bluuebunny/crossref_metadata_2025 huggingface dataset:
Midlevel Providers Focusing on Geriatrics Improve Care and Outcomes of Fall-Related Injuries Among the Elderly
Authors: Holt Matthew F. , Testerman George M.
Published: November 2021

Background

A rural level 1 trauma center underwent a consolidation to level III status in a new trauma network system. A dedicated group of midlevel practitioners emphasizing early mobilization, a geriatric care model, and fall prevention replaced surgical residents in the level 3 center. We hypothesized that outcomes of elderly fall-related injuries may be enhanced with midlevel providers using a geriatric-focused care model.

Methods

An IRB-approved trauma registry review of patients over 65 years of age with a fall-related injury admitted to a rural trauma center 1 year prior to and 1 year following a trauma center consolidation from level 1 to level III designation evaluated demographics, anticoagulant use, comorbidities, and clinical outcomes. Statistical analysis included t-test and regression analysis.

Results

327 patients injured by falls were seen over a 2-year study period. The number of patients admitted with a fall-related injury and the injury severity were similar over the study period. Increasing age and anticoagulant use increased length of stay and mortality (both with P < .05). Mortality rates and patient level of independence on discharge were improved in the later period involving midlevel practitioners (both with P < .05).

Discussion

Trauma centers and trauma system networks face increasing challenges to provide resources and providers of care for patients injured by falls, especially for the growing elderly population. Midlevel providers focusing on geriatric clinical issues and goals may enhance care and outcomes of elderly fall-related injuries.
How to make sense of citizen expertise in participatory projects?
Authors: Meriluoto Taina , Kuokkanen Kanerva
Published: November 2021

This article proposes a pragmatist theorising of different repertoires of valuation as an analytical grid to understand how actors of participatory projects assess the value of citizen expert participation. It conducts justification analysis on interview data from 21 projects that engage citizens as lay experts in Finland to illustrate how this analytical approach helps explain the contradicting meanings assigned to the concept as well as the resulting possibilities for participation. The article identifies two main conflicts in which different justifications for citizen expertise become explicit: debates over who can be a citizen expert and what the scope of their participation should be. Our results show how in the Finnish context, industrial justifications are often used to bolster claims for the right to participate. However, the industrial value-base is also the most reoccurring object of critique, suggested to create a narrow and above-defined role of a citizen-engineer for the citizen experts. The article illustrates how the diverse justifications might lead to contradicting constructions of citizen expertise, contributing to conflicting expectations, ambiguous and tokenistic participation, and feelings of exclusion among policy actors. It argues for justification analysis as a tool to identify and compare these undergirding valuations across policy fields and contexts.
Affiliate stigma of mental illness in family caregivers of persons with mental illness in Hong Kong
Authors: Li Xu-Hong , Deng Shu-Yu , Zhang Tian-Ming , Wang Yi-Zhou , Wei Dan-Nuo , Wong Irene Yin Ling , Chan Cecilia Lai-Wan , Ran Mao-Sheng
Published: November 2021

Background:

Affiliate stigma of family caregivers may severely influence family caregiving, early treatment, and recovery of people with mental illness (PMI), and it may be impacted by the knowledge of mental illness and contact with PMI. However, little is known about the correlation between affiliate stigma of family caregivers of PMI and contact in Hong Kong.

Aims:

This study aimed to investigate affiliate stigma and its influencing factors among family caregivers of PMI in Hong Kong.

Methods:

A total of 106 family caregivers in Hong Kong participated in the study. The measurements included affiliate stigma, contacts (quantity, quality, and level), knowledge, prejudice, and discriminatory behaviors. Multiple regression analyses were employed.

Results:

The mean score of affiliate stigma scale (ASS) in family caregivers was 2.17 ( SD = 0.65). In regression analyses, the results showed that contact quantity and contact level were significantly associated with higher affiliate stigma and its cognitive domain, while contact quality (e.g. positive contact) were significantly associated with lower affiliate stigma and its all domains among family caregivers. The positive relationship between prejudicial attitudes and affiliate stigma was also found.

Conclusions:

Affiliate stigma is severe among family caregivers of PMI in Hong Kong. The results of this study indicate that contact, especially positive contact, contributes to reducing affiliate stigma among family caregivers of PMI. The results of this study are important for development of health policy on reducing stigma in family caregivers of PMI. The effectiveness of Enhancing Contact Model (ECM) should be examined in future anti-stigma interventions.
The “Believing Woman” and Her ekklēsia: Rethinking Intersectional Households and Manuscript Variations in the Widows’ Tale (1 Tim 5:3–16)
Authors: Kartzow Marianne Bjelland
Published: November 2021

The widows of the Pastoral Epistles (1 Tim 5:3–16) have been a puzzle for interpreters for generations. In the “Widows’ Tale” different categories of women are given a whole set of instructions, including how they shall be organized and with whom to live. In this article, I will highlight the interpretative potential of the very last verse of the paragraph, where “a believing woman who has widows” is mentioned. In some important manuscripts, scribes have added “believing man” in v. 16, while others have left out the woman altogether. What can these disagreements and changes tell? I will argue that not enough scholarly attention has been directed to this verse. There is huge potential for a new understanding of the whole paragraph hidden here. Attention to alternative housing arrangements and manuscript variations will be employed as interpretative tools. I will use the disagreement among scribes to rethink variety and difference, and to reimagine ekklēsia within intersectional early Christian households.
A Bag for All Systems: Historicizing Shopping Bags in Eastern European Consumer Culture, 1980–2000
Authors: Valtin-Erwin Leah
Published: November 2021

Amidst widespread shortages in the 1980s, consumers in late communist-era Eastern Europe strategically carried shopping bags with them everywhere in case an opportunity to pick up scarce goods arose. After 1989, the routine use of reusable string shopping bags declined in favor of single-use plastic bags provided in supermarkets. Over time, however, string bags were widely reconstituted as a popular nostalgic commodity. This paralleled, in reverse, the trajectory of plastic bags, especially those bearing Western branding, which had been desired but scarce commodities in the 1980s before postcommunist reforms rendered them ubiquitous. In this article, I argue that the shopping bag’s function as both an instrument of consumption and a potential commodity in and of itself helps us better historicize how late communist shortage, the rupture of 1989, and the ensuing period of change transformed the perception and memory of the role of material objects in late twentieth-century Eastern Europe. To ascertain how their embedded meaning and social function has been constantly repurposed, I analyze representations of shopping bags in print and media culture from the 1980s and 1990s as well as nostalgic sources created more recently, alongside anecdotes and recollections in academic and commercial texts.
How to Put the Cart Behind the Horse in the Cultural Evolution of Gender
Authors: Saunders Daniel
Published: November 2021

In The Origins of Unfairness, Cailin O’Connor develops a series of evolutionary game models to show that gender might have emerged to solve coordination problems in the division of labor. One assumption of those models is that agents engage in gendered social learning. This assumption puts the explanatory cart before the horse. How did early humans have a well-developed system of gendered social learning before the gendered division of labor? This paper develops a pair of models that show it is possible for the gendered division of labor to arise on more minimal assumptions.
Ecoliteracy among Tribals in Eastern India
Authors: Majumdar Koustab , Chatterjee Dipankar
Published: November 2021

This article is based on field research investigating levels of ecoliteracy and associating factors among four tribal groups in Jharkhand and West Bengal, involving 360 respondents from the Lodha, Santhal, Asur and Oraon communities. The study revealed low to extremely high levels of ecoliteracy and identified several specific factors as significant predictors of ecoliteracy levels. While gender, occupation and total monthly income of respondents did not influence such levels, the study conclusively indicates that detachment from forest and natural resources is detrimental to the preservation and cultivation of ecoliteracy and that the connection of people and forests requires careful multidimensional attention.
Teaching What Society Needs: “Hacking” an Introductory Marketing Course With Sustainability and Macromarketing
Authors: Watson Forrest , Stanton Julie , Beninger Stefanie , Domegan Christine , Reppel Alexander , Shapiro Stanley
Published: November 2021

Marketing classes are often focused on the micro level, failing to account for wider societal issues. In this article, we argue for the inclusion of a wider macro-sustainability focus, one that “hacks” marketing education. With that objective in mind, we developed and delivered an introductory marketing course that integrated both the micro and the macro, thus infusing the course with macro-sustainability. This was done through an “expanded voice” perspective that included alternate complementary micro and macro class sessions while using a traditional managerial marketing textbook supplemented by macro-sustainability materials. We also integrated a controversies approach to support discussion and learning. We taught this course to 150 undergraduate students and conducted both quantitative and qualitative assessments of the course, including comparing results with an “unhacked” marketing course. Findings indicated increased awareness of macro-sustainability topics and movement on appreciation of sustainability and the role marketing can have in achieving this awareness. Finally, we offer a model of how marketing classes at all levels can be “hacked” with a macro-sustainability approach.
Relationships between monocyte count to high-density lipoprotein cholesterol ratio and cardiovascular outcomes in patients commencing dialysis
Authors: Kim Dongryul , Kim Da Won , Lee Yeon Hee , Park So Yeon , Song Young Woo , Shin Hyeonoh , Yoon Hye Eun , Park Hoon Suk , Choi Bum Soon , Kim Byung Soo , Ban Tae Hyun , Shin Seok Joon
Published: November 2021

Objective

High monocyte to high-density lipoprotein cholesterol ratio (MHR) is known to be a risk factor for cardiovascular (CV) complications. We aimed to evaluate the relationship between MHR and CV outcomes in patients commencing dialysis.

Methods

The medical records of patients who started maintenance dialysis between January 2006 and July 2017 were reviewed. The primary outcomes were all-cause mortality and overall CV mortality and the secondary outcomes were CV event-free survival and the incidence of CV complications.

Results

Five hundred ninety-seven patients were enrolled and allocated to low- or high-MHR groups. All-cause mortality did not differ between the groups during a mean follow-up period of 3.9 years. In addition, overall CV mortality did not differ between the groups. However, CV event-free survival was significantly lower in the high-MHR group than in the low-MHR group (47.5% vs. 59.0%). Multivariate Cox regression analysis showed that high MHR was an independent predictor of CV events (HR 1.886, 95% CI 1.015–3.505).

Conclusion

High MHR at the time of initiation of dialysis may represent a useful predictor of CV complications.
Enhanced whale optimization algorithm for sizing of hybrid wind/photovoltaic/diesel with battery storage in Algeria desert
Authors: Yahiaoui Adel , Tlemçani Abdelhalim
Published: November 2021

This paper focuses on the optimization and operation of the renewable energy power sources for electrification of isolated rural city in Algeria desert. For this purpose, a system composed by photovoltaic (PV), wind turbine (WT), diesel generator (DG), and battery bank (BB) as well as for storing the energy in the electrical form to meet the load. In the present paper we are interested in evolutionary algorithms for solving optimization problem of hybrid renewable energy system. A new meta-heuristic algorithm namely whale optimization algorithm (WOA) is used to solve optimization problem of cost of energy (COE) and total net present cost (TNPC) including reliability evaluation by using basic probabilistic concept in order to find Loss of Power Supply Probability (LPSP). The WOA mimics the social behavior of humpback whales. This algorithm is inspired by the bubble-net hunting strategy. Three recent algorithms, particle swarm optimization (PSO), grey wolf optimizer (GWO), and modified grey wolf optimizer (M-GWO) are also implemented in this work. For examining the accuracy, stability, and robustness of proposed optimization technique two case studies have been tested. The results of simulations and comparison with other methods exhibit high accuracy and validity of the proposed whale optimization algorithm to solve optimization problem of hybrid renewable energy system.
Prevalence of Mental Health and Addiction Service use Prior to and During Incarceration in Provincial Jails in Ontario, Canada: A Retrospective Cohort Study
Authors: Kurdyak Paul , Friesen Erik L , Young Jesse T , Borschmann Rohan , Iqbal Javaid , Huang Anjie , Kouyoumdjian Fiona
Published: November 2021

Objective

Individuals with mental illness and addiction are overrepresented in prisons. Few studies have assessed mental health and addiction (MHA)-related service use among individuals experiencing incarceration using health administrative data and most focus on service use after prison release. The objective of this study was to determine the prevalence of MHA-related service use in the 5 years prior to and during incarceration.

Methods

We used linked correctional and administrative health data for people released from Ontario provincial jails in 2010. MHA-related service use in the 5 years prior to the index incarceration was categorized hierarchically into four mutually exclusive categories based on the type of service use: psychiatric hospitalization, MHA-related emergency department (ED) visit, MHA-related outpatient visit (from psychiatrist or primary care physician), and no MHA-related service use. Demographic, diagnostic, and incarceration characteristics were compared across the four service use categories. MHA-related service use during the index incarceration was assessed by category and length of incarceration.

Results

A total of 48,917 individuals were included. Prior to incarceration, 6,116 (12.5%) had a psychiatric hospitalization, 8,837 (18.1%) had an MHA-related ED visit, and 15,866 (32.4%) had an MHA-related outpatient visit. Of the individuals with any MHA-related service prior to incarceration, 60.4% did not receive outpatient care from a psychiatrist prior to incarceration and 65.6% did not receive MHA-related care during incarceration.

Conclusion

Despite a high prevalence of mental illness and addiction among people experiencing incarceration, access to and use of MHA-related care prior to and during incarceration is poor. Increasing the accessibility and use of MHA-related services throughout the criminal justice pathway is warranted.
Improving Care in Neonatal Intensive Units During the COVID-19 Pandemic: A Survey on Electronic Health Communication
Authors: Giuseppe De Bernardo , Giuseppina Napoletano , Desiree Sordino , Angela Sodano , Maurizio Giordano , Perrone Serafina
Published: November 2021

Background: A novel virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started spreading through Italy and the world from February 2020, and the pandemic threatened the family-centred care (FCC) model used in the neonatal intensive care unit (NICU). Teleconferences and video calls were employed to keep parents in contact with their babies. This study aimed to evaluate satisfaction and stress levels between parents in the telematic family-centred care group (T-FCC) versus the FCC group and the no Family-Centred Care (N-FCC) group. Methods A prospective cohort pilot study was carried out from April to May 2020. A parental stressor scale and the NICU satisfaction questionnaire were administered to parents at the time of discharge of their newborns. Parents in T-FCC group could see their newborns via video calls, while those in the FCC and N-FCC groups were extracted from our previously published database. Results Parents in the T-FCC group were more satisfied and less stressed than those in the N-FCC group. Experiences of the mothers and fathers in the T-FCC group were similar. However, the FCC group showed the best results. Conclusion The T-FCC group showed satisfaction with the quality of information received about their babies and felt that their privacy was considered and respected by the medical staff. Parents were also less stressed because they could monitor what happens to the baby through a video, however, they could not intervene if there was a problem. Data support the use of video calls to improve insight into clinical conditions and communication between doctors, nurses, and parents during the pandemic.
Conceptualising ‘Within-Group Stigmatisation’ among High-Status Workers
Authors: Bamber Matthew , McCormack John , Lyons Brent J
Published: November 2021

This article explores the identity challenges facing teaching-only faculty (TOF), whose occupational self-perceptions are fundamentally contradicted by the way institutional others perceive them. We show how this manifests into a set of stigmatising practices and processes across two dimensions: contact (informal messaging) and contract (formal messaging). The sense of being unjustly stigmatised is amplified because the teaching-only role is generally seen as high-status by outsiders, and the work itself is relatively free from real or metaphorical dirt. Hence, we propose the concept of within-group stigmatisation. Next, we shine light on the implications of this form of occupational stigmatisation through the lens of organisational (dis)identification. In contrast to theoretical expectations, the analysis of our extensive survey and interview data shows that TOF identify with their role but disidentify with the organisation. Finally, we reflect on the importance and broader applicability of our concept of within-group occupational stigmatisation.
Parent Contributions to the Development of Political Attitudes in Adoptive and Biological Families
Authors: Willoughby Emily A. , Giannelis Alexandros , Ludeke Steven , Klemmensen Robert , Nørgaard Asbjørn S. , Iacono William G. , Lee James J. , McGue Matt
Published: November 2021

Where do our political attitudes originate? Although early research attributed the formation of such beliefs to parent and peer socialization, genetically sensitive designs later clarified the substantial role of genes in the development of sociopolitical attitudes. However, it has remained unclear whether parental influence on offspring attitudes persists beyond adolescence. In a unique sample of 394 adoptive and biological families with offspring more than 30 years old, biometric modeling revealed significant evidence for genetic and nongenetic transmission from both parents for the majority of seven political-attitude phenotypes. We found the largest genetic effects for religiousness and social liberalism, whereas the largest influence of parental environment was seen for political orientation and egalitarianism. Together, these findings indicate that genes, environment, and the gene–environment correlation all contribute significantly to sociopolitical attitudes held in adulthood, and the etiology and development of those attitudes may be more important than ever in today’s rapidly changing sociopolitical landscape.
Imaginary friend play in light of enactivism
Authors: Rucińska Zuzanna
Published: November 2021

Review of psychological data of how children engage in imaginary friend play (IFP) shows that it involves a lot of explicit embodied action and interaction with surrounding people and environments. However, IFP is still seen as principally an individualistic activity, where, in addition to those interactions, the actor has to mentally represent an absent entity in imagination in order to engage in IFP. This capacity is deemed necessary because the imaginary companion is absent or not real. This article proposes a proof of concept argument that enactivism can account for complex imaginary phenomena as imaginary friend play. Enactivism proposes thinking of IFP in a fundamentally different way, as an explicitly embodied and performative act, where one does not need to mentally represent absent entities. It reconceptualizes imagination involved in IFP as strongly embodied, and proposes that play environments have present affordances for social and normative interactions that are reenacted in IFP—there is no “absence” that needs to be mentally represented first. This article argues that IFP is performed and enacted in the world without having to be represented in the mind first, which best captures the social and interactive nature of this form of play.
Neonatal Resuscitation Guidelines—Recent Updates and Implications
Authors: Bandiya Prathik , Nanda Debasish , Bandyopadhyay Tapas
Published: November 2021

Neonatal resuscitation guidelines are based on the most recent evidence-based interventions and provide recommendation for practice. The guidelines are being updated periodically to reflect the newer evidences to improve care. The guidelines continuously look forward to improve the algorithm and make it simpler and user friendly to help the clinicians learn and practice as a team. In addition to knowledge, the need of skill development and practice has been emphasized in the recent guidelines. Recently, American Heart Association and The European Resuscitation Council have updated their guidelines on neonatal resuscitation. In this update, we have summarized the recommendations from the 2 recent guidelines on neonatal resuscitation and discussed their clinical implications in resource limited setting.
Outdoor Adventure and Experiential Education and COVID-19: What Have We Learned?
Authors: Leonard Aaron M. , Ewert Alan W. , Lieberman-Raridon Kodiak , Mitten Denise , Rabinowitz Erik , Deringer S. Anthony , Schwartz Forrest , Smith Steve , Norton Christine L. , Regentin John , Bagley Sherry , Anderson Ileana
Published: November 2021

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) now known as COVID-19 changed the world and the outdoor adventure and experiential education (OAEE) fields were not immune. These changes significantly impacted various OAEE programs in multiple ways and at different levels of intensity. Purpose: The purpose of this study was to ascertain the impacts of the COVID-19 pandemic on the OAEE fields and identify how OAEE organizations have responded to those impacts. Methodology/Approach: Using a three-phase study and a multi-method approach to data collection and analyses, respondents from 115 OAEE organizations (N=115) were asked to indicate how and in what ways their organizations have been impacted by the pandemic and in what ways their organizations have responded to those challenges. Findings/Conclusions: Many organizations responded not being ready for the impacts from the COVID-19 pandemic. Significant impacts were noted from most of the OAEE organizations responding and included closings, staff reductions, and downsizing as well as operational changes. Many organizations reported ways they are attempting to mitigate the pandemic effects. Implications: Important questions were raised in this paper as to how well prepared the OAEE fields might be for the next crisis.
Effective Small and Medium-Sized Enterprise Import Strategy: Its Drivers, Moderators, and Outcomes
Authors: Leonidou Leonidas C. , Palihawadana Dayananda , Aykol Bilge , Christodoulides Paul
Published: November 2021

The authors propose a conceptual model of the drivers, moderators, and outcomes of a firm's effective import strategy, anchored on the dynamic capabilities and industrial organization theories. Whereas the former theory explains the mechanism through which dynamic capabilities facilitate import strategy effectiveness, which boosts competitive advantage and ultimately enhances financial performance, the latter theory sets the foundation for explaining the contingency role of both competitive intensity and environmental uncertainty on translating effective import strategy into competitive advantage. The model was tested using a sample of 151 small and medium-sized British importers, with results indicating that high levels of certain dynamic capabilities of a generic (i.e., adaptive and entrepreneurial) and import-specific (i.e., source identification and market development) nature are conducive to import strategy effectiveness. Study results also revealed that import strategy effectiveness generates both a product-differentiation advantage and a low-cost advantage, although this is contingent on the degree of competitive intensity and environmental uncertainty prevailing in the importer's home market. Finally, the study confirmed that both productdifferentiation advantage and low-cost advantage have a favorable impact on the importer's financial performance.
Calcineurin Regulates Synaptic Plasticity and Nociceptive Transmission at the Spinal Cord Level
Authors: Huang Yuying , Chen Shao-Rui , Pan Hui-Lin
Published: November 2021

Calcineurin, the predominant Ca2+/calmodulin-dependent serine/threonine protein phosphatase (also known as protein phosphatase 2B), is highly expressed in immune T cells and the nervous system, including the dorsal root ganglion and spinal cord. It controls synaptic transmission and plasticity by maintaining the appropriate phosphorylation status of many ion channels present at presynaptic and postsynaptic sites. As such, normal calcineurin activity in neurons and synapses is mainly involved in negative feedback regulation in response to increased neuronal activity and intracellular Ca2+ levels. Calcineurin inhibitors (e.g., cyclosporine and tacrolimus) are widely used as immunosuppressants in tissue and organ transplantation recipients and for treating autoimmune diseases but can cause severe pain in some patients. Furthermore, diminished calcineurin activity at the spinal cord level may play a major role in the transition from acute to chronic neuropathic pain after nerve injury. Restoring calcineurin activity at the spinal cord level produces long-lasting pain relief in animal models of neuropathic pain. In this article, we provide an overview of recent studies on the critical roles of calcineurin in regulating glutamate NMDA and AMPA receptors, voltage-gated Ca2+ channels, potassium channels, and transient receptor potential channels expressed in the spinal dorsal horn and primary sensory neurons.
Comparing the effects and safety of dorzolamide hydrochloride + timolol maleate versus brimonidine after neodymium-doped yttrium aluminium garnet laser capsulotomy posterior capsule opacification
Authors: Çakmak Kaan , Erbil Hasan , Mesci Cem , Korkmaz Şafak
Published: November 2021

Aim

Posterior capsular opacification is treated using neodymium-doped yttrium aluminium garnet laser capsulotomy that leads to increased intraocular pressure. Here, we compare the effects of dorzolamide hydrochloride + timolol maleate versus brimonidine on intraocular pressure. We also investigate their side effects after neodymium-doped yttrium aluminium garnet laser capsulotomy. In these patients, there are no prior studies comparing the results of these two drugs.

Materials

Ninety patients with posterior capsule opacification contributed to the study. They received yttrium aluminium garnet laser capsulotomy. After yttrium aluminium garnet laser capsulotomy, they were randomized into three groups. Group 1 received dorzolamide hydrochloride + timolol maleate; Group 2 took brimonidine; and Group 3, the control group, took no drug. Group 1 took dorzolamide hydrochloride + timolol maleate eye drops 1 h before the procedure and on the third hour of the first day and two times per day between the second and the seventh days. Group 2 took brimonidine eye drops 1 h before the procedure and on the third hour of the first day, two times per day between the second and the seventh days.

Results

Brimonidine had a similar side effect profile to the fix combination. Intraocular pressure on the first ( p = 0.87) and third days ( p = 0.124) were similar in Group 1 (dorzolamide hydrochloride + timolol maleate), Group 2 (brimonidine) and the control group. The mean intraocular pressure value of the control group was significantly higher than Groups 1 and 2 because the anti-glaucomatous effects of the drugs become prominent on the seventh day ( p = 0.041). In Group 1 and Group 2, intraocular pressure was significantly lower than the control group on the seventh day ( p = 0.041). Stinging, itching, hyperemia and Tyndall rates were similar in Group 1, Group 2 and the control group. Watery eyes were less common in the brimonidine group than in the dorzolamide hydrochloride–timolol maleate and the control groups on the seventh day ( p = 0.02). Brimonidine also significantly lowered the chemosis rate on the third ( p = 0.04) and seventh ( p = 0.03) days.

Conclusion

We suggest that brimonidine and a combination of dorzolamide + timolol are similarly effective at reducing eye pressure for routine cases. In cases where intraocular pressure attacks might be at higher risk, using the dorzolamide + timolol combination would be more appropriate.
Safety and efficacy of nurse led intravitreal injection service with Precivia® injection assist device
Authors: Ahmed Ibrar , Maghsoudlou Panayiotis , Hasan Hani , Abumattar Allaaeldin , Shah Nimish
Published: November 2021

Introduction

Intravitreal anti-VEGF injections are the most frequently performed outpatient procedure in the UK. Ophthalmic allied healthcare professionals are replacing medical professionals in delivering injections nationwide. The use of injection assist devices such as Precivia® has been well established and increasingly adopted to aid in their safe delivery. We present outcomes of nurse-led intravitreal injections using the Precivia® injection assist device over a five-year period in the UK.

Methods

A retrospective review was completed of all anti-VEGF intravitreal injections delivered at the Great Western Hospital between May 2015 and May 2020.

Results

Over the five-year study period, 2318 patients underwent a total of 26,923 intravitreal injections; 20,421 (75.8%) of which were delivered by appropriately trained ophthalmic nurses. The annual number of injections increased year-on-year from 2112 injections in 2015-2016 to 5410 injections in 2019-2020. The mean age of patients was 75.7±12.2 years with a female-to-male ratio was 1.17:1. Wet age-related macular degeneration represented the major indication for injections followed by retinal vein occlusion and diabetic maculopathy respectively. Three cases of post-injection endophthalmitis out of 20,421 (0.015%) injections in nurse injection group were identified during the study period. There were no cases of lens touch, retinal detachment or systemic thromboembolic events.

Conclusion

Use of the Precivia® intravitreal injection assist device by trained ophthalmic allied health professionals is a safe and cost-effective way to deliver intravitreal injections service.
Telehealth impact on biomedical, psychosocial, and behavioural outcomes in patients with diabetes older than 50 years: A systematic synthesis without meta-analysis
Authors: Kaveh Mohammad Hossein , Faradonbeh Maryam Rabiey , Kaveh Sara
Published: November 2021

Background

Elderly people with diabetes are among high-risk groups that require more attention. With the increasing use of technology in healthcare, much emphasis has been placed on telehealth because of its potential to reduce unnecessary healthcare services consumption. We aimed to review and analyse the evidence of various interventions on the effect of using telehealth on biomedical, behavioural, and psychosocial outcomes in patients with diabetes over 50 years.

Methods

The search method of this systematic synthesis without meta-analysis was guided by the preferred reporting items for systematic reviews (PRISMA) and the new reporting guideline synthesis without meta-analysis (SWiM) in systematic reviews. A coherent search strategy was designed to retrieve articles in databases such as PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to June 2020. We excluded articles with eligibility criteria of the age of under 50 years old and studies conducted on patients with gestational diabetes. The outcomes were categorized into biomedical, behavioural, and psychosocial outcomes. The methodology of articles was evaluated by the Standard Cochrane Collaboration risk of bias tool in Revman 5.3 software.

Findings

Overall, 18 studies with 8273 patients with diabetes over the age of 50 were included in this systematic review. Biomedical outcomes such as blood sugar tests and cholesterol tests had significant improvement by using telehealth. Frequency of self-monitored blood glucose (SMBG) and self-efficacy were behavioural outcomes that increased by telehealth utilization. Telehealth had a positive impact on psychosocial outcomes like depression, quality of life (QoL), cognitive decline, and social support.

Interpretation

Telehealth has the ability to improve multiple outcomes such as behavioural and psychosocial outcomes in health services consumers. Due to varied telehealth interventions and follow-up durations, firm conclusions cannot be reached. As the research investigations studied in the present study were of different kinds and had used different follow-up periods, there is a need for further rigorous studies which consider socio-economic, cultural, and clinical differences.
Effect of carbon nanotubes on microhardness and adhesion strength of high-velocity oxy-fuel sprayed NiCr–Cr3C2 coatings
Authors: Kuruba Manjunatha , Gaikwad Giridhara , Natarajan Jegadeeswaran , Koppad Praveennath G
Published: November 2021

NiCr–Cr3C2 coatings are widely used for high temperature and tribological applications due to their high hardness, oxidation, and wear resistance properties. In the present investigation, an attempt is made to further enhance the hardness and adhesion strength of NiCr–Cr3C2 coatings by reinforcing them with multi-walled carbon nanotubes. The carbon nanotubes (3–7 wt%) with varying weight percentages were mixed with NiCr–Cr3C2 using a planetary ball rolling mill and sprayed on SA213 T12 (T12 alloy steel tube) using a high-velocity oxy-fuel spraying process. The microstructures of mixed powder, coating cross-section, and fractured coating surface were characterized using a scanning electron microscope while X-ray diffraction was used for phase identification in the fractured coating surface. The coated samples were subjected to microhardness and adhesion strength tests according to ASTM E384 and ASTM D4541-09 standards. Out of all coatings, NiCr–Cr3C2/7% carbon nanotube composite coating showed the lowest porosity of 1.17%, highest microhardness, and adhesion strength of 563.8 HV and 55.8 MPa, respectively. A fracture analysis after a pull-off adhesion test revealed adhesion failure for NiCr–Cr3C2 coating and combined adhesion/cohesion failure for NiCr–Cr3C2/7% carbon nanotube composite coating.
Significance of Neutrophil to Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Diabetic Foot Ulcer and Potential New Therapeutic Targets
Authors: Serban Dragos , Papanas Nikolaos , Dascalu Ana Maria , Kempler Peter , Raz Itamar , Rizvi Ali A. , Rizzo Manfredi , Tudor Corneliu , Silviu Tudosie Mihail , Tanasescu Denisa , Pantea Stoian Anca , Gouveri Evanthia , Ovidiu Costea Daniel
Published: November 2021

Diabetic foot ulcer (DFU) is a well-known complication of diabetes and a significant burden on the national health systems. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio are inexpensive and easily accessible biomarkers that have proved to be useful in several inflammatory, infectious and cardiovascular diseases. We carried out a comprehensive review examining the association of NLR and PLR with the onset and progression of DFU. PLR and NLR were significantly increased in patients with DFU, compared with a control group of T2DM patients without DFU, and correlate well with DFU severity, evaluated by Wagner and IWGDF grading scales. In patients with diabetic foot infections (DFI), elevated NLR and PLR were correlated with osteomyelitis, increased risk of amputation, and septic complications. The significance of the elevated value of these biomarkers in DFU is related to chronic hyperglycemia and low-grade systemic inflammation, atherosclerotic and vascular complications, and also the associated septic factor. Serial, dynamic follow-up can provide useful information in planning and monitoring DFU treatment, as well as in risk stratification of these vulnerable patients. Further randomized studies are needed to set the cut-off values with clinical significance.
Pterostilbene Inhibits the Melanogenesis Activity in UVB-Irradiated B164A5 Cells
Authors: Basri Dayang Fredalina , Lew Leong Chen , Muralitharan Raveena Vaidheswary , Nagapan Tava Shelan , Ghazali Ahmad Rohi
Published: November 2021

Pterostilbene is a potent antioxidant and anti-inflammatory agent. However, its chemopreventive effects via anti-tyrosinase activity and inhibitory effects on melanin content have not been reported previously. Hence, this study aimed to investigate the anti-melanogenic activity of pterostilbene on UVB-irradiated B164A5 mouse melanoma cells. The effects of pterostilbene and resveratrol on cell viability were determined by MTT assay, whereas melanin content and tyrosinase assay were employed to assess melanogenesis activity. Western blot analysis was performed to determine the tyrosinase expression. Based on the MTT assay, the IC50 value of pterostilbene on UVB-irradiated B164A5 cells was 34.0 ± 3.43 μM, in comparison to resveratrol (>100 μM). Next, 5 and 10 μM pterostilbene showed a significant dose-dependent inhibition ( P < .01) of tyrosinase activity in UVB-irradiated B164A5 cells at 37.14 ± 2.71% and 58.36 ± 6.8%, respectively. The findings from the tyrosinase assay also confirmed the downregulation of tyrosinase expression in UVB-irradiated B164A5 cells as measured by Western blot analysis. Finally, 10 μM pterostilbene showed a significantly decreased melanin content ( P < .01) in UVB-irradiated B164A5 cells, at 27.34 ± .98 μg/mL. In conclusion, pterostilbene showed anti-melanogenic activity that was 10 times more potent than resveratrol in the UVB-irradiated B164A5 cell.
Equality and Equity in Compensating Patient Engagement in Research: A Plea for Exceptionalism
Authors: Bélisle-Pipon Jean-Christophe , Couture Vincent , Roy Marie-Christine
Published: November 2021

Engaging citizens and patients in research has become a truism in many fields of health research. It is now seen as a laudable—if not compulsory—activity in research for yielding more impactful and meaningful citizen/patient outcomes and steering research in the right direction. Although this research approach is increasingly common and commendable, we recently encountered a major obstacle in obtaining an ethics certificate from an institutional review board (IRB) to conduct a study that places citizen/patient perspectives on equal footing with those of academic/policy experts. The obstacle was the interpretation of fairness in terms of compensation for research participation (i.e. honoraria). In terms of research ethics, this raised an important question: Should all types of participants be compensated equally, or should exceptions be made for citizen/patient participants? We argue that there are good reasons for exceptionalism and that clearer guidance on citizen/patient engagement in research should be embedded into research ethics doctrine.
Surgical lysis of nerve entrapment caused by retroperitoneal fibrosis/adhesions; two case reports and a literature review
Authors: Usta Taner , Yilmaz Salih , Topbas Selcuki Nura Fitnat , Ayhan Isil , Kale Ahmet , Oral Engin
Published: November 2021

Introduction:

Retroperitoneal fibrosis (adhesions) in the pelvic area is rare and not well known in gynecology. However, their presence can cause compression neuropathy leading to severe pain symptoms involving the lower extremities. A neuropelveological approach can be applied in dealing with such cases in diagnosis and management.

Objective:

To demonstrate neurolysis of sacral nerves in patients with retroperitoneal fibrosis (adhesions).

Case presentations:

Case 1: A 43-year-old gravidity 1 parity 1 female patient with known endometriosis presented with dysmenorrhea, dyspareunia, and left-sided sciatica. Gynecological examination revealed a rectovaginal nodule and full obliteration of pouch of Douglas. Robot-assisted laparoscopic sacral neurolysis and dissection of pouch of Douglas with rectal nodule shaving was performed. The patient was symptom free 6 months postoperatively. Case 2: A 49 years old gravidity 2 parity 2 female patient presented with severe pain on the left groin and leg, dysuria, and constipation, which required frequent manual evacuation of the feces. The begin of her symptoms coincided with a previous laparoscopic total hysterectomy, where she experienced postsurgical hemorrhage. Laparoscopic sacral neurolysis with adhesiolysis was performed. The patient was symptom free 6 months postoperatively.

Conclusion:

Pelvic retroperitoneal fibrosis (adhesions) are rarely encountered in gynecology. However, they should be included in differential diagnosis in patients presenting with pelvic pain accompanied by lower extremity pain, urinary, and/or bowel symptoms. Since presurgical diagnosis of fibrosis (adhesions) is hard with visualization techniques such as transvaginal ultrasound or magnetic resonance imaging, a thorough neuropelveological examination can be helpful in such cases.
Validation of an emotional stop-signal task to probe individual differences in emotional response inhibition: Relationships with positive and negative urgency
Authors: Allen Kenneth J. D. , Johnson Sheri L. , Burke Taylor A. , Sammon M. McLean , Wu Christina , Kramer Max A. , Wu Jinhan , Schatten Heather T. , Armey Michael F. , Hooley Jill M.
Published: November 2021

Performance on an emotional stop-signal task designed to assess emotional response inhibition has been associated with Negative Urgency and psychopathology, particularly self-injurious behaviors. Indeed, difficulty inhibiting prepotent negative responses to aversive stimuli on the emotional stop-signal task (i.e. poor negative emotional response inhibition) partially explains the association between Negative Urgency and non-suicidal self-injury. Here, we combine existing data sets from clinical (hospitalised psychiatric inpatients) and non-clinical (community/student participants) samples aged 18–65 years ( N = 450) to examine the psychometric properties of this behavioural task and evaluate hypotheses that emotional stop-signal task metrics relate to distinct impulsive traits among participants who also completed the UPPS-P ( n = 223). We specifically predicted associations between worse negative emotional response inhibition (i.e. commission errors during stop-signal trials representing negative reactions to unpleasant images) and Negative Urgency, whereas commission errors to positive stimuli – reflecting worse positive emotional response inhibition – would relate to Positive Urgency. Results support the emotional stop-signal task’s convergent and discriminant validity: as hypothesised, poor negative emotional response inhibition was specifically associated with Negative Urgency and no other impulsive traits on the UPPS-P. However, we did not find the hypothesised association between positive emotional response inhibition and Positive Urgency. Correlations between emotional stop-signal task performance and self-report measures were the modest, similar to other behavioural tasks. Participants who completed the emotional stop-signal task twice ( n = 61) additionally provide preliminary evidence for test–retest reliability. Together, findings suggest adequate reliability and validity of the emotional stop-signal task to derive candidate behavioural markers of neurocognitive functioning associated with Negative Urgency and psychopathology.
Identification and functional analysis of novel oncogene DDX60L in pancreatic ductal adenocarcinoma
Authors: Wu Hongjin , Tian Weiwei , Tai Xiang , Li Xuanpeng , Li Ziwei , Shui Jing , Yu Juehua , Wang Zhihua , Zhu Xiaosong
Published: November 2021

Background

Pancreatic ductal adenocarcinoma (PDAC) is a lethal cancer. Approximately 80% of patients initially diagnosed with locally advanced or metastatic disease survive only 4–11 months after diagnosis. Tremendous efforts have been made toward understanding the biology of PDAC.

Results

In this study, we first utilized next-generation sequencing technique and existing microarray datasets to identify significant differentially expressed genes between PDAC and non-tumor adjacent tissue. By comparing top significant survival genes in PDAC Gene Expression Profiling Interactive Analysis database and PDAC transcriptome data from patients, our integrated analysis discovered five potential central genes (i.e., MYEOV, KCNN4, FAM83A, S100A16, and DDX60L). Subsequently, we analyzed the cellular functions of the potential novel oncogenes MYEOV and DDX60L, which are highly expressed in PDAC cells. Notably, the knockdown of MYEOV and DDX60L significantly inhibited the metastasis of cancer cells and induced apoptosis. Further RNA sequencing analyses showed that massive signaling pathways, particularly the TNF signaling pathway and nuclear factor-kappa B (NF-κB) signaling pathway, were affected in siRNA-treated cancer cells. The siDDX60L and siMYEOV significantly inhibited the expression of chemokine CXCL2, which may potentially affect the tumor microenvironment in PDAC tissues.

Conclusions

The present findings identified the novel oncogene DDX60L, which was highly expressed in PDAC. Transcriptome profiling through siRNA knockdown of DDX60L uncovered its functional roles in the PDAC in humans.