bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethical Challenges in Independent Living Donor Advocacy
Authors: Vittone Sarah B. , Crowell Nancy A.
Published: June 2021

The Independent Living Donor Advocate, who is required on the transplant team, advocates, promotes, and protects the interests of the donor. Previously described ethical challenges perceived by these advocates and the variability of their responses prompted further inquiry. Research Questions: How are ethical obligations perceived by ILDAs? What ethical principles do ILDAs identify as the basis of their decision making? What are the ethical challenges for ILDAs? Study Design: A descriptive cross-sectional survey was designed and administered via REDCap. Participants were recruited from the National Kidney Foundation Living Donor Advocate email list. Quantitative and qualitative data on their role, ethical decision making, and perceived ethical issues, by seriousness and frequency, were collected. Results: Thirty-four participants responded. Nonmaleficence was ranked as the primary ethical principle used in decision making. Participants rated obligations to protect higher than advocacy. Participants reported experiencing internal ethical conflict to protect over advocate for the donor. The most serious ethical challenge participants perceived for donors was their decisional capacity, followed by their emotional or psychological distress, which was also described as a frequent donor challenge experienced in their role. Discussion: The results of this survey validate previous descriptions that the advocate role is largely perceived as protective. Their independent nature as well as the inherent vulnerabilities of the potential living donor compels the continued mitigation of ethical challenges, to enhance advocacy and protection for the living donor.
Predictors and Complications of Post Kidney Transplant Leukopenia
Authors: Vinson Amanda , Teixeira Alyne , Kiberd Bryce , Tennankore Karthik
Published: June 2021

Background:

Leukopenia occurs frequently following kidney transplantation and is associated with adverse clinical outcomes including increased infectious risk. In this study we sought to characterize the causes and complications of leukopenia following kidney transplantation.

Methods:

In a cohort of adult patients (≥18 years) who underwent kidney transplant from Jan 2006-Dec 2017, we used univariable Cox proportional Hazards models to identify predictors of post-transplant leukopenia (WBC < 3500 mm3). Factors associated with post-transplant leukopenia were then included in a multivariable backwards stepwise selection process to create a prediction model for the outcome of interest. Cox regression analyses were subsequently used to determine if post-transplant leukopenia was associated with complications.

Results:

Of 388 recipients, 152 (39%) developed posttransplant leukopenia. Factors associated with leukopenia included antithymocyte globulin as induction therapy (HR 3.32, 95% CI 2.25-4.91), valganciclovir (HR 1.84, 95% CI 1.25-2.70), tacrolimus (HR 3.05, 95% CI 1.08-8.55), prior blood transfusion (HR 1.17 per unit, 95% CI 1.09- 1.25), and donor age (HR 1.02 per year, 95% CI 1.00-1.03). Cytomegalovirus infection occurred in 26 patients with leukopenia (17.1%). Other than cytomegalovirus, leukopenia was not associated with posttransplant complications.

Conclusion:

Leukopenia commonly occurred posttransplant and was associated with modifiable and non-modifiable pretransplant factors.
Galinha Pintadinha Runs the World: A Made-for-Children Brazilian Cartoon in the Global Flow of Television Content
Authors: Holzbach Ariane Diniz
Published: June 2021

The objective of this article is to understand how the YouTube hit Galinha Pintadinha (Lottie Dottie Chicken), a naïve Brazilian animation aimed at preschool children, defies the power of big media companies and offers new ways of audiovisual enjoyment. I will describe the emergence of the animation and its YouTube channel called Galinha Pintadinha, which initially had only the Brazilian preschool audience as a target, and then I will analyze its internationalization process that has been developing on YouTube. I have paid attention to the uploaded video strategies of the seven international YouTube channels of Galinha Pintadinha (American, British, French, Italian, Indian, Japanese, and Spanish) considering the number of subscribers to each channel, the number of views, and the growth of the channels. The success reached by Galinha Pintadinha around the world is a result of the audiovisual reconfiguration processes considering the Brazilian audiovisual history in the global flow of media content.
Adaptation of a Mailed-FIT Kit and Patient Navigation Intervention to Increase Colorectal Cancer (CRC) Screening Among Spanish-Speaking Hispanic/Latino Patients
Authors: Jang Sou Hyun , Cole Allison , Brown Emily V.R. , Ko Linda
Published: June 2021

Background:

Hispanic/Latino populations experience significant barriers to colorectal cancer (CRC) screening. ProCRCScreen is a multicomponent CRC screening program that can help primary care clinics improve CRC screening rates, but it needs adaptation to better meet the health care needs of Spanish-speaking Hispanic/Latino populations.

Methods:

We conducted four focus groups with 22 Spanish-speaking Latino patients and used inductive qualitative content analysis to identify potential program adaptations.

Results:

We identified lack of social support for CRC screening and confusion about completing stool-based testing as important barriers to CRC screening. Participants recommended increased specificity of the fecal immunochemical test (FIT) instructions to increase the likelihood of successful test completion, especially for first-time screening. They also endorsed patient navigation for support in completing CRC screening.

Discussion:

We adapted the informational materials and workflows for the ProCRCScreen program. Future research to test the adapted program is needed.
“It’s the End of the PhD as We Know it, and We Feel Fine…Because Everything Is Fucked Anyway”: Utilizing Feminist Collaborative Autoethnography to Navigate Global Crises
Authors: Rutter Nikki , Hasan Ecem , Pilson Anna , Yeo Emma
Published: June 2021

Unpacking our experiences as trainee researchers navigating a global pandemic; in this research four researchers identify and interpret otherwise individual experiences through a collective lens. These shared responses are collated and understood through the multivocal method of what we term a “feminst collaborative auto-ethnography.” Relational ethics using a praxis of care, in line with feminist epistemology underpin the systematic analysis of our shared experiences to enhance intersubjectivity and the co-construction of knowledge. Individual reflections and collaborative sessions were utilized to immerse ourselves both situationally and critically into the pool of data. Concurrently creating and analyzing our collaborative inquiry. We utilized mind maps, probing, and reflexivity to engage with our individual and shared social, emotional, and structural challenges. Through analysis of the collaborative data we identified that we had all developed safety seeking strategies, and that a focused research method not only provided direction, but provided a support network. The researchers found that collaborative autoethnography is a useful and holistic method of understanding and navigating adversities in the PhD process, allowing for us to interpret multiple levels of adversity and support-strategies during Covid-19 times.
The research for characters of detonated rupture disks used in rarefaction wave gun for test
Authors: Jian Wang , Pengfei Bu , Wenjun Ruan
Published: June 2021

In this paper, numerical and experimental analysis were carried out to study the characters of the detonated rupture disks used in rarefaction wave gun for test. The pressure bearing capacity and cutting blasting ability of the disks were studied in detail. The research results showed that the designed detonated rupture disks could withstand the maximum pressure of 140 MPa or more during launch process. The central detonating spoke had an annular cutting depth of about 1.3 mm. It was not the shearing deformation at the supporting edge but the excessive tensile deformation at the middle position that led to the failure. The disk was cut and destroyed as a whole satisfyingly, so the rationality and feasibility of the detonated rupture disks used in rarefaction wave gun for test were verified, which could provide a reference for the development of rarefaction wave artillery and similar low recoil weapons.
Development of an ANN model for prediction of tool wear in turning EN9 and EN24 steel alloy
Authors: Baig Rahmath Ulla , Javed Syed , Khaisar Mohammed , Shakoor Mwafak , Raja Purushothaman
Published: June 2021

An imperative requirement of a modern machining system is to detect tool wear while machining to maintain the surface quality of the product. Vibration signatures emanating during machining with a single point cutting tool have proven to be good indicators for the tool’s health. The current research undertaken utilizes vibration signatures while turning EN9 and EN24 steel alloy to predict tool life using Artificial Neural Network (ANN). During initial meager experimentation, tool acceleration during machining was recorded, and the width of the flank wear at the end of each run was measured using Tool Makers Microscope. The recorded experimental data is utilized to develop the neural network with the variation of operating parameters and corresponding tool vibration with measured tool flank wear. The endeavor undertaken for the development of ANN flank wear prediction model was effective with a regression coefficient of 0.9964. The proposed methodology of indirect measurement of tool wear is efficient, economical for the machining industry to predict tool life, which in turn avoids catastrophic tool failure.
Research on the influencing factors of thermal characteristics of high-speed grease lubricated angular contact ball bearing
Authors: Zhang Chang , Guo Dan , Tian Jiyin , Niu Qingbo
Published: June 2021

The high temperature rise of grease lubricated angular contact ball bearing under high speed operation will affect the working accuracy of the bearing, and even lead to the loss of accuracy. In this paper, a friction heat generation model for high-speed grease lubricated angular contact ball bearing was established. Based on the quasi-static analysis model, the thermal expansion of the bearing components is brought into the quasi-static equilibrium equation, and the modified quasi-static analysis model of high-speed grease lubricated ACBB is obtained. Under grease lubrication conditions, a local bearing heat-generation model was employed to assess power losses in different contact zones, in which bearing contact parameters, external loads, and rotation speeds conditions were fully considered. Moreover, the temperature distribution of grease lubricated high-speed bearing was analyzed by the multi node thermal network method. Through the analysis model of bearing dynamic and thermal characteristics considering the influence of thermal expansion established, bearing contact parameters have significant differences. The calculated values of outer ring temperature of grease lubricated angular contact ball bearing is in good agreement with the experimental values. The model can predict the temperature values of grease lubricated angular contact ball bearing under axial load at high speed.
Rap, Islam and Jihadi Cool: The attractions of the Western jihadi subculture
Authors: Qvotrup Jensen Sune , Fuglsang Larsen Jeppe , Sandberg Sveinung
Published: June 2021

Recent scholarship has explored the potential of subcultural theory for understanding the convergence of Western street and jihadi subcultures. The role of jihadi rap in this radical hybrid culture, however, is yet uncharted. We argue that subcultural analysis allows an understanding of the aesthetic fascination of jihadism, sometimes referred to as jihadi cool, and that jihadi rap should be seen as an integrated part of this cultural amalgam. To better understand the role of hip-hop in the hybrid street-jihadi culture, this paper offers a historical analysis of the relationship between hip-hop and Islam and detailed insight into the more contemporary, and marginal, phenomena of jihadi rap. We track the continuities and discontinuities from the presence of Black Islam in early hip hop to recent convergences between hip hop and jihadism. Our analysis draws on Lévi-Strauss concepts of bricolage and floating signifiers. Subcultures and hip-hop music are seen as bricolages that draw on a multitude of cultural references with their own particular history. In these cultural bricolages, Islam often acts as a floating signifier, with different and often ambiguous meanings. We argue and demonstrate that Islam has a long history of being part of hip-hop rebellion and attraction and that this, channelled through jihadi rap, can contribute to jihadi cool and the contemporary pull of Western jihadi subcultures.
Multimorbidity groups based on numbers of chronic conditions are associated with daily activity
Authors: Klinedinst Tara C , Terhorst Lauren , Rodakowski Juleen
Published: June 2021

Objective

Instrumental activities of daily living (IADL) are important for managing multiple chronic conditions (MCC) and maintaining independence while aging. Using data from the National Health and Aging Trends Study (NHATS), we answered the question: are there differences in ability and performance of IADL among groups of older adults with 0–1 (no MCC), 2–4 (low MCC), and 5+ chronic conditions (multisystem morbidity: MM)?

Methods

Cross-sectional study using Poisson regression and incidence rate ratios. Participants were 6,019 community-dwelling older adults who regularly take medications. We derived composite variables for ability and performance of IADL; MCC groups were based on count of 11 chronic conditions.

Results

Older adults with MM had lower IADL count for ability (IRR = .81) and performance (IRR = .77), and MM group significantly predicted both ability and performance of IADL (p < .001); ‘low MCC’ group was not significantly different than ‘no MCC’ regarding disability.

Discussion

Having MM is statistically and clinically different than having low MCC or no MCC; 5+ chronic conditions may be a meaningful inclusion criterion for interventions to decrease disability and 2–4 chronic conditions may be better for trials to prevent disability. Researchers should measure both ability and performance of daily activity.
Commentary on Elkjær et al.’s (2020) Meta-Analysis on Expansive Versus Contractive Nonverbal Displays
Authors: Körner Robert , Röseler Lukas , Schütz Astrid
Published: June 2021

We offer a critical perspective on the meta-analysis by Elkjær et al. (2020) by pointing out three constraints: The first refers to open-science practices, the second addresses the selection of studies, and the third offers a broader theoretical perspective. We argue that preregistration and adherence to the highest standards of conducting meta-analyses is important. Further, we identified several missing studies. Regarding the theoretical perspective, we suggest that it may be useful to tie body positions into the dominance-prestige framework and, on that basis, to distinguish two types of body positions. Such an approach has the potential to account for discrepancies in previous meta-analytical evidence regarding the effects of expansive versus contractive nonverbal displays. Future research may thus be able to provide not only methodological but also theoretical innovations to the field of body positions.
How ISIS represented enemies as ineffectual in Dabiq: A multimodal critical discourse analysis
Authors: Rasoulikolamaki Sahar , Kaur Surinderpal
Published: June 2021

This paper is a multimodal critical discourse study of other-representation in ISIS’s magazine, Dabiq, It focuses on both the micro-level analysis of actor and action representation, and the macro-structure of negative other-depiction in Dabiq from both textual and visual perspectives. Through in-depth examination of linguistic and non-linguistic elements, the study aimed to unfold ISIS’s ideology at the global level, which is to construct its desired reality and eventually to recruit supporters. The analysis was carried out on fifteen issues of Dabiq following a conceptual and analytical framework within Multimodal Critical Discourse Analysis employing Van Leeuwen’s Socio-semantic inventory. The results show a considerable number of systematic utilizations of discursive strategies by ISIS to belittle its enemies and downgrade their practices. Throughout Dabiq, the out-group participants are represented either as passive reactants who are afflicted by ISIS’s attacks or as powerless agents whose actions are trivial and carry no significant weight. Ineffectuality of ‘others’ has further been substantiated by the visual analysis. Deactivation of out-groups is closely tied to ISIS’s propaganda of self-alteration to achieve the double aim of casting fear among their adversaries and brainwashing the audience by twisting the reality, and persuading them that the enemies’ chance of winning this war is dim.
The potential effects of autonomous vehicles on walking
Authors: Pettigrew Simone
Published: June 2021

Vehicle automation is progressing rapidly and autonomous vehicles (AVs) are forecast to become a central feature of transportation systems globally. This development has the potential to result in profound changes in walking behaviors. The present study examined this issue from the perspective of relevant experts for the purpose of informing health policy. Interviews were conducted with 44 key stakeholders in Australia ( n = 34), the European Union ( n = 5), the UK ( n = 4), and the US ( n = 1). The stakeholders represented a wide range of sectors including government, AV manufacturing/servicing companies, transport policy consortiums, technology firms, insurers (public and private), trade unions, consumer representation organizations, and academia. Two potential scenarios were evident in interviewees’ discussions of the ways AVs are likely to be introduced and the implications for walking behaviors. The most beneficial scenario, but the least likely to eventuate, was considered to be the situation where people relinquish private vehicle ownership and rely on a combination of walking, public transport, and on-demand transport. The alternative scenario involved greater private AV ownership, traffic congestion, and urban sprawl, resulting in less walking activity. The convergence of the stakeholders’ views around the opposing identified scenarios highlights the need for proactive policy development to ensure the emerging transport transformation does not result in substantial increases in sedentarism.
Designing a multi-component ‘Stop Bullying-School Intervention Program’ in Chandigarh, a North Indian Union Territory
Authors: Rana Monica , Gupta Madhu , Malhi Prahbhjot , Grover Sandeep , Kaur Manmeet
Published: June 2021

Bullying, a prevalent global public health issue, is proven to have an adverse impact on the physical and psychological health of school students. There are few intervention programs to prevent bullying in the South East Asian Region, and none in India. The objective of this study was to design a multi-component antibullying intervention program known as ‘Stop Bullying–School Intervention Program (SB-SIP)’ for school students. It was developed in five stages. Stage one was the review of existing literature on intervention studies to prevent bullying, globally. A qualitative study to explore the beliefs and perceptions of teachers, students, and parents regarding antibullying intervention programs was conducted in stage two. In the third stage, a conceptual model was framed. A consultation workshop was conducted to finalize the contents of the intervention in the fourth stage. Pretesting of the intervention was done in the fifth stage. The literature review provided evidence that a whole-school intervention program based on the socio-ecological model was the most effective. The awareness of the effects of bullying and effective strategies to prevent it in the school setting was suggested to be part of the SB-SIP by the majority of the participants in the focus group discussions. The recommendations given by the stakeholders in the consultation workshop contributed mainly to the method of delivery of the program. The five-stage process helped in recognition of the conceptual model and modifiable factors, which exerts its effects on bullying and its psychosocial outcome, through which the multi-component antibullying intervention program SB-SIP was finalized.
Towards Smarter and Fairer Justice? A Review of the Chinese Scholarship on Building Smart Courts and Automating Justice
Authors: Papagianneas Straton
Published: June 2021

This article reviews how Chinese scholars debate the policy of building smart courts in the context of judicial reform. This policy entails the automation and digitisation of judicial processes. It is part of broader judicial reforms that aim to create a more accurate and consistent judiciary. The article identifies four reform concepts that guide the debate: efficiency, consistency, transparency and supervision, and judicial fairness. This review is a meta-synthesis, using practices of narrative and systematic literature reviews, focusing on evaluating and interpreting the Chinese scholarship and reform concepts. It reviews how Chinese scholars discuss the implications of judicial automation and digitisation. Additionally, it analyses the normative concepts behind the reform goals within China’s political-legal context. The analysis finds that the generally positive evaluation in the debate can be explained by an instrumentalist understanding of the reform concepts and the political purpose of courts in the Chinese political-legal context.
A Content Analysis of Selected State Plans for Gifted and Talented Education
Authors: Lockhart Kari , Meyer Melanie S. , Crutchfield Kacey
Published: June 2021

Programs for gifted and talented education should be guided by research-based practices, but states’ policies vary in their recommendations for programming, and in how they hold local education agencies accountable for implementing those recommendations. State plans for gifted and talented education rely on the voluntary compliance of districts to implement policies meeting students’ advanced academic needs and providing opportunities for talent development. State plans for gifted education may outline expectations, but leave much about the implementation up to districts. Even within a state, gifted education services vary widely across districts and individual schools. This research identified 11 state plans for gifted education that included guidance on identification, curriculum, service options, professional development, and program evaluation. Through thematic analysis, eight primary themes and three secondary themes were identified, which demonstrate the necessity of ongoing program evaluation balancing the need for standardization with the need to adapt policies to fit local contexts.
Clinical Trials of COVID-19 Therapies Should Account for Diabetes and Hyperglycemia
Authors: Klonoff David C. , Messler Jordan , Valk Timothy , Jagannathan Ram , Pasquel Francisco J. , Umpierrez Guillermo E.
Published: June 2021

Complications of Coronavirus Disease 2019 (COVID-19) occur with increased frequency in people admitted to the hospital with diabetes or hyperglycemia. The increased risk for COVID-19 infections in the presence of these metabolic conditions is in part due to overlapping pathophysiologic features of COVID-19, diabetes, and glucose control. Various antiviral treatments are being tested in COVID-19 patients. We believe that in these trials, it will be useful to evaluate treatment effect differences in patients stratified according to whether they have diabetes or hyperglycemia. In this way, it will be possible to better facilitate development of antiviral treatments that are most specifically beneficial for the large subset of COVID-19 patients who have diabetes or hyperglycemia.
Endovascular treatment of cavernous carotid artery aneurysms: A 10-year, single-center experience
Authors: Lee Hubert , Marotta Thomas R , Spears Julian , Sarma Dipanka , Montanera Walter , Bharatha Aditya
Published: June 2021

Background

Cavernous carotid artery aneurysms can be treated by several endovascular techniques including flow diversion (FD) and parent vessel occlusion (PVO). We reviewed our institution’s consecutive series of endovascularly treated cavernous carotid artery aneurysms to compare these two modalities and their associated clinical and radiographic outcomes.

Methods

All patients harboring a cavernous carotid artery aneurysm treated by FD or PVO from January 2008 to December 2018 were enrolled. Data were collected retrospectively and analyzed on patient presentation, aneurysm dimensions, treatments and related complications, rate of aneurysm occlusion, sac regression, and outcomes.

Results

Fourteen patients were treated with FD and 12 underwent PVO subsequent to passing a balloon test occlusion. There was no significant difference between treatment modalities in aneurysmal occlusion (97.0 ± 8.4% (FD) vs. 100% (PVO), p = 0.23), degree of sac regression (62.5 ± 16.7% (FD) vs. 56.8 ± 24.3% (PVO), p = 0.49), or near-complete to complete symptom improvement (66.7% (FD) vs. 81.8% (PVO), p = 0.62). Major complications included subarachnoid hemorrhage from aneurysmal rupture in 1 (7.1%) patient post-FD and 2 (16.7%) ischemic strokes following PVO.

Conclusions

Endovascular treatment of cavernous carotid artery aneurysms by FD or PVO are both effective and safe. There is insufficient evidence to recommend one technique over the other and decision making should be individualized to the patient, their aneurysm morphology, and operator experience.
Disparate trends of atherosclerotic plaque evolution in stroke patients under 18-month follow-up: a 3D whole-brain magnetic resonance vessel wall imaging study
Authors: Xiao Jiayu , Song Shlee S , Schlick Konrad H , Xia Shuang , Jiang Tao , Han Tong , Jackson Robert J , Diniz Marcio A , Dumitrascu Oana M , Maya Marcel M , Lyden Patrick D , Li Debiao , Yang Qi , Fan Zhaoyang
Published: June 2021

Purpose

The trend of atherosclerotic plaque feature evolution is unclear in stroke patients with and without recurrence. We aimed to use three-dimensional whole-brain magnetic resonance vessel wall imaging to quantify the morphological changes of causative lesions during medical therapy in patients with symptomatic intracranial atherosclerotic disease.

Methods

Patients with acute ischemic stroke attributed to intracranial atherosclerotic disease were retrospectively enrolled if they underwent both baseline and follow-up magnetic resonance vessel wall imaging. The morphological features of the causative plaque, including plaque volume, peak normalized wall index, maximum wall thickness, degree of stenosis, pre-contrast plaque-wall contrast ratio, and post-contrast plaque enhancement ratio, were quantified and compared between the non-recurrent and recurrent groups (defined as the recurrence of a vascular event within 18 months of stroke).

Results

Twenty-nine patients were included in the final analysis. No significant differences were found in plaque features in the baseline scan between the non-recurrent ( n = 22) and recurrent groups ( n = 7). The changes in maximum wall thickness (–13.32% vs. 8.93%, P = 0.026), plaque-wall contrast ratio (–0.82% vs. 3.42%, P = 0.005) and plaque enhancement ratio (–11.03% vs. 9.75%, P = 0.019) were significantly different between the non-recurrent and recurrent groups. Univariable logistic regression showed that the increase in plaque-wall contrast ratio (odds ratio 3.22, 95% confidence interval 1.55–9.98, P = 0.003) was related to stroke recurrence.

Conclusion

Morphological changes of plaque features on magnetic resonance vessel wall imaging demonstrated distinct trends in symptomatic intracranial atherosclerotic disease patients with and without stroke recurrence.
Highly prevalent Russian HIV-1 V3-loop sequence variants are susceptible to maraviroc
Authors: Lewis ME , Jubb B , Simpson P , Lopatukhin A , Kireev D , Bobkova M , Craig C , van der Ryst E , Westby M , Butler SL
Published: June 2021

Introduction

Maraviroc inhibits CCR5-tropic HIV-1 across different subtypes in vitro and has demonstrated efficacy in clinical trials. V3-loop amino acid variants observed in individual maraviroc-resistant viruses have not been found to be predictive of reduced susceptibility. Sequence-database searches have demonstrated that approximately 7.3% of viruses naturally encode these variants, raising concerns regarding potential pre-existing resistance. A study from Russia reported that combinations of these same amino acids are present in the V3 loops of the Russian variant subtype A (IDU-A, now A6) with a much greater prevalence (range: 74.4%–92.3%) depending on the combination. However, these studies and database searches did not include phenotypic evaluation.

Methods

Sixteen Russian HIV-1 isolates (including sub-subtype A6 viruses) were assessed for V3 loop sequence and phenotypic susceptibility to maraviroc.

Results

All 12 of the A6 viruses and 2/4 subtype B isolates encoded V3-loop variants that have previously been identified in individual virus isolates with reduced susceptibility to maraviroc. However, despite the prevalence of these V3-loop amino acid variants among the tested viruses, phenotypic sensitivity to maraviroc was observed in all instances. Similarly, reduced susceptibility to maraviroc was not found in virus from participants who experienced virologic failure in a clinical study of maraviroc in Russia (A4001101, [NCT01275625]).

Discussion

Altogether, these data confirm that the presence of individual or combinations of V3-loop amino acid residues in sub-subtype A6 viruses alone does not predict natural resistance to maraviroc and that V3-loop genotype analysis of R5 virus prior to treatment is not helpful in predicting clinical outcome.
Non-alcoholic fatty liver disease is associated with increased risk of chronic kidney disease
Authors: Cai Xiaoyan , Sun Lichang , Liu Xiong , Zhu Hailan , Zhang Yang , Zheng Sulin , Huang Yuli
Published: June 2021

Background and Aims:

Whether non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident chronic kidney disease (CKD) independent of established cardio-renal risk factors remains controversial. We aimed to provide a quantitative estimate of the association and strength between NAFLD and risk of CKD after adjustment for multiple cardio-renal risk factors.

Methods:

We searched electronic databases (PubMed, Embase, and Google Scholar) for studies published from database inception until 30 November 2020. Analysis included cohort studies that reported multivariable-adjusted risk ratios [including odds ratios, relative risks (RRs), or hazard ratios] and 95% confidence intervals (CIs) for CKD of NAFLD compared with individuals without NAFLD.

Results:

A total of 11 cohort studies were included comprising 1,198,242 participants (46.3% women) for analysis. The median follow-up duration was 3.7 years, with 31,922 cases of incident CKD. Compared with individuals without NAFLD, unadjusted models showed that NAFLD was associated with a higher risk of CKD (RR 1.54, 95% CI 1.38–1.71). After adjusting for multiple cardio-renal risk factors, the CKD risk was still significantly increased in patients with NAFLD (RR 1.39, 95% CI 1.27–1.52). Compared with individuals without NAFLD, the adjusted absolute risk increase in NAFLD for CKD was 5.1 (95% CI 3.5–6.8) per 1000 person-years.

Conclusion:

NAFLD is associated with an increased risk of incident CKD independent of established cardio-renal risk factors.
The effect of doxycycline on neuron-specific enolase in patients with traumatic brain injury: a randomized controlled trial
Authors: Mansour Noha O. , Shama Mohamed A. , Werida Rehab H.
Published: June 2021

Objective:

We aimed to examine the effect of doxycycline on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage in traumatic brain injury (TBI) patients.

Methods:

Patients were randomly assigned into two groups ( n = 25 each) to receive either placebo or doxycycline (200 mg daily), with their standard management for 7 days.

Results:

NSE serum levels in the doxycycline and control groups on day 3 were 14.66 ± 1.78 versus 18.09 ± 4.38 ng/mL, respectively ( p = 0.008), and on day 7 were 12.3 ± 2.0 versus 16.43 ± 3.85 ng/mL, respectively ( p = 0.003). Glasgow Coma Scale (GCS) on day 7 was 11.90 ± 2.83 versus 9.65 ± 3.44 in the doxycycline and control groups, respectively ( p = 0.031). NSE serum levels and GCS scores were negatively correlated ( r = −0.569, p < 0.001).

Conclusion:

Adjunctive early use of doxycycline might be a novel option that halts the ongoing secondary brain injury in patients with moderate to severe TBI. Future larger clinical trials are warranted to confirm these findings.
The effects of vertebral rotation on the position of the aorta relative to the spine in patients with adult degenerative scoliosis
Authors: Liang Yan , Xu Shuai , Zhao Yongfei , Liu Haiying , Mao Keya
Published: June 2021

Aims:

This study aimed to explore the effects of vertebral rotation on the position of the aorta relative to the thracolumbar and lumbar spine, and to identify risk factors for vertebral rotation in patients with adult degenerative scoliosis (ADS).

Methods:

A total of 71 patients with ADS were divided into left scoliosis (LS) group ( n = 40 cases) and right scoliosis (RS) group ( n = 31cases) with well-matched demographics. Apical vertebrae, Cobb angle (°), coronal horizontal movement, thoracolumbar kyphosis (TLK) and Nash–Moe rotation classification were measured on X-ray. The Cartesian coordinate system was established on T2-MRI for each level of intervertebral disc on thracolumbar and lumbar spine, where aorta–vertebrae angle (α), aorta–vertebrae distance (d), and vertebral rotation angle (γ) for each level of T12-L1 to L3-L4 on MRI were defined within the Cartesian coordinate system.

Results:

There was no statistical difference in the distribution of apical vertebrae between LS and RS groups. Nash–Moe classification was of no significance between the two groups. When there was a larger Cobb angle and coronal horizontal movement, a greater γ in LS group and a lower γ in RS group were noted (both p < 0.001). There was no correlation among γ, α, and d in LS group ( p = 0.908 and 0.661, respectively) nor in RS group ( p = 0.738 and 0.289, respectively). In LS group, Nash–Moe classification correlated to Cobb angle, coronal movement and TLK. In RS group, it correlated to Cobb angle and coronal movement. Cobb angle was the risk factor for Nash–Moe classification in RS group while no factors were identified in LS group. Coronal movement was independent risk factor for γ ( p = 0.003) in LS group. Moreover, γ was affected by Cobb angle ( p = 0.001) and coronal horizontal movement ( p = 0.006) in RS group.

Conclusion:

Vertebral rotation could be predicted by Cobb angle or coronal horizontal movement measured on X-ray in ADS patients and aorta maintained in a relatively normal position in patients with ADS.
Humanoid service robots: The future of healthcare?
Authors: Ozturkcan Selcen , Merdin-Uygur Ezgi
Published: June 2021

Humanoid service robots made swift progress in extending a helping hand to the strained global healthcare during the COVID-19 pandemic. This case provides an overview of the robots’ inclusion in healthcare regarding pre- and intra-pandemic contexts. Specific focus is devoted to humanoid service robots as their shape, size, and mobility make them advantageous in using the physical spaces designed for humans. A collection of examples from hospitals worldwide is presented in illustrating the humanoid service robots’ deployment in healthcare during the COVID-19 pandemic. The pointed future directions aim to facilitate better decision- and policy-making that may ease human anxiety and promote greater acceptance.
Rethinking crisis dynamics from the perspective of online publics: A case study of Dolce & Gabbana’s China crisis
Authors: Ban Zhuo , Lovari Alessandro
Published: June 2021

On November 18, 2018, the Italian fashion house Dolce & Gabbana (D&G) released a controversial video on all their social media channels. The video triggered an instant outcry from the general Chinese public, who called the video a racist caricature of Chinese culture. D&G responded to the crisis with several image repair strategies. This study examines D&G’s crisis communication efforts in the wake of this incident. Departing from corporate-oriented perspectives prevalent in the field of public relations, this study employs a dynamic, public-oriented view of crisis communication, which focuses on the dynamic, interactive process of crisis development from the standpoint of the publics. By analyzing communicative behavior on Twitter (an increasingly influential alternative public sphere in China) and in particular, comments and responses toward the crisis communication strategies employed by D&G, we have identified four prominent themes, or ways that publics framed their key messages against the corporation: “Apology not enough”; “Apology done badly”; “Call to unite against D&G”; and “Sarcasm, mockery, and abuse.” And they can be interpreted as a number of crisis communication strategies of the global, online publics. Based on our analysis of the D&G case, we discuss the theoretical implications of a dynamic, public-oriented perspective (DPOP) on crisis communication, highlighting its key areas of difference from the corporate-oriented perspective (COP).
Strategic problematization of sustainability reframing dissent in strategic communication for transformation
Authors: Weder Franzisca
Published: June 2021

Involving stakeholders in organizational decisions is essential in the present sustainability movement, associated with the social license to operate and specific forms of communication in, from and about organizations with an impact orientation. This paper introduces a concept of strategic problematization of sustainability for transformation as innovative approach to Public Relations (PR), acknowledging the plurality of agonistic voices in stakeholder engagement processes in social, cultural and environmental transformations and challenging the normative concept of dialogue and solution- and consensus-oriented approaches to date. The article discusses the transformative potential of PR by reframing dissent and introducing problematization as ability to agonize and, therefore, as key process of constructive strategic communication for sustainable development. Three conversational procedures in water (scarcity) management on a local, national and international level were chosen to explore the potential of strategic problematization in relation to sustainability as normative framework of today’s society. The implications of the case studies and the conceptual framework expand existing engagement theories with a critical perspective and manifest the transformative potential of PR for a sustainable future.
Naive patients with suspicious prostate cancer and positive multiparametric magnetic resonance imaging (mp-MRI): is it time for fusion target biopsy alone?
Authors: Checcucci Enrico , De Cillis Sabrina , Amparore Daniele , Garrou Diletta , Aimar Roberta , Piana Alberto , Piramide Federico , Granato Stefano , Cattaneo Giovanni , Manfredi Matteo , Fiori Cristian , Bollito Enrico , Stura Ilaria , Migliaretti Giuseppe , Porpiglia Francesco
Published: June 2021

Objectives:

To determine if standard biopsy still has a role in the detection of prostate cancer or clinically significant prostate cancer in biopsy-naive patients with positive multiparametric magnetic resonance imaging.

Materials and methods:

We extracted, from our prospective maintained fusion biopsy database, patients from March 2014 to December 2018. The detection rate of prostate cancer and clinically significant prostate cancer and complication rate were analysed in a cohort of patients who underwent fusion biopsy alone (group A) or fusion biopsy plus standard biopsy (group B). The International Society of Urological Pathology grade group determined on prostate biopsy with the grade group determined on final pathology among patients who underwent radical prostatectomy were compared.

Results:

Prostate cancer was found in 249/389 (64.01%) and 215/337 (63.8%) patients in groups A and B, respectively ( P=0.98), while the clinically significant prostate cancer detection rate was 57.8% and 55.1% ( P=0.52). No significant differences in complications were found. No differences in the upgrading rate between biopsy and final pathology finding after radical prostatectomy were recorded.

Conclusions:

In biopsy-naive patients, with suspected prostate cancer and positive multiparametric magnetic resonance imaging the addition of standard biopsy to fusion biopsy did not increase significantly the detection rate of prostate cancer or clinically significant prostate cancer. Moreover, the rate of upgrading of the cancer grade group between biopsy and final pathology was not affected by the addition of standard biopsy.

Level of evidence:

Not applicable for this multicentre audit.
Longitudinal cohort analysis of patients with metastatic penile cancer treated in a large quaternary academic centre
Authors: Liu Wing K , Patel Reena , Crawford Ruairidh , Ayres Benjamin , Watkin Nick , Tree Alison , Pickering Lisa , Patel Hiten RH , Ashfar Mehran
Published: June 2021

Objective:

This study aimed to provide real-world data on the multidisciplinary management of metastatic penile squamous-cell carcinoma (mpSCC) patients and their survival outcomes, particularly those who receive best supportive care (BSC).

Methods:

A retrospective analysis of 1720 patients, managed via a supra-regional penile-specialist multidisciplinary team was conducted between January 2006 and May 2020.

Results:

A total of 101 patients (median age 63 years; interquartile range 56–72 years; 73% ECOG 0/1) were included. Of these, 32% (32/101) had previously received adjuvant chemotherapy prior to metastatic recurrence, 58% (59/101) received chemotherapy and 42% (42/101) received BSC. Further, 17% (17/101) received second-line systemic therapy, and 3% (3/101) received third-line systemic therapy. For first-line systemic-therapy, there was a 46% (27/59) clinical benefit rate (CBR), with 9% (5/59) complete response, 15% (9/59) partial response and 22% (13/59) stable disease. Patients receiving second-line therapy ( n=17) had a 29% (5/17) CBR. Median progression-free survival for first- and second-line treatment was 3.2 and 2.2 months, respectively. Median overall survival (mOS) for all patients was 6.2 months. mOS for first-line chemotherapy, second-line chemotherapy and BSC patients was 7.2, 4.5 and 2.0 months, respectively.

Conclusions:

First-line platinum-based chemotherapy is associated with notable response rates in mpSCC patients. Agents with better response rates are needed urgently potentially in combination with platinum-based chemotherapy.

Level of evidence:

Level 2b.
Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team
Authors: Pestka Deborah L. , Paterson Nicole L. , Benedict Katarzyna A. , Williams Donovan D. , Shellenbarger Beth A. , McVay-Steer Allison J. , Cheng Tiffany , Pangburn Jennifer , Warner Debra , Bryant Lisa
Published: June 2021

As part of a population health-focused primary care transformation, in 2019 a health system in Minnesota developed a primary care team to exclusively care for high-cost high-need patients. Through its development and implementation, the team has discovered several key lessons in delivering care to complex patients. These lessons include the benefits of more integrative team-based care, the need and advantages of designated complex care team members, the importance of teamwork both within and outside of the complex care team, the need for frequent communication, and the importance of identifying mental health needs. In addition, there are several areas that require ongoing research and exploration, such as determining when a patient is able to graduate out of the program, how to enhance access to the complex care team, determining appropriate visit characteristics, and model feasibility. While addressing the needs of high cost high need patients is essential to improving quality of care and decreasing health care costs, there are several unique challenges and opportunities that come with caring for this patient population. Although this highly integrated model of care continues to evolve, the initial lessons learned may inform other health systems and care teams undertaking the care of complex patients.
Examining the Impact of Customers’ Awareness, Risk and Trust in M-Banking Adoption
Authors: Tiwari Prashant , Tiwari Shiv Kant , Gupta Ashish
Published: June 2021

Mobile banking services have been a significant breakthrough in the electronic banking system and have many potential demands for online banking services to connect with consumers. Although there has been a rapid expansion of information technology (IT) in banking, which offers multiple opportunities in the global market, massive growth has not been seen in India’s m-banking adoption. Several kinds of research on m-banking adoption have been conducted in various countries, and it has been observed that India has great potential for m-banking. Nonetheless, users are not quite sure about its use for a few reasons. The present study extends the applicability of technology acceptance model (TAM) constructs in connection with customers’ awareness, perceived risk and perceived trust to investigate the user’s behavioural intention of m-banking adoption. The authors tested the proposed framework by using regression analysis in SPSS 23 and collected a sample of 311 mobile banking users by using convenience sampling. In support of the previous studies, findings revealed that perceived usefulness, perceived ease of use, customer awareness, perceived risk and perceived trust significantly adopted m-banking services in the Indian context.