bluuebunny/crossref_metadata_2025 huggingface dataset:
Expanding role of radiotherapy in adenoid cystic carcinoma of the tracheobronchial tree: a new horizon
Authors: Dracham ChinnaBabu , Khosla Divya , Kapoor Rakesh , Dey Treshita , Periasamy Kannan , Elangovan Arun , Madan Renu , Goyal Shikha , Kumar Narendra
Published: May 2021

Background:

Primary adenoid cystic carcinomas (ACCs) of central trachea-bronchi system are rare and heterogeneous tumors. Definitive radiotherapy (RT) is the recommended treatment in surgically unresectable or incomplete resection or in the presence of severe comorbidities.

Objective:

To evaluate the clinical features and outcomes of patients with ACC of trachea-bronchi treated with radiotherapy.

Methods:

Retrospective medical records review was done in all patients with histologically confirmed ACC of trachea-bronchi between January 2010 and December 2019. Patient disease and treatment characteristics and toxicity data were analyzed. Overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were computed using Kaplan-Meier method (log-rank test).

Results:

Nineteen patients (10 women and 9 men) were included in this analysis with median age of 40 years (range, 14–70). Of these patients, 63.2% (n = 12) presented in stage IV disease. Twelve and three patients received definitive (median dose 67.8 Gy) and adjuvant (median dose 50 Gy) RT, respectively. The median follow-up was 42.5 months (range, 4–120); 15 patients were alive and 4 were dead at that time. Local recurrence or progression was observed in 52.6% and distant metastasis found in 47.3% of patients. The 5-year OS, LRFS, and DMFS for all patients were 81.2%, 52.8%, and 39.6%, respectively. Baseline lymph node involvement showed significant impact on OS (56.3% vs 100%, p = 0.011). Among patients receiving definitive RT, patients with higher RT dose (⩾66 Gy) had significantly better survival outcomes (5-year LRFS: 75% vs 16.7%, p = 0.013).

Conclusion:

Definitive RT is an exemplary treatment for unresectable disease. Higher dose is recommended to improve long-term outcomes.
What are agile, flexible, or adaptable employees and students? A typology of dynamic individual differences in applied settings
Authors: Lang Jonas WB , Runge J Malte , De Fruyt Filip
Published: May 2021

The applied psychology literature has discussed and used a variety of different definitions of dynamic individual differences. Descriptions like dynamic, agile, adaptive, or flexible can refer to a variety of different types of constructs. The present article contributes to the literature by presenting an organizing typology of dynamic constructs. We also conducted a literature review of four major applied journals over the last 15 years to validate the taxonomy and to use it to map what type of dynamic individual differences constructs are typically studied in the applied psychology literature. The typology includes six basic conceptualizations of dynamic individual differences: Variability constructs (inconsistency across situations), skill acquisition constructs (learning new skills), transition constructs (avoiding “loss” in behavior/skill after unforeseen change), reacquisition constructs (relearning after change), acceleration/deceleration constructs (losing or gaining energy by displaying the behavior), and integration/dissolution constructs (behavior becomes more or less uniform). We provide both verbal and statistical definitions for each of these constructs, and demonstrate how these conceptualizations can be operationalized in assessment and criterion measurement using R code and simulated data. We also show how researchers can test different dynamic explanations using likelihood-based R2 statistics.
The price of knowledge and the wisdom of innocence: A difficult journey through the employability discourse in higher education
Authors: Barkas Linda Anne , Armstrong Paul-Alan
Published: May 2021

Through the examination of knowledge artefacts, utilising an analytical metaphorical representation, the authors present an exploration of higher education. In this way, the exploration is depicted as a schizophrenic, dichotomic journey through the difficult discourse of knowledge, wisdom, and employability in higher education institutions. The article explores how the place and value of knowledge appear fractured in the higher education curriculum. Applying Root Cause Analysis, it is argued that the marketisation, commercialisation and commodification of higher education, with the resulting emphasis on economic value through the employability of graduates, has created unintended consequences in the sector. To insert employability initiatives, something has to give in the module structure so that everything can be fitted in. That ‘something’ is the sacrifice of wisdom within the deeper knowledge of a subject. The authors argue that the depth of knowledge has unintentionally been negatively affected by embedding employability. While some students position themselves strategically to use their education for their individual gain, others want to learn more deeply, and become anxious that they do not have the time to reflect on what they have learned. It is recommended that a deeper reflexive conversation must take place between all stakeholders in higher education if it is to have a future in economic terms.
Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study
Authors: Nabukalu Doreen , Ponticiello Matthew , Bennett Thomas , Clark Sunday , King Rachel , Mwanga-Amumpaire Juliet , Sundararajan Radhika
Published: May 2021

Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients ( n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers ( n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26–0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93–0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03–2.48). Healers (AOR = 1.16, 95% CI 1.07–1.26) and clients (AOR = 1.28, 95% CI 1.13–1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.
Robust regression with asymmetric loss functions
Authors: Fu Liya , Wang You-Gan
Published: May 2021

In robust regression, it is usually assumed that the distribution of the error term is symmetric or the data are symmetrically contaminated by outliers. However, this assumption is usually not satisfied in practical problems, and thus if the traditional robust methods, such as Tukey’s biweight and Huber’s method, are used to estimate the regression parameters, the efficiency of the parameter estimation can be lost. In this paper, we construct an asymmetric Tukey’s biweight loss function with two tuning parameters and propose a data-driven method to find the most appropriate tuning parameters. Furthermore, we provide an adaptive algorithm to obtain robust and efficient parameter estimates. Our extensive simulation studies suggest that the proposed method performs better than the symmetric methods when error terms follow an asymmetric distribution or are asymmetrically contaminated. Finally, a cardiovascular risk factors dataset is analyzed to illustrate the proposed method.
Disentangling the transformation of the German model: The role of firms’ strategic decisions and structural change
Authors: Herrero Daniel
Published: May 2021

This paper explores the transformation of the German employment and industrial relations model from a political economy approach. Using the IAB Establishment Panel, the evolution of atypical employment and the coverage of the dual system of industrial relations is analysed in different groups of firms. Additionally, using a shift-share technique, we estimate the impact of the change in the employment structure on this process. The results reveal that once institutional constraints were relaxed, firms across the whole economy increased their use of flexible work and individualized the wage bargaining. Moreover, our findings suggest that structural change played a minor role in the process.
Impact of Sleep Apnea, Daytime Sleepiness, Comorbidities, and Depression on Patients’ Heart Failure Health Status
Authors: Piamjariyakul Ubolrat , Shapiro April L. , Wang Kesheng , Zulfikar Rafia , Petitte Trisha , Shafique Saima , Smith Carol E.
Published: May 2021

There is a gap in current research on common factors that impact patients with advanced heart failure (HF). The purpose of this secondary data analysis was to explore associations of those factors with three empirically verified measures of HF-related clinical, physical, and mental health status. Baseline data of 198 advanced systolic HF (EF < 40%) patients were analyzed. Patients were 61.6% male, with a mean age of 62.3 ( SD = 13.2) years. The multivariable general linear modeling results indicated that patients who had poorer scores on HF-related clinical status were those who had sleep apnea ( β = −6.6, p < .05), daytime sleepiness ( β = −9.4, p < .01), four or more comorbidities ( β = −11.8, p < .001), and depression ( β = −18.7, p < .001). Depression was associated with all three measures of HF-related health status. These findings alert nurses to assess for sleep apnea and to use known screening measures for daytime sleepiness, depression, and comorbidities.
Basal Cell Carcinoma of Prostate With MSMB–NCOA4 Fusion and a Probable Basal Cell Carcinoma In Situ: Case Report
Authors: Pedersen Vilde , Petersen Katrine S. , Brasso Klaus , Østrup Olga , Loya Anand C.
Published: May 2021

Basal cell carcinomas of prostate (BCCP) are very rare. Most arise in the transition zone and thus are associated with lower urinary tract symptoms and rarely associated with elevated prostate-specific antigen (PSA). These features make diagnosis/early diagnosis difficult because of the routine protocols followed. Basal cell carcinomas have distinctive histopathological, immunohistochemical, and to some extent also different molecular characteristics. Basal cell carcinoma in situ (BCCIS) is a nonexistent histological lesion as per the current literature, but here is an attempt to describe it through this case.

A 74-year-old man presented with hematuria and previous diagnosis of prostatic hyperplasia. Based on this history, he underwent a prostatectomy ad modum Freyer. Pathological examination surprisingly revealed a diffusely infiltrative tumor with nonacinar adenocarcinoma morphology and many glandular structures probably representing BCCIS. Tumor was diagnosed as BCCP. Patient presented with metastasis to the abdominal wall 8 months postprostatectomy.

BCCP is an aggressive type of prostate cancer, which might be challenging to diagnose based on routine protocols. This results in delayed diagnosis and treatment and thus poor prognosis. Furthermore, patients with this subtype of prostate cancer need appropriately designed, and maybe a totally different follow-up regimen as PSA is of no use for BCCP patients. Finally, diagnosis of BCCIS, if agreed upon its existence needs to be studied in larger cohorts as a precursor lesion.
Pitfalls in Frozen Section: A Case of Incidental Papillary Mesothelioma
Authors: Shkolnik Elina , Marcus Jenna , Heller Debra S.
Published: May 2021

Well-differentiated papillary mesothelioma is an uncommon benign, although potentially recurrent mesothelial lesion that occurs in the peritoneum of women over a wide age range. We recently encountered an incidental case sent for frozen section at the time of hysterectomy for endometrial carcinoma. Familiarity with this lesion will help prevent overinterpretation as a serous carcinoma.
Access to Mental Healthcare in the 21st Century: An Evolutionary Concept Analysis
Authors: Smith-East Marie , Conner Norma E. , Neff Donna Felber
Published: May 2021

Background:

One of the most important aspects of receiving medical care is access to that care. For people with mental illness who have greater healthcare needs and are at risk for poor health outcomes, reduced access to care constitutes a crisis. While the COVID-19 (coronavirus disease 2019) pandemic continues to affect the United States, specifying what it means to have access to mental healthcare is more critical than ever.

Aims:

The aims of this concept analysis are to review definitions and descriptions of access to mental healthcare in the literature and to synthesize the relevance of these findings to inform future research, theory development, policy, and practice.

Methods:

The concept of access to mental healthcare was analyzed using Rodgers’s evolutionary concept analysis method. CINAHL, PsycINFO, and MEDLINE were queried for peer-reviewed articles about access to mental healthcare published from January 2010 to April 2020 ( n = 72). Data were reviewed for concept antecedents, attributes, consequences, surrogate, and related terms.

Results:

Five models of access to mental healthcare were identified, with several antecedents and consequences: utilization, economic loss/gain, incarceration, and patient/provider satisfaction. Cross-sectional and predictive studies highlighted three interrelated attributes: clinical management, healthcare delivery, and connectedness.

Conclusions:

The concept of access to mental healthcare is often used stagnantly across disciplines to create health policies, yet the concept is transformative. Future research requires up-to-date operational definitions of access to mental healthcare to target interdisciplinary approaches.
A Test-Retest Reliability Generalization Meta-Analysis of Judgments Via the Policy-Capturing Technique
Authors: Zhu Ze , Tomassetti Alan J. , Dalal Reeshad S. , Schrader Shannon W. , Loo Kevin , Sabat Isaac E. , Alaybek Balca , Zhou You , Jones Chelsea , Fyffe Shea
Published: May 2021

Policy capturing is a widely used technique, but the temporal stability of policy-capturing judgments has long been a cause for concern. This article emphasizes the importance of reporting reliability, and in particular test-retest reliability, estimates in policy-capturing studies. We found that only 164 of 955 policy-capturing studies (i.e., 17.17%) reported a test-retest reliability estimate. We then conducted a reliability generalization meta-analysis on policy-capturing studies that did report test-retest reliability estimates—and we obtained an average reliability estimate of .78. We additionally examined 16 potential methodological and substantive antecedents to test-retest reliability (equivalent to moderators in validity generalization studies). We found that test-retest reliability was robust to variation in 14 of the 16 factors examined but that reliability was higher in paper-and-pencil studies than in web-based studies and was higher for behavioral intention judgments than for other (e.g., attitudinal and perceptual) judgments. We provide an agenda for future research. Finally, we provide several best-practice recommendations for researchers (and journal reviewers) with regard to (a) reporting test-retest reliability, (b) designing policy-capturing studies for appropriate reportage, and (c) properly interpreting test-retest reliability in policy-capturing studies.
Virtual learning solutions in COVID-19 era: University Italian Ophthalmology department perspective
Authors: Gallenga Carla Enrica , Agnifili Luca , D’Aloisio Rossella , Brescia Lorenza , Toto Lisa , Perri Paolo
Published: May 2021

Introduction:

Few months after the COVID-19 pandemic burst, many aspects of the human life, including education, dramatically changed. Because of the lockdown measures taken to limit the virus spread in Italy, in-person teaching and learning have been interrupted in all health care disciplines and readapted in virtual formulae.

Methods:

As academic ophthalmology departments, we had to maintain the educational needs of medical and orthoptic students, internships, surgical training of residents, as well as to cover the scientific update of health care personnel (HCPs), and the continuation of research and academic activities. To assure these needs we ideated an educational strategy and a team, which was then translated on a multichannel virtual platform created with Microsoft Teams.

Results:

In this platform there were 21 channels organized in a public view mode, open to all Team members, or in private view mode to separate non-permanent HCPs, internships, residents, and students’ tasks, from permanent HCPs tasks. Virtual channels were dedicated to provide theoretical lessons, clinical cases, surgical video, internal meetings and webinar, to offer news from scientific societies, requests of appointments from biomedical companies, links with ophthalmological websites, to move forward research projects, to participate at institutional academic duties, and to obtain feedbacks from users. Residents continued their training on surgery using a surgical simulator, after consulting an agenda uploaded into the dedicated virtual channel.

Conclusion:

These positive initial results should represent a boost to rapidly proceed with the development of even more versatile virtual learning solutions, given that the forecasts for the duration of the COVID-19 pandemic are not encouraging.
Effectiveness and safety of cladribine in MS: Real-world experience from two tertiary centres
Authors: Pfeuffer Steffen , Rolfes Leoni , Hackert Jana , Kleinschnitz Konstanze , Ruck Tobias , Wiendl Heinz , Klotz Luisa , Kleinschnitz Christoph , Meuth Sven G , Pul Refik
Published: May 2021

Background:

Oral cladribine has been approved for the treatment of relapsing multiple sclerosis (MS) yet real-world evidence regarding its effectiveness and safety remains scarce.

Objective:

To evaluate efficacy and safety outcomes of MS patients following induction of cladribine.

Methods:

We evaluated our prospective cohort of cladribine-treated MS patients from two tertiary centres in Germany. Relapses, disability worsening and occurrence of new or enlarging T2-hyperintense magnetic resonance imaging (MRI) lesions were assessed as well as lymphocyte counts and herpes virus infections.

Results:

Among 270 patients treated with cladribine, we observed a profound reduction of both relapses and new or enlarging MRI lesions. Treatment appeared more efficacious, especially in patients without previous therapy or following platform substances. Patients switching from natalizumab were prone to re-emerging disease activity. Among patients following dimethyl fumarate pre-treatment, severe lymphopenia was common and associated with increased rates of herpes virus manifestations.

Conclusion:

Overall, we observed an efficacy and safety profile of cladribine consistent with data from the phase 3 clinical trial. However, patients switching from natalizumab experienced suboptimal disease control beyond rebound activity following cessation of natalizumab. Furthermore, dimethyl fumarate pre-treatment was associated with a profound risk of developing severe lymphopenia and subsequent herpes virus infections.
Consumer movements, brand activism, and the participatory politics of media: A conversation
Authors: Kozinets Robert V , Jenkins Henry
Published: May 2021

This is a scripted adaptation of a conversational podcast interview between Henry Jenkins and Robert Kozinets about contemporary consumer activism and its relationship to media studies. After the interview, the conversants agreed to develop the transcript of the conversation in order to be more relevant to a scholarly audience who are interested in how Jenkins’ ideas apply to the understanding and investigation of consumer culture today. The conversation frames and synthesizes a range of thinking around activism, fan studies, brand management, and consumer culture theory. Couched in the American context but containing themes that may also relate to global culture in the current moment, it covers the theoretical as well as the pragmatic concerns of many of the stakeholders in the world of contemporary consumer activism, from the activists themselves to the brand managers who respond to their actions to the creators who write the stories that inspire them both. Topics include the relevance of participatory culture today, anti-racism and the role of media, consumer conflicts with brands and the corporations who police them, the importance of civic imagination to civic engagement, differences between brand managers and story creators, consumer activism in the workplace, activist and participatory approaches to civic research, the nature of contemporary consumer activist movements, the impact of intersectionality, and the prefigurative possibilities for change today.
Efficacy and Safety of Platinum-Based Chemotherapy as First-Line Therapy for Metastatic Triple-Negative Breast Cancer: A Meta-Analysis of Randomized Controlled Trials
Authors: Lu Fei , Hou Yu , Chen Zhengting , Jiang Jie , He Xi , Xia Yaoxiong , Cao Ke , Chang Li , Li Wenhui
Published: May 2021

Background:

Triple-negative breast cancer constitutes approximately 12%-17% of all breast cancer cases, and >33% of patients develop distant metastases. Systemic cytotoxic chemotherapy is the primary treatment for patients with metastatic triple-negative breast cancer; however, the role of first-line platinum-based chemotherapy in these patients remains controversial. This meta-analysis evaluated the efficacy and safety of platinum-based first-line chemotherapy for patients with metastatic triple-negative breast cancer.

Methods:

We systematically searched the PubMed, Embase, Cochrane, and Clinical Trials registry databases up to June 1, 2020 to identify randomized controlled trials that investigated platinum-based vs. first-line platinum-free chemotherapy in patients with metastatic triple-negative breast cancer. We used fixed and random effects models to calculate pooled hazard ratios and odds ratios with 95% confidence intervals for progression-free and overall survival, objective response rates, and grade 3 and 4 adverse events.

Results:

Four randomized controlled trials ( N = 590 patients) were included. Platinum-based chemotherapy significantly increased the objective response rates from 43.1% to 62.7% (odds ratio 2.34, 95% confidence interval 1.66-3.28, P < 0.001). Three randomized controlled trials ( N = 414 patients) reported survival outcomes. Patients administered platinum-based regimens showed significantly longer progression-free survival (hazard ratio 0.55, 95% confidence interval 0.37-0.82, P = 0.004) and a nonsignificant trend toward improved overall survival (hazard ratio 0.76, 95% confidence interval 0.57-1.00, P = 0.05). Only 2 studies reported the rates of grade 3 and 4 adverse events; grade 3-4 thrombocytopenia was more commonly associated with platinum-based chemotherapy (odds ratio 7.54, 95% confidence interval 1.37-41.60, P = 0.02) and grade 3-4 fatigue with platinum-free chemotherapy (odds ratio 0.23, 95% confidence interval 0.08-0.68, P = 0.008).

Conclusions:

First-line platinum-based chemotherapy was associated with significantly increased objective response rates, longer progression-free survival, and a nonsignificant trend toward improved overall survival in patients with metastatic triple-negative breast cancer at the high risk of grade 3-4 thrombocytopenia.
Assessing Sleep Architecture With Polysomnography During Posttraumatic Amnesia After Traumatic Brain Injury: A Pilot Study
Authors: Fedele Bianca , McKenzie Dean , Williams Gavin , Giles Robert , Olver John
Published: May 2021

Background

Early-onset sleep disturbance is common following moderate to severe traumatic brain injury (TBI) and often emerges while patients are in posttraumatic amnesia (PTA). However, sleep disruptions during this subacute recovery phase are not well-defined, and research often utilizes indirect measures (actigraphy) that quantify sleep based on activity. This study aims to examine sleep macro-architecture and sleep quality directly with ambulatory polysomnography (PSG) and measure endogenous salivary melatonin levels for patients experiencing PTA following moderate to severe TBI.

Method

Participants were recruited from an inpatient TBI rehabilitation unit. Nighttime PSG was administered at the patient’s bedside. Two saliva specimens were collected for melatonin testing on a separate evening (24:00 and 06:00 hours) using melatonin hormone profile test kits.

Results

Of 27 patients in whom PSG was recorded, the minimum required monitoring time occurred in n =17 (adherence: 63%) at a median of 37.0 days (quartile 1 [Q1] to quartile 3 [Q3]: 21.5-50.5) postinjury. Median non–rapid eye movement (NREM) and REM sleep proportions were similar to normal estimates. Slow-wave sleep was reduced and absent in 35.3% of patients. Sleep periods appeared fragmented, and median sleep efficiency was reduced (63.4%; Q1-Q3: 55.1-69.2). Median melatonin levels at both timepoints were outside the normal range of values specified for this test (from Australian Clinical Labs).

Conclusion

This study reports that ambulatory PSG and salivary melatonin assessment are feasible for patients experiencing PTA and offers new insight into the extent of sleep disturbance. Further research is necessary to understand associations between PTA and sleep disturbance.
Principal leadership practices, professional learning communities, and teacher commitment in Hong Kong kindergartens: A multilevel SEM analysis
Authors: To Ken Hang , Yin Hongbiao , Tam Winnie Wing Yi , Keung Chrysa Pui Chi
Published: May 2021

In response to the needs for kindergarten principals to foster teachers’ capacities and commitment, this study examined the relationships between professional learning communities, principal leadership practices, and teacher commitment to kindergartens among 2106 teachers from 153 Hong Kong kindergartens, analyzing by using multilevel structural equation modeling. The result showed that principal leadership practices facilitated the development of professional learning communities at school and teacher levels, and exerted a direct effect on teacher commitment at the teacher level. However, the mediating effects of different professional-learning-community components were found distinctive. Implications for leading kindergartens in the reform time are discussed.
A case of Fanconi anaemia in pregnancy
Authors: Adeleke Peter Akinlade , Ciantar Etienne
Published: May 2021

Fanconi anaemia is a rare autosomal recessive chromosomal instability syndrome characterised by progressive bone marrow failure, skeletal defects, reduced fertility and increased susceptibility to malignancy. Successful pregnancy in both transplanted and non-transplanted patients have been recorded. In this paper, we present a woman diagnosed with Fanconi anaemia and who had a spontaneous conception at the age of 25 years with an uneventful delivery at 38 weeks of pregnancy.
Spinal cord injury and pregnancy
Authors: Robertson Katherine , Ashworth Felicity
Published: May 2021

Pregnancy in women with spinal cord injury is considered high risk because it may exacerbate many of their existing problems, including autonomic dysreflexia, spasms, decubitus ulcers, urinary tract infections and respiratory infections. Due to the relative rarity of spinal cord injury in the general obstetric population, clinicians often lack familiarity of these specific problems and the women themselves are usually more experienced in their own management than their obstetric team. However, studies have demonstrated that pregnancy outcomes are generally good with appropriate and experienced obstetric care. In this review, we examine the available literature and provide advice on pre-conception counselling and the antenatal, intrapartum and postnatal management of pregnant women with spinal cord injury.
Islands, modernity, and other worlds that never end
Authors: Davis Sasha
Published: May 2021

In this commentary, I follow up on Chandler and Pugh’s (2021) article, ‘Anthropocene Islands: There Are Only Islands After the End of the World’, to explore two central facets of their argument. First, I explore just why analyses of dynamic patterns of relational entanglements in island environments are particularly detrimental to modernist fantasies of a dichotomous world. Second, I critique whether the frame of ‘the Anthropocene’ is the most accurate way to depict the emerging knowledges of relationality in island (and other) geographies.
On storiation and what is washed ashore: The Anthropocene as big kahuna
Authors: Martinez Elena Burgos
Published: May 2021

This commentary begins by outlining current debates on the notion of the Anthropocene from a critical perspective. Subsequently, it will discuss how Pugh and Chandler (2021) directly address such a problematic and how their work contributes to pluralising contemporary academic debates on the Anthropocene. Their previous academic engagements are no stranger to questions of epistemic discrimination in the broad fields of geography, geopolitics, island studies, and social research, and, more concretely, mainstreamed anthropological thinking. This commentary will therefore focus on their call for storiation and its relevance for contemporary debates seeking more ethical, localised, fluid, and coherent approaches to environmental degradation, environmental history, island identity, geopolitics of climate change, and indigeneity. From all the shapes storiation can take, this commentary focuses on indigenous storiation as embodiment.
A journey of a thousand miles begins with a single step: Towards a Confucian geopolitics
Authors: Kong Lily
Published: May 2021

This commentary welcomes the opportunity of a dialogue on the development of a Confucian geopolitics that offers an alternative to the prevailing dominant geopolitical theories. Three areas are discussed to further development of such an alternative. The first is the challenges (and not only the opportunities) of recovering Confucian values to inform foreign policy and international relations. The second is the appropriation of Confucian philosophy to legitimize state action, and how this is actually playing out in present-day China. The third is the slippage between narrative and practice – that is, how a narrative of Confucian geopolitics is translated in practice and how practice is or is not reflected in the narrative.
Kyphosis-Related Information On The Internet Is the Quality, Content and Readability Sufficient for the Patients?
Authors: Agar Anıl , Sahin Adem
Published: May 2021

Study Design:

A quality-control Internet-based study using recognized quality scoring systems.

Objective:

The aim of the study is to evaluate the quality, content and readability of online information on kyphosis.

Methods:

The 3 most frequently used search engines were identified and a search for “Kyphosis” was made in each. The 2 reviewers categorized their Web-sites by type, and the quality of each was assessed using well-known scoring systems, including the DISCERN score, JAMA benchmark, GQS, and the kyphosis specific content score. The Flesch-Kincaid grade level (FKGL) was used to assess the readability. The quality of the information was also evaluated according to the presence and absence of the HONcode.

Results:

Sixty unique Web sites were identified and analyzed. The distribution of the categories was 33 (55%) medical, 22 (36.7%) academic, 2 (3.3%) non-physician, 2 (3.3%) commercial and 1 (1.7%) physician. There wasn’t statistically significant difference between the sources in terms of DISCERN, JAMA, GQS and KSC scores ( P > 0.05). However, a review of the FKGL scores revealed that the academic-based websites’ FKGL score was significantly higher than the medical-based websites ( P: 0.007). Also there wasn’t statistically significant difference among the DISCERN, JAMA, GQS, KSC, FKRS and FKGL scores of the web-sites according to the HON code’s presence ( P > 0.05).

Conclusion:

Information about kyphosis on the Internet is of limited quality and low information value. The readability of the online information in our results showed a significantly higher reading level than the sixth grade level recommended by the AMA and NIH.
Injection Site Pain, Onset and Duration of Action of Botulinum Toxin Reconstituted in Normal Saline With and Without Sodium Bicarbonate: A Prospective, Single Center, Randomized, Double-Blind Interventional Study
Authors: Alghonaim Yazeed , Hijazi Leen O. , Alraee Sondus A. , Alqubaisy Yasser
Published: May 2021

Purpose: This study was designed to investigate the effects of botulinum toxin type A injections diluted with the mixture of sodium bicarbonate and normal saline on pain reduction, onset of action, and duration of action. Methods: This is a prospective, randomized, double-blind clinical study, which included 30 female patients (age >25). The patients were randomized to receive botulinum toxin injections diluted with normal saline and sodium bicarbonate on one side of the face and saline control injections on the other side. Pain severity was assessed using visual analogue scale. The onset and duration of action were recorded according to the patients’ subjective opinions after 1 week and 3 months, respectively. Results: Lower pain intensity ratings were observed when botulinum toxin was diluted with 0.05 and 0.1 mL of sodium bicarbonate as compared to saline. Regarding the onset of action, the botulinum toxin injections diluted with saline and 0.1-mL sodium bicarbonate side showed faster response in many patients than other dilutions ( P < .001). Both the 0.05-mL and 0.1-mL sodium bicarbonate concentrations showed longer duration effects on patients than other concentrations. Conclusion: The use of sodium bicarbonate and saline in a mixture for the dilution of botulinum toxin can decrease patients’ discomfort and provide a faster action with longer duration effects.
Theory-driven, rapid formative research on quality improvement intervention for critical care of patients with COVID-19 in Argentina
Authors: Roberti Javier , Jorro Facundo , Rodríguez Viviana , Belizán María , Arias Pilar , Ratto María Elena , Reina Rosa , Ini Natalí , Loudet Cecilia , García-Elorrio Ezequiel
Published: May 2021

The challenges of implementing interventions in healthcare settings have been more apparent during the COVID-19 pandemic. This pre-implementation evaluation used a rapid qualitative approach to explore barriers and facilitators to an intervention in intensive care units in Argentina, aimed to promote the use of personal protection equipment, provide emotional support for professionals, and achieve patient flow goals. Data were collected using semi-structured interviews with health professionals of 15 public hospitals in Argentina. Normalization Process Theory was used to guide content analysis of the data. Participants identified potential barriers such as the incorporation of non-specialist staff, shortage of resources, lack of communication between groups and shifts. Potential facilitators were also identified: regular feedback and communication related to implementation, adequate training for new and non-specialist staff, and incentives (e.g., scholarships). The immediacy of the pandemic demanded rapid qualitative research, sharing actionable findings in real time.
DuPont Decomposition for Fertilizer Companies
Authors: Bansal Rohit , Kumar Kar Sanjay , Kaur Manminder
Published: May 2021

The case focuses on analysing the top two Indian fertilizer companies’ performance in terms of revenue and income for 2019–2020, Coromandel International Limited (CIL) and Gujarat State Fertilizers & Chemicals Limited (GSFC). Based on performance appraisal, students are expected to select the better company for investment to get a better return. To make such a decision, students must analyse DuPont decomposition, modified (also known as additive or alternate) DuPont approach and Altman Z-score. The case aims to teach analysis of companies’ financial statements using financial ratios. It explains how the DuPont method and Altman Z-score can recognize the factors that affect a company’s performance through assessment of profitability, efficiency and leverage.

The case is appropriate for financial accounting courses, audit and assurance, financial modelling, accounting practice and regulations. After studying the issues, students should analyse the business models of CIL and GSFC by reviewing their history since incorporation, product and service offerings, revenue, margins, assets, borrowings and market capitalization ( Bodie & Merton, 2000 , Finance, Prentice-Hall). We are particularly interested in assessing the current financial position, market position and strategies of the companies and their peer group and evaluating the role of gatekeepers, such as business analysts, audit committees, external auditors, institutional investors and regulators, in enhancing the quality of financial reporting.
Insights into the endophytic bacterial community comparison and their potential role in the dimorphic seeds of halophyte Suaeda glauca
Authors: Wang Hongfei , Narsing Rao Manik Prabhu , Gao Yanli , Li Xinyang , Gao Rui , Xie Yuanguo , Li Qiuli , Li Wenjun
Published: May 2021

Background

Seed dimorphism has been thought to be a bet-hedging strategy that helps plants survive in the disturbed environment and has been widely studied for its ecological adaptation mechanism. Many studies showed that seed-associated microorganisms play an important role in enhancing plant fitness, but information regarding endophytic bacteria associated with dimorphic seeds is limited. This study explores the influence of seed coat structure and seed phytochemical properties on the community composition and diversity of endophytic bacteria of dimorphic seeds of Suaeda glauca. In this study, we used 16S rRNA high-throughput gene sequencing method to compare the community composition and bacterial diversity between brown and black seeds of Suaeda glauca.

Results

A significant difference was observed in seed coat structure and phytochemical properties between brown and black seeds of S. glauca. Total 9 phyla, 13 classes, 31 orders, 53 families, 102 genera were identified in the dimorphic seeds. The dominant phyla were Proteobacteria, Firmicutes, and Actinobacteria. The results showed that seed dimorphism had little impact on the diversity and richness of endophytic bacterial communities but significantly differs in the relative abundance of the bacterial community between brown and black seeds. At the phylum level, Actinobacteria tend to be enriched significantly in brown seeds. At the genus level, Rhodococcus, Ralstonia, Pelomonas and Bradyrhizobium tend to be enriched significantly in brown seeds, while Marinilactibacillus was mainly found in black seeds. Besides, brown seeds harbored a large number of bacteria with plant-growth-promoting traits, whereas black seeds presented bacteria with enzyme activities (i.e., pectinase, cellulolytic and xylanolytic activities).

Conclusion

The endophytic bacterial community compositions were significantly different between dimorphic seeds of Suaeda glauca, and play an important role in the ecological adaptation of dimorphic seeds by performing different biological function roles. The endophytic bacterial communities of the dimorphic seeds may be influenced mainly by the seed coat structureand partly by the seed phytochemical characteristics. These findings provide valuable information for better understanding of the ecological adaptation strategy of dimorphic seeds in the disturbed environment.
Adverse childhood experiences and future self-rated health: a prospective cohort study
Authors: Jahn Alexander , Rysgaard Timmi K. , Andersen Johan Hviid , Winding Trine Nøhr
Published: May 2021

Background

Negative life events (re) occurring during childhood is often described as adverse childhood experiences (ACEs) and may have long-lasting negative effects on health. Previous studies on the association between ACEs and self-rated health (SRH) have primarily been focusing on chronic diseases in elderly, non-Scandinavian populations using a cross-sectional design. The aim of the study was to examine the associations between ACEs and SRH in early adulthood and to investigate if disadvantageous health-behavioral strategies explain the association between ACEs and SRH.

Methods

A prospective cohort study using data from The West Jutland Cohort Study (N = 2.255). Baseline data on exposure to ACEs were collected from surveys at the age of 15 and 18 and respondents were categorized into having experienced 0, 1–2, 3 or > 4 ACEs. The outcome SRH stems from surveys at the age of 21 and 28 and was dichotomized into moderate and good SRH. The association between ACE-categories and SRH at age 21 and 28 were analyzed separately by logistic regression with a two-step adjustment model, adjusting for potential confounders and disadvantageous health-behavioral strategies.

Results

More than half of the participants reported at least one ACE (56.3%) with “bullying” and “loss of parent, parental separation or divorce” being the most prevalent. Participants who reported > 4 ACEs, compared to those with 0 ACEs, had a 2.6-fold increased odds (95% CI 1.3; 5.1) of having moderate SRH at the age of 21, and a 2.7-fold increased odds (95% CI 1.4; 5.4) of moderate SRH at the age of 28 years, when adjusted for potential confounders. Further, small attenuations of the estimates were seen when adjusting for disadvantageous health-behavioral strategies. A significant exposure response relationship between the ACE-categories and moderate SRH were seen both at age 21 and 28.

Conclusion

The study showed an association between ACEs and moderate SRH in young adulthood, and experiencing multiple ACEs increased the odds of reporting moderate SRH. Information on ACEs could help identifying people with a higher risk of future health problems and accentuates a growing need for early prevention in homes with children who has experienced adverse events.
Use of simulation in teaching haematological aspects to undergraduate medical students improves student’s knowledge related to the taught theoretical underpinnings
Authors: Alsuwaidi Laila , Kristensen Jorgen , HK Amar , Al Heialy Saba
Published: May 2021

Background

Simulation is an educational method which has several modalities and applications. In the last few decades Simulation-Based Medical Education (SBME) has become a significant influence in medical education. Despite the recognized potential of simulation to be used widely in support of healthcare education, there are no studies focused on the role of simulation in teaching haematology. Moreover, the reaction level is the most commonly reported in medical education. This study evaluates, at two levels of Kirkpatrick’s model, the effectiveness of incorporating SBME in teaching haematological aspects to medical students.

Methods

A total of 84 second year medical students from two cohorts received theoretical components of Haematopoietic and Immune System in 4 credits course, delivered using lecture approach. First cohort students (n = 49) participated in interactive learning tutorials to discuss clinical vignettes. Second cohort (n = 35) students participated in simulation sessions where the tutorial’s clinical vignettes were developed to clinical simulation scenarios conducted in the simulation centre. The potential influence of the simulation in learning enhancement was evaluated using Kirkpatrick’s Evaluation Framework.

Results

The students rated the simulation sessions highly and found them to be a valuable learning experience. The category performance summary, generated by the assessment platform, demonstrates improvement in the student’s knowledge enhanced by the SBME.

Conclusions

Adaptation of SBME in teaching haematological aspects is a feasible way to improve the student’s knowledge related to the taught theoretical foundations. SBME has the potential to enhance the undergraduate medical curriculum and it is expected, in the near future, to be an increasingly recommended educational strategy to bridge the gap between theory and practice.
Medical students’ experience with accessing medical records in Saudi Arabia: a descriptive study
Authors: Almulhem Jwaher A.
Published: May 2021

Background

Medical students can enhance their knowledge by accessing patients’ medical records and documenting patient care. This study assessed medical students’ access to paper medical records and electronic health records (EHRs) in Saudi Arabia and compared students’ experience of accessing paper medical records and EHR from their perspective.

Methods

This cross-sectional study enrolled second-year to intern medical students randomly from different medical colleges in Saudi Arabia. A self-developed survey was administered to them. It comprised 28 items in three sections: general information about medical students and their level of accessing medical records, their experience with the medical record system used in hospitals, and their preference for the medical record type.

Results

62.8% of participants had access to medical records, with 66.1% of them having access to EHRs and 83.27% had read-only access. The EHR group and paper group mostly liked being able to reach medical records effortlessly (70.1% and 67.1%, respectively). The EHR group had a better experience compared to the paper group withU = 5200, Mean Rank = 122.73,P = .04. Students who trained in University – owned and National Guard hospitals had better experiences compared to students who trained in other hospitals with Mean Ranks =122.35, and 147.99, respectively.

Conclusion

Incorporating EHR access into the medical curriculum is essential for creating new educational opportunities that are not otherwise available to medical students.