bluuebunny/crossref_metadata_2025 huggingface dataset:
Liberal Democracy on the Edge? Anxieties in a Shifting Global (dis)order
Authors: Kutlay Mustafa , Öniş Ziya
Published: May 2022

The future of liberal democracy appears to be uncertain. This article develops a holistic approach to examine the prospects of liberal democracy by focusing on how three main regime types—that is, “established democratic regimes,” “hybrid regimes,” and “established authoritarian regimes”—interact with each other. We argue structural global political economy trends, which largely created the current authoritarian populist tide, remain strong despite signs of democratic renewal emerged with the recent new green Keynesian turn in established Western democracies, a more unified transatlantic response to the Russian invasion of Ukraine and growing political-economic fragility of key hybrid regimes ruled by authoritarian populist leaders. Also, the resilience of various types of autocracies which co-exist and reinforce one another through economic linkages and political coalitions should not be underestimated, especially demonstrative effects of the Russia–China partnership. Both democratic and authoritarian forms of capitalism face serious problems of income and wealth inequality, raising challenges over “performance legitimacy” in both regime types. In this context, the performance and political-economic orientation of hybrid regimes will have a crucial bearing on the fortunes of liberal democracy on a global scale.
Transformative Learning Theory and Its Application to the Delivery of Community Maintenance Programs for Men Who Have Sexually Offended
Authors: Youssef Carollyne
Published: May 2022

Given public perceptions about those who have sexually offended, there tends to be a focus on offence-specific intervention programs in a bid to address re-offending risk. With a significant portion of the literature on sexual offending focused on the development and evaluation of interventions targeting this behavior, there is little that considers community maintenance programs (CMPs) or those programs in the community where those who are released from prison are attempting to reintegrate. Further, there is no known research considering the theoretical underpinnings of or a framework for delivering CMPs. This paper offers Transformative Learning Theory as a potential framework for the delivery of CMPs and offers that adult learning theory needs to be considered in the delivery of offending interventions.
Surgical Management of Jones Fractures in Athletes: Orthobiologic Augmentation: A Systematic Review and Meta-analysis of 718 Fractures
Authors: Attia Ahmed Khalil , Robertson Greg A.J. , McKinley John , d’Hooghe Pieter P. , Maffulli Nicola
Published: May 2022

Background:

The use of orthobiologics is expanding. However, the use of orthobiologic augmentation in primary fracture fixation surgery remains limited. Primary fracture fixation of the fifth metatarsal (Jones) in athletes is one of the rare situations where primary orthobiologic augmentation has been advocated.

Purpose:

To determine the effect of orthobiologic augmentation on the outcome of surgically managed Jones fractures in athletes.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 2 independent team members searched several databases including PubMed, MEDLINE, Embase, Google Scholar, Web of Science, Cochrane Library, and ClinicalTrials.gov through March 2021 to identify studies reporting on surgically managed Jones fractures of the fifth metatarsal exclusively in athletes. The primary outcomes were the return to play (RTP) rate and time to RTP, whereas the secondary outcomes were time to union, union rate, and refractures. Data were presented by type of treatment (biologically augmented fixation or fixation alone).

Results:

In the biologically augmented fixation group, successful RTP was reported in 195 (98.98%) of 197 fractures (odds ratio [OR], 97.5%; 95% CI, 95.8%-100%; I2 = 0), with a mean time to RTP of 10.3 weeks (95% CI, 9.5-11.1 weeks; I2 = 99%). In the group that received fixation without biological augmentation, successful RTP was reported in 516 (99.04%) of 521 fractures (OR, 98.7%; 95% CI, 97.8%-99.7%; I2 = 0], with a mean time to RTP of 9.7 weeks (95% CI, 7.84-11.53 weeks; I2 = 98.64%]. In the biologically augmented fixation group, fracture union was achieved in 194 (98.48%) of 197 fractures (OR, 97.6%; 95% CI, 95.5%-99.7%; I2 = 0%), with a mean time to fracture union of 9.28 weeks (95% CI, 7.23-11.34 weeks; I2 = 98.18%). In the group that received fixation without biological augmentation, fracture union was achieved in 407 (93.78%) of 434 fractures (OR, 97.4%; 95% CI, 96%-98.9%; I2 = 0%), with a mean time to fracture union of 8.57 weeks (95% CI, 6.82-10.32 weeks; I2 = 98.81%).

Conclusion:

Orthobiologically augmented surgical fixation of Jones fractures in athletes is becoming increasingly common, despite the lack of comparative studies to support this practice. Biologically augmented fixation of Jones fractures results in higher fracture union rates than fixation alone but similar rates of RTP and time to RTP. Although the current evidence recommends primary surgical fixation for the management of Jones fractures in athletes, further high quality comparative studies are required to establish the indication for orthobiologic augmentation.
Exploring the views of Iranian planning professionals on children’s active involvement in urban planning
Authors: Manouchehri Bahar , Burns Edgar A , Davoudi Sina , Sharifi Ayyoob
Published: May 2022

This article explores the extent to which urban planning professionals in Iran are prepared to facilitate children’s inclusion in city decision-making. What do Iranian planners believe about the potential effectiveness of children’s inclusion? Evidence from research in Mashhad elicited ambivalent reactions on the part of planners. They held conflicting viewpoints on children’s involvement from various perspectives, including its feasibility, its value to children and to the planning system, and its implications for their own roles. There was evidence, however, that planners’ current purpose could change from passively instrumental roles to advocacy, partnership and communication. The paper considers how the functioning of the larger planning system might incorporate child-participation initiatives, facilitating a more democratic approach to planning and citizen participation in urban environments.
Short-term effectiveness and tolerability of carbon dioxide laser for anal high-grade squamous intraepithelial lesions in individuals living with HIV
Authors: Fuertes Irene , Chivite Iván , Cranston Ross D , Sánchez Emilia , Cordón Encarna , Rodríguez-Carunchio Leonardo , Blanco José L
Published: May 2022

Background:

Ablative treatment of intra-anal high-grade squamous intraepithelial lesions (HSIL) reduces the risk of progression to anal squamous cell carcinoma. Our objective was to assess the short-term effectiveness and tolerability of the carbon dioxide laser for treating intra-anal HSIL in patients at high risk of anal cancer.

Methods:

This is an exploratory, pilot, single-arm, clinical trial of treatment response for anal HSIL in people living with HIV diagnosed with ≤3 not previously treated HSILs. Individuals were treated with one carbon dioxide laser treatment session. Clinical assessment by high resolution anoscopy and systematic recording of adverse events was performed.

Results:

Fifty-two patients with 72 HSILs were included. Response to treatment was assessed in 48 (92.3%) patients; in the per-protocol population analysis, complete, partial, and no response was seen in 50% ( n = 24), 20.8% ( n = 10) and 29.1% ( n = 14), respectively. Being older than 40 years and having a CD4 T-cell count lower than 200 cells/μL at diagnosis of HSIL were significantly associated with a poor response to treatment. Data on adverse events was recorded for 49 patients and 69.4% ( n=34) reported no symptoms after the procedure.

Conclusions:

Carbon dioxide laser ablation is a promising and well tolerated treatment for intra-anal HSIL.
Evaluating specimen pooling for Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium screening in asymptomatic men who have sex with men
Authors: Moran Angelica , Gipson Monique , Hazra Aniruddha , Tesic Vera
Published: May 2022

Background

Screening for Neisseria gonorrhoeae and Chlamydia trachomatis is recommended for individuals at high-risk for sexually transmitted infections (STIs), while the role of Mycoplasma genitalium screening is still unclear. We evaluated whether specimen pooling is an effective alternative for sexually transmitted infection testing during resource shortages.

Methods

This 2-year prospective study enrolled 135 asymptomatic patients from a community outreach site who identified as men who have sex with men. Oropharyngeal, urine, and/or rectal swab specimens were pooled and tested using the Aptima Combo 2 assay for Neisseria gonorrhoeae and Chlamydia trachomatis. The Aptima Mycoplasma genitalium assay was performed on 34 patients whose specimens had sufficient sample volume for additional testing. Results from pooled specimens were compared to results obtained by individual-site testing.

Results

The positive percent agreement (PPA) between pooled testing and individual-site testing was 93.8% and negative percent agreement (NPA) was 100% for Neisseria gonorrhoeae. For Chlamydia trachomatis, the PPA was 85.7% and NPA was 99.2%. A PPA of 72.7% and NPA of 95.7% were observed for Mycoplasma genitalium. Discrepancy analysis revealed the majority of false-negative pools were from failure to detect positive rectal samples.

Conclusions

Specimen pooling reduces sensitivity of the Aptima assays for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium and thus should be used with caution.
Factors associated with non-use of condoms among heterosexually-active single people in Germany: Results from the first representative, population-based German health and sexuality survey (GeSiD)
Authors: Cerwenka Susanne , Wiessner Christian , Mercer Catherine H , Matthiesen Silja , Pietras Laura , von Rüden Ursula , Dekker Arne , Briken Peer
Published: May 2022

Background: Against the backdrop of rising STI incidence among the heterosexual population, sexually active single people are at particularly high STI transmission risk. Gaining insight into circumstances related to condoms non-use in this population is therefore important for developing effective health interventions. Methods: The nationally-representative survey, GeSiD (German Health and Sexuality Survey) undertaken 2018–2019, interviewed 4,955 people aged 18–75 years. A total of 343 heterosexually-active single participants answered a question about condom use at last sex. Data on sociodemographic characteristics, sexual behaviours and circumstances of last sex were analysed to identify independently associated factors. Results: Condom non-use at last sex was reported more commonly by participants aged >35 years than by younger participants (48.5 vs 33.7%, respectively) and more likely among longer relationships (adjusted odds ratio [AOR]: 2.43) or early loving relationships (AOR: 3.59) than in one-night-stands. It was also associated with not discussing using condoms before sex (AOR: 6.50) and with reporting non-use of condoms at sexual debut (AOR: 4.75). Conclusions: Non-use of condoms is a common STI risk behaviour among heterosexually-active single people in Germany and so needs promoting from sexual debut throughout the life course, regardless of relationship type and age, but particularly among middle-aged and older people.
Association between interferon-I producing plasmacytoid dendritic cells and thrombotic antiphospholipid syndrome
Authors: Rosa dos Santos Ana Paula , de Oliveira Vaz Camila , Hounkpe Bidossessi Wilfried , Jacintho Bruna Cardoso , Oliveira José Diogo , Tripiquia Vechiatto Mesquita Gabriela Lisiane , Pereira dos Santos Irene , Annichino-Bizzacchi Joyce , Appenzeller Simone , de Moraes Mazetto Fonseca Bruna , Orsi Fernanda Andrade
Published: May 2022

Background: Thrombotic risk in antiphospholipid syndrome (APS) is conferred by the association of antiphospholipid (aPL) antibodies (first hit) with additional pro-coagulant stimulus (second hit), such as inflammation. Among inflammatory responses, the production of large amounts of interferon (IFN)-I by plasmacytoid dendritic cells (pDCs) is at the basis of the pathophysiology of systemic autoimmune disorders, which raises the hypothesis that this mechanism could also be associated with vascular manifestations of APS. Purpose: Here, we determined the association of pDCs and IFN-I production with thrombotic APS. Research design: Patients with thrombotic primary (t-PAPS) and secondary APS (t-SAPS), asymptomatic aPL carriers and individuals without thrombosis (controls) were included. Data collection and analysis: Circulating pDCs and IFN-α intracellular expression (in the presence or not of oligodeoxynucleotides (CP) stimulus) were quantified by flow cytometry. The expression of five IFN-I inducing genes: ISG15, OASL, Ly6E, MX1, and OAS1 in mononuclear cells was determined by qPCR. Between-group differences were evaluated using chi-square or Kruskal–Wallis tests. Results: A total of 50 patients with t-PAPS, 50 patients with t-SAPS, 20 aPL carriers, and 50 individuals without thrombosis (controls) were included. Intracellular expression of IFN-α was increased after CPG stimulation in both t-SAPS (1.56%; IQR 1.07–2.02) and t-PAPS (0.96%; IQR 0.55–1.24), when compared to aPL carriers (0.71%; IQR 0.42–0.93) and controls (0.48%; IQR 0.24–0.78; p < .0001). ISG15, OASL, Ly6E, MX1, and OAS1 mRNA expressions were higher in t-SAPS (but not in t-PAPS) than in aPL carriers and controls. The expression of proteins and mRNA related to IFN-I response was similar between the triple aPL-positive profile and other aPL profiles. Conclusion: Our results indicate an association of IFN-I response and t-APS. Since IFN-I expression was not increased in aPL carriers or associated with a higher-risk aPL profile, this mechanism does not appear to be related to the presence of aPL alone. IFN-I response could possibly constitute a complementary mechanism for triggering clinical manifestations in APS.
Effective Employee Engagement During COVID-19: Driver for Employee Well- Being in the Long Run
Authors: Kaur Simran , Sharma Richa
Published: May 2022

The term “employee engagement” represents a broad construct which covers various facets of human resource management, focusing on the strategic initiatives being undertaken by organizations to build trust and reputation among its employees. Despite of the available text on the subject, concrete explanation of the concept still remains. Although much has been written on the subject, yet it remains inconsistently defined and conceptualized. It is a strong factor that impacts employee’s commitment towards the organization, his wellness, and job performance, further laying the foundation of organizational success. It becomes even more relevant in the current time of pandemic when the entire world is facing turbulence and there is a lot of apprehension in the mind of the employees in regard of their financial stability and job security. This article attempts to explore, compile, and present the various engagement strategies generally adopted by companies and newer approaches used during this COVID-19 period using an integrated and comprehensive literature review on the basis of research papers, blogs, articles, newsletters, and reports of various organizations.
Feasibility and Burden of Lay Caregivers Providing Daily Massages to Patients With Cancer Receiving Hospice and Palliative Care
Authors: Moosvi Karen , Schoppee Tasha M. , Xavier Stacy , Henderson Kristen , Suarez Marie L. , Yao Yingwei , Wilkie Diana J.
Published: May 2022

Professional massages reduce symptoms experienced by cancer patients, but are costly. A cost-effective way to include this therapy routinely in hospice care is to teach family caregivers to give massages as part of their caregiving activities. However, the burden on caregivers is unknown and might offset patient benefits or cost savings. The pilot study aim was to explore feasibility issues related to licensed massage therapists training caregivers to give massages at home, the burden of giving four daily massages to hospice patients, and feedback about the training and massage delivery. In this pretest/posttest study, caregivers completed the Caregiver Reaction Assessment (CRA), received training on standardized massage techniques from a licensed massage therapist who evaluated their proficiency the following day. Caregivers gave daily massages for 3 days and afterward completed the CRA. Then a researcher interviewed the dyad for feedback about the training and massage delivery. We used paired t tests to evaluate CRA scores and content analysis of interview data. Thirty-nine caregivers (mean age = 46 years, 69% female) completed the study. After training, all but three caregivers provided daily massages. Some caregivers reported minor logistical challenges in massage delivery and documentation, mutual satisfaction, relaxation, and tender moments ranging from laughter and story sharing to closure activities. Mean CRA scores were not significantly different pretest to posttest. We conclude that repeated-dose massages by caregivers to patients dying of cancer is feasible and is worthy of further study to determine the benefits of massage therapy, caregiver and patient experiences, and caregiver burden.
Adaptive fuzzy observer-based mismatched faults and disturbance design for singular stochastic T-S fuzzy switched systems
Authors: Yan Yuqing , Zhang Huaguang , Sun Jiayue , Wang Yingchun
Published: May 2022

This paper deals with the problem of observer-based mismatched faults for switched singular fuzzy systems subject to disturbances. First, in order to obtain the estimation of unmeasurable or partially measurable states, fuzzy adaptive observer is obtained, eliminating the influence of external disturbances and mismatched faults, simultaneously. Second, by constructing appropriate piecewise Lyapunov functions and average dwell time, the switched singular fuzzy stochastic system with external parameter perturbations and faults is guaranteed to be robustly stable Further, by solving the linear matrix inequalities a sufficient condition to maintain the stability of error dynamic system is presented. Finally, to illustrate the proposed method is available, numerical examples are presented.
The Impact of Metabolic Syndrome on Quality of Life Among Individuals With Knee Osteoarthritis Living in Egypt
Authors: Samaan Sara F. , Taha Sara I.
Published: May 2022

Background:

Several studies have linked metabolic syndrome (MetS) to osteoarthritis (OA), but they have not looked into how MetS can affect the health-related quality of life (HRQOL) of OA individuals.

Objectives:

We aimed to assess the association of MetS and its components, including obesity, hypertension, hyperglycemia, and dyslipidemia, with HRQOL among Egyptians with knee OA.

Methods:

This cross-sectional study comprised 116 adult Egyptian participants with knee OA. They were divided into 2 groups based on whether or not they had the MetS. All participants were subjected to a thorough medical history taking and a detailed medical examination. The Kellgren and Lawrence (K/L) scale evaluated OA in all individuals using anteroposterior knee radiographs. The Health Assessment Questionnaire-Disability Index (HAQ-DI) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess participants’ HRQOL; their higher scores indicate more disability. Spearman rank and Pearson’s correlation analyses were used to assess the association between variables.

Results:

Diabetes, hypertension, dyslipidemia, and obesity were significantly associated with the OA + MetS group with a prevalence of 77.6%, 82.8%, 77.6%, and 50.0%, respectively. According to the K/L scale, 70.7% of the OA + MetS group had grade IV knee affection. The HAQ-DI and WOMAC scores were significantly ( P < .001) higher among the OA + MetS individuals compared with the OA individuals. Interleukin (IL)-6 serum levels were also significantly higher in the OA + MetS group ( P = .036) and increased significantly with the more serious radiological damage and functional disability. We found significant positive correlations between HAQ-DI and WOMAC with waist circumference ( P = .004, .001), as well as triglycerides ( P = .006, .008), cholesterol ( P = .041, .048), fasting blood sugar ( P < .001, < .001) and significant negative correlations with high-density lipoprotein levels ( P = .628, .002).

Conclusions:

Individuals with knee OA with MetS showed more significant radiological damage, severe functional disability, and poor HRQOL. They also had higher levels of IL-6, which correlated significantly with the degree of disability, promoting it as a significant therapeutic target.
Support for European Union membership comes in various guises: Evidence from a Correlational Class Analysis of novel Dutch survey data
Authors: van den Hoogen Elske , Daenekindt Stijn , de Koster Willem , van der Waal Jeroen
Published: May 2022

While ample research has scrutinised the causes and consequences of support for the European Union, a pressing question remains: what do people actually mean when they express support for, or opposition to, their country’s membership of the institution? We use Correlational Class Analysis to assess this. Our analysis of high-quality representative Dutch survey data ( n = 2053), including novel items informed by in-depth qualitative research, reveals that European Union support comes in three guises: federalist, non-federalist and instrumental-pragmatist Strikingly, many Europhiles are not federalists. In addition, we reveal that the social bases of the three types of support especially differ regarding political competence, political orientation, and media consumption. The implications for ongoing debates on European Union atttidues are discussed.
How can each brand’s buyer base buy the category at above the average rate?
Authors: Dawes John G
Published: May 2022

An apparent anomaly in brand metrics data is that the aggregated buyer base of each brand appears to buy the category at above the average rate. This seems arithmetically impossible. The effect is real, but it has a simple explanation. It is caused by the fact that heavy category buyers buy more brands than light buyers do. They therefore appear in the buyer base of multiple brands, and so inflate the category buying rate for each brand to above the overall average rate. This study shows what it calls the ‘category purchase rate anomaly’ in empirical data, as well as demonstrating how it occurs via a simulated dataset.
A novel method for steel bar all-stage pitting corrosion monitoring using the feature-level fusion of ultrasonic direct waves and coda waves
Authors: Sun Xiangtao , Zhang Minghui , Gao Weihang , Guo Chuanrui , Kong Qingzhao
Published: May 2022

Corrosion monitoring of steel bars has drawn extensive attention in recent decades. Conventional ultrasonic method, utilizing direct waves to detect damage, is adequate for severe pitting corrosion but suffers from low sensitivity to incipient pitting corrosion. Coda wave technique, a very sensitive method to subtle changes in medium using later arrival wave packets, is innovatively introduced to monitor pitting corrosion of steel bars, especially in the early stages. The decorrelation coefficient (DC) values are calculated to quantify the variations of both direct waves and coda waves. To overcome the limitations of coda waves for severe pitting corrosion and remedy the low sensitivity of direct waves for incipient pitting corrosion, a feature-level data fusion strategy is proposed to integrate the two probing waves to monitor all-stage pitting corrosion of steel bars. The combination of direct waves and coda waves could exploit the complementary merits in various pitting corrosion configurations. The proposed feature-level fusion strategy of ultrasonic coda waves and direct waves intercepted from the same recorded signals opens a new perspective in all-stage pitting corrosion monitoring of steel bars and contributes a novel scheme for whole-process damage evaluation of structures.
Comparative study of stator current-based and vibration-based methods for railway traction motor bearing cage fault diagnosis at high-speed condition
Authors: Sun Qi , Chen Chunjun , Liu Xinchang
Published: May 2022

Traction motor’s rolling element bearings are one of the most critical components for the structural health monitoring of high-speed train vehicles. Most structural health monitoring techniques for railway rolling element bearings are using vibration signal. However, the vibration characteristic of cage defect is difficult to be transmitted to external monitoring point owing to the location of cage in bearing. Hence, the cage defect of Railway Traction Motor Bearing (RTMB) is usually difficult to be recognized with motor housing vibration acceleration signal. Considering Induction Motor (IM) itself a sensor, the mechanical imbalance of bearing cage defect can reflect in stator current through the motor gap magnetic field rather than a solid transmission path. A novel strategy with stator current for monitoring the traction motor bearing cage health status in High-Speed Train (HST) is proposed in this paper. This method requires no additional sensor in the practical application. To prove the strategy is feasible and more effective than vibration-based method for the cage fault diagnosis of RTMB, a comprehensive experiment investigation with a real railway traction motor of a HST is completed. Artificial cage defects are processed on bearings at both ends of the induction motor, respectively. Three high-speed (≥250 km/h) conditions are observed. The data analysis results show that vibration-based method is almost invalid at high-speed condition and the proposed current-based method is feasible and effective for the fault diagnosis of high-speed railway traction motor bearing cage.
Shared Leadership in Virtual Teams at Work: Practical Strategies and Research Suggestions for Human Resource Development
Authors: Han Soo Jeoung , Hazard Nani
Published: May 2022

Working in virtual teams has become more prevalent in some industries, especially following the coronavirus (COVID-19) pandemic. To address rapidly developing markets, businesses are implementing changes in leadership structures, work systems, and technology adoption. Human resource development (HRD) and virtual HRD (VHRD) practitioners and researchers must draw on best practices from previous research regarding virtual teams to help meet organizational needs and changes. Shared leadership is one of the emerging approaches showing promise in tackling complex challenges as it responds to problems by drawing on all members’ expertise rather than on the authority of a few. To understand shared leadership in virtual teams, we conducted a systematic literature review to identify how shared leadership is conceptualized and measured in virtual team research. We also synthesized the antecedents and outcomes of shared leadership in virtual teams. We presented practical remote work strategies and future research suggestions for HRD and VHRD.
Clinical Reasoning among Registered Nurses in Emergency Medical Services: A Case Study
Authors: Andersson Ulf , Andersson Hagiwara Magnus , Wireklint Sundström Birgitta , Andersson Henrik , Maurin Söderholm Hanna
Published: May 2022

In emergency medical services (EMS), the clinical reasoning (CR) of registered nurses (RNs) working in ambulance care plays an important role in providing care and treatment that is timely, accurate, appropriate and safe. However, limited existing knowledge about how CR is formed and influenced by the EMS mission hinders the development of service provision and decision support tools for RNs that would further enhance patient safety. To explore the nature of CR and influencing factors in this context, an inductive case study examined 34 observed patient–RN encounters in an EMS setting focusing on ambulance care. The results reveal a fragmented CR approach involving several parallel decision-making processes grounded in and led by patients’ narratives. The findings indicate that RNs are not always aware of their own CR and associated influences until they actively reflect on the process, and additional research is needed to clarify this complex phenomenon.
Contrast Enhanced Computed Tomography in the Diagnosis of Acute Pyogenic Flexor Tenosynovitis
Authors: Myers Devon M. , Goubeaux Craig , Skura Brian , Warmoth Patrick J. , Taylor Benjamin C.
Published: May 2022

Background:

The diagnosis of infectious flexor tenosynovitis (FTS) has historically been made based on physical exam using Kanavel’s signs. The specificity of these findings has come into question. We looked to evaluate the use of contrast-enhanced computed tomography (CT) in increasing the successful diagnosis of FTS.

Methods:

Two adult cohorts were formed, one of patients with FTS confirmed in the operating room and the second of patients with ICD.10 identified finger cellulitis (FC), without concomitant FTS. Demographics, laboratory values, CT scans, and examination findings were evaluated. Axial CTs were evaluated in the coronal and sagittal planes and tendon sheath/tendon width were measured. The tendon sheath/tendon was recorded as a ratio in the coronal (CR) and sagittal (SR) planes. Continuous and dichotomous variables were analyzed and measures of sensitivity, specificity, and predictivity were calculated. Seventy patients were included, 35 in the FTS cohort and 35 with FC.

Result:

A higher number of Kanavel signs were present in the FTS group (2.9 vs. 0.5, P < .05), with CR and SR both being significantly larger in the FTS group ( P < .05). CR and SR cutoffs ≥ 1.3 provided high sensitivity, specificity, and positive predictive value (PPV) for FTS. Likelihood of FTS increased 5.9% and 5.5% for every 0.1 increase in CR and SR, respectively, with a 14% increase for every additional Kanavel sign.

Conclusion:

In conclusion, CT ratios are useful in identifying FTS; and when used on their own or in combination with Kanavel’s signs, CR and SR objectively improve the diagnosis of FTS.
Bringing the “Joy of Healthy Eating” to Advanced Medical Students: Utilizing a Remote Learning Platform to Teach Culinary Medicine: Findings from the First Online Course Based on the ACLM’s Whole-Food Plant-Based Culinary Medicine Curriculum
Authors: Yousef Natalie M. , Wallace Robert J. , Harlan Gregory A. , Beale Elizabeth
Published: May 2022

Over 80% of chronic disease is caused by lifestyle practices, including an unhealthy diet. Despite this, most medical students in the United States graduate having received minimal nutrition education, guidance towards improving their nutrition, or skills needed to coach patients to adopt a healthier diet. This study aimed to educate fourth-year medical students in evidence-based knowledge regarding a delicious, whole-food plant-based diet while introducing practical culinary skills and patient coaching skills. We adapted an open-source culinary medicine curriculum designed for in-person teaching of pre-clinical medical students to provide a novel 1-month online elective to fourth-year medical students. We used a 26-item pre/post questionnaire to assess change in evidence-based knowledge regarding nutrition, culinary skills, patient coaching skills, and attitudes toward a whole-food plant-based diet. In addition, we reviewed narrative comments by the student participants, course directors, and medical-school administrators. Scores in all 4 domains were tested, and for all individual questions, they showed statistically significant improvement following the course. Most narrative responses were positive, and areas for improvement were also identified. We successfully adapted an open-source whole-food plant-based culinary medicine curriculum for advanced medical students into a 1-month elective taught on a virtual platform. This course filled a need for training in nutrition and counseling for these students as they start their professional careers.
Cross-cultural adaptation and reliability of the Arabic version of Children’s Hand-use Experience Questionnaire (CHEQ)
Authors: Amer Ahmed , Alomari Mahmoud A. , Jarl Gustav , Ajarmeh Majd M , Migdadi Fathi , Eliasson Ann-Christin , Hermansson Liselotte
Published: May 2022

Background

Validated outcome measures are essential for assessment and treatment of children with disabilities. The Children’s Hand-use Experience Questionnaire (CHEQ) was developed and validated for use in Western countries for children with unilateral hand dysfunction. This study aimed to perform a cross-cultural adaptation and investigate reliability for the Arabic CHEQ.

Methods

Translation and cross-cultural adaptation were performed in four phases: (i) forward-translation and reconciliation with feedback from parents and typically developing children from Jordan ( n = 14); (ii) backward-translation and review; (iii) cognitive debriefing with parents and/or their children with unilateral hand dysfunction ( n = 17); and (iv) review and proofreading. In the psychometric analyses, 161 children from Jordan (mean age [SD] 10y 8 m [5y 8 m]; 88 males) participated. Internal consistency was evaluated with Cronbach’s alpha. Test-retest reliability was evaluated in 39 children with intraclass correlation coefficient (ICC) and weighted kappa (κ).

Results

Synonyms of four words were added to accommodate for different Arabic dialects. On average, 93% of children with unilateral hand dysfunction and their parents understood the CHEQ items. One response alternative, ‘ Get help’, to the opening question was unclear for 70% of the respondents and need further explanation. Two items about using a knife and fork were difficult to comprehend and culturally irrelevant. High internal consistency was demonstrated (Cronbach’s alphas 0.94- 0.97) and moderate to excellent ICC (0.77–0.93). For 18 individual items, κ indicated poor to good agreement (κ between 0.28 and 0.66).

Conclusions

After the suggested minor adjustments, the Arabic CHEQ will be comprehensible, culturally relevant and reliable for assessing children with unilateral hand dysfunction in Jordan.
Empowering the police during COVID-19: How do normative and instrumental factors impact public willingness to support expanded police powers?
Authors: Sargeant Elise , McCarthy Molly , Williamson Harley , Murphy Kristina
Published: May 2022

This article seeks to test the police ‘empowerment hypothesis’ to better understand public support for police powers during the COVID-19 pandemic. To do so, we draw on Australian survey data to compare the efficacy of the instrumental and normative models of police empowerment to enforce social distancing regulations. We find that instrumental concerns about risk dominate participants’ willingness to empower the police during the COVID-19 pandemic. However, when it comes to what police can do to encourage police empowerment, procedural justice appears to be more important than police effectiveness, supporting the normative model. Our article adds to the limited but growing body of research that examines the correlates of police empowerment and the conditions under which members of the public are willing to grant police expanded powers.
Effects of oral glibenclamide versus subcutaneous insulin on perinatal outcome of patients with gestational diabetes mellitus: A randomized clinical trial
Authors: Faraji Azam , Tahamtani Lida , Maharlouei Najmeh , Asadi Nasrin
Published: May 2022

Background

The first-line treatment for gestational diabetes mellitus remains insulin, but oral hypoglycemic agents are easier and cheaper to use. The aim of the current study was to compare the efficacy and safety of oral glibenclamide and subcutaneous insulin on the serum glucose control and perinatal outcome of patients with gestational diabetes mellitus.

Materials and methods

This randomized clinical trial was conducted during a 2-year period from 2017 to 2019 in two tertiary healthcare centers in Shiraz, Iran. We included 84 singleton pregnancies between 24 and 34 weeks of gestation diagnosed with gestational diabetes mellitus. Patients were randomly assigned to oral glibenclamide ( n = 44) or subcutaneous insulin ( n = 40) according to a standard protocol and followed until delivery. The primary endpoint was to compare the glycemic level of patients, and the secondary outcomes included pregnancy adverse events and neonatal complications such as preeclampsia, preterm and premature rupture of membranes, preterm labor, placental abruption, maternal hypoglycemia, birth weight, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, and neonatal intensive care unit admission.

Results

The two study groups had comparable baseline characteristics. After treatment, the two study groups were comparable regarding fasting blood glucose ( p = 0.398) and 2 h postprandial glucose ( p = 0.085). There was no significant difference between the two groups regarding the rate of preeclampsia ( p = 0.250), preterm rupture of membranes ( p = 0.998), preterm labor ( p = 0.495), hypoglycemia ( p = 0.476), and abruption ( p = 0.815). There was no significant difference between the two study groups in birth weight ( p = 0.863) and the Apgar score at 1 ( p = 0.190) and 5 min ( p = 0.055). The rates of neonatal adverse events including hypoglycemia ( p = 0.999), hyperbilirubinemia ( p = 0.160), neonatal intensive care unit admission ( p = 0.852), and respiratory distress syndrome ( p = 0.665) were comparable between the two groups.

Conclusion

The results of the current study demonstrate that oral glibenclamide is as effective and safe as subcutaneous insulin in glycemic control and maternal and neonatal outcomes in women with gestational diabetes mellitus. Thus, it could be used as first-line treatment of gestational diabetes mellitus.
An observational analysis of climbing an obstacle in mountain biking: A case study
Authors: Iglesias Adrián , Lapresa Daniel , Dalmau Josep M , Anguera M Teresa
Published: May 2022

An observation system has been designed within observational methodology that permits analysis and intervention in the technical action of climbing an obstacle in mountain biking. Using records that correspond to the performance of an elite athlete, the ideal technique for climbing an obstacle has been inferred. Data collection and coding was done using LINCE software. The reliability of the observation system was guaranteed via intra-observer concordance, using Cohen’s Kappa coefficient. The generalisability analysis carried out has guaranteed the homogeneity of the records and the validity of the observation instrument. The data packages obtained detail the behaviour of the cyclist in each observed technical action. Through a lag sequential analysis, regularities were found in performance technique, establishing four fundamental phases and nuances that characterise the action in detail at the start and end of the phases: pedal stroke, handlebar pull, hip push and stabilisation.
Modeling the industry perspective of university-industry collaborative innovation alliances: Player behavior and stability issues
Authors: Song Yang , Berger Ron , Rachamim Matti , Johnston Andrew , Colladon Andrea Fronzetti
Published: May 2022

Many firms find it challenging to develop innovations, evidenced by the ever-mounting number of university-industry research alliances. This study examines the strategic choices of actors who participate in collaborative innovation alliances involving partnerships between industry and universities (U-I) based on a stochastic evolutionary game model. White noise was introduced to reflect uncertainty and the stochastic interferences caused by the differences between actors. Using the Itô stochastic differential equation theory, we analyze stability issues of player behaviors in the evolution of a collaborative innovation alliance. The results illustrate that improvements in innovation efficiency can contribute to U-I collaborative innovation alliances. High knowledge complementarity appears to be unbeneficial to the stability of these alliances, and controlling knowledge spillovers may suppress free-rider problems from both sides of the game. Our study contributes to innovation research by providing a decision-making reference for the design of U-I cooperation.
Assessment of Healthcare Professionals’ Wellbeing During a Peak of the COVID-19 Pandemic in a Healthcare System in Ohio
Authors: Dyer Natalie L , Adan Francoise , Barnett Tyler , Dusek Jeffery A
Published: May 2022

Objective

The purpose of this cross-sectional study was to evaluate multiple indices of wellbeing in healthcare professionals during the COVID-19 pandemic.

Methods

Healthcare professionals were invited to participate across the University Hospitals healthcare system in Ohio, USA. Participants (N = 6397) completed online questionnaires on their wellbeing, including healthy behaviors, safety and security, mental and physical health concerns, and social support. Differences in wellbeing across demographics were also assessed.

Results

Overall, healthcare professionals’ mean subjective wellbeing was 7.98 (1.50) and their future health score was 3.98 (1.13). Room for improvement was noted for diet, sleep, and positive thinking. Males reported significantly higher levels of overall wellbeing and future health scores, including fruit and vegetable intake and physical activity, and alcohol use, whereas females reported higher levels of positive thinking and tobacco use. Of the three largest racial groups, White and Asian employees scored significantly higher on future health, M = 4.00 (1.17) and M = 4.10 (1.13), than Black or African American employees, M = 3.74 (1.10).

Conclusions

This cross-sectional study assessed the wellbeing of healthcare workers during the initial peak of the COVID-19 pandemic prior to vaccine delivery. Future work will implement strategies to improve healthcare workers’ wellbeing in an individualized way based on our findings, as well as evaluate changes in wellbeing and future health scores across time.
The Impact of Behavioral Biases on Individuals’ Financial Choices under Uncertainty: An Empirical Approach
Authors: Banerji Joyita , Kundu Kaushik , Alam Parveen Ahmed
Published: May 2022

All human beings are limited by their knowledge and interpretative abilities, leading them to rely on more simplifications to make the decision-making more tractable. Kahneman and Tversky’s landmark work recognized that individuals’ choices often systematically deviate from the neo-classical expectations of rationality, and such deviations are known as behavioral biases. This article aims to examining how the behavioral biases relate to each other and impact the investment decision of individuals. The relationships between behavioral biases may be used to develop certain profiles of financial behavior, which the finance agents can use to provide more custom choices to their clients. The population for this study was the individual investors of the Indian financial markets and any individuals who may be prospective investors. A research instrument was created, for the sake of studying such association, the pilot survey of which revealed the items which were most reliable, which were retained and used for the final round of data collection. The analysis of the collected data revealed that there are relationships between the behavioral biases themselves. Based on such relationships, the biases were categorized and investor decision-making profiles were proposed.
Association of stroke lesion shape with newly detected atrial fibrillation – Results from the MonDAFIS study
Authors: Pimentel Bernardo Crespo , Ingwersen Thies , Haeusler Karl Georg , Schlemm Eckhard , Forkert Nils D , Rajashekar Deepthi , Mouches Pauline , Königsberg Alina , Kirchhof Paulus , Kunze Claudia , Tütüncü Serdar , Olma Manuel C , Krämer Michael , Michalski Dominik , Kraft Andrea , Rizos Timolaos , Helberg Torsten , Ehrlich Sven , Nabavi Darius G , Röther Joachim , Laufs Ulrich , Veltkamp Roland , Heuschmann Peter U , Cheng Bastian , Endres Matthias , Thomalla Götz
Published: May 2022

Paroxysmal Atrial fibrillation (AF) is often clinically silent and may be missed by the usual diagnostic workup after ischemic stroke. We aimed to determine whether shape characteristics of ischemic stroke lesions can be used to predict AF in stroke patients without known AF at baseline. Lesion shape quantification on brain MRI was performed in selected patients from the intervention arm of the Impact of standardized MONitoring for Detection of Atrial Fibrillation in Ischemic Stroke (MonDAFIS) study, which included patients with ischemic stroke or TIA without prior AF. Multiple morphologic parameters were calculated based on lesion segmentation in acute brain MRI data. Multivariate logistic models were used to test the association of lesion morphology, clinical parameters, and AF. A stepwise elimination regression was conducted to identify the most important variables. A total of 755 patients were included. Patients with AF detected within 2 years after stroke ( n = 86) had a larger overall oriented bounding box (OBB) volume ( p = 0.003) and a higher number of brain lesion components ( p = 0.008) than patients without AF. In the multivariate model, OBB volume (OR 1.72, 95%CI 1.29–2.35, p < 0.001), age (OR 2.13, 95%CI 1.52–3.06, p < 0.001), and female sex (OR 2.45, 95%CI 1.41–4.31, p = 0.002) were independently associated with detected AF. Ischemic lesions in patients with detected AF after stroke presented with a more dispersed infarct pattern and a higher number of lesion components. Together with clinical characteristics, these lesion shape characteristics may help in guiding prolonged cardiac monitoring after stroke.
HLA-matching with PTCy: a reanalysis of a CIBMTR dataset with propensity score matching and donor age
Authors: Ambinder Alexander , Jain Tania , Tsai Hua-Ling , Horowitz Mary M. , Jones Richard J. , Varadhan Ravi
Published: May 2022

Blood or marrow transplantation (BMT) outcomes using haploidentical donors (Haplo) and posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis compare favorably to HLA-matched donors using calcineurin inhibitor–based prophylaxis. A recent Center for International Blood and Marrow Transplant Research analysis of patients receiving homogenous PTCy-based prophylaxis found that, with reduced intensity conditioning, Haplo BMTs had worse outcomes than matched unrelated donor (MUD) BMTs. Due to significant differences between groups, we reanalyzed the dataset using propensity score matching and, additionally, added a donor age variable. After matching MUD BMTs to Haplo BMTs in a 1:5 ratio, no significant differences were found between groups across all measured baseline characteristics. Outcomes analyses demonstrated no significant differences in overall survival (hazard ratio [HR] of mortality with MUD vs Haplo [95% confidence interval], 0.95 [0.65-1.16], P = .75), disease-free survival (HR of relapse or death, 0.98 [0.73-1.18], P = .89), relapse rate (HR, 1.06 [0.77-1.38], P = .69), or nonrelapse mortality (NRM) (HR, 0.85 [0.42-1.13], P = .49) between groups. After stratification by conditioning intensity, MUD BMTs in the reduced-intensity cohort had lower risk of NRM (HR, 0.56 [0.14-0.99], P = .05), with no significant difference in other clinical outcomes. These results suggest the effect of HLA matching on BMT outcomes with PTCy is less meaningful than previously reported. Timely identification of a young, at least half-matched (related or unrelated) donor may be more important than finding a fully matched donor if the latter leads to a delay in BMT or use of an older donor.