bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms for Extreme Precipitation Changes in a Tropical Archipelago
Authors: Argüeso Daniel , Luca A. Di , Jourdain N. C. , Romero R. , Homar V.
Published: May 2022

The Maritime Continent is one of the most challenging regions for atmospheric models. Processes that modulate deep convection are poorly represented in models, which affects their ability to simulate precipitation features accurately. Thus, future projections of precipitation over the region are prone to large uncertainties. One of the key players in modeling tropical precipitation is the convective representation, and hence convection-permitting experiments have contributed to improve aspects of precipitation in models. This improvement creates opportunities to explore the physical processes that govern rainfall in the Maritime Continent, as well as their role in a warming climate. Here, we examine the response to climate change of models with explicit and parameterized convection and how that reflects in precipitation changes. We focus on the intensification of spatial contrasts as precursors of changes in mean and extreme precipitation in the tropical archipelago. Our results show that the broad picture is similar in both model setups, where islands will undergo an increase in mean and extreme precipitation in a warmer climate and the ocean will see less rain. However, the magnitude and spatial structure of such changes, as well as the projection of rainfall percentiles, are different across model experiments. We suggest that while the primary effect of climate change is thermodynamical and it is similarly reproduced by both model configurations, dynamical effects are represented quite differently in explicit and parameterized convection experiments. In this study, we link such differences to horizontal and vertical spatial contrasts and how convective representations translate them into precipitation changes.
An Investigation of the Effective Climate Sensitivity in GFDL’s New Climate Models CM4.0 and SPEAR
Authors: Zhao Ming
Published: May 2022

Despite a relatively low climate sensitivity indicated by atmospheric-only simulations with uniform sea surface temperature (SST) warming, GFDL’s new climate model CM4.0 participating in CMIP6 and the seasonal-to-decadal prediction system SPEAR, both of which use an identical atmospheric model AM4.0, produce relatively high effective climate sensitivity (EffCS). The substantial increase in CM4.0’s EffCS is found to be caused by additional positive forcing associated with the CO2 fertilization effect on vegetation, enhanced positive feedback due to stronger reduction in Southern Hemisphere (SH) sea ice concentration (SIC), and clouds whose feedback depends on SST warming patterns. Compared to a SPEAR run using a static vegetation model (SPEAR-SV), CM4.0 produces roughly 30% larger EffCS, among which roughly 1/3 of the increase is due to dynamical vegetation with the rest due primarily to changes in SIC. Although cloud feedback does not explain the key feedback differences among CM4.0, SPEAR, and SPEAR-SV, it is the primary cause of the models’ increase (less negative) in TOA net feedback during the later period of their quadrupling CO2 simulations due to changes in their SST warming patterns. Moreover, CM4.0’s SST warming pattern and its effects on cloud feedback appear to be the leading cause of CM4.0’s EffCS increase compared to the earlier generation GFDL model ESM2M, which produces one of the lowest EffCS values among CMIP5 models. In comparison, CM4.0’s enhanced reduction in SH SICs plays a slightly less important role in its increase in EffCS compared to ESM2M.
Remotely Monitored Buoys for Observing the Growth and Development of Sea Ice In Situ
Authors: Obbard Rachel W. , Bradley Alice C. , Rigor Ignatius
Published: May 2022

This paper describes a remotely monitored buoy that, when deployed in open water prior to freeze up, permits scientists to monitor not only temperature with depth, and hence freeze up and sea ice thickness, but also the progression of sea ice development—e.g., the extent of cover at a given depth as it grows (solid fraction), the brine volume of the ice, and the salinity of the water just below, which is driven by brine expulsion. Microstructure and In situ Salinity and Temperature (MIST) buoys use sensor “ladders” that, in our prototypes, extend to 88 cm below the surface. We collected hourly measurements of surface air temperature and water temperature and electrical impedance every 3 cm to track the seasonal progression of sea ice growth in Elson Lagoon (Utqiaġvik, Alaska) over the 2017/18 ice growth season. The MIST buoy has the potential to collect detailed sea ice microstructural information over time and help scientists monitor all parts of the growth/melt cycle, including not only the freezing process but the effects of meteorological changes, changing snow cover, the interaction of meltwater, and drainage.

Significance Statement

There is a need to better understand how an increasing influx of freshwater, one part of a changing Arctic climate, will affect the development of sea ice. Current instruments can provide information on the growth rate, extent, and thickness of sea ice, but not direct observations of the structure of the ice during freeze up, something that is tied to salinity and local air and water temperature. A first deployment in Elson Lagoon in Utqiaġvik, Alaska, showed promising results; we observed fluctuations in ice temperatures in response to brief warmings in air temperature that resulted in changes in the conductivity, liquid fraction, and brine volume fraction within the ice.
Skill Assessment of NCEP Three-Way Coupled HWRF–HYCOM–WW3 Modeling System: Hurricane Laura Case Study
Authors: Kim Hyun-Sook , Meixner Jessica , Thomas Biju , G. Reichl Brandon , Liu Bin , Mehra Avichal , Wallcraft Alan
Published: May 2022

In this research, we develop a three-way coupled prediction system to advance the realization of air–sea interaction processes. This study considers the sea-state-dependent momentum flux and nonlinear interactions between waves, winds, and ocean currents using the U.S. National Centers for Environmental Prediction’s operational Hurricane Weather Research and Forecasting (HWRF)-Hybrid Coordinate Ocean Model (HYCOM) coupled modeling system. Wave feedback is performed through the air–sea interaction module (ASIM) added to WAVEWATCH III (WW3), which employs the wave boundary layer to parameterize unresolved high-frequency tail spectra by using the mean flux profile constructed from the conservation of total momentum and wave energy. The atmospheric momentum flux is updated using the sea-state-dependent Charnock coefficient, wave-induced stress, and ocean surface currents before being passed to HYCOM. Wave coupling in HYCOM includes Coriolis–Stokes forcing to simulate wave–current interactions and to enhance mixing to account for Langmuir turbulence. The fully coupled system is tested for Hurricane Laura (2020). This paper examines the forecast skills of the individual component models by comparing simulations with observations. Without skill degradation of HYCOM and WW3, the three-way coupling method improves the track and intensity forecast skills by 5% each over those of HWRF-HYCOM coupling, and 27% and 17% over those of uncoupling, respectively. Importantly, this fully coupled system outperforms rapid intensification by reducing the intensification magnitude and matching the occurrence and duration. Overall, the forecast performance evaluated in the study establishes a baseline for the next-generation hurricane prediction system.

Significance Statement

This study is the documentation of the numerical advancement of tropical cyclone (TC) forecasting and the demonstration of the improvement of the TC intensity forecast. A key asset is the importance of wave coupling and inclusion of the nonlinear interactions in the air–sea interaction zone, and is to advance the current U.S. NCEP operational coupled hurricane modeling system. By assessing simulations for Hurricane Laura (2020), we demonstrate skill improvement of the storm structure, and intensity forecasts, especially for rapid intensification (RI) by correcting the timing and the magnitude of RI simulated by uncoupling and two-way coupling.
Formal commitments versus actual practices? Narratives as tools of epistemic governance in the debate over Finnish forestry
Authors: Sivonen Marja H , Syväterä Jukka
Published: May 2022

Nation states often end up adopting practices that are incongruent with their formal commitments to international efforts, such as mitigation of climate change. Although the necessity of a transfer towards carbon-neutral societies is widely understood, such decoupling is a challenge to transition. This study analyses the political discourse in the Finnish media from 2017 to 2018 around the European Union's Land Use, Land Use Change and Forestry (LULUCF) Regulation. The discourse embodies a contradiction, as the Finnish government sought to justify its aim to log a record amount of forest while officially pledging to climate change mitigation. The forest industry and the government launched a major lobbying campaign to influence the regulation calculations to be adopted by the European Union. Several representatives of the scientific community rose to oppose the government's plan of action by distributing scientific knowledge on the negative climate effects caused by extensive forestry; a vigorous public debate around the correct ways to use this natural resource ensued. Our analysis identifies three prevailing narratives, each portraying and resolving the contradiction in a distinct way. We argue that narratives work as tools of epistemic governance and demonstrate how policy actors selectively weave scientific knowledge into such narratives.
Laparoscopic Heller Myotomy With EGD and Balloon Dilation: A Durable Solution for Achalasia
Authors: Zambetti Benjamin R. , Murphy William G. , Craner Domenic , Wong Denise L. , Pettigrew Benjamin D. , Webb David L. , Voeller Guy R. , Stoikes Nathaniel F. N.
Published: May 2022

Background

Laparoscopic Heller myotomy (LHM) and esophageal balloon dilation (BD) are the two mainstays of achalasia treatment—this study examines the outcomes when they are performed simultaneously without fundoplication.

Methods

All patients undergoing LHM&BD were reviewed for demographic and procedural data, and to see if additional procedures for achalasia had been performed. Patients were surveyed using the Eckardt score and the GERD quality-of-life score (GERD-HRQL) to assess the durability of repair.

Results

From 2013-2020, 66 patients underwent LHM&BD. There were no esophageal perforations and a median LOS of 1 day. Seven patients have required additional operations or procedures at median 4-years follow up. 31 patients (47%) responded to the survey. The average Eckardt score was 2.9 (goal<4) with mean GERD-HRQL of 14.4 (goal<25).

Conclusions

LHM&BD allows for a safe, durable repair of achalasia. Reflux symptoms are manageable with PPI without fundoplication and the re-intervention rate similar to published values.
Creating a Welcoming Surgery Residency Training Program for LGBTQ Trainees
Authors: Pernar Luise I. , Hess Donald T.
Published: May 2022

General Surgery residencies have been perceived as unwelcoming to lesbian, gay, bisexual, transgender, and queer (LGBTQ) applicants. Historically, applicants have been reluctant to reveal their LGBTQ status when interviewing for residency positions and LGBTQ surgery residents are more likely to consider leaving their residency. Despite the increased acceptance in society and calls for diversity by governing bodies, there is a perception that the field of surgery is lagging behind. In this article, we summarize the recent literature concerning LGBTQ status in surgery residencies and the impact it has on students and trainees. We then review the recent calls to action to remedy the identified shortcomings. We then share what has been done by our surgery residency, which has been successful in recruiting LGBTQ-identifying residents and summarize recommendation for moving forward.
Racial residential patterns in Singapore: What happens after the implementation of racial quotas in public housing?
Authors: Yap Yvonne
Published: May 2022

The Ethnic Integration Policy in Singapore functions to socially engineer ethnic desegregation in public housing. Aside from investigating whether the Ethnic Integration Policy has truly achieved its stated goal, urban researchers have also devoted much attention to investigating the Ethnic Integration Policy’s secondary effects, such as how it has facilitated the creation of divergent resale housing markets for different ethnic groups. Most of these studies focus on the Ethnic Integration Policy’s effects at a household level. Little attention, however, has been paid to the straightforward question of how and to what extent the Ethnic Integration Policy contributes to geographic stratification in Singapore. Anecdotally, Singaporeans find it easy to name which neighbourhoods contain clusters of rich or poor households or which neighbourhoods are popular ethnic enclaves, but researchers have yet to develop a formal model of how the Ethnic Integration Policy and social-economic inequality interact. Using a mix of planning area and survey data, this article examines the spatial relationships between the Ethnic Integration Policy and ethnic and socio-economic clusters in Singapore. This article finds that contrary to past literature that have mostly attributed racial clustering as occurring among racial minorities, racial clustering occurs mostly among the Chinese when nation-level residential change is considered.
Does inequality exacerbate status anxiety among higher earners? A longitudinal evaluation
Authors: Bartram David
Published: May 2022

According to The Spirit Level, inequality is bad for everyone—including people with higher incomes. That conclusion is evident also in research exploring the impact of inequality on status anxiety. But existing research on this topic is cross-sectional (and gives too much weight to statistical significance). I construct a longitudinal analysis to explore whether status anxiety increases with inequality, especially among higher earners. I use country-level averages of status anxiety for this purpose and ignore individual-level control variables, on the grounds that they are not antecedents of the focal independent variable, inequality. In contrast to previous research, I find that increases in inequality lead to lower levels of status anxiety for higher earners. People at the top appear to benefit from inequality in this sense—a finding that runs against the idea that inequality is bad for everyone.
Social exclusion of US immigrants in the 21st century: A systematic review of qualitative studies
Authors: Lee Sunwoo
Published: May 2022

Corresponding to the growth of the immigrant population in the late-20th and early-21st centuries, immigrants’ difficulties have been intensified and diversified in the United States. Drawing on the lens of social exclusion, this study aims to synthesize recent qualitative studies on immigrants’ challenges in the United States. This study conducted a systematic review with 22 studies on immigrants’ exclusion experiences. Results from this study indicate several types of immigrants’ social exclusion and barriers to their inclusion. The findings of this study fortify our understanding of the social exclusion dynamics among immigrants and provide meaningful implications for their social inclusion.
Signaling Strength with Handicaps
Authors: Reich Noam
Published: May 2022

In the presence of incomplete information, strong states have an incentive to invest in costly signals that can differentiate them from weaker states. I argue that states can signal strength by handicapping themselves, deliberately reducing their combat effectiveness. In an ultimatum crisis bargaining model, I show that strong states can reduce the risk of war by making themselves weaker without reducing their demands. The key to this result is a comparative advantage that allows stronger types to fight more effectively with handicaps. This allows for an equilibrium where (1) stronger states adopt larger handicaps, thereby revealing their strength to the receiver, (2) larger handicaps are more likely to deter the receiver, and, (3) the positive risk of war precludes weaker types from imitating handicap signals. The ability to reveal strength peacefully has important ramifications for theories of mutual optimism, war termination, and the relationship between parity and war incidence.
Joint Specificity and Lateralization of Upper Limb Proprioceptive Perception
Authors: Abi Chebel Najib M. , Roussillon Nadege A. , Bourdin Christophe , Chavet Pascale , Sarlegna Fabrice R.
Published: May 2022

Proprioception is the sense of position and movement of body segments. The widespread distribution of proprioceptors in human anatomy raises questions about proprioceptive uniformity across different body parts. For the upper limbs, previous research, using mostly active and/or contralateral matching tasks, has suggested better proprioception of the non-preferred arm, and at the elbow rather than the wrist. Here we assessed proprioceptive perception through an ipsilateral passive matching task by comparing the elbow and wrist joints of the preferred and non-preferred arms. We hypothesized that upper limb proprioception would be better at the elbow of the non-preferred arm. We found signed errors to be less variable at the non-preferred elbow than at the preferred elbow and both wrists. Signed errors at the elbow were also more stable than at the wrist. Across individuals, signed errors at the preferred and non-preferred elbows were correlated. Also, variable signed errors at the preferred wrist, non-preferred wrist, and preferred elbow were correlated. These correlations suggest that an individual with relatively consistent matching errors at one joint may have relatively consistent matching errors at another joint. Our findings also support the view that proprioceptive perception varies across upper limb joints, meaning that a single joint assessment is insufficient to provide a general assessment of an individual’s proprioception.
Regional Peripheralization as Contextual Source of Populist Attitudes in Germany and Czech Republic
Authors: Dvořák Tomáš , Zouhar Jan , Treib Oliver
Published: May 2022

This article seeks to shed more light on the reasons for the regionally uneven distribution of populist attitudes. We take into account both individual-level and contextual drivers and focus mainly on the latter. We argue that regional peripheralization processes are a key contextual condition driving populist attitudes, especially in post-communist settings. The empirical analysis is based on a unique dataset combining comparable items from two representative surveys covering Germany ( N = 2112) and the Czech Republic ( N = 1000) with economic and demographic characteristics of relevant regional contexts in both countries (167 constituencies in Germany and 77 districts in the Czech Republic). Using multilevel regression models, the article shows that individual-level characteristics do not alone drive populist attitudes. In contrast, the results show that living in peripheral areas of the Czech Republic and eastern Germany increases the likelihood of having populist attitudes. These peripheries are characterized by unfavourable economic conditions in the Czech Republic and demographic decline in eastern Germany.
Decision-Making Process for the Implementation of the Child Therapeutic Support Limitation Plan: Nurses' Experiences
Authors: Nilson Cristine , Vieira Ana Cláudia , de Moura Bubadué Renata , Stein Renato Tetelbom , Lago Patricia Miranda
Published: May 2022

Aim: To present nurses’ experience in the decision-making process for implementing a therapeutic support limitation plan in the PICU. Method: Qualitative exploratory research was conducted through semi-structured interviews with 25 intensive care nurses from January to June 2019. The textual corpus was then submitted for content analysis. Results: Two categories emerged: the nurse and decision-making process of the TSLP and ambivalence of the participating nurse’s feelings in implementing the TSLP. These categories are interrelated in that the decision-making process mobilizes the ambivalence of the participating nurses’ feelings. Final considerations and implications for practice: The starting point of communication between the health teams consists of acquiring information about the concerned child’s end-of-life care plan with no prospect of cure and with some form of therapeutic limit admitted to the PICU. Therefore, this study helps to map possible research gaps on the topic and mobilize researchers to build educational materials, protocols, and tools for comprehensive care that can be used by nurses when faced with ethical dilemma, such as decision-making through TSLP.
Ambivalent borders and hybrid culture: The role of culture and exclusion in historical European discourses of migration
Authors: Ayame Hiraide Lydia
Published: May 2022

This article reflects on historical arguments about migration in conceptualisations of Europe, highlighting an ambivalent support of migration within Europe on the grounds of mutual cultural enrichment. There is a strong tradition, dating back to French and German eighteenth-century thinkers, such as Herder, Voltaire and Fichte, of citing cultural diversity, plurality and exchange to construct an idea of Europe. ‘Europolitanism’, the ideal of Europe as an open space of welcome movement and unprejudiced exchange, conceals, however, exclusionary tendencies: exchange has never been intended for all social groups. Contemporary theorisations of Europe, based ostensibly on cultural exchange, synthesis and plurality, have their roots in Romantic and Enlightenment thought, but then as now there are questions to be asked about participation in pan-European identity formation.
Mariátegui, Race, and the Comintern’s National Question
Authors: Becker Marc
Published: May 2022

José Carlos Mariátegui’s open engagement with Marxist theory and his adaptation of its ideas to his Latin American reality brought him into conflict with other leftists. At a continental conference of communist parties in Buenos Aires in 1929, he criticized the Comintern’s proposal to carve up the Americas into independent African-descent and Quechua and Aymara republics, arguing that conceptualizing the struggle in ethnic rather than class terms was a mistake. From documents preserved in the Comintern archives it appears that these comments had echoes in Moscow. Two newly translated Spanish-language documents on the “national question” challenge notions that Comintern officials were unaware of or ill-informed about developments in Latin America and are important to understanding their responses and challenges to his ideas on race and oppressed nationalities.

El compromiso abierto de José Carlos Mariátegui con la teoría marxista y su adaptación de estas ideas a la realidad latinoamericana lo pusieron en conflicto con otras y otros de la izquierda. En una conferencia continental de partidos comunistas en Buenos Aires en 1929, criticó la propuesta de la Internacional Comunista de dividir las Américas en repúblicas independientes afrodescendientes y quechuas y aymaras, argumentando que conceptualizar la lucha en términos étnicos en lugar de términos de clase era un error. Los documentos conservados en los archivos de la Internacional Comunista sugieren que estos comentarios hicieron eco en Moscú. Dos documentos en español recientemente traducidos en torno a la “cuestión nacional” desafían las nociones de que los funcionarios de la Internacional Comunista no estaban al tanto o estaban mal informados sobre los acontecimientos en América Latina, asunto que resultan importante para comprender sus respuestas y desafíos a las ideas de Mariátegui sobre raza y nacionalidades oprimidas.
‘Walking a fine line’: Union perspectives on partnership in nursing and midwifery workplaces
Authors: Guillaume Cécile , Kirton Gill
Published: May 2022

Drawing on qualitative research in the main UK unions for nurses/midwives, this article explores union reps’ views of the functioning of workplace partnership in two feminized professions working in the English National Health Service (NHS). Through the investigation of two professional unions, which despite their vitality remain under-researched, the study offers an investigation of the interactions between formal and informal partnership arrangements at the workplace level, the ways in which they intersect with the professional nature of the union context, and the deterioration of working conditions. In doing so, this article contributes to reflections on the prospects of workplace partnership for professional trade unions.
Unmet Needs of Individuals With Acute Traumatic Eye Injury
Authors: Gerolamo Angela M. , Gentsch Alexzandra , Alexander Rachel , Paglia Helen , Schlegel Lauren , Rising Kristin L.
Published: May 2022

Introduction: Although traumatic eye injuries can have a far-reaching impact on an individual and society, traumatic eye injury has not been a focus of research. The purpose of this study is to examine individuals’ experiences after traumatic vision loss and identify their needs. Methods: We used a qualitative approach to conduct semi-structured interviews with individuals who experienced traumatic vision loss and were treated at a specialty eye hospital in an urban setting. Participants also completed a demographic survey and the National Eye Institute Visual Functioning Questionnaire–25 (VFQ-25). Content analysis was used to analyze qualitative data and descriptive statistics were used to summarize quantitative data. Results: Interviews with 26 participants resulted in three categories of patient needs: informational, functional, and psychosocial. Participants wanted more information from providers about what to expect over time and identified driving as a significant challenge that affected their daily lives. Participants offered suggestions for addressing their functional needs including assistance with transportation to appointments, physical therapy, and occupational therapy. Participants also discussed how vision loss affected their livelihood and finances, with a subset of participants experiencing significant mental health distress. Some participants suggested that a recovery coach, peer support, support groups, and mental health services would be beneficial for addressing their psychosocial needs. Discussion: Our findings point to a significant gap in services available to meet the needs of individuals with traumatic eye injuries. Future research is needed to test the effect of an integrated-care model that includes routine offering of psychosocial and functional services for patients with acute vision loss to determine the effect on outcomes. Implications for Practitioners: This work has far-reaching implications for providers, since it supports the need for the development and delivery of integrated interventions that emphasize addressing psychosocial and functional aspects of recovery.
ECMO simulation training during a worldwide pandemic: The role of ECMO telesimulation
Authors: Wong Alfred SK , Marwali Eva M , Maclaren Graeme , Ogino Mark , Fraser John , Chi Keung Peter Lai , Fitria Liza , Adriane Prieta , Sin Simon WC
Published: May 2022

Background:

Extracorporeal membrane oxygenation (ECMO) is a supportive therapy used in the most severe forms of acute respiratory distress syndrome. Due to its intrinsic complexity and relatively low annual volume, simulation is essential for efficient and appropriate ECMO management. COVID-19 has limited the opportunities for high-fidelity in-person simulation training when many hospitals are looking to expand their ECMO services to battle the ongoing pandemic. To meet this demand, the National Cardiovascular Center Harapan Kita, Jakarta, Indonesia, conducted a 3-day ECMO course entailing online didactic lectures (adult and paediatric stream), water drills and telesimulation.

Purpose:

The purpose of the study is to report the evaluation result of this novel model of education during COVID-19 outbreak.

Data collection:

Participants were given an ECMO knowledge pre-course and post-course test and a telesimulation evaluation survey at the conclusion and these data were collected.

Results:

The course was attended by 104 physicians, critical care nurses and perfusionists. Pre-course and post-course assessments showed a significant improvement in ECMO knowledge (60.0% vs 73.3%, respectively). Overall, the participants rated the telesimulation positively, and most found it acceptable to in-person simulation training considering the pandemic restrictions.

Conclusion:

Despite the complexities of ECMO, our recent experience demonstrates ECMO education and simulation delivered online is feasible, welcomed and supportive of a change in ECMO training course format. As we incorporate more innovative digital technologies, telesimulation may further enhance the quality of future ECMO training.
Development of Perceived Family Support and Positive Mental Health in Junior High School Students: A Three-Year Longitudinal Study
Authors: Hu Shiyue , Cai Dan
Published: May 2022

The study aimed to explore the development trend of positive mental health and the interaction between adolescents’ perceived family support and positive mental health. A 3-year longitudinal survey of perceived family support and positive mental health (resilience and self-efficacy) for four waves was conducted with 564 junior high school students (297 girls, mean age = 11.12 ± 0.38 years at baseline). The Latent Growth Curve Modeling indicated that adolescents’ resilience and general self-efficacy showed a curve upward trend, which increased first and then decreased. The development rate decreased each year. The cross-lagged panel model and a random intercept cross-lagged panel model concluded that perceived family support was strongly associated with positive mental health of junior high school students. Family support was important for developing positive mental health in early adolescence. Therefore, attention and interventions targeting positive mental health changes in early adolescence are particularly effective. And, it is important to encourage parents of adolescents to continue to provide support and guidance.
Giant cervical goiter in Hashimoto’s thyroiditis: A case report
Authors: Tao Tang , Gang Yang , Ji Sun , Xiao-Li Chen , Wei-Nan Li , Qiang Li , Jian-Jiao Zhu , Yong-Fu Xiong , Jing-Dong Li
Published: May 2022

A giant cervical goiter, defined as a thyroid mass larger than 8 cm in diameter, is usually a nodular or adenomatous goiter. A giant cervical goiter can also be caused by hyperthyroidism (i.e., Hashimoto’s thyroiditis). The surgical indications for patients with Hashimoto’s disease include suspected malignant tumors, persistent symptoms related to the disease, or persistent enlargement of the goiter. We herein describe a woman who developed symptoms of compression from a thyroid tumor, the volume of which was almost the largest reported in the relevant literature to date. The bilateral lobes of the giant thyroid tumor were removed by total en bloc excision. We protected the bilateral recurrent laryngeal nerve and preserved the bilateral upper and lower parathyroid glands in situ. The excised left lobe tumor was 16 × 9 × 5.5 cm, whereas the right lobe tumor was 12 × 8 × 4 cm. The pathological diagnosis was Hashimoto’s thyroiditis. Although surgical excision is difficult, it is still the main treatment modality for giant goiters in patients with Hashimoto’s thyroiditis and can help to reduce the occurrence of complications.
Face learning via brief real-world social interactions induces changes in face-selective brain areas and hippocampus
Authors: Sliwinska Magdalena W. , Searle Lydia R. , Earl Megan , O’Gorman Daniel , Pollicina Giusi , Burton A. Mike , Pitcher David
Published: May 2022

Making new acquaintances requires learning to recognise previously unfamiliar faces. In the current study, we investigated this process by staging real-world social interactions between actors and the participants. Participants completed a face-matching behavioural task in which they matched photographs of the actors (whom they had yet to meet), or faces similar to the actors (henceforth called foils). Participants were then scanned using functional magnetic resonance imaging (fMRI) while viewing photographs of actors and foils. Immediately after exiting the scanner, participants met the actors for the first time and interacted with them for 10 min. On subsequent days, participants completed a second behavioural experiment and then a second fMRI scan. Prior to each session, actors again interacted with the participants for 10 min. Behavioural results showed that social interactions improved performance accuracy when matching actor photographs, but not foil photographs. The fMRI analysis revealed a difference in the neural response to actor photographs and foil photographs across all regions of interest (ROIs) only after social interactions had occurred. Our results demonstrate that short social interactions were sufficient to learn and discriminate previously unfamiliar individuals. Moreover, these learning effects were present in brain areas involved in face processing and memory.
Rural Anaesthesia Practice: Attitudes and Recruitment following a Period of Anaesthetic Training in Rural and Regional Hospitals. A Survey of New Consultants
Authors: Dooney N. M. , Osborn K. D.
Published: May 2022

The provision of specialist anaesthetic services to rural and remote locations in Australia poses an ongoing challenge-Initiatives to improve delivery of specialist anaesthetic services include the provision of anaesthesia training opportunities at rural hospitals. Previous surveys of trainees demonstrated the positive effect of rural training on attitudes toward subsequent practice in rural areas. We aimed first to survey attitudes of specialist anaesthetists towards anaesthetic training at rural and regional hospitals. We then compared the current workplace of those who had experienced a period of training at rural/regional hospitals versus those who did not. A web-based survey was distributed to fellows of the Australian and New Zealand College of Anaesthetists who had commenced consultant practice in the preceeding five years. Six hundred and fifteen surveys were distributed with a response rate of 53%. Respondents held their rural training experience in high regard. Anaesthetic specialists with a period of training in rural/regional areas were more likely to subsequently practise in rural areas compared to those who did not.
What Role Does Geragogy Play in the Delivery of Digital Skills Programs for Middle and Older Age Adults? A Systematic Narrative Review
Authors: Gates Jessica R. , Wilson-Menzfeld Gemma
Published: May 2022

This systematic narrative review aimed to explore the implementation and delivery of digital skills programs for middle and older age adults; and understand the presence of adult learning theory (namely, geragogy/critical geragogy) in their delivery. A database search was undertaken to examine international literature, published between 2010 and 2020. From 1,713 papers identified during the database searches, 17 papers were included. Thematic synthesis was used to analyze the papers in this review. Themes were generated relating to the implementation and delivery of digital skills programs: negative perceptions of aging; the learning environment; and value of technology. The role of geragogy/critical geragogy is not explicit in the delivery of digital skills programs in this review but has an underlying thread of empowerment and embodies the ethos of these learning theories to some extent. The findings of this review have been used to develop recommendations for delivering digital skills to older adults.
Exploring Coping Strategies and Barriers in Dementia Care: A Mixed-Methods Study of African American Family Caregivers in Kentucky
Authors: Rote Sunshine M. , Moon Heehyul E. , Kacmar Allison M. , Moore Sharon
Published: May 2022

This study explores coping strategies and barriers to dementia care experienced by African American dementia caregivers in Kentucky. Utilizing a convergent mixed-method design integrating focus group and survey data on African American dementia caregivers recruited through churches in Kentucky ( N = 28), we elucidate three coping strategies: love-based coping, religion-based coping, and family support. Results from survey data supported these themes, with over 90% of participants reporting that they provide care to give back to family members and for religious reasons. However, over half of the caregivers’ reported strain due to three barriers identified by focus group data: time constraints, low support, and the high cost of formal care. This exploratory study highlights the importance of intervention tactics for African American dementia caregivers that focus not only on individual and family support but also community-based outreach and support.
Driving, Social Distancing, Protective, and Coping Behaviors of Older Adults Before and During COVID-19
Authors: Roe Catherine M. , Bayet Sayeh , Hicks Jamie , Johnson Ann M , Murphy Samantha , Doherty Jason M. , Babulal Ganesh M.
Published: May 2022

A thorough understanding of individual characteristics of older adults during the COVID-19 pandemic is critical for managing the ongoing pandemic course and planning for the future pandemics. Here, we explore the impact of the COVID-19 pandemic on driving, social distancing, protective, and coping behaviors of older adults. This study reports data on participants aged above 65 whose driving behaviors are being monitored using Global Positioning System (GPS) devices. Participants completed a COVID-19 survey in May 2020. We found that older adults decreased their number of days driving, number of trips per day, as well as average driving speed, and had fewer speeding incidents following COVID-19 onset. We also show that female and African American older adults engaged in more positive coping and cleaning behaviors, and had greater decreases in the number of days driving during the pandemic. The findings highlight the importance of considering older adults’ individual characteristics for an equitable response to the COVID-19 pandemic.
Purpose in Life and Cognition Interact to Impact Healthcare and Financial Decision Making in Old Age
Authors: Stewart Christopher C. , Yu Lei , Glover Crystal M. , Bennett David A. , Wilson Robert S. , Boyle Patricia A.
Published: May 2022

Objectives: Little is known about the contribution of positive psychological factors, such as purpose in life, to healthcare and financial decision making in aging. Here, we examined the relationship between purpose and decision making and tested the hypothesis that purpose benefits decision making, particularly when cognition is limited. Methods: Participants were 1081 community-based older adults without dementia. Healthcare and financial decision making was measured via a 12-item performance-based instrument. Purpose was measured via a 10-item scale. Results: In a linear regression model adjusted for age, sex, and education, higher global cognition was associated with better performance on the decision making measure, as expected. Purpose was not directly related to decision making. However, the interaction of purpose with cognition was significant, such that greater purpose was associated with better decision making among persons with lower cognition. Discussion: Purpose in life may promote better decision making among older adults with lower cognition.
Is it a Macho Thing? Older Adults’ Perceptions of Gender Differences inFall Prevention Class Participation
Authors: Arnold Catherine , Lanovaz Joel , Banman Danelle
Published: May 2022

Perceptions that women are in greater need of fall prevention might impact their participation in programs. This study aimed to understand gender differences in motivating factors and experiences in a fall prevention program. Thirty-four adults (18 men and 16 women) aged 60 years or older participated in focus groups after 12 weeks of fall prevention exercises and education. Six main themes emerged. It might be a macho thing represented an overarching theme of why men might not participate in fall prevention as readily as women. Personal experience as a motivator, Get my balance back, and Challenges/Successes were common themes for men and women. Both genders realized the benefits of the program; however, men emphasized the importance of personal outcomes ( Being part of something bigger), whereas women highlighted group outcomes ( Socialization). These findings can guide the future messaging and marketing of fall prevention programs for older adults.
Communication of Code Status Escalation for Nurses and Physicians in the Intensive Care Unit: A Case Study
Authors: Paddley Brianna , Espin Sherry , Indar Alyssa , Rose Don , Bookey-Bassett Sue
Published: May 2022

Background

Interprofessional teams working in the Intensive Care Unit (ICU) care for patients requiring varying degrees of life sustaining therapy. A patient's code status can help clinicians to understand the appropriate life support measures to deliver to patients in this setting. Members of the interprofessional team, such as physicians and nurses, can experience challenges related to communication when the code status is unclear.

Purpose

The purpose of this study was to explore how nurses and physicians in the ICU experience communication of code status escalations.

Methods

A qualitative case study approach was used. Participants were physicians and nurses, working in the medical-surgical ICU of a large, urban academic hospital. Data were collected using semi-structured interviews, observations of health care rounds and a chart review. Data were analyzed using qualitative content analysis.

Results

Thematic findings include: (1) engaging in an interprofessional discussion, (2) finding consistent documentation, (3) revisiting the code status, and (4) telling the patient story. The study findings also provide contextual information about participants’ experiences of code status communication during the first wave (February 2020 to May 2020) of the COVID-19 pandemic.

Conclusions

The results of this study could inform standard communication frameworks or practices related to dissemination of code status decisions among members of the ICU team.
An injectable thermosensitive hydrogel/nanomicelles composite for local chemo-immunotherapy in mouse model of melanoma
Authors: Akbari Vajihe , Hejazi Elham , Minaiyan Mohsen , Emami Jaber , Lavasanifar Afsaneh , Rezazadeh Mahboubeh
Published: May 2022

Recently, cancer immunotherapy and its combination with chemotherapy has been considered to improve therapeutic efficacy with lower systemic toxicity. Here, we prepared a thermosensitive hydrogel based hyaluronic acid (HA) encapsulated with macrophage colony-stimulating factor (GM-CSF) and paclitaxel (PTX) for chemoimmunotherapy of cancer. For this purpose, the micelles were prepared with the mixture of pluronic F127 (PF127) and tocopheryl polyethylene glycol (TPGS) and loaded with PTX. In the following step, thermosensitive hydrogel using PF127 and HA was prepared and co-encapsulated with the micelles and GM-CSF. Rheological performance, friability, release patterns for PTX and GM-CSF, and stability of GM-CSF in the hydrogel were evaluated in details. In-vitro and in vivo immunologic activities of GM-CSF in the hydrogel were also evaluated via numbering macrophages and recruited DCs in transwells and after subcutaneous injection of the GM-CSF-loaded hydrogel. Finally, mouse model of subcutaneous melanoma was induced in female C57 mice using B16 F10 cell line and the effect of optimized formulation was evaluated based on tumor volume and histological analysis. The hydrogel could maintain the biological activity of the incorporated drugs and exhibited a more prolonged release for PTX compared to GM-CSF. GM-CSF-releasing HA/PF127 hydrogel successfully recruited macrophages in vitro. Moreover, the most potent anti-tumor effect was observed following the intra-tumoral injection of the optimized formulation in melanoma bearing mice, compared to immunization by the GM-CSF and PTX alone. The current formulation shows a great promise to conquer resistant malignancies and provides a new approach for co-encapsulating of hydrophobic anticancer drugs and growth factor.
Expanding and Testing a Latinx Differential Coercion and Social Support Theory of Crime
Authors: Curry Theodore R. , Zavala Egbert
Published: May 2022

We develop and test an extension of differential coercion and social support (DCSS) theory focused on Latinx individuals that employs measures of coercion and social support, both at the individual and environmental levels, that may be especially salient to this population. Data come from Latinx adults (n=863) randomly sampled from El Paso County, Texas and were analyzed using logistic and OLS regression analyses and employed the PROCESS Macro for assessing mediating relationships. Findings show moderate support for hypotheses. Specifically, a structural measure of social support (neighborhood social support) was inversely associated with family violence and mediated relationships between three separate measures of coercion and family violence, supporting predictions. However, two cultural measures of social support (enculturation to Mexico and familismo) did not demonstrate such relationships, failing to support predictions. Additional findings show that two of the three measures of coercion (neighborhood crime and disorder and police harassment) were inversely associated with family violence as predicted, but that a third measure, acculturation to the U.S., was not. Implications for DCSS theory and criminal offending for Latinx are discussed.
Special Education Teachers’ Preservice Experience With Inclusive Postsecondary Education Programs: Impact on Professional Practices and Dispositions for Secondary Transition Professionals
Authors: Plotner Anthony J. , Marshall Kathleen J. , Smith-Hill Rebecca B.
Published: May 2022

Highly qualified and well-prepared transition professionals are arguably the most important piece to improve postsecondary outcomes for youth with diverse needs. A dearth of dynamic field placements for preservice teachers to connect coursework to practice has been identified as a gap in teacher training. This need could be potentially filled by facilitating opportunities for preservice teachers to work in an inclusive postsecondary education program for college students with disabilities as these programs become more prevalent across the country. Researchers used a mixed-methods sequential design to examine the perceptions of graduates from a special education program regarding their experience in working with an inclusive postsecondary education program (IPSE) while completing their coursework. Researchers found that all survey respondents indicated working within an IPSE had an important impact on their current professional lives working with individuals with disabilities. Specifically, four major themes emerged from interviews regarding practices and philosophy shifts. Furthermore, findings showed that building rapport with students, advocating for students and facilitating inclusive outcomes had an impact on them as professionals. Reported changes in overall beliefs before and after working with the IPSE were also found. These findings are discussed and implications are provided.