bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflation and Cross-National Homicide: Assessing Nonlinear and Moderation Effects Across 65 Countries, 1965–2015
Authors: Rennó Santos Mateus , Testa Alexander , Weiss Douglas B.
Published: January 2021

Criminologists have long speculated that economic conditions play a role in driving crime trends. Emerging research finds that inflation rates are associated with crime rates both within the United States and cross-nationally. Inflation is hypothesized to increase crime by incentivizing illegal markets and organized criminal activity and by reducing the legitimacy of social institutions. Existing research on the association between inflation and homicide rates has been limited to single-country studies or multicountry studies consisting of developed countries only. Moreover, there has been limited attention to the potential complexity of this relationship, including whether it is nonlinear, as crime rates may only increase after a certain threshold of inflation is reached, and whether the criminogenic impact of inflation may be moderated by socioeconomic development, as developing countries are anticipated to be more adversely impacted by the criminogenic influence of inflation. Drawing on a sample of 65 economically diverse countries from 1965 to 2015, we find a positive direct relationship between inflation and homicide rates, although we do not find evidence that this association is nonlinear. Finally, contrary to expectation, we find that the inflation–homicide relationship is most impactful in countries with higher levels of development. We discuss these findings in the context of cross-national predictors of crime.
Understanding Variations in the Framing of People Living With HIV: A Mixed-Methods Study of Photos in Chinese News
Authors: Dan Viorela , Ren Chunbo
Published: January 2021

We explore the framing of people living with HIV in news photos from China through two studies. Study 1 consists of a Q-sort exercise and post-sorting qualitative interviews with 10 Chinese individuals. Insights are used to develop operational definitions of visual frames for use in Study 2, a quantitative content analysis. News photos of 290 people living with HIV are analyzed in Study 2 (2000–2015). Results reveal unique features of Chinese news photos, such as blurring and pixelation despite positive framing. They also suggest variations in news framing by region (community structure).
Is the duration of castration resistance predictive for sequential treatment responses in the metastatic castration-resistant prostate cancer setting?
Authors: Dülgar Özgecan , Özyükseler Deniz Tataroğlu , Başak Mustafa , Ay Seval , Tural Deniz , Yıldırım Mahmut Emre , Gümüş Mahmut
Published: January 2021

Objective

Prostate cancer is the second leading cause of cancer death in men. Androgen deprivation therapy (ADT) has been the primary therapeutic approach for treatment of prostate cancer. However,nearly all patients develop the castration-resistant disease . We evaluated real-world data with abiraterone and enzalutamide treatment. By this data, we aimed to analyze whether that prior short response to ADT could predict response to subsequent therapy with androgen receptor axis targeted agent (ARATA).

Material and Method

We collected data from two cancer centers, 151 consecutive patients with treated abiraterone or enzalutamide in the first line of metastatic castration resistant prostat cancer (mCRPC) setting were included. The patients who received docetaxel in castration naive setting is also included. Time to castration resistance (TTCR) was defined as the duration from the initial to failure of primary ADT.

Results

Patients with treated ARATA were divided into two groups according to the time to castration resistance (TTCR). Patients who became resistant to ADT up to one year had a median PFS of 6.6 months, compared to median PFS of 13.3 months for patients who responded ADT for more than 1 year. (p = 0.002). In the post-docetaxel setting, median PFS is 12.6 months of patients with treated ARATA who had TTCR for more than one year, and median PFS is 6.6 months in those who had TTCR less than one year (p = 0.007).Univariate and multivariate analyses were performed to determine the clinical factors on ARATA outcomes. Eastern Cooperative Oncology Group (ECOG) performance status(PS), median prostate-specific antigen(PSA) and time to CRPC were significantly predicted outcomes of ARATA on multivariate analysis.

Conclusion

TTCR is also a predictor for PFS of the patients who were treated ARATA both whole cohort and post-docetaxel.
Bilateral congenital hypertropic strabismus fixus: A case report
Authors: Li Qingji , Zhou Feng , Lu Yingying
Published: January 2021

Purpose:

To report an unusual and rare case of both eyes fixed in an extreme superomedial position.

Case report:

A case of 48-year-old woman presented with both eyes fixed in an extreme superomedial position; the microcorneas were covered almost completely by the upper eyelids even when she opened her eyes. A forced duction test was performed to confirm there were severe restrictions in all directions. She underwent disinsertion of the superior and medial rectus muscle, inferior oblique muscle belly transposition and sclera fixation. At the 1-year follow-up, there was improved ocular alignment.

Conclusion:

This case may be a special form of myopic strabismus fixus. The infratemporal fossa may be a bony landmark related to the etiology of global fixation.
Goldilocks Rounding: Achieving Balance Between Accuracy and Parsimony in the Reporting of Relative Effect Estimates
Authors: Efird Jimmy T
Published: January 2021

Researchers often report a measure to several decimal places more than what is sensible or realistic. Rounding involves replacing a number with a value of lesser accuracy while minimizing the practical loss of validity. This practice is generally acceptable to simplify data presentation and to facilitate the communication and comparison of research results. Rounding also may reduce spurious accuracy when the extraneous digits are not justified by the exactness of the recording instrument or data collection procedure. However, substituting a more explicit or simpler representation for an original measure may not be practicable or acceptable if an adequate degree of accuracy is not retained. The error introduced by rounding exact numbers may result in misleading conclusions and the interpretation of study findings. For example, rounding the upper confidence interval for a relative effect estimate of .996 to 2 decimal places may obscure the statistical significance of the result. When presenting the findings of a study, authors need to be careful that they do not report numbers that contain too few significant digits. Equally important, they should avoid providing more significant figures than are warranted to convey the underlying meaning of the result.
An analytical model for open-ended squeeze film damper with a circumferential central groove
Authors: Fan Tieshu , Behdinan Kamran
Published: January 2021

In this paper, the effect of a circumferential central groove on an open-ended squeeze film damper is analytically investigated. Flow equations in both the central groove and film land are solved by applying the technique of separation of variables. Model validation is presented by a rotor-squeeze film damper test rig using a recorded squeeze film damper film pressure, where a significant improvement from a classical squeeze film damper model is shown. It is found that the central groove has a high and stable pressure region while neglecting the groove effect that would over-estimate the damping force. Both simulation and experiment show that the increase of supply flow escalates the damper pressure and it could possibly avoid the film cavitation, thus raising the squeeze film damper reaction force. In addition, the effects of different groove cross-section shapes including rectangle, square, semi-circle, and semi-ellipse are evaluated. Model sensitivity shows that the size of the central groove has more impact on the damper performance than the shape of the groove.
Understanding the effects of economic policy uncertainty on US tourism firms’ performance
Authors: García-Gómez Conrado Diego , Demir Ender , Chen Ming-Hsiang , Díez-Esteban José María
Published: January 2021

This study analyzes the impact of economic policy uncertainty (EPU) on the performance of US tourism firms using a sample of 296 publicly traded tourism companies from 2000 to 2018 with a sample of 3068 firm-year observations. Estimation results of panel regressio tests based on the system-generalized method of moments indicate that EPU has a negative impact on return on assets (ROA), return on equity (ROE), and Tobin’s Q. Our results are consistent for different variable specifications. We also find that firm size and leverage play a moderating role in the relationship between EPU and firm performance. Panel quantile regression results show that the impact of EPU on US tourism firm performance is asymmetric. Specifically, low-performing (25% quantile of ROA and ROE) firms are less affected by EPU, and for the case of Tobin’s Q, EPU does not affect firms with a high growth opportunity (100% quantile of Tobin’s Q).
Enhancing developmental–behavioral pediatric rotations by teaching residents how to evaluate autism in primary care
Authors: Hine Jeffrey F , Wagner Liliana , Goode Rachel , Rodrigues Verity , Taylor Julie Lounds , Weitlauf Amy , Warren Zachary E
Published: January 2021

Most pediatric residency programs do not provide adequate practical experiences for residents in autism-related care, with a specific dearth of training in diagnostic processes. Without this training, residents enter the primary care workforce with uncertainty surrounding implementation of standard-of-care recommendations for children with autism. Our curriculum was designed to improve upon previously passive shadowing experiences within our developmental–behavioral pediatric rotation by integrating hands-on training in within-practice diagnostic identification and care coordination. In addition to multiple web-based learning activities (including a tutorial teaching administration of an interactive assessment tool), residents were required to actively participate in autism evaluations under supervision of an attending provider. Data were collected to assess feasibility of curricular changes as well as increased comfort level across recommended practice behaviors. Regarding feasibility, 95% of residents completed training components and pre-/post-ratings indicated significant increases in comfort in identifying symptoms/risk for autism, providing feedback about diagnostic decision, and effectively connecting families with services. Outcomes suggest feasibility of model and significantly increased resident comfort level across a range of recommended practice behaviors. This project reflects a first step in advancing incorporation of autism training into pediatric residency programs.

Lay abstract

Most physician preparation programs do not provide enough practical experiences in autism-related care. This is especially true for how to assess for and diagnose autism. Without this training, many pediatricians are not well prepared to implement appropriate care for children with autism and their families. We designed a curriculum to improve training for medical residents that involved explicit hands-on training in diagnostic identification and care coordination for toddlers at risk for autism. We collected data to assess whether our enhanced curriculum led to increased comfort level across recommended practice behaviors. Almost all the residents were able to complete the training within their rotation and our surveys indicated significant increases in residents feeling more comfortable identifying symptoms of autism, providing feedback about diagnostic decisions, and effectively connecting families with services. A significant majority of residents considered it appropriate or very appropriate for children to receive a diagnosis solely from a primary care provider. Our results suggest feasibility of the enhanced model, and this project reflects the first step in advancing incorporation of autism training into pediatric residency programs.
Zombie forensics: the use of the polygraph and the integrity of the criminal justice system in England and Wales
Authors: Kotsoglou Kyriakos N.
Published: January 2021

The criminal justice system of England and Wales increasingly deploys the polygraph to extract information from released offenders. Although there is little judicial authority regarding the admissibility of polygraph evidence, we should not misinterpret silence as legal uncertainty. The paper will, first, show that the central claim for the understanding of the polygraph—i.e. the presupposition that the polygraph indicates deception—is inextricably linked to an obsolete paradigm in psychology (Introspection). Secondly, I will turn to first principles in the law of evidence, especially the general ban on opinion evidence and the requirement for scientific validity. The requirement that expert evidence has a sufficiently reliable scientific basis explains why polygraph evidence cannot be adduced at the criminal process. Thirdly, I will draw attention to the use of polygraph tests in the context of probation, pursuant to the Offender Management Act 2007. With the use of the polygraph, the criminal justice system does not only infringe the released offender’s human rights, but also fails to protect the public. The combination of inadmissibility of the polygraph in the criminal process and its use from probation services creates thus a major contradiction which is detrimental to the integrity of the legal order.
Durability of coral-reef-sand concrete beams reinforced with basalt fibre-reinforced polymer bars in seawater
Authors: Xin Wang , Jianzhe Shi , Lining Ding , Yundong Jin , Zhishen Wu
Published: January 2021

A combination of coral reef sand (CRS) concrete and fibre-reinforced polymer (FRP) bars provides an effective solution to the durability deficiency in conventional RC structures. This study experimentally investigates the durability of CRS concrete beams reinforced with basalt FRP (BFRP) bars in a simulated marine environment. Flexural tests are conducted on a total of fourteen CRS concrete beams aged in a cyclic wet-dry saline solution at temperatures of 25, 40 and 55°C. The variables comprise the types of reinforcement (steel and BFRP), the aging duration and the temperature. The failure modes, capacities, deflections and crack development of the beams are analysed and discussed. The results indicate that the ultimate load of the beams exhibits no degradation after aging, whereas the failure mode of the BFRP-CRS concrete beams transition from flexure to shear, which is caused by the degradation in the mechanical properties of the stirrups. The aged BFRP-CRS concrete beams show a substantial increase of over 70% in their initial stiffness compared with the control beams (beams without aging) and a substantial decrease in their crack width after aging due to the prolonged maturation of the concrete. Furthermore, a formula for calculating the shear capacity in the existing code is modified by a partial factor equal to 2, which can predict the capacity of a CRS concrete beam reinforced with BFRP bars in a marine environment.
Imagining daylight: Evaluating participants' perception of daylight in work environments
Authors: Sawyer Azadeh O.
Published: January 2021

This paper presents an experimental research study intended to evaluate daylight perception in work environments. The current metrics for assessing daylight in work environments involve quantifying daylight and do not provide insight into the actual appearance of the space, thus overlooking the qualitative aspects of light and their effect on occupants. Conceptual content cognitive mapping (3CM), a mixed methodology, was used to obtain participants' hierarchical knowledge structure and mental model of daylight in work environments. This method was selected to understand the end users' perception of an environment rather than measuring the physical environment. A cognitive map of 50 participants, half architects and half non-architects, was created using 3CM. The results present a list of daylight lexicon and a vast selection of concepts related to physical and psychological comfort among all participants. This experiment reveals that connectivity and emotional reactions are the two dominant underlying dimensions describing daylight in work environments. The results illustrate both similarities and disjunctions between two groups of participants regarding the selected daylight terms and characterizations. The results also indicate the need to augment current planning practices with a qualitative multi-disciplinary approach to create more pleasant working environments.
Early predictors of discharge to home among severely injured geriatric patients: A single-system retrospective cohort study
Authors: Lai Krista , Anantha Ram V , Fawcett Vanessa , Tsang Bonnie , Kim Michael , Widder Sandy ,   on behalf of the Edmonton Zone Trauma and Acute Care Surgery Collaborative
Published: January 2021

Background

Injured geriatric patients experience significant functional decline during their hospitalization, limiting their ability to be discharged home which is a valuable outcome among this vulnerable population. We therefore sought to evaluate the clinical characteristics of injured elderly patients managed within our trauma system and identify early predictors for discharge to home.

Methods

In this single-system retrospective cohort study, we evaluated significantly injured (Injury Severity Score ≥12) geriatric (age ≥65 y) patients admitted from Northern Alberta between 2011 and 2016. The primary outcome was discharge disposition to home. Data was analyzed with descriptive statistics, and univariable and multivariable logistic regression modelling. P values less than 0.05 were considered statistically significant.

Results

We identified 1548 patients with a median age of 77. Falls accounted for 47% of injuries with median injury severity score of 22; 47% of patients were discharged home with a median hospital length of stay of 8 days. All-cause in-hospital mortality was 19%. On multivariable regression, age, injury severity score, heart rate, systolic blood pressure, and Glasgow Coma Score were independent predictors for discharge home, as well as hospital and intensive care unit length of stay.

Conclusion

Nearly half of severely injured geriatric trauma patients were discharged home. The identified predictors provide clues to disposition on admission that trauma providers may use to guide in-hospital care planning, disposition planning, and stimulate early goals of care discussions.
‘Forced to report’: Affective proximity and the perils of local reporting on Syria
Authors: Al-Ghazzi Omar
Published: January 2021

Based on interviews with Syrian media practitioners, this article uses the notion of affective proximity to make sense of local media practitioners’ reporting and witnessing of suffering in their country and community. I argue that the life-risking, and sometimes deadly, media practices of local reporters and witnesses, as well as their emotional labour, often do not feature in understandings of journalism when it is conceived as a purely professional discursive pursuit. I explain affective proximity in terms of an imagined space (or the lack thereof) between a media practitioner, on the one hand, and the event they are representing and participating in, on the other. In relation to Syria, I use it to analyse the word ‘revolution’ and what it mediates, the shifting boundaries between activism and journalism, and experiences of, and in, violence. I make the case that the study of affect and emotion in global news should be contextualized within the unequal power relations that give shape to journalistic roles and modes of representaiton.
Media’s portrayal of CAM: Exploring 40 years of narratives and meanings in public discourse
Authors: Lopera-Pareja Emilia H , Cano-Orón Lorena
Published: January 2021

The media are a key element in being able to assess how the climate of public opinion regarding Complementary and Alternative Medicines (CAM) has evolved over the years. The aim of this study is to explore the variation of the media representations along 40 years (1979–2018) in Spanish newspapers to assess if the press has contributed to legitimise, delegitimise or maintain the status quo of these therapies. From quantitative and qualitative approaches, we evaluate the media attention, the narratives, linguistic terms and tone used, and the relations between them. Results indicate the media reporting on CAM has remained relatively stable during the first 37 years (1979–2015) of the study, but in the last 3 years a radical change has been observed in media attention, tone, language and arguments used. Media representations of this issue evolves from a period of low media attention (1979–2015), in which CAM was legitimised, to another period of high media attention (2016–2018), in which CAM was delegitimised.
Multivariate ordinal random effects models including subject and group specific response style effects
Authors: Schauberger Gunther , Tutz Gerhard
Published: January 2021

Common random effects models for repeated measurements account for the heterogeneity in the population by including subject-specific intercepts or variable effects. They do not account for the heterogeneity in answering tendencies. For ordinal responses in particular, the tendency to choose extreme or middle responses can vary in the population. Extended models are proposed that account for this type of heterogeneity. Location effects as well as the tendency to extreme or middle responses are modelled as functions of explanatory variables. It is demonstrated that ignoring response styles may affect the accuracy of parameter estimates. An example demonstrates the applicability of the method.
Supporting the call for improving the code of publication ethics to incorporate editorial decisions regarding the causation of harm by publication
Authors: Giele Henk P
Published: January 2021

It is argued that editors have a moral responsibility to reject submissions that they felt publication of which may cause harm. However, Ploeg and others suggest that there may exist better alternatives to rejection. He also called for the code of publication ethics to incorporate acknowledgement of the moral responsibility for the effects of publishing, define benefits and harms of publishing, and specify a range of actions an editor may take. This letter highlights a recent such rejection ostensibly made on the basis of harm, but could easily be construed as editorial bias, and supports the call for improving the code of publication ethics to guide editors and secure consistency in decisions.
Student Retention in Higher Education: Why Students Choose to Remain at University
Authors: Nieuwoudt Johanna E. , Pedler Megan L.
Published: January 2021

This research captured the voices of 578 current university students investigating whether they have considered leaving university without completing their studies, what caused them to consider leaving their studies, and explored the reasons that led them to stay. The majority of participants had considered leaving university without completing their course. Multiple factors contributed to this consideration, with family commitments, financial strain, time management, expected study load, and work commitments cited most frequently. Similarly, multiple factors influenced participants’ decision to stay at university, with students’ commitment to achieving personal and career goals, and social support received cited most frequently. Thus, for the majority of participants there were multiple factors that caused them to consider leaving university and there were multiple factors contributing to their decision to stay. This novel research contributes to the limited amount of literature that explores the reasons students stay at university despite experiencing multiple challenges.
Characterization and modeling of thermal protective fabrics under Molotov cocktail exposure
Authors: Mandal Sumit , Song Guowen , Rossi Rene M , Grover Indu B
Published: January 2021

This study aims to characterize and model the thermal protective fabrics usually used in workwear under Molotov cocktail exposure. Physical properties of the fabrics were measured; and, thermal protective performances of the fabrics were evaluated under a fire exposure generated from the laboratory-simulated Molotov cocktail. The performance was calculated in terms of the amount of thermal energy transmitted through the fabrics; additionally, the time required to generate a second-degree burn on wearers’ bodies was predicted from the calculated transmitted thermal energy. For the characterization, the parameters that affected the protective performance were identified and discussed with regards to the theory of heat and mass transfer. The relationships between the properties of the fabric systems and the protective performances were statistically analyzed. The significant fabric properties affecting the performance were further employed in the empirical modeling techniques − Multiple Linear Regression (MLR) and Artificial Neural Network (ANN) for predicting the protective performance. The Coefficient of Determination (R2) and Root Mean Square Error (RMSE) of the developed MLR and ANN models were also compared to identify the best-fit model for predicting the protective performance. This study found that thermal resistance and evaporative resistance are two significant properties (P-Values < 0.05) that negatively affect the transmitted thermal energy through the fabric systems. Also, R2 and RMSE values of ANN model were much higher (R2 = 0.94) and lower (RMSE = 37.42), respectively, than MLR model (R2 = 0.73; RMSE = 191.38); therefore, ANN is the best-fit model to predict the protective performance. In summary, this study could build an in-depth understanding of the parameters that can affect the protective performance of fabrics used in the workwear of high-risk sectors employees and would provide them better occupational health and safety.
Role of Quantitative EEG and EEG Reactivity in Traumatic Brain Injury
Authors: Wang Jian , Huang Li , Ma Xinhua , Zhao Chunguang , Liu Jinfang , Xu Daomiao
Published: January 2021

Objective

This study aimed to explore the effectiveness of quantitative electroencephalogram (EEG) and EEG reactivity (EEG-R) to predict the prognosis of patients with severe traumatic brain injury.

Methods

This was a prospective observational study on severe traumatic brain injury. Quantitative EEG monitoring was performed for 8 to 12 hours within 14 days of onset. The EEG-R was tested during the monitoring period. We then followed patients for 3 months to determine their level of consciousness. The Glasgow Outcome Scale (GOS) score was used. The score 3, 4, 5 of GOS were defined good prognosis, and score 1 and 2 as poor prognosis. Univariate and multivariate analyses were employed to assess the association of predictors with poor prognosis.

Results

A total of 56 patients were included in the study. Thirty-two patients (57.1%) awoke (good prognosis) in 3 months after the onset. Twenty-four patients (42.9%) did not awake (poor prognosis), including 11 cases deaths. Univariate analysis showed that Glasgow coma scale (GCS) score, the amplitude-integrated EEG (aEEG), the relative band power (RBP), the relative alpha variability (RAV), the spectral entropy (SE), and EEG-R reached significant difference between the poor-prognosis and good-prognosis groups. However, age, gender, and pupillary light reflex did not correlate significantly with poor prognosis. Furthermore, multivariate logistic regression analysis showed that only RAV and EEG-R were significant independent predictors of poor prognosis, and the prognostic model containing these 2 variables yielded a predictive performance with an area under the curve of 0.882.

Conclusions

Quantitative EEG and EEG-R may be used to assess the prognosis of patients with severe traumatic brain injury early. RAV and EEG-R were the good predictive indicators of poor prognosis.
Echocardiographic assessment and critical care management of peri-partum women with unexpected left ventricular failure
Authors: Greatorex Ben , Colebourn Claire , Ormerod Oliver
Published: January 2021

Introduction

Cardiac disease remains the largest single cause of maternal death. Whilst uncommon, left ventricular failure during pregnancy and delivery can be devastating to both mother and child. Echocardiography can play a significant role in rapidly establishing a diagnosis, guiding initial therapy and then monitoring response.

Clinical vignettes

The history, presentation and management of three cases of peri-partum left ventricular failure is examined: stress cardiomyopathy in a 34 year old with twins, left ventricular dysfunction secondary to pre-eclampsia in a 22 year old with a singleton pregnancy and a true peri-partum cardiomyopathy in a 42 year old with IVF twins. The defining risk factors, presenting characteristics and echocardiographical findings for each pathology are highlighted.

Conclusion

Echocardiography is playing an increasingly important role in the immediate assessment and management of left ventricular failure. This is especially true in the peri-partum woman, where establishing the correct therapy is both challenging and crucial due to the significant cardiovascular changes that occur around the time of delivery. To this end we believe that echocardiography should be rapidly available to guide the management of these patients by a multidisciplinary team made up of obstetricians, cardiologists, anaesthetists and intensive care physicians.
Assessing the psychological impact of COVID-19 on intensive care workers: A single-centre cross-sectional UK-based study
Authors: Dykes Natasha , Johnson Oliver , Bamford Peter
Published: January 2021

Background

COVID-19 has presented a unique set of psychological stressors for healthcare professionals. There is currently a dearth of literature establishing the impact amongst intensive care workers, who may be at the greatest risk. This study aimed to establish the prevalence of anxiety, depression and post-traumatic stress disorder amongst a cohort of intensive care workers within the United Kingdom.

Methods

A questionnaire was designed to incorporate validated screening tools for depression (Patient Health Questionnaire, PHQ-9) anxiety (Generalised Anxiety Disorder Scale, GAD-7), and post-traumatic stress disorder (Impact of Event Scale–Revised, IES-R). All intensive care workers at the Countess of Chester Hospital (UK) were eligible. Data was collected between 17th June and 8th July 2020.

Results

The majority of the 131 respondents were nurses (52.7% [69/131]) or doctors (32.8% [43/141]). Almost one-third (29.8% [39/131]) reported a significant or extreme impact of COVID-19 on their mental health. In total, 16%(21/131) had symptoms of moderate depression, 11.5%(15/131) moderately severe depression and 6.1%(8/131) severe depression. Females had significantly higher mean PHQ-9 scores than males (8.8 and 5.7 respectively, p = 0.009). Furthermore, 18.3% (24/131) had moderate anxiety with 14.5% (19/131) having severe anxiety. Mean GAD-7 scores were higher amongst females than males (8.7 and 6.3 respectively, p = 0.028). Additionally, 28.2% (37/131) reported symptoms consistent with a diagnosis of PTSD (IES-R ≥ 33). Despite these findings, only 3.1% (4/131) of staff accessed trust mental health support.

Conclusion

The impact of COVID-19 on intensive care workers is significant and warrants specific focus and attention in order to preserve this key sector of the workforce.
Partnership with families in early childhood education: Exploratory study
Authors: Murphy Catherine , Matthews Jan , Clayton Olivia , Cann Warren
Published: January 2021

CHILDREN LEARN in the context of relationships with important caregivers. The early childhood education and care (ECEC) sector increasingly recognises that supporting strong relationships between families and ECEC services is a powerful way to improve children’s educational, health and wellbeing outcomes. We report findings from a study which, via online surveys and focus groups with parents and educators, sought to understand (a) parents’ experiences of collaborative practice, (b) educators’ confidence in working with families, and (c) educators’ perceptions of training needs. The results suggest families commonly feel welcomed and respected but desire improvements in educator communication. Most educators reported high confidence to share children’s progress but less confidence to greet families by name, raise or respond to parent concerns, or work with families facing significant parenting stressors. These findings indicate a need for practice support and training to improve educators’ skills and confidence in partnering with families.
Mitigation of Rebound Hyperglycemia With Real-Time Continuous Glucose Monitoring Data and Predictive Alerts
Authors: Acciaroli Giada , Welsh John B. , Akturk Halis Kaan
Published: January 2021

Background:

Excess carbohydrate intake during hypoglycemia can lead to rebound hyperglycemia (RH). We investigated associations between RH and use of real-time continuous glucose monitoring (rtCGM) and an rtCGM system’s predictive alert.

Methods:

RH events were series of sensor glucose values (SGVs) >180 mg/dL starting within two hours of an antecedent SGV <70 mg/dL. Events were characterized by their frequency, duration (consecutive SGVs >180 mg/dL × five minutes), and severity (area under the glucose concentration-time curve). To assess the impact of rtCGM, data gathered during the four-week baseline phase (without rtCGM) and four-week follow-up phase (with rtCGM) from 75 participants in the HypoDE clinical trial (NCT02671968) of hypoglycemia-unaware individuals were compared. To assess the impact of predictive alerts, we identified a convenience sample of 24 518 users of an rtCGM system without predictive alerts who transitioned to a system whose predictive alert signals an SGV ≤55 mg/dL within 20 minutes (Dexcom G5 and G6, respectively). RH events from periods of blinded versus unblinded rtCGM wear and from periods of G5 and G6 wear were compared with paired t tests.

Results:

Compared to RH events in the HypoDE baseline phase, the mean frequency, duration, and severity of events fell by 14%, 12%, and 23%, respectively, in the follow-up phase (all P < .05). Compared to RH events during G5 use, the mean frequency, duration, and severity of events fell by 7%, 8%, and 13%, respectively, during G6 use (all P < .001).

Conclusions:

Rebound hypreglycemia can be objectively quantified and mitigated with rtCGM and rtCGM-based predictive alerts.
Tranexamic Acid in Foot and Ankle Surgery: A Topical Review and Value Analysis
Authors: Johns William L. , Walley Kempland C. , Jackson Benjamin , Gonzalez Tyler A.
Published: January 2021

Tranexamic acid (TXA) has become a commonly used perioperative intervention in total joint arthroplasty, shoulder and knee arthroscopy, and spinal procedures in order to minimize blood loss, hematoma formation, hemarthrosis, and wound healing complications. There is a potential role for TXA use in foot and ankle procedures, with limited studies suggesting a potential benefit in minimizing postoperative wound complications and blood loss without an increased risk of thromboembolic events. In light of the profound clinical and financial impact of TXA use in other orthopaedic subspecialties and the early successes in foot and ankle surgery, we aim to provide more information about TXA and its use in foot and ankle surgery. Therefore, the purpose of this review is to perform a comprehensive literature review on the topic of TXA use in foot and ankle procedures in order to describe the pertinent available literature on the use of TXA in orthopaedic surgery and its implications specifically in foot and ankle surgery. It is our aim to identify potential benefits and shortcomings in the available evidence on TXA use for foot and ankle surgery in hopes to (1) best inform foot and ankle surgeons where beneficial and safe and (2) inspire further research on this topic as it relates to clinical management for foot and ankle patients.

Levels of Evidence: Level IV
The Effects of Needs for Security and Certainty on Economic Beliefs: The Role of Political Engagement and the Welfare State Model
Authors: Czarnek Gabriela , Kossowska Małgorzata
Published: January 2021

We suggest that the effects of needs for security and certainty (NSC) on economic beliefs result from potentially competing dispositional (political engagement) and contextual (the country-level political narrative around the welfare state) influences. An analysis of data from the 2016 European Social Survey ( N = 40,870) showed that at low levels of political engagement, NSC is associated with left-wing beliefs. However, at high levels of political engagement, the NSC effects are conditional on a country’s welfare state model: NSC is related to right-wing beliefs in Liberal, Continental, and Southern types, but the effects are nonsignificant in the Nordic type and the reverse under the Eastern type. Analysis of 2018 round of the same survey ( N = 45,575) corroborated the main findings (except the Southern type for which NSC effects were nonsignificant). This study advances knowledge on the psychological roots of economic beliefs and contributes to the understanding of people’s political choices.
Thailand’s new right, social cleansing and the continuing military–monarchy entente
Authors: Taylor James
Published: January 2021

The article looks at the nature of the state and society in contemporary Thailand using a comparative historical analysis. Thailand is led by an officer corps, faithful only to the monarchy regime, while the land is at the disposal of the absolute sovereign who unquestionably holds control over its terrain, resources and people. It is a mix of Siamese palingenetic ultranationalist sentiment with re-interpretations of a conservative Buddhist ideology which is based on the morality and right of the rulers to rule. To the military leaders, its general officers, the military–monarchy nexus embodies a supreme source of secular morality and power with the right to dominate and where the ends (always) justify the means. Thai society has become irreparably divided by the interests of the ruling elites, defining the exceptions and, it is argued, comparable to historical and contemporary authoritarian regimes elsewhere. The article argues that the country, led by the New Right, articulates disarming elements of semi-fascism under the military, in a compact with the interests of the monarchy.
Nikaidoh Procedure: The Wet Lab Trainee’s Perspective
Authors: Castillo Romero César , Ricciardi Gabriella
Published: January 2021

Congenital heart surgeons’ training is complex and challenging. The learning curve is long and the increasing complexity of pathologies is demanding. In order to develop adequate surgical-skill competencies, “in vivo” and simulation-based practicing are paramount. Simulation can be performed either on a computer screen or animal hearts and prosthetic models. In this article, we illustrate a porcine Wet Lab simulation for the Nikaidoh operation to point out its potential advantage to learn complex congenital surgery procedures.
Levoatriocardinal Vein With Multiple Ventricular Septal Defects and Without Left-Sided Valvular Atresia
Authors: Patel Kartik , Kakkar Deepti , Ananthnarayan Chandrasekaran , Patel Ravi , Patel Dinesh , Parmar Tarun , Mishra Amit , Gajjar Trushar
Published: January 2021

Levoatriocardinal vein without left-sided valvular atresia is rare. We hereby present an image of the levoatriocardinal vein in a patient with multiple muscular ventricular septal defect with small atrial septal defect and mitral regurgitation.
Partial Anomalous Pulmonary Venous Connection: Forty-Six Years of Follow-Up
Authors: Nielsen Anne Kathrine M. , Hjortdal Vibeke E.
Published: January 2021

Background:

Surgical repair of partial anomalous pulmonary venous connection (PAPVC) may disturb the electrical conduction in the atria. This study documents long-term outcomes, including the late occurrence of atrial tachyarrhythmia and bradyarrhythmia.

Methods:

This retrospective study covers all PAPVC operations at Aarhus University Hospital between 1970 and 2010. Outcome measures were arrhythmias, sinus node disease, pacemaker implantation, pathway stenosis (pulmonary vein(s), intra-atrial pathway, and/or superior vena cava), and mortality. Data were collected from databases, surgical protocols, and hospital records until May 2018.

Results:

A total of 83 patients were included with a postoperative follow-up period up to 46 years. Average age at follow-up was 43 ± 21 years. During follow-up, new-onset atrial fibrillation or atrial flutter appeared in four patients (5%). Sinus node disease was present in nine patients (11%). A permanent pacemaker was implanted in seven patients (8%) at an average of 12.7 years after surgery. Pulmonary venous and/or superior vena cava obstruction was seen in five patients (6%). Stenosis was most prevalent in the two-patch technique, and arrhythmia was most prevalent in the single-patch technique. Sixty-seven (81%) of 83 patients had neither bradyarrhythmias nor tachyarrhythmias or pacemaker need.

Conclusions:

This study contributes important long-term data concerning the course of patients who have undergone repair of PAPVC. It confirms that PAPVC can be operated with low postoperative morbidity. However, late-onset stenosis, bradyarrhythmias and tachyarrhythmias, and need for pacemaker call for continued follow-up.
Giant Left Atrial Appendage Aneurysm in an Infant
Authors: Rawtani Sanjog
Published: January 2021

Our division wishes to share interesting case images of a giant aneurysm of the left atrial appendage in an infant. He was asymptomatic and was diagnosed incidentally. The aneurysm was excised uneventfully. Left atrial appendage aneurysms are commonly reported in adults, but they are quite rare in the infant population.
Risk Factors for Undernutrition at Admission Among Adult Hospitalized Patients at a Referral Hospital in Indonesia
Authors: Bunawan Nur Chandra , Suseno Dwi , Dillon Drupadi H. S. , Rinaldi Ikhwan , Purnamasari Dyah
Published: January 2021

Patients with undernutrition at admission have higher risks to worsen their nutritional status, which is linked to an increase in morbidity and mortality. This study investigated the prevalence of undernutrition at admission and its associated factors. A cross-sectional study was conducted on patients aged 18 to 59 years old in Internal Medicine ward at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, between July and September 2019. Factors that might be associated with undernutrition at admission, such as age, sex, marital status, Charlson Comorbidity Index (CCI) and type of comorbidity, depression, and neutrophil–lymphocyte ratio (NLR), were assessed. Bivariate and multivariate analyses were used to determine the associated factors. Sixty hospitalized patients with median age of 42 years and 76.7% with married status joined the study. The most common reason for hospitalization was acute gastrointestinal disease with gallstones as the most common comorbidity. Undernutrition exists in 26.7% of subjects. High CCI score was observed among 11.7% subjects and half of subjects had NLR category ≥5. Bivariate analysis revealed that unmarried status, age ≥40 years, and malignancy were associated with undernutrition at admission. Logistic regression analysis showed malignancy as an independent predictor of undernutrition during the initial hospital admission (odds ratio [OR] = 11.8; 95% confidence interval [CI]: [1.1, 125.7]). The prevalence of undernutrition at admission was 26.7%. Factors associated with an increased prevalence of undernutrition at admission were age <40 years, unmarried status, and malignancy. Malignancy was an independent factor of the prevalence of undernutrition at admission.
Minimum 2-Year Analysis of S2-Alar-Iliac Screw Fixation for Adult Spinal Deformity
Authors: Ha Alex S. , Hong Daniel Y. , Luzzi Andrew J. , Coury Josephine R. , Cerpa Meghan , Sardar Zeeshan , Lenke Lawrence G.
Published: January 2021

Study Design:

Retrospective cohort.

Objective:

Determine the rate and risk factors for S2AI screw-related pain after adult spinal deformity surgery with a minimum 2-year follow-up.

Methods:

A consecutive 83 spinal deformity patients undergoing surgical treatment between August 2015 and December 2017 with minimum 2-year follow-up for S2AI screw complication and screw-related pain were included. Linear regression was performed on various risk factors and postoperative S2AI screw-related pain. Subset analysis of 53 patients was performed on preoperative and postoperative SRS and ODI scores, operative data, and radiographic data.

Results:

The overall proportion of S2AI screw-related pain was 9.6%. An S2AI screw complication was identified radiographically in 10.8% of patients; among these, 22.2% experienced S2AI screw-related pain. 3.4% of all patients underwent S2A1 screw removal. The SRS, ODI, sagittal vertical axis (SVA), and coronal alignment scores/measurements improved following treatment in all patients. However, the mean difference for the pre and postoperative SRS function score (1.2 ± 0.5 vs 0.9 ± 0.8) and SVA (4.0 ± 4.9 cm vs 2.1 ± 4.8 cm) were higher for the pain group.

Conclusions:

A minimum 2-year analysis of S2AI screw fixation in adult spinal deformity patients showed that 9.6% of patients experienced S2AI screw-related pain and 3.4% of patients had S2A1 screws removed. The size and the number of S2AI screws did not predict postoperative pain, nor were radiographic findings correlated with clinical outcomes. The patient outcome scores, coronal alignment, and SVA improved for all patients, but within the pain group there was an overall larger change in the SVA and SRS function score.
Effectiveness of duloxetine on severity of pain and quality of life in chronic low back pain in patients who had posterior spinal fixation
Authors: Samadi Arezoo , Salehian Razieh , Kiani Danial , Jolfaei Atefeh Ghanbari
Published: January 2021

Background:

In this study, we want to search the effectiveness of Duloxetine on the severity of pain and quality of life in patients with chronic low back pain who had posterior spinal fixation.

Methods:

In this randomized, placebo-controlled trial done in 6 months 50 patients who had CLBP and were candidates for PSF surgery selected and divided into two groups (drug and placebo). They filled the VAS, SF-36, and Hamilton questionnaires before surgery and after 6 weeks from using 30 mg of duloxetine or placebo.

Results:

Significant differences were evidenced among groups for the Visual Analogue Scale (P = 0.005) and Verbal Analogue Scale (p = 0.003). Patients in the Duloxetine group have more visual and verbal pain scores than the placebo group. In the quality of life, there was a significant difference between the two groups before the intervention. Also, significant differences were evidenced among groups for the Hamilton Anxiety Rating Scale (p = 0.17). After the intervention, only the Hamilton Anxiety Rating Scale (p = 0.001) and ‘bodily pain’ and ‘general health’ subscales of quality of life (p = 0.008, 0.004, respectively) have a significant difference between the two groups. There was a significant difference between pre and post-intervention in the Hamilton Anxiety Rating Scale only in the duloxetine group. Also, in terms of quality of life, the subscales of ‘physical role’, ‘emotional role’, ‘physical pain’ and ‘total score of quality of life’ in the duloxetine and placebo groups were significantly different between pre and post-intervention. However, the subscales of ‘physical function’ and ‘general health’ were significantly different only in the duloxetine group between pre and post-intervention.

Conclusion:

The results suggest that the use of duloxetine in patients who had spinal surgery can help to better control back pain, on the other hand, it can cause a better psychological condition that affects the quality of life.