bluuebunny/crossref_metadata_2025 huggingface dataset:
Model of an Advanced Practice Provider–Led Head and Neck Cancer Survivorship Clinic: Evaluation of a 4‐Year Experience
Authors: Silva‐Nash Jennifer , Davis Kyle P. , Gardner James Reed , Sunde Jumin , Vural Emre , Rose Samantha , Moreno Mauricio Alejandro
Published: January 2022

Objective

To report the efficacy and safety of an advanced practice provider–led head and neck cancer survivorship clinic.

Study Design

Retrospective chart review.

Setting

Tertiary academic medical center.

Methods

Patients were enrolled into the survivorship clinic after undergoing 1‐year follow‐up with the primary head and neck surgeon. Those enrolled between December 2016 and October 2020 were retrospectively reviewed for diagnosis, staging, pattern of recurrence, visit frequency, and compliance. Surgical respectability of recurrent disease was used as a surrogate for timely diagnosis.

Results

An overall 570 patients were followed within the survivorship clinic. The mean length of follow‐up was 13.6 months. Mucosal primaries represented 72.6% of patients. A majority of the primary malignancies were squamous cell carcinoma (77.7%). The most common primary subsites were the oropharynx (26.7%), oral cavity (25.1%), cutaneous (17.0%), and larynx (15.3%). Recurrence was detected in 50 patients (8.8%): 26 local, 12 regional, and 14 distant. Two patients had multiple synchronous recurrences. Twelve (2.1%) second primary cancers were detected. Of the 36 cases of locoregional recurrence, 32 (88.9%) were deemed amenable to salvage surgical intervention, with or without adjuvant therapy. Negative margins were obtained in 21 of the 23 (91.3%) local recurrences that underwent salvage resection.

Conclusion

Advanced practice provider–based surveillance of head and neck cancer, without risk stratification, appears to be a sound model but needs further prospective evaluation. Consistent with literature, 88.9% of patients with locoregional recurrence were candidates for curative‐intent salvage surgery, emphasizing that recurrences are identified in a timely fashion.
Accessible and engaging voices: Teaching English to adult second-language learners with visual impairment using WhatsApp voice notes in India
Authors: J Karthika , Selvam Veena
Published: January 2022

This case study explored the possibility of using WhatsApp voice notes to teach English to adult learners with visual impairment. The study has documented in detail the challenges and advantages of learning and teaching English through WhatsApp.

In this case study, both quantitative and qualitative data were collected and integrated and analysed to understand feasibility of using WhatsApp to teach English to learners with visual impairment. Even though the case study was primarily qualitative, some quantitative data were also collected and analysed numerically. The numerical data were analysed using descriptive statistics and reported using numbers and in the form of tables and figures. Furthermore, non-numerical data were examined inductively and reported thematically.

The advantage of using WhatsApp voice notes was that it provided a platform for the learners to converse in English and an opportunity to reflect on their own learning process and progress critically. It provided a collaborative learning experience independent of the conventional learning experience of a classroom. The study revealed that the learners with visual impairment were more engaged in the learning process and in improving their speaking skill when WhatsApp voice notes were used. The coding of messages and detailed analysis of message categories clearly revealed the social-emotional skills of each participant in the study. The message categories were adapted from Community of Inquiry Framework and message categories suggested by Naaman et al.
Kinetics of tissue oxygenation index during fast and slow cardiopulmonary bypass initiation
Authors: Turra Jan , Bauer Adrian , Möbius Andreas , Wojdyla Jacob , Eisner Christoph
Published: January 2022

Introduction

Despite being a daily clinical application in cardiac operating theaters, an evidence-based approach on how to optimally initiate the heart–lung machine (HLM) to prevent critical phases of cerebral ischemia is still lacking. We therefore designed a study comparing two different initiation times for starting the cardiopulmonary bypass (CPB).

Methods

We conducted a monocentric, randomized, and prospective study comparing the impact of two initiation times, a rapid initiation of 15 s and a slow initiation of 180 s to reach the full target flow rate of 2.5 L/min/m2 times the body surface area, on cerebral tissue oxygenation by near infrared spectroscopy measurements.

Results

The absolute values in tissue oxygenation index (TOI) showed no difference between the groups before and after the CPB with a 10% drop in oxygenation index in both groups due to the hemodilution through the HLM priming. Looking at the kinetics a rapid initiation of CPB produced a higher negative rate of change in TOI with a total of 21% in critical oxygenation readings compared to 6% in the slow initiation group.

Conclusion

In order to avoid critical phases of cerebral ischemia during the initiation of CPB for cardiac procedures, we propose an initiation time of at least 90 s to reach the 100% of target flow rate of the HLM.
Optimal design and sensitivity analysis of airfoil-shaped rotor blade for Savonius wind turbine by using response surface methodology
Authors: Hosseini Imeni Seyedeh Zeinab , Kaabinejadian Amirreza , Ami Ahmadi Hesam , Moghimi Mahdi
Published: January 2022

The Savonius wind turbine is cost-effective, simple in structure, and potentially usable in urban areas but suffers from poor efficiency. Further, vortices emerges downward results in a higher rate of exergy loss and lower wind energy to power conversion rate. Thus, the objective of the present study is to enhance the performance of the Savonius wind turbine and reduction of generated friction entropy considering the novel design of airfoil-shaped blade. For this purpose, nine important design parameters of airfoil-shaped blade were chosen and dozen design points were designed based on the Plackett-burman method. After carrying out the screening analysis, the response surface methodology has been used to conduct sensitivity analysis and investigate the higher-order correlations to discover the optimal design of studied airfoil-shaped blade. The obtained results indicate that the optimal design could augment the power coefficient up to 12.89% at TSR = 0.8, compared to conventional semicircular rotor blade.
Impact of the nature of the capillary wall on plasma refilling during hemodialysis
Authors: Yashiro Masatomo , Kotera Hirohisa
Published: January 2022

Objectives:

Our aim was to clarify the impact of the nature of the capillary wall, defined by the contribution of large (LP), small (SP), and ultrasmall (UP) pores, on plasma refilling in a hemodialysis session.

Methods:

This study included data from 78 patients. The relative blood volume change (ΔBV%) was monitored using a Crit-Line monitor. A bioimpedance device was used to measure extracellular and intracellular fluid volumes, and the excess fluid mass (MExF) was calculated. We simulated blood volume change (sΔBV%) based on a three-pore model. Hydraulic permeability of the capillary wall (LpS) and fractional contribution of LP to LpS (αLP) were determined by fitting sΔBV to ΔBV. The total refilling volume (TVref) was calculated from the total ultrafiltration volume and total blood volume change. Values were standardized to a body surface area of 1.73 m2 and are denoted by the subscript BSA.

Results:

LpS and αLP were 3.09 (2.32, 4.68) mL/mmHg/min and 0.069 (0.023, 0.109), respectively. The standardized regression coefficient (β) of the ultrafiltration rate (UFRBSA) and initial excess fluid mass (MExF,BSA,0) by multiple linear regression analysis of TVref,BSA without (Model 1) and with (Model 2) αLP were as follows: UFRBSA, 0.714/<0.001 (β/p); MExF,BSA,0, 0.247/<0.001 (Model 1); UFRBSA, 0.799/<0.001; MExF,BSA,0, 0.066/0.237; and αLP, −0.327/<0.001 (Model 2).

Conclusions:

The impact of volume overload (MExF,BSA,0) on plasma refilling became insignificant with the addition of αLP in the model, suggesting that the nature of the capillary wall described by inter-endothelial gaps (LP) may have a greater impact on plasma refilling than volume overload.
Cardiogenic shock treated with temporary mechanical circulatory support in Brazil: The effect of learning curve
Authors: Scolari Fernando Luís , Trott Geraldine , Schneider Daniel , Goldraich Livia Adams , Frederico Tonietto Tulio , Moura Lídia Zytynski , Bertoldi Eduardo Gehling , Rover Marciane Maria , Wolf Jonas Michel , Souza Denise de , Clausell Nadine , Polanczyk Carisi Anne , Rohde Luis Eduardo , Rosa Regis Goulart , Wainstein Rodrigo Vugman
Published: January 2022

Aims:

Treatment with mechanical circulatory support (MCS) has been proposed to mitigate mortality in cardiogenic shock (CS). However, there is a lack of data on MCS programs implementation and the effect of the learning curve on its outcomes in limited resources countries such as Brazil.

Methods:

Prospective cohort of patients with CS admitted in four tertiary-care centers treated with Impella CP or veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Clinical outcomes were peri-procedural complications, short-term mortality rate, and the centers’ learning curve. The cohort was divided into two periods: from April 2017 to July 2018 ( n = 24), and from August 2018 to December 2020 ( n = 25).

Results:

The study enrolled 49 patients [age 59 (43–63) years; 34 (70%) males]. The most common causes for CS were acute myocardial infarction in 22 (45%) and acute decompensation of chronic heart failure in 10 (20%). VA-ECMO was employed in 35 (71%) and Impella CP in 14 (29%) of patients. Overall complications occurred in 37 (76%) of patients, where major bleeding in 19 (38%) was the most common. The overall mortality rate was 61%, but it was lower in the second period (40%) in comparison to the first period (83%), p = 0.002. The learning curve analysis showed a decrease in the mortality rate after 40 consecutive cases.

Conclusions:

Implementation of a temporary MCS program for refractory CS in a limited resource country is feasible. The learning curve effect might have played a role on survival rate since high morbimortality has decreased within time reaching optimal results by the end of the study.
Modelling the effects of particle size pretreatment method on biogas yield of groundnut shells
Authors: Olatunji Kehinde Oladoke , Madyira Daniel M , Ahmed Noor A , Jekayinfa Simeon O , Ogunkunle Oyetola
Published: January 2022

Optimising biogas yields from anaerobic digestion of organic wastes is significant to maximum energy recovery in the biodigestion process and has become an important topic of interest. Substrate particle size is an important process parameter in biogas production, and it precedes other pretreatments methods for the majority of the lignocellulose materials. Optimisation of biogas yield using Response Surface Methodology (RSM) was done, and temperature, hydraulic retention time and particle size were considered variables to develop the predictive models. Pretreatment of groundnut shells was investigated using particle size reduction of mechanical pretreatment methods. After pretreatment, 30 samples were digested in a batch digester at mesophilic temperature. The experimental results showed that the temperature, hydraulic retention time and particle size had significant effects of interaction ( p < 0.05). The optimum experimental and predicted yields are: 44.70 and 42.92 (lNkgoDM) organic dry matter biogas yield, 20.80 and 19.09 (lN/kgFM) fresh mass biogas yield, 24.00 and 22.68 (lNCH4oDM) organic dry methane yield and 12.30 and 15.59 (lNCH4FM) fresh mass methane yield, respectively. The R2 recorded for the four yield components were 0.6268, 0.5875, 0.6109 and 0.5547. These values seem to be lower and a sign of the average fit of the model. Biogas production from groundnut shells was significantly improved with statistical optimisation and the pretreatment method.
Association of Social Integration with Cognitive Status in a Multi-Ethnic Cohort: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study
Authors: Calmasini Camilla , Swinnerton Kaitlin N. , Zimmerman Scott C. , Peterson Rachel L. , George Kristen M. , Gilsanz Paola , Hayes-Larson Eleanor , Mayeda Elizabeth Rose , Mungas Dan M. , Whitmer Rachel A. , Glymour Medellena Maria
Published: January 2022

We evaluated overall and race-specific relationships between social integration and cognition in older adults. Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort participants included 1343 Asian, Black, Latino, or non-Latino White Kaiser Permanente Northern California members. We estimated the effect of social integration on verbal episodic memory, semantic memory, and executive function derived from the Spanish and English Neuropsychological Assessment (SENAS) Scales. Social integration scores included marital status; volunteer activity; and contact with children, relatives, friends, and confidants. We estimated covariate-adjusted linear mixed-effects models for baseline and 17-month follow-up cognition. Social integration was associated with higher baseline cognitive scores (average [Formula: see text] = 0.066 (95% confidence interval: 0.040, 0.092)) overall and in each racial/ethnic group. The association did not vary by race/ethnicity. Social integration was not associated with the estimated rate of cognitive change. In this cohort, more social integration was similarly associated with better late-life cognition across racial/ethnic groups.
The condition of urban agriculture in a Chinese global city: evidence from the field
Authors: Talamini Gianni , Zhang Qi , Viganò Paola
Published: January 2022

Urban agriculture (UA) encompasses different practices and dissimilar agendas, not all environmentally and socially savoury, ranging from food security to leisure and recreation. Although there is a wealth of literature on UA, little research has investigated its presence and role in a Chinese global city against the backdrop of unbridled urbanisation. This article focuses on Nanshan District in Shenzhen, a vast, rapidly urbanising region in China. We analyse the social and spatial characteristics of UA and its regulation. Employing a mixed-method approach that combines spatial analysis and in-depth semi-structured interviews, the results demonstrate the coexistence and interaction of diverse types of UA. What emerges is a socio-biologically rich heterogeneity of precarious practices, overlooked by the local authorities, but contributing to stewardship, social development and community engagement, while preserving a precious agricultural heritage. This article presents policy insights and advocates for government involvement in recognising the social significance of UA.
Selenium nutritional status and its association with SLEDAI-2K, HOMA-IR and lipid profile in Juvenile Systemic Lupus Erythematosus patients
Authors: do Prado Rogério , Aires Patricia P , Suano-Souza Fabíola I , Affonso Fonseca Fernando Luiz , Terreri Maria Teresa , Sarni Roseli O. S.
Published: January 2022

Objectives

To assess nutritional status regarding selenium in adolescents with Juvenile Systemic Lupus Erythematosus (jSLE) and analyze possible associations with disease activity, insulin resistance and lipid profile.

Methods

This was an observational, cross-sectional study of 31 female adolescents with jSLE and 31 healthy female volunteers as a comparison group. We obtained demographic, anthropometric (weight, stature, waist, and neck circumferences), and clinical data (disease activity measured by SLEDAI-2K) from both groups; laboratory data including: lipid profile, plasma selenium, erythrocyte glutathione peroxidase activity (GPx), plasma malondialdehyde (MDA), ultrasensitive C-reactive protein (usCRP), insulin levels, and glycemia (Homeostasis Model Assessment for Insulin Resistance—HOMA-IR).

Results

Mean age at diagnosis of jSLE group was 15.9±1.7 years, with mean disease duration of 3.6±2.6 years. 48% of patients and controls had below-reference Se levels (≤46mcg/L). GPx was more frequently below reference levels (<4.171U/L) in the jSLE group, compared to controls. A ROC curve was used to assess the power of the variables to discriminate between both groups; insulin (AUC = 0.712; CI 95% 0.584–0.840), waist-to-height ratio (AUC = 0.704; CI 95% 0.572–0.837), and HOMA-IR (AUC = 0.689; CI 95% 0.556–0.822) were the variables with the greatest discriminatory power. Linear regression showed an independent inverse association between Se levels and c-LDL; no such correlation was found for GPx activity. SLEDAI-2 K and HOMA-IR showed no association with levels of Se and GPx activity.

Conclusions

Approximately, 50% of jSLE adolescents had below reference Se levels. The frequency of inadequate GPx values was higher in patients, compared to controls. There was an independent inverse association between Se and c-LDL levels in both groups; this was not the case for HOMA-IR and SLEDAI-2K. The data show the importance of assessing Se nutritional status in jSLE patients.
Inference on latent factor models for informative censoring
Authors: Ungolo Francesco , van den Heuvel Edwin R.
Published: January 2022

This work discusses the problem of informative censoring in survival studies. A joint model for the time to event and the time to censoring is presented. Their hazard functions include a latent factor in order to identify this joint model without sacrificing the flexibility of the parametric specification. Furthermore, a fully Bayesian formulation with a semi-parametric proportional hazard function is provided. Similar latent variable models have been described in literature, but here the emphasis is on the performance of the inferential task of the resulting mixture model with unknown number of components. The posterior distribution of the parameters is estimated using Hamiltonian Monte Carlo methods implemented in Stan. Simulation studies are provided to study its performance and the methodology is implemented for the analysis of the ACTG175 clinical trial dataset yielding a better fit. The results are also compared to the non-informative censoring case to show that ignoring informative censoring may lead to serious biases.
Cord-Blood Engraftment Using an Enhanced Dual-Conditioning Regimen for Malignant Hematologic Diseases
Authors: Ding Jiahua , Fang Yongjun , Zhou Rongfu , Gu Yan , Du Shengnan , Lu Qin , Yue Qingqing
Published: January 2022

To explore a more effective conditioning regimen for umbilical cord blood transplantation (UCBT) to treat hematologic malignancies, we conducted a cohort study of a fludarabine/busulfan/cytarabine plus cyclophosphamide 200 mg/kg regimen. Forty-two consecutive patients with leukemia, myelodysplastic syndrome, or lymphoma received the regimen. The median number of infused total nucleated cells per kilogram was 5.5 × 107 (1.81–20.6), the median number of infused CD34+ cells per kilogram was 1.58 × 105 (0.58–6.6), and the median follow-up for surviving patients was 37 months (4.0–79.5 months). The cumulative incidence of neutrophil engraftment at 31 days was 100% [95% confidence interval (CI): 0.9159–1.0], and the median time to neutrophil engraftment was 19 days. The cumulative incidence of nonrelapse mortality was 12.76% (95% CI: 0.0455–0.2356) at 180 days and 3 years. The 3-year overall survival (OS) and disease-free survival (DFS) rates were 71.6% and 59.6%, respectively. Especially in patients who received transplants in the early and intermediate stages, the 3-year OS and DFS rates were 90.3% (95% CI: 0.805–1.0) and 76.2% (95% CI: 0.608–0.956), respectively. The regimen significantly improved engraftment and survival, indicating that the high graft failure of UCBT was caused by rejection.
Book review: Neeladri Bhattacharya, Kunal Chakrabarti, S. Gunasekaran, Janaki Nair and Joy L. K. Pachuau (Eds.), JNU Stories: The First Fifty Years
Authors: John Mary E.
Published: January 2022

Neeladri Bhattacharya, Kunal Chakrabarti, S. Gunasekaran, Janaki Nair and Joy L. K. Pachuau (Eds.), JNU Stories: The First Fifty Years. Aleph Books, 2020, 467 pages., ₹999 (Hardback). ISBN: 975-81-948741-9-5.
Role of JAK/STAT in the Neuroinflammation and its Association with Neurological Disorders
Authors: Jain Mayank , Singh Mukul Kumar , Shyam Hari , Mishra Archana , Kumar Shailendra , Kumar Ambrish , Kushwaha Jitendra
Published: January 2022

Background:

Innate immunity is mediated by a variety of cell types, including microglia, macrophages, and neutrophils, and serves as the immune system's first line of defense. There are numerous pathways involved in innate immunity, including the interferon (IFN) pathway, TRK pathway, mitogen-activated protein kinase (MAPK) pathway, Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway, interleukin (IL) pathways, chemokine pathways (CCR5), GSK signaling, and Fas signaling.

JAK/STAT is one of these important signaling pathways and this review focused on JAK/STAT signaling pathway only. The overactivation of microglia and astrocytes influences JAK/STAT's role in neuroinflammatory disease by initiating innate immunity, orchestrating adaptive immune mechanisms, and ultimately constraining inflammatory and immunological responses. The JAK/STAT signaling pathway is one of the critical factors that promotes neuroinflammation in neurodegenerative diseases.

Key message:

Given the importance of the JAK/STAT pathway in neurodegenerative disease, this review discussed the feasibility of targeting the JAK/STAT pathway as a neuroprotective therapy for neurodegenerative diseases in near future.
Contemporary Prevalence of Byssinosis in Low- and Middle-Income Countries: A Systematic Review
Authors: Nafees Asaad Ahmed , Matteis Sara De , Burney Peter , Cullinan Paul
Published: January 2022

We aimed to identify the contemporary prevalence of byssinosis through a systematic review. Medline, Web of Science, Embase, and Global Health databases were used to identify studies published in any language between 2000 and 2019, reporting primary data on byssinosis among adults. We used the Joanna Briggs Institute checklist to estimate the risk of bias in studies and undertook a qualitative, narrative data analysis. The review considered the prevalence of byssinosis, chest tightness, and airflow obstruction in textile workers in low- and middle-income countries (LMICs). We found 26 relevant studies that included 6930 workers across 12 countries. Most of the studies (n = 19) were from Asia, and seven from African countries. Twenty-five studies were cross-sectional surveys while one was a cohort study. The prevalence of byssinosis was reported by 18 studies, and ranged from 8% to 38%, without any clear associations, at the group level, between the prevalence of byssinosis and durations of workers’ exposures. Prevalence of chest tightness ranged between 4% and 58% and that of airflow obstruction between 10% and 30%. A strong correlation ( r = 0.72) was found between prevalence of byssinosis and cotton dust levels. Our findings indicate that byssinosis remains a significant, contemporary problem in some parts of the textile sector in LMICs.
A six-session group-based pilot intervention for alcohol and other drug use in hospitalised mentally ill young offenders
Authors: Parsons Annie , Hoadley Benjamin , Hitzeman Cortney , Parkin Sarah , Kasinathan John
Published: January 2022

Objective

This study aims to evaluate a group-based intervention for alcohol and other drug (AOD) use offered to incarcerated youth hospitalised with mental illness.

Methods

A six-session group-based intervention for AOD use was offered to young offenders with mental illness, hospitalised in the Adolescent Unit of the Forensic Hospital, Sydney, between June 2015 and May 2017. Pre- and post-intervention measures were collected using the Brief Psychiatric Rating Scale (BPRS), Treatment Entry Questionnaire, Drug-Related Locus of Control (DRLOC) and Drug-Taking Confidence Questionnaire, short version.

Results

Pre- and post-intervention measures were compared utilising paired t-tests. Following the intervention, there was a significant reduction in the severity of psychiatric symptoms rated using the BPRS and a significant difference in DRLOC measures, reflecting increased internal locus of control.

Conclusions

Improved internal drivers for reducing AOD use and improvement in symptoms of mental illness suggest similar interventions may be beneficial and may not impact recovery even during episodes of acute illness.
Rural Hispanic Perceptions of Mental Health: A Qualitative Study
Authors: Moyce Sally , Thompson Sophia , Metcalf Madeline , Velazquez Maria , Aghbashian Elizabeth , Sisson Nathaniel , Claudio David
Published: January 2022

Introduction:

In 2020, 18.4% of Hispanics experienced mental illness, yet only about a third received treatment compared with nearly half of non-Hispanic Whites. In Montana, where only 11% of the mental health needs are currently met, service utilization is low. The purpose of this study was to determine the perceptions of the Hispanic immigrant population in a rural state on mental health and professional service utilization.

Methods:

Using a descriptive phenomenological approach, we conducted semi-structured telephone interviews in Spanish. Audio recordings were transcribed, translated to English, and analyzed for themes.

Results:

We recruited a sample of 14 participants from Mexico, Ecuador, Colombia, and Venezuela ranging in age from 33 to 59. We identified five themes: definitions of mental health, maintaining mental health, familismo/socialization, stigma, and acculturation stress.

Discussion:

Novel findings point to the need for Spanish-language services focused on reducing stigma around mental illness and incorporating the importance of social connections.
Sleep Health, Acculturation, and Acculturative Stress in Immigrants in the United States: A Scoping Review
Authors: Chapagai Swaty , Martyn-Nemeth Pamela
Published: January 2022

Introduction:

Poor sleep health has been widely associated with chronic illnesses, and immigrant populations in the United States do not experience optimal sleep, putting them at increased risk of such illnesses. The purpose of this scoping review was to synthesize published literature on the influence of acculturation and acculturative stress on the sleep health of immigrant populations in the United States.

Method:

This scoping review was guided by Arksey and O’Malley’s framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline, and 16 research articles were included in its synthesis of results.

Results:

Findings indicated that immigrants in the United States have poor sleep health and that acculturation and acculturative stress may be major influencing factors. In addition, demographic and socio-contextual factors such as gender, economic status, education, and employment characteristics influenced immigrants’ sleep. Race and ethnicity were additional factors influencing sleep, but the limited number of studies in this area precludes determination of which groups are most affected. Chronic stress, depressive symptoms, and language influenced immigrants’ sleep health, but mixed results were observed for generational status.

Discussion:

Future sleep studies should include vulnerable and understudied immigrant groups and consider all socio-contextual and psychological factors potentially affecting sleep health. In health settings serving immigrant groups, nurses should emphasize screening for these factors. Also, comparative studies are needed to identify specific factors that may affect sleep health in particular immigrant ethnic groups.
Educational Resources and Self-Management Support to Engage Patients in Advance Care Planning: An Interpretation of Current Practice in the US
Authors: Gazarian Priscilla , Gupta Avni , Reich Amanda , Perez Stephen , Semco Robert , Prigerson Holly , Ashana Deepshikha , Dey Tanujit , Carlston Daniel , Cooper Zara , Weissman Joel , Ladin Keren
Published: January 2022

Background

Educational resources and decision aids help patients, their care partners and health care providers prepare for and confidently engage in Advance Care Planning (ACP). Incorporating ACP resources as part of a self-management approach may lead to fuller engagement with ACP beyond identifying a surrogate decision-maker, towards supporting a person to identify their values and goals and to communicate them with their care partners and health care providers.

Objective

To examine the use of educational resources and decision aids to support self-management of ACP in 11 health systems across the US.

Methods

This study was a qualitative interview study examining barriers and facilitators to ACP. Guided by interpretative description and the chronic care model, we sought to describe how health care stakeholders (clinicians and administrators) and patients use ACP resources to support engagement with ACP.

Results

274 health care stakeholders were interviewed, and 7 patient focus groups were conducted across 11 health systems. The majority of participants reported using resources to support completion of preference documentation, with fewer participants using resources that promote more engagement in ACP. ACP resources were reported as valuable in preparing for and complementing a complex, interpersonal, and interprofessional process. Barriers to using resources included a lack of a defined workflow and time.

Conclusion

Our data suggest that ACP resources that promote engagement are valued but under-utilized in practice. The use of ACP resources with an inter-professional team and a self-management approach is a promising strategy to mitigate the barriers of ACP implementation while improving engagement in ACP.
Enhanced method for optimum driving point identification for modal testing
Authors: Pasch Gerwin , Wischmann Stefan , Drichel Pascal , Jacobs Georg , Berroth Joerg
Published: January 2022

Modal testing is used to experimentally determine the dynamic behavior of mechanical structures. The planning of the positions for exciting the structure, the so-called driving points, is essential for efficient experimental modal testing. Driving points are identified either by an initial assumption of possible excitation points and the experimental evaluation of their quality, or with the help of numerical models and indicators for optimal driving point selection. However, for practical applications, several driving points are usually required to excite all modes in the frequency range of interest, which is not covered in state-of-the-art indicators for driving point selection. This paper therefore presents a method for driving point identification with consideration of multiple driving points. Additionally, a criterion was developed that considers the excitability of modes, risks of double hits, and the excitation orientation simultaneously in order to increase the accuracy of the driving point identification. This criterion enables the evaluation of the excitation quality of each surface node and any mode combination using an automated selection method for determining the optimum set of driving points. The presented method assumes that natural frequencies and eigenvectors from preliminary numerical models are available for planning. By applying the method on application examples, the reduced effort required for a full modal analysis is demonstrated.
A Manifesto for Posthuman Creativity Studies
Authors: Harris Daniel , Holman Jones Stacy
Published: January 2022

This article advances a manifesto for a posthuman creativity studies that highlights the emergent, collective, and ecological aspects of creativity, offering propositions that problematize any individualist or human-exceptionalist approach to the field. We attend to a range of extra/ordinary affects, encounters, and modalities for expanding creative possibilities in the 21st century. Beginning with a recognition that creativity must be rewilded from its current capture in economic and educational discourses, we argue for more sustainable re-engagements. In the specificity of these encounters, we manifest 10 commitments to posthuman creativity as the foundations for a more dynamic and more-than-human creative agency.
Faculty and Staff Perceptions of Title IX Mandatory Reporting Policies at Two Institutions
Authors: Koon-Magnin Sarah , Mancini Christina
Published: January 2022

Most faculty and staff at postsecondary institutions are mandatory reporters who must disclose sexual assault to a Title IX Coordinator. However, scholarship examining their role is sparse. We address this gap by investigating perceptions and experiences of employees ( n = 166) at two institutions. Findings indicate that most employees are aware of their reporting duties, likely to comply, have received training, and support mandated reporting. Additionally, we find significant sociodemographic differences in perceptions of mandatory reporting. Those who have had a direct experience reporting have mixed reactions to the process. We discuss research and policy implications.
QTc prolongation during levofloxacin and triazole combination chemoprophylaxis: Prevalence and predisposing risk factors in a cohort of hematopoietic cell transplantation recipients
Authors: Moghnieh Rima , Khalil Ahmad , Bizri Nazih , Francis Nadine , Imad Sabine , Mezher Maria , Mrad Zahraa , Ibrahim Jad , Zahran Kamal , Farroukh Farah , Itani Malak , Assaad Amani , Sinno Loubna , Abdallah Dania , Ibrahim Ahmad
Published: January 2022

Background

QTc interval prolongation has been reported when combining fluoroquinolones and triazoles for chemoprophylaxis in cancer patients. Herein, we aimed to identify the prevalence and contributing factors to QTc prolongation in hematopoietic cell transplantation (HCT) recipients who received these agents during the neutropenic phase.

Methods

This is a retrospective medical chart review conducted at a university hospital in Lebanon from 2017 to 2020. It included all adult HCT inpatients on antimicrobial prophylaxis with fluoroquinolones and triazoles and whose baseline ECG monitoring done prior to chemoprophylaxis administration, then on day-3 and day-6 of therapy, were available.

Results

Overall, 68 HCT recipients met our inclusion criteria, of which 22% developed QTc prolongation. Based on bivariate analysis, female gender contributed to QTc prolongation ( P = 0.001). There was a trend to QTc prolongation in patients with predisposing thyroid disease ( P = 0.12), grade 2 vomiting and diarrhea ( P = 0.16, P = 0.46, respectively), baseline hypokalemia ( P = 0.18) and hypocalcemia ( P = 0.3), hypomagnesemia on day-3 ( P = 0.21) and day-6 hyponatremia ( P = 0.36). Patients receiving two or more drugs with a known or probable risk of QTc prolongation (other than the fluoroquinolone/ triazole combination) were more prone to experience a prolonged QTc interval ( P = 0.09). None of the patients that had QTc prolongation died or developed serious arrhythmias.

Conclusion

The prevalence of QTc prolongation was 22% among HCT recipients on fluoroquinolone and triazole prophylaxis, yet we did not identify any independent risk factors for this issue. None of the patients that had QTc interval prolongation died or developed serious arrhythmias.
Evaluation of potential drug-drug interactions in cancer patients at a tertiary care hospital in Pakistan
Authors: Choudary Nida Ashraf , Khan Asad , Wahid Abdul , Abubakar Muhammad , Atif Muhammad , Ahmad Nafees
Published: January 2022

Background

Despite harboring a high burden of cancer patients who are at high risk of potential drug-drug interactions (pDDIs), there is scarcity of published information about pDDIs in cancer patients from Pakistan.

Objective

To evaluate frequency, pattern, mechanism and factors associated with pDDIs in cancer patients treated at a tertiary care hospital in Pakistan.

Methods

In this cross-sectional analytical study, a total of 253 eligible ambulatory cancer patients treated at Center for Nuclear Medicine and Radiotherapy Hospital Quetta were evaluated for pDDIs using IBM Micromedex® Drug Interactions. SPSS (version 26) was used for conducting multivariate analysis to find factors associated with the presence pDDIs. A p-value <0.05 was considered statistically significant.

Results

A total of 141/253 (55.7%) patients were exposed to at-least one pDDI. A total of 251 pDDIs were noted with a median of one pDDI/per patient (interquartile range:1–2) Majority interactions were of major severity (72.9%), pharmacodynamic (49.8%) and had fair documentation level (64.1%). Anti-cancer drugs were involved in 73.0% pDDIs with doxorubicin as the most commonly involved (40.0%) anti-cancer followed by cyclophosphamide (27.6%) and cisplatin (13.5%). Potential cardiac adverse events made the bulk (33.8%) of predicted events. Receiving >2 anti-cancer (OR = 5.19, p-value = 0.001) and >6 ancillary drugs (OR = 4.16, p-value = 0.033) emerged as the risk factors of pDDIs.

Conclusions

The prevalence of pDDIs was within the range reported in published literature. Solid medication review, availability of DDI detecting tools and clinical pharmacist, and paying special attention to the high-risk patients may reduce the frequency of pDDIs at the study site.
Veering of Rayleigh–Lamb waves in orthorhombic materials
Authors: Nobili Andrea , Erbaş Bariş , Signorini Cesare
Published: January 2022

We analyse veering of Rayleigh–Lamb waves propagating in a plane of elastic symmetry for a thin orthotropic plate. We demonstrate that veering results from interference of partial waves in a similar manner as it occurs in systems composed of one-dimensional (1D) structures, such as beams or strings. Indeed, in the neighbourhood of a veering point, the system may be approximated by a pair of interacting tout strings, whose wave speed is the geometric average of the phase and group velocity of the relevant partial wave at the veering point. This complementary pair of partial waves provides the coupling terms in a form compatible with a action–reaction principle. We prove that veering of symmetric waves near the longitudinal bulk wave speed repeats itself indefinitely with the same structure. However, the dispersion behaviour of Rayleigh–Lamb waves are richer than that of 1D systems, and this reflects also on the veering pattern. In fact, the interacting tout string model fails whenever the dispersion branch is not guided by either partial wave. This often occurs when neighbouring veering points interact and partial waves no longer provide guiding curves.
Associations Between Video Game Engagement and ADHD Symptoms in Early Adolescence
Authors: Tiraboschi Gabriel Arantes , West Greg L. , Boers Elroy , Bohbot Veronique D. , Fitzpatrick Caroline
Published: January 2022

Objective:

We aim to investigate the direction of causality of the association between adolescent video game playing and later development of ADHD symptoms using a population-based sample of Canadian Youth.

Method:

The present study is based on longitudinal cohort data ( N = 1,467). Youth self-reported weekly hours of video game playing as well as ADHD symptoms at both 12 and 13 years of age.

Results:

Cross-lagged panel model were estimated to examine how adolescent video game playing prospectively contributes to ADHD symptoms while simultaneously considering how adolescent ADHD symptoms may prospectively contribute to videogame playing. Analyses revealed a significant positive association between adolescent video games playing at age 12 and ADHD symptoms at age 13. Youth ADHD symptoms at age 12 did not predict video game use at age 13.

Conclusion:

Our results help clarify the direction of causality of the association between video game playing and ADHD symptoms and provide evidence that video game playing can represent a risk factor for the development of attention problems in early adolescence.
Pelvic tilt and functional acetabular position after total hip arthroplasty: an EOS 2D/3D radiographic study
Authors: Loppini Mattia , Pisano Alessandro , Ruggeri Riccardo , Della Rocca Antonello , Grappiolo Guido
Published: January 2022

Purpose:

In total hip arthroplasty (THA), the functional anatomy of the spinopelvic unit should be taken into account to provide the correct functional positioning of the implant. The relationship between the spine and the pelvis in the sagittal plane is represented by pelvic tilt (PT). The sacral slope (SS) has been proposed as a more reliable parameter than the anterior pelvic plane (APP) to express the PT. This study investigated the relationship between the APP and the SS; and the relationship between the APP and the SS, respectively, with the postoperative acetabular orientation.

Methods:

45 patients undergoing primary THA were prospectively enrolled. The EOS 2D/3D system was used to perform the radiographic evaluation before and 3 months after surgery. The following parameters were measured in both standing and sitting position: SS, APP, acetabular anteversion (AA) and inclination (AI).

Results:

The SS values did not show any correlation with the values of the APP angle. The changes of the SS in the transition from the standing to the sitting position significantly correlated with the changes of the AA ( r = −0.61; p < 0.0001). A weak correlation was found between the APP angle and the AA in standing position ( r = −0.35; p = 0.02).

Conclusions:

The SS accurately expresses the functional orientation of the pelvis in the sagittal plane, and the functional orientation of the cup after hip replacement. Therefore, SS could be taken into account by navigation systems in order to achieve a patient-specific functional position of the acetabular cup.
Seasonal Diversity of Microeukaryotes in the Han River, Korea Through 18S rRNA Gene Metabarcoding
Authors: Choi Tae-June , Malik Adeel , An Hyung-Eun , Kim Jung-Il , Dinh Do Thinh , Kim Chang-Bae
Published: January 2022

Freshwater ecosystems contain a large diversity of microeukaryotes that play important roles in maintaining their structure. Microeukaryote communities vary in composition and abundance on the basis of temporal and environmental variables and may serve as useful bioindicators of environmental changes. In the present study, 18S rRNA metabarcoding was employed to investigate the seasonal diversity of microeukaryote communities during four seasons in the Han River, Korea. In total, 882 unique operational taxonomic units (OTUs) were detected, including various diatoms, metazoans (e.g., arthropods and rotifers), chlorophytes, and fungi. Although alpha diversity revealed insignificant differences based on seasons, beta diversity exhibited a prominent variation in the community composition as per seasons. The analysis revealed that the diversity of microeukaryotes was primarily driven by seasonal changes in the prevailing conditions of environmental water temperature and dissolved oxygen. Moreover, potential indicator OTUs belonging to diatoms and chlorophytes were associated with seasonal and environmental factors. This analysis was a preliminary study that established a continuous monitoring system using metabarcoding. This approach could be an effective tool to manage the Han River along with other freshwater ecosystems in Korea.
Providing HIV Prevention of Mother to Child Transmission (PMTCT) Services to Migrants During the COVID-19 Pandemic in South Africa: Insights of Healthcare Providers
Authors: Bisnauth Melanie A , Coovadia Ashraf , Kawonga Mary , Vearey Jo
Published: January 2022

Background:

In March 2020, COVID-19 entered South Africa, resulting in 2.9 million cases, the country took preventative and precautionary measures to control the spread of COVID-19 infection. These measures limited population mobility especially for migrant women living with HIV (WLWH) and the provision of PMTCT services. The purpose of this research was to explore the challenges of the COVID-19 pandemic on PMTCT provision by healthcare providers and understand what strategies could be implemented with lifelong antiretroviral therapy (ART) for migrants to better manage the program.

Methods:

Twelve in-depth interviews were conducted with healthcare providers across city and provincial levels on how the changes to the healthcare system with COVID-19 affected highly mobile patients’ adherence and utilization of PMTCT services. A thematic content analysis was used for emerging themes and guided by The Utilization of PMTCT Services conceptual framework.

Results:

Five main themes emerged: (1) Facilitators and barriers to adherence, which included the need for multi-month dispensing for the long term supply of antiretrovirals (ARVs) and the fear of contracting COVID-19 at the hospital that disrupted patients’ continuum of care; (2) Healthcare providers work environment, where participants felt overwhelmed with the high patient demand and the lack of infrastructural resources to follow social distancing protocols; (3) Financial challenges and opportunity costs, PMTCT proved difficult for migrants due to border closures and documentation required to receive care, this resulted in treatment interruption and left many unable to receive support at the facility due to capacity restrictions; (4) Interpersonal interactions, mistreatment, and xenophobic attitudes existed toward the migrant HIV population; and (5) “Program sustainability” revealed three key areas for strengthening: longer duration of time allocated with counseling for same-day initiation, the increased use of technology, and translation services for migrants.

Conclusions:

It is important to take what was learned during the pandemic and integrate it into routine service delivery, which includes long-term medication supply to reduce risk with multiple visits to collect medication, and the use of technology to alleviate the high-burden of patient demand. Healthcare policies that work toward inclusion and sustainability for migrants are needed to improve the integration of safer and practical methods of PMTCT provision into health systems.
Epidemiology and Risk Factors of Healthcare-Associated Infections in Critically Ill Patients in a Tertiary Care Teaching Hospital in Nepal: A Prospective Cohort Study
Authors: Shrestha Sailesh Kumar , Trotter Andrew , Shrestha Pradeep Krishna
Published: January 2022

Background:

Healthcare-associated infection (HAI) is an important public health problem, particularly in intensive care units (ICUs). We aimed to examine the epidemiology and risk factors of HAIs in our ICUs and study their microbiological profile.

Methods:

We evaluated 100 consecutive patients in 3 medical and surgical ICUs of a tertiary care teaching hospital daily starting in January 2016 using the Centers for Disease Control and Prevention definitions and methods. We determined the incidence and sites of HAIs, identified the causative microorganism, and studied their antibiotic sensitivity profiles. We investigated risk factors for the development of an HAI using a multiple logistic regression model.

Results:

Of 300 patients, 129 patients (43%) developed HAIs (55.96 HAI events per 1000 ICU-days). Pneumonia was the most common type of HAI (57, 41%). Escherichia coli was the most frequently isolated microorganism (20, 29%) and 74% of the pathogens isolated were multi-drug resistant. The presence of an invasive device (Odds Ratio, 4.29; 95% Confidence Interval, 2.52-7.51) and use of sedation (Odds Ratio, 2.24; 95% Confidence Interval, 1.31-3.87) were the statistically significant risk factors for HAIs.

Conclusions:

We found a high incidence of HAIs in our ICUs and a high burden of multidrug-resistant microorganisms highlighting the importance of infection control and antibiotic stewardship.