bluuebunny/crossref_metadata_2025 huggingface dataset:
How Specific Are Learning Disabilities?
Authors: Peterson Robin L. , McGrath Lauren M. , Willcutt Erik G. , Keenan Janice M. , Olson Richard K. , Pennington Bruce F.
Published: January 2021

Despite historical emphasis on “specific” learning disabilities (SLDs), academic skills are strongly correlated across the curriculum. Thus, one can ask how specific SLDs truly are. To answer this question, we used bifactor models to identify variance shared across academic domains (academic g), as well as variance unique to reading, mathematics, and writing. Participants were 686 children ages 8 to 16. Although the sample was overselected for learning disabilities, we intentionally included children across the full range of individual differences in this study in response to growing recognition that a dimensional, quantitative view of SLD is more accurate than a categorical view. Confirmatory factor analysis identified five academic domains (basic reading, reading comprehension, basic math, math problem-solving, and written expression); spelling clustered with basic reading and not writing. In the bifactor model, all measures loaded significantly on academic g. Basic reading and mathematics maintained variance distinct from academic g, consistent with the notion of SLDs in these domains. Writing did not maintain specific variance apart from academic g, and evidence for reading comprehension-specific variance was mixed. Academic g was strongly correlated with cognitive g ( r = .72) but not identical to it. Implications for SLD diagnosis are discussed.
The Opioid Epidemic and Homicide in the United States
Authors: Rosenfeld Richard , Wallman Joel , Roth Randolph
Published: January 2021

Objectives:

Evaluate the relationship between the opioid epidemic and homicide rates in the United States.

Methods:

A county-level cross-sectional analysis covering the period 1999 to 2015. The race-specific homicide rate and the race-specific opioid-related overdose death rate are regressed on demographic, social, and economic covariates.

Results:

The race-specific opioid-related overdose death rate is positively associated with race-specific homicide rates, net of controls. The results are generally robust across alternative samples and model specifications.

Conclusions:

We interpret the results as reflecting the violent dynamics of street drug markets, although more research is needed to draw definitive conclusions about the mechanisms linking opioid demand and homicide.
Necropsy protocol for newborn mice
Authors: Capas-Peneda Sara , Munhoz Morello Gabriela , Lamas Sofia , S Olsson I Anna , Gilbert Colin
Published: January 2021

Neonatal mortality is high in laboratory mouse breeding, and causes are poorly understood. Post-mortem analysis of pups is an often overlooked source of information and insight. We present a necropsy protocol for neonatal mice designed for easy practical application by animal technicians.
Motor Competence in Children With and Without Ambliopia
Authors: Sá Cristina dos Santos Cardoso de , Luz Carlos , Pombo André , Rodrigues Luis Paulo , Cordovil Rita
Published: January 2021

The purpose of this study was to assess the motor competence of children with and without amblyopia. Study participants were 165 primary school children, aged 6–9 years, divided into three groups based on their visual acuity with the Snellen chart: (a) non-amblyopia, (b) corrected amblyopia, and (c) non-corrected amblyopia. We assessed the children’s motor competence with the Motor Competence Assessment battery (MCA) and their physical activity with the Physical Activity Questionnaire for Older Children (PAQ-C). The non-amblyopia group presented significantly better motor competence on the MCA than either the corrected amblyopia group or the non-corrected amblyopia group; there were no statistically significant motor differences between the two amblyopia subgroups. Amblyopia versus non-amblyopia differences on the MCA were mainly in stability and locomotor components, involving dynamic balance and the change of spatial position and direction of movement, but not in the manipulative component (ball throwing velocity and ball kicking velocity). Predictably, from within an integrated visual motor perspective of child development, our findings suggest that intact vision played an important role in children’s motor competence. The development of fundamental motor skills, especially of stability and locomotor skills, may be affected by poor visual processing in that participants with uncorrected amblyopia showed poor movement accuracy, uncoordinated movement, and impaired balance.
A Directional Congruency Effect of Amplified Dilated Time Perception Induced by Looming Stimuli With Implied Motion Cues
Authors: Seo Joohee , Kim Euisun , Kim Sung-Ho
Published: January 2021

The perception of time is not veridical, but, rather, it is susceptible to environmental context, like the intrinsic dynamics of moving stimuli. The direction of motion has been reported to affect time perception such that movement of objects toward an observer (i.e., looming stimuli) is perceived as longer in duration than movement of objects away from the observer (i.e., receding stimuli). In the current study we investigated whether this looming/receding temporal asymmetry can be modulated by the direction of movement implied by static cues of images. Participants were presented with images of a running person, rendered from either the front or the back (i.e., representing movement toward or away from the observer). In Experiment 1, the size of the images was constant. In Experiment 2, the image sizes varied (i.e., increasing: looming; or decreasing: receding). In both experiments, participants performed a temporal bisection task by judging the duration of the image presentation as “short” or “long”. In Experiment 1, we found no influence of implied-motion direction in the participants’ duration perceptions. In Experiment 2, however, participants overestimated the duration of the looming, as compared to the receding image in relation to real motion. This finding replicated previous findings of the looming/receding asymmetry using naturalistic human-character stimuli. Further, in Experiment 2 we observed a directional congruency effect between real and implied motion; stimuli were perceived as lasting longer when the directions of real and implied motion were congruent versus when these directions were incongruent. Thus, looming (versus receding) movement, a perceptually salient stimulus, elicits differential temporal processing, and higher-order motion processing integrates signals of real and implied motion in time perception.
Boredom as an Aversive Emotion Experienced by English Majors
Authors: Zawodniak Joanna , Kruk Mariusz , Pawlak Mirosław
Published: January 2021

Despite a growing focus on positive psychology in recent years, negative emotions have not ceased to play a crucial role in learning additional languages in the classroom. This paper reports a study that investigated one such negative emotion – boredom – as experienced by 115 advanced learners of English. They were asked to write a descriptive paragraph about boredom that they experienced during English classes. Qualitative analysis resulted in the identification of five broad categories of factors responsible for student boredom – namely, language tasks, the teacher, modes of class organization, class components and others. On that basis, some boredom-coping solutions are offered.
Improving the Behavior of Children With Fetal Alcohol Spectrum Disorders
Authors: Hutton Laura
Published: January 2021

Prenatal exposure to alcohol causes a pattern of brain-based deficits and is associated with behavioral challenges (Wozniak et al., 2019). Understanding the neurocognitive behaviors common among individuals with fetal alcohol spectrum disorders (FASD) can increase teachers’ effectiveness (Tremblay et al., 2017). Environmental changes, such as modifying the classroom, providing high levels of structure, and increasing adult supervision, have been shown to improve the behavior of individuals with FASD (Bohjanen et al., 2009). There is also emerging evidence that explicit instruction in metacognitive strategies is effective with this population (Makela et al., 2019. Students with FASD can benefit from being explicitly taught to stop and think before acting and to use rehearsal, memory aids, and positive self-talk.
Neurological recovery with serological response in a rabies survivor on long-term follow-up
Authors: Hamide Abdoul , Kaliyappan Anupriya , Mani Reeta S , Krishnamurthy Aishwarya
Published: January 2021

An 18-year-old girl presented with headache, vomiting, dysarthria, diplopia and ataxia following a stray dog bite 20 days prior to presentation. The dog was killed by her neighbours. She received three doses of anti-rabies vaccine and one dose of rabies immunoglobulin (RVIG) before presentation. Diagnosis of rabies was confirmed based on four-fold rise in serum and CSF rabies virus neutralizing antibodies (RVNA) by rapid fluorescent focus inhibition test (RFFIT) titres coupled with history of dog-bite and a normal MRI. With supportive care and empirical administration of IVIG her condition improved over months and at her final visit to hospital at five years, she was physically independent with mild persistent dysarthria. Ours is one of the longest followed cases of rabies survivor in whom we had used IVIG empirically and could demonstrate the decline in the RVNA level in CSF and verify the steady neurological recovery over five years.
Reconsidering the Reference Category
Authors: Johfre Sasha Shen , Freese Jeremy
Published: January 2021

Social scientists often present modeling results from categorical explanatory variables, such as gender, race, and marital status, as coefficients representing contrasts to a “reference” group. Although choosing the reference category may seem arbitrary, the authors argue that it is an intrinsically meaningful act that affects the interpretability of results. Reference category selection foregrounds some contrasts over others. Also, selecting a culturally dominant group as the reference can subtly reify the notion that dominant groups are the most “normal.” The authors find that three of four recently published tables in Demography and American Sociological Review that include race or gender explanatory variables use dominant groups (i.e., male or white) as the reference group. Furthermore, the tables rarely state what the reference is: only half of tables with race variables and one-fifth of tables with gender variables explicitly specify the reference category; the rest leave it up to the reader to check the methods section or simply guess. As an alternative to this apparently standard practice, the authors suggest guidelines for intentionally and responsibly choosing a reference category. The authors then discuss alternative ways to convey results from categorical explanatory variables that avoid the problems of reference categories entirely.
Social support, depression, anxiety, and quality of life among persons living with type 2 diabetes: a path analysis
Authors: Obo Henry , Kugbey Nuworza , Atefoe Ethel
Published: January 2021

Co-morbid mental health problems among persons living with type 2 diabetes have a significant influence on diabetic persons’ self-care and, ultimately, quality of life. However, the mechanisms linking the co-morbid mental health problems of type 2 diabetes patients to the decreased quality of life are not fully understood. This study examined the direct and indirect influences of co-morbid depression and anxiety on the quality of life of 115 persons living with type 2 diabetes, using a cross-sectional survey design. Frequencies and percentages were used to summarize the data, and the Pearson correlation was used to determine the bivariate association between the study variables. PROCESS Macro in SPSS was used for mediation analyses. The findings show that depression and anxiety had significant negative correlations with the quality of life of persons living with type 2 diabetes. However, only depression had a significant negative correlation with social support. On the contrary, social support significantly and positively correlated with quality of life. The mediation analysis shows that social support partially mediated the relationship between depression and quality of life after adjusting for the sex of the participants. However, social support did not have a significant mediation effect on the link between anxiety and quality of life after adjusting for the sex of the participants. The availability of social support, especially peer support, could buffer the negative emotional experiences associated with living with type 2 diabetes and improve the quality of life for persons living with this health condition.
“I Have Been a Sojourner in a Foreign Land”: A Qualitative Inquiry on the Psychological Experiences of International Students Enrolled in a Christian University
Authors: Moh Sarah-Ann , Kim Paul Youngbin , Geil Dalton , Ryu Sung Hun
Published: January 2021

International students make up 5.5% of all university students in the United States. In addition, international students consist of approximately 4% of the student population in Christian higher education. Although there is a significant number of international students enrolled in faith-based institutions, this population remains underrepresented in multicultural psychological literature. Thus, applying the intrapersonal-interpersonal-spiritual framework, we interviewed 15 international students from a Christian university to investigate their unique and shared experiences with the general international student population in the United States. The Consensual Qualitative Research method (CQR) was employed, and seven principal domains were identified: (a) religiousness, (b) reactions toward international students, (c) social support and acceptance, (d) hopes and expectations, (e) cultural adaptation, (f) cultural differences, and (g) international student identity. Similar themes to those present in the existing international student literature were established, but differential themes related to religiousness were discovered as well. Implications for Christian campuses are discussed.
Healing from shame: Possible and desirable?
Authors: Campanale Andrea
Published: January 2021

This article offers a multidisciplinary exploration of whether healing from shame is possible, what implications it has for the gospel and how healing might be appropriated in ordinary people’s lives. It draws on scripture and a very personal experience of one person’s healing from shame to draw lessons from an understanding of mission in honour/shame cultures to help those struggling with toxic shame in the postmodern, highly individualised West. Examining the relevance of story, spiritual practices and self-help, it is asserted that healing is ultimately experienced as the restoration of a relationship with God and with other, as well as with the self.
Adolescent Threats and Violence: An Intriguing Difference
Authors: Leach Chelsea L. , Harden Scott , Heath Ashley , Hayes Jordana , Newcombe Carla , Johnston Michelle , Hasan Tasneem
Published: January 2021

Relatively little is known about young people who engage in targeted acts of violence. In this study, we explored a sample of young people referred to a youth forensic mental health service for a risk assessment of general violence risk, targeted violence risk, or both general and targeted violence risk. Exploratory comparisons were made across mental health issues and criminogenic risk factors, and results indicated that young people referred for a threat-only assessment were around 20 times more likely to have a depressive mood disorder than young people referred for a violence-only assessment. Furthermore, young people referred for a threat assessment had lower rates of physical abuse, family mental health issues, and prior offending. These results indicate that young people referred for an assessment of targeted violence risk may be distinguished from young people referred for general violence risk, which has important implications for their assessment and treatment.
Effect of viscosity on oil recovery by spontaneous imbibition from partially water-covered matrix blocks
Authors: Zhang Qi , Wu Xinyue , He Yingfu , Meng Qingbang
Published: January 2021

Spontaneous imbibition is an important mechanism of oil recovery from fractured reservoirs and unconventional reservoirs. Oil is produced by combining co- and counter-current imbibition when the matrix blocks was partially covered by water. In this paper, we focused on the effect of viscosity ratios on oil production by spontaneous imbibition and established the numerical model for one-dimensional linear imbibition with TEO-OW boundary conditions, which was validated by the experimental data. The effect of viscosity ratio on co- and counter-current imbibition is investigated and scaling result of the imbibition recovery curve for wide range of viscosity ratio using the conventional scaling equation was tested, which indicates that the close correlation was achieved only when oil-water viscosity ratios are higher. Then, a modified scaling equation was developed based on the piston-like assumption for one-dimensional co-current imbibition and close correlation of imbibition recovery curves was achieved when viscosity ratios are lower. Finally, correlation of imbibition recovery curves was improved for wide range of viscosity ratios by combining conventional and modified scaling equation. Results show that since the shape of imbibition recovery curves is not similar for different viscosity ratios, it is difficult to obtain the perfect correlation using the constant viscosity term.
Fracture criterion of basic roof deformation in fully mechanized mining with large dip angle
Authors: Yang Ke , Wei Zhen , Chi Xiaolou , Gao Ansen , Fu Qiang
Published: January 2021

To explore the structure evolution of overlying strata and pressure characteristics of coal mining with large dip angle, the basic roof mechanical model was established that based on the thin plate theory and the development characteristics of 1212 (3) working face of Panbei Mine. The formula was deduced that used for calculating the basic roof stress distribution in large dip angle coal seam. It revealed the mechanism evolution of mining stress and its influence on overburden deformation. Furthermore, it was also discussed that the effect of false roof on the failure of the basic roof. It showed that the false roof increases the differentiation of gangue’s filling rate in goaf and improves the evolution rate of basic roof fracture. It is the main influencing factor that the large dip angle leads to the “scoop” distribution of the stress and deformation in basic roof. It dominates the evolution of overburden fractures and the regional instability. The maximum deformation of the basic roof is located in the middle and upper part of the working face. This theoretical model is verified by means of numerical simulation and field monitoring.
Effect of Therapist Coaching Statements on Parenting Skills in a Brief Parenting Intervention for Infants
Authors: Heymann Perrine , Heflin Brynna H. , Bagner Daniel M.
Published: January 2021

Behavioral parenting interventions have been shown to decrease early childhood behavior problems by improving parenting skills. Few studies have examined the impact of therapist coaching statements on parenting skill acquisition, especially among ethnic minority families and non-English-speaking families. In this study, we examined therapists’ use of responsive and directive coaching statements during the first coaching session in a brief parenting intervention, the Infant Behavior Program (IBP), on changes in parenting skill acquisition. Participants were 24 mothers of 12- to 15-month-olds, with elevated levels of behavioral problems from primarily Latinx and low-income backgrounds. Mothers who heard more responsive coaching from their therapist showed greater increases in positive parenting skills. Spanish-speaking therapists used fewer responsive coaching statements and more commands, however, language spoken did not moderate the effect of these statements on changes in parenting skills. Responsive coaching statements in English and Spanish had a positive impact on parenting skill acquisition.
The Blame Intensity Inventory: Assessing the Propensity to Blame Harshly and Its Unique Capacity to Predict Malicious Satisfaction From Offender Victimization
Authors: Gill Michael J. , Cerce Stephanie C.
Published: January 2021

Blame permeates our social lives. When done properly, blame can facilitate the upholding of moral norms. When done with excessive intensity or harshness, however, blame can have significant negative impacts. Here, we develop and validate a scale—the Blame Intensity Inventory—to measure individual differences in the propensity for intense blame responses. First, we present evidence for its convergent and divergent validity by examining relations with existing scales. In addition, in two studies, we show that the Blame Intensity Inventory—rooted in an affective conception of blame—predicts hostile responses to offenders better than do measures focused on blame-related cognitive appraisals (e.g., free will, intentionality). Finally, in three studies, we show that Blame Intensity uniquely predicts malicious satisfaction, or gratification upon learning that an offender has suffered gratuitous harm. Results are discussed in terms of important research questions that could be addressed using the Blame Intensity Inventory.
Global perspectives on physical and nonphysical discipline: A Bayesian multilevel analysis
Authors: Grogan-Kaylor Andrew , Castillo Berenice , Pace Garrett T. , Ward Kaitlin P. , Ma Julie , Lee Shawna J. , Knauer Heather
Published: January 2021

Background and Objective:

Sixty countries worldwide have banned the use of physical punishment, yet little is known about the association of physical and nonphysical forms of child discipline with child development in a global context. The objective of this study is to examine whether physical punishment and nonphysical discipline are associated with child socioemotional functioning in a global sample of families from 62 countries and whether country-level normativeness of physical punishment and nonphysical discipline moderated those associations.

Methods:

Data for this study are from 215,885 families in the fourth and fifth rounds of the United Nations Children’s Fund Multiple Indicator Cluster Surveys. Bayesian multilevel logistic models were used to analyze the associations of physical punishment and nonphysical discipline (i.e., taking away privileges and verbal reasoning) with three different outcomes representing children’s socioemotional functioning: getting along well with other children, aggression, and becoming distracted.

Results:

The use of physical punishment was not associated with getting along with other children, was associated with increased aggression, and was associated with increases in distraction. Taking away privileges was associated with lower levels of getting along with other children, higher levels of aggression, and higher levels of becoming distracted. Verbal reasoning (i.e., explaining why a behavior was wrong) was associated with higher levels of getting along with other children, higher levels of aggression, and higher levels of becoming distracted. Country-level normativeness moderated some of these associations but in general the direction of effects was consistent.

Conclusions:

Results suggest that eliminating physical punishment would benefit children across the globe and align with the United Nations Convention on the Rights of the Child, which calls for all children to be free from physical violence. More attention needs to be focused on the associations of nonphysical forms of discipline with child functioning across the globe.
Love in Cyberspace: Self Presentation and Partner Seeking in Online Dating Advertisements of Older Adults
Authors: Watson Wendy , Stelle Charlie
Published: January 2021

This qualitative content analysis of a systematically selected sample of 200 heterosexual adults aged 60+ years examined older adults’ self-presentation in online dating ads and what they sought in a partner. Online dating ads were examined from one site for adults of all ages ( match.com ) and a site specifically geared to older adults (ourtime.com). Results showed that aspects of self that are presented for men and women, although in different order of importance, included one’s status, enjoying leisure activities and being fun-loving, kind/compassionate, and being friend and family focused. Men and women were interested in a companion and someone fun-loving and kind/compassionate. Additionally, women sought a partner who was honest and would do leisure activities with them. Men sought women who were physically attractive and would provide emotional support. The discussion focuses on gender differences and how the act of self-presentation is central in the narratives of dating ads for older adults.
Opportunities and Constraints of the Partner Market and Educational Assortative Mating
Authors: Stauder Johannes , Kossow Tom
Published: January 2021

This study aims to determine to what extent the opportunities and restrictions of the partner market influence educational assortative mating. It also analyzes the interplay between the opportunity structure and preferences. Matching district-based partner market indicators to heterosexual couples when they move in together based on the German Socio-Economic Panel, we find strong effects of the opportunity structure on educational homogamy. The results further imply that the density of the supply of potential partners is more important for educational assortative mating than imbalanced supply and competition. While the impact of partner market imbalances on assortative mating is a mere effect of the opportunity structure, the effects of the partner market density of relevant and available partners in space weakly imply that homophile and maximization preferences are simultaneously at work.
Educating Homecare Nurses about Deprescribing of Medications to Manage Polypharmacy for Older Adults
Authors: Sun Winnie , Tahsin Farah , Abbass Dick Jennifer , Barakat Caroline , Turner Justin , Wilson Dale , Reid-Haughian Cheryl , Ashtarieh Bahar
Published: January 2021

The purpose of this study is to evaluate the acceptability, appropriateness, and effectiveness of educational intervention with homecare nurses about deprescribing of medications among older adults. An evaluation research study was conducted using survey design to evaluate deprescribing education with a total sample of 45 homecare nurses from three homecare organizations. Post-training evaluation data were evaluated using Likert scale and open-ended questions were analyzed using descriptive statistical analyses and qualitative thematic analysis. Post-intervention questionnaire responses provided descriptions about homecare nurses’ perspectives related to deprescribing education, as well as the effectiveness of training in addressing their knowledge gaps. The pilot-testing of deprescribing learning modules and educational training revealed acceptability and suitability for future scale-up to expand its future reach and adoption by other homecare organizations. This study provided important implications into the barriers that impact the effectiveness of deprescribing education, and facilitators that support the future refinement of learning modules.
Bitter Taste Receptors and Chronic Otitis Media
Authors: Kaufman Adam C. , Colquitt Lauren , Ruckenstein Michael J. , Bigelow Douglas C. , Eliades Steven J. , Xiong Guoxiang , Lin Cailu , Reed Danielle R. , Cohen Noam A.
Published: January 2021

Objective

To evaluate the presence of bitter taste receptors (T2Rs) in the middle ear and to examine their relationship with chronic ear infections.

Study Design

Cross‐sectional study.

Setting

Tertiary care hospital.

Methods

This study enrolled 84 patients being evaluated for otologic surgery: 40 for chronic otitis media (COM) and 44 for other surgical procedures (controls). We collected a small piece of mucosa from 14 patients for mRNA analysis and from 23 patients for immunohistochemistry. A total of 55 patients underwent a double‐blind taste test to gauge sensitivity to phenylthiocarbamide, denatonium, quinine, sucrose, and sodium chloride; 47 patients gave a salivary sample for single‐nucleotide polymorphism analysis of rs1376251 (TAS2R50) and rs1726866 (TAS2R38).

Results

Bitter taste receptors were found in all samples, but the repertoire varied among patients. T2R50 was the most consistently identified receptor by mRNA analysis. Its rs1376251 allele was related to susceptibility to COM but not the expression pattern of T2R50. Ratings of bitterness intensity of phenylthiocarbamide, a ligand for T2R38, differed significantly between the COM and control groups.

Conclusion

T2Rs were found within the middle ear of every patient sampled; the rs1376251 allele of TAS2R50 appears to be related to chronic ear infections. These receptors are an intriguing target for future research and possible drug targeting.
Status of cardiovascular surgery in Japan between 2017 and 2018: A report based on the Japan Cardiovascular Surgery Database. 3. Valvular heart surgery
Authors: Abe Tomonobu , Kumamaru Hiraku , Nakano Kiyoharu , Motomura Noboru , Miyata Hiroaki , Takamoto Shinichi
Published: January 2021

Objectives

We aimed to present data regarding the current status and trends of valvular heart surgeries in Japan from the Japan Cardiovascular Surgery Database for the 2017–2018.

Methods

We extracted data on cardiac valve surgeries performed in 2017 and 2018 from the Japan Cardiovascular Surgery Database. We determined the trend in the number of aortic valve replacement procedures from 2013 to 2018. The operative mortality rates were calculated for representative valve procedures stratified by age group. Data regarding minimally invasive procedures and transcatheter aortic valve replacement in the Japan Cardiovascular Surgery Database are also presented.

Results

In conjunction with the dramatic increase in the number of transcatheter aortic valve replacements in 2017 and 2018, surgical aortic valve replacement also increased from 26,054 to 28,202. The operative mortality rate in first-time valve procedures was 1.8% in isolated aortic valve replacement, 0.9% in isolated mitral valve repair, and 8.2% and 4.6% in mitral valve replacement with biological prostheses and with mechanical prostheses, respectively. Regarding minimally invasive procedures, 30.8% of first-time isolated mitral valve plasty procedures were performed by a right thoracotomy. Although patients who underwent surgery by a right thoracotomy had better clinical outcomes, it was also apparent that patients who underwent surgery by a right thoracotomy had lower operative risk profiles. The overall mortality rates after transcatheter aortic valve replacement and surgical aortic valve replacement were 1.5% and 1.8%, respectively.

Conclusion

We have reported benchmark data on heart valve surgery in 2017 and 2018 from the Japan Cardiovascular Surgery Database.
Status of cardiovascular surgery in Japan between 2017 and 2018: A report based on the Cardiovascular Surgery Database. 2. Isolated coronary artery bypass surgery
Authors: Saito Aya , Kumamaru Hiraku , Motomura Noboru , Miyata Hiroaki , Takamoto Shinichi
Published: January 2021

Background

Clinical outcomes (as national clinical data) of isolated coronary artery bypass grafting have been successively reported, based on data registered in the Japan Cardiovascular Surgery Database, since 2013. In this study, we analysed the clinical results of isolated coronary artery bypass from 2017 to 2018 as a biannual report.

Methods

Data from the Japan Cardiovascular Surgery Database on isolated coronary artery bypass performed in 2017 and 2018 were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery.

Results

Isolated off-pump coronary artery bypass was performed in 54.6% ( n = 14,684) of all coronary artery bypass cases ( n = 26,913), and graft material for the left anterior descending artery was the left internal thoracic artery in 76.4% of cases and the right internal thoracic artery in 19.0% of cases. Operative mortality was 1.5% in elective cases (on-pump coronary artery bypass 1.9% and off-pump 1.2%, p < 0.001), 7.4% in emergency cases (on-pump 10.2% and off-pump 4.3%, p < 0.001), and 2.5% overall. Postoperative morbidity was generally lower in off-pump coronary artery bypass. The severity of surgery with expected mortality, evaluated using JapanSCORE II, is increasing every year.

Conclusions

Our findings suggest that short-term operative results for isolated coronary artery bypass are stable, and operative candidates are shifting to higher-risk patients.
‘Ethical’ artificial intelligence in the welfare state: Discourse and discrepancy in Australian social services
Authors: James Alexandra , Whelan Andrew
Published: January 2021

In recent years, a discourse of ‘ethical artificial intelligence’ has emerged and gained international traction in response to widely publicised AI failures. In Australia, the discourse around ethical AI does not accord with the reality of AI deployment in the public sector. Drawing on institutional ethnographic approaches, this paper describes the misalignments between how technology is described in government documentation, and how it is deployed in social service delivery. We argue that the propagation of ethical principles legitimates established new public management strategies, and pre-empts questions regarding the efficacy of AI development; instead positioning implementation as inevitable and, provided an ethical framework is adopted, laudable. The ethical AI discourse acknowledges, and ostensibly seeks to move past, widely reported administrative failures involving new technologies. In actuality, this discourse works to make AI implementation a reality, ethical or not.
Referral patterns for catheter-directed thrombolysis for iliofemoral deep venous thrombosis
Authors: Patel Kirtan D , Tang Alison YY , Zala Ashik DJ , Patel Rakesh , Parmar Kishan R , Das Saroj
Published: January 2021

Objectives

Post thrombotic syndrome (PTS) is a serious complication of deep venous thromboses (DVTs). PTS occurs more frequently and severely following iliofemoral DVT compared to distal DVTs. Catheter directed thrombolysis (CDT) of iliofemoral DVTs may reduce PTS incidence and severity. We aimed to determine the rate of iliofemoral DVT within our institution, their subsequent management, and compliance with NICE guidelines.

Methods

Retrospective review of all DVTs diagnosed over a 3-year period was conducted. Cases of iliofemoral DVT were identified using ICD-10 codes from patient notes, and radiology reports of Duplex scans. Further details were retrieved, such as patient demographics and referrals to vascular services. NICE guidance was applied to determine if patients would have been suitable for CDT. A survey was sent to clinicians within medicine to identify awareness of CDT and local guidelines for iliofemoral DVT management.

Results

225 patients with lower limb DVTs were identified. Of these, 96 were radiographically confirmed as iliofemoral DVTs. The median age was 77. 67.7% of iliofemoral DVTs affected the left leg. Right leg DVTs made up 30.2% and 2.1% were bilateral DVTs. Of the 96 iliofemoral DVTs, 21 were deemed eligible for CDT. Only 3 patients (14.3%) were referred to vascular services, and 3 received thrombolysis. From our survey, 95.5% of respondents suggested anticoagulation alone as management for iliofemoral DVT. Only one respondent recommended referral to vascular services. There was a knowledge deficiency regarding venous anatomy, including superficial versus deep veins.

Conclusions

CDT and other mechanochemical procedures have been shown to improve outcomes of patients post-iliofemoral DVT, however a lack of awareness regarding CDT as a management option results in under-referral to vascular services. We suggest closer relations between vascular services and their “tributary” DVT clinics, development of guidelines and robust care pathways in the management of iliofemoral DVT.
‘Cold bedrooms’ and other cooling facilities in UK children’s hospices, how they are used and why they are offered: A mixed methods study
Authors: Hackett Julia , Beresford Bryony
Published: January 2021

Background:

The death of a child is acutely distressing. Evidence on the benefits and value to parents of spending time with their dead child have now been integrated into routine practice and is regarded as a bereavement support intervention. UK children’s hospices have a tradition of using ‘cooling facilities’ (cold bedrooms, cooled blanket/mattress) to extend this period of time by slowing deterioration of the body.

Aims:

To describe: (1) type and use of cooling facilities in UK children’s hospices, policies and practices regarding their use, and any changes over time. (2) Director of care’s views on the purpose of cooling facilities and the rationale for hospice-specific practices.

Methods:

An explanatory mixed-methods design consisting two phases: a crosssectional survey of directors of care of UK children’s hospices ( n = 52) followed by semi-structured telephone interviews with a sub-sample of respondents. Survey data were analysed using descriptive statistics and interview data using directed content analysis.

Results:

41/52 hospices completed the survey and 13 directors of care were interviewed. All hospices had cooling facilities. Some offered use of portable cooling facilities at home, though take-up appears low. Hospices differed in approaches to managing care and duration of use. Views on whether parents should observe deterioration informed the latter. Directors of care believed they provide families with time to say ‘goodbye’ and process their loss. Challenges for staff were reported.
Timely identification of patients in need of palliative care using the Double Surprise Question: A prospective study on outpatients with cancer
Authors: Ermers Daisy JM , Kuip Evelien JM , Veldhoven CMM , Schers Henk J , Perry Marieke , Bronkhorst Ewald M , Vissers Kris CP , Engels Yvonne
Published: January 2021

Background:

The Surprise Question (“ Would I be surprised if this patient were to die within the next 12  months?”) is widely used to identify palliative patients, though with low predictive value. To improve timely identification of palliative care needs, we propose an additional Surprise Question (“ Would I be surprised if this patient is still alive after 12  months?”) if the original Surprise Question is answered with “no.” The combination of the two questions is called the Double Surprise Question.

Aim:

To examine the prognostic accuracy of the Double Surprise Question in outpatients with cancer.

Design:

A prospective study.

Participants:

Twelve medical oncologists completed the Double Surprise Question for 379 patients.

Results:

In group 1 (original Surprise Question “yes”: surprised if dead) 92.1% (176/191) of the patients were still alive after 1 year, in group 2a (original and additional Surprise Question “no”: not surprised if dead and not surprised if alive) 60.0% (63/105), and in group 2b (original Surprise Question “no,” additional Surprise Question “yes”: surprised if alive) 26.5% (22/83) ( p < 0.0001). The positive predictive value increased by using the Double Surprise Question; 74% (61/83) vs 55% (103/188). Anticipatory palliative care provision and Advance Care Planning items were most often documented in group 2b.

Conclusions:

The Double Surprise Question is a promising tool to more accurately identify outpatients with cancer at risk of dying within 1 year, and therefore, those in need of palliative care. Studies should reveal whether the implementation of the Double Surprise Question leads to more timely palliative care.
Role of perivascular and meningeal macrophages in outcome following experimental subarachnoid hemorrhage
Authors: Wan Hoyee , Brathwaite Shakira , Ai Jinglu , Hynynen Kullervo , Macdonald R Loch
Published: January 2021

The distribution and clearance of erythrocytes after subarachnoid hemorrhage (SAH) is poorly understood. We aimed to characterize the distribution of erythrocytes after SAH and the cells involved in their clearance. To visualize erythrocyte distribution, we injected fluorescently-labelled erythrocytes into the prechiasmatic cistern of mice. 10 minutes after injection, we found labelled erythrocytes in the subarachnoid space and ventricular system, and also in the perivascular spaces surrounding large penetrating arterioles. 2 and 5 days after SAH, fluorescence was confined within leptomeningeal and perivascular cells. We identified the perivascular cells as perivascular macrophages based on their morphology, location, Iba-1 immunoreactivity and preferential uptake of FITC-dextran. We subsequently depleted meningeal and perivascular macrophages 2 days before or 3 hours after SAH with clodronate liposomes. At day 5 after SAH, we found increased blood deposition in mice treated prior to SAH, but not those treated after. Treatment post-SAH improved neurological scoring, reduced neuronal cell death and perivascular inflammation, whereas pre-treatment only reduced perivascular inflammation. Our data indicate that after SAH, erythrocytes are distributed throughout the subarachnoid space extending into the perivascular spaces of parenchymal arterioles. Furthermore, meningeal and perivascular macrophages are involved in erythrocyte uptake and play an important role in outcome after SAH.
Normative distribution of posterior circulation tissue time-to-maximum: Effects of anatomic variation, tracer kinetics, and implications for patient selection in posterior circulation ischemic stroke
Authors: Goldman-Yassen Adam E , Straka Matus , Uhouse Michael , Dehkharghani Seena
Published: January 2021

The generalization of perfusion-based, anterior circulation large vessel occlusion selection criteria to posterior circulation stroke is not straightforward due to physiologic delay, which we posit produces physiologic prolongation of the posterior circulation perfusion time-to-maximum (Tmax). To assess normative Tmax distributions, patients undergoing CTA/CTP for suspected ischemic stroke between 1/2018-3/2019 were retrospectively identified. Subjects with any cerebrovascular stenoses, or with follow-up MRI or final clinical diagnosis of stroke were excluded. Posterior circulation anatomic variations were identified. CTP were processed in RAPID and segmented in a custom pipeline permitting manually-enforced arterial input function (AIF) and perfusion estimations constrained to pre-specified vascular territories. Seventy-one subjects (mean 64 ± 19 years) met inclusion. Median Tmax was significantly greater in the cerebellar hemispheres (right: 3.0 s, left: 2.9 s) and PCA territories (right: 2.9 s; left: 3.3 s) than in the anterior circulation (right: 2.4 s; left: 2.3 s, p < 0.001). Fetal PCA disposition eliminated ipsilateral PCA Tmax delays (p = 0.012). Median territorial Tmax was significantly lower with basilar versus any anterior circulation AIF for all vascular territories (p < 0.001). Significant baseline delays in posterior circulation Tmax are observed even without steno-occlusive disease and vary with anatomic variation and AIF selection. The potential for overestimation of at-risk volumes in the posterior circulation merits caution in future trials.
β2 glycoprotein I participates in phagocytosis of apoptotic neurons and in vascular injury in experimental brain stroke
Authors: Grossi Claudia , Artusi Carolina , Meroni PierLuigi , Borghi Maria Orietta , Neglia Laura , Lonati Paola Adele , Oggioni Marco , Tedesco Francesco , De Simoni Maria-Grazia , Fumagalli Stefano
Published: January 2021

Beta-2 Glycoprotein I (β2-GPI) is the main target of anti-phospholipid antibodies (aPL) in the autoimmune anti-phospholipid syndrome, characterized by increased risk of stroke. We here investigated the antibody independent role of β2-GPI after ischemia/reperfusion, modeled in vivo by transient middle cerebral artery occlusion (tMCAo) in male C57Bl/6J mice; in vitro by subjecting immortalized human brain microvascular endothelial cells (ihBMEC) to 16 h hypoxia and 4 h re-oxygenation. ApoH (coding for β2-GPI) was upregulated selectively in the liver at 48 h after tMCAo. At the same time β2-GPI circulating levels increased. β2-GPI was detectable in brain parenchyma and endothelium at all time points after tMCAo. Parenchymal β2-GPI recognized apoptotic neurons (positive for annexin V, C3 and TUNEL) cleared by CD68+ brain macrophages. Hypoxic ihBMEC showed increased release of IL-6, over-expression of thrombomodulin and IL-1α after re-oxygenation with β2-GPI alone. β2-GPI interacted with mannose-binding lectin in mouse plasma and ihBMEC medium, potentially involved in formation of thrombi. We show for the first time that brain ischemia triggers the hepatic production of β2-GPI. β2-GPI is present in the ischemic endothelium, enhancing vascular inflammation, and extravasates binding stressed neurons before their clearance by phagocytosis. Thus β2-GPI may be a new mediator of brain injury following ischemic stroke.
Spiritual Well-Being and Purpose in Life Among Conscripts: A Case Study in Iran
Authors: Torkaman Mahya , Farokhzadian Jamileh , Fadaei Mohammad Hosein
Published: January 2021

Background: Spiritual Well-Being (SWB) is an important aspect of health. Since soldiers, as members of community, are faced with numerous spiritual, psychological, and physical problems, belief in spirituality can play an important role in explaining their purpose in life (PIL). Therefore, this study aimed to evaluate SWB, PIL, and the relationship between these two concepts in conscripts. In this cross-sectional study, 301 soldiers were selected by available sampling method from one of the military barracks in Iran 2019. Data were collected using the demographic, SWB, and PIL questionnaires. The results showed that SWB of the soldiers were at the high level (100.6 ± 12.30) and their PIL were at the moderate level (112.92 ± 13.70). Furthermore, a direct and intermediate relationship was observed between the soldiers' SWB and PIL (P <0.001, r = 0.50). Based on the findings, increased SWB enhanced PIL in soldiers and vice versa. To increase generalizability of the data, studies over a larger statistical population are recommended in different cultures. Findings of this study can also identify the interventional strategies to increase the soldiers' purpose in life.
Are Discount Rates Too High? Population Health and Intergenerational Equity
Authors: Braithwaite R. Scott , Roberts Mark S.
Published: January 2021

Increasing attention is being paid to policy decisions in which shorter-term benefits may be eclipsed by longer-term harms, such as environmental damage. Health policy decisions have largely been spared this scrutiny, even though they too may contribute to longer-term harms. Any healthy population or society must sustain itself through reproduction, and therefore, transgenerational outcomes should be of intrinsic importance from a societal perspective. Yet, the discount rates typically employed in cost-effectiveness analyses have the effect of minimizing the importance of transgenerational health outcomes. We argue that, because cost-effectiveness analysis is based on foundational axioms of decision theory, it should value transgenerational outcomes consistently with those axioms, which require discount rates substantially lower than 3%. We discuss why such lower rates may not violate the Cretin-Keeler paradox.