bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression and Health-Related Quality of Life Among Elderly Patients during the COVID-19 Pandemic in Israel: A Cross-sectional Study
Authors: Levkovich Inbar , Shinan-Altman Shiri , Essar Schvartz Neta , Alperin Mordechai
Published: February 2021

Aim:

This study aims to assess how optimism, social support, and perceived susceptibility are associated with depressive symptoms and health-related quality of life among elderly patients during the COVID-19 pandemic in Israel.

Methods:

In a cross-sectional study, 256 participants age 60 through 95 completed the following self-administered questionnaires: Perceived Susceptibility, Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Symptoms of Depression (CES-D) and health-related quality of life (SF-12v2 Health Survey). Data were collected from June to July 2020, 3 months after the COVID-19 state of emergency was declared in Israel. Participants were interviewed by family medicine residents via telephone. Statistical analyses included Pearson correlations, t-tests between groups, regression analyses, and Hayes’ PROCESS to analyze a moderated mediation model.

Results:

Of the elderly participants, 37.5% were classified as having depression. Optimism, social support and health-related quality of life were positively associated. Higher optimism and social support were related to lower perceived susceptibility and lower depression. Results of a multivariate regression explained 29% of the variance in depression and 19% of the variance in health-related quality of life. The relationships assessed by 4 Process models were significant, such that higher optimism and social support were related to lower perceived susceptibility, which in turn was related to higher depression and lower health-related quality of life.

Conclusions:

Optimism and social support may be effective in coping with challenges and buffering depression. Perceived susceptibility may mediate the association of optimism and social support with higher depression and lower health-related quality of life. The conclusions of this study underscore the need to treat depression among older adults during this period. Hence, healthcare providers should also support elderly patients living at home. In giving this type of help, healthcare providers should strive to increase social support and optimism among older adults.
Mortality Risk Assessment at the Admission in Patient With Proximal Femur Fractures: Electrolytes and Renal Function
Authors: Vigni Giulio Edoardo , Bosco Francesco , Cioffi Alessio , Camarda Lawrence
Published: February 2021

In patients over 65y.o. who were surgically treated for a hip fracture, electrolytes have not been specifically studied as predictors of mortality. The main purpose of this study was to assess whether electrolytes and chronic kidney disease (CKD) stages, evaluated at admission, could represent a pre-operative prognostic factor in this population. Moreover, the role of epidemiological and clinical parameters was analyzed with and without a surgical timing stratification. This retrospective study included 746 patients. For each patient, their age, gender, fracture classification, Hb value, comorbidities, ASA class, chronic kidney disease, creatinine levels, electrolytes and surgical timing were collected. CKD-epi, MDRD, modified MDRD and BIS1 were used to obtain eGFR and CKD stages. All parameters were analyzed individually and in relation to the different surgical timing. Descriptive statistics, Chi-square test and survivability analysis with Kaplan Meier curve were used. In patients with a hip fracture non-significant association with increased mortality was shown for the following variables: Hb value, sodium values, calcium values, CKD stages and creatinine values. Otherwise altered kalemia was associated with a statistically significant increase in mortality as well as male gender, two or more comorbid medical conditions, advanced age (>75 years), higher ASA class. Surgery performed within 72h resulted in a statistically significant reduction in mortality at 6 months and, when performed in 24h-48h, a further reduction at 4 years. Age and ASA class statistically significant increased mortality regardless the surgical timing. Male patients operated after 48h from hospitalization were associated with a statistically significant increase in mortality rate. Two or more comorbidities were related to a statistically significant increased number of deaths when patients were treated after 96h. Altered kalemia values at hospitalization are associated with a statistically significant increase in mortality in patients operated after 72h from admission.
Urban and Spatial Planning: Pragmatic Considerations for Plan Implementation Improvements (A Case Study of the City of Bor)
Authors: Nikolić Dragana S. , Pantić Marijana D. , Jokić Vesna T.
Published: February 2021

The main task of planning documents is to achieve maximal rationality in the use of space, spatial resources, and balanced territorial development. The preparation of plans is regulated by a legislative framework, which embraces multiple phases and stakeholders. In a perfect planning process, it would be expected that all the elements are well coordinated and brought to common understanding, but in reality, obstacles and challenges can occur in any of these steps, especially in the implementation phase. Although a plan is fully prepared to be practiced, its implementation might be omitted. Therefore, this article analyzes the full process of spatial and urban planning from the perspective of plan implementation. The methodology is based on a combination of different data collection methods (interviews, fieldwork, direct observation) with the analysis of plans and the particular mention of those plans that picture the implementation issues the most. Also, legislative acts and semi-annual and annual reports on the achievements of the local government budget are analyzed. The approach indicates that plan implementation depends the most on the willingness of the government to perform changes in the system and to peruse punitive policy comprehensively. Although it is about implementation at the local level, the success primarily depends on clear definitions given in the legislative acts, freedom of the local communities to make their own decisions, and financial decentralization, side by side with the regional and local circumstances, institutional technical and staff capacities, and application of participatory planning that involves actors from various sectors.
An Investigation of Fiat Characterization and Evolutionary Dynamics of the Cryptocurrency Market
Authors: Donmez Cem Cagri , Sen Doruk , Dereli Ahmet Fatih , Horasan M. Bilal , Yildiz Cagri , Kaplan Donmez Nergis Feride
Published: February 2021

Recent developments in global financial markets revealed that cryptocurrencies experienced rapid growth due to the popularity of blockchain technology and its evolving position in the digital finance industry. The rise of cryptocurrencies led economists to question generally accepted financial practices. Particularly the interaction between two different types of financial markets arose as a hot research topic to discover specific relationships and differences between major cryptocurrencies and fiat currencies. Therefore, this article aims to examine analyze by attaching importance to the Bitcoin to investigate significant linkages and analyze critical direct and indirect connections. In this research, Bitcoin—which is known as the most prominent cryptocurrency on the market—and 50 different conventional currencies are taken into consideration by applying cross-correlation, HT (hierarchical tree), and MST (minimum spanning tree) methods. The results of this work can be utilized by academicians and economists for further research related to the subject.
Western-Educated Chinese Christian Returnees, Nationalism, and Modernity: Comparison Between the Pre-1949 Era and the Post-1978 Era
Authors: Huang Yuqin
Published: February 2021

For more than 100 years, China has seen waves of students and scholars heading overseas and studying in the West as well as the concomitant returning waves. This study draws on information obtained from secondhand documents and firsthand field studies to analyze and compare two returning waves involving the complex dynamics of globalization/indigenization of Christianity in China. The first returning wave began in the early 1900s and lasted until 1950, in which many went overseas because of their connections with Western missionaries. The second returning wave is currently occurring following the study-abroad fever after 1978, in which many were exposed to the proselytizing endeavor of overseas Chinese Christian communities and eventually converted to Christianity before returning to China. The article compares the following themes in relation to these two groups of Christian returnees: their negotiation with their religious identities upon the return, perceptions on the meaning of Christianity to themselves and to China, their transnational religious networks, and potential implications to the glocalization of Christianity in China. Consequently, it involves the following topics that are important throughout the modern Chinese history: modernity/religion paradox, East–West interaction in relation to Christianity, contributions of Western-educated professionals to China, glocalization of Christianity in China, and complex internationalist/nationalist interaction.
Impact of a Yogic Breathing Technique on the Well-Being of Healthcare Professionals During the COVID-19 Pandemic
Authors: Kanchibhotla Divya , Saisudha Bharathi , Ramrakhyani Somya , Mehta Darshan H
Published: February 2021

Background

The COVID-19 pandemic has created unprecedented challenges for healthcare globally, the brunt of which has been borne by the health care providers (HCPs). These challenges are felt more keenly in India, as they stretch an insufficiently resourced healthcare system. The long hours, cross over of responsibilities, lack of resources to adequately care for patients, and concerns around safety of self and loves ones, have led to a spike in anxiety, depression, insomnia and other stress – related disorders in healthcare providers. Sudarshan Kriya Yoga (SKY) is a mind-body intervention that has been studied in multiple clinical populations. Prior to this study, there has been no exploration of the impact of SKY on healthcare providers, specifically the impact of a mind-body intervention like SKY on HCPs during a pandemic.

Objective

This study aims to investigate the impact of SKY on the well-being of HCPs during the COVID-19 pandemic.

Methods

We conducted a pilot feasibility study with a single arm pre-post design. SKY was taught to participants in a 4-day online breath and meditation workshop. We measured outcomes related to depression, anxiety, resilience, life satisfaction, and quality of sleep.

Results

Ninety-two subjects completed the study survey before and after the intervention. A significant reduction was observed in the levels of stress, anxiety and depression immediately after the program. In addition, the participants reported sig1nificant improvement in life satisfaction, resilience, and the quality of their sleep.

Conclusion

The results indicate that SKY breathing technique had a positive impact on the well-being of healthcare professionals during the pandemic. Participants experienced improved quality of sleep, enhanced satisfaction with life, and increased resilience after SKY. This pilot study provides important data for future multi-site randomized controlled trials to study the impact of yogic techniques on well-being of the HCPs.
Can We All Speak the Same ‘Language’ for Our Patients’ Sake? Feedback on Interprofessional Communication and Related Resources
Authors: Nguyen Janet , Hunter Jennifer , Smith Lorraine , Forth Amy , Tyler Amy , Furney Louise , Ee Carolyn , Harnett Joanna E
Published: February 2021

Background

The Australasian Integrative Medicine Association (AIMA) established a working group to develop the AIMA Guiding Principles for Letter Writing and Letter Writing Templates. The guiding principles were developed to promote effective communication between the diverse range of healthcare practitioners (HCPs) that patients choose to consult. Following the development of the Interprofessional Communication (IPC) resources, AIMA undertook a public consultation as part of a quality assurance process to evaluate the relevance and utility of the resource.

Aim

This study reports stakeholder feedback on AIMA’s draft guiding principles document. It explores stakeholder attitudes towards IPC and HCPs letter-writing, and interest in ongoing continuing professional development (CPD).

Methods

A cross-sectional survey involving 1) an online public consultation survey and 2) a paper survey collected following IPC CPD activities. Quantitative data were analysed using Chi square and Fisher-Freeman-Halton Test. Responses to open ended questions were coded and subject to a thematic analysis.

Results

The 64 survey participants and 55 CPD participants represented the Australian healthcare sectors and lay community. Most thought IPC is important (n = 112/117; 96%) and the resources were informative (n = 112/119; 94%), understandable (n = 111/119; 93%), and clinically relevant (n = 105/117; 90%). HCP reported wide variations in their frequency of correspondence with other practitioner types, with rates often concerningly low. Key IPC themes identified were the importance of continuity of care, clarity of communication, and professional practice. CPD participants were most interested in further IPC training (p = 0.001).

Conclusions

The IPC resources affirm the role of formal communication pathways, such as letters of correspondence to support coordinated, patient-centred and multidisciplinary care. Challenges with letter writing and IPC signal the need for more student and professional education on the subject to promote continuity of patient care and the delivery of high quality, integrative medicine and health care services.
Outcomes After Lumbar Disk Herniation Surgery in the Dutch Population
Authors: Schepens Maike H. J. , van Hooff Miranda L. , van Erkelens Judith A. , Bartels Ronald , Hoebink Eric , Smits Margot , Kuijpens Johannes L. P. , van Limbeek Jacques
Published: February 2021

Study Design:

Retrospective cohort study.

Objective:

There is only limited data on the outcome of primary surgery of lumbar disk herniation (LDH) in Dutch patients. The objective of this study is to describe undesirable outcomes after primary LDH.

Methods:

The National Claims Database (Vektis) was searched for primary LDH operations performed from July 2015 until June 2016, for reoperations within 18 months, prescription of opioids between 6 to 12 months and nerve root block within 1 year. A combined outcome measure was also made. Group comparisons were analyzed with the Student’s t-test.

Results:

Primary LDH surgery was performed in 6895 patients in 70 hospitals. Weighted mean of reoperations was 7.3%, nerve root block 6.7% and opioid use 15.6%. In total, 23.0% of patients had one or more undesirable outcomes after surgery. The 95% CI interval exceeded the 50% incidence line for 14 out of 26 hospitals with less than 50 surgical interventions per year. Although the data suggested a volume effect on undesired outcomes, the t-tests between hospitals with volume thresholds of 100, 150 and 200 interventions per year did not support this ( P values 0.078, 0.129, 0.114).

Conclusion:

This unique nationwide claims-based study provides insight into patient-relevant undesirable outcomes such as reoperation, nerve root block and opioid use after LDH surgery. About a quarter of the patients had a serious complication in the first follow up year that prompted further medical treatment. There is a wide variation in complication rates between hospitals with a trend that supports concentration of LDH care.
Effects of chitosan-collagen dressing on wound healing in vitro and in vivo assays
Authors: Zhang Min-Xia , Zhao Wan-Yi , Fang Qing-Qing , Wang Xiao-Feng , Chen Chun-Ye , Shi Bang-Hui , Zheng Bin , Wang Shou-Jie , Tan Wei-Qiang , Wu Li-Hong
Published: February 2021

The present study was designed to fabricate a new chitosan-collagen sponge (CCS) for potential wound dressing applications. CCS was fabricated by a 3.0% chitosan mixture with a 1.0% type I collagen (7:3(w/w)) through freeze-drying. Then the dressing was prepared to evaluate its properties through a series of tests. The new-made dressing demonstrated its safety toward NIH3T3 cells. Furthermore, the CCS showed the significant surround inhibition zone than empty controls inoculated by E. coli and S. aureus. Moreover, the moisture rates of CCS were increased more rapidly than the collagen and blank sponge groups. The results revealed that the CCS had the characteristics of nontoxicity, biocompatibility, good antibacterial activity, and water retention. We used a full-thickness excisional wound healing model to evaluate the in vivo efficacy of the new dressing. The results showed remarkable healing at 14th day post-operation compared with injuries treated with collagen only as a negative control in addition to chitosan only. Our results suggest that the chitosan-collagen wound dressing were identified as a new promising candidate for further wound application.
From Product to Process: The Rhetoric of Sustainability and Evolving Management Practice
Authors: Cyphert Dale
Published: February 2021

Business adopted a terminology of sustainability to defend, then justify, and finally explain practices that acknowledged resource limitations as inherent in the business environment. Tracing the rhetoric across a half century of business use demonstrates an expansion of the concept of sustainability to encompass managerial attention to finite human, capital, and political resources. A rhetoric of sustainability seemed to promise a revolution in management practice, and practitioners have indeed adopted principles of complex systems. The sustainability terminology retains its narrower focus on environmentally responsible corporate activities, however, and management communication pedagogy has not yet recognized the emerging discourse of adaptive communication practices.
The Complexity of Living with Diabetes and Urinary Incontinence for Older Adults with Multiple Chronic Conditions Receiving Home Care Services: An Interpretive Description Study
Authors: Northwood Melissa , Ploeg Jenny , Markle-Reid Maureen , Sherifali Diana
Published: February 2021

Over 40% of older adults with diabetes receiving home-care services experience urinary incontinence. However, experiential knowledge is lacking on how these older adults live with diabetes and incontinence. Interpretive description methodology was used to explore the experiences of 18 older adults with diabetes and urinary incontinence receiving home-care services in Ontario, Canada. Five themes emerged from the findings: (a) enduring urinary incontinence: “patch it in pads”; (b) struggling to manage diabetes, incontinence, and multiple chronic conditions: “a balancing act”; (c) covering the costs of care: “I can’t afford it”; (d) counting on a caregiver: “he does everything”; and (e) home-care services not meeting my needs: “it’s not individual.” These findings suggest that living with urinary incontinence and diabetes is a complex and challenging experience. This evidence could inform the provision of comprehensive home care to support self-care for this population.
Co-opted boards and earnings management: Evidence of reduced short-termist behavior
Authors: Harris Oneil , Erkan Asligul
Published: February 2021

This study contributes to the emerging literature on board co-option by examining how and to what extent co-opted directors influence managers’ attitudes about earnings management. We find robust evidence that co-option mitigates both real activities and accrual-based earnings management. Our findings support the view that higher co-option reduces managerial short-termism because it enhances managers’ job security as co-opted directors are known to be less likely to remove managers from office. Our results are robust to different measures of both co-option and earnings management, and they continue to hold after accounting for endogeneity and selection concerns. Finally, we provide additional evidence showing that a higher degree of co-option lowers the likelihood of the chief executive officer (CEO) being forcefully removed from the office for managing earnings in the previous year.

JEL CLASSIFICATION G30; G34; G39
The Devil We Know: Legal Precedent and the Preservation of Injustice
Authors: Hennes Erin P. , Dang Layla
Published: February 2021

A hallmark feature of the common law tradition is reliance on past decisions, or precedent, to resolve legal ambiguity and ensure consistency across similar cases. Yet the intent of precedent—to safeguard equity—may be undermined by nonconscious psychological processes. The behavioral and brain sciences show that decision-making can be contaminated by a human proclivity (endemic among both judges and laypeople) to justify and legitimize extant societal arrangements. Examples from case law and empirical legal studies illustrate how precedent may impede social justice in ways that are predictable from psychological theory. Highlighted in particular are barriers to justice disproportionately encountered by members of historically disadvantaged groups. The article closes with a discussion of opportunities for institutional reform and a call for continued scholarship examining the prevalence and impact of status-quo-maintaining biases in the legal system.
Elevating the Objectives of Higher Education to Effectively Serve Students From Diverse Socioeconomic Backgrounds
Authors: Destin Mesmin , Rosario R. Josiah , Vossoughi Shirin
Published: February 2021

As colleges and universities expand the socioeconomic diversity of their student populations, many policies and practices require reconceptualization to better serve all students. Recent social psychology and learning sciences research directly informs how to support the achievement and well-being of students from lower socioeconomic status backgrounds, with attention to intersecting minoritized identities. These approaches challenge assimilationist and deficit-based views of student identities in addressing factors at multiple levels of their sociocultural contexts. Building from the evidence, recommendations emphasize committing financial resources to allow for full access and participation in higher education. Also, specific faculty practices and development opportunities can enhance teaching. Finally, community emerges as a central theme; recommendations enhance student connections within and beyond the college environment.
What We Bring With Us: Investing in Latinx Students Means Investing in Families
Authors: Covarrubias Rebecca
Published: February 2021

The educational landscape of the United States has shifted as more low-income, first-generation Latinx students enroll in 4-year universities. Despite this, many underlying structures and practices of these institutions still reflect the cultural norms of culturally dominant groups (e.g., White, upper-to-middle-class, continuing-generation), privileging individualism. This overlooks the cultural values of low-income, first-generation Latinx students, who often prioritize interdependent connections and obligations. When universities do not recognize familial obligations, students must decide between helping family or doing well in school—which complicates their capacity to succeed academically. To graduate diverse future leaders and build a diverse workforce, educators and policymakers must consider that investing in students means investing in their families, too. Concrete examples, from small interventions to large-scale policy changes, illustrate meaningful investment strategies.
Promoting Gender Equality by Supporting Men’s Emotional Flexibility
Authors: Croft Alyssa , Atkinson Ciara , May Alexis M.
Published: February 2021

Progress toward gender equality has slowed or stalled in recent years, primarily because gender stereotypes and roles are changing more quickly for women than men. Women are increasingly free to behave more like men, whereas a similar freedom for men (to behave more like women) has been slower to emerge. Expectations governing men remain rigid: They are discouraged from showing weakness/vulnerability and encouraged to assert masculinity by demonstrating strength/toughness. These expectations undermine men’s emotional flexibility, which not only harms their physical health and well-being but also systematically impedes gender equality efforts. We summarize both the direct and indirect consequences of men’s relative emotional inflexibility, as well as cultural and psychological barriers to men’s emotional flexibility development. We then provide empirically based policy recommendations for cultivating emotional flexibility in men, which could in turn foster their physical and mental health, undermine traditional gender stereotypes, and promote broader gender equality in the United States.
Harnessing Visible Representation to Mitigate Bias
Authors: Shropshire Jessica L. , Johnson Kerri L.
Published: February 2021

Numerous attempts to improve diversity by way of changing the hearts of decision makers have fallen short of the desired outcome. One underappreciated factor that contributes to bias resides not in decision makers’ hearts, but instead in their minds. People possess images, or mental representations, for specific roles and professions. Which mental image or representation springs spontaneously to mind depends on the current status quo within a field. Whether or not an individual or groups’ appearance matches visual stereotypes results in perceptually mediated preferences and prejudices, both of which harbor pernicious assumptions about who belongs in a professional setting and why. Leveraging these scientific insights can enact change. Shifting visible exemplars can change people’s mental representations and their heart’s evaluative reactions to others.
Firm Size and Employment during the Pandemic
Authors: Lin Ken-Hou , Aragão Carolina , Dominguez Guillermo
Published: February 2021

Previous studies have established that firm size is associated with a wage premium, but the wage premium has declined in recent decades. The authors examine the risk for unemployment by firm size during the initial outbreak of coronavirus disease 2019 in the United States. Using both yearly and state-month variation, the authors find greater excess unemployment among workers in small enterprises than among those in larger firms. The gaps cannot be entirely attributed to the sorting of workers or to industrial context. The firm size advantage is most pronounced in sectors with high remotability but reverses in the sectors most affected by the pandemic. Overall, these findings suggest that firm size is linked to greater job security and that the pandemic may have accelerated prior trends regarding product and labor market concentration. They also point out that the initial policy responses did not provide sufficient protection for workers in small and medium-sized businesses.
The Relative Effects of Prazosin on Individual PTSD Symptoms: Evidence for Pathophysiologically-Related Clustering
Authors: Hendrickson Rebecca C. , Millard Steven P. , Pagulayan Kathleen F. , Peskind Elaine R. , Raskind Murray A.
Published: February 2021

Background

The α1-adrenoreceptor antagonist prazosin has in many but not all studies been found to be effective for PTSD associated nightmares, hyperarousal symptoms, and total symptom severity. The particular efficacy of prazosin for nightmares and hyperarousal symptoms suggests there may be a subset of PTSD symptoms that are more tightly associated with an α1-adrenoreceptor mediated noradrenergic mechanism, but cross traditional diagnostic symptom clusters. However, the efficacy of prazosin for individual symptoms other than nightmares and sleep disruption has not previously been examined.

Methods

In a post hoc reanalysis of a previously published, randomized controlled trial of twice daily prazosin for PTSD, we examined the relative effect of prazosin on individual items of the CAPS for DSM-IV, and tested whether prazosin responsiveness predicted the partial correlation of the changes in symptom intensity at the level of individual subjects. Results were not adjusted for multiple comparisons.

Results

Prazosin showed the largest effect for distressing dreams, anhedonia, difficulty falling or staying asleep, difficulty concentrating, and hypervigilance. These items were also (a) of higher baseline severity in the underlying population, and (b) more related in how they fluctuated at the level of individual subjects. Covariance analysis did not support a clear cutoff between highly prazosin responsive items and those showing a smaller, not statistically significant response.

Conclusions

In this data set, twice daily prazosin substantially reduced not only nightmares and sleep disruption, but the majority of hyperarousal symptoms, with some evidence of efficacy for avoidance symptoms. The relationship of baseline symptom distribution to which symptoms showed significant response to prazosin reinforces the possibility that differences in a clinical trial’s participant populations may significantly influence trial outcome. The pattern of symptom endorsement at the level of individual subjects was consistent with prazosin-responsive items sharing a common pathophysiologic mechanism.
Editorial: Special Issue on Interdisciplinary and Experiential Entrepreneurship Education
Authors: Winkler Christoph , Winkel Doan , Shields Julienne , Barber Dennis , Levin Donna , J. Zane Lee
Published: February 2021

A group of six colleges and universities (East Carolina University, Iona College, John Carroll University, Millikin University, Rowan University, Worcester Polytechnic Institute) partnered up to co-host the January 2020 USASBE Conference in New Orleans, LA, with the theme Interdisciplinary & Experiential Entrepreneurship Education. The conference thematically aligned its overall program with this special issue, which features scholars and programs representing the arts, design, engineering, liberal arts, physical sciences, STEM, and – yes – business. This editorial further discusses the importance of interdisciplinary entrepreneurship education as an inherent feature of itself to truly evolve as a discipline.
Impact of indirect education on knowledge and perception on cervical cancer and its prevention among the parents of adolescent girls: an interventional school-based study
Authors: Jacob Rony Abraham , Abraham Priya Srambical , Thomas Feba Rachel , Navya Vytila , Sebastian Juny , Ravi Mandyam Dhati , Gurumurthy Parthasarathi
Published: February 2021

Background:

India has almost 225 million adolescent girls and they seem to be at a disadvantage, both economically and by their lack of knowledge on human papilloma virus (HPV) vaccine, when compared to adolescent girls of other Asian countries.

Aim:

To assess the prevalence of HPV vaccination and to identify the impact of education in improving the knowledge and perception about the HPV infection and vaccination among the parents of adolescent girls.

Methodology:

The prospective interventional study was conducted in four schools within a South Indian City, Mysuru. The informed consent form and the questionnaire were sent home with the identified adolescent girls during the pre-interventional phase. Educational sessions were conducted for the students in their school and an education leaflet was distributed to their parents. Three weeks later, questionnaires were re-administered to the parents via the enrolled girls and their responses were collected.

Results:

The prevalence of HPV vaccination in the study population was 4.4%. There was a statistically significant improvement in knowledge in the post-interventional phase of the study ( p = 0.001), but could not identify a significant change in their perception ( p = 0.479). Parents belonging to the socioeconomic class of upper middle and upper lower showed better improvement at the end of the study, with a percentage improvement of 58.93% and 48.44%, respectively.

Conclusion:

The study proved that the healt care professional can target school children to communicate effectively to their parents on the importance of HPV vaccine as the study clearly observed a positive behavioral change among the study population.
Information-driven Supply Chain During a Catastrophic Event: COVID-19 Pandemic
Authors: Safa Mahdi , Sharma Nomita , Zelbst Pamela
Published: February 2021

We learn painful lessons these days about the hidden weaknesses in the supply chains, while the surge reflects a new inflection point of the COVID-19 outbreak. Healthcare experts, politicians, academics, and supply chain practitioners need to collaborate to build a reform agenda and roadmap for our humanitarian supply chain. This study aims at investigating and assessing risks on the supply chain, especially for health care supplies. The theme of the article is based on the development of an information-driven model to help in the assessment of supply chain risk. An integrative review technique has been used to analyze literature to develop prepositions for the model. The main actors of the model are supply chain preparedness, supply chain risk, supply chain response, and supply chain recovery. The findings identify that timely preparation and assessment of supply chain risk can result in accurate adoption of the practices that can not only reduce supply chain risk but also enhance supply chain recovery during any catastrophic event.
Prognostic factors of resectable perihilar cholangiocarcinoma: a systematic review and meta-analysis of high-quality studies
Authors: Liang Lei , Li Chao , Jia Hang-Dong , Diao Yong-Kang , Xing Hao , Pawlik Timothy M. , Lau Wan Yee , Shen Feng , Huang Dong-Sheng , Zhang Cheng-Wu , Yang Tian
Published: February 2021

Data on prognostic factors associated with outcome following resection of perihilar cholangiocarcinoma vary. We sought to define and characterize current available evidence on prognostic factors associated with perihilar cholangiocarcinoma after resection. The PubMed, Embase, and Cochrane library were systematically searched for relevant studies published before December 2019. Prognostic factors were identified from multivariate regression analyses in studies. Only high-quality studies were included (Newcastle–Ottawa Scale > 6 stars). A total of 45 studies involving 7338 patients were analyzed. The meta-analysis demonstrated that serum bilirubin levels (hazard ratio: 1.76, 95% confidence interval: 1.27–2.44), serum CA19-9 levels (hazard ratio: 1.32, 95% confidence interval: 1.05–1.65), tumor size (hazard ratio: 1.27, 95% confidence interval: 1.04–1.55), major vascular involvement (hazard ratio: 1.61, 95% confidence interval: 1.09–2.38), distance metastasis (hazard ratio: 17.60, 95% confidence interval: 2.01–154.09), perioperative blood transfusion (hazard ratio: 1.36, 95% confidence interval: 1.15–1.62), T-stage (hazard ratio: 1.96, 95% confidence interval: 1.47–2.61), lymph node metastasis (hazard ratio: 2.06, 1.83–2.31), resection margin status (hazard ratio: 2.34, 95% confidence interval: 1.89–2.89), not-well histology differentiation (hazard ratio: 2.03, 95% confidence interval: 1.69–2.44), perineural invasion (hazard ratio: 2.37, 95% confidence interval: 1.59–3.55), and lymphovascular invasion (hazard ratio: 1.41, 95% confidence interval: 1.15–1.73) were prognostic factors for poorer overall survival. Adjuvant chemotherapy (hazard ratio: 0.37, 95% confidence interval: 0.25–0.55) had a positive effect on prolonged overall survival. In addition, positive resection margin status (hazard ratio: 1.96, 95% confidence interval: 1.47–2.61) and lymph node metastasis (hazard ratio: 2.06, 95% confidence interval: 1.83–2.31) were associated with poorer disease-free survival. The prognostic factors identified in the present meta-analysis can be used to characterize patients in clinical practice and enrich prognostic tools, which could be included in future trial designs and generate hypotheses to be tested in future research to promote personalized treatment.
Prognostic Impact of Sphingosine Kinase 1 in Nonsmall Cell Lung Cancer
Authors: Motono Nozomu , Ueda Yoshimichi , Shimasaki Miyako , Iwai Shun , Iijima Yoshihito , Usuda Katsuo , Uramoto Hidetaka
Published: February 2021

Bioactive sphingolipid is clearly relevant to lung physiology. The relationship of the bioactive sphingolipid pathway to pulmonary disease has been studied in cellular, tissue, and animal model, including lung cancer models. The samples of 53 patients diagnosed with nonsmall cell lung carcinoma (NSCLC) between June 2009 and May 2014 at our hospital were analyzed. Immunohistochemical (IHC) analysis was performed. The degree of immunostaining was reviewed and scored. Using this method of assessment, we evaluated the IHC score of sphingosine kinase 1 (SPHK1), vimentin, E-cadherin, and Ki-67. Both invasive adenocarcinoma cell and squamous cell carcinoma cell were well stained by SPHK1, and fibroblasts were also well stained by SPHK1. Although the IHC score of SPHK1 was not significantly differed between invasive adenocarcinoma and squamous cell carcinoma, the IHC scores of fibroblast, vimentin, and Ki-67 were higher in squamous cell carcinoma than invasive adenocarcinoma. Correlation among IHC scores in each of invasive adenocarcinoma and squamous cell carcinoma was performed. SPHK1 had positive correlation with both fibroblast and Ki-67, and fibroblast and Ki-67 had also positive correlation in invasive adenocarcinoma. On the contrary, SPHK1 had no significant correlation with fibroblast, and had negative correlation with Ki-67 in squamous cell carcinoma. Although there was not significant prognostic difference in SPHK1 score ( P = .09), IHC score high group tended to be worse on relapse-free survival. SPHK1 might be prognostic factor in lung-invasive adenocarcinoma and novel target for drug against lung-invasive adenocarcinoma.
Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor
Authors: Souza da Silva Ricella M , Queiroga Eduardo M , Paz Alexandre R , Neves Fabiana F P , Cunha Karin S , Dias Eliane P
Published: February 2021

The tumor stroma plays a relevant role in the initiation and evolution of solid tumors. Tumor-stroma ratio (TSR) is a histological feature that expresses the proportion of the stromal component that surrounds cancer cells. In different studies, the TSR represents a potential prognostic factor: a rich stroma in tumor tissue can promote invasion and aggressiveness. The aim of this study was to evaluate the reproducibility and determine the interobserver agreement in the TSR score. The stromal estimate was evaluated in patients diagnosed with colorectal adenocarcinoma (CRA), who underwent surgical resection. We also evaluated age, gender, and other anatomopathological features. Tumor-stroma ratio was calculated based on the slide used in routine diagnostic pathology to determine the T-status. Stromal percentages were separated into 2 categories: ⩽50%—low stroma and >50%—high stroma. The interobserver agreement in the TSR scoring was evaluated among 4 pathologists at different stages of professional experience, using 2 different ways to learn the scoring system. In total, 98 patients were included in this study; 54.1% were male, with a mean age of 61.9 years. Localized disease was diagnosed in 60.2% of patients. Stromal-poor CRA was predominant. The concordance between the TSR percentages of the 4 pathologists was substantial (Kappa > 0.6). There was greater agreement among pathologists for stromal-poor tumors. Substantial agreement and high reproducibility were observed in the determination of TSR score. The TSR score is feasible, suggesting that the presented methodology can be used to facilitate the determination of the stromal proportion of potential prognostic factor.
Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors
Authors: Bous Rany M. , Kumar Anand , Valiathan Manish
Published: February 2021

Cleft lip and Palate (CLP) is the most common craniofacial condition. Management of patients with clefts often requires multi-disciplinary rehabilitation of the orofacial structures. This case report demonstrates the multi-disciplinary management of an adult with a cleft lip and palate, highlighting the benefits of 3-Dimensional (3D) diagnosis, treatment planning and clinical execution of the plan. The patient presented with a severe maxillary deficiency, mandibular asymmetry, and congenitally missing maxillary right central and lateral incisors. This case report demonstrates an alternative approach for the management of cases with ipsilateral missing central and lateral incisors. The maxillary right canine substituted the congenitally missing maxillary right central incisor, while the maxillary right first premolar substituted the congenitally missing right lateral incisor, eliminating the need for prosthetic replacements. Total treatment time was 19 months, and the burden of care for the patient was minimized. An acceptable occlusion was achieved, and the patient’s esthetics improved significantly at the end of treatment. More importantly, the patient reported a marked improvement in his quality of life.
Seismic performance of a retrofitted heritage unreinforced masonry building during the 2010/2011 Canterbury earthquakes
Authors: Misnon Aina Noor , Abeling Shannon , Hare John , Shedde Devina , Jafarzadeh Reza , Ingham Jason , Dizhur Dmytro
Published: February 2021

The Heritage Hotel (formerly Old Government Buildings) is one of the architectural heritage icons of Christchurch, New Zealand. Seismic retrofitting was undertaken on the structure in 1995 to achieve the earthquake loading provisions of the 1992 standard for design loadings (NZS 4203:1992). This building is a distinguished 1909 unreinforced masonry Italian High Renaissance palazzo building. The retrofit work included the installation of new lateral load-resisting structural systems, refurbishment of individual building elements, and partial building demolition with a total cost of approximately NZ$3.75 million. Detailed observations following the 2010/2011 Canterbury earthquakes showed that the building was subject to only minor damage during the September 2010 earthquake, whereas the February 2011 event caused some damage to exterior stonework and flooding in the basement due to liquefaction. This damage was easily repaired, and the building was fully functional by September 2013. Reported herein are details showcasing the success of the seismic retrofit and post-earthquake performance observations.
Sonourethrography With Pharmaco-Penile Doppler in Penile Fractures: A Complete and Productive Imaging Combination
Authors: Agarwal Arjit , Raj Singh Manish , Joon Pawan
Published: February 2021

Penile fracture is a rare urological emergency requiring prompt diagnosis and management. The role of high-resolution ultrasonography is established in detecting a tear, in the tunica albuginea. The late complications of penile fracture are distressing and may manifest as asymmetrical and insufficient penile tumescence, penile ischemia, and sometimes urethral stenosis. The current case series demonstrates the combined role of post-papaverine penile Doppler duplex ultrasonography and sonourethrography techniques in assessing the late presenting cases of penile fractures. The combination of these two techniques was found to be a useful comprehensive imaging tool. This combination can be employed in clinical practice to define the extent of trauma and penile insufficiency, in an efficient manner.
Europe’s evolving graduate labour markets: supply, demand, underemployment and pay
Authors: Green Francis , Henseke Golo
Published: February 2021

For most students the aspiration to gain employment in a graduate job is the main motivation for going to university. Whether they fulfil this aspiration depends considerably on national graduate labour markets. We analyse the comparative evolution of these markets across Europe over the decade leading up to 2015, focusing on supply, graduate/high-skilled jobs, underemployment, wages, the graduate wage premium and the penalty for underemployment. The supply of tertiary graduates increased everywhere and converged, and this upward convergence is forecast to persist. In contrast the growth of graduate jobs was slower, not ubiquitous and nonconvergent. Underemployment was spreading, though at a modest rate; this rise was convergent but not ubiquitous. The rise was most substantial in Slovenia, Slovakia, the Czech Republic, Poland, Italy and Greece. Graduates’ real wages trended predominantly downward, but varied a great deal between countries. The graduate wage premium declined by more than one percentage point in seven countries. Inferences are drawn for the formation of education policy, for the broader discourse on HE, and for research on graduate futures.
One-step generation of a targeted knock-in calf using the CRISPR-Cas9 system in bovine zygotes
Authors: Owen Joseph R. , Hennig Sadie L. , McNabb Bret R. , Mansour Tamer A. , Smith Justin M. , Lin Jason C. , Young Amy E. , Trott Josephine F. , Murray James D. , Delany Mary E. , Ross Pablo J. , Van Eenennaam Alison L.
Published: February 2021

Background

The homologous recombination (HR) pathway is largely inactive in early embryos prior to the first cell division, making it difficult to achieve targeted gene knock-ins. The homology-mediated end joining (HMEJ)-based strategy has been shown to increase knock-in efficiency relative to HR, non-homologous end joining (NHEJ), and microhomology-mediated end joining (MMEJ) strategies in non-dividing cells.

Results

By introducing gRNA/Cas9 ribonucleoprotein complex and a HMEJ-based donor template with 1 kb homology arms flanked by the H11 safe harbor locus gRNA target site, knock-in rates of 40% of a 5.1 kb bovine sex-determining region Y (SRY)-green fluorescent protein (GFP) template were achieved in Bos taurus zygotes. Embryos that developed to the blastocyst stage were screened for GFP, and nine were transferred to recipient cows resulting in a live phenotypically normal bull calf. Genomic analyses revealed no wildtype sequence at the H11 target site, but rather a 26 bp insertion allele, and a complex 38 kb knock-in allele with seven copies of the SRY-GFP template and a single copy of the donor plasmid backbone. An additional minor 18 kb allele was detected that looks to be a derivative of the 38 kb allele resulting from the deletion of an inverted repeat of four copies of the SRY-GFP template.

Conclusion

The allelic heterogeneity in this biallelic knock-in calf appears to have resulted from a combination of homology directed repair, homology independent targeted insertion by blunt-end ligation, NHEJ, and rearrangement following editing of the gRNA target site in the donor template.

This study illustrates the potential to produce targeted gene knock-in animals by direct cytoplasmic injection of bovine embryos with gRNA/Cas9, although further optimization is required to ensure a precise single-copy gene integration event.