bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of social interactions, professional supports and fear of death on adults' preferences for life‐sustaining treatments and palliative care
Authors: Huang Ya‐Ling , Yates Patsy , Thorberg Fred Arne , Wu Chiung‐Jung (Jo)
Published: April 2021

Aim

To explore the significance of culture, professional support in the community, social interactions and intrapersonal determinants of adults' preferences for life‐sustaining treatments and palliative care.

Methods

A cross‐sectional design with a Social Ecological Model was used. Between 1 October 2012 and 31 December 2012, 474 adults aged ≥20 years living in a city of Southern Taiwan completed the survey. Data were analysed using hierarchical multiple regression.

Results

The life‐sustaining measures model was significant with 15.3% (p < 0.0001) of the variance in the Modified Emmanuel Medical Directives being explained by variables of death of self and healthcare services' support. The palliative care model was significant with 18% (p < 0.0001) of the variance in the Modified Hospice Attitude Scale being explained by variables of palliative care knowledge, death of self and social interactions. However, cultural value adherence did not predict adults' preferences for life‐sustaining measures and community resources support did not predict palliative care preference.

Conclusions

Findings enhance our understanding of the significance of different societal levels on adults' preferences for end‐of‐life care. Palliative care knowledge, fear of death, healthcare services' support and social interactions are essential factors that need to be taken into consideration when it comes to discussion about life‐sustaining treatments and palliative care.
Decentralized resource allocation for interdependent infrastructures resilience: a cooperative game approach
Authors: Mohebbi Shima , Barnett Katherine , Aslani Babak
Published: April 2021

Interdependent critical infrastructures are governed by several sectors working together to maintain social, economic, and environmental well‐being. Although many models focus on a centralized view for networks for the restoration planning of these networks, rarely is there only one decision maker for the infrastructure networks. In the decentralized decision‐making paradigm, individual decision makers need to decide how to prioritize areas of the network and eventually improve the aggregated infrastructure systems resilience. There is a dearth of quantitative studies analyzing resource allocation decisions considering both decentralized and cooperative aspects. This paper aims to propose a coalitional game theory approach to address decentralized resource allocation for interdependent water distribution and road networks. In particular, combining coalitional game theory with weighted graphs creates an order of repair for each node in the coalitions. Subsequently, the decision makers can pass the information on to the master problem, reducing the complexity of the resource allocation problem for the interdependent networks. The proposed approach is applied to water distribution and transportation networks in the City of Tampa, Florida. We compare the decentralized solutions to centralized solutions in different scenarios to demonstrate the feasibility of our approach for the city‐scale networks. The results indicated the superiority of the proposed framework in terms of computational time and solution quality.
Modeling and simulation of broiler carcass precooling by computational fluid dynamics
Authors: Cotrim Weskley da Silva , Coimbra Jamille Coelho , Cotrim Keyla Cristina Francisco
Published: April 2021

There are few studies with mathematical models representative of the effect of agitation on the poultry carcass cooling. Thus, the Computational Fluid Dynamics (CFD) technique was applied in the modeling and simulation of this process. Two process conditions were studied: (a) without agitation (NA) by recirculation (0 m3 hr−1) and (b) with agitation (WA) by recirculation (8 m3 hr−1). The simulation was performed in the software ANSYS 18.2 in a steady‐state step, for the fluid flow, followed by a transient step (60 min), for the heat transfer. In NA condition R2 is equal to 0.9959 and NRMSE (%) of 6.32%. WA condition obtained R2 equal to 0.9923 and NRMSE (%) of 6.39%. The final temperatures were 7.11 and 5.31°C, for recirculation flows of 0 and 8 m3 hr−1, respectively. Increases in the volumetric flow of recirculation have a positive effect on reducing the time required for reaching the final temperature of the carcass.

Practical Applications

We demonstrate that the CFD model was able to adequately predict the temperature drop profile inside the carcass, overcoming the capacity of traditional empirical models. The CFD model was sensitive to the effects of the cooling water turbulence. It was possible to numerically demonstrate that the turbulence generated by the agitation of the cooling water by recirculation causes a positive effect on the cooling rate of the carcasses. The results point to the possibility of using CFD modeling to optimize the equipment and the precooling process of poultry carcasses. Such optimization can represent a reduction in energy consumption for cold water production or even a reduction in precooling time, which contributes to the environmental sustainability and microbiological safety of poultry meat.
The effects of infant behavioural sleep interventions on maternal sleep and mood, and infant sleep: A randomised controlled trial
Authors: Rouzafzoon Mozhgan , Farnam Farnaz , Khakbazan Zohre
Published: April 2021

Infant sleep problems are one of the first challenges for parents, negatively influencing infants and mothers. The present study examined the effects of preventive behavioural sleep intervention (BSI) on infant sleep patterns, maternal sleep quality, and depression. A clinical randomised multicentre controlled trial was conducted involving 82 mothers and their infants aged 2–4 months in Iran from August 2018 to April 2019. The intervention group received BSI, which included one individual 90‐min class session, booklet, voice messages, and follow‐up calls; while the control group received training on general infant safety. Details of infant sleep, maternal sleep quality, and postnatal depression were measured through the sleep diary, Pittsburgh Sleep Quality Index, and Edinburgh Postnatal Depression Scale, respectively, before and at 8 weeks after the training. In the intervention group, both the mean infant “night‐time sleep period” and infant “longest self‐regulated sleep period” were 81 min longer than the controls (p < .001). With an improvement of 160 min, the mean infant bedtime was decreased to 22:20 hours in the intervention group, substantially earlier than the controls (00:30 hours). The mean infant “night‐time awakenings with signals” did not significantly change (2.6‐ and 2.5‐times in the intervention and control groups, respectively). The intervention led to a significant improvement in maternal sleep quality and depression (p < .05). The present study acknowledges the positive effects of an early preventive infant BSI on infant sleep, maternal mood, and maternal sleep. Our present results also imply the importance of considering sleep patterns differences and cultural‐based intervention’s design.
The paradox of thrift in a two‐sector Kaleckian growth model
Authors: Fanti Lucrezia , Zamparelli Luca
Published: April 2021

We analyze the paradox of thrift in a two‐sector Kaleckian growth model. We consider an economy with one consumption and one investment good, differential sectoral mark‐ups and profit rates equalization. We show that when the investment function depends on aggregate capacity utilization and on the aggregate profit share (the Bhaduri–Marglin investment function) the paradox of thrift in its growth version may fail if mark‐ups are higher in the investment good sector. In this case, an increase in the saving rate produces a reallocation of economic activity toward the investment good sector; the aggregate profit share rises and its positive effect on investment may offset the reduction in average capacity utilization if investment is relatively more sensitive to profitability than to the level of activity.
A scoping review of approaches for measuring ‘interdependent’ collaborative performances
Authors: Sebok‐Syer Stefanie S. , Shaw Jennifer M. , Asghar Farah , Panza Michael , Syer Mark D. , Lingard Lorelei
Published: April 2021

Introduction

Individual assessment disregards the team aspect of clinical work. Team assessment collapses the individual into the group. Neither is sufficient for medical education, where measures need to attend to the individual while also accounting for interactions with others. Valid and reliable measures of interdependence are critical within medical education given the collaborative manner in which patient care is provided. Medical education currently lacks a consistent approach to measuring the performance between individuals working together as part of larger healthcare team. This review's objective was to identify existing approaches to measuring this interdependence.

Methods

Following Arksey & O’Malley's methodology, we conducted a scoping review in 2018 and updated it to 2020. A search strategy involving five databases located >12 000 citations. At least two reviewers independently screened titles and abstracts, screened full texts (n = 161) and performed data extraction on twenty‐seven included articles. Interviews were also conducted with key informants to check if any literature was missing and assess that our interpretations made sense.

Results

Eighteen of the twenty‐seven articles were empirical; nine conceptual with an empirical illustration. Eighteen were quantitative; nine used mixed methods. The articles spanned five disciplines and various application contexts, from online learning to sports performance. Only two of the included articles were from the field of Medical Education. The articles conceptualised interdependence of a group, using theoretical constructs such as collaboration synergy; of a network, using constructs such as degree centrality; and of a dyad, using constructs such as synchrony. Both descriptive (eg social network analysis) and inferential (eg multi‐level modelling) approaches were described.

Conclusion

Efforts to measure interdependence are scarce and scattered across disciplines. Multiple theoretical concepts and inconsistent terminology may be limiting programmatic work. This review motivates the need for further study of measurement techniques, particularly those combining multiple approaches, to capture interdependence in medical education.
Temporal Disruptions in Debussy's and Ravel's Programmatic Sonatas
Authors: Aziz Andrew
Published: April 2021

This article develops analytical tools which illustrate temporal disruptions in the programmatic works for Debussy and Ravel and reshape traditional modes of sonata analysis. In Debussy, a new analytical paradigm, one that invokes his affinity for filmic techniques, is the aborted rondo‐sonata, which employs a post‐expositional breakthrough following an expositional disruption: a rondo form retrospectively morphs into a sonata following the breakthrough. For Ravel, the key analytical tool is what I callresetting of the formal compass(RFC): virtuosic passages, analogous to a formal Etch‐A‐Sketch as a reaction to the music having become ‘lost’ or ‘confused’, that restore formal consciousness. Previous scholarship on Ravel suggests the presence of arch form; the current theory permits an interpretation consistent with a linear, forward‐vectored thematic trajectory. Each of these concepts is based on sonata form's rotational structure, in which temporal fissures disrupt the order of thematic modules either by binding two non‐continuous thematic events or by neutralising formal function to resume thematic progress. When the analyses in are considered in tandem, they can help to build a unifying theory of fin‐de‐siècle French sonata forms.
Association of fear of falling with frailty in community‐dwelling older adults: A cross‐sectional study
Authors: Qin Yuan , Li Junxin , McPhillips Miranda , Lukkahatai Nada , Yu Fang , Li Kun
Published: April 2021

This study aimed to describe frailty and fear of falling and examine the cross‐sectional association between frailty and fear of falling in community‐dwelling older adults in China. We recruited 165 older adults from five selected communities in the five districts of Changchun, Jilin Province. Participants were asked to complete a demographic questionnaire, the Short Falls Efficacy Scale‐International, and the Tilburg Frailty Indicator. We found that 60% of our participants were frail and that 81% reported a fear of falling. Using binary logistic regression, we found that the participants with fear of falling were 7.2 times more likely to be frail. These findings suggest that fear of falling should be regularly screened in clinical practice to help identify older adults with greater risks of frailty. Future longitudinal studies of larger sample size are needed to confirm the association. Moreover, frailty prevention programs that include strategies to reduce the fear of falling should be tested among community‐dwelling older adults.
Episode‐level reflux characteristics: How experienced reviewers differentiate true reflux from artifact on pH‐impedance studies
Authors: Rogers Barrett , Rogers Benjamin , Frazzoni Marzio , Savarino Edoardo , Roman Sabine , Sifrim Daniel , Gyawali C. Prakash
Published: April 2021

Background

Accurate reflux episode identification is crucial for pH‐impedance interpretation. Individual reflux episode characteristics associated with inter‐reviewer concordance are incompletely understood.

Methods

Ambulatory pH‐impedance studies from 19 GERD patients (median age 52 years, 78.9% F) were analyzed by 5 reviewers. Metadata from pH‐impedance studies were exported to a dedicated software tool designed to compare episode‐by‐episode identification between reviewers within a ±7.5 s window. Patient position, acidic vs. nonacidic episodes, acid clearance time (ACT), bolus clearance time (BCT), and proximal extent of reflux episodes were compared between episodes identified by all reviewers against those identified by automated analysis, and one to four reviewers, respectively.

Results

Automated analysis identified 1644 episodes (median 78 episodes per patient, IQR 64‐108), of which 84.9% were identified by ≥3 reviewers and 57.1% by all reviewers; 339 unique episodes were added by at least 1 reviewer. Characteristics defining 5 reviewer concordance included acid reflux episodes (88.9%), upright episodes (88.4%), high proximal extent (median 17 cm, IQR 15‐17 cm), and longer acid clearance times (67.0 s, IQR 29.0‐146.0 s) (P < 0.001 compared to 1‐4 reviewer concordance for each). In contrast, 1 reviewer‐identified episodes were 69.8% acidic, 76.9% upright, and limited to the distal esophagus. Using 5‐reviewer concordance, designation of GERD evidence changed from automated analysis in 16%‐19% of patients.

Conclusions

Acidic episodes with high proximal extent in the upright position and longer acid clearance times on pH‐impedance studies have the highest concordance for identification by expert reviewers. Reflux episode identification may be influenced by reviewer opinion despite availability of established criteria.
Plant chemistry and food web health
Authors: Schlaeppi Klaus , Gross Josef J. , Hapfelmeier Siegfried , Erb Matthias
Published: April 2021

Plants are systemically relevant to our planet not only by constituting a major part of its biomass, but also because they produce a vast diversity of bioactive phytochemicals. These compounds often modulate interactions between plants and the environment, and can have substantial effects on plant consumers and their health. By taking a food web perspective, we highlight the role of bioactive phytochemicals in linking soils, plants, animals and humans and discuss their contributions to systems health. The analysis of connections among food web components revealed an underexplored potential of phytochemicals to optimize food web health and productivity.
Moniliophthoraperniciosa, the causal agent of witches’ broom disease of cacao, interferes with cytokinin metabolism during infection of Micro‐Tom tomato and promotes symptom development
Authors: Costa Juliana L. , Paschoal Daniele , da Silva Eder M. , Silva Jamille S. , do Carmo Rafael M. , Carrera Esther , López‐Díaz Isabel , Rossi Mônica L. , Freschi Luciano , Mieczkowski Piotr , Peres Lazaro E. P. , Teixeira Paulo J. P. L. , Figueira Antonio
Published: April 2021

Moniliophthoraperniciosacauses witches’ broom disease of cacao and inflicts symptoms suggestive of hormonal imbalance. We investigated whether infection of the tomato (Solanumlycopersicum) model system Micro‐Tom (MT) by the Solanaceae (S)‐biotype ofMoniliophthoraperniciosa, which causes stem swelling and hypertrophic growth of axillary shoots, results from changes in host cytokinin metabolism.

Inoculation of an MT‐transgenic line that overexpresses the ArabidopsisCYTOKININOXIDASE‐2 gene (35S::AtCKX2) resulted in a reduction in disease incidence and stem diameter. RNA‐sequencing analysis of infected MT and35S::AtCKX2revealed the activation of cytokinin‐responsive marker genes when symptoms were conspicuous.

The expression of anMoniliophthoraperniciosatRNA‐ISOPENTENYL‐TRANSFERASEsuggests the production of isopentenyladenine (iP), detected in mycelia growninvitro. Inoculated MT stems showed higher levels of dihydrozeatin andtrans‐zeatin but not iP. The application of benzyladenine induced symptoms similar to infection, whereas applying the cytokinin receptor inhibitors LGR‐991 and PI55 decreased symptoms.

Moniliophthoraperniciosaproduces iP that might contribute to cytokinin synthesis by the host, which results in vascular and cortex enlargement, axillary shoot outgrowth, reduction in root biomass and an increase in fruit locule number. This strategy may be associated with the manipulation of sink establishment to favour infection by the fungus.
An action‐oriented framework for systems‐based solutions aimed at childhood obesity prevention in US Latinx and Latin American populations
Authors: Garcia Leandro M. T. , Hunter Ruth F. , de la Haye Kayla , Economos Christina D. , King Abby C.
Published: April 2021

Childhood obesity in US Latinx and Latin American populations is a persistent, complex public health issue and, as such, requires solutions grounded on systems science theory and methods. In this paper, we introduce an action‐oriented framework to design, implement, evaluate, and sustain whole‐of‐community systems changes for childhood obesity prevention in US Latinx and Latin American populations. Our framework covers six action steps: (1) foster multisectoral team; (2) map the system, its context, and drivers; (3) envision system‐wide changes; (4) effect system‐wide changes; (5) monitor, learn, and adapt; and (6) scale and sustain. We also propose 10 principles that put human and environmental rights and systems thinking at the center of these systems‐based solutions. For each action step, we provide a list of concrete activities, methods, approaches, and examples that can be used to guide and inform the work needed to achieve the expected outputs. Finally, we discuss how a wider adoption of systems science for childhood obesity prevention among US Latinx and Latin American populations can be encouraged and sustained.
Capacity for childhood obesity research in Latin American and US Latino populations: State of the field, challenges, opportunities, and future directions
Authors: Salvo Deborah , Parra Diana C. , Jáuregui Alejandra , Reséndiz Eugen , Garcia‐Olvera Armando , Velazquez Daniel , Aguilar‐Farias Nicolas , Colón‐Ramos Uriyoán , Hino Adriano A. , Kohl Harold W. ( Bill) , Pratt Michael , Ramirez Varela Andrea , Ramirez‐Zea Manuel , Rivera Juan A.
Published: April 2021

Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity‐related articles published June 2015–December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity‐related articles (505 from Latin America, 124 from the United States, and 17 US–Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross‐border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.
Is the right ventricular function affected by permanent pacemaker?
Authors: Sinkar Kunal , Bachani Neeta , Bagchi Avishek , Jadwani Jaipal , Panicker Gopi Krishna , Bansal Raghav , Mahajan Ankit , Lokhandwala Yash
Published: April 2021

Aims

The effect of right ventricular (RV) pacing on left ventricular (LV) function has been extensively evaluated, but the effect on RV function per se has not been evaluated systematically. We aimed to assess the effect of dual chamber pacemaker on RV function.

Methods and Results

All consecutive patients undergoing dual chamber pacemaker from January 2018 to March 2019 for AV block with a structurally normal heart were included. They underwent pre‐procedure detailed echocardiography (including three‐dimensional [3D] RV ejection fraction [RVEF]), a screening echocardiogram 2 days after pacemaker implantation and again a detailed echocardiogram at 6‐month follow‐up. We compared the baseline echocardiographic RV parameters with those 6 months after the pacemaker implantation. A total of 60 patients underwent successful pacemaker implantation. At 6 months, most of the patients were pacemaker dependent with pacing percentage of 98.9% ± 2.4%; there was a significant increase in TR and a mean drop in RVEF by 2.8 ± 5%, with 23 (38.3%) having at least a 5% decrease in RVEF. The drop in RVEF positively correlated with TR vena contracta at 6 months but did not correlate with pulmonary artery systolic pressure at 6 months.

Conclusion

Our study shows the presence of demonstrable RV dysfunction as early as 6 months in a majority of patients who have undergone pacemaker implantation.
The Changing Age Distribution of the United States
Authors: Preston Samuel H. , Vierboom Yana C.
Published: April 2021

The age distribution of a population is a product of a century of demographic history. This paper describes how the history of births, deaths, and migrations has fashioned the US age distribution in 2018. It also shows how that history, combined with contemporary processes, was actively producing changes in the age distribution between 2013 and 2018. Changes in survivorship, migration, and births all contributed to population aging during this period, with a declining growth rate of births the leading contributor. Using a novel approach, the paper demonstrates how the inertia reflected in changing age distributions sheds light on the future population of the United States. Massive growth in the population above age 70 will occur by 2033 if recent age patterns of age‐specific mortality and migration are maintained.
The effect of rituximab on the quality of life of children with refractory nephrotic syndrome
Authors: Takahashi Toshiyuki , Okamoto Takayuki , Yokota Isao , Sato Yasuyuki , Hayashi Asako , Ueda Yasuhiro , Aoyagi Hayato , Ueno Michihiko , Kobayashi Norio , Uetake Kimiaki , Nakanishi Masanori , Ariga Tadashi
Published: April 2021

Background

Rituximab (RTX) is an effective treatment for maintaining remission in patients with nephrotic syndrome (NS), but there are few reports on the effect of RTX treatment on quality of life (QOL). The purpose of this study was to examine the effect of periodically repeated RTX treatment from the perspective of QOL.

Methods

We systematically assessed the QOL of pediatric patients with refractory NS and parents’ perceptions of their children’s QOL through a 2 year RTX treatment protocol. Pediatric patients from Hokkaido University Hospital with refractory NS who met our specific criteria were enrolled between January 2015 and December 2015. The RTX infusion was performed 4 times at 6‐month intervals, followed by mizoribine administration with early discontinuation of calcineurin inhibitors. Quality of life scores were measured by the Pediatric Quality of Life Inventory version 4.0 (PedsQL) at each RTX administration and evaluated 2 years later.

Results

Twenty‐two patients were analyzed. The patients’ QOL and their parents’ perceptions of their QOL improved over our 2 year treatment protocol. Nevertheless, the parents' scores were lower than the patients’ scores on all scales, with slower improvement.

Conclusions

Our treatment protocol showed a significant improvement of QOL in patients with refractory NS. Although the risk of the RTX treatment should be considered, the treatment is useful for patients with refractory NS.
Prophylactic antithrombotic management in adult and pediatric kidney transplantation: A systematic review and meta‐analysis
Authors: Bapistella Sascha , Zirngibl Matthias , Buder Kathrin , Toulany Nikan , Laube Guido F. , Weitz Marcus
Published: April 2021

Background

RGT is a major cause for early graft loss after KTx. Although evidence‐based recommendations are lacking, aP is often used to prevent RGT. This systematic review aimed to determine the effectiveness and safety of aP in adult and pediatric KTx recipients.

Methods

MEDLINE, EMBASE, Cochrane Controlled Trials Register, conference proceedings, and electronic databases for trial registries were searched for eligible studies using search terms relevant to this review (April 21, 2020). The systematic review was carried out following the recommendations of the Cochrane Collaboration and the Prefered Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Statement.

Results

Twelve studies comprising 2370 patients (adult = 1415, pediatric = 955) were included, of which three were RCTs. The overall risk for developing RGT was lower in the group with aP compared with the control group (RR 0.24, 95% confidence interval 0.12–0.49). The antithrombotic drugs used were heparin (7/12), acetylsalicylic acid (2/12), a combination of both (2/12), and dipyridamole (1/12) with a high variability in timing, dosing, and mode of application. Adverse effects were reported rarely, with minor bleeding as the main complication. The non‐randomized studies had significant risks of bias in the domains of patient selection, confounder, and measurement of outcomes.

Conclusion

Based on pooled analysis, aP seems to reduce the risk of RGT in KTx. However, the reliability of these results is limited, as the quality of the available studies is poor and information on adverse effects associated with aP is scarce. Additional high‐quality research is urgently needed to provide sufficient data supporting the use of aP in KTx.
Genetic variability and evolutionary dynamics of tomato black ring virus population
Authors: Budzyńska Daria , Hasiów‐Jaroszewska Beata , Elena Santiago F.
Published: April 2021

Tomato black ring virus (TBRV) is an important pathogen infecting a wide range of plant species worldwide. Phylogenetic studies of TBRV have already been conducted, although limited by the use of short genomic regions or a reduced amount of isolates. In the present study, we carried out an exhaustive phylogenetic and population genetic analysis based on the coat protein gene (CP) sequence of 57 TBRV isolates originating from different host plants and European geographic regions (47 isolates from Poland, 8 from Lithuania, one from the UK, and one from Hungary). Moreover, the selective pressure acting on particular codons and coevolution of amino acid residues in the CP were analysed. The results clearly showed that the TBRV population is being shaped by recombination and both positive and purifying selection. The analyses revealed that the placement of TBRV isolates in the phylogenetic trees was nonrandom, with isolates clustering according to host plant families and geographic origin.
Visual pedagogy‐guided toothbrushing training to enhance fine motor skills in individuals with intellectual disabilities and impaired fine motor skills
Authors: Tangnuntachai Nichruethai , Smutkeeree Apiwan , Jirarattanasopha Varangkanar , Leelataweewud Pattarawadee
Published: April 2021

Aims

To evaluate the effect of visual pedagogy‐guided toothbrushing training on oral hygiene, toothbrushing ability, and fine motor skills in individuals with intellectual disability (ID) and impaired fine motor skills.

Methods

This quasi‐experimental study comprised 37 subjects aged 6–24 years. The plaque index (PI), gingival index (GI), toothbrushing ability, and fine motor skills were evaluated before and after 3 and 6 months of individual visual pedagogy‐guided toothbrushing training. Friedman's post hoc test and Spearman's correlation coefficient were used for statistical analyses.

Results

The PI, GI, toothbrushing ability, and fine motor skills of the 23 subjects who remained in the study at the 6‐month follow‐up period significantly improved from those measured at baseline (p < 0.05). A significant association was observed between the improvements in both toothbrushing ability and fine motor skills (p < 0.05).

Conclusions

Visual pedagogy‐guided toothbrushing training could improve the oral hygiene and toothbrushing ability of individuals with ID and impaired fine motor skills. Moreover, improvements in the toothbrushing ability could enhance the fine motor skills of these individuals.
On regional integration, fiscal income, and GDP per capita
Authors: Han Yutao , Song Zhen
Published: April 2021

This paper investigates the economic impacts of regional integration on a small, less developed jurisdiction in a dynamic fiscal competition environment. The trade‐offs between the economic benefits and the loss of policy flexibility resulting from integration are analyzed from the perspectives of fiscal revenue and GDP per capita. Our results show that the small jurisdiction's loss of flexibility in policymaking can dominate the other effects of integration. Specifically, if the small jurisdiction's efficiency in providing public inputs is originally sufficiently high (low), regional integration always reduces (improves) its net revenue, independently of the extent of efficiency improvement due to integration. However, when the small jurisdiction's efficiency is originally intermediate, the impact on net revenue crucially depends on the magnitude of the efficiency effect. Our analysis also characterizes the trade‐offs resulting from integration between policy flexibility on the one hand and capital mobility and fiscal equalization on the other.
Is America coming apart? Socioeconomic segregation in neighborhoods, schools, workplaces, and social networks, 1970–2020
Authors: Mijs Jonathan J. B. , Roe Elizabeth L.
Published: April 2021

As income inequality in the United States has reached an all‐time high, commentators from across the political spectrum warn about the social implications of these economic changes. America, they fear, is “coming apart” as the gap between the rich and poor grows into a fault line. This paper provides a comprehensive review of empirical scholarship in sociology, education, demography, and economics in order to address the question: How have five decades of growing economic inequality shaped America's social landscape? We find that growing levels of income inequality have been accompanied by increasing socioeconomic segregation across (1) friendship networks and romantic partners, (2) residential neighborhoods, (3) K‐12 and university education, and (4) workplaces and the labor market. The trends documented in this review give substance to commentators' concerns: compared to the 1970s, rich and poor Americans today are less likely to know one another and to share the same social spaces. The United States is a nation divided.
Log‐symmetric quantile regression models
Authors: Saulo Helton , Dasilva Alan , Leiva Víctor , Sánchez Luis , de la Fuente‐Mella Hanns
Published: April 2021

Regression models based on the log‐symmetric family of distributions are particularly useful when the response variable is continuous, positive, and asymmetrically distributed. In this article, we propose and derive a class of models based on a new approach to quantile regression using log‐symmetric distributions parameterized by means of their quantiles. Two Monte Carlo simulation studies are conducted utilizing theRsoftware. The first one analyzes the performance of the maximum likelihood estimators, the Akaike, Bayesian, and corrected Akaike information criteria, and the generalized Cox–Snell and random quantile residuals. The second one evaluates the size and power of the Wald, likelihood ratio, score, and gradient tests. A web‐scraped box‐office data set of the movie industry is analyzed to illustrate the proposed approach. Within the main results of the simulation carried out, the good performance of the maximum likelihood estimators is reported.
Identifying road avoidance behavior using time‐geography for red deer in Banff National Park, Alberta, Canada
Authors: Loraamm Rebecca , Anderson James , Burch Claire
Published: April 2021

Analysis of animal movement as a complex spatiotemporal signal attenuated by behavioural and contextual factors comprises a recent perspective in the time‐geographic study of movement. For their significant ecological and human impacts, animal–roadway interactions have become a particularly important subject matter in this arena. Analyses relying on spatiotemporal aggregation or reductive modelling of the information held in movement trajectories may overlook the influences of behaviour and environmental context. Towards expanding perspectives on animal movement and roadway interactions, this research acknowledges and characterizes the varying influence of temporally dynamic elements in the environmental context at fine spatiotemporal scales. In particular, these elements are hourly traffic volumes and their effect on the probability of animal–roadway interactions. A set of methods from time geography and signal analysis, including the probabilistic space‐time prism, comprehensive probability surface, and cross‐correlation were combined to provide for serial comparison of hourly roadway interaction probabilities and traffic volumes for red deer (Cervus elaphus) tracked in Banff National Park, Alberta, Canada. Results suggest a cyclical, diurnal repulsion in roadway interaction probabilities from periods of higher traffic volume at the hourly scale in the study area, consistent with prior theoretical and empirical findings on ungulates living in similar environmental settings.
Clinical risk score for predicting invasive fungal disease after allogeneic hematopoietic stem cell transplantation: Analysis of the China Assessment of Antifungal Therapy in Hematological Diseases (CAESAR) study
Authors: Sun Yuqian , Hu Jiong , Huang He , Chen Jing , Li Jianyong , Ma Jun , Li Juan , Liang Yingmin , Wang Jianmin , Li Yan , Yu Kang , Hu Jianda , Jin Jie , Wang Chun , Wu Depei , Xiao Yang , Huang Xiaojun
Published: April 2021

Background and objective

Invasive fungal disease (IFD) is associated with a high mortality for patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (allo‐HSCT). This study aimed not only to develop a proven/probable IFD risk‐scoring model but to identify high‐risk populations that would benefit from anti‐fungal prophylaxis.

Methods

Data from the China Assessment of Antifungal Therapy in Hematological Diseases (CAESAR) study were retrieved, and all patients (n = 1053) undergoing allo‐HSCT were randomly divided into the training set (n = 685) for model development and the validation set (n = 368) for model verification. A weighted risk score for proven or probable IFD was established through multivariate logistic regression analysis.

Results

The study population had a mean age of 28.95 years and the majority underwent myeloablative transplantation in complete remission 1 (53.4%). Five risk factors of IFD were identified, namely neutropenia lasting longer than 14 days, corticosteroid use, diabetes, haploidentical donor, and unrelated donor. Based on the risk score for IFD, the patients were categorized into three groups: low risk (score 0‐4, 1.5%‐4.0%), intermediate risk (score 5‐8, 9.8%), and high risk (score>8, 24.7%‐14.0%). Anti‐fungal prophylaxis may provide benefits for patients with intermediate (8.5% vs. 18.5%, P = .0085) or high risk (19.4% vs. 30.8%, P = .4651) but not low risk (2.1% vs. 3.8%, P = .6136) of IFD.

Conclusion

A practical weighted risk score for IFD in patients receiving allo‐HSCT was established, which can aid decision‐making regarding the administration of anti‐fungal prophylaxis.
Stress Concentrations Around Spheroidal Inclusions and Cavities
Authors: Edwards R. H.
Published: April 2021

Previous investigations have been concerned with the stress concentration around a spheroidal cavity under certain restricted loading assumptions. In this paper exact closed solutions are obtained for the following: (a) The distribution of stress around a spheroidal inclusion in an elastic body which is in an arbitrary uniform state of stress infinitely far from the inclusion, and, in particular, for the distribution of stress around a spheroidal cavity under the same loading conditions. (b) The thermal stress distribution arising from distinct uniform temperature changes applied to the spheroidal inclusion and the surrounding medium. Technically important features of the solutions obtained are discussed.
Shakedown in Continuous Media
Authors: Symonds P. S.
Published: April 2021

A new and simpler proof is given for a theorem due to Melan concerning the conditions under which an elastic-plastic body will “shake down” i.e., reach a residual stress state on which only elastic stresses are superimposed for all further variations of the surface loading stresses within limits prescribed at surface points. The theorem is applied to discuss the case of a circular bar subjected to an axial force and a torsional moment which vary independently between given limits. Relations to previous work on trusses and rigid frames are discussed briefly.
Influence of Flame Front on the Flow Field
Authors: Tsien H. S.
Published: April 2021

Flame front is a region in the flow field where rapid change in the chemical composition of the fluid occurs with consequent release of chemical energy in the form of heat. In the majority of cases the phenomenon is a very complicated one involving the heat transfer by conduction and radiation, the changes in concentration of the different components by diffusion and chemical reaction. Owing to this and the difficult problem of chemical kinetics, only recently the complete theory of flame front has been formulated, particularly by the group under J. O. Hirschfelder. Fortunately, as a result of the rapid rate of chemical reaction, the thickness of the flame front under ordinary conditions is generally very small, being less than 1 mm. Therefore, if one is interested in the influence of flame front on the flow field but not on the detailed structure of the flame, the flame can be assumed as infinitesimally thin, and only the final changes of the state of fluid due to combustion need be considered. This procedure is entirely analogous to that of treating the shock wave as having zero thickness in studying dynamics of compressible fluids. This simplification will be adopted for the present investigation.
Buckling of a Sandwich Cylinder Under Uniform Axial Compressive Load
Authors: Eringen A. Cemal
Published: April 2021

A boundary-value problem of elasticity for a thick hollow circular cylinder is solved under the following boundary conditions, namely, (a) on the lateral surfaces, displacements are specified as arbitrary functions of the longitudinal co-ordinates only, and (b) at both ends, the radial displacements and the longitudinal surface forces are taken to be equal to zero. The displacements, strains, and stresses are obtained in terms of these arbitrary displacement functions. The stresses determined are used to obtain the buckling load of a sandwich cylinder, which employs the thick hollow cylinder as the core. Two simultaneous differential equations are obtained from the equilibrium conditions between the contacting lateral surfaces of the sandwich material (faces) and the core. Numerical calculations and curves are made of the buckling stress for a given core material and for two types of face materials employed in aircraft design. In a special case, when the radius approaches infinity, the result is found to be in good agreement with previously published experimental results. No test data for the general case were available to the author during the preparation of this paper.
Stresses in Pipe Bundles
Authors: Poritsky H. , Horvay G.
Published: April 2021

For purposes of stress analysis, a closely packed bundle of very many pipes can be replaced by a homogeneous but nonisotropic solid (HNS for short). This paper deals with the derivation of the elastic constants of the HNS, the solution of its stress problem under certain conditions, and the conversion of the results into stresses and displacement of individual pipes. As an example, the thermal stresses are determined that arise in a pipe bundle due to a nonuniform axial temperature gradient.
A Note on Elastic Surface Deformation
Authors: Kornhauser Murray
Published: April 2021

Surface deformation of elastic bodies having the same modulus is treated by the standard texts on elasticity, but the applicability of the solution is limited to the range of the tables of coefficients presented. This note extends the tables to cover the range that applies to bodies having one principal curvature much larger than the other. Some inaccuracy in the tables in current use also is noted. The reader is referred to any good text on elasticity for a general discussion of this problem.
Velocity Distributions and Design Data for Ideal Incompressible Flow Through Cascades of Airfoils
Authors: Resnick Robert , Green L. J.
Published: April 2021

Theoretical incompressible velocity distributions for three airfoils in various cascade arrangements and for different entering-air angles are presented. Design charts and design formulas relating cascade angle, entering-air angle, turning angle, and blade camber are presented for 10 per cent thick airfoils at solidity 1. An empirical turning-angle formula is developed and is found to be reasonably accurate and rather generally applicable.
Transverse Vibrations of a Free Circular Plate Carrying Concentrated Mass
Authors: Roberson R. E.
Published: April 2021

The plate under consideration carries a concentrated mass at its center, which is struck impulsively in a direction perpendicular to the undisturbed plate face. Only circularly symmetric vibrations are considered. The solution is carried out by the use of the Laplace transform method, treating the concentrated mass as a plate-density impulse. The first four natural frequencies are displayed as functions of mass ratio, and the first mode shape is displayed for three mass ratios. The natural frequencies, particularly the higher, are shown to be very sensitive to changes in mass ratio at small values of the concentrated mass.
Sinusoidal Torsional Buckling of Bars of Angle Section Under Bending Loads, as a Problem in Plate Theory
Authors: Plass H. J.
Published: April 2021

Timoshenko has applied plate theory to each leg of an angle-section bar to determine the critical compressive load needed to cause sinusoidal torsional buckling. In this paper his idea is used to calculate the critical bending load needed to cause sinusoidal torsional buckling of an angle bar. The bending is assumed to be applied so that the extreme fibers of the angle are in compression, the vertex in tension. Approximate results are first obtained by means of the Rayleigh-Ritz method. The approximate deflection functions from which the energy terms are computed are based upon certain infinite-series solutions. After having obtained approximate results, exact values are obtained, using the approximate values as a guide to limit the amount of calculation. The results of this calculation are shown in Fig. 5, where they are compared with those predicted by bar theory. Differences between the two theories become more noticeable as the bar becomes short compared to its flange width. It is found that the critical bending load becomes larger very rapidly as the ratio of length to width of the flanges decreases. Bar theory predicts no such increase. The reason for this difference is explained.
On the Inextensional Theory of Deformation of a Right Circular Cylindrical Shell
Authors: Hermes R. M.
Published: April 2021

The inextensional theory of bending of shells is considered. By the method of superposition the known solution is extended to include two cases which can easily be investigated experimentally. The experimental results are compared with the theoretical solution, indicating the degree of approximation involved in the use of the inextensional theory.
A General Method of Calculating the Mϵmax Diagram in Plastic Bending of Beams
Authors: Phillips Aris
Published: April 2021

In this paper we give a new method for finding the Mϵmax curve in the case of symmetrical pure bending of bars in plasticity. This method is both accurate and comparatively easy to use. At the end of the paper we show how it is possible to express any σ-ϵ curve as the sum of a number of elastic plastic-stress strain lines.
Torsion of Curved Beams of Rectangular Cross Section
Authors: Langhaar H. L.
Published: April 2021

Recently, W. Freiberger obtained an exact solution of the problem of uniform torsion of a segment of a ring of circular cross section. This paper presents a solution of the problem for the rectangular cross section. O. Göhner previously treated this case by an approximation method.
On the Direction of Fatigue Cracks in Polycrystalline Ingot Iron
Authors: McClintock F. A.
Published: April 2021

A statistical analysis is developed to show how a microscopic shear failure can result in the apparent tensile failure of polycrystalline iron in rotary bending fatigue tests.
The Time Required for Constant-Volume Combustion
Authors: Campbell A. S.
Published: April 2021

By combining the results of an elementary thermodynamic analysis of the temperature distribution in the burned gases of a constant-volume bomb with an examination of the velocity relations at the flame front, it is possible to relate the “normal burning velocity” to the time rate of production of burned gases. Integration of this equation leads to an estimate of the time required for the combustion process.