bluuebunny/crossref_metadata_2025 huggingface dataset:
Odds-wise view: Whose ideas prevail in the global integrity campaigns against match-fixing?
Authors: Tak Minhyeok , Choi Chang-Hwan , Sam Michael P
Published: October 2021

The global expansion of sports betting has resulted in the formation of (inter)national governing regimes aimed at sustaining revenue and regulating attendant issues, including match-fixing. This article explores the workings of these regimes vis-à-vis the management of match-fixing issues in sport. More particularly, this article focuses on betting monitoring programmes as countermeasures against match-fixing and conceptualises these as social instruments that ultimately define issues and influence the wider integrity agenda of anti-match-fixing campaigns. Analysing documentary, observation and interview data from two disparate monitoring programmes, the results show that betting monitoring is a technical extension of corporate risk management, invariably reflecting the business interests of the betting industry. Therefore, the operating logic of betting monitoring defines match-fixing as an act of sabotaging the competitive edge of betting companies. Moreover, this interest-laden paradigm reigns within the broader policy agenda of sport integrity by equating the betting industry's interest with that of sport. From this, the article suggests that betting monitoring plays a part in the legitimation of commercial gambling by reframing the issue of match-fixing as a common enemy that gambling and sport join forces to combat, not a risk that gambling brings to sport.
Predisposing Factors for Posttraumatic Osteoarthritis After Malleolus Fracture Fixation in Patients Younger Than 50 Years
Authors: Beak Jong Seok , Kim Yeong Tae , Lee Sung Hyun
Published: October 2021

Background:

The purpose of this study was to identify the risk factors for posttraumatic osteoarthritis (OA) after surgery for ankle fractures in patients aged ≤50 years.

Methods:

We performed a retrospective review of consecutive patients who underwent surgery for ankle fractures and were followed up for a minimum period of 5 years. The patients were assigned to 2 groups according to the presence of advanced OA at the last follow-up. Binary logistic regression was used to model the correlation between risk factors and OA. Functional outcomes were assessed using the Foot and Ankle Outcome Score.

Results:

The data of 332 patients who met the inclusion criteria were included in the analysis. The overall rate of posttraumatic arthritis was 27.7% (nonarthritis group: 240 patients, arthritis group: 92 patients). The arthritic change was significantly affected by BMI (95% confidence interval [CI] 1.29-19.76; adjusted odds ratio [OR] ≥ 30, 6.56), fracture-dislocation injury (CI 1.66-11.57; adjusted OR, 4.06), posterior malleolus (PM) fracture (CI 1.92-12.73, adjusted OR > 25% of the articular surface, 5.72), and postoperative articular incongruence (CI 1.52-18.10; adjusted OR, 7.21). The mean scores of the arthritis group were lower than those in the nonarthritis group ( P < .05).

Conclusion:

Obesity, fracture-dislocation injury, concomitant large PM fracture, and articular incongruence were risk factors of posttraumatic OA after surgery for ankle fractures. Surgeons should be aware that accurate reduction is critical in patients with ankle fractures with associated large PM fractures, especially those with obesity or severe initial injuries such as fracture-dislocation.

Level of Evidence:

Level III, case control study.
The Use of Evaluability Assessments in Improving Future Evaluations: A Scoping Review of 10 Years of Literature (2008–2018)
Authors: Lam Steven , Skinner Kelly
Published: October 2021

Since the beginning of the 21st century, evaluability assessments have experienced a resurgence of interest. However, little is known about how evaluability assessments have been used to improve future evaluations. In this article, we identify characteristics, challenges, and opportunities of evaluability assessments based on a scoping review of case studies published since 2008 ( n = 59). We find that evaluability assessments are increasingly used for program development and evaluation planning. Several challenges are identified: politics of evaluability; ambiguity between evaluability and evaluation, and limited considerations of gender equity and human rights. To ensure relevance, evaluability approaches must evolve in alignment with the fast-changing environment. Recommended efforts to revitalize evaluability assessment practice include the following: engaging stakeholders; clarifying what evaluability assessments entail; assessing program understandings, plausibility, and practicality; and considering cross-cutting themes. This review provides an evidence base of practical applications of evaluability assessments to support future evaluability studies and, by extension, future evaluations.
Bouncing ball lubrication
Authors: Larsson Roland
Published: October 2021

My interest in the lubrication mechanisms of a ball bouncing and impacting an oily plate brought me into contact with Professor Duncan Dowson. Our very first meeting was at a conference where we presented almost identical results. After that, in 1995, I was invited to Leeds University for a one-semester visit. I was still a PhD student and the visit helped me a lot to develop as a person and as a scientist Duncan helped me in this development through his skilful guidance and by putting me in touch with other knowledgeable people in my field. The bouncing ball problem was about understanding elastohydrodynamic lubrication (EHL) under non-steady conditions. In fact, most EHL contacts operate under non-steady conditions since load, speed and curvature often varies rapidly during the operation of machine elements such as gears, rolling bearings and cam mechanisms. In this paper, I will tell you about the bouncing ball problem and how Duncan Dowson became an important person for me.
Task modality and language-related episodes in young learners: An attempt to manage accuracy and editing
Authors: Martínez-Adrián María , Gallardo-del-Puerto Francisco
Published: October 2021

Task modality (oral vs. writing) has been found to affect the production, nature and resolution of the language-related episodes (LREs) produced by adult learners in collaborative interaction, a finding also attested in very recent and still limited research with young learners, a population that deserves greater attention in the literature. Besides, previous research has not yet considered the incorporation of LREs in the final output of both oral and written tasks. Nor has it controlled for the differential levels of accuracy that the oral vs. the written modality demand, or the opportunity for revising the output equally in both modalities. Besides, little is known about learners’ motivation towards tasks of different modality. This article fills these gaps by examining the effect of task-modality on the production of LREs by 10- to 12-year-old schoolchildren performing an oral+writing task and an oral+editing task, as well as its effect on their task motivation. Task modality effects were evinced in terms of nature and incorporation of LREs, the written mode leading to greater focus on form and incorporation of accurately resolved LREs. The possibility of editing the oral output resulted in enhanced target-likeness of resolved LREs. As for task motivation, learners perceived both tasks as equally motivating.
Advances in Research on Abused Women in China: Bibliometric Analysis by CiteSpace
Authors: Han Xiao , Wei Dong
Published: October 2021

China has made remarkable progress in preventing and intervening in domestic violence against women. Scholars have reported on this development. Methodologically, this paper, which draws on 3362 references selected from the China National Knowledge Infrastructure, uses the bibliometric method to summarize the characteristics, evolution, and frontiers of key topics into research on abused women in China between 1993 and 2020. The paper has three key findings. (1) The volume of literature has grown continuously, but in three stages: initial, rapid growth, and peak fluctuation; (2) the topic has five research hotspots: fundamental issues in domestic violence against women; new legislation, notably the 2015 Anti-Domestic Violence Law; social support for abused women; matrimonial disputes involving abused women; and conviction and sentencing of abused women who kill their husbands; and (3) the current research frontiers lie within the defects of the Anti-Domestic Violence Law and challenges in the implementation of the law. In addition, the paper examines characteristics and limitations of the study on abused women in China and suggests changes in practice, policy, and directions for future research.
The Characteristics of Power Spectral Density in Bipolar Disorder at the Resting State
Authors: Sunaga Masakazu , Takei Yuichi , Kato Yutaka , Tagawa Minami , Suto Tomohiro , Hironaga Naruhito , Sakurai Noriko , Fukuda Masato
Published: October 2021

Bipolar disorder (BD) is a common psychiatric disorder, but its pathophysiology is not fully elucidated. The current study focused on its electrophysiological characteristics, especially power spectral density (PSD). Resting state with eyes opened magnetoencephalography data were collected from 21 patients with BD and 22 healthy controls. The whole brain's PSD was calculated from source reconstructed waveforms at each frequency band (delta: 1-3 Hz, theta: 4-7 Hz, alpha: 8-12 Hz, low beta: 13-19 Hz, high beta: 20-29 Hz, and gamma: 30-80 Hz). We compared PSD values on the marked vertices at each frequency band between healthy and patient groups using a Mann-Whitney rank test to examine the relationship between significantly different PSD and clinical measures. The PSD in patients with BD was significantly decreased in lower frequency bands, mainly in the default mode network (DMN) areas (bilateral medial prefrontal cortex, bilateral precuneus, left inferior parietal lobe, and right temporal cortex in the alpha band) and salience network areas (SAL; left anterior insula [AI] at the delta band, anterior cingulate cortex at the theta band, and right AI at the alpha band). No significant differences in PSD were observed at low beta and high beta. PSD was not correlated with age or other clinical scales. Altered PSDs of the DMN and SAL were observed in the delta, theta, and alpha bands. These alterations contribute to the vulnerability of BD through the disturbance of self-referential mental activity and switching between the default mode and frontoparietal networks.
Study of a parabolic cylinder elastic-plastic contact model
Authors: Guo Tieneng , Hua Xu , Yan Zhijie , Meng Lingjun , Peng Liwei
Published: October 2021

Based on Hertz contact theory, two parabolic cylinder normal contact models are established. The effect of contact angle on normal approach, actual contact area, and normal contact stiffness are investigated, and the effect of the distance from the focus to the directrix (focus distance) on the mechanical characteristics of the models is further analyzed. The parabolic cylinder contact model was verified by simulation analysis and comparison with cylinder contact model. The results demonstrated that the contact angle, focal distance, and load have significant effects on the mechanical properties of the model. The simulation data are basically consistent with the contact model data, and the parabolic cylinder contact model and cylinder contact model have the same change trend. The results verify the correctness of the parabolic cylinder contact model and reveal the variation of the mechanical properties of the contact model.
Girl YouTubers in Peru as economic agents negotiating gender and class identities
Authors: Leon Laura , Ames Patricia
Published: October 2021

The study examines the role of children as producers, distributors, and consumers in the digital realm. Additionally, it also explores class and gender identities they create and perform in this modality. We focus on young female YouTubers (8–11 years old) from Peru, a country that has experienced significant economic expansion in the first decades of the 21st century. The study analyzes 40 videos created by five girl YouTubers. The discussion addresses the economic role children perform in the digital economy as they produce value through content creation, distribute goods, and engage in globalized consumption. The paper also discusses the ways girls display gender and class identities in their products and their consumption patterns. Throughout the analysis, we use the key concept of children’s agency; the discussion reveals both the concept’s reach and limitations in the context of consumer culture, gender regimes, and neoliberal policies.
Cardiac biomarkers as indicators of right ventricular dysfunction and recovery in chronic thromboembolic pulmonary hypertension patients after balloon pulmonary angioplasty therapy – a cardiac magnetic resonance imaging cohort study
Authors: Kriechbaum Steffen D. , Vietheer Julia M. , Wiedenroth Christoph B. , Rudolph Felix , Barde Marta , Wolter Jan‐Sebastian , Haas Moritz , Fischer‐Rasokat Ulrich , Weferling Maren , Rolf Andreas , Hamm Christian W. , Mayer Eckhard , Guth Stefan , Keller Till , Roller Fritz C. , Liebetrau Christoph
Published: October 2021

Background

In chronic thromboembolic pulmonary hypertension, right heart failure determines outcome. Balloon pulmonary angioplasty therapy allows right heart recovery, which can be monitored by cardiac magnetic resonance imaging. This study evaluates whether cardiac biomarkers (NT‐proBNP, MR‐proANP, sST2, and PAPP‐A) are associated with cardiac magnetic resonance imaging findings prior to and after balloon pulmonary angioplasty therapy.

Methods

This observational cohort study enrolled 22 chronic thromboembolic pulmonary hypertension patients who underwent balloon pulmonary angioplasty therapy and completed a six‐month follow‐up including cardiac magnetic resonance imaging. Biomarker levels were compared with findings for right heart morphology and function derived from cardiac magnetic resonance imaging.

Results

Pulmonary hemodynamics improved after balloon pulmonary angioplasty therapy [pulmonary vascular resistance: 7.7 (6.0–9.0) vs. 4.7 (3.5–5.5) wood units, p < 0.001; mean pulmonary artery pressure 41 (38–47) vs. 32 (28–37) mmHg, p < 0.001]. Cardiac magnetic resonance imaging findings indicated right heart maladaptation at baseline and recovery after therapy [right ventricular end‐diastolic volume 192 (141–229) ml vs. 143 (128–172) ml, p = 0.002; right ventricular end‐systolic volume 131 (73–157) ml vs. 77 (61–99) ml (p < 0.001); right ventricular ejection fraction (RVEF) 34 (28–41) % vs. 52 (41–54) %; p < 0.001]. Biomarker level cut‐offs [NT‐proBNP 347 ng/L (area under the curve (AUC) 0.91), MR‐proANP 230 pg/L (AUC 0.78), PAPP‐A 14.5 mU/L (AUC 0.81), and sST2 48.0 ng/ml (AUC 0.88)] indicated a RVEF ≤ 35% at baseline. The dynamics of NT‐proBNP (rs = −0.79; p < 0.001), MR‐proANP (rs = –0.80; p < 0.001), and sST2 (rs = –0.49; p = 0.02) correlated inversely with the improvement in RVEF after therapy. A relative decrease of NT‐proBNP < 53% (AUC 0.86) and MR‐proANP < 24% (AUC 0.82) indicated a limited RVEF response.

Conclusions

In chronic thromboembolic pulmonary hypertension patients, cardiac magnetic resonance imaging findings illustrate right heart failure and recovery after balloon pulmonary angioplasty therapy. Cardiac biomarker levels correlate with right heart parameters at baseline and their dynamics after therapy.
A computational model of contributors to pulmonary hypertensive disease: impacts of whole lung and focal disease distributions
Authors: Ebrahimi Behdad Shaarbaf , Tawhai Merryn H. , Kumar Haribalan , Burrowes Kelly S. , Hoffman Eric A. , Wilsher Margaret L. , Milne David , Clark Alys R.
Published: October 2021

Pulmonary hypertension has multiple etiologies and so can be difficult to diagnose, prognose, and treat. Diagnosis is typically made via invasive hemodynamic measurements in the main pulmonary artery and is based on observed elevation of mean pulmonary artery pressure. This static mean pressure enables diagnosis, but does not easily allow assessment of the severity of pulmonary hypertension, nor the etiology of the disease, which may impact treatment. Assessment of the dynamic properties of pressure and flow data obtained from catheterization potentially allows more meaningful assessment of the strain on the right heart and may help to distinguish between disease phenotypes. However, mechanistic understanding of how the distribution of disease in the lung leading to pulmonary hypertension impacts the dynamics of blood flow in the main pulmonary artery and/or the pulmonary capillaries is lacking. We present a computational model of the pulmonary vasculature, parameterized to characteristic features of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension to help understand how the two conditions differ in terms of pulmonary vascular response to disease. Our model incorporates key features known to contribute to pulmonary vascular function in health and disease, including anatomical structure and multiple contributions from gravity. The model suggests that dynamic measurements obtained from catheterization potentially distinguish between distal and proximal vasculopathy typical of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. However, the model suggests a non‐linear relationship between these data and vascular structural changes typical of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension which may impede analysis of these metrics to distinguish between cohorts.
Bisoprolol and/or hyperoxic breathing do not reduce hyperventilation in pulmonary arterial hypertension patients
Authors: Peters Eva L. , van Campen Jasmijn S.J.A , Groepenhoff Herman , de Man Frances S. , Vonk Noordegraaf Anton , Bogaard Harm J.
Published: October 2021

Hyperventilation is common in pulmonary arterial hypertension and may be related to autonomic imbalance. Patients underwent exercise testing and hyperoxic breathing before and after bisoprolol treatment. We found that neither beta blocker treatment nor hyperoxic breathing in patients reduced hyperventilation at rest and during exercise, although it reduced heart rate.
A case of primary tracheal squamous cell carcinoma arising from malignant transformation of recurrent respiratory papillomatosis, with a complete response to concurrent chemoradiotherapy
Authors: Kovacs Aaron C , Vodanovich Domagoj , Mogridge Emily K , Wun Lisa , Corry June
Published: October 2021

Recurrent respiratory papillomatosis is a human papillomavirus-mediated condition characterised by the development of benign squamous papillomata of the respiratory tract. Malignant transformation of recurrent respiratory papillomatosis, while rare, carries a poor prognosis and there are limited data surrounding treatment options, particularly in inoperable disease. We present the case of a 64-year-old male who developed malignant airway obstruction secondary to primary tracheal squamous cell carcinoma in the setting of a 5-year history of recurrent laryngotracheal papillomatosis, requiring placement of tracheostomy while on veno-venous extracorporeal membranous oxygenation. He was managed with cisplatin-based definitive chemoradiotherapy and had a complete metabolic response on post-treatment positron emission tomography/computed tomography, and remains free of recurrent squamous cell carcinoma at 16 months following treatment. This case supports the use of combined chemoradiotherapy as a potential therapeutic option for patients with primary tracheal squamous cell carcinoma, and emphasises the challenges associated with the long-term management of recurrent respiratory papillomatosis.
Altered consciousness with transient abnormal signals in the hippocampus: A case report
Authors: Ota Koshi , Nishii Tomonobu , Fujii Kensuke , Oishi Yasuo , Onishi Naoya , Ota Kanna , Yokoyama Hiroki , Takasu Akira
Published: October 2021

Hippocampal infarction is relatively rare. Many different diseases can mimic hippocampal infarction including transient global amnesia, Alzheimer’s disease, epilepsy, encephalitis, and encephalopathies. An 89-year-old man was transported to our hospital for altered consciousness. Diffusion-weighted magnetic resonance imaging revealed slightly intense signals in the hippocampus with a mildly decreased apparent diffusion coefficient. Serial magnetic resonance imaging revealed features of hippocampal infarction. Symptoms and cognitive function gradually improved with rehabilitation, and he was transferred to a rehabilitation facility on Hospital Day 38. Hippocampal infarction is rare in patients with altered mental status, but should be considered when magnetic resonance imaging shows findings suggestive of this condition. Other differential diseases should be ruled out by serial magnetic resonance imaging and observation of the clinical course.
Modeling Economic Risk in the QISMUT Countries: Evidence From Nonlinear Cointegration Tests
Authors: He Xiaojuan , Kirikkaleli Dervis , Torun Melike , Li Zecheng
Published: October 2021

This study aims to examine the causal and long-term effects of domestic finance, political risks, and global risk on domestic economic risk in QISMUT countries, namely Qatar, Indonesia, Saudi Arabia, Malaysia, UAE, and Turkey, covering the period of 1997Q1 to 2015Q2. The study used the threshold cointegration test, which involves Gregory and Hansen Cointegration and Hatemi-J Cointegration tests. The tests endogenously combined possible regime shifts in the long-run relationship of the underlying variables. Our results reveal (i) the presence of cointegration among the time series variables with endogenous structural breaks. The linear Toda-Yamamoto causality and nonlinear—Diks and Panchenko and Hatemi-J—causality test shows (ii) changes in domestic financial risk significantly lead to changes in economic risk in the QISMUT countries; (iii) domestic political risk causes economic risk in Indonesia, Qatar, Saudi Arabia, UAE; (iv) global risk affects significantly on economic risk in Saudi Arabia, Turkey, and UAE. Critical policy intervention could include governors in the QISMUT countries should control financial stability indicators such as domestic and foreign debts, exchange rate, and liquidity problems to control macroeconomic dynamics in their respective markets.
Influence of Graft Bending Angle on Femoral Tunnel Widening After Double-Bundle ACL Reconstruction: Comparison of Transportal and Outside-In Techniques
Authors: Lee Do Kyung , Kim Jun Ho , Lee Byung Hoon , Kim Hyeonsoo , Jang Min Jae , Lee Sung-Sahn , Wang Joon Ho
Published: October 2021

Background:

Previous studies have suggested that increased mechanical stress due to acute graft bending angle (GBA) is associated with tunnel widening and graft failure after anterior cruciate ligament (ACL) reconstruction. Few studies have compared the GBA between the outside-in (OI) and the transportal (TP) techniques.

Purpose:

To evaluate the influence of GBA on clinical outcomes and tunnel widening after ACL reconstruction with OI versus TP technique.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included in the study were 56 patients who underwent double-bundle ACL reconstruction (n = 28 in the OI group and n = 28 in the TP group). Clinical outcomes (Lysholm, International Knee Documentation Committee, Tegner score, and knee laxity) 1 year postoperatively were evaluated. Computed tomography scans at 5 days and 1 year postoperatively were used for imaging measurements, and the femoral tunnel was divided into the proximal third, middle, and aperture sections. The GBA and cross-sectional area (CSA) were measured using image analysis software and were compared between groups. A correlation analysis was performed to determine if the GBA affected clinical outcomes or tunnel widening.

Results:

No significant difference was observed in clinical outcomes between the groups. The GBA of both the anteromedial (AM) and posterolateral bundles were more acute in the OI group compared with the TP group ( P < .05). The CSA at the AM tunnel aperture increased significantly in the OI group (84.2% ± 64.3%) compared with the TP group (51.4% ± 36.7%) ( P = .04). However, there were no differences in the other sections. In the Pearson correlation test, GBA was not correlated with tunnel widening or clinical outcomes.

Conclusion:

Regardless of technique, the GBA did not have a significant influence on tunnel widening or clinical outcomes. Considering a wider AM tunnel aperture, a more proximal and posterior AM tunnel position might be appropriate with the OI technique.
Anterior Cruciate Ligament Reconstruction Using Autologous Hamstrings Augmented With the Ligament Augmentation and Reconstruction System Versus Hamstrings Alone: A Comparative Cohort Study
Authors: Aujla Randeep S. , Ebert Jay R. , Annear Peter T.
Published: October 2021

Background:

Few studies have reported the return-to-sports (RTS) rate in patients after augmentation of autologous anterior cruciate ligament reconstruction (ACLR) with the Ligament Augmentation and Reconstruction System (LARS).

Purpose/Hypothesis:

The purpose of this study was to compare postoperative outcomes in patients who underwent ACLR with single-bundle 4-strand hamstring autograft either without augmentation (HA-ACLR group) or with LARS augmentation (AUG-ACLR group). It was hypothesized that clinical outcomes and RTS rates would be better in the AUG-ACLR group at the 1-year follow-up, with similar outcomes in both cohorts by 2 years.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent ACLR between April 2014 and December 2017 were included in the current comparative study if they were skeletally mature and had 1- and 2-year follow-up outcomes; patients with concomitant meniscal surgery were also included. Included were 66 patients with AUG-ACLR (mean age, 26.8 years; 67% male) and 130 patients with HA-ACLR (mean age, 27.5 years; 61% male). Subjective outcome measures included the International Knee Documentation Committee Subjective Knee Evaluation Form, Knee injury and Osteoarthritis Outcome Score, Lysholm scale, Tegner activity scale, and the Noyes sports activity rating scale. Objective measures included knee laxity, maximal isokinetic knee flexion and extension strength, and the results of 4 functional hop tests.

Results:

There were no significant differences between the study groups in age, sex distribution, body mass index, time to surgery, or number of concurrent meniscal surgeries. At the 1-year follow-up, the AUG-ACLR group had a significantly higher Tegner score ( P = .001) and rates of RTS ( P = .029) and return to preinjury level of sport ( P = .003) compared with the HA-ACLR group. At the 2-year follow-up, there were no differences in these measures between groups. There were no between-group differences in other subjective outcomes, knee laxity, or strength and hop test results at either postoperative time point. There were also no differences in rerupture rates or other complications between the groups.

Conclusion:

Patients with AUG-ACLR had higher 1-year postoperative Tegner scores and rates of RTS and preoperative sport level compared with the HA-ACLR group. The 2-year rerupture rate for the AUG-ACLR group was low, and no intra-articular inflammatory complications were noted.
Knotless Reconstruction of Chronic Achilles Tendon Ruptures With <3-cm Defects: Technique Tip
Authors: Haghverdian Justin C. , Gross Christopher E. , Hsu Andrew R.
Published: October 2021

Chronic Achilles tendon ruptures can result in tendon lengthening and significant functional deficits including gait abnormalities and diminished push-off strength. Surgical intervention is typically required to restore Achilles tension and improve ankle plantarflexion strength. A variety of surgical reconstruction techniques exist depending on the size of the defect and amount of associated tendinosis. For smaller tendon defects 2 to 3 cm in size, primary end-to-end repair using an open incision and multiple locking sutures is an established technique. However, a longer skin incision and increased soft tissue dissection is required, and failure at the suture-tendon interface has been reported that can result in postoperative tendon elongation and persistent weakness. In this report, we describe a novel technique to reconstruct chronic midsubstance Achilles tendon ruptures using a small incision with knotless repair of the tendon secured directly to the calcaneus. This technique minimizes wound healing complications, increases construct fixation strength, and allows for early range of motion and rehabilitation.

Level of Evidence: Level V, Expert Opinion.
Development and evaluation of an LGBT+ education programme for palliative care interdisciplinary teams
Authors: Chidiac Claude , Grayson Kate , Almack Kathryn
Published: October 2021

Background:

Despite national policy recommendations to enhance healthcare access for LGBT+ (lesbian, gay, bisexual, transgender, and those who do not identify as cisgender heterosexual) people, education on LGBT+ issues and needs is still lacking in health and social care curricula. Most of the available resources are focused on primary care, mental health, and sexual health, with little consideration to broader LGBT+ health issues and needs. The limited available educational programmes pertaining to LGBT+ individuals outside the context of sexual or mental health have mainly focused on cancer care or older adults.

Aim:

To support palliative care interdisciplinary teams to provide LGBT+ affirmative care for people receiving and needing palliative and end-of-life care.

Methods:

A 1½-h workshop was developed and evaluated using Kotter’s eight-step process for leading change. Across four hospices, 145 health and social professionals participated in the training. A quasi-experimental non-equivalent groups pre–post-test design was used to measure self-reported levels of knowledge, confidence, and comfort with issues, and needs and terminology related to LGBT+ and palliative care.

Results:

There was a significant increase in the reported levels of knowledge, confidence, and comfort with issues, needs, and terminology related to LGBT+ and palliative care after attending the training. Most participants reported that they would be interested in further training, that the training is useful for their practice, and that they would recommend it to colleagues.

Conclusion:

The project illustrates the importance of such programmes and recommends that such educational work is situated alongside wider cultural change to embed LGBT+-inclusive approaches within palliative and end-of-life care services.
Abdominal ectopic pregnancy following a frozen embryo transfer cycle: a case report
Authors: Li Yan , Geng Jiaxuan , He Qiaohua , Lu Jin , Xu Jin , Zhang Ying , Zhang Cuilian
Published: October 2021

Background

Abdominal ectopic pregnancy (AEP) is a rare form of ectopic pregnancy. As the number of in-vitro fertilization (IVF) procedures continues to increase, the incidence of AEP will also rise. However, the rarity and atypical presentation of AEP make early diagnosis challenging.

Case presentation

Herein, we report an AEP following frozen-thawed embryo transfer (FET) in an artificial cycle. The patient was misdiagnosed with implantation failure when the serum human chorionic gonadotropin (hCG) level was detected as 2.59mIU/ml at fourteenth day after embryo transfer. Therefore, she was suggested to stop luteal phase support. However, a ruptured AEP was developed 33 days following embryo transfer, which was diagnosed by laparoscopic surgery.

Conclusions

The case highlighted the delayed serum β-hCG and massive intraperitoneal hemorrhage may be clues to make early diagnosis of AEP. Clinicians must attach great importance to close monitoring and bear in mind the possibility of abdominal pregnancy.
Virtual reality for 3D histology: multi-scale visualization of organs with interactive feature exploration
Authors: Liimatainen Kaisa , Latonen Leena , Valkonen Masi , Kartasalo Kimmo , Ruusuvuori Pekka
Published: October 2021

Background

Virtual reality (VR) enables data visualization in an immersive and engaging manner, and it can be used for creating ways to explore scientific data. Here, we use VR for visualization of 3D histology data, creating a novel interface for digital pathology to aid cancer research.

Methods

Our contribution includes 3D modeling of a whole organ and embedded objects of interest, fusing the models with associated quantitative features and full resolution serial section patches, and implementing the virtual reality application. Our VR application is multi-scale in nature, covering two object levels representing different ranges of detail, namely organ level and sub-organ level. In addition, the application includes several data layers, including the measured histology image layer and multiple representations of quantitative features computed from the histology.

Results

In our interactive VR application, the user can set visualization properties, select different samples and features, and interact with various objects, which is not possible in the traditional 2D-image view used in digital pathology. In this work, we used whole mouse prostates (organ level) with prostate cancer tumors (sub-organ objects of interest) as example cases, and included quantitative histological features relevant for tumor biology in the VR model.

Conclusions

Our application enables a novel way for exploration of high-resolution, multidimensional data for biomedical research purposes, and can also be used in teaching and researcher training. Due to automated processing of the histology data, our application can be easily adopted to visualize other organs and pathologies from various origins.
Core health-components, contextual factors and program elements of community-based interventions in Southeast Asia – a realist synthesis regarding hypertension and diabetes
Authors: Pardoel Zinzi E. , Reijneveld Sijmen A. , Lensink Robert , Widyaningsih Vitri , Probandari Ari , Stein Claire , Hoang Giang Nguyen , Koot Jaap A. R. , Fenenga Christine J. , Postma Maarten , Landsman Johanna A.
Published: October 2021

Background

In Southeast Asia, diabetes and hypertension are on the rise and have become major causes of death. Community-based interventions can achieve the required behavioural change for better prevention. The aims of this review are 1) to assess the core health-components of community-based interventions and 2) to assess which contextual factors and program elements affect their impact in Southeast Asia.

Methods

A realist review was conducted, combining empirical evidence with theoretical understanding. Documents published between 2009 and 2019 were systematically searched in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar and PsycINFO and local databases. Documents were included if they reported on community-based interventions aimed at hypertension and/or diabetes in Southeast Asian context; and had a health-related outcome; and/or described contextual factors and/or program elements.

Results

We retrieved 67 scientific documents and 12 grey literature documents. We identified twelve core health-components: community health workers, family support, educational activities, comprehensive programs, physical exercise, telehealth, peer support, empowerment, activities to achieve self-efficacy, lifestyle advice, activities aimed at establishing trust, and storytelling. In addition, we found ten contextual factors and program elements that may affect the impact: implementation problems, organized in groups, cultural sensitivity, synergy, access, family health/worker support, gender, involvement of stakeholders, and referral and education services when giving lifestyle advice.

Conclusions

We identified a considerable number of core health-components, contextual influences and program elements of community-based interventions to improve diabetes and hypertension prevention. The main innovative outcomes were, that telehealth can substitute primary healthcare in rural areas, storytelling is a useful context-adaptable component, and comprehensive interventions can improve health-related outcomes. This extends the understanding of promising core health-components, including which elements and in what Southeast Asian context.
Risk factors of total blood loss in the posterior surgery for patients with thoracolumbar metastasis
Authors: Cui Yunpeng , Shi Xuedong , Mi Chuan , Wang Bing , Li Huaijin , Pan Yuanxing , Lin Yunfei
Published: October 2021

Background

Blood loss in posterior surgery patients with thoracolumbar metastasis posed a significant challenge to surgeons. This study aimed to explore the risk factors of blood loss in posterior surgery for patients with thoracolumbar metastasis.

Methods

One hundred forty-two patients were retrospectively reviewed. Their baseline characteristics were recorded. The Gross equation was used to calculate blood loss on a surgical day. Multivariate linear regression was used to analyze the risk factors.

Results

Mean blood loss of 142 patients were 2055 ± 94 ml. Hypervascular primary tumor (kidney, thyroid and liver) (P = 0.017), wide or marginal excision (en-bloc: P = 0.001), metastasis at the lumbar spine (P = 0.033), and the presence of extraosseous tumor mass (P = 0.012) were independent risk factors of blood loss in the posterior surgery. Sub-analysis showed that wide or marginal excision (en-bloc: P < 0.001) and metastasis at lumbar spine (P = 0.007) were associated with blood loss for patients with non-hyper vascular primary tumors. Wide or marginal excision (piece-meal: P = 0.014) and the presence of an extraosseous tumor mass (P = 0.034) were associated with blood loss for patients with hypervascular primary tumors.

Conclusion

Hypervascular primary tumor (kidney, thyroid, and liver) was an independent risk factor of blood loss in the posterior surgery. The presence of extraosseous tumor mass and wide or marginal excision (piece-meal) were independent risk factors for patients with hypervascular primary tumors. Metastasis at the lumbar spine and wide or marginal excision (en-bloc) were independent risk factors for patients with non-hyper vascular primary tumors.
Development of a secondary school-based digital behaviour change intervention to improve tooth brushing
Authors: Marshman Zoe , El-Yousfi Sarab , Kellar Ian , Dey Donna , Robertson Mark , Day Peter , Chestnutt Ivor , Pavitt Sue , de Araujo Mariana , Innes Nicola
Published: October 2021

Background

Dental caries in adolescents remains a significant public health problem with few oral health promotion interventions aimed at reducing dental caries in secondary school-aged students. Previous oral health and mobile health (mHealth) research has suggested the need for the development of a school-based behaviour change intervention incorporating a digital component. This study aimed to describe the development process of a behaviour change intervention to improve the oral health of students aged 11–16 years attending secondary schools in the UK.

Methods

A six-step process was used to develop the complex intervention informed by behaviour change theory and involving students, young people, parents and teachers in the process. The steps were: (1) identifying the target behaviours, namely tooth brushing with a fluoride toothpaste (2) identifying the theoretical basis and developing the causal model (3) reviewing the relevant literature and developing the logic model (4) designing the intervention with young people, parents and school staff (5) specifying the intervention content and (6) translating this content into features of the intervention and piloting.

Results

The resultant intervention included a quality-assured classroom-based session (CBS) (guided by a lesson plan and teaching resources), delivered by school teachers which was embedded within the school curriculum. This CBS was followed by a series of (Short Message Service) SMS texts delivered twice daily to student’s mobile telephones with the content, duration and timing of the messages informed by involvement of students and young people.

Conclusions

An intervention to improve the oral health of secondary school students through improved tooth brushing was rigorously developed based on behaviour change theory and work with young people, parents and school staff. Further research is needed to evaluate the outcomes and processes involved following the delivery of this intervention.

BRIGHT Trial Trial Registration ISRCTN12139369.
Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review
Authors: Mengesha Endalkachew Worku , Alene Getu Degu , Amare Desalegne , Assefa Yibeltal , Tessema Gizachew A
Published: October 2021

Background

Social capital has become an important concept in the field of public health, and is associated with improved health services uptake. This study aimed to systematically review the available literature on the role of social capital on the utilization of maternal and child health services in low- and middle-income countries (LMICs).

Methods

Mixed-methods research review and synthesis using three databases PubMed, Scopus, and Science Direct for peer-reviewed literature and Google Scholar and Google search engines for gray literature were performed. Both quantitative and qualitative studies conducted in LMICs, published in English and in grey literature were considered. Prior to inclusion in the review methodological quality was assessed using a standardized critical appraisal instrument.

Results

A total of 1,545 studies were identified, of which 13 records were included after exclusions of studies due to duplicates, reading titles, abstracts, and full-text reviews. Of these eligible studies, six studies were included for quantitative synthesis, and seven were included for qualitative synthesis. Of the six quantitative studies, five of them addressed the association between social capital and health facility delivery. Women who lived in communities with higher membership in groups that helps to form intergroup bridging ties had higher odds of using antenatal care services. Synthesized qualitative findings revealed that women received some form of emotional, informational, and instrumental support from their network members. Receiving health information from trusted people and socio-cultural factors influenced the use of maternal and child health services.

Conclusions

Social capital has a great contribution to improve maternal and child health services. Countries aiming at improving maternal and child health services can be benefited from adapting existing context-specific social networks in the community. This review identified limited available evidence examining the role of social capital on maternal and child health services uptake and future studies may be required for an in-depth understanding of how social capital could improve maternal and child health services.

Systematic review registration

PROSPERO CRD42021226923.
Health insurance and health system (un) responsiveness: a qualitative study with elderly in rural Tanzania
Authors: Amani Paul Joseph , Hurtig Anna-Karin , Frumence Gasto , Kiwara Angwara Denis , Goicolea Isabel , San Sebastiån Miguel
Published: October 2021

Background

Health insurance (HI) has increasingly been accepted as a mechanism to facilitate access to healthcare in low and middle-income countries. However, health insurance members, especially those in Sub-Saharan Africa, have reported a low responsiveness in health systems. This study aimed to explore the experiences and perceptions of healthcare services from the perspective of insured and uninsured elderly in rural Tanzania.

Method

An explanatory qualitative study was conducted in the rural districts of Igunga and Nzega, located in western-central Tanzania. Eight focus group discussions were carried out with 78 insured and uninsured elderly men and women who were purposely selected because they were 60 years of age or older and had utilised healthcare services in the past 12 months prior to the study. The interview questions were inspired by the domains of health systems’ responsiveness. Qualitative content analysis was used to analyse the data.

Results

Elderly participants appreciated that HI had facilitated the access to healthcare and protected them from certain costs. But they also complained that HI had failed to provide equitable access due to limited service benefits and restricted use of services within schemes. Although elderly perspectives varied widely across the domains of responsiveness, insured individuals generally expressed dissatisfaction with their healthcare.

Conclusions

The national health insurance policy should be revisited in order to improve its implementation and expand the scope of service coverage. Strategic decisions are required to improve the healthcare infrastructure, increase the number of healthcare workers, ensure the availability of medicines and testing facilities at healthcare centers, and reduce long administrative procedures related to HI. A continuous training plan for healthcare workers focused on patients´ communication skills and care rights is highly recommended.
Access-to-care: evidence from home-based postnatal coordinated care after hospital discharge
Authors: Zbiri Saad , Rozenberg Patrick , Milcent Carine
Published: October 2021

Background

Home-based postnatal care after hospital discharge has become an integral part of postnatal care. This study aimed to determine the factors relating either to individuals or the healthcare system that affect enrollment and full participation (adherence) in the French home-based postnatal coordinated care program (PRADO).

Methods

All admitted women for delivery in a French district over one year and eligible for this home-based midwifery support after hospital discharge were included (N = 4189). Both a simple probit model and a probit Heckman selection model were used. The control variables were the characteristics of the women, the municipalities, and the hospitals.

Results

Approximately 68% of the eligible women chose to enroll in the PRADO program, of who nearly 60% fully participated in this program. Enrollment in the program was influenced mostly by the family context, such as the woman’s age at the time of her pregnancy and the number of children in the household, the woman’s level of prenatal education and information about postnatal care, as well as some hospital variables such as the characteristics and organization of the maternity units. Full participation in the program was influenced by the accessibility to health professionals, particularly midwives. Furthermore, the women’s level of prenatal education and information about postnatal care, as well as their accessibility to health professionals, correlated with the socioeconomic environment.

Conclusion

While individual factors impacted enrollment in the PRADO program, only healthcare system-related factors influenced full participation in the program. A public health policy promoting home-based postnatal care could increase the women’s participation by improving their level of prenatal education and information about postnatal care. In addition, reducing regional inequality is likely to have a positive impact, as the availability of health professionals is a key factor for participation in home-based postnatal coordinated care.