bluuebunny/crossref_metadata_2025 huggingface dataset:
System of professional training for psychologists at the EMERCOM of Russia
Authors: Shoigu Yulia S.
Published: April 2023

Background. Ye work is marked by high social signiZcance as the task of preserving life, physical and mental health, and psychological well-being of both people a[ected by emergency situations and specialists who provide the aid is especially topical. Year by year the modern world demonstrates many threats, dangers, risks and presents new challenges to people in ordinary life as well as in professional activity. Ye complexity of psychologist’s professional activity at the EMERCOM of Russia, the peculiarities of working conditions, the high cost of an error determine the relationship between the complex, multi-level training system and the e[ectiveness of psychological assistance to emergency situation provided to victims and to the employees of the EMERCOM of Russia. Objective. Ye aim of this article is to analyze the relationship between the requirements to profession and the system of specialist training; to describe the content and features of training at di[erent stages of professional development. Results. Ye article presents long-term results of the development of an integrated system of training for psychologists at the EMERCOM of Russia. Ye system aims to improve and maintain the e\ciency of activity, mental and physical health and professional longevity of a specialist. It includes participation of specialists in the implementation of higher professional education programmes at universities; development and implementation of professional psychological selection, taking into account the requirements for the personal qualities of a specialist and the psychogram of a psychologist at the EMERCOM of Russia; conducting a professional interview on theoretical and applied issues; providing adaptation for a specialist in the workplace through a developed system of mentoring, integration of a specialist into the service; introduction of a uniZed system of normative and methodological support for activities; implementation of the advanced training system and creation of conditions and opportunities for continuous improvement of professional skills. Conclusion. Ye training system of psychological service specialists is a complex, multi-level system of organizational and methodological measures. Its structure and features are determined by the requirements imposed by the conditions of professional activity. Ye ultimate goal of the specialists training in psychological service of the EMERCOM of Russia is to improve the quality of psychological assistance to the victims in emergency situations and to provide mental health, psychological well-being and professional longevity of psychologists
A multidisciplinary approach reveals a new species of glassfrog from Colombia (Anura: Centrolenidae: Nymphargus)
Authors: MONTILLA SEBASTIÁN O. , ARCILA-PÉREZ LUISA F. , TORO-GÓMEZ MARÍA PAULA , VARGAS-SALINAS FERNANDO , RADA MARCO
Published: April 2023

Anurans of the family Centrolenidae are a highly diverse clade of Neotropical treefrogs. In the last two decades, glassfrogs have become a model system for studies in ecology and evolutionary biology, in part because their taxonomy and phylogenetic relationships are considered relatively well established. However, there are still many gaps in our knowledge, for example, which morphological characters are important for species delimitation. Consequently, several species complexes in Centrolenidae remain unresolved. Using data on external and internal morphology of adult individuals, tadpoles, advertisement call traits and genetic sequences, we describe a new species of glassfrog (Nymphargus pijao sp. nov.) endemic to Colombia that has been previously missasigned to Nymphargus griffithsi. We include in this description data of three phenotypic characters related to pectoral musculature and testis size, which have been traditionally overlooked in studies about the taxonomy and systematics of glassfrogs. In addition, we present details of a low-cost method implemented in the field to rear tadpoles of the new species. This methodology can solve common problems during the management and care of glassfrogs egg masses and tadpoles, and hence, promotes their description for more species and a better knowledge of the anuran biodiversity in Neotropics.
The WRF-Based Incremental Analysis Updates and Its Implementation in an Hourly Cycling Data Assimilation System
Authors: Chen Min , Huang Xiang-Yu , Wang Wei
Published: April 2023

An incremental analysis update (IAU) scheme is successfully implemented into a WRF/WRFDA-based hourly cycling data assimilation system with the goal to reduce the imbalance introduced by the high-frequency intermittent data assimilation, especially when radar data are included. With the application of IAU, the analysis increment is smoothly introduced into the model integration over a time window centered at the analysis time. As in digital filter initialization (DFI), the IAU scheme is able to limit large shocks in the early part of a model forecast. Compared to DFI, IAU does better in hydrometeor spinup and produces more continuous precipitation forecasts from cycle to cycle. The run with IAU is shown to improve the precipitation forecast skills (10+% for CSI scores) compared to the regular cycling forecasts without IAU. The data assimilation system with IAU is also able to accept more observations due to balanced first-guess fields. Comparable results are obtained in IAU tests when the time-varying weights are used versus constant weights. Because of its better property, the IAU with the time-varying weights is implemented in the operational system.
Plus ça Change. . . Perceptions of New Orleans English Before and After the Storm
Authors: Dajko Nathalie , Carmichael Katie
Published: April 2023

In this paper, we present a focused perceptual dialectology study of variation in a single metropolitan area: New Orleans, Louisiana, long overlooked by linguists. We asked participants to complete a map-drawing activity using two maps, one of the city and its nearest suburbs, and one of the larger cultural zone. We also added the dimension of time by additionally asking participants to complete a map showing changes that have occurred since Hurricane Katrina in 2005, which we identified as a catalyst for an increase in the rate of demographic change in the city. The results show that, unlike similar participants in other studies, African American and white New Orleanians draw the same city but label it differently, suggesting they occupy the same space but live in different places. When considering change over time, participants highlighted differences in the ethnic makeup of the city. We conclude that ethnicity in New Orleans is a key—if not the key—driver of perception both of linguistic variation and of change. With this study we confirm the importance of working with local actors to understand the way language practices map onto speakers’ understandings of space and place and the ways they may influence variation and change. The findings we present here provide us with key questions that will strengthen the results of production studies currently underway, demonstrating the significance of such work as a corollary to production studies.
From resentment to deconstruction: Whistleblowing as a politico-legal tool of labour law enforcement
Authors: Mezihorak Petr , Murgia Annalisa
Published: April 2023

By focusing on three groups of whistleblowers in Slovakia speaking out against the use of bogus self-employment in their companies, this study contributes to the debate on the political dimension of whistleblowing. Specifically, it conceptualises whistleblowing as a practice that opens up broader societal, ethical and political questions by examining its relationship to institutions, with particular interest in those institutions that create the law. In doing so, the study analyses how labour law and enforcement institutions are deconstructed through the long process of whistleblowing, which involves the interactions of multiple institutions and social actors in a regulatory space that tend to sustain (bogus) self-employment.
Intraoperative electrical stimulation for persistent, post-traumatic facial paralysis
Authors: North Monique , Weishaar Jeffrey , Leonetti John P.
Published: April 2023

Approximately 7–10% of temporal bone fractures result in facial nerve paralysis. Treatment is dependent upon the severity of the nerve trauma and can range from conservative medical management to surgical intervention. A study by Hato et al. detailed the relationship between surgical timing and recovery rate for patients with facial nerve palsy secondary to temporal bone trauma. The rates of complete recovery and good recovery decline that the longer surgical intervention is delayed. We present the case of a 14-year-old male with a temporal bone fracture and delayed onset right-sided facial paralysis. This patient was treated with a transmastoid middle cranial fossa (MCF) approach with intraoperative electrical stimulation of the perigeniculate portion of the facial nerve. Despite a 53-day delay between trauma and surgical intervention, the patient’s facial function improved from House Brackmann (HB) grade VI to grade II within 6 months. Intraoperative facial nerve stimulation, which we have previously used for unresolved Bell’s palsy, may be useful for patients with post-traumatic, persistent facial paralysis.
From the wet and sandy shore by the eternal sea: Exploring the experience of threshold consciousness following life or death surgery and its impact on practice
Authors: Bayley Bruce Howard
Published: April 2023

This piece stems from my own experience of a threshold consciousness that followed life-or-death surgery in 2015, when surgeons had informed me that I had only 2 days to live and offered me 2 days palliative care as an alternative choice. My survival of the surgery together with the experience of that threshold consciousness led me to a re-appraisal of my own practice in Dramatherapy. Out of my personal survival of a state bordering on death, I invite contemplation of different levels of consciousness experienced and the internal and external dramas encountered and pondering questions as to how we all may access clearer and more conscious perspectives of ourselves and fuller potentials of physical, mental, emotional, psychological, cosmic and spiritual resources for self-knowledge and consciousness than may be offered by current states of the current material scientific world view alone.
Description of patient reported experience measures (PREMs) for hospitalised patients with palliative care needs and their families, and how these map to noted areas of importance for quality care: A systematic review
Authors: Virdun Claudia , Garcia Maja , Phillips Jane L , Luckett Tim
Published: April 2023

Background:

The global need for focused improvements in palliative care within the acute hospital setting is well noted. A large volume of evidence exists detailing what hospitalised patients with palliative care needs and their families note as important for high quality care. Patient Reported Experience Measures (PREMs) are one mechanism that hospitals could use to inform improvement work. To date there has not been a review of PREMs available for hospitalised patients with palliative care needs and/or their family, nor how they align with noted priorities for high quality care.

Aim:

To identify and describe PREMs designed for hospitalised patients with palliative care needs and their families; and their alignment with patient and family identified domains for high quality care.

Design:

A systematic review.

Data sources:

A systematic search of CINAHL, Medline and PsycInfo was conducted up to September 23, 2022 and supplemented by handsearching article reference lists and internet searches. PREMs written in English and designed for patients with palliative care needs in acute hospitals were eligible for inclusion. Included PREMs were described by: summarising key characteristics; and mapping their items to domains noted to be important to hospitalised patients with palliative care needs and their families informed by outcomes from a published study completed in 2021. Evidence for psychometric properties were reviewed.

Results:

Forty-four PREMs with 827 items were included. Items per PREM varied from 2 to 85 (median 25, IQR 13–42). Two-thirds ( n = 534, 65%) of the items were designed for families and a third ( n = 283, 34%) for hospitalised patients, and very few ( n = 10, 1%) for both. Sixty-six percent of items measured person-centred care, 30% expert care and 4% environmental aspects of care. Available PREMs address between 1 and 11 of the 14 domains of importance for quality palliative care. PREMs had a median of 38% (IQR 25.4–56.3) of items >Grade 8 measured by the Flesch-Kincaid readability test, with Grade 8 or lower recommended to ensure health information is as accessible as possible across the population.

Conclusions:

Whilst 44 PREMs are available for hospitalised patients with palliative care needs or their families, a varied number of items are available for some domains of care provision that are important, compared to others. Few are suitable for people with lower levels of literacy or limited cognitive capacity due to illness.
Iatrogenic suffering at the end of life: An ethnographic study
Authors: Green Laura , Capstick Andrea , Oyebode Jan
Published: April 2023

Background:

Across the developed West, a significant proportion of older people die in hospital It has been argued that an acute hospital setting is not well equipped to support dying well. A palliative approach, which involves recognising and alleviating suffering, might lead to improved quality of care. Yet suffering is an intangible and contested phenomenon and little is known about people’s actual experiences of suffering in this clinical setting.

Aim:

To examine the context of end-of-life care for older people in an acute hospital setting, particularly focusing on the experience of suffering.

Design:

An observational study, using an ethnographic approach. Data analysis was inductive and iterative. Reflexive analysis included observations and inferences from a participant-observer perspective. Over a period of 3 months in 2016, 186 h of observations of clinical care were carried out.

Settings/participants:

The study was carried out on a 30-bedded acute older peoples’ hospital ward in the United Kingdom. Participants included 11 patients and 33 members of staff and visitors.

Results:

Patient suffering was influenced by a range of factors. Delays in recognising and acknowledging dying often led to treatments that were burdensome or futile, exacerbating patient suffering. This was frequently associated with clinical decision-making that did not take into consideration long term concerns such as prognosis or quality of life. Environmental factors in the physical clinical setting such as noise and smell also exacerbated suffering. Finally, aspects of interpersonal interactions, such as paternalistic attitudes or ineffective communication, affected patient experience.

Conclusion:

Acute care for older people in hospital was shaped by an overarching ideology of rescue which predicted and dictated the process of care. Suffering was not restricted to the direct experiences of life-limiting illness but was also associated with the experience of receiving care in an acute hospital setting. Avoiding or minimising iatrogenic suffering is an essential component of compassionate care.
Wikipedia and Shostakovich Meets Goya: Elaborative Narration and Music Enhance Affect Derived From Art
Authors: Özger Can , Choudhury Naseem
Published: April 2023

We sought to understand the common interaction between music, information and visual art. The evoked affect of college students (N = 47, F = 35, M = 11, NB = 1) were measured via The Implicit Positive and Negative Affect Test (IPANAT) after a presentation of Francisco Goya's Black Paintings. There were three randomly assigned groups with a narration about the artist's life and the significance of his paintings (group N), classical music (group M) and both (group NM). Participant's art knowledge was also assessed, as determined by the Vienna Art Interest and Art Knowledge Questionnaire (VAIAK). Group NM reported significantly lower affect scores, indicating more intense emotional experiences as opposed to other two groups (N = 47, F(2)= 4.099, p = .023). The knowledge and interest scores had no effect on the affect score. The implications of the findings and potential explanations are discussed through the lens of different models of art perception.
Normative Values of Tibial Tubercle–Trochlear Groove Distance and Tibial Tubercle–Posterior Cruciate Ligament Distance in Children
Authors: Park Se Jin , Won Seung Hyun , Park Moon Seok , Sung Ki Hyuk
Published: April 2023

Background:

Patellar instability is a common knee pathology in skeletally immature patients. In skeletally mature populations, a tibial tubercle–trochlear groove (TT-TG) distance of ≥20 mm is generally considered a pathological value. However, as pediatric patients grow and as the TT-TG distance varies with age, applying the same cutoff value as adult patients to them is unreasonable.

Purpose/Hypothesis:

This study aimed to analyze the normative values of the TT-TG and tibial tubercle–posterior cruciate ligament (TT-PCL) distances in children with no patellofemoral instability and to propose the cutoff value of the TT-TG and TT-PCL distances predictive of increased risk of patellofemoral instability in pediatric patients. We hypothesized that the TT-TG and TT-PCL distances increase with age in children and adolescents.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Magnetic resonance imaging scans of the knee were collected from the patellar instability group and the control group. The TT-TG and TT-PCL distances were measured. The normalized values of the TT-TG and TT-PCL distances were calculated by dividing them by the femoral width. Segmented analysis with 1 breakpoint was performed for both the TT-TG and the TT-PCL distances. The optimal cutoff values of the TT-TG and TT-PCL distances were calculated by maximizing the sum of the sensitivity and specificity.

Results:

A total of 87 patients had patellar instability, and 509 patients did not. The median values of TT-TG and TT-PCL distances in the control group (8.18 mm and 19.48 mm, respectively) were significantly smaller than those in the instability group (16.10 mm and 24.41 mm, respectively). For those aged <15 years, the TT-TG distance significantly increased by 0.39 mm as the age increased by 1 year. The TT-PCL distance increased by 1.14 mm/year until the age of 11 years. In our cohort, the cutoff value of the TT-TG distance of 14.90 mm yielded 66% sensitivity and 81.9% specificity for predicting an increased risk of patellar instability. The cutoff value of the TT-PCL distance of 23.68 mm yielded 63.9% sensitivity and 65.3% specificity for predicting an increased risk of patellar instability.

Conclusion:

In our cohort of 596 participants, we have documented the normative values of the TT-TG and TT-PCL distances in children aged <20 years. During the surgery for patellar instability in pediatric patients, orthopaedic surgeons should consider the normative values of the TT-TG and TT-PCL distances according to age to determine which patients need distal realignment surgery.
Association Between Anterior Tibial Subluxation of Lateral Compartment and High-Grade Knee Laxity in Patients With Anterior Cruciate Ligament Deficiency
Authors: Ye Zipeng , Wu Xiulin , Chen Jiebo , Cho Eunshinae , Xie Guoming , Dong Shikui , Xu Junjie , Zhao Jinzhong
Published: April 2023

Background:

High-grade knee laxity and excessive anterior tibial subluxation (ATS) are correlated with poor clinical outcomes in patients with anterior cruciate ligament (ACL) deficiency and share similar risk factors; however, the association between excessive ATS and high-grade knee laxity remains unclear.

Purpose:

To identify the association between excessive ATS and high-grade knee laxity in patients with ACL deficiency and determine the possibility that ATS can predict high-grade knee laxity.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 226 patients who underwent ACL reconstruction between May 2018 and March 2022 were analyzed in the present study; the high-grade group consisted of 113 patients who had a grade 3 result on the preoperative anterior drawer test, Lachman test, or pivot-shift test while under anesthesia, and the low-grade group consisted of 113 matched patients. The ATS values for medial and lateral compartments (ATSMC and ATSLC) were measured on magnetic resonance imaging while patients relaxed the quadriceps in the supine position under no anesthesia. The optimal cutoff values of ATSMC and ATSLC for high-grade knee laxity were determined using receiver operating characteristic curves. Univariate and multivariate logistic regression analyses with stratification were performed to identify the association between excessive ATS and high-grade knee laxity.

Results:

Compared with the low-grade group, the high-grade group had a longer time from injury to surgery; higher rates of medial meniscus posterior horn tear (MMPHT), lateral meniscus posterior horn tear (LMPHT), and anterolateral ligament (ALL) abnormality; and larger lateral tibial slope, ATSMC, and ATSLC. The optimal cutoff value was 2.6 mm (sensitivity, 52.2%; specificity, 76.1%) for ATSMC and 4.5 mm (sensitivity, 67.3%; specificity, 64.6%) for ATSLC in predicting high-grade knee laxity. After adjustment for covariates, ATSLC ≥4.5 mm (odds ratio [OR], 2.94; 95% CI, 1.56-5.55; P = .001), MMPHT (OR, 2.62; 95% CI, 1.35-5.08; P = .004), LMPHT (OR, 2.39; 95% CI, 1.20-4.78; P = .014), and ALL abnormality (OR, 2.09; 95% CI, 1.13-3.89; P = .019) were associated with high-grade knee laxity. The association between excessive ATSLC and high-grade knee laxity was validated in patients with acute ACL injury as well as those with chronic ACL injury.

Conclusion:

Excessive ATSLC was associated with high-grade knee laxity in patients who had ACL deficiency, with a predictive cutoff value of 4.5 mm. This study may help surgeons estimate the degree of knee instability more accurately before anesthesia and may facilitate preliminary surgical decision-making, such as appropriate graft choices and consideration of extra-articular augmentation.
Fabrication of poloxamer based besifloxacin thermosensitive in situ gelling nanoemulsions for ophthalmic delivery
Authors: Kassaee Seyedeh Negin , Nili-Ahmadabadi Amir , Mahboobian Mohammad Mehdi
Published: April 2023

The present study aimed to develop and investigate besifloxacin (BSF) in situ gel nanoemulsions (NEs) consisting of two hydrophilic polymers, that is, poloxamer 407 (P407) and poloxamer 188 (P188), for ocular delivery. BSF loaded in situ gel-NEs containing triacetin (oil), Cremophor®RH 40 (surfactant), Transcutol®P (co-surfactant), poloxamer 407 and poloxamer 188 (gelling agents) were prepared by spontaneous emulsification method. The optimum in situ gel nanoemulsion was selected based on gelation temperature. The selected formulation was evaluated for physicochemical characteristics, including droplet size, refractive index, pH, transparency, and viscosity. Further investigations such as in vitro drug release, ex vivo corneal permeation, HET-CAM, pre-corneal residence time antibacterial efficacy studies were conducted too. Developed BSF in situ gel nanoemulsion showed acceptable physicochemical properties with a nano-metric droplet size of 19 nm and PDI of 0.21. Moreover, In vitro release studies revealed that the in situ gel formulation could sustain drug release as only 40% of the BSF was released within 1 h. Permeability coefficient (Papp) of BSF through the excised bovine cornea was found 6.01 × 10−6 cm/s during 6 h. In addition, the HET-CAM evaluation confirmed the non-irritancy of the optimum BSF in situ gel NEs. The pre-corneal residence time evaluation indicated prolonged retention of in situ gel-NEs on the eye surface. Finally, antibacterial susceptibility investigations illustrated remarkable efficacy against Pseudomonas aeruginosa and Staphylococcus aureus. The current findings demonstrated that this proposed BSF-loaded in situ gel-NEs could be considered as a potential novel drug delivery formulation against ophthalmic bacterial infections.
Examining the Role of Physical Function on Future Fall Likelihood in Older Adults With a Fear of Falling, With and Without Activity Restriction
Authors: Garbin Alexander J. , Fisher Beth E.
Published: April 2023

Objectives

Assess the influence of physical function on balance and future falls in older adults with fear of falling (FOF) and whether activity restriction modifies the contribution to falls. Methods: Analyses utilized data from Baltimore Longitudinal Study of Aging ( n = 680) and National Health and Aging Trends Study ( n = 4376) community-dwelling older adults. The role of physical function was examined by comparing balance performance and future fall odds before/after controlling for function in older adults with/without FOF. Fall likelihood analyses were repeated with FOF stratified by activity restriction. Results: When controlling for physical function, differences in balance and fall odds secondary to FOF/activity restricting FOF reduced but remained significant. Fall odds secondary to non-activity restricting FOF only slightly decreased. Discussion: Physical function contributes to balance and falls in older adults with FOF, more so in those restricting activity. Reduced balance and increased fall risk persists independent of function suggesting additional contributing factors.
Understanding understanding in psychiatry
Authors: Gough Joseph
Published: April 2023

Originally put forward to defend history from the encroachment of physics, the distinction between understanding and explanation was built into the foundations of Karl Jaspers’ ‘phenomenological’ psychiatry, and it is revised, used and defended by many still working in that tradition. On the face of it, this is rather curious. I examine what this notion of ‘understanding’ amounts to, why it entered and remains influential in psychiatry, and what insights for contemporary psychiatry are buried in the notion. I argue that it is unhelpfully associated with the view that the mental is epistemologically and methodologically autonomous, but that it nevertheless highlights an important lacuna in many views of psychiatry and the scientific study of humans more generally.
Preclinical Evaluation of interferon-gamma primed human Wharton’s jelly-derived mesenchymal stem cells
Authors: Park Sang-Jin , Kim Dae Seong , Choi Myeongjin , Han Kang-Hyun , Han Ji-Seok , Yoo Keon Hee , Moon Kyoung-Sik
Published: April 2023

The potential of human mesenchymal stem cells (MSCs) for cell therapy has been investigated in numerous immune-mediated conditions; MSCs are considered one of the most promising cellular therapeutics to treat intractable diseases. Recently, approaches to prime MSCs have been investigated, thereby generating cellular products with enhanced potential for a variety of clinical applications. Interferon-gamma (IFN-γ) priming is a current approach used to increase the therapeutic efficacy of MSCs. In this study, we determined the systemic toxicity, tumorigenicity and biodistribution of IFN-γ-primed Wharton’s jelly-derived (WJ)-MSCs in male and female BALB/c-nu/nu mice. There were no deaths or pathologic lesions in the mice treated with 5 × 106 cells/kg IFN-γ-primed MSCs in the repeated dose study. In the tumorigenicity study, one of the subcutaneously treated mice showed bronchioloalveolar adenoma in the lung but tested negative for human-specific anti-mitochondrial antibody, suggesting the spontaneous murine origin of the adenoma. A biodistribution study using real-time quantitative polymerase chain reaction demonstrated the systemic IFN-γ-primed MSC clearance by day 28. Based on the toxicity, biodistribution, and tumorigenicity studies, we concluded that IFN-γ-primed MSCs at 5 × 106 cells/kg do not induce tumor formation and adverse changes.
Prophets, puppets, and pinheads: Contesting the authority of science in the COVID-19 era
Authors: Urkens Jolan , Houtman Dick
Published: April 2023

This article studies resemblances between academic postmodernism and today’s popular contestations of the authority of science by means of a qualitative content analysis of 657 critical online comments on a Belgian newspaper article about the COVID-19 crisis that features a prominent Belgian virologist. The comments portray scientists as (1) prophets who pretend their knowledge to be superior to competing understandings of the world; (2) puppets who figure in hidden schemes that cannot stand the light of day; and (3) pinheads who lack the intellectual competence to give solid scientifically informed advice. While the first two critiques do at first sight resemble academic postmodernism, they are in fact informed by the markedly modern understanding that objective and neutral scientific knowledge is as feasible as it is desirable. What we find, then, are not contestations of the authority of science per se, but indeed of practices deemed deviant aberrations of science.
Rebel spirits at sea: Disrupting EUrope’s weaponizing of time in maritime migration governance
Authors: Stierl Maurice
Published: April 2023

In August 2020, a motor yacht formerly owned by French customs authorities set sail in the Mediterranean Sea in search of migrant boats in distress. Funded by the street artist Banksy, the search and rescue engagement of the Louise Michel was meant to prevent both the continuous loss of migrant lives at sea and mass interceptions to North Africa. Assessing her maiden voyage and strategic conception, as well as her operational and political impact, the article argues that the intervention of the Louise Michel and her activist crew can be regarded as an attempt to disrupt EUrope’s ‘weaponization’ of time in the governance of maritime migration. Over recent years, EU member states have sought to systematically decelerate rescues while accelerating interceptions of escaping migrant boats. With her speed, unprecedented in the ‘civil fleet’ and on a par with EUropean and Libyan naval assets, the activists have sought to disrupt the EUro–Libyan interception regime which has led to the forced return of over 120,000 people to Libya since 2016.
Modeling of photo-thermo-sensitive hydrogels by applying the temperature expansion analogy
Authors: Mählich Daniel , Ehrenhofer Adrian , Wallmersperger Thomas
Published: April 2023

Hydrogels are an outstanding material for sensor and actuator applications, for example, chemosensors and microfluidics, and have been extensively studied in both, experiments as well as in modeling within the last years. The theoretical investigations of hydrogels are key factors for the development of new hydrogel-based concepts in research and engineering. The recent approaches in modeling of the light-sensitive behavior of hydrogels are often complicated and very detailed. Commonly, they are based on the Helmholtz free energy function within a continuum-mechanical framework. In contrast, the Stimulus Expansion Model (SEM) is a simple and very effective approach to embed the swelling properties of a hydrogel into a continuum mechanical framework. Originally, the SEM was applied to chemical stimulation processes based on available experimental swelling curves. The current work provides an extension of the SEM for photo-thermo-sensitive hydrogels. The present approach considers (i) the attenuation of light by applying Lambert-Beer’s law as well as (ii) the energy transfer of light into heat. In this study, PNIPAm hydrogels with incorporated light-absorbing particles of copper-chlorophyllin are investigated. To demonstrate the capabilities of the presented approach, the effect of the variation of (i) light power, (ii) particle volume fraction, and (iii) ambient temperatures on the swelling behavior is analyzed. The obtained results show an excellent correlation with experimental results from literature. Concluding, the extended Stimulus Expansion Model provides further opportunities to design and simulate photo-thermo-sensitive hydrogels for engineering applications.
Just Transition for Healthy People on a Healthy Planet
Authors: Narayan Shweta
Published: April 2023

The definition of Just Transition in recent years has been shaped by the political and ideological leanings of multiple stakeholders. Labor movements look at a Just Transition that secures workers’ rights and jobs; environmental justice groups include whole communities impacted by fossil fuel in their description; multilateral institutions, investors, and transnational corporations see it through lenses of economics, financial support, and investment. However, a perspective on health is missing in all these approaches. The COVID-19 pandemic has established the importance of health-based planning, making evident the co-dependence of ecological health and human well-being. The debilitating post-pandemic economic crisis has reiterated the interlinkage between economics, public health, and the environment. This document posits that health is the overlapping but missing link between the different movements’ dream for Just Transition into an equitable world, and to heal people and the planet damaged by fossil fuels. We need Just Transition that has holistic health systems and accessible healthcare services at its core.
A Newborn with Extremely Rare Cerebro-Costo-Mandibular Syndrome; A Case Report Study
Authors: Mirfazeli Arezou , Shariatalavi Reyhaneh , Lashkarbolouk Narges , Lahoti Dorna , Mazandarani Mahdi
Published: April 2023

Background

Cerebro-costo-mandibular syndrome (CCMS) is a rare congenital syndrome consisting of the main features of micrognathia and posterior rib gaps. Due to multiple abnormalities, patients almost have difficulty breathing with upper airway obstruction, decreased thoracic capacity, spina bifida, and scoliosis.

Case presentation

We describe a case of a late preterm neonate boy presenting with low Apgar, respiratory distress, and complicated orofacial anomalies that had a poor outcome. His radiographic findings showed mandibular hypoplasia (micrognathia), chest deformity, multiple posterior rib gap defects, and abnormal costotransverse articulation. Based on physical examination and radiologic findings, the diagnosis of CCMS confirmed for the patient.

Conclusion

Physicians should always consider the diagnosis of CCMS in all infants with micrognathia and rib-gap defects. These infants need careful respiratory function monitoring. Early airway management improves growth and development. In addition, their physical and psychological development should be assessed regularly.
A Rare Case of Metaplastic Thymoma Presenting With Myasthenia Gravis
Authors: Vega Prado Ilianne , Shymansky John , Apte Anisha , Mortman Keith , Kaminski Henry J. , Barak Stephanie
Published: April 2023

Thymomas are tumors of the mediastinum often associated with autoimmune conditions, in particular myasthenia gravis. In contrast, among the fewer than 40 reports of metaplastic thymoma, myasthenia gravis is rarely found. We describe the fourth patient, and first man, with metaplastic thymoma and myasthenia gravis. A 34-year-old had acute onset of double vision with associated dysphagia and was found to have an elevation of serum acetylcholine receptor antibodies. He underwent a transsternal thymectomy. Tissue sections showed a biphasic proliferation of keratin-positive epithelial cells with a complement of spindle cells confirming the diagnosis of metaplastic thymoma. Terminal deoxynucleotidyl transferase (TDT)-positive T lymphocytes were rare and only found in the periphery of the tumor, consistent with thymic remnant. A YAP1::MAML2 gene fusion, with an in-frame fusion between genes YAP1 Exon5 (NM_001130145) and MAML2 Exon2 (NM_032427) was found, supporting further the diagnosis of metaplastic thymoma (Anchored multiplex RNA sequencing [Archer Dx, Boulder, CO] assay). The patient's gender and relatively young age, the presence of an autoimmune condition, and the lack of lymphocytic infiltrate all contribute unusual features to this case and suggest avenues for further exploration.
Predicting Lifetime Suicide Attempts in a Community Sample of Adolescents Using Machine Learning Algorithms
Authors: Jankowsky Kristin , Steger Diana , Schroeders Ulrich
Published: April 2023

Suicide is a major global health concern and a prominent cause of death in adolescents. Previous research on suicide prediction has mainly focused on clinical or adult samples. To prevent suicides at an early stage, however, it is important to screen for risk factors in a community sample of adolescents. We compared the accuracy of logistic regressions, elastic net regressions, and gradient boosting machines in predicting suicide attempts by 17-year-olds in the Millennium Cohort Study ( N = 7,347), combining a large set of self- and other-reported variables from different categories. Both machine learning algorithms outperformed logistic regressions and achieved similar balanced accuracies (.76 when using data 3 years before the self-reported lifetime suicide attempts and .85 when using data from the same measurement wave). We identified essential variables that should be considered when screening for suicidal behavior. Finally, we discuss the usefulness of complex machine learning models in suicide prediction.
Impact of Vitamin K Administration on Elevated International Normalized Ratio in Chronic Liver Disease
Authors: Smith Carmen B. , Hennessey Erin K. , Crossey Caroline D. , Crannage Andrew J.
Published: April 2023

Limited studies assess the efficacy of vitamin K administration in patients with chronic liver disease (CLD). However, vitamin K is commonly used to treat elevations in international normalized ratio (INR) in these patients with the intended benefit of reducing bleeding risk. This retrospective, single-center cohort study aimed to evaluate the impact of vitamin K administration on INR in patients with CLD. Hospitalized patients ≥ 18 years of age with a diagnosis of CLD or cirrhosis and received vitamin K were included. The primary outcome was the absolute change in INR from baseline to 24 to 48 h after vitamin K administration. Secondary endpoints included subgroup analyses of the primary outcome by route of administration and single versus multidose administration, and incidence of in-hospital venous thromboembolism (VTE) or major bleeding. A total of eighty-five patients, primarily with Child–Pugh class C (76.5%), were included. Route of vitamin K administration included oral (PO) (72%) and intravenous (IV) (26%) with a mean daily dose of 8.5 ± 2.3 mg. The absolute change in INR was −0.07 ± −0.35 following vitamin K administration. There was no difference in absolute INR change between single versus multiple dose administration (−0.16 ± −0.35 and −0.03 ± −0.35; P= .13) or between PO versus IV administration (−0.06 ± −0.23 and −0.18 ± −0.48; P = .11). The incidences of in-hospital VTE and major bleeding were 2.4% and 3.5%, respectively. The administration of vitamin K in hospitalized patients with CLD resulted in minimal INR change, suggesting this intervention may not have the intended benefit of reducing bleeding risk.
The Risk, Need, and Responsivity Relevance of Working Alliance in a Sexual Offense Treatment Program: Its Intersection With Psychopathy, Diversity, and Treatment Change
Authors: Olver Mark E. , Stockdale Keira C. , Riemer Emily K.
Published: April 2023

The current study examined the self-reported working alliance of men attending a high intensity sexual offense treatment program and its associations with psychopathy, sexual violence risk, treatment change, and recidivism, in a Canadian sample of 317 incarcerated men followed up an average of approximately 10 years post release. Working Alliance Inventory (WAI; Horvath & Greenberg, 1989 ) self-reported total, Task, Bond, and Goal scores were positively correlated with treatment related changes in risk, and inversely associated with Psychopathy Checklist-Revised (PCL-R; Hare, 1991 ; Wang & Hare, 2003 ) scores. The Affective facet of the PCL-R, representing the callous-unemotional features of the syndrome, uniquely predicted lower Bond and Goal scores controlling for the other facets. Cox regression survival analyses demonstrated that sexual violence risk predicted increased sexual recidivism while change predicted decreased sexual recidivism controlling for PCL-R total score; however, WAI scores (particularly the Goal component) were also unexpectedly associated with increased sexual recidivism. For violent recidivism, psychopathy, risk, and change incremented the prediction of general violence, while the WAI was not significantly associated with this outcome. A set of parallel analyses, stratified by Indigenous ethnocultural heritage, demonstrated some continuity, but also potential areas of difference, in substantive findings. Risk, need, responsivity implications of the working alliance for the treatment of high psychopathy correctional clientele, and how this may intersect with Indigenous heritage, are discussed.
HIV Treatment and Mental Health Outcomes Among Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV in a Pilot Multicomponent Intervention in Guatemala City
Authors: Barrington Clare , Davis Dirk A. , Angeles Gustavo , Pajarito Rompich Angela Yolanda , Santa Luce Renato , Shelus Victoria , Northbrook Sanny
Published: April 2023

Globally, gay, bisexual, and other men who have sex with men (GBMSM) are disproportionately affected by HIV, but few interventions address mental health and HIV outcomes among GBMSM living with HIV. The purpose of this study was to pilot a multicomponent intervention, integrating emotional well-being (EW) and health navigation for GBMSM living with HIV in Guatemala City. We implemented a 12-month intervention, including a four-session EW component and a health navigation component among newly diagnosed and reengaged GBMSM with HIV ( n = 112). We conducted socio-behavioral surveys at baseline and endline to measure patient characteristics and HIV, and mental health outcomes as well as viral load testing. We documented participation in EW sessions and used a smartphone application to track navigation mode, frequency, and content. Using first-difference estimation modeling, we assessed associations between participation in EW and navigation and mental health (depression and anxiety symptoms) and HIV outcomes (HIV treatment adherence, viral suppression). Acceptability was high for EW (86%) and navigation (99%). During the intervention, viral suppression increased significantly and anxiety and depression decreased significantly. Participation in EW sessions and greater navigation frequency and duration were associated with being suppressed, whereas higher emotional navigator support was associated with being unsuppressed. Participation in EW sessions was associated with reduced anxiety. Findings suggest that multicomponent interventions integrating individual counseling and navigation may promote EW and sustained viral suppression. Future intervention research is needed to confirm whether HIV and mental health outcomes are attributable to the intervention and to assess mechanisms of influence.
Inclusive learning in Ireland: A case study
Authors: Buckley Lucy-Ann , Quinlivan Shivaun
Published: April 2023

Ireland ratified the Convention on the Rights of Persons with Disabilities (CRPD) in 2018. However, the CRPD’s provisions on inclusive education have not been widely considered in relation to Irish third level education. This article outlines the findings from two research projects that examined the experiences of students with disabilities at one Irish university. It begins by considering the scope of inclusive education in the CRPD, addressing this through the prism of two cross-cutting rights, accessibility and reasonable accommodation. It outlines the Irish legislative context, identifying significant gaps between existing legal provisions and Ireland’s CRPD obligations. It then explores the practical realisation of inclusive education at the case study university. The article argues that accessibility in the CRPD is broader than both Irish legislative requirements and the general institutional understanding. Noting that students face significant difficulties accessing effective reasonable accommodations in practice, the paper contends that this may be partly attributable to the silo-ing of institutional knowledge and the lack of a ‘whole educational environment’ approach, as well as attitudinal barriers. These impediments prevent the full and equal participation of students with disabilities in tertiary education. The paper then draws on the CRPD to offer suggestions for enhancing inclusive practice.
Antecedents and consequences of behavioural intention to use virtual reality in tourism: Evidence from Gen-Y and Gen-Z consumers in Egypt
Authors: Elkhwesky Zakaria , Abuelhassan Abuelhassan Elshazly , Elkhwesky Esraa Fayez Youssif , Khreis Sawsan Haider Abdullah
Published: April 2023

Virtual reality (VR) is an advanced technology that has a significant impact on tourism and travel worldwide. Drawing on the social cognitive theory (SCT) and theory of planned behaviour (TPB), the current paper examined the effect of consumers’ travel fear due to pandemics, wars, and terrorism (TFPWT), their concern about the environmental impact of touristic travel (EITT), and technology anxiety (TA) on their behavioural intention to use VR in tourism and consequently on their willingness to pay premium and electronic word-of-mouth (EWoM). It also analysed the moderating role of venturesomeness. A number of 522 questionnaires from Gen-Y and Gen-Z consumers in Egypt and the covariance-based structural equation modelling (CB-SEM) were used to test the model. The findings showed that consumers’ travel fear and their concern regarding the environmental impact of travel have a significant and positive effect on their behavioural intention to use VR in tourism. On contrary, consumers’ behavioural intention is significantly and negatively influenced by TA. Consumers’ behavioural intention has a significant and positive impact on their willingness to pay premium and EWoM. No significant moderating effect is reported regarding venturesomeness. The research holds significant implications for both theory and practice.
Medical necessity under weak evidence and little or perverse regulatory gatekeeping
Authors: Ioannidis John PA
Published: April 2023

Medical necessity (claiming that a medical intervention or care is – at minimum – reasonable, appropriate and acceptable) depends on empirical evidence and on the interpretation of that evidence. Evidence and its interpretation define the standard of care. This commentary argues that both the evidence base and its interpretation are currently weak gatekeepers. Empirical meta-research suggests that very few medical interventions have high quality evidence in support of their effectiveness and very few of them also have relatively thorough assessments of their potential harms. Therefore, evidence on the risk-benefit ratios carries almost always very large uncertainty. Arbitration about medical necessity is thus left to the interpretation process. Professional guidelines are notoriously unreliable and biased in this regard. Regulatory approval ends up being the key arbitrator, but over the years the regulatory process has been subverted. Regulatory approval currently does not mean that an intervention has a favourable risk-benefit ratio, but simply that it can be marketed, sold and made profit from. The process leads to a tragedy of commons where the final victim is society at large: medical necessity is invoked as an alibi for medicine to absorb societal resources.