bluuebunny/crossref_metadata_2025 huggingface dataset:
Civil–Military Relations: Through a Perilous Lens
Authors: Banerjee Vasabjit , Webeck Sean P.
Published: July 2022

Since Huntington’s seminal work The Soldier and the State, the scholarship on civil–military relations in the American context has often emphasized the need for a professional military to maintain an apolitical stance and let the civilian principals lead. In this article, we ask, what can we learn about civil-military relations by seeking to better understand the relationship between political institutions and the politicization of the military? We argue that this literature insufficiently accounts for the perils that exist within separation of powers (i.e., presidential) systems. Consequently, the existing scholarship cannot distinguish when politicization happens because of or despite civilian principals. We use long-standing arguments from Comparative Politics to explain why problems of separation of powers systems are endemic to these institutions. We then present five questions and two examples to facilitate a theoretical reframing of the subject. Our argument suggests more work is needed to understand how American political institutions shape civil–military relations.
Power Sharing and Coups d’état in Postconflict Settings: Evidence From Burundi and Guinea-Bissau
Authors: De Bruin Erica
Published: July 2022

In postconflict settings, peace agreements often include power-sharing provisions that integrate formerly warring parties into the state. The aim of such provisions is to prevent conflict from resuming. At the same time, however, they can inadvertently increase the risk of coups d’état. Existing research identifies a correlation between peace agreements and coups, but the causal mechanisms underlying this association remain underexplored. This article argues that power sharing affects the motives of incumbent elites to intervene in politics via a coup and the opportunity for former rebels to do so successfully. Evidence from coup attempts in Burundi and Guinea-Bissau illustrates the plausibility of these arguments and suggests ways to extend them in future work. While debate remains over whether power sharing prevents civil war recurrence, this article shows how it can create incentives for other forms of political violence.
Conservative therapy significantly reduces patients’ chronic venous disease symptoms: A Caribbean insight into the VEIN Act Program
Authors: Dialsingh Isaac , Mohammed Saeed Rashaad , Medford Rei Sebastian , Budhoo Emerson , White-Gittens Ian , Maharaj Dale
Published: July 2022

Objectives

We sought to determine the baseline demographic and clinical characteristics of patients with Chronic Venous Disease (CVD) across the Caribbean, and to evaluate patients’ compliance to conservative therapy and the effectiveness of such therapy in reducing patients’ CVD symptoms.

Method

Patients were enrolled into the VEIN Act Program, and their demographic data, CVD symptoms (and their intensity) and CEAP C-classification was recorded at the first visit. Patients were prescribed conservative therapy, and symptom intensity and patient compliance and satisfaction evaluated at a follow-up visit.

Results

We enrolled 193 patients into the study, most of which (76%) were female, between 39–78 years (80%) and within the C2-C4a classes (56.1%). Pain (61.1%) and heaviness (58.5%) were the most common symptoms. Patient compliance to the prescribed treatment was relatively high for all modalities (>75%) and most patients (92.1%) were at least somewhat satisfied with their treatment.

Conclusions

Patient compliance to conservative therapy for management of CVD is high across the Caribbean, and such therapy is effective in reducing intensity of CVD symptoms.
Consumers’ Cooperation with Sustainability Programs: The Role of Luxury Branding and Profit Motive Attribution
Authors: Chen Ning , Petersen Francine Espinoza
Published: July 2022

In this research, we investigate consumers’ willingness to cooperate with luxury versus non-luxury hotels’ environmental protection programs. We find that while consumers’ cooperation with non-luxury hotels becomes less favorable when consumers perceive the sustainability program to have a profit motive, consumers’ cooperation with luxury hotels remains high even when consumers perceive the hotel’s sustainability program to be profit-driven. We find a similar pattern for customer loyalty. In addition, we find that this interactive effect emerges when affective attitudes toward luxury brands are strong. These results contribute to the literature by identifying a condition where profit motive attribution does not hurt consumer conservation intentions and by revealing a condition where luxury brands may benefit from sustainability programs. We discuss theoretical and practical implications as well as directions for future research.
The role of family musical involvement in family relationships
Authors: Gao Yili , MacDonald Raymond AR , Wilson Graeme B
Published: July 2022

Previous studies suggest that family musical activities have a positive influence on family cohesion and well-being. Despite the significance of both family and music in people’s lives, few studies have focused on the function of music within the family unit, and very few have examined families in China. This study presents a qualitative investigation into the effects of family musical involvement (FMI) on Chinese family relationships. Participants were recruited from Chengdu, Sichuan, China. Six urban families with 16 people in total participated in the in-depth interviews. The participating families had all experienced the one-child policy and participant accounts include retrospective accounts. The interviews were analyzed using thematic analysis. Findings suggest that FMI can exert both positive and negative impacts on family relationships. FMI can benefit parental relationships and parent–child relationship through nurturing a joint hobby and sharing the responsibility of child rearing. It can also bring about challenges to families, such as encountering issues of integration and control. The impact of negative experiences was short term, as it was often mediated by the participants in a positive way. FMI benefits families, but the challenges of organizing and maintaining it should not be taken for granted.
Mexican-Heritage Ethnic Identity: How Coco Serves as Context for Ethnic Socialization
Authors: Walsh Abigail S. , Azmitia Margarita
Published: July 2022

This study investigated the role of media as a context for ethnic socialization in Mexican-heritage families. We studied whether and how Mexican-heritage parents used the Disney film Coco as a springboard to talk with their children about important cultural traditions, values, and practices. Participants included 23 parent-child dyads. Children were in kindergarten through fifth grade. Parents and children completed quantitative ethnic identity surveys individually, watched the movie together, and were interviewed individually about their experiences with and conversations about the film. Results showed that ethnic identity, ethnic socialization, and orientation toward Mexican or American media were associated with parent-child conversations and experiences with Coco. Participants’ who scored high on ethnic identity and socialization scales discussed nuanced ways in which the cultural representation in Coco related to their own cultural practices and experiences.
Evaluation of Loop Diuretic Dosing Following Sodium-Glucose Cotransporter 2 Inhibitor Initiation in Patients With Heart Failure
Authors: Trudeau Brooke M. , Allen Larry A. , Billups Sarah J. , Saseen Joseph J. , Pearson Scott M.
Published: July 2022

Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have demonstrated cardiovascular benefits in patients with heart failure, many of which take loop diuretics. There are no evidence-based recommendations identifying which patients may require loop diuretic dose decreases or how to adjust loop diuretic doses when SGLT2is are initiated. Objectives: The main objective of this study was to investigate the frequency and degree of adjustments in loop diuretic doses after SGLT2i initiation in patients with heart failure. Methods: In this retrospective evaluation, patients seen in the UCHealth system with a diagnosis of heart failure who were prescribed a loop diuretic before initiation of SGLT2i were identified. We described loop diuretic dose changes at the time of SGLT2i initiation, at 6 months after initiation, and at 1 year after initiation. We also described de-escalation of maintenance medications that can contribute to hypotension at these time points. Data were evaluated using descriptive statistics. Results: A total of 100 patients were included. Loop diuretic dose was reduced empirically upon SGLT2i initiation in 2.0% of patients. Reduction of loop diuretic dose within the first 6 months of starting an SGLT2i occurred in 8.0% of patients. From baseline to 12 months after starting SGLT2i therapy, 14.0% of patients had loop diuretic dose reduction. Conclusions: Most of our patients with HF did not have change in loop diuretic dose after initiation of an SGLT2i. In patients who did have loop diuretic dose reduction, most occurred within 6 months after starting SGLT2i therapy rather than empirically at time of initiation.
CFD modelling on flow field characteristics of engine cooling water jacket and its cooling performance improvement based on coolant transport path analysis method
Authors: Tan Libin , Yuan Yuejin , Huang Can
Published: July 2022

Reasonable coolant flow distribution and its heat transfer coefficient (HTC) distribution are of great significance to the cooling performance of water-cooled engine. Therefore, the present paper proposes a coolant transport path analysis method aiming at analyzing coolant velocity distribution and optimizing the coolant flow characteristics of water jacket based on Computational Fluid Dynamics (CFD), with particular emphasis on the assessment of coolant flow velocity distributions of high-temperature area of engine head water jacket. First, the coolant flow characteristics of a single-cylinder water jacket is investigated and it is found that coolant velocity of exhaust bridge is less than 1.5 m/s and the HTC distribution of water jacket under three flow conditions of 15 L/min, 25 L/min and 35 L/min have a small area reaching 5000 W/(m2∙K). Some areas have no coolant flow and the mass flowrate distribution of each gasket hole is unreasonable, proving that original water jacket structure has some shortcomings and need to be optimized. Based on coolant transport analysis, an improved design of the single cylinder water jacket is proposed and HTC distribution of improved water jacket meet cooling requirements that HTC in high heat load area are above 5000 W/(m2∙K). The coolant transport path analysis method for optimizing coolant flow characteristics of water jacket proves to be an effective way through successful application and remarkable achievement in the other single-cylinder water jacket and two-cylinder water jacket that coolant flow distribution become more reasonable and coolant velocity of high-temperature areas are bigger than 1.5 m/s.
A case for the provision of assisted dying in prisons founded on the right to self-determination: Creating equivalence between prisoners and non-prisoners?
Authors: Fenwick Daniel , Tomczak Philippa , Cochrane Alasdair
Published: July 2022

This article makes the case for the provision of access to assisted death in prisons, founded on the right to self-determination under Article 8(1) ECHR, in order to create equivalence between prisoners and non-prisoners. It considers possible State justifications for interferences with the right under Article 8(2) and whether they would meet the Convention standards of legality and proportionality. In relation to proportionality, it is argued that the foundational basis for restrictions on assisted dying imposed on both the general and prison populations derives from the concept of human dignity, a concept which is also fundamental to prisoners’ rights. Under the banner of proportionality, from an initial presumption of equivalence of access to assisted dying, the article identifies certain conditions inherent in the prison situation that inevitably oppose human dignity and which provide a plausible basis for divergence. Ultimately, it is concluded that an absolute bar on provision of access to assisted dying in prisons cannot be justified, but that the factors that undermine dignity in prison could justify a degree of divergence from creation of equivalence between the prison and the non-prison populations in terms of such access.
Moulding and Sustaining Excellence and Passion of Teachers through Resilience in the Post-Covid-Pandemic Era
Authors: C. Rekha Francis , Fraga F.X. Virgin
Published: July 2022

Human resource excellence through resilience is a recent area of research in organisations to overcome all pitfalls of the workforce. Due to the pandemic wave of COVID-19, all institutions were closed for reducing the crisis dilemma; the entire world was affected especially the education sector. The lockdown system throughout the world arose out of the Corona epidemic and has created changes in the model of teaching, that is, from a conventional-lecture method to a virtual classroom system. Though the sudden shift affected the entire sector of education, the aftermath of this situation has adversely disturbed the college teachers and students. This study aimed at reducing the stress, worries and technological issues that college teachers are experiencing in Thrissur district, Kerala. By following a simple random sampling method, the study was conducted among 268 teachers who were working in a college by administering a self-structured questionnaire. The result through the SEM analysis has shown that resilience has prevented negative mental health, and stress in work while there was an increased work–life balance, that is, the well-being of teachers. It has created a signature strength in their work.
End-of-Life Experiences Within a Dementia Support Program During COVID-19: Context and Circumstances Surrounding Death During the Pandemic
Authors: Brungardt Adreanne , Cassidy Jessica , LaRoche Ashley , Dulaney Sarah , Sawyer R. John , Possin Katherine L. , Lum Hillary D.
Published: July 2022

Background: Persons with dementia (PWD) and their caregivers are uniquely impacted by the COVID-19 pandemic, including higher risk of mortality for PWD. Objectives: To describe the context and circumstances of deaths of PWD within a dementia support program during the COVID-19 pandemic. Design: Retrospective data collection of PWD deaths between March 1, 2020 and February 28, 2021. Setting/Subjects: Decedents enrolled in Care Ecosystem, a multidisciplinary team model for dementia care at University of California San Francisco, Ochsner Health, and UCHealth. Measurements: Using mixed methods, we analyzed data using descriptive measures and team-based thematic analysis to understand the end-of-life (EOL) experience of PWD-caregiver dyads. Results: Twenty-nine PWD died across three sites. Almost half (45%) were between ages 70-79 and 12 (41%) were women. Eighteen (62%) died at a private residence; two died in the hospital. Hospice was involved for 22 (76%) patients. There were known causes of death for 15 (53%) patients. Only two deaths were directly related to COVID-19 infection. Social isolation was perceived to have a high or very high impact for 12 (41%) decedents. Four qualitative themes were identified: (1) isolation due to the pandemic, (2) changes in use of dementia supports and resources, (3) impact on goals of care decisions, and (4) communication challenges for EOL care coordination. Conclusion: Among PWD and caregivers enrolled in a dementia support program, the COVID-19 pandemic had direct and indirect influences on mortality and EOL experiences of PWD. Caregivers’ experiences of caring, decision making, and bereavement were also affected.
Prediction of the Invasiveness of Ground-Glass Nodules in Lung Adenocarcinoma by Radiomics Analysis Using High-Resolution Computed Tomography Imaging
Authors: Zhang Tianqi , Li Xiuling , Liu Jianhua
Published: July 2022

Background

Pure ground-glass nodules (pGGNs) have been considered inert tumors due to their biological behavior; however, their prognosis is not completely consistent because of differences in internal pathological component. The aim of this study was to explore whether radiomics can be used to identify the invasiveness of pGGNs.

Methods

The retrospective study received the relevant ethical approval. After postoperative pathological confirmation, sixty-five patients with lung adenocarcinoma pGGNs (≤30 mm) were enrolled in this study from January 2015 to October 2018. All the cases were randomly divided into training and test groups in a 7:3 ratio. In total, 385 radiomics features were obtained from HRCT images, and then least absolute shrinkage and selection operator (LASSO) logistic regression was applied to the training group to obtain optimal features to distinguish the invasion degree of lesions. The diagnostic efficiency of the radiomics model was estimated by the area under the curve (AUC) of the receiver operating curve (ROC), and verified by the test group.

Results

The optimal features (“GLCMEntropy_angle135_offset1” and “Sphericity”) were selected after applying the LASSO regression to develop the proposed radiomics model. This prediction model exhibited good differentiation between pre-invasive and invasive lesions. The AUC for the test group was 0.824 (95%CI: 0.599-1.000), indicating that the radiomics model has some prediction ability.

Conclusion

The HRCT radiomics features can discriminate pre-invasive from invasive lung adenocarcinoma pGGNs. This non-invasive method can provide more information for surgeons before operation, and can also predict the prognosis of patients to some extent.
‘You Can’t Do Anything Right’: How Adolescents Experience and Navigate the Achievement Imperative on Social Media
Authors: Krogh Søren Christian
Published: July 2022

The rise in mental health issues among youth has been linked to an emergence of an achievement imperative, causing a rise in personal expectations and achievement demands, with social media highlighted as a significant contributor to these developments. This study examined experiences of achievement demands on social media and well-being through focus groups and individual interviews with early adolescents ( n = 80, ages 12–16 years). Achievement demands and a culture of perfection, along with their negative effects hereof, were mainly experienced in relation to adolescents’ public digital lives and, particularly among the youngest adolescents, the quantity and frequency of communication with friends. Achievement practices were structured by gender, with higher expectations for girls to present self-centred idealized and attractive versions of themselves. Boys were more often expected to appear social, active and prosperous. Sexual presentations of girls and self-centred pictures of boys were often considered distasteful and associated with lower-class culture.
Minocycline treatment in clinically isolated syndrome and serum NfL, GFAP, and metalloproteinase levels
Authors: Camara-Lemarroy Carlos , Metz Luanne , Kuhle Jens , Leppert David , Willemse Eline , Li David KB , Traboulsee Anthony , Greenfield Jamie , Cerchiaro Graziela , Silva Claudia , Yong V Wee
Published: July 2022

Background:

In the trial of Minocycline in Clinically Isolated Syndrome (MinoCIS), minocycline significantly reduced the risk of conversion to clinically definite multiple sclerosis (CDMS). Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are emerging biomarkers in MS, and minocycline modulates matrix metalloproteinases (MMPs).

Objective:

To assess the value of blood NfL and GFAP as a biomarker of baseline and future disease activity and its utility to monitor treatment response in minocycline-treated patients with clinically isolated syndrome (CIS).

Methods:

We measured NfL, GFAP, and MMPs in blood samples from 96 patients with CIS from the MinoCIS study and compared biomarkers with clinical and radiologic characteristics and outcome.

Results:

At baseline, NfL levels correlated with T2 lesion load and number of gadolinium-enhancing lesions. Baseline NfL levels predicted conversion into CDMS at month 6. GFAP levels at baseline were correlated with T2 lesion volume. Minocycline treatment significantly increased NfL levels at 3 months but not at 6 months, and decreased GFAP levels at month 6. Minocycline decreased MMP-7 concentrations at month 1.

Discussion:

Blood NfL levels are associated with measures of disease activity in CIS and have prognostic value. Minocycline increased NfL levels at month 3, but reduced GFAP and MMP-7 levels.
Does threat from COVID-19 stimulate attitudes amenable to public cooperation? Evidence from India
Authors: Singh Shane P , Tir Jaroslav
Published: July 2022

Especially before the development of vaccines, efforts to combat the spread of COVID-19 relied heavily on public cooperation with health directives that highlight the virus’ existential threat. In this article, we test whether exposure to information about threat from the pandemic induces in individuals positive orientations towards their compatriots and society – thus providing the micro-foundations of the ‘we are in this together’ sentiment that would bolster public cooperation. Fielding a pre-registered experiment in the early days of the pandemic in India, we randomised exposure to a vignette referencing the biological threat. We find no evidence that treatment increased positive attitudes towards one’s compatriots or society. If anything, the treatment had a negative effect, which bodes poorly for efforts to obtain public cooperation in the fight against the virus.
Butterfly Broke Off
Authors: Dill LeConte J.
Published: July 2022

This poem is an autoethnopoetic exploration of my experiences with health conditions and diagnoses, navigating the medical–industrial complex, remembering my body, and actively in pursuit of healing. This work juxtaposes sociocultural herstories with personal herstories and juxtaposes playfulness and humor with seriousness, frustration, and grief. Ultimately, this piece critically analyzes medical analyses and seeks to recover the body. To view the original version of this poem, see the supplemental material section of this article online.
The Proposal
Authors: Jackson Alana
Published: July 2022

While the connection between arts, culture, and public health is not new, intentional efforts toward cross-sector collaboration in these areas are being lifted as timely and transformative. This is a call to artists, creatives, culture bearers, and activators. This is a call to public health practitioners, doctors, educators, and the myriad of peoples whose work touches the public’s health. In this piece, I propose a marriage of these two seemingly disparate disciplines—arts and public health—their actors and engagements. In this piece, I propose this marriage as dance, as movement, as evolution, even revolution. What could our world look like if more of the people and the sectors of arts and public health worked together to advance our most pressing public health priorities? I offer this work to help us imagine the possibilities of growing this intentional collaboration. This piece both proposes and marries; iterates and exemplifies. By presenting this work as poetry, I propose that art not be the afterthought, the accent, the cherry on top as we strive to address public health issues, a multitude exacerbated and illuminated in the face of COVID-19. I posit that art is the consistency, the substance, the forethought, and a vehicle through which we can come to realize the positive change that we hope to see. As we ponder our next potential public health engagements, know this. Not only can this marriage soothe us and move us; but it can literally improve us. This is the proposal. Will you accept?

To view the original version of this poem, see the supplemental material section of this article online.
Three-dimensional localization algorithm of mobile nodes based on received signal strength indicator-angle of arrival and least-squares support-vector regression
Authors: Zhang Lieping , Peng Huihao , He Jiajie , Zhang Shenglan , Zhang Zuqiong
Published: July 2022

Node localization is one of the key technologies in the wireless sensor network research field, which is crucial to the high-accuracy localization of mobile nodes, but the positioning error of traditional algorithms such as received signal strength indicator and angle of arrival is more than 4 m, which has almost no practical value. For example, the localization accuracy of the localization algorithm based on received signal strength indicator will be reduced sharply when affected by signal reflection, multipath propagation, and other interference factors. To solve the problem, a three-dimensional localization algorithm of mobile nodes was proposed in this article based on received signal strength indicator–angle of arrival and least-squares support-vector regression, which fused the ranging information of received signal strength indicator algorithm and the angle of arrival algorithm and optimized the estimated distance of unknown nodes. Next, the mobile node model and least-squares support-vector regression modeling mechanism were built according to the hop count of the shortest distance between nodes. Finally, the unknown mobile nodes were localized based on least-squares support-vector regression modeling. The experimental results showed that compared with the localization algorithms without optimized ranging information or least-squares support-vector regression modeling, the algorithm proposed in this study exhibited significantly improved stability, a reduced mean localization error by more than 50%, and increased localization accuracy.
Lean combustion and emission performance of a gasoline direct injection engine with active pre-chamber
Authors: Zhang Li , Huang Zhaoming , Wang Tao , Zhao Niu , Cheng Haiyan , Chen Weiguo
Published: July 2022

Pre-chamber jet ignition technology can effectively improve flame propagation speed and in-cylinder combustion rate, so it is conducive to the improvement of thermal efficiency and fuel economy. While, studies on the key parameters of the influence of active pre-chamber on combustion and emissions are not systematic. The influence of the key parameters of injection control in active pre-chamber on combustion and emission is not clear at present. Thus, in this paper, an active pre-chamber jet ignition system was designed and used in a single cylinder GDI engine, and the effects of compression ratio and pre-chamber injection strategy on pre-chamber jet ignition were experimentally studied, as well as the comparison of pre-chamber jet ignition and conventional spark ignition. The results show that, at 2750 r/min, IMEP 11 bar operation point, lean burn can effectively reduce the fuel consumption and increase the thermal efficiency of gasoline engine. Adopting traditional spark plug system can extend the lean burn limit to excess air ratio of 1.5 with the gross indicated thermal efficiency (GITE) of 45% limited by unstable combustion, while resembling active pre-chamber system can achieve GITE of 46.5% with the excess air ratio of 2.0 with the help of much more stable combustion. And the NOx emission of active-pre-chamber system has been reduced by 78% compared by conventional spark plug system. Increasing the compression ratio to 14.8 can further reduce the indicated fuel consumption to 177 g/kWh, and increase the GITE to 48.5% and further reduce the NOx emission to lowest 0.53 g/kWh with the excess air ratio of 2.1. With the increase of pre-chamber injection pressure, the ignition stability increases, the combustion duration decrases, and thermal efficiency increases. With the increase of the pre-chamber injection duration, the ignition delay first decreases and then increases. When the injection duration increases to 800 μs, COV is greater than 3%. If the pre-chamber injection duration further increase, the COV increases, the combustion phasing retard, and the thermal efficiency decreases. With the increase of pre-chamber injection duration and pressure, the wetting wall fuel increases, which leads to the increase of PN emission.
Upgraded trajectory planning method deployed in autonomous exploration for unmanned aerial vehicle
Authors: Zhang Tong , Yu Jiajie , Li Jiaqi , Wei Jianli
Published: July 2022

Autonomous exploration is grounded on target decision and trajectory planning, which is widely deployed on unmanned aerial vehicles. However, existing methods generally only focus on the exploration effect of target decision but neglect the environment information gained with trajectory planning during flight, resulting in redundant exploration trajectories and low exploration efficiency. This article proposes an upgraded method of trajectory planning for autonomous exploration work. We design a fresh cost term considering the frontier information in the part of trajectory optimization. Besides, yaw angles are planned independently to catch more environment information during flight. We present extensive simulations and real-world tests. The results show that our proposed method reduces the exploration cost time by 10–15% compared with the previous one.
A framing effect of intertemporal and spatial choice
Authors: Kuang Yi , Huang Yuan-Na , Li Shu
Published: July 2022

A given spatial distance can be measured using either a length or a time unit. A spatial-choice problem with given distances represented in a space frame and in a time frame is logically equivalent. Different representations of the same choice problem should yield the same preferences according to the invariance principle. To test invariance in the context of spatial choice, we used a constant velocity to construct six spatial (intertemporal) choice problems with single-placed (single-dated) outcomes in a space (time) frame and investigated whether invariance-violating behaviour could be detected under the two frames (Studies 1–3). If such behaviour existed, we then aimed to determine whether two models—the attribute-comparison model, which predicts a framing effect occurs if framing shifts people’s judgement of the inequality relationship between the differences of two options in time/space dimension and that in outcome dimension, and the utility comparison model, which predicts that a framing effect occurs if framing shifts people’s judgement of the inequality relationship between two options’ overall utility—could account for it, and which of these two models is better supported by the data (Studies 2–3). The results indicate that a time–space framing effect existed, as people’s preference orders were significantly changed by the different descriptions of spatial-choice problems, and this new time–space framing effect could be satisfactorily explained by the attribute-comparison rather than the utility comparison model. Our findings could support the creation of new forms of choice architecture that improve decisions about health, wealth, and happiness.
Where did you go?! Trans-diegetic address and formal innovation in Phoebe Waller-Bridge’s television series Fleabag
Authors: Wilson Anna
Published: July 2022

The article examines formal innovation, authorship and representation within Phoebe Waller-Bridge’s television series Fleabag (2016–2019). Through close examination of the developed use of direct address within the programme, in particular two key moments of trans-diegetic address, the analysis considers how, contrary to ontological assumptions, the adaptation of the theatrical ‘aside’, when converted for screen, can function to support, strengthen, layer and enhance aspects of a narrative, as well as help build performer/audience connectivity through perceptions of intimacy, authenticity and female agency.
Tumor vessel normalization and immunotherapy in gastric cancer
Authors: Yu Xianzhe , He Shan , Shen Jian , Huang Qiushi , Yang Peng , Huang Lin , Pu Dan , Wang Li , Li Lu , Liu Jinghua , Liu Zelong , Zhu Lingling
Published: July 2022

Gastric cancer (GC) is a common malignant tumor, and patients with GC have a low survival rate due to limited effective treatment methods. Angiogenesis and immune evasion are two key processes in GC progression, and they act synergistically to promote tumor progression. Tumor vascular normalization has been shown to improve the efficacy of cancer immunotherapy, which in turn may be improved through enhanced immune stimulation. Therefore, it may be interesting to identify synergies between immunomodulatory agents and anti-angiogenic therapies in GC. This strategy aims to normalize the tumor microenvironment through the action of the anti-vascular endothelial growth factor while stimulating the immune response through immunotherapy and prolonging the survival of GC patients.
Sarcopenia and frailty combined increases the risk of mortality in patients with decompensated cirrhosis
Authors: Guo Gaoyue , Li Chaoqun , Hui Yangyang , Mao Lihong , Sun Mingyu , Li Yifan , Yang Wanting , Wang Xiaoyu , Yu Zihan , Fan Xiaofei , Jiang Kui , Sun Chao
Published: July 2022

Background:

Both sarcopenia and frailty are prevalent in patients with decompensated cirrhosis and associated with negative outcomes. However, few studies investigated the impact of their coexistence on mortality. We aimed to evaluate the role of sarcopenia and frailty on survival in a cohort of hospitalized cirrhotics.

Methods:

This was an observational cohort study including 221 patients hospitalized for decompensated events. The cutoff for low skeletal muscle index (SMI) at the third lumbar vertebra level on computed tomography built by our previous work (male: SMI <46.96 cm2/m2; female: SMI <32.46 cm2/m2) was used for the diagnosis of sarcopenia. Individuals with a Frailty Index >0.38 were considered frail. The sample was divided into four groups: sarcopenia and frailty (SF); sarcopenia and non-frailty (SN); non-sarcopenia and frailty (NF); and non-sarcopenia and non-frailty (NN). Follow-up for survival lasted 2 years.

Results:

Sarcopenia and frailty were present in 21.7% and 14.5% of the patients, respectively. The frequency of frailty in the group of sarcopenic patients was significantly higher than in the patients without sarcopenia (27.1% versus 11%, p = 0.009). In the survival analysis, the SF group showed a higher hazard ratio (2.604 in model 1; 4.294 in model 2) for mortality when compared with the NN group. In addition, the concurrence of those two conditions does give rise to incremental risk for mortality when compared with the group with each disturbance separately, namely, the SN/NF group.

Conclusion:

In conclusion, cirrhotic patients with sarcopenia and frailty combined showed higher mortality risk.
A pediatric posterior neck venous malformation with an endocranial extension
Authors: Sellami Moncef , Ben Ayed Mariam , Makni Saadia , Sellami Boudawara Tahya , Kallel Souha , Charfeddine Ilhem
Published: July 2022

Venous malformations are frequently localized in the head and neck region. However, a cervical localization with an endocranial extension is rather a very uncommon occurrence. We present a case of a 4-year-old child who presented with a large posterior cervical mass evolving for a year, firm and painful at palpation. Imaging was required, revealing a posterior cervical mass with an extension to adjacent structures, a destruction of the occipital bone and an endocranial extension. A macrobiopsy of the mass showed numerous irregular vessels. A surgical treatment was performed due to the extension of the mass, the esthetic prejudice it caused and the uncertain diagnosis. Venous malformation diagnosis was confirmed by a histological examination of the resected piece. Surgical management was not associated with the mass recurrence in our case. Here, we aim at identifying the clinical and radiological features of venous malformations, and at describing the different therapeutic features of this condition.
Frontline, Essential, and Invisible: The Needs of Low-Wage Workers in Hospital Settings During COVID-19
Authors: Zerden Lisa de Saxe , Richman Erica L. , Lombardi Brianna , Forte Alexandria B.
Published: July 2022

Background:

Frontline health care workers are particularly vulnerable to burnout and diminished well-being as they endure COVID-19 pandemic-related stressors. While physicians and nurses are the public face of those experiencing burnout in hospitals, these stressors also affect low-wage workers such as food and housekeeping/janitorial service workers whose roles largely remain “invisible” when conceptualizing the essential health workforce and understanding their needs. This study sought to understand the experiences of frontline essential workers to better support them and prevent burnout.

Methods:

Using a semi-structured interview guide, we conducted 20 in-depth qualitative interviews with workers in three U.S. states. Thematic content analysis was conducted to code and analyze interviews.

Results:

Workers had an average of 5.8 years in their jobs, which included food services, housekeeping/janitorial, and patient transport roles. Analysis revealed four prominent stressors contributing to worker burnout: changes in duties and staff shortages, fear of contracting or transmitting COVID-19, desire for recognition of their job-related risk, and unclear communication on safety precautions and resources. Protective factors included paid time-off, mental health supports, sense of workplace pride, and self-coping strategies.

Conclusion/Application to Practice:

As health systems continue to grapple with care delivery in the context of COVID-19, identifying best practices to support all workers and prevent burnout is vital to the functioning and safety of hospitals. Further consideration is warranted to create policies and multipronged interventions to meet workers’ tangible needs while shifting the culture, so all members of the health workforce are seen and valued.
Living up to Parental Expectations, Psychological Separation, and Life Satisfaction
Authors: Lee Soojung , Kim Myung Sun , Lee Dohyung , Yon Kyu Jin , Nelson Alex J.
Published: July 2022

This study examined the relationship between living up to parental expectations (LPE) and life satisfaction as well as the moderating effect of psychological separation on this relationship among South Korean college students. The participants ( N = 343) completed an online survey measuring the study variables. We divided psychological separation into conflictual independence (CI) and general independence (GI) and performed multiple regression analysis. The results revealed a positive association between LPE and life satisfaction. Our analysis also indicated that GI moderated the relationship between LPE and life satisfaction. Specifically, the positive association between LPE and life satisfaction was significant for participants with lower levels of GI. We discussed the significance of these findings and explained their implications for counseling settings in terms of cultural considerations.
Using Narrative Vignettes to Understand the Misuse and Diversion of Stimulants Among College Students With and Without a Prescription
Authors: Valencia Brian , Garcia Jacquelyn , Diaz Roldan Kate , Amador Ayala Jeovanna , Garcia Candelaria , Flyswithhawks Romajean , Looby Alison , McMullen Jaimie , Bavarian Niloofar
Published: July 2022

We used the narrative vignette/storytelling approach to provide a holistic illustration of prescription stimulant misuse [PSM] and diversion [PSD] initiation and maintenance among college-attending emerging adults. We conducted 32 semi-structured, theory-guided interviews with 20 students during spring and summer 2019. The participants were diverse with respect to age, race/ethnicity and gender, and had a history of PSM and/or PSD. We created four narrative vignettes using a multi-step, collaborative process that incorporated patterns of what contributed to initiation and maintenance for four identified student groups (i.e., PSM with and without a prescription and PSD with and without a prescription). Characteristics of the individual, social and broader environments influenced behavior initiation, and positive reinforcement from trial behavior contributed to maintenance. Similarities and differences were identified across the groups. Approaches for PSM and PSD prevention and intervention in college-attending emerging adults should be multifaceted and consider prescription status.
External validation of ABCD series scores for predicting early stroke events following transient ischemic attack in a large nationwide registry
Authors: Weng Jia-Xu , Gu Hong-Qiu , Wang Shang , Yang Kai-Xuan , Yang Xin , Wang Chun-Juan , Meng Xia , Zhao Xing-Quan , Wang Yong-Jun , Li Zi-Xiao
Published: July 2022

Introduction:

In the context of modern guideline-based strategies, new validations of prognostic scores for predicting early stroke risk are needed. We aimed to compare the validity of the ABCD series scores and assess the incremental values of risk components for predicting in-hospital stroke events in patients with transient ischemic attack (TIA).

Patients and methods:

We abstracted data from the Chinese Stroke Center Alliance (CSCA), a nationwide registry with 68,433 TIA patients admitted within 7 days of symptom onset from 1476 hospitals. TIA was defined by time-based criteria according to the World Health Organization (WHO). The discrimination of ABCD, ABCD2, ABCD2-I, and ABCD3 scores for predicting in-hospital stroke events was assessed by the area under the receiver-operating characteristics curves (AUC). The incremental predictive values of added risk predictor were determined by net reclassification improvement (NRI) and integrated discrimination improvement (IDI).

Results:

A total of 29,286 TIA patients were included, of whom 1466 (5.0%) had in-hospital stroke events. Compared with ABCD2-I score (AUC 0.79, 95% confidence interval [CI] 0.77–0.80), ABCD (AUC 0.58, 95% CI 0.57–0.60), ABCD2 (AUC 0.58, 95% CI 0.56–0.59), and ABCD3 (AUC 0.58, 95% CI 0.56–0.60) had lower predictive utility. An incremental value was observed when adding infarction on DWI (IDI = 0.0597, NRI = 1.1036) into ABCD2 score to be ABCD2-I.

Conclusion:

The traditional scales utilizing medical history (ABCD, ABCD2, and ABCD3 scores) show fair ability for predicting in-hospital stroke events after TIA, but the ABCD2-I score, which adds infarction on DWI, improves the predictive ability.
Throat Spray With Blended Essential Oils Promotes Healthy Lung Function Among Women: A Randomized, Double Blinded, Placebo Controlled Clinical Trial
Authors: Hawkins Jessie , Hires Christy , Dunne Elizabeth , Keenan Lindsey
Published: July 2022

Introduction

There are numerous internal and external environmental threats to lung health. Compromised respiratory health can affect a person's quality of life. This clinical trial evaluated the effects of Teramune Bronchus on lung health among healthy adult women.

Methods

The participants were women, aged 18 - 60 years old (n = 35). They sprayed either the proprietary essential oil based blended product (Teramune Bronchus) or a placebo into their throats 4-6 times per day during waking hours for 3 days. There was a baseline survey before using the spray and then follow-up data were collected at the end of day 3. The three primary outcomes for this study include a total bronchial symptom score, the chest domain in the Wisconsin Upper Respiratory Symptom Scale (WURSS), and subjective bronchial wellbeing.

Results

On day 3, the bronchial health of the participants who received the throat spray had significantly larger change scores when compared those with the placebo spray. All chest-related symptoms were resolved fully by the end of the trial for the participants who used Teramune. Participants using the intervention were almost twice as likely to say they felt better and believed the product helped them achieve lung health.

Conclusion

This study provides evidence that the use of Teramune Bronchus supports respiratory health. Teramune Bronchus boosts respiratory health among healthy women through the use of plant-based essential oils.
Experiences and Expectations of Young Residents of Impoverished Neighbourhoods in Central America
Authors: Sandoval-García Carlos
Published: July 2022

This article analyses experiences and expectations of young residents of impoverished neighbourhoods in Central American capital cities. Four main subject areas are explored: the representation of the local and national environment, demands and desires for the future, the means by which young people expect to achieve (or not achieve) said demands, and sociodemographic factors. The selected neighbourhoods were El Limón in Guatemala City, Popotlán in San Salvador, Nueva Capital in Tegucigalpa, Jorge Dimitrov in Managua and La Carpio in San José. A sample of 300 respondents were selected using sampling quotas. One of the primary findings of the study is that 37.7% of participants neither study nor work, and that only 15% have access to social security. Although inequality was not identified as being among the most pressing problems, when asked about the distribution of wealth in their respective countries, 73.6% of participants considered said distribution to be ‘very unfair’ or ‘unfair’. This recognition of inequality coexists with a deeply rooted conservatism and a largely unquestioned belief in the legitimacy of destiny and parental authority. Against this historical background, electoral democracy is far from offering any kind of significant or profound response and has deepened the institutional void, and in many cases, migration has become more of a push than a choice.
‘I feel … I need to defend myself’: Exploring the influence of social worker’s attachment history on the social worker-client relationship
Authors: Ash Zoe , Grey Ben
Published: July 2022

This paper offers a qualitative exploration of the influence of attachment patterns on individual social worker-client relationships. An attachment theory-informed IPA methodology is employed to gain insight into the experiences of three practicing social workers. The Adult Attachment Interview and Meaning of the Client interview (adapted version of the Meaning of the Child Interview) are used alongside Interpretive Phenomenological Analysis, triangulating findings and common themes. We found evidence of specific childhood experiences and dangers replayed in interactions with their client, albeit in an individualised and context-dependent rather than uniform way. Also, the dangers inherent in the institutional context of child protection work can intensify tensions from workers’ past history, resulting in a more defensive and self-protective approach than might have been expected from considering the professional’s childhood attachment relationships alone. Therefore, expectations of the professional-client relationships in this context should be realistic on what can be achieved, focussing less on transformation and ‘certainty’, and more on increasing awareness and capacity to tolerate difficult feelings arising from past history that may be elicited in the professional-client relationship.