bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conceptual connections between science and engineering in elementary teachers’ unit plans
Authors: Pleasants Jacob , Tank Kristina M. , Olson Joanne K. 
Published: April 2021

AbstractBackgroundAround the world, efforts are underway to include engineering design as part of elementary science instruction. A common rationale for those efforts is that Engineering Design-based Science Teaching (EDST) is a productive pedagogical approach for developing students’ understanding of core science concepts. Effectively utilizing EDST requires that teachers develop design activities that are highly connected to science content so that students can apply and expand their understanding of relevant concepts. In this study, we examine how a group of elementary (grades 3–5) pre-service and in-service teachers incorporated EDST into their planned science instruction. Those teachers were participants in a professional development project aimed at supporting EDST. We examine the ways that participants used EDST, the extent to which engineering design activities were connected to science concepts, and factors associated with those connections.ResultsMost of the participants in the study developed science units in which an engineering design activity was placed at the end of the unit. Approximately half of those design activities lacked connections to the science concepts in the unit; they were typically related to the topic of the science unit, but did not require the use or development of key science ideas. Eleven percent of participants developed engineering activities with deep connections to science concepts, and 35% developed activities with shallow connections. No differences were found between life science, physical science, and earth/space science units in terms of the extent of conceptual connections. However, we did find that participants who utilized and adapted published engineering curriculum materials rather than make them from scratch were more likely to have unit plans with higher levels of conceptual connections.ConclusionsOur findings suggest that elementary teachers need additional support in order to effectively utilize EDST in their classrooms. Even within the context of a supportive professional development project, most of the engineering activities developed by our participants lacked substantial connections to the science concepts in their unit plans. Our findings highlight the value of high-quality curriculum materials to support EDST as well as the need to further expand the curriculum resources that are available to elementary teachers.
Who is a scientist? The relationship between counter-stereotypical beliefs about scientists and the STEM major intentions of Black and Latinx male and female students
Authors: Nguyen Ursula , Riegle-Crumb Catherine 
Published: April 2021

AbstractBackgroundDespite the diverse student population in the USA, the labor force in Science, Technology, Engineering, and Mathematics (STEM) does not reflect this reality. While restrictive messages about who belongs in STEM likely discourage students, particularly female and minoritized students, from entering these fields, extant research on this topic is typically focused on the negative impact of stereotypes regarding math ability, or the existence of stereotypes about the physical appearance of scientists. Instead, this study builds on the limited body of research that captures a more comprehensive picture of students’ views of scientists, including not only the type of work that they do but also the things that interest them. Specifically, utilizing a sample of approximately 1000 Black and Latinx adolescents, the study employs an intersectional lens to examine whether the prevalence of counter-stereotypical views of scientists, and the association such views have on subsequent intentions to pursue STEM college majors, varies among students from different gender and racial/ethnic groups (e.g., Black female students, Latinx male students).ResultsWhile about half of Black and Latinx students reported holding counter-stereotypical beliefs about scientists, this is significantly more common among female students of color, and among Black female students in particular. Results from logistic regression models indicate that, net of control variables, holding counter-stereotypical beliefs about scientists predicts both young men’s and women’s intentions to major in computer science and engineering, but not intentions to major in either physical science or mathematics. Additionally, among Black and Latinx male students, counter-stereotypical perceptions of scientists are related to a higher likelihood of intending to major in biological sciences.ConclusionsThe results support the use of an intersectional approach to consider how counter-stereotypical beliefs about scientists differ across gender and racial/ethnic groups. Importantly, the results also suggest that among Black and Latinx youth, for both female and male students, holding counter-stereotypical beliefs promotes intentions to enter particular STEM fields in which they are severely underrepresented. Implications of these findings and directions for future research, specifically focusing on minoritized students, which are often left out in this body of literature, are discussed.
Integrated slice-specific dynamic shimming diffusion weighted imaging (DWI) for rectal Cancer detection and characterization
Authors: Qiu Jianxing , Liu Jing , Bi Zhongxu , Sun Xiaowei , Wang Xin , Zhang Junling , Liu Chengwen , Zhu Jinxia , Qin Naishan 
Published: April 2021

Abstract
Purpose
To compare integrated slice-specific dynamic shimming (iShim) diffusion weighted imaging (DWI) and single-shot echo-planar imaging (SS-EPI) DWI in image quality and pathological characterization of rectal cancer.

Materials and methods
A total of 193 consecutive rectal tumor patients were enrolled for retrospective analysis. Among them, 101 patients underwent iShim-DWI (b = 0, 800, and 1600 s/mm2) and 92 patients underwent SS-EPI-DWI (b = 0, and 1000 s/mm2). Qualitative analyses of both DWI techniques was performed by two independent readers; including adequate fat suppression, the presence of artifacts and image quality. Quantitative analysis was performed by calculating standard deviation (SD) of the gluteus maximus, signal intensity (SI) of lesion and residual normal rectal wall, apparent diffusion coefficient (ADC) values (generated by b values of 0, 800 and 1600 s/mm2 for iShim-DWI, and by b values of 0 and 1000 s/mm2 for SS-EPI-DWI) and image quality parameters, such as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of primary rectal tumor. For the primary rectal cancer, two pathological groups were divided according to pathological results: Group 1 (well-differentiated) and Group 2 (poorly differentiated). Statistical analyses were performed with p < 0.05 as significant difference.

Results
Compared with SS-EPI-DWI, significantly higher scores of image quality were obtained in iShim-DWI cases (P < 0.001). The SDbackground was significantly reduced on b = 1600 s/mm2 images and ADC maps of iShim-DWI. Both SNR and CNR of b = 800 s/mm2 and b = 1600 s/mm2 images in iShim-DWI were higher than those of b = 1000 s/mm2 images in SS-EPI-DWI. In primary rectal cancer of iShim-DWI cohort, SIlesion was significantly higher than SIrectum in both b = 800 and 1600 s/mm2 images. ADC values were significantly lower in Group 2 (0.732 ± 0.08) × 10− 3 mm2/s) than those in Group 1 ((0.912 ± 0.21) × 10− 3 mm2/s). ROC analyses showed significance of ADC values and SIlesion between the two groups.

Conclusion
iShim-DWI with b values of 0, 800 and 1600 s/mm2 is a promising technique of high image quality in rectal tumor imaging, and has potential ability to differentiate rectal cancer from normal wall and predicting pathological characterization.
Intestinal intussusception and progressive anemia due to pyogenic granuloma of the ileum: a case report
Authors: Nagakari Kodai , Yago Akikazu , Ohkura Yu , Tomita Daisuke , Haruta Shusuke , Takazawa Yutaka , Ueno Masaki 
Published: April 2021

Abstract
Background
Pyogenic granuloma is a benign vascular tumor, usually occurring on the skin or in the oral cavity. Small intestinal pyogenic granuloma is extremely rare, but intestinal intussusception due to the tumor is even rarer. Only 3 cases have been reported in the English literature at this writing.

Case presentation
An 86-year-old woman presented with abdominal pain and vomiting. Laboratory data discovered anemia. Contrast-enhanced computed tomography revealed small bowel obstruction due to intestinal intussusception. After decompression by long tube for 1 week, the obstruction did not improve and the anemia got worse. Therefore, laparoscopic assisted small bowel resection was performed as a diagnostic therapy. Pathology confirmed the diagnosis of pyogenic granuloma. The postoperative course was uneventful and the patient was discharged 10 days after surgery.

Conclusions
We experienced a case of intestinal intussusception and progressive anemia due to pyogenic granuloma of the ileum. Although the condition is extremely rare, surgeons must take into consideration the tumor in similar cases, and complete surgical resection is required.
An extremely rare case of desmoplastic fibroblastoma exhibiting rapid growth in the chest wall: a case report
Authors: Ota Hideki , Ishida Hirotaka , Matsumoto Hidekazu , Ishiyama Tomoharu 
Published: April 2021

AbstractBackgroundDesmoplastic fibroblastoma is an uncommon, benign, fibrous tumor exhibiting infiltrative growth. Most of these tumors are small, slow-growing, and develop as subcutaneous lesions in the extremities. Cases of desmoplastic fibroblastoma in the chest wall are quite rare, and the preoperative diagnosis of such cases remains challenging as these tumors can mimic the characteristics of desmoid-type fibromatosis, which often occurs in the chest wall. We aimed to describe a rare case of desmoplastic fibroblastoma exhibiting rapid growth in the chest wall of a patient that was successfully treated with marginal excision only by diagnostic imaging before surgery.Case presentationA 79-year-old man was admitted to our hospital after experiencing right shoulder pain lasting for a few months. A 4 × 4 × 2 cm mass was incidentally detected at the right second rib two years prior. Chest computed tomography revealed a well-defined homogeneous mass with a muscle-like density along the right lateral chest wall, the size of which had increased to 12 × 10 × 4.5 cm in two years. Dynamic contrast-enhanced computed tomography revealed abundant vascularity at the periphery of the tumor. Magnetic resonance imaging revealed iso-intensity to muscle on T1-weighted images, slightly high intensity on T2-weighted images, and rim-like contrast enhancement at the periphery of the tumor, with uniform thickness on gadolinium-enhanced T1-weighted images with fat suppression. Rim-like contrast enhancement is an imaging feature that can distinguish cases of desmoplastic fibroblastoma from desmoid-type fibromatosis. We diagnosed the tumor as desmoplastic fibroblastoma by diagnostic imaging without tissue biopsy. Marginal excision with videoscopic assistance was performed through a small incision. The pathological diagnosis was desmoplastic fibroblastoma. The patient’s postoperative course was uneventful, and his shoulder pain was relieved after the surgery.ConclusionsDesmoplastic fibroblastoma in the chest wall is extremely rare, but should be considered in the differential diagnosis when desmoid-type fibromatosis is clinically suspected. Gadolinium-enhanced magnetic resonance imaging is helpful in confirming the differential diagnosis.
Assessment of the outcome of percutaneous pedicle screws in management of degenerative and traumatic dorsal and lumbar pathologies
Authors: Hussein Ayman , Ibrahim Hamdy , Mashaly Hazem , Hefny Sameh , El Gayar Abdelrahman 
Published: April 2021

AbstractBackgroundPercutaneous pedicle screw technique is relatively a recent technique that evolved the concept of posterior spinal instrumentation, utilizing familiar fluoroscopic landmarks to guide the procedure of screws insertion, which despite being technically demanding, it avoids the Musculo-ligamentous damage associated with the conventional posterior technique.Aim of the workThis study aims to report our experience in managing traumatic and degenerative spine pathologies by the minimally invasive percutaneous technique and assessing its radiological and functional outcome.Materials and methodsA prospective observational study that included the analysis of the functional, operative, biochemical, and radiological outcomes of 20 patients who underwent uniplanar fluoroscopic-guided dorsal and/or lumbar percutaneous pedicle screw fixation procedures with or without fusion using the sextant, longitude, and Spineart system and any reported complications between January 2018 and December 2019.ResultsThe clinical and radiological analysis of 100 percutaneous pedicle screws in degenerative (n:11) and traumatic (n:9) dorsal and/or lumbar cases revealed that the biomechanical stabilizing characteristics are comparable to the conventional posterior approach with the added benefits of the paraspinal muscle-sparing. Satisfactory functional outcome represented in the improvement of the postoperative back pain visual analog score and Oswestry Disability Index Score with acceptable morbidity and complications rate was noticed.ConclusionsPercutanous pedicle screw fixation is a landmark in the evolution of the minimally invasive spine surgery which can be a safe alternative to the conventional posterior muscle stripping technique with a comparable functional and radiological outcome and good biomechanical profile and an acceptable morbidity rate.
Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome
Authors: Ayad Sherif W. , El Zawawy Tarek H. , Lotfy Mohamed I. , Naguib Ahmed M. , El Amrawy Ahmed M. 
Published: April 2021

AbstractBackgroundSignificance of totally occluded culprit coronary artery in patients presenting with non-ST segment elevation myocardial infarction (NSTEMI) is underestimated. The aim of the study was to evaluate the incidence and impact of totally occluded culprit artery on in-hospital and 6 months follow-up outcomes of NSTEMI acute coronary syndrome (ACS) patients.ResultsWe collected retrospectively data of 500 NSTEMI patients who presented to our hospital from June 2016 to June 2017. All patients underwent PCI within 72 h of presentation. We excluded patients with cardiogenic shock, prior CABG, and STEMI. Patients were divided into two groups according to pre-procedural culprit vessel thrombolysis in myocardial infarction (TIMI) flow. Group 1, TIMI flow 0 total coronary occlusion, included 112 patients (22.4%). Group 2, TIMI flow 1–3 non-total occlusion, included 388 patients (77.6%). Group 1 patients had significantly higher incidence of smoking (p=0.01), significantly higher level of cardiac enzymes (p<0.001), significantly more collaterals (p<0.001), and significantly more LCX and RCA as the culprit vessel (p<0.01), while group 2 patients had significantly higher incidence of diabetes (p=0.02) and significantly more LAD as the culprit vessel. There were no significant differences between the two groups regarding the major adverse cardiac and cerebrovascular events (MACCE) in-hospital (5.3% in totally occluded group vs. 1% in non-totally occluded group,p=0.07), but group 1 patients had significantly higher incidence of in-hospital arrhythmia (8.9% in group 1 vs. 1% in group 2,p=0.007). After 6 months follow-up, there were no significant differences regarding MACCE between the 2 groups after 6 months follow-up (5.4% in group 1 vs. 4.6% of group 2,P=0.24).Conclusion22.4% of NSTEMI patients have a totally occluded culprit artery. The presence of an occluded culprit artery did not significantly affect the clinical outcomes of NSTEMI patients either in-hospital or after 6 months follow-up but was associated with significantly higher incidence of in-hospital arrhythmia.
Diffusion tensor imaging on 3-T MRI breast: diagnostic performance in comparison to diffusion-weighted imaging
Authors: Abdelhady Dalia , Abdelbary Amany , Afifi Ahmed H. , Abdelhamid Alaa-eldin , Hassan Hebatallah H. M. 
Published: April 2021

AbstractBackgroundBreast cancer is the most prevalent cancer among females. Dynamic contrast-enhanced MRI (DCE-MRI) breast is highly sensitive (90%) in the detection of breast cancer. Despite its high sensitivity in detecting breast cancer, its specificity (72%) is moderate. Owing to 3-T breast MRI which has the advantage of a higher signal to noise ratio and shorter scanning time rather than the 1.5-T MRI, the adding of new techniques as diffusion tensor imaging (DTI) to breast MRI became more feasible.Diffusion-weighted imaging (DWI) which tracks the diffusion of the tissue water molecule as well as providing data about the integrity of the cell membrane has been used as a valuable additional tool of DCE-MRI to increase its specificity.Based on DWI, more details about the microstructure could be detected using diffusion tensor imaging. The DTI applies diffusion in many directions so apparent diffusion coefficient (ADC) will vary according to the measured direction raising its sensitivity to microstructure elements and cellular density. This study aimed to investigate the diagnostic accuracy of DTI in the assessment of breast lesions in comparison to DWI.ResultsBy analyzing the data of the 50 cases (31 malignant cases and 19 benign cases), the sensitivity and specificity of DWI in differentiation between benign and malignant lesions were about 90% and 63% respectively with PPV 90% and NPV 62%, while the DTI showed lower sensitivity and specificity about 81% and 51.7%, respectively, with PPV 78.9% and NPV 54.8% (P-value ≤ 0.05).ConclusionWhile the DWI is still the most established diffusion parameter, DTI may be helpful in the further characterization of tumor microstructure and differentiation between benign and malignant breast lesions.
Adaptation of a quality improvement approach to implement eScreening in VHA healthcare settings: innovative use of the Lean Six Sigma Rapid Process Improvement Workshop
Authors: Pittman James O. E. , Rabin Borsika , Almklov Erin , Afari Niloofar , Floto Elizabeth , Rodriguez Eusebio , Lindamer Laurie 
Published: April 2021

Abstract
Background
The Veterans Health Administration (VHA) developed a comprehensive mobile screening technology (eScreening) that provides customized and automated self-report health screening via mobile tablet for veterans seen in VHA settings. There is agreement about the value of health technology, but limited knowledge of how best to broadly implement and scale up health technologies. Quality improvement (QI) methods may offer solutions to overcome barriers related to broad scale implementation of technology in health systems. We aimed to develop a process guide for eScreening implementation in VHA clinics to automate self-report screening of mental health symptoms and psychosocial challenges.

Methods
This was a two-phase, mixed methods implementation project building on an adapted quality improvement method. In phase one, we adapted and conducted an RPIW to develop a generalizable process guide for eScreening implementation (eScreening Playbook). In phase two, we integrated the eScreening Playbook and RPIW with additional strategies of training and facilitation to create a multicomponent implementation strategy (MCIS) for eScreening. We then piloted the MCIS in two VHA sites. Quantitative eScreening pre-implementation survey data and qualitative implementation process “mini interviews” were collected from individuals at each of the two sites who participated in the implementation process. Survey data were characterized using descriptive statistics, and interview data were independently coded using a rapid qualitative analytic approach.

Results
Pilot data showed overall satisfaction and usefulness of our MCIS approach and identified some challenges, solutions, and potential adaptations across sites. Both sites used the components of the MCIS, but site 2 elected not to include the RPIW. Survey data revealed positive responses related to eScreening from staff at both sites. Interview data exposed implementation challenges related to the technology, support, and education at both sites. Workflow and staffing resource challenges were only reported by site 2.

Conclusions
Our use of RPIW and other QI methods to both develop a playbook and an implementation strategy for eScreening has created a testable implementation process to employ automated, patient-facing assessment. The efficient collection and communication of patient information have the potential to greatly improve access to and quality of healthcare.
An integrated knowledge translation approach to address avoidable rehospitalisations and unplanned admissions for older people in South Australia: implementation and evaluation program plan
Authors: Harvey Gillian , Pham Clarabelle T. , Inacio Maria C. , Laver Kate , Lynch Elizabeth A. , Jorissen Robert N. , Karnon Jonathan , Bourke Alice , Forward John , Maddison John , Whitehead Craig , Rupa Jesmin , McNamara Carmel , Crotty Maria 
Published: April 2021

Abstract
Background
Repeated admission to hospital can be stressful for older people and their families and puts additional pressure on the health care system. While there is some evidence about strategies to better integrate care, improve older patients’ experiences at transitions of care, and reduce preventable hospital readmissions, implementing these strategies at scale is challenging. This program of research comprises multiple, complementary research activities with an overall goal of improving the care for older people after discharge from hospital. The program leverages existing large datasets and an established collaborative network of clinicians, consumers, academics, and aged care providers.

Methods
The program of research will take place in South Australia focusing on people aged 65 and over. Three inter-linked research activities will be the following: (1) analyse existing registry data to profile individuals at high risk of emergency department encounters and hospital admissions; (2) evaluate the cost-effectiveness of existing ‘out-of-hospital’ programs provided within the state; and (3) implement a state-wide quality improvement collaborative to tackle key interventions likely to improve older people’s care at points of transitions. The research is underpinned by an integrated approach to knowledge translation, actively engaging a broad range of stakeholders to optimise the relevance and sustainability of the changes that are introduced.

Discussion
This project highlights the uniqueness and potential value of bringing together key stakeholders and using a multi-faceted approach (risk profiling; evaluation framework; implementation and evaluation) for improving health services. The program aims to develop a practical and scalable solution to a challenging health service problem for frail older people and service providers.
Soaring seas, forest fires and deadly drought: climate change conspiracies and mental health
Authors: Jack Alexander , Panchal Reena 
Published: April 2021

SummaryThere is scientific consensus that anthropogenic climate change is real and that it provides an existential threat to humanity and the planet. In this article, we focus on climate change conspiracy theories and the impact of such beliefs on mental health. We discuss the psychiatric disorders that might be relevant to conspiracy belief endorsement and we present the underlying psychological mechanisms. We note that there is little to no literature to associate beliefs about climate change with serious mental health conditions. However, we anticipate that such beliefs may manifest pathologically in psychiatric presentations as climate change becomes increasingly at the forefront of the global agenda.