bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive dysfunction and mortality in multiple sclerosis: Long-term retrospective review
Authors: Cavaco Sara , Ferreira Inês , Moreira Inês , Santos Ernestina , Samões Raquel , Sousa Ana Paula , Pinheiro Joaquim , Teixeira-Pinto Armando , Martins da Silva Ana
Published: December 2021

Background:

Cognitive dysfunction as a predictor of clinical progression and mortality in multiple sclerosis (MS) is still a matter of debate.

Objective:

The aim of this study was to explore the long-term outcome associated with neuropsychological performance in a cohort of patients with MS.

Methods:

A series of 408 MS patients had previously undergone a comprehensive neuropsychological assessment and a contemporaneous neurological evaluation (T1). A retrospective review of the clinical records was conducted 102–192 months after T1. Demographic and clinical data regarding the last clinical appointment with EDSS measurement (T2) were collected and the date of the last clinical contact or death (TS) was recorded.

Results:

This review revealed that cognitive dysfunction (T1) was associated with higher odds of transitioning from relapsing–remitting course to a progressive disease course (adjusted odds ratio (OR) = 2.29, p = 0.043) and higher hazard of death in the total sample (adjusted hazard ratio (HR) = 3.07, p = 0.006) and the progressive disease course subgroup (adjusted HR = 3.68, p = 0.007), even when adjusting for other covariates.

Discussion:

The study results demonstrate that cognitive dysfunction in MS is predictive of poorer prognosis and mortality.
Effects of telehealth-assisted interventions among people living with HIV/AIDS: A systematic review and meta-analysis of randomized controlled studies
Authors: Saragih Ita Daryanti , Tonapa Santo Imanuel , Osingada Charles Peter , Porta Carolyn M , Lee Bih-O
Published: December 2021

Introduction

Taking antiretroviral therapy (ART) is a daily necessity for people living with HIV but these individuals experience multiple barriers and challenges to medication adherence. Interventions to support medication adherence have yielded effects in the expected direction, but the extent to which telehealth or virtually delivered interventions to promote adherence are effective among people living with HIV/AIDS remains unknown. We aimed to address this knowledge gap and inform future research and practice that promotes the well-being of people living with HIV/AIDs through telehealth interventions addressing medication use.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted using the following databases: Academic Search Complete, Cochrane library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, MEDLINE, PubMed, OVID (UpToDate), and the Web of Science. Relevant full-text articles published through September 2021 were retrieved. The revised Cochrane risk of bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth-assisted interventions for people living with HIV/AIDS. Stata 16.0 was used for statistical analysis.

Results

A total of 12 studies (N = 3557 participants) that used telehealth-assisted interventions for people living with HIV/AIDS were included. Telehealth interventions were found to increase the adherence to treatment (standardized mean difference [SMD]: 0.21; 95% confidence interval (CI): 0.03 to 0.40), to reduce depressive symptoms (SMD: −2,74; 95% CI: −3.39 to −2.09), and to improve perceived quality of life (SMD: 0.74; 95% CI: 0.37 to 1.10).

Discussion

The meta-effects of telehealth-assisted interventions include significantly enhanced adherence to treatment, improved quality of life, and reduced depressive symptoms among people living with HIV/AIDS. These findings suggesting that delivering health management interventions remotely through telehealth-assisted modalities was both feasible and effective in yielding health benefits for people living with HIV/AIDS. Integrating telehealth-assisted interventions as a modality in HIV/AIDS care might support continuity of care and sustained well-being. Future research should evaluate telehealth intervention outcomes and examine mediating, moderating, or other tailorable variables affecting intervention effectiveness.
Classroom learning of English L2 requests: Input and interactional opportunities in French secondary schools
Authors: Siddiqa Aisha , Whyte Shona
Published: December 2021

With today’s strong focus on communicative competence in second language (L2) classrooms, speech acts like suggestions, requests, refusals, and apologies are often investigated in interlanguage pragmatic (ILP) as well as instructional pragmatics. Even though there is strong evidence in ILP research that purports that L2 learners respond well to pragmatic instruction (Taguchi, 2015), the teaching of L2 pragmatics is not always prioritized in textbooks, teaching programmes or teacher education (Barron, 2016; Savvidou & Economidou-Kogetsidis, 2019) with the consequence that pragmatic learning can only occur incidentally. The present study examines opportunities to acquire L2 requests for 308 English as a foreign language (EFL) learners across 7 years of instruction in French secondary schools, investigating textbooks preferred by teachers, classroom interaction (39 hours), and teacher perspectives (semi-structured interviews with 10 teachers). After a pragmatic analysis of 15 EFL textbooks with a focus on requests, the study examines the incidence of metapragmatic input in 39 hours of teaching in 13 classes at 3 levels, and relates interactional patterns with interview data from the 10 teachers concerned. Findings suggest limited pragmatic input in both textbooks and classroom interaction. By comparing the profiles of teachers who encouraged L2 requests with those who did not, the study offers new explanations for L2 learners’ limited pragmatic development which also broadly corroborate previous findings of somewhat limited potential for L2 pragmatic development in obligatory school contexts.
Boredom in online English language classes: Mediating variables and coping strategies
Authors: Pawlak Mirosław , Derakhshan Ali , Mehdizadeh Mostafa , Kruk Mariusz
Published: December 2021

Although boredom has been the subject of increasing scrutiny in second language (L2) learning recently, very little is known about how this emotion can affect teachers and students involved in Covid-19 prompted online English education. To address this gap, through maximum variation sampling, this qualitative study surveyed the opinions of 34 teachers and 256 students from universities across Iran to find out which class mode (online versus physical classes) and course type (content-based versus skills-based courses) were more boring, and what – if any – coping strategies these individuals used to get over boredom. The majority of teachers and students deemed online classes more boring than traditional, in-person classes. While teachers regarded skills-based and content-based courses as equally boring, most students believed that content-based online courses were more boredom-inducing due to their lecture-type nature. Moreover, whereas the teachers had a variety of useful coping strategies in their toolbox, an alarming number of students reported either not knowing how to deal with boredom or resorting to debilitative strategies, such as playing games or leaving class altogether when boredom reached an unbearable level. The findings are discussed in light of existing evidence from boredom and personality research, and practical suggestions are made.
Queering deportability: The racial and gendered politics of lesbian anti-deportation activism
Authors: Lewis Rachel
Published: December 2021

This article explores how deportability structures the experiences of lesbian refugees and asylum seekers in the United Kingdom. The first part of the article considers the racial and gendered processes through which the UK asylum system transforms lesbian migrants into detainable and deportable subjects. Part two then examines lesbian migrant protests that are emerging to contest the United Kingdom’s participation in the global deportation regime. The final part of the article discusses how deportation has become absorbed into the cycle of lesbian migration and asylum. The article concludes by calling for a feminist, queer, and anti-racist understanding of the processes through which lesbian migrant deportability is produced and experienced in 21st century Britain.
Crossroads of parental decision making: Intersections of hope, communication, relationships, and emotions
Authors: Koch Amie , Albrecht Tara , Kozhumam Arthi S , Son Heeyeon , Brandon Debra , Docherty Sharron L
Published: December 2021

Parents of children born with complex life-threatening chronic conditions (CLTCs) experience an uncertain trajectory that requires critical decision making. Along this trajectory, hope plays an influential but largely unexplored role; therefore, this qualitative descriptive study explores how parent and provider hope may influence decision making and care of a child born with CLTCs. A total of 193 interviews from 46 individuals (parents, nurses, physicians, and nurse practitioners) responsible for the care of 11 infants with complex congenital heart disease (CCHD) were analyzed to understand how hope features in experiences related to communication, relationships, and emotions that influence decision making. Overall, parental hope remained strong and played a pivotal role in parental decision making. Parents and professional healthcare providers expressed a range of emotions that appeared to be integrally linked to hope and affected decision making. Providers and parents brought their own judgments, perceptions, and measure of hope to relationships, when there was common ground for expressing, and having, hope, shared decision making was more productive and they developed more effective relationships and communication. Relationships between parents and providers were particularly influenced by and contributory to hope. Communication between parents and providers was also responsible for and responsive to hope.
Increasing inequalities in disability-free life expectancy among older adults in Sweden 2002–2014
Authors: Sundberg Louise , Agahi Neda , Wastesson Jonas W. , Fritzell Johan , Fors Stefan
Published: December 2021

Background:

In an aging society with increasing old age life expectancy, it has become increasingly important to monitor the health development in the population. This paper combines information on mortality and disability and explores educational inequalities in disability-free life expectancy in the aging population in Sweden, and to what extent these inequalities have increased or decreased over time.

Methods:

A random sample of the Swedish population aged 77 years and above ( n=2895) provided information about disability in the population in the years 2002, 2004, 2011 and 2014. The prevalence of disability was assessed by five items of personal activities of daily living and incorporated in period life tables for the corresponding years, using the Sullivan method. The analyses were stratified by sex and educational attainment. Estimates at ages 77 and 85 years are presented.

Results:

Disability-free life expectancy at age 77 years increased more than total life expectancy for all except men with lower education. Women with higher education had a 2.7-year increase and women with lower education a 1.6-year increase. The corresponding numbers for men were 2.0 and 0.8 years. The educational gap in disability-free life expectancy increased by 1.2 years at age 77 years for both men and women.

Conclusions:

While most of the increase in life expectancy was years free from disability, men with lower education had an increase of years with disability. The educational differences prevailed and increased over the period as the gains in disability-free life expectancy were smaller among those with lower education.
Examining the digital renewal of news communication: A categorization of presentation modes in digital journalism
Authors: Püchel Lea , Wellbrock Christian-Mathias
Published: December 2021

Our daily dealings with media products are shaped by the use of generic designations such as journalistic presentation modes, for example, news, commentary, and Instagram-story. Yet, scholarship has examined presentation modes only selectively and lacks empirical investigations in this domain. Based on literature and a quantitative content analysis of jury protocols of the German online journalism award “Grimme Online Award,” this article explores how presentation modes are constructed and further develops a framework for a categorization of presentation modes with eight dimensions: Content and Function, Author, Sources, Periodicity, Material Substrate, Structure, Media, and Interactive-Engagement Elements. This study is the first to empirically assess journalistic presentation mode dimensions and manifestations.
The degree of heterogeneity of news consumption in Germany—Descriptive statistics and relations with individual differences in personality, ideological attitudes, and voting intentions
Authors: Sindermann Cornelia , Kannen Christopher , Montag Christian
Published: December 2021

This study aimed to examine the degree of homogeneity versus heterogeneity of individuals’ political information environments across offline and online media types and relations with sociodemographic variables, personality, and political attitudes. In two online surveys, German participants (sample 1: N = 686; sample 2: N = 702) provided information on sociodemographic variables, consumption of political news, and voting intentions, and completed the Big Five Inventory and Right-Wing Authoritarianism (RWA) and Social Dominance Orientation (SDO) scales. Results revealed that absolutely homogeneous political news consumption was evident for a small proportion of individuals (2.04% and 0.43%). Openness (positively) and Agreeableness (negatively) exhibited significant associations with the degree of heterogeneity of political information environments across samples. No consistent patterns of relations with either the ideological attitudes of RWA and SDO or voting intentions were observed. The findings shed light on the existence of absolutely homogeneous political information environments and “who” might be prone to a more homogeneous versus more heterogeneous information environment.
Performance and operability of an electrically driven propulsor
Authors: Eryilmaz Ibrahim , Li Huayang , Pachidis Vassilios , Laskaridis Panagiotis , Zhu Zi-Qiang , Jewell Geraint Wyn
Published: December 2021

This manuscript discusses the operation of an electrically driven fan for a hybrid-electric propulsion system for BAe-146 aircraft. The thrust requirement is fed into an integrated cycle and aerodynamic design tool for the sizing of a ducted fan as one of the main propulsors, podded under the wing as a replacement for a turbofan engine. The electric motor design is initiated with the torque and speed requirements and with the dimensional constraints arising from the driven fan geometry. The fan operation and aerodynamic design are derived by changing the fan pressure ratio and hub-to-tip ratio to obtain a 2-D design space. Surface-mounted permanent magnet electric motor designs are mapped on the 2-D fan design space. The design and operational flexibility of the system is investigated through three scenarios. In the first scenario, the aircraft rate of climb is changed to downsize the electric motor. In the second scenario, the electric motor rated frequency is changed to increase the power density and in the third scenario the electric motor current density is changed for the same purpose. The investigated three scenarios provide design and operational guidelines for reducing the weight of the electric motor for a direct drive application.
One identity, two flags: Christian nationalists, the Israeli flag and national authenticity
Authors: Barreto Amílcar A , Kim HyungJin
Published: December 2021

Although we commonly associate a national identity with one flag—its own—some nationalists express their identities with two. In recent years Christian nationalists in the United States and South Korea have been flying the Israeli flag alongside their own. We posit that their symbolic agendas are focused more on domestic issues than foreign policy. Christian nationalists endeavor to overturn the official variants of their respective national identities which embrace pluralism and secularism. They signal their authentic nation by flying the Israeli flag alongside their own in order to convey biblicality. By symbolically setting themselves apart from their non-pious compatriots these nationalists are promoting an alternative, multi-tiered national identity which situates religious Christians at the top and all others underneath.
‘Hayan na ang mga Hampas-dugo! (the Penitents are coming!)’: Penitensya as religious-dark tourism
Authors: Wight Alexander Craig , Victoria Mabel
Published: December 2021

This paper applies indigenous research methods to understand the motives of visitors attending Penitensya (a Lenten Filipino ritual involving violent ritualistic performances) which we introduce as a novel form of religious-dark tourism. The paper also examines the tourism product potential of Penitensya as a controversial, yet potentially valuable feature of Filipino public culture. The motives of visitors to the Penitensya ritual in the Philippines during the 2019 schedule of events are examined to understand the touristic appeal of this unique form of religious-dark pilgrimage which involves overt and abject rituals of mortification and self-harm. Analysis suggests that the motives for attending Penitensya resonate with the motives of visitors to dark tourism attractions, and these include the allure of a novel cultural experience, knowledge-seeking and rubbernecking. The findings suggest that Penitensya might have unrealised potential as a legitimate form of intangible Filipino cultural heritage, but in order to authenticate the event as part of the nation’s cultural tourism product mix it must be carefully curated and marketed, and embraced by local authorities and the wider community.
Journaling among home care workers during the COVID-19 pandemic: A promising method for qualitative data collection
Authors: Bandini Julia I , Rollison Julia , Etchegaray Jason
Published: December 2021

Qualitative methods that capture individual lived experiences throughout rapidly changing circumstances are particularly important during public health emergencies. The COVID-19 pandemic has put home care workers at risk as they provide vital services in homes to individuals with chronic conditions or disabilities. Using a 6-week journaling process in which we enrolled participants at different points, we sought to examine experiences of home care workers ( n = 47) in the United States in New York and Michigan during April–July 2020 of the COVID-19 pandemic. Our methods for data collection and analysis were guided by a general qualitative approach as we aimed to examine the weekly perspectives and lived experiences of home care workers. We asked individuals to respond to our journaling prompts weekly to capture their reflections in “real time.” To better understand home care workers’ perspectives on journaling and the broader external context in which they provided care, we triangulated our data with interviews with home care workers ( n = 19) and home health agency representatives ( n = 9). We explored the feasibility of a rolling journaling process during an unprecedented public health emergency, characterized by rapid changes and uncertainty in day-to-day life, and reflect on lessons learned to guide future research on journaling for data collection, particularly for marginalized workers during public health crises, when events are evolving rapidly.
Neurorehabilitation in Adults With Traumatic Upper Extremity Amputation: A Scoping Review
Authors: Rydland Jake , Spiegel Stephanie , Wolfe Olivia , Alterman Bennett , Johnson John T , Wheaton Lewis A
Published: December 2021

Background

Most of the current literature around amputation focuses on lower extremity amputation or engineering aspects of prosthetic devices. There is a need to more clearly understand neurobehavioral mechanisms related to upper extremity amputation and how such mechanisms might influence recovery and utilization of prostheses.

Objective

This scoping review aims to identify and summarize the current literature on adult traumatic upper limb amputation in regard to recovery and functional outcomes and how neuroplasticity might influence these findings.

Methods

We identified appropriate articles using Academic Search Complete EBSCO, OVID Medline, and Cochrane databases. The resulting articles were then exported, screened, and reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines.

Results

Eleven (11) studies met the study criteria. Of these studies, 7 focused on sensory involvement, 3 focused on neuroplastic changes post-amputation related to functional impact, and 1 study focused on motor control and learning post-amputation. Overall, these studies revealed an incomplete understanding of the neural mechanisms involved in motor rehabilitation in the central and peripheral nervous systems, while also demonstrating the value of an individualized approach to neurorehabilitation in upper limb loss.

Conclusions

There is a gap in our understanding of the role of neurorehabilitation following amputation. Overall, focused rehabilitation parameters, demographic information, and clarity around central and peripheral neural mechanisms are needed in future research to address neurobehavioral mechanisms to promote functional recovery following traumatic upper extremity amputation.
The Association of Vitamin D3 With Early Anastomotic Leakage in Patients Undergoing Hemicolectomy Surgery
Authors: Layeg Hojat , Meshki Vahide K. , Karami Mohammad Y. , Moosavi Seyed Amin , Kafili Ehsan , Amestejani Morteza
Published: December 2021

Background

Anastomotic leak (AL) is one of the most important postoperative complications after hemicolectomy with stapled anastomosis. This study aimed to evaluate the association of preoperative vitamin D3 with early anastomotic leakage after right colon cancer surgery with stapled anastomosis.

Method

In this prospective cohort study, 535 patients who underwent right colon cancer surgery (right hemicolectomy) with stapled anastomosis were enrolled. A subset of 315 patients was included in the study after meeting the inclusion criteria. Preoperative vitamin D level was measured and analyzed for association with early AL using univariable and multivariable logistic regression analyses.

Result

This study included 315 cases; among them, 18 (5.71%) patients developed early AL. Vitamin D3 was significantly higher among patients without early AL ( P < .001). Low vitamin D3 status was reported among 111 patients (35.2%) and 204 (64.8%) of patients did not have low vitamin D3 status (sufficient level = 30-100 ng/mL). Sufficient vitamin D3 levels before right colon cancer surgery with stapled anastomosis was associated inversely with early AL (crude OR = .89, 95% CI = .85-.94, P < .001 and adjusted OR = .89, 95% CI = .82-.98, P = .02).

Conclusion

The vitamin D3 level has a protective association with early AL. As a result, low vitamin D3 status may be a risk factor for early AL development, suggesting that it can be one of the predictors of early AL occurrence.
Effect of perioperative blood pressure variability on cerebral hyperperfusion syndrome after carotid artery stenting: A retrospective study
Authors: He Guo-yong , Li Yan-hua , Wei Jun-jie , Xiao Ji-dong , Chen Yuan , Fan Bing-lin , Zhong Wei-zhang
Published: December 2021

Objective

To investigate the effect of perioperative blood pressure variability on cerebral hyperperfusion syndrome after carotid artery stenting.

Methods

A retrospective analysis was conducted of data collected from 418 patients who underwent carotid artery stenting in Guangxi Zhuang Autonomous Region People's Hospital in China. The blood pressure data were collected during operation (after balloon dilation, before stent release, after stent release) and within 3 days after the operation. The blood pressure variability was evaluated by measuring the mean, maximum, minimum, max–min, standard deviation (SD) of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The correlation between blood pressure variability and cerebral hyperperfusion syndrome was analysed.

Results

Blood pressure data from 418 patients were analysed. Twenty patients (4.8%) developed cerebral hyperperfusion syndrome. The parameters of blood pressure variability were divided into four groups according to quartile. After adjusting for age, symptomatic carotid stenosis, unilateral carotid stenosis, bilateral carotid stenosis, collateral circulation, diabetes mellitus and chronic kidney disease, multivariate analysis showed that SBPMax, SBPMin, SBPMax−Min, SBPCV, DBPSD, DBPMax, DBPMin, DBPMax−Min and DBPCV were associated with the occurrence of cerebral hyperperfusion syndrome ( P < 0.05), respectively.

Conclusion

This study suggests that blood pressure variability during the perioperative period may increase the risk of cerebral hyperperfusion syndrome.
Predictors of 30-day mortality after endovascular thrombectomy for large vessel occlusion in the elderly
Authors: Lai Yen-Jun , Peng Szu-Hsiang , Lai Wei-Jen , Li Ai-Hsien , Yen Ho-Hsian , Huang Lih-Wen , Tang Chih-Wei
Published: December 2021

Objectives

Elderly acute ischemic stroke (AIS) patients (≥80 years) would have dismal clinical outcomes even after successful endovascular revascularization for large vessel occlusion (LVO) in the anterior circulation. We aimed to identify predictors of 30-day mortality after endovascular thrombectomy (EVT) in the elderly.

Materials and Methods

We included older patients who underwent EVT for AIS due to LVO within 6 h after stroke onset in the anterior circulation between 2017 and 2019. Patients due to posterior circulation stroke, with intracerebral hemorrhage (ICH) or pre-stroke modified Rankin Scale (mRS) score of 4 and 5 were excluded. The primary outcome was mortality within 30 days of EVT. The association between clinical, imaging, procedural, follow-up imaging and mortality were analyzed. Successful reperfusion was defined as modified Thrombolysis in Cerebral Infarction (mTICI) score of 2b or 3. Possible predictors of 30-day mortality were assessed by univariate and multivariable logistic regression.

Results

Total 238 AIS patients eligible for EVT were identified with 58 patients aged 80 years or more. 48 patients met inclusion criteria. Median age was 86 years (age range, 82–102 years). Successful reperfusion was achieved in 38 (79.2%) patients. The 30-day and 90-day mortality rate were 25% and 33.3%, respectively. The independent predictors of 30-day mortality were collateral scores <3 on mCTA (adjusted OR, 16.571; 95% CI, 1.041–263.868; p = 0.047) and number of passes (adjusted OR, 2.475; 95% CI, 1.047–5.847; p = 0.039).

Conclusions

Lower collateral scores on mCTA and higher number of passes in thrombectomy were independently predictive of 30-day mortality in the elderly.
The effect of different playing surfaces on soccer skill performance
Authors: O’Meagher Reilly , O’Reilly John , Ali Ajmol
Published: December 2021

Football (soccer) is traditionally played on natural grass but artificial surfaces are becoming an increasing popular alternative. Understanding how different surfaces affect a player's skill performance has not been examined. This study sought to compare soccer skill performance, using a validated test, on natural grass, third generation (3G) artificial turf, and indoor sprung wooden floor. Following familiarisation, 14 male players (12.7 ± 0.5 years-old, with 6.21 years playing experience) performed the Loughborough Soccer Passing Test (LSPT) on three different surfaces in the following order: indoor, grass and artificial turf. Players were given two practise attempts before the best of two trials were recorded. Movement time was faster on artificial turf (45.1 ± 1.3 s) than natural grass (46.2 ± 1.8 s; p = 0.045), but there was no difference in overall LSPT performance between grass (54.1 ± 4.2 s) and artificial turf (54.0 ± 4.7 s; p = 0.92). Overall LSPT performance was better on indoor surface (50.9 ± 4.6 s) than grass (p = 0.02) and artificial turf (p = 0.02) due to reduced penalty time on the indoor surface (5.5 ± 3.3 s) than grass (7.9 ± 2.9 s; p = 0.001) and artificial turf (8.9 ± 3.9 s; p = 0.003). There is no difference in soccer skill performance between grass and 3G artificial turf. Skill performance on an indoor surface was ∼6% better than both grass and 3G artificial turf due to better ball control and/or accuracy of passing. Our findings will enable comparison of studies using the LSPT on indoor and outdoor (grass or artificial) surfaces.
Delayed timing of breeding attempts, but not time lost to nest construction, reduces the annual reproductive output of the Eastern Phoebe (Sayornis phoebe)
Authors: Enos Janice K , Hauber Mark E , Aidala Zachary
Published: December 2021

For many birds, nest construction is a costly aspect of parental care, trading finite energetic resources between parental care and self-maintenance. For multi-brooded organisms with short breeding seasons, such as migratory passerines, repeated nest construction could be especially costly if the activity delays the onset of breeding attempts. Earlier studies on passerines that reuse nests between breeding seasons suggested that time lost to initial nest construction reduces seasonal reproductive output. However, costs associated with building new nests between breeding attempts, within the same breeding season, have largely been ignored. Here, we experimentally removed first nests, after fledging or failing, of Eastern Phoebes ( Sayornis phoebe), to evaluate how the annual onset of breeding and nest construction between breeding attempts affected parental investment into second attempts. We found that first egg laying date negatively predicted the probability of second breeding attempts, but experimental treatment (first nest removal vs. control) did not. Neither first egg laying date nor treatment statistically influenced any of the reproductive traits in second breeding attempts (clutch size, nestling body condition, and nestling growth rate). We conclude that in this species, second breeding attempts are limited by the initial onset of seasonal reproduction, and not by time lost to nest construction between breeding attempts.
Safety Profile of Synthetic Elastic Degradable Matrix for Soft Tissue Reconstruction in Foot & Ankle Surgery
Authors: Kelly Michael J. , Dean Daniel M. , Hussaini Syed H. , Neufeld Steven K. , Cuttica Daniel J.
Published: December 2021

Background

Augmentation of soft tissue repairs has been helpful in protecting surgically repaired tissues as they heal. FlexBand (Artelon, Marietta, Georgia) is a synthetic, degradable, polycaprolactone-based polyurethane urea (PUUR) matrix that has been investigated and used for soft tissue repair in a variety of settings. The purpose of this study was to evaluate the safety profile of a PUUR matrix in a large cohort of patients undergoing soft tissue repairs about the foot and ankle.

Methods

A retrospective chart review of consecutive patients who underwent surgery using FlexBand to augment a soft tissue repair was performed to evaluate for major and minor complications related to the PUUR matrix. Results. A total of 105 patients with an average >6 months follow-up were included. The most common procedures were spring ligament repair, Achilles tendon repair, and Brostrom. There were 12 complications. Four major complications occurred with only 1 requiring PUUR matrix removal. Patients with wound complications had a higher body mass index (BMI) and rate of smoking.

Conclusion

Complication rates involving PUUR matrix in soft tissue foot and ankle reconstruction procedures are low and comparable with historical complication rates. The PUUR matrix is safe for use in a variety of soft tissue procedures about the foot and ankle. Level of Evidence: Level 4, Retrospective case-series
Institutional Herding: Causality and Persistence
Authors: Kumar S S S
Published: December 2021

We investigate the causality in herding between foreign portfolio investors (FPIs) and domestic mutual funds (MFs) in the Indian stock market. The estimated herding levels are considerably higher than those observed in other international markets, and herding is prevalent in small stocks. We find that institutional investors follow contrarian-trading strategies, unlike what was documented in most other markets. Analysis of the aggregate herding measure shows a bi-directional causality between FPIs and MFs. Further analysis using directional herding measures indicate no evidence of causality between institutional herds on the sell-side. But we find causality on the buy-side and it is running in both directions between FPIs and MFs, implying a feedback of information. Given the tendency of institutions for herding in small stocks, adopting contrarian-trading strategies, the observed sell-side causality is perhaps having a salubrious effect. As institutional investors are contrarians, their trading activity will lead to price corrections in small stocks aligning with the fundamentals, thereby contributing to market efficiency.

JEL Classification: C23, C58, G23, G15, G40
Wildlife in the Digital Anthropocene: Examining human-animal relations through surveillance technologies
Authors: von Essen Erica , Turnbull Jonathon , Searle Adam , Jørgensen Finn Arne , Hofmeester Tim R. , van der Wal René
Published: December 2021

Digital surveillance technologies enable a range of publics to observe the private lives of wild animals. Publics can now encounter wildlife from their smartphones, home computers, and other digital devices. These technologies generate public-wildlife relations that produce digital intimacy, but also summon wildlife into relations of care, commodification, and control. Via three case studies, this paper examines the biopolitical implications of such technologically mediated human-animal relations, which are becoming increasingly common and complex in the Digital Anthropocene. Each of our case studies involves a different biopolitical rationale deployed by a scientific-managerial regime: (1) clampdown (wild boar); (2) care (golden eagle); and (3) control (moose). Each of these modalities of biopower, however, is entangled with the other, inaugurating complex relations between publics, scientists, and wildlife. We show how digital technologies can predetermine certain representations of wildlife by encouraging particular gazes, which can have negative repercussions for public-wildlife relations in both digital and offline spaces. However, there remains work to be done to understand the positive public-wildlife relations inaugurated by digital mediation. Here, departing from much extant literature on digital human-animal relations, we highlight some of these positive potentials, notably: voice, immediacy, and agency.
The American Rescue Plan Act Funds and Students With Extensive Support Needs: Three Considerations for Technology Access and Use
Authors: Reed Alexandra S. , Francis Grace L. , Kinas-Jerome Marci
Published: December 2021

The COVID-19 pandemic highlighted inequities in technology literacy and access for students with extensive support needs (ESN) in k-12 settings. Technology is critical for students with ESN to continue lifelong learning after graduation. The unprecedented level of funds from the American Relief Plan provides schools opportunities to invest in sustainable and accessible technology which benefits all students. The Universal Design for Learning (UDL) framework is used to increase access to learning for all students, and should be applied to decision making surrounding technology investment and purchasing. This essay provides three considerations for schools to reflect on when spending ARP Act funds: (a) use UD to purchase technology, (b) provide UDL professional development to teach technology literacy skills, and (c) provide learning opportunities aimed at technology use among students with ESN.
RETRACTED ARTICLE: Post-operative blood pressure and 3-year major adverse cardiac events in Chinese patients undergoing PCI
Authors: Gan Lijun , Sun Dandan , Cheng Yuntao , Wang Deyang , Wang Fen , Wang Lin , Li Wei , Shen Dandan , Guo Daotong , Zhang Zonglei , Wang Haiyan , Li Jinli , Yang Yong , Liang Tao
Published: December 2021

Background

There is no clear evidence for the target value of blood pressure control after Percutaneous coronary intervention (PCI). Therefore, our study was designed to explore the relationship between blood pressure after PCI and major adverse cardiac events (MACE) during 3-year follow-up.

Methods

This study is a prospective study. We included the patients who were diagnosed with acute coronary syndrome and underwent PCI stent implantation operation. The study initially collected information of 552 patients. The start and end times of the study are from January 1, 2017 to December 31, 2020. The independent variables of this study are the average systolic blood pressure and the average diastolic blood pressure after PCI. The dependent variable is the occurrence of MACE events in patients within 3 years after PCI. MACE is defined as acute myocardial infarction, recurring chest pain, heart failure, stroke, revascularization and cardiac death.

Results

A total of 514 subjects met the inclusion criteria. The average age of the study subjects is 61.92 ± 9.49 years old, of which 67.12% are male. 94 subjects had a MACE event within 3 years, and the occurrence rate was 18.29%. There is no significant non-linear or linear relationship between diastolic blood pressure and MACE events. There is a curvilinear relationship between the average systolic blood pressure of patients after PCI and MACE events within 3 years and the inflection point is 121. On the left side of the inflection point, the effect size and 95% CI are 1.09 and 1.01–1.18, respectively (P = 0.029). The impact size and 95% CI at the right inflection point were 1.00 and 0.98–1.02(P = 0.604), respectively.

Conclusion

There is a curvilinear relationship between systolic blood pressure and prognosis of patients after PCI. Under the premise of ensuring the safety of patients, maintaining lower blood pressure after surgery is beneficial to improve the prognosis of patients.
Model of care and chance of spontaneous vaginal birth: a prospective, multicenter matched-pair analysis from North Rhine-Westphalia
Authors: Tietjen Sophia L. , Schmitz Marie-Therese , Heep Andrea , Kocks Andreas , Gerzen Lydia , Schmid Matthias , Gembruch Ulrich , Merz Waltraut M.
Published: December 2021

Background

Advantages of midwife-led models of care have been reported; these include a higher vaginal birth rate and less interventions. In Germany, 98.4% of women are giving birth in obstetrician-led units. We compared the outcome of birth planned in alongside midwifery units (AMU) with a matched group of low-risk women who gave birth in obstetrician-led units.

Methods

A prospective, controlled, multicenter study was conducted. Six of seven AMUs in North Rhine-Westphalia participated. Healthy women with a singleton term cephalic pregnancy booking for birth in AMU were eligible. For each woman in the study group a control was chosen who would have been eligible for birth in AMU but was booking for obstetrician-led care; matching for parity was performed.

Mode of birth was chosen as primary outcome parameter. Secondary endpoints included a composite outcome of adverse outcome in the third stage and / or postpartum hemorrhage; higher-order obstetric lacerations; and for the neonate, a composite outcome (5-min Apgar < 7 and / or umbilical cord arterial pH < 7.10 and / or transfer to specialist neonatal care). Statistical analysis was by intention to treat. A non-inferiority analysis was performed.

Results

Five hundred eighty-nine case-control pairs were recruited, final analysis was performed with 391 case-control pairs. Nulliparous women constituted 56.0% of cases. For the primary endpoint vaginal birth superiority was established for the study group (5.66%, 95%-CI 0.42% – 10.88%). For the composite newborn outcome (1.28%, 95%-CI -1.86% - -4.47%) and for higher-order obstetric lacerations (2.33%, 95%-CI -0.45% - 5.37%) non-inferiority was established. Non-inferiority was not present for the composite maternal outcome (-1.56%, 95%-CI -6.69% - 3.57%). The epidural anesthesia rate was lower (22.9% vs. 41.1%), and the length of hospital stay was shorter in the study group (p < 0.001 for both).

Transfer to obstetrician-led care occurred in 51.2% of cases, with a strong association to parity (p < 0.001). Request for regional anesthesia was the most common cause for transfer (47.1%).

Conclusion

Our comparison between care in AMU and obstetrician-led care with respect to mode of birth and other outcomes confirmed the superiority of this model of care for low-risk women. This pertains to AMU where admission and transfer criteria are in place and adhered to.
Functional status in relation to depression among elderly individuals in Indonesia: a cross-sectional analysis of the Indonesian National Health Survey 2018 among elderly individuals
Authors: Idaiani Sri , Indrawati Lely
Published: December 2021

Background

Depression among elderly individuals is related to physical illness, functional status, prolonged treatment and other factors. Depression is not effectively treated with medication but can be alleviated by treating the physical illness and improving functional status. Therefore, this study aims to determine the relationship between functional status and depression in elderly individuals in Indonesia.

Methods

The data used were obtained from a national survey dataset, namely, the Basic Health Research and Socio-Economic Survey in 2018, which was carried out in 34 provinces and 514 districts or cities. The total number of respondents was 93,829, aged ≥60 years. Functional status and depression were assessed using the Barthel index and MINI (Mini International Neuropsychiatric Interview), respectively. Furthermore, data processing was carried out with the Statistical Package for Social Sciences (SPSS) version 26 program and analyzed using the chi-square test and multiple logistic regression with the complex sample method.

Results

Elderly individuals with severe dependence were at the greatest risk of becoming depressed compared to those without functional impairment or with independence after considering sociodemographic factors and disease history have 5.730 (95% CI = 4.302-7.632) the adj odds. Furthermore, this figure was higher than that of individuals with total dependence have 4.147 (95% CI = 3.231-5.231) the adj odds. The physical illness experienced also played a role in the risk for depression, which was higher among elderly individuals with stroke and a history of injury. The sociodemographic factors involved include low education and economic levels. In contrast, the area of residence and marital status had no statistically significant effect on the relationship between functional disorders and depression.

Conclusions

Elderly individuals with decreased functional status are prone to depression. The highest probability for depression was observed among those with severe dependence compared to those with total dependence. Consequently, interventions that involve various sectors, including social and family support, are needed.
Biosynthesis and metabolic engineering of 1-hydroxyphenazine in Pseudomonas chlororaphis H18
Authors: Wan Yupeng , Liu Hongchen , Xian Mo , Huang Wei
Published: December 2021

Background

1-Hydroxyphenazine (1-OH-PHZ) is a phenazine microbial metabolite with broad-spectrum antibacterial activities against a lot of plant pathogens. However, its use is hampered by the low yield all along. Metabolic engineering of microorganisms is an increasingly powerful method for the production of valuable organisms at high levels. Pseudomonas chlororaphis is recognized as a safe and effective plant rhizosphere growth-promoting bacterium, and faster growth rate using glycerol or glucose as a renewable carbon source. Therefore, Pseudomonas chlororaphis is particularly suitable as the chassis cell for the modification and engineering of phenazines.

Results

In this study, enzyme PhzS (monooxygenase) was heterologously expressed in a phenazine-1-carboxylic acid (PCA) generating strain Pseudomonas chlororaphis H18, and 1-hydroxyphenazine was isolated, characterized in the genetically modified strain. Next, the yield of 1-hydroxyphenazine was systematically engineered by the strategies including (1) semi-rational design remodeling of crucial protein PhzS, (2) blocking intermediate PCA consumption branch pathway, (3) enhancing the precursor pool, (4) engineering regulatory genes, etc. Finally, the titer of 1-hydroxyphenazine reached 3.6 g/L in 5 L fermenter in 54 h.

Conclusions

The 1-OH-PHZ production of Pseudomonas chlororaphis H18 was greatly improved through systematically engineering strategies, which is the highest, reported to date. This work provides a promising platform for 1-hydroxyphenazine engineering and production.

Graphical Abstract