bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Surface Fluxes in MJO Propagation through the Maritime Continent
Authors: Hudson Justin , Maloney Eric
Published: December 2022

The “barrier effect” of the Maritime Continent (MC) is a known hurdle in understanding the propagation of the Madden–Julian oscillation (MJO). To understand the differing dynamics of MJO events that propagate versus stall over the MC, a new tracking algorithm utilizing 30–96-day-filtered NOAA Interpolated OLR anomalies is presented. Using this algorithm, MJO events can be identified, tracked, and described in terms of their propagation characteristics. Latent heat flux from OAFlux and CYGNSS surface winds and fluxes are compared for MJO events that do and do not propagate through the MC. Events that successfully propagate through the MC demonstrate regional surface flux anomalies that are stronger, more spatially coherent, and have a larger fetch. The spatial scale of convective anomalies for events that successfully propagate through the MC region is also larger than for terminating events. Large-scale enhancement of latent heat fluxes near and to the east of the date line, equally driven by dynamic and thermodynamic effects, also accompanies MJO events that successfully propagate through the MC. These findings are placed in the context of recent theoretical models of the MJO in which latent heat fluxes are important for propagation and destabilization.
Chemosensory Dysfunction 3-Months After COVID-19, Medications and Factors Associated with Complete Recovery
Authors: Fornazieri Marco Aurélio , Silva José Lucas Barbosa da , Gameiro Juliana Gutschow , Scussiato Henrique Ochoa , Ramos Rafael Antônio Matias Ribeiro , Cunha Bruno Machado , Figueiredo Alan Felipe , Takahashi Eduardo Hideki , Marin Gabrielli Algazal , Caetano Igor Ruan de Araújo , Meli Tainara Kawane , Higuchi Diego Issamu , Santos Rafael Rodrigues Pinheiro dos , Rampazzo Ana Carla Mondek , Pinna Fábio de Rezende , Voegels Richard Louis , Doty Richard L.
Published: December 2022

Objectives:

To examine the longitudinal prevalence and recovery of olfactory, gustatory, and oral chemesthetic deficits in a sizable cohort of SARS-CoV-2 infected persons using quantitative testing. To determine whether demographic and clinical factors, mainly the medications used after the COVID-19 diagnosis, influence the test measures.

Methods:

Prospective cohort in a hospital with primary, secondary, tertiary, and quaternary care. Patients with confirmed COVID-19 were tested during the acute infection phase (within 15 days of initial symptom, n = 187) and one (n = 113) and 3 months later (n = 73). The University of Pennsylvania Smell Identification Test, the Global Gustatory Test, and a novel test for chemesthesis were administered at all visits.

Results:

During the acute phase, 93% were anosmic or microsmic and 29.4% were hypogeusic. No one was ageusic. A deficit in oral chemesthesis was present in 13.4%. By 3 months, taste and chemesthesis had largely recovered, however, some degree of olfactory dysfunction remained in 54.8%. Remarkably, patients who had been treated with anticoagulants tended to have more olfactory improvement. Recovery was greater in men than in women, but was unrelated to disease severity, smoking behavior, or the use of various medications prior to, or during, COVID-19 infection.

Conclusions:

When using quantitative testing, olfactory disturbances were found in nearly all SARS-CoV-2 infected patients during the acute infection phase. Taste or chemesthetic deficits were low. Olfactory impairment persisted to some degree in over half of the patients at the 3-month follow-up evaluation, being more common in women and less common in those who had been treated earlier with anticoagulants.

Level of Evidence:

3
Farm Laws: Regulation-revolution?—Assessing the Need, Intent and Impact of the New Farm Laws from an Economic Perspective
Authors: Mehta Sanjana
Published: December 2022

In September 2020, through a voice vote in the Rajya Sabha, the Indian Parliament passed the infamous three farm bills. This triggered a series of protests and resistance that manifested in one of the world’s biggest displays of dissent. A lot has been said about the intent and potential impact of the farm bills. India is a majorly agricultural economy, so not only do these farm bills hold the potential to disrupt our economy, the protests it has triggered are further indicative of a radical change. This article breaks down the intent of the now-repealed legislation, its potential impact on the economy, positive and negative, and how the resultant protests have impacted a country headed towards a recessionary period. The article marks battles won and lost, and paves a potential path forward.

JEL Code: E6
Examining the Aftermath of Work-Family Conflict Episodes: Internal Attributions, Self-Conscious Emotions, Family Engagement, and Well-Being
Authors: Chen Zheng , Promislo Mark D. , Powell Gary N. , Allen Tammy D.
Published: December 2022

Little empirical research exists on attributions that people make regarding work-family conflict that they experience. Our study used attribution theory to examine the aftermath of work-family conflict episodes. We used a diary method in which respondents reported their daily encounters with work-family conflict, attributions they made about its causes, feelings of guilt and shame they experienced, and their levels of daily family engagement and well-being after work. Based on Ilies et al. (2012) we hypothesized that internal attributions of work-family conflict would be associated with feelings of guilt and shame, and that these emotions would in turn be differentially associated with daily after-work outcomes. We also hypothesized that the degree to which individuals were satisfied with the resolution of their work-family conflict would moderate the relationship between internal attribution and guilt/shame. Results largely supported our hypotheses, with guilt demonstrating a positive link to family engagement while shame showed a negative association. We also found that shame, but not guilt, was negatively associated with daily well-being. One’s level of satisfaction with the resolution of work-family conflict emerged as a key variable as well. Lastly, we discuss the theoretical and practical ramifications of our findings.
Unto the least of these: Caring for the vulnerable in the time of COVID
Authors: White Frederick J.
Published: December 2022

As the COVID-19 pandemic initially unfolded in early 2020, medical systems were rapidly overwhelmed with critically ill patients. Intensive care resources were strained and, in some cases, insufficient. Concepts of triage and allocation of life-saving resources, once only hypothetical, were called into action. Vulnerable elderly, chronically ill, and disabled patients found themselves subject to protocols and guidelines that singled them out for disparate access to treatments. In this article, I overview the historical background of the early COVID-19 crisis, frontline triage guidelines in Italy and New York City, the conceptual nature of triage, the problematic practice of reallocation, the ethical principles that were challenged, how Judeo-Christian teachings inform these issues, and conflicts of physician duties with attendant moral distress. I close with a set of normative guideline statements that could help define a path through the extreme scarcities of a catastrophic pandemic crisis surge.
A theological and ethical analysis of the response of the Eastern Orthodox to the COVID-19 pandemic
Authors: LeMasters Philip
Published: December 2022

The response of the Eastern Orthodox Church to the COVID-19 pandemic reflects its distinctive theological and liturgical traditions as well as its decentralized system of governance. Foundational beliefs and practices inform Orthodoxy’s understanding of the imperative to care for the physical well-being of the sick. Points of disagreement arose in Orthodox communities concerning public health restrictions on attendance at the Divine Liturgy, the use of a common communion spoon, whether diseases may be transmitted through the Eucharist, and the appropriateness of receiving vaccinations tested or produced with cell lines derived from the tissue of aborted fetuses. Such contested matters reflect points of tension between characteristic beliefs and practices of Orthodoxy and its commitment to care for the health of neighbors during a global pandemic.
The Past, Present, and Future of Monkeypox: A Rapid Review Regarding Prevalence and Prevention
Authors: Masood Waniyah , Khan Hira Anas , Cheema Huzaifa Ahmad , Shahid Abia , Bilal Wajeeha , Kamal Manar Ahmed , Essar Mohammad Yasir , Ahmad Shoaib , Marzo Roy Rillera
Published: December 2022

While monkeypox virus (MPXV) remained endemic in central and western African countries, a sudden unusual spike of global cases among non-endemic countries is an enigma for scientists. With 257 cases reported as of 26th May 2021, a multi-country outbreak of monkeypox has been declared in countries including the UK, EU/EEA states, and North America. Even though the likelihood of transmissibility of MPXV is limited compared to COVID-19, yet a coordinated multidisciplinary effort is required to prevent any further global expansion. Few appropriate responsive approaches to contain the infection could be; limiting the contact with potential animal reservoirs, isolation of confirmed cases, using PPEs to prevent human-human transmission, awareness activities, and administration of pre and post prophylactic vaccination. In this review, we have discussed the previous and current outbreaks of MPXV along with the abrupt actions that are needed to address the situation.
Adaptive H-infinity extended Kalman filtering for a navigation system in presence of high uncertainties
Authors: Yazdkhasti Setareh , Sabzevari Danial , Sasiadek Jurek Z.
Published: December 2022

The optimal performance of the Kalman filters is highly dependent on the measurement and process noise characteristics, making the whole system unable to achieve the desired estimation in the presence of non-Gaussian mean noise distribution and high initial uncertainties. Recently, the H-infinity filter, as a robust algorithm, has been broadly used, as it is not being dependent on the pre-knowledge of the noise nature; however, making a balance between high robustness and estimation accuracy is a challenging issue. Hence, to overcome this problem, a new adaptive H-infinity extended Kalman filter (AHEKF) was designed in this paper, which benefits from both high robustness and precision. The suggested algorithm contains two adaptive sections to achieve high accuracy as well as controlling the effects of time-varying noise characteristics, high initial uncertainties, and abnormal data that can degrade the accuracy of state estimation in an integrated navigation system. The presented algorithm was used to integrate data from two independent sensors data. The simulation results for an inertial navigation system (INS)/global positioning system (GPS) sensor fusion are presented and compared with the standard H-infinity filter, extended Kalman filter (EKF), and unscented Kalman filter (UKF) to show the effectiveness of the proposed algorithm. Evaluations demonstrate that the AHEKF achieves over 50% higher accuracy and robustness, and over 2.5 times faster convergence of estimation errors than the standard H-infinity filter.
Sample-data output-feedback parameter variable control of glucose for type 1 diabetes mellitus patients
Authors: Hooshmandi Kaveh , Bayat Farhad
Published: December 2022

This paper presents a new approach for nonlinear sampled-data output-feedback control of blood glucose concentration (BGC) in patients with type 1 diabetes mellitus (T1DM). The Bergman minimal model (BMM) describing the glucose-insulin regulatory system is framed as a linear parameter-varying (LPV) model that the sampled glucose measurement with the quantized insulin infusion is considered as input delay. The proposed method utilizes the input-delay approach based on a parameter-dependent Lyapunov–Krasovskii functional (LKF) and provides the parameterized matrix inequality conditions for the design of the controller. Using the slack variables, the design conditions are converted to a new form that can achieve feasible solutions by solving a limited number of bilinear matrix inequality. The proposed architecture guarantees stability in a compact set of states for all the trajectories with the parametric uncertainty to address the issue of inter-patient variability. Simulation results confirm that the proposed sampled-data static output-feedback LPV controller with only glucose measurement regulates the BGC despite the parametric uncertainty and meal disturbances in T1DM patients.
Intersections of spirituality, relationships, and music education: Applications of lessons from the Pixar film, Soul
Authors: Smith Raychl
Published: December 2022

How can music educators explore the intersections of spirituality, relationships, and music education? The purpose of this paper is to examine how the Pixar film, Soul, models the transformation that can occur when a music teacher embraces spirituality and the preciousness of everyday life both in and out of the classroom through experiences in spatiality, corporeality, temporality, and relationality. To explore the film’s implications, I use a conceptual model of spirituality from van der Merwe and Habron and a theoretical framework from Boyce-Tillman which explores ideas of eudaimonia, spirituality, and music education. The film’s protagonist, Joe Gardner, who evolves past his own ego and comes to share the joy of everyday experiences with a fearful student, may serve as a model for music educators who are seeking to find meaning in the daily life of music teaching and learning. Because discussing films seems so natural to our social experience, pondering how characters evolve and come to understand their purpose may help music teachers develop a deeper understanding of their own identity and interconnected relationships with students.
Responding to coercive control in criminal justice domestic violence perpetrator programmes in England and Wales: Conceptual, operational, and methodological complexities
Authors: Renehan Nicole
Published: December 2022

Evaluations of domestic violence perpetrator programmes have not produced evidence that they are as effective at reducing male, non-violent, coercively controlling behaviours. This article proposes such limitations are understood by adopting a more complex conceptualisation of coercive control for which the reasons are both gendered and biographically unique. Drawing on document analyses and in-depth interviews with eight programme facilitators and an in-depth case study of one male participant, this article explores the merits and limitations of the cognitive behavioural, skills-based criminal justice programme, Building Better Relationships, in addressing coercively controlling behaviours. The dual (re)conceptualisation of coercive control proposed has implications for both practice and programme evaluation methods.
Evaluating Theory-Based Correlates of Dissociation: A Nomological Network Study
Authors: Polizzi Craig P. , Aksen Damla E. , Sleight Fiona G. , Lynn Steven Jay
Published: December 2022

Informed by the transtheoretical/transdiagnostic model (TTM) of dissociation, we tested the nomological network of dissociation by evaluating the unique relations among dissociation and its facets (i.e., depersonalization, amnesia, absorption, taxon) with variables pertinent to competing dissociation theories (e.g., posttraumatic stress disorder [PTSD] symptoms, resilience, fantasy proneness, cognitive failures, sleep) while controlling for neuroticism, affect, and social desirability. Self-report measures were administered online to undergraduate students ( N  =  352). We found robust relations among dissociation and sociocognitive variables (i.e., fantasy proneness, cognitive failures, thought control) and correlations among dissociation and trauma-related variables (e.g., PTSD symptoms, resilience). Variables relevant to different dissociation theories uniquely related to distinct dimensions of dissociation. We observed significant indirect effects on dissociation for sleep, cognitive failures, and fantasy proneness. Results support the sociocognitive and posttraumatic models of dissociation, thereby highlighting nuances in dissociation's nomological network and confirming the value of the TTM as an integrative model.
Representative Driving Cycles for Trinidad and Tobago with Slope Profiles for Electric Vehicles
Authors: Maharaj Bhopendra Seunarine , King Graham
Published: December 2022

The rise of plug-in battery electric vehicles presents an excellent opportunity for small island developing states such as those of the Caribbean. The vehicles offer improved energy efficiency, enhanced energy security, and reduced foreign exchange expenditure. Incentivizing the uptake of electric vehicles seems to be an obvious policy decision, but there could be unintended consequences. Real-world driving cycles are essential for validating electric-vehicle energy and economic benefits using simulation studies. In drive-cycle methodologies, the microtrip method is the preferred choice for countrywide representation and is ideal for fuel consumption estimations. This paper reports on the first such real-world driving cycle for the Caribbean, specifically Trinidad and Tobago, which is developed using a microtrip construction method with a novel approach to establishing a slope profile. Highway and suburban segments show some distinct characteristics, including relatively high average accelerations and decelerations in the highway and suburban cycles and low average speeds of 40.2 km/h (highway) and 21.74 km/h (suburban). The driving cycle is unique but reasonable when compared with others derived in emerging economies.
Enhancing Dementia Knowledge and Self-Efficacy of In-Home Supportive Services Caregivers Through Online Training
Authors: Yeh Jarmin , Pond Brittney , Beld Matthew , Garcia Andrea , Mauricio Juvenal , Mata-Pacheco Juliana , Eldridge Corinne , Ross Leslie
Published: December 2022

California’s In-Home Supportive Services (IHSS) program provides vital home care to low-income consumers, some of whom live with Alzheimer’s disease or related dementias (ADRD). Yet, most IHSS caregivers receive little or no training in dementia care. We present preliminary descriptive results of the IHSS + ADRD Training Project, a 10-week, competency-based, dementia training program, delivered online, for IHSS caregivers, in Alameda County. Increase in dementia knowledge and self-efficacy at training completion supports the importance of continuing and expanding this work.
Writing Process Feedback Based on Keystroke Logging and Comparison With Exemplars: Effects on the Quality and Process of Synthesis Texts
Authors: Vandermeulen Nina , Van Steendam Elke , De Maeyer Sven , Rijlaarsdam Gert
Published: December 2022

This intervention study aimed to test the effect of writing process feedback. Sixty-five Grade 10 students received a personal report based on keystroke logging data, including information on several writing process aspects. Participants compared their writing process to exemplar processes of equally scoring (position-setting condition) or higher-scoring students (feed-forward condition). The effect of the feedback on writing performance and process was compared to a national baseline study. Results showed that feed-forward process feedback had an effect on text quality comparable to one grade of regular schooling. The feedback had an effect on production, pausing, revision, and source use, which indicates that it supported participants in self-regulating their writing process. Additionally, we explored the students’ perception of the feedback to get an insight into its strengths and weaknesses. This study shows the potential of writing process feedback and discusses pedagogical implications and options for future research.
Experimental investigation on mechanical and microstructural behaviour of GFRP elastomeric nanocomposites
Authors: Kamboj Sumit , Sharma Lochan , Chhibber Rahul , Mehta Rajeev
Published: December 2022

In many industrial applications elastomers are frequently used due to its low cost. In present study the Ethylene propylene diene elastomer (EPDM) was used. Solution intercalation method adopted to synthesize EPDM/OMMT clay nanocomposites using organically modified montmrillonite clay. At different loading levels of clay (2%, 3% and 5% weight) various characterizations such as tensile strength, flexural strength and d-spacing behaviour were performed. X-ray diffraction technique was used to study the d-spacing behaviour of different nanocomposites at 2%, 3% and 5% weight percentage of clay loading level. Clay dispersion in the rubber matrix was observed by scanning electron microscope. Comparative study between pure EPDM specimen and EPDM clay nanocomposite specimen was carried out. Modulus as well as flexural strength value was higher for EPDM clay specimen as compared to pure EPDM specimen.
Love, grief and violence – A study of Camille Kouchner's La Familia grande (2021)
Authors: Petocz Orsolya Katalin
Published: December 2022

In her 2021 book La Familia grande, Camille Kouchner testifies to the event of sexual violence more precisely that of incestuous hebephiliac rape within her family. In extensive discussions that followed the publication of the book, the media has focused on the allegations of incestuous rape against Olivier Duhamel upon his stepson, twin-brother of Kouchner, nicknamed ‘Victor’ in La Familia grande. Kouchner's nuclear and extended family is part of a French politico-cultural elite that has been shaken by Kouchner's unveiling of violence. Acknowledging this context, this article looks closely at the text itself, and also situates it in relation to works by other woman members of Kouchner's family, with a sharp focus on the work of Évelyne Pisier, Kouchner's mother. This article teases out questions of love, grief and violence as related to Kouchner's testimony, presenting a case for close attention to the literary work alongside its paratexts. I argue that shifting away from the violence of Duhamel's acts, the book turns towards the ways in which the heteropatriarchal structures of the family allow for the perpetration of such an act and the perpetuation of its violence through silencing. This reading argues for the necessary unveiling of a filiation of women, to form a possible resistance to normative narratives of the family. This article further connects Judith Butler's thoughts about incest prohibition and Évelyne Pisier's queer-inclusive feminism.
The exploration of shared genes and molecular mechanisms of systemic lupus erythematosus and atherosclerosis
Authors: Fan Ji-Lin , Wu Di , Zhu Ting-Ting , Tian Xiao-Ling , Liu Si-Jia , Zhang Shi-Liang
Published: December 2022

Objective

Despite widespread recognition, the mechanisms underlying the relationship between systemic lupus erythematosus (SLE) and atherosclerosis (AS) are still unclear. Our study aimed to explore the shared genetic signature and molecular mechanisms of SLE and AS using a bioinformatics approach.

Methods

Gene expression profiles of GSE50772 (contains peripheral blood mononuclear cells from 61 SLE patients and 20 normal samples) and GSE100927 (contains 69 AS plaque tissue samples and 35 control samples) were downloaded from the Gene Expression Database (GEO) before the differentially expressed genes were obtained using the “limma” package in R. The differential genes were then subjected to gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis using the DAVID online platform to annotate their functions. The intersection targets of PPI and WGCNA were used as key shared genes for SLE and AS with their diagnostic value as shared genes being verified through ROC curves. Finally, Cytoscape 3.7.2 software was used to construct a miRNA-mRNA network map associated with the shared genes.

Results

A total of 246 DEGs were identified, including 189 upregulated genes and 57 downregulated genes, which were mainly enriched in signaling pathways such as TNF signaling pathway, IL-17 signaling pathway, and NF-kB signaling pathway. The molecular basis for the relationship between SLE and AS may be the aforementioned signaling pathways. Following ROC curve validation, the intersection of PPI and WGCNA, as well as AQP9, CCR1, CD83, CXCL1, and FCGR2A, resulted in the identification of 15 shared genes.

Conclusion

The study provided a new perspective on the common molecular mechanisms between SLE and AS, and the key genes and pathways that were identified as being part of these pathways may offer fresh perspectives and suggestions for further experimental research.
Electroacupuncture inhibits hippocampal neuronal apoptosis and improves cognitive dysfunction in mice with vascular dementia via the JNK signaling pathway
Authors: Liu Yaru , Yan Zhenyang , Ren Yafei , Wang Woyu , Ke Yinze , Wang Yifan , Qi Rongming
Published: December 2022

Background:

Electroacupuncture (EA) has been shown to reduce cognitive impairment in vascular dementia (VaD) patients. However, the mechanism of action remains unknown.

Objective:

The c-Jun N-terminal kinase (JNK) signaling pathway plays an important role in apoptosis. Herein, we focused on whether EA can inhibit apoptosis and alleviate cognitive impairment by regulating the JNK signaling pathway using a mouse model of VaD induced by modified bilateral common carotid artery occlusion (BCCAo).

Methods:

In experiment I, 60 mice were randomly divided into a Sham group, BCCAo group, BCCAo + EA group, BCCAo + Sham-EA group, BCCAo + SP group (receiving the selective JNK inhibitor SP600125) and BCCAo + SP + EA group. Morris water maze tests, TdT-mediated dUTP-biotin nick end labeling (TUNEL) staining and flow cytometry were used to evaluate the effect of the EA intervention on VaD. In experiment II, 30 mice were randomly divided into a Sham group, BCCAo group, BCCAo + EA group, BCCAo + SP group and BCCAo + SP + EA group. Western blotting and real-time reverse transcription polymerase chain reaction were used to detect protein and mRNA expression of key factors in the JNK signaling pathway in the hippocampus.

Results:

EA, SP600125 and EA + SP600125 significantly inhibited hippocampal apoptosis and improved cognitive impairment in VaD model mice. There were no significant differences between the BCCAo group and the BCCAo + Sham-EA group. EA, EA + SP600125 and SP600125 inhibited the phosphorylation of JNK and caspase-3. EA and EA + SP600125 promoted protein and mRNA expression of B-cell lymphoma 2 (Bcl-2) in the hippocampus of VaD mice and inhibited protein and mRNA expression of activator protein (AP)-1, p53 and Bax.

Conclusion:

EA can reverse cognitive deficits and inhibit hippocampal neuronal apoptosis in VaD model mice, at least partially through inhibition of the JNK signaling pathway and regulation of apoptosis signals.
The best interests of the child in the case law of the Court of Justice of the European Union
Authors: Lonardo Luigi
Published: December 2022

The principle that ‘in all actions relating to children (…) the child's best interests must be a primary consideration’ (Article 24(2) EU Charter of Fundamental Rights) is widely applied by the Court of Justice of the European Union (CJEU). This article considers preliminary rulings in which the CJEU had recourse to the best interests of the child as the criterion for settling the dispute in the main proceeding. For analytical purposes, these cases may be grouped in two clusters: cases resembling child custody disputes, and other cases. It is argued that, in the light of the varied factual circumstances of the judicial disputes, the application of the criterion of best interests of the child as primary consideration warrants further scrutiny. To this end, this article identifies and assesses a practical and a conceptual challenge to the widespread application of the criterion. The former posits that the criterion is indeterminate, and this article considers whether drawing from Article 3 of the Convention on the Right of the Child may help in solving the uncertainty; the latter maintains that the test is unjust and self-defying, a critique that this article finds only partially founded, for cases resembling child custody disputes.
Understanding and Supporting Students Who Stutter: A Guide for Special Educators
Authors: Thome Emma Kate
Published: December 2022

Stuttering is a common disorder addressed by speech-language pathologists in elementary schools. Although students who stutter likely receive specialized services from speech-language pathologists, other school personnel, including special and general educators, play a key role in creating supportive and positive learning environments for these students. Most special education teachers, however, receive little or no information about stuttering. Yet, because special educators collaborate and consult regularly with general educators, they are well positioned to communicate essential information about supports that can be provided. Increased understanding of stuttering and techniques for supporting students can greatly minimize the negative outcomes experienced by many students who stutter. This article provides teachers with (a) information about stuttering to improve understanding of the disorder, (b) guidance on how to provide classroom and student-level supports to create a positive learning environment for students who stutter, and (c) recommendations for collaborating with speech-language pathologists.
Social Skills Prioritization: Gathering Consensus From Parents, Students, and Teachers
Authors: Dobbins Nicole , Brandon Regina R. , Jones Vita L. , Higgins Kyle
Published: December 2022

The ability to interact with others in socially appropriate ways is critical for functioning in the community, school, and at home. These interaction skills are considered to be a crucial component of social resiliency and are believed to be important developmental skills, particularly for children/youth with disabilities. This article discusses the prioritization process concerning the importance of specific social skills to be taught in school through the perceptions of parents, teachers, and students. This involves the participants viewing specific social skills with a focus on the importance of their usage within the contexts of home/community, school, and with peers. The collection of data from the three informant groups is discussed, and the building of consensus through the prioritization of the social skills is presented and illustrated. The resulting prioritization list of skills then determines the order of the skills to be taught through a social skills curriculum.
Echocardiographic Evaluation of Postoperative Coaptation Geometry of Left AV Valve in Complete Atrioventricular Septal Defect
Authors: Kinami Hiroo , Morita Kiyozo , Shinohara Gen , Uno Yoshimasa
Published: December 2022

Background:

We sought to determine the difference in geometric parameters in the left atrioventricular valve (LAVV) postoperative complete atrioventricular septal defect (CAVSD) compared to the normal heart, and the correlation between geometric and functional parameters for detecting the mechanism of LAVV regurgitation (LAVVR) in CAVSD.

Methods:

LAVV geometric parameters based on complete and acceptable quality echocardiograms of 18 patients with repaired CAVSD compared with 17 normal controls. LAVVR severity was also quantified by indexed vena contracta (I-VC) (mm) and % jet area/left atrium area (% Jet/LA), and the correlation with LAVV parameters in the CAVSD group was investigated.

Results:

In the CAVSD group, the posterior closing angle (Pc) was nearly the same as the anterior closing angle (Ac), yet in the normal heart, the Pc angle was double the Ac angle. The anterior opening angle (Ao) and posterior-to-anterior leaflet diameter ratio (a/p) in the CAVSD group was also significantly smaller. The CAVSD group also had a shorter indexed coaptation length (I-CL) and indexed tenting height (I-TH). Displacement length (ΔD) differed completely between the CAVSD and Normal groups, and also showed a strong positive correlation to the functional parameters of LAVVR (% Jet/LA: r = .70, P = .02; I-VC: r = .60, P = .02).

Conclusions:

The parameters in this study were applicable to CAVSD AV valve coaptation characteristics. We introduced 2 novel measures that may provide important insights into the differences in geometry and performance of the LAVV in repaired CAVSD as compared to normal hearts.
Remote consultations in primary care across low-, middle- and high-income countries: Implications for policy and care delivery
Authors: Williams Siân , Barnard Amanda , Collis Phil , Correia de Sousa Jaime , Ghimire Suraj , Habib Monsur , Jelen Tessa , Kanniess Frank , Mak Vince , Martins Sonia , Paulino Ema , Pinnock Hilary , Roman Miguel , Sandelowsky Hanna , Tsiligianni Ioanna , van der Steen Laurine , Weber Donatelli Fabio
Published: December 2022

The COVID-19 pandemic mandated a substantial switch in primary health care delivery from an in-person to a mainly remote telephone or video service. As the COVID-19 pandemic approaches its third year, limited progress appears to have been made in terms of policy development around consultation methods for the post-acute phase of the pandemic. In September 2020, the International Primary Care Respiratory Group convened a global panel of primary care clinicians – including family physicians, paediatricians, pharmacists, academics and patients – to consider the policy and health management implications of the move to remote consultations in the primary care setting. The group gave special consideration to how and how far remote consultations should be integrated into routine primary health care delivery. Remote consultations can be a useful alternative to in-person consultations in primary care not only in situations where there is a need for viral infection control but also for the routine delivery of chronic disease management. However, they may not be more time efficient for the clinician, and they can add to the workload and work-related stress for primary care practitioners if they remain the dominant consultation mode. Remote consultations are also less appropriate than in-person consultations for new disease diagnosis, dealing with multiple issues and providing complex care. Ensuring health care professionals have the appropriate skill set to effectively deliver remote consultations, administrative and/or IT support and appropriate reimbursement will be key to achieving optimal integration of remote consultations into routine clinical practice. Addressing digital access and digital literacy issues at a societal level will also be essential to ensure individuals have fair and equitable access to the internet and sufficient security for exchange of personal and health-related data.
Lifetime economic potential of mobile stroke units in acute stroke care: A model-based analysis of the drivers of cost-effectiveness
Authors: Rink Johann S , Froelich Matthias F , Nour May , Saver Jeffrey L , Szabo Kristina , Hoyer Carolin , Fassbender Klaus C , Schoenberg Stefan O , Tollens Fabian
Published: December 2022

Background and purpose

To simulate patient-level costs, analyze the economic potential of telemedicine-based mobile stroke units for acute prehospital stroke care, and identify major determinants of cost-effectiveness, based on two recent prospective trials from the United States and Germany.

Methods

A Markov decision model was developed to simulate lifetime costs and outcomes of mobile stroke unit. The model compares diagnostic and therapeutic pathways of ischemic stroke, hemorrhagic stroke, and stroke mimic patients by conventional care or by mobile stroke units. The treatment outcomes were derived from the B_PROUD and the BEST-mobile stroke unit trials and further input parameters were derived from recent literature. Uncertainty was addressed by deterministic and probabilistic sensitivity analyses. A lifetime horizon based on the US healthcare system was adopted to evaluate different cost thresholds for mobile stroke unit and the resulting cost-effectiveness. Willingness-to-pay thresholds were set at 1x and 3x gross domestic product per capita, as recommended by the World Health Organization.

Results

In the base case scenario, mobile stroke unit care yielded an incremental gain of 0.591 quality-adjusted life years per dispatch. Mobile stroke unit was highly cost-effective up to a maximum average cost of 43,067 US dollars per patient. Sensitivity analyses revealed that MSU cost-effectiveness is mainly affected by reduction of long-term disability costs. Also, among other parameters, the rate of stroke mimics patients diagnosed by MSU plays an important role.

Conclusion

This study demonstrated that mobile stroke unit can possibly be operated on an excellent level of cost-effectiveness in urban areas in North America with number of stroke mimic patients and long-term stroke survivor costs as major determinants of lifetime cost-effectiveness.
The role of functional disability and social support in psychological outcomes for individuals with pediatric hypermobile ehlers–danlos syndrome
Authors: Bieniak Keely H , Tinkle Brad T , Tran Susan T
Published: December 2022

Hypermobile Ehlers–Danlos syndrome (hEDS) includes physical symptoms of chronic pain, fatigue, gastrointestinal dysfunction, and joint subluxations/dislocations. This study aims to fill a research gap regarding the psychosocial well-being in pediatric hEDS by assessing relationships between functional disability, social support, and mental health. Increased functional disability is hypothesized to be associated with increased mental health challenges, specifically anxiety and depression, and general social support is hypothesized to moderate this relationship, such that higher perceived social support will mitigate the negative psychological impacts of functional disability. Gender’s influence on mental health in pediatric hEDS is also explored. Thirty-four youth with pediatric hEDS recruited from a United States Midwest multidisciplinary genetics clinic completed self-report questionnaires. Results demonstrate associations between functional disability and mental health, and social support and mental health independently; however, moderation was not found. Functional disability and social support each have a unique influence on the mental health of children with pediatric hEDS and should each receive clinical attention. Exploratory analyses into the influence of gender provide a groundwork for future studies.
How much paediatric major trauma is truly paediatric? Experience from a level 1 urban Major Trauma Centre
Authors: Sanchez-Thompson Natalia , Platt Esther , Aylwin Christopher , Rees Clare , Alexander Nicholas , Hettiaratchy Sheehan
Published: December 2022

Background:

At its inception, there was no formal provision for children within the English major trauma network. There are now combined and stand-alone centres, but the scarcity of paediatric trauma facilities in some regions can result in long patient transfers and impact patient outcomes. The objective of this study was to determine the proportion of paediatric trauma patients who may benefit from input by adult services or may be safely managed within the local adult MTC, either because of patient physiology or injury patterns.

Methods:

All trauma presentations to our urban MTC aged ≤16 over a 3-year period were retrospectively identified and grouped, based on age and weight. ‘Young adult’ mechanisms of trauma and patient destinations (whether paediatric or adult wards) were determined.

Results:

There were 847 paediatric trauma cases recorded with a mean age of 9 and a male preponderance. Based on age and weight, 10–45% of cases could be considered physiologically adult-like, and 22–28% pubertal. Almost all penetrating trauma occurred in males, increasing with age. 14% of all admissions were managed on adult wards, with frequency increasing with patient age and with mechanism of actions (MOIs) relating to interpersonal violence.

Conclusion:

In this dataset, nearly half of paediatric trauma was ‘pubertal’ or ‘adult’ in their physiology and of these most presented with ‘young adult’ MOIs. These children likely benefit from combined paediatric and adult trauma services; where these do not exist, some older patients may be safely managed within local adult MTCs.
Hotel service quality dimensions and attributes: An analysis of online hotel customer reviews
Authors: Kalnaovakul Kanapot , Promsivapallop Pornpisanu
Published: December 2022

This study examines service quality dimensions and attributes of the hotel industry in a famous beach resort destination of Phuket based on 25,267 online reviews from the TripAdvisor website collected for 56 hotels. Machine learning analysis using the KNIME analytics platform was employed to analyze four datasets, namely the total dataset, the couple dataset, the family dataset, and the friend dataset. The results reveal six dimensions of guest service quality in the hotel industry: leisure activities, tangibles and surroundings, reliability, responsiveness, service process, and food, with specific attributes identified in each dimension. The study was able to verify the robustness of HOLSERV Plus model as the dimensions developed by topic modelling of online reviews are found to correspond to the dimensions of HOLSERV framework, with some adaptation required. It is also confirmed by the current study that the same set of service quality dimensions and attributes is not applicable to all groups of customers, instead each group has its own unique requirements and expectations. In addition, service process is revealed in this study as the most sensitive dimension that determines customer dissatisfaction.
If this is indoctrination, we are all indoctrinated
Authors: Armstrong Luke
Published: December 2022

When thinking about moral education, a concern of liberals is that such education ought not to be indoctrinatory. There are various definitions of indoctrination, but a common theme is that indoctrination prevents us from critically assessing our own beliefs. Indoctrinatory education, then, teaches a doctrine in such a way that students will not countenance any alternative doctrines. A state which forced its citizens to endorse a doctrine in this way would not be a liberal state. However, if indoctrination consists in an inability to critically assess our own beliefs, I argue that we are all partly indoctrinated. Evidence drawn from neuroscience and psychology suggests that the basis of our beliefs lies in emotion rather than reason, and there is no independent space from which we can critically assess our own belief systems. This is not to justify an explicit form of state indoctrination, in which the state forces beliefs upon us. Instead, it is to assess problems with how we understand indoctrination within education. There is no entirely adequate solution to these problems, though education aimed at open-mindedness offers the most promise.
Building human capital in Kazakhstan: Information-processing skills and socio-economic outcomes of the population
Authors: Toimbek Diana
Published: December 2022

Recent economic diversifications of Kazakhstan from over-reliance on the extraction of natural resources are mainly based on increasing the quality of human capital by building a knowledge-based economy as an instrument for long-term sustainable development. In this regard, the paper explores the level of cognitive skills of the adult population in Kazakhstan and their associations with important life outcomes. Research is based on one of the prominent studies in adult literacy — The Programme for the International Assessment of Adult Competencies (PIAAC), and revealed that the performance of Kazakhstanis in information-processing skills is below the average; smaller differences in competencies between the top and bottom performers, which indicates small inequalities in skills acquisition; and a low level of variance between adults with tertiary and secondary education, demonstrating the low education quality. Multiple linear regression of the research indicates that the educational attainment of the population has the highest association with all three information-processing skills, while labour force participation negatively affects the growth of literacy, numeracy, and problem-solving in technology-rich environment (PS-TRE) skills. The main recommendations of the paper are to profoundly transform social institutions, enhance national educational quality, and exercise continuous learning in the country.
Development and evaluation of a regional diabetes service App for patient education, self-management and clinic engagement
Authors: Griffin Kirstin E , Jabbal Monu , Turtle Emma J
Published: December 2022

Background:

We created a free NHS App to deliver all patient information on type 1 diabetes to help promote self-management. This became an invaluable way of getting information to patients during the pandemic when all face-to-face clinics were suspended. The aim of this study is to investigate patient perceptions of the App.

Methods:

A questionnaire-based cross-sectional study was designed by the diabetes team to obtain quantitative data.

Results:

The mean score of patient accessibility to diabetes information and services before using the App was 5.1, and after using the App was 8.8 ( p < 0.001). Among the patients, 91% would recommend the App, 57.2% agree the App helps them schedule and attend their screening appointments and 73.7% agree the App has improved their self-management of type 1 diabetes.

Conclusion:

Patients agree the App has improved accessibility to diabetes information and services and has helped with self-management of their condition. Patients are likely to recommend the App to friends and family who have diabetes.
Impact of a Culturally Grounded Running Program on Four Components of Wellness Among Indigenous Participants: A Pilot Study of the Running Medicine Program
Authors: Fleg Anthony , Abeyta Nicolette , Houck Jonathan , Baca Kristen , Nguyen Cindy , Claw Ashleigh , Shaffer Jaida
Published: December 2022

Movement as medicine is the premise behind Running Medicine (RM), a community-based wellness program that began in 2016 in New Mexico. RM is centered in the Indigenous traditions of running and is oriented to improving the four dimensions of wellness—mind, body, spirit, and social. Using retroactive surveys of RM’s Spring 2019 participants, we investigated the program’s effectiveness in the realms of physical, mental, spiritual, and social wellness. Based on data from participant surveys, RM appears to be effective at improving the four realms of wellness. Indigenous participants improved to a greater degree in mental and social wellness than non-Indigenous participants, while the opposite was true for physical and spiritual wellness. For both groups, the largest effect size among the four domains was seen in social wellness. Among our participants, this culturally grounded approach to wellness appears to be effective at improving the four realms of physical, mental, spiritual, and social wellness.