bluuebunny/crossref_metadata_2025 huggingface dataset:
Personalised music for residents with dementia in an Australian rural aged‐care setting
Authors: Kuot Abraham , Barton Elsa , Tiri Grace , McKinlay Trevor , Greenhill Jennene , Isaac Vivian
Published: February 2021

Objective

Personalised music reportedly has a positive effect on behaviour and mood in people living with dementia. This intervention has not been conducted in low‐resourced or rural aged‐care settings. We evaluated the effect of a non–therapist‐led personalised music listening intervention on residents with dementia and workplace culture in a rural aged‐care facility in South Australia.

Design

Qualitative pilot study.

Setting

Rural aged‐care home in South Australia.

Participants

Ten residents with dementia and 15 aged‐care staff participated in this study.

Interventions

Ten residents participated in an 8‐week music program. Four focus groups were conducted with aged‐care staff post‐intervention. A thematic analysis was used to identify emerging themes.

Main outcome measure

Personalised music positively influenced resident's behaviour and well‐being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care.

Results

Three themes emerged: quality of life, personalised care and better aged‐care environment. Personalised music positively influenced resident's behaviour and well‐being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care.

Conclusion

Personalised music program is an effective, low‐cost intervention to improve quality of life and personalised care of residents living with dementia, staff well‐being, and a workplace and culture in low‐resourced or rural aged‐care settings.
Clinical presentation and management of food protein‐induced enterocolitis syndrome in 113 Swedish children
Authors: Ullberg Josefin , Fech‐Bormann Mareike , Fagerberg Ulrika L.
Published: February 2021

Background

Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated food allergy causing severe acute gastrointestinal symptoms and lethargy, mainly affecting infants and young children. There are geographic variations in its clinical features. This study aimed to describe the clinical characteristics and management of FPIES in Swedish children.

Methods

The study included children who presented with acute FPIES during 2008–2017. All Swedish pediatric departments (n = 32) were invited to report their known patients. Data were collected through chart reviews and interviews with parents.

Results

Eighteen pediatric departments contributed, and 113 patients were included. Most had a family history of atopy (74%), and 51% had an atopic disease. Common trigger foods were cow's milk (26%), fish (25%), oat (22%), and rice (8%). Most patients (85%) reacted to a single food. The median age at first reaction was 3.9 months for cow's milk and 6.0 months for other foods (p < 0.001, range 1.0 month to 9 years). Repetitive vomiting (100%), lethargy (86%), and pallor (61%) were common symptoms; 40% had diarrhea. Sixty percent visited the emergency department, and 27% of all patients were hospitalized. Most patients were diagnosed clinically (81%). Specific IgE for the trigger food was positive in 4/89 tested patients (4%), and skin prick test for the trigger food was positive in 1/53 tested patients (2%).

Conclusions

In our Swedish study of 113 children, cow's milk, fish, and oat were the commonest trigger foods. Most patients reacted to a single food, and IgE sensitization was rare.
Glycemic benefits with adherence to testosterone therapy in men with hypogonadism and type 2 diabetes mellitus
Authors: Jenkins Craig R. , Rittel Alex , Sturdivant Rodney X. , Wan Jen , Clerc Philip G. , Manning Evan , Jenkins Lydia M. , Wardian Jana L. , Graybill Sky D.
Published: February 2021

Background

While previous studies have demonstrated testosterone's beneficial effects on glycemic control in men with hypogonadism and Type 2 Diabetes, the extent to which these improvements are observed based on the degree of treatment adherence has been unclear.

Objectives

To evaluate the effects of long‐term testosterone therapy in A1C levels in men with Type 2 Diabetes Mellitus and hypogonadism, controlling for BMI, pre‐treatment A1C, and age among different testosterone therapy adherence groups.

Materials and methods

We performed a retrospective analysis of 1737 men with diabetes and hypogonadism on testosterone therapy for 5 years of data from 2008–2018, isolating A1C, lipid panels, and BMI results for analysis. Subjects were categorized into adherence groups based on quartiles of the proportion of days covered (> 75% of days, 51–75% of days, 26–50% of days and 0–25% of days), with >75% of days covered considered adherent to therapy.

Results

Pre‐treatment median A1C was 6.8%. Post‐treatment median A1C was 7.1%. The adherent group, >75%, was the only group notable for a decrease in A1C, with a median decrease of −0.2 (p = 0.0022). BMI improvement was associated with improved post‐treatment A1C (p = 0.007). When controlling for BMI, age, and pre‐treatment A1C, the >75% adherence group was associated with improved post‐treatment A1C (p < 0.001).

Discussion

When controlling for all studied variables, testosterone adherence was associated with improved post‐treatment A1C. The higher the initial A1C at the initiation of therapy, the higher the potential for lowering the patient's A1C with >75% adherence. Further, all groups showed some reduction in BMI, which may indicate that testosterone therapy may affect A1C independent of weight loss.

Conclusion

Even when controlling for improved BMI, pre‐treatment A1C, and age, testosterone positively impacted glycemic control in diabetes patients with hypogonadism, with the most benefit noted in those most adherent to therapy (>75%).
Effect of SARS‐CoV‐2 infection during the second half of pregnancy on fetal growth and hemodynamics: A prospective study
Authors: Rizzo Giuseppe , Mappa Ilenia , Maqina Pavjola , Bitsadze Victoria , Khizroeva Jamilya , Makatsarya Alexander , D’Antonio Francesco
Published: February 2021

Introduction

Our objective was to compare the fetal growth velocity and fetal hemodynamics in pregnancies complicated and in those not complicated by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection.

Material and methods

Prospective case‐control study of consecutive pregnancies complicated by SARS‐CoV‐2 infection during the second half of pregnancy matched with unaffected women. The z scores of head circumference, abdominal circumference, femur length, and estimated fetal weight were compared between the two groups. Fetal growth was assessed by analyzing the growth velocity of head circumference, abdominal circumference, femur length, and estimated fetal weight between the second‐ and third‐trimester scans. Similarly, changes in the pulsatility index of uterine, umbilical, and middle cerebral arteries, and their ratios were compared between the two study groups.

Results

Forty‐nine consecutive pregnancies complicated, and 98 not complicated, by SARS‐CoV‐2 infection were included. General baseline and pregnancy characteristics were similar between pregnant women with and those without SARS‐CoV‐2 infection. There was no difference in head circumference, abdominal circumference, femur length, and estimated fetal weight z scores between pregnancies complicated and those not complicated by SARS‐CoV‐2 infection at both the second‐ and third‐trimester scans. Likewise, there was no difference in the growth velocity of all these body parameters between the two study groups. Finally, there was no difference in the pulsatility index of both maternal and fetal Doppler scans throughout gestation between the two groups.

Conclusions

Pregnancies complicated by SARS‐CoV‐2 infection are not at higher risk of developing fetal growth restriction through impaired placental function. The findings from this study do not support a policy of increased fetal surveillance in these women.
Cooperative conversion and communalization: Closely observed interactions between the material and the mental
Authors: Charmettant Hervé , Renou Yvan
Published: February 2021

Various authors, including Elinor Ostrom, have shown that the legal form of a cooperative has many of the characteristics of a Common. Here we focus on cooperative conversion, through which conventional enterprises become labor‐managed firms (LMFs), viewing it dynamically as a communalization process. These processes are addressed in the light of a field survey carried out in France, looking at six firms involved in cooperative conversion. The changes entailed are two‐dimensional, both material and mental. This is visible, for example, when finding the capital to mount an LMF: members of the workforce must draw on their own funds; they must also believe in the project. Through our empirical observations we highlight the obstacles in the way of forming an LMF. In particular participants must undertake a work of negotiation hinging on stakes marked by the two, largely inseparable dimensions. Ultimately we query the ethic brought into play in the collective action of constituting a Common. Specifically, individuals must contribute to a collective action underpinned by principles of self‐governance, or commoning, the rock on which the Common rests. A key finding of our study is to demonstrate that a Common can only be successfully created if the constituent processes are consistent with the overall goal. In other words the manner in which we travel is inseparable from our final destination; otherwise we shall surely lose our way.
Recruitment prediction for multicenter clinical trials based on a hierarchical Poisson–gamma model: Asymptotic analysis and improved intervals
Authors: Mountain Rachael , Sherlock Chris
Published: February 2021

We analyze predictions of future recruitment to a multicenter clinical trial based on a maximum‐likelihood fitting of a commonly used hierarchical Poisson–gamma model for recruitments at individual centers. We consider the asymptotic accuracy of quantile predictions in the limit as the number of recruitment centers grows large and find that, in an important sense, the accuracy of the quantiles does not improve as the number of centers increases. When predicting the number of further recruits in an additional time period, the accuracy degrades as the ratio of the additional time to the census time increases, whereas when predicting the amount of additional time to recruit a further patients, the accuracy degrades as the ratio of to the number recruited up to the census period increases. Our analysis suggests an improved quantile predictor. Simulation studies verify that the predicted pattern holds for typical recruitment scenarios in clinical trials and verify the much improved coverage properties of prediction intervals obtained from our quantile predictor. In the process of extending the applicability of our methodology, we show that in terms of the accuracy of all integer moments it is always better to approximate the sum of independent gamma random variables by a single gamma random variable matched on the first two moments than by the moment‐matched Gaussian available from the central limit theorem.
Genome‐wide DNA methylation analysis along the progression of gastric marginal zone B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT) type
Authors: Dugge Rucha , Wagener Rabea , Mӧller Peter , Barth Thomas F. E.
Published: February 2021

Extra‐nodal marginal zone B‐cell lymphoma (MZBL) of mucosa‐associated lymphoid tissue is an indolent lymphoma mostly affecting the gastrointestinal tract. The lymphoma initially has small‐cell morphology (SC‐MZBL) and often arises in the background of Helicobacter pylori‐induced gastritis. In some cases, a clonal malignant progression to large‐cell morphology (LC‐MZBL) is observed. Here, we studied the DNA methylation profile of 30 gastric MZBLs along their progression. Genome‐wide DNA methylation profiling, identified 7698 significantly differentially methylated loci during gastric MZBL progression (σ/σmax ≥0·4, q ≤ 0·001). LC‐MZBL showed hypermethylation in comparison to SC‐MZBL with an enrichment of regions involved in transcriptional regulation. In conclusion, our present data show that the morphological distinction between SC‐ and LC‐MZBL is reflected by characteristic DNA methylation profiles.
Low participation in preventative health measures in a cohort of liver transplant recipients: A cross‐sectional analysis
Authors: Low Elizabeth S. L. , Gow Paul J. , Testro Adam , Sinclair Marie
Published: February 2021

Background

Despite high rates of infection and malignancy post‐solid organ transplant, there are little data on patient participation in preventative health care.

Methods

We conducted a cross‐sectional survey of post‐liver transplant patients to evaluate insight into transplant‐associated infective and neoplastic risks, and receipt of vaccination and cancer surveillance in accordance with Australian and local institution‐specific guidelines. Descriptive analyses were used to assess characteristics potentially influencing adherence.

Results

Of 219 patients surveyed, adherence to bowel cancer surveillance was significantly reduced in those distant from transplantation compared with those recently transplanted (95.8% if transplanted ≤ 5 years ago vs. 68.3% if transplanted > 5 years ago, P < .001). Skin cancer surveillance participation with annual physician‐directed examination was low (42.9%), particularly in younger patients (29.5% in < 50yo vs. 48.1% in ≥ 50yo, P = .01), who were also less adherent to vaccination recommendations (72.1% in < 50yo vs. 87.3% in ≥ 50yo, P = .008).

Conclusions

This is the first analysis of preventative healthcare participation in a cohort of Australian liver transplant recipients, revealing concerning adherence to bowel and skin cancer surveillance recommendations. Major interventions to avoid preventable disease in this high‐risk cohort are warranted.
Mortality, viral clearance, and other clinical outcomes of hydroxychloroquine in COVID‐19 patients: A systematic review and meta‐analysis of randomized controlled trials
Authors: Kashour Zakariya , Kashour Tarek , Gerberi Danielle , Tleyjeh Imad M.
Published: February 2021

Many meta‐analyses have been published about the efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID‐19). Most of them included observational studies, and few have assessed HCQ as a prophylaxis or evaluated its safety profile. We searched multiple databases and preprint servers for randomized controlled trials (RCTs) that assessed HCQ for the treatment or prevention of COVID‐19. We summarized the effect of HCQ on mortality, viral clearance, and other clinical outcomes. Out of 768 papers screened, 21 RCTs with a total of 14,138 patients were included. A total of 9 inpatient and 3 outpatient RCTs assessed mortality in 8596 patients with a pooled risk difference of 0.01 (95% confidence interval [CI] 0.00–0.03, I2 = 1%, p = 0.07). Six studies assessed viral clearance at 7 days with a pooled risk ratio (RR) of 1.11 (95% CI 0.86–1.42, I2 = 61%, p = 0.44) and 5 studies at 14 days with a pooled RR of 0.96 (95% CI 0.89–1.04, I2 = 0%, p = 0.34). Several trials showed no significant effect of HCQ on other clinical outcomes and. Five prevention RCTs with 5012 patients found no effect of HCQ on the risk of acquiring COVID‐19. Thirteen trials showed that HCQ was associated with increased risk of adverse events. We observed, with high level of certainty of evidence, that HCQ is not effective in reducing mortality in patients with COVID‐19. Lower certainty evidence also suggests that HCQ neither improves viral clearance and other clinical outcomes, nor prevents COVID‐19 infection in patients with high‐risk exposure. HCQ is associated with an increased rate of adverse events.
Thy3a nodules with cytological atypia: True indeterminate or papillary thyroid carcinoma waiting for a full diagnosis?
Authors: Piana Simonetta , Bisagni Alessandra , Frasoldati Andrea
Published: February 2021

The agreement of the different cytological categories used worldwide is a long lasting and highly debated topic. Although the systems are broadly similar, some differences still exist especially in grey areas, i.e. the poorly defined classes like Thy3a. Trying to reduce the interobserver variability, we limit the diagnosis of THY3a to cases with scanty atypia (SA), which is the first and most important pattern described by Van der Horst et al. and encompasses cases in which some atypical features are present but their interpretation can be influenced by cell scarcity, artefacts and cystic changes.
Red rod‐shaped crystals in a soft tissue aspirate
Authors: Rani Deepa , Gupta Arsh , Varshney Anupam , Gupta Atul
Published: February 2021

Cytodiagnosis of a rare undifferentiated neoplasm of unknown histogenesis with red needle‐shaped crystals mimicking Auer rods is presented with histological features and differential diagnosis described.
Election Outcomes and Individual Subjective Wellbeing in Great Britain
Authors: Gray Daniel , Pickard Harry , Munford Luke
Published: February 2021

Exploiting novel longitudinal data on individuals in Great Britain matched to their parliamentary constituency, we find that supporting the incumbent political party, at both the national and constituency levels, exerts a positive influence on individual subjective wellbeing. This relationship varies across different measures of subjective wellbeing, gender and personal characteristics. We then implement a regression discontinuity in time design to estimate the impact of a quasi‐natural experiment, where we exploit the timing of the survey around the 2010 election date in order to identify a causal relationship. We find that Liberal Democrat supporters have approximately one‐unit higher level of overall life satisfaction after their party’s electoral success.
Neutral and niche‐based factors simultaneously drive seed and invertebrate removal by red harvester ants
Authors: Luna Pedro , García‐Chávez Juan H. , Izzo Thiago , Sosa Vinicio J. , Del‐Claro Kleber , Dáttilo Wesley
Published: February 2021

1. The factors that drive resource removal by insect predators hold the clue to understanding their role in structuring ecological communities and their evolution. Harvester ants are formidable seed predators and invertebrate carcass feeders. However, the extent to which neutral and niche‐based factors drive the selection and removal of preferred food resources by such ants has been neglected in the literature.

2. In this study authors evaluated how the richness of plants and their abundance, along with resource proximity, density, nutrient content, and seasonal changes affect the selective harvest of resources by the harvester ant Pogonomyrmex barbatus in a Neotropical semi‐arid region where resource availability changes across rainy and dry seasons.

3. In accordance with the neutral‐niche theory shaping biotic interactions, the authors observed that P. barbatus more frequently collects the seeds of the most abundant plant species located within their foraging areas, both in the dry and rainy seasons. The authors also observed that resources located in the proximity of nests, and those that are available at high density, are removed more often in the dry, whereas protein‐rich resources located at close range were removed most often in the rainy (i.e. niche‐based factors). Moreover, temporal fluctuations in the collection of seeds and invertebrates by P. barbatus suggest that the phenology of plants is a factor that can affect the availability and collection of resources.

4. The findings exemplify how the dynamics between an insect predator and its food resource can be simultaneously explained by both neutral and niche‐based factors.
Comparisons between self‐reported and interview‐verified psychotic‐like experiences in adolescents
Authors: Sun Meng , Wang Dongfang , Jing Ling , Yang Ning , Zhu Rongting , Wang Jiali , Chen Xiaodong , Zhou Liang
Published: February 2021

Aim

The 15‐item positive subscale of the Community Assessment of Psychic Experiences (CAPE‐P15) has been widely used for measuring self‐reported psychotic‐like experiences (PLEs). However, its validity has not been well established. This study aimed to explore the consistency of self‐reported PLEs (PLEs‐S) and interview‐verified PLEs (PLEs‐I) based on the same items of the CAPE‐P15.

Methods

A total of 1255 college students completed the CAPE‐P15 for measuring lifetime and current PLEs. Half of the students with high‐risk scores and 5% of the rest were interviewed through telephone. Telephone interviews were based on the items of the CAPE‐P15 using the symptom criteria for attenuated positive symptom syndrome.

Results

When considering the presence of PLEs only, all κ values and correspondence rates (CRs) fell below the thresholds. However, there was adequate consistency for lifetime PLEs when associated distress was also considered in self‐report (κ = .432, CR = 90.0%). Among three factors, only bizarre experiences (BEs) showed adequate diagnostic accuracy in detecting lifetime PLEs when combined with distress. Cut‐off points of 1.30 (sensitivity of 89.2% and specificity of 92.3%) and 1.57 (sensitivity of 79.2% and specificity of 73.8%) for frequency scores were found to best identify genuine PLEs during lifetime and in the past month, respectively.

Conclusions

Although the validity of the CAPE‐P15 for genuine PLEs is unsatisfactory, the scale showed much better diagnostic accuracy when combined with associated distress, especially for detecting lifetime PLEs. Self‐report items on BEs may be more sensitive and specific when identifying PLEs in late adolescence.
What can critical femininity offer reviewing? A case for reviewing with empathy
Authors: Whiley Lilith A.
Published: February 2021

In academia, hegemonic patriarchal norms equate scientific quality with masculinity, and reviewing has followed in this tradition often channeling an angry army general instead of an empathetic peer invested in supporting the development of a manuscript. Indeed, femininity and emotionality are ostracized in favor of “rational” and “scholarly” (masculine) “science.” What can, then, critical femininity offer reviewing? In this piece, I put a case forward for reviewing with empathy.
Between and within‐woman differences in the association between menstruation and migraine days
Authors: McGinley James S. , Wirth R. J. , Pavlovic Jelena M. , Donoghue Stephen , Casanova Amparo , Lipton Richard B.
Published: February 2021

Objective

To investigate between and within‐woman differences in the association between menstruation and migraine days.

Background

Prior diary studies have shown that at the population level, aggregating across individuals, the odds of migraine increase during the perimenstrual window (from day −2 to day +3, where +1 is the first day of bleeding). These studies have been neither long nor large enough to assess the association between migraine and menses from an individual perspective. Consequently, existing research on menstrual‐related migraine has largely overlooked between and within‐woman variation that is critical for progressing clinical understanding and practice.

Methods

Intensive longitudinal data for the current study were collected in a digital platform (N1‐Headache®) that tracks individual migraine‐related factors daily. Participants for the current study were actively menstruating adult (18+ years old) women who used the platform. Two variables were of primary interest, migraine day (no/yes) and menstrual status (inside or outside the 5‐day perimenstrual window).

Results

The sample consisted of 203 women with a mean age of 35.6 (SD = 8.7) years. At baseline, the women reported an average of 30.6 (SD = 23.6) headache days over the last 3 months. Analyses were based on a total of 53,302 days (median of 150 per person), 18,520 of which were migraine days (median of 44 per person), and a total of 2,126 menstrual cycles (median of 7 per person). Results showed that the 5‐day perimenstrual window was associated with a 34% increase in odds of a migraine day compared to other days (OR = 1.34, 95% CI: 1.23–1.45, p < 0.0001). Importantly, there was between and within‐woman variability in the association between menses and migraine days (between‐woman variability: p = 0.002; within‐woman [between‐cycles] variability: p < 0.0001). Exploration of these individual differences demonstrated that relationship between menses and migraine days varied more within‐person across cycles than between women.

Discussion

This study supports previous research and demonstrates that the odds of migraine days are elevated from day −2 to day +3 of the menstrual cycle. We also show that the effect of menses on migraine days varies more within‐woman than between‐women. This work provides an initial foundation for better understanding menstrual‐related migraine from the perspective of the individual patient.
Defining a new normal: A qualitative exploration of the parent experience during the single ventricle congenital heart disease interstage period
Authors: Elliott Melissa , Erickson Lori , Russell Cynthia L. , Chrisman Matthew , Gross Toalson Jami , Emerson Amanda
Published: February 2021

Aim

To explore parents’ experience of transition in the period between the palliative cardiac surgeries (i.e., the interstage period) of an infant with single ventricle congenital heart disease.

Design

We conducted an exploratory naturalistic inquiry using a qualitative descriptive approach.

Methods

A purposive sample of 11 parents of children with single ventricle disease was selected among families that participated in an interstage‐period parental home monitoring program during the past 2 years. Interviews and field observations were conducted September–October 2019, and data were analyzed for themes. Analysis of data was inductive, although study questions and the interpretation of results were informed by Meleis’ transition theory.

Results

Parents described the experience of transition in interstage as a striving for normality, a theme that was clustered in subthemes of home, self, and infant.

Conclusion

Parents' experiences of striving for normality indicated a need for more targeted efforts to address parents’ psychosocial needs during the highly stressful interstage transition.

Impact

This research underscored the complexity of parents’ psychosocial support needs on returning home after their child's first palliative surgery. The findings also suggest need for examination of the transition following the second palliative heart surgery, when the home monitoring program is withdrawn. Understanding parent needs will help guide healthcare teams in developing ways to support parents as they adjust to home, self, and child.
“The light at the end of the tunnel”. Discharge experience of older patients with chronic diseases: A multi‐centre qualitative study
Authors: Facchinetti Gabriella , Albanesi Beatrice , Piredda Michela , Marchetti Anna , Ausili Davide , Ianni Andrea , Di Mauro Stefania , De Marinis Maria Grazia
Published: February 2021

Aim

To explore the experiences of being discharged from hospital of older patients with chronic diseases at time of discharge.

Design

Multi‐centre descriptive qualitative study.

Methods

Semi‐structured interviews were conducted with older patients with chronic diseases discharged from two Italian university hospitals, between March 2017 and October 2019. The interviews were audio‐recorded, transcribed verbatim and analysed using inductive content analysis. Several strategies were used to ensure the credibility, dependability, confirmability, authenticity and transferability of the findings. The study was reported in accordance with Standards for Reporting Qualitative Research and Consolidated criteria for reporting qualitative research.

Results

Sixty‐five patients participated in the study. Six main categories emerged: feelings, need for information, time of fragility, need for support, need for trusting relationships, and home as a caring place.

Conclusion

Older patients with chronic diseases are patients who require quality discharge planning with a patient‐centred care vision. Healthcare professionals should intervene more extensively and deeply in the discharge process, balancing the patients' perception of their needs against organizational priorities and the wish to return home with that of not being abandoned.

Impact

Discharge from hospital remains an area of concern as older people have varying degrees of met and unmet needs during and following hospital discharge. Discharge is characterized by conflicting feelings of patients, who need information and support of healthcare professionals through trusting and continuous relationships. Understanding the experience of discharge is essential to support older patients with chronic diseases, considering that discharge from hospital is not an end point of care but a stage of the process involving care transition. The reframing of discharge as another transition point is crucial for healthcare professionals, who will be responsible for making their patients fit for discharge by preparing them to manage their chronic condition at home.
Augmented reality assisted learning achievement, motivation, and creativity for children of low‐grade in primary school
Authors: Yousef Ahmed Mohamed Fahmy
Published: February 2021

There is a large volume of published studies describing the positive role of Augmented Reality (AR) in educational settings. However, there is a paucity of empirical work that explores its role in supporting primary school pupil's motivation and creativity. Moreover, numerous studies have confirmed that pupils have difficulties in learning geometry and thinking geometrically. In this context, this paper explores the possibility of using AR software for low‐grade primary school pupils to enhance their creative thinking and increase their motivation during the informal geometry training course. A research‐based design process is adopted to replicate the primary school pupil's learning in this study, where pupils in the experimental group used mobile application to access AR virtual manipulatives, pupils in the control group used physical manipulatives. The applied AR technology allows pupils to handle 2D and 3D rounded corners and simple closed curves to find the most effective solutions for some learning challenges. Sixty‐two pupils from the first‐grade primary school in Egypt have participated in this study with the aim of investigating: (a) the primary school pupil's achievements and creative thinking in using AR techniques, and (b) the specific strategies that can increase their motivation and engagement. The most obvious finding to emerge from this study is that there was no statistically significant difference between the groups in geometry learning achievement, while statistically significant differences were found between the groups in the motivation and creative thinking skills in favour of the experimental group.
Kidney function and markers of renal damage after renal denervation. Does method of measurement matter? The Reshape CV‐Risk Study
Authors: Solbu Marit D. , Miroslawska Atena , Norvik Jon V. , Eriksen Bjørn O. , Steigen Terje K.
Published: February 2021

Data suggest that renal denervation (RDN) in treatment‐resistant hypertension (TRHT) is safe in terms of renal function. However, most studies report kidney function as creatinine‐based estimated glomerular filtration rate (eGFR), which may be biased by non‐renal factors. Damage markers other than albuminuria have never been evaluated after RDN. In this non‐randomized RDN trial, we studied changes in kidney function, assessed as measured GFR (mGFR) and various GFR estimates, six months and two years after RDN. We also examined changes in albuminuria and a biomarker of tubular dysfunction. Adult non‐diabetic patients with TRHT and eGFR ≥45 ml/min/1.73 m2 were recruited from hypertension clinics. Before bilateral RDN, mGFR was measured by iohexol clearance. We estimated eGFR from serum creatinine and cystatin C (eGFRcrea, eGFRcys, and eGFRcreacys), and albumin‐creatinine ratio (ACR) and N‐acetyl‐β‐D‐glucosaminidase (NAG)‐creatinine ratio (NAG‐CR) were measured in spot urines. All measurements were repeated after six and twenty‐four months.

Twenty patients, mean age 54 (±9) years and baseline mGFR 83 (±20) ml/min/1.73 m2 underwent RDN. After six months, mGFR fell, eGFRcrea remained unchanged, whereas eGFRcys and eGFRcreacys increased. At 2 years’ follow‐up, eGFRcreacys was significantly lower than at baseline. mGFR was 78 (±28) ml/min/1.73 m2. Change in ambulatory systolic BP predicted change in eGFRcrea. Urinary NAG‐CR, but not ACR, increased during follow‐up.

Different GFR assessments gave diverging results after RDN. Therefore, care should be taken to method when evaluating kidney function after RDN. Increases in a tubular dysfunction biomarker suggest that kidney damage may occur. Long‐term renal follow‐up is needed after RDN.
Reproducibility study of nocturnal blood pressure dipping in patients with high cardiovascular risk
Authors: Burgos‐Alonso Natalia , Ruiz Arzalluz Maria Victoria , Garcia‐Alvarez Arturo , Fernandez‐Fernandez de Quincoces Daniel , Grandes Gonzalo
Published: February 2021

It has been shown that in most people there is a physiological reduction in blood pressure during nighttime sleep, it falling by approximately 10% compared to daytime values (dippers). On the other hand, in some people, there is no nighttime reduction (non‐dippers). Various studies have found an association between being a non‐dipper and a higher risk of cardiovascular disease, but few have assessed whether the nocturnal pattern is maintained over time. From the database of the TAHPS study, data were available on 225 patients, each of whom underwent 24‐hour ambulatory blood pressure monitoring (ABPM) on four occasions over a period of 5 months. We studied the reproducibility of the nocturnal BP dipping pattern with mixed linear analysis and also calculated the concordance in the classification of patients as dippers or non‐dippers. The intraclass correlation coefficients between the different ABPM recordings were 0.482 and 0.467 for systolic and diastolic blood pressure, respectively. Two‐thirds (67%) and 70% of the patients classified, respectively, as dippers or non‐dippers based on systolic and diastolic blood pressure readings in the first ABPM recording were found to have the same classification based on the subsequent recordings. We conclude that the reproducibility of nocturnal dipping patterns and concordance of dipper vs non‐dipper status in individual patients is modest and therefore that we should be cautious about recommending treatments or interventions based on these patterns.
Governing canal life
Authors: COWAN DAVE , HARDY BARBARA
Published: February 2021

This article focuses on the governance of canals in England and Wales. The Canal & River Trust (CRT), the owner and manager of the waterways, has a statutory responsibility to grant ‘certificates’ or licences. The licence constructs a category called ‘continuous cruisers’ who live aboard their boat. Drawing on a sample of interviews with ‘continuous cruiser liveaboards’ (CCLs), we discuss how their governance by the CRT has gradually encroached on their everyday lives, leading them to reconsider their lives on the canal. We illustrate this through exploring how the CRT translated obscure legislation to make it legible through techniques of simplification, but did so in a way that had problematic effects on CCLs; and how apparently enabling and constraining regulation operates, paradoxically, in contradictory ways, both significantly affecting CCLs’ everyday lives. At heart, there is a simple story here of a nomadic way of life that is of relatively recent vintage but that is being (or perceived as being) sedentarized.
Radiographic diagnoses in 80 cats before and 73 cats after unobstructing the urethra
Authors: Young C. S. , Todd J. M. , Rendahl A. , Lulich J. P.
Published: February 2021

Objective

The aim of this study was to investigate causes for feline urethral obstruction and determine whether the frequency of radiographic diagnoses differs between cats radiographed before or after unobstruction of the urethra.

Materials and Methods

A retrospective cross‐sectional study of cats with naturally occurring urethral obstruction was performed. Only cats presenting for their first urethral obstruction in which radiography was integrated in the initial evaluation were included. The diagnosis frequency (overall and for each disease type) was compared between cats radiographed before or after unobstruction of the urethra.

Results

Eighty cats (52%) had radiographs obtained before unobstructing the urethra and 73 cats (48%) had radiographs taken after unobstructing the urethra. Cats radiographed before unobstruction had a greater frequency of radiographic diagnoses than those radiographed after unobstruction (61% versus 45%). This difference was largely due to a greater frequency of urethral plugs detected before unobstructionversusafter unobstruction (45% versus 5.5%).

Clinical Significance

Radiographs obtained before unobstructing the urethra provided a diagnostic advantage for detecting a cause for urethral obstruction compared to radiographs obtained after unobstructing the urethra. Urethral plugs were the most common diagnosis.
Contentious Politics in the Courthouse: Law as a Tool for Resisting Authoritarian States in the Middle East
Authors: Schaaf Steven D.
Published: February 2021

Under what conditions will individuals mobilize law to resist states that operate above the law? In authoritarian countries, particularly in the Middle East, law is a weapon the state wields for social control, centralizing power, and legitimation. Authoritarian legal codes are overwhelmingly more deferential to state authority than protective of citizens' rights. Nevertheless, people throughout the Arab world deploy law to contest a broad array of state abuses: land expropriations, unlawful arrests, denials of jobs and welfare, and so on. Using detailed interviews in Jordan and Palestine, I outline a theory of law as a tool for resisting authoritarian state actors. Integrating qualitative insights with survey experiments fielded in Egypt and Jordan, I test this theory and show that aggrieved individuals mobilize law when they expect courts are powerful and attainable allies in contentious politics. My results further demonstrate that judicial independence does not uniformly increase authoritarian publics' willingness to access courts.
The Second Karabakh War: Russia vs. Turkey?
Authors: Yavuz M. Hakan , Huseynov Vasif
Published: February 2021

The Karabakh region and surrounding territories—occupied by Armenia for the last 26 years—represented a classic “frozen” ethno‐territorial conflict in the post‐Soviet world. The conflict erupted in September 2020, and Azerbaijan managed to liberate the occupied territories. This article examines the causes and consequences of the recent Karabakh war between Armenia and Azerbaijan. After summarizing the historical origins of the conflict, the article offers an analysis of four main causes that renewed hostilities. The 44‐day war resulted in a military victory for Azerbaijan and catastrophic defeat for Armenia. The outcome not only shook up the Armenian political establishment, but also revealed a contentious dimension in the alignment between Turkey and Russia. The article concludes by analyzing the motives of Turkey's extensive involvement in the conflict and the Russian‐imposed truce deal, both of which are likely once again to freeze the dynamics that hold the central parties hostage to Russia.
The Practice of Corruption in Lebanon
Authors: Barroso Cortés Francisco Salvador , Kéchichian Joseph A.
Published: February 2021

For nearly a century, the absence of ethical norms within Lebanese political circles encouraged the practice of corruption that transformed the praxis into an unparalleled art form, one that generated clout‐wielding elites. Sophisticated public power mechanisms created for the benefit of the country's eighteen religious denominations, transformed them into partners‐in‐corruption, secured greater quotas of power, and exclusive hold on all public resources. What this translated into was a “neo‐patrimonial” dynamic, which the October 2019 revolutionaries challenged, with calls to reconsider the political management of the country as well as the existing system of government. The 2020 impact of the Coronavirus (COVID‐19) disease aggravated conditions, as Beirut displayed amateurish attention to serious health challenges, which added insults to ongoing economic injuries. This paper evaluates what political elites actually did, even at the height of enduring crises, focusing on the banking sector to highlight the rise of a new mafiocracy. It closes with an assessment of future challenges that Beirut will confront.
Quality of life and associated factors among adults living with cancer and their family caregivers
Authors: Gabriel Israel , Creedy Debra , Coyne Elisabeth
Published: February 2021

This study examined the association of needs, health literacy, and quality of life among adult Nigerians with cancer and family caregivers. A descriptive study was conducted involving 240 adults with cancer and family caregivers attending a tertiary hospital. More than two‐thirds of participants reported moderate or high needs. Information (90.8%) and spiritual support (85%) were the domains of highest need among adults with cancer. Family/social support (85%) and spiritual support (81.7%) ranked the highest among family caregivers. A negative correlation was found between needs and quality of life. Stepwise regression analysis showed that needs and literacy explained 36% of the variance in adults with cancer's quality of life and 28% of the variance in family caregivers’ quality of life. Spiritual need accounted l for 9.5% and 9.1% of variation for adults with cancer and family caregivers, respectively. Findings suggest that interventions with a focus on social/family and spiritual needs may improve wellbeing of adults with cancer and caregivers in Nigeria. This research are generalizable to other low‐income countries where family values and spirituality are often a strong feature of daily life.
Enteral nutrition feeding practices by intensive care nurses: A retrospective evaluation
Authors: Crossfield Claire L. , Russo Philip L. , Bucknall Tracey K.
Published: February 2021

Background

Enteral nutrition (EN) is an integral component of standard management of critically ill patients in intensive care. However, achieving adequate nutrition in this environment continues to present many challenges.

Design

A descriptive exploratory design using a retrospective review of medical records.

Aims and objectives

The aims of this study were to describe nursing practice associated with EN feeding and identify barriers to optimal nutritional delivery in the intensive care unit (ICU).

Methods

Patients admitted to a major Australian metropolitan health service ICU during a 6‐month period, and who received EN for at least 72 hours, were eligible for inclusion. Documented text from patient medical records was analysed using content analysis. Numerical data were analysed using SPSS software (version 25.0). Descriptive and inferential statistics were calculated.

Results

A total of 150 patients were included in the study. The mean time from admission to EN commencement was 12.6 hours, with 59.3% commenced within 12 hours of admission. Only 9.3% of patients commenced EN at the target rate. Of the 150 patients, 24 (16%) received 80% of nutrition targets within 72 hours of admission. Patients who had EN commenced within 12 hours of admission and at the target rate were significantly more likely to achieve nutritional requirements (P = <.01). Patients who received an initial dietitian review within 24 hours of admission were more likely to achieve nutrition requirements (P = <.01).

Conclusions

Commencing EN on time and meeting target volumes remains challenging in the ICU patient. Airway management, procedural requirements, and delayed dietitian review for prescribed hourly rate initiation provide barriers to optimal nutrition delivery to critically ill patients. Tackling these barriers may require interdisciplinary interventions.

Relevance to clinical practice

Providing adequate nutrition to critically ill patients is challenging. This study provides evidence that day's one and two are problematic to EN delivery; particularly concerning airway management, procedural requirements, and delayed dietitian review for prescribed hourly rate initiation. Highlighting the need for further research into these aspects of nutrition management.
Implications of SARS‐CoV‐2 infection for neurogastroenterology
Authors: Marasco Giovanni , Lenti Marco Vincenzo , Cremon Cesare , Barbaro Maria Raffaella , Stanghellini Vincenzo , Di Sabatino Antonio , Barbara Giovanni
Published: February 2021

Background

Coronavirus disease 2019 (COVID‐19) is associated with gastrointestinal and hepatic manifestation in up to one fifth of patients. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the etiologic agent of COVID‐19, infects gastrointestinal epithelial cells expressing angiotensin‐converting enzyme 2 (ACE2) receptors triggering a cascade of events leading to mucosal and systemic inflammation. Symptomatic patients display changes in gut microbiota composition and function which may contribute to intestinal barrier dysfunction and immune activation. Evidence suggests that SARS‐CoV‐2 infection and related mucosal inflammation impact on the function of the enteric nervous system and the activation of sensory fibers conveying information to the central nervous system, which, may at least in part, contribute symptom generation such as vomiting and diarrhea described in COVID‐19. Liver and pancreas dysfunctions have also been described as non‐respiratory complications of COVID‐19 and add further emphasis to the common view of SARS‐CoV‐2 infection as a systemic disease with multiorgan involvement.

Purpose

The aim of this review was to highlight the current knowledge on the pathophysiology of gastrointestinal SARS‐CoV‐2 infection, including the crosstalk with the gut microbiota, the fecal‐oral route of virus transmission, and the potential interaction of the virus with the enteric nervous system. We also review the current available data on gastrointestinal and liver manifestations, management, and outcomes of patients with COVID‐19.
Exercise‐induced allergic reactions after achievement of desensitization to cow's milk and wheat
Authors: Kubota Shohei , Kitamura Katsumasa , Matsui Teruaki , Takasato Yoshihiro , Sugiura Shiro , Ito Komei
Published: February 2021

Background

We have previously reported that more than half of the patients who achieved desensitization after wheat rush oral immunotherapy (OIT) developed exercise‐induced allergic reaction on desensitization (EIARD). However, data on EIARDs after slow OIT are lacking. Therefore, this study aimed to investigate the results of exercise provocation tests (EPTs) in patients after slow OIT for cow's milk and wheat allergies.

Methods

This was a retrospective chart review of 87 EPTs in 74 patients. The EPTs were performed in patients who were desensitized to at least 6,600 mg cow's milk protein or 5,200 mg wheat protein with slow OIT and were identified to be at a high risk of EIARDs. EPTs were performed after ingestion of the maximum desensitization dose. The patients’ clinical characteristics and symptoms were analyzed.

Results

The EPT results were positive for cow's milk in 49% (21/43) of the patients and for wheat in 48% (15/31) of the patients. There was no significant difference in the clinical characteristics between the EIARD‐positive and EIARD‐negative groups. The specific IgE (sIgE) levels before OIT and the reduction rates of sIgE before and after OIT did not correlate with the outcomes of the EPTs. Among the EIARD‐positive patients, 13 patients (cow's milk, n = 7; wheat, n = 6) underwent a second EPT, and the EIARD disappeared in 8 patients (cow's milk, n = 4; wheat, n = 4).

Conclusion

EIARDs were observed after slow OIT for cow's milk and wheat. Further research into the predictive factors of EIARDs in these patients is needed to understand its clinical manifestations.