bluuebunny/crossref_metadata_2025 huggingface dataset:
There’s no sugar-coating psychological distress and illness perceptions in gestational diabetes mellitus: depression and anxiety are associated with negative illness perceptions
Authors: Maguire Paul A , Cummings Jasmine A , Reay Rebecca E , Nolan Christopher J , Looi Jeffrey C L
Published: September 2021

Objective:

To gain an understanding of how women with gestational diabetes perceive their illness, and whether depressive/anxiety symptoms and/or psychological distress influence these illness perceptions.

Method:

A cross-sectional study was conducted with 159 pregnant women aged 18–44 attending gestational diabetes clinics. Participants completed a questionnaire, which included the Edinburgh Depression Scale (EDS), Kessler 10-item Psychological Distress Scale (K-10), Brief Illness Perception Questionnaire (BIPQ), and psychiatric/general health items. Multiple regression was used to explore the relationship between EDS (total and anxiety subscale) scores and BIPQ scores, as well as between K-10 (total and anxiety subscale) scores and BIPQ scores.

Results:

Regression analysis revealed a positive association between EDS total/anxiety subscale scores and BIPQ total score, as well as between K-10 total/anxiety subscale scores and BIPQ total score, controlling for potentially confounding variables. There was a strong positive correlation between EDS total score and K-10 total score. The most frequently expressed concern about GDM was an adverse effect on their baby’s health. A poor diet was the most frequently reported perceived ‘cause’ of GDM.

Conclusion:

Greater severity of depressive and anxiety symptoms, and psychological distress, is associated with more negative illness perceptions of GDM in pregnant women.
Supportive Care Needs: Perspectives of Cancer Patients and Healthcare Providers
Authors: Kim Wonsun , Shin Chanam , Larkey Linda , Jo Soojung , James Dara
Published: September 2021

This descriptive qualitative study was conducted to understand supportive care needs from the perspectives of cancer patients and their healthcare providers (HCPs). Data collected from a purposive sample of 15 individuals (eight cancer patients and seven HCPs) using individual semi-structured interviews (60–90 minutes) were analyzed using thematic analysis. Four themes emerged from interview data in both patients and their HCPs: (1) information and resources, (2) peer support groups, (3) support for caregivers, and (4) tailored care. These four themes were discussed with subtle differences between groups. In addition, communication with and among HCPs was discussed by patients, while survivorship was mentioned by HCPs. Findings from this study indicate that nurses and other HCPs should provide supportive care congruent with the needs, preferences, and priorities of cancer patients through active and bidirectional communication with patients as well as interdisciplinary collaboration, which may optimize patient outcomes and use of resources.
A novel approach for characterizing frozen soil damage based on mesostructure
Authors: Chen Shijie , Ma Wei , Li Guoyu
Published: September 2021

In this study, the relationship between the computed tomography (CT) number and the density of frozen soil was established on a macro and mesoscopic scale, aimed at overcoming the shortcomings of the mesoscopic damage behavior predicted by previous macroscopic research on frozen soil. In addition, considering the influence of stress level and temperature, a mesoscopic structural damage variable was proposed, which could reflect the damage characteristics of frozen soil. On this basis, combining the meso-damage of frozen soil with the macro-mechanical response, the mechanism of the damage evolution of frozen soil under stress was studied. It was found that the variation law of porosity was consistent with the law of the mesoscopic damage expansion in frozen soil. In the initial stage of stress loading, compaction was observed before meso-crack expansion. The internal structure exhibited a strengthening effect, by which the damage was reduced. The macroscopic mechanical properties were characterized by an elastic strain phase. As the stress continued to increase, an inflection point of the damage value appeared, and the damage gradually increased. The starting point of the meso-fracture expansion curve could represent the stress yield point on the macroscopic mechanical curve, and also represented the inflection point of the volume change of the material from the contraction to the dilatancy. When the damage value was gradually increased and became equal to the initial value, the deviatoric stress reached the peak of the macroscopic mechanical curve.
Walking to the Pier and Back
Authors: Stiegler Sam
Published: September 2021

This article narrativizes a walking go-along interview I, a cis white queer man, completed with JS, a Black trans young woman, while walking to the Christopher Street Pier in the West Village of New York City. The narrative form of this piece works to think against white- and cis-normative senses of time-keeping and place-making by illuminating how our bodies and social positions were perceived in relationship to each other and the environs of the go-along. While the Pier has long been an important public and community space for trans and queer Black and Latinx communities, especially young people, it has concurrently faced waves of gentrification that have made this place inhospitable to these communities. Giving an account of this walking interview through this contested area attends to JS’s experience and perception of place, community, history, and safety, including the ways it aligns and is in tension with my own and others’ experiences and perceptions of the Pier and its surroundings.
Functional relevance of macular telangiectasia (MacTel) area on multicolour imaging in type 2 MacTel
Authors: Venkatesh Ramesh , Reddy Nikitha Gurram , Agrawal Sameeksha , Pereira Arpitha , Mutalik Deepashri , Mishra Pranjal , Yadav Naresh Kumar , Chhablani Jay
Published: September 2021

Purpose:

To analyse the correlation between area of macular telangiectasia (MacTel) involvement on multicolour (MC) imaging, disease stages and visual acuity in type 2 MacTel.

Methods:

In this retrospective analysis of MC images, confirmed cases of type 2 MacTel were graded into different disease stages as per Gass and Blodi and Yannuzzi et al classification systems. The ‘MacTel area’ was calculated by marking the outer boundary of an area with abnormally increased reflectivity to confocal blue wavelength light. At every follow-up visit, best-corrected visual acuity, MacTel area and stage of disease on the MC image was documented. Analyses between disease stage, MacTel area and visual acuity was carried out.

Results:

In total, 92 eyes of 49 patients were included in the study. The mean age was 59.6 ± 8.96 years. About 182 high-quality gradable MC images were available for analysis. There was a statistically significant difference in the visual acuity ( p < 0.001) and area of involvement ( p < 0.001) in the non-proliferative and proliferative type 2 MacTel groups. An increase in disease severity stage statistically correlated positively with Mactel area ( r = 0.544; p < 0.001) and logMAR visual acuity ( r = 0.329; p < 0.001). Over time, there was a significant increase in area of MacTel involvement ( p = 0.012) with an associated decrease in the visual acuity ( p = 0.023).

Conclusion:

The MacTel area measured on MC imaging showed a strong positive correlation with disease stage and a negative correlation with visual acuity. This could serve as a useful biomarker in clinical trials and understanding the natural history of the disease.
The value of adult orthodontics: Do the public’s willingness-to-pay values reflect the profession’s?
Authors: Edwards Kathryn , Rae Jennifer , Rolland Sarah , Vernazza Christopher R.
Published: September 2021

Objective:

To explore how the public and dental professionals would value an orthodontic service for adults by eliciting their willingness-to-pay (WTP), a standardised health economics technique which quantifies ‘strength of preference’ in monetary terms. Despite increasing demand, adults in the UK are only eligible for NHS orthodontic treatment if there is severe dental health or complex multidisciplinary need. Orthodontic services are provided to children aged under 18 years who are eligible by their Index of Orthodontic Treatment Need (IOTN) score. Consequently, many adults who may have a need for treatment as determined by IOTN are unable to access this service.

Design:

Cross-sectional survey.

Setting:

General dental practices in North East England and national specialists approached through the British Orthodontic Society (BOS).

Participants:

Public participants were recruited from general dental practices. Dentists were recruited from local dental lists and members of the BOS.

Methods:

Participants were asked if they would be willing to pay to see an orthodontic service extended to all adults in England with a qualifying IOTN. Clinical photographs of three malocclusions were presented and maximum WTP in additional tax per household per year was elicited using shuffled payment cards.

Results:

A total of 205 dentists and 206 public participants were recruited. Pairwise tests showed a statistically significant difference in WTP between the public and professionals for all malocclusions, with the public giving higher valuations. In both groups, the Class III scenario elicited a higher WTP than the class I or II malocclusion. However, when all other factors were controlled for using a regression analysis, the group (public or profession) and the other variables did not significantly influence WTP.

Conclusion:

The public and professionals were willing to pay for an adult orthodontic service. Due to this variability and unpredictability the allocation of healthcare resources will remain contentious.
Oscillations, boundaries and ethical care: Social work practitioner-researcher experiences with qualitative end-of-life care research
Authors: Moon Felicity , Mooney Christine , McDermott Fiona , Poon Peter , Kissane David W
Published: September 2021

Policy and research acknowledge that the quality of end-of-life care in hospitals can be poor, with families reporting significant concerns regarding physical and psychosocial care. In order to design appropriate evidenced-based care approaches, we conducted qualitative research examining the perspectives of bereaved families of patients who received end-of-life care in our health network. This paper reports on ethical dilemmas facing practitioner-researchers conducting interviews with bereaved families. We recruited 40 bereaved family members to participate in semi-structured interviews discussing the care a loved one received while a patient under the general medicine units. Bereaved participants expressed grief, humour and anger regarding their experience, and several reported perceptions of negligent and harmful care. Irrespective of the protocols in place to mitigate distress, this posed an ethical dilemma for the practitioner-researcher as a member of the health network, who needed to balance clinical and research roles when responding to distress. The practitioner-researcher’s own bias and assumptions emerged when analysing families’ distressing recollections. More broadly, the issues discussed have clinical implications for models of hospital bereavement support. Participants’ use of photos and mementos jointly served to include the presence of the deceased in the research interview, but also highlighted the potential to utilise visual methods to examine sensitive research issues. It helps every practitioner-researcher to distinguish between research-oriented goals and clinical responsibilities to care provision as they consider their human research ethics application before beginning any research.
Child Maltreatment During COVID-19: Key Conclusions and Future Directions Based on a Systematic Literature Review
Authors: Marmor Amitai , Cohen Noa , Katz Carmit
Published: September 2021

The COVID-19 pandemic has had a far-ranging impact. As societies struggled to minimize infection, questions arose regarding the consequences for children. Initial research reported the urgent need for child protective services worldwide to adapt existing policies and practices to protect children from maltreatment during this time, which is the rationale for the current systematic literature review. This review examined studies published in peer-reviewed journals from March 2020 to October 2020 on child maltreatment (CM) in the context of COVID-19. Twenty-five manuscripts met the inclusion criteria and were predominantly from the United States, with three international studies. The majority of the studies included CM reports during COVID-19 based on official data. The results clearly demonstrated an increased risk for children alongside a worrisome international decrease in CM reports. Only two studies addressed interventions during the pandemic. The current review highlights that, along with the obligation of scholars to advance the protection of children during COVID-19, there is much that is unknown. Future studies should examine the impact of the pandemic on children and their surrounding systems as well as child protective services’ responses, which face enormous challenges during a pandemic. An additional conclusion is that, since children were not identified as a health risk group during the pandemic, their protection rights may have been jeopardized. Furthermore, the variance identified in the policies of different countries pinpoints the urgent need to establish an international protocol for protecting children from maltreatment during COVID-19, a protocol that will hopefully be a basis for policymakers worldwide.
Evaluation of VMAT Planning Strategies for Prostate Patients with Bilateral Hip Prosthesis
Authors: To David , Xhaferllari Ilma , Liu Manju , Liang Jian , Knill Cory , Nandalur Sirisha , Gustafson Gary , Lack Danielle
Published: September 2021

Purpose: In this study, we investigate linac volumetric-modulated arc therapy (VMAT) planning strategies for bilateral hip prostheses prostate patients with respect to plan quality and deliverability, while limiting entrance dose to the prostheses. Methods: Three VMAT plans were retrospectively created for 20 patients: (1) partial arcs (PA), (2) 2 full arcs optimized with 500 cGy max prostheses dose (MD), and (3) 2 full arcs optimized with max dose-volume histogram (DVH) constraint of 500 cGy to 10% prostheses volume (MDVH). PA techniques contained 6 PA with beam angles that avoid entering each prosthesis. For each patient, other than prostheses constraints, the same Pinnacle VMAT optimization objectives were used. Plans were normalized with PTV D95% = 79.2 Gy prescription dose. Organ-at-risk DVH metrics, monitor units (MUs), conformality, gradient, and homogeneity indices were evaluated for each plan. Mean entrance prosthesis dose was determined in Pinnacle by converting each arc into static beams and utilizing only control points traversing each prosthesis. Plan deliverability was evaluated with SunNuclear ArcCheck measurements (gamma criteria 3%/2 mm) on an Elekta machine. Results: MD and MDVH had similar dosimetric quality, both improved DVH metrics for rectum and bladder compared to PA. Plan complexities among all plans were similar (average MUs: 441-518). Conformality, homogeneity, and gradient indices were significantly improved in MD and MDVH versus PA ( P < .001). Gamma pass rates for MD (99.0 ± 1.2%) and MDVH (99.2 ± 0.99%) were comparable. A significant difference over PA was observed (96.8 ± 1.6%, P < .001). Field-by-field analysis demonstrated 12/20 PA plans resulted in fields with pass rates <95% versus 1/20 plans for MD and none for MDVH. Cumulative mean entrance doses to each prosthesis were 62.9 ± 17.7 cGy for MD plans and 83.4 ± 27.5 cGy for MDVH plans. Conclusion: MD and MDVH plans had improved dosimetric quality and deliverability over PA plans with minimal entrance doses (∼1% of prescription) to each prosthesis and are an improved alternative for bilateral prostheses prostate patients.
Controversial Issues Regarding Positive Bone Margins in Surgery for Diabetic Foot Osteomyelitis: A Pilot Study
Authors: Aragón-Sánchez Javier , Víquez-Molina Gerardo , López-Valverde María Eugenia
Published: September 2021

Obtaining clean margins in patients who undergo surgical treatment for diabetic foot osteomyelitis (DFO) is recommended. We hypothesize that the rate of recurrence of the infection is not associated with positive margins, even when using a short-term duration of postoperative antibiotic treatment. We conducted a retrospective pilot study of patients who underwent surgery for DFO confirmed by histopathological analysis of the resected bone from August 1, 2020, to December 1, 2020. Bone samples were taken from the proximal margins to be studied by microbiology and histopathology. Twenty-five (89.3%) patients underwent conservative surgery, and 3 (10.7%) patients underwent a minor amputation. After surgery, the antibiotics were stopped in 19 (67.9%) patients and continued in 9 (32.1%) patients for a median period of 4 days. The microbiology of the bone margins was positive in 20 (71.4%) cases, but the histopathology of the bone margins was positive in just 7 (25%) cases. Recurrence of the infection was detected in 3 (10.7%) patients. Seventeen (68%) patients with microbiological-positive margins did not have a recurrence of infection, while 3 (100%) patients had a recurrence of infection ( P = .53). Six (24%) patients among those with histopathological-positive margins did not have a recurrence of infection, and1 (33.3%) patient had a recurrence of infection ( P = 1). The recurrence of infection was low and always detected in soft tissues, including the cases with a histopathological-positive bone margin. Postoperative antibiotics were administered for a short period of time and not based on the analysis of bone margins.
A validation study on the thermal simulation of the human body-clothing-environment system through wear trials
Authors: Awais Muhammad , Krzywinski Sybille , Wölfling Bianca-Michaela , Classen Edith
Published: September 2021

The following analysis deals with the validation study for the already published thermal simulation of the human body-clothing-environment system through wear trials. Three test persons and a clothing system were selected for this study. The simulation process chain includes 3D scanning, clothing fit considering the deformation properties of fabrics, 3D analysis of air gaps between skin and clothing, and thermophysiological analysis of the human body taking into account different metabolic rates. Moreover, subjective wear trials were performed in a climatic chamber to validate the simulation results. The results show good validation for the core body and mean skin temperature, however, discrepancies were observed on comparing the local skin temperatures. The presented simulation approach offers a holistic solution for product development in the areas of sportswear, workwear, outdoor, and protective clothing.
Sound absorbing and insulating properties of natural fiber hybrid composites using sugarcane bagasse and bamboo charcoal
Authors: Sakthivel Santhanam , Senthil Kumar Selvaraj , Solomon Eshetu , Getahun Gedamnesh , Admassu Yohaness , Bogale Meseret , Gedilu Mekdes , Aduna Alemu , Abedom Fasika
Published: September 2021

This research paper reports a study on thermal and sound insulation samples developed from sugarcane bagasse and bamboo charcoal for automotive industry applications. The sugarcane bagasse and bamboo charcoal fiber is a potential source of raw material that can be considered for thermal and sound insulation applications. Natural fibers are commonly used in diverse applications and one of the most important applications is sound absorption. Natural fiber hybrid composite currently is in greater demand in industries because of their advantages such as low cost, biodegradability, acceptable physical properties, and so on. Eco-friendly sound-absorbing composite materials have been developed using bamboo charcoal and sugarcane bagasse fibers. From these fibers five types of natural fiber green composite were developed using the compression bonding technique. The natural composite noise control performance contributes to its wider adoption as sound absorbers. The sound absorption coefficient was measured according to ASTM E 1050 by the Impedance tube method. The physical properties of natural fiber composites such as thickness, density, porosity, air permeability, and thermal conductivity were analyzed for all samples in accordance with ASTM Standard. The result exposed that natural fiber green composite were absorbing the sound resistance of more than 70% and the natural fibers composites provide the best acoustic absorption properties, these composite materials have adequate moisture resistance at high humidity conditions without affecting the insulation and acoustic properties.
Exploring perceptions regarding family-based delirium management in the intensive care unit
Authors: Pandhal Jasmin Kaur , Van Der Wardt Veronika
Published: September 2021

Background

Delirium is a common complication in patients treated in the intensive care unit (ICU). Family members can help alleviate patient anxiety and may be able to aid in the management of delirium. This study aimed to explore the perceptions of former ICU patients and their families together, regarding the involvement of family in delirium management.

Method

Nine audio-recorded, semi-structured interviews took place with former ICU patients together with a family member. Participants were interviewed after their intensive care follow-up clinic appointment in an East Midlands hospital in England. Interviews were transcribed, coded and analysed using thematic analysis.

Results

Three themes were identified: ‘understanding about delirium’; ‘influencers of delirium management: family and healthcare professionals’ and ‘family-based delirium care’. Participants expressed that family have a valuable role to play in the management of delirium in the ICU. However, education and guidance is needed to support the family in how delirium can be managed and the current treatment options available. It is important for ICU staff to gain an understanding of the patient’s life and personality to personalise delirium management to the needs of the patient and their family.

Conclusion

This study found that family presence and knowledge about the patient may be beneficial to delirium management in the ICU. Further research should investigate the effectiveness of the strategies and interventions to understand their influence on delirium management in ICU patients.
Colorectal cancer during pregnancy or postpartum: Case series and literature review
Authors: Rogers Jane E , Woodard Terri L , Gonzalez Graciela MN , Dasari Arvind , Johnson Benny , Morris Van K , Kee Bryan , Vilar Eduardo , Nancy You Y. , Chang George J. , Bednarski Brian , Skibber John M. , Rodriguez-Bigas Miguel A. , Eng Cathy
Published: September 2021

Background

Colorectal cancer in young adults is on the rise. This rise combined with delayed childbearing increases the likelihood of colorectal cancer diagnosed during pregnancy or in the postpartum period.

Methods

Electronic health records were used to identify individuals with colorectal cancer in pregnancy or the postpartum period from 1 August 2007 to 1 August 2019.

Results

Forty-two cases were identified. Median age at diagnosis was 33 years. Most (93%) were diagnosed in an advanced stage (III or IV) and had left-sided colorectal cancer tumors (81%). Molecular analysis was completed in 18 (43%) women with microsatellite status available in 40 (95%). The findings were similar to historical controls. Sixty percent were diagnosed in the postpartum period. Common presenting symptoms were rectal bleeding and abdominal pain.

Conclusion

Currently there is no consensus recommendation regarding how to manage colorectal cancer during pregnancy. Given the overlapping symptoms with pregnancy, patients often present with advanced disease. We encourage all health care professionals caring for pregnant women to fully evaluate women with persistent gastrointestinal symptoms to rule out colorectal cancer.
Maturity onset diabetes of the young
Authors: Qureshi Muhammad Yassir Yaqub , Nawaz Rabia
Published: September 2021

GPs not only diagnose common metabolic and endocrine conditions, but also must recognise rare disorders and ultimately offer accurate diagnoses with appropriate investigations. In cases where treatment options exist, an early diagnosis is often crucial to the success of treatment and the possibility of reversing or stalling progressive symptoms. Maturity onset diabetes of the young (MODY) is a rare form of diabetes, which is different from type 1 and type 2 diabetes mellitus (DM) and characterised by a single gene ‘monogenic’ mutation with autosomal-dominant inheritance. It is estimated that approximately 80% of patients with MODY are initially misdiagnosed with type 1 or type 2 DM, and awareness of this condition among primary care physicians should improve diagnosis. The aim of this article is to present basic information about this rare, but rather important, genetic disorder that is linked to diabetes in younger people.
Radium-223 in combination with enzalutamide in metastatic castration-resistant prostate cancer: a multi-centre, phase II open-label study
Authors: McDermott Raymond S. , Greene John , McCaffrey John , Parker Imelda , Helanova Sylva , Baird Anne-Marie , Teiserskiene Ausra , Lim Marvin , Matthews Helen , Deignan Olwyn , Feeney John , Thirion Pierre G. , Finn Stephen P. , Kelly Paul J.
Published: September 2021

Background:

Radium-223 and enzalutamide are approved agents for patients with metastatic castration-resistant prostate cancer (mCRPC). Combining radium-223 and enzalutamide to improve outcomes is of clinical interest due to their differing modes of action and non-overlapping toxicity profiles.

Methods:

This phase II study enrolled patients with mCRPC and bone metastases. Patients received six cycles of radium-223 in combination with enzalutamide, followed by enzalutamide alone. The primary endpoint was safety for the combination; secondary endpoints included radiographic/clinical progression-free survival (PFS), PSA PFS, overall survival (OS), change in alkaline phosphatase, patient-reported pain outcomes and skeletal related events.

Results:

Forty-five patients received the combination treatment: 42 patients (93.3%) received all six cycles. Fourteen patients (31.1%) developed grade 3 or 4 toxicities, most commonly fatigue and neutropaenia. Fractures during the combination period occurred in four patients (8.9%). A further 13 patients (28.9%) developed fractures after completing combination treatment, giving a total of 17 patients (37.8%) who developed a fracture at any time on study. The median time to fracture was greater than 17.2 months [95% confidence interval (CI), 17.2–not estimable]. The median time to PSA progression was 18.1 months (95% CI, 12.68–22.60) and the median time to radiological/clinical progression was 28.0 months (95% CI, 22.54–not reached). At the primary analysis, 19 (42.2%) out of 45 patients had died with a median OS not reached (mean 34.8 months, standard error 1.4).

Conclusion:

In men with progressive mCRPC and bone metastases, the combination of radium-223 and enzalutamide was tolerable with the majority of patients completing the combination treatment. Bone fractures during the combination period were uncommon; however, we did identify a higher incidence of fractures occurring in patients after completing combination treatment. Bone health agents should be administered and bone health should be closely monitored following treatment with radium-223 and enzalutamide.
Compliance and Fidelity With an Injury Prevention Exercise Program in High School Athletics
Authors: Krug Mickey I. , Vacek Pamela M. , Choquette Rebecca , Beynnon Bruce D. , Slauterbeck James R.
Published: September 2021

Background:

Use of injury prevention programs (IPPs) by high school athletes has increased but their success in reducing injury depends on program compliance and fidelity of exercise performance.

Hypothesis:

Compliance with the 11+ IPP and exercise performance fidelity by high school athletic teams depend on sex, sport, and level of play.

Study Design:

Secondary analyses of data from a randomized controlled trial (RCT).

Level of Evidence:

Level 2.

Methods:

The 11+ IPP was implemented by 100 male and female high school athletic teams (American football, soccer, basketball, and lacrosse). Team compliance and fidelity with the program were evaluated by direct observation of warm-up routines and a weekly online survey completed by coaches. Differences in compliance and fidelity due to sport, sex, and level of play were assessed by analysis of variance.

Results:

Coaches reported that their teams performed the full IPP an average of 1.45 times per week, and 28% of observed warm-ups included all exercises in the IPP. Compliance differed by sport but not by level of play or the athletes’ sex. At the end of the season, cueing was observed 19% of the time and differed by sport. Good technique was observed 66% of the time and varied by level of play.

Conclusion:

Team compliance with the IPP varied by sport and was below the recommended number of sessions per week needed to reduce injury. Removal of implementation barriers and improved support from coaches are needed at all levels of play for IPPs to be effective.

Clinical Relevance:

Clinical and sports practitioners intending to implement an IPP at the high school level should anticipate and address barriers that affect program compliance and fidelity of exercise performance. Frequent follow-up and instruction may be necessary for successful adoption of the IPP.
Pandemics Initially Spread Among People of Higher (Not Lower) Social Status: Evidence From COVID-19 and the Spanish Flu
Authors: Berkessel Jana B. , Ebert Tobias , Gebauer Jochen E. , Jonsson Thorsteinn , Oishi Shigehiro
Published: September 2021

According to a staple in the social sciences, pandemics particularly spread among people of lower social status. Challenging this staple, we hypothesize that it holds true in later phases of pandemics only. In the initial phases, by contrast, people of higher social status should be at the center of the spread. We tested our phase-sensitive hypothesis in two studies. In Study 1, we analyzed region-level COVID-19 infection data from 3,132 U.S. regions, 299 English regions, and 400 German regions. In Study 2, we analyzed historical data from 1,159,920 U.S. residents who witnessed the 1918/1919 Spanish Flu pandemic. For both pandemics, we found that the virus initially spread more rapidly among people of higher social status. In later phases, that effect reversed; people of lower social status were most exposed. Our results provide novel insights into the center of the spread during the critical initial phases of pandemics.
Digitization of Bibles in Greater China (1661–1960)
Authors: Wong Simon
Published: September 2021

Bible translations in (or for) Greater China may be classified into three categories: Chinese, Han dialects, and indigenous languages. All these language groups witness translation activities by Protestant missionaries. However, in its earliest history, Bible translation was pioneered by missionaries of Eastern Christianity in the seventh century or even earlier, whereas from the Catholic side, clear historical narrative has recorded Bible translation work in the thirteenth century by John of Montecorvino (1247–1328) into a Tatar language. Sadly, this work was not preserved. The earliest extant Bible translation in this vast area was published in 1661 in the Siriya language of Taiwan. This article reports on two major digitization projects: digitization of old Chinese Bibles (1707–1960), including 51 translations in total, and digitization of Bibles in Han dialects/fangyan and indigenous languages (1661–1960)—about 50 languages (including dialects) and 60 translations. These two projects represent the largest and most systematic full-text digitization of the Bible heritage of the area ever undertaken.
A Preliminary Investigation of School Counselors’ Attitudes and Behaviors Toward Research and Professional Information Seeking
Authors: Belser Christopher T. , Mason Erin C. M.
Published: September 2021

To investigate what school counselors read for professional information seeking and how they engage with research, we surveyed practicing school counselors about their behaviors, attitudes, and beliefs toward engaging with school counseling-related information resources. The findings highlight gaps between the usage of newer web-based resources and traditional research and identified potential incongruence between school counselors’ beliefs about engaging with research and their actual behaviors. We provide implications for school counselor training and professional development.
Emergency Room “Opt-Out” HIV Testing Pre- and During COVID-19 Pandemic in a Large Community Health System
Authors: Eckardt Paula , Niu Jianli , Montalvo Sheila
Published: September 2021

Background:

South Florida has the highest HIV rates across the country. Emergency Rooms (ERs) are optimal clinical sites for the identification of people living with HIV. We aimed to evaluate the feasibility and yield of opt-out HIV testing among ER patients in a large community healthcare system in South Florida, and determine the impact of the COVID-19 pandemic on HIV testing.

Methods:

This was a retrospective study conducted in the Memorial Healthcare System, Hollywood, Florida. HIV test was offered on an “opt-out” basis to patients aged 16 years or older presenting to the ER of the Memorial Regional Hospital between July 2018 and August 2020. Number of ER visits, HIV testing offered, acceptance of HIV testing, tested positive for HIV infection and linkage to care were reviewed and analyzed.

Results:

A total of 105,264 (53.7%) patients of 196,110 ER visits were eligible for HIV testing and 39,261 (37.3%) completed HIV testing. Of those tested, 206 (0.5%) patients tested positive, with 54 (26.2%) new infected patients and 152 (73.8%) known infected patients who had not disclosed their status. 45 (60%) of 75 patients with known HIV infections who were not engaged in HIV care were successfully relinked into care after testing, and engagement in care increased from 50.7% pre-testing to 80.3% post-testing (p = 0.001). 45 (83.3%) of 54 newly diagnosed patients were successfully linked into care. During the COVID-19 pandemic, there was a significant reduction in both the ER visits and HIV tests as compared with the pre-pandemic period (p = 0.007 and p < 0.001, respectively).

Conclusion:

An “Opt-out” HIV testing program was successfully implemented in a community hospital ERs. The use of this strategy successfully identified patients with undiagnosed HIV infection and improved their engagement in HIV care. Given the impact of COVID-19 pandemic on the testing program, new strategies should develop to reduce service disruption and maintain the progress of “Opt-out” HIV testing.
Performance and Return to Sport After Open Fracture in National Football League Players
Authors: Cotton Michael O. , Sliepka Joseph M. , Klavas Derek M. , McCulloch Patrick C. , Harris Joshua D. , Jack Robert A.
Published: September 2021

Background:

Open fractures are debilitating injuries for athletes. No prior studies have investigated open fractures in National Football League (NFL) players.

Purpose:

To compare outcomes after open fracture in NFL players in terms of (1) time to return to sport (RTS), (2) postinjury career length and games played per season, (3) postinjury performance, and (4) postinjury performance compared with matched controls.

Study Design:

Retrospective comparative series; Level of evidence, 3.

Methods:

Publicly available records were used to identify NFL players who had sustained an open fracture between 1970 and 2018. Controls were matched to injured players by age, experience, position, and preinjury performance. RTS was defined as playing in at least 1 NFL game after open fracture. Comparisons between injured and control players were made using the paired-samples Student t test.

Results:

Injuries in 37 players were analyzed (age, 27.2 ± 3.6 years; experience, 4.4 ± 3.6 seasons).  The 3 most common locations for open fracture were the tibia/fibula (n = 16), hand/finger (n = 12), and forearm/wrist (n = 3). A total of 30 (81%) players had a mean time of RTS of 9.3 ± 8.2 months after open fracture; of these players, 4 (13.3%) who sustained hand/finger open fracture did not undergo surgical treatment. There was no difference in postinjury career length or games played per season between control and injured players. Postinjury performance was similar to preinjury performance in injured players, and postinjury performance scores were similar between injured and control players. There were significant differences between players who sustained upper extremity and lower extremity open fractures in RTS time (4.0 ± 4.8 vs 14.6 ± 7.4 months, respectively; P = .00007) and postinjury performance (6.4 ± 4.3 vs 3.3 ± 2.1, respectively; P = .03).

Conclusion:

RTS after open fracture among NFL players was high. Players who sustained an open fracture had similar games played per season, career length, and performance compared with matched controls. Players who sustained an upper extremity open fracture had a faster RTS time, higher RTS rate, and improved postinjury performance compared with players who sustained a lower extremity open fracture.
Association Between Comorbid Depression and Rates of Postoperative Complications, Readmissions, and Revision Arthroscopic Procedures After Elective Hip Arthroscopy
Authors: Freshman Ryan D. , Salesky Madeleine , Cogan Charles J. , Lansdown Drew A. , Zhang Alan L.
Published: September 2021

Background:

Depression and related psychiatric diagnoses are common in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). The effects of depression on postoperative complications, readmissions, and additional ipsilateral hip surgery are not well studied.

Hypothesis:

Patients with preoperative depression who undergo hip arthroscopy for FAIS would experience higher rates of 90-day postoperative complications and readmissions, with an increased risk of additional ipsilateral hip procedures, as compared with patients without depression.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective cohort study between 2010 and 2019 was performed using the Mariner/PearlDiver database. Current Procedural Terminology and International Classification of Diseases codes were used to compare patients with and without preexisting depression who underwent hip arthroscopy for FAIS. Patients were matched at a 1:1 ratio based on age, sex, Charlson Comorbidity Index, body mass index, and tobacco use. Patients undergoing shoulder or knee arthroscopy were also identified to compare lifetime preoperative depression prevalence amongst groups.

Results:

The lifetime preoperative depression prevalence was significantly higher in patients undergoing hip arthroscopy as compared with patients undergoing shoulder or knee arthroscopy (25.4% vs 22.2% vs 19.8%; P < .001). When compared with the patients without depression, patients with preoperative depression had higher rates of 90-day readmissions (2.4% vs 1.5%) and complications, including urinary tract infection (36.2% vs 28.9%), pneumonia (12.9% vs 9.1%), hematoma formation (3.1% vs 1.9%), acute kidney injury (4.0% vs 2.6%), deep venous thrombosis/pulmonary embolism (2.6% vs 1.7%), and superficial infection (4.9% vs 2.8%; P < .01 for all comparisons). Preoperative depression was associated with significantly higher odds of undergoing revision hip arthroscopy within 2 years (6.3% vs 2.4%; P < .001).

Conclusion:

Patients with preexisting depression experienced higher rates of 90-day postoperative complications and hospital readmissions after elective hip arthroscopy for FAIS and were more likely to undergo revision hip arthroscopy within 2 years of the index procedure.
Cross-analysis for the assessment of urban environmental quality: An interdisciplinary and participative approach
Authors: Sinda Haouès-Jouve , Aude Lemonsu , Benoit Gauvrau , Alexandre Amossé , Arnaud Can , Bertrand Carrissimo , Noémie Gaudio , Julia Hidalgo , Claudia Lopez-Rieu , Delphine Chouillou , Isabelle Richard , Luc Adolphe , Isabelle Berry-Chikhaoui , Julien Bouyer , Samuel Challéat , Cécile De Munck , Elisabeth Dorier , Gwenael Guillaume , Sophie Hooneart , Julien Le Bras , Dominique Legain , Jean-Pierre Levy , Valéry Masson , Solène Marry , Danny Nguyen-Luong , Juan-Carlos Rojas-Arias , Gao Zhenlan
Published: September 2021

The goal of this research is to assess environmental quality at the neighbourhood level through a multi-dimensional and multi-sensory approach that combines social and physical methodologies. For this purpose, an interdisciplinary protocol has been designed to simultaneously collect physical parameter measurements (related to microclimate and acoustics) and survey data on perceptions (involving residents and non-residents). The cross-referenced analysis of data collected at six contrasting places in a district in Toulouse (France) enabled us (i) to better understand and prioritise the factors that influence residents' assessment of the quality of their living environment and (ii) to understand to what extent the differentiation of the places by the inhabitants converges with the differentiation of these places based on acoustic and micrometeorological measurements. The statistical analysis based on individuals showed the importance of noise and air quality that rank just after the aesthetic dimension for all respondents. Nevertheless, the quality of maintenance and the feeling of security that the place inspires seem to be as crucial as these environmental criteria for the inhabitants. The analysis focused on the sites highlighted the consistency between the typology of places based on perceptions and that based on acoustic measurements, which confirms the high inhabitants' sensitivity to this environmental component.
Rapid earthquake loss assessment based on machine learning and representative sampling
Authors: Stojadinović Zoran , Kovačević Miloš , Marinković Dejan , Stojadinović Božidar
Published: September 2021

This article proposes a new framework for rapid earthquake loss assessment based on a machine learning damage classification model and a representative sampling algorithm. A random forest classification model predicts a damage probability distribution that, combined with an expert-defined repair cost matrix, enables the calculation of the expected repair costs for each building and, in aggregate, of direct losses in the earthquake-affected area. The proposed building representation does not include explicit information about the earthquake and the soil type. Instead, such information is implicitly contained in the spatial distribution of damage. To capture this distribution, a sampling algorithm, based on K-means clustering, is used to select a minimal number of buildings that represent the area of interest in terms of its seismic risk, independently of future earthquakes. To observe damage states in the representative set after an earthquake, the proposed framework utilizes a local network of trained damage assessors. The model is updated after each damage observation cycle, thus increasing the accuracy of the current loss assessment. The proposed framework is exemplified using the 2010 Kraljevo, Serbia earthquake dataset.
Modeling IKZF1 lesions in B-ALL reveals distinct chemosensitivity patterns and potential therapeutic vulnerabilities
Authors: Rogers Jason H. , Gupta Rohit , Reyes Jaime M. , Gundry Michael C. , Medrano Geraldo , Guzman Anna , Aguilar Rogelio , Conneely Shannon E. , Song Tidie , Johnson Cade , Barnes Sean , Cristobal Carlo D.D. , Kurtz Kristen , Brunetti Lorenzo , Goodell Margaret A. , Rau Rachel E.
Published: September 2021

IKAROS family zinc finger 1 (IKZF1) alterations represent a diverse group of genetic lesions that are associated with an increased risk of relapse in B-cell acute lymphoblastic leukemia. Due to the heterogeneity of concomitant lesions, it remains unclear how IKZF1 abnormalities directly affect cell function and therapy resistance, and whether their consideration as a prognostic indicator is valuable in improving outcome. CRISPR/Cas9 strategies were used to engineer multiple panels of isogeneic lymphoid leukemia cell lines with a spectrum of IKZF1 lesions to measure changes in chemosensitivity, gene expression, cell cycle, and in vivo engraftment that can be linked to loss of IKAROS protein. IKZF1 knockout and heterozygous null cells displayed relative resistance to a number of common therapies for B-cell acute lymphoblastic leukemia, including dexamethasone, asparaginase, and daunorubicin. Transcription profiling revealed a stem/myeloid cell–like phenotype and JAK/STAT upregulation after IKAROS loss. A CRISPR homology-directed repair strategy was also used to knock-in the dominant-negative IK6 isoform into the endogenous locus, and a similar drug resistance profile, with the exception of retained dexamethasone sensitivity, was observed. Interestingly, IKZF1 knockout and IK6 knock-in cells both have significantly increased sensitivity to cytarabine, likely owing to marked downregulation of SAMHD1 after IKZF1 knockout. Both types of IKZF1 lesions decreased the survival time of xenograft mice, with higher numbers of circulating blasts and increased organ infiltration. Given these findings, exact specification of IKZF1 status in patients may be a beneficial addition to risk stratification and could inform therapy.
Core set of patient-reported outcomes for myelodysplastic syndromes: an EUMDS Delphi study involving patients and hematologists
Authors: Stojkov Igor , Conrads-Frank Annette , Rochau Ursula , Koinig Karin A. , Arvandi Marjan , Puntscher Sibylle , van Marrewijk Corine , Fenaux Pierre , Symeonidis Argiris , Chermat Fatiha , Garelius Hege , Bowen David , Mittelman Moshe , Mora Elvira , de Witte Theo , Efficace Fabio , Siebert Uwe , Stauder Reinhard
Published: September 2021

Patient-reported outcomes (PROs) are relevant and valuable end points in the care of patients with myelodysplastic syndromes (MDS). However, a consensus-based selection of PROs for MDS, derived by both patients and hematologists, is lacking. We aimed to develop a core set of PROs for patients with MDS as part of the prospective European LeukemiaNet MDS (EUMDS) Registry. According to international guidelines, candidate PROs were identified from a comprehensive literature search of MDS studies. Overall, 40 PROs were selected and evaluated in a two-round Delphi survey by 40 patients with MDS and 38 hematologists in the first round and 38 patients and 32 hematologists in the second round. Based on an agreement scale and predefined inclusion criteria, both patients and hematologists selected “general quality of life” as a core PRO. Hematologists also selected “transfusion-dependency burden” and “ability to work/activities of daily living” as core PROs. The second Delphi round increased PRO rating agreements. Statistically significant rating differences between patients and hematologists were observed for 28 PROs (Mann-Whitney U test; P < .05) in the first round and for 19 PROs in the second round, with “disease knowledge” and “confidence in health care services” rated notably higher by patients. The overall mean PRO ratings correlation between the 2 groups was moderate (Spearman’s rank correlation coefficient = 0.5; P < .05). This first consensus on a core set of PROs jointly developed by patients and hematologists forms the basis for patient-centered care in daily practice and clinical research.