bluuebunny/crossref_metadata_2025 huggingface dataset:
Pancreatic islet transplantation under the kidney capsule of mice: model of refinement for molecular and ex-vivo graft analysis
Authors: Thévenet Julien , Gmyr Valery , Delalleau Nathalie , Pattou François , Kerr-Conte Julie
Published: April 2021

Diabetes cell therapy by human islet transplantation can restore an endogenous insulin secretion and normal glycaemic control in type 1 diabetic patients for as long as 10 years post transplantation. Before transplantation, each clinical islet preparation undergoes extensive in-vitro and in-vivo quality controls. The in-vivo quality control assay consists of transplanting human islets under the kidney capsule of immunocompromised mice. Currently, it is considered the best predictive factor to qualify clinical transplant efficiency. This chimeric model offers a wide area of study since it combines the possibility of producing not only quantitative but also a maximum of qualitative data. Today’s technological advances allow us to obtain more accurate and stronger data from the animals used in research while ensuring their comfort and well-being throughout the protocol, including cage enrichment and pain treatment during and after surgery. As demonstrated in this valuable model, we are able to generate more usable results (Refine), while reducing the number of animals used (Reduce), by focusing on the development of ex-vivo analysis techniques (Replace), which clearly highlights the Burch and Russell 3Rs concept.
The development of a UK police traumatic events checklist
Authors: Miller JK , Brewin CR , Soffia M , Elliott-Davies M , Burchell BJ , Peart A
Published: April 2021

One in five UK police officers suffers from Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, yet there is no gold standard measure of trauma exposure available. This study coded 4,987 exposures reported by 1,531 UK police officers, using their own language. The resulting checklist describes over 70% of typical ‘worst’ reported traumatic incidents (plus situational factors, including Covid19). The Police Traumatic Experiences Checklist is a practical tool of value for self-assessment and peer support, and can facilitate attempts by Occupational Health and management to improve monitoring and treatment access.
Towards a Concept of Political Robustness
Authors: Sørensen Eva , Ansell Christopher
Published: April 2021

How effective are different political institutions, policy-making processes and policies when it comes to mediating, mitigating and managing vertical and horizontal political tensions caused by disruptive societal challenges and political polarization? The present crisis for liberal democracy places this question high on the research agenda. A concept of political robustness is helpful for identifying the properties of political systems with a strong capacity for coping with political instability and conflict. This article defines political robustness, draws the contours of a conceptual framework for analysis of the political robustness of political systems and applies it illustratively to the political robustness of liberal democracies. We propose that the robustness of a political system depends on how much those who voice political demands—which differs greatly over time and between regimes—are involved in aggregating and integrating political demands into binding decisions.
High-performance computing simulations of self-gravity in astronomical agglomerates
Authors: Rocchetti Néstor , Nesmachnow Sergio , Tancredi Gonzalo
Published: April 2021

This article describes the advances in the design, implementation, and evaluation of efficient algorithms for self-gravity simulations in astronomical agglomerates. Three algorithms are presented and evaluated: the occupied cells method, and two variations of the Barnes–Hut method using an octal and a binary tree. Two scenarios are considered in the evaluation: two agglomerates orbiting each other and a collapsing cube. The results show that the proposed octal tree Barnes–Hut method allows improving the performance of the self-gravity calculation up to 100 times with respect to the occupied cells method, while having good numerical accuracy. The proposed algorithms are efficient and accurate methods for self-gravity simulations in astronomical agglomerates.
Digital imaging of the oil permeation mechanism in an oleophobic textile
Authors: Zhang Gannian , Zhang Qinfa
Published: April 2021

Resistance of military clothing to oil permeation is important for effective protection against chemical warfare. In this paper, while a military textile is rendered oleophobic (oil contact angle ≈ 120°) through plasma-assisted deposition of perfluorodecyl acrylate (PFAC8), permeation of the textile by silicon oil is observed. Using high-definition digital imaging, we study the oil permeation dynamics, rationalize the permeation with a plausible mechanism and identify the threshold textile pore size for prevention of the permeation. We find that oil permeates defects of PFAC8 textiles. Our data suggests a linear variation for oil permeation volume ΔV with time t and implies a gravity-driving permeation mechanism. The mechanism comprises three stages involving merging and propagation of oil–yarn contact lines. The threshold pore size dm scales with σ/ P, where σ is the oil surface tension and P is the hydrostatic head exerted by the oil drop. The paper indicates the importance of an undamaged textile structure to ‘robust’ oil resistance.
COVID-19: A Crisis and a Tragedy—What’s Next?
Authors: Vicini Andrea
Published: April 2021

Reflecting on the global pandemic caused by COVID-19, theological ethics examines political dynamics, focuses on those affected, discusses hard ethical choices, comments on religious engagements, considers language choices, reflects on the impact on ordinary lives, and ponders what should follow after controlling the infection. Learning from the past and the present, looking forward requires targeted engagements aimed at promoting health, a critical rethinking of human progress, a renewed solidarity accompanied by social reforms, and a sustainable future.
Web archiving of indigenous knowledge systems in South Africa
Authors: Balogun Tolulope , Kalusopa Trywell
Published: April 2021

The purpose of the paper was to highlight the digitization of Indigenous Knowledge Systems (IKS) in institutional repositories in South Africa with a view to develop a framework for Web archiving IKS-related websites in South Africa. Anchored on the interpretivist paradigm, the qualitative research method was adopted for this research. The multiple case study research strategy was considered appropriate for the study. Data was gathered through face-to-face in-depth interviews and content analysis. Interviews were conducted with eight IKS staff at the IKS Documentation Centres across four provinces in South Africa. The study revealed that although there are efforts to digitize IKS and make them accessible through some channels online, there are no specific digital preservation policies guiding the project. Apart from the fact that there are policies in place to support any Web archiving initiative, the concept of Web archiving was generally unfamiliar to the respondents. The respondents admitting to the lack of a standard policy guiding the digitization project also admitted to a lack of knowledge or in-depth understanding of Web archiving and its prospect as a digital preservation measure. The research, therefore, proposes a Web archiving framework that should be incorporated in the digital preservation policy framework. This research will be useful to policymakers and all stakeholders in South Africa and other parts of Africa.
The General Public Knowledge, Attitude, and Practices Regarding COVID-19 During the Lockdown in Asian Developing Countries
Authors: Qalati Sikandar Ali , Ostic Dragana , Fan Mingyue , Dakhan Sarfaraz Ahmed , Vela Esthela Galvan , Zufar Zuhaib , Sohu Jan Muhammmad , Mei Jinlan , Thuy Troung Thi Hong
Published: April 2021

The recent outbreak of coronavirus disease (COVID-19) is the worst global crisis. Since no successful treatment and vaccine have been reported, efforts to improve the public's knowledge, attitudes, and practices are critical to reducing the spread of COVID-19. This study aims to investigate the general public knowledge, attitude, and practices regarding COVID-19. A cross-sectional online survey was conducted in three developing countries (China, India, and Pakistan). The reason for choosing only three countries is to identify the cross-border effect statistically and data collection constraints. The IBM SPSS version 23.0 was used for descriptive, univariate, and multivariate analysis of the study. One thousand one hundred and sixty participants completed the study, one-quarter of them were female, and three-quarters were male. The study's findings evidenced that the knowledge and attitude correlation was 58.4% and between knowledge and practices 18.2%. Furthermore, the knowledge was found lower in females, among India and Pakistan, and people aged less and equivalent to 30 years. The attitudes among respondents were found poorer among unmarried females and India and Pakistan residents. While the practices found lower among employed, unemployed and, respondents had a bachelor's degree, and females reside in India. And future studies should focus on factors that influence the government regarding the imposition of lockdown, boost the economy in the pandemic, and motivate the general public to follow the health institution's instructions.
Theorising ‘racial/colonial primitive accumulation’: settler colonialism, slavery and racial capitalism
Authors: Issar Siddhant
Published: April 2021

This article reconceptualises the Marxist notion of ‘primitive accumulation’, examining how settler colonialism and anti-Black racial domination structure American capitalism. The analysis intervenes in theorisations of primitive accumulation in both critiques of neoliberalism and the growing literature on racial capitalism. It shows how particular appropriations of primitive accumulation in the context of neoliberalism not only treat the concept as, ultimately, external to the core logic of capitalism, but also ignore the ways racial domination and colonisation configure capital’s violence. Simultaneously, within racial capitalism scholarship, primitive accumulation is prone to conceptual stretching, often flattening disparate forms of land and labour expropriation. In contrast, through the analytic of ‘racial/colonial primitive accumulation’, the author elucidates how normative wage-labour exploitation is predicated on settler colonialism and racial slavery and its afterlives. This thus adds precision to received understandings of capitalist expropriation, while also pushing the literature on racial capitalism beyond a white/Black binary.
Evaluating Correlations of External Factors and Performance Measures of the Multimodal Transportation System in Florida
Authors: Sun Yanshuo , Choi Juyeong , Nickdoost Navid , Kirtonia Sajeeb , VanDenBogaert Jessica
Published: April 2021

The objective of this study is to quantify the correlation between nearly 100 external factors and over 70 performance measures of the Florida multimodal transportation system, based on the empirical data covering a 10 year period (2009–2018). We first use time-lagged cross-correlation to quantify the correlation between each pair of external factors and performance measures. We then identify the highly correlated external factors with all performance measures or a subset of them. We find that Percentage of Population in Poverty (Florida), Number of Housing Units (Florida), House Price Index (National), Consumer Price Index–Rent Price Index (Florida), and Percentage of Population in Poverty (National) are the external factors highly correlated with the whole system, while the external factors highly correlated with different modes vary. This paper thus contributes to the transportation performance measurement literature by proposing a practical procedure based on time series analysis to help transportation agencies identify important external factors for tracking and monitoring.
Toward a Critical Race Theory of Prison Order in the Wake of COVID-19 and Its Afterlives: When Disaster Collides with Institutional Death by Design
Authors: Friedman Brittany
Published: April 2021

In this article, I bridge critical sociological perspectives on penal institutions with insights from the sociology of disaster to advance a critical race theory of prison order in the wake of COVID-19 and its afterlives. Penal institutions officially categorize people as detainees, inmates, or prisoners in order to deliberately relegate human beings to a degraded social status, ultimately in service of an intentionally racist system. I theorize why prisons are natural epicenters for COVID-19, identifying the following institutional parameters as social factors: (1) death is by institutional design, where prison order is arranged so that people categorized as prisoners die socially, psychically, and physically; (2) promoting institutional survival rather than human survival is second nature during a disaster because the preexisting social organization of prison life serves this purpose; and (3) when a disaster strikes causing severe loss to people and resources, uncertainty is managed by implementing strategies that magnify the death(s) of incarcerated people in exchange for the life of the institution.
The Dual Dependency of Natural-Resource-Rich Labor Markets in Contemporary Society
Authors: Mueller J. Tom
Published: April 2021

This article presents an integrative theoretical framework of subnational natural resource dependence. I argue that rural natural resource dependence represents a special case of the core-periphery relationship, where rural, resource-rich labor markets form a dual dependency on both the global capitalist economy and the local natural environment. This occurs because the contradiction between spatially fixed natural resources and the mobility of capital prompts both external interests and local power elites to use their power to pressure rural labor markets in directions outside their best interest and to exploit rural labor. I argue that both extractive (e.g., mining, timber, agriculture) and nonextractive (e.g., tourism, real estate) forms of natural resource development share this contradiction. Although pushing different uses of the resource base, extractive and nonextractive development do not fundamentally vary in their exploitative relationship with rural labor markets.
Making Meaning of Peace: A Study of Adolescents in Bogota, Colombia
Authors: Velez Gabriel
Published: April 2021

In post-conflict and transitional settings, adolescents are important civic and political actors as potential peacebuilders. Policy and programming often focus on promoting prosocial outcomes for these younger generations, but there has been growing attention to their perspectives and psychological development. Drawing on theory in developmental psychology, adolescents interpret and respond to context in forming ideas about key concepts like peace, understanding society and their place in it, and constructing their orientations toward peace. This study extends current literature by exploring how Colombian adolescents describe peace within the context of a peace process in their country. Ninety-six 15- to 18-year-olds in and around Bogotá, Colombia, were interviewed about peace. Their responses were analyzed inductively using an adapted thematic analysis. Findings indicated that the individual was central to how respondents talked about peace; that is, peace begins and depends on the internal states. From this basis, individuals then created peace through interpersonal relations. There were some differences by respondents’ SES, such as in how respondents described peace as requiring equality in society, but none found for gender or age. This study demonstrates the need to provide concrete opportunities for these adolescents to see individual contributions and broader interpersonal peace as possible.
Subconcussive Head Impacts and Neurocognitive Function Over 3 Seasons of Youth Football
Authors: Rose Sean C. , Yeates Keith Owen , Nguyen Joseph T. , Ercole Patrick M. , Pizzimenti Natalie M. , McCarthy Matthew T.
Published: April 2021

Objective:

To determine the association between repetitive subconcussive head impacts and neurobehavioral outcomes in youth tackle football players.

Methods:

Using helmet-based sensors, we measured head impacts for 3 consecutive seasons of play in 29 male players age 9-11. Cumulative impact g’s were calculated. Players completed a battery of outcome measures before and after each season, including neuropsychological testing, vestibular-ocular sensitivity, and self- and parent-reported measures of symptoms and attention-deficit hyperactivity disorder (ADHD).

Results:

Average cumulative impact over 3 seasons was 13 900 g. High-intensity hits predicted worse change for self-reported social adjustment ( P = .001). Cumulative impact did not predict change in any of the outcome measures. History of ADHD, anxiety, and depression predicted worse change for self-reported symptoms and social adjustment, independent of head impacts. When players were stratified into 3 groups based on cumulative impact across all 3 seasons, differences in outcome measures existed prior to the start of the first season. These differences did not further increase over the course of the 3 seasons.

Conclusion:

Over 3 consecutive seasons of youth tackle football, we found no association between cumulative head impacts and neurobehavioral outcomes. Larger sample sizes and longer follow-up times would further assist in characterizing this relationship.
Intimate Partner Violence Perpetration Among Military Spouses
Authors: Park Yangjin , Sullivan Kathrine , Riviere Lyndon A. , Merrill Julie C. , Clarke-Walper Kristina
Published: April 2021

Military spouses are an understudied population with respect to intimate partner violence (IPV) perpetration. Due to the unique demands of service members’ jobs, military couples are documented to experience particular individual, couple, and family-level risk factors that may lead to IPV perpetration. Using the frustration-aggression hypothesis and considering the possibility of mutual violence, we examined (a) the direct effects of stressful events, marital discord, and work–family conflict on IPV perpetration among military spouses and (b) the indirect effect of anger arousal between stressful events, marital discord, and work–family conflict on IPV perpetration. This study is a secondary analysis of data drawn from a survey of army spouses conducted by the Walter Reed Army Institute of Research in 2012. The sample consists of 314 female spouses of active-duty members (white 75%, enlisted 80%). After controlling for covariates (including spouse race, rank, household size, age, living distance from military installation), the direct effects of marital discord and anger on IPV perpetration were statistically significant. Also, the direct effects of marital discord and work–family conflict on anger were significant. The path model demonstrated that the indirect effects of marital discord and work–family conflict on IPV perpetration via anger were significant. Finally, most physical and verbal violence was reported to occur in the form of mutual violence with their partners. Study findings suggest that the pathway of risk factors impacting IPV might differ depending on the sources of stress. The Family Advocacy Program, military social work practitioners, and other behavioral health providers should consider domains of risk and provide support to military spouses that is specifically tailored to these risk factors. Furthermore, considering the mediating role of anger arousal in the relationship between marital discord, work–family conflict and IPV, programs to address anger might be helpful to reduce IPV among military spouse perpetrators.
Association Between Girl-child Marriage and Intimate Partner Violence in Sub-Saharan Africa: Insights From a Multicountry Analysis of Demographic and Health Surveys
Authors: Ahinkorah Bright Opoku , Onayemi Olayinka Modupe , Seidu Abdul-Aziz , Awopegba Oluwafemi Emmanuel , Ajayi Anthony Idowu
Published: April 2021

While considerable attention has been given to the health consequences of child marriage in Sub-Saharan Africa (SSA), limited studies exist on its impact on intimate partner violence (IPV) in the region. We address this gap by examining the link between child marriage and IPV. We tested our study hypothesis using demographic and health survey data of 28,206 young women aged 20-24 years from 16 SSA countries with recent surveys (2015-2019). Binary logistic regression models were used to examine the effect of child marriage on IPV. Child marriage prevalence ranged from 13.5% in Rwanda, in East Africa, to 77% in Chad, in Central Africa, while IPV ranged from 17.5% in Mozambique in Southern Africa to 42% in Uganda, in East Africa. Past year experience of IPV was higher among young women who married or begun cohabiting before the age of 18 (36.9%) than those who did at age 18 or more (32.5%). This result was consistent for all forms of violence: physical violence (22.7% vs 19.7%), emotional violence (25.3% vs 21.9%), and sexual violence (12% vs 10.4%). After controlling for covariates, we found that young women in SSA who married before 18 years were more likely to experience IPV than those who married as adults (AOR: 1.20; 95% CI [1.12, 1.29]). Significant heterogeneity was observed in the country-level results, with a higher likelihood of IPV found in 14 of the 16 countries and lower in Angola and Chad. Child marriage is associated with a higher likelihood of IPV in most SSA countries, suggesting that ending child marriage will result in a substantial reduction in IPV. There is a need to institute policies to support and protect women who marry as children from abusive relationships in SSA.
Portraits de femmes dans le roman français contemporain
Authors: Bernard Isabelle
Published: April 2021

Cet article propose de scruter les portraits de femmes proposés dans quelques oeuvres romanesques actuelles qui prennent part au projet de (re)connaissance de la vérité multiple et pluriforme du féminin. Afin de cerner les caractéristiques majeures des états de femmes d’aujourd’hui, il propose d’abord de s’attacher à une figure de couple homosexuel ; il souligne ensuite la forte prégnance sociale des intrigues qui font des héroïnes tout à la fois des victimes et des meurtrières, déclinaisons des « femmes puissantes » de Marie NDiaye ; il cerne enfin la part liée au corps violenté des femmes.
The role of universities in regional development strategies: A comparison across actors and policy stages
Authors: Fonseca Liliana , Nieth Lisa
Published: April 2021

The emergence of collaborative approaches in innovation policy and regional governance has increased expectations for universities to engage in strategy making and assume broader roles and responsibilities. Nonetheless, complexities inherent to the policy process, regional context and universities’ own institutional and organisational capacity are often ignored or under-explained when framing universities’ roles. Although these roles are frequently introduced, they have been superficially conceptualised in the literature. This study develops a deeper theoretical and empirical understanding of universities’ contributions in the different stages of regional innovation strategy processes. Through a comparative case study of four European universities, it explores the variation of these roles by policy stage and university actors involved in the strategies. Findings suggest universities have expanded to perform new planning-related roles (e.g. consultation, mediation) and that diverse factors (e.g. the regional context, such as urban versus peripheral) determine their participation in regional strategies. However, strategic coordination within universities and with regional bodies is needed for the optimisation of their engagement in the regional governance process.

JEL Codes: I23, I25, O20, O30, R58
Migrating Souvenir Bullet: The Management Dilemma
Authors: Swain Srikant Kumar , Arora Rajnish Kumar , Mittal Radhe Shyam
Published: April 2021

The cranio-cerebral trauma following gunshot injuries has high mortality and morbidity, with 66% to 90% victims dying before reaching hospital and only half of those treated in hospital surviving. However, in case of most salvageable patients, the question which poses dilemma to treating physicians is the decision as to when and why remove the retained missile.

A 21-year-old man was observing a gunfight in the street from his balcony. Suddenly something struck his forehead and there was a small amount of bleeding toward the medial end of his left eyebrow. He had moderate headache and dizziness. Because of nonresolution of headache over seven days he was hospitalized and underwent X ray of the skull and CT of the head, which showed a retained metallic bullet in left inferior parieto-occipital region without any significant hemorrhage. As there was no neurological deficit or meningeal signs, he was managed conservatively. His symptoms improved gradually within next week and he was discharged home. His most recent follow-up was 28 months since injury and imaging showed migration of the bullet to the right inferior temporal region. As he was completely asymptomatic throughout, no intervention was offered. However, long-term follow-up for potential complications of migration, hydrocephalus, and abscess formation is advisable.
We Speak a Different Language: End-of-Life and Bereavement Experiences of Older Lesbian, Gay, and Bisexual Women Who Have Lost a Spouse or Partner
Authors: Valenti Korijna G. , Janssen Leah M. , Enguidanos Susan , de Medeiros Kate
Published: April 2021

We examine the end-of-life (EOL) experiences, communications, and grief support during and after their loved one’s death of older lesbian, gay, and bisexual women (LGB) ages 60 to 85 who have lost a spouse or partner. Queer gerontology was used as a theoretical framework, and descriptive qualitative analytical methods were used to discern themes. Through semi-structured interviews with a purposive sample of 16 participants, we identified two main themes: Gathering the Women and Compassionate Care. Although older LGB women may have some similar support needs as non-LGB adults, other needs are distinct but often unmet. While our participants’ interactions with health care professionals were overtly positive, there was often a lack of communication about grief resources, including lesbian and women-specific grief groups. Overall researchers, policymakers, and practitioners should be mindful of the importance of fully integrating and including populations into their care practices to avoid creating systems of superficial tolerance.
Conversations About Opioids: Impact of the Opioid Overdose Epidemic on Social Interactions for People Who Live With Chronic Pain
Authors: Dassieu Lise , Heino Angela , Develay Élise , Kaboré Jean-Luc , Pagé M. Gabrielle , Hudspith Maria , Moor Gregg , Choinière Manon
Published: April 2021

The objective of this study was to understand the impact of the opioid overdose epidemic on the social lives of people suffering from chronic pain, focusing on interactions within their personal and professional circles. The study was based on 22 in-depth interviews with people living with chronic pain in Canada. Using thematic analysis, we documented three main impacts of the opioid overdose epidemic: (a) increased worries of people in pain and their families regarding the dangers of opioids; (b) prejudices, stigma, and discrimination faced during conversations about opioids; and (c) stigma management attempts, which include self-advocacy and concealment of opioid use. This study represents important knowledge advancement on how people manage stigma and communicate about chronic disease during everyday life interactions. By showing negative effects of the epidemic’s media coverage on the social experiences of people with chronic pain, we underscore needs for destigmatizing approaches in public communication regarding opioids.
Exploring Cancer Pain Self-Management Needs and Preferences: A Meta-Ethnography
Authors: Anderson Alice , Starkweather Angela , Cong Xiaomei , Kyounghae Kim , Judge Michelle , Schulman-Green Dena
Published: April 2021

Self-management of chronic disease and related symptoms provides a framework for understanding the contextual factors that influence self-management knowledge and skills that patients and families require to manage their condition on a day-to-day basis. The management of cancer pain is a significant issue for patients and families, and their experience can provide insight on cancer pain self-management support needs and preferences. A meta-synthesis of 20 qualitative research articles on self-management of cancer pain was conducted to gain a deeper understanding of the self-management support needs of patients with cancer pain. Noblit and Hare’s meta-ethnographic model was used. The meta-synthesis resulted in increased understanding of the needs and preferences for self-management support of cancer pain and the role of the health care practitioner. Practical implications are presented.
Inflammatory and Prothrombotic Biomarkers Associated With the Severity of COVID-19 Infection
Authors: Lopez-Castaneda Sandra , García-Larragoiti Nallely , Cano-Mendez Alan , Blancas-Ayala Kenia , Damian-Vázquez Guadalupe , Perez-Medina Ana Itzel , Chora-Hernández Luis David , Arean-Martínez Carlos , Viveros-Sandoval Martha Eva
Published: April 2021

Among COVID-19 hospitalized patients, high incidence of alterations in inflammatory and coagulation biomarkers correlates with a poor prognosis. Comorbidities such as chronic degenerative diseases are frequently associated with complications in COVID-19 patients. The aim of this study was to evaluate inflammatory and procoagulant biomarkers in COVID-19 patients from a public hospital in Mexico. Blood was sampled within the first 48 h after admission in 119 confirmed COVID-19 patients that were classified in 3 groups according to oxygen demand, evolution and the severity of the disease as follows: 1) Non severe: nasal cannula or oxygen mask; 2) Severe: high flow nasal cannula and 3) Death: mechanical ventilation eventually leading to fatal outcome. Blood samples from 20 healthy donors were included as a Control Group. Analysis of inflammatory and coagulation biomarkers including D-dimer, interleukin 6, interleukin 8, PAI-1, P-selectin and VWF was performed in plasma. Routine laboratory and clinical biomarkers were also included and compared among groups. Concentrations of D-dimer (14.5 ± 13.8 µg/ml) and PAI-1 (1223 ± 889.6 ng/ml) were significantly elevated in severe COVID-19 patients (P < 0.0001). A significant difference was found in interleukin-6, PAI-1 and P-selectin in non-severe and healthy donors when compared to Severe COVID-19 and deceased patients (P < 0.001). VWF levels were also significantly different between severe patients (153.5 ± 24.3 UI/dl) and non-severe ones (133.9 ± 20.2 UI/dl) (P < 0.0001). WBC and glucose levels were also significantly elevated in patients with Severe COVID-19. Plasma concentrations of all prothrombotic biomarkers were significantly higher in patients with a fatal outcome.
State Child Welfare Policies and the Measurement of Child Maltreatment in the United States
Authors: Day Elizabeth , Tach Laura , Mihalec-Adkins Brittany
Published: April 2021

State-level child welfare policies and practices affect what can be referred, investigated, and substantiated as child maltreatment, and these institutional factors vary across states and over time. Researchers typically have not accounted for these factors in analyses, confounding institutional features with the underlying construct they seek to study. The present study addresses this limitation by demonstrating how changes in specific state child welfare policies and practices influence reported and substantiated maltreatment in the National Child Abuse and Neglect Data System (NCANDS). Using negative binomial models with state and year fixed-effects to analyze data from 2005 to 2018, we found significant influence of state policy and practice changes on state-level rates of reported and substantiated maltreatment over time. If a state implemented three of the most common policy changes—adding mandated reporters, centralized intake, and staff—its maltreatment reports were an estimated 32% higher than they would have been in the absence of these changes. By contrast, most state policy changes decreased the number of reports that were substantiated—by 24% if they implemented both differential response and higher standards of proof. Implications for future research and policy are discussed.
The study of dry eye and meibomian glands in psoriasis
Authors: Taheri Ahmad Reza , Allahyari Elahe , Zeinaly Mostafa , Nikandish Malihe
Published: April 2021

Background:

To investigate aqueous and lipid layers of the tear film as well as meibomian gland structure by meibography in psoriatic patients in the Iranian population.

Methods:

This case-control study was conducted on 31 psoriasis patients and 31 controls in Birjand University of Medical Sciences in 2018. The sampling method was available from the date of approval of the proposal in the Ethics Committee until it reached the sample size. After entering the study, patients were examined individually with a slit lamp. Then, Ocular Surface Disease Index (OSDI) score assessment, Schirmer test 1, lacrimal measurement with SM tube, tear break-up time (TBUT), and meibomian glands imaging by SBM Sistemi were done. Finally, the obtained data were entered into SPSS 15 software and analyzed at a significant level of less than 0.05.

Results:

The two groups were matched according to age and gender ( p = 0.39 and p = 0.80; respectively). With the exception of the SM Tube score, the mean of all tear film and meibomian glands functional and structural parameters including Schirmer test 1, TBUT, and meibography were significantly different between patients and control groups. Moreover, the proportion of abnormal OSDI (OSDI ⩾ 13) and the dry eye was significantly higher in psoriasis patients.

Conclusions:

Psoriasis is associated with dry eye as well as meibomian glands atrophy and dysfunction.
Effects of shear keys and track system on the behavior of simply-supported bridges for high-speed trains subjected to transverse earthquake excitations
Authors: Meng Dongliang , Chen Shizai , Yang Menggang , Hu Shangtao
Published: April 2021

China railway track system II (CRTS-II) slab ballastless track is usually constructed on high-speed railway (HSR) bridges to ensure the rail smoothness and the running safety of high-speed trains, but the use of the longitudinal continuous track system would significantly alter the dynamic characteristics of the bridges and therefore influence the bridge seismic responses. The pounding at shear keys has also been identified as one of the critical factors affecting the seismic behavior of bridges. To investigate the effects of shear keys and CRTS-II track system on the seismic behavior of HSR simply-supported bridges subjected to transverse earthquake excitations, detailed 3D finite element models are developed by using ABAQUS. The seismic responses calculated from the bridges with and without considering shear keys are firstly compared. The result shows that the shear keys can effectively limit the development of pier-girder relative displacement and thus decrease the potential of girder dislocation. However, large pounding forces would be generated between the shear keys and bearing pads and transferred to bridge piers, which will amplify the seismic responses of the bridge piers. The result of seismic analyses of multiple-span simply-supported bridges with and without considering the track system shows that the track system will significantly influence the distribution of seismic forces among the bridge spans. For a bridge with equal pier heights, considering the track system will reduce the seismic responses of side spans (close to subgrade) but will increase those of the middle spans. Whereas an opposite trend is found for bridges with high middle piers and short side piers.
The impact of COVID-19 infection on hip fracture 30-day mortality
Authors: Fadulelmola Ahmed , Gregory Rob , Gordon Gavin , Smith Fiona , Jennings Andrew
Published: April 2021

Introduction:

A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality.

Method:

Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection.

Results:

The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission.

Conclusion:

Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.
Low-Dose Perioperative Corticosteroids Can Be Administered Without Additional Morbidity in Patients Undergoing Bilateral Total Knee Replacement: A Retrospective Follow-up Study of a Randomized Controlled Trial
Authors: McLawhorn Alexander S. , Poultsides Lazaros A. , Sakellariou Vasileios I. , Kunze Kyle N. , Fields Kara G. , Jules-Elysée Kethy , Sculco Thomas P.
Published: April 2021

Background: Short-term benefits of perioperative corticosteroid injections (CSIs) for bilateral total knee replacement (BTKR) include suppressed inflammation, improved knee motion, and reduced pain. Very little is known about the long-term benefits, complications, and safety of corticosteroids administered in the perioperative period. Purpose: We sought to compare 3-year follow-up outcomes of BTKR patients who received perioperative CSI with those who received placebo. We hypothesized that there would be no statistically significant differences in functional outcomes or adverse events based on whether or not CSIs were administered in the perioperative period. Methods: We conducted a retrospective review of chart and registry data of BTKR patients from a prior randomized controlled trial to compare outcomes in patients who received hydrocortisone vs placebo injections after BTKR (ClinicalTrials.gov: NCT01399268 and NCT01815918). Outcomes were compared at 6 and 12 weeks and at 1, 2, and 3 years. The Knee Injury and Osteoarthritis Outcome Scores (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate clinical outcomes. Cochran-Mantel-Haenszel tests were used to compare the risk of complications between treatments after adjustment for trial. When possible, summary relative risk estimates were calculated using the Mantel-Haenszel method. Results: No BTKR patients in the treatment group developed an infection. The risk of complications did not increase in patients who received CSI compared with those who received placebo. Patients in the CSI group experienced greater reductions in pain and stiffness, though these results were not statistically significant. There were no statistically significant differences in the KOOS-Symptoms, KOOS-Activities of Daily Living, KOOS-Sports, KOOS-Quality of Life, or WOMAC Function scores. Conclusions: Low-dose corticosteroids can be administered in selected patients who undergo BTKR without increasing the risk of adverse events. At 3-year follow-up, administration of low-dose corticosteroids did not result in superior clinical outcomes scores when compared with placebo.
A feasibility randomised controlled trial of targeted oxygen therapy in mechanically ventilated critically ill patients
Authors: Martin Daniel S , McNeil Margaret , Brew-Graves Chris , Filipe Helder , O’Driscoll Ronan , Stevens Jia Liu , Burnish Rachel , Cumpstey Andrew F , Williams Norman R , Mythen Michael G , Grocott Michael PW
Published: April 2021

Background

Despite oxygen being the commonest drug administered to critically ill patients we do not know which oxygen saturation (SpO2) target results in optimal survival outcomes in those receiving mechanical ventilation. We therefore conducted a feasibility randomised controlled trial in the United Kingdom (UK) to assess whether it would be possible to host a larger national multi-centre trial to evaluate oxygenation targets in mechanically ventilated patients.

Methods

We set out to recruit 60 participants across two sites into a trial in which they were randomised to receive conservative oxygenation (SpO2 88–92%) or usual care (control – SpO2 ≥96%). The primary outcome was feasibility; factors related to safety and clinical outcomes were also assessed.

Results

A total of 34 patients were recruited into the study until it was stopped due to time constraints. A number of key barriers to success were identified during the course of the study. The conservative oxygenation intervention was feasible and appeared to be safe in this small patient cohort and it achieved wide separation of the median time-weighted average (IQR) SpO2 at 91% (90–92%) in conservative oxygenation group versus 97% (96–97%) in control group.

Conclusion

Whilst conservative oxygenation was a feasible and safe intervention which achieved clear group separation in oxygenation levels, the model used in this trial will require alterations to improve future participant recruitment rates in the UK.
Coercion in Disguise? A Reassessment of Brazilian Education and Health Reforms
Authors: Schlegel Rogerio , Vazquez Daniel Arias
Published: April 2021

In federations and other regionalised arrangements, the search for co-operation may lead to a hierarchical alignment where the centre concentrates policy decision-making power. The use of conditional grants to build this kind of co-ordination can disguise its rather coercive character when opt-out clauses are counteracted by fiscal constraints that virtually force subnational adherence. Previous accounts on recentralisation in Latin America have overlooked this feature, particularly by mistakenly identifying the transfer of fiscal resources and responsibilities with authority over policies. The article adopts a configurational approach, focused on mechanisms, to reassess two Brazilian programmes redesigned in the 1990s and 2000s – the Fundamental Education Fund (Fundef) and the Basic Health Care Programme ( Programa de Atenção Básica, PAB). Our evidence shows that both reforms followed hierarchical paths and received massive adherence of municipalities. We discuss how this kind of coercion in disguise is especially concerning in settings where some retrenchment of social expenditure is expected.
Local Response to Forced Adaptation Challenges: Lessons from a Post-flooding School Rebuilding Controversy
Authors: Plein Christopher
Published: April 2021

This study focuses on school rebuilding experiences in a distressed rural county in the wake of severe flooding. While considering scholarly literature, and making use of relevant public records and media coverage, the centerpiece of this qualitative study is an analysis of 391 public comments made in response to proposed rebuilding plans. The study focuses on how the schools rebuilding debate was socially constructed in response to the flood and in a time of growing awareness of climate change. The findings suggest that the debate was framed along lines familiar to rural school closure and consolidation controversies in general and in context of underlying political and social conditions specific to the county. Themes of power and powerlessness, fairness and justice, and community identity and viability were predominant. Specific discussion of climate change and associated themes was notably absent in the public comments. The findings suggest that existing sociopolitical context and policy domains may shape the consideration of new adaptation choices, whether forced by immediate events such as a natural disaster, or influenced by longer term concerns relating to climate change.
Risk assessment in aortic aneurysm repair by medical specialists versus the American College of Surgeons National Surgical Quality Improvement Program risk calculator outcomes
Authors: van Schaik Jan , Hers Tessa M , van Rijswijk Carla SP , Schooneveldt Maaike S , Putter Hein , Eefting Daniël , van der Vorst Joost R
Published: April 2021

Objective

The aim of this online clinical vignette-based survey study was to compare risk assessments by vascular surgeons, anaesthesiologists and interventional radiologists involved in treating patients with aortic aneurysms in the Netherlands with the NSQIP risk calculator outcomes.

Methods

Participants, recruited using purposive sampling, provided their estimation of the likelihood of postoperative complications and events following aortic surgery in five fictional cases. These cases were subsequently scored using the NSQIP calculator. The risk assessments were statistically analysed using the ANOVA and student t-test.

Results

All participating specialists i.e. twelve vascular surgeons, ten interventional radiologists and ten anaesthesiologists completed the survey. In the vast majority of outcomes and vignettes, no significant differences were found between various specialists, whereas significant differences were found between the NSQIP risk calculator outcomes and the combined risk assessments of the specialists. Overall, specialist risk assessments differ from the NSQIP, but neither particularly higher nor lower compared to the risk calculator.

Conclusions

Risk assessment by vascular surgeons, anaesthesiologists and interventional radiologists differs significantly with NSQIP risk calculator outcomes, within the framework of both endovascular and open aortic aneurysm repair. Based on these results, implementing the NSQIP risk calculator in preoperative workup could be of added value in both patient planning as well as adequately informing patients for obtaining consent.