bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Effects of University Reputation and City Image on International Student Destination Choice: Evidence from a Flagship University in Taipei
Authors: Ma Ai-hsuan Sandra
Published: May 2021

University reputation and destination image are key factors shaping the choice to study in developed Western countries. While East Asia is emerging as a new contender in the international higher education market, little is known about how international students perceive and are attracted to the higher education institutions in this region. Moreover, while the destination image was represented by the host country image in most studies, the effect of city image on study destination choice should be given more attention due to the geographic and social embeddedness of universities in cities. This study drew the survey data from a flagship university in Taipei to examine the impact of university reputation and city image on international student destination choice, and employed factor analysis to identify the dimensions of university reputation and city image. The analysis confirms university reputation and city image as important elements in international student destination choice in the Asian context. It further identifies four factors creating discrepant weighting of these two elements in study destination choice: degree/non-degree program, level of study, type of international student identity, and region of origin. Theoretical and policy implications of findings are discussed at the end of the paper.
Effect of the Arab Spring on Stabilization Capacity of the MENA Monarchies
Authors: Korotayev Andrey V , Khokhlova Alina A
Published: May 2021

In the Middle East and North Africa (MENA) region after the Arab Spring, monarchy has turned out to be a far stronger negative predictor of destabilization than it was before 2011. For the MENA, the period after 2010 can be subdivided into three periods: a mass protests period (2011–2012), the period of explosive growth of radical Islamist activities (2013–2016), and the second mass protest period (since 2016). Our analysis demonstrates that monarchies’ stabilization capacity was preserved in 2011–2012 and grew substantially during 2013–2016, as MENA monarchies turned out to be more resilient in the face of the outbreak of radical Islamism in the region.
Toward an Abolitionist Practice of Psychology: Reimagining Psychology’s Relationship With the Criminal Justice System
Authors: Klukoff Hannah , Kanani Haleh , Gaglione Claire , Alexander Apryl
Published: May 2021

The social justice uprisings that have stemmed from several recent highly publicized murders of Black people by police have shed increasing light on the systems of oppression, inequity, and white supremacy that have been the backbone of the United States’ policing and criminal justice systems since their inception. The American Psychological Association, along with many professional organizations across the subfields of psychology, has released its statement outlining how psychology must contribute to the eradication of systemic racism and white supremacy. In this article, we address the need for psychology and its subfields to acknowledge our complicity in certain systems of oppression, such as our ties to law enforcement and the police, our support of mental health reforms that merely increase the scope of a punitive criminal justice system, and our complicity in the harm done by our current immigration policies. We argue that the best way, in fact the only way, for the profession to move toward an antiracist psychological practice is to embrace an abolitionist framework so that we may reimagine our relationships with historically oppressive institutions and rebuild our clinical practices to promote life-affirming interventions and liberation for individuals and communities.
Precisely Closed Reduction of Nasal Bone Fracture Assisted With Plain Film Measurements Under the Picture Archiving and Communication System
Authors: Yang Tzu-Hsien , Fang Chien-Liang , Tsai Chong-Bin , Chen Ming-Shan , Changchien Chih-Hsuan , Yang Hsin-Yi , Fang Kai-Jan
Published: May 2021

Objectives:

To prevent aesthetic and functional deformities, precisely closed reduction is crucial in the management of nasal fractures. Plain film radiography (PF), ultrasonography (USG), and computed tomography can help confirm the diagnosis and classification of fractures and assist in performing closed reduction. However, no study in the literature reports on precisely closed reduction assisted with PF measurements under the picture archiving and communication system (PACS).

Methods:

We retrospectively evaluated 153 patients with nasal bone fracture between January 2013 and December 2017. Surgeons conducted precisely closed reduction assisted with PF measurement of the distance between the fracture site and nasal tip under PACS on 34 patients (group A). Another group on 119 patients were reduced under surgeon’s experience (group B).

Results:

No significant differences in age, gender, Arbeitsgemeinschaft fur Osteosynthesefragen (AO) classification, and reduction outcome were observed between group A and group B ( P > .05). The operative time of the group A was significantly lower (12.50 ± 4.64 minutes) compared to group B (23.78 ± 11.20 minutes; P < .001). After adjusted age, gender, and AO classification, patients in group A scored 10.46 minutes less on the operative time than those in group B ( P < .001). In addition, the severity of nasal bone fracture (AO classification, β = 3.37, P = .002) was positive associated with the operative time.

Conclusions:

In this study, closed reduction in nasal bone fracture assisted with PF measurements under PACS was performed precisely, thereby effectively decreasing operative time and the occurrence of complications. This procedure requires neither the use of new instruments or C-arm nor USG or navigation experience. Moreover, reduction can be easily performed using this method, and it requires short operative time, helps achieve great reduction, less radiation exposures, and is cost-effective.
Inflammatory Myofibroblastic Tumor (IMT) of the Trachea Excised by Transtracheal Surgery: Case Report
Authors: Ohba Shinichi , Matsumoto Fumihiko , Kojima Masataka , Fujimaki Mitsuhisa , Fukumura Yuki , Ikeda Katsuhisa
Published: May 2021

This report describes an extremely rare case of a primary inflammatory myofibroblastic tumor of the trachea. The patient underwent surgical resection by a transtracheal approach and reconstruction with esophageal tracheoplasty. This case report highlights the rarity of such tumors and a minimally invasive and safe surgical technique for tumors around the central neck structures.
Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives
Authors: Macchi Zachary A , Ayele Roman , Dini Megan , Lamira Jensine , Katz Maya , Pantilat Steven Z , Jones Jacqueline , Kluger Benzi M
Published: May 2021

Background:

COVID-19 has impacted persons with serious illness, including those with chronic, neurodegenerative conditions. While there are several reports on COVID-19’s impact on inpatient palliative care, literature is limited about the impact on outpatient care which may be more relevant for these patients.

Aim:

To generate a person-centered description of the impact of COVID-19 from the perspectives of patients living with neurodegenerative disease and caregivers to improve outpatient palliative care delivery.

Design:

This qualitative study used rapid analysis via matrix design to identify emergent themes related to participant perspectives on the challenges of COVID-19. Data sources included semi-structured interviews, open-ended survey responses, medical record documentation and participant-researcher communications.

Setting/Participants:

Data was collected from 108 patients with Parkinson’s disease, Alzheimer’s disease or related disorders and 90 caregivers enrolled in a multicenter, clinical trial of community-based, outpatient palliative care between March 20, 2020 and August 8, 2020 (NCT03076671).

Results:

Four main themes emerged: (1) disruptions to delivery of healthcare and other supportive services; (2) increased symptomatic and psychosocial needs; (3) increased caregiver burden; (4) limitations of telecommunications when compared to in-person contact. We observed that these themes interacted and intersected.

Conclusions:

Patients and caregivers have unmet care needs because of the pandemic, exacerbated by social isolation. While telemedicine has helped improve access to healthcare, patients and caregivers perceive clear limitations compared to in-person services. Changes in society and healthcare delivery in response to COVID-19 highlight ongoing and novel gaps that must be addressed to optimize future outpatient palliative care for neurologic illness.
Health and social care professionals’ experiences of providing end of life care during the COVID-19 pandemic: A qualitative study
Authors: Hanna Jeffrey R. , Rapa Elizabeth , Dalton Louise J , Hughes Rosemary , Quarmby Louise M , McGlinchey Tamsin , Donnellan Warren J , Bennett Kate M , Mayland Catriona R , Mason Stephen R
Published: May 2021

Background:

Health and social care professionals’ ability to address the needs of patients and their relatives at end of life is likely to have been impacted by the COVID-19 pandemic.

Aim:

To explore health and social care professionals’ experiences of providing end of life care during the COVID-19 pandemic to help inform current/future clinical practice and policy.

Design:

A qualitative interview study. Data were analysed using thematic analysis.

Setting/participants:

Sixteen health and social care professionals working across a range of clinical settings in supporting dying patients during the first wave (March–June 2020) of the COVID-19 pandemic in the United Kingdom.

Results:

Participants reported emotional and practical challenges to providing end of life care during the pandemic, including increases in patient numbers, reduced staffing levels and relying on virtual platforms for sensitive, emotive conversations with relatives. Participants were central to promoting connections between patients and their families at end of life and creating opportunities for a final contact before the death. However, the provision of support varied as a consequence of the pressures of the pandemic. Results are discussed under two themes: (1) challenges and facilitators to providing end of life care, and (2) support needs of relatives when a family member was dying during the COVID-19 pandemic.

Conclusion:

There is a need for flexible visiting arrangements at end of life during a pandemic. A systems-level approach is necessary to promote the wellbeing of health and social care professionals providing end of life care during and after a pandemic.
Emotion Sharing in Preadolescent Children: Divergence From Friendships and Relation to Prosocial Behavior in the Peer Group
Authors: Kwon Kyongboon , Willenbrink Jessica B. , Bliske Madeline N. , Brinckman Bridget G.
Published: May 2021

We examined the extent to which children’s emotion-sharing relationships were unique from friendships. We also examined the association between emotional experience and emotion sharing as well as the association between emotion sharing and prosocial behavior. Participants were 456 children ( Mage = 10.6 years) from the Midwestern United States. Peer nominations and self-report were used to assess study constructs. Despite considerable convergence between friendships and emotion-sharing relationships, children did not share emotions with 31% of close friends and 20% of emotion-sharing partners were not close friends, indicating divergence of the two relationships. Experience of happiness was positively associated with emotion sharing; emotion sharing was positively associated with prosocial behavior. Compared with boys, girls identified more partners and more same-gender peers for emotion-sharing relationships and they shared feelings with friends to a greater extent. We discussed emotion sharing as a compelling means for the development of children’s affective and social competence.
Evaluation of Triage Tests When Existing Test Capacity Is Constrained: Application to Rapid Diagnostic Testing in COVID-19
Authors: Bouttell Janet , Hawkins Neil
Published: May 2021

Objectives

A triage test is used to determine which patients will undergo an existing or “reference” test. This article explores the potential value of using triage tests before reference tests when the capacity of the reference test is constrained.

Methods

We developed a simple model with inputs: prevalence, sensitivity, specificity, and reference test capacity. We included a case study of rapid diagnostic tests for SARS-CoV-2 antigens used as triage tests before a reference polymerase chain reaction test. Performance data were obtained from an evaluation performed by an academic center on 425 samples from testing centers in the United Kingdom and Germany.

Results

When reference test capacity is constrained, the use of a triage test leads to a relative expansion of the population tested and cases identified; both are higher with a high-specificity triage test. When reference test capacity is not constrained, the potential advantages of introducing a triage test can be assessed using a standard cost-utility framework, balancing the utility of the reduction in the number of reference tests required against the disutility of missed cases associated with the use of a lower-sensitivity triage test. In the constrained case, the advantage of a triage testing strategy in terms of population covered and cases identified is reduced as the prevalence increases. In the unconstrained case, the reduction in reference tests required is reduced and the number of cases missed increase as the prevalence rises.

Conclusion

When the availability of the reference test is constrained, tests added in a triage position do not need high levels of accuracy to increase the number of cases diagnosed. This has implications in many disease areas, including COVID-19.
Identifying Targets for the Prevention of Childhood Undernutrition in a Resource-Limited Peri-Urban Ecuadorian Community
Authors: Attia Suzanna L. , Schmidt Wolf-Peter , Osorio Janeth Ceballos , Young Thomas , Schadler Aric , Plasencia Julie
Published: May 2021

Background:

In middle-income countries, malnutrition concentrates in marginalized populations with a lack of effective preventive strategies.

Objective:

Identify risk factors for undernutrition in a peri-urban Ecuadorian community of children aged 12 to 59 months.

Methods:

Data from a cross-sectional survey in 2011 of children 1 to 5 years were analyzed including demographic data, medical history and examination, food frequency questionnaire (FFQ), anthropometric measurements, and blood for complete blood count, C-reactive protein, vitamin A, iron, and zinc levels. Dietary Diversity Score (DDS) was calculated from FFQ. Bivariate and multivariate analysis assessed effects on primary outcome of undernutrition by DDS, vitamin deficiencies, and demographic and nutritional data.

Results:

N = 67, 52.2% undernourished: 49.3% stunted, 25.4% underweight, and 3% wasted; 74.6% (n = 50) were anemic and 95.1% (n = 39) had low serum zinc. Dietary Diversity Score was universally low (mean 4.91 ± 1.36, max 12). Undernutrition was associated with lower vitamin A levels (20 306, IQR: 16605.25-23973.75 vs 23665, IQR: 19292-26474 ng/mL, P = .04); underweight was associated with less parental report of illness (43.8%, n = 7 vs 80% n = 40, P = .005) and higher white blood count (13.7, IQR: 11.95-15.8 vs 10.9, IQR: 7.8-14.23 × 109/L, P = .02). In multiple regression, risk of undernutrition decreased by 4% for every $10 monthly income increase (95 CI%: 0.5%-7.4%, P = .02, n = 23); risk of underweight decreased by 0.06 for every increased DDS point (adjusted odds ratio: 0.06; 95 CI%: 0.004-0.91, P = .04, n = 23).

Conclusions:

In this peri-urban limited-resource, mostly Indigenous Ecuadorian community, stunting exceeds national prevalence, lower monthly income is the strongest predictor of undernutrition, lower DDS can predict some forms of undernutrition, and vitamin deficiencies are associated with but not predictive of undernutrition.
Digital Storytelling in Older Adults With Typical Aging, and With Mild Cognitive Impairment or Dementia: A Systematic Literature Review
Authors: Rios Rincon Adriana Maria , Miguel Cruz Antonio , Daum Christine , Neubauer Noelannah , Comeau Aidan , Liu Lili
Published: May 2021

The rates of dementia are on the rise as populations age. Storytelling is commonly used in therapies for persons living with dementia and can be in the form of life review, and reminiscence therapy. A systematic literature review was conducted to examine the range and extent of the use of digital technologies for facilitating storytelling in older adults and their care partners, and to identify the processes and methods, the technologies used and their readiness levels, the evidence, and the associated outcomes. Eight electronic databases were searched: Medline, EMBASE, PsycINFO, CINAHL, Abstracts in Social Gerontology, ERIC, Web of Science, and Scopus. We included 34 studies. Mild cognitive impairment or dementia represented over half of medical conditions reported in the studies. Overall, our findings indicate that the most common use of digital storytelling was to support older adults’ memory, reminiscence, identity, and self-confidence; however, the level of evidence of its effectiveness was low.
Modal properties of a two-stage planetary gear system with a Timoshenko beam as the intermediate shaft model
Authors: Liu Hui , Zhan Zhaobin
Published: May 2021

This study investigates the mode properties of a two-stage planetary gear (TSPG) system with short intermediate shafts. For this purpose, the rotating intermediate shafts in this system are considered Timoshenko beams and compared with the Euler-Bernoulli beam model. The gyroscopic effect is also considered in the TSPG model. The natural frequencies are given, and mode energy analysis is applied to quantify the importance of intermediate shafts in the total TSPG system. The vibration modes are speed dependent, and three mode types exist. The influence of the rotational speed, length of intermediate shafts and number of planets is evaluated.
Numerical analysis on the conceptual design of an air-breathing engine inlet working in mach number 3∼5.5
Authors: Huo Chao , Yang Zhenhua , Zhang Zhengze , Liu Peijin
Published: May 2021

Based on the equal-intensity shock theory, this article designed a supersonic inlet working in Mach number 3.0∼5.5 with the background of an air-breathing engine. The inlet applied the four-shock train mixed compression configuration and inserted a sidewall compression at the beginning of the isolator. Through developing effective 3D RANS computations validated by current experiments, the performance of the designed inlet was identified. The designed inlet self-starts at freestream Mach number Ma∞ = 3.0 under which the total pressure recovery coefficient has dramatic increment, and the aerodynamic choking at the inlet throat no longer presents; the inlet keeps working at all studied flight states with zero angle of attack (AoA) and achieves shock-on-lip at the design point Ma∞ = 5.0. Both positive and negative AoAs can disrupt the equal-intensity shock allocations, which degrade the inlet performance. The inlet obtains maximum total pressure recovery coefficient at zero AoA. The maximum back pressure at Ma∞ = 3.0∼5.5 obtained by the inlet surpasses the requirements and keeps a certain margin. The inlet performance basically meets all the goals proposed by the engine.
Structural performance under solar radiation of the 30.5-meter-high Flamenco Ice Tower
Authors: Li Qingpeng , Mergny Elke , Pronk Arno , Wu Yue , Luo Peng
Published: May 2021

Structural performance under solar radiation for structures in ice or ice composite is of vital importance. In this paper, the performance of the 30.5-meter-high Flamenco Ice Tower is numerically studied in detail. To carry out this research, material properties of ice composite are first studied based on different types of tests. Subsequently, structural performance of the ice tower under solar radiation is analyzed in ABAQUS. Through this research, the simulation method for structural performance of shell structures in ice composite is tested to be successful, which will contribute to the future development and applications of ice structures.
Finding Synergy in Academe: An Interview With Dave L. Edyburn
Authors: Boone Randall , Higgins Kyle
Published: May 2021

Dave L. Edyburn, PhD, is a professor emeritus in the Department of Exceptional Education at the University of Wisconsin-Milwaukee and more recently the associate dean for research in the College of Community Innovation and Education at the University of Central Florida. His teaching and research interests focus on the use of technology to enhance teaching, learning, and performance. He has authored more than 175 articles and book chapters on the use of technology in special education, and his work represents a variety of contributions to theory, research, policy, and practice.
The Invisible Population of Students With Learning Disabilities in South Korea
Authors: Shin Mikyung , Choi Nari
Published: May 2021

Over the past decade, there has been a rapidly declining trend in the prevalence of students with learning disabilities in South Korea. In 2019, only 1.5% of students receiving special education support were identified as having learning disabilities. This column reports on three current issues related to learning disabilities to provide a greater understanding of this declining trend in South Korea: (a) the ongoing debate on the definition of students with learning disabilities, (b) the continuing disagreement on the identification criteria for students with learning disabilities, and (c) the public’s limited understanding of learning disabilities. Suggestions for future directions are also discussed.
The Role of Cultural Differences in Customer Retention: Evidence from the High-Contact Service Industry
Authors: Fam Kim-Shyan , Liat Cheng Boon , Cham Tat-Huei , Tan Chia Yi Mandy , Ting Hiram
Published: May 2021

Current tourism landscape and dynamism of the business environment have increased market competitiveness in the high-contact service industry. Hotel operators must now pay greater heed to customer retention by exploring ways to improve customer engagement and experience. Toward this end, this study aimed to examine the interplays between relationship marketing, perceived service quality, corporate image, customer satisfaction, and customer loyalty, as well as the moderating effect of cultural difference between Asian and Western tourists. Using a questionnaire, data were collected from 400 international tourists and analyzed with the structural equation modeling technique. While the direct relationships pertaining the variables of interest were found to be significant, Asian tourists appeared to hold stricter standards in employee–customer interactions and satisfaction-based loyalty than Western tourists. Discussion and implications are provided to promote the development of fruitful hotel–customer relationships in this industry with a heightened customer orientation.
Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19
Authors: Sahai Aditya , Bhandari Rohan , Godwin Matthew , McIntyre Thomas , Chung Mina K , Iskandar Jean-Pierre , Kamran Hayaan , Hariri Essa , Aggarwal Anu , Burton Robert , Kalra Ankur , Bartholomew John R , McCrae Keith R , Elbadawi Ayman , Bena James , Svensson Lars G , Kapadia Samir , Cameron Scott J
Published: May 2021

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is an ongoing viral pandemic marked by increased risk of thrombotic events. However, the role of platelets in the elevated observed thrombotic risk in COVID-19 and utility of antiplatelet agents in attenuating thrombosis is unknown. We aimed to determine if the antiplatelet effect of aspirin may mitigate risk of myocardial infarction, cerebrovascular accident, and venous thromboembolism in COVID-19. We evaluated 22,072 symptomatic patients tested for COVID-19. Propensity-matched analyses were performed to determine if treatment with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) affected thrombotic outcomes in COVID-19. Neither aspirin nor NSAIDs affected mortality in COVID-19. Thus, aspirin does not appear to prevent thrombosis and death in COVID-19. The mechanisms of thrombosis in COVID-19, therefore, appear distinct and the role of platelets as direct mediators of SARS-CoV-2-mediated thrombosis warrants further investigation.
Bond position function between deformed steel bars and early-age cementitious grout
Authors: Peng Gang , Niu Ditao , Hu Xiaopeng , Wu Xiao , Zhang Yong
Published: May 2021

Pullout tests for the deformed steel bars in early-aged cementitious grout by considering the variables of testing ages, cover thicknesses, and diameters of steel bar were conducted, and the local bond stress–slip relationship at different positions of the anchorage length of steel bar was studied. Results indicated that, with the increase of testing age, the load-slip curves exhibited a higher ultimate load and had steeper ascending and descending branches; however, the slippage at the ultimate load exhibited a decreasing trend. Moreover, with the increase of cover thickness and diameter of steel bar, the ultimate load of pullout specimens increased obviously, while the corresponding slips generally had no obvious correlations. According to an analysis of the measured rebar strain, the distributions of the steel stress and bond stress as well as the relative slip along the embedded length were obtained under different external loads. Steel stress transfer and bond stress distribution parameters were introduced to characterize the nonuniformity of the distributions of the steel stress and bond stress along the steel bar, and the effects of the testing age, cover thickness, and diameter of steel bar on these two parameters were analyzed. Results showed that the both of these two parameters increased with the increasing tensile load, testing age, and cover thickness and with the decreasing diameter of steel bar. Thereafter, the local bond stress-slip relationships along the anchorage length and position functions reflecting the variations of these relationships were proposed.
Preliminary Effectiveness of Brief Prolonged Exposure Therapy for PTSD: Expanding Access to Effective Therapies
Authors: Booysen Duane D. , Kagee Ashraf
Published: May 2021

Over the last three decades, several empirically supported trauma therapies have been developed to treat post-traumatic stress disorder (PTSD). Yet issues such as access to treatments and dropout are ongoing barriers to adequate dissemination and implementation, especially in low resource settings. To this end, we present results on the preliminary effectiveness of a brief prolonged exposure therapy (PE) for PTSD in South Africa, a low resource setting. Based on a case-series design, seven participants ( n = 7) from diverse socio-cultural backgrounds were recruited and started a six-session brief PE for PTSD and co-morbid depression and anxiety. To examine the treatment outcomes, participants were assessed at baseline, during treatment, post-intervention, and at 3-month follow-up. Overall, brief PE reduced symptoms of PTSD, depression, and anxiety from baseline to post-intervention, and at 3-month follow-up. A downward trend in symptoms was evident during treatment, with slight symptom variations during exposure sessions. In conclusion, a six-session brief PE intervention produced positive outcomes for PTSD, depression, and anxiety at two community counseling centers in South Africa. We reflect on the implementation of brief PE in a South African context.
The Costs of Seeking Shelter for Renters With Discrediting Background Records
Authors: Reosti Anna
Published: May 2021

This study illuminates an understudied pathway through which disadvantage is reproduced in the rental housing market: the housing search, application, and tenant screening process. Using in-depth interviews with 25 housing-seekers with criminal conviction records, past evictions, and damaged credit histories, this article examines the direct role of the rental housing search and application process in reproducing economic precarity and social disadvantage among renters with discrediting background records, beyond delimiting their housing options. Its findings suggest that navigating the housing search from a position of acute market disadvantage comes with significant costs for this population, including the financial burden of repeated application fees and the psychological strains associated with the specter of indefinite housing insecurity. The findings also demonstrate how the housing search process may undermine the willingness of stigmatized renters to contest exploitative or unlawful rental practices by reinforcing awareness of their degraded status in the rental market.
Team Situation Awareness and Conflict: A Study of Human–Machine Teaming
Authors: McNeese Nathan J. , Demir Mustafa , Cooke Nancy J. , She Manrong
Published: May 2021

This article focuses on two fundamental human–human teamwork behaviors and seeks to understand them better in human–machine teams. Specifically, team situation awareness (TSA) and team conflict are examined in human–machine teams. There is a significant need to identify how TSA and team conflict occur during human–machine teaming, in addition to how they impact each other. In this work, we present an experiment aimed at understanding TSA and team conflict in the context of human–machine teaming in a remotely piloted aircraft system (RPAS). Three conditions were tested: (1) control: teams consisted of all humans; (2) synthetic: teams consisted of the pilot role being occupied by a computational agent based on ACT-R architecture that employed AI capabilities, with all other team roles being humans; and (3) experimenter: an experimenter playing the role of the pilot as a highly effective computational agent, with the other roles being humans. The results indicate that TSA improved over time in synthetic teams, improved and then stabilized over time in experimenter teams, and did not improve in control teams. In addition, results show that control teams had the most team conflict. Finally, in the control condition, team conflict negatively impacts TSA.
Domain decomposition modeling of carotid artery stenosis based on 3D rotational angiography
Authors: Yao Qinghe , Zhu Hongkun
Published: May 2021

An experiment-based computational study that helps analyze blood flow behavior and wall shear stress (WSS) distribution is reported in this work. Large scale numerical analysis of hemodynamics in swine-specific stenosed carotid artery based on in vivo surgery is presented. A pressure stabilized domain decomposition method is used to symmetrize the linear systems of Navier-Stokes equations and the convection-diffusion equation. A numerical expression of swine blood flow and a detailed swine carotid vessel model with stenosis are newly proposed, and the empirical function of WSS was validated for the swine model. Two wall models, a rigid and another elastic, are compared in precisely modelling for pathological analysis of vascular disease like carotid atherosclerosis and hemangioma. The flexible wall performs better in representing experimental conditions while the stern wall is much more efficient. Numerical results show that the stenosis has a great influence on the behavior and characters of blood and its subsequent affect the WSS of the vessel; further details show how stenosis affect the distribution and magnitude of wall shear stress in an artery which lay a foundation for further medical study.
Intracellular versus extracellular inhibition of calpain I causes differential effects on pain in a rat model of joint inflammation
Authors: McDougall Jason J , McConnell Miranda , Reid Allison R
Published: May 2021

Calpain I is a calcium-dependent cysteine protease which has dual effects on tissue inflammation depending on its cellular location. Intracellularly, calpain I has pro-inflammatory properties but becomes anti-inflammatory when exteriorised into the extracellular space. In this study, the effect of calpain I on joint pain was investigated using the kaolin/carrageenan model of acute synovitis. Evoked pain behaviour was determined by von Frey hair algesiometry and non-evoked pain was measured using dynamic hindlimb weight bearing. Local administration of calpain I reduced secondary allodynia in the acute inflammation model and this effect was blocked by the cell impermeable calpain inhibitor E-64c. Calpain I also blocked the algesic effect of the protease activated receptor-2 (PAR-2) cleaving enzyme mast cell tryptase. The cell permeable calpain blocker E-64d also produced analgesia in arthritic joints. These data suggest that calpain I produces disparate effects on joint pain viz. analgesia when present extracellularly by disarming PAR-2, and pro-algesic when the enzyme is inside the cell.
The impact of ocrelizumab on health-related quality of life in individuals with multiple sclerosis
Authors: Glanz Bonnie I , Zurawski Jonathan , Casady Emily C , Shamah Rebecca , Weiner Mira , Chitnis Tanuja , Weiner Howard L , Healy Brian C
Published: May 2021

Background

Ocrelizumab is approved for the treatment of both relapsing and progressive multiple sclerosis (MS).

Objective

To examine the impact of ocrelizumab on health-related quality of life (HRQOL) in individuals with MS.

Methods

Ninety-eight individuals with relapsing and 32 with progressive MS were enrolled. Participants were administered a battery of patient-reported outcome (PRO) measures at their first ocrelizumab infusion, and infusions at 6 and 12 months. PRO measures included the Medical Outcomes Study SF-36 and Neuro-QoL.

Results

At baseline, participants had low mean scores across HRQOL domains. After 12 months, increases were observed on SF-36 Role-Physical, General Health, Vitality, Role-Emotional, Mental health and Mental Component Summary. On Neuro-QoL, improvements were seen in Positive Affect, Anxiety, Emotional and Behavioral Dyscontrol and Fatigue. Several demographic and clinical characteristics were associated with HRQOL at baseline. The strongest associations were between physical HRQOL measures and measures of MS disability. Associations between the longitudinal change in HRQOL scores and baseline demographic and clinical characteristics were mild.

Conclusions

We observed significant improvements across multiple mental HRQOL domains at 12 months in individuals treated with ocrelizumab. These findings support the use of HRQOL measures to provide a subjective measure of treatment impact that complements traditional outcomes.
Prioritizing Information Sources and Requirements in Students’ Choice of Higher Education Destination: Using AHP Analysis
Authors: Ürer Erdil Damla , Tümer Mustafa , Nadiri Halil , Aghaei Iman
Published: May 2021

Attracting and enrolling international students have become the primary concern of marketing efforts of higher education institutions. For this purpose, understanding the decision-making process of students is vital. This study examines the information sources, requirements, and choice factors of international students who study their higher education in an emerging higher education destination. This study is conducted through a quantitative approach, based on both exploratory factor analysis (EFA) and the analytic hierarchy process (AHP). A survey was conducted with students who enrolled at a state university for the first time. University websites are identified as the most used sources of information. According to the study’s findings, job and scholarship opportunities are identified as the first and most crucial concern of international students. This study is of particular significance for higher education institutions in emerging higher education destinations to better understand students’ decision-making process.
Patient Satisfaction After Lower Extremity Total Joint Arthroplasty: An Analysis of Medical Comorbidities and Patient Demographics
Authors: Frane Nicholas , Stapleton Erik J , Petrone Brandon , Atlas Aaron , Lutsky Larry , Cohn Randy M
Published: May 2021

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has received increased attention to determine which demographics may influence patient satisfaction after Total Hip and Knee Arthroplasty. The purpose of this study was to evaluate the various effects that patient-specific factors, medical comorbidities, and demographics had on patient satisfaction. Two thousand and ninety-two patients underwent lower extremity total joint arthroplasty at our institution between 2014 and 2018. Nine hundred twenty-three of these patients responded to their HCAHPS survey (44%). Most patients (609, 66%) underwent primary total knee arthroplasty followed by 244 (26.4%) total hip arthroplasties, 35 (3.8%) revision total knee arthroplasties, 28 (3.0%) bilateral total knee arthroplasties, and 7 (0.8%) revision total hip arthroplasties. Increasing age and length of stay were associated with a decrease in patient satisfaction whereas patients who were married reported higher satisfaction. Patients discharged to a rehabilitation facility had a 12% decrease in top-box response rate compared to those discharged home. Contrary to our hypothesis, specific procedure type and the presence of comorbidities failed to predict patient satisfaction. The results of this study shed light on the intricate relationship between patient satisfaction and patient-specific factors. Furthermore, health care workers can counsel patients on expected satisfaction when considering total hip and knee arthroplasty.
Heavy metal pollutants and their spatial distribution in surface sediments from Thondi coast, Palk Bay, South India
Authors: Perumal Karthikeyan , Antony Joseph , Muthuramalingam Subagunasekar
Published: May 2021

Background

The concentration of heavy metals and their spatial distribution in surface sediments collected from the Thondi coast, Palk Bay, South India were analysed in this study. The sediment grain size, pH, EC, and major elements (Fe, and Al), heavy metal concentrations (Mn, Cr, Zn, Cd, Ni, Cu, and Pb) were determined and the values for the geoaccumulation index (Igeo), enrichment factor (EF), potential contamination index (Cp), potential ecological risk index (RI), contamination factor (CF), modified contamination degree (mCd), degree of contamination (Cd), and potential contamination factors (Cp) were calculated based on their background values to determine the pollution level of the study area. Multivariate analysis such as Pearson’s correlation coefficient, principal component analysis/factor analysis (PCA/FA), cluster analysis, and regression analysis are a versatile method for identifying heavy metal sources and determining the relationship between pollutants in marine sediment.

Results

The pollution indices, namely EF, CF, Cd, mCd, CP, RI, and Igeo, revealed that the heavy metal contamination was due to Cd, while a moderate level of contamination was caused by Cu, Zn, Pb, and Cr. The principal component analysis and correlation matrix analysis showed a strong positive loading for Cd due to its high level of contamination in the study area. Anthropogenic inputs such as municipal wastewater, domestic sewage discharge, fishing harbour activities, and industrial and aquaculture wastes led to the increased Cd concentration in the study area. Moreover, the pollution load index revealed that the sediments were polluted by heavy metals.

Conclusion

The findings of this study revealed that the increased concentration of heavy metals in the study area increases the toxicity in the marine environment, thus affecting the ecosystem.
Healthcare workers’ compliance and its potential determinants to prevent COVID-19 in public hospitals in Western Ethiopia
Authors: Etafa Werku , Gadisa Gosa , Jabessa Shibiru , Takele Tagay
Published: May 2021

Background

Globally, Coronavirus disease-19 has created unprecedented challenges to public health. Healthcare workers (HCWs) are at risk of COVID-19 because of their profession. There are limited studies conducted in Ethiopia among HCWs regarding their compliance with COVID-19 preventive measures. Therefore, this study intended to assess HCWs’ compliance with measures to prevent COVID-19, and its potential determinants in public hospitals in Western Ethiopia.

Methods

A self-administered, multicenter hospital-based cross-sectional survey was proposed to 422 randomly selected HCWs working in seven public hospitals in Western Ethiopia identified as COVID-19 referral centers. Data were entered into Epi Data version 3.1 and analyzed using SPSS version 24. Binary logistic regression was used to identify potential determinants of outcome variables at p-value < 0.05.

Results

Out of 422 completed questionnaires, the overall HCWs’ compliance with COVID-19 prevention is 22% (n = 404). In multivariate regression analysis, factors such as spending most of caring time at bedside (AOR = 1.94, 95%CI, 1.06–3.55), receiving training on infection prevention/COVID-19 (AOR = 1.86, 95%CI, 1.04–3.33), reading materials on COVID-19 (AOR = 2.04, 95%CI, 1.14–3.63) and having support from hospital management (AOR = 2.09, 95%CI, 1.20–3.64) were found to be significantly associated with COVID-19 preventive measures. Furthermore, inadequate supplies of appropriate personal protective equipment (83.2%), insufficient supportive medications (78.5%), and lack of provision of adequate ventilation (77.7%) were the barriers to COVID-19 prevention most frequently mentioned by participants.

Conclusion

Our findings highlight HCWs’ poor compliance with COVID-19 preventive measures. Providing information and refreshing training to improve the level of healthcare workers’ adherence with COVID-19 prevention is as imperative as increasing staff commitment to supply resources necessary to protect HCWs and to reduce healthcare-associated infections transmission of SARS-COV-2.
Referring patients with chronic kidney disease back to primary care: a criteria-based analysis in outpatient renal clinics
Authors: van Dipten Carola , van Dam Davy Gerda Hermina Antoin , de Grauw Wilhelmus Joannes Carolus , ten Dam Marcus Antonius Gerard Jan , Hermans Marcus Matheus Hendrik , Assendelft Willem Jan Jozef , Haan Nynke Dorothea Scherpbier-de , Wetzels Jacobus Franciscus Maria
Published: May 2021

Background

The increased demand for nephrology care for patients with chronic kidney disease (CKD) necessitates a critical review of the need for secondary care facilities and the possibilities for referral back to primary care. This study aimed to evaluate the characteristics and numbers of patients who could potentially be referred back to primary care, using predefined criteria developed by nephrologists and general practitioners.

Method

We organised a consensus meeting with eight nephrologists and two general practitioners to define the back referral (BR) criteria, and performed a retrospective cohort study reviewing records from patients under nephrologist care in three hospitals.

Results

We reached a consensus about the BR criteria. Overall, 78 of the 300 patients (26%) in the outpatient clinics met the BR criteria. The characteristics of the patients who met the BR criteria were: 56.4% male, a median age of 70, an average of 3.0 outpatients visits per year, and a mean estimated glomerular filtration rate of 46 ml/min/1,73m2. Hypertension was present in 67.9% of this group, while 27.3% had diabetes and 16.9% had cancer. The patients who could be referred back represented all CKD stages except stage G5. The most common stage (16%) was G3bA2 (eGFR 30 ≤ 44 and ACR 3 ≤ 30).

Conclusion

A substantial proportion of patients were eligible for referral back to primary care. These patients often have a comorbidity, such as hypertension or diabetes. Future research should focus on generalisability of the BR criteria, the feasibility of actual implementation of the back referral, follow-up assessments of renal function and patient satisfaction.
MRI-based early diagnosis: a diabetic Charcot spine case report
Authors: Nedel Barbara Limberger , Duarte Juliana Avila , Gerchman Fernando
Published: May 2021

Background

Spinal neuroarthropathy (SNA), also known as Charcot spine, is an uncommon aggressive arthropathy, secondary to loss of proprioceptive and nociceptive feedback from the spine. A diagnosis of SNA is frequently delayed due to the scarcity of symptoms in its early stages, leading to significant neurological deterioration. Therefore, prompt suspicion of the disease is critical to providing better outcomes. This case assembles two rare characteristics of SNA: diabetic aetiology and a precocious time of diagnosis, and aims to highlight the magnetic resonance imaging (MRI) findings that allowed for the diagnosis.

Case presentation

A 44-year-old woman, with long-term type 1 diabetes, presented with a two-month history of progressive lumbar pain, difficulty in maintaining an upright position, and discrete trunk forward-leaning. Diabetes-related vasculopathy and nephropathy were already known, and laboratory test results did not show any new abnormalities. A lumbar MRI revealed extensive signal intensity changes of the L2 and L3 vertebral bodies associated with marginal areas of enhancement and the involvement of regions adjacent to interapophyseal articulations and spinous processes from L2–L3 to L5–S1, in association with degenerative changes of the thoracolumbar spine. These findings were identified by the radiologist as suggestive of SNA. To rule out neoplastic and infectious disease, a bone biopsy at the L2–L3 level was executed. The pathology report revealed intervertebral disc material and fragments of fibrous tissue, with a complete absence of inflammatory cells. It was decided to perform a six-month MRI follow-up, which showed stability of the findings, confirming the hypothesis of Charcot spine. The patient was under clinical and radiological follow-up and did not require surgical fixation at the moment of diagnosis. After 2.5 years from the initial diagnosis, a new MRI revealed progression of the lesions with oedema and enlarged paravertebral soft tissues; these findings are compatible with the patient’s latest complaints of lumbar pain recurrence.

Conclusion

To the best of our knowledge, this is the first case report of an MRI-based early diagnosis of diabetic SNA, a rare disease with nonspecific symptoms in its initial stages and a wide spectrum of differential diagnoses. The MRI findings, distinctly the involvement of both anterior and posterior spinal elements, were the key to allowing for the proper diagnosis. A precocious diagnosis, although challenging, is fundamental to providing early intervention and to preventing further neurological impairment.