bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Pragmatic, Complacent, Critical–Cynical, or Empathetic?” Youth Civic Engagement as Social Appraisal
Authors: Perez-Manjarrez Everardo 
Published: May 2022

Background/Context: Many studies have systematized the wide range of youth civic engagement mechanisms identified to date; however, how young people deal with a complex flux of sociocultural and personal variables which condition their scope of engagement has received less attention. Purpose/Objective/Research Question/Focus of Study: This article analyzes youths’ appraisal of social issues and how this assessment influences the ways in which they engage with those issues. It also examines the elements of their inner worlds and their cultural settings that they consider deciding whether to get involved in one way or another. Research Design: A narrative discourse analysis is completed on two hundred Mexican and Spanish adolescents’ explanations of an advertisement that sparked discussion on issues of undocumented immigration, discrimination, and past territorial disputes between the U.S.A. and Mexico. Youth civic engagement is categorized through ‘ways of engagement,’ a category that comprises the assessment of social issues performed by adolescents based on four constructs: civic knowledge, morals, discourse, and positioning. The analysis shows that four ‘ways of engagement’ are common to all the participants: pragmatic, complacent, critical-cynical, and empathetic. Findings/Results: The findings show how the participants assess the advertisement’s possible intentions, positioning, and moral implications; at the same time, they explain the potential solutions they see possible while taking their own stands toward the advertisement. This type of personal appraisal makes them decide in what way they engage with this issue. Conclusions: Finally, reflections on the possible implications of the four ‘ways of engagement’ for citizenship education are presented.
“Friendship Brought Me Into it, but Commitment Bought Me Into it”: Civic Engagement Motivations Among Highly Engaged Asian American Youth
Authors: Cheung Amy 
Published: May 2022

Background/Context: There is currently a dearth of research on Asian American civic engagement broadly, and the scholarship on Asian American youth is even more limited. The lack of research contributes to opacity in understanding how Asian Americans fit into the civic landscape. Purpose/Objective/Research Question/Focus of Study: This study offers a window into the civic engagement experiences of a group of Asian American youth and differentiates the motivations that initiated their civic engagement from the motivations that sustained it. The research questions are: (a) How do these Asian American adolescents describe the motivations behind their civic engagement? (b) How do they make choices among different kinds of civic engagement? (c) What do they describe as the impact of their civic engagement? Research Design: Participants in this study were 14 highly engaged Asian American youth, 16 to 18 years of age, from a small city in the Northeast. I conducted semistructured interviews with the participants, examining their descriptions of civic involvement. Knowledge of youth civic engagement has tended to emanate from survey studies that count and categorize civic participation as opposed to investigating youth’s own meaning-making of their civic activities. Thus, to answer the “why” of civic participation, I took a grounded theory approach to explore youth’s own constructions of what motivated their civic involvement. Findings/Results: Participants initiated civic involvement with instrumental motivations to “look good for college” and socialize with friends, whereas continuing civic engagement was supported by a deep relational commitment to teenage colleagues in their civic endeavors, a sense of self-efficacy engendered through complex civic work, and pride in making a tangible impact on their community. Asian American youth in this study demonstrated sophisticated capabilities as civic actors and sustained their civic engagement through organizations that scaffolded the development of such capabilities. Conclusions/Recommendations: Participants’ experiences illustrate how civic engagement motivations can change. While individuals were the unit of analysis in this study, participants’ experiences point strongly to the integral role of organizations in supporting continued, rather than intermittent, civic engagement. Specifically, organizations can support youth in continuing their civic involvement in the long term by facilitating conditions for young people to build deep relationships in furtherance of common goals and appealing to identities that can be bolstered through civic participation.
Aerosol Generation During Nasal Airway Instrumentation
Authors: Sayahi Tofigh , Workman Alan D. , Kelly Kerry E. , Ardon‐Dryer Karin , Presto Albert A. , Bleier Benjamin S. 
Published: May 2022

AbstractObjectiveAirborne aerosol transmission, an established mechanism of SARS‐CoV‐2 spread, has been successfully mitigated in the health care setting through the adoption of universal masking. Upper airway endoscopy, however, requires direct access to the face, thereby potentially exposing the clinic environment to infectious particles. This study quantifies aerosol production during rigid nasal endoscopy (RNE) and RNE with debridement (RNED) as compared with intubation, a posited gold standard aerosol‐generating procedure.Study DesignProspective cross‐sectional study.SettingSubspecialty single‐center clinic and surgical study.MethodThree aerosol detectors (NANOSCAN‐3910, OPS‐3330, and APS‐3321) with a particle size sensitivity of 10 to 20,000 nm were utilized to detect particulate production during the clinical care of 209 patients undergoing RNE/RNED and 25 patients undergoing intubation.ResultsRNE and RNED produced statistically significant particles over baseline in 29.3% and 51.0% of subjects (P = .003‐.049 and .002‐.047, respectively). Intubation produced statistically significant particles in 31.2% (P = .001‐.015). The mean ± SD particle diameter in all tests was 69.9 ± 10.5 nm with 99.7% <300 nm. There were no statistical differences in particle production among RNE, RNED, and intubation. The presence of concomitant cough, sneeze, or prolonged speech similarly did not significantly affect particle production during any procedure.ConclusionsInstrumentation of nasal airway produces airborne aerosols to a similar degree of those seen during intubation, independent of reactive patient behaviors such as cough or sneeze. These data suggest that an improved understanding is necessary of both the definition of an aerosol‐generating procedure and the functional consequences of procedural aerosol generation in clinical settings.
Differences in social brain function in autism spectrum disorder are linked to the serotonin transporter: A randomised placebo-controlled single-dose crossover trial
Authors: Wong Nichol ML , Dipasquale Ottavia , Turkheimer Federico , Findon James L , Wichers Robert H , Dimitrov Mihail , Murphy Clodagh M , Stoencheva Vladimira , Robertson Dene M , Murphy Declan G , Daly Eileen , McAlonan Grainne M 
Published: May 2022

Background: Alterations in the serotonergic control of brain pathways responsible for facial emotion processing in people with autism spectrum disorder (ASD) may be a target for intervention. However, the molecular underpinnings of autistic-neurotypical serotonergic differences are challenging to access in vivo. Receptor-Enriched Analysis of functional Connectivity by Targets (REACT) has helped define molecular-enriched functional magnetic resonance imaging (fMRI) brain networks based on a priori information about the spatial distribution of neurochemical systems from available PET templates. Methods: We used REACT to estimate the dominant fMRI signal related to the serotonin (5-HT) transporter (SERT) distribution during processing of aversive facial emotion in adults with and without ASD. We first predicted a group difference in baseline (placebo) functioning of this system. We next used a single 20 mg oral dose of citalopram, a serotonin reuptake inhibitor, to test the hypothesis that network activity in people with and without ASD would respond differently to inhibition of SERT. To confirm the specificity of our findings, we also repeated the analysis with 5-HT1A, 5-HT1B, 5-HT2A and 5-HT4 receptor maps. Results: Using REACT with the SERT map, we found a baseline group difference in the SERT-enriched response to faces in the ventromedial prefrontal cortex. A single oral dose of citalopram ‘shifted’ the response in the ASD group towards the neurotypical baseline but did not alter response in the control group. Similar differences in SERT-enriched response were observed after controlling for other 5-HT maps. Conclusions: Our findings suggest that the SERT-enriched functional network is dynamically different in ASD during processing of socially relevant stimuli. Whether this acute neurobiological response to citalopram in ASD translates to a clinical target will be an important next step.
Family Caregivers’ Challenges in Cancer Pain Management for Patients Receiving Palliative Care
Authors: Chi Nai-Ching , Nakad Lynn , Han Soojeong , Washington Karla , Hagiwara Yuya , Riffin Catherine , Oliver Debra Parker , Demiris George 
Published: May 2022

Context Family caregivers (FCs) of cancer patients play a crucial role in managing their care partner’s pain, but little research has examined FCs’ specific challenges regarding the provision of pain management (PM) to cancer patients receiving palliative care. Objectives To determine the demographic and clinical characteristics of FCs who encounter challenges in PM and to elucidate the specific challenges that FCs face when managing pain for their care partner with cancer. Methods We conducted a secondary analysis of 40 interview transcripts of FCs who were caring for persons with cancer. Interviews were audio-recorded, transcribed verbatim, and analyzed using deductive thematic analysis. Results The three major identified challenges to PM for FCs of persons with cancer were: (1) communication and teamwork issues, (2) caregiver-related issues, and (3) patient-related issues. Communication and teamwork issues encompassed caregivers’ receipt of inadequate information regarding PM, and inappropriate and ineffective communication from the healthcare team. Caregiver issues pertained to caregivers’ fear and beliefs, concurrent responsibilities, and lack of pain-related knowledge and skills. Patient issues related to their own fear and beliefs, psychological and physiological well-being, adherence to medications, and reluctance to report pain. Conclusion Findings of this study have implications for future research and practice related to cancer PM in palliative care. Results suggest the need for FC training in PM as well as clear clinical practice guidelines and resources to help providers prepare, educate, and communicate with FCs regarding PM.
Is Parents’ ADHD Symptomatology Associated With the Clinical Feasibility or Effectiveness of a Psychoeducational Program Targeting Their Children’s ADHD?
Authors: Lindström Therese , Kierkegaard Suttner Axel , Forster Martin , Bölte Sven , Hirvikoski Tatja 
Published: May 2022

Objective: To examine if the clinical feasibility and effectiveness of a psychoeducational program targeting children’s ADHD differ between parents with varying ADHD symptom severities. Method: An open trial analyzed data from 549 parents of children with ADHD aged 3 to 17 years, who participated in psychoeducation at an outpatient habilitation/disability clinic. In all analyses, parents were stratified into three symptom severity groups (low/middle/high) based on scores on an ADHD screening scale. Results: Parental ADHD symptom severity was not associated with results on any outcome, although the odds of having incomplete data were higher in parents reporting higher symptom severity. Across the entire sample, we observed high program completion rates, positive acceptability ratings and large increases in parental knowledge. Conclusions: Psychoeducation may be beneficial regardless of the participating parent’s ADHD symptomatology. Further research is needed to examine whether these results are generalizable to parents diagnosed with ADHD, an underrepresented group in our study.
The awareness and usage of orthodontic apps and social media by orthodontists in the UK: A questionnaire-based study
Authors: Prithiviraj Dharshini , Siddiqui Nausheen R , Smyth Robert SD , Hodges Samantha J , Sharif Mohammad Owaise 
Published: May 2022

Objective: To assess the awareness and usage of mobile apps and social media among orthodontic clinicians to support patients with orthodontic treatment, support the professional development of orthodontists, and identify any relevant apps and social media platforms currently recommended to patients. Design: Cross-sectional questionnaire-based study. Setting: United Kingdom. Methods: A questionnaire was developed and distributed to members of the British Orthodontic Society (BOS). To increase the response rate, the questionnaire was circulated at three time points between January and March 2020. Results: A total of 149 orthodontists responded to the questionnaire (15% response rate) with 113 orthodontists completing all questions (11.4%). Of those who answered, 81% (n = 111) had been qualified for >10 years, 35% worked in practice (n = 48), 34% worked in a hospital (n = 47) and 26% worked in both hospital and practice (n = 36). The results indicated that 20% of clinicians (n = 22) used apps to support patients and 33% (n = 37) reported using apps for professional purposes. Brush DJ appeared to be the most popular patient focused app (39%, n = 18) whereas the IOTN (17%, n = 8), Invisalign (17%, n = 8) and Dental Monitoring apps (9%, n = 4) were the most popular clinician-focused apps. With regard to social media, 53% (n = 60) of respondents reported that they used social media to communicate generic orthodontic information and promote their practice to patients. The most commonly used social media platforms were Facebook and Instagram. Of respondents, 96% expressed a willingness to recommend an evidence-based mobile app to patients if available, and 88% were willing to recommend an evidence-based social media platform. Conclusions: Orthodontic clinicians are utilising mobile apps and social media to support both patients and their own professional development. There is a willingness to increase the use of evidence-based platforms and apps to support patients.
Integration of Reinforcement Learning in a Virtual Robotic Surgical Simulation
Authors: Bourdillon Alexandra T. , Garg Animesh , Wang Hanjay , Woo Y. Joseph , Pavone Marco , Boyd Jack 
Published: May 2022

Background. The revolutions in AI hold tremendous capacity to augment human achievements in surgery, but robust integration of deep learning algorithms with high-fidelity surgical simulation remains a challenge. We present a novel application of reinforcement learning (RL) for automating surgical maneuvers in a graphical simulation. Methods. In the Unity3D game engine, the Machine Learning-Agents package was integrated with the NVIDIA FleX particle simulator for developing autonomously behaving RL-trained scissors. Proximal Policy Optimization (PPO) was used to reward movements and desired behavior such as movement along desired trajectory and optimized cutting maneuvers along the deformable tissue-like object. Constant and proportional reward functions were tested, and TensorFlow analytics was used to informed hyperparameter tuning and evaluate performance. Results. RL-trained scissors reliably manipulated the rendered tissue that was simulated with soft-tissue properties. A desirable trajectory of the autonomously behaving scissors was achieved along 1 axis. Proportional rewards performed better compared to constant rewards. Cumulative reward and PPO metrics did not consistently improve across RL-trained scissors in the setting for movement across 2 axes (horizontal and depth). Conclusion. Game engines hold promising potential for the design and implementation of RL-based solutions to simulated surgical subtasks. Task completion was sufficiently achieved in one-dimensional movement in simulations with and without tissue-rendering. Further work is needed to optimize network architecture and parameter tuning for increasing complexity.
The prognostic impact of bone metastasis in patients with metastatic urothelial carcinoma treated with first-line platinum-based chemotherapy
Authors: Alqaisi Husam A. , Stecca Carlos , Veitch Zachary W. , Riromar Jamila , Kaiser Jeenan , Fallah-Rad Nazanin , Jiang Di Maria , North Scott , Samnani Sunil , Alimohamed Nimira , Sridhar Srikala S. 
Published: May 2022

Background: In metastatic urothelial cancer (mUC), bone metastasis (BM) are associated with significant morbidity and mortality, yet their role as an independent prognostic variable remains unclear. We aimed to determine the impact of BM on overall survival (OS) in patients with mUC treated with first-line platinum-based chemotherapy (PBC). Methods: mUC patients receiving PBC at the Princess Margaret Cancer Center, Tom Baker Cancer Center, or Cross Cancer Institute from January 2005 to January 2018 were identified retrospectively using central pharmacy database records. Patient disease, treatment, and response characteristics were collected. Progression-free survival (PFS) and OS were estimated using the Kaplan–Meier method. Variables reaching significance ( p < 0.05) in univariable analysis (UVA) of survival (OS) were included in multivariable analysis (MVA) (Cox). Results: Overall, 376 patients with a median follow-up of 16.8 (range: 2.2–218.3) months were included. Median age was 67 (range: 28–91) years, 76% were male, 63% had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–1, and 41% had BM. All patients received first-line PBC. Patients with BM had inferior median PFS (4.9 months (95% CI 3.6–6.2) versus 6.5 months (95% CI 5.4–7.6), p = 0.03) and median OS (8.8 months (95% CI 7.8–9.7) versus 10.8 months (95% CI 9.1–12.5), p = 0.002). In UVA, ECOG PS 2–3 ( p < 0.001), presence of BM ( p = 0.002), and WBC count ⩾ 11,000 cells/mm3 ( p = 0.001) were associated with inferior survival. Prior cystectomy ( p < 0.001) and lack of progression (stable disease, partial or complete response) on treatment was associated with improved OS ( p < 0.001). These variables maintained significance in MVA. Conclusion: In this retrospective study, mUC patients with BM had worse OS suggesting that BM may be an independent negative prognostic factor and including BM as a stratification factor in future mUC clinical trial designs may be warranted. A greater focus must be placed on novel therapeutic strategies to better manage BM to reduce both morbidity and mortality.
Stigma and healthcare access among men who have sex with men and transgender women who have sex with men in Senegal
Authors: Dibble Kate E , Baral Stefan D , Beymer Matthew R , Stahlman Shauna , Lyons Carrie E , Olawore Oluwasolape , Ndour Cheikh , Turpin Nunez Gnilane , Toure-Kane Coumba , Leye Diouf Nafissatou , Diouf Daouda , Drame Fatou Maria , Mboup Souleymane , Murray Sarah M 
Published: May 2022

Objectives: Cisgender gay, bisexual, and other men who have sex with men and transgender women experience HIV incidence disparities in Senegal. These analyses determined how depression and different stigma mechanisms related to sexual behavior are associated with healthcare access, sexually transmitted infection testing, and HIV testing among cisgender gay, bisexual, and other men who have sex with men and transgender women across three cities in western Senegal. Methods: Logistic regression assessed the relationship of three stigma scales (stigma from family and friends, anticipated healthcare stigma, and general social stigma) and depression with these outcomes. Results: Depression and stigma were not associated with healthcare access, sexually transmitted infection testing, or HIV testing. However, individuals who had disclosed their sexual identity to a medical provider were more likely to test for HIV. Conclusions: Sexual behavior stigma experienced by cisgender gay, bisexual, and other men who have sex with men and trans women in Senegal may not limit access to routine healthcare, but may limit disclosure of sexual orientation and practices, limiting access to appropriate HIV prevention services.
Decompressive craniectomy combined with temporal pole resection in the treatment of massive cerebral infarction
Authors: Lu Wenchao , Jia Dong , Qin Yanchang 
Published: May 2022

Abstract
Objective
To evaluate the efficacy and prognosis of decompressive craniectomy combined with temporal pole resection in the treatment of massive cerebral infarction, in order to provide basis for treatment selection.

Methods
The clinical data of the patient with massive cerebral infarction treated in our hospital from January 2015 to December 2018 were analyzed retrospectively. According to the surgical methods, the patients were divided into control group (decompressive craniectomy) and study group (decompressive craniectomy + temporal pole resection). Intracranial pressure monitoring devices were placed in both groups. The NIHSS scores of the two groups before and 14 days after operation, the changes of intracranial pressure, length of hospital stay, length of NICU, mortality and modified Rankin scale before and after treatment were compared between the two groups.

Results
The NIHSS score of the two groups after operation was lower than that before operation, and the NIHSS score of the study group was significantly lower than that of the control group (P < 0.05); The intracranial pressure in the study group was significantly lower than that in the control group (P < 0.05); One month after operation, the mortality of the study group (13.0%) was lower than that of the control group (27.8%). After one year of follow-up, the mortality of the study group (21.7%) was significantly lower than that of the control group (38.8%) (P < 0.05); The scores of mRS in the two groups were significantly improved compared with those before treatment (P < 0.05), and the scores of mRS in the study group were better than those in the control group (P < 0.05).

Conclusion
Decompressive craniectomy combined with temporal pole resection has a better effect in the treatment of patients with massive cerebral infarction. It has good decompression effect, the postoperative intracranial pressure is well controlled, and significantly reduced the mortality. So it has better clinical application value.