bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicentre, randomised controlled feasibility study to compare a 10-week physiotherapy programme using an interactive exercise training device to improve walking and balance, to usual care of children with cerebral palsy aged 4–18 years: the ACCEPT study protocol
Authors: Rapson Rachel , Marsden Jonathan , Latour Jos , Ingram Wendy , Stevens Kara Nicola , Cocking Laura , Carter Bernie 
Published: May 2022

IntroductionChildren with cerebral palsy (CP) frequently undertake physiotherapy programmes to improve walking and balance. They often require adult support to exercise in a functional position. A novel interactive exercise trainer has been devised to enable children to exercise with against resistance in a functional position, but its efficacy has yet to be proved. A novel protocol has been developed to determine whether a randomised controlled trial (RCT) is feasible.AimTo establish whether it is feasible to conduct an RCT to assess the effectiveness of a 10-week physiotherapy intervention using an interactive trainer in children with CP.Methods and analysisThis study is multicentre randomised controlled feasibility trial with an embedded qualitative study. Forty children with CP, Gross Motor Function Classification System (GMFCS) I–III will be recruited from community paediatric physiotherapy caseloads. Participants will be randomised to 10 weeks of training with the interactive training device or to usual physiotherapy care. The mediolateral motion of the centre of mass estimate and Paediatric Balance Scale will be explored as potential primary outcomes measures, tested at baseline, 10 weeks and follow-up at 20 weeks. The views of child participants, their parents and physiotherapists will be gained through e-diaries and qualitative interviews.Feasibility will be determined by examining recruitment and retention rates, completeness of, adherence to the intervention, appropriateness of outcome measures and effectiveness of blinding. Results will be reported in accordance to Consolidated Standards of Reporting Trials (CONSORT) guidelines.Ethics and disseminationPhysiotherapists, children and parents have informed trial design and information leaflets. Results will be disseminated via publications, conferences and to families. This study has approval from North of Scotland Research Ethics Committee (20/NS/0018).Trial registration numberISRCTN80878394.
Retrospective observational study of the robustness of provider network structures to the systemic shock of COVID-19: a county level analysis of COVID-19 outcomes
Authors: Linde Sebastian , Egede Leonard E 
Published: May 2022

ObjectiveTo evaluate whether certain healthcare provider network structures are more robust to systemic shocks such as those presented by the current COVID-19 pandemic.DesignUsing multivariable regression analysis, we measure the effect that provider network structure, derived from Medicare patient sharing data, has on county level COVID-19 outcomes (across mortality and case rates). Our adjusted analysis includes county level socioeconomic and demographic controls, state fixed effects, and uses lagged network measures in order to address concerns of reverse causality.SettingUS county level COVID-19 population outcomes by 3 September 2020.ParticipantsHealthcare provider patient sharing network statistics were measured at the county level (with n=2541–2573 counties, depending on the network measure used).Primary and secondary outcome measuresCOVID-19 mortality rate at the population level, COVID-19 mortality rate at the case level and the COVID-19 positive case rate.ResultsWe find that provider network structures where primary care physicians (PCPs) are relatively central, or that have greater betweenness or eigenvector centralisation, are associated with lower county level COVID-19 death rates. For the adjusted analysis, our results show that increasing either the relative centrality of PCPs (p value<0.05), or the network centralisation (p value<0.05 or p value<0.01), by 1 SD is associated with a COVID-19 death reduction of 1.0–1.8 per 100 000 individuals (or a death rate reduction of 2.7%–5.0%). We also find some suggestive evidence of an association between provider network structure and COVID-19 case rates.ConclusionsProvider network structures with greater relative centrality for PCPs when compared with other providers appear more robust to the systemic shock of COVID-19, as do network structures with greater betweenness and eigenvector centralisation. These findings suggest that how we organise our health systems may affect our ability to respond to systemic shocks such as the COVID-19 pandemic.
Effects of Companion Dogs on Adult Attachment, Emotion Regulation, and Mental Wellbeing in Hong Kong
Authors: Chan Hiu Wo , Wong Daniel Fu Keung 
Published: May 2022

Abstract
This study utilized attachment theory to explore the functions of companion animals (pets) and the influence of secure human-pet bond on attachment security and emotion regulation among companion-animal guardians (pet owners) in Hong Kong. Hierarchical regression analyses were conducted exploring the relative influence of adult attachment and pet attachment on mental wellbeing, and the moderating effect of pet attachment on emotion regulation. Results revealed a consistent attachment pattern across human-human and human-pet bonds. A secure human-pet bond can act as a positive catalyst that exerts a moderating effect on emotion reappraisal. Treating pets as family members/friends helps pet owners receive the security that they lack in adult attachment. This study verified the role of pets as a “security supplement” (an additional supply of security) rather than a complete substitute for a human attachment figure. Implications for theory, service practice, and policy are discussed.
Altitudinal variation in flower color and attraction pattern of Rhododendron arboreum Sm. in central Himalayan Region of Uttarakhand, India
Authors: Mamgain Akshay 
Published: May 2022

Abstract
This study highlights the importance of flower color variation and attraction as a mechanism for pollination and protection of floral parts. As part of this study, a survey relating to flower color variation and differences in spotting pattern (nectar guides) was conducted on Rhododendron arboreum, a widespread tree species in the mountainous region of Uttarakhand state, at 43 different altitudinal locations. Seven original color morphs of flowers and five types of spot variation in the nectar guide were observed. The study underlines the role of flower color polymorphism in both pollination and adaptation to varied environmental conditions. Further, the significance of nectar guides in directing the visitor to the reward is discussed. This study has the potential to enhance existing knowledge about flower color variation and attraction to the environment.
Construction of a Research Requirement Participant Pool Using Open-Source Software
Authors: Westfall Jonathan E. , Hill Evan M. 
Published: May 2022

Introduction Recruiting undergraduate students to participate in research has long been an established practice within psychology. Although this data source has weaknesses, this involvement in the research process has considerable pedagogical value in teaching students research methodology. Statement of the Problem Most common software packages used to manage participant pools tend to be expensive, to the extent that it prohibits access for small institutions and departments. Literature Review Highlighting the problem, we cite research related to using undergraduates as participants, pedagogical value of these experiences, and current trends in software distribution. We then provide evidence of successful implementation of open-source software (OSS) in educational settings, and conclude with OSS options capable of addressing the problem of access. Teaching Implications By providing students research experiences, both as a researcher and as a participant, we enhance their understanding of this process. Secondary to this, we can foster within them a skill set that is valuable to disciplines outside of academia. Conclusion The implementation of an OSS system to manage research participants provides a cost-effective means to expand the learning and research opportunities of available to students.
The Lady and the Gentleman: Changing Gender Relations and Anxieties in Early Malayalam Cartoons
Authors: Ali Nassif Muhammed 
Published: May 2022

Kerala, towards the end of the nineteenth century, witnessed an awakening which left impressions on all the walks of the society. The advent of modernity, which was triggered by the British rule as well the state’s attempt to widen education and welfare measures, initiated reform movements among almost all the communities. The accessibility to modern education and resultant exposure to scientific, philosophic and humanistic values as well as ideas such as liberty, equality, secularism and individualism changed the perception of men and women towards the society and towards the self. This also resulted in the formation and spread of media and journalism, which in turn led to the rise of humour magazines and eventually, cartoons in Malayalam. However, the perception of these media and medium towards the other aspects of modernity was quite complex to say the least. The western educated woman and man, it can be found, have been featured in quite a number of cartoons across magazines. The article, therefore, focuses on the representations of changing gender relations in the Malayali society through cartoons published in humour magazines ( Sanjayan, Vishwaroopam, Naradar and Sarasan) from late 1930s to 1960s. Starting with Sanjayan, these cartoons targeted the ‘modern’ women and men, albeit in different ways. Those on women lampooned their emancipation, education, access to the public sphere etc. and its perceived effect on the sociocultural setup, especially within and in relation to the institutions of marriage and family. On the other hand, men were ridiculed for their westernisation and emasculation.
Anti-Müllerian hormone as a diagnostic tool to identify queens with ovarian remnant syndrome
Authors: Flock Ulrike , Fischer Stine , Weeger Jasmin , Reese Sven , Walter Beate 
Published: May 2022

Objectives Ovarian remnant syndrome (ORS) is suspected when heat signs occur in spayed individuals, but further diagnostic procedures are necessary to exclude other possible oestrogen sources, such as the adrenal gland or exogenous supplementation. Anti-Müllerian hormone (AMH), secreted by granulosa cells or Sertoli cells, serves to differentiate sexually intact from gonadectomised animals and has been described in dogs as a tool for diagnosing ORS. The aim of this study was to evaluate if AMH determination can be used to diagnose ORS in cats. Methods AMH was measured with a chemiluminescence immunoassay in serum samples of 15 sexually intact, 9 spayed and 16 cats with a history of heat signs after spaying. Abdominal ultrasound (n = 13), vaginal smears (n = 7), progesterone measurement (n = 5) and laparotomy (n = 14) were used to determine the presence of ovarian tissue. After surgery, a histological examination of the obtained tissue was performed in the cats with suspected ORS. Results In 15 cats with ORS the AMH serum concentrations were significantly higher than in spayed cats (n = 10; P = 0.025) and significantly lower than in sexually intact cats (n = 15; P = 0.001). Among the cats with ORS, the highest AMH serum concentrations were measured in the queens with cystic ovarian alterations and in one cat from which a whole ovary was obtained. The cat with the lowest AMH serum concentration had a simultaneous high progesterone serum concentration. Cats with ORS did not show any heat signs after surgical removal of the ovarian tissue. Conclusions and relevance A single determination of AMH in blood serum is a useful diagnostic tool for the diagnosis of ORS in cats, regardless of the hormonal activity of the remnant ovarian tissue.
Achilles Tendon Repairs: Identification of Risk Factors for and Economic Impact of Complications and Reoperation
Authors: Trivedi Nikunj N. , Varshneya Kunal , Calcei J. Blake , Lin Kenneth , Sochaki Kyle R. , Voos James E. , Safran Marc R. , Calcei Jacob G. 
Published: May 2022

Background: Compared with nonoperative management, Achilles tendon repair is associated with increased rates of complications and increased initial healthcare cost. However, data are currently lacking on the risk factors for these complications and the added healthcare cost associated with common preoperative comorbidities. Hypothesis: Identify the independent risk factors for complications and reoperation after acute Achilles tendon repair and calculate the added cost of care associated with having each preoperative risk factor. Study Design: Retrospective cohort study. Level of evidence: Level 3. Methods: A retrospective review of a large commercial claims database was performed to identify patients who underwent primary operative management for Achilles tendon rupture between 2007 and 2016. The primary outcome measures of the study were risk factors for (1) postoperative complications, (2) revision surgery, and (3) increased healthcare resource utilization. Results: A total of 50,279 patients were included. The overall complication rate was 2.7%. The most common 30-day complication was venous thromboembolism (1.2%). The rate of revision surgery was 2.5% at 30 days and 4.3% at 2 years. Independent risk factors for 30-day complications in our cohort included increasing age, hyperlipidemia, hypertension, female sex, obesity, and diabetes. Independent risk factors for revision surgery within 2 years included female sex, tobacco use, hypertension, obesity, and the presence of any postoperative complication. The average 5-year cost of operative intervention was $17,307. The need for revision surgery had the largest effect on 5-year overall cost, increasing it by $6776.40. This was followed by the presence of a postoperative complication ($3780), female sex ($3207.70), and diabetes ($3105). Conclusion: Achilles tendon repair is a relatively low-risk operation. Factors associated with postoperative complications include increasing age, hyperlipidemia, hypertension, female sex, obesity, and diabetes. Factors associated with the need for revision surgery include female sex, hypertension, obesity, and the presence of any postoperative complication. Female sex, diabetes, the presence of any complication, and the need for revision surgery had the largest added costs associated with them. Clinical Relevance: Surgeons can use this information for preoperative decision-making and during the informed consent process.
Scenicite, a new uranyl-sulfate mineral from the White Canyon district, San Juan County, Utah, USA
Authors: Kampf Anthony R. , Plášil Jakub , Olds Travis A. , Ma Chi , Marty Joe 
Published: May 2022

AbstractThe new mineral scenicite (IMA2021-057), [(UO2)(H2O)2(SO4)]2⋅3H2O, was found in the Green Lizard, Giveaway–Simplot, Markey and Scenic mines, White Canyon district, San Juan County, Utah, USA, where it occurs as a secondary phase on granular quartz matrix in association with various combinations of deliensite, gypsum, natrozippeite, rietveldite and shumwayite. Scenicite crystals are transparent, light green yellow, poorly formed blades or prisms, up to 0.1 mm in length. The mineral has white streak and vitreous lustre. It exhibits bright greenish-white fluorescence (405 nm laser). It is brittle with irregular, curved fracture and a Mohs hardness of ~2. It has excellent {100} and good {001} cleavages. The calculated density is 3.497 g cm–3. Optically, the mineral is biaxial (–) with α = 1.556(2), β = 1.573(2), γ = 1.576(2) (white light); 2V = 45(3)°; extreme r < v dispersion; orientation: X = c, Y = a, Z = b; pleochroism: X and Y = colourless, Z = light green–yellow; and X = Y < Z. The Raman spectrum exhibits bands consistent with UO22+, SO42– and O–H. Electron microprobe analysis provided the empirical formula U1.996S2.005O19H13.997. The five strongest powder X-ray diffraction lines are [dobs Å(I)(hkl)]: 7.69(70)(201), 5.63(100)(111), 4.92(84)(202,310), 4.80(93)(401) and 3.398(55)(020,120,511,601). Scenicite is orthorhombic, Pca21, a = 21.2144(15), b = 6.8188(3) c = 11.2554(6) Å, V = 1628.18(16) Å3 and Z = 4. In the structure of scenicite (R1 = 0.0365 for 1259 I > 2σI), linkages of pentagonal bipyramids and tetrahedra form an infinite neutral [(UO2)(SO4)(H2O)2] chain. The structure of shumwayite contains topologically identical chains.
Comparison of emergency airway management techniques in the performance of emergent Cricothyrotomy
Authors: George Nicholas , Consunji Gabriel , Storkersen Jordan , Dong Fanglong , Archambeau Benjamin , Vara Richard , Serrano Jan , Hajjafar Reza , Tran Louis , Neeki Michael M. 
Published: May 2022

Abstract
Introduction
Emergent cricothyrotomy (EC) is a rare and lifesaving procedure to secure a difficult airway when other methods have failed. Many techniques have been discussed in the literature. This study aimed to identify major techniques used to perform EC in a regional trauma center and evaluate outcomes associated with the techniques.

Methods
Patients who underwent EC at Arrowhead Regional Medical Center between 1-1-2009 and 1-1-2019 were reviewed for eligibility for this study. Patients’ data were extracted from the trauma database. Chi-square tests were conducted to assess the difference on variables between the techniques.

Results
A total of 51 (0.17%) of these patients required EC and were included in the database. The two most prevalent techniques were the scalpel-bougie-tube (SBT) and the surgical cricothyrotomy technique (SCT). More than half (n = 27, 52.9%) of the cohort received the SBT. There was no statistically significant difference between the two techniques with regards to demographic variables, including age (p = 0.7528), injury severity score (ISS, p = 0.896), gender (p = 0.3709), and race (p = 0.8935). However, the SCT group had a statistically higher Glasgow Coma Scale (GCS) than the SBT group (p = 0.0036). There was no statistically significant difference in mortality or complications between these two groups (p = 0.2172 for mortality).

Discussion
Two techniques of EC were identified as preferred techniques. Both procedures were successful in securing an emergency airway, noting a difference in the time to completion of the two techniques. Given the rarity of the procedure, practitioners may choose the method based on their training and the availability of appropriate instruments.
Effects of continuous subcutaneous insulin infusion on the microstructures, mechanical properties and bone mineral compositions of lumbar spines in type 2 diabetic rats
Authors: Hu Xiaorong , Gong He , Hou Aiqi , Wu Xiaodan , Shi Peipei , Zhang Yingying 
Published: May 2022

Abstract
Background
Continuous subcutaneous insulin infusion (CSII) for the treatment of type 2 diabetes (T2D) can improve the structure and strength of femur of rats, but the effect of CSII treatment on the lumbar spine of T2D rats is unknown. The purpose of this study is to investigate the effects of CSII on the microstructure, multi-scale mechanical properties and bone mineral composition of the lumbar spine in T2D rats.

Methods
Seventy 6-week-old male Sprague–Dawley (SD) rats were divided into two batches, each including Control, T2D, CSII and Placebo groups, and the duration of insulin treatment was 4-week and 8-week, respectively. At the end of the experiment, the rats were sacrificed to take their lumbar spine. Microstructure, bone mineral composition and nanoscopic-mesoscopic-apparentand-macroscopic mechanical properties were evaluated through micro-computed tomography (micro-CT), Raman spectroscopy, nanoindentation test, nonlinear finite element analysis and compression test.

Results
It was found that 4 weeks later, T2D significantly decreased trabecular thickness (Tb.Th), nanoscopic-apparent and partial mesoscopic mechanical parameters of lumbar spine (P < 0.05), and significantly increased bone mineral composition parameters of cortical bone (P < 0.05). It was shown that CSII significantly improved nanoscopic-apparent mechanical parameters (P < 0.05). In addition, 8 weeks later, T2D significantly decreased bone mineral density (BMD), bone volume fraction (BV/TV) and macroscopic mechanical parameters (P < 0.05), and significantly increased bone mineral composition parameters of cancellous bone (P < 0.05). CSII treatment significantly improved partial mesoscopic-macroscopic mechanical parameters and some cortical bone mineral composition parameters (P < 0.05).

Conclusions
CSII treatment can significantly improve the nanoscopic-mesoscopic-apparent-macroscopic mechanical properties of the lumbar spine in T2D rats, as well as the bone structure and bone mineral composition of the lumbar vertebrae, but it will take longer treatment time to restore the normal level. In addition, T2D and CSII treatment affected bone mineral composition of cortical bone earlier than cancellous bone of lumbar spine in rat. Our study can provide evidence for clinical prevention and treatment of T2D-related bone diseases.
Caring ability of nursing students pre- and post-internship: a longitudinal study
Authors: Hu Shuang , Chen Jia , Jiang Renzhou , Hu Huiping , Hu Zhonghao , Gao Xiong , Chen Wenjun 
Published: May 2022

Abstract
Background
Nursing students’ internship experiences may significantly impact their caring ability. However, there is a lack of comprehensive evaluation of undergraduate nursing students' caring ability pre-and post-internship in China. This study aimed to explore the differences in the caring ability of undergraduate nursing students before and after internship.

Methods
The sample comprised 305 undergraduate nursing students who had undergone internships during 2018–2020 in three hospitals in Changsha, China. Caring Ability Inventory was used to measure and compare nursing students' caring ability before and after internship. Descriptive statistics and paired t-test were employed to analyze data in SPSS software (version 22.0).

Results
A total of 300 students completed the survey (response rate = 98.37%). The overall score of caring ability and scores of cognitive and patience dimensions were higher after internship than before internship (P < 0.05). There was no significant improvement in the courage dimension (P > 0.05).

Conclusions
Caring ability of undergraduate nursing students in China was at a low level, their overall caring ability significantly improved after the internship, indicating a positive relationship between internship and caring ability. Nursing educators and clinical nurses should emphasize the importance of caring ability development in internship planning and encourage nursing students to engage more with patients.