bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apathy in small vessel cerebrovascular disease is associated with deficits in effort-based decision making
Authors: Saleh Youssuf , Le Heron Campbell , Petitet Pierre , Veldsman Michele , Drew Daniel , Plant Olivia , Schulz Ursula , Sen Arjune , Rothwell Peter M , Manohar Sanjay , Husain Masud 
Published: January 2021

AbstractPatients with small vessel cerebrovascular disease frequently suffer from apathy, a debilitating neuropsychiatric syndrome, the underlying mechanisms of which remain to be established. Here we investigated the hypothesis that apathy is associated with disrupted decision making in effort-based decision making, and that these alterations are associated with abnormalities in the white matter network connecting brain regions that underpin such decisions. Eighty-two patients with MRI evidence of small vessel disease were assessed using a behavioural paradigm as well as diffusion weighted MRI. The decision-making task involved accepting or rejecting monetary rewards in return for performing different levels of physical effort (hand grip force). Choice data and reaction times were integrated into a drift diffusion model that framed decisions to accept or reject offers as stochastic processes approaching a decision boundary with a particular drift rate. Tract-based spatial statistics were used to assess the relationship between white matter tract integrity and apathy, while accounting for depression. Overall, patients with apathy accepted significantly fewer offers on this decision-making task. Notably, while apathetic patients were less responsive to low rewards, they were also significantly averse to investing in high effort. Significant reductions in white matter integrity were observed to be specifically related to apathy, but not to depression. These included pathways connecting brain regions previously implicated in effort-based decision making in healthy people. The drift rate to decision parameter was significantly associated with both apathy and altered white matter tracts, suggesting that both brain and behavioural changes in apathy are associated with this single parameter. On the other hand, depression was associated with an increase in the decision boundary, consistent with an increase in the amount of evidence required prior to making a decision. These findings demonstrate altered effort-based decision making for reward in apathy, and also highlight dissociable mechanisms underlying apathy and depression in small vessel disease. They provide clear potential brain and behavioural targets for future therapeutic interventions, as well as modelling parameters that can be used to measure the effects of treatment at the behavioural level.
The Bully Pulpit:trolling the trolls with polysemous monstrosity
Authors: Snider Madison 
Published: January 2021

AbstractThe photography of Haley Morris-Cafiero partakes in a larger feminist response to the vitriol of online misogyny that implicates the current moderation environment of online social platforms. This analysis illuminates Morris-Cafiero’s work of transgressive feminist art, using the body as a means for subverting the gaze of online misogyny and fat-shaming and presenting it anew. Morris-Cafiero uses self-portraiture to remark on the subject of online harassment as both the recipient and the sender. Bringing gendered histories of monstrosity into conversation with contemporary gendered online harassment, this article argues that the work of The Bully Pulpit exemplifies a new conception of polysemous monstrosity through which to understand the presentation of self, both for the artist and her trolls.
The International Classification of Health Interventions: an ‘epistemic hub’ for use in public health
Authors: Fortune Nicola , Madden Richard , Riley Therese , Short Stephanie 
Published: January 2021

AbstractThe current lack of a common basis for collecting data on population-level prevention and health promotion interventions causes public health to be relatively invisible within broader health systems, making it vulnerable to funding cuts when there is pressure to reduce spending. Further, the inconsistent use of terms for describing interventions hinders knowledge translation and building an evidence base for public health practice and policy. The International Classification of Health Interventions (ICHI), being developed by the World Health Organization, is a standard statistical classification for interventions across the full scope of health systems. ICHI has potential to meet the need for a common language and structure for describing and capturing information about prevention and health promotion interventions.We report on a developmental appraisal conducted to examine the strengths and limitations of ICHI for coding interventions delivered for public health purposes. Our findings highlight classification challenges in relation to: consistently identifying separate components within multi-component interventions; operationalizing the ICHI concept of intervention target when there are intermediary targets as well as an ultimate target; coding an intervention component that involves more than one ICHI target or action; and standardising what is being counted. We propose that, alongside its purpose as a statistical classification, ICHI can play a valuable role as an ‘epistemic hub’, to be used flexibly by public health actors to meet a range of information needs, and as a basis for improved communication and exchange.
Assessment of the effects of exposure to extremely low-frequency magnetic fields on MDCK epithelial cell lines under a controlled environment
Authors: Domínguez Gonzalo , Cardiel Eladio , Sánchez Elsa , Hernández Pablo-Rogelio 
Published: January 2021

AbstractTo assess the effects of exposure to extremely low-frequency magnetic fields (ELF-MFs) on MDCK cell lines, experiments were performed in a chamber under controlled conditions (temperature, humidity and CO2). Therefore, the measured physicochemical and electrical changes in the cells are due solely to the magnetic field exposure and not to external factors. A developed sinusoidal magnetic field generator produced the ELF-MFs with a uniform magnetic field and adjustable intensity and frequency. Three experimental indicators were used: (i) transepithelial electrical impedance (TEEI); (ii) cell migration and proliferation; and (iii) expression of the proteins of the tight junctions, and changes in the area and shape of the cell nuclei. No significant effects on TEEI values were observed when 10 and 50 G 60 Hz magnetic fields were applied to confluent cell monolayers. There were no significant differences in migration and proliferation of the cell monolayer exposed to 60 Hz magnetic fields10 and 50 G , but a contact inhibition factor was observed. The expression of the CLDN-1 protein decreased by 90% compared with the control, while ZO-1 protein expression increased by 120%. No significant effects were observed in the area and shape of the cell nuclei. Experimentation in a controlled environment, under physiological conditions, ensures that the observed effects were strictly due to exposure to magnetic fields. Different exposure conditions are necessary to determine the impact on TEEI and cell migration–proliferation indicators.
Optimizing Helmet Pad Placement Using Computational Predicted Injury Pattern to Reduce Mild Traumatic Brain Injury
Authors: Tan X Gary , Matic Peter 
Published: January 2021

ABSTRACTIntroductionThis effort, motivated and guided by prior simulated injury results of the unprotected head, is to assess and compare helmet pad configurations on the head for the effective mitigation of blast pressure transmission in the brain in multiple blast exposure environments.Materials and MethodsA finite element model of blast loading on the head with six different helmet pad configurations was used to generate brain model biomechanical responses. The blast pressure attenuation performance of each pad configuration was evaluated by using the calculated pressure exposure fraction in the brain model. Monte Carlo simulations generated repetitive blast cumulative exposures.ResultsSignificant improvement of a 6-Pad Modified configuration compared to a 6-Pad Baseline configuration indicates the importance of providing protection against the side blast. Both 12-Pad configurations are very effective in mitigating pressure in the brain. Repetitive blast exposure statistics for operational exposures shows that pad configurations with a larger number of pads and smaller gaps between pads perform better than the configurations with a smaller number of pads and larger gaps between pads.ConclusionsOptimizing helmet pad size and/or placement could provide an improved protection by minimizing the side blast orientation effects and mitigating high-pressure fields in the brain from repeated blast exposures.
Mechanical Assessment of Tissue Properties During Tourniquet Application
Authors: Hooke Alexander W , Hallbeck M Susan , Prytz Erik , Jonson Carl-Oscar , Lowndes Bethany R 
Published: January 2021

ABSTRACTIntroductionSuccessful tourniquet application increases survival rate of exsanguinating extremity hemorrhage victims. Tactile feedback during tourniquet application training should reflect human tissue properties in order to increase success in the field. This study aims to understand the mechanical properties of a human limb during tourniquet application.MethodSix cadaveric extremities—three uppers and three lowers—were tested from three body mass index groups: low (&lt;19) healthy (19-24), and overweight (&gt;24). Each specimen donned with a tourniquet and mounted to a servo-hydraulic testing machine, which enabled controlled tightening of the tourniquet while recording the tourniquet tension force and strap displacement. A thin-film pressure sensor placed between the specimen and the tourniquet recorded contact pressure. Each limb was tested with the tourniquet applied at two different sites resulting in testing at the upper arm, forearm, thigh, and shank.ResultsThe load displacement curves during radial compression were found to be nonlinear overall, with identifiable linear regions. Average contact pressure under the tourniquet strap at 200N and 300N of tension force was 126.3 (σ = 41.2) mm Hg and 205.3 (σ = 75.3) mm Hg, respectively. There were no significant differences in tissue stiffness or contact pressure at 300N of tension force between limb (upper vs. lower) or body mass index. At 200N of tension, the upper limb had significantly higher contact pressure than the lower limb (P = 0.040). Relative radial compression was significantly different between upper (16.74, σ = 4.16%) and lower (10.15, σ = 2.25%) extremities at 200N tension (P = 0.005).ConclusionsSimulation of tissue compression during tourniquet application may be achieved with a material exhibiting elastic properties to mimic the force-displacement behavior seen in cadaveric tissue or with different layers of material. Different trainers for underweight, healthy, and overweight limbs may not be needed. Separate tourniquet training fixtures should be created for the upper and lower extremities.
A Novel Approach to Negative Pressure Wound Therapy: Use of High Suction Capillary Device to Improve Wound Healing
Authors: Chatterjee Ranjit , Riddle Tara M , Poskarbiewicz Melisa K , Babcock George F 
Published: January 2021

ABSTRACT

Introduction
Negative Pressure Wound Therapy (NPWT) is a procedure used for nonhealing wounds. In NPWT, a special sealed dressing of large cell foam (&gt;400 µm) or gauze is connected to a pump. Most commonly, negative pressures between −10 and −125 millimeters of mercury (mm Hg) are used. The mechanism of healing is unknown but maybe attributable to removal of the exudate and bacteria, and the stimulation of tissue repair through microdeformation. Reticulated foams with micron-size open cells, Capillary Suction Devices (CSD; 100 to 5 µm) exert capillary suction between 10 and 70 mm of Hg with a multilayered foam dressing.

Materials and Methods
Yorkshire pigs received 5 surgical excision wounds, 3 cm2, on each side of the back. The wounds were covered with a NPWT dressing (110 mm Hg negative pressure by a pump), CSD with capillary suctions of 30 mm Hg (CSD-30) and 70 mm Hg (CSD-70), and a conventional gauze dressing. The wounds were measured on day 2, and then every 4-5 days thereafter; the total fluid collected by the various dressing over time.

Results
By post-wound day 20, the wounds treated with CSD-70 and NPWT were 100% closed while the wounds treated with CSD-30 and gauze were 65% and 45%, respectively. This indicated comparable wound closure efficacies for CSD-70 and NPWT. The average total fluid uptake measured in grams dry weight were similar for CSD-70 and NPWT, 36 and 38 g, respectively, while the values were 24 g for CSD-30 and 12 g for gauze. However, the maximum fluid uptake observed at day 2 indicated that CSD-70 and CSD 30, 24 and 14 g, respectively, were superior to NPWT and gauze 12 and 7 g, respectively.

Conclusion
This data indicate comparable wound closure efficacies for CSD-70 and NPWT. It is felt that CSD is an effective, safe, and lower cost alternative to vacuum-assisted NPWT.
Pelvic Injury Risk Curves for the Military Populations From Lateral Impact
Authors: Yoganandan Narayan , Rooks Tyler F , Chancey Valeta Carol , Pintar Frank A , Banerjee Anjishnu 
Published: January 2021

ABSTRACTIntroductionCurrent methods for transporting military troops include nonstandard seating orientations, which may result in novel injuries because of different types/directions of loading impact. The objective of this study is to develop pelvic injury risk curves (IRCs) under lateral impacts from human cadaver tests using survival analysis for application to military populations.MethodsPublished data from lateral impacts applied to whole-body cadaver specimens were analyzed. Forces were treated as response variables. Demographics and body mass index (BMI) were covariates. Injury risk curves were developed for forces without covariates, for males, females, 83 kg body mass, and 25 kg/m2 BMI. Mean and ± 95% confidence interval IRCs, normalized confidence interval sizes at discrete risk levels, and quality indices were obtained for each metric-covariate combination curve.ResultsMean age, stature, total body mass, and BMI were 70.1 ± 8.6 years, 1.67 ± 0.1 m, 67.0 ± 14.4 kg, and 23.9 ± 3.97 kg/m2, respectively. For a total body mass of 83 kg, peak forces at 10%, 25%, and 50% probability levels were 5.7 kN, 7.4 kN, and 9.6 kN, respectively. For males, peak forces at the 10%, 25%, and 50% probability levels were 4.8 kN, 6.4 kN, and 8.4 kN, respectively. For females, peak forces at the 10%, 25%, and 50% probability levels were 3.0 kN, 4.0 kN, and 5.2 kN, respectively. Other data and risk curves are given.ConclusionsThe IRCs developed in this study can be used as injury criteria for the crashworthiness of future generation military vehicles. The introduction of BMI, sex, and total body mass as covariates quantified their contributions. These IRCs can be used with finite element models to assess and predict injury in impact environments to advance Soldier safety. Manikins specific to relevant military anthropometry may be designed and/or evaluated with the present IRCs to assess and mitigate musculoskeletal injuries associated with this posture and impact direction.
Soldiers’ Perception of a Behavioral Intervention for Positive Airway Pressure Therapy Adherence in a Military Treatment Facility
Authors: Ee Juliana S , Pham Christopher K , Shaha David P , Rogers Mary C , Cacace Gregory S , Mounts Charles W 
Published: January 2021

ABSTRACT

Introduction
The incidence of obstructive sleep apnea in military personnel has increased over 500% since the early 2000s. Adherence to continuous positive airway pressure (PAP), an efficacious treatment, has been suboptimal. This article presents a behavioral intervention model for enhancing PAP therapy adherence and describes how the model was received by military personnel.

Materials and Methods
The study population comprised 254 out of 280 military personnel (93% men, mean age 39 years) who attended a 90-minute behavioral intervention class within the first 8 weeks of PAP use. They were coached on the Knowledge, Skills, Attitudes (KSA) model of PAP therapy success: Knowledge about obstructive sleep apnea and PAP treatment; Skills to develop a habitual loop for nightly PAP use; and Attitudes that address readiness, barriers, and solutions for sustaining PAP use. Participants completed a voluntary, anonymous postclass survey that inquired of their perception of various elements of the class. Data were analyzed using descriptive statistics and a paired sample t-test.

Results
In participants’ self-rating of how much they know about PAP treatment before and after the class, their ratings indicated that they experienced a significant increase in knowledge (P &lt; 0.0001). On the postclass survey, 77% of the participants (N = 195/254) “agree a lot” or “strongly agree” that the class gave them tools to have a successful treatment and 78% (N = 198/254) noted that it was a valuable educational experience. The Knowledge portion was rated by 79% (N = 201/254) of the participants as “quite a lot” or “extremely” beneficial. The Skills segment was rated as “quite a lot” or “extremely” beneficial by 72% (N = 183/254) of the participants. The Attitudes discussion was perceived as “quite a lot” or “extremely” beneficial by 70% (N = 178/254) of the participants. Participants’ free-text responses to “what was most helpful” were generally positive.

Conclusions
A KSA model of behavioral intervention for enhancing PAP therapy adherence was well received by participants. Future research will assess the impact of this intervention on adherence as measured by objective indicators.
The Application of a Computerized Cognitive Screening Tool in Naval Aviators
Authors: Chee Shawnna M , Bigornia Veronica E , Logsdon Daniel L 
Published: January 2021

ABSTRACTIntroductionThe CogScreen-Aeromedical Edition (CogScreen-AE) is a computerized neurocognitive assessment screening tool developed for the Federal Aviation Administration as a rapid, reliable means of measuring neurocognitive deficiency in civilian airline pilots. This has potential use and assessment of military aviators flying high performance aircraft under extreme conditions; however, no data exist on how the dynamic flight environment affects CogScreen-AE scores. The objectives of this study were to determine what changes in performance on CogScreen-AE scores are seen post-flight in Naval Aviators flying high performance aircraft and to determine the potential for use of CogScreen-AE as a screening tool to evaluate degree of impairment, recovery from neurological illness, and return to duty status of a military aviator.Materials and MethodsRepeated measures, within-subjects experimental design with three CogScreen-AE administrations—introduction session, preflight session, and postflight session. An experimental study group was exposed to dynamic flight between preflight and postflight sessions, while a control group flew a desktop computer flight simulator between sessions. Data were analyzed by mixed model ANOVA using Statistical Package for the Social Sciences to compare CogScreen-AE pre- and postflight performance on 5 composite scores of variables that account for 45% of the variance in predicting flight performance.ResultsPreflight versus postflight scores demonstrated no significant differences in performance attributable to flight in high performance aircraft.ConclusionsThe CogScreen-AE performance is shown to be consistent preflight to post-flight. These data show that CogScreen-AE may be a reliable clinical instrument for assessing aviators’ cognitive function with regard to return to flight duty decision-making. We anticipate future work in determining how CogScreen-AE can be utilized in the operational environment and documenting recovery from neurologic illness.
Female Military Officers Report a Desire for Menstrual Suppression During Military Training
Authors: Ricker Emily A , Goforth Carl W , Barrett Amelia S , Deuster Patricia A , de la Motte Sarah J 
Published: January 2021

ABSTRACT

Introduction
Service women face female-specific challenges that present physiological and logistical burdens and may impact readiness. The stress of training can change menstrual patterns and symptoms, and limited access to hygienic, private facilities can hinder menstrual management. Therefore, suppressing menses with continuous hormonal contraception may be of interest.

Materials and Methods
The 9-item “Military Women’s Attitudes Toward Menstrual Suppression.” questionnaire was administered to female officers upon entry (baseline) and graduation (post) from a 6-month secondary training course. Respondents rated their attitudes about menstruation and the stress of training, the desire for menstrual suppression, and the logistical burden of menstruation on a 1 (strongly agree) through 5 (strongly disagree) scale. Wilcoxon Signed Rank Tests determined changes in the distribution of responses from baseline to post.

Results
Female officers (n = 108) completed baseline and post questionnaires (age 25.2 ± 0.3 years). At baseline, the majority disagreed/strongly disagreed that the stress of training “makes periods worse than usual” (n = 77, 71%), “increases menstrual symptoms and bleeding” (n = 77, 71%), or “magnifies premenstrual syndrome” (PMS; n = 69, 64%). Although 50% (n = 54) agreed/strongly agreed that “stopping periods while women are training is a good idea,” 37% (n = 40) disagreed/strongly disagreed. The majority agreed/strongly agreed that menstrual suppression would prevent “the worry about menstrual supplies” (n = 75, 70%) and “the inconvenience of having a period during training” (n = 69, 64%). Many agreed/strongly agreed that it is difficult to deal with periods during training because “there is no privacy” (n = 52, 48%), “the inability to find adequate facilities” (n = 70, 65%), and “the lack of opportunity to use adequate facilities” (n = 52, 48%). Opinions remained largely consistent from baseline to post.

Conclusions
The desire for menstrual suppression among service women during training is high. Military health care providers should be prepared to counsel service women about strategies to manage menstruation, including the efficacy of continuous hormonal contraception for menstrual suppression. Future studies investigating benefits or risks of continuous hormonal contraception for menstrual suppression in service women should inform the clinical recommendations.