bluuebunny/crossref_metadata_2025 huggingface dataset:
Frog and Toad at the Academy: Gareth B. Matthews on how children’s literature goes philosophical
Authors: Gregory Maughn Rollins , Laverty Megan Jane
Published: January 2022

Gareth B. Matthews (1929–2011) inaugurated the study of philosophy in children’s literature by simultaneously arguing (1) that philosophy is essentially an encounter with certain kinds of perplexities, (2) that genuine philosophical perplexities are readily found in many children’s stories, and (3) that many children are capable of appreciating and enjoying them. He wrote 58 reviews of philosophical children’s stories and co-authored a series of teacher guides for using such stories. Following Matthews’ example, others have produced resources recommending children’s stories as stimuli for intergenerational philosophical dialog. In our research, we study and systematize the different ways that Matthews understood children’s stories to go philosophical. Here, we introduce five of those ways: philosophical story irony, philosophical story fancy, thought experiment, philosophical fable, and philosophical story realism. For each of these ways, we define a set of literary elements and describe the kind of philosophical perplexity they invite, illustrating with examples from children’s literature reviewed and discussed by Matthews. We intend our article to shed new light on Matthews’ scholarship, to guide (ourselves and others) in locating some of the elements in children’s stories that occasion different types of philosophical perplexity, and to spark new conversations among philosophers and educators about this promising field.
Students’ Non-Cognitive Profiles and their Relationships with Academic Stress and Persistence in Higher Education
Authors: Wong Wan Hoong , Chapman Elaine
Published: January 2022

To reduce their attrition rates, institutions need to ensure that their students can manage the stressors they confront in their academic work and persist to complete their study programs. Given the significance of non-cognitive attributes in education, this study aimed to identify the non-cognitive profiles exhibited by students which related significantly to academic stress and persistence levels in the middle of a given academic year. Undergraduate students from one of the largest private higher education institutions in Singapore participated in two online surveys. A total of 565 and 122 students participated in the first and second surveys, respectively. Results indicated that three distinct non-cognitive profiles could be identified, which were associated significantly with students’ academic stress levels and their intentions to persist with their studies. Possible implications for enhancing student outcomes by offering students with opportunities to enhance their affective ‘readiness’ profiles are discussed.
Care Quality, Patient Safety, and Nurse Outcomes at Hospitals Serving Economically Disadvantaged Patients: A Case for Investment in Nursing
Authors: Viscardi Molly Kreider , French Rachel , Brom Heather , Lake Eileen , Ulrich Connie , McHugh Matthew D.
Published: January 2022

We sought to evaluate if better work environments or staffing were associated with improvements in care quality, patient safety, and nurse outcomes across hospitals caring for different proportions of patients who are economically disadvantaged. Few actionable approaches for hospitals with quality and resource deficits exist. One solution may be to invest in the nurse work environment and staffing. This cross-sectional study utilized secondary data from 23,629 registered nurses in 503 hospitals from a four-state survey collected in 2005–2008. Each 10% increase in the proportion of patients who are economically disadvantaged was associated with 27% and 22% decreased odds of rating unit-level care quality as excellent and giving an “A” safety grade, respectively. Each 10% increase was also associated with 9%, 25%, and 11% increased odds of job dissatisfaction, intent to leave, and burnout, respectively. The work environment had the largest association with each outcome. Accounting for the nurse work environment lessened or eliminated the negative outcomes experienced at hospitals serving high proportions of patients who are economically disadvantaged. Leaders at hospitals serving high proportions of patients who are economically disadvantaged, as well as state and federal policymakers, should work to improve quality, safety, and nurse outcomes by strengthening nurse work environments. Improving work environments highlights the role of nursing in the health care system, and policies focused on work environments are needed to improve the experiences of patients and nurses, especially at hospitals that care for many patients who are economically disadvantaged.
Dementia Awareness Challenges in Sub-Saharan Africa: A Cross-Sectional Survey Conducted Among School Students in Ghana
Authors: Spittel Susanne , Kraus Elke , Maier André
Published: January 2022

The survey focuses on identifying dementia awareness challenges among Ghanaian school students. Data were generated in a cross-sectional survey (n = 1137). 9.3% of school students showed dementia awareness whilst the community respondents, representing both higher age and level of education, showed greater awareness (32.2%, P < .001). 45% of respondents believed in witchcraft and 57% were afraid of potentially being harmed by witchcraft. Age and education did not influence people’s belief in witchcraft. Moreover, dementia symptoms were often mistaken for witchcraft, especially by those who had encountered a person accused of witchcraft: “swearing at others” (24%), displaying “memory loss” and “confused speech” (22%), “forgetfulness” and who was seen “roaming around” (19%). Lack of dementia awareness was particularly evident among school students whereas belief in witchcraft was similar in both respondent groups. There was a correlation between low dementia awareness rates and misinterpretation of dementia symptoms with attribution to witchcraft.
Omentin-1 and diabetic foot
Authors: Gatev Tsvetan , Byalkova Viktoriya , Poromanski Ivan , Velikova Tsvetelina , Vassilev Dobrin , Kamenov Zdravko
Published: January 2022

Introduction: Diabetic foot disease is an advanced complication of diabetes mellitus, which is associated with severe invalidization and high mortality rate among affected people. Many factors are involved in its pathogenesis but not all of them are fully elucidated. Objectives: Adipose tissue and its hormones – adipokines, are related to diabetic complications and metabolic disorders. Until now, there are limited data on their role in diabetic foot. The aim of this cross-sectional study is to determine the levels of the adipokine omentin-1 in people with and without diabetic foot disease and to look for its potential involvement in this complication. Methods: Eighty patients with type 2 diabetes and mean age of 60.8±10.5 years were included in this study. They were divided into two groups: with (n=36) and without (n=44) diabetic foot disease. Standard antrometric, clinical and laboratory tests were made. Body composition was analyzed by bioelectrical impedance based device. Serum omentin-1 was measured using ELISA method. Results: Levels of omentin-1 were significantly higher among people with diabetic foot disease (700.2±345.1 ng/ml), compared to the other group (560.2±176.7 ng/ml). This difference remained significant even after adjusting for potential confounders. In a regression model omentin-1 proved its predictive value for development of diabetic foot. Conclusion: Adipokines, and particularly omentin-1, might be included in the pathogenesis of diabetic foot disease.
Biological Therapy on Infected Traumatic Wounds: A Case-Control Study
Authors: Bhartiya Satyanam Kumar , Prasad Rina , Sharma Sumit , Shukla VijayKumar , Nath Gopal , Kumar Rajesh
Published: January 2022

Background:Traumatic wound is a great challenging issue to surgeons, because of large in size, heavily contaminated, infected and unscenic. Infection proceeded to progressive tissue necrosis, septicemia, organ failure or even death. Majority has polymicrobial infections. Bacteriohage therapy will have revolutionized in the treatment of wound. The present study was planned to evaluate the efficacy of topical bacteriophage therapy on large traumatic wounds in comparison with conventional therapy. Methods:The Study conducted from Sept. 2018 to July 2020. Samples between 12- 60 years was taken into study. Customized bacteriophage applied over the wound after serial debridement in case and conventional dressing in control. Fifty four wounded person met the clinical inclusion criteria; 27 in each group. Wound swab and tissue biopsy was taken for bacterial isolation. Isolated specific phage was applied over the wound on alternate day till the wound become sterile and fit for further definitive management. Results: A significant and rapid improvement was observed in wound healing in cases then control group. Average number of day required for complete granulation of wound and attaining sterility was half in cases then control. The hospital stay of the patients on BT was half (20days) than those on CT (40 days). The financial analysis also favours the BT over CT as only 1/third expenditure incurred in BT group as compared to CT Conclusion:Topical Bacteriophage therapy is efficient, effective to clearing the infection in shorter length of time and cost effective for infected traumatic wounds as compared to conventional dressing.
Seeking Approval from Universities to Research the Views of Their Staff. Do Gatekeepers Provide a Barrier to Ethical Research?
Authors: Christian Katherine , Johnstone Carolyn , Larkins Jo-ann , Wright Wendy
Published: January 2022

A “gatekeeper” controls access to an organization; “gatekeeper approval” is often needed before external research can take place within an organization. We explore the need for gatekeeper approval for research with university staff employing, as a case study, a project which collected data in Australia. This case study addresses known issues, seemingly rarely addressed in the literature. The Human Research Ethics Committee (HREC)'s requirement for approval from individual universities to approach their staff brought significant consequences, exacerbated by the lack of university procedures for such approvals. Simultaneously, since invitations could legitimately be distributed via other avenues, such approval was superfluous. We recommend the HREC's blanket requirement for institutional approval instead be considered on a case-by-case basis depending on the risk of the research, and perhaps waived for low-risk research where participants are able to provide informed consent, and that universities establish processes to deal with requests from external researchers.
Telehealth for rehabilitation and recovery after stroke: State of the evidence and future directions
Authors: English Coralie , Ceravolo Maria Gabriella , Dorsch Simone , Drummond Avril , Gandhi Dorcas BC , Halliday Green Judith , Schelfaut Ben , Verschure Paul , Urimubenshi Gerard , Savitz Sean
Published: January 2022

Aims:

The aim of this rapid review and opinion paper is to present the state of the current evidence and present future directions for telehealth research and clinical service delivery for stroke rehabilitation.

Methods:

We conducted a rapid review of published trials in the field. We searched Medline using key terms related to stroke rehabilitation and telehealth or virtual care. We also searched clinical trial registers to identify key ongoing trials.

Results:

The evidence for telehealth to deliver stroke rehabilitation interventions is not strong and is predominantly based on small trials prone to Type 2 error. To move the field forward, we need to progress to trials of implementation that include measures of adoption and reach, as well as effectiveness. We also need to understand which outcome measures can be reliably measured remotely, and/or develop new ones. We present tools to assist with the deployment of telehealth for rehabilitation after stroke.

Conclusion:

The current, and likely long-term, pandemic means that we cannot wait for stronger evidence before implementing telehealth. As a research and clinical community, we owe it to people living with stroke internationally to investigate the best possible telehealth solutions for providing the highest quality rehabilitation.
J-shape relation of blood pressure reduction and outcome in acute intracerebral hemorrhage: A pooled analysis of INTERACT2 and ATACH-II individual participant data
Authors: Wang Xia , Di Tanna Gian Luca , Moullaali Tom J , Martin Renee’ H , Shipes Virginia B , Robinson Thompson G , Chalmers John , Suarez Jose I , Qureshi Adnan I , Palesch Yuko Y , Anderson Craig S
Published: January 2022

Objective:

The aim of this study was to better define the shape of association between the degree (“magnitude”) of early (< 1 h) reduction in systolic blood pressure (SBP) and outcomes in patients with acute intracerebral hemorrhage (ICH) through pooled analysis of the second Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) and second Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-II) datasets.

Methods:

Association of the continuous magnitude of SBP reduction described using cubic splines and an ordinal measure of the functional outcome on the modified Rankin scale (mRS) scores at 90 days were analyzed in generalized linear mixed models. Models were adjusted for achieved (mean) and variability (standard deviation, SD) of SBP between 1 and 24 h, various baseline covariates, and trial as a random effect.

Results:

Among 3796 patients (mean age 63.1 (SD = 13.0) years; female 37.4%), with a mean magnitude (< 1 h) of SBP reduction of 28.5 (22.8) mmHg, those with larger magnitude were more often non-Asian and female, had higher baseline SBP, received multiple blood pressure (BP) lowering agents, and achieved lower SBP levels in 1–24 h. Compared to those patients with no SBP reduction within 1 h (reference), the adjusted odds of unfavorable functional outcome, according to a shift in mRS scores, were lower for SBP reductions up to 60 mmHg with an inflection point between 32 and 46 mmHg, but significantly higher for SBP reductions > 70 mmHg. Similar J-shape associations were evident across various time epochs across 24 h and consistent according to baseline hematoma volume and SBP and history of hypertension.

Interpretation:

A moderate degree of rapid SBP lowering is associated with improved functional outcome after ICH, but large SBP reductions over 1 h (e.g. from > 200 to target < 140 mmHg) were associated with reduction, or reversal, of any such benefit.
Intracranial atherosclerosis: Review of imaging features and advances in diagnostics
Authors: Kim Song J , Schneider David J , Feldmann Edward , Liebeskind David S
Published: January 2022

Intracranial atherosclerotic disease is one of the leading causes of ischemic strokes and poses a moderate risk of recurrence. Diagnosis is currently limited to stenosis on luminal imaging, which likely underestimates the true prevalence of the disease. Detection of non-stenosing intracranial atherosclerosis is important in order to optimize secondary stroke prevention strategies. This review collates findings from the early seminal trials and the latest studies in advanced radiological techniques that characterize symptomatic intracranial atherosclerotic disease across various imaging modalities. While computed tomography angiography (CTA) and magnetic resonance angiography (MRA) comprise diagnostic mainstays in identifying stenotic changes secondary to atherosclerosis, emerging techniques such as high-resolution MRA, quantitative MRA, and computational fluid dynamics may reveal a myriad of other underlying pathophysiological mechanisms.
PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study
Authors: Obermannova Radka , Selingerova Iveta , Rehak Zdenek , Jedlicka Vaclav , Slavik Marek , Fabian Pavel , Novotny Ivo , Zemanova Milada , Studentova Hana , Grell Peter , Zdrazilova Dubska Lenka , Demlova Regina , Harustiak Tomas , Hejnova Renata , Kiss Igor , Vyzula Rostislav
Published: January 2022

Background:

Perioperative chemotherapy is a recommended treatment approach for localised oesophago-gastric junction adenocarcinoma, but not all patients respond to neoadjuvant chemotherapy. Early identification of non-responders and treatment adaptation in the preoperative period could improve outcomes. GastroPET is a national, multicentre phase II trial evaluating a 18FDG-PET/CT-guided preoperative treatment strategy with the R0 resection rate as a primary endpoint. Here, we report on the accuracy of the methodology, the feasibility of the study design and patient safety data after enrolment of the first 63 patients.

Methods:

Patients with locally advanced oesophago-gastric junction adenocarcinoma (Siewert I – III) stage Ib–IIIc underwent baseline 18FDG-PET/CT scanning and re-evaluation after 14 days of oxaliplatinum-5FU-(docetaxel) chemotherapy. Responders were defined by a ⩾ 35% decrease in tumour FDG standardised uptake value (SUV)average from baseline. Responders continued with the same chemotherapy for 2 to 3 months prior to surgery. PET-non-responders switched to preoperative chemoradiotherapy [weekly carboplatin and paclitaxel with concurrent radiotherapy (45 Gy in 25 fractions)]. Here, we aim to confirm the feasibility of FDG-PET-based response assessment in a multicenter setting and to compare local versus central reading. In addition, we report on the feasibility of the study conduct and patient safety data.

Results:

A total of 64 patients received baseline and sequential 14-day 18FDG-PET/CT scanning. And, 63 were allocated to the respective treatment arm according to PET-response [35 (56%) responders and 28 (44%) non-responders]. The concordance of local versus central reading of SUV changes was 100%. Until the date of this analysis, 47 patients (28 responders and 19 non-responders) completed surgery. Postoperative complications of grade ⩾ 3 (Common Terminology Criteria for Adverse Events, CTCAE Version 5.0) were reported in five responders (18%; 95% CI: 7.9–36%) and two non-responders (11%; 95% CI: 2.9–31%), with no statistical difference ( p = 0.685). One patient in each arm died after surgery, leading to a postoperative in-hospital mortality rate of 4.3% (2/47 patients; 95% CI: 1.2–14%).

Conclusion:

Local and central FDG-SUV quantification and PET-response assessment showed high concordance. This confirms the accuracy of a PET-response-guided treatment algorithm for locally advanced oesophago-gastric junction cancer in a multicenter setting. Preoperative treatment adaptation revealed feasible and safe for patients.
A new Butenolide Derivative from the Brown Alga Sargassum micracanthum
Authors: Kim Ji-Yul , Lee Jeong Min , Kim Hyun-Soo , Ki Dae-Won , Yim Mi-Jin , Ko Seok-Chun , Shin Jung Min , Lee Myeong Seok , Park Yun Gyeong , Lee Dae-Sung
Published: January 2022

A new butenolide derivative (1), along with three known compounds (2-4) were isolated from the MeOH extract of brown alga Sargassum micracanthum. The structures of 1 to 4 were determined by the analyses of 1D and 2D NMR and mass spectroscopic data. The known compounds (2-4) were identified as (5 E,10 Z)-6,10,14-trimethylpentadeca-5,10-dien-2,12-dione (2), (5 E,9 E)-6,10,14-trimethylpentadeca-5,9-dien-2,12-dione (3), and (-)-loliolide (4) by comparing with their published spectroscopic data. The antioxidant activities of compounds 1 to 4 were evaluated based on using 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activities. Compounds 1 to 4 were inactive at the concentration of 200 μM.
How Right-Wing Populists Engage with Cross-Cutting News on Online Message Boards: The Case of ForoCoches and Vox in Spain
Authors: Juarez Miro Clara , Toff Benjamin
Published: January 2022

Anecdotal evidence suggests a link between online message boards and the rise of far-right movements, which have achieved growing electoral success globally. Press accounts and scholarship have suggested these message boards help to radicalize like-minded users through exposure to shared media insulated from cross-cutting viewpoints (e.g., Hine et al. 2017 ; Palmer 2019). To better understand what role online message boards might play for supporters of right-wing populist movements, we focus on the Spanish political party Vox and its supporters’ use of the message board ForoCoches, a fan site for car enthusiasts, which became an important platform for the party. Using more than 120,000 messages collected from threads mentioning the party between 2013–2019, we examine the URLs shared to show how mainstream news media events shape the conversation online and how users not only were exposed but deeply engaged with cross-cutting news sources. We argue that the use of sites such as ForoCoches should be viewed in the context of a broader increasingly hybrid political and media landscape where activity online and offline cannot be understood separate from one another. Moreover, our findings suggest that the online political discussions that take place in Vox-related threads on ForoCoches resemble normatively positive deliberative spaces—albeit in this case in support of illiberal political positions. In other words, our findings complicate conventional notions about the benefits of political talk, especially online, as a democratically desirable end in and of itself.
Recent advancement in the treatment of boys and adolescents with hypogonadism
Authors: Rey Rodolfo A.
Published: January 2022

Clinical manifestations and the need for treatment varies according to age in males with hypogonadism. Early foetal-onset hypogonadism results in disorders of sex development (DSD) presenting with undervirilised genitalia whereas hypogonadism established later in foetal life presents with micropenis, cryptorchidism and/or micro-orchidism. After the period of neonatal activation of the gonadal axis has waned, the diagnosis of hypogonadism is challenging because androgen deficiency is not apparent until the age of puberty. Then, the differential diagnosis between constitutional delay of puberty and central hypogonadism may be difficult. During infancy and childhood, treatment is usually sought because of micropenis and/or cryptorchidism, whereas lack of pubertal development and relative short stature are the main complaints in teenagers. Testosterone therapy has been the standard, although off-label, in the vast majority of cases. However, more recently alternative therapies have been tested: aromatase inhibitors to induce the hypothalamic-pituitary-testicular axis in boys with constitutional delay of puberty and replacement with GnRH or gonadotrophins in those with central hypogonadism. Furthermore, follicle-stimulating hormone (FSH) priming prior to hCG or luteinizing hormone (LH) treatment seems effective to induce an enhanced testicular enlargement. Although the rationale for gonadotrophin or GnRH treatment is based on mimicking normal physiology, long-term results are still needed to assess their impact on adult fertility.
Tolerability and Safety of Switching from Rituximab to Ocrelizumab: Evaluating Factors Associated with Infusion Related Reactions
Authors: Alvarez Enrique , Nair Kavita V. , Sillau Stefan , Shelton Ian , Seale Rebecca , Selva Sean , Corboy John , Vollmer Timothy L
Published: January 2022

Background

Ocrelizumab and rituximab are frequently used treatments for multiple sclerosis (MS). Data on switching from rituximab to ocrelizumab is limited.

Objectives

To assess the frequency, severity, and factors of infusion related reactions (IRRs) in patients with MS who switch from rituximab to ocrelizumab, compared to those who stay on rituximab.

Methods

Prospective study on MS patients aged 18–65, on rituximab for at least 2 cycles, who either switched to ocrelizumab (switch group) or stayed on rituximab (comparator group) (n = 100 each). Participants were followed for IRRs, safety, and tolerability over 12 months.

Results

The proportion of IRRs in patients who continue on rituximab (14%) were similar to those who switched to ocrelizumab on Day 1 (14%; p = 1.000) and Week 24 (12%; p = 0.647) but higher than at Day 15 (4%; 0.005). The risk of IRRs for the switch group was associated with the presence of B cells (CD19 and/or CD20 counts ≥1%) increasing by 5.01 (1.49, 16.82) times on Day 1 (p = 0.007). Antidrug antibodies to ocrelizumab were not associated with IRRs. No other safety concerns were identified in switching to ocrelizumab.

Conclusion

IRRs are similar between both groups, which suggests that it is safe to switch from rituximab to ocrelizumab.
Usefulness of two-dimensional measurements for the evaluation of brain volume and disability in multiple sclerosis
Authors: Ajitomi Satori , Fujimori Juichi , Nakashima Ichiro
Published: January 2022

Background

Two-dimensional (2D) measures have been proposed as potential proxies for whole-brain volume in multiple sclerosis (MS).

Objective

To verify whether 2D measurements by routine MRI are useful in predicting brain volume or disability in MS.

Methods

In this cross-sectional analysis, eighty-five consecutive Japanese MS patients—relapsing-remitting MS (81%) and progressive MS (19%)—underwent 1.5 Tesla T1-weighted 3D MRI examinations to measure whole-brain and grey matter volume. 2D measurements, namely, third ventricle width, lateral ventricle width (LVW), brain width, bicaudate ratio, and corpus callosum index (CCI), were obtained from each scan. Correlations between 2D measurements and 3D measurements, the Expanded Disability Status Scale (EDSS), or processing speed were analysed.

Results

The third and lateral ventricle widths were well-correlated with the whole-brain volume ( p < 0.0001), grey matter volume ( p < 0.0001), and EDSS scores ( p = 0.0001, p = .0004, respectively).The least squares regression model revealed that 78% of the variation in whole-brain volume could be explained using five explanatory variables, namely, LVW, CCI, age, sex, and disease duration. By contrast, the partial correlation coefficient excluding the effect of age showed that the CCI was significantly correlated with the EDSS and processing speed ( p < 0.0001).

Conclusion

Ventricle width correlated well with brain volumes, while the CCI correlated well with age-independent (i.e. disease-induced) disability.
Central Nervous System Demyelination Related to Tumour Necrosis Factor Alpha Inhibitor
Authors: Chey Shin Yee , Kermode Allan G.
Published: January 2022

Background

An association between tumour necrosis factor alpha (TNF-α) inhibitors exposure and central nervous system (CNS) demyelinating disorders has been postulated but is poorly understood.

Objectives

Describe the clinical spectrum and progress of a cohort of patients who developed demyelinating disorder following exposure to TNF-α inhibitor.

Methods

Retrospective chart review of patients who presented to a single neurologist in Western Australia between May 2003 and July 2020.

Results

7 patients (6 females and 1 male) were identified. Mean age was 49.1 years. Mean follow-up time was 2.9 years. Mean interval between commencement of TNF-α inhibitor and onset of demyelinating event was 3 years. The spectrum of demyelinating events included transverse myelitis ( N = 3), acute brainstem syndrome ( N = 1) and optic neuritis ( N = 1). 2 patients had an atypical presentation but had MRI findings which unequivocally showed demyelinating changes. 2 patients had a monophasic event while the other 5 patients were diagnosed to have multiple sclerosis. All symptomatic patients with multiple sclerosis were started on disease modifying therapy and remained relapse free during follow-up.

Conclusion

Exposure to TNF-α inhibitor appears to increase the risk of demyelinating event. Whether TNFα inhibition directly results in CNS demyelination or trigger demyelination in susceptible individuals requires further research.
Abnormal sperm morphology is associated with sensitization to inhaled allergens
Authors: Adamczak Rafał , Ukleja-Sokołowska Natalia , Pasińska Magdalena , Zielińska Joanna , Leśny Mateusz , Dubiel Mariusz
Published: January 2022

Background: Allergy is associated with the loss of tolerance of environmental antigens, combined with a pathological immune response. There were no studies up to date that would show whether the quality of semen decreases in people with allergic diseases. Material and methods: The research included men who reported to the Gynecological Outpatient Clinic due to reproductive difficulties, defined as the lack of pregnancy after one year of regular intercourse. Semen quality was assessed according to the World Health Organization (WHO) standard. All patients underwent skin prick tests with the most important inhalation allergens (such as hazel, silver birch, mugwort, rye, dog, cat, Dermatophagoides farinae, Dermatophagoides pteronyssinus, alder, Alternaria alternata, Cladosporium herbarum, and grass mix). The data was statistically analyzed. Results: Results of 52 patients aged 25–52 years (34.62 ± 4.96) were analyzed. The mean BMI (Body mass index) was 28.25 (+ −3.77). It was found that 38 men (73%) had increased body weight, and 14 men (26.9%) were obese (BMI > = 30). 13 patients were smokers (25%), and 24 patients (46%) had skin tests positive for at least one inhaled allergen. Sperm tail defects were statistically more significant in patients allergic to birch, rye, cat, alder, and grass. In patients allergic to Alternaria alternata, head defects were statistically more significant ( p < .05). No association was found between allergy to house dust mites, mugwort, hazel, and dogs and the deterioration of semen. Conclusion: Allergy due to inhalation allergens had an influence on the quality of male semen. Further research is necessary to establish the immunological bases of this phenomenon.
Industry 4.0 Technologies for the Manufacturing and Distribution of COVID-19 Vaccines
Authors: Sarfraz Azza , Sarfraz Zouina , Sarfraz Muzna , Abdul Razzack Aminah , Bano Shehar , Singh Makkar Sarabjot , Thevuthasan Sindhu , Paul Trissa , Khawar Sana Muhammad , Azeem Nishwa , Felix Miguel , Cherrez-Ojeda Ivan
Published: January 2022

Background

The evolutionary stages of manufacturing have led us to conceptualize the use of Industry 4.0 for COVID-19 (coronavirus disease 2019), powered by Industry 4.0 technologies. Using applications of integrated process optimizations reliant on digitized data, we propose novel intelligent networks along the vaccine value chain. Vaccine 4.0 may enable maintenance processes, streamline logistics, and enable optimal production of COVID-19 vaccines.

Vaccine 4.0 Framework

The challenge in applying Vaccine 4.0 includes the requirement of large-scale technologies for digitally transforming manufacturing, producing, rolling-out, and distributing vaccines. With our framework, Vaccine 4.0 analytics will target process performance, process development, process stability, compliance, quality assessment, and optimized maintenance. The benefits of digitization during and post the COVID-19 pandemic include first, the continual assurance of process control, and second, the efficacy of big-data analytics in streamlining set parameter limits. Digitization including big data-analytics may potentially improve the quality of large-scale vaccine production, profitability, and manufacturing processes. The path to Vaccine 4.0 will enhance vaccine quality, improve efficacy, and compliance with data-regulated requirements.

Discussion

Fiscal and logistical barriers are prevalent across resource-limited countries worldwide. The Vaccine 4.0 framework accounts for expected barriers of manufacturing and equitably distributing COVID-19 vaccines. With amalgamating big data analytics and biometrics, we enable the identification of vulnerable populations who are at higher risk of disease transmission. Artificial intelligence powered sensors and robotics support thermostable vaccine distribution in limited capacity regions, globally. Biosensors isolate COVID-19 vaccinations with low or limited efficacy. Finally, Vaccine 4.0 blockchain systems address low- and middle-income countries with limited distribution capacities.

Conclusion

Vaccine 4.0 is a viable framework to optimize manufacturing of vaccines during and post the COVID-19 pandemic.
Is Porcine Small Intestinal Submucosal Extracellular Matrix (ECM) a Suitable Material for Right Ventricular Outflow Tract Reconstruction in Association With Pulmonary Valve Replacement?
Authors: Burke Christopher R. , Lewis Erik , Schreiter Nicholas A. , Bartlett Heather , Krieger Eric V. , Anagnostopoulos Petros V. , Verrier Edward D. , Hermsen Joshua L.
Published: January 2022

Pulmonary valve replacement (PVR) with right ventricular outflow tract (RVOT) reconstruction is a common congenital cardiac operation. Porcine submucosal intestinal-derived extracellular matrix (ECM) patches have been used for RVOT reconstruction. We present 2 adult patients with Tetralogy of Fallot who underwent PVR with RVOT reconstruction utilizing ECM. Both cases required reoperation due to patch dehiscence causing a large paravalvular leak. One patient also had a pseudoaneurysm associated with ECM dehiscence. There may be a propensity for ECM dehiscence in this application and, based on these cases, we recommend avoidance of ECM in RVOT reconstruction with PVR. PVR patients repaired with ECM should be monitored for this complication.
An Alternative Approach for a High Partially Anomalous Pulmonary Venous Connection to the Superior Vena Cava: “A Drawbridge Technique”
Authors: Sekelyk Roman , Kozhokar Dmytro , Safonov Vsevolod , Yemets Illya
Published: January 2022

We present an alternative technique for the repair of a high partially anomalous pulmonary venous connection to the superior vena cava.
Factors in Saudi FDI Inflow
Authors: Samargandi Nahla , A. Alghfais Mohammed , AlHuthail Hadeel M.
Published: January 2022

This study explores the driving factors for attracting Foreign Direct Investment (FDI) inflow in the Saudi Arabian economy in two stages. First, it applies a general to specific approach to form a model reflecting theoretical and anecdotal evidence of the Saudi Arabian economy. Second, we analyse time series data over the years 1984 to 2018. applying Autoregressive Distributed Lags (ARDL) approach, incorporating several structural breaks. This study explores Saudi membership of the World Trade Organization (WTO) and institutional quality, identifying them as promising factors in fostering FDI inflows in the economy. Our empirical investigation demonstrates that the Saudi economy experienced a higher inflow of FDI during the global financial crisis (GFC) due to economic stability. Trade openness is found to be conducive to promote FDI inflow. This study provides several policy implications.
Attributes Influencing Overall Tourist Satisfaction and Its Consequences for Muslim-Majority Destination
Authors: Fajriyati Ilisa , Afiff Adi Zakaria , Gayatri Gita , Hati Sri Rahayu Hijrah
Published: January 2022

In the context of Muslim-friendly tourism, marketers have to pay attention to the needs of their main target, Muslim tourists. This study aimed to examine the influence of destination attributes, including both generic and Islamic attributes, on overall tourist satisfaction to get a more comprehensive view. Likewise, this study investigated the effect of overall tourist satisfaction on its consequences. The moderation effect of Islamic religiosity on the relationship between Islamic attributes and overall tourist satisfaction was also considered. An online survey was conducted, with a sample of 231 Muslims who traveled to Muslim-majority cities, and the data were analyzed using Structural Equation Modeling. The results showed that both generic and Islamic attributes positively influence overall tourist satisfaction, while its consequences affected their behavioral, attitudinal loyalty, and churn intention. Overall tourist satisfaction was not found to affect complaint intention. Likewise, the moderation effect of Islamic religiosity was insignificant.
“Emotional Distancing”: Change and Strain in U.S. Young Adult College Students’ Relationships During COVID-19
Authors: Dotson Miranda P. , Castro Elena Maker , Magid Nina T. , Hoyt Lindsay T. , Suleiman Ahna Ballanoff , Cohen Alison K.
Published: January 2022

We analyzed qualitative data from 707 USA college students aged 18–22 in late April 2020 regarding if and how their relationships had changed at the start of the COVID-19 pandemic. Most (69%) participants experienced relationship changes, most of whom (77%) described negative changes: less overall contact, feeling disconnected, and increased tension, some of which was due to conflict over pandemic-related public health precautions. Physical distancing from social contacts also created emotional distancing: it was harder to maintain affective connections via online platforms and within the isolating context of shelter-in-place. Due to emerging adulthood being a sensitive window for social development, the COVID-19 pandemic-induced emotional distancing could have long-term ramifications for this cohort’s relationships over the course of their lives.
Identity negotiation of Chinese international students in Canada: A study on cosmopolitan post-graduation settlement
Authors: Zhao Sebastian , Ebanda de B’beri Boulou
Published: January 2022

This study focuses on analyzing the acculturation of Chinese international students in Canada, emphasizing students' post-graduation settlement in China, Canada, or in other countries. Chinese international students commonly experience a multilayered acculturative adjustment when they are challenged by a new culture. In this process, they develop an identity negotiation that impacts their settlement into a new country. This study mobilizes four notions of acculturation (e.g., assimilation, integration, marginalization, and separation), to evaluate Chinese international students’ identity negotiation after university. This research uses 17 semi-structured interviews to understand how participants' identities were negotiated through their acculturative adjustment. First, the findings highlight the importance of career factors and family values in participants' settlement decisions. Second, the balance between Chinese identity and Canadian identity has some impact on student’s migration plans.
Surgical Results of Chronic Distal Biceps Ruptures: A Systematic Review
Authors: Bajwa Arpun , Simon Maciej J.K. , Leith Jordan M. , Moola Farhad O. , Goetz Thomas J. , Lodhia Parth
Published: January 2022

Background:

Distal biceps tendon tears can cause weakness and fatigue with activities requiring elbow flexion and supination. Surgical management of chronic tears (>21 days) is not well described in the literature.

Purpose:

To determine the clinical outcomes of chronic distal biceps repairs and reconstructions.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

We performed a search of Medline (PubMed and Ovid), EMBASE, CINAHL physical therapy, Cochrane Database of Systematic Reviews and Central Register of Controlled Trials, and PubMed Central from inception until September 29, 2020, to identify articles on chronic distal biceps ruptures. The inclusion criteria were studies with at least 1 outcome measure and 10 patients with chronic distal biceps ruptures treated surgically. The quality of the included studies was assessed with the methodological index for nonrandomized studies (MINORS) score. Functional outcomes and complications were reviewed.

Results:

A total of 12 studies were included after systematic database screenings. The MINORS scores ranged from 5 to 19. There were a total of 1704 distal biceps ruptures, of which 1270 were acute and 434 were chronic. Average follow-up time was 12 months to 5.1 years. Single-incision (n = 3), 2-incision (n = 2), or both (n = 6) surgical techniques were used in these studies. Four studies described the use of autografts, and 4 articles used allografts in the chronic repair. Range of motion, function, and strength outcomes were similar when compared with the contralateral arm. Pain was reduced to minimal levels. Main postoperative complications were of paresthesia (specifically to the lateral antebrachial cutaneous nerve), which were temporary in 69.1% of cases.

Conclusion:

The results of this review indicate that surgical management of chronic distal biceps ruptures demonstrates improvement in outcomes including pain reduction and functional ability. Although there may be a slightly higher immediate complication rate, the functional outcomes remain comparable with those seen in the patient population with acute distal biceps.
Trajectories of imitation skills in preschoolers with autism spectrum disorders
Authors: Pittet Irène , Kojovic Nada , Franchini Martina , Schaer Marie
Published: January 2022

Background

Imitation skills play a crucial role in social cognitive development from early childhood. Many studies have shown a deficit in imitation skills in children with autism spectrum disorders (ASD). Little is known about the development of imitation behaviors in children with ASD. This study aims to measure the trajectories of early imitation skills in preschoolers with ASD and how these skills impact other areas of early development.

Methods

For this purpose, we assessed imitation, language, and cognition skills in 177 children with ASD and 43 typically developing children (TD) aged 2 to 5 years old, 126 of which were followed longitudinally, yielding a total of 396 time points.

Results

Our results confirmed the presence of an early imitation deficit in toddlers with ASD compared to TD children. The study of the trajectories showed that these difficulties were marked at the age of 2 years and gradually decreased until the age of 5 years old. Imitation skills were strongly linked with cognitive and language skills and level of symptoms in our ASD group at baseline. Moreover, the imitation skills at baseline were predictive of the language gains a year later in our ASD group. Using a data-driven clustering method, we delineated different developmental trajectories of imitation skills within the ASD group.

Conclusions

The clinical implications of the findings are discussed, particularly the impact of an early imitation deficit on other areas of competence of the young child.
Deep learning-based pancreas volume assessment in individuals with type 1 diabetes
Authors: Roger Raphael , Hilmes Melissa A. , Williams Jonathan M. , Moore Daniel J. , Powers Alvin C. , Craddock R. Cameron , Virostko John
Published: January 2022

Pancreas volume is reduced in individuals with diabetes and in autoantibody positive individuals at high risk for developing type 1 diabetes (T1D). Studies investigating pancreas volume are underway to assess pancreas volume in large clinical databases and studies, but manual pancreas annotation is time-consuming and subjective, preventing extension to large studies and databases. This study develops deep learning for automated pancreas volume measurement in individuals with diabetes. A convolutional neural network was trained using manual pancreas annotation on 160 abdominal magnetic resonance imaging (MRI) scans from individuals with T1D, controls, or a combination thereof. Models trained using each cohort were then tested on scans of 25 individuals with T1D. Deep learning and manual segmentations of the pancreas displayed high overlap (Dice coefficient = 0.81) and excellent correlation of pancreas volume measurements (R2 = 0.94). Correlation was highest when training data included individuals both with and without T1D. The pancreas of individuals with T1D can be automatically segmented to measure pancreas volume. This algorithm can be applied to large imaging datasets to quantify the spectrum of human pancreas volume.
The effect of longstanding silicone oil on retina choroid and optic nerve in eyes with retinal detachment: an optical coherence tomography study
Authors: Karaca Umut , Kucukevcilioglu Murat , Durukan Ali Hakan , Akincioglu Dorukcan
Published: January 2022

Background

The study aims to evaluate peripapillary retinal nerve fiber layer thickness (RNFL-T), central macular thickness (MT), choroidal thickness (CT), and thickness of each retinal layer after automatic segmentation in patients who underwent retinal detachment (RD) repair with longstanding silicone oil tamponade.

Methods

We enrolled 33 patients who underwent complicated primary rhegmatogenous RD surgery and followed up with a long-term silicone tamponade were included in this retrospective comparative (case–control) study. RNFL-T, CT, and thickness of each retinal layer after automatic segmentation analysis were measured after the longstanding silicone removal surgery.

Results

The mean silicone oil removal time was 15.1 ± 15.2 (7–70) months. The overall average thickness of the RNFL was 90.7 ± 13.6 μm in the operated eyes and 118.3 ± 35.6 μm in the sound eyes, with a statistically significant difference. The overall average central MT was 186.3 ± 57.7 μm and was significantly lower in the operated eyes than in the sound eyes. Inner retinal layers of the study group showed a significant thinning in the nerve fiber layer, ganglion cell layer, inner plexiform layer, and inner nuclear layer as compared to that of the sound eyes. The subfoveal CT was 213.7 ± 86.6 μm in the study eyes and 217.7 ± 115.5 μm in the control eyes. There was no significant difference between the study eyes and controls.

Conclusion

The effects of silicone oil on the retina remain uncertain; however, morphological results in our study have shown direct or indirect silicone oil–induced toxicity, especially in the inner retinal layers.
Socioeconomic differences in psychiatric treatment before and after self-harm: an observational study of 4,280 adolescents and young adults
Authors: Pitkänen Joonas , Remes Hanna , Aaltonen Mikko , Martikainen Pekka
Published: January 2022

Background

Individuals in higher socioeconomic positions tend to utilise more mental health care, especially specialist services, than those in lower positions. Whether these disparities in treatment exist among adolescents and young adults who self-harm is currently unknown.

Methods

The study is based on Finnish administrative register data on all individuals born 1986–1994. Adolescents and young adults with an episode of self-harm treated in specialised healthcare at ages 16–21 in 2002–2015 (n=4280, 64% female) were identified and followed 2 years before and after the episode. Probabilities of specialised psychiatric inpatient admissions and outpatient visits and purchases of psychotropic medication at different time points relative to self-harm were estimated using generalised estimation equations, multinomial models and cumulative averages. Socioeconomic differences were assessed based on parental education, controlling for income.

Results

An educational gradient in specialised treatment and prescription medication was observed, with the highest probabilities of treatment among the adolescents and young adults with the highest educated parents and lowest probabilities among those whose parents had basic education. These differences emerged mostly after self-harm. The probability to not receive any treatment, either in specialised healthcare or psychotropic medication, was highest among youth whose parents had a basic level of education (before self-harm 0.39, 95% CI 0.34–0.43, and after 0.29, 95% CI 0.25–0.33 after) and lowest among youth with higher tertiary educated parents (before self-harm: 0.22, 95% CI 0.18–0.26, and after 0.18, 95% CI 0.14–0.22). The largest differences were observed in inpatient care.

Conclusions

The results suggest that specialised psychiatric care and psychotropic medication use are common among youth who self-harm, but a considerable proportion have no prior or subsequent specialised treatment. The children of parents with lower levels of education are likely to benefit from additional support in initiating and adhering to treatment after an episode of self-harm. Further research on the mechanisms underlying the educational gradient in psychiatric treatment is needed.