bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fit to be King! Iconographies of Kingship and Political Identities in Early Sixteenth-Century Sindh
Authors: Akhtar Munazzah 
Published: May 2022

Abstract
In 1508 the legendary Sulṭān of Sindh, Niẓām al-Dīn Jām Nindō, of the Samma dynasty (1351–1522) died. The Sulṭān’s death occasioned a major political shift in Sindh at the turn of the sixteenth century, which ultimately led to the fall of the Sammas in 1522. This period is marked with repeated instances of military and civil unrests and dethroning attempts. The primary theme of this article is to demonstrate that these particular cycles of political instability defined the parameters of contemporary architectural undertakings. For this purpose, two of the most ambitious funerary constructions in the Samma royal necropolis of Maklī at Thatta (southern Sindh)—the tomb enclosure of Samma military commander Mubārak Khān and the monumental mausoleum of Sulṭān Niẓām al-Dīn—are reassessed. The article also locates political undertones in the architecture of these mausolea, and deciphers the implicit subtext interlaced into their epigraphic as well as visual motifs.
Large-Eddy and Flight Simulations of a Clear-Air Turbulence Event over Tokyo on 16 December 2014
Authors: Yoshimura R. , Suzuki K. , Ito J. , Kikuchi R. , Yakeno A. , Obayashi S. 
Published: May 2022

Abstract
In this study, a clear-air turbulence event was reproduced using a high-resolution (250 m) large-eddy simulation in the Weather Research and Forecasting (WRF) Model, and the resulting wind field was used in a flight simulation to estimate the vertical acceleration changes experienced by an aircraft. Conditions were simulated for 16 December 2014 when many intense turbulence encounters (and one accident) associated with an extratropical cyclone were reported over the Tokyo area. Based on observations and the WRF simulation, the turbulence was attributed to shear-layer instability near the jet stream axis. Simulation results confirmed the existence of the instability, which led to horizontal vortices with an amplitude of vertical velocity from +20 to −12 m s−1. The maximum eddy dissipation rate was estimated to be over 0.7, which suggested that the model reproduced turbulence conditions likely to cause strong shaking in large-size aircraft. A flight simulator based on aircraft equations of motion estimated vertical acceleration changes of +1.57 to +0.08 G on a Boeing 777-class aircraft. Although the simulated amplitudes of the vertical acceleration changes were smaller than those reported in the accident (+1.8 to −0.88 G), the model successfully reproduced aircraft motion using a combination of atmospheric and flight simulations.
Strength-Based Parenting and Academic Motivation in Adolescents Returning to School After COVID-19 School Closure: Exploring the Effect of School Belonging and Strength Use
Authors: Arslan Gökmen , Allen Kelly-Ann , Waters Lea 
Published: May 2022

The present study aimed to examine whether the level of strength-based parenting a student receives during remote learning affects their levels of academic motivation once returning to school. Additionally, the study sought to explore whether school belonging mediated the association between strength-based parenting and academic motivation and whether student strength use moderated this mediating relationship. The sample comprised of secondary school students who had recently returned back to campus, following a period of COVID-19 enforced remote learning ( n = 404; age range: 11 to 18 years; M = 14.75, SD = 1.59; 50.2% female, and 3% non-/other gendered or declined to answer). Strength-based parenting had a significant predictive effect on student academic motivation with school belonging mediating the association between strength-based parenting and academic motivation. The mediating effect of school belonging on the association between strength-based parenting and academic motivation was moderated by strength use during remote learning. The results of the study are discussed using a positive education lens with implications for improving skills and strategies to foster positive student functioning in times of remote learning and crisis.
From Detractive to Democratic: The Duty of Teacher Education to Disrupt Structural Ableism and Reimagine Disability
Authors: Keefe Elizabeth Stringer 
Published: May 2022

Background: There is scant research on whether or how special education teacher preparation plays a role in shaping, maintaining, or perpetuating ableism and oppression for disabled students, which the author proposes is “structural ableism.” This conceptual article argues that special education teacher preparation programs’ systems and structures should be examined for ways they inadvertently contribute to ableist perceptions of disability to ensure that such structures do not influence the lenses and practice of the teachers they produce. Purpose: This article proposes that special education teacher preparation programs’ systems and structures should be examined for ways they inadvertently contribute to oppressive educational conditions and negative or ableist perceptions of disability to ensure that such structures do not influence the lenses and practice of the teachers they produce. In this article, the author theorizes “structural ableism,” which she defines as “a complex system of hierarchical and discriminatory processes, policies, and institutions that privilege and prefer able-bodied people, fail to represent or meaningfully include disabled persons’ voices, and are grounded in a network of ableist beliefs and practices that maintain and reproduce unequal outcomes for disabled people and benefit able-bodied people.” Conclusion: The author concludes that teacher preparation has a duty to embrace inclusivity through the lens of democratic education to help “shift disability toward a more inclusive ideology, and identify and dismantle oppressive structures that perpetuate ableism in teacher candidates.”
Clinical nutrition approach in medical management of COVID-19 hospitalized patients: A narrative review
Authors: Roudi Fatemeh , Saghi Effat , Ayoubi Samaneh Sadat , Pouryazdanpanah Mahdieh 
Published: May 2022

Background: Malnutrition in COVID-19 hospitalized patients is associated with a high-risk condition to increase disease severity and prolonging the recovery period. Therefore, nutritional therapy, including supplements plays a critical role to reduce disease-related complications and the length of hospital stay. Aim: To review the latest evidence on nutritional management options in COVID-19 hospitalized patients, as well as possibly prescribed supplements. Methods: This review was conducted by considering the latest recommendations, using the guidelines of the American Society of Enteral and Parenteral (ASPEN) and the European Society of Enteral and Parenteral (ESPEN), and searching Web of Science, PubMed/Medline, ISI, and Medline databases. The relevant articles were found using a mix of related mesh terms and keywords. We attempted to cover all elements of COVID-19 hospitalized patients’ dietary management. Results: Energy demand in COVID-19 patients is a vital issue. Indirect Calorimetry (IC) is the recommended method to measure resting energy expenditure. However, in the absence of IC, predictive equations may be used. The ratio of administered diet for the macronutrients could be based on the phase and severity of Covid-19 disease. Moreover, there are recommendations for taking micronutrient supplements with known effects on improving the immune system or reducing inflammation. Conclusions: Nutritional treatment of COVID-19 patients in hospitals seems to be an important element of their medical care. Enteral nutrition would be the recommended feeding method for early nutrition support. However, data in the COVID-19 nutritional domain relating to micronutrient supplementation are still fragmentary and disputed, and further study is required.
Methods for Communicating the Impact of Parameter Uncertainty in a Multiple-Strategies Cost-Effectiveness Comparison
Authors: Wolff Henri B. , Qendri Venetia , Kunst Natalia , Alarid-Escudero Fernando , Coupé Veerle M.H. 
Published: May 2022

Purpose Analyzing and communicating uncertainty is essential in medical decision making. To judge whether risks are acceptable, policy makers require information on the expected outcomes but also on the uncertainty and potential losses related to the chosen strategy. We aimed to compare methods used to represent the impact of uncertainty in decision problems involving many strategies, enhance existing methods, and provide an open-source and easy-to-use tool. Methods We conducted a systematic literature search to identify methods used to represent the impact of uncertainty in cost-effectiveness analyses comparing multiple strategies. We applied the identified methods to probabilistic sensitivity analysis outputs of 3 published decision-analytic models comparing multiple strategies. Subsequently, we compared the following characteristics: type of information conveyed, use of a fixed or flexible willingness-to-pay threshold, output interpretability, and the graphical discriminatory ability. We further proposed adjustments and integration of methods to overcome identified limitations of existing methods. Results The literature search resulted in the selection of 9 methods. The 3 methods with the most favorable characteristics to compare many strategies were 1) the cost-effectiveness acceptability curve (CEAC) and cost-effectiveness acceptability frontier (CEAF), 2) the expected loss curve (ELC), and 3) the incremental benefit curve (IBC). The information required to assess confidence in a decision often includes the average loss and the probability of cost-effectiveness associated with each strategy. Therefore, we proposed the integration of information presented in an ELC and CEAC into a single heat map. Conclusions This article presents an overview of methods presenting uncertainty in multiple-strategy cost-effectiveness analyses, with their strengths and shortcomings. We proposed a heat map as an alternative method that integrates all relevant information required for health policy and medical decision making. Highlights To assess confidence in a chosen course of action, decision makers require information on both the probability and the consequences of making a wrong decision. This article contains an overview of methods for presenting uncertainty in multiple-strategy cost-effectiveness analyses. We propose a heat map that combines the probability of cost-effectiveness from the cost-effectiveness acceptability curve (CEAC) with the consequences of a wrong decision from the expected loss curve. Collapsing of the CEAC can be reduced by relaxing the CEAC, as proposed in this article. Code in Microsoft Excel and R is provided to easily analyze data using the methods discussed in this article.
The Competent Computational Thinking Test: Development and Validation of an Unplugged Computational Thinking Test for Upper Primary School
Authors: El-Hamamsy Laila , Zapata-Cáceres María , Barroso Estefanía Martín , Mondada Francesco , Zufferey Jessica Dehler , Bruno Barbara 
Published: May 2022

With the increasing importance of Computational Thinking (CT) at all levels of education, it is essential to have valid and reliable assessments. Currently, there is a lack of such assessments in upper primary school. That is why we present the development and validation of the competent CT test (cCTt), an unplugged CT test targeting 7–9 year-old students. In the first phase, 37 experts evaluated the validity of the cCTt through a survey and focus group. In the second phase, the test was administered to 1519 students. We employed Classical Test Theory, Item Response Theory, and Confirmatory Factor Analysis to assess the instruments’ psychometric properties. The expert evaluation indicates that the cCTt shows good face, construct, and content validity. Furthermore, the psychometric analysis of the student data demonstrates adequate reliability, difficulty, and discriminability for the target age groups. Finally, shortened variants of the test are established through Confirmatory Factor Analysis. To conclude, the proposed cCTt is a valid and reliable instrument, for use by researchers and educators alike, which expands the portfolio of validated CT assessments across compulsory education. Future assessments looking at capturing CT in a more exhaustive manner might consider combining the cCTt with other forms of assessments.
Abrocitinib: A New FDA-Approved Drug for Moderate-to-Severe Atopic Dermatitis
Authors: Perche Patrick O. , Cook Madison K. , Feldman Steven R. 
Published: May 2022

Objective The objective of this article is to review abrocitinib, an oral Janus kinase (JAK) 1 inhibitor, for the treatment of patients with moderate-to-severe atopic dermatitis (AD). Data Sources A literature search of MEDLINE (PubMed) was performed for articles from inception through end-March 2022 using the following search terms: atopic dermatitis, abrocitinib, PF-04965842, methotrexate, cyclosporine, dupilumab, ruxolitinib, and JAK-STAT pathway. Study Selection and Data Extraction English articles relating to pharmacology, pharmacokinetics, efficacy, and safety of abrocitinib, and other conventional systemic medications for AD, were included. Data Synthesis Across phase IIb and phase III clinical trials, abrocitinib was efficacious with an average of 47.5% patients on 200 mg abrocitinib and 32.0% on 100 mg abrocitinib achieving an Investigator’s Global Assessment (IGA) of 0 or 1 at 12 weeks. In comparison with dupilumab 300 mg subcutaneously every other week, patients on abrocitinib 200 mg once daily had improved disease severity and itch response. The majority of adverse events were not severe and self-limited. Relevance to Patient Care and Clinical Practice Prior to Food and Drug Administration (FDA) approval of abrocitinib, prednisone was the only FDA-approved oral medication for AD. Although biologics such as dupilumab have revolutionized care, some patients prefer oral medications. Compared with clinical trials of conventional AD treatments, abrocitinib appears more effective. Conclusions Abrocitinib is an efficacious oral JAK 1 inhibitor recently FDA-approved for patients ≥ 18 years old with moderate-to-severe AD who have not responded to systemic medications or when contraindicated otherwise.
Patient Activation of Persons With Opioid Use Disorder in Intensive Outpatient Treatment
Authors: Keen Alyson , Lu Yvonne , Oruche Ukamaka M. , Mazurenko Olena , Burke Draucker Claire 
Published: May 2022

Background High patient activation is associated with a variety of positive health outcomes. Although increasing patient activation in persons with opioid use disorder (OUD) in intensive outpatient treatment (IOT) programs may increase engagement and improve outcomes, little is known about how patient activation is manifested in these programs. Aims To describe types of instances in which persons play an active role in their IOT or show self-determination in their recovery generally (patient activation) and types of instances in which they play a passive role in their IOT or have recovery directed by others (patient nonactivation). Methods A qualitative descriptive study using data from a larger grounded theory study was conducted. Interviews were completed with 14 persons with OUD who attended an IOT program within a large health care system in the Midwest. Content analysis was used to create a typology of instances of patient activation or nonactivation in participants’ IOT experiences. Results Six types of instances were identified: (1) making and enacting one’s own treatment decisions, (2) actively collaborating with staff, (3) self-determining one’s disclosure in groups, (4) making a commitment to treatment, (5) taking responsibility for one’s recovery, and (6) taking actions to avoid return to use. Conclusions Patient activation is multidimensional and plays a salient role in IOT experiences. IOT staff should engage patients as active participants in their treatment and encourage mutual goal-setting and shared-decision but should be aware that some approaches used too early in treatment may impede recovery.
The TWIST Tool Predicts When Patients Will Recover Independent Walking After Stroke: An Observational Study
Authors: Smith Marie-Claire , Barber Alan P. , Scrivener Benjamin J. , Stinear Cathy M. 
Published: May 2022

Background The likelihood of regaining independent walking after stroke influences rehabilitation and hospital discharge planning. Objective This study aimed to develop and internally validate a tool to predict whether and when a patient will walk independently in the first 6 months post-stroke. Methods Adults with stroke were recruited if they had new lower limb weakness and were unable to walk independently. Clinical assessments were completed one week post-stroke. The primary outcome was time post-stroke by which independent walking (Functional Ambulation Category score ≥ 4) was achieved. Cox hazard regression identified predictors for achieving independent walking by 4, 6, 9, 16, or 26 weeks post-stroke. The cut-off and weighting for each predictor was determined using β-coefficients. Predictors were assigned a score and summed for a final TWIST score. The probability of achieving independent walking at each time point for each TWIST score was calculated. Results We included 93 participants (36 women, median age 71 years). Age < 80 years, knee extension strength Medical Research Council grade ≥ 3/5, and Berg Balance Test < 6, 6 to 15, or ≥ 16/56, predicted independent walking and were combined to form the TWIST prediction tool. The TWIST prediction tool was at least 83% accurate for all time points. Conclusions The TWIST tool combines routine bedside tests at one week post-stroke to accurately predict the probability of an individual patient achieving independent walking by 4, 6, 9, 16, or 26 weeks post-stroke. If externally validated, the TWIST prediction tool may benefit patients and clinicians by informing rehabilitation decisions and discharge planning.
Rationale and current evidence of aquatic exercise therapy in venous disease: A narrative review
Authors: Bissacco Daniele , Mosti Giovanni , D’Oria Mario , Lomazzi Chiara , Casana Renato , Morrison Nick , Caggiati Alberto 
Published: May 2022

Chronic venous disorders (CVD) of the lower limbs can be treated with different strategies. Typically, conservative management is based on compression therapy, anticoagulants and venoactive drugs. Endovenous treatments remain the gold standard to treat saphenous insufficiency, with sclerotherapy and surgery maintaining a role in selected cases. In addition, several ‘unconventional’ approaches have been proposed to prevent CVD progression and complications, minimize symptoms and improve the quality of life and postoperative outcomes. Among these, balneotherapy and aquatic exercises are proving as valid and effective supporting treatments, as mentioned in a growing number of scientific publications. Moreover, aquatic protocols have been studied for both venous and lymphatic insufficiency. For these reasons, they were mentioned in the last CVD guidelines provided by the European Society for Vascular Surgery.  The aim of this narrative review is to overview and summarize current literature evidences on the role and effectiveness of aquatic rehabilitative protocols in CVD, reviewing old and current literature. Furthermore, the physical basis of the effects of water immersion on lower limb venous and tissues modifications are also described.
Endoscopic Sinus Surgery in Older Patients With Significant Medical Comorbidities
Authors: Huang Ryan J. , Teitelbaum Jordan I. , Issa Khalil , Truong Tracy , Kim Heewon , Kuchibhatla Maragatha , Hachem Ralph Abi , Goldstein Bradley J. , Jang David W. 
Published: May 2022

Background Endoscopic sinus surgery (ESS) offers excellent outcomes for patients with chronic rhinosinusitis (CRS) in the general population. It is unclear whether older patients with significant medical comorbidities experience similar benefits. Objective The purpose of this study is to evaluate whether increasing medical comorbidity is associated with worse sinonasal quality of life outcomes after ESS in older patients. Methods This is a retrospective study of CRS patients 55 years or older who underwent elective ESS at an academic institution from July 2017 to June 2019. 22-Item Sino-Nasal Outcomes Test (SNOT-22) scores were gathered at baseline as well as at 3 and 6 months following surgery. Data on demographics, medical comorbidities, preoperative Lund-Mackay (LM) scores, and postoperative complications were extracted from the medical record. The Charlson Comorbidity Index (CCI) was calculated for each patient. Multivariate linear regression was used to evaluate a potential association between CCI and change in SNOT-22 scores at 3 months postoperatively. Results A total of 205 patients met inclusion criteria with a mean (SD) CCI score of 2 (2.4) and a CCI score range of 0 to 11. The mean (SD) LM score was 8 (5.3). Rates of asthma and nasal polyposis were 28.3% and 36.6%, respectively. The mean (SD) improvement in SNOT-22 scores at 3 and 6 months compared to baseline was 17.9 (19.7) and 20.9 (18.1) points, respectively. After adjusting for covariates, there was no significant association between CCI and change in SNOT-22 scores. Conclusion Greater medical comorbidity is not associated with worse SNOT-22 outcomes postoperatively, although future studies are needed to determine if comorbidities are associated with higher complication rates. A multidisciplinary approach to perioperative care is critical in maintaining the safety and efficacy of ESS in this patient population.