bluuebunny/crossref_metadata_2025 huggingface dataset:
Variability in negative affect is an important feature of neuroticism above mean negative affect once measurement issues are accounted for
Authors: Wenzel Mario , Rowland Zarah , Mey Lara K , Kurth Karolina , Tüscher Oliver , Kubiak Thomas
Published: May 2022

Neuroticism is an important predictor of well-being that is conceptualized by high levels of mean negative affect and negative affect variability. However, research has shown that negative affect variability only explained limited additional variance in neuroticism when the confound with mean negative affect was accounted for using a modified version of the standard deviation ( SD), the relative standard deviation ( RSD). Here, we (a) examined the suitability of the RSD as a variability measure, (b) introduced the number of negative affect episodes as an alternative measure of negative affect variability, and (c) investigated the relationship between neuroticism and negative affect variability, accounting for measurement error. Re-analyzing three experience sampling datasets ( N = 430 participants), we found several issues with the RSD, which limits its use as a negative affect variability measure, and which were not found for the number of negative affect episodes measure. Moreover, only the SD and the number of negative affect episodes explained substantial variance in neuroticism above mean negative affect. Thus, neuroticism was associated with experiencing negative affect more strongly and more often in daily life, when measurement error was accounted for, which demonstrates the importance to model reliability and to correct accordingly.
The development of trait greed during young adulthood: A simultaneous investigation of environmental effects and negative core beliefs
Authors: Mussel Patrick , de Vries Jantje , Spengler Maik , Frintrup Andreas , Ziegler Matthias , Hewig Johannes
Published: May 2022

Recent models of personality development have emphasized the role of the environment in terms of selection and socialization effects and their interaction. Our study provides partial evidence for these models and, crucially, extends these models by adding a person variable: Core beliefs, which are defined as mental representations of experiences that individuals have while pursuing need-fulfilling goals. Specifically, we report results from a longitudinal investigation of the development of trait greed across time. Based on data from the German Personality Panel, we analyzed data on 1,965 young adults on up to 4 occasions, spanning a period of more than 3 years. According to our results, negative core beliefs that have so far been proposed only in the clinical literature (e.g., being unloved or being insecure) contributed to the development of trait greed, indicating that striving for material goals might be a substitute for unmet needs in the past. Additionally, greedy individuals more often self-selected themselves into business-related environments, which presumably allow them to fulfill their greed-related need to earn a lot of money. Our results expose important mechanisms for trait greed development. Regarding personality development in general, core beliefs were identified as an important variable for future theory building.
Bioavailability of Orally Administered Drugs in Critically Ill Patients
Authors: Forsberg Johanna , Bedard Emma , Mahmoud Sherif H.
Published: May 2022

Critically ill patients managed in the Intensive Care Unit (ICU) suffer from several pathophysiological alterations due to critical illness resulting in potential changes in the pharmacokinetics of drugs including systemic absorption. Nevertheless, these patients are still given some medications in unadjusted doses thereby putting the patients at a risk for therapy failure. The objective for this study was to summarize the available evidence regarding oral drug absorption in the ICU. A literature search of the databases MEDLINE, EMBASE, and PubMed was conducted on (February 24, 2020). Articles discussing the rate and/or extent of orally administered drugs in critically ill patients were included. A total of 58 studies were found: 17 interventional studies, 33 observational studies (30 prospective, 3 retrospective) and 8 case reports. A total of 43 articles reported altered drug absorption in critically ill patients suggesting the need for alternative measures to facilitate treatment success. The absorption of orally administered drugs may be altered in critically ill patients. Measures for altered drug absorption in critically ill patients were suggested such as holding tube feeding before and after medication administration, increasing doses of orally administrated drugs and using alternate routes of administration.
Something’s Gotta Give: The Relationship Between Time in Eldercare, Time in Childcare, and Employee Wellbeing
Authors: Duxbury Linda , Halinski Michael , Stevenson Maggie
Published: May 2022

While existing research indicates that “sandwiched” employees (those with both childcare and eldercare demands) have lower wellbeing than employees with only eldercare demands, there is little understanding how childcare and eldercare demands interact to create those differences. Drawing on two studies, we hypothesize childcare demands amplify the negative impact of eldercare demands on wellbeing. Study 1 operationalizes childcare as a dichotomous variable (i.e., has childcare or not), and examines the relationship between hours per week in eldercare and wellbeing for two groups of employees: those with eldercare and those in the sandwich generation. Study 2, which operationalizes childcare as a continuous variable (i.e., hours in childcare per week), explores how time in childcare moderates the relationship between time in eldercare and wellbeing. Findings show time in eldercare is negatively associated with wellbeing, and the impact of childcare on the relationship between time in eldercare and wellbeing is dependent on how one operationalizes wellbeing and childcare constructs.
Students’ work placement learning and employability nexus: Reflections from experiential learning and social cognitive career theories
Authors: Chukwuedo Samson Onyeluka , Ementa Christiana Ngozi
Published: May 2022

To curtail difficulties in higher education relating to students’ learning with few or no real-life examples, poor acquisition of practical skills, a lack of confidence concerning their prospective career, and a fear of unemployment, it is imperative to engage students in real-life work environments before graduation. Drawing on the integration of Experiential Learning Theory and Social Cognitive Career Theory, the authors explore the work placement learning (WPL), career decision self-efficacy (CDSE), engagement in practical skills (EPS), and perceived employability skills (PES) nexuses. The participants in the study (N = 451) were technical and vocational education undergraduates drawn from four universities in Nigeria. Using data collected via a cross-sectional survey, the study results reveal that WPL is positively and strongly associated with PES. The results also show that WPL has a positive indirect influence on PES via CDSE and EPS, indicating the presence of serial mediation. The results further show that WPL has discrete positive indirect effects on PES via the dimensions of CDSE (self-appraisal, occupational information, goal selection, planning and problem-solving). The implications of the findings for higher education institutions are, accordingly, set out.
Fault diagnosis of rolling element bearing based on spatiotemporal intrinsic mode decomposition
Authors: Zhang Yuanxiu , Li Zhixing , Yanxue Wang
Published: May 2022

In view of the problem that source signals cannot be effectively separated in the process of blind source separation of similar nonstationary nonlinear signals, a spatiotemporal intrinsic mode decomposition method was proposed for bearing fault diagnosis. Spatiotemporal intrinsic mode decomposition can separate source signals and construct Fourier basis dictionaries and nonlinear signal models. The fault components can be separated by using this method in fault diagnosis. The proper initial phase function is selected for blind source separation of signals and signal decomposition components are obtained. By simulation analysis, spatiotemporal intrinsic mode decomposition than the fast independent component analysis method can more intuitive clearly separate the signals of admixed with large modulation components of correlation coefficient, and through the impact of component kurtosis index to judge fault, inherent modal decomposition method better prove time restore original bearing vibration signals and fault impact. Through the analysis and comparison of experimental data, the spatiotemporal intrinsic mode decomposition method has a significant effect on the fault diagnosis and analysis of rolling bearing outer ring, inner ring, and can intuitively express the fault characteristic frequency and frequency doubling through the analysis of envelope spectrum. In processing the industrial data, the spatiotemporal intrinsic mode decomposition method can also find the frequency characteristics of inner ring fault more clearly and accurately. Therefore, the spatiotemporal intrinsic mode decomposition method can solve the problem of blind source separation and realize fault diagnosis in rolling bearing fault field.
Nonlinear analysis and control of an underactuated 3-DOF control moment gyroscope with experimental validation
Authors: D Gobiha , G Rohith
Published: May 2022

Nonlinear controllers have been extensively abstracted in recent times. Nevertheless, real time implementation for underactuated MIMO physical systems is rarely attempted. This work proposes a nonlinear framework based on dynamical analysis and the sliding mode based control technique to control a highly coupled and nonlinear MIMO underactuated control moment gyroscope. First, an analytical formulation based on dynamic characterization is proposed to understand both the unactuated dynamics and the performance constraints of the gyroscope. This characterization helps in designing a feasible nonlinear sliding mode controller which helps in a simple and straightforward control of the system through the entire operating regime. The effectiveness of the proposed nonlinear control and analytical framework is established by successful implementation on the experimental gyroscope setup.
Holistic Health Practices of Rural Thai Homebound Older Adults: A Focused Ethnographic Study
Authors: Detthippornpong Supussajee , Songwathana Praneed , Bourbonnais Anne
Published: May 2022

Introduction:

Supporting independent functioning of homebound, chronically ill older adults (HOAs) is a major concern across cultures. In Thailand, actions HOAs take to remain independent and maintain their holistic (mental, physical, and spiritual) health is understudied. Therefore, we explored self-care practices used by rural Thai HOAs to maintain their independence.

Methods:

We used a focused ethnographic approach, recruiting HOAs, their families, and community members from a rural area in Southern Thailand. Data were analyzed using content analysis.

Results:

Sixteen HOAs and 23 family/community members participated. Three themes emerged: self-care to stay healthy, sharing life with family and society in a positive way, incorporating both folk and modern medicine to maintain health. Factors facilitating holistic health practices were supportive family network, Thai cultural beliefs, community strength and support, and health care services.

Discussion/Conclusions:

These findings may help health care professionals develop interventions supporting holistic health practices of Thai HOAs to remain independent.
Finding the missing link? The impact of co-ethnicity, pan-ethnicity, and cross-ethnicity on Latino vote choice
Authors: Cuevas-Molina Ivelisse , Nteta Tatishe M
Published: May 2022

Surveys show that Latinos more strongly identify with their ethnic identities (i.e. national origin) than their pan-ethnic identity as “Latino/Hispanic.” Given the primacy of ethnic identity among Latinos, what impact does shared ethnic versus pan-ethnic identity between candidates and voters have on Latino vote choice? Studies suggest that an “identity-to-politics link” exists among Latinos; however, we believe the measurement of “co-ethnicity” should be reexamined. Using a survey experiment embedded in a module of the 2016 Cooperative Congressional Election Study, we randomize the ethnic, pan-ethnic, and partisan identification of a fictional male congressional candidate in a contest against a white non-Hispanic candidate to examine the role of shared ethnic identity on Latino vote choice. We find that Latinos, regardless of candidate partisanship, more strongly support co-ethnic candidates relative to candidates with whom they share a pan-ethnic identity. We also find that Latinos are significantly more supportive of a cross-ethnic Latino candidate compared to a pan-ethnic Latino candidate; and that Latinos are more likely to cross partisan lines to support a co-ethnic candidate. These results not only suggest that there exists a Latino “identity to politics” link, but that the extant scholarship has underestimated the size and scope of this electoral connection.
Serum Human Epididymis Protein 4 as a Prognostic Marker in Cervical Cancer
Authors: Hwang Woo Yeon , Suh Dong Hoon , Kim Kidong , Kim Yong Beom , No Jae Hong
Published: May 2022

Objectives

The objective is to evaluate the prognostic value of serum human epididymis protein 4 (HE4) as a tumor marker in patients with cervical cancer.

Methods

Sixty-seven patients with cervical cancer treated at Seoul National University Bundang Hospital from September 2014 to May 2018 were retrospectively reviewed. Serum HE4 levels were measured by immunoassay before starting primary treatment. A mean serum HE4 level of 72.6 pmol/L was used to divide the patients into low and high HE4 groups. Patient characteristics, clinicopathological variables, and survival outcomes were compared between the two groups.

Results

The low and high HE4 groups included 55 (82.1%) and 12 (17.9%) patients at diagnosis, respectively. Higher HE4 levels were significantly associated with older age at diagnosis (age <50: .0% vs age ≥50: 100.0%; P = .002), menopause (premenopause: 8.3% vs postmenopause: 91.7%; P = .009), higher FIGO stage (stage I–II: 33.3% vs III–IV: 66.7%; P = .017), large tumor size (<4.0 cm: 41.7% vs ≥4.0 cm: 58.3%; P = .029), positive lymph node metastasis (negative: 41.7% vs positive: 58.3%; P = .049), and involvement of the parametrium (negative: 25.0% vs positive: 75.0%; P = .002). Higher HE4 level was a predictive factor for worse overall survival but not for progression-free survival. Elevated HE4 levels were not independent factors for the prediction of either overall survival or progression-free survival. Subgroup analysis by histological type revealed similar results for patients with squamous cell carcinoma.

Conclusions

High levels of HE4 expression correlated with poor overall survival, indicating that elevated HE4 levels are associated with a poor prognosis for patients with cervical cancer.
Research on detection and recognition methods of gas pipelines based on acoustic signal feature analysis
Authors: Liu Enbin , Wen Zhaorong , Guo Bingyan , Yu Bin , Chen Qikun
Published: May 2022

In the process of reconstruction and expansion of gas pipeline, it is easy to destroy in-service gas pipeline and cause safety accidents. In order to realize the detection of in-service pipelines, based on the characteristics of low sound pressure level and easy attenuation of acoustic signals of gas pipelines, the detection and identification method of gas pipelines based on acoustic signal feature analysis was studied by using Hilebert–Huang transform algorithm and optimized Back Propagation (BP) neural network. This method takes the gas pipeline flow noise signals obtained by numerical simulation and experimental verification as the research object, and the underwater acoustic signals are collected for comparative analysis. Empirical Mode Decomposition (EMD) was used to decompose the two signals, and the time-domain waveform of Intrinsic Mode Functions (IMF) component was obtained, and the characteristic parameters of peak value and peak frequency were determined. The energy characteristic parameters of Hilbert marginal spectrum were calculated, and the characteristic database of gas pipeline flow noise signal was obtained. The optimized BP neural network was used for pattern recognition. The results show that the identification rate of gas pipeline acoustic signal can reach 97.5% by using this method, which verifies the effectiveness of the gas pipeline detection and identification method in this paper.
Assessment of digital risks in child and adolescent mental health services: A mixed-method, theory-driven study of clinicians’ experiences and perspectives
Authors: Lau-Zhu Alex , Anderson Ciorsdan , Lister Matthew
Published: May 2022

Children and adolescents in the UK spend increasingly more time in the digital world, raising societal fears about digital risks in this age group. Professionals are not always aware of the ever-developing research or guidance available around digital safety. This gap underscores the need to understand current experiences and determinants of digital risk assessment, including clinicians’ views on barriers and facilitators. A mixed-method design was used. Fifty-three clinicians working in child and adolescent mental health services (CAMHS) in South England took part in a survey; of these 12 took part in semi-structured interviews. A psychological model of behavioural change (COM-B: capabilities, opportunities, motivation and behaviour) guided the analyses. Survey data revealed that clinicians showed awareness and concerns for several digital risk issues but there appeared to be gaps in their knowledge and practice. Interview data revealed different factors influencing staff enquiry about digital risks in CAMHS. These included aspects of capabilities (knowledge and skills), opportunities (resources, organisational context and empowerment of youth), and motivations (habit change, emotional experiences, and professional identity/role). Targeting both staff-level and organisation-level barriers to digital risk assessments in CAMHS is crucial. This study informs service improvement to ensure that children and young people safely navigate the digital world.
Experimental study of the valve rotation in a valvetrain car engine
Authors: Jelenschi Liviu , Öchsner Andreas , Scutaru Maria Luminita , Vlase Sorin , Marin Marin
Published: May 2022

The rotational motion of the valve during engine operation exists and research presented in this paper has shown that it can have significant importance in the costs related to the operation of the system. The main motion of the valve is an alternating translation along its axis of symmetry, but which is accompanied by an independent rotation around its own axis, possibly due to the constructive shape of the valve. This rotational movement is an important phenomenon with practical applications. The existence of this valve rotation movement has a number of advantages, mainly leading to an increase in the operating period of the valve and implicitly of the engine. An experimental study of the valve rotation is presented in the paper and a comparison with theoretical models is made.
Optical investigation on the interaction between a fuel-spray and an oil wetted wall with the focus on secondary droplets
Authors: Maliha Malki , Stumpf Bastian , Beyer Felix , Kühnert Marius , Kubach Heiko , Roisman Ilia , Hussong Jeanette , Koch Thomas
Published: May 2022

Since the technology of direct injected engines has become more and more prevalent, combustion anomalies such as pre-ignition events have been occurring with increasing frequency. The interaction between the fuel-spray and the oil wetted cylinder liner is considered to be a partial cause for these phenomena. The incoming fuel jet can lead to a detachment of secondary droplets, which may affect pre-ignition events due to their changed flammability properties. To characterize these secondary droplets, spatially and temporally highly resolved optical investigations on the fuel-oil-film-interaction are carried out in this work. Using laser induced fluorescence and two high-speed cameras both fluids are optically separated. Thereby the secondary droplets can be detected and characterized in size, velocity vector, and composition.
Seeing bodies in social sciences research: Body mapping and violent extremism in Kenya
Authors: Aroussi Sahla , Badurdeen Fathima A , Verhoest Xavier , Jakala Michaelina
Published: May 2022

While violence is often targeted at and experienced by bodies with different identities or appearance, studies of violence in social sciences research often neglect the body as a data source and site of analysis. This article makes an original contribution to the literature on visual methods in general and arts-based approaches specifically, by focusing on the understudied and underutilised method of body mapping. It is novel in developing techniques for using body mapping as a tool for seeing violent extremism in international politics. The approach here enables researchers to engage with a potentially difficult topic and interrogate the nuances of how violent extremism is understood, experienced and resisted at a local community level. In so doing, it produces a rich, original data set of 20 body maps, interviews and focus group discussions with 10 men and 10 women from Muslim communities from around the coast in Kenya created during two 5-day intensive body mapping workshops held in Mombasa in November 2019. This embodied storytelling challenges dominant ideas about violent extremism and makes visible otherwise marginalised and obscured personal narratives and lived experiences of violence. This is of fundamental importance because everyday violence and exclusion not only go unaddressed in the efforts to tackle violent extremism but are also exacerbated by the excessive security measures used by the government in its effort to counter the threat of groups such as Al-Shabaab. The techniques we develop in this article have significant advocacy potential and societal impact: body mapping creates a platform and a tool for highlighting and challenging everyday practices such as female genital mutilation, violence against women, discrimination, racism, police brutality, tribalism and marginalisation. It can also transcend linguistic and educational barriers to enable access to a diverse audience and create bridges between divided communities.
There and (not quite) back again: A theatre and performance instructional team’s journey through COVID-19 in Australia
Authors: Banks Hannah Joyce , Walling Carl , Loth Jo
Published: May 2022

This article details the journey of a Theatre and Performance team working in Australian higher education during the COVID-19 pandemic. Using reflective practice informed by Social Constructivism, we addressed the dilemmas of building and shifting an online community of learners. Act One considers the unknown as we shifted online, and the new year gave way to a semester of developing solutions for teaching theatre in isolated learning environments. This focused on: peer-to-peer communication; group tasks in solo formats; and mechanisms for support. Act Two details the shift back into face-to-face collaborative learning environments focusing on artistic voice and flexible collaboration. How does one re-establish an ensemble while recognizing potential traumatic experiences? We developed effective pedagogical strategies in response to the crisis and pre-existing fault lines within a theatre curriculum. As the world recovers, we must recognize that the journey taken must inform future practice.
Climate change and displacement: Towards a pluralist approach
Authors: Draper Jamie
Published: May 2022

This paper sets out a research agenda for a political theory of climate displacement, by critically examining one prominent proposal—the idea of a normative status for ‘climate refugees’—and by proposing an alternative. Drawing on empirical work on climate displacement, I show that the concept of the climate refugee obscures the complexity and heterogeneity of climate displacement. I argue that, because of this complexity and heterogeneity, approaches to climate displacement that put the concept of the climate refugee at their centre will fail to treat like cases alike and relevantly different cases differently. In response to these failings, I outline an alternative—the pluralist theory of climate displacement—which confronts the specific challenges that climate displacement poses in different practical and institutional contexts, whilst also treating climate displacement as a unified phenomenon at the second-order level of burden-sharing.
Moderating effects of emotion regulation difficulties and resilience on students’ mental health and well-being during the COVID-19 pandemic
Authors: Rufino Katrina A , Babb Stephanie J , Johnson Ruth M
Published: May 2022

This study examined whether emotion regulation difficulties and resilience in college students moderated changes in mental health over the course of the COVID-19 pandemic. Participants ( N = 321) completed surveys assessing mental health, in addition to levels of emotion dysregulation, and resilience during the pandemic, then utilized an anchoring prompt to recall mental health experiences before the pandemic. Correlations revealed participants with higher levels of emotion dysregulation also reported lower levels of resilience. Analyses using the SPSS Macro MEMORE ( Montoya, 2019 ) revealed participants with higher levels of emotion regulation difficulties had greater increases in depression and insomnia, and greater decreases in well-being over the course of the COVID-19 pandemic, while participants with lower levels of resilience had greater increases in depression, anxiety, and insomnia over the course of the pandemic. These results highlight the importance of additional support services and mental health training at universities to meet college students’ immediate and long-term emotional needs stemming from the pandemic.
Safety of Percutaneous Femoral Access for Endovascular Aortic Aneurysm Repair Through Previously Surgically Exposed or Repaired Femoral Arteries
Authors: Meertens Max M. , Tenorio Emanuel R. , Lemmens Charlotte C. , Marcondes Giulianna B. , Lima Guilherme B. B. , Schurink Geert Willem H. , Mendes Bernardo C. , Oderich Gustavo S. , Mees Barend M. E.
Published: May 2022

Objective:

Percutaneous femoral artery access is being increasingly used in endovascular aortic repair (EVAR). The technique can be challenging in patients with previously surgically exposed or repaired femoral arteries because of excessive scar tissue. However, a successful percutaneous approach may cause less morbidity than a “re-do” open femoral approach. The aim of this study was to assess the impact of prior open surgical femoral exposure on technical success and clinical outcomes of percutaneous approach.

Methods:

This study retrospectively reviewed the clinical data of patients who underwent percutaneous EVAR between 2010 and 2020 at 2 major aortic centers. Patients were divided into 2 groups (with or without prior open surgical femoral access) for analysis of clinical outcomes. Only punctures with sheaths ≥12Fr were included for analysis. The access and (pre)closure techniques were similar in both institutions. Primary end points were intraoperative technical success, access-related revision, and access complications. A multivariate analysis was performed to identify determinants of conversion to open approach and femoral access complications in intact and re-do groins.

Results:

A total of 632 patients underwent percutaneous (complex) EVAR: 98 had prior open surgical femoral access and 534 patients underwent de novo femoral percutaneous access. A total of 1099 femoral artery punctures were performed: 149 in re-do and 950 in intact groins. The extent of endovascular repair included 159 infrarenal, 82 thoracic, 368 fenestrated/branched, and 23 iliac branch devices. No significant differences were seen in technical success (re-do 93.3% vs intact 95.3%, p=0.311), access-related surgical revision (0.7% vs 0.6%, p=0.950), and access complications (2.7% vs 4.0%, p=0.443). For the whole group, significant predictors for access complications in multivariate analyses were main access site (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.07%–5.35%; p=0.033) and increase of the procedure time per hour (OR 1.65; 95% CI 1.34%–2.04%; p<0.001), while increase in sheath-vessel ratio had a protective effect (OR 0.33; 95% CI 0.127%–0.85%; p=0.021). Surgical conversion was predicted by main access site (OR 2.32; 95% CI 1.28%–4.19%; p=0.007) and calcification of 50% to 75% of the circumference of the access vessel (OR 3.29; 95% CI 1.38%–7.86%; p=0.005).

Conclusion:

Within our population prior open surgical femoral artery exposure or repair had no negative impact on the technical success and clinical outcomes of percutaneous (complex) endovascular aortic aneurysm repair.
Robustness Assessment of Images From a 0.35T Scanner of an Integrated MRI-Linac: Characterization of Radiomics Features in Phantom and Patient Data
Authors: Ericsson-Szecsenyi Rebecka , Zhang Geoffrey , Redler Gage , Feygelman Vladimir , Rosenberg Stephen , Latifi Kujtim , Ceberg Crister , Moros Eduardo G.
Published: May 2022

Purpose: Radiomics entails the extraction of quantitative imaging biomarkers (or radiomics features) hypothesized to provide additional pathophysiological and/or clinical information compared to qualitative visual observation and interpretation. This retrospective study explores the variability of radiomics features extracted from images acquired with the 0.35 T scanner of an integrated MRI-Linac. We hypothesized we would be able to identify features with high repeatability and reproducibility over various imaging conditions using phantom and patient imaging studies. We also compared findings from the literature relevant to our results. Methods: Eleven scans of a Magphan® RT phantom over 13 months and 11 scans of a ViewRay Daily QA phantom over 11 days constituted the phantom data. Patient datasets included 50 images from ten anonymized stereotactic body radiation therapy (SBRT) pancreatic cancer patients (50 Gy in 5 fractions). A True Fast Imaging with Steady-State Free Precession (TRUFI) pulse sequence was selected, using a voxel resolution of 1.5 mm × 1.5 mm × 1.5 mm and 1.5 mm × 1.5 mm × 3.0 mm for phantom and patient data, respectively. A total of 1087 shape-based, first, second, and higher order features were extracted followed by robustness analysis. Robustness was assessed with the Coefficient of Variation (CoV < 5%). Results: We identified 130 robust features across the datasets. Robust features were found within each category, except for 2 second-order sub-groups, namely, Gray Level Size Zone Matrix (GLSZM) and Neighborhood Gray Tone Difference Matrix (NGTDM). Additionally, several robust features agreed with findings from other stability assessments or predictive performance studies in the literature. Conclusion: We verified the stability of the 0.35 T scanner of an integrated MRI-Linac for longitudinal radiomics phantom studies and identified robust features over various imaging conditions. We conclude that phantom measurements can be used to identify robust radiomics features. More stability assessment research is warranted.
Acute Symptomatic Free-Floating Thrombus in the Innominate Artery, a Case Series
Authors: Torrealba Jose Ignacio , Valdés Francisco J , Garrido Luis , Mertens Renato , Mariné Leopoldo , Bergoeing Michel , Vargas Francisco
Published: May 2022

Background

Innominate artery embolism may result in upper extremity ischemia or stroke. A free-floating thrombus originating from the IA is an unusual and dangerous disorder with embolic potential. Only isolated cases have been described showing different treatment modalities.

Purpose

To present 3 cases of free-floating thrombus in the IA treated at our institution with 3 different approaches.

Cases

The first case is a patient with a free-floating thrombus in the IA treated with cervical debranching and ligation of the proximal right carotid artery; another case of a patient treated with a hybrid approach with deployment of an iliac limb in the IA plus right carotid to subclavian bypass; and a third case of a patient operated by open arch thrombectomy.

Conclusions

Free-floating thrombus in the IA is a threatening condition feasible to be managed through different customized surgical approaches in specialized centers.
Postmortem Diagnosis of the Proteus Syndrome by Next Generation Sequencing of Affected Brain Tissue
Authors: Baker Tiffany G. , Glen William B. , Wilson Robert C. , Batalis Nicholas I. , Wolff Daynna J. , Welsh Cynthia T.
Published: May 2022

We report a case of a somatic overgrowth syndrome diagnosed at forensic autopsy with the aid of next generation sequencing as Proteus syndrome. Somatic overgrowth syndromes result from spontaneous somatic mutations that arise early in development and display a mosaic pattern of expression in patient tissues. Due to the temporal and anatomic heterogeneity of these syndromes, phenotypes vary widely, resulting in clinical overlap. Furthermore, the variable ratio of mutated to nonmutated cells in patient tissue can result in low-level mutations that could be missed using Sanger sequencing. Due to these factors, recent literature points to next generation sequencing (NGS) as an adjunct to diagnosis of these rare entities. A male in his fourth decade of life presented to our forensic autopsy service with physical features suggestive of a somatic overgrowth syndrome. Due to the paucity of clinical information accompanying the individual, a definitive diagnosis based on physical characteristics, alone, was not possible. Next generation sequencing of affected formalin-fixed and paraffin-embedded brain tissue confirmed the presence of the variant in AKT1 (c.49G>A, p.Glu17Lys, in 14.13% of reads) found in Proteus syndrome. To our knowledge, this is the first report of the mosaic variant of AKT1 detected in brain tissue and the first reported case of a postmortem diagnosis of Proteus syndrome with the aid of NGS. We conclude that NGS can be used as an adjunctive method to support a specific diagnosis among the somatic overgrowth syndromes postmortem in the absence of sufficient clinical history.
Phenolic Composition and Antioxidant Properties of 2 Taxa of Macadamia Flowers
Authors: Yang Wei-hai , Lu Chao-zhong
Published: May 2022

This study investigated the differences in phenolic composition and antioxidant properties among 4 extracts (eg,70% acetone, 70% methanol, 70% ethanol, and water) of 2 taxa of Macadamia flowers (“Nanya No.2” and “HAES695” cultivars). The results showed that the phenolic compounds and antioxidant properties of the extracts were taxa- and solvent-dependent. “Nanya No.2” flowers possessed remarkably more phenolics and flavonoids, with more robust antioxidant activities than “HAES695”. The 70% acetone extract exhibited the highest polyphenol levels and antioxidant capacities, indicating that 70% acetone would be the most efficient solvent for extracting phenolic antioxidants from macadamia flowers. The high-performance liquid chromatography (HPLC) analysis revealed rutin and catechin as the richest compounds in the extracts of both cultivars. Ferulic acid, catechin, phlorizin, quercetin, and kaempferol positively correlated with the antioxidant properties of the macadamia flowers. These results provide valuable information for utilizing macadamia flowers in antioxidant foods.
Resident-Driven Dysphagia Screening Protocol for Expedited Antithrombotic Delivery in Acute Ischemic Stroke
Authors: Zhang Linda , Kamen Scott , Niles Jennifer , Goss Jessica , Heslin Mark E. , Vigilante Nicholas , Thau Lauren , Edwards Christopher , Marden Kyle R. , Thon Jesse M. , Yeager Terri , Siegler James E.
Published: May 2022

Background

We implemented a multi-disciplinary process improvement intervention at our Comprehensive Stroke Center with speech/language pathologists to expedite oral medication delivery in stroke patients. Following a failed nursing dysphagia screen, trained neurology physicians screened dysphagia further to approve use of oral medications. We analyzed the safety and efficacy of this intervention.

Methods

We analyzed retrospectively collected data for hospital course, timing of first screen, first oral medication use, and complications (e.g., aspiration pneumonia) in consecutive ischemic stroke patients (9/2019-07/2021). Patients were included if they passed a dysphagia assessment by physicians (Ph), nurses (RN), or speech/language pathologists (SLP). Arrival-to-dysphagia screen and arrival-to-antithrombotic were assessed using restricted mean survival time (RMST).

Results

Of the 789 included patients, 673 were passed by RN, 104 by SLP, and 12 by Ph. Compared to patients passed by SLP, those passed by Ph were younger and had less severe deficits ( P < .01 for both). Patients were screened more quickly by Ph than RN or SLP (median 38 vs 182 vs 1330-min post-arrival, P = .0001; 299-min RMST difference vs RN [95%CI 22-575, P = .03]; 470-min RMST difference vs SLP [95%CI 175-765, P = .002]). This translated to faster oral antithrombotic use for Ph-passed patients (138-min RMST difference vs RN [95%CI 59-216]; 332-min RMST difference vs SLP [95%CI 253-411]). No patients passed by Ph experienced aspiration pneumonia (0%).

Conclusions

We safely conducted a physician-driven dysphagia screening paradigm which led to faster oral antithrombotic delivery without signal of patient harm. Physician availability to complete dysphagia screens in acute stroke patients was a limitation.
Changes in Attachment to Parents and Peers and Relations With Mental Health During the COVID-19 Pandemic
Authors: Song Qingfang , Vicman Jess M. , Doan Stacey N.
Published: May 2022

Using a longitudinal design, we examined changes in parent and peer attachment among college students, and their predictive and protective roles in relation to mental health problems during the COVID-19 pandemic. College students ( N = 106) rated their parent and peer attachment, and self-reported anxiety, loneliness, and depressive symptoms 1 year before and during the pandemic. Participants also rated the impact of COVID-19 related stressors (CRS). Results demonstrate significant increases in loneliness and depression and a decrease in peer attachment security during the pandemic. Increases in peer attachment security were negatively correlated with loneliness during the pandemic. Parent attachment buffered the relationship between the impact of CRS and mental health problems during the pandemic. Guided by the integrated framework from attachment theory and life course theory, the current study discussed findings and practices regarding the important role of attachment for college students and their adjustment to the pandemic.
Fracture-Separation of the Medial Humeral Epicondyle Caused by Arm Wrestling: A Systematic Review
Authors: Ogawa Kiyohisa , Yoshida Atsushi , Matsumura Noboru , Inokuchi Wataru
Published: May 2022

Background:

Arm wrestling is a popular sport in which various injuries have occurred, even in children.

Purpose:

To analyze reported fracture-separation of the medial humeral epicondyle (MHE) caused by arm wrestling to determine its mechanism and provide a current overview.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

The PubMed and Web of Science databases were searched using the terms “arm wrestling” and “humeral fracture” or “medial humeral epicondyle fracture”; and “sports” and “humeral fracture” or “medial humeral epicondyle fracture,” following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The inclusion criteria were English full-text articles on arm wrestling–induced MHE fracture that described patient characteristics and presented appropriate images. Studies with a lack of appropriate images or detailed description of the injury situation were excluded. The patient characteristics were evaluated, and the ratios of treatment selection and outcomes were evaluated using the chi-square test.

Results:

Included were 27 studies with a total of 68 patients, all boys with a mean age of 14.6 ± 1.24 years (based on n = 65, with 3 patients excluded from this calculation as no definitive age was provided). Boys aged 14 to 15 years accounted for 72% (49/68) of the cases. Fracture occurred suddenly during arm wrestling in 63 boys, while the other 5 boys experienced antecedent medial elbow pain. The match status at the time of injury, provided for 46 patients, was varied. In 31 boys with known match details, injury occurred when a participant suddenly added more force to change the match status. Eight patients displayed anterior and/or proximal displacement of the MHE fragment. Treatment was nonoperative in 25 patients and operative in 38 patients (n = 63, excluding 5 unknown patients). In 35 patients followed up for ≥3 months (mean, 17.6 ± 12.3 months), outcomes were not significantly different between the operative and nonoperative groups.

Conclusion:

MHE fracture-separation caused by arm wrestling occurred mostly in boys aged 14 to 15 years regardless of the match status. The likely direct cause is forceful traction of the attached flexor-pronator muscles. A relative mechanical imbalance during adolescence may be an underlying cause. A sudden change from concentric to eccentric contraction of the flexor-pronator muscles increases the likelihood of fracture occurrence.
Difficulties in Diagnosis Acute Necrotizing Encephalopathy of Childhood: A Case Report
Authors: Handryastuti Setyo , Silvana Sisca , Yunus Reyhan Eddy , Taufiqqurrachman Iqbal , Rafli Achmad
Published: May 2022

Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition of encephalopathy which commonly occurs in healthy children. This case report will discuss the diagnostic approach in a female child, three years old, with neurologic deficits. The diagnostic approach of ANEC consists of clinical manifestation, laboratory examination, cerebrospinal fluid (CSF) analysis, and neuroimaging interpretation. The patient had high liver enzyme, normal CSF analysis with appearances of edema, hemorrhage and necrosis in serial brain magnetic resonance imaging (MRI).
Perceptual Matching of Room Acoustics for Auditory Augmented Reality in Small Rooms - Literature Review and Theoretical Framework
Authors: Neidhardt Annika , Schneiderwind Christian , Klein Florian
Published: May 2022

For the realization of auditory augmented reality (AAR), it is important that the room acoustical properties of the virtual elements are perceived in agreement with the acoustics of the actual environment. This perceptual matching of room acoustics is the subject reviewed in this paper. Realizations of AAR that fulfill the listeners’ expectations were achieved based on pre-characterization of the room acoustics, for example, by measuring acoustic impulse responses or creating detailed room models for acoustic simulations. For future applications, the goal is to realize an online adaptation in (close to) real-time. Perfect physical matching is hard to achieve with these practical constraints. For this reason, an understanding of the essential psychoacoustic cues is of interest and will help to explore options for simplifications. This paper reviews a broad selection of previous studies and derives a theoretical framework to examine possibilities for psychoacoustical optimization of room acoustical matching.
Characteristics of Frailty in Haemodialysis Patients
Authors: Hendra Heidy , Sridharan Sivakumar , Farrington Ken , Davenport Andrew
Published: May 2022

Background: Both frailty and cachexia increase mortality in haemodialysis (HD) patients. The clinical frailty score (CFS) is a seven-point scale and less complex than other cachexia and frailty assessments. We wished to determine the characteristics of frail HD patients using the CFS. Methods: Single centre cross-sectional study of HD patients completing physical activity questionnaires with bioimpedance measurements of body composition and hand grip strength (HGS). Results: We studied 172 HD patients. The CFS classified 54 (31.4%) as frail, who were older (70.4±12.2 vs 56.2 ± 16.1 years, p < 0.001), greater modified Charlson co-morbidity (3 (2–3) versus 1.5 (0–3), p < 0.001), and body fat (33 (25.4–40.2) versus 26.2 (15.8–34) %, p < 0.01), but lower total energy expenditure (1720 (1574–1818) versus 1870 (1670–2194) kcal/day, p < 0.01), lean muscle mass index (9.1 (7.7–10.1) versus 9.9 (8.9–10.8) kg/m2), and HGS (15.3 (10.3–21.9) versus 23.6 (16.7–34.4) kg), both p < 0.001. On multivariable logistic analysis, frailty was independently associated with lower active energy expenditure (odds ratio (OR) 0.98, 95% confidence limits (CL) 0.98–0.99, p = 0.001), diabetes (OR 5.09, CL 1.06–16.66) and HGS (OR 0.92, CL 0.86–0.98). Discussion: Frail HD patients reported less active energy expenditure, associated with reduced muscle mass and strength. Frail patients were more likely to have greater co-morbidity, particularly diabetes. Whether physical activity programmes can improve frailty remains to be determined.
Coproducing the Learning Environment: Lessons Learned from a Year of Near-Peer Teaching
Authors: Humphrey Kristen N. , Daulton Robert S. , Weber Danielle , Sall Dana , Kelleher Matthew
Published: May 2022

PURPOSE

Few medical schools offer electives with the goal of teaching medical students to be effective teachers prior to residency. We developed a novel year-long, longitudinal course, the Clinical Teaching Elective (CTE), that develops fourth-year medical students as student teachers within Clinical Skills (CS).

APPROACH/METHODS

The elective was designed by Clinical Skills (CS) Course Directors and two fourth-year medical students (M4) as a longitudinal elective. The elective involves teaching in the Simulation Center where M4 student instructors teach first and second-year medical students. Each session, in addition to simulated patient case topics, emphasizes application of a key topic within medical education (ie clinical reasoning, reflective practice, dual process reasoning).

DISCUSSION

Six “teaching takeaways” were crafted to summarize common themes experienced by near-peer medical student educators. Teaching is not about the destination, but rather the diagnostic journey. Students thrive when learning is co-produced. A little bit of praise goes a long way. You can't please every learner. When students struggle, there is more to teach than just the answer. Facilitating learner independent thinking promotes future autonomy.

SIGNIFICANCE

A novel CTE for fourth-year medical students that emphasizes medical education pedagogy prepares students to serve as educators in residency. The CTE provides an opportunity for medical students to develop into effective clinical educators prior to residency. The focus of our elective on medical education pedagogy furthers medical student understanding of adult learning theory and fosters professional development in teaching clinical reasoning.