bluuebunny/crossref_metadata_2025 huggingface dataset:
Practice of Telehealth in Otolaryngology: A Scoping Review in the Era of COVID‐19
Authors: Gonzalez Joseph N. , Axiotakis Lucas G. , Yu Victoria X. , Gudis David A. , Overdevest Jonathan B.
Published: May 2021

Objective

The COVID‐19 pandemic has spurred widespread adoption and advancement in telehealth activities, representing a marked change in otolaryngology practice patterns. The present study undertakes a scoping review of research focused on telehealth in otolaryngology (teleotolaryngology) to identify key themes and commonly utilized outcome measures that will assist future development in this growing field.

Data Sources

PubMed, Embase, and Cochrane databases and reference review.

Review Methods

Per guidelines of the PRISMA Extension for Scoping Reviews, we performed database queries using a comprehensive search strategy developed in collaboration with research librarians at the Columbia University Irving Medical Center. We identified 596 unique references to undergo title and abstract review by 2 independent reviewers, leaving 439 studies for full‐text review.

Results

We included 285 studies for extraction of notable findings, leaving 262 unique studies after accounting for content overlap. We identified core outcome measures, including patient and provider satisfaction, costs and benefits, quality of care, feasibility, and access to care. Publication volume increased markedly over time, though only 4% of studies incorporated randomized study group assignment. Using an iterative approach to thematic development, we organized article content across 5 main themes: (1) exploration of teleotolaryngology evolution, (2) role in virtual clinical encounters, (3) applications in interdisciplinary care and educational initiatives, (4) emerging and innovative technologies, and (5) barriers to implementation.

Conclusion

This scoping review of teleotolaryngology documents its evolution and identifies current use cases, limitations, and emerging applications, providing a foundation from which to build future studies, inform policy decision making, and facilitate implementation where appropriate.
Emotions in Aotearoa New Zealand: Reflexive emotionalisation in a colonised context
Authors: Holmes Mary
Published: May 2021

Reflexive emotionalisation means increased thinking about and acting on emotional experiences in response to major changes to social life, such as those accompanying colonisation. This article explains and develops this novel concept, assessing its usefulness through an exploratory assessment of reflexive emotionalisation in the formation of Aotearoa New Zealand as a colonised settler state. It is argued that as cultures met and sought to coexist, emotions were vital. Focusing on reflexive emotionalisation in Aotearoa reveals how differences in feeling rules were navigated, sometimes in violent ways, as power shifted towards the colonisers. Feelings of belonging are important in that ongoing process of reflexive emotionalisation, the elucidation of which provides a new understanding of social change and settler state formation that avoids casting colonised peoples as passive objects of ‘progress’ brought by colonisers.
The diagnostic accuracy of intravoxel incoherent motion and diffusion kurtosis imaging in the differentiation of malignant and benign soft-tissue masses: which is better?
Authors: Liu Yajie , Yin Zhenzhen , Li Xiangwen , Zhang Yu , Yuan Yuan , Wei Lai , Wang Shaowu
Published: May 2021

Background

It is difficult for conventional magnetic resonance imaging (MRI) to distinguish benign soft-tissue masses (STMs) from malignant masses.

Purpose

To quantitatively compare the diagnostic value of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in STMs.

Material and Methods

The data from 58 patients with STMs were retrospectively analyzed. The GE Discovery 3.0-T MRI scanner was used to acquire conventional MRI sequences, IVIM, and DKI images. The chi-square test, independent sample t-test, and Mann–Whitney U tests were used to compare the differences between conventional MRI features, IVIM, and DKI parameters (Dslow, Dfast, f, mean kurtosis [MK], and mean diffusivity [MD]) between the benign and malignant groups. Receiver-operating characteristic (ROC) curve analysis was also performed.

Results

Tumor size and depth are statistically different in STTs. Dslow, MK, and MD values in the malignant groups are significantly lower than the benign groups ( P < 0.05). However, Dfast and f values are not statistically different between the two groups. The area under the curve (AUC) of Dslow value (0.859) is higher than MD (0.765) and MK (0.676) values for identifying benign and malignant STMs. The Dslow value showed the best specificity (82.93%). The sensitivity and specificity of IVIM and DKI parameters are higher than that of conventional MRI sequences.

Conclusion

IVIM and DKI can be used to distinguish between benign and malignant STMs, with Dslow as the most meaningful parameter.
Differentiation of microinfiltration and simple-edema areas in VX2 bone tumors by diffusion kurtosis imaging in animal experiments: a preliminary study
Authors: Yajun Fang , Limin Tang , Ruizhi Zhou , Qi Xu , Haisong Chen
Published: May 2021

Background

Dual-energy computed tomography, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to distinguish microinvasion areas of malignant bone tumors. However, reports of diffusion kurtosis imaging (DKI) to determine the extent of intramedullary infiltration are relatively rare.

Purpose

To assess the application value of MR-DKI in differentiating areas of microinfiltration and simple edema in rabbit bone VX2 tumor models.

Material and Methods

Conventional MRI and DKI were performed on 25 successfully constructed rabbit VX2 bone tumor models. We acquired a midline sagittal section of the tumor for hematoxylin and eosin staining. Using pathological findings as the gold standard and combining them with MRI data, strict point-to-point control was performed to delineate regions of interest (ROIs) in the microinfiltration and simple-edema areas of bone tumors for quantitative measurement of mean diffusivity (MD) and mean kurtosis (MK). MD and MK values between microinfiltration and simple-edema areas were compared using an independent sample t-test, and the diagnostic values were evaluated by receiver operating characteristic (ROC) curve analysis.

Results

In comparison with the simple-edema area, the micro-infiltration area demonstrated significantly smaller MD values and larger MK values ( P < 0.05), and MD showed a better area under the curve (AUC) than MK (AUC = 0.884 vs. AUC = 0.690) for distinguishing the microinfiltration area from the simple-edema area. The optimal cutoff MD value was 1108.5 mm2/s with a sensitivity of 84% and specificity of 84%.

Conclusion

DKI can distinguish the microinfiltration and simple-edema areas of malignant bone tumors in animal experiments.
Chinese Aesthetic Mask: Three Forehead and Five Eyes—Holistic Processing and Facial Attractiveness
Authors: Lin Jia , Zhou Guomei
Published: May 2021

Human face processing has been attributed to holistic processing. Here, we ask whether humans are sensitive to configural information when perceiving facial attractiveness. By referring to a traditional Chinese aesthetic theory—Three Forehead and Five Eyes—we generated a series of faces that differed in spacing between facial features. We adopted a two-alternative forced-choice task in Experiment 1 and a rating task in Experiment 2 to assess attractiveness. Both tasks showed a consistent result: The faces which fit the Chinese aesthetic theory were chosen or rated as most attractive. This effect of configural information on facial attractiveness was larger for faces with highly attractive features than for faces with low attractive features. These findings provide experimental evidence for the traditional Chinese aesthetic theory. This issue can be further explored from the perspective of culture in the future.
Use of Linear Programming to Develop Complementary Feeding Recommendations to Improve Nutrient Adequacy and Dietary Diversity Among Breastfed Children in the Rural Philippines
Authors: Mejos Karen Kay , Ignacio Maria Socorro , Jayasuriya Rohan , Arcot Jayashree
Published: May 2021

Background:

Lack of dietary diversity in complementary feeding contributes to nutrient gaps leading to undernutrition. Food-based strategies have been successfully used to enrich the complementary diets of infants and young children. However, context-specific recommendations based on an objective diet optimization are needed to formulate sound and practical nutritional guidelines.

Objectives:

The present study aimed to identify problem nutrients in complementary diets and formulate complementary feeding recommendations (CFRs) using linear programming analysis for children aged 6 to 23 months in the rural Philippines.

Methods:

A cross-sectional survey was conducted in the municipality of Mercedes, Philippines. Dietary intakes of breastfed children 6 to 8, 9 to 11, and 12 to 23 months of age (n = 297) were assessed using a multipass 24-hour recall method with 7-day food consumption frequency. A linear programming tool was used to identify the recommended nutrient intakes that could not be met within the existing local food patterns and develop CFRs that would best fulfill nutrient adequacy for 11 modeled micronutrients.

Results:

Problem nutrients in the current diets were iron and calcium in any age-group, zinc for 6 to 8 and 9 to 11 months old, and thiamine and folate for 12 to 23 months old children. Adoption of CFRs with 4 to 5 food groups in the diet would ensure the adequacy of 7 to 8 nutrients, depending on the age-group.

Conclusion:

Within the boundaries of local dietary patterns, adequacy for most nutrients could be achieved by promoting realistic servings of nutrient-dense foods and food groups. The linear programming results provide an evidence-based strategy in designing interventions to improve the quality of Filipino complementary diets.
A quasi-transient coupling approach to the modeling of conjugate heat transfer in the autoclave
Authors: Zhu Junhong , Frerich Tim , Dimassi Adli , Droste David , Herrmann Axel S
Published: May 2021

Structural aerospace composite parts are generally cured in an autoclave. To achieve a homogeneous curing, computational fluid dynamics simulations have been increasingly used in thermal optimization. However, a transient computational fluid dynamics simulation of autoclave processing is resource intensive. This article outlines the concept of a quasi-transient coupling strategy to deal with the conjugate heat transfer problem inside an autoclave. In this approach, a computational fluid dynamics model is coupled with a finite element method (FEM) model through incorporating an empirical-based analytic equation, which describes the dependence of the heat transfer coefficient on pressure and temperature, into the computational fluid dynamics computations. This approach bridges the temporal disparities between the fluid and the solid, thus minimizing the global computing time. To validate this method, two simulation cases have been studied. In both cases, two different coupling computations are compared, namely a full-transient simulation as the reference computation and the introduced quasi-transient simulation. First, the quasi-transient coupling approach is implemented by performing the transient heat transfer analysis on a flat plate. The results indicate that this approach can predict accurate transient temperature fields, and the computational effort is reduced by up to 87%. Subsequently, this method is used in a real autoclave and validated by known experimental data. The simulation results are in good agreement with the experimental results, with a mean temperature error lower than 1.9°C. This indicates the capability and efficiency of this approach in solving a conjugate heat transfer problem for autoclave processing.
None the wiser: Year-long longitudinal study on effects of adversity on wisdom
Authors: Dorfman Anna , Moscovitch David A , Chopik William J , Grossmann Igor
Published: May 2021

Research on consequences of adversity appears inconclusive. Adversity can be detriment to mental health, promoting maladaptive patterns of thoughts. At the same time, posttraumatic growth studies suggest that overcoming major adversity facilitates growth in wisdom-related patterns of thoughts. We address this puzzle by examining how distinct types of adversity impact wisdom over time and how individual differences in self-distanced (rather than self-immersed) reflection on adversity relate to different wisdom trajectories. In a four-wave prospective year-long study, participants ( N = 499) recalled and reflected every three months on the most significant recent adverse event in their life. They reported how much they engaged in wise reasoning—intellectual humility, open-mindedness to diverse perspectives and change, search for compromises and resolution—as well as self-distancing during reflections. Independent raters identified seven distinct adversity types (e.g. social conflict, economic hardship, major trauma) in open-ended descriptions. Growth curve analyses revealed little evidence of positive change in wise-reasoning over the course of a year, and some evidence of negative change for health-related adversity. Although self-distancing was associated with stability in wisdom, self-immersing was associated with negative change in wisdom in reflections on social conflicts over time. We discuss implications these results have for adversity, change vs. resilience in character strengths, and self-distancing.
Exploring Mechanisms in the Entrepreneurial Passion–Entrepreneurial Behavior Relationship: Mediating Role of Growth-Oriented Intentions
Authors: Qian Shanshan , Brannon David L. , Tabak Filiz
Published: May 2021

This research explores the mechanisms that connect entrepreneurial passion (EP) to entrepreneurial behavior. We investigate the mediating impact of growth-oriented intentions on the relationship between EP and behavior. We conducted a two-wave longitudinal survey study and recruited a sample of 235 undergraduate students from a business school in the Mid-Atlantic region of the United States. Our findings indicate EPs for inventing and for founding are significantly related to entrepreneurial behavior and that growth-oriented intentions partially mediate the relationships between passions for founding and for inventing with behavior. We discuss implications of our findings.
Focused for Some, Exploratory for Others: Job Search Strategies and Successful University-to-Work Transitions in the Context of Labor Market Ambiguity
Authors: Okay-Somerville Belgin , Scholarios Dora
Published: May 2021

This article examines the role of student job search strategies that differ in goal-directedness (focused, exploratory, and haphazard) in achieving successful university-to-work transitions (i.e., employment in jobs with high skill use/development and qualification–job match). The relationship between job search and employment outcomes is considered in two labor market contexts—high or low ambiguity—which are represented by the comparison between arts, humanities, and social sciences (AHSS) and science, technology, engineering, and mathematics (STEM) graduates, respectively. Using two-wave survey data, we find that job search strategies during university do not explain, yet differentially impact, successful outcomes one year after graduation. Fully exploring opportunities was particularly beneficial for STEM graduates (low ambiguity context) and more focused job search was beneficial for AHSS graduates (high ambiguity context). Paradoxically, findings both question and reinforce the efficacy of career agency for overcoming barriers to labor market entry, depending on the job search context. The study contributes to the agency and context debates relevant for school-to-work transitions.
Multi-properties optimization of welding parameters of wire arc additive manufacture in dissimilar joint of iron-based alloy and nickel-based superalloy using grey-based Taguchi method
Authors: Xia Yufeng , Peng Mengxia , Teng Haihao , Chen Yanhong , Zhang Xue
Published: May 2021

In order to adapt to the high temperature and heavy load process environment of large forgings, a novel die with “fist-like” structure was designed. The iron-based welding material (RMD248) as the “bone” layer and the nickel-based superalloy welding material (ERNiCr-3) as the “skin” layer were welded on the matrix by wire arc additive manufacture (WAAM). In this work, the grey based Taguchi methodology was used to optimize welding parameters (welding voltage, welding speed and wire feed speed) considering excellent multi-properties (hardness and ultimate tensile strength of high-temperature tensile test) of the dissimilar joint of RMD248 and ERNiCr-3. Further, analysis of variance was done to ascertain the influence of welding parameters on response parameters. Experimental results showed that welding speed was the most effective input parameter followed by wire feed speed and welding voltage. Finally, optimal result was verified through confirmation experiments. Meanwhile, the effect of welding speed on the microstructure and mechanical properties of joint was studied. The microstructures were characterized by optical microscopy (OM), energy dispersive spectrometer (EDS). The results indicated that the microstructure of RMD248 was consisted of more retained austenite at lower welding speed. For ERNiCr-3, the finer columnar crystal structure at higher welding speed was observed. At lower welding speed, the microhardness of RMD248 was just slightly lower, but that of ERNiCr-3 was significantly higher, and the ultimate tensile strength was higher. Therefore, the specimen at lower welding speed had better comprehensive mechanical properties.
3D transient numerical simulation of a helical roots air compressor for FCVs
Authors: Wei Huan , Xing Linfen , Wang Bingqi , Feng Jianmei , Peng Xueyuan
Published: May 2021

Oil-free helical Roots air compressors which have great application potential in air circulation systems for high-power fuel cell systems, such as commercial fuel cell vehicles (FCVs), have the advantages of active adaptation, low cost, large flow rate and high reliability. In this study, a three-dimensional transient numerical simulation model of a helical Roots air compressor was established by considering all leakage clearances. In this study, hexahedral structured dynamic grids were generated in the working chamber and the rotating angle was updated at an increment of 1° to ensure the mesh quality of the entire solving domain. The accuracy of the simulation model was validated using experimental data, and the maximum deviation was less than 4.0%. Based on the simulated results, the pressure field and variation of the pressure field with the rotation angle are presented. It shows that the pressure fluctuation at the discharge side was larger than that at the suction side. The influence of various leakage clearance on the volumetric efficiency was analyzed comparatively. Additionally, the flow field characteristic of clearance was revealed. It is found that the rotor tip clearance was the major factor for the reduction of volumetric efficiency when the size was larger than 0.12 mm instead of the interlobe clearance. It is suggested that more attention should be paid to control the clearance size to ensure the performance of helical Roots air compressors.
Layer thickness optimization of ceramic composite for body armor by considering volume, weight, and cost
Authors: Palaci Yuksel , Arikan Mustafa M
Published: May 2021

This study investigates visualization of optimized layer thickness with a ternary diagram by considering Volume, Weight, and Cost priorities to determine the composite structure of alternative ceramics to use in body armor application by using the Digital Logic Method (DLM). Three criterion priorities (volume, weight, cost) have been investigated to help designers decide on optimum ceramic material for their applications. Alumina (Al2O3), silicon carbide (SiC), silicon nitride (Si3N4), and boron carbide (B4C) were analyzed and ranked to decide for material selection based on priorities. The analysis results showed that silicon nitride (Si3N4) had the maximum performance index (PI) point (80.0) based on the volume priority. On the other hand, while boron carbide (B4C) had the maximum PI point (76.4) in terms of the weight priority, alumina (Al2O3) was determined to be the best material according to the cost priority. PI point of alumina (Al2O3) was calculated as 100. A ternary diagram was developed for decision-makers to visualize material selection performances. The optimization of the ceramic composite layer thickness of the alternative ceramic materials is visualized by considering three criteria.
Analysis of the cycloidal reducer output mechanism while taking into account machining deviations
Authors: Bednarczyk Sławomir
Published: May 2021

There are three main rolling nodes in the cycloidal gear reducer: the gear, output mechanism and central bearing. To transfer the drive from the active side to the output side of the gear, an output mechanism is used, which is formed by bushings mounted on pins located in the output shaft. During the operation of the reducer, the bushings roll around the wheel holes with a cycloidal contour. Using the structure and geometry of the output mechanism, an analysis of the backlash distribution in it was conducted, taking into account the machining deviations of the elements and surfaces forming this mechanism. Then, the distribution of forces and contact pressures were determined. The results of the analysis suggest that the backlash distribution, forces and contact pressures largely depend on the tolerance of the radius of the bushings’ arrangement and the holes in the planet wheel. The results obtained allow for the optimal selection of machining deviations in terms of received contact pressures.
Finite-time disturbance observer–based funnel voltage control strategy for vehicle-to-grid inverter in islanded mode
Authors: Dai Yuchen , Zhang Liyan , Liu Guofu , Xu Dezhi , Yang Chengshun
Published: May 2021

Based on vehicle-to-grid technology, electric vehicles can be used as power sources in the case of power failure. With the aim to reduce voltage overshoot and improve the anti-disturbance ability of the vehicle-to-grid inverter, a high-performance voltage control strategy based on funnel control and finite-time disturbance observer is developed. First, the dynamic model of the inverter in dq-frame is established, and the lumped disturbance including the unmodeled part is considered. Next, a novel funnel variable is proposed to ensure that the voltage tracking error can be stabilized within the prescribed funnel boundary, and thus enhance the transient performance. Then, a novel finite-time disturbance observer is designed to estimate the lumped disturbance in the system such as load fluctuations, and improve the anti-disturbance ability of the controller. Moreover, the second-order sliding mode differentiator is introduced to estimate the derivative of the virtual control law and eliminate the explosion of complexity problem in the derivation process. Finally, the finite-time stability of the proposed voltage control strategy is analyzed via the Lyapunov theory. The effectiveness of the proposed control strategy is verified by two cases.
Academicians’ awareness, attitude, and use of open access during the COVID-19 pandemic
Authors: Turgut Yigit Emrah , Aslan Alper , Denizalp Nuran Varlı
Published: May 2021

The aim of this research is to reveal academics’ awareness, attitude, and use of open access. In line with the research purpose, the survey research design is adopted. This research consists 151 academics from 12 basic research areas; eight of them being Professor Dr, 17 being Associate Professor Dr, 49 being Doctor Lecturer, and 77 being Research Assistant or Lecturer. A questionnaire consisting of 19 open access and five demographic information questions was used for the data collection tool. The research results show that 75% of the academics have open access awareness and that their awareness is generally created by information that they obtain through the Internet and their friends. In addition, most of the academics indicate that their awareness of open access has increased during the pandemic period. When considering the level of academics’ use of open access, it is found that 75% of the academics use articles in open access journals for their own research and 51% of the academics do not publish any articles in open access journals.
Clinical characteristics of itch in cutaneous lupus erythematosus: A prospective, multicenter, multinational, cross-sectional study
Authors: Samotij Dominik , Szczęch Justyna , Antiga Emiliano , Bonciani Diletta , Caproni Marzia , Chasset François , Dańczak-Pazdrowska Aleksandra , Furukawa Fukumi , Hasegawa Minoru , Hashizume Hideo , Ikeda Takaharu , Islam Aminul , Kim Hee Joo , Lesiak Aleksandra , Misery Laurent , Mowla Mohammad Rafiqul , Polańska Adriana , Szepietowski Jacek C , Tsuruta Daisuke , Verdelli Alice , Werth Victoria P , Reich Adam
Published: May 2021

Objective

Pruritus is an important symptom frequently accompanying various inflammatory skin conditions and some recent data indicated that it may be associated with autoimmune connective tissue diseases. The aim of this study was to assess the frequency and clinical presentation of itch in CLE.

Methods

A multinational, prospective, cross-sectional study was performed to assess the prevalence, intensity and clinical characteristic of pruritus in various subtypes of CLE. A total of 153 patients with active CLE lesions were included. Their age ranged between 17 and 82 years (mean 49.8 ± 15.4 years), and 115 patients (75.2%) were women. The disease activity and damage were assessed according to the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). Pruritus severity was assessed with Numeric Rating Scale (NRS) and the 12-Item Pruritus Severity Scale. Dermatology Life Quality Index and EQ-5D questionnaire were used to measure quality of life.

Results

Pruritus was present in 116 (76.8%) of patients of whom half had NRS scoring equal or above 4 points indicating moderate or severe pruritus. Most commonly itch was localized on the scalp, face (excluding ears and nose) and arms (40.5%, 36.2%, 31.9%, respectively). Sensations connected with pruritus were most frequently described as burning, tingling and like ants crawling feeling, but 31.9% patients described it as “pure itch”. More than half of patients reported that pruritus was present every day, and it was most frequent during the evenings. The pruritus scoring and the CLASI activity score were significantly correlated (r = 0.42, p = 0.0001), while no correlation was found with the CLASI damage score (p = 0.16). Both the maximum and average itch intensity were correlated with systemic lupus erythematosus (SLE) activity measured with the Systemic Lupus Erythematosus Disease Activity Index.

Conclusions

Pruritus is a common, but frequently overlooked symptom of CLE. Its intensity correlates with the activity of CLE, but not with the skin damage. In more than a half of patients it occurs on a daily basis. The correlation between the intensity of pruritus and the activity of the skin lesions and the systemic involvement indicate that pruritus could be an individual indicator of both SLE and CLE activity.
Potential genetic basis of B cell hyperactivation in murine lupus models
Authors: Ju JY , Xu ZW
Published: May 2021

Background

Lupus B cells not only produce autoantibodies against nuclear antigens but also provide co-stimulation to T cells. However, there is still a lack of comprehensive understanding of the mechanism underlying lupus B cell hyperactivation.

Methods

This study focuses on the detection of B cell activation status, analysis of early BCR signaling response, DNA sequencing, and quantity determination of BCR signaling regulators in murine lupus models.

Results

Our result showed that there is a B cell hyperactivation with a significant elevation of B cell activation markers, and a BCR signaling hyperactivity with an abnormal increase of phosphorylated BCR signaling molecules and cytoplasmic calcium in the early response to BCR crosslinking in B6.Sle1/2/3 lupus mouse. Whole exome sequencing identified a multiple point mutation in the exon of many BCR signaling regulators in common murine lupus models, MRL/lpr, NZM2410, BXSB, NZB, and NZW strains. cNDA sequencing confirmed FcγR2b, Ly9, Pirb, Siglecg, and CD22 BCR signaling regulator variants in B6.Sle1/2/3 lupus mouse, but surface protein expression of these regulators on B cells showed an abnormal increase.

Conclusion

Our findings support that these BCR signaling regulator variants are potential causative genes of B cell hyperactivation in murine lupus models through their possible functional reduction.
The effects of media narratives about failures and discoveries in science on beliefs about and support for science
Authors: Ophir Yotam , Jamieson Kathleen Hall
Published: May 2021

This study examines the effects of exposure to media narratives about science on perceptions pertaining to the reliability of science, including trust, beliefs, and support for science. In an experiment ( n = 4497), participants were randomly assigned to read stories representing ecologically valid media narratives: the honorable quest, counterfeit quest, crisis or broken, and problem explored. Exposure to stories highlighting problems reduced trust in scientists and induced negative beliefs about scientists, with more extensive effects among those exposed to the “crisis/broken” accounts and fewer for those exposed to “counterfeit” and “problem explored” stories. In the “crisis/broken” and “problem explored” conditions, we identified a three-way interaction in which those with higher trust who considered the problem-focused stories to be representative of science were more likely to believe science is self-correcting and those with lower trust who perceived the stories to be representative were less likely to report that belief. Support for funding science was not affected by the stories. This study demonstrates the detrimental consequences of media failure to accurately communicate the scientific process, and provides evidence for ways for scientists and journalists to improve science communication, while acknowledging the need for changes in structural incentives to obtain such a goal.
Spatio-temporal Assessment of Landscape Ecological Risk and Associated Drivers: A Case Study of Delhi
Authors: Mondal Biswajit , Sharma Pragya , Kundu Debolina , Bansal Sarita
Published: May 2021

Urbanization is considered as the key driver for land use and land cover (LULC) changes across the globe and Delhi is no exception to this phenomenon. The population of Delhi has almost doubled from 8.4 million in 1991 to 16.3 million in 2011. Correspondingly, the built-up area has also increased from 336.82 to 598.22 km 2 during 1999–2018. This urban expansion has led to emergence of serious ecological risk and fragmentation of the landscape. In this context, it is imperative to analyse the level of risks induced by such urban expansion and its underlying associations with other factors. This article quantifies the LULC changes in Delhi during 1999–2018 using Landsat 5 (TM) and Landsat 8 (OLI) data. A spatio-temporal sprawl induced risk assessment index has been developed by combining landscape fragmentation score and land use land cover vulnerability score. The landscape fragmentation score was based on four landscape metrics, whereas the vulnerability score was computed from LULC data. The article also assesses the association between risk areas and economic activities, environmental and infrastructural amenities that are considered key drivers of urban expansion in Delhi. To estimate spatio-temporal variability between risk areas and key drivers, ordinary least square regression and geographical weighted regression (GWR) were used. The GWR results reveal that sprawl-induced ecological risk in Delhi is strongly associated with economic activity, infrastructural accessibility and environmental amenities. This spatial empirical assessment also shows that urban growth incentives or services such as roads, metro rail, schools and hospitals can also create pressure on the landscape if local authorities arbitrarily provide these services across space without considering the associated risks.
Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis
Authors: Croker James Alton , Bobitt Julie , Sanders Sara , Arora Kanika , Mueller Keith , Kaskie Brian
Published: May 2021

Introduction:

Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care.

Methods:

Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care.

Results:

In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05).

Discussion:

Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.
Optimizing Outcomes After Cleft Palate Repair: Design and Implementation of a Perioperative Clinical Care Pathway
Authors: Cawthorn Thomas R. , Todd Anna R. , Hardcastle Nina , Spencer Adam O. , Harrop A. Robertson , Fraulin Frankie O. G.
Published: May 2021

Objective:

To evaluate the development process and clinical impact of implementing a standardized perioperative clinical care pathway for cleft palate repair.

Design:

Medical records of patients undergoing primary cleft palate repair prior to pathway implementation were retrospectively reviewed as a historical control group (N = 40). The historical cohort was compared to a prospectively collected group of patients who were treated according to the pathway (N = 40).

Patients:

Healthy, nonsyndromic infants undergoing primary cleft palate repair at a tertiary care pediatric hospital.

Interventions:

A novel, standardized pathway was created through an iterative process, combining literature review with expert opinion and discussions with institutional stakeholders. The pathway integrated multimodal analgesia throughout the perioperative course and included intraoperative bilateral maxillary nerve blocks. Perioperative protocols for preoperative fasting, case timing, antiemetics, intravenous fluid management, and postoperative diet advancement were standardized.

Main Outcome Measures:

Primary outcomes include: (1) length of hospital stay, (2) cumulative opioid consumption, (3) oral intake postoperatively.

Results:

Patients treated according to the pathway had shorter mean length of stay (31 vs 57 hours, P < .001), decreased cumulative morphine consumption (77 vs 727 μg/kg, P < .001), shorter time to initiate oral intake (9.3 vs 22 hours, P = .01), and greater volume of oral intake in first 24 hours postoperatively (379 vs 171 mL, P < .001). There were no differences in total anesthesia time, total surgical time, or complication rates between the control and treatment groups.

Conclusions:

Implementation of a standardized perioperative clinical care pathway for primary cleft palate repair is safe, feasible, and associated with reduced length of stay, reduced opioid consumption, and improved oral intake postoperatively.
Analysis of the interventions in antineoplastic therapy by a clinical pharmacy service at a tertiary hospital in Brazil
Authors: da Rocha Camile , Carlotto Juliane , Zanis Neto Jose
Published: May 2021

Background

Medication errors are avoidable occurrences that can assume clinically significant dimensions and impose relevant costs to the health system, especially in the context of antineoplastic therapy.

Objective

Assess the clinical significance and economic impacts of a clinical pharmaceutical service. This retrospective study consists of an analysis of pharmacy interventions and drug-related problems found in a review of electronic prescriptions referring to antineoplastic therapy of a public teaching tertiary hospital in Brazil.

Method

Retrospective descriptive study obtained from electronic records of drug-related problems and pharmaceutical interventions related to antineoplastic therapy for oncological and hematological diseases, obtained through the pharmacotherapy review service. The accepted interventions were analyzed for the financial impact generated, evaluating your direct costs. The perception of clinical significance of a random sample of interventions was ascertained by the experts' opinion, using the Delphi method.

Results

The most frequent problem was a “lack of information to professionals” (25.06%), “problems as to the frequency and interval of doses” (22.90%), and “medication underdosing” (16.20%). Dose adjustment (31.50%) and clarifications (30.90%) were the most frequent pharmaceutical interventions. In the second round of Delphi, experts rated 77.77% of interventions as extremely significant and very significant. The main drugs reported in the interventions were cyclophosphamide, carboplatin, methotrexate, folinic acid, and monoclonal antibodies. The savings amounted to US$1,193,970.18 and involved mainly bortezomib, dactinomycin, and monoclonal antibodies.

Conclusion

Clinical pharmacy services contributed to the rational use of medicines presenting clinical significance and avoiding waste of financial resources.
The Association of Family Support and Health Education with the Status of Overweight and Obesity in Patients with Type 2 Diabetes Receiving Outpatient Treatment: Evidence from a Hospital in Vietnam
Authors: Ha Nguyen Thanh , Sinh Duong Truong , Ha Le Thi Thu
Published: May 2021

This study aims to establish the association of family support and nutrition and health education by health workers with the status of overweight and obesity among patients with type 2 diabetes mellitus (T2DM) receiving outpatient treatment at a hospital. This descriptive cross-sectional study was conducted on 280 outpatients with type 2 diabetes at Bach Mai hospital from December 2019 to September 2020 by using assessments of anthropometric parameters and examining dietary habits and family support, as well as nutrition and health education and counseling by health workers. The prevalence of overweight and obesity in patients with T2DM was 35.4% (51.2% in men and 22.2% in women; P < .05). Patients never or rarely supported by their families or counseled by health workers were more vulnerable to overweight and obesity than those who frequently received support and counseling (OR = 1.41 vs 2.06; P < .05). Family support and counseling from health workers play a crucial role in promoting and sustaining healthy dietary habits and proper physical exercise in diabetic patients, contributing to their lowered risk of overweight and obesity.
Party footprints in Africa: Measuring local party presence across the continent
Authors: Krönke Matthias , Lockwood Sarah J , Mattes Robert
Published: May 2021

The conventional view of Africa’s political parties holds that they are organizationally weak, with little presence at the grass roots. Yet, few studies are based on systematically collected data about more than a handful of parties or countries at any given point. In this paper, we attempt to remedy this situation, by focusing on one crucial aspect of party organization – the local presence that enables political parties to engage with and mobilize voters during and between elections – and developing the first systematic, survey-based measure of the extent of this presence across 35 countries. We draw on a wide variety of data to demonstrate the validity and reliability of this new index, and in the process showcase its ability to be calculated at a number of different levels. Finally, we illustrate its utility by applying it to a key substantive question in the literature.
Diabetes mellitus was not associated with lower amputation-free survival after open revascularization for chronic limb-threatening ischemia – A nationwide propensity score adjusted analysis
Authors: Lilja Erika , Gottsäter Anders , Miftaraj Mervete , Ekelund Jan , Eliasson Björn , Svensson Ann-Marie , Zarrouk Moncef , Acosta Stefan
Published: May 2021

The risk of major amputation is higher after urgently planned endovascular therapy for chronic limb-threatening ischemia (CLTI) in patients with diabetes mellitus (DM). The aim of this nationwide cohort study was to compare outcomes between patients with and without DM following urgently planned open revascularization for CLTI from 2010 to 2014. Out of 1537 individuals registered in the Swedish Vascular Registry, 569 were registered in the National Diabetes Register. A propensity score adjusted Cox regression analysis was conducted to compare outcome between the groups with and without DM. Median follow-up was 4.3 years and 4.5 years for patients with and without DM, respectively. Patients with DM more often had foot ulcers ( p = 0.034) and had undergone more previous amputations ( p = 0.001) at baseline. No differences in mortality, cardiovascular death, major adverse cardiovascular events (MACE), or major amputation were observed between groups. The incidence rate of stroke was 70% higher (95% CI: 1.11–2.59; p = 0.0137) and the incidence rate of acute myocardial infarction (AMI) 39% higher (95% CI: 1.00–1.92; p = 0.0472) among patients with DM in comparison to those without. Open vascular surgery remains a first-line option for a substantial number of patients with CLTI, especially for limb salvage in patients with DM. The higher incidence rates of stroke and AMI among patients with DM following open vascular surgery for infrainguinal CLTI require specific consideration preoperatively with the aim of optimizing medical treatment to improve cardiovascular outcome postoperatively.
Shared or unique trajectories of PTSD and depression in children over time since an earthquake
Authors: Zhou Xiao , Wu Xinchun
Published: May 2021

Posttraumatic stress disorder (PTSD) and depression are common outcomes in children and adolescents following natural disasters. However, because of the comorbidity of PTSD and depression, their mutual relationship affects their relative trajectories over time. Therefore, this study examined the joint trajectories of PTSD and depression and assessed their consistency over time. Using self-report questionnaires, we surveyed 303 children in the worst-affected area of the Ya’an earthquake at 6 months, 1 year, and 18 months post-disaster. Four latent joint trajectories of PTSD and depression were identified: a chronic depression-delayed PTSD symptoms group ( n = 59, 19.5%), a chronic PTSD-delayed depressive symptoms group ( n = 10, 3.3%), a low-symptoms group ( n = 208, 68.6%), and a chronic depression-PTSD symptoms recovery group ( n = 26, 8.6%). Companionship and affirmative value were more likely to be observed in the low-symptoms group. These findings illustrate that PTSD and depression development are heterogeneously distributed, and various types of social support fill different roles in differentiating distinct joint trajectories of PTSD and depression.
Encouraging foot care in people with and without diabetes through narrative communication
Authors: Reaney Matthew , Gladwin Thomas , Chmiel Nik , Churchill Susan
Published: May 2021

In order to minimize risk of infection and potential foot complications, it is recommended that people with and without diabetes check their feet regularly for problems such as cuts, sores, blisters or calluses. Hence, an understanding of how to craft effective messages to encourage people to check their feet is important. Two studies investigated the use of narrative stories to encourage foot problem detection behaviour; Study 1 in a general population sample ( N = 193), and Study 2 in a sample of people with type 1 or type 2 diabetes ( N = 129). In both studies participants were randomised to either (a) receive an information sheet written in first-person narrative; (b) the same in non-narrative format; or (c) no information sheet. Changes in weekly detection behaviour was the outcome of interest. In both studies, greater detection behaviour was observed in the narrative message condition vs. non-narrative condition and the non-narrative condition vs. no information condition. Our findings have implications for the design of health messages in delivering effective foot care education to people with and without diabetes, suggesting that narrative information sheets may be more effective than non-narrative information sheets.
An investigation of adherence to best practice guidelines for autism diagnosis in New Zealand
Authors: Taylor Lauren J , Eggleston Matthew JF , Thabrew Hiran , van der Meer Larah , Waddington Hannah , Whitehouse Andrew JO , Evans Kiah
Published: May 2021

Recent studies of autism diagnosis in New Zealand have revealed inconsistent implementation of best practice standards in autism assessment and high rates of parental dissatisfaction with the diagnostic process. These findings have arisen despite the development and dissemination of the New Zealand Autism Spectrum Disorder Guideline (the Guideline). In this study, we investigated current diagnostic processes, and adherence to the Guideline in New Zealand, for an opportunity sample of 117 health professionals who practice across a wide range of diagnostic services, health professionals and geographic regions in New Zealand. The results show considerable variability in practice, and suggest specific areas for improvement. These include the robustness of diagnostic evaluations conducted in private settings, the provision of specialist assessment services for youth and adults presenting for autism diagnosis, and the uniformity of post-diagnostic supports and services. These findings have implications for further implementation of the Guideline in New Zealand.

Lay abstract

Many clinicians in New Zealand do not follow guidelines for best practice in autism diagnosis. In this study, we investigated the processes that health professionals in New Zealand follow when diagnosing autistic children and adults. We asked 117 health professionals from a range of services and regions in New Zealand, how they identify and diagnose autism. We found that there are differences in the way that clinicians in New Zealand diagnose autism. We identified areas in which autism diagnosis in New Zealand could be improved, for example, by establishing more services to diagnose autism in adolescents and adults, and providing more consistent support after a person is diagnosed with autism. These findings will help to improve autism diagnosis in New Zealand.