bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations Between Health Literacy and End-of-Life Care Intensity Among Medicare Beneficiaries
Authors: Luo Qingying , Shi Kewei , Hung Peiyin , Wang Shi-Yi
Published: January 2021

Background:

Despite well-documented disparities in end-of-life (EOL) care, little is known about whether patients with low health literacy (LHL) received aggressive EOL care.

Objective:

This study examined the association between health literacy (HL) and EOL care intensity among Medicare beneficiaries.

Method:

We conducted a retrospective analysis of Medicare fee-for-service decedents who died in July-December, 2011. ZIP-code-level HL scores were estimated from the 2010-2011 Health Literacy Data Map, where a score of 225 or lower was defined as LHL. Aggressive EOL care measures included repeated hospitalizations within the last 30 days of life, no hospice enrollment within the last 6 months of life, in-hospital death, and any of above. Using hierarchical generalized linear models, we examined the association between HL and aggressive EOL care.

Results:

Of 649,556 decedents, the proportion of decedents who received any aggressive EOL care among those in LHL areas was 82.7%, compared to 72.7% in HHL areas. In multivariable analyses, decedents residing in LHL areas, compared to those in HHL areas, had 31% higher odds of aggressive EOL care (adjusted odds ratio [AOR] 1.31; 95% confidence interval [CI]:1.21-1.42), including higher odds of no hospice use (AOR 1.35; 95% CI: 1.27-1.44), repeated hospitalization (AOR 1.07; 95% CI: 1.01-1.14) and in-hospital death (AOR 1.21; 95% CI: 1.13-1.29).

Conclusion:

Medicare beneficiaries who resided in LHL areas were likely to receive aggressive EOL care. Tailored efforts to improve HL and facilitate patient-provider communications in LHL areas could reduce EOL care intensity.
Deficient Emotional Self-Regulation and Sleep Problems in ADHD with and without Pharmacological Treatment
Authors: Sanabra Miriam , Gómez-Hinojosa Tary , Grau Núria , Alda Jose A.
Published: January 2021

Objective:

The purpose of this study is to analyse DESR and its influence on sleep parameters in three different groups of children and adolescents: a group newly diagnosed with ADHD naïve, a group with ADHD under pharmacological treatment and a control group.

Method:

Subjects were a total of 327 children and adolescents. Two groups diagnosed with ADHD: 108 medication-naïve and 80 under pharmacological treatment; and one group with 136 healthy subjects. DESR was defined using anxious/depressed, attention problems and aggressive behaviors (AAA) scales from the Child Behavior Checklist (CBCL), and sleep through the Sleep Disturbance Scale for Children.

Results:

Significant differences were found comparing the three groups ( p = .001), with a significantly higher profile on DESR in ADHD subjects, especially those who did not undergo treatment, and a positive correlation between DESR and sleep.

Conclusion:

Children and adolescents with ADHD without treatment present higher DESR than healthy controls and consequently higher sleep problems.
The Psychological Vulnerability of French University Students to the COVID-19 Confinement
Authors: Le Vigouroux Sarah , Goncalves Aurélie , Charbonnier Elodie
Published: January 2021

Even before the current pandemic, university students were known to have high levels of hassles, anxiety, and depressive symptoms. In all probability, the advent of COVID-19 has substantially raised these levels. The present study measured the emotional state of university students during lockdown and identified the relevant situational and psychological factors. To this end, 1,297 French university students were assessed during lockdown, which lasted from 16 March to 11 May in France. Situational factors included the belief that lockdown was compromising their future job prospects, COVID-19 symptoms, and health concerns. Psychological factors included students’ implicit theory of emotion, and the coping strategies they used during lockdown. We explored the extent to which these factors were associated with levels of hassles, anxiety, and depressive symptoms. Results indicated that students’ belief that lockdown was compromising their future job prospects was positively related to hassles ( r = .34, p < .001), while concerns about their own health and that of relatives were positively associated with anxiety ( r = .37 and .34; p < .001). In addition, use of the positive reframing coping strategy mediated the effect of students’ implicit theory of emotion on their depressive symptoms. Even though the national lockdown is now over, the pandemic will continue to have a major impact on university students over the coming months. It is therefore essential for universities to provide them with adequate psychological support.
Self-Service Technology in the Hospitality and Tourism Settings: A Critical Review of the Literature
Authors: Shiwen Lu , Kwon Jookyung , Ahn Jiseon
Published: January 2021

Self-service technology (SST) and its applications are changing the way the hospitality and tourism industry provides products and services to their customers. Although the use of SST is a remarkable change for service providers because its use can meet customers’ pursuit of an efficient life, research provides a sufficient overview of how the usage of SST influences customers’ service experience in the tourism and hospitality settings remains lacking. Thus, this study aims to provide an understanding of previous SST research and a basis for exploring the influential factors regarding SST adoption. To achieve this purpose, SST papers in leading hospitality and tourism academic journals were reviewed. Although the number of articles is limited, content analysis allows the authors to understand a phenomenon and identify research topics and methods in SST studies. Also, this study contributes to existing SST literature by providing future research guidelines.
Fire reaction of sandwich panels with corrugated and honeycomb cores made from natural materials
Authors: Chanda Avishek , Kim Nam Kyeun , Wijaya Willsen , Bhattacharyya Debes
Published: January 2021

In recent years, the synthetic cores of sandwich panels have experienced an increase in demand to be replaced by environmentally friendly materials. Furthermore, with the stringent fire protocols introduced in the building codes due to recent fire incidents around the world, it is imperative to conduct fire performance studies for all structural materials. The mechanical performances of the different core structures in sandwich panels have been extensively studied and documented in the literature, although the influence of those core structures on the fire reaction properties has not yet been fully understood. The aim of this work is to experimentally investigate, for the first time, the effects of the core structures, namely, corrugated and honeycomb cores manufactured from flax reinforced polymeric composites and radiata pine plywood, on their flammability. A bench-scale cone calorimeter has been employed to measure the fire reaction properties of the two types of materials along with the subsequent effects of the core structures. The orientations of the cores were observed to significantly impact the performances of the samples under fire. The honeycomb cores, with the open cells exposed to the heat flux, generally had better fire performance compared to those of the corrugated cores with higher time to ignition (10 s or more) and time to peak heat release (65 s or more), having almost similar initial masses and peak heat release rates. Furthermore, among the two material systems, the plywood cores outperformed the flax-FRPP cores, specifically in ignition time, smoke production, total heat release and peak heat release rate. The results helped in confirming that the honeycomb cores have overall better fire performance and the use of plywood as the core material is viable even when fire is involved.
Environmental Health Services and Professionals Level of Engagement in Different Sectors in Eastern Ethiopia: A Mixed Methods Study Design
Authors: Damtew Yohannes Tefera , Desta Binyam Negussie , Sileshi Adey
Published: January 2021

Introduction:

Environmental health (EH) services have a long history in Ethiopia, but data on environmental health services quality and the magnitude of environmental health professionals’ engagement has never been addressed. This study was conducted to assess the quality of environmental health services in different sectors and professionals’ level of engagement in Eastern Ethiopia.

Methods:

Institution based cross-sectional mixed study design was implemented. A cluster sampling technique was employed to select 83 participants. Data were collected using a pretested questionnaire and an interview guide. Descriptive, bivariate, multivariate, and thematic analysis was carried out.

Results:

Professionals’ performance in most services were reported to be average or low. Only 19.5% of participants responded as having good satisfaction in their job. The multiple logistic regression analysis showed factors associated with selected environmental health services. The odds of identifying environmental problems was associated with profession (adjusted odds ratio (AOR): 4.1; 95% confidence interval (CI): 1.3-7.6) and level of education (AOR: 3.1; 95%CI: 0.9-5.9). The factors contributing to introducing innovative solutions to EH problems were type of institution (AOR: 3.1, 95%CI = 1.6-9.3), profession (AOR: 3.4, 95%CI = 1.1-12.2), and level of support and emphasis offered (OR: 5.6, 95% CI = 2.2-11.9). Level of job satisfaction was also associated with the above-mentioned independent variables.

Conclusion:

The current study showed low level of professionals’ engagement and factors associated with the quality of environmental health services in different sectors. Therefore, Ethiopian Federal Ministry of Health and other concerned ministries, agencies, and authorities should intervene accordingly to improve the service and level of professionals’ engagement.
Imaging modalities for cardiovascular phenotyping in asymptomatic people living with HIV
Authors: Bonou Maria , Kapelios Chris J , Athanasiadi Eleni , Mavrogeni Sophie I , Psichogiou Mina , Barbetseas John
Published: January 2021

Cardiovascular disease (CVD) has emerged as a leading cause of non-HIV-related mortality among people living with HIV (PLWH). Despite the growing CVD burden in PLWH, there is concern that general population risk score models may underestimate CVD risk in these patients. Imaging modalities have received mounting attention lately to better understand the pathophysiology of subclinical CVD and provide improved risk assessment in this population. To date, traditional and well-established techniques such as echocardiography, pulse wave velocity, and carotid intima thickness continue to be the basis for the diagnosis and subsequent monitoring of vascular atherosclerosis and heart failure. Furthermore, novel imaging tools such as cardiac computed tomography (CT) and cardiac CT angiography (CCTA), positron emission tomography/CT (PET/CT), and cardiac magnetic resonance (CMR) have provided new insights into accelerated cardiovascular abnormalities in PLWH and are currently evaluated with regards to their potential to improve risk stratification.
‘Bad choices’: Unintended pregnancy and abortion in nurses’ and counsellors’ accounts of providing pre-abortion counselling
Authors: Mavuso Jabulile Mary-Jane Jace , Macleod Catriona Ida
Published: January 2021

Little research tackles healthcare providers’ experiences in conducting pre-abortion counselling sessions in circumstances where pregnant persons may request an abortion. We report on a study conducted in South Africa, in which two nurses and two counsellors were asked about how they conduct these counselling sessions. Using a synthetic narrative approach, we present these health workers’ micro-narratives about their motivations for providing abortion services, the purpose of the counselling, their information-giving practices, and whether and how third parties are included in the counselling. We highlight how these micro-narratives are premised on discursive resources that problematise unintended pregnancy and abortion. These resources enable and justify directive counselling that undermines pregnant peoples’ reproductive autonomy. We locate such directiveness within dominant anti-abortion discourse and call for training to reframe normative understandings of abortion.
“Companion, friend, four-legged fluff ball”: The power of pets in the lives of LGBTQ+ young people experiencing homelessness
Authors: Schmitz Rachel M , Carlisle Zachary T , Tabler Jennifer
Published: January 2021

Experiences of homelessness are challenging for lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) young people. LGBTQ+ young adults without stable housing endure mental health struggles stemming from multiple structural disadvantages. In navigating stressors, LGBTQ+ young people may develop bonds with companion animals, or pets. Demonstrating the diverse ways LGBTQ+ young adults manage mental health challenges while homeless, we qualitatively analyzed the narratives of 17 LGBTQ+ young adults (18–25) surrounding their pet relationships. Participants emphasized the positive power of pets in their lives to help offset stressors. These findings illustrate how marginalized young people manage their mental health through informal resources. Incorporating companion animals could potentially enhance services for LGBTQ+ youth experiencing marginalization.
Housing conditions as predictors of common childhood illness: Evidence from Nigeria Demographic and Health Surveys, 2008–2018
Authors: Iyanda Ayodeji E , Adaralegbe Adeleye , Miranker Molly , Lasode Mayowa , Lu Yongmei
Published: January 2021

Several studies have examined the impacts of water, sanitation, hygiene, and general housing conditions on childhood health in developing countries. However, up-to-date knowledge and change pattern in common childhood illness prevalence over time are scarce in Nigeria. To contribute toward meeting the Sustainable Development Goals three and six, we used pooled data ( N = 94,053) from the Nigeria Demographic Health Surveys from 2008 to 2018 to examine the trend and determinants of four childhood illnesses: diarrhea, fever, cough, and respiratory infection. Multivariate logistic regression was used to estimate the determinants of the four health outcomes. Our results indicate that between 2008 and 2018, the prevalence of childhood diarrhea, cough, and fever slowly declined. However, there was a drastic decline in childhood-related respiratory illness. Housing conditions, sanitation facilities, and water sources were significantly associated with childhood illness based on the logistic regression analysis. Based on our findings, we recommend general improvement in housing conditions that can eradicate childhood cough, fever, and respiratory infections.
From democracy at others’ expense to externalization at democracy’s expense: Property-based personhood and citizenship struggles in organized and flexible capitalism
Authors: Eversberg Dennis
Published: January 2021

This contribution investigates the anthropological foundations of European democracies’ continuous entanglement with economic and military expansionism and a hierarchical separation between public and private spheres, both of which have enabled the appropriation of nature and others’ labour as property on which citizens’ abstract personhood could be founded. Drawing on an argument made by David Graeber, it is suggested that modern European history can be interpreted as a process of the ‘generalization of avoidance’, in which such abstract, property-based forms of personhood, which were initially what defined the superior party in relations of hierarchy, came to be a model for the figures of market participant and citizen within the spheres of formal equal exchange of economy and politics. From this perspective, and building on an account of different stages of capitalist history as ‘subjectivation regimes’, the article then analyses the transition from the ‘exclusive democracy’ of post-war organized capitalism in Western Europe, in which citizens’ entitlement, through the collective guarantees of ‘social property’ (Castel), increasingly allowed individualized competitive practices of status attainment and gave rise to individualist movements for extended citizenship, to current-day flexible capitalism. This regime, seizing on those calls and instrumentalizing the desires for competitive status consumption, has effected a broad restructuring of the social as a unified field of competition in which new hierarchies and inequalities materialize in global chains of appropriation, causing a ‘dividual’ fragmentation of property-based personhood and generating calls for responsible citizenship as an inherent counter-movement. In conclusion, it is suggested that anthropologists have much to contribute to investigating the possibility of democratic, post-capitalist ‘anthropologies of degrowth’.
Involute spline couplings in aero-engine: Predicting nonlinear dynamic response with mass eccentricity
Authors: Xue Xiangzhen , Huo Qixin , Dearn Karl D , Liu Jian , Jia Jipeng
Published: January 2021

This work presents a nonlinear dynamic model considering the multi-tooth meshing behaviour and mass eccentricity of an involute spline coupling to tackle the serious problem of involute spline failure, in aviation power transmission systems. The dynamic meshing force is calculated for the same. Based on this, the influence of different mass eccentricities on the nonlinear dynamic response of the spline coupling was investigated in aero-engines. The results show that when the mass eccentricity is small, its impact on the system is insignificant. When the eccentricity reaches a certain value, the quasi-periodic and chaotic state appears alternately. Meanwhile, it can be concluded that the acceleration-frequency spectrum during the multi-periodic phase is an approximation of the working frequency with the accuracy affected by multiple teeth engagements. This was validated by the vibration experiments of the involute spline coupling. The proposed model, which considers the multi-tooth meshing behaviour and the mass eccentricity provides a reference model for the dynamic analysis of similar structures. The nonlinear dynamic response results attained lay a good theoretical foundation for fretting damage analysis and precise designs for involute spline couplings.
Militarized aesthetics of hegemonic masculinity in America’s Army: Proving Grounds (2013): a multimodal legitimation analysis
Authors: Elyamany Nashwa
Published: January 2021

Military-themed videogames are significant cultural artifacts that shape popular geopolitical narratives and venerate dominant post-9/11 War on Terror discourses. Overwhelmingly resonant with the Military Entertainment Complex, these artifacts, not excluding America’s Army (2002–2013), envision the world through a Western lens. Over the past decades, America’s Army has come to challenge dominant orthodoxies and ideological presuppositions, disseminating new configurations of power. The article argues that the latest installment of the game, America’s Army: Proving Grounds (2013), marks a paradigmatic shift from the post-9/11 discourse permeating most military-themed videogames. Taking past scholarship on geopolitics and multimodal legitimation as points of departure, the current study unfolds the militarized aesthetics and politics of gameplay unique to America’s Army: Proving Grounds in its capacity to promote redefined ideals of hegemonic masculinity, on the one hand, and substantiate US universal legitimacy, on the other. To this end, the research endeavor proposes a more nuanced multimodal legitimation analytical framework in an attempt to capture the full spectrum of the semiotic affordances instilled in the gaming space. Key convergent discourses and practices of hegemony emerge therein, fundamentally: proficiency, efficiency, virtuosity, agility, nobility, solidarity, precision, stoicism, and aggression. The spatio-temporal shift away from post-9/11 discourses reifies new militaristic representations of hegemonic masculinity symbiotically entangled with futuristic and non-contemporary ideological war narratives.
Cognitive load reduction strategies in questionnaire design
Authors: Brosnan Kylie , Grün Bettina , Dolnicar Sara
Published: January 2021

Survey data quality suffers when respondents have difficulty completing complex tasks in questionnaires. Cognitive load theory informed the development of strategies for educators to reduce the cognitive load of learning tasks. We investigate whether these cognitive load reduction strategies can be used in questionnaire design to reduce task difficulty and, in so doing, improve survey data quality. We find that this is not the case and conclude that some of the traditional survey answer formats, such as grid questions, which have been criticized in the past lead to equally good data and do not frustrate respondents more than alternative formats.
Little Miss Homeless: creative methods for research impact
Authors: Earle-Brown Harriet
Published: January 2021

Women’s homelessness is a significant and increasing problem in the UK. Yet, much research on homelessness does not acknowledge the particular gendered issues homeless women face. Furthermore, the small amount of research available on the matter is often restricted to academic and professional audiences. Little Miss Homeless, a culture jammed children’s book, was produced with the intention of making wider public audiences aware and engaged with issues relating to women’s homelessness. This article traces through the process of producing the book and reflects on the emerging interest within cultural geography to use creative methods of research dissemination in order to engage wider public audiences with our research.
The European Credit Transfer System (ECTS) from the perspective of Irish teacher educators
Authors: Gleeson Jim , Lynch Raymond , McCormack Orla
Published: January 2021

The European Credit Transfer System (ECTS), one of the main pillars of the Bologna Process, was heavily influenced by external forces such as internationalisation, globalisation and market values. It was also immune to national/regional policy influences and differences between academic disciplines. The authors investigated a) Irish teacher educators’ perceptions of the reasons for the introduction of the ECTS and b) the influence of the ECTS on teacher educators’ practice. A Qualtrics survey including both closed and open-ended questions was sent to all Irish teacher educators. Asked about the rationale for the introduction of the ECTS and about its influence on their professional work, these respondents rated and ranked the importance of student mobility and the transferability of their academic achievements ahead of teaching and learning aspects. These findings, which were confirmed by participants’ open-ended responses, are discussed from the following macro-contextual perspectives: inattention to general HE curriculum issues in an environment dominated by discipline-based silos; the limitations of top-down reform, particularly at the implementation stage; low ERASMUS participation rates of Irish student teachers; and the ECTS focus on skills, competences and pre-determined learning outcomes. The influence of these contextual factors is summarised in the conclusion, along with some implications for teacher education.
Topologies of desire: Fantasies and their symptoms in educational policy futures
Authors: Saari Antti
Published: January 2021

This article studies topological reflexivity in educational policy discourse, when policy is considered in terms of eradicating the distances involved and increasing mobility and commensurability. Topological reflexivity is critically evaluated from a Lacanian point of view as a form of political fantasy which structures reality within the coordinates of desire. The article also unpacks two prominent symptoms of fantasy – dislocation and paradoxical elements – that subvert the functioning of these very same fantasies. First, while heralding imminent fulfilment and the promise of pleasure in new learning environments, these discourses are also obliged to keep the object of desire at a certain distance. Second, while educational policy discourse is founded on subjective autonomy and a freedom to develop learning environments, it implicitly requires teachers and schools to implement new learning environments and to take pleasure in doing so. Attempts to grapple with these symptoms of fantasy take the form of denying not only the repetition inherent in such discourses, but also the othering of teachers who express resistance to such changes.
Blurring Lines of Responsibility: How Institutional Context Affects Citizen Biases Regarding Policy Problems
Authors: Page Douglas , Peshkopia Ridvan
Published: January 2021

Existing research suggests that individuals assign responsibility for policy problems based on prior biases like partisanship. However, what remains speculation is whether institutions that blur lines of responsibility elicit more biased responsibility-assignment when compared to institutions with clearer lines of responsibility. European Union enlargement provides an opportunity to examine responsibility-assignment for policy problems within multiple countries, where the EU triggers biases (pro- and anti-EU membership) when it works to export the policies required for membership. In surveys of Albania, Bosnia and Herzegovina, and Kosovo, we examine responsibility-assignment to governments for inequality in pay between women and men, which the EU asks prospective members to address. We find that biased attributions of blame for pay inequality are strongest in the Bosnian regions where multilevel governance is the most pronounced, while the unitary governments of Albania, Bosnia’s Republika Srpska, and Kosovo do not yield biased responsibility-assignment. Our results are consequential for multilevel governance.
Comparison of Intensity Modulated Radiotherapy Treatment Plans Between 1.5T MR-Linac and Conventional Linac
Authors: Ding Shouliang , Li Yongbao , Liu Hongdong , Li Rui , Wang Bin , Zhang Jun , Chen Yan , Huang Xiaoyan
Published: January 2021

In this study, we assess the dosimetric qualities and usability of planning for 1.5 T MR-Linac based intensity modulated radiotherapy (MRL-IMRT) for various clinical sites in comparison with IMRT plans using a conventional linac. In total of 30 patients with disease sites in the brain, esophagus, lung, rectum and vertebra were re-planned retrospectively for simulated MRL-IMRT using the Elekta Unity dedicated treatment planning system (TPS) Monaco (v5.40.01). Currently, the step-and-shoot (ss) is the only delivery technique for IMRT available on Unity. All patients were treated on an Elekta Versa HDTM with IMRT using the dynamic multileaf collimator (dMLC) technique, and the plans were designed using Monaco v5.11. For comparison, the same dMLC-IMRT plan was recalculated with the same machine and TPS but only changing the technique to step-and-shoot. The dosimetric qualities of the MRL-IMRT plans, to be evaluated by the Dose Volume Histograms (DVH) metrics, Homogeneity Index and Conformality Index, were compared with the clinical plans. The planning usability was measured by the optimization time and the number of Monitor Units (MUs). Comparing MRL-IMRT with conventional linac based plans, all created plans were clinically equivalent to current clinical practice. However, MRL-IMRT plans had higher dose to skin and larger low dose region of normal tissues. Furthermore, MRL-IMRT plans had significantly reduced optimization time by comparing conventional linac based plans. The number of MUs of MRL-IMRT was increased by 23% compared with ss-IMRT, and no difference from dMLC-IMRT. In conclusion, clinically acceptable plans can be achieved with 1.5 T MR-Linac system for multiple tumor sites. Given the differences in machine characteristics, some minor differences in plan quality were found between MR-Linac plans and current clinical practice and this should be considered in clinical practice.
COVID-19 pandemic: An era of myths and misleading advertisements
Authors: Hussian Tarif , Choudhary Manjusha , Budhwar Vikas , Saini Garima
Published: January 2021

COVID-19 pandemic has shattered the global health economy. Advertisers take advantage of fear and emotions in society due to the pandemic outbreak. Rumors spread rapidly through digital media are another form of misinformation. False claims advertising is a combination of misinformation and disinformation that is fatal and moral deterioration to global society. True information is of central importance in society to avoid false information during the pandemic to control unexpected damage. Without scientific and evidence-based information about all kinds of products and services through advertisements on social media people often use to shift social attitudes. Society always relies on national and harmonious international regulatory bodies during any kind of epidemic and disaster credibility for true information. In most of the Countries, false advertisements are illegal. Countries need to continuously introduce a strict regulatory framework with the Suo Motu surveillance system to breach false advertisements on all media platforms about health care products and services.
Analysis of the differences in serve effectiveness between Billie Jean King Cup (former Fed Cup) and Davis Cup doubles tennis matches
Authors: Martínez-Gallego Rafael , Crespo Miguel , Jiménez Jorge
Published: January 2021

The doubles game has considerable relevance in professional tennis, especially in team competitions such as the Billie Jean King Cup (former Fed Cup) (BJKC) and the Davis Cup (DC). However, there are very few studies that have carried out quantitative notational analysis to provide information on the specific features of this tennis modality. The goal of this study was to analyse the differences in serve direction and effectiveness of male and female teams in matches played at BJKC and DC ties. A total of 29,207 serves; 7,578 of BJKC and 21,628 of DC matches were analysed. The data was obtained through the Hawk-Eye system. The results showed that with the first serve, both BJKC and DC teams tried to move the receiver by serving to zones W (wide) and T to take the initiative of the point, while with the second serve teams took lower risks and mainly served to zone B (body). In general, in DC matches the effectiveness of the serve was greater than in BJKC ones. The first serve effectiveness in DC matches was found to be higher in each direction, while the differences in the effectiveness of the second serve was only found in the zone C (body) of the advantage service box. This information can be particularly relevant for coaches to design the doubles training sessions and the strategic planning of doubles matches on reliable and quantitative information.
Fluid management: An update for perioperative practitioners
Authors: Wood Christopher
Published: January 2021

An interprofessional team approach is required to achieve optimum fluid balance for patients during the perioperative period. Incorrect management of fluid assessment and monitoring is associated with adverse outcomes. The scientific understanding of perioperative fluid balance has improved over recent years leading to changes in clinical practice with regard to volume and choice of intravenous fluid. It is important that perioperative practitioners have an understanding of intravenous fluid, fluid compartmentalisation, fluid mechanics and intravascular fluid control mechanisms. Optimum fluid status not only shortens hospital stay but also reduces the incidence of postoperative nausea and vomiting and complication profiles. This article aims to provide perioperative practitioners with a comprehensive overview of fluid management. It will cover important issues surrounding physiological control of fluid balance, choice of intravenous fluid therapy, methods to monitor intravascular volume and factors which influence delivery.
The Lethal Effect of Bacillus subtilis Z15 Secondary Metabolites on Verticillium dahliae
Authors: Abuduaini Xieerwanimu , Aili Ailina , Lin Rongrong , Song Ganggang , Huang Yu , Chen Zhongyi , Zhao Heping , Luo Qin , Zhao Huixin
Published: January 2021

Bacillus subtilis Z15 (BS-Z15), isolated from cotton rhizosphere soil, inhibits Verticillium dahliae and suppresses cotton Verticillium wilt in pot experiments. We investigated the influence of environmental factors, pH, temperature, ultraviolet light, protease, and incubation time on the stability of BS-Z15 secondary metabolites (SMs), and the mechanism underlying the cytotoxicity of BS-Z15 SMs on V. dahliae. BS-Z15 and its fermentation broth inhibited V. dahliae, and this effect was mediated by its SMs. These were shown to be stable to the influence of the above environmental factors. BS-Z15 SMs decreased the viability of V. dahliae conidia in a time-dependent manner. Scanning electron microscopy showed that BS-Z15 and its SMs resulted in flattened and depressed conidia. BS-Z15 SMs induced morphological abnormalities in the hyphae, which showed rough aberrant structures, reduced conidiophore production, and accelerated aging. Flow cytometry using Hoechst/propidium iodide double staining revealed that BS-Z15 SMs induced necrosis in V. dahliae in a time-dependent manner. Fluorescence microscopy showed that BS-Z15 SMs did not induce apoptotic bodies in the conidia of V. dahliae but caused significant changes in karyotypes, accompanied by nuclear lysis and nucleic-acid diffusion, which may play important roles in necrosis. In addition, 0.3 mg/mL BS-Z15 SMs had no effect on either the mitochondrial membrane potential or the synthesis of proapoptotic proteins, indicating that the SMs did not induce apoptosis in V. dahliae. Their lethal effect on V. dahliae was by inducing necrosis in its conidia and hyphae. BS-Z15 SMs thus have potential as biological pesticides to control Verticillium wilt in cotton.
Resveratrol and Curcumin Attenuate Ex Vivo Sugar-Induced Cartilage Glycation, Stiffening, Senescence, and Degeneration
Authors: Mehta Shikhar , Young Cameron C. , Warren Matthew R. , Akhtar Sumayyah , Shefelbine Sandra J. , Crane Justin D. , Bajpayee Ambika G.
Published: January 2021

Objective

Advanced glycation end-product (AGE) accumulation is implicated in osteoarthritis (OA) pathogenesis in aging and diabetic populations. Here, we develop a representative nonenzymatic glycation-induced OA cartilage explant culture model and investigate the effectiveness of resveratrol, curcumin, and eugenol in inhibiting AGEs and the structural and biological hallmarks of cartilage degeneration.

Design

Bovine cartilage explants were treated with AGE–bovine serum albumin, threose, and ribose to determine the optimal conditions that induce physiological levels of AGEs while maintaining chondrocyte viability. AGE crosslinks, tissue stiffness, cell viability, metabolism and senescence, nitrite release and loss of glycosaminoglycans were assessed. Explants were cotreated with resveratrol, curcumin, or eugenol to evaluate their anti-AGE properties. Blind docking analysis was conducted to estimate binding energies of drugs with collagen II.

Results

Treatment with 100 mM ribose significantly increased AGE crosslink formation and tissue stiffness, resulting in reduced chondrocyte metabolism and enhanced senescence. Blind docking analysis revealed stronger binding energies of both resveratrol and curcumin than ribose, with glycation sites along a human collagen II fragment, indicating their increased likelihood of competitively inhibiting ribose activity. Resveratrol and curcumin, but not eugenol, successfully inhibited AGE crosslink formation and its associated downstream biological response.

Conclusions

We establish a cartilage explant model of OA that recapitulates several aspects of aged human cartilage. We find that resveratrol and curcumin are effective anti-AGE therapeutics with the potential to decelerate age-related and diabetes-induced OA. This in vitro nonenzymatic glycation-induced model provides a tool for screening OA drugs, to simultaneously evaluate AGE-induced biological and mechanical changes.
The correlation between the cardiovascular instability and the size of the developed ischaemic lesions in patients who underwent carotid stenting
Authors: Csizmadia Sándor , Kaszás Zsófia , Klucsai Róbert , Bartha Éva , Vörös Erika
Published: January 2021

Aims

In this study we investigated the relationship between cardiovascular instability and the size of the developed ischaemic lesions during carotid stent implantation by diffusion-weighted (DWI) magnetic resonance (MR) examination.

Material and methods

We retrospectively analyzed anaesthesia reports and follow-up MR examinations after stent implantation of 192 patients in a 3-year period. Nineteen aspects of cardiovascular status were analyzed. We registered the duration of the intervention, low and high blood pressure (BP) values during anaesthesia and heart rates. The fluctuations of BP and heart rate and the time of their compensations after the stent expansion were also recorded. Values were compared with the number and the size of ischaemic lesions on DWI scans. We used Spearman and Kendall rank correlations and Welch’s tests for statistical analysis. Values of p ≤ 0.05 were considered as statistically significant.

Results

Decreased heart rate significantly correlated with the number ( p = 0.0123) and size ( p = 0.00323) of ischaemic lesions during stent expansion. Other cardiovascular parameters did not show any significant correlations.

Conclusions

Our results indicate that only heart rate attenuation affects the size of ischaemic lesions; thus the prevention of bradycardia is highly important.
Enhancing performance of a computed tomography perfusion software for improved prediction of final infarct volume in acute ischemic stroke patients
Authors: Rava Ryan A , Snyder Kenneth V , Mokin Maxim , Waqas Muhammad , Podgorsak Alexander R , Allman Ariana B , Senko Jillian , Bhurwani Mohammad Mahdi Shiraz , Hoi Yiemeng , Davies Jason M , Levy Elad I , Siddiqui Adnan H , Ionita Ciprian N
Published: January 2021

Computed tomography perfusion (CTP) is crucial for acute ischemic stroke (AIS) patient diagnosis. To improve infarct prediction, enhanced image processing and automated parameter selection have been implemented in Vital Images’ new CTP+ software. We compared CTP+ with its previous version, commercially available software (RAPID and Sphere), and follow-up diffusion-weighted imaging (DWI). Data from 191 AIS patients between March 2019 and January 2020 was retrospectively collected and allocated into endovascular intervention ( n = 81) and conservative treatment ( n = 110) cohorts. Intervention patients were treated for large vessel occlusion, underwent mechanical thrombectomy, and achieved successful reperfusion of thrombolysis in cerebral infarction 2b/2c/3. Conservative treatment patients suffered large or small vessel occlusion and did not receive intravenous thrombolysis or mechanical thrombectomy. Infarct and penumbra were assessed using intervention and conservative treatment patients, respectively. Infarct and penumbra volumes were segmented from CTP+ and compared with 24-h DWI along with RAPID, Sphere, and Vitrea. Mean infarct differences (95% confidence intervals) and Spearman correlation coefficients (SCCs) between DWI and each CTP software product for intervention patients are: CTP+  = (5.8 ± 5.9 ml, 0.62), RAPID = (10.0  ± 5.2 ml, 0.73), Sphere = (3.0 ± 6.0 ml, 0.56), Vitrea = (7.2 ± 4.9 ml, 0.66). For conservative treatment patients, mean infarct differences and SCCs are: CTP+ = (–8.0 ± 5.4 ml, 0.64), RAPID = (–25.6 ± 11.5 ml, 0.60), Sphere = (–25.6 ± 8.0 ml, 0.66), Vitrea = (1.3 ± 4.0 ml, 0.72). CTP+ performed similarly to RAPID and Sphere in addition to its semi-automated predecessor, Vitrea, when assessing intervention patient infarct volumes. For conservative treatment patients, CTP+ outperformed RAPID and Sphere in assessing penumbra. Semi-automated Vitrea remains the most accurate in assessing penumbra, but CTP+ provides an improved workflow from its predecessor.
A Cube Version of the Square–Diamond Illusion
Authors: Ito Hiroyuki , Nose Daichi
Published: January 2021

The square–diamond illusion is often referred to as a type of size illusion. However, the 45-degree tilting of a square remarkably affects perceived corner angles when a cube version of the figure is used. This illusion is measured and discussed in relation to anisotropy in shape interpretation.
Improved low-risk criteria scores for combination therapy of sildenafil and generic bosentan in patients with congenital heart disease with severe pulmonary hypertension: A prospective open label study
Authors: Durongpisitkul Kritvikrom , Chungsomprasong Paweena , Vijarnsorn Chodchanok , Chanthong Prakul , Kanjanauthai Supaluck , Soongswang Jarupim
Published: January 2021

Objective

We evaluated the efficacy and safety of the bosentan as a sequential add-on therapy with sildenafil in pulmonary arterial hypertension with congenital heart disease (PAH-CHD) patients.

Material and method

Twenty patients who were receiving sildenafil were given generic bosentan for up to a year. Hemodynamic data was collected from cardiac catheterization at pretreatment and at three months. Comparisons were made between the total scores of the four, low-risk criteria adapted from the 2015 ESC/ERS pulmonary hypertension guidelines, which are: 1) WHO functional class of I or II, 2) 6MWD of more than 440 m, 3) right atrial pressure of less than 8 mm Hg, and 4) cardiac index ≥2.5 L/min/m2, performed at the beginning of therapy, 3-months, 6-months, and 1 year.

Results

Patients’ average age was 27 ± 11 years old (12–53). PVRi decreased from 16.7 ± 9.5 to 12.7 ± 10.3 Wood unit (WU) m2 (p = 0.025) and PVRi/SVRi decreased from 0.69 ± 0.33 to 0.49 ± 0.32 (p = 0.001). During the follow-up, the composite scoring of the low risk scores for 19 patients was increased significantly from 1.8 ± 1.0 at baseline to 2.3 ± 0.9 at 3 months, to 2.9 ± 0.8 at 6 months, and 3 ± 0.7 at 1 year (p = 0.001).

Conclusion

We demonstrated intermediate term benefits for generic bosentan as an add-on therapy to sildenafil in patients with PAH-CHD by improving PVRi, and PVRi/SVRi at three months. A significant improvement was also seen in the combined scores of the low-risk criteria from below 2 to 3 at one year (p = 0.001). Thai Clinical Trials Registry (TCTR): TCTR identification number is TCTR20200506006.
Thoracic spondylotic myelopathy presumably caused by diffuse idiopathic skeletal hyperostosis in a patient who underwent decompression and percutaneous pedicle screw fixation
Authors: Miyoshi Shota , Morino Tadao , Takeda Haruhiko , Nakata Hiroshi , Hino Masayuki , Misaki Hiroshi , Murakami Yusuke , Imai Hiroshi , Miura Hiromasa
Published: January 2021

A 74-year-old man developed bilateral lower limb spastic paresis. He was diagnosed with thoracic spondylotic myelopathy presumably caused by mechanical stress that was generated in the intervertebral space (T1-T2) between a vertebral bone bridge (C5-T1) due to diffuse idiopathic skeletal hyperostosis after anterior fixation of the lower cervical spine and a vertebral bone bridge (T2-T7) due to diffuse idiopathic skeletal hyperostosis in the upper thoracic spine. Treatment included posterior decompression (T1-T2 laminectomy) and percutaneous pedicle screw fixation at the C7-T4 level. Six months after surgery, the patient could walk with a cane, and the vertebral bodies T1-T2 were bridged without bone grafting. For thoracic spondylotic myelopathy associated with diffuse idiopathic skeletal hyperostosis, decompression and percutaneous pedicle screw fixation are effective therapies.
Providing Care for Transgender Persons With Kidney Disease: A Narrative Review
Authors: Collister David , Saad Nathalie , Christie Emily , Ahmed Sofia
Published: January 2021

Purpose of review:

Nephrologists are increasingly providing care to transgender individuals with chronic kidney disease (CKD). However, they may lack familiarity with this patient population that faces unique challenges. The purpose of this review is to discuss the care of transgender persons and what nephrologists should be aware of when providing care to their transgender patients.

Sources of information:

Original research articles were identified from MEDLINE and Google Scholar using the search terms “transgender,” “gender,” “sex,” “chronic kidney disease,” “end stage kidney disease,” “dialysis,” “transplant,” and “nephrology.”

Methods:

A focused review and critical appraisal of existing literature regarding the provision of care to transgender men and women with CKD including dialysis and transplant to identify specific issues related to gender-affirming therapy and chronic disease management in transgender persons.

Key findings:

Transgender persons are at an increased risk of adverse outcomes compared with the cisgender population including mental health, cardiovascular disease, malignancy, sexually transmitted infections, and mortality. Individuals with CKD have a degree of hypogonadotropic hypogonadism and decreased levels of endogenous sex hormones; therefore, transgender persons with CKD may require reduced exogenous sex hormone dosing. Exogenous estradiol therapy increases the risk of venous thromboembolism and cardiovascular disease which may be further increased in CKD. Exogenous testosterone therapy increases the risk of polycythemia which should be closely monitored. The impact of gender-affirming hormone therapy on glomerular filtration rate (GFR) trajectory in CKD is unclear. Gender-affirming hormone therapy with testosterone, estradiol, and anti-androgen therapies changes body composition and lean body mass which influences creatinine generation and the performance for estimated glomerular filtration rate (eGFR) equations in transgender persons. Confirmation of eGFR with measured GFR is reasonable if an accurate knowledge of GFR is needed for clinical decision-making.

Limitations:

There are limited studies regarding the intersection of transgender persons and kidney disease and those that exist are mostly case reports. Randomized controlled trials and observational studies in nephrology do not routinely differentiate between cisgender and transgender participants.

Implications:

This review highlights important considerations for providing care to transgender persons with kidney disease. Additional research is needed to evaluate the performance of eGFR equations in transgender persons, the effects of gender-affirming hormone therapy, and the impact of being transgender on outcomes in persons with kidney disease.
Key Influencers in Public Diplomacy 2.0: A Country-Based Social Network Analysis
Authors: Ingenhoff Diana , Calamai Giada , Sevin Efe
Published: January 2021

This article presents a study of Twitter-based communication in order to identify key influencers and to assess the role of their communication in shaping country images. The analysis is based on a 2-month dataset comprised of all tweets including hashtags of the three countries selected for this study: Austria, Switzerland, and the Netherlands. Following a two-step flow model of communication, we initially identified the influential Twitter users in all three countries based on their centrality measures. Subsequently, we carried out a qualitative content analysis of tweets posted by these influential users. Finally, we assessed the similarities and differences across the three country cases. This article offers new insights into public diplomacy 2.0 activities by discussing influence within the context of country images and demonstrating how opinion leaders can play a more dominant role than states or other political actors in creating and disseminating content related to country image. The findings also provide practical insights in the production of a country’s image and its representation on new media platforms.