bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Filterless Frequency 32-Tupling Photonic Scheme To Generate Sub-Terahertz Wave Signal Enabled By Optical Polarization Modulators
Authors: Chen Xinqiao , Liu Xiaorui , Li Zhihan 
Published: August 2021

Abstract
A novel scheme based on polarization modulators to generate Sub-Terahertz wave (Sub-THz) signal with frequency 32-tupling is proposed. The system consists of two subsystems in cascade, and each subsystem consists of 4 paralleled polarization modulators. In this scheme, by properly controlling two subsystems, an optical signal with optical carrier and ±16th-order optical sidebands is achieved. Next, by adjusting the optical attenuator and optical phase shifter, the optical carrier can be canceled. Finally, the Sub-THz wave with frequency 32-tupling can be obtained after beaten in the photodetector. The results show the ±16th-order optical sideband suppression ratio (OSSR) is derived as 55.7 dB and the radio frequency sideband suppression ratio (RFSSR) of the 32-tupling Sub-THz wave is derived as 43.66 dB, which are consistent with the theoretical analysis very well. Meanwhile, the effects of phase offset, modulation index, and attenuator deviation on suppression ratio are analyzed.
Dealing with Sensitive Research and the Professional/Researcher Dilemma; A Reflective Account on Men Living with Advanced Prostate Cancer
Authors: Salifu Yakubu , Almack Kathryn , Caswell Glenys 
Published: August 2021

Abstract
Background: There is developing literature that addresses the ethics and sensitivity of undertaking research with patients (and their family members) receiving palliative or end of life care, but there is little published guidance for a novice researcher and sparse evidence in this area that take account of culturally sensitive and resource-poor settings. Sensitive research can be emotionally challenging for researchers too.Aim/ Method: This is a reflective account that draws upon research with men who have advanced prostate cancer and their family caregivers in a health resource-limited contextFindings: From a research standpoint, two sets of operational issues on challenging emotions and ethics were encountered. The first set of challenges involved the difficulty of researching in a poorly resourced country where many of the things that are taken for granted in the Western world is not the same for researchers. Patients and their caregivers have little access to palliative care, and family members provide most care at home. The second set of challenges entails having to navigate dual roles seamlessly as a nurse as well as a researcher-in-training. Dealing with the issue of double identity and interviewing while dealing with concerns about the care that the researcher observed could be dangerous to the participant's health. Discussion: Although 'sensitive research' may provoke participants' emotional responses, and may put the researcher in a researcher/professional role conflict, it does have the potential for offering a therapeutic relationship. These included navigating issues of conducting interviews while also being asked for advice or identifying concerns about the care that were observed as potentially dangerous to the participant's health. Reaching out to participants about a research topic that carries cultural perceptions as a shameful and stigmatising disease is also challenging. Additionally, many aspects of fieldwork present additional considerations in resource-poor contexts. For example, travelling to and arranging fieldwork presents practical challenges, with poor transport and means of contacting participants. Conclusion: This article presents insights into palliative care research in a cultural context where there are many challenges beyond those discussed and encountered in resource-rich contexts. Such a hazing role between nurse and researcher has repercussions for nurses who do qualitative research into sensitive topics that elicit a passionate, emotional response.
Comprehensive Mental Health Facets And Association With Age, Stress And Coping Amid 'The New Normal' Pandemic: How Do Adolescents Differ From Adults?
Authors: Singh Shweta , Datta Manjistha , Gupta Pawan , Batra Saakshi , Tripathi Rakesh , Mahour Pooja , Arya Amit , Tripathi Adarsh , Gupta Bandna , Agarwal Manu , Nischal Anil , Agarwal Vivek , Dalal P.K. 
Published: August 2021

Abstract
Background: Given varied forms of stressors in the backdrop of the COVID 19 pandemic, adolescents are particularly vulnerable to specific mental health challenges. It pertinent to explore how adolescents differ from adults regarding the comprehensive mental health facets amid the 'new normal, i.e., the duration between the first and second wave of COVID-19 in a developing country like India. The present study aimed to compare the comprehensive mental health facets of adolescents with the adults. Also, it aimed to explore the association of mental health facets with age, perceived stress, coping and impact of pandemic. Methods: The study followed a cross-sectional design with 1,027 participants [456 adolescents; 347 young and 224 middle age-adults] recruited from schools and colleges. The Comprehensive DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure, Perceived Stress Scale and Brief COPE Scale were used for assessment. The difference between groups was analyzed using the Chi-Square Test of Independence and correlational analysis was done using Spearman Rank Correlation. Multiple regression analyses were performed for the mental health facets along with bootstrapping method. Results: 33.77% of adolescents, 25.65% of young adults, and 17.41% of middle-aged adults reported that their symptoms started during the pandemic. Compared to adults, the adolescents reported higher depression, anxiety, suicidal ideations, anger, and somatic complaints. Significantly higher adolescent females (39.9%) were found to have sleep disturbances compared to their male counterparts (25.5%). Therefore, it can be observed Adolescents are more clinically vulnerable in most domains. The correlational analysis showed that most mental health domains, except substance use showed moderate-to-low correlations with ‘Impact of COVID’. Perceived stress, impact of COVID, self-distraction, self-blaming were significant independent positive predictors for all the mental health domains except substance use. ‘Age’ was negatively associated with depression anxiety, repetitive thoughts, personality changes, suicidal ideations and memory, and positively associated with ‘substance use’ at low levels. Maladaptive coping was moderately positively correlated with all the mental health domains. Conclusion: It can be observed Adolescents are more clinically vulnerable in most domains. This study provides a comprehensive analysis for assessment and clinical decision-making to combat the mental health problems arising and exacerbating due to the COVID-19 pandemic. The findings will help in planning and implementing an appropriate interventional program, and making policy decisions related to the vulnerable group of adolescents.
Reconstruction of Complex Soft-Tissue Defects in Buttock Using The Proximally Based Anterolateral Thigh Flap: An Alternative Algorithm
Authors: Wang Danying , Zang Mengqing , Zhu Shan , Chen Bo , Li Shanshan , Han Tinglu , Liu Yuanbo 
Published: August 2021

Abstract
Background

Local and free flaps are most widely used in buttock reconstruction. However, local flaps and free flaps may not be appropriate for all complex soft tissue defects in buttock. In this study, we propose an alternative approach for buttock reconstruction and provide preliminary assessment in clinical efficacy of using a proximally based anterolateral thigh flap for buttock reconstruction.
Methods

In this study, we retrospectively analyzed the data of the patients with medium- to large-sized defects of buttock. All patients underwent buttock defect reconstruction using a proximally based anterolateral thigh flap between August 2012 and December 2020.
Results

Eight pedicled anterolateral thigh flaps were used to reconstruct buttock defects after tumor ablation in six patients, scar revision in one patient, melanocytic nevus resection in one patient. Flap size ranged from 25 × 8 cm to 30 × 12 cm, with pedicle length ranging from 12 to 20 cm. Flaps were elevated based on the distal musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery and completely survived without any perfusion-related complications. We achieved satisfactory results from both the functional and aesthetic point-of-view at the 6-month follow-up in all cases.
Conclusions

The proximally based anterolateral thigh flap can be a valuable reconstructive option with sufficient tissue and a long vascular pedicle for buttock defect reconstruction.
Coping and Resilience: Two Peas in a Pod? A Mixed-methods Study on the Association Between Coping and Resilience among Caretakers of School-going Children with Disabilities in Uganda
Authors: Namasaba Mariam , Kazembe Neo , Seera Georgina , Baguwemu Ali Ayub 
Published: August 2021

Abstract
BackgroundIn Africa, caretakers of children with disabilities face stigma and report feeling isolated. The caretakers may take their children to school in the hope of finding solace from grim societal norms. However, schools for children with disabilities are often too ill-equipped to support the children or their caretakers. No study has examined how structural settings (like the type of school) may frame the association between coping and resilience. Thus, this study examined the association between coping and resilience among caretakers of school-going children with disabilities in Uganda.Methods The study used mixed methods to survey 621 caretakers of children with disabilities in Kampala district, Uganda. Hierarchical cluster analysis followed by binary logistic regression was conducted to examine the association between school type and caretakers’ coping patterns. Hierarchical linear regression was then employed to assess the association between coping and resilience with the type of school and other covariates. Qualitative data were analyzed through thematic analysis. Qualitative and quantitative results were triangulated with a convergent joint display.ResultsCaretakers of children in inclusive schools were more likely to use adaptive coping skills than caretakers of children in special needs schools (Adjusted Odds Ratio (AOR) = 1.5; p = 0.04; 95% CI = 1.02-2.30). Caretakers of children in special needs schools had significantly higher resilience than caretakers of children in inclusive schools (B = 2.65; SE_B = 1.21; p = 0.02; n = 621). Caretakers who received social support from the school had significantly higher resilience than caretakers who received social support from informal sources (B = 2.33; SE_ B= 1.05; p = 0.03; B= 1.87)ConclusionThis study underscores the importance of structural factors, such as the school type, in framing caretakers' psychological outcomes. Schools that provide social support to caretakers play a crucial mediating role in how caretakers cope and influence their ability to adapt to the challenges they face. Therefore, schools for children with disabilities are an avenue that can be leveraged to support families and improve the psychological health outcomes of children and their caretakers.
Effect of Acetylation Modification on Structure and Properties of Windmill Palm Fiber
Authors: Chen Changjie , Tan jing , Zhang Weiguo , Wang Zhong , Wang Guohe , Wang Xinhou 
Published: August 2021

Abstract
Windmill palm fiber, a high-quality cellulose resource, can be extracted from discarded palm sheath. However, its application in textile filling and composite reinforcement is limited due to its hydrophilic solid. In this paper, effects of chemical treatment such as alkali, acetyl chloride, and acetic anhydride treatment on the micro-morphology, water repellency, sound absorption, thermal conductivity and thermal stability of the windmill palm fiber were investigated. The results showed that the surface of windmill palm fiber treated by alkali was relatively smooth and compact. In comparison, the acetylation treatment destroyed the cell wall with micro-holes on the surface. Acetylation modification can significantly improve the water repellency of fibers. Furthermore, thewater static contact angle can be achieved 148o. Acetylation treatment improved the sound absorption performance of the fiber mat with an average sound absorption coefficient of 0.47, kept low thermal conductivity of under 0.050 W/(m℃), and improved the thermal stability with the initial decomposition temperature 356oC.
Investigating The Benefits of Online Running Groups On The Well-Being of Their Female Running Members
Authors: Hughes Susan , Moorhead Anne 
Published: August 2021

Abstract
BackgroundOnline running communities are becoming increasingly prevalent within social media, and many groups have been exclusively established for female runners. The aim of this study was to investigate the wellbeing benefits and limitations of using Facebook running groups among women. MethodologyThe research design was a quantitative online survey. This survey was completed by 349 adult members of Facebook running groups for women. The online survey consisted of a validated scale, the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), to calculate individual wellbeing scores. Data were analysed using SPSS, conducting descriptives, frequencies and correlations tests. ResultsThe results showed that 14% of participants’ scores indicated a high level of wellbeing, 66% had a wellbeing score in the moderate range and 21% of participants scored in the range of low-level wellbeing. Participants specified how they perceived women’s running Facebook groups to benefit or limit areas of wellbeing. Responses indicated perceived benefits to sense of optimism, interest in other people and sense of feeling good about themselves. There were negligible perceived wellbeing limitations. Members who had been running for the longest reported to engage more frequently with the groups, which may suggest their identities as runners have strengthened over time. ConclusionOverall, this study clearly found that women’s running Facebook groups can provide wellbeing benefits for their members.
Paraganglioma Presenting Atypical Initial Symptoms: a Case Report
Authors: Eguchi Shu , Ono Rintaro , Sato Takeshi , Yada Keigo , Umehara Naoki , Narumi Satoshi , Ichihashi Yosuke , Nozaki Taiki , Kanomata Naoki , Hasegawa Tomonobu , Ozawa Miwa , Hasegawa Daisuke 
Published: August 2021

Abstract
Background: Paraganglioma (PGL), an extra-adrenal pheochromocytoma, is a rare tumor, especially in children. Here, we present a case of PGL with atypical initial symptoms.Case presentation: For seven months, an eight-year-old boy complained of polyuria and weight loss, followed by proteinuria and headache for one month prior to admission. He was admitted to our hospital due to an afebrile seizure. His blood pressure remained markedly elevated even after cessation of the convulsion. Magnetic resonance imaging of the brain revealed posterior reversible encephalopathy syndrome. Abdominal computed tomography showed a mass lesion encasing the left renal artery, measuring 41 mm in length along its major axis. The plasma and urine levels of normetanephrine were elevated. Additionally, iodine-123-metaiodobenzylguanidine scintigraphy showed an abnormal uptake in the abdominal mass with no evidence of metastasis. We tentatively diagnosed him with PGL. Substantial alpha- and beta-blocking procedures were performed, followed by a tumor resection and an extended left nephrectomy on day 31 of hospitalization. Pathological findings confirmed the diagnosis of PGL. The postoperative course was uneventful, and his blood pressure normalized without the use of antihypertensive agents. Genetic testing revealed a known SDHB germline mutation. The patient remained asymptomatic for eleven months after surgery without relapse.Conclusion: It remains challenging to diagnose pheochromocytoma/PGL (PPGL) promptly because PPGL can present with a variety of symptoms. Although PPGL is a rare disease, especially in children, it should be considered in differential diagnosis when various unexplained symptoms persist.
Evaluation of Health Care Professional Response To Patient-Reported Distress In Gynecologic Oncology Clinics At An Academic Cancer Centre
Authors: Atallah Soha , Bender Jackie , Fyles Anthony , Han Kathy , Milosevic Michael , Ferguson Sarah E. , L’heureux Stephanie , Liu ZhihuiAmy , Croke Jennifer 
Published: August 2021

Abstract
Objective: To evaluate health care professional (HCP) documentation of elevated patient-reported symptoms and subsequent intervention in gynecologic oncology clinics. Methods: This was a retrospective chart review of gynecologic oncology patients within a single institution. Prior to their clinical encounter, patients complete the validated Edmonton Symptom Assessment System revised (ESAS-r) questionnaire. Patients with any ESAS-r symptom score ≥4 (moderate-severe) were eligible for analysis. A stratified sampling method was used: 100 patients were randomly selected with 20 patients per year from 2012 to 2016. Patient, tumor and treatment characteristics were extracted from medical records. Health care provider (HCP) documentation of elevated symptoms and subsequent intervention were evaluated. Descriptive statistics were used to report symptom prevalence, HCP documentation and intervention. Fisher’s exact test evaluated documentation and intervention rates according to symptom severity and total ESAS-r score. Results: Between January 2012 and December 2016, 5849 patients completed the ESAS-r. Symptoms scores were ≥ 4 in 3216 patients (55%). In our sample of 100, ovarian (42%) and endometrial (34%) malignancies were most common. Median age was 55 years (range 47-63). Median ESAS-r score was 24 (range: 5-84), with tiredness being the most prevalent symptom reported by patients. HCP documented at least one elevated symptom in 50 patients (50%), most commonly for pain (71%) and least commonly for nausea (4%). Subsequent interventions were offered to only 32 patients (32%), most commonly for pain (56%). Higher median total ESAS-r score was associated with higher rate of documentation (p=0.004) and higher rate of intervention (p<0.001). Conclusions: A significant proportion of gynecologic oncology patients report symptom that should prompt an intervention. However, HCPs documented symptoms in only half of patients and reported interventions in only one third. These results highlight gaps and opportunities for improving symptom screening and response in the “real-world” setting.
Phenotypic Evolution of The Wild Progenitor of Cultivated Barley (Hordeum Vulgare Subsp. Spontaneum (C. Koch) Thell.) Across Bioclimatic Regions In Jordan
Authors: Hajaj Nawal Al , Grando Stefania , Ababnah Maysoon , Alomari Nawar , Albatianh Ahmad , Nesir Jeehan , Migdadi Hussain , Shakhatreh Yahya , Ceccarelli Salvatore 
Published: August 2021

Abstract
Climate change affects the evolutionary potential and the survival of wild plant populations by acting on fitness traits. Resurrection approach was applied to investigate the phenotypic changes during the evolution of the wild progenitor of cultivated barley, Hordeum spontaneum K. Koch in Jordan. We compared 40 Hordeum spontaneum K. Koch populations collected in Jordan in 1991 with 40 Hordeum spontaneum K. Koch populations collected from the same sites in 2014. In the comparison we included seven Hordeum vulgare checks (one local landrace and six improved varieties). The analysis of the phenotypic data showed that the populations were aggregated according to their ecological geographical pattern in two groups with a significant (p < 0.0001) correlation between groups. Four heritable traits, namely plant height, biological yield, number of tillers, and awn length, determined the phenotypic structure of the populations. The two populations collected at 23 years distance, diverged in two distinctive phenotypic structure categories; a conserved structure and an evolved structure with a reduction in the phenotypic trait diversity in the population collected in 2014. These results reveal the value of combining phenotypic and environmental data to understand the evolution and adaptation of the population to climate change over a long period and the consequences on the wild progenitor of cultivated barley collection to avoid loss of genetic materials.
Comparison of Perioperative Outcomes in Open and Laparoscopic Radical Cystectomy with Modified Ureterosigmoidostomy (MainzII): A Retrospective Analysis
Authors: Zhang Bin , He Yang , Zheng Duo , Liu Junyao , Qi Peng , Han Dali , Yue Zhongjin , Shang Panfeng 
Published: August 2021

Abstract
Background: To analyze perioperative conditions and long-term efficacy of open modified ureterosigmoidostomy urinary diversion (OMUUD) in patients with bladder cancer who underwent open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC).Methods: In this retrospective study, the clinical data of patients who underwent open and laparoscopic radical cystectomy plus open modified ureterosigmoidostomy urinary diversion in our hospital were collected from January 2011 to December 2019. In addition, perioperative data of 56 patients who underwent ORC and OMUUD were compared with those of 118 patients who underwent laparoscopic radical cystectomy (LRC) plus OMUUD. A long-term follow-up was performed to compare the overall survival (OS) and progression-free survival (PFS) rate between the two groups.Results: Results showed that there was no significant difference between ORC+OMUUD group and LRC+OMUUD group in terms of gender, age, body index, pre-operative ASA grade, history of transurethral resection of bladder tumor (TURBT) before surgery, tumor T stage, lymph node dissection range, pathological grade, and positive postoperative surgical margin. The mean operation time in the open group was shorter than that in the laparoscopic group （P<0.001）. Moreover, the estimated intraoperative blood loss（P<0.001）and postoperative hospital stay（P=0.023）were better in the laparoscopic group than in the open group. The incidence of complications between 30 days (P=0.665) and 90 days (P=0.211) time-points after surgery was not significantly different. Similarly, the OS (P=0.237) and PFS (P=0.307) between the two groups were comparable.Conclusion: This study shows that the LRC group has long operation time, but less estimated intraoperative blood loss, short postoperative hospital stay, small trauma, and fast postoperative recovery compared to open surgery. Moreover, the incidence of complications at 30 - and 90-days postoperation, as well as the OS and PFS is not different between laparoscopy and open surgery.