bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulating short-term rentals: Joined cases C-724/18 and C-727/18 Cali Apartments
Authors: Pantazi Tania
Published: June 2021

The increase in short-term rentals via online platforms has captured the attention of scholars and regulators. Short-term letting is now considered a considerable alternative to traditional tourist accommodation contracts, challenging matters such as conditions in the housing market and consumer protection. Online platforms, such as Airbnb, Booking.com , Expedia and Tripadvisor, now provide offers for short-term accommodation contracts along with traditional accommodation options (hotels, hostels, apartments). The recent decision of the European Court of Justice in Joined cases C-724/18 and C-727/18 addresses for the first time the issue of regulation of short-term rentals in Member States and evaluates a national authorization scheme in light of the Services Directive. The present paper provides a brief background of European regulation affecting short-term rentals and discusses the judgment and its implications for future developments.
The Cinematic Summoned Self: The Call of Christ in Martin Scorsese’s Silence
Authors: Mayward Joel
Published: June 2021

American filmmaker Martin Scorsese’s theologically imbued cinematic approach arguably reached its apotheosis in his 2016 film Silence, an adaptation of Shūsaku Endō’s 1966 novel. Through my theological film criticism, a novel constructive form of theologizing I call “theocinematics,” I propose that Silence is both a cinematic theology about vocation in its meditation on a fervent young priest’s discernment of the voice of Christ and Scorsese’s modus operandi par excellence— Silence is film as theology and filmmaking as vocation. In my analysis, I draw from philosopher Paul Ricoeur’s hermeneutics and his concept of “the summoned self” to provide a framework for an intersubjective divinely given vocation. I also attend to film theorist Michel Chion’s notion of the acousmêtre and its use in Silence to depict the summoning voice of Christ.
Pre-existing Inequality II: Social Workers Assess Impact of COVID-19 on Medicare Home Health Beneficiaries
Authors: Cabin William
Published: June 2021

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicated there were no studies on the impact of COVID-19 on Medicare home health beneficiaries. In a previous issue of this journal, the author addressed the literature gap by presenting a study on home care nurses’ perceptions of the impact of COVID-19 on Medicare home health beneficiaries. The current study is a companion qualitative study to the nurses’ study. It is based on interviews of a convenience sample of 52 home care social workers from 11 different home health agencies in New York City between April 1 and September 30, 2020. Seven major themes emerged, 6 of which were identical to the themes identified by the nurses. The only new theme was limits on the ability to provide psychosocial interventions had more severe consequences. The 7 themes were: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; there was limited staff and equipment to care for patients; and limits on the ability to provide psychosocial interventions had more severe consequences.
A Survey of Faculty Advisers at Student-Run Agencies: Can Organizational Theory Help to Guide Future Research?
Authors: Borgognoni Brooke , LeBlanc Wicks Jan
Published: June 2021

This survey of faculty advisers examined major variables and findings of past research on student-run agencies using organizational theory. Larger agencies appeared to offer training in more formalized business procedures among a more diverse client base, found in previous research to be helpful to student-run agency graduates now on the job. Hopefully, results will help future researchers identify which factors may best facilitate specific student performance outcomes at agencies of all types and sizes.
Evaluating the Clinical Utility of Routine Sentinel Lymph Node Biopsy and the Value of Adjuvant Chemotherapy in Elderly Patients Diagnosed With Oestrogen Receptor Positive, Clinically Node Negative Breast Cancer
Authors: Davey Matthew G , Ryan Éanna J , Burke Daniel , McKevitt Kevin , McAnena Peter F , Kerin Michael J , Lowery Aoife J
Published: June 2021

Background:

Sentinel lymph node biopsy (SLNB) provides staging information and guides adjuvant therapy in early breast cancer (EBC). Routine SLNB in oncogeriatricians with low-risk EBC remains controversial.

Aims:

To evaluate axillary management in elderly patients diagnosed with oestrogen receptor positive (ER+), clinically lymph node negative (cLN−) EBC, and to assess whether SLNB affects further axillary management or adjuvant chemotherapy (ACTX) decision making.

Methods:

Female patients aged > 65 years, diagnosed with ER+, human epidermal growth factor receptor-2 negative (HER2−), and cLN− breast cancer (BC), who underwent surgery and SLNB were included. Clinicopathological predictors of ACTX and completion axillary lymph node dissection (CALND) were determined. Kaplan-Meier analyses assessed survival outcomes.

Results:

A total of 253 patients were included (median age: 72 years, range: 66-90), all underwent SLNB; 50 (19.8%) had lymphatic metastasis on SLNB (SLNB+). Of these, 19 proceeded to CALND (38.0%), 10 (52.6%) of whom had further axillary disease (ALND+). 20 of the 50 SLNB+ patients received ACTX (40.0%) as did 31 of the 203 SLNB− patients (15.2%) ( P < .001). Oncotype DX (ODX) testing was utilized in 82 cases (32.8%). Younger age ( P < .001), SLNB+ ( P < .001) and ODX score ( P = .003) were all associated with ACTX prescription. ODX > 25 (OR: 4.37, 95% CI: 1.38-13.80, P = .012) independently predicted receiving ACTX. Receiving ACTX and proceeding to CALND did not improve disease-free ( P = .485 and P = .345) or overall survival ( P = .981 and P = .646).

Conclusions:

Routine SNLB may not be necessary in elderly patients diagnosed with ER+, cLN− EBC. Future oncogeriatric practice is likely to see genomic testing guiding ACTX prescription in this group.
Evaluation of process parameters for poly(ether ether ketone) to poly(ether ether ketone) friction welded joint
Authors: Senkathir Sangli , Pramanik Sumit , Mukherjee Manidipto
Published: June 2021

Poly(ether ether ketone) is a semicrystalline organic polymer. It has widely been used as high-performance engineering plastic owing to its high melting point (343 °C), excellent mechanical strength, and outstanding chemical resistance. Therefore, poly(ether ether ketone) and its composites have shown lots of applications in aerospace and medical fields. However, its application is restricted due to poor strength at the mechanically joint components. Thus, this scope leads us to study an alternative method of the joint process that will lead to finding a new joining process for poly(ether ether ketone)-based materials. In this study, a solid-state joining process was conducted to join two poly(ether ether ketone) rods by a friction welding process. Here, we statistically optimized the values of forge load, friction load, and friction welding time as 100 N, 450 N, and 8 s, respectively, which have more influence on tensile stress and hardness of the material after the friction welding process. It has been found that the forge load had the highest influence and the forge time had the least influence on tensile strength. Their optimal values were calculated after considering the trend in hardness values by statistical analysis using Minitab software. However, after the optimal values, the above parameter showed a negative effect on the high tensile stress due to the change in crystallinity of the friction welding processed poly(ether ether ketone) as confirmed by X-ray diffraction and thermal analyses.
Sex Work in Slovenia: Assessing the Needs of Sex Workers
Authors: Markelj Leja , Selan Alisa , Dolinar Tjaša , Sande Matej
Published: June 2021

The research comprehensively identifies the needs and problems of sex workers in Slovenia from the point of view of three groups of actors in a decriminalized setting. The objective of the rapid needs assessment was to identify the needs of sex workers as perceived by themselves. In order to gain a deeper insight into this topic, we analyzed the functioning of the organizations working with the population, and examined the perspective of the clients. The results of the study show that no aid programmes have been developed for sex workers, even though organizations from various fields often come in contact with this population. Sex workers express the need to be informed about various topics (health, the law, legal advice) and emphasize client relations as the primary issue. The findings indicate the need for the development of a specialized aid programmes to address the fields of advocacy, reducing social distress and providing psychosocial assistance.
Digitised caring intimacies: More-than-human intergenerational care in Japan
Authors: Hjorth Larissa , Lupton Deborah
Published: June 2021

Popular media and policy discussions of digital health for supporting older people in the ‘super-aged’ context of Japan often focus on novel technologies in development, such as service robots, AI devices or automated vehicles. Very little research exists on how Japanese people are engaging with these technologies for self-care or the care of others. In this article, we draw on our ethnographic research with Japanese families engaging in digitised self-care and intergenerational care to show how more mundane and well-established digital media and devices – such as the LINE message app, digital games and self-tracking apps – are contributing to digital kinship, mediated co-presences and care relations. We argue that these practices involve enactments of care that are benevolent and intimate forms of datafication and dataveillance that have emerged in response to the recent disruption of traditional face-to-face forms of health care and family relationships in Japan.
Impact of a manager-oriented intervention on occupational exposures and well-being among pregnant hospital and day-care employees: A cluster randomised trial
Authors: Begtrup Luise Mølenberg , Brauer Charlotte , Jensen Johan Høy , Søgaard Tøttenborg Sandra , Flachs Esben Meulengracht , Hammer Paula Edeusa Cristina , Malmros Per Åkesson , Bonde Jens Peter Ellekilde
Published: June 2021

Background:

Pregnancy can make it difficult to cope with demands at work and may affect women’s well-being. We investigated if a manager-targeted educational intervention reduced demanding occupational exposures and improved the psychosocial work environment and well-being among pregnant employees.

Methods:

Data came from a cluster randomised trial in Danish hospitals and day-care institutions. Work units were assigned randomly and were non-blinded to the intervention, where managers were either invited to participate in a three-hour seminar addressing job adjustment in pregnancy or assigned to a control group undertaking their usual practice. Self-reported outcomes by pregnant employees at the work units were the proportion of pregnant employees with demanding occupational exposures, good psychosocial work environment and good well-being. Mixed logistic regression was applied in the population of responders and in intention-to-treat analyses using multiple imputations.

Results:

We included 915 pregnant employees: 451 in the intervention group and 464 in the control group. Of 216 invited managers, 103 (48%) participated in the seminar. A total of 339 (37%) pregnant employees answered the questionnaire. The proportion of pregnant employees who had demanding occupational exposures, good psychosocial work environment and good well-being in the intervention versus the control group were 36% versus 39% (odds ratio (OR)=0.90, 95% confidence interval (CI) 0.57–1.44), 56% versus 59% (OR=1.01, 95% CI 0.60–1.71) and 77% versus 73% (OR=1.13, 95% CI 0.68–1.87), respectively.

Conclusions:

This manager-targeted educational intervention did not reduce demanding occupational exposures and did not improve the psychosocial work environment or the well-being among pregnant employees in hospital and day-care settings. Comprehensive and participatory interventions may be considered in future studies.
Data from national health registers as endpoints for the Tromsø Study: Correctness and completeness of stroke diagnoses
Authors: Varmdal Torunn , Løchen Maja-Lisa , Wilsgaard Tom , Njølstad Inger , Nyrnes Audhild , Grimsgaard Sameline , Mathiesen Ellisiv B.
Published: June 2021

Aim:

To assess whether stroke diagnoses in national health registers are sufficiently correct and complete to replace manual collection of endpoint data for the Tromsø Study, a population-based epidemiological study.

Method:

Using the Tromsø Study Cardiovascular Disease Register for 2013–2014 as the gold standard, we calculated correctness (defined as positive predictive value, PPV) and completeness (defined as sensitivity) of stroke cases in four different data subsets derived from the Norwegian Patient Register and the Norwegian Stroke Register. We calculated the sensitivity and PPV with 95% confidence intervals (CIs) assuming a normal approximation of the binomial distribution.

Results:

In the Norwegian Stroke Register we found a sensitivity of 79.8% (95% CI 74.2–85.4) and a PPV of 97.5% (95% CI 95.1–99.9). In the Norwegian Patient Register the sensitivity was 86.4% (95% CI 81.6–91.1) and the PPV was 84.2% (95% CI 79.2–89.2). The overall highest levels were found in a subset based on a linkage between the Norwegian Stroke Register and the Norwegian Patient Register, with a sensitivity of 88.9% (95% CI 84.5–93.3), and a PPV of 89.3% (95% CI 85.0–93.6).

Conclusions:

Data from the Norwegian Patient Register and from the linked data set between the Norwegian Patient Register and the Norwegian Stroke Register had acceptable levels of correctness and completeness to be considered as endpoint sources for the Tromsø Study Cardiovascular Disease Register. The benefits of using data from national registers as endpoints in epidemiological studies must be weighed against the impact of potentially decreased data quality.
Study on dynamic characteristics of leaf spring system in vibration screen
Authors: Zhou Jiacheng , Hu Chao , Wang Ziqiu , Ren Zhengfa , Wang Xiaoyu , Mao Kuanmin
Published: June 2021

By studying dynamic characteristics of the leaf spring system, a new elastic component is designed to reduce the working load and to a certain extent to ensure the linearity as well as increase the amplitude in the vertical and horizontal directions in vibration screen. The modal parameters, amplitudes, and amplification factors of the leaf spring system are studied by simulation and experiment. The modal results show that the leaf spring system vibrates in horizontal and vertical directions in first and second mode shapes, respectively. It is conducive to loosening and moving the particles on the vibration screen. In addition, it is found that the maximum amplitude and amplification factor in the horizontal direction appear at 300 r/min (5 Hz) while those in the vertical direction appear at 480 r/min (8 Hz), which are higher than those in the disc spring system. Moreover, the amplitude of the leaf spring system increases proportionally with the increase of exciting force while the amplification factors are basically the same under different exciting forces, indicating the good linearity of the leaf spring system. Furthermore, the minimum exciting force occurs in the leaf spring system under the same amplitude by comparing the exciting force among different elastic components. The above works can provide guidance for the industrial production in vibration screen.
Ethnic trauma in migration: FSU-born Israeli women’s narratives in an online support group
Authors: Prashizky Anna , Remennick Larissa
Published: June 2021

This article lays ground for the concept of ethnic trauma for understanding the crisis of migration and its aftermath. The analysis is based on autobiographical stories recently published by the online community of the women who immigrated to Israel from the USSR/FSU as children or adolescents (Generation 1.5) in the early 1990s. Despite its self-selected nature, this story-telling project captures many generic features of the Russian-Israeli (and other) immigrant experiences. These stories form a collective narrative featuring trauma, coping and eventual victory – a discursive plot quite typical for contemporary Israeli therapeutic culture. In the age of identity politics, ethnic trauma becomes a political tool deployed in the struggle for recognition by different immigrant and minority groups. The discourse of trauma, resilience and overcoming/catharsis incorporates immigrants in the local discourse, letting them negotiate their identity and claim full belonging. Thus, ethnic trauma emerges as a political resource to support immigrants’ claims of equal rights and demands for symbolic reparations.
Modulation signal bispectrum with optimized wavelet packet denoising for rolling bearing fault diagnosis
Authors: Guo Junchao , Shi Zhanqun , Zhen Dong , Meng Zhaozong , Gu Fengshou , Ball Andrew D
Published: June 2021

Transient impulses caused by local faults are critical informative indicators for rolling element bearing fault diagnosis. The methods for accurately extracting transient impulses while suppressing strong background noise and interference components have received extensive studies. In this article, a novel fault diagnosis scheme based on optimized wavelet packet denoising and modulation signal bispectrum is proposed, which takes advantage of the transient impulse enhancement of wavelet packet denoising and the demodulation ability of modulation signal bispectrum to diagnose bearing faults more accurately. First, the measured signals are decomposed into a series of time–frequency subspaces using wavelet packet transform. An optimal threshold value is selected based on the proposed threshold criterion by considering unbiased autocorrelation of envelope and Gini index of the transient impulses. Subsequently, the subspaces are denoised by the wavelet packet denoising with the optimized threshold value, and the master subspaces that containing the fault-related transient impulses are selected based on the Gini index indicator. Finally, the modulation signal bispectrum is utilized to further purify the signal and extract the modulation components contained in the transient impulses, and the suboptimal modulation signal bispectrum slices are selected based on the characteristic frequency intensity coefficient. The modulation signal bispectrum detector is then obtained by averaging the suboptimal modulation signal bispectrum slices to determine the type of the bearing faults. The proposed wavelet packet denoising-modulation signal bispectrum is validated based on the simulation and experimental studies. Compared with the variational mode decomposition and Teager energy operator, fast kurtogram as well as conventional modulation signal bispectrum, the proposed wavelet packet denoising-modulation signal bispectrum method has superior performance in extracting the fault feature of the incipient defects on different bearing components.
Reflecting on 50 years: The University Without Walls and integrative interdisciplinary learning
Authors: Dallmann Abigail Armstrong
Published: June 2021

The University Without Walls experiment on the University of Massachusetts, Amherst campus, began in 1971. The central animating concepts of the original experiment include the value of knowledge that is learned both within and without ‘the walls’ of the university. These various knowledge sources are integrated into the student’s individualized plan of study within an interdisciplinary analytic framework. This approach is described here as integrative interdisciplinary studies and its on-going strength as an approach to adult learning is in the synergy of these approaches. An integrative interdisciplinary approach supports transformative learning within a context-specific understanding of knowledge.
Metrics on Restaurant Ordering Behavior
Authors: Schamel Guenter , Santos-Arteaga Francisco Javier
Published: June 2021

The academic literature analyzing the behavior and interactions among commensals at a table generally resorts to experimental settings with volunteer decision makers or focuses on receipts issued at actual restaurants. The experimental approach widens the potential scope of the phenomena that can be analyzed but is subject to observer effects, with decision makers being aware of the fact that their actions are being monitored. The approach using receipts is not subject to observer effects but limited in its scope by lacking interactions with the commensals and the data that can be collected. In the current article, we make extensive use of a data set collected by restaurant personnel following specific instructions. They gathered information on a number of decisions made at the table throughout the whole meal without the commensals being aware that they are being monitored. As a result, we are able to examine empirically the importance that the choices of the first-person ordering (the leader) may have for the decisions made by the other commensals at the table. In particular, we study the similarity of orders—in terms of dishes, drinks, and prices—between the table leader and the other commensals. Our results reveal that table leaders, both male and female, have a considerable influence on the choices made by other commensals under a variety of different scenarios. We also describe the differences arising when males and females act as table leaders, as well as the influence that specific payment arrangements have on the ordering behavior of the commensals.
Contralateral catheterization of the ophthalmic artery to deliver intra-arterial chemotherapy in retinoblastoma
Authors: Saal-Zapata Giancarlo , Rodríguez Rodolfo , Rodriguez-Calienes Aaron , Cordero Raúl
Published: June 2021

Retinoblastoma is the most frequent ocular malignancy in the pediatric population and intra-arterial chemotherapy has emerged as the first-line treatment of this entity with cure rates ranging from 33–100%, depending on the severity of the disease. We present the case of an advanced retinoblastoma in a pediatric patient who underwent intra-arterial chemotherapy through a contralateral route due to unsuccessful catheterization of the ophthalmic artery. The patient was diagnosed with a class D retinoblastoma which underwent the catheterization of the ophthalmic artery through the contralateral internal carotid and through the anterior communicating artery. In this case, intra-arterial chemotherapy administration was successfully delivered without complications. Contralateral routes for intra-arterial chemotherapy are safe and allow adequate penetration of the chemotherapeutic drugs in cases where a well-developed anterior communicating artery is present.
Complementary and alternative medicine use among older adults with musculoskeletal pain: findings from the European Social Survey (2014) special module on the social determinants of health
Authors: Morrissey Ann-Marie , O’Neill Aoife , O’Sullivan Kieran , Robinson Katie
Published: June 2021

Background:

This study describes the use of complementary and alternative medicine (CAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report CAM use is also examined.

Methods:

Cross-sectional European Social Survey Round 7 data from 21 countries were examined for participants aged 55 years and older, who reported musculoskeletal pain that hampered daily activities in the past 12 months.

Results:

Of the 4950 older adult participants reporting musculoskeletal pain that hampered daily activities, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one CAM treatment in the previous year. Manual body-based therapies (MBBTs) were most used, including massage therapy (17.9%) and osteopathy (7.0%). Alternative medicinal systems (AMSs) were also popular with 6.5% using homoeopathy and 5.3% reporting herbal treatments. A general trend of higher CAM use in younger participants was noted. CAM use was associated with physiotherapy use, female gender, higher levels of education, being in employment and living in West Europe. Those reporting multiple health problems were more likely to use all CAM treatments, except MBBT.

Conclusion:

A third of older Europeans with musculoskeletal pain report CAM use in the previous 12 months. Certain subgroups with higher rates of CAM use could be identified. Clinicians should comprehensively and routinely assess CAM use among older adults with musculoskeletal pain.
A rare presentation of transient hypothermia in HIV infection: A case report and systematic review of cases
Authors: Farouji Iyad , Chan Kok Hoe , Abed Hossam , DaCosta Theodore , Vefali Baris , Rushdy Abanoub , Suleiman Addi , Slim Jihad
Published: June 2021

Hypothermia defined as a core body temperature less than 35°C causes hundreds of deaths annually in the United States. It can occur in a variety of clinical settings, including environmental exposure, shock, infection, metabolic disorders, alcohol, or drug toxicity, and malnutrition. This condition can affect many different organ systems and may lead to serious complications including cardiac arrhythmia. Hypothermia is extremely rare in people living with HIV but can be seen in severely malnourished patients or those who are not receiving antiretroviral therapy (ART). It is a life-threatening situation that should be treated aggressively. To the best of our knowledge, there are only a few cases that have been reported for people living with HIV presenting with hypothermia and sinus bradycardia. Herein, we are reporting a very rare case of people living with AIDS who presented with hypothermia complicated by sinus bradycardia. In addition, we also performed a systematic review of cases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, to investigate the clinical characteristics and outcomes associated with this rare complication. This systematic review of cases hopefully can increase the awareness of this rare entity and help improve its outcome.
Fibromuscular dysplasia in a middle-aged transgender man: The role of hormones in disease pathogenesis
Authors: Wheat Heather L , Alencherry Ben P , Carman Teresa L , Shishehbor Mehdi H , Gornik Heather L
Published: June 2021

Fibromuscular dysplasia is an uncommon non-inflammatory arteriopathy. Hormonal factors are believed to play a role in disease pathogenesis given the overwhelming female predominance of this disease. We describe a case of a 56-year-old transgender man on prolonged testosterone therapy diagnosed with renal fibromuscular dysplasia after presenting with hypertensive urgency.
Clinical performance of polymer-coated paclitaxel-eluting stent implanted for diffuse and calcified superficial femoral artery stenotic lesions: Insights from a patient on hemodialysis
Authors: Yoshioka Naoki , Takagi Kensuke , Tokuda Takahiro , Morita Yasuhiro , Morishima Itsuro
Published: June 2021

In recent years, various devices have been approved for peripheral artery disease with femoropopliteal lesions. However, treatment of long, calcified, and diffused lesions is still challenging because these lesions are associated with restenosis. This report described the case of an 82-year-old man with bilateral severely calcified and diffused long lesions in the superficial femoral artery that was treated using polymer-coated paclitaxel-eluting stent and interwoven nitinol stent. After 6 months, in-stent restenosis was observed at the implantation site of the interwoven nitinol stents. Polymer-coated paclitaxel-eluting stents were deployed at the in-stent restenosis site. After another 6 months, angiography and intravascular ultrasound imaging revealed no restenosis at the polymer-coated paclitaxel-eluting stent site. Optical coherence tomography was also performed, revealing that the stent struts were well covered by neointima, which was very thin at approximately 0.1 mm. This representative case demonstrated substantial differences in the effects of devices; in other words, the superiority of polymer-coated paclitaxel-eluting stent in treating long, diffuse, and calcified lesions indicated that its implantation is a reasonable option when the initial gain was obtained following sufficient vessel preparation.
Impact of shoulder, elbow and forearm position on biceps tendon excursion: A cadaveric study
Authors: Phornphutkul Chanakarn , Sripongsai Ratthapol
Published: June 2021

Purpose:

This experimental study investigated the long head biceps tendon (LHBT) excursion that occurs at various positions of the upper limb during tendon stabilizing procedures. We hypothesized that shoulder abduction, elbow extension and forearm pronation would maximize the excursion of the LHBT and potential impacts on tendon stabilization.

Materials & Methods:

Forequarter specimens from 12 fresh frozen cadavers were used in this study. The study was performed at 0° and 30° of shoulder abduction. Elbow position was either 90° of flexion or full extension with the forearm either in full pronation or supination. A total of 14 combinations of positions were studied. A load of 55 N was applied to the distal biceps. The excursion of the proximal part of LHBT was measured for each of the different positions.

Results:

At a shoulder position of 30° of flexion, shoulder abduction of 30° created significantly greater excursion than 0° of shoulder abduction ( p < 0.001). Both full extension of the elbow and full pronation of the forearm also showed significant excursion of the tendon when compared to supination ( p < 0.001).

Conclusions:

The position of the shoulder, elbow and forearm has a significant effect on biceps excursion. Thirty degrees of shoulder abduction and 30° of forward flexion with the elbow in full extension and the forearm in full pronation maximizes excursion.

Clinical Relevance:

Information about the excursion of the LHBT affected by the position of the upper limb is useful for any biceps tendon stabilizing procedure. During an operation, the position of the upper limb should be monitored in order to maintain a proper anatomic length-tension relationship.
Business strategies and tournament incentives: Evidence from China
Authors: Sun Li , Habib Ahsan , Huang Hedy Jiaying
Published: June 2021

We investigate the association between business strategy and firm-level tournament incentives in China and find that business strategy is associated with tournament incentives positively. We further find that this positive relationship manifests itself in local, but not central, state-owned enterprises (SOEs). In addition, we also offer some evidence that foreign institutional investors play a moderating role on the positive association between business strategy and tournament incentives. Our study fills a gap in the existing tournament literature by incorporating business strategy as an important determinant of tournament incentives in China.

JEL CLASSIFICATION M10; G30; J33
Interdependencies, caring, and commoning: The case of herders in Ethiopia and Germany
Authors: Blau Jill P
Published: June 2021

This paper examines commoning and practices of care from a feminist lens, here implying a focus on interdependencies of various spheres of life as well as social categories of difference. Through examples from two case studies of herders as commoners (the Nyangatom in Ethiopia and the Rechtler_innen in Germany), I establish connections between everyday that are inseparable when it comes to sustaining life and commons, while also highlighting conceptual challenges for feminist commons analysis.
Inter-rater reliability of subthreshold psychotic symptoms in individuals with 22q11.2 deletion syndrome
Authors: Moore Tyler M. , Salzer Deby , Bearden Carrie E. , Calkins Monica E. , Kates Wendy R. , Kushan Leila , Gallagher Robert Sean , Frumer Dafna Sofrin , Weinberger Ronnie , McDonald-McGinn Donna M. , Gur Raquel E. , Gothelf Doron
Published: June 2021

Background

Pathways leading to psychosis in 22q11.2 deletion syndrome (22q11.2DS) have been the focus of intensive research during the last two decades. One of the common clinical risk factors for the evolution of psychosis in 22q11.2DS is the presence of positive and negative subthreshold psychotic symptoms. The gold standard for measuring subthreshold symptoms is the Structured Interview for Prodromal Syndromes (SIPS) and its accompanying Scale of Prodromal Symptoms (SOPS) ratings. Although the scale has been used by many centers studying 22q11.2DS, the inter-site reliability of the scale in this population has never been established.

Methods

In the present study, experienced clinical assessors from three large international centers studying 22q11.2DS independently rated video recordings of 18 adolescents and young adults with 22q11.2DS.

Results

The intraclass correlations coefficients (ICCs) among three raters for the SOPS total scores, as well as for the positive, negative, and disorganization subscale scores, were good-to-excellent (ICCs range 0.73–0.93). The raters were also able to reliably determine the subjects’ subthreshold syndrome status (ICC = 0.71). The reliability of individual items was good-to-excellent for all items, ranging from 0.61 for motor disturbances [G3] to 0.95 for bizarre thinking.

Conclusions

Our results show that trained clinicians can reliably screen for subthreshold psychotic symptoms in individuals with 22q11.2DS. To increase assessment reliability, we suggest specific clarifications and simplifications to the standard SIPS interview for future studies.
The bacterial community composition and its environmental drivers in the rivers around eutrophic Chaohu Lake, China
Authors: Shao Keqiang , Yao Xin , Wu Zhaoshi , Jiang Xingyu , Hu Yang , Tang Xiangming , Xu Qiujin , Gao Guang
Published: June 2021

Background

Bacterial community play a key role in environmental and ecological processes in river ecosystems. Rivers are used as receiving body for treated and untreated urban wastewaters that brings high loads of sewage and excrement bacteria. However, little is known about the bacterial community structure and functional files in the rivers around the eutrophic Chaohu Lake, the fifth largest freshwater lake in China, has been subjected to severe eutrophication and cyanobacterial blooms over the past few decades. Therefore, understanding the taxonomic and functional compositions of bacterial communities in the river will contribute to understanding aquatic microbial ecology. The main aims were to (1) examine the structure of bacterial communities and functional profiles in this system; (2) find the environmental factors of bacterial community variations.

Results

We studied 88 sites at rivers in the Chaohu Lake basin, and determined bacterial communities using Illumina Miseq sequencing of the 16 S rRNA gene, and predicted functional profiles using PICRUSt2. A total of 3,390,497 bacterial 16 S rRNA gene sequences were obtained, representing 17 phyla, and 424 genera; The dominant phyla present in all samples were Bacteroidetes (1.4-82.50 %), followed by Proteobacteria (12.6–97.30 %), Actinobacteria (0.1–17.20 %). Flavobacterium was the most numerous genera, and accounted for 0.12–80.34 % of assigned 16 S reads, followed by Acinetobacter (0.33–49.28 %). Other dominant bacterial genera including Massilia (0.06–25.40 %), Psychrobacter (0-36.23 %), Chryseobacterium (0.01–22.86 %), Brevundimonas (0.01–12.82 %), Pseudomonas (0-59.73 %), Duganella (0.08–23.37 %), Unidentified Micrococcaceae (0-8.49 %). The functional profiles of the bacterial populations indicated an relation with many human diseases, including infectious diseases. Overall results, using the β diversity measures, coupled with heatmap and RDA showed that there were spatial variations in the bacterial community composition at river sites, and Chemical oxygen demand (CODMn) and (NH4+ )were the dominant environmental drivers affecting the bacterial community variance.

Conclusions

The high proportion of the opportunistic pathogens (Acinetobacter, Massilia, Brevundimonas) indicated that the discharge of sewage without adequate treatment into the rivers around Chaohu Lake. We propose that these bacteria could be more effective bioindicators for long-term sewage monitoring in eutrophic lakes.
Correction to: Association between plasma lipid levels during acute coronary syndrome and long-term malignancy risk. The ABC-4* study on heart disease
Authors: Berton Giuseppe , Cordiano Rocco , Cavuto Fiorella , Bagato Francesco , Mahmoud Heba Talat , Pasquinucci Mattia
Published: June 2021

An amendment to this paper has been published and can be accessed via the original article.
Impact of acute total occlusion of the culprit artery on outcome in NSTEMI based on the results of a large national registry
Authors: Terlecki Michał , Wojciechowska Wiktoria , Dudek Dariusz , Siudak Zbigniew , Plens Krzysztof , Guzik Tomasz J. , Drożdż Tomasz , Pęksa Jan , Bartuś Stanisław , Wojakowski Wojciech , Grygier Marek , Rajzer Marek
Published: June 2021

Background

The impact of acute total occlusion (TO) of the culprit artery in non-ST-segment elevation myocardial infarction (NSTEMI) is not fully established. We aimed to evaluate the clinical and angiographic phenotype and outcome of NSTEMI patients with TO (NSTEMITO) compared to NSTEMI patients without TO (NSTEMINTO) and those with ST-segment elevation and TO (STEMITO).

Methods

Demographic, clinical and procedure-related data of patients with acute myocardial infarction who underwent percutaneous coronary intervention (PCI) between 2014 and 2017 from the Polish National Registry were analysed.

Results

We evaluated 131,729 patients: NSTEMINTO (n = 65,206), NSTEMITO (n = 16,209) and STEMITO (n = 50,314). The NSTEMITO group had intermediate results compared to the NSTEMINTO and STEMITO groups regarding mean age (68.78 ± 11.39 vs 65.98 ± 11.61 vs 64.86 ± 12.04 (years), p < 0.0001), Killip class IV on admission (1.69 vs 2.48 vs 5.03 (%), p < 0.0001), cardiac arrest before admission (2.19 vs 3.09 vs 6.02 (%), p < 0.0001) and death during PCI (0.43 vs 0.97 vs 1.76 (%), p < 0.0001)—for NSTEMINTO, NSTEMITO and STEMITO, respectively. However, we noticed that the NSTEMITO group had the longest time from pain to first medical contact (median 4.0 vs 5.0 vs 2.0 (hours), p < 0.0001) and the lowest frequency of TIMI flow grade 3 after PCI (88.61 vs 83.36 vs 95.57 (%), p < 0.0001) and that the left circumflex artery (LCx) was most often the culprit lesion (14.09 vs 35.86 vs 25.42 (%), p < 0.0001).

Conclusions

The NSTEMITO group clearly differed from the NSTEMINTO group. NSTEMITO appears to be an intermediate condition between NSTEMINTO and STEMITO, although NSTEMITO patients have the longest time delay to and the worst result of PCI, which can be explained by the location of the culprit lesion in the LCx.
Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia
Authors: Al-Qahtani Mohammad H. , Yousef Abdullah A. , Awary Bassam H. , Albuali Waleed H. , Al Ghamdi Mohammed A. , AlOmar Reem S. , AlShamlan Nouf A. , Yousef Haneen A. , Motabgani Sameerah , AlAmer Naheel A. , Alsawad Kawthar M. , Altaweel Fatimah Y. , Altaweel Kawther S. , AlQunais Roaya A. , Alsubaie Fatima A. , Al Shammari Malak A.
Published: June 2021

Background

The Emergency Room (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia.

Methods

This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome.

Results

The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38).

Conclusions

A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.
Anti-neutrophil cytoplasmic antibody-associated vasculitis accompanied by type II heparin-induced thrombocytopenia resulting in asymptomatic cerebral infarction: a case report
Authors: Furuto Yoshitaka , Kawamura Mariko , Yamashita Jumpei , Yoshikawa Takahiro , Namikawa Akio , Isshiki Rei , Takahashi Hiroko , Shibuya Yuko
Published: June 2021

Background

Heparin-induced thrombocytopenia (HIT) involves platelet activation and aggregation caused by heparin or HIT antibodies associated with poor survival outcomes. We report a case of HIT that occurred after hemodialysis was started for rapidly progressive glomerulonephritis (RPGN), which was caused by anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), and ultimately resulted in asymptomatic cerebral infarction.

Case presentation

A 76-year-old Japanese man was urgently admitted to our hospital for weight loss and acute kidney injury (serum creatinine: 12 mg/dL). Hemodialysis therapy was started using heparin for anticoagulation. Blood testing revealed elevated titers of myeloperoxidase anti-neutrophil cytoplasmic antibodies, and renal biopsy revealed crescentic glomerulonephritis with broad hyalinization of most of the glomeruli and a pauci-immune staining pattern. These findings fulfilled the diagnostic criteria for microscopic polyangiitis, and the patient was diagnosed with RPGN caused by AAV. Steroid pulse therapy, intermittent pulse intravenous cyclophosphamide, and oral steroid therapy failed to improve the patient’s renal function, and maintenance dialysis was started. However, on day 15, his platelet count had decreased to 47,000/µL, with clotting observed in the hemodialysis catheter. Magnetic resonance imaging of the head identified acute asymptomatic brain infarction in the left occipital lobe, and a positive HIT antibody test result supported a diagnosis of type II HIT. During hemodialysis, the anticoagulant treatment was changed from heparin to argatroban. Platelet counts subsequently normalized, and the patient was discharged. A negative HIT antibody test result was observed on day 622.

Conclusions

There have been several similar reports of AAV and HIT co-existence. However, this is a rare case report on cerebral infarction with AAV and HIT co-existence. Autoimmune diseases are considered risk factors for HIT, and AAV may overlap with other systemic autoimmune diseases. To confirm the relationship between these two diseases, it is necessary to accumulate more information from future cases with AAV and HIT co-existence. If acute thrombocytopenia and clotting events are observed when heparin is used as an anticoagulant, type II HIT should always be considered in any patient due to its potentially fatal thrombotic complications.
Magnitude and determinants of neural tube defect in Africa: a systematic review and meta-analysis
Authors: Atlaw Daniel , Tekalegn Yohannes , Sahiledengle Biniyam , Seyoum Kenbon , Solomon Damtew , Gezahegn Habtamu , Tariku Zerihun , Tekle Yared , Chattu Vijay Kumar
Published: June 2021

Background

Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa.

Methods

The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A random-effect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran’s Q-statistics and I2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg ’s tests, and the association between determinant factors and NTDs was estimated using a random-effect model.

Results

Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19–0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04–10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99–5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27–4.31) were found to be determinants of NTDs.

Conclusions

The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.