bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of HRSA-Funded Expansion of Physician Assistant Training Grants 2011–2016
Authors: Rolls Joanne , Lessard Donovan , Smith Tyler , Keahey David
Published: July 2021

Purpose

The Affordable Care Act (ACA), enacted in 2010, created the Expansion of Physician Assistant Training (EPAT) grant with the goal of increasing the number of physician assistants (PAs) entering primary care. There has been no analysis regarding the practice patterns of students graduating from EPAT-funded programs. This study aimed to describe the workforce impact of federal investment in PA education through the EPAT program.

Methods

In 2018 the authors administered an anonymous electronic survey to all 27 EPAT PA programs funded from 2010 to 2015. The goal was to assess program and graduate characteristics, practice patterns, and intention to apply to similar future opportunities. The survey was IRB exempt.

Results

There was a 59.30% response rate representing 366 total graduates, which reflected 62.46% of the 586 Health Resources and Services Administration (HRSA)-reported total EPAT-funded students. Of the respondents, 16.41% of EPAT recipients self-identified as non-White, 4.54% indicated Hispanic ethnicity, 53.65% identified as being of disadvantaged status, and 32.92% reported coming from rural backgrounds. Sixty-three percent entered primary care immediately following graduation, while 87.88% reported practicing primary care immediately after graduation or at the last point of contact. Fifty-two percent of EPAT graduates practiced in medically underserved areas (MUAs).

Conclusion

Recipients of HRSA EPAT funding practiced in primary care specialties immediately following graduation at a rate that was 2.5 times higher than the national PA average. This specialty choice was durable for several years post-graduation. The EPAT program funded over 140 PA graduates who immediately practiced in MUAs. This funding supported a more racially and ethnically diverse student population and higher number of students coming from rural areas than the national average for PA students.
Survival benefit of endocrine dysfunction following immune checkpoint inhibitors for nonthyroidal cancers
Authors: Kotwal Anupam , Ryder Mabel
Published: July 2021

Purpose of review

Our goal is to review pertinent data evaluating the association between immune checkpoint inhibitor (ICI)-induced endocrine dysfunction and survival in cancer patients as well as to understand the potential molecular links between these.

Recent findings

ICIs have revolutionized cancer therapy but have also led to multiple immune-related adverse events (irAEs). Studies have demonstrated a link between the development of irAEs and improved survival, suggesting that ICI-induced antitumor immunity and autoimmunity are coupled. Thyroid irAEs are most frequently and strongly associated with improved survival, particularly in the context of overt thyroid dysfunction. Other endocrine irAEs, such as hypophysitis and diabetes are quite rare wherein the treatment approach or the disease process itself may mitigate improvement in survival. Preclinical and translational data indicate a role for CD4+ T cells, regulatory T cells and/or cytokines mediating irAEs, including thyroiditis.

The development of irAEs is associated with improved tumor responses and survival in cancer patients. Thyroid irAEs, alone or in combination with other irAEs, are most strongly associated with improved outcomes. Biomarkers of response to ICIs are lacking, despite well-characterized pathologic and genomic susceptibilities predicting ICI efficacy. Early detection of thyroid irAEs may identify patients most likely to have durable antitumor response to ICIs. Although irAEs and antitumor immunity appear ‘coupled’, translational studies indicate the potential for their ‘uncoupling’, which could enable antitumor efficacy with greater safety margins.
Dynamic balance recovery in chronic acquired brain injury participants following a perturbation training
Authors: Joubran Katherin , Bar-Haim Simona , Shmuelof Lior
Published: July 2021

Acquired brain injury (ABI) is defined as a damage to the brain that occurs after birth. Subjects post-ABI frequently suffer from dynamic balance impairments that persist years after the injury. This study aimed to investigate the effect of a perturbation method using mechatronic shoes that introduce unexpected balance perturbations on the recovery of dynamic balance and gait velocity in chronic ABI participants. In an intervention trial, 35 chronic ABI participants (stroke and traumatic brain injury) participated in 22 sessions of perturbation training, twice a week for 3 months. Dynamic balance was assessed pre- and post-training using Community Balance and Mobility Scale (CB&M). Gait velocity was also assessed in the stroke participants using the 10 Meter Walking Test (10MWT). Dynamic balance improved significantly post-training (P = 0.001). This improvement was greater than the improvement that was observed in a sub-group that was tested twice before training (P = 0.04). Sixteen participants (45.7%) out of 35 met or exceeded minimal detectable change (MDC) of the CB&M Scale. Self-paced velocity also improved significantly (P = 0.02) but only two participants (9.5%) out of 21 exceeded the MDC of 10MWT post-stroke. Our results suggest that unexpected balance perturbation training using mechatronic shoes leads to an improvement in dynamic balance and gait velocity in chronic ABI participants. The advantage of perturbation training using mechatronic shoes with respect to conventional balance training should be further examined.
Objective Vision-related Indications for Clear and Tinted Football Helmet Visors
Authors: Weise Katherine K. , Swanson Mark W. , Galt Sarah J. , Springer Daniel B. , Crosson Jason N. , DeCarlo Dawn K. , Hale Matthew Heath , Nicholson Joshua Ryne , Robinson James B.
Published: July 2021

SIGNIFICANCE

Football helmet visors are popular among players and may increase safety. However, they may also be costly or impractical, or impair the evaluation of head and neck injury. Determining an objective list of vision-related clinical conditions may help meet risk-benefit ratios while increasing access to care to athletes with special needs.

PURPOSE

The purpose of this study was to determine an objective list of vision-related conditions that may benefit from clear and tinted football helmet visor use in athletes.

METHODS

After comprehensive dilated eye examinations on 58 Division I collegiate football players at the University of Alabama at Birmingham between February 2017 and June 2018, an expert panel in vision care, sports medicine, and football equipment convened to determine vision-related conditions most important for clear or tinted football helmet visor use.

RESULTS

In August 2018, the list drafted by the expert vision and sports medical panel in which a clear football helmet visor might be justified included conditions associated with retinal detachment and unilateral or binocular vision loss as well as high refractive error, refractive surgery, corneal compromise, and other conditions, which would necessitate additional eye protection. Of the 58 players examined, 3 (5%) were determined to have eye conditions that would require a clear visor as deemed by the expert panel, and 3 (5%) were determined to have eye conditions for which a clear visor was recommended. No players met indications for a tinted visor including congenital eye conditions that limit useful vision in daylight or bright-light environments, acquired conditions that may increase light sensitivity, and light-induced systemic conditions.

CONCLUSIONS

This objective list of eye and vision-related systemic conditions is intended to mitigate the risk of long-term eye damage and/or vision deprivation. Clear and especially tinted football helmet visors require the sports medicine team to evaluate factors that will maximize the vision, head, and neck health of the athlete while increasing accessibility to sports for individuals with unique abilities.
The Association between Baseline Eye Tracking Performance and Concussion Assessments in High School Football Players
Authors: Oldham Jessie R. , Master Christina L. , Walker Gregory A. , Meehan William P. , Howell David R.
Published: July 2021

SIGNIFICANCE

Concussions are complex injuries that require a multifaceted testing battery. Vision impairments are common after concussion, but it is unknown exactly how eye tracking may be affected after injury and how it is associated with other clinical concussion assessments.

PURPOSE

This study aimed to (1) examine the relationship between eye tracking performance (BOX score) and other common concussion evaluations, (2) identify if eye tracking adds novel information that augments baseline concussion evaluations, and (3) examine the effect of age, concussion history, and attention-deficit/hyperactivity disorder on eye tracking and other ophthalmological measures.

METHODS

A total of 102 male high school football athletes (age, 16.0 years; 95% confidence interval, 15.8 to 16.2 years) completed a series of visual and neurocognitive tests during their pre-season baseline assessment. The main outcome measures were BOX score, near point of convergence (NPC) distance, binocular accommodative amplitude (BAA) distance, Standardized Assessment of Concussion score, and Immediate Post-Concussion Assessment and Cognitive Testing composite scores.

RESULTS

BOX score was not significantly associated with symptoms, Standardized Assessment of Concussion score, NPC distance, BAA distance, or any Immediate Post-Concussion Assessment and Cognitive Testing composite scores. Age, concussion history, attention-deficit/hyperactivity disorder, and number of prior years playing football were not significantly associated with BOX score or NPC distance, but there was a significant association between concussion history and greater BAA distance (β = 1.60; 95% confidence interval = 0.19 to 3.01; P < .03). The BOX score cutoff of 10 resulted in a 12% false-positive rate.

CONCLUSIONS

Eye tracking was not significantly associated with the commonly used clinical concussion assessments. These results suggest that an objective eye tracking variable may be a valuable addition to the current concussion battery.
IDH2 R172 Mutations Across Poorly Differentiated Sinonasal Tract Malignancies
Authors: Glöss Stefanie , Jurmeister Philipp , Thieme Anne , Schmid Simone , Cai Wei Y. , Serrette Rene N. , Perner Sven , Ribbat-Idel Julika , Pagenstecher Axel , Bläker Hendrik , Keber Ursula , Stadelmann Christine , Zechel Sabrina , Johann Pascal D. , Hasselblatt Martin , Paulus Werner , Thomas Christian , Dohmen Hildegard , Baumhoer Daniel , Frank Stephan , Agaimy Abbas , Schüller Ulrich , Vasudevaraja Varshini , Snuderl Matija , Liu Cheng Z. , Pfister David G. , Jungbluth Achim A. , Ghossein Ronald A. , Xu Bin , Capper David , Dogan Snjezana
Published: July 2021

IDH2 R172 mutations occur in sinonasal undifferentiated carcinoma (SNUC), large-cell neuroendocrine carcinoma (LCNEC), sinonasal adenocarcinomas, and olfactory neuroblastoma (ONB). We performed a clinical, pathologic, and genetic/epigenetic analysis of a large IDH2-mutated sinonasal tumor cohort to explore their distinct features. A total 165 sinonasal/skull base tumors included 40 IDH2 mutants studied by light microscopy, immunohistochemistry, and genome-wide DNA methylation, and 125 IDH2 wild-type tumors used for comparison. Methylation profiles were analyzed by unsupervised hierarchical clustering, t-distributed stochastic neighbor embedding dimensionality reduction and assessed for copy number alterations (CNA). Thirty-nine histologically assessable cases included 25 (64.1%) SNUC, 8 (20.5%) LCNEC, 2 (5.1%) poorly differentiated adenocarcinomas, 1 (2.7%) ONB, and 3 (7.7%) IDH2-mutated tumors with ONB features. All cases were high-grade showing necrosis (82.4%), prominent nucleoli (88.9%), and median 21 mitoses/10 HPFs. AE1/AE3 and/or CAM 5.2 were positive in all and insulinoma-associated protein 1 (INSM1) in 80% cases. All IDH2 mutants formed one distinct group by t-distributed stochastic neighbor embedding dimensionality reduction separating from all IDH2 wild-type tumors. There was no correlation between methylation clusters and histopathologic diagnoses. Recurrent CNA included 1q gain (79.3%), 17p loss (75.9%), and 17q gain (58.6%). No CNA differences were observed between SNUC and LCNEC. IDH2 mutants showed better disease-specific survival than SMARCB1-deficient (P=0.027) and IDH2 wild-type carcinomas overall (P=0.042). IDH2-mutated sinonasal tumors are remarkably homogeneous at the molecular level and distinct from IDH2 wild-type sinonasal malignancies. Biology of IDH2-mutated sinonasal tumors might be primarily defined by their unique molecular fingerprint rather than by their respective histopathologic diagnoses.
The Caucasian Hump: Radiologic Study of the Osteocartilaginous Vault versus Surface Anatomy. Clinical Implications in Structured and Preservation Rhinoplasty
Authors: Rodrigues Dias David , Cardoso Luis , Santos Mariline , Sousa e Castro Sandra , Almeida e Sousa Cecília , Gonçalves Ferreira Miguel
Published: July 2021

Background:

The relation between the osteocartilaginous nasal vault and nasal hump characteristics has not been fully investigated.

Methods:

Measurements were collected from computed tomographic nasal scans in the midsagittal plane in adult Caucasian patients seeking rhinoplasty because of nasal hump from January of 2015 to December of 2018. Measurements were compared to those of sex- and age-matched patients not seeking rhinoplasty (control group). Patients with other significant nasal deformities were excluded. The correlations between nasal hump length, height, and osteocartilaginous nasal vault measurements were assessed. Distances from the beginning of the nasal hump to the kyphion and ethmoidal points were measured as well. The location of the nasal hump apex in relation to the keystone area structures was detailed.

Results:

The study included 134 Caucasian patients, with 67 presenting nasal hump. The mean patient age was 32.9 years and 69.6 percent were female patients. Nasal hump measured a mean 17 ± 2.7 mm in length and 1.8 mm (range, 1.1 to 3.8 mm) in height. Nasal hump length correlated with nose length and nasal bone length. Nasal hump height correlated with nose length and the angle over the kyphion. In 97 percent of patients, the nasal hump began caudal to the ethmoidal point, and in all patients, the kyphion was underneath the nasal hump. The nasal hump is not a symmetric structure and, in all patients, its apex was situated above the septal cartilage.

Conclusions:

The nasal hump characteristics are mainly attributable to the septal cartilage, and this should be the cornerstone of any dorsal hump reduction strategy. The caudal aspect of the nasal bones contributes to the nasal hump, whereas the posterior ethmoidal plate rarely does.
A newly designed shoulder orthosis for patients with glenohumeral subluxation: a clinical evaluation study
Authors: Verloop Willemijn R.G. , Haarman Claudia J.W. , van Vliet Reinout O. , de Koning John L. , Rietman Johan S.
Published: July 2021

Background:

Shoulder complaints from glenohumeral subluxation are a common problem and limit patients during daily activities.

Objective:

To assess the clinical pros and cons and usability of a newly developed shoulder orthosis (Roessingh Omo Support [ROS]) in patients with chronic shoulder complaints.

Study design:

Retrospective cross-sectional study.

Methods:

All patients older than 18 years who received the ROS were invited. Medical information was collected from medical records. Two questionnaires were sent to the patient: The “Shoulder Rating Questionnaire” (SRQ, max 100 points) for evaluation before and during use and a custom orthosis usability questionnaire.

Results:

In total, 28 patients (34 orthoses) participated in the study. Neuralgic amyotrophy was the most common diagnosis (64.3%). The SRQ showed a significant positive change of 8.9 points (from 35.0 [SD 12.6] to 43.9 [SD 14.3]). The most described goal was pain reduction (76.5%). 47.1% of the patients achieved their goal(s), and 71.4% were still using the orthosis. The mean satisfaction rate was 7.1 (SD 1.4).

Conclusion:

The use of the ROS shows a significant functional improvement (SRQ), a decrease of pain, and a high degree of satisfaction, although the individual experiences of the patients are highly variable. Some modifications to the design to improve comfort may be needed.
The impact of alteration in gut microbiome in the pathogenesis of nonalcoholic fatty liver disease
Authors: Jacob Jake S. , Ahmed Aijaz , Cholankeril George
Published: July 2021

Purpose of review

We have increasing evidence that alterations of the intestinal microbiome have a strong influence on human health. Previous work has demonstrated the association between changes in the microbiome and metabolic risk factors. One related area of interest is the relationship between dysbiosis and nonalcoholic fatty liver disease (NAFLD), as the global prevalence of NAFLD, and its resultant complications, increases.

Recent findings

In this review, we summarize the hypothesized pathophysiology of dysbiosis-mediated progression of NAFLD, including promotion of an inflammatory intestinal environment, increased intestinal permeability, endogenous ethanol production, short-chain fatty acid production, secondary bile acid metabolism, and choline depletion. We also review potential therapeutic interventions of the microbiome to slow or prevent NAFLD progression, including antibiotics, probiotics, prebiotics, fecal microbiota transplant, and farnesoid × receptor agonism.

Much of the evidence supporting dysbiosis-mediated NAFLD progression has been gathered in high-quality animal trials. There remains a need for additional observational and randomized controlled trials in humans to establish causality between the suspected factors and pathogenesis of NAFLD.
Scan Time Reduction in Intravoxel Incoherent Motion Diffusion-Weighted Imaging and Diffusion Kurtosis Imaging of the Abdominal Organs: Using a Simultaneous Multislice Technique With Different Acceleration Factors
Authors: Xu Hui , Zhang Nan , Yang Da-Wei , Ren Ahong , Ren Hao , Zhang Qian , Zhu Jin-Xia , Li Gui-Jin , Yang Zheng-Han
Published: July 2021

Objective

To investigate the feasibility of quantitative intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) analyses in the upper abdominal organs by simultaneous multislice diffusion-weighted imaging (SMS-DWI).

Subjects and Methods

In this prospective study, a total of 32 participants underwent conventional DWI (C-DWI) and SMS-DWI sequences with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) in the upper abdomen with multiple b-values (0, 10, 20, 50, 80, 100, 150, 200, 500, 800, 1000, 1500, and 2000 seconds/mm2) on a 3 T system (MAGNETOM Prisma; Siemens Healthcare, Erlangen, Germany). Image quality and quantitatively measurements of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), mean kurtosis (MK), and mean apparent diffusivity (MD) for the liver, pancreas, kidney cortex and medulla, spleen, and erector spine muscle were compared between the 3 sequences.

Results

The acquisition times for C-DWI, SMS2-DWI, and SMS3-DWI were 10 minutes 57 seconds, 5 minutes 9 seconds, and 3 minutes 54 seconds. For image quality parameters, C-DWI and SMS2-DWI yielded better results than SMS3-DWI (P < 0.05). SMS2-DWI had equivalent IVIM and DKI parameters compared with that of C-DWI (P > 0.05). No statistically significant differences in the ADC, D, f, and MD values between the 3 sequences (P > 0.05) were observed. The D* and MK values of the liver (P = 0.005 and P = 0.012) and pancreas (P = 0.019) between SMS3-DWI and C-DWI were significantly different.

Conclusions

SMS2-DWI can substantially reduce the scan time while maintaining equivalent IVIM and DKI parameters in the abdominal organs compared with C-DWI.
68Ga-DOTATATE PET/CT in Pituitary Carcinoma
Authors: Kaya Gursan , Soydas Turan Basak , Dagdelen Selcuk , Berker Mustafa , Tuncel Murat
Published: July 2021

A 47-year-old woman with atypical pituitary adenoma was referred to the neurosurgery department due to recent back pain. She had multiple transsphenoidal surgery, stereotactic body radiation, and 177Lu-DOTATATE therapy. Her spinal MRI showed multiple spinal masses. The patient underwent 68Ga-DOTATATE PET/CT to confirm the metastatic spread of the disease. PET/CT images showed increased uptake at the local recurrent tumor site and spinal metastases confirmed by biopsy to pituitary carcinoma. Our case presents the role of 68Ga-DOTATATE PET/CT in patients with pituitary carcinoma.
Techniques and Trends of Facial Feminization Surgery
Authors: Siringo Nicolette V. , Berman Zoe P. , Boczar Daniel , Chaya Bachar F. , Diep Gustave K. , Trilles Jorge , Mazzei Sara , Rodriguez Colon Ricardo , Rodriguez Eduardo D.
Published: July 2021

Background

Facial feminization surgery is composed of a variety of craniomaxillofacial surgical procedures that are increasingly sought after by male-to-female transgender patients and by those seeking feminization of the face. Facial feminization surgery can play a prominent role in alleviating gender dysphoria. In consideration of an observed increase in gender-affirming procedures performed in recent years, a broad knowledge base in the techniques, outcomes, and challenges of facial feminization surgery should be established by surgeons offering these procedures. Our review was designed to critically appraise the current literature and inform future advancements in gender-affirming surgical practice. In addition, we detail a representative case to illustrate the senior author's approach to full facial feminization.

Methods

A comprehensive literature search of the PubMed, EMBASE, and Cochrane databases was conducted for studies published through June 2020 using following the search terms: “Face” OR “facial” OR “craniofacial” AND “Feminization” OR “Feminization Surgery” OR “Gender Reassignment” OR “Gender Affirming Surgery” OR “Gender Confirmation Surgery.” Data on procedures, outcomes, patient age, follow-up time, complications, and patient satisfaction were collected. The data were categorized by facial thirds and then further stratified by facial feature.

Results

Our search yielded 388 articles. Thirty articles fit our inclusion criteria, and of these, 23 articles were included in the review. We extracted primary data pertaining to 3554 patients with an age range of 18 to 73 who underwent 8506 total procedures. Most of the procedures addressed the upper facial third (hairline, forehead, and brow), comprising 49.1% of total procedures performed. Further categorization by facial feature revealed that the most commonly addressed feature was the forehead (34.6% of procedures), followed by the nose (12.8%) and the chin (12.2%). In studies that used quantitative measures to gauge patient-reported outcomes, satisfaction was high.

Conclusions

Facial feminization surgery seems to be safe, whether it is conducted in a single stage or as a staged procedure. Patients report high satisfaction and better gender congruency after facial feminization procedures. Further research is needed to establish best surgical practice and gauge patient satisfaction beyond the length of average follow-up and determine the frequency with which adjunctive procedures are sought out.
Crowdfunding for Gender-Affirming Mastectomy
Authors: Faletsky Adam , Han Jane J. , Lee Karen J. , Zhou Guohai , Singer Sean , Talbot Simon G. , Mostaghimi Arash
Published: July 2021

Introduction

Limitations in insurance coverage may cause patients to turn to crowdfunding to raise money for gender-affirming procedures. In this study, we analyze the impact of Medicaid insurance coverage on gender-affirming mastectomy campaigns posted on GoFundMe.com.

Methods

Between March 1 and 12, 2021, we accessed GoFundMe.com to analyze available campaigns requesting monetary contributions for gender-affirming mastectomy. Campaigns were identified using the search term “top surgery” followed by the state's name. Duplicate campaigns, campaigns whose primary goal was not gender-affirming mastectomy, and ongoing campaigns were excluded. Campaigns were then categorized according to their state's coverage of gender-affirming surgery: explicit exclusion (EE), explicit inclusion (EI), or no explicit statement of gender-affirming care. We collected data on the number of donors and shares, the fundraising goal, and the total amount raised for each campaign. Common themes within campaign narratives were identified and assessed by each reviewer. Finally, we collected data on the photographs posted by campaign creators.

Results

Our search yielded 790 campaigns, with an overall mean of 58 ± 99 donors and 212 ± 288 shares. The mean fundraising goal and amount raised among all campaigns were $6811 ± $5027 and $2579 ± $3072, respectively. Fundraising goals were most likely to be met in an EI state than an EE state (26.3% vs 8.1%; P < 0.001). The mean amount sought was highest in EE states and lowest in EI states, whereas the mean amount raised was lowest in EE states and highest in EI states. Of the campaigns, 97.1% mentioned personal or situational characteristics in the narrative section; 16.2% of all campaigns expressed negative feelings about posting on GoFundMe.com to raise money for their surgeries.

Conclusion

Disparities in health care coverage of gender-affirming surgeries were seen between state categories, with a decreased need for crowdfunding in states explicitly including coverage of gender-affirming surgery. Many transgender patients used crowdfunding to pay for transition-related health care costs, relying on the kindness of strangers and their social network at the expense of their personal privacy. Expansion of legislative coverage of gender-affirming surgeries may alleviate some of this financial burden and reduce transgender patients' reliance on crowdfunding campaigns.
Spontaneous Osteogenesis of Dehiscent Frontal Sinus Wall After Endoscopic Removal of Mucocele
Authors: Tan Arthur Dexian , Kwek James Wei Ming , Loh Ian , Lee Tee Sin
Published: July 2021

Paranasal sinus mucoceles commonly cause erosions of the bony walls. Currently, such defects can be managed conservatively with promising short-term outcomes. Long-term outcomes of these defects have not been described. The authors describe a 28-year-old patient with complete spontaneous osteogenesis of the large dehiscent frontal sinus posterior wall, secondary to a large mucocele, 9 years from functional endoscopic sinus surgery with the defect managed conservatively. Owing to the osteogenic potential of the dura, the authors postulate that the presence of dura beneath the bony deformity of the posterior frontal sinus wall had likely initiated the osteogenesis and restored the defect. This report substantiates studies demonstrating the osteogenic potential of an intact dura. Conservative management is an option for selected large defects of the posterior wall of the frontal sinus.
Biomarker Evidence of the Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) in Chronic Critical Illness (CCI) After Surgical Sepsis
Authors: Darden Dijoia B. , Brakenridge Scott C. , Efron Philip A. , Ghita Gabriela L. , Fenner Brittany P. , Kelly Lauren S. , Mohr Alicia M. , Moldawer Lyle L. , Moore Frederick A.
Published: July 2021

Objective:

To analyze serial biomarkers of the persistent inflammation, immunosuppression, and catabolism syndrome (PICS) to gain insight into the pathobiology of chronic critical illness (CCI) after surgical sepsis.

Background:

Although early deaths after surgical intensive care unit sepsis have decreased and most survivors rapidly recover (RAP), one third develop the adverse clinical trajectory of CCI. However, the underlying pathobiology of its dismal long-term outcomes remains unclear.

Methods:

PICS biomarkers over 14 days from 124 CCI and 225 RAP sepsis survivors were analyzed to determine associations and prediction models for (1) CCI (≥14 intensive care unit days with organ dysfunction) and (2) dismal 1-year outcomes (Zubrod 4/5 performance scores). Clinical prediction models were created using PIRO variables (predisposition, insult, response, and organ dysfunction). Biomarkers were then added to determine if they strengthened predictions.

Results:

CCI (vs RAP) and Zubrod 4/5 (vs Zubrod 0–3) cohorts had greater elevations in biomarkers of inflammation (interleukin [IL]-6, IL-8, interferon gamma-induced protein [IP-10], monocyte chemoattractant protein 1), immunosuppression (IL-10, soluble programmed death ligand-1), stress metabolism (C-reactive protein, glucagon-like peptide 1), and angiogenesis (angiopoietin-2, vascular endothelial growth factor, vascular endothelial growth factor receptor-1, stromal cell-derived factor) at most time-points. Clinical models predicted CCI on day 4 (area under the receiver operating characteristics curve [AUC] = 0.89) and 1 year Zubrod 4/5 on day 7 (AUC = 0.80). IL-10 and IP-10 on day 4 minimally improved prediction of CCI (AUC = 0.90). However, IL-10, IL-6, IL-8, monocyte chemoattractant protein 1, IP-10, angiopoietin-2, glucagon-like peptide 1, soluble programmed death ligand-1, and stromal cell-derived factor on day 7 considerably improved the prediction of Zubrod 4/5 status (AUC = 0.88).

Conclusions:

Persistent elevations of PICS biomarkers in the CCI and Zubrod 4/5 cohorts and their improved prediction of Zubrod 4/5 validate that PICS plays a role in CCI pathobiology.
Characterization of the CaCO3 calcination process by the Porod invariant behaviour
Authors: Ciccariello Salvino
Published: July 2021

The concave behaviour of the Porod invariant observed during the calcination of CaCO3 powder samples suggests the following picture of the evolving internal structure of the samples. The outset sample is formed by a crystalline CaCO3 phase and a void phase. During the calcination, the first phase shrinks in volume at fixed density since the temperature increase breaks down the crystalline structure at the interface, leading to the formation of an amorphous phase comprising an equal number of CO2 and CaO atomic groups. The last groups gradually condense, forming a third phase of solid CaO of constant density and increasing volume fraction, while the companion CO2 groups flow out of the sample. The amorphous phase occupies, with a variable density, all the volume left free by the other two phases. At the end of the calcination, both the volume fraction of the first phase and the density of the amorphous phase vanish so that the sample will again be made up of two phases: the voids and the solid CaO. Best-fitting the resulting theoretical expressions of the Porod invariant and of the Porod law coefficient to the observed values, one can determine the matter densities, volume fractions and specific surface areas of the phases.
Orientational mapping of minerals in Pierre shale using X-ray diffraction tensor tomography
Authors: Mürer Fredrik K. , Madathiparambil Aldritt Scaria , Tekseth Kim Robert , Di Michiel Marco , Cerasi Pierre , Chattopadhyay Basab , Breiby Dag W.
Published: July 2021

Shales have a complex mineralogy with structural features spanning several length scales, making them notoriously difficult to fully understand. Conventional attenuation-based X-ray computed tomography (CT) measures density differences, which, owing to the heterogeneity and sub-resolution features in shales, makes reliable interpretation of shale images a challenging task. CT based on X-ray diffraction (XRD-CT), rather than intensity attenuation, is becoming a well established technique for non-destructive 3D imaging, and is especially suited for heterogeneous and hierarchical materials. XRD patterns contain information about the mineral crystal structure, and crucially also crystallite orientation. Here, we report on the use of orientational imaging using XRD-CT to study crystallite-orientation distributions in a sample of Pierre shale. Diffraction-contrast CT data for a shale sample measured with its bedding-plane normal aligned parallel to a single tomographic axis perpendicular to the incoming X-ray beam are discussed, and the spatial density and orientation distribution of clay minerals in the sample are described. Finally, the scattering properties of highly attenuating inclusions in the shale bulk are studied, which are identified to contain pyrite and clinochlore. A path forward is then outlined for systematically improving the structural description of shales.
Space groups and crystallographic symmetry: writing a multi-featured tutorial in a new style
Authors: Foxman Bruce M.
Published: July 2021

Knowledge of space groups and the implications of space group symmetry on the physical and chemical properties of solids are pivotal factors in all areas of crystalline solids. As Jerry Jasinski and I met to bring our ideas in teaching this subject to life, we both felt that `early and often' – teaching the concepts with textual and visual reinforcement, is the key to providing a sound basis for students in this subject. The tutorial contains > 200 PowerPoint `slides', in five modules, arranged by crystal class; a sixth module covers special topics. A `credits' module gives the direct addresses of all embedded links. Space-group diagrams appear in International Tables format. The triclinic and monoclinic groups (2 + 13) are built from `scratch', and are derived from the Hermann–Mauguin symbol. An additional section provides practice on many (but not all) of the orthorhombic groups in crystal class 222. Finally, a `Special Topics' section on enantiomorphous space groups features space groups P41 and P43. In the tutorial, lattice points build iteratively and interactively via keyclick, and the coordinates of points `pop up' as the unit cell is filled. We trust that the elements of guidance, inquiry and occasional humor will make the learning process enjoyable.
Linking brand attitude to word-of-mouth and revisit intentions in the restaurant sector
Authors: Foroudi Pantea , Palazzo Maria , Sultana Asfia
Published: July 2021

Purpose

Following the planned behaviour theory, the aim of the paper is to analyse the role played by brand attachment, brand characteristics and congruence in enhancing brand attitude while leading to revisit intentions and word-of-mouth (WOM) in the restaurant sector.

Design/methodology/approach

The study is based on the quantitative method and considered 464 questionnaires fulfilled by customers of restaurants. The data were explored employing the partial least square–structural equation modelling (PLS-SEM).

Findings

This study expands the literature about WOM and revisit intentions. The paper states that brand attitude positively influenced revisit intentions and WOM. Besides, findings highlighted that analysed concepts were positively correlated and that they played an important role in impacting revisit intentions and WOM, apart from one factor: social self-congruity, which was not significantly related to brand attitude.

Practical implications

The results of this paper show practitioners how to develop suitable strategies that set the bases for developing customer loyalty and repeat business. By putting into practice these suggestions in the restaurant sector, brands can easily build up their attitude and boost a positive WOM and the intention to revisit.

Originality/value

The study offers a conceptual framework to explore the significance of several factors, including revisit intentions and WOM. In practice, taking into account the proposed framework, it is suggested that restaurant managers should assess these two items using several factors including congruence, brand characteristics and brand attachment.
Frito-Lay North America: The Making of a Net Zero Snack Chip
Authors: Teichman William , Larson Andrea
Published: July 2021

Implementing a sustainability strategy requires firms to consider economic, strategic, environmental, and community perspectives. Suitable for MBA, undergraduate, and executive learners, this sustainability case covers innovation, intrapreneurship, and strategy. A technical note entitled, “Corporate Greenhouse Accounting: Carbon Footprint Analysis” (UVA-ENT-0113) is an effective complement. Frito-Lay’s Arizona facility pilots a program to take its snack chip manufacturing off the grid. Decision makers discuss operating, financial, marketing, and corporate strategy as the facility calculates its carbon footprint, converts to non-fossil-fuel energy sources, and stops relying on the scarce local water supply.
Green Ox
Authors: Moore Marian Chapman , Wilcox Ronald T. , Henderson Geraldine R.
Published: July 2021

”Green Ox” was written specifically for a midterm exam in an MBA marketing management class. Rather than focus on one particular concept or issue (e.g., segmentation, product line depth), the case challenges students to develop a marketing strategy for a food and beverage manufacturer’s new line of sports beverages, which contain beneficial antioxidants. Focal decisions include choosing a segmentation scheme(s) and a specific target segment(s) and articulating a positioning statement(s) for the new product—all in light of market trends, customer information, and competitor positions. Students must also make recommendations regarding the product name, number of products in the line, and the price (including a break-even analysis). Distribution and promotion issues are downplayed, yet there is sufficient information to determine whether students’ recommendations on the larger issues account for the necessary integration of the 4Ps.
Analysis of the two-way causal nexus between macroeconomic factors and infrastructure development: the experience of selected African countries
Authors: Azolibe Chukwuebuka Bernard
Published: July 2021

Purpose

The purpose of this study is to analyze the two-way causal nexus between macroeconomic factors such as foreign aid, industrialization, economic growth, population growth, urbanization, control of corruption and the infrastructure development index of the top-ranking African countries from 2003 to 2018.

Design/methodology/approach

The study adopts various econometric tools such as cross-sectional dependence test, panel unit root and cointegration test and Dumitrescu and Hurlin panel Granger causality test in ascertaining the relevant relationships between the variables under consideration.

Findings

The main findings of the Granger causality test result revealed a bidirectional causal relationship between foreign aid and infrastructure and between urbanization and infrastructure. The study also found unidirectional causality running from population growth to infrastructure while a zero causal relationship existed between industrialization and infrastructure, economic growth and infrastructure and lastly, between control of corruption and infrastructure. The study concludes that the major macroeconomic factors that influence infrastructure development in these selected African countries are foreign aid, population explosion and urbanization. Also, their high infrastructure development index has causal influence in only attracting more foreign aid and also promoting urban expansion.

Originality/value

To the best of the author's knowledge, the study is unique as it is the first to determine the two-way causal nexus between macroeconomic factors and infrastructure development using a sample of the top ten African countries in infrastructure ranking. The findings reflect the current situation in Africa.
When the sense of place value is challenged by pandemic: value exchange in indigenous community-based tourism in Sade-Lombok, Indonesia
Authors: Rembulan Cicilia Larasati , Kusumowidagdo Astrid
Published: July 2021

Purpose

The purpose of this study is to investigate problems that emerged in indigenous community-based tourism during the COVID-19 pandemic, to identify the actors involved and to identify values that were exchanged between actors during the pandemic. This research is crucial given the limited studies around indigenous community-based tourism during the pandemic, especially within the perspectives of value exchange theory.

Design/methodology/approach

This research used a constructionist paradigm with a qualitative case study design. Data collection included interviews with six participants, virtual observation, an open-ended questionnaire to 22 community members and 20 tourists, analysis of a book written by Sade’s customary chief and social media artifacts. This study was conducted during the COVID-19 pandemic, where physical distancing measures were applied, therefore most data were collected remotely. Purposive sampling was used and research credibility was increased through detailed note taking, data sources triangulation and member checking. Data analysis was conducted with a coding process, which involved continuous iterations.

Findings

Problems identified were decreased revenue and power disadvantage suffered by indigenous community-based tourism. The actors involved in value exchanges varied, including value supporter (i.e. government, private sector such as television, university), value creator (i.e. tourist) or secondary value provider (i.e. travel agent). Values emerged in the interaction between actors in the network. Changes in value exchanges were in terms of value types, relationship intensity between actors and ways of doing the exchange. Non-human factor (i.e. non-actor) was also involved.

Research limitations/implications

Due to restrictive circumstances (i.e. COVID-19 pandemic), the data collection procedure was limited to online communications and letter correspondence. Therefore, opportunities to capture the full phenomenon might be missed as the researchers could not physically meet with the participant.

Practical implications

It was possible for value exchange to alter due to situational factors, including a pandemic. Business diversification is needed by indigenous community-based tourism to achieve a power advantage. Values were found in the relationship between actors, hence, meeting channels or dialogue with other actors could be optimized.

Originality/value

The context of this study, which was indigenous community-based tourism during a pandemic contributed to the study’s originality. Research in this context, which used a clear theoretical framework such as value exchange theory, is scarce. Thus, opportunities for transferability are broad.
Socialising tourism after COVID-19: reclaiming tourism as a social force?
Authors: Higgins-Desbiolles Freya , Bigby Bobbie Chew , Doering Adam
Published: July 2021

Purpose

This article considers the possibilities of and barriers to socialising tourism after the coronavirus disease 2019 (COVID-19) pandemic. Such an approach allows us to transform tourism and thereby evolve it to be of wider benefit and less damaging to societies and ecologies than has been the case under the corporatised model of tourism.

Design/methodology/approach

This conceptual analysis draws on the theorisation of “tourism as a social force” and the new concept of “socialising tourism”. Using critical tourism approaches, it seeks to identify the dynamics that are evident in order to assess the possibilities for socialising tourism for social and ecological justice. It employs an Indigenous perspective that the past, present and future are interconnected in its consideration of tourism futures.

Findings

COVID-19 has fundamentally disrupted tourism, travel and affiliated industries. In dealing with the crisis, borders have been shut, lockdowns imposed and international tourism curtailed. The pandemic foregrounded the renewal of social bonds and social capacities as governments acted to prevent economic and social devastation. This disruption of normality has inspired some to envision radical transformations in tourism to address the injustices and unsustainability of tourism. Others remain sceptical of the likelihood of transformation. Indeed, phenomena such as vaccine privilege and vaccine tourism are indicators that transformations must be enabled. The authors look to New Zealand examples as hopeful indications of the ways in which tourism might be transformed for social and ecological justice.

Practical implications

This conceptualisation could guide the industry to better stakeholder relations and sustainability.

Social implications

Socialising tourism offers a fruitful pathway to rethinking tourism through a reorientation of the social relations it fosters and thereby transforming its social impacts for the better.

Originality/value

This work engages with the novel concept of “socialising tourism”. In connecting this new theory to the older theory of “tourism as a social force”, this paper considers how COVID-19 has offered a possible transformative moment to enable more just and sustainable tourism futures.
Data usage-based privacy and security issues in mobile app recommendation (MAR): a systematic literature review
Authors: Beg Saira , Khan Saif Ur Rehman , Anjum Adeel
Published: July 2021

Purpose

Similarly, Zhu et al. (2014) and Zhang et al. (2014) stated that addressing privacy concerns with the recommendation process is necessary for the healthy development of app recommendation. Recently, Xiao et al. (2020) mentioned that a lack of effective privacy policy hinders the development of personalized recommendation services. According to the reported work, privacy protection technology methods are too limited for mobile focusing on data encryption, anonymity, disturbance, elimination of redundant data to protect the recommendation process from privacy breaches. So, this situation motivated us to conduct a systematic literature review (SLR) to provide the viewpoint of privacy and security concerns as mentioned in current state-of-the-art in the mobile app recommendation domain.

Design/methodology/approach

In this work, the authors have followed Kitchenham guidelines (Kitchenham and Charters, 2007) to devise the SLR process. According to the guidelines, the SLR process has three main phases: (1) define, (2) conduct the search and (3) report the results. Furthermore, the authors used systematic mapping approach as well to ensure the whole process.

Findings

Based on the selected studies, the authors proposed three main thematic taxonomies, including architectural style, security and privacy strategies, and user-usage in the mobile app recommendation domain. From the studies' synthesis viewpoint, it is observed that the majority of the research efforts have focused on the movie recommendation field, while the mainly used privacy scheme is homomorphic encryption. Finally, the authors suggested a set of future research dimensions useful for the potential researchers interested to perform the research in the mobile app recommendation domain.

Originality/value

This is an SLR article, based on existing published research, where the authors identified key issues and future directions.