bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Checklist Tool to Assess the Quality of Skin Lesion Images Acquired by Consumers Using Sequential Mobile Teledermoscopy
Authors: Koh Uyen , Betz-Stablein Brigid , O’Hara Montana , Horsham Caitlin , Curiel-Lewandrowski Clara , Soyer H. Peter , Janda Monika
Published: April 2021

Background: Mobile teledermoscopy is an emerging technology that involves imaging and digitally sending dermoscopic images of skin lesions to a clinician for assessment. High-quality, consistent images are required for accurate telediagnoses when monitoring lesions over time. To date there are no tools to assess the quality of sequential images taken by consumers using mobile teledermoscopy. The purpose of this study was to develop a tool to assess the quality of images acquired by consumers. Methods: Participants imaged skin lesions that they felt were concerning at baseline, 1-, and 2-months. A checklist to assess the quality of consumer sequential imaging of skin lesions was developed based on the International Skin Imaging Collaboration guidelines. A scale was implemented to grade the quality of the images: 0 (low) to 18 (very high). Intra- and inter-reliability of the checklist was assessed using Bland-Altman analysis. Using this checklist, the consistency with which 85 sets of images were scored by 2 evaluators were compared using Kappa statistics. Items with a low Kappa value <0.4 were removed. Results: After reliability testing, 5 of the items were removed due to low Kappa values (<0.4) and the final checklist included 13 items surveying: lesion selection; image orientation; lighting; field of view; focus and depth of view. Participants had a mean age of 41 years (range 19–73), and 67% were female. Most participants (84%, n = 71/85) were able to select and image the correct lesion over time for both the dermoscopic and overview images. Younger participants (<40 years old) scored significantly higher (8.1 ± 2.1) on the imaging checklist compared to older participants (7.1 ± 2.4; p = 0.037). Participants had most difficulty with consistent image orientation. Conclusions: This checklist could be used as a triage tool to filter images acquired by consumers prior to telediagnosis evaluation, which would improve the efficiency and accuracy of teledermatology and teledermoscopy processes. It may also be used to provide feedback to the consumers to improve image acquisition over time.
Real-World Experience with Artificial Intelligence-Based Triage in Transferred Large Vessel Occlusion Stroke Patients
Authors: Morey Jacob R. , Zhang Xiangnan , Yaeger Kurt A. , Fiano Emily , Marayati Naoum Fares , Kellner Christopher P. , De Leacy Reade A. , Doshi Amish , Tuhrim Stanley , Fifi Johanna T.
Published: April 2021

Background and Purpose: Randomized controlled trials have demonstrated the importance of time to endovascular therapy (EVT) in clinical outcomes in large vessel occlusion (LVO) acute ischemic stroke. Delays to treatment are particularly prevalent when patients require a transfer from hospitals without EVT capability onsite. A computer-aided triage system, Viz LVO, has the potential to streamline workflows. This platform includes an image viewer, a communication system, and an artificial intelligence (AI) algorithm that automatically identifies suspected LVO strokes on CTA imaging and rapidly triggers alerts. We hypothesize that the Viz application will decrease time-to-treatment, leading to improved clinical outcomes. Methods: A retrospective analysis of a prospectively maintained database was assessed for patients who presented to a stroke center currently utilizing Viz LVO and underwent EVT following transfer for LVO stroke between July 2018 and March 2020. Time intervals and clinical outcomes were compared for 55 patients divided into pre- and post-Viz cohorts. Results: The median initial door-to-neuroendovascular team (NT) notification time interval was significantly faster (25.0 min [IQR = 12.0] vs. 40.0 min [IQR = 61.0]; p = 0.01) with less variation (p < 0.05) following Viz LVO implementation. The median initial door-to-skin puncture time interval was 25 min shorter in the post-Viz cohort, although this was not statistically significant (p = 0.15). Conclusions: Preliminary results have shown that Viz LVO implementation is associated with earlier, more consistent NT notification times. This application can serve as an early warning system and a failsafe to ensure that no LVO is left behind.
Circulating Serum Magnesium and the Risk of Venous Thromboembolism in Men: A Long-Term Prospective Cohort Study
Authors: Kunutsor Setor K. , Laukkanen Jari A.
Published: April 2021

Background and Objective: Serum magnesium, an essential trace element involved in processes that regulate cardiovascular function, has been linked to the risk of atherosclerotic cardiovascular disease. However, the potential association between serum magnesium and venous thromboembolism (VTE) has not been previously investigated. We aimed to assess the prospective association of serum magnesium with the risk of VTE. Methods: Serum magnesium was measured using atomic absorption spectrometry in 2,361 men aged 42–61 years with no history of VTE at baseline in the Kuopio Ischemic Heart Disease prospective cohort. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for VTE. Results: A total of 159 incident VTE events were recorded during a median follow-up of 27.1 years. The risk of VTE per 1 SD increase in serum magnesium in the age-adjusted analysis was (HR 1.30; 95% CI 0.46–3.69). The association remained consistent in analyses adjusted for systolic blood pressure, body mass index, total cholesterol, triglycerides, smoking status, a history of type 2 diabetes, a history of coronary heart disease, medication for dyslipidemia, alcohol consumption, physical activity, socioeconomic status, serum active calcium, high-sensitivity C-reactive protein, and a history of cancer (HR 1.38; 95% CI 0.48–3.96). Comparing the extreme tertiles of serum magnesium, the corresponding adjusted HRs were 1.17 (95% CI 0.81–1.70) and 1.17 (95% CI 0.81–1.70), respectively. Conclusion: In a middle-aged Caucasian male population, serum-circulating magnesium was not associated with a future risk of VTE. Further studies in women, other age groups, and other populations are required to generalize these findings.
Excess Body Weight and Gastrointestinal Cancer Risk
Authors: Scherübl Hans
Published: April 2021

Background: Excess body weight (EBW), defined as a body mass index (BMI) ≥25 kg/m2, has become the second most important as well as a potentially modifiable risk factor for cancer in many industrialized countries. The more excess weight people have, the higher the risk of certain cancers. Over the past several decades, EBW has been increasing globally not only among adults, but also among children and adolescents. Summary: EBW is causally associated with colorectal, esophageal (adenocarcinoma), gastric (cardia), pancreatic, biliary and hepatocellular cancer. EBW when combined with tobacco smoking, risky alcohol use, or diabetes can act synergistically to cause gastrointestinal cancer. In recent years, more and more young adults (20–40 years old) were diagnosed with EBW-associated neoplasms. People with EBW should be encouraged to join cancer screening programs. Key Messages: Keeping a healthy weight is a major public health concern and reduces the risk of cancer.
Hyperspectral Imaging: A New Intraoperative Tool for Pouch Assessment in Patients Undergoing Restorative Proctocolectomy
Authors: Jansen-Winkeln Boris , Takoh Jonathan P. , Chalopin Claire , Maktabi Marianne , Lyros Orestis , Sucher Robert , Hoffmeister Albrecht , Teich Niels , Köhler Hannes , Gockel Ines
Published: April 2021

Introduction: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a challenging operation. Especially the mobilization of the pouch into the pelvis can be complex. Adequate perfusion of the pouch is required for optimal healing and functioning. Methods: With hyperspectral imaging (HSI) wavelengths between 500 and 1,000 nm can be analyzed in addition to visible light and by reflecting patterns. This intraoperative procedure is non-invasive, contact-free, and no contrast medium is needed. Fifteen patients undergoing IPAA were examined prospectively, and the pouch was evaluated by HSI intraoperatively. HSI was measured in standardized fashion at 4 defined locations of the J-pouch. Each measurement took about 10 s. The clinical postoperative course was assessed in all patients and correlated to the intraoperative HSI findings. Results: Mean near-infrared perfusion and oxygenation of patients showed values ≥74% for all defined pouch areas, revealing good blood supply. Three minor anastomotic leaks were detected by standard pouchoscopy in the postoperative course, which could be treated conservatively with endosponge therapy. Conclusion: HSI values of perfusion and oxygenation of the IPAA were high. The leak rate is associated with redo procedures. This is reflected by the current literature and most likely related to the higher complexity of the revisional pouch operation. HSI has proved itself as a quick and effective new intraoperative tool to evaluate pouch perfusion objectively and quantitatively.
Safety and Efficacy of Trans-Perineal Urethroplasty for Management of Post-Traumatic Urethral Strictures in Pediatric Age-Group
Authors: Chaudhari Radheshyam , Sharma Amit , Shaikh Irfan , Andankar Mukund , Pathak Hemant
Published: April 2021

Introduction: Trans-perineal urethroplasty is the preferred treatment for distraction urethral injuries in adults. However, management of such injuries in children is challenging because of functional implications in a growing child. In the present study, we aim to evaluate the safety and efficacy of perineal urethroplasty for distraction urethral injuries in children. Methods: The medical records of prepubertal pediatric patients (age <14 years) with traumatic urethral distraction injuries managed by perineal urethroplasty were retrospectively reviewed and analyzed with respect to demographics, stricture characteristics, management, complications, follow-up, and outcome. Results: A total of 14 patients were included in the study. Ten had membranous, and 4 had bulbar urethral strictures. All membranous strictures were secondary to pelvic trauma; bulbar strictures were secondary to blunt perineal trauma; 7 patients had associated pelvic fractures. Anastomotic urethroplasty was used in 10 patients (71.4%) and buccal mucosal graft urethroplasty was done in 4 patients (38.6%). The mean follow-up duration was 56 months (range 24–76). Surgery was primarily successful in 85.7%. Failed repair in 2 patients was successfully managed with augmented anastomotic urethroplasty. Post-operatively, the mean maximal urinary flow rate was 26.4 mL/s. No significant complications occurred. All boys are continent. There was no chordee or urethral diverticula, during follow-up. Conclusion: In pediatric patients, bulbar and membranous strictures can be treated successfully with urethroplasty using the perineal approach. Longer follow-up is needed to confirm that these good results are maintained as these patients cross into adulthood, especially as these repairs were done before puberty.
Hypercapnia in COPD Patients Undergoing Endobronchial Ultrasound under Local Anaesthesia and Analgosedation: A Prospective Controlled Study Using Continuous Transcutaneous Capnometry
Authors: Galetin Thomas , Strohleit Daniel , Magnet Friederike Sophie , Schnell Jost , Koryllos Aris , Stoelben Erich
Published: April 2021

Background: Flexible bronchoscopy (FB) in analgosedation causes alveolar hypoventilation and hypercapnia, the more so if patients suffer from COPD. Nonetheless, neither is capnometry part of standard monitoring nor is there evidence on how long patients should be monitored after sedation. Objectives: We investigated the impact of COPD on hypercapnia during FB with endobronchial ultrasound (EBUS) in sedation and how the periprocedural monitoring should be adapted. Methods: Two cohorts of consecutive patients – with advanced and without COPD – with the indication for FB with EBUS-guided transbronchial needle aspiration in analgosedation received continuous transcutaneous capnometry (ptcCO2) before, during, and for 60 min after the sedation with midazolam and alfentanil. Main Results: Forty-six patients with advanced COPD and 44 without COPD were included. The mean examination time was 26 ± 9 min. Patients with advanced COPD had a higher peak ptcCO2 (53.7 ± 7.1 vs. 46.8 ± 4.8 mm Hg, p < 0.001) and mean ptcCO2 (49.5 ± 6.8 vs. 44.0 ± 4.4 mm Hg, p < 0.001). Thirty-six percent of all patients reached the maximum hypercapnia after FB in the recovery room (8 ± 11 min). Patients with COPD needed more time to recover to normocapnia (22 ± 24 vs. 7 ± 11 min, p < 0.001). They needed a nasopharyngeal tube more often (28 vs. 11%, p < 0.001). All patients recovered from hypercapnia within 60 min after FB. No intermittent ventilation manoeuvres were needed. Conclusion: A relevant proportion of patients reached their peak-pCO2 after the end of intervention. We recommend using capnometry at least for patients with known COPD. Flexible EBUS in analgosedation can be safely performed in patients with advanced COPD. For patients with advanced COPD, a postprocedural observation time of 60 min was sufficient.
ІДЕНТИФІКАЦІЯ ПАРАМЕТРІВ У SIR-МОДЕЛЯХ ЗА РЕЗУЛЬТАТАМИ ПАНДЕМІЇ COVID-19 В ТЕРНОПІЛЬСЬКІЙ ОБЛАСТІ
Authors: Martsenyuk V. P. , Andreychyn M. A. , Sverstiuk A. S. , Kopcha V. S. , Сhaychuk О. Т. , Panychev V. O.
Published: April 2021

Мета роботи – запропонувати методи аналізу та прогнозування розповсюдження пандемії COVID-19 в Тернопільській області на основі SIR-моделі.

Матеріали і методи. Вхідними даними для аналізу та прогнозування розповсюдження пандемії COVID-19 служили показники Тернопільського обласного лабораторного центру МОЗ України. Аналіз і прогнозування розповсюдження цієї пандемії у Тернопільській області здійснено на основі SIR-моделі в пакеті R.

Результати досліджень. Отримано результати експериментальних досліджень кількості прогнозованих випадків інфікування та осіб, які одужали, з використанням SIR-моделі розповсюдження пандемії COVID-19 на основі лінійних і нелінійних диференціальних рівнянь на 60, 100 та 1000 діб.

Висновки. Абсолютна похибка прогнозування піку пандемії COVID-19 у Тернопільській області на основі SIR-моделі з використанням нелінійних диференційних рівнянь становить 10 діб, що пояснюється введенням своєчасних та ефективних заходів Центром громадського здоров’я МОЗ України та ДУ «Тернопільський обласний лабораторний центр МОЗ України».
КОРОНАВІРУСНІ ІНФЕКЦІЇ У ЛЮДИНИ
Authors: Shyrobokov V. P. , Poniatovsky V. A.
Published: April 2021

До 2003 р. у світі було відомо лише про два людські коронавіруси (HCoV), які спричиняли ураження дихальної системи легкого ступеня. Пізніше спалахи тяжкого гострого респіраторного синдрому (SARS), близькосхідного респіраторного синдрому (MERS) та COVID-19 прикули увагу всього світу до емерджентних коронавірусних інфекцій та еволюцію їх збудників. Ситуація з COVID-19 показала, наскільки руйнівною та небезпечною для життя може бути інфекція, зумовлена коронавірусами. Наведені сучасні дані про коронавіруси, які здатні уражати людей. Зазначено особ­ливості будови та класифікації коронавірусів, проаналізовано їх еволюційний шлях.
Development and Validation of Machine Learning–Based Race-Specific Models to Predict 10-Year Risk of Heart Failure: A Multicohort Analysis
Authors: Segar Matthew W. , Jaeger Byron C. , Patel Kershaw V. , Nambi Vijay , Ndumele Chiadi E. , Correa Adolfo , Butler Javed , Chandra Alvin , Ayers Colby , Rao Shreya , Lewis Alana A. , Raffield Laura M. , Rodriguez Carlos J. , Michos Erin D. , Ballantyne Christie M. , Hall Michael E. , Mentz Robert J. , de Lemos James A. , Pandey Ambarish
Published: April 2021

Background:

Heart failure (HF) risk and the underlying risk factors vary by race. Traditional models for HF risk prediction treat race as a covariate in risk prediction and do not account for significant parameters such as cardiac biomarkers. Machine learning (ML) may offer advantages over traditional modeling techniques to develop race-specific HF risk prediction models and to elucidate important contributors of HF development across races.

Methods:

We performed a retrospective analysis of 4 large, community cohort studies (ARIC [Atherosclerosis Risk in Communities], DHS [Dallas Heart Study], JHS [Jackson Heart Study], and MESA [Multi-Ethnic Study of Atherosclerosis]) with adjudicated HF events. The study included participants who were >40 years of age and free of HF at baseline. Race-specific ML models for HF risk prediction were developed in the JHS cohort (for Black race–specific model) and White adults from ARIC (for White race–specific model). The models included 39 candidate variables across demographic, anthropometric, medical history, laboratory, and electrocardiographic domains. The ML models were externally validated and compared with prior established traditional and non–race-specific ML models in race-specific subgroups of the pooled MESA/DHS cohort and Black participants of ARIC. The Harrell C-index and Greenwood-Nam-D’Agostino χ2tests were used to assess discrimination and calibration, respectively.

Results:

The ML models had excellent discrimination in the derivation cohorts for Black (n=4141 in JHS, C-index=0.88) and White (n=7858 in ARIC, C-index=0.89) participants. In the external validation cohorts, the race-specific ML model demonstrated adequate calibration and superior discrimination (Black individuals, C-index=0.80–0.83; White individuals, C-index=0.82) compared with established HF risk models or with non–race-specific ML models derived with race included as a covariate. Among the risk factors, natriuretic peptide levels were the most important predictor of HF risk across both races, followed by troponin levels in Black and ECG-based Cornell voltage in White individuals. Other key predictors of HF risk among Black individuals were glycemic parameters and socioeconomic factors. In contrast, prevalent cardiovascular disease and traditional cardiovascular risk factors were stronger predictors of HF risk in White adults.

Conclusions:

Race-specific and ML-based HF risk models that integrate clinical, laboratory, and biomarker data demonstrated superior performance compared with traditional HF risk and non–race-specific ML models. This approach identifies distinct race-specific contributors of HF.
The COVID-19 Pandemic and the Fragile Balance of a Small Zoo: the Case of Pistoia Zoo in Italy
Authors: Bandoli Francesca , Cavicchio Paolo
Published: April 2021

Zoos and aquaria have progressively evolved into conservation centres aimed at conserving biodiversity through educational, recreational, research and integrated conservation activities. Their work is based on a strong cooperation at national and international level, that enables the collaborative management of hundreds of thousands of animals and the protection of endangered species through integrated conservation programmes. The COVID-19 pandemic and the associated health, social and economic crisis have greatly impacted the zoological community, leading to multifaceted consequences especially for small private institutions. Here, we present the operational and ethical challenges, as well as the opportunities, arisen from the on-going crisis, focusing on Pistoia Zoo (Italy) as a case study. We finally discuss ethical and operational constraints and perspectives which could characterize the upcoming future of zoological facilities.
Systematic revision of Calligrapha s. str. Chevrolat (Coleoptera: Chrysomelidae, Chrysomelinae)
Authors: GÓMEZ-ZURITA JESÚS
Published: April 2021

In this work, the Chrysomelinae leaf beetle subgenus Calligrapha s. str. Chevrolat, 1836 is revised, offering redescriptions and keys for identification of twelve species currently considered in this group, allied to the South American species Calligrapha polyspila (Germar, 1821), the generic type of Calligrapha. The current species count results from important taxonomic changes. These include reversing a long-held synonymy, resurrecting the name Calligrapha mexicana Stål, 1859 stat. rev. for a species that is different from Chrysomela serpentina Rogers, 1856; upgrading the status of Polyspila serpentina var. discrepans Achard, 1923 to Calligrapha discrepans (Achard) stat. rev.; and formally proposing a number of new synonymies for several species, including: (1) Calligrapha discrepans (Achard) (= Calligrapha serpentina ssp. temaxensis Bechyné, 1952 syn. nov.); (2) Calligrapha fulvipes (Gistel, 1848) (= Calligrapha bajula Stål, 1860 syn. nov.; = Calligrapha nupta Stål, 1859 syn. nov.; = C. sponsa Stål, 1859 syn. nov.); and (3) Calligrapha polyspila (Germar) (= Polyspila polyspila var. bilineolata Achard, 1923 syn. nov.; = Polyspila polyspila var. plagata Achard, 1923 syn. nov.).
An updated checklist of marine gastropods of the Persian Gulf and Gulf of Oman
Authors: AMINI-YEKTA FATEMEH , DEKKER HENK
Published: April 2021

Here we review and evaluate the marine gastropods of the Persian Gulf and Gulf of Oman based on published accounts. A total of 850 species belonging to 129 families have records in the Persian Gulf (585) and Gulf of Oman (648), of which 383 species occurred in both regions. We updated the taxonomy and deleted records with dubious identifications. The resultant checklist documents the currently known diversity of marine gastropods from the Persian Gulf and Gulf of Oman and provides a foundation for future studies of the biodiversity of these areas.
Long-distance radiation of Rossby waves from the equatorial current system
Authors: Farrar J. Thomas , Durland Theodore , Jayne Steven R. , Price James F.
Published: April 2021

Measurements from satellite altimetry are used to show that sea-surface height (SSH) variability throughout much of the North Pacific is coherent with the SSH signal of the tropical instability waves (TIWs) that result from instabilities of the equatorial currents. This variability has regular phase patterns consistent with freely propagating barotropic Rossby waves radiating energy away from the unstable equatorial currents, and the waves clearly propagate from the equatorial region to at least 30°N. The pattern of SSH variance at TIW frequencies exhibits remarkable patchiness on scales of hundreds of kilometers, which we interpret as being due to the combined effects of wave reflection, refraction, and interference. North of 40°N, more than 6000 km from the unstable equatorial currents, the SSH field remains coherent with the near-equatorial SSH variability, but it is not as clear whether the variability at the higher latitudes is a simple result of barotropic wave radiation from the tropical instability waves. Even more distant regions, as far north as the Aleutian Islands off of Alaska and the Kamchatka Peninsula of eastern Russia, have SSH variability that is significantly coherent with the near-equatorial instabilities. The variability is not well represented in the widely used gridded SSH data product commonly referred to as the AVISO or DUACS product, and this appears to be a result of spatial variations in the filtering properties of the objective mapping scheme.
Assessing Seaglider® Model-based Position Accuracy on an Acoustic Tracking Range
Authors: Bennett James S. , Stahr Frederick R. , Eriksen Charles C. , Renken Martin C. , Snyder Wendy E. , Van Uffelen Lora J.
Published: April 2021

Seagliders® are buoyancy-driven autonomous underwater vehicles whose sub-surface position estimates are typically derived from velocities inferred using a flight model. We present a method for computing velocities and positions during the different phases typically encountered during a dive-climb profile based on a buoyancy-driven flight model. We compare these predictions to observations gathered from a Seaglider deployment on the acoustic tracking range in Dabob Bay (200 m depth, mean vehicle speeds ~30 cm s-1), permitting us to bound the position accuracy estimates and understand sources of various errors. We improve position accuracy estimates during long vehicle accelerations by numerically integrating the flight-model's fundamental momentum-balance equations. Overall, based on an automated estimation of flight-model parameters, we confirm previous work that predicted vehicle velocities in the dominant dive and climb phases are accurate to < 1 cm s-1, which bounds the accumulated position error in time. However, in this energetic tidal basin, position error also accumulates due to unresolved depth-dependent flow superimposed upon an inferred depth-averaged current.
Peter Pan, Wendy, and the Lost Boys: A Dead Mother Complex
Authors: White Robert S.
Published: April 2021

Melanie Klein and André Green offer competing descriptions of primitive mental development. The former emphasizes the need to control internal objects through splitting and projective identification, while the latter emphasizes a narcissistic retreat from objects through progressive deadening of the self. To bridge these theoretical differences a spectrum of fantasies is proposed ranging from reanimation (bringing deadness back to life) to reparation (healing damage caused by paranoid attack). Clinically, alternations between these two defensive patterns occur, acting together to avoid painful anxieties. The interplay of these defenses is illustrated by a dream drawn from clinical practice, from the life of James Barrie, and from his fictional creation Peter Pan.
A Case Using the Process Model of Multicultural Counseling Competence
Authors: Sahu Ankita , Console Katie , Tran Vy , Xie Siming , Yin Caroliina , Meng Xiao , Ridley Charles R.
Published: April 2021

This article presents a hypothetical counseling case that demonstrates the use of the process model of multicultural counseling competence. The counselor is an African American woman at a university counseling service, and the client is a young Chinese American woman and a sophomore at the university. First, we present an introduction to the case, giving a profile description of the client and counselor. Second, we unveil the counseling process through the model’s three phases, with demonstrations of the various features of the model. The unfolding format of the case captures the process nature of the model and dynamic interactions in the facilitation of therapeutic change. Selected excerpts illustrate counselor and client dialogue during the course of counseling, and examples of counselor multicultural counseling competencies highlight the prescriptive use of the process model. Third, we provide a reflection of the case, adding commentary on the application of the model.
The Process Model of Multicultural Counseling Competence
Authors: Ridley Charles R. , Sahu Ankita , Console Katie , Surya Shruti , Tran Vy , Xie Siming , Yin Caroliina
Published: April 2021

The mental health professions need to reconceptualize multicultural counseling competence and innovate their models in order to provide better guidance to their professionals. To this end, we first redefine multicultural counseling competence with the goal of overcoming its pervasive definitional problems. We then propose the process model of multicultural counseling competence, which aims to rectify the limitations of the existing models. Our model integrates strengths of the three major models—skills-based, adaptation, and process-oriented—while also adding new components. Seven foundational principles undergird our complex and dynamic model. The model consists of three distinct phases: preparation, intake and in-sessions, and termination. In addition, the model consists of five clinical operations. The superordinate operation is deep-structure incorporation of culture. Subordinating to and rotating around this superordinate operation are: infusing preparation, developing a therapeutic alliance, adapting interventions, and evaluating process and outcome. Although these clinical operations interact dynamically at multiple levels within the model, the ultimate purpose is still the attainment of positive therapeutic outcomes.
The Ram’s Horns: Reflections on the Legacy of Abdias Nascimento
Authors: Nascimento Elisa Larkin
Published: April 2021

Abdias Nascimento’s legacy is timely in a world experiencing exacerbated racial conflict and setbacks in public policy addressing inequality. This essay addresses two dimensions: on one hand, Nascimento’s life and work, and the tools he used to combat racism in the diverse realms of social and political activism as well as culture and the arts; on the other, IPEAFRO’s efforts and initiatives to make his legacy a living one, current with the needs of our time. My sources are my firsthand experience as Nascimento’s translator, co-author, and co-worker for 36 years; and his archives, the contents of which IPEAFRO is in the process of organizing, microfilming, digitizing, and making available via internet, a project that I coordinate.
Africology and the Question of Disciplinary Language
Authors: Mazama Ama
Published: April 2021

This essay is a contribution to Africology’s discipline-building. It examines more particularly the importance of disciplinary language, stressing the need for clear language and consistent definitions. Of particular concern are terms like “African-centeredness” and “Africancentered” which have never been clearly defined although they are widely used. This clout, this essay argues, impedes discipline-building efforts by introducing and sustaining semantic and terminological incoherence.
Flutter of variable stiffness composite laminates in supersonic flow with temperature effects
Authors: Ouyang Xiaosui , Liu Yi
Published: April 2021

The nonlinear thermal flutter behavior of variable stiffness composite laminates (VSCL) with curvilinear fibers in high supersonic flow is investigated. The first order shear deformation theory (FSDT) combining von Karman large-deflection strain-displacement relations, quasi-steady first-order piston theory aerodynamics and quasi-steady thermal stress theory are used to formulate the nonlinear panel flutter finite element equations of motion. The fiber orientation within a layer is assumed to vary linearly from [Formula: see text] at the center to [Formula: see text] at the vertical edges of the rectangular lamina. The flutter characteristics of variable stiffness composite laminates with different temperature distributions are then studied. The results show that the critical dynamic pressure decreases as [Formula: see text] or [Formula: see text] increases, whereas the limit cycle amplitude increases as [Formula: see text] or [Formula: see text] increases for the same dynamic pressure. The critical dynamic pressure and limit cycle amplitude both increase when the temperature gradient along panel thickness increases. Simple harmonic motions, unharmonic but periodic motions, and chaotic motions can be observed on VSCL under different temperatures. It also turns out that temperature distribution has similar influence on both the critical dynamic pressure and limit cycle amplitude of VSCL.
Cooperation and Trust Across Societies During the COVID-19 Pandemic
Authors: Romano Angelo , Spadaro Giuliana , Balliet Daniel , Joireman Jeff , Van Lissa Caspar , Jin Shuxian , Agostini Maximilian , Bélanger Jocelyn J. , Gützkow Ben , Kreienkamp Jannis , Leander N. Pontus
Published: April 2021

Cross-societal differences in cooperation and trust among strangers in the provision of public goods may be key to understanding how societies are managing the COVID-19 pandemic. We report a survey conducted across 41 societies between March and May 2020 ( N = 34,526), and test pre-registered hypotheses about how cross-societal differences in cooperation and trust relate to prosocial COVID-19 responses (e.g., social distancing), stringency of policies, and support for behavioral regulations (e.g., mandatory quarantine). We further tested whether cross-societal variation in institutions and ecologies theorized to impact cooperation were associated with prosocial COVID-19 responses, including institutional quality, religiosity, and historical prevalence of pathogens. We found substantial variation across societies in prosocial COVID-19 responses, stringency of policies, and support for behavioral regulations. However, we found no consistent evidence to support the idea that cross-societal variation in cooperation and trust among strangers is associated with these outcomes related to the COVID-19 pandemic. These results were replicated with another independent cross-cultural COVID-19 dataset ( N = 112,136), and in both snowball and representative samples. We discuss implications of our results, including challenging the assumption that managing the COVID-19 pandemic across societies is best modeled as a public goods dilemma.
Barriers to training in laparoscopic surgery in low- and middle-income countries: A systematic review
Authors: Wilkinson Ellen , Aruparayil Noel , Gnanaraj J , Brown Julia , Jayne David
Published: April 2021

Laparoscopic surgery has the potential to improve care in resource-deprived low- and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using ‘LMIC’, ‘Laparoscopy’ and ‘Training’. Two researchers screened results with mutual agreement. Included papers were in English, focused on abdominal laparoscopy and training in LMICs. PRISMA guidelines were followed; 2992 records were screened, and 86 full-text articles reviewed to give 26 key papers. Thematic grouping identified seven key barriers: funding; availability and maintenance of equipment; local access to experienced laparoscopic trainers; stakeholder dynamics; lack of knowledge on effective training curricula; surgical departmental structure and practical opportunities for trainees. In low-resource settings, technological advances may offer low-cost solutions in the successful implementation of laparoscopic training and improve access to surgical care.
Study of novel solar assisted heating system
Authors: Davies Gareth , Blower John , Hall Richard , Maidment Graeme
Published: April 2021

The potential for energy, carbon dioxide equivalent (CO2e) and cost savings when using low emissivity (low-ε) transpired solar collectors (TSCs), combined with heat pumps in a range of configurations, has been investigated using computer modelling. Low-ε TSCs consist of metal solar collector plates with a spectrally sensitive surface, perforated with holes. Ambient air is drawn through the holes and heated by convection from the solar collector plate, increasing the air temperature by up to 25 K. The heated air can be used for e.g. space heating, or pre-heating water in buildings. The models developed have been used to compare the performance of low-ε TSC/heat pump heating systems in small and large buildings, at a range of locations. The model results showed savings in energy, CO2e and costs of up to 16.4% when using low-ε TSCs combined with an exhaust air heat pump compared with using the exhaust air heat pump alone.

Practical application: If the UK is to meet its target of reaching net zero greenhouse gas emissions by 2050, it will be necessary to adopt low or zero carbon heating technologies. The novel low emissivity transpired solar collector device investigated can contribute to this. Its advantages include: (i) utilising solar radiation; (ii) readily integrated with existing heating systems e.g. heat pumps; (iii) significant energy, CO2e emissions and cost savings; (iv) low cost device; (v) minimal energy input i.e. one small fan; (vi) can be retrofitted to existing buildings; (vii) its benefits were applicable at all of the (wide range of) locations tested.
Overheating assessment in flats with glazed balconies in warm-summer humid continental climate
Authors: Grudzińska Magdalena
Published: April 2021

Greenhouse systems in the form of glazed balconies may be accomplished both in the newly designed buildings and in the existing ones, raising their energy standard in a quick and inexpensive way. However, basic parameters influencing the efficiency of the systems are often chosen intuitively, not allowing to fully benefit from the sunspaces or causing overheating of the rooms and discomfort for the users. These issues are common drawbacks of passive systems and may become especially important in the aspect of anthropogenic climate changes, including temperature rise and summer heatwaves. The paper presents results of a long-term summer temperature monitoring in flats with glazed balconies of different construction. They were located in prefabricated multi-family buildings, in residential districts of Lublin and Zamość. The cities are situated in the south-eastern part of Poland, belonging to the warm-summer humid continental climate area. The monitoring enabled overheating assessment according to the concept of adaptive comfort and connecting it with the sunspace construction and the inhabitants’ behaviour. These issues are new aspects in the research area, and the work is a part of extensive studies including monitoring and dynamic simulations of dwellings with passive greenhouse systems in Poland.

Practical application: Glazed balconies raise the energy standard of buildings in a quick and inexpensive way, but it is important to consider their function not only during the heating season but also in the summer. Recording of temperatures enabled the monitoring of thermal conditions in the flats and the overheating assessment. It is possible to keep the internal temperature in the rooms within the desired range thanks to the sunspace ventilation and occupants’ behaviour.
What do we know about indoor air quality of nurseries? A review of the literature
Authors: Zhang Shuo , Mumovic D , Stamp Samuel , Curran Katherine , Cooper Elizabeth
Published: April 2021

Considering the alarming rise in the rate of asthma and respiratory diseases among school children, it is of great importance to investigate all probable causes. Outside of the home, children spend most of their time in school. Many studies have researched the indoor environmental quality of primary and secondary school buildings to determine the exposure of school children to indoor air pollution. However, studies of very young children in nurseries are scarce. Unlike at elementary schools or universities, children in nurseries are more vulnerable due to their physiology, inability to articulate discomfort and to adapt their behaviour to avoid exposures. This article reviews current studies on the indoor environment in nurseries. It summarizes air pollution levels and related environmental and behavioural factors in nurseries that have been reported in the literature. Additionally, exposure to indoor air pollution and related potential health outcomes are examined. This review concludes that indoor air pollution in nurseries often exceeds current guidelines, and designers and policymakers should be made aware of the impact on the health and wellbeing of children in nurseries. Proper interventions and guidelines should be considered to create a healthy indoor environment for nursery children.

Practical application: Previous IAQ assessments have mainly focused on indoor temperatures and CO2 levels. Data on comprehensive monitoring (including PMs, NO2, O3 and other pollutants) of indoor air quality of nurseries are scarce. Particularly in the UK, studies about indoor air quality in nurseries have not been founded. This paper categorized relevant articles according to the focus of the study, to provide evidence to a better understanding of current indoor air quality in nursery environments.
Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status
Authors: Saroul Nicolas , Puechmaille Mathilde , Lambert Céline , Hassan Achraf Sayed , Biau Julian , Lapeyre Michel , Mom Thierry , Bernadach Maureen , Gilain Laurent
Published: April 2021

Objectives

To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer.

Study Design

Single‐center retrospective study of prospectively collected data.

Setting

Tertiary referral center.

Methods

Ninety‐two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival.

Results

In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P =. 002, for stage T3‐4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P =. 008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P =. 02). Social deprivation was not a prognostic factor.

Conclusion

Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.
Hearing Their Voices: Parents’ Perceptions of Preschool Special Education Evaluations With Dual-Language Learners
Authors: Harvey Hattie , Wennerstrom Erin Kinavey
Published: April 2021

Advancing equity in early childhood education is crucial as our broader society faces issues of inequities across systems, including education. Professionals must honor children’s home language and cultural contexts, coming from a perspective of value and respect rather than from a traditionally dominant Eurocentric perspective. Through this study, we share the perspectives of 22 U.S. parents of dual-language learners (DLLs) as they experienced an evaluation for preschool special education. Through a mixed-methods approach using survey and interview data, three primary themes emerged: (a) relationships and interactions, (b) home language and cultural context, and (c) the evaluation process. Significant differences in satisfaction emerged between those who had participated in Part C Early Intervention services versus those who had not.
Effect of a three-piece inflatable penile prosthesis combined with a phosphodiesterase-5 inhibitor on erectile dysfunction
Authors: Wang Jian , Wu Peng , Liu Qiang , Ben Liangliang , Chen Geng , Han Zhijuan , Peng Hui
Published: April 2021

Objective

To investigate the therapeutic effect of implanting a three-piece inflatable penile prosthesis (IPP) combined with the phosphodiesterase-5 inhibitor sildenafil in severe erectile dysfunction (ED) patients.

Methods

This randomized controlled study included 123 ED patients. Sixty-two patients received the IPP implantation and 61 patients received the IPP implantation and the phosphodiesterase-5 inhibitor sildenafil. Erectile function and sexual life quality were evaluated using the five-item International Index of Erectile Function (IIEF) and modified Sexual Life Quality Questionnaire–Quality of Life domain (mSLQQ-QoL), respectively. Serum interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, vascular cell adhesion molecule (VCAM)-1, and intercellular adhesion molecule (ICAM)-1 levels were assessed. Kaplan–Meier curves were used to assess the overall IPP survival.

Results

Implantation of the three-piece IPP with sildenafil improved erectile function and sexual life quality, alleviated the inflammatory response, reduced the complication rate, and improved overall IPP survival.

Conclusion

Implantation of the three-piece IPP combined with a phosphodiesterase-5 inhibitor significantly improved clinical outcomes and the prognosis in ED patients.
Outcomes of head and neck cancer management from two cancer centres in Southern and Northern Europe during the first wave of COVID-19
Authors: Tagliabue Marta , Russell Beth , Moss Charlotte , De Berardinis Rita , Chu Francesco , Jeannon Jean-Pierre , Pietrobon Giacomo , Haire Anna , Grosso Enrica , Wylie Harriet , Zorzi Stefano , Proh Michele , Brunet-Garcia Aina , Cattaneo Augusto , Oakley Richard , De Benedetto Luigi , Arora Asit , Riccio Stefano , Fry Alistair , Bruschini Roberto , Townley William , Giugliano Gioacchino , Orfaniotis Georgios , Madini Marzia , Dolly Saoirse , Borghi Ester , Aprile Danila , Zurlo Valeria , Bibiano Debora , Mastrilli Fabrizio , Chiocca Susanna , Van Hemelrijck Mieke , Gandini Sara , Simo Ricard , Ansarin Mohssen
Published: April 2021

Objective:

To describe the approach and outcomes from two cancer centres in Southern and Northern Europe during the first wave of coronavirus disease 2019 (COVID-19) of patients with head and neck cancer (HNC).

Methods:

Data collection was performed on a retrospective cohort of patients surgically treated for primary HNC between March and May 2020, using data from two tertiary hospitals: the European Institute of Oncology (Milan) and Guy’s & St Thomas’ NHS Foundation Trust (London).

Results:

We included 77 patients with HNC. More patients with COVID-19 were taking angiotensin-converting enzyme (ACE) inhibitors and had Clavien-Dindo Classification grade I compared to negative patients, respectively (60% vs 22% [ p = 0.058] and 40% vs 8% [ p = 0.025]). Multivariate logistic regression analyses confirmed our data ( p = 0.05 and 0.03, respectively). Sex and age were statistically significantly different ( p = 0.05 and <0.001 respectively), showing more male patients (75% vs 53.66%, respectively) and more elderly patients in Italy than in the United Kingdom (patients aged >63 years: 69.44% vs 29.27%).

Conclusions:

This study presents a large cohort of patients with HNC with nasopharyngeal swab during the first peak of the COVID-19 pandemic in Europe. Patients with HNC with COVID-19 appeared more likely to develop postsurgical complications and to be taking ACE inhibitors. The preventive measures adopted guaranteed the continuation of therapeutic surgical intervention.
The Alt-Right’s continuation of the ‘cultural war’ in Euro-American societies
Authors: Bar-On Tamir
Published: April 2021

In this paper, I argue that the Alt-Right needs to be taken seriously by the liberal establishment, the general public, and leftist cultural elites for five main reasons: 1) its ‘right-wing Gramscianism’ borrows from the French New Right ( Nouvelle Droite – ND) and the French and pan-European Identitarian movement. This means that it is engaged in the continuation of a larger Euro-American metapolitical struggle to change hearts and minds on issues related to white nationalism, anti-Semitism, and racialism; 2) it is indebted to the metapolitical evolution of sectors of the violent neo-Nazi and earlier white nationalist movements in the USA; 3) this metapolitical orientation uses the mass media, the internet, and social media in general to reach and influence the masses of Americans; 4) the ‘cultural war’ means that the Alt-Right’s spokesman Richard Spencer, French ND leader Alain de Benoist, and other intellectuals see themselves as a type of Leninist vanguard on the radical right, which borrows from left-wing authors such as Antonio Gramsci and their positions in order to win the metapolitical struggle against ‘dominant’ liberal and left-wing political and cultural elites; and 5) this ‘cultural war’ is intellectually and philosophically sophisticated because it understands the crucial role of culture in destabilizing liberal society and makes use of important philosophers such as Friedrich Nietzsche, Carl Schmitt, Julius Evola and others in order to give credence to its revolutionary, racialist, and anti-liberal ideals.