bluuebunny/crossref_metadata_2025 huggingface dataset:
A History of the Ottoman Fez before Mahmud II (ca. 1600–1800)
Authors: Ben Ismail Youssef
Published: December 2021

The history of the Ottoman fez is usually told with the nineteenth century as a point of departure. In the 1820s and 1830s, the reforms initiated by Sultan Mahmud II (r. 1808–39) elevated the red felt cap to the rank of official headgear of the Ottoman empire. But little is known about its history prior to its adoption by the state: where did the fez come from and how did it become so prevalent in the Ottoman empire? This essay examines the global history of the fez in the seventeenth and eighteenth centuries. Taking Mahmud II’s reforms as an endpoint, it examines the process by which the headgear first came to be both culturally visible and commercially available in the Ottoman realm. Three aspects of this history are considered: the trans-imperial history of the fez as a commercial commodity, its cultural reception in the Ottoman world, and the establishment of a community of Tunisian fez merchants in early modern Istanbul.
Colonial Zaytuna: The Making of a Minaret in French-Occupied Tunisia
Authors: Lamine Sihem
Published: December 2021

In March 1892, eleven years after the establishment of the French protectorate in Tunisia, a congregation of ulemas, religious scholars, and students, as well as representatives of the waqf administration (Jamʿiyyat al-Awqāf) gathered in the ṣaḥn of the Zaytuna Mosque to lay the cornerstone of a new minaret. The pre-exiting tower, whose latest major renovations dated from the seventeenth-century Ottoman Muradid times, was deemed hazardous; it was therefore entirely demolished and replaced by a large-scale replica of the nearby Hafsid Kasbah Mosque of Tunis. The new minaret of the Zaytuna Mosque rose in tandem with the Saint Vincent de Paul Cathedral of Tunis, and simultaneously with the nascent French neighborhoods of Tunis outside and along the medina walls. This article explores the intricate and fascinating context of the construction of a monumental minaret in a city that was gradually severing ties with its Ottoman past and surrendering to a newly established colonial rule. It questions the role and aspirations of the French administration in the minaret project, the reasons that led to the revival of the Almohad architectural style in the late nineteenth-century Maghrib, and the legacy left by the re-appropriation of this style in North Africa.
New Data on the Luster Tiles of ʿAbd al-Samad’s Shrine in Natanz, Iran
Authors: Leone Anaïs
Published: December 2021

This essay offers new data for identifying and reconstructing the original luster tilework decoration of the tomb chamber of the ʿAbd al-Samad shrine in Natanz, central Iran. The decorated complex around the tomb was likely built during the Ilkhanid period. The removal of Ilkhanid-period luster tiles from their original location has left very few buildings with their original decoration. Moreover, the stripping of an important number of monuments led to the arrival of thousands of tiles of unidentified or incomplete provenance in public and private collections. By cross-referencing available information about preserved revetments (e.g., dimensions, inscriptions, provenance, designs) with verifiable data collected at surviving monuments, it is possible to bridge the gap and unite formerly isolated elements. This study formulates new proposals about the luster tilework in the shrine of ʿAbd al-Samad, especially with regard to the complex ensemble of the mihrab. By locating and detailing the different zones of its decorative scheme, the ensemble becomes more coherent as a whole despite its remaining gaps.
Pre-service Physics Teachers’ Beliefs about Learning Physics and Their Learning Achievement in Physics
Authors: Kim Hong-Jeong , Im Sungmin
Published: December 2021

This study investigates pre-service teachers’ beliefs about learning physics and explores how beliefs correlate with learning achievement as evidenced by conceptual understanding and grades in a year-long physics course. To investigate beliefs about learning physics, 14 second-year pre-service teachers in a teacher training program in South Korea completed a Likert-style questionnaire called the Beliefs About Learning Physics Survey (BAPS). To measure learning achievement, final grades for the physic course were obtained and the Force Concept Inventory (FCI) was used to assess conceptual understanding. Analysis revealed that pre-service physics teachers’ beliefs about learning physics had a positive correlation with conceptual understanding but not with motivational beliefs. Students’ grades in physics had a positive correlation with cognitive beliefs, regardless of changes in pre- and post-test responses. Implications about how to utilize pre-service physics teachers’ beliefs about learning physics as an epistemological resource for teaching and learning physics are discussed.
2. Blissful Beginnings
Authors: Graham Philip
Published: December 2021

Mary Wilson, who became Mary Warnock, was born on 14 April 1924. On both sides of her family, she had distinguished forebears. Her paternal grandfather was a distinguished judge, knighted for his services to the law. Her mother’s family was of German Jewish origin but had converted to Anglicanism. Her maternal grandfather was a banker, whose wealth subsidised the affluent lifestyle of Mary’s family. He was made a baronet for his services to the Treasury. Her father died before Mary was born. Mary was largely brought up by her nanny, a ‘character’ who had a great influence on her. She was home tutored until the age of nine. Then she attended St. Swithun’s School, Winchester first as a day girl, then a boarder. This was a High Anglican school for girls which put its main emphasis on the development of moral behaviour rather than on academic subjects. She transferred at sixteen to Prior’s Field, a far more liberal school where she flourished, winning the top scholarship to Lady Margaret Hall, Oxford. Before going up to Oxford she spent two terms working as an assistant in a boy’s preparatory school.
3. Emerging
Authors: Graham Philip
Published: December 2021

Mary entered Oxford as an undergraduate to read Greats in October 1942 in the middle of World War Two and stayed until April 1944. The war-time atmosphere was bleak, and her diary reveals she was often cold and hungry. Her lecturers and tutors are described. Over a period of nine months, she was frequently and regularly sexually harassed by one of her teachers, a man over thirty years older than herself. In marked contrast to her later accounts which make light of the matter, the descriptions in her diary of this experience reveal much guilt and confusion. She found the syllabus very stretching and had time for little else though she formed a close friendship with Elisabeth de Gaulle, the daughter of the French resistance leader, later President of France. She just scraped a first-class result in the Mods part of her degree. In the spring of 1944, as a result of wartime regulations, she had to leave Oxford to work in a ‘reserved’ occupation as a teacher at Sherborne School for Girls. She returned in October 1946 to a greatly changed Oxford and a much fuller life. Her two intimate relationships with male undergraduates before meeting her future husband, Geoffrey Warnock, are described in her diaries. Geoffrey was a moral philosopher, later to be Principal of Hertford College and Vice-Chancellor of Oxford University. In 1948 she was awarded a first-class degree in Greats. She spent 1948-49 in postgraduate study. In the summer of 1949, she married Geoffrey and was appointed a lecturer, and later a fellow, of St. Hugh’s College, Oxford.
Innovative Substrate-Integrated Hollow Waveguide Coupled Attenuated Total Reflection Sensors for Quantum Cascade Laser Based Infrared Spectroscopy in Harsh Environments
Authors: Teuber Andrea , Stach Robert , Haas Julian , Mizaikoff Boris
Published: December 2021

An innovative mid-infrared spectroscopic sensor system based on quantum cascade lasers has been developed. The system combines the versatility of substrate-integrated hollow waveguides (IHWGs) with the robustness of attenuated total reflection (ATR) crystals employed as internal reflection waveguides for evanescent field sensing. IHWGs are highly reflective metal structures that propagate infrared (IR) radiation and were used as light pipes for coupling radiation into the ATR waveguide. The combined IHWG-ATR device has been designed such that the utmost stability and robustness of the optical alignment were ensured. This novel assembly enables evanescent field absorption measurements at yet unprecedently harsh conditions, that is, high pressure and temperature. Combining these advantages, this innovative sensor assembly is perfectly suited for taking ATR spectroscopy into the field where the robustness of the assembly and optical alignment is essential.
Living the past? Do historical legacies moderate the relationship between national chauvinism/cultural patriotism and xenophobic attitudes toward immigrants
Authors: Ariely Gal
Published: December 2021

This study seeks to understand how national chauvinism and cultural patriotism are related to xenophobic attitudes toward immigrants. It does this by examining the extent to which historical legacy, in terms of geopolitical threats and national identity, moderates this relationship. A multilevel analysis across 24 European countries combines measures of national chauvinism, cultural patriotism, and xenophobic attitudes at the individual level with historical data, the geopolitical threat scale, and the national identity longevity index at the country level. Findings demonstrate that, according to these measures, historical legacies of threats and conflicts do not have an interaction effect, but the longevity of national identity moderates the relationship between national chauvinism/cultural patriotism and xenophobic attitudes. That is, in countries with greater national identity longevity, the positive relations between national chauvinism and xenophobic attitudes are weaker, but the negative relations between cultural patriotism and xenophobic attitudes are stronger. These findings contribute to the understanding of national identity by suggesting how it is related to a nation’s historical legacy.
A theory of social programs, legitimacy, and citizen cooperation with the state
Authors: Aldama Abraham
Published: December 2021

Aid and social programs are commonly used to fight insurgencies. However, sometimes they fail to achieve their goal of increasing citizen cooperation with the state. I propose a series of game-theoretic models that focus on the strategic interaction between a state and a citizen in the face of a challenge to the state’s monopoly of power by an insurgency. I argue that even if the provision of aid or social programs increases citizens’ intrinsic motivation to cooperate with the state, it does not necessarily translate into more cooperation. I show that citizen cooperation depends on whether the increase in the provision of aid is accompanied by an increase in the use of violent or hard tools by the state, the citizens’ expectation of future rewards, and the insurgency’s response. The models thus provide a rationale for why even if social programs increase state legitimacy, they may fail to increase citizen cooperation.
Empowerment & Reminiscence: Possible Tools in Dietary Health Promotion in the Elderly
Authors: Robinson John , Eceleston Zena , Mcevoy Maureen , Hackett Allan
Published: December 2021

The COMA report “The Nutrition of Elderly People” recommended that elderly people should be targeted for health education programmes in order to maintain nutritional status in this group. Recent research indicates that interventions which aim to influence nutritional behaviour are more likely to succeed if they involve target populations at all stages of the process. This paper outlines a preliminary action research project which attempted to identify some key issues influencing eating behaviour in a group of elderly people based in the Halewood area of Knowsley, Merseyside. An innovative methodology, combining empowerment and reminiscence, was used to produce a nutritional advice leaflet which will be used as a resource within the local community.
Constructively Engaging Exploitive Waste Management in India: The Case of Paryavaran Mitra and its Justice Motivated Effort at Empowering Rag-Picking Women
Authors: Jagadale Sujit Raghunathrao , Santos Nicholas J. C.
Published: December 2021

Constructive Engagement (CE) aims at developing sustainable and equitable marketing systems that ensure collective well-being. This paper reflects on an initiative that constructively engages with impoverished market actors, i.e., rag-picking women in India. It is endeavored by operationalizing Integrative Justice Model (IJM) principles while trying to tackle the issue of solid waste management. Our findings suggest that CE across the spectrum in the value chain is required to alleviate the conditions of disadvantaged market actors and improve their well-being. Our qualitative inquiry in rag-picking women’s lives and an initiative of social enterprise contribute to the ongoing conversation in macromarketing literature- (1) by empirically evidencing how the CE operationalizes the IJM and help redress the issues of social traps and internalities; (2) by uniquely connecting the macro issues of waste management with the issues of honesty, fairness, dignity and deserved justice in the neglected market transactions; (3) that IJM principles guide the constructive engagement process.
Effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia: A systematic review
Authors: Escher Anne A , McKinnon Sarah , Berger Sue
Published: December 2021

Introduction

Occupational therapists work with clients with impaired communication to re-engage in valued occupations. This systematic review seeks to answer the question: What are effective interventions within the scope of occupational therapy practice to address participation for adults with aphasia?

Method

A systematic review of the literature was completed using PubMed, PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Database of Systematic Reviews, and OT Seeker databases. Intervention studies within the scope of occupational therapy practice with a participation outcome, and published in peer reviewed journals from 2000 to 2019, were included. The quality of each study was assessed using the Mixed Methods Appraisal Tool.

Findings

Thirteen articles fit the inclusion criteria. Categories of interventions that emerged from the data include community-based groups, individually tailored programs, adaptation/presentation of materials, interprofessional interventions, and psychoeducation.

Conclusion

There is evidence to support the use of interventions within the scope of occupational therapy practice to increase participation for people with aphasia. Specifically, the use of community-based groups and adaptation of materials are effective to facilitate participation. Most of the studies were pre-post one group design; however, they demonstrated positive results for participation outcomes. More research is needed on people with aphasia that focuses on participation in meaningful occupations.
Voluntary Association Participation and White Ethnic Diversity in Rural Iowa Communities
Authors: Painter Matthew A.
Published: December 2021

Membership in voluntary associations is of core importance to civil society. In this study, I build on the large literature that focuses on how community racial/ethnic diversity affects individuals’ joining of—and participation within—voluntary associations. The central focus is on White ethnicity or European ancestry, which I analyze using the 2004 Iowa Community Survey and 2000 U.S. Census data. I find that White ethnic diversity is associated with fewer overall memberships and less frequent participation, with differing effects for various large groupings of voluntary organizations. I close our study by discussing the implications of my findings for organizations and the broader community.
Double burden? Implications of indebtedness to general life satisfaction following negative life events in international comparison
Authors: Müller Nora , Pforr Klaus , Hochman Oshrat
Published: December 2021

While debt is not problematic per se, it can become an additional burden when people experience negative life events–like unemployment, a severe disease, divorce, or their partner’s death–which can be detrimental for individuals’ subjective wellbeing. We investigate first, a potential moderating effect of economic resources or, better yet, lack thereof in the relations between negative life events and general life satisfaction, and second, whether this moderating effect is a function of state-level policies. We expect that, on average, debt has a reinforcing effect on the negative relationship between negative life events and general life satisfaction. Moreover, we expect that country-level policies protecting individuals from the negative consequences of experiencing a negative life event or indebtedness can explain the country differences in the moderating effect of debt. We test our assumptions among the population aged 50+ applying data from the Survey of Health, Ageing and Retirement (SHARE). We apply a two-stage fixed-effects regression approach to estimate the moderation effect of debt on the relationship between negative life events and general life satisfaction within and across countries. Although we find an almost zero average moderating effect of debt across countries, we find large variance in the moderating effects between countries. This variance can be explained by debt regime, but not by the generosity of the public unemployment and the public health systems, or the level of gender equality.
Avoiding material hardship: The buffer function of wealth
Authors: Rodems Richard , Pfeffer Fabian T
Published: December 2021

We assess how a variety of disruptive life-course events impact the economic wellbeing of US households and trace the importance of household wealth in helping families who experience these events avoid entering a spell of material hardship. Using longitudinal data from two panels of the Survey of Income and Program Participation (SIPP), we draw on direct measures of material hardship, disruptive events and household assets. Our analyses reveal that the relationship between disruptive events and the likelihood of experiencing a new spell of material hardship strongly varies across the wealth distribution, suggesting that high household wealth provides an effective private safety net. By distinguishing different types of disruptive events, we demonstrate that divorce, disability and income loss entail a risk of material hardship but also that this risk is effectively buffered by substantial wealth. Different types of hardship – namely, financial, food and medical hardship – respond in similar ways.

Like public insurance schemes, wealth insurance helps buffer the effects of disruptive events on material hardship, but unlike public insurance schemes, reliance on private wealth further stratifies the economic wellbeing of households. Policy options for addressing this highly stratified private insurance scheme include disposing of the need for it by funding more robust public insurance, for instance through wealth taxation.
Leader Tenure, Genocide, and Politicide During Civil War
Authors: Uzonyi Gary
Published: December 2021

Why do some governments engage in genocide or politicide during civil war while others do not? I argue that leader tenure influences bargaining possibilities between the regime and rebels. Rebels face less uncertainty about a longer-tenured leader’s willingness to commit to concessions to end the conflict with terms that better the rebels’ position. This narrows the longer-tenured leader’s ability to credibly offer the rebels concessions. Facing a constrained bargaining environment, longer-tenured leaders become more likely to turn to atrocity in an effort to fully defeat the opposition group and its supporters. Statistical analysis of all genocide and politicide in civil war since 1946 supports this claim. Evidence from Milosevic’s atrocities in Kosovo help illustrate the mechanisms.
Unanticipated Profound Paralysis and Sugammadex Dosing Implications After Videoscopic Thoracic Surgery
Authors: McKittrick Melissa L. , Lombard Frederick W.
Published: December 2021

A bedridden patient with empyema presented for thoracoscopic decortication. During the procedure, despite a post-tetanic count (PTC) of 0 via calibrated quantitative neuromuscular monitoring, persistent diaphragmatic movement impaired operating conditions, so rocuronium was re-dosed. After surgery, the patient had 0 PTC. Sugammadex was titrated to achieve baseline neuromuscular strength, monitoring the effect of each 200-mg dose. Ultimately, 1200 mg was required to achieve baseline strength. We describe monitor troubleshooting, considerations with unexpectedly deep neuromuscular blockade, the importance of routine quantitative neuromuscular monitoring, and one strategy for sugammadex reversal in patients with profound paralysis outside of the standard dosing guidelines.
Reducing Prejudice Through Promoting Cross-Group Friendships
Authors: Killen Melanie , Luken Raz Katherine , Graham Sandra
Published: December 2021

Around the globe, individuals are affected by exclusion, discrimination, and prejudice targeting individuals from racial, ethnic, and immigrant backgrounds as well as crimes based on gender, nationality, and culture (United Nations General Assembly, 2016). Unfortunately, children are often the targeted victims (Costello & Dillard, 2019). What is not widely understood is that the intergroup biases underlying systemic racism start long before adulthood with children displaying notable signs of intergroup bias, sometimes before entering grade school. Intergroup bias refers to the tendency to evaluate members of one’s own group more favorably than someone not identified with one’s group and is typically associated with prejudicial attitudes. Children are both the victims and the perpetrators of bias. In this review, we provide evidence of how biases emerge in childhood, along with an analysis of the significant role of intergroup friendships on enhancing children’s well-being and reducing prejudice in childhood. The review focuses predominantly on the context of race, with the inclusion of several other categories, such as nationality and religion. Fostering positive cross-group friendships in childhood helps to address the negative long-term consequences of racism, discrimination, and prejudice that emerges in childhood and continues through to adulthood.
Influences of Unmodified and Carboxylated Carbon Nanotubes on Lipid Profiles in THP-1 Macrophages: A Lipidomics Study
Authors: Pei Lanjie , Yang Wenxiang , Cao Yi
Published: December 2021

Since the possible roles of surface modifications in determining multi-walled carbon nanotube (MWCNT)–promoted endoplasmic reticulum (ER) stress-mediated lipid-laden macrophage foam cell formation are still in debate, we compared unmodified and carboxylated MWCNT-induced cytotoxicity, lipid profile changes, and expression of ER stress genes in THP-1 macrophages. Particularly, we focused on lipid profile changes by using lipidomics approaches. We found that unmodified and carboxylated MWCNTs significantly decreased cellular viability and appeared to damage the cellular membrane to a similar extent. Likewise, the results from Oil Red O staining showed that both types of MWCNTs slightly but significantly induced lipid accumulation. In keeping with Oil Red O staining results, lipidomics data showed that both types of MWCNTs up-regulated most of the lipid classes. Interestingly, almost all lipid classes were relatively higher in carboxylated MWCNT-exposed THP-1 macrophages compared with unmodified MWCNT-exposed cells, indicating that carboxylated MWCNTs more effectively changed lipid profiles. But in contrast to our expectation, none of the MWCNTs significantly induced the expression of ER stress genes. Even, compared with carboxylated MWCNTs, unmodified MWCNTs induced higher expression of lipid genes, including macrophage scavenger receptor 1 and fatty acid synthase. Combined, our results suggested that even though carboxylation did not significantly affect MWCNT-induced lipid accumulation, carboxylated MWCNTs were more potent to alter lipid profiles in THP-1 macrophages, indicating the need to use omics techniques to understand the exact nanotoxicological effects of MWCNTs. However, the differential effects of unmodified and carboxylated MWCNTs on lipid profiles might not be related with the induction of ER stress.
Do Parental Education-Related Inequality Matter in Child and Adolescent Utilization of Mental Health Services: Results From a Norwegian Register Linkage Study
Authors: Bøe Tormod , Hysing Mari , Askeland Kristin G , Skogen Jens Christoffer , Heradstveit Ove
Published: December 2021

Equitable access to health care point to equal access to care for those with equal needs, but pro-rich and pro-educated inequities have been documented in specialized mental health care utilization. This study aimed to investigate equity in Norwegian adolescents’ use of child and adolescent mental health services (CAMHS) with regards to parental education levels, using a survey of 10 257 Norwegian 16- to 19-year-olds subsequently linked to CAMHS data from the Norwegian Patient Registry (n = 970 had been in contact with CAMHS). Analyses using concentration indices ( C) suggested adolescents with parents with lower education levels had more mental health problems (ie, larger need; C = −0.032, P < .001) and were more in contact with CAMHS ( C = −0.025, P < .001). Regression analysis suggested that CAMHS contact, and number of unique admissions was largely distributed according to need, but participants whose parents had basic education levels were in contact with CAMHS for slightly longer than predicted from their self-reported mental health problems, age, and sex. Results from this study suggested that contact with CAMHS was largely equitable and mostly influenced by need. There was little evidence of parental education-related inequity in access to, and use of, specialized mental health services.
The sensory imperative
Authors: Juhlin Christina , Holt Robin
Published: December 2021

With this essay, we identify and resist a sensory imperative in management and organizational research and beyond. We define the sensory imperative as an uncritical embrace of the idea that the senses offer a unique and attractive methodological and political position for studying managerial and organizational life and for challenging dominant forms of knowledge production. By falling in with this imperative, the turn to the senses in management and organization studies risks losing sight of its own mediations. We propose three ways of regaining sight of these mediations, which, we argue, come together as an analytical sensorisation – a study of, rather than with, the senses.
Technological innovation in policing and crime prevention: Practitioner perspectives from London
Authors: Laufs Julian , Borrion Hervé
Published: December 2021

Digital technology now plays a critical role in policing and security management, with policing apps, drones and body-worn cameras potentially being game-changers. Adoption of such technologies is, however, not straightforward and depends upon the buy-in of senior management teams and users. This study examines what obstacles practitioners face in the procurement, deployment and use of crime prevention and detection technologies. The issue is explored through a number of expert interviews conducted with practitioners in London between August 2019 and March 2020. This work expands previous, more theoretical, literature on the topic by adding a practical perspective and advances the understanding of issues faced in innovation processes and their management. We identified a variety of issues and obstacles to technological innovation for policing. These include the deployment of new systems at the cost of old ones, lack of financial and political support, issues in public–private partnerships, and public acceptability. Although individual practitioners may have the expertise and willingness to unleash the full potential of surveillance and crime-reduction technologies, they are usually restrained by institutional rules or, in some cases, inefficiencies. In terms of the latter, this study especially highlights the negative impact of a lack of technical interoperability of different systems, missing inter- and intra-agency communication, and unclear guidelines and procedures.
Climate Change as a National Security Issue: Examining Framing Effects Across Party
Authors: Gainous Jason , Merry Melissa K.
Published: December 2021

Research suggests that framing climate change as a national security issue can shape opinion about climate change. This research is less clear about what exactly constitutes a “national security frame” and what aspects of this frame are most persuasive. We use a survey experiment to compare the relative effects of three types of national security frames we identify. Results show that a frame centered on energy dependence had the strongest effect and was the most consistent across partisanship. Surprisingly, the effects ran in the opposite direction for Democrats and Republicans on both outcomes—negative for Democrats and positive for Republicans. We also show that the energy dependence frame moderated the influence of respondents’ affect toward political candidates and parties on their climate change attitudes. The results suggest that the energy dependence frame can shape public opinion, but that it must be tailored to particular audiences to avoid backfire effects.
“Moving the Rubble”: Reflection, Conscientization, and Transformative Learning With Men Incarcerated for Organized Crime in Mexico
Authors: Strickland Rebecca Danielle
Published: December 2021

While many scholars have examined transformative learning in different prison education programs, the field has only recently reached Latin America. This article presents a participatory action research project which has been operating in a prison for men accused of organized crime in Jalisco, Mexico, since 2018. The analysis is based on testimonies related to personal and collective transformation in a context of multifaceted oppression. It also explores the blurry lines between reflection, conscientization, and transformation, inviting us to consider how transformative education relates to social stigma and freedom.
An explainable Artificial Intelligence approach to study MCI to AD conversion via HD-EEG processing
Authors: Morabito Francesco Carlo , Ieracitano Cosimo , Mammone Nadia
Published: December 2021

An explainable Artificial Intelligence (xAI) approach is proposed to longitudinally monitor subjects affected by Mild Cognitive Impairment (MCI) by using high-density electroencephalography (HD-EEG). To this end, a group of MCI patients was enrolled at IRCCS Centro Neurolesi Bonino Pulejo of Messina (Italy) within a follow-up protocol that included two evaluations steps: T0 (first evaluation) and T1 (three months later). At T1, four MCI patients converted to Alzheimer’s Disease (AD) and were included in the analysis as the goal of this work was to use xAI to detect individual changes in EEGs possibly related to the degeneration from MCI to AD. The proposed methodology consists in mapping segments of HD-EEG into channel-frequency maps by means of the power spectral density. Such maps are used as input to a Convolutional Neural Network (CNN), trained to label the maps as “T0” (MCI state) or “T1” (AD state). Experimental results reported high intra-subject classification performance (accuracy rate up to 98.97% (95% confidence interval: 98.68–99.26)). Subsequently, the explainability of the proposed CNN is explored via a Grad-CAM approach. The procedure detected which EEG-channels (i.e., head region) and range of frequencies (i.e., sub-bands) were more active in the progression to AD. The xAI analysis showed that the main information is included in the delta sub-band and that, limited to the analyzed dataset, the highest relevant areas are: the left-temporal and central-frontal lobe for Sb01, the parietal lobe for Sb02, the left-frontal lobe for Sb03 and the left-frontotemporal region for Sb04.
Role of antifibrotics in the management of idiopathic inflammatory myopathy associated interstitial lung disease
Authors: Wilfong Erin M. , Aggarwal Rohit
Published: December 2021

The antifibrotic therapies nintedanib and pirfenidone were first approved by the United States for the treatment of idiopathic pulmonary fibrosis in 2014. In 2020, nintedanib received U.S. Food and Drug Administration (FDA) approval for the treatment of all progressive fibrosing interstitial lung disease (ILD). Given that a major cause of mortality and morbidity in the idiopathic inflammatory myopathies (IIM) is progressive interstitial lung disease and respiratory failure, antifibrotic therapies may be useful as adjuvant to traditional immunosuppression. However, randomized controlled trials of antifibrotic therapies in IIM are lacking. The purpose of this review is to (1) summarize the mechanism of action of nintedanib and pirfenidone in ILD with possible role in IIM-ILD, (2) review the clinical data supporting their use in interstitial lung disease in general, and more specifically in connective tissue disease associated ILD, and (3) discuss the evidence and remaining challenges for using antifibrotic therapies in IIM-ILD.
School Garden Benefits: Health Promotion and Environmental Conservation
Authors: Alexander Gina K. , Grannum Donald R.
Published: December 2021

Garden-based learning promotes environmental awareness, health, and wellness across the school community and beyond. In this article, we review the literature on the benefits of school gardening and describe firsthand experiences for garden success. By sharing lessons learned, our aim is to inspire school nurses to join forces with like-minded teachers and staff or take the lead to build capacity in their school for gardening and a green culture dedicated to the conservation of natural resources.
Changes in Sleep Quality Following Treatment for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis
Authors: Fried Jacob , Yuen Erick , Gudis David A. , Schlosser Rodney J. , Nguyen Shaun A. , Rowan Nicholas R.
Published: December 2021

Background

Chronic rhinosinusitis (CRS) presents with broad and systemic manifestations, including impaired sleep; however, the impact of CRS treatments upon sleep is unknown.

Objective

To establish the effect of medical or surgical CRS treatment on subjective and objective sleep metrics for patients not previously diagnosed with sleep apnea.

Methods

Review of PubMed, Scopus, Web of Science, and the Cochrane Library was performed from the databases’ date of inception through August 13, 2020, for studies evaluating the effect of CRS treatment on sleep quality. All studies reporting on subjective and objective sleep parameters for patients with CRS, with completed pre- and posttreatment data were included. Studies composed of patients with diagnosed sleep apnea were excluded.

Results

Sixteen unique studies reporting data on a total of 1770 patients (mean age, 50.6 ± 15.6 (n = 1675) years) following treatment for CRS were included. Patient-reported outcome measures, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Fatigue Severity Scale, demonstrated mean posttreatment differences of −2.8 (95% CI: −4.9 to −0.7), −2.4 (95% CI: −3.7 to −1.2), and −1.2 (95% CI: −1.6 to −0.7), respectively. The SNOT-22 and its sleep domain demonstrated a mean posttreatment difference of −23.5 (95% CI: −31.7 to −15.3) and −5.4 (95% CI: −6.8 to −4.0), respectively. EpSS, FSS and SNOT-22 exceeded their respective reported MCID values. Objective findings did not significantly change with treatment; mean difference: AHI: 0.7 (95% CI: −1.5 to 2.9), oxygen nadir: 0.3 (95% CI: −0.4 to 0.9).

Conclusions

Treatment of CRS may lead to clinically meaningful reduction in disease burden and improvements in both overall sleep quality and patient-reported fatigue. Despite clinically meaningful quality of life improvements, objective sleep parameters did not demonstrate corresponding posttreatment improvements.
Dysphagia as the Presenting Symptom for Inclusion Body Myositis
Authors: Esteban Marcus Juan , Kassar Darine , Padilla Osvaldo , McCallum Richard
Published: December 2021

Dysphagia can be one of the manifestations of inflammatory myopathies (IMs). In some patients, it can be one of the presenting symptoms or the only symptom. We present a patient with dysphagia and progressive muscle weakness who was eventually diagnosed with inclusion body myositis (IBM). Treatment with oral steroid provided no major improvement in symptoms and thus was eventually stopped. Dysphagia in IMs is associated with complications and poor prognosis. A multidisciplinary approach is needed in its diagnosis and management as this report exemplifies.
Care Experiences of Older People in the Emergency Department: A Concurrent Mixed-Methods Study
Authors: Mwakilasa Magreth Thadei , Foley Conor , O’Carroll Tracy , Flynn Rachel , Rohde Daniela
Published: December 2021

The growing population of older people has increased demand to meet their complex healthcare needs, including in emergency departments (EDs). This study explored the experiences of people aged 65+ in Irish EDs, involving secondary analysis of quantitative and qualitative data from the 2019 National Inpatient Experience Survey (NIES). Experiences in the ED and overall hospital experiences were dichotomized as poor to fair or good to very good. Logistic regression was used to model quantitative data. Free text comments relating to EDs were thematically analyzed. Of 12,343 survey participants, 4,442 (39.9%) were aged 65+ years and used the ED. Longer waiting times, completion of the questionnaire by another person either with or on behalf of the patient, and having both a medical card and private health insurance were predictors of poor to fair ED experiences. Patients aged 85+ years were more likely to report good to very good ED experiences. Poor experiences in the ED were associated with poorer overall hospital experiences (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.76 to 2.73, p < .001). Thematic analysis revealed that long waiting times and unpleasant waiting conditions, including lack of communication, privacy, and personal care were important challenges encountered in the ED, with some older patients noting their preference for separate ED services. There is a need to reduce waiting times and integrate user perspectives in the planning, organization, and delivery of ED care to improve experiences and quality of care for a growing older population.
Thrombin spatial distribution determines protein C activation during hemostasis and thrombosis
Authors: Marar Tanya T. , Matzko Chelsea N. , Wu Jie , Esmon Charles T. , Sinno Talid , Brass Lawrence F. , Stalker Timothy J. , Tomaiuolo Maurizio
Published: December 2021

Rebalancing the hemostatic system by targeting endogenous anticoagulant pathways, like the protein C (PC) system, is being tested as a means of improving hemostasis in patients with hemophilia. Recent intravital studies of hemostasis demonstrated that, in some vascular contexts, thrombin activity is sequestered in the extravascular compartment. These findings raise important questions about the context-dependent contribution of activated PC (APC) to the hemostatic response, because PC activation occurs on the surface of endothelial cells. We used a combination of pharmacologic, genetic, imaging, and computational approaches to examine the relationships among thrombin spatial distribution, PC activation, and APC anticoagulant function. We found that inhibition of APC activity, in mice either harboring the factor V Leiden mutation or infused with an APC-blocking antibody, significantly enhanced fibrin formation and platelet activation in a microvascular injury model, consistent with the role of APC as an anticoagulant. In contrast, inhibition of APC activity had no effect on hemostasis after penetrating injury of the mouse jugular vein. Computational studies showed that differences in blood velocity, injury size, and vessel geometry determine the localization of thrombin generation and, consequently, the extent of PC activation. Computational predictions were tested in vivo and showed that when thrombin generation occurred intravascularly, without penetration of the vessel wall, inhibition of APC significantly increased fibrin formation in the jugular vein. Together, these studies show the importance of thrombin spatial distribution in determining PC activation during hemostasis and thrombosis.
Treatment of older adult or frail patients with multiple myeloma
Authors: Grant Shakira J. , Freeman Ciara L. , Rosko Ashley E.
Published: December 2021

Older adults with multiple myeloma (MM) are a growing population, and personalizing treatment based on disease and health status is imperative. Similar to MM staging systems that provide disease-related prognostic information, myeloma-specific frailty tools can better identify subgroups at greatest risk for treatment-related toxicity and early treatment discontinuation, as well as predict overall survival. Several myeloma-specific validated tools are well studied. Although these fitness/frailty scores have shaped our understanding of the heterogeneity among older adults with myeloma, the application of such scores in treatment decision making (ie, transplant considerations, relapse) is an unmet need. Here we outline how to incorporate frailty assessments in the evaluation of older adults with MM in the clinical setting with consideration of other factors such as patient preferences, treatment risks/benefits, life expectancy, and disease biology.
Cryptogenic oozers and bruisers
Authors: Smock Kristi J. , Moser Karen A.
Published: December 2021

Bleeding disorders with normal, borderline, or nondiagnostic coagulation tests represent a diagnostic challenge. Disorders of primary hemostasis can be further evaluated by additional platelet function testing modalities, platelet electron microscopy, repeat von Willebrand disease testing, and specialized von Willebrand factor testing beyond the usual initial panel. Secondary hemostasis is further evaluated by coagulation factor assays, and factor XIII assays are used to diagnose disorders of fibrin clot stabilization. Fibrinolytic disorders are particularly difficult to diagnose with current testing options. A significant number of patients remain unclassified after thorough testing; most unclassified patients have a clinically mild bleeding phenotype, and many may have undiagnosed platelet function disorders. High-throughput genetic testing using large gene panels for bleeding disorders may allow diagnosis of a larger number of these patients in the future, but more study is needed. A logical laboratory workup in the context of the clinical setting and with a high level of expertise regarding test interpretation and limitations facilitates a diagnosis for as many patients as possible.
Blast and accelerated phase CML: room for improvement
Authors: How Joan , Venkataraman Vinayak , Hobbs Gabriela Soriano
Published: December 2021

Tyrosine kinase inhibitors (TKIs) revolutionized the treatment of chronic myeloid leukemia (CML). With TKI therapy, the percentage of patients who progress to accelerated phase (AP) or blast phase (BP) CML has decreased from more than 20% to 1% to 1.5% per year. Although AP- and BP-CML occur in a minority of patients, outcomes in these patients are significantly worse compared with chronic phase CML, with decreased response rates and duration of response to TKI. Despite this, TKIs have improved outcomes in advanced phase CML, particularly in de novo AP patients, but are often inadequate for lasting remissions. The goal of initial therapy in advanced CML is a return to a chronic phase followed by consideration for bone marrow transplantation. The addition of induction chemotherapy with TKI is often necessary for achievement of a second chronic phase. Given the small population of patients with advanced CML, development of novel treatment strategies and investigational agents is challenging, although clinical trial participation is encouraged in AP and BP patients, whenever possible. We review the overall management approach to advanced CML, including TKI selection, combination therapy, consideration of transplant, and novel agents.
Noninfectious lung complications of hematopoietic cell transplantation
Authors: Williams Kirsten M.
Published: December 2021

Noninfectious lung diseases contribute to nonrelapse mortality. They constitute a spectrum of diseases that can affect the parenchyma, airways, or vascular pulmonary components and specifically exclude cardiac and renal causes. The differential diagnoses of these entities differ as a function of time after hematopoietic cell transplantation. Specific diagnosis, prognosis, and optimal treatment remain challenging, although progress has been made in recent decades.
How to avoid the problem of erythrocyte alloimmunization in sickle cell disease
Authors: Pirenne France , Floch Aline , Habibi Anoosha
Published: December 2021

Erythrocyte alloimmunization is a major barrier to transfusion in sickle cell disease (SCD) because it can lead to transfusion deadlock and the development of life-threatening hemolytic transfusion reactions (HTRs). Several risk factors have been identified, such as blood group polymorphism in these patients of African ancestry frequently exposed to antigens they do not carry and an inflammatory clinical state of the disease. The most important preventive measure is prophylactic red blood cell antigen matching, and there is a consensus that matching for Rh (D, C, E, c, e) and K antigens should be performed for all SCD patients. However, some patients are high responders and more at risk of developing antibodies and HTRs. For these patients, the extension of matching to other blood groups, including variant antigens of the RH blood group, the use of genotyping rather than serology to characterize significant blood groups, and the prophylactic administration of immunosuppressive treatments remain a matter of debate due to low levels of certainty concerning their effects and the difficulty of determining which patients, other than those already immunized, are at high risk. These issues were recently addressed by a panel of experts established by the American Society of Hematology. Here, we review and stratify the various interventions for preventing alloimmunization, based on the literature and our experience and taking into account the obstacles to their implementation and any future developments required.