of communication in health and development is well recognised. Strategic communication informs, educates and influences. In addressing varied health and development issues, including the challenges involving diseases control, more targeted communication strategies are designed to make optimum use of available resources to achieve the planned results in a given context. Based on research, that is, the community-based study of risk factors and the operational research, communication theories evolved and so did the strategies and practices for result-driven health and development communication. In this article, some approaches have been examined to better understand the role of strategic communication in development and health, including disease control.

Information dissemination through ‘extension approach’, first for agriculture development and later for family planning, adapted and boosted through advertising and marketing frameworks led to wide awareness about the methods and techniques of family planning but not the adoption at the same levels. Experience and research studies demonstrated that mere ‘awareness’ was not adequate for fostering adoption of ‘new’ practices; instead, it required sustained investments in communication for social and behavioural change processes. For this, bottom-up communication design, participatory communication with community involvement, evidence-based advocacy and preparedness for risk communication are required for effective communication and health and development. As HIV/AIDS posed an initial challenge for communication scholars earlier in the 1980s, so is the COVID-19 pandemic throwing a major communication challenge today. The article attempts to analyse the approaches and shed light on the role of communication in health and development, especially in the context of health crisis.
Innovation in Primary Healthcare in the Twenty-first Century
Authors: Islam Q. M.
Published: April 2021

COVID-19 once again has shown the world the importance of an urgent need for revitalising the health system based on a strong primary healthcare foundation. It is clear that without a community-based grassroots level care delivery system, Test, Trace and Isolation may not be an effective operational possibility. Politics of health with consequent austerity programme and dependence on secondary hospital care–based system has proved to be ineffective and costly in meeting the changing demands for healthcare of the population. Demographic and epidemiological transition with the increasing burden of chronic care; unfinished agenda of Millennium Development Goals (MDGs) and the new challenge of achieving Sustainable Development Gaos (SDGs), including Universal Health Care; improving quality along with access to care; and addressing the existing inequity in healthcare service, politicians and public health leaders must realise and invest in people-centred, need-based primary healthcare. Significant and sustained productivity gains can be made through various innovations that can change how quality services are delivered and reduce inequity. In order for primary healthcare to become fit for purpose, it must improve its allocative, technical and service delivery efficiencies; effectiveness and responsiveness of care; access, quality and equity of care; and have an inbuilt monitoring and accountability framework. The system must create a conducive political, social and service delivery environment for innovations. Today, developing countries, as well as developed countries, are all strengthening their primary healthcare system through various innovations to maximise the use of scarce resources to reach all people who need care and minimising cost, wastage and inefficiencies.
Managing Health at District Level: A Framework for Enhancing Programme Implementation in India
Authors: Dawa Natasha , Narayan Thelma , Narain Jai Prakash
Published: April 2021

COVID-19 pandemic has brought to the fore the need for a strong health system for the social protection of people and to improve health programme implementation in the coming years. India has made great progress in health over the past 50 years; however, despite the progress made, it is faced with several challenges. While infectious diseases remain an unfinished agenda, chronic non-communicable diseases (NCDs) are rising and are now the leading cause of mortality in the country. This is further compounded by the prevailing inequalities in access to quality health care among population groups including those living in remote rural areas. To achieve Universal Health Coverage and Sustainable Development Goals by 2030, India in 2017 revised its National Health Policy and committed itself to attain the highest possible level of good health and well-being, through preventive and promotive health interventions. While policies are enunciated and plans are formulated, the implementation at ground level is at best tardy and lack lustre As an administrative unit for programme implementation, a district has a key role to play in implementing national programmes and in delivery of basic health services to the people. They are strategically placed to plan, organise and lead efforts meant to deliver primary health care services through better management of existing resources and by fully engaging all relevant stakeholders in contributing towards achievement of national health goals and in responding to a public health emergency such as Covid-19. Planning and managing health problems need an improved and responsive health governance. Strategic planning, monitoring and evaluation require integration and coordination of various health programmes including dealing with health crises, fostering inter-sectoral involvement and engagement of the community as a key actor. Efforts are needed to ensure that services reach the most vulnerable and marginalised sections of the society. Adequate governance support at district level through a whole-of-society approach is essential to bridge the health inequities and ensure equitable access to health services.
Partnerships in Health Development
Authors: Abeykoon Palitha
Published: April 2021

The COVID-19 pandemic has thrown into bold relief the need for an all-of-society response supported by regional and global partnerships to control the epidemic. Addressing the social determinants of health, Universal Health Coverage, the non-communicable disease (NCD) burden, the other communicable diseases and the achievement of the Sustainable Development Goals (SDGs) all would require a close collaboration among different sectors and stakeholders, including the private sector.

Partnerships connote three fundamental themes—a relative equality between the partners, mutual commitment to agreed objectives and mutual benefit for the stakeholders involved. The decisions are made jointly, and roles are not only respected but are also backed by legal and moral rights. The World Health Organization (WHO) has been and continues to be the foremost promoter as well as the host for many of the global and regional partnerships in health. A typological classification would include technical assistance partnerships supporting service access and provision of services including drugs, partnerships focusing on research and development, advocacy and resource mobilisation and financing partnerships mainly to provide funds for definite disease programmes.

Partnerships in health have brought and continue to bring multiple benefits to the countries. But they also engender several challenges, including the duplication of effort and waste, high transaction costs (usually to government), issues of accountability and consequent lack of alignment with country priorities.

As partnerships become increasingly significant in the twenty-first century, better coordination, particularly in terms of donor harmonisation with national priorities, would be needed. It is not ambitious to attempt the elusive ideal where all parties will benefit from one other with a give and take between all stakeholders. Partnerships in health could well herald a new dawn for health development in the South-East Asia Region.
How do Stock Market Participants Value ESG Performance? Evidence from Middle Eastern and North African Countries
Authors: Al-Hiyari Ahmad , Kolsi Mohamed Chakib
Published: April 2021

Empirical evidence indicates that Environmental, Social, and Governance (ESG) practices are associated with firm financial performance, but little is known about stock market participants’ behaviour towards ESG practices, especially in unfavourable settings, where the level of shareholders’ protection is relatively weak. In this article, we examine whether ESG performance provides shareholders with value-relevant information to help them in their equity pricing decisions. Using a cross-country sample of non-financial firms drawn from 10 Middle East and North African (MENA) countries between the period from 2013 to 2019, we find evidence, which is based on the price specification of Ohlson (1995) valuation model, that ESG performance practices are positively priced by market participants and add incremental information content to earnings and book value of equity (BVE). However, when we split the aggregate ESG performance into its components, governance practice is found to be more value relevant than social practice, while the environmental pillar is found to be value (ir)relevant to shareholders. Results using the return valuation model complement and validate the price model specification. Our results suggest that social capital and institutional structures prevail on firm environmental impact. These results are robust to a set of additional tests. Overall, our empirical results indicate that market participants incorporate ESG performance when assessing firm value for the MENA region. Our findings could have several implications for managers, stockholders and regulatory bodies.
Siblings Dealing with Pediatric Cancer: A Family- and Context-oriented Approach
Authors: Van Schoors Marieke , Sels Laura , Goubert Liesbet , Verhofstadt Lesley L.
Published: April 2021

Background: Pediatric cancer is a severe life-threatening disease that poses significant challenges to the life of the siblings. Based on the social ecology model, the current study is aimed at exploring the association between intrafamilial (family functioning, family support) and contextual (network support) resources, and the individual adjustment of siblings facing cancer in their brother/sister. Methods: Participants were 81 siblings of children with leukemia or non-Hodgkin lymphoma. The mean siblings’ age was 10.32 years. Siblings completed the Family Environment Scale, the Social Support Questionnaire for Children, the Situation-Specific Emotional Reactions Questionnaire, and the Pediatric Quality of Life Inventory. Data were analyzed using a multi-level approach. Results: Family functioning, family support, and network support proved to be related to siblings’ cancer-related emotional reactions post-diagnosis. In addition, the present study suggests taking into account the gender of the ill child and the age of the siblings. Discussion: Our findings led to the conclusion that resources at both the intrafamilial level and the contextual level are important for explaining sibling adjustment post-diagnosis. Interventions targeting the sibling, the family, and the external network are warranted to enhance sibling adjustment.
The Experiences of Family Members of Ventilated COVID-19 Patients in the Intensive Care Unit: A Qualitative Study
Authors: Chen Chiahui , Wittenberg Elaine , Sullivan Suzanne S. , Lorenz Rebecca A. , Chang Yu-Ping
Published: April 2021

Background:

Visitor restrictions caused challenges for family members when their loved ones had coronavirus disease (COVID-19) and were ventilated. Limited studies have reported on family members’ experiences and support needs.

Aim:

To explore the experiences and support needs of family members of ventilated COVID-19 patients in the intensive care unit (ICU).

Design:

Exploratory, qualitative design, using in-depth individual telephone interviews, and analyzed using thematic analysis.

Setting/Participants:

Ten family members of adult COVID-19 patients in the ICU.

Result:

Seven key themes represented family members’ experiences: (a) reactions to the COVID-19 diagnosis, (b) COVID-19 as a destabilizing force on the family unit, (c) COVID-19’s effects on bereavement outcomes, (d) desperately seeking information, (e) family member needs, (f) conflicting feelings about video calls, and (g) appreciation of care. Family members’ feelings about the patient’s diagnosis and how the virus was contracted exacerbated their stress and anxiety. They struggled to feel informed about care that they could not witness and had difficulty understanding information. Family members reported that video calls were unhelpful. While these experiences made them question the quality of care, they expressed their appreciation of the frontline healthcare providers taking care of their loved ones.

Conclusion:

The stress and uncertainty of family members of critically ill patients with COVID-19 were influenced by their inability to feel connected to the patient and informed about care. Healthcare providers should assess each individual family’s burden and preferences, and this should include establishing structured, timely, and consistent communication regarding patient care during the pandemic including early referral to palliative care.
Does Sleep Position Influence Sleep-Disordered Breathing in Infants With Cleft Palate: A Feasibility Study?
Authors: Murray Clare S. , Walsh Tanya , Bannister Trisha , Metryka Aleksandra , Davies Karen , Lin Yin Ling , Williamson Paula , Callery Peter , O’Brien Kevin , Shaw William , Bruce Iain ,   On behalf of the SLUMBRS Study Advisory Group (SAG) and Respiratory Group
Published: April 2021

Objective:

Cleft palate (CP) can affect breathing, leading to sleep-disordered breathing (SDB). Sleep position can affect SDB, but the optimum sleep position for infants with CP is unknown. We aimed to determine the design of a pragmatic study to investigate the effect of the 2 routinely advised sleep positions in infants with CP on oxygen saturations.

Design:

A multicentered observational cohort.

Setting:

Four UK-based cleft centers, 2 advising supine- and 2 side-lying sleep positions for infants with CP.

Participants:

Infants with isolated CP born July 1, 2015, and December 31, 2016. Of 48 eligible infants, 30 consented (17 side-lying; 13 supine).

Interventions:

Oxygen saturation (SpO2) and end-tidal carbon dioxide (ETCO2) home monitoring at age 1 and 3 months. Qualitative interviews of parents.

Outcome Measures:

Willingness to participate, recruitment, retention, and acceptability/success (>90 minutes recording) of SpO2 and ETCO2 monitoring.

Results:

SpO2 recordings were obtained during 50 sleep sessions on 24 babies (13 side-lying) at 1 month (34 sessions >90 minutes) and 50 sessions on 19 babies (10 side-lying) at 3 months (27 sessions >90 minutes). The ETCO2 monitoring was only achieved in 12 sessions at 1 month and 6 at 3 months; only 1 was >90 minutes long. The ETCO2 monitoring was reported by the majority as unacceptable. Parents consistently reported the topic of sleep position in CP to be of importance.

Conclusions:

This study has demonstrated that it is feasible to perform domiciliary oxygen saturation studies in a research setting and has suggested that there may be a difference in the effects of sleep position that requires further investigation. We propose a study with randomization is indicated, comparing side-lying with supine-lying sleep position, representing an important step toward better understanding of SDB in infants with CP.
Development of a control architecture for a parallel three-axis robotic arm mechanism using CANopen communication protocol
Authors: Lee Fu-Shin , Lin Chen-I , Chen Zhi-Yu , Yang Ru-Xiao
Published: April 2021

Based upon the CANopen communication protocol and the LabVIEW graphic programing procedures, this paper develops a closed-loop control architecture for a parallel three-axis (Delta) robotic arm mechanism. The accomplishments include prototyping a parallel three-axis robotic arm mechanism, assembling servomotors with associated encoders and gearsets, coding CANopen communication scripts for servomotor controllers and a host supervision GUI, coding forward/inverse kinematics scripts to compute the required servomotor rotations and the coordinates of a movable platform or the mechanism, coding tracking error compensation scripts for effective closed-loop griper control, and coding integration scripts to command and supervise the mechanism motion on the LabVIEW-based host GUI. During the development stage, this research designed and prototyped the parallel three-axis robotic arm mechanism based upon basic Delta robot kinematics. To control the mechanism effectively and accurately, this study implemented the CANopen communication protocol, which characterizes high speed and stable transmission. The protocol applies to the CANopen communication channels among the controllers and the host supervision GUI. On the LabVIEW development platform, the coded supervision GUI performs issuing/receiving messages to the CANopen-based controllers. The controllers excite the servomotors and actuate the parallel mechanism to track prescribed trajectories in a closed-loop control fashion. Meanwhile, an electromagnet attached to the movable platform of the robotic mechanism performs satisfactory picking/placing object actions.
Human Papilloma Virus 18-Positive Submucosal Small Cell Neuroendocrine Carcinoma of the Vagina: An Immunohistochemical and Genomic Study
Authors: Kitazono Ikumi , Akahane Toshiaki , Sakihama Mika , Yanazume Shintaro , Matsushita Michiko , Tabata Kazuhiro , Kobayashi Yusuke , Kobayashi Hiroaki , Umekita Yoshihisa , Tanimoto Akihide
Published: April 2021

Primary vaginal neuroendocrine carcinoma (NEC) is extremely rare among female genital tract tumors. Here, we report 2 cases of vaginal small cell NEC (SCNEC) using immunohistochemistry and next-generation sequencing (NGS) analysis. The 2 patients were in their mid-to-late 70s, presented with abnormal vaginal bleeding and had a vaginal submucosal mass. The biopsied or resected tumors showed a typical neuroendocrine morphology consisting of solid nests of atypical tumor cells, with no specific organoid patterns, and proliferating in the vaginal submucosa. Immunohistochemical analysis showed strong and diffuse expression of chromogranin A, synaptophysin, and p16, but no thyroid transcription factor 1 expression. Additionally, both cases were positive for human papillomavirus (HPV) 18. An NGS-based cancer panel analysis revealed that the tumors carried NF1 and AR mutations, but no major driver mutations were detected. The results of this study suggested that HPV18 infection is linked to vaginal SCNEC.
Contamination of the Mini C-Arm During Foot and Ankle Surgery
Authors: Momenzadeh Kaveh , Williams Caroline , Czerwonka Natalia , Kwon John Y. , Nazarian Ara , Miller Christopher P.
Published: April 2021

Background:

Many orthopedic surgeries utilize intraoperative fluoroscopy. The mini C-arm is an advantageous device as it can be easily used without the need for a dedicated radiology technician. However, there are concerns that the mini C-arm may represent a potential source of contamination and subsequent postoperative infection. Previous investigations of standard C-arm drapes have shown high rates of contamination. Similar contamination rates would be even more concerning for the mini C-arm as it requires physically maneuvering the machine. This study aimed to determine the rate of mini C-arm drape contamination and identify high-risk areas.

Methods:

Fifty foot and ankle surgeries requiring the use of mini C-arm fluoroscopy were included. Eight locations on the mini C-arm drape were sampled at the conclusion of each procedure. Culture Q-swabs were used for sampling defined locations. Swab samples were then assessed for bacterial growth on a 5% blood agar plate using a semiquantitative technique.

Results:

In 70% of surgical cases, contamination was observed in at least 1 location. Six of the 8 evaluated locations were found to have significantly higher contamination in comparison with their corresponding negative controls (Mann-Whitney U test, P < .05). The “outer portion of the upper arm” (location 1) exhibited bacteria growth in 26% ( P < .0001) of cases. The “superior portion of the x-ray source” (location 2) exhibited growth in 30% ( P < .0001) of cases. These were the highest-risk areas for contamination and were both significantly more likely to be involved than the “inferior portion of the x-ray source” and “superior portion of the beam receiver,” locations 4 and 5, respectively. Fourteen percent (7/50) C-arm cases and 1.72% (1/58) Achilles tendon surgery control cases developed surgical site infection ( P = .0234; OR, 9.27).

Conclusion:

Bacterial contamination of the mini C-arm drape was found to be common after foot and ankle procedures. Contamination was more prevalent on the outer ring areas of the C-arm, both at the emitter and receiver.

Level of Evidence:

Level III, prospective cohort study.
Correlation of Different Methods of Measuring Pronation of the First Metatarsal on Weightbearing CT Scans
Authors: Conti Matthew S. , Patel Tamanna J. , Caolo Kristin C. , Amadio Joseph M. , Miller Mark C. , Costigliola Stephen V. , Ellis Scott J. , Conti Stephen F.
Published: April 2021

Background:

There is no consensus in the foot and ankle literature regarding how to measure pronation of the first metatarsal in patients with hallux valgus. The primary purpose of this study was to compare 2 previously published methods for measuring pronation of the first metatarsal and a novel 3-dimensional measurement of pronation to determine if different measurements of pronation are associated with each other.

Methods:

Thirty patients who underwent a modified Lapidus procedure for their hallux valgus deformity were included in this study. Pronation of the first metatarsal was measured on weightbearing computed tomography (WBCT) scans using the α angle with reference to the floor, a 3-dimensional computer-aided design (3D CAD) calculation with reference to the second metatarsal, and a novel method, called the triplanar angle of pronation (TAP), that included references to both the floor (floor TAP) and base of the second metatarsal (second TAP). Pearson’s correlation coefficients were used to determine if the 3 calculated angles of pronation correlated to each other.

Results:

Preoperative and postoperative α angle and 3D CAD had no correlation with each other ( r = 0.094, P = .626 and r = 0.076, P = .694, respectively). Preoperative and postoperative second TAP and 3D CAD also had no correlation ( r = 0.095, P = .624 and r = 0.320, P = .09, respectively). However, preoperative and postoperative floor TAP and α angle were found to have moderate correlations ( r = 0.595, P = .001 and r = 0.501, P = .005, respectively).

Conclusion:

The calculation of first metatarsal pronation is affected by the reference and technique used, and further work is needed to establish a consistent measurement for the foot and ankle community.

Level of Evidence:

Level III, retrospective cohort study.
Evaluating the Factor Structure and Criterion Validity of the Canadian Little DCDQ: Associations Between Motor Competence, Executive Functions, Early Numeracy Skills, and ADHD in Early Childhood
Authors: Hudson Kesha N. , Willoughby Michael T.
Published: April 2021

The Canadian Little Developmental Coordination Disorder Questionnaire (Little DCDQ-CA) is a parent-report screening instrument that identifies 3- to 4-year-old children who may be at risk for Developmental Coordination Disorder (DCD). We tested the factor structure and criterion validity of the Little DCDQ-CA in a sample of preschool-aged children in the United States ( N = 233). Factor analysis indicated that the DCDQ-CA was best represented by one factor. Using cutoff scores that were proposed by the developer, 45% of the sample was identified as at-risk for DCD. Although a much larger percentage of children was identified as at-risk than would be expected based on the prevalence of formal DCD diagnoses in the population, the Little DCDQ-CA demonstrated good criterion validity. Specifically, compared with their peers, children who exceeded the at-risk criterion demonstrated worse motor competence, executive functioning skills, and early numeracy skills and were rated as having greater ADHD behaviors by their teachers, all consistent with expectations for children who are at risk for DCD. Results are discussed as they relate to future use of the Little DCDQ-CA.
The Development of Preliminary HiTOP Internalizing Spectrum Scales
Authors: Watson David , Forbes Miriam K. , Levin-Aspenson Holly F. , Ruggero Camilo J. , Kotelnikova Yuliya , Khoo Shereen , Bagby R. Michael , Sunderland Matthew , Patalay Praveetha , Kotov Roman
Published: April 2021

As part of a broader project to create a comprehensive self-report measure for the Hierarchical Taxonomy of Psychopathology consortium, we developed preliminary scales to assess internalizing symptoms. The item pool was created in four steps: (a) clarifying the range of content to be assessed, (b) identifying target constructs to guide item writing, (c) developing formal definitions for each construct, and (d) writing multiple items for each construct. This yielded 430 items assessing 57 target constructs. Responses from a heterogeneous scale development sample ( N = 1,870) were subjected to item-level factor analyses based on polychoric correlations. This resulted in 39 scales representing a total of 213 items. The psychometric properties of these scales replicated well across the development sample and an independent validation sample ( N = 496 adults). Internal consistency analyses established that most scales assess relatively narrow forms of psychopathology. Structural analyses demonstrated the presence of a strong general factor. Additional analyses of the 35 nonsexual dysfunction scales revealed a replicable four-factor structure with dimensions we labeled Distress, Fear, Body Dysmorphia, and Mania. A final set of analyses established that the internalizing scales varied widely—and consistently—in the strength of their associations with neuroticism and extraversion.
The Performance of College Students on the Iowa Gambling Task: Differences Between Scoring Approaches
Authors: Barnhart Wesley R. , Buelow Melissa T.
Published: April 2021

The Iowa Gambling Task (IGT) is one of the most common behavioral decision-making tasks used in clinical and research settings. Less-than-expected performance among healthy adults generates concerns about the validity of this task, and it is possible the particular scoring approach utilized could impact interpretation. We examined how performance patterns changed across several scoring approaches, utilizing a large, college student sample, both with ( n = 406) and without ( n = 1,547) a self-reported history of psychiatric or other diagnosis. Higher net scores were seen when participants selected decks with a low loss frequency than decks with high long-term outcomes; however, participants overall underperformed the IGT normative data sample. Receiver operating characteristic curves examining multiple scoring approaches revealed no threshold of impaired performance that both maximized sensitivity and minimized false positive rate on the IGT. Scoring approach matters in the determination of impaired decision making via the IGT in adults.