bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Neurodegeneration and Macular Perfusion in the Progression of Diabetic Retinopathy: A 3-Year Longitudinal Study
Authors: Marques Inês P. , Ferreira Sónia , Santos Torcato , Madeira Maria H. , Santos Ana Rita , Mendes Luís , Lobo Conceição , Cunha-Vaz José
Published: February 2022

Objective and Purpose: The aim of this study was to explore the relation between retinal neurodegenerative changes and vessel closure (VC) in individuals with nonproliferative diabetic retinopathy (NPDR) in a follow-up period of 3 years. Design: This is a 3-year prospective longitudinal study with four annual visits. Participants: This study involved 74 individuals with type 2 diabetes, NPDR, and Early Treatment Diabetic Retinopathy Study grades from 10 to 47, one eye/person. An age-matched healthy control population of 84 eyes was used as control group. Methods: Participants were annually examined by color fundus photography, spectral domain-optical coherence tomography (SD-OCT) and OCT-angiography (OCTA). VC was assessed by OCTA vessel density maps. SD-OCT segmentations were performed to access central retinal thickness (CRT) and retinal neurodegeneration considered as thinning of the ganglion cell plus inner plexiform layer (GCL + IPL). Results: Type 2 diabetic individuals presented significantly higher CRT (p = 0.001), GCL + IPL thinning (p = 0.042), and decreased vessel density at the superficial capillary plexus (p < 0.001) and full retina (FR) (p = 0.001). When looking at changes occurring over the 3-year period of follow-up (Table 2), there were statistically significant decreases in GCL + IPL thickness (−0.438 μm/year; p = 0.038), foveal avascular zone circularity (−0.009; p = 0.047), and vessel density in superficial capillary plexus (−0.172 mm−1/year; p < 0.001), deep capillary plexus (DCP) (−0.350 mm−1/year; p < 0.001), and FR (−0.182 mm−1/year; p < 0.001). A statistically significant association was identified between GCL + IPL thinning and decrease in DCP vessel density (β = 0.196 [95% confidence interval: 0.037, 0.355], z = 2.410, p = 0.016), after controlling for age, gender, diabetes duration, hemoglobin A1c level, and CRT. Conclusions: Retinal neurodegenerative changes show a steady progression during a 3-year period of follow-up in eyes with NPDR and appear to be directly associated with progression in decreased vessel density including vascular closure through preferential involvement of the DCP. Our findings provide evidence that retinal neuropathy is linked with microvascular changes occurring in diabetic patients.
Analysis of Integrated Vapor Transport Biases
Authors: Reynolds Carolyn A. , Crawford William , Huang Andrew , Barton Neil , Janiga Matthew A. , McLay Justin , Flatau Maria , Frolov Sergey , Rowley Clark
Published: February 2022

High-fidelity analyses and forecasts of integrated vapor transport (VT) are central to the study of Earth’s hydrological cycle as well as high-impact phenomena such as monsoons and atmospheric rivers. The impact of the in-line analysis correction-based additive inflation (ACAI) on IVT biases and forecast errors is examined within the Navy Earth System Prediction Capability (Navy ESPC) global coupled system. The ACAI technique uses atmospheric analysis corrections from the data assimilation system to approximate model bias and as a representation of stochastic model error to simultaneously reduce systematic and random errors and improve ensemble performance. ACAI reduces the global average magnitude of the 7- and 14-day IVT bias by 16%–17% during Northern Hemisphere summer, reaching 70% reductions in some tropical regions. The global average IVT bias reduction is similar to the bias reduction for low-level wind speed bias and considerably smaller than the bias reduction in total precipitable water. The localized regions where ACAI increases IVT bias occur where the control IVT biases change sign and structure with increasing forecast lead time, such as the South Asian monsoon region. Substituting analyzed wind or moisture fields for the forecast fields when calculating the forecast IVT confirms that, on average, wind errors dominate the IVT error calculation in the tropics, although wind and moisture error contributions are comparable in the extratropics. The existence of regions where using either analyzed winds or analyzed moisture increases IVT bias or mean absolute error reveals areas with compensating errors.
Association of Physical Activity, Sports, and Screen Time With Adolescent Behaviors in Youth Who Visit the Pediatric Emergency Department
Authors: Shenoi Rohit P. , Linakis James G. , Bromberg Julie R , Casper T. Charles , Richards Rachel , Chun Thomas H. , Gonzalez Victor M. , Mello Michael J. , Spirito Anthony
Published: February 2022

Moderate to vigorous physical activity (MVPA), sports, and reduced screen time are associated with favorable youth risk profiles. We evaluated the association of MVPA, sports, and screen time with adolescent behaviors among pediatric emergency department youth. Adolescents were assessed for alcohol/drug use, risky behavior, conduct disorder, and depressive mood. MVPA was activity for ≥5 days/week and ≥60 minutes/day. Increased screen time was ≥3 hours/day computer/TV use for non-schoolwork. Multivariable regression studied association between MVPA, sports, and increased screen time and outcomes adjusting for demographics and academic achievement. Older age and lower academic achievement were significantly associated with risky behaviors, conduct disorder, and depression. Youth who endorsed MVPA and sports participation had less depression (odds ratio [OR] = 0.76; confidence interval [CI] = 0.66-0.87). Increased screen time was associated with conduct disorder (OR = 1.6; CI = 1.3-2.1), depression (OR = 1.2; CI = 1.0-1.4), and drug use (OR = 1.8; CI = 1.1-2.8). In pediatric emergency department youth, MVPA and sports participation is associated with less depression. Increased screen time is associated with conduct disorders, depression, and drug use.
Agricultural Income Tax in India: Introducing Threshold-Based Tax Exemption
Authors: Trumboo Naveed
Published: February 2022

Agricultural income earned by a person in India is exempted from taxation as far as the Income Tax Act, 1961 is concerned. This article explores the case for introducing threshold-based Agricultural Income Tax (AIT) exemption in India. The article examines this proposal using the existing literature and body of work available on the subject. The study comes to the conclusion that the existing blanket exemption on agricultural income is undesirable from the perspective of fiscal policy and principle of equity. It is suggested that a reasonable monetary threshold should be defined above which agricultural income will be subject to taxation at the national level. The findings indicate that such a measure will increase revenues, check tax evasion and widen the tax-base in the country. It has also been proposed that AIT should be implemented by the Central government at the national level, and the local government authorities must also be involved for information collection and monitoring at the ground level. Finally, the study suggests some policy strategies to implement and administer threshold-based AIT in India.
Assisted dying
Authors: Samuels Alec
Published: February 2022

Encouraging or assisting suicide, the legal situation, attempts to change the law, the case for and against.
Day or Night at the Museum: A UX Analysis of Virtual Exhibits
Authors: Williams Joseph
Published: February 2022

The virtual museum tour has claimed new audiences during the pandemic, but not all virtual tours are created equal. First, this paper will explore the world of virtual museums and UX scholarship. Secondly, the paper will propose a viable set of options in determining effectiveness of virtual museums. Thirdly, the paper will discuss specific examples of UX design among museum virtual exhibits offered currently, specifically those that do not require any additional downloads or software. Finally, the paper intends to discuss the implications of high quality UX design within the realm of virtual museum tour.
Hookworm re-infection rate and efficacy of single-dose albendazole among pregnant women in Debre Elias District, Northwest Ethiopia: A single-arm trial
Authors: Aschale Yibeltal , Abebaw Abtie , Atnaf Aytenew , Mengist Abeba , Kassie Bekalu , Yihunie Wubetu
Published: February 2022

Hookworm is one of the soil-transmitted nematodes causing anaemia and low birth weight in pregnant women. This study aimed to assess albendazole efficacy and re-infection rate among pregnant women. A community-based cross-sectional study was conducted from February to September 2021 in Debre Elias District. Albendazole (400mg) was administered to assess efficacy and hookworm re-infection rate. Though the cure rate of single-dose albendazole was 81.7%, with an overall egg reduction rate of 92.5%, the re-infection rate of hookworm 18–24 weeks post-treatment was substantial at 21.4%. More effective intervention measures are thus needed.
In This Together? Exploring Moderating and Mediating Effects of Shared Racial Fate on the Predictive Role of Racial Socialization and Discrimination on Black Activism
Authors: Ajayi Alex A. , Grier-Reed Tabitha , Houseworth James
Published: February 2022

This study examined the predictive role of reported racial socialization (i.e., preparation for bias and promotion of mistrust), racial discrimination, and shared racial fate on sociopolitical activism in a sample of 353 Black Americans. In addition, we examined the moderating and mediating role of shared racial fate as a variable by which the other contextual factors predict sociopolitical activism. Results from multiple regression analyses indicated that preparation for bias and racial discrimination were the only unique predictors of sociopolitical activism. Results also indicated that shared racial fate significantly moderated the relationship between reported racial discrimination and sociopolitical activism. Finally, shared racial fate significantly mediated the relationship between promotion of mistrust and sociopolitical activism. These findings are timely as we are at a critical point in U.S. history where there are widespread calls for social justice. We provide insight into factors that may contribute to sociopolitical engagement. Implications for culturally responsive pedagogy, curricula, and interventions are discussed.
Comparing the Sexual and Mental Health of Justice-Involved Youth Across Gender and Sexual Orientation
Authors: Hsu Kevin J. , Walden Angela L. , Kendall Ashley D. , Snow-Hill Nyssa L. , Emerson Erin M. , Donenberg Geri R.
Published: February 2022

Justice-involved youth may experience unique sexual and mental health risks related to both their gender and sexual orientation. Although previous research has revealed important gender and sexual orientation differences in the sexual and mental health of justice-involved youth, no study has yet examined gender and sexual orientation differences simultaneously within the same sample. The present study addressed this gap in a sample of 347 probation-involved youth, 13–17 years old, recruited as part of a randomized controlled trial of PHAT Life, an HIV/STI, mental health, and substance use prevention program. On the one hand, female and non-heterosexual youth were less likely than male and heterosexual youth to report having ever had sex and to be considered high sexual risk. On the other hand, female youth were more likely than male youth to test positive for STIs and to report certain mental health problems, but non-heterosexual youth showed no difference from heterosexual youth. Finally, female non-heterosexual youth were more likely to report externalizing problems than youth of other gender and sexual orientation combinations. Findings highlight the need for prevention and intervention efforts that specifically target justice-involved youth who identify as female, non-heterosexual, or both.
“I Personally Wouldn’t Know Where to Go”: Adolescents’ Perceptions of Mental Health Services
Authors: Goodwin John , Savage Eileen , O’Donovan Aine
Published: February 2022

The aim of this study was to explore perceptions of mental health services from the perspectives of adolescents with no prior service experience. Thirty students in the Transition Year (fourth year) of secondary school participated in this study: 22 females and 8 males, aged 15 to 16. There was equal distribution across rural and urban settings. Participants had no prior experience of accessing mental health services. Data were collected in secondary school settings in the Republic of Ireland. An interpretive description approach guided this study. Data were collected through individual interviews. To complement interviews, participants drew images of mental health care environments and mental health staff members; drawings were not subjected to analysis. Data (participant interviews) were analyzed using qualitative content analysis. Three themes were identified. Participants suggested that “mental health services” differed from “psychiatric services,” with the latter term perceived more negatively. Uncertainty about how to access these services was voiced. Considering the vulnerability of adolescents to the experience of mental distress, education around mental health services is warranted. It is expected that provision of education in this area would enhance service delivery, improve adolescents’ help-seeking behaviors for mental distress, and reduce stigma.
Socio-Economic Inequality and Quality of Life in Russia
Authors: Voeykov Michael , Anisimova Galina
Published: February 2022

The article deals with the social aspects of economic inequality in society. Special attention is paid to non-monetary indicators of social stratification of Russian society. It substantiates the conclusion that economic inequality in Russian society has reached a critical line fraught with serious social threats.
Narrative policy framework at the macro level—cultural theory-based beliefs, science-based narrative strategies, and their uptake in the Canadian policy process for genetically modified salmon
Authors: Williams Teshanee T , Kuzma Jennifer
Published: February 2022

This study utilizes the Narrative Policy Framework (NPF) and cultural theory to examine the use of policy narratives by coalitions (meso-level) and the institutional uptake (macro-level). We analyze Parliamentary hearings about genetically modified (GM) salmon in Canada to associate narrative strategies with certain cultural worldviews and policy-stances. We explore narrative strategies used by cultural groups with regard to whether they contain the scope of GM salmon issues to “science-only” (direct health and environmental impacts) or expand the issues to “science-plus” (to include broader economic, social, or cultural impacts). Finally, we examine whether certain framings of GM salmon issues or specific cultural narratives are preferentially taken up in the final policy documents generated after the hearings. Our findings reveal significant relationships between policy-stance (pro-vs anti-GM), the cultural disposition of a policy narrative, the narrative strategies being used, and ultimately policy uptake. For example, narratives with hierarchical cultural dispositions were more likely to expand the scope of the issue to science-plus when supporting their own policy position (typically pro-GM) but contain the scope to “science-only” when refuting an anti-GM policy-stance. With regard to policy uptake, final government documents referred more to narratives that contained the scope to “science-only” and expressed hierarchical or individualistic dispositions in comparison to the hearings. This study has practical implications for understanding whose perspectives and arguments are legitimized in national policy debates about GM foods. It also extends NPF theory to how narratives containing specific cultural dispositions and risk-based framings influence policy uptake at the macro-level.
Fabrication of micro molds by electrodeposition under supergravity field
Authors: Hu Xiaoyun , Qu Ningsong
Published: February 2022

Nowadays, micro molds have been playing an increasing crucial part in social and industrial fields. As the industry develops, the wear resistance of the micro molds has become more and more important because of its effects on the service life and economic benefit. Improving the hardness of the micro molds was an alternative to enhance its wear resistance, which can be realized by the electrodeposition of Nickel cobalt silicon carbide (Ni–Co/SiC). In this paper, attempts were made to fabricate Ni–Co/SiC micro molds, where supergravity field was introduced to further better the microhardness of the micro molds. The effects of supergravity field on the SiC content, morphology and microhardness of the Ni–Co/SiC micro mold were experimentally investigated. It was demonstrated that under gravity field, grain size is refined, and both the microhardness and morphology were dramatically improved. Finally, Ni–Co/SiC micro-pit molds were successfully obtained using optimized parameters. Production of Ni–Co/SiC micro molds with enhanced microhardness is feasible via electrodeposition under supergravity field.
Mapping the abject: Women's embodied experiences of premenstrual body dissatisfaction through body-mapping
Authors: Ryan Samantha , Ussher Jane M , Hawkey Alexandra
Published: February 2022

Women's body shame and body dissatisfaction increase in the premenstrual phase of the cycle, associated with premenstrual distress. However, the meaning and consequences of premenstrual body dissatisfaction remain underexplored. The aim of this study was to explore how women who report premenstrual body dissatisfaction construct and experience their bodies, using qualitative arts-based methods. Four hundred and sixty women completed online open-ended survey questions and 16 women took part in body-mapping and an interview. Thematic analysis identified three major themes: construction of the premenstrual body as abject, manifested by positioning of the body and self as fat, leaking and dirty; self-policing and self-regulation through increased scrutinising and concealment of the premenstrual body; and resistance of cultural constructions of idealised femininity. These findings emphasise the need to acknowledge changes in body dissatisfaction across the menstrual cycle, and the implication for women's feelings about the self. Internalisation of negative constructions of the female body plays a role in women's experience of premenstrual change and distress. There is a need for further research to examine the role of body management behaviours in premenstrual body dissatisfaction and distress.
Does National Culture Influence Corporate ESG Disclosures? Evidence from Cross-Country Study
Authors: Roy Abhijit , Mukherjee Paramita
Published: February 2022

The present study empirically investigates the influence of country-level informal institutions on corporate ESG disclosures. We use country-level culture as the measure of informal institution. The study reveals that, more than economic factors, country-level culture better explains the wide variations of corporate ESG disclosure practices across countries. We use larger sample than the earlier studies and apply hierarchical linear modelling (HLM) technique for estimation. The study reports significant association between different measures of national culture, as proposed by Hofstede, and corporate ESG disclosures. Further, we also report the direct impact as well as the moderating role of firm characteristics on firms’ disclosure decisions. We find that firm size is an important factor along with Tobin’s Q that sometimes strengthens or weakens the overall effects of different cultural dimensions on ESG disclosures. Adoption of Williamson’s framework of ‘New Institutional Economics’ in the context of corporate ESG behaviour is a novel contribution to the existing body of knowledge.
When Bad News Becomes Routine: Slowly-Developing Problems Moderate Government Responsiveness
Authors: Epp Derek A. , Thomas Herschel F.
Published: February 2022

Established theories of the policy process recognize the challenges governments face in processing information. We examine how the ways in which public problems develop over time condition subsequent policy actions. We contend that policymakers will become routinized to and consequently under-respond to the accumulating signals of slowly-developing problems (i.e., those featuring long runs of relatively small changes). Event history analyses leverage variation across the United States in the development of the COVID-19 pandemic and the subsequent implementation of social distancing policies. Looking across the 50 states and Washington DC, we find that regions that saw protracted deterioration in their health situation were slower to respond with social distancing than those that saw an abrupt deterioration to the same point. These results highlight the risks associated with problems that worsen only gradually over time.
Combining Family Systems Approaches to Address BIPOC Families’ Racial Trauma Amidst the Global Pandemic
Authors: Daniels Aubrey D.
Published: February 2022

The ACE study ( Felitti et al., 1998 ) led to the recognition of the prevalence and impact of trauma. However, since the ACE study sample was mostly white and middle class, the Philadelphia task force implemented their own study to account for trauma of a more diverse sample. A result of the study was a list of evidence-based treatments to be utilized with BIPOC populations. Of the evidence-based treatments was, ecosystemic structural family therapy (ESFT). A similar effective approach is the family resilience framework. When combined, the approaches can be effective with BIPOC families during the global pandemic and racial trauma, something not typically at the forefront of family counseling goals. In this article, I explain the four steps family counselors should follow when combining the approaches to better approach and treat racial trauma while also partaking in effective advocacy to enhance family resilience of BIPOC families. A case study is provided for family counselors to understand how to effectively utilize this combined approach.
Novel MAP4::RAF1 Fusion in a Primary Bone Sarcoma: Expanding the spectrum of RAF1 Fusion Sarcoma
Authors: Yeung Maximus C. F. , Lam Albert Y. L. , Shek Tony W. H.
Published: February 2022

Soft tissue tumors with RAF1 fusion had been emerging as a group of tumors with peculiar histology and immunoprofile. While a case series and rare case reports of RAF1 translocated sarcoma had been reported, to our knowledge a primary bone tumor with RAF1 translocation and fusion partner with MAP4 had not been described in the literature. The patient was a 60-year-old lady, with strong family history of breast cancer, who presented with pathological fracture of right humerus. X-ray revealed a 9.7 cm juxta-articular lesion of the proximal humerus, which was expansile and lytic with a non-sclerotic well defined border distally, radiologically suggestive of a giant cell tumor of bone. Excision was performed after initial biopsy. Histology showed a monomorphic low grade spindle cell lesion with prominent hyalinized stroma. Immunohistochemistry demonstrated diffuse CD34 staining, with focal staining for S100. Gene sequencing for histone 3 H3 genes was negative for hotspot mutation. Targeted RNA-seq sequencing revealed the presence of MAP4::RAF1 fusion, which was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) and fluorescence in-situ hybridization (FISH) break-apart probes involving both genes. The overall features were consistent with a primary bone sarcoma with RAF1 fusion. This report expanded the spectrum of RAF1 fusion sarcoma and was the first report documenting its primary occurrence in bone.
Tumor Deposits and Perineural Invasion had Comparable Impacts on the Survival of Patients With Non-metastatic Colorectal Adenocarcinoma: A Population-Based Propensity Score Matching and Competing Risk Analysis
Authors: Luo Bin , Chen Xianzhe , Cai Guanfu , Hu Weixian , Li Yong , Wang Junjiang
Published: February 2022

Background

Both tumor deposits (TD) and perineural invasion (PNI) have been identified as risk factors for poor survival in patients with non-metastatic colorectal adenocarcinoma (CRC). However, the adverse impacts of TD and PNI on the survival of patients with non-metastatic CRC have not been compared.

Method

Patients with non-metastatic CRC with known TD and PNI status were selected from the Surveillance, Epidemiology, and End Results (SEER) database. First, bivariate logistic regression analysis was utilized to identify the factors associated with TD and PNI status. Then, patients were divided into four groups, according to TD and PNI status. Propensity score matching (PSM) was performed to balance the baseline covariates. The impact of TD and PNI on survival was assessed by analyzing overall survival (OS) and cancer-specific mortality (CSM) rates. OS was calculated by the Kaplan–Meier method with log-rank analysis. CSM was estimated by competing risk analysis using the Fine and Gray model.

Results

A total of 70 689 patients with CRC met the inclusion and exclusion criteria. The positive rates of TD and PNI were 9.37% and 9.91%, respectively. For TD, the most important risk factor was N stage. With respect to PNI, the most significant factor was T stage. Tumor location, tumor size, differentiation grade, and serum CEA level were also correlated with TD and PNI status. After PSM, 1849 pairs were selected. Patients with TD+PNI+ status had the worst 5 year CSM and 5 year OS. In addition, the long-term survival outcomes of patients with TD+PNI− and TD−PNI+ status were comparable.

Conclusion

The adverse impacts of TD and PNI on the survival of patients with non-metastatic CRC were comparable. CRC patients with both TD and PNI positive had the worst survival outcome.
Maxwell–Eshelby relation in Cosserat elasticity theory
Authors: Shirani Milad
Published: February 2022

In this work, using quasiconvexity and rank-one convexity conditions in Cosserat elasticity theory, we derive the Maxwell–Eshelby relation for Cosserat bodies with a surface of discontinuity.
Theoretical investigation of hybrid foil-magnetic bearings on operation mode and load sharing strategy
Authors: Zhang Hang , Yin Qianwei , Guan Hanqing , Cao Yuanlong , Feng Kai
Published: February 2022

This paper presents a theoretical investigation on operation mode and load sharing strategy of hybrid foil-magnetic bearings (HFMBs). According to the inherent characteristics of gas foil bearings (GFBs) and active magnetic bearings (AMBs), six possible work scopes are discussed to understand the operation mode of HFMBs. A numerical model coupling the calculations of the film pressure in GFBs and the magnetic forces in AMBs is conducted to predict the operation performance of HFMBs. The accuracy of the model is proved by comparing the predicted and tested friction torques. Analysis on the static and dynamic performance of HFMBs within three representative cases is conducted by varying the load sharing ratio. The dynamic supporting stiffness and operation position of HFMBs can be obviously enhanced by adjusting the operating mode and load sharing strategy. Results show that the direct stiffness and dynamic damping of HFMBs adopting hybrid mode are significantly higher than those adopting AMB or GFB independent mode.
Friction material wear: Effects and interactions between service brake temperature, lining contact pressure, and vehicle speed
Authors: Roman Alexandre , Vieira Braga Lemos Guilherme , Gasparin Alexandre Luís
Published: February 2022

International standards and original equipment manufacturers (OEM) procedures usually define wear tests in organic materials focusing on the brake lining temperature. The current work presents an approach combining different brake pads temperatures, vehicle speeds, and brake pressures for analyzing their effects and interactions in the friction material wear through dynamometer tests. Therefore, mechanical properties were evaluated, where internal shear strength had the most significant influence on wear; furthermore, compressive strength and flexural strength did not considerably change with variations on the test parameters. A 23 factorial design of the experiment (DOE) showed that the brake temperature alone was not the main factor for increasing wear, and the primary wear mechanism was abrasion. Furthermore, higher vehicle speed (80 km/h) along with greater brake pressure (3 bar) promoted the highest friction material mass loss (10.8 g).
Slow Story-Making in Urgent Times
Authors: Rice Carla M. , Temple Jones Chelsea , Mündel Ingrid
Published: February 2022

In the context of an alarmingly sped up “slow death” for disabled people living under emergency COVID-19 medical triage protocols in Ontario, Canada, that produce, naturalize, and weaponize our vulnerability, we assert that slow digital story-making opens a threshold space filled with complex, relational, lively collaborative worldmaking. Here, we analyze videos made by three digital/multimedia story-makers, known as experimenters, who express the turbulence they lived through via storywork that described their unique yet entwined vantage points. Following Rosi Braidotti’s caution against capitalizing on tragedy, we offer Donna Haraway’s “compost writing” as an alternative to building theory. By compos(t)ing online multimedia stories that straddle digital/human/more-than-human realms, we take up “digital composting” as an unfinished methodology wherein we move collectively, even from the isolation of our own homes. We posit slow digital story-making as a way of “staying with the trouble” as we find ourselves worldmaking at the complex threshold between life/death, vulnerability/resistance, individual/relational, human/nonhuman. To compost digital multimedia stories is to leave them to ruminate in the complex entanglements of posthuman existences in urgent times.
WholeheartedMD: Medical Students Embracing Vulnerability and Finding Fulfillment
Authors: Smith Alexis , Barnett Erica , Frates Beth
Published: February 2022

Introduction. Medical Students experience high levels of stress throughout their four years. When the COVID-19 pandemic exacerbated this, there was a need for programming and this created an opportunity to provide a whole person, lifestyle medicine approach to enhance medical student wellbeing. Methods. Two student leaders and one faculty member created a 12-week program that addressed the 6 pillars of lifestyle medicine as well as positive psychology. The program was offered to all first year students, and within 12 hours the roster was full with 15 students. The program was held weekly by Zoom for 1-2 hours. Results. Attendance was high each week with full participation from everyone present. In the post program evaluation form, conducted one year after completion of the program, 100% of respondents reported they would recommend this group to another medical student, 71% reported they used tools learned from the group at least weekly. Participants noted that growth mindset, gratitude, mindfulness, priorities, and relationship building were the most used well-being strategies learned in the program. Conclusion. An intervention that is based on the 6 pillars of lifestyle medicine and positive psychology and presented by Zoom is feasible in medical school and well accepted by medical students.
Chemical constituents from the leaves of Tripterygium wilfordii and their cytotoxic activity
Authors: Jiang Zhi-Chao , Li Zi-Heng , Li Peng-Yu
Published: February 2022

A new flavonol glycoside derivate named kaempferol 3- O- trans- p-coumaroyl-7- O- α-ʟ-rhamnoside (1), together with five known compounds (2–6), was isolated from the EtOAc-soluble extract of the leaves of Tripterygium wilfordii. The structure of new compound was elucidated with spectroscopic and physico-chemical analyses. All the isolates were evaluated for in vitro cytotoxic activity against four human cancer cells including HepG2, Hep3B, A549 and MCF-7. Among them, compound 1 exhibited the significant cytotoxic activities against HepG2 and Hep3B cells with IC50 values of 6.8 ± 1.6 and 4.2 ± 1.3 μM, respectively. The above data demonstrated the potential of 1 for the treatment of liver cancer. In addition, 4 also showed moderate inhibitory activity on HepG2 and Hep3B cells with IC50 values of 16.1 ± 2.3 and 10.7 ± 1.8 μM, respectively.
Is this the humanism we have been looking for?
Authors: Lorimer Jamie
Published: February 2022

Büscher offers a useful review of the convergence between strands of post-Marxian and more-than-human praxis alongside an assertion of the points of distinction between these approaches. This response agrees that environmental geography needs to define the human but outlines three points of disagreement, relating to: Büscher’s elevation of self-consciousness as the defining human property; his desire to maintain the Nature-Society divide; and his treatment of basic alienation. It argues for a more capacious understanding of the human that is defined neither in opposition to Nature, nor taken as universally ‘fallen’ from a past moment of unalienated existence.
Digital Health Testbeds in Sweden: An exploratory study
Authors: Jabin Md Shafiqur Rahman , Nilsson Evalill , Nilsson Anna-Lena , Bergman Patrick , Jokela Päivi
Published: February 2022

Objective

This study explored the Swedish digital health testbeds through the lens of complexity science.

Methods

The purposive sampling was used to identify 38 digital health testbed organizations to conduct interviews in written or audio-conferencing. The interview responses were aggregated and analyzed using thematic analysis. The themes were mainly generated through complexity theory and the principles of complex adaptive systems.

Results

Fifteen testbed organizations responded, comprising 13 written responses and two audio-conferencing. Five main theoretical themes were generated: agents and diversity, connections and communication, adaptation and learning, perturbations, and path dependence. Agents and diversity depicted different types of testbeds, stakeholders and innovation, and the primary function and purpose of the testbeds. Various factors enhancing connections and communications among multiple stakeholders were identified, such as the quality of e-health solutions and the 2030 Agenda for Sustainable Development. Some adaptation and learning factors, such as internal reorganization, sharing and creating learning opportunities, and additional funding, guaranteed the sustainability of testbeds. Perturbations were characterized by two factors: non-linear interactions – lack of commitment and transparency in stakeholders' engagement, and uncertainty about testbed definitions and concepts. Path dependence highlighted the importance of history, such as previous positive and negative experiences.

Conclusion

This study provided insights into testbeds' organization, their functions, how various aspects were challenged, and how they adapted to overcome and improve the system issues. Identifying the stakeholders and relevant factors, commissioning an evaluation, backing up with a contingency plan, securing adequate funding, and disseminating the findings can improve the testbeds' design and implementation.
Strategies to Improve Compliance with Clinical Nursing Documentation Guidelines in the Acute Hospital Setting: A Systematic Review and Analysis
Authors: Bunting Jeanette , de Klerk Melissa
Published: February 2022

Introduction

This systematic review attempts to answer the following question – which strategies to improve clinical nursing documentation have been most effective in the acute hospital setting?

Methods

A keyword search for relevant studies was conducted in CINAHL and Medline in May 2019 and October 2020. Studies were appraised using the Joanna Briggs Institute (JBI) critical appraisal for quasi-experimental studies. The studies were graded for level of evidence according to GRADE principles. The data collected in each study were added to a Summary of Data (SOD) spreadsheet. Pre intervention and a post intervention percentage compliance scores were calculated for each study where possible i.e. (mean score/possible total score) × (100/1). A percentage change in compliance for each study was calculated by subtracting the pre intervention score from the post intervention score. The change in compliance score and the post intervention compliance score were both added to the SOD and used as a basis for comparison between the studies. Each study was analyzed thematically in terms of the intervention strategies used. Compliance rates and the interventions used were compared to determine if any strategies were effective in achieving a meaningful improvement in compliance.

Results

Seventy six full text articles were reviewed for this systematic review. Fifty seven of the studies were before and after studies and 66 were conducted in western countries. Publishing dates for the studies ranged from 1991 to 2020. Eleven studies included documentation audits with personal feedback as one of the strategies used to improve nursing documentation. Ten of these studies achieved a post intervention compliance rate ≥ 70%.

Conclusion

Notwithstanding the limitations of this study, it may be that documentation audit with personal feedback, when combined with other context specific strategies, is a reliable method for gaining meaningful improvements in clinical nursing documentation. The level of evidence is very low and further research is required.
Witness Protection: An Imperative for Criminal Justice
Authors: Qureshi Daniyal
Published: February 2022

India is one of the few democracies in the world that does not have a witness protection law in spite of such high crimes rates. The incompetence of the bureaucratic setup of democracy condemned the criminal justice system to being reduced to a mere namesake. This article attempts to provide an understanding of the condition of a witness in the criminal justice system. Without any witness protection laws, the courts have suffered from having to afford security and protection to the citizens that present themselves to testify before the court. Witnesses turn hostile in such a large number of cases and are exposed to threats and manipulation in the course of any criminal proceedings. The legislative efforts in the past have largely failed to provide any solution to this problem.

While it is undoubtedly contented that witness protection is non-dispensable for a fair trial, this article explores the avenue of whether witness protection could be a judicial function. While most jurisdictions across the world run witness protection programmes through the executive, these programmes are wildly transparent and directly answerable to the government. However, in India, given the vast population of the land and the already available infrastructure of the courts and the concerns regarding a full-fledged witness protection programme expressed by various sources from the government over time, it takes considerable deliberation to vest power in the judiciary for an efficient criminal justice system.

Nonetheless, at present, the 2018 scheme of witness protection is the only legislative entity available to the criminal justice system which is inexecutable and offers little relief to the problems.
BTK inhibitors impair humoral and cellular responses to recombinant zoster vaccine in CLL
Authors: Pleyer Christopher , Laing Kerry J. , Ali Mir A. , McClurkan Christopher L. , Soto Susan , Ahn Inhye E. , Nierman Pia , Maddux Emeline , Lotter Jennifer , Superata Jeanine , Tian Xin , Wiestner Adrian , Cohen Jeffrey I. , Koelle David M. , Sun Clare
Published: February 2022

Vaccinations effectively prevent infections; however, patients with chronic lymphocytic leukemia (CLL) have reduced antibody responses following vaccinations. Combined humoral and cellular immune responses to novel adjuvanted vaccines are not well characterized in CLL. In an open-label, single-arm clinical trial, we measured the humoral and cellular immunogenicity of the recombinant zoster vaccine (RZV) in CLL patients who were treatment naïve (TN) or receiving Bruton tyrosine kinase inhibitor (BTKi) therapy. The primary endpoint was antibody response to RZV (≥fourfold increase in anti-glycoprotein E [anti-gE]). Cellular response of gE-specific CD4+ T cells was assessed by flow cytometry for upregulation of ≥2 effector molecules. The antibody response rate was significantly higher in the TN cohort (76.8%; 95% confidence interval [CI], 65.7-87.8) compared with patients receiving a BTKi (40.0%; 95% CI, 26.4-53.6; P = .0002). The cellular response rate was also significantly higher in the TN cohort (70.0%; 95% CI, 57.3-82.7) compared with the BTKi group (41.3%; 95% CI, 27.1-55.5; P = .0072). A concordant positive humoral and cellular immune response was observed in 69.1% (95% CI, 56.9-81.3) of subjects with a humoral response, whereas 39.0% (95% CI, 24.1-54.0) of subjects without a humoral response attained a cellular immune response (P = .0033). Antibody titers and T-cell responses were not correlated with age, absolute B- and T-cell counts, or serum immunoglobulin levels (all P > .05). RZV induced both humoral and cellular immune responses in treated and untreated CLL patients, albeit with lower response rates in patients on BTKi therapy compared with TN patients. This trial was registered at www.clinicaltrials.gov as #NCT03702231.
Do older adults with multimorbidity prefer institutional care than those without multimorbidity? The role of functional limitation
Authors: Zhao Dan , Li Jie , Gao Tingting , Sun Jingjie , Wang Yi , Wang Qiong , Zhou Chengchao
Published: February 2022

Background

Population ageing and social transformation present tremendous challenges to the informal support system of older adults, which engendered institutional care in China. This study aimed to examine the association between multimorbidity and institutional care willingness, and investigate whether there is an interaction effects between multimorbidity and functional limitations on institutional care willingness among Chinese older adults.

Methods

Data were obtained from the sixth National Health Service Survey of Shandong province, China. The sample included 8583 older adults (age ≥ 60 years; 51.7% women), 44.8% without chronic diseases, 34.8% and 20.4% with one chronic condition and multimorbidity, respectively. Multivariable logistic regression models and marginal effects analysis were used to the interaction effects analysis.

Results

A total of 666 (7.8%) participants had institutional care willingness in Shandong, China. Participants with multimorbidity were more likely to have institutional care willingness than their peers without chronic condition (OR = 1.25, 95% CI = 1.06, 1.55) after adjusted for confounders. Marginal effect analysis showed that under the condition that other variables remain unchanged, the probability of them with multimorbidity choosing institutional care for older adults with functional limitations was 6.9% lower than those without multimorbidity (95% CI = -0.128, -0.010, P = 0.023). The interaction effect between chronic health conditions and functional limitation for older adults to choose institutional care was statistically significant, and the average interaction effect was 4.83% (Z = -2.70, $${S}_{\overline{x} }$$

S

x
¯

 = 0.0189, P < 0.05).

Conclusions

This relationship between multimorbidity and institutional care willingness varied by functional limitations. To better meet the care needs among older adults with multimorbidity and functional limitations, more resources and incentives should be provided to encourage the building-up of eldercare institutions. The governments should also establish long-term care system and to provide better home-based care for older adults, as older adults who prefer home care remain the majority.
Characterizing patients with rare mucormycosis infections using real-world data
Authors: Zhang Yayue , Sung Anita H. , Rubinstein Emily , Benigno Michael , Chambers Richard , Patino Nataly , Aram Jalal A.
Published: February 2022

Background

Invasive mucormycosis (IM) is a rare and often life-threatening fungal infection, for which clinical and epidemiological understanding is lacking. Electronic health record (EHR) data can be utilized to elucidate large populations of patients with IM to address this unmet need. This study aimed to descriptively assess data on patients with IM using the Optum® EHR dataset.

Methods

US patient data from the Optum® deidentified EHR dataset (2007–2019) were analyzed to identify patients with IM. Patients with hematologic malignancies (HM), at high risk of IM, were selected and sorted by IM diagnosis (ICD9 117.7; ICD10 B46). Demographics, comorbidities/other diagnoses, and treatments were analyzed in patients with IM.

Results

In total, 1133 patients with HM and IM were identified. Most were between 40 and 64 years of age, Caucasian, and from the Midwest. Essential primary hypertension (50.31%) was the most common comorbidity. Of the 1133 patients, only 33.72% were prescribed an antifungal treatment. The most common antifungal treatments were fluconazole (24.27%) and posaconazole (16.33%), which may have been prophylactic, and any AmB (15.62%).

Conclusions

A large population of patients with IM were identified, highlighting the potential of analyzing EHR data to investigate epidemiology, diagnosis, and the treatment of apparently rare diseases.