bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving eye screening practice among pediatric rheumatology patients receiving hydroxychloroquine
Authors: AlAhmed Ohoud , Way Amanda , Akoghlanian Shoghik , Barbar-Smiley Fatima , Lemle Stephanie , MacDonald Darby , Frost Emily , Wise Kelly , Lee Lindsey , Ardoin Stacy P , Sivaraman Vidya
Published: December 2020

Objective

Hydroxychloroquine (HCQ) is commonly used in the treatment of various autoimmune diseases related to its many benefits and favorable safety profile. Although HCQ retinopathy was considered to be uncommon, a prevalence of 7.5% was described in a recent study making early detection critical. The most updated screening guidelines by the American Academy of Ophthalmology were published in 2016; however, it lacked pediatric-specific recommendations and the overall compliance with screening guidelines was poor in previous studies. We developed a quality improvement (QI) initiative aiming to create institutional screening recommendations. Additionally, to increase eye screening in pediatric rheumatology clinic for patients receiving HCQ from 65% to 85% in 12 months and to sustain that rate for at least 6 months.

Methods

We formed a multidisciplinary team of pediatric rheumatologists and ophthalmologists, clinical pharmacist, clinic nurses, QI specialist, quality data technician and administrative staff. We included patients receiving HCQ and who were evaluated at Nationwide Children’s Hospital rheumatology clinic. A key driver diagram was formulated to identify barriers to compliance and determine possible interventions. Main interventions included summarizing screening guidelines in a step by step algorithm, increasing awareness of these guidelines among patients and providers, improving collaboration and communication with ophthalmologists, and initiating pre-visit planning.

Results

Baseline performance data included 164 patients. Fifty-four (33%) of those patients were at high risk for HCQ retinopathy. Of them, 50% were on HCQ dose of >5 mg/kg/day and 31.5% had been taking HCQ for ≥5 years. Two center line shifts were noticed over the course of the project. The target of 85% compliance was reached in February 2019 and was sustained until December 2019.

Conclusions

Our study highlights the importance of interdisciplinary communication to increase awareness of screening guidelines among medical providers and patients. Pre-visit planning played a major role in identifying patients and opportunities for optimizing eye screening in patients at risk for HCQ retinopathy. Collaboration between rheumatologists and ophthalmologists is crucial in managing patients on HCQ. The implementation of same-day eye screening allowed this collaboration to be more efficient. Future efforts are being directed at monitoring and improving utilization of the effective interventions.
And this is what we sing – what do we sing? Exploring the football fan songs of the Northern Irish ‘Green and White Army’
Authors: Bell John , Bell Paul
Published: December 2020

This paper draws upon digital recordings of Northern Ireland football fans singing in the stadium during all 10 qualifying matches for the 2016 UEFA European Football Championship. Supplemented by participant observation and interview data with 21 supporters themselves, the paper challenges assertions within the literature which focus upon the predominance of sectarian singing amongst a section of Northern Ireland football supporters. Although vocal manifestations of football fandom may initially appear to be randomly driven by irrational emotions, on the contrary, there is an underlying structure and sequence to fandom in the stadium in which certain factors promote collective singing at particular times. The paper identifies four key themes in particular: the timing in a match; whether or not a goal has been scored; if there is a lull or a break in play; and the use of musical instruments to encourage the wider collective to sing. We argue that it is important to understand the process by which collective singing occurs in the football stadium rather than fixating upon the alleged racist or sectarian psychopathology of the individuals involved. Such knowledge may assist in supporting those fan organisations that seek to challenge discriminatory behaviour in the stadium, particularly in the current context of the European (UEFA) and World football governing bodies (FIFA) punishing fans collectively, regardless of whether or not the majority in the stadium are opposed to what is being sung in their name.
Recurrent and reversible bilateral palmar blue discoloration following administration of liposomal daunorubicin-cytarabine (Vyxeos®) for acute myeloid leukemia with myelodysplasia-related changes
Authors: Triesel Katherine , Chiang Timothy , Seabury Robert , Miller Christopher
Published: December 2020

Introduction

With novel treatment strategies for acute myeloid leukemia becoming more readily utilized in the clinical practice setting, new data on potential treatment-related adverse events also has become available.

Case report

We present a patient case on a previously unreported potential adverse event related to liposomal daunorubicin-cytarabine administration. The patient experienced bilateral discoloration of the palms of his hands that resolved after completion of the treatment cycle, only to recur at cycle two of therapy. Management and outcome: No intervention was required as the condition resolved within a week of onset.

Discussion

With newer therapeutic modalities becoming more used in the clinical setting, it is important to understand the potential risks of treatment-related adverse events that come with them. To our knowledge this is the first case reporting blue-skin discoloration related to liposomal daunorubicin-cytarabine.
Twice weekly prophylaxis with trimethoprim/sulfamethoxazole for Pneumocystis jirovecii pneumonia in pediatric oncology patients
Authors: Awad Monica , Sierra Caroline M , Mesghali Elhaam , Bahjri Khaled
Published: December 2020

Current recommendations for prophylaxis of Pneumocystis jirovecii pneumonia in oncology patients include administration of trimethoprim/sulfamethoxazole (TMP/SMX) three times weekly or the same total weekly dose given daily. The primary objective of this study was to evaluate the efficacy of two consecutive days per week of TMP/SMX for prevention of Pneumocystis jirovecii pneumonia (PJP) in pediatric oncology patients. A retrospective cohort, single-center analysis was conducted in oncology patients 21 years and younger who received TMP/SMX for PJP prophylaxis between February 1, 2013 and July 31, 2017. Changes to the prophylaxis regimen were documented and analyzed. A total of 322 patients received TMP/SMX on two consecutive days per week for PJP prevention, of whom four had confirmed PJP (1.3%). Neutropenia was the most common reason for switching to alternative prophylaxis therapy (11.5%). Two consecutive prophylaxis days with TMP/SMX may be insufficient to prevent PJP in children with hematologic malignancies. Neutropenia remains a barrier for TMP/SMX use for PJP prophylaxis. Further studies to compare PJP incidence in children receiving alternative prophylaxis regimens should be considered.
Comparative Analysis of Pesticide Use Determinants Among Smallholder Farmers From Costa Rica and Uganda
Authors: Staudacher Philipp , Fuhrimann Samuel , Farnham Andrea , Mora Ana M , Atuhaire Aggrey , Niwagaba Charles , Stamm Christian , Eggen Rik IL , Winkler Mirko S
Published: December 2020

Pesticides are used globally in agriculture and pose a threat to the health of farmers, communities, and the environment. Smallholder farmers in low- and middle-income countries have generally a low socio-economic status and educational level. Consequently, they are particularly vulnerable to negative impacts of pesticides on their health, yields, or land. In a Knowledge, Attitude, and Practices study, we compared the pest management practices between a market-oriented farming system in Zarcero County, Costa Rica, and a subsistence-based farming system in Wakiso District, Uganda. We conducted a cross-sectional survey among smallholder farmers from Costa Rica (n = 300) in 2016 and from Uganda (n = 302) in 2017. We enrolled conventional and organic farmers, but also farmers with mixed practices and non-applicators of any pest management strategy. We found that the majority of pesticides used in both case studies are classified as highly hazardous by the World Health Organization. While more than 90% of smallholder farmers from both countries were aware of the negative health effects of pesticide exposure, <11% in Costa Rica and <2% in Uganda reported using personal protective equipment every time they handled or applied pesticides. Hygiene and other safe use practices were not adopted by all farmers (<61%), especially among farmers applying more hazardous pesticides. Conventional farmers from Costa Rica (14%) and Uganda (19%) reported disposing pesticide residuals into rivers. Using a logistic regression we found that organic farmers were more likely to having been trained on safe pesticide use practices. Using a robust regression, we observed that smallholder household income was primarily driven by education and not directly by the use of synthetic pesticides. Our results suggest that negative effects of pesticides can be managed over the whole life cycle, from purchase, via storage and application to residual and waste management by fostering professionalization of farmers. We advise future safe use and handling interventions to consider the pesticide use-related socioeconomic and demographic findings highlighted in this paper.
The WeReha Project for an Innovative Home-Based Exercise Training in Chronic Stroke Patients: A Clinical Study
Authors: Bellomo Rosa Grazia , Paolucci Teresa , Saggino Aristide , Pezzi Letizia , Bramanti Alessia , Cimino Vincenzo , Tommasi Marco , Saggini Raoul
Published: December 2020

Background:

Telerehabilitation (TR) in chronic stroke patients has emerged as a promising modality to deliver rehabilitative treatment-at-home. The primary objective of our methodical clinical study was to determine the efficacy of a novel rehabilitative device in terms of recovery of function in daily activities and patient satisfaction and acceptance of the medical device provided.

Methods:

A 12-week physiotherapy program (balance exercises, upper and lower limb exercises with specific motor tasks using a biofeedback system and exergaming) was administered using the WeReha device. Twenty-five ( N = 25) chronic stroke outpatients were enrolled, and the data of 22 patients was analyzed. Clinical data and functional parameters were collected by Berg Balance scale (BBS), Barthel Index (BI), Fugl-Meyer scale (FM), Modified Rankin scale (mRS), and Technology Acceptance Model (TAM) questionnaire at baseline (T0), after treatment (T1), and at the 12-week follow-up (T2). Statistical tests were used to detect significant differences ( P < .05), and Cohen’s (Co) value was calculated.

Results:

BI scores improved significantly after treatment ( P = .036; Co 0.776, medium), as well as BBS scores ( P = .008; Co 1.260, high). The results in FM scale ( P = .003) and mRS scores ( P = .047) were significant post treatment. Follow-up scores remained stable across all scales, except the BI. The A and C sub-scales of the TAM correlated significantly to only a T2 to T1 difference for BI scores with P = .021 and P = .042.

Conclusion:

Currently, the WeReha program is not the conventional therapy for stroke patients, but it could be an integrative telerehabilitative resource for such patients as a conventional exercise program-at-home. ClinicalTrials.gov identifier: NCT03964662.
Numerical analysis of axial load effects on RC bridge columns under blast loading
Authors: Yuan Sujing , Hao Hong , Zong Zhouhong , Li Jun
Published: December 2020

Blast load and its effects on transportation infrastructure especially bridge structures have received considerable attention in recent years. The RC bridge columns are considered as the most critical structural members because their failure leads to collapse of the bridge. Although RC bridge columns are typical axial load-carrying components, the studies on blast-resistant capacity of RC bridge columns usually neglect the axial load effect since it is commonly assumed that neglecting the axial load leads to conservative predictions of column responses. This assumption is true when column failure is governed by flexural response since axial compressive load generates a prestress in column which compensates concrete tensile stress induced by bending response. When subjected to blast loads, column response however could be governed by shear response. In this case neglecting axial loading effect does not necessarily lead to conservative predictions of column responses. In this study, high-fidelity finite element (FE) models for both non-contact explosion and contact explosion were developed in LS-DYNA. The FE models were validated with field blast test data. Subsequently, intensive simulations of the RC bridge columns with and without axial load subjected to a wider range of blast loading scenarios, including far-field, near-field and contact explosion were conducted. The influence of axial load on the dynamic performance of RC bridge columns corresponding to different blast loading scenarios was discussed.
The modified Lindstedt–Poincare method for solving quadratic nonlinear oscillators
Authors: Yeasmin Ismot A , Rahman MS , Alam MS
Published: December 2020

Recently, an analytical solution of a quadratic nonlinear oscillator has been presented based on the harmonic balance method. By introducing a small parameter, a set of nonlinear algebraic equations have been solved which usually appear among unknown coefficients of several harmonic terms. But the method is not suitable for all quadratic oscillators. Earlier, introducing a small parameter to the frequency series, Cheung et al. modified the Lindstedt–Poincare method and used it to solve strong nonlinear oscillators including a quadratic oscillator. But due to some limitations of both parameters, a changed form of frequency-related parameter (introduced by Cheung et al.) has been presented for solving various quadratic oscillators.
Barriers to knowledge acquisition and utilisation in child welfare decisions: A qualitative study
Authors: McCafferty Paul , Taylor Brian J
Published: December 2020

Permanency decisions in child welfare are recognised as being challenging. Nevertheless, society and the profession expect that professional judgements should be of the highest quality, consistent, reliable, fully justified and informed by evidence of what works, particularly where decisions are potentially life-changing. However, barriers to knowledge acquisition and utilisation exist, preventing practitioners from gaining the full range of knowledge they require, leading to permanency decisions being interventionist and protectionist in orientation (author, 2020). Think-aloud protocols and semi-structured interviews, in conjunction with a vignette, were used with social workers ( N = 17) in statutory services to explore barriers to knowledge acquisition and utilisation in permanency decisions for children in state care.

Findings

The main barriers to knowledge use were (1) misunderstanding or misuse of theory, (2) limitations in training and learning and (3) organisational issues.

Applications

By developing a real-world understanding of the barriers and listening to the views of the professionals themselves, we can begin to realistically inform policy and practice, with the aim of decreasing the barriers to knowledge acquisition and utilisation in permanency decision-making. If we appreciate the barriers to knowledge acquisition and utilisation in permanency decision-making more fully, then perhaps we can reduce them, thereby facilitating more fully informed decisions that best serve the individual needs of children and their families.
Serum ESPL1 Can Be Used as a Biomarker for Patients With Hepatitis B Virus-Related Liver Cancer: A Chinese Case-Control Study
Authors: Wang Rongming , Zang Weiwei , Hu Bobin , Deng Deli , Ling Xiaozhang , Zhou Huikun , Su Minghua , Jiang Jianning
Published: December 2020

Aims:

To investigate the feasibility of serum extra spindle pole bodies-like 1 (ESPL1) used as a biomarker for patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

Methods:

131 chronic HBV-infection patients were recruited and divided into HBV S gene integration, non-HBV S gene integration, chronic hepatitis B (CHB), HBV-related liver cirrhosis (LC) and HBV-related HCC group, 24 non-HBV-related HCC patients were selected as HCC control group, 30 people without HBV-infection as healthy control group. Serum ESPL1 were detected and compared.

Results:

ESPL1 level of integration group was significantly higher than that of non-integration group (346.7 vs 199.6 ng/ml, P = 0.000) and healthy control group (346.7 vs 41.3 ng/ml, P = 0.000). ESPL1 level of non-integration group was significantly higher than that of healthy control group (199.6 vs 41.3 ng/ml, P = 0.000); ESPL1 levels in chronic HBV-infection related groups were increased in turn according to CHB group (95.8 ng/ml), HBV-related LC group (268.2 ng/ml), HBV-related HCC group (279.9 ng/ml) and integration group (346.7 ng/ml). Except that there was no significant difference in ESPL1 levels between HBV-related LC and HCC group ( P = 0.662), pairwise comparisons between other groups showed significant differences ( P < 0.05). ESPL1 level of HBV-related HCC group was significantly higher than that of non-HBV-related HCC group (279.9 vs 46.6 ng/ml, P = 0.000), there was no noticeable difference between non-HBV-related HCC and healthy control group (46.6 vs 41.3 ng/ml, P = 0.848). ESPL1 level of HBV-related HCC group after resection was significantly lower than that of before resection (178.4 vs 260.8 ng/ml, P = 0.000).

Conclusions:

Chronic HBV-infection patients with high ESPL1 level may indicate HBV S gene integration and is a high-risk population for HBV-related HCC. Serum ESPL1 can be used as a biomarker for screening HBV-related HCC high-risk population and monitoring recurrence.
YAP activation in melanoma contributes to anoikis resistance and metastasis
Authors: Zhao Bei , Xie Jun , Zhou Xiyuan , Zhang Lixia , Cheng Xiankui , Liang Chenglin
Published: December 2020

Melanoma is inherently heterogeneous, providing resistance to apoptosis. Anoikis resistance is a hallmark feature of metastatic melanoma to escape apoptosis when cells lose contact with adjacent cells or extracellular matrix. The yes-associated protein transcription co-activator is the effector of Hippo pathway. Herein, we investigated the function of yes-associated protein in anoikis resistance of melanoma cells. When melanoma cells were grown under anchorage-independent condition, anoikis-resistant cells displayed higher levels of yes-associated protein activation than the cells that were attached to the basement membrane, as evidenced by downregulated phosphorylated yes-associated protein at Ser127 and higher expression of downstream genes BCL2 and MCL-1. Yes-associated protein overexpression directly enhanced the anoikis resistance and metastatic potential of melanoma cells. Conversely, yes-associated protein inhibitor CA3 exhibited Dose-dependent induction of anoikis in resistant melanoma cells and exerted great inhibition on cell migration. Knockdown of yes-associated protein expression by shRNA also rendered melanoma cells susceptible to anoikis and interrupted cell invasiveness. Yes-associated protein inhibition in anoikis-resistant cells also reduced the number of metastatic nodules in the lung sections of SCID mice. Clinically, higher yes-associated protein level in the lung metastasis tissues correlated with higher BCL2 and MCL1 expressions compared with the non-metastasis tissues. Overall, our finding suggests that the aberrant activation of yes-associated protein exerts important role on anoikis resistance and metastatic capability of melanoma cells.
Postmodern Life, Restaurants, and COVID-19
Authors: Shigihara Amanda Michiko
Published: December 2020

“COVID-19 is threatening the livelihood of the U.S. restaurant industry and its employees because of public-space avoidance, shelter-in-place orders, mandatory restaurant/bar shutdowns, and modified service (i.e., takeout and delivery only). All of these changes will have long-lasting, devastating economic impacts on the industry.”
Mobilizing COVID-19 Science
Authors: Adams Jimi , Light Ryan , Theis Nicholas
Published: December 2020

While there are many uncertainties about the ensuing COVID-19 pandemic, scientific mobilization that integrates knowledge from across the wide-ranging intersection of applicable expertise will optimize our response strategy. As we continue to coordinate these efforts, sociological contributions can continue to identify improved social coordination opportunities, even while practicing social distancing.
Sexism Among American Adults
Authors: Edwards Margaret , Schaffner Brian
Published: December 2020

While there is a scholarly consensus on sexism's critical role in contemporary society, we know little about the basic facts regarding sexist attitudes. How widespread is sexism in America? Which Americans are most sexist? Is sexism limited to men, or do many women also express sexist attitudes? Here, the authors answer these questions and more.
Why is Income Inequality Growing?
Authors: Krisel Rebecca
Published: December 2020

Rebecca Krisel on Review of Class Attitudes in America: Sympathy for the Poor, Resentment of the Rich, and Political Implications by Spencer Piston.
Coming Vaccine Battle
Authors: Reich Jennifer
Published: December 2020

“Though small, the recent protests we've seen across the U.S. signal what is likely to come as governments grapple with how to move forward, particularly if a vaccine against SARS-CoV-2, the virus causing the pandemic becomes available.”
Transcranial Doppler: The Fifth Decade
Authors: Alexander Thomas H. , Hennigan Allison , Harrison Preston , Plotkin George
Published: December 2020

In 1981, the Norwegian physiologist, Rune Aaslid, developed a device that made it possible to apply the transcranial Doppler (TCD) sonographic technique to the human brain. In 1983, Albrecht Harders, a German neurosurgeon, worked out a clinically practicable method that would allow for bedside, atraumatic measurements to be made of the blood flow velocity in the large arteries in the Circle of Willis. This simple test is based on a single-element transducer technology but requires a knowledge of anatomy, physiology, and pathology that transcends any single discipline.
Complications After Clinic-Based Wide Awake Local Anesthesia No Tourniquet Hand Surgery at a Single Private Practice
Authors: Reynolds Michael , Srinivasan Ramesh C. , Person David W.
Published: December 2020

Background

This study was designed to analyze the results of all wide awake local anesthesia no tourniquet (WALANT) procedures performed on the hand and wrist at a single practice hand surgery practice with a focus on quantifying and qualifying complications.

Methods

This retrospective chart review included 424 patients who underwent WALANT hand procedures in the minor procedure room of our private practice between 2015 and 2017. Patients were divided into groups based on the type of procedure, including carpal tunnel release, A1 pulley release, first dorsal compartment release, extensor tendon repair, mass excision, and foreign body removal. Data pertaining to patient demographics and complications were recorded.

Results

The overall complication rate for all procedures was 2.8% for 424 patients: A1 pulley release (n = 314, 2.5%), first dorsal compartment release (n = 11, 9%), extensor tendon repairs (5.5%), and mass excision (4%). The carpal tunnel release and foreign body removal groups experienced no complications. No adverse events (arrhythmias, vasovagal, etc.) were observed during the use of the WALANT technique.

Conclusions

Clinic-based WALANT hand surgery procedures are equally safe compared to the same procedures performed in the operating room at an ambulatory surgery center or hospital.
Moving and handling care of bariatric patients: a survey of clinical nurse managers
Authors: Dockrell Sara , Hurley Graham
Published: December 2020

Background

The prevalence of obesity is rising, and obese persons are more likely to use healthcare services and require moving and handling care.

Aims

This study explored the frequency, logistics and barriers to the provision of bariatric patient-handling care including equipment availability in acute hospitals.

Methods

A cross-sectional study design using an anonymous 24-item questionnaire was used to survey 322 clinical nurse managers. Completed hard-copy questionnaires ( n = 132) were returned by post.

Results

Most clinical nurse managers (93.1%) provided care for bariatric patients and 85.6% reported barriers to the provision of bariatric care within their clinical area. The principal barriers were lack of equipment (75%), staff (65.2%) and training (57.6%). Only 11.4% owned all the required equipment. Owning equipment provided significantly greater access to a hoist ( P = 0.001) and chair ( P = 0.032) than renting. Only 9.5% reported that rented equipment always arrives on time. The majority (74.4%) did not have guidelines for caring for bariatric patients, and 46.2% considered this to be a barrier.

Conclusions

Barriers to caring for bariatric patients were identified. Most of the equipment was rented, and significant delays in its delivery were reported. The need for education and training and the dissemination of policies and guidelines were identified.
Molecular docking and density functional theory studies on creatine, guanidinoacetic acid, and their phosphorylated analogues binding to muscle creatine kinase
Authors: Vraneš M , Ostojić S , Podlipnik Č , Tot A
Published: December 2020

Comparative molecular docking studies on creatine and guanidinoacetic acid, as well as their phosphorylated analogues, creatine phosphate, and phosphorylated guanidinoacetic acid, are investigated. Docking and density functional theory studies are carried out for muscle creatine kinase. The changes in the geometries of the ligands before and after binding to the enzyme are investigated to explain the better binding of guanidinoacetic acid and phosphorylated guanidinoacetic acid compared to creatine and creatine phosphate.
Multimodal brain monitoring following traumatic brain injury: A primer for intensive care practitioners
Authors: Casault Colin , Couillard Philippe , Kromm Julie , Rosenthal Eric , Kramer Andreas , Brindley Peter
Published: December 2020

Traumatic brain injury (TBI) is common and potentially devastating. Traditional examination-based patient monitoring following TBI may be inadequate for frontline clinicians to reduce secondary brain injury through individualized therapy. Multimodal neurologic monitoring (MMM) offers great potential for detecting early injury and improving outcomes. By assessing cerebral oxygenation, autoregulation and metabolism, clinicians may be able to understand neurophysiology during acute brain injury, and offer therapies better suited to each patient and each stage of injury.

Hence, we offer this primer on brain tissue oxygen monitoring, pressure reactivity index monitoring and cerebral microdialysis. This narrative review serves as an introductory guide to the latest clinically-relevant evidence regarding key neuromonitoring techniques.
From revolutionary Paris to Nootka Sound to Saint-Domingue: The international politics and prejudice behind Wollstonecraft’s theory of the rights of humanity, 1789–91
Authors: Botting Eileen Hunt
Published: December 2020

Against the background of the international political crises generated by the early phase of the French Revolution at Nootka Sound in 1790 and in Saint-Domingue in 1791, Mary Wollstonecraft developed a capacious political theory of the “rights of humanity.” She pushed beyond narrow post-revolutionary European constructions of “the rights of man” which ignored or excluded “the poor,” “Indians,” “African slaves,” and “women.” While closely following the international politics of the French Revolution, Wollstonecraft developed the core arguments of A Vindication of the Rights of Men (1790) and A Vindication of the Rights of Woman (1792). Her key philosophical innovation was to publicly universalize the conceptual scope of rights, such that rights were no longer—implicitly or explicitly—solely the legal entitlement of propertied white European men, but rather the moral and political entitlement of the whole of humanity across nations. Yet she rhetorically contradicted and philosophically limited the cross-cultural universalism of her theory of equal rights by punctuating her arguments with Western Protestant and Orientalist stereotypes of Eastern despotism. Consequently, international politics and international prejudice shaped Wollstonecraft’s theory of equal rights and her application of it to peoples and cultures beyond those of Western Protestant Europe.
‘The Impossible Possibility of Love’: Reinhold Niebuhr’s thought on racial justice
Authors: Hartnett Liane
Published: December 2020

Love has been long lauded for its salvific potential in U.S. anti-racist rhetoric. Yet, what does it mean to speak or act in love’s name to redress racism? Turning to the work of the North American public intellectual and theologian, Reinhold Niebuhr (1892–1971), this essay explores his contribution to normative theory on love’s role in the work of racial justice. Niebuhr was a staunch supporter of civil rights, and many prominent figures of the movement such as James Cone, Jesse Jackson, Martin Luther King Jr., J. Deotis Roberts and Cornel West drew on his theology. Indeed, Niebuhr underscores love’s promise and perils in politics, and its potential to respond to racism via the work of critique, compassion, and coercion. Engaging with Niebuhr’s theology on love and justice, then, not only helps us recover a rich realist resource on racism, but also an ethic of realism as antiracism.
Re-reading Niebuhr’s The Children of Light and the Children of Darkness: The crisis of democracy in an interdependent world then and now
Authors: Ashworth Lucian M
Published: December 2020

Reinhold Niebuhr’s The Children of Light and the Children of Darkness is one of the key English-language texts in the post-war settlement literature of the early 1940s. This article analyses the book on three interconnected levels: the nature of the argument made by Niebuhr in the book, its place in the broader post-war settlement literature of the early 1940s, and its relevance to the current problems of right-wing populism and the climate crisis. While the main theme of the book is the necessity and impossibility of democracy, it shares with the work of Isaiah Bowman and David Mitrany a concern for the tension between the state and interdependence. The deepening of this tension since has helped keep Niebuhr relevant, although his initial distinction between the children of light and the children of darkness has been complicated by both populism and the climate crisis.
Failure patterns and outcomes of dose escalation of stereotactic body radiotherapy for locally advanced pancreatic cancer: a multicenter cohort study
Authors: Zhu Xiaofei , Cao Yangsen , Su Tingshi , Zhu Xixu , Ju Xiaoping , Zhao Xianzhi , Jiang Lingong , Ye Yusheng , Cao Fei , Qing Shuiwang , Zhang Huojun
Published: December 2020

Objective:

This study aims to compare recurrence patterns and outcomes of biologically effective dose (BED10, α/β = 10) of 60–70 Gy with those of a BED10 >70 Gy for locally advanced pancreatic cancer (LAPC).

Methods:

Patients from three centers with a biopsy and a radiographically proven LAPC were retrospectively included and data were prospectively collected from June 2012 to June 2019. Radiotherapy was delivered by stereotactic body radiation therapy. Recurrences were categorized as in-field, marginal, and outside-the-field recurrence. Patients in two groups were required to receive abdominal enhanced contrast CT or MRI every 2–3 months and CA19-9 examinations every month during follow-up. Treatment-related toxicities were evaluated every month. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method.

Results:

After propensity score matching, there were 486 patients in each group. The median prescription dose of the two groups was 37 Gy/5–8 f (range: 36–40.8 Gy/5–8 f) and 42 Gy/5–8 f (range: 40–49.6 Gy/5–8 f), respectively. The median OS of patients with a BED10 >70 Gy and a BED10 60–70 Gy was 20.3 months (95% CI: 19.1–21.5 months) and 18.2 months (95% CI: 17.8–18.6 months) respectively ( p < 0.001). The median PFS of the two cohorts was 15.4 months (95% CI: 14.2–16.6 months) and 13.3 months (95% CI: 12.9–13.7 months) respectively ( p < 0.001). A higher incidence of in-field and marginal recurrence was found in patients with BED10 of 60–70 Gy (in-field: 97/486 versus 72/486, p = 0.034; marginal: 109/486 versus 84/486, p = 0.044). However, more patients with BED10 >70 Gy had grade 2 or 3 acute (87/486 versus 64/486, p = 0.042) and late gastrointestinal toxicities (77/486 versus 55/486, p = 0.039) than those with BED10 of 60–70 Gy.

Conclusion:

BED10 >70 Gy was found to have the best survival benefits along with a higher incidence of acute and late gastrointestinal toxicities. Therefore, a higher dose may be required in the case of patients’ good tolerance.
Early childhood teachers’ management of their changing roles regarding digital technologies in kindergarten: A grounded theory study
Authors: Schriever Vicki
Published: December 2020

This paper examines how early childhood teachers employed in kindergarten, understand and manage their changing roles regarding digital technologies. Nineteen participants were involved in the study. Symbolic interactionism provided the theoretical lens to investigate each early childhood teacher’s lived experiences and grounded theory provided the methodological theory and methods. Following data analysis, a central category, Professional Agency, and three major categories, Professional Identity, Pedagogical Practices, and Relationships with Families, were derived. These categories, together with the relevant empirical literature, form the key features of the Early Childhood Teacher Management of Digital Technologies Framework. This Framework contributes to knowledge and presents a substantive theory that explains how early childhood teachers manage their changing roles with digital technologies in their kindergarten.
Social recognition and employee engagement: The effect of social media in organizations
Authors: Nayak Bimal Chandra , Nayak Gopal Krishna , Jena Debasish
Published: December 2020

In the contemporary dynamic business context (characterized by stiff competition, high uncertainty, growth of global as well as virtual organizations, etc.), setting up systems for recognizing and engaging employees which need constant endeavor from present-day organizations. Hence, organizations are actively exploring and adopting novel initiatives through strategies platforms for their employer engaging effort, moving the organization image to the “company of employee’s choice” and connecting their strategic talent acquisition supply chain into that eco-system. Qualitative data analysis through 65 semi-structured interviews with employees working with various Software and Research & Development sectors, Human Resources and Talent Management professionals working for information technologies companies, IT-enabled (Business Process Outsourcing) BPO, and KPO (Knowledge Process Outsourcing) Services, as well as talent acquisition organizations, confirm the utilization of social media for social recognition & employee engagement in their organizations. The study contributes to the fields of talent management and social networks and has several key messages for practitioners regarding the expediency and effectiveness of social networks in organizations.
Fatal intracranial haemorrhage in a hypertensive patient with atrial fibrillation and coronavirus disease 2019
Authors: Krzystanek Ewa , Gawryluk Justyna , Arkuszewski Michal
Published: December 2020

We present a case of a fatal cerebral haemorrhage in an 82-year-old male patient with coronavirus disease 2019 (COVID-19), who was taking prophylactic oral anticoagulation because of atrial fibrillation (rivaroxaban 20 mg q.d. for two years). On admission, the patient was deeply comatose, mechanically ventilated, with tachycardia up to 150 bpm, high blood pressure >210/120 mmHg and a body temperature >39°C. A computed tomography scan of the head showed a large intracerebral haemorrhage located in the deep structures of the right hemisphere, with a mass effect and bleeding to the ventricles. Rivaroxaban was discontinued at admission. The patient tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but he did not have typical symptoms of pneumonia. In the following days, the patient’s neurological condition did not improve, and a fever of up to 40°C and abnormal coagulation parameters remained resistant to pharmacotherapy. The patient developed multi-system organ failure and died on day 8. Here, we review the recent literature and discuss the possible association of SARS-CoV-2-mediated endothelial injury and cardiovascular disorders with cerebrovascular complications. We postulate that anti-inflammatory treatment in COVID-19 and the stabilisation of endothelium functions can be particularly important in patients with pre-existing cardiovascular conditions.
Clinical profiles of patients referred to an ear, nose and throat specialist clinic via community mobile hearing clinic in Singapore
Authors: Lim Zee Hui , Soo Ying Pei , Loo Jenny Hooi Yin
Published: December 2020

Background:

Community-based audiology service is new to the Singapore’s health-care landscape. Cases deemed unsuitable to remain under audiologists’ management in the community are referred to ear, nose and throat (ENT) specialists.

Objectives:

Analysis of the clinical profiles for these referred cases revealed the local community burden of otological and auditory conditions.

Methods:

This was a retrospective, cross-sectional pilot study. Clinical records of 375 patients who were seen by audiologists at a community-based mobile hearing clinic (MHC) and warranted ENT specialist referrals were extracted for descriptive analysis.

Results:

A total of 83.73% ( n=314) of patients attended their ENT appointments as advised by audiologists. Most patients (57.07%, n=234) had one condition diagnosed by the ENT specialist. One patient had four ENT conditions. Twenty-two types of otological conditions were diagnosed. Chronic suppurative otitis media, otitis externa, impacted cerumen and otitis media with effusion made up the four most frequently seen conditions in this subgroup. Twelve types of auditory conditions were diagnosed, with asymmetrical hearing loss topping the list. Sixteen types of other ENT conditions were diagnosed. Four incidental findings of vestibular schwannoma were reported.

Conclusion:

Many of the otological conditions diagnosed were chronic. Auditory conditions were predominantly hearing loss. Yet, they were found unnoticed or untreated by patients at the time of their visit to the MHC. This community-based audiology clinic had a catalytic effect on promoting timely or even early otological/hearing diagnosis and treatment. Understanding the prevailing ENT conditions of our wider population indicates the potential for growing community-based hearing health-care provision.
Active screening for COPD among hospitalized smokers – a feasibility study
Authors: Mycroft Katarzyna , Korczynski Piotr , Jankowski Piotr , Kutka Mikolaj , Zelazna Olga , Zagaja Marcin , Wozniczko Kornelia , Szafranska Urszula , Koltowski Lukasz , Opolski Grzegorz , Krenke Rafal , Gorska Katarzyna
Published: December 2020

Background:

Spirometry is a primary tool for early chronic obstructive pulmonary disease (COPD) detection in patients with risk factors, for example, cigarette smoking. The aim of this study was to evaluate the strategy of an active screening for COPD among smokers admitted to the pulmonary and cardiology department.

Methods:

This prospective study was conducted between February and March 2019. All hospitalized smokers aged 40 years and older completed an original questionnaire and had spirometry measurement with a bronchial reversibility test (if applicable) performed by medical students using a portable spirometer.

Results:

One hundred and eighty-eight patients were eligible to participate in the study. Seventy (37%) subjects refused to participate. Eventually, 116 (62%) patients were included in the final analysis and 94 (81%) performed spirometry correctly. In total, 32 (34 %) patients were found to have COPD. Nine (28%) of these patients were newly diagnosed, 89% of them had mild-to-moderate airway obstruction. Patients with newly diagnosed COPD were significantly younger [age 63 (56–64) versus 69 (64–78) years], had a longer smoking-free period [17 (13–20) versus 9 (2–12) years], had fewer symptoms and had a better lung function compared with patients with a previous diagnosis of COPD ( p < 0.05 for all comparisons).

Conclusion:

The proposed diagnostic strategy can be successfully used to improve COPD detection in the inpatient setting. The majority of the newly diagnosed COPD patients had mild-to-moderate airway obstruction. Patients who should be particularly screened for COPD include ex-smokers with less pronounced respiratory symptoms.
A study of Taiwanese children’s learning and preferences in game-based learning scenarios
Authors: Tang Joni Tzuchen
Published: December 2020

Game-Based Learning (GBL) today involves the use of computers and video games specifically aimed at producing learning outcomes among children. Most games are designed to balance different subject matters and to assess the ability of the learners in retaining or applying the acquired knowledge. Children enjoy playing games and are completely involved in the activity for its own sake. “Flow State” refers to the amplification of a child’s concentration, interest, and mindsets while learning. This study intends to verify children’s preferences and interests in Game-based Learning. The study used big data analysis and methods to let children play 10 different games. The results will answer the following questions: 1. How long can children stay engaged while playing digital games? What is the relation between the length of engagement and their flow state? 2. Do children’s preferences in games differ between genders? 3. What are the children's preferences in games regarding different ages? 4. What are the relations between children's interests and achievements? Is children’s flow state related to their learning performances? The study answered the above questions in a quality-focused manner as a reference to the game design for early childhood and preschool teachers.
Norwegian midwives’ experiences of relational continuity of midwifery care in the primary healthcare service: A qualitative descriptive study
Authors: Aune Ingvild , Tysland Trude , Amalie Vollheim Sigrid
Published: December 2020

The World Health Organization recommends that all countries with a well-developed midwifery service offer a midwifery-based practice formed on relational continuity of care. Pregnant women in Norway have stated that they experience the service throughout the childbearing process as fragmented. The present study aimed to gain knowledge about how midwives working in the primary healthcare service experience relational continuity of midwifery care and what challenges they encounter. In-depth interviews were conducted with 10 midwives working in different public health clinics in Norway. The qualitative data were carefully analysed using systematic text condensation. The COREQ checklist was applied. The participants indicated the importance of providing individualised midwifery care by meeting the women early in pregnancy and establishing a mutual relationship built on trust and safety. This helped ease the midwife’s work. The midwives expressed a desire for continuity in the follow-up of the women, but this was not always possible due to a lack of capacity. This study shows that relational continuity of midwifery care is important to midwives working in the primary healthcare service. The midwives wanted a midwifery-led practice that would allow them to lead their profession and use their full expertise. To achieve relational continuity in the primary healthcare service, the informants declared the importance of management seeing the midwives’ potential.
Market-Making Practices of Private Tutoring in Finland: Commercialization of Exam Preparation for Admission to Higher Education
Authors: Jokila Suvi , Haltia Nina , Kosunen Sonja
Published: December 2020

Purpose:

This study focuses on courses that prepare applicants for universities’ highly competitive entrance examinations in Finland. The analysis clarifies the market-making practices and the construction of this field.

Design/Approach/Methods:

To understand these processes, we use Çalişkan and Callon’s five framings for studying marketization as a heuristic framework. In our analysis, we combine different data sets, including data on course provision, thematic interviews, documents, and ethnographic notes.

Findings:

In this article, we argue that the preparatory course markets in Finland are an example of private tutoring which operates in the privacy of the university applicants’ exam preparation process, thus commercializing this process. The market making of this type of private tutoring is an assemblage of a variety of agents that interact in parallel with each other.

Originality/Value:

This study aims to contribute to the systemic understanding of the assemblage of private tutoring markets in an equality-focused Nordic country by providing new heuristic lenses from economic sociology through which to view private tutoring.
Stress and Coping Among Health Professions Students During COVID-19: A Perspective on the Benefits of Mindfulness
Authors: Luberto Christina M , Goodman Janice H , Halvorson Bonnie , Wang Amy , Haramati Aviad
Published: December 2020

Many health professions students experience elevated stress and burnout during their professional education and training. With the added challenges of COVID-19, students face a whole new set of stressors. Students in the Spring 2020 semester of our online academic course, “Mindfulness for Healthcare Providers,” began confronting the COVID-19 crisis after several weeks of mindfulness meditation practice as part of the course. Students discussed their experiences using the course discussion boards, providing a unique opportunity to explore the practical application of mindfulness for student well-being during a crisis. Themes from the discussion board revealed a range of novel stressors and concerns due to COVID-19 (physical health, mental health, societal implications, academic and clinical training disruptions). All students reported that mindfulness practice helped them cope by improving specific mindfulness skills (focus, appreciation, cognitive de-centering, non-reactivity). Mindfulness training may be a useful approach to promoting student well-being during a crisis.