bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Associations of Changes in Noncombustible Nicotine or Tobacco Product and Combustible Cigarette Use Habits With Subsequent Short-Term Cardiovascular Disease Risk Among South Korean Men: A Nationwide Cohort Study
Authors: Choi Seulggie , Lee Kiheon , Park Sang Min
Published: October 2021

Background:

The associations of changes in noncombustible nicotine or tobacco product (NNTP) and combustible cigarette (CC) use habits with subsequent cardiovascular disease (CVD) risk are still unclear.

Methods:

The study population consisted of 5 159 538 adult men who underwent health screening examinations during both the first (2014–2015) and second (2018) health screening periods from the Korean National Health Insurance Service database. All participants were divided into continual CC-only smokers, CC and NNTP users, recent (<5 years) CC quitters without NNTP use, recent CC quitters with NNTP use, long-term (≥5 years) CC quitters without NNTP use, long-term CC quitters with NNTP use, and never smokers. Propensity score matching analysis was conducted to further compare CVD risk among CC quitters according to NNTP use. Starting from the second health screening date, participants were followed up until the date of CVD event, death, or December 31, 2019, whichever came earliest. Multivariable Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% CIs for CVD risk according to changes in NNTP and CC smoking habits.

Results:

Compared with continual CC-only smokers, CC and NNTP users (aHR, 0.83 [95% CI, 0.79–0.88]) and initial CC smokers who quit CCs and switched to NNTP use only (recent CC quitters with NNTP use, aHR, 0.81 [95% CI, 0.78–0.84]) had lower risk for CVD. After propensity score matching, recent CC quitters with NNTP use (aHR, 1.31 [95% CI, 1.01–1.70]) had higher risk for CVD than recent CC quitters without NNTP use. Similarly, compared with long-term CC quitters without NNTP use, long-term CC quitters with NNTP use (aHR, 1.70 [95% CI, 1.07–2.72]) had higher CVD risk.

Conclusions:

Switching to NNTP use among initial CC smokers was associated with lower CVD risk than continued CC smoking. On CC cessation, NNTP use was associated with higher CVD risk than CC quitting without NNTPs. Compared with CC smokers who quit without NNTP use, CC quitters who use NNTPs may be at higher future CVD risk.
Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study
Authors: Vasan Ramachandran S. , Song Rebecca J. , Xanthakis Vanessa , Mitchell Gary F.
Published: October 2021

Higher central pulse pressure is associated with higher carotid-femoral pulse wave velocity (CFPWV) and an increased risk of cardiovascular disease (CVD). A smaller aortic root diameter (AoR) is associated with higher central pulse pressure. We hypothesized that the combination of a smaller AoR and higher CFPWV is associated with increased CVD risk (relative to a larger AoR and lower CFPWV). We tested this hypothesis in the community-based Framingham Study (N=1970, mean age 60 years, 57% women). We created sex-specific longitudinal echocardiographic AoR trajectories over 2 decades, categorizing participants into smaller versus larger AoR groups. We cross-classified participants based on their AoR trajectory and CFPWV (dichotomized at the sex-specific median). We used Cox regression to relate the cross-classified groups to CVD incidence on follow-up (median 17 years): lower CFPWV, larger AoR (referent group; 6.4/1000 person-years); lower CFPWV, smaller AoR (6.9/1000 person-years); higher CFPWV, larger AoR (23.1/1000 person-years); and higher CFPWV, smaller AoR (21.9/1000 person-years). In sex-pooled analyses, groups with higher CFPWV were associated with a multivariable-adjusted 1.8-fold risk of CVD (
P
<0.01) regardless of AoR size. We observed effect modification by sex (
P
for sex×AoR-CFPWV group interaction 0.04). In men, the group with smaller AoR and higher CFPWV was associated with a 2.5- to 2.8-fold risk of CVD (
P
<0.001). In women, the group with larger AoR and higher CFPWV experienced a statistically nonsignificant 70% to 80% higher CVD risk. Our observations indicate that the prognostic significance of a smaller versus larger AoR varies in men versus women. Additional studies are warranted to confirm our findings.
Pediatric Ambulatory Blood Pressure Classification: The Case for a Change
Authors: Mitsnefes Mark , Flynn Joseph T. , Brady Tammy , Baker-Smith Carissa , Daniels Stephen R. , Hayman Laura L. , Tran Andrew , Zachariah Justin P. , Urbina Elaine M.
Published: October 2021

In 1997, Soergel et al

1

published the first set of normative values for ambulatory blood pressure monitoring (ABPM) in children. Since then, the clinical utility of ABPM has increased dramatically, and now, ABPM is accepted as the standard method to confirm the diagnosis of hypertension in children. Despite significant progress in the field of pediatric ABPM, many important questions remain unanswered. One of the most controversial issues is how to define ambulatory hypertension in children. The purpose of this review is to discuss the limitations of the current pediatric ABPM classification scheme and to provide the justification and rationale for a new classification.
Timing and Dose of Upper Limb Motor Intervention After Stroke: A Systematic Review
Authors: Hayward Kathryn S. , Kramer Sharon F. , Dalton Emily J. , Hughes Gemma R. , Brodtmann Amy , Churilov Leonid , Cloud Geoffrey , Corbett Dale , Jolliffe Laura , Kaffenberger Tina , Rethnam Venesha , Thijs Vincent , Ward Nick , Lannin Natasha , Bernhardt Julie
Published: October 2021

This systematic review aimed to investigate timing, dose, and efficacy of upper limb intervention during the first 6 months poststroke. Three online databases were searched up to July 2020. Titles/abstracts/full-text were reviewed independently by 2 authors. Randomized and nonrandomized studies that enrolled people within the first 6 months poststroke, aimed to improve upper limb recovery, and completed preintervention and postintervention assessments were included. Risk of bias was assessed using Cochrane reporting tools. Studies were examined by timing (recovery epoch), dose, and intervention type. Two hundred and sixty-one studies were included, representing 228 (n=9704 participants) unique data sets. The number of studies completed increased from one (n=37 participants) between 1980 and 1984 to 91 (n=4417 participants) between 2015 and 2019. Timing of intervention start has not changed (median 38 days, interquartile range [IQR], 22–66) and study sample size remains small (median n=30, IQR 20–48). Most studies were rated high risk of bias (62%). Study participants were enrolled at different recovery epochs: 1 hyperacute (<24 hours), 13 acute (1–7 days), 176 early subacute (8–90 days), 34 late subacute (91–180 days), and 4 were unable to be classified to an epoch. For both the intervention and control groups, the median dose was 45 (IQR, 600–1430) min/session, 1 (IQR, 1–1) session/d, 5 (IQR, 5–5) d/wk for 4 (IQR, 3–5) weeks. The most common interventions tested were electromechanical (n=55 studies), electrical stimulation (n=38 studies), and constraint-induced movement (n=28 studies) therapies. Despite a large and growing body of research, intervention dose and sample size of included studies were often too small to detect clinically important effects. Furthermore, interventions remain focused on subacute stroke recovery with little change in recent decades. A united research agenda that establishes a clear biological understanding of timing, dose, and intervention type is needed to progress stroke recovery research. Prospective Register of Systematic Reviews ID: CRD42018019367/CRD42018111629.
Two new species of Seira Lubbock, 1870 (Collembola: Entomobryidae: Seirinae) from Brazilian Caatinga
Authors: NUNES RUDY CAMILO , CIPOLA NIKOLAS GIOIA , BELLINI BRUNO CAVALCANTE
Published: October 2021

Two new species of Seira Lubbock are described and illustrated, Seira picoensis sp. nov., from Picos municipality, and Seira trisetosa sp. nov., from Serra das Confusões National Park, Caracol municipality, both in Piauí State, Brazil. Seira picoensis sp. nov. resembles other species of the genus with four macrochaetae in abdomen I, but differs by other aspects of the dorsal chaetotaxy and unguiculus shape. Seira trisetosa sp. nov. resembles S. ferruginea Rapoport & Izarra, S. frater (Bonet), S. oceanica Yosii and S. tinguira Cipola & Bellini by the abdomen I with 3 macrochaetae, but also differs by other features such as the antenna IV morphology, overall dorsal chaetotaxy and unguiculus shape. We also provide a brief discussion on the mucro shape in Seirinae.
New genus and four new species of anthuroid isopods (Crustacea: Peracarida) from southern Mexican Pacific
Authors: JARQUÍN-MARTÍNEZ UBALDO , GARCÍA-MADRIGAL MARÍA DEL SOCORRO
Published: October 2021

Anthuroid Isopoda are a poorly studied crustacean taxon in the Tropical Eastern Pacific, barely 21 species recorded, while to the southern Mexican Pacific, only eight species have been recorded. This study aims to increase knowledge of the species that inhabit the region. One hundred and one specimens from seven localities of the coast of Guerrero and Oaxaca were examined. Four new species were identified, belonging to three genera and two families: Negoescuanthura bastidai n. gen., n. sp., Colanthura gabinae n. sp., Paranthura amorensis n. sp. and P. tientai n. sp. A new genus is established, Negoescuanthura, very close to the genus Accalathura; the former is characterized by sucker-like cuticular structures on the antennal peduncle, while the latter lack these structures.
The CORDEX-CORE EXP-I Initiative: Description and Highlight Results from the Initial Analysis
Authors: Giorgi Filippo , Coppola Erika , Jacob Daniela , Teichmann Claas , Abba Omar Sabina , Ashfaq Moetasim , Ban Nikolina , Bülow Katharina , Bukovsky Melissa , Buntemeyer Lars , Cavazos Tereza , Ciarlo` James , da Rocha Rosmeri Porfirio , Das Sushant , di Sante Fabio , Evans Jason P. , Gao Xuejie , Giuliani Graziano , Glazer Russell H. , Hoffmann Peter , Im Eun-Soon , Langendijk Gaby , Lierhammer Ludwig , Llopart Marta , Mueller Sebastial , Luna-Nino Rosa , Nogherotto Rita , Pichelli Emanuela , Raffaele Francesca , Reboita Michelle , Rechid Diana , Remedio Armelle , Remke Thomas , Sawadogo Windmanagda , Sieck Kevin , Torres-Alavez José Abraham , Weber Torsten
Published: October 2021

We describe the first effort within the Coordinated Regional Climate Downscaling Experiment–Coordinated Output for Regional Evaluation, or CORDEX-CORE EXP-I. It consists of a set of twenty-first-century projections with two regional climate models (RCMs) downscaling three global climate model (GCM) simulations from the CMIP5 program, for two greenhouse gas concentration pathways (RCP8.5 and RCP2.6), over nine CORDEX domains at ∼25-km grid spacing. Illustrative examples from the initial analysis of this ensemble are presented, covering a wide range of topics, such as added value of RCM nesting, extreme indices, tropical and extratropical storms, monsoons, ENSO, severe storm environments, emergence of change signals, and energy production. They show that the CORDEX-CORE EXP-I ensemble can provide downscaled information of unprecedented comprehensiveness to increase understanding of processes relevant for regional climate change and impacts, and to assess the added value of RCMs. The CORDEX-CORE EXP-I dataset, which will be incrementally augmented with new simulations, is intended to be a public resource available to the scientific and end-user communities for application to process studies, impacts on different socioeconomic sectors, and climate service activities. The future of the CORDEX-CORE initiative is also discussed.
Blasts from the Past: Reimagining Historical Storms with Model Simulations to Modernize Dam Safety and Flood Risk Assessment
Authors: Mahoney Kelly , McColl Chesley , Hultstrand Douglas M. , Kappel William D. , McCormick Bill , Compo Gilbert P.
Published: October 2021

Accurate estimation of the potential “upper limit” for extreme precipitation is critical for dam safety and water resources management, as dam failures pose significant risks to life and property. Methods used to estimate the theoretical upper limit of precipitation are often outdated and in need of updating. The rarity of extreme events means that old storms with limited observational data are often used to define the upper bound of precipitation. Observations of many important old storms are limited in spatial and temporal coverage, and sometimes of dubious quality. This reduces confidence in flood hazard assessments used in dam safety evaluations and leads to unknown or uncertain societal risk. This paper describes a method for generating and applying ensembles of high-resolution, state-of-the-art numerical model simulations of historical past extreme precipitation events to meet contemporary stakeholder needs. The method was designed as part of a research-to-application-focused partnership project to update state dam safety rules in Colorado and New Mexico. The results demonstrated multiple stakeholder and user benefits that were applied directly into storm analyses utilized for extreme rainfall estimation, and diagnostics were developed and ultimately used to update Colorado state dam safety rules, officially passed in January 2020. We discuss how what started as a prototype research foray to meet a specific user need may ultimately inform wider adoption of numerical simulations for water resources risk assessment, and how the historical event downscaling method performed offers near-term, implementable improvements to current dam safety flood risk estimates that can better serve society today.
Historical changes in the Davis Strait Baffin Bay surface winds and waves, 1979-2016
Authors: Wang Xiaolan L. , Casas-Prat Mercè , Feng Yang , Crosby Alex , Swail Val R.
Published: October 2021

This study presents and analyzes Environment Canada’s Davis Strait Baffin Bay (EC-DSBB) Wind and Wave Reanalysis for the period 1979-2016, to characterize the historical changes in the surface wind speed and ocean surface waves. The trend analysis is carried out only for the months of May-December, when there is a significant ice-free sea area. The results show that 10-meter wind speed (Ws) has increased significantly in most area of the domain in September-December, with some significant decreases over the open water area in June and July. The Ws increases are most extensive in September, with significant increases in both the mean and extremes. It is also shown that the mean wind direction (Wd) has a distinctive seasonal variation, being mainly north- and northwest-ward in June-August, and predominantly south- and southeast-ward in May and September-December. The most notable changes in Wd are seen in June. The results also show that significant wave height (Hs) and wave power (Wp) have significantly increased in September-December and decreased in June. For example, the September regional mean Hs has increased at a rate of 0.4%/year. In September-December, the local Ws increases seem to be the main driver for the Hs and Wp increases, but such southeast-ward direction is favored by increasing fetch as sea ice retreats. In September and December, the positive trend in both Ws and Hs has intensified in the 2001-2016. In June, however, the mean Wd and the changes therein also play an important role in the Hs changes, which are more affected by remotely generated waves.
The Rise of Presidential Eschatology: Conspiracy Theories, Religion, and the January 6th Insurrection
Authors: Bond Bayleigh Elaine , Neville-Shepard Ryan
Published: October 2021

This essay argues that the insurrection at the United States Capitol on January 6, 2021, can be partially explained by the rise of what we call presidential eschatology, a religious master narrative that represents a historic shift from presidents appealing to God to presidents becoming a messiah figure. More specifically, we trace President Trump’s embrace of this kind of religious discourse—which we contend is a form of weaponized political communication aiming to undermine democracy—to his acceptance of a millennialist narrative fashioned by QAnon conspiracy theorists. Through a close reading of primary sources from the movement, the study illustrates how these eschatological themes surfaced in QAnon's discourse and were exploited by Trump and his allies as they sought to overturn the 2020 presidential election.
Generative Scholarship Through Prospective Theorizing: Appreciating the Roots and Legacy of Organization Development and Change to Build a Bright Future
Authors: Pavez Ignacio , Godwin Lindsey , Spreitzer Gretchen
Published: October 2021

How can Organization Development and Change (ODC) research and practice help create healthy, vibrant, and humane organizations and communities? This has been a guiding question for the field of ODC throughout a year-long series of activities (e.g., design meetings, webinars, and informal dialogues) linked to the 50th anniversary celebration of the ODC Division of the Academy of Management. In this paper, we provide our own reflections on this unfolding dialogue by proposing that ODC's future can be bolstered by leveraging its legacy and historical strengths as the basis to engage in a systematic approach for doing prospective theory-building ( Cooperrider, 2021 ), particularly on grand challenges like the transition to the Anthropocene. That is, we advocate for building theory that focuses on intentionally co-creating a better future rather than take it for granted or merely describing (and projecting) the past. In doing so, we believe ODC scholars and practitioners will be better equipped to create what we refer to as generative scholarship and write the next chapter for ODC as a revitalizing force in the world.
Asthma Among Adults and Children by Urban–Rural Classification Scheme, United States, 2016-2018
Authors: Guo Zijing , Qin Xiaoting , Pate Cynthia A. , Zahran Hatice S. , Malilay Josephine
Published: October 2021

Objectives

Although data on the prevalence of current asthma among adults and children are available at national, regional, and state levels, such data are limited at the substate level (eg, urban–rural classification and county). We examined the prevalence of current asthma in adults and children across 6 levels of urban–rural classification in each state.

Methods

We estimated current asthma prevalence among adults for urban–rural categories in the 50 states and the District of Columbia and among children for urban–rural categories in 27 states by analyzing 2016-2018 Behavioral Risk Factor Surveillance System survey data. We used the 2013 National Center for Health Statistics 6-level urban–rural classification scheme to define urban–rural status of counties.

Results

During 2016-2018, the current asthma prevalence among US adults in medium metropolitan (9.5%), small metropolitan (9.5%), micropolitan (10.0%), and noncore (9.6%) areas was higher than the asthma prevalence in large central metropolitan (8.6%) and large fringe metropolitan (8.7%) areas. Current asthma prevalence in adults differed significantly among the 6 levels of urban–rural categories in 19 states. In addition, the prevalence of current asthma in adults was significantly higher in the Northeast (9.9%) than in the South (8.7%) and the West (8.8%). The current asthma prevalence in children differed significantly by urban–rural categories in 7 of 27 states. For these 7 states, the prevalence of asthma in children was higher in large central metropolitan areas than in micropolitan or noncore areas, except for Oregon, in which the prevalence in the large central metropolitan area was the lowest.

Conclusions

Knowledge about county-level current asthma prevalence in adults and children may aid state and local policy makers and public health officers in establishing effective asthma control programs and targeted resource allocation.
Optimal design on Watt-chain double-toggle mold clamping mechanism for injection molding machine
Authors: Hsieh Long-Chang , Chen Tzu-Hsia , Lai Po-Cheng , Zheng Sheng-wen
Published: October 2021

Introduction

The mode clamping mechanism is the most important part of forming section for the plastic injection molding machine. If this mechanism has double-toggle effects at the close position, it will get a larger clamping force and have higher safety. This study focuses on the optimal design of the Watt-chain mechanism with double-toggle effects at the close position.

Methods

The Watt-chain double-toggle mechanism is chosen to be the mold clamping mechanism by referring to the existing patents. Then, the kinematic characteristics of the Watt-chain double-toggle mechanism are analyzed by the vector loop method. Finally, based on the kinematic requirements and the proposed optimal design process according to the objective function, the optimal design on Watt-chain double-toggle mechanism is accomplished in this study.

Results

This study proposes an optimal design process on Watt-chain double-toggle mold clamping mechanism. By following the optimal design process, the optimal Watt-chain double-toggle mold clamping mechanism has a maximum acceleration 3418 mm/s2 ( amax = 3418 mm/s2) and a force ratio is 2.24 ( Fin/ Fout = 2.24).

Discussion

According to the studies on the optimal designs of mechanisms, the optimal Watt-chain double-toggle mechanism, which is better than the multiple-joint double-toggle mold clamping mechanism in the existing patent by reducing 19.5% of acceleration and 30% of a driving force, is proposed. The results of this study could be the design reference in engineering when designing mold clamping mechanisms for plastic injection molding machines.
The ‘Boomer remover’: Intergenerational discounting, the coronavirus and climate change
Authors: Elliott Rebecca
Published: October 2021

Based on an analysis of Twitter data, this article examines the appearance of generational ideas in the ways that people have defined the experience and significance of the coronavirus and climate change, as well as related them to each other. I characterize the narrative frame as one of intergenerational discounting: a description of breakdown in reciprocal obligations of care, giving rise to accusations of hypocrisy, expressions of resentment and rage, and the description of the virus as the ‘Boomer remover’. This frame normatively licenses withdrawal from intergenerational action in pursuit of collective objectives, as well as erases the disproportionate negative effects of crisis conditions on those facing intersecting intragenerational disadvantages. In addition to analysing a strategic but thus far unexplored data source for social problems theory and the sociology of generations – tweets – the article contributes to this scholarship by demonstrating how generational ideas work to morally link different conditions to each other.
Feeling Time, Fashioning Age: Pre-teen Girls Negotiating Life Course and the Ageing Process Through Dress
Authors: Blanchard-Emmerson Julie
Published: October 2021

Based on research with eight to eleven-year-old girls from the South of England, I discuss the relationship between their clothes, identity, temporality, life course and the ageing process. Despite media accounts suggesting the passivity of pre-teen girls’ fashionable dress consumption, unknowingly becoming prematurely sexualised through hyper-feminine dress, by using the interlinking of materiality and life course as a lens to explore girls’ understanding of fashion, my research showed that girls engage with popular debates about age-appropriate dress. I demonstrate that the participants were aware of sexual generationing and explored older, hyper-feminine, sexualised identities at specific, socially-approved times. Most significantly, this materiality/life course approach offers new insights into how girls explore the past, present and the future, feeling the passing of time and the ageing process on their bodies, through the materiality of their clothes. It is through dress that girls come to understand age, temporality and where they are on their life course.
Environment or Economy? Food Concerns and Sustainable Food Transitions in the UK
Authors: Foden Mike , Head Emma , Katz-Gerro Tally , Martens Lydia
Published: October 2021

Recent years have seen the emergence of calls for the transformation of food systems to make these more responsive to environmental, access and health challenges. Addressing how the UK food system may best meet these challenges, this article develops understanding of the multiple food concerns that guide practices of food provisioning at the intersection between markets and domestic life. Combining insights from a survey questionnaire and qualitative fieldwork from research that was part of the EU Horizon2020 SafeConsume project, we depict how practices of food provisioning are guided by concerns driven by economic and environmental logics. The findings suggest economy is prevalent while environmental food ethics are marginalised. The conclusion discusses how the adopted practice theoretical approach, which combines an analysis of the socio-material arrangements of provisioning and the relationship between food concerns and higher order considerations, advances understanding of the nature of food concerns and the challenges of sustainable food transitioning.
Sustainable materials with high insulation capacity obtained from wastes from hemp industry processed by wet-laid
Authors: Gutierrez-Moscardo O , Canet M , Gomez-Caturla J , Lascano D , Fages E , Sanchez-Nacher L
Published: October 2021

This article reports on the revalorization of hemp waste from the textile industry, focusing on the development of new sustainable materials with high insulating properties. Wet-laid technology was used to manufacture nonwovens with different binding fibers, polylactic acid, and viscose fibers. The characterization of the acoustic insulating capacity was carried out using a Kundt tube, and the thermal insulating performance by measuring the heat transmission resistance ( R) and thermal conductivity ( λ). The results showed that the developed nonwovens have lower thermal conductivity values of about 0.027–0.034 W/(m K), were even lower than those of traditional thermal insulating materials, being the sample with 100 g/m2 of areal density and with a composition of 80% of hemp, 10% of polylactide and 10% of viscose the one with the lowest thermal conductivity (0.027 W/(mK). Their acoustic absorption capacity was around 0.76 at a frequency of 6 kHz, in samples containing high hemp waste (>80 wt%). However, the heterogeneous, discontinuous, and high void density structure that contributes to excellent insulating properties, lead to a decrease in their mechanical properties. This demonstrated that these materials are suitable for substituting traditional materials in insulating applications. Additionally, antifungal tests were carried out. However, hemp nonwovens proved to be inefficient against fungal proliferation.
Through the Ivory Curtain: African Americans in Cleveland Heights, Ohio, before the Fair Housing Movement
Authors: Souther J. Mark
Published: October 2021

This article examines the largely neglected history of African American struggles to obtain housing in Cleveland Heights, a first-ring suburb of Cleveland, Ohio, between 1900 and 1960, prior to the fair housing and managed integration campaigns that emerged thereafter. The article explores the experiences of black live-in servants, resident apartment building janitors, independent renters, and homeowners. It offers a rare look at the ways that domestic and custodial arrangements opened opportunities in housing and education, as well as the methods, calculations, risks, and rewards of working through white intermediaries to secure homeownership. It argues that the continued black presence laid a foundation for later advances beginning in the 1960s that made Cleveland Heights, like better-known Shaker Heights, a national model for suburban racial integration.
Open-sleeve technique: A new approach for aortic valve leaflet reconstruction in small children
Authors: Ishidou Motonori , Hirose Keiichi , Ikai Akio , Sakamoto Kisaburo
Published: October 2021

A boy was diagnosed with a unicuspid aortic valve with severe stenosis at birth. Percutaneous balloon aortic valvuloplasty was performed four times; however, he had severe heart and growth failure. Thus, aortic valve repair was performed at age 2 years and 6 months. He weighed 6.6 kg. The aortic valve annulus diameter was 9.8 mm (z value = 0.43). We report on a small toddler with congenital aortic stenosis who was successfully treated with autologous pericardial aortic valve leaflet reconstruction using the open-sleeve technique.
Lambert–Eaton myasthenic syndrome revealed after surgery of lung adenocarcinoma
Authors: Kabiri El Hassane , Hammoumi Massine El , Sbitti Yassir
Published: October 2021

We report a very rare case of cT1N0M0 lung adenocarcinoma reveling Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old nonsmoking woman, with several comorbidities consulted for cough and dyspnea. Chest radiograph and CT scanning detected a left lower lobe mass; Needle biopsy confirmed differentiated adenocarcinoma; 18FDG-PET scan and Brain MRI eliminated metastatic disease dissemination. Our patient underwent a left lower lobectomy with mediastinal lymphadenectomy (pT1N0M0), no adjuvant chemotherapy was administrated. One month later patient present a muscle weakness in both lower limbs and fatigability followed by an inability to walk. The diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings and a treatment with Amifampridine (3, 4-diaminopyridine phosphate [3, 4-DAP]) was prescribed with evident efficacy for symptoms.
A Systematic Chart Review of Adults with Post-Traumatic Stress Disorder: Data from a Tertiary Care Psychiatry Center in India
Authors: Krishnakumari K. , Munivenkatappa Manjula , Hegde Shantala , Muralidharan Kesavan
Published: October 2021

Background:

Post-traumatic stress disorder (PTSD) is an understudied construct in the psychiatric setting. The majority of existing Indian studies on PTSD focus on the general population or disaster-stricken communities. Here, we present data from a five-year retrospective chart review from a tertiary care psychiatric center in India.

Methods:

Medical records of adult patients (≥18 years) who had attended psychiatry outpatient services between April 1, 2015 and March 31, 2020 (five years) and were diagnosed with PTSD, as per ICD-10 criteria, were reviewed ( n = 113). The relevant sociodemographic and clinical details were extracted using a semistructured pro forma.

Results:

The percentage of adult patients with PTSD diagnosis in the five years was 0.22%. PTSD was more common in females (n = 65, 57.5%). Most patients had interpersonal trauma (n = 85, 75.2%), specifically sexual abuse (n = 47, 41.6%).The median age of onset was 22 years. All the patients had re-experiencing symptoms, with an equally high rate of avoidance (n = 109, 96.5%) and arousal symptoms (n = 110, 97.3%). 82%(93) had a comorbid psychiatric disorder, with mood disorder being the most common (n = 44, 38.9%). Males had a higher rate of comorbid substance use disorder (n = 14, 29.2%) and depression (n = 20, 42%), and females had a higher rate of comorbid dissociative disorder (n = 13, 20%). Most of the patients received non-trauma-focused psychological interventions, and only 18% (20) received evidence-based trauma-focused psychological interventions.

Conclusion:

Interpersonal trauma, specifically sexual abuse, largely contributes to PTSD among adults attending psychiatric services. The need for trauma-focused psychological interventions is underscored.
Don’t Throw Your Heart Away: Increased Transparency of Donor Utilization Practices in Transplant Center Report Cards Alters How Center Performance Is Evaluated
Authors: Butler Alison E. , Chapman Gretchen B.
Published: October 2021

Background

Publicly available report cards for transplant centers emphasize posttransplant survival and obscure the fact that some centers reject many of the donor organs they are offered (reflecting a conservative donor acceptance strategy), while others accept a broader range of donor offers (reflecting an open donor acceptance strategy).

Objective

We assessed how the provision of salient information about donor acceptance practices and waitlist survival rates affected evaluation judgments of hospital report cards given by laypeople and medical trainees.

Methods

We tested 5 different report card formats across 4 online randomized experiments ( n1 = 1,003, n2 = 105, n3 = 123, n4 = 807) in the same hypothetical decision. The primary outcome variable was a binary choice between transplant hospitals (one with an open donor acceptance strategy and the other with a conservative donor acceptance strategy).

Results

Report cards featuring salient information about donor organ utilization rates (transplant outcomes categorized by quality of donor offers accepted) or overall survival rates (outcomes from both waitlist and transplanted patients) led lay participants (studies 1, 3, and 4) and medical trainees (study 2) to evaluate transplant centers with open donor acceptance strategies more favorably than centers with conservative strategies.

Limitations

Due to the nature of the decision, a hypothetical scenario was necessary for both ethical and practical reasons. Results may not generalize to transplant clinicians or patients faced with the decision of where to join the transplant waitlist.

Conclusions

These findings suggest that performance evaluations for transplant centers may vary significantly based not only on what outcome information is presented in report cards but also how the information is displayed.
Incorporating diffusion-weighted imaging in a diagnostic algorithm for multiparametric MR mammography
Authors: Vassiou Katerina , Fanariotis Michael , Tsougos Ioannis , Fezoulidis Ioannis
Published: October 2021

Background

Apparent diffusion coefficient (ADC) measurements are not incorporated in BI-RADS classification.

Purpose

To assess the probability of malignancy of breast lesions at magnetic resonance mammography (MRM) at 3 T, by combining ADC measurements with the BI-RADS score, in order to improve the specificity of MRM.

Material and Methods

A total of 296 biopsy-proven breast lesions were included in this prospective study. MRM was performed at 3 T, using a standard protocol with dynamic sequence (DCE-MRI) and an extra echo-planar diffusion-weighted sequence. A freehand region of interest was drawn inside the lesion, and ADC values were calculated. Each lesion was categorized according to the BI-RADS classification. Logistic regression analysis was employed to predict the probability of malignancy of a lesion. The model combined the BI-RADS classification and the ADC value. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated.

Results

In total, 153 malignant and 143 benign lesions were analyzed; 257 lesions were masses and 39 lesions were non-mass-like enhancements. The sensitivity and specificity of the combined method were 96% and 86%, respectively, in contrast to 95% and 81% with BI-RADS classification alone.

Conclusion

We propose a method of assessing the probability of malignancy in breast lesions by combining BI-RADS score and ADC values into a single formula, increasing sensitivity and specificity compared to BI-RADS classification alone.
Household Decision-Making: Implications for Production, Consumption, and Sale of Nutrient-Rich Foods
Authors: Tadesse Seifu , Kershaw Meghan , Knapp Rachel , Gizaw Rahel , Biadgilign Sibhatu , Feleke Amare , Dessalegn Yigzaw , Abuye Cherinet , Kennedy Eileen
Published: October 2021

Household decision-making influences choices related to the production, sale, purchase, and consumption of nutrient-rich foods. The present study assessed the effect of household decision-making in 2 regions of Ethiopia within 2 groups of households, most vulnerable households and model farmer households. The study focused on identifying barriers and facilitators relating to decisions about nutrient-rich foods—in this case fruits, vegetables, and animal source foods. The results provide insights into how future agricultural programs can affect key aspects of decision-making to maximize the positive impacts on diet and food security.
Examining the Likelihood of Parents’ Homework Involvement With Elementary-Age Students With Individualized Education Programs
Authors: Womack Tyler A. , Johnson Austin H.
Published: October 2021

Elementary-age students with Individualized Education Programs (IEPs) tend to experience more challenges and demonstrate lower homework completion as compared with peers without IEPs. Parent involvement in homework can significantly improve a child’s homework achievement, but little research has examined the factors associated with higher levels of homework involvement for parents of children with IEPs. Using the 2016 Parent and Family Involvement survey, weighted hierarchical ordinal logistic regression analysis was implemented to determine how a child’s IEP status, parents’ demographic characteristics, school-level variables, and parents’ expectations predicted parents’ odds of helping their child with homework. Results indicated parents’ race and income, along with school communication, parent satisfaction, and the interaction between a child’s IEP status and parents’ expectations predicted parents’ likelihood of involvement in their child’s homework. The implications of these findings and future directions are discussed.
Public health leadership: Competencies to guide practice
Authors: Strudsholm Tina , Vollman Ardene Robinson
Published: October 2021

In 2013, the Community Health Nurses of Canada in partnership with the Canadian Institute of Public Health Inspectors and the Manitoba Public Health Managers Network received funding from the Public Health Agency of Canada to develop a set of interdisciplinary leadership competencies for seven public health disciplines. The Leadership Competencies for Public Health Practice in Canada project comprised a multimethod research approach that included a scoping literature review, on-line survey, webinar-based focus groups, and a modified Delphi process. The 49 leadership competencies for public health practice were organized according to the LEADS Canada capabilities. The leadership competencies extend the core public health competencies and discipline-specific competencies and reflect foundational values of public health. The leadership competencies can be applied to professional development pathways, mentoring programs, and performance appraisals to advance public health practice. How these competencies have been enacted by public health leaders during the COVID-19 pandemic is discussed.
Extractivism and Labour Control: Reflections of Turkey’s ‘Coal Rush’ in Local Labour Regimes
Authors: Çelik Coşku
Published: October 2021

This study analyses labour processes and local labour control strategies in the extractive industries and regions as the reflections of state-capital-labour-nature relations. I argue that, for the analysis of labour control in extractive industries, there is a need to pay attention to (i) the significance of the natural resource for global capital accumulation processes and for the development policies of the state; (ii) the formation of the local labour market through proletarianization of rural population and other means of labour supply; (iii) the organization of work considering both natural limits (such as geological structure of the basin) and workforce composition; and (iv) the use of local political, institutional and community dynamics. Drawing upon the fieldwork carried out in Soma Coal Basin, this paper shows how Turkey’s coal rush shapes local labour control strategies.
Rocuronium Reversal in the Emergency Department: Retrospective Evaluation of Hemodynamic Instability Following Administration of Sugammadex Versus Neostigmine With Glycopyrrolate
Authors: Hile Garrett B. , Healy Karl J. , Almassalkhi Lars R.
Published: October 2021

Background: Rocuronium is an intermediate-acting non-depolarizing neuromuscular blocking agent frequently used in the emergency department for rapid sequence intubation. The prolonged effects of rocuronium may prevent the ability to conduct a meaningful neurological examination, thereby delaying appropriate diagnosis and treatment. Sugammadex and neostigmine are pharmacologic agents commonly used to reverse rocuronium. The safety of sugammadex versus neostigmine with glycopyrrolate for the reversal of rocuronium in the emergency department has not been well described. Objective: Evaluate the occurrence of hemodynamic instability post-administration of sugammadex versus neostigmine with glycopyrrolate in the emergency department for the reversal of rocuronium. Methods: A retrospective cohort study conducted among adult patients that received sugammadex or neostigmine with glycopyrrolate in the emergency department for the reversal of rocuronium. The primary outcome was occurrence of hemodynamic instability that required escalation of treatment. Secondary outcomes included occurrence of hypotensive, bradycardic, or cardiac arrest events. Results: A total of 37 patients met inclusion criteria (n = 10, sugammadex; n = 27, neostigmine). There was no difference between the two groups in regard to hemodynamic instability that required escalation of treatment within 30 minutes after receiving either sugammadex or neostigmine with glycopyrrolate ( P = .557). Conclusion: There was no difference between the two groups in regard to occurrence of hemodynamic instability that required escalation of treatment. Given the small sample size, future studies are warranted to further delineate the safety of sugammadex and neostigmine with glycopyrrolate for the reversal of rocuronium in the emergency department.
Acoustic and phase portrait analysis of leading-edge roughness element on laminar separation bubbles at low Reynolds number flow
Authors: Jabbari Hossein , Ali Esmaeili , Djavareshkian Mohammad Hasan
Published: October 2021

Since laminar separation bubbles are neutrally shaped on the suction side of full-span wings in low Reynolds number flows, a roughness element can be used to improve the performance of micro aerial vehicles. The purpose of this article was to investigate the leading-edge roughness element’s effect and its location on upstream of the laminar separation bubble from phase portrait point of view. Therefore, passive control might have an acoustic side effect, especially when the bubble might burst and increase noise. Consequently, the effect of the leading-edge roughness element features on the bubble’s behavior is considered on the acoustic pressure field and the vortices behind the NASA-LS0417 cross-section. The consequences express that the distribution of roughness in the appropriate dimensions and location could contribute to increasing the performance of the airfoil and the interaction of vortices produced by roughness elements with shear layers on the suction side has increased the sound frequency in the relevant sound pressure level (SPL). The results have demonstrated that vortex shedding frequency was increased in the presence of roughness compared to the smooth airfoil. Also, more complexity of the phase portrait circuits was found, retrieved from velocity gradient limitation. Likewise, the highest SPL is related to the state where the separation bubble phenomenon is on the surface versus placing roughness elements on the leading edge leads to a negative amount of SPL.
Lifting the Bar: A Relationship-Orienting Intervention Reduces Recidivism Among Children Reentering School From Juvenile Detention
Authors: Walton Gregory M. , Okonofua Jason A. , Remington Cunningham Kathleen , Hurst Daniel , Pinedo Andres , Weitz Elizabeth , Ospina Juan P. , Tate Hattie , Eberhardt Jennifer L.
Published: October 2021

When children return to school from juvenile detention, they face a severe stigma. We developed a procedure to orient educators and students toward each other as positive relationship partners during this period. In Study 1, through a structured exercise, students reentering school powerfully articulated to an educator of their choosing their prosocial hopes for school as well as challenges they faced. In a preliminary field trial ( N = 47), presenting this self-introduction to this educator in a one-page letter via a third-party requesting the educator’s help reduced recidivism to juvenile detention through the next semester from 69% to 29%. In Study 2 (preregistered), the letter led experienced teachers ( N = 349) to express greater commitment to, anticipate more success for, and feel more love and respect for a student beginning their reentry into school, potentially initiating a better trajectory. The results suggest how relationship-orienting procedures may sideline bias and make school more supportive for students facing stigma.
Bringing society back into our understanding of European cross-border care
Authors: Stan Sabina , Erne Roland
Published: October 2021

We are pleased to discuss our study on the European Health Insurance Card (EHIC) and the redistributive effects of EHIC-related east–west patient and payment flows across regions and social classes. Our critics confirm our key finding: EHIC patient outflows from Eastern European (EE) to Western European (WE) countries result in a much higher relative burden for the budgets of EE states than outflows from WE to EE do for WE countries. Starting from what they see as the true mission of social security coordination, however, they also tell us that we should never have studied the redistributive impact of EHIC patient and payment flows in the first place. In this response, we therefore explicate the differences between our empirical sociological perspective and our critics’ normative legal approach. This is important, especially when social facts contradict normative legal assumptions as in our case. The EU laws that govern EHIC patient and payment flows are indeed based on the free movement provisions of the EU’s internal market project, but our empirical findings show that the promise of ‘economic, social and territorial cohesion, and solidarity among Member States’ contained in Article 3.3 of the Treaty of the European Union is not realized in practice in the case of east–west EHIC payment flows and patient mobility.