bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between 2010 Medicare Reform and Inpatient Rehabilitation Access in People With Intracerebral Hemorrhage
Authors: Ifejika Nneka L. , Vahidy Farhaan S. , Reeves Mathew , Xian Ying , Liang Li , Matsouaka Roland , Fonarow Gregg C. , Grotta James C.
Published: August 2021

Background

Evidence suggests intracerebral hemorrhage survivors have earlier recovery compared with ischemic stroke survivors. The Centers for Medicare and Medicaid Services prospective payment system instituted documentation rules for inpatient rehabilitation facilities (IRFs) in 2010, with the goal of optimizing patient selection. We investigated whether these requirements limited IRF and increased skilled nursing facility (SNF) use compared with home discharge.

Methods and Results

Intracerebral hemorrhage discharges to IRF, SNF, or home were estimated using GWTG (Get With The Guidelines) Stroke registry data between January 1, 2008, and December 31, 2015 (n=265 444). Binary hierarchical models determined associations between the 2010 Rule and discharge setting; subgroup analyses evaluated age, geographic region, and hospital type. From January 1, 2008, to December 31, 2009, 45.5% of patients with intracerebral hemorrhage had home discharge, 22.2% went to SNF, and 32.3% went to IRF. After January 1, 2010, there was a 1.06% absolute increase in home discharge, a 0.46% increase in SNF, and a 1.52% decline in IRF. The adjusted odds of IRF versus home discharge decreased 3% after 2010 (adjusted odds ratio [aOR], 0.97; 95% CI, 0.95–1.00). Lower odds of IRF versus home discharge were observed in people aged <65 years (aOR, 0.92; 95% CI, 0.89–0.96), Western states (aOR, 0.89; 95% CI, 0.84–0.95), and nonteaching hospitals (aOR, 0.90; 95% CI, 0.86–0.95). Adjusted odds of SNF versus home discharge increased 14% after 2010 (aOR, 1.14; 95% CI, 1.11–1.18); there were significant associations in all age groups, the Northeast, the South, the Midwest, and teaching hospitals.

Conclusions

The Centers for Medicare and Medicaid Services 2010 IRF prospective payment system Rule resulted in fewer discharges to IRF and more discharges to SNF in patients with intracerebral hemorrhage. Health policy changes potentially affect access to intensive postacute rehabilitation.
Association Between Diagnosis Code Expansion and Changes in 30‐Day Risk‐Adjusted Outcomes for Cardiovascular Diseases
Authors: Gilstrap Lauren , Wadhera Rishi K. , Austin Andrea M. , Kearing Stephen , Joynt Maddox Karen E. , Yeh Robert W.
Published: August 2021

BACKGROUND

In January 2011, Centers for Medicare and Medicaid Services expanded the number of inpatient diagnosis codes from 9 to 25, which may influence comorbidity counts and risk‐adjusted outcome rates for studies spanning January 2011. This study examines the association between (1) limiting versus not limiting diagnosis codes after 2011, (2) using inpatient‐only versus inpatient and outpatient data, and (3) using logistic regression versus the Centers for Medicare and Medicaid Services risk‐standardized methodology and changes in risk‐adjusted outcomes.

METHODS AND RESULTS

Using 100% Medicare inpatient and outpatient files between January 2009 and December 2013, we created 2 cohorts of fee‐for‐service beneficiaries aged ≥65 years. The acute myocardial infarction cohort and the heart failure cohort had 578 728 and 1 595 069 hospitalizations, respectively. We calculate comorbidities using (1) inpatient‐only limited diagnoses, (2) inpatient‐only unlimited diagnoses, (3) inpatient and outpatient limited diagnoses, and (4) inpatient and outpatient unlimited diagnoses. Across both cohorts,
International Classification of Diseases, Ninth Revision
(
ICD‐9
) diagnoses and hierarchical condition categories increased after 2011. When outpatient data were included, there were no significant differences in risk‐adjusted readmission rates using logistic regression or the Centers for Medicare and Medicaid Services risk standardization. A difference‐in‐differences analysis of risk‐adjusted readmission trends before versus after 2011 found that no significant differences between limited and unlimited models for either cohort.

CONCLUSIONS

For studies that span 2011, researchers should consider limiting the number of inpatient diagnosis codes to 9 and/or including outpatient data to minimize the impact of the code expansion on comorbidity counts. However, the 2011 code expansion does not appear to significantly affect risk‐adjusted readmission rate estimates using either logistic or risk‐standardization models or when using or excluding outpatient data.
Improving Outcomes After Stroke: From Stroke Units to Mobile Stroke Units
Authors: Alexandrov Andrei V. , Nilanont Yongchai
Published: August 2021

A proactive clinical approach to stroke care improved functional outcomes with implementation of specialized in-hospital stroke units, urgently delivered systemic thrombolysis, mechanical thrombectomy and most recently with mobile stroke units deployed in the field. An 18% absolute difference in outcomes as a shift across all modified Rankin Scale strata at 3 months in the recent Berlin study may not be explained by just 8.8% more patients treated within the golden hour for thrombolytic treatment from symptom onset. These findings parallel the findings in the largest controlled multi-center BEST-MSU trial (Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit) to date. A shortcoming in blinding of the investigators to the mode of transportation is similar to blinding to the endovascular treatment in PROBE (Prospective Randomized Open, Blinded End-Point) design used in thrombectomy trials. A faster access to stroke experts and brain imaging in the field for all patients suspect of stroke regardless symptom nature, severity, duration or resolution delivered by mobile stroke units is likely the reason for improved outcomes akin the impact observed in the initial multidisciplinary approach to in-hospital stroke units and reperfusion therapies delivery.
The ascending arousal system promotes optimal performance through mesoscale network integration in a visuospatial attentional task
Authors: Wainstein Gabriel , Rojas-Líbano Daniel , Medel Vicente , Alnæs Dag , Kolskår Knut K. , Endestad Tor , Laeng Bruno , Ossandon Tomas , Crossley Nicolás , Matar Elie , Shine James M.
Published: August 2021

Previous research has shown that the autonomic nervous system provides essential constraints over ongoing cognitive function. However, there is currently a relative lack of direct empirical evidence for how this interaction manifests in the brain at the macroscale level. Here, we examine the role of ascending arousal and attentional load on large-scale network dynamics by combining pupillometry, functional MRI, and graph theoretical analysis to analyze data from a visual motion-tracking task with a parametric load manipulation. We found that attentional load effects were observable in measures of pupil diameter and in a set of brain regions that parametrically modulated their BOLD activity and mesoscale network-level integration. In addition, the regional patterns of network reconfiguration were correlated with the spatial distribution of the α2a adrenergic receptor. Our results further solidify the relationship between ascending noradrenergic activity, large-scale network integration, and cognitive task performance.
To Believe Is Not to Think: A Cross-Cultural Finding
Authors: Van Leeuwen Neil , Weisman Kara , Luhrmann Tanya Marie
Published: August 2021

Are religious beliefs psychologically different from matter-of-fact beliefs? Many scholars say no: that religious people, in a matter-of-fact way, simply think their deities exist. Others say yes: that religious beliefs are more compartmentalized, less certain, and less responsive to evidence. Little research to date has explored whether lay people themselves recognize such a difference. We addressed this question in a series of sentence completion tasks, conducted in five settings that differed both in religious traditions and in language: the United States, Ghana, Thailand, China, and Vanuatu. Participants everywhere routinely used different verbs to describe religious versus matter-of-fact beliefs, and they did so even when the ascribed belief contents were held constant and only the surrounding context varied. These findings support the view that people from diverse cultures and language communities recognize a difference in attitude type between religious belief and everyday matter-of-fact belief.
Nomenclature and taxonomic placement of the infraspecific taxa recognised in the Malagasy Kalanchoe miniata (Crassulaceae subfam. Kalanchooideae) by Perrier de la Bâthie and Boiteau and Mannoni in the 20th century
Authors: SMITH GIDEON F. , SHTEIN RONEN
Published: August 2021

The nomenclature that Perrier de la Bâthie and Boiteau & Mannoni successively published for the Malagasy K. miniata (Crassulaceae subfam Kalanchooideae) in the 1920s and 1940s, respectively, is analysed. New synonyms are recorded for K. miniata and designations not validly published are noted. The infraspecific names published in K. miniata by Perrier de la Bâthie and Boiteau & Mannoni are interpreted as referring to material that belong to three species, namely to K. miniata, K. pseudocampanulata, and K. pubescens. Several names are typified and a new combination, K. pubescens var. tsinjoarivensis, based on K. miniata var. tsinjoarivensis, is published.
Phylogenetic reappraisal and epitypification of Laccaria macrocystidiata (Hydnangiaceae, Basidiomycota)
Authors: DOVANA FRANCESCO , MORENO GABRIEL , PARA ROBERTO , LAVORATO CARMINE , MUCCIARELLI MARCO
Published: August 2021

Laccaria macrocystidiata, a marasmioid species, originally described as Laccaria affinis f. macrocystidiata from Central Italy, was synonymised with the North American taxon Laccaria laccata var. pallidifolia, but only on a morphological basis. In this paper, the independent position of L. macrocystidiata from L. laccata var. pallidifolia and other species of Laccaria is pointed out on the basis of ITS-LSU phylogenetic analyses. According to our results, Laccaria macrocystidiata var. longispinosa is considered a synonym of Laccaria macrocystidiata. Laccaria macrocystidiata holotype consists of only one basidioma in poor condition; thus, a new epitype from an Italian collection was designated.
Typification of Ficus sect. Americanae (Moraceae): F. aurea and F. pertusa complexes
Authors: PEDERNEIRAS LEANDRO CARDOSO , MITIDIERI-RIVERA NICOLE , ROMANIUC-NETO SERGIO , MANSANO VIDAL DE FREITAS
Published: August 2021

Lectotypes are designated for following 14 binomials: Ficus chaparensis, F. complicata, F. garcesii, F. halliana, F. morantensis, F. ochroleuca, F. venusta, Pharmacosycea peruviana, Urostigma baccatum, U. cestrifolium forma major, U. erythrostictum, U. populneum forma mexicanum, U. sapidum, and U. subtriplinervium forma ellipticum. Corrections of citations are made in F. palmicida, F. savannarum, U. geminum and U. subtriplinervium forma major.
Teaching a Weather Forecasting Class in the 2020s
Authors: Galen Lars van , Hartogensis Oscar , Benedict Imme , Steeneveld Gert-Jan
Published: August 2021

We report on redesigning the undergraduate course in synoptic meteorology and weather forecasting at Wageningen University (the Netherlands) to meet the current-day requirements for operational forecasters. Weather strongly affects human activities through its impact on transportation, energy demand planning, and personal safety, especially in the case of weather extremes. Numerical weather prediction (NWP) models have developed rapidly in recent decades, with reasonably high scores, even on the regional scale. The amount of available NWP model output has sharply increased. Hence, the role and value of the operational weather forecaster has evolved into the role of information selector, data quality manager, storyteller, and product developer for specific customers. To support this evolution, we need new academic training methods and tools at the bachelor’s level. Here, we present a renewed education strategy for our weather forecasting class, called Atmospheric Practical, including redefined learning outcomes, student activities, and assessments. In addition to teaching the interpretation of weather maps, we underline the need for twenty-first-century skills like dealing with open data, data handling, and data analysis. These skills are taught using Jupyter Python Notebooks as the leading analysis tool. Moreover, we introduce assignments about communication skills and forecast product development as we aim to benefit from the internationalization of the classroom. Finally, we share the teaching material presented in this paper for the benefit of the community.
Routine Repeat Imaging of Pediatric Blunt Solid Organ Injuries Is Not Necessary
Authors: Fletcher Kelsey L. , Meagher Mitchell , Spencer Brianna L. , Morgan Madison E. , Safford Shawn D. , Armen Scott B. , Hazelton Joshua P. , Perea Lindsey L.
Published: August 2021

Introduction

Nonoperative management of hemodynamically stable patients with blunt splenic and/or hepatic injury has been widely accepted in the pediatric population. However, variability exists in the utilization and timing of repeat imaging to assess for delayed complications during index hospitalization. Recent level-IV evidence suggests that repeat imaging in children should be performed based on a patient’s clinical status rather than on a routine basis. The aim of this study is to examine the rate of delayed complications and interventions in pediatric trauma patients with blunt splenic and/or hepatic injuries who undergo repeat imaging prompted either by a clinical change (CC) or non-clinical change (NCC).

Methods

A 9-year (2011-2019), retrospective, dual-institution study was performed of children (0-17 years) with blunt splenic and/or hepatic injuries. Patients were grouped based on reason for repeat imaging: CC or NCC. The rate of organ-specific delayed complications and interventions was examined by reason for scan.

Results

A total of 307 injuries were included in the study period (174 splenic, 113 hepatic, and 20 both). Of 194 splenic injuries, 30(15.5%) underwent repeat imaging (CC = 19; NCC = 11). Of 133 hepatic injuries, 27(20.3%) underwent repeat imaging (CC = 21; NCC = 6). There was no difference in the incidence of organ-specific delayed complications between the CC and NCC groups. Of the 4 patients with complications necessitating intervention, only one was identified based on NCC.

Conclusions

Our data suggest routine repeat imaging is unnecessary in children with blunt splenic and/or hepatic injuries; therefore, practitioners may rely on a patient’s clinical change.
Matched and Fully Private? A New Self-Generated Identification Code for School-Based Cohort Studies to Increase Perceived Anonymity
Authors: Calatrava Maria , de Irala Jokin , Osorio Alfonso , Benítez Edgar , Lopez-del Burgo Cristina
Published: August 2021

Anonymous questionnaires are frequently used in research with adolescents in order to obtain sincere answers about sensitive topics. Most longitudinal studies include self-generated identification codes (SGICs) to match information. Typical elements include a combination of letters and digits from personal data. However, these data may make the participant feel that their answers are not truly anonymous, and some studies using these types of SGICs have been perceived as not entirely anonymous by some participants. Furthermore, data protection laws could place limits on research carried out with these codes. The objective of our article is to test an SGIC with a higher degree of anonymity. We conducted two studies. In Study 1, we tested the perceived anonymity of this new SGIC code. Adolescents aged 12 to 18 years ( N = 601) completed an anonymous questionnaire about lifestyles and risk behaviors, which also included the SGIC. Adolescents with and without risk behaviors were compared regarding whether or not they answered to the SGIC questions. We did not find any differences to suggest that participants felt identifiable. In Study 2, we assessed the efficiency of the new SGIC. At baseline, 123 students from two high schools (eighth grade) filled in questionnaires consisting of the new SGIC and their full names. Two years later, these same students (then in the 10th grade) were invited to fill in the same information again (116 students responded to this second call). A total of 97 students were present in both waves. The SGIC showed a moderate performance, with good enough indices of recall and precision. Evidence suggests that the new SGIC is a suitable tool for the anonymous matching of adolescents in follow-ups of school cohorts.
Thermoplastic polyurethane/CNT nanocomposites with low electromagnetic resistance property
Authors: Lee Chia-Fang , Chen Chin-Wen , Chuang Fu-Sheng , Rwei Syang-Peng
Published: August 2021

Multi-wall carbon nanotubes (MWCNTs) at 0.5 wt% to 2 wt% proportions were added to thermoplastic polyurethane (TPU) synthesized with polycarbonatediol (PCDL), 4,4’-methylene diphenyl diisocyanate (MDI), and 1,3-butanediol(1,3-BDO). To formulate a new TPU-MWCNT nanocomposite, the composite was melt-blended with a twin-screw extruder. To ensure the even dispersion of MWCNTs, dispersant (ethylene acrylic ester terpolymer; Lotader AX8900) of equal weight proportion to the added MWCNTs was also added during the blending process. Studies on the mechanical and thermal properties, and melt flow experiments and phase analysis of TPU-MWCNT nanocomposites, these nanocomposites exhibit higher tensile strength and elongation at break than neat TPU. TPU-MWCNT nanocomposites with higher MWCNT content possess higher glass-transition temperature (Tg), a lower melt index, and greater hardness. Relative to neat TPU, TPU-MWCNT nanocomposites exhibit favorable mechanical properties. By adding MWCNTs, the tensile strength of the nanocomposites increased from 7.59 MPa to 21.52 MPa, and Shore A hardness increased from 65 to 81. Additionally, TPU-MWCNT nanocomposites with MWCNTs had lower resistance coefficients; the resistance coefficient decreased from 4.97 × 1011 Ω/sq to 2.53 × 104 Ω/sq after adding MWCNTs, indicating a conductive polymer material. Finally, the internal structure of the TPU-MWCNT nanocomposites was examined under transmission electron microscopy. When 1.5 wt% or 2 wt% of MWCNTs and dispersant were added to TPU, the MWCNTs were evenly dispersed, with increased electrical conductivity and mechanical properties. The new material is applicable in the electronics industry as a conductive polymer with high stiffness.
A Preliminary Study Examining Self-Reported Invincibility, Alcohol Problems, and the Nonmedical Use of Prescription Stimulants in College Students
Authors: Kennedy Susan , Millin Paula , Kennedy Gary J.
Published: August 2021

The nonmedical use of prescription stimulants (NMUPS) is becoming more common among college students. Identifying the variables associated with NMUPS is important for educational efforts and to promote wellness in vulnerable students. The present study examined the relationships between self-reported invincibility, alcohol problems, and NMUPS in 175 college students. Path analysis tested the hypotheses that males would report higher invincibility that would be related to alcohol use and alcohol problems. Using structural equation modeling, significant relationships were found between invincibility and alcohol-related problems. Alcohol problems may be related to NMUPS. A total effect of invincibility, mediated by alcohol use, may be a path whereby invincibility positively influences NMUPS. Students reporting high levels of invincibility may be at risk for the NMUPS and might benefit from efforts regarding the potential harmful consequences of taking these substances without a prescription.
Magnifying the first points of life: Harvey and Descartes on generation and scale
Authors: Basse Eriksen Christoffer
Published: August 2021

In this essay, I study the contested role of magnification as an observational strategy in the generation theories of William Harvey and René Descartes. During the seventeenth century, the grounds under the discipline of anatomy were shifting as knowledge was increasingly based on autopsia and observation. Likewise, new theories of generation were established through observations of living beings in their smallest state. But the question formed: was it possible to extend vision all the way down to the first points of life? Arguing that the potential of magnification hinged on the metaphysics of living matter, I show that Harvey did not consider observational focus on the material composition of blood and embryos to be conducive to knowledge of living bodies. To Harvey, generation was caused by immaterial, and thus in principle invisible, forces that could not be magnified. Descartes, on the other hand, believed that access to the subvisible scale of natural bodies was crucial to knowledge about their nature. This access could be granted through rational introspection, but possibly also through powerful microscopes. The essay thus ends with a reflection on the importance of Cartesian corpuscularianism for the emergence of microscopical anatomy in seventeenth-century England.
Examining the Influence of Transformational Leadership and Green Culture on Pro-Environmental Behaviors: Empirical Evidence From Florida City Governments
Authors: Azhar Aisha , Yang Kaifeng
Published: August 2021

Despite growing interest in greening initiatives, the environmental performance of public organizations largely depends on the voluntary participation of public employees in undertaking pro-environmental behaviors (PEBs). Can organizations encourage better participation? What is the role of leadership and organizational culture in influencing these behaviors? This study investigates the influence of transformational leadership and organizational green culture on employees’ PEBs. Data were collected through a survey of public employees in two city governments in Florida. Confirmatory factor analysis followed by the multiple regression analysis were employed to test the proposed model. Findings reveal that organizational factors have the potential to influence the workplace PEBs, but in a complex manner. Certain barriers are found to significantly moderate the effects of organizational factors on employees’ PEBs
Bullying and Harassment as a Consequence of Workplace Change in the Australian Civil Service: Investigating the Mediating Role of Satisfaction With Change Management
Authors: Kleizen Bjorn , Wynen Jan , Boon Jan , de Roover Jolijn
Published: August 2021

Public sector organizations frequently restructure due to shifting management trends, crises, and political developments. Earlier research indicates that the sometimes-drastic reforms implemented in government strongly affect employees, causing psychosocial effects such as frustration, stress, and negative work environments. This may in turn increase the likelihood of severe phenomena such as workplace bullying and harassment. It remains unclear, however, how public organizations can introduce changes while preventing side-effects such as bullying and harassment. The goal of this article is twofold. First, we test whether evidence on the relationship between workplace change and bullying and harassment holds when using a large, public sector-wide sample. Second, we investigate whether satisfaction with change management plays a mediating role. Using cross-sectional and strata-based panel data analyses on Australian data, results indicate a positive relationship between workplace change and workplace bullying and harassment, but also suggest that satisfaction with change management mitigates this effect.
Safety of Intravenous Push Ertapenem Compared to Intravenous Piggyback at a Tertiary Academic Medical Center
Authors: Corrado Michael J. , Riselli Andrew , McLaughlin Kevin C. , Szumita Paul M. , Anger Kevin E.
Published: August 2021

Background: Recent shortages of intravenous (IV) fluids have resulted in healthcare systems converting administration of many medications from IV piggyback (IVPB) to IV push (IVP). Administering medications via IVP presents numerous advantages; however, IV site reactions such as phlebitis and infiltration may occur. Objective: The objective of this analysis is to evaluate the infusion site safety of ertapenem given as peripheral IVP compared to IVPB in adult patients. Methods: This was an institutional review board–approved, single-center, retrospective study. Patients, ages 18 or older, receiving IV ertapenem were identified. The major endpoints analyzed were IV site reactions including phlebitis and infiltration. The Naranjo Nomogram was utilized to assess the causality of the reactions to determine the likelihood of whether the event was caused by the medication itself or other factors. Results: To date, 283 administrations (92 patients) in the IVP group and 319 administrations (82 patients) in the IVPB group were analyzed. There were 13 IV site reactions compared to 8 in the IVP vs IVPB group, respectively ( P-value = 0.16). Ten of the events in the IVP group were deemed “possible” and 2 deemed “doubtful,” while the remaining event was considered “probable” per the Naranjo Nomogram. Of the events in the IVPB group, all 8 were found to be “possible.” Conclusion: The administration of IVP ertapenem showed comparable rates of infusion site reactions compared to IVPB. Implementation of IVP ertapenem appears to be associated with infusion site safety similar to IVPB and should be considered safe to administer.
Temporary Contracts, Employment Trajectories and Dualisation: A Comparison of Norway and Sweden
Authors: Berglund Tomas , Nielsen Roy A , Reichenberg Olof , Svalund Jørgen
Published: August 2021

This study compares the labour market trajectories of the temporary employed in Norway with those in Sweden. Sweden’s employment protection legislation gap between the strict protection of permanent employment and the loose regulation of temporary employment has widened in recent decades, while Norway has maintained balanced and strict regulation of both employment types. The study asserts that the two countries differ concerning the distribution of trajectories, leading to permanent employment and trajectories that do not create firmer labour market attachment. Using sequence analysis to analyse two-year panels of the labour force survey for 1997–2011, several different trajectories are discerned in the two countries. The bridge trajectories dominate in Norway, while dead-end trajectories are more common in Sweden. Moreover, the bridge trajectories are selected to stronger categories (mid-aged and higher educated) in Sweden than in Norway. The results are discussed from the perspective of labour market dualisation.
Flat-rate personal income tax in Lithuania, Romania and Hungary: A revolutionary policy idea without revolutionary outcomes
Authors: Kovács Borbála
Published: August 2021

A decade of writing on the politics of flat-rate tax adoption and diffusion across post-socialist Europe and Asia has presented these reforms as revolutionary, but at least bold. However, in what ways they might have proven so and for whom has not been investigated. Based on a micro-level study of actual personal income tax rates for the 1991–2018 period, the article engages critically with the scope of the flat tax ‘revolution’ in three different flat tax nations, early adopter Lithuania, later-adopter Romania and recent-adopter Hungary. The analysis shows that the introduction of flat-rate tax in no way revolutionised actual tax burdens for the majority of earners, not even for high-income earners, whose tax burdens had been declining for at least a decade before the arrival of flat tax in both Romania and Hungary. The article also reveals the crucial role played by standard tax credits in shaping tax regime progressivity not only in flat tax regimes, but also progressive ones. The article suggests that the novelty of policy ideas cannot be assumed, but needs to rest on comparisons of outcomes.
Exploring barriers and possible actions suggested in rural libraries for information society: Perspectives from library practitioners in Malaysia
Authors: Shaifuddin Norshila , Satirah Wan Mohd Saman Wan , Abdullah Sani Mad Khir Johari , Yu Halida
Published: August 2021

This study aims to explore the barriers when developing information societies and to suggest possible actions for rural libraries to participate in information societies, tailored to the needs of Malaysian rural libraries. This study employed a three-round Delphi technique; including a face-to- face interview in the first round, followed by two rounds of close-ended survey questions presented in a Likert-type scale format distributed to a selected group of leaders with experience in rural library planning and strategies. It reveals how funding, library infrastructures, information communication technology, local content resources, and human resources adversely affected rural libraries in the development of an information society. Based on the recommendation elicited for the five categories, this study suggests possible actions that provide practical guidance on the actions to be taken by the rural libraries in developing an information society.
Book review: Thomas H. Davenport and Jeanne G. Harris, Competing on Analytics
Authors: Suri Neha
Published: August 2021

Thomas H. Davenport and Jeanne G. Harris, Competing on Analytics, 2017, Harvard Business School Press, 320 pp., $35. ISBN: 9781633693722 (Hardback).
Recommendations for Virtual Qualitative Health Research During a Pandemic
Authors: Pocock Tessa , Smith Melody , Wiles Janine
Published: August 2021

Qualitative health research has been uniquely affected by the COVID-19 pandemic. Various public health directives will likely remain in place until this pandemic is fully controlled, creating long-lasting impacts on the design and conduct of qualitative health research. Virtual qualitative research provides an alternative to traditional interviews or focus groups and can help researchers adhere to public health directives. In this commentary, we respond to methodological needs created by the COVID-19 pandemic. Specifically, we explore unique elements of, and recommendations for, the design and conduct of obtrusive virtual qualitative research (online interviews, online focus groups, and email interviews) and demonstrate crucial ethical, recruitment, analytical, and interpretive considerations. Researchers are currently faced with an ethical imperative to advance virtual qualitative research methods and ensure that rigorous qualitative health research continues during this pandemic and beyond. Our discussions provide a starting point for researchers to explore the potential of virtual qualitative research.
Evaluation of the effect of phenobarbital administration on the biochemistry profile, with a focus on serum liver values, in epileptic cats
Authors: Hermans Michelle , Charalambous Marios , Pakozdy Akos , Eisl-Glantschnigg Ursula , Neßler Jasmin , Van Meervenne Sofie AE , Serrano Gonçalo , Cornelis Ine , Van Ham Luc , Paepe Dominique , Broeckx Bart JG , Bhatti Sofie FM
Published: August 2021

Objectives

Phenobarbital (PB) is the most common antiseizure drug (ASD) used for the management of feline epilepsy. In dogs, PB is known to cause serum liver enzyme induction and hepatotoxicity, especially after administration long term or in high concentrations. In cats, insufficient evidence is available to draw similar conclusions. The aim of this study was to evaluate the effect of PB administration on the serum biochemistry profile of epileptic cats. As an additional objective, other adverse effects arising, related to PB treatment, were recorded.

Methods

Medical records of four veterinary centres were retrospectively reviewed for epileptic cats receiving PB treatment. Cats were included if they had a diagnosis of idiopathic epilepsy or structural epilepsy; a normal baseline serum biochemistry profile; at least one follow-up serum biochemistry profile; no concurrent disease or had not received medication that could possibly influence liver function or lead to serum liver enzyme induction. Alkaline phosphatase, alanine aminotransferase (ALT), aspartate transaminase and gamma-glutamyl transferase activities, and total bilirubin, bile acids, glucose, albumin, total protein, urea and creatinine concentrations before and during PB administration were recorded. PB serum concentration was also recorded, when available.

Results

Thirty-three cats (24 males, nine females) with a median age of 3 years (range 2 months to 12 years) met the inclusion criteria. Idiopathic or structural epilepsy was diagnosed in 25 (76%) and eight (24%) cats, respectively. The follow-up period ranged from 9 to 62 months. This study found an increase in ALT in three cats, possibly related to a PB serum concentration >30 µg/ml. No statistically significant increase in serum liver enzymes or other evaluated biochemistry parameters was found by comparing pre- and post-treatment parameters.

Conclusions and relevance

PB administration did not result in hepatic enzyme induction or other biochemical abnormalities in cats. This strengthens the safety profile of PB as an ASD in cats.
Acoustics in South African classrooms: Regulations versus reality
Authors: van Reenen Coralie , Plessis Chrisna du
Published: August 2021

This research set out to broaden the pool of evidence regarding the acoustic conditions at schools in South Africa. A review of local and international literature, standards and design guidelines shows that the ideal classroom acoustic conditions of 35 dBA ambient and 0.7 s reverberation time are required to enable a suitable environment for teaching and learning. A review of local literature revealed a very small body of knowledge regarding actual acoustic conditions and monitoring of classroom acoustics and that these cases demonstrated ambient noise levels in classrooms (whether occupied or unoccupied) to be above the recommendations of the relevant South African National Standard (SANS 10103). The limited local research promted the need for this case study. The findings of a province-wide survey of urban schools showed that traffic noise is the main source of noise disturbance in schools. A case study of five schools showed that the average outdoor noise level at schools exposed to traffic throughout the day is 63.3 dBA and the average indoor noise level at these schools when classrooms are unoccupied is approximately 58 dBA, which is significantly higher than the requirement. The reverberation time in classrooms was between 0.6 and 1.75 s. It is concluded that the current acoustic conditions in South African urban schools is poor when evaluated against the South African National Standards. However, since this is based on only five case studies, a broader study is required to understand the general conditions and establish suitable mitigation measures.
The effect of national disease-modifying therapy subsidy policy on long-term disability outcomes in people with multiple sclerosis
Authors: Claflin Suzi B , Campbell Julie A , Mason Deborah F , Kalincik Tomas , Simpson-Yap Steve , Norman Richard , Butzkueven Helmut , Carroll William M , Palmer Andrew J , Blizzard C Leigh , van der Mei Ingrid , Taylor Bruce V
Published: August 2021

Background:

Disease-modifying therapies (DMTs) are used to treat people with relapsing-onset multiple sclerosis (ROMS), but our knowledge is largely limited to their short-term effects.

Objective:

To determine (1) the impact of national-level DMT subsidy policy on DMT use and health outcomes in people with MS (PwMS) and (2) the long-term effects of DMT on disability and quality of life (QoL; 5-level EQ-5D version (EQ-5D-5L) utility value).

Methods:

This observational cohort study compared Australian and New Zealand populations with different levels of DMT availability 10–20 years post-ROMS diagnosis. Between-country differences were assessed using standardised differences. Associations were assessed with multivariable linear regression models.

Results:

We recruited 328 Australians and 256 New Zealanders. The Australian cohort had longer DMT treatment duration, greater proportion of disease course treated and shorter duration between diagnosis and starting DMT. The Australian cohort had lower median Expanded Disability Status Scale (EDSS) (3.5 vs 4.0) and Multiple Sclerosis Severity Score (MSSS) (3.05 vs 3.71) and higher QoL (0.71 vs 0.65). In multivariable models, between-country differences in disability and QoL were largely attributed to differential use of DMT.

Conclusions:

This study provides evidence for the impact of national-level DMT policy on disability outcomes in PwMS. Where DMTs are more accessible, PwMS experienced less disability progression and improved QoL 10–20 years post-diagnosis.
Impact of exercise format and repetition on learning verb–noun collocations
Authors: Ferguson Peter , Siyanova-Chanturia Anna , Leeming Paul
Published: August 2021

A growing number of studies have probed the effectiveness of certain exercise formats in the learning of multi-word expressions (MWEs) in classroom settings. However, a number of important variables, such as MWE retention over an extended period of time and the role of repetition, have so far not been considered. Furthermore, studies have focused primarily on university level learners, with young L2 learners being almost entirely disregarded. The present study sought to address these gaps with 148 high school students who were randomly assigned one of three fill-in-the-gap exercises: (1) word-format, where participants selected the appropriate verb from a list provided; (2) letter-format, where the first-letter of the missing verb was provided as a clue; and (3) phrase-format, where participants chose an appropriate intact phrase from a list. Participants did the exercise once, twice or three times. The study investigated the effects of exercise format and repetition on the learning of 20 verb–noun collocations, one and eight weeks following the treatment. Results from generalized linear mixed-effects modeling showed that both exercise and repetition had significant impact on the learnability of the target MWEs, but the format had a smaller effect size than repetition. Rasch analysis was also used to examine the potential difference in the difficulty of MWEs, and how this difficulty may interact with the exercise format. The findings largely support previous research, but also underline the importance of repetition and suggest that exercise format does not uniformly interact with the learnability of MWEs.
Computational analysis of reinforced concrete structures subjected to fire using a multilayered finite element formulation
Authors: Sosso Batoma , Paz Gutierrez Fabian M , Berke Péter Z
Published: August 2021

Fire is a critical risk in reinforced concrete (RC) structures and appropriate structural resistance against it has to be ensured. In this contribution, an approach using corotational layered beam finite elements is employed in which the cross-section temperature is derived from a low-cost closed form model, as opposed to the more commonly used fully computational thermal analysis. The effect of geometrical and material nonlinearities (constitutive behavior fitted to experimental data for concrete and steel), material degradation as a function of temperature rise, and the contributions of thermal, transient, and creep strains are incorporated in the structural analysis. The computational results are favorably compared to experimental data from the literature for an RC beam and for a larger RC frame. Taking benefit of the layered beam formulation offering local insight into the cross-sectional and material behavior, the relationship between the structural degradation and data extracted from the cross-sectional behavior is successfully established. Noteworthy originalities of the contribution are the use of ultimate strain and its evolution as a function of temperature for both materials and the explanation of the observed structural response in fire conditions from cross-sectional data.
Ground tire rubber/polyamide 6 thermoplastic elastomers produced by dry blending and compression molding
Authors: Fletes Roberto C Vázquez , López Erick O Cisneros , Gudiño Pedro Ortega , Mendizábal Eduardo , Núñez Rubén González , Rodrigue Denis
Published: August 2021

This study investigates the addition of ground tire rubber (GTR) into virgin polyamide 6 (PA6) to produce thermoplastic elastomer (TPE) blends. In particular, a wide range of GTR concentration (0–100% wt.) was possible by using a simple dry blending technique of the materials in a powder form followed by compression molding. The molded samples were characterized in terms of morphological (scanning electron microscopy), physical (density and hardness) and mechanical (tension, flexion and impact) properties. The results showed a decrease in tensile and flexural moduli and strengths with GTR due to its elastomeric nature. However, significant increases were observed on the tensile elongation at break (up to 167%) and impact strength (up to 131%) compared to the neat PA6 matrix. Based on the results obtained, an optimum GTR content around 75% wt. was observed which represents a balance between high recycled rubber content and a sufficient amount of matrix to recover all the particles. These results represent a first step showing that a simple processing method can be used to produce low cost PA6/GTR compounds with a wide range of physical and mechanical properties.
Measuring MPs’ Responsiveness: How to Do it and Stay Out of Trouble
Authors: Campbell Rosie , Bolet Diane
Published: August 2021

This article reviews the issues raised by the reaction to an audit experiment, studying the responsiveness of British MPs to their constituents, in November and December 2020. The experiment was part of a wider comparative project investigating the linkage between legislators and their constituents. We sent two short emails to all MPs asking how they and their party were going to respond to the economic impact of the COVID-19 pandemic. We were required by our ethics committee to debrief the subjects, providing the opportunity to withdraw from the analysis. The scale of the reaction to the debriefing email was neither desired nor anticipated ( https://www.bbc.co.uk/news/uk-politics-56196967 ). We explain how we got ourselves into such difficulty, how we might have stayed out of it and the wider implications of our experience for experimental research on politicians. We reflect on the ethical issues raised by the reaction to our research, alongside the role that communications with legislators, the wider parliamentary community and the media should play in research design when conducting experiments with politicians as subjects.
Percutaneous Treatment of Concomitant Severe Aortic Stenosis and Thoracoabdominal Aortic Aneurysm
Authors: Painchaud-Bouchard Ariane-Sophie , Potvin Jeannot , Forcillo Jessica , Ruz Ricardo , Elkouri Stephane
Published: August 2021

Purpose:

Although rare in occurrence, symptomatic severe aortic stenosis and large thoracoabdominal aortic aneurysm (TAAA) found in combination pose a real therapeutic challenge, especially in elderly frail patients. Surgical approaches for combined treatment are complex and at high risk of complications while staged procedures carry the risk of an unfavorable evolution of the condition temporarily left untreated. Minimally invasive approaches may therefore prove a more suitable strategy for these patients.

Case Report:

We present the case of a 78-year-old woman with symptomatic severe aortic stenosis (AS) and a TAAA of 7.8 cm in diameter. Transcatheter treatment of both conditions was successfully performed in a staged manner. The first intervention consisted of combined transfemoral transcatheter aortic valve implantation (TAVI) immediately followed by a zone 3 thoracic endovascular aortic endoprosthesis deployment. In order to reduce the extent of intercostal arteries coverage and mitigate the risk of medullar ischemia, a second-stage percutaneous endovascular treatment of the TAAA was performed with a customized 4-fenestration prosthesis. Early and 12-month clinical and radiologic follow-up were favorable.

Conclusion:

This case demonstrates how a strong multidisciplinary collaboration allows for successful resolution of complex clinical scenarios.
Numerical analysis of crimping behaviour of triaxial braided structures
Authors: Ochola Jerry , Malengier Benny , Van Langenhove Lieva
Published: August 2021

The mechanical properties of tubular braided structures influence their inherent performance during application as biomedical materials. In their use as stents, braided structures are forced to conform to the topology of the host tissues. Triaxial braided structures have had limited use in tissue repair and organ support even though they have the potential of offering equal if not better performance compared to bi-axial braided structures. A study of the mechanical dynamics of tri-axial braids would be crucial in the potential design of customised structures for advanced tissue repair and organ support. This study therefore uses Finite Element Methods (FEM) to design and develop triaxial braided structures and investigate their crimping behaviour using parametric modeling and numerical analysis in their potential application as biomedical materials. The results in this study portrayed that the presence of axial yarns in tubular braided structure offers improved performance in terms of stability of the structure.
Immune Checkpoint Inhibitors in Special Populations
Authors: Shan Qianyun , Lu Hongyang
Published: August 2021

Cancer is the second leading cause of death in the worldwide. With the growing burden of cancer, the studies on early diagnosis, treatment and prevention of cancer are rapidly increasing. Recently, many new therapeutic strategies have been discovered, among which immunotherapy has dramatically changed the outlook for cancer treatment. Several clinical trials are underway around the world to produce potential treatments. However, these trials set certain strict joining conditions, so that the clinical data cannot be fully applied in the real world. To help clinical oncologists with treatment decision-making, this review collected recent studies on special populations receiving immunotherapy, including organ transplant patients, pregnant women, pediatric patients, patients with pulmonary tuberculosis, patients with human immunodeficiency virus, and patients with autoimmune diseases and mental illness.
Online Memes and COVID-19
Authors: Flaherty Michael G. , Rughiniş Cosima
Published: August 2021

In this article, the authors highlight their findings on online memes to see what they reveal about self and time during the COVID-19 pandemic. Their analysis shows that the self and time are related aspects of social interaction. The self is akin to a theatrical performance and our perception of time is altered by problematic circumstances.
Development of Culinary and Self-Care Programs in Diverse Settings: Theoretical Considerations and Available Evidence
Authors: Munroe Dominique , Moore Miranda A. , Bonnet Jonathan P. , Rastorguieva Krystyna , Mascaro Jennifer S. , Craighead Linda W. , Haack Carla I. , Quave Cassandra L. , Bergquist Sharon H.
Published: August 2021

Culinary-based self-care programs are innovative and increasingly utilized models for catalyzing behavior change and improving health and well-being. The content, duration, and delivery of existing programs vary considerably. Between January and August 2019, we developed a teaching kitchen and self-care curriculum, which was administered as part of a year-long worksite well-being program to employees at an academic healthcare system. The curriculum domains included culinary skills, nutrition, physical activity, yoga, stress management, mindful eating, and ethnobotany. An informal systematic literature search was performed to assemble and evaluate key principles and practices related to self-care domains, learning methodologies, and programmatic design considerations. Here, we provide a qualitative summary of the evidence-informed development of the curriculum intervention.