bluuebunny/crossref_metadata_2025 huggingface dataset:
Breasts, Butts, and Thighs—Oh My! Weight Spurt and Body Image Messages in Girls’ Puberty Books
Authors: Blazek Janelle L. , Saint Arnault Denise M. , Carter Rona
Published: February 2022

Analyze popular girls’ puberty books to understand what messages they portray about weight spurt and body image. A critical ethnography was conducted of 13 best-selling books about girls’ puberty. This analysis specifically focused on messages about weight gain/spurt and body image presented in the books and whether these were aligned with larger cultural understandings of weight gain and body image. A data-driven thematic analysis was conducted on the portions of each book relevant to weight gain and body image. The cultural fat-phobic scripts were prevalent in the books, contrasting the well-intended developmental messages. Discussions of weight tended to be negatively framed and weight gain expectations were distressingly vague. The books discussed the necessity of and biological rationale for those changes while normalizing variation in timing. The books also focused on developing a positive body image during this time. Understanding this allows us to see the pervasive, conflicting messages about weight-spurts that girls are receiving from these resources, which can be used to tailor book choice and outreach programs.
Handheld Point-of-Care Ultrasound: Safety Considerations for Creating Guidelines
Authors: Hsieh Adam , Baker Maxwell B , Phalen Joseph M , Mejias-Garcia Julio , Hsieh Alan , Hsieh Alex , Canelli Robert
Published: February 2022

Background

Compared to traditional ultrasound machines, emerging handheld point-of-care-ultrasound (HPOCUS) systems exhibit superior portability and affordability. Thus, they have been increasingly embraced in the intensive care setting. However, there is scarce data on patient safety and current regulatory body guidelines are lacking. Here, we critically appraise the literature with a focus on the merits, concerns, and framework of existing POCUS guidelines. Subsequently, we provide recommendations for future regulatory guidelines.

Methods

A comprehensive literature review was conducted using the PubMed database employing the key words “point-of-care/handheld/portable ultrasound” and “guidelines” alone, in combination, and using thesaurus terms. Eligible articles were scrutinized for description of potential benefits and concerns of HPOCUS, especially from a patient safety perspective, as well as currently existing POCUS practice guidelines. Data was extracted, reported thematically using a narrative synthesis approach, then subsequently used to guide our proposed guidelines.

Results

The most widely reported benefits of HPOCUS include superior portability, affordability, imaging, facilitation of expedited diagnosis and management, and integration with medical workplace flow. However, major barriers to adoption include device security/patient confidentiality and patient safety. Furthermore, except for a policy published by the American College of Emergency Physicians (ACEP) in 2018, there are few other national regulatory guidelines pertaining to handheld POCUS. In light of this, we propose a framework for HPOCUS guideline development to address these and other concerns. Such guidelines include training and credentialing, bioengineering approval, and strategic integration with electronic medical record systems.

Conclusion

HPOCUS can be a powerful tool for expedited diagnosis and management guidance. However, there is limited data regarding patient safety and current regulatory body guidelines are lacking. Our assessment illuminates that there remain many unsolved problems about HPOCUS, and in turn, we propose guidelines to address safe regulation and implementation.
Socialisation vs the Market: The Peculiarities of Russian Capitalism
Authors: Kolganov Andrey
Published: February 2022

The author shows the changes that the system of commodity relations is undergoing in the early 21st century. These changes are seeing the market take on an all-encompassing character, and we are witnessing a comprehensive manipulation of market actors by corporate capital. The present-day market is limited and undermined not only by state regulation but also by a process of socialisation, which represents the totality of transitional relationships and institutions. Having characterised this new quality of the relations of the market, the author demonstrates the specific nature of these processes in contemporary Russia, where the most modern forms of market relations and the most archaic are being propagated simultaneously. The green shoots of socialisation are characterised by the contradiction between the retention of a number of the achievements of the preceding system, and the development of shadow state regulation and ‘manual control’.
Improved exponential model for thermal error modeling of machine-tool spindle based on fruit fly optimization algorithm
Authors: Liao Qihao , Yin Qin , Xie Luofeng , Yin Guofu
Published: February 2022

Establishing a robust thermal error model is crucial for thermal error compensation of machine tools. In this paper, an improved exponential model for thermal error modeling was proposed. First, the improved exponential model is established by combining the exponential model and the temperature-dependent model. Second, the improved fruit fly optimization algorithm is used to determine the parameters. Finally, two strategies are used to select the optimal sensor location from six potential ambient temperature sensors. The ambient temperature data is proved to be effective in improving the robustness of the model. The average root mean square error of the proposed model, the exponential model without ambient temperature, and the linear model are 1.18 μm, 1.79 μm, and 2.70 μm, respectively. The modeling results show that the proposed model has high accuracy and strong robustness, which is suitable for workshop environment and variable conditions in thermal error modeling of machine tools.
FATA Merges into Pakistan’s National System
Authors: Usman Sahibzada Muhammad
Published: February 2022

This article examines the Federally Administered Tribal Areas (FATA) in the Pakistani national system. In the current global war on terrorism, Pakistan’s FATA became a stronghold from jihadist to terrorist. After 9/11, under international pressure, the Pakistani government worked hard to implement its law in FATA. During this process, Pakistani forces push the Taliban out of tribal areas through military operations. To guarantee peace, prosperity and stability in the area, Pakistan combines mainstream tribal areas into the country by implementing a comprehensive legal framework for illegal areas. This article examines Pakistan’s integration options that allow FATA to enter its federal system and inspects the integrating tribal areas with Khyber Pakhtunkhwa (KPK) Province, which has great similarities with its race, religion and culture and is part of the federal system for 70 years. This article also focuses on the economic and administrative reforms necessary to establish real national control and FATA’s consolidation on an equal footing with other provinces of Pakistan.
Modeling and experimental implementation of a flexible SMA wire-based gripper for confined space operation
Authors: Zhou Haiqin , Ma Nan
Published: February 2022

The shape memory alloy (SMA) is increasingly utilized among many industrial and civil applications as it is small in size but mighty in output. However, most of the current SMA-based mechanisms face with the low controllability or bulk dimension. In this paper, a novel flexible SMA wire-based gripper is developed to address these challenges for improving the clamping stability and stroke for confined operation. To achieve this, the long SMA wire was spaced smartly within a miniature space to increase the output, further, to improve the stroke of the gripper (14 mm vs conventional 2 mm). Then, the theoretical model of the system was established by considering the thermal effect of SMA material and the static performance of the flexible beams. After that, the experimental setups were prototyped to crossly test the performances of the proposed SMA gripper. It can be seen from the experimental results that the model presented in this paper can be validated with high accuracy (error: 3.4%). It can also be found that the SMA gripper can realize the high tracking performances (i.e. 8.9% accuracy in displacement step response, 10.8% in displacement tracking response, and 12.1% accuracy in clamping force tracking response, respectively) for the industrial applications.
High-grade Transformation in Adult Granulosa Cell Tumor: Potential Diagnostic Challenges and the Utility of Molecular Testing
Authors: Mubeen Aysha , Martin Ian , Dhall Deepti
Published: February 2022

Adult granulosa cell tumor (AGCT) is the most common sex cord-stromal tumor, accounting for about 1% of all ovarian tumors. It has a propensity for recurrences, especially late in the disease course. High-grade or sarcomatoid transformation has been rarely described in AGCT. We present a case of a 65 year old woman who presented with hemodynamic shock and bowel obstruction from a large pelvic mass. Histologic examination revealed predominantly high-grade epithelioid and spindled cells with high mitotic activity and necrosis. A minor component suggestive of AGCT was also identified. Molecular analysis confirmed the diagnosis of AGCT by revealing FOXL2 C134W mutations. Additionally, TP53 mutations were also detected which may contribute to the high-grade transformation. Our case is unique because the high-grade sarcomatous component constituted most of the tumor and the areas of “typical” AGCT were minor. Also, the clinical and operative findings did not suggest a specific site of origin leading to a broad differential diagnosis. High-grade transformation in AGCT is a rarely described phenomenon. The awareness of this presentation is helpful in reaching the correct diagnosis. Molecular analysis may be an extremely helpful adjunct in challenging cases.
An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 1. Description of Claims and Claimants
Authors: Howard Ninica L. , Adams Darrin , Cole Jena
Published: February 2022

Home-based health care can be physically and emotionally demanding, resulting in injury or illness. Washington State’s workers’ compensation compensable claims between 2006 and 2016 were analyzed to describe the characteristics of injured home-based health care (HBHC) providers and the burden created by these injuries. Comparisons were made with clinical health care (CHC) providers, as well as between all compensable claims and work-related musculoskeletal disorder (WMSD) claims. Over 90% of claimants for both HBHC and CHC were female. The mean age of all compensable HBHC claimants (45.7 years) was significantly older than for CHC, with the majority (54.5%) between the ages of 40 and 59. However, HBHC claimants with WMSDs were younger, overall. Across health care type and claim type, the majority of injured care providers were overweight or obese (BMI ≥ 25). The highest mean age occurred among claimants injured from falls, either on the same level or to a lower level (HBHC: 48.3-48.6 years, CHC: 46.1-48.1 years). This same group also had the highest BMIs. WMSDs accounted for 47.3% of HBHC compensable claims and 50.3% for CHC. Falls on the same level were the second most common injury event among HBHC claims. For both HBHC and CHC, back injuries were the most common body part for both claim types (all compensable claims: 28.8% HBHC and 23.9% CHC, WMSD claims: 60.8% HBHC and 47.5% CHC). Overexertion was the injury event most attributed to WMSDs (HBHC: 82.6%, CHC: 71.6), overexertion during lifting being the most prevalent overexertion type (HBHC: 27.8%, CHC: 19.6%).
An experimental investigation of low viscosity lubricants on three piece oil control rings cylinder liner friction
Authors: Forder Michael D , Morris Nicholas , King Paul , Balakrishnan Sashi , Howell-Smith Sebastian
Published: February 2022

Reducing energy use and improving engine efficiency is a complex task however to date a continued reduction of lubricant viscosity has proved effective. Reducing viscosity decreases hydrodynamic friction and pumping losses however it can also exacerbate boundary friction losses. Detailed and representative component level experimentation is required to understand the effects of viscosity reduction on friction and opportunity for further optimisation. This paper presents a novel motored reciprocating Tribometer which has been developed to measure the friction between complete cylinder liners and three-piece oil control rings. The system holds individual or multiple rings stationary in a bespoke ring holder and reciprocate the cylinder liner thereby replicates the relative kinematics of the components in service. The new design has many operational advantages to identify and benchmark the individual contribution of oil control ring friction including near total isolation of oil ring-cylinder liner bore conjunction, pure rectilinear motion and use of full components without resorting to split liner/ring geometries. The experimental rig is used to measure friction at the three-piece oil control ring- cylinder liner conjunction when lubricated with two low viscosity lubricants. The results show prevalence of mixed regime lubrication across the speeds, temperatures and lubricants investigated. The oil control ring under investigation is shown to operate in mixed regime lubrication and at cold start the introduction of lower viscosity lubricants such as 0W-8 showed higher level of oil control ring-cylinder liner friction in comparison to the 0W-40. The information and experimental facility are of critical use for engine designers when considering the potential contradictory component efficiency behaviour when moving to ultra-low viscosity lubricants.
Tension between local, regional and national levels in Norway’s handling of COVID-19
Authors: Fosse Anette , Svensson Anders , Konradsen Ingvill , Abelsen Birgit
Published: February 2022

Aims:

This study aimed to explore the tension between local, regional, and national authorities evoked by some rural municipalities’ decisions to impose local infection-control measures during the first weeks of the COVID-19 pandemic in Norway.

Methods:

Eight municipal Chief Medical Officers of Health (CMOs) participated in semi-structured interviews, and six crisis management teams participated in focus-group interviews. Data were analysed with systematic text condensation. Boin and Bynander’s interpretation of crisis management and coordination and Nesheim et al.’s framework for non-hierarchical coordination in the state sector inspired the analysis.

Results:

Uncertainty in the face of a pandemic with unknown damage potential, lack of infection-control equipment, patient transport challenges, vulnerable staff situation and planning of local COVID-19 beds were some of the reasons for rural municipalities imposing local infection-control measures the first weeks of the pandemic. Local CMOs’ engagement, visibility and knowledge contributed to trust and safety. Differences in perspectives between local, regional and national actors created tension. Existing roles and structures were adjusted, and new informal networks arose.

Conclusions:

Strong municipal responsibility in Norway and the quite unique arrangement with local CMOs in every municipality with the legal right to decide temporary local infection-control measures seemed to facilitate a balance between top-down and bottom-up decision making. Tension between rural, regional and national actors that arose due to local infection-control measures, and the following dialogue and mutual adjustment of perspectives, led to a fruitful balance between national and local measures in Norway’s handling of the COVID-19 pandemic.
Gaming and social media use among adolescents in the midst of the COVID-19 pandemic
Authors: Nilsson Anders , Rosendahl Ingvar , Jayaram-Lindström Nitya
Published: February 2022

Background and aims: The COVID-19 pandemic has dramatically changed life circumstances for adolescents worldwide. With schools being closed and regular activities being cancelled, gaming and social media use are activities that might gain in importance. There is a risk that these online behaviours have negative effects on other important activities, such as being physically active, sleeping, and studying, as well as general well-being. The aim of this study was to investigate the effects of the COVID-19 pandemic on gaming and social media use, and its effects on the well-being of adolescents. Methods: A total of 1232 adolescents (82.5% female) participated in an anonymous web survey containing questions on gaming, social media use, and perceived negative consequences of gaming and social media use during the COVID-19 pandemic. The results were analysed with a quasi-Poisson regression model. Results: The results indicated an increase in gaming and social media use, which was associated with negative consequences and perceived well-being. A majority of adolescents reported that they used social media more than they felt comfortable with. There were large differences between boys and girls, with girls being more negatively affected across measures. Discussion: The increase in gaming and social media use during the COVID-19 pandemic might have negative effects on the well-being of adolescents, and on other activities that are important to health. Our interpretation of the findings is that gaming and social media use might partly function as coping mechanisms to deal with stress and/or boredom resulting from COVID-19 restrictions. There is a risk that these coping strategies become maladaptive over time. Conclusions: The restrictions from the COVID-19 pandemic have resulted in an increase in the amount of time adolescents spend gaming and on social media, which might have negative effects on their well-being. This study highlights the urgent need to consider adaptive and healthy coping strategies for adolescents given the pandemic may mean that daily living could continue to be altered in the near future.
Bodily ethnography: Some epistemological challenges of participation
Authors: Förster Till
Published: February 2022

Bodily participation provides insights that mere observation cannot offer. Based on an ethnographic vignette, this article explores how bodily interactions in ethnographic fieldwork raise awareness for non-observational knowledge and hidden social practices. It looks at how such encounters shape all participants, including the ethnographer, and how subtle bodily interactions constitute a social space that remains invisible to outsiders but where intersubjectivity unfolds. It then addresses differences between participation and observation in ethnography and the epistemological problems it leads to: First, bodily social practice is largely non-predicative, but ethnographers are urged to put it in words – which affect their relationship to that practice and how they can engage in it. The second challenge is the habituation of bodily practices. The longer ethnographers engage in such social practices, the more they will develop routines and no longer focus consciously on them. Both can distort the ethnographic account of bodily practices.
Feasibility and Safety of Delayed Catheter Removal Technique in Percutaneous Trans-Hepatic Portal Vein Embolization
Authors: He Chengjian , Ge Naijian , Yang Yefa
Published: February 2022

Background: This retrospective study aimed to evaluate the technical feasibility and safety of the delayed catheter removal technique in trans-hepatic portal vein embolization (PVE) and to explore a suitable technique. Methods: This was a retrospective study. In 278 consecutive patients, the puncture tract of the trans-hepatic PVE was treated using the delayed catheter removal technique after PVE. The existence of peripheral hepatic hematoma formation was assessed using ultrasound (US). Follow-up examinations such as magnetic resonance imaging (MRI), computed tomography (CT), and/or US were performed to evaluate perihepatic hematoma formation, hemoperitoneum, and other major complications. Results: Instant hemostasis was achieved in all patients after the procedure. PVE-associated complications were observed in 9 patients (3.24%). No perihepatic hematoma or hemoperitoneum was found in any of the patients. Conclusion: With the appropriate technique, the delayed catheter removal technique can be reliably utilized as a substitute for hemostasis as it is simple and free. This technique should be further evaluated and compared with other methods. Advances in knowledge: This study is the first to investigate the safety and feasibility of the delayed catheter removal technique for embolizing the puncture tract of the trans-hepatic PVE.
Creating Transformative Interdisciplinary Learning Opportunities for College Students
Authors: Bass Michelle , Dompierre Kerry-Ann B. , McAlister Martha
Published: February 2022

Collaboration across multiple perspectives enhances the potential for innovative solutions to the complex issues of our time. An interdisciplinary education (IDE) community of practice (CoP) proved to be a catalyst for bringing together interested faculty from across a large public college to create an IDE learning event focused on homelessness. Using a qualitative research approach, we explored the process and impact on student learning. Four main themes emerged: authentic engagement, transcending perspectives, collective responsibility, and cultivating curiosity. The first three themes identify the transformative power of IDE, while the last theme highlights the challenge of remaining open to differing perspectives. We learned the value of incorporating perspectives beyond strictly disciplinary views, such as narratives from those directly impacted by homelessness—to stimulate empathy, transformation, and the will to act.
Pre-Treatment Breast Cancer Patients Show Neural Differences in Frontal Alpha Asymmetry
Authors: Prashad Neelam , Melara Robert D. , Root James C. , Ahles Tim A.
Published: February 2022

Cognitive impairment has been observed consistently in a subset of breast cancer survivors. Yet, still unknown is whether neural and behavioral effects of cancer exist prior to treatment, which may contribute to later cognitive decline. The current study investigated pre-treatment differences in attention performance and frontal alpha asymmetry (FAA), an established neural index of inhibitory control, in non-metastatic breast cancer patients ( n = 42) compared with healthy controls ( n = 28). We additionally investigated whether differences between groups appear in specific cuing conditions and across different stages of information processing. Participants underwent EEG while completing the Attention Network Task (ANT), a cognitive measure of alerting, orienting, and inhibitory control of attention. Results revealed no behavioral differences between patients and controls but significantly greater right-hemisphere alpha activity (reduced inhibitory control) in patients, particularly to uninformative (no cue, double cue) versus informative (valid cue) cues and in later stages of information processing (400–800 ms post-stimulus). Results suggest neural differences between groups to uncertain stimulus environments that have yet to manifest behaviorally. FAA may thus serve as a unique neural correlate that could potentially be used to predict later cognitive decline.
Messiness in photography, war and transitions to peace: Revisiting Bosnia: Uncertain Paths to Peace
Authors: Bellmer Rasmus , Möller Frank
Published: February 2022

During and after the wars in ex-Yugoslavia, Bosnia was a laboratory for new photographic approaches to war, violence and civilian suffering. Among these approaches, Fred Ritchin and Gilles Peress’s online photo essay, Bosnia: Uncertain Paths to Peace (1996), emphasized interpretive openness, plurality of meaning, narrative non-linearity and audience interaction, thus redefining as merits what photojournalism had formerly regarded as liabilities. The project convincingly represented the ongoing conflict’s multilayeredness and the vicissitudes of the transition to peace: on a day-to-day level, ambivalence ruled and alliances shifted; chaos, confusion and unpredictability prevailed. The project’s users experience the conflict’s messiness through the website’s overall organization which inhibits easy orientation, thus reproducing the conflict’s disorder. In the grids, in particular, non-sequitur panel-to-panel transitions illustrate the conflict’s lack of sense as it is traditionally understood. The project is an important precursor to current war photography, aiming to acknowledge the messiness of violent conflict rather than reducing it to simple but misleading narratives.
The Effects of Salt-Water Processing of Phellodendri Chinensis Cortex on the Enhancement of Kidney Absorption of the Main Alkaloids
Authors: Zhang Fan , Li Li , Zhao Jia-hui , Ge Xiu-tong , Gao Hui , Jia Tian-zhu
Published: February 2022

Phellodendri chinensis cortex (PC) is a commonly used traditional Chinese medicine for clearing heat. It is often applied in the clinical practice by using the salt-water processing method. According to the theory of Chinese meteria medica processing, after being processed with salt-water, traditional Chinese medicine can increase absorption of the kidney and enhance the effects of kidney disease treatments, which can be abbreviated as “entering into kidney by processing with salt-water”. PC is a typical traditional Chinese medicine using the salt-water processing method. The resulting salt-water processed PC（SPC）can specifically enter the kidney meridian, as compared to raw PC (RPC), which enhances the kidney yin nourishing and purges away kidney fire. However, the effect of “entering into kidney by processing with salt-water” of PC has not been proven and its mechanism is unknown. Therefore, it is of great significance to compare the renal absorption effect of PC before and after salt-water processing and elucidate its mechanism. In this article, using the PC alkaloid content as an indicator, a human proximal tubular epithelial cell (HK-2 cell) experiment and the binding rate of alkaloids to lysozyme-kidney target enzyme was was conducted to simulate kidney absorption in vitro. These results were combined with an investigation of the alkaloid content in rat kidneys after a gavage of PC solution, comprehensively evaluating the difference in kidney absorption after salt-water processing. Compared with RPC, the efflux of SPC alkaloids in the HK-2 cell permeability experiment was significantly reduced, and affinity of the lysozyme-kidney target enzyme was higher. In addition, those who were given SPC had a higher alkaloid concentration in the kidneys than the RPC group. Finally, we verified enhanced kidney absorption effect of PC by salt-water processing, and to a certain extent revealed the mechanism of enhanced kidney absorption of SPC.
The Role of Hyaluronic Acid for Soft Tissue Indications: A Systematic Review and Meta-Analysis
Authors: Khan Moin , Shanmugaraj Ajaykumar , Prada Carlos , Patel Ashaka , Babins Eric , Bhandari Mohit
Published: February 2022

Context:

Soft tissue injuries are often treated with injectables such as corticosteroids and platelet-rich plasma (PRP) to reduce inflammation and promote healing. There is increasing evidence examining the use of hyaluronic acid (HA) for the management of soft tissue injuries.

Objective:

To evaluate the treatment effect and role of HA for available soft tissue indications.

Data Sources:

A search of PubMed, MEDLINE, EMBASE, and CENTRAL from the inception date of each database through February 24, 2021, was conducted for all randomized controlled trials (RCTs) involving the use of HA for soft tissue indications. Two reviewers independently screened articles for eligibility and extracted data from included studies for analysis. We assessed risk of bias for all included studies and pooled outcomes using a fixed-effects model. Outcomes (ie, function and pain relief) were categorized to short-term (<6 weeks, 6-12 weeks) and mid-term (>12 weeks) data. We present effect estimates as mean differences (MDs) and standardized mean differences (SMDs) and present the estimate of effect of HA for available indications in relation to available comparators.

Study Design:

Meta-analysis of RCTs.

Level of Evidence:

Level 1.

Results:

Of the 6930 articles screened, 19 RCTs (n = 1629 patients) were eligible and included in this review. HA was evaluated across a variety of soft tissue indications including rotator cuff disease, elbow pain, ankle sprains, Achilles tendinopathy, patellar tendinopathy, and trigger finger. Of the 19 RCTs, 11 were placebo-controlled and 9 used active comparators (PRP, cortisone, prolotherapy, or extracorporeal shockwave therapy). The pooled treatment effect of HA across most soft indications against placebo and active comparators demonstrated benefit in short-term pain <6 weeks (MD visual analogue scale [VAS] 2.48, 95% CI 2.31-2.65) and 6 to 12 weeks (MD VAS 2.03, 95% CI 1.86-2.20). Mid-term pain relief also favored HA over comparators across indications >12 weeks from administration (MD VAS 3.57, 95% CI 3.35-3.78). High heterogeneity was present with rotator cuff (10 trials, I2 = 94%), and elbow tendinopathy (2 trials, I2 = 99%). We identified uncertain benefit for trigger finger (2 trials, I2 = 67%). Heterogeneity for ankle sprains, patellar tendinopathy and Achilles tendinopathy could not be assessed as they only had 1 trial each.

Conclusion:

This systematic review and meta-analysis support HA’s efficacy in the treatment of a variety of soft tissue indications. Understanding the relative effects of HA to other injectable modalities requires additional, large trials.
Mission Drift and Scale: An Empirical Analysis of Indian Micro Finance Institutions
Authors: Ranjani K. S. , Singh Poonam , Revulagadda Rajeev Kumar
Published: February 2022

Studies have found that a small scale of operations could limit the firm performance since they do not enjoy economies of scale. Since the microfinance industry is focused on provision of financial services to the poor, performance is measured both from a social as well as financial perspective. As firms increase their scale of operations, their social performance needs to be on par with their financial performance. To measure the effect of scale on performance, we use data from the Microfinance Information Exchange (MIX) market consisting of 245 Microfinance Institutions (MFIs) covering a period of 21 years from 1999 to 2019. The dependent variables are outreach, efficiency, and financial performance. The control variables are age and the regulatory status of the firm. We find that while factors like financial performance, client retention, and measures of operational efficiency are dependent on scale; they come at the cost of outreach. The pursuit of economic goals by large MFIs seems to hamper their ability to reach the poorest and/or most needy clients, implying mission drift. This study thus draws the attention of policy makers to the importance of supporting small MFIs to survive and continue to address the social goals of MFIs.
Risk of Concussion After a Targeting Foul in Collegiate American Football
Authors: Aukerman Douglas F. , Bohr Adam D. , Poddar Sourav K. , Romano Russell , Petron David J. , Ghajar Jamshid , Giza Christopher C. , Lumba-Brown Angela , McQueen Matthew B. , Harmon Kimberly G.
Published: February 2022

Background:

The targeting rule was adopted by the National Collegiate Athletic Association (NCAA) in 2008 to discourage dangerous contact during collegiate American football competition. Although targeting rules have been emphasized as a means to reduce concussion rates, there is currently no evidence that targeting plays are higher risk for concussion than other plays in American football.

Purpose:

To compare the rate of concussion occurring during targeting versus nontargeting plays in American collegiate football.

Study Design:

Cross-sectional study.

Methods:

Concussions occurring in games in the 2016-2019 Pac-12 Conference were classified as having occurred during either (1) a play where a targeting penalty was called or (2) all other plays. Targeting plays were further categorized to either those in which the call was upheld or those overturned by the on-field official after replay review. The number of targeting plays and the total number of plays during games were also recorded. Concussion incidence (per 1000 plays) and risk ratios were calculated.

Results:

Overall, 538 games with 68,670 plays were reviewed, during which 213 concussions occurred (15 during plays where targeting was called and 198 on other plays) and 141 targeting penalties were called. The incidence of concussion was 106.4/1000 plays for targeting plays (including 141.2/1000 upheld targeting fouls and 53.6/1000 overturned targeting fouls) and 2.9/1000 plays for nontargeting plays. The risk of concussion during targeting plays was 36.9 (95% CI, 22.4-60.7) times greater than that for all other plays. The risk of concussion during targeting plays upheld was 49.0 (95% CI, 28.5-84.2) times greater than that for all other plays.

Conclusion:

Concussion risk was significantly higher during plays in which targeting was called, especially those in which targeting fouls were upheld.

Clinical Relevance:

This study supports eliminating or reducing targeting from American football. The results of this study suggest that players should be screened for concussion after targeting plays are called.
Changing Nature of Work and Employment in the Gig Economy: The Role of Culture Building and Leadership in Sustaining Commitment and Job Satisfaction
Authors: Thomas Sita Mary , Baddipudi Venkat
Published: February 2022

Industry reports indicate a double-digit growth in India’s gig economy. In this changing world of work, sustaining employee commitment and job satisfaction becomes increasingly challenging, starting with getting clear about who one considers as an ‘employee’. In this article, first, an attempt is made to build a perspective in which ‘employee’, ‘commitment’ and ‘satisfaction’ are relooked at, in the changing context of ‘employing human resources’ in organisations. In this new perspective, we explore the role of leadership and culture in impacting employee commitment and job satisfaction. We review extant literature and present a conceptual framework that proposes to understand how organisations can integrate the gig model of working into their system, thereby making the best use of it. Further gaps and directions for future research are presented.
Different Occupations & Different Contexts: Implications for Wellness
Authors: Ruckmani Smita , Venkateswaran Vijaya
Published: February 2022

This article discusses basic components of wellness in the workplace based on observations from selective literature and live case studies of a few people in employment in the present-day context. It discusses the dynamics and suggests possible interventions. This article presents some fundamental frameworks to understand wellness at work. Based on a brief review of related literature, the authors present many work correlates of varying work experiences and occupational conditions that lead to psychological problems.A few case studies of people with decreased wellness/mental health are presented from a clinical psychology perspective under different occupational/work and life contexts. The authors discuss the individual strength dimension while coping with unwellness. They propose to corporate HR that mental wellness is as important a dimension as physical wellness and needs to be given attention to in this gig economy. Companies should consciously undertake initiatives. A framework to understand and improve mental health among employees is suggested.
Experiences of Hispanic Safety Net Clinic Patients With Diabetes During the COVID-19 Pandemic
Authors: Vickery Katherine D. , Novotny Paul J. , Ford Becky R. , Lantz Kiley , Kavistan Silvio , Singh Davinder , Hernandez Valentina , Sia Irene G. , Wieland Mark L.
Published: February 2022

Purpose:

The purpose of this study was to characterize the material, health (general and diabetes-specific), and social impacts of the COVID-19 pandemic on Hispanic adults with type 2 diabetes who did not experience COVID-19 infection.

Methods:

This cross-sectional and longitudinal study used surveys within a clinical trial of 79 Hispanic adult clinic patients with type 2 diabetes. Cross-sectional measures included the Coronavirus Anxiety Scale, items from the Coronavirus Impact Scale, and the Pandemic Impacts Inventory. Longitudinal measures included the Summary of Diabetes Self-Care, health care utilization, and measures of diabetes self-efficacy, social support, and quality of life.

Results:

Participants were majority low-income, Spanish-speaking females with poor diabetes control. Coronavirus anxiety was low despite majority of participants having an affected family member and frequent access barriers. More than half of participants reported moderate/severe pandemic impact on their income. Diabetes self-care behaviors did not change between prepandemic and pandemic measures. Diabetes self-efficacy and quality of life improved despite fewer diabetes-related health care visits.

Conclusions:

Despite high levels of access barriers, financial strain, and COVID-19 infection of family members, Hispanic adults with type 2 diabetes continued to prioritize their diabetes self-management and demonstrated substantial resilience by improving their self-efficacy and quality of life.
De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials
Authors: Wang Ge , Wang Xiao , Zhao Guanqi , Huang Xin , Guo Ruifeng , Nie Shaoping
Published: February 2022

Background

To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear.

Methods

We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models.

Results

Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71).

Conclusions

The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients.
Factors associated with the severity of road traffic injuries from emergency department based surveillance system in two Mexican cities
Authors: Gómez-García Lourdes , Hidalgo-Solórzano Elisa , Pérez-Núñez Ricardo , Jacobo-Zepeda Vanessa F. , Ascencio-Tene Ricardo G. , Lunnen Jeffrey C. , Mehmood Amber
Published: February 2022

Background

Limited data from low- and middle-income countries (LMICs) on the severity of road traffic injuries (RTIs) and their relation to different variables of interest are routinely obtained. Knowledge on this subject relies on evidence from high-income countries, which might not be the same as in LMICs. This information is greatly needed to advance and inform local and regional efforts towards the United Nations’ Decade of Action and the Sustainable Development Goals.

Methods

From May 2012 to November 2014, a RTI surveillance system was implemented in two referral hospitals in two Mexican cities, León and Guadalajara, with the objective of exploring the relationship between Injury Severity Score (ISS) and different sociodemographic characteristics of the injured as well as different variables related to the event and the environment. All individuals suffering RTIs who visited the Emergency Rooms (ER) were included after granting informed consent. A Zero-Truncated Negative Binomial Model was employed to explore the statistical association between ISS and variables of interest.

Results

3024 individuals participated in the study: 2185 (72.3%) patients from León and 839 patients (27.7%) from Guadalajara. Being male, in the 20–59 age-group, having less schooling, events occurring in Guadalajara, on Sundays, at night, and arriving at ER via public/private ambulance were all associated with an increased log count of ISS. Found a significant interaction effect (p-value< 0.05) between type of road user and alcohol intake six hours before the accident on severity of the injury (ISS). The use of illicit drugs, cellphones and safety devices during the event showed no association to ISS.

Conclusions

Our study contributes to the statistical analysis of ISS obtained through RTI hospital surveillance systems. Findings might facilitate the development and evaluation of focused interventions to reduce RTIs in vulnerable users, to enhance ER services and prehospital care, and to reduce drink driving.
Studying patterns and predictors of HIV viral suppression using A Big Data approach: a research protocol
Authors: Zhang Jiajia , Olatosi Bankole , Yang Xueying , Weissman Sharon , Li Zhenlong , Hu Jianjun , Li Xiaoming
Published: February 2022

Background

Given the importance of viral suppression in ending the HIV epidemic in the US and elsewhere, an optimal predictive model of viral status can help clinicians identify those at risk of poor viral control and inform clinical improvements in HIV treatment and care. With an increasing availability of electronic health record (EHR) data and social environmental information, there is a unique opportunity to improve our understanding of the dynamic pattern of viral suppression. Using a statewide cohort of people living with HIV (PLWH) in South Carolina (SC), the overall goal of the proposed research is to examine the dynamic patterns of viral suppression, develop optimal predictive models of various viral suppression indicators, and translate the models to a beta version of service-ready tools for clinical decision support.

Methods

The PLWH cohort will be identified through the SC Enhanced HIV/AIDS Reporting System (eHARS). The SC Office of Revenue and Fiscal Affairs (RFA) will extract longitudinal EHR clinical data of all PLWH in SC from multiple health systems, obtain data from other state agencies, and link the patient-level data with county-level data from multiple publicly available data sources. Using the deidentified data, the proposed study will consist of three operational phases: Phase 1: “Pattern Analysis” to identify the longitudinal dynamics of viral suppression using multiple viral load indicators; Phase 2: “Model Development” to determine the critical predictors of multiple viral load indicators through artificial intelligence (AI)-based modeling accounting for multilevel factors; and Phase 3: “Translational Research” to develop a multifactorial clinical decision system based on a risk prediction model to assist with the identification of the risk of viral failure or viral rebound when patients present at clinical visits.

Discussion

With both extensive data integration and data analytics, the proposed research will: (1) improve the understanding of the complex inter-related effects of longitudinal trajectories of HIV viral suppressions and HIV treatment history while taking into consideration multilevel factors; and (2) develop empirical public health approaches to achieve ending the HIV epidemic through translating the risk prediction model to a multifactorial decision system that enables the feasibility of AI-assisted clinical decisions.
Clinical language search algorithm from free-text: facilitating appropriate imaging
Authors: Chaudhari Gunvant R. , Chillakuru Yeshwant R. , Chen Timothy L. , Pedoia Valentina , Vu Thienkhai H. , Hess Christopher P. , Seo Youngho , Sohn Jae Ho
Published: February 2022

Background

The comprehensiveness and maintenance of the American College of Radiology (ACR) Appropriateness Criteria (AC) makes it a unique resource for evidence-based clinical imaging decision support, but it is underutilized by clinicians. To facilitate the use of imaging recommendations, we develop a natural language processing (NLP) search algorithm that automatically matches clinical indications that physicians write into imaging orders to appropriate AC imaging recommendations.

Methods

We apply a hybrid model of semantic similarity from a sent2vec model trained on 223 million scientific sentences, combined with term frequency inverse document frequency features. AC documents are ranked based on their embeddings’ cosine distance to query. For model testing, we compiled a dataset of simulated simple and complex indications for each AC document (n = 410) and another with clinical indications from randomly sampled radiology reports (n = 100). We compare our algorithm to a custom google search engine.

Results

On the simulated indications, our algorithm ranked ground truth documents as top 3 for 98% of simple queries and 85% of complex queries. Similarly, on the randomly sampled radiology report dataset, the algorithm ranked 86% of indications with a single match as top 3. Vague and distracting phrases present in the free-text indications were main sources of errors. Our algorithm provides more relevant results than a custom Google search engine, especially for complex queries.

Conclusions

We have developed and evaluated an NLP algorithm that matches clinical indications to appropriate AC guidelines. This approach can be integrated into imaging ordering systems for automated access to guidelines.