bluuebunny/crossref_metadata_2025 huggingface dataset:
Inequality, welfare and punishment. Comparative notes between the Global North and South
Authors: Sozzo Máximo
Published: December 2021

In this paper, I will describe how two strong connections between, on the one hand, income inequality and welfare generosity, and, on the other, punitiveness, have been built in both theoretical and empirical explorations in the contemporary comparative literature on the sociology of punishment. Then, I will point out the strong concentration of these explorations on national cases from the Global North as a potential limitation. From there, I will try to ‘southernize’ this debate, through three empirical exercises related to a region of the Global South, Latin America. First, I will include this region in a global comparison of clusters of countries to define whether there is an association between the levels of income inequality and welfare generosity and the levels of punitiveness, both now and in the recent past. Second, I will analyse if the same relationships exist within Latin America countries, both now and in the recent past. Finally, I will examine whether these same relationships are relevant for understanding the evolution of the levels of punitiveness in Latin America over the last three decades. Based on the results of these three exercises, I will examine the shortcomings stemming from assuming these strong statements as universal, placeless and timeless, warning that the styles of comparison that have generated them have to be taken as starting points rather than as arrival points of the analysis and stressing that our analyses about contemporary penal differences, while taking macroscopic dimensions into account, should give a strong centrality to the ‘proximate’ processes that mould penal actions and results.
Engaging Employees Through a Virtuous Environment! Does Positive Affect Mediate in the Relationship?
Authors: Sharma Himani , Goyal Richa
Published: December 2021

The Problem

The high rate of disengagement among the workforce affects the overall functioning of the organizations as disengaged employees are not only dissatisfied but can also spread negativity among their fellows. Therefore, there is an emerging need to ascertain how organizations can contribute in reducing such disengagement.

The Solution

Findings from this study suggests that an organizational environment of respect, trust, forgiveness, and care and concern can solve the problem of disengagement. Such an environment requires management support in creating a culture that recognizes the role of empathy in boosting positive emotions and reducing employees’ negativity.

The Stakeholders

Human resource development practitioners, researchers, scholars, managers, and others who are interested in pursuing research in this area.
If We Knew Then: A Postscript to the Kerner Report
Authors: Loessberg Rick
Published: December 2021

The Kerner Report, which examined why 1967s rioting occurred, is one of America’s most important works on race and the inner city. Yet, for many, a belief exists that it has been ignored and represents a lost opportunity. Knowing now how the report was received, is there anything that could have been done to produce a more influential report? To answer this question, this article utilizes recent interviews with key Kerner Report participants. Such information not only expands our knowledge about the report, but given recent proposals to create new Kerner-type commissions to address today’s disparities, it possesses additional relevance.
A Programmatic Evaluation of School Preparedness for Latinx Children and Families: A Partnership Program
Authors: Williams Amy A. , Johnson Emily E.
Published: December 2021

Introduction: Latinx children are the fastest-growing ethnic minority of children under the age of 5 years in a tri-county area in the Southeastern United States (US Census, 2018). There are limited culturally and linguistically appropriate school preparedness initiatives in this geographic region. Methods: A cultural and linguistic appropriate program was developed in coordination with the state's largest Latinx advocacy organization and two patient-centered pediatric medical homes (PCPMHs) after securing extramural grant funding for an evidenced-based home visitation program using skilled community health workers (CHWs) aimed at Latinx children at the age of 0–5 years and their caregivers. The program includes developmental screenings using the Ages & Stages Questionnaires®, Third Edition (ASQ®-3), CHW role modeling of developmentally appropriate play, early literacy, connection to resources, oral health, nutrition, and physical activity. Results: Of the 103 unique children represented in this programmatic evaluation that received an initial and follow-up ASQ®-3 developmental screening, paired t-tests indicate statistically significant improvement in mean scores from the first to second ASQ®-3 in all five major developmental domains with the largest gains represented in the communication and fine motor skill domains. Conclusion: This evaluation suggests that low-frequency home visits from skilled CHWs can have a beneficial effect on development in early childhood. PPCMHs can serve as a hub for these community-based programs.
Treating Severe Traumatic Brain Injury: Combining Neurofeedback and Hyperbaric Oxygen Therapy in a Single Case Study
Authors: White Rebecca D , Turner Robert P , Arnold Noah , Bernica Annie , Lewis Brigitte N , Swatzyna Ronald J
Published: December 2021

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days. After gaining consciousness, he was discharged to a brain injury treatment center that worked with physical, speech, and occupational issues. He was discharged after eight months with significant speech, ambulation, spasticity, and cognitive issues as well as the onset of posttraumatic epilepsy. His parents sought hyperbaric oxygen treatment (HBOT) from a doctor in Louisiana. After 165 dives, the HBOT doctor recommended an addition of neurofeedback (NFB) therapy. In March 2019 the patient started NFB therapy intermixed with HBOT. The combination of NFB and HBOT improved plasticity and functionality in the areas of injury and the correlated symptoms including short-term memory, personality, language, and executive function, as well as significantly reducing the incidence of seizures. Severe brain injuries often leave lasting deficits with little hope for major recovery and there is a need for further research into long-term, effective neurological treatments for severe brain injuries. These results suggest that HBOT combined with NFB may be a viable option in treating severe brain injuries and should be investigated.
Impact of Psychosocial Occupational Therapy Combined with Anodal Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex on the Cognitive Performance of Patients with Schizophrenia: A Randomized Controlled Trial
Authors: Fathi Azar Elahe , Hosseinzadeh Samaneh , Nosrat Abadi Masoud , Sayad Nasiri Mohamad , Haghgoo Hojjat Allah
Published: December 2021

Background

The most common cognitive dysfunctions in patients with schizophrenia are information processing, memory, and learning. Based on the hypothesis of rehabilitation and brain stimulation in memory and learning, adding a form of neuromodulation to conventional rehabilitation might increase the effectiveness of treatments.

Aims

To explore the effects of psychosocial occupational therapy combined with anodal Transcranial Direct Current Stimulation (tDCS) on cognitive performance in patients with Schizophrenia.

Methods

Twenty-four patients diagnosed with schizophrenia were randomized into the experimental and control groups. We used The Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Loewenstein Occupational Therapy Cognitive Assessment battery (LOTCA) to assess spatial recognition, attention, visual memory, learning abilities, and high-level cognitive functions like problem-solving. All participants received customized psychosocial occupational therapy activities. Furthermore, the experimental group received 12 sessions of active anodal tDCS for 20 minutes with 2 mA intensity on the left dorsolateral prefrontal cortex (DLPFC) while the patients in the sham group received sham tDCS.

Results

Combining tDCS to conventional psychosocial occupational therapy resulted in a significant increase in spatial memory, visual learning, and attention.

Conclusions

Anodal tDCS on the left DLPFC improved visual memory, attention, and learning abilities. Contrary to our expectations, we could not find any changes in complex and more demanding cognitive functions.
Semantic segmentation guided feature point classification and seam fusion for image stitching
Authors: Huang Huafeng , Chen Fei , Cheng Hang , Li Liyao , Wang Meiqing
Published: December 2021

Image stitching can be employed to stitch images taken from different times, perspectives, or devices into a panorama with a wider view. However, the imaging specification of images to be stitched is strict. If the imaging specification is not satisfied, artefacts caused by inaccurate alignment and unnatural distortion will occur. Semantic segmentation can solve the classification problem at the pixel level; however, image stitching significantly depends on the accuracy of feature points. Therefore, this paper proposes an image stitching algorithm based on semantic segmentation to guide feature point classification and seam fusion. First, the images are recognized by a cascade semantic segmentation network, and the image feature points are classified. Thereafter, the corresponding homography transformations are calculated using different class feature points, and the best homography mapping for the entire target image is selected. Finally, a seam-cutting algorithm based on semantic segmentation is used to compute the seam, and a feathering Poisson fusion with distance transformation is used to eliminate artefacts and light differences. Experiments show that the algorithm can generate transitional natural and perceptual stitching results even under the influence of perspective and light differences.
Regaining motion among patients with shoulder pathology - are all exercises equal?
Authors: Rabin Alon , Maman Eran , Dolkart Oleg , Kazum Efi , Kozol Zvi , Uhl Timothy L , Chechik Ofir
Published: December 2021

Background

Little information exists to guide the choice of exercise for regaining shoulder range of motion (ROM). The purpose of this study was to compare the maximal ROM reached, pain and difficulty associated with 4 commonly prescribed exercises.

Methods

Forty (9 females) patients with various shoulder disorders and a limited flexion ROM performed 4 exercises for regaining shoulder flexion ROM in a randomized order. Exercises included the self-assisted flexion, forward bow, table slide and rope-and-pulley. Participants were videotaped while performing all exercises and the maximal flexion angle reached during each exercise was recorded using Kinovea motion analysis freeware (Kinovea 0.8.15). Pain intensity and the perceived level of difficulty associated with each exercise were also recorded.

Results

The forward bow and table slide generated significantly greater ROM compared with the self-assisted flexion and rope-and-pulley (P ≤ 0.005). The self-assisted flexion was associated with a greater pain intensity compared with the table slide and rope-and-pulley (P = 0.002) and a greater perceived level of difficulty compared with the table slide (P = 0.006).

Conclusions

Due to the greater ROM allowed, and similar or even lower level of pain or difficulty, clinicians may wish to initially recommend the forward bow and table slide for regaining shoulder flexion ROM.
Outcomes of split vs full-thickness skin grafts in scalp reconstruction in outpatient local anaesthetic theatre
Authors: Sun Luxi , Patel Animesh JK
Published: December 2021

Background

Surgical excision remains the cornerstone of simultaneous diagnosis and treatment of suspicious skin lesions, and the scalp is a high-risk area for skin cancers due to increased cumulative lifetime ultraviolet (UV) exposure. Due to the inelasticity of scalp skin, most excisions with predetermined margins require reconstruction with skin grafting.

Methods

A retrospective single-centre cohort study was performed of all patients undergoing outpatient local anaesthetic scalp skin excision and skin graft reconstruction in the Plastic Surgery Department at Addenbrookes Hospital over a 20-month period between 1 April 2017 and 1 January 2019. In total, 204 graft cases were collected. Graft reconstruction techniques included both full-thickness and split-thickness skin grafts. Statistical analysis using Z tests were used to determine which skin grafting technique achieved better graft take.

Results

Split-thickness skin grafts had a statistically significant ( P = 0.01) increased average take (90%) compared to full-thickness skin grafts (72%). Using a foam tie-over dressing on the scalp led to a statistically significant ( P = 0.000036) increase in skin graft take, from 38% to 79%.

Conclusion

In skin graft reconstruction of scalp defects after skin cancer excision surgery, split skin grafts secured with foam tie-over dressings are associated with superior outcomes compared to full-thickness skin grafts or grafts secured with sutures only.
Unique Association of Aortopulmonary Window With Anomalous Origin of Left Coronary Artery From Pulmonary Artery in an Infant: A Blessing in Disguise?
Authors: Arvind Balaji , Devagourou Velayoudam , Saxena Anita
Published: December 2021

Aortopulmonary window (APW) seen in association with anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is extremely uncommon. When faced with this combination, ALCAPA usually goes undetected since most of the clinical and echocardiographic features of ALCAPA, including ventricular dysfunction are absent due to co-existent pulmonary hypertension. Herein we report a 5-month-old child with a large APW in whom a preoperative computed tomography angiogram facilitated the diagnosis of ALCAPA. The case is described for its rarity and the challenges faced during management. Also, it is extremely crucial that this coronary anomaly is identified and corrected during surgery, since failure to do so results in unforeseen postoperative ventricular dysfunction.
The Causal Relationship Between China-Africa Trade, China OFDI, and Economic Growth of African Countries
Authors: Obobisa Emma Serwaa , Chen Haibo , Ayamba Emmanuel Caesar , Nyarko Mensah Claudia
Published: December 2021

Recently, China has emerged as the largest trading partner and a significant source of investment in the African continent. Although there is consent on the increasing importance of China and Africa’s economic partnership, there are many controversies on how it affects African countries. Debates on China in Africa have, however, relied on grandiloquence rather than empirical studies. This study explores the causal link between China-Africa trade, China’s outward foreign direct (OFDI), and economic growth of 24 Sub-Saharan Africa countries from 1999 to 2018. The aggregated panel is classified into upper-middle-income, low-middle income, and low-income Sub-Saharan African countries. In the long run, key findings from the feasible generalized least squares (FGLS) estimator unveiled that; (i) China-Africa trade negatively contributes to economic growth among all panels. (ii) China’s OFDI improves economic growth in the low middle and low-income African countries whereas a significant negative liaison is evidenced in the upper-middle-income African countries. (iii) Labor force have a negative impact on economic growth whiles gross capital formation is evidenced to positively impact economic growth at all the panels. The Dumitrescu and Hurlin Granger causality unveiled a one-sided causal link from China-Africa trade to economic growth at all panels. The study proposes policy recommendations based on the results.
Imagery Rescripting Versus Extinction: Distinct and Combined Effects on Expectancy and Revaluation Learning
Authors: Woelk Mandy , Krans Julie , Raes Filip , Vervliet Bram , Hagenaars Muriel A.
Published: December 2021

Anxiety disorders are effectively treated with exposure therapy, but relapse remains high. Fear may reinstate after reoccurrence of the negative event because the expectancy of the aversive outcome (unconditioned stimulus [US]) is adjusted but not its evaluation. Imagery rescripting (ImRs) is an intervention that is proposed to work through revaluation of the US. The aim of our preregistered study was to test the effects of ImRs and extinction on US expectancy and US revaluation. Day 1 ( n = 106) consisted of acquisition with an aversive film clip as US. The manipulation (ImRs + extinction, extinction-only, or ImRs-only) took place on Day 2. Reinstatement of fear was tested on Day 3. Results showed expectancy learning in both extinction conditions but not in the ImRs-only condition and no enhanced revaluation learning in ImRs. The combination of ImRs and extinction slowed down extinction but did not protect against reinstatement, which pleads in favor of stand-alone interventions in clinical practice.
La Aplicación de una Propuesta Multimedia para el Desarrollo de algunas Habilidades Musicales en Niños de Preescolar Mexicanos: Un Estudio de Caso
Authors: Valdivia José Marcos Partida
Published: December 2021

El presente artículo refiere un estudio en el que se puso a prueba una propuesta multimedia derivada de una investigación realizada entre los años 2013 y 2015. Dicha propuesta se orientó a desarrollar el ritmo y la audición en niños del nivel educativo de preescolar (de los 3 a los 5 años de edad) de contextos mexicanos y consistió en actividades mediadas por computadora con el instrumento de guitarra (acústica). En situaciones de juego con el instrumento, el niño genera diferentes sonidos que son captados y procesados por la computadora. En la aplicación de esta propuesta participó una niña de 3 años de edad y una maestra de nivel básico de educación, con el fin de que los resultados obtenidos permitan perfeccionar las primeras actividads diseñadas. Los hallazgos de este estudio muestran la necesidad de perfeccionar la propuesta principalmente en el aspecto didáctico y técnico. Se identifica un cierto potencial didáctico en los instrumentos musicales que puede ser explorado mediante el uso de tecnologías. En el caso del instrumento de guitarra, fue posible identificar implícitamente algunos aspectos de mediación sociocultural en los que esta investigación deberá profundizar posteriormente.
El debate en el aula de dirección de orquesta como mecanismo de aprendizaje individual y colectivo
Authors: de Reizábal Margarita Lorenzo , Gómez Manuel Benito
Published: December 2021

La formación en dirección de orquesta se ha basado tradicionalmente en un modelo de imitación del maestro donde uno de los objetivos principales era la reproducción del modelo. Sin embargo, el Espacio Europeo de Educación Superior requiere una reorganización de los roles tradicionales del profesorado y los estudiantes; a aquéllos les atribuye un papel de ayuda y soporte del aprendizaje de los estudiantes y a éstos un papel más activo y comprometido con sus propios objetivos de aprendizaje. Desde esa perspectiva, esta investigación explora el papel de los debates como mediador del aprendizaje individual y de grupo. Para ello se ha diseñado un escenario de hetero-observación en el que un grupo de 28 estudiantes de 1º de Dirección de Orquesta de un Conservatorio Superior de Música en España observan y debaten sobre la actuación gestual de cada uno de ellos dirigiendo desde el podio. La investigación explora la riqueza de los debates que han tenido lugar post-observación y la estructura discursiva empleada, mostrando que los mismos han propiciado avances y mejoras en la gestualidad del grupo estudiado.
Proceso de autoevaluación de un Conservatorio Profesional de Música y determinación de áreas de mejora
Authors: Ruiz Elena Berrón , Guerrero Inés María Monreal
Published: December 2021

El presente artículo recoge los resultados de la investigación realizada en el Conservatorio Profesional de Música de Segovia, la cual tuvo como propósito valorar su calidad como institución educativa y plantear propuestas de mejora. En dicha investigación se persiguieron dos objetivos: por un lado, identificar las áreas más deficitarias y que, por tanto, deberían abordarse de forma prioritaria en un futuro plan de mejora del Centro, y, por otro, plantear algunas de las acciones concretas que se podrían emprender dentro de cada una de estas áreas para solucionar los déficits detectados. Para la recogida de datos, se utilizaron cuatro cuestionarios extraídos del modelo estandarizado de autoevaluación de la Junta de Castilla y León y una entrevista grupal semiestructurada. En el estudio participaron profesorado, familias, alumnado y personal no docente. Entre las conclusiones del estudio cabe destacar las cuatro áreas en las que sería recomendable incidir de for ma preferente para mejorar el servicio educativo del Conservatorio: planificación, organización, liderazgo y gestión de recursos.
Predictores de desempeño académico y deserción en una Licenciatura en Música en México
Authors: Ortega Juan Pablo Correa , Vaca Irma Susana Carbajal
Published: December 2021

Los índices de eficiencia ter minal y titulación son indicadores esenciales para el diseño de políticas de educación superior en México. El diseño de un proceso de admisión eficiente debería contribuir a la prevención del rezago y la deserción por bajo desempeño académico.

En el presente estudio se explora el poder predictivo de tres variables que conforman el proceso de admisión a la licenciatura en música la Universidad Autónoma de Aguascalientes: la nota promedio de bachillerato (Bach.); la prueba de acceso a la universidad EXANI II (Exani); y el examen especial de ingreso (EEI). A través de análisis de correlación y regresión lineal se concluyó que Bach es la variable que mejor predice el desempeño global; e lEEI explic a principalmente el desempeño en los primeros semestres; y la dimensión de español del Exani explica principalmente el desempeño de materias de contexto como cultura e historia de la música.

En la interpretación de estos resultados debe tenerse en cuenta que el desempeño académico universitario es un fenómeno multicausal y que los programas universitarios de música ya no persiguen la for mación tradicional de músicos de oficio, sino la formación de profesionales con un perfil polivalente.
La evaluación de las pruebas de acceso a las Enseñanzas Profesionales de Música de Cataluña
Authors: Duran Maria Andreu , Ferrer Imma Ponsatí , Ponsatí Daniel Cassú , Castell Pere Godall , Guillem Miquel Amador , Pérez Joaquim Miranda
Published: December 2021

El Departamento de Educación de la Generalidad de Cataluña en coordinación con el Grupo de Investigación en Educación Auditiva Musical (GREAM) de la Universidad Autónoma de Barcelona y con todos los centros que imparten enseñanzas profesionales de música (Asociación de Conservatorios de Cataluña, ACCAT), inició un estudio para evaluar el apartado de lenguaje musical de la prueba de acceso al primer curso de las enseñanzas profesionales de música durante el curso académico 2012-2013. Para ello se concretaron dos objetivos específicos que marcaron dos líneas de investigación paralelas: 1) obtener la valoración del profesorado de lenguaje musical en torno a los ejercicios de la prueba; 2 ) analizar el rendimiento de los aspirantes, tanto globalmente como en cada uno de los ejercicios. Los resultados obtenidos nos permitió revisar y consensuar la prueba de acceso incorporando cambios con respecto a la prueba inicial.
Dissent, its Persecutors, and the New Russia
Authors: Lipman Maria
Published: December 2021

The post-Soviet decades have brought about significant changes of the Russian social landscape. A countless number of civic initiatives engaged in charitable operation, legal assistance, education, environment, arts and culture, etc. have emerged across Russia. Self-help communities and effective crowd-funding for all kinds of purposes are evidence of public solidarity inconceivable in the Soviet state. The second half of the 2010s were marked by a rise in investigative reporting based on state-of-the-art data journalism and the rapid progress in social media. Apparently, the impressive rise in civil society has become a matter of growing concern for the Russian government, and in the past year, the Kremlin has stepped up persecutions of political activists and investigative media. This repressive surge is reminiscent of the events some four decades ago when the Soviet government undertook to radically eliminate the dissident movement. The activists of today may be different from the Soviet dissidents, but for now, they are just as defenseless vis-à-vis the state as the dissidents were.
Actively Engaging with Social Entrepreneurs: The Social Enterprise Audit
Authors: Fernhaber Stephanie A.
Published: December 2021

Social entrepreneurship is on the rise. For educators, it is no longer a question of if we should teach social entrepreneurship, but rather how we might best do so. The Social Enterprise Audit is introduced as an innovative way to combine in-class learning with active engagement in the social entrepreneurship community. Student teams are matched with local social enterprises. As foundational concepts of social entrepreneurship are taught in the classroom, student teams visit and meet with their social enterprise partner to apply the concepts. The final deliverable includes an analysis and critique of the social enterprise along with a set of recommendations. The structured approach is easy for the instructor to implement and aligns directly with course material. Students benefit by nurturing their identity as a social entrepreneur while developing a skillset that equips them to make a difference.
Open Posterior Glenoid Reconstruction Using a Distal Tibial Allograft
Authors: Tauro Tracy M. , Condron Nolan B. , Quigley Ryan J. , Bodendorfer Blake M. , Cole Brian J.
Published: December 2021

Background:

Posterior instability is less common than anterior instability but can be seen in contact athletes and posttraumatically. Distal tibial allograft reconstruction for glenoid bone loss was first described by Provencher and colleagues in 2009 and an arthroscopic technique for posterior glenoid reconstruction using a distal tibial allograft was later described by Gupta et al in 2013.

Indications:

The primary indications for posterior distal tibial allograft include the failure of conservative management, recurrent instability after an arthroscopic stabilization, or glenoid bone loss > 20% to 25%.

Technique Description:

The patient is positioned in lateral decubitus, and examination under anesthesia is performed. Following arthroscopic evaluation, an incision is made medial to the posterolateral aspect of the acromion at the glenohumeral joint level. Electrocautery is carried to the deltoid, which is split in line with its fibers. A split between the infraspinatus and teres minor is performed. Vertical capsulotomy is performed, and deep retractors are placed. Attention is turned to the back table for graft preparation. The graft is measured, marked on the lateral aspect of the articular surface, and cut accordingly. Two 3.5-mm holes are drilled 1 cm apart, and the graft is thoroughly irrigated before being placed into the wound. A 2.5-mm drill is used in the 3.5-mm holes, and two 3.5-mm solid fully threaded screws are placed under power and tightened by hand. The wound is closed in the traditional fashion.

Results:

Graft nonunion and/or resorption are the primary concerns following posterior distal tibial allograft. Amar et al found no cases of nonunion or partial unions on 6-month computerized tomography (CT) scan, most patients having no or <50% resorption. Millet et al also found bony union by CT scan and improved patient-reported outcome measures. A case series by Gilat et al found 90% of patients reported restoration of stability.

Discussion/Conclusion:

Posterior distal tibial allograft is a successful surgical intervention for patients with recurrent posterior shoulder instability with glenoid bone loss.
Documenting the Interactive Effects of Project Manager and Team-Level Communication Behaviors in Integrated Project Delivery Teams
Authors: Manata Brian , Miller Vernon D. , Mollaoglu Sinem , Garcia Angelo J.
Published: December 2021

This study examines the influence of project managers’ communication behaviors in integrated project delivery (IPD) projects. This study also considers the impact of team-level information sharing on team-level outcomes (i.e., goal alignment, decision quality, process commitment, and project quality). Results indicate that team information sharing was perceived as beneficial, but the effects of project manager communication behaviors were inconsistent. Interaction analyses indicated that project managers’ communication behaviors hindered team functioning if teams were already engaging in adequate levels of information sharing. This manuscript contributes to the project management corpus by explicating an integrative model whereby project manager and team-level information-sharing behaviors are modeled simultaneously.
Fetal and maternal outcome in patients with active lupus nephritis: comparison between new-onset and pre-existing lupus nephritis
Authors: Lian Xing-Ji , Fan Li , Xia Xi , Huang Xia-Min , Ye Hong-Jian , Yu Xue-Qing , Chen Hai-Tian , Chen Wei
Published: December 2021

Background

This study aimed to investigate fetal and maternal outcomes in women with active lupus nephritis (LN). Specifically, we compared women who had new-onset LN and those with pre-existing LN during pregnancy.

Methods

Patients with active LN during pregnancy were divided into the new-onset group (LN first occurred during pregnancy) and the pre-existing group (a history of LN) on the basis of the onset time of LN. Data on clinical features, laboratory findings, and pregnancy outcome were collected and analyzed between the two groups. Multivariate logistic regression analysis was used to compare the effects of active LN on adverse pregnancy outcomes.

Results

We studied 73 pregnancies in 69 women between 2010 and 2019. Of these, 38 pregnancies were in the pre-existing LN group and 35 were in the new-onset group. Patients with pre-existing LN had a higher risk of composite adverse fetal outcomes than those with new-onset LN [adjusted odds ratio (ORs), 44.59; 95% confidence interval (CI), 1.21–1664.82;P= 0.039]. However, the two groups had similar adverse maternal outcomes (ORs, 1.24; 95% CI, 0.36–4.29). Serum albumin and proteinuria significantly improved after pregnancy (P< 0.001). Kaplan–Meier analysis showed that the long-term renal outcome was similar between the two groups.

Conclusions

Pregnant patients with pre-existing LN were associated with a higher risk of composite adverse fetal outcomes than those with new-onset LN. However, these two groups of patients had similar adverse maternal outcomes. The long-term renal outcomes were not different after pregnancy between these two groups.
Predicting time to relapse in patients with schizophrenia according to patients’ relapse history: a historical cohort study using real-world data in Sweden
Authors: Jørgensen Kristian Tore , Bøg Martin , Kabra Madhu , Simonsen Jacob , Adair Michael , Jönsson Linus
Published: December 2021

Background

For patients with schizophrenia, relapse is a recurring feature of disease progression, often resulting in substantial negative impacts for the individual. Although a patient’s relapse history (specifically the number of prior relapses) has been identified as a strong risk factor for future relapse, this relationship has not yet been meticulously quantified. The objective of this study was to use real-world data from Sweden to quantify the relationship of time to relapse in schizophrenia with a patient’s history of prior relapses.

Methods

Data from the Swedish National Patient Register and Swedish Prescribed Drug Register were used to study relapse in patients with schizophrenia with a first diagnosis recorded from 2006–2015, using proxy definitions of relapse. The primary proxy defined relapse as a psychiatric hospitalisation of ≥7 days’ duration. Hazard ratios (HRs) were calculated for risk of each subsequent relapse, and Aalen-Johansen estimators were used to estimate time to next relapse.

Results

2,994 patients were included, and 5,820 relapse episodes were identified using the primary proxy. As the number of previous relapses increased, there was a general trend of decreasing estimated time between relapses. Within 1.52 years of follow-up, 50% of patients with no history of relapse were estimated to have suffered their first relapse episode. 50% of patients with one prior relapse were estimated to have a second relapse within 1.23 years (HR: 1.84 [1.71–1.99]) and time to next relapse further decreased to 0.89 years (HR: 2.77 [2.53–3.03]) and 0.22 years (HR: 18.65 [15.42–22.56]) for 50% of patients with two or ten prior relapses, respectively. Supplementary analyses using different inclusion/exclusion criteria for the study population and redefined proxies of relapse reflected the pattern observed with the primary analyses of a higher number of prior relapses linked with increased risk of/reduced estimated time to the next relapse.

Conclusions

The results suggested a trend of accelerating disease progression in schizophrenia, each relapse episode predisposing an individual to the next within a shorter time period. These results emphasise the importance of providing early, effective, and tolerable treatments that better meet a patient’s individual needs.
Economic burden of varicella in Europe in the absence of universal varicella vaccination
Authors: Pawaskar Manjiri , Méroc Estelle , Samant Salome , Flem Elmira , Bencina Goran , Riera-Montes Margarita , Heininger Ulrich
Published: December 2021

Background

Though the disease burden of varicella in Europe has been reported previously, the economic burden is still unknown. This study estimated the economic burden of varicella in Europe in the absence of Universal Varicella Vaccination (UVV) in 2018 Euros from both payer (direct costs) and societal (direct and indirect costs) perspectives.

Methods

We estimated the country specific and overall annual costs of varicella in absence of UVV in 31 European countries (27 EU countries, plus Iceland, Norway, Switzerland and the United Kingdom). To obtain country specific unit costs and associated healthcare utilization, we conducted a systematic literature review, searching in PubMed, EMBASE, NEED, DARE, REPEC, Open Grey, and public heath websites (1/1/1999–10/15/2019). The number of annual varicella cases, deaths, outpatient visits and hospitalizations were calculated (without UVV) based on age-specific incidence rates (Riera-Montes et al. 2017) and 2018 population data by country. Unit cost per varicella case and disease burden data were combined using stochastic modeling to estimate 2018 costs stratified by country, age and healthcare resource.

Results

Overall annual total costs associated with varicella were estimated to be €662,592,061 (Range: €309,552,363 to €1,015,631,760) in Europe in absence of UVV. Direct and indirect costs were estimated at €229,076,206 (Range €144,809,557 to €313,342,856) and €433,515,855 (Range €164,742,806 to €702,288,904), respectively. Total cost per case was €121.45 (direct: €41.99; indirect: €79.46). Almost half of the costs were attributed to cases in children under 5 years, owing mainly to caregiver work loss. The distribution of costs by healthcare resource was similar across countries. France and Germany accounted for 49.28% of total annual costs, most likely due to a combination of high numbers of cases and unit costs in these countries.

Conclusions

The economic burden of varicella across Europe in the absence of UVV is substantial (over 600 M€), primarily driven by caregiver burden including work productivity losses.
Free combination of dutasteride plus tamsulosin for the treatment of benign prostatic hyperplasia in South Korea: analysis of drug utilization and adverse events using the National Health Insurance Review and Assessment Service database
Authors: Lulic Zrinka , Son Hwancheol , Yoo Sang-Bae , Cunnington Marianne , Kapse Pratiksha , Miller Diane , Cortes Vanessa , Park Suna , Bhak Rachel H. , Duh Mei Sheng
Published: December 2021

Objective

To assess the use and safety of free combination therapy (dutasteride and tamsulosin), dutasteride monotherapy, or tamsulosin monotherapy in patients with benign prostatic hyperplasia (BPH).

Methods

This non-interventional retrospective cohort study used claims data from the Korea Health Insurance Review and Assessment-National Patient Sample database. Patients with BPH ≥ 40 years of age receiving combination therapy (dutasteride 0.5 mg and tamsulosin 0.4 mg daily) or dutasteride 0.5 mg, or tamsulosin 0.4 mg daily dose between 2012 and 2017 were included. The frequency, duration of treatment and risk of any adverse event (AE) or serious AE (SAE) was compared for combination therapy versus each monotherapy using non-inferiority testing.

Results

Of 14,755 eligible patients, 1529 (10.4%) received combination therapy, 6660 (45.1%) dutasteride monotherapy, and 6566 (44.5%) tamsulosin monotherapy. The proportion of patients treated with combination therapy exceeded the pre-specified 3% threshold for ‘frequent’ use. Safety results indicated a similar risk of any AE and SAE irrespective of treatment group. The adjusted relative risk for any AE over the treatment observation period comparing combination therapy with dutasteride monotherapy was 1.07 (95% confidence interval [CI] 1.03, 1.12), and with tamsulosin monotherapy was 0.98 (95% CI 0.95, 1.02) demonstrating non-inferiority. The adjusted relative risk for any SAE was 1.07 (95% CI 0.66, 1.74) and 0.90 (95% CI 0.56, 1.45), compared with dutasteride and tamsulosin monotherapy, respectively. Although the SAE results did not statistically demonstrate non-inferiority of combination therapy based on pre-specified margins, the 95% CI for the risk ratio estimates included the null with a lower limit below the non-inferiority margins, indicating no meaningful differences in SAE risk between groups. Absolute SAE risks were low.

Conclusion

Combination therapy with dutasteride and tamsulosin is frequently used in real-world practice in South Korea for treatment of BPH and demonstrates a safety profile similar to either monotherapy.
Genetically modified large animal models for investigating neurodegenerative diseases
Authors: Yang Weili , Chen Xiusheng , Li Shihua , Li Xiao-Jiang
Published: December 2021

Neurodegenerative diseases represent a large group of neurological disorders including Alzheimer’s disease, amyotrophic lateral sclerosis, Parkinson’s disease, and Huntington’s disease. Although this group of diseases show heterogeneous clinical and pathological phenotypes, they share important pathological features characterized by the age-dependent and progressive degeneration of nerve cells that is caused by the accumulation of misfolded proteins. The association of genetic mutations with neurodegeneration diseases has enabled the establishment of various types of animal models that mimic genetic defects and have provided important insights into the pathogenesis. However, most of genetically modified rodent models lack the overt and selective neurodegeneration seen in the patient brains, making it difficult to use the small animal models to validate the effective treatment on neurodegeneration. Recent studies of pig and monkey models suggest that large animals can more faithfully recapitulate pathological features of neurodegenerative diseases. In this review, we discuss the important differences in animal models for modeling pathological features of neurodegenerative diseases, aiming to assist the use of animal models to better understand the pathogenesis and to develop effective therapeutic strategies.
Measuring migration 2.0: a review of digital data sources
Authors: Tjaden Jasper
Published: December 2021

The interest in human migration is at its all-time high, yet data to measure migration is notoriously limited. “Big data” or “digital trace data” have emerged as new sources of migration measurement complementing ‘traditional’ census, administrative and survey data. This paper reviews the strengths and weaknesses of eight novel, digital data sources along five domains: reliability, validity, scope, access and ethics. The review highlights the opportunities for migration scholars but also stresses the ethical and empirical challenges. This review intends to be of service to researchers and policy analysts alike and help them navigate this new and increasingly complex field.
Patterns of student collaborative learning in blended course designs based on their learning orientations: a student approaches to learning perspective
Authors: Han Feifei , Ellis Robert A.
Published: December 2021

This study combines research methods from student approaches to learning research and social network analysis (SNA) to examine patterns of students’ collaborative learning based on their learning orientations amongst 193 postgraduates enrolled in a blended course. The study identified two distinct learning orientations, namely ‘understanding’ and ‘reproducing’, which differed in approaches to learning through inquiry, approaches to using online learning technologies, perceptions of the online workload, and academic outcomes. On the basis of students’ learning orientations and their choice of whether to collaborate and with whom to collaborate, five networks representing five patterns of collaborative learning were found. From these, two did not reveal any collaboration (Understanding Alone and Reproducing Alone networks); and three revealed collaborations (Understanding Collaboration, Mixed Collaboration, Reproducing Collaboration networks). A range of SNA measures were calculated and revealed different features of the three collaboration networks. Viewed together, the combined methodologies suggest that the Understanding Collaboration network has more desirable features of collaboration, such as the intensity of collaboration, having closely knitted groups who tended to seek out and welcome peers and who tended to engage more often in both face-to-face and online modes. The study suggests that helping students adjust their learning orientations, designing some compulsory collaborative assessment tasks, and configuring the composition of collaborative groups are productive strategies likely to improve students’ experiences of collaborative learning.
Dual PD-1 and CTLA-4 Checkpoint Blockade Using Balstilimab and Zalifrelimab Combination as Second-Line Treatment for Advanced Cervical Cancer: An Open-Label Phase II Study
Authors: O'Malley David M. , Neffa Maryna , Monk Bradley J. , Melkadze Tamar , Huang Marilyn , Kryzhanivska Anna , Bulat Iurie , Meniawy Tarek M. , Bagameri Andrea , Wang Edward W. , Doger de Speville Uribe Bernard , Hegg Roberto , Ortuzar Feliu Waldo , Ancukiewicz Marek , Lugowska Iwona
Published: December 2021

PURPOSE

Balstilimab (antiprogrammed death-1) and zalifrelimab (anticytotoxic T-lymphocyte–associated antigen-4) are two new checkpoint inhibitors emerging as promising investigational agents for the treatment of advanced cervical cancer. This phase II trial (ClinicalTrials.gov identifier: NCT03495882 ) evaluated the combination of balstilimab plus zalifrelimab in patients with recurrent and/or metastatic cervical cancer who relapsed after prior platinum-based therapy.

PATIENTS AND METHODS

Patients were intravenously dosed with balstilimab 3 mg/kg once every 2 weeks and zalifrelimab 1 mg/kg once every 6 weeks, for up to 24 months. The primary end point was objective response rate (ORR, RECIST version 1.1, assessed by independent central review). Secondary end points included duration of response, safety and tolerability, and survival.

RESULTS

In total, 155 women (median age, 50 years [range, 24-76 years]) were enrolled and treated with balstilimab plus zalifrelimab; 125 patients had measurable disease at baseline and one prior line of platinum-based therapy in the advanced setting, and these patients constituted the efficacy-evaluable population. The median follow-up was 21 months. The confirmed ORR was 25.6% (95% CI, 18.8 to 33.9), including 10 complete responders and 22 partial responders, with median duration of response not reached (86.5%, 75.5%, and 64.2% at 6, 9, and 12 months, respectively). The ORRs were 32.8% and 9.1% in patients with programmed death ligand-1–positive and programmed death ligand-1–negative tumors, respectively. For patients with squamous cell carcinoma, the ORR was 32.6%. The overall disease control rate was 52% (95% CI, 43.3 to 60.6). Hypothyroidism (14.2%) and hyperthyroidism (7.1%) were the most common immune-mediated adverse events.

CONCLUSION

Promising and durable clinical activity, with favorable tolerability, was seen in this largest trial to date evaluating dual programmed death-1/cytotoxic T-lymphocyte–associated antigen-4 blockade in patients with recurrent and/or metastatic cervical cancer. Further investigation of the balstilimab and zalifrelimab combination in this setting is continuing.
Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline
Authors: Vogelbaum Michael A. , Brown Paul D. , Messersmith Hans , Brastianos Priscilla K. , Burri Stuart , Cahill Dan , Dunn Ian F. , Gaspar Laurie E. , Gatson Na Tosha N. , Gondi Vinai , Jordan Justin T. , Lassman Andrew B. , Maues Julia , Mohile Nimish , Redjal Navid , Stevens Glen , Sulman Erik , van den Bent Martin , Wallace H. James , Weinberg Jeffrey S. , Zadeh Gelareh , Schiff David
Published: December 2021

PURPOSE

To provide guidance to clinicians regarding therapy for patients with brain metastases from solid tumors.

METHODS

ASCO convened an Expert Panel and conducted a systematic review of the literature.

RESULTS

Thirty-two randomized trials published in 2008 or later met eligibility criteria and form the primary evidentiary base.

RECOMMENDATIONS

Surgery is a reasonable option for patients with brain metastases. Patients with large tumors with mass effect are more likely to benefit than those with multiple brain metastases and/or uncontrolled systemic disease. Patients with symptomatic brain metastases should receive local therapy regardless of the systemic therapy used. For patients with asymptomatic brain metastases, local therapy should not be deferred unless deferral is specifically recommended in this guideline. The decision to defer local therapy should be based on a multidisciplinary discussion of the potential benefits and harms that the patient may experience. Several regimens were recommended for non–small-cell lung cancer, breast cancer, and melanoma. For patients with asymptomatic brain metastases and no systemic therapy options, stereotactic radiosurgery (SRS) alone should be offered to patients with one to four unresected brain metastases, excluding small-cell lung carcinoma. SRS alone to the surgical cavity should be offered to patients with one to two resected brain metastases. SRS, whole brain radiation therapy, or their combination are reasonable options for other patients. Memantine and hippocampal avoidance should be offered to patients who receive whole brain radiation therapy and have no hippocampal lesions and 4 months or more expected survival. Patients with asymptomatic brain metastases with either Karnofsky Performance Status ≤ 50 or Karnofsky Performance Status < 70 with no systemic therapy options do not derive benefit from radiation therapy. Additional information is available at www.asco.org/neurooncology-guidelines .