bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Cross-Sector Collaboration in Local Health Departments: A Cluster Analysis
Authors: Grant Alexis K.
Published: November 2020

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.
Surveying Primary Care Nurse Practitioners: An Overview of National Sampling Frames
Authors: Harrison Jordan M. , Germack Hayley D. , Poghosyan Lusine , Martsolf Grant R.
Published: November 2020

Nurse practitioners (NPs) represent the fastest growing segment of the U.S. primary care workforce. Surveys of primary care NPs can help to better understand the care NPs deliver across different health care settings, the factors that impact NP job satisfaction and burnout, and the structural capabilities required to support their practice. The purpose of this article is to provide an overview of national sampling frames that can be used by researchers interested in surveying or studying the U.S. primary care NP workforce. We conducted an environmental scan and review of published literature on the NP workforce to identify data sources that can be used to sample primary care NPs. In this article, we (a) identify the data elements needed to develop an NP sampling frame and (b) describe national data sets that can be used to sample primary care NPs, including the strengths and weaknesses of each. This information is intended to facilitate research on the primary care NP workforce to inform practice and policy.
Metatarsal Head Resection Versus a Removable Mechanical Device for Offloading of the Neuropathic Diabetic Plantar Forefoot Ulcer
Authors: Elbarbary Ahmed H. , Sallam Emad M. , Ismail Ahmed M.
Published: November 2020

Although surgical offloading seems a more permanent solution for prevention and treatment of neuropathic plantar diabetic forefoot ulcers (DFUs), the evidence for this assumption is weak and needs further studies to be established. The aim of this retrospective study is to compare the healing efficacy, associated morbidity, and recurrence rates of surgical versus removable knee-high offloading for neuropathic plantar (DFUs) healing. From January 2016 to January 2018, 70 neuropathic plantar forefoot DFUs were nonrandomly assigned to either removable knee-high cam-walker (n = 35), or metatarsal head, or accessory bone resection (n = 35). The primary endpoints were the frequency and rate of complete healing, and the rate of ulcer area reduction within 4 months. The secondary endpoints were 4 months morbidity and ulcer recurrence within 12 months. After 4 months, complete healing was significantly inferior with cam-walker compared with surgical offloading; 24 (67.6%) versus 31 patients (88.6%), respectively, P = .015. Ulcer area reduction was 2.4 cm2 (66.7%) versus 2.6 cm2 (83.9%), P = .001, in the mechanical versus the surgical groups, respectively. The mean healing time was 3.6 ± 2.1 versus 2.8 ± 0.6 months in the mechanical versus the surgical groups, respectively, P = .012. Morbidity and recurrence show nonsignificant differences between both groups. Ulcer recurrence was noted in 5/35 (14.3%) versus 2/35 (5.7%), in mechanical versus surgical groups, respectively, P = .23. Therefore, metatarsal head/accessory bone resection offered improved healing efficacy but similar morbidity and recurrence to the removable cam-walker.
Continuous EEG in ICU: Not a Luxury After All
Authors: Bermeo-Ovalle Adriana
Published: November 2020

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Development Against Violence: Prime Minister’s Rural Development Fellowship (PMRDF) in India
Authors: Khatun Hena , Tripathy Jyotirmaya
Published: November 2020

This article advances the literature on development vis-à-vis Naxal violence in India by using the Prime Minister’s Rural Development Fellowship (PMRDF) as a site of developmental meaning making. In the process, it reappraises the idea of the development state, its relation with violence, and its ways of vernacularizing itself through PMRDF. Drawing from the experience of three PMRD Fellows from West Bengal and interrogating existing scholarship on the subject, we argue that development matters in people’s lives and is a bulwark against violence, something which legitimates the development state. We also propose that far from being an arm of the security state as some critiques promote, PMRDF was an interactive space that brought the state and people to conversation and offered development actors who discovered themselves among local people rather than within bureaucracy. What is attempted here is not a broad theory which guides local developmental practices but a grounded approach that can work as a contingent model to understand conflict and development and how they relate to people’s place within the state.
Understanding Everyday Peace in Cambodia: Plurality, Subtlety, and Connectivity
Authors: Lee SungYong
Published: November 2020

This article explores the nature of everyday peace in local communities in Cambodia. Drawing on interviews and observation and focusing on the reconstruction of relationship between community residents and former Khmer Rouge leaders, the analysis demonstrates that everyday peace in these communities is characterised by three features: plurality, subtlety, and connectivity. The findings demonstrate how the nature of social relationships with former harm-doers varies within and between communities; sheds light on the subtle, mundane, and episodic ways in which peace is sustained and manifested; and highlights the connectivity of local agency with broader political contexts that contribute to shaping everyday practices and experiences of peace. In conclusion, this article revisits the fixity and homogeneity of the peace in a society which is assumed by many studies, calls for further exploration of the prepolitical nature of everyday peace, and discusses implications for a recent academic debate over victims’ silence.
Three-Dimensional vs Two-Dimensional Completely Minimally Invasive 2-Stage Esophagectomy With Intrathoracic Hand-Sewn Anastomosis for Esophageal Cancer: Comparison of Intra-and Postoperative Outcomes
Authors: Abbassi Omar , Patel Krashna , Jayanthi Naga Venkatesh
Published: November 2020

Background. Completely minimally invasive esophagectomy (CMIE) has been associated with reduced morbidity compared to open esophagectomy in the treatment of esophageal cancer. Three-dimensional (3D) vision can enhance depth perception during minimally invasive surgery when compared to two-dimensional (2D) vision. We aimed to compare outcomes from 2-stage CMIEs when performed in 2D vs 3D. Method. All consecutive 2-stage CMIEs performed for esophageal or gastroesophageal junctional cancer at a single-centre between 2016 and 2018 were identified from a prospectively maintained database. All operations were completed in either 2D or 3D. All esophagogastric anastomoses were hand-sewn thoracoscopically. Intraoperative and postoperative clinical parameters were compared between 2D and 3D CMIE. Results. Overall, 98 patients underwent a 2-stage CMIE, of which 59 (60.2%) were in 2D and 39 (39.8%) in 3D. Median operative blood loss was less in the 3D group compared to the 2D group (283 mls vs 409 mls, P = .016). A higher number of lymph nodes were retrieved from 3D CMIE (30 vs 25, P = .010). The median duration of surgery was 407 minutes (interquartile ranges (IQR): 358-472 minutes) and 426 minutes (IQR: 369-509 minutes) when performed in 2D and 3D, respectively ( P = .162). There were no significant intergroup differences in 30-day postoperative complications, short-term mortality, and hospital stay. Conclusion. We report reduced blood loss and higher lymph node yield when performing 3D CMIE than 2D CMIE. Other intraoperative and postoperative clinical outcomes were similar in both groups. A randomized controlled trial is needed to validate these findings of superior outcomes from CMIE performed in 3D over 2D.
HPV Vaccine and College-Age Men: A Scoping Review
Authors: Laserson Alyssa K. , Oliffe John L. , Krist Jennifer , Kelly Mary T.
Published: November 2020

The human papillomavirus (HPV) potentially affects every sexually active man in the United States and Canada. In 2017, the vaccine became publicly funded in Canada for males ages 9–26, and was integrated into school vaccination programs. In 2019, HPV vaccination was recommended as routine for all U.S.-based males and females ages 9 through 26, and a shared decision for adults >26 years; however, since the approval of the vaccine in 2006 for females only, the age and dosing recommendations for males have followed a complicated and changing trajectory. Current adherence rates are low among college and university age males (18–26 years); therefore, understanding and addressing the barriers and facilitators for men’s HPV vaccination is critically important. The purpose of the current scoping review is to provide a synthesis of recent literature pertaining to HPV in college and university age men, as a means to guiding health-care providers (HCPs). Drawing from 15 published articles, three thematic findings were inductively derived. Theme one, lack of awareness, was underpinned by men’s knowledge deficits about their eligibility for, and the availability of HPV vaccines. Theme two, underestimating and embodying risk, included men’s engagement in sexual activities while misinformed or denying the risk for contracting HPV. The third theme, strategies for increasing men’s awareness, summarizes messaging strategies used to lobby young men to vaccinate. The review findings indicate gender-sensitive interventions targeting college-age men, including early, frequent, and consistent messaging on HPV are key.
Analysis of branch artery orifice angulation: Feasibility of the shelf technique for the treatment of wide-neck bifurcation aneurysms
Authors: Onay Mehmet , Binboga Ali Burak , Altay Cetin Murat
Published: November 2020

Background and purpose

The aim of this study was to investigate the feasibility of the shelf technique by analyzing the angle between the two branch orifices and to present its safety and effectiveness compared with that of the double-stent technique.

Materials and methods

Patients with complex wide-neck bifurcation aneurysms (WNBAs) who underwent stent-assisted coiling (SAC) were reviewed. The study sample was divided into two groups: single SAC (shelf technique) and double SAC. The angle between the lines connecting the superior and inferior points of each branch orifice (α angle) was measured by two neurointerventional radiologists in both groups. The inter- and intraobserver repeatability and consistency of the α angle were assessed. The effect of the α angle on the feasibility of using the shelf technique to treat WNBA was analyzed. Technical and clinical success rates were investigated by comparing both groups.

Results

Forty-eight patients (32 shelf technique and 16 double-stent technique) were included. There was excellent agreement between the intra- and interobserver repeatability and consistency of α angle measurements. The α angle was smaller in the shelf technique group than in the double-SAC group (p < 0.001). The technical and clinical success rates of both groups were similar based on long-term follow-up (p > 0.05).

Conclusion

WNBA treatment with the shelf technique is safe and effective. The α angle is a useful parameter to evaluate the performance of the shelf technique. The shelf technique is more suitable for WNBAs with a narrow α angle.
Risk assessment of wheel polygonization on high-speed trains based on Bayesian networks
Authors: Zeng Yuanchen , Song Dongli , Zhang Weihua , Zhou Bin , Xie Mingyuan , Qi Xiaoyue
Published: November 2020

Wheel polygonization is an important failure mode for high-speed trains and causes huge maintenance costs, however, the studies on its reliability and risk are rare. First, failure effects analysis via dynamical simulations and tests indicates that high-order polygonization induces large wheel-rail forces and vehicle vibrations, which is quite detrimental to reliability and safety. Then, correlation analysis demonstrates that wheel polygonization is affected by season, wheel diameter, vehicle type and historical incidence rate. Next, a Bayesian network topology is designed based on related factors in sequential wheel operation process, and a risk assessment model based on an array of Bayesian networks is developed to produce the probability distribution of wheel polygonization over different severities. Further, the model is trained through a two-step scheme based on historical measurement data, including partially missing data. Finally, the proposed model is validated to effectively assess polygonization risks and detect high-risk wheels. Its application to risk-based maintenance can support the decision-making of wheel reprofiling, reduce failure impacts on reliability, and save maintenance costs.
Group & save sampling in lumbar decompression: A review into current practice
Authors: McKenna M , Abdelaal A
Published: November 2020

The risks, benefits and technical aspects of surgery require careful consideration. One element of this is the requirement of postoperative blood transfusion. Patients who undergo elective lumbar decompression are at a low risk of requiring a postoperative transfusion yet undergo multiple preoperative group & save tests. For those who are at a low risk of bleeding, a single group & save sample may be adequate. This review analysed the postoperative blood loss and transfusion rate associated with lumbar decompression surgery without fusion in one institution. A subsequent cost analysis and review of the literature was performed. The aim was to assess whether single group & save sampling, within the context of lumbar decompression, was cost effective and amenable to the patient without impacting patient care. Average blood loss was estimated as a drop in Hb of 12.3g/dl. Six patients (14%) had Hb loss of over 20g/dl. No patients underwent a blood transfusion. Through examination of medical records, we found that 65% of patients (35) were suitable for single group & save sampling, estimating a saving of £2415.95 (53%). Selective group & save testing holds economic potential and safeguards patients from undergoing unnecessary testing. The next step after this review would be a prospective multi-centre study.
A qualitative study of men’s behavioural changes during weight loss maintenance
Authors: Lozano-Sufrategui L , Pringle A , Carless D , Drew KJ
Published: November 2020

Aim:

This study aims to understand the behaviour changes men who attended a weight loss programme engage in during weight maintenance. Understanding the needs of men in the context of weight loss maintenance is important, as they are underrepresented in this body of literature.

Method:

Given its focus on personal experience, this study adopted a qualitative design. Semi-structured interviews supported by participant-generated photo-elicitation techniques to explore the behavioural changes 12 men engaged in 6 months after attending a men-only weight loss programme. Data analysis was undertaken through thematic analysis and Gleeson’s polytextual thematic analysis.

Results:

This study suggests that the key behaviours men engaged in to maintain weight loss can be classified into four categories: (1) ‘Small’ changes, (2) Informed decisions, (3) Monitoring of behaviours, and (4) Dealing with ambivalence.

Conclusion:

This study makes an original contribution to knowledge and can have important implications for practice in the area of men’s health, particularly with regard to the long-term impact of weight loss interventions.
Polyhydroxynaphthoquinone Pigment From Vietnam Sea Urchins as a Potential Bioactive Ingredient in Cosmeceuticals
Authors: Nhu Hieu Vo Mai , Thanh Van Tran Thi , Hang Cao Thi Thuy , Mischenko Natalia P. , Sergey A. Fedoreyev , Truong Hai Bang
Published: November 2020

In this study, valuable polyhydroxynaphthoquinone (PHNQ) pigments were recovered from sea urchin food waste and were investigated as a potential bioactive ingredient for cosmeceuticals. The crude PHNQ pigment extract from 4 Vietnam sea urchins, Diadema setosum, Diadema savignyi, Stomopneustes variolaris, and Tripneustes gratilla, exhibited effective 2,2-diphenyl-1-picryl-hydrazyl-hydrate scavenging activity, tyrosinase inhibitory activity, and antibacterial activity. The moisturizing cream with 0.5% of PHNQ pigments from D. setosum and Tripneustes gratilla sea urchins showed no dermal irritation over 14 days of mouse skin test. Four major active components in PHNQ were identified via high-performance liquid chromatography coupled with diode array detector and mass spectrometry. Echinochrome A contributed considerably to the antioxidant activity of the extracts while those containing echinochrome A and spinochrome E were significantly active against various bacteria. The promising results laid the foundation for establishing a novel process from food waste to innovative biomaterial and formulating eco-friendly skincare products with PHNQ components from sea urchins as precious ingredient.
Feelin’ Real/Unbroken: Imagining Blackqueer Education Through Autopoetic Inquiry
Authors: Callier Durell M.
Published: November 2020

This autopoetic inquiry offers insights into and critiques of public education. The author specifically interrogates the absence of curricula, which focuses on the fullness of Black LGBTQ+ representation. Through the usage of pivotal artists, lyrics, poetry, and reflection, the author centers a Blackqueer analysis to argue for a reparative educational experience for Black LGBTQ+ youth. Mirrored within the essay is the reality that Black and queer individuals must exhume Black and queer histories, ancestors, and community across the curriculum for ourselves. Likewise, educational practitioners and those who profess to love Black and queer youth must create curricula that represent the totality of Black and queer pasts and present.
Shared Decision Making in Endodontics
Authors: Rajagopal Sandhya , Kelly Aengus
Published: November 2020

Engaging patients in shared decision making (SDM) is a professional requirement since the Montgomery ruling in 2015. Endodontic treatments present a specific challenge to achieving SDM, both for the clinician and the patient. The treatments are often perceived as more challenging to complete by the clinician, and the assessment of risk and likely outcome requires a deep understanding of the (limited) evidence base. For the patient, decisions can be required at a time of acute symptoms and prolonged treatments. There are health literacy demands in comparison to some less complex dental treatments. Treatment decisions may be based more on inherent biases and prior experiences than objective probabilities. This article discusses options and supports effective shared decision making in endodontic treatment.
Endodontic Management of Traumatised Permanent Anterior Teeth
Authors: Phillips Jillian M. , McCann Catherine T. , Welbury Richard
Published: November 2020

Traumatised permanent anterior teeth can require endodontic treatment which may be immediate as part of acute trauma management, or delayed due to the development of sequelae. This paper will enable clinical decision making by exploring a range of situations in which endodontic treatment may be indicated, and also offer practical advice regarding effective endodontic treatment for paediatric dental trauma patients.

Endodontic treatment of traumatised permanent teeth in paediatric patients is often challenging. However, with timely decision making and appropriate treatment, these teeth can often last throughout childhood and adolescence thus ensuring that a young patient does not have the social burden of a missing tooth and needing a prosthesis, and has the maximum restorative options available to them as they enter adulthood.
Data-bodies and data activism: Presencing women in digital heritage research
Authors: Thompson Terrie Lynn
Published: November 2020

As heritage-as-the-already-occurred folds into heritage-in-the-making practices, temporal and spatial fluidity is made more complex by digital mediation and particularly by Big Data. Such liveliness evokes ontological, epistemological and methodological challenges. Drawing on more-than-human theorizing, this article reframes the notion of data-bodies to advance data activist-oriented research in heritage. Focused primarily on women, it examines how their distributed agency and voice with respect to data practices and the (re)makings of (digital) heritage could be amplified. I describe three methodological directions, influenced by feminist work in critical data studies, which could be employed by researchers: attuning to and becoming with data, making data physical and changing narratives. From data-bodies to haunted data, performative data curation and mapping data-bodies, and attuning to data streams and re-voicing narratives, this article contributes to discussions of how to engage critically and creatively with the datafication of digital heritage practices, knowings and ontologies.
Renal adenocarcinoma associated with hypertrophic osteopathy in a cat
Authors: Elhamiani Khatat Sarah , Vallefuoco Rosario , El Mrini Meryem , Canonne-Guibert Morgane , Rosenberg Dan
Published: November 2020

Case summary

A 10-year-old neutered male domestic shorthair cat was diagnosed with renal adenocarcinoma associated with hypertrophic osteopathy. The cat was referred for chronic ambulation difficulties. The physical examination showed a painful thickening of all four limbs, a right cranial abdominal mass and a conjunctival hyperaemia. Radiographic findings were consistent with extensive periosteal new bone formation involving not only the diaphyses of the fore- and hindlimbs, but also of the pelvis, tarsus and carpus. Abdominal ultrasonography and CT revealed a mass within the right kidney and a primary neoplasm was suspected. A ureteronephrectomy of the right kidney was performed and histopathology confirmed the diagnosis of renal adenocarcinoma. Although clinical improvement of the lameness occurred after surgery, no radiographic changes of hypertrophic osteopathy lesions were observed at the 9-month follow-up.

Relevance and novel information

Feline cases of hypertrophic osteopathy are rarely reported in the literature and only a few of them were associated with abdominal neoplastic diseases. To our knowledge, this is the first case of renal adenocarcinoma associated with hypertrophic osteopathy in a cat.
Moral character and the civic mission of American universities: The Catholic, Jesuit vision of justice education
Authors: Sokol Bryan W , Sanchez Steven J , Wassel Bobby , Sweetman Leah , Peterson Ashlei M
Published: November 2020

The formation of students’ moral character is a critical part of civic engagement programs in US higher education. This is especially evident in Catholic, Jesuit education, which emphasizes pedagogical practices at the intersection of faith and justice. Advances in the fields of moral psychology and civic education, particularly service-learning, further clarify the vision of justice found in both the Jesuit tradition and the emancipatory ideals of American democracy. The influence of the Center for Service and Community Engagement at Saint Louis University, a mid-sized Jesuit institution in the Midwestern United States, signals a way for making this vision a reality through “social projection.”
Impact of the 2020 COVID-19 Pandemic on Ambulatory Hepatitis C Testing
Authors: Sperring Heather , Ruiz-Mercado Glorimar , Schechter-Perkins Elissa M.
Published: November 2020

Introduction:

Coronavirus disease 2019 (COVID-19) has led to unprecedented modifications to healthcare delivery in the U.S. To preserve resources in preparation for a COVID-19 surge, Boston Medical Center (BMC) implemented workflows to decrease ambulatory in-person visits effective March 16th, 2020. Telemedicine was incorporated into clinical workflows and much preventive care, including Hepatitis C (HCV) testing, was not routinely performed.

Objective:

To explore the impact that the COVID-19 rapid restructuring response has had on HCV testing and identification hospital-wide and in ambulatory settings.

Methods:

BMC utilizes reflex confirmatory testing for HCV. When a sample is HCV Ab positive, it is automatically reflexed for confirmatory RNA and genotype testing. HCV test results for patients were collected daily. We compared unique patient tests for 3.5 month periods before and after March 16th, 2020. Descriptive statistics showed total tests and total new HCV RNA+ before versus after, both hospital-wide and in ambulatory clinics alone. Mean daily tests completed were compared.

Results:

Hospital-wide, total HCV testing decreased by 49.6%, and new HCV+ patient identification decreased by 42.1%. In ambulatory clinics, testing decreased by 71.9%, and new HCV+ identification decreased by 63.3%. Hospital-wide, mean daily tests decreased by 22.9 tests per day (95% CI: 17.9-28.0, P < .001), and mean daily new HCV+ identification decreased by 0.36 (95% CI: 0.20-0.53, P < .001). In ambulatory clinics, mean daily tests decreased by 22.1 tests per day (95% CI: 17.5-26.7, P < .001) and mean daily HCV+ decreased by 1.40 (95% CI: 1.03-1.76, P < .001).

Conclusion:

The COVID-19 systematic emergency response led to decreased HCV testing and identification, and in this regard telemedicine acts as a barrier to HCV care. Other public health initiatives must be monitored in the context of telemedicine workflows. Continued monitoring of HCV screening trends is vital, and adaptive approaches to work toward the goal of HCV elimination are needed.
Evaluating the Effectiveness of Online Educational Modules and Interactive Workshops in Alleviating Symptoms of Mild to Moderate Depression: A Pilot Trial
Authors: Murillo Luis A. , Follo Emily , Smith April , Balestrier Julienne , Bevvino Deborah L.
Published: November 2020

Introduction

Depression is a common health concern in primary care with barriers to treatment well documented in the literature. Innovative online psychoeducational approaches to address barriers to care have been well received and can be cost effective. This pilot trial evaluated the effectiveness of an online psychoeducation curriculum intended to alleviate symptoms of depression while utilizing minimal staff resources.

Methods

A small (n = 29) randomized control pilot study was conducted. Online psychoeducational content was delivered in 5 to 10-minute videos over 8 weeks. Participants engaged in moderated discussions on workshop topics. The Patient Health Care Questionnaire (PHQ-9) was used to measure pre/post scores. Two Likert scale questions were used to determine subjective changes in understanding of depression and coping skills.

Results

Paired T-test analysis showed an average PHQ-9 improvement of 4.37 ( P = .01) in the intervention arm and 1.81 ( P = .172) in the control group. No significant difference in delta PHQ-9 score was found between groups via difference in difference analysis ( P = .185). Effect size was 0.59. No improvement in Likert scores for question 1 or 2 were detected by paired T test in either group.

Conclusion

This pilot trial of interactive online psychoeducational content shows initial promise as there was a significant improvement in PHQ-9 scores within the intervention arm. The comparison of delta scores between intervention and control arms was not statistically significant although this is likely due to the underpowered nature of the pilot trial. This data trend justifies the need for a larger validation trial of this intervention.
Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture
Authors: Luangwaranyoo Aris , Suksintharanon Methasit , Tangadulrat Pasin , Iamthanaporn Khanin , Hongnaparak Theerawit , Yuenyongviwat Varah
Published: November 2020

Background:

Hemi hip arthroplasty is one treatment option for femoral neck fractures; however, there has been limited evidence on factors associated with blood transfusions following hemi hip arthroplasty. Hence, the aim of this study was to identify the predictors of blood transfusion after hemi hip arthroplasty, which could lead to the establishment of proper guidelines for management protocols.

Materials and Methods:

This study was a retrospective cohort study, conducted in a single center of 323 femoral neck fracture patients having undergone hemi hip arthroplasty. Peri-operative factors and demographic data were extracted from the electronic medical records, from 2007 to 2019. A predictive model was developed by logistic regression (LR), and adjusted by multivariate logistic regression.

Result:

One hundred and twenty-six (39%) patients received blood transfusions. On multivariate analysis, those of a female gender (odds ratio (OR) 2.00, p = 0.037), having a body mass index lower than 18.5 kg/m2 (OR 2.40, p = 0.028), lower preoperative hemoglobin levels (OR 0.52, p < 0.001) and given general anesthesia (OR 2.07, p = 0.028) were shown to be significantly associated with a higher risk of requiring a blood transfusion.

Conclusion:

The authors recommend that preparation of blood components coupled with the utilization of blood conserving methods for high risk patients, as studies have stated, in addition to the consideration of spinal anesthesia; if patients have no contraindication, should be implemented.
Impact of a University-Wide Interdisciplinary Mind-Body Skills Program on Student Mental and Emotional Well-Being
Authors: Novak Brenna K , Gebhardt Anna , Pallerla Harini , McDonald Susan Blocksom , Haramati Aviad , Cotton Sian
Published: November 2020

Background

Positive effects of mind-body skills programs on participant well-being have been reported in health professions students. The success seen with medical students at this university led to great interest in expanding the mind-body skills program so students in other disciplines could benefit from the program.

Objective

The purpose of this study was to assess the effects of a 9-week mind-body skills program on the mental and emotional well-being of multidisciplinary students compared to controls. We also sought to determine if the program’s effects were sustained at 1-year follow-up.

Methods

A cross-sectional pre-post survey was administered online via SurveyMonkey to participants of a 9-week mind-body skills program and a control group of students from 7 colleges at a public university from 2017–2019. Students were assessed on validated measures of stress, positive/negative affect, resilience, depression, anxiety, fatigue, sleep disturbance, mindfulness, empathy, and burnout. Scores were analyzed between-groups and within-groups using bivariate and multivariate analyses. A 1-year follow-up was completed on a subset of participants and controls.

Results

279 participants and 247 controls completed the pre-survey and post-survey (79% response rate; 71% female, 68% white, mean age = 25 years). Participants showed significant decreases in stress, negative affect, depression, anxiety, sleep disturbance, and burnout, while positive affect, resilience, mindfulness, and empathy increased significantly ( P <  .05). Only sleep disturbance showed a significant decrease in the control group. Follow-up in a subset of participants showed that only mindfulness remained elevated at 1-year ( P <  .05), whereas the significant changes in other well-being measures were not sustained.

Conclusion

Participation in a 9-week mind-body skills program led to significant improvement in indicators of well-being in multidisciplinary students. A pilot 1-year follow-up suggests that effects are only sustained for mindfulness, but not other parameters. Future programming should focus on implementing mind-body skills booster sessions to help sustain the well-being benefits.
Trigger finger due to phalangeal osteochondroma of an adult: A case report
Authors: Kwon Hoi Young , Kang Hong Je
Published: November 2020

Trigger finger is stenosing tenosynovitis that occurs in A1 pulley. It usually occurs idiopathically in patients’ 40s and 50s. On the other hand, pediatric trigger finger usually occurs before 8 years old in pediatric patients. Even though being rare, a tumor occurred in the soft tissue or bone near flexor tendons can cause a trigger finger. Trigger finger due to osteochondroma is very rare. Furthermore, most cases of trigger finger due to osteochondroma occur in pediatric patients with hereditary multiple osteochondromatosis (HMO). The authors report this case of a trigger finger caused by a solitary osteochondroma that occurred in the proximal portion of the proximal phalanx of the left middle finger, of a 21-year-old patient. The symptoms were relieved after excision of the osteochondroma. If a patient with unusual demographics visits, the cause of trigger finger may not be idiopathic. Evaluation methods such as x-rays and ultrasonography can be helpful to rule out other causes, such as tumors.
Characteristics of Socially Isolated Residents in Long-Term Care: A Retrospective Cohort Study
Authors: Chamberlain Stephanie A. , Duggleby Wendy , Teaster Pamela B. , Estabrooks Carole A.
Published: November 2020

Objectives: To identify socially isolated long-term care residents and to compare their demographic characteristics, functional status, and health conditions to residents who are not isolated. Methods: We conducted a retrospective cohort study using the Resident Assessment Instrument, Minimum Data Set, 2.0 (RAI-MDS) data, from residents in 34 long-term care homes in Alberta, Canada (2008–2018). Using logistic regression, we compared the characteristics, conditions, and functional status of residents who were socially isolated (no contact with family/friends) and non-socially isolated residents. Results: Socially isolated residents were male, younger, and had a longer length of stay in the home, than non-socially isolated residents. Socially isolated residents lacked social engagement and exhibited signs of depression. Discussion: Socially isolated residents had unique care concerns, including psychiatric disorders, and co-morbid conditions. Our approach, using a single item in an existing data source, has the potential to assist clinicians in screening for socially isolated long-term care residents.
A Nurses’ Personal Labor and Postpartum Experience During COVID-19
Authors: Shackleford Jenna L
Published: November 2020

This special interest article describes a nurses’ labor and postpartum experience during the COVID-19 pandemic
“Everyone wants this market to grow”: The affective post-politics of municipal green bonds
Authors: García-Lamarca Melissa , Ullström Sara
Published: November 2020

As more cities seek to address environmental and climate change woes, the issuance of municipal green bonds to finance such initiatives is growing. But how do issuers and investors conceptualise and enact green bonds in relation to building a more sustainable society? What socionatures are produced with these bonds, and for whom? Based on fieldwork in Gothenburg, the first municipality in the world to issue green bonds, we bring together the literature on green finance, post-politics and affect through an urban political ecology lens to unpack the processes, practices and discourses underlying green bonds. We argue that green bonds ultimately serve as a new path to attract and circulate capital within the consensual, non-antagonistic sustainable order, where claims of doing good and building a good conscience are affective mechanisms that play an important, yet underexplored, role. In the conclusion, we reflect on the broader role of green finance and the possibility of harnessing affect and the political towards building more transformative and emancipatory urban socio-environments.
The Intersection between COVID-19, the Gene Family of ACE2 and Alzheimer’s Disease
Authors: Haghighi Mahdi Montazer , Kakhki Erfan Ghani , Sato Christine , Ghani Mahdi , Rogaeva Ekaterina
Published: November 2020

We reviewed factors that might influence COVID-19 outcomes (eg, neurological symptoms), including the link to Alzheimer’s disease. Since the virus triggers COVID-19 infection through binding to ACE2, we focused on the ACE2 gene family, including ACE. Both ACE2 and ACE are involved in the renin–angiotensin system (RAS). In general, ACE causes inflammation and vasoconstriction, while ACE2 leads to anti-inflammation activity and vasodilation. The disturbed balance between these counter-regulatory pathways could influence susceptibility to COVID-19. Notably, dysregulation of the RAS-equilibrium contributes to Alzheimer’s disease. Differences in the incidence and symptoms of COVID-19 in diverse populations could be attributed to variability in the human genome. For example, ACE and ACE2 variations could modify the outcome of COVID-19 in different populations. It would be important to conduct genome-wide studies to detect variants influencing COVID-19 presentation, with a special focus on variants affecting immune-related pathways and expression of RAS-related genes.
Use of the ReCIVA device in breath sampling of patients with acute breathlessness: a feasibility study
Authors: Holden Karl A. , Ibrahim Wadah , Salman Dahlia , Cordell Rebecca , McNally Teresa , Patel Bharti , Phillips Rachael , Beardsmore Caroline , Wilde Michael , Bryant Luke , Singapuri Amisha , Monks Paul , Brightling Chris , Greening Neil , Thomas Paul , Siddiqui Salman , Gaillard Erol A.
Published: November 2020

Introduction

Investigating acute multifactorial undifferentiated breathlessness and understanding the driving inflammatory processes can be technically challenging in both adults and children. Being able to validate noninvasive methods such as breath analysis would be a huge clinical advance. The ReCIVA® device allows breath samples to be collected directly onto sorbent tubes at the bedside for analysis of exhaled volatile organic compounds (eVOCs). We aimed to assess the feasibility of using this device in acutely breathless patients.

Methods

Adults hospitalised with acute breathlessness and children aged 5–16 years with acute asthma or chronic stable asthma, as well as healthy adult and child volunteers, were recruited. Breath samples were collected onto sorbent tubes using the ReCIVA® device and sent for analysis by means of two-dimensional gas chromatography-mass spectrometry (GCxGC-MS). The NASA Task Load Index (NASA-TLX) was used to assess the perceived task workload of undertaking sampling from the patient's perspective.

Results

Data were available for 65 adults and 61 children recruited. In total, 98.4% of adults and 75.4% of children were able to provide the full target breath sample using the ReCIVA® device. NASA-TLX measurements were available in the adult population with mean values of 3.37 for effort, 2.34 for frustration, 3.8 for mental demand, 2.8 for performance, 3.9 for physical demand and 2.8 for temporal demand.

Discussion

This feasibility study demonstrates it is possible and acceptable to collect breath samples from both adults and children at the bedside for breathomics analysis using the ReCIVA® device.
An audit of COPD: diagnosis and management in general practice
Authors: Hamad Ghassan , Rigby Alan , Morice Alyn H.
Published: November 2020

Introduction

COPD is a spectrum of disorders primarily caused by smoking and characterised by progressive, not fully reversible airflow obstruction with a forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7.

Methods

From November 2016 to March 2017 we audited patients with COPD in five general practices in Hull and East Riding, UK. We looked at deviation from the locally agreed guidelines. We extracted data on severity, exacerbations, medication and eosinophil count.

Results

We assessed 1088 records. Median age was 70.9 years; 577 (53%) were male. About two-thirds of patients on the COPD register have an FEV1/FVC ratio in the diagnostic range for COPD, however, 388 (36%) out of 1088 had a ratio of ≥0.7. In the patients with a ratio of ≥0.7, 259 (67%) out of 388 had an FEV1<80% of predicted. Patients with frequent exacerbations were more likely to be prescribed inhaled corticosteroid (ICS)-containing inhalers (incidence rate ratio of 2). FEV1% predicted was a poor indicator of exacerbation frequency; however, the presence of elevated blood eosinophil counts (EOS) on at least two occasions was highly predictive of exacerbations. When ICSs, FEV1, EOS were examined in combination, they were highly significant predictors for exacerbations.

Conclusion

FEV1maybe a more accurate diagnostic parameter in primary care. Historical evidence of blood eosinophilia is a better predictor than FEV1. The combination of biomarkers may prove more accurate indicator of future exacerbation frequency, leading to targeted intervention.
Developing EU environmental standards for the food, drink and milk industries: key environmental issues and data collection
Authors: Giner Santonja Germán , Karlis Panagiotis
Published: November 2020

Background

The European Commission organised the review of the best available techniques reference document for the food, drink and milk industries according to the provisions of the Industrial Emissions Directive (Directive 2010/75/EU). Under this policy, an exchange of information between Member States, industrial organisations, non-governmental organisations promoting the protection of the environment and the European Commission took place.

Results

A crucial part of developing these EU environmental standards was the systematic determination of the key environmental issues of the food, drink and milk sector. Key environmental issues were defined for emissions to air and water, and for energy and water consumption. The key environmental issues were systematically determined using four criteria proposed by the European Commission. Moreover, a data collection procedure was designed and real-plant emissions and consumption data were obtained for the first time from a representative variety of food, drink and milk installations across the European Union.

Conclusions

The development of the EU environmental standards for the food, drink and milk sector are based on a systematic determination of the key environmental issues and on a representative data collection for this sector. This paper also highlights the main normative, organisational and procedural factors addressed during the environmental policy integration carried out to develop these standards.
Characterization of gut microbiota associated with clinical parameters in intrahepatic cholestasis of pregnancy
Authors: Li Rong , Chen Xuehai , Liu Zhongzhen , Chen Yan , Liu Chuan , Ye Lingfei , Xiao Liang , Yang Zhenjun , He Jian , Wang Wen-Jing , Qi Hongbo
Published: November 2020

Background

Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease.

Methods

A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different operational taxonomic units (OTUs) between ICP and controls were also identified.

Results

Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray–Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups. PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups.

Conclusions

Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.