bluuebunny/crossref_metadata_2025 huggingface dataset:
Infection With a Novel Rickettsiella Species in Emperor Scorpions (Pandinus imperator)
Authors: Han Sushan , Armién Aníbal G. , Hill Janet E. , Fernando Champika , Bradway Dan S. , Stringer Elizabeth , Newton Alisa L. , Huang Yanyun
Published: August 2020

Rickettsiella infection was diagnosed in 4 adult emperor scorpions ( Pandinus imperator) from 2 different collections over a 3-year period. One case had a 2-day history of weakness, failure to lift the tail, or respond to stimulation, with rapid progression to death. The other 3 cases were found dead. There were no gross lesions, but histologically the hemolymphatic vasculature and sinuses, presumed hematopoietic organ, heart, midgut and midgut diverticula, nerves, and skeletal muscle were infiltrated with phagocytic and granular hemocytes with necrosis. Phagocytic hemocytes contained abundant intracellular microorganisms that were Fite’s acid-fast-positive, Macchiavello-positive, variably gram-positive or gram-negative, and Grocott’s methenamine silver-negative. By transmission electron microscopy, hemocytes contained numerous phagocytic vacuoles with small dense bacterial forms (mean 0.603 × 0.163 μm) interspersed with large bacterial forms (mean 1.265 × 0.505 μm) and few intermediary forms with electron-dense nucleoids and membrane-bound crystalline arrays (average 4.72 μm). Transmission electron microscopy findings were consistent with bacteria of the family Coxiellaceae. Based on sequencing the 16S ribosomal RNA gene, the identity was confirmed as Rickettsiella, and phylogenetic analysis of protein-coding genes gidA, rspA, and sucB genes suggested the emperor scorpion pathogen as a new species. This study identifies a novel Rickettsiella causing infection in emperor scorpions and characterizes the unique pathological findings of this disease. We suggest this organism be provisionally named Rickettsiella scorpionisepticum.
Effectiveness of high-frequency individual reminiscence interventions using life story books on persons with dementia
Authors: Asano Tomoaki , Wang Chih-Wen , Tsugaruya Megumi , Ishikawa Takashi
Published: August 2020

Introduction

Reminiscence therapy, using life story books, is a non-pharmacological treatment and helps promote psychosocial benefits in people with dementia. This research thus aimed to determine the effects of life story books among participants with dementia of different severities.

Method

The experimental group ( n = 36) underwent three semi-structured interviews over 10 weeks. After a 2-week life story books-production interval, the experimental group received the intervention over 4 weeks, five times weekly. The following 12 weeks were the follow-up period. The control group ( n = 30) underwent the first and last assessments, with a 6-month interval, while receiving their usual care services.

Results

Participants’ cognitive functioning was mostly maintained at follow-up in the experimental group, but significantly declined in the control group. The experimental group showed no significant change in cognition among participants with severe dementia during all periods, assessed using the behavioural and psychological symptoms of dementia, and the caregivers’ burden decreased significantly from before to after the intervention.

Conclusion

These results demonstrate that life story book interventions are an effective tool in improving the relationship between caregivers and people with dementia, and could help people with dementia maintain cognitive function, even those with severe dementia.
A novel, low-cost transradial socket fabrication method using mass-producible components and expanding rigid foam
Authors: Miller Laura A , Pickerill Thomas , Kuiken Todd A
Published: August 2020

Background:

Millions of people in low- and middle-income countries lack access to prosthetic care. A well-fitting, durable socket is important for prosthesis comfort and function, but conventional fabrication techniques require highly trained clinicians and specialized equipment.

Objectives:

To increase access to prosthetic care by developing a simple, low-cost socket fabrication method that does not require specialized equipment or electricity, and can be performed by persons with minimal prosthetic training.

Study Design:

Socket fabrication methods and socket function were evaluated in a pilot feasibility study.

Technique:

We describe a rapid method for fabricating a rigid foam socket directly over the residual limb, with a mass producible, strong, cosmetically appealing plastic outer shell. We fabricated sockets for four individuals with unilateral transradial amputations and evaluated socket function.

Results:

An individual with no formal prosthetic training was able to fabricate sockets and assemble a functional, comfortable prosthesis system within 90 min. All necessary supplies can be provided in a kit for under US$100.

Discussion:

Further work is required to determine durability, assess comfort, refine suspension methods, and to develop instructional materials.

Conclusions:

We developed a simplified, inexpensive method to fabricate sockets on the residual limb using expandable foam with an integrated cosmetic/structural covering (i.e. an exoskeletal system), for persons with transradial amputation. A transradial prosthesis socket can be fabricated in around 90 min. and all necessary materials, tools, and written instructions for fabrication and fitting can be provided in a kit. Specialized equipment and electricity are not required. Instructions for fabrication and fitting can be provided in multiple languages using online videos.
Optimized calcium supplementation approach in post-dilution CVVHDF using regional citrate anticoagulation
Authors: Bi Xiao , Zhang Qi , Zhuang Feng , Lu Wei , Ding Feng
Published: August 2020

Background:

Regional citrate anticoagulation has been recommended as first choice for anticoagulation of continuous renal replacement therapy. Precise calcium supplementation is important for the safety of regional citrate anticoagulation. In this study we aimed to provide an optimized calcium supplementation approach for regional citrate anticoagulation in post-dilution continuous venous-venous hemodiafiltration.

Methods:

Twenty-seven patients receiving post-dilution continuous venous-venous hemodiafiltration anticoagulated by citrate were included in this study. The ionized calcium levels were monitored and maintained in the targeted range. After linear regression analysis of the clearance of non-protein bound calcium and calculating the ratio of the non-protein bound calcium concentration to total calcium concentration, we concluded the mathematical model for calcium supplementation.

Results:

Positive correlations were found between the clearance of non-protein bound calcium and both dialysate flow rates (r = 0.647, p < 0.001) and ultrafiltration plus substitution fluid flow rates (r = 0.525, p = 0.005). The ratio of the non-protein bound calcium concentration to total calcium concentration values at the pre-filter point after infusion of citrate were constant about 0.83. Based on the clearance and the calcium ratio, the amount of extracorporeal calcium removal can be estimated with a simplified equation.

Conclusions:

We provided an optimized calcium supplementation approach for post-dilution continuous venous-venous hemodiafiltration anticoagulated by citrate which may help to estimate the amount of extracorporeal circuit removal of calcium with regard to different dosages of regional citrate anticoagulation.
Shades of Universality: Variation of Performances in the Glocalized Israeli Human Rights Discourse
Authors: Bornstein Ben
Published: August 2020

Discursive variations of human rights are typically examined in a cross-national comparison, while usually referring to local arenas as homogeneous particularistic spaces confronting glocal uniform performances of human rights. Using a comparative analysis of six paradigmatic altruistic Israeli nongovernmental organizations (NGOs), and critically reviewing globalization and human rights literature, this study challenges the cross-national-oriented studies and the common analysis of human rights in local settings as a monolithic phenomenon. By mapping the Israeli organizational field of human rights, the study reveals substantial variations in terms of glocal identity, which allow the creation of an analytical framework for contextualizing local diversity. This diversity, as this paper shows, includes distinct models of human rights activities, which were mostly absent or dismissed as inauthentic in research thus far. The paper discusses the importance of future awareness of intranational variations, and the potential contribution this may have to the sociological understanding of current human rights institutions. Finally, the paper concludes by raising awareness to liberal normative assumptions in research, which may lead to the exclusion of alternative social phenomena from inquiry, especially in the case of moral discourses.
Politics at the Mall: The Moral Foundations of Boycotts
Authors: Fernandes Daniel
Published: August 2020

This article examines the motivations of liberals and conservatives to boycott and buycott. Nine studies demonstrate that although both liberals and conservatives engage in consumer political actions, they do so for different reasons influenced by their unique moral concerns: Liberals engage in boycotts and buycotts that are associated with the protection of harm and fairness moral values (individualizing moral values), whereas conservatives engage in boycotts and buycotts that are associated with the protection of authority, loyalty, and purity moral values (binding moral values). In addition, the individualizing moral values lead to a generally more positive attitude toward boycotts, which explains why liberals are more likely to boycott and buycott. Liberals’ greater concern for the suffering of others and unfair treatment makes them more likely to engage in consumer political actions. Conservatives, in turn, engage in consumer political actions in relatively rarer cases in which their binding moral values are affected by corporate activity.
Methodological Uncertainty and Multi-Strategy Analysis: Case Study of the Long-Term Effects of Government Sponsored Youth Training on Occupational Mobility
Authors: Droy Laurence T. , Goodwin John , O’Connor Henrietta
Published: August 2020

Sociological practitioners often face considerable methodological uncertainty when undertaking a quantitative analysis. This methodological uncertainty encompasses both data construction (e.g. defining variables) and analysis (e.g. selecting and specifying a modelling procedure). Methodological uncertainty can lead to results that are fragile and arbitrary. Yet, many practitioners may be unaware of the potential scale of methodological uncertainty in quantitative analysis, and the recent emergence of techniques for addressing it. Recent proposals for ‘multi-strategy’ approaches seek to identify and manage methodological uncertainty in quantitative analysis. We present a case-study of a multi-strategy analysis, applied to the problem of estimating the long-term impact of 1980s UK government-sponsored youth training. We use this case study to further highlight the problem of cumulative methodological fragilities in applied quantitative sociology and to discuss and help develop multi-strategy analysis as a tool to address them.
Applied systems thinking: The impact of system optimization strategies on financial and quality performance in a team-based simulation
Authors: Cady Phil
Published: August 2020

At its core, this research was undertaken to explore the extent to which system optimization leadership strategies such as innovation, collaboration, and data-driven decision-making affect financial and quality performance in organizations. A quasi-experimental pretest-posttest research design was used to examine the increase or decrease in system performance as a result of treatment in the form of a systems thinking workshop and strategy discussion. The application of three-core system strategies lead to significant gains in financial performance across all teams, and an increase in quality performance in all but one team. In addition to an increase in performance, this research also revealed the tendency of social systems to reflexively sub-optimize their performance and at times lose focus on higher order system goals. Helpful recommendations for leadership practice and future research are presented with a view to helping optimize whole systems and not solely their parts.
The preparation of chitosan membrane improved with nanoparticles based on unsaturated fatty acid for using in cancer-related infections
Authors: Kizaloglu Abdullah , Kilicay Ebru , Karahaliloglu Zeynep , Hazer Baki , Denkbas Emir Baki
Published: August 2020

This study includes the design of a chitosan membrane decorated with unsaturated fatty acid–based carrier system for cancer treatment and antibacterial application. For this, polystyrene-graft-polyoleic acid-graft-polyethylene glycol was prepared by free radical polymerization and characterized. Nanoparticles and caffeic acid–loaded nanoparticles were prepared by solvent evaporation technique and optimized. The short-term stability of nanoparticles was investigated at 4°C. Drug encapsulation and loading efficiency were evaluated. The chitosan membrane and caffeic acid–loaded nanoparticles embedded into chitosan membrane were fabricated. The caffeic acid loaded nanoparticles embedded into chitosan membrane showed controlled release. The mechanical properties of all samples were investigated. The caffeic acid–loaded nanoparticles embedded into chitosan membranes indicated excellent antibacterial properties against the Escherichia coli and Staphylococcus aureus. The anticancer activity of all the samples was evaluated against SaOS-2 human primary osteogenic sarcoma and MC3T3-E1 pre-osteoblast cell lines by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay, the flow cytometry and double staining methods. As a result, the designed carrier system showed great potential to cancer-associated infections treatment in bone cancer cases.
The Role of Human Milk in Decreasing Necrotizing Enterocolitis Through Modulation of the Infant Gut Microbiome: A Scoping Review
Authors: Davis Jessica A. , Baumgartel Kelley , Morowitz Michael J. , Giangrasso Vivianna , Demirci Jill R.
Published: August 2020

Background

Necrotizing enterocolitis is associated with a high incidence of morbidity and mortality in premature infants. Human milk minimizes necrotizing enterocolitis risk, although the mechanism of protection is not thoroughly understood. Increasingly, dysbiosis of the infant gut microbiome, which is affected by infant diet, is hypothesized to play a role in necrotizing enterocolitis pathophysiology.

Research aim

The aim of this scoping review was to summarize the state of the science regarding the hypothesis that the gut microbiome composition is a mediator of the relationship between human milk and decreased incidence of necrotizing enterocolitis within a sample of human infants.

Methods

Electronic databases and reference lists were searched for peer-reviewed primary research articles addressing the link between human milk, gut microbiome composition, and subsequent incidence of necrotizing enterocolitis among human infants.

Results

A total of four studies met criteria for inclusion in this review. Of these, evidence supporting the link between human milk, gut microbiome composition, and necrotizing enterocolitis was found in two (50%) studies.

Conclusion

Some evidence linking all three variables is provided in this review. Given the small number of available studies, and the limitations of those studies, more research is urgently needed to thoroughly understand the protection against necrotizing enterocolitis gained through the provision of human milk.
Aerobic vaginitis – An underdiagnosed cause of vaginal discharge – Narrative review
Authors: Sonthalia Sidharth , Aggarwal Parul , Das Shukla , Sharma Poonam , Sharma Rahul , Singh Sweety
Published: August 2020

The concept of vaginal dysbiosis was for long considered synonymous with bacterial vaginosis (BV), which is characterized by a homogenous non-inflammatory vaginal discharge. The inflammatory variant of vaginal dysbiosis, called aerobic vaginitis (AV), has remained unknown to a large part of the global dermatology and venereology community, gynaecologists and reproductive tract infection specialists with consequential under diagnosis. AV significantly differs from BV, in clinical presentation, diagnostic criteria and management. The deleterious impact of untreated AV on pregnancy merits discussion. Understanding AV is also crucial for better comprehension of desquamative inflammatory vaginitis (DIV), the most severe form of the same entity. We review the condition’s epidemiology, risk factors and suspected aetiology, symptoms and signs, and the latest evidence-backed approach to diagnosis and treatment. The ideal diagnostic approach and treatment for AV/DIV are yet to be established. The currently recommended diagnostic approach for AV/DIV merits an overhaul by incorporating changes to render it feasible for resource-constraint countries. The diagnostic criteria lack a uniform applicability in different physiological groups of women and cannot be used in postpartum or postmenopausal states at the same cut-off levels. Similarly, treatment guidelines merit a relook, and customization, given the equivocality of options suggested by different investigators.
Parametric studies on interacting parameters influencing heat pipe performance
Authors: Kumar Vineet , Jain Sanjay V , Shah Yash , Lakhera Vikas J
Published: August 2020

The performance of a heat pipe is governed by many parameters, the effects of which may influence each other. Hence, it is utmost important to optimize the combination of these parameters for an effective energy transfer in a heat pipe. In the present study, the interacting effects of four different parameters affecting the effectiveness of heat pipe are studied namely the fluid filling ratio (20%, 30%, 40%), the pressure inside the heat pipe (0.2 bar, 1 bar, 1.8 bar), the number of wick layers (0, 1, 2) and the inclination angle of heat pipe (0°, 45°, 90°). The response surface method based on central composite design approach is applied to optimize the number of experiments. The effects of interacting parameters on the effectiveness of heat pipe are discussed. Among the various parameters, the pressure inside the heat pipe was found to be the most important parameter followed by the fluid filling ratio, the inclination of heat pipe and the number of wick layers. From the analysis, the optimum combination of parameters was obtained as 40% filling ratio, 0.2 bar pressure, 2 wick layers and 0° inclination. At this point, the effectiveness predicted with the model and obtained through experiments was found to be 0.630 and 0.649 respectively. Based on the experimental results, a quadratic empirical model is developed which predicts the effectiveness of heat pipe within [Formula: see text]% of the experimental results for different operating conditions of heat pipe.
Reliable state of health condition monitoring of Li-ion batteries based on incremental support vector regression with parameters optimization
Authors: Ben Ali Jaouher , Azizi Chaima , Saidi Lotfi , Bechhoefer Eric , Benbouzid Mohamed
Published: August 2020

State of health condition monitoring of Li-ion batteries is an important issue for safe and reliably operation of battery-powered products. Consequently, it remains a challenging subject for industrial and academic studies. In this article, an incremental support vector regression is proposed for battery state of health lifetime estimation. In order to improve the battery state of health forecasting accuracy, the quantum-behaved particle swarm optimization is proposed to define reliably the incremental support vector regression parameters. The validation of the proposed method was done based on the NASA battery data set, and it demonstrates that it yields good performance in remaining useful life estimation of Li-ion batteries. This case study shows that compared with the linear, polynomial regression methods, and compared to previous works, the proposed method can obtain more accurate state of health prediction results. Even for state of health prediction starting from the cycle near capacity regeneration, the proposed model can still accurately estimate the global degradation trend. Furthermore, the proposed quantum-behaved particle swarm optimization–incremental support vector regression combination has greater robustness when the training data contain noise and measurement outliers. This allows satisfactory prediction performances without pre-processing the data manually.
Bullous lupus as the first manifestation of systemic lupus erythematosus in the pediatric population: A diagnostic challenge in daily practice
Authors: Torres Saavedra Fabio Andrés , Campo Lyna Ramirez , Mendez Monica Velasquez , Barreneche Natalia Mejia , Suaza Gloria Andrea Vargas , Restrepo Juan David Ruiz , Martinez-Gomez Manuel
Published: August 2020

Introduction

In the GLADEL cohort, the bullous lupus (BSLE) prevalence was 0.41%. However, literature on pediatric BSLE is scarce. This study described the clinical, histological, and immunological characteristics and the treatment response in a series of children with BSLE as the first clinical manifestation of pediatric SLE.

Methods

The clinical, histological, and immunological characteristics of a series of 5 cases of BSLE between 2010-2019 from two reference centers in Colombia were analyzed.

Results

All cases had bullous lesions that resolved with residual hypopigmentation. One had a focal seizure, and another arthritis with thrombocytopenia. Two had transient proteinuria with normal urinalysis. Anti-nuclear antibody titers ranged from 1:160 to 1:2560, and four were anti-dsDNA (+). Five patients had anti-RNP antibodies, and four anti-Sm antibodies. All had low C3, and 80% low C4 counts; 80% had erythrocyte sedimentation rate (ESR) ≥20 mm/hour and 60% had C-reactive protein (CRP) ≥0.5 mg/dL. All patients responded to glucocorticoids and dapsone. Histology reports and direct immunofluorescence (DIF) test showed subepidermal blisters with neutrophils in the papillary dermis and linear deposits of Igs/complement proteins in 80% of the skin biopsies. IgG/IgM was present in 5 samples. IgA was positive in 60% and C3 in 80%.

Conclusions

In this pediatric series, BSLE tends to have a monophasic behavior associated with neuropsychiatric, skeletal, and hematological involvement in 40% of the patients, and with good prognosis.
Dielectric properties of polymer/clay nanocomposites
Authors: Anwar Nadeem , Ishtiaq Muhammad , Shakoor Abdul , Niaz Niaz Ahmad , Rizvi Tasneem Zahra , Qasim Muhammad , Irfan Muhammad , Mahmood Arshad
Published: August 2020

Intercalated and exfoliated nanocomposites of insulating polymers poly methyl methacrylate and acrylonitrile butadiene styrene with organically modified montmorillonite (OMMT) was prepared by solution casting method. Formation of polymer nanocomposites was confirmed by X-Ray Diffraction. Fourier transform infrared spectroscopy confirmed the interaction between polymers and cations on the surface of OMMT layers. Dielectric properties of these nanocomposites were examined at room temperature in the frequency range of 100 Hz–1 MHz. The findings of dielectric measurements exhibited higher real and imaginary dielectric permittivity values for exfoliated nanocomposites and lesser real and imaginary dielectric permittivity values for intercalated nanocomposites as compared with pure polymers in the same frequency range. The increase in the permittivity values is attributed to Maxwell Wagner polarization in exfoliated nanocomposites because of increased interfacial area between polymer and the clay layers. Decrease in dielectric permittivity in intercalated polymer nanocomposites is attributed to restricted mobility of polymer chains due to nanoscopic confinement of the polymer with the silicate layers.
Nursing Student Differences in Transcultural Self-Efficacy by Culture Curriculum: A Longitudinal Study
Authors: James Linda , Stiles Anne , Stephens Chas
Published: August 2020

Introduction

Longitudinal studies regarding educational strategies to help nursing students gain transcultural self-efficacy skills are limited. This study aimed to compare the long-term effects of an entry-level nursing culture course (ELNCC) on transcultural self-efficacy (TSE) in beginning nursing students with a graduating class who did not have the ELNCC.

Method

Using a longitudinal, quasi-experimental time-series design, data were collected using Jeffreys’s Transcultural Self-Efficacy Tool (TSET) from the experimental group ( n = 106) pre- and post-ELNCC, end of second semester, and program exit. A control group of 62 senior nursing students who did not take the ELNCC were administered the TSET once, at graduation.

Results

All posttest scores were significantly higher than pretest scores in overall TSE, cognitive, practical, and affective dimensions. At graduation, the experimental group’s scores were significantly higher than those of the control group in all dimensions except the affective.

Discussion

This study supports the early introduction of a separate culture course with field components to teach TSE to nursing students.
Waveform optimization of a two-axis smooth impact drive mechanism actuator
Authors: Wang Jianxiang , Chen Yuxi , Peng Yuxin , Song Xian , Zhang Yangkun , Zhang Mingming
Published: August 2020

This paper presents a data-driven method for waveform optimization of a two-axis smooth impact drive mechanism (SIDM) actuator. The actuator was constructed by two piezoelectric elements (PZTs) perpendicularly fixed to an L-shaped base for two-axis positioning. An XY stage was designed and constructed by assembling the two-axis SIDM actuator. The XY stage could position long motion ranges of several millimeters with nanometer-level resolution, and the size was confined to be 20 mm (X) × 20 mm (Y) × 4.5 mm (H). The data-driven method based on the long short-term memory (LSTM) neural networks was used to predict the optimum input voltage waveform of the actuator. With the optimized input voltage waveform, it was verified that the maximum velocity of the stage could be improved about two times.
Spiritual Practice and Management Education Pedagogy: Exploring the Philosophical Foundations of Three Spiritual Traditions
Authors: Burton Nicholas , Culham Tom , Vu Mai Chi
Published: August 2020

Can the philosophical foundations of spiritual practices inform management education pedagogy and in the long-run support emotional development and more ethical and responsible business practice? In this article, we introduce the essential aspects of three different spiritual traditions—Daoist inner work, Buddhist mindful reflexivity, and Quaker discernment—and lay out some foundations between these essential aspects and management education pedagogy. We offer examples of utilizing these concepts in teaching business ethics in order to offer a foundational discussion for future elaboration. Our experiences also illuminate that instructor preparation is a key ingredient if the kinds of teaching we advance are to gain traction and contribute to the repeated calls for pedagogical innovations that challenge dominant paradigms. We offer some concluding remarks, pathways for future research and indicate a list of resources that can support potential instructors.
Intra-articular Injections of Hyaluronic Acid on Osteochondral Lesions of the Talus After Failed Arthroscopic Bone Marrow Stimulation
Authors: Hwang Yeok Gu , Lee Jin Woo , Park Kwang Hwan , Hsienhao Chang , Han Seung Hwan
Published: August 2020

Background:

The purpose of the study was to compare clinical and functional outcomes before and after hyaluronic acid (HA) injections in patients with osteochondral lesions of the talus who experienced a failure of their primary treatment with arthroscopic microfracture surgery.

Methods:

A total of 40 patients were included in the final study. These patients had received microfracture surgery but continued to experience postoperative pain over an average of 13.0 months (range, 0-81 months) and were available for investigation with a mean follow-up for 29.1 months (SD 14.7; range 2.6-79.6 months). All patients received intra-articular injections of HA once per week for 3 weeks. We assessed clinical and functional outcomes before and after injection using the American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), Short Form Health Survey (SF-36), the visual analog scale (VAS) for pain, and the Alexander subjective scale.

Results:

The AOFAS score significantly increased from 50.7 ± 13.8 to 79.9 ± 13.8 and the FAOS scores for symptom, pain, daily living, and sports were significantly higher postinjection compared to preinjection (all P < .001). Similarly, the mean VAS for pain was significantly decreased after 6 weeks following injection and continued to decrease over the follow-up period; the mean VAS was significantly lower postinjection compared to preinjection at 12 months ( P < .001).

Conclusion:

Intra-articular HA injections on average significantly improved clinical and functional scores after failed primary operative treatment. HA injections may provide an alternative to secondary operative treatment and provide better clinical outcomes than other conservative treatments.

Level of Evidence:

Level II, prospective observational cohort study.
Early Effects of Home Health Value-Based Purchasing on Quality Star Ratings
Authors: Teshale Salom M. , Schwartz Margot L. , Thomas Kali S. , Mroz Tracy M.
Published: August 2020

The Home Health Value-Based Purchasing Model (HHVBP) is a new Medicare model wherein home health agencies compete to achieve higher reimbursements by demonstrating improved value according to clinical and patient experience-related quality measures. Many measures used in HHVBP overlap with measures used in quality star ratings for home health agencies. Thus, improvements in quality measures used in HHVBP may also be reflected in changes in star ratings. However, it is unclear whether agencies competing in HHVBP improve their Centers for Medicare & Medicaid Services star ratings compared with those not competing. Using publicly available data from Centers for Medicare & Medicaid Services, we evaluated the effect of HHVBP on quality of patient care and patient experience composite star ratings over a 2-year period using a difference-in-differences analysis. We found evidence for a small, statistically significant increase in quality of patient care star ratings for agencies participating in HHVBP, and no effect on patient experience ratings.
Regimes of Youth Participation? Comparative Analysis of Youth Policies and Participation across European Cities
Authors: Walther Andreas , Lüküslü Demet G. , Loncle Patricia , Pais Alexandre
Published: August 2020

This article problematizes the assumption that national policies have a direct impact on youth participation at the local level and analyses the relationships between local forms of youth participation and local and national policies. Relying on data from a EU project funded under the HORIZON 2020 programme, the article focuses on formally institutionalized settings of youth participation and elaborates local constellations of youth participation in six European cities. These constellations may be referred to as regimes of youth participation as they reflect wider structures of power and knowledge that influence the way in which young people’s practices in public spaces and their claims of being part of society are recognized. However, the analysis reveals that rather deducing it from the model of welfare regimes, such a typology needs to be developed starting from the local level and should consider the ways in which different relationships between local youth policies and national welfare states affect youth participation.
Assessment of Sesame Street online autism resources: Impacts on parental implicit and explicit attitudes toward children with autism
Authors: Dickter Cheryl L , Burk Joshua A , Anthony Laura Gutermuth , Robertson Hillary A , Verbalis Alyssa , Seese Sydney , Myrick Yetta , Anthony Bruno J
Published: August 2020

The current study sought to characterize implicit bias toward children with autism and examine whether viewing educational materials about autism would change attitudes toward children with autism. A website developed by Sesame Street containing information about autism and resources for families was distributed to parents of children with autism ( n = 473) and parents of children without autism ( n = 707). Pre- and post-test measures of implicit bias toward children with autism; explicit attitudes and knowledge about autism; and parenting confidence, strain, and stigma were completed before and after the website was presented. Results indicated that parents of children with autism showed less implicit bias compared with those of non-autistic children during the pre-test, but the groups did not differ at the post-test. Parents without autistic children and those with more negative explicit attitudes showed a greater reduction in implicit bias from the pre- to the post-test. In addition, for parents of children with autism, a more positive change in explicit attitudes and increased knowledge from the pre- to the post-test was associated with more empowerment at the post-test. Together, our findings suggest that the online educational resources can reduce implicit bias against children with autism and help mitigate some of the psychological issues associated with parenting children with autism.
Sex logics: Negotiating the prison rape elimination act (PREA) against its’ administrative, safety, and cultural burdens
Authors: Rudes Danielle S , Magnuson Shannon , Portillo Shannon , Hattery Angela
Published: August 2020

The Prison Rape Elimination Act (PREA) reforms correctional institutions via administrative mechanisms and represents a major shift in both correctional policy and workplace practice. Using qualitative data within six prisons in one U.S. state, finding suggest that staff view PREA as an administrative, safety, and cultural burden, which creates a misalignment of institutional logics. Rather than seeing themselves as central to eliminating prison sexual misconduct/violence, staff see PREA as interfering with their “real” custody/control work. This misalignment has major implications for the productive implementation and use of PREA and the broader shift to administrative rather than legal processes for institutional reform.
“In the tube” following sternotomy: A quasi-experimental study
Authors: Park L , Coltman C , Agren H , Colwell S , King-Shier K M
Published: August 2020

Background

Traditionally, physical movement has been limited for cardiac surgery patients, up to 12-weeks post-operatively. Patients are asked to use “standard sternal precautions,” restricting their arm movement, and thereby limiting stress on the healing sternum.

Aim

To compare return to function, pain/discomfort, wound healing, use of pain medication and antibiotics, and post-operative length of hospital stay in cardiac surgery patients having median sternotomy who used standard sternal precautions or Keep Your Move in the Tube movement protocols post-operatively.

Methods

A quasi-experimental design was used (100 standard sternal precautions and 100 Keep Your Move in the Tube patients). Patients were followed in person or by telephone over a period of 12-weeks postoperatively. Outcomes were measured at day 7, as well as weeks 4, 8, and 12 weeks.

Results

The majority of participants (77% in each group) were male and had coronary artery bypass graft surgery (66% standard sternal precautions and 72% Keep Your Move in the Tube). Univariate analysis revealed the standard sternal precautions group had lesser ability to return to functional activities than the Keep Your Move in the Tube group (p < 0.0001) over time. This difference was minimized however, by week 12. Multivariate analysis revealed that increasing age, body mass index, and female sex were associated with greater functional impairment over time, but no difference between standard sternal precautions and Keep Your Move in the Tube groups.

Conclusions

Keep Your Move in the Tube, a novel patient-oriented movement protocol, has potential for cardiac surgery patients to be more confident and comfortable in their recovery.
Process-Based Cognitive Behavioral Therapy: A Framework for Conceptualization and Treatment
Authors: Pavlacic Jeffrey M. , Young John
Published: August 2020

Process-Based Cognitive Behavioral Therapy (PB-CBT) is the integration of biological, psychological, and social factors into idiographic structural models used to conceptualize patient problems and select transdiagnostic, evidence-based procedures for clinical intervention to improve well-being. Despite the clinical utility and applicability of this transdiagnostic approach to case conceptualization and treatment, little research or formal guidance exists on how to create individualized structural models in clinical practice. Traditional clinical psychology, on the contrary, employs a diagnosis to treatment matching system. While useful, diagnosis to treatment models of intervention neglect contextual factors that contribute to patient problems and have led to a proliferation of treatment manuals for specific diagnoses. The current case study described a college male who coped with emotional difficulties through avoidance, isolation, food restriction, and alcohol use. In addition to psychopathology, the patient also identified as bisexual in a predominantly homophobic social environment, which exacerbated psychological distress. These various factors were integrated into a structural model that aided the selection of transdiagnostic interventions. At the conclusion of treatment, the patient reported meaningful reductions in psychological symptoms, in addition to various functional gains consistent with his values, such as an increased ability to tolerate difficult emotions, increased mindfulness skills, and an openness to discuss emotions with peers. Structural models and transdiagnostic interventions may help conceptualize patients presenting with multiple forms of psychopathology.
One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap
Authors: Vaienti Luca , Cottone Giuseppe , Zaccaria Giovanna , Rampino Cordaro Emanuele , Amendola Francesco
Published: August 2020

The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.
Tele-Mental Connectivity: Pseudo-Therapy or The New Reality?
Authors: Salpekar Jay A.
Published: August 2020

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A clean and efficient down processing technology based on two physical methods
Authors: Qiang Taotao , Pu Yadong , Zhang Qi
Published: August 2020

In this study, a clean and efficient down processing technology improved the bulkiness of the down fibers by two physical methods. On the one hand, amino polysiloxane compound SI-G was used to modify down fibers physically. On the other hand, the structure of down fibers keratin was changed and the elasticity of down was increased by adjusting the temperature, so the bulkiness of down fibers was improved. The results showed that the most suitable condition for down fibers in the air-blast dusting machine was a temperature of 60 ± 2°C when the SI-G dosage was 2% of the weight of down, the performance of down fibers was the best. The bulkiness increased by 49%, the cleanliness increased by 92%, and the residual fat rate did not change significantly. Evidence was provided by scanning electron microscope and energy dispersive spectrometer (SEM-EDS), nuclear magnetic resonance spectrometer (13C-NMR), X-ray Diffractometer (XRD) and Raman spectroscopy analysis. The results showed that, on the one hand, amino polysiloxane SI-G adsorbed on the down surface, making the fiber smooth, soft, and elastic. On the other hand, the conformation of down fibers keratin changed, the conformation of keratin macromolecule α-helix increased relatively, and the random crimp conformation decreased relatively, which makes the protein structure more regular and elastic, so the bulkiness of the down fibers improved.
Altered Response to Total Body Irradiation of C57BL/6-Tg (CAG-EGFP) Mice
Authors: Liu Cuihua , Tanaka Kaoru , Katsube Takanori , Varès Guillaume , Maruyama Kouichi , Ninomiya Yasuharu , Fardous Zeenath , Sun Chao , Fujimori Akira , Moreno Stéphanie G. , Nenoi Mitsuru , Wang Bing
Published: August 2020

Application of green fluorescent protein (GFP) in a variety of biosystems as a unique bioindicator or biomarker has revolutionized biological research and made groundbreaking achievements, while increasing evidence has shown alterations in biological properties and physiological functions of the cells and animals overexpressing transgenic GFP. In this work, response to total body irradiation (TBI) was comparatively studied in GFP transgenic C57BL/6-Tg (CAG-EGFP) mice and C57BL/6 N wild type mice. It was demonstrated that GFP transgenic mice were more sensitive to radiation-induced bone marrow death, and no adaptive response could be induced. In the nucleated bone marrow cells of GFP transgenic mice exposed to a middle dose, there was a significant increase in both the percentage of cells expressing pro-apoptotic gene Bax and apoptotic cell death. While in wild type cells, lower expression of pro-apoptotic gene Bax and higher expression of anti-apoptotic gene Bcl-2, and significant lower induction of apoptosis were observed compared to GFP transgenic cells. Results suggest that presence of GFP could alter response to TBI at whole body, cellular and molecular levels in mice. These findings indicate that there could be a major influence on the interpretation of the results obtained in GFP transgenic mice.
Virtual Scribe Services Decrease Documentation Burden Without Affecting Patient Satisfaction: A Randomized Controlled Trial
Authors: Benko Savannah , Idarraga Alex J. , Bohl Daniel D. , Hamid Kamran S.
Published: August 2020

Background

Virtual scribe services (VSS) are a contemporary take on the in-person scribes utilized as a means to reduce administrative burden on physicians and enhance the physician-patient interaction. The purpose of this study was to determine whether VSS use could decrease the time an orthopaedic foot and ankle surgeon spends on documentation without diminishing the patient experience as compared with traditional postencounter dictation (TD).

Methods

Fifty patients presenting for first-time visits with a single orthopaedic foot and ankle surgeon were prospectively enrolled and randomized to VSS or TD prior to the physician-patient encounter. Time spent with the patient in the exam room and time spent documenting away from the patient were recorded. A postencounter survey assessed patient satisfaction, perception of physician empathy, understanding of the plan, and perception of the amount of time spent with the physician.

Results

Of 50 patients enrolled, 25 were randomized to VSS. Time spent documenting away from the patient differed significantly between VSS and TD (1.2 ± 0.7 minutes for VSS vs 5.8 ± 1.7 minutes for TD, P < .001) as did time elapsed between the end of the visit and the start of dictation (0 ± 0 for VSS vs 118.2 ± 72.7 minutes for TD, P < .001). There was a trend toward more time spent with the patient in the VSS group than in the TD group (14.2 ± 5.9 minutes for VSS vs 11.4 ± 5.1 minutes for TD, P = .069). There were no differences between groups in survey responses regarding satisfaction, empathy, understanding, or perception of sufficient time spent with the physician ( P > .05 for each).

Conclusions

VSS use in an orthopaedic foot and ankle practice significantly decreased documentation time and allowed for completion of documentation during patient visits without differences in quality metrics as compared to TD. Orthopaedic surgeons can consider VSS a HIPAA-compliant documentation option with time savings and no measurable difference in patient satisfaction.

Levels of Evidence:

Level II: Randomized controlled trial
The Ellis Jones Method of Treating Chronic Peroneal Subluxation: Revisited and Colorized After 87 Years
Authors: Gökkuş Kemal , Sahin Mehmet Sukru , Sargin Mehmet Baris
Published: August 2020

Chronic cases of peroneal subluxation typically call for surgical treatment; however, research on current surgical procedures suggests nonuniformity. The purpose of this study is to remind surgeons of the efficacy of an older surgical method by using the case of a selected patient. In this study, the Ellis Jones procedure was performed on a patient who had been suffering from a chronic peroneal subluxation for 22 years, since, in this particular case, other approaches were deemed likely to be unsuccessful. The patient had hypertrophied, frayed, and swollen tendons, which were unsuitable to be rerouted, whereas the superior peroneal retinaculum was diminished and deepening procedures would not be able to establish sufficient volume for retaining the hypertrophied tendons. After the debridement and repair of the peroneal tendons, ¼ of the lateral Achilles tendon was split, passed through a hole in the fibula, and sutured onto itself, and the subluxation path of the peroneal tendons was closed with an effective tendon barrier. The patient returned to work after 8 weeks of the surgery and was followed up for 4 years postoperatively. On selected patients, the Ellis Jones surgical method might therefore still be applied.

Levels of Evidence: Level V
Cutaneous Hyperpigmentation Secondary to High-Dose Tigecycline: A Case Report
Authors: Alsemari Muhannad A. , Hakeam Hakeam A. , Alsalman Hussain , Amin Tarek
Published: August 2020

High-dose tigecycline therapy is gaining wide acceptance in treating infections caused by multidrug-resistant bacteria. There are no reports of cutaneous hyperpigmentation with the use of high-dose tigecycline. Here we report a case of a woman who developed reversible cutaneous hyperpigmentation within 48 h of receiving high-dose tigecycline.
Adolescent identity: The importance of the social history
Authors: Silverstein Laura , Zander Emily , Middleman Amy B
Published: August 2020

This is a unique case of a patient with trichotillomania, depression, and anxiety for 2 years, serving as coping strategies for underlying gender dysphoria. To our knowledge, a case of a patient presenting with this unique constellation of comorbid conditions has not previously been reported. This case stresses the importance of providers obtaining a full social history consistently and repeatedly while providing a nonjudgmental environment for patients to disclose sensitive and potentially fluid information related to gender identity and sexuality.