bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanical Testing of Scapular Spine Autograft for Anterior Glenoid Bone Augmentation
Authors: Mittelsteadt Marcus , Nelson Bradley J. , Rohman Eric M. , Arciero Robert A. , Tompkins Marc A.
Published: May 2022

Background:

Augmentation of anterior glenoid defects with bone graft can improve shoulder stability and reduce the risk of redislocation. Several characteristics of the scapular spine may make it a suitable harvest site, avoiding the disadvantages associated with other glenoid augmentation procedures.

Purpose:

To evaluate the capacity of scapular spine autograft to restore the stabilizing joint-reaction forces of the shoulder in simulated scenarios of bony anterior shoulder instability.

Study Design:

Controlled laboratory study.

Methods:

We obtained 6 matched pairs of fresh-frozen cadaveric shoulders. Skin, subcutaneous tissues, and non–rotator cuff muscles were removed from the specimens, leaving intact the rotator cuff musculature and shoulder capsule. A customized testing device was used to translate the humerus 1 cm anteriorly on the glenoid under 25 N of axial compression force. The peak joint-reaction force of the glenohumeral joint was then measured under 3 conditions: (1) specimen with intact glenoid, (2) specimen after a bone defect measuring 25% of the maximal width of the glenoid was made in the anteroinferior glenoid, and (3) specimen after size-matched glenoid augmentation with a scapular spine tricortical autograft. The primary outcome was the change in peak joint-reaction forces between the defect state and augmented state.

Results:

One matched pair was removed from final analysis secondary to anatomic concerns that undermined the accuracy of test results. Among the 10 remaining specimens, all showed a significant decrease in peak joint-reaction force after the glenoid defect was created compared with the intact state ( P < .001). All remaining specimens showed an increase in peak joint-reaction force in the augmented state compared with the defect state ( P < .001). On average, the augmented state restored 81% of the peak reaction force of the glenohumeral joint compared with the intact state, a nonsignificant difference ( P = .07).

Conclusion:

The study findings indicated that autograft harvested from the scapular spine increased the bony restraint to anterior shoulder dislocation in shoulders with glenoid bone loss.

Clinical Relevance:

The scapular spine is an alternative for bony augmentation of glenoid defects in shoulder instability.
Prevalence of Computer Use among Geriatric In- and Outpatients
Authors: Jørgensen Bodil B. , Damsgaard Else Marie , Simonsen Mia M. , Gregersen Merete
Published: May 2022

Objective: Despite its many benefits, tele-rehabilitation is not widely used by the older generations. This study aimed to investigate the opportunity to offer tele-rehabilitation in a geriatric population by determining the prevalence of computer use and to examine whether the patients’ characteristics affect computer use. Design: Cross-sectional study. Patients: Cognitive well-functioning in- and outpatients aged 65 years or older. Methods: Patients were consecutively included and surveyed. Results: A total of 249 patients participated in the survey. Among them, 124 were computer users. Four of these never went online. Compared to non-users, computer users were younger OR: 0.91 (95% CI: 0.87; 0.94) p = 0.001, less frail OR: 0.37 (95% CI: 0.25;0.55) p = 0.001, had a higher functional capacity OR: 1.02 (95% CI 1.01; 1.03) p = 0.001 and more often had an education at high school level or higher OR: 1.7 (95% CI: 1.41; 2.40). Conclusion: Only half of the geriatric patients are computer users. If tele-rehabilitation is to be adopted by a wider geriatric population challenged by reduced mobility, long transportation times, or frailty, computer training, user friendly devices and computer support should be considered beforehand.
Associations Between Parental Depression, Self-efficacy, and Early Childhood Development in Malnourished Haitian Children
Authors: She Xinshu , Perera Sajithya , Andre Martine , St. Fleur Jacklin , Hilaire Johanne , Evans Andrea , Long Jack , Wing Delight , Carpenter Christopher , Wilson Kim , Palfrey Judith , Stulac Sara
Published: May 2022

Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.
Summer Hospitalization and Bronchial Asthma Make Treatment of Respiratory Syncytial Virus Infection Difficult: A Retrospective Study in Japan
Authors: Oikawa Kosuke , Ochiai Hirotaka , Matsuhashi Kazuhiko , Sakurai Motoichiro , Suzuki Manabu , Koganesawa Masaya , Terada Tomomasa , Ishii Yoko , Kokaze Akatsuki , Mizuno Katsumi
Published: May 2022

In recent years, epidemics of respiratory syncytial virus (RSV) have been seen in the summer in Japan. Patients hospitalized in the summer used a high-flow oxygen administration device more frequently than patients hospitalized in the winter. This study was a retrospective study to examine the variables associated with duration of oxygen therapy and severe cases. Subjects were pediatric patients diagnosed with RSV infection and hospitalized for treatment during the 5 years from April 2014 to March 2019. Data from 292 patients were analyzed. Duration of oxygen therapy was significantly associated with bronchial asthma (partial regression coefficient: 0.897, P = .004). Hospitalization in summer was significantly associated with severe condition (adjusted odds ratio: 4.07, 95% confidence interval: 1.16-14.27). The present study showed that bronchial asthma is a risk factor for prolonged oxygen therapy and infection in summer is a risk factor for progression to severe condition in cases of RSV infection.
Review Article: Audrey Truschke, The Language of History: Sanskrit Narratives of Muslim Pasts
Authors: Mahalakshmi R.
Published: May 2022

Audrey Truschke, The Language of History: Sanskrit Narratives of Muslim Pasts (New Delhi: Penguin Random House India), 2021, xlviii + 354 pp., ₹699.
Labourers and Artisans in Seventeenth-Century Ahmadabad
Authors: Kumar Rakesh
Published: May 2022

Among the inhabitants of medieval Indian cities, the largest group was naturally represented by its workforce. They were a crucial element in the urban dynamics of these cities. Ahmadabad, during the seventeenth century, was the leading manufacturing hub of Gujarat besides being the administrative headquarters of that province. This ensured varied employment opportunities for different categories of labourers and artisans residing in the city and its neighbourhood. Leveraging several analytical tools, the present study is an attempt to provide an insight into the contribution of the workforce behind the economic prosperity of Ahmadabad in the seventeenth century.
Book review: Arunima Dutta, Fleeting Agencies: A Social History of Indian Coolie Women in British Malaya
Authors: Basu Rajsekhar
Published: May 2022

Arunima Dutta, Fleeting Agencies: A Social History of Indian Coolie Women in British Malaya (Cambridge: Cambridge University Press), xviii + 240 pp., ₹1,195 (Hb).
Midwives Experiences of Managing Clients with Eclampsia in a low Resource Setting: A Qualitative Descriptive Study
Authors: Dartey Anita Fafa , Dzansi Gladys , Lotse Comfort Worna , Obuobisa Racheal , Afua Bosu Celestine Emefa , Afaya Agani
Published: May 2022

Objective

Eclampsia remains a public health issue, especially in low-resource countries worldwide. Midwives are the backbone of the pregnancy and delivery process. Midwives trained in the necessary knowledge and skills are more likely to notice early warning signals of preeclampsia and immediately help clients in such emergencies. This study explored midwives’ experiences in managing patients with eclampsia in Ghana.

Methods

This study was conducted among eight registered midwives at maternity units of two district hospitals in the Eastern Region of Ghana, using an exploratory, descriptive qualitative research design. A purposive sampling technique was adopted to select and interview participants. Interviews were audio-recorded, transcribed, and analyzed using qualitative thematic analysis. The right of participation and withdrawal from the study was respected.

Findings

The three emerged overriding themes are: 1. Midwives have knowledge (warning signs, regimens, and prevention of complications) about the management of eclampsia. 2. Challenges in managing clients included inadequate equipment, staffing, and access to drugs. 3. Strategies for mitigating barriers to care for women with eclampsia (adherence to protocols, teamwork, peer mentoring and supervision, midwives’ attitude, and client education.

Conclusion

Midwives working in underserved facilities have the knowledge and skill to monitor and manage pregnant women experiencing eclampsia. However, they need to be supported with appropriate resources and advanced equipment to ensure adherence to protocols on managing eclampsia promptly referred. Continuous training and workshops for midwives in the management of hypertension in pregnancy are recommended and the public educated on the dangers of eclampsia.
Determining the Impact of an Alarm Management Program on Alarm Fatigue among ICU and Telemetry RNs: An Evidence Based Research Project
Authors: Dee Stacie A. , Tucciarone Jessica , Plotkin Gary , Mallilo Christina
Published: May 2022

This evidence-based research project provides an appraisal of current research on how an alarm management program impacts alarm fatigue among registered nurses (RNs) in both intensive care units (ICUs) and telemetry units. Alarm fatigue is a major problem recognized by both the American Association of Critical-Care Nurses (AACN) and the Joint Commission. RNs are the primary caretakers of critically ill patients in ICUs and telemetry units and therefore are at the greatest risk for alarm fatigue.

The researchers performed an evidence synthesis to determine the impact of an alarm management program on alarm fatigue among ICU and telemetry RNs. A literature search was conducted using scientific databases such as PubMed, CINAHL, Trip, Cochrane Review, and Google Scholar. Our search strategy included the following terms: adult registered nurse, inpatient registered nurse, ICU registered nurses, RNs, Nurse Practitioners, alarm fatigue, alarm management strategy, education, cardiac monitor alarm, alarm strategies, alarm bundle, telemetry alarm, and cardiac monitor. Any studies involving the pediatric population, pulse oximeter alarms, and ventilator alarms were excluded. Due to the lack of available randomized control trials and cohort studies, the authors included two quality improvement (QI) projects. Finally, six studies were taken into consideration for review. The authors appraised each of the six articles using the Critical Appraisal Skills Programme Checklist (CASP) Tool. This tool allowed the authors to synthesize information based on the outcomes and determine the level of the evidence of each article in order to make evidence-based practice recommendations on implementing alarm management programs. Conclusion: Despite extensive literature highlighting the astronomical prevalence of alarm fatigue in RNs, there was a lack of current high-quality data related to implementing alarm management programs. Therefore, more research is needed to support the utilization of alarm management programs in ICUs and telemetry units to improve alarm fatigue among RNs.
Intolerance of Uncertainty and Self-Compassion in Medical Students: Is There a Relationship and Why Should We Care?
Authors: Poluch Maria , Feingold-Link Jordan , Papanagnou Dimitrios , Kilpatrick Jared , Ziring Deborah , Ankam Nethra
Published: May 2022

Managing the uncertainty of clinical practice represents a significant source of stress for clinicians, including medical students transitioning into the clinical workplace. Self-compassion, a strategy to better cope with stress and burnout, may represent a skill that can be leveraged to better prepare learners for the uncertainty inherent in clinical practice. A negative correlation between intolerance of uncertainty and self-compassion has been demonstrated in undergraduate students and in the general population. An examination of this relationship in medical students may help inform future curricular development for addressing burnout in undergraduate medical education. We electronically administered the Intolerance of Uncertainty Short Scale and the Self-Compassion Short Form to 273 third-year medical students from a single institution and analyzed data via regression. A significant negative correlation was found between intolerance of uncertainty and self-compassion (p < 0.0001). Students with higher levels of self-compassion showed lower levels of intolerance of uncertainty. This is consistent with findings in other populations. Our findings offer a starting point for designing training experiences that strengthen student self-compassion to enhance their ability to reconcile the uncertainty they will encounter in clinical practice.
Narrative Inquiry into the Professional Identity-Making of Ghanaian Midwives
Authors: Asamoah Ampofo Evelyn , Caine Vera , Clandinin D Jean
Published: May 2022

Professional identity-making is a complex life-making endeavor that is shaped by both the personal and professional knowledge landscapes in which people live and work. Using narrative inquiry, four midwives who had worked in diverse contexts in Ghana were purposively selected. We highlight how midwives’ experiences across time, place, and in diverse contexts shape their professional identity-making. Three main life experiences that shape professional identity-making were discovered: 1. Childhood experiences, 2. Education experiences, and 3. Professional work experiences. Midwifery education should prepare students to attend to this complex and ongoing identity development, in order to enhance midwifery practice.
Harnessing Followership to Empower Graduate Medical Education Trainees
Authors: Bunin Jessica L , Durning Steven , Weber Lauren
Published: May 2022

Followership is the leadership practiced by individuals who are in positions of responsibility without authority, whereby they exert their influence to help execute the vision of their leaders. The central principle of followership is a commitment to actively support leaders and organizations. Without effective followers, organizations flounder, decision-making lies only at the top echelons, and plans are either incompletely executed or not executed at all. In this perspective, we introduce the concept of followership as an important part of leadership development. We explore pedagogical methods for teaching graduate medical education (GME) trainees the followership tenets of service, assuming responsibility, and challenging leadership as necessary skills to achieve partnership with their leaders. We argue that developing followership skills, specifically partnering skills, can help trainees excel as leaders and attendings. GME trainees who practice effective followership take initiative by co-managing their patients with their attendings. By displaying both willingness to serve and challenge their leaders, they add to the success of the whole unit. Followership is a skill that can be learned. Learners should reflect on their own followership style and identify areas for flexibility and growth. Those seeking to become partners should solicit explicit feedback, observe their role models, and seek opportunities to role play situations that highlight the difficulties of followership. Partnership allows for development of a space between leaders and followers to experience empathy, reward ownership, and grow leaders.
Recruiting Business Expatriates in Portugal: The Moderating Role of Employee Willingness
Authors: Coelho João Vasco
Published: May 2022

The present study examines the practices that multinational companies located in a small, open and peripheral European economy (Portugal) are acting to build talent pools for expatriate assignments. The role of employee willingness (to go) is explored as a dimension influencing the existing firm staffing practices’ success. By using a Portuguese sample, the study examines whether prior findings in mature economies and consolidated multinational companies can be generalised to peripheral and less-developed international business settings. Five business contexts and 24 expatriate cases were considered to ground empirical analysis. The prevalence of internal recruitment practices, informal and closed systems and staffing criteria, and less established international mobility and staffing experience, suggest the existence of critical differences with the current best-of-breed practices. Study findings indicate that divergent willingness profiles operate as moderating factors of firm propensity to use international work to support expansion goals. A typology of business expatriate willingness profiles ( conformist expatriates, trajectory-focused expatriates and disrupted expatriates) is proposed to showcase expatriation assignments as a contemporary socioeconomic heterogenetic condition.
Cardiac CT for intra-cardiac thrombus detection in embolic stroke of undetermined source (ESUS)
Authors: Barnea Rani , Agmon Inbar Nardi , Shafir Gideon , Peretz Shlomi , Mendel Rom , Naftali Jonathan , Shiyovich Arthur , Kornowski Ran , Auriel Eitan , Hamdan Ashraf ,   Cardiac CT for Undetermined Source of Embolic Stroke (CaCTUSES) Working Group
Published: May 2022

Introduction:

Embolic stroke of undetermined source (ESUS) is a common medical challenge regarding secondary prevention strategy. Cardiac imaging is the cornerstone of embolic stroke workup, in an effort to diagnose high risk cardio-embolic sources. Cardiac computed tomography angiography (CCTA) is an emerging imaging modality with high diagnostic performance for intra-cardiac thrombus detection. The yield of CCTA implementation in addition to standard care in ESUS workup is unknown. Thus, the aim of this study was to assess the utility of CCTA in detecting intra-cardiac thrombi in the routine ESUS workup.

Patients and methods:

This is a retrospective observational analysis of ESUS cases managed in vascular neurology unit between 2019 and 2021. Within this ESUS registry, consecutive patients undergoing CCTA were included and carefully analyzed.

Results:

During the study period 1066 Ischemic stroke (IS) cases were treated and evaluated. 266/1066 (25%) met ESUS criteria and 129/266 (48%) underwent CCTA. Intra-cardiac thrombus was detected by CCTA in 22/129 (17%; 95% CI, 11.5%−23.5%) patients: left ventricular thrombus (LVT) in 13 (10.1%) patients, left atrial appendage (LAA) thrombus in 8 (6.2%) patients, and left atrial (LA) thrombus in 1 (0.8%) patient. Only 5/22 (23%) of these thrombi were suspected, but could not be confirmed, in trans-thoracic echocardiogram (TTE). Among CCTA-undergoing patients, 27/129 (21%; 95% CI, 14%−28%) were found to have an indication (including pulmonary embolism) for commencing anticoagulation (AC) treatment, rather than anti-platelets. In favor of CCTA implementation, 22/266 (8.2%; 95% CI, 4.9%−11.5%) patients within the entire ESUS cohort were diagnosed with intra-cardiac thrombus, otherwise missed.

Conclusion:

CCTA improves the detection of intra-cardiac thrombi in addition to standard care in ESUS patients. The implementation of CCTA in routine ESUS workup can change secondary prevention strategy in a considerable proportion of patients.
The shape and size of urban blocks
Authors: Shpuza Ermal
Published: May 2022

Two measures of shape compactness and fragmentation are coupled together into a plot that is defined as a two-dimensionalmatrix for classifying boundary shapes. Block shapes in a large sample of cities result in a swallowtail distribution in the matrix, which exposes two fundamental ways of transforming the basic compact block: by dissection, corresponding to large blocks with internal dendritic streets, and by stretching and bending, corresponding to serpentine blocks in hilly terrains and edge blocks along highways, railroads, and canals. The density of cases in each matrix zone reveals the realization of actual blocks out of the probable shape combinations as a manifestation of the social logic of urban form. The observed affinity between the shape and size of non-basic blocks in cities is used to formulate a model that explains them according to the constraints of arranging plots along the streets combined with the requirements for the intelligibility of navigation and the minimization of travel distance. Considering blocks as intra-street cells, the proposed block classification reveals important links between topological and geometric aspects of the street networks thus contributing to urban modeling, morphological classification, and comparative studies.
Exploring land use functional variance using mobile phone derived human activity data in Shanghai
Authors: Ren Xiyuan , Guan ChengHe , Wang De , Yang Junyan , Zhang Bo , Keith Michael
Published: May 2022

Land use functions can categorize places where people perform different socioeconomic activities. This classification plays an important role in urban management, policy making, and resource allocation. However, due to the rapid changes of built environment and living demands, human activities might vary significantly, in space and time, even within the same land use function as conventionally defined, impeding the formulation of targeted and user-oriented planning policies. This study took the first step to explore land use subcategorization using mobile phone-derived human activities. The study area is the 5,298 census tracts in Shanghai. Sixteen million mobile phone users’ data were collected from Shanghai Mobile Co., Ltd., in 2014. We proposed a multi-dimensional indicator framework to capture collective features of activities and identified land use subcategories using the K-Means clustering method. Analysis of variance (ANOVA) was applied to detect the proportion of activity variances captured by the classification results. Subcategory labelling method was applied to reveal the relationship between land use subcategories and built environment factors. The results show that (1) Conventional land-use functional zones (LFZs) cannot fully capture the activity variances, especially in behavioral regularity and temporal variation; (2) According to the variance analysis, at least four to five subcategories should be identified upon current LFZs to capture the main activity variances; and (3) In the case of Shanghai, land use subcategories presented palpable spatial regularity, which revealed a citywide structure deserves for further study. We concluded that data-derived activity features can provide an innovative perspective complementary to existing land use classification standards and facilitate policymakers with their decision-making processes on urban resource allocation.
Perception of Subjective Well-being of the Lodha Tribe in West Bengal
Authors: Majumdar Koustab , Chaterjee Dipankar
Published: May 2022

This article discusses the subjective perception of the well-being of the people of the Lodha tribe in West Bengal, India. Relying on the qualitative method of research, this study interviewed participants ( n = 53) from the Lodha tribal community of West Bengal in eastern India. Positive effect, happiness and domain satisfaction were the framework to capture the subjective perception of well-being. The study finds that there are four major themes emerged as the perception of subjective well-being: health, traditional knowledge, festivals and social connectedness. Further, this study conclusively suggests not only that policies should be incorporated that can improve the material benefit (housing, livelihood and biological health) but focus should also be made beyond it (promotion of mental health, indigenous knowledge and social connectedness).
Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome
Authors: Govindaraju Viren K. , Schimmel Olivia C. , Trese Matthew G. J. , Garretson Bruce R. , Faia Lisa J.
Published: May 2022

Purpose:

We present a complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome including bilateral exudative retinal detachments, bullous chemosis, and impaired ocular motility.

Methods:

The patient was followed in the inpatient and outpatient setting with clinical examinations, optical coherence tomography, widefield fundus photography, neuroimaging including magnetic resonance imaging of the brain/orbits, as well as carotid artery ultrasonography.

Results:

Our patient was admitted with bilateral vision changes in the setting of preeclampsia and HELLP syndrome and was found to have bilateral exudative detachments, retinal exudation, severe bullous chemosis, and impaired motility. She was started on intravenous dexamethasone followed by an extended prednisone taper with resolution of her ocular findings and return of her vision to baseline.

Conclusions:

There is evidence that HELLP syndrome and preeclampsia are proinflammatory syndromes. Aggressive blood pressure control, corticosteroids, and a multidisciplinary approach might accelerate visual and systemic recovery in these complex cases.
Greenwashing in Palestine/Israel: Settler colonialism and environmental injustice in the age of climate catastrophe
Authors: Hughes Sara Salazar , Velednitsky Stepha , Green Amelia Arden
Published: May 2022

Israeli innovations in “green” technology are ostensibly aimed at sustainable resource management and climate change mitigation. But sustainable development and environmental (in)justice in Palestine/Israel need to be examined through interdisciplinary perspectives that account for the broader settler colonial and neoliberal contexts in which they occur. Taking into account the historical and geographic context of Israel's scientific development, we argue that Israel's green technologies are fundamentally structured by the Zionist project of appropriating Palestinian lands. Within settler colonial analysis, environmental injustice comprises part of a broader pattern of settler domination of Indigenous ecological relations, requiring attending not to ‘equity’ in relations with the state and environment but a reckoning with settler privilege and the return of land to Indigenous communities. We analyze the use of environmental infrastructures—specifically in the areas of waste management, renewable energy, and agricultural technologies (“agritech”)—as mechanisms for land appropriation and dispossession in Palestine/Israel. Our analysis of ‘greenwashing’ as a rhetorical strategy asserts that regardless of the ecological impact of individual technologies, in Israel's settler colonial context they further indigenous dispossession and elimination and are therefore incommensurable with long-term socio-ecological resilience. Through this analysis of Israeli greenwashing, we discuss Israeli sustainability initiatives and technological innovations not as ahistorical discourses, commodities, or technologies, but as elements of a historically situated settler colonial project.
Disasters and indigenous peoples: A critical discourse analysis of the expert news media
Authors: Mosurska A , Clark-Ginsberg A , Sallu S , Ford JD
Published: May 2022

Attempts to shift the ways disasters have traditionally been managed away from authoritarian, top-down approaches toward more bottom-up and inclusive processes often involve incorporating viewpoints from marginalised and vulnerable groups. Recently as part of this process, there have been calls for greater inclusion of Indigenous peoples in disaster management. In theory, this also suggests a shift in power structures, towards recognising Indigenous peoples as experts in disaster management. However, in popular imagination and policy Indigenous peoples often appear to be caricatured and misrepresented, for instance through tropes of Indigenous peoples as custodians of the environment or especially vulnerable to environmental change. These framings matter because they can result in disaster management policies and practices that do not capture Indigenous peoples’ complex realities. However, these framings have not been analysed in the context of disasters. In this article, we aim to better understand these framings through a critical discourse analysis of how Indigenous peoples in disasters are represented in the expert news media. We identify five discourses, including a dominant one of disasters as natural phenomena to be addressed through humanitarianism and technocratic interventions. Such discourses render Indigenous peoples helpless, depoliticize disasters and are justified by framing governments and NGOs as caring for Indigenous peoples. However, we also identify competing discourses that focus on systems of oppression and self-determination in disaster management. These discourse recognise disasters as political and include discussion of the role of colonialism in disaster creation. As care emerged as a means through which intervention was justified, we conclude by asking questions of who is cared for/about in disasters and how that care is performed.
Endless modernisation: Power and knowledge in the Green Morocco Plan
Authors: Mathez Andrea , Loftus Alex
Published: May 2022

In 2008, in the aftermath of the World Food Crisis and in a context of an unfolding New Green Revolution for Africa, Morocco launched the Green Morocco Plan to ‘modernise’ its agricultural sector, thereby making the latter the main driver for economic growth and for the alleviation of rural poverty. Yet, the technicist-productivist rationale of the Green Morocco Plan, characteristic of New Green Revolution modernisation schemes, renders any positive socio-ecological outcome unlikely. Hence, recent studies of the Green Morocco Plan have focused on its impacts on food security, inequality and environment. However, how the Green Morocco Plan's rationale is (re)produced within a given set of socio-ecological, material relations has to date attracted relatively little attention. This study, therefore, explores the power-knowledge dynamics of the modernisation discourse within the Green Morocco Plan as a driver of socio-ecological change. Bringing together insights from political ecology, critical development and agri-food studies, we show how the entangled set of ideological, material, political and technical processes embodied within the Green Morocco Plan favours a reductionist view of agricultural development as increasing yields and profits. In so doing, such a view perpetuates efforts to ‘modernise’ smallholder/family farming.
Tailored Fundoplication for GERD With Impedance Planimetry (EndoFLIP™)
Authors: Wu Hoover , Ungerleider Sara , Attaar Mikhail , Wong Harry J. , Kuchta Kristine , Denham Woody , Linn John , Ujiki Michael B.
Published: May 2022

Introduction:

Impedance planimetry with the endoluminal functional lumen imaging probe (FLIP) has been used to measure the gastroesophageal junction (GEJ) tightness, the distensibility index (DI), during anti-reflux surgery. We describe our institutional experience of a tailored fundoplication algorithm utilizing FLIP to select whether patients should have Laparoscopic Nissen Fundoplication (LNF) or Toupet Fundoplication (LTF) for treatment of gastroesophageal reflux disease (GERD).

Methods and procedures:

A prospectively maintained quality database was queried. Patients who underwent laparoscopic fundoplication for GERD from 2008 to June 2021 were analyzed. Multiple patient factors and intraoperative FLIP measurements were used to guide decision making from 2017 to 2021. Outcomes included quality of life surveys, Reflux Symptom Index, Gastroesophageal Reflux Disease-Health Related Quality of Life (GERDHRQL), and Dysphagia score.

Results:

A total of 357 patients were reviewed, 2008-December 2016 (N = 248, 81% LNF) and January 2017 to June 2021 (N = 109, 32% LNF). In the FLIP group, LNF patients had a larger DI compared to LTF patients, 6.5 ± 2.4 mm2/mmHg at hernia reduction ( P < .01). Upon 2-year follow-up, FLIP patients reported lower gas-bloat scores, 0.9 ± 1.1 versus 1.8 ± 1.4 in non-FLIP patients ( P < .01). Patients with normal esophageal motility in the FLIP group had less gas-bloat syndrome than the non-FLIP group (0.9 ± 1.1 vs 1.9 ± 1.4, P < .01).

Conclusions:

Incorporating FLIP into a tailored fundoplication algorithm led to less gas bloat. Careful selection of which patients can tolerate a Nissen fundoplication may optimize outcomes. Continued exploration with intraoperative impedance planimetry can impact the postoperative quality of life after anti-reflux surgery.
Determining factors of access and equity in higher education: A systematic review
Authors: Wanti Mega , Wesselink Renate , Biemans Harm , Brok Perry den
Published: May 2022

This literature review study aims to provide an overview of influencing factors of access to and equity in higher education. In this way, the research offers insight into specific factors that support or hinder access and equity, respectively. Forty factors from thirty-three peer-reviewed articles, mostly from three continents: Europe, Australia, and America, published between 2014 and 2018, were selected for further analysis. The articles were analyzed into four organizational levels: government, university, pre-university education, and student. Most findings on this topic discuss government policies and financial support. In addition to financial support, the significance of this paper discusses social support influence (by peers, by family, by teachers, by university officers, and via programs) to improve access and equity in higher education. Social support emerged as crucial for both access and equity. This study alerts researchers, teachers, administrators at the university level, and policy-makers at the national level to focus more on social relations between peers, students, and lecturers, support by the managerial level, and establishing programs that provide basic academic skills to disadvantaged groups.
Consumers’ access to information about medicine prices and availability as an enabler of last mile medicine access: A scoping review
Authors: Mureyi Dudzai , Gwatidzo Shingai D , Matyanga Celia MJ
Published: May 2022

Information about where medicines are in stock and how much they cost facilitates consumers’ timely access to affordable medicines by enabling price comparisons and the identification of stockists. Our aims were to: (1) Review how consumer access to price and availability information is engaged within the Medicine Access discourse and (2) identify factors associated with the existence of interventions that provide consumers with medicine availability and price information. We conducted two scoping reviews. We reviewed 26 medicine access and pharmaceutical system strengthening frameworks to assess how they conceptualise information access. We then reviewed four interventions that provide consumers with availability and price information to identify the factors associated with these interventions’ existence. We found that in the medical access discourse, information is mainly cast as helpful to entities that ensure medicine access for populations. Information as an enabler of medicine procurement for consumers/households is less emphasised. We then identified the following eight factors that facilitate consumer access to reliable medicine price and availability information: the recognition of a medicine access problem that can be mitigated by consumer access to information; cross-sectoral collaboration; the willingness of medicine sellers to disclose their inventory information; having information quality control measures; appropriate incentives for intervention adoption; enabling legal environments; systems of pooling information; and access to digital information technology infrastructure. We recommend that more theoretical and implementation attention ought to be directed at how medicine price and medicine availability information can empower individual consumers to make sound purchasing decisions.
Examining Implementation of Positive Behavioral Interventions and Supports in Rural Schools
Authors: Garbacz S. Andrew , Santiago Rachel T. , Gulbrandson Kim
Published: May 2022

School-wide PBIS implementation is associated with positive academic and behavioral outcomes. Research supports the importance of school context in implementation and sustainment, but more work is needed to explore the role of community locale, particularly for rural communities that experience context-specific strengths and challenges in accessing resources. The purpose of this study was to examine variables that may influence PBIS implementation fidelity, sustained fidelity, training, and assessment and how these variables vary across geographic locales. Nine years of statewide PBIS implementation and school-level data were drawn from a longitudinal statewide dataset for the U.S. state of Wisconsin. Results of generalized linear models, MANOVA, and discriminant analysis indicated (a) consistent assessment and sustained fidelity in rural and town schools were positively associated with district size and enrollment of minoritized students, but they were negatively associated with enrollment of ELL students (with grade level also having an association with sustained fidelity); (b) locale had an effect on fidelity, assessment, and training; and (c) rural and city locales had the greatest differences from each other in training, assessment, and fidelity. Study limitations and future research directions are discussed.
A 3-decade multicenter European experience with cladribine as upfront treatment in 384 patients with hairy cell leukemia
Authors: Broccoli Alessandro , Argnani Lisa , Cross Matthew , Janus Agnieszka , Maitre Elsa , Troussard Xavier , Robak Tadeusz , Dearden Claire , Else Monica , Catovsky Daniel , Zinzani Pier Luigi
Published: May 2022

Key Points

Cladribine is regarded as the first treatment of choice for symptomatic hairy cell leukemia. This large international study reports a complete response in 72% of cases and a continuous complete response in 20% of patients.
Patronage effects of off-peak service improvements in regional public transport
Authors: Hansson Joel , Pettersson-Löfstedt Fredrik , Svensson Helena , Wretstrand Anders
Published: May 2022

The purpose of this study is to look into patronage effects of extended supply outside peak hours on regional public transport services. Previous studies have shown that the service frequency is an attribute of great importance for regional passengers, but little is known about the details regarding peak and off-peak frequencies or service hours. The present study addresses this knowledge gap, departing from the hypothesis that additional off-peak supply means more flexibility for the passengers in terms of departure time options, and possibly also a sense of security for passengers who are uncertain about the time of their (return) trips. Essentially, the added off-peak departures may attract more passengers even if they normally do not or only occasionally use the off-peak services. The patronage effects are explored through four case studies from the region of Scania in southern Sweden. The cases include regional rail and bus services where substantial improvements have been made outside peak hours, resulting in at least hourly all-day services. The results of the study provide new insights into the fundamental planning policy trade-off between maximum frequency and span of public transport services in urban peripheries and rural areas. Importantly, the results suggest that improved time coverage may lead to substantial patronage growth, and this growth is evident also during peak hours, despite unaltered peak hour frequencies. Hence, off-peak departures cannot be assessed only through patronage levels in isolated time periods, let alone on the individual departures.
Eating in a losing cause: limited benefit of modified macronutrient consumption following infection in the oriental cockroach Blatta orientalis
Authors: Sieksmeyer Thorben , He Shulin , Esparza-Mora M. Alejandra , Jiang Shixiong , Petrašiūnaitė Vesta , Kuropka Benno , Banasiak Ronald , Julseth Mara Jean , Weise Christoph , Johnston Paul R. , Rodríguez-Rojas Alexandro , McMahon Dino P.
Published: May 2022

Background

Host–pathogen interactions can lead to dramatic changes in host feeding behaviour. One aspect of this includes self-medication, where infected individuals consume substances such as toxins or alter their macronutrient consumption to enhance immune competence. Another widely adopted animal response to infection is illness-induced anorexia, which is thought to assist host immunity directly or by limiting the nutritional resources available to pathogens. Here, we recorded macronutrient preferences of the global pest cockroach,Blatta orientalisto investigate how shifts in host macronutrient dietary preference and quantity of carbohydrate (C) and protein (P) interact with immunity following bacterial infection.

Results

We find thatB. orientalisavoids diets enriched for P under normal conditions, and that high P diets reduce cockroach survival in the long term. However, following bacterial challenge, cockroaches significantly reduced their overall nutrient intake, particularly of carbohydrates, and increased the relative ratio of protein (P:C) consumed. Surprisingly, these behavioural shifts had a limited effect on cockroach immunity and survival, with minor changes to immune protein abundance and antimicrobial activity between individuals placed on different diets, regardless of infection status.

Conclusions

We show that cockroach feeding behaviour can be modulated by a pathogen, resulting in an illness-induced anorexia-like feeding response and a shift from a C-enriched to a more P:C equal diet. However, our results also indicate that such responses do not provide significant immune protection inB. orientalis, suggesting that the host’s dietary shift might also result from random rather than directed behaviour. The lack of an apparent benefit of the shift in feeding behaviour highlights a possible reduced importance of diet in immune regulation in these invasive animals, although further investigations employing pathogens with alternative infection strategies are warranted.
Comparative genome analysis among Variovorax species and genome guided aromatic compound degradation analysis emphasizing 4-hydroxybenzoate degradation in Variovorax sp. PAMC26660
Authors: Ghimire Nisha , Kim Byeollee , Lee Chang-Muk , Oh Tae-Jin
Published: May 2022

Background

While the genusVariovoraxis known for its aromatic compound metabolism, no detailed study of the peripheral and central pathways of aromatic compound degradation has yet been reported.Variovoraxsp. PAMC26660 is a lichen-associated bacterium isolated from Antarctica. The work presents the genome-based elucidation of peripheral and central catabolic pathways of aromatic compound degradation genes inVariovoraxsp. PAMC26660. Additionally, the accessory, core and unique genes were identified amongVariovoraxspecies using the pan genome analysis tool. A detailed analysis of the genes related to xenobiotic metabolism revealed the potential roles ofVariovoraxsp. PAMC26660 and other species in bioremediation.

Results

TYGS analysis, dDDH, phylogenetic placement and average nucleotide identity (ANI) analysis identified the strain asVariovoraxsp. Cell morphology was assessed using scanning electron microscopy (SEM). On analysis of the core, accessory, and unique genes, xenobiotic metabolism accounted only for the accessory and unique genes. On detailed analysis of the aromatic compound catabolic genes, peripheral pathway related to 4-hydroxybenzoate (4-HB) degradation was found among all species while phenylacetate and tyrosine degradation pathways were present in most of the species including PAMC26660. Likewise, central catabolic pathways, like protocatechuate, gentisate, homogentisate, and phenylacetyl-CoA, were also present. The peripheral pathway for 4-HB degradation was functionally tested using PAMC26660, which resulted in the growth using it as a sole source of carbon.

Conclusions

Computational tools for genome and pan genome analysis are important to understand the behavior of an organism. Xenobiotic metabolism-related genes, that only account for the accessory and unique genes infer evolution through events like lateral gene transfer, mutation and gene rearrangement. 4-HB, an aromatic compound present among lichen species is utilized by lichen-associatedVariovoraxsp. PAMC26660 as the sole source of carbon. The strain holds genes and pathways for its utilization. Overall, this study outlines the importance ofVariovoraxin bioremediation and presents the genomic information of the species.