bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the Coronavirus (COVID-19) Pandemic on the Care of Pediatric Acute Appendicitis
Authors: Head William T. , Parrado Raphael H. , Cina Robert A.
Published: December 2021

Background

Appendicitis is the most common abdominal surgical emergency in children. With the rise of the Coronavirus-19 pandemic, quarantine measures have been enforced to limit the viral transmission of this disease. The purpose of this study was to identify differences in the clinical presentation and outcomes of pediatric acute appendicitis during the Coronavirus-19 pandemic.

Methods

A single-institution retrospective assessment of all pediatric patients (<18 years old) with acute appendicitis from December 2019 to June 2020 was performed at a tertiary care children’s hospital. Patients were divided into two groups: (1) the Pre-COVID group presented on or before March 15, 2020, and (2) the COVID group presented after March 15, 2020. Demographic, preoperative, and clinical outcomes data were analyzed.

Results

45 patients were included with a median age of 13 years [IQR 9.9 - 16.2] and 35 males (78%). 28 patients were in the Pre-COVID group (62%) and 17 in the COVID group (38%). There were no differences in demographics or use of diagnostic imaging. The COVID group did have a significantly delayed presentation from symptom onset (36 vs 24 hours, P < .05), higher Pediatric Appendicitis Scores (8 vs 6, P = .003), and longer hospital stays (2.2 vs 1.3 days, P = .04). There were no significant differences for rates of re-admission, re-operation, surgical site infection, perforation, or abscess formation.

Conclusion

During the Coronavirus-19 pandemic, the incidence of pediatric acute appendicitis was approximately 40% lower. These children presented in a delayed fashion with longer hospital stays. No differences were noted for postoperative complications.
Toe Pressure Measurements in Patients Suspected of Critical Limb Ischemia
Authors: Dari Loubna , Barcat Damien , Ally Benjamin , Lagarde David , Boulon Carine , Lacroix Philippe , Constans Joël
Published: December 2021

An objective hemodynamic assessment is mandatory to confirm Critical Limb Ischemia (CLI). Toe pressure measurement is recommended. We compared toe measurements obtained using the Laser Doppler method (LD) (PERIMED PeriFlux, Sweden) considered as the reference test, with those obtained with a portable device using photoplethysmography (PPG) (Sys Toe Atys Medical, France). A total of 93 (123 legs) patients from 3 French hospitals with a clinical suspicion of CLI were included and had measurements with each device carried out by skilled operators. PPG was unable to provide a measurement in 10 patients. Lin’s Coefficient correlation concordance (CCC) and Bland and Altman’s scatter plot were analyzed for the 83 remaining patients, CCC was .84 95%CI (.77–.89). For detection of CLI, Cohen’s kappa was .67 95%CI (.53–.81). The PPG device is fairly reliable for toe pressure measurement in patients suspected of CLI and could be useful when LD is not available. However, it fails to deliver a measurement in approximately 10% of cases. No conclusion should be made about CLI for these patients when no measurement is obtainable and other methods should be used (LD, transcutaneous oxygen pressure) to assess perfusion of the limbs.
A Meta-Analytic Review of the Effect of Socioeconomic Status on Academic Performance
Authors: Selvitopu Abdullah , Kaya Metin
Published: December 2021

The two main purposes of the current meta-analysis were (a) to determine the relation between socioeconomic status (SES) of students and academic performance (AP) (b) and evaluate the effect of several potential moderating factors in this relation. Data covered the publications between 2010 and 2019, and the dataset consisted of 48 independent studies that included 62 different samples, and the total sample was 386.601. Findings revealed that the relation between SES and academic performance represented a moderate positive correlation. All moderators, type of SES measure, academic performance scale, location, grade level, subjects of academic performance, and year, produced significant effects, respectively. These findings were discussed for every category of moderators with the related literature.
Components of Context: Respecifying the Role of Context in Migration Research
Authors: Lara-García Francisco
Published: December 2021

For a century, scholars have studied immigrant integration in a range of destinations. Yet, the precise role of context in shaping integration outcomes remains poorly understood. Drawing from an analysis of an original database of articles and books in migration studies, I argue that this knowledge gap may be due to two closely related tendencies in the scholarship. First, case selection has relied on criteria such as the immigrant population's size and growth rate that are not clearly connected to integration outcomes. Second, most scholars have studied either heavily urban contexts (with large immigrant populations) or very rural contexts (where the immigrant population is growing rapidly), while much less attention has been given to destinations in-between. To improve the understandings of the role of context in immigrant integration, migration scholars should endeavor to move past population criteria when selecting study sites and to study the full range of contexts where immigrants are settling. To contribute to these efforts, I propose a framework that does not rely on population or newness as criteria for case selection and that focuses, instead, on the components of context that existing research has shown matters for intergenerational mobility. I also introduce a typology of contexts based on possible combinations of four of these components and offer some initial hypotheses of how these context types might affect immigrant integration. The arguments presented here recenter the role of local context in migration studies and contribute to debates about where and how scholars should study context moving forward.
Feline hypertrophic cardiomyopathy: reduced microvascular density and involvement of CD34+ interstitial cells
Authors: Rodríguez Josep M. Monné , Fonfara Sonja , Hetzel Udo , Kipar Anja
Published: December 2021

The sequence of pathological events in feline hypertrophic cardiomyopathy (fHCM) is still largely unknown, although we know that fHCM is characterized by interstitial remodeling in a macrophage-driven pro-inflammatory environment and that myocardial ischemia might contribute to its progression. This study aimed to gain further insights into the structural changes associated with interstitial remodeling in fHCM with special focus on the myocardial microvasculature and the phenotype of the interstitial cells. Twenty-eight hearts (16 hearts with fHCM and 12 without cardiac disease) were evaluated in the current study, with immunohistochemistry, RNA-in situ hybridization, and transmission electron microscopy. Morphometrical evaluations revealed a statistically significant lower microvascular density in fHCM. This was associated with structural alterations in capillaries that go along with a widening of the interstitium due to the accumulation of edema fluid, collagen fibers, and mononuclear cells that also proliferated locally. The interstitial cells were mainly of fibroblastic or vascular phenotype, with a substantial contribution of predominantly resident macrophages. A large proportion expressed CD34 mRNA, which suggests a progenitor cell potential. Our results indicate that microvascular alterations are key events in the pathogenesis of fHCM and that myocardial interstitial cell populations with CD34+ phenotype play a role in the pathogenesis of the disease.
Effect of specific melodic scales of Indian music in reducing state and trait anxiety: A randomized clinical trial
Authors: Kunikullaya Ubrangala Kirthana , Kunnavil Radhika , Goturu Jaisri , M Vijayadas , Prakash Vadagenahalli S , Murthy Nandagudi Srinivasa
Published: December 2021

Music is an aesthetic stimulus that evokes a subjective experience in every individual involved with it. Music as a modality to reduce anxiety and stress has been researched scientifically across the world, but evidence regarding Indian musical scales (ragas) is meager. Healthy individuals were randomly divided into four groups where three groups—A ( Ahir Bhairav), B ( Kaunsi Kanada), and C ( Bhimpalas)—received a music intervention (10 min) while Group D was the control group. Anxiety was scored using the State-Trait Anxiety Inventory (STAI) before and after the intervention. Data analysis was done using analysis of covariance (ANCOVA). All three scales reduced STAI scores significantly, with Scale B causing the maximum reduction in the score. After adjusting for the pre-trait scores, it was observed that age ( p = .002) and gender ( p = .018) affected the post-trait scores. A regression analysis on gender showed a significant association of trait scores in Group C ( p = .01; odds ratio [OR] = 0.125). Scales A and C had more beneficial effects in females while Scale B was beneficial among males. Thus, listening to any of the three chosen Indian scales reduced anxiety. Listening to music does have therapeutic implications for anxious and stressed individuals.
Parent-child nonverbal engagement during spoken versus sung book-sharing in preschoolers with and without autism
Authors: Liu Talia , Schultz Benjamin G , Dai Danielle , Liu Christina , Lense Miriam D
Published: December 2021

Providing natural opportunities that scaffold interpersonal engagement is important for supporting social interactions for young children with autism spectrum disorder (ASD). Musical activities are often motivating, familiar, and predictable, and may support both children and their interaction partners by providing opportunities for shared social engagement. We assessed multiple facets of nonverbal social engagement—child and caregiver visual attention and interpersonal movement coordination—during musical (song) and non-musical (picture) book-sharing contexts in caregiver–child dyads of preschoolers with ( n = 13) and without ( n = 16) ASD. Overall, children with ASD demonstrated reduced visual attention during the book sharing activity, as well as reduced movement coordination with their caregivers, compared to children with typical development. Children in both diagnostic groups, as well as caregivers, demonstrated greater visual attention (gaze toward the activity and/or social partner) during song books compared to picture books. Visual attention behavior was correlated between children and caregivers in the ASD group but only in the song book condition. Findings highlight the importance of considering how musical contexts impact the behavior of both partners in the interaction. Musical activities may support social engagement by modulating the behavior of both children and caregivers.
Coastal erosion in sandy beaches along a tectonically active coast: The Chile study case
Authors: Martínez Carolina , Grez Patricio Winckler , Martín Roberto Agredano , Acuña César Esparza , Torres Iván , Contreras-López Manuel
Published: December 2021

Coastal erosion in 45 sandy beaches covering nearly 2000 km along the tectonically active Chilean coast is assessed during the last four decades. The historical analysis is based on the assessment of decadal changes of the shoreline position extracted from topographic surveys, aerial photographs, satellite images and survey maps using the DSAS software. Results show that 80% of the sites presented erosion rates (>−0.2 m/y), 7% beaches accreted (>0.2 m/y) while 13% remained stable. Eroded beaches include headland bay beaches, embayed and pocket beaches. A discussion on the possible causes explaining these results is conducted. While changes in offshore wave climate are spatially smooth within the region, relative mean sea level changes are highly variable and modulated by tectonic activity; the reduction of the sediment supply explains erosion rates in few cases.
An efficient semi-analytical static and free vibration analysis of laminated and sandwich beams based on linear elasticity theory
Authors: Yin Zhao , Gao Hangduo , Lin Gao
Published: December 2021

Based on the two-dimensional (2D) elastic theory without enforcing any beam assumption, an efficient semi-analytical scaled boundary finite element method (SBFEM) is proposed to solve the bending and free vibration responses of composite laminated and sandwich beams under the mechanical load. The scaled center is placed at infinity, which produces the accurate result by discretizing only the longitudinal direction of the beam structure treated as a one-dimensional (1D) discretization problem. A new kind of 1D high-order spectral element shape functions with the advantages of high accuracy and superior convergence is introduced in SBFEM coordinate system to approximate the geometric model and corresponding variables. The principle of weighted residual in conjunction with the Green’s theorem are applied to obtain the SBFEM governing equation of each layer with respect to radial displacement fields. The solution of equation is indicated analytically by a matrix exponential function, which can be accurately solved by using the precise integration technique (PIT). Finally, an effective and simple stiffness matrix is obtained. By comparing two examples with the solutions based on the finite element method (FEM), the results show that the proposed method has good accuracy and rapid convergence with only a few meshes. The numerical examples are given to investigate the parametric effects of the stacking sequence, thickness ratio, boundary condition, and load form on the variation of the displacement, stress and natural frequency. The results validate that the present technique is also applicable to the complex beam structure with softcore layer inside.
Sexual Dysfunction Among Egyptian Idiopathic Parkinson’s Disease Patients
Authors: Elshamy Ahmed M. , Mohamed Ehab S. , Al-Malt Ayman M. , Ragab Osama A.
Published: December 2021

Background

One of the non-motor features of idiopathic Parkinson’s disease (IPD) is sexual dysfunction (SD) which is under-recognized and, consequently, undertreated. This study aimed to evaluate SD in patients with IPD.

Patients and methods

The study was conducted on 67 IPD patients; 30 healthy subjects with age and gender matching with the patients served as the control group. All participants were subjected to sexual function assessment using the Arabic version of Arizona Sexual Experience Scale (ASEX), Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI), while the severity of IPD was assessed using the modified Hoehn and Yahr scoring scale and MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS).

Results

There were no statistically significant differences between patients with IPD and the control group regarding MMSE, hypertension, diabetes mellitus, or dyslipidemia. However, BDI scores were significantly higher in patients with IPD. The rate of SD among our patients was 64% compared to 30% in the control group. The total score and subscales of ASEX were significantly higher in IPD patients than in controls. SD showed a significant correlation with the severity of the IPD irrespective of other variables, including patient age, sex, disease duration, hypertension, diabetes, dyslipidemia, smoking, and dose of L-dopa.

Conclusion

SD is a commonly underrated feature in patients with IPD; it should be investigated carefully as it is an important non-motor symptom that correlates with disease severity.
Probable Encephalopathy and Spasticity in a Multiple Sclerosis Patient Following Carbapenem Administration: A Case Report and Brief Literature Review
Authors: Klimko Claire V , Sanders James M , Johns Meagan L
Published: December 2021

Purpose: The purpose of this case report is to describe spasticity and encephalopathy that developed in a multiple sclerosis patient following carbapenem administration. Summary: A 55-year-old female with multiple sclerosis developed spasticity and encephalopathy within 24 hours of meropenem and ertapenem administration. This was the second time that she had developed encephalopathy following carbapenem administration. The patient gradually recovered over four days following discontinuation of carbapenem therapy. Conclusion: Carbapenem neurotoxicity, a well-documented adverse effect, has been linked to several risk factors, including central nervous system lesions. Despite this, there is little evidence describing the risk of neurotoxicity in patients with multiple sclerosis. It is important to understand the potential adverse effects of carbapenems in specific patient populations to help guide appropriate treatment of infections.
The Association Between Post-Traumatic Stress and Depressive Symptoms Among Older Puerto Ricans in Boston: How Does Loneliness Matter?
Authors: Wang Kaipeng , Zhang Anao , Cuevas Adolfo G. , De Fries Carson M. , Hinton Ladson , Falcón Luis M.
Published: December 2021

Objectives

To examine the association between post-traumatic stress and depression and whether such an association differs by level of loneliness among older Puerto Ricans.

Methods

Data were collected from 304 Puerto Ricans aged 60 and above living in the Greater Boston area who responded to questionnaires. We used ordinary least squares regression to examine the association between post-traumatic stress, loneliness, and depressive symptoms.

Results

Post-traumatic stress was significantly associated with higher levels of depression. The association between post-traumatic stress and depression was stronger for those experiencing a higher degree of loneliness.

Discussion

In working with older Puerto Ricans experiencing post-traumatic stress, it is important for mental health professionals to incorporate the assessment of loneliness and to prevent and reduce comorbid depression by addressing loneliness through improving social skills, enhancing social support, and reducing maladaptive social cognition.
Intercountry adoption swimming against the tide: Restitution in Samoa
Authors: Fronek Patricia , Rotabi-Casares Karen S , Common Robert
Published: December 2021

Intercountry adoption (ICA) is a contested practice represented by competing discourses of humanitarianism, exploitation, poverty and wealth. Multiple factors have contributed to decreasing numbers of adoption globally including documented incidents of fraud which have accumulated over the last two decades. There is little recompense for families subjected to the fraudulent removal of their children, the children, and adoptive parents who are also defrauded. This article reports on the troubled progression of fraudulent ICA, presents a case of fraud and novel restitution in Samoa and concludes that restitution pathways should also facilitate contact and reunification of children with their families.
Study on formation mechanism of edge defects of high-volume fraction SiCp/Al composites by longitudinal-torsional ultrasonic vibration-assisted milling
Authors: Xiang Daohui , Li Bo , Peng Peicheng , Shi Zhanli , Li Yanqin , Gao Guofu , Zhao Bo
Published: December 2021

SiCp/Al composites are a kind of particle-reinforced composite material, which has been widely used in various fields due to its excellent performance. However, during the machining, the damage and failure of the SiC particles, the aluminum matrix, and the interface phase will cause many surface and edge defects. These defects will seriously affect the application of SiCp/Al composites. In this paper, a finite element model of randomly distributed multi-cell SiCp/Al composites with longitudinal-torsional ultrasonic vibration-assisted milling was established to analyze the formation mechanism of edge defects of the material. The simulation results showed that the main reason for the formation of edge defects was that the interface, SiC particles, and the Al matrix will produce cracks during machining, and these cracks will propagate and cause particle breakage, matrix tearing, and edge gaps. According to different machined parameters, the ultrasonic vibration-assisted milling experiment was carried out. The test results showed that the actual processed workpiece does have defects such as edge gaps. The depth of cut and the feed per tooth had a serious influence on the edge defect value, while the cutting speed had a small effect. Moreover, under the condition of applying appropriate ultrasonic amplitude, the phenomenon of edge defects and the surface quality were significantly improved. Therefore, the application of ultrasonic vibration-assisted milling can improve the surface and edge quality of SiCp/Al composites.
Validation of the automated neuropsychological assessment metrics for assessing cognitive impairment in systemic lupus erythematosus
Authors: Yuen Kimberley , Beaton Dorcas , Bingham Kathleen , Katz Patricia , Su Jiandong , Diaz Martinez Juan Pablo , Tartaglia Maria Carmela , Ruttan Lesley , Wither Joan E. , Kakvan Mahta , Anderson Nicole , Bonilla Dennisse , Choi May Y. , Fritzler Marvin J. , Green Robin , Touma Zahi
Published: December 2021

Objective

We previously demonstrated the utility of the Automated Neuropsychological Assessment Metrics (ANAM) for screening cognitive impairment (CI) in patients with systemic lupus erythematosus (SLE) and developed composite indices for interpreting ANAM results. Our objectives here were to provide further support for the ANAM’s concurrent criterion validity against the American College of Rheumatology neuropsychological battery (ACR-NB), identify the most discriminatory subtests and scores of the ANAM for predicting CI, and provide a new approach to interpret ANAM results using Classification and Regression Tree (CART) analysis.

Methods

300 adult SLE patients completed an adapted ACR-NB and ANAM on the same day. As per objectives, six models were built using combinations of ANAM subtests and scores and submitted to CART analysis. Area under the curve (AUC) was calculated to evaluate the ANAM’s criterion validity compared to the adapted ACR-NB; the most discriminatory ANAM subtests and scores in each model were selected, and performance of models with the highest AUCs were compared to our previous composite indices; decision trees were generated for models with the highest AUCs.

Results

Two models had excellent AUCs of 86 and 89%. Eight most discriminatory ANAM subtests and scores were identified. Both models demonstrated higher AUCs against our previous composite indices. An adapted decision tree was created to simplify the interpretation of ANAM results.

Conclusion

We provide further validity evidence for the ANAM as a valid CI screening tool in SLE. The decision tree improves interpretation of ANAM results, enhancing clinical utility.
Daylong Mobile Audio Recordings Reveal Multitimescale Dynamics in Infants’ Vocal Productions and Auditory Experiences
Authors: Warlaumont Anne S. , Sobowale Kunmi , Fausey Caitlin M.
Published: December 2021

The sounds of human infancy—baby babbling, adult talking, lullaby singing, and more—fluctuate over time. Infant-friendly wearable audio recorders can now capture very large quantities of these sounds throughout infants’ everyday lives at home. Here, we review recent discoveries about how infants’ soundscapes are organized over the course of a day. Analyses designed to detect patterns in infants’ daylong audio at multiple timescales have revealed that everyday vocalizations are clustered hierarchically in time, that vocal explorations are consistent with foraging dynamics, and that some musical tunes occur for much longer cumulative durations than others. This approach focusing on the multiscale distributions of sounds heard and produced by infants is providing new, fundamental insights on human communication development from a complex-systems perspective.
Conflicts, Confrontations and Conduits in Rural Environments: Is Resilience at Work in Gokwe South Rural District?
Authors: Chirisa Innocent , Nel Verna
Published: December 2021

This article explores conflicts, confrontations and conduits for sustainable development in rural environments. Fragility and degradation with a slight resilience manifest heavily in Gokwe South Rural District (GSRD), Zimbabwe. The article notes rural development as a double-edged sword, bringing tremendous opportunities for innovation but also causing increased ecological degradation. As such, it often results in conflicts and confrontations among stakeholders. Like many Zimbabwean rural settlements, GSRD is experiencing serious land disputes. conflicts arise from the proposed changes, like extension of infrastructure, perceived by some stakeholders as contrary to their interests and wishes. Using focus group discussions and thematic analysis, a trend of how conflicts and confrontations emerged was established in GSRD. The findings show that land transition from rural to urban status without consultations instigates conflict between different development agencies and communities.
Bancor Comes of Age: A Case for an Indian Bitcoin Reserve
Authors: Komath Ashwath
Published: December 2021

John Maynard Keynes proposed the concept of ‘Bancor’ in 1940 as a supranational currency that would serve as the international reserve currency. The concept did not take off at the time, despite the underlying need to liberate the international system from the hegemonic tendencies of a national currency serving as a global medium of exchange. The emergence of Bitcoin makes it possible to revive the idea of a de-nationalised global medium of exchange. This article examines the feasibility of such an idea by examining a viable state policy for adoption and use in the international realm.
Stress analysis on the irregular surface of visco-porous piezoelectric half-space subjected to a moving load
Authors: Rakshit Sharmistha , Mistri Kshitish Ch , Das Amrita , Lakshman Anirban
Published: December 2021

Response of moving load over a surface is an intriguing problem of mechanics to determine the stability and strength of a structure. Owing to this the present theoretical framework is devoted to find the stresses and electrical displacements of an irregular visco-porous piezoelectric half-space originated due to a uniformly moving line load. Expressions for normal stress, shear stress and electrical displacements have been derived in closed form. Effect of irregularity depth, irregularity factors and frictional coefficient on the stresses and electrical displacements are delineated graphically. Numerical demonstration of procured results is interpreted by means of graphs for two different materials, namely PZT-5A and PZT-7. A comparative study emphasising various irregularity (parabolic, rectangular and no irregularity) is among the salient features of the study.
Solution-Focused Brief Therapy for Depression Among Adolescents and Young Adults Diagnosed With Cancer: An Open Pilot Trial
Authors: Zhang Anao
Published: December 2021

Purpose

This pilot study evaluates the acceptability and preliminary efficacy of solution-focused brief therapy (SFBT) for depression, anxiety, and hope among adolescent and young adult (AYA) diagnosed with cancer. Method: 10 AYAs with a primary sarcoma diagnosis participated in an open pilot of SFBT for their depression between January and June 2019 delivered by trained social work interns.

Results

All participants completed four planned sessions and reported strong acceptability of SFBT. Statistically significant improvements were observed for pre- and post-treatment scores for depression, anxiety, and levels of hope. These improvements were maintained at 1-month follow up, with significant patterns of difference in study participants’ depression, anxiety, and levels of hope over time.

Conclusions

SFBT is an acceptable intervention approach for depression (and anxiety) among AYAs diagnosed with cancer. SFBT offers a brief, strength-based, and hope-engendering approach to address mental health concerns among young adult diagnosed with cancer.
PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care
Authors: Ritchie Kim , Cramm Heidi , Aiken Alice , Donnelly Catherine , Goldie Catherine
Published: December 2021

Co-occurring posttraumatic stress disorder symptoms and dementia can result in increased symptoms, such as suspicion, aggression, and nightmares in Veterans that can be difficult to manage in long-term care environments. The objective of the study was to explore how the co-occurrence of posttraumatic stress disorder symptoms and dementia are understood in Canadian Veterans who are living in long-term care. A descriptive multiple case study was conducted in two Veteran long-term care facilities in Canada. Data collection consisted of semi-structured interviews with Veterans, their family caregivers, and health care providers, non-participant observation, and a chart audit. Three major themes emerged relating to symptom expression and care approach: a) symptoms are the same but different; b) differences in the complexity of care; and c) added dimensions involved in care. The results of this study contribute foundational information about co-occurring posttraumatic and dementia symptoms that can inform policy, care approaches, and potential interventions.
Understanding the Course of Critical Illness Through a Lifeworld Approach
Authors: Flinterud Stine Irene , Moi Asgjerd L. , Gjengedal Eva , Ellingsen Sidsel
Published: December 2021

An increasing number of individuals receive and survive intensive care treatment; however, several individuals experience problems afterward, which may threaten recovery. Grounded in a lifeworld approach, the aim of this study was to explore and describe what intensive care patients experience as limiting and strengthening throughout their illness trajectories. Ten former intensive care patients were interviewed three to eight months after hospital discharge. Using Giorgi’s phenomenological analysis, a general structure of gaining strength through a caring interaction with others was revealed. The structure consisted of three constituents: feeling safe through a caring presence, being seen and met as a unique person, and being supported to restore capacity. Being met with a humanistic approach and individualized care appeared to be important, and the findings are discussed within the framework of lifeworld-led care. To facilitate improved aftercare of the critically ill, more tailored support throughout the illness trajectory is needed.
The Healthcare Journey of Women With Advanced Gynecological Cancer From Diagnosis Through Terminal Illness: Qualitative Analysis of Progress Note Data
Authors: Dillon Ellis C. , Chopra Vidita , Mesghina Elizabeth , Milki Anthony , Chan Ava , Reddy Ravali , Kapp Daniel S. , Silver Barbara A. , Chan John K.
Published: December 2021

Objective

To examine women’s journeys with gynecologic cancer from before diagnosis through death and identify elements of their healthcare experience that warrant improvement.

Methods

This exploratory study used longitudinal progress notes data from a multispecialty practice in Northern California. The sample included women with stage IV gynecological cancer diagnosed after 2011 and who died before 2018. Available progress notes from prior to diagnosis to death were qualitatively analyzed.

Results

We identified 32 women, (median age 61 years) with mostly uterine (n=17) and ovarian (n=9) cancers and median survival of 9.2 months (min:2.9 and max:47.5). Sixteen (50%) received outpatient palliative care and 18 (56%) received hospice care. The analysis found wide variation in documentation about communication about diagnosis, prognosis, goals of care, stopping treatment, and starting hospice care. Challenges included escalating/severe symptoms, repeated urgent care/emergency department/hospital encounters, and lack of or late access to palliative and hospice care. Notes also illustrated how patient background and goals influenced care trajectory and communication. Documentation styles varied substantially, with palliative care notes more consistently documenting conversations about goals of care and psychosocial needs.

Conclusion

This analysis of longitudinal illness experience of women with advanced gynecological cancer suggests that clinicians may want to (1) prioritize earlier discussion about goals of care; (2) provide supplemental support to patients with higher needs, possibly through palliative care or navigation; and (3) write notes to enhance patient understanding now that patients may access all notes.
Factors Associated With Self-Perception in Oral Health of Pregnant Women
Authors: Corchuelo-Ojeda Jairo , González Pérez Guillermo Julián , Casas-Arcila Alejandro
Published: December 2021

Background

Health perception is a subjective predictor of long-term morbidity and mortality. Few studies address the perception that pregnant women have of their oral health.

Objective

The objective of this study was to explore the relationship between socioeconomic factors and self-assessment of oral health in pregnant women from Cali, Colombia.

Method

A cross-sectional study was carried out with a sample of 998 pregnant women, calculated using the formula to estimate a proportion in finite populations, with a confidence level of 95%. A questionnaire was applied for sociodemographic characterization, as well as to enquire about oral health perception, knowledge, and practices of oral health.

Results

The mean age of the surveyed mothers was 24.7, with a standard deviation of 6.1, of which 23.6% were adolescents. The perception they had about their oral health status was considered good by 60.8%. Of the 82.9% who reported having attended dentistry, more than half perceived good oral health. Pregnant women with no history of oral problems, with a perception of medium or high income, and with good oral hygiene practices tend to have a good perception of their oral health.

Conclusion

Pregnant women with no history of oral problems, with a perception of medium or high income, and with good oral hygiene practices tend to have a good perception of their oral health.
Protein Expression in the Gastrocnemius Muscle of a Rodent Shrapnel-Injury Model
Authors: Hoffman Jessica F. , Vergara Vernieda B. , Kalinich John F.
Published: December 2021

With shrapnel injuries, the metal fragment is usually left in place to reduce the risk of morbidity extensive surgery might bring. This means the individual may retain those metals for the remainder of their life. Often the long-term health effects of the embedded metal are not known, especially with respect to protein damage and perturbations of muscle repair pathways. In this study, using homogenates of rat gastrocnemius muscle implanted with pellets of military-relevant metals, we investigated expression of iNOS and eNOS, enzymes involved in nitric oxide production, as well as MMP-2 and MMP-9, matrix metalloproteinases associated with muscle repair. In addition, hydroxynonenal-modified proteins were investigated to assess metal-induced oxidative damage and metal levels in the gastrocnemius determined. Metals were implanted for up to 12 months in order to determine the long-term effects on the expression of muscle-associated proteins. With the exception of iron and cobalt at 1-month post-implantation, there were no significant differences in metal levels in the gastrocnemius in any of the cohorts. Protein expression analysis showed significant decreases in iNOS and eNOS in the 6-month and 12-month lead and depleted uranium groups. Hydroxynonenal-modified proteins were also significantly increased in the iron, copper, lead, and depleted uranium groups. These results suggest that some embedded metals can induce long-term oxidative damage, as well as affect enzyme systems involved in signal transduction.
Disease-modifying drugs for multiple sclerosis and subsequent health service use
Authors: Ng Huah Shin , Zhu Feng , Kingwell Elaine , Zhao Yinshan , Yao Shenzhen , Ekuma Okechukwu , Svenson Lawrence W , Evans Charity , Fisk John D , Marrie Ruth Ann , Tremlett Helen
Published: December 2021

Objective:

We assessed the relationship between the multiple sclerosis (MS) disease-modifying drugs (DMDs) and healthcare use.

Methods:

Persons with MS (aged ⩾18 years) were identified using linked population-based health administrative data in four Canadian provinces and were followed from the most recent of their first MS/demyelinating event or 1 January 1996 until the earliest of death, emigration, or study end (31 December 2017 or 31 March 2018). Prescription records captured DMD exposure, examined as any DMD, then by generation (first-generation (the injectables) or second-generation (orals/infusions)) and individual DMD. The associations with subsequent all-cause hospitalizations and physician visits were examined using proportional means model and negative binomial regression.

Results:

Of 35,894 MS cases (72% female), mean follow-up was 12.0 years, with person-years of DMD exposure for any, or any first- or second-generation DMD being 63,290, 54,605 and 8685, respectively. Any DMD or any first-generation DMD exposure (versus non-exposure) was associated with a 24% lower hazard of hospitalization (adjusted hazard ratio, aHR: 0.76; 95% confidence intervals (CIs): 0.71–0.82), rising to 29% for the second-generation DMDs (aHR: 0.71; 95% CI: 0.58–0.88). This ranged from 18% for teriflunomide (aHR: 0.82; 95% CI: 0.67–1.00) to 44% for fingolimod (aHR: 0.56; 95% CI: 0.36–0.87). In contrast, DMD exposure was generally not associated with substantial differences in physician visits.

Conclusion:

Findings provide real-world evidence of a beneficial relationship between DMD exposure and hospitalizations.
Extended dosing of monoclonal antibodies in multiple sclerosis
Authors: van Kempen Zoé LE , Toorop Alyssa A , Sellebjerg Finn , Giovannoni Gavin , Killestein Joep
Published: December 2021

Over the past two decades, treatment options for patients with multiple sclerosis (MS) have increased exponentially. In the current therapeutic landscape, “no evidence of MS disease activity” is within reach in many of our patients. Minimizing risks of complications, improving treatment convenience, and decreasing health care costs are goals that are yet to be reached. One way to optimize MS therapy is to implement personalized or extended interval dosing. Monoclonal antibodies are suitable candidates for personalized dosing (by therapeutic drug monitoring) or extended interval dosing. An increasing number of studies are performed and underway reporting on altered dosing intervals of anti-α4β1-integrin treatment (natalizumab) and anti-CD20 treatment (ocrelizumab, rituximab, and ofatumumab) in MS. In this review, current available evidence regarding personalized and extended interval dosing of monoclonal antibodies in MS is discussed with recommendations for future research and clinical practice.
Flexibility in autism during unpredictable shifts of socio-emotional stimuli: Investigation of group and sex differences
Authors: Lacroix Adeline , Dutheil Frédéric , Logemann Alexander , Cserjesi Renata , Peyrin Carole , Biro Brigi , Gomot Marie , Mermillod Martial
Published: December 2021

Considering the mixed nature of reports of flexibility difficulties in autism, we hypothesized that a task that more closely resembles the challenges faced in real life would help to assess these difficulties. Autistic and typically developing adults performed an online Emotional Shifting Task, involving non-explicit unpredictable shifts of complex socio-emotional stimuli, and the Task Switching Task, involving explicit predictable shifts of simple character stimuli. Switch cost (i.e. the difference in performance between Shift and Non Shift conditions) was larger in the autistic group than in the comparison group for the Emotional Shifting Task but not for the Task Switching Task. Females responded faster than males in the Emotional Shifting Task. On the Task Switching Task, typically developing males responded faster than typically developing females, whereas there was a female advantage in the autistic group. Our findings suggest that factors such as predictability, explicitness of the shift rule, stimulus type as well as sex could play a critical role in flexibility difficulties in autism.

Lay abstract

Flexibility difficulties in autism might be particularly common in complex situations, when shifts (i.e. the switch of attentional resources or strategy according to the situation) are unpredictable, implicit (i.e. not guided by explicit rules) and the stimuli are complex. We analyzed the data of 101 autistic and 145 non-autistic adults, without intellectual deficiency, on two flexibility tasks performed online. The first task involved unpredictable and non-explicit shifts of complex socio-emotional stimuli, whereas the second task involved predictable and explicit shifts of character stimuli. Considering the discrepancies between laboratory results and the real-life flexibility-related challenges faced by autistic individuals, we need to determine which factor could be of particular importance in flexibility difficulties. We point out that the switch cost (i.e. the difference between shift and non-shift condition) was larger for autistic than for non-autistic participants on the complex flexibility task with unpredictable and non-explicit shifts of socio-emotional stimuli, whereas this was not the case when shifts were predictable, explicit and involved less complex stimuli. We also highlight sex differences, suggesting that autistic females have better social skills than autistic males and that they also have a specific cognitive profile, which could contribute to social camouflaging. The findings of this work help us understand which factors could influence flexibility difficulties in autism and are important for designing future studies. They also add to the literature on sex differences in autism which underpin better social skills, executive function, and camouflaging in autistic females.
Wear and Morphological Analysis on Basalt/Sisal Hybrid Fiber Reinforced Poly lactic acid Composites
Authors: Govindan P , Arul Jeya Kumar A , Lakshmankumar A
Published: December 2021

The investigation was undertaken to evaluate the wear behavior of basalt fiber and sisal fiber reinforced polylactic acid PLA composites. Basalt saline-treated chopped fiber and treated sisal chopped fiber were alloyed with polylactic acid and the samples were obtained using an injection mold in a twin-screw extruder. Three weight fraction samples were prepared, namely PBSi-1 (90% by weight polylactic acid, 5% by weight basalt and 5% by weight sisal), PBSi-2 (85% by weight polylactic acid, 7.5% by weight basalt and 7.5% by weight sisal) and PBSi-3 (80% by weight polylactic acid, 10% by weight basalt and 10% by weight sisal). The wear behavior of the prepared specimen were determined using a Pin-on-disc. The wear loss was measured at four different loads (10 N, 20 N, 30 N and 40 N) and four different sliding speeds (100 rpm, 150 rpm, 200 rpm and 250). The wear mechanism map was generated based on the wear regime nature using the Fuzzy Cluster C-means algorithm. The PBSi-3 composite showed a more mild wear regime than the severe and ultra-severe wear, due to the increase in the basalt and sisal fiber content within the composite that results in an increase of hardness and wear resistance. The predominant mechanism observed in the SEM image of PBSi-3 composite is ironing, which indicates the lesser wear occurrence in the composite.
The more, the better? Effects of transparency tools and moderators on the perceived credibility of news articles
Authors: Henke Jakob , Holtrup Stefanie , Möhring Wiebke
Published: December 2021

Transparency is often discussed as a way to increase the public’s perception of journalism. While its adoption by newsrooms is relatively well studied, only a few studies have investigated its effects on news users’ credibility judgments. We build on research about transparency effects and report the results of two online experiments (total N = 2262), one with a local and one with a national newspaper frame. Our results suggest that transparency does not affect the perceived message and source credibility newspaper articles and that moderating factors such as cognitive involvement and media skepticism are more important predictors of credibility assessments.
Love-based relationships between teachers and students in early childhood education
Authors: Shih Yi-Huang
Published: December 2021

As a philosophical basis of education, ‘love’ is crucial to early childhood education. For this reason, early childhood education should cultivate young children’s loving attitudes. Hence, by analysing related work, this paper explored how love-based relationships may be developed between preschool teachers and young children in early childhood education. The methods are as follows: (1) fostering love in preschool teachers’ hearts; (2) creating loving relationships between preschool teachers and young children; (3) providing opportunities for young children to practice loving behaviour; (4) giving young children freedom; (5) maintaining an open dialogue; (6) emphasising democratic participation; (7) avoiding indoctrination; (8) respecting young children’s experiences and discoveries; (9) allowing young children to make choices and (10) understanding young children as individuals.
Oldies but Goldies! Twenty Years After, the Journal of Sports Economics at a Crossroads?
Authors: Andreff Wladimir
Published: December 2021

The present article first delineates core sport economics and compares the content of the Journal of Sports Economics (JSE) in different periods of time, then with other core publications in sport economics. Finally, a comparison is undertaken with articles in sport economics which have been published in generalist economics journals over the past two decades. A major conclusion is that the JSE appears to be the mainstream journal in quantitative sport microeconomics. Other strengths and weaknesses are exhibited and tentatively explained, including a marginal attention paid to non-microeconomic issues in sport and some other unheeded topics. A final conclusion is geared toward options for the editorial policy in the decades to come.
Graphene coated cotton nonwoven for electroconductive and UV protection applications
Authors: Jain Vinit Kumar , Chatterjee Arobindo
Published: December 2021

The functional properties and applications of graphene coated textiles depend on the magnitude of graphene add-on which in turn is influenced by the type of substrate and the dipping conditions. In the present study, optimized GO (graphene oxide) dipping conditions are identified for the preparation of cost-effective and scalable rGO (reduced graphene oxide) coated cotton nonwoven for electroconductive and UV (ultraviolet) blocking applications. To understand the influence of GO dipping variables on rGO add-on and electrical resistivity of cotton, batch adsorption studies are carried out in loose fibre form to eliminate the structural influence of yarn or fabric. Batch adsorption studies suggest that GO concentration, pH of GO solution and sodium dithionite (reductant) concentration are the most influencing dipping variables and these dipping variables are optimized for cotton nonwoven fabric using Box–Behnken response surface design to achieve minimum surface resistivity. The rGO coated cotton nonwoven fabric shows excellent UV blocking properties (UV protection factor = 89.38) at the optimized GO dipping conditions. Physical properties of cotton nonwoven fabric such as GSM, thickness, stiffness, breaking strength and elongation are analysed at different dipping cycles. After the rGO coating, bending rigidity, bending modulus and breaking elongation of the cotton nonwoven fabric decrease, whereas the breaking strength increases. rGO coated cotton fabric exhibits excellent stability towards multiple washing and rubbing. The graphene coated cotton is characterised by FT-IR, XRD, Raman, TGA, FESEM and LEICA image analyser.