bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practical guidelines to build Sense of Community in online medical education
Authors: van der Meer Gerben H. , Milota Megan , de Jonge Rosalein R. , Jansen Renée S. 
Published: February 2021

AbstractObjectivesSense of Community (SoC) refers to the cognitive or emotional connections established between physically separated learners; it is essential for study success. The recent COVID‐19 pandemic highlighted the need for practical guidelines to facilitate building a SoC in online medical preclerkship education in the Netherlands. Therefore, this qualitative study aims to (a) examine perceptions of SoC from both students’ and teachers’ perspectives in an online elective course during the COVID‐19 pandemic in order to (b) provide a conceptual framework with practical guidelines to medical educators on how to build SoC in online education.MethodsThe study had an exploratory qualitative design. Semi‐structured focus groups with student (n = 15) and teacher (n = 5) volunteers were conducted. Participants discussed their experienced SoC using the storyline method. In addition, course developers (n = 2) were interviewed and lecturers (n = 5) wrote an experience story. Audio‐ and video‐recordings were transcribed verbatim and both the ensuing transcripts and experience stories were analysed using an inductive thematic analysis.ResultsAll students experienced an increase of SoC during the eight‐week course. Five themes were identified: ‘social contacts made possible by a physical campus’, ‘group dynamics’, ‘teacher influence’, ‘education format’ and ‘teachers’ Sense of Community’. The authors formulated challenges and practical guidelines on how to build SoC based on these themes.ConclusionsThis exploratory qualitative study provides a conceptual framework with practical guidelines for medical educators on how to build SoC in online medical preclerkship education. These guidelines provide a valuable starting point to build SoC in online education for medical educators and students alike.
Biomechanical Evaluation of Oblique Lumbar Interbody Fusion with Various Fixation Options: A Finite Element Analysis
Authors: Song Chengjie , Chang Hengrui , Zhang Di , Zhang Yingze , Shi Mingxin , Meng Xianzhong 
Published: February 2021

ObjectiveThe aim of the present study was to clarify the biomechanical properties of oblique lumbar interbody fusion (OLIF) using different fixation methods in normal and osteoporosis spines.MethodsNormal and osteoporosis intact finite element models of L1–S1 were established based on CT images of a healthy male volunteer. Group A was the normal models and group B was the osteoporosis model. Each group included four subgroups: (i) intact; (ii) stand‐alone cage (Cage); (iii) cage with lateral plate and two lateral screws (LP); and (iv) cage with bilateral pedicle screws and rods (BPSR). The L3–L4 level was defined as the surgical segment. After validating the normal intact model, compressive load of 400 N and torsional moment of 10 Nm were applied to the superior surface of L2 to simulate flexion, extension, left bending, right bending, left rotation, and right rotation motions. Surgical segmental range of motion (ROM), cage stress, endplate stress, supplemental fixation stress, and stress distribution were analyzed in each group.ResultsCage provided the minimal reduction of ROM among all motions (normal, 82.30%–98.81%; osteoporosis, 92.04%–97.29% of intact model). BPSR demonstrated the maximum reduction of ROM (normal, 43.94%–61.13%; osteoporosis, 45.61%–62.27% of intact model). The ROM of LP was between that of Cage and BPSR (normal, 63.25%–79.72%; osteoporosis, 70%–87.15% of intact model). Cage had the minimal cage stress and endplate stress. With the help of LP and BPSR fixation, cage stress and endplate stress were significantly reduced in all motions, both in normal and osteoporosis finite element models. However, BPSR had more advantages. For cage stress, BPSR was at least 75.73% less than that of Cage in the normal model, and it was at least 80.10% less than that of Cage in the osteoporosis model. For endplate stress, BPSR was at least 75.98% less than that of Cage in the normal model, and it was at least 78.06% less than that of Cage in the osteoporosis model. For supplemental fixation stress, BPSR and LP were much less than the yield strength in all motions in the two groups. In addition, the comparison between the two groups showed that the ROM, cage stress, endplate stress, and supplemental fixation stress in the normal model were less than in the osteoporosis model when using the same fixation option of OLIF.ConclusionOblique lumbar interbody fusion with BPSR provided the best biomechanical stability both in normal and osteoporosis spines. The biomechanical properties of the normal spine were better than those of the osteoporosis spine when using the same fixation option of OLIF.
Risk Factors of Elbow Stiffness After Open Reduction and Internal Fixation of the Terrible Triad of the Elbow Joint
Authors: He Xiao , Fen Quan , Yang Jiarui , Lei Yutian , Heng Lisong , Zhang Kun 
Published: February 2021

ObjectiveTo analyze the risk factors of elbow stiffness following open reduction and internal fixation of the terrible triad of the elbow joint.MethodsA retrospective study was conducted of 100 patients with the terrible triad of the elbow joint, who had been treated at our hospital from January 2015 to December 2018. All patients were treated with a loop plate to repair the ulnar coronoid process. According to the severity of the injury, the radial head was either fixed or replaced, and the lateral collateral ligament was repaired with an anchor. According to the range of motion of the elbow during the last follow‐up, the patients were divided into two groups. The stiffness group (displayed extension–flexion or pronation–supination <100°) consisted of 30 patients. The second group, named the non‐stiffness group (exhibited extension–flexion and pronation–supination ≥100°), consisted of 70 patients. Related risk factors included age, gender, smoking, diabetes, whether the fracture is on the dominant side, mechanism of injury, fracture classification, time from injury to surgery, configuration of internal fixation of the radial head, postoperative immobilization time, and use of anti‐heterotopic ossification drugs (oral indomethacin). Both t‐test and chi squared test were used to analyze any significant differences. Only the variables with a P < 0.05 in the tests were retested into a logistic multiple regression in order to screen risk factors of elbow stiffness.ResultsAll patients were followed up for 12–48 months (average, 25.7 months), and all patients exhibited bone healing. Multivariate regression analysis showed that high‐energy injury (OR = 3.068, 95% CI 1.134–8.295, P = 0.027), time from injury to surgery > 1 week (OR = 2.714, 95% CI 1.029–7.159, P = 0.044), and postoperative immobilization time (OR = 3.237, 95% CI 1.176–8.908, P = 0.023) were independent risk factors of elbow stiffness after surgery for the terrible triad of the elbow.ConclusionHigh‐energy injury, the time from injury to surgery > 1 week, and postoperative joint immobilization time > 2 weeks are the independent risk factors of elbow stiffness after surgery of the terrible triad of the elbow, which should be treated carefully in clinical treatment.
Skin eruptions in children: Drug hypersensitivity vs viral exanthema
Authors: Tsabouri Sophia , Atanaskovic‐Markovic Marina 
Published: February 2021

AbstractChildhood rashes or exanthemas are common and are usually relatively benign. There are many causes of rash in children, including mainly viruses, and less often bacterial toxins, drugs, allergens and other diseases. Viral exanthema often appears while children are taking a medication in the course of a viral infection; it can mimic drug exanthema and is perceived as a drug allergy in 10% of cases. In the vast majority of cases, the distinction between virus‐induced and drug‐induced skin eruption during the acute phase is not possible. The drugs most commonly implicated are beta‐lactams (BL) and non‐steroidal anti‐inflammatory drugs (NSAIDs). Viruses, commonly Epstein‐Barr virus (EBV), human herpesvirus 6 (HHV6) and cytomegalovirus (CMV), and the bacterium,Mycoplasma pneumoniae, may cause exanthema either from the infection itself (active or latent) or because of interaction with drugs that are taken simultaneously. Determination of the exact diagnosis requires a careful clinical history and thorough physical examination. Haematological and biochemical investigations and histology are not always helpful in differentiating between the two types of exanthema. Serological and polymerase chain reaction (PCR) assays can be helpful, although a concomitant acute infection does not exclude drug hypersensitivity. A drug provocation test (DPT) is although considered the gold standard for the diagnosis and is not preferred by the patients. Skin tests are not well tolerated, and in vitro tests, such as the basophil activation test and lymphocyte transformation, are of low sensitivity and specificity and their relevance is debatable. Based on current evidence, we propose a systematic clinical approach for timely differential diagnosis and management of rashes in children who present a cutaneous eruption while receiving a drug.
In Defense of Deliberative Indispensability
Authors: Lutz Matt 
Published: February 2021

AbstractDavid Enoch has argued that we can be justified in believing in irreducibly normative reasons on the grounds that such reasons are deliberatively indispensable. This deliberative indispensability argument has been attacked from a variety of angles and is generally held to be rather weak. In this paper, I argue that existing criticisms of the deliberative indispensability argument do not touch the core of Enoch's argument. Properly understood, the deliberative indispensability argument is much stronger than its critics allege. It deserves to be taken seriously.
Sodium sequestration confers salinity tolerance in an ancestral wild rice
Authors: Solis Celymar Angela , Yong Miing‐Tiem , Venkataraman Gayatri , Milham Paul , Zhou Meixue , Shabala Lana , Holford Paul , Shabala Sergey , Chen Zhong‐Hua 
Published: February 2021

AbstractWild rice Oryza rufipogon, a progenitor of cultivated rice Oryza sativa L., possesses superior salinity tolerance and is a potential donor for breeding salinity tolerance traits in rice. However, a mechanistic basis of salinity tolerance in this donor species has not been established. Here, we examined salinity tolerance from the early vegetative stage to maturity in O. rufipogon in comparison with a salt‐susceptible (Koshihikari) and a salt‐tolerant (Reiziq) variety of O. sativa. We assessed their phylogeny and agronomical traits, photosynthetic performance, ion contents, as well as gene expression in response to salinity stress. Salt‐tolerant O. rufipogon exhibited efficient leaf photosynthesis and less damage to leaf tissues during the course of salinity treatment. In addition, O. rufipogon showed a significantly higher tissue Na+ accumulation that is achieved by vacuolar sequestration compared to the salt tolerant O. sativa indica subspecies. These findings are further supported by the upregulation of genes involved with ion transport and sequestration (e.g. high affinity K+ transporter 1;4 [HKT1;4], Na+/H+ exchanger 1 [NHX1] and vacuolar H+‐ATPase c [VHA‐c]) in salt‐tolerant O. rufipogon as well as by the close phylogenetic relationship of key salt‐responsive genes in O. rufipogon to these in salt‐tolerant wild rice species such as O. coarctata. Thus, the high accumulation of Na+ in the leaves of O. rufipogon acts as a cheap osmoticum to minimize the high energy cost of osmolyte biosynthesis and excessive reactive oxygen species production. These mechanisms demonstrated that O. rufipogon has important traits that can be used for improving salinity tolerance in cultivated rice.
Can proactive fiscal policy achieve the goal of “Beyond Keynesianism”?
Authors: Ke Xiao , Yan Yuanke 
Published: February 2021

AbstractThis study aims to assess whether counter‐cyclical fiscal policy to release infrastructure bottlenecks achieved the goal of “Beyond Keynesianism,” that is, to stimulate long‐term economic growth. The proactive fiscal policy during the Asian financial crisis dramatically expanded the National Highway System in China. Taking the highway project as an example, we evaluate its impact on per capita output and employment growth and investigate the underlying mechanism. Using provincial panel data from 1995 to 2016, our system generalized method of moments estimation finds that this large‐scale high‐rank road infrastructure project leads to an increase in per capita GDP growth. Automobile‐intensive industries benefit most from it. A channel analysis indicates that the growth effect is driven by structural transformation. Further, the project increases overall employment, mainly in secondary industries. It also creates extra demand for road transportation and longer‐distance road freight transport by facilitating the flow of both commodities and passengers.
Affects of policy design: The case of young carers in the Care Act 2014 and the Children and Families Act 2014
Authors: Alexander Chloe 
Published: February 2021

AbstractThis article presents an analysis of policies on young carers in England, considering both the design but also the lived experience of policy subjects. Drawing on affect theory we can increase understanding of the reach of these policies into family life and the nature of English policy‐making focussed on this group. This analytic framework presents the opportunity to draw on the use of affect theory developed in other disciplines but less so in the discipline of social policy. The article argues, firstly, that normative messages through policy design are conveyed to families through affects. Secondly, it argues that hierarchies of subject positions established within policy design are reaching and impacting on young carers and their families through affective pressures. This article demonstrates that affect theory contributes to the analysis of social policies on young carers and also illuminates the impacts of policies in the context of limited formal implementation.
Guaranteed Minimization of the Bit Error Ratio for MIMO Systems: A
Mathematical Viewpoint
Authors: Auer Ekaterina , Ahrens Andreas 
Published: February 2021

Abstract
Multiplying the capacity of communication links by using the multiple-input multiple-output (MIMO) mechanism has become an essential part of various wireless standards. In this paper, we focus on the bit error ratio (BER) in such systems and consider its optimization under parameter uncertainty from a formal point of view (including methods with result verification). The theoretical results are demonstrated using a close-to-life application.
Evaluation of Relationship Between Shape of a Rigid Body Unifilar Centrifugal Pendulum Vibration Absorber and Vibration Suppression Performance
Authors: Inoue Tsuyoshi , Okumura Ryota , Yabui Shota , Jiang Xiangyu 
Published: February 2021

Abstract
The torsional vibration hinders the reduction of automobile exhaust gas emitted by using engines with a reduced number of cylinders. Centrifugal pendulum vibration absorbers (CPVA) have been used in engines to suppress torsional vibration. To clarify the dynamics of CPVAs, much analysis has been conducted using the point mass CPVA as the model of rigid body bifilar CPVA. However, few attempts have been made to analyze the rigid body unifilar CPVA on vibration suppression performance in frequency response. In this study, the authors have analyzed the dynamics of the rigid body unifilar CPVA, focusing on the influence of shape parameters. The results verified that the shape parameters, which relating to moment of inertia or radius of gyration of rigid body unifilar CPVA, influence the vibration suppression performance in frequency response. Moreover, the numerical simulation results were confirmed experimentally and showed in good agreement with the experimental results, and both indicated the dependence of the vibration suppression performance on the shape parameters of the rigid body unifilar CPVA.
Cannabidiol Does Not Impair Anabolic Signaling Following Eccentric Contractions in Rats
Authors: Langer Henning T. , Mossakowski Agata A. , Pathak Suraj , Mascal Mark , Baar Keith 
Published: February 2021

Cannabidiol (CBD) has proven clinical benefits in the treatment of seizures, inflammation, and pain. The recent legalization of CBD in many countries has caused increased interest in the drug as an over-the-counter treatment for athletes looking to improve recovery. However, no data on the effects of CBD on the adaptive response to exercise in muscle are available. To address this gap, we eccentrically loaded the tibialis anterior muscle of 14 rats, injected them with a vehicle (n = 7) or 100 mg/kg CBD (n = 7), and measured markers of injury, inflammation, anabolic signaling, and autophagy 18 hr later. Pro-inflammatory signaling through nuclear factor kappa B (NF-kB) (Ser536) increased with loading in both groups; however, the effect was significantly greater (36%) in the vehicle group (p < .05). Simultaneously, anabolic signaling through ribosomal protein S6 kinase beta-1 (S6K1) (Thr389) increased after eccentric contractions in both groups with no difference between vehicle and CBD (p = .66). The ribosomal protein S6 phosphorylation (240/244) increased with stimulation (p < .001) and tended to be higher in the CBD group (p = .09). The ubiquitin-binding protein p62 levels were not modulated by stimulation (p = .6), but they were 46% greater in the CBD compared with the vehicle group (p = .01). Although liver weight did not differ between the groups (p = .99) and levels of proteins associated with stress were similar, we did observe serious side effects in one animal. In conclusion, an acute dose of CBD decreased pro-inflammatory signaling in the tibialis anterior without blunting the anabolic response to exercise in rats. Future research should determine whether these effects translate to improved recovery without altering adaptation in humans.
Austerity, resilience and the management of actors in public hospitals: a qualitative study from South Africa
Authors: Fana Thanduxolo , Goudge Jane 
Published: February 2021

BackgroundGlobal economic recession coupled with internal inefficiencies and corruption has led to a period of austerity in the South African healthcare system.This paper examines the strategies used by management in response to austerity in the three public hospitals and their effect on organisational functioning.MethodsWe used a comparative qualitative case study approach, collecting data using a combination of in-depth interviews with managers, and focus group discussion and interviews with shop stewards and staff.ResultsAusterity, imposed by the introduction of a provincial cost containment committee, has led to a reduction in staff, benefits, shortages of equipment and delayed procurement and recruitment processes. Managers in the first hospital maintained training on labour relations for staff and managers, they jointly planned how to cope with reduced staff and initiated a new forum for HR and finance staff. These strategies improved the way actors engaged, enabling them to resolve problems. Good communication ensured that staff understood what was within the hospitals control and what was not. A second hospital relied on absorptive strategies, such as asking staff to do more with less. The result was resistance, and greater use of sick leave. Some staff gave their own money to help feed patients but were angry at management for putting them in this difficult position. Leadership in the third hospital did not manage actors well either; help from the Government’s Expanded Public Works Programme was rejected by the unions, managers did not attend meetings as they felt their contributions were not listened to. Poor communication meant that the managers and staff did not understand what was within the hospital’s control and what was not; a misunderstanding led to a physical fight between managers.ConclusionOrganisational resilience in the face of austerity requires leaders to manage different stakeholders well. Hospital managers who promote democratic or participatory leadership and management, open communication, teamwork and trust among all stakeholders will lead better functioning organisations. A special focus should be placed on such practices to develop the resilience of health systems’ organisations.
Learning-by-doing: the importance of experiential knowledge sharing for meeting the information needs of people with colorectal cancer in Germany—a qualitative study
Authors: Kaiser Maleen , Adami Sandra , Lucius-Hoene Gabriele , Muller-Nordhorn Jacqueline , Goerling Ute , Breuning Martina , Holmberg Christine 
Published: February 2021

ObjectiveThe aim of this article is to understand how, when and why the topics of information and information needs arise when people diagnosed with colorectal cancer (CRC) narrate their illness experiences.MethodsGuided by principles of grounded theory, a qualitative interview study was conducted that collected a wide variety of illness experiences with CRC in Germany using maximum variation sampling. Sampling criteria included place of residence, age at interview, age at diagnosis, treatment, disease course and sociodemographic factors such as varying family backgrounds and professions.Setting and participantsMen and women diagnosed with CRC in different parts of Germany were sought via physicians, social workers and psychologists in hospital settings, organisations offering psychosocial support for patients with cancer, self-help groups, rehabilitation centres, newspapers and personal contacts. The interviewees in the final sample (n=41) had been diagnosed with CRC between 4 weeks and 36 years prior to the interview.ResultsThree inter-related categories of information needs emerged from the analysis: the need for non-medical information for daily life; the challenge of integrating the bodily changes that accompany CRC in everyday life; and sources of non-medical information concerning handling daily life. Learning to live with the bodily changes of CRC in everyday life was described as a long process of learning-by-doing. While sources for medical information were clear, finding practical information was often a challenge. The best source of such information was often seen to be other people living with the disease, who shared their experiential knowledge, as well as stoma and nutritional therapists.ConclusionInformation needs are part of the process and struggle to normalise everyday life after a disruptive diagnosis and treatment. Providing access to practical knowledge and information from others with CRC experience may be an important resource for patient support.