bluuebunny/crossref_metadata_2025 huggingface dataset:
Winter’s Topography, Law, and the Colonial Legal Imaginary in British Columbia
Authors: Unger Matthew P.
Published: May 2021

This article examines how images of nature, weather, and topography disclose a politics of recognition (who is visible/invisible) invested in a burgeoning criminal justice milieu, where punishment of wrongdoing became increasingly racialized in British Columbia during the early confederation period of Canada’s history. Drawing from archived court documents and colonial writing, it examines dominant environmental metaphors and tropes that structured this politics of recognition within the colonial legal imaginary. I argue that images and understandings of topography, nature, weather, and seasons shaped the background enactment of law in early Canadian lawmaking practices. By examining these natural tropes, this article seeks to understand the contours of a contextually specific colonial legal imaginary as a vital component for entry into the criminal justice system. This colonial legal imaginary predisposes certain groups, and particularly Indigenous peoples, as subject to the constraining power of law, thereby fueling the growth of crime control industries over the last 150 years.
Numerical and analytical study on the mechanical properties of a connector with long-fiber and metal laminated bolts for prefabricated construction
Authors: Zhang Xiaoming , Ren Danni , Liu Xin , Guan Sujun , Yu Xindi , Chen Jinxinag , Nie Chunlong
Published: May 2021

To improve the mechanical performances of joints in prefabricated construction, a type of connection structure with long-fiber and metal laminated bolts (referred to as a fiber-metal connector) is proposed and investigated by simulation and theoretical methods. The results include the following: (1) The fiber layer in bolts can form a second stiffness during rotation. This mechanical characteristic improves the bearing capacities and energy dissipation ability of the connector relative to the conventional metal connector, which are expected to effectively limit the elastoplastic rotational displacement of a structure. (2) For the reason, the fiber layer can bear load in the plastic phase due to its high-strength characteristic in the length direction. (3) A bilinear model for the bearing curve of the fiber-metal connector is proposed, and equations for optimization of fiber layer thickness are obtained with a target on bearing capacity and energy dissipation ability which are approximately higher 30% and 13% than that of the conventional metal connector, respectively. This research is expected to provide a theoretical basis for the application of this fiber-metal connector in engineering and improve the safety of prefabricated structures.
Structural behavior of GFRP reinforced recycled aggregate concrete columns with polyvinyl alcohol and polypropylene fibers
Authors: Rafique Umer , Ali Ather , Raza Ali
Published: May 2021

The objective of this research study is to demonstrate the axial compressive behavior of GRFC columns by fabricating five circular columns (1150 mm high and 250 mm in cross-section) and testing them under axial concentric loading. Two different kinds of fibers, that is, polyvinyl alcoholfibers (PVA) and polypropylene fibers (PPF) were incorporated into the concrete. Two types of transverse confinement (GFRP hoops and GFRP spirals) were provided. The efficiency of GFRP hoops was explored by providing them at the spacing of 75 mm, 150 mm, and 250 mm, respectively. The efficiency of GFRP spirals was examined by keeping the spacing of 38 mm and 75 mm, respectively. The GRFC columns confined with GFRP spirals portrayed higher axial strength and higher ductility indices. Furthermore, an extensive finite element modeling (FEM) was performed by considering the effect of hybrid fibers using a modified concrete damaged plastic (CDP) model. The proposed FEM captured the axial response and cracking behavior of GRFC columns with high accuracy. This study also proposed a new empirical model for capturing the axial strength of GRFC columns by considering the influence of GFRP bars and lateral confinement of GFRP hoops/spirals.
Taking stock of COVID-19 policy measures to protect Europe’s elderly living in long-term care facilities
Authors: Frisina Doetter Lorraine , Preuß Benedikt , Rothgang Heinz
Published: May 2021

The current COVID-19 pandemic has come to impact all areas of life involving the health, psycho-social and economic wellbeing of individuals, as well as all stages of life from childhood to old age. Particularly, the frail elderly have had to face the gravest consequences of the disease; while reporting measures tend to differ between countries making direct comparisons difficult, national statistics worldwide point to a disproportionate and staggering share of COVID-19 related mortality coming from residential long-term care facilities (LTCFs). Still, the severity of the impact on the institutionalized elderly has not been uniform across countries. In an effort to better understand the disparities in impact on Europe’s elderly living in LTCFs, we review data on mortality outcomes seen during the first wave of the pandemic (months March to June 2020). We then set out to understand the role played by the following two factors: (1) the infection rate in the general population and (2) member state adherence to policy recommendations put forth by the European Centre for Disease Prevention and Control (ECDC) targeting the LTC sector. Regarding the latter, we compare the content of national policy measures in six countries – Austria, Denmark, Germany, Ireland, Spain and Sweden – with those of the ECDC. Our findings establish that infection rates in the general population accounted for most of the variation in mortality among member states, however adherence to EU policy helped to explain the residual variation between cases. This suggests that in order to best protect the institutionalized elderly from infectious disease of this kind, countries need to adopt a two-pronged approach to developing measures: one that aims at reducing transmission within the general population and one that specifically targets LTCFs.
Deep reinforcement learning for dynamic control of fuel injection timing in multi-pulse compression ignition engines
Authors: Henry de Frahan Marc T , Wimer Nicholas T , Yellapantula Shashank , Grout Ray W
Published: May 2021

Conventional compression-ignition (CI) engines have long offered high thermal efficiencies and torque across a wide range of loads, but often require extensive exhaust gas treatment that decreases efficiency to meet ever-increasing emissions regulations. One strategy to decrease emissions is to split the fuel injection into a series of smaller injections. In this paper, we explore a new way of discovering optimal control strategies for the next generation of CI engines using deep reinforcement learning (DRL). We outline a DRL procedure to maximize the weighted reward of engine work while minimizing end-of-cycle NO x emissions. Through the procedure outlined in this paper, we show that the DRL agent is able to reduce NO x emissions threefold while only decreasing network by 2%. We demonstrate the use of transfer learning (TL) across hierarchies of physical models to accelerate the learning process, making this approach feasible for a range of control problems within this space. This paper presents a framework and demonstration for using DRL to design control systems in technology areas such as multi-pulse engine control where a hierarchy of models combined with multi-objective rewards are used for optimal operation.
Is there a relationship between implicit motives and eating action types: An exploratory study in Germany
Authors: Lampmann Lyn , Emberger-Klein Agnes , Menrad Klaus
Published: May 2021

Investigating unconscious human behaviours is a complex issue, given that people have hardly access to their unconscious. Food-related behaviour is one of these behaviours in which the unconscious plays a central role. Therefore, the connection of the unconscious and food-related behaviour is difficult to comprehend. Hence, our exploratory study deals with the relationship between implicit motives as an important part of the unconscious and their relationship with food-related behaviour. For this purpose, we used the Operant Multi-Motive Test (OMT), which offers information about implicit motives of individuals. Based on 37 qualitative problem-centred interviews conducted in Bavaria, Germany, we identified seven eating action types that we combined with the results derived from the OMT. These deliver profound insights into how people eat due to their identity. The approach of this study is explorative and provides a first insight into a possible relationship between implicit motives and food-related behaviour that are presented descriptively. Our initial results show that a relationship between implicit motives and food-related behaviour can be assumed, although it cannot be directly deduced from the sole analysis of food-related behaviour. However, nutrition consultancies, food companies, policy makers and advisors may be interested in these insights related to understanding the impact of the unconscious on food-related behaviour.
Multilingual policies as dystopia: From less to more desirable futures in education
Authors: Barros Sandro R , Devarajan Darshana
Published: May 2021

In ‘Literature and Life’, Deleuze remarks that all literature manifests as delirium, and, as such, the destiny of literature is to play itself out between two poles that create and reflect life back to itself: what the human desires, and the constant changes life imposes onto us. Taking Deleuze’s statement as a point of departure concerning the power of social fiction, this article mobilizes the dystopian imagination as a tool to evaluate what language policies do as they channel human desire to shape linguistic practices. Specifically, this article explores the extent to which the literary dystopian lens can help us plot more desirable futures for multilingualism in education. Through a critical fabulation about India’s three-language policy’s effects in schools, we bear witness to this language policy’s disciplinarian action, which reinforces linguistic hierarchies and territorial disputes present in this nation’s history. Indeed, decisions on policies meant to assist linguistically minoritized students have often rested on complicated assumptions about what language means. These assumptions operate under liberal and neoliberal ideologies that commodify and narrow citizens’ linguistic choices, thereby framing one’s authority over language as something that exists outside the human mind. By approaching India’s three-language policy as a futuristically fabulated case study, we reflect on the potentiality of dystopian narratives to function as an analytical method and a critical lens to anticipate ethical problems in language policies’ design.
Don’t You be My Neighbor: Support for Racial-Exclusion Constitutional Provisions in Mid-19th Century Indiana and Illinois
Authors: Heckelman Jac C. , Dinan John
Published: May 2021

Racially discriminatory provisions in the U.S. Constitution and southern state constitutions have been extensively analyzed, but insufficient attention has been brought to these provisions when included in northern state constitutions. We examine constitutional provisions excluding blacks from entering the state that were adopted by various northern states in the mid-19th Century. Previous scholarship has focused on the statements and votes of the convention delegates who framed these provisions. However, positions taken by delegates need not have aligned with the views of their constituents. Delegates to state constitutional conventions held in Illinois in 1847, Indiana in 1850 and 1851, and Oregon in 1857 opted to submit to voters racial-exclusion provisions separate from the vote to approve the rest of the constitution. We exploit this institutional feature by using county-level election returns in Illinois and Indiana to test claims about the importance of partisan affiliation, religious denomination, social-welfare policy concerns, labor competition, and racial-threat theory in motivating popular support for entrenching racially discriminatory policies in constitutions. We find greater levels of support for racial exclusion in areas where Democratic candidates polled better and in areas closer to slave-holding states where social-welfare policy concerns would be heightened. We find lower levels of support for racial exclusion in areas (in Indiana) with greater concentrations of Quakers. Our findings are not consistent with labor competition or racial-threat theories.
Early Detection of Cerebral Herniation by Continuous Electroencephalography and Quantitative Analysis
Authors: Alsallom Faisal , Casassa Charles , Akkineni Keerthana , Lin Lu
Published: May 2021

Continuous electroencephalography (cEEG) and quantitative analysis of EEG (qEEG) are used in various circumstances such as detecting seizures, identifying acute or delayed cerebral ischemia, monitoring sedative therapy, or assessing prognosis. The authors report 2 cases: (1) Case #1 was a patient with unilateral cerebral edema and uncal herniation with asymmetric cEEG and qEEG changes detected an hour before clinical examination changes were noted and (2) Case #2 was a patient with diffuse cerebral edema and trans-tentorial herniation with symmetric cEEG and qEEG changes detected an hour before clinical examination changes were noted. These cases demonstrate the ability of cEEG and qEEG in early detection of different types of cerebral herniation. qEEG can be utilized by intensive care unit (ICU) staff not trained in EEG interpretation as a surveillance method to detect cerebral herniation, which may provide an opportunity for early intervention in high-risk patients.
Informed Consent for Online Research—Is Anybody Reading?: Assessing Comprehension and Individual Differences in Readings of Digital Consent Forms
Authors: Geier Caitlin , Adams Robyn B. , Mitchell Katharine M. , Holtz Bree E.
Published: May 2021

Informed consent is an important part of the research process; however, some participants either do not read or skim the consent form. When participants do not read or comprehend informed consent, then they may not understand the potential benefits, risks, or details of the study before participating. This study used previous research to develop experimentally manipulated online consent forms utilizing various presentations of the consent form and interactive elements. Participants ( n = 576) were randomly exposed to one of six form variations. Results found that the highly interactive condition was significantly better for comprehension than any of the other conditions. The highly interactive condition also performed better for readability, though not significantly. Further research should explore the effects of interactive elements to combat habituation and to engage participants with the parts of the consent form unique to the study.
A numerical study on the influence of hole defects on impact behavior of Twaron® fabric subjected to low-velocity impacts
Authors: Huang Canyi , Cui Lina , Xia Hong , Qiu Yiping , Ni Qing-Qing
Published: May 2021

In the present study, a finite element impact model was created and analyzed by commercial FEM code ANSYS®-AUTODYN and then validated by drop weight impact experiment. Moreover, models of single- and multilayer panels of plain weave as well as different weaving architectures were designed and created with and without holes to compare impact properties. The influence of the size and location of hole defect on the impact behavior of single-layer Twaron® fabric were investigated, the degree of influence of hole defects with different sizes on the impact behavior and the influence level by different location of the hole defects were well investigated in. In addition, the effect of hole defects on the impact behavior of multi-layer armor panel were studied. Hole defects were less influential in terms of impact contact force and had less severe constraining effect on front layer of the panel when the number of multi-layer armor panels increased. Furthermore, the effect of hole defects on the impact behavior of different weaving architectures (i.e. plain, twill, basket, and satin weave) were analyzed. Plain weave fabric had the highest energy absorption capability in impact scenarios with and without holes among all the woven architectures. Plain weave fabric was the most affected and twill weave was the least affected by hole defects in terms of transverse wave velocity; the satin weave was the most affected and the twill weave was the least affected by hole defects in terms of energy absorption. These findings will provide guidance for engineering of soft body amour and composite materials.
Diet Quality, Physical Activity, and Weight Changes and Their Association With 6-Year Risk of Metabolic Syndrome in Mexican Adults
Authors: Perez-Rodriguez Marcela , Talavera Juan Osvaldo , Salmeron Jorge
Published: May 2021

Background. Among lifestyle factors, obesity has been postulated as the most important risk factor for metabolic syndrome (MS). Lifestyle factors such as physical activity (PA), diet quality, and weight management are so closely related, it is not clear if the role of lifestyle factors is exclusively through its effect on weight, or if they contribute independently. Objective. To examine the effect of lifestyle factors such as diet quality, weight change, and leisure time PA on MS occurrence in lean and overweight/obese (OW/OB) adults over a 6-year period. Methods. This was a longitudinal analysis of data from adults participating in the Health Workers Cohort Study. Results. A total of 1046 participants were included; 37.2% of the OW/OB group and 16.2% of the lean participants developed MS. Becoming overweight had a hazard ratio (HR) of 3.06 for developing MS compared with remaining lean (95% CI = 1.98, 4.74). Going from OW/OB to lean was associated with lower risk of MS (HR = 0.41; 95% CI = 0.22, 0.79). Among OW/OB, becoming active was associated with lower risk (HR = 0.63; 95% CI = 0.42, 0.95) in comparison with an inactive pattern; diet quality was not associated with occurrence of MS. Conclusion. Weight change was the most relevant factor predicting MS over a 6-year period.
Understanding mental health outcomes related to compassion fatigue in parents of children diagnosed with intellectual disability
Authors: Davenport Stacy , Zolnikov Tara Rava
Published: May 2021

Background:

Parenting a child diagnosed with intellectual disability includes a variety of stressors. The degree to which stress affects these parents has been given little emphasis. Compassion fatigue includes experiencing an emotional response to being unable to relieve the suffering of a loved one, burnout, strain and stress on the caregiver. Compassion fatigue develops in parents of children diagnosed with intellectual disability due to their caregiving roles.

Method:

A phenomenological qualitative study was conducted using 25 semi-structured interviews to understand the mental health outcomes of parents caring for a child diagnosed with intellectual disability.

Results:

The results showed that initial emotional reactions after receiving their child’s diagnosis was a combination of anxiety, depression and compassion satisfaction. This study’s findings suggest that parents of children diagnosed with intellectual disability experience moderate levels of compassion fatigue in the caring of their child.

Conclusions:

This research provides evidence that the caregiving of a child diagnosed with intellectual disability comes with a myriad of stressors that can lead to compassion fatigue.
Work environment characteristics that satisfy principals in China, Germany and the USA
Authors: Wang Chuang , Hancock Dawson R , Müller Ulrich
Published: May 2021

Effective school leadership is crucial to a school’s success. Yet throughout the world, attracting and retaining qualified school leaders is often a formidable challenge. To discern ways in which we may recruit and retain competent school leaders, this study compares the extent to which principals in three industrialized countries, China, Germany and the USA, value the characteristics of their positions as principals. Survey responses of principals in these three countries reveal many factors that gratify and some factors that disappoint principals about their work environments. Comparing the similarities and differences of the principals’ responses in these countries provides insights into ways in which we may learn from each other about the factors that influence the recruitment and retention of qualified principals.
Investigating the underlying mechanisms of the enactment effect: The role of action–object bindings in aiding immediate memory performance
Authors: Makri Angeliki , Jarrold Christopher
Published: May 2021

Previous research has established that enacted action–object phrases lead to superior immediate memory performance compared with purely verbal memory. In the current investigation, Experiment 1 examined how enactment separately affects immediate memory for actions and objects in 24 adults by presenting action–object phrases and asking participants to recall either the actions or the objects presented in correct serial order. The results showed that when employed at presentation, enactment led to superior recall performance compared with verbal repetition, but this effect was significant only for memory for actions and not objects. Enactment during immediate recall did not lead to better memory performance compared with verbal recall for either actions or objects. To examine whether the lack of an enactment at recall was due to the splitting of action–object phrases at retrieval, Experiment 2 ( n = 24) examined memory for whole action–object phrases under enactment at recall. The results showed a typical enactment at recall benefit. Furthermore, a novel binding analysis suggested that enactment recall increased the likelihood of action features being remembered in a bound pair rather than alone. Together these findings suggest that action–object bindings play a crucial role in the manifestation of the enactment effect in immediate recall, especially when enactment is employed at the recall phase.
Age-related changes in time perception: The impact of naturalistic environments and retrospective judgements on timing performance
Authors: Riemer Martin , Wolbers Thomas , van Rijn Hedderik
Published: May 2021

Reduced timing abilities have been reported in older adults and are associated with pathological cognitive decline. However, time perception experiments often lack ecological validity. Especially the reduced complexity of experimental stimuli and the participants’ awareness of the time-related nature of the task can influence lab-assessed timing performance and thereby conceal age-related differences. An approximation of more naturalistic paradigms can provide important information about age-related changes in timing abilities. To determine the impact of higher ecological validity on timing experiments, we implemented a paradigm that allowed us to test (1) the effect of embedding the to-be-timed stimuli within a naturalistic visual scene and (2) the effect of retrospective time judgements, which are more common in real life than prospective judgements. The results show that compared with out-of-context stimuli, younger adults benefit from a naturalistic embedding of stimuli (reflected in higher precision and less errors), whereas the performance of older adults is reduced when confronted with naturalistic stimuli. Differences between retrospective and prospective time judgements were not modulated by age. We conclude that, potentially driven by difficulties in suppressing temporally irrelevant environmental information, the contextual embedding of naturalistic stimuli can affect the degree to which age influences the performance in time perception tasks.
Green Advertising for the Sustainable Luxury Market
Authors: Lim Dong Jae (Jay) , Youn Nara , Eom Hyo Jin
Published: May 2021

Consumers are increasingly interested in environmental issues, which have raised their expectations of firms’ environmentally conscious efforts. The purpose of this study is to investigate how green messages in advertisements conveying a firm’s commitment to the environment can effectively influence consumer attitudes and behavioral intentions. Furthermore, this study examines the psychological mechanism underlying such an effect. The results of two studies show that firms’ eco-friendly efforts as revealed in advertisements for luxury products generated favorable attitudes in consumers and increased their behavioral intentions more than firms’ eco-friendly efforts as revealed in advertisements for mass products. This process was driven by trust in the ad message, especially for consumers of luxury brands and who are not confused by green message. This research provides empirical evidence that green ads presenting a firm’s commitment to the environment can effectively influence consumers when brands are used to promote eco-friendly products in luxury markets.
Social Emotional Learning in Schools: The Importance of Educator Competence
Authors: Gimbert Belinda G. , Miller Dustin , Herman Emily , Breedlove Meghan , Molina Citlali Estela
Published: May 2021

As professionals charged with fostering student learning and well-being, educators—school leaders, teachers, school counselors, pre-service teachers—should demonstrate social emotional competence. In this study, we apply the Collaborative for Academic, Social, and Emotional Learning’s framework—self-awareness, self-management, social awareness, relationship skills, responsible decision-making—to ascertain what we know from scholarship about educators’ SEL competence. We conclude with guiding principles for training programs and professional learning opportunities for strengthening educators’ understanding of their own SEL to improve daily pedagogical practice and ensure each school-wide initiative around SEL drives seamless strategies for attaining school improvement outcomes.
The Natural History of Medial Meniscal Tears in the ACL Deficient and ACL Reconstructed Rat Knee
Authors: Kaneguchi Akinori , Ozawa Junya , Minamimoto Kengo , Yamaoka Kaoru
Published: May 2021

Objective

The process of anterior cruciate ligament (ACL) injury-induced meniscal tear formation is not fully understood. Clinical studies have shown that ACL reconstruction (ACLR) reduces the development of secondary meniscal tears, but it is difficult to gain insight into the protective effects of ACLR from clinical studies alone. Using rat ACL transection (ACLT) and ACLR models, we aimed to reveal (1) the formation process of meniscal tears secondary to ACLT and (2) the protective effects of ACLR on secondary meniscal tears.

Design

ACLT surgery alone or with ACLR was performed on the knees of rats. Histomorphological and histopathological changes were examined in the posteromedial region of the meniscus in intact rats and in rats that received ACLT or ACLR up to 12 weeks postsurgery. In addition, anterior-posterior joint laxity was measured using the universal testing machine to evaluate the effects of ACLT and ACLR on joint laxity.

Results

AAnterior-posterior laxity was significantly increased by ACLT compared to the intact knee. This ACLT-induced joint laxity was partially but significantly reduced by ACLR. Meniscal proliferation and hyaline cartilage–like tissue formation were detected in the medial meniscus at 4 weeks post-ACLT. At 12 weeks post-ACLT, hyaline cartilage–like tissue was replaced by ossicles and meniscal tears were observed. These ACLT-induced abnormalities were attenuated by ACLR.

Conclusions

Our results suggest that ACLT-induced joint laxity induces secondary medial meniscal tears through meniscal proliferation and ossicle formation via endochondral ossification. Joint re-stabilization by ACLR suppresses meniscal proliferation and ossicle formation and consequently prevents secondary meniscal tears.
Percutaneous spine biopsy under cone beam computed tomography guidance for spondylodiscitis: Time is diagnosis
Authors: Cannavale Alessandro , Nardis Piergiorgio , Lucatelli Pierleone , Corona Mario , Santoni Mariangela , Cannavale Giuseppe , Teodoli Leonardo , Bezzi Mario , Catalano Carlo
Published: May 2021

Background and purpose

Percutaneous spine biopsies for spondylodiscitis have been long discussed due to the low microbiologic yield. This retrospective study evaluated factors of cone beam computed tomography-guided spine biopsies that may affect microbiologic yield.

Methods

We retrospectively reviewed percutaneous spine biopsies under cone beam computed tomography for spondylodiscitis performed from January 2015–December 2020. Clinical and technical features such as the time from initial symptoms to biopsy, level biopsied, biopsy needle type/gauge, technical approach, radiation dose, technical success and microbiologic yield were recorded. Pre-procedure magnetic resonance imaging findings were also recorded such as the number of vertebral bodies involved, and disc morphology. Univariate logistic regression analysis and Receiver operating characteristic analysis were performed to assess any relationship between relevant factors and positive cultures.

Results

A total of 50 patients underwent cone beam computed tomography-guided biopsies for spondylodiscitis, with resulted positive cultures in 18 patients (36%). The mean time from the initial referral of spinal symptoms to procedure in the positive culture group was the most influential finding for positive cultures (odds ratio 56.3, p < 0.001). Among magnetic resonance imaging findings, thin or degenerated intervertebral disc was a negative factor for positive cultures (odds ratio 0.09, p = 0.006). Univariate analysis showed that percutaneous approach (transpedicular vs posterolateral/interlaminar) needle size (11–13 g vs 16–18G, odds ratio 1.2, p = 0.7) and site of biopsy (disc vs bone vs disc plus endplate) did not significantly affect the microbiologic yield of spine biopsy.

Conclusion

Percutaneous cone beam computed tomography-guided biopsy for spondylodiscitis is a reliable and safe technique and its microbiologic yield may increase if biopsy is performed within the acute phase of infection.
Body Mass Index, Multi-Morbidity, and COVID-19 Risk Factors as Predictors of Severe COVID-19 Outcomes
Authors: Nanda Sanjeev , Chacin Suarez Audry S. , Toussaint Loren , Vincent Ann , Fischer Karen M. , Hurt Ryan , Schroeder Darrell R. , Medina Inojosa Jose R. , O’Horo John C. , DeJesus Ramona S. , Abu Lebdeh Haitham S. , Mundi Manpreet S. , Iftikhar Salma , Croghan Ivana T.
Published: May 2021

Purpose

The purpose of the present study was to investigate body mass index, multi-morbidity, and COVID-19 Risk Score as predictors of severe COVID-19 outcomes.

Patients

Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between January 1, 2020 and May 23, 2020; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens.

Measures

Demographic and clinical data were extracted from the electronic medical record. The data included: date of birth, gender, ethnicity, race, marital status, medications (active COVID-19 agents), weight and height (from which the Body Mass Index (BMI) was calculated, history of smoking, and comorbid conditions to calculate the Charlson Comorbidity Index (CCI) and the U.S Department of Health and Human Services (DHHS) multi-morbidity score. An additional COVID-19 Risk Score was also included. Outcomes included hospital admission, ICU admission, and death.

Results

Cox proportional hazards models were used to determine the impact on mortality or hospital admission. Age, sex, and race (white/Latino, white/non-Latino, other, did not disclose) were adjusted for in the model. Patients with higher COVID-19 Risk Scores had a significantly higher likelihood of being at least admitted to the hospital (HR = 1.80; 95% CI = 1.30, 2.50; P < .001), or experiencing death or inpatient admission (includes ICU admissions) (HR = 1.20; 95% CI = 1.02, 1.42; P = .028). Age was the only statistically significant demographic predictor, but obesity was not a significant predictor of any of the outcomes.

Conclusion

Age and COVID-19 Risk Scores were significant predictors of severe COVID-19 outcomes. Further work should examine the properties of the COVID-19 Risk Factors Scale.
Extending Expectancy Theory to Food Intake: Effect of a Simulated Fast-Food Restaurant on Highly and Minimally Processed Food Expectancies
Authors: Cummings Jenna R. , Hoover Lindzey V. , Turner Meredith I. , Glozier Kalei , Zhao Jessica , Gearhardt Ashley N.
Published: May 2021

Unhealthy diets are widespread and linked to a number of detrimental clinical outcomes. The current preregistered experiment extended expectancy theory into the study of food intake; specifically, we tested whether a fast-food restaurant affects food expectancies, or the emotions one expects to feel while eating highly processed foods (e.g., pizza) and minimally processed foods (e.g., carrots). Participants ( N = 200, mean age = 18.79 years) entered a simulated fast-food restaurant or a neutral space, completed questionnaires, and engaged in a bogus taste test. The simulated fast-food restaurant increased positive highly processed food expectancies ( d = 0.29). Palatable eating coping motives scores did not moderate the effect; however, this clinically relevant pattern of eating behavior was associated with greater positive highly processed food expectancies. In addition, there was an indirect effect of the fast-food restaurant on ad libitum food intake through positive highly processed food expectancies. Reducing positive highly processed food expectancies may improve diet, which may broadly affect health.
Biomechanical Properties of Double-Row Transosseous Rotator Cuff Repair Combined With the Cinch Stitch in the Lateral Row
Authors: Ito Kentaro , Sakaguchi Katsunobu , Sekihata Hirosi , Sugita Naoki , Kadono Yuho
Published: May 2021

Background:

The self-cinching stitch has been verified to have high mechanical strength. The mechanical strength of combining transosseous rotator cuff repair (RCR) and the self-cinching stitch in the lateral row is unknown.

Purpose/Hypothesis:

The purpose of this study was to evaluate the biomechanical properties of transosseous RCR combined with the cinch stitch in the lateral row. We hypothesized that this construct would have better mechanical strength than would transosseous repair using a vertical cinch stitch or simple stitch.

Study Design:

Controlled laboratory study.

Methods:

Rotator cuff tears were simulated in 48 porcine shoulder specimens. The tears were repaired using 1 of 6 repair configurations: 2–simple stitch transosseous repair alone (group 2TO), with a vertical cinch stitch (group 2TO-VC), or with a horizontal cinch stitch (group 2TO-HC) or 4–simple stitch transosseous repair alone (group 4TO), with a vertical cinch stitch (group 4TO-VC), or with a horizontal cinch stitch (group 4TO-HC). All specimens were set at a 45° angle from the footprint and underwent cyclic loading from 10 to 160 N for 200 cycles, followed by a load-to-failure test at 10 mm/min.

Results:

During cyclic loading, all specimens in group 2TO and half of the specimens in group 2TO-VC failed by suture pullout. In the other groups, none of the specimens failed before 200 cycles. The yield load in group 2TO-HC was significantly greater than that in group 2TO-VC (261.43 vs 219.54 N, respectively; P < .05). There were significant differences between groups 4TO-HC and 4TO with regard to elongation (3.92 vs 5.68 mm, respectively), yield load (304.04 vs 246.94 N, respectively), and linear stiffness (63.44 vs 52.28 N/mm, respectively) ( P < .01 for all). Group 4TO-HC also had shorter elongation and a superior yield load and linear stiffness compared with group 2TO-HC ( P < .05 for all), and group 4TO-VC had shorter elongation and a stronger maximum load to failure and yield load than did group 2TO-VC ( P < .05 for all).

Conclusion:

Increasing the number of medial simple stitches can prevent suture pullout. Adding the horizontal cinch stitch to the lateral row in transosseous repair can further improve biomechanical properties through a self-cinching mechanism.

Clinical Relevance:

Transosseous RCR with a horizontal cinch stitch in the lateral row may reduce the retear rate.
A Public Health Summer Experience for High School Students
Authors: Liang Laura E. , Zivkovic Alexandra , Passannante Marian R.
Published: May 2021

Prior to the COVID-19 pandemic, many high school students were unaware of careers in public health—that there are many options available for those interested in improving health and preventing disease beyond being a doctor or a nurse. The Rutgers School of Public Health (R-SPH) developed PHocus (Public Health: Outbreaks, Communities, and Urban Studies) to introduce high school students to the interdisciplinary field of public health as well as to promote population and individual health. The PHocus Summer Experience was designed for high school students to explore population health and learn about the fundamentals of epidemiology, the breadth of topics addressed by public health, and public health careers. R-SPH hosted PHocus as 1-week sessions in Summer 2018 and 2019, available at both the School’s Piscataway, New Jersey, and Newark, New Jersey, locations. The Newark sessions targeted recruitment from high schools with underserved, minority, and/or economically disadvantaged students, and tuition for these students was supported through external funding. Across 2018 and 2019 PHocus Summer Experiences, 130 students participated, representing 63 high schools, in four 1-week sessions. The experience was rated very highly by participants; on a 4-point scale (1 = strongly disagree to 4 = strongly agree), the median score for the program being a worthwhile experience was 4.0. R-SPH faculty, staff, and students, as well as external stakeholders, eagerly volunteered to be part of the program, suggesting that this educational program can be reproduced at other schools and programs of public health.
Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach
Authors: Paul N.R. , Baker S.R. , Gibson B.J.
Published: May 2021

Introduction:

Patients’ decisions to undergo major surgery such as orthognathic treatment are not just about how the decision is made but what influences the decision.

Objectives:

The primary objective of the study was to identify the key processes involved in patients’ experience of decision making for orthognathic treatment.

Methods:

This study reports some of the findings of a larger grounded theory study. Data were collected through face-to-face interviews of patients who were seen for orthognathic treatment at a teaching hospital in the United Kingdom. Twenty-two participants were recruited (age range 18–66 y), of whom 12 (male = 2, female = 10) were 6 to 8 wk postsurgery, 6 (male = 2, female = 4) were in the decision-making stage, and 4 (male = 0, female = 4) were 1 to 2 y postsurgery. Additional data were also collected from online blogs and forums on jaw surgery. The data analysis stages of grounded theory methodology were undertaken, including open and selective coding.

Results:

The study identified the central role of dental care professionals (DCPs) in several underlying processes associated with decision making, including legitimating, mediating, scheduling, projecting, and supporting patients’ decisions. Six categories were related to key aspects of decision making. These were awareness about their underlying dentofacial problems and treatment options available, the information available about the treatment, the temporality of when surgery would be undertaken, the motivations and expectation of patients, social support, and fear of the surgery, hospitalization, and potentially disliking their new face.

Conclusion:

The decision-making process for orthognathic treatment is complex, multifactorial, and heavily influenced by the role of DCPs in patient care. Understanding the magnitude of this role will enable DCPs to more clearly participate in improving patients’ decision-making process. The findings of this study can inform future quantitative studies.

Knowledge Transfer Statement:

The results of this study can be used both for informing clinical practice around enabling decision making for orthognathic treatment and also for designing future research. The findings can better inform clinicians about the importance of their role in the patients’ decision-making process for orthognathic treatment and the means to improve the patient experience. It is suggested that further research could be conducted to measure some of the key constructs identified within our grounded theory and assess how these change during the treatment process.
Making Cavities History: A Global Policy Consensus for Achieving a Dental Cavity–Free Future
Authors: Pitts N.B. , Mayne C.
Published: May 2021

These global consensus recommendations on caries and cavities, as well as evidence that caries is the most prevalent noncommunicable disease (NCD) globally, should be shared throughout institutional, health care professional, industrial, civil society, and patient communities so that the recommendations can be incorporated into policies for achieving a dental cavity-free future. Appropriate inclusion within strategies and action plans globally and locally will accelerate progress toward Making Cavities History, as well as improving NCDs and wider health.
The Influence of Applicant and Reviewer Gender on Resident Selection for Internal Medicine
Authors: Katz Steven J
Published: May 2021

Background:

While gender bias in medicine, including physician training, has been well described, less is known about gender bias in the selection process for post graduate residency training programs. This analysis reviews the potential role of gender on resident selection for an internal medicine residency program.

Methods:

File review and interview overall and component scores were analyzed based on the gender of the applicant. File review scores were further analyzed based on the reviewer’s gender.

Results:

Women applicants scored higher than men applicants on their file review. There were no differences in any one component score except for leadership in art. Women file reviewers scored applicants higher than men file reviewers, but there was no difference between gender scores. There was no difference in overall or component interview scores between men or women applicants. Scoring did not impact the expected rank performance of applicants based on gender at any stage of the selection process.

Conclusions:

While higher scores were observed in women applicants upon their file review, and women reviewers provided higher file review scores, this did not appear to impact the expected number of women and men applicants at each stage of the applicant process. This suggests a potential lack of gender bias at these stages of applicant selection.
Pharmacotherapy as an adjunct to vitrectomy
Authors: Villegas Victor M. , González Mónica P. , Berrocal Audina M. , Murray Timothy G.
Published: May 2021

Vitreoretinal surgery has advanced extensively from the first days of vitrectomy. During the last decade, new developments in intravitreal pharmacotherapy have created new opportunities to enhance the surgical outcomes of our patients. In this article, we review and discuss some of the supporting evidence of different pharmacotherapies that may be used as an adjunct to vitrectomy for select common etiologies. Triamcinolone acetonide, dexamethasone, and angiogenesis inhibitors are among the most commonly used drugs given their safety profile and proven efficacy. Other pharmaceuticals have also shown promising results in small studies. The adoption of individualized medical treatments prior, during, and after vitrectomy will continue to increase as new evidence supporting the benefit of pharmacotherapy as an adjunct to vitrectomy becomes available.
To what extent do medication experts agree on diagnoses derived from psychotropic medication prescribed for children and adolescents in a state Medicare database?
Authors: O’Brien Conor , Rapp John T.
Published: May 2021

This study evaluated the extent to which psychotropic medication experts agreed on psychiatric/behavior diagnoses derived from 30 individuals’ psychotropic medication regimens. Three medication experts reviewed the medication regimens and inferred one or more diagnoses based on the medication listed. Thereafter, we used kappa statistical analyses and category-by-category analyses to evaluate agreement of diagnoses (a) across all three reviewers for two time points (separated by 8 to 14 months) covered by each data set, (b) across each pairing of reviewers at the two time points, and (c) within each reviewer across both time points. Between-reviewer kappa statistical analyses of first- and last-regimen data yielded only five instances with excellent agreement and 13 instances of poor agreement. All remaining instances indicated various levels of disagreement. Similarly, within-expert kappa statistical analyses showed two instances with excellent agreement, four instances with poor agreement, and the remaining instances with various levels of disagreement. Overall, the highest kappa values were attached to low-count regimens, while most scores, regardless of medication count, were low and indicated potential disagreement. The category-by-category analyses yielded similar results. A secondary, conditional analysis revealed higher agreements between and within reviewers when medication regimens contained psychotropic medications typically prescribed to individuals diagnosed with Attention Deficit Hyperactivity Disorder.
Robust Project-Based Organizations for the Design of Complex Engineered Systems
Authors: Maier-Speredelozzi Valerie , Still Bryan
Published: May 2021

Cost and schedule overruns have become increasingly common in projects that set out to deliver complex engineered systems. Considering the well-established relationship between systems and organizations that design them, this article compares real-world, project-based organizational forms to idealized forms using agent-based models. It identifies multiscale networks as the preferred theoretical form and structures based on military staffs as the preferred practical form for organizations that design complex engineered systems. Matrix organizations are particularly susceptible to congestion failure, whereas military staffs are more robust and better suited to meeting demands for cross-functional collaboration and communication.
driveR: a novel method for prioritizing cancer driver genes using somatic genomics data
Authors: Ülgen Ege , Sezerman O. Uğur
Published: May 2021

Background

Cancer develops due to “driver” alterations. Numerous approaches exist for predicting cancer drivers from cohort-scale genomics data. However, methods for personalized analysis of driver genes are underdeveloped. In this study, we developed a novel personalized/batch analysis approach for driver gene prioritization utilizing somatic genomics data, called driveR.

Results

Combining genomics information and prior biological knowledge, driveR accurately prioritizes cancer driver genes via a multi-task learning model. Testing on 28 different datasets, this study demonstrates that driveR performs adequately, achieving a median AUC of 0.684 (range 0.651–0.861) on the 28 batch analysis test datasets, and a median AUC of 0.773 (range 0–1) on the 5157 personalized analysis test samples. Moreover, it outperforms existing approaches, achieving a significantly higher median AUC than all of MutSigCV (Wilcoxon rank-sum test p < 0.001), DriverNet (p < 0.001), OncodriveFML (p < 0.001) and MutPanning (p < 0.001) on batch analysis test datasets, and a significantly higher median AUC than DawnRank (p < 0.001) and PRODIGY (p < 0.001) on personalized analysis datasets.

Conclusions

This study demonstrates that the proposed method is an accurate and easy-to-utilize approach for prioritizing driver genes in cancer genomes in personalized or batch analyses. driveR is available on CRAN:https://cran.r-project.org/package=driveR.