bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the performance of existing and novel equivalence tests for fit indices in structural equation modelling
Authors: Beribisky Nataly , Cribbie Robert A.
Published: July 2023

It has been suggested that equivalence testing (otherwise known as negligible effect testing) should be used to evaluate model fit within structural equation modelling (SEM). In this study, we propose novel variations of equivalence tests based on the popular root mean squared error of approximation and comparative fit index fit indices. Using Monte Carlo simulations, we compare the performance of these novel tests to other existing equivalence testing‐based fit indices in SEM, as well as to other methods commonly used to evaluate model fit. Results indicate that equivalence tests in SEM have good Type I error control and display considerable power for detecting well‐fitting models in medium to large sample sizes. At small sample sizes, relative to traditional fit indices, equivalence tests limit the chance of supporting a poorly fitting model. We also present an illustrative example to demonstrate how equivalence tests may be incorporated in model fit reporting. Equivalence tests in SEM also have unique interpretational advantages compared to other methods of model fit evaluation. We recommend that equivalence tests be utilized in conjunction with descriptive fit indices to provide more evidence when evaluating model fit.
Third ventricular width by transcranial sonography is associated with cognitive impairment in Parkinson's disease
Authors: Gao Hong‐ling , Qu Yi , Chen Sheng‐chong , Yang Qing‐mei , Li Jing‐yi , Tao An‐yu , Mao Zhi‐juan , Xue Zheng
Published: July 2023

Background

One‐fourth of Parkinson's disease (PD) patients suffer from cognitive impairment. However, few neuroimaging markers have been identified regarding cognitive impairment in PD.

Objective

This study aimed to explore the association between third ventricular width by transcranial sonography (TCS) and cognitive decline in PD.

Method

Participants with PD were recruited from one medical center in China. Third ventricular width was assessed by TCS, and cognitive function was analyzed by the Mini‐Mental State Examination (MMSE). Receiver operating characteristic (ROC) analysis and Cox model analysis were utilized to determine the diagnostic and predictive accuracy of third ventricular width by TCS for cognitive decline in PD patients.

Result

A total of 174 PD patients were recruited. Third ventricular width was negatively correlated with MMSE scores. ROC analysis suggested that the optimal cutoff point for third ventricular width in screening for cognitive impairment in PD was 4.75 mm (sensitivity 62.7%; specificity 75.6%). After 21.5 (18.0, 26.0) months of follow‐up in PD patients without cognitive impairment, it was found that those with a third ventricular width greater than 4.75 mm exhibited a 7.975 times higher risk of developing cognitive impairment [hazard ratio = 7.975, 95% CI 1.609, 39.532, p = 0.011] compared with patients with a third ventricular width less than 4.75 mm.

Conclusion

Third ventricular width based on TCS emerged as an independent predictor of developing cognitive impairment in PD patients.
Clinical outcomes of generic versus brand‐name clopidogrel for secondary prevention in patients with acute myocardial infarction: A nationwide cohort study
Authors: Chan Cze Ci , Tung Ying‐Chang , Lee Kuang‐Tso , Chan Yi‐Hsin , Chu Pao‐Hsien
Published: July 2023

Skepticism exists among healthcare workers and patients regarding the efficacy and safety of generic medication, despite its potential to lower healthcare costs. This study aimed to compare the outcomes of a generic clopidogrel and its brand‐name counterpart for secondary prevention in patients with acute myocardial infarction (AMI). Using the Taiwan National Health Insurance Research Database, we identified 49,325 patients who were hospitalized for AMI between January 1, 2008 and December 31, 2013 and prescribed either generic or brand‐name clopidogrel. Among them, 2419 (4.9%) were prescribed the generic clopidogrel. After propensity score matching, both the generic and brand‐name groups consisted of 2382 patients. The primary efficacy outcome was a composite of myocardial infarction, coronary revascularization, ischemic stroke, and all‐cause death. The primary safety outcome was major bleeding requiring hospitalization. At a mean follow‐up of 2.5 years, the generic and brand‐name clopidogrel groups had comparable risks of primary efficacy outcome (41.9% vs. 42%; hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.88–1.04), and the risks of the individual components were also similar. There were no significant differences between the two groups in major bleeding (7.9% vs. 7.9%; HR 0.99; 95% CI 0.81–1.21). Subgroup analyses also revealed no statistically significant interactions between the treatment effect and various subgroups. In this retrospective database analysis, the generic clopidogrel was comparable to its brand‐name counterpart regarding cardiovascular and bleeding outcomes for the treatment of patients with AMI.
En face position of the major duodenal papilla using a reopenable clip during endoscopic retrograde cholangiopancreatography
Authors: Saito Hirokazu , Ikebata Akiko , Hashigo Shunpei
Published: July 2023

Watch a video of this article.
A teleological interpretation of Bonhoeffer's concept of “A World Come of Age”
Authors: Dankers Paul , Willerton Christian W.
Published: July 2023

This paper explores Dietrich Bonhoeffer's concept of “the nonreligious interpretation of biblical terms in a world come of age,” best known from his Letters and Papers from Prison (LPP). As a case study of its possibilities, we will survey South African thinkers who have explored the concept in rapidly changing contexts. Our leading question is whether academic theology can develop a teleological narrative for a nation that has “come of age.” When a nation or culture becomes so secular that it “outgrows” a traditional use of biblical terms, can those terms be reinterpreted to provide a teleological narrative for the nation? Bonhoeffer can be a resource for academic theologians to address issues in public theology, especially the suffering and oppression of communities still in pain despite a democratic system.
Counter‐terrorism and humanitarian action: UK INGO responses since 2015
Authors: Nadel Sam , Walton Oliver
Published: July 2023

There has been growing awareness in recent years of the wide‐ranging negative impacts that counter‐terrorism measures and sanctions impose on humanitarian action. Drawing on semi‐structured interviews with the staff of international non‐governmental organisations (INGOs), this paper examines these impacts on INGOs based in the United Kingdom. This is a context where a particularly complex array of laws, policies, and regulatory regimes have emerged alongside an increasingly hostile political and media setting for INGOs, creating an environment characterised by uncertainty. The paper shows that counter‐terrorism measures and sanctions are leading INGOs to adopt more conservative approaches to partnership in areas controlled by proscribed groups, undermining broader commitments to the localisation agenda. The analysis reveals that perceptions of risk within INGOs vary considerably, but that despite this, INGOs have developed strategies to reduce the impacts of counter‐terrorism measures, which over time, have led to improved coordination, and in some instances, a willingness to push back against regulations.
Temporal variation in nitrous oxide (N2O) fluxes from an oil palm plantation in Indonesia: An ecosystem‐scale analysis
Authors: Stiegler Christian , Koebsch Franziska , Ali Ashehad Ashween , June Tania , Veldkamp Edzo , Corre Marife D. , Koks Joost , Tjoa Aiyen , Knohl Alexander
Published: July 2023

The rapidly growing areal extent of oil palm (Elaeis guineensis Jacq.) plantations and their high fertilizer input raises concerns about their role as substantial N2O sources. In this study, we present the first eddy covariance (EC) measurements of ecosystem‐scale N2O fluxes in an oil palm plantation and combine them with vented soil chamber measurements of point‐scale soil N2O fluxes. Based on EC measurements during the period August 2017 to April 2019, the studied oil palm plantation in the tropical lowlands of Jambi Province (Sumatra, Indonesia) is a high source of N2O, with average emission of 0.32 ± 0.003 g N2O‐N m−2 year−1 (149.85 ± 1.40 g CO2‐equivalent m−2 year−1). Compared to the EC‐based N2O flux, average chamber‐based soil N2O fluxes (0.16 ± 0.047 g N2O‐N m−2 year−1, 74.93 ± 23.41 g CO2‐equivalent m−2 year−1) are significantly (~49%, p < 0.05) lower, suggesting that important N2O pathways are not covered by the chamber measurements. Conventional chamber‐based N2O emission estimates from oil palm up‐scaled to ecosystem level might therefore be substantially underestimated. We show that the dynamic gas exchange of the oil palm canopy with the atmosphere and the oil palms' response to meteorological and soil conditions may play an important but yet widely unexplored role in the N2O budget of oil palm plantations. Diel pattern of N2O fluxes showed strong causal relationships with photosynthesis‐related variables, i.e. latent heat flux, incoming photosynthetically active radiation and gross primary productivity during day time, and ecosystem respiration and soil temperature during night time. At longer time scales (>2 days), soil temperature and water‐filled pore space gained importance on N2O flux variation. These results suggest a plant‐mediated N2O transport, providing important input for modelling approaches and strategies to mitigate the negative impact of N2O emissions from oil palm cultivation through appropriate site selection and management.
The impact of expert by experience involvement in teaching in a DClinPsych programme; for trainees and experts by experience
Authors: Kerry Ellie , Collett Nicola , Gunn Jason
Published: July 2023

Introduction

There is a growing acknowledgement of the value of creating partnerships between those delivering and those accessing health services. Less is known about this in the context of clinical psychology doctoral training programmes. This study explores the models of involvement of experts by experience (EbEs) in teaching on a DClinPsych course in England; the impact of this both for EbEs and trainee clinical psychologists and whether improvements are required to better meet their needs.

Methods

An audit of current involvement was conducted by reviewing course records. Two survey questionnaires designed around commonly used frameworks of participation and reflective learning were completed by EbEs and trainees. Thematic Analysis was used to evaluate the written feedback from the surveys.

Results

Records of current EbE involvement were found to be lacking in detail and sometimes missing. Key themes extrapolated from the surveys highlighted the importance of EbE involvement in supporting the wellbeing of EbEs and the learning experiences of trainees.

Conclusions

Recommendations with regard to the processes for future involvement of EbEs in teaching are put forward.

Patient or Public Contribution

A carer of a service user was consulted about the design of the participant information sheet, consent form and the survey questionnaire which was sent to the EbEs. A trainee clinical psychologist was also consulted to provide a trainee perspective on the above forms and the survey questionnaire that was sent to trainees. Further to this, the first author's supervisor identifies as a user of physical and mental health services and provided continued supervision and support regarding the direction of the study including the research questions, design, methodology and interpretation of results.
Structure‐mechanical properties correlation in bulk LiPON glass produced by nitridation of metaphosphate melts
Authors: Torres Victor M. , Kalnaus Sergiy , Martin Steve W. , Duggan Caitlin , Westover Andrew S.
Published: July 2023

The glassy solid electrolyte Lithium phosphorous oxynitride (LiPON) has been widely researched in thin film solid state battery format due to its outstanding stability when cycled against lithium. In addition, recent reports show thin film LiPON having interesting mechanical behaviors, especially its ability to resist micro‐scale cracking via densification and shear flow. In the present study, we have produced bulk LiPON glasses with varying nitrogen contents by ammonolysis of LiPO3 melts. The resulting compositions were determined to be LiPO3‐3z/2Nz, where 0 ≤ z ≤ 0.75, and the z value of 0.75 is among the highest ever reported for this series of LiPON glasses. The short‐range order structures of the different resulting compositions were characterized by infrared, Raman, 31P magic angle spinning nuclear magnetic resonance, and X‐ray photoelectron spectroscopies. Instrumented nano‐indentation was used to measure mechanical properties. It was observed that similar to previous studies, both trigonally coordinated (Nt) and doubly bonded (Nd) N co‐exist in the glasses in about the same amounts for z ≤ 0.36, the limit of N content in most previous studies. For glasses with z > 0.36, it was found that the fraction of the Nt increased significantly while the fraction of Nd correspondingly decreased. The incorporation of nitrogen increased both the elastic modulus and hardness of the glass by approximately a factor of 1.5 when N/P ratio reaches 0.75. At the same time, an apparent embrittlement of the glass was observed due to nitridation, which was revealed by nanoindentation with an extra sharp nanoindenter tip.
‘I Am a Man’: Countering Oppression through Appeal to Kind Membership
Authors: Killmister Suzy
Published: July 2023

All too often, social kinds function as sites of oppression. To be a woman, to be Black, to be trans – each, in its own way, situates someone at the lower end of a social hierarchy. Membership in such groups thus constitutes a liability: notwithstanding the goods people draw from sharing in these identities, they also stand at perpetual risk of those same identities exposing them to significant harm. What, if anything, can members of oppressed groups do to counter that oppression? In this article I explore one possible strategy: people can – and do – strategically invoke their membership in what I call ‘anti‐oppressive kinds’, in order to contest the oppression they face qua members of oppressed groups. Focusing on one particularly salient anti‐oppressive kind, the human, I first offer an explanation as to how and why its invocation might be politically effective, before considering some hazards with its use.
The natural CAD/CAM anterior implant single tooth restoration: A novel digital workflow
Authors: Passos Leandro , de Vasconcellos Adalberto Bastos , Kanashiro Lucio , Kina Sidney
Published: July 2023

Objective

To report a novel digital workflow to replace an anterior maxillary tooth lost due to trauma with an implant multilayer restoration by using the patient's extracted tooth as a final crown restoration using computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology.

Clinical Considerations

Instead of using the patient's natural tooth as an immediate provisional restoration to achieve predictable results in terms of esthetics and soft tissue structure, a novel digital strategy was performed to obtain a natural final crown restoration by using the patient's tooth associated with a lithium disilicate customized implant abutment.

Conclusions

The perspective of using this strategic approach for implant restorative dental treatments in patients with traumatic root fractures in the anterior region has great potential as it helps to maintain the emergence profile of the natural dentition and esthetics.

Clinical Significance

Optimal esthetic outcomes are challenging in implant dentistry regarding soft tissue structure and morphology factors. Using natural teeth from surgery to deliver the final restoration might be beneficial when an anterior tooth is lost due to trauma.
Interpreting phylogenetic placements for taxonomic assignment of environmental DNA
Authors: Ewers Isabelle , Rajter Lubomír , Czech Lucas , Mahé Frédéric , Stamatakis Alexandros , Dunthorn Micah
Published: July 2023

Taxonomic assignment of operational taxonomic units (OTUs) is an important bioinformatics step in analyzing environmental sequencing data. Pairwise alignment and phylogenetic‐placement methods represent two alternative approaches to taxonomic assignments, but their results can differ. Here we used available colpodean ciliate OTUs from forest soils to compare the taxonomic assignments of VSEARCH (which performs pairwise alignments) and EPA‐ng (which performs phylogenetic placements). We showed that when there are differences in taxonomic assignments between pairwise alignments and phylogenetic placements at the subtaxon level, there is a low pairwise similarity of the OTUs to the reference database. We then showcase how the output of EPA‐ng can be further evaluated using GAPPA to assess the taxonomic assignments when there exist multiple equally likely placements of an OTU, by taking into account the sum over the likelihood weights of the OTU placements within a subtaxon, and the branch distances between equally likely placement locations. We also inferred the evolutionary and ecological characteristics of the colpodean OTUs using their placements within subtaxa. This study demonstrates how to fully analyze the output of EPA‐ng, by using GAPPA in conjunction with knowledge of the taxonomic diversity of the clade of interest.
Assisted living or nursing home: Who is moving in?
Authors: Wang Jinjiao , Mao Yunjiao , McGarry Brian , Cai Shubing , Temkin‐Greener Helena
Published: July 2023

Background

Despite the rapid growth of assisted living (AL) communities and the increasing similarity between AL and nursing home (NH) populations, little is known about the characteristics of older adults at the time of AL admission and how these characteristics compare to individuals newly admitted to NH from the community. This study examined the individual, facility, and geographic factors associated with new AL admission.

Methods

This retrospective descriptive study used data from the national Medicare enrollment and claims datasets, the Minimum Data Set, and the Medicare Provider Analysis and Review. The study cohort included 158,124 Medicare beneficiaries newly admitted to ALs and 715,261 newly admitted to NHs during 10/2017–10/2019. Multinomial logistic regression analysis and logistic regression analysis were conducted to examine factors associated with new admissions.

Results

Demographic, socioeconomic, and health service use characteristics were associated with new admission to long‐term care. Specifically, Medicare fee‐for‐service beneficiaries, those age 75 years and older, male, having one skilled nursing facility (SNF) stay or any hospital stay in the past 6 months are more likely to be newly admitted to AL, whereas those who are dually eligible, racial/ethnic minorities, and having two or more SNF stays in the past 6 months are more likely to be admitted to an NH.

Conclusion

There are substantial differences between individuals who are newly admitted from the community to AL versus those to NH.
“No, It's You:” Dyadic perceived need for change predicts relationship education outcomes
Authors: Crapo J. Scott , Bradford Kay , Kopystynska Olena , Spuhler Bryan K. , Higginbotham Brian J.
Published: July 2023

Relationship education (RE) efforts have been shown to help couples and individuals with a variety of family relationships. However, much still needs to be identified in terms of what factors are salient to outcomes. Drawing on therapeutic models of change, we have identified perceived need for change as one such potential factor. Using data from a couple RE course (n = 447 couples), we assessed how dyadic congruence and average ratings of each partner's need for change were associated with change in three RE outcomes: knowledge, communication, and commitment. In general, the more partners perceived that their partner needed to change, above and beyond what their partner thought, the less change occurred. Implications for RE programming and implementation are discussed, as well as the potential role of therapeutic models and techniques in RE.
Reaction time in psychomotor vigilance task is related to hypoxic load in males with sleep apnea
Authors: Pahari Purbanka , Korkalainen Henri , Karhu Tuomas , Arnardottir Erna Sif , Töyräs Juha , Leppänen Timo , Nikkonen Sami
Published: July 2023

Oxygen saturation (SpO2)‐based parameters are more strongly linked to impaired daytime vigilance than the conventional diagnostic metrics in patients with obstructive sleep apnea (OSA). However, whether the association between SpO2‐based parameters and impaired daytime vigilance is modulated by sex, remains unknown. Hence, we investigated the interplay between sex and detailed SpO2‐based metrics and their association with impaired vigilance in patients with OSA. The study population consisted of 855 (473 males, 382 females) patients with suspected OSA who underwent overnight polysomnography and psychomotor vigilance task (PVT). The population was grouped by sex and divided into quartiles (Q1–Q4) based on median reaction times (RTs) in the PVT. In addition to conventional diagnostic metrics, desaturation severity (DesSev), fall severity (FallSev), and recovery severity (RecovSev) were compared between the sexes and between the best (Q1) and worst (Q4) performing quartiles by using cumulative distribution functions (CDFs). Additionally, sex‐specific covariate‐adjusted linear regression models were used to investigate the connection between the parameters and RTs. The CDFs showed significantly higher hypoxic load in Q4 in males compared to females. In addition, the DesSev (β = 8.05, p < 0.01), FallSev (β = 6.48, p = 0.02), RecovSev (β = 9.13, p < 0.01), and Oxygen Desaturation Index (β = 12.29, p < 0.01) were associated with increased RTs only in males. Conversely, the Arousal Index (β = 10.75–11.04, p < 0.01) was associated with impaired vigilance in females. The severity of intermittent hypoxaemia was strongly associated with longer RTs in males whereas the Arousal Index had the strongest association in females. Thus, the impact of hypoxic load on impaired vigilance seems to be stronger in males than females.
Systolic third sound associated with systolic anterior motion of the mitral valve in cats with obstructive hypertrophic cardiomyopathy
Authors: Saponaro Vittorio , Mey Clémence , Vonfeld Irène , Chamagne Antoine , Alvarado Maria‐Paz , Cadoré Jean‐luc , Chetboul Valérie , Desquilbet Loïc
Published: July 2023

Background

Third heart sounds in cats frequently are associated with hypertrophic cardiomyopathy (HCM) but their exact characterization and timing within the cardiac cycle remains unknown.

Objectives

Characterize third heart sounds in cats by phonocardiography and test the ability of 3 observers with different levels of experience and training to recognize third systolic heart sounds in cats.

Animals

Fifty client‐owned cats of different breeds presented for heart screening.

Methods

Cats were prospectively assessed using an electronic stethoscope (with digital recording) and then underwent full conventional echocardiographic examination. Audio recordings were blindly assessed in a random order by 3 observers: the cardiologist who collected clinical data, as well as a trained and an untrained junior veterinarian. Cohen's kappa coefficients were calculated to quantify agreement between the opinion of each observer and the echocardiography results (considered the gold standard).

Results

Twenty cats had a third systolic sound on phonocardiography and an obstructive HCM phenotype with systolic anterior motion of the mitral valve (SAM) on echocardiography. Agreement with echocardiography was very good for the experienced cardiologist, substantial for the trained junior veterinarian, and poor for the untrained junior veterinarian (kappa of 0.92, 0,64, and 0.08, respectively).

Conclusions and Clinical Importance

We describe here a new auscultatory abnormality in cats with obstructive HCM. It could help a trained non‐cardiologist veterinarian in suspecting obstructive HCM in cats based on auscultation only.
An exploratory international survey of the assessments and interventions used by occupational therapists and physiotherapists during the hospitalization of people with Guillain‐Barré syndrome
Authors: Houlahan Madeline , Gintings Nicole , Burdon Madeline , Ashby Samantha
Published: July 2023

Guillain‐Barré syndrome is a rare neurological condition. Although some people make a substantial functional recovery, almost half require intensive rehabilitation. Data were collected using a cross‐sectional survey which investigated the assessments and interventions used by occupational therapists and physiotherapists for people with Guillain‐Barré syndrome. Seventy valid responses were received from 10 countries. The survey highlighted four factors about current practice: (i) practitioners did not identify the use of formal clinical guidelines or protocols for Guillain‐Barré Syndrome treatment of the upper limb; (ii) a range of standardized and non‐standardized assessment and goal‐setting tools are utilized; (iii) interventions include passive and active range of motion exercises, and the prescription of upper limb/hand splints; and (iv) interdisciplinary practice is common in the intensive care unit and during acute phases of Guillain‐Barré syndrome, whereas discipline‐specific work is more common during rehabilitation. A range of goal‐setting and assessment tools are used by occupational therapists and physiotherapists during the hospitalization of people with Guillain‐Barré syndrome. The type and duration of interventions vary and may reflect the lack of international protocols for Guillain‐Barré syndrome rehabilitation.
Linaria sagrensis (Plantaginaceae), a new high mountain species from the SE Iberian Peninsula
Authors: Blanca Gabriel , Cueto Miguel , Fuentes Julián , Gutiérrez Leonardo , Sáez Llorenç , Bruno Navarro Francisco
Published: July 2023

Linaria sagrensis, from the south‐eastern Iberian Peninsula, is here newly described, illustrated, and compared with its morphologically closest relatives from L. sect. Supinae: L. pruinosa, L. nevadensis, L. glacialis and L. alpina subsp. alpina. The species is characterized by being perennial, entirely glandular‐hairy, with inflorescence dense and corymbiform, and calyx lobes unequal; corolla small, pinkish‐violet, with conspicuous dark veins and yellow to orangish palate, and spur shorter than the rest of the corolla; capsule globose, glandular‐hairy at apex; seeds large, black to dark greyish, with apparently smooth disc, though with very few and scattered small tubercles, and light‐grey wing. Linaria sagrensis is endemic to Sierra de la Sagra (N Granada province, Spain), growing in calcareous screes of the Mediterranean high mountain. Additionally, L. aeruginea subsp. pruinosa is here raised to species rank, L. pruinosa, and therefore a new combination is proposed. The value of seed characters in Linaria taxonomy is discussed based on newly discovered infraspecific variability in several taxa.
Unique presentation of late‐onsetPneumocystis pneumonia in a pediatric kidney transplant recipient
Authors: Grewal Manpreet , Srivastava Ruma , Ang Jocelyn Y. , Salimnia Hossein , Jain Amrish
Published: July 2023

Background

Restrictive lung disease leading to abnormal lung function in kidney transplant recipients is commonly associated with noninfectious complications or medications used for post‐transplant immunosuppression. Herein, we report an interesting case of pediatric kidney transplant recipient with weight loss and abnormal spirometry who was diagnosed to have late‐onset Pneumocystis pneumonia.

Case Report

A 17‐year‐old male patient with a history of allergic rhinitis, mild persistent asthma, and deceased donor kidney transplant, performed 18 months prior, presented for routine evaluation of his asthma to the pulmonology clinic. He was clinically asymptomatic except for a weight loss of 8 kg over 6‐month period prior to presentation. Patient's spirometry was suggestive of a restrictive pattern and further investigation using a high‐resolution computed tomography (HRCT) of the chest showed bilateral diffuse ground‐glass reticulonodular opacities with subpleural sparing suggestive of interstitial pneumonitis. A bronchoscopy with bronchoalveolar lavage revealed organisms consistent with Pneumocystis jirovecii on gomori‐methenamine‐silver (GMS) staining. Beta‐d‐glucan testing in serum revealed a level of >500 pg/mL (normal 0‐59 pg/mL) further supportive of Pneumocystis jirovecii infection. Patient was treated with a 6‐week course of trimethoprim‐sulfamethoxazole. His weight loss and beta‐d‐glucan levels improved over a course of 6 months, and he continues to be on trimethoprim‐sulfamethoxazole prophylaxis.

Conclusion

Late‐onset Pneumocystis jirovecii infection in kidney transplant recipients can have an atypical presentation. Treating physicians should consider PJP in the differential diagnosis of unexplained weight loss in pediatric kidney transplant recipients, especially those receiving a large cumulative burden of immunosuppression.
The impact of COVID‐19 on American Society for Public Administration's scholar and practitioner membership
Authors: Knox Claire Connolly , Moloney Kim , Entress Rebecca M. , Thornton Tonya E. , Jeong Bok Gyo , Bernier Nathalie
Published: July 2023

The novel coronavirus, or SARS‐CoV‐2, which caused COVID‐19, emerged in China in December 2019 and by March 2020 had rapidly spread becoming a global pandemic. The pandemic tested nearly every aspect of the public sector including efforts to respond to, recover from, and mitigate its impacts. This Viewpoint explores COVID‐19 impact on US‐based public administration scholars and practitioners. The results of a survey conducted for members of the American Society for Public Administration showed that respondents grappled with issues involving institutional trust, organizational inequity and capacity, group‐based inequity, health measures, shifts in academic practice, and challenges arising from intergovernmentalism. We conclude with recommendations for future research.
A mixed‐methods analysis of stereotypical female librarian representation in memes
Authors: Neville Jennifer
Published: July 2023

This essay is a mixed‐methods analysis of stereotypical female librarian representation in memes.

Background

Librarianship has been a female‐dominated field since the 19th century. Because of the influx of women, the field has been seen as feminized, which means that it was seen in a negative light and less important than other jobs. Feminization led to two predominant female librarian stereotypes: the spinster librarian and the sexy librarian. Under the pretext of humor, internet memes of stereotypical librarians are damaging to women in librarianship.

Objective

The purpose of this essay was to explore how female librarians were stereotypically represented in memes and why they were characterized thusly.

Methods

Quantitative information concerning how female librarians were represented in memes was compiled through a content analysis, entered into the input form, and tallied using Microsoft Excel. The extent of the representation was also measured through quantitative means by assessing the number of available memes. Finally, the reasons why female librarians were represented as such was explored using a feminist theory framework.

Results

The memes from the sample stressed certain traits of female librarians such as tight clothing, rigid postures, and stern expressions. The images framed these traits as the most important qualities of female librarians. The sexy librarian stereotype was much more common than the spinster. More importantly, perhaps, was the crossover of representation, which created a new version that blended the spinster and sexy librarian trope. Images must be read in terms of the context; the images in the memes showed mainly objectification and gender stereotyping.

Conclusion

The memes from the research sample demonstrated that there was still a significant amount of stereotyping and perpetuation of the feminization of librarianship. Representing female librarians in such a way indicated that her contributions were marginal, that she was only in the library to be objectified. The humorous text of the memes acted as an attempt to make light of the stereotyped imagery, but instead of being ironic and or intellectual, it served to propagate the stereotype. By treating female librarians in this manner, feminization of the profession continued and was maintained in the meme world.
Overestimation of fibrinogen concentration in cryoprecipitate by repeated freeze–thawing with long thawing period as used in the Clauss method
Authors: Tanaka Yumi , Matsumoto Takeshi , Kadoya Kanae , Shimokaria Yuji , Tawara Isao , Katayama Naoyuki , Ohishi Kohshi
Published: July 2023

Background

Cryoprecipitate (CRY) is widely used for treating acquired hypofibrinogenemia. During our study to determine an optimal preparation method, we noticed that the measurement of fibrinogen concentration in CRY had a risk of overestimation. We analyzed this condition and mechanism.

Study Design and Methods

CRY was prepared from fresh frozen plasma (FFP) under four conditions: A, 30 h thawing time, 2 cycles; B, 24 h thawing time, 2 cycles; C, 30 h thawing time, 1 cycle; and D, 24 h thawing time, 1 cycle. Then, fibrinogen concentrations in CRY and cryosupernatant (CS) were measured by the Clauss method.

Results

Purification (CRY/CRY+CS) and recovery (CRY/FFP) rates in CRY prepared under 2‐cycle conditions were higher than those under 1 cycle. However, recovery rates often exceeded 100%, particularly in the case of CRY prepared under A condition, and fibrinogen concentrations calculated by direct measurement were higher than those indirectly calculated from FFP and CS, suggesting an overestimation of fibrinogen values. The level of soluble fibrin monomer complex was considerably higher in CRY prepared under A than under D condition, indicating that CRY adopted a hypercoagulated state. We further found that repeated thawing/freezing increased fibrinogen values as measured by the Clauss method while mechanical vortexing did not.

Discussion

Our findings suggest that direct assessment of fibrinogen contents in CRY prepared by repeated freeze–thawing with a longer thawing period presents a higher risk of overestimation. For the purpose of quality control, we propose an alternative method to indirectly estimate fibrinogen concentrations in CRY from those of CS and FFP.
La concepción platónica de la verdad ontológica en la República a la luz de la verdad predicativa del Sofista
Authors: Tabakian Diego
Published: July 2023

En el presente trabajo me propongo reconstruir la concepción ontológica de la verdad de los libros V-VI de la República a la luz de la conceptualización de la verdad predicativa del Sofista. Mi hipótesis interpretativa es que en ambos diálogos Platón distingue la verdad de sus condiciones de posibilidad, en especial, de su fundamento ontológico. Procuraré mostrar que las concepciones ontológica y predicativa de la verdad en el pensamiento platónico son incompatibles porque se fundamentan en ontologías diferentes.
Exergoeconomics of a Solar-Assisted Double-Effect Absorption Cogeneration System Integrated With a Cold Thermal Energy Storage System
Authors: Alghamdi Abdulmajeed , Sherif S. A.
Published: July 2023

The cogeneration system described in this paper is constructed based on a solar-assisted double-effect absorption cogeneration cycle with an adjustable cooling-to-power ratio. As a proposed technique to benefit from the ability to adjust the cooling-to-power ratio, this system is integrated with a cold thermal energy storage system. The procedure described here will be applied to a combined cooling and power system with a thermal energy storage capability for a large medical center in Jeddah, Saudi Arabia. Through an exergoeconomic analysis of the integrated system on a typical summer day in Jeddah, we found that the integrated system could fulfill the cooling and power demands of the medical center under study with an exergetic efficiency of 53.97%. From an economics perspective, the integrated system was found to deliver cooling and power with average unit costs of 222.89 $/GJ and 17.06 $/GJ, respectively. These costs were found to be lower than the unit costs of the respective cooling and power costs delivered to the medical center if they were obtained from an electrically-driven vapor compression system and the electric grid, respectively. For the case study investigated, it has been found that using the integrated system is a desirable approach due to the system’s lower unit costs as well as its relatively short payback period. Additionally, it has been found that although cogeneration systems constructed based on the double-effect combined cooling and power cycle have higher exergy destruction and capital investment rates, they have a lower unit cost for the produced exergy in comparison with those of cogeneration systems constructed based on a single-effect combined cooling and power cycle.
Reactive plasma sputtering deposition of polycrystalline GaN thin films on silicon substrates at room temperature
Authors: Srinivasan Lakshman , Jadaud Cyril , Silva François , Vanel Jean-Charles , Maurice Jean-Luc , Johnson Erik , Roca i Cabarrocas Pere , Ouaras Karim
Published: July 2023

We report on the successful growth of polycrystalline GaN thin films on Si (100) substrates at room temperature (without intentional heating) using radiofrequency reactive magnetron sputtering. We use Ar and N2 as the main sputtering and N-atom precursor gas sources, respectively, and a gallium cathode as the Ga-atom source. We focus here on studying the effect of working pressure, as it is found to be the parameter that plays the most influential role on the crystalline quality of the thin films in the investigated range (20–95 mTorr). The morphology, microstructure, and composition profile of the GaN thin films are analyzed using a set of ex situ solid-state characterization techniques. This study reveals that for process pressures below 50 mTorr, the resulting films possess an amorphous nature, while for process pressures above that they become polycrystalline. Most of the crystalline films are found to be nanostructured with grain sizes typically ranging from 10 to 30 nm in size. The highest growth rate of ∼ 2.9 Å/s is obtained for the deposition carried out at 50 mTorr. At this pressure, the films exhibit the best crystallinity with a dominant wurtzite hexagonal structure. The elemental distribution of Ga and N throughout the growth profile is uniform with a sharp interface at the substrate, demonstrating one of the interests in working at low temperatures to avoid melt-back etching, a destructive reaction between gallium and silicon, that usually takes place at high temperatures.
Supplemental Material: High-temperature altered oceanic crust recycling into oceanic-island basalt–like mantle produces alkaline continental crust driven by mélange diapirs: Insights from isotopic tracing and numerical modeling
Authors: Liu Huichuan , Huangfu Pengpeng , al. et
Published: July 2023

Supplemental Texts S1–S9: Analytical methods. Supplemental Tables S1–S7: Analytical results. Supplemental Figures S1–S5: Supporting figures.
Sweat conductivity diagnostic accuracy for cystic fibrosis: a systematic review and meta-analysis
Authors: Zhang Linjie , Nomiyama Seiko , Bedran Renata Marcos , Alvim Cristina Gonçalves , Ribeiro José Dirceu , Camargos Paulo
Published: July 2023

Objective

We conducted a systematic review and meta‐analysis of diagnostic test accuracy studies to summarise the properties of sweat conductivity (SC) to rule in/out cystic fibrosis (CF).

Data source

We searched PubMed, Embase, Web of Science, Google Scholar, SciELO and LILACS up to 13 March 2023.

Study selection

We selected prospective and retrospective diagnostic test accuracy studies which compared SC, measured through two well-established and commercially available devices, that is, Nanoduct or Sweat-Chek Analyser, to quantitative measurement of sweat chloride.

Main outcome measures

Pooled sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (−LR), and their corresponding 95% CIs.

Data extraction and synthesis

The Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies guidelines were followed. Data were extracted by one reviewer and checked by another. The hierarchical summary receiver operating characteristics model was used to estimate diagnostic test accuracy.

Results

Ten studies involving 8286 participants were included. The pooled estimates of sensitivity, specificity, +LR and −LR were 0.97 (95% CI 0.94 to 0.98), 0.99 (95% CI 0.98 to 0.99), 171 (95% CI 58 to 500) and 0.02 (95% CI 0.01 to 0.05), respectively. Sensitivity analyses did not reveal a substantial impact of study-level factors on the results, such as study quality, cut-off values for a positive test, study sample size and participant age group. The quality of evidence was considered moderate.

Conclusion

SC demonstrated excellent diagnostic performance. In addition, its accuracy parameters suggest its role as an alternative to the sweat test for CF diagnosis.

PROSPERO registration number

CRD42022284504.
EarlySupervisedIncrementalResistanceTraining (ESpIRiT) following cardiac surgery via a median sternotomy: a study protocol of a multicentre randomised controlled trial
Authors: Md Ali Nur Ayub , El-Ansary Doa , Abdul Rahman Mohd Ramzisham , Ahmad Suriah , Royse Colin , Huat Chong Tze , Muhammad Nor Mohamad Arif , Dillon Jeswant , Royse Alistair , Haron Hairulfaizi , Ismail Muhamad Ishamudin , Abdul Manaf Mohd Rizal , Katijjahbe Md Ali
Published: July 2023

Introduction

There is no consistency in current practice pertaining to the prescription and progression of upper limb resistance exercise following cardiac surgery via median sternotomy. The aim of this study is to investigate whether less restrictive sternal precautions with the addition of early-supervised resistance training exercise improves upper limb function and facilitates recovery following median sternotomy.

Methods and analysis

This is double-blind randomised controlled trial, with parallel group, concealed allocation, blinding of patients and assessors, and intention-to-treat analysis. 240 adult participants who had median sternotomy from eight hospitals in Malaysia will be recruited. Sample size calculations were based on the unsupported upper limb test. All participants will be randomised to receive either standard or early supervised incremental resistance training. The primary outcomes are upper limb function and pain. The secondary outcomes will be functional capacity, multidomain recovery (physical and psychological), length of hospital stay, incidence of respiratory complications and quality of life. Descriptive statistics will be used to summarise data. Data will be analysed using the intention-to-treat principle. The primary hypothesis will be examined by evaluating the change from baseline to the 4-week postoperative time point in the intervention arm compared with the usual care arm. For all tests to be conducted, a p value of <0.05 (two tailed) will be considered statistically significant, and CIs will be reported. The trial is currently recruiting participants.

Ethics and dissemination

The study was approved by a central ethical committee as well as the local Research Ethics Boards of the participating sites (UKM:JEP-2019-654; Ministry of Health: NMMR-50763; National Heart Centre: IJNREC/501/2021). Approval to start was given prior to the recruitment of participants commencing at any sites. Process evaluation findings will be published in peer-reviewed journals and presented at relevant academic conferences.

Trial registration number

International Standard Randomised Controlled Trials Number (ISRCTN17842822).
Evaluations of statistical methods for outlier detection when benchmarking in clinical registries: a systematic review
Authors: Hansen Jessy , Ahern Susannah , Earnest Arul
Published: July 2023

Objectives

Benchmarking is common in clinical registries to support the improvement of health outcomes by identifying underperforming clinician or health service providers. Despite the rise in clinical registries and interest in publicly reporting benchmarking results, appropriate methods for benchmarking and outlier detection within clinical registries are not well established, and the current application of methods is inconsistent. The aim of this review was to determine the current statistical methods of outlier detection that have been evaluated in the context of clinical registry benchmarking.

Design

A systematic search for studies evaluating the performance of methods to detect outliers when benchmarking in clinical registries was conducted in five databases: EMBASE, ProQuest, Scopus, Web of Science and Google Scholar. A modified healthcare modelling evaluation tool was used to assess quality; data extracted from each study were summarised and presented in a narrative synthesis.

Results

Nineteen studies evaluating a variety of statistical methods in 20 clinical registries were included. The majority of studies conducted application studies comparing outliers without statistical performance assessment (79%), while only few studies used simulations to conduct more rigorous evaluations (21%). A common comparison was between random effects and fixed effects regression, which provided mixed results. Registry population coverage, provider case volume minimum and missing data handling were all poorly reported.

Conclusions

The optimal methods for detecting outliers when benchmarking clinical registry data remains unclear, and the use of different models may provide vastly different results. Further research is needed to address the unresolved methodological considerations and evaluate methods across a range of registry conditions.

PROSPERO registration number

CRD42022296520.