bluuebunny/crossref_metadata_2025 huggingface dataset:
The Voice to Parliament proposal and ‘the people’ of the Constitution
Authors: Arcioni Elisa
Published: April 2021

The concept of ‘the people' in the Australian Constitution is at the heart of our system of representative government. The Voice proposal in the Uluru Statement from the Heart is consistent with the way in which ‘the people’ have been understood by the High Court – both their identity and their political roles under the Constitution. This consistency is one of the many reasons to support constitutional enshrinement of the Voice.
Investors’ Reactions to CSR News in Family Versus Nonfamily Firms: A Study on Signal (In)credibility
Authors: Sekerci Naciye , Jaballah Jamil , van Essen Marc , Kammerlander Nadine
Published: April 2021

We study family firm status as an important condition in signaling theory; specifically, we propose that the market reacts more positively to positive, and more negatively to negative, CSR news (i.e., signals) from family firms than to similar news from nonfamily firms. Moreover, we propose that during recessions, the direction of these relationships reverses. Based on an event study of 1247 positive and negative changes in the CSR ratings for all firms listed on the French SFB120 stock market index (2003-2013), we find support for our hypotheses. Moreover, a post hoc analysis reveals that the relationships are contingent on whether a family CEO leads the firm.
A Systematic Mapping Review of Family Perspectives About Received Mental Health Interventions
Authors: Walters Caroline , Petrakis Melissa
Published: April 2021

Purpose:

Families experience their own journey in adjusting to the role of carer. The purpose of this review was to understand from the perspective of families and carers which practices, and health system responses meet their needs in supporting people who experience mental health challenges.

Methods:

A systematic evidence mapping review was conducted, through searching five electronic databases to identify peer-reviewed studies, written in English and published between the years 2010 and 2020, that prioritized the perspectives of families.

Results:

Fifty-five studies met the inclusion criteria and were mapped according to the country of author, year, methodology, who delivered, and intervention mode and format.

Discussion:

The review demonstrated a diversity of interventions with growing numbers of studies considering the view and experiences of carers. There is evidence of increasingly active participation of carers in designing, leading, or facilitating interventions, recognizing the importance of coproduction in tailoring family and carer support.
Examining Barriers and Facilitators to Palliative Care Access in Rural Areas: A Scoping Review
Authors: Cai Yun , Lalani Nasreen
Published: April 2021

Background:

Despite the growth of palliative care (PC), access to PC remains challenging for rural Americans living with chronic diseases. Given the demand and benefits of PC, a comprehensive view of PC access would inform policymakers in developing PC services in rural areas.

Objective:

This scoping review aimed to understand the barriers and facilitators to PC access in rural areas from the voices of service users and service providers during the past decade.

Methods:

A scoping literature review was conducted from 2010 to 2020 using MEDLINE, CINAHL, and PsychINFO databases. Results: Twenty-eight studies met inclusion criteria. Barriers to PC access in rural areas mostly arose in structural issues: (1) the inadequate knowledge and awareness of PC among both service users and providers and (2) the poorly structured PC system. Other barriers included communication gaps/challenges between providers and patients/families and cultural barriers. The facilitators mainly originated in patients/families’ connectedness with local providers and with other social networks such as friends.

Conclusions:

These findings highlight the need for funding support to increase provider competency, service availability and accessibility, and the public knowledge and awareness of PC in rural areas. A holistic and tailored PC model that standardizes care delivery, referral and coordination, including family caregiver support programs, can improve care access. Future practice and research are warranted to implement and evaluate innovative approaches, such as a coordinated community-based approach, to the successful integration of PC in rural communities.
Advancing Leadership Education and Development: Integrating Adult Learning Theory
Authors: Allen Scott J. , Rosch David M. , Riggio Ronald E.
Published: April 2021

Leader development serves as a strong focus in the mission statements of many business school programs. Looking at business school leader development programs through the lens of adult learning theory, we assert that there is an overreliance on cognitive training (e.g., lecture) as the primary form of education used in preparing future business leaders, neglecting other relevant learning orientations. In response, we advance a comprehensive model of business leader education and training that incorporates and integrates five primary orientations to adult learning (cognitivist, behaviorist, humanistic, social cognitive, constructivist). We argue that other professional training curricula, most notably, medical school and military education, draw more fully on these five orientations to adult learning and that these represent comparative models for what business schools could be doing in leader development. We conclude by providing concrete suggestions for how business educators might apply the model in their own programs.
Birth Defect Co-Occurrence Patterns Among Infants With Cleft Lip and/or Palate
Authors: Sanchez Maria Luisa Navarro , Benjamin Renata H. , Mitchell Laura E. , Langlois Peter H. , Canfield Mark A. , Swartz Michael D. , Scheuerle Angela E. , Scott Daryl A. , Northrup Hope , Schaaf Christian P. , Ray Joseph W. , McLean Scott D. , Chen Han , Lupo Philip J. , Agopian A.J.
Published: April 2021

Objective:

To investigate 2- to 5-way patterns of defects co-occurring with orofacial clefts using data from a population-based registry.

Design:

We used data from the Texas Birth Defects Registry for deliveries between 1999 and 2014 to Texas residents, including 1884 cases with cleft palate (CP) and 5289 cases with cleft lip with or without cleft palate (CL±P) without a known syndrome. We identified patterns of defects co-occurring with CP and with CL±P observed more frequently than would be expected if these defects occurred independently. We calculated adjusted observed-to-expected ( O/ E) ratios to account for the known tendency of birth defects to cluster nonspecifically.

Results:

Among infants without a syndrome, 23% with CP and 21% with CL±P had at least 1 additional congenital anomaly. Several combinations of defects were observed much more often than expected. For example, the combination of CL±P, congenital hydrocephaly, anophthalmia, and other nose anomalies had an O/ E ratio of 605. For both CP and CL±P, co-occurrence patterns with the highest O/ E ratios involved craniofacial and brain abnormalities, and many included the skeletal, cardiovascular, and renal systems.

Conclusions:

The patterns of defects we observed co-occurring with clefts more often than expected may help improve our understanding of the relationships between multiple defects. Further work to better understand some of the top defect combinations could reveal new phenotypic subgroups and increase our knowledge of the developmental mechanisms that underlie the respective defects.
The Association of School Nurse Workload With Student Health and Academic Outcomes: A Cross-Sectional Study
Authors: Schroeder Krista , Young Ally , Adman Gail , Ashmeade Ann Marie , Bonas Estherlyn , Day Sophia E. , Konty Kevin
Published: April 2021

This study assessed associations between school nurse workload and student health and academic outcomes. We hypothesized that lower school nurse workload would be associated with better student outcomes, with associations being greater for members of groups who experience health disparities. Our methods entailed secondary analysis of data for New York City school students in kindergarten through 12th grade during 2015–2016 ( N = 1,080,923), using multilevel multivariate regression as the analytic approach. Results demonstrated lower school nurse workload was associated with better outcomes for student participation in asthma education but not chronic absenteeism, early dismissals, health office visits, immunization compliance, academic achievement, or overweight/obesity. Our findings suggest school nurses may influence proximal outcomes, such as participation in disease-related education, more easily than downstream outcomes, such as absenteeism or obesity. While contrary to our hypotheses, results align with the fact that school nurses deliver community-based, population health–focused care that is inherently complex, multilevel, and directly impacted by social determinants of health. Future research should explore school nurses’ perspectives on what factors influence their workload and how they can best impact student outcomes.
Natural Language Processing Performance for the Identification of Venous Thromboembolism in an Integrated Healthcare System
Authors: Woller Bela , Daw Austin , Aston Valerie , Lloyd Jim , Snow Greg , Stevens Scott M. , Woller Scott C. , Jones Peter , Bledsoe Joseph
Published: April 2021

Real-time identification of venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) and pulmonary embolism (PE), can inform a healthcare organization’s understanding of these events and be used to improve care. In a former publication, we reported the performance of an electronic medical record (EMR) interrogation tool that employs natural language processing (NLP) of imaging studies for the diagnosis of venous thromboembolism. Because we transitioned from the legacy electronic medical record to the Cerner product, iCentra, we now report the operating characteristics of the NLP EMR interrogation tool in the new EMR environment. Two hundred randomly selected patient encounters for which the imaging report assessed by NLP that revealed VTE was present were reviewed. These included one hundred imaging studies for which PE was identified. These included computed tomography pulmonary angiography—CTPA, ventilation perfusion—V/Q scan, and CT angiography of the chest/ abdomen/pelvis. One hundred randomly selected comprehensive ultrasound (CUS) that identified DVT were also obtained. For comparison, one hundred patient encounters in which PE was suspected and imaging was negative for PE (CTPA or V/Q) and 100 cases of suspected DVT with negative CUS as reported by NLP were also selected. Manual chart review of the 400 charts was performed and we report the sensitivity, specificity, positive and negative predictive values of NLP compared with manual chart review. NLP and manual review agreed on the presence of PE in 99 of 100 cases, the presence of DVT in 96 of 100 cases, the absence of PE in 99 of 100 cases and the absence of DVT in all 100 cases. When compared with manual chart review, NLP interrogation of CUS, CTPA, CT angiography of the chest, and V/Q scan yielded a sensitivity = 93.3%, specificity = 99.6%, positive predictive value = 97.1%, and negative predictive value = 99%.
Evaluation of a primary antifungal prophylaxis protocol for preventing invasive mold infections after allogeneic hematopoietic stem cell transplantation
Authors: Herity Leah B , Cruz Oveimar A De la , Aziz May T
Published: April 2021

Introduction

Invasive mold infections contribute to morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation. The optimal strategy for primary antifungal prophylaxis in this patient population remains uncertain.

Methods

Medical records of patients who underwent allogeneic hematopoietic stem cell transplantation between 1 January 2013 and 31 December 2017 were retrospectively reviewed. Adult patients were included if they received micafungin followed by fluconazole, with the option to escalate to voriconazole, for antifungal prophylaxis. The primary outcome was the incidence rate of proven or probable invasive mold infection. Secondary outcomes were time to invasive mold infection diagnosis, invasive mold infection-related mortality, and risk factors associated with invasive mold infection.

Results

Two hundred patients were included in the study, a majority of whom underwent matched unrelated (46%) or matched related (33%) donor transplants. The incidence rate of proven or probable invasive mold infection was 18.4 cases per 100 patient-years, with a one-year cumulative incidence of 14%. Median time to proven or probable invasive mold infection was 94 days post-transplant (IQR 26–178), with invasive mold infection-related mortality occurring in 18 (64%) of 28 patients diagnosed with invasive mold infection. Comparison of invasive mold infection-free survival by potential risk factors failed to show any significant differences.

Conclusions

In this real-life cohort of allogeneic hematopoietic stem cell transplantation recipients, the incidence of proven or probable invasive mold infection was higher than expected based on previous literature. In the absence of standard guidance on anti-mold prophylaxis in this patient population and given that unique risk factors for invasive mold infection may differ between institutions, it is essential that centers performing allogeneic hematopoietic stem cell transplantation routinely monitor their antifungal prophylaxis strategies for effectiveness.
Autonomy or Security? Core Value Trade-Offs and Spillovers in Servicescapes for Vulnerable Customers
Authors: Sandberg Birgitta , Hurmerinta Leila , Leino Henna M. , Menzfeld Mira
Published: April 2021

This study deepens knowledge on the implementation of core values in servicescapes by analyzing how core value trade-offs and spillovers occur within servicescapes and how vulnerable stakeholders cope with them. We use an explorative approach and draw on rich data collected in two nursing homes. Our study demonstrates how the autonomy-security trade-offs originate in different dimensions of the servicescapes. Further analysis reveals how individual customers may conflict with the core values and core purposes of the respective servicescapes. We also contribute to the discussion on customer vulnerability by considering vulnerability in the extended customer entity and by identifying the active coping mechanisms of vulnerable customers. Practitioners can increase the quality of care by identifying and taking into account the core values of both vulnerable primary and secondary customers and by deliberately supporting their coping with core value trade-offs and spillovers.
Composition of lymphocyte subpopulations in normal and mildly reactive peripheral lymph nodes in cats
Authors: Rütgen Barbara C , Baszler Elisabeth , Weingand Nicole , Wolfesberger Birgitt , Baumgartner Daniel , Hammer Sabine E , Groiss Sandra , Fuchs-Baumgartinger Andrea , Saalmüller Armin , Schwendenwein Ilse
Published: April 2021

Objectives

Flow cytometric (FCM) immunophenotyping of lymphoid tissue aspirates is an available adjunct for feline lymphoma diagnostics. Reference data have only been established for feline peripheral blood. Studies investigating the composition of normal and mildly reactive feline lymph nodes (LNs) are lacking. The aim of this prospective study was to establish reference data for lymphocyte subpopulations in normal and mildly reactive feline peripheral LNs using a standardised multicolour panel of antibodies.

Methods

Macroscopically inconspicuous mandibular and/or popliteal LNs from 31 adult cats, which were euthanased for reasons other than haematological diseases, were excised and processed within 5 h after death. Multicolour flow cytometry using eight different feline-specific, anti-canine and human cross-reactive monoclonal antibodies used in current diagnostic marker panels was performed after cytological exclusion of pathological states and complemented by lymphocyte clonality testing, histopathology and immunohistochemistry (IHC) to ensure the absence of lymphoid disease.

Results

Of 31 cats, the immunophenotyping data of 24 individuals could be included as histopathology and clonality testing excluded a pathological condition. Lymphocyte populations showed the following positive antibody reactions: CD18+ 86.3% ± 13.86%, CD3+ 54.81% ± 11.10%, CD5+ 57.39% ± 12.66%, CD21+ 40.42% ± 12.40%, CD79alphacy+ (CD79αcy) 30.41% ± 13.49% and CD14+ 0.75% ± 1.35%. There were 30.88% ± 13.48% CD4+ and 12.91% ± 6.68% CD8+ cells. Cytology revealed a mixed population of mostly lymphoid cells in all samples. The absence of a monoclonal/oligoclonal neoplastic population was confirmed by lymphocyte clonality testing. Histopathology and IHC showed a normal or mildly reactive pattern in all cases.

Conclusions and relevance

This study establishes FCM immunophenotyping data of lymphocyte populations of normal and mildly reactive feline peripheral LNs. For the first time, anti-CD5, CD4, CD8 and CD21 reference data in normal and mildly reactive feline peripheral LNs are presented. CD18, CD3, CD14 and CD79αcy have been used to establish reference data for the first time in any feline material.
Effect of topical 0.5% tetracaine hydrochloride on intraocular pressure in ophthalmologically normal cats
Authors: Faghihi Houman , Rajaei Seyed Mehdi , Ostadhasan Hesam , Alagha Hannah Emami
Published: April 2021

Objectives

The aim of this study was to assess the effect of topical tetracaine hydrochloride 0.5% on intraocular pressure (IOP) in ophthalmologically normal cats.

Methods

Twenty domestic shorthair cats (40 eyes) were used in this study. Each cat was randomly allocated to one of two groups (treatment or control). Baseline IOP (T0) was measured in each cat, and then one drop of tetracaine hydrochloride 0.5% or artificial tears was administered into a randomly chosen eye of each cat in the treatment and control groups, respectively. Repeat IOP measurements were performed at 2 mins (T2), 5 mins (T5), 15 mins (T15) and 30 mins (T30) with a rebound tonometer.

Results

Mean baseline IOP in all eyes was 20.6 ± 2.5 mmHg. After the unilateral administration of tetracaine, mean IOP decreased significantly in the treated eye at T2 ( P = 0.01). Mean IOP returned to baseline values at T15. The mean IOPs in the treated eyes at T0, T2, T5, T15 and T30 were 20.6 ± 3.3 mmHg, 18.2 ± 2.5 mmHg, 18.2 ± 3.4 mmHg, 20.2 ± 3.2 mmHg and 19.8 ± 2.7 mmHg, respectively. A significant difference in IOP was found at all time points between the tetracaine and control groups (P <0.03).

Conclusions and relevance

The results of the present study showed a statistically significant reduction in mean IOP 2 mins after the administration of tetracaine hydrochloride 0.5% in the treated eyes of the cats.
Control of felinine-derived malodor in cat litter
Authors: Robins Lori I , Napier Stephanie , Seek Carolina M , Gao Xin , Flegler Carol , Mackenzie Charles D
Published: April 2021

Objectives

Malodors stemming from soiled cat litter are a major frustration for cat owners, despite the widespread use of absorbent litters with claims of odor control. Technologies for effective litter odor control have not been rigorously evaluated. Here, we report on the effectiveness of a novel litter formulation of 1-monochlorodimethylhydantoin (MCDMH)-modified clinoptilolite zeolite (MCDMH-Z) to control the odors of 3-mercapto-3-methylbutanol (3M3MB) and ammonia, the principal products generated by the enzymatic breakdown of felinine and urea, respectively.

Methods

The efficacy of MCDMH-Z for the odor control of 3M3MB was determined by solid-phase microextraction and gas chromatography mass spectrometry analysis, colorimetric analysis and a sensory panel. Enzyme inhibition was monitored by a colorimetric coupled assay for ammonia. The antimicrobial properties were measured by a reduction in colony-forming units (CFUs).

Results

3M3MB proved highly susceptible to modification by MCDMH-Z granules. Headspace above litter exposed to MCDMH-Z showed no detectable 3M3MB; levels >59 ng were detected in commercially available products. Urease activity decreased by >97% after incubation with MCDMH-Z to 0.14 mg/ml. Cat litter F showed comparable inhibition (0.13 mg/ml); others showed less inhibition, producing up to 4.8 mg/ml of ammonia. MCDMH-Z reduced the CFUs of Proteus vulgaris by six log reduction values in 30 mins; in the same amount of time, no reduction was seen with commercial products tested. The odor control capability of the MCDMH-Z granules was further supported by a sensory panel scoring 3M3MB-spiked litters.

Conclusions and relevance

Samples of commercially available litter products showed an effect on malodor, or inhibition of urease, or contained antimicrobial activity; no samples were capable of accomplishing these concurrently. In contrast, MCDMH-Z granules were effective in all three test categories. Control of felinine-derived odors, in particular, has the potential to improve cat owner satisfaction, and may beneficially affect cat behaviors provoked by pheromonally active sulfurous metabolites deposited in the litter.
XEN45 real-life evaluation: Survival analysis with bleb needling and major revision outcomes
Authors: Ventura-Abreu Néstor , Dotti-Boada Marina , Muniesa-Royo María Jesús , Izquierdo-Serra Jordi , González-Ventosa Andrea , Millá Elena , Pazos Marta
Published: April 2021

Purpose:

To evaluate real-life outcomes of XEN45 stent surgery including bleb needling (BN) and surgical bleb revision (SBR).

Methods:

Retrospective analysis of all XEN45 gel stents implanted in a tertiary glaucoma center with a minimum follow-up of 6 months. The main outcomes were intraocular pressure (IOP), the number of glaucoma medications, postoperative maneuvers like BN, and subsequent SBR. Success was defined as IOP ⩽ 18 and 20% reduction (criterion A), ⩽15 and 25% reduction (criterion B), and ⩽12 mmHg and 30% reduction (criterion C) reached with (qualified) or without (complete) medications at the last visit. Complete failure was defined as additional glaucoma surgery, loss of light perception, or sight-threatening complications. Multivariable Cox regression and Kaplan-Meier survival estimates tests were performed.

Results:

Fifty-eight eyes with either stand-alone or combined Phaco-XEN surgery were included. Complete success by the different definitions was 50.0% (95% confidence interval, 5.8%–84.5%) (A), 50.0% (5.8%–84.5%) (B), and 25% (0.9%–66.5%) (C) whereas qualified success was 38.3% (1.6%–80.1%), 31.7% (2.0%–71.4%), and 0%, respectively, at the 24-months visit. 30% of cases underwent BN with 5-Fluorouracil, and SBR was performed in 17.5% of eyes. Low IOP levels at 1-month and early BN were significantly associated with success. The highest chance of failure was achieved in the combined Phaco-XEN group undergoing SBR.

Conclusions:

In our real-life setting, the first month IOP was associated with greater success rates. Although BN obtained improved IOP values, SBR was associated with a greater bleb survival in the stand-alone XEN group. Both BN and SBR had poor outcomes in the combined Phaco-XEN group.
Significance of African Diets in Biotherapeutic Modulation of the Gut Microbiome
Authors: Isibor PO , Akinduti PA , Aworunse OS , Oyewale JO , Oshamika O , Ugboko HU , Taiwo OS , Ahuekwe EF , Obafemi YD , Onibokun EA , Oziegbe O , Oniha MI , Olopade BK , Atolagbe OM , Adekeye BT , Ajiboye IB , Bello OA , Popoola JO , Ayanda OI , Akinnola OO , Olasehinde GI , Eni AO , Nwinyi OC , Omonhinmin CA , Oranusi SU , Obembe OO
Published: April 2021

Diet plays an essential role in human development and growth, contributing to health and well-being. The socio-economic values, cultural perspectives, and dietary formulation in sub-Saharan Africa can influence gut health and disease prevention. The vast microbial ecosystems in the human gut frequently interrelate to maintain a healthy, well-coordinated cellular and humoral immune signalling to prevent metabolic dysfunction, pathogen dominance, and induction of systemic diseases. The diverse indigenous diets could differentially act as biotherapeutics to modulate microbial abundance and population characteristics. Such modulation could prevent stunted growth, malnutrition, induction of bowel diseases, attenuated immune responses, and mortality, particularly among infants. Understanding the associations between specific indigenous African diets and the predictability of the dynamics of gut bacteria genera promises potential biotherapeutics towards improving the prevention, control, and treatment of microbiome-associated diseases such as cancer, inflammatory bowel disease, obesity, type 2 diabetes, and cardiovascular disease. The dietary influence of many African diets (especially grain-base such as millet, maize, brown rice, sorghum, soya, and tapioca) promotes gut lining integrity, immune tolerance towards the microbiota, and its associated immune and inflammatory responses. A fibre-rich diet is a promising biotherapeutic candidate that could effectively modulate inflammatory mediators’ expression associated with immune cell migration, lymphoid tissue maturation, and signalling pathways. It could also modulate the stimulation of cytokines and chemokines involved in ensuring balance for long-term microbiome programming. The interplay between host and gut microbial digestion is complex; microbes using and competing for dietary and endogenous proteins are often attributable to variances in the comparative abundances of Enterobacteriaceae taxa. Many auto-inducers could initiate the process of quorum sensing and mammalian epinephrine host cell signalling system. It could also downregulate inflammatory signals with microbiota tumour taxa that could trigger colorectal cancer initiation, metabolic type 2 diabetes, and inflammatory bowel diseases. The exploitation of essential biotherapeutic molecules derived from fibre-rich indigenous diet promises food substances for the downregulation of inflammatory signalling that could be harmful to gut microbiota ecological balance and improved immune response modulation.
Remote-Working Carbon-Saving Footprint: Could COVID-19 Pandemic Establish a New Working Model with Positive Environmental Health Implications?
Authors: Maipas Sotirios , Panayiotides Ioannis G , Kavantzas Nikolaos
Published: April 2021

Urban air pollution is a major problem with known negative health implications, such as respiratory and cardiovascular diseases. Lockdown measures have caused the reductions of various urban pollutants, such as nitrogen dioxide (NO2), particulate matters (PMs), and polycyclic aromatic hydrocarbons (PAHs). COVID-19 pandemic has also established remote-working as an antidote to declining economic activity due to lockdown measures. The environmental health implications of the new hybrid-working model, which drastically reduces the number of circulating vehicles, appear to be positive enough to reveal an emerging opportunity. Since this hybrid model may have started becoming a widely accepted working model, the current situation has revealed the opportunity of remote-working arrangements to serve as a supplementary mitigative and adaptive measure against urban environmental deterioration. Also, a remote-working carbon-saving footprint may be introduced in order to evaluate a firm’s carbon footprint reduction due to remote-working arrangements. These workings arrangements may be accompanied by improvements and expansions of urban green spaces and with broader use of electric vehicles, transforming our cities into more sustainable, safe, healthy, and worth-living environments.
Not ‘my economy’: A political ethnographic study of interest in the economy
Authors: Killick Anna
Published: April 2021

Some political economists explain the apparent downplaying of the importance of economic issues in political events such as Brexit with reference to the growing anger or despair people on low incomes feel about the economy. This ‘everyday political economy’ article draws on an ethnographic study conducted between 2016 and 2018 with residents of an English city to explore what people think about the phenomenon of the economy. It reveals significant differences in how interested high- and low-income participants are in the economy and its role as a bedrock for welfare. Low-income participants are more negative about the economy, particularly contesting politicians’ claims that it is distinct from the human sphere, when they view it as controlled by the rich. However, reasoning is based on post-2008 crisis economic conditions, and any lack of interest in the economy may be more calculative and temporary than is often assumed.
Numerical simulation of the effects of canopy properties on airflow and pollutant dispersion in street canyons
Authors: Wang Le , Tian Wen-Xin , Zhao Xiu-Yong , Huang Chuan-Qing
Published: April 2021

The air flow and pollutant concentration fields in a street canyon affected by trees could affect the comfort and health of residents. At present, the description of the non-uniform/discontinuous distribution of leaves is difficult. In this study, the leaf distribution in the canopy was characterized by establishing non-continuous (uniform/random) algorithm based on a numerical simulation method, and the effects of canopy properties including, height, porosity and uniform/random leaf distribution, on the airflow and pollutant concentration fields in urban street canyons were investigated. The position of the tree canopy was found to directly affect the airflow field form and the air velocity distribution in the street canyon at low inflows. The average air velocity in the street canyon could be reduced significantly when the top of the tree canopy is near the top of the street canyon. The air velocity and pollutant concentration in the street canyon would vary only slightly due to the canopy porosity. Due to the increasing canopy porosity, the air velocity would increase, and the pollutant concentration would be reduced. The leaves are non-continuous and uniformly distributed at constant porosity, which does not significantly change the velocity distribution and pollutant concentration in the street canyon.
Shelter-based services for survivors of human trafficking in Cambodia: Experiences and perspectives of survivors
Authors: Tsai Laura Cordisco , Lim Vanntheary , Nhanh Channtha
Published: April 2021

In Southeast Asia, services for survivors of human trafficking have historically been centralized within shelter programs. Minimal research has, however, been conducted regarding trafficking-specific shelters, particularly research that highlights the perspectives of survivors themselves. This manuscript presents the perspectives of survivors of human trafficking and sexual exploitation on their own experiences pertaining to trafficking-specific shelter services. We analyzed data from the Butterfly longitudinal research (BLR) study, a 10-year longitudinal study exploring the lives, trajectories, and viewpoints of survivors of human trafficking and sexual exploitation in Cambodia. We analyzed 236 in-depth interviews and narrative summaries of interviews conducted between 2011 and 2016 using an interpretive phenomenological approach ( n = 79). Four themes were identified: feeling privileged to live in a shelter; lacking freedom and feeling imprisoned by rules; limited engagement with family; and mixed experiences with counseling. Findings inform critical recommendations for implementing trauma-informed care and strengthening mental health services for survivors, including services provided within shelter programs and within the anti-human trafficking movement more broadly.
Introduction
Authors: Williams David Lay
Published: April 2021

This introduction to the review symposium on Ryan Patrick Hanley’s works on the relatively neglected early modern philosopher François Fénelon (1651–1715) provides a brief overview of the symposium itself before turning to Hanley’s treatment of Fénelon’s work on the intersection of politics and religion, culminating in a comparison of Fénelon with his most celebrated admirer, Jean-Jacques Rousseau. The article sketches how both francophone thinkers employ conceptions of divine justice as a measure to counter the dangers of amour-propre, contrasting Fénelon’s thick theology with Rousseau’s thin theology.
A comparison of the ethical climate of operating rooms from the perspective of operating room nursing students and staff: An analytical study
Authors: Esmaelzadeh Fatemeh , Nematollahi Monirsadat
Published: April 2021

Background

The ethical climate is an essential component of organizational climate or culture. The ethical climate is necessary for clinical practice in operating rooms.

Objective

This study aimed to compare the ethical climate from the perspective of operating room nursing students and operating room staff of hospitals affiliated with Mashhad University of Medical Sciences, Iran.

Method

This analytical study was performed on 95 operating room nursing students and 169 operating room staff of hospitals in Mashhad, Iran. The students were selected through the census method and the staff were selected by using stratified random sampling. The data were collected via Olson’s Hospital Ethical Climate Survey and analyzed by using BMI SPSS version 21.

Results

The total mean scores of the ethical climate were 3.44 ± 0.45 and 3.32 ± 0.48 from students and staff’s perspectives, and the independent t-test showed no significant difference between them ( p < 0.05). In addition, from the students’ and staff’s points of view, the scores of communication with nurse managers were (3.95 ± 0.59), and (3.61 ± 0.91), the scores of communication with peers were (3.75 ± 0.43) and (3.48 ± 0.59), the scores of communication with patients and staff were (3.18 ± 0.6) (3.33 ± 0.62), respectively with no significant difference ( p > 0.05). Furthermore, the results of the study indicated a significant difference in communication with physicians’ score between operating room staff (2.82 ± 0.49) and students’ views (3.25 ± 0.6) ( p < 0.05).

Conclusion

Although it is difficult to create a right ethical climate in operating rooms, but hospital managers should implement practical programs to improve the ethical climate of operating rooms and inter-professional teamwork. Besides, deans of faculties can provide ethical-based education for students, who can effectively create an ethical climate.
Insulin increases central aortic stiffness in response to hyperglycemia in healthy humans: A randomized four-arm study
Authors: Horton William B , Jahn Linda A , Hartline Lee M , Aylor Kevin W , Patrie James T , Barrett Eugene J
Published: April 2021

Introduction:

Increasing arterial stiffness is a feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Multiple studies demonstrate divergence of carotid-femoral pulse wave velocity and augmentation index in persons with diabetes mellitus, though mechanisms responsible for this are unclear.

Materials and methods:

We tested the effect of acutely and independently increasing plasma glucose, plasma insulin, or both on hemodynamic function and markers of arterial stiffness (including carotid-femoral pulse wave velocity, augmentation index, forward and backward wave reflection amplitude, and wave reflection magnitude) in a four-arm, randomized study of healthy young adults.

Results:

Carotid-femoral pulse wave velocity increased only during hyperglycemic-hyperinsulinemia (+0.36 m/s; p = 0.032), while other markers of arterial stiffness did not change (all p > 0.05). Heart rate (+3.62 bpm; p = 0.009), mean arterial pressure (+4.14 mmHg; p = 0.033), central diastolic blood pressure (+4.16 mmHg; p = 0.038), and peripheral diastolic blood pressure (+4.09 mmHg; p = 0.044) also significantly increased during hyperglycemic-hyperinsulinemia.

Conclusions:

Hyperglycemic-hyperinsulinemia acutely increased cfPWV, heart rate, mean arterial pressure, and diastolic blood pressure in healthy humans, perhaps reflecting enhanced sympathetic tone. Whether repeated bouts of hyperglycemia with hyperinsulinemia contribute to chronically-enhanced arterial stiffness remains unknown.
Validation of a breath-holding test as a screening test for exercise-induced hypoxemia in chronic respiratory diseases
Authors: Ideguchi Hideharu , Ichiyasu Hidenori , Fukushima Kazuaki , Okabayashi Hiroko , Akaike Kimitaka , Hamada Shohei , Nakamura Kazuyoshi , Hirosako Susumu , Kohrogi Hirotsugu , Sakagami Takuro , Fujii Kazuhiko
Published: April 2021

The detection of exercise-induced hypoxemia is important for evaluating disease status in patients with chronic respiratory diseases. The 6-min walk test (6MWT) is useful for detecting exercise-induced hypoxemia. This pilot study aimed to validate the breath-holding test (BHT) as a screening for exercise-induced hypoxemia and compare its utility with that of the 6MWT in patients with chronic respiratory diseases. Fifty-nine patients with chronic respiratory diseases underwent BHTs lasting 10, 15, and 20 s. Percutaneous oxygen saturation (SpO2), pulse rate, and severity of dyspnoea were measured. The participants also underwent a 6MWT, a pulmonary function test, and analysis of arterial blood gas at rest. Multivariate linear regression analysis was performed to identify significant predictors of desaturation in the 6MWT. The minimum SpO2 during the BHT (all durations) and 6MWT were significantly correlated. Receiver operating characteristic analysis revealed the optimal cut-off for predicting SpO2 < 90% during the 6MWT as a minimum SpO2 ≤ 94% during the 15-s BHT. Perceived dyspnoea and maximum pulse rate were significantly lower during the 15-s BHT than during the 6MWT. In the multivariate linear regression analysis, the minimum SpO2 during the 15-s BHT (β, 0.565, p < 0.001) and %DLco (β, 0.255, p < 0.028) were independent predictors of desaturation in the 6MWT. The minimum SpO2 during the 15-s BHT may be a useful measure for screening for exercise-induced hypoxemia in patients with chronic respiratory diseases. The BHT is easier to perform, more readily available, and better tolerated than the 6MWT.
Performance of the Gore VBX Balloon Expandable Endoprosthesis as Bridging Stent-Graft in Branched Endovascular Aortic Repair for Thoracoabdominal Aneurysms
Authors: Torsello Giovanni B , Pitoulias Apostolos , Litterscheid Sarah , Berekoven Bärbel , Torsello Giovanni-Federico , Austermann Martin , Bosiers Michel J
Published: April 2021

Purpose

Bridging stent stability is crucial for efficacy and safety of branched aortic endovascular repair (bEVAR) of thoracoabdominal aortic aneurysms (TAAAs). In this study, we assess the performance of the new Viabahn Balloon-Expandable endoprosthesis (VBX) in bEVAR. Based on our learning curve we give recommendations for a safe and effective use of the device.

Materials and Methods

We prospectively collected the data of patients with TAAAs undergoing bEVAR between December 2017 and December 2019. All patients with implantation of at least 1 VBX stent-graft as bridging stent were included in our single-center analysis. Demographic, comorbidity, and computed tomography angiography (CTA) data of 112 patients were retrospectively evaluated. Primary endpoint was a composite of branch-related technical success and freedom from target vessel instability. Secondary endpoints were clinical and ongoing clinical success.

Results

Primary endpoint: technical success was achieved in all patients (100%) with a freedom from target vessel instability of 96.3% after a median follow-up of 18 months. Overall mortality was 13.4% (n=15) and 13 patients underwent secondary interventions, 12 of them are still alive and 1 suffered from aneurysm sac expansion, consequently an ongoing clinical success of 75.9% was reached. After modification of the implantation technique during the course of the study by selecting longer stent lengths after accurate estimation of vessel curvature and expected adaptation of the flexible endoskeleton to the specific anatomical conditions, no type Ic endoleaks were observed in the last 70 cases.

Conclusions

The VBX stent-graft can be safely used as bridging stent for branched thoracoabdominal repair. However, learning curve should be considered to avoid type Ic endoleak and edge stenosis. Based on this experience longer landing zones and 2-step deployment of VBX are useful for successful bridging also of challenging target vessels.
Bacterial Profile and Antimicrobial Resistance Patterns of Infected Diabetic Foot Ulcers in Iran: A Systematic Review and Meta-Analysis of Cross-Sectional Studies
Authors: Shahrokh Samaneh , Aliye Tabatabaee , Yazdi Maryam , Siavash Mansour , Aminorroaya Ashraf
Published: April 2021

Since infectious foot ulcers represent one of the major causes of lower-limb amputation, it calls for an appropriate action for early detection and sufficient treatment of diabetic foot infection (DFI). The present study aimed at investigating the bacterial epidemiology and antimicrobial resistance (AMR) patterns of DFIs in Iran. We have conducted a systematic search in PubMed, Embase, Web of Science, Scopus, Google Scholar, and Scientific Information Database to identify all articles reporting the proportion of different kinds of bacteria isolated from Iranian DFI samples. Quality was assessed using Joanna Briggs Institute tool. A pooled estimate of proportion with a corresponding 95% confidence interval (95% CI) was calculated using the random effect method. Fifteen studies were eligible, of which 1970 bacterial isolates were obtained from 1316 patients. The most predominant isolates recovered from DFIs was Staphylococcus aureus with a pooled proportion of 24.29% (95% CI: 20.25%, 28.57%) from which 55% (95% CI: 38%, 72%) were methicillin-resistant S. aureus (MRSA). Among Gram-negative strains, Escherichia coli had the highest proportion (17.19%; 95% CI: 13.96%, 20.68%) followed by Pseudomonas aeruginosa, 7.54% (95% CI: 4.56%, 11.14%). The highest pooled estimates of resistance against cotrimoxazole and ciprofloxacin were found in S. aureus 66% (95% CI: 48%, 82%) and E coli isolates 68% (95% CI: 51%, 84%), respectively. Our study revealed that AMR is at a high level in Iran and clinicians should be aware of bacterial resistance patterns to prescribe appropriate antibiotic regimens.
Long-term Mortality of a Cohort of Patients Undergoing Surgical Treatment for Diabetic Foot Infections. An 8-year Follow-up Study
Authors: Aragón-Sánchez Javier , Víquez-Molina Gerardo , López-Valverde María Eugenia , Aragón-Hernández Javier , Rojas-Bonilla José María , Murillo-Vargas Christian
Published: April 2021

We analyzed a retrospective cohort of 150 patients with diabetic foot infections (DFIs) who underwent surgical treatment to determine long-term outcomes. The median follow-up of the series was 7.6 years. Cox’s proportional hazards model for survival time was performed and hazard ratios (HRs) were estimated. Survival times were plotted using the Kaplan–Meier method. Fifteen patients (10%) required readmission after discharge from the hospital for a recurrence of the infection. Ninety patients (60%) had re-ulcerations. Forty-nine (54.4% of those re-ulcerated) required new admission and 24 of them (26.6% of those re-ulcerated) finally required a new amputation. Overall cumulative survival rates at 1, 5, and 8 years were 95%, 78%, and 64%, respectively. Predictive variables of long-term mortality were insulin treatment (HR: 2.0, 95% CI: 1.1-3.6, P = .01), female sex (HR: 3.1, 95% CI: 1.7-5.3, P<.01) and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 (HR: 2.2, 95% CI: 1.1-4.2, P = .01). In conclusion, patients undergoing surgical treatment for DFIs had a high rate of recurrences and mortality. Women, patients who underwent treatment with insulin, and those with eGFR <60 ml/min/1.73 m2 had a higher risk of long-term mortality.
The Impact of COVID-19 Pandemic on Vascular Leg Ulcers
Authors: Sallustro Marianna , Florio Anna
Published: April 2021

The aim of this study was to evaluate the impact of 2 lockdown periods during coronavirus disease 2019 (COVID-19) on the course and management of nonhealing vascular ulcers of lower limbs. A total of 41 patients were included in the study. Before the pandemic began they had been seen at our unit at weekly intervals. During lockdown from March 9, 2020, to May 18, 2020 subjects were not allowed to enter the hospital unless they needed urgency or emergency surgery, or oncological management. During the second lockdown, from October 19, 2020, to December 11, 2020 patients could be followed up at distance by direct outreach including telephoning contacts. Data obtained early after each lockdown were compared with those obtained prior to the pandemic. Data for the first lockdown show that pain intensified and there was an increase in the recurrence rate of wounds, of their severity, and of superimposed infections as compared with the prelockdown period. The risk of lower-limb amputation was also considerably greater. During the second and less restrictive lockdown, patients were followed up by telemedicine and data indicate that skin lesions had not worsened any further. The management of vascular wounds was impacted by the pandemic unfavorably with health care failures in the hospital as well as in the primary care settings. In conclusion, the treatment of vascular leg ulcers is challenged by the COVID-19 pandemic as this spreads worldwide. This seems to be in keeping with what happens for other diseases. The data we obtained indicate that the pandemic-related lockdown has a deleterious effect on vascular skin wounds, with an increase of severity and mortality risk. The impact appears to be proportional to the number and the degree of limitations imposed on people.
The Molecular Dichotomy Between Epileptic and Functional Seizures
Authors: Szaflarski Jerzy P.
Published: April 2021

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Common Femoral Artery Stenting: Computed Tomography Angiography Based Long-Term Patency
Authors: Martin Rabellino , Vanesa G Di Caro , Raleigh Juan Valle , Jose Chas , Vadim Kotowicz , Maynar Manuel , Zander Tobias
Published: April 2021

Background:

Despite considerable morbid-mortality rates, common femoral endarterectomy is still considered the gold standard for atherosclerotic common femoral artery (CFA) disease. The aim of this study was to demonstrate computed tomography angiography based long-term patency after CFA stent placement and to analyze associated risk factors for restenosis.

Methods:

A retrospective and observational study was carried out in consecutive patients treated with endovascular stent placement in CFA lesions. A clinical follow-up and imaging study was performed using MD-CTA to assess different degrees of in stent restenosis (ISR) and primary, assisted, and secondary patency rates.

Results:

In a 5-year period, 35 extremities were treated in 33 patients with self-expandable nitinol stents. The technical success was 100% without complications related to the procedure. The mean follow-up (FU) was 32.2 months, and 8 limbs were lost. The degree of CFA stenosis was reduced from 79.69 ± 26.47% to 11.23 ± 24.53%. ISR < 20%, 20–70%, and ≥ 70% was evident in 15 (55.6%), 9 (33.3%), and 3 (11.1%) limbs, respectively. Estimated primary, assisted, and secondary patency was 79.5, 96.3, and 96.3%, respectively, after 24 months and 79.5, 96.3, and 96.3%, respectively after 60 months, with a freedom of clinical driven target lesion revascularisation rate of 87.8%.

Conclusion:

Endovascular treatment with self-expandable nitinol stents in CFA lesions had a high technical success rate and was related to few complications. A mild form of intimal hyperplasia was observed in a considerable number of cases. However, long-term patency was high; therefore, CFA stent placement might be a suitable therapeutic alternative in selected patients.