bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomizing India’s Presence in Automotive Global Value Chains
Authors: Dash Ankita , Chanda Rupa
Published: September 2021

Global value chains (GVCs) are the modus operandi of contemporary international trade and production. However, the operational underpinnings of what facilitates or hinders participation of firms in their respective sectoral GVCs are surprisingly understudied. This article attempts to discover the potential factors—ranging from regulatory, institutional, technological, trade-related and financial to sectoral, and input-related elements—affecting GVC participation of automotive firms in India. A firm-level field survey was undertaken to better understand firms’ perceptions regarding these factors. The findings were analysed using principal component analysis (PCA) and partial least squares structural equation modelling (PLS-SEM), which revealed that certain policies such as state government initiatives and the Competition Act, as well as trade facilitation measures like standardisation of procedural requirements and trade agreements were the most significant factors aiding firms’ participation in automotive GVCs, while institutional, technological and input-related aspects were deterrents to such participation. Our findings have important implications for policymaking in the country for encouraging greater GVC participation of firms, especially small and medium enterprises.

JEL Codes: F14, F6
Effectiveness and safety of ultrasound-guided hydrostatic reduction for children with acute intussusception
Authors: Yang Heying , Wang Guantao , Ding Yi , Li Yanan , Sun Beibei , Yue Ming , Wang Jiaxiang , Song Dongjian
Published: September 2021

Objective

This study aims to explore the effectiveness and safety of the new-type ultrasound-guided hydrostatic reduction for children with acute intussusception.

Methods

The clinical data of 364 children with primary acute intussusception who underwent nonsurgical reduction in our hospital between January 2016 and May 2019 were retrospectively analyzed. Among the 364 children, 119 formed the hydrostatic reduction group. There were 89 males and 30 females, and the average age of admission was 25.13 ± 1.43 months. Among the pneumatic reduction group of 245 patients, there were 163 males and 82 females. The average age of admission was 22.47 ± 1.52 months. The reduction rate, length of stay, and perforation rate were compared between the two groups.

Results

Univariate analysis showed that the reduction rate in the hydrostatic group (94.96%) was higher than in the pneumatic group (85.31%) ( p = 0.007), and the hospital stay (2.76 ± 0.15 days) of the hydrostatic reduction group was shorter than that of the pneumatic reduction group (3.56 ± 0.35 days) ( p = 0.038). In children with intussusception time >48 h, the reduction rate was 95.45% in the hydrostatic reduction group and 86.20% in the pneumatic reduction group.

Conclusion

The new-type ultrasound-guided hydrostatic reduction has a higher reduction rate in the treatment of acute intussusception in children results in a shortened hospital stay, It is effective, safe, and avoids radiation exposure.
Origin of authigenic albite in a lacustrine mixed-deposition sequence (Lucaogou Formation, Junggar Basin) and its diagenesis implications
Authors: Wu Haiguang , Zhou Junjun , Hu Wenxuan , Sun Funing , Kang Xun , Zhang Yunfeng , He Wenjun , Feng Chengcheng
Published: September 2021

Authigenic albites occur widely in clastic reservoirs with important implications for diagenesis and reservoir formation. The middle Permian Lucaogou Formation in the Jimusaer Sag (Junggar Basin, NW China), where major exploration breakthroughs in shale oil have been achieved, reveals a new phenomenon that authigenic albites are abundant in unique mixed carbonate–volcanic–clastic sequences. This has not been reported in the literatures. To fill the knowledge gap, the origin of these authigenic albites and their relationship with dissolution pores (i.e. diagenesis implications) were investigated. Results show that two types (I and II) of authigenic albite were identified within the shale oil reservoirs. Euhedral Type I authigenic albites with 3–10 μm only occur in dolarenite intraclasts and are symbiotic with amorphous dolomite minerals with a pure chemical composition of >99% albite-end-member content. Larger Type II authigenic albites with 10–50 μm are widely distributed in reservoirs, primarily in dissolution pores, and coexist with authigenic dolomite minerals or dolomite overgrowths. Their chemical composition is less pure with anorthite-end-member contents that range from undetectable to 9.77%, with an average of 1.34%. A symbiotic relationship, pure chemical composition, size, and euhedral morphology indicate that Type I authigenic albites precipitated during syngenetic hydrothermal action. However, the morphology of dissolution pores, residual symbiotic “orthoclase”, impure chemical composition and carbon–oxygen isotope indicate that Type II were the products of the dissolution and reprecipitation of “perthite” crystal pyroclasts influenced by acid organic fluids in latter diagenesis. The differential dissolution of “orthoclase” and “albite” components in “perthite” crystal pyroclasts formed enormous intergranular secondary pores in the presence of dolomite minerals in the shale oil reservoirs.
Managing More than Poverty When Living With Addiction: Parents’ Emotion and Identity Work
Authors: Gazso Amber
Published: September 2021

In this article, I qualitatively explore the emotion and identity work of parents living with addiction to drugs or alcohol and accessing social assistance, specifically Ontario Works, in Toronto, Canada. Through narrative and discourse analysis of in-depth interviews, I show how parents (re-) produce or (re-) negotiate their identities as mothers and fathers in relation to feeling rules constituted in three broader, cultural discourses about family relations, addiction, and poverty: welfare dependency; intensive mothering; and families as a safe haven. I argue that this emotion and identity work is necessitated by how these feeling rules collude or clash with parents master status of addict entrenched in their relationships with social assistance policy and caseworkers and perceived by others too. I conclude with a consideration of the social policy and justice implications of my findings, including the need to overturn the stigmatization of addiction and poverty.
Association Between Twitter Mentions and Academic Citations in Otolaryngology Literature
Authors: Deshpande Nikita , Crossley Jason R. , Malekzadeh Sonya
Published: September 2021

Objective

To evaluate the relationship between Twitter mentions and academic citations in otolaryngology literature.

Study Design

Retrospective cross‐sectional analysis.

Setting

Altmetric Twitter mention and Google Scholar citation rosters.

Methods

Original research articles from 10 leading otolaryngology journals were assessed 26 months after print publication. Article Twitter mentions were tracked through the Altmetric Bookmarklet, and article citation data were determined through the Google Scholar search engine. Twitter mentions and citation metrics of articles were compared through 2‐tailed t test analysis (P <. 05).

Results

Of all articles, 50.7% (152/300) had at least 1 Twitter mention. Of all article Twitter mentions, 25% (432/1758) happened within the first week of online publication dates, while 64% (1130/1758) occurred between online and print publication dates. Articles mentioned on Twitter had 1.6‐fold more Google Scholar citations (8.6 ± 0.7, mean ± SD) than articles with no Twitter mentions (5.4 ± 0.4, P <. 01). A total of 8% (24/300) of publications were tweeted by their authors. Articles self‐tweeted by authors were associated with an 8.4‐citation increase (14.8 ± 3.1) for Google Scholar when compared with articles not shared by their authors on Twitter (6.4 ± 0.4; 2.3‐fold increase, P <. 01).

Conclusion

Most otolaryngology articles are disseminated over Twitter, with greatest Twitter activity occurring before print publication date of articles. Citations within 2 years of release are positively associated with the number of mentions on Twitter. Article Twitter mentions may augment the academic influence of otolaryngology publications.
Dopaminergic and noradrenergic modulation of stress-induced alterations in brain activation associated with goal-directed behaviour
Authors: van Ruitenbeek Peter , Quaedflieg Conny WEM , Hernaus Dennis , Hartogsveld Bart , Smeets Tom
Published: September 2021

Background:

Acute stress is thought to reduce goal-directed behaviour, an effect purportedly associated with stress-induced release of catecholamines. In contrast, experimentally increased systemic catecholamine levels have been shown to increase goal-directed behaviour. Whether experimentally increased catecholamine function can modulate stress-induced reductions in goal-directed behaviour and its neural substrates, is currently unknown.

Aim:

To assess whether and how experimentally induced increases in dopamine and noradrenaline contribute to the acute stress effects on goal-directed behaviour and associated brain activation.

Methods:

One hundred participants underwent a stress induction protocol (Maastricht acute stress test; MAST) or a control procedure and received methylphenidate (MPH) (40 mg, oral) or placebo according to a 2 × 2 between-subjects design. In a well-established instrumental learning paradigm, participants learnt stimulus–response–outcome associations, after which rewards were selectively devalued. Participants’ brain activation and associated goal-directed behaviour were assessed in a magnetic resonance imaging scanner at peak cortisol/MPH concentrations.

Results:

The MAST and MPH increased physiological measures of stress (salivary cortisol and blood pressure), but only MAST increased subjective measures of stress. MPH modulated stress effects on activation of brain areas associated with goal-directed behaviour, including insula, putamen, amygdala, medial prefrontal cortex, frontal pole and orbitofrontal cortex. However, MPH did not modulate the tendency of stress to induce a reduction in goal-directed behaviour.

Conclusion:

Our neuroimaging data suggest that MPH-induced increases in dopamine and noradrenaline reverse stress-induced changes in key brain regions associated with goal-directed behaviour, while behavioural effects were absent. These effects may be relevant for preventing stress-induced maladaptive behaviour like in addiction or binge eating disorder.
Assessing the effects of methodological differences on outcomes in the use of psychedelics in the treatment of anxiety and depressive disorders: A systematic review and meta-analysis
Authors: Leger Robert F , Unterwald Ellen M
Published: September 2021

Background:

Classical psychedelics are a group of drugs which act as agonists on the serotonin-2A (5-HT2A) receptor. Evidence suggests they may have a uniquely rapid and enduring positive effect on mood. However, marked heterogeneity between methodological designs in this emerging field remains a significant concern.

Aims:

To determine how differences in the type of psychedelic agent used and the number of dosing sessions administered affect subjects’ depression and anxiety outcomes and adverse drug reactions (ADR).

Methods:

This review collected and screened 1591 records from the MEDLINE and Web of Science databases for clinical trials reporting objective data on mood for subjects with a known anxiety or depression.

Results:

After screening, nine clinical trials met inclusion criteria. Meta-analysis of these studies showed significant, large positive effect sizes for measures of anxiety (Cohen’s d = 1.26) and depression (Cohen’s d = 1.38) overall. These positive effects were also significant at acute (⩽1 week) and extended (>1 week) time points. No significant differences were observed between trials using different psychedelic agents (psilocybin, ayahuasca or lysergic acid diethylamide (LSD)), however, a significant difference was observed in favour of trials with multiple dosing sessions. No serious ADR were reported.

Conclusion:

Psilocybin, ayahuasca and LSD all appear to be effective and relatively safe agents capable of producing rapid and sustained improvements in anxiety and depression. Moreover, the findings of the present analysis suggest that they may show a greater efficacy when given to patients over multiple sessions as compared to the more common single session used in many of the existing trials.
Analysis of Headway and Speed Based on Driver Characteristics and Work Zone Configurations Using Naturalistic Driving Study Data
Authors: Xu Dan , Xue Chennan , Zhou Huaguo
Published: September 2021

The objective of this paper is to analyze headway and speed distribution based on driver characteristics and work zone (WZ) configurations by utilizing Naturalistic Driving Study (NDS) data. The NDS database provides a unique opportunity to study car-following behaviors for different driver types in various WZ configurations, which cannot be achieved from traditional field data collection. The complete NDS WZ trip data of 200 traversals and 103 individuals, including time-series data, forward-view videos, radar data, and driver characteristics, was collected at four WZ configurations, which encompasses nearly 1,100 vehicle miles traveled, 19 vehicle hours driven, and over 675,000 data points at 0.1 s intervals. First, the time headway selections were analyzed with driver characteristics such as the driver’s gender, age group, and risk perceptions to develop the headway selection table. Further, the speed profiles for different WZ configurations were established to explore the speed distribution and speed change. The best-fitted curves of time headway and speed distributions were estimated by the generalized additive model (GAM). The change point detection method was used to identify where significant changes in mean and variance of speeds occur. The results concluded that NDS data can be used to improve car-following models at WZs that have been implemented in current WZ planning and simulation tools by considering different headway distributions based on driver characteristics and their speed profiles while traversing the entire WZ.
Transtendon Suture Bridge Repair of Both-Sided Partial-Thickness Rotator Cuff Tears: Midterm Outcomes
Authors: Suh Dongwhan , Park Sang-Eun , Han Young-Hun , Kim Eung-Sic , Ji Jong-Hun
Published: September 2021

Background:

Among symptomatic partial-thickness rotator cuff tears (PTRCT) indicated for surgery, both-sided (concurrent articular and bursal side) PTRCT are rarely reported and discussed in the literature. Without clinical data on and definite guidelines for treating these rare partial tears, appropriate management cannot be expected.

Purpose:

To calculate the prevalence of both-sided PTRCT and to evaluate clinical outcomes after arthroscopic transtendon suture bridge repair of both-sided PTRCT at a minimum 3-year follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

Among symptomatic PTRCT that required arthroscopic surgery (765 patients) between March 2008 and December 2014, 178 both-sided partial tears were confirmed arthroscopically, and arthroscopic transtendon suture bridge repair was performed in 100 patients enrolled in our study after exclusion criteria were applied. The presence of concurrent articular and bursal side partial tears was confirmed via arthroscopy, with Ellman grade >2 on either the bursal or the articular side of these both-sided partial tears. Without tear completion, transtendon suture bridge repair was performed in all cases. Clinical outcomes including clinical scores and range of motion were evaluated at a mean of 5.3 ± 1.4 years (range, 3-8 years). Follow-up magnetic resonance imaging (MRI) was performed at 6 to 12 months (mean ± SD, 11 ± 5.20 months) after surgery to evaluate the tendon integrity (Sugaya classification) of the repaired rotator cuff.

Results:

The mean age was 57.5 ± 7.8 years, and 65% of patients were women. Mean preoperative American Shoulder and Elbow Surgeons, University of California Los Angeles, Simple Shoulder Test, and Constant-Murley outcome scores of 52 ± 14, 19 ± 4, 6 ± 2, and 69 ± 10 significantly improved postoperatively to 94 ± 5, 33 ± 2, 11 ± 1, and 93 ± 5, respectively ( P < .001). Mean forward flexion, abduction, external rotation, and internal rotation improved significantly from 148°± 31°, 134°± 39°, 22°± 13°, and L2 preoperatively to 154°± 17°, 151°± 60°, 29°± 14°, and T10 postoperatively, respectively ( P < .001). The retear rate on follow-up MRI scans was 2%. As per Sugaya classification on postoperative MRI scans, type 1 healing was found in 29%; type 2, in 60%; type 3, in 9%; and type 4, in 2%.

Conclusion:

Among all symptomatic PTRCT that required surgery, both-sided PTRCT were more common than expected. Arthroscopic transtendon suture bridge repair of these both-sided PTRCT showed satisfactory clinical outcomes at a minimum 3-year follow-up.
Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department
Authors: Nightingale Ginah , Scopelliti Emily M. , Casten Robin , Woloshin Monica , Xiao Shu , Kelley Megan , Chang Anna Marie , Hollander Judd E. , Leiby Benjamin E. , Peterson Andrew M. , Pizzi Laura T. , Rising Kristin L. , White Neva , Rovner Barry
Published: September 2021

Background: Medication-related problems in older Blacks with diabetes mellitus (DM) are not well established. Objectives: To describe the frequency of medication-related problems in older Blacks with DM presenting to the emergency department (ED). Methods: The study was a cross-sectional analysis of baseline data from a randomized controlled trial evaluating Blacks aged ≥60 years of age presenting to the ED. Polypharmacy, potentially inappropriate medication (PIM) use, and anticholinergic score were evaluated. Results: Of 168 patients (median age = 68, range 60–92), most ( n = 164, 98%) were taking ≥5 medications, and 67 (39.9%) were taking a PIM. A majority ( n = 124, 74%) were taking a medication with an anticholinergic score ≥1. Number of medications was correlated with number of PIMs ( r = .22, p = .004) and anticholinergic score ( r = .50, p < .001). Conclusion: Polypharmacy and PIM use was common in older Blacks with DM.
The Coronavirus Pandemic and Global Governance: The Domestic Diffusion of Health Norms in Global Health Security Crises
Authors: Biswas Shreejita
Published: September 2021

The recent outbreak of the COVID-19 pandemic demands imperative discussions in the field of health security and global governance. Traditional studies on health care and global governance have acknowledged the significance of “global” as it rested on the fact that epidemics and pandemics are not restricted within national boundaries. The COVID-19 pandemic has challenged the hierarchical division of norm diffusion. Despite the structural inequalities, the patterns of behavior of various countries, such as China, the USA, Italy, South Korea, and India, in managing the crisis suggest a favorable ground for bringing in the importance of national-level decision-making in the global versus local debate. Building upon the arguments from norm theories of diffusion, the article contributes to our understanding that for an effective analysis of the politics of global health governance, the power of local channels in the diffusion of essential health norms cannot be undermined. The article studies the role played by the local-level diffusion processes, in this case, the national state actors in reshaping and integrating essential health norms to make it workable for broader global relevance. As a result, following the norm theories of diffusion, this article analyzes the global–local dynamics with regard to public health in the context of the spread of the COVID-19 health security threat.
Effect of a Nurse-Led Education Program for Stroke Patients on Sleep Quality and Quality of Life: A Randomized Controlled Study
Authors: Urcan Zeynel , Kolcu Merve
Published: September 2021

Nurse-led education and follow-up for stroke patients may facilitate management and improve quality of life. This study investigated the effect of a nurse-led education program for stroke patients on sleep and life quality. A total of 92 stroke patients (46 in the intervention group, 46 in the control group) aged 18 to 75 years who were independently mobile (less than or equal to one assistive device) and had no other neurologic or psychiatric disorders or history of sleep disorder prior to stroke were included. Patients randomized to the intervention group completed a 20-week education and follow-up program including information about stroke, rehabilitation, adaptation to daily life, and the importance of sleep quality. In the posttest, the intervention group had significantly higher sleep quality and stroke-specific quality of life scores than the control group. This study may serve as a guide for nurses who work with stroke patients.
Modelling tourism competitiveness in small Pacific island countries
Authors: Kumar Nikeel N , Patel Arvind , Singh Rup
Published: September 2021

This study models overall and bilateral tourism competitiveness in small Pacific island countries (PICs), namely, Cook Islands, Fiji, Tonga, Samoa and Vanuatu. The pooled mean group approach, which corrects for cross-sectional dependence and non-stationarity, is used for estimation with quarterly data from 2002 to 2019. The findings indicate that for Fiji and Vanuatu, other PICs are competing destinations and that Fiji and Vanuatu face the strongest bilateral competition amongst the selected PICs. Cross-price elasticities are insignificant for Tonga and are generally negative for the Cook Islands and Samoa. Thus, while for Fiji and Vanuatu, the Cook Islands is a competing destination, Fiji and Vanuatu are complementary destinations for the Cook Islands. Therefore, destinations that more closely resemble each other face stronger competition, and the nature and strength of competitive behaviour between two destinations are different for each concerned destination.
L1 versus L2 writing processes: What insight can we obtain from a keystroke logging program?
Authors: Mohsen Mohammed Ali
Published: September 2021

Writing in a language different from one’s mother tongue is a daunting task. The same challenge may apply to languages that have diglossic features whose spoken form differs from the written form. This article investigates Arab students’ writing behaviors (fluency, pauses, and revision) in response to an argumentative composition in their L1 (first language: Arabic) and L2 (second language: English), given that understanding their complexities in writing processes would help instructors to rectify language writing-related problems. Guided by Kellogg’s model, this article attempts to investigate the cognitive processes underlying these writing behaviors as aided by a keystroke logging program (Inputlog 7.0). It also examined if writing behaviors would be correlated to the writing quality of their produced final texts. Data were collected from log files of the Inputlog generated upon the students’ writing processes, screened video recordings, and a stimulated recall interview. Results indicated that compared with L2 writing in character production, L1 writing processes were highly significant, less significant in pauses over word boundaries, and highly significant in time on the task factor. Concerning revision behavior, no significant differences were found in time spent on deletion and insertion, whereas a significant difference was found in R-burst for L2 writing. As regards quality of text, many pauses and minimal production of words tend to be negative indicators for writing quality output. Pedagogical implications and suggestions for future research are highlighted.
NANOG Promotes Cell Proliferation, Invasion, and Stemness via IL-6/STAT3 Signaling in Esophageal Squamous Carcinoma
Authors: Deng Li , Zhang Xinping , Xiang Xiaocong , Xiong Rong , Xiao Dongqin , Chen Zhu , Liu Kang , Feng Gang
Published: September 2021

Background: Cancer cells have properties similar to those of stem cells, including high proliferation and self-renewal ability. NANOG is the key regulatory gene that maintains the self-renewal and pluripotency characteristics of embryonic stem cells. We previously reported that knockdown of the pluripotent stem cell factor NANOG obviously reduced the proliferation and drug-resistance capabilities of esophageal squamous cell carcinoma (ESCC). In this study, we gained insights into the potential regulatory mechanism of NANOG, particularly in ESCC. Methods: NANOG was ectopically expressed in the Eca-109 cell line via pcDNA3.1 vector transfection. The mRNA expression of different genes was detected using quantitative real-time polymerase chain reaction, and protein quantification was performed by western blotting. The enzyme-linked immunosorbent assay was used to detect the expression of interleukin 6 (IL-6). The capabilities of proliferation, migration, and invasion were investigated using cell count and Transwell assays. The tumor sphere-forming assay was used to investigate the sphere formation capacity of cancer stem cells. Results: The expression of NANOG promoted the cell proliferation and sphere formation capacity of cancer stem cells in a dose-dependent manner. IL-6-mediated activation of signal transducer and activator of transcription 3 (STAT3) was closely related to the expression of NANOG in ESCC. Consistently, the target genes of STAT3, including CCL5, VEGFA, CCND1, and Bcl-xL, were upregulated upon the overexpression of NANOG. Conclusion: These results revealed that the expression of NANOG promotes cell proliferation, invasion, and stemness via IL-6/STAT3 signaling in ESCC.
A review of the green synthesis of ZnO nanoparticles using plant extracts and their prospects for application in antibacterial textiles
Authors: Xu Jun , Huang Yubo , Zhu Shihui , Abbes Nedra , Jing Xiaoning , Zhang Liang
Published: September 2021

In an era of environmentally friendly development, methods of the green synthesis of zinc oxide nanoparticles (ZnO NPs) from plant extracts have become a focus of research attention because of the benefits of environmental sustainability, simplicity, and low price. The present review introduces a green mechanism for the synthesis of ZnO NPs using the extracts of plants, exploring factors that influence the morphology of ZnO NPs and their antibacterial properties, and the mechanisms of antibacterial action. The results indicate that the factors that influence morphology include the intrinsic crystallographic morphological properties and conditions of the preparation of ZnO NPs. In terms of preparation conditions, the influence of plant extract concentration, precursor concentration, reaction time, and calcination temperature on NP morphology is related to the species of plants used, with precursor concentration the most significant factor affecting the morphology of ZnO NPs. A pH of 12 appears be the most appropriate alkalinity for the synthesis of ZnO NPs from plant extracts. In addition, the synthesized ZnO NPs display excellent antibacterial properties, the mechanism of which involves photocatalysis, reactive oxygen species, and interactions between ZnO NPs and bacterial surfaces. Factors influencing the antibacterial properties are the type of bacteria and the concentration and morphology of ZnO NPs. Finally, the methods of preparation of antibacterial textiles using synthetic ZnO NPs are discussed in relation to the preparation of antibacterial fibers, fabric, and composite textiles. Here, the future trend of such antibacterial textiles is considered, providing the direction for further research of antibacterial textiles.
Elective ENT surgery during the COVID-19 pandemic: Experience from a single UK centre
Authors: Ally Munira , Patel Anant , Tanna Ravina , Kenyon Olivia , Vijendren Ananth , Mochloulis George
Published: September 2021

Aim

To analyse the outcomes of patients who underwent elective ENT surgery during the first peak of the COVID-19 pandemic in a COVID free site.

Methods

This is a retrospective single centre case series of all patients undergoing elective ENT surgery over a 16-week period between 1 April and 22 July 2020.

Results

No patients, out of our cohort of 85, developed postoperative COVID-19 symptoms or complications of COVID-19. There were no mortalities.

Conclusion

The results suggests that hospitals can safely manage elective ENT operating services during the pandemic.
Gender differences in non-cystic fibrosis bronchiectasis severity and bacterial load: the potential role of hormones
Authors: Brooke-Hollidge Anna , Conway Joy , Lewis Adam
Published: September 2021

Non cystic-fibrosis bronchiectasis (NCFB) is a complex chronic respiratory disease, characterised by excessive sputum production and abnormal permanent dilation of bronchi. Mucus accumulation leads to recurrent bacterial infections and increased bacterial load, causing vicious cycles of structural damage and decreased lung function. Respiratory physiotherapy management of NCFB includes airway clearance techniques and use of nebulised, hypertonic saline. Despite advances in treatment, a consistent relationship has been observed between gender and disease occurrence, with a higher prevalence amongst females. Furthermore, NCFB presents most aggressively amongst post-menopausal females, a group likely exposed to higher levels of progesterone (P4) over a longer period of time. The effects of gender-specific hormones on bacterial load and physiotherapy management of people living with NCFB remain unknown. The aim of this narrative review was to discuss the potential influence of gender specific hormones on NCFB disease progression and influence on physiotherapy, medical management and future research. SCOPUS and PUBMED electronic databases were used to conduct searches for relevant studies using specific inclusion and exclusion criteria. Secondary inclusion of relevant literature was obtained from primary paper references. Previous literature suggests that P4 may impair Cilia Beat Frequency (CBF) in airway epithelium. Reduction in CBF may further reduce ability to expectorate amongst individuals with NCFB, increasing bacterial load and likelihood of exacerbations, negatively impacting on disease progression. Furthermore, coadministration of Estrogen has been suggested to offer opposing effects to that of P4 only. These findings question whether hormonal levels may be monitored, controlled and optimised within management and treatment of females with NCFB to improve airway clearance, reduce exacerbations and improve quality of life. Larger scale, long-term trials are required to further explore the effects of gender specific hormones on NCFB and the viability of treatment with hormone replacement therapy.

The reviews of this paper are available via the supplemental material section.
Dementia-Friendly Design: A Set of Design Criteria and Design Typologies Supporting Wayfinding
Authors: van Buuren L. P. G. , Mohammadi M.
Published: September 2021

Objectives, purpose, or aim:

This study aims to gain insights into the implementation of theoretical knowledge on dementia-friendly design into practice to (1) identify key design criteria stimulating spatial orientation and wayfinding for seniors with dementia and (2) determine the optimal design for this purpose.

Background:

Spatial orientation problems of seniors with dementia can be counteracted by the design of the physical environment of inpatient care facilities. Research has been conducted about design features supporting wayfinding skills for this target group, however, not on their implementation.

Methods:

Fourteen floor plans of the living group of built projects have been evaluated on 14 design criteria supporting wayfinding skills for the target group and measurable in floor plans by the performance of a comparative floorplan analysis and multicriteria assessment.

Results:

Although one third of the evaluated design criteria are properly implemented, all floor plans of the selected projects had some gaps in fulfilling all design criteria. Five typological floor plans—based on the circulation systems of the cases—were distinguished: one straight corridor structured by two walls, one corridor with corners, two corridors separated from each other by the living room, a continuous loop corridor, and a corridor framed by a wall and interior elements (e.g., cabinets). The majority of the cases was based on a linear system with one straight corridor.

Conclusions:

Based on this study, three of the five discovered typological floor plans work well for stimulating wayfinding. Furthermore, special attention need to be given to the configuration of the floor plans, shape, and daylight in the corridor.
Space Use and the Physical Attributes of Acute Care Units: A Quantitative Study
Authors: Kelly David , Pingel Michael J.
Published: September 2021

This article shares the results of a quantitative analysis of the space use and physical attributes of 140 acute care units (ACU) completed since 2007.

Objective:

To fill a gap in the literature with respect to the state of practice for ACU design over the study period by investigating relationships among the physical characteristics and density of completed ACUs.

Background:

Robust industry interest about the topic—further agitated by the dearth of large-scale quantitative research regarding ACU space use—motivated completion of the study.

Method:

Through extraordinary collaboration by participating firms, floor plans of 140 new ACUs from the study period were gathered, systematically measured, and then analyzed.

Results:

Structural bay size, nurse station location, and the number of beds per unit were found to have significant relationships to ACU floor-gross area per bed. Additionally, nine significant associations among the explanatory variables were found, including moderate relationships among bay size, nurse station location, room handedness, and toilet room placement.

Conclusion:

The results suggest that project design teams tend to bundle key physical attributes together when planning ACUs. Moreover, density increases resulting from bay size reduction diminish as the bay size drops below 31′. Any impacts resulting from the major external events demarking the last decade were not sufficient to appreciably affect ACU density. Lastly, those concerned with increasing density and controlling ACU floor gross area are alerted to explore design options featuring bay sizes of approximately 30′ in conjunction with a centralized nursing model containing more than 32 beds per unit.
The Role of Short-Term and Longer Term Immigration Trends on Voting for Populist Radical Right Parties in Europe
Authors: Ramos Miguel R. , Schumann Sandy , Hewstone Miles
Published: September 2021

The success of populist radical right parties (PRRPs) in Europe has, in part, been attributed to growing immigration, but previous findings have found an inconsistent relationship between immigration and voting for PRRPs. We address previous inconsistencies by suggesting a time-focused perspective on intergroup relations. We disentangle short-term from longer term immigration trends and argue that a recent increase in immigration should predict PRRP support. With time, however, citizens will adapt to these demographic changes and voting for PRRPs could decline. We drew on official immigration records and representative data from the European Social Survey, capturing the voting behavior of 75,874 individuals from 15 European countries between 2002 and 2014. We found that a recent increase in immigration predicted more PRRP voting, and this relationship was strengthened under conditions of higher economic strain and inequality. In contrast, sustained immigration in the longer term was not related with PRRP votes.
Gender and economic security in southeast Asia
Authors: Nair Tamara
Published: September 2021

Economic security in southeast Asia is often connected to the survival and security of states. This macro definition can be contrasted with a more people-centred approach to economic security. This article focuses on this aspect. Of particular concern is how men and women are affected differently in unstable times. We witness this now in this global pandemic. The current economic insecurities of women are not a reflection of historical gender norms but more a creation of contemporary neoliberal economics as practised in the region. While southeast Asia does well as a global economic hub, women do not have a fair share in its gains. By examining issues of power, liberating policies and women's rights and the right to decent work, the article ultimately posits greater intervention in narrowing economic inequalities. This will be a vital step in rebuilding national economies in southeast Asia, post-pandemic and in the years to come.
The value of “General Practitioners–Specialists” mode: A focus group study of patients with asthma in mastering inhalation skills
Authors: Zhao Jiayi , Fan Jian , Chai Rong , Zhang Rong , Han Yiping
Published: September 2021

This study focused on using “General Practitioners–Specialists” (GP-S) mode to teach the patients with asthma to master inhalation skills. 200 patients with asthma being admitted to the respiratory department of Shanghai Changhai Hospital were included in the study from January to December in 2018. There were 100 cases in the control group and 100 cases in the experimental group. The control groups received routine instruction and the experimental group adopted GP-S mode education, respectively, to learn mastering dry powder inhaler skills. The level of mastery and errors in the use of inhaled medications were recorded after each guidance. After four times’ instruction in two different ways, the patient’s mastery of inhalation skills gradually improved. After the guidance through the GP-S mode, the incidence of inhalation errors after each times instruction was 67%, 28%, and 7%, respectively. The later one was significantly lower than the previous one (67% vs. 28%, χ2 = 30.496, p < 0.001; 28% vs. 7%, χ2 = 15.273, p < 0.001). After twice instructions, the GP-S mode was associated with the lower incidence of inhaler device operating errors versus the regular guidance method (10% vs. 26%, χ2 = 8.672, p = 0.005); the same as the third guidance (2% vs. 11%, χ2 = 6.664, p = 0.018). Similarly, after thrice instructions, the incidence of inhalation method errors in the GP-S mode group was significantly lower than the regular guidance mode group (4% vs. 15%, χ2 = 7.037, p = 0.018), and there was still existing statistical difference of inhalation method errors between the two groups after four times instructions (3% vs. 11%, χ2 = 4.916, p = 0.049). General Practitioners–Specialists mode can effectively improve the patient’s mastery of inhalation skills, which significantly reduced the incidence of errors in the use of inhaled drugs and improved the overall management effectivity of asthma and patients’ compliance.
Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report
Authors: Yip Jeffrey Yuk Chiu
Published: September 2021

Introduction

Peritonitis remains the primary cause of treatment failure among patients with end-stage kidney disease on continuous ambulatory peritoneal dialysis. However, detailed case analyses illustrating the application of current research in clinical practice remain scant. This case report aimed to elucidate the roles of dialysis nurses in a hospital setting in the management of a 62-year-old male patient with a history of kidney failure secondary to amyloidosis.

Case Presentation

The patient was diagnosed with continuous ambulatory peritoneal dialysis-associated peritonitis.

Management and Outcomes

Dialysis nurses applied evidence-based practices in the management of the patient’s exit-site infection, imbalanced nutrition, and psychosocial concerns. The patient was discharged after 7 days, with a comprehensive treatment regimen, including an individualized peritoneal dialysis protocol adjusted to his daily schedules, education on self-care techniques, and continual nutritional management to prevent recurrence and improve his overall health. This case report shows that admissions for continuous ambulatory peritoneal dialysis-associated peritonitis require evidence-based nursing interventions specific to, and geared toward, each patient’s prioritized health problems.

Discussion

Peritonitis cases are preventable with appropriate nursing interventions that can lower the chance of treatment failure and long-term impact caused by an abrupt switch to hemodialysis. To successfully manage patients with continuous ambulatory peritoneal dialysis-associated peritonitis, dialysis nurses should appreciate the intricacies of the analyses underpinning their professional practices in promoting the patient’s self-care techniques.
The Experiences of Ghanaian Midwives on the Use of Nonadjustable Delivery Beds: A Qualitative Study
Authors: Dartey Anita F. , Dzansi Gladys , Atachie Constancia , Sunnu Evelyn , Nyande Felix K.
Published: September 2021

Background

Hospital beds are of great assistance to both clients and caregivers as they give lots of choices to the users. More often, clients have difficulty getting in and out of beds, but the adjustable features of the beds make it possible for them to be comfortable, regardless of their condition. This situation may not be the same if nonadjustable delivery beds (NADBs) are used in conducting deliveries at health care facilities. This study explored the experiences of midwives using NADBs in selected Christian Health Association of Ghana (CHAG) hospitals in the Volta Region of Ghana.

Methods

The study employed an exploratory qualitative research design with purposive sampling. Semistructured interview data were audio recorded. The inclusion criteria were professional midwives with at least 1 year of working skills and the midwives should have conducted deliveries using NADBs during their practice. Data were collected concurrently with data transcription and analyzed using content analysis. Saturation was reached after the 20th interview.

Results

Three themes emerged from the study: NADBs not comfortable to work with, assumption of awkward postures, and the nature of the delivery beds.

Conclusion

The findings of the study show that midwives experience several setbacks in the use of NADBs in conducting deliveries as they sacrifice their health for work.
Discrimination of Marginalized Sections in Kashmir: A Never-Ending Legacy (1846 Onwards)
Authors: Moochi Javid Ahmad
Published: September 2021

Society undergoes changes with passage of time due to internal and external factors. However, more radical nature of changes takes place due to external factors. Such changes prompt social reorganization. Kashmiri culture and society is no exception to this rule where penetration of different exogenous influence has led to the process of active assimilation, re-orientation and accommodation of over-all socio-cultural setup. In diverse societies inhabitants are differentiated on the basis of colour, caste, creed, etc. In the same way the inhabitants of the Kashmir valley are stratified and include many marginalized communities such as Watals, Dombs, Galwans, Dhobis, Hanjis, etc. These marginalized communities are assigned the lowest position in Kashmiri society only because of their profession and caste. Although the dominant religion of masses in Kashmir is Islam but actually it was only in sixteenth century that Islam replaced Hinduism in Kashmir. Islam preaches equality and universal brotherhood, and it negates distinction of its followers based on any ground. Thus with the advent of Islam in the valley it can be expected that the above mentioned distinctions would be diminished. But that is not the case. Even after adopting Islam the caste restrictions of Hinduism, which was prevalent before the inception of Islam, remained deeply rooted in the minds of Kashmiris. Those who were at the top of the hierarchy still corner all the privileges for them and the weaker sections are deprived and marginalized. This article attempts to highlight this discrimination, which is visible in Kashmir’s contemporary society as well.
Trends in Leadership Within Orthopedic Foot and Ankle Fellowships
Authors: Weissman Joshua P. , Goedderz Cody , Mutawakkil Muhammad Y. , Swiatek Peter R. , Gerlach Erik B. , Patel Milap S. , Kadakia Anish R.
Published: September 2021

Background:

No study in the orthopedic literature has analyzed the demographic characteristics or surgical training of foot and ankle fellowship directors (FDs). Our group sought to illustrate demographic trends among foot and ankle fellowship leaders.

Methods:

The American Orthopaedic Foot & Ankle Society (AOFAS) Fellowship Directory for the 2021 to 2022 program year was queried in order to identify all foot and ankle fellowship leaders at programs currently offering positions in the United States and Canada. Data points gathered included age, sex, race/ethnicity, location of surgical training, time since training completion until FD appointment, length in FD role, and individual research H-index.

Results:

We identified 68 fellowship leaders, which consisted of 48 FDs and 19 co-FDs. Sixty-five individuals (95.6%) were male, and 3 (4.4%) were female. As regards race/ethnicity, 88.2% of the leadership was Caucasian (n = 60), 7.4% was Asian American (n = 5), 1.5% was Hispanic/Latino (n = 1), and 1.5% was African American (n = 1). The average age was 51.5 years, and the calculated mean Scopus H-index was 15.28. The mean duration from fellowship training to fellowship leader position was 11.23 years.

Conclusion:

Leaders within foot and ankle orthopedic surgery are characterized by research prowess and experience, but demographic diversity is lacking.

Level of Evidence:

Level III.
Industry Payments to Foot and Ankle Surgeons and Their Effect on Total Ankle Arthroplasty Outcomes
Authors: Donoughe J. Scott , Safavi Kiya Shazadeh , Rezvani Aryan , Healy Nicholas , Jupiter Daniel C. , Panchbhavi Vinod K. , Janney Cory C.
Published: September 2021

Background:

The Centers for Medicare & Medicaid Services (CMS) Open Payments public database provides a means for increased transparency of physicians’ financial relationships with industry. Total ankle arthroplasty is a procedure with long-term clinical implications and variable outcomes. We compared physician-reported conflict-of-interest (COI) disclosures in the journal Foot & Ankle International ( FAI) to CMS database information to evaluate for discrepancies.

Methods:

Articles published in FAI reporting clinical outcomes of total ankle arthroplasty from 2015 and 2019 were reviewed. Payment information in the CMS database was cross-referenced with disclosure statements and International Committee of Medical Journal Editors (ICMJE) forms associated with the manuscript. Statistical analysis was performed to determine if industry payments were appropriately disclosed or influenced outcomes.

Results:

We reviewed 173 articles pertaining to ankle arthroplasty, with 27 meeting inclusion criteria. Of 120 total authors with 98 unique authors, 114 (95%) disclosed appropriately in disclosure statements. Twenty-two studies (82%) had appropriate declarations for the entire manuscript. For the 27 senior authors, only 2 discrepancies between manuscript disclosure and the Open Payments public database were noted, showing 13 total disclosures in the Open Payments public database vs 11 disclosed in the manuscript. There was no relationship between industry payments and the outcome of the manuscript ( P = .725).

Conclusion:

The majority of author disclosure statements accurately reflected the Open Payments public data. Additionally, payments were not significantly associated with positive outcomes reported for the specific implant. Overall, authors publishing on ankle arthroplasty in FAI are disclosing appropriately.

Level of Evidence:

Level IV, systematic review; survey study; literature review.