bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Descending Thoracic Aortic Diseases: Similarities and Differences Among Cardiovascular Guidelines
Authors: Spanos Konstantinos , Nana Petroula , Behrendt Christian-Alexander , Kouvelos George , Panuccio Giuseppe , Heidemann Franziska , Matsagkas Miltiadis , Debus E. Sebastian , Giannoukas Athanasios , Kölbel Tilo
Published: January 2021

Cardiovascular societies have developed recommendations regarding the management of thoracic aortic diseases. While improvements in treatment have been observed during the past decade in regard to patient selection, thoracic endovascular aortic repair (TEVAR) and associated techniques, and high-volume centralization, the broad expansion of TEVAR has raised considerations about its indications, appropriateness, limitations, and application. The aim of this systematic review was to assess the similarities and differences among current cardiovascular societies’ guidelines for the management of thoracic aortic diseases. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from January 2009 to May 2020. The initial search identified 990 articles. After exclusion of duplicate or inappropriate articles, the final analysis included 5 articles from cardiovascular societies published between 2010 and 2020. Selected controversial topics were analyzed, including diagnosis, imaging, spinal cord ischemia prevention, and management of the most important thoracic aortic pathologies. The analysis included data concerning the therapeutic approach in acute and chronic type B aortic dissection, penetrating aortic ulcer, intramural hematoma, thoracic aortic aneurysm, and traumatic aortic injury, as well a discussion of inflammatory aneurysms, aortitis, and genetic syndromes. The review presents consistent and controversial recommendations, as well as “gray zone” issues that need further investigation. There was significant overlap and agreement among the 5 societies regarding the management of thoracic aortic diseases. Especially in dissection and aneurysm management, TEVAR has established its role as the treatment of choice. However, robust evidence is still needed in many aspects of the management of thoracic aortic pathologies.
Thrift Television in South Korea: The Long Recession and the Financial Makeover of Female Consumers in Homo Economicus (EBS)
Authors: Kim Bohyeong
Published: January 2021

This article explores South Korean “thrift” television by examining Homo Economicus (EBS), a reality TV show that challenged participants to save ten thousand dollars in six months with guidance from financial advisors. Situating thrift television within the broader sociohistorical context of the long recession after the 1997 Asian financial crisis, I show how Homo Economicus suggested frugality as a way of life in a time of precarity and economic polarization by providing techniques of compulsory thrift and turning participants into aspirational savers. Gendered narratives of consumption played a pivotal role in the process and the program took millennial women as its main target of intervention. Gendered thrift television exemplifies the ways media culture problematizes women’s consumption while failing to address structural gender inequality. I also discuss the close relation between thrift television and online financial communities that served as a crucial space where thrift television found its financial experts.
Poly(butylene succinate) fibrous dressings containing natural antimicrobial agents
Authors: Aliko Kinana , Aldakhlalla Mohamad Basel , Leslie Laura J , Worthington Tony , Topham Paul D , Theodosiou Eirini
Published: January 2021

Poly(butylene succinate) (PBSU) is a biodegradable and biocompatible synthetic aliphatic polyester, which has been used extensively in packaging, catering and agriculture, and more recently in drug delivery and bone and cartilage repair. PBSU-based mats created by electrospinning show promise as wound dressing materials because of their good mechanical properties, high surface area-to-volume ratio and increased levels of porosity. In this work, we present the creation of antimicrobial PBSU fibrous mats through the incorporation of natural food grade agents via blend electrospinning. Three types of edible gums (namely arabic, karaya and tragacanth), two essential oils (coriander and lavender), and one free fatty acid (linoleic acid) were added to PBSU containing a chain extender and their effect on six clinically relevant pathogens was evaluated. Mats containing essential oils at the highest concentration studied (7% w/v) showed some antimicrobial behaviour against S. aureus, E. hirae and P. aeruginosa, whereas the incorporation of linoleic acid at both concentrations tested (3% and 5% w/v) gave a strong reaction against S. pyogenes. Gum arabic was the only gum that had a considerable impact on S. aureus. Furthermore, the three gums enhanced the mechanical properties of the polymer mats and brought them closer to those of the human skin, whilst all agents maintained the high biocompatibility of the PBSU mats when contacted with mouse fibroblasts. This work, for the first time, shows the great promise of PBSU blended fibres as a skin substitute and paves the way towards bioactive and cost effective wound dressings from renewable materials.
Dynamic Effects of CAM Techniques on Inflammation and Emotional States: An Integrative Single-Case Study on a Breast Cancer Survivor
Authors: Schubert Christian , Ott Michaela , Hannemann Julian , Singer Magdalena , Bliem Harald R. , Fritzsche Kurt , Burbaum Christina , Chamson Emil , Fuchs Dietmar
Published: January 2021

Background:

This study on a breast cancer survivor investigated how episodic practice of various complementary and alternative medicine (CAM) techniques affected the dynamics of emotional states and urinary neopterin—an inflammation marker.

Methods:

The 49-year-old female patient (diagnosis: ductal breast carcinoma 5 years before study start, suffering from chronic fatigue and depression) collected her entire urine in 12-hour intervals (from about 8 a.m. to 8 p.m. and from about 8 p.m. to 8 a.m.) for 28 days. The resulting 55 consecutive urine samples were analyzed for neopterin and creatinine levels using HPLC. Also in 12-hour intervals, the patient filled out questionnaires on emotional states and everyday routine, including CAM practice. Weekly, she was interviewed to identify emotionally meaningful everyday incidents, including use of CAM techniques. Time series analysis consisted of ARIMA modeling and cross-correlational analyses.

Results:

Qualitative evaluation revealed that, with the exception of Tai Chi, all CAM techniques, that is, Jin Shin Jyutsu, music, physiotherapy and energy healing, were experienced as positive. Cross-correlational analyses showed that practice of such CAM techniques was followed first by significant ( P < .05) increases in positive mood and mental activity on the same day (lag 0) and then by decreases in positive mood after a total of 72 to 84 hours (+lag 6) and in mental activity after a total of 84 to 96 hours (+lag 7). Negative mood, by contrast, first decreased on the day of CAM practice (lag 0) and then increased after a total of 84 to 96 hours (+lag 7) following CAM. Moreover, urinary neopterin levels first increased on the day of CAM practice (lag 0) and then decreased after a total of 36 to 48 hours (+lag 3). Similar biphasic effects were also detected for irritation in response to CAM, although only partly significant.

Conclusion:

Cyclic psychophysiological response patterns following CAM practice were attributable to biopsychosocial feedback mechanisms involving personally meaningful experiences. As lower neopterin levels following CAM point to a health-promoting effect, the patient of this study may have actively contributed to her healing process through episodic CAM practice.
Minireview: Insights into anti-interferon-γ autoantibodies
Authors: Chawansuntati Kriangkrai , Rattanathammethee Kritsadee , Wipasa Jiraprapa
Published: January 2021

The association between the presence of anti-interferon-γ autoantibodies and the onset of immunodeficiency with intracellular infections has been clearly established. No standard regimen to control the production of these pathogenic autoantibodies, apart from antimicrobial therapy to eliminate infections, contributes to the medical burden of this syndrome, which sometimes has a fatal outcome. In this review, we summarize the findings on anti-interferon-γ autoantibodies to facilitate further research and to provide guidance for treatment strategies.
The Effect of COVID-19 on Training and Case Volume of Vascular Surgery Trainees
Authors: Ilonzo Nicole , Koleilat Issam , Prakash Vivek , Charitable John , Garg Karan , Han Daniel , Faries Peter , Phair John
Published: January 2021

Background:

In many facilities, the coronavirus disease (COVID-19) pandemic caused suspension of elective surgery. We therefore sought to determine the impact of this on the surgical experience of vascular trainees.

Methods:

Surgical case volume, breadth, and the participating trainee post-graduate level from 3 large New York City Hospitals with integrated residency and fellowship programs (Mount Sinai, Montefiore Medical Center/Albert Einstein College of Medicine, and New York University) were reviewed. Procedures performed between February 26 to March 25, 2020 (pre-pandemic month) and March 26 to April 25, 2020 (peak pandemic period) were compared to those performed during the same time period in 2019. The trainees from these programs were also sent surveys to evaluate their subjective experience during this time.

Results:

The total number of cases during the month leading into the peak pandemic period was 635 cases in 2019 and 560 cases in 2020 (12% decrease). During the peak pandemic period, case volume decreased from 445 in 2019 to 114 in 2020 (74% reduction). The highest volume procedures during the peak pandemic month in 2020 were amputations and peripheral cases for acute limb ischemia; during the 2019 period, the most common cases were therapeutic endovascular procedures. There was a decrease in case volume for vascular senior residents of 77% and vascular junior and midlevel residents of 75%. There was a 77% survey response rate with 50% of respondents in the senior years of training. Overall, 20% of respondents expressed concern about completing ACGME requirements due to the COVID-19 pandemic.

Conclusions:

Vascular surgery-specific clinical educational and operative experiences during redeployment efforts have been limited. Further efforts should be directed to quantify the impact on training and to evaluate the efficacy of training supplements such as teleconferences and simulation.
Imbuing Occupations with Spiritual Significance Fosters Experiences of Hope
Authors: Redlich Amirav Dorit , Larsen Denise , Taylor Elizabeth
Published: January 2021

In theories of occupational therapy, occupation serves as a conduit for creating meaning and well-being. A crucial component of occupational therapy is developing and maintaining hope of clients during periods of major difficulty. Understanding the relationship between hope and occupation can prove helpful in stressful situations, such as caring for children with chronic illnesses. The aim of the present study was to identify occupations that foster experiences of hope among mothers of adult children with mental illness. A qualitative approach, informed by a constructivist framework and thematic analysis, was used to interpret and explicate relevant occupation-related themes that fostered hope in four mothers. The mother-participants reported engaging in various occupations, yet only occupations that were imbued with spiritual significance fostered experiences of hope. This study brings to the forefront of occupational therapy discourse the issue of spiritual connectedness as a potential link between occupations and hope.
COVID-19 Risk Perceptions and Social Distancing Practice in Latin America
Authors: Alicea-Planas Jessica , Trudeau Jennifer M. , Vásquez Mazariegos William F.
Published: January 2021

Objectives:

Many developing countries use social distancing as part of their mitigation strategy during epidemics. This study aimed to understand individual decisions to practice different social distancing measures in the immediate emergence of COVID-19.

Study design:

Utilizing social media advertising and snowball sampling, a web-based survey was administered in 16 Latin American countries.

Methods:

We estimated seemingly unrelated Probit models to identify factors associated with the decision to implement social distancing practices.

Results:

From 5,480 respondents, estimated marginal effects indicate that risk perceptions are positively related to distancing from friends or relatives and avoiding public places but do not seem to influence the decision to stay home. Results also indicate that risk perceptions are related to household income, the number of reported COVID-19 cases in the country, and perceived preparedness of the health care system.

Conclusions:

Our findings support the notion that people will follow social distancing measures if there is a clear understanding of risk. Providing the public ways to access accurate numbers of confirmed cases can inform perception of disease severity. Since household income was a determinant of practicing social distancing, without financial assistance, some will be forced to break regulations in order to procure food or resources for their survival.
Spatial Struggles and the Politics of Peace: The Aung San Statue as a Site for Post-War Conflict in Myanmar’s Kayah State
Authors: Olivius Elisabeth , Hedström Jenny
Published: January 2021

This article explores processes of place-making and space-making around the erection of the Aung San statue in Kayah state in Myanmar and draws out the competing visions of peace that are articulated through them. The raising of the statue unleashed widespread public protest, which was largely met by repression by the Myanmar authorities. Drawing on interviews, focus groups, and documentary sources, we argue that the statue constitutes an attempt to establish a post-war political order centred on the reassertion of government authority in ethnic minority areas and the creation of unity through the imposition of one national identity. However, the statue has also been appropriated as a key site for the articulation of alternative visions of peace and development. The conflict around the statue thereby makes visible ongoing struggles over the meaning of peace and shows how these post-war struggles are fought on and through space and place.
Robotic Pneumonectomy for Lung Cancer: Perioperative Outcomes and Factors Leading to Conversion to Thoracotomy
Authors: Patton Byron D. , Zarif Daniel , Bahroloomi Donna M. , Sarmiento Iam C. , Lee Paul C. , Lazzaro Richard S.
Published: January 2021

Objective

In the tide of robot-assisted minimally invasive surgery, few cases of robot-assisted pneumonectomy exist in the literature. This study evaluates the perioperative outcomes and risk factors for conversion to thoracotomy with an initial robotic approach to pneumonectomy for lung cancer.

Methods

This study is a single-center retrospective review of all pneumonectomies for lung cancer with an initial robotic approach between 2015 and 2019. Patients were divided into 2 groups: surgeries completed robotically and surgeries converted to thoracotomy. Patient demographics, preoperative clinical data, surgical pathology, and perioperative outcomes were compared for meaningful differences between the groups.

Results

Thirteen total patients underwent robotic pneumonectomy with 8 of them completed robotically and 5 converted to thoracotomy. There were no significant differences in patient characteristics between the groups. The Robotic group had a shorter operative time ( P < 0.01) and less estimated blood loss ( P = 0.02). There were more lymph nodes harvested in the Robotic group ( P = 0.08) but without statistical significance. There were 2 major complications in the Robotic group and none in the Conversion group. Neither tumor size nor stage were predictive of conversion to thoracotomy. Conversions decreased over time with a majority occurring in the first 2 years. There were no conversions for bleeding and no mortalities.

Conclusions

Robotic pneumonectomy for lung cancer is a safe procedure and a reasonable alternative to thoracotomy. With meticulous technique, major bleeding can be avoided and most procedures can be completed robotically. Larger studies are needed to elucidate any advantages of a robotic versus open approach.
Relationship Dynamics Associated With Dating Violence Among Adolescents and Young Adults: A Feminist Post-Structural Analysis
Authors: Giordano Peggy C. , Copp Jennifer E. , Manning Wendy D. , Longmore Monica A.
Published: January 2021

We focus on the character of adolescent and young adult relationships, and argue that attention to interpersonal features of intimate partner violence (IPV) is necessary for a comprehensive view of this form of violence. Drawing on ideas from feminist post-structural perspectives, we highlight studies that develop a somewhat non-traditional but nevertheless gendered portrait of relationships as a backdrop for exploring dyadic processes associated with IPV. Findings are based on quantitative and qualitative analyses from a longitudinal study of a large, diverse sample of young women and men interviewed first during adolescence, and five additional times across the transition to adulthood.
Neighborhoods and Intimate Partner Violence: A Decade in Review
Authors: Wright Emily M. , Pinchevsky Gillian M. , Xie Min
Published: January 2021

We consider the broad developments that have occurred over the past decade regarding our knowledge of how neighborhood context impacts intimate partner violence (IPV). Research has broadened the concept of “context” beyond structural features such as economic disadvantage, and extended into relationships among residents, collective “action” behaviors among residents, cultural and gender norms. Additionally, scholars have considered how the built environment might foster (or regulate) IPV. We now know more about the direct, indirect, and moderating ways that communities impact IPV. We encourage additional focus on the policy implications of the research findings.
A Generative Sequential Mixed Methods Approach Using Quantitative Measures to Enhance Social Constructionist Inquiry
Authors: Romaioli Diego
Published: January 2021

In order to enhance core mixed methods research designs, social scientists need an approach that incorporates developments in the social constructionist perspective. This work describes a study that aimed to promote occupational well-being in hospital departments where employees are at risk of burnout, based on a constructionist inquiry developed starting from the Maslach Burnout Inventory. Taking this study as an example, we define a “generative sequential mixed methods approach” as a process that involves consulting quantitative studies to identify criticalities on which to conduct focused, transformative investigations. The article contributes by envisaging ways to mix qualitative and quantitative methods that consider a “generative” and “future-forming” orientation to research, in line with recent shifts in social psychology.
Morgellons Disease: The Spread of a Mass Psychogenic Illness via the Internet and Its Implications in Hand Surgery
Authors: Nunziato Carl A. , Egeland Brent M. , Gurman Andrew , Henry Steven L.
Published: January 2021

Somatic manifestations of mental illness sometimes occur in patients presenting to hand specialists. These conversion disorders can also occur in groups, a phenomenon known as “mass psychogenic illness.” The increasing penetrance of the Internet and social media in modern society has greatly facilitated the interaction of patients with others with similar disorders. One example relevant to hand surgery is “Morgellons disease,” a disorder popularized in 2002 and characterized by a firm belief in foreign material extruding from the skin, leading to nonhealing, self-inflicted ulcerations and excoriations. A series of 4 patients collected through an informal survey of hand surgeons regarding experience with Morgellons disease is reviewed and discussed. All patients in the series presented with a chief complaint of foreign material extruding from the hand. In 1 case, the complaint was made by a young patient’s mother. In none of the patients were foreign bodies identified, although 2 patients demonstrated significant ulcerations and scars from self-excoriation. Three patients had a somatic condition affecting the hand or upper extremity, 1 directly related to self-excoriation and 2 unrelated. Treatments, workups, and ultimate outcomes varied among patients. Patients presenting with Morgellons disease often undergo multiple unnecessary tests and are at risk of inappropriate procedures. It is therefore important that providers have a compassionate understanding of the involved psychology. Herein, we offer an approach to the recognition of and treatment strategies for these patients.
The Effects of a Nutrition Education Program on Dietary Intake and Biomarkers in HIV+ Adults
Authors: Poles Jillian , Tiozzo Eduard , Konefal Janet , Rodriguez Allan , Woolger Judi M. , Lewis John E.
Published: January 2021

Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). Dietary behavior modification may assist in the treatment of CVD, but the optimal dose of nutrition education is unknown. The current aim was to determine if a weekly 1-hour nutrition education program would improve multiple outcomes among PLWH. Methods. Participants (n = 62) were assessed on dietary intake, serum biomarkers, and physical characteristics at baseline and 3 months, and percent change was calculated. Participants were grouped into 3 attendance categories of the classes: none, fair, or good. Analyses of covariance were performed on the outcomes. Results. Calories, protein, fat, saturated fat, carbohydrate, sugar, added sugar, and glycemic load were significantly different (all P values <.05). Those who attended no class typically had increases in these variables versus those with fair or good attendance. High-density lipoprotein cholesterol (HDL-C; P = .006) and total cholesterol/HDL-C ratio ( P = .083) were different, as those who attended no class or had fair attendance worsened, but those with good attendance improved. Conclusions. Several outcomes improved more so among those with good class attendance versus those with either fair or no attendance. Thus, an interactive nutrition education program may be an effective tool to help improve the health of PLWH.
Development of the final version of the occupational adaptation questionnaire for family caregivers
Authors: Nagai Takashi , Ishii Yoshikazu , Kohiyama Kengo , Takenaka Takahiro , Yamada Takashi
Published: January 2021

Background

Given the growing role of family caregivers in meeting the increasing demand for ageing-related care in Japan, the occupational adaptation of family caregivers needs to be evaluated.

Methods

This study developed the Occupational Adaptation Questionnaire for Family Caregivers (OAQC) and evaluated its reliability, validity, and effectiveness. To develop the OAQC item pool, the construct ‘Occupation of nursing care engaged in by family caregivers’ was evaluated. Using the Delphi method, 8 experts evaluated 64 items and confirmed that 41 items adequately represented the domain. The scale was then completed by 216 family caregivers of users of outpatient service establishments affiliated with hospitals in the Chubu region. The validity of the scale items was tested, and statistical analysis was performed. The construct validity and internal consistency of the OAQC were examined using exploratory factor analysis and the ω coefficient, respectively.

Results

The discrimination ability and difficulty level were calculated using the item response theory. The findings showed that the scale’s reliability and validity were satisfactory. Construct validity was acceptable for 16 items with 5 factors. The OAQC also had high internal consistency, reliability, and effectiveness. The item slope parameters and difficulty parameters revealed good item response, indicating that the scale could effectively measure family caregivers’ occupational adaptation.

Conclusion

The scale was compatible with the data obtained from family caregivers. Given its overall effectiveness, data obtained using the OAQC can contribute towards implementing personal care support programs for caregivers and enriching their lives by offering support from an occupational adaptation perspective.
Study on the predictive effect of fibrinogen on vascular calcification
Authors: Zhang Jing , Yang Yan , Zhang Hongsong , Gao Pengju , Zhang Zepeng , Fu Wenxiu , Zheng Lihua , Zhao Yaheng
Published: January 2021

Background

Fibrinogen, lipoprotein, and high-density lipoprotein levels were associated with vascular calcification, but their predictive capacity for a vascular calcification was not reported.

Aims

The purpose of this study was to evaluate the predictive efficacy of fibrinogen, lipoprotein, and high-density lipoprotein by retrospective analysis of fibrinogen, lipoprotein, and high-density lipoprotein levels in patients with vascular calcification, to explore the effective predictive indexes of vascular calcification, to predict the occurrence and development of vascular calcification, and to provide a simple and effective method for the diagnosis and prevention of vascular calcification. Hypothesis: Fibrinogen is a good prediction of vascular calcification.

Methods

Univariate and multivariate analyses were used to assess the effects of fibrinogen, lipoprotein, and high-density lipoprotein on the CV, and the ROC curve of the predictive model was used to assess its predictive effectiveness. We collected the relevant indicators of 462 patients admitted to the Department of Vascular Surgery of the First Hospital of Hebei Medical University from August 2018 to July 2020, including 189 patients with vascular calcification (40.9%) and 273 patients without vascular calcification (59.1%); 75% of the collected data is used for modeling (modeling group) and 25% for verification (verification group).

Results

Results from the multivariate analysis showed fibrinogen, lipoprotein, and high-density lipoprotein to be independent predictors of vascular calcification. Next, the three-factor models are developed respectively. The area below the ROC curve in the fibrinogen, lipoprotein, and high-density lipoprotein forecast model was 0.8018, 0.7348, and 0.7019, respectively.

Conclusions

Fibrinogen is more predictive than high-density lipoprotein and lipoprotein in patients with arteriosclerosis.
Clinical features and management strategy of symptomatic spontaneous isolated celiac artery dissection
Authors: Gao Xiujuan , Xie Weiping , Shang Dan , Liu Jianyong , Jin Bi , Xu Ying Jiang
Published: January 2021

Objectives

The aim of this study was to evaluate the clinical features and management strategy for patients with symptomatic spontaneous isolated celiac artery dissection (SICAD).

Methods

In this retrospective study, consecutive patients with symptomatic SICAD from two institutions were included. The demographics, clinical manifestations, comorbidities, imaging findings and treatment strategy selection were obtained from the medical records. The general epidemiological data, treatment regimens and clinical and follow-up outcomes were analysed.

Results

Patients were divided into the conservative treatment group (group A, n = 26) and endovascular treatment group (group B, n = 11). Of these 37 patients, extent of dissection in both groups included only celiac trunk (61.54%% vs. 18.18%, p = 0.03), common hepatic artery (CHA) and splenic artery (SA) (3.85%% vs. 54.55%, p = 0.001), CHA (7.69% vs. 18.18%, p = 0.57), SA (23.08% vs. 9.09, p = 0.65) and left gastric artery (LGA) (3.85% vs. 54.55%, p = 0.99). Of note, the extension of the lesion in group A was shorter than that in group B. In addition, there were significantly more type IIb in group A than in group B (42.31% vs. 9.09%, p = 0.06) and the mean length of dissection in group A was 42.3 ± 54.71 mm which was significantly shorter than that in the group B 58.45 ± 3.71 mm ( p =0.04). During a median follow-up of 11.5 months, the 1, 3, 6 and 12 month follow-ups were completed in 100% (37/37), 100% (37/37), 94.59% (35/37) and 91.19% (34/37) of patients, respectively. The cumulative rate of persistent disease stability in patients with endovascular treatment group was higher than in that conservative treatment group at the 3, 6, 9 and 12 months (50% vs. 16.67%, p = 0.001; 80% vs. 37.5%, p =0.03; 100% vs. 62.5%, p = 0.012;100% vs. 91.67%, p = 0.02 respectively).

Conclusion

Most symptomatic SICAD have a tendency to persistent disease stability after conservative treatment. Risk factors for failed conservative treatment were length of dissection and branch involvement. Furthermore, endovascular treatment was associated with a high technical success and persistent disease stability rate, which might be reserved for patients with failed conservative treatment.
Alterations of serum levels of plasminogen, TNF-α, and IDO in granulomatosis with polyangiitis patients
Authors: Kyurkchiev Dobroslav , Yoneva Tsvetelina , Yordanova Adelina , Kurteva Ekaterina , Vasilev Georgi , Zdravkova Yana , Sheytanov Ivan , Rashkov Rasho , Ivanova-Todorova Ekaterina
Published: January 2021

Background

Granulomatosis with polyangiitis (GPA) is a representative of vasculitides associated with anti-neutrophil cytoplasmic autoantibodies. “Classical” antibodies directed against proteinase 3 are involved in the pathogenesis and are part of the GPA diagnosis at the same time. Along with them, however, antibodies against Lysosomal-Associated Membrane Protein-2 (LAMP-2) and antibodies directed against plasminogen have been described in GPA. Objectives and methodology: We performed a cross-sectional study enrolling 34 patients diagnosed with GPA. Our study was aimed at looking for correlations between serum levels of LAMP-2 and plasminogen and the clinical manifestations of the GPA. Furthermore, we examined serum levels of tumor necrosis factor-alpha (TNF-α) and its associated indoleamine-pyrrole 2,3-dioxygenase (IDO), as well as we looked for a correlation between these cytokines and the clinical manifestations of GPA.

Results

The results showed that in GPA, serum plasminogen levels were negatively associated with renal involvement (receiver operating characteristic (ROC) area under the curve (AUC) of 0.78) (95% CI 0.53–0.91), p = 0.035, and the extent of proteinuria, Spearman’s Rho = –0.4, p = 0.015. Increased levels of TNF-α and IDO correlated with disease activity, Spearman’s Rho =0.62, p = 0.001 and Spearman’s Rho = 0.4, p = 0.022, respectively, whereas only TNF-α was increased in severe forms of GPA with lung involvement (ROC AUC of 0.8) (95% CI 0.66–0.94), p = 0.005.

Conclusions

In this study, we demonstrate the alteration of soluble factors, which play an important role in the pathogenesis of GPA and their relationship with the clinical manifestations of the disease. Our main results confirm the associations of increased secretory TNF-α and some clinical manifestations, and we describe for the first time decreased serum plasminogen levels and their association with renal involvement.
Adapting isotonic dose-finding to a dynamic set of drug combinations with application to a phase I leukemia trial
Authors: Wages Nolan A , Reed Daniel R , Keng Michael K , Conaway Mark R , Petroni Gina R
Published: January 2021

Background/aims

This article describes the proposed design of a phase I study evaluating the safety of ceramide nanoliposome and vinblastine among an initial set of 19 possible dose combinations in patients with relapsed/refractory acute myeloid leukemia and patients with untreated acute myeloid leukemia who are not candidates for intensive induction chemotherapy.

Methods

Extensive collaboration between statisticians and clinical investigators revealed the need to incorporate several adaptive features into the design, including the flexibility of adding or eliminating certain dose combinations based on safety criteria applied to multiple dose pairs. During the design stage, additional dose levels of vinblastine were added, increasing the dimension of the drug combination space and thus the complexity of the problem. Increased complexity made application of existing drug combination dose-finding methods unsuitable in their current form.

Results

Our solution to these challenges was to adapt a method based on isotonic regression to meet the research objectives of the study. Application of this adapted method is described herein, and a simulation study of the design’s operating characteristics is conducted.

Conclusion

The aim of this article is to bring to light examples of novel design applications as a means of augmenting the implementation of innovative designs in the future and to demonstrate the flexibility of adaptive designs in satisfying changing design conditions.
Safety culture and systems thinking for predicting safety competence and safety performance among registered nurses in Saudi Arabia: a cross-sectional study
Authors: Mahsoon Alaa Nabil , Dolansky Mary
Published: January 2021

Background

Medical errors are a worldwide concern and the contribution of nurses’ safety competence and performance to these errors is a high priority. It has been over 20 years since the first report of the need to address medical errors. New approaches are needed for enhancing safety competence and performance.

Aims

This study explored the relationships among systems thinking, educational level, safety culture, safety competence and safety performance among registered nurses working in medical and surgical units in Saudi Arabia.

Methods

A correlational cross-sectional design with a convenience sample of 84 registered nurses was used.

Results

Systems thinking predicted 16% of safety knowledge ( F[2, 81] = 7.61, P = 0.001), while safety culture, baccalaureate education and completion of safety training predicted 19% of safety skill ( F[3, 78] = 2.80, P = 0.001). A safety culture that promoted learning from mistakes predicted 15% of safety performance measured based on nurses’ self-report of the number of errors in the past 3 months ( F[3, 75] = 2.86, P = 0.008).

Conclusions

Professional development including systems thinking and safety training are the necessary next steps for nurses. In addition, policy changes facilitating organisations to support learning from mistakes will contribute to reducing medical errors.
Strangers in our midst: Immigration, social capital and segmented conflict
Authors: Griffiths Clare E
Published: January 2021

Putnam famously stated in his ‘hunkering down’ thesis that residents of diverse communities experiencing immigration retreat into their homes inhibiting the production of ‘social capital’. Immigration is therefore often posited to disrupt communities and positive social interaction, ultimately increasing tension and conflict between groups. Moving beyond Putnam’s simplistic account that immigration inevitably disrupts social capital, this article aims to instead show the complex features of civility and conflict that can co-exist among migrant and local communities. The research was based in a small working-class town in the North West of England that experienced the migration of Polish workers. Using a mixture of quantitative and qualitative methods, the key results show how new Polish migrants in particular demonstrate complex forms of social interaction displaying in-group hostility but out-group civility. Lenski’s notion of ‘status inconsistency’ is used to help explain why migrants with a high level of education but a low income are particularly mistrustful and intolerant of others.
Correctional oversight bodies’ resources and protections across the European Union: Are their hands tied?
Authors: Aizpurua Eva , Rogan Mary
Published: January 2021

Oversight bodies play a critical role in upholding human rights standards in prison. Several international instruments require states to establish independent forms of prison oversight and to give them the powers they need to conduct their work. Resources are central to the effectiveness and independence of oversight bodies. Of equal importance is the ability of prison oversight bodies to offer protections against reprisals for those who choose to speak to them and for their own staff. In this article, we provide results from the first survey of prison oversight bodies in the European Union and the United Kingdom, focusing on the resources and protections which prison oversight bodies in these states have to enable them to conduct their work. Our results suggest the need to strengthen the financial independence of prison oversight bodies, with slightly less than half of the bodies having their own budget to monitor prisons. Bodies which had their own budgets had a greater number of staff members and a greater variety of professional backgrounds among their members, likely influencing their ability to fulfil their mandate. Our results also point to the need to develop further protection mechanisms against reprisals for those who speak with inspectors as well as for staff from prison oversight bodies.
Recollections of a lost kingdom: The varied interactions between history and memory in South Sulawesi, Indonesia
Authors: Wellen Kathryn
Published: January 2021

This paper looks at the ways in which the Bugis of South Sulawesi, Indonesia remember their distant past. The example of Allangkanangngé ri Latanété, a palace site of the legendary polity of Cina, exemplifies how memories are mediated by cultural practices and socio-historical factors, as well as how they are included and excluded from histories, over a long period of time and through massive social changes. These social changes include the transition from a non-literate to a literate society, the demise of Cina and rise of agricultural kingdoms, colonialism, independence, and the advent of the digital age. The case of Allangkanangngé and Cina exemplifies how forgetting can serve new political situations; the way in which popular folk culture can maintain a memory despite historiographical oblivion; and the extent to which the Indonesian government is willing to appropriate history for nationalist purposes. It also exemplifies how history and memory can be synergistic or separate at different points in time.
A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients
Authors: Fang Xia , Chan Ping-tak , Zhou Shengbo , Dai Xinyi , Guo Ruiji , Wang Bin
Published: January 2021

Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results.

Level of evidence: IV
The influence of design variations in footwear medial-lateral support on the running biomechanics of older female runners
Authors: Lilley Kim , Stiles Victoria , Dixon Sharon
Published: January 2021

Reports of greater incidence of knee pain and injury in older female runners compared with their younger counterparts may be associated with differences in lower limb biomechanics that influence knee joint loading. The aim of this study was to investigate footwear interventions aimed at influencing lower limb biomechanics in older female runners (>45 years). Strategies for reducing peak rearfoot eversion and the external knee adductor moment were investigated, since both measures have been associated with knee joint injury. Twenty female runners (mean age 50.7 ± 5.6 years) performed 10 running trials in four footwear conditions: neutral running shoe (Control); neutral shoe with 4° medial heel wedge insole (Medial Wedge); neutral shoe with 4° lateral heel wedge insole (Lateral Wedge); and neutral shoe with combined insole with 5° lateral wedge and medial arch support (Combined Insole). Peak rearfoot eversion and knee external adductor moment were compared for the four conditions using RMANOVA and post-hoc Tukey tests ( p < 0.05). Compared with the Control, peak rearfoot eversion was lower for the Combined Insole condition, with this value being lower than for all other insole conditions ( p < 0.05). Compared with the Control, the peak knee external adductor moment was lower for the Lateral Wedge and the Combined Insole conditions ( p < 0.05). These results support the use of a combined insole with lateral wedge and medial arch support for the reduction of peak rearfoot eversion and peak knee external adductor moment, variables that have been associated with increased risk of knee injury. If aiming to reduce knee external adductor moment alone, then the lateral wedge technology employed in this study provides an effective method for older female runners.
A power-critique of academic rankings: Beyond managers, institutions, and positivism
Authors: Welsh John
Published: January 2021

The bulk of research on academic rankings is policy-oriented, preoccupied with ‘best practices’, and seems incapable of transcending the normative discourse of ‘governance’. To understand, engage, and properly critique the operation of power in academic rankings, the rankings discourse needs to escape the gravity of ‘police science’ and embrace a properly political science of ranking. More specifically, the article identifies three pillars of the extant research from which a departure would be critically fruitful – positivism, managerialism, institutionalism – and then goes on to outline three aspects of rankings that a critical political analysis should explore, integrate, and develop into future research from the discourses of critical theory – arkhè, dispositif, and dialectik.
Adapting care provision and advocating for unprotected unaccompanied minors in Paris in the context of COVID-19
Authors: Gautier Lara , Poveda Juan-Diego , Nguengang Wakap Stéphanie , Bouchon Magali , Quesnel-Vallée Amélie
Published: January 2021

Unaccompanied minors (UMs) are children under 18 who arrive on the territory of a foreign country without the care of a guardian. In many countries their access to social and health care services depends on their legal recognition as minors. For instance, in France, high rejection rates of minor status place unprotected UMs in social precarity, such that in Paris, civil society organizations (CSOs) have stepped in to offer social, medical, and psychological care to unprotected UMs. In the context of the COVID-19 pandemic however, CSOs had to adapt their care provision.

We review promising CSO-led initiatives to ensure continuity of care for this population. In doing so, we highlight how, by promoting UMs’ healthy behaviors in the context of the pandemic, continued social interactions between CSO members and unprotected UMs may have contributed to disease prevention among UMs. In addition, CSOs have continued to advocate for sheltering unprotected UMs, calling on public authorities to take action.
Healthy cities and self-reported health: evidence from Israel
Authors: Bar Ilan Dana , Reingewertz Yaniv , Baron-Epel Orna
Published: January 2021

The World Health Organization’s Healthy Cities Network (HCN) enlists community stakeholders (residents, businesses, non-governmental organizations and municipal governments) to promote health, quality of life and sustainable development in urban settings. The project, now three decades old, involves thousands of municipalities globally, including 52 in Israel. However, there is very little evidence regarding the effects of joining the HCN. This study examines whether HCN membership affects residents’ self-reported health (SRH). Social survey data for Israel’s 13 largest cities in 2005–2017 were analyzed using difference-in-differences and event study research designs. We use the gradual entry of cities to the HCN to compare SRH before and after network entry. Examined variables include municipal spending on health and duration of the city’s participation in the network. Data were analyzed through multivariate linear regression with fixed effects at the city and year levels. Joining the HCN does not have an immediate effect on SRH. SRH increases with the duration of the city’s participation in the network, but this result is only marginally statistically significant. Municipal health spending mildly increases with membership duration. A weak negative association was found between municipal health spending and SRH. Duration of a city’s membership in the HCN is positively associated with residents’ SRH; this association is not explained by an increase in municipal health spending. Identifying a mechanism for this improvement is beyond the scope of this study and is left for future research.
Cross-cultural adaptation, validity, and reliability of the Persian version of the Upper Limb Functional Index
Authors: Mokhtarinia Hamid Reza , Zareiyan Armin , Gabel Charles Philip
Published: January 2021

Introduction

The Upper Limb Functional Index (ULFI) is a patient-reported outcome measure (PROM) designed to evaluate both the functional status and the level of participation in patients with upper limb musculoskeletal disorders (ULMSDs). The purpose of this study was translation, cross-cultural adaptation, and psychometric evaluation of the original ULFI into Persian (ULFI-Pr).

Methods

The original ULFI was translated into Persian through double forward and backward translations. Consecutive symptomatic upper limb patients (n = 180, male = 60%, age = 38.21 ± 7.13) were recruited and completed the ULFI-Pr and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Internal consistency and test-retest reliability were determined using Cronbach’s Alpha and the Intra-class Correlation Coefficient (ICC2.1). Criterion validity was analyzed by evaluating the Pearson’s r correlation coefficient between the ULFI-Pr and DASH questionnaires. Construct validity was examined through exploratory factor analysis (EFA) using Maximum Likelihood Extraction with Promax rotation.

Results

The original ULFI was translated and cross-culturally adapted into Persian with only minor wording changes. The ULFI-Pr demonstrated high levels of internal consistency (α = 0.91) and test-retest reliability (ICC2.1=0.92). The correlation between the ULFI and DASH was high (r = 0.71). The EFA demonstrated a one-factor structure that explained 38.2% of total variance. No floor or ceiling effects were observed.

Conclusion

The ULFI-Pr can be considered as a region-specific, single-factor structure PROM for evaluation of patients with upper limb disorders for clinical and research purposes in Persian language populations.