bluuebunny/crossref_metadata_2025 huggingface dataset:
Corporate governance, market orientation and performance of Iran’s upscale hotels
Authors: Kazemian Soheil , Djajadikerta Hadrian Geri , Said Jamaliah , Roni Saiyidi Mat , Trireksani Terri , Alam Md Mahmudul
Published: April 2021

Market orientation has been known as an efficient managerial tool to assist in sustaining the performance of organisations. Market orientation has three dimensions, namely customer orientation, competitor orientation and inter-function coordination. This paper evaluates how corporate governance influences the three dimensions of market orientation within Iran's upscale hotels. The impacts of the three dimensions of market orientation on the hotels' social and financial performance are also examined to determine if market orientation mediates the relationships between corporate governance and performance. Partial least squares structural equation modelling (PLS-SEM) is used to analyse the survey data collected from the executives of four- and five-star hotels in Mashhad, Iran. Results show that corporate governance positively influences the three dimensions of market orientation, while overall market orientation influences financial and social performance. Specifically, customer orientation and inter-function coordination significantly reinforce such mediation, whereas the influence of competitor orientation is limited to financial performance.
Diverse teams researching diversity: Negotiating identity, place and embodiment in qualitative research
Authors: Mathijssen Brenda , McNally Danny , Dogra Sufyan , Maddrell Avril , Beebeejaun Yasminah , McClymont Katie
Published: April 2021

Fieldwork encounters are not only contingent to biographical subjectivities, but are mediated by a confluence of identity, place and embodiment. This paper offers reflexive accounts of researchers with various socio-cultural and disciplinary backgrounds, who collaborated as a team to examine the varied funerary experiences and needs of established minorities and recent migrants in England and Wales. Focusing on the researchers’ varied personal experiences with death and bereavement and on their performances of minority and majority ethnic and migrant identities, the paper highlights the mediated and embodied nature of fieldwork. It argues that reflection on the various aspects of intersectional researcher identity is necessary for a rigorous fieldwork practice that takes transparency and politics into account. This facilitates a deeper understanding of the positionality of both researchers and interlocutors, and the situated co-production of knowledge. In doing so, the paper illustrates that conducting research with a diverse team of researchers contributes to better understanding the complexity and multifacetedness of social phenomena.
Misinformation about fake news: A systematic critical review of empirical studies on the phenomenon and its status as a ‘threat’
Authors: Miró-Llinares Fernando , Aguerri Jesús C.
Published: April 2021

After the 2016 US presidential elections, the term ‘fake news’ became synonymous with disinformation and a catch-all term for the problems that social networks were bringing to communication. Four years later, there are dozens of empirical studies that have attempted to describe and analyse an issue that, despite still being in the process of definition, has been identified as one of the key COVID-19 cyberthreats by Interpol, is considered a threat to democracy by many states and supranational institutions and, as a consequence, is subject to regulation or even criminalization. These legislative and criminal policy interventions form part of the first stage in the construction of a moral panic that may lead to the restriction of freedom of expression and information. By analysing empirical research that attempts to measure the extent of the issue and its impact, the present article aims to provide critical reflection on the process of constructing fake news as a threat. Via a systematic review of the literature, we observe, firstly, that the concept of fake news used in empirical research is limited and should be refocused because it has not been constructed according to scientific criteria and can fail to include relevant elements and actors, such as governments and traditional media. Secondly, the article analyses what is known scientifically about the extent, consumption and impact of fake news and argues that it is problematic to establish causal relationships between the issue and the effects it has been said to produce. This conclusion requires us to conduct further research and to reconsider the position of fake news as a threat as well as the resulting regulation and criminalization.
Addressing the changing rehabilitation needs of patients undergoing thoracic surgery
Authors: Langer Daniel
Published: April 2021

The rehabilitation needs of individuals undergoing thoracic surgery are changing, especially as surgical management is increasingly being offered to patients who are at risk of developing functional limitations during and after hospital discharge. In the past rehabilitative management of these patients was frequently limited to specific respiratory physiotherapy interventions in the immediate postoperative setting with the aim to prevent postoperative pulmonary complications. In the past two decades, this focus has shifted toward pulmonary rehabilitation interventions that aim to improve functional status of individuals, both in the pre- and (longer-term) postoperative period. While there is increased interest in (p)rehabilitation interventions the majority of thoracic surgery patients are however currently on their own with respect to progression of their exercise and physical activity regimens after they have been discharged from hospital. There are also no formal guidelines supporting the referral of these patients to outpatient rehabilitation programs. The current evidence regarding rehabilitation interventions initiated before, during, and after the hospitalization period will be briefly reviewed with special focus on patients undergoing surgery for lung cancer treatment and patients undergoing lung transplantation. More research will be necessary in the coming years to modify or change clinical rehabilitation practice beyond the acute admission phase in patients undergoing thoracic surgery. Tele rehabilitation or web-based activity counseling programs might also be interesting emerging alternatives in the (long-term) postoperative rehabilitative treatment of these patients.
Will We Lose If We Lose You? Players’ Absence, Teams’ Performance and the Overlapping of Competitions
Authors: Pérez Levi
Published: April 2021

It is common for elite players to represent their respective countries in international competitions. However, there is a potential cost to the club team derived from that situation (risk of injury, fatigue, psychological momentum, etc.). This paper evaluates the impact of players’ absence on European football teams’ performance by focusing on the Africa Cup of Nations as the case study. The results indicate that the sending of players to the African tournament has a relatively small negative impact on teams’ performance. But this cannot be generalized to all the leagues and loses significance when corrected by players’ abilities.
Distally Based Sural Fasciocutaneous Flaps for Reconstructing Soft Tissue Defects Proximal and Distal to the Tarsometatarsal Joints: A Comparative Analysis
Authors: Luo Zhaobiao , Ni Jiangdong , Lv Guohua , Wei Jianwei , Liu Lihong , Peng Ping , Dong Zhonggen
Published: April 2021

Distally based sural fasciocutaneous (DBSF) flaps are widely used for reconstructing soft tissue defects of the foot. The purpose of this paper was to compare the clinical efficacy of the use of flaps to repair defects in areas proximal and distal to the level of the tarsometatarsal joints in a relatively large number of patients and to analyze the effects of factors on the risk of developing partial necrosis of the flaps. Between April 2001 and December 2019, a total of 355 DBSF flaps were utilized to cover soft tissue defects in the foot. According to the furthest location of the defects reconstructed with the flaps, the flaps were divided into the proximal foot group (n = 260) and the distal foot group (n = 95). The partial necrosis rates, their influencing factors, and the clinical outcomes of the procedure were compared between the two groups. In the proximal foot group, the partial necrosis rate (6.2%, 16 of 260) was significantly lower than that in the distal foot group (14.7%, 14 of 95) ( P < .05). The proportion of successful coverage of the defects using the flaps alone or in combination with a simple salvage treatment was comparable between the groups ( P > .05). The ratio of unfavorable conditions in the distal foot group was higher than that in the proximal foot group ( P < .05). DBSF flaps can be effectively utilized to repair defects in the proximal and distal areas of the foot. The use of a DBSF flap to repair defects in the proximal areas of the foot is superior to the use of DBSF flaps for repairing defects in the distal areas of the foot in terms of reliable survival of the flap.
Knee Kinetics and Kinematics in Patients With Ankle Arthroplasty and Ankle Arthrodesis
Authors: Roney Andrew R. , Kraszewski Andrew P. , Demetracopoulos Constantine A. , Hillstrom Howard J. , Deland Jonathan T. , de Cesar Netto Cesar , Saito Guilherme H. , Day Jonathan , Ellis Scott J.
Published: April 2021

Background: Previous literature suggests that patients treated with total ankle arthroplasty (TAA) versus ankle arthrodesis (AA) may have better function and lower risk for adjacent joint arthritis in the foot. Little is known on how these interventions affect proximal joints such as the knee. Questions: We sought to assess whether patients with TAA and AA exhibited altered biomechanics linked to the onset and progression of knee osteoarthritis (KOA). We used the knee adduction moment (KAM), a surrogate measure for the mechanical load experienced at the medial tibiofemoral compartment, because it is linked with the onset and progression of KOA. Methods: At a minimum of 2 years postoperatively, instrumented 3-dimensional walking gait was recorded in 10 TAA and 10 AA patients at self-selected walking speeds. TAA patients had either a Salto Talaris or INBONE prosthesis. Average first and second peak KAMs (Nm/kg), KAM impulse (Nm-s/kg), and range-of-motion (ROM, °) were calculated on both the affected and unaffected limbs for each patient. Results: There were no significant differences in the KAM’s first and second peaks, impulse, or knee ROM in any plane between the unaffected and affected limbs, or between TAA and AA. Conclusion: TAA and AA may not meaningfully affect ipsilateral knee kinetics and KAMs in short-term follow-up. This study highlights the importance of continuing to study these parameters in larger cohorts of patients with longer follow-up to determine how our treatment of end-stage ankle arthritis may affect the incidence or progression of ipsilateral KOA.
Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review
Authors: Shah Nihar S. , Suriel Peguero Emil , Umeda Yuta , Crawford Zachary T. , Grawe Brian M
Published: April 2021

Background:

With an increase in the treatment options available for massive rotator cuff tears, understanding the long-term outcomes of the chosen modality is important.

Questions/Purpose:

The purpose of this study was to systematically review the available literature on repair of massive rotator cuff repairs and learn the longevity of outcomes, the failure rate, outcomes after failure, and any contributing factors to poor outcomes or failure.

Methods:

We conducted a systematic review of the MEDLINE, Cochrane, and Embase databases to find studies that investigated the long-term results of repair of massive rotator cuff repairs. Studies were excluded if they did not stratify results of massive tears, provide a definition for a massive rotator cuff tear, or report isolate patients with long-term follow-up.

Results:

Six studies met the inclusion criteria, for a total of 472 shoulders; average patient age was 57.6 years. Follow-up ranged from 119 to 240 months. Outcome scores improved significantly following repair and were maintained throughout follow-up. The repair failure rate across studies was 39.2%. Patients who suffered retear had significantly worse outcome scores than patients with intact tendons at long-term follow-up.

Conclusions:

The existing literature on long-term follow-up after massive rotator cuff repair is scarce and not of high level of evidence. This review found repair of massive rotator cuff tears leads to long-term maintained improvements in outcome measures. Failure of repair is quite common, but results following failure are superior to preoperative outcomes.
Use of generic medicines in the Middle East: Knowledge, perceptions and experiences of the Sulaimani population, KRI, Iraq
Authors: Uctu Ramazan
Published: April 2021

The aim of this study is to assess the level of knowledge, perception, and experiences of the Sulaimani population in KRI, Iraq. A descriptive and cross-sectional survey was performed with 389 participants (283 male, 106 female) in the city of Sulaimani. The main method of collecting data was done through a questionnaire which was made up of two sections; firstly assessing the demographic characteristics of the sample population, and secondly assessing their knowledge towards generic medicines and their perceptions of generic medicine usage and purchasing intention. The Cronbach’s alpha coefficient was 0.726 which is considered as an acceptable value to measure internal consistency of the sampled population. As a result, this study showed that the sampled population did not have sufficient knowledge about generic medicines and would therefore also not be considering replacing branded medicines with the generics. This is mostly related to poor awareness of generic medicines and lack of publicity or awareness campaigns surrounding generic medicines. This study recommends that authorities invest in publicizing the use of generics and implement public awareness campaigns.
The effect of spin level and ball exit speed on forearm muscle activity in the tennis forehand stroke
Authors: Rigozzi Chantelle , Cox Jeremy , Vio Gareth A , Martens William L , Poronnik Philip
Published: April 2021

Elbow tendinopathy injuries are very common in tennis players. One of the commonly accepted theories describing the development of elbow tendinopathy in tennis is based on stiffness of the forearm skeletal muscle units and their repetitive overuse in the forehand stroke. Our objective was to use a novel microcontroller based wearable device to compare the influence of different forehand spin levels (flat, topspin and lob) and ball exit speed on forearm muscle activity in the potential onset of elbow tendinopathy in experienced adult tennis players. Peak normalised extensor carpi radialis (ECR) and flexor carpi radialis (FCR) muscle activity corresponding to each forehand shot and ball exit speed were determined and analysed. For the ECR shots (flat = 121, topspin = 272 and lob = 273) by 8 players, Kruskal-Wallis test (p < 0.001) and Post-Hoc tests revealed a significant difference between the flat and topspin spin levels (p < 0.01) and flat and lob spin levels (p < 0.001). For the FCR shots (flat = 125, topspin = 301 and lob = 303) by 9 players, Kruskal-Wallis test showed no significant difference between the three spin levels. For the corresponding ball speed, the Kruskal-Wallis (p < 0.001) and subsequent Post-Hoc (p < 0.001) showed that flat hits had the significantly highest ball speed followed by topspin then lob accordingly for both muscles included shots. Our results suggest that coaches could consider recommending players to hit forehands with topspin in order to potentially reduce the risk of developing lateral elbow tendinopathy.
Card collection: An examination of whether yellow and red cards affect base salary under Major League Soccer’s salary cap
Authors: Lussier Jenna , Kim Jun Woo , Magnusen Marshall J , Kim Kyoung Tae
Published: April 2021

We examine the effect of card (yellow and red) collection on player remuneration under the salary cap in Major League Soccer (MLS). The data contain 1478 observations of 731 players under contract between 2015 and 2019. Though the number of yellow cards a player collected had a significant impact, the number of red cards collected was not found to be a significant factor. On average, when a player has accumulated more than eight yellow cards over the course of the regular season, his salary was dropped substantially. If a player receives more than two red cards, his salary was decreased. A key result was that players who were aggressive without crossing the line to the point of being ejected from the field of play received comparatively higher salaries.
Optimal tissue sampling during ERCP and emerging molecular techniques for the differentiation of benign and malignant biliary strictures
Authors: Kamp Eline J. C. A. , Dinjens Winand N. M. , Doukas Michail , Bruno Marco J. , de Jonge Pieter Jan F. , Peppelenbosch Maikel P. , de Vries Annemarie C.
Published: April 2021

Patients with cholangiocarcinoma have poor survival since the majority of patients are diagnosed at a stage precluding surgical resection, due to locally irresectable tumors and/or metastases. Optimization of diagnostic strategies, with a principal role for tissue diagnosis, is essential to detect cancers at an earlier stage amenable to curative treatment. Current barriers for a tissue diagnosis include both insufficient tissue sampling and a difficult cyto- or histopathological assessment. During endoscopic retrograde cholangiopancreatography, optimal brush sampling includes obtaining more than one brush within an individual patient to increase its diagnostic value. Currently, no significant increase of the diagnostic accuracy for the new cytology brush devices aiming to enhance the cellularity of brushings versus standard biliary brush devices has been demonstrated. Peroral cholangioscopy with bile duct biopsies appears to be a valuable tool in the diagnostic work-up of indeterminate biliary strictures, and may overcome current technical difficulties of fluoroscopic-guided biopsies. Over the past years, molecular techniques to detect chromosomal instability, mutations and methylation profiling of tumors have revolutionized, and implementation of these techniques on biliary tissue during diagnostic work-up of biliary strictures may be awaited in the near future. Fluorescence in situ hybridization has already been implemented in routine diagnostic evaluation of biliary strictures in several centers. Next-generation sequencing is promising for standard diagnostic care in biliary strictures, and recent studies have shown adequate detection of prevalent genomic alterations in KRAS, TP53, CDKN2A, SMAD4, PIK3CA, and GNAS on biliary brush material. Detection of DNA methylation of tumor suppressor genes and microRNAs may evolve over the coming years to a valuable diagnostic tool for cholangiocarcinoma. This review summarizes optimal strategies for biliary tissue sampling during endoscopic retrograde cholangiopancreatography and focuses on the evolving molecular techniques on biliary tissue to improve the differentiation of benign and malignant biliary strictures.
Outlook into the future of front-line immune checkpoint inhibition in metastatic urothelial carcinoma
Authors: Brown Jason R. , Krane Spencer , Garcia Jorge , Barata Pedro C.
Published: April 2021

Immune checkpoint inhibition has been approved for front-line treatment of metastatic bladder cancer in patients who are cisplatin-ineligible and demonstrate programmed death-ligand 1 (PD-L1) positivity. This approval followed the positive results of IMvigor210 and KEYNOTE-052 studies. Immunotherapy has also demonstrated efficacy as maintenance therapy patients for patients who initially respond to platinum-based chemotherapy. Other studies have investigated combinations of immunotherapy with chemotherapy, combinations between immunotherapies, and immunotherapy with novel agents. Although these combinations have demonstrated promise, further investigation is necessary to optimize the patients who would benefit from these approaches. Biomarkers beyond PD-L1 scoring can help predict response and resistance to immune checkpoint inhibition and will be integral to future studies.
Off-label use of anti-IL-1 drugs in rheumatic diseases
Authors: Stefania Silvia , Colia Ripalta , Cinzia Rotondo , Corrado Addolorata , Cantatore Francesco Paolo
Published: April 2021

Interleukin-1 (IL-1) plays a key role in the pathogenesis of different rheumatic diseases. There are now several agents available on the market capable of blocking IL-1. The proven effectiveness and excellent safety of these drugs makes them a possible therapeutic option in the treatment of IL-1 driven diseases, when previous therapies are contraindicated or ineffective. This article discusses the European wide off-label use of these drugs for the treatment of rheumatic diseases.
Activation of RAW264.7 cells by PCp-I, a polysaccharide from Psoralea corylifolia L, through NF-κB/MAPK signalling pathway
Authors: Wang Honglin , Xu Xiaoqing , Yin Zhenhua , Wang Mengke , Wang Baoguang , Ma Changyang , Wang Jinmei , Kang Wenyi
Published: April 2021

PCp-I is a polysaccharide isolated and identified from the Psoralea corylifolia L. by our research group. In this study, the immunomodulatory effects of PCp-I on RAW264.7 cells was evaluated. PCp-I could enhance the level of NO along with up-regulation of iNOS mRNA in RAW264.7 cells. The PCp-I could significantly up-regulate the mRNA expression of TNF- α and IL-6 in RAW264.7 cells, and then the expression of TNF- α, IL-6, ROS and the phagocytic activity were increased. Additionally, PCp-I could significantly up-regulate the phosphorylation level of p65, p38, ERK and JNK proteins, which proved that PCp-I could activate the macrophages by MAPKs and NF- κB signalling pathway and the TLR4 may be one of the receptors of PCp-I regulate the RAW264.7 cells.
A Midwest COVID-19 Cohort for the Evaluation of Multimorbidity and Adverse Outcomes from COVID-19
Authors: Nanda Sanjeev , Toussaint Loren , Vincent Ann , Fischer Karen M. , Hurt Ryan , Schroeder Darrell R. , Chacin Suarez Audry S. , Medina Inojosa Jose R. , O’Horo John C. , DeJesus Ramona S. , Abu Lebdeh Haitham S. , Mundi Manpreet S. , Iftikhar Salma , Croghan Ivana T.
Published: April 2021

Objective

To describe the process and outcome of creating a patient cohort in the early stages of the COVID-19 pandemic in order to better understand the process of and predict the outcomes of COVID-19.

Patients and Methods

A total of 1169 adults aged 18 years of age or older who tested positive in Mayo Clinic Rochester or the Mayo Clinic Midwest Health System between January 1 and May 23 of 2020.

Results

Patients were on average 43.9 years of age and 50.7% were female. Most patients were white (69.0%), and Blacks (23.4%) and Asians (5.8%) were also represented in larger numbers. Hispanics represented 16.3% of the sample. Just under half of patients were married (48.4%). Common comorbid conditions included: cardiovascular diseases (25.1%), dyslipidemia (16.0%), diabetes mellitus (11.2%), chronic obstructive pulmonary disease (6.6%), asthma (7.5%), and cancer (5.1%). All other comorbid conditions were less the 5% in prevalence. Data on 3 comorbidity indices are also available including the: DHHS multi-morbidity score, Charlson Comorbidity Index, and Mayo Clinic COVID-19 Risk Factor Score.

Conclusion

In addition to managing the ever raging pandemic and growing death rates, it is equally important that we develop adequate resources for the investigation and understanding of COVID-19-related predictors and outcomes.
OSHA and NIOSH Turn 50
Authors: McPhaul Kathleen M.
Published: April 2021

OSHA and NIOSH turn 50 in 2021. Practice resources are described as well as links for following the respective 50-year anniversary reflections.
Regional (dis)integration beyond governments: A comparison in social and civil society participation between Mercosur and SADC
Authors: Ramanzini Junior Haroldo , Theodoro Luciano Bruno
Published: April 2021

The aim of this article is to analyse the involvement of civil society in regional integration organizations through a comparative analysis of social/civil society channels in the Southern Common Market (Mercosur) and the Southern African Development Community (SADC). We seek to analyse the level of openness and the trajectory of both blocs in relation to civil society participation. The instruments and strategies employed by civil society actors in both regions are contrasted, aiming to understand how prominent and successful they have been in terms of influencing the decision-making processes of Mercosur and the SADC, which have been traditionally marked by their intergovernmental and interpresidential characters. We argue that civil society involvement in regionalism is shaped by regional institutional design, member states’ support for societal participation and civil society resources. Thus, this article seeks to contribute to the comparative regionalism literature, setting out an analytical comparative framework for assessing the role of civil society in regional organizations from the Global South.
Globalization, de-globalization, and re-globalization: Some historical context and the impact of the COVID pandemic
Authors: Madhok Anoop
Published: April 2021

The Covid-19 pandemic has exposed many of the weaknesses in our current systems of government and commerce. In this essay, I provide some historical context to the recent era of “hyper-globalization.” I then present multiple factors—economic, social, political, technological, and governance-related—that collectively explain why globalization has peaked and is on the retreat. Following this, I use the analogy of a three-legged stool to explain the importance of recalibrating the economy, state, and society so as to realize a healthier alignment among them. Finally, I look at where globalization might be going next and the implications for firms, concluding with some lessons that we can take away from the COVID crisis.

JEL CLASSIFICATION: M10, M16, M19
Talent management challenges during COVID-19 and beyond: Performance management to the rescue
Authors: Aguinis Herman , Burgi-Tian Jing
Published: April 2021

The COVID-19 pandemic has resulted in significant talent management challenges including (a) hiring freezes and layoffs; (b) salary freezes, canceled bonuses, and pay reductions; (c) how work is done (i.e., teleworking); and (d) increased employee stress and burnout. Also, COVID-19 has made it evident that many organizations do not implement state-of-the-science performance management systems and, instead, have just performance appraisal systems that typically involve a once-a-year evaluation and review, little effort to provide feedback and coaching on an ongoing basis, little alignment between employee performance and the organization’s strategic goals, a focus on past performance only, and ownership by the human resources function instead of those rating and being rated. Thus, the lack of value contributed by the usual performance evaluation and review process is the reason why so many organizations are postponing or even completely discontinuing performance evaluations. We argue that when implemented using evidence-based recommendations, performance management (rather than appraisal) serves important administrative, strategic and communication, developmental, organizational maintenance, and documentation purposes and therefore can be particularly useful in addressing contemporary talent management challenges. We offer five recommendations on how to adapt and improve performance management that will help organizations navigate crises like COVID-19 and, just as importantly, allow them to thrive after the crisis is over: (1) measure results in addition to behaviors, (2) measure adaptive performance, (3) conduct stay interviews to retain top performers, (4) implement a multisource performance management system, and (5) collect and use performance promoter scores.

JEL CLASSIFICATION: J5 Labor–Management Relations, Trade Unions, and Collective Bargaining; M1 Business Administration; M5 Personnel Economics
Developing Coaching Mindset and Skills
Authors: Cannon Mark , Douglas Susan , Butler Deborah
Published: April 2021

As the use of coaching in organizations continues to grow, managers are increasingly expected to coach their subordinates. However, the development of managerial coaching skills has generally not kept up with organizational desires and needs. We offer a role-play methodology with two scenarios for teaching coaching mindset and related skills. The remedial coaching scenario offers an opportunity to practice coaching an employee on a performance issue or problem. The developmental coaching scenario provides an opportunity for the person being coached to choose a topic to further professional development. The role-plays use a trio format, which has the distinctive benefit of actively involving all members of the class. Each participant takes a turn playing each of the roles of coach, employee, and observer. The observer/feedback giver role enables each student to receive personal feedback. The exercise can be conducted in both in-person and online class formats.
Barriers in communicating medication changes at hospital discharge: Informing CancelRx design requirements
Authors: Yang Yushi , Pitts Samantha I , Chen Allen R
Published: April 2021

Objectives

This operational study aims to investigate the barriers in communicating medication changes at hospital discharge, and to inform design requirements of the CancelRx functionality to better support the communication.

Methods

We conducted seven semi-structured interviews with inpatient prescribers at an urban academic medical center. The interview protocol was framed from a human factors perspective, specifically the work system design approach. We took notes of the interviews and identified the initial themes of system barriers that may impact patient safety.

Results

Medication changes need to be communicated to multiple stakeholders. We identified two initial themes of the system barriers: the lack of an information flow that connects all the involved stakeholders, and the difficulties to communicate key pieces of information. We identified three key pieces of information that are difficult to communicate: the discontinuation reasons, the notification urgency, and the duration of changes.

Conclusions

While the CancelRx functionality can facilitate the communication (e.g. prescribers no longer need to call pharmacists when a medication is discontinued), enhancements are needed to address the system barriers. We proposed enhanced design requirements of the CancelRx functionality, e.g., to allow users to specify a reason for a medication discontinuation and transmit the reasons to other stakeholders, to indicate the urgency of notification, to specify the duration of a change, and to receive system status feedback .
Experiential Avoidance and Meaning in Life as Predictors of Valued Living: A Daily Diary Study
Authors: Pavlacic Jeffrey M. , Schulenberg Stefan E. , Buchanan Erin M.
Published: April 2021

Values-based interventions encourage engagement in valued living as a means to promote psychological well-being. Valued living is best operationalized as ongoing, reinforcing behavioral patterns consistent with idiographic values that facilitate psychological well-being and improved mental health. Cross-sectional research illustrates positive associations between valued living and well-being and negative associations between valued living and psychopathology. However, it is important to have an understanding of different daily-level factors that predict fluctuations in valued living. Consistent with cognitive and behavioral models, meaning may positively relate to engagement in valued living, while experiential avoidance negatively relates to valued living. To address these relationships at the daily level, we systematically examined valued living, meaning, and experiential avoidance using ecological momentary assessment across 14 days with 73 college students. Multilevel modeling supported a positive relationship between meaning (i.e., at both the within- and between-person level) and daily valued living, above and beyond the within-person effects of experiential avoidance. The results elucidate a daily link between valued living and aspects of well-being. Further, these results show that constructs commonly assessed cross-sectionally fluctuate at the daily level, which sets the stage for future research programs that examine factors promoting and inhibiting fluctuations in meaning, experiential avoidance, and valued living. These results have important implications for prevention of mental health problems and promotion of psychological well-being.
Dynamic mechanical behaviors of epoxy resin/hollow polymeric microsphere composite foams under forced non-resonance and forced resonance
Authors: Li Rui , Fan Guisen , Ouyang Xiao , Wang Guojun , Wei Hao
Published: April 2021

Composite foams with 10–50 vol% hollow polymeric microspheres were prepared using bisphenol A epoxy resin and polyetheramine curing agent as the matrix. The results demonstrated that the density, hardness, and static mechanical properties of the epoxy resin/hollow polymer microsphere composite foams, as well as their dynamic mechanical properties under forced non-resonance, were similar to those of polymer/hollow glass microsphere composite foams. At 25°C and under 1–100 Hz forced resonance, the first-order and second-order resonance frequencies of the composite foams shifted to the low-frequency region as the volume fraction of hollow polymer microspheres increased. Meanwhile, the first-order and second-order loss factors of the as-prepared composite foams were improved by 41.7% and 103.3%, respectively, compared with the pure epoxy resin. Additionally, the first-order and second-order loss factors of the as-prepared composite foams reached a maximum at 40 vol% and 30 vol% hollow polymer microspheres, respectively. This research helps us to expand the application range of composite foam materials in damping research.
Diabetes Self-Management Education Support Healthy Teaching Kitchen Cooking Classes Delivered Using a Telehealth Technology
Authors: Cross Samantha , Kurmas Neal , Byrne Cally , Julius Mary , Burant Christopher , Utech Anne , Aoun Arianna
Published: April 2021

Purpose

The purpose of the study was to evaluate the effectiveness of diabetes self-management education and support (DSMES) among veterans with diabetes using the Healthy Teaching Kitchen (HTK) by means of telehealth communication.

Methods

A retrospective chart review collected data from veterans with type 2 diabetes (T2DM) that participated in the DSMES-HTK program at 2 Veterans Affairs Northeast Ohio Healthcare System facilities between February 2013 and December 2018. A factorial design was used to compare A1C data and use of clinical video telehealth from main hub to satellite site. Statistical analyses were performed using SPSS (Version 25). Repeated measures analysis of variance (RMANOVA) were performed to compare mean A1C in veterans that attended HTK at the main site versus a telehealth site. RMANOVA was also used to compare mean A1C in veterans that attended at least 1 hands-on class versus those that attended at least 1 demonstration class.

Results

A1C values of all groups improved over time and were sustained regardless of DSMES-HTK delivery method or location.

Conclusions

Sustained improvement in A1C was observed in patients that participated in both DSMES-HTK in person and via clinical video telehealth classes conducted by hub site facilitator with RDN, CDCES credential. The use of a clinical video telehealth strategy for DSMES-HTK capitalizes on limited, highly skilled, credentialed instructional team members.
Swallowing dysfunction in patients hospitalised due to a COPD exacerbation
Authors: Gonzalez Lindh Margareta , Janson Christer , Blom Johansson Monica , Jonsson Mimmi , Mälberg Emma , Allansson Elina , Holm Cecilia , Jennische Margareta , Koyi Hirsch
Published: April 2021

Objectives

This cross-sectional study aimed to investigate the prevalence of self-reported and clinically screened swallowing dysfunction (dysphagia) in COPD patients with severe exacerbations and to identify any associated factors. Findings were then compared to a control group.

Methods

Participants included 30 patients hospitalised due to a COPD exacerbation. The control group consisted of 30 adults hospitalised with acute cardiac symptoms. Data were derived from spirometry, the 150 mL timed water swallow test, a cookie swallow test and a dyspnoea questionnaire (modified Medical Research Council (mMRC)). Scores from the 10-item Eating Assessment Tool (EAT-10) were calculated to assess patient perception of swallowing dysfunction.

Results

Self-reported swallowing dysfunction and clinical signs thereof were more common in COPD patients than in the control group (67%versus23% and 80%versus37%, respectively; p≤0.001). Clinical signs of swallowing dysfunction in the group with acute exacerbation of COPD were associated with self-reported swallowing dysfunction (p=0.02) and xerostomia (p=0.04). Dyspnoea (mMRC ≥2) was more common among the COPD patients (90%versus47%, p<0.001). There was a significant negative correlation between lung function and self-reported dysphagia (r=−0.39, p=0.03), but not between lung function and clinically screened dysphagia (r=−0.23, p=0.21).

Conclusion

COPD patients hospitalised with an acute exacerbation experienced significantly more self-reported and clinically screened swallowing dysfunction compared to a control group of patients with cardiac symptoms. Both patient groups experienced dyspnoea, but it was twice as common in the group with acute exacerbation of COPD. Both groups also experienced xerostomia.
Survival time prediction by integrating cox proportional hazards network and distribution function network
Authors: Baek Eu-Tteum , Yang Hyung Jeong , Kim Soo Hyung , Lee Guee Sang , Oh In-Jae , Kang Sae-Ryung , Min Jung-Joon
Published: April 2021

Background

The Cox proportional hazards model is commonly used to predict hazard ratio, which is the risk or probability of occurrence of an event of interest. However, the Cox proportional hazard model cannot directly generate an individual survival time. To do this, the survival analysis in the Cox model converts the hazard ratio to survival times through distributions such as the exponential, Weibull, Gompertz or log-normal distributions. In other words, to generate the survival time, the Cox model has to select a specific distribution over time.

Results

This study presents a method to predict the survival time by integrating hazard network and a distribution function network. The Cox proportional hazards network is adapted in DeepSurv for the prediction of the hazard ratio and a distribution function network applied to generate the survival time. To evaluate the performance of the proposed method, a new evaluation metric that calculates the intersection over union between the predicted curve and ground truth was proposed. To further understand significant prognostic factors, we use the 1D gradient-weighted class activation mapping method to highlight the network activations as a heat map visualization over an input data. The performance of the proposed method was experimentally verified and the results compared to other existing methods.

Conclusions

Our results confirmed that the combination of the two networks, Cox proportional hazards network and distribution function network, can effectively generate accurate survival time.
Transcriptomic and proteomic analysis of putative digestive proteases in the salivary gland and gut of Empoasca (Matsumurasca) onukii Matsuda
Authors: Shao Ensi , Song Yujuan , Wang Yaomin , Liao Yichen , Luo Yufei , Liu Sijun , Guan Xiong , Huang Zhipeng
Published: April 2021

Background

Infestation by tea green leafhoppers (Empoasca (Matsumurasca) onukii) can cause a series of biochemical changes in tea leaves. As a typical cell-rupture feeder, E. onukii secretes proteases while using its stylet to probe the tender shoots of tea plants (Camellia sinensis). This study identified and analyzed proteases expressed specifically in the salivary gland (SG) and gut of E. onukii through enzymatic activity assays complemented with an integrated analysis of transcriptomic and proteomic data.

Results

In total, 129 contigs representing seven types of putative proteases were identified. Transcript abundance of digestive proteases and enzymatic activity assays showed that cathepsin B-like protease, cathepsin L-like protease, and serine proteases (trypsin- and chymotrypsin-like protease) were highly abundant in the gut but moderately abundant in the SG. The abundance pattern of digestive proteases in the SG and gut of E. onukii differed from that of other hemipterans, including Nilaparvata lugens, Laodelphax striatellus, Acyrthosiphum pisum, Halyomorpha halys and Nephotettix cincticeps. Phylogenetic analysis showed that aminopeptidase N-like proteins and serine proteases abundant in the SG or gut of hemipterans formed two distinct clusters.

Conclusions

Altogether, this study provides insightful information on the digestive system of E. onukii. Compared to five other hemipteran species, we observed different patterns of proteases abundant in the SG and gut of E. onukii. These results will be beneficial in understanding the interaction between tea plants and E. onukii.
Eudiplozoon nipponicum (Monogenea, Diplozoidae) and its adaptation to haematophagy as revealed by transcriptome and secretome profiling
Authors: Vorel Jiří , Cwiklinski Krystyna , Roudnický Pavel , Ilgová Jana , Jedličková Lucie , Dalton John P. , Mikeš Libor , Gelnar Milan , Kašný Martin
Published: April 2021

Background

Ectoparasites from the family Diplozoidae (Platyhelminthes, Monogenea) belong to obligate haematophagous helminths of cyprinid fish. Current knowledge of these worms is for the most part limited to their morphological, phylogenetic, and population features. Information concerning the biochemical and molecular nature of physiological processes involved in host–parasite interaction, such as evasion of the immune system and its regulation, digestion of macromolecules, suppression of blood coagulation and inflammation, and effect on host tissue and physiology, is lacking. In this study, we report for the first time a comprehensive transcriptomic/secretome description of expressed genes and proteins secreted by the adult stage of Eudiplozoon nipponicum (Goto, 1891) Khotenovsky, 1985, an obligate sanguivorous monogenean which parasitises the gills of the common carp (Cyprinus carpio).

Results

RNA-seq raw reads (324,941 Roche 454 and 149,697,864 Illumina) were generated, de novo assembled, and filtered into 37,062 protein-coding transcripts. For 19,644 (53.0%) of them, we determined their sequential homologues. In silico functional analysis of E. nipponicum RNA-seq data revealed numerous transcripts, pathways, and GO terms responsible for immunomodulation (inhibitors of proteolytic enzymes, CD59-like proteins, fatty acid binding proteins), feeding (proteolytic enzymes cathepsins B, D, L1, and L3), and development (fructose 1,6-bisphosphatase, ferritin, and annexin). LC-MS/MS spectrometry analysis identified 721 proteins secreted by E. nipponicum with predominantly immunomodulatory and anti-inflammatory functions (peptidyl-prolyl cis-trans isomerase, homolog to SmKK7, tetraspanin) and ability to digest host macromolecules (cathepsins B, D, L1).

Conclusions

In this study, we integrated two high-throughput sequencing techniques, mass spectrometry analysis, and comprehensive bioinformatics approach in order to arrive at the first comprehensive description of monogenean transcriptome and secretome. Exploration of E. nipponicum transcriptome-related nucleotide sequences and translated and secreted proteins offer a better understanding of molecular biology and biochemistry of these, often neglected, organisms. It enabled us to report the essential physiological pathways and protein molecules involved in their interactions with the fish hosts.
Intraoperative transfusion practice in burned children in a university hospital over four years: a retrospective analysis
Authors: Wittenmeier Eva , Katharina Astor , Schmidtmann Irene , Griemert Eva-Verena , Kriege Marc , König Tatjana , Nina Pirlich
Published: April 2021

Background

Patient blood management programs should be applied to the pediatric population, but little is known about the current transfusion practice of pediatric burn injury patients. This retrospective study was performed to evaluate the practice of red blood cell (RBC) transfusion in children with burn injury, their predictive factors, and adherence to the German transfusion guideline.

Methods

We reviewed the RBC transfusion practice of all children younger than 8 years with burn injury who were operated during a four-year period in a German university medical center. We analyzed the data associated with transfusion and guideline conformity of transfusion triggers for RBCs from the beginning to the end of hospital stay using logistic regression.

Results

During the four-year period, 138 children (median age 21 months, minimum-maximum 9–101 months) with burn injury needed surgery, 31 children were transfused with RBCs. During their hospital stay, the median hemoglobin concentrations (Hb) of transfused and non-transfused children were 8 g/dL (6.3–11.3 g/dL) and 10.7 (7–13.8 g/dL), respectively. Total body surface area burned (TBSA) (OR = 1.17 per % TBSA, 95% CI = [1.05; 1.30], p = 0.0056), length of surgery (OR = 1.016 per minute, 95% CI = [1.003; 1.028], p = 0.0150), and Hb (OR = 0.48 per 1 g/dl in Hb, 95% CI = [0.24; 0.95], p = 0.0343) were associated with transfusion while other factors (age, gender, ASA, and catecholamines) did not show notable association. Length of stay was mainly influenced by TSBA (+ 1.38 days per %, p <  0.0001), age (+ 0.21 days per month, p = 0.0206), and administering of catecholamines (+ 14.3 days, p = 0.0118), but not by RBC transfusion. The decision to transfuse was in 23% too restrictive and in 74% too liberal according to the German guidelines.

Conclusions

Amount of TBSA, length of surgery, and Hb influenced the RBC transfusion rate in burned children. However, age and length of stay were not affected by transfusion of RBCs. In clinical practice of burned children, physicians follow a more liberal transfusion strategy than the proposed in guidelines.