bluuebunny/crossref_metadata_2025 huggingface dataset:
Time to Recovery and Determinants of Uncomplicated Severe Acute Malnutrition Among 6 to 59 Months Children From the Outpatient Therapeutic Feeding Program in North Shewa Zone of Oromia Region, Ethiopia: A Prospective Follow-up Study
Authors: Bekalu Amare , Sahlu Degemu , Tadesse Addisu Waleligne , Asmare Biachew , Hune Yidersail , Tilahun Bayou
Published: June 2022

Background:

Community-based management of acute malnutrition is implementing in Ethiopia but there is scarce information in our study set up regarding the time to recovery and its predictors of severe acute malnutrition among 6 to 59 months children, so this study aimed to assess the time to recovery and its predictors for uncomplicated severe acute malnutrition among 6 to 59 children managed at the outpatient therapeutic program in north Shewa zone, Ethiopia.

Methods:

A health post-based prospective follow-up study was conducted on 6 to 59 months children from November 20/2020 to February 20/2021. A total of 423 children had included in the study. A structured interviewer-administered questionnaire had used. The median time to recovery had calculated using the Kaplan-Meier curve. Bi-variable and multi-variable Cox regression models with a 95% confidence interval (CI) were done. Finally, the variable that had a P-value < .05 in the multi-variable analysis was declared as the predictors of time to recovery. Proportional hazard assumption was checked graphically and using Schoenfeld residual test.

Result:

From the total 423 Children, 327 (77.3%) recovered. The median time to recovery was 42 (IQR 14) days. Children from food secure households; AHR = 9.6 with 95% CI (8.1-18.5), mild food insecure; AHR = 6.5 with 95% CI (3.1, 13.8), moderate food insecure; AHR = 2.5 with 95% CI (1.2-5.3). Mothers who traveled less than 2 hours walking distance to the health post; AHR = 2.6 with 95% CI (1.8-18.7). Children who received the correct dose of the RUTF AHR = 1.6 with 95% CI (1.1-2.3), children who measured their weight weekly AHR = 1.5 with 95% CI (1.1-2.0), and children treated by health extension worker who took the Nutrition-related training AHR = 2.1 with 95% CI (1.0-4.5) were predictors of time to recovery.

Conclusion:

The median time to recovery was within the acceptable range of the Ethiopian protocol for the management of uncomplicated SAM in the Outpatient setup. Household food security status, the distance between home and health posts, the correct dose of RUTF, weekly weight measurement per protocol, and HEWs nutrition-related training status were the significant predictors of time to recovery.
The short-term effects of electoral reforms
Authors: Lago Ignacio , Martínez i Coma Ferran
Published: June 2022

While electoral reforms clearly affect how seats are (re)distributed among parties immediately after their adoption, they do not significantly change the (re)distribution of votes among parties. As political knowledge is positively related to turnout, we argue that the effect of majoritarian electoral reforms on the number of parties is contingent upon the turnout in the last election prior to the reform. Specifically, the lower the turnout level in the previous election, the more effective the majoritarian reform will be. However, the psychological effect of proportional reforms relies on the interplay between elites and voters and is highly uncertain. The argument is tested using aggregated data from 43 major electoral reforms worldwide from 1945 to 2020 and individual data from the first election held in New Zealand after the 1993 electoral reform.
Mechanical properties of cast half-grouted sleeve splice with rebar bonding defects
Authors: Che Wenpeng , Chen Jianwei , Liu Ziye , Tian Wenling
Published: June 2022

This paper describes an experimental study on the mechanical properties of cast half-grouted sleeve splice with rebar bonding defects, i.e. strip off ribs or mortar coatings of connecting rebar, which may lead to inadequate cohesiveness between the rebar and grout. A total of 12 groups of specimens were tested to study the effects of bonding defects on the bearing capacity, failure modes, and strain distribution of the grouted sleeve splice. The strip off rib length-to-embedded length ratios (0.3, 0.5, and 1), the proportion of mortar coating surface area along the embedded length (0.5 and 1), and the rebar diameter (12 mm and 20 mm) were investigated. The test results show that the failure modes of the specimens can be divided into rebar tensile failure and rebar bond slip failure. The load-displacement responses of the specimens occurring due to rebar failure were similar. Moreover, the bond strength between the rebar and grout decreased significantly, while the strip off rib length increased. When the strip off rib length coefficient reached 100%, compared with a specimen with no defects, the average tensile capacity of the sleeves splice of 12 mm and 20 mm diameter rebars were decreased by 26.5% and 58.3%, respectively. The mortar coating had no significant effect on the connection performance of the specimens. To evaluate the performance of the specimens, based on the experimental data, simple ratios comprising the yield, strength, ductility and capacity ratios were discussed and proposed.
Reciprocal journalism’s double-edged sword: How journalists resolve cognitive dissonance after experiencing harassment from audiences on social media
Authors: Deavours Danielle , Heath Will , Miller Kaitlin , Viehouser Misha , Palacios-Plugge Sandra , Broussard Ryan
Published: June 2022

Reciprocal journalism is a daily practice for American journalists. Previous studies show it benefits journalists, newsrooms, and audiences (e.g. Coddington, Lewis & Holton, 2018). Conversely, journalists also experience harassment when interacting with audiences online, causing them to view audiences less favorably (Lewis, Zamith, & Coddington, 2020). Through in-depth interviews with 24 professional and former journalists, this study finds journalists experience cognitive dissonance after experiencing harassment during reciprocal journalism, but they are not likely to stop the practice due to organizational and individual benefits perceived as greater than the negatives. The study finds journalists feel personally responsible for resolving dissonance and often use unhealthy resolution techniques like normalization, victim blaming, or perspective-taking to deal with online abuse. The end result could mean dangerous consequences for individuals and the industry long-term. Results suggest a cultural shift in the industry would be necessary to significantly ease dissonant cognitions among individual journalists.
Durkheim and the possible connections between social theory and colonialism
Authors: Dawson Matt
Published: June 2022

In this piece I explore how Bhambra and Holmwood’s Colonialism and Modern Social Theory implies three different questions that can be asked concerning the connections between colonialism and social theory. With reference to their discussion of Durkheim, I suggest the answers they offer to these possible questions return us to what Kurasawa termed the ‘constitutive paradox’ of Durkheim’s relation to colonialism, namely a mix of political acceptance while also questioning its ideological legitimacy. While exploring Durkheim’s comments on colonialism, race, the state and his own Jewishness, I emphasise the need for a careful historical sociology which reckons with the different possible connections between social theory and colonialism.
Novel, original, and business as usual: Contributing in the humanities
Authors: Hellström Tomas
Published: June 2022

This paper focuses on how contributions are argued in research proposals in the humanities. Due to standardizing tendencies in research funding towards formats characteristic of science, technology, engineering and mathematics (STEM) subjects, there has been concern that the humanities are marginalized. In this study, ‘contribution statements’ were identified in proposals funded by the Bank of Sweden Tercentenary Foundation across the humanistic disciplines. These statements were systematically analyzed in terms of type and structure of contributions advanced. The results suggest that the humanities differ from the sciences in terms of specificity of focus, a high level of ‘acceptable serendipity’ in proposed outcomes, but that these disciplines structurally tend to adhere to the same types of research contribution arguments as STEM. A better understanding of the way in which humanities scholars frame contributions offers insight into how these fields change and how they relate to developments in the science policy and funding landscape.
Extending observations of ambient light level and active travel to explore age and gender differences in reassurance
Authors: Fotios S , Uttley J , Gorjimahlabani S
Published: June 2022

Previous studies have gained data from automated counters to compare the influence of ambient light level on the numbers of people walking and cycling. This paper reports an exploratory study using instead in-person counting, the advantage being that the apparent age and gender of each pedestrian and cyclist can also be recorded. The analysis compares travel counts in case and control periods, with case periods in daylight and darkness, to isolate the effect of change in ambient light level. As expected, the results reveal that there are fewer people walking and cycling after dark. What was unexpected was that for pedestrians, the deterrence of darkness was similar for males and females, which disagrees with previous studies capturing stated preferences suggesting that darkness is a greater deterrent for females than for males.
CLIC1 Drives Angiogenesis in Hepatocellular Carcinoma by Modulating VEGFA
Authors: Wei Xuyong , Pan Binhua , Yang Mengfan , Shu Wenzhi , Khan Abdul Rehman , Su Renyi , Lin Hanchao , Xu Xiao
Published: June 2022

Background: Chloride intracellular channel 1 (CLIC1) is upregulated in hepatocellular carcinoma (HCC). The present study aimed to investigate the role of CLIC1 in HCC angiogenesis. Materials and Methods: Immunohistochemistry (IHC) was used to test the expression of CLIC1 and CD34 in 67 pairs of HCC and paracarcinoma tissues. The prognosis data of the patients were used to analyze the clinical relevance of CLIC1. We built a coculture system of HCC cells and endothelial cells to explore the migration of endothelial cells. Conditioned media (CMs) from HCC cells was then collected to assess endothelial cell migration. Experiments were then conducted to confirm the relationship between CLIC1 and angiogenesis in a subcutaneous tumor model. Results: CLIC1 expression was higher in HCC tumor tissues than in paracarcinoma tissues. Patients with increased CLIC1 expression showed a higher microvascular density (MVD; P = .013). Kaplan-Meier curves indicated that patients with lower expression of CLIC1 had better overall survival ( P < .001) and recurrence-free survival ( P = .046). Vascular endothelial growth factor A (VEGFA) in CMs from CLIC1-knockdown cells was lower than in the control group, while VEGFA in CMs from CLIC1 overexpression cells was higher than in the control group. CMs from CLIC1 overexpression cell lines promote the in vitro migration of EA.hy926 cells. Meanwhile, adding Bevacizumab to CMs from CLIC1 overexpression cells significantly inhibited this migration. The growth of xenograft tumors derived from CLIC1-knockdown Huh7 cells was restrained compared with the control group ( P < .001). IHC staining showed MVD was higher in tumors with CLIC1 overexpression. Conclusion: CLIC1 is a promising biomarker for predicting the prognosis of HCC patients, and expression of CLIC1 correlates with angiogenesis in HCC through regulating VEGFA
Tripartite motif-containing 25 facilitates immunosuppression and inhibits apoptosis of glioma via activating NF-κB
Authors: Ge Mao-xu , Shi Yi-kang , Liu Dong
Published: June 2022

As a crucial tumor type of the central nervous system, gliomas are characterized by a dismal prognosis. Tripartite motif-containing 25 (TRIM25), an essential E3 ubiquitin ligase, participates in various biological processes. This study sought to demonstrate its functional role in gliomas. Data obtained from publicly available databases – including The Cancer Genome Atlas (TCGA), the Chinese Glioma Genome Atlas (CGGA), and the Repository for Molecular Brain Neoplasia Data (REMBRANDT) – were employed. TRIM25 expression pattern and its association with different clinical characteristics were analyzed. Kaplan–Meier analysis was utilized to compare different TRIM25 expressions with glioma patients’ survival. Subsequently, we performed bioinformatic analyses to investigate the biological functions of TRIM25, which were further validated by in vitro experiments, CIBERSORT algorithm, and ESTIMATE evaluation. TRIM25 expression was upregulated in glioma patients and can predict an unfavorable prognosis. Bioinformatic results indicated the involvement of TRIM25 in apoptosis and immune regulation. TRIM25 was associated with programmed death-ligand 1 (PD-L1) related and macrophage-induced immune suppression in gliomas. Meanwhile, silencing TRIM25 promoted apoptosis in glioma cells, which is attributed to its regulation of NF-κB. Therefore, TRIM25 contributed to the glioma malignant progression and suppressive immune microenvironments via NF-κB activation, which may play a therapeutic role in gliomas.
The Complex Process of Using the Interconnected Knee Arthroplasty Device Clearance Pathway
Authors: Zhu Andrew , Ying Xiaohan , Pean Christian A. , Sheth Neil P. , Cross Michael B. , Gonzalez Della Valle Alejandro , Premkumar Ajay
Published: June 2022

Background: The clearance of medical devices by the US Food and Drug Administration (FDA) has remained largely unchanged since 1976, when the Medical Device Amendments Act established a system classifying devices into 3 categories based on safety risk to the consumer. The system allows for the clearance of many orthopedics devices through the 510(k) premarket pathway, which is based on “predicate ancestors,” previously cleared devices that are “substantially equivalent.” Purpose: We sought to trace the predicate ancestors of modern total knee arthroplasty (TKA) devices, specifically those recently cleared for marketing by the 510(k) pathway that claim substantial equivalence to prior devices, despite potential differences in material science and design. In addition, we aimed to document which TKA devices cleared by the 510(k) pathway have substantial equivalence to devices that have since been recalled by the FDA. Methods: To create a comprehensive list of TKA devices, we used FDA Classification Process Codes corresponding to knee arthroplasty to search the FDA’s databases from May 28, 1976, the start of the 510(k) process, to May 1, 2021. Of 1309 resulting devices, 89 were excluded as not related to arthroplasty. For each of the remaining devices, we analyzed the descendant devices that claimed substantial equivalence, either directly or indirectly. We used data of recalled designs to determine both the absolute number of recalled devices and the number of currently cleared devices that presented substantial equivalence claims upon predicates that have since been recalled. Results: Of 1220 knee devices cleared or approved, 6 (0.5%) were approved through the premarket approval application (PMA) process, and 1214 (99.5%) were cleared through the 510(k) pathway. Of the 1214 cleared devices, 217 (17.9%) have been recalled and 204 (16.8%) have ties to at least 1 recalled predicate device linked through generational claims of substantial equivalence. We found 90 devices (7.4%) linked directly to a recalled predicate device. Conclusions: Most knee arthroplasty devices are cleared for marketing through reliance on a complex web of equivalency to previously cleared predicates. We found that many TKA devices thus connected were cleared decades apart, with multiple iterations of design and material modifications. Many currently marketed TKA devices have claimed equivalency to predicates that have been recalled. Our findings suggest the need for novel regulatory strategies that might further patient safety while balancing the unwanted effects of regulatory burden.
A Mixed-Methods Pilot Evaluation of Manhood 2.0, a Program to Reduce Unintended Pregnancy Among Young Men
Authors: Manlove Jennifer , Parekh Jenita , Whitfield Brooke , Griffith Isabel , Garg Aapta , Fasula Amy M.
Published: June 2022

One promising though understudied approach to addressing race/ethnic disparities in teen pregnancy rates is through sexual and reproductive health (SRH) programming for young men. This pilot study assessed the feasibility, quality, and preliminary efficacy of Manhood 2.0—a group-based, after-school SRH program for young Black and Latino men, which examines gender norms. This mixed-methods study describes program attendance and quality; participant experiences and engagement in the program; and changes in participant gender norms, knowledge, attitudes, self-efficacy, and social support. Quantitative data from baseline and post-intervention surveys ( n = 51) were analyzed using paired t-tests and McNemar’s tests. Qualitative data from five post-intervention focus groups ( n = 27) were transcribed, coded, and analyzed for themes. At baseline, participants were ages 15 to18 years ( M = 16.4 years), 30% were Latino, 66% were Black, 34% ever had sex, and 44% of sexually active participants had sex without any contraceptive method or condom. Quality ratings by program observers were high. The majority of participants (61%) attended at least 75% of sessions, and 96% rated Manhood 2.0 as “very good” or “excellent.” Pre–post comparisons showed increases in receipt of SRH information; contraception knowledge; positive attitudes about supporting partners in pregnancy prevention; self-efficacy in partner communication about sex; discussing program content with friends and family; and social competence and support. Focus group participants described benefits from the Manhood 2.0 content (i.e., full range of contraceptive methods, sexual consent, gender norms) and delivery (i.e., reflective discussion, nonjudgmental facilitators). Findings suggest that Manhood 2.0 is a promising SRH program for young men.
Radial Osteotomy With Callus Distraction for the Correction of Severe Madelung Deformity
Authors: Sugiura Hirotaka , Horii Emiko , Koh Shukuki
Published: June 2022

We report a case of an 11-year-old girl with bilateral severe Madelung deformity who underwent radial osteotomy with callus distraction. The distal radial articulation was corrected at surgery, and a unilateral fixator was subsequently used for callus distraction. No postoperative complication was noted. The patient did not need any additional surgeries for correction of the deformity. Forty-three months after surgery, the patient had a nearly full range of motion without any pain. Forearm deformity was not noticeable, except for surgical scar on both wrists.
The effects of couple stress lubricants and surface roughness on squeeze EHL motion between porous medium layer and elastic ball
Authors: Chu Li-Ming , Chang-Jian Cai-Wan , Hsu Hsiang-Chen
Published: June 2022

This paper investigated the effects of porous media layer (PML) and couple stress (CS) lubricants at pure squeeze action in an isothermal elastohydrodynamic lubrication (EHL) point contact with surface roughness (SRN) under constant load condition. The modified transient stochastic Reynolds equation was derived in polar coordinates by means of the Christensen’s stochastic theory and the Stokes’s CS fluid theory. The Gauss-Seidel method (GSM) and the finite difference method (FDM) were both used to solve simultaneously modified transient stochastic Reynolds, force equilibrium, elasticity deformation, and rheology equations. The simulation results revealed that the greater permeability ( K) and porous layer thickness (Φ) are, the smaller central pressures ( Pc) are, and the smaller film thicknesses ( H) are. The times required for achieving maximum central pressures (Pcmax) decrease with increasing K and Φ. Due to squeeze and elastic deformation effects, the slope values of central velocity ( Vc) change from negative to positive. The magnitude of Vc and Vmin decreased with decreasing K and Φ. The Hcmin of circular type RN are greater than that of radial type RN. The Pcmax of radial type RN are slightly greater than that of circular type RN.
Axial compression behavior of precast circular semi-continuous concrete-filled steel tube columns
Authors: Cao Bing , Xie Mingming , Zhu Longfei , Cao Wancheng , Huang Bo , Du Yihan , Wang Jiawei , Yang Yizhen , Wang Changsheng
Published: June 2022

To study the axial compression performance of precast circular semi-continuous concrete-filled steel tube (PCSCFST) column, a total of 17 specimens were prepared and tested, including 13 PCSCFST columns and 4 continuous CFST columns. This PCSCFST column is made up of upper and lower steel tubes and outer steel tubes connected by bolts, which has the advantages of easy factory production and convenient transportation. The results showed that shear failure occurred in continuous CFST columns, but not in PCSCFST columns, bolts had obvious influence on failure mode. Maintaining the consistency of the thickness of each steel tube on the specimen can not only improve the local buckling, but also avoid the short plate effect to give full play to the material performance. Moreover, with the increase of steel tube thickness, concrete strength, bolt diameter, reduction of specimen length and pure bolt connection instead of bolt and weld combination connection, the deformation resistance of bolts and axial compression performance of specimens had been enhanced. However, the increase of bolt diameter from 12 to 18 mm resulted in a better strength degradation rate, but worse bearing capacity and deformation resistance. Finally, the predictions of the ultimate bearing capacity of PCSCFST columns under axial compression agree well with the test results, the average value of Nexp/ Npre and the variance are 0.998 and 0.00111.
A speedup method for solving the inverse kinematics problem of robotic manipulators
Authors: Xie Shuxin , Sun Lining , Wang Zhenhua , Chen Guodong
Published: June 2022

The inverse kinematics problem involves the study that the inverse kinematics solver needs to calculate the values of the joint variables given the desired pose of the end-effector of a robot. However, to apply to seven-degree-of-freedom robots with arbitrary configuration, analytical methods need to fix one joint and set an increment when the current value fails to solve the inverse kinematics problem. Although numerical methods based on inverse differential kinematics are efficient in solving the inverse kinematics problem of seven-degree-of-freedom robots with arbitrary geometric parameters, they are deficient in numerical stability and time-consuming for convergence to one solution governed by the initial guess. In order to reduce the execution time of an inverse kinematics solver, this article introduces a speedup method for analytical and numerical methods, which can improve their performance.
Role extension in advanced ultrasound practice: A framework approach and case study
Authors: Reeve Ruth , Higginson Antony , Ball Christopher , Beable Richard , Smith Mike
Published: June 2022

Introduction:

Role extension into novel areas of ultrasound practice can be challenging for health care professionals. Expansion into existing areas of advanced practice typically occurs using established processes and accredited training; however, in areas where there is no formal training, there can be a lack of support for how to develop new and progressive clinical roles.

Topic Description:

This article presents how the use of a framework approach for establishing areas of advanced practice can support individuals and departments with safely and successfully developing new roles in ultrasound. The authors illustrate this via the example of a gastrointestinal ultrasound role, developed in an NHS department.

Discussion:

The framework approach comprises three elements, each interdependent upon and inform each other: (A) Scope of practice, (B) Education and competency and (C) Governance. (A) Defines (and communicates) the role extension and area(s) of subsequent ultrasound imaging, interpretation and reporting. By identifying the why, how and what is required this informs (B) the education and assessment of competency for those taking on new roles or areas of expertise. (C) Is informed by (A) and is an ongoing process of quality assurance to safeguard high standards in clinical care. In supporting role extension, this approach can facilitate new workforce configurations, skill expansion and enable increasing service demands to be met.

By defining and aligning the components of scope of practice, education/competency and governance, role development in ultrasound can be initiated and sustained. Role extension utilising this approach brings benefits for patients, clinicians and departments.
Institutionalising restorative justice for adults in Scotland: An empirical study of criminal justice practitioners’ perspectives
Authors: Butler Siobhan , Maglione Giuseppe , Buchan Jamie
Published: June 2022

While in some European and extra-European countries the incorporation of restorative justice into policy frameworks is a dated and widely studied phenomenon, in others it is a more recent and scarcely researched process. The Scottish Government is making renewed efforts to institutionalise restorative justice including the ambitious goal of making adult restorative justice available nationwide by 2023. In this article, we analyse the consequences of these recent attempts, addressing a gap in knowledge on adult restorative justice in Scotland. We gathered views from justice professionals ( n = 17), involved in organising and delivering adult restorative justice, on the implementation of the policy and the future of Scottish restorative justice. Findings show that participants support expanding restorative justice services, but are sceptical about the Scottish Government’s approach. They advocate for a coordinated but locally sensitive model of restorative justice development, to some extent challenging the stark opposition between ‘purist’ and ‘maximalist’ approaches to the expansion of restorative justice. These findings generate evidence to critically assess Scottish restorative justice policy and its implementation, while drawing implications for the development of restorative justice across Europe.
Death’s common sense: Casualty counts in war reportage from Syria and beyond
Authors: Blacksin Isaac
Published: June 2022

In distilling war to the amount of bodily harms it causes, war becomes measurable, comparable, and intelligible in its journalistic depiction. Yet the self-evidence of casualty counts mystifies both the contingencies of numerical production and the discursive authority that numbers are employed to evoke. Utilizing two years of ethnographic research with the international press corps in Syria, Iraq, and Lebanon, this article argues that the importance of casualty counts may be less the statistical reality of war such numbers purport to deliver than it is the symbolism these numbers provide. The ongoing conflict in Syria provides a central case study, approached ethnographically through two registers. First, the author examines on-the-ground casualty counting, demonstrating that what cannot be counted of war yet affects those journalists tasked to quantify war. This circumstance throws into doubt the utility of numbers – and the authority of journalism – for distilling war’s reality. Second, he examines how data on total wartime deaths in Syria, collected by monitoring organizations, is acquired and reproduced by journalists. Here journalists must reckon with the translation of statistical uncertainty into symbolic truth. Finally, the author reflects on the particularity of casualty counts as a journalistic convention, and considers how this particularity is hidden behind a journalistic common sense.
Aesthetic correction of short nail deformity in congenital brachydactyly Type D by distraction lengthening
Authors: Jiang Yongkang , Hou Zhidian , Huang Lei , A. Chi Jialun , Zhang Yingfan , Sun Wenhai
Published: June 2022

Brachydactyly Type D is a congenital condition of the thumb in which there is a short and broad thumbnail. Although the thumb function is often unaffected, some patients seek surgery for cosmetic improvement. This study aimed to describe our method of distraction lengthening to correct nail deformity in brachydactyly Type D. A total of 163 thumbs in 95 patients underwent this surgery between 2018 and 2021.The mean thumbnail length improved from 9 mm to 15 mm, with a mean percentage increase of 62%. The ratio of nail length to width changed from 0.6 to 1.1, which was equal to normal. The mean increased fingernail length/width ratio was 0.5, with a percentage change of 78%. No obvious surgical scar was observed. The thumb function was not significantly affected. We conclude that aesthetic correction of short nail deformity in brachydactyly Type D can be achieved by distraction lengthening with high satisfaction and without functional impairment.

Level of evidence: IV
A curious case of ‘COVID toes’ in pregnancy
Authors: Wilson-Morkeh Harold , Thorne Iona
Published: June 2022

The novel coronavirus of 2019 (COVID-19) can affect multiple organ systems with a wide spectrum of illness severity. Its effect on the respiratory tract is well-documented and has resulted in considerable excess mortality worldwide. However, observed cutaneous manifestations of COVID-19 are rising, ranging from short-lived viral exanthems to vesicular eruptions and urticaria. An unusual subgroup of these manifestations – pseudo-chilblains, also referred to as pernio-like lesions or ‘COVID toes’ – describes the acral areas of erythema and oedema that can affect young individuals following COVID-19. We present a case associated with pustule and vesicle formation occurring in the context of pregnancy.
The effect of health promotion training provided to elderly individuals during the COVID-19 pandemic on healthy lifestyle behaviors
Authors: Polat Filiz , Karasu Fatma
Published: June 2022

Background:

One of the areas most affected by the COVID-19 pandemic is health promotion. In order to improve the quality of life of elderly individuals, it is important to develop and implement effective intervention strategies that can prevent negative health outcomes.

Purpose:

The aim of this study is to determine the effect of health promotion training provided to elderly individuals on healthy lifestyle behaviors.

Methods:

This study was conducted as a randomized-controlled experimental study. The study was completed with 140 elderly individuals over 65 years of age, including 70 participants in intervention group and 70 participants in control group. The data were collected using the Information Form and the Healthy Lifestyle Behaviors Scale-I. Training was provided to the intervention group as one session a week for three weeks. Percentage, arithmetic mean, and standard deviation as well as chi-square, dependent samples t-test, and independent samples t-test were used to assess the data.

Findings:

While the pretest mean score of the intervention group for the overall Healthy Lifestyle Behaviors Scale-I was 103.90 ± 16.96, their posttest mean score was 136.17 ± 19.60 and it was found that there was a statistically significant difference between the results ( p = 0.000). While the pretest mean score of the control group for the overall Healthy Lifestyle Behaviors Scale-I was 107.22 ± 21.09, their posttest mean score was 106.57 ± 21.49 and it was found that there was no statistically significant difference between the results ( p = 0.609).

Conclusion:

It was observed that healthy lifestyle behaviors of elderly individuals in the intervention group improved positively.
Cost-effectiveness of ribociclib for premenopausal or perimenopausal women with HR+/HER2− advanced breast cancer: a Brazilian public health care system perspective
Authors: Rosa Daniela Dornelles , Magliano Carlos Alberto da Silva , Simon Sergio D. , Amorim Gilberto , Reinert Tomás , Landeiro Luciana , Gagliato Débora de Melo , Exman Pedro , Argolo Daniel , Guilgen Gisah , Mano Max , Testa Laura , Liedke Pedro , Barroso Romualdo , Sasse Mariana , Buehler Anna Maria
Published: June 2022

Introduction:

The MONALEESA-7 trial compared ribociclib plus endocrine therapy (ET) with placebo as first-line treatment of advanced luminal/HER2-negative breast cancer (ABC) in premenopausal and perimenopausal women (age <50 years) and showed significant benefits to progression-free survival and overall survival. This study aimed to compare the cost-effectiveness of ribociclib + ET versus ET alone in patients with ABC from the perspective of the Brazilian public national health system.

Methods:

We calculated the incremental cost-effectiveness ratio (ICER) using a Markov model with progression-free survival, post-progression survival, and death states. We expressed ICER as incremental costs per progression-free life-year (PFLY) and quality-adjusted life-year (QALY) gained in a 10-year time horizon. We used parametric survival distributions fit to MONALEESA-7 data to generate survival distributions for progression-free and post-progression survival. The largest British preference study in breast cancer served as the basis to estimate health-state utilities. We estimated direct costs (ABC treatment, follow-up, monitoring, and adverse events) using Brazilian-specific values from public sources. An expert consensus panel determined the resource patterns required. We applied annual discounts of 5% to costs and QALYs.

Results:

Ribociclib + ET resulted in an incremental gain of 1.03 PFLYs and 0.80 QALYs at a cost of $37,319.31. The ICER of ribociclib + ET versus ET was $36,379.41 per PFLY gained and $46,590.79 per QALY gained. In deterministic sensitivity analysis, results were primarily affected by the annual discount rate, followed by the cost of ribociclib. In probabilistic sensitivity analysis, simulations agreed with the base-case.

Conclusion:

Ribociclib increased PFLYs and QALYs in patients with HR+/HER2− ABC when added to ET. Because Brazil does not have a formally defined cost-effectiveness threshold, other domains need to be considered for incorporation decisions, such as disease burden and humanistic impact on this young, economically active population. These findings may be useful in discussions for incorporation of ribociclib into the Brazilian public health system.
Effects of Micro Architectural Environmental Interventions on Handwashing Compliance of Adolescents: A School-Based Intervention Trial
Authors: Bai Xiaoxia , Li Xinxin , Yan Ding , Yang Hui , Tu Kun
Published: June 2022

Purpose:

Aimed to explore more practical interventions for handwashing compliance (HWC) and protect the minor’ health with the pandemic background, this study tested whether micro architectural interventions would promote HWC of adolescents through active experience.

Background:

Despite the well-documented benefits of handwashing (HW), low compliance is common among adolescents. HW space in schools has always been treated as attached spaces of little matter, which is unfavorable to public health. According to environment behavior perspective, personal motivation of HWC may be motivated by active environment.

Method:

A school-based investigation and a 30-week environmental behavior experiment were conducted when students returned to school after the COVID-19 pandemic closure in 2020 in China to evaluate the effects of active environment interventions selected by previous survey on promoting adolescents’ HW rate. Digital infrared counters were used to unobtrusively document their behavior.

Results:

Results in summer revealed a positive effect on all intervention groups. The effects of combined interventions were higher than the effect of any single intervention. However, HW rates of all groups declined sharply in the coldest month and the between-group differences decreased. Significant correlations were found between HW rates and satisfaction with the intervention schemes.

Conclusions:

Findings suggest that architectural environmental intervention may potentially be a positive, friendly, and one-time investment mean to expand the HWC intervention scope from passive policies to positive experience, and HW space design for adolescents should be treated as a public health strategy.
Bilateral diaphragmatic dysfunction: A cause of persistent dyspnea in patients with post-acute sequelae of SARS-CoV-2
Authors: Gill Christine , Garg Alpana , Fakih Rami , Hamzeh Nabeel Y
Published: June 2022

Persistent shortness of breath is one of the most common concerns reported by patients with post-acute sequelae of SARS-CoV-2. Here, we present a case of bilateral diaphragmatic paralysis as a cause shortness of breath that developed after SARS-CoV-2 infection. A middle-aged gentleman with history of sleep apnea and body mass index 27.9 kg/m2 presented to our post-COVID clinic with 3 months of dyspnea and orthopnea after contracting SARS-CoV-2 in November 2020. During acute infection, he was hospitalized for hypoxemia, which improved with steroids and supplemental oxygen. At 3 months, he continued to report dyspnea and orthopnea. On examination, he had tachycardia and increased respiratory rate with paradoxical respiratory abdominal movement. Chest imaging showed elevated bilateral hemidiaphragms without any parenchymal lung disease. Pulmonary function test revealed severe ventilatory defect with restrictive lung disease. He was diagnosed with bilateral diaphragmatic dysfunction which was confirmed by absence of evoked potentials in diaphragm after phrenic nerve stimulation bilaterally. He was advised to use continuous positive airway pressure machine to assist with breathing at night. At his last follow-up (1-year post-infection), he was symptomatically improving without specific interventions.
The Role of Teaching Styles in the Development of School Alienation and Behavioral Consequences: A Mixed Methods Study of Luxembourgish Primary Schools
Authors: Grecu Alyssa L. , Hadjar Andreas , Simoes Loureiro Kevin
Published: June 2022

This mixed-method research study aims at an analysis of the role of teaching styles in the development of school alienation and behavioral consequences. Applying an in-depth design, this study combines a quantitative panel study, a student survey (grades 5–6), and qualitative focus groups with Luxembourgish primary school students (grade 6). Methodologically, we aim to demonstrate potentials and limits of integrating quantitative and qualitative research. Quantitative results show that teaching styles affect students’ alienation from teachers and from learning, and eventually from classroom participation and social behavior. Qualitative content analysis reveals that students characterize a fair teaching style as the equal treatment of all students regarding classroom rules and teachers’ empathy for students’ intentions.
Persistent Eosinophilia and Fever in Pancreatitis: A Clinical Conundrum
Authors: Noel John , Fields Abbott , Rami Arrouk , Nirupma Sharma
Published: June 2022

A healthy 11-year-old girl presents with epigastric abdominal pain, fever, weight loss, and decreased appetite for 1 month. On physical examination, she appears ill, dehydrated, and cachectic. Her abdominal examination is significant for large ascites with a fluid wave and is nontender to palpation. Her labs show leukocytosis with an eosinophilic-predominant granulocytosis and an absolute eosinophil count of 6800/mm3. She has elevated serum inflammatory markers, hypoalbuminemia, and lipase is 5000 U/L. Magnetic resonance cholangiopancreatography (MRCP) shows an irregular and dilated pancreatic duct, so she had an endoscopic retrograde cholangiopancreatography with pancreatic stent placement, paracentesis, and colonoscopy. Her peritoneal fluid was significant for an eosinophilic-predominant granulocytosis with no evidence of malignancy on flow cytometry. All other studies and cultures did not reveal an etiology. She initially showed improvement, 18 days later she developed a fever, night sweats, tachycardia, and abdominal distention. Empiric antibiotics were initiated due to concern for infected pancreatic necrosis versus spontaneous bacterial peritonitis. Repeat MRCP showed interval development of 2 peripancreatic fluid collections and re-accumulation of ascites. She continued to have daily fever ranging from 39°C to 40°C. Repeat paracentesis and evaluation of her peritoneal fluid showed resolution of eosinophilia with an elevated neutrophil count, negative Gram stain, and no growth on culture. She completed a 10-day course of antibiotics, however, remained febrile with elevated inflammatory markers and leukocytosis throughout her hospitalization. A genetic panel to evaluate for a hereditary cause of chronic pancreatitis was sent and returned positive for a mutation of the serine protease inhibitor Kazal type 1.
A Case of Prenatally Diagnosed Congenital Adrenal Hyperplasia With Brain Morphometric Differences
Authors: Rajagopalan Vidya , Overholtzer Lloyd Nate , Kim William S. , Wisnowski Jessica L. , Miller David A. , Geffner Mitchell E. , Kim Mimi S.
Published: June 2022

We report a case of a fetus with a prenatal diagnosis of classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. Although CAH is typically assessed postnatally, this fetal case had multiple prenatal clinical assessments made feasible by an interdisciplinary CAH center. The approach facilitated the development and delivery of comprehensive and earlier care for the fetus, and the family living with this complex, congenital condition, with perinatology, endocrinology, genetic counseling, psychology, and urology involvement. As well, the addition of fetal MRI to standard ultrasound revealed significant deficits in the biparietal diameter, occipitofrontal diameter, and total intracranial volume of the fetal CAH brain. These early anomalies in the brain suggest that neurological comorbidities observed in older children and adults with CAH should be studied as early as prenatally, with the addition of fetal MRI to ultrasound potentially being useful for identifying and understanding prenatal anomalies in CAH.
A Multilevel, Agent-Centered Analysis of Intersectionality in a Hispanic-Serving Institution: The Case of College Internship Access for Latinx Students
Authors: Hora Matthew T. , Wolfgram Matthew , Huerta Adrian H. , Lee Changhee , Gopal Anita
Published: June 2022

Internships are widely viewed as “door openers” to opportunity, yet students without ample financial, social, and institutional supports are often excluded from these experiences. This exclusion is especially problematic for Latinx students attending Hispanic-Serving Institutions, for whom an internship could be transformative. In this article, we elaborate upon Núñez’s (2014) multilevel model of intersectionality to highlight how agents’ perceptions, social categories, embodied practices, and broader contextual forces interrelate to shape Latinx students’ access to internship opportunities at a university in the border region of Texas. Using inductive thematic, correlational, and social-network analysis techniques to analyze survey (n = 192) and focus group (n = 12) data, we find that gender, academic major, socioeconomic status, and race intersect with organizational (e.g., insufficient information) and contextual (e.g., labor markets) factors to shape students’ access and perceptions. We provide recommendations for disrupting systemic inequalities in internship access and culturally appropriate programming and ideas for future research.
Development and Validation of the Psychiatric Inpatient Experience (PIX) Survey: A Novel Measure of Patient Experience Quality Improvement
Authors: Klemanski David H. , Barnes Todd , Bautista Cynthia , Tancreti Cristina , Klink Beth , Dix Ebony
Published: June 2022

Objective: Managing patient experience is critical in transforming organizational cultures into high-quality patient-centered care systems. Patient experience measurement should ideally entail a framework for understanding a patient's interactions and perceptions across the continuum of care. The purpose of this study was to develop a psychometrically valid survey via a rigorous measurement development and validation process. Methods: An initial 28-item, five-domain survey with 2 additional open-ended prompts for narrative feedback was developed and piloted using exploratory and confirmatory factor analyses on a sample of 2438 individuals. A thematic analysis was subsequently performed based on the open-ended items to elucidate primary and secondary themes of patients’ narrative feedback. Results were used to further inform a conceptual framework and item design. Results: Factor analyses produced 4 factors (treatment team relationships, nursing team presence, treatment effectiveness, and healing environment). These 4 factors are associated with inpatient psychiatric patient experience, suggesting validity. Discussion: The Psychiatric Inpatient Experience (PIX) ysurvey integrates patient experience theory as well as aspects of patient-centered care that are important to psychiatric inpatients. It provides organization and discipline-specific feedback to facilitate opportunities for patient experience improvements.
Patient Priorities for Pulmonary Rehabilitation Research
Authors: O’Hoski Sachi , Ellerton Cindy , Ellerton Lauren , Brooks Dina , Goldstein Roger
Published: June 2022

Patient engagement in setting research priorities may guide a clinical research program to ensure relevance to the target population. In this cross-sectional survey, people who had participated in pulmonary rehabilitation were asked to prioritize research topics relevant to this area. Twenty-four previously identified topics were presented under 7 themes. Respondents were asked to select all themes and topics of importance, and then to rank them in order of importance. Ninety-six responses were included. The top ranked topic in the top ranked theme was creating an after-maintenance program to keep patients on track.
Working from home: Findings and prospects for further research
Authors: Kaiser Stephan , Suess Stefan , Cohen Rachel , Mikkelsen Elisabeth Naima , Pedersen Anne Reff
Published: June 2022

Working from home has not only attracted attention during the Covid-19 pandemic but has been researched for a long time in connection with topics such as the flexibilization of work, digitalisation and changing values. Central issues around the organisational and societal phenomenon of working from home are linked to the resources and strains of employees. This has direct consequences for the leadership and management of human resources. In this article, we review the results of research contributions available in this issue and at the same time show that working from home raises even broader questions, for example about the emergence of new hybrid forms of organisation and employment or social justice or new infrastructures for living and working.