bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal Trends of Out-of-Hospital Cardiac Arrests Without Resuscitation Attempt by Emergency Medical Services
Authors: Waldmann Victor , Karam Nicole , Gaye Bamba , Bougouin Wulfran , Dumas Florence , Sharifzadehgan Ardalan , Narayanan Kumar , Kassim Haoiinda , Beganton Frankie , Jost Daniel , Lamhaut Lionel , Loeb Thomas , Adnet Frédéric , Agostinucci Jean-Marc , Deltour Sandrine , Revaux François , Ludes Bertrand , Voicu Sebastian , Megarbane Bruno , Jabre Patricia , Cariou Alain , Marijon Eloi , Jouven Xavier ,   on behalf Paris-SDEC investigators
Published: March 2021

Background:

Significant improvements in survival from out-of-hospital cardiac arrest (OHCA) have been reported; however, these are based only on data from OHCA in whom resuscitation is initiated by emergency medical services (EMS). We aimed to assess the characteristics and temporal trends of OHCA without resuscitation attempt by EMS.

Methods:

Prospective population-based study between 2011 and 2016 in the Greater Paris area (6.7 million inhabitants). All cases of OHCA were included in collaboration with EMS units, 48 different hospitals, and forensic units.

Results:

Among 15 207 OHCA (mean age 70.7±16.9 years, 61.6% male), 5486 (36.1%) had no resuscitation attempt by EMS. Factors that were independently associated with increase in likelihood of no resuscitation attempt included: age of patients (odds ratio, 1.06 per year [95% CI, 1.05–1.06],
P
<0.001), female sex (odds ratio, 1.21 [95% CI, 1.10–1.32],
P
=0.002), OHCA at home location (odds ratio, 3.38 [95%CI, 2.86–4.01],
P
<0.001), and absence of bystander (odds ratio, 1.94 [95% CI, 1.74–2.16],
P
<0.001). Overall, the annual number of OHCA increased by 9.1% (from 2923 to 3189,
P
=0.028). This increase was related to an increase of the annual number of OHCA without resuscitation attempt by EMS by 26.3% (from 993 to 1253,
P
=0.012), while the annual number of OHCA with resuscitation attempt by EMS did not significantly change (from 1930 to 1936,
P
=0.416). Considering only cases with resuscitation attempt, survival rate at hospital discharge increased (from 7.3% to 9.5%,
P
=0.02). However, when considering all OHCA, survival improvement did not reach statistical significance (from 4.8% to 5.7%,
P
=0.17).

Conclusions:

We demonstrated an increase of the total number of OHCA related to an increase of the number of OHCA without resuscitation attempt by EMS. This increasing proportion of OHCA without resuscitation attempt attenuates improvement in survival rates achieved in EMS-treated patients.
Why Indonesia Adopted ‘Quiet Diplomacy’ over R2P in the Rohingya Crisis: The Roles of Islamic Humanitarianism, Civil–Military Relations, and asean
Authors: Smith Claire Q. , Williams Susannah G.
Published: March 2021

Following atrocities against the minority Muslim Rohingya population by the Myanmar military, several states have imposed sanctions and deployed international justice strategies against the Myanmar government. In contrast, Indonesia has used an alternative ‘quiet diplomacy’ approach, focused on aid delivery to affected communities and cooperation with Myanmar. The paper presents one of the first empirical examinations of Indonesia’s role, and considers Indonesia’s approach from a realpolitik perspective to show why Indonesia has avoided R2P measures. The paper identifies three factors that shaped Indonesia’s approach: Islamic humanitarianism, Indonesia’s own experience of managing civil–military relations during a contested democratic transition, and its continued commitment to core asean principles. The paper also contributes to wider debates by identifying some of the limitations of R2P, especially in terms of how R2P can be sidelined by national and regional diplomatic priorities, in this case manifested in the quiet diplomacy approach.
Pedagogies of Turkish Mosque Education in the Netherlands
Authors: Sözeri Semiha , Altinyelken H.K. , Volman M.L.L.
Published: March 2021

This is a study of mosque pedagogies and their relevance for the formation of the moral and political identity of Turkish-Dutch youth. Based on fieldwork in two mosques affiliated with Milli Görüş and Diyanet in the Netherlands, the study identifies three different pedagogies practiced in the mosque classrooms: pedagogy of national identity building, unorthodox pedagogies of bonding, and pedagogies of moral formation. The findings show that teaching activities in both mosques contain messages pertaining to citizenship norms and values in areas such as interaction between different genders, ideas of crime, justice and punishment, relationship to authority and boundaries of individual autonomy. Apart from auxiliary use of Dutch and copying Dutch schools’ motivation and discipline strategies, we did not find specific Dutch aspects of the education that was provided. The intention to create a pious and nationalist diaspora youth was a common denominator for the pedagogies of both mosques.
IPR Regime and Antitrust Implications of Mergers and Acquisitions: With a Focus on Software and Pharmaceutical Sector
Authors: Beena P. L.
Published: March 2021

This article seeks to analyze the trends and patterns of mergers and acquisitions (M&As) during the Trade-Related Intellectual Property Rights regime and addresses the antitrust issues related to innovation and competition in the framework of competition policy. Empirical evidence supports the view that enhancing size in terms of corporate control of equity, product market share, and innovation market share could be the motivations for the M&A phenomenon in the sector such as software and pharmaceuticals. These sectors were able to extract relatively more profit margin as compared to the manufacturing sector. This article further observes anticompetitive practices in terms of pricing and abuse of dominance in these two industries. The study argues for introducing regulatory mechanisms in the competition policy which could address the antitrust implications of M&As that are engaged in by knowledge-based firms and start-ups. This is because such acquisitions can reduce the incentives to innovate or change the innovative and competitive dynamics in the relevant market.
Probing Heterogeneity in Attenuated Total Reflection Surface-Enhanced Infrared Absorption Spectroscopy (ATR-SEIRAS) Response with Synchrotron Infrared Microspectroscopy
Authors: Tu Kaiyang , Morhart Tyler A. , Read Stuart T. , Rosendahl Scott M. , Burgess Ian J.
Published: March 2021

The heterogeneity of metal island films electrodeposited on conductive metal oxide modified internal reflection elements is shown to provide a variable attenuated total reflection surface-enhanced infrared absorption spectroscopy (ATR-SEIRAS) response. A self-assembled monolayer of a ferrocene-terminated thiol monolayer (FcC11SH) was formed on the gold islands covering a single substrate, which was measured using both a conventional spectrometer and a custom-built horizontal microscope. Cyclic voltammetry and ATR-SEIRAS results reveal that the FcC11SH-modified substrate undergoes a reversible electron transfer and an associated re-orientation of both the ferrocene/ferrocenium headgroup and the hydrocarbon backbone. The magnitude of the absorption signal arising from the redox changes in the monolayer, as well as the IR signature arising from the ingress/egress of the perchlorate counterions, is shown to depend significantly on the size of the infrared beam spot when using a conventional Fourier transform infrared spectrometer. By performing equivalent measurements on a horizontal microscope, the primary cause of the differences in the signal level is found to be the heterogeneity in the density of gold islands on the conductive metal oxide.
What is the People’s Republic of China to Canada? Towards a rethinking of bilateral relations
Authors: Woo Yuen Pau
Published: March 2021

Relations with the People’s Republic of China (PRC) will be the single biggest Canadian foreign policy challenge for the foreseeable future. The trajectory of bilateral relations will be shaped, above all, by US–PRC strategic competition. Canadian views on the PRC are defined by a litany of problems in the current relationship, with relatively little reflection on the broader and longer-term problématique. This article, adapted from a November 2020 speech to the Canada–China Friendship Society of Ottawa, proposes a reconceptualization of the PRC as Canada's “global neighbour.” On virtually all the issues that matter to Canada, the PRC is in our neighbourhood, and we are in the PRC’s, whether we like it or not. The article offers five principles for the conduct of relations with Beijing—emphasizing the importance of independence in Canadian foreign policy in the context of a Sino–US great power conflict that is likely to persist for decades.
Relationship Between Social Media Use and Students’ Cyberbullying Behaviors in a West Malaysian Pubic University
Authors: Adebayo David Obafemi , Ninggal Mohd Tajudin
Published: March 2021

Social media is widely used by university students in modern times, although, serious psychological damage is caused to users through cyberbullying activities. This study examined the relationship between social media use and students’ cyberbullying behaviors in a west Malaysian public university. Correlational survey was adopted, while 400 undergraduates purposively selected from three faculties participated in the study. Questionnaire entitled “Engagement on Social Media Use (ESMU)” was used for data collection. Two hypotheses were tested using SEM-PLS3. Results indicated that social media use and gender significantly related to cyberbullying behaviors. Counseling is recommended to assist in stemming cyberbullying behaviors among undergraduates.
A Catholic Perspective: Triage Principles and Moral Distress in Pandemic Scarcity
Authors: Kenny Nuala , Kotalik Jaro , Herx Leonie , Coelho Ramona , Leiva Rene
Published: March 2021

Striving to be faithful to the moral core of medicine and to spiritual, moral, and social teaching of the church, Catholic physicians see their role as an extension of the healing ministry of Jesus. When faced with a situation in which a large number of gravely ill people are seeking care, but optimal treatment such as ventilation in intensive care unit cannot be offered to all because of scarcity of resources, Catholic physicians recognize the need to consider the common good and to assign a priority to patients for whom such treatments would be most probably lifesaving. Making these evaluations, physicians will use only objective medical criteria regarding the benefits and risks to patients and will be mindful that all persons deserve equal respect for their dignity. Discrimination or prejudicial treatment against patients based on factors such as age, disability, race, gender, quality of life, and possible long-term survival cannot be morally justified. Triage process should incorporate respect for autonomy of both the patient and the professional and opportunity for an appeal of a triage decision. Other principles and values that will affect how a triage protocol is developed and applied are proportionality, equity, reciprocity, solidarity, subsidiarity, and transparency. The current coronavirus pandemic can provide valuable lessons and stimulus for reforms and renewal.

Catholic physicians strive to continue the healing ministry of Jesus Christ and be faithful to the moral core of medicine. In situations such as pandemic, the scarcity of personnel and technological resources create serious challenges and even moral distress. Church teachings on dignity, the common good and protection of the vulnerable help guide decisions based on public medical criteria and shared decision-making.
Life Skills Development Through Sport in Brazil: A Study Based on Self-Determination Theory
Authors: Nascimento Junior José Roberto Andrade do , Freire Gabriel Lucas Morais , Quinaud Ricardo T. , Oliveira Daniel Vicentini de , Cronin Lorcan Donal
Published: March 2021

This study investigated whether a large sample of youth participants’ life skills development through sport was impacted by demographic variables and/or variables based on self-determination theory. Participants were 461 Brazilian youth sport (325 boys; 136 girls) aged 10–17 years ( Mage = 15.12, SD = 1.44). Participants completed a self-report research survey to assess demographic variables, coach autonomy support, basic need satisfaction, and sport motivation. We analyzed data using cluster analysis, a chi-square test and multivariate analysis of variance. We found that sport participants in the high life skills development cluster were older ( p = .007) and had more years of sport experience ( p = .032). Compared to the low life skills development cluster, sports participants in the high life skills development cluster displayed higher scores for coach’s autonomy support ( p = .001), autonomy satisfaction ( p = .002), competence satisfaction ( p = .001), relatedness satisfaction ( p = .001), and identified regulation ( p = .023). In practice, these findings indicate that coaches should seek to satisfy participants’ three basic psychological needs and encourage an identified regulation form of motivation when trying to promote participants’ life skills development through sport.
The Value of Community Health Literacy Assessments: Health Literacy in Maryland
Authors: Platter Heather , Kaplow Katya , Baur Cynthia
Published: March 2021

Objective

Community health assessments have typically not measured health literacy at the community level. We developed the Community Health Literacy Assessment (CHLA) framework to describe county and regional health literacy activities, assets, gaps, and opportunities in Maryland.

Methods

We implemented the CHLA framework in Maryland from January to August 2018. We conducted an environmental scan of Maryland’s 24 counties to identify community resources, health indicators, and organizations. We targeted local health improvement coalitions and health departments for interviews in each county. We conducted qualitative interviews to understand what key community organizations throughout Maryland are doing to implement health literacy best practices and policies. We used summative content analysis to review, quantify, and interpret interview data.

Results

We conducted 57 interviews with participants from 56 organizations representing all 24 counties in Maryland. We captured data on multiple dimensions of health literacy and identified 3 main themes: health literacy assets and activities, health literacy gaps, and health literacy opportunities. The most cited asset was collecting data to inform health literacy practices, the most cited gap was using jargon with community members, and the most cited opportunity was increasing public awareness of existing health programs through improved outreach and teaching health information–seeking behaviors.

Conclusion

A systematic community health literacy assessment is a feasible way to collect a large amount of health literacy data, which can inform strategic planning, determine community interventions, and ultimately lead us toward a health-literate society. We recommend that others replicate the CHLA framework to operationalize health literacy as a health indicator and include it as a community health assessment measure.
Comparative Methodologic and Practical Considerations for Life Expectancy as a Public Health Mortality Measure
Authors: Roubal Anne M. , Pollock Elizabeth A. , Gennuso Keith P. , Blomme Courtney K. , Givens Marjory L.
Published: March 2021

Introduction

Life expectancy is a public health metric used to assess mortality. We describe life expectancy calculations for US counties and present methodologic considerations compared with years of potential life lost before age 75 (YPLL-75) and premature age-adjusted mortality (PAAM), 2 commonly used length-of-life metrics.

Methods

We used death data from the National Center for Health Statistics for 2015-2017 and other health measures from the 2019 County Health Rankings & Roadmaps. We calculated life expectancy from birth at the county level using an abridged life table and the Chiang method of variance. Studentized residuals identified counties with discordant life expectancy and YPLL-75 or PAAM values. Correlations tested associations of life expectancy with key health measures (eg, smoking, child poverty, uninsured).

Results

Among 3073 US counties, life expectancy ranged from 62.4 to 98.0 years, with a mean of 77.4 years. Life expectancy was strongly and negatively correlated with YPLL-75 ( r = −0.91) and PAAM ( r = −0.95) at the county level. Life expectancy was also associated with other key health metrics, such as smoking, employment, and education rates, where an improvement in the health factor indicated improvement in the respective length-of-life measure. Counties with discordant life expectancy and YPLL-75 or PAAM values had differing age structures.

Practice Implications

Commonly used length-of-life metrics in population health settings are differentiated by methodological matters, such as computation complexity, data availability, and differential risk among age groups, especially among the very old or very young. The choice of metric should consider these factors, in addition to practical concerns, such as the communication needs of the audience.
Maximizing Learning Management Systems to Support Mathematical Problem Solving in Online Learning
Authors: Zhang Ling , Jackson Haidee A. , Hunt Tiffany L. , Carter Richard Allen , Yang Sohyun , Emerling Christopher R.
Published: March 2021

Mathematical problem solving is a complex cognitive activity, which poses difficulties for students with and without disabilities in inclusive learning environments. With a variety of functions, Learning Management Systems (LMSs) have the potential to enhance personalized learning to meet the diverse needs of all students. This paper provides teachers guidance on using LMSs to implement evidence-based practices for math problem solving in an online learning environment. This paper introduced multiple functions commonly available in most LMSs, such as quiz, multimedia content editor, Learning Tools Interoperability (LTI), and learning analytics. Guidance is provided to teachers to leverage these features to maximize student learning experiences, such as engaging in multimedia learning activities, interacting with the teacher and peers, and receiving tailored feedback.
Empathic Communication Skills Across Applied Undergraduate Psychology Courses: A Replication Study
Authors: Reich Catherine M. , LaCaille Lara J. , Axford Katherine E. , Slaughter Natalina R.
Published: March 2021

Background:

Although undergraduate psychology curriculum should cultivate performance-based skills to prepare students for helping professions, little work to date has addressed this standard.

Objective:

This research replicates the methods used in a previous study by examining pre-post changes in empathic communication skills and perceived communication competence across two applied psychology courses: Basic Helping Skills and Internship. This study extended this work by also exploring learning gains from different formats (i.e., face-to-face vs. online), internship types (mental health-related vs. not mental health-related), and the longevity of learning gains.

Method:

Psychology students ( N = 171) completed a measure of communication competence and provided written empathic responses on a vignette-based performance measure at the start and end of the semester.

Results:

Students perceived their communication skills as improving over time; however, only students in the Basic Helping Skills course showed improved empathic communication skills, especially when the instruction was in a face-to-face format. Students with previous skill training maintained their learning gains over time.

Conclusion:

Student empathic communication improves most with face-to-face instruction in Basic Helping Skills rather than an internship experience.

Teaching Implications:

For the development of empathic communication skills, prerequisite requirements for Internship and instructive scaffolding for the application of skills may be recommended.
The continuum of election violence: Gendered candidate experiences in the Maldives
Authors: Bjarnegård Elin
Published: March 2021

Research on election violence often does not capture its psychological and gendered dimensions. Gender differences on the continuum of violence, as acknowledged in other fields, are applied here to election violence. Specifically, this article explores ways to unveil the forms of election violence that are hidden from the view of an external observer because they are either not carried out in public or not recognized as violence. Survey data and interview material was collected from men and women political candidates participating in the 2014 national elections in the Maldives. The study concludes that the continuum of violence is relevant for adequately assessing the full range of illegitimate acts used against men and women candidates to affect electoral races. Women candidates in the Maldives were more exposed than men candidates to threats and to verbal and figurative sexualized aggression.
Brexit and the union: Territorial voice, exit and re-entry strategies in Scotland and Northern Ireland after EU exit
Authors: McEwen Nicola , Murphy Mary C
Published: March 2021

This article examines the effects of Brexit on the internal boundaries and territorial future of the United Kingdom (UK). Divergent Brexit preferences, coupled with the process of negotiating and preparing for Brexit, have raised new questions about the ability of the UK to remain united. Focusing upon Scotland and Northern Ireland, where territorial challenges are most acute, the article draws upon and adapts Hirschman’s voice, exit and loyalty framework to examine the strategic choices and options faced by institutional actors in each case when determining constitutional and political options in response to Brexit. The article contends that, while credible exit threats were used to bolster voice in the Brexit negotiations, the Brexit vote and subsequent process have exposed the limitations of territorial voice, and unleashed new exit dynamics. We enhance the framework by exploring the concept of re-entry, exploring the contrasting paths these territories would face to re-enter the European Union (EU).
Political institutions, state capacity, and crisis management: A comparison of China and South Korea
Authors: Mao Yexin
Published: March 2021

How do political institutions influence crisis management? By comparing responses to COVID-19 in China and South Korea, this article argues that different political institutions affect countries’ responses to crises by shaping state capacity. First, the article proposes a state capacity-driven crisis management framework including four types of capacity: information capacity, decision-making and implementation capacity, coercive capacity, and mobilization and cooperation capacity. Second, the article contributes to the literature by making linkages between different forms of state capacity and regime type. Combinations of state capacity are different in democracies and authoritarian regimes because state capacities are shaped by two different institutional arrangements: central–local government relations and state–society relations. Additionally, the article finds that the impacts of political institutions on crisis management through different state capacities are contingent on scenarios such as the different stages of a crisis.
Mapping the drivers of negative campaigning: Insights from a candidate survey
Authors: Maier Jürgen , Nai Alessandro
Published: March 2021

Which candidates are more likely to go negative, and under which conditions? We analyze self-reported survey data from candidates having run in the 2017 German federal election for the main parties. More specifically, we test a comprehensive set of factors supposed to drive the use of (a) negative campaigning in general, (b) policy attacks, and (c) character attacks. Our results show that for all three versions of negative campaigning the political profile of candidates is most important, followed by personality traits, perceived campaign dynamics, social profile, and available campaign resources. Within these categories, five factors are important across the board: members of the governing parties are less likely to attack, ‘extreme ideology’ of the candidate fuels the use of attack politics, candidates who believe that the media can persuade voters attack more often, disagreeable candidates tend to go negative, and male candidates are more likely to attack than females.
Work–Family Conflicts among Female Staff of Higher Institutions in Nigeria
Authors: Ademuyiwa J. A. , Dahunsi T. N. , Adetunji A. A. , Adeniran A. O.
Published: March 2021

Striking balance and maintaining harmony between work and family have always been a great challenge for women in general. This article examines factors that conflict between official responsibilities and family demand among female staff of higher institution of learning in Nigeria. A structured questionnaire is administered to female staff of higher institutions across the country. Hierarchical sampling technique is used to select female staff from each institution. Simple percentage and bar charts are used to present the socio-demographic characteristics of respondents. The mean responses for each factor are ranked and the first four ranked factors are discussed. Stress, mental fatigue, and psychological burnout/disorder are the major effects observed, while resuming and closing work at convenience is the major mechanism being used by women in tertiary institutions. Other highly ranked mechanisms are using a housekeeper/help, using a childcare center closer to workplace, and using help from colleagues in carrying out official assignments.
Impact of the 2020 pandemic of COVID-19 on Families with School-aged Children in the United States: Roles of Income Level and Race
Authors: Chen Cliff Yung-Chi , Byrne Elena , Vélez Tanya
Published: March 2021

This study examined the experiences of families with school-aged children during the first three months of the 2020 pandemic of COVID-19 in the United States, while focusing on the roles of income level and race/ethnicity in their experiences. Two hundred and twenty-three parents of school-aged children participated in this study by completing an online survey. The results revealed that low-income and lower-middle class parents, as well as parents of color, experienced more instrumental and financial hardships due to the pandemic, when compared to their higher income, White counterparts. In contrast, parents with higher income and White parents were more likely to feel stressed over structuring home learning environments and planning educational and physical activities at home for their children. The overall findings suggest that family income level and race/ethnicity play a significant role in the lives of families coping with a variety of challenges due to the pandemic.
Thoracoplasty: Still relevant to current practice
Authors: Phillip Rebecca , Bettis Amber , Davenport Daniel , Saha Sibu
Published: March 2021

Background

Management of residual pleural space remains a challenge in the practice of thoracic surgery. Options include thoracotomy with muscle flap/wound vac, Eloesser procedure, or thoracoplasty. We examine current practice and short-term outcomes of thoracoplasty in the American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP).

Methods

A retrospective review of thoracoplasty procedures (by CPT® code 32900, 32905, or 32906) in the ACS NSQIP database from the years 2012 to 2017 was performed. The ACS NSQIP prospectively collects perioperative and rigorous 30-day outcome data for patients undergoing major thoracic surgical nationally.

Results

The dataset contained 131 thoracoplasties in patients with an average age of 48 years (SD 19), average BMI of 26 kg/m2 (SD 5), 48% female, and 21% of minority race. Forty percent of patients were ASA class III and 10% class IV–V. Five percent of the patients had muscle flap in addition to thoracoplasty. Median operative duration was 101 min (interquartile range 61–167) and 8% of patients required blood transfusion. The average length of hospital stay was 6 days (SD 9), and 93% of patients were discharged home. There was one death, and 23% experienced other major morbidity. Thirty-day readmission occurred in 8% of patients and 6% returned to the operating room within 30 days. Four percent of patients experienced respiratory failure, 4% sepsis, and 5% developed pneumonia.

Conclusions

Short-term outcomes of current thoracoplasty demonstrate low mortality and morbidity. Thoracoplasty should remain in our armamentarium for managing residual pleural space.
‘Somebody stuck me in a bag of sand’: Lived experiences of the altered and uncomfortable body after stroke
Authors: Stott Hannah , Cramp Mary , McClean Stuart , Turton Ailie
Published: March 2021

Objective:

This study explored stroke survivors’ experiences of altered body perception, whether these perceptions cause discomfort, and the need for clinical interventions to improve comfort.

Design:

A qualitative phenomenological study.

Setting:

Participants’ homes.

Participants:

A purposive sample of 16 stroke survivors were recruited from community support groups. Participants (median: age 59; time post stroke >2 years), were at least six-months post-stroke, experiencing motor or sensory impairments and able to communicate verbally.

Interventions:

Semi-structured, face-to-face interviews were analysed using an interpretive phenomenological approach and presented thematically.

Results:

Four themes or experiences were identified: Participants described (1) a body that did not exist; (2) a body hindered by strange sensations and distorted perceptions; (3) an uncontrollable body; and (4) a body isolated from social and clinical support. Discomfort was apparent in a physical and psychological sense and body experiences were difficult to comprehend and communicate to healthcare staff. Participants wished for interventions to improve their comfort but were doubtful that such treatments existed.

Conclusion:

Indications are that altered body perceptions cause multifaceted physical and psychosocial discomfort for stroke survivors. Discussions with patients about their personal perceptions and experiences of the body may facilitate better understanding and management to improve comfort after stroke.
Effects of tube voltage and iodine contrast medium on radiation dose of whole-body CT
Authors: Yoshida Morikatsu , Nakaura Takeshi , Oda Seitaro , Kidoh Masafumi , Nagayama Yasunori , Uetani Hiroyuki , Azuma M , Sakabe Daisuke , Hirai Toshinori , Funama Yoshinori
Published: March 2021

Background

The low-tube-voltage scan generally needs a higher tube current than the conventional 120 kVp to maintain the image noise. In addition, the low-tube-voltage scan increases the photoelectric effect, which increases the radiation absorption in organs.

Purpose

To compare the organ radiation dose caused by iodine contrast medium between low tube voltage with low contrast medium and that of conventional 120-kVp protocol with standard contrast medium.

Material and Methods

After the propensity-matching analysis, 66 patients were enrolled including 33 patients with 120 kVp and 600 mgI/kg and 33 patients with 80 kVp and 300 mgI/kg (50% iodine reduction). The pre- and post-contrast phases were assessed in all patients. The Monte Carlo simulation tool was used to simulate the radiation dose. The computed tomography (CT) numbers for 10 organs and the organ doses were measured. The organ doses were normalized by the volume CT dose index, and the 120-kVp protocol was compared with the 80-kVp protocol.

Results

On contrast-enhanced CT, there were no significant differences in the mean CT numbers of the organs between 80-kVp and 120-kVp protocols except for the pancreas, kidneys, and small intestine. The normalized organ doses at 80 kVp were significantly lower than those of 120 kVp in all organs (e.g. liver, 1.6 vs. 1.9; pancreas, 1.5 vs. 1.8; spleen, 1.7 vs. 2.0) on contrast-enhanced CT.

Conclusion

The low tube voltage with low-contrast-medium protocol significantly reduces organ doses at the same volume CT dose index setting compared with conventional 120-kVp protocol with standard contrast medium on contrast-enhanced CT.
An Emphasis on Engineering Controls and Administrative Controls in the Prevention and Control of COVID-19 in an Orthodontic Setting: Thinking Beyond Tomorrow
Authors: Prakash R , Digumarthi Uday K
Published: March 2021

Introduction: Most of the initial focus in handling COVID-19 had been based on avoiding exposure by refraining from rendering most treatments other than those considered an emergency or urgent. Post-lockdown, with the resumption of most activities, there has been concern over the possibility of transmission scenarios if sufficient care is not taken. The control and prevention of the spread of infections when elimination of exposure is not possible is chiefly achieved through the judicious use of engineering controls and administrative controls in a clinical setting in addition to the standard protocols and transmission-based protocols. True safety lies in being one step ahead. There have been mentions of the possibility that COVID-19 could be opportunistic airborne in its spread, in addition to being spread via saliva, droplets, and contaminated surfaces or objects.

Method: A literature search of PubMed, Google Scholar, Cochrane Library, and advisories released by such organizations as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Ministry of Health and Family Welfare (MOFHW), European Centre for Disease Prevention and Control (ECDC), Chinese Center for Disease Control and Prevention (China CDC), American Dental Association (ADA), Canadian Dental Association (CDA), French National Dentists Association, Dental Council of Belgium, National Health Service, England (NHS UK), National Health Service Scotland (NHS Scotland), and International Society for Infectious Diseases (ISID) was performed, with search parameters aimed at gathering information pertaining to infection control and cross infection control in dental settings as related to orthodontics.

Result: There have been numerous articles and advisories published over the last 20 years, but the main focus has been on safe practices and to an extent on personal protective equipment, with relatively less emphasis on the need for respiratory protection by way of engineering controls and administrative controls. This review highlights the engineering and administrative controls that can be put into effect to make infection control and prevention much more effective.

Conclusion: Any health care facility must be able to prevent, contain, and control infections with no risk of nosocomial infections. For this, an assumption has to be made that every individual in a health care setting is either at risk or a risk, depending on whether the person is infected or not. Meticulous attention to stringent policies of hygiene and infection control and prevention, coupled with suitable supporting engineering and administrative controls, is to be made a standard way of life in such facilities.
Biocompatible chicken bone extracted dahllite/hydroxyapatite/collagen filler based polysulfone membrane for dialysis
Authors: Zaman Shafiq Uz , Zaman Muhammad Khaliq U , Irfan Muhammad , Rafiq Sikander , Irfan Masooma , Muhammad Nawshad , Saif-ur-Rehman  , Wajeeh Salman , Naz Gul
Published: March 2021

In the current study, dahllite/hydroxyapatite/collagen filler extracted via calcination of wasted chicken bone was blended with PSf polymer to obtain highly biocompatible, and antifoulant hemodialysis membranes. FTIR and Raman spectroscopic analysis was done to obtain information about the bonding chemistry of the obtained filler. The intermolecular interaction that existed between dahllite/hydroxyapatite/collagen filler and pristine PSf was confirmed by Raman spectroscopic study. The PSf polymer exhibited a sponge-like structure owing to its high thickness and slow exchange with non-solvent in coagulation bath whilst the instantaneous de-mixing course produced finger-like capillaries in dahllite/hydroxyapatite/collagen filler based PSf membranes as exposed by SEM photographs. The presence of different wt. % of filler composition in the PSf matrix improved the mechanical strength as revealed by fatigue analysis. The hydrophilic character improved by 78% while leaching consistency adjusted to 0%–4%. Pure water permeation (PWP) flux improved by nine times. The pore profile improved with the addition of filler as revealed by hydrophilicity experiment, PWP flux, and SEM micrographs. Fouling evaluation results disclosed that filler based membranes showed 36% less adsorption of protein (BSA) solution together with more than 84% flux recovery ratio. The biocompatibility valuation analysis unveiled that membranes composed of filler showed extended prothrombin and thrombin coagulation times, reduced activation of fibrinogen mass, and less adhesion of plasma proteins in comparison with pristine PSf membrane. The adsorption capacity of fabricated membranes for urea and creatinine improved by 31% (in the case of urea) and 34% (in the case of creatinine) in contrast with pristine PSf membrane. The overall results showed that the M-3 membrane was optimized in terms of surface properties, protein adhesion, anticoagulation activity, and adsorption amount of urea and creatinine.
Effects of severe hydronephrosis on the outcomes of percutaneous nephrolithotomy with one-shot dilation method
Authors: Micoogullari Uygar , Yucel Cem , Sueluzgen Tufan , Kisa Erdem , Keskin Mehmet Zeynel , Isoglu Cemal Selcuk , Ilbey Yusuf Ozlem
Published: March 2021

Objective:

To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique.

Materials and methods:

Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate.

Results:

There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant ( p = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant ( p < 0.001).

Conclusion:

Only the presence of severe hydronephrosis was found to be associated with the change in hemoglobin and postoperative blood transfusion.
The equivalent method of double V-wing honeycombs on the in-plane dynamic impact
Authors: Qu Yunfei , Wang Dian , Zhang Hongye
Published: March 2021

The double V-wing honeycomb can be applied in many fields because of its lower mass and higher performance. In this study, the volume, in-plane elastic modulus and unit cell area of the double V-wing honeycomb were analytically derived, which became parts of the theoretical basis of the novel equivalent method. Based on mass, plateau load, in-plane elastic modulus, compression strain and energy absorption of the double V-wing honeycomb, a novel equivalent method mapping relationship between the thickness–width ratio and the basic parameters was established. The various size factor of the equivalent honeycomb model was denoted as n and constructed by the explicit finite element analysis method. The mechanical properties and energy absorption performance for equivalent honeycombs were investigated and compared with hexagonal honeycombs under dynamic impact. Numerical results showed a well coincidence for each honeycomb under dynamic impact before 0.009 s. Honeycombs with the same thickness–width ratio had similar mechanical properties and energy absorption characteristics. The equivalent method was verified by theoretical analysis, finite element analysis and experimental testing. Equivalent honeycombs exceeded the initial honeycomb in performance efficiency. Improvement of performance and weight loss reached 173.9% and 13.3% to the initial honeycomb. The double V-wing honeycomb possessed stronger impact resistance and better load-bearing capacity than the hexagonal honeycomb under impact in this study. The equivalent method could be applied to select the optimum honeycomb based on requirements and improve the efficiency of the double V-wing honeycomb.
Systematic Analysis of Extracting Data on Advance Directives from Patient Electronic Health Records (EHR) in Terminal Oncology Patients
Authors: Starr Jason S. , Skelton William Paul , Rahmanian Kiarash P. , Guenther Robert , Allen William L. , George Thomas J. , Moseley Ray E.
Published: March 2021

Background:

Advance directives are legal documents that include living wills and durable health care power of attorney documents. They are critical components of care for seriously ill patients which are designed to be implemented when a patient is terminally ill and incapacitated. We sought to evaluate potential reasons for why advance directives were not appropriately implemented, by reviewing the electronic health record (EHR) in patients with terminal cancer.

Methods:

A retrospective analysis of the EHR of 500 cancer patients from 1/1/2013 to 12/31/2016 was performed. Data points were manually collected and entered in a central database.

Results:

Of the 500 patients, 160 (32%) had an advance directive (AD). The most common clinical terminology used by physicians indicating a terminal diagnosis was progressive (36.6%) and palliative (31%). The most common clinical terminology indicating incapacity was altered mental status (25.6%), and not oriented (14%). 34 (6.8%) patients met all criteria of having a terminal diagnosis, a documented AD, and were deemed incapacitated. Of these patients who met all of these data points, their ADs were implemented on average 1.7 days (SD: 4.4 days) after which they should have been. This resulted in a total of 58 days of additional care provided.

Discussion:

This study provided insight on to how ADs are managed in day to day practice in the hospital. From our analysis it appears that physicians are able to identify when a patient is terminal, however, it is typically later than it should have been recognized. Further studies should be performed focusing on harnessing the power of the EHR and providing physicians formative and evaluative feedback of practice patterns to ensure that ADs are honored when appropriate.
Emulsion-free chitosan–genipin microgels for growth plate cartilage regeneration
Authors: Erickson Christopher , Stager Michael , Riederer Michael , Payne Karin A , Krebs Melissa
Published: March 2021

The growth plate is a cartilage tissue near the ends of children’s long bones and is responsible for bone growth. Injury to the growth plate can result in the formation of a ‘bony bar’ which can span the growth plate and result in bone growth abnormalities in children. Biomaterials such as chitosan microgels could be a potential treatment for growth plate injuries due to their chondrogenic properties, which can be enhanced through loading with biologics. They are commonly fabricated via an emulsion method, which involves solvent rinses that are cytotoxic. Here, we present a high throughput, non-cytotoxic, non-emulsion-based method to fabricate chitosan–genipin microgels. Chitosan was crosslinked with genipin to form a hydrogel network, and then pressed through a syringe filter using mesh with various pore sizes to produce a range of microgel particle sizes. The microgels were then loaded with chemokines and growth factors and their release was studied in vitro. To assess the applicability of the microgels for growth plate cartilage regeneration, they were injected into a rat growth plate injury. They led to increased cartilage repair tissue and were fully degraded by 28 days in vivo. This work demonstrates that chitosan microgels can be fabricated without solvent rinses and demonstrates their potential for the treatment of growth plate injuries.
The Gendered Consequences of a Weak Infrastructure of Care: School Reopening Plans and Parents’ Employment During the COVID-19 Pandemic
Authors: Collins Caitlyn , Ruppanner Leah , Christin Landivar Liana , Scarborough William J.
Published: March 2021

The COVID-19 pandemic has upended in-person public education across the United States, a critical infrastructure of care that parents—especially mothers—depend on to work. To understand the nature and magnitude of school closures across states, we collected detailed primary data—the Elementary School Operating Status database (ESOS)—to measure the percentage of school districts offering in-person, remote, and hybrid instruction models for elementary schools by state in September 2020. We link these data to the Current Population Survey to evaluate the association between school reopening and parents’ labor force participation rates, comparing 2020 labor force participation rates to those observed prepandemic in 2019. We find that, across states, the maternal labor force participation rate fell to a greater extent than that of fathers. In 2019, mothers’ rate of labor force participation was about 18 percentage points lower than fathers’. By 2020, this gap grew by 5 percentage points in states where schools offered primarily remote instruction. We show that schools are a vital source of care for young children, and that without in-person instruction, mothers have been sidelined from the labor force. The longer these conditions remain in place, the more difficult it may be for mothers to fully recover from prolonged spells of nonemployment, resulting in reduced occupational opportunities and lifetime earnings.
Legal Evaluation for Security Exception Claims About the Cross-Border Transfer of the Korean Map: A Case of Google
Authors: Um Dan-Bi
Published: March 2021

Google, a U.S. company, has made repeated requests for the cross-border transfer of the Korean map. The requests have been rejected by the South Korean government, citing security concerns for satellite imagery. This article examined the legality of this rejection based on the Security Regulations on National Spatial Information of South Korea. The legal evaluation showed that the Korean government does not have the legal authority to regulate the online provision of satellite imageries by U.S. companies. Strict regulations of satellite imagery services, which are not specified in the current domestic law, create uncertainties for domestic and foreign companies providing online mapping services. This article offered legal insights on how to fundamentally address the deep-rooted stumbling block raised in the 2020 U.S. Trade Barrier Report concerning the cross-border transfer of the Korean map.