bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Validity of the SEEV Model as a Process Measure of Situation Awareness: The Example of a Simulated Endotracheal Intubation
Authors: Grundgeiger Tobias , Hohm Anna , Michalek Annabell , Egenolf Timo , Markus Christian , Happel Oliver 
Published: February 2021

Objective In the context of anesthesiology, we investigated whether the salience effort expectancy value (SEEV) model fit is associated with situation awareness and perception scores. Background The distribution of visual attention is important for situation awareness—that is, understanding what is going on—in safety-critical domains. Although the SEEV model has been suggested as a process situation awareness measure, the validity of the model as a predictor of situation awareness has not been tested. Method In a medical simulation, 31 senior and 30 junior anesthesiologists wore a mobile eye tracker and induced general anesthesia into a simulated patient. When inserting a breathing tube into the mannequin’s trachea (endotracheal intubation), the scenario included several clinically relevant events for situation awareness and general events in the environment. Both were assessed using direct awareness measures. Results The overall SEEV model fit was good with no difference between junior and senior anesthesiologists. Overall, the situation awareness scores were low. As expected, the SEEV model fits showed significant positive correlations with situation awareness level 1 scores. Conclusion The SEEV model seems to be suitable as a process situation awareness measure to predict and investigate the perception of changes in the environment (situation awareness level 1). The situation awareness scores indicated that anesthesiologists seem not to perceive the environment well during endotracheal intubation. Application The SEEV model fit can be used to capture and assess situation awareness level 1. During endotracheal intubation, anesthesiologists should be supported by technology or staff to notice changes in the environment.
The Bioethical Dilemma of Gender-Affirming Therapy in Children and Adolescents
Authors: Robles Monique 
Published: February 2021

Since the establishment of the first transgender clinic in the United States in 2007, over sixty clinics associated with children’s hospitals have opened across the nation and are seeing very young children and adolescents with a diagnosis of gender dysphoria (GD). Once known as gender identity disorder, GD has been redefined by the latest version of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition ( DSM-5) not as a mental illness but as the distress experienced by individuals related to their biological sex. The widely accepted practice of gender-affirming therapy (GAT) to treat a vulnerable population despite the associated health risks, the lack of supportive scientific evidence for the pharmacological and surgical interventions, along with the unqualified claim that these interventions will decrease the rate of suicide in these individuals presents a significant bioethical dilemma. The growing trend of GD not only impacts the individuals diagnosed but also society, culture, and the integrity of the profession of medicine. This article utilizes the five-box method, an ethical decision-making framework, to address the implications of the proposed treatment. Once applied, it becomes clear that the hormonal and surgical approaches used are not scientifically or ethically justified. The patient’s autonomy and preferences should be respected, yet constrained, if there exists a considerable risk to the well-being of the individual without proven benefits. The quality of life of those receiving this treatment has not been shown to be significantly improved long term, and the mental, physical, and spiritual health of individuals with GD is not thoroughly addressed in these clinics. The important social and contextual factors, on both microcosmic and macrocosmic scales, are minimized in favor of promoting an ideology. Ultimately, Catholic moral teaching reveals that this widely recommended treatment violates the body–soul union, disregards the principle of totality and integrity, and debases the dignity of humanity. Summary: This article examines GAT, the paradigm used in treating individuals identifying as transgender, through the lens of an EDMF. Each stage of this widely proposed treatment - social affirmation, pubertal blockade, administration of cross-sex hormones, and sex reassignment surgery - poses harms and risks that are not fully disclosed to minors and families, creating a bioethical dilemma. Dialogue utilizing science and reasoning must be encouraged to assist individuals who experience a gender identity that rejects their biological sex. This approach would also contribute to the well-being of society.
Death following extreme temperature exposure: Histological, biochemical and immunohistochemical markers
Authors: Natanti Alice , Mazzanti Roberta , Palpacelli Marco , Turchi Chiara , Tagliabracci Adriano , Pesaresi Mauro 
Published: February 2021

Introduction Defining extreme temperatures as the cause of death remains challenging. It is mostly based on circumstantial, macroscopic and microscopic features. Methods We retrospectively compared groups of cases of fatal hypothermia, fatal hyperthermia and non-extreme temperature-related deaths. We analysed specific histological findings, focusing on samples from the liver, pancreas and kidney. Results Between 1 January 2013 and 31 December 2016, 15 autopsies were performed for deaths related to extreme temperatures. They included 11 cases of fatal hypothermia (group A), four cases of fatal hyperthermia (group B) and eight controls (group C). Perinuclear hepatocyte vacuolisation was observed in seven cases of hypothermia, one case of hyperthermia and four controls. Pancreatic cytoarchitecture was well preserved in two cases of hypothermia, one case of hyperthermia and two controls. No particular microscopic feature was found in pancreatic samples. Renal epithelial tubular cell vacuolisation was observed in seven cases of hypothermia and one case of hyperthermia, while it was absent in all controls. Chromogranin A (CgA) was markedly positive in the pancreatic tissue of five cases of fatal hypothermia and one control, and mildly positive in one case of fatal hyperthermia. No significant p-values were observed for any comparisons ( p > 0.05), except when hypothermia cases group were compared to the control group for the Armanni–Ebstein phenomenon test ( p = 0.0078). Conclusions Although our study did not find a specific microscopic marker, hepatocyte vacuolisation, the Armanni–Ebstein phenomenon and pancreatic CgA positivity, taken together, may be useful tools to confirm hypo- and hyperthermia-related deaths, in addition to circumstantial and macroscopic findings.
Participatory COVID-19 Surveillance Tool in Rural Appalachia
Authors: Runkle Jennifer D. , Sugg Maggie M. , Graham Garrett , Hodge Bryan , March Terri , Mullendore Jennifer , Tove Fletcher , Salyers Martha , Valeika Steve , Vaughan Ellis 
Published: February 2021

Introduction Few US studies have examined the usefulness of participatory surveillance during the coronavirus disease 2019 (COVID-19) pandemic for enhancing local health response efforts, particularly in rural settings. We report on the development and implementation of an internet-based COVID-19 participatory surveillance tool in rural Appalachia. Methods A regional collaboration among public health partners culminated in the design and implementation of the COVID-19 Self-Checker, a local online symptom tracker. The tool collected data on participant demographic characteristics and health history. County residents were then invited to take part in an automated daily electronic follow-up to monitor symptom progression, assess barriers to care and testing, and collect data on COVID-19 test results and symptom resolution. Results Nearly 6500 county residents visited and 1755 residents completed the COVID-19 Self-Checker from April 30 through June 9, 2020. Of the 579 residents who reported severe or mild COVID-19 symptoms, COVID-19 symptoms were primarily reported among women (n = 408, 70.5%), adults with preexisting health conditions (n = 246, 70.5%), adults aged 18-44 (n = 301, 52.0%), and users who reported not having a health care provider (n = 131, 22.6%). Initial findings showed underrepresentation of some racial/ethnic and non–English-speaking groups. Practical Implications This low-cost internet-based platform provided a flexible means to collect participatory surveillance data on local changes in COVID-19 symptoms and adapt to guidance. Data from this tool can be used to monitor the efficacy of public health response measures at the local level in rural Appalachia.
A combined sound field prediction method in small classrooms
Authors: Yang Da , Mak Cheuk Ming 
Published: February 2021

In this paper, a new combination method for sound field prediction is proposed. An optimization approach based on the genetic algorithm is employed for optimizing the transition frequency of the combined sound field prediction method in classrooms. The selected optimization approach can identify the optimal transition frequency so that the combined sound field prediction can obtain more efficient and accurate prediction results. The proposed combined sound field prediction method consists of a wave-based method and geometric acoustic methods that are separated by the transition frequency. In low frequency domain (below the transition frequency), the sound field is calculated by the finite element method (FEM), while a hybrid geometric acoustic method is employed in the high frequency domain (above the transition frequency). The proposed combined prediction models are validated by comparing them with previous results and experimental measurements. The optimization approach is illustrated by several examples and compared with traditional combination results. Compared to existed sound field prediction simulations in classrooms, the proposed combination methods take the sound field in low frequencies into account. The results demonstrate the effectiveness of the proposed model. Practical applications: This study proposes a combined sound field prediction method separated by transition frequency. A genetic algorithm optimization method is employed for searching the optimal transition frequency. The outcomes of this paper are essential for acoustical designs and acoustical environmental assessments.
Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS
Authors: Koskinen Anni , Lundberg Marie , Lilja Markus , Myller Jyri , Penttilä Matti , Huhtala Heini , Lee John M. , Blomgren Karin , Toppila-Salmi Sanna 
Published: February 2021

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.
A Decision-making Approach for Choosing a Reliable Product under the Hesitant Fuzzy Environment via a Novel Distance Measure
Authors: Dutta Palash , Saikia Rupjit 
Published: February 2021

Executive Summary In the contemporary time, the reliability of any product has become a big issue from the customer’s perspective due to exponentially mushrooming markets of electronics and digital gadgets. Since the use of digital equipment is tremendously increasing, as a consequence, the production and availability of products are also increasing rampantly. Due to the flooding of digital products, customers often end up in a dilemma regarding the abundant choice and subsequently, become very much dependent upon the reviews of experts and fellow customers as well. In many cases, unfortunately, it is encountered that the products are not reliable enough as suggested by the reviewers. Besides, it is often seen that the manufacturing companies provide almost similar types of features and facilities for products and customers usually end up in a dilemma The confusion gets triggered when varieties of commodities are manufactured and supplied by different manufacturers bearing almost the same features nearly at the same price. In such situations, the reviews of experts and customers already using the product become essential. The reliability of a product relies upon the reviews of the previous customers of the same product. In this article, fuzzy multi-criteria decision-making methodology has been employed to find the reliability of a product considering different features of the product based on the reviews of customers and experts. This paper presents a neo distance measure on hesitant fuzzy set which is found on the notion of score function and mean deviation. Explanatory instances are provided to reveal the distinctiveness and merit of our proposed idea on distance measure over existing distance measures. After that, the proposed distance measure is applied in the decision-making approach for taking up the best electronic products. It is evidenced that the proposed distance measure is beneficial to measure distance degree between two unequal Hesitant Fuzzy Elements (HFEs) without putting extra elements in the shorter HFE. The proposed distance measures can be utilized in the decision-making field in the near future under diverse conditions to display undetermined particulars in a much-clarified manner.
Gender Differences in Earnings Rewards to Personality Traits in Wage-employment and Self-employment Labour Markets
Authors: Mohammed Ibrahim , Baffour Priscilla Twumasi , Rahaman Wassiuw Abdul 
Published: February 2021

In an extensive review of wage determination papers, it is concluded that the standard demographic and human capital factors explain little of earning differentials. Consequently, there is a growing interest among economists to include non-cognitive skills measured by personality traits in recent empirical literature to explain variations in earnings. In a bid to contribute empirical evidence to this strand of literature, this study examines the associations between the Big-Five personality traits (i.e., agreeableness, conscientiousness, openness, extraversion and neuroticism) and earnings, using the World Bank’s Skills towards Employment and Productivity (STEP) data on Ghana. The study employed regression techniques to estimate a series of semi-logarithmic wage equations that include demographic and human capital factors and the Big-Five personality traits to determine how important these factors are in explaining wage and self-employment earnings. Furthermore, the estimations of the wage equations are done separately for males and females to highlight any gender differences in the way personality traits contribute to earnings. Findings are largely consistent with the literature but uniquely demonstrate that in a power-distant culture like Ghana, where, traditionally, girl-child education has been relegated to the background, agreeable females, and not males, are rewarded in the formal wage employment labour market. However, in the informal self-employment labour market, conscientious males, and not females, are positively rewarded with higher earnings. These unique findings contribute to our understanding of the gender differences in the relative importance of non-cognitive skills in the formal and informal labour markets. JEL Codes: J31, J24
First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder
Authors: Sessa Ben , Higbed Laurie , O’Brien Steve , Durant Claire , Sakal Chloe , Titheradge Daniel , Williams Tim M , Rose-Morris Anna , Brew-Girard Elsa , Burrows Sam , Wiseman Chantelle , Wilson Sue , Rickard James , Nutt David J 
Published: February 2021

Background: 3,4-methylenedioxymethamphetamine (MDMA) therapy has qualities that make it potentially well suited for patients with addictions, but this has never been explored in a research study. We present data from the Bristol Imperial MDMA in Alcoholism (BIMA) study. This is the first MDMA addiction study, an open-label safety and tolerability proof-of-concept study investigating the potential role for MDMA therapy in treating patients with alcohol use disorder (AUD). Aims: This study aimed to assess if MDMA-assisted psychotherapy can be delivered safely and can be tolerated by patients with AUD post detoxification. Outcomes regarding drinking behaviour, quality of life and psychosocial functioning were evaluated. Methods: Fourteen patients with AUD completed a community alcohol detoxification and received an eight-week course of recovery-based therapy. Participants received two sessions with MDMA (187.5 mg each session). Psychological support was provided before, during and after each session. Safety and tolerability were assessed alongside psychological and physiological outcome measures. Alcohol use behaviour, mental well-being and functioning data were collected for nine months after alcohol detoxification. Results: MDMA treatment was well tolerated by all participants. No unexpected adverse events were observed. Psychosocial functioning improved across the cohort. Regarding alcohol use, at nine months post detox, the average units of alcohol consumption by participants was 18.7 units per week compared to 130.6 units per week before the detox. This compares favourably to a previous observational study (the ‘Outcomes’ study) by the same team with a similar population of people with AUD. Conclusions: This study provides preliminary support for the safety and tolerability of a novel intervention for AUD post detox. Further trials to examine better the therapeutic potential of this approach are now indicated.
Optimal dosing for psilocybin pharmacotherapy: Considering weight-adjusted and fixed dosing approaches
Authors: Garcia-Romeu Albert , Barrett Frederick S , Carbonaro Theresa M , Johnson Matthew W , Griffiths Roland R 
Published: February 2021

Background: Growing evidence suggests psilocybin, a naturally occurring psychedelic, is a safe and promising pharmacotherapy for treatment of mood and substance use disorders when administered as part of a structured intervention. In most trials to date, psilocybin dose has been administered on a weight-adjusted basis rather than the more convenient procedure of administering a fixed dose. Aims: The present post hoc analyses sought to determine whether the subjective effects of psilocybin are affected by body weight when psilocybin is administered on a weight-adjusted basis and when psilocybin is administered as a fixed dose. Methods: We analyzed acute subjective drug effects (mystical, challenging, and intensity) associated with therapeutic outcomes from ten previous studies (total N = 288) in which psilocybin was administered in the range 20 to 30 mg/70 kg (inclusive). Separate multivariate regression analyses examined the relationships between demographic variables including body weight and subjective effects in participants receiving 20 mg/70 kg ( n  = 120), participants receiving 30 mg/70 kg ( n = 182), and participants whose weight-adjusted dose was about 25 mg (to approximate the fixed dose that is currently being evaluated in registration trials for major depressive disorder) ( n = 103). Results: In the 20 mg/70 kg and 30 mg/70 kg weight-adjusted groups, and in the fixed dose group, no significant associations were found between subjective effects and demographic variables including body weight or sex. Across a wide range of body weights (49 to 113 kg) the present results showed no evidence that body weight affected subjective effects of psilocybin. Conclusions: These results suggest that the convenience and lower cost of administering psilocybin as a fixed dose outweigh any potential advantage of weight-adjusted dosing.
Imaging features of rhinocerebral mucormycosis: from onset to vascular complications
Authors: Mazzai Linda , Anglani Mariagiulia , Giraudo Chiara , Martucci Matia , Cester Giacomo , Causin Francesco 
Published: February 2021

Rhinocerebral mucormycosis (RCM) may result in severe intracranial ischemic and hemorrhagic lesions. Both computed tomography (CT) and magnetic resonance imaging (MRI) play an essential role in the diagnosis of RCM, but whereas CT is better for assessing bone erosion, MRI is superior in evaluating soft tissue, intraorbital extension, and in assessing intracranial and vascular invasion. Specific CT and MRI techniques, such as CT angiography or enhanced MR angiography, and more advanced MRI sequences such as gadolinium-3D Black Blood imaging, contribute to the assessment of the extension of vascular invasion. In this pictorial review, we describe specific CT and MRI signs of RCM, mainly focusing on its life-threatening complications due to vascular involvement.
Characterisation of two unusual cases of haemoglobin Bart’s hydrops foetalis caused by –SEA and large novel α-globin gene cluster deletions
Authors: Wang Yunan , Xiong Ying , Liu Chang , Lu Jian , Wang Jicheng , Qin DanQing , Liu Ling , Wu Jing , Zhao Xin , Fang Liyuan , Du Li , Yin Aihua 
Published: February 2021

Background We describe 2 unusual haemoglobin (Hb) Bart’s hydrops cases that could not be explained by traditional factors. Case presentation: Two families with a diagnosis or history of foetal hydrops were enrolled. A suspension-array system was used to detect the 23 most frequent mutations in southern China. Multiplex ligation-dependent probe amplification (MLPA) was used to screen for possible deletions. Precise characterisation of the breakpoints of the novel variants and uniparental disomy analysis were performed using a single nucleotide polymorphism (SNP) array. Quantitative fluorescence PCR was used to eliminate maternal cell contamination and nonpaternity. In case 1, the suspension-array system indicated a maternal heterozygous (–SEA/) deletion, and the paternal sample was negative. The foetal hydrops was caused by the maternal (–SEA/) deletion and a de novo α-globin gene deletion (–193). In case 2, the paternal sample had a heterozygous (–SEA/) deletion, and MLPA and SNP array analysis revealed a large maternal deletion (–227) that encompassed the α-globin gene, which explained the history of Hb Bart’s foetal hydrops. Conclusions Our cases describe 2 new α0-thalassaemia deletions and illustrate the importance of using a combination of methods to detect rare types of α-thalassaemia.