bluuebunny/crossref_metadata_2025 huggingface dataset:
Democracy, citizenship, and corporate governance reform: How to deal with the internationalization of corporate activity
Authors: Thompson Grahame
Published: November 2021

Commercial companies are increasingly being recognized as agents of societal governance operating alongside the public authorities in their traditional role as governance bodies. In addition, companies are claiming to be ‘corporate citizens’ in the way they deal with their environmental, employment and social/ethical responsibilities. Given the fact that large corporations are now heavily internationalized in their operational characteristics – with branches, subsidiaries, affiliates and extended supply chains operating in multiple jurisdictions – can such organizations be brought into a democratic register? Citizenship and democracy are conventionally associated with a territorial state, national sovereignty and jurisdictional independence. So, how can internationalized companies be subject to democratic forms of governance? An added problem arises with platform companies and blockchain organized digital currency providers whose operations transcend national borders from the start. This contribution discusses the issues of and provides a way for considering corporate democracy afresh in these rapidly evolving contexts.
Secessionist conflict as diversion from inequality: The missing link between grievance and repression
Authors: Dzutsati Valery
Published: November 2021

Why do some secessionist claims turn violent and others stay peaceful? This study elucidates the role of inequality and diversionary tactics of states in secessionist violence. Horizontal inequality increases the grievances of minorities and fuels rebellion. States with high vertical inequality prefer to suppress peripheries instead of increasing redistribution and alleviating their material grievances. States shun redistributing toward peripheral regions because sharing with one group prompts demands for redistribution among other groups, including the dominant group. Fearing resource reallocation at the national scale and potential loss of their elevated social status, the elites opt for violent solutions for secessionist crises. Using a new dataset on self-determination movements I test these conjectures and find strong support for them.
Effect of Premorbid Beta-Blockers on Mortality in Patients With Sepsis: A Systematic Review and Meta-Analysis
Authors: Hasegawa Daisuke , Sato Ryota , Prasitlumkum Narut , Nishida Kazuki
Published: November 2021

Objective

The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis.

Data Sources

We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813).

Study Selection

Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use.

Data Extraction

Two authors extracted the patients’ characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality.

Data Synthesis

Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; P = .12; I2 = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; P < .001; I2 = 0%).

Conclusion

Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis.
Latin American Consensus on the Management of Sepsis in Children: Sociedad Latinoamericana de Cuidados Intensivos Pediátricos [Latin American Pediatric Intensive Care Society] (SLACIP) Task Force: Executive Summary
Authors: Fernández-Sarmiento Jaime , De Souza Daniela Carla , Martinez Anacaona , Nieto Victor , López-Herce Jesús , Soares Lanziotti Vanessa , Arias López María del Pilar , De Carvalho Werther Brunow , Oliveira Claudio F. , Jaramillo-Bustamante Juan Camilo , Díaz Franco , Yock-Corrales Adriana , Ruvinsky Silvina , Munaico Manuel , Pavlicich Viviana , Iramain Ricardo , Márquez Marta Patricia , González Gustavo , Yunge Mauricio , Tonial Cristian , Cruces Pablo , Palacio Gladys , Grela Carolina , Slöcker-Barrio Maria , Campos-Miño Santiago , González-Dambrauskas Sebastian , Sánchez-Pinto Nelson L , Celiny García Pedro , Jabornisky Roberto
Published: November 2021

Objective: The aim of this study was to develop evidence-based recommendations for the diagnosis and treatment of sepsis in children in low- and middle-income countries (LMICs), more specifically in Latin America. Design: A panel was formed consisting of 27 experts with experience in the treatment of pediatric sepsis and two methodologists working in Latin American countries. The experts were organized into 10 nominal groups, each coordinated by a member. Methods: A formal consensus was formed based on the modified Delphi method, combining the opinions of nominal groups of experts with the interpretation of available scientific evidence, in a systematic process of consolidating a body of recommendations. The systematic search was performed by a specialized librarian and included specific algorithms for the Cochrane Specialized Register, PubMed, Lilacs, and Scopus, as well as for OpenGrey databases for grey literature. The GRADEpro GDT guide was used to classify each of the selected articles. Special emphasis was placed on search engines that included original research conducted in LMICs. Studies in English, Spanish, and Portuguese were covered. Through virtual meetings held between February 2020 and February 2021, the entire group of experts reviewed the recommendations and suggestions. Result: At the end of the 12 months of work, the consensus provided 62 recommendations for the diagnosis and treatment of pediatric sepsis in LMICs. Overall, 60 were strong recommendations, although 56 of these had a low level of evidence. Conclusions: These are the first consensus recommendations for the diagnosis and management of pediatric sepsis focused on LMICs, more specifically in Latin American countries. The consensus shows that, in these regions, where the burden of pediatric sepsis is greater than in high-income countries, there is little high-level evidence. Despite the limitations, this consensus is an important step forward for the diagnosis and treatment of pediatric sepsis in Latin America.
Use of High-Flow Nasal Cannula in Patients With Pneumonia and Hypoxemic Respiratory Failure at Altitudes Above 2600 m: What Is the Best Predictor of Success?
Authors: Daniel Molano Franco , Mario Gómez Duque , Edgar Beltrán , Mario Villabon , Alejandra Hurtado , Nicolas Gómez , Pablo Vásquez , Victor Nieto , Albert Valencia , Diego Garzón , Antonio Viruez-Soto , Ramon Masclans Joan
Published: November 2021

Introduction: The use of high-flow nasal cannulas (HFNC) in patients with hypoxemic ventilatory failure reduces the need for mechanical ventilation and does not increase mortality when intubation is promptly applied. The aim of the study is to describe the behavior of HFNC in patients who live at high altitudes, and the performance of predictors of success/failure of this strategy. Methods: Prospective multicenter cohort study, with patients aged over 18 years recruited for 12 months in 2020 to 21. All had a diagnosis of hypoxemic respiratory failure secondary to pneumonia, were admitted to intensive care units, and were receiving initial management with a high-flow nasal cannula. The variables assessed included need for intubation, mortality in ICU, and the validation of SaO2, respiratory rate (RR) and ROX index (IROX) as predictors of HFNC success / failure. Results: One hundred and six patients were recruited, with a mean age of 59 years and a success rate of 74.5%. Patients with treatment failure were more likely to be obese (BMI 27.2 vs 25.5; OR: 1.03; 95% CI: .95-1.1) and had higher severity scores at admission (APACHE II 12 vs 20; OR 1.15; 95% CI: 1.06-1.24). Respiratory rates after 12 (AUC .81 CI: .70-.92) and 18 h (AUC .85 CI: .72-0.90) of HFNC use were the best predictors of failure, performing better than those that included oxygenation. ICU mortality was higher in the failure group (6% vs 29%; OR 8.8; 95% CI:1.75-44.7). Conclusions: High-flow oxygen cannula therapy in patients with hypoxemic respiratory failure living at altitudes above 2600 m is associated with low rates of therapy failure and a reduced need for mechanical ventilation in the ICU. The geographical conditions and secondary physiological changes influence the performance of the traditionally validated predictors of therapy success. Respiratory rate <30 proved to be the best indicator of early success of the device at 12 h of use.
Posttraumatic Stress among Pediatric Critical Care Physicians in the United States in Association with Coronavirus Disease 2019 Patient Care Experiences
Authors: Kalyanaraman Meena , Sankar Ashwini , Timpo Edem , McQueen Derrick , Morparia Kavita , Bergel Maria , Rosenblatt Joshua
Published: November 2021

Posttraumatic stress among pediatric critical care physicians in the United States in association with coronavirus disease 2019 patient care experiences. Our objective was to assess the prevalence of posttraumatic stress (PTS) and its association with COVID-19 patient care experiences among pediatric critical care physicians. Our study was a cross-sectional study of pediatric critical care physicians in the United States. We measured PTS which included posttraumatic stress disorder (PTSD) and subthreshold posttraumatic stress disorder (SubPTSD) using validated PTSD Checklist- 5 survey tool. Association of PTS with COVID-19 patient care experiences was analyzed using regression analysis. Prevalence of PTS was noted in 120 among 294 pediatric critical care physicians (41%; 95% CI, 35-47%). The predominant symptoms were that of hyperarousal and feelings of negative cognition and mood. Among our physicians with PTS, 19% had PTSD and 81% had SubPTSD. Demographic and practice characteristics were not significant for increased PTS on regression analysis. Posttraumatic stress was significantly associated with physicians testing positive or taking time off for COVID-19 illness, self-isolation, fear of infecting their loved ones, families scared of being infected, feeling helpless, patients expressing fears of dying, having pre-existing depression, anxiety, or insomnia, working beyond comfort level of training and having thoughts of quitting (p < 0.05). Thoughts of quitting was associated with the highest significant increase in PTS scores (coefficient:11.643; 95% CI:8.551,14.735; P < 0.01) followed by feeling of helplessness (coefficient:11.055; 95% CI: 8.484,13.624; P < 0.01) and need for additional medications for depression, anxiety and insomnia (coefficient: 10.980; 95% CI: 4.970, 16.990; P < 0.01). Posttraumatic stress is high in pediatric critical care physicians and is associated with various COVID-19 patient care experiences. Thoughts of quitting was associated with highest increase in posttraumatic stress score which could have major implications for the workforce in the future. Subthreshold posttraumatic stress disorder should be recognized, and mental health issues of pediatric critical care physicians addressed.
Floating solar photovoltaic plants in India – A rapid transition to a green energy market and sustainable future
Authors: Charles Rajesh Kumar J. , Majid MA
Published: November 2021

The 18,000 square kilometers of water reservoirs in India can generate 280 GW of solar power through floating solar photovoltaic plants. The cumulative installed capacity of FSPV is 0.0027 GW, and the country plans to add 10 GW of FSPV to the 227 GW renewable energy target of 2022. The FSPV addition is small related to the entire market for solar energy, but each contribution is appreciated in the renewable energy market. FSPV could be a viable alternative for speeding up solar power deployment in the country and meeting its NDC targets. So far, the country has achieved the world's lowest investment cost for a floating solar installation. Despite the lower costs, generalizations are still premature because FSPV is still in its initial stages of market entry. Continuous innovation and timely adoption of innovative ideas and technology will support India in meeting its solar energy goals and progressing toward a more sustainable future. Governments must establish clear and enforceable policies to assist developers in reducing risks and increasing investor confidence in the sector. Economic and financial feasibility are examined, and various difficulties in technology, design, finances, environment, maintenance, and occupational health that impact the FSPV deployment are discussed. Based on the research, effective and comprehensive FSPV policy suggestions are included to support establishing an appropriate market, fostering competition and innovation, and attracting large-scale investment. This paper aims to stimulate interest among various policy developers, energy suppliers, industrial designers, ergonomists, project developers, manufacturers, health and safety professionals, executing agencies, training entities, and investment institutions of the FSPV plant to implement effective governance planning and help them to participate in their ways to assure sustainable growth.
Weighted pseudo-values for partly unobserved group membership in paediatric stem cell transplantation studies
Authors: Mittlböck Martina , Pötschger Ulrike , Heinzl Harald
Published: November 2021

Generalised pseudo-values have been suggested to evaluate the impact of allogeneic stem cell transplantation on childhood leukaemia. The approach compares long-term survival of two cohorts defined by the availability or non-availability of suitable donors for stem cell transplantation. A patient's cohort membership becomes known only after completed donor search with or without an identified donor. If a patient suffers an event during donor search, stem cell transplantation will no longer be indicated. In such a case, donor search will be ceased and cohort membership will remain unknown. The generalised pseudo-values approach considers donor identification as binary time-dependent covariate and uses inverse-probability-of-censoring weighting to adjust for non-identified donors. The approach leads to time-consuming computations due to multiple redefinitions of the risk set for pseudo-value calculation and an explicit adjustment for waiting-time bias. Here, the problem is looked at from a different angle. By considering the probability that a donor would have been identified after ceasing of donor search, weights for common pseudo-values are defined. This leads to a faster alternative approach as only a single risk set is necessary. Extensive computer simulations show that both, the generalised and the new weighted pseudo-values approach, provide approximately unbiased estimates. Confidence interval coverage is satisfactory for typical clinical scenarios. In situations, where donor identification takes considerably longer than usual, the weighted pseudo-values approach is preferable. Both approaches complement each other as they have different potential in addressing further aspects of the underlying medical question.
Moral distress in nursing students: Cultural adaptation and validation study
Authors: Mazzotta Rocco , De Maria Maddalena , Bove Davide , Badolamenti Sondra , Saraiva Bordignon Simonì , Silveira Luana Claudia Jacoby , Vellone Ercole , Alvaro Rosaria , Bulfone Giampiera
Published: November 2021

Background:

Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students.

Aim:

This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the exams necessary to progress to the next level).

Research design:

The study used a cross-sectional research design.

Participants and research context:

Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy.

Ethical considerations:

The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent.

Results:

The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753–0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate.

Discussion:

The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students.

Conclusion:

This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.
“I’m Grateful, but Am I?”: The Exploration of Gratitude as a Complex Experience Among Malaysian Cancer Patients
Authors: Hussin Nur Atikah Mohamed , Mohammad Taufik , Jamaludin Shariffah Suraya Syed
Published: November 2021

Gratitude has gained attention among health researchers for its benefits among chronic illness. However, most of the studies were focusing on the positive effects, neglecting the complex dimensions of gratitude that can contribute to both opportunities and challenges for chronic illness patients. This study aims to understand gratitude among cancer patients in Malaysia from a sociocultural perspective. This includes understanding how cancer patients view gratitude and the impacts of gratitude throughout their cancer-battling journey. This qualitative study involved 35 cancer patients. A thematic analysis was done to analyze the collected data. Among the themes discovered were searching for meaning, meaningful experience, gratitude through the enrichment activities, and gratitude as religious cultural expectations. This study suggests that gratitude is an important experience for chronic illness patients. The ability to understand this experience is vital to support and empower the patients throughout their daily lives.
Early Maxillary Dentoalveolar Changes in Children with Unilateral Cleft Lip and Palate After Palatal Repair: A Pilot Study
Authors: Singhania Shreepriya , Bhojraj Nandlal
Published: November 2021

Objective

To assess early maxillary dentoalveolar changes in children with unilateral cleft lip and palate (UCLP) up to 6 months after palatoplasty.

Design

Pilot study.

Patients and Participants

Eight children with UCLP at the age of 18 to 30 months, who were awaiting palatal repair, were included.

Interventions

All participants with repaired lip were scheduled for palatal repair between 18 and 24 months by Bardach's technique.

Main Outcome Measure(s)

Arch widths, arch depths, and arch perimeter was measured on 32 dental casts of 8 participants at 4 time points: just prior to palatal repair (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after palatal repair. Manual method using digital vernier caliper (Zhart, India) was used for model analysis. Intraexaminer reliability was also assessed.

Results

Only one examiner assessed all the dental casts after blinding. There was a significant decrease in the intercanine width (29.75 ± 1.98 mm at T1 to 26.42 ± 1.67 mm at T4; P < .001) and anterior arch depth (9.86 ± 1.07 mm at T1 to 8.29 ± 1.51 mm at T4; P < .001). Growth occurred in intertuberosity width (38.18 ± 1.40 mm at T1 to 39.76 ± 1.09 mm at T4; P < .001) and total arch depth (24.36 ± 1.21 mm at T1 to 26.79 ± 1.04 mm; P < .001) over 6 months post-surgery.

Conclusions

There was growth restriction in the anterior part of the palate, whereas the posterior region continued to grow after palatal repair. These changes were observable even in the early months after palatoplasty.
Classification Systems of Cleft Lip, Alveolus and Palate: Results of an International Survey
Authors: Houkes Ruben , Smit Johannes , Mossey Peter , Don Griot Peter , Persson Martin , Neville Amanda , Ongkosuwito Edwin , Sitzman Tom , Breugem Corstiaan
Published: November 2021

Objective

This study aimed to identify commonly used classification systems by cleft providers around the world, including the perceived indications and limitations of each system.

Design

A cross-sectional survey.

Participants

A total of 197 registrants from three international cleft/craniofacial meetings.

Interventions

Participants were sent a web-based questionnaire concerning cleft classification systems.

Main Outcome Measures

Frequency of commonly used classification systems, their perceived indications and limitations.

Results

A total of 197 respondents from 166 different centers completed the questionnaire. Healthcare professionals from all disciplines responded, with the most frequent respondents being plastic surgeons (38.1%), maxillofacial surgeons (28.4%) and orthodontists (23.9%). Eighteen different classification systems were in use. The most frequently used systems were the International Statistical Classification of Diseases and Related Health Problems (ICD-10) (35.5%), LAHSHAL (34.0%), and Veau (32.5%) classification systems. Most respondents (32.5%) indicated that anatomical and morphological characteristics are essential components of a classification system. However, respondents indicated that their current classification systems lacked sufficient description of cleft extension and severity.

Conclusions

Great variety in the use of classification systems exists among craniofacial specialists internationally. The results recommend the usage of the LAHSHAL classification of OFCs, due to its comprehensiveness, relatively high implementation rate globally, convenience of usage and complementarity with the ICD-10 system. Moreover, it can overcome deficiencies inextricably linked to ICD-10, such as incapacity to describe laterality and clefts of the alveolus. More international exposure to the merits of using the LAHSHAL classification system would be highly recommended.
Early Nutrition among Infants Admitted to the NICU with Cleft Lip and Palate
Authors: Tahmasebifard Neda , Briley Patrick M. , Ellis Charles , Perry Jamie L.
Published: November 2021

Objective

The objective of this study was to examine differences in human milk feeding outcomes among infants admitted to a neonatal intensive care unit (NICU) with and without cleft lip and palate (CLP).

Method

Data were used from a sample of infants admitted to the NICU with and without CLP from the 2018 National Vital Statistics System. For baseline comparisons, Chi-square tests of independence were used to compare categorical variables, and independent samples t tests were used for continuous variables. Logistic regression models were performed to determine the odds of human milk feeding at discharge in infants admitted to the NICU with CLP.

Results

The total sample included 345,429 infants admitted to the NICU, of which 660 had CLP. Significant differences were found among the following variables when baseline comparisons were made between infants admitted to the NICU with and without CLP: mother's race, mother's education, maternal smoking record, childbirth delivery method, presence of maternal pre-pregnancy diabetes, five-minute APGAR score, multiparity record (having more than one baby at birth), gestational age, and gestational weight. After controlling for baseline differences, results indicated reduced odds of human milk feeding at discharge in infants admitted to the NICU with CLP compared to those without CLP (OR = .543; 95% CI.455,.648).

Conclusion

Results suggest reduced odds of human milk feeding at discharge among infants admitted to the NICU with CLP compared to those without CLP. These findings emphasize the necessity of awareness and facilitation of human milk feeding in this population.
Spindle Cell Lipoma with Ossification Mimicking Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma: A Case Report
Authors: Ichikawa Jiro , Kawasaki Tomonori , Imada Hiroki , Enomoto Atsushi , Taniguchi Naofumi , Tatsuno Rikito , Kanno Satoshi , Haro Hirotaka
Published: November 2021

Although spindle cell lipoma (SCL) is a subtype of lipoma, the characteristics of SCL are observed in both lipomatous and non-lipomatous tumors. In this article, we present a case of SCL with ossification mimicking atypical lipomatous tumors/well-differentiated liposarcomas (ALTs/WDLs). Considering the findings of magnetic resonance imaging and needle biopsy, which exhibited ALTs/WDLs, marginal resection was performed. Histopathological findings demonstrated mature adipocytes and spindle cells without atypia and no malignant osteoid tissue in the ossified region. In addition, immunohistochemistry (IHC) showed positive staining for CD34, heterogeneous retinoblastoma protein deficiency, and negative staining for mouse double minute 2 homolog (MDM2) and cyclin-dependent kinase. Fluorescence in-situ hybridization showed negative amplification of MDM2. The final diagnosis of the tumor was established using IHC as an extremely rare SCL with ossification.
Developing a simplified method for analysis and design of isolated structures with the novel quintuple friction pendulum system under bidirectional near-field excitations
Authors: Keikha Hamed , Amiri Gholamreza Ghodrati
Published: November 2021

Simplified analysis methods for seismically isolated structures proposed in recent structural codes and specifications are frequently used to reduce the computational effort and to simplify the design procedure, either directly for special cases or for checking the results of nonlinear response history analysis. Of the approximate methods, the equivalent lateral force procedure using the effective stiffness and effective damping is one of the best known. In this study, the simplified method is developed by combining the equivalent lateral force procedure with the capacity spectrum method and evaluated in terms of maximum isolator displacements and base shears for isolated structures with recently invented quintuple friction pendulum isolators , with different geometrical and frictional properties, under two different response spectra with corresponding two different sets of bidirectional near-field ground motions for stiff and soft soils site classes. In order to assess the accuracy of the simplified method, the delivered results of the ELF procedure are compared to those of nonlinear response history analysis, by modelling the quintuple friction pendulum isolator 3D element in OpenSees. Eventually, comments on the accuracy of the simplified method are given to make its applications more appropriate in practical design of base isolation systems.
Determination of material properties of a linearly elastic peridynamic material
Authors: Aguiar Adair R , Seitenfuss Alan B
Published: November 2021

We investigate the properties of an isotropic linear elastic peridynamic material in the context of a three-dimensional state-based peridynamic theory, which considers both length and relative angle changes, and is based on a free energy function proposed in previous work that contains four material constants. To this end, we consider a class of equilibrium problems in mechanics to show that, in interior points of the body where deformations are smooth, the corresponding solutions in classical linear elasticity are also equilibrium solutions in peridynamics. More generally, we show that the equations of equilibrium are satisfied even when two of the four peridynamic constants are arbitrary. Pure torsion of a cylindrical shaft and pure bending of a cylindrical beam are particular cases of this class of problems and are used together with a correspondence argument proposed elsewhere to determine these two constants in terms of the elasticity constants of an isotropic material from the classical linear elasticity. One of the constants has a singularity in the Poisson ratio, which needs further investigation. Two additional experiments concerning bending of cylindrical beam by terminal load and anti-plane shear of a hollow cylinder, which do not belong to the previous class of problems, are used to validate these results.
Youth Demographic Characteristics and Risk Perception of Using Alternative Tobacco Products: An Analysis of the 2014–2015 Canadian Student Tobacco, Alcohol, and Drugs Survey (CSTADS)
Authors: Okpalauwaekwe Udoka , Nwoke Chinenye Nmanma , Messier Jacinthe
Published: November 2021

Background

There is a growing attraction by youth to alternative tobacco products (ATPs) such as e-cigarettes and hookahs. This study investigated risk perceptions and demographic characteristics associated with ATP use in grade 8–10 students.

Methods

Data were drawn from the 2014/15 cycle of the CSTADS. The analytic sample included 1819 students from a total pool of 42 094 students who completed the survey. Logistic regression models were used to examine factors (demographic characteristics and risk perception) associated with ATP use in the past 30 days.

Results

12% of students in grade 8–10 self-identified as having used ATPs in the past 30-days, with a majority of students in grade 10 (56%). Male students had higher odds of reporting ATP use when compared to females. Although a lesser proportion of Indigenous students reported ATP use in comparison to White students (31% vs 61%), Indigenous students were 2.42 (1.49, 3.93) times as likely to use ATPs as White students. Students who perceived smoking hookah once in a while as “no to slight risk” were 1.58 (1.09, 2.28) times more likely to report ATP use than students who perceived “moderate to great risk.” Also, students who perceived using e-cigarettes on a regular basis as “no to slight risk” were 2.21 (1.53, 3.21) times more likely to report ATP use as students who perceived “moderate-great risk.”

Conclusion

A significant number of grade 8–10 students use ATPs, especially e-cigarettes, with the misconception of minimal health risks. There remains the need to do more to counteract the rise in social and epidemiological alternative tobacco use trends among the youth.
Reactive and proactive aggression in clinical adolescents with attention-deficit/hyperactivity disorder: The moderating role of gender and comorbidities
Authors: Vida Peter , Balazs Judit , Gadoros Julia , Nagy Peter , Halasz Jozsef
Published: November 2021

Aggression is well-known problem in adolescent with Attention-Deficit/Hyperactivity Disorder (ADHD), but the precise relation of reactive and proactive aggression by gender and comorbidities has not been characterized in this population. The aim of this study was to assess the level of reactive and proactive aggression in adolescents with ADHD and in matched non-ADHD clinical controls. The level of aggression was assessed by the Reactive and Proactive Aggression Questionnaire in 391 adolescents with ADHD and in 391 matched non-ADHD clinical controls. The selection of adolescents with ADHD was representative for a three-year–long period in Vadaskert Child Psychiatry Hospital. General Linear Model was used to assess the difference by ADHD, gender, and comorbidities on the level of reactive and proactive aggression. The presence of ADHD was associated with higher levels of reactive and proactive aggression. In girls, the effect of ADHD on reactive aggression was more profound. The presence of oppositional defiant disorder or conduct disorder in both groups resulted in higher levels of aggression. Our data suggest that adolescents with ADHD have higher level of aggressive behavior, and girls are especially vulnerable in terms of reactive aggressive behavior.
HBV co-infection is associated with persistently elevated liver stiffness measurement in HIV-positive adults: A 6-year single-centre cohort study in Nigeria
Authors: Rivera Adovich S , Machenry Stephen , Okpokwu Jonathan , Olatunde Bola , Ugoagwu Placid , Auwal Muazu , Sule Halima , Agaba Patricia , Agbaji Oche O , Thio Chloe L , Murphy Robert Leo , Hawkins Claudia
Published: November 2021

Background

In Nigeria, the effect of Hepatitis B virus (HBV) on long-term liver outcomes in persons with HIV (PLH) has not been described. We determined changes in liver stiffness measure (LSM) using transient elastography over 6 years in HIV mono-infected and HIV-HBV co-infected Nigerians initiating antiretroviral therapy (ART) and factors associated with LSM decline.

Methods

This single centre, cohort study enrolled ART-naïve HIV mono- and HIV-HBV co-infected adults (≥18 years) at the APIN Public Health Initiatives–supported HIV Care and Treatment Centre at Jos University Teaching Hospital, Nigeria, from 7/2011 to 2/2012. LSM at baseline, Years 3 and 6 were analysed using longitudinal models to estimate changes over time and their predictors.

Results

Data from 100 (31%) HIV-HBV co-infected and 225 (69%) HIV mono-infected participants were analysed. Median LSM at baseline was 6.10 (IQR: 4.60–7.90) kPa in co-infected and 5.10 (IQR: 4.40–6.10) kPa in mono-infected participants. In adjusted analyses, average LSM was not significantly different between Year 0 and 3 (β = 0.02, −0.22 to 0.26, p = 0.87 and Year 0 and 6 (β = −0.02, −0.23 to 0.27, p = 0.88) in both groups ( p>0.05), but co-infected participants had significantly higher LSM than mono-infected throughout follow-up (β = 0.018, 0.019–0.28, p < 0.001). Year 3 LSM differed according to ART initiation status by Year 3 (initiators - non-initiators: −0.87, −1.70 to −0.29).

Conclusion

In this cohort, LSM remained higher among HIV-HBV co-infected versus HIV mono-infected participants throughout follow-up. Our findings emphasize the continuing need for monitoring of liver outcomes in HIV-HBV co-infected populations on ART and the importance of preventing HBV infection among PLH to optimize liver health.
Automatic modal parameters identification and uncertainty quantification based on block-bootstrap and multi-stage clustering under ambient excitation
Authors: Luo Yongpeng , Liu Yuangui , Han Jianping , Liu Jingliang
Published: November 2021

This study proposes an algorithm for autonomous modal estimation to automatically eliminate false modes and quantify the uncertainty caused by the clustering algorithm and ambient factors. This algorithm belongs to the stochastic subspace identification (SSI) techniques and is based on the Block-Bootstrap and multi-stage clustering analysis. First, the Block-Bootstrap is introduced to decompose the response signal of the structure into M blocks of data. The covariance-driven stochastic subspace identification (SSI-Cov) method is used to process a random sample of data and obtain the corresponding M stabilization diagrams. In addition, the hierarchical clustering method is adopted to carry out the secondary clustering of the picked stable axis according to the defined distance threshold. Then, false modes are eliminated according to the proposed true and false modal discrimination index ( MDI). Finally, the above steps are repeated B times, and MDI is used to modify the initial modal parameters of group B. The mean value of elements in the cluster is taken as the recognition result of modal parameters, and the standard deviation is used to measure the accuracy of the recognition result. The numerical simulation results and the modal parameter identification of the Jing-yuan Yellow River Bridge show that, for identifying true and false modals, the proposed modal discrimination index is more effective than the threshold value of the traditional index. Also, it was found that the proposed method can eliminate the uncertainty introduced in the clustering process. In addition, this method can remove the influence of ambient noises, and it can improve the identification accuracy. It will be shown that this method has better anti-noise performance.
Nonlinear dynamic analysis of gear system in shearer cutting section under wear failure
Authors: Sheng Lianchao , Li Wei , Ye Guo , Feng Ke
Published: November 2021

Gear wear failure is one of the important failures of the gear system in the shearer cutting section. To reveal the influence mechanism of shearer cutting gear wear on the system dynamic characteristics, considering coupling factors such as time-varying meshing stiffness, dynamic gear clearance, internal error excitation, end load constraint and bearing radial clearance under wear failure, an improved dynamic model of shearer drive gear system is introduced to present an in-depth investigation of uniform wear of gear teeth effect. The dynamic meshing stiffness of gears under different degrees of wear is analysed. Furthermore, the bifurcation diagram is utilized to observe the motion state of the system experiencing different excitation frequencies, support damping as well as terminal loads. It is demonstrated that the gear surface wear could bring a change in gear dynamic transmission error, vibration impact state and amplitude, which is mainly manifested in increasing the unstable area and the vibration amplitude of the gear system, providing a method for monitoring and diagnosing of gear surface faults.
Effect of fiber dosage on water permeability using a newly designed apparatus and crack monitoring of steel fiber–reinforced concrete under direct tensile loading
Authors: Hussain Zahoor , Pu Zhang , Hussain Abasal , Ahmed Shakeel , Shah Atta Ullah , Ali Aitzaz , Ali Azhar
Published: November 2021

Cracks in concrete structures have always been the main reason to allow the aggressive and harmful agents to infringe the concrete resulting in its deterioration and decreasing lifespan. In the present study, the water permeability of the cracked concrete has been investigated. The consequences of cracking on the durability and endurance of concrete were also studied. A state-of-the-art permeability setup was designed to measure the water flow in normal and fiber-reinforced concrete under direct tensile loading. The setup was convenient for determining the average stress applied to the concrete specimens and simultaneously the maximum crack opening. Furthermore, the effect of fiber content on the cracking geometry (tortuosity and roughness) was evaluated by incorporating the coordinate data of the cracked surface using a 3D sensor-based laser scanning data acquisition system. To understand the effect of fiber content on the cracking geometry (tortuosity and roughness), the acquired data were then analyzed. Test results show that the designed setup is suitable to measure the water permeability under direct tensile loading. Water permeability decreased upon increasing the steel fiber dosage. Besides, the results show that tortuosity decreased while surface roughness increased with the fiber dosage increment. Promising preliminary results indicated that there is an inverse relationship between surface roughness and water permeability. The crack sensing setup successfully monitored the crack.
Clamp links: A novel type of reciprocal frame connection
Authors: Castriotto Caio , Tavares Felipe , Celani Gabriela , Popovic Larsen Olga , Browne Xan
Published: November 2021

Reciprocal frames (RFs) are complex structural systems based on mutual support between elements. One of the main challenges for these structures is achieving geometrical complexity with ease for assembly. This paper describes the development of a new type of connection for RF that uses a single bolt to fix a whole fan. The method used was the Research Through Design, using algorithmic modelling and virtual and physical prototyping. After the exploration of different alternatives, the connection selected was structurally evaluated with a 3D solid finite element analysis (FEM) software and a 2D bar parametric model. Finally, a full-scale pavilion was built as a proof-of-concept. A total of 47 connections were fabricated using four 3D-printed templates combined with a hand router. The construction allowed us to draw conclusions on the connection design and the assembly method, and the process as a whole can contribute to the development of new structural links and production methods.
Inferior Longitudinal Fascicle and Reading: Exploring Their Relationship Through a Brain Stimulation Case Study
Authors: Papatzalas Christos , Papathanasiou Ilias , Paschalis Thanasis , Tzerefos Christos , Kapsalaki Eftychia , Petsiti Argyro , Fountas Kostas
Published: November 2021

Awake brain surgery allows for maximal tumor resection, while minimizing postoperative deficits, even when the tumor is located within eloquent brain regions. In the current study, we present the case of a patient who underwent awake craniotomy to remove a space-occupying lesion located at the left (dominant) temporal lobe. During subcortical mapping, electrical stimulation of the inferior longitudinal fasciculus caused severe errors (paralexias) on a semantic odd-word out task but not on other tasks that use different input routes and processes. The cognitive neuropsychological model for single word processing assisted us to associate a specific structure (inferior longitudinal fascicle [ILF]) with a specific cognitive process (i.e., access to the semantic system). Our results highlight the importance of subcortical fascicles in reading and agree with previous studies regarding the critical role of ILF in reading comprehension.
Conditions for cross-border policy transfer and cooperation: Analysing differences between higher education and vocational training
Authors: Graf Lukas , Lohse Anna P.
Published: November 2021

Against the backdrop of an increasingly interconnected world as well as the growing role of inter- and supranational organizations, policy transfer has become a widespread phenomenon, not least in the realm of education. While policy transfer research has focused predominantly on isolated education sectors, less is known about the overall institutional conditions that favour or inhibit policy movement in different education sectors. We argue that the conditions for cross-border policy synthesis, as a central form of policy transfer, differ systematically between the two main education sectors preparing for labour market entry, namely higher education (HE) and vocational education and training (VET). Taking the case of the cross-border region of France, Germany and Switzerland as an example, the institutional analysis shows that demand-side, programmatic, contextual and application conditions are more favourable towards cross-border policy synthesis in HE than VET.
Eight-hour versus 24-h urethral catheter removal following elective caesarean section for reducing significant bacteriuria: A randomized controlled trial
Authors: Igbodike Emeka Philip , Awowole Ibraheem Olayemi , Kuti Olufemi O , Ajenifuja Kayode Olusegun , Eleje George Uchenna , Olateju Simeon Olugbade , Olopade Bolatito Opeyemi , Ijarotimi Omotade Adebimpe , Irek Emmanuel Oladayo , Igbodike Njideka Theresa , Ayegbusi Oluwole Ekundayo , Ikechebelu Joseph Ifeanyichukwu , Okpala Boniface Chukwuneme , Loto Olabisi Morebisi , Fehintola Akintunde Olusegun , Ajiboye Akinyosoye Deji , Fajobi Olusola , Abuchi Chima Stephene , Onwudiegwu Uchenna Uchenna , Fasubaa Olusola Benjamin , Orji Ernest Okechukwu , Makinde Olufemiwa Niyi , Owolabi Alexander Tuesday , Adeyemi Adebanjo Babalola
Published: November 2021

Background:

There is no consensus on the preferred time to remove urethral catheter post caesarean section.

Aim:

To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section.

Methods:

A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. ( www.pactr.org:PACTR202105874744483 )

Results:

There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: −24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: −38.8; CI: −111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001)

Conclusions:

An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes
The impact of pendular model on decision-making and tactical-technical performance of U18 male volleyball players
Authors: de Oliveira Castro Henrique , Praça Gibson M , Mesquita Isabel MR , Afonso José , De Conti Teixeira Costa Gustavo , Moreno Maria Perla , Morales Juan CP , Greco Pablo J
Published: November 2021

This study aimed to verify the influence of applying the Pendular Model of Tactical-Technical Training (Pendular Model) on decision-making and tactical-technical performance of U18 male volleyball athletes. A total of 44 U18 volleyball athletes participated in the study, divided into two groups: experimental group ( n = 23) and control group ( n = 21). The Declarative Tactical Knowledge Test in Volleyball was used for the decision-making analysis, while the Instrument for Technical-Tactical Performance Assessment in Volleyball was used for the specific tactical-technical performance components level analysis in the game. Experimental group athletes performed 24 training sessions using the Pendular Model, and control group athletes maintained 24 sessions of regular training. There was a significant difference in decision-making in the extremity attack and setting situations, being better in the experimental group than the control group in the pre and postintervention moments. There were significant differences in the adjustment, decision-making, and effectiveness components in athletes’ tactical-technical performance in game situations, being greater in the experimental group compared to the control group in the moments after 12 sessions and postintervention. It is concluded that the Pendular Model proved to be effective for improving decision-making in extremity attack and setting video situations and in the tactical-technical performance in the game in the adjustment, decision-making, and effectiveness components for male U18 volleyball athletes.