bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a decentralized investigational drug service pharmacist in a cancer clinical trial infusion unit
Authors: Baroody Christina , Sandler Melissa , Hong Christine , Madanat Yazan F , Conley Stefanie
Published: October 2023

Introduction

Investigational drug service (IDS) oversees and manages use of investigational products. There is limited data on utility of pharmacy services in clinical trial conduct and outcomes, specifically on the value of a decentralized IDS pharmacist.

Methods

This is a quasi-experimental study conducted in an oncology clinical trial infusion unit. A retrospective chart review was done to reflect current practice from January through June 2022. A decentralized IDS pharmacist was piloted in December 2022. Data collected included number and types of consults, personnel requesting the consult, and intervention performed. A satisfaction questionnaire was conducted after the pilot program.

Results

A total of 16.3% (173 of 1062 patient visits) of pharmacy consults were completed in the centralized IDS pharmacy model, while 44.5% (81 of 182 patient visits) of pharmacy consults were completed during the decentralized IDS pharmacist pilot, p < .001. Decentralized IDS pharmacist completed 77% (62/81) of the consults during the pilot period. Most common types of consults were toxicity management (20%), electronic medical record issues (17%), and tubing and drug administration issues (16%). More than 80% of respondents to the satisfaction questionnaire responded that implementation of a decentralized IDS pharmacist is acceptable, appropriate, and feasible.

Conclusion

This pilot study demonstrated that a decentralized IDS pharmacist in an oncology clinical trial infusion unit improved accessibility to an IDS pharmacist, increased pharmacy consults relevant to patient care and optimized centralized pharmacists medication distribution workflow. Further studies are needed to evaluate patient benefits from implementing decentralized IDS pharmacist in direct patient care activities.
Reproductive Interconception Care Among Women Recently Pregnant and Homeless: A Qualitative Analysis
Authors: Galvin Annalynn M. , Akpan Idara N. , Lewis Melissa A. , Walters Scott T. , Thompson Erika L.
Published: October 2023

Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of women who were recently pregnant and homeless. A semi-structured interview guide and demographic survey were developed based on epidemiological findings, Information-Motivation-Behavioral Skill framework components, and a review by community health workers for content validity. After conducting 12 interviews with women recently pregnant and homeless in a local continuum of care in 2022, audio-recorded interviews were transcribed, iteratively coded using a priori and emerging codes, and thematically analyzed. Key themes were identified to determine implications and next steps to improving reproductive interconception care uptake. Interrelated themes focused on information (e.g., knowledge and misconceptions about pregnancy, birth intervals, contraception), motivation (e.g., attitudes about interconception care experiences, perinatal social influences), behavioral skills (e.g., objective ability to obtain interconception care and perceived self-efficacy related to attending maternal postpartum visits and increasing birth intervals), and macro-level factors (e.g., obtaining housing, contextualizing socioeconomic factors, navigating COVID-19). The findings suggest the need for flexible, streamlined, and personalized interconception care delivery that acknowledges pressing housing and relationship considerations and supports women’s autonomy. Improvements to reproductive interconception care may reduce future unintended pregnancies, increase birth intervals, and improve birth outcomes among women experiencing homelessness.
Visual Aesthetic Quotient: Establishing the Effects of Computational Aesthetic Measures for Servicescape Design
Authors: S Kumar Deepak , Sahadev Sunil , Purani Keyoor
Published: October 2023

Visual aesthetics play a pivotal role in attracting and retaining customers in service environments. Building on theories of environmental psychology, this study introduces a novel and comprehensive aesthetic measure for evaluating servicescape design, which is called as the “visual aesthetic quotient” (VAQ). This measure is presented as the ratio of the dimensions of order and complexity in servicescape's visual design, and it aims to provide an objective and holistic approach of servicescape design evaluation. In addition, we introduce and validate a pioneering method for quantifying order and complexity objectively using algorithmic models applied to servicescape images. We investigated and established the influence of the VAQ on the perceived attractiveness of servicescapes, developing its role further in this context. The entire approach was comprehensively and rigorously examined using four studies (social media analytics, eye-tracking, a field experiment, and an experimental design), contributing to conceptual advancement and empirical testing. This study provides a novel, computational, objective, and holistic aesthetic measure for effective servicescape design management by validating computational aesthetic measures and establishing their role in influencing servicescape attractiveness; testing the mediation of processing fluency and pleasure; and examining the moderating effects of service context.
Screening for Cystic Fibrosis Related Complications in the Context of a Pandemic and Altered Models of Care
Authors: Doumit Michael , Strachan Roxanne , Lazarus Raynuka , Middleton Peter , Dentice Ruth , Marouvo Jessica , Jeffrey Laura , Selvadurai Hiran , Sivam Sheila , Pacey Verity , Jaffe Adam , Gray Kelly
Published: October 2023

Background:

Standard of care recommend that patients with cystic fibrosis (CF) require screening investigations to assess for complications. Changing models of care due to the COVID19 pandemic may have impacted completion of recommended screening.

Objective:

To compare the frequency of screening investigations completed in people with CF before and after the onset of the COVID19 pandemic.

Methods:

Medical records were reviewed at 4 CF-specialist centers to identify screening investigations completed in the 12-months before and after pandemic onset.

Results:

Records of 625 patients were reviewed. Prior to pandemic onset, there was between center variability in completion of screening investigations. There was greatest baseline variation between centers in performing oral glucose tolerance test (OGTT); range 38%-69%, exercise tests; 3%-51% and sputum screening for non-tuberculous mycobacteria; 53%-81%. Following pandemic onset, blood tests, and sputum cultures were maintained at the highest rates. Exercise testing, CXR and OGTT exhibited the greatest declines, with reductions at individual centers ranging between 10%-24%, 22%-43%, and 20%-26%, respectively. Return to in-person visits following pandemic onset was variable, ranging from 16% to 74% between centers.

Conclusion:

Completion of screening investigations varies between CF centers and changes in models of care, such as increased virtual care in response to COVID19 pandemic was associated with reduction in completion of investigations. Centers would benefit from auditing their adherence to standards of care, particularly considering recent changes in care delivery.
A retrodictive qualitative modeling study of complex and dynamic language learning motivation viewed as control, value and truth effectiveness
Authors: Bielak Jakub , Mystkowska-Wiertelak Anna
Published: October 2023

The dynamics of second language learning motivation (L2 motivation), which depends on multiple intra-personal and contextual influences, is increasingly examined. As part of this research trend, we explore the usefulness of a global view of motivation – covering control, value and truth effectiveness – for tracing English majors’ motivational development spanning their entire learning histories. Viewing L2 motivation as a complex system, we employ complex dynamic systems theory and retrodictive qualitative modeling. We created a “blueprint” integrating diverse motivational forces under the three types of effectiveness. Control emerged as crucial as, in interaction with the others, it pushed the motivational system into qualitatively different states, particularly through feedback on progress and the (non-)compatibility of goal foci (promotion/prevention) with learning strategies (eager/vigilant). The motivational development of seven learners representing different learner archetypes was captured in (1) a common motivational base in the form of slow motivational evolution (for one learner this was exhaustive), and (2) distinct signature dynamics, i.e. developmental patterns, which involved periodic attractor states (for four learners whose motivation was fluctuating considerably) and fixed point attractor states (for two learners whose motivation was strong, with just one major fall/change). Pedagogy-wise, we recommend that teachers foster success experiences, communicate/discuss teaching goals, consider individualized instruction, and use/teach (meta-)motivational strategies highlighting the control, value and truth effectiveness types, promotion/prevention goal foci, and eager/vigilant strategies.
Barriers to healthcare and a ‘triple empathy problem’ may lead to adverse outcomes for autistic adults: A qualitative study
Authors: Shaw Sebastian CK , Carravallah Laura , Johnson Mona , O’Sullivan Jane , Chown Nicholas , Neilson Stuart , Doherty Mary
Published: October 2023

Autistic people experience more co-occurring health conditions and, on average, die younger than non-autistic people. Despite growing awareness of health inequities, autistic people still report barriers to accessing healthcare. We aimed to explore the experiences of autistic people accessing healthcare, shining a light on the complex interplay of relevant factors and to explain, at least in part, the possible reasons underling health disparities and adverse health outcomes. This is a qualitative study from an autistic research team. Data were collected from 1248 autistic adults as part of a large, mixed-methods, international survey exploring barriers to primary healthcare. This article reports the qualitative findings, following a thematic analysis. Using our exploratory findings, we then constructed a model to explain the reported experiences. Respondents reported a variety of barriers. Here, our article gives voice to their stories, in their own words. Themes included: early barriers; communication mismatch; doubt – in oneself and from doctors; helplessness and fear; and healthcare avoidance and serious adverse health outcomes. Our constructed model outlines a chronological journey through which healthcare access barriers may lead to adverse health outcomes. Our findings also build on the double empathy problem, situating this in a medical context, proposing a triple empathy problem.

Lay abstract

Autistic people live with more mental and physical health conditions and, on average, die younger than non-autistic people. Despite widespread commitments to tackling these issues, autistic people still report various barriers to accessing healthcare. This article aims to explore the area in depth, from the perspective of autistic people. This research benefits from being led by autistic people, for autistic people – all of the researchers are autistic, and most of us are also medical doctors. Data, in the form of written comments and stories, were collected as part of a large survey. Here, we explored these for common themes and possible deeper meaning within the experiences. People who took part reported a variety of barriers. Here, our article gives voice to their stories, in their own words. Themes included: early barriers; communication mismatch; doubt – in oneself and from doctors; helplessness and fear; and healthcare avoidance and adverse health outcomes. Our findings allowed us to create a model that aimed to understand and explain the reported barriers in the context of the previously known consequences. We also built on wider autism theories to explain our findings in more depth.
Performance assessment of post-tensioned concrete-filled steel tube beams using unbonded tendons with uncertainty quantification
Authors: Ghaemdoust Mohammad Reza , Yang Jian , Wang Feiliang , Li Siping , Jamhiri Babak
Published: October 2023

The centerpiece of many research projects is evaluating the structural performance of the concrete-filled steel tubes (CFSTs). When these structural elements are employed as flexural members, some parts of the concrete infill are subjected to tension, and consequently the concrete is cracked so that the confinement effect is reduced. Therefore, the application of tendons and modification of the CFST configuration are deployed to improve the serviceability of the CFST beams. A non-linear finite element (FE) model considering the effects of the material and geometrical non-linearity and initial imperfection is developed. Concurrently, an analytical model based on the plastic stress distribution method (PSDM) is proposed to compare the results. In addition, a probabilistic assessment along with the uncertainty quantification is conducted to calculate the reliability indices and the sensitivity of the beams to the variation of the input variables. The results of the study demonstrate that the implemented measures considerably enhance the moment capacity and serviceability performance of the CFST beams. Moreover, the sensitivity analyses show the significance of the variables on the model output with different steel yield stress values and the importance is ordered as the steel tube width followed by the steel tube thickness and the concrete strength.
Investigative interviewing with suspects: Exploring current practices among Malaysian police
Authors: Chung Kai Li , Wong Yi Shan , Kamaluddin Mohammad Rahim , Bull Ray
Published: October 2023

The interviewing of suspects is a key component in the investigation process. Although a great deal of research on interrogation and interviewing techniques has been conducted in the past, much of this work has been undertaken outside South East Asia. This new study examined Malaysian police officers’ reported rate of use of a large variety of investigative interviewing techniques categorised into six domains: rapport and relationship building, context manipulation, emotion provocation, confrontation/competition, collaboration and presentation of evidence. Eighty-eight police officers primarily from the criminal investigation department, narcotics crime investigation department, commercial crime investigation department, and traffic enforcement and investigation department participated in a pen-and-paper survey. Findings revealed that many police officers in the current study report adopting investigative interviewing techniques that are largely in line with ethical, non-coercive guidelines.
“Social workers by day and terrorists by night?” Wounded healers, restorative justice, and ex-prisoner reentry
Authors: Albert Allely
Published: October 2023

Common to many post-conflict societies, former political prisoners and combatants in Northern Ireland are often portrayed as security threats rather than as potential contributors to societal peacebuilding processes. This distrust limits their ability to contribute to the transitional landscape and additionally hinders desistance processes during their reentry from prison. Drawing from the work of Maruna, LeBel, and others on “wounded healers,” this article critically examines the restorative justice work of ex-prisoners who have become involved in leadership roles within community based restorative justice. It is argued that such practitioner work can help former combatants overcome many of the challenges typically associated with reentry, contributing to a “strength-based” approach to desistance, impacting factors such as employment, social bonds, internal narratives, and agency. This work also enables individuals to showcase their desistance to others, highlighting their “earned redemption” and encouraging society to acknowledge that reentry is a two-way street.
Sustaining journalistic continuity in the face of change: Announcing a new editor at the New York Times
Authors: Carlson Matt
Published: October 2023

An ample body of journalism studies research examines moments of disruption when a particular critical incident sparks widespread reflection about news and journalism. But we should not neglect how moments of orchestrated non-disruption perpetuate journalistic ideologies while stifling potential alternatives or deeper calls for change. This was the case when on April 19, 2022, the New York Times announced that managing editor Joseph Kahn would be taking over as executive editor from the retiring Dean Baquet. As an amiable and expected event, the Times promoted both a discourse of continuity surrounding journalistic norms and practices with a discourse of change focused on digital innovation and global audience growth. These discourses were challenged by critics who used the opportunity to lambaste the Times for insufficient news coverage of antidemocratic forces and a resistance to foundational introspection. This incident reveals how the Times sought to maintain its cultural authority and status as an elite journalistic institution while shaping normative expectations about journalism. It underscores the importance of attending to the interpretive power that privileged news organizations possess to speak about journalism at a time when many voices are contesting what news ought to look like.
Facilitating Factors and Barriers to the Implementation of the Icelandic Prevention Model of Adolescent Substance Use in Chile: A Focus Group Study
Authors: Sepúlveda Carolina , Ibáñez Carlos , Libuy Nicolás , Guajardo Viviana , Araneda Ana María , Contreras Lorena , Donoso Paula , Mundt Adrian P.
Published: October 2023

The use of alcohol and other drugs is a major public health problem in adolescence. The implementation of evidence-based prevention strategies is still scarce in the global south. This study aimed to evaluate facilitators and barriers to the implementation of the Icelandic prevention model of adolescent substance use (IPM) in Chile. We conducted a qualitative study of stakeholders during the implementation process of the IPM in six municipalities of the Metropolitan Region of Santiago, Chile. We convened six focus groups with parents and professionals from schools and municipal prevention teams (38 participants). Recordings were transcribed and submitted to a six-step thematic analysis. The following facilitators emerged: Participants valued the contribution of the IPM to articulate existing programs and teams, its community focus, and the local data obtained through the survey. There were also several barriers: Those included resistance to adopting a foreign model, the tension between generating local strategies and looking for measures to ensure the fidelity of the implementation, socioeconomic differences between and within municipalities, low-risk perception and supervision of parents in Chile, and a culture that generally does not discourage adolescent substance use. Implementation of the IPM was largely accepted by the stakeholders who agreed with the community approach of the model. The main barriers to consider were related to cultural and socioeconomic factors that need to be addressed in further research and may limit the effects of the model in Chile.
Intraparty Republican Factionalism as Identity in the Modern American South
Authors: Cooper Christopher A. , Huffmon Scott H. , Knotts H. Gibbs , McKee Seth C.
Published: October 2023

Party factions are central to our understanding of American politics, but what role do party factions play within the electorate? With an August 2022 survey of the American South, we investigate factions within the modern GOP. We find evidence that faction identities overlap, as most Republicans hold some degree of identification with multiple factions. We also employ multivariate analyses to show that, despite evidence of overlap, Make America Great Again (MAGA) identifiers hold distinguishable opinions on President Trump and a variety of election issues. This research demonstrates the importance of factions within the southern Republican electorate and argues that factions can be an identity, representing a new way to conceive of intraparty factions in American politics.
The Technological Mediation of Collective Memory Through Historical Video Games
Authors: Matei Ștefania
Published: October 2023

This article discusses how genre-related procedural rhetorics might be employed in video games to (re)shape the way we think about history. The theoretical interpretation follows a postphenomenological line of inquiry in understanding how the sense of collective memory is shaped across playable environments. Through their medium-specific characteristics, historical video games define the nature of the representations through which history is brought to human experience and knowledge. However, collective memory should be understood neither as a process of recall nor as an aesthetics of historiophoty, but, rather, as a phenomenon of technological mediation: historical video games disclose the reality of the past as “a world to be remembered” and shape humans as “remembering subjects” in morally relevant ways. Therefore, video games based on history participate in the politics of remembrance and play a powerful role in the governance of mnemonic subjectivity by activating and reifying contingent norms of commemoration.
Non-operative Treatment Options for Osteoarthritis in the Hip
Authors: Nicholas Erin , Cheng Jennifer , Moley Peter J.
Published: October 2023

With the increased disability associated with osteoarthritis (OA) progression, and the significant socioeconomic burden of joint replacement surgeries, there is a need for more reliable conservative treatments for patients presenting with hip OA. Most studies of OA treatments involve the knee. We conducted a literature search and reviewed non-operative hip OA treatment recommendations by the Osteoarthritis Research Society International, the American College of Rheumatology, American Academy of Orthopedic Surgeons, and European Alliance of Associations for Rheumatology, as well as Cochrane Reviews. Non-steroidal anti-inflammatory drugs and corticosteroid injections are the most supported and recommended options for hip OA; other medications with potential benefits for short-term pain relief include acetaminophen and tramadol. Most societies recommend against the use of glucosamine, typical opioids, and viscosupplementation injections. Platelet-rich plasma has potential benefits, but evidence of its effectiveness is incomplete. Further research is needed to better inform and guide clinicians who create treatment plans for patients with symptomatic hip OA.
Principle capabilities of crocheted fabrics for composite materials
Authors: Storck Jan Lukas , Steenbock Liska , Dotter Marius , Funke Herbert , Ehrmann Andrea
Published: October 2023

A first limited approach for the automated production of crocheted fabrics was introduced in 2019. However, the knowledge on crocheted fabrics is very scarce and only few technical applications are presented in the literature. To provide a basis for possible future technical applications, the general tensile properties of crocheted fabrics are explored, and a promising application as composite reinforcement is introduced. Due to the early development state of the crochet machine prototype, conventionally hand-made crocheted fabrics are studied and the benefit of improving the machine is evaluated. The mechanical properties of crocheted fabrics depend significantly on the individual crocheter, but fabrics produced from the same person are sufficiently reproducible for reasonable investigations. Anisotropic properties with a trend toward higher resisted forces in course compared to wale direction were identified with crochets constructed from single crochet (sc) and from half double crochet (hdc) stitches. Furthermore, a tendency toward higher possible loads at larger elongations was revealed for crocheted fabrics compared to knitted ones. To the best of our knowledge, for the first time crocheted aramid fabrics were used in epoxy composites. With a crocheted reinforcement in a non-cut composite produced by vacuum-assisted hand lay-up, significantly higher ultimate tensile strength and Young’s modulus were recorded compared to a knitted one with comparable fracture modes.
A Cancer Center Multidisciplinary Lifestyle Medicine Clinic: Description of Program and Patient Population
Authors: Millstein Rachel A. , Lee Hannah , Lapioli Alisa , Winters Loren , Sullivan Carol , Bateman Samantha , Frates Elizabeth , Comander Amy , Eisenstat Stephanie , Peppercorn Jeffrey , O’Donnell Elizabeth K.
Published: October 2023

Background

Cancer survivorship guidelines emphasize Lifestyle Medicine (LM) pillars, including physical activity, healthy eating, restorative sleep, stress management, and avoiding risky substance use. We describe the development and patient population of a multidisciplinary LM clinic in oncology.

Methods

The clinic launched virtually in 2020. Patients had same-day consultations with an oncologist/nurse practitioner, nutritionist, and psychologist. Patients completed a one-time online survey assessing demographics, quality of life, LM pillars, and mental health. Descriptive statistics were used to characterize the population.

Results

Seventy-six patients took the survey (July 2020-January 2023). Most were female, non-Hispanic White, with early-stage cancers. The mean BMI was 30 kg/m2. A minority of patients met aerobic physical activity (27.6%) and dietary (28.6%) recommendations. Two-thirds (67%) reported sleep difficulties, and 30%–36% reported elevated anxiety/depression. Over half (53.3%) gained weight due to cancer treatment and 78.7% were trying to lose weight.

Conclusion

This paper details the baseline LM needs of cancer survivors seeking lifestyle consultation and describes the development of the clinic to address these concerns. Patients were open to evaluation and treatment in an oncology-focused LM clinic. This clinic model has potential to improve quality of life for survivors.
Artificial intelligence improves transfer times and ischemic stroke workflow metrics
Authors: Field Nicholas C , Entezami Pouya , Boulos Alan S , Dalfino John , Paul Alexandra R
Published: October 2023

Introduction

Rapid initiation of mechanical thrombectomy (MT) for the treatment of large-vessel occlusion (LVO) critically improves patient outcomes. Artificial intelligence algorithms aid in the identification of LVOs and improve door to puncture times as well as patient transfer times.

Objectives

We aimed to determine whether the implementation of an LVO detection algorithm that provides immediate active notification to the thrombectomy team provider's cell phone would improve ischemic stroke workflow at our institution and aid in patient transfer from outlying hospitals when compared to our prior system of passive computed tomography perfusion software analysis and radiologist interpretation and notification.

Methods

A retrospective review of our institutional thrombectomy registry was performed for all patients who underwent MT between January 2020 and March 2022. Demographic, radiographic, and stroke workflow metrics and notification times were collected. Transfer times and stroke metrics were compared pre- and post-implementation of the Viz.ai (Viz.ai, San Francisco, California, USA) smartphone application.

Results

Two hundred sixty-two patients underwent MT during the study period. Door-to-puncture time decreased 15 min ( p = 0.009) after the implementation of Viz.ai at our Comprehensive Stroke Center. Transfer time from outside hospitals that implemented Viz.ai was reduced by 37 min ( p = 0.04). There was no significant change in transfer time over the same time period in outlying hospitals that did not implement the Viz.ai software.

Conclusion

Active notification of the neurosurgical team significantly reduces patient transfer time and initiation of MT.
Changes in Radiographic Alignment Following Metatarsophalangeal Fusion, Distal Metatarsal Osteotomy, and Lapidus
Authors: Dusch Timothy , Guareschi Alexander , Moore Andrew , Hoch Caroline , Gross Christopher E. , Scott Daniel J.
Published: October 2023

Background

The purpose of this study is to evaluate the effect of the different surgical treatments for hallux valgus on various radiographic measures of bunion correction.

Methods

A retrospective cohort study was conducted at a single academic medical center involving 2 fellowship-trained foot and ankle surgeons. One hundred and nineteen feet (110 patients) were included. Procedures included first metatarsophalangeal (MTP) arthrodesis (n = 88), Chevron and/or Scarf osteotomy (n = 23), and Lapidus (n = 8). Overall, 78.2% of patients were female, mean age was 60.49 (range, 16-81) years, and mean follow-up was 1.20 (range, 0.25-3.92) years.

Results

Hallux valgus angle (HVA) significantly differed preoperatively (MTP = 33.33°, Chevron/Scarf = 27.03°, Lapidus = 32.56°; P = .026). There was no difference in distal metatarsal articular angle (DMAA) preoperatively (MTP = 18.87°, Chevron/Scarf = 17.80°, Lapidus = 14.39°; P = .629). At final follow-up, DMAA was significantly greatest among the Lapidus bunionectomy cohort (MTP = 9.63°, Chevron/Scarf = 13.51°, Lapidus = 17.45°; P = .005). There was no difference in infection (MTP = 6.8%, Chevron/Scarf = 4.4%, Lapidus = 0.0%; P = 1.00) or reoperation (MTP = 19.3%, Chevron/Scarf = 21.7%, Lapidus = 12.5%; P = .921) rates between cohorts, although both rates were highest in the first MTP arthrodesis group.

Conclusion

Among the 3 hallux valgus corrections studied, Lapidus bunionectomy fared the worst regarding DMAA correction at first follow-up and final follow-up, compared with MTP fusion and distal metatarsal osteotomies. Other radiographic measures showed no significant difference among the groups.

Level of Evidence:

Level III: Retrospective cohort study
The history of oral decitabine/cedazuridine and its potential role in acute myeloid leukemia
Authors: Briski Robert , Garcia-Manero Guillermo , Kantarjian Hagop , Ravandi Farhad
Published: October 2023

Decitabine, a member of the 5-azanucleosides, has a dose-dependent mechanism of action in vitro: termination of DNA replication at high doses, and inhibition of DNA methyltransferase at low doses. The alteration of DNA methylation patterns by low-dose decitabine is hypothesized to upregulate genes, which promote myeloblast differentiation. In a phase III clinical trial, low-dose decitabine achieved a superior overall response rate (ORR) when compared with ‘treatment choice’ [consisting of low-dose cytarabine (80%) and supportive care (20%)] as a frontline treatment for elderly patients with acute myeloid leukemia (AML). Despite an improved ORR, the median overall survival (OS) for elderly patients with AML was poor, <1 year. In turn, venetoclax was added to low-dose decitabine, the combination of which significantly improved the ORR and median OS in elderly patients with AML. Currently, hypomethylating agents are being combined with other novel therapies as investigational strategies for elderly and unfit patients with AML. They are also being evaluated as components of maintenance therapy in patients achieving remission. An oral formulation of decitabine has been developed which relies on the concomitant use of oral cedazuridine to protect against first pass metabolism. This oral formulation, which has been approved in myelodysplastic syndrome, is intended to increase convenience of use and therefore compliance in patients. This review characterizes the evolution of decitabine, its oral formulation, and its future in the treatment of AML.
Bilateral incarcerated Morgagni hernia with bowel obstruction: A case report
Authors: Nguyen Minh Thao , Pham Anh Vu
Published: October 2023

Morgagni hernia is a rare congenital diaphragmatic hernia associated with the minor retro-xiphoid region between the sternal and costal attachments. The bilateral and complicated Morgagni hernia occurred exceptionally rarely, at a rate of 4% and 6.5%. An 81-year-old woman with occasional constipation went to the emergency department for epigastric pain and vomiting 3 days before. She could no longer pass gas that caused abdominal distention. Clinical examination and ultrasound showed partial bowel obstruction, an unspecified cause. She received nil per os, nasogastric decompression. The abdominal and chest computed tomography Scan showed the bilateral diaphragmatic hernia, and the dilated loops of the cecum and ascending colon were 7 cm. She required an emergency operation to resolve the etiology of bowel obstruction. The midline incision was chosen to release the hernia contents and repair the posterior sternal defects with Polypropylene mesh. An abdominal approach can solve a bilateral incarcerated Morgagni hernia.
Mortality of neuromyelitis optica spectrum disorder patients in an Argentinean population: A study from the RelevarEM registry
Authors: Carnero Contentti Edgar , Lopez Pablo A , Pettinicchi Juan Pablo , Criniti Juan , Pappolla Agustín , Miguez Jimena , Cristiano Edgardo , Patrucco Liliana , Liwacki Susana , Tkachuk Verónica , Balbuena María E , Vrech Carlos , Deri Norma , Correale Jorge , Marrodan Mariano , Ysrraelit María C , Leguizamon Felisa , Luetic Geraldine , Menichini María L , Tavolini Darío , Mainella Carolina , Zanga Gisela , Burgos Marcos , Hryb Javier , Barboza Andrés , Lazaro Luciana , Alonso Ricardo , Fernández Liguori Nora , Nadur Débora , Alonso Serena Marina , Caride Alejandro , Paul Friedemann , Rojas Juan I
Published: October 2023

We aimed to evaluate mortality and causes of death among Argentinean neuromyelitis optica spectrum disorder (NMOSD) patients and identify predictors of death. Retrospective study included 158 NMOSD patients and 11 (7%) patients died after 11 years of follow-up for a total exposure time of 53,345 days with an overall incidence density of 2.06 × 10.000 patients/day (95% CI 1.75–2.68). Extensive cervical myelitis with respiratory failure (45%) was the most frequent cause of death. Older age (HR = 2.05, p = 0.002) and higher disability score (HR = 2.30, p < 0.001) at disease onset were independent predictors of death. We found an 11-year mortality rate of 7% in Argentinean NMOSD patients.
Development and techno-economic analysis of hybrid annuity model for highway projects of India
Authors: Sarkar Debasis , Bhatt Naimish
Published: October 2023

The hybrid annuity model is relatively new in the Indian economy as the private investors are still reluctant to adopt this public–private partnership model. This paper aims at developing and proposing a suitable hybrid annuity model for a highway project in Gujarat, India. A detailed financial analysis has been carried out to compute the net present value and internal rate of return. It has been observed that the breakeven and payback period is obtained after about 8 to 9 years. The corresponding net present value is about 28.253 million Indian rupee. The corresponding internal rate of return as observed from the analysis is about 20%. Thereby, the HAM model has been found to be techno-economically suitable and feasible for the development of new highways in Indian subcontinent particularly in the stretches of low traffic density.
Prevalence of Upper Respiratory Tract Infections Before, During, and After the COVID-19 Pandemic in Germany: A Cross-Sectional Study of 2 167 453 Outpatients
Authors: Loosen Sven H. , Plendl Wolfgang , Konrad Marcel , Tanislav Christian , Luedde Tom , Roderburg Christoph , Kostev Karel
Published: October 2023

Background:

Although the burden of the COVID-19 pandemic on global healthcare systems is declining, long-term sequelae such as long COVID syndrome and other disease dynamics not primarily associated with COVID-19 remain a challenge. Recent data suggest that the incidence of non-COVID upper respiratory tract infections (URTI) is increasing sharply in the post-pandemic period, but there is a lack of real-world data from Germany in this respect.

Methods:

This cross-sectional study evaluated the number of patients with a diagnosis of URTI from the Disease Analyzer database (IQVIA) between January 2019 and December 2022. The number of UTRI diagnoses per practice and the duration of sick leave per patient were compared over time.

Results:

A total of 1 872 935 individuals (1 403 907 patients from general practices (GP) and 469 028 patients from pediatric offices) were included, 48% of whom were female. The number of URTI patients per practice was significantly higher in 2022 than in 2019 (732 vs 464, 58%, P < .001), and this was observed for both women (56%, P < .001) and men (60%, P < .001). The post-pandemic increase in the number of URTI diagnoses correlated with age and was highest in the age group between 18 and 30 years (22%, P < .001) and lowest in older patients >70 years (3%). In pediatric patients (<18 years), the increase was highest in the age group ≤5 years (89%). Both the number of patients per practice on sick leave due to URTI (184 vs 92) and the average duration of sick leave (+2 days) increased from 2019 to 2022.

Conclusion:

Our data suggest a dramatic increase in the incidence of URTI among all demographic subgroups in Germany between 2019 and 2022, which was associated with a tremendous impact on socioeconomic variables such as the frequency or duration of sick leave. These data could be of great importance in current pandemic management and the management of future pandemics.
Promoting Women’s Empowerment: Linkages Between Financial Development, Employment and Economic Growth in Selected African Economies
Authors: Asaleye Abiola John , Strydom Kariena
Published: October 2023

Women’s empowerment (WE) is one of the main challenges to economic development in African countries. Scholars have criticized national development initiatives to focus on well-being issues and treat women as the passive beneficiaries of welfare-enhancing assistance. This study uses panel fully modified least square and vector error correction model to investigate the impact of interactive effects of WE and financial development (FD) on employment and economic growth based on the World Bank income group as follows: upper-middle-income countries (UMIC), lower-middle-income countries (LMIC), and low-income countries (LIC). The findings show that the interactive effects of WE and FD on output and employment is not significant in the long run in LMIC and LIC. Despite the significance of these interactive effects in UMIC, the coefficient is less than one. Also, the causality result in the UMIC shows feedback between WE and economic growth. And that FD has a direct influence on growth in LMIC, while WE has a direct influence on employment in LIC.
China’s Standards of English Language Ability: Voice From English Teachers at Chinese Universities
Authors: Sang Yuan
Published: October 2023

The birth of China’s Standards of English Language Ability (CSELA) marks a new era of English education in China. As the country’s first national English standard, CSELA is expected to significantly refine the current system of English assessment and further improve the quality of English education. Due to its relatively short history, there is still much unknown about the impact that CSELA may have on English teaching, learning, and testing. Therefore, this study is conducted to demonstrate how Chinese English teachers in higher education view this new standard of English. Based on semi-structured interviews with 15 university English teachers divided into three focus groups, findings demonstrate that practitioners generally hold positive attitudes toward CSELA in terms of its possible contribution to English teaching and learning. In the meantime, English teachers also share certain concerns, especially about their unpreparedness with the new standard. Finally, participants further express their needs in English teaching, as well as their desire to be more deeply involved in policy making processes. These results provide important information to enrich the field’s knowledge about CSELA. A set of implications emerge based on these findings.
Strategy-making: The use and misuse of artifacts to achieve common understanding
Authors: Friis Ole , Mathiasen John Bang
Published: October 2023

Strategists intentionally use artifacts to promote their perception of a prudent strategic choice. Separating artifacts and strategists’ intentionality blurs our understanding of how strategy-making unfolds. Our study addresses the dynamics of strategists’ intentionality and their use of artifacts in strategy-making. The study provides empirical evidence that artifacts act as stand-ins for the strategists’ intentionality, used to guide or misused to curb the strategy-making. The implications of our study contribute to the understanding that (1) we can neither assume that the individuals’ intentionality is predictable nor that the involved strategists achieve a common understanding, (2) strategist–artifact relationships are pivotal to align or misalign different strategists’ interests, (3) the mediating role of artifacts is mutable entailing strategists materializing artifacts and adding text and symbols to intentionally manage the strategy-making, and (4) strategists deliberately use many artifacts to reach the intended strategy, not necessarily implementing the optimal strategy choice.

JEL CLASSIFICATION: L190
Visualizing the Spatial Distribution of Energy Insecurity in the United States
Authors: Laird Jennifer , Cello Mateo , Mena Allen , Hernández Diana
Published: October 2023

Prior to 2020, little was known about how energy insecurity varies across U.S. states. The recent release of energy insecurity data from the Energy Information Administration facilitates the exploration of energy insecurity at the state level using the Residential Energy Consumption Survey. In this visualization, the authors use choropleth maps to show spatial variation in (1) forgoing basic necessities such as food or medicine to pay an energy bill and (2) keeping the home at an unhealthy temperature. Both are strategies used by households to prevent energy insecurity. The visualization highlights the state-level prevalence of each indicator.
The conceptual difficulties Saudi female ELL students encountered in learning algebra: A case of a college preparatory program
Authors: Eltoum Russina A
Published: October 2023

This research explores the type of conceptual difficulties that female Saudi students encounter in Introductory Algebra courses at college level and identifies pedagogical practices that might impact students’ learning of algebra. Instructional tasks were designed and implemented for 12 weeks to collect and analyze data. The research sample consisted of a study group of 28 students from an Introductory Algebra class. The findings identified and classified the types of difficulties that the students encountered and suggested instructional models to overcome or minimize them and a theme to teach and learn algebra.
National liquefaction loss database and event-level fragility functions
Authors: Chansky Alexander , Baise Laurie Gaskins , Moaveni Babak
Published: October 2023

Liquefaction can be a significant contributor to loss due to earthquakes as observed during the Canterbury earthquake sequence or the 1995 Kobe earthquake. Geospatial liquefaction models can be used to estimate liquefaction extent after an earthquake but do not estimate liquefaction damage or impact. This article presents a liquefaction loss database for the United States and event-level fragility functions (EFFs) using aggregate liquefaction hazard measures (LHMs) derived from geospatial liquefaction models. The liquefaction loss database for the United States is developed by sampling earthquakes with Magnitude > 5.0 between the years of 1964 and 2019 in the continental United States and Alaska. Within this sample of 42 earthquakes, 11 resulted in liquefaction loss. Estimates were characterized by the type of infrastructure (e.g. transportation, utilities, and buildings) and the subcategory (e.g. for buildings: residential, commercial, and public), and then loss was estimated using the 2018-equivalent US dollar amount. When possible, loss estimates were obtained directly from the literature. Within this sample of 42 earthquakes, 6 events resulted in estimated monetary losses from liquefaction damage greater than 1% of the total event loss, including one with liquefaction damage greater than 10%. Using estimates for aggregate liquefaction hazard and population exposure derived from geospatial liquefaction models as LHMs, EFFs are presented using cost-based damage state (DS) thresholds in the United States. The fragility functions also include confidence intervals representing the uncertainty in probabilities of exceeding DS thresholds. Aggregate liquefaction hazard was found to be a preferred LHM for liquefaction loss, especially when evaluating transportation and building loss. Aggregate population exposure was found to be a better LHM for utilities. In addition, a second set of EFFs is presented using an expanded international dataset and DSs which are assigned relative to overall earthquake damage rather than cost-based DSs.
Stroke in a patient of anaphylaxis—a case report and brief review
Authors: Shankar Takshak , Vempalli Nagasubramanyam , Asokan Reshma , Pillai Aadya , Infimate D. J. Lalneiruol
Published: October 2023

Background

The use of nonionic low-osmolar contrast media has significantly reduced the risk of hypersensitivity reactions. Despite this, severe reactions continue to occur unpredictably. An ischemic stroke in the setting of anaphylaxis is extremely rare.

Case report

A 64-year-old male with no prior allergies went into anaphylactic shock following the administration of iohexol which improved after treatment. He later developed a multi-territorial ischemic stroke.

Conclusion

An ischemic stroke in the setting of an anaphylaxis is a rare occurrence, which can be attributed to multiple factors in our patient.