bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive Assessment of Mobile Service Privacy Security Based on FAHP and D–S Theory
Authors: Yang Ming , Gao Tilei , Jiang Rong , Jia Li , Yang Di
Published: February 2022

As an indispensable medium for people’s daily life and communication, mobile applications provide users with a variety of services. In order to enjoy these services, users inevitably need to provide personal privacy information or authorization to application providers in the process of use. In the case of insufficient privacy security evaluation, even if users use the applications verified by the application market, their privacy security will be threatened because of their weak awareness of privacy protection. Therefore, in order to ensure the privacy security of users, this paper establishes a mobile service assessment attribute model including 3 risk categories and 11 risk indicators. Based on this model, this paper proposes a service risk weight assessment method based on FAHP (fuzzy analytical hierarchy process), defines the risk level and its trust degree from two aspects of risk frequency and risk loss, and puts forward a reasonable fusion method for different assessment results of risk level based on D–S (Dempster–Shafer) theory, so as to realize the multidimensional and multilayer assessment of mobile service risk. Finally, the case analysis shows that the method proposed in this paper is reasonable and feasible and has important value for improving the security of mobile services and managing users’ privacy information.
Impacts of Addition of Palm Kernel Shells Content on Mechanical Properties of Compacted Shale Used as an Alternative Landfill Liners
Authors: Amagu Clement A. , Enya Beatrice O. , Kodama Jun-ichi , Sharifzadeh Mostafa
Published: February 2022

The design of landfill liners of waste disposal to reduce migration of leachate containment, low swelling, and shrinkage and ensure sufficient shear strength to resist bearing capacity and instability of the landfill has been a major challenging task to landfill engineers. Over the last decade, there has been an increase in research on the stability of substitute materials as liners that are environmentally friendly, cost‐effective, and socially beneficial due to the growing cost of traditional landfill liners. In this regard, geotechnical tests were conducted on shale samples treated with 0–12% (increment of 2%) of palm kernel shell ash (PKSA) and pulverized palm kernel shell (PPKS) to evaluate their suitability as alternative landfill liners using West African Standard (WAS) and Modified AASHTO Standard (MAS) for compactive energy. The shale has more percentage of finer fractions, thus classified as poorly graded soil (A‐7‐5). The Atterberg limit tests show that liquid and plastic limits decrease with an increase in plasticity index as the percentage of addition of PKSA and PPKS content increases. The results also established that the maximum dry density (MDD), volumetric shrinkage strain (VSS), and hydraulic conductivity significantly decrease, while the optimum moisture content (OMC) increases as the content of PKSA and PPKS increases at both compactive efforts. The maximum strengths of 380.30 and 448.70 kPa were obtained at 4% of both stabilizers. From the results, it can therefore be concluded that the treated compacted shale meets the condition of the suitability of landfill liners. Furthermore, with the use of industrial and agricultural wastes such as palm kernel shells as replacement materials with natural soils used as liners, significant social, economic, and environmental impact of landfills and reduction in wastes can be achieved. The research results can provide a reference for similar conditions of landfill liners worldwide.
Indication of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer (Gastripec, Gastrichip)
Authors: Rau Beate , Feldbrügge Linda , Gronau Felix , Alberto Vilchez Miguel Enrique , Thuss-Patience Peter , Bonnot Pierre Emmanuel , Glehen Olivier
Published: February 2022

Background: Gastric cancer (GC) is associated with a poor prognosis mostly due to peritoneal metastasis, which will develop in time during the patient’s disease history. To prevent and treat peritoneal metastasis, different kinds of treatment regimens have been described. Summary: In this review, we addressed two main topics – prophylaxis and treatment of peritoneal metastasis in GC. Prevention should be directed towards diminishing cancer cell spillage and reducing adherence of cancer cells to the abdominal cavity. Postoperative washing of the abdomen with or without chemotherapy and additional heat are herein discussed. Key Messages: Treatment of existing peritoneal metastasis is effective in patients with limited disease and tumour spread. Cytoreductive surgery including resection of peritoneal metastasis followed directly with hyperthermic intraperitoneal chemotherapy can increase overall survival and progression-free survival in selected patients. Drugs, duration and time schedules of intraperitoneal chemotherapy are reviewed and presented. Intraperitoneal chemotherapy seems to improve the prognosis of patients with GC and peritoneal metastasis after complete resection of both primary and metastatic tumours.
Unconscious Influences on “Free Will” Movement Initiation: Slow-wave Brain Stimulation and the Readiness Potential
Authors: Armstrong Samuel , Bland Nicholas S. , Sale Martin V. , Cunnington Ross
Published: February 2022

A central objective in the study of volition has been to identify how changes in neural activity relate to voluntary—“free will”—movement. The readiness potential (RP) is observed in the EEG as a slow-building signal that precedes action onset. Many consider the RP as a marker of an underlying preparatory process for initiating voluntary movement. However, the RP may emerge from ongoing slow-wave brain oscillations that influence the timing of movement initiation in a phase-dependent manner. Transcranial alternating current stimulation (tACS) enables brain oscillations to be entrained at the frequency of stimulation. We delivered tACS at a slow-wave frequency over frontocentral motor areas while participants (n = 30) performed a simple, self-paced button press task. During the active tACS condition, participants showed a tendency to initiate actions in the phase of the tACS cycle that corresponded to increased negative potentials across the frontocentral motor region. Comparisons of premovement EEG activity observed over frontocentral and central scalp electrodes showed earlier onset and increased amplitude of RPs from active stimulation compared with sham stimulation. This suggests that movement-related activity in the brain can be modulated by the delivery of weak, nonconsciously perceptible alternating currents over frontocentral motor regions. We present novel findings that support existing theories, which suggest the timing of voluntary movement is influenced by the phase of slow-changing oscillating brain states.
Milliet Dechales as Historian of Mathematics
Authors: Malet Antoni
Published: February 2022

The Jesuit C.F. Milliet Dechales (1621–1678), author of one of the most famous early modern mathematical encyclopedias, Cursus seu mundus mathematicus (1674), wrote a hundred-folio-page long treatise devoted to the “progress of mathematics,” which was published in the second, enlarged edition of his encyclopedia (1690). His historical treatise covers the gamut of mixed mathematics—including astronomy, mechanics, optics, music, geography and navigation, ars tignaria (art of timber-framing), and architecture. The early modern historical narratives about the mathematical sciences, from Regiomontanus’s Oratio (1464) onwards, have been aptly characterized by their literary form and goals rather than their historical content. Rhetoric, humanistic topoi, and philosophical filiation turned the histories of mathematics into powerful tools for different purposes. My account of Dechales’ tract on the “progress of mathematics” analyzes the ways in which it dovetails with Jesuit approaches to mathematics, provides legitimation to the mathematical sciences as well as to their authors, and contributes to define the role and boundaries of the discipline, in particular vis-à-vis natural philosophy.
Self-Consciousness without an “I”: A Critique of Zahavi’s Account of the Minimal Self
Authors: Alweiss Lilian
Published: February 2022

This paper takes Zahavi’s view to task that every conscious experience involves a “minimal sense of self.” Zahavi bases his claim on the observation that experience, even on the pre-reflective level, is not only about the object, but also has a distinctive qualitative aspect which is indicative of the fact that it is for me. It has the quality of what he calls “for-meness” or “mineness.” Against this I argue that there are not two phenomena but only one. On the pre-reflective level, experience is transparent. Conscious experience may well be reflexive (insofar as it is relation to me) but this does not imply that I additionally have a sense of what it is like for me to have that experience.

I do not just happen to disagree with Zahavi’s account of pre-reflective experience but, more importantly, I am concerned that he imposes it onto his interpretation of Edmund Husserl. Zahavi claims that when Husserl argues that consciousness is necessarily a form of self-consciousness, he must be committed to the view that we necessarily have a sense of ownership. However, Husserl only claims that I am self-conscious but not that I am a self that owns its consciousness. Zahavi thus misses the novelty of Husserl’s position, namely that I do not need to have a sense of abiding ownership, to have experience.
Bringing the New World Home: Moravian Gemeintag Meetings and Protestant Pastoral Authority, 1738–1746
Authors: Pietrenka Benjamin M.
Published: February 2022

This essay offers the first comparative examination of the German Moravian Gemeintag and British evangelical “Letter Day” meetings in the mid-eighteenth century. Gemeintag meetings established a new, experimental approach to pastoral leadership at gatherings for religious devotion and prayer by endowing the lived spiritual experiences of believers with edificatory and didactic authority. The experiences and testimonies of believers read aloud at epistolary prayer meetings utilized this novel symbolic authority to the most significant effect by supplying material examples of, rather than biblical aphorisms or clerical pronouncements about, God’s favor. Comparative structural analyses and close readings of the epistolary content reveal how believers in distant mission fields temporarily operated as authorized mediators of the Gospel message. The Gemeintag and its British evangelical offspring, thus, made valuable contributions to the blurring of increasingly fluid ecclesiastical and pastoral boundaries wrought by the pluralization of Protestantism in the early modern period.
Word Embeddings Reveal How Fundamental Sentiments Structure Natural Language
Authors: van Loon Austin , Freese Jeremy
Published: February 2022

Central to affect control theory are culturally shared meanings of concepts. That these sentiments overlap among members of a culture presumably reflects their roots in the language use that members observe. Yet, the degree to which the affective meaning of a concept is encoded in the way linguistic representations of that concept are used in everyday symbolic exchange has yet to be demonstrated. The question has methodological as well as theoretical significance for affect control theory, as language may provide an unobtrusive, behavioral method of obtaining EPA ratings complementary to those heretofore obtained via questionnaires. We pursue a series of studies that evaluate whether tools from machine learning and computational linguistics can capture the fundamental affective meaning of concepts from large text corpora. We develop an algorithm that uses word embeddings to predict EPA profiles available from a recent EPA dictionary derived from traditional questionnaires, as well as novel concepts collected using an open-source web app we have developed. Across both a held-out portion of the available data as well as the novel data, our best predictions correlate with survey-based measures of the E, P, and A ratings of concepts at a magnitude greater than 0.85, 0.8, and 0.75 respectively.
Societal Emphasis on Religious Faith as a Cultural Context for Shaping the Social-Psychological Relationships Between Personal Religiosity and Well-Being
Authors: Li Liman Man Wai , Lou Xiaobin , Bond Michael Harris
Published: February 2022

How does a society’s religious context affect the relationships between personal religiosity and well-being? To explore this question, we used two measures of personal religiosity, the absolute importance of religion, and the importance of religion relative to the importance of six life domains, viz., family, friends, work, politics, leisure, and religion. To test the generalizability of relationships between these two measures of personal religiosity and well-being, we tested them across representative samples of 66,992 persons from 47 societies varying in their emphasis on socializing children for religious faith. Pan-societally, personal religiosity predicted many of the five well-being measures including satisfaction with life, happiness, subjective health, trust of strangers, and trust of known others, but in opposite directions depending on whether the absolute or the relative importance of personal religiosity was used. Controlling for wealth, a societal emphasis on socializing children for religious faith moderated the links of personal religiosity with happiness, trust of strangers, and trust of known others, but most evidence revealed that a societal emphasis on religious faith attenuated the strength of these linkages. We argue that measuring an individual’s religiosity in the context of their daily living yields a more realistic view of religion’s role in personal life and social living and suggest that there are both personal and social costs for investing strongly in religion relative to other domains of daily life. Societal religious context must also be assessed to provide a more nuanced understanding of personal religiosity and its associated correlates.
Language-based Opacity Verification and Enforcement in the Framework of Labeled Petri Nets
Authors: Habbachi Salwa , Li Zhiwu , Wu Naiqi , Khalgui Mohamed
Published: February 2022

This work deals with the language-based opacity verification and enforcement problems in discrete event systems modeled with labeled Petri nets. Opacity is a security property that relates to privacy protection by hiding secret information of a system from an external observer called an “intruder”. A secret can be a subset of a system's language. In this case, opacity is referred to as language-based opacity. A system is said to be language-based opaque if an intruder, with a partial observation on the system's behavior, cannot deduce whether the sequences of events corresponding to the generated observations are included in the secret language or not. We propose a novel and efficient approach for language-based opacity verification and enforcement, using the concepts of basis markings and basis partition. First, a sufficient condition is formulated to check language-based opacity for labeled Petri nets by solving an integer-programming problem. A unique graph, called a modified basis reachability graph (MBRG), is then derived to verify different language-based opacity properties. The proposed method relaxes the acyclicity assumption of the unobservable transition subnet thanks to the basis partition notion. A new embedded insertion function technique is also provided to deal with opacity enforcement. This technique ensures that no new observed behavior is created. A verification algorithm is developed to check the enforceability of a system. Finally, once a system is proved to be enforceable, an algorithm is given to construct a new structure, called an insertion automaton, which synthesizes all possible insertion functions that ensure opacity.
TikTok and Attention-Deficit/Hyperactivity Disorder: A Cross-Sectional Study of Social Media Content Quality
Authors: Yeung Anthony , Ng Enoch , Abi-Jaoude Elia
Published: February 2022

Objectives

Social media platforms are increasingly being used to disseminate mental health information online. User-generated content about attention-deficit/hyperactivity disorder (ADHD) is one of the most popular health topics on the video-sharing social media platform TikTok. We sought to investigate the quality of TikTok videos about ADHD.

Method

The top 100 most popular videos about ADHD uploaded by TikTok video creators were classified as misleading, useful, or personal experience. Descriptive and quantitative characteristics of the videos were obtained. The Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) and Journal of American Medical Association (JAMA) benchmark criteria were used to assess the overall quality, understandability, and actionability of the videos.

Results

Of the 100 videos meeting inclusion criteria, 52% ( n = 52) were classified as misleading, 27% ( n = 27) as personal experience, and 21% ( n = 21) as useful. Classification agreement between clinician ratings was 86% (kappa statistic of 0.7766). Videos on the platform were highly understandable by viewers but had low actionability. Non-healthcare providers uploaded the majority of misleading videos. Healthcare providers uploaded higher quality and more useful videos, compared to non-healthcare providers.

Conclusions

Approximately half of the analyzed TikTok videos about ADHD were misleading. Clinicians should be aware of the widespread dissemination of health misinformation on social media platforms and its potential impact on clinical care.
Awareness and Perceptions of Palliative Care Among the Elderly: A Qualitative Study
Authors: Lei Lei , Lu Ya , Gan Quanxi , Hu Zongping , Luo Yu
Published: February 2022

Objectives: With the rapidly aging population worldwide, the demand for palliative care is increasing. Palliative care publicity and education must be further developed globally, especially for the elderly. It is essential to perform targeted promotion by understanding the awareness and needs of palliative care of the elderly. This study aimed to investigate elderly people's awareness of palliative care and their own views on and needs for palliative care, which could provide a basis for the popularization of palliative care among them. Methods: A total of 20 elderly people were recruited to participate in the semi-structured, and in-depth interviews. Participants were from communities and nursing homes in Chongqing, China. The interview transcripts were coded using the method of thematic analysis. Results: Finally, 4 themes and 10 subthemes were identified, that is: unawareness of the concept of palliative care (never heard of palliative care, confusion between euthanasia and palliative care), motivations for accepting palliative care (personal perspective: less suffering; family perspective: relieving the burden), factors influencing palliative care decision (cost of palliative care, knowledge of palliative care, opinion of decision-making agents), and necessity and preferences for publicizing palliative care (eagerness to know more about palliative care, focusing on policy and charges, preference for Electronic Media Advertising). Conclusions: Palliative care publicity among the elderly is important and necessary. Findings in this study could provide some insights into how to popularize palliative care among the elderly. Considering the preference of the elderly for access to palliative care information, simultaneous publicity through TV and online channels is suggested. Since the elderly would like to choose their doctors and adult children as decision-making agents, more communication between community, health professionals and family is advocated.
Collaborative Approaches to Promote Family Caregiving for Thai-Muslim Older Adults
Authors: Perngmark Pajongsil , Waebuesa Nurma , Holroyd Eleanor
Published: February 2022

This action research study aimed to develop, implement and evaluate the feasibility of an Islamic-based intervention program that included three main Islamic tenets and concept of family collaboration to promote comprehensive homebound care for Thai-Muslim older adults in southern Thailand. Using action research cycles, interviews with five dyads of healthcare recipients (Thai-Muslim older adults and their family primary caregivers) and with seven Thai-Muslim healthcare professionals (five clinical nurses, a physician and a pharmacist) were undertaken alongside participant observations. Inadequate knowledge, insufficient skills, low family involvement, poor negotiation skills, and the need for better integration of Islamic doctrines were identified. Satisfaction was expressed with the program components and activities, with a qualitative audit data revealed that family primary caregivers felt that they had gained more self-confidence, increased their caregiving knowledge and improved their skills. All stakeholders expressed a desire to further engage and maintain this collaborative program. Engaging with Islamic doctrines and concepts of family collaboration support improvements in homebound care for Muslim older adults. Using on core values of Islamic moral belief systems provides an important and culturally sensitized framework for engaging healthcare providers and family members in the Muslim older adults’ comprehensive homebound care.
Human-centred risk-potential-based trajectory planning of autonomous vehicles
Authors: Wang Zezhong , Wei Chongfeng
Published: February 2022

Although autonomous vehicles (AV) have been rapidly developed, their control technology is not sufficiently mature for daily use, yet not human-centred enough. Some studies regarding trajectory planning are overly conservative and the vehicle avoids obstacles in an unhuman-like trajectory which causes discomfort to passengers; meanwhile, other studies are overly simplistic, the transport scenario, and vehicle trajectory are disregarded. The potential field (PF) algorithm is one of the most frequently used methods for the trajectory planning of AVs; however, most studies regarding the PF algorithm do not consider driving comfort and smoothness. This paper introduces optimised human-centred dynamic trajectory planning for AVs. The PF algorithm is implemented in a vehicle simulation model, which is integrated with model predictive control (MPC). The reference path is planned by PF algorithm and improved by MPC. The human-centred AV control is proposed in a simulation environment. The proposed planning method achieves a trade-off between safety, driving comfort, and driving smoothness and is validated with several driving simulation scenarios.
Arsenic trioxide-induced cardiotoxicity triggers ferroptosis in cardiomyoblast cells
Authors: Wang Linya , Liu Shuguang , Gao Chao , Chen Hui , Li Jing , Lu Jiran , Yuan Yuan , Zheng Xueling , He Hongbo , Zhang Xixi , Zhang Ruidong , Zhang Yuanyuan , Wu Ying , Lin Wei , Zheng Huyong
Published: February 2022

Arsenic trioxide (ATO) has been found to be effective in acute promyelocytic leukemia. However, ATO-induced severe cardiotoxicity limits its clinical application. To date, the mechanisms of ATO-induced cardiotoxicity remain unclear. It is hypothesized that ferroptosis may trigger ATO-induced cardiotoxicity; however, this has not yet been investigated. To clarify this hypothesis, rat cardiomyocyte H9c2 cells were treated with ATO with or without ferrostain-1 (Fer-1). The results indicated that ATO exposure induced H9c2 cell death and apoptosis, and the ferroptosis inhibitor Fer-1, administered for 24 h before ATO exposure, suppressed ATO-induced cell death, and apoptosis, as determined by Annexin V-APC/7-AAD apoptosis assay. Furthermore, Fer-1 displayed a cardioprotective effect through inhibiting the ATO-induced production of intracellular reactive oxygen species, improving the ATO-induced loss of the mitochondrial membrane potential, alleviating hyperactive endoplasmic reticulum stress, and alleviating the ATO-induced impairment in autophagy in H9c2 cells. Overall, the cardioprotective effect of Fer-1 against ATO-induced cell injury implies that ATO may trigger ferroptosis to induce cardiotoxicity. These findings lay the foundation for exploring the potential value of ferroptosis inhibitors against ATO-induced cardiotoxicity in the future.
Sexual harassment in the legal profession: An analysis of the current legislative framework
Authors: Moretti Alana
Published: February 2022

This article examines sexual harassment as it affects the legal profession, weighing up the efficacy of the legislative provisions in Australia in the Sex Discrimination Act 1984 (Cth) ( SDA). The article considers the recommendations for reform made by various reviews in recent years and the 2021 amendments to sexual harassment provisions. Following consideration of the alternate legislative drafting options and analysis of the approach taken in New Zealand, this article concludes that to address the systemic sexual harassment culture in the legal profession, change needs to go beyond the scope anticipated in current legislative amendments.
Deciding to Leave Care Is Not Dropout: The Emerging Adult Perspective
Authors: Green Shawna Marie , Boothroyd Roger A. , Armstrong Mary , Lubotsky Levin Bruce , Martinez Tyson Dinorah , Massey Oliver
Published: February 2022

Emerging adults discontinue behavioral health treatment at rates ranging from 30% to 50%. This study explored dropout using semi-structured interviews ( N = 20). Participants were engaged in a group therapy program, Healthy Transitions. Findings revealed the lack of therapeutic relationship and logistical issues such as cost, transportation, and conflicting work schedules contributed to dropout. Participants indicated that alleviating logistical barriers and feeling a connection to their peers and group leader prevented dropout. This program was free, transportation was provided, and sessions were in the evening. Participants expressed peer educators made them feel less judged and/or stigmatized than a one-on-one therapy appointment. These findings reinforce logistical issues and lack of a therapeutic relationship contribute to dropout and highlight the benefits of flexible scheduling and reinforce the importance of a therapeutic relationship in preventing dropout.
How Does Ethical Leadership Relate to Team Creativity? The Role of Collective Team Identification and Need for Cognitive Closure
Authors: Keem Sejin , Koseoglu Gamze , Jeong Inseong , Shalley Christina E.
Published: February 2022

We investigate how and when ethical leadership predicts team creativity. With its strong compliance with organizational norms and procedures, ethical leadership can be seen as antithetical to creativity. Similarly, collective need for cognitive closure can negatively impact creativity as this is a motivational tendency toward making quick decisions and avoiding open-ended processes. However, we argue that they both can have a positive effect on team creativity when collective team identification is considered as an underlying mechanism. Accordingly, we hypothesize that ethical leadership fosters team creativity via strengthening collective team identification, and collective need for cognitive closure positively moderates the indirect relationship between ethical leadership and team creativity via collective team identification. We studied 55 teams in a food-services organization in South Korea in a multi-wave and multi-source design and found support for our hypotheses.
A Novel Look at Peer Problems: Examining Predictors of Children’s Sociometric Ratings of Classmates With ADHD Symptoms
Authors: Mikami Amori Yee , Na Jennifer Jiwon , Ferrari Mario A. , Owens Julie Sarno
Published: February 2022

Research predominantly focuses on problematic behaviors in children with symptoms of attention-deficit/hyperactivity disorder (ADHD) to explain why they are disliked by their classroom peers. By contrast, the current study explores characteristics of peers that are associated with them disliking classmates with ADHD symptoms. To do so, we undertook a novel methodological approach using hierarchical linear modeling to examine the strength of the association between child characteristics, their sociometric ratings given to classmates, and the recipients’ ADHD symptom levels. Participants were 194 children (Grades K–4) in 12 classrooms. Using the sociometric method, children rated their liking versus disliking of each classmate. Children’s ADHD symptoms were reported by the teacher. Children’s self-reported stigma about ADHD, their own sociometric ratings received, and teacher ratings of children’s academic competence were collected. Results suggested that children who reported more stigma about ADHD, and who were more socially and academically competent, had a stronger negative association between the sociometric ratings they gave and the recipients’ ADHD symptoms (i.e., were more likely to dislike classmates with ADHD symptoms). These effects were strongest at the end of the academic year relative to the beginning of the year. Implications for interventions targeting the peer group are discussed.
Applying the CAPE framework to measure equity and inform policy in computer science education
Authors: Warner Jayce R , Fletcher Carol L , Martin Nicole D , Baker Stephanie N
Published: February 2022

The push to make computer science (CS) education available to all students has been closely followed by increased efforts to collect and report better data on where CS is offered, who is teaching CS, and which students have access to, enroll in, and ultimately benefit from learning CS. These efforts can be highly influential on the evolution of CS education policy, as education leaders and policymakers often rely heavily on data to make decisions. Because of this, it is critical that CS education researchers understand how to collect, analyze, and report data in ways that reflect reality without masking disparities between subpopulations. Similarly, it is important that CS education leaders and policymakers understand how to judiciously interpret the data and translate information into action to scale CS education in ways designed to eliminate inequities. To that end, this article expands on recent research regarding the use of data to assess and inform progress in scaling and broadening participation in CS education. We describe the CAPE framework for assessing equity with respect to the capacity for, access to, participation in, and experience of CS education and explicate how it can be applied to analyze and interpret data to inform policy decisions at multiple levels of educational systems. We provide examples using large, statewide datasets containing educational and demographic information for K-12 students and schools, thereby giving leaders and policymakers a roadmap to assess and address issues of equity in their own schools, districts, or states. We compare and contrast different approaches to measuring and reporting inequities and discuss how data can influence the future of CS education through its impact on policy.
The World Stroke Academy: A World Stroke Organization global pathway to improve knowledge in stroke care
Authors: Saposnik Gustavo , Galanos Laura Ceci , Guerrero Rodrigo , Casagrande Florencia , Adhamidhis Emili , Gao Meah Ming Yang , Grupper Maria Fredin , Arsovska Anita
Published: February 2022

Background

The World Stroke Academy (WSA) ( www.world-stroke-academy.org ) is the educational platform of the World Stroke Organization (WSO). It facilitates educational activities (e.g. webinars and eLearning modules) and supports the WSO mission by providing high-quality stroke education to healthcare professionals. It provides evidence-based educational materials in a variety of formats to meet the needs of the WSO membership.

Aim

This article introduces the WSA, its core activities, and outlines how to access the many educational resources it offers.

Results

The WSA offers high-quality peer reviewed stroke education material and uses outcome metrics to assess and improve the quality of medical training of healthcare professionals. This article also highlights the importance of identifying knowledge and knowledge-to-action gaps through the creation of special projects and initiatives. It describes three areas in which the WSA has carried out recent educational initiatives, namely: life after stroke, women in stroke, and stroke checklist/pre-printed stroke orders.

Conclusion

WSA material is freely available, and we would encourage the global stroke community to use, and contribute to, its resources.
Long-term effect of moxibustion on irritable bowel syndrome with diarrhea: a randomized clinical trial
Authors: Bao Chunhui , Wu Luyi , Shi Yin , Shi Zheng , Jin Xiaoming , Shen Jiacheng , Li Jing , Hu Zhihai , Chen Jianhua , Zeng Xiaoqing , Zhang Wei , Ma Zhe , Weng Zhijun , Li Jinmei , Liu Huirong , Wu Huangan
Published: February 2022

Background:

Moxibustion is increasingly used for treatment of irritable bowel syndrome (IBS). This study investigated the long-term effects of moxibustion for IBS with diarrhea (IBS-D).

Methods:

Patients with IBS-D were assigned to receive moxibustion or sham moxibustion (52 each, 3× per week, 6 weeks) and were followed up to 24 weeks. The acupoints were bilateral ST25 and ST36, body surface temperatures at acupoints were 43°C ± 1°C and 37°C ± 1°C for the moxibustion and sham groups, respectively. Primary outcome was changes in IBS Adequate Relief (IBS-AR) from baseline to 6 weeks. Secondary outcomes included the following: IBS symptom severity scale (IBS-SSS), Bristol stool form scale (BSS), IBS quality of life (IBS-QOL), and Hospital Anxiety and Depression Scale (HADS).

Results:

Based on an intention-to-treat analysis, the rate of IBS-AR in the moxibustion group was significantly higher than the sham group at 6 weeks (76.9% versus 42.3%; p < 0.001); the mean decrease of total IBS-BSS score in the moxibustion group was lower than that of the sham group (−116.9 versus −61.5; p < 0.001), both of which maintained throughout the follow-up period. Five specific domains of the IBS-SSS were lower in the moxibustion group than the sham, throughout ( p < 0.001). At week 6, the rate of reduction >50 points in IBS-SSS of the treatment group was significantly higher than that of the sham ( p < 0.001), which persisted throughout the follow-up period. Similar long-lasting improvements were observed in BSS, stool frequency, and stool urgency ( p < 0.001). Improvements of IBS-QOL and HADS were comparable between the groups.

Conclusions:

Moxibustion treatment benefits the long-term relief of symptoms in IBS-D patients.

Trial registration:

Clinical trials.gov (NCT02421627). Registered on 20 April 2015.
Shorter Intensive Care Unit Stay (12 Hours) Post Thrombolysis Is Safe and Reduces Length of Stay for Minor Stroke Patients
Authors: Cencer Samantha , Tubergen Tricia , Packard Laurel , Gritters Danielle , LaCroix Hattie , Frye Angela , Wills Nicole , Zachariah Joseph , Wees Nabil , Khan Nadeem , Min Jiangyong , Dejesus Michelle , Combs Jordan , Khan Muhib
Published: February 2022

The current standard of practice for patients with acute ischemic stroke treated with intravenous tissue-type plasminogen activator (tPA) requires critical monitoring for 24-hours post-treatment due to the risk of symptomatic intracranial hemorrhage (sICH). This is a costly and resource intensive practice. In this study, we evaluated the safety and efficacy of this standard 24-hour ICU monitoring period compared with a shorter 12-hour ICU monitoring period for minor stroke patients (NIHSS 0-5) treated with tPA only. Stroke mimics and those who underwent thrombectomy were excluded. The primary outcome was length of hospital stay. Secondary outcome measures included sICH, deep venous thrombosis (DVT), pulmonary embolism (PE), pneumonia, favorable discharge to home or acute rehabilitation, readmission within 30 days, and favorable functional outcome defined as modified Rankin scale (mRS) of 0-2 at 90 days. Of the 122 patients identified, 77 were in the 24-hour protocol and 45 were in 12-hour protocol. There was significant difference in length of hospital stay for the 24-hour ICU protocol (2.8 days) compared with the 12-hour ICU protocol (1.8 days) ( P < 0.001). Although not statistically significant, the 12-hour group had favorable rates of sICH, 30-day readmission rates, favorable discharge disposition and favorable functional outcome. Rates of DVT, PE and aspiration pneumonia were identical between the groups. Compared with 24-hour ICU monitoring, 12-hour ICU monitoring after thrombolysis for minor acute ischemic stroke was not associated with any increase in adverse outcomes. A randomized trial is needed to verify these findings.
Preoperative Risk Factors Affecting Outcome in Surgically Treated Pyogenic Spondylodiscitis
Authors: Ukon Yuichiro , Takenaka Shota , Makino Takahiro , Kashii Masafumi , Iwasaki Motoki , Sakai Yusuke , Inoue Takuya , Ishiguro Hiroyuki , Kaito Takashi
Published: February 2022

Study Design

Retrospective study

Objective

The primary aim of this study was to investigate the predictors of severe complications in patients following surgery for pyogenic spondylodiscitis (PS) using a surgeon-maintained database. The secondary aim was to investigate the predictors of early recovery.

Methods

We introduced a surgeon-maintained database of prospectively collected multicenter data that mainly focused on perioperative complications in 2012. Our surgeon-maintained database allows the retrospective collection of detailed data. We analyzed 143 patients who underwent surgery for PS from the 19,056 patients in the prospective surgeon-maintained database at 27 affiliated institutions between 2013 and 2017. Data relating to preoperative patient factors, infection factors, surgical factors, and pre- and postoperative blood tests was retrospectively collected. We performed multivariate regression analysis to evaluate the predictors of postoperative severe complications and early recovery in patients with PS.

Results

High updated Charlson comorbidity index (uCCI), chronic pulmonary disease, diabetes, Gram-negative bacteria, pyogenic osteoarthritis, high preoperative white blood cell count, and low preoperative platelet count were significantly associated with severe complications in patients undergoing surgery for PS. A high uCCI was the sole independent negative predictor on early recovery.

Conclusion

Careful perioperative management is necessary if surgery is performed on patients who are at a high risk of life-threatening events.
A viable option for immediate mobilisation: Primary total knee replacement with supplementary osteosynthesis for acute complex tibial plateau fracture in elderly
Authors: Asikin Muhamad Zharif , Hayyun Muhammad Fathi , Yusof Mohamad Fauzlie
Published: February 2022

The principle of periarticular fracture is well established. However, the gold standard in treating tibial plateau fracture remains controversial. Lack of adequate soft tissue and complexity of the fracture involved succumbs to poor postoperative outcomes and high complication rate for infection, implant failure and non-union. Furthermore, the treatment of the elderly complicates the decision. It is because time is an essence since decubitus complication is associated with prolonged immobilisation. In addition, other complication related to this fracture such as accelerated secondary osteoarthritis and pain leads to further immobilisation. Traditionally, secondary total knee replacement (TKR) is indicated for this type of fracture, while the initial aim is to achieve bone healing. However, its failure related complication, the detrimental challenge in addressing ligament balance, extensor mechanism scarring and patella mal-tracking, thus, it is not commonly practised. The author has successfully demonstrated the use of primary TKR with supplementary locking plate in a post-traumatic Schatzker V tibial plateau fracture in a 75-year-old gentleman to allow immediate weightbearing. Thus, removing the complication associated with immobilisation and exhibit the advantage of TKR in obtaining a painless functional knee. In successive follow-up shows a favourable outcome and improved functional knee outcome compared to the premorbid state.
A Constructivist Grounded Theory of Staff Experiences Relating to Early Mobilisation of Mechanically Ventilated Patients in Intensive Care
Authors: Clarissa Catherine , Salisbury Lisa , Rodgers Sheila , Kean Susanne
Published: February 2022

Early mobilisation of mechanically ventilated patients has been suggested to be effective in mitigating muscle weakness, yet it is not a common practice. Understanding staff experiences is crucial to gain insights into what might facilitate or hinder its implementation. In this constructivist grounded theory study, data from two Scottish intensive care units were collected to understand healthcare staff experiences relating to early mobilisation in mechanical ventilation. Data included observations of mobilisation activities, individual staff interviews and two focus groups with multidisciplinary staff. Managing Risks emerged as the core category and was theorised using the concept of risk. The middle-range theory developed in this study suggests that the process of early mobilisation starts by staff defining patient status and includes a process of negotiating patient safety, which in turn enables performing accountable mobilisation within the dynamic context of an intensive care unit setting.
Nurses’ Experiences of Caring for Long-Term Care Residents With Dementia During the COVID-19 Pandemic
Authors: Scerri Anthony , Borg Xuereb Christian , Scerri Charles
Published: February 2022

The COVID-19 pandemic has had a negative impact on older persons who reside in long-term care settings, especially residents living with dementia. The physical and psychological burden of the current pandemic has also been felt by frontline caring staff including nurses caring for persons living with dementia. The aim of the study was to explore the experiences of nurses while caring for residents with dementia who resided in long-term dementia care units during the COVID-19 pandemic. Nine Maltese nurses working in dementia care units were interviewed during the month of February 2021. Following analysis of the transcripts, three themes were identified; ‘living the challenges of the pandemic’, ‘passing through a roller coaster of emotions’ and ‘building on personal and organisational resilience’. The participants lived through several challenges which in turn generated both positive and negative emotions. Moving forward through this period mostly relied on their coping strategies, how they negotiated infection control measures with the residents’ quality of life and how their organisation was able to provide quality dementia care pre-COVID-19. The study indicated how personal and organisational resilience could have influenced the participants’ experience of the pandemic and helped nursing staff in developing new ways of working.
Improving School Outcomes for Transgender and Gender-Diverse Youth: A Rapid Review
Authors: Feijo Marina , Fontanari Anna Martha Vatse , Boeira Laura do Santos , Wendt Guilherme , Bloniewski Tomasz , Costa Angelo Brandelli
Published: February 2022

Transgender and gender-diverse students may experience poorer school outcomes due to a threatening school climate. A rapid review using systematic search found 2,111 studies mentioned LGBTQ + students, but only three were peer-reviewed empirical tests of potential interventions to improve school outcomes among transgender and gender-diverse youth: (a) Sexual orientation, gender identity, and/or gender expression ( SOGIE) inclusive policies were associated with greater school safety, less victimization, less social aggression, and higher teacher support. (b) Among the interventions, the use of the chosen name in school reduced negative health outcomes. (c) Gay–Straight Alliances ( GSA) reduced reports of frequent gender-based bullying. Several implementation facilitators for school interventions included transgender and gender-diverse students, along with informative families, trained teachers, and supportive principals. Randomized controlled trials focusing on this population would contribute greater certainty when developing school interventions. The lack of high-quality studies should serve as a wake-up call to conduct the necessary research.
Asian Americans’ Parent–Child Conflict and Racial Discrimination May Explain Mental Distress
Authors: Choi Yoonsun , Jeong Eunseok , Park Michael
Published: February 2022

Despite being stereotyped as problem-free and high-achieving, Asian Americans are vulnerable to mental distress (e.g., depression, suicidal ideation, and suicide), according to the limited available studies. Ethnic subgroups also have more variable outcomes than the monolithic category, “Asians or Asian Americans,” may suggest; but even across communities, few utilize mental health care compared to other racial/ethnic groups. To illustrate the needed evidence, a longitudinal survey of Filipino and Korean Americans found that mental distress among young Asian Americans increased at an alarming rate during the transition from adolescence to young adulthood. Two prominent contextual factors, parent–child conflict and racial discrimination, explained the uptick in mental distress. The surge of anti-Asian discrimination since the COVID-19 pandemic requires anti-discrimination policy, while parent–child conflict requires working with families in a culturally competent way.
Building Equitable Access and Inclusion for Children Growing up in the Digital Age
Authors: Barr Rachel
Published: February 2022

Beginning during infancy, digital media are a pervasive part of family life, affecting opportunities to learn and time in family relationships. Research showing the potentially negative impacts of media on very young children led to recommendations of restricted media usage. Other research has examined how educational media can promote child outcomes and well-being. However, stark issues of digital inequity remain. Many families experience underconnectivity, with both income and geography limiting access to adequate bandwidth. Finally, cracks in the democratic structure of the Internet are emerging. Software engineers and social scientists revealed that algorithms determine children's media content and exploitative features manipulate the duration of media exposure. The article evaluates media usage for very young children. Based on this risk–benefit analysis, the article proposes a policy to increase the inclusiveness and safety of the digital space for all young children.
The Night Dr. Lupo “Blew Up” the Tennessee Peanut Company
Authors: Cohu Jeff G.
Published: February 2022

This short caselet focuses on the challenges and opportunities presented by an unanticipated “viral” moment for the Tennessee Peanut Company, a small start-up company still in its infancy. After receiving unsolicited recognition from a leading Twitch streamer, Dr Lupo, the company experienced explosive sales orders which repeatedly crashed their website and sales order inventory system, leading to massive levels of sales of sold-out products. The case challenges students to determine how they would respond to a similar viral moment which simultaneously presents growth opportunities and many operational challenges and risks.